JP2007185400A - Medical purpose technique evaluation system, technique evaluation device, and program for technique evaluation device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a tool, which can objectively evaluate the technique of medical actions such as surgery and palpation, to a doctor or a medical student. <P>SOLUTION: A medical purpose technique evaluation system 10 comprises a soft material 18 which contains a cut 27, in which an evaluated person such as the doctor and the medical student performs in an imitation way suturing treatment, and can be elasticity deformed by force acting on the perimeter of the cut 27, a reflection type photointerrupter 16 which measures a state quantity according to the deformation of this soft material 18, and a technique evaluation device 12 which calculates the evaluation value of the technique to the suturing treatment from the measured value of this reflection type photointerrupter 16. The technique evaluation device 12 computes the evaluation value by substituting a value based on the measuring result of the reflection type photointerrupter 16 for the parameter of an evaluation function established beforehand. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a medical technique evaluation system, a technique evaluation apparatus, and a technique evaluation apparatus program. More specifically, the present invention can objectively evaluate doctors and medical students' techniques for various medical practices such as procedures during surgery. The present invention relates to a medical procedure evaluation system, a procedure evaluation apparatus, and a procedure evaluation apparatus program.

At the time of surgery, procedures such as incision and excision of tissue, suture of the incision and excised tissue, and ligation to tie the suture are performed. To improve. However, since training for the human body is limited, a simulator for surgical training that simulates the human body is known as a training tool for improving the surgical technique (see Patent Document 1). Useful for less experienced doctors and medical students.
JP 2005-10164 A

  However, even if inexperienced doctors and medical students train using the simulator, etc., there is no tool for objectively evaluating their own skills. There is no choice but to ask for an evaluation. Therefore, in such a case, there is a possibility that the evaluation of the technique may not be performed accurately, and in order to obtain the evaluation, an instructor who always performs the evaluation is necessary, and the training accompanied by the evaluation is performed alone. There is a disadvantage that it cannot be performed efficiently.

  The present invention has been devised by paying attention to such inconveniences, and its purpose is to objectively evaluate doctors and medical students with respect to procedures of medical practices such as surgery and palpation. A medical procedure evaluation system, a procedure evaluation apparatus, and a procedure evaluation apparatus program that can be performed are provided.

(1) In order to achieve the above-mentioned object, the medical technique evaluation system according to the present invention includes a target part where the evaluation subject simulates a medical practice and can be elastically deformed by a force acting around the target part. A soft material, a sensor for measuring a state quantity according to the deformation of the soft material, and a technique evaluation device for obtaining an evaluation value of the technique for the medical action from the measurement value of the sensor,
The technique evaluation device employs a configuration in which a value based on a measurement result of the sensor is substituted for a parameter of a preset evaluation function to calculate the evaluation value.

  (2) The sensor is a reflective photointerrupter including a light emitting element and a light receiving element, and is provided at a position where light from the light emitting element is reflected by the soft material and can be received by the light receiving element. It is possible to adopt a configuration in which a substitution value for the parameter is obtained based on a change in current passing through the light receiving element.

  (3) Here, the technique evaluation device creates a voltage change graph indicating a relationship between a voltage detection unit that detects a voltage value from the light receiving element and a voltage value for each time from the start to the end of the medical practice. Data aggregation unit, a data calculation unit for obtaining a value that is an index related to the procedure from the data of the data aggregation unit, and an evaluation value for calculating the evaluation value by substituting this value for the parameter of the evaluation function The calculation unit is provided.

  (4) At this time, the index indicates the time required from the start to the end of the medical practice, the minimum voltage value during the medical practice, the area of the region surrounded by the voltage change graph and the time axis. When the unit time area divided by the required time and the FFT peak ratio obtained by dividing the second highest peak value by the highest peak value with respect to the Fourier transform graph obtained by fast Fourier transforming the voltage change graph, Good.

(5) Further, the present invention provides a medical use method for obtaining an evaluation value of a procedure of the medical practice based on a detection value of a sensor that measures a state quantity corresponding to a deformation of a target part in which the evaluation subject simulates the medical practice. A technique evaluation device,
A configuration is employed in which a value serving as an index related to the procedure is obtained from the detection result of the sensor, the value is substituted into a parameter of a preset evaluation function, and the evaluation value is calculated.

(6) Furthermore, the present invention provides a medical evaluation method for obtaining an evaluation value of a technique for a medical action based on a detection value of a sensor that measures a state quantity corresponding to a deformation of a target part in which the evaluation subject simulates the medical action. A program for executing the technique evaluation device of
The technique evaluation apparatus functions so as to obtain a value serving as an index related to the procedure from the detection result of the sensor, substitute the value into a parameter of a preset evaluation function, and calculate the evaluation value. The structure of letting it take is adopted.

  According to the present invention, an evaluation value according to the ability can be obtained for a medical practice technique such as surgery or palpation performed on a soft material by a doctor or medical student as an evaluation subject. The technique can be quantitatively evaluated, and the training with the objective evaluation can be efficiently performed independently.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  FIG. 1 shows a schematic configuration diagram of a medical procedure evaluation system according to the present embodiment. In this figure, a medical procedure evaluation system 10 is a system for evaluating a procedure of a suturing procedure at the time of surgery performed by a doctor, a medical student or the like, and the suturing procedure is simulated by a person to be evaluated such as a doctor or a medical student. And a technique evaluation device 12 that performs quantitative evaluation on the suture treatment performed on the simulation body 11.

  As shown in FIGS. 1 and 2, the simulated body 11 includes a base 14 having a substantially rectangular shape in plan view, a substrate 15 fixed on the base 14, and a sensor wired to the substrate 15. The reflection type photo interrupter 16, the frame 17 disposed on the substrate 15 so as to surround the side periphery of the reflection type photo interrupter 16, and the upper surface of the frame 17 so as to cover the reflection type photo interrupter 16 are fixed and evaluated. And a soft material 18 that can be elastically deformed by a force applied by a person's suturing treatment.

  The reflection type photointerrupter 16 is a known one including a light emitting element 20 that emits light by a current from a power source (not shown) and a light receiving element 21 that receives light emitted from the light emitting element 20. In this light receiving element 21, the magnitude of the current passing from a power source (not shown) toward the ground differs according to the amount of received light, and the current branches from the upstream side of the light receiving element 21 to the procedure evaluation device 12 side. Thus, the circuit configuration flows. The reflective photointerrupter 16 is provided with a filter (not shown) that prevents external light from being received by the light receiving element 21.

  Here, the light emitted from the light emitting element 20 is reflected by the soft material 18 covering the reflective photointerrupter 16 from above and received by the light receiving element 21, but is reflected by the elastic deformation of the soft material 18. When the distance between the photo interrupter 16 and the soft material 18 changes, the amount of light received by the light receiving element 21 changes, and the magnitude of the current passing through the light receiving element 21 changes. Along with this, the magnitude of the current that branches from the upstream side of the light receiving element 21 and flows to the technique evaluation device 12 side changes. Specifically, as the distance between the reflective photointerrupter 16 and the soft material 18 becomes shorter, the current passing through the light receiving element 21 increases, while the current flowing to the technique evaluation device 12 side decreases, resulting in the technique evaluation. The voltage of the circuit branched to the device 18 side becomes high.

  The frame 17 is provided in an outer shape having a substantially rectangular shape in plan view, and a through portion 23 having a substantially circular shape in plan view is formed at the center thereof, and the reflective photo interrupter 16 is accommodated in the through portion 23. It has become so. The penetrating portion 23 is set higher (deeper) than the reflective photointerrupter 16 and is set so that a gap is generated between the lower surface of the soft material 18 and the reflective photointerrupter 16 in the initial state without deformation. . The height of the gap is determined in consideration of the elastic deformation range of the soft material 18 and the characteristics of the reflective photointerrupter 16. Specifically, the relationship between the distance from the soft material 18 to the reflective photointerrupter 16 and the voltage passing through the light receiving element 21 is set in a substantially linear range.

  The soft material 18 includes a urethane foam 25 having a substantially rectangular shape in plan view having substantially the same outer dimensions as the frame 17, a pseudo-skin 26 fixed to the upper surface of the urethane foam 25, the urethane foam 25 and the pseudo-skin. 26 and a notch 27 formed in 26.

  The pseudo-skin 26 is formed of pudding gel that simulates the state of human skin, has substantially the same planar shape as the urethane foam 25, and is set thinner than the thickness of the urethane foam 25.

  The cuts 27 are formed in the vertical direction in FIG. 2, and the length in the vertical direction is set to be larger than the width in the same direction of the reflective photointerrupter 16, and the urethane foam 25 extends from the surface of the pseudo-skin 26. Is provided in a wedge shape having a depth extending to the middle of the cross section. The incision 27 simulates an incision portion of the skin at the time of surgery. When the evaluation subject sutures the incision 27, a technique evaluation for the suturing treatment is performed as described later. Therefore, the incision 27 constitutes a target part for simulating a treatment at the time of surgery in which the evaluation subject becomes a medical practice.

The technique evaluation device 12 is configured by software and hardware, and includes a plurality of program modules and processing circuits such as a processor. The technique evaluation device 12 includes a voltage detection unit 29 that detects a voltage value (hereinafter simply referred to as “voltage value”) from the light receiving element 21 side and converts it into a digital signal, and a timer 30 that measures time at a predetermined timing. From the data totaling unit 31 in which a voltage change graph G ₁ (see FIG. 3) showing the relationship of the voltage value with respect to each time from the start to the end of the suturing treatment for the incision 27 is created, The data calculation unit 32 for obtaining values of various indexes related to the suture technique, the evaluation value calculation unit 33 for calculating the evaluation value Z of the suture technique from the data totaling unit 31 and the data calculation unit 32, and the obtained evaluation value And a display unit 34 for displaying Z.

  The voltage detector 29 measures a voltage value every predetermined time (2 μsec in the present embodiment) from the start to the end of the time measurement by the timer 30, and the voltage value is measured for a predetermined time (in this embodiment, 50 msec). ) The average voltage value averaged in units is obtained.

  The timer 30 starts to time when the evaluation subject puts the needle into the cut 27 and ends when the needle is removed from the cut 27. These start and end commands are not particularly limited, but may be manually performed by visually observing the notch 27, or may be automatically performed based on photographing with a camera (not shown).

  The data totaling unit 31 plots the average voltage value obtained by the voltage detection unit 29 in correspondence with time. Here, the voltage value is given a sign of “+” when the soft material 18 is deformed upward from an initial state in which the soft material 18 is not deformed, while the soft material 18 is deformed downward from the initial state. Is set so that a sign of “-” is attached.

In the data computation unit 32, a required time X ₁ from the start to the end of suturing, the minimum voltage value X ₂ between the suturing, the area of the region surrounded by the voltage change graph G ₁ and the time axis A Fourier transform graph G ₂ showing the relationship between the frequency and power as well as the unit time area X ₃ divided by the required time X ₁ and the voltage change graph G ₁ by fast Fourier transform (FFT) (FIG. 4). a reference), and the Fourier transform graph G ₂ in the FFT peak ratio X ₄ obtained by dividing the high peak value P ₂ in the second highest peak value P ₁ is calculated.

In the evaluation value calculation unit 33, each of the evaluation functions calculated by the data calculation unit 32 is used as an evaluation function of the following equation using the required time X ₁ , the minimum voltage value X ₂ , the unit time area X ₃ , and the FFT peak ratio X ₄ as parameters. An evaluation value Z is obtained by substituting the value.
Z = AX ₁ + BX ₂ + CX ₃ + DX ₄ + E
A, B, C, D, and E are constants.
This evaluation function acquires each value of the parameter for each of a plurality of doctors and a plurality of inexperienced persons in advance and uses a known discriminant analysis so that the average of the evaluation values Z becomes 0. Each constant A to E is obtained, and it is determined that the suturing technique is better as the evaluation value Z is larger. It is also possible to arbitrarily set a part or all of A to E.

In addition, as a parameter here, as long as it is an index that affects the upper and lower hands of the suturing technique, anything can be adopted regardless of the type or number, and accordingly, an evaluation function is separately obtained by discriminant analysis. The evaluation function may be applied. The index in the present embodiment affects the upper and lower hands of the suturing technique as described below. In other words, the shorter the required time X ₁ , the more proof that it can have a high skill. The minimum voltage value X ₂ are as soft material member 18 is deformed downward, smaller is, the physician with a high technique is sutured, not only on the suture surface of the incision 27, the suture is made deep incision 27 This is because the soft material 18 can be greatly deformed downward. Furthermore, the unit time area X ₃ is stitched to the deep portion is to distinguish whether it is uniformly. Further, FFT peak ratio X _4, when the physician with a high technique is sutured, since tremor during suturing small mountain (peak) is decreased in the Fourier transform graph G _2, second highest peak value P ₂ This is because the FFT peak ratio X ₄ obtained by dividing the above by the highest peak value P ₁ is considered to be small.

  Therefore, according to such an embodiment, an evaluation function using four indexes that determine the suturing technique as parameters can be obtained by the technique evaluating device 12 having a relatively simple configuration by suturing the cut 27 of the soft material 18. It is possible to automatically obtain an evaluation value Z representing the suturing technique, and it is possible to easily obtain an objective evaluation of the suturing technique even if the instructor is not accompanied.

  In the embodiment, the reflection type photo interrupter 16 is used as a sensor for measuring the deformation of the soft material 18. However, the present invention is not limited to this, and a predetermined state quantity corresponding to the deformation of the soft material 18 is measured. Any sensor can be used. For example, an ultrasonic sensor or the like can be used instead. Further, a plurality of reflection type photo interrupters 16 may be arranged. In this way, a more accurate technique evaluation can be obtained.

  Further, in the present invention, by adjusting the shape of the soft material 18, it is possible to evaluate other surgical procedures such as cutting and ligation, and other medical procedures.

  Furthermore, the soft material 18 is not limited to the configuration of the present embodiment, and may be anything that can be elastically deformed according to the procedure to be evaluated. However, when the reflective photo interrupter 16 is used as in the present embodiment, it is preferably formed of a highly translucent material.

  In addition, the configuration of each part of the apparatus in the present invention is not limited to the illustrated configuration example, and various modifications are possible as long as substantially the same operation is achieved.

The schematic block diagram of the medical technique evaluation system which concerns on this embodiment. The schematic plan view of a simulation body. The voltage change graph which shows the relationship between time and voltage. A Fourier transform graph showing the relationship between frequency and power.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Medical procedure evaluation system 12 Procedure evaluation apparatus 16 Reflection type photo interrupter (sensor)
18 Soft material 20 Light emitting element 21 Light receiving element 27 Cutting (target part)
29 Voltage detection unit 31 Data aggregation unit 32 Data operation unit 33 Evaluation value calculation unit Z Evaluation value G ₁ Voltage change graph G ₂ Fourier transform graph X ₁ Required time X ₂ Minimum voltage value X ₃ Unit time area X ₄ FFT peak ratio

Claims (6)

An evaluation subject includes a target part that simulates a medical practice, a soft material that can be elastically deformed by a force acting around the target part, and a sensor that measures a state quantity according to the deformation of the soft material, A technique evaluation device for obtaining an evaluation value of a technique for the medical action from the measurement value of the sensor,
The medical technique evaluation system, wherein the technique evaluation device substitutes a value based on a measurement result of the sensor into a parameter of a preset evaluation function and calculates the evaluation value.   The sensor is a reflective photointerrupter including a light emitting element and a light receiving element, and is provided at a position where light from the light emitting element is reflected by the soft material and can be received by the light receiving element, and passes through the light receiving element. The medical procedure evaluation system according to claim 1, wherein a substitution value for the parameter is obtained based on a change in current to be performed.   The technique evaluation device includes a voltage detection unit that detects a voltage value from the light receiving element, and a data totaling unit that creates a voltage change graph indicating a relationship between the voltage value for each time from the start to the end of the medical action; A data operation unit that obtains a value that is an index related to the procedure from the data of the data aggregation unit, and an evaluation value calculation unit that calculates the evaluation value by substituting the value into a parameter of the evaluation function The medical procedure evaluation system according to claim 2, wherein:   The index is a unit obtained by dividing the required time from the start to the end of the medical practice, the minimum voltage value during the medical practice, the area of the region surrounded by the voltage change graph and the time axis by the required time. And a FFT peak ratio obtained by dividing a second highest peak value by a highest peak value with respect to a Fourier transform graph obtained by performing a fast Fourier transform on the voltage change graph. 3. The medical procedure evaluation system according to 3. A medical technique evaluation device for obtaining an evaluation value of a technique of the medical action by a detection value of a sensor that measures a state quantity corresponding to a deformation of a target part in which the evaluation object person performs a medical action in a simulated manner,
A technique evaluation device, wherein a value serving as an index related to the procedure is obtained from a detection result of the sensor, the value is substituted into a parameter of a preset evaluation function, and the evaluation value is calculated. An evaluation target person performs a medical technique evaluation device for obtaining an evaluation value of a technique for the medical action based on a detection value of a sensor that measures a state quantity corresponding to a deformation of a target part that simulates a medical action. A program,
The technique evaluation apparatus functions so as to obtain a value serving as an index related to the procedure from the detection result of the sensor, substitute the value into a parameter of a preset evaluation function, and calculate the evaluation value. A program for a technique evaluation device characterized by causing

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