JP5714508B2 - 電気外科手術中の神経監視 - Google Patents
電気外科手術中の神経監視 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
- A61B5/7217—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7225—Details of analog processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7246—Details of waveform analysis using correlation, e.g. template matching or determination of similarity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/725—Details of waveform analysis using specific filters therefor, e.g. Kalman or adaptive filters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
Description
y[n]=x[n]−x[n−1]+α・y[y−1]
ここでx[n]は(入力モジュールから受信した)入力信号、y[n]は出力信号、およびαは定数である。必要に応じて、αの値は、信号の低周波成分も遮断するように調整されることが可能である。フィルタの適用後、信号のDC成分が遮断される。その後、遮断されたDC信号は、ステップ306において出力される。
〔態様1〕
電気手術器の動作中に患者からの電気信号および/または手術用金属間アーチファクトを感知するようになっている、神経統合監視システム用の信号処理モジュールにおいて、
感知プローブに電気的に結合され、患者の筋電図(EMG)活動および電気手術器の動作を示す入力信号を受信するようになっている、入力モジュールと、
前記入力モジュールに電気的に結合され、前記入力信号の条件を検出して、前記患者から受信するEMG活動のレベルに応じて前記条件を分類するようになっている、EMG検出モジュールと、
前記EMG検出モジュールに結合され、前記検出される条件を示す出力信号を提供するようになっている、出力モジュールと、を含む、信号処理モジュール。
〔態様2〕
態様1記載の信号処理モジュールにおいて、
前記入力信号のアーチファクトを検出し、前記出力信号を抑制するための兆候を前記出力モジュールに提供するようになっているアーチファクト検出モジュールをさらに含む、信号処理モジュール。
〔態様3〕
態様2記載の信号処理モジュールにおいて、
前記アーチファクトは、前記入力信号における電力の推定値に基づいて検出される、信号処理モジュール。
〔態様4〕
態様2記載の信号処理モジュールにおいて、
前記アーチファクトは、前記入力信号の周波数成分の推定値に基づいて検出される、信号処理モジュール。
〔態様5〕
態様2記載の信号処理モジュールにおいて、
前記入力モジュールは、多数の感知プローブから多数の入力信号を受信するようになっており、ミューティングモジュールは、前記多数の入力信号のうちの少なくとも1つを選択的に抑制するようになっている、信号処理モジュール。
〔態様6〕
態様1から5のいずれか1項に記載の信号処理モジュールにおいて、
前記入力信号における低周波ノイズを抑制するようになっている直流フィルタモジュールをさらに含む、信号処理モジュール。
〔態様7〕
態様1から6のいずれか1項に記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記入力信号において検出されるEMG活動のレベルを閾値と比較し、当該比較の兆候を前記出力モジュールに提供するようになっている、信号処理モジュール。
〔態様8〕
態様7記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記入力信号におけるエネルギーのレベルを推定して、前記EMG活動がエネルギーレベル閾値よりも大きいか否かを判断する、信号処理モジュール。
〔態様9〕
態様8記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記入力信号の自己共分散または自己相関を計算して、EMG活動のレベルを検出する、信号処理モジュール。
〔態様10〕
態様8記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記入力信号の多数のサンプルを使用して、当該入力信号の自己共分散または自己相関を計算する、信号処理モジュール。
〔態様11〕
態様9記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記入力信号の複数のサンプルを使用して、当該入力信号のウェーブレットまたはシグモイド分類関数を使用する、信号処理モジュール。
〔態様12〕
態様1から11のいずれか1項に記載の信号処理モジュールにおいて、
前記電気手術器によって形成されるノイズをフィルタリングし、患者におけるEMG活動の兆候を前記出力モジュールに提供するようになっている、EMG復元モジュールをさらに含む、信号処理モジュール。
〔態様13〕
態様12記載の信号処理モジュールにおいて、
前記EMG復元モジュールは、参照プローブを使用して、前記電気手術器によって形成される前記ノイズを推定する、信号処理モジュール。
〔態様14〕
電気手術器の動作中に使用する神経統合監視システムにおいて、
患者のEMG活動および前記電気手術器の動作を示す入力信号を生成するようになっている感知プローブと、
態様1から13のいずれか1項に記載の信号処理モジュールと、を含む、神経統合監視システム。
〔態様15〕
態様14記載の神経統合監視システムにおいて、
前記プローブは、前記電気手術器によって生成されるノイズ信号の基本周波数をフィルタリングするフィルタを含む、神経統合監視システム。
Claims (14)
- 電気手術器の動作中に患者からの電気信号および/または手術用金属間アーチファクトを感知するようになっている、神経統合監視システム用の信号処理モジュールにおいて、
複数の感知プローブに電気的に結合され、当該複数の感知プローブの各々から複数の入力信号を同時に受信するようになっている入力モジュールであって、当該複数の入力信号の第1入力信号が患者の筋電図(EMG)活動を示し、当該複数の入力信号の第2入力信号が金属間接触のアーチファクトを示す、入力モジュールと、
前記入力モジュールに電気的に結合され、前記第1入力信号の条件を検出して、前記患者から受信するEMG活動のレベルに応じて前記条件を分類するようになっている、EMG検出モジュールと、
前記第2入力信号の前記アーチファクトを検出するようになっているアーチファクト検出モジュールと、
前記EMG検出モジュール及び前記アーチファクト検出モジュールに結合され、前記第1入力信号における前記検出される条件を示す第1出力信号と前記アーチファクトを示す第2出力信号とを同時に提供するようになっている、出力モジュールと、を含む、信号処理モジュール。 - 請求項1記載の信号処理モジュールにおいて、
前記アーチファクトは、前記第2入力信号における電力の推定値に基づいて検出される、信号処理モジュール。 - 請求項1記載の信号処理モジュールにおいて、
前記アーチファクトは、前記第2入力信号の周波数成分の推定値に基づいて検出される、信号処理モジュール。 - 請求項1記載の信号処理モジュールにおいて、
前記アーチファクト検出モジュールは、前記第2入力信号を選択的に抑制するようになっている、信号処理モジュール。 - 請求項1から4のいずれか1項に記載の信号処理モジュールにおいて、
前記第2入力信号における、閾値よりも低い周波数を有するノイズを抑制するようになっている直流フィルタモジュールをさらに含む、信号処理モジュール。 - 請求項1から5のいずれか1項に記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記複数の入力信号において検出されるEMG活動のレベルを閾値と比較し、高レベルのEMG活動の存在の判断の結果を前記出力モジュールに提供するようになっている、信号処理モジュール。 - 請求項6記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記複数の入力信号におけるエネルギーのレベルを推定して、前記EMG活動がエネルギーレベル閾値よりも大きいか否かを判断する、信号処理モジュール。 - 請求項7記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記複数の入力信号の自己共分散または自己相関を計算して、EMG活動のレベルを検出する、信号処理モジュール。 - 請求項7記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記複数の入力信号の多数のサンプルを使用して、当該複数の入力信号の自己共分散または自己相関を計算する、信号処理モジュール。 - 請求項8記載の信号処理モジュールにおいて、
前記EMG検出モジュールは、前記複数の入力信号の複数のサンプルを使用して、当該複数の入力信号のウェーブレットまたはシグモイド分類関数を使用する、信号処理モジュール。 - 請求項1から10のいずれか1項に記載の信号処理モジュールにおいて、
前記電気手術器によって形成されるノイズをフィルタリングし、患者におけるEMG活動を示す信号を前記出力モジュールに提供するようになっている、EMG復元モジュールをさらに含む、信号処理モジュール。 - 請求項11記載の信号処理モジュールにおいて、
前記EMG復元モジュールは、参照プローブを使用して、前記電気手術器によって形成される前記ノイズを推定する、信号処理モジュール。 - 電気手術器の動作中に使用する神経統合監視システムにおいて、
患者のEMG活動および前記電気手術器の動作を示す複数の入力信号を生成するようになっている複数の感知プローブと、
請求項1から12のいずれか1項に記載の信号処理モジュールと、を含む、神経統合監視システム。 - 請求項13記載の神経統合監視システムにおいて、
前記プローブは、前記電気手術器によって生成されるノイズ信号の基本周波数をフィルタリングするフィルタを含む、神経統合監視システム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US12/363,154 | 2009-01-30 | ||
US12/363,154 US8989855B2 (en) | 2009-01-30 | 2009-01-30 | Nerve monitoring during electrosurgery |
PCT/US2010/021504 WO2010090835A1 (en) | 2009-01-30 | 2010-01-20 | Nerve monitoring during electrosurgery |
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JP2012516205A JP2012516205A (ja) | 2012-07-19 |
JP5714508B2 true JP5714508B2 (ja) | 2015-05-07 |
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Country | Link |
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US (2) | US8989855B2 (ja) |
EP (2) | EP3181044B1 (ja) |
JP (1) | JP5714508B2 (ja) |
KR (1) | KR101634840B1 (ja) |
CN (1) | CN102368951B (ja) |
CA (1) | CA2751073C (ja) |
WO (1) | WO2010090835A1 (ja) |
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Also Published As
Publication number | Publication date |
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US20100198099A1 (en) | 2010-08-05 |
CA2751073A1 (en) | 2010-08-12 |
EP3181044A1 (en) | 2017-06-21 |
AU2010210963A1 (en) | 2011-08-18 |
CN102368951A (zh) | 2012-03-07 |
US20150157237A1 (en) | 2015-06-11 |
JP2012516205A (ja) | 2012-07-19 |
KR101634840B1 (ko) | 2016-06-29 |
EP2391266A1 (en) | 2011-12-07 |
EP3181044B1 (en) | 2022-11-30 |
CA2751073C (en) | 2017-09-05 |
CN102368951B (zh) | 2014-08-13 |
US8989855B2 (en) | 2015-03-24 |
US9566015B2 (en) | 2017-02-14 |
KR20110113645A (ko) | 2011-10-17 |
WO2010090835A1 (en) | 2010-08-12 |
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