JP6870958B2 - Intraoperative management device for surgical instruments and intraoperative management method for surgical instruments - Google Patents

Description

The present invention relates to an apparatus and a method for intraoperatively managing the delivery of a surgical instrument to the surgical field and the recovery from the surgical field.

Efficient operation of the operating room is one of the issues in hospital management. This is because the shorter the operation time, the more patients can be operated on, and the number of patients can be increased without depending on the increase in the operating room, which requires a large space and enormous cost. One of the factors that hinders the shortening of the operation time is the confirmation work of the surgical instruments before and after the operation. The number of surgical instruments used in large-scale surgery may exceed 100, so all surgical instruments are lined up on a deployment table to check the type and number before surgery, and all surgical instruments are lined up after surgery. I try to check each one to see if it is the same as before. And it is not possible to close the wound until it is confirmed that there is no abnormality. The reason why the confirmation work takes a lot of time and effort is to eliminate the omission of recovery from the surgical field of the surgical instrument and surely prevent the residual in the body.

As an example of the conventional management method of surgical instruments, Japanese Patent Application Laid-Open No. 7-178106 assigns a bar code label L capable of machine input to a computer to the surgical instruments, and records the history information of each surgical instrument. A method of managing surgical instruments managed by a computer is disclosed. However, this patent document lacks disclosure of intraoperative management of surgical instruments in order to eliminate omission of recovery of surgical instruments from the surgical field and reliably prevent residual in the body.

Japanese Unexamined Patent Publication No. 7-178106

By the way, the delivery and collection of surgical instruments to the surgical field is managed by a nurse who delivers the surgical instruments to and from the surgeon, and is often performed mainly according to the rules set by the hospital. However, the more types and numbers of surgical instruments used, the more complex the management of surgical instruments in and out of the surgical field becomes, and the more difficult it is to manage without the advanced expertise and experience of nurses. In addition, long-term surgery that exceeds 10 hours puts a heavy burden on nurses and makes mistakes more likely to occur. Therefore, nurses are often changed on the way, and it is a heavy burden for nurses because they have to take over the management situation with the utmost care. And checking the types and numbers of all surgical instruments before and after surgery is indispensable for ensuring the safety of patients, no matter how difficult it may be. As described above, the conventional intraoperative management of surgical instruments is a heavy burden even for veteran nurses, and since confirmation work before and after surgery cannot be omitted, it can contribute to shortening the surgical time. The current situation is that we cannot expect it.

It is the present invention that has been made against the background of the above-mentioned intraoperative management of surgical instruments. The purpose is to enable easy and reliable intraoperative management of surgical instruments, and to achieve both patient safety and efficient operation of the operating room.

In order to achieve the above object, the present invention is configured to have the following features.

That is, the present invention is an intraoperative management device for a surgical instrument in a surgical field, and is an acquisition unit that acquires an identification code for individually identifying the surgical instrument, and the surgical instrument corresponding to the identification code acquired by the acquisition unit. Provided is an intraoperative management device for a surgical instrument, comprising a control unit for displaying a reader display screen for displaying a list as if the surgical instrument has been paid out to the surgical field.

According to this, the acquisition unit acquires an identification code for identifying the individual surgical instrument, and the control unit displays a reader display screen that lists the surgical instruments corresponding to the identification code as if they were paid out to the surgical field. Therefore, by looking at the reader display screen, it is possible to reliably grasp the surgical instruments that have been paid out to the surgical field. Therefore, if it is confirmed that there is no surgical instrument that has been paid out, it means that there is no surgical instrument that is being paid out in the surgical field, so that intraoperative management can be performed easily and reliably.

In the present invention, the control unit determines the presence or absence of the acquired identification code that matches the identification code newly acquired by the acquisition unit, and the surgical instrument corresponding to the identification code determined to match. , Can be erased from the reader display screen. That is, when the newly acquired identification code matches the acquired identification code, it means that the identification code of the same individual has been acquired twice. That is, the "acquired identification code" is the identification code acquired when the surgical instrument is paid out to the surgical field, and the "newly acquired identification code" is the identification code acquired when the surgical instrument is collected from the surgical field. It is an identification code. When the same identification code is acquired twice, the control unit deletes the surgical instrument corresponding to the identification code from the reading instrument display screen, so that only the surgical instrument in the surgical field is displayed on the reading instrument display screen. Only the surgical instruments inside can be easily grasped.

In the present invention, the control unit can be configured to display an unreadable instrument display screen that lists the surgical instruments whose identification code cannot be obtained as unreadable instruments that are paid out to the surgical field. .. According to this, even if there is no choice but to use a surgical instrument whose identification code cannot be obtained for some reason, the control unit displays a list of surgical instruments paid out to the surgical field on the unreadable instrument display screen. Even with such surgical instruments, it is possible to reliably control the delivery and collection to the surgical field.

Further, in order to achieve the above object, the present invention is an intraoperative management method of a surgical instrument in a surgical field, and corresponds to a step of acquiring an identification code for identifying an individual of the surgical instrument with an acquisition device and the identification code. Provided is an intraoperative management method of a surgical instrument having a step of displaying a reader display screen for displaying a list of the surgical instruments as being delivered to the surgical field on a display device.

According to this, in order to execute the step of displaying the reader display screen that lists the surgical instruments corresponding to the identification code as if they were paid out to the surgical field, the surgical instruments are paid out to the surgical field by looking at the reader display screen. You can surely grasp the surgical instrument you are using. Therefore, if it is confirmed that there is no surgical instrument that has been paid out, it means that there is no surgical instrument that is being paid out in the surgical field, so that intraoperative management can be performed easily and reliably.

The "identification code" in the above invention can be, for example, a two-dimensional symbol, and the "acquisition unit" can be an image pickup device (code reader). Further, the two-dimensional symbol can be configured as an engraved portion directly engraved on the surgical instrument or a seal portion printed with the two-dimensional symbol and fixed to the surgical instrument.

According to the present invention, the delivery of the surgical instrument to the surgical field can be easily grasped by the list display through the reader display screen, so that the surgical instrument in the surgical field currently in use can be reliably managed. Wear. Therefore, it is possible to efficiently operate the operating room with the first priority being to ensure the safety of the patient.

Further, in the present invention, the recovery of the surgical instrument from the surgical field can be easily grasped through the reader display screen, so that the surgical instrument remaining in the surgical field after the use is stopped and the surgical instrument is recovered can be surely performed. Can be managed.

Further, in the present invention, even if the surgical instrument cannot obtain the identification code, the payment to the surgical field can be easily grasped through the unreadable instrument display screen, so that it is safe even when using such a surgical instrument. It is possible to manage the withdrawal and collection.

Explanatory drawing which shows the outline around the operating table. The external view which shows the right side surface of the intraoperative management apparatus of the surgical instrument by one Embodiment. The explanatory view which shows an example of the hardware configuration of the intraoperative management apparatus of FIG. The explanatory view which shows an example of the hardware configuration of the control part of FIG. Explanatory drawing which shows an example of the display screen displayed by the intraoperative management apparatus of FIG. Explanatory drawing which shows an example of the display screen following FIG. Explanatory drawing which shows an example of the display screen following FIG.

Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

FIG. 1 schematically shows the situation around the operating table in the operating room, and the patient P lies on the operating table 1. The visible surgical site where the surgery is performed is the operating field P1, and next to it is the surgeon D and the nursing that hands over the various surgical instruments 3 placed on the deployment table 2 to the surgeon D. Master N is waiting. Next to the nurse N, an intraoperative management device 4 of the surgical instrument 3 according to the embodiment of the present invention is deployed.

A container containing a set of surgical instruments 3 required for surgery is brought into the operating room. The surgical instruments 3 taken out of the container are arranged on the deployment table 2. The container and the surgical instrument 3 included in the container are all individually managed for traceability. A two-dimensional symbol 3a is attached to each surgical instrument 3 as an "identification code" for identifying an individual. The two-dimensional symbol 3a can be the data matrix used in the GS1 standard. Such a two-dimensional symbol 3a may be directly engraved on the surgical instrument 3 or may be printed on a sticker attached to the surgical instrument 3. The two-dimensional symbol 3a includes at least a type and a serial number as identification data for identifying the surgical instrument 3 as an individual. Therefore, even if the surgical instruments 3 are of the same type, the serial numbers are different, so that individual identification is possible.

The nurse N takes the surgical instrument 3 instructed by the surgeon D, first reads the two-dimensional symbol 3a with the intraoperative management device 4, and then hands it to the surgeon D. The intraoperative management device 4 manages the surgical instrument 3 as if it had been paid out to the surgical field P1 by reading the two-dimensional symbol 3a. After that, when the surgical instrument 3 is returned from the surgeon D, the nurse N also reads the two-dimensional symbol 3a with the intraoperative management device 4. The intraoperative management device 4 manages the surgical instrument 3 as if it had been recovered from the surgical field P1 by rereading the two-dimensional symbol 3a of the surgical instrument 3 of the same individual.

Intraoperative management device 4 [Figs. 1 to 7]
As shown in FIG. 2, the intraoperative management device 4 includes a tablet terminal 5, a retainer 6 that holds the back of the tablet terminal 5, a support portion 7 that holds the retainer 6, a main body portion 8 that holds the support portion 7, and a main body portion 8. It is provided with a reading unit 9 extending forward from the front surface of the tablet, a support column 10 extending from the bottom surface of the main body portion 8, and a leg portion 11 that holds the support column 10 and supports the entire intraoperative management device 4. The support column 10 is movable up and down with respect to the leg portion 11, and the height of the reading unit 9 is such that the work can be easily performed according to the height of the deployment table 2 on which the surgical instruments 3 are arranged, the height of the nurse N, and the like. The position can be adjusted.

The tablet terminal 5 is a tablet-type computer device, and the intraoperative management device 4 manages the surgical instrument 3 intraoperatively by executing the surgical instrument intraoperative management program in which the control unit 13 described later of the tablet terminal 5 is installed. It can be carried out. The tablet terminal 5 is provided with a touch panel 5a so that an input operation can be performed by touching the display screen 5b. The installation angle of the tablet terminal 5 can be changed by a support arm 7a rotatably supported by the support portion 7.

The reading unit 9 is provided with a base portion 9a and an imaging unit 9b connected to the main body portion 8, and a code reader 9c as an “acquisition unit” is installed inside the imaging unit 9b. The code reader 9c is a reader for the two-dimensional symbol 3a of the surgical instrument 3 and is connected to the tablet terminal 5. The data of the two-dimensional symbol 3a read by the code reader 9c is first stored in the volatile storage unit 13b, which will be described later, and then stored in the non-volatile storage unit 13c. A cylindrical cover 9d made of sterilized hard resin is attached to the reading unit 9. The cover 9d is composed of a cover body 9d1 and a cover base 9d2, and when the cover base 9d2 is fitted to the outer periphery of the base end of the cover body 9d1, a mounting hole for a vinyl sterilization cover 12 is provided between them. The holes (not shown) are fitted so as to sandwich them. As a result, in the vicinity of the patient on the operating table 1, only the cover 9d is exposed to the outside of the sterilization cover 12, and the other part of the intraoperative management device 4 can be covered with the sterilization cover 12. The cover 9d and the sterile cover 12 are disposable and should be replaced after each surgery.

At the tip of the cover body 9d1, an oblique reading port 9d3 whose opening end is inclined obliquely is formed. The diagonal reading port 9d3 is used so that the code reader 9c can accurately read the reading port 9d3. The code reader 9 is provided with a light emitting unit by a high-intensity LED serving as an illumination light source and a light receiving unit by an image pickup element such as a CMOS image sensor. If the tip of the cover body 9d1 is a horizontal reading port instead of the diagonal reading port 9d3, the light of the light emitting part is reflected toward the light receiving part by the metal surgical instrument 3 and is likely to cause a reading error, until it can be read normally. The posture of the surgical instrument 3 must be changed many times, and the reading efficiency is very poor. However, since the oblique reading port 9d3 is used in the present embodiment, the amount of reflected light toward the light receiving portion can be significantly reduced by applying the surgical instrument 3 to the edge of the oblique reading port 9d3 so as to span the diameter direction. it can. Therefore, according to the oblique reading port 9d3, there are few reading errors, the reading can be performed instantly by holding it over, and there is no stagnation due to reading at the time of payout or collection.

Next, the hardware configuration of the intraoperative management device 4 will be described. As shown in an example thereof in FIG. 3, the intraoperative management device 4 is connected to a control unit 13 provided in the tablet terminal 5 and a liquid crystal display of the tablet terminal 5 connected to the control unit 13 and displaying information output from the control unit 13. It has a display unit 14 such as a device, and an input unit 15 such as a keyboard, a mouse, a touch panel 5a, a camera, and a code reader 9c for inputting information to the control unit 13. The hardware configuration of the intraoperative management device 4 is not limited to this.

Further, FIG. 4 is a diagram showing an example of the hardware configuration of the control unit 13. As shown in this figure, the control unit 13 mainly consists of a semiconductor device and wiring connecting them, and includes a CPU (Central Processing Unit) 13a, a volatile storage unit 13b such as a RAM, and a hard disk, a flash memory, or the like. A non-volatile storage unit 13c, a network interface 13d connected to an access relay unit such as a fire wall or a switch, or a network, and an external connection interface 13e for connecting to an externally connected device such as an input unit 15 or a display unit 14. Have. The configuration of the control unit 13 is not limited to this.

The network interface 13d may be connected to a surgical instrument management system (not shown) in a hospital so that the intraoperative management device 4 and the surgical instrument management system in the hospital are linked. In this case, various data such as history data acquired by the intraoperative management device 4 can be shared with the surgical instrument management system, and the data for individually identifying the container and the surgical instrument 3 contained in the container can be managed by the surgical instrument management system. It may be acquired from the system with the tablet terminal 5.

Further, the tablet terminal 5 is not limited to the tablet-type computer device, and may be another computer device such as a desktop computer or a server computer having the same configuration as in FIGS. 3 and 4.

Intraoperative management method of surgical instrument Next, an intraoperative management method of the surgical instrument 3 using the intraoperative management device 4 will be described. FIG. 5 is a diagram showing an example of the intraoperative instrument management screen 16 displayed on the display unit 14 of the liquid crystal display device or the like of the tablet terminal 5 of the intraoperative management device 4. The intraoperative instrument management screen 16 is roughly divided into a progress display screen 16a, a reading instrument display screen 16b, an unreadable instrument display screen 16c, an unreadable instrument input screen 16d, and an end screen 16e.

On the progress display screen 16a, the operation start button 16a1 pressed at the start of the operation, the elapsed time display unit 16a2 indicating the elapsed time from the start of the operation, and the number of instruments used indicating the total number of surgical instruments 4 currently used in the surgical field P1 are displayed. Part 16a3 is displayed.

The reader display screen 16b is a reader number display unit 16b1 that displays the total number of surgical instruments 3 that have read the two-dimensional symbol 3a currently used in the surgical field P1, and is currently used in the surgical field P1. A reader display unit 16b2 indicating the name of the surgical instrument 3, the start time of use, and the number of surgical instruments 3 is displayed.

On the unreadable instrument display screen 16c, the unreadable instrument number display unit 16c1 displaying the total number of surgical instruments 3 for which the two-dimensional symbol 3a currently used in the surgical field P1 could not be read, the current surgical field P1 The unreadable instrument display 16c2 indicating the unreadable surgical instrument 3 used in is displayed.

On the unreadable instrument input screen 16d, the unreadable instrument payout button 16d1 pressed when the surgical instrument 3 that cannot read the two-dimensional symbol 3a is dispensed to the surgical field P1, and the surgical instrument that cannot read the two-dimensional symbol 3a. The unreadable instrument collection button 16d2, which is pressed when collecting 3 from the surgical field P1, is displayed. All of these are input by touch operation on the touch panel 5a. Further, the non-readable instrument payout button 16d1 is colored in red, and the reader collection button 16d2 is colored in blue so that they can be easily distinguished from each other.

On the end screen 16e, an end button 16e1 pressed at the end of surgery is arranged. When the end button 16e is pressed, the elapsed time of the elapsed time display unit 16a2 is stopped. Further, at this time, it is necessary that no display of the surgical instrument 3 remains on the reading instrument display screen 16b and the unreadable instrument display screen 16c, and the fact that the surgical instrument 3 remains here means that the surgical instrument 3 is in the surgical field P1. It means that it remains.

Management of payout of surgical instrument 3 Nurse N presses the operation start button 16a1 at the start of the operation. Then, the counting of the elapsed time of the elapsed time display unit 16a2 starts. When the surgeon D instructs the delivery of the scalpel, for example, the nurse N takes the scalpel 3A from the deployment table 2 and causes the code reader 9c of the intraoperative management device 4 to read the two-dimensional symbol 3a. When the two-dimensional symbol 3a can be read normally, the control unit 13 may output a sound so that the two-dimensional symbol 3a can be known. The control unit 13 displays "1" on the number of instruments used display unit based on the data of the read two-dimensional symbol 3a, "female" as the name on the reader display unit 16b2, and "09:15" as the start time of use. : 30 ”and the quantity“ 1 ”are displayed.

Next, when the surgeon instructs the delivery of the forceps, the nurse causes the code reader 9c to read the two-dimensional symbol 3a of the forceps 3B. The control unit 13 displays "2" on the number of instruments used display unit based on the read data of the two-dimensional symbol 3a, "forceps" as the name on the reader display unit 16b2, and "09:18" as the start time of use. : 09 ”and the quantity“ 1 ”are displayed (see FIG. 6).

Further, when using the surgical instrument 3 without the two-dimensional symbol, the nurse N presses the unreadable instrument payout button 16d1 displayed on the unreadable instrument input screen 16d. As a result, as shown in FIG. 6, the control unit 13 displays a display in which the payout display 16d3 by the red arrow of the same color as the unreadable instrument payout button 16d1 moves so as to flow from top to bottom. Is displayed so that nurse N can confirm that the input operation has been performed. Further, by this input operation, the control unit 13 displays "3" on the number of used instruments display unit, displays "1" on the unreadable instrument number display unit 16c1 on the unreadable instrument display screen 16c, and displays the unreadable instrument. “Unreadable instrument” is displayed on the unit 16d2.

As described above, neither the surgical instrument 3 capable of reading the two-dimensional symbol 3a nor the surgical instrument 3 capable of reading the two-dimensional symbol 3a can reliably manage the payout to the surgical field P1.

Management of recovery of surgical instrument 3 Next, in order to recover surgical instrument 3 from the surgical field P1, for example, when the scalpel 3A is received from the surgeon D, the nurse N reads the two-dimensional symbol 3a again by the code reader 9c. Let me. The CPU 13a of the control unit 13 verifies whether the identification data matching the read identification data is primarily stored in the volatile storage unit 13b. Since there is matching identification data here, "2" is displayed on the number of instruments used display unit, and "female", "09:15:30", and "1" displayed on the reader instrument display unit 16b2. Erase any display. As a result, only the surgical instrument 3 used in the surgical field P1 is always displayed on the reader display screen 16b.

Further, in order to recover the unreadable surgical instrument 3 used in the surgical field P1, when the nurse N receives it from the surgeon D, the nurse N presses the unreadable instrument recovery button 16d2 on the unreadable instrument input screen 16d. Push. As a result, as shown in FIG. 7, the control unit 13 displays a display in which the collection display 16d4 by the blue arrow of the same color as the unreadable instrument collection button 16d2 moves so as to flow from the bottom to the top on the unreadable instrument input screen. It is displayed on 16d so that nurse N can confirm that the input operation has been performed. Further, by this input operation, the control unit 13 displays "1" on the number of used instruments display unit, displays "0" on the unreadable instrument number display unit 16c1 on the unreadable instrument display screen 16c, and displays the unreadable instrument. The "unreadable instrument" displayed on the unit 16d2 is erased. As a result, only the surgical instrument 3 used in the surgical field P1 is always displayed on the unreadable instrument display screen 16c, and in the case of FIG. 7, it is at a glance that there is no surgical instrument 3 used. It will be displayed so that it can be understood.

Finally, the forceps 3B displayed in FIG. 7 is also used in the surgical field P1 on the reader display screen 16b by performing the same recovery operation as the scalpel 3A described above when collecting the forceps 3B from the surgical field P1. It will be displayed so that it can be seen at a glance that the surgical instrument 3 is not present. Then, if you press the button to end the surgery, the timekeeping will stop.

All the historical data for each surgical instrument 3, such as the withdrawal and collection of the surgical instrument 3 to the surgical field P1, are recorded in the non-volatile storage unit 13c and can be reviewed after the operation. In addition, these historical data can also be shared by the surgical instrument management system of the hospital.

As described above, according to the intraoperative management device 4 of the surgical instrument 3 and the intraoperative management method, the payout of the surgical instrument 3 to the surgical field P1 can be easily grasped by the list display through the reader display screen 16b. The burden on nurse N is small, and it is possible to reliably manage the surgical instrument 3 in the surgical field P1 currently in use. Therefore, it is possible to efficiently operate the operating room with the first priority being to ensure the safety of the patient.

In addition, since the collection of the surgical instrument 3 from the surgical field P1 can be easily grasped through the reading instrument display screen 16b, the burden on the nurse N is small, and even with this, the surgical instrument 3 is returned to the surgical field P1 after being stopped and collected. The remaining surgical instrument 3 can be reliably managed.

Further, even if the surgical instrument 3 cannot acquire the two-dimensional symbol 3a, the payout to the surgical field P1 can be easily grasped through the unreadable instrument display screen 16c, so that even when such a surgical instrument 3 is used. , The burden on nurse N is small, and the payout and collection can be managed safely.

1 Operating table 2 Deployment table 3 Surgical instrument 3a Two-dimensional symbol (identification code)
3A Scalpel 3B Forceps 4 Intraoperative management device for surgical instruments 5 Tablet terminal 5a Touch panel 6 Retainer 7 Support 7a Support arm 8 Main body 9 Reading 9a Base 9b Imaging 9c Code reader 9d Cover 9d1 Cover body 9d2 Cover base 9d3 10 Strut 11 Leg 12 Sterilization cover 13 Control 13a CPU
13b Volatile storage unit 13c Non-volatile storage unit 13d Network interface 13e External connection interface 14 Display unit 15 Input unit 16 Intraoperative instrument management screen 16a Progress display screen 16a1 Surgery start button 16a2 Elapsed time display unit 16a3 Number of instruments used display unit 16b Reader Display screen 16b1 Number of reading instruments display 16b2 Reading instrument display 16c Unreadable instrument display screen 16c1 Unreadable number of instruments display 16c2 Unreadable instrument display 16d Unreadable instrument input screen 16d1 Unreadable instrument payout button 16d2 Unreadable instrument collection button 16d3 Payout display 16d4 Recovery display 16e End screen 16e1 End button P Patient P1 Surgical field D Surgeon N Nurse

Claims (5)

It is an intraoperative management device for surgical instruments in the surgical field.
An acquisition unit that acquires an identification code that identifies the surgical instrument individually,
A reading unit having the acquisition unit and
The main body that supports the reading unit and
A control unit that displays a reader display screen that lists and displays the surgical instruments corresponding to the identification code acquired by the acquisition unit as those that have been paid out to the surgical field.
A display unit of a computer device for displaying the reader display screen is provided.
The reading unit is provided so as to extend forward from the front surface of the main body unit.
The display unit is arranged above the main body unit to display the reader display screen toward the front.
The acquisition unit reads the identification code of the surgical instrument held over the acquisition unit when the surgical instrument is dispensed to the surgical field.
Wherein, intraoperative management apparatus surgical instruments to display only the surgical instrument that is paid to the operating field from said read said identification code acquisition section to the reading instrument display screen.
The control unit determines the presence or absence of the acquired identification code that matches the newly acquired identification code, and displays the surgical instrument corresponding to the identification code determined to match the reader display screen. The intraoperative management device for a surgical instrument according to claim 1, which is erased from.
The operation unit according to claim 1 or 2, wherein the control unit displays an unreadable instrument display screen that lists the surgical instruments whose identification code cannot be obtained as unreadable instruments that are paid out to the surgical field. Management device.
The intraoperative management device for a surgical instrument according to any one of claims 1 to 3, wherein the identification code is a two-dimensional symbol directly engraved on the surgical instrument.
It is an intraoperative management method for surgical instruments in the surgical field.
When the surgical instrument is dispensed to the surgical field, the surgical instrument is held over an acquisition device provided in a reading unit extending forward from the front of the main body to acquire an identification code for identifying the individual surgical instrument. Steps to get on the device and
Show read instrument display screen for displaying a list of only the surgical device械corresponding to the identification code obtained by holding said acquisition device as being paid out to the operating field to a display device for displaying toward the front Steps to be performed, and how to manage surgical instruments intraoperatively.

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