JP2000175935A - Medical system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To secure a medical operation of equal skill independent from the degree of skill of a doctor by providing a medical system allowing the doctor to diagnosing the patient and operating the affected part of a patient according to an instruction based on this diagnosis. SOLUTION: A picture acquiring means 1 acquires the picture of the patient 22, a display means 2 display-outputs this picture to allow the doctor 24 to diagnose the patient based on this picture and a receiving means 3 receives an instruction concerning the affected part 23 of the patient 22 to be the object of the operation and the form of the operation, which are decided by the diagnosis by the doctor 24. The means 1 acquires the picture of the patient 22 to be the object of the operation, a specifying means 11 specifies the part 23 from the body of the patient 22 based on this picture and the instruction, a control means 12 controls arms 5, 6 executing operating operation using a treating tool to execute operation to the specified affected part 23 by the form according to the instruction.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical system in which a doctor diagnoses a patient and operates an affected part of the patient in accordance with instructions based on the diagnosis.

[0002]

2. Description of the Related Art In medical treatment for diagnosing a patient and operating on the affected part, a doctor diagnoses the patient based on his / her knowledge and experience, and the doctor performs an operation on the affected part specified by his / her own hand. That is being done. For example, in a surgical operation using an endoscope, an endoscope, forceps, and the like are inserted into a body cavity through a hole formed in a patient's body wall, and various treatments are performed on an affected part in the body cavity using the forceps. Is performed by a doctor. Such an operation can be realized only by making a small hole in the patient's body wall, and thus has the advantage that the wound is small.

FIG. 4 shows an example of the above-mentioned endoscopic surgical operation. In the figure, the doctor shows the patient's body wall 31
In this example, the forceps 33 are inserted into the body cavity through the trocar tube 32 inserted into the patient, and the affected part 35 is operated using the forceps 33 while viewing the affected part 35 of the patient with the endoscope 34.

[0004] For example, Japanese Patent Application Laid-Open No. 7-194609 describes a medical master-slave manipulator capable of operating a patient with a slave arm by remotely controlling the slave arm. In the meantime, a doctor can carry out an endoscopic surgical operation with a slave arm that operates in accordance with the operation of the arm operation unit by carrying the portable arm operation unit (master arm).

[0005]

However, in the medical embodiment described above, even when the doctor directly operates the patient, for example, the doctor operates the portable arm operating section. Even in the case of operating a patient by remote control, the success of the operation depends on the skill level of the doctor in any case, and thus, there is a case where such a situation occurs. On the other hand, in diagnosing a patient, usually, it is necessary to rely on the knowledge and experience of a doctor, and the sensibility based on the experience of the doctor may greatly contribute to finding an affected part.

The present invention has been made in view of such conventional circumstances, and the diagnosis of a patient is performed based on the experience and sensitivity of a doctor, while the operation of an affected part is performed mechanically according to the doctor's instructions. By doing so, it is possible to realize an operation of equality without depending on the skill level of the doctor, etc., thereby achieving a medical system that can improve the efficiency of the entire medical treatment consisting of diagnosis and operation The purpose is to provide.

[0007]

Means for Solving the Problems To achieve the above object, a medical system according to the present invention comprises the following steps.
The doctor diagnoses the patient and operates on the affected part of the patient according to instructions based on the diagnosis. That is, for example, at the time of diagnosis, the first image obtaining means obtains an image of the patient, and the display means displays and outputs the image obtained by the first image obtaining means, thereby making the doctor make a diagnosis based on the image. Here, the doctor makes a diagnosis based on the image displayed and output by the display means, and determines the affected part of the patient to be operated on and the mode of the operation based on the diagnosis. Then, the receiving means receives an instruction regarding the affected part of the patient to be operated on and the mode of the operation determined by the doctor's diagnosis.

For example, during surgery, the second image obtaining means obtains an image of a patient to be operated on, and the specifying means performs surgery based on the image obtained by the second image obtaining means and the instruction received by the receiving means. The affected part is specified from the target patient's body, and the control means controls the arm for performing a surgical operation using the treatment tool by external control, and the received part receives the affected part specified by the specifying means by the receiving means. Surgery is performed according to the instructions.

Therefore, while the diagnosis of the patient is made based on the experience and sensitivity of the doctor, the operation of the affected part is performed mechanically in accordance with the doctor's instructions, so that the doctor does not need to perform surgery, for example. It is possible to diagnose many patients, and for example, since the operation is performed mechanically, it is possible to ensure an operation that is equally good without depending on the skill of the doctor, and from this, the diagnosis and It is possible to improve the efficiency of the entire medical treatment including the operation.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS One embodiment according to the present invention will be described with reference to the drawings. FIG. 1 shows an example of a medical system according to the present invention. The medical system of the present example shown in FIG. 1 includes an endoscope robot 1 that operates an endoscope, a display device 2 that displays and outputs an image acquired by the endoscope,
A receiving unit 3 that receives various instructions from a user, a control unit 4 that controls these processing units 1 to 3 and arms 4 and 5 described below via cables and the like, a forceps arm 5 that operates forceps, A trocar arm 6 for manipulating the trocar is provided. Further, the control unit 4 includes a specifying unit 11 and a control unit 12, which will be described later, as functional units particularly related to the present invention.

FIG. 1 shows a patient 22 placed on an operating table 21 together with the medical system of the present embodiment,
An affected part 23 of the patient 22 and a doctor 24 diagnosing the patient 22 are shown. In the present example, as one mode of the medical system according to the present invention, the doctor 24 diagnoses the patient 22 on the operating table 21 based on an image acquired by the endoscope of the endoscope robot 1, and based on the diagnosis. The control unit 4 controls the arms 5 and 6 in accordance with instructions from the doctor 24 to
Shows a case where the affected part 23 is operated.

The endoscope robot 1 is installed, for example, near the operating table 21 and has a function of operating the endoscope under the control of the control unit 4. The endoscope has, for example, a function of acquiring an image of a body cavity, and the acquired image is transmitted to the control unit 4. In FIG. 1, the endoscope is not shown. In the present example, a first image acquisition unit that acquires an image of a patient by such an endoscope function,
Second image acquisition means for acquiring an image of a patient to be operated is constituted.

The display device 2 has a function of displaying and outputting an image output from the control unit 4 on a screen. In this example, the image acquired by the endoscope described above is transmitted through the control unit 4. The display is output by the display device 2.
In the present embodiment, a display unit that allows a doctor to make a diagnosis based on the image by displaying and outputting the image acquired by the first image acquiring unit using the function of the display device 2 is provided.

The receiving unit 3 is composed of, for example, a keyboard and a mouse, and has a function of receiving various instructions from a user. Further, instructions and the like received by the receiving unit 3 are transmitted to the control unit 4. In this example,
The doctor 24 as a user receives an instruction relating to the affected part 23 of the patient 22 to be operated on and an instruction relating to the mode of operation.
And the receiving unit 3 accepts these instructions. However, the user who inputs these instructions does not necessarily need to be a doctor. For example, a person who has received instructions from a doctor may receive the instructions instead of the doctor. May be input to the reception unit 3. In this example, such a function of the receiving unit 3 constitutes a receiving unit that receives an instruction regarding an affected part of a patient to be operated on and a mode of the operation determined by a doctor's diagnosis.

The control unit 4 has a function of controlling each of the processing units 1 to 3, 5 and 6, and as described above, the control unit 4 of this embodiment specifies the affected part 23 from the body of the patient 22. And a control unit 12 for performing an operation by controlling the arms 5 and 6.

The specifying means 11 is a means for specifying the affected part from the body of the patient to be operated on the basis of the image acquired by the second image acquiring means and the instruction accepted by the accepting means. Based on the image acquired by the endoscope of the endoscope robot 1 and the instruction received by the reception unit 3, the affected part 23 is specified from the body of the patient 22 to be operated on. The control means 12 of the control unit 4 will be described later.

In the present embodiment, the control unit 4 is provided with hardware resources having, for example, a processor and a memory, and the processor executes the control program to execute the processing units 1 to 3, 5, 6 and the functional units. Although the processing performed by the processing 11 and 12 is controlled, in the present invention, for example, each functional means for executing each processing can be configured as an independent hardware circuit.

The forceps arm 5 is, for example, a robot arm installed near the operating table 21, and has a function of performing a surgical operation using the forceps by manipulating the forceps under the control of the control unit 4. Further, the forceps have a function of, for example, removing an affected part in a body cavity. In FIG. 1 described above,
Illustration of the forceps is omitted.

The trocar arm 6 is, for example, an operating table 21.
And has a function of performing a surgical operation using the trocar by manipulating the trocar under the control of the control unit 4. The trocar has a function of inserting a trocar tube by making a hole in the body wall of the patient 22, for example, and it is possible to insert forceps and the like into the body cavity through the trocar tube. In addition,
In FIG. 1, the illustration of the trocar is omitted.

In this embodiment, the arm for performing a surgical operation using a treatment tool under external control is constituted by the arm 5 for forceps and the arm 6 for trocar described above. In this example, a forceps or a trocar is used as a processing tool, but the type of the processing tool is not particularly limited. For example, a scalpel, a clip for stopping a blood vessel, and an end cutter for separating tissue. A treatment tool such as (trade name) can also be used.

The control means 12 of the control section 4 controls the arm to perform an operation on the affected part specified by the specifying means in accordance with the instruction received by the receiving means. In the example, by controlling the arm 5 for the forceps and the arm 6 for the trocar, the operation is performed on the affected part 23 specified by the specifying means 11 in a manner according to the instruction received by the receiving part 3. .

Next, an example of a procedure such as a process performed by the medical system having the above configuration and a diagnosis performed by a doctor will be described with reference to FIG. First, an example of a processing procedure in which the doctor 24 diagnoses the patient 22 and receives an instruction based on the diagnosis will be described. That is, first, the control unit 4 controls the endoscope robot 1 so that the patient 22 is controlled by the endoscope.
(Step S1), and the control unit 4 causes the control unit 4 to display and output the image on the screen of the display device 2 (step S2).

Here, the doctor 24 makes a diagnosis based on the image displayed on the screen of the display device 2, and determines the affected part 23 of the patient 22 to be operated on and the mode of the operation based on the diagnosis. In this example, the doctor 24 who made the diagnosis
Operates the reception unit 3 to input an instruction regarding the diseased part 23 determined by the diagnosis and the mode of the operation.

As a method of designating the affected part 23, for example, a part corresponding to the affected part 23 in an image displayed on the screen is marked by touching with a pen, or coordinates on the screen (for example, XY coordinates) are used. ) Can be used to specify the affected part 23. As a method of designating the operation mode, for example, a method of selecting an appropriate operation from various operation modes prepared in advance, or an appropriate operation from various operation operations prepared in advance is performed. By selecting in combination, it is possible to use a method of designating a surgical mode constituted by a combination of these surgical operations.

In response to the input from the doctor 24 as described above, the receiving unit 3 receives an instruction from the doctor 24 and transmits it to the control unit 4 (step S3). The diagnosis by the doctor 24 as described above, the determination of the affected part 23 and the mode of operation based on the diagnosis, and the input of the instruction regarding the determined affected part 23 and the mode of operation are not necessarily performed during the operation. For example, it may be performed in advance before the operation is started.

Next, an example of a processing procedure for operating the affected part 23 of the patient 22 in accordance with an instruction received from the doctor 24 will be described. That is, first, based on the image of the patient 22 obtained by the endoscope of the endoscope robot 1 by the specifying unit 11 of the control unit 4 and the instruction on the affected part 23 received by the reception unit 3, the operation of the patient 22 to be operated on is performed. For example, the position of the affected part 23 is specified from the body (step S4).

The control unit 12 of the control unit 4 controls the forceps arm 5 and the trocar arm 6 to execute a surgical operation using the forceps and the trocar. A surgical operation is performed under the endoscope in a manner according to the instruction received by the reception unit 3 with respect to 23 (step S5).

An example of the operation mode of the endoscopic surgery performed in this manner will be described with reference to FIG. In the figure, a series of surgical operations such as “insertion of trocar”, “insertion of forceps”, “operation of forceps”, “extraction of forceps”, “extraction of trocar”, and “treatment of wound” are combined. An example in which the configured operation mode is specified by the doctor 24 is shown. In the surgery of the present example, for example, the control unit 4 controls the endoscope robot 1 to constantly obtain an endoscope image in the body cavity of the patient 23 and
Is detected.

That is, the control means 12 of the control section 4
First, by controlling the trocar arm 6, a trocar tube is inserted into the body wall near the affected part 23 of the patient 22 by making a hole of, for example, about 2.5 mm (step S11).
Next, for example, insufflation gas is introduced into the body cavity to secure an operation area, and then the forceps are inserted into the body cavity of the patient 22 through the trocar tube by controlling the forceps arm 5 (step S12).

Next, the control means 12 of the control section 4 executes processing such as cutting off the affected part 23 by operating the forceps inserted into the body cavity of the patient 22 (step S13). When the operation of the forceps is completed, the control means 12 of the control unit 4 controls the forceps arm 5 to pull out the forceps from the body cavity of the patient 22 (step S14). The trocar tube is extracted from the body cavity of the patient 22 by controlling the step 6 (step S15), and then the wound is formed by making a hole of about 2.5 mm with the trocar, for example, by sticking a patch on the wound to process the wound. Perform (step S16). Although not shown in FIG. 1, the wound can be treated using an arm, for example, as in the case of a surgical operation using forceps or a trocar. Similarly, the above-described process of introducing the insufflation gas into the body cavity can be performed by controlling the trocar arm 6, for example.

As described above, in the medical system of the present embodiment,
The diagnosis of the patient can be performed by the doctor to ensure an accurate diagnosis based on the experience and sensitivity of the doctor, and the operation of the affected part can be controlled by the control unit 4, the arms 5, 6, etc. according to the doctor's instructions. Is automatically performed, it is possible to ensure an operation of an even good skill without depending on the skill of the doctor. With such a configuration, in the medical system of the present example, the efficiency of the entire medical treatment including the diagnosis and the operation can be improved.

Specifically, in the medical system of the present embodiment, for example, a doctor does not need to perform surgery, and only needs to perform diagnosis and instructions for surgery, so that many patients can be diagnosed more quickly. For example, even if the doctor is not highly skilled in the operation, a proper diagnosis can be performed on the patient by the control unit 4 or the like by performing an appropriate diagnosis.

Further, in the medical system of this embodiment, since the operation is mechanically performed by the control unit 4 or the like, for example, by providing the patient with the operation of equal goodness as described above, the reliability of the operation can be maintained at a certain level or higher. Can give
Further, for example, since the operation time can be shortened, it is also possible to reduce the burden on the patient due to the operation. Also, unlike a case where a doctor performs an operation, for example, there is no fatigue due to the operation, and since the operation can be performed at any time, for example, at night, it is possible to make the patient more susceptible to the operation.

Further, in the medical system of the present embodiment, the doctor 24 can operate by connecting the control unit 4 and the display device 2 shown in FIG. 1 using a telephone line, for example. The patient 22 can be diagnosed based on the image of the patient 22 even at a place far away from the place. Therefore, for example, the patient 22 on an isolated island
Is diagnosed by a doctor 24 at a remote location,
It is also possible to automatically perform the operation of the patient 22 on a remote island in accordance with an instruction from a remote place,
As described above, the medical system of this example can greatly contribute to medical care in a remote place.

Here, in the above embodiment, the doctor 24 is instructed by the doctor 24 based on the image of the patient 22 obtained by the endoscope.
Although the control unit 4 diagnoses the patient 2 and performs an operation by specifying the affected part 23 of the patient 22 based on the image or the like of the patient 22 acquired by the endoscope, a means for acquiring the image of the patient (No. An endoscope may not necessarily be used as the (one image acquisition unit or the second image acquisition unit), and a configuration for acquiring an image of a patient by various means such as an X-ray or an ultrasonic wave may be used.

Means for acquiring an image to be displayed to a doctor to make a diagnosis (first image acquiring means) and means for acquiring an image for identifying an affected part from the body of a patient to be operated (first image acquiring means) The two image acquisition means) are not necessarily the same as in the above embodiment, and may be different, for example. Specifically, for example, a doctor diagnoses a patient based on an image obtained by an X-ray, and receives an instruction regarding an affected part to be operated on and an operation mode,
It is also possible to use a configuration in which the affected part is specified from the body of a patient to be operated on based on an image obtained by an ultrasonic wave or an endoscope, and the operation is performed. It is only necessary that the affected part can be specified from the body of the patient to be operated on the basis of the image acquired by the acquiring means.

In the above embodiment, as a preferred embodiment, the endoscope for acquiring an image of a patient is mechanically operated by the endoscope robot 1. However, for example, the endoscope is manually operated by a doctor who makes a diagnosis. It is also possible to use a configuration in which an image of a patient is obtained by operating a mirror or the like.

Further, in the above embodiment, the mode in which the operation is performed using two arms is shown. However, in the present invention, the number of arms is not particularly limited, and may be, for example, one. There may be three or more. Further, not only a mode in which one treatment tool is handled by one arm, but also a mode in which a plurality of treatment tools are handled in a single arm in accordance with the procedure of surgery can be used.

[0039]

As described above, according to the medical system of the present invention, it is possible to ensure an accurate diagnosis based on the experience and sensibility of the doctor by making the doctor diagnose the patient. In addition, by performing the operation of the affected part mechanically in accordance with the instructions of the doctor, it is possible to ensure an operation of equal skill without depending on the skill of the doctor. Efficiency can be achieved.

[Brief description of the drawings]

FIG. 1 is a diagram showing an example of a medical system according to one embodiment of the present invention.

FIG. 2 is a flowchart illustrating an example of a procedure of a process performed by the medical system.

FIG. 3 is a flowchart illustrating an example of a procedure of a process of an endoscopic surgical operation.

FIG. 4 is a diagram illustrating an example of an endoscopic surgical operation.

[Explanation of symbols]

1. Endoscope robot, 2. Display device,
3 ··· Reception unit, 4 ·· Control unit, 5 ··· Arm for forceps,
6. Trocar arm, 11 ... Identifying means, 1
2 ·· Control means, 21 ·· Operating table, 22 ·· Patient,
23 ... affected area, 24 ... doctor,

Claims (1)

[Claims] 1. A medical system for causing a doctor to diagnose a patient and operating on an affected part of the patient in accordance with instructions based on the diagnosis, wherein the first image obtaining means obtains an image of the patient, and the first image obtaining means Display means for displaying and outputting the obtained image to a doctor for making a diagnosis based on the image, and receiving means for receiving an instruction regarding the affected part of the patient to be operated on and the mode of the operation to be determined by the doctor's diagnosis, Second image acquiring means for acquiring an image of a patient to be operated on, and specifying means for specifying an affected part from the body of a patient to be operated on the basis of the image obtained by the second image obtaining means and the instruction received by the receiving means And an arm for performing a surgical operation using the treatment tool under external control; and a receiving hand for the affected part specified by the specifying means by controlling the arm. Medical system characterized by comprising a control means for performing surgery in a manner in accordance with the instruction received by.