JPWO2021137108A5 - - Google Patents

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JPWO2021137108A5
JPWO2021137108A5 JP2022540452A JP2022540452A JPWO2021137108A5 JP WO2021137108 A5 JPWO2021137108 A5 JP WO2021137108A5 JP 2022540452 A JP2022540452 A JP 2022540452A JP 2022540452 A JP2022540452 A JP 2022540452A JP WO2021137108 A5 JPWO2021137108 A5 JP WO2021137108A5
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target location
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Priority claimed from PCT/IB2020/062359 external-priority patent/WO2021137108A1/en
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医療システムであって、
経皮的に人体解剖学的構造にアクセスするように構成されている医療器具から第１のセンサデータを受信し、解剖学的管腔を通じて前記人体解剖学的構造にアクセスするように構成された内視鏡から第２のセンサデータを受信するように構成された通信インターフェースと、
制御回路であって、前記通信インターフェースに通信可能に結合され、かつ
前記第１のセンサデータに少なくとも部分的に基づいて、前記医療器具の向きを判定することと、
前記第２のセンサデータに少なくとも部分的に基づいて、
前記人体解剖学的構造内の標的場所を判定することと、
前記標的場所への経皮的アクセスのための標的軌道を判定することと、
前記医療器具の前記向きの前記標的軌道への位置合わせを示唆する器具－位置合わせ要素を含むインターフェースを表示させることと、を行うように構成された、制御回路と、を備える、医療システム。 A medical system,
receiving first sensor data from a medical instrument configured to percutaneously access a human anatomy , and configured to access the human anatomy through an anatomical lumen. a communication interface configured to receive second sensor data from the endoscope ;
a control circuit communicatively coupled to the communication interface and determining an orientation of the medical device based at least in part on the first sensor data;
based at least in part on the second sensor data;
determining a target location within the human anatomy;
determining a target trajectory for percutaneous access to the target location;
a control circuit configured to display an interface including an instrument-alignment element that suggests alignment of the orientation of the medical instrument to the target trajectory. 前記制御回路が、
位置変化パラメータを第１の値に設定することであって、前記位置変化パラメータが、前記医療器具の移動単位に対する前記インターフェース内の前記器具－位置合わせ要素の位置変化量を示唆する、設定することと、
前記医療器具が前記標的場所への所定の近接範囲内にあると判定することと、
前記医療器具が前記標的場所への前記所定の近接範囲内にあると判定することに少なくとも部分的に基づいて、前記位置変化パラメータを第２の値に設定することであって、前記第２の値が、前記第１の値よりも大きい、前記医療器具の前記移動単位に対する前記器具－位置合わせ要素の位置変化量に関連付けられている、設定することと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
setting a position change parameter to a first value, the position change parameter indicating an amount of position change of the instrument-alignment element within the interface relative to a unit of movement of the medical instrument; and,
determining that the medical device is within a predetermined proximity to the target location;
setting the position change parameter to a second value based at least in part on determining that the medical device is within the predetermined proximity to the target location; and setting a value associated with a change in position of the instrument-alignment element relative to the unit of movement of the medical instrument, the value being greater than the first value. , the medical system according to claim 1. 前記標的場所に経皮的にアクセスするように構成された前記医療器具を更に備え、前記医療器具が、前記第１のセンサデータを前記通信インターフェースに提供するように構成されているセンサを含み、
前記標的軌道が、前記第１のセンサデータに少なくとも部分的に基づいて判定される、請求項１に記載の医療システム。 further comprising the medical device configured to percutaneously access the target location, the medical device including a sensor configured to provide the first sensor data to the communication interface;
The medical system of claim 1, wherein the target trajectory is determined based at least in part on the first sensor data. 前記第２のセンサデータを前記通信インターフェースに提供するように構成されているセンサを含む前記内視鏡を更に備える、請求項１に記載の医療システム。 The medical system of claim 1 , further comprising the endoscope including a sensor configured to provide the second sensor data to the communication interface. 前記制御回路が、
前記医療器具の前記向きが前記標的軌道と位置合わせされていると判定することと、
前記医療器具の前記向きが前記標的軌道と位置合わせされているという示唆を表示させることと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
determining that the orientation of the medical device is aligned with the target trajectory;
The medical system of claim 1, further configured to: display an indication that the orientation of the medical instrument is aligned with the target trajectory. 前記制御回路が、
前記医療器具の前記向きが閾値量を超えて前記標的軌道と位置ずれしていると判定することと、
前記医療器具の前記向きが前記閾値量を超えて前記標的軌道と位置ずれしているという示唆を表示させることと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
determining that the orientation of the medical instrument is misaligned with the target trajectory by more than a threshold amount;
2. The medical system of claim 1, further configured to display an indication that the orientation of the medical instrument is misaligned with the target trajectory by more than the threshold amount. 前記制御回路が、
前記医療器具の前記標的場所への近接を判定することと、
前記医療器具の前記標的場所への前記近接の示唆を表示させることと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
determining proximity of the medical device to the target location;
2. The medical system of claim 1, further configured to: display an indication of the proximity of the medical instrument to the target location. 前記制御回路が、
前記医療器具が前記標的場所を越えて挿入されていると判定することと、
前記医療器具が前記標的場所を越えて挿入されているという示唆を表示させることと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
determining that the medical device is inserted beyond the target location;
The medical system of claim 1, further configured to: display an indication that the medical device is being inserted beyond the target location. 前記制御回路が、
前記医療器具が前記標的場所に到達したと判定することと、
前記医療器具が前記標的場所に到達したという示唆を表示させることと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
determining that the medical device has reached the target location;
2. The medical system of claim 1, further configured to: display an indication that the medical instrument has reached the target location. 前記制御回路が、
前記医療器具の前記向きが閾値量を超えて前記標的軌道と位置ずれしていると判定することと、
前記医療器具が前記人体解剖学的構造内に挿入されていると判定することと、
前記医療器具の前記向きが前記閾値量を超えて前記標的軌道と位置ずれしているという前記判定、及び前記医療器具が前記人体解剖学的構造内に挿入されているという前記判定に少なくとも部分的に基づいて、前記医療器具を前記人体解剖学的構造から後退させるための示唆を表示させることと、を行うように更に構成されている、請求項１に記載の医療システム。 The control circuit is
determining that the orientation of the medical instrument is misaligned with the target trajectory by more than a threshold amount;
determining that the medical device is inserted within the human anatomy;
the determination that the orientation of the medical device is misaligned with the target trajectory by more than the threshold amount; and the determination that the medical device is inserted into the human anatomy; and displaying a suggestion for retracting the medical instrument from the human anatomy based on the medical system of claim 1 . コンピュータ実行可能命令を記憶する１つ又は２つ以上の非一時的コンピュータ可読媒体であって、前記コンピュータ実行可能命令が、制御回路によって実行されると、前記制御回路に、
人体解剖学的構造にアクセスするように構成された内視鏡からセンサデータを受信することであって、前記センサデータが、前記内視鏡の遠位端部分の位置を示唆する、受信することと、
経皮的に前記人体解剖学的構造にアクセスするように構成されている医療器具の向きを判定することと、
前記センサデータに少なくとも部分的に基づいて、前記人体解剖学的構造内の標的場所を判定することと、
前記標的場所への経皮的アクセスのための標的軌道を判定することと、
前記医療器具の前記向きの前記標的軌道への位置合わせを示唆する器具－位置合わせ要素を含むインターフェースを表示させることと、を含む動作を実行させる、１つ又は２つ以上の非一時的コンピュータ可読媒体。 one or more non-transitory computer-readable media storing computer-executable instructions, the computer-executable instructions, when executed by a control circuit, causing the control circuit to:
Receiving sensor data from an endoscope configured to access a human anatomy, wherein the sensor data is indicative of a position of a distal end portion of the endoscope. and,
determining the orientation of a medical device configured to percutaneously access the human anatomy;
determining a target location within the human anatomy based at least in part on the sensor data ;
determining a target trajectory for percutaneous access to the target location;
displaying an interface including an instrument-alignment element suggesting alignment of the orientation of the medical instrument to the target trajectory; Medium. 前記インターフェースが、位置合わせマーキングを更に含み、前記位置合わせマーキングに対する前記器具－位置合わせ要素の位置決めが、前記医療器具の前記向きの前記標的軌道への前記位置合わせを示唆する、請求項１１に記載の１つ又は２つ以上の非一時的コンピュータ可読媒体。 12. The interface further comprises alignment markings, and positioning of the instrument-alignment element relative to the alignment markings suggests alignment of the orientation of the medical instrument to the target trajectory. one or more non-transitory computer-readable media. 前記位置合わせマーキングが、境界マーキングを含み、前記動作が、
前記医療器具の前記向きが閾値量を超えて前記標的軌道と位置ずれしていると判定することと、
前記器具－位置合わせ要素を前記境界マーキングへの所定の距離範囲内に表示させることと、を更に含む、請求項１２に記載の１つ又は２つ以上の非一時的コンピュータ可読媒体。 the alignment markings include boundary markings, and the operation comprises:
determining that the orientation of the medical instrument is misaligned with the target trajectory by more than a threshold amount;
13. The one or more non-transitory computer-readable media of claim 12, further comprising: displaying the instrument-alignment element within a predetermined distance to the boundary marking. 前記動作が、
前記医療器具の前記向きが前記標的軌道と位置合わせされていると判定することと、
前記器具－位置合わせ要素を、前記位置合わせマーキングと位置合わせされた配列で表示させることと、を更に含む、請求項１２に記載の１つ又は２つ以上の非一時的コンピュータ可読媒体。 The said operation is
determining that the orientation of the medical device is aligned with the target trajectory;
13. The one or more non-transitory computer-readable media of claim 12, further comprising: displaying the instrument-alignment element in an aligned arrangement with the alignment marking. 前記動作が、
前記医療器具の前記標的場所への近接を判定することと、
前記インターフェース内に、前記医療器具の前記標的場所への前記近接の示唆を表示させることと、を更に含む、請求項１１に記載の１つ又は２つ以上の非一時的コンピュータ可読媒体。 The said operation is
determining proximity of the medical device to the target location;
12. The one or more non-transitory computer-readable media of claim 11, further comprising displaying in the interface an indication of the proximity of the medical device to the target location. 前記動作が、
前記医療器具が前記標的場所を越えて挿入されていると判定することと、
前記インターフェース内に、前記医療器具が前記標的場所を越えて挿入されているという示唆を表示させることと、を更に含む、請求項１１に記載の１つ又は２つ以上の非一時的コンピュータ可読媒体。 The said operation is
determining that the medical device is inserted beyond the target location;
12. The one or more non-transitory computer-readable media of claim 11, further comprising: displaying in the interface an indication that the medical device is being inserted beyond the target location. . 前記動作が、
前記医療器具の前記向きが測定単位だけ変化したと判定すること、及び前記医療器具が前記標的場所への所定の近接範囲外にあると判定することに応答して、前記インターフェース内の前記器具－位置合わせ要素の位置を第１の量だけ更新することと、
前記医療器具の前記向きが前記測定単位だけ変化したと判定すること、及び前記医療器具が前記標的場所への前記所定の近接範囲内にあると判定することに応答して、前記インターフェース内の前記器具－位置合わせ要素の前記位置を第２の量だけ更新することと、を更に含む、請求項１１に記載の１つ又は２つ以上の非一時的コンピュータ可読媒体。 The said operation is
the instrument within the interface in response to determining that the orientation of the medical instrument has changed by a measurement unit; and in response to determining that the medical instrument is outside a predetermined proximity to the target location; updating the position of the alignment element by a first amount;
in response to determining that the orientation of the medical device has changed by the unit of measurement and determining that the medical device is within the predetermined proximity to the target location. and updating the position of an instrument-alignment element by a second amount. 方法であって、
制御回路によって、人体解剖学的構造にアクセスするように構成されている医療器具の向きを判定することと、
前記人体解剖学的構造内の標的場所を判定することと、
前記制御回路によって、前記標的場所にアクセスするための前記医療器具の所望の経路を示唆する標的軌道を判定することと、
前記制御回路によって、前記医療器具の前記向きの前記標的軌道への位置合わせを示唆する器具－位置合わせ要素を含むインターフェースを表示させることと、を含む、方法。 A method,
determining, with the control circuit, an orientation of a medical device configured to access the human anatomy;
determining a target location within the human anatomy;
determining, by the control circuit, a target trajectory indicative of a desired path for the medical device to access the target location;
causing the control circuit to display an interface including an instrument-alignment element that suggests alignment of the orientation of the medical instrument to the target trajectory. 前記医療器具からセンサデータを受信することと、
前記センサデータに少なくとも部分的に基づいて、前記医療器具の前記向きが前記標的軌道と位置合わせされていると判定することと、
前記医療器具の前記向きが前記標的軌道と位置合わせされているという示唆を表示させることと、を更に含む、請求項１８に記載の方法。 receiving sensor data from the medical device;
determining that the orientation of the medical device is aligned with the target trajectory based at least in part on the sensor data;
19. The method of claim 18, further comprising displaying an indication that the orientation of the medical instrument is aligned with the target trajectory. 前記医療器具からセンサデータを受信することと、
前記センサデータに少なくとも部分的に基づいて、前記医療器具の前記標的場所への近接を判定することと、
前記医療器具の前記標的場所への前記近接を示唆する進行表現を表示させることと、を更に含む、請求項１８に記載の方法。 receiving sensor data from the medical device;
determining proximity of the medical device to the target location based at least in part on the sensor data;
19. The method of claim 18, further comprising displaying a progress representation indicating the proximity of the medical instrument to the target location. 前記医療器具から追加のセンサデータを受信することと、
前記追加のセンサデータに少なくとも部分的に基づいて、前記医療器具の前記向きが閾値量を超えて前記標的軌道と位置ずれしていると判定することと、
前記進行表現の少なくとも一部分内に、前記医療器具の前記向きが前記閾値量を超えて前記標的軌道と位置ずれしているという示唆を表示させることと、を更に含む、請求項２０に記載の方法。 receiving additional sensor data from the medical device;
determining that the orientation of the medical device is misaligned with the target trajectory by more than a threshold amount based at least in part on the additional sensor data;
21. The method of claim 20, further comprising displaying an indication within at least a portion of the progress representation that the orientation of the medical instrument is misaligned with the target trajectory by more than the threshold amount. . 前記医療器具から追加のセンサデータを受信することと、
前記追加のセンサデータに少なくとも部分的に基づいて、前記医療器具が前記標的場所を越えて挿入されていると判定することと、
前記進行表現の少なくとも一部分内に、前記医療器具が前記標的場所を越えて挿入されているという示唆を表示させることと、を更に含む、請求項２０に記載の方法。 receiving additional sensor data from the medical device;
determining that the medical device is inserted beyond the target location based at least in part on the additional sensor data;
21. The method of claim 20, further comprising displaying an indication within at least a portion of the progress representation that the medical device is being inserted beyond the target location. 前記医療器具からセンサデータを受信することと、
前記センサデータに少なくとも部分的に基づいて、前記医療器具の前記向きが閾値量を超えて前記標的軌道と位置ずれしていると判定することと、
前記センサデータに少なくとも部分的に基づいて、前記医療器具が前記人体解剖学的構造内に挿入されていると判定することと、
前記針の前記向きが前記閾値量を超えて前記標的軌道と位置ずれしていると判定すること、及び前記医療器具が前記人体解剖学的構造内に挿入されていると判定することに少なくとも部分的に基づいて、前記医療器具を前記人体解剖学的構造から後退させるための示唆を表示させることと、を更に含む、請求項１８に記載の方法。 receiving sensor data from the medical device;
determining that the orientation of the medical device is misaligned with the target trajectory by more than a threshold amount based at least in part on the sensor data;
determining that the medical device is inserted into the human anatomy based at least in part on the sensor data;
at least in part: determining that the orientation of the needle is misaligned with the target trajectory by more than the threshold amount; and determining that the medical device is inserted into the human anatomy. 19. The method of claim 18, further comprising: displaying a suggestion for retracting the medical instrument from the human anatomy based on the condition. 第１の値を位置変化パラメータと関連付けることであって、前記位置変化パラメータが、前記医療器具の移動単位に対する前記器具－位置合わせ要素の位置変化量を示唆する、関連付けることと、
前記医療器具が前記標的場所への所定の近接範囲内にあると判定することと、
前記医療器具が前記標的場所への前記所定の近接範囲内にあると判定することに少なくとも部分的に基づいて、第２の値を前記位置変化パラメータと関連付けることと、を更に含む、請求項１８に記載の方法。 associating a first value with a position change parameter, the position change parameter indicative of a position change of the instrument-alignment element relative to a unit of movement of the medical instrument;
determining that the medical device is within a predetermined proximity to the target location;
19. Associating a second value with the position change parameter based at least in part on determining that the medical instrument is within the predetermined proximity to the target location. The method described in. 針のガイダンスを支援するための方法であって、前記方法が、
医療システムの制御回路によって、患者内に経皮的に挿入されるように構成されている針から第１のセンサデータを受信することと、
前記第１のセンサデータに少なくとも部分的に基づいて、前記制御回路によって、前記針の向きを判定することと、
前記制御回路によって、前記患者の解剖学的管腔内に少なくとも部分的に配設されている内視鏡から第２のセンサデータを受信することと、
前記第２のセンサデータに少なくとも部分的に基づいて、前記制御回路によって、前記患者の臓器内の標的場所を判定することと、
前記制御回路によって、前記標的場所に経皮的にアクセスするための標的軌道を判定することと、
前記制御回路によって、前記針の前記向きを表す針－位置合わせアイコンを含むインターフェースを表すユーザインターフェースデータを生成することであって、前記インターフェース内の前記針－位置合わせアイコンの位置決めが、前記針の前記向きの前記標的軌道への位置合わせを示唆する、生成することと、
前記ユーザインターフェースデータに少なくとも部分的に基づいて前記インターフェースを表示することと、を含む、方法。 A method for assisting in needle guidance, the method comprising:
receiving first sensor data from a needle configured to be percutaneously inserted into a patient by a control circuit of the medical system;
determining, by the control circuit, an orientation of the needle based at least in part on the first sensor data;
receiving, by the control circuit, second sensor data from an endoscope disposed at least partially within the anatomical lumen of the patient;
determining, by the control circuit, a target location within the patient's organ based at least in part on the second sensor data;
determining, by the control circuit, a target trajectory for percutaneously accessing the target location;
generating, by the control circuit, user interface data representing an interface including a needle-alignment icon representative of the orientation of the needle, wherein the positioning of the needle-alignment icon in the interface is indicative of the orientation of the needle; suggesting or generating an alignment of the orientation to the target trajectory;
displaying the interface based at least in part on the user interface data. 前記インターフェースが、境界マーキングを更に含み、前記方法が、
前記針の前記向きが閾値量を超えて前記標的軌道と位置ずれしていると判定することと、
変形された形状で前記境界マーキングに前記針－位置合わせアイコンを表示することと、を更に含む、請求項２５に記載の方法。 the interface further includes boundary marking, and the method further comprises:
determining that the orientation of the needle is out of position with the target trajectory by more than a threshold amount;
26. The method of claim 25, further comprising displaying the needle-alignment icon on the boundary marking in a deformed shape. 前記針の前記向きが前記標的軌道と位置合わせされていると判定することと、
前記インターフェース内に、前記針の前記向きが前記標的軌道と位置合わせされているという示唆を表示することと、を更に含む、請求項２５に記載の方法。 determining that the orientation of the needle is aligned with the target trajectory;
26. The method of claim 25, further comprising displaying an indication in the interface that the orientation of the needle is aligned with the target trajectory. 前記針の前記標的場所への近接を判定することと、
前記インターフェース内に、前記針の前記標的場所への前記近接を示唆する進行バーを表示することと、を更に含む、請求項２５に記載の方法。 determining proximity of the needle to the target location;
26. The method of claim 25, further comprising displaying a progress bar in the interface indicating the proximity of the needle to the target location. 前記針が前記標的場所に到達したことを判定することと、
前記インターフェース内に、前記針が前記標的場所に到達したという示唆を表示することと、を更に含む、請求項２５に記載の方法。 determining that the needle has reached the target location;
26. The method of claim 25, further comprising displaying in the interface an indication that the needle has reached the target location. 前記針が前記標的場所を越えて挿入されていると判定することと、
前記インターフェース内に、前記針が前記標的場所を越えて挿入されているという示唆を表示することと、を更に含む、請求項２５に記載の方法。 determining that the needle is inserted beyond the target location;
26. The method of claim 25, further comprising displaying an indication in the interface that the needle is inserted beyond the target location.
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