JP3660887B2 - Surgery support device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a surgery support apparatus, and is particularly suitable for a surgery support apparatus provided with a recording means.
[0002]
[Prior art]
Conventionally, in order to know what kind of operation has been performed after the operation, recording images of an endoscope and a surgical microscope, memories of a medical staff such as a surgeon, and the like are relied upon.
[0003]
Furthermore, not only an endoscopic image but also an image filing device that records the age and sex of a patient, the start time and the end time of performing an endoscopic examination, and the like has been used.
[0004]
In Japanese Patent Application Laid-Open No. 2000-33072, an endoscope image is obtained in which information that an image filing device has can be obtained by an endoscope device, and information that is generated by the endoscope device can be obtained by an image filing device. A filing system is disclosed.
[0005]
On the other hand, various developments have been made on devices that allow remote control by interposing computer control between an observation instrument such as a surgical instrument or an endoscope and a surgeon who operates the surgical instrument, and many patents have been published. . For example, in Japanese Patent Application Laid-Open No. 61-76126, a target value given by an operation plate provided in an operation unit is made to coincide with a detection value of a potentiometer that detects a rotational position of a motor that winds a wire that bends the bending unit. Discloses an endoscope angle operation device for controlling the motor by an arithmetic processing unit.
[0006]
[Problems to be solved by the invention]
With conventional technology, in the case of surgical recording using a camera image such as an endoscope, only a part of the image is shown in the image, and it is not possible to grasp a part that cannot be confirmed on the screen, such as out of the field of view of the image. Not considered. Therefore, it is difficult to grasp the movement of the surgical tool in contact with the tissue or pressing the organ outside the field of view, and how the surgeon handles the surgical tool. It is also difficult to confirm whether it is. For areas that cannot be confirmed on the screen, it is necessary to rely on imagination to understand the situation, analyze the behavior of surgical instruments, or explain to third parties.
[0007]
In addition, the conventional technology does not consider the clarification of the causal relationship regarding the symptoms that occur in the human body due to the therapeutic action. In other words, as a result of who operated and how the surgical tool was operated as recorded images, or as a result of the operation of the surgical tool, what kind of treatment was performed on the organ. It is difficult to know if it has happened after surgery.
[0008]
In addition to the surgeon, when a plurality of assistants support treatment, it is difficult to know who is operating which surgical tool from the image alone. It is difficult to read from the recorded video of an endoscope or a microscope from which point the surgeon or assistant changed during the process, for example.
[0009]
In the case of using a device that remotely controls a medical instrument by using a control means, the conventional technology does not consider that a surgeon, a patient, or the like leaves a record for grasping a treatment status by remote operation after the operation. For this reason, it is difficult to grasp the state of operation of the device, the operation status of the device, the status of operation, and the like after the operation.
[0010]
It is not considered to clarify the causal relationship between the operation performed by the operator and the action actually generated. Therefore, it is difficult to clearly identify whether the action that has actually occurred is the result of following the operator's instruction accurately or the result of the action that is different from the operation instruction. Alternatively, it is difficult to clearly grasp how much the difference between the operator's instruction and the movement of the surgical tool that actually operates is.
[0011]
When using a device that remotely controls a medical instrument using a control means, it is necessary to fully consider how the device should be operated, including how to operate the device for cases. It is hard to say that a person is fully considered for trial and error during treatment, and that the treatment time is extended or the operation is not performed properly. Even if operation records are recorded for each device, they cannot be used sufficiently.
[0012]
When a plurality of videos related to the same operation, patient biometric information, and the like are recorded on each recording medium, it is not taken into account to grasp the temporal correlation between the information recorded on each recording medium. In other words, when a phenomenon in one of multiple records is confirmed, other recording information at the moment when the phenomenon occurs is found from other recording media, and the situation at the moment when the phenomenon occurs is accurately grasped. Is not easy. For this reason, the correlation between multiple records, such as the cause-and-effect relationship between records, ascertaining the cause and result of a certain phenomenon, the occurrence of a phenomenon and the accompanying symptoms, and the signs that inform the occurrence, etc. It is difficult to make multifaceted observations and judgments at the moment of occurrence.
[0013]
When viewing multiple video records related to the same surgery, it is not only difficult to synchronize and play back each recording itself, but also the viewer will browse the video for attention while visually reciprocating. It is difficult to observe while keeping the synchronism of the observer, and the observer gets tired. Therefore, the visual acuity and attention are reduced, and the response time to the stimulus is delayed, and it is difficult to accurately analyze a long-time image.
[0014]
If the medium that stores the surgical record is lost, the record itself or the record medium is damaged, or if the record is duplicated or edited, the leakage of personal information or privacy may be infringed, or the reliability of the record itself, Credibility, accuracy, etc. will be reduced. Privacy protection and the establishment of information technology are socially demanded, and there is a need for sufficient countermeasures for devices that support surgery, but it is difficult to say that conventional technologies are sufficiently considered for these. . Furthermore, when transmitting and receiving personal information including the symptoms of these diseases and the state of treatment via a network, the risk of information leaking during transmission and reception increases.
[0015]
If the reliability, accuracy, and credibility of the recorded information is impaired, even if the operation status and treatment actions are analyzed based on this, sufficient reliability and accuracy are obtained for the result. , Credibility is not obtained.
As described above, the conventional techniques have various problems, and the present invention has been made to solve at least one of these problems.
[0016]
[Means for Solving the Problems]
The present invention Remote operation means equipped with at least one of a surgical tool for treating the affected area or observation means for observing the affected area, and operating according to an instruction from the operator, and operation input means for the operator to instruct the remote operation means to perform an operation When, Treatment status observation means for observing the status of operating the operation input means; Process the operation instruction input to the operation input means. The Control means for controlling the remote operation means, and control information used when the control means controls the operation are recorded. Having a recording medium Recording means and Reproducing means for reproducing the control information recorded on the recording medium; The recording means comprises The operation input information input by the operation input means, the treatment status information observed by the treatment status observation means, and the biological information measured by the biological information measurement means for measuring the biological information of the patient are synchronized in time series. And having a function of recording on the recording medium, The control means is the recording means. In Record Is The The operation input information Based on the remote Action Or at least one of the operation input means is controlled to reproduce The reproduction means reproduces the treatment status information and the biological information recorded in the recording means on the display means for reproduction in synchronization with the reproduction of the operation by the control means. Do Surgery support device with function It is what .
[0017]
Further, the present invention comprises a remote operation means that is equipped with a surgical instrument for treating an affected area and an observation means for observing the affected area, and operates according to an instruction from an operator, The remote operation means The operator Action The Instructions Do Operation input means And the operation input means At least one of the operating situation or the situation around the patient Observation Treatment status observation means A control unit that processes the operation instruction input to the operation input unit and controls the remote operation unit; and a recording unit that includes a recording medium that records control information used when the control unit controls the operation; Reproducing means for reproducing the control information recorded on the recording medium, the recording means comprising the operation input information input by the operation input means, the treatment status information observed by the treatment status observation means, The control means has a function of recording the affected part information observed by the observation means and the biological information measured by the biological information measuring means for measuring the biological information of the patient in time series in synchronization with the recording medium. Has a function of controlling to reproduce at least one operation of the remote operation means or the operation input means based on the operation input information recorded in the recording means. The reproduction means reproduces the treatment status information, the affected area information, and the biological information recorded in the recording means on the display means for reproduction in synchronization with the reproduction of the operation by the control means. Have the ability to Surgery support device It is what .
[0018]
The present invention also provides: Surgical instrument capable of treating the affected area or observation means capable of observing the affected area, an identifier included in the surgical instrument or the observation means, and a position measuring device capable of measuring the coordinates of the identifier in a space with a predetermined point as the origin , Data collection means for measuring the position and orientation of an operator who handles the surgical instrument or the observation means, and the position measurement device Positional measurement information output from the biological information output from the biological information measuring means for measuring the biological information of the patient, and Output from the data collection means Position and posture A recording means for recording information; and a reproducing means for reading the information recorded by the recording means and outputting the information to the display means. Stage ,Record The position measurement information, the biological information, and the position and orientation Time series information for grasping the time-series relative relationship of information is attached to the information to be recorded and recorded on a recording medium. Have the ability to And said playing hand Stage , Based on the time series information of each information recorded in the recording means attached to the recording information, The position measurement information, the biological information, and the position and orientation Adjust the time to play the information and update the screen display Have function Surgery support device It is what .
[0019]
DETAILED DESCRIPTION OF THE INVENTION
FIG. 1 is a configuration diagram of a surgery support apparatus according to an embodiment of the present invention. FIG. 2 shows the configuration of the distal end portion 24 of the remote operation means 3 shown in FIG. FIG. 3 shows the configuration of the recording means. FIG. 4 shows the configuration of a plurality of recording means. FIG. 5 shows a screen configuration for displaying the recorded information.
[0020]
The configuration of the embodiment shown in FIG. 1 will be described.
[0021]
The operation input means 2 that can be operated by the operator 1 and the remote operation means 3 that can be operated in accordance with the operation input instruction are connected via the control means 19 so as to be controllable. The control means 19, the treatment status observation means 7 for observing the operation status of the operator 1, the observation means 5 for observing the state of the affected part, and the biological information measuring means 6 for measuring the biological information of the patient 4 are respectively recorded means 8a. To be able to communicate information.
[0022]
The recording unit 8a is configured to record the input information on the recording medium 10a through the recording processing unit 9 that processes the information into a predetermined format and state.
[0023]
The recording means 8a is connected to the reproducing means 11a through the recording medium 10a so that information can be transmitted. The reproducing unit 11a is connected to the display unit 12a and the control unit 19 so as to be able to transmit information.
[0024]
Information transmission is performed by connecting the input / output units equipped in each means through a signal path using electricity or light (electromagnetic waves).
[0025]
Each element and operation of the above configuration will be described.
[0026]
The remote operation means 3 is a part for controlling the position and orientation of the part for treating and observing the patient 4 and the function of the surgical instrument. In FIG. 1, the distal part 24 is connected to the distal part 24 via the holder 14. The holding device 16 is equipped so that the position and orientation can be controlled. Although not shown, the holding device 16 is equipped with necessary actuators and sensors so that the operation can be controlled in accordance with instructions from the operator 1 or the control means 19 described below.
[0027]
The distal end portion 24 includes medical manipulators 22a and 22b (FIG. 2) capable of controlling the position and orientation of the surgical tools 23a and 23b (FIG. 2) capable of treating the affected area, and the lens system of the observation means 5 capable of observing the affected area. 21 are freely bundled by the holding tool 14. The position / posture and opening / closing operation of the surgical instrument are realized by controlling the drive unit 15 (FIG. 1) in accordance with an operation instruction from the control means 19 or the operator 1. FIG. 2 shows a state in which two medical manipulators 22a and 22b are provided. However, the medical manipulators 22a and 22b can be changed according to the judgment of the operator, and there may be one or more than three. Alternatively, there may be a case where only the position and orientation of the lens system 21 of the observation means 5 are remotely operated instead of the surgical instrument. Although the surgical tools 23a and 23b illustrate a forceps shape including two movable gripping portions, the shape and type of the surgical tools are not limited to this figure. Various surgical tools such as a lever, a laser knife, an electric knife, a suction tube, a washing tube, a needle, a peeler, a scissors, a catheter, and a balloon catheter can be used at the discretion of the operator 1 who is an operator.
[0028]
The operation input means 2 controls the movement of the operation lever 18 which is one of input devices for the operator 1 to instruct the operation command to the remote operation means 3 and the operation input means 2 and the remote operation means 3. The user interface 17 is used for such purposes as changing the setting of these parameters or transmitting the processing result of the control means 19 to the operator 1. Although not shown in detail in the user interface 17, buttons, switches, sensors, or microphones as voice input means, which are electrical, optical, or mechanical input means for the operator 1 to input settings, are provided. It is preferable to include the input unit used, a monitor as a means for displaying characters, pictures, images, etc., a speaker as a sound output means, and the like. The operation lever 18 of FIG. 1 has a force sensor (not shown) as means for detecting an operation input, and is operated by driving an actuator based on the operation input of the operator 1 detected by the force sensor. The posture of the lever 18 is controlled. The posture of the operation lever 18 is controlled according to the input of the operator in normal treatment, but the posture can be changed by an operation command from the control means 19. The operation input means 2 other than the operation lever 18 includes a device that provides an electrical or optical signal by a button or a switch, a sensor such as a gyro that measures position, speed, acceleration, or the like, or the position of the line of sight. A device that provides an output signal of a sensor such as a line-of-sight detector or a data glove that measures body movements or a device, or a device that provides voice operation instructions as a signal may be used. In this case, the operation input means 2 may include a device that does not have an actuator.
The control unit 19 controls at least one of the operation input unit 2 and the remote operation unit 3 in accordance with the operation instruction input from the operator 1 and the setting instructed from the user interface 17. Alternatively, at least one of the operation input unit 2 and the remote operation unit 3 is controlled according to information output from the reproduction unit 11a or read from the reproduction unit 11a instead of the operation instruction input from the operator 1. Similar to the configuration in which both the operation input unit 2 and the remote operation unit 3 are controlled by the single control unit 19, each of the operation input unit 2 and the remote operation unit 3 has the control unit 19, and the control unit 19 communicates with each other. Of course, it is also possible to connect with the above.
The recording unit 8a includes a recording processing unit 9 that converts input information into a state for recording, and a recording medium 10a that records an output from the recording processing unit 9. As the recording medium 10a, a method based on an existing technique for recording using magnetism, light, electricity, or the like can be easily used. The recording medium 10a may be fixed to the recording means 8a or detachable. The recording unit 8a and the reproducing unit 11a may be configured in advance so as to be accessible to the fixedly mounted recording medium 10a, or the recording unit 8a so that the removable recording medium 10a can be read and written by a plurality of units. The reproducing means 11a may be provided with a recording medium attaching / detaching means and a recording medium reading / writing means having the same specifications.
[0029]
The recording unit 8a is an output from a device that operates during treatment, and records information indicating the operation of the medical device and the state of treatment (hereinafter referred to as treatment information 41) during the treatment operation. The treatment information 41 includes, for example, an operation state and a treatment state image transmitted from the treatment state observation unit 7, a sensor output or a sensor output of the operation input unit 2 and the remote operation unit 3 transmitted from the control unit 19. The control amount calculated from the information, the information input to the user interface 17 by the operator 1 or the information of the control parameter, the control output signal 75 comprising the voltage or pulse output from the control means 19 to each actuator or sensor, and the observation means 5 is an image of the vicinity of the affected part input from 5, a patient's biological information transmitted from the biological information measuring means 6, and the like. Information input from the control means 19 to the recording means as one of the treatment information 41 is referred to as control information 40. This control information 40 means control variables and sensor information necessary and sufficient to reproduce at least one operation of the operation input unit 2 and the remote operation unit 3.
[0030]
As shown in FIG. 3A, the recording processing unit 9 uses time code transmission unit 42 for transmitting time series data from the starting time and time code 38 obtained from the time code transmission unit 42 as treatment information 41. It consists of a treatment information shaping unit 43 to be added. In the recorded information shaping unit 43, processing such as data alignment, combination, division, compression, selection of necessary data, attachment of data type identification information, etc. so that the treatment information 41 can be easily used by the reproducing means 11a as necessary. Do some of them.
[0031]
The time code 38, which is time series information unified between information, indicates an elapsed time from the starting time such as the start of control. For example, the absolute time or the difference data from the starting time based on the absolute time is used. This is a unified information that is recorded at the same time as the information of each device is recorded, such as the number of occurrences of the character string, the counter inside the control means that occurs periodically at a predetermined interval from the starting time, the number of occurrences of the control loop, etc. It is.
[0032]
Examples of recording information 39, 39a, 39b stored in the recording medium 10a are shown in FIGS. FIG. 9 shows an example of recorded information when various types of information are arranged and recorded in order of time code. Recorded information 39 includes patient data 64 that summarizes the date, patient, surgeon, anesthesiologist, assistant, and other names, symptoms, treatment plan, etc., and equipment used for treatment, such as remote operation means 3 and operation input. A file header 37 describing device data 65 for identifying a device such as a serial number such as means 2 is recorded at the head of a predetermined recording area, and then includes control information 40, biological information, image information, and the like. Treatment information 41 is recorded along with the time code 38. The file header 37 is recorded at the start of operation, and otherwise, it is continuously recorded every time information is input during treatment.
[0033]
Recording may be performed by adding a time code 38 for each treatment information 41, but recording methods such as a predetermined order and a predetermined relative address may also be recorded by a method of recording a plurality of pieces of treatment information 41 following one time code 38. By defining the rules to be specified and recording them continuously, it is possible to easily specify the position of information to be known according to the rules for recording. In addition, when the sampling timing for obtaining each information is different for each apparatus and only updated data is recorded, the number of information recorded for one time code 38 is different for each time code 38. It will be. In this case, each of the plurality of treatment information 41 is recorded with a data header 67 specifying the type and content of each information. Thereby, even if the predetermined number of information is not recorded at the predetermined position, the necessary data can be specified by referring to the data header 67. Specifying the data means, for example, recognizing the contents by distinguishing each piece of information such as the output of a certain sensor provided in the operation input means 2 and the pulse of the patient.
[0034]
In addition to the example in which the treatment information 41 is recorded in the order of the time code 38 as shown in FIG. 9, the data format (classification by voice information, character string information, number sequence information, image information, etc.) and data as shown in FIG. The data is classified into a plurality of recorded information 39a and 39b according to the type of data such as the contents of the output device or data (classification of control information 40, biological information, image information, etc.), or according to the sampling timing for obtaining the information. It is also effective to create a file group recorded in the order of the time code 38 and manage the configuration of the file group by describing it in the file header 37. In FIG. 10, only two of A and B are illustrated, but it is naturally possible to record by dividing into two or more. At this time, the number of data recorded together with one time code 38 in one piece of recorded information classified and stored may be one or plural. In addition to the patient data 64 and the device data 65 for identifying the used medical device, the file header 37 is a file that indicates in what file structure all information recorded by the recording means 8 is recorded. Group configuration data 66, one or a plurality of data headers 67 for specifying the data contents managed by the file header 37 provided for each recording information, and simultaneously used for reproducing an operation or reproducing a treatment situation The link data 68 that summarizes the information data header 67 is recorded.
[0035]
The number of recording means 8a is not limited to one, and a plurality of recording means may be used in accordance with input information. In this case, as shown in FIG. 4, the unified time code 38 is distributed from the time code transmission unit 42 to each recording means (8c, 8d, 8e), and each recording means (8c, 8d, 8e) The code 38 and the treatment information 41 are added and recorded. Moreover, you may provide the time code transmission part 42 in each recording means (8c, 8d, 8e), respectively. When the time code 38 is based on the elapsed time from the start of treatment, there is no problem even if there is a deviation in the absolute time of the time code transmission unit 42 here. By adopting a configuration in which the code transmission unit 42 is synchronized, it is possible to synchronize the reproduction of the treatment information 41 even with the time code 38 based on the absolute time.
[0036]
The reproducing unit 11a reads the information recorded on the recording medium 10a, restores the information subjected to the processing such as compression by the recording processing unit 9 to a state usable by the control unit 19 and the display unit 12a, and displays the information on the display unit 12a. Or it outputs to the control means 19.
The flow of operations of the operation input unit 2 and the remote operation unit 3 will be described with reference to FIGS.
[0037]
FIG. 6 shows the operation and data flow performed in the normal treatment operation, and FIG. 7 shows the operation and data flow for controlling the operation input means 2 and the remote operation means 3 based on the control information 40 recorded during the treatment. Show. FIG. 8 shows the control flow of the data update management routine 36 shown in FIG.
[0038]
Normally, when the remote operation means 3 is operated by an instruction by an operation input from the operator 1, the operation is controlled by periodically executing the flow shown in FIG.
[0039]
First, when the operator 1 makes an operation input (25), the operation input is detected (26), and the position and orientation of the operation lever 18 and the remote operation means 3 as the operation input means 2 are detected (29). The control amount 34 of the operation input means 2, that is, the operation direction and the operation amount of the operation lever 18 are calculated based on the operation input information, the position / orientation information, and the control parameters indicating the control method and operation contents such as the operation mode. 27). The operation lever 18 is controlled based on the calculated control amount 34 (28), and a control signal such as voltage or pulse is sent to the controlled object. As a result, the position and orientation of the operation lever 18 are controlled. Based on the information detected by the position / orientation detection routine 29 and the control parameter information managed by the control parameter management routine 32, the control amount 34 of the remote operation means 3 is calculated (30). The remote action means 3 is controlled (31) to realize the therapeutic action.
[0040]
Simultaneously with such control, operation input data 33 (see FIG. 7) periodically detected by the operation input detection routine 26, position / orientation data 45 detected by the position / orientation detection routine 29, a control amount calculation routine 27, Control amount data 34 detected at 30, control parameter data 35 set by the operator 1 through the interface 17, or changed according to the control status, and control of pulses and voltages output from the control means 19 to each actuator, sensor, etc. The output signal 75 and the like are transmitted to the recording means 8a and recorded on the recording medium 10a. The recording unit 8a may be configured in the same apparatus as the control unit 19 and the reproducing unit 11a, or may be installed remotely. Of course, a configuration in which information is transmitted to a remote recording medium and recorded is also possible. The recording medium 10a may be fixedly mounted on the recording means 8a or may be removable. Recording on the recording medium 10a can be realized by a system that uses magnetism, electricity, or light.
[0041]
Next, referring to FIG. 7, the control operation based on the recorded control information 40 and the data flow will be described.
[0042]
In the control of FIG. 6, the calculation of information used for control and the output of signals are performed based on the detection data and the calculation result. In the control of FIG. 7, the calculation of information used for control based on the recorded information is performed. The signal is output. The operation control performed based on such recording is called operation reproduction. The reproduction of the operation is performed as follows, for example.
[0043]
In the recording means 8a, as one of the treatment information 41, the operation input data 33 which is the control information 40, the position and orientation data 45 of the operation lever 18 and the remote operation means 3, the control amount data 34, the control parameter data 35, the control output signal 75 etc. are recorded.
[0044]
Instead of the operation force generated by the operation input of the operator 1, the operation input data 33 and the control parameter data 35 which are one of the recorded information are read by the reproducing means 11a, and the data update management routine 36 operates the operation input data at a predetermined timing. 33, the control amount of the operation lever 18 is calculated by the operation input means control amount calculation routine 27 so that the updated operation force data 33 is information input by the operator 1, and the position and orientation are controlled. When this is done (28), the operation of the operator 1 can be created in a pseudo manner and the treatment operation can be reproduced.
[0045]
Alternatively, the position / orientation data 45 and the control parameter data 35 of the operation input unit 2 are read by the reproducing unit 11a, and the data update management routine 36 rewrites the position / orientation data 45 and the control parameter data 35 at a predetermined timing to update the position / orientation data. Using the data 45 as a control target, the operation input means control amount calculation routine 27 calculates the control amount of the operation lever 18 with reference to the control parameter data to control the position and orientation (28). This makes it possible to reproduce the operation during treatment.
[0046]
Alternatively, the control amount data 34 and the control parameter data 35 of the operation lever 18 are read by the reproducing unit 11a, and the data referred to by the data update management routine 36 is rewritten to the data read by the reproducing unit 11a at a predetermined timing. It is also possible to control the position and orientation of the lever 18 (28) and to transmit a control output signal 75 to the controlled object. In this case, reproduction of the relationship between the input force and the control amount is omitted.
[0047]
Alternatively, the control output signal 75 is read, the data update management routine 36 measures a predetermined timing, overwrites the data, and outputs a voltage or a pulse from the control means 19 to the actuator or sensor according to the updated data. As a result, the operation lever 18 and the remote operation means 3 can be directly controlled based on the recorded signal to reproduce the operation. In this case, information such as the input force is omitted.
[0048]
Simultaneously with the reproduction of the operation of the operation input unit 2, the remote operation unit 3 can also reproduce the operation based on the recorded information.
[0049]
Further, for example, the movement of the operation input means 2 is omitted, and the control amount data 34 and the control parameter data 35 of the remote operation means 3 are read by the reproducing means 11a, and the data to be referred to by the data update management routine 36 based on this is read out. It is possible to rewrite at a predetermined timing, determine the control amount of the remote operation means 3 (30), and control the position and orientation of the remote operation means 3 (31). When the operation input means 2 is not provided with an actuator, it becomes the same as this.
[0050]
Whether only the operation input unit 2 or the remote operation unit 3 reproduces the operation or the operation reproduction by synchronizing both may be selected according to the user's request and purpose. The operation of the operation input unit 2 may be reproduced, and the operation of the remote operation unit 3 may be reproduced by the same control as during treatment according to the reproduced operation. Further, there is a relationship that can be calculated according to the control law used for controlling the apparatus between the control information 40 such as the operation input data 33, the position and orientation data 45, the control amount data 34, the control parameter data 35, and the control output signal 75. Exists. It is also possible to check whether or not a predetermined control signal has been output by checking the calculation under control based on the control information 40. This is an effective means for confirming that the control of the apparatus is functioning normally.
[0051]
A control flow performed in the data update management routine 36 will be described with reference to FIG. This control flow is executed for each control loop and all information necessary for reproducing the operation. First, necessary control information 40 is read from the reproducing means 11a (56). Next, in order to read the time code 38 of the data recorded simultaneously with the read control information 40 and calibrate the time code such as the elapsed time from the start of the operation and the time measured by the control means 19, Convert to a variable that means the elapsed time from the start of operation. This is time1 (57). Next, the time measured by the control device is read and converted into a variable indicating the elapsed time from the start of the operation in the same manner as time1, and this is set as a variable time2 (58). By comparing time1 and time2, and when time1 is equal to or greater than time2, the control means updates data used for control (60). When time1 is smaller than time2, the process ends without updating the data, and FIG. 8 is repeated again in the next control loop.
[0052]
When the control output signal 75 is used to reproduce the operation, in the data update (60), a voltage and a pulse are output to a predetermined output destination according to the updated data.
[0053]
In addition to the case where the control information 40 is read from a storage area such as a memory that is processed inside the playback means 11a and temporarily stored in a usable state, the information fetched from the playback means 11a is temporarily stored. There may be a memory in the control means 19. It is also possible to configure the apparatus so that these read-in memories are the same.
[0054]
When the recorded information 39 is classified and stored in several file groups, the target file can be searched from the information in the file header 37. By searching for the target file name in advance, it is possible to search from the file name. When the treatment information 41 is stored at a predetermined position, the information is read by moving an address of a predetermined length from the time code 38. Moreover, even if the order and position of the treatment information 41 are uncertain, the target information can be read with reference to the data header 67 indicating the contents of the data. There is no problem even if the reading of the time code 38 and the reading of the data contents are mixed, and when the time code 38 and the data are recorded together, the time code 38 and the data are separated after the reading. The number of data for reproducing the operations of the operation input means 2 and the remote operation means 3 is at least the number of degrees of freedom in each device. Data reading and data updating are performed on all information necessary for reproducing recorded information. As for the updated data, the time code is set so that the data to be updated next is always read from the memory of the data medium read from the recording medium 10a, the reproducing means 11a, or the reproducing means 11a. Wait for 38 comparisons.
[0055]
With the configuration as described above, the following effects can be obtained.
[0056]
Since it has a function of controlling at least one operation of the remote operation means 3 or the operation input means 2 by the control means 19 based on the record information 39 that records the operation during treatment, the remote operation means 3 or the operation input The operation during the operation of the means 2 can be reproduced. Further, based on the record information 39 in which the operation during treatment is recorded, it is possible to reproduce the synchronized treatment information with reference to the time code 38 recorded along with the treatment information 41 in the record information 39.
[0057]
Because it is possible to reproduce the treatment operation performed during the operation after the operation, check the operation content and treatment operation, such as what operation was performed or how the surgical tool moved, Analysis and treatment status can be easily grasped after surgery.
[0058]
Since it is possible to reproduce the operation using an actual apparatus, it is possible to confirm the behavior of the surgical instrument in a range that cannot be confirmed on the screen without being caught in the field of view recorded in the endoscope image. In addition, multiple observers can visually confirm the actual movement from various angles at the same time, making it possible to examine, grasp, analyze, and explain postoperative treatment details more specifically and effectively. It becomes like this.
[0059]
Since the operation is reproduced based on the recorded information, it is possible to operate repeatedly based on a certain range of information according to the user's request, and it is important according to the request of the person who observes the operation. Can efficiently observe, analyze, grasp, explain, etc.
[0060]
Since the recorded information can be moved through the removable recording medium 10a, even if the operation input means 2 and the remote operation means 3 that are actually used cannot be used for processing such as sterilization, an apparatus having the same specifications is used. By using it, the operation can be reproduced.
[0061]
It is also possible to reproduce the operation by synchronizing the models of the operation input means 2 and the remote operation means 3 manufactured by computer graphics or the like based on the actual treatment information 41 reproduced by the reproduction means 11a.
[0062]
Even when the operation input means 2 and the remote operation means 3 have the control means 19 independently, since the control information 40 is recorded with the time code 38 unified by the recording means 8a, the time between each control means 19 is recorded. Even if there is a deviation in the setting, the information to be recorded is not affected by the setting of the control means 19, and the timing of the actually generated operation is accurately recorded. Ruko Is possible. Also, in reproducing the operation, by taking the operation timing based on the elapsed time from the start of control, even if there are a plurality of control means, it is possible to reproduce in time synchronization. This is not limited to the control means, and it is possible to record and reproduce the treatment information 41 in time synchronization between a plurality of medical devices connected to the recording device such as a plurality of measuring devices.
[0063]
Since the patient information 64 and the device data 65 are recorded as the file header 37 in the record information 39, even when organizing or maintaining the information after surgery or when using the treatment information 41 recorded by a third party. The recorded information contents can be easily grasped, and information management and information use can be easily performed. Further, the file header 37 includes a structure of recorded information recorded during the operation, a data header 67 for identifying data recorded in the recorded information, link data 68 indicating related information that needs to be reproduced simultaneously when the recorded information is used, and the like. Recording makes it easy to manage information and use information after surgery even if information with different sampling timings or information with different types and contents of data is distributed and recorded in different recording information 39a and 39b. Can be performed. The number to be dispersed can be arbitrary. In this way, by managing information by the file header 37 and enhancing the simplicity and flexibility of information handling, the configuration and type of medical equipment used for treatment, the output format and timing of information, etc. are not limited. The mode of information to be recorded can be flexibly dealt with in accordance with the information to be recorded, and the operability and operability of postoperative use of the treatment information 41 can be further improved.
[0064]
By comparing the recorded control information 40 with each other and substituting and checking the control formula used for the control, it is possible to confirm that the device under treatment was functioning normally according to the control law. As a result, it is possible to improve the validity of the reproduced operation and the operation of the remote operation means 3 with respect to the operation input means 2, and the reliability of the control information 40 and the reproduced operation.
[0065]
Next, the observation means 5, treatment status observation means 7, biological information measurement means 6 and the like will be described with reference to FIG. The observation means 5 shown in FIG. 1 is a medical instrument such as an endoscope, and is an apparatus that provides the operator 1 with the situation near the affected area as image information or graphic information. 1 and 2 show an example of an apparatus that bundles an endoscope lens system 21 together with a surgical instrument. The video information of the observation means 5 is transmitted to the recording unit 8a as shown in the figure, while being provided to the operator using a television or a dedicated monitor (not shown) as one of the display means. As the observation means 5, as long as it observes the situation in the vicinity of the affected part, in addition to the endoscope, other medical instruments such as a surgical microscope, a video microscope, and an ultrasonic probe, and measuring instruments such as CT and MRI are similarly used. Can be configured. These are configured according to the treatment content.
[0066]
The treatment status observation means 7 shown in FIG. 1 is an imaging system such as a camera that captures the state of the operator who is performing the operation and the operator 1. The treatment status observing means 7 may be provided on an instrument provided in the operating room such as a ceiling or a surgical light in the operating room or the operation input means 2. A state around the patient is photographed separately from the state of the operator 1 who operates the operation input means 2 by one or more treatment state observation means 7 and the treatment state observation means 7 provided so as to be operable in position and orientation. It is also possible to configure such that the assistant participating in the treatment, the state of progress of the treatment, etc. are observed and transmitted to the recording means 8a. The biological information measuring means 6 shown in FIG. 1 measures some of the patient's biological information such as electrocardiogram, respiration, invasive blood pressure, non-invasive blood pressure, blood oxygen saturation, body temperature, pulse, heart rate. While the measured information is transmitted to the recording means 8a, it is possible to provide information to the surgeon through a television or a dedicated monitor which is one of the display devices by branching the information transmission path (not shown). .
[0067]
The treatment information 41 obtained by the observation means 5, the biological information measurement means 6 and the treatment status observation means 7 is processed by the recording means 8a together with the control information 40 obtained by the control means 19, or a similar process is performed. Are recorded on the recording medium 10a.
[0068]
FIG. 5 shows an example of the screen configuration displayed on the display means 12a or the display means 12b installed remotely. Details on remote installation will be described later. In one screen, the operation state 52 obtained from the treatment state observing means 7, the state 51 of the affected part obtained from the observing means 5, the graph 53 showing the transition of biological information, the heartbeat 54, the body temperature 55, etc. The biometric information information indicating the state with numerical values or graphics is also displayed. At this time, each piece of information is synchronized and reproduced by updating the data with reference to the time code 38 in the same manner as reproducing the operation. In FIG. 5, heart rate and body temperature are taken as examples, but this may be displayed as any of the measured biological information according to the request of the observer. Furthermore, since it is only a difference in an output format whether it is set as a character string display or a graph display, what is necessary is just to change according to the observer's request. Hereinafter, a person who reproduces the operation or views the display means is called an observer.
[0069]
Each information of the affected part state 51, the operation state 52, and the biological information 53, 54, 55 is displayed in an integrated manner, and the reproduction timing of each information is displayed with reference to the time code 38 recorded with the information. By doing so, it is possible to observe a synchronized image of both the state of the affected area and the operation status in the same field of view of the observer, so that the affected area state 51 and the operation state 52 can always be observed at the same time. As a result, the relationship between the movements of the surgical tool can be easily grasped. The affected part state and the operation state may be expressed using computer graphics or the like based not only on the actually captured image but also on the actually captured image.
[0070]
By updating the treatment information 41 on the basis of the time code 38, the operation input means 2 and the remote operation means 3 are reproduced at the same time as the other devices having different recording intervals, such as the observation means 5 and the biological information measurement means 6. It is possible to reproduce the treatment information 41 in a synchronized manner. As a result, information reproduced on the display screen, operations of the operation input means 2 and the remote operation means 3, or changes in the patient's condition and biological information, etc., and operations using the operation input means 2 and the remote operation means 3 are performed. The relationship between device movements can be observed in relation to each other so that treatment status and operation status can be understood, analyzed, confirmed, and explained to others after surgery, more specifically, effectively and easily. Become.
[0071]
Compare the recorded image of the affected area situation with the state of motion reproduction, identify the movement that cannot be recorded in the control information 40, such as the movement of the patient itself or the relative position relationship between the movement of the affected area and the remote operation means 3, It becomes possible to observe.
[0072]
It is also possible to collect control information 40 that does not infringe on the privacy of the patient from the recorded treatment information 41, information on the observation means 5 and treatment status observation means 7, etc., and use it as an example of reference for planning treatments. Yes, and by using this as a reference, it can be used to realize more efficient and safe operations by taking advantage of precedents.
[0073]
The treatment situation observation means 7 records the treatment situation by embedding a unified time code 38 together with the image of the observation means such as an endoscope, etc., so that the treatment situation observation means 7 records the treatment situation. It becomes possible to grasp the progress of treatment more accurately by combining the surrounding situation that cannot be grasped from the information 40 and the situation reflected in the endoscopic image.
[0074]
Recording and playback at a remote location will be described with reference to FIG. As shown in FIG. 1, the recording means 8a is equipped with a transmission / reception means 13a, and is connected to transmission / reception means 13b, 13c provided at a place away from the surgical site through a wired or wireless network or communication line. . The transmission / reception means 13b is connected to the recording means 8b so as to be able to transmit and receive, and has a function of recording on a recording medium 10b different from the recording medium 10a recorded by the recording means 8a. The transmission / reception means 13c is connected to the reproduction means 11b provided at a location distant from the treatment site, and the output from the reproduction means 11b is connected to be displayed on the display means 12b. Similarly, the transmission / reception means 13b and 13c are connected to the network so that the treatment information 41 recorded in the recording medium 10b can be displayed on the display means 12b.
[0075]
Since the recording information 39 can be transmitted to the recording means 8b and the reproducing means 11b installed remotely via the network, the recording information 39 is stored using a large-capacity recording medium that collectively manages the recording information 39. Furthermore, it is possible to reproduce the operation by reproducing the recorded information 39 installed remotely and centrally managed via the network.
[0076]
The reproduction of the operation is not only after the operation but also during the operation, the recording information 39 is recorded on the recording medium 10a, and at the same time, the recording information 39 is transmitted to the reproducing means 11b provided remotely via the network and used for the treatment. It is also possible to reproduce the currently performed treatment operation using the same kind of operation input means 2 and remote operation means 3 as those of the present invention. At this time, by observing the information of the living body information measuring means 6, the observing means 5 and the treatment status observing means 7 in accordance with the reproduction of the movement, the operating situation of the surgical instrument and the biological information of the patient can be obtained even when the observer is remote. It is possible to grasp the treatment status including transition more accurately in real time.
[0077]
The specific recording information 39 is received through the transmission / reception means 13b and 13c from the place where the treatment information 41 is managed after the operation, and the operation status is analyzed as necessary using the reproduction means 11b and the display means 12b. It is possible to explain the status of surgery to the three parties.
[0078]
FIG. 3B shows another example relating to the recording processing unit 9. The information processed by the recording information shaping unit 43 is encrypted by the falsification preventing means 44 and then recorded on the recording medium 10a.
[0079]
The encryption method is configured to have an encryption dedicated key and a decryption dedicated key, such as a public key method. The encryption dedicated key is managed by the recording unit 8a, and the decryption dedicated key is managed by the reproducing unit 11a. When the treatment information 41 is recorded, it is encrypted using the encryption-dedicated key and then recorded on the recording medium. At the time of reproduction, the encrypted information recorded on the recording medium is used with the decryption-dedicated key. Combine.
[0080]
By managing and operating the respective keys separately in the recording means 8a and the reproducing means 11a, the recorded information 39 can be browsed only by using a specific reproducing means. It is more certain to prevent this.
[0081]
Since it becomes difficult for the reproducing means 11a not having the encryption-dedicated key to encrypt again, it is possible to prevent the recorded information 39 from being falsified and to further improve the credibility of the recorded information 39. Since the credibility of the recorded information 39 is high, it is possible to improve the accuracy, credibility, and effectiveness of reproducing the operation based on the recorded information 39 and analyzing and grasping the treatment status.
[0082]
When a plurality of recording means 8a and reproduction means 11a are installed in a facility that is grouped in a network such as a hospital or between hospitals and in which the mutual browsing of the recorded information 39 is permitted in advance, the same encryption is performed by the plurality of recording means 8a. The dedicated key is managed, and the same decryption dedicated key is managed by a plurality of reproducing means 11a. As a result, the recording information 39 using the recording means 8a for managing the same encryption-dedicated key can be decrypted with the same decryption-dedicated key, regardless of which recording means 8a is recorded. The encrypted recording information 39 can be easily reproduced via any network using any reproduction means that manages the same decryption-dedicated key, and decryption is performed at an external facility where mutual browsing is not permitted. Since the encrypted recording information 39 cannot be browsed because the dedicated key is different, it is possible to prevent the leakage of the recording information 39 and the personal information while ensuring the convenience of easily reproducing the information.
[0083]
FIG. 13 is a configuration diagram of a recording unit and a reproducing unit of a surgery support apparatus including a detachable permission unit that manages keys for encryption and decryption. The other components of the recording means and reproducing means are the same as those in FIG. As shown in FIG. 13, the encryption-dedicated key or the decryption-dedicated key is made independent as the encryption permission unit 73 or the decryption permission unit 74 and can be detached from the recording unit 8a or the reproduction unit 11a. These permission means may be of any shape such as a card type or a car key as long as it can record an encryption dedicated key and a decryption dedicated key. In each permission means, an encryption-dedicated key or a decryption-dedicated key is recorded as electrical information or magnetic information. Alternatively, an electric signal or optical signal circuit that can identify the encryption-dedicated key or the decryption-dedicated key is provided in each permission unit. Alternatively, the portion where the permission unit is attached to the recording unit or the reproduction unit is printed with a code indicating an encryption-only key or a decryption-only key, or is processed with a shape such as a step or a through hole.
[0084]
These permission means are called encryption key hardware and decryption key hardware.
[0085]
The recorded information 39 is attached with the time code 38 by the recorded information shaping unit 43, processed as described above, and encrypted by the falsification preventing means 44. When the treatment information 41 is encrypted, the falsification preventing unit 44 uses an electric signal, an optical signal, a magnetic signal, or an image signal to store the encryption-dedicated key recorded in the encryption key hardware that is the encryption permission unit 73. Alternatively, it is read by recognizing the shape of the installed permission means. Encryption is performed using the read encryption key, and the encrypted information is recorded on the recording medium 10a.
[0086]
The encrypted information is decrypted by the decrypting means 70 of the reproducing means 11a. At this time, the decryption unit 70 reads and reads the decryption-dedicated key recorded in the decryption key hardware, which is the decryption permission unit 74 attached to the reproduction unit 11a, in the same manner as the reading of the encryption-dedicated key. Decrypt using the decryption-dedicated key. The decrypted information is restored by the recorded information restoring unit 71 from the processing performed by the recorded information shaping unit 43 of the recording unit 8a to a state that can be used for reproducing information, and restored to a predetermined apparatus. 72 is sent. If the decryption-dedicated key recorded in the decryption permission means 74 does not correspond to the encryption-dedicated key when encrypted, decryption cannot be performed normally.
[0087]
It is also possible to store a read-only key for encryption or decryption, and to read the key only once during a series of recording processing or reproduction processing. Alternatively, it may be read every time encryption and decryption are performed.
[0088]
Information for identifying a person who manages the permission means (manager identification information), for example, an individual name, a serial number, and the like is added to each permission means and added to the encryption dedicated key and the decryption dedicated key. When using the encryption permission means 73 and the decryption permission means 74, a recording device for recording the administrator identification information recorded in each permission means is provided in the recording means 8a and the reproduction means 11a. Alternatively, the administrator identification information when the encryption permission unit 73 is used may be recorded in the file header of the recording information recorded by the recording unit 8a. It is also easy to record the use date according to the administrator identification information.
[0089]
When recording information 39 is recorded, it is possible to record and encrypt information by attaching encryption key hardware to the recording means 8a. When reproducing the recording information 39, decryption key hardware is attached to the reproduction means 11a. Thus, information can be decoded and reproduced. A person who is permitted to record and reproduce the treatment information 41 manages the encryption key hardware and the decryption key hardware, so that the encryption dedicated key and the decryption dedicated key can be easily managed and permitted. Since it becomes more difficult to record and browse those who have not, the effect of preventing leakage of personal information can be further enhanced.
[0090]
In the encryption permission means 73 and the decryption permission means 74, information that can identify the person managing each permission means is recorded together with the encryption dedicated key and the decryption dedicated key, and each permission means is used. Since the information can be recorded as a record, it is possible to grasp who recorded the information and when or who viewed the information, and the record information 39 can be stored and managed more safely. The effect of preventing information leakage can be improved.
[0091]
Furthermore, even if different recording means 8a are used in a plurality of treatments, if the encryption key hardware storing the same encryption dedicated key is used, the hardware storing the decryption dedicated key paired therewith is stored. By using this, it is possible to reproduce the treatment information 41 using any reproduction means, and the operational convenience can be further improved.
[0092]
Moreover, even if the same recording means is used, a group that can view this information has a decryption-dedicated key corresponding to the encryption-dedicated key by using encryption key hardware that stores different encryption-dedicated keys. It can be limited to groups, and the convenience of management and operation of the recorded information 39 can be further improved.
[0093]
When transmitting / receiving via the network, the recorded information 39 can be encrypted and communicated, so that information can be prevented from leaking to a third party during transmission of the recorded information 39, and information relating to the patient's privacy called the recorded information 39 Can be securely transmitted and received via a network. Furthermore, it is possible to prevent leakage of personal information even in transmission using radio waves, etc., and to perform it safely. By installing radio wave transmission / reception devices even in remote areas where network networks such as optical fibers are not established, Transmission / reception of the record information 39 becomes available.
[0094]
Since transmission / reception of the recording information 39 via the network has high security and can prevent falsification after recording, the recording information 39 can be stored using a large-capacity recording medium that collectively manages the recording information 39. Management can be performed more safely.
[0095]
FIG. 11 shows an embodiment when using a surgical instrument that does not have a control means for performing operation control. In FIG. 11, the transmission / reception means and the like shown in FIG. 1 are omitted, but the same configuration can be adopted. The surgical instrument 62 is provided with an identifier 63. The hand that handles the surgical instrument 62 of the operator 1 is equipped with a data glove 61 that is a means for detecting the operation input status. The data glove 61 can detect, for example, the angle of each joint from the wrist to the tip by detecting, for example, a change in the resistance of the resistor or a change in the optical path length of the optical fiber. The treatment state observation means 7 detects the coordinates of the identifier 63 or outputs an optical, magnetic or mechanical position measuring device that outputs a signal capable of calculating the coordinates, or processes a photographed image with a camera that is a photographing means. And the image processing means for detecting the coordinates of the identifier 63. The identifier 63 is composed of feature points such as a marker of a type specified by the position measurement device or the image processing means, or a unique shape that can be specified by the position measurement device or the image processing means.
[0096]
The patient's biological information from the biological information measuring means 6, the video of the affected area from the observation means 5, the operation command information from the data glove 61, and the coordinate information of the identifier 63 from the treatment status observation means 7 are stored in the recording means 8a. The information is input and converted into a state for recording the treatment information 41 by the recording processing unit 9 similar to FIG. The recorded information is restored by the reproducing means 11a and displayed on the display means 12a. At this time, as in FIG. 5, the display content is provided by integrating and reproducing various information, but at this time, the operation state 52 is created based on information obtained from the data glove or the position detection means. Display using computer graphics. Regarding the reproduction of the motion, the position / posture of the surgical tool, the movement of the operator's hand, and the like are expressed using computer graphics based on the recorded information 39. Since computer graphics create models based on the three-dimensional information obtained from data gloves and optical position measurement devices, it is possible to change the orientation and orientation of the displayed model according to the needs of the observer. is there. By using such a configuration, it is possible to obtain the same effect as the configuration shown in FIG. 1 even when using a surgical instrument without a control means.
[0097]
In the configuration shown in FIG. 1, the operator 1 is equipped with the data glove 61 and operates the operation input means 2, or the treatment status for providing the identifier 63 on the remote operation means 3 and detecting the position and orientation of the identifier A configuration having a position measuring device or an image processing device can be used as the observation means.
[0098]
With this configuration, it is possible to record the movement of the hand of the operator who is operating the operation lever 18 in addition to the information on the position and orientation in which the operation lever 18 is operated according to the operation input. Alternatively, before starting treatment, the identifier 63 is attached to a part of the patient's body, or a part of the patient's body and a characteristic part is used as the identifier 63, and the position of the patient where the coordinate system of the operating room can be placed By identifying the posture and detecting the identifier 63 of the remote operation means 3 during treatment, the relative positional relationship between the patient 4 and the remote operation means 3 can be quantitatively measured.
[0099]
Since the position and orientation information of the operation lever 18 can be compared with the information from the data glove 61 separately from the control of the operation input means 2, the position and orientation data of the operation lever 18 detected by the operation input means 2 is complemented, or There is an effect of improving the credibility of the control information 40.
[0100]
Since the position and orientation of the remote operation means 3 in the coordinate system of the operating room can be specified, the arrangement of the operation input means 2 and the positional relationship with the patient 4 can be clarified, and the treatment operation can be reproduced more accurately. Become.
[0101]
FIG. 12 shows a treatment situation in which a plurality of remote operation means 3, 3a, identifiers 63, 63a provided in the respective remote operation means 3, 3a, and coordinates of the identifiers 63, 63a can be detected in the configuration shown in FIG. Each of the remote operations includes a plurality of observation means 5, 5 a and a plurality of surgical tools as in the distal end portion 24, as necessary. Parts that can be described with reference to FIG. 1 are omitted in FIG.
[0102]
The treatment status observation means 7 calculates the coordinates of the positions of the identifiers 63 and 63a using image processing, or performs coordinate detection or coordinate calculation using a position measurement device which is one of the treatment status observation means 7. . The position measuring device may be capable of detecting a plurality of devices simultaneously, or may be a device that detects one identifier with one position measuring device. When a position measuring device that detects one identifier is used, a position measuring device is prepared for each remote operation means, and the coordinates of each identifier are detected. At this time, when the position measuring means is optical, each of the identifier and the position measuring means is set in a positional relationship in which only the identifier of the remote operation means to be measured enters the measurement range, A shielding plate or the like may be provided between them to prevent unnecessary identifiers from entering the measurement range.
[0103]
The detected coordinate information of the remote operation means 3 and 3a is transmitted to the recording means in the same manner as the control information 40 and the like.
[0104]
Thereby, it is possible to reproduce the operation of the plurality of remote operation means 3 and 3a in time synchronization, and when reproducing the operation of the remote operation means 3 and 3a, each remote operation means is reproduced. By referring to the coordinate information of 3 and 3a, it is possible to accurately reproduce the installation status between the apparatuses.
[0105]
Further, even when the reproduction of the operation is displayed using graphic means such as computer graphics, the position and orientation of the remote operation means are controlled based on the control information 40, and at the same time, the remote operation means is remotely controlled based on the coordinate information of each remote operation means. It is possible to accurately reproduce the change in the relative positional relationship of the operating means.
[0106]
Therefore, in addition to being able to accurately and easily grasp the operation of the surgical instrument and the remote operation means during treatment, it is possible to grasp the relative relationship between the remote operation means and the surgical instrument in detail and easily during the treatment. become.
[0107]
By using these examples, it is possible to store the record information 39 corresponding to various situations without being limited by the type of medical device used during the treatment or the specification of data output. It is now easier and more accurate to grasp the treatment content after surgery, and by reproducing the treatment information 41 based on the recorded information, multiple observers can analyze and examine the treatment content at the same time. It is possible to conduct information, such as explaining to the third party from the doctor in charge, etc. while confirming the treatment status and the degree of understanding with each other, flexibly reproducing and providing information according to the situation Secondary usage is possible with easy and understandable expressions. In addition, according to these effects, the use of the recorded information 39, the ease of management and maintenance, and the protection of the privacy of the patient are compatible, so that the practical use in the actual site is high and the use value of the information is improved. be able to. The intention of the surgeon's treatment regarding the treatment content can be clarified by combining the confirmation that the control of the device is functioning normally and the reproduction of the recorded information 39. Furthermore, it is possible to provide a system that is difficult to falsify but has high operational convenience, and it is possible to easily provide information that is effective and highly reliable in identifying the cause.
[0108]
【The invention's effect】
According to the present invention, since it is configured as described above, it is possible to provide a surgery support apparatus suitable for grasping and analyzing the contents of treatment operations performed after surgery.
[Brief description of the drawings]
FIG. 1 is a configuration diagram of a surgery support apparatus according to the present invention.
FIG. 2 is a schematic view of a distal end portion of a remote operation means.
FIG. 3 is a configuration example of a recording processing unit.
FIG. 4 is a configuration example using a plurality of recording means.
FIG. 5 is an example of a treatment information display screen.
FIG. 6 is a diagram showing a control operation and data flow in the control means when performing a normal operation.
FIG. 7 is a diagram showing a control operation and data flow in the control means when reproducing the operation.
FIG. 8 is a control flow for updating data based on a time code.
FIG. 9 is a conceptual diagram of treatment information organized by time code.
FIG. 10 is a conceptual diagram of treatment information composed of a plurality of file groups classified by type of treatment information.
FIG. 11 is a configuration diagram when a surgical instrument that does not perform operation control by a control unit is used.
FIG. 12 is a configuration diagram using a plurality of remote operation means.
FIG. 13 is a configuration diagram having hardware dedicated to encryption and decryption.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Operator, 2 ... Operation input means 3, 3a ... Remote operation means, 4 ... Patient 5, 5a ... Observation means, 6 ... Biological information measurement means, 7 ... Treatment status observation means, 8a, 8b, 8c, 8d, 8e ... recording means, 9 ... recording processing unit, 10a, 10b ... recording medium, 11a, 11b ... reproducing means, 12a, 12b ... display means, 13a, 13b, 13c ... transmission / reception means, 14, 14a ... holding device, DESCRIPTION OF SYMBOLS 15, 15a ... Drive part, 16 and 16a ... Holding | maintenance apparatus, 17 ... User interface, 18 ... Operation lever, 19 ... Control means, 21 ... Lens system, 22a, 22b ... Medical manipulator, 23a, 23b ... Surgical instrument, 24, 24a ... tip, 25 ... operation input operation, 26 ... operation force detection routine, 27 ... operation input means control amount calculation routine, 28 ... operation input means control routine, 29 ... position and orientation detection routine 30 ... Remote operation means control amount calculation routine, 31 ... Remote operation means control routine, 32 ... Control parameter management routine, 33 ... Operation input data, 34 ... Control amount data, 35 ... Control parameter data, 36 ... Data update management routine, 37 ... File header, 38 ... Time code, 39, 39a, 39b ... Recording information, 40 ... Control information, 41, 41a, 41b, 41c ... Treatment information, 42 ... Time code transmission unit, 43 ... Recording information shaping unit, 44 ... tamper prevention means, 45 ... position and orientation data, 48, 49, 50 ... recording means, 51 ... affected part state image, 52 ... operation state image, 53 ... graph showing transition of biological information, 54 ... heart rate display, 55 ... body temperature Display, 61 ... Data glove, 62 ... Surgical instrument, 63, 63a ... Identifier, 64 ... Patient data, 65 ... Device data, 66 ... Configuration data , 67 ... Data header, 68 ... Link data, 70 ... Decryption means, 71 ... Recorded information restoring unit, 72 ... Treatment information to be reproduced, 73 ... Encryption permission means, 74 ... Decryption permission means, 75 ... Control output signal .

Claims (13)

A remote operation means equipped with at least one of a surgical tool for treating the affected area or an observation means for observing the affected area, and operating according to an instruction from the operator;
Operation input means for an operator to instruct the remote operation means to perform an operation;
Treatment status observation means for observing the status of operating the operation input means;
And control means for controlling the remote operation means processes the operation instruction input to the operation input means,
Recording means having a recording medium for recording control information used when the control means controls the operation ;
Playback means for playing back the control information recorded on the recording medium ,
The recording means includes the operation input information input by the operation input means, the treatment status information observed by the treatment status observation means, and the biological information measured by the biological information measurement means for measuring the biological information of the patient. Having the function of recording on the recording medium in time series synchronization,
Wherein said control means has a function of controlling so as to reproduce the operation of at least one of said remote operation means or said operation inputting means based on the operation input information recorded in the recording means,
The reproduction means has a function of reproducing the treatment status information and the biological information recorded in the recording means so as to be reproduced by displaying them on the display means in synchronization with the reproduction of the operation by the control means. apparatus.   The operation support apparatus according to claim 1, wherein a plurality of types of control information input to the recording means are combined with time series information unified between information for identifying the occurrence or recording moment of each information, A surgery support apparatus that records with a recording unit and operates at least one of the remote operation unit or the operation input unit according to the time-series information based on the recorded information.   3. The surgical operation support apparatus according to claim 1, wherein identification information for identifying the content of the control information is attached to the control information input to the recording means and recorded by the recording means, and the remote operation means or When the control means controls at least one operation of the operation input means based on the recorded information, the necessary information is specified based on the identification information, and the control means reads predetermined control information to control the operation. Surgery support device having a function of performing.   The operation support apparatus according to claim 2 or 3, wherein the observation means for observing the treatment status of the affected area, and the treatment status observation means for photographing at least one of a situation in which the operation input means is operated or a situation around the patient. The time series information unified between the information for identifying the occurrence or recording moment of each information, or the identification information for identifying the contents of the information to be recorded in addition to the time series information, the observation means and the Recording means for recording in accordance with image information obtained from the treatment status observation means, content of the image information recorded by the recording means is identified by the identification information, and reproduction means for reproducing predetermined image information Display means for displaying information, and the operation of at least one of the remote operation means or the operation input means is performed based on the recorded control information. And at the same time controls based on the said image information to the display unit, the based on the time series information together recorded in the recorded information, operation support apparatus for reproducing and displaying in synchronization with the operation control.   5. The operation support apparatus according to claim 4, further comprising biological information measuring means for measuring biological information of a patient, information measured by the biological information measuring means, and identifying the occurrence or recording instant of the plurality of measured information. Recording means for recording identification information for identifying the content of information to be recorded in addition to the time series information unified between the time series information and the biological information obtained from the biological information measuring means; And a display means for displaying the reproduced information, and at least one operation of the remote operation means or the operation input means is performed based on the recorded control information. At the same time as the control based on the sequence information, and further, the image information is reproduced and displayed using the reproduction means and the display means, and at the same time, the biological information is displayed on the display means. Based on the time series information together recorded in the recording biological information, the operation support apparatus for reproducing and displaying the operation control further in synchronization with the image information playback.   6. The surgical operation support apparatus according to claim 2, wherein, based on the recorded information, at least one operation state or operation transition of the remote operation unit or the operation input unit is displayed as an image or a drawing. An operation support apparatus for displaying on a display means using a display. A remote operation means equipped with a surgical tool for treating the affected area and an observation means for observing the affected area, and operating according to an instruction from the operator;
Operation input means for an operator to instruct the remote operation means to perform an operation ;
Treatment status observation means for observing at least one of a situation in which the operation input means is operated or a situation around the patient ;
Control means for processing the operation instruction input to the operation input means to control the remote operation means;
Recording means having a recording medium for recording control information used when the control means controls the operation;
Playback means for playing back the control information recorded on the recording medium,
The recording unit is configured to measure the operation input information input by the operation input unit, the treatment status information observed by the treatment status observation unit, the affected part information observed by the observation unit, and the biological information of the patient. Having the function of recording the biological information measured by the measuring means on the recording medium in time series synchronization;
The control means has a function of controlling to reproduce at least one operation of the remote operation means or the operation input means based on the operation input information recorded in the recording means,
The reproduction means has a function of reproducing the treatment status information, the affected area information, and the biological information recorded in the recording means in a manner that is displayed and reproduced in synchronization with the reproduction of the operation by the control means. A surgical operation support device having   8. The surgery support apparatus according to claim 2, wherein the information to be recorded is encrypted in the recording unit that records at least one of the control information, the image information, and the biological information. And a reproducing unit that decrypts the encrypted information. Based on the information decrypted by the reproducing unit, the remote operation unit or the operation input unit performs at least one operation. An operation support apparatus that performs control based on time-series information, reproduces and displays the image information based on the time-series information, or reproduces and displays the biological information based on the time-series information.   9. The falsification preventing means in the surgical operation support apparatus according to claim 8, further comprising encryption and decryption means for encrypting using the encryption-dedicated key and decrypting the encrypted information using the decryption-dedicated key. The operation support apparatus in which the recording unit has an encryption-dedicated key and the reproduction unit has a decryption-dedicated key. In surgery supporting system according to claim 8 or claim 9, encrypted private key or the decryption private key of said tamperproof means, detachable encrypted authorization means or decoding permission means der Ru surgery assistance apparatus.   The operation support apparatus according to any one of claims 2 to 10, further comprising: a transmission / reception unit, wherein the transmission / reception unit is communicably connected to another transmission / reception unit, and the other transmission / reception unit includes the transmission / reception unit. Another recording means capable of recording the information received from, another reproducing means capable of reproducing the received information, or another display capable of reproducing and displaying the received information via the other reproducing means The operation support apparatus is connected to at least one of the means or another operation input means or another control means capable of controlling another remote operation means based on the received information.   The surgery support device according to any one of claims 2 to 11, wherein the remote operation means has an identifier, a position measurement device capable of measuring coordinates of the identifier in a space having a predetermined point as an origin, and Data collection means for measuring the position and orientation of an operator who handles the surgical instrument or the observation means, and the recording means outputs information output from at least one of the position measurement device or the data collection means as the control information or the data Like the image information or the biological information, the time series information is added or recorded together with the identification information in addition to the time series information, the recorded information is read by the reproduction means, and the display means is used. The output of the position measuring device or the output of the data collecting means represents the actual image or shape of the remote operation means or the operator's hand. Shape surgery supporting system for displaying with a figure indicating or a transition or change of the output. A surgical tool capable of treating the affected area or an observation means capable of observing the affected area;
An identifier possessed by the surgical instrument or the observation means;
A position measuring device capable of measuring the coordinates of the identifier in a space with a predetermined point as the origin;
Data collection means for measuring the position and orientation of an operator who handles the surgical instrument or the observation means;
Recording means for recording position measurement information output from the position measurement device , biological information output from biological information measurement means for measuring biological information of a patient, and position and orientation information output from the data collection means;
Reproducing means for reading out the information recorded by the recording means and outputting it to the display means;
The recording hand stage, the position measurement information to be recorded, the recording to the body information, and the recording medium time-series information attached to the recording information for time grasp the series relative relationship of the position and orientation information the ability to possess,
The reproduction hand stage, based on the time series information of the recording means each information recorded as an attachment to the recording information, the position measurement information, the body information, and adjust the time for reproducing the position and orientation information And a surgery support apparatus having a function of updating the screen display.

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