JP2006280445A - In-vivo leaving prevention system, and gauze - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an in-vivo leaving prevention system capable of surely preventing an article from being left inside the body of a patient, and to provide gauze. <P>SOLUTION: Tags 7 having intrinsic identification information respectively are attached to medical implements used for a surgery. Also, tag readers 61 and 62 are respectively arranged at a machine base inside an operating room and a place where used implements are to be placed, and the respective tags 7 are recognized by the tag readers 61 and 62 at any time or periodically. In the case that there is a tag 7 not recognized by any tag readers 61 and 62, it is defined that the implement to which the tag 7 is attached is in use and the list is displayed at a display part 3. Further, a small-sized tag reader 63 for searching is provided, and in the case that the implement in use is recognized before closing a wound, the inside of the body of the patient is searched by the tag reader 63 for searching. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a system for preventing surgical instruments and the like from being left in the body of a patient in the medical field, and a gauze suitably used for this system.

  In the medical field, a medical error in which gauze, forceps, etc. are left in the patient's body after surgery is regarded as a problem. Efforts have been made to prevent this type of mistake, but at present, the number of used gauze, forceps, etc. is counted, and the number of leftovers in the patient's body is confirmed by checking the number. Is just taken. This method depends only on the ability of the individual operating staff who is busy during the operation, so it cannot be said that there is no risk of miscounting.

Further, in recent years, it has become important to record a medical practice performed so that it can be verified after the fact (see, for example, Patent Document 1). The same applies to the confirmation of the presence or absence of leftovers in the body, but it is difficult to leave objective evidence as to whether or not the confirmation work has been properly performed by the above method. In the unlikely event of an accident, it is almost impossible to verify. For example, there is a method in which a metal wire is previously embedded in gauze and X-ray imaging is performed to check the remaining gauze in the body. However, this method can only confirm the result of the remaining gauze. In addition to exposing the patient to X-rays for imaging, the patient is forced to bear a heavy burden, for example, if a residual gauze is found, which is helpful in preventing medical errors. I can not say.
JP 2004-280455 A

As described above, it is the current situation that the presence or absence of leftovers in the body is relied upon manually, and there is a need to provide a system that can more reliably prevent this type of medical error.
This invention is made | formed by the said situation, The objective is to provide the body leaving prevention system and gauze which can prevent reliably that articles | goods remain in a patient's body.

  In order to achieve the above object, according to an aspect of the present invention, a plurality of wireless tags individually attached to a plurality of medical instruments and a mounting base for the medical instruments in an operating room are disposed within a certain distance. A first tag reader that detects a wireless tag, a second tag reader that is installed at a location different from the mounting table in the operating room and detects a wireless tag that is close within a certain distance, and is detected by the first tag reader. And a notification unit configured to notify an operator of an alarm when the number of wireless tags detected by the second tag reader does not match at a specific time before closing. Item 12. A system for preventing indwelling in a body according to Item 1 is provided.

  By taking such means, the surgical instrument on the mounting table is detected by the first tag reader, and its location can be confirmed. Moreover, the location of a used instrument can also be confirmed by installing a 2nd tag reader in the place where a used instrument is put. If the number of wireless tags detected by the first and second tag readers does not match, it is concluded that there is a wireless tag that is not detected at any location, that is, the surgical instrument remains in the patient. It is done. By notifying the alarm based on this, it is possible to reliably prevent the article from being left in the patient.

  ADVANTAGE OF THE INVENTION According to this invention, the body leaving prevention system which can prevent reliably that articles | goods are left in a patient's body, and a gauze can be provided.

  FIG. 1 is a system block diagram showing an embodiment of a system for preventing in-vivo according to the present invention. This system is implemented, for example, by installing dedicated software on a general-purpose workstation, and is formed with the information processing unit 1, the storage unit 2, and a plurality of tag readers 61, 62,. The information processing unit 1 is connected with a display unit 3, an input unit 4, and a warning notification unit 5 as a user interface. The storage unit 2 records information acquired by the tag readers 61, 62,.

  As shown in FIG. 2, in this embodiment, wireless tags 7 (hereinafter referred to as tags 7) are individually attached to medical instruments such as gauze 8 and forceps 9. Tags 7 are attached to all medical devices that are used during surgery and that are likely to be left in the patient. Each tag 7 has a chip memory (not shown) and stores unique identification information in this memory. When the tag 7 comes close to the tag reader within a certain distance, the identification information of the tag 7 is read in a non-contact manner and recorded in the recording unit 2.

  The amount of tag information should be sufficient to identify all the gauze and instruments used in the operation. For example, if a tag capable of holding 8-bit numerical information is used, 256 gauze / instrument etc. can be identified. The information processing section 1 monitors numerical information as identification information and the tag 7 detected by the tag reader in real time. The display unit 3 displays the identification information of each tag 7 and the corresponding instrument name. The input unit 4 receives information input by an operator, a processing trigger, and the like, and inputs them to the system. The warning notification unit 5 issues a warning by voice or the like when there is a leftover in the body before closing.

  FIG. 3 is a schematic view showing an arrangement state in the operating room of the in-vivo detention system according to the present invention. In FIG. 3, a workstation WS, an instrument table, and a used gauze container are disposed around a surgical bed on which a surgical patient is laid. Among these, the workstation WS implements the system of FIG. 1, and includes an information processing unit 1, a storage unit 2, a display unit 3, and an input unit 4 (keyboard and mouse).

  Tag readers 61 to 63 are connected to the workstation WS. The tag reader 61 is disposed on the instrument table, and the tag reader 62 is disposed in the used gauze case. That is, a tag reader is fixed to a place where gauze and instruments may be placed. The tag reader 63 is not fixed at a specific location, and is small enough to be used close to a certain extent on the back side of an organ. That is, the tag reader 63 is used to search for a leftover object in the patient. The identification information of the tag 7 read by the tag readers 61 to 63 is transferred to the workstation WS and stored in the recording unit 2.

  The gauze 8 and forceps 9 before use are arranged on the instrument table, and the tags 7 are attached to the gauze 8 and the forceps 9 one by one. All of these tags 7 are detected by a tag reader 61. Further, the used gauze 8 is discarded in the used gauze container, and the tag 7 of the discarded gauze 8 is detected by the tag reader 62. On the other hand, the gauze 8 and the forceps 9 in use on the surgical bed are out of the detection area of the tag readers 61 and 62 and are not recognized.

  The tag reader recognizes only tags 7 that are close to each other within a certain distance, and cannot recognize tags 7 that are separated. Therefore, as shown in Fig. 3, by installing a tag reader in a place where medical instruments such as instrument tables and used gauze holders are put together, it is possible to keep track of unused instruments at the workstation WS. become. On the other hand, it can be seen that the appliances taken out from the placement place are in use because the attached tag 7 cannot be recognized by the tag reader. Next, the effect | action in the said structure is demonstrated in detail over several embodiment.

[First Embodiment]
First, before starting the operation, the surgical staff arranges the instruments such as the gauze 8 and the forceps 9 on the instrument table. If an activation trigger such as a mouse click operation or a keyboard Enter key press (both input unit 4) is given to the system before the opening, the tag readers 61 and 62 start reading processing of the adjacent tag 7. Thereafter, the tag readers 61 and 62 periodically acquire the identification information of the tag 7.

The tag reader 61 reads the identification information of the tag 7 attached to the instruments on the instrument table. Thereby, identification information such as gauze / instruments scheduled to be used in the operation is read and recorded in the recording unit 2 of the workstation WS. If the identification information of the tag 7 attached to each instrument is known in advance, the database shown in Table 1 is recorded in the recording unit 2.

  By using the database of Table 1, each instrument is managed separately. The contents of this database are displayed on the display unit 3, and the surgical staff can visually confirm the instruments used. If the identification information cannot be read for some reason, such as damage to the tag 7, it can be determined that the tag 7 is not used for surgery at this time. In the case of an instrument that must be used, the operator registers it directly in the database via a keyboard, mouse, or the like.

Similarly, the tag reader 62 also reads the identification information, but the gauze 8 is not used before the opening and nothing is contained in the used gauze case. Therefore, at this time, the identification information is not acquired in the tag reader 62. Table 2 shows the contents of the database of the recording unit 2 at this time.

When surgery is started, the necessary gauze and instruments are taken out of the instrument table. The gauze / instruments taken out are separated from the tag reader 61. If the gauze / instruments are separated from the tag reader 61 by a certain distance, communication with the tag reader 61 is interrupted. Thereafter, the used gauze 8 is discarded in the used gauze container and immediately recognized by the tag reader 62. The used forceps 9 are sequentially returned to the instrument table and recognized again by the tag reader 61. Thus, recognizable instruments are managed as (before use or after use), and unrecognized instruments are managed as (in use). As shown in FIG. 3, for example, when two forceps 9 and two gauze 8 are in use, identification information recorded in the recording unit 2 is as shown in Table 3.

That is, the tag reader 61 recognizes 10 gauze and two forceps, and the tag reader 62 recognizes one gauze. The gauze with the numbers 002 and 009 and the forceps with the numbers 020 and 023 are not recognized by any tag reader, so that it can be seen that they are in use. The gauze, instruments, etc. that are not recognized in this way are listed as shown in Table 4 as instruments currently in use.

  The listed appliances in use are displayed on the display unit 3. Thereby, the medical staff can grasp | ascertain the instrument in use easily.

The surgical staff reconfirms the contents of the display unit 3 after the procedure is completed and before closing. If an instrument in use is displayed at this time, the instrument may remain in the patient. Thus, the search reader 63 is used to search the patient body. If there is a tag 7 recognized by the search reader 63, the contents shown in Table 5 are displayed on the display unit 3, and a special sound is generated by the warning notification unit 5 to call attention.

  Note that Tables 3 and 4 are not updated depending on the identification information recognized by the tag reader 63. Tables 3 and 4 are updated only based on the recognition information by the tag readers 61 and 62.

  Thus, in this embodiment, the tag 7 which has identification information specific to each medical instrument used for surgery is attached. In addition, tag readers 61 and 62 are respectively arranged at an instrument table in the operating room and a place where used instruments are placed, and each tag 7 is periodically recognized by the tag readers 61 and 62. If there is a tag 7 that is not recognized by any of the tag readers 61 and 62, it is determined that the device to which the tag 7 is attached is in use, a list thereof is displayed on the display unit 3, and a warning is issued. Further, a small tag reader 63 for searching is provided, and when a device in use is recognized before closing, the searching body of the patient is searched by the searching tag reader 63.

  Since it did in this way, the medical staff can grasp | ascertain the instrument in use at a glance, and can confirm the presence or absence of in-vivo residuals, such as a surgical instrument, without requiring complicated troubles, such as confirmation of a number. Furthermore, since the names of surgical instruments and the like that may be left in the body are displayed, a targeted search is possible. For these reasons, it is possible to reliably prevent the article from being left in the patient.

[Second Embodiment]
Next, a second embodiment of the present invention will be described. In this embodiment, when the tag 7 is recognized by the tag readers 61 to 63, the identification information and the time when the identification information is acquired are associated with each other and recorded in the recording unit 2. For example, when recognition processing by the tag readers 61 and 62 is performed at intervals of 5 seconds, time data as shown in Table 6 is recorded in time series for the gauze 001 placed on the instrument table.

According to Table 6, gauze 001 was recognized until (10:33:49), but was not recognized at (10:33:54) after 5 seconds, so it was taken out of the instrument table. I understand. It records similarly about another instrument, and accumulate | stores in the recording part 2 as log data. If there is a possibility that the accumulation of the log data may press the capacity of the recording unit 2, as shown in Table 7, only the time when the change occurs is recorded for each instrument.

  By accumulating such log data, it becomes easy to analyze the surgical pattern after the fact. In particular, a more powerful analysis system can be constructed by recording the time information of the tag reader together with data such as video and audio during surgery in combination with the medical information system taken up as Patent Document 1. In such an application, the time when the gauze 8 was taken out can be found by the data reproducing software, and the time information can be used to efficiently find a scene to be noticed in a long-time operation record. For example, in Tables 6 and 7, it can be specified that gauze 001 was taken out and used at 10:33:54. Furthermore, if other gauze is taken out at the same time, it is suggested that a large amount of bleeding has occurred, and this is an opportunity to confirm the video and audio at that time.

  As described above, by recording the identification information and the use start time in association with each medical device, the generated log data can be used as a cue when analyzing “surgery record” composed of intraoperative video, audio, and the like. Can be used, and the analysis can be made more efficient. As a result, it is possible to more easily create evidence that proves that the number management of medical devices has been properly performed, and it is possible to construct a system that can greatly contribute to the needs of medical sites in recent years.

[Third Embodiment]
In this embodiment, a simple form of the in-vivo detention system according to the present invention will be described. In the first and second embodiments, the tag 7 having identification information is used. Instead, in this embodiment, the tag 7 having no identification information is used, and only the number of read tags is managed. First, the number of all tags is counted before the opening, and the number is recorded in the recording unit 2. Next, the number of tags 7 read again by the tag reader before closing is counted. Then, the two count values are compared, and if these count values are different, it can be seen that some device is left in the patient. The object of the present invention can also be achieved by such a simple system.

[Fourth Embodiment]
Next, a fourth embodiment of the present invention will be described with reference to FIGS. In this embodiment, a gauze that can be suitably used in the in-vivo residue prevention system according to the present invention will be described. Gauze is often cut from a large gauze dough. Therefore, in order to embed the tag 7 in the gauze, the tag 7 is arranged so that each cut gauze also includes one or more tags 7. In particular, in this embodiment, as shown in FIG. 4, some mark is given so that the place where the tag 7 is embedded can be seen at a glance.

  As a mark, a heat-resistant paint with a conspicuous color is applied in the form of dots, or a thread serving as a mark is woven. If a paint is used, a paint that can withstand sterilization is preferable. In this way, it is easy to include the tag 7 in the cut gauze when cutting the gauze dough with scissors. Further, as shown in FIG. 5, perforations M may be inserted, and the tags 7 may be included one by one in the portion surrounded by the perforations M. According to this embodiment, it is possible to realize a gauze that can be suitably used in the in-vivo detention system according to the present invention.

  The present invention is not limited to the above embodiment. For example, in the above-described embodiment, identification information of appliances that are not in use (that is, unused or after use) is always grasped, and appliances that cannot recognize the identification information are regarded as being used. Instead of this, a tag reader may be installed on, for example, a surgical bed in order to more actively recognize the gauze and instruments being used. Due to the characteristics of the existing tag 7, when the water component is close, it is difficult to read unless the tag reader is too close, and gauze and instruments are used in the patient's body, especially behind the organ. May not recognize the tag 7 attached to them, but such a system is also conceivable due to future improvements in characteristics.

  For example, in addition to the database shown in Table 1, information input from a keyboard, a mouse, or the like may be recorded in the recording unit 2. That is, before reading the identification information, the name of each instrument is specifically designated by an operator's manual operation, and thereafter the identification information of each tag 7 is read by the system. In this way, gauze, instruments, etc. can be individually distinguished and managed on the workstation WS. To specify the name of the instrument, a word such as gauze or forceps is directly input to the workstation WS from the keyboard, or the instrument type is specified from a menu list prepared in advance on the workstation WS.

  In addition, the position of the tag reader is not limited to the instrument table and the used gauze holder, and if there are used gauze holders at a plurality of places or places where used instruments are placed, the tag readers are also arranged at such places as appropriate. As described above, the location and number of tag readers may be different for each operating room. In addition, a reader in the form of a gate reader may be provided near the operating room entrance. In this case, the identification information of all instruments is read when brought into the operating room. Even if there are gauze / instruments brought in during the operation, the identification information can be read without overlooking. Thus, various arrangements and numbers of tag readers can be considered. Specifically, [medical instrument mounting table + other (used instrument storage etc.)], [operating room entrance + other (used instrument storage etc.)], [operating room entrance + medical instrument mounting + other ( Combination of used equipment storage))] is conceivable.

  Further, in the first to third embodiments, the tag 7 is periodically recognized by the tag readers 61 and 62. Instead of this, the tag readers 61 and 62 may recognize the tag 7 as needed. For example, a tag reading request may be given to the system via the input unit 4 only before the opening and before the closing. Upon receiving this request, the workstation WS updates the list of the gauze / instrument in use based on the identification information in the tag reader at that time, and displays it on the display unit 3. Thus, the content of the display unit 3 does not necessarily need to be updated in real time.

  Moreover, in the said 1st-3rd embodiment, when there exist the instrument in use before closing, an alarm was alert | reported. Instead of this, it is also possible to display only a device that may be left in the body on the display unit 3. That is, the object of the present invention can be achieved only by the display by the display unit 3 without providing the warning notification unit 5.

  Furthermore, the form which does not display on the display part 3, or the system which does not have the display part 3 in the first place can be considered. Even in such a system, the identification information read by the tag readers 61 and 62 is collated and compared by background processing, so that it is possible to recognize instruments in use inside the system. Such processing is performed as needed, and the surgical staff gives an information update request to the system via the input unit 4 before closing, so that the presence or absence of the gauze / instrument in use can be confirmed. In a system that does not include the display unit 3, the operation staff can be warned of the presence of an instrument in use by a warning such as a voice from the warning notification unit 5.

  In the embodiment of the present invention, the tag format may be passive or active. The passive tag itself does not have a power source, and transmits identification information triggered by an electromagnetic wave transmitted from the tag reader. An active tag has a power source and autonomously transmits information to the tag reader. Either type of tag can be used in the present invention. When the tag information is read, the content information in Table 3 and Table 4 is updated, and the display content on the display unit 3 is also updated accordingly. Furthermore, the present invention is not limited to a wireless tag, and can be realized by using a means that can identify a surgical instrument in a non-contact manner.

  Furthermore, the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

1 is a system block diagram showing an embodiment of an in-vivo detention system according to the present invention. The schematic diagram which shows the attachment state of the radio | wireless tag 7 in embodiment of this invention. The schematic diagram which shows the arrangement | positioning state in the operating room of the in-body residual prevention system concerning this invention. The figure which shows an example of the gauze concerning embodiment of this invention. The figure which shows the other example of the gauze concerning embodiment of this invention.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Information processing part, 2 ... Memory | storage part, 3 ... Display part, 4 ... Input part, 5 ... Warning alert | reporting part, 61, 62 ... Tag reader, 63 ... Search tag reader, 7 ... Wireless tag, 8 gauze, 9 ... Forceps , WS ... workstation, M ... perforation

Claims (11)

Non-contact identification means for individually identifying a plurality of medical devices;
Management means for managing the medical device identified by the non-contact identification means;
A system for preventing indwelling in the body, comprising a notification means for notifying an operator of an alarm when the number of medical devices managed by the management means does not match before and after the wound is opened. A plurality of wireless tags individually attached to a plurality of medical devices;
A tag reader that detects a wireless tag that is close within a certain distance;
And a display unit for displaying a list of medical instruments corresponding to the wireless tag detected by the tag reader. A plurality of wireless tags individually attached to a plurality of medical devices;
A tag reader that detects a wireless tag that is close within a certain distance;
An in-body detention prevention system comprising a notifying means for notifying an operator of an alarm when the number of wireless tags detected by the tag reader does not match before opening and closing. A plurality of wireless tags individually attached to a plurality of medical devices;
A first tag reader for detecting a wireless tag that is close within a certain distance;
A second tag reader that is installed at a location different from the first tag reader and detects a wireless tag that is close within a certain distance;
Informing means for notifying an operator of an alarm when the number of wireless tags detected by the first tag reader and the number of wireless tags detected by the second tag reader do not match at a specific time before closing. A system for preventing indwelling in the body. Each of the plurality of wireless tags has unique identification information;
The first and second tag readers obtain identification information of the detected wireless tags,
Furthermore, it comprises a database that associates the identification information of the plurality of wireless tags and their attachment destination device names,
The informing means identifies an appliance name corresponding to identification information of a wireless tag that is not detected by any of the first and second tag readers with reference to the database, and notifies the operator of the appliance name. The body detention system according to claim 4. Furthermore, based on the database, individual instrument names corresponding to the identification information group acquired by the first tag reader and individual instrument names corresponding to the identification information group acquired by the second tag reader are obtained. The system for preventing leftover in a body according to claim 5, further comprising display means for displaying. The system according to claim 5, further comprising recording means for recording the identification information acquired by the first and second tag readers and the acquisition time in association with each other. The system according to claim 4, further comprising a search tag reader that detects a wireless tag that can be used in the vicinity of a surgical field of a patient during surgery and that is close within a certain distance. . The system according to claim 4, wherein the first tag reader is installed on a mounting table for the medical instrument in an operating room. It is a gauze used by cutting from gauze fabric,
A gauze characterized in that a plurality of identifiable wireless tags are embedded in the gauze fabric, and a mark is attached to the embedded portion. A gauze used by cutting along the perforations provided in the gauze fabric,
A gauze characterized in that an identifiable wireless tag is embedded in a portion surrounded by the perforation of the gauze fabric.

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