JP2016116751A - Endoscope insertion shape observation system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an insertion shape observation system which facilitates an operator's observation and allows an operator to intuitively grasp an insertion shape, without hindering a helper's traffic line.SOLUTION: An endoscope insertion shape observation system 3 comprises: a receiver 7 which receives a transmission signal from a transmission signal generator provided at an endoscope insertion part 4b; an insertion shape image generator which generates an insertion shape image of an endoscope insertion part inserted into a subject on the basis of the reception signal from the receiver; and a display 7 which comprises a display screen 7 for displaying the insertion shape image and is integrally provided with the receiver on the rear side of the display screen.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an endoscope insertion shape observation apparatus that observes an insertion state of an endoscope.

  Conventionally, endoscope apparatuses have been widely used in the medical field. An endoscope apparatus is a medical device having an elongated flexible insertion section, and an operator can insert the insertion section into a subject and observe the inside of the subject. An endoscopic image in the subject imaged by the endoscope can be displayed on a monitor. However, it is impossible to know how the endoscope insertion portion is inserted into the subject from the endoscopic image.

  Therefore, as a device that can know the insertion state of the endoscope at the time of insertion of the endoscope, a plurality of source coils incorporated in the insertion portion, a receiving antenna comprising a plurality of sense coils arranged in the coil block, An endoscope insertion shape observation apparatus having a monitor on which an insertion shape of an insertion portion is displayed has been developed. For example, various endoscope insertion shape observation apparatuses disclosed in Patent Documents 1 to 3 and the like previously filed by the present applicant have been proposed.

  The receiving antenna of the endoscope insertion shape observation device needs to be disposed in the vicinity of the subject in order to detect the magnetic field from the source coil in the insertion portion with high accuracy. For this reason, it is common to use it by attaching to a stand and arrange | positioning on a bedside, or attaching to the rail of a bed using an attachment. In any case, the receiving antenna is generally arranged on the opposite side of the operator with the bed interposed therebetween so as not to hinder the operator. In addition, the endoscope insertion shape observation device rotates the image of the insertion portion displayed on the monitor by a predetermined angle with respect to the reception surface of the reception antenna in consideration of the difference in position between the operator and the reception antenna. And can be displayed.

JP 2000-135198 A JP-A-2005-87772 JP 2000-83889 A

  However, an assistant is usually arranged on the bedside facing the surgeon, and the flow of the assistant is obstructed by the reception antenna and the connection cable connected to the reception antenna.

  In addition, when the operator confirms the insertion shape of the insertion portion, the operator must first take his eyes off the subject and move his eyes to the monitor of the endoscope insertion shape display device. This obstructs the insertion operation of the insertion portion. Furthermore, although it is possible to display the image of the insertion portion displayed on the monitor by rotating it by a predetermined angle with respect to the receiving surface of the receiving antenna, the operator's standing position changes at any time, so the operator's viewpoint It is difficult to always display the inserted shape image along the line. Therefore, the surgeon must determine how the insertion portion is curved and arranged in the subject in consideration of the image on the monitor and the direction of his / her line of sight. There is a problem that it is difficult to grasp. It is also conceivable that the surgeon cannot easily grasp the insertion shape, and thus takes time for procedures such as insertion operation of the insertion portion and manual compression.

  An object of the present invention is to provide an endoscope insertion shape observation device that is easy for an operator to observe and allows the operator to intuitively grasp the insertion shape without obstructing the flow line of the assistant. .

  An endoscope insertion shape observation apparatus according to the present invention is inserted into a subject based on a reception unit that receives a transmission signal from a transmission signal generation unit provided in an endoscope insertion unit, and a reception signal of the reception unit. An insertion shape image generation unit that generates an insertion shape image of the endoscope insertion unit and a display screen that displays the insertion shape image, and the reception unit is integrally provided on the back side of the display screen And a display unit.

  According to the present invention, there is an effect that it is easy for the operator to observe and the insertion shape can be intuitively grasped by the operator without obstructing the flow line of the assistant.

The block diagram which shows the whole structure of the medical system containing the endoscope insertion shape observation apparatus which concerns on the 1st Embodiment of this invention. Explanatory drawing for demonstrating the utilization method of an endoscope insertion shape observation apparatus. The block diagram which shows the specific structure of the probe 21 inserted in the insertion part 4b in FIG. The block diagram which shows the specific structure of the control unit 10 in FIG. Explanatory drawing for demonstrating the structure of the receiving / display unit 7 in FIG. Explanatory drawing which shows the state currently inserted in the large intestine from the anus of the test subject P which lies on the bed 6 for a test in a lateral position. Explanatory drawing which shows arrangement | positioning of the receiving / display unit 7 corresponding to FIG. Explanatory drawing which shows the display of the reception and display unit 7 corresponding to FIG. Explanatory drawing which shows the receiving / display unit employ | adopted in 2nd Embodiment. The block diagram which shows the control unit employ | adopted in 2nd Embodiment. Explanatory drawing which shows the mode of observation in a separation position. Explanatory drawing which shows the mode of observation in a proximity | contact position.

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

(First embodiment)
FIG. 1 is a configuration diagram showing an overall configuration of a medical system including an endoscope insertion shape observation apparatus according to a first embodiment of the present invention. FIG. 2 is an explanatory diagram for explaining a method of using the endoscope insertion shape observation apparatus.

  The medical system 1 includes an endoscope device 2 and an endoscope insertion shape observation device 3. The endoscope device 2 includes an endoscope 4, a light source device 11, a processor 12, and a monitor 5. The endoscope 4 is an elongated and flexible insertion portion 4b that is inserted into the body cavity of the subject P, which is the subject, and an operation that is connected to the proximal end of the insertion portion 4b and is provided with various operating devices. And a cable 4c for connecting the operation unit 4a and the processor 12 to each other.

  FIG. 1 shows an example in which the light source device 11 and the processor 12 are placed on a medical trolley 9. The monitor 5 is attached to a movable arm provided in the medical trolley 9. The endoscope 4 can be hooked on a hook of a medical trolley 9.

  The light source device 11 generates illumination light for illuminating the subject. Illumination light from the light source device 11 is guided to the distal end portion of the insertion portion 4b by a light guide inserted into the insertion portion 4b of the endoscope 4, and is irradiated on the subject from the distal end portion of the insertion portion 4b. An imaging element (not shown) is arranged at the distal end of the insertion portion 4b, and reflected light (return light) from the subject reflected by the subject is formed as a subject optical image on the light receiving surface of the imaging element. It is like that. The image sensor is driven and controlled by the processor 12, converts the subject optical image into an image signal, and outputs the image signal to the processor 12. The processor 12 includes an image signal processing unit (not shown). The image signal processing unit receives an image signal from the image sensor, performs signal processing, and outputs an endoscopic image after the signal processing to the monitor 5. . Thus, an endoscopic image of the subject is displayed on the screen of the monitor 5.

  A bending portion is provided at the distal end of the insertion portion 4b, and this bending portion is driven to be bent by a bending knob (not shown) provided in the operation portion 4a. The surgeon can push the insertion portion 4b into the body cavity while operating the bending knob to bend the bending portion.

  In the present embodiment, the endoscope insertion shape observation device 3 for observing the insertion state of the insertion portion 4 b is configured by a control unit 10, an insertion state detection probe 21, and a reception / display unit 7. Is done. The control unit 10 of the endoscope insertion shape observation device 3 is placed on the medical trolley 9, and an insertion state detection probe 21 is inserted into the insertion portion 4b as described later. The reception / display unit 7 is connected to the control unit 10 by a cable 8c, and can be moved to any position within the range of the length of the cable 8c.

  FIG. 2 shows a state in which the insertion portion 4b is inserted into the large intestine from the anus of the subject P lying on the examination bed 6. FIG. 2 shows a state where the operator O holds the operation unit 4a of the endoscope 4 connected to the processor 12 on the medical trolley 9 by the cable 4c. FIG. 2 shows a state in which the operator O supports the receiving / display unit 7 connected to the control unit 10 on the medical trolley 9 by the cable 8c by hand. When the reception / display unit 7 is not used, the reception / display unit 7 can be placed on the uppermost tray 9a of the medical trolley 9 or can be stored by being hooked on a hook (not shown) on the side. It has become. Thereby, even when the medical trolley 9 is moved, the receiving / display unit 7 and the control unit 10 can be moved while being connected by the cable 8c, and the attaching / detaching work of the cable 8c is not necessary. The receiving / display unit 7 may be held by an assistant other than the operator, for example, or may be fixed to a stand or the like. If necessary, the stand may be movable.

  In the present embodiment, the reception / display unit 7 includes an antenna unit 49 and a monitor 42. The control unit 10, the probe 21, and the reception / display unit 7 are connected to each other via cables 4c and 8c, respectively, and the drive of the probe 21 and the reception / display unit 7 is controlled by the control unit 10. As will be described later, the probe 21 radiates an electromagnetic wave with a magnetic field corresponding to the insertion position in the body of the insertion portion 4b to the surroundings, and the reception / display unit 7 detects the magnetic field radiated by the probe 21 and controls the detection result. Transmit to unit 10. Thereby, the control unit 10 calculates | requires the insertion shape of the insertion part 4b, produces | generates the image (insertion shape image) according to an insertion shape, and outputs it to the receiving / display unit 7 via the cable 8c. The monitor 42 of the receiving / display unit 7 displays the input insertion shape image on the screen.

  In the present embodiment, as will be described later, the receiving / display unit 7 is provided with a handle 8b (see FIG. 5), and the surgeon holds the handle 8b and arranges the receiving / display unit 7 appropriately. It can be changed. For example, as shown in FIG. 2, the surgeon can place the reception / display unit 7 between the subject and the subject P so as to face the subject P. The control unit 10 generates an insertion shape image corresponding to the arrangement position and orientation of the reception / display unit 7.

  For example, when the surgeon places the receiving / display unit 7 approximately between his / her eyes and the subject P, an insertion shape image corresponding to the surgeon's line of sight can be obtained. It is possible to always display an insertion shape image corresponding to the line of sight of the operator regardless of the standing position of the operator. Thereby, the surgeon can intuitively grasp the shape of the insertion portion 4b in the body of the subject P. In addition, the monitor 42 of the reception / display unit 7 is disposed between the operator and the subject P, and the operator can observe the inserted shape image with the eyes hardly distant from the subject P. .

  Next, a specific configuration of each part of the endoscope insertion shape observation device 3 will be described with reference to FIGS. 3 and 4 are block diagrams showing specific configurations of the probe 21 and the control unit 10 inserted into the insertion portion 4b in FIG.

  The control unit 31 of the control unit 10 shown in FIG. 4 can be configured by a processor such as a CPU, for example, and may operate based on a program stored in a memory (not shown). The control unit 31 controls the entire control unit 10. Note that a memory (not shown) stores not only a program describing the processing of the control unit 31 but also data used in a position estimation algorithm described later.

  The control unit 31 controls the source coil control unit 32. The source coil control unit 32 is configured by, for example, an FPGA or the like, and is controlled by the control unit 31 to generate waveform data and a clock that are sources of a magnetic field generated in the probe 21. The source coil control unit 32 gives waveform data and a clock for the probe 21 to the source coil drive unit 33. The source coil driving unit 33 generates a signal for driving the probe 21 and outputs the signal through the I / F 34.

  For example, the source coil drive unit 33 may be configured by a D / A converter that performs digital / analog conversion of waveform data, a low-pass filter (hereinafter referred to as LPF), a constant current conversion circuit, or the like. For example, the source coil driving unit 33 may supply a constant current sine wave based on the waveform data from the source coil control unit 32 to the probe 21.

  As will be described later, the probe 21 is provided with a plurality of coils. The source coil drive unit 33 can individually supply a sine wave to each coil of the probe 21. The distribution of the sine wave to each coil of the probe 21 is controlled by the control unit 31. That is, the controller 31 can control which coil of the probe 21 is supplied with the sine wave.

  As shown in FIG. 3, the probe 21 is inserted into a treatment instrument insertion channel (not shown) in the insertion portion 4b. A plurality of transmission coils 24-1, 24-2,... (Hereinafter simply referred to as transmission coils 24 when there is no need to distinguish each) is attached to the probe 21 along the probe axis, for example, at predetermined intervals. ing. By inserting the probe 21 into the treatment instrument insertion channel and fixing the distal end or the rear end of the probe 21, a plurality of transmission coils 24-1, 24-2,... At a predetermined interval in the axial direction of the insertion portion 4b. Will be placed.

  Each transmission coil 24 is supplied with a high-frequency sine wave from the I / F 34 of the control unit 10 via the I / F 25. Each transmission coil 24 emits an electromagnetic wave with a magnetic field to the surroundings when a high-frequency sine wave is applied. The control unit 10 can sequentially drive the transmission coils 24-1, 24-2,... At an appropriate time interval, for example, every several tens of milliseconds. Moreover, the control part 31 of the control unit 10 can designate separately the timing which each transmission coil 24-1, 24-2, ... generates a magnetic field.

  FIG. 5 is an explanatory diagram for explaining the configuration of the reception / display unit 7. FIG. 5A shows the configuration of the reception / display unit 7 viewed from the first surface 41a side, and FIG. 5B shows the configuration of the reception / display unit 7 viewed from the second surface 41b side. Is shown. In FIG. 5, the reception / display unit 7 includes a main body 8a and a handle 8b. The main body 8a is a housing in which the display screen of the monitor 42 is arranged on the first surface 41a. The 2nd surface 41b of the main-body part 8a is a surface facing the 1st surface 41a. A handle 8b is fixed to the bottom surface of the main body 8a. The handle 8b is configured to have a shape and size that can be grasped by an operator's hand, and has, for example, a cylindrical shape.

  The main body portion 8a is provided with two terminals 43a and 43b connected to the cable 8c. The terminal 43a is connected to the I / F 44a, and gives a signal from the I / F 40 of the control unit 10 transmitted through the cable 8c to the I / F 44a. The terminal 43b is connected to the I / F 44b, and the output of the I / F 44b is supplied to the I / F 35 of the control unit 10 via the terminal 43b and the cable 8c.

  As shown in FIG. 5, the main body 8a has an antenna on the second surface 41b side opposite to the first surface 41a on which the display screen of the monitor 42 is provided, that is, on the back side of the display screen of the monitor 42. Coil blocks 45a to 45d constituting the unit 49 (hereinafter, simply referred to as the coil block 45 when it is not necessary to distinguish each) are provided. In addition, although the example using four coil blocks 45a-45d is shown in FIG. 5, the number of the coil blocks 45 can be changed suitably, and three pieces which can form a plane by the line which connects the position of the coil block 45 are shown. That is all you need. That is, the coil block 45 is disposed on a predetermined plane (hereinafter referred to as a receiving antenna surface). For example, a plurality of coil blocks 45 may be arranged at the positions of the vertices of a regular polygon. FIG. 5 shows an example in which four coil blocks 45 are used. In this case, the coil blocks 45 are arranged at substantially vertex positions of a regular square.

  The coil block 45 includes two or three sense coils 46 wound in three directions so that the respective coil surfaces are orthogonal to each other, and each sense coil 46 has a magnetic field of an axial component orthogonal to the coil surface. A signal proportional to the intensity of the signal is detected. For example, the coil block 45 is configured with an optimal number of turns and impedance for receiving a magnetic field that changes in a predetermined cycle without attenuation. The coil block 45 receives the generated magnetic field and converts it into a voltage signal. It is designed to output. The coil block 45 outputs the detection result of the magnitude of the surrounding magnetic field via the I / F 44b. The I / F 44 b outputs the detection result of the coil block 45 to the I / F 35 of the control unit 10.

  In the example of FIG. 5, an example using four coil blocks 45 is shown, and outputs of a total of 12 sense coils 46 are given to the signal detection unit 36 from the I / F 35 of the control unit 10. The signal detector 36 performs predetermined signal processing on the input signal and then outputs the signal to the source coil position analyzer 37. The electromotive voltage generated in the coil block 45 is extremely weak. Therefore, the signal detection unit 36 is configured by, for example, an LPF, an amplifier, an A / D converter, etc., removes signals other than necessary (disturbance noise) from the input signal, amplifies, converts the signal into a digital signal, and converts it into a source coil It may be supplied to the position analysis unit 37.

  The source coil position analysis unit 37 is configured by a DSP, for example, and calculates position coordinates of each transmission coil 24 with respect to the coil block 45 from a signal received via the I / F 35 based on a known position estimation algorithm. . The calculation result of the position coordinates by the source coil position analysis unit 37 is supplied to the insertion shape image generation unit 38 via the control unit 31. The insertion shape image generation unit 38 generates a linear image as an insertion shape image by connecting the position coordinates of each transmission coil 24.

  The insertion shape image generated by the insertion shape image generation unit 38 is given to the display control unit 39. The display control unit 39 generates display data for displaying the insertion shape image generated by the insertion shape image generation unit 38 on the monitor 42 and outputs the display data to the reception / display unit 7 via the I / F 40. ing.

  Display data from the I / F 40 is given to the I / F 44 a through the terminal 43 a of the reception / display unit 7. The I / F 44a gives the input display data to the monitor 42. The monitor 42 can be configured by, for example, an LCD or the like, and displays an insertion shape image based on the relative positional relationship between the transmission coil 24 and the coil block 45 based on display data. FIG. 5A shows that the insertion shape image 47 is displayed on the display screen of the monitor 42.

  The source coil position analysis unit 37 can obtain the relative three-dimensional position of each of the transmission coils 24-1, 24-2,... With respect to the coil block 45 by using one coil block 45 of the reception / display unit 7. This makes it possible to generate an insertion shape image. That is, the source coil position analysis unit 37 calculates the three-dimensional position coordinates of the transmission coils 24-1, 24-2,... With the coil block 45 as the coordinate origin. Further, by arranging the coil block 45 at the apex of the regular polygon, the source coil position analysis unit 37 uses the reception antenna surface formed by the regular polygon as a reference to each of the transmission coils 24-1 and 24-2. ,... Can be calculated.

  For example, the coil block 45 may be arranged at the position of the apex of a quadrangle that forms a plane parallel to the second surface 41 b of the reception / display unit 7. In this case, the three-dimensional position coordinates of the transmission coils 24-1, 24-2,... Are calculated with reference to the second surface 41b of the reception / display unit 7, and an insertion shape image is generated. It will be. The first and second surfaces 41a and 41b of the reception / display unit 7 and the display screen of the monitor 42 are provided substantially parallel to each other at positions relatively close to each other. Since it is close and parallel, it can be said that the inserted shape image is generated based on the display screens of the first and second surfaces 41 a and 41 b and the monitor 42.

  In the present embodiment, the operator holds the handle 8b and arranges the reception / display unit 7 so that the first and second surfaces 41a and 41b are parallel to a surface perpendicular to the line of sight. Can do. Therefore, in this case, the source coil position analysis unit 37 calculates the three-dimensional position coordinates of each of the transmission coils 24-1, 24-2,... On the basis of a plane perpendicular to the operator's line of sight, thereby inserting the insertion shape. An image will be generated. That is, when the surgeon supports the reception / display unit 7 so that the second surface 41b faces the abdomen of the subject P in which the insertion portion 4b is inserted, the display screen of the monitor 42 An insertion shape image of the operator's eye line is displayed on the display screen of the monitor 42.

  Next, the operation of the embodiment configured as described above will be described with reference to FIGS. FIG. 6 is an explanatory view showing a state in which the insertion portion 4b is inserted into the large intestine from the anus of the subject P lying in the lateral position on the examination bed 6, and FIG. 6 (a) is a plan view seen from above. 6B shows a side view of the subject P viewed from the back side, and FIG. 6C shows a front view of the subject P viewed from the head side. FIG. 7 is an explanatory view showing the arrangement of the reception / display unit 7 corresponding to FIG. 6, and FIGS. 7 (a) to 7 (c) correspond to FIGS. 6 (a) to 6 (c), respectively. 8 is an explanatory view showing the display of the reception / display unit 7 corresponding to FIG. 7, and FIGS. 8A to 8C correspond to FIGS. 7A to 7C, respectively.

  An operator or the like inserts the insertion portion 4 b of the endoscope 4 from the anus of the subject P lying on the bed 6. The endoscope insertion shape observation device 3 obtains three-dimensional position coordinates of the plurality of transmission coils 24 of the probe 21 built in the insertion portion 4b at predetermined time intervals. That is, the control unit 31 of the control unit 10 controls the source coil control unit 32 to supply high-frequency signals to the transmission coils 24-1, 24-2,. The source coil drive unit 33 is controlled by the source coil control unit 32 to generate a high frequency signal, and the high frequency signal is transmitted to each of the transmission coils 24-1, 24-2,... Of the probe 21 via the I / F 34 at a predetermined timing. Supply signal. The transmission coils 24-1, 24-2,... Supplied with the high-frequency signal generate electromagnetic waves with a magnetic field. This magnetic field is received by each coil block 45 of the reception / display unit 7, and a detection result corresponding to the magnetic field strength is taken into the signal detection unit 36 via the I / F 35 of the control unit 10.

  In the present embodiment, as shown in FIG. 2, the surgeon holds the handle 8b of the reception / display unit 7, and the first surface 41a side of the reception / display unit 7, that is, the display screen of the monitor 42 With the side facing forward, the second surface 41b of the reception / display unit 7 is supported so as to face the site where the insertion shape is to be observed.

  The source coil position analysis unit 37 is provided with information on the drive timing of each transmission coil 24-1, 24-2,... From the detection result of the block 45, the three-dimensional position coordinates of each of the transmission coils 24-1, 24-2,... Are obtained according to a known position estimation algorithm.

  The position coordinates are supplied to the insertion shape image generation unit 38, and the insertion shape image generation unit 38 generates an insertion shape image based on the position coordinates. The probe 21 is inserted into the treatment instrument insertion channel of the insertion portion 4b, and each transmission coil 24 is disposed at a known position at a predetermined interval along the shape of the insertion portion 4b. That is, the position of each transmission coil 24 indicates a discrete position of the insertion portion 4b. The insertion shape image generation unit 38 can generate an insertion shape image corresponding to the schematic shape of the insertion unit 4b by interpolating the discrete positions.

  When generating the insertion shape image, the source coil position analyzing unit 37 uses the reception antenna surface formed by a regular polygon whose apex is the arrangement position of the coil block 45 as a reference, and each of the transmission coils 24-1, 24-2. Each three-dimensional position coordinate is calculated. Therefore, the insertion shape image is generated in a shape based on the first and second surfaces 41 a and 41 b of the reception / display unit 7, that is, the position and orientation of the display screen of the monitor 42.

  The insertion shape image generation unit 38 gives the generated insertion shape image to the display control unit 39. The display control unit 39 generates display data based on the inserted shape image and outputs the display data to the reception / display unit 7 via the I / F 40. The monitor 42 of the reception / display unit 7 takes in the display data via the I / F 44a and displays the insertion shape image on the screen.

  As shown in FIG. 2, the surgeon is a surface in which the first and second surfaces 41a and 41b of the receiving / display unit 7 are substantially perpendicular to the line of sight at a position near the line of sight toward the site where the insertion shape is to be observed. The receiving / display unit 7 can be supported so that Therefore, in this case, on the display screen of the monitor 42 of the reception / display unit 7, the insertion shape of the insertion portion 4b viewed from the operator's viewpoint is displayed.

  The receiving / display unit 7 is only connected to the control unit 10 by the cable 8c. Even when the operator changes his / her position, the operator can change the insertion shape at a position near the line of sight toward the site where the insertion shape is to be observed. The receiving / display unit 7 can be supported so that the first and second surfaces 41a and 41b are substantially perpendicular to the line of sight. Accordingly, the insertion shape of the insertion portion 4b viewed from the viewpoint of the operator can be displayed on the display screen of the monitor 42 of the reception / display unit 7 at all times.

  6 to 8 are for explaining the relationship between the arrangement of the reception / display unit 7 and the inserted shape image displayed on the monitor 42. FIG. Reference numerals 7a to 7e in FIGS. 7A to 7C denote the reception / display units 7 arranged at different positions and orientations, respectively.

  Reference numeral 7a in FIGS. 7A to 7C indicates that the reception / display unit 7 is arranged so that the first and second surfaces 41a and 41b are horizontal immediately above the abdomen of the subject P. Yes. In this case, the same display as when the insertion portion 4b inserted into the subject P is viewed from above as shown in FIG. 6A is performed. FIG. 8A shows the display in this case, and an insertion shape image 47a corresponding to the insertion portion 4b is displayed on the display screen of the monitor.

  7A to 7C indicate that the reception / display unit 7 is arranged so that the first and second surfaces 41a and 41b are vertical on the back side of the subject P. In this case, the same display as when the insertion portion 4b inserted into the subject P is viewed from the side as shown in FIG. 6B is performed. FIG. 8B shows the display in this case, and an insertion shape image 47 b corresponding to the insertion portion 4 b is displayed on the display screen of the monitor 42.

  Reference numeral 7c in FIGS. 7A to 7C denotes a receiving / display unit so that the first and second surfaces 41a and 41b are inclined at 45 degrees obliquely at a position of 45 degrees obliquely above the back side of the subject P. 7 is arranged. In this case, the same display as when the insertion part 4b inserted into the subject P is viewed from a position obliquely 45 degrees above the back side of the subject P is performed. FIG. 8C shows the display in this case, and an insertion shape image 47c corresponding to the insertion portion 4b when viewed from the viewpoint is displayed on the display screen of the monitor.

  Reference numeral 7d in FIGS. 7A to 7C indicates that the receiving / display unit 7 is placed on the bed 6 at the foot of the subject P with the first and second surfaces 41a and 41b being horizontal. Yes. In this case, the reception antenna surface formed by the regular polygon formed by the coil block 45 does not face the insertion portion 4b side inserted into the subject P at all, so that no insertion shape image is generated. In this case, as shown in FIG. 8D, the insertion shape image generation unit 38 may display a display 48 indicating that a valid insertion shape image could not be generated.

  Also, reference numeral 7e in FIGS. 7A to 7C denotes a receiving / display unit so that the first and second surfaces 41a and 41b are horizontal on the subject P side on the head side of the subject P. 7 is arranged. Also in this case, since the insertion shape image generation unit 38 cannot generate a valid insertion shape image, it was not possible to generate a valid insertion shape image as shown in FIG. A display 48 may be displayed.

  Since the insertion shape image generation unit 38 can generate an insertion shape image based on the detection result of one coil block 45, the orientation of the first and second surfaces 41a and 41b of the reception / display unit 7 is determined. Even when the (normal direction) does not face the site of the subject P to be observed, an effective insertion shape image may be generated depending on the orientations of the first and second surfaces 41a and 41b. Therefore, the surgeon does not need to accurately orient the direction (normal direction) of the first and second surfaces 41a and 41b to the site to be observed of the subject P, and disturbs the work in a direction approximately along his / her line of sight. What is necessary is just to arrange | position the receiving / display unit 7 in the position which does not become.

  As described above, in the present embodiment, the reception / display unit including the reception antenna and the monitor is movable and can be disposed in any position and orientation. For example, when observing the insertion shape, if the receiving / display unit is placed between the surgeon and the subject, the movement of a caregiver or the like who is normally located on the bedside facing the surgeon by means of a receiving antenna or monitor, etc. The line does not interfere. Also, for example, the position of the subject along the line of sight of the operator who wants to observe the region to be observed so that the reception antenna surface formed by the regular polygon formed by the antenna block in the reception / display unit faces the region to be observed. In the case of the arrangement, the insertion shape image of the operator's eyes can be displayed. Thereby, the surgeon can intuitively grasp the insertion shape. In addition, since the display screen is provided substantially parallel to the receiving antenna surface, the operator hardly needs to take his eyes off the subject when confirming the insertion shape, thereby improving the workability of the insertion operation of the insertion portion. it can. Further, since the operator can freely change the position and direction of the reception / display unit, more three-dimensional information can be easily obtained. In addition, for example, when manual compression is performed, it is easy to specify the location and direction where compression is required, and the change in the insertion shape of the endoscope during compression can be observed from various directions, making it smooth and efficient. Manual compression is possible.

(Second Embodiment)
9 and 10 relate to a second embodiment of the present invention. FIG. 9 is an explanatory diagram showing a receiving / display unit employed in the second embodiment. FIG. 10 is a diagram illustrating the second embodiment. It is a block diagram which shows the control unit employ | adopted in a form. In FIG. 9 and FIG. 10, the same components as those in FIG. 5 and FIG. Moreover, in this Embodiment, the whole structure of a medical system and the structure of the probe 21 are the same as that of FIG.1 and FIG.3, and description is abbreviate | omitted.

  In the present embodiment, the insertion shape image is enlarged or reduced according to the distance between the reception / display unit 50 and the insertion portion 4b and displayed.

  9, the reception / display unit 50 is different from the reception / display unit 7 of FIG. 5 in that it includes a main body 51 to which a distance sensor 52 for measuring a distance and a switch 53 are added. A distance sensor 52 is provided on the second surface 41b of the reception / display unit 50, that is, the surface opposite to the first surface 41a on which the display screen of the monitor 42 is arranged. The distance sensor 52 is composed of, for example, an infrared distance sensor or the like, and can measure the distance from the body surface of the subject P by directing the second surface 41b toward the subject P. The distance sensor 52 measures the distance to the subject P and outputs the measurement result to the I / F 35 of the control unit 60 via the I / F 44b. The distance sensor 52 may be provided at any position as long as the distance between the reception / display unit 50 and the subject P can be measured.

  In the example of FIG. 9, a configuration in which a total of four distance sensors 52 are attached in the vicinity of each coil block 45 is shown. However, for example, one distance sensor 52 is arranged in the center of the second surface 41b. A configuration may be possible, or a configuration in which a total of two, one each above and below the second surface 41b, may be arranged, or a total of two, one each on the diagonal of the second surface 41b. But you can. When three or more distance sensors 52 are used, it is better to arrange all the distance sensors 52 so as to be positioned at the vertices of substantially regular polygons corresponding to the number.

  10, the control unit 60 is different from the control unit 10 of FIG. 4 in that a distance sensor distance analysis unit 61 and an insertion shape image size adjustment unit 62 are added. The signal detection unit 36 gives a signal based on the output of the sense coil 46 among the signals captured by the I / F 35 to the source coil position analysis unit 37, and sends a signal based on the output of the distance sensor 52 to the distance sensor distance analysis unit 61. To give.

  The distance sensor distance analysis unit 61 analyzes the distance between the subject P and the distance sensor 52 (the distance between the second surface 41b) based on the output of the distance sensor 52, and the analysis result is controlled by the control unit 31. To the inserted shape image size adjustment unit 62. The insertion shape image size adjustment unit 62 determines the enlargement / reduction magnification of the insertion shape image generated by the insertion shape image generation unit 38 based on the analysis result of the distance sensor distance analysis unit 61, and displays the determined magnification as a display control unit. Output to 39. The display control unit 39 generates display data for enlarging or reducing the insertion shape image generated by the insertion shape image generation unit 38 according to the magnification determined by the insertion shape image size adjustment unit 62, and displays the I / F 40. To the monitor 42.

  In the example of FIG. 10, the example in which the insertion shape image size adjustment unit 62 determines the enlargement / reduction ratio according to the distance to the subject P has been described. However, the enlargement / reduction ratio is fixed to a predetermined magnification. For example, it may be set in advance when the control unit 60 is manufactured. Further, the enlargement / reduction ratio may be registered in the control unit 60 by a user operation. In this case, the insertion shape image size adjustment unit 62 may give a predetermined enlargement / reduction ratio to the display control unit 39 when the distance from the subject falls within a predetermined range.

  Further, as shown in FIG. 9, the switch 53 is provided in the reception / display unit 50, and the magnification is changed according to the mode in which the insertion shape image generated by the insertion shape image generation unit 38 is displayed as it is and the distance analysis result. The mode for displaying the displayed image may be switchable by the switch 53.

  Next, the operation of the embodiment configured as described above will be described with reference to FIGS. 11 and 12 are explanatory diagrams for explaining the operation of the second embodiment. FIG. 11 shows a state of observation at a separated position, and FIG. 12 shows a state of observation at a close position. Yes.

  Also in the present embodiment, the control unit 60 generates a high frequency signal, the transmission coils 24-1, 24-2,... Of the probe 21 generate a magnetic field based on the high frequency signal, and the antenna unit 49 of the reception / display unit 50. The operation of detecting the magnetic field of the transmitting coil 24 and generating the insertion shape image based on the detection result is the same as that of the first embodiment.

  In the present embodiment, the distance sensor 52 provided on the second surface 41b of the reception / display unit 50 measures the distance to the subject P facing the second surface 41b and displays the measurement result. The data is output to the I / F 35 of the control unit 60 via the I / F 44b. The signal detection unit 36 extracts the measurement result of the distance sensor 52 from the output of the I / F 35 and outputs it to the distance sensor distance analysis unit 61. The distance sensor distance analysis unit 61 analyzes the distance between the subject P and the distance sensor 52 and outputs the analysis result to the insertion shape image size adjustment unit 62 via the control unit 31.

  The insertion shape image size adjustment unit 62 instructs the display control unit 39 to perform an enlargement / reduction ratio based on the analysis result of the distance sensor distance analysis unit 61. Thereby, the display control unit 39 generates display data for enlarging or reducing the insertion shape image generated by the insertion shape image generation unit 38 in accordance with the instructed magnification. This display data is supplied to the monitor 42 via the I / F 40 and the I / F 44a.

  Thus, on the display screen of the monitor 42, the enlargement / reduction ratio according to the distance between the subject P and the distance sensor 52, that is, the distance from the subject P to the second surface 41b of the reception / display unit 50. Then, the inserted shape image is enlarged and displayed. For example, when the distance between the subject P and the second surface 41b is equal to or greater than a predetermined distance, the insertion shape image size adjustment unit 62 determines the entire area of the insertion shape image generated by the insertion shape image generation unit 38. An enlargement / reduction ratio of 1 can be set. In this case, the entire area of the insertion shape image is displayed on the display screen of the monitor 42.

  FIG. 11 shows an example of this case. The operator O grasps the reception / display unit 50 and places the reception / display unit 50 in a separated position where the distance from the subject P is relatively far from the proximity position indicated by the broken line. The receiving / display unit 50 in this case is indicated by reference numeral 50a. In this case, an image 55 a of the entire insertion shape image is displayed on the monitor 42 of the reception / display unit 50.

  By the way, the operator O may want to enlarge and display a partial region of the insertion shape image in order to facilitate confirmation of the insertion state in a part of the insertion portion 4b. In this case, as shown in FIG. 12, the operator O grasps the reception / display unit 50 and positions it at a close position where the distance to the subject P is relatively close from the separated position indicated by the broken line. . Reference numeral 50b in FIG. 12 indicates the reception / display unit 50 at the close position. In this case, the monitor 55 of the reception / display unit 50 displays an image 55b in which a part of the insertion shape image is enlarged.

  In this case, the enlargement magnification is determined by the insertion shape image size adjustment unit 62 based on the analysis result of the distance sensor distance analysis unit 61. The area to be enlarged is determined according to the relative positional relationship between the transmission coil 24 and the sense coil 46. The surgeon O moves the reception / display unit 50 in a direction parallel to the second surface 41b, so that the area to be enlarged can be changed, and the surgeon displays the insertion shape at an arbitrary position on the monitor 42. It can be displayed on the screen. Note that the insertion shape image may be enlarged based on the center of the screen.

  As described above, in the present embodiment, the distance sensor is provided, and the insertion shape image to be displayed is enlarged / reduced according to the measurement result of the distance sensor, and the surgeon moves the receiving / display unit closer to or away from the subject. By performing the operation, the part to be observed can be enlarged and reduced. Thereby, the surgeon can grasp the endoscope insertion shape at the site to be observed in more detail. For example, when the insertion portion is bent and is not advanced in the body cavity of the subject, the operator can enlarge the specific position of the insertion portion by a simple operation of bringing the reception / display unit close to the subject. Thereby, it becomes easy to specify the position of the insertion portion where the deflection occurs, and it is possible to efficiently perform a procedure such as manual compression.

  The present invention is not limited to the above-described embodiments as they are, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Moreover, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the above embodiments. For example, you may delete some components of all the components shown by embodiment. Furthermore, constituent elements over different embodiments may be appropriately combined.

    DESCRIPTION OF SYMBOLS 1 ... Medical system, 2 ... Endoscope apparatus, 3 ... Endoscope insertion shape observation apparatus, 4 ... Endoscope, 4b ... Insertion part, 5, 42 ... Monitor, 6 ... Bed, 7 ... Reception / display unit, 8a ... main body, 8b ... handle, 10 ... control unit, 12 ... processor, 49 ... antenna unit.

Claims (7)

A receiving unit for receiving a transmission signal from a transmission signal generating unit provided in the endoscope insertion unit;
An insertion shape image generation unit that generates an insertion shape image of the endoscope insertion unit inserted into the subject based on a reception signal of the reception unit;
An endoscope insertion shape observation apparatus, comprising: a display screen that displays the insertion shape image; and a display portion that is integrally provided with the receiving portion on the back side of the display screen. A main body unit to which the receiving unit and the display unit are integrally attached;
The endoscope shape observation apparatus according to claim 1, further comprising: a grip portion attached to the main body portion. The transmission signal generation unit has a plurality of transmission coils provided at predetermined intervals in the endoscope insertion unit,
The endoscope shape observation apparatus according to claim 1, wherein the reception unit includes a plurality of reception coils that respectively detect magnetic fields generated by the plurality of transmission coils. The plurality of receiving coils are arranged on a predetermined plane,
The endoscope shape observation apparatus according to claim 3, wherein the insertion shape image generation unit generates the insertion shape image with reference to the predetermined plane. The predetermined plane is substantially parallel to the display screen;
When the display screen is arranged between the surgeon's viewpoint and the transmission signal generator, the insertion shape image generation unit displays the insertion shape image of the operator's eye line on the display screen. The endoscope shape observation apparatus according to claim 4, wherein A distance measuring unit for measuring a distance between the receiving unit and the subject;
6. An image size changing unit that displays an image in which an enlargement / reduction ratio of the inserted shape image is changed according to a measurement result of the distance measuring unit on the display screen. The endoscope shape observation apparatus according to any one of the above. The endoscope shape observation apparatus according to claim 6, wherein the distance measurement unit is provided in the reception unit.

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