JP2018068353A - Endoscope detection system, endoscope detection device, endoscope hood, and endoscope detection method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope detection system, etc. that contribute to quickly determining a gastrostoma forming site.SOLUTION: An endoscope detection system for detecting the position of an endoscope in a body includes a hood mounted at the tip of the endoscope, and a detection device for detecting the position of the hood. The detection device includes a magnetic flux generation part for generating a magnetic flux, a magnetic flux detection part for detecting a change in the magnetic flux generated by the magnetic flux generation part, an analysis part for analyzing the position of the hood based on the change in the magnetic flux detected by the magnetic flux detection part, and a display part for displaying the result of the analysis by the analysis part, and the hood includes a magnetic body part constituted of a magnetic material.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an endoscope detection system, an endoscope detection device, an endoscope hood, and an endoscope detection method, and more particularly to an endoscope detection system that detects the position of an endoscope in the body.

  When constructing a gastric fistula, the determination of the construction site is extremely important. By constructing the gastric fistula at an appropriate position, the skin condition can be well maintained after the construction operation. Moreover, tube management becomes easy and the life after a patient's operation becomes comfortable. On the other hand, if a gastric fistula is constructed at an inappropriate position, the patient is painful and defective granulation is formed, and the skin forms redness and erosion, which makes management difficult.

  For this reason, determination of the construction site of the gastric fistula is important. The ideal position for constructing a gastric fistula is a site where it can be safely constructed, and the abdominal wall and the stomach wall are surely close to each other. As a guide, it is supposed to be a flat place with two fingers apart from the ribs. A position that is not too close to the umbilicus is preferred to avoid the onset of umbilitis. In addition, it is preferable that the body is not greatly depressed when sitting and there is no skin disease. However, it is not determined only from the position of the body surface. Rather, endoscopic findings and findings when pressing from the abdominal wall into the stomach are emphasized.

  Here, the outline of the operation procedure of gastrostomy is shown using FIG. FIG. 5 is a diagram showing a flow for constructing a gastric fistula according to a conventional method. (A) A state of determining a gastric fistula construction site, (b) A state of attaching a gastric fistula, and (c) It is a figure which shows a mode that setting was completed. In addition, the flow by the introducer method in which insertion of an endoscope is only required once and the risk of infection is small will be described. When determining the construction position, as shown in FIG. 5A, the endoscope 101 is inserted from the oral cavity 103 and air is sent into the stomach 105 to sufficiently inflate the stomach 105. A doctor presses the abdominal wall 109 with a finger 107, and the construction position is determined based on the experience of the doctor based mainly on the degree of compression of the abdominal wall 109 and the pressure of the anterior stomach wall 111 (non-patent document). Reference 1). Further, as shown in FIG. 5B, a gastric fistula catheter 115 is directly inserted into the stomach 105 and attached to the abdominal wall 109 via the trocar 113 after incision of the skin. Subsequently, as shown in FIG. 5C, the gastric fistula construction operation is completed by fixing the gastric fistula catheter 115 with the balloon 117 and the stopper 119.

Takahiro Okada, “Gastrostomy Management Manual Thinking Together”, “Home Medicine Net Yokohama”, November 22, 2011 [Search September 7, 2016], Internet <URL: http: // www. zaitaku.in.arena.ne.jp/img/irou/manual.pdf>

    However, conventional methods that rely on physician experience often require more than half of the time required for the entire process of gastrostomy for site determination.

  In some cases, the liver may protrude greatly toward the stomach. In the past, it has been known that there were cases where the liver was accidentally damaged and bleeding, or a catheter was placed in the stomach through the liver, resulting in a liver tumor. When the abdominal wall is thick, the pressed findings are dull and it is difficult to determine the positional relationship with other organs such as the liver and the large intestine.

  Therefore, an abdominal CT examination may be performed before gastrostomy surgery. In such a case, since it takes time to determine the construction site, the burden on the patient and the surgeon in charge of gastric fistula construction is heavy.

  Therefore, an object of the present invention is to provide an endoscope detection system that contributes to prompt determination of a gastric fistula construction site.

  A first aspect of the present invention is an endoscope detection system that detects a position of an endoscope in a body, and a hood that is attached to a distal end of the endoscope, and a detection that detects the position of the hood. The detection device includes: a magnetic flux generation unit that generates magnetic flux; a magnetic flux detection unit that detects a change in magnetic flux generated by the magnetic flux generation unit; and a change in magnetic flux detected by the magnetic flux detection unit. An endoscope detection system having an analysis unit for analyzing the position of the hood and a display unit for displaying an analysis result of the analysis unit, and the hood has a magnetic body unit made of a magnetic material. is there.

  According to a second aspect of the present invention, there is provided an endoscope detection system according to the first aspect, wherein the magnetic body portion has a shape having no rotational symmetry in a state where the hood is attached to a distal end of the endoscope. I am doing.

  A third aspect of the present invention is the endoscope detection system according to the second aspect, wherein the magnetic body portion has a cylindrical shape, has a cut, and / or has a thickness. Have changes.

  A fourth aspect of the present invention is the endoscope detection system according to any one of the first to third aspects, wherein the magnetic body portion is outside the magnetic body portion so that the magnetic body portion does not come into contact with the outside. The resin part further comprised is provided.

  According to a fifth aspect of the present invention, there is provided an endoscope detection device that detects a position of an endoscope in a body, a magnetic flux generation unit that generates a magnetic flux, and changes in the magnetic flux generated by the magnetic flux generation unit. An endoscope comprising: a magnetic flux detection unit to detect; an analysis unit that analyzes the position of the endoscope based on a change in magnetic flux detected by the magnetic flux detection unit; and a display unit that displays an analysis result of the analysis unit. Mirror detection device.

  According to a sixth aspect of the present invention, there is provided an endoscope hood attached to a distal end of an endoscope, comprising a magnetic body portion made of a magnetic material and having a cylindrical shape, wherein the magnetic body portion is An endoscope hood having a notch and / or a change in the thickness of the tube.

  A seventh aspect of the present invention is an endoscope detection method in an endoscope detection system that detects the position of an endoscope in the body, and the endoscope detection system is attached to the distal end of the endoscope. A hood to be mounted; and a detection device that detects a position of the endoscope; a magnetic flux generation step in which the detection device generates a magnetic flux; and a magnetic flux detection step in which a change in the magnetic flux generated by the detection device is detected. And an analysis step for analyzing the position of the hood based on a change in magnetic flux detected in the magnetic flux detection step, and a display step for displaying an analysis result in the analysis step.

  An eighth aspect of the present invention is a program for causing a computer to execute the endoscope detection method according to the seventh aspect.

  A ninth aspect of the present invention is a computer-readable recording medium on which a program according to the eighth aspect is recorded.

  Note that the endoscope detection method described above expresses the function of the medical device itself as a method, and does not include a process performed by a doctor. Therefore, it is not a method (so-called medical practice) for operating, treating or diagnosing humans.

  The recording medium includes a USB memory and an external hard disk, for example, and indicates a non-temporary recording medium.

  According to each aspect of the present invention, it is easy to specify which area the video displayed on the monitor of the endoscope room is viewed from outside the abdominal wall. As a result, the time required for the operation can be shortened, and the burden on the patient and the surgeon can be greatly reduced. For example, the determination of the gastric fistula construction site, which conventionally took about 30 minutes, can be greatly shortened to about 5 minutes.

  Moreover, in this invention, although a hood is provided with a magnetic body part, it is a passive member which does not generate | occur | produce a magnetic flux. This system is constructed by attaching the hood according to the present invention, which is a detection object, to the distal end of the endoscope in contrast to the endoscope system that has been completed outside the body and has already been introduced in each organization. it can. Therefore, it is not necessary to replace it with a large-scale and expensive dedicated system, and an inexpensive and simple introduction can be expected. Even in an institution where it is difficult to introduce an expensive system such as a small clinic, it is possible to contribute to reducing the burden on patients and doctors.

  Furthermore, the hood according to the present invention has a simple structure and can reduce the cost, so that it can be disposable. Therefore, as long as the usage is observed and used, a clean product can always be used without the need for sterilization, and the risk of infectious diseases can be reduced.

  In addition, it is not necessary to depend on the experience of the doctor to determine the appropriate site for gastrostomy. Therefore, it becomes easy to determine an appropriate gastrostomy site regardless of the experience of the surgeon.

  Further, conventionally, there is a case where the surgeon can visually confirm the light emitted from the endoscope in the stomach when the endoscope reaches the stomach by turning off the illumination of the endoscope room. The surgeon squeezed from the abdominal wall relying on this light, and the situation was confirmed on the monitor as an image taken by the endoscope in the stomach. However, with this method, the surgeon is forced to perform a mental and physical burden because the operation is performed in a dim light with the light turned off.

  In this regard, according to the present invention, it is not necessary to darken the illumination of the endoscope room, so that the burden on the surgeon can be reduced.

  Furthermore, according to the 2nd, 3rd or 6th viewpoint of this invention, it becomes possible to detect the change of the magnetic flux according to the rotation angle of the hood in addition to the position of the hood in the stomach. In other words, since the effect on the magnetic flux generated by the magnetic flux generation unit is also provided, it is possible to provide the surgeon with information on which angle and which direction the hood is currently facing. Then, it becomes easy to specify which direction the endoscope is facing and which gastric wall is being viewed. Therefore, it becomes easier to shorten the time required for an appropriate gastric fistula construction site.

  Further, according to the third aspect of the present invention, when the detection device is moved, it is possible to analyze whether the detection device is approaching or moving away from the hood and display it to the surgeon. Therefore, it becomes easier to shorten the time required for an appropriate gastric fistula construction site.

  Conventionally, it is difficult to extract a magnetic body portion such as a metal when it is detached within a unit. For this reason, there are obstacles to the use of the magnetic part in the hood. According to the 4th viewpoint of this invention, it becomes possible to reduce the risk that a magnetic body part contacts a body by covering a magnetic body part with a resin part.

It is a block diagram which shows the outline | summary of the endoscope detection system which concerns on this invention. It is a figure which shows the example of the external appearance of the detection apparatus which concerns on this invention, (a) The example of the external appearance of the surface, (b) The example of the external appearance of the back surface. It is a perspective view which shows the example of the hood which concerns on this invention. It is a figure which shows an example of a mode using the endoscope detection system which concerns on this invention, (a) The figure which shows a mode that the detection of an endoscope is performed, and (b) The front of the detection apparatus in use condition It is a figure which shows the example of the external appearance of a surface. It is a figure which shows the flow which constructs a gastric fistula by the conventional method, (a) A mode that determines a gastric fistula construction site, (b) A mode that a gastric fistula is mounted | worn, and (c) Construction was completed It is a figure which shows a mode.

  Embodiments of the present invention will be described below with reference to the drawings. The embodiments of the present invention are not limited to the following examples.

  FIG. 1 is a block diagram showing an outline of an endoscope detection system 1 according to an embodiment of the present invention (an example of an “endoscope detection system” recited in the claims). Hereinafter, an outline of the endoscope detection system 1 will be described.

  Referring to FIG. 1, an endoscope detection system 1 includes a detection device 3 (an example of “detection device” and “endoscope detection device” described in claims) and a hood 5 (“ Examples of “hood” and “endoscope hood”. The detection device 3 includes a magnetic flux generation unit 7 (an example of a “magnetic flux generation unit” described in the claims), a magnetic flux detection unit 9 (an example of a “magnetic flux detection unit” described in the claims), an acceleration detection unit 11, , A gyro sensor 13, an analysis unit 15 (an example of an “analysis unit” described in claims of the present application), a display unit 17 (an example of “display unit” described in claims of the present application), and a power switch 21. The magnetic flux detection unit 9 includes a first magnetic flux sensor 23, a second magnetic flux sensor 25, a third magnetic flux sensor 27, and a fourth magnetic flux sensor 29. The display unit 17 includes a distance display unit 31 and a direction display unit 33. The hood 5 includes a magnetic part 37 (an example of a “magnetic part” in the claims) and a resin part 39 (an example of a “resin part” in the claims).

  The endoscope detection system 1 detects the position of the endoscope in the body. The detection device 3 detects the position of the endoscope by detecting the position of the hood 5. The magnetic flux generator 7 generates a magnetic flux. The magnetic flux detector 9 detects the magnetic flux generated by the magnetic flux generator 7. The acceleration detection unit 11 detects the acceleration of the detection device 3. The gyro sensor 13 detects the three-dimensional inclination of the detection device 3. The analysis unit 15 analyzes the relative positional relationship between the detection device 3 and the hood 5 based on the detection results of the magnetic flux detection unit 9, the acceleration detection unit 11, and the gyro sensor 13. The display unit 17 displays the analysis result of the analysis unit 15 to the user.

  Next, details of the appearance and configuration of the detection device 3 will be described with reference to FIG. FIG. 2 is a diagram showing an example of the appearance of the detection device according to the present invention, and is a diagram showing (a) the appearance of the front surface and (b) the appearance of the back surface.

  With reference to Fig.2 (a), the detection apparatus 3 is provided with the distance display part 31 and the direction display part 33 in the front surface 41 (surface which a user visually recognizes in use condition). The distance display unit 31 is configured by arranging a plurality of LEDs in a line. Moreover, the direction display part 33 is comprised by one center LED and several LED which surrounds the LED cyclically | annularly.

  Referring to FIG. 2B, the detection device 3 has a first magnetic flux detection unit 9 on the back surface 43 (a surface opposite to the front surface and a surface with respect to the abdominal wall of the patient in use). A magnetic flux sensor 23, a second magnetic flux sensor 25, a third magnetic flux sensor 27, and a fourth magnetic flux sensor 29 are provided. The 2nd magnetic flux sensor 25, the 3rd magnetic flux sensor 27, and the 4th magnetic flux sensor 29 are arranged at the vertex of an equilateral triangle. The first magnetic flux sensor 23 is arranged at the center of gravity of the equilateral triangle.

  In addition, the detection device 3 includes a power switch 21 on a side surface different from the front surface and the back surface. By depressing the power switch 21, the detection device 3 is turned on. The detection device 3 according to the present embodiment detects the hood 5 while the power switch 21 is pressed down.

  Next, the appearance and configuration of the hood 5 will be described with reference to FIG. FIG. 3 is a perspective view showing an example of the hood 5 according to the present invention.

  The hood 5 is attached to the distal end of the endoscope. Further, since the hood 5 includes the magnetic body portion 37 made of a magnetic material, the hood 5 changes the magnetic flux generated by the magnetic flux generation portion 7. The magnetic flux detection unit 9 detects this change. A resin portion 39 made of silicon resin covers the surface of the hood 5. For this reason, even if the hood 5 contacts the organ, the organ is not damaged.

  Next, functions of the endoscope detection system 1 will be described with reference to FIG. FIG. 4 is a diagram illustrating an example of a state in which the endoscope detection system according to the present invention is used, (a) a diagram illustrating a state of detecting an endoscope, and (b) a detection device in a use state. It is a figure which shows the example of the external appearance of the front surface.

  Referring to FIG. 4 (a), after inserting the endoscope with the hood 5 attached to the tip, the air is sufficiently inflated by sending air into the stomach. The surgeon determines the site for constructing the gastric fistula while checking the image taken by the endoscope on the monitor. If an appropriate part is found from the endoscopic findings, the position of the hood 5 is detected using the detection device 3.

  Specifically, when the surgeon in charge depresses the power switch 21, the magnetic flux generation unit 7 inside the detection device 3 generates a magnetic flux (an example of a “magnetic flux generation step” in the claims of the present application). The magnetic flux detection unit 9 on the back surface of the detection device 3 detects the magnetic flux generated by the magnetic flux generation unit 7 (an example of a “magnetic flux detection step” described in claims). Since there are the second magnetic flux sensor 25, the third magnetic flux sensor 27, and the fourth magnetic flux sensor 29 around the first magnetic flux sensor 23, detection including the direction in which the magnetic flux changes as seen from the detection device 3 is performed. Is possible. Moreover, the acceleration detection part 11 and the gyro sensor 13 detect the acceleration and angle of a detection apparatus, respectively. Based on the detection results of the magnetic flux detection unit 9, the acceleration detection unit 11, and the gyro sensor 13, the analysis unit 15 determines the relative positional relationship between the detection device 3 and the hood 5, and the hood 5 viewed from the detection device 3. The direction, whether or not it is approaching, and the like are analyzed (an example of “analysis step” described in the claims). The display unit 17 displays the analysis result of the analysis unit 15 (an example of “display step” described in the claims).

  With reference to FIG.4 (b), the distance display part 31 lights many LED, so that the detection apparatus 3 and the hood 5 approach. While the user moves the detection device 3, the distance display unit 31 displays the distance between the detection device 3 and the hood 5 and whether or not the detection device 3 is approaching the hood 5. Moreover, the direction display part 33 displays the direction of the hood 5 seen from the detection device 3 by turning on one or a plurality of LEDs among the central LED and a plurality of LEDs surrounding the LED in a ring shape. To do.

  Here, it is desirable that the detection device 3 not only detects the position of the hood 5 but also displays the portion displayed on the monitor to the user. This is because the part A of the anterior stomach wall that hits vertically above the hood 5 does not necessarily coincide with the part B of the anterior stomach wall that is projected on the monitor.

  In this regard, the magnetic body portion 37 of the hood 5 has a planar shape instead of a point shape. Therefore, the influence of the hood 5 on the magnetic flux varies depending on the inclination of the hood 5. The magnetic flux detection unit 9 detects this difference and the analysis unit 15 can analyze the inclination of the hood 5 and the endoscope. When the display unit 17 also displays the inclination of the hood 5, the surgeon who is the user can quickly determine the gastrostomy site.

  In addition, the magnetic body of the hood 5 is provided with a more characteristic change in magnetic flux by, for example, making a part of the magnetic body a characteristic configuration, such as cutting in part or changing the thickness. Also good. Here, the characteristic structure should just be with a magnetic body, and the shape of the food | hood 5 comprised by a resin part is not ask | required.

  The distance display unit only needs to know the distance between the detection device and the hood, and may have a configuration other than the above embodiment. For example, the arrangement of the LEDs may be an arrangement other than one line, or the distance may be indicated by means other than the LEDs. Moreover, the display method by a distance display part should just know the distance of the distance of a detection apparatus and a hood, and systems other than the system which lights many LEDs as it approaches are also sufficient. Similarly, the direction display unit may have a configuration or display method other than the above-described embodiment. For example, the distance and direction of the hood may be displayed to the user using a liquid crystal (LCD) as the display means.

  In addition, the magnetic flux sensor provided in the magnetic flux detection unit only needs to be able to detect magnetic flux data that leads to analysis of the position of the hood and the direction viewed from the detection device, and the number of magnetic flux sensors may be other than four. The magnetic flux sensor may be used alone, and the position of the hood can be indicated by performing analysis together with the detection results of the acceleration detection unit 11 and the gyro sensor 13.

  Further, in FIG. 2B, the magnetic flux detection unit exists on the back side of the display unit and is all integrated, but the magnetic flux generation unit and each sensor unit may be independent. For example, it is considered that the operability and visibility of the user are improved by making the magnetic flux generation unit 7, the magnetic flux detection unit 9, the acceleration detection unit 11, and the gyro sensor 13 independent from the detection device 3.

  Furthermore, the power switch may be provided at a position where it can be easily operated by the user, and may be provided on a side other than the side surface. The power input method may be other than a push button type, or may be a method of maintaining a power-on state with a finger released, such as a toggle switch.

  Furthermore, the resin portion may be a resin other than a silicone resin or a material other than a resin as long as it is a material that is a cover that is hard to be damaged by contact with an organ. In addition, the resin portion needs to cover the magnetic body portion, but does not need to be trapped by the shape of the magnetic body portion to be included.

  Furthermore, the detection device may analyze the position of the anterior stomach wall that the endoscope projects on the monitor instead of the position of the hood and display it to the user.

  DESCRIPTION OF SYMBOLS 1 ... Endoscope detection system, 3 ... Detection apparatus, 5 ... Hood, 7 ... Magnetic flux generation part, 9 ... Magnetic flux detection part, 11 ... Acceleration detection part, 13 ... Gyro sensor 15 ... analysis unit 17 ... display unit 21 ... power switch 23 ... first magnetic flux sensor 25 ... second magnetic flux sensor 27 ... third magnetic flux Sensor, 29 ... 4th magnetic flux sensor, 31 ... Distance display part, 33 ... Direction display part, 37 ... Magnetic body part, 39 ... Resin part

Claims (9)

An endoscope detection system for detecting the position of an endoscope in the body,
A hood attached to the distal end of the endoscope;
A detection device for detecting the position of the hood,
The detection device is:
A magnetic flux generator for generating magnetic flux,
A magnetic flux detection unit for detecting a change in magnetic flux generated by the magnetic flux generation unit;
An analysis unit for analyzing the position of the hood based on a change in magnetic flux detected by the magnetic flux detection unit;
A display unit for displaying an analysis result of the analysis unit;
The said hood is an endoscope detection system which has a magnetic body part comprised with the magnetic material.   The endoscope detection system according to claim 1, wherein the magnetic body portion has a shape having no rotational symmetry in a state where the hood is attached to a distal end of the endoscope. The magnetic part is
It has a cylindrical shape,
The endoscope detection system according to claim 2, further comprising a notch and / or a change in the thickness of the tube.   The endoscope detection system according to any one of claims 1 to 3, further comprising a resin portion that is formed of a resin outside the magnetic body portion so that the magnetic body portion does not come into contact with the outside. An endoscope detection device that detects the position of an endoscope in the body,
A magnetic flux generator for generating magnetic flux,
A magnetic flux detection unit for detecting a change in magnetic flux generated by the magnetic flux generation unit;
An analysis unit for analyzing the position of the endoscope based on a change in magnetic flux detected by the magnetic flux detection unit;
An endoscope detection apparatus comprising: a display unit that displays an analysis result of the analysis unit. An endoscope hood attached to the tip of an endoscope,
A magnetic body made of a magnetic material and having a cylindrical shape,
The endoscope hood has an incision and / or a change in the thickness of the tube. An endoscope detection method in an endoscope detection system for detecting the position of an endoscope in a body,
The endoscope detection system includes:
A hood attached to the distal end of the endoscope;
A detection device for detecting the position of the endoscope,
A magnetic flux generation step in which the detection device generates magnetic flux;
A magnetic flux detection step for detecting a change in magnetic flux generated by the detection device;
An analysis step for analyzing the position of the hood based on a change in magnetic flux detected in the magnetic flux detection step;
An endoscope detection method including a display step of displaying an analysis result in the analysis step.   A program for causing a computer to execute the endoscope detection method according to claim 7.   A computer-readable recording medium on which the program according to claim 8 is recorded.