JP5297937B2 - Medical observation system - Google Patents

Description

  The present invention relates to a medical observation system that images a body cavity of a patient, and more particularly, to a medical observation system that is suitably configured so as not to cause a burden on a patient due to excessive supply of air supply gas.

  A fiberscope and an electronic scope are generally known as medical devices used when an operator diagnoses a body cavity of a patient. For example, an operator who uses an electronic scope inserts the insertion portion of the electronic scope into a body cavity and guides the insertion distal end portion provided at the distal end of the insertion portion to the vicinity of the subject. The surgeon operates the operation unit of the electronic scope or the video processor as necessary, and illuminates the subject with the illumination light emitted from the light source device. The surgeon images the reflected light image of the illuminated subject with a solid-state imaging device such as a CCD (Charge Coupled Device) mounted on the insertion tip. The surgeon observes the captured image of the subject through a monitor and performs diagnosis and treatment.

  By the way, the stomach and intestine, which are the observation targets of this type of medical observation system, are usually deflated, it is difficult to secure a field of view for imaging, and are not in a state suitable for observation by a scope. Therefore, in order to ensure an observation visual field, the medical observation system is equipped with an air supply function for sending gas from the insertion tip of the scope to inflate the stomach and intestine. A specific configuration example of a medical observation system with an air supply function is described in Patent Document 1.

  The medical observation system described in Patent Document 1 does not cause a burden on the patient due to the expansion of the stomach wall when the gas supply gas is excessively supplied into the stomach. Alternatively, suction is automatically performed and the pressure in the stomach is maintained at an appropriate value.

Japanese Patent Publication No. 3-24844

  However, in the medical observation system described in Patent Document 1, it is pointed out that the adhering matter adhering to the stomach wall or the like is sucked against the surgeon's will during decompression. In addition, it is pointed out that when the pressure is reduced, the suction force of the suction pump is too strong, and the stomach may be sharply deflated, and smooth diagnosis is temporarily hindered. That is, the medical observation system described in Patent Document 1 is not a preferable configuration because it has the above disadvantages instead of causing a burden on the patient due to excessive supply of air supply gas.

  The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a medical observation system that is suitably configured so as not to cause a burden on the patient due to excessive supply of air-feeding gas. That is.

  A medical observation system according to an aspect of the present invention that solves the above problems includes an air supply unit that sends air from the distal end of a scope into a body cavity, and a pressure detection unit that detects a pressure near the distal end of the scope. And a gas cooling means for cooling the gas sent out by the air supply means when the detected pressure reaches a predetermined threshold value.

  That is, according to the medical observation system according to the present invention, in order to avoid an excessive increase in pressure in the body cavity, the pressure in the body cavity is reduced by supplying cooled air into the body cavity, and the pressure in the body cavity is adjusted appropriately. Can be in range. For this reason, the burden on the patient due to excessive supply of the air supply gas is effectively avoided. In addition, since suction is not used as the decompression means, a smooth diagnosis can be made without any inconvenience that the adhering matter adhering to the stomach wall or the like is sucked against the surgeon's will or rapid stomach deflation due to suction. There is no inconvenience that is hindered.

  The medical observation system according to the present invention further includes input means for inputting predetermined patient information, and threshold calculation means for calculating a predetermined threshold referred to by the gas cooling means based on the input patient information. It is good also as a structure. Here, the threshold value calculation means may be configured to calculate a predetermined threshold value in consideration of the type of scope to be used.

  The medical observation system according to the present invention may further include a temperature detection unit that detects the temperature near the distal end of the scope. The gas cooling means may be configured to cool the gas delivered by the air feeding means to a temperature corresponding to the detected temperature when the detected pressure has not reached a predetermined threshold value.

  ADVANTAGE OF THE INVENTION According to this invention, the medical observation system suitably comprised so that the burden of the patient by the excessive supply of insufflation gas may not be produced is provided.

It is a block diagram which shows the structure of the medical observation system of embodiment of this invention. It is a flowchart which shows the body cavity pressure adjustment process performed in the medical observation system of embodiment of this invention.

  Hereinafter, a medical observation system according to an embodiment of the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a block diagram illustrating a configuration of a medical observation system 1 according to the present embodiment. As shown in FIG. 1, the medical observation system 1 includes an electronic scope 100 that images a subject. The electronic scope 100 is electrically and optically connected to the processor 200 via a connector unit (not shown). The processor 200 is an apparatus that integrally includes a signal processing device that processes a signal of an image captured by the electronic scope 100 and a light source device that illuminates a body cavity that does not reach natural light via the electronic scope 100. In another embodiment, the signal processing device and the light source device may be configured separately.

  The processor 200 has a system power source 202 and a lamp power igniter 204. The system power source 202 converts the voltage from the commercial power source to increase or decrease the voltage, and supplies it to each circuit of the processor 200 or to the electronic scope 100 as a power source. When a voltage is supplied from a commercial power supply, the lamp power igniter 204 generates a pulse voltage and starts the lamp 208 supported by the lamp house 206.

  The processor 200 includes a control circuit 220 that controls each element constituting the medical observation system 1. The control circuit 220 outputs clock pulses for adjusting signal processing timing to various circuits in the medical observation system 1 after the processor 200 is powered on. In FIG. 1, some connections (for example, connections between the system power supply 202 and each circuit of the processor 200) that complicate the drawing are not shown for the sake of convenience.

  The lamp 208 emits white light after being started by the lamp power igniter 204. As the lamp 208, a high-intensity lamp such as a xenon lamp, a halogen lamp, a mercury lamp, or a metal halide lamp is suitable. The illumination light emitted from the lamp 208 is collected by the condenser lens 210 and enters the incident end of an LCB (light carrying bundle) 102.

  Illumination light incident on the incident end of the LCB 102 propagates by repeating total reflection inside the LCB 102. The illumination light that has propagated through the LCB 102 is emitted from the exit end of the LCB 102 disposed at the tip of the electronic scope 100. The illumination light emitted from the exit end of the LCB 102 illuminates the subject via the light distribution lens 104. The reflected light from the subject enters the objective lens 106 and forms an optical image on the light receiving surface of the solid-state image sensor 108 by the power of the objective lens 106.

  The solid-state image sensor 108 is, for example, a single-plate color CCD having a Bayer-type pixel arrangement, accumulates an optical image formed by each pixel on the light receiving surface as charges according to the amount of light, and each color of R, G, B Is converted into an image signal corresponding to. The converted image signal is amplified by the preamplifier 110 and input to the driver signal processing circuit 112.

  Based on the clock pulse of the control circuit 220, the driver signal processing circuit 112 controls driving of the solid-state imaging device 108 at a timing synchronized with the frame rate of the video processed on the processor 200 side. The memory 114 stores information unique to the electronic scope 100 (for example, the number and sensitivity of pixels of the solid-state imaging device 108, a compatible rate, or a model number). The driver signal processing circuit 112 accesses the memory 114 and reads information unique to the electronic scope 100.

  The driver signal processing circuit 112 outputs the read unique information to the control circuit 220 and the image signal to the signal processing circuit 222. Between the driver signal processing circuit 112 and the control circuit 220 or the signal processing circuit 222, an insulating circuit (not shown) using a photocoupler or the like is disposed. That is, the electronic scope 100 and the processor 200 are electrically insulated.

  The control circuit 220 performs various calculations based on the unique information from the driver signal processing circuit 112 and generates a control signal. The control circuit 220 uses the generated control signal to control the operation and timing of various circuits in the processor 200 so that processing suitable for the electronic scope connected to the processor 200 is performed. Further, the control circuit 220 may be configured to have a table in which a model number of the electronic scope is associated with control information suitable for the electronic scope of the model number. In this case, the control circuit 220 refers to the control information in the correspondence table and controls the operation and timing of various circuits in the processor 200 so that processing suitable for the electronic scope connected to the processor 200 is performed.

  The signal processing circuit 222 performs predetermined signal processing such as clamping, knee, γ correction, interpolation processing, AGC (Auto Gain Control), and A / D conversion on the image signal from the driver signal processing circuit 112. The signal processing circuit 222 buffers the image signal after predetermined processing in the frame memory 224 in units of frames. The frame memory 224 sweeps the buffered image signal to the post-processing circuit 226 at a predetermined timing. The post-processing circuit 226 converts the image signal from the frame memory 224 into a video signal conforming to a predetermined standard such as NTSC (National Television System Committee) or PAL (Phase Alternating Line), and sequentially outputs it to the monitor 300. As a result, a color image of the subject is displayed on the monitor 300.

The medical observation system 1 has an air supply function for supplying an air supply gas such as air or CO ₂ (air in the present embodiment) to the stomach or intestine in order to assist diagnosis by the operator. Below, the structure and process for implement | achieving an air_supply function are demonstrated concretely.

  FIG. 2 is a flowchart showing the body cavity pressure adjustment process executed in the medical observation system 1 of the present embodiment. The body cavity pressure adjustment process in FIG. 2 will be described on the assumption that the insertion tip of the electronic scope 100 is disposed in the vicinity of the site to be observed. In the description and drawings in the present specification, each processing step of the body cavity pressure adjustment processing is abbreviated as “S”.

  As shown in FIG. 1, the processor 200 has an operation panel 228. The surgeon operates the operation panel 228 to input predetermined patient information such as the patient's age, body type, and sex. The control circuit 220 starts executing the body cavity pressure adjustment process of FIG. 2 in response to the input of patient information. The body cavity pressure adjustment process in FIG. 2 is continuously executed until a predetermined operation is performed by the operation panel 228 or until the medical observation system 1 is stopped. Patient information can also be input using a keyboard (not shown).

  In the process of S1 in FIG. 2, the control circuit 220 converts the input patient information into intermediate data for calculating appropriate pressure using, for example, a predetermined function. The control circuit 220 accesses the appropriate pressure calculation database 230 using the converted intermediate data. In the appropriate pressure calculation database 230, the upper limit value of the appropriate pressure in the body cavity empirically obtained through past cases, clinical trials, etc. (hereinafter referred to as “appropriate pressure upper limit value”) is associated with the intermediate data. Stored. In the process of S2 of FIG. 2, the control circuit 220 reads the appropriate pressure upper limit value in the body cavity corresponding to the intermediate data from the appropriate pressure calculation database 230.

  In addition, the appropriate pressure upper limit value in the body cavity is different for each part (for example, stomach or intestine) in the body cavity. In general, the electronic scope is designed specifically for use in diagnosing a specific part (for example, stomach or intestine) in a body cavity. Therefore, in the present embodiment, the control circuit 220 reads the model number (type) of the electronic scope 100 stored in the memory 114, for example, and refers to the correspondence table so that the insertion tip of the electronic scope 100 is arranged. It may be configured to specify a site. In this case, the control circuit 220 generates intermediate data in consideration of the information on the identified observation target region, accesses the appropriate pressure calculation database 230, and sets an appropriate pressure upper limit suitable for the patient and the observation target region. Read the value.

  Here, as shown in FIG. 1, a pressure sensor 116 and a temperature sensor 118 are provided at the insertion tip of the electronic scope 100. The control circuit 220 monitors the output of the pressure sensor 116 and the temperature sensor 118 during the execution of the intra-body-cavity pressure adjustment process of FIG. 2, and detects the pressure and temperature in the body cavity near the insertion tip. .

  As shown in FIG. 1, the processor 200 has a built-in pump 232. The built-in pump 232 supplies air in the atmosphere to the gas tank 234, for example. The output of the built-in pump 232 is determined by the value of the DC voltage supplied from the system power supply 202. The temperature inside the gas tank 234 is cooled by an electronic cooling device 238 controlled by a cooling controller 236. Specifically, in the process of S3 in FIG. 2, the control circuit 220 sets the cooling controller 236 so that the temperature inside the gas tank 234 becomes a predetermined temperature (here, the temperature in the body cavity detected by the temperature sensor 118). Is controlled to operate the electronic cooling device 238. The electronic cooling device 238 may be, for example, an air cooling type or a water cooling type. The electronic cooling device 238 may be a cooling device such as a compressor or a Peltier element.

  The gas tank 234 is configured such that the inside of the gas tank 234 is pressurized by the output of the built-in pump 232, and the internal gas is sent to one end of the air supply pipe 242 through the air supply port 240 according to the pressurization pressure. Yes. The other end of the air supply pipe 242 is connected to an air supply channel 122 provided in the electronic scope 100 via a connection port 120. The gas delivered from the gas tank 234 continues to be supplied into the body cavity from the air supply port 124 through the air supply pipe 242 and the air supply channel 122.

  The pressure in the body cavity increases according to the supplied air supply amount. In the process of S4 in FIG. 2, the control circuit 220 determines whether or not the pressure in the body cavity detected by the pressure sensor 116 has reached the appropriate pressure upper limit value read out in the process of S2. When the detected pressure has not reached the appropriate pressure upper limit value (S4: NO), the control circuit 220 repeatedly executes the processes of S3 and S4. When the detected pressure reaches the appropriate pressure upper limit (S4: YES), the control circuit 220 controls the cooling controller 236 to operate the electronic cooling device 238 so that the temperature inside the gas tank 234 decreases by a predetermined temperature. (S5). As a result, the gas inside the gas tank 234 cooled to a predetermined temperature is supplied into the body cavity via the air supply pipe 242 and the air supply channel 122, and the pressure in the body cavity is reduced. The control circuit 220 continuously performs the processes of S5 and S6 until the detected pressure decreases to a value lower than the appropriate pressure upper limit value by a predetermined value (S6: NO). When the detected pressure falls to a value lower than the appropriate pressure upper limit value by a predetermined value (S6: YES), the control circuit 220 returns to the process of S3.

  That is, according to the body cavity pressure adjustment process of FIG. 2, in order to avoid an excessive pressure rise in the body cavity, the pressure in the body cavity is lowered by supplying cooled air into the body cavity, and the pressure in the body cavity is adjusted appropriately. Can be in range. For this reason, the burden on the patient due to excessive supply of the air supply gas is effectively avoided. In addition, since suction is not used as the decompression means, a smooth diagnosis can be made without any inconvenience that the adhering matter adhering to the stomach wall or the like is sucked against the surgeon's will or rapid stomach deflation due to suction. There is no inconvenience that is hindered.

  The above is the description of the embodiment of the present invention. The present invention is not limited to the above-described configuration, and various modifications can be made within the scope of the technical idea of the present invention. For example, the control circuit 220 may perform a process of lowering the supply voltage to the built-in pump 232 by the system power supply 202 by a certain value as an alternative to the process of S5 in FIG. As a result, the output of the built-in pump 232 is reduced, the amount of air supplied to the body cavity is reduced, and the effect of lowering the pressure in the body cavity is obtained as in the process of S5 in FIG.

  In another embodiment, for example, the process of S3 in FIG. 2 may not be executed. In this case, there is an advantage that the temperature sensor 118 is not necessary and the configuration of the medical observation system 1 can be simplified.

DESCRIPTION OF SYMBOLS 1 Medical observation system 100 Electronic scope 116 Pressure sensor 118 Temperature sensor 122 Air supply channel 124 Air supply port 200 Processor 230 Appropriate pressure calculation database 232 Built-in pump 234 Gas tank 236 Cooling controller 238 Electronic cooling device

Claims (4)

An air supply means for sending air into the body cavity from the distal end of the scope;
Pressure detecting means for detecting the pressure near the tip, and
A gas cooling means for cooling the gas delivered by the air feeding means when the detected pressure reaches a predetermined threshold;
A medical observation system characterized by comprising: Input means for inputting predetermined patient information;
Threshold calculation means for calculating the predetermined threshold based on the inputted patient information;
The medical observation system according to claim 1, further comprising:   The medical observation system according to claim 2, wherein the threshold value calculation unit calculates the predetermined threshold value in consideration of a type of scope to be used. Further comprising a temperature detecting means for detecting the temperature in the vicinity of the tip,
The gas cooling means cools the gas delivered by the air feeding means to a temperature corresponding to the detected temperature when the detected pressure does not reach a predetermined threshold value. The medical observation system according to any one of claims 1 to 3.

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