JP4436638B2 - Endoscope apparatus and endoscope insertion operation program - Google Patents

Description

  The present invention relates to an endoscope apparatus and an endoscope insertion operation program capable of safely and accurately performing an insertion operation of an insertion portion such as an endoscope into a body cavity duct.

In recent years, endoscope systems and endoscope apparatuses have been widely used. These endoscope systems and endoscope apparatuses are provided with a treatment instrument inserted into a treatment instrument insertion channel as needed by observing an organ or the like in the body cavity by inserting an elongated insertion portion into the body cavity. Various therapeutic treatments can be performed using this.
In recent years, medical endoscope systems and endoscope apparatuses are used to diagnose an affected area using a three-dimensional image obtained by capturing a tomographic image of a subject using, for example, a computed tomography (CT) apparatus. It has become like this.

  One such three-dimensional image is a three-dimensional image of the lung bronchus. The three-dimensional image of the lung bronchus is used to three-dimensionally grasp the position of an abnormal part suspected of lung cancer, for example. The diagnosis of whether or not the affected part is abnormal is performed by, for example, inserting a bronchoscope into the lung bronchus to confirm the abnormal part grasped as described above by biopsy. This is done by taking a sample of the abnormal part tissue with a biopsy tool protruding from the sample.

In general, an endoscope is provided with an objective optical system and an image sensor for obtaining an observation image in the duct, or an observation means such as an objective optical system and an image guide fiber at an insertion part to be inserted into the duct or at the distal end thereof. Built-in. Further, the endoscope has a bending portion on the distal end side of the insertion portion for freely directing the direction of the distal end portion of the insertion portion in a desired direction. The endoscope having such a configuration has a complicated shape while bending the bending portion so that the distal end portion of the insertion portion is directed in various desired directions or twisting the insertion portion. It can be inserted into the pipeline.
For this reason, for example, in a duct in a body cavity having multiple stages of branching, such as the bronchi, when the location of the abnormal part is close to the end of the branching, the insertion part of the endoscope can be correctly targeted in a short time. It is difficult to reach the site.

  In order to solve this problem, for example, in Japanese Patent Laid-Open No. 2000-135215, a three-dimensional image of a duct in the subject is created based on image data of a three-dimensional region of the subject, and the three-dimensional image is displayed on the three-dimensional image. A route to the target point along the pipeline is obtained, a virtual endoscopic image of the pipeline along the route is created based on the image data, and the virtual endoscopic image is monitored A device for guiding a bronchoscope to a target site has been proposed.

  In such a conventional endoscope apparatus, a live endoscopic image of a subject imaged by a bronchial endoscope is displayed, and a virtual endoscopic image in the bronchus is displayed on a monitor. Guides the insertion destination of the mirror insertion section. In this case, the surgeon appropriately rotates the endoscope insertion portion while viewing the three-dimensional virtual endoscopic image and the live endoscope image, or enters the bronchus while bending the bending portion. The endoscope insertion part is inserted.

  However, as described above, the bronchi not only has multi-stage branches, but the images at the branches are similar images having a plurality of branch destination paths. For example, as shown in FIGS. 17 (A) and 17 (B), the bronchoscope 200 is configured such that the distal end portion 200A of the insertion portion is bent by the bending portion 200B with respect to the branched peripheral portion 201A of the bronchi 201. It is bent and reaches the region of interest. FIG. 17 is a schematic view showing a state when a conventional bronchoscope is inserted into the bronchus, and FIG. 17A shows a case where the conventional bronchoscope is inserted into the bronchus. FIG. 17 (B) is a schematic side view of FIG. 17 (A).

  At this time, in the bronchoscope, for example, when the obtained endoscopic image has a characteristic branch structure as shown in FIG. Can be easily distinguished. However, the above bronchoscope is of interest, for example, when the obtained endoscopic image is as shown in FIG. It is difficult to distinguish the branch direction of a part from only the image. 18 is an image display example showing an endoscopic image obtained by a conventional bronchoscope, and FIG. 18A shows an endoscopic image obtained by a conventional bronchoscope. A first image display example, FIG. 18B, is a second image display example showing an endoscopic image obtained by a conventional bronchoscope.

On the other hand, JP-A-5-127100 and US Pat. No. 5,280,781 describe an endoscope gravity direction indicating device capable of confirming the relationship between an endoscope image and a gravity direction. . Japanese Patent Application Laid-Open No. 11-281897 filed earlier by the present applicant describes an endoscope capable of detecting the direction of gravity by providing a gravity detector such as a gyro.
However, as described in the above-mentioned Japanese Patent Application Laid-Open No. 11-281897, disposing a gravity detecting means such as a gyro at the distal end of the insertion portion has a restriction on the outer diameter of the insertion portion of the endoscope. It is difficult to use for a bronchoscope.

Therefore, the conventional (bronchial) endoscope apparatus cannot accurately detect the gravity direction of the distal end portion of the insertion portion, and it is difficult to specify the branching direction of the bronchus where the region of interest is located. In order to reach the target site correctly in a short time, the actual situation is that it is entrusted to a skilled doctor who has extensive experience in endoscopic surgery.
Therefore, in order to insert the endoscope insertion portion into the target site in the body cavity, it is desirable to insert the endoscope insertion portion reliably and in a short time.
JP 2000-135215 A JP-A-5-127100 US Pat. No. 5,280,781 Japanese Patent Laid-Open No. 11-281897

  The problem to be solved is that it has been difficult to reliably insert the endoscope insertion portion into the target site in the body cavity in a short time.

According to the first aspect of the present invention, the insertion length information for measuring the insertion length of the endoscope insertion portion inserted into the subject, the insertion speed information for measuring the insertion speed of the insertion portion, and the twist angle of the insertion portion are calculated. A detection unit that detects insertion operation information that is at least one of twist angle information to be measured and angle angle information that measures an angle angle of the bending portion of the insertion unit, and the insertion operation information detected by the detection unit as a reference As the insertion operation information to be stored, the reference insertion operation information and a storage for associating and storing an endoscope image obtained by imaging the subject at the position of the distal end portion of the endoscope insertion portion at the time of the insertion operation A control unit that monitors the insertion operation status of the endoscope insertion unit by comparing the insertion operation information serving as a reference stored in the storage unit and the insertion operation information obtained during the operation from the detection unit; It is characterized by having It is.
Also, a second aspect of the present invention, in the endoscope apparatus according to claim 1, wherein the storage unit, the insertion operation instruction comment information, the association has been inserted operation information and the endoscopic image is stored It is characterized in that a corresponding portion of information is additionally recorded and stored.
According to a third aspect of the present invention, in the endoscope apparatus according to the first aspect, the control unit further relates to the reference insertion operation information during the insertion operation stored in the storage unit. An endoscope image at the position of the distal end portion of the insertion portion is compared with an endoscope image at the position of the distal end portion of the insertion portion at the time of the insertion operation during the operation, and the state of the endoscope insertion operation is monitored.
According to a fourth aspect of the present invention, the endoscope apparatus according to the first or third aspect further comprises a notification unit for notifying an insertion operation state and an operation instruction based on a comparison analysis result by the control device. It is said.
Further, a fifth aspect of the present invention, in the endoscope apparatus according to claim 2, based on the insertion length of the insertion portion to be detected by the detector for detecting the insertion operation information, and additionally stored in the storage unit inserted The feature is that an operation instruction comment is notified from the notification section.
Further, according to a sixth aspect of the present invention, in the endoscope apparatus according to the first aspect, the control unit includes an endoscopic image obtained from the distal end portion of the insertion portion and insertion operation information obtained from the detection portion; The insertion operation information serving as a reference read from the storage unit and the endoscopic image associated with the operation information are sequentially compared, analyzed, and the result is output to the notification unit to be used by the operator. It is characterized by monitoring the mirror insertion operation status and giving instructions for the insertion operation.
According to a seventh aspect of the present invention, in an endoscope insertion operation program for inserting an endoscope insertion portion into a subject, the insertion length of the endoscope insertion portion inserted into the subject is measured. At least one of insertion length information, insertion speed information for measuring the insertion speed of the insertion portion, twist angle information for measuring the twist angle of the insertion portion, and angle angle information for measuring the angle angle of the bending portion of the insertion portion. A detection step for detecting the insertion motion information, and the insertion motion information detected in the detection step as reference insertion motion information, and the reference insertion motion information and the insertion of the endoscope at the time of the insertion motion A storage step of associating and storing an endoscopic image obtained by imaging the subject at the front end position of the head, insertion reference information stored in the storage step, and intraoperatively obtained in the detection step Be It is characterized by comprising, a comparison monitoring step of monitoring the insertion operation status of the endoscope insertion portion by comparing the input operation information.
Further, according to an eighth aspect of the present invention, in the endoscope apparatus according to the seventh aspect , the insertion operation instruction comment information for a corresponding portion of the stored associated insertion operation information and endoscopic image information. It has the additional recording process which adds and memorize | stores.
According to a ninth aspect of the present invention, in the endoscope apparatus according to the eighth aspect , the additional recording step is based on the insertion length of the insertion portion detected by the detection step of detecting the insertion operation information. It is characterized by having a step of notifying the additionally stored insertion operation instruction comment.

  The endoscope apparatus and the endoscope insertion operation program according to the present invention have an advantage that the endoscope insertion portion can be reliably and quickly inserted into a target site in a body cavity.

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

  1 to 8 relate to a first embodiment of an endoscope system and an endoscope apparatus according to the present invention, and FIG. 1 shows an endoscope system and an endoscope apparatus common to the embodiments of the present invention. FIG. 2 is a block diagram showing a schematic configuration of a main configuration unit provided, FIG. 2 is a block diagram showing a schematic configuration of an endoscope system and an endoscope apparatus of the first embodiment, and FIG. 3 is an endoscope system of FIG. FIG. 4 is a configuration diagram showing a specific configuration example of the endoscope apparatus, FIG. 4 is a configuration diagram showing a specific configuration example of the insertion length measuring unit of the endoscope insertion unit, and FIG. 4 (A) is an endoscope. 4 is a configuration diagram showing an insertion length measuring section of the insertion section, FIG. 4B is a configuration diagram showing a modification of the insertion length measuring section of the endoscope insertion section in FIG. 4A, and FIG. 5 is an endoscope insertion section. 5A is a configuration diagram illustrating a specific configuration example of the twist angle measurement unit, FIG. 5A is a configuration diagram illustrating the twist angle measurement unit of the endoscope insertion unit, and FIG. 5B is a diagram illustrating FIG. FIG. 6 is a diagram illustrating a reference insertion operation information stored in the storage unit of FIG. 1, and FIG. 6A is a configuration diagram illustrating a modification of the twist angle measurement unit of the endoscope insertion unit of FIG. 6B is a graph showing the angle angle of the bending portion with respect to the insertion length of the endoscope insertion portion, FIG. 6B is a graph showing the twist angle of the insertion portion with respect to the insertion length of the endoscope insertion portion, and the insertion length of the endoscope insertion portion. FIG. 7 is an explanatory diagram showing an example of the operation of the notification unit in the first embodiment, and FIG. 7 (A) is a graph showing the execution of action comment text, comment image display, comment voice reproduction (speech), etc. 3 is a first screen display example displayed on the display device of FIG. 3, FIG. 7B is a second screen display example displayed on the display device of FIG. 3, and FIG. 7C is a display device of FIG. The displayed third screen display example, FIG. 7D shows the operation instruction angle with respect to the current insertion length. Rough, FIG. 8 is a flow chart showing an endoscope system, insertion operation program of the endoscope apparatus of the first embodiment.

As shown in FIG. 1, an endoscope system, an endoscope apparatus 1 includes a processing device 2 having a storage unit 2A, peripheral equipment 3 necessary for endoscopic diagnosis, and an endoscope described later as a bronchial endoscope. An endoscope main body 4 having a mirror insertion unit, an insertion operation information collection unit 5, an endoscope video output unit 6, a comment input unit 7, and an editing unit 8 are provided.
The insertion operation information collection unit 5 detects and collects information for a skilled operator to insert and insert the endoscope insertion unit into the bronchi as reference insertion operation information. The insertion operation information collection unit 5 includes a detection unit such as a sensor that can acquire the insertion operation information via the peripheral device 3 and the endoscope body 4.

  The insertion operation information includes the angle angle of the bending portion, the twist angle of the insertion portion, the insertion length of the insertion portion, the insertion speed of the insertion portion, the insertion portion distal end fixed state, the insertion portion holding portion fixed state, and the like. The insertion motion information is detected and captured by the detection unit of the insertion motion information collection unit 5. The insertion operation information collection unit 5 supplies the acquired insertion operation information to the processing device 2. The processing device 2 uses the information on the angle of the bending portion, the twisting angle of the insertion portion, and the insertion length of the insertion portion as the insertion operation information, to determine the relative relationship between the distal end portion of the insertion portion and the body cavity duct that is the subject. Thus, an endoscopic image at that position is associated with the position (in particular, based on the insertion length of the insertion portion).

The endoscopic video output unit 6 receives an endoscopic image (Live image) obtained from the distal end portion (having an objective optical system and an imaging device not shown) of the endoscopic insertion portion 4A of the bronchial endoscope 14. The data is output to the processing device 2.
Although not shown, the comment input unit 7 includes a character input unit, a voice input unit, and an image input unit. The comment input unit 7 creates comment information via each input unit and outputs the comment information to the processing device 2 when there is a characteristic operation or a point to be noted with respect to the insertion operation information. Yes.

  The processing device 2 includes a storage unit 2A having a large storage capacity, and includes the insertion operation information obtained by the insertion operation information collection unit 5 and the endoscope image from the endoscope video output unit 6. It memorize | stores in the memory | storage part 2A as time series data. In this case, the processing device 2 stores the insertion operation information and the endoscope image in association with each other for each time. Here, the processing device 2 detects the relative positional relationship between the distal end portion of the endoscope insertion portion and the subject from the insertion operation information, and the storage unit 2A associates the positional relationship information with the endoscope image. And memorized. In this case, the processing device 2 associates the relative position information of the distal end portion of the endoscope insertion portion and the subject, the endoscope image at this position, and the insertion operation information at this position. The stored information is stored in the storage device 2A.

Further, when comment information such as an insertion operation instruction is supplied from the comment input unit 7, the processing device 2 is the associated insertion operation information and endoscope image stored in the storage unit 2A. Comment information can be added to a portion corresponding to time-series data and stored again.
An editing unit 8 is connected to the processing device 2. The editing unit 8 reads stored information stored in the storage unit 2A of the processing device 2 and erases unnecessary information or rearranges the information to re-record the information again.

Next, the configuration of the endoscope system and the endoscope apparatus 1 according to the first embodiment will be described with reference to FIG.
The endoscope system and endoscope apparatus 1 include an analysis unit 9 and a notification unit 10 as a monitoring control unit shown in FIG. 2 in addition to the configuration shown in FIG.

  The analysis unit 9 as the monitoring control unit is connected to the insertion operation information collection unit 5, the endoscope video output unit 6, and the processing device 2, and includes live insertion operation information and endoscope images, and a reference as storage information. And an endoscopic image associated with the motion information (an endoscopic image obtained by imaging the subject at the position of the distal end of the insertion portion detected based on the insertion motion information). Yes. The analysis unit 9 collects the insertion operation information and the endoscope image from the insertion operation information collection unit 5 and the endoscope video output unit 6 in real time by the operator performing a bronchoscope operation. Sequential comparison and analysis of the collected insertion motion information and endoscopic image and the inserted reference motion information and endoscopic image, which are the stored information stored in the storage unit 2A of the processing device 2, are used as a reference. The comparison result is output to the notification unit 10 to monitor the insertion operation of the endoscope insertion unit of the surgeon.

  The notification unit 10 includes a display unit and an audio reproduction unit. The notification unit 10 displays or reproduces the comparison result from the analysis unit 9 using characters, video, audio, or the like, thereby presenting a reference insertion operation information to the operator as an insertion operation procedure. Yes.

  As shown in FIG. 3, the endoscope system and endoscope apparatus 1 includes a display device 11 as a notification unit 10 having a speaker and a monitor, a processing device 2 including a storage unit 2 </ b> A, and an insertion operation having an analysis unit 9. In order to safely and smoothly insert the mass processing device 12, the bronchoscope 14 having the insertion portion 4A, and the insertion of the endoscope insertion portion 4A into a body cavity such as a bronchus through the mouth of the patient 50 An endoscope video processor 13 including a mouthpiece 14A that holds the endoscope insertion portion 4A so that it can be inserted, and an endoscope image output portion 6 that processes endoscope image information from the bronchoscope 14. The bending operation angle collecting unit 15A is provided in the bronchoscope 14 as the insertion motion information collecting unit 5 and measures the angle angle of the bending unit. The insertion length measuring unit 15B (insertion speed) measures the insertion length of the insertion unit. Can be configured to be detectable ) And it has a twist angle measuring unit 15C that measures the twist angle of the insertion portion.

When making a diagnosis, the bronchoscope 14 is held inserted by the mouthpiece 14A by the mouthpiece 14A held in the mouth of the patient.
In the vicinity of the operation portion of the bronchoscope 14, an operation lever 14B for adjusting the angle of the bending portion of the endoscope insertion portion 4A is provided. When the angle of the bending portion is adjusted by the operation lever 14B, the angle angle obtained by bending the bending portion by the operator is measured by the angle measuring portion 15A provided in the vicinity.

  The endoscopic video processor 13 processes endoscopic image data from the bronchial endoscope 14 by the endoscopic video output unit 6, outputs the processed data to the insertion motion amount processing device 12, and also measures the angle measurement unit of the bending unit. 15A, the insertion length measurement unit 15B of the insertion unit (measurement of the insertion speed of the insertion unit if necessary) and the measurement result from the twist angle measurement unit 15C of the insertion unit are taken in, and the measurement results are inserted in the same manner. Output to the quantity processing device 12.

  The insertion motion amount processing device 12 executes the respective processes by the processing device 2 and the analysis unit 9 as a monitoring control unit described above, obtains insertion motion information of the insertion portion by the operator, and obtains the obtained insertion The operation information and the endoscope image are sequentially compared and analyzed with the reference insertion operation information stored in the storage unit 2A and the endoscope image (memory information) associated with this information, and the operation status is monitored. At the same time, the comparison result is output to the display device 11 for display.

  The display device 11 has a monitor and a speaker, and controls the insertion operation status and operation instructions of the bronchoscope 14 with characters, images, voices, and the like based on the analysis and comparison results under the control of the insertion operation amount processing device 12. By letting the person know, reference insertion operation information and procedures can be reflected in endoscopic surgery. A specific notification instruction example by the display device 11 as the notification unit 10 will be described later.

Next, specific configuration examples of the insertion length measurement unit 15B of the insertion unit and the twist angle measurement unit 15C of the insertion unit will be described with reference to FIGS. 4 (A) to 5 (B).
First, a configuration example of the insertion length measurement unit 15B of the insertion unit will be described.
For example, as shown in FIG. 4A, the insertion length measurement unit 15B of the insertion unit is arranged so as to contact the peripheral surface of the endoscope insertion unit 4A that is inserted into the bronchus. A pair of rollers 16 rotatable in the moving direction and a potentiometer 17 as a measuring unit for measuring the rotation amount of the rollers 16 are configured. The measuring unit that measures the rotation amount of the roller 16 is not limited to the potentiometer 17 and may be configured using another angle measurement device that can measure the rotation angle of the roller 16. In this case, the insertion speed of the insertion portion can be measured by measuring the insertion length per unit time.

In the insertion length measuring unit 15B having the above-described configuration, the pair of rollers 16 rotate as the endoscope insertion unit 4A pushes and pulls, and at the same time, the potentiometer 17 rotates in conjunction with this rotation, so that the roller rotation amount is increased. The potentiometer rotation amount is measured, and the measurement result is converted into an electrical signal and output to the insertion motion amount processing device 12. On the other hand, the insertion motion amount processing device 12 obtains the insertion length of the insertion portion based on the measurement result. In this case, the insertion length of the insertion portion can be obtained by (Equation 1) shown below.
Insertion length of insertion portion = k (predetermined conversion coefficient) × rotation amount of potentiometer (Expression 1)
Next, another modification is shown.
As shown in FIG. 4B, the insertion length measuring unit 15B of the insertion unit is one or a plurality that captures in real time the movement of the marker 4a provided at equal intervals on the peripheral surface of the endoscope insertion unit 4A. A video camera 18 and an image processing unit 19 that performs real-time image processing on the imaging signal from the video camera 18 and calculates the amount of movement of the marker 4a on the screen (on the display screen of the display device 11). It is configured. The imaging unit that captures the movement of the marker 4a in real time is not limited to the video camera 18, and may be configured using a two-dimensional imaging device, for example, a CIS.

  The insertion length measurement unit 15B of the insertion unit configured as described above captures the marker 4a that is moved by the video camera 18 in real time as the endoscope insertion unit 4A is pushed and pulled. Then, the image processing unit 19 performs image processing on the imaging signal from the video camera 18 in real time, calculates the movement amount of the marker 4a on the screen (on the display screen of the display device 11), and calculates the calculation result. First, the insertion length of the insertion part is obtained.

Next, a configuration example of the twist angle measurement unit 15C of the insertion unit will be described.
For example, as shown in FIG. 5A, the twist angle measurement unit 15C of the insertion unit is arranged so as to contact the peripheral surface of the endoscope insertion unit 4A that is inserted into the bronchus. It is composed of a pair of rollers 16A that are rotatable in the rotation direction, and a potentiometer 17A as a measuring unit that measures the amount of rotation of the rollers 16A. Note that the measurement unit that measures the rotation amount of the roller 16A is not limited to the potentiometer 17A as described above, and may be configured using another angle measurement device that can measure the rotation angle of the roller 16A.

The twist angle measuring unit 15C of the insertion unit having the above-described configuration is interlocked with the rotation of the pair of rollers 16A when the endoscope insertion unit 4A itself is twisted as the endoscope insertion unit 4A is pushed and pulled. Then, the potentiometer 17A rotates. Thus, the twist angle measuring unit 15C of the insertion unit measures the potentiometer rotation amount based on the roller rotation amount, converts the measurement result into an electrical signal, and outputs the electrical signal to the insertion operation amount processing device 12. And this insertion operation amount processing apparatus 12 calculates | requires the twist angle of an insertion part based on a measurement result. In this case, the twist angle of the insertion portion can be obtained by (Equation 2) shown below.
Twist angle of insertion portion = h (predetermined conversion coefficient) × rotation amount of potentiometer (Equation 2)
Next, another modification is shown. As shown in FIG. 5B, similarly to the insertion length measurement unit 15B of the insertion unit, it is provided on the circumferential surface of the endoscope insertion unit 4A at equal intervals in the same direction as the insertion direction of the endoscope insertion unit 4A. One or a plurality of video cameras 18A for capturing the movement of the marker 4b in real time, and image processing is performed on the imaging signals from the video camera 18A in real time, and on the screen (on the display screen of the display device 11). The image processing unit 19 calculates an amount of movement of the marker 4b (not shown, but substantially the same as the configuration of FIG. 4B) 19. In this example as well, the imaging unit that captures the movement of the marker 4b in real time is not limited to the video camera 18A as in the configuration shown in FIG. 4B, and a two-dimensional imaging device such as a CIS is used. It may be configured.

  The twist angle measuring unit 15C of the insertion unit configured as described above captures the amount of movement of the marker 4b moved by the video camera 18A when the endoscope insertion unit 4A itself is twisted as the endoscope insertion unit 4A is pushed and pulled. The image signal from the video camera 18A is processed in real time, the amount of movement of the marker 4b on the screen (on the display screen of the display device 11) is calculated, and the insertion unit Find the twist angle.

Next, the operation of the endoscope system and the endoscope apparatus 1 according to the first embodiment will be described with reference to FIGS.
Now, it is assumed that the surgeon diagnoses bronchi and the like using the endoscope system and the endoscope apparatus 1 of the present embodiment. A control unit (not shown) of the insertion motion amount processing device 12 activates a processing routine of the endoscope insertion motion program shown in FIG. That is, the storage information stored in the storage unit 2A in the insertion motion amount processing device 12 in the process of step S1 (the insertion operation information serving as a reference and the endoscope image at the distal end position of the insertion unit during this operation) is read. The process proceeds to step S2.

  In step S2, the control unit rearranges the stored data based on the insertion length of the insertion unit. For example, examples of stored data obtained by this processing are shown in FIGS. 6 (A) and 6 (B).

  FIG. 6A shows insertion operation information indicating how much the angle angle of the bending portion shown on the vertical axis is according to the insertion length of the insertion portion shown on the horizontal axis. FIG. 6B shows insertion operation information indicating how much the twist angle of the insertion portion shown on the vertical axis is relative to the insertion length of the insertion portion shown on the horizontal axis. Similarly, in the case of endoscopic images and comment information stored in association with reference insertion operation information, rearrangement is performed based on the insertion length of the insertion portion as necessary, for example, FIG. As shown in FIG. 6C, insertion operation instruction data for executing sentence A, image B display, sound C reproduction (speech), and the like is created according to the insertion length of the insertion portion on the horizontal axis.

In this case, each insertion operation instruction data is calculated as a function of the insertion length of the insertion section as shown in equations (3) and (4) shown below.
Curved portion angle angle = f (insertion length of insertion portion) (Equation 3)
Twist angle of insertion part = g (insertion length of insertion part) (Equation 4)
Note that the endoscope image and the instruction comment information (sentence, voice, image) are also calculated by the function of the insertion portion insertion length.

  And the said control part transfers a process to following step S3, and measures the insertion length of the insertion part currently operated by the operator in this process in real time using the insertion length measurement part 15B of the insertion part. The process proceeds to step S4.

  In the process of step S4, the control unit inputs the insertion length of the insertion part measured in step S3 using the relational expressions (formulas 3 and 4) prepared in the process of step S2, and the bending part. The endoscope image associated with the angle angle, the twist angle of the insertion portion, the insertion operation information, and the instruction comment information to be displayed are obtained, and the process proceeds to step S5.

The control unit outputs and displays the data obtained in step S4 on the display device 11 (see FIG. 3) as the notification unit 10 by the process of step S5.
Thereafter, the process returns to step S3, the processing routine of steps S3 to S5 is periodically executed, and an instruction for an insertion operation is given to the surgeon.
Display examples presented on the display device 11 by the process of step S5 are shown in FIGS. 7 (A) to 7 (C).

  For example, as shown in FIG. 7A, the control unit of the insertion operation amount processing device 12 of the insertion unit performs an insertion operation on the screen by performing at least three multi-screen displays on the screen of the display device 11. Announce instructions. That is, two screens 11A and 11B are displayed on the upper part of the screen of the display device 11, and one screen 11C is displayed on the lower part of the screen. The screen 11A is obtained by the endoscope insertion unit 4A of the bronchoscope. An endoscopic image (live image) is displayed, and on the other screen 11B, a virtual endoscopic image (VBS image) inside the bronchus based on the CT image data according to the insertion length of the insertion portion inserted into the subject. ) Is displayed. At the same time, on the screen 11C at the bottom of the screen, an instruction for an insertion operation is displayed by guidance, and this character is reproduced as sound via the speaker 11D. That is, with reference to the insertion length of the insertion portion, the angle angle of the bending portion, the twist angle of the insertion portion, and the like are instructed by characters and voice while showing the live image and VBS image to the operator.

When there is instruction comment information or comment information is added by the editing unit 8 shown in FIG. 1, for example, as shown in FIG. 6C, the comment information (sentence, audio) is based on the insertion length of the insertion unit. , Image) is displayed on a corresponding screen on the screen of the display device 11 or reproduced and presented by the speaker 11D.
In the example shown in FIG. 7A, instead of the virtual endoscopic image displayed on the screen 11B, an endoscopic image based on the insertion length of the insertion unit stored in association with the reference insertion operation information is displayed. It is also made to do.

  Further, in the example shown in FIG. 7A, as shown in FIG. 7C, the screen 11B has a display bar 21a indicating the current angle of the angle of the bending portion and the stored reference insertion operation information. The curved portion angle display portion 20b displaying the display bar 21b indicating the operation instruction angle, the display bar 22a indicating the current angle of the twist angle of the insertion portion, and the display bar 22b indicating the stored reference insertion operation instruction angle are displayed. The twist angle display unit 20c of the insertion unit and the display unit 20a that displays an endoscopic image of the position of the distal end of the insertion unit in the insertion operation associated with the reference insertion operation information are simultaneously displayed to the operator. You may make it present.

  Further, in the first embodiment, as shown in FIG. 7B, an endoscope image based on the same insertion length stored in association with reference insertion operation information is displayed in a screen 11A for displaying a live image. It may be displayed on the screen 11a, whereby a more detailed instruction for the insertion operation can be presented. Therefore, the endoscope apparatus 1 </ b> A can reliably insert the insertion portion of the bronchoscope 14.

  Further, as another display example of the insertion operation instruction, as shown in FIG. 7C, a display bar 21a indicating the current angle of the angle of the bending portion and the stored reference insertion operation are displayed in the sub-screen 11a. A curved portion angle display portion 20b displaying a display bar 21b indicating an operation instruction angle as information, a display bar 22a indicating a current angle of a twist angle of the insertion portion, and a display bar 22b indicating a stored reference insertion operation instruction angle The twist angle display unit 20c of the insertion unit displaying the image and the display unit 20a displaying the endoscopic image of the insertion unit tip position in the insertion operation associated with the reference insertion operation information are displayed simultaneously. You may make it show to an operator. In this case, the insertion operation instruction angle is expressed with respect to the insertion length of the current insertion portion as shown in FIG. Then, when the current angle and the insertion operation instruction angle are too different, control may be performed so as to display or reproduce a warning character or voice on the display device 11.

  As described above, according to the first embodiment, it is possible to present an instruction for an insertion operation based on the insertion operation information of the insertion unit serving as a reference so that the endoscope can be reliably and quickly placed on the target site. It becomes possible to insert.

  9 to 12 relate to an endoscope system and endoscope apparatus according to a second embodiment of the present invention, and FIG. 9 shows a schematic configuration of the endoscope system and endoscope apparatus of the second embodiment. FIG. 10 is a block diagram showing a configuration example of the automatic insertion operation unit in the second embodiment, and FIG. 11 is an explanatory diagram showing reference insertion operation information stored in the storage unit of FIG. (A) is a graph showing the angle angle of the curved portion with respect to time, FIG. 11 (B) is a graph showing the insertion length of the endoscope insertion portion with respect to time, and FIG. 11 (C) is a graph of the endoscope insertion portion with respect to time. FIG. 12 is a block diagram showing a specific configuration example of the automatic insertion operation unit in FIG. 10. 9 to 12, the same components as those in the endoscope apparatus 1 of the first embodiment are denoted by the same reference numerals, description thereof is omitted, and only different portions will be described.

  The endoscope system and the endoscope apparatus according to the second embodiment include an automatic insertion operation unit 23 that controls the insertion operation instruction by the notification unit 10 according to the first embodiment and the insertion operation based on the instruction. The other features are substantially the same as those of the endoscope apparatus 1 of the first embodiment.

  As shown in FIG. 9, in the endoscope apparatus (system) 1B of the second embodiment, the automatic insertion operation unit 23 is arranged between the analysis unit 9, the peripheral device 3, and the bronchoscope 14. . The automatic insertion operation unit 23 performs the same processing contents as the notification unit 10 of the first embodiment, and performs various operations of the bronchoscope 14 and other peripheral devices 3 based on the analysis result from the analysis unit 9. Control automatically.

In other words, the automatic insertion operation unit 23 controls to automatically perform the insertion operation of the insertion unit of the bronchoscope 14 based on the analysis result. As the insertion portion insertion operation of the bronchoscope 14, the bending portion angle operation, the insertion portion twisting operation, the insertion portion insertion operation, the insertion portion distal end fixing / releasing operation and the insertion are substantially the same as in the first embodiment. There is a holding part fixing / releasing operation of the part.
In this case, as in the first embodiment, the insertion operation status of the bronchoscope 14 that is automatically inserted may be displayed on the display device 11.

Next, a configuration for automatic insertion operation of the bronchoscope 14 is shown in FIG. This automatic insertion apparatus is provided with a plurality of drive units for performing an insertion operation of the insertion unit of the bronchoscope 14 controlled by the automatic insertion operation unit 23.
The plurality of driving units include various motors such as an angle adjusting motor 24A for a bending portion, an insertion length adjusting motor 25A for an insertion portion, and a twist angle adjusting motor 26A for an insertion portion.

  The angle adjusting motor 24A is formed integrally with the angle angle measuring unit 24B of the bending portion of the bronchial endoscope 14, and its rotation axis is a bending portion angle angle adjusting mechanism (not shown) of the bronchial endoscope 14. 2), the angle operation of the bending portion of the endoscope insertion portion 4A can be performed. The angle angle measuring unit 24B of the bending portion constantly detects the angle angle of the bending portion and outputs the detection result to the automatic insertion operation unit 23.

  The insertion length adjusting motor 25A of the insertion portion is arranged so as to contact the peripheral surface of the endoscope insertion portion 4A that is inserted into the bronchus, and is directly connected to a pair of rollers that rotate in the moving direction of the endoscope insertion portion 4A. Thus, a driving force is applied to the roller. An insertion length measuring unit 25B for measuring the rotation amount of the insertion length adjusting motor 25A of the insertion unit is provided in the vicinity, and the measurement result is always output to the automatic insertion operation unit 23. ing.

  The twist angle adjusting motor 26A of the insertion portion is arranged so as to contact the peripheral surface of the endoscope insertion portion 4A to be inserted into the bronchus. The twist angle adjusting motor 26A of the insertion portion is directly connected to a pair of rollers that rotate in the rotation direction (twist direction) of the endoscope insertion portion 4A, and applies a driving force to the rollers. Further, a twist angle measuring section 26B of the insertion section for measuring the rotation amount of the twist angle adjusting motor 26A of the insertion section is provided in the vicinity, and the measurement result is always output to the automatic insertion operation section 23. Yes.

  The automatic insertion operation unit 23 calculates the angle of the current bending part of the bronchoscope 14 from the measurement results from the angle angle measurement part 24B of the bending part, the insertion length measurement part 25B of the insertion part, and the twist angle measurement part 26B of the insertion part. Recognizing the angle, the insertion length of the insertion portion, and the twist angle of the insertion portion, the insertion state of the endoscope insertion portion 4A becomes an insertion operation state based on the reference insertion operation information read from the storage unit 2A. The rotational drive of the angle adjusting motor 24A for the curved portion, the insertion length adjusting motor 25A for the insertion portion, and the twist angle adjusting motor 26A for the insertion portion is controlled.

  That is, in this embodiment, an example of insertion operation information serving as a reference read from the storage unit 2A is shown in FIG. 11A, FIG. 11B, and FIG. The section 23 is provided with an angle adjusting motor 24A for inserting the bending portion so that the insertion operation state of the insertion section of the bronchoscope 14 substantially matches the operation information shown in FIGS. 11 (A) to 11 (C). It controls the rotational drive of the insertion length adjusting motor 25A and the twist angle adjusting motor 26A of the insertion portion.

FIG. 12 shows the configuration of the automatic insertion operation unit 23.
As shown in FIG. 12, the automatic insertion operation unit 23 includes a CPU 23a as a control unit that performs various drive controls of the bronchoscope 14, readout control of the storage unit 2A, and the like, and an insertion operation that serves as a reference from the storage unit 2A. An input interface (hereinafter referred to as I / F) 23b for capturing information, a ROM 23c for storing operation information such as the acquired insertion operation information, a program necessary for automatic insertion operation, and the bronchoscope The RAM 23d that temporarily stores a measurement result related to the insertion of the 14 insertion portions and the reference insertion motion information as a work area for performing comparison calculation processing, and a drive signal for driving and controlling the angle adjustment motor 24A of the bending portion. A first amplifier 23e for amplifying and outputting, an I / F 23h for taking in a measurement result from the angle angle measurement unit 24B of the insertion unit, and insertion A second amplifier 23f that amplifies and outputs a drive signal for driving and controlling the insertion length adjusting motor 25A, an I / F 23i for capturing a measurement result from the insertion length measurement unit 25B of the insertion unit, A third amplifier 23g that amplifies and outputs a drive signal for driving and controlling the twist angle adjustment motor 26A, and an I / F 23j for taking in a measurement result from the twist angle measurement unit 26B of the insertion unit are provided.

  In the endoscope apparatus (system) 1B of the second embodiment, the automatic insertion operation unit 23 causes the angle angle measurement unit 24B of the bending unit, the insertion length measurement unit 25B of the insertion unit, and the twist angle measurement unit 26B of the insertion unit. At the same time as recognizing the current angle angle of the curved portion of the bronchoscope 14, the insertion length of the insertion portion, and the twist angle of the insertion portion, the insertion state of the endoscope insertion portion 4A is read from the storage portion 2A. Rotation drive of the angle adjustment motor 24A for the bending portion, the insertion length adjustment motor 25A for the insertion portion, and the twist angle adjustment motor 26A for the insertion portion is controlled so that an insertion operation state based on the insertion operation information serving as a reference is obtained. To do. Thereby, the endoscope apparatus (system) 1B of the second embodiment can automatically perform the insertion operation of the insertion portion in the bronchial endoscope 14 based on the reference insertion operation information.

In the second embodiment, it has been described that the insertion operation of the insertion unit of the bronchoscope 14 is automatically performed by the automatic insertion operation unit 23. However, for example, the configuration can be switched between the automatic mode and the manual mode. When manual operation is required, the operation mode may be switched to the manual mode and an operation instruction may be presented to the operator as in the first embodiment.
Therefore, according to the second embodiment, the insertion operation of the insertion portion of the bronchoscope 14 can be automatically performed based on the reference insertion operation information. An endoscope can be inserted into a target site reliably and in a short time.

  By the way, in this embodiment, the insertion operation of the insertion portion is reliably and quickly performed by reflecting the insertion operation information as a reference in the insertion operation of the insertion portion of the bronchoscope 14 by the operator in the endoscopic operation. However, it is possible to make effective use of the reference insertion motion information by allowing the surgeon to experience the reference insertion motion information using the training endoscope apparatus. Such an embodiment is shown below.

  13 to 15 relate to an endoscope system and endoscope apparatus according to a third embodiment of the present invention, and FIG. 13 shows a schematic configuration of the endoscope system and endoscope apparatus of the third embodiment. FIG. 14 is a block diagram showing the endoscope system and endoscope apparatus of the third embodiment, and FIG. 15 is a view showing a screen display example of the virtual image display apparatus of FIG. In FIGS. 13 to 15, the same components as those in the endoscope apparatus 1 of the first embodiment are denoted by the same reference numerals, description thereof is omitted, and only different portions are described.

  An endoscope apparatus (system) 1C of the third embodiment is a training endoscope having a training bronchoscope having a substantially similar configuration in place of the bronchoscope 14 of the first embodiment. The virtual endoscope image data output unit 6A that outputs the virtual endoscope image data is provided instead of the endoscope video output unit 6, and is substantially the same as the editing unit 8 and the analysis unit 9. An edit analysis unit 32 capable of performing the above process is provided. Other configurations are substantially the same as those in the first embodiment.

  As shown in FIG. 13, in the endoscope apparatus (system) 1C of the third embodiment, the storage unit 2A of the processing apparatus 2 stores reference insertion operation information and virtual endoscope image data. . These stored data can be read out, rearranged, and edited by the editing analysis unit 32 as in the first embodiment.

  The training endoscope unit 31 includes a bronchoscope having a peripheral device 3 and an endoscope insertion unit 4A, and is configured in substantially the same manner as the bronchoscope 14 shown in the first embodiment. is there. As shown in FIG. 14, the training endoscope unit 31 includes an angle measurement unit 15A for a bending portion, an insertion length measurement unit 15B for an insertion portion, and a twist angle measurement portion 15C for an insertion portion. The training endoscope unit 31 outputs the insertion operation information obtained by the measurement units 15A, 15B, and 15C to the editing analysis unit 32. In addition, a freeze button 15D is provided in the vicinity of the hand operation unit of the training endoscope. When the freeze button 15D is pressed, the virtual endoscopic image displayed at that time is displayed as a snapshot.

The virtual endoscopic image data output unit 6A generates a virtual endoscopic image (VBS image) inside the bronchus based on the CT image data, and outputs the virtual endoscopic image (VBS image) to the editing analysis unit 32.
The virtual image display device 33 is configured in substantially the same manner as the display device 11 used in the first embodiment. The virtual image display device 33 displays a virtual endoscopic image obtained by the insertion operation of the training endoscope unit 31 by performing at least three multi-screen displays.

  The edit analysis unit 32 obtains the insertion motion information from the insertion portion measurement result by the operator using the training endoscope unit 31, and the obtained insertion motion information and virtual endoscopic image are stored in the storage unit 2A. The storage information (reference insertion operation information, endoscopic image) is sequentially compared and analyzed to monitor the insertion operation status, and at the same time, the comparison result is output to the virtual image display device 33 for display. Yes.

  In this case, as shown in FIG. 7A, for example, the edit analysis unit 32 displays two screens 33A and 33B at the upper part of the screen of the virtual image display device 33 and one screen 33C at the lower part of the screen. ing. On this screen 33A, a virtual endoscopic image (VBS image) from the virtual endoscopic image data output unit 6A is displayed based on each insertion motion measurement result of the training endoscope unit 31, and the other screen. In 33B, a snapshot of the virtual endoscopic image (VBS image) displayed when the freeze button 15D of the training endoscope unit 31 is pressed is displayed. At the same time, past snapshots (VBS images) 34 are listed on the screen 33C at the bottom of the screen in order from the shorter insertion section insertion length from left to right (see FIG. 15).

The snapshot list display information on the screen 33C is stored in the storage unit 2A of the processing device 2 under the control of the editing analysis unit 32, and the virtual image as the notification unit 10 is the same as in the first embodiment. By displaying on the display device 33, it is possible to present an operation instruction to the operator who is inserting the training endoscope unit 31.
Other configurations and operations are the same as those in the first embodiment.
Therefore, according to the third embodiment, the insertion operation information used as a reference and the procedure can be effectively utilized by allowing an operator who receives training to experience the insertion operation information serving as a reference using the training endoscope apparatus. For example, if it is used as an educational system, it can greatly contribute to the improvement of the operator's insertion skill and the like.

Note that, in the endoscope apparatus (system) 1C of the third embodiment, the training endoscope section 31 is automatically set based on the insertion operation information used as a reference by the editing analysis section 32, as in the second embodiment. By performing the operation, the operator who operates the training endoscope unit 31 may experience the same insertion method as the reference insertion operation information and procedure.
In the first to third embodiments, it has been described that an insertion operation instruction corresponding to reference insertion operation information is given while displaying a VBS image in addition to a live image, but the present invention is not limited to this. Of course, the insertion operation instruction may be presented while only the live image is displayed.

FIG. 16 relates to a fourth embodiment of the endoscope system and endoscope apparatus according to the present invention, and FIG. 16 is a configuration diagram showing a medical treatment system of the fourth embodiment.
In the first to third embodiments, an example is shown in which the present invention is applied to an insertion portion of an endoscope. However, the fourth embodiment relates to, for example, insertion of a vascular treatment catheter as a medical treatment instrument having an elongated insertion portion. This is an application example.

  The medical treatment system of the fourth embodiment shown in FIG. 16 is an insertion position information collecting unit instead of the insertion operation information collecting unit of the first embodiment, and relates to the insertion of a vascular treatment catheter (hereinafter simply referred to as a catheter) 51. Since it is an Example, the endoscope image output part is abbreviate | omitted.

  In this embodiment, a catheter insertion length measuring unit 52 for detecting the insertion position of a vascular treatment catheter (hereinafter simply referred to as a catheter) 51 is provided, and position information of the catheter tip detected by the measuring unit 52 is shown in the figure. Not to be output to the insertion position information collecting unit. The catheter insertion length measurement unit 52 is disposed, for example, in the internal space of the apparatus main body 53 attached to the body surface. The device main body 53 is formed with openings 55a and 55b through which the catheter 51 can be inserted at two locations, a distal end side portion and a proximal end side portion.

  In the apparatus main body 53, a guide wheel 62 for guiding the catheter 51 and a pair of first and second clamping wheels 61 and 64 for feeding or pulling back the catheter are arranged. A gear 63 is coaxially attached to the second clamping wheel 64, and the gear 63 rotates in accordance with the advancement and retraction of the catheter 51 in a state where the catheter 51 is nipped and pressed. The gear 63 meshes with the worm gear 65, and an encoder 67 is disposed on the rotation shaft 66 of the worm gear 65 to constitute the catheter insertion length measuring unit 52.

  A signal line 67a extends to the encoder 67, and a signal from the encoder 67 via the signal line 67a is not shown in the figure with a configuration substantially similar to that of the insertion operation amount processing device 12 described in the first embodiment. An insertion length and position of the catheter 51 inside the blood vessel 68 are calculated by being input to the catheter insertion position processing device.

The operation of the catheter insertion length measuring unit 52 configured as described above will be described.
The catheter 51 is led out of the apparatus main body 53 through the opening 55a formed at the distal end portion of the apparatus main body 53, and then again inside the apparatus main body 53 via the opening 55b formed at the proximal end portion. It is introduced in the space. The catheter 51 is inserted between the first sandwiching wheel 61 and the second sandwiching wheel 64 and is extended or pulled back by a predetermined force. In this embodiment, the second clamping wheel 64 rotates according to the insertion amount of the catheter 51, and the gear part 63 is rotated by the rotation of the second clamping wheel 64, so that the worm gear 65 meshed with the gear part 63 is changed. The rotation amount is converted into an electrical signal by the encoder 67, and insertion length information is output to the catheter insertion position processing device.

  The catheter insertion position processing device calculates the insertion length of the catheter 51 inside the blood vessel 68 based on the signal from the encoder 67, and performs substantially the same processing as the first embodiment according to the calculated insertion length, The instruction comment information to be displayed or notified in association with the insertion position information is output to a display device as a notification unit for display or notification.

Due to the above-described configuration and operation, the present invention is applied to the vascular treatment catheter 51 which is a medical treatment instrument having an elongated insertion portion, almost the same as when applied to the endoscope insertion portion described in the first to third embodiments. Applicable.
In the fourth embodiment, the blood vessel treatment catheter 51 has been described as a medical treatment instrument. However, the present invention is not limited to this, and an endoscope such as a forceps inserted into a treatment instrument insertion channel of an endoscope, for example. Of course, the present invention can also be applied to a treatment tool.
The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

[Appendix]
Appendix 1. In a medical treatment system having an elongated insertion portion for insertion into a subject,
A positional relationship detection unit for detecting a relative positional relationship between the distal end of the insertion unit and the subject;
An information input unit capable of inputting predetermined information;
A storage unit that stores the positional information detected by the positional relationship detection unit in association with the predetermined information;
A medical treatment system comprising:

Appendix 2. In an endoscope system having an insertion portion for insertion into a subject,
A positional relationship detection unit for detecting a relative positional relationship between the distal end of the insertion unit and the subject;
An information input unit capable of inputting predetermined information;
A storage unit that stores the positional information detected by the positional relationship detection unit in association with the predetermined information;
An endoscope system comprising:

Appendix 3. In the endoscope system according to attachment 2,
The positional relationship detection unit is an insertion length detection unit that detects an insertion length of the insertion unit of the endoscope with respect to a subject.
Appendix 4. In the endoscope system according to attachment 3,
The positional relationship detection unit further includes at least one of a bending angle detection unit that detects a bending angle of the bending unit of the endoscope and a twist angle detection unit that detects a twist angle of the insertion unit of the endoscope. It is characterized by having.

Appendix 5. In the endoscope system according to attachment 2,
The predetermined information includes at least endoscopic image information in a subject imaged by an endoscope, character information, a virtual endoscopic image generated based on the three-dimensional data of the subject, and insertion operation information. It is characterized by being one.

Appendix 6. In an endoscope insertion operation program for inserting an endoscope insertion portion into a subject,
A positional relationship detection step of detecting a relative positional relationship between the distal end portion of the insertion portion and the subject;
An information input process for inputting predetermined information;
A storage step of storing the positional information detected in the positional relationship detection step in association with the predetermined information input in the information input step;
An endoscope insertion operation program characterized by comprising:

Appendix 7. In the endoscope insertion operation program according to attachment 6,
The positional relationship detection step is an insertion length detection step of detecting an insertion length of the insertion portion of the endoscope with respect to the subject.
Appendix 8. In the endoscope insertion operation program according to attachment 7,
The positional relationship detection step further includes at least one of a bending angle detection step of detecting a bending angle of the bending portion of the endoscope and a twist angle detection step of detecting a twist angle of the insertion portion of the endoscope. It is characterized by having.

Appendix 9. In the endoscope insertion operation program according to attachment 6,
The predetermined information is at least one of image information in a subject imaged by an endoscope, character information, a virtual image generated based on three-dimensional data of the subject, and insertion operation information. Features.
Appendix 10. In an endoscope system having an insertion part for insertion into a subject part,
A storage unit that stores predetermined information in association with information on a relative positional relationship between the distal end of the insertion unit and the subject;
A positional relationship detection unit for detecting a relative positional relationship between the subject and the distal end of the insertion unit;
An information output unit that outputs predetermined information associated with the positional relationship information detected by the positional relationship detection unit from the storage unit;
An endoscope system comprising:

Appendix 11. In the endoscope system according to attachment 10,
It has a drive part which performs the operation | movement for inserting the said insertion part in the said test object based on the predetermined information output from the said information output part.
Appendix 12. In the endoscope system according to attachment 10,
The predetermined information is at least one of image information in a subject imaged by an endoscope, character information, a virtual image generated based on three-dimensional data of the subject, and insertion operation information. Features.

Appendix 13. In an endoscope insertion operation program for inserting an endoscope insertion portion into a subject,
A positional relationship detection step of detecting a relative positional relationship between the distal end portion of the insertion portion and the subject;
Predetermined information corresponding to the positional information detected in the positional relationship detecting step from a storage unit that stores predetermined information in association with the relative positional relationship between the distal end of the insertion unit and the subject. An information output process for outputting
An endoscope insertion operation program characterized by comprising:

Appendix 14. In the endoscope insertion operation program according to attachment 13,
The positional relationship detection step is an insertion length detection step of detecting an insertion length of the insertion portion of the endoscope with respect to the subject.
Appendix 15. In the endoscope insertion operation program according to attachment 14,
The positional relationship detection step further includes at least one of a bending angle detection step of detecting a bending angle of the bending portion of the endoscope and a twist angle detection step of detecting a twist angle of the insertion portion of the endoscope. It is characterized by having.
Appendix 16. In the endoscope insertion operation program according to attachment 13,
The predetermined information is at least one of image information in a subject imaged by an endoscope, character information, a virtual image generated based on the three-dimensional data of the subject, and insertion operation information. And

Appendix 17. A detection unit for detecting insertion operation information of an endoscope insertion unit to be inserted into a subject;
The insertion motion information detected by the detection unit is used as reference insertion motion information, and the reference insertion motion information and the subject at the distal end position of the endoscope insertion portion at the time of the insertion operation are obtained. A storage unit for storing the endoscope image in association with each other,
A control unit that monitors the insertion operation status of the endoscope insertion unit by comparing the insertion operation information serving as a reference stored in the storage unit and the insertion operation information obtained during the operation from the detection unit;
An endoscope apparatus comprising:

Appendix 18. In the endoscope apparatus according to attachment 17,
The insertion operation information includes insertion length information for measuring an insertion length of an endoscope insertion portion, insertion speed measurement information for measuring an insertion speed of the insertion portion, twist angle information for measuring a twist angle of the insertion portion, and an insertion portion. It is at least one of angle angle information for measuring the angle angle of the curved portion.
Appendix 19. In the endoscope apparatus according to attachment 17,
The storage unit is characterized in that the insertion operation instruction comment information is added to and stored in the corresponding portions of the stored associated insertion operation information and endoscope image information.

Appendix 20. In the endoscope apparatus according to attachment 17,
The control unit further includes an endoscopic image of the position of the distal end of the insertion portion at the time of the insertion operation stored in the storage unit in association with the reference insertion operation information, and the distal end of the insertion portion at the time of the insertion operation during surgery. The endoscope insertion operation status is monitored by comparing the endoscopic images of the partial positions.
Appendix 21. In the endoscope apparatus according to appendix 17 or 20,
It has a notification part which notifies an insertion operation situation and operation directions based on a comparison analysis result by the control device.
Appendix 22. In the endoscope apparatus according to appendix 19,
An insertion operation instruction comment additionally stored in the storage unit is notified from the notification unit based on the insertion length of the insertion unit detected by the detection unit that detects the insertion operation information.
Appendix 23. In the endoscope apparatus according to attachment 17,
The control unit is associated with the endoscopic image obtained from the distal end of the insertion unit and the insertion operation information obtained from the detection unit, the reference insertion operation information read from the storage unit, and the operation information. An endoscope image is sequentially compared, analyzed, and the result is output to a notification unit to monitor an operator's endoscope insertion operation status and give an instruction to the insertion operation.

Appendix 24. In an endoscope insertion operation program for inserting an insertion portion of an endoscope into a subject,
A detection step of detecting insertion operation information of an endoscope insertion portion to be inserted into a subject;
The insertion motion information detected in the detection step is used as reference insertion motion information, and the reference insertion motion information and a subject at the distal end position of the endoscope insertion portion at the time of the insertion motion are obtained by imaging. A storage step of storing the associated endoscope image in association with each other;
A comparison monitoring step of monitoring the insertion operation status of the endoscope insertion portion by comparing the insertion operation information serving as a reference stored in the storage step with the insertion operation information obtained during the operation in the detection step;
An endoscope insertion operation program characterized by comprising:

Appendix 25. In the endoscope insertion operation program according to attachment 24,
An additional recording step of adding and storing insertion operation instruction comment information in a corresponding portion of the stored associated insertion operation information and endoscope image information is provided.
Appendix 26. In the endoscope insertion operation program according to attachment 25,
The method includes a step of notifying an insertion operation instruction comment additionally stored in the additional recording step based on an insertion length of the insertion portion detected by the detection step of detecting the insertion operation information.

Addendum 27. Information detected in advance as insertion operation information of an endoscope insertion unit to be inserted into a subject is used as reference insertion operation information, and the reference insertion operation information and the endoscope insertion unit at the time of this insertion operation A storage unit that associates and stores an endoscopic image obtained by imaging the subject at the tip position;
An insertion unit insertion drive unit for inserting an endoscope insertion unit into the subject;
A control unit for controlling the operation of the insertion unit insertion drive unit based on the reference insertion operation information stored in the storage unit;
An endoscope apparatus comprising:
Appendix 28. Information pre-detected as insertion operation information of the endoscope insertion unit inserted into the subject is used as reference insertion operation information, and a storage unit that stores the reference insertion operation information;
A detection unit for detecting insertion motion information of the training endoscope;
A control unit that monitors the insertion operation status by comparing the insertion operation information serving as a reference stored in the storage unit with the insertion operation information obtained from the detection unit;
An endoscope apparatus comprising:

Appendix 29 Information detected in advance as insertion operation information of the endoscope insertion unit to be inserted into the subject is used as reference insertion operation information, and the reference insertion operation information and the endoscope insertion unit at the time of this insertion operation are used. A storage unit that associates and stores an endoscopic image obtained by imaging the subject at the tip position;
A detection unit for detecting insertion motion information of the training endoscope;
A data storage unit storing virtual endoscope image data of the position of the distal end portion of the training endoscope insertion unit at the time of each insertion operation of the training endoscope;
Insertion tip position at the time of the insertion operation stored in the storage unit in association with the reference insertion operation information stored in the storage unit and the reference insertion operation information stored in the data storage unit Control for monitoring the insertion operation status by comparing the endoscopic image of the image, the insertion operation information obtained from the detection unit, and the virtual endoscopic image of the position of the distal end of the insertion unit during the insertion operation of the training endoscope And
An endoscope apparatus comprising:

It is a block diagram which shows schematic structure of the main structure part provided in the endoscope system and endoscope apparatus common to each Example of this invention. It is a block diagram which shows schematic structure of the endoscope system of 1st Example, and an endoscope apparatus. It is a block diagram which shows the specific structural example of the endoscope system of FIG. 2, and an endoscope apparatus. It is a block diagram which shows the specific structural example of the insertion length measurement part of an endoscope insertion part. It is a block diagram which shows the specific structural example of the twist angle measurement part of an endoscope insertion part. It is explanatory drawing which shows the insertion operation information used as the reference | standard memorize | stored in the memory | storage part of FIG. It is explanatory drawing which shows the operation example of the notification part in 1st Example. It is a flowchart which shows the control operation program of the endoscope system of 1st Example, and an endoscope apparatus. It is a block diagram which shows schematic structure of the endoscope system of 2nd Example, and an endoscope apparatus. It is a block diagram which shows the structural example of the automatic insertion operation | movement part in 2nd Example. It is explanatory drawing which shows the insertion operation information used as the reference | standard memorize | stored in the memory | storage part of FIG. It is a block diagram which shows the specific structural example of the automatic insertion operation | movement part of FIG. It is a block diagram which shows schematic structure of the endoscope system and endoscope apparatus of 3rd Example. It is a block diagram which shows the endoscope system and endoscope apparatus of 3rd Example. It is a figure which shows the example of a screen display of the virtual image display apparatus of FIG. It is a block diagram which shows the medical treatment system of 4th Example. It is the schematic which shows a mode when the conventional bronchoscope is inserted in a bronchus. It is an image display example which shows the endoscopic image obtained with the conventional bronchoscope.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Endoscope system, endoscope apparatus 2 Processing apparatus 2A Storage part 3 Peripheral device 4 Endoscope body 5 Insertion operation information collection part 6 Endoscope image output part 7 Comment input part 8 Editing part 9 Analysis part 10 Notification part DESCRIPTION OF SYMBOLS 11 Display apparatus 12 Insertion operation amount processing apparatus 13 Video processor for endoscope 14 Bronchoscope 14A Mouthpiece 14B Operation lever 15A Angle measurement part 15B Insertion length measurement part 15C Twist angle measurement part 16, 16A Roller 17, 17A Potentiometer 18 , 18A Video camera 19 Image processing unit

Attorney Susumu Ito

Claims (9)

Insertion length information for measuring an insertion length of an endoscope insertion portion to be inserted into a subject, insertion speed information for measuring an insertion speed of the insertion portion, twist angle information for measuring a twist angle of the insertion portion, the insertion A detection unit that detects insertion operation information that is at least one of angle angle information that measures an angle angle of the curved portion of the unit;
The insertion motion information detected by the detection unit is used as reference insertion motion information, and the reference insertion motion information and the subject at the distal end position of the endoscope insertion portion at the time of the insertion operation are obtained. A storage unit for storing the endoscope image in association with each other,
A control unit that monitors the insertion operation status of the endoscope insertion unit by comparing the insertion operation information serving as a reference stored in the storage unit and the insertion operation information obtained during the operation from the detection unit;
An endoscope apparatus comprising: The said storage part adds and memorize | stores the insertion operation instruction | indication comment information with respect to the corresponding | compatible part of the memorize | stored associated insertion operation information and endoscopic image information, The memorize | stored Endoscopic device. The control unit further includes an endoscopic image of the position of the distal end of the insertion portion at the time of the insertion operation stored in the storage unit in association with the reference insertion operation information, and the distal end of the insertion portion at the time of the insertion operation during surgery. The endoscope apparatus according to claim 1, wherein an endoscope insertion operation state is monitored by comparing the endoscope images of the partial positions . The endoscope apparatus according to claim 1, further comprising a notification unit that notifies an insertion operation state and an operation instruction based on a comparison analysis result by the control device. 3. The endoscope according to claim 2, wherein an insertion operation instruction comment additionally stored in the storage unit is notified from the notification unit based on the insertion length of the insertion unit detected by the detection unit detecting the insertion operation information. Mirror device. The control unit is associated with the endoscopic image obtained from the distal end of the insertion unit and the insertion operation information obtained from the detection unit, the reference insertion operation information read from the storage unit, and the operation information. The endoscope image is sequentially compared, the analysis is performed, the result is output to a notification unit, and the endoscope insertion operation status of the surgeon is monitored and an instruction for the insertion operation is given. The endoscope apparatus according to 1. In an endoscope insertion operation program for inserting an insertion portion of an endoscope into a subject,
Insertion length information for measuring an insertion length of an endoscope insertion portion to be inserted into a subject, insertion speed information for measuring an insertion speed of the insertion portion, twist angle information for measuring a twist angle of the insertion portion, the insertion A detection step of detecting insertion operation information that is at least one of angle angle information for measuring an angle angle of the curved portion of the portion;
The insertion motion information detected in the detection step is used as reference insertion motion information, and the reference insertion motion information and a subject at the distal end position of the endoscope insertion portion at the time of the insertion motion are obtained by imaging. A storage step of storing the associated endoscope image in association with each other;
Insertion operation information serving as a reference stored in the storage step and obtained during the operation in the detection step
A comparison monitoring step of comparing the insertion operation information and monitoring the insertion operation status of the endoscope insertion portion;
An endoscope insertion operation program characterized by comprising: 8. The recording apparatus according to claim 7, further comprising: an additional recording step of adding and storing the insertion operation instruction comment information with respect to corresponding portions of the stored associated insertion operation information and endoscope image information . Endoscope insertion operation program. 9. The method according to claim 8, further comprising a step of notifying an insertion operation instruction comment additionally stored in the additional recording step based on an insertion length of the insertion portion detected by the detection step of detecting the insertion operation information. The endoscope insertion operation program described.

Images