RU143299U1 - MEDICAL PROCEDURE MODELING SYSTEM (OPTIONS) - Google Patents

Abstract

1. A modeling system for simulating a medical procedure, including: a simulated organ; a simulated endoscope located in the simulated organ and containing a sensor for determining the location of the specified simulated endoscope inside the simulated organ; tactile feedback mechanism located in the simulated organ and designed to provide tactile feedback applied to the simulated endoscope. 2. The system according to claim 1, characterized in that the simulated organ is placed in a portable case. The system according to claim 1, characterized in that it also contains a data processing unit. The system according to claim 3, characterized in that the data processing unit is placed on a remote server. The system according to claim 3, characterized in that the data processing unit comprises a communication interface configured to exchange data with a remote server over the network. The system according to claim 1, characterized in that the tactile feedback mechanism includes a tube and a rod, which is configured to increase or decrease pressure on the tube using an electric motor. The system according to claim 6, characterized in that for controlling the electric motor a controller is provided, configured to exchange data with the data processing unit. The system according to claim 1, characterized in that the modeled organ is selected from the group of modeled organs consisting of a simulated gastrointestinal tract and a simulated bronchial tract.

Description

The technical field to which the utility model relates.

This utility model relates to a system for preparing and teaching students how to perform medical procedures and, specifically, to a system for teaching students how to perform endoscopy procedures.

State of the art

Endoscopy is an important minimally invasive medical procedure. Flexible gastroendoscopy serves as an important medical tool for surgical and diagnostic procedures in the gastrointestinal tract. In practice, gastroendoscopy or bronchoscopy is performed by inserting an endoscope, which is a flexible tube, into the gastrointestinal or bronchial tract, respectively, either through the patient’s mouth or rectum. A qualified doctor manipulates the tube using special controls. The end of the tube, which is inserted into the patient’s body, contains a camera and one or more surgical instruments, such as a clamp or forceps for taking tissue samples from the specified tract. The doctor must manipulate the tube in accordance with the images of the gastrointestinal or bronchial tract coming from the camera and displayed on the video screen. The lack of direct visual feedback from these paths is one of the factors that makes endoscopy difficult and difficult to master. This lack of feedback also increases the difficulty of coordinating movements and properly manipulating the endoscopic device. Thus, flexible gastroendoscopy is a difficult procedure to perform and study.

As a rule, students are taught how to perform flexible gastroendoscopy in accordance with the traditional model of medical education, in which students observe and help more experienced doctors. Unfortunately, observation alone cannot provide the necessary training for such complex medical procedures. Students can also perform procedures on animals and human corpses, but neither one nor the other reproduces the visual and tactile sensations that arise when working with a living patient. Thus, traditional medical training is not suitable for modern technologically complex medical procedures.

In an attempt to provide more realistic medical training for performing such procedures, simulation devices have been developed that seek to reproduce tactile sensations and / or visual feedback when performing these procedures in order to improve medical training without endangering patients.

US Pat. No. 6,857,878 discloses a system for modeling a medical procedure performed on a subject’s body, which contains a simulated organ, a simulated medical instrument, and a localizer for locating the instrument in the organ. The system is also equipped with a visual display device for reproducing images obtained during the medical procedure. The visual display device also includes a three-dimensional mathematical model for modeling an organ, which is divided into many linear segments. The location of the instrument in the organ is used to select a segment, which, in turn, is used to select images for playback on a visual display device.

Utility Model Disclosure

Thus, a system for modeling a medical procedure is proposed. The system may include a simulated anatomical structure of the physical tract and a simulated endoscope. The system may also include a sensor and a localizer for determining the location of the simulated endoscope in the simulated anatomical structure, a visual display device for reproducing images obtained during the medical procedure based on the specific location of the endoscope, and a tactile feedback mechanism to provide tactile feedback applied to the simulated endoscope. In addition, the system may include a processing unit for calculating image data when creating images based on a mathematical model of a simulated anatomical structure and for determining visual feedback and calculating tactile feedback in accordance with the determined location of the endoscope, and a communication interface for exchanging data with the remote server.

A new technical result achieved by the claimed modeling system consists in combining its three technical components with the possibility of modeling medical procedures that are perceived by the user to be absolutely realistic. The practical effect is that the user has the opportunity to gain the necessary medical experience in a safe environment, without endangering the examined people or animals, because thanks to the proposed technical solution, the user becomes more skilled in conducting the learned medical procedure. The combined effect provided by applying an endoscope to the simulated organ and by receiving tactile feedback from it allows the user to accumulate experience that is absolutely realistic, and therefore the effectiveness of his training increases.

In addition, in accordance with one embodiment of the utility model, a simulated anatomical structure can be placed in a portable case.

In addition, in accordance with one embodiment of the utility model, the data processing unit may be deleted with respect to the modeling system.

In addition, in accordance with one embodiment of the utility model, the data processing unit may be located on a remote server.

In some embodiments, the communication interface may be configured to communicate with a remote server over a network.

In some embodiments, the tactile feedback mechanism may include a tube and a rod, which is configured to increase or decrease pressure on the tube using an electric motor.

In addition, in accordance with one embodiment of the utility model, this motor may be controlled by a controller configured to exchange data with the data processing unit.

In addition, in accordance with one embodiment of the utility model, the simulated procedure may include an emergency medical procedure module.

In some embodiments, the emergency medical procedure module may include a simulated procedure selected from the group consisting of actions such as removing a foreign object, treating bleeding, and removing mucous plugs.

In addition, in accordance with one embodiment of the utility model, the emergency medical procedure module may include modeling one or more types of interactions selected from the group of interactions consisting of the interaction between a foreign object and surrounding tissue, the interaction between a foreign object and a simulated tool, and interactions between a foreign object and an endoscope.

In addition, in accordance with one embodiment of the utility model, modeling the interaction of a foreign object and surrounding tissue may include performing at each update cycle a series of user-defined iterations during which the speed, direction, and the selected time interval of the foreign object are used to calculate the current position of the foreign object inside the simulated anatomical structure.

In addition, in accordance with one embodiment of the utility model, collisions between a foreign object and surrounding tissue can be detected when performing a series of user-defined iterations.

In addition, in accordance with one embodiment of a useful collision model, collisions can be identified during collision tests on polygons and optimization of the tree structure of the spheres.

In addition, in accordance with one embodiment of the utility model, the new speed and direction of a foreign object can be calculated based on the colliding polygons, their elasticity, and taking into account physical effects.

In addition, in accordance with one embodiment of the utility model, the system may also include a remote server on which the data processing unit is located.

In addition, in accordance with one embodiment of the utility model, the simulated anatomical structure may be selected from the group of simulated anatomical structures consisting of a simulated gastrointestinal tract and a simulated bronchial tract.

In addition, in accordance with one embodiment of the utility model, a server is provided for processing one or more simulation models of a medical procedure. The server may include a data processing unit configured to exchange data with one or more modeling systems, which include a simulated endoscope and a simulated anatomical structure of the physical tract, while the data processing unit is configured to process these one or more simulation models of a medical procedure based on information about the location related to the location of each simulated endoscope in the corresponding simulated anatomical structure of each of indicated by one or more modeling systems.

Brief Description of the Drawings

In order to better understand the presented examples and assess the possibilities of their practical application, the description contains the following drawings, the links to which are given later in the text. It should be noted that the drawings are given as an example only and in no way limit the scope of the utility model. For components of the same type, the same reference designators are used.

Figure 1 shows an example image of a medical modeling system in accordance with one embodiment of a utility model.

FIG. 2 shows an example image of a screen display in accordance with one embodiment of the utility model.

FIG. 3A shows an example of a process implementation diagram of a method in accordance with one embodiment of a utility model for creating a visual model of a simulated organ and generating visual feedback.

FIG. 3B is a block diagram illustrating an example of a video processing and information display system in accordance with one embodiment of the utility model.

FIG. 4 is a structural diagram illustrating an example of a training system in accordance with one embodiment of a utility model.

FIGS. 5A and 5B show an example of a simulated gastrointestinal tract in accordance with one embodiment of the utility model.

FIG. 6A-C illustrates various aspects of a power feedback system in accordance with one embodiment of the utility model.

FIG. 7A-C illustrates a second embodiment of a power feedback system in accordance with one embodiment of the utility model.

FIGS. 8A-8E show another embodiment of a system in accordance with one embodiment of a utility model.

FIGS. 9A-9E show a tool block in accordance with one embodiment of the utility model.

FIG. 10A shows a portable modeling system in accordance with one embodiment of the utility model.

FIG. 10B depicts some of the internal elements of a portable modeling system in accordance with one embodiment of the utility model.

FIG. 10C shows a power feedback unit of an endoscope of a portable modeling system in accordance with one embodiment of the utility model.

Figure 11 shows a cloud modeling system according to one embodiment of a utility model.

It should be understood that for the sake of simplicity and clarity of the image, the elements shown in the figures need not be made to scale. For example, the dimensions of some elements may be exaggerated relative to other elements for clarity. In addition, where appropriate, the reference signs in the drawings may be repeated indicating similar or similar elements.

Utility Model Implementation

In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the methods and apparatus. However, it will be understood by those skilled in the art that the present methods and apparatus can be practiced without these specific details. In other cases, well-known methods, procedures, components have not been described in detail, so as not to complicate the understanding of the present methods and devices.

Although the examples disclosed and discussed in the present application are not limited in this regard, the terms “plurality” or “set” as used herein may include, for example, “several” or “two or more”. The terms "plural" or "set" can be used in this description of a utility model to describe two or more components, devices, elements, blocks, parameters, etc. Unless expressly provided, embodiments of the method described herein are not limited to any particular order or sequence. In addition, some of the described examples of the method or its elements can occur or run at the same time.

Unless otherwise specified, then, as is clear from the discussion that follows, it should be understood that the terms used throughout the description, such as “addition”, “connection”, “choice”, “rating”, “processing”, “calculation”, “Calculation”, “definition”, “designation”, “isolation” and the like, may refer to actions and (or) processes performed by a computer, computer processor, computing system, or similar electronic computing device that manipulates and (or) converts data presented as fi physical (for example, electronic) quantities in registers and (or) memory blocks of a computer system, to other data similarly represented as physical quantities in registers and (or) memory blocks of a computer system or other devices for storing, transmitting or displaying information .

This utility model relates to a system for modeling an endoscopic procedure, specifically, a flexible gastroendoscopic procedure or a flexible bronchoendoscopic procedure. The system may include a dummy into which a simulated endoscope is inserted. Visual feedback is provided using a video monitor. In some embodiments, realistic images are displayed on the monitor in real time in accordance with the manipulations performed by the simulated endoscope. In some embodiments, a virtual reality video image is displayed on a monitor.

In addition, in some embodiments, realistic tactile feedback is provided so that the tactile and visual forms of feedback are interconnected, as would be the case in a living patient. In some embodiments of the utility model, a learning system is proposed for preparing students and checking their progress. Thus, the system according to the utility model provides for realistic modeling of the medical endoscopic procedure, as well as modules of basic skills for preparing and testing students.

The principles and operation of the system in accordance with a useful model for medical modeling and, specifically, for modeling a medical endoscopic procedure, preferably including the transfer of training results and assessment of skills of students to a teacher, or control of medical personnel, will be more clear from the following drawings and the accompanying description , it should be understood that these drawings are for illustrative purposes only and do not limit the scope of the utility model. In addition, although the description below refers to the modeling of the gastrointestinal system and the respiratory system, it should be noted that this is done only for the sake of clarity and in no way limits the scope of the utility model.

We turn now to the drawings. FIG. 1 shows a system 10 for medical modeling in accordance with one embodiment. The system 10 may include a dummy 12 representing the subject, on whose body a medical procedure is to be performed, a simulated endoscope 14 and a data processing unit 16 with a video monitor 18. Student 20 is shown interacting with the system 10 by manipulating the simulated endoscope 14 inside the dummy 12. As is further shown below 5A and 5B, the mannequin 12 contains a simulated organ into which the simulated endoscope 14 is inserted. As the student 20 manipulates the simulated endoscope 14, the tactile and visual reverse with ide determined in accordance with the position of endoscope 14 within the simulated organ (not shown). Visual feedback is provided in the form of a display on the video monitor 18. Calculations of the necessary data are performed by the processing unit 16, so that the student 20 receives a realistic tactile and visual feedback 20.

Figure 2 shows an example image of the on-screen display on the monitor 18 in accordance with one embodiment of the utility model. The on-screen display 22 includes graphical feedback 24. Graphical feedback 24 is a visual image that can be seen if an endoscope is inserted into the body of a living patient. Graphical feedback 24 is capable of accurate and realistic modeling of visual data that would be obtained from this part of the gastrointestinal tract of a living patient. Although graphical feedback 24 is shown as a static image, it should be understood that it is provided for illustrative purposes only, and that the actual visual feedback data will take the form of an almost continuous stream of simulated images based on the actual video stream of the data obtained by actually performing endoscopic procedures. Thus, the stream of images represented by graphic feedback 24 provides a student (not shown) with realistic visual feedback. In another embodiment, the visual feedback is a graphic animation that mimics real images that would be obtained from this part of the gastrointestinal tract of a living patient.

In addition, the on-screen display 22 preferably includes a number of GUI (graphical user interface) functions associated with the preferred training functions of the utility model. For example, the accompanying display 26 clearly shows the location of the simulated endoscope within the simulated gastrointestinal tract. The accompanying display 26 includes a schematic gastrointestinal tract 28 into which the schematic endoscope 30 is inserted. The accompanying display 26 can be enabled or disabled so that the student can only see the accompanying display 26 if the tracking function is enabled.

In addition, additional functions of the on-screen display 22 may include a help button 32, upon activation of which information is displayed on the monitor, for example, an endoscope control guide. Similarly, the prompt button 34 preferably provides the student with one or more suggestions on how to proceed with the medical procedure. When the “medical history” button 36 is pressed, on-screen display 22 will display information related to one of the selected simulated “medical history” options that can help the student in determining subsequent actions to be taken. When you press the button "results of execution" 38 on-screen display 22 will be displayed analysis and quantitative assessment of student actions. All or some of these functions may constitute part of an embodiment of a training system for preparing a student to perform a medical endoscopic procedure, which is presented in more detail in FIG. 4.

FIGS. 3A and 3B are structural diagrams of video processing, as well as a system and method for displaying information in accordance with one embodiment. FIG. 3A shows a diagram of a process for implementing a method for processing and displaying video data in accordance with one embodiment, serving as a generalization of the method used by the system shown in FIG. 3B. Additional information regarding specific aspects of the method in accordance with one of the embodiments described below with reference to FIGU.

The method and system according to the options for implementation offer a solution to a number of problems in the field of medical modeling, in particular, modeling the gastroendoscopy procedure. This procedure involves visualizing the inside of the gastrointestinal tract, such as the colon. The large intestine is an elastic body with a curved structure. The inner surface of the colon as a whole has the ability to deform, and, more specifically, is locally deformable. All such spatial deformations can be calculated according to the mathematical model of the colon, and then visually reproduced in real time in order to provide realistic visual feedback for the user.

FIG. 3A shows a method for preparing a model and generating visual feedback in accordance with one embodiment, including steps for preparing a computerized model of the colon, as well as steps for displaying the colon.

In step 1 of the method shown in FIG. 3A, actual video data can be recorded on digital or analog storage media in the process of performing a real medical endoscopic procedure on a living patient. In addition, such data may also include MRI (magnetic resonance imaging), ultrasound and CT - (computed tomography) scans collected using procedures performed on living patients.

In step 2, individual images are extracted, for example, using a device for capturing image frames, and then digitized. In step 3, the digitized images are preferably selected taking into account the clarity and lack of visual artifacts, and then stored in the texture mapping database. In some embodiments, the quality of the digitized images is improved before storage. In some embodiments, texture mapping also includes animation. This animation allows you to simulate various effects, such as random vibrations of colon tissue or an endoscope, as well as events such as fluid flowing in a lower direction by gravity.

At step 4, a three-dimensional mathematical model of the human colon is built. For example, a three-dimensional mathematical model may be a polygonal model, such as a spline. This mathematical function represents the colon as a family of curves so that points in the three-dimensional structure of the colon are displayed on the spline. For example, the colon can be modeled as a straight line that is deformed by changing the spline for a given model until the model matches the data. Alternatively, the spline can be placed inside the colon and displayed on the colon. Many splines can be used, for example, to model the junction of the stomach with the small intestine.

In some embodiments, the mapping may be performed in a three-dimensional coordinate system along the x, y, and z axes. In some embodiments, the display can be made in the coordinates "time, angle and radius" inside the colon. A combination of two different types of coordinates may also be used, for example, time, x and y. Both the spline itself and the display of the spline on the colon can be changed to obtain new, different visual representations of the colon, for example, to obtain a set of theoretical “test options” for students to study. Changes can be made, for example, in accordance with the data of MRI (magnetic resonance imaging). In addition, the data obtained using MRI and (or) CT scans can be cleaned and reassembled to more accurately determine the geometric characteristics of the simulated colon. In some embodiments, these procedures may be performed automatically in accordance with such data. In some embodiments, the implementation of these procedures can be fully or partially performed manually. Thus, the mathematical model in accordance with the options for implementation allows for quick visual reproduction of these data on the model of the colon.

In accordance with one embodiment, the loop itself of the endoscope cable can be modeled. Such a loop occurs when a person performing an endoscopic procedure, “real” or simulated, inadvertently changes direction within the rectum, turning the endoscope itself. Such a loop can be very dangerous for the patient, so it would be advisable to identify it during the simulation, warning the student about the presence of a sign of incorrect procedure, which led to the formation of the loop.

The loop can be formed using a spline in accordance with one of the options for implementation and coordinate with the power feedback. You can determine the length of the cable that was inserted into the rectum, as well as the length of the colon from the rectum (entry point of the endoscope) to the current position of the endoscope. The size of the rectum is then calculated from the difference of these two lengths, and the loop is modeled according to the spline.

A method for visually reproducing a colon in accordance with one embodiment may include a series of steps described below, which may be executed as instructions to a program executed by a processor for processing data. The method may include a step (step 5 in FIG. 3A) of dividing the colon into multiple sections. Separation is linear, since the spatial movement of the simulated endoscope may be limited. In other words, the simulated endoscope cannot "jump" from one section of the colon to another, but should instead move linearly along the simulated colon.

Due to this separation, only one segment needs to be processed at any given time, although if the necessary computing resources were available, many segments could be processed almost simultaneously. In addition, the separation reduces the processing of video data to a much more manageable task, since this model may in some cases include thousands of polygons in the preferred embodiment, although the number of polygons in each segment is much smaller.

In addition, only those areas that are on the line of sight of the simulated camera, and, as a result, are either directly visible or will soon become visible, are selected for visual reproduction in order to reduce the amount of computation required for reproduction. The number of sections that will be visually reproduced cannot be determined in advance, since their number on the line of sight may be different under certain circumstances. For example, when the camera moves around the bend of the colon, the line of sight of the camera is very short, so that a relatively smaller number of sections, or sections of a smaller size, should be reproduced.

Then, in step 6, the visual attributes of the colon area that is being scanned by the simulated camera are determined. These visual attributes can be determined according to a number of factors, including, for example, the location of the distal end of the endoscope where the camera is located and the direction in which the camera is facing. Other factors may include the shape of the simulated colon and the history of camera movement within the colon. With this last factor in mind, previous movements of the endoscope inside the colon, determined by the student’s actions, have a significant effect on the area of the colon that the camera visualizes at any given time. For example, if a student caused a loop to form by acting improperly with an endoscope, as described above, this “loop” can be correctly modeled only by taking into account the history of movements when determining visual feedback.

In step 7, an analysis of the local deformation of at least one of these sections is performed to determine whether such deformation affects the spline itself. After that, the displayed coordinates are quickly converted from the system “time, angle and radius” to the system x, y and z. Then, in step 8, the local deformation of the colon tissue is determined by interpolating the radius to determine the degree of such deformation. Since time, angle, and radius may not provide enough information to perform this calculation, the volume of the colon is further altered in accordance with the mathematical model.

For deformations exclusively on a local scale, such as the point of contact between the end of the endoscopic instrument and the colon with a small amount of effort on the part of the instrument, the level of detail in this zone can be increased by adding additional polygons to the calculations performed on the model to stretch all or most points in the adjacent area without distortion. Stretching can be performed in accordance with a given function, which allows you to change the spline model locally.

This method of modeling the "stretching" of the colon can also be used to model local areas of irregularity, such as a polyp. Polyps can be mapped onto the model of the colon by points, thereby adjusting the visual representation of the tissue to include both the polyp itself and the structural changes in the tissue associated with this polyp.

Then, in step 9, the various types of data that were described above are used to actually convert the visual data into an image of the colon. The initial mapping of such data to a model in some cases preferably involves minor adjustments made manually by the programmer. Alternatively, such a display may be fully automatic.

At step 10, the texture mapping from the database is superimposed on the model fragment. This texture mapping may include digitized images and additional animation. In step 11, the resulting images are displayed on the monitor. As already noted, images can be displayed on the monitor as a continuous stream in accordance with the location of the simulated endoscope inside the simulated gastrointestinal tract. In addition, as noted above, such a mapping of coordinates is preferably performed in accordance with a mathematical model of the colon, for example, a spline.

FIG. 3B, a video processing and information display system in accordance with one embodiment is shown in more detail. The video processing and information display system 40 may include an on-screen display 22 for displaying processed video data. Video data may be formed as follows. First of all, the data can be recorded on a video tape using real gastroendoscopic procedures, as shown in the recording unit 42. This data can be collected and stored in an analog format, for example, such as S-VHS video format, or in a digital format, such as, for example, a stream HD video data to obtain a high-quality representation of the visual images displayed on the screen during the actual endoscopic procedure, as shown in block 44. Then at least a portion of the frames of the video stream, or all frames, are extracted indie visually using the device 46 for capturing image frames to form digitized images, if they were not obtained in digital form. After that, individual digitized images can be selected taking into account the clarity and lack of visual artifacts, such as reflections from the endoscopic equipment itself. Further, the images in the selected frames can be enhanced and added to the texture mapping database 48.

The database can store two types of texture mapping. The first type of texture display is designed to enhance the realistic visual aspects of images, for example, by removing visual artifacts. The second type of texture mapping is designed to simulate the behavior of a living organ and a real endoscope, as represented by block 50. During real endoscopic procedures on a living patient, the colon tissue shifts slightly, and the endoscope itself vibrates and sways. This displacement is modeled visually by adding random animation of images, as well as by adding effects such as fluid flowing in a lower direction under the influence of gravity. Such an animation enhances the realistic nature of the visual presentation of the colon.

In order for advanced images to display correctly, they must correspond to the manipulation and location of the simulated endoscope inside the simulated colon. In particular, image texture mapping is performed in accordance with the location of the endoscope within the colon. Such a correspondence between the location of the endoscope inside the colon and the texture mapping is provided by the texture mapping processor 52. After that, the data and texture mappings become easily accessible to the display portion of the visual system 40, as shown by block 54.

However, the simple reproduction of selected advanced frames in a mass video stream can quickly lead to an overflow of computing resources and cause a loss in synchronization of visual display relative to the physical location of the simulated endoscope. In addition, such a video stream may not allow the correct display of images in accordance with the movement of the endoscope, which preferably has six degrees of freedom. Thus, simple reproduction is not enough to provide realistic images, even when displayed on a three-dimensional surface.

The video data processing and information display system 40 may include a three-dimensional mathematical model of at least part of the gastrointestinal tract 56, for example, such as that shown in FIG. 3A. Although model 56 is described in this application as a three-dimensional model of the colon, it should be understood that it in no way limits the scope of the utility model. Model 56 may include multiple segments 58 and even multiple segments.

When you move the simulated endoscope along the simulated colon, the location of the endoscope is determined by the localizer 60, described in more detail below. The localizer 60 then instructs the object loader 62 to load the corresponding segment 58 for access by the visual system 40, as shown in block 54 and described above. In the shown embodiment, the three segments 58 are ready for access from the loader of the objects 62 at any given time. The particular segment 58 in which the endoscope is currently located may be stored in a DRAM (random access dynamic memory) or RAM (random access memory) memory unit in combination with the texture mapping described above. The next segment 58 and the previous segment 58 can also be stored in an easily accessible place, although not necessarily in RAM or DRAM.

The display of each image from a particular segment 58 into which the simulated endoscope was inserted can be optimized using the segment optimizer 64. The segment optimizer 64 receives information from the localizer 60, as well as a series of images obtained by superimposing the texture mapping on the corresponding segment 58, and then transmits each particular image to the screen manager 66 for display on the screen display 22.

In addition, the screen manager 66 can work with the support of a real-time visualizer 68, for example, implemented in the Direct 3D ^tm program (Microsoft Inc., Seattle, WA). The real-time visualizer 68 provides the necessary software support for exchanging data with the graphics adapter 70 in order to actually display the images on the screen display 22. Any suitable version of the graphics adapter 70 may be used, for example, to ensure optimal performance, the graphics adapter 70 may have VRAM ( RAM for video images) of at least 8 or at least 16 MB. An example of a suitable graphics adapter 70 is the NVidia GEforce 660 graphics card. The real-time performance of the visualizer 68 can be improved by the mathematical expressions optimizer 72, for example, implemented in Visual C ++. The interaction between the segment optimizer 64 and the screen manager 66 on the one hand and the localizer 60 on the other can be achieved using the program interface 74. The program interface 74 allows the localizer 60 to exchange data with other components of the visual system 40 in order to obtain information regarding the location of the endoscope inside simulated anatomical structure.

In embodiments, the localizer 60 may include a sensor 76, for example, manufactured by Ascension Technology Corp. The sensor 76 senses location information from within the simulated organ 77, which is described as a colon in this application for discussion purposes and is not limiting. The sensor 76 is controlled by the control unit 82. The location information is transmitted to the control device 78, which is connected to the servomotor 80 (for example, manufactured by Haydon Switch and Instrument Co.). As the simulated endoscope moves through the colon, the endoscope comes into contact with various parts of the colon (not shown; see FIGS. 5 and 6 below). Tactile feedback may be provided alternately by each servomotor 80 that manipulates the colon material.

The visual system 40 may also include a user interface 84, for example, implemented in Visual C ++ or Flash. User interface 84 includes GUI functions described previously with reference to FIG. 2. In addition, the user interface 84 may allow the visual system 40 to interact with the network interface 86, for example, so that other students can view the on-screen display 22 over the network. User interface 84 may also enable the activation of learning functions of at least one or more training modules 88. Training module 88 may include a specific scenario, for example, a subject suffering from colon cancer, removing a foreign object from the respiratory tract in bronchial asthma, so that introduce the student to various types of diagnostic and medical problems. It is expected that the student will correctly respond to the presented scenario.

An example of a training system is illustrated in more detail in the structural diagram presented in FIG. 4. The training system 90 starts up, as shown in block 92. Then the user is prompted to indicate whether the actual interaction with the simulated endoscope is required, or the user prefers to be trained in the theory of endoscopy, as shown in block 94. The screen then asks if the user is a newbie, as shown in block 96. If the answer is yes, the user is prompted to enter certain information, as shown in block 98. If the answer is no, the user is prompted to enter identification information such as to the name or user ID as shown by block 100.

After that, the user is invited to choose the type of training. For example, the user may choose training on topics 102, training on the basis of procedures 104, or training based on the description of single cases 106. Training on topics 102 may include, for example, topics such as basic endoscope manipulation, biopsy, and polypectomy. Topics training 102 may include screen support, as shown in block 108.

Training based on the description of single cases 106 can be selected, for example, in accordance with the case number and the required level of professional qualification, for example, "beginner", "intermediate", "specialist". Separate case descriptions can be created by the teacher or professor by combining the characteristics of the various stored case descriptions. For example, a professor can create a case history suitable for a 20-year-old man suffering from colitis so that a student can further develop an endoscopic procedure on such a patient. Another option may be that the teacher creates and assigns a curriculum, which may include, in addition to the selected simulated cases, instructional training material in written, audio or video format. The curriculum can be user generated or provided by the professional community and approved using common educational standards. Thus, the training system 90 preferably has the flexibility to study many different types of patients.

If necessary, screen support can be provided both for training based on the analysis of individual cases 106 and for training based on procedures 104, as shown in block 110. If screen support is not needed, the user can indicate whether the training session is an official test, as shown in block 112. Thus, the training system 90 may include both the possibility of learning and testing students' knowledge.

According to one embodiment, the training system may include a simplified version of a simulated endoscopic process that allows you to teach the correct manipulation of the endoscope in accordance with visual feedback and allows the student to understand the correspondence between visual and tactile feedback. In such a simplified version, the quality of execution and the degree of mastery of one or more specific tasks, such as manipulating the endoscope inside the colon, would be especially noted.

In fact, this embodiment can be generalized to create a way of teaching a student the specific skills necessary to perform a real medical procedure. This method may include the step of extracting a portion of the visual feedback of the actual medical procedure, which would preferably include fewer visual details than all the visual feedback obtained during the medical procedure. This part of the visual feedback will preferably allow the student to study the movement of the instrument as a necessary skill.

For example, a simplified version may in some cases not contain many, or even most of the visual details of the colon in the form of visual feedback. Instead, the colon can be presented in the form of a smooth, relatively devoid of characteristic features tube having the geometry and dimensions of the colon to ensure consistency with the movement of the simulated endoscope in the interior of the colon. More preferably, the simplified version could be implemented as a game in which students would score points for the correct manipulation of the endoscope and lose points in the event of incorrect manipulations. Thus, students would have the opportunity to study the manipulations necessary for the successful implementation of endoscopy, without being distracted by visual details, being in a low-voltage and even “entertaining” environment.

FIGS. 5A and 5B depict mechanical aspects of a simulated gastrointestinal tract in accordance with one embodiment. FIG. 5A shows a sectional view of a mannequin 114. The mannequin 114 may be about one meter wide, which approximately corresponds to the size of a real patient. The simulated anatomical structure 116 (eg, the gastrointestinal tract) is shown inside the dummy 114. For simplicity, the simulated anatomical structure 116 includes only the colon, it should be understood that this in no way limits the scope of the utility model. The simulated anatomical structure 116 is connected to the transmitter 118 and the signal processing device 120, also placed inside the dummy 114. As shown in the figure, the simulated endoscope 122 can be inserted inside the dummy 114 through the hole 124. In this case, since the endoscopy of the colon is being examined, the hole 124 models the rectum of the subject.

The simulated endoscope 122 can be moved left, right, up and down, forward and backward within the boundaries of the simulated anatomical structure. In one embodiment, the simulated endoscope 122 is about 180 cm long, or about 60 cm in the case of a simulated bronchoscope, similar to the length of a real endoscope. The diameters of the end of the simulated endoscope 122 or the rest of it are similar to the sizes of real endoscopes used in the simulation (such as a colonoscope, bronchoscope, gastroscope and duodenoscope).

After the simulated endoscope 122 is inserted into the simulated anatomical structure 116, the sensor 76 at the end of the simulated endoscope 122 allows you to determine the location of the simulated endoscope 122. The sensor 76 preferably has at least three degrees of freedom, but in some embodiments it has six degrees of freedom in for the purpose of efficient modeling by manipulating the endoscope 122. If the sensor 76 has six degrees of freedom, the determined orientation directions include rectangular Cartesian coordinates X, Y, Z, as well as rotation around the longitudinal axis, elevation and azimuth. In addition, the sensor 76 may include a sensor transmitter 126, which allows you to determine the exact angle and location of the sensor 76 relative to the anatomical structure 116. The sensor transmitter 126 transmits data to the signal processing device 120, which then analyzes and processes the signal. After that, the processed signal is transmitted to the transmitter 118 for transmission to the electronic unit 128 and the DC drive unit 130. The signal is converted by the DC drive unit 130 and sent to the electronic unit 128. Then, the electronic unit 128 sends the position and orientation of the sensor 76 to the program interface 74 so that the rest of the display system can use this information to display the correct images on the on-screen display 22 to create visual feedback.

Embodiments provide both visual and tactile feedback. Tactile feedback can be achieved by applying efforts to the simulated endoscope 122 from the side of the simulated anatomical structure 116, as shown in FIG.6A-6C. Alternatively, tactile feedback can be achieved by mechanically acting on the simulated endoscope 122, as shown in FIGS. 7A-7D. In one embodiment in which tactile feedback is provided by applying force to the simulated endoscope 122, the simulated anatomical structure 116 may be made of a semi-elastic material that gives a feeling of a smooth and damp surface. Real sensations of sliding along a semi-elastic, smooth and wet material can also be achieved using the mechanism of the endoscope 122 itself, as in the case of tactile feedback provided by the mechanical action of the simulated endoscope 122.

A further embodiment of the simulated anatomical structure 116, in which the simulated anatomical structure 116 is placed inside the box 132, and not in the dummy 114 itself, is shown in FIG. The advantage of the box 132 is that it can serve to hold any radio frequency waves so that the mechanism of the simulated anatomical structure 116 can be controlled, for example, by transmitting radio frequency waves. Since some types of medical equipment are highly sensitive to radio frequency waves, it is necessary that they remain within the dummy 114. Therefore, box 132 will isolate the simulated anatomical structure 116 from the external environment outside the dummy, acting as a Faraday cage (shielded camera). Details of the simulated anatomical structure 116 are better seen in FIG. 6A, it being understood that FIG. 5A, 5B and 6A depict the same simulated anatomical structure (e.g., the gastrointestinal tract) 116.

FIG. 6A shows a simulated anatomical structure (gastrointestinal tract) 116 in accordance with one embodiment in which tactile feedback is provided by forces acting on the simulated endoscope 122 using the mechanism contained in the simulated anatomical structure 116. The simulated anatomical structure 116 is made of semi-elastic material. A set of motion blocks 134 is spaced along the outer surface of the simulated anatomical structure 116. For purposes of illustration, seven motion blocks 134 are shown. Each motion block 134, shown in more detail in FIG. 6B, is equipped with at least one, and preferably several, servomotors 80 preferably linear motors.

Each servomotor 80 may be connected to a piston 136. Details of the piston 136 are shown in an enlarged view in FIG. Each piston 136 may be connected to a heel 138, which is in contact with a portion of the material of the outer surface of the simulated anatomical structure 116. The heel 138 may actually be attached to a portion of the material of the outer surface to facilitate handling of the material.

Various types of pistons 136 may be used. For example, the first type, two samples of which are shown for illustration purposes, is a vertical force piston 140 causing vertical movement of a portion of the surface of the simulated anatomical structure 116. The second type, one sample of which is shown for purposes of illustration, is horizontal force piston 142 causing horizontal movement of a portion of the surface of the simulated anatomical structure 116. In the shown preferred embodiment, the servo vigatel 80 is an oscillating motor placed directly against the material of the simulated anatomical structure 116, the piston 142 includes only horizontal force motor, without affecting a structure similar to vertical force piston 140. Since each piston 136 has a servo motor 80 associated with it, the necessary vertical and horizontal movement of the outer surface of the simulated anatomical structure 116 can be precisely determined by the action of the servo motor 80.

Each piston 136, or heel 138 attached thereto, can contact the material of the simulated anatomical structure 116 to manipulate this material by applying force to an endoscope (not shown). For example, as shown in FIG. 6B, the first vertical force piston 144 can be moved closer to the servomotor 80, while the second vertical force piston 146 can be moved further away from the servomotor 80. These movements reposition the material of the simulated anatomical structure 116, creating forces applied to simulated endoscope, similar or identical to those that are felt when performing a real endoscopic procedure. In addition, the horizontal force piston 142, which is preferably a single oscillating servomotor, as shown in the figure, can move horizontally, providing a finer adjustment of the sensations caused by tactile feedback. Since the servomotors 80 are located on the three-dimensional surface of the simulated anatomical structure 116, the force exerted on the endoscope will act in three directions.

The actions of the servomotor 80 can, in turn, be controlled by a digital controller 82. The digital controller 82 can be, for example, a card inserted in a personal computer (PC) to perform the specified calculations necessary to simulate a medical process. The program executed by the processing unit 16 (see FIG. 1) can use the location and orientation information received from the sensor 76 located on the simulated endoscope 122 to determine the position of the simulated endoscope 122. Next, the program transmits commands to the digital controller 82 in in accordance with the required tactile sensations, which the operator must perceive from the simulated endoscope 122 located in a specific place inside the simulated anatomical structure 116. After that, the digital controller 82 At least one servomotor 80 is required to actuate the associated piston 136 in accordance with the need to provide sensations caused by tactile feedback.

The digital controller 82 may be connected to the servomotors 80 wirelessly, for example, using infrared radiation. However, the restrictions on the emission of waves with certain lengths, for example, radio frequency waves, in the conditions of hospital or medical institutions in many cases makes connecting with a wire coming from a digital controller 82 to each servomotor 80 more acceptable. In the embodiment shown in FIG. 6B, each servomotor 80 is connected to a motion controller 144 by a wire. The motion block controller 144 is also connected to the digital controller 82 via a single wire (not shown). This configuration limits the number of individual connections to the digital controller 82 for increased efficiency.

FIG. 6C shows an enlarged sectional view of a servomotor, which, as noted above, is preferably a linear motor. The servo motor 80 may, for example, be about 100 mm wide and 45 mm high.

FIGS. 7A-7D show a tactile feedback mechanism in accordance with one embodiment. In this embodiment, the mechanism is located within the simulated endoscope itself, and not in the simulated gastrointestinal tract. Similarly to the previous embodiment, the simulated gastrointestinal tract can be placed inside a mannequin, which is almost life-size with an opening for modeling the rectum. In addition, from the point of view of a student or other person managing a simulated endoscope, both options for implementation should ensure proper modeling of the medical procedure. However, as described in more detail below, the real mechanism for providing the tactile part of the simulation is of a different nature.

FIG. 7A shows a simulated endoscope 146 in accordance with another embodiment. The movements and actions of the simulated endoscope 146 are controlled using a set of controls 148. The end of the simulated endoscope 146 is located inside the guide sleeve 150. The guide sleeve 150, shown in more detail in FIG. 7B, may remain inside the simulated gastrointestinal tract (not shown; see. FIG. 7C) in order to maintain a realistic appearance of the simulated endoscope 146 before being inserted into a mannequin (not shown). A metal bracket 152 may be attached to the end of the endoscope 146, labeled with the word “sample” or another word, to make it clear that the endoscope 146 is only a model and is not a true medical tool. The inner side of the guide sleeve 150 is preferably magnetized, for example, by electric current. Thus, when the end of the endoscope 146 is inserted into the mannequin, the metal bracket 152 is attached to the guide sleeve 150 so that the guide sleeve 150 remains attached to the end of the endoscope 146.

The guide sleeve 150 may include one or more ball bearings 154 attached to the outer surface of the guide sleeve 150. In addition, the guide sleeve 150 may contain one or more plungers 156 attached to it. As shown in an enlarged view shown in FIG. 7B, one at the end of the guide sleeve 150 there is a stretch of elastic material 158. As shown in the figures, the end of the endoscope 146 is inserted through the guide sleeve 150, while at the end of the endoscope 146 there is a sensor 76, as in the above embodiment Realization of a simulated endoscope.

FIG. 7C shows a simulated endoscope 146 after the second embodiment of the simulated gastrointestinal tract 160 has been introduced inside. The simulated gastrointestinal tract 160 may be made of rigid material. In addition, the simulated gastrointestinal tract 160 may have a common anatomical shape and features of the real gastrointestinal tract for two reasons. Firstly, the tract, having a common anatomical shape, is easier to place inside the mannequin due to its bends and turns. Secondly, the general anatomical form can provide tangible tactile feedback. For example, when any endoscope is inserted deeper into the colon, the shape of the colon causes a change in tactile sensations when the endoscope moves around a bend in the colon. Thus, the general anatomical shape is more useful for effective modeling.

When moving the endoscope 146 inside the simulated gastrointestinal tract 160, the guide sleeve 150 allows the operator to perceive tactile feedback as follows. Ball bearing 154 rolls along the inner surface of the gastrointestinal tract 160. Each ball bearing 154 has five degrees of freedom of movement. Each plunger 156 is connected to a linear motor 162, as shown in section in FIG.7D. The linear motor 162 is controlled in the same way as the servo motor in the previous embodiment. Having received signals from the computer, the linear motor 162 makes the plunger 156 move in the vertical direction, thereby allowing the operator of the simulated endoscope 146 to perceive the sensations of tactile feedback. Thus, the guide sleeve 150 causes the tactile feedback to be transmitted back through the endoscope 146.

In addition, as noted above, the guide sleeve 150 may have a stretch of elastic material 158. The stretch of elastic material 158 causes the end of the endoscope 146 to experience some resistance under certain circumstances, for example, when the end is bent backward. Thus, the elastic material 158 restricts the movement of the end at certain angles.

A particular advantage of the utility model is that most of the tactile sensations are determined by the endoscope itself, therefore it is easier to control them using the data processing unit. In addition, anatomical features such as a fistula can easily be added to commands coming from a computer without causing the need to change the physical model of the simulated gastrointestinal tract. In addition, under certain circumstances, the tissue of the real colon pushes the endoscope back, and this situation is easier to reproduce in the second embodiment of the utility model. Thus, the second embodiment of the simulated gastrointestinal tract and endoscope is more flexible in terms of reproducing a larger number of anatomical features and conditions.

FIGS. 8A-8E show yet another embodiment of a simulated endoscope and colon in accordance with a utility model. FIG. 8A shows a system for medical modeling in accordance with one embodiment. System 164 may include a dummy 166 representing the subject to perform the procedure, a simulated endoscope (not shown, see FIG. 8D) and a data processing unit 168 with a video monitor 170. Dummy 166 may include a palpable portion 172 for determining the location of the simulated endoscope by feeling for the abdominal region of the mannequin 166. The palpable portion 172 may contain a light source (not shown), such that after the student determines the location of the simulated endoscope, the light can be ignited so that to show the actual location of the simulated endoscope.

Dummy 166 may include a simulated organ 174 into which a simulated endoscope is inserted. The simulated organ 174 may be a colon, for example, made in the form of a straight tube, while the force feedback necessary for bending in the colon will be provided by the force feedback mechanism 176. The visual feedback for the simulated medical procedure may not depend from the geometric shape of the modeled organ 174, so that the visual and tactile feedback are almost completely independent of the structure of the modeled organ 174.

Feedback mechanism 176 may include a pneumatic force feedback device 178 (shown in more detail in FIGS. 8B, 8D, and 8E). Two such pneumatic force feedback devices 178 may be provided, one near the mouth 180 of the mannequin 166 and the other near the rectum 182 of the mannequin 166. An air hose 184 may connect each pneumatic force feedback device 178 to the air pump 186. The air pump 186 may also include an air pump control unit 188, which is connected to the data processing unit 168 to control the amount of air pumped into the pneumatic force feedback device 178.

Processing unit 168 may also include a modem 190 or other communication interface for exchanging data with other devices. For example, the modem 190 may provide the connection of the processing unit 168 to the Internet or Intranet for the provision of telemedicine services, or to the manufacturer’s Intranet / computer network in order to carry out repairs or troubleshooting.

FIGS. 8B and 8C show in more detail the components of the pneumatic force feedback device 178. As shown in FIG. 8B, part of the simulated endoscope 192 interacts with the pneumatic force feedback device 178 to provide the student with power feedback. The force feedback device 178 may include a set of inflatable rings 194 (shown in more detail in the fully inflated position in FIG. 8C). All inflatable rings 194 may have different radii. In some embodiments, there are four such rings 194, at least one of which has a larger radius than the endoscope 192, and at least one of which has a smaller radius than the endoscope 192. The amount of air supplied to the rings 194 determines the degree of filling the air of each ring 194, preferably individually, thereby determining the amount of force applied to the endoscope 192.

In some embodiments, each ring 194 takes one second or less to reach a position where it is completely filled with air. In some embodiments, the air flow rate can reach up to 100 liters per minute, and the pressure can reach 3 atmospheres. Rings 194 can be used to create both passive force feedback, such as occurs when the rectum contracts, and active feedback, for example, when air is pumped into the simulated organ 174 in accordance with the functional attribute of the simulated endoscope 192 (see FIG. 8E )

FIG. 8D shows in detail the force feedback mechanism 176 in accordance with one embodiment. The rings 194 can be connected to the air pump 186 through a hose 184, which can be divided into two hoses 196, the first hose 196 serving to pump air into the rings 194, and the second hose 196 to pump air from the rings 194. The amount of air pumped air pump 186, is regulated by the controller 188 of the air pump. The actions of the controller 188 of the air pump can be controlled by the processing unit 168 through the (analog-to-digital) I / O board 198.

FIG. 8E shows in detail a simulated endoscope 192 in accordance with one embodiment. The simulated endoscope 192 may have a handle 200 with various controls, including a first control 202 for pumping air into the simulated organ 174 and a second control 204 for sucking air from the simulated organ 174. The simulated endoscope 192 may include a surgical instrument control device 206 into which various surgical instruments may preferably be inserted in some cases (see FIGS. 9A-9E). The simulated endoscope 192 may also have a receiver 208, for example, a mini-bird sensor (Ascension Ltd., Burlington, Vermont, USA). A receiver 208 may be located at the end of the simulated endoscope 192. A receiver 208 may be configured to receive data from a transmitter 210 located in the manikin 166 (see FIG. 8A), thereby determining the position of the end of the simulated endoscope 192 within the simulated organ 174. The transmitter 210 may be a mini-bird transmitter (Ascension Ltd.). Then, the receiver 208 can transmit these signals to the data processing unit 168, which uses these signals to determine the magnitude of the power feedback and visual communication displayed to the student on the monitor 178.

As described above, FIGS. 9A-9E show an implementation of a surgical instrument control device 206 into which various surgical instruments can be inserted. The surgical instrument control device 206 may include a clip 212 inserted into the sleeve of the instrument 214, thereby simulating a true endoscope clip. This clamp is used to perform polypectomy and, as a rule, is equipped with a loop that appears from the tip of the clamp when manipulating the device. This loop is applied around the polyp and tightened tightly. After that, an electric current is passed through the loop to cut off the polyp and cauterize this zone.

Similar to the present clip, the clip 212 is inserted when the student holds the handle of the clip 216, on which a button or other controls can be placed to simulate the effects of the flow of “electric current” through the “loop”. The sleeve for the tool 214 may include a tool control unit 218 for recognizing the movements of the clamp 212 and converting these movements into power and visual feedback. Visual feedback may optionally include, for example, a visual display of the “loop” of the clamp, as well as the display of the polyp before and after the “polypectomy”. In addition, the location of the loop can be monitored, preferably including up and down movements within the endoscope, as well as the “rotational” movement of the loop. The tool control unit 218 is connected to an input / output board in a processing unit (not shown) in order to perform the necessary calculations for various types of feedback.

FIGS. 9B and 9C show two types of clamp 212 interacting with the tool control unit 218 inside the tool sleeve 214. The tool control unit 218 is provided with a guide wheel 220 and a light wheel 222 for detecting movements of the clip 212 (FIG. 9B). In the light wheel 222 there is a set of cutouts through which light can pass. In the instrument control unit 218, there is also a first light source 224 and a first optical sensor 226, as well as a second light source 228 and a second optical sensor 230 (FIG. 9C). When the light wheel 222 is rotated as a result of the movement of the clamp 212, the light passage of the first light source 224 and the second light source 228 is alternately blocked and unlocked so that the light signal is alternately recognized or not recognized by the first optical sensor 226 and the second optical sensor 230.

FIG. 9C shows a second embodiment of a tool control unit. In this embodiment, the tool control unit 232 is provided with two guide wheels 234. The guide wheels 234 help guide the movement of the clip 212 inside the tool sleeve 214. The light wheel 236 also has cutouts that alternately locks and unlocks the passage of light when the clip 212 is rotated inside the tool sleeve 214. A light source (not shown) emits light that is detected if it passes through the light wheel 236 by a photoelectric sensor 238. Then, the photoelectric sensor 238 sends signals to and a printed circuit board (PCB) 240, which is connected to a computer (not shown), so that these signals can be converted by the computer into the desired visual and power feedback.

FIG. 9E shows a foot pedal 242 for performing a simulated polypectomy. The foot pedal 242 has an oil piston 244 and a microswitch 246. The microswitch 246 is connected to an input / output board in a processing unit (not shown) to convert the movement of the foot pedal 242 to the desired visual and power feedback.

In order to accurately reproduce the tactile sensations created by a real endoscope when performing a medical procedure, these sensations should be accurately recorded during the endoscopic procedure on a living patient. For example, tactile sensation data can be obtained with the help of a doctor who performs an endoscopic procedure by wearing virtual reality gloves such as DataGloves.TM. Tracking VR System (Greenleaf Medical Systems). These gloves are known for their ability to record tactile sensations and feedback experienced by a physician when performing a real endoscopic procedure. Such real data is important because tactile sensations change during the procedure. For example, the correlation between the movement of the endoscope and the visual display gradually decreases as the endoscope is inserted deeper into the gastrointestinal tract. Thus, collecting real data is an important step towards creating an accurate, realistic endoscopic modeling system.

In accordance with another embodiment, a simulated biopsy device (not shown) is provided. This biopsy device would simulate a real biopsy device used to take tissue samples from the gastrointestinal tract during endoscopy. The real biopsy device is inside the endoscope. When the endoscope operator wants to take a sample, a biopsy device appears at the end of the endoscope, and at that moment becomes visible on the display screen. Then, the forceps of the biopsy device are opened and pressed into the tissue. After this, the forceps are closed and the biopsy device is removed. Removing the tissue causes blood to build up as the remaining tissue bleeds.

Similarly, the simulated biopsy device will only appear on the display screen when, as a result of the actions of the operator of the simulated endoscope, the simulated biopsy device appears at the end of the endoscope. The forceps of the biopsy device are preferably visualized by animation, more preferably with relatively high resolution, because the forceps are small in size and high resolution will not require unnecessary over-expenditure of personal computer resources. Bleeding from tissue and blood clots resulting from the accumulation of blood will also be displayed using animation.

FIG. 10A shows a portable simulation system in accordance with embodiments. The portable simulation system 300 includes a housing 306 that accommodates the mechanical and electronic elements of the simulation system (see FIG. 10b). The system may include a safety cap 308 that can be removably closed (see 330 in FIG. 10B and FIG. 10C) through which a simulated endoscope can be inserted. In some embodiments, the opening may be shaped to represent the shape of the organ into which the simulated endoscope is to be inserted (eg, a human mouth, nose, or anus). In other embodiments, a simple opening not having the shape of a particular human organ may be used.

The portable simulation system 300 may also include one or more sockets and / or connectors, for example, connectors 310 for connecting peripheral devices (such as clamps, pedals, or a syringe), communication connectors 314 for connecting and exchanging data with a computer, and an Ethernet connector 312 for LAN connections (local area network).

A portable simulation system may comprise, according to embodiments, various elements, including, for example, an endoscope monitoring element, including tracking the insertion of a simulated endoscope, retrieving, turning left and right, bending the end left / right, bending the end up / down, buttons and levers for selecting a scope. It may also include an endoscope force feedback element, an instrument tracking element, an instrument feedback element. FIG. 10B depicts some of the internal elements of a portable modeling system in accordance with embodiments. The portable modeling system may include a power feedback unit 320, including an opening 330 through which the simulated endoscope can be inserted and manipulated, a bronchoscope tracking unit 322, an Ethernet communication card 324, a communication interface 326, and a peripheral unit 328.

FIG. 10C shows a power feedback unit of an endoscope (ESR) of a portable modeling system in accordance with one embodiment. ESR block 320 may include a power feedback tube 332 designed to absorb the effects of a simulated endoscope (not shown in this figure) through aperture 330. An electric motor / electromagnet 334 can be used to apply feedback force using a force feedback rod 333, as determined by the algorithm feedback, which can be implemented by the processing unit of the modeling system through the controller 336. The power feedback rod 333 can rise and fall, while resetting (during ema) or by increasing the pressure applied to the simulated endoscope inside the force feedback tube. As the pressure increases, the friction force applied to the simulated endoscope increases, so it becomes more difficult for the trainee to move and manipulate it inside the tube 332, and more effort is required to complete the operations.

Power is provided by power supply 338. To add resilience to the power feedback rod, an elastic spring 340 can be used to provide the user with a more even feel when increasing or decreasing the power feedback.

The modeling system in accordance with the utility model may be designed to teach emergency medical procedures. In some embodiments, such an emergency care procedure may simulate, for example, a bronchial endoscopy situation in order to train a surgeon or medical student in the correct actions in such a situation.

A module of an emergency care procedure in accordance with embodiments may include, for example, training in the extraction of a foreign object, practicing bleeding treatment (e.g., bleeding in the gastrointestinal tract, bleeding in the lungs) and removal of mucous plugs.

For example, training in the extraction of a foreign object may include the task of removing from the lungs breathing objects, using a set of instruments that can be inserted into the bronchial tract and lungs through a bronchoscope (an endoscope used for bronchial procedures).

Learning to recover a foreign object may include modeling the interaction between the foreign object and the surrounding tissue, the interaction between the foreign object and the simulated tool used, and the interaction between the foreign object and the endoscope.

The interaction between a foreign object and the surrounding tissue can be implemented in several stages. At each update cycle, a series of user-defined iterations are performed during which, for example, the following calculations can be performed:

A) the speed, direction and the selected time interval of a foreign object can be used to calculate the current position of a foreign object (calculation can be done separately for each foreign object);

B) collisions of a foreign object with surrounding tissue can be identified. Collision tests, for example, can be performed on polygons, with the possible use of a tree structure (schematic tree) of spheres;

C) the new speed and direction of the object can be calculated based on the colliding polygons, their elasticity, taking into account physical influences, such as gravity and attenuation coefficient.

In accordance with embodiments, simulated procedures may include exposure to fluids such as water, blood, or any other fluid (eg, a drug).

For example, when learning the procedure for emergency stopping of bleeding, blood is included in the modeling process, for example, in the texture space. A source of liquid (for example, blood, water, or another liquid with known characteristics) in three-dimensional space causes a spot to be applied to the graphic texture displayed on the corresponding coordinates of the texture display. Characteristics of fluid stains may vary in radius, color, intensity, shape, etc. The fluid source can remain active or deactivate according to the simulation configuration.

At each visualization cycle using multiple passes, the following modeling steps can be applied to display fluid distribution. Each pixel is compared with neighboring pixels. A pixel may receive fluid from a neighboring pixel, transmit fluid to a neighboring pixel, or maintain its current state. The effect of evaporation may also be taken into account. When deciding on the "liquid" status of a pixel, its relative location, relation to the direction of gravity, viscosity, and user-defined configuration can be taken into account.

In accordance with embodiments, the processing mechanism for the flow of fluid along the seams (edges) of the texture display can determine the ratio between pixels located on one side of the seam that are displayed on the corresponding pixels on the other side, thereby allowing the transfer of blood flow from one side to the opposite. In some embodiments, a mechanism for processing fluid accumulation at local minima may be used. Accumulations can form during the flow of fluid in connection with the features of the anatomical structure of the simulated organ and the density of the fluid. The processing mechanism of such clusters allows you to simulate the accumulated blood in appropriate places.

In accordance with the embodiments, the gravitational force can be applied dynamically, while the gravitational force is adjusted taking into account the position of the patient’s body or the inclusion of the suction of the liquid, and the response in the process of modeling the fluid occurs in real time.

In some embodiments, the camera lens may become dirty when the virtual camera touches the simulated fluid.

Modeling a fluid may include obtaining flushing reactions in which the fluid dissolves, allowing absorption.

In accordance with some embodiments, fluid modeling may include a bleeding treatment simulation. In this case, active bleeding can decrease in intensity or stop in one or more of the following cases: a) stop or decrease naturally after a predetermined time (for example, counted in seconds); b) stopping or decreasing after applying pressure in a localized space with a balloon for a predetermined time; c) stopping or decreasing after the introduction of a predetermined amount of frozen saline that comes in direct contact with the bleeding source; d) stopping or decreasing after administration of a predetermined amount of adrenaline coming into direct contact with the source of bleeding; e) stopping or decreasing after argon-plasma coagulation (APC) or cauterization of a source of bleeding.

According to one embodiment, the application describes cloud modeling. Cloud modeling allows you to run complex simulation models on relatively low-level computers, which usually do not support a large amount of mathematical calculations and labor-intensive functions for constructing graphic images.

In some embodiments, the implementation of cloud modeling involves one or more local computers that are connected to hardware for tracking the modeling system and tactile feedback, as well as a remote server on which the simulation is performed.

11, a cloud modeling system according to one embodiment is shown. In the example shown in FIG. 11, two modeling systems 212a and 212b are provided for medical modeling, each of which includes tracking devices for the modeling system and tactile feedback, respectively 208a and 208b (in this example, modeling systems of the gastrointestinal tract with simulated endoscope, 210a and 210b, respectively), with each of these devices exchanging data with the corresponding computing unit 206a and 206b. Modeling systems are configured to exchange data with a remote cloud modeling server 204.

Cloud simulation server 204 may receive simulation data from simulation systems 212a, 212b.

In some embodiments, the cloud simulation server 204 may provide generalized information about the simulation models performed by the simulation systems 212a, 212b to all users. In some embodiments, generalized information may be provided only to a user or group of users with certain privileges.

So, the generalized information can be a specific assessment or scores of one or a series of modeling procedures performed on any of the modeling systems 212a, 212b, on some of them, or on all systems. In some embodiments, the aggregated information may include statistical and analytical data relating to one or a series of modeling procedures performed on any of the modeling systems 212a, 212b, on some of them, or on all systems. In some embodiments, the aggregated information may include results shown by one or a group of users studying on any of the modeling systems 212a, 212b.

In some embodiments, the cloud simulation server can implement simulation models locally, with the servers of the simulation systems acting as terminals for which each trainee is trained.

In some embodiments, for each procedure performed on a modeling system (for example, 212a or 212b), a set of indicators used to evaluate the actions of the trainee can be stored. When the system is connected to a network (for example, to the Internet), this set of indicators can be automatically synchronized using a "cloud" environment with a remote simulation server that stores data from the modeling system. In some embodiments, the implementation of this data may include information about the registration of new users, the results shown, specialized courses.

Several simulation systems (for example, 212a, 212b) can be connected to the remote simulation server at different times or simultaneously, allowing you to create a single access point to all the data of the modeling center.

Cloud simulation data synchronization can include built-in security features that only allow users with the appropriate level of authority to access data.

It should be understood that the above description is intended to serve only as an example, and that many other options for implementation can be implemented without going beyond the scope of the utility model and deviating from its essence.

Examples may include devices for performing the operations described in this application. Such devices may be specially made for the desired purpose, or may include computers or processors selectively activated or reconfigured by a computer program stored in computers. Such computer programs can be stored on a machine-readable stationary storage medium, any type of disk, including floppy disks, optical disks, compact discs, read-only memory (CD-ROM), magneto-optical disks, read-only memory (ROM) devices random access memory (RAM), electrically programmable ROM devices (EPROM, electrically programmable read-only memories), electrically erasable and programmable ROM devices (EEPROM, electrically erasable and programmable read only memories), magnetic or optical cards, or any q ugoy type of media suitable for storing electronic instructions. It should be understood that to implement the intent of the examples described in this application, various programming languages can be used. Examples may include an article of manufacture, such as a computer-readable stationary storage medium, such as a memory device, disk drive, or USB flash drive that encodes, includes, or stores instructions, such as machine instructions, which, when executed by a processor or controller, implement the described here are the ways. These commands can cause the execution of the processes that implement the described methods, the processor or controller.

Various applications are disclosed herein. Features of some embodiments may be combined with features of other options; thus, some embodiments may be a combination of features of several embodiments. The above application text is provided for purposes of illustration and description. It is not exhaustive and does not limit the utility model to the form in which it is presented. Specialists in this field it is clear that in the framework of the described ideas, you can offer many modifications, changes, replacement options or equivalents. In this regard, it should be understood that the attached formula of the utility model applies to all such modifications and changes, each of which is included in the true scope of the utility model.

Although certain features of a utility model have been illustrated and described herein, those skilled in the art will be able to propose many modifications, changes, replacement options, or equivalents. In this regard, it should be understood that the attached formula of the utility model applies to such modifications and changes, each of which is included in the true scope of the utility model.

Claims (8)

1. A modeling system for modeling a medical procedure, including: simulated organ; a simulated endoscope located in the simulated organ and containing a sensor for determining the location of the specified simulated endoscope inside the simulated organ; tactile feedback mechanism located in the simulated organ and designed to provide tactile feedback applied to the simulated endoscope. 2. The system according to claim 1, characterized in that the simulated organ is placed in a portable case. 3. The system according to claim 1, characterized in that it also contains a data processing unit. 4. The system according to claim 3, characterized in that the data processing unit is placed on a remote server. 5. The system according to claim 3, characterized in that the data processing unit comprises a communication interface configured to exchange data with a remote server over the network. 6. The system according to claim 1, characterized in that the tactile feedback mechanism includes a tube and a rod, which is configured to increase or decrease pressure on the tube using an electric motor. 7. The system according to claim 6, characterized in that for controlling the electric motor there is a controller configured to exchange data with the data processing unit. 8. The system according to claim 1, characterized in that the simulated organ is selected from the group of simulated organs consisting of a simulated gastrointestinal tract and a simulated bronchial tract.