JP7166760B2 - 外科的処置アトラスを用いた手術システムの構成 - Google Patents
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Description
この出願は、2015年6月9日に出願された仮出願第62/173,077号の優先権を主張し、その全文を本明細書中に参照として援用し、優先権の利益を本明細書において主張する。
遠隔操作は、ある距離を置いた機械の操作を指す。最小侵襲遠隔操作医療システムでは、外科医が、患者の体内の手術部位を見るカメラを含む内視鏡を使用することがある。幾つかの実施形態では、立体画像を取り込むことができ、それは外科的処置中に深さの知覚を可能にする。
図8は、例示的な手術計画ツール800の概略図を示している。1つの態様において、手術計画ツール800は、電子医療デバイス記録データベース830とデータ通信する遠隔操作手術システム50を含む。ここに示す遠隔操作手術システム50は、図4に示す遠隔操作システム50と類似する。1つの態様において、電子医療記録データベース830は、特定の病院又は複数の病院で治療を受けた患者の医療記録を含む。病院の現場に配置されるサーバにデータベース830を実装することができる。イントラネットネットワークを通じて病院のコンピュータからデータベース830中に含まれる医療記録エントリにアクセスすることができる。代替的に、例えば、多数のクラウドデータストレージサービスのうちの1つを使用して、病院から離れた場所に配置される遠隔サーバにデータベース830を実装することができる。この場合、データベース830の医療記録エントリは、クラウドサーバに格納され、インターネットアクセスを備えるコンピュータによってアクセスされることができる。
幾つかの場合には、医療従事者が所与の患者に対して行われた過去の外科的処置のビデオ記録を見ることができるのが望ましい。1つの態様では、ある医療状態を治療する第1の外科的処置を受けた患者は、その後に、同じ医療状態の再発を治療する或いは第1の外科的処置の手術部位の近くに位置する解剖学的構造を治療する第2の外科的処置を必要とする。1つの態様において、第1の外科的処置の手術部位事象は手術部位ビデオ記録に取り込まれ、ビデオ記録は患者の電子医療記録の部分としてデータベース830中にアーカイブ記録される。患者に対して第2の外科的処置を行うに先立ち、医療従事者は、データベース830のサーチを行って、患者の以前の外科的処置のビデオ記録を探し出すことができる。
1つの態様において、データベース830は、クラウドデータストレージサービスを使用して遠隔サーバに実装され、多数のヘルスケア提供者によってアクセス可能である。図8を参照すると、破線によって示すように、手術計画ツール800は、任意的に、(破線によって示すような)遠隔操作手術システム850と、(破線で示すような)パーソナルコンピュータ840とを含む。1つの態様では、遠隔操作手術システム50及びパーソナルコンピュータ820が第1のヘルスケア提供者に配置され、遠隔操作手術システム850及びパーソナルコンピュータ840が第2の場所に配置され或いは第2の医療提供者にさえ配置される点を除き、遠隔操作手術システム850は、遠隔操作手術システム50と類似し、パーソナルコンピュータ840は、パーソナルコンピュータ820と類似する。1つの態様では、第1の患者が、医療状態の外科的治療を必要とし、第1のヘルスケア提供者で遠隔操作手術システム50を使用して外科的処置を受ける。外科的処置のビデオ記録がデータベース830にアーカイブ記録される。後に、第2の患者が、同じ医療状態の外科的治療を必要とし、第2のヘルスケア提供者で遠隔操作手術システム850を使用して外科的治療を受けることを計画する。第2の患者に対して外科処置を行うに先立ち、医療従事者は、安全なインターネット接続を通じてデータベース830にアクセスし、類似の処置の手術部位ビデオ記録についてデータベース830を検索する。1つの態様において、第2の患者を治療する医療従事者は、第1の患者の身元の知識を取得することなく、第1の患者の外科的処置のビデオ記録をデータベース830から取り出すことができる。このようにして、第1の患者のプライバシーが維持される。1つの態様において、第1の患者の外科的処置のビデオ記録は、第1の患者を治療した医療従事者によって作成されたハイライト及び/又は注釈を含む。
手術計画ツール800は、コンピュータ実行可能なコードの形態において実施されるパターンマッチング及び解析アルゴリズムを含むことができる。1つの態様において、パターンマッチング及び解析アルゴリズムは、手術計画ツール800の不揮発性メモリデバイスに格納され、データベース830中にアーカイブ記録されたビデオ記録を解析するように構成される。従前に議論したように、データベース830中にアーカイブ記録されたビデオ記録830の各々は、特定のメタデータ情報でタグ付けされ且つ/或いは特定のメタデータが埋め込まれることができる。このメタデータ情報は、患者の年齢、性別、及び患者の健康又は病歴を記述する他の情報のような、患者情報を含むことができる。加えて、従前に議論したように、メタデータ情報は、医療従事者によって作成されたハイライト又は注釈を含むことができる。1つの態様において、これらのハイライト及び注釈は、ビデオ録画に埋め込まれ、データベース830中にビデオと共にアーカイブ記録される。
図9は、手術計画ツールを使用する方法900を示している。1つの態様において、手術計画ツールは、図8の手術計画ツール800と類似する。910で、医療患者を記述する事実又は特性、例えば、患者が患っている医療状態が、医療デバイスによって受信される。医療デバイスは、遠隔操作手術システム(例えば、図1の遠隔操作手術システム10又は図4の遠隔操作手術システム50)に位置するユーザインターフェースを介して、或いは、代替的に、図8のパーソナルコンピュータと類似のパーソナルコンピュータを通じて、この事実又は特性を受信することができる。920で、医療デバイスは、910で受信した事実又は特性を使用して、医療デバイスデータベースから外科的処置の少なくとも1つの関連するビデオ記録を取り出す。930で、医療デバイスは、ビデオ記録を使用して、手術計画情報を決定する。1つの態様において、手術計画情報は、記録された処置において使用される器具の種類を含む。940で、医療デバイスは、930で決定された手術計画情報をユーザに表示する。
Claims (13)
- 遠隔操作手術システム(手術システム)の1つ又はそれよりも多くの事例と共に使用するための方法であって、
前記手術システムの1つ又はそれよりも多くの事例のコンピュータプロセッサが、前記手術システムの前記1つ又はそれよりも多くの事例の各事例内の外科的処置の多数の発生内に生成される手術器具動作を示す手術器具運動学的情報を記録することから得られる手術器具動作の各々と関連付けられる運動学的署名の各々を評価すること、
前記手術システムの1つ又はそれよりも多くの事例の前記コンピュータプロセッサが、手術器具動作の各々と関連付けられる運動学的署名の各々を決定すること、
前記手術システムの1つ又はそれよりも多くの事例の前記コンピュータプロセッサが、運動学的署名の各々を手術器具動作の各々をもたらす制御信号の各々と関連付ける、前記手術システムの前記1つ又はそれよりも多くの事例内の1つ又はそれよりも多くのコンピュータ可読ストレージデバイス内の情報構造を生成すること、
前記手術システムの事例のコンピュータプロセッサが、外科的処置の実行中に、該実行中の手術器具運動学的情報を運動学的署名のうちの少なくとも1つの運動学的署名と比較すること、及び
前記手術システムの前記事例の前記コンピュータプロセッサが、前記手術システムの前記事例内の前記外科的処置の実行中に、該実行中の手術器具運動学的情報と各運動学的署名との間の一致に応答して、前記手術システムの前記事例内で前記実行中の前記手術器具運動学的情報と一致する各運動学的署名に関連する制御信号を発することを含む、
方法。 - 遠隔操作手術システム(手術システム)と共に使用するための方法であって、
前記手術システムの1つ又はそれよりも多くの事例内の外科的処置の多数の発生の各々について、前記手術システムの前記1つ又はそれよりも多くの事例のコンピュータプロセッサが、前記外科的処置の前記発生中の前記手術システムの前記1つ又はそれよりも多くの事例内の手術シーンの画像を記録すること、
前記手術システムの1つ又はそれよりも多くの事例の前記コンピュータプロセッサが、前記手術シーンの画像の各々と関連付けられる手術画像署名の各々を決定すること、
前記手術システムの1つ又はそれよりも多くの事例の前記コンピュータプロセッサが、手術画像署名の各々を手術器具動作の各々をもたらす制御信号の各々と関連付ける、前記手術システムの前記1つ又はそれよりも多くの事例内の1つ又はそれよりも多くのコンピュータ可読ストレージデバイス内の情報構造を生成すること、
前記手術システムの事例のコンピュータプロセッサが、前記外科的処置の実行中に、前記外科的処置の前記事例内の手術シーン内の手術画像を手術画像署名のうちの少なくとも1つの手術画像署名と比較すること、及び
前記手術システムの前記事例の前記コンピュータプロセッサが、前記手術システムの前記事例内の前記外科的処置の実行中に、該実行中の手術画像と各手術画像署名との一致に応答して、前記手術システムの前記事例内で前記実行中の前記手術画像と一致する前記各手術画像署名に関連する制御信号を発することを含む、
方法。 - 前記手術システムの前記事例の前記コンピュータプロセッサが、前記制御信号に応答して、器具が動く速さを調節することを更に含む、請求項1又は2に記載の方法。
- 前記手術システムの前記事例の前記コンピュータプロセッサが、前記制御信号に応答して、器具の動きの範囲を調節することを更に含む、請求項1又は2に記載の方法。
- 前記手術システムの前記事例の前記コンピュータプロセッサが、前記制御信号に応答して、ガイダンスを提供する視覚的画像を操作者に提供することを更に含む、請求項1又は2に記載の方法。
- 遠隔操作手術システム(手術システム)と共に使用する方法であって、
前記手術システムの1つ又はそれよりも多くの事例内の外科的処置の多数の発生の各々について、前記手術システムの前記1つ又はそれよりも多くの事例のコンピュータプロセッサが、前記外科的処置の発生中に前記手術システム内の手術シーンの画像を記録すること、
前記手術システムの1つ又はそれよりも多くの事例の前記コンピュータプロセッサが、手術シーンの画像の各々と関連付けられる手術画像署名及び運動学的署名の各々を決定すること、
前記手術システムの1つ又はそれよりも多くの事例の前記コンピュータプロセッサが、手術画像署名及び運動学的署名の各々を手術器具動作の各々をもたらす制御信号の各々と関連付ける、前記手術システムの前記1つ又はそれよりも多くの事例内の1つ又はそれよりも多くのコンピュータ可読ストレージデバイス内の情報構造を生成すること、
前記手術システムの事例のコンピュータプロセッサが、外科的処置の実行中に、前記手術システムの前記事例内の手術シーン内の手術画像を手術画像署名のうちの少なくとも1つの手術画像署名と比較すること、
前記手術システムの事例の前記コンピュータプロセッサが、前記外科的処置の前記実行中に、該実行中の手術器具運動学的情報を運動学的署名のうちの前記少なくとも1つの運動学的署名と比較すること、及び
前記手術システムの前記事例の前記コンピュータプロセッサが、前記手術システムの前記事例内の前記外科的処置の前記実行中に、前記実行中の手術画像と各手術画像署名との間の一致及び前記実行中の前記手術器具運動学的情報と各運動学的署名との間の一致に応答して、前記手術システムの前記事例内で前記実行中の前記手術画像と一致する前記各手術画像署名に関連する制御信号及び前記実行中の前記手術器具運動学的情報と一致する前記各運動学的署名に関連する制御信号を発することを含む、
方法。 - 遠隔操作手術システム(手術システム)であって、
コンピュータ可読ストレージデバイス内の情報構造であって、運動学的署名の各々を当該手術システムの1つ又はそれよりも多くの事例内の外科的処置の複数の発生内に生成される手術器具動作を示す手術器具運動学的情報を記録することから得られる手術器具動作の各々をもたらす制御信号の各々と関連付ける、情報構造と、
プロセッサであって、
外科的処置の実行中に、該外科的処置中に生成される器具運動学的情報を運動学的署名のうちの少なくとも1つの運動学的署名と比較し、
前記外科的処置の前記実行中に、前記外科的処置中に生成される器具運動学的情報と前記運動学的署名のうちの少なくとも1つの運動学的署名との間の一致に応答して、前記外科的処置中に生成される器具運動学的情報と一致する前記運動学的署名のうちの少なくとも1つの運動学的署名に関連する前記各制御信号を発する
ように構成される、
プロセッサと、
器具であって、前記各制御信号に応答してその動きを調節するように構成される器具とを含む、
遠隔操作手術システム。 - 遠隔操作手術システム(手術システム)であって、
コンピュータ可読ストレージデバイス内の情報構造であって、手術画像署名の各々を当該手術システムの1つ又はそれよりも多くの事例内の外科的処置の複数の発生の各々について前記外科的処置の前記発生中に当該手術システム内の手術シーンの画像を記録することから得られる手術器具動作の各々をもたらす制御信号の各々と関連付ける、情報構造と、
プロセッサであって、
当該手術システム内の外科的処置の実行中に、手術シーン内の手術画像を前記手術画像署名のうちの少なくとも1つの手術画像署名と比較し、
前記外科的処置の前記実行中に、該実行中の手術画像と前記手術画像署名のうちの前記少なくとも1つの手術画像署名との間の一致に応答して、当該手術システム内で前記実行中の前記手術画像と一致する前記手術画像署名のうちの少なくとも1つの手術画像署名に関連する前記各制御信号を発する
ように構成される、
プロセッサと、
器具であって、前記各制御信号に応答してその動きを調節するように構成される器具とを含む、
遠隔操作手術システム。 - 前記制御信号に応答して、前記器具は、器具が動く速さを調節するように構成される、請求項7又は8に記載のシステム。
- 前記制御信号に応答して、前記器具は、前記器具の動きの範囲を調節するように構成される、請求項7又は8に記載のシステム。
- 前記制御信号に応答して、前記器具は、操作者に提供される視覚的ガイダンスを調節するように構成される、請求項7又は8に記載のシステム。
- 遠隔操作手術システム(手術システム)であって、
1つ又はそれよりも多くの運動学的署名と、1つ又はそれよりも多くの手術画像署名とを、当該手術システムの動作をもたらす制御信号と関連付ける、コンピュータ可読ストレージデバイス内の情報構造と、
プロセッサとを含み、該プロセッサは、
外科的処置の実行中に、該外科的処置中に生成される器具運動学的情報を少なくとも1つの運動学的署名と比較し、
当該手術システム内の外科的処置の実行中に、手術シーン内の手術画像を少なくとも1つの手術画像署名と比較し、
前記外科的処置中に生成される前記器具運動学的情報と前記少なくとも1つの運動学的署名との間の一致及び手術シーン内の手術画像と前記少なくとも1つの手術画像署名との間の一致に応答して、前記器具運動学的情報と一致する前記少なくとも1つの運動学的署名に関連する制御信号及び前記手術シーン内の前記手術画像と一致する前記少なくとも1つの手術画像署名に関連する制御信号を発する
ように構成され、
前記少なくとも1つの一致する運動学的署名は、前記少なくとも1つの一致する手術画像署名と情報構造内で関連付けられる、
遠隔操作手術システム。 - 器具であって、前記制御信号に応答してその動きを調節するように構成される器具を更に含む、請求項12に記載の遠隔操作手術システム。
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CN107847283B (zh) | 2022-02-22 |
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US11737841B2 (en) | 2023-08-29 |
KR102523779B1 (ko) | 2023-04-20 |
EP3307196A4 (en) | 2019-06-19 |
US11058501B2 (en) | 2021-07-13 |
US20210315650A1 (en) | 2021-10-14 |
EP3307196A1 (en) | 2018-04-18 |
CN114376733A (zh) | 2022-04-22 |
US20240024051A1 (en) | 2024-01-25 |
JP2022162123A (ja) | 2022-10-21 |
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