DE102015205463B4 - Technology for creating audio environments in the operating room - Google Patents

Abstract

Apparatus (100) for creating audio environments in an operating room (150), comprising: a plurality of portable intercom units (110) each having at least one microphone (112); a mixer (120) connected to the plurality of intercom units (110 ) is in signal exchange (122; 124) and is designed for the program-controlled signal line between the plurality of intercom units (110); a memory (130) for storing different control programs which each define the program-controlled signal line, at least one of the control programs being responsible for the signal exchange between the Limit the number of intercom units to form the audio environments; and a controller (140) which is designed to determine one of the control programs and to control the mixer (120) for the program-controlled signal line between the plurality of intercom units (110) in accordance with the specific control program, characterized in that the intercom units (110) are headphones ( 114), which are designed to suppress ambient noise, and that each intercom unit (110) is assigned a first threshold value and the intercom units or the mixer (120) are designed to suppress the signal exchange for a signal from the microphone (114) whose Level is less than the first threshold.

Description

Technical area

The present disclosure relates to the audio environment of an operating room. In particular, a device for creating audio environments in an operating room is provided.

background

During an operation there is often a high noise level in an operating room, which can briefly or periodically reach that of a busy motorway. Noises from equipment in the operating room, holding walls and the voices of many people are exemplary causes of the high noise level. However, such a background noise regularly has a negative impact on the people working in it, can cause stress and provoke errors.

The article "A Noise-Reduction Program in a Pediatric Operation Theater Is Associated With Surgeon's Benefits and a Reduced Rate of Complications: A Prospective Controlled Clinical Trial", CR Engelmann et al., Annals of Surgery, Volume 259, Issue 5, pp. 1025 -1033, detects the negative consequences of the background noise and suggests measures to reduce noise. However, conventional measures can restrict or delay processes and functions in the operating room.

The document US 2009/0299924 A1 be set. There it is essentially not about suppressing ambient noise, but rather about creating a hierarchical structure of functions and systems using a knowledge base.

The document US 2004/0153747 A1 describes threshold values for acoustic signal transmission for controlling medical systems from a distance. It is not about creating an audio environment.

The document US 2003/0130016 A1 describes the use of so-called headsets, with headphones suppressing ambient noise, but this concerns wireless signal transmission over short distances and not the creation of an audio environment for people.

The document US 2010/0052871 A1 describes the communication between patients and nursing staff in different rooms of a hospital.

Outline of the invention

The object of the present invention is to improve the background noise and / or processes in the operating room during an intervention.

For this purpose, the invention provides a device according to claim 1.

Local suppression of ambient noise by means of the intercom units in conjunction with the restricted signal line between the intercom units can be used to implement one or more audio environments with a significantly reduced noise level that are adapted to the operation using the different control programs.

The background noise can be reduced and / or individualized in terms of volume and number of sources. Not every person in the operating room needs to hear all of the sound sources in the operating room. For example, no person needs to hear the air conditioning. For example, the operating room nurse does not have to hear the anesthetist. The anesthetist, for example, does not have to hear the heart-lung machine's alarm. For example, processes in the operating room can be improved or accelerated through targeted communication.

At least one of the control programs can restrict the signal exchange compared to a fully networked signal exchange between the plurality of intercom units. As a result of the different control programs, the program-controlled signal line can form separate audio environments and / or changeable audio environments. The separate audio environments can coexist temporarily and / or simultaneously.

The signal line can comprise signal forwarding with or without signal processing. The signal line can also be referred to as signal routing.

The controller can be designed to determine the control program by means of a user interface and / or as a function of time in accordance with an operation schedule.

The controller can also be designed to recognize a voice control instruction in the signal exchange. The controller can determine or modify the control program in accordance with the recognized control instruction. For example, it is possible to switch between a communication mode and a protocol mode according to the control instruction. In protocol mode, the microphone signal can be sent to one or more intercom units recorded, for example for an operation protocol. The device can also transcribe the microphone signal by means of speech recognition, for example to create an electronic or printed protocol.

The control program can define a communication direction of the signal line and / or signal processing in the signal line. The memory can contain a variety of control programs. The control programs can be sorted in the memory according to operation types and / or operation teams.

The control can also be designed to detect personal identifiers in the operating room, for example by means of radio frequency identification (RFID). The control program can be determined as a function of one or more personal identifiers recorded in the operating room. The person registration enables a signal line that is dependent on the operation team. Furthermore, the volume and / or a faded in audio channel can be controlled as a function of the recorded person identifier.

Each intercom unit can be assigned to a signal group. The signal groups can be functional groups in the operating room. The program-controlled signal line can be designed to limit the signal exchange between the intercom units to the respectively assigned signal group.

The control program can define a hierarchy of the intercom units and / or the signal groups. Each intercom unit can be assigned to a hierarchy level. The program-controlled signal line can be designed to restrict the exchange of signals with intercom units of a high hierarchical level, for example to intercom units of the same hierarchical level and / or a next lower hierarchical level.

A matrix can be stored in the memory for each control program. The matrix can determine the respective signal line. The program-controlled signal line between two of the intercom units can be defined by a matrix entry in the matrix.

A symmetrical part of the matrix can determine the signal group assignment. An anti-symmetrical part of the matrix can determine the hierarchy.

The signal groups can overlap. Two signal groups can comprise one or more common intercom units. The common intercom unit or the common intercom units of two overlapping signal groups can be the intercom unit or the intercom units with the highest hierarchical level of all intercom units in the two signal groups.

A first threshold value can be assigned to each intercom unit. The intercom units or the mixer can be designed to suppress the signal exchange for a signal from the microphone whose level is lower than the first threshold value. The application of the first threshold is also referred to as blanking or gating.

The intercom units or the mixer can also be designed to filter or attenuate signal pulses (for example a cough, a crack or a bang). The filter can have a filter duration, a response time and / or a fall time. These can be determined according to the control program.

The mixer can also be designed to output a prerecorded audio channel by means of the headphones at least one of the intercom units. The audio channel can be a music channel. The prerecorded audio channel can be stored in the memory of the device and / or obtained as a data stream via a data network (e.g. the Internet). The audio channel can also be received by a (for example analog or digitally modulated) broadcast signal.

The mixer can also be designed to interrupt or fade out the output of the audio channel while the respective intercom unit is exchanging signals (for example while the first threshold value is exceeded). The mixer can determine a volume of the audio channel as a function of a general noise level in the operating room. The general noise level can be determined by means of a room microphone in the operating room or by averaging the signals from the microphones of the intercom units.

The mixer can also be designed to detect a state (for example an alarm state) of one or more functional units in the operating room (for example as a status signal). The device can furthermore comprise one or more pickups each for detecting the status signal of a functional unit. The consumers can have a unidirectional signal exchange with the mixer.

The functional units can include patient monitoring (for example an electrocardiograph), dosage pumps (for example syringe pumps), a ventilation unit and / or a heart-lung machine. Each of the functional units can be assigned to a signal group. An alarm signal of the functional unit corresponding to the alarm state can be output by means of the headphones of the intercom units that are assigned to the signal group of the functional unit.

The pick-up can have a microphone for capturing an acoustic signal from the functional unit. As an alternative or in addition, the functional unit can have an (for example electrically or inductively coupled) interface to the consumer. As an alternative or in addition, the pick-up can have a piezoelectric sensor for detecting the status signal. The piezoelectric sensor can be attached or attachable to the functional unit.

The headphones of at least one of the intercom units can be designed for spatial sound reproduction. The memory can store a spatial sound direction for intercom units, for example by means of the matrix entries. For example, the matrix entry can each include a component for a left and right side of the headphones. The mixer can be designed to output a signal from the microphone of one of the other intercom units in accordance with the respectively stored spatial sound direction by means of the headphones for spatial sound reproduction.

The controller can be designed to store and / or record an absolute or relative position in the operating room of at least one of the intercom units and / or the recipients. Their signal group assignment can be changed depending on the voice control instruction and / or the recorded absolute position. The controller can be designed to change the stored spatial sound direction as a function of the detected relative position.

A subset of the intercom units can be in wireless signal exchange with the mixer. The mixer can be a matrix mixer. The control program can define a bidirectional or unidirectional signal exchange for each intercom unit, which the mixer implements. The matrix entries can also determine a volume.

The device, for example the intercom units and / or the mixer, can furthermore comprise a compressor. The compressor can be designed to detect the signal level of the microphone and to reduce a control voltage of an amplifier of the microphone when a second threshold value is exceeded. A dynamic range of the signal level can be restricted by an upper limit. The upper limit can also be referred to as a limiter.

Alternatively, the routing, the gating and / or the compressor can be implemented by digital signal processing, for example by means of general processors or signal processors.

Figure list

• 1 ein schematisches Blockschaltbild eines Ausführungsbeispiels einer Vorrichtung zur Bildung von Audioumgebungen in einem Operationsraum zeigt;
• 2 eine beispielhafte Matrixdarstellung eines Speichers zur Bestimmung einer Signalleitung zeigt, die durch die Vorrichtung der 1 umsetzbar ist;
• 3 eine beispielhafte Hierarchie und eine beispielhafte Gruppenzuordnung schematisch darstellt;
• 4 ein beispielhaftes erstes Steuerprogramm mittels der Matrixdarstellung der 2 zeigt;
• 5 einen anti-symmetrischen Anteil des beispielhaften Steuerprogramms der 4 schematisch darstellt;
• 6 einen symmetrischen Anteil des beispielhaften Steuerprogramms der 4 schematisch darstellt; und
• 7 ein beispielhaftes zweites Steuerprogramm mittels der Matrixdarstellung der 2 zeigt.

Further features of the invention are explained on the basis of exemplary embodiments with reference to the accompanying drawings, of which

• 1 shows a schematic block diagram of an embodiment of an apparatus for forming audio environments in an operating room;
• 2 FIG. 11 shows an exemplary matrix representation of a memory for determining a signal line which is carried out by the apparatus of 1 is feasible;
• 3 schematically illustrates an exemplary hierarchy and an exemplary group assignment;
• 4th an exemplary first control program using the matrix representation of 2 shows;
• 5 an anti-symmetrical portion of the exemplary control program of the 4th represents schematically;
• 6th a symmetrical portion of the exemplary control program of the 4th represents schematically; and
• 7th an exemplary second control program using the matrix representation of 2 shows.

Detailed description

1 shows schematically an apparatus 100 for creating audio environments in an operating room 150 . The device 100 comprises a large number of subscriber units. The subscriber units are each used as intercom units 110 , Customers 116 or trained as listeners.

Any intercom unit 110 can function, at least alternately, as an audio source and for audio output. The intercom units 110 each have a headphone 112 and at least one microphone 114 on. The headphone 112 and the microphone 114 can each be mechanically connected to a headset. Alternatively, at least the microphone 114 be integrated into surgical clothing. Preferably, each person working in the operating room wears an intercom unit.

The takers 116 can only function as an audio source. The takers 116 are each on stationary or portable functional units 152 in the operating room 150 attachable or arranged. For example, customers include 116 a microphone 118 , an electrical interface or an inductive coupling to the respective functional unit 152 .

The device 100 further comprises a mixer 120 . The participant units 110 and 116 stand with the mixer 120 in signal exchange. The signal exchange is wired (shown schematically with reference symbols 122 ) and / or radio-based (shown schematically with reference symbols 124 ). In one embodiment, the signal exchange with stationary participants is wired and with mobile participants is radio-based. In another embodiment, there are consumers 116 wired. The signal exchange with intercom units 110 is radio based.

The mixer 120 is for the program-controlled signal line between the large number of subscriber units 110 and 116 educated. The functionality of the signal line is also referred to as routing.

The device 100 further comprises a memory 130 for storing different control programs, each of which defines the program-controlled signal line. At least one of the control programs restricts the exchange of signals between the plurality of subscriber units in order to form the audio environments. The restriction means that not every intercom unit 110 listens to all audio sources.

One control 140 the device 100 is designed to determine one of the control programs and the mixer 120 for the program-controlled signal line between the large number of subscriber units 110 and 116 to control according to the particular control program.

The headphones 112 are designed for passive noise suppression, for example in a high frequency range, for example in the frequency range above 3000 Hz. The headphones 112 can be worn on or in one or both ears.

In one embodiment, the headphones are also designed to actively suppress ambient noise, for example in a low frequency range, for example in the frequency range from 100 Hz to 400 Hz and / or in a medium frequency range, for example in the frequency range from 400 Hz to 3000 Hz headphone 114 built-in microphone, an ambient noise is recorded and from this according to an acoustic transfer function of the headphones 114 calculates the amount of ambient noise that would remain in the ear. To compensate for this component, an anti-phase sound signal is used in the headphones 114 generated.

Through the combination of noise suppression and program-controlled signal lines, targeted audio environments can be created that improve the background noise for each participant. The audio environments can be adapted to the processes and functions in the operating room. The adaptation can take place once by determining a control program and / or during the intervention.

Alternatively or in addition, the headphones 112 and the microphone 114 of the intercom units 110 in each case or in part according to the document US 2004/0037444 A1 be trained. The intercom units 110 can in a protective suit according to the document US 2007/0028372 A1 be integrated.

1 shows an exemplary arrangement of the subscriber units 110 and 116 in the operating room 150 . The signal line, or the control program for defining the signal line, can depend on the spatial arrangement of the subscriber units 110 and or 116 depend. For example, an operation team is divided into groups that neither hear nor need to hear each other.

The microphones 114 only switch on when someone is speaking. At least individual participants can also choose from various music channels that are connected to the mixer 120 are provided. The mixer 120 is designed to be used on the respective intercom unit 110 to interrupt, fade out or play back the played music channel more quietly when speaking at the respective intercom unit or when the signal from a microphone of another intercom unit is played back according to the signal line.

The in the embodiment of 1 The intercom units shown can be assigned to the following people: A - surgeon, B - first assistant doctor, C - second assistant doctor, D - cardiological medical technician, E - operating room nurse, F - springer, G - anesthesiologist, H - anesthesiology nurse / nurse , and I - guest.

In the in 1 shown embodiment of the device 100 the guest I is only a headset 112 and no microphone 114 assigned (listening participant). Guest I is an example of a subscriber unit that only has audio output for the mixer 120 is. The functional units 152 are examples of subscriber units that only have audio sources for the mixer 120 are.

For example, in the case of a local anesthetic procedure, additional headphones can be used 112 be assigned to the patient. Unless the headphones 112 If the patient complains about the surgical area, it does not have to be sterile.

The headphone 112 of the patient is in unidirectional signal exchange with the mixer 120 , for example to play music. The music playback will be interrupted by instructions from the surgeon. Furthermore, for example in the case of a neurological intervention, the patient can have an intercom unit 110 be assigned for intraoperative function monitoring.

Furthermore, the device 100 for external communication with a participant outside the operating room 150 be trained. The external connection can be made via a landline telephone network, a cellular network and / or the Internet. For example, depending on the functional units used 152 a system technician J using the intercom 110 be consulted. As an alternative or in addition, there is an operating room lock in the operating room 150 Equipped with an intercom, also with the mixer 120 is in signal exchange.

The functional units 152 can include the functions of patient monitoring, ventilation, heart-lung machine (HLM) and, depending on the case, metering pumps (which are also referred to as "perfusor tree").

2 shows an embodiment of a matrix 200 . The matrix 200 represents a control program that is stored in memory 130 is stored and the signal line through the mixer 120 certainly. Matrix entries 202 the matrix determine whether (and optionally how) the intercom units 110 through the mixer 120 are coupled.

Thus, a matrix entry G _{i, j} = 0 determines that the intercom unit j does not hear the intercom unit i. In one embodiment, a matrix entry G _{i, j} > 0 determines the volume with the intercom unit j that intercom unit i hears. In the case of multi-channel playback, for example through stereo headphones 112 , each matrix entry can determine a coupling value for each channel. 2 shows coupling values for the channels left (L) and right (R).

The multi-channel signal line enables directional listening. For example, if doctor A is always to the right of doctor B, he will hear this more intensely in the corresponding ear. A visually perceived arrangement thus corresponds to the acoustic perception.

In a first expanded exemplary embodiment, the matrix entry determines 202 furthermore a signal processing, for example parameters for a gate, a compressor, a limiter, a linear amplification and / or an equalizer.

The gate suppresses a signal line below a minimum level. For example, breathing sounds can be masked out. The limiter restricts the signal line to a maximum level. For example, coughing or sneezing sounds can be suppressed. The compressor determines a dynamic range (volume range). The level of the signal from the microphone 114 is compressed by a non-linear function to the level of the signal from the headphones 112 . A loud conversation can be muffled. A whisper can be amplified by the non-linear function. The compressor enables a homogeneous sound.

In a second expanded exemplary embodiment (which can be combined with the first), the matrix entry determines 202 a frequency-dependent transfer function, for example for the relative spatial positioning of the sound source by means of binaural sound reproduction.

Furthermore, the signal from the microphone 114 on the respective headphones 112 are output, which is done by positive diagonal entries in the matrix 200 can be represented. The amount of the diagonal entry can determine the volume in such a way that a self-perception corresponds to a state without headphones 112 corresponds to.

The signals of individual or all microphones can be recorded before, during and / or after the intervention, for example for logging purposes. Digital recording preferably employs audio data compression. For example, 8 hours of audio recording can be stored at 100MB to 200MB.

As an alternative or in addition, the controller 140 (e.g. with effect for a single or multiple intercom units 110 or for the entire device 100 ) can be switched between a communication mode and a protocol mode. The audio signal from the microphone 114 of the intercom unit concerned 110 is recorded in the log mode in a separate file. The file bears a personal identifier, the of the intercom unit concerned 110 assigned.

As an alternative or in addition, it is possible to switch to a command mode in which the audio signal of the microphone 114 of the intercom unit concerned 110 is not forwarded according to the signal line. Control instructions in the audio signal of the microphone 114 of the intercom unit concerned 110 are controlled by the controller 140 determined by means of speech recognition of control terms and / or numeric numeric words. The control 140 changes the control program, for example individual matrix entries 202 , according to the specific tax instruction.

The change between the modes is carried out by speech recognition of key terms (for example "log recording" for the log mode, "communication" for the communication mode and "program change" for the command mode). As an alternative or in addition, changes in the modes are triggered by a push button, proximity sensor and / or gesture recognition. The snap fastener can be attached under clothing. The proximity sensor can be a capacitive sensor. The gestures can be detected optically, for example by means of a camera in the visible or infrared spectrum.

3 shows intercom units 110 that with digits 1 to 7th are numbered. The intercom units 2 , 4th and 5 as 3 , 6th and 7th are signal groups 302 or. 304 assigned. There is also a hierarchy of intercom units 110 Are defined. Different hierarchy levels 306 are shown vertically. The group assignment 308 is shown horizontally.

The program-controlled signal line corresponds to the hierarchy. In this way, the intercom unit 1 is heard by every other intercom unit 2 to 7. Conversely, the intercom unit 1 only hears the next lower hierarchy level, namely the intercom units 2 and 3. The intercom unit 7 only hears (for example for the in 1 shown guest I).

4th shows a more detailed first embodiment of the matrix 200 a control program that the hierarchy 306 and the group assignment 308 considered. To simplify the illustration, the matrix entries determining the signal line are included 202 binary. A matrix entry “0” at position i, j determines that no signal is passed from intercom unit i to intercom unit j. A matrix entry “1” at position i, j specifies that the mixer 120 forwards the signal from the intercom unit i to the intercom unit j.

The hierarchy 306 is in the matrix 200 of the control program. 5 shows the anti-symmetrical part 500 the matrix 200 the 4th . The anti-symmetrical part 500 is represented by a lower triangular matrix. The entries 502 have the values G _{j, i} -G _{i, j} . The sum over the j-th column indicates the asymmetry between being heard and listening. The sum is a measure of the hierarchy level of the intercom unit j The maximum determines the intercom unit with the highest hierarchy level. In the example of the matrix 200 the 4th the intercom unit j _max = 1 has the highest hierarchy level 4th .

Furthermore, the group assignment is 308 in the matrix 200 of the control program. 6th shows the symmetrical part 600 the matrix 200 the 4th . The symmetrical part 600 is represented by a lower triangular matrix. The entries 602 have the values G _{i, j} + G _{j, i} . After deleting the column j _{max of} the top of the hierarchy (shown in dashed lines in 6th ), are the signal groups 302 and 304 by entries other than zero 602 in the symmetrical part 600 certainly.

7th Figure 3 shows a more detailed second embodiment of the matrix 200 . The matrix 200 determines unidirectional signal lines 702 . That’s the matrix 200 not square. Above coding of hierarchy 306 and group assignment 308 is applicable to the square sub-matrix of the bidirectional signal lines. The square sub-matrix includes in the case of the matrix 200 in 7th the top 9x9 matrix entries 202 .

The one due to the non-square overhang of the matrix 200 certain unidirectional signal lines 702 affects music channels. The music channel individually determined by the control program is displayed in the assigned signal group on the respective headphones when there is no communication 112 issued. A residual noise can be masked by the music output.

Furthermore, the intercom units 110 the participant at the operating table is wired. This enables better audio quality to be achieved. The cable routing does not restrict participants without a change of position.

The intercom units 110 Individual participants, for example 3 or 4 intercom units, are connected to the mixer via a radio link 120 connected. This affects the intercom units 110 of the anesthesiologist, the anesthesiology nurse and the jumper.

The control program is in memory 130 stored before the intervention and, if necessary, is saved using the control 140 loaded and through the mixer 120 implemented. Each participant is assigned their own volume and individual sound mix. The signal line is in each case through separate buses of the mixer 120 realized.

The device is compatible with the use of surgical robots, for example a Da Vinci surgical system.

Claims (12)

Apparatus (100) for creating audio environments in an operating room (150), comprising: a plurality of portable intercom units (110) each having at least one microphone (112); a mixer (120) which is in signal exchange (122; 124) with the plurality of intercom units (110) and is designed for the program-controlled signal line between the plurality of intercom units (110); a memory (130) for storing different control programs which each define the program-controlled signal line, at least one of the control programs restricting the exchange of signals between the plurality of intercom units to form the audio environments; and a controller (140) which is designed to determine one of the control programs and to control the mixer (120) for the program-controlled signal line between the plurality of intercom units (110) in accordance with the specific control program, characterized in that the intercom units (110) Have headphones (114), which are designed to suppress ambient noise, and that each intercom unit (110) is assigned a first threshold value and the intercom units or the mixer (120) are designed to exchange signals for a signal from the microphone (114) suppress whose level is lower than the first threshold value. Device according to Claim 1 wherein the controller (140) is further designed to recognize a voice control instruction in the signal exchange and to determine or modify the control program in accordance with the recognized control instruction. Device according to Claim 1 or 2 , wherein the control program defines a communication direction of the signal line and / or a signal processing in the signal line. Device according to one of the Claims 1 to 3 , each intercom unit (110) being assigned to a signal group (302; 304). Device according to Claim 4 , wherein the program-controlled signal line is designed to limit the signal exchange between the intercom units to the respectively assigned signal group. Device according to Claim 5 , wherein the control program defines a hierarchy (306) of the intercom units (110) and / or the signal groups (302; 304). Device according to one of the Claims 1 to 6th wherein a matrix (200) is stored in the memory (130) for each control program, the program-controlled signal line between each two of the intercom units (110) being defined by a matrix entry in the matrix (200). Device according to Claim 6 and 7th , an anti-symmetrical component (500) of the matrix (200) determining the hierarchy (306) and / or a symmetrical component (600) of the matrix (200) determining the signal group assignment (308). Device according to one of the Claims 1 to 8th wherein the mixer (120) is further designed to output a prerecorded audio channel (702) at least one of the intercom units (110) by means of the headphones (112). Device according to one of the Claims 1 to 9 wherein the mixer (120) is further designed to detect an alarm state of one or more functional units (152) of the operating room (150). Device according to Claim 10 , further comprising a piezoelectric sensor which is attached or attachable to the functional unit for detecting the alarm state. Device according to one of the preceding claims, wherein the controller (140) is designed to switch between a communication mode and a protocol mode, and the switchover takes place by speech recognition of key terms.

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