JP2006280591A - Surgery supporting system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To support implementation of smooth techniques by easily and assuredly detecting hollow viscera unrelated to treatment. <P>SOLUTION: An endoscope system 1 as a surgery supporting system comprises a surgical device 2 for offering treatment to a treatment section in the body of a patient 5 with a laparotomy technique and a hollow viscus shape detection device 3 used to support (aid) the laparotomy technique. The hollow viscus shape detection device 3, for example, inserts a probe 15 as a hollow viscus insertion probe into a blood vessel of the patient 5 lying on a bed 4 and is used as a vessel position informing means when the technique is implemented. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a surgery support apparatus that supports surgery using a magnetic field generation element and a magnetic field detection element.

  2. Description of the Related Art In recent years, an endoscope shape detecting apparatus that detects the shape of an endoscope inserted into a body or the like using a magnetic field generating element and a magnetic field detecting element and performs display by a display means has come to be used.

  For example, Japanese Patent Application Laid-Open No. 2003-290129 discloses an apparatus that detects an endoscope shape using a magnetic field and displays the detected endoscope shape. Then, a plurality of magnetic field generating elements arranged at predetermined intervals in the insertion portion of the endoscope inserted into the body are driven to generate a magnetic field around the elements, and each magnetic field generating element is arranged by a magnetic field detecting element arranged outside the body. A three-dimensional position is detected, a curve continuously connecting the magnetic field generating elements is generated, and a modeled three-dimensional image of the insertion portion is displayed on the display means.

  By observing the image, the surgeon can grasp the position of the distal end portion of the insertion portion inserted into the body, the insertion shape, and the like, and can smoothly perform the insertion operation to the target site.

On the other hand, in a surgical operation, a high-frequency cautery device, an ultrasonic treatment device, or the like is used when performing treatment on an affected organ.
JP 2003-290129 A

  However, luminal organs that are unrelated to the affected organ, such as blood vessels and ureters, are distributed in the vicinity of the treatment site of the affected organ. Although it is necessary to perform treatment while avoiding the hollow organs, these hollow organs are often hidden in the affected organs, and there is a problem that it is difficult to visually recognize and the procedure cannot be performed smoothly.

  The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a surgical operation support apparatus that can easily and reliably detect a luminal organ unrelated to a procedure and support a smooth procedure. It is said.

The surgical operation support device of the present invention is
A probe in which a plurality of one of a magnetic field generating element and a magnetic field detecting element are arranged inside an insertion portion to be inserted into the body of a subject;
A treatment instrument in which one or a plurality of the one element is disposed in the vicinity of a treatment section for performing treatment on a target site of the subject;
The other elements of the magnetic field generating element and the magnetic field detecting element are arranged outside the subject, and the respective positions of the one element arranged on the probe and the one element arranged on the treatment tool are determined. And detecting means for detecting using the position of the other element as a reference.

  According to the present invention, there is an effect that it is possible to easily and surely detect a luminal organ irrelevant to a procedure and to support a smooth procedure.

  Embodiments of the present invention will be described below with reference to the drawings.

  1 to 12 relate to a first embodiment of the present invention, FIG. 1 is a configuration diagram showing a configuration of a surgical system, FIG. 2 is a diagram showing a configuration of the probe of FIG. 1, and FIG. 3 is a diagram of the surgical tool of FIG. FIG. 4 is a diagram showing an example of arrangement of coils built in the coil unit of FIG. 1, FIG. 5 is a diagram showing the configuration of the luminal organ shape detecting device of FIG. 1, and FIG. 6 is a diagram of FIG. FIG. 7 is a diagram showing a detailed configuration of the reception block of FIG. 5, FIG. 8 is a timing diagram showing the operation of the 2-port memory, etc. of FIG. 6, and FIG. 9 is a diagram of FIG. FIG. 10 is an explanatory diagram for explaining the processing of FIG. 9, FIG. 11 is a diagram showing a configuration of a first modification of the probe of FIG. 1, and FIG. 12 is a diagram for explaining the operation of the luminal organ shape detecting device. It is a figure which shows the structure of the 2nd modification of this probe.

  As shown in FIG. 1, a surgical operation system 1 as a surgical operation support device in the present embodiment is used for a surgical device 2 for performing treatment on a treatment site in the body of a patient 5 by a laparotomy technique, and for assisting (assisting) a laparotomy technique. A luminal organ shape detecting device 3, and this luminal organ shape detecting device 3 inserts a probe 15 as a luminal organ insertion probe into, for example, a blood vessel of a patient 5 lying on a bed 4 to perform a laparotomy technique. Used as blood vessel position notification means.

  The surgical apparatus 2 includes, for example, a high-frequency ablation apparatus 103 that supplies a high-frequency current, and a surgical tool 100 as a treatment tool that cauterizes a treatment site in the body of the patient 5 using the high-frequency current from the high-frequency ablation apparatus 103. The cautery device 103 and the surgical tool 100 are connected by a cable 102.

  As shown in FIG. 2, the probe 15 is composed of a thin and flexible guide wire 15a. Inside the guide wire 15a, for example, 16 magnetic field generating elements (or source coils) extend from the distal end to the proximal end. ) 14a, 14b,..., 14p (hereinafter represented by reference numeral 14i: the number of source coils is not limited to 16). As shown in FIG. 3, the surgical tool 100 includes a magnetic field generating element (or source coil) 140 in the vicinity of the distal end where the electrode 110 serving as a treatment portion is provided.

  Returning to FIG. 1, the source cable 16 extended from the rear end of the probe 15 is a detection device (also referred to as a device main body) serving as a detection means whose connector 16 a at the rear end is the device main body of the luminal organ shape detection device 3. 21 is detachably connected. Similarly, the source cable 101 extended from the rear end of the surgical tool 100 has a rear end connector 101 a detachably connected to the detection device 21 of the luminal organ shape detection device 3.

  The source coil 14i, 140 generates a magnetic field by applying a drive signal from the detection device 21 side to the source coils 14i, 140 as magnetic field generating means via the source cables 16, 101 as drive signal transmitting means.

  The detection device 21 disposed near the bed 4 on which the patient 5 lies is provided with a (sense) coil unit 23 that can move up and down in the vertical direction. A detection element (sense coil) is arranged.

  More specifically, as shown in FIG. 4, for example, sense coils 22 a-1, 22 a-2, 22 a-3, and 22 a-4 whose center Z coordinate is the first Z coordinate, for example, facing the X axis, Sense coils 22b-1, 22b-2, 22b-3, 22b-4 facing the Y axis, which is a second Z coordinate whose center Z coordinate is different from the first Z coordinate, and the center Z coordinate is 12 sense coils (hereinafter referred to as reference numeral 22j) of sense coils 22c-1, 22c-2, 22c-3, 22c-4 facing the Z axis which is a third Z coordinate different from the first and second Z coordinates. Is represented).

  The sense coil 22j is connected to the detection device 21 via a cable 23a from the coil unit 23. The detection device 21 is provided with an operation panel 24 for a user to operate the device. The detection device 21 includes a liquid crystal monitor 25 as display means for displaying the detected luminal organ shape (hereinafter referred to as a probe image) and the tip position of the surgical tool 100 (hereinafter referred to as a tool tip image). Located at the top.

  As shown in FIG. 5, the luminal organ shape detection device 3 includes a transmission block 26 for driving the source coils 14i and 140, a reception block 27 for receiving a signal received by the sense coil 22j in the coil unit 23, and a reception block. The control block 28 is configured to process the signal detected in the block 27.

  As shown in FIG. 6, in the probe 15, as described above, 16 source coils 14i for generating a magnetic field are arranged at a predetermined interval, and the source coil 14i and the source coil 140 are transmitted. It is connected to 17 source coil drive circuits 31 that generate drive signals having different frequencies constituting the block 26.

  The source coil drive circuit unit 31 drives each source coil 14 i of the probe 15 and the source coil 140 of the surgical tool 100 with sinusoidal drive signals having different frequencies, and the respective drive frequencies are internal to the source coil drive circuit unit 31. Are set by drive frequency setting data storage means (not shown) or drive frequency setting data (also referred to as drive frequency data) stored in the drive frequency setting data storage means. This drive frequency data is stored in the source coil drive circuit unit 31 via a PIO (parallel input / output circuit) 33 by a CPU (central processing unit) 32 which is a shape estimation means for performing probe shape calculation processing in the control block 28. It is stored in drive frequency data storage means (not shown).

  On the other hand, twelve sense coils 22 j in the coil unit 23 are connected to a sense coil signal amplification circuit unit 34 that constitutes a reception block 27.

  In the sense coil signal amplifying circuit section 34, as shown in FIG. 7, twelve single-core coils 22k constituting the sense coil 22j are respectively connected to the amplifying circuit 35k and 12 processing systems are provided. After a minute signal detected by the heart coil 22k is amplified by the amplifier circuit 35k, the filter circuit 36k has a band through which a plurality of frequencies generated by the source coil group passes, and unnecessary components are removed and output to the output buffer 37k. An ADC (analog / digital converter) 38k converts the control block 28 into a readable digital signal.

   The reception block 27 includes a sense coil signal amplification circuit unit 34 and an ADC 38k. The sense coil signal amplification circuit unit 34 includes an amplification circuit 35k, a filter circuit 36k, and an output buffer 37k.

  Returning to FIG. 6, the 12 outputs of the sense coil signal amplifying circuit unit 34 are transmitted to the 12 ADCs 38 k and supplied from the control signal generating circuit unit 40 which is a numerical data writing means in the control block 28. It is converted into digital data having a predetermined sampling period by a clock. This digital data is written into a 2-port memory 42 as data output means via a local data bus 41 by a control signal from the control signal generation circuit unit 40.

  As shown in FIG. 7, the 2-port memory 42 is functionally composed of a local controller 42a, a first RAM 42b, a second RAM 42c, and a bus switch 42d. The ADC 38k starts A / D conversion by the A / D conversion start signal from the controller 42a, and the bus switch 42d alternately reads the first RAMs 42b and 42c while switching the RAMs 42b and 42c by the switching signal from the local controller 42a. Used as a memory, data is always taken in after a power-on by a write signal.

  Returning to FIG. 6 again, the CPU 32 transfers the digital data written in the 2-port memory 42 by the control signal from the control signal generation circuit 40 from the local data bus 43, the PCI controller 44 and the PCI bus 45 (see FIG. 7). Frequency component corresponding to the driving frequency of each source coil 14 i and source coil 140 by performing frequency extraction processing (fast Fourier transform: FFT) on the digital data using the main memory 47. Then, the spatial position coordinates of each source coil 14i provided in the probe 15 and the source coil 140 of the surgical tool 100 are calculated from each digital data of the separated magnetic field detection information.

  Further, the insertion state of the probe 15 and the tip position of the surgical tool 100 are estimated from the calculated position coordinate data, and display data forming a probe image and a tool tip image is generated and output to the video RAM 48. The data written in the video RAM 48 is read by the video signal generation circuit 49, converted into an analog video signal, and output to the liquid crystal monitor 25. When this analog video signal is input, the liquid crystal monitor 25 displays a probe image and a tool tip image on the display screen.

  In the CPU 32, magnetic field detection information corresponding to each source coil 14i and source coil 140, that is, electromotive force (amplitude value of a sine wave signal) and phase information generated in the single core coil 22k constituting each sense coil 22j is calculated. The The phase information indicates the polarity ± of the electromotive force.

  The operation of this embodiment configured as described above will be described.

  When the probe 15 is inserted into the blood vessel of the patient 5 and an abdominal procedure for applying treatment to the treatment site in the patient 5 using the surgical tool 100 is started (see FIG. 1), as shown in FIG. In S <b> 1, the detection device 21 of the luminal organ shape detection device 3 detects the position of each source coil 14 i of the probe 15. Subsequently, in step S <b> 2, the detection device 21 detects the position of the source coil 140 of the surgical tool 100.

  Next, in step S3, the detection device 21 generates a probe image and a tool tip image based on the detected position information, and in step S4, as shown in FIG. 10, the probe image 150 and the tool tip image 151 are displayed on the monitor 25. Is displayed.

  This process is repeated until the end of the procedure is detected in step S5.

  As described above, in this embodiment, the positional relationship between the blood vessel through which the probe 15 is inserted and the distal end of the surgical tool 100 can be clearly displayed by the probe image 150 and the tool distal end image 151 on the monitor 25. Even if the surgeon cannot easily see the blood vessel to be noted when performing treatment on the treatment site, the operator can easily recognize the blood vessel by visually recognizing the positional relationship between the probe image 150 and the tool tip image 151. And the procedure can be supported appropriately.

  In this embodiment, the plurality of source coils 14i are arranged on the probe 15 inserted into the blood vessel or the like to detect the shape of the blood vessel. However, the present invention is not limited to this, and as shown in FIG. A plurality of source coils 14i may be arranged inside to detect the shape of the blood vessel. In addition, as shown in FIG. 12, a plurality of source coils 14 i may be arranged not on the side wall of the hollow catheter 160 but on the outer periphery of the catheter 160. That is, the luminal organ insertion probe may be the catheter 160 shown in FIG.

  In this embodiment, a blood vessel has been described as an example of a luminal organ. Needless to say, a luminal organ, a bile duct, an intestinal tract, and the like can be used as a luminal organ whose shape is detected according to a procedure.

  When the luminal organ is a bile duct, intestinal tract, or the like, instead of the probe 15, an endoscope capable of shape detection disclosed in Japanese Patent Application Laid-Open No. 2003-290129 or the like can be used as a luminal organ insertion probe.

  FIGS. 13 to 17 relate to the second embodiment of the present invention, FIG. 13 is a diagram showing the configuration of the surgical tool, and FIG. 14 shows the operation of the luminal organ shape detecting device when the surgical tool of FIG. 13 is used. FIG. 15 is a first explanatory diagram for explaining the processing of FIG. 14, FIG. 16 is a second explanatory diagram for explaining the processing of FIG. 14, and FIG. 17 is a third explanation for explaining the processing of FIG. FIG.

  Since the second embodiment is almost the same as the first embodiment, only different points will be described.

  As shown in FIG. 13, the surgical tool 100 of the present embodiment has a plurality of at least two source coils 140 and 141 arranged along the longitudinal axis in the vicinity of the tip where the electrode 110 is provided. By detecting the positions of the two source coils 140 and 141, the tip position of the surgical tool 100 and the orientation of the surgical tool 100 are detected. Other configurations are the same as those of the first embodiment.

  The operation of this embodiment configured as described above will be described.

  When the probe 15 is inserted into the blood vessel of the patient 5 and an abdominal procedure for applying treatment to the treatment site in the patient 5 using the surgical tool 100 is started (see FIG. 1), as shown in FIG. In S <b> 11, the detection device 21 of the luminal organ shape detection device 3 detects the position of each source coil 14 i of the probe 15. Subsequently, in step S <b> 12, the detection device 21 detects the positions of the source coils 140 and 141 of the surgical tool 100.

  Next, in step S13, the detection device 21 generates a probe image and a tool tip image based on the detected position information, and in step S14, as shown in FIG. 15, the probe image 150 and the tool tip image 151a are displayed on the monitor 25. Is displayed.

  In this embodiment, since the orientation of the surgical tool 100 is calculated by the source coils 140 and 141, the tool tip image 151a is an image that shows the position and orientation of the surgical tool 100 as shown in FIG. Yes.

  In step S15, the detection device 21 calculates the shortest distance L between the probe image and the tool tip, and displays distance information 201 indicating the distance L on the monitor 25 in step S16 as shown in FIG.

  Next, in step S17, the detection device 21 determines whether the distance L is less than the predetermined distance L0. If the distance L is less than the predetermined distance L0, as shown in FIG. 17 in step S18, as shown in FIG. A warning display process for displaying warning information 202 indicating that the tool 100 is approaching on the monitor 25 is executed.

  This process is repeated until the end of the procedure is detected in step S19.

  As described above, in this embodiment, in addition to the effects of the first embodiment, the direction of the surgical tool 100 can be visually recognized by the tool tip image 151a, so that the operator recognizes the approach state between the blood vessel and the surgical tool 100. It becomes possible.

  Further, since the distance information 201 and the warning information 202 are displayed on the monitor 25, the approaching state can be recognized more reliably.

  If the distance L is less than the predetermined distance L0, the warning information 202 is displayed on the monitor 25. However, a warning may be given by an audio signal through a speaker (not shown) or a light emitting means (not shown) (for example, provided in the detection device 21). A warning may be issued by emitting a lamp or LED.

  18 and 19 relate to the third embodiment of the present invention, FIG. 18 is a block diagram showing the configuration of the surgical system, and FIG. 19 is a flowchart for explaining the operation of the luminal organ shape detecting device of FIG.

  Since the third embodiment is almost the same as the second embodiment, only different points will be described, and the same components are denoted by the same reference numerals and description thereof will be omitted.

  In this embodiment, as shown in FIG. 18, the detection device 21 of the luminal organ shape detection device 3 outputs the output of the high-frequency cauterization device 103 to the control cable 300 according to the approach state between the blood vessel and the surgical tool 100. Control through. Other configurations are the same as those of the second embodiment.

  The operation of this embodiment configured as described above will be described.

  As shown in FIG. 19, steps S1 to S18 are the same as those in the second embodiment. In this embodiment, after the warning display process in step S18, the detection device 21 detects the probe image and the tool in step S21. It is determined whether or not the distance L to the tip is less than the limit minimum distance Lmin that is shorter than the predetermined distance L0. If it is determined that the distance is less than the minimum minimum distance Lmin, the detection device 21 controls the output stop of the high-frequency cauterization device 103 via the control cable 300 in step S22.

  Other processes are the same as those in the second embodiment, and this process is repeated until the end of the procedure is detected in step S19.

  As described above, in this embodiment, in addition to the effect of the second embodiment, when the blood vessel and the distal end of the surgical tool 100 become less than the minimum minimum distance Lmin shorter than the predetermined distance L0, the output of the high-frequency cautery device 103 can be stopped. it can.

  20 to 22 relate to the fourth embodiment of the present invention, FIG. 20 is a block diagram showing the configuration of the surgical system, FIG. 21 is a flowchart for explaining the operation of the luminal organ shape detecting device of FIG. 20, and FIG. It is explanatory drawing explaining the process of 21. FIG.

  Since the fourth embodiment is almost the same as the third embodiment, only different points will be described, and the same components are denoted by the same reference numerals and description thereof will be omitted.

  In the first to third embodiments, the laparotomy technique has been described as an example. In this embodiment, an embodiment applied to a minimally invasive laparoscopic technique will be described.

  As shown in FIG. 20, this embodiment includes a laparoscope 400 that is inserted into the abdominal cavity through a trocar (not shown). In this embodiment, the surgical tool 100 is also inserted into the abdominal cavity through a trocar (not shown).

  In the laparoscope 400, a light guide (not shown) is inserted, and the light guide transmits illumination light from the light source unit in the video processor 401, and transmits illumination light transmitted from an illumination window provided at the distal end of the insertion unit. The light is emitted to illuminate the target site of the patient 5 and the like. An object such as an illuminated target part is imaged on the eyepiece by an objective lens and a relay lens attached to an observation window provided adjacent to the illumination window. A camera head 402 is detachably provided at the image formation position, and an image is formed on an image sensor (CCD) disposed on the camera head 402, and the image sensor performs photoelectric conversion.

  The photoelectrically converted signal is subjected to signal processing by a video signal processing unit in the video processor 401 to generate a standard video signal, which is displayed on an image observation monitor 403 connected to the video processor 401. The video processor 401 outputs endoscopic image data of a subject such as a target region to the detection device 21 of the luminal organ shape detection device 3. Other configurations are the same as those of the third embodiment.

  The operation of this embodiment configured as described above will be described.

  When the probe 15 is inserted into the blood vessel of the patient 5, the laparoscope 400 and the surgical tool 100 are guided to the treatment site in the patient 5 through the trocar, and the treatment by the laparoscopic procedure is started, as shown in FIG. In step S31, the detection device 21 of the luminal organ shape detection device 3 detects the position of each source coil 14i of the probe 15. Subsequently, in step S <b> 32, the detection device 21 detects the positions of the source coils 140 and 141 of the surgical tool 100.

  Next, in step S33, the detection device 21 generates a probe image and a tool tip image based on the detected position information.

  Subsequently, the detection device 21 captures endoscopic image data of a subject such as a target portion imaged by the camera head 402 in step S34, performs image processing on the endoscopic image data captured in step S35, for example, An image portion of the surgical tool 100 is extracted.

  Subsequently, the detection device 21 corrects the orientations of the probe image and the tool tip image so that the tool tip image matches the image position of the image portion of the surgical tool 100 extracted in step S36.

  Then, as shown in FIG. 22, the detection device 21 displays the endoscope image data captured in the live image display area 410 of the monitor 25 in step S <b> 37, and the probe image 150 in the shape display area 411 of the monitor 25. And the tool tip image 151a are displayed. At this time, the tool tip image 151a displayed in the shape display area 411 is an image at the same position and in the same direction in each area as the surgical tool 100 displayed in the live image display area 410 by the correction in step S36. Thus, the arrangement of the probe image 150 and the tool tip image 151a displayed in the shape display area 411 matches the endoscopic image data displayed in the live image display area 410.

  The subsequent processing after step S15 is the same as that in the third embodiment.

  As described above, in the present embodiment, the same effect as that of the third embodiment can be obtained also in the laparoscopic procedure.

  In addition, not only a laparoscope but also a flexible insertion part, for example, an electronic endoscope may be used.In this case, the surgical tool is a tool inserted into the treatment instrument channel of the electronic endoscope. Needless to say, by providing a source coil at the tip of the tool, the same operation / effect as in the present embodiment can be obtained.

  FIGS. 23 and 24 relate to Embodiment 5 of the present invention, FIG. 23 is a configuration diagram showing the configuration of the surgical system, and FIG. 24 is an explanatory diagram for explaining the operation of the luminal organ shape detection device of FIG.

  Since the fifth embodiment is almost the same as the fourth embodiment, only different points will be described, and the same components are denoted by the same reference numerals and description thereof will be omitted.

  As shown in FIG. 23, in this embodiment, in addition to the surgical tool 100, the second surgical tool 500 is inserted into the abdominal cavity through a trocar (not shown).

  The second surgical tool 500 is a grasping forceps or the like, for example. Although not shown, source coils 140 and 141 are provided in the vicinity of the grasping portion at the distal end, as in the case of the surgical tool 100. , 141 is detachably connected to the detection device 21 of the luminal organ shape detection device 3 by the connector 501a of the source cable 501 extending from the rear end of the surgical tool 500, and the source coil 140 of the surgical tool 100, It is driven in the same manner as 141.

  Other configurations are the same as those in the fourth embodiment.

  In the present embodiment, the same processing as in the fourth embodiment (see FIG. 21) is performed. However, as shown in FIG. 24, the shape display area 411 of the monitor 25 has a probe image 150 and a tool tip image of the surgical tool 100. In addition to 151a, a tool tip image 510 of the second surgical tool 500 is displayed. At this time, the display shape is generated according to the tool so that the tool tip image 151a and the tool tip image 510 can be identified.

  Further, in order to make the tool tip image 151a and the tool tip image 510 more distinguishable, they may be displayed in different colors or the like. In this case, the distance information 201 is displayed in accordance with the color of the tool tip image. Even when the warning information 202 (see FIG. 17) is displayed, it is displayed in accordance with the color of the tool tip image to be warned.

  As described above, in this embodiment, in addition to the effects of Embodiment 4, even when a plurality of surgical tools are used, the procedure can be appropriately supported.

  25 and FIG. 26 relate to Embodiment 6 of the present invention, FIG. 25 is a block diagram showing the configuration of the surgical system, and FIG. 26 is an explanatory diagram for explaining the operation of the luminal organ shape detecting device of FIG.

  Since the sixth embodiment is almost the same as the fourth embodiment, only different points will be described, and the same components are denoted by the same reference numerals and description thereof will be omitted.

  As shown in FIG. 25, in this embodiment, in addition to the probe 15, a second probe 600 that detects the shape of a blood vessel requiring attention other than the blood vessel whose shape is detected by the probe 15 is used.

  The second probe 600 is configured in the same manner as the probe 15, and the source coil 14 i of the second probe 600 is connected to the luminal organ shape detection device 3 by the connector 601 a of the source cable 601 extending from the rear end of the probe 600. It is detachably connected to the detection device 21 and is driven in the same manner as the source coil 14 i of the probe 15.

  Other configurations are the same as those in the fourth embodiment.

  In the present embodiment, the same processing as in the fourth embodiment (see FIG. 21) is performed. However, as shown in FIG. 26, the shape display area 411 of the monitor 25 includes the probe image 150 of the probe 15 and the surgical tool 100. In addition to the tool tip image 151a, a probe image 610 of the second probe 600 is displayed. At this time, the probe image 150a and the probe image 610 are displayed in different colors so as to be distinguishable. In this case, the distance information 201 is displayed in accordance with the color of the tool tip image. Even when the warning information 202 (see FIG. 17) is displayed, it is displayed in accordance with the color of the tool tip image to be warned.

  As described above, in this embodiment, in addition to the effects of the fourth embodiment, even when there are a plurality of luminal organs such as blood vessels requiring attention, a probe provided with the source coil 14i is disposed in the plurality of luminal organs, By detecting the shape, the procedure can be supported appropriately.

  27 and FIG. 28 relate to Embodiment 7 of the present invention, FIG. 27 is a view showing a configuration of a surgical tool, and FIG. 28 is a cross-sectional view showing a cross section taken along line AA of FIG.

  Since the seventh embodiment is almost the same as the first embodiment, only different points will be described, and the same components are denoted by the same reference numerals and description thereof will be omitted.

  In this embodiment, as shown in FIGS. 27 and 28, for example, a magnetic coil unit 700 in which a source coil 140 is incorporated in a mounting portion using the spring property of a material can be attached to the distal end portion of the surgical tool 100. Composed.

  The other configuration is the same as that of the first embodiment, and the same operation and effect as those of the first embodiment can be obtained in this embodiment.

  In addition, the attachment method to the magnetic coil unit 700 to the surgical tool 100 is not limited to this, and other fixing means may be used. Further, the source coil 140 portion may be separable from the magnetic coil unit 700.

  A plurality of magnetic coil units 700 may be set on the surgical tool 100.

  The present invention is not limited to the above-described embodiments, and various changes and modifications can be made without departing from the scope of the present invention.

The block diagram which shows the structure of the surgery system which concerns on Example 1 of this invention. The figure which shows the structure of the probe of FIG. The figure which shows the structure of the surgical tool of FIG. The figure which shows the example of arrangement | positioning of the coil incorporated in the coil unit of FIG. The block diagram which shows the structure of the luminal organ shape detection apparatus of FIG. The figure which shows the structure of the receiving block and control block of FIG. The figure which shows the detailed structure of the receiving block of FIG. Timing diagram showing the operation of the 2-port memory of FIG. The flowchart explaining the effect | action of the luminal organ shape detection apparatus of FIG. Explanatory drawing explaining the process of FIG. The figure which shows the structure of the 1st modification of the probe of FIG. The figure which shows the structure of the 2nd modification of the probe of FIG. The figure which shows the structure of the surgical tool which concerns on Example 2 of this invention. The flowchart explaining the effect | action of the luminal organ shape detection apparatus at the time of using the surgical tool of FIG. First explanatory diagram for explaining the processing of FIG. Second explanatory view for explaining the processing of FIG. FIG. 14 is a third explanatory diagram for explaining the process of FIG. The block diagram which shows the structure of the surgery system which concerns on Example 3 of this invention. FIG. 18 is a flowchart for explaining the operation of the luminal organ shape detection apparatus of FIG. The block diagram which shows the structure of the surgery system which concerns on Example 4 of this invention. 20 is a flowchart for explaining the operation of the luminal organ shape detection device of FIG. Explanatory drawing explaining the process of FIG. The block diagram which shows the structure of the surgery system which concerns on Example 5 of this invention. Explanatory drawing explaining the effect | action of the luminal organ shape detection apparatus of FIG. The block diagram which shows the structure of the surgery system which concerns on Example 6 of this invention. Explanatory drawing explaining the effect | action of the luminal organ shape detection apparatus of FIG. The figure which shows the structure of the surgical tool concerning Example 7 of this invention. Sectional drawing which shows the AA line cross section of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Surgical system 2 ... Surgical apparatus 3 ... Luminal organ shape detection apparatus 14i, 140 ... Source coil 15 ... Probe 21 ... Detection apparatus 23 ... Coil unit 22j ... Sense coil 24 ... Operation panel 26 ... Transmission block 27 ... Reception block 28 ... Control block 100 ... Surgical tool Agent Patent attorney Susumu Ito

Claims (14)

A probe in which a plurality of one of a magnetic field generating element and a magnetic field detecting element are arranged inside an insertion portion to be inserted into the body of a subject;
A treatment instrument in which one or a plurality of the one element is disposed in the vicinity of a treatment section for performing treatment on a target site of the subject;
The other elements of the magnetic field generating element and the magnetic field detecting element are arranged outside the subject, and the respective positions of the one element arranged on the probe and the one element arranged on the treatment tool are determined. And a detection means for detecting using the position of the other element as a reference. The treatment instrument is provided with a plurality of the one element,
The operation according to claim 1, wherein the detection unit detects an approach direction of the treatment tool to the target site based on positions of the plurality of one elements arranged on the treatment tool. Support device. The operation support apparatus according to claim 1, wherein the detection unit calculates a shortest distance between the treatment unit of the treatment tool and the probe based on a detection result. The operation support apparatus according to claim 3, wherein the detection unit issues a warning when the shortest distance is less than a predetermined distance. The treatment tool is an energy treatment tool for performing treatment by applying energy to a target site of the subject from the treatment unit,
The operation support apparatus according to claim 4, wherein the detection unit stops application of the energy to the energy treatment device when the shortest distance is less than a predetermined limit distance. The operation support apparatus according to claim 3, wherein the shortest distance calculated by the detection unit is displayed on a display unit. Having an endoscope apparatus for imaging a target portion of the subject;
The said detection means produces | generates the shape image of the said probe based on the endoscopic image of the said target site | part from the said endoscopic apparatus, and the front-end | tip image of the said treatment tool. The operation support apparatus according to any one of the above. The surgery support apparatus according to claim 1, wherein the probe is configured by a guide wire. The surgery support apparatus according to any one of claims 1 to 7, wherein the probe includes a catheter. The surgery support apparatus according to any one of claims 1 to 7, wherein the probe is configured by an endoscope. Based on the position of each element obtained by the detection means, the shape image of the probe, and the shape image generation means for generating tip position information and a shape image of the treatment section;
The surgery support apparatus according to any one of claims 1 to 6, further comprising display means for displaying the image generated by the shape image generation means on the same screen. The surgical operation support apparatus according to claim 10, wherein tip position information and shape images of a plurality of the treatment tools are displayed on the display means. A probe in which a plurality of one of a magnetic field generating element and a magnetic field detecting element are arranged inside an insertion portion to be inserted into the body of a subject;
One of the magnetic field generating element and the magnetic field detecting element is built in, and the indicator means having an attachment part to the treatment instrument;
The other elements of the magnetic field generating element and the magnetic field detecting element are arranged outside the subject, and the respective positions of the one element arranged on the probe and the one element arranged on the index means are determined. And a detection means for detecting using the position of the other element as a reference. The surgery support apparatus according to claim 1, wherein the shape of the probe and the distal end portion of the treatment unit are displayed on a display unit based on position information detected by the detection unit.

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