JP2012081102A - Puncture operation support system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a puncture operation support system allowing the appropriate penetration depth of a puncture needle to be recognized by voice signals from the right and left of earphones put in both ears, offering excellent responsiveness of the voice signals for the penetration depth of the puncture needle in spite of a simple structure, and permitting puncture operation while looking at an ultrasonic diagnostic image on a monitor mounted in front of the eyes.SOLUTION: The puncture operation support system includes a sensor for measuring the penetration depth of the puncture needle, and a sine wave oscillation means for converting the signals measured based on the sensor into sine waves to oscillate. Voices obtained by allowing the output sine waves to pass through the high-pass filter side of a combination of a high-pass filter and a low-pass filter of substantially the same cutoff frequency are output to one earphone of the right and left earphones, and the voices that have passed through the low-pass filter side are output to the other earphone to sense the optimum penetration depth by the voice signals.

Description

When a puncture needle is inserted into a subject, such as puncture aspiration cytodiagnosis, and cells are collected from the target site, a tissue piece is collected from a lesioned part, a medical solution is injected into a living body affected part, and further, In many fields, puncture operations of puncture needles have been performed in order to perform a treatment or the like for removing the accumulated liquid.
The present invention relates to a puncture operation support system for performing such a puncture operation safely and properly.

For example, puncture aspiration cytology is performed under an ultrasound diagnostic image for a thyroid nodular lesion or an enlarged cervical lymph node lesion.
For patients with enlarged cervical lymphadenopathy, there are many arteries and veins and nerves, including the common neck and internal and external carotid arteries. Since the direction of the ultrasonic wave that serves as a guide is limited and the puncture site, puncture axis, and puncture posture cannot be made constant, complications are likely to occur compared to puncture to a thyroid nodule.
Therefore, it was necessary to change the posture angle of the puncture each time, and there was a risk of occasionally bleeding.
Conventionally, as shown in FIG. 6, the doctor 2 or the like who inserts the probe 31 of the ultrasonic device 30 operates the probe 31 and the posture of the puncture 110 is different from the posture of the puncture 110. There was a risk that the needle would advance to a dangerous site without knowing that it was displaced.

Patent Document 1 discloses a technique for detecting a moving amount and a puncture angle of a puncture needle by providing a puncture adapter in an ultrasonic probe and inserting a puncture needle along the puncture adapter.
However, the technique disclosed in the publication has a problem that it is difficult to match the monitor image with the insertion direction and depth of the puncture needle because the imaging direction of the ultrasonic probe and the insertion direction of the puncture needle intersect. It was.

JP 2005-323669 A

The present invention can recognize the appropriate insertion depth of the puncture needle from the audio signals from the left and right of the earphones attached to the ears on both sides, and the audio signal for the insertion depth of the puncture needle while having a simple structure. An object of the present invention is to provide a puncture operation support system with excellent responsiveness.
It is another object of the present invention to provide a puncture operation support system that enables a puncture operation while viewing an ultrasonic diagnostic image on a small monitor mounted in front of the eye.

A puncture operation support system according to the present invention includes a sensor for measuring a puncture depth of a puncture needle, a sine wave oscillating means for converting a signal measured based on the sensor into a sine wave and oscillating,
The output sine wave is combined with a high-pass filter and a low-pass filter with approximately the same cutoff frequency, and the sound that has passed through the high-pass filter side is output to one horn of the left and right horns, and the low-pass filter side It is characterized in that the optimum penetration depth can be detected by a voice signal by outputting the voice that has passed through the voice to the other horn.

Here, the means for measuring the insertion depth of the puncture needle is not limited as long as the amount of insertion of the puncture needle can be detected as a signal.
For example, it is possible to irradiate and reflect infrared rays on the body surface of the insertion site, and to measure the insertion depth from the difference between the measurement distance and the distance between the sensor and the needle tip.
The sine wave used in the present invention is preferably a low frequency of 2,000 Hz or less so as not to cause malfunction in peripheral medical equipment.

  By combining a high-pass filter that suppresses passage when the frequency is lower than the same cutoff frequency (threshold) and a low-pass filter that suppresses passage when the frequency is higher than this cutoff frequency, The sound that enters the ear is switched to a relatively low-frequency sound and a high-frequency sound, and the output is maximized in the vicinity of the cutoff frequency.

When the present invention has a small monitor mounted in front of at least one of the eyes of the person performing the insertion operation of the puncture needle, and an ultrasonic device for outputting an image to the small monitor, It is no longer necessary to turn the neck to view the monitor screen as in the past, and the operator can operate the ultrasound probe with one hand while looking at the small monitor attached in front of the eye and the puncture device with the other hand it can.
In this case, a small monitor may be connected to the earphone, and the small monitor may be attached / detached in front of the eyes, or a small microphone may be connected to the earphone and the system may be controlled by inputting voice to the small microphone. .

  The puncture operation support system according to the present invention makes it possible to recognize the puncture depth of the puncture needle from the audio signals entering the left and right ears, and when the puncture depth approaches the planned depth, It is possible to change the voice to a loud voice and to change the voice to the high frequency side when trying to insert deeper. Excellent responsiveness.

  If you put on a small monitor in front of you, you can insert it while checking the image just by changing the viewpoint without turning your neck.

The functional block diagram for outputting an audio | voice to an earphone based on the signal obtained with the sensor which measures distance is shown. The example of the combination of the apparatus which comprises the system which concerns on this invention is shown. The structural example of a puncture device is shown. The state of puncture operation is shown. An example of mounting and dismounting a small monitor is shown. The conventional puncture operation method is shown.

  Hereinafter, the system according to the present invention will be described with reference to the drawings. However, the present invention is not limited to this embodiment, and can be appropriately changed and applied within the scope of the gist of the invention.

FIG. 2 shows a configuration example of devices and the like constituting the system according to the present invention, and FIG. 3 shows a configuration example of the puncture device.
First, functional blocks for outputting sound from the earphone 21 will be described with reference to FIG.
The body surface 1 and the sensor 22 are composed of a sensor 22 including a lamp 22a for irradiating the body surface 1 corresponding to a site where the puncture needle is inserted and a detector 22b for detecting reflected light from the body surface 1. Measure the distance.
When the sensor 22 approaches or is far from the body surface 1, the distance changes, for example, the output voltage of the sensor 22 changes.
The output voltage signal to the arithmetic processing by the analog arithmetic unit S _1, is converted to a sine wave analog signal of when the voltage input to the sine wave oscillator circuit S _2.
Since it is easy to hear a sound with a frequency of around 800 Hz in the human ear, it was decided to use a frequency of 600 Hz to 1,000 Hz. However, it prevents the sound from being emitted even when the sensor 22 is far away from the body surface 1. For the purpose, the output sine wave was suppressed by a primary voice filter S ₃ , for example, a high-pass filter (HPF) having a cutoff frequency of 400 Hz, from passing low frequency components.
Next, a low pass filter (LPF) [right audio Filter right horn audio signal to earphone 21 which outputs up signal S ₄ which is filtered by the right channel power amplifier with that of the example 800Hz cutoff frequency (threshold) output to 21b _(S 6).
On the other hand, also high-pass filters to the cut-off frequency (threshold) to 800 Hz (HPF) [left audio Filter left horn 21a of the audio signal earphones 21 a signal S ₅ was filtered and output up by the left channel power amplifier with Output to.
In this way, a sound with a relatively low frequency is output from the right horn 21b, and a sound with a relatively high frequency is output from the left horn 21a.
Thus, through the sound from both the highpass and lowpass filter as shown by f ₀ at the graph of S ₇ is in a state in which penetration depth of the puncture needle becomes optimum, sensed from both ears as the largest sound Is done.
When the insertion depth of the puncture needle is shallower than the target, a small bass sound enters the ear from the right horn and it can be confirmed that the battery has not run out. The penetration depth can be obtained.
If you insert deeper, you can hear a low-pitched sound from the left horn.
Therefore, it is possible to effectively prevent deep and erroneous insertion.

Next, a system configuration example will be described.
As shown in FIG. 2, the sensor 22 attached to the puncture device 10 is connected to the control unit 20 by a cord 20b, and the control unit 20 and the earphone 21 are also electrically connected by a cord 20a.
The earphone 21 shown in the present embodiment has a left horn 21a attached to the left ear and a right horn 21b attached to the right ear, and a small monitor 50 is attached.
The small monitor 50 is connected to the drive unit 52 and is detachable in front of one eye as shown in FIG.
As a result, the small monitor 50 can be mounted in front of the eyes or housed on the drive unit side as necessary, and the field of view can be minimized.
In this embodiment, the microphone 60 is further attached to the earphone 21, and the control unit 20, the ultrasonic device 30 and the like can be controlled via the microphone 60. However, the microphone 60 is not necessarily required.
For the diagnosis of the insertion site, the examination part 31a of the probe 31 connected to the ultrasonic apparatus 30 with the code 31b is usually brought into contact with the body surface while outputting an image to the monitor 40 installed in the ultrasonic apparatus 30. Do.

FIG. 3 shows a structural example of the puncture device 10.
The mounting portion 14 for installing the collar portion 15 b of the cylinder 15 a of the syringe 15 and the grip 11 are connected by a slide rod 12.
The operating portion 13 can slide back and forth along the slide rod 12, and the flange portion of the operating portion 13 is fitted with the flange portion of the piston 15c of the syringe.
A puncture needle 16 is attached to the distal end side of the syringe 15.
A sensor 22 for measuring the distance L from the body surface 1 is attached to the front side of the mounting portion 14, and the L dimension of the sensor 22 can be adjusted along the gauge 23.
Since the distance between the distal end portion 16a of the puncture needle 16 and the sensor 22 is known in advance, when the distance from the body surface 1 is measured by the sensor 22, the insertion depth d is obtained as a difference from the above. .
While grasping the grip 11 and listening to the sound of the earphone 21 with the puncture needle 16, the image projected on the small monitor 50 is inserted as guide information.
When the operation unit 13 is pulled toward the grip 11 with the needle tip reaching the target site, cells and tissue pieces are collected in the syringe 15.
The state of this operation is shown in FIG.
While operating the probe 31 with one hand, the puncture needle 16 is inserted with the other hand.
As described above, since the small monitor 50 is attached to the earphone 21, the insertion operation can be performed safely and accurately based on the audio signal while checking the insertion angle without turning the neck.

  The system according to the present invention is not limited to the field of collecting cells or tissue pieces from specimens such as humans and animals, but can also be applied to various medical fields such as drug solution injection.

DESCRIPTION OF SYMBOLS 1 Body surface 10 Puncture device 16 Puncture needle 20 Control part 21 Ear horn 21a Left horn 21b Right horn 22 Sensor 30 Ultrasonic device 31 Probe 40 Monitor 50 Small monitor 60 Microphone

Claims (4)

A sensor for measuring the insertion depth of the puncture needle, and a sine wave oscillating means for converting a signal measured based on the sensor into a sine wave and oscillating;
The output sine wave is combined with a high-pass filter and a low-pass filter with approximately the same cutoff frequency, and the sound that has passed through the high-pass filter side is output to one horn of the left and right horns, and the low-pass filter side The puncture operation support system is characterized in that the optimum penetration depth can be detected by a voice signal by outputting the voice that has passed through to the other horn. A small monitor mounted in front of at least one of the eyes of the person performing the insertion operation of the puncture needle;
The puncture operation support system according to claim 1, further comprising an ultrasonic device for outputting an image to the small monitor.   The puncture operation support system according to claim 2, wherein the small monitor is connected to the earphone, and the small monitor is detachably mounted in front of the eyes.   The puncture operation support system according to claim 1, wherein a small microphone is connected to the earphone and the system can be controlled by inputting voice to the small microphone.

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