WO2020045883A1 - Lesion sensing system for laparoscopic surgery - Google Patents

Lesion sensing system for laparoscopic surgery Download PDF

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Publication number
WO2020045883A1
WO2020045883A1 PCT/KR2019/010606 KR2019010606W WO2020045883A1 WO 2020045883 A1 WO2020045883 A1 WO 2020045883A1 KR 2019010606 W KR2019010606 W KR 2019010606W WO 2020045883 A1 WO2020045883 A1 WO 2020045883A1
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Prior art keywords
clip
antenna
antenna coil
electronic tag
lesion
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PCT/KR2019/010606
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French (fr)
Korean (ko)
Inventor
최창인
안석영
주환이
박초롱
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부산대학교병원
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Publication of WO2020045883A1 publication Critical patent/WO2020045883A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90Identification means for patients or instruments, e.g. tags
    • A61B90/98Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00115Electrical control of surgical instruments with audible or visual output
    • A61B2017/00119Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00221Electrical control of surgical instruments with wireless transmission of data, e.g. by infrared radiation or radiowaves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3904Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3954Markers, e.g. radio-opaque or breast lesions markers magnetic, e.g. NMR or MRI
    • A61B2090/3958Markers, e.g. radio-opaque or breast lesions markers magnetic, e.g. NMR or MRI emitting a signal

Definitions

  • the present invention relates to a laparoscopic lesion detection system, and more specifically, consisting of a clip detector for detecting a marker clip mounted with an electronic tag (RFID) by applying a conventional endoscope hemostatic clip, low-frequency electromagnetic tag detector antenna Design of a new laparoscopic lesion detection system with adjustable detection range through design.
  • RFID electronic tag
  • Laparotomy is a traditional surgical technique that is still used frequently in modern medicine.
  • laparotomy has disadvantages such as risk of wound infection, slow recovery after surgery, and deterioration of cosmetic satisfaction due to scarring.
  • Laparoscopic gastrectomy first introduced by Kitano in 1994 for gastric cancer, attempted to overcome the above-mentioned shortcomings of laparotomy by inserting a surgical tool into the abdomen instead of the abdomen.
  • Laparoscopic surgery has already been recognized as a standard operation in early gastric cancer, and many researchers have reported excellent laparoscopy for advanced gastric cancer. Laparoscopic surgery has several advantages over laparotomy, including less postoperative pain, faster recovery, and better cosmetic results. However, it is difficult to palpate the lesion by hand during surgery, and it may be difficult to determine the exact location of the lesion because of the use of instruments. In particular, early lesions or benign lesions growing into the lumen of the intestine may not be marked by the tabernacle, so it may be difficult to determine the location of the appropriate resection margin.
  • Hyung WJ and two others introduced a method to identify lesions using laparoscopic ultrasound during gastric submucosal tumors growing into the lumen, which can be easily and safely performed. It has a limitation that it can fail to identify the lesion because of the small size of the clip.
  • Kim HI and two others presented a method to detect preoperatively installed abdominal X-rays in 80 early gastric cancer patients.
  • Kim BS and three others used Radio-Opaque Gauze. We reported a method to identify lesions after X-ray.
  • Various methods through gastroscopy were also introduced. Jeong O. et al.
  • Reported a self-transfusion tattoo method in which blood was collected from the patient in 2012 and injected into the lower mucosa of the gastric mucosa with a preoperative gastroscope.
  • the method was used to identify the location of the lesion on the gastrointestinal mucosa by injecting a dye under the gastric mucosa through an endoscope during surgery without installing a clip before surgery.
  • the present invention is to provide a laparoscopic surgical lesion detection system consisting of a clip detector for detecting a marker clip of the addition of an electronic tag (RFID), the operator can determine the location of the lesion without palpation during laparoscopic surgery.
  • RFID electronic tag
  • the present invention derives the correlation of the maximum detection distance of the clip detector that can detect the marker clip and the induction coefficient for the antenna coil of the clip detector, quantitative detection range to laparoscopic surgical lesion that can be adjusted with high accuracy To provide a detection system.
  • Laparoscopic lesion detection system is disposed adjacent to the lesion to be operated, the marker clip is mounted on the electronic tag (RFID) so that the location of the lesion in a non-contact manner;
  • a clip detector configured to detect the marker clip without palpation, including an antenna coil for detecting the electronic tag, wherein the clip detector can adjust a maximum detection distance capable of detecting the marker clip. It is characterized in that it is provided to.
  • the marker clip is characterized in that formed in a cylindrical shape.
  • the clip detector comprising an antenna wire connected to the antenna coil, the contact point of the antenna coil and arranged to extend in one direction; And a main body connected to an end of the antenna, the main body including a handle formed to penetrate in a circular cross-sectional shape, wherein the main body comprises: an electronic tag detecting circuit for sensing the electronic tag; And a dial having a power transmission device connected to the antenna wire therein and having a plurality of modes displayed according to the maximum sensing distance so as to be selected as one of the plurality of modes.
  • the contact point in contact with the antenna coil connected to the antenna wire by the power transmission device is moved, accordingly the Induction coefficient is changed, characterized in that the maximum detection distance of the marker clip is adjusted.
  • the induction coefficient of the antenna coil according to the maximum sensing distance of the predetermined marker clip is derived by Equation 1 to Equation 3, And a range in which the contact is moved by the dial by using the maximum sensing distance and the derived induction coefficient of the antenna coil.
  • the clip detector is characterized in that for outputting a beep sound when detecting the marker clip.
  • the lesion detection system for laparoscopic surgery of the present invention there is an effect that can reduce the existing excision area to at least 16%, up to 50% or less during laparoscopic surgery.
  • the laparoscopic lesion detection system of the present invention can adjust the maximum detection distance that can detect the marker clip, by adjusting it according to the thickness of the barrier to effectively determine the location of the lesion to determine the resection site more clearly Can be.
  • the laparoscopic lesion detection system of the present invention is a type of addition to the endoscope insertion process in the process of resection of the lesion using a perforation-endoscopic insertion-endoscope and detection needle-a resection instrument, etc. Because of this, there is an effect that can be used without difficulty even for the operator who is familiar with the existing surgical method.
  • the laparoscopic lesion detection system of the present invention the operation can be completed by the operator alone without the operation of the patient or the cooperation of other surgeries, it is effective to save a lot of surgery time.
  • 1 is a view showing the shape of the laparoscopic surgery lesion detection system of the present invention to be used in the actual laparoscopic surgery in the surgical field.
  • FIG. 2 is a view for explaining the driving principle of the RFID employed in the laparoscopic surgical lesion detection system of the present invention.
  • FIG. 3 is a view showing a state in which the marker clip according to the invention is actually installed in the stomach.
  • FIG. 4 is a view showing the length of the cylindrical marker clip in accordance with the present invention.
  • FIG. 5 is a diagram illustrating an electronic tag (RFID) in a planar form.
  • FIG. 6 is a correlation regression graph for barrier thickness and maximum sensing distance derived from experiments of planar electronic tags (RFID).
  • FIG. 7 is a graph showing ellipses corresponding to the maximum sensing distance up, down, left, and right derived from experiments of a cylindrical RFID.
  • FIG. 10 is a perspective view of a clip sensor of the laparoscopic surgical lesion detection system according to the present invention.
  • FIG. 11 is a prototype of the clip detector of the laparoscopic surgical lesion detection system according to the present invention.
  • FIG. 12 is a view showing an operation between the antenna coil and the dial for varying the maximum detection distance of the marker clip of the clip sensor according to the present invention.
  • FIG. 13 is a diagram illustrating a communication circuit for transmitting sensing information of a clip sensor according to the present invention to a PC.
  • Laparoscopic lesion detection system is disposed adjacent to the lesion to be operated, the marker clip 10 is equipped with an electronic tag (RFID) so that the location of the lesion in a non-contact manner ; And a clip detector 20 configured to detect the marker clip 10 without palpation, including an antenna coil 211 detecting the electronic tag.
  • RFID electronic tag
  • Laparoscopic surgical lesion detection system of the present invention will be utilized in the form as shown in Figure 1 in the actual laparoscopic surgery site, where A is the gastrointestinal site where the marker clip 10 is installed, B is the endoscope and clip detector (20) A surgical needle with a built-in), and C means an ablation apparatus to remove the lesion site. That is, the detection needle (B) is inserted into the body through the perforation during laparoscopy, finds the position of the stomach through the endoscope, and then uses the marker clip 10 and the clip detector 20 to detect the correct position. It is.
  • radio frequency identification (RFID) technology employed in the laparoscopic surgical lesion detection system of the present invention will be described in detail.
  • RFID Electronic tagging
  • Basic RFID system is composed of an electronic tag and an RFID tag detector, in the present invention, the electronic tag is formed on the marker clip 10, the RFID tag detector is formed of the clip detector 20.
  • 2 illustrates a driving principle of an electronic tag (RFID).
  • RFID Electronic tag
  • Two RLC circuits each including the coil 11 of the marker clip 10 and the antenna coil 211 of the clip sensor 20 may transmit signals using mutual induction. Since RFD technology uses radio waves, they have different characteristics depending on the frequency band of radio waves. The higher the frequency, the shorter the wavelength, the higher the energy, and the longest detection distance.
  • the operating frequency of the clip detector of the present invention is designed to a low frequency band in the range of 125 to 134 kHz with long wavelength and high transmittance.
  • the marker clip 10 is applied to the conventional endoscope hemostatic clip, the electronic clip (RFID) is mounted on the existing medical clip is manufactured as an RFID integrated clip.
  • RFID RFID
  • the marker clip 10 is attached to the lesion site as shown in Figure 3 by a separate means, the marker clip 10 may have a length of about 11mm as shown in FIG.
  • the electronic tag is composed of an integrated circuit chip containing an antenna and unique data, and may be classified into a passive tag and an active tag according to whether power is supplied.
  • the electronic tag (RFID) is a passive tag that operates only with an induced current of the clip sensor 20 without power supply because the electronic tag is used only for sensing, not for data transmission.
  • the shape of the RFID affects the shape of the sensing area and the sensing distance. In general, the wider the antenna volume, the longer the sensing range.
  • the electronic tag RFID
  • the marker clip 10 is also formed in a cylindrical shape.
  • Cylindrical electronic tags (examples) used in the experiments are as shown in Figs. 3 and 4, and planar electronic tags (examples) are as shown in Fig. 5.
  • Both types of electronic tags were measured at two positions, the cardia and anterior part of the pig, and the colon was a total of two positions, thin and thick.
  • the clip sensor 20 was measured the farthest distance that the marker clip 10 is detected, the thickness of each part was also measured to analyze the correlation between the thickness and the sensing distance.
  • the up, down, left, right points of each direction based on the position of the marker clip 10 is set so as to vertically cross each, the marker clip (10 times each) ) The longest distance is detected, and in the comparative example, since the surface area to be attached is wide, it was measured 25 times each.
  • the upper part of the stomach was thickest with 7 mm, and the thin intestine was thinnest with 2 mm.
  • the longest distance at which RFID was recognized was measured differently depending on the thickness of the barrier, the closest distance was 7mm and the longest distance was 22mm.
  • Table 2 the maximum sensing distance was correlated with increasing thickness of the barrier.
  • the graph of FIG. 7 is an ellipse derived assuming that these axes are parallel to the long axis and short axis of the ellipse since the upper and lower detection points and the left and right points cross each other perpendicularly.
  • the long axis, short axis length, and area of each derived ellipse are shown in Table 4 below.
  • Sensing range is up to 12.5 mm, at least 5.0 mm, all tend to be smaller than the existing surgical resection 20 to 50 mm.
  • the coil radius was 6 mm, and the measured sensing distance range was excluded this radius. When cutting, the maximum sensing distance range of 18.5 mm including the coil radius would be the accurate sensing distance range.
  • the area decreases in the height direction in the form of a torus or a sphere with a hole in the middle thereof, and thus the detection range varies depending on the thickness.
  • the area is relatively constant. Since the sensing range is constant regardless of thickness in the embedded wall thinner than the maximum sensing distance, it is expected that the convenience will be high even when designing the clip sensor 20 having a variable sensing distance later.
  • the deviation may appear as it is tilted. Looking at the graph of the front government of FIG. 7 it can be inferred that the short of the ellipse is shorter than the other parts because the electronic tag installed in the thick front government camouflage wall is inclined.
  • the detection range of the actual cylindrical electronic tag may be a case in which the ends of the cylindrical ends are cut off as shown in FIG. 8C. In this case, however, the range is smaller than the standard of ablation at the time of actual surgery, so it can be regarded as a valid result. However, since the experiment was performed in a constricted state rather than in the expanded state, it is expected that there will be no significant effect in actual surgery.
  • the laparoscopic surgical lesion detection system of the present invention according to the present invention, as shown in Figure 9, so that the operator can easily detect using the clip sensor 20 cylindrical marker clip 10 on the stomach barrier You can install it.
  • the clip detector 20 is a device for detecting the marker clip 10 by inducing with the cylindrical electronic tag (RFID) of the marker clip 10, in the present invention of the marker clip 10 It is designed to adjust the maximum detectable distance.
  • RFID cylindrical electronic tag
  • the clip detector 21 communicates in a capacitive manner using directly generated electromagnetic waves. This is a simpler design than the inductive method in which a magnetic field generated directly by the electronic tag changes the communication, and has a merit of designing various sensing distances. More specifically, the clip detector 21 may be designed in a manner of changing a response characteristic by using a magnitude of an internal coil induction coefficient among capacitive methods.
  • the clip detector 20 includes an antenna wire 212 connected to the antenna coil 211 and a contact point of the antenna coil 211 and disposed to extend in one direction.
  • An antenna 21 comprising; And a main body 22 connected to an end of the antenna 21.
  • the antenna coil 211 is located at the end farthest from the main body 22 in the antenna 21, and mutually induced with the coil 11 of the mark tag 10.
  • the antenna wire 211 is electrically connected between the antenna coil 211 and the main body 22. As shown in FIG. 12, the antenna wire 211 is connected to the antenna coil 211 through two contacts 212a and 212b. Contact The two contacts 212a and 212b are divided into a movable contact 212a and a fixed contact 212b, which will be described in detail as shown in the dial 223 to be described later.
  • the main body 22 has a handle portion 221 is formed through the circular cross-sectional shape; An electronic tag detecting circuit (222) for detecting the electronic tag (RFID); And a dial 223 having a power transmission device (not shown) connected to the antenna wire 212 therein, and displaying a plurality of modes according to the maximum sensing distance so as to be selected as one of the plurality of modes. It includes.
  • the handle part 221 is designed to be easy for the operator to use when the clip detector 20 is inserted into the adapter tube used in laparoscopic surgery at the time of surgery to detect the marker clip 10.
  • the electronic tag detection circuit 222 has a structure in which the antenna coil 211 is induced by the coil 11 of the marker clip 10 to detect the marker clip 10.
  • the dial 223 may be displayed in a plurality of modes according to the maximum sensing distance, and may be selected by the operator as one of the plurality of modes.
  • the power transmission device selects the mode.
  • the movable contact 212a in contact with the antenna coil 211 connected to the antenna wire 212 is moved.
  • the antenna coil 211 Since the number of turns of 211 is changed, the induction coefficient of the antenna coil 211 also changes accordingly, so that the clip detector 20 can finally detect the marker clip 10 at the longest distance. It can change the distance.
  • the power transmission device may be appropriately selected by those skilled in the art as long as the power transmission device is a device capable of pushing and pulling the movable contact 212a.
  • the induction coefficient of the antenna coil 211 according to the maximum sensing distance of the marker clip 10 can be derived by the following equations (1) to (3).
  • the wavelength length of the electromagnetic wave frequency used is the wavelength length of the electromagnetic wave frequency used.
  • Is typically set to -20dB, the blocking signal strength of the RLC circuit.
  • Equation 1 Denotes the amount of signal strength reduction, and the applied distance is applied to the desired distance.
  • the minimum signal strength can be obtained from. That is, the desired distance
  • the wavelength length of the electromagnetic wave frequency used from Equation 1 Can be derived, Is the resonance frequency of the antenna circuit from Equation 2 above.
  • Can be derived Is the induction coefficient of the antenna coil as a variable from [Equation 3] Can be obtained.
  • the antenna wire is connected by the dial 223. (212a) It may be possible to accurately set the moving range of the moving contact.
  • the clip detector 20 having a variable maximum sensing distance may select a mode according to the size or severity of the lesion site of the patient. Specifically, if the lesion site size is small and the initial symptom, the induction coefficient is reduced to minimize the maximum detection distance, so that the dial 223 may be adjusted to allow surgery near the lesion site, while the lesion site size is large. If severe, the dial 223 will be adjusted in a manner that increases the induction coefficient to maximize the maximum sensing distance.
  • the clip detector 20 may be configured to communicate with a PC based on a user program protocol (UDP) when the electronic tag detection circuit 222 is detected. Therefore, the clip detector 20 is configured to output a beep when detecting the marker clip 10, so that the operator can detect the marker clip 10 without looking at the connected monitor screen, that is, the position of the lesion. Can be easily identified.
  • UDP user program protocol
  • the communication is made of the MCU of the clip sensor 20 UDP client, PC to the UDP server, the communication speed between the average of 1ms or less as a test result, which is a speed that will not affect the electronic tag detection.
  • the clip detector 20 may be made in wireless communication with a PC.
  • A gastrointestinal site with marker clip

Abstract

The present invention relates to a lesion sensing system for laparoscopic surgery and, more specifically, to a new technology relating to a lesion sensing system for laparoscopic surgery, the system comprising: a marking clip configured by applying an existing endoscopic hemostatic clip, so as to include an electronic tag (RFID) mounted therein; and a clip sensor for detecting the marking clip, wherein a sensing range can be adjusted by antenna designing of a low-frequency electronic tag sensor. [Representative drawing] figure 1

Description

복강경 수술용 병변 감지 시스템Laparoscopic Lesion Detection System
본 발명은 복강경 수술용 병변 감지 시스템에 관한 것으로, 더욱 상세하게는 기존의 내시경용 지혈 클립을 응용하여 전자태그(RFID)를 탑재시킨 표식클립을 탐지하는 클립감지기로 구성되며, 저주파 전자태그 감지기 안테나 설계를 통해 감지 범위가 조절 가능한 새로운 복강경 수술용 병변 감지 시스템에 관한 기술이다.The present invention relates to a laparoscopic lesion detection system, and more specifically, consisting of a clip detector for detecting a marker clip mounted with an electronic tag (RFID) by applying a conventional endoscope hemostatic clip, low-frequency electromagnetic tag detector antenna Design of a new laparoscopic lesion detection system with adjustable detection range through design.
기존의 복부 수술법은 개복을 동반하는 개복수술이 주류였다. 개복수술은 전통적으로 사용되어 온 수술법으로 현대의학에서도 여전히 많은 빈도로 사용되고 있다. 그러나, 개복수술은 창상 감염의 위험과 술후 회복이 느리고 흉터로 인한 미용학적 만족도 저하 등의 단점을 가지고 있다. 그에 대한 대안으로 위암에 대해 1994년 Kitano가 처음 소개한 복강경 위 절제술은 개복대신 복부에 작은 천공 후 수술기구를 삽입하여 수술하는 방식으로 위에서 언급한 여러 개복수술의 단점을 극복하고자 하였다. 복강경 수술기구와 수술기술이 발전하고 삶의 질에 대한 환자와 의사의 관심이 증가하면서 최근 위장 암의 수술경향은 개복수술에서 복강경수술로 바뀌고 있다. 이미 조기 위암에서는 복강경 수술이 표준 수술로 인정받고 있고, 진행 위암에 대한 복강경 수술의 우수성을 여러 연구자들이 보고하고 있다. 복강경 수술은 개복수술에 비해 적은 술후 통증, 빠른 회복, 우수한 미용학적 결과 등 여러 가지 장점을 가진다. 그러나 수술시 병변을 손으로 촉지하기가 어렵고, 기구를 이용하기 때문에 병변의 정확한 위치를 확인하는 것이 어려울 수 있다. 특히, 조기 병변이나 장의 내강으로 성장하는 양성병변의 경우 장막으로 표시가 나지 않기 때문에 병변의 위치를 파악하여 적절한 절제연을 정하기 어려운 경우가 있다.Conventional abdominal surgery has been followed by laparotomy with open abdomen. Laparotomy is a traditional surgical technique that is still used frequently in modern medicine. However, laparotomy has disadvantages such as risk of wound infection, slow recovery after surgery, and deterioration of cosmetic satisfaction due to scarring. As an alternative, Laparoscopic gastrectomy, first introduced by Kitano in 1994 for gastric cancer, attempted to overcome the above-mentioned shortcomings of laparotomy by inserting a surgical tool into the abdomen instead of the abdomen. With the development of laparoscopic surgery instruments and surgical techniques and the increasing interest of patients and doctors about the quality of life, the surgical trend of gastrointestinal cancer has recently shifted from laparotomy to laparoscopic surgery. Laparoscopic surgery has already been recognized as a standard operation in early gastric cancer, and many researchers have reported excellent laparoscopy for advanced gastric cancer. Laparoscopic surgery has several advantages over laparotomy, including less postoperative pain, faster recovery, and better cosmetic results. However, it is difficult to palpate the lesion by hand during surgery, and it may be difficult to determine the exact location of the lesion because of the use of instruments. In particular, early lesions or benign lesions growing into the lumen of the intestine may not be marked by the tabernacle, so it may be difficult to determine the location of the appropriate resection margin.
위 절제술의 경우 수술 중 내시경을 시행하거나 X-ray 촬영을 통한 확인 방법이 소개되기도 하였으나 그 과정의 복잡함과 타 과와의 협업 문제로 임상에서 널리 시행되지 못하고 있으며, 대장 절제술 역시 점막 하에 염료를 주사하여 병변을 표시하는 문신법이 소개되기도 하였으나 수술 전 내시경을 한 번 더 해야하기 때문에 환자의 불편과 추가시술에 따른 경제적인 문제가 있고, 특히 염료가 신속하게 확산되기 때문에, 문신법 후 시간이 지날수록 그 효과는 빠르게 떨어지게 된다. 이러한 문제로 인해 의사들에게는 병변 확인을 위한 신 의료기술에 대한 충족되지 못한 수요가 있었다. 위암의 안전 절제연에 있어서는 의견에 약간의 차이는 있지만, 현재 일본 의료계에서는 약 20mm에서 50mm로 절제연을 두고 위를 절제할 것을 권고하고 있고, 국내 의료계에서도 일반적으로 이러한 기준을 따르고 있다. 하지만, 술 후 삶의 질 개선을 위해 최근 최소 침습수술에 대한 관심이 커지고 있고 이를 실현하기 위한 기술개발 요구도 지속되고 있는 실정이다.In the case of gastrectomy, endoscopy during surgery or X-ray imaging method was introduced, but it is not widely used in clinical practice due to the complexity of the process and collaboration with other departments, and colorectal resection is also injected into the mucosa. Although the tattoo method was used to mark lesions, there was an economic problem due to the patient's discomfort and additional procedures because the endoscopy had to be done one more time before surgery, and especially since the dye spreads rapidly, The more quickly the effect falls. These problems led to unmet demand for new medical technologies for identifying lesions. Although there are some differences in opinion about the safety margin of gastric cancer, Japanese medical community recommends cutting the stomach with a margin of about 20mm to 50mm, and the domestic medical community generally follows these standards. However, in order to improve the quality of life after surgery, interest in minimally invasive surgery has recently increased, and the demand for technology development for realizing this has been continued.
기존에도 여러 가지 방법을 이용하여 복강경 수술시 병변의 위치를 확인하기 위한 방법을 연구한 사례가 있었다.Previously, there have been cases of using various methods to determine the location of lesions during laparoscopic surgery.
2005년 Hyung W. J. 외 2인은 내강으로 자라는 위 점막 하 종양에 대해 수술 중 복강경 초음파를 이용하여 병변을 확인하는 방법을 소개하였는데, 이는 쉽고 안전하게 시행할 수 있다는 장점을 가지나 수술자가 복강경 초음파 술기에 숙달되어야 하고 클립의 크기가 작기 때문에 병변 확인에 실패할 수 있다는 한계점을 가진다. Kim H. I. 외 2인은 2011년 보고에서 조기 위암 환자 80명에서 수술 중 복부X-ray를 통하여 수술 전 설치한 클립을 찾아내는 방법을 제시하였고, 2014년 Kim B. S. 외 3인은 Radio-Opaque Gauze를 이용해 X-ray 촬영 후 병변을 확인하는 방법을 보고하였다. 위 내시경을 통한 여러 방법들도 소개되었다. Jeong O. 외 3인이 2012년 환자의 혈액을 채혈하여 술 전 위 내시경으로 위 점막 하층에 채혈한 혈액을 주사하여 장막에 병변을 표시하는 자가수혈문신법을 보고하였고, Xuan Y. 외 3인도 역시 수술 전 클립 설치 없이 수술 중 내시경을 통하여 염료를 위 점막 하에 주사하여 위 장막에서 병변의 위치를 확인하는 방법을 소개하였다.In 2005, Hyung WJ and two others introduced a method to identify lesions using laparoscopic ultrasound during gastric submucosal tumors growing into the lumen, which can be easily and safely performed. It has a limitation that it can fail to identify the lesion because of the small size of the clip. In a 2011 report, Kim HI and two others presented a method to detect preoperatively installed abdominal X-rays in 80 early gastric cancer patients.In 2014, Kim BS and three others used Radio-Opaque Gauze. We reported a method to identify lesions after X-ray. Various methods through gastroscopy were also introduced. Jeong O. et al. Reported a self-transfusion tattoo method in which blood was collected from the patient in 2012 and injected into the lower mucosa of the gastric mucosa with a preoperative gastroscope. In addition, the method was used to identify the location of the lesion on the gastrointestinal mucosa by injecting a dye under the gastric mucosa through an endoscope during surgery without installing a clip before surgery.
[비특허문헌][Non-Patent Documents]
(1) Hyung W. J, Lim J, 등, “Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic-assisted gastrectomy” Surgical Endoscopy And Other Interventional Techniques, 2005, 19:1353-1357.(1) Hyung W. J, Lim J, et al., “Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic-assisted gastrectomy” Surgical Endoscopy And Other Interventional Techniques, 2005, 19: 1353-1357.
(2) Kim H. I, Hyung W. J, 등, “Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy” Surgical Endoscopy, 2011, 25:958-963.(2) Kim H. I, Hyung W. J, et al., “Intraoperative portable abdominal radiograph for tumor localization: a simple and accurate method for laparoscopic gastrectomy” Surgical Endoscopy, 2011, 25: 958-963.
(3) Kim B. Su, Yook J. H, 등, “A simplified technique for tumor localization using preoperative endoscopic clipping and radio-opaque markers during totally laparoscopic gastrectomy” The American Surgeon 2014, 80:1266-1270.(3) Kim B. Su, Yook J. H, et al., “A simplified technique for tumor localization using preoperative endoscopic clipping and radio-opaque markers during totally laparoscopic gastrectomy” The American Surgeon 2014, 80: 1266-1270.
(4) Jeong O, Cho S. B, 등, “Novel technique for intraoperative tumor localization during totally laparoscopic distal gastrectomy: endoscopic autologous blood tattooing” Surgical Endoscopy, 2012, 26:1778-1783.(4) Jeong O, Cho S. B, et al., “Novel technique for intraoperative tumor localization during totally laparoscopic distal gastrectomy: endoscopic autologous blood tattooing” Surgical Endoscopy, 2012, 26: 1778-1783.
(5) Xuan Y, Hur H, 등, “Efficacy of intraoperative gastroscopy for tumor localization in totally laparoscopic distal gastrectomy for cancer in the middle third of the stomach” Surgical Endoscopy, 2013, 27:4364-4370.(5) Xuan Y, Hur H, et al., “Efficacy of intraoperative gastroscopy for tumor localization in totally laparoscopic distal gastrectomy for cancer in the middle third of the stomach” Surgical Endoscopy, 2013, 27: 4364-4370.
상기 비특허문헌 1 내지 5의 연구결과에서 확인할 수 있듯이 수술 중 부가적인 조작을 해야 하거나, 수술자의 숙련도, 신뢰성, 지속성 등의 문제로 이러한 결과들이 임상 현장에서 실제로 활용되고 있지는 않다. 따라서, 이러한 단점을 극복하고 실제 임상현장에 사용 가능한 병변의 위치를 마킹하는 기술개발에 대한 필요성이 제기되었다.As can be seen from the research results of the non-patent documents 1 to 5, such operations are not actually utilized in the clinical field due to problems such as skill, reliability, and persistence of the operator. Therefore, there is a need to develop a technology for overcoming these shortcomings and marking the location of lesions that can be used in actual clinical settings.
본 발명은 전자태그(RFID)를 부가한 형태의 표식클립을 감지하기 위한 클립감지기로 구성되어, 복강경 수술 시 수술자가 촉지하지 않고 병변의 위치를 파악할 수 있는 복강경 수술용 병변 감지 시스템을 제공하고자 한다. The present invention is to provide a laparoscopic surgical lesion detection system consisting of a clip detector for detecting a marker clip of the addition of an electronic tag (RFID), the operator can determine the location of the lesion without palpation during laparoscopic surgery. .
또한, 본 발명은 표식클립을 감지할 수 있는 클립감지기의 최대감지거리와 클립감지기의 안테나코일에 대한 유도계수의 상관식을 도출하여, 감지범위를 정량화화시켜 정확도 높게 조절할 수 있는 복강경 수술용 병변 감지 시스템을 제공하고자 한다.In addition, the present invention derives the correlation of the maximum detection distance of the clip detector that can detect the marker clip and the induction coefficient for the antenna coil of the clip detector, quantitative detection range to laparoscopic surgical lesion that can be adjusted with high accuracy To provide a detection system.
본 발명이 해결하고자 하는 과제들은 이상에서 언급한 과제로 제한되지 않으며, 여기에 언급되지 않은 본 발명이 해결하려는 또 다른 과제들은 아래의 기재로부터 본 발명이 속하는 기술 분야에서 통상의 지식을 가진 자에게 명확하게 이해될 수 있을 것이다.The problem to be solved by the present invention is not limited to the above-mentioned problem, another problem to be solved by the present invention not mentioned herein is to those of ordinary skill in the art from the following description It will be clearly understood.
본 발명에 따른 복강경 수술용 병변 감지 시스템은, 수술하고자 하는 병변에 인접하게 배치되며, 상기 병변의 위치를 비접촉인 방식으로 확인할 수 있도록 전자태그(RFID)가 탑재되는 표식클립; 및 상기 전자태그를 감지하는 안테나코일을 포함하여, 촉지하지 않고 상기 표식클립을 감지할 수 있도록 구성되는 클립감지기;를 포함하고, 상기 클립감지기는 상기 표식클립의 감지가 가능한 최대감지거리를 조정할 수 있도록 마련되는 것을 특징으로 한다.Laparoscopic lesion detection system according to the present invention, is disposed adjacent to the lesion to be operated, the marker clip is mounted on the electronic tag (RFID) so that the location of the lesion in a non-contact manner; And a clip detector configured to detect the marker clip without palpation, including an antenna coil for detecting the electronic tag, wherein the clip detector can adjust a maximum detection distance capable of detecting the marker clip. It is characterized in that it is provided to.
또한, 본 발명에 따른 복강경 수술용 병변 감지 시스템에 있어서, 상기 표식클립은 원통형으로 형성되는 것을 특징으로 한다.In addition, in the laparoscopic surgical lesion detection system according to the present invention, the marker clip is characterized in that formed in a cylindrical shape.
또한, 본 발명에 따른 복강경 수술용 병변 감지 시스템에 있어서, 상기 클립감지기는, 상기 안테나코일과, 상기 안테나코일의 접점과 연결되며 일 방향으로 연장되도록 배치되는 안테나전선을 포함하는 안테나; 및 상기 안테나의 단부에 연결되며, 원 단면 형상으로 관통되어 형성되는 손잡이부를 포함하는 본체;를 포함하고, 상기 본체는, 상기 전자태그를 감지하기 위한 전자태그감지회로; 및 상기 안테나전선과 연결되는 동력전달장치가 내부에 구비되고, 최대감지거리에 따라 다수 개의 모드가 표시되어 상기 다수 개의 모드 중 한 개로 선택될 수 있는 다이얼;을 포함하는 것을 특징으로 한다.In addition, in a laparoscopic surgical lesion detection system according to the present invention, the clip detector, the antenna comprising an antenna wire connected to the antenna coil, the contact point of the antenna coil and arranged to extend in one direction; And a main body connected to an end of the antenna, the main body including a handle formed to penetrate in a circular cross-sectional shape, wherein the main body comprises: an electronic tag detecting circuit for sensing the electronic tag; And a dial having a power transmission device connected to the antenna wire therein and having a plurality of modes displayed according to the maximum sensing distance so as to be selected as one of the plurality of modes.
또한, 본 발명에 따른 복강경 수술용 병변 감지 시스템은 상기 다이얼의 모드가 선택되면, 상기 동력전달장치에 의해 상기 안테나전선과 연결되는 상기 안테나코일과 접하는 상기 접점이 이동되고, 이에 따라 상기 안테나코일의 유도계수가 변화되어 상기 표식클립의 상기 최대감지거리가 조정되는 것을 특징으로 한다.In addition, in the laparoscopic surgical lesion detection system according to the present invention, when the mode of the dial is selected, the contact point in contact with the antenna coil connected to the antenna wire by the power transmission device is moved, accordingly the Induction coefficient is changed, characterized in that the maximum detection distance of the marker clip is adjusted.
또한, 본 발명에 따른 복강경 수술용 병변 감지 시스템에 있어서, 기설정된 상기 표식클립의 상기 최대감지거리에 따른 상기 안테나코일의 상기 유도계수는 수학식 1 내지 수학식 3에 의해 도출되어, 상기 기설정된 최대감지거리와 상기 도출된 상기 안테나코일의 상기 유도계수를 이용하여 상기 다이얼에 의해 상기 접점이 이동되는 범위를 설정하는 것을 특징으로 한다.In the laparoscopic surgical lesion detection system according to the present invention, the induction coefficient of the antenna coil according to the maximum sensing distance of the predetermined marker clip is derived by Equation 1 to Equation 3, And a range in which the contact is moved by the dial by using the maximum sensing distance and the derived induction coefficient of the antenna coil.
또한, 본 발명에 따른 복강경 수술용 병변 감지 시스템에 있어서, 상기 클립감지기는 상기 표식클립을 감지할 때 비프음을 출력시키는 것을 특징으로 한다.In addition, in the laparoscopic surgical lesion detection system according to the present invention, the clip detector is characterized in that for outputting a beep sound when detecting the marker clip.
상기 과제의 해결 수단에 의해, 본 발명의 복강경 수술용 병변 감지 시스템은, 복강경 수술 시 기존 절제 면적을 최소 16%, 최대 50% 이하로 축소시킬 수 있는 효과가 있다.By the means for solving the above problems, the lesion detection system for laparoscopic surgery of the present invention, there is an effect that can reduce the existing excision area to at least 16%, up to 50% or less during laparoscopic surgery.
또한, 본 발명의 복강경 수술용 병변 감지 시스템은, 표식클립을 감지할 수 있는 최대감지거리를 조정할 수 있어, 장벽의 두께에 따라 이를 조절하여 효과적으로 병변 위치를 확인할 수 있어 절제 부위를 보다 명확하게 결정할 수 있다. In addition, the laparoscopic lesion detection system of the present invention can adjust the maximum detection distance that can detect the marker clip, by adjusting it according to the thickness of the barrier to effectively determine the location of the lesion to determine the resection site more clearly Can be.
또한, 본 발명의 복강경 수술용 병변 감지 시스템은, 기존 복강경 수술의 과정인 천공 - 내시경 삽입 - 내시경과 탐지침을 이용하여 병변 확인 - 절제 기구 등을 이용한 병변 절제 과정에서 내시경 삽입 과정에 부가되는 형식이기 때문에 기존 수술방법에 익숙한 수술자에게도 어려움 없이 사용할 수 있는 효과가 있다.In addition, the laparoscopic lesion detection system of the present invention is a type of addition to the endoscope insertion process in the process of resection of the lesion using a perforation-endoscopic insertion-endoscope and detection needle-a resection instrument, etc. Because of this, there is an effect that can be used without difficulty even for the operator who is familiar with the existing surgical method.
또한, 본 발명의 복강경 수술용 병변 감지 시스템은, 수술중 환자를 조작하거나 타과의 협조없이 수술자 혼자서 모든 과정을 끝낼 수 있고 수술시간 또한 많이 절약할 수 있는 효과가 있다.In addition, the laparoscopic lesion detection system of the present invention, the operation can be completed by the operator alone without the operation of the patient or the cooperation of other surgeries, it is effective to save a lot of surgery time.
도 1은 실제 수술 현장에서 복강경 수술 시에 활용될 본 발명의 복강경 수술용 병변 감지 시스템의 형태를 나타낸 도면이다.1 is a view showing the shape of the laparoscopic surgery lesion detection system of the present invention to be used in the actual laparoscopic surgery in the surgical field.
도 2는 본 발명의 복강경 수술용 병변 감지 시스템에서 채용하는 RFID의 구동 원리를 설명하기 위한 도면이다.2 is a view for explaining the driving principle of the RFID employed in the laparoscopic surgical lesion detection system of the present invention.
도 3은 본 발명에 따른 표식클립이 실제로 위장에 설치된 모습을 나타낸 도면이다.3 is a view showing a state in which the marker clip according to the invention is actually installed in the stomach.
도 4는 본 발명에 따른 원통형 표식클립의 길이를 나타낸 도면이다.4 is a view showing the length of the cylindrical marker clip in accordance with the present invention.
도 5는 평면 형태의 전자태그(RFID)를 나타낸 도면이다.5 is a diagram illustrating an electronic tag (RFID) in a planar form.
도 6은 평면 형태의 전자태그(RFID)를 실험한 결과 도출된 장벽 두께와 최대감지거리에 대한 상관 회귀분석 그래프이다.FIG. 6 is a correlation regression graph for barrier thickness and maximum sensing distance derived from experiments of planar electronic tags (RFID).
도 7은 원통 형태의 전자태그(RFID)를 실험한 결과 도출된 상하좌우 최대감지거리에 해당하는 타원을 나타낸 그래프이다.FIG. 7 is a graph showing ellipses corresponding to the maximum sensing distance up, down, left, and right derived from experiments of a cylindrical RFID.
도 8은 평면 형태의 전자태그(RFID)를 실험한 결과 도출된 최대감지범위(A), 원통 형태의 전자태그(RFID)를 실험한 결과 도출된 이상적인 최대감지범위(B) 및 원통 형태의 전자태그(RFID)를 실험한 결과 도출된 실제 최대감지범위(C)를 나타낸 그래프이다.8 shows the maximum detection range (A) derived from the experiment of the planar electronic tag (RFID), the ideal maximum detection range (B) derived from the experiment of the cylindrical electron tag (RFID), and the cylindrical electron. It is a graph showing the actual maximum detection range (C) derived from the experiment of the tag (RFID).
도 10은 본 발명에 따른 복강경 수술용 병변 감지 시스템의 클립감지기의 사시도이다.10 is a perspective view of a clip sensor of the laparoscopic surgical lesion detection system according to the present invention.
도 11은 본 발명에 따른 복강경 수술용 병변 감지 시스템의 클립감지기의 시제품이다.11 is a prototype of the clip detector of the laparoscopic surgical lesion detection system according to the present invention.
도 12는 본 발명에 따른 클립감지기의 표식클립 최대감지거리를 가변시키기 위한 안테나코일과 다이얼 사이의 동작을 나타내기 위한 도면이다.12 is a view showing an operation between the antenna coil and the dial for varying the maximum detection distance of the marker clip of the clip sensor according to the present invention.
도 13은 본 발명에 따른 클립감지기의 감지정보를 PC로 전송시키는 통신 회로를 나타낸 도면이다.FIG. 13 is a diagram illustrating a communication circuit for transmitting sensing information of a clip sensor according to the present invention to a PC.
이상과 같은 본 발명에 대한 해결하고자 하는 과제, 과제의 해결 수단, 발명의 효과를 포함한 구체적인 사항들은 다음에 기재할 실시예 및 도면들에 포함되어 있다. 본 발명의 이점 및 특징, 그리고 그것들을 달성하는 방법은 첨부되는 도면과 함께 상세하게 후술되어 있는 실시예들을 참조하면 명확해질 것이다.Specific matters including the problem to be solved, the means for solving the problem, and the effects of the present invention as described above are included in the following embodiments and the drawings. Advantages and features of the present invention, and methods for achieving them will be apparent with reference to the embodiments described below in detail in conjunction with the accompanying drawings.
본 발명의 일 실시예에 따른 복강경 수술용 병변 감지 시스템은 수술하고자 하는 병변에 인접하게 배치되며, 상기 병변의 위치를 비접촉인 방식으로 확인할 수 있도록 전자태그(RFID)가 탑재되는 표식클립(10); 및 상기 전자태그를 감지하는 안테나코일(211)을 포함하여, 촉지하지 않고 상기 표식클립(10)을 감지할 수 있도록 구성되는 클립감지기(20);를 포함한다.Laparoscopic lesion detection system according to an embodiment of the present invention is disposed adjacent to the lesion to be operated, the marker clip 10 is equipped with an electronic tag (RFID) so that the location of the lesion in a non-contact manner ; And a clip detector 20 configured to detect the marker clip 10 without palpation, including an antenna coil 211 detecting the electronic tag.
본 발명의 복강경 수술용 병변 감지 시스템은 실제 복강경 수술 현장에서 도 1에 도시된 바와 같은 형태로 활용될 것으로, 여기서 A는 표식클립(10)이 설치된 위장 부위를, B는 내시경과 클립감지기(20)가 내장된 수술용 탐지침, 그리고 C는 병변 부위를 절제할 절제기구를 의미한다. 즉, 탐지침(B)이 복강경수술 시 천공을 통해 체내로 삽입되어, 내시경을 통해 위장의 위치를 찾은 후, 정확한 위치를 탐지하기 위해 상기 표식클립(10) 및 상기 클립감지기(20)를 활용하는 것이다.Laparoscopic surgical lesion detection system of the present invention will be utilized in the form as shown in Figure 1 in the actual laparoscopic surgery site, where A is the gastrointestinal site where the marker clip 10 is installed, B is the endoscope and clip detector (20) A surgical needle with a built-in), and C means an ablation apparatus to remove the lesion site. That is, the detection needle (B) is inserted into the body through the perforation during laparoscopy, finds the position of the stomach through the endoscope, and then uses the marker clip 10 and the clip detector 20 to detect the correct position. It is.
기존 복강경 수술의 과정인 천공 - 내시경삽입 - 내시경과 탐지침을 이용하여 병변 확인 - 절제기구 등을 이용한 병변절제단계 중, 상기 내시경삽입 단계에 상기 클립감지기(20)를 단순히 부가하는 형식이기 때문에 기존 수술 방법에 익숙한 수술자들에게도 적합하다 할 수 있다. 또한, 최근 장기의 절제와 연결의 전 과정을 복강경 수술로 끝내는 방식에 비추어 볼 때 현재 장기 절제는 수술자의 숙련도에 많은 영향을 받게되고 기존의 연구자들이 보고한 방법을 적용하기에는 수술 시간의 연장, 방법의 복잡성, 마취된 환자를 조작해야하는 위험 때문에 한계가 있다. 따라서, 본 발명의 복강경 수술용 병변 감지 시스템은 술자의 숙련도에 대한 의존도를 최대한 낮추고, 환자에 가해지는 위험을 최소화하며, 술기를 단순화 시키면서도 신뢰도는 높이는 방향으로 개발되었다.Existing laparoscopy is a process of perforation-endoscope insertion-confirmation of lesions using endoscopes and detection needles-during the resection of the lesion using a resection instrument, the clip detector 20 is simply added to the endoscope insertion step. It may also be suitable for surgeons who are familiar with surgical methods. In addition, in view of the recent method of ending the entire process of organ resection and connection with laparoscopic surgery, the current organ resection is greatly influenced by the skill of the operator and the length of operation time is not enough to apply the methods reported by the existing researchers. Due to its complexity, the risk of manipulating anesthetized patients is limited. Therefore, the laparoscopic lesion detection system of the present invention has been developed in such a way as to reduce the dependence on the skill of the operator as much as possible, minimize the risk to the patient, and increase the reliability while simplifying the technique.
우선적으로, 본 발명의 복강경 수술용 병변 감지 시스템에서 채용한 전자태그(RFID; Radio Frequency Identification) 기술에 대해서 상세히 서술하기로 한다.First, the radio frequency identification (RFID) technology employed in the laparoscopic surgical lesion detection system of the present invention will be described in detail.
전자태그(RFID) 기술은 RF 스펙트럼의 에너지를 이용하여 물리적 접촉 없이 데이터를 전송할 수 있는 기술이다. 기본적인 RFID 시스템은 전자태그와 RFID 태그 감지기로 구성되며, 본 발명에서 상기 전자태그는 상기 표식클립(10)에, 상기 RFID 태그 감지기는 상기 클립감지기(20)로 형성된다. 도 2는 전자태그(RFID)의 구동 원리를 나타내고 있다. 상기 표식클립(10)의 코일(11)과 상기 클립감지기(20)의 안테나코일(211)을 각각 포함하는 두 개의 RLC 회로가 서로 상호유도현상을 이용하여 신호를 전달할 수 있는 것이다. 전자태그(RFD) 기술은 라디오 파를 사용하기 때문에, 라디오 파의 주파수 대역에 따라 다른 특성을 가지며, 주파수가 높을수록 파장이 짧아지면서 고에너지이고, 감지 거리가 가장 길다.Electronic tagging (RFID) technology uses energy in the RF spectrum to transmit data without physical contact. Basic RFID system is composed of an electronic tag and an RFID tag detector, in the present invention, the electronic tag is formed on the marker clip 10, the RFID tag detector is formed of the clip detector 20. 2 illustrates a driving principle of an electronic tag (RFID). Two RLC circuits each including the coil 11 of the marker clip 10 and the antenna coil 211 of the clip sensor 20 may transmit signals using mutual induction. Since RFD technology uses radio waves, they have different characteristics depending on the frequency band of radio waves. The higher the frequency, the shorter the wavelength, the higher the energy, and the longest detection distance.
본 발명에서는 인체 내에서, 주로 위와 대장에 상기 표식클립(10)을 부착시켜 작동하기 때문에, 파장이 짧아 투과성이 낮은 고주파 대역이나 초 고주파대역의 RFID는, 사용하기에 어려움이 있고 상대적으로 고에너지파이기 때문에 신체 안정성에 악영향을 끼칠 가능성이 있다. 따라서, 본 발명의 클립감지기의 작동주파수는 파장이 길고 투과성이 높은 125 내지 134 kHz 범위의 저주파 대역으로 설계된다.In the present invention, since the marker clip 10 is mainly attached to the stomach and the large intestine in the human body, RFID having a short wavelength and low permeability or a high frequency band having a high transmittance is difficult to use and has a relatively high energy. Pies can adversely affect your stability. Therefore, the operating frequency of the clip detector of the present invention is designed to a low frequency band in the range of 125 to 134 kHz with long wavelength and high transmittance.
이하에서는, 상기 표식클립(10)과 상기 클립감지기(20)에 대해 각각 상세히 서술하기로 한다.Hereinafter, the marker clip 10 and the clip sensor 20 will be described in detail.
먼저, 상기 표식클립(10)은 기존의 내시경용 지혈 클립을 응용한 것으로, 기존의 의료용 클립에 전자태그(RFID)를 탑재시켜 RFID 일체형 클립으로 제조된다. 상기 표식클립(10)은 별도의 수단에 의해 도 3에 도시된 바와 같이 병변 부위에 부착되며, 상기 표식클립(10)은 도 4에 도시된 바와 같이 약 11mm의 길이를 가질 수 있다.First, the marker clip 10 is applied to the conventional endoscope hemostatic clip, the electronic clip (RFID) is mounted on the existing medical clip is manufactured as an RFID integrated clip. The marker clip 10 is attached to the lesion site as shown in Figure 3 by a separate means, the marker clip 10 may have a length of about 11mm as shown in FIG.
상기 전자태그(RFID)는 안테나와 고유 데이터를 담고 있는 집적회로 칩으로 구성되며, 전원 공급의 여부에 따라 수동적태그와 능동적태그로 구분될 수 있다. 본 발명에서는 전자태그를 활용함에 있어 데이터 전송이 아닌 감지만을 목적으로 하므로, 상기 전자태그(RFID)는 전원공급 없이 상기 클립감지기(20)의 유도전류로만 동작하는 수동적태그인 것을 특징으로 한다.The electronic tag (RFID) is composed of an integrated circuit chip containing an antenna and unique data, and may be classified into a passive tag and an active tag according to whether power is supplied. In the present invention, the electronic tag (RFID) is a passive tag that operates only with an induced current of the clip sensor 20 without power supply because the electronic tag is used only for sensing, not for data transmission.
또한, 상기 전자태그(RFID)의 형상은 감지 영역의 형태와 감지 거리에 영향을 미치는데, 일반적으로 안테나 체적이 넓을수록 긴 감지 범위를 가지게 된다. 본 발명에서는 상기 전자태그(RFID)가 원통형으로 구성되고, 그러므로 상기 표식클립(10) 또한 원통형으로 형성된다.In addition, the shape of the RFID affects the shape of the sensing area and the sensing distance. In general, the wider the antenna volume, the longer the sensing range. In the present invention, the electronic tag (RFID) is formed in a cylindrical shape, and thus the marker clip 10 is also formed in a cylindrical shape.
[실험예]Experimental Example
상기 전자태그(RFID)의 형상이 원통형일 때 더 효과적인 것을 입증하기 위해, 하기 표 1과 같이 실시예와 비교예를 설정하여 장벽의 두께별 감지거리 및 감지범위를 분석하였다. 또한, 실험을 통해 절제 범위를 표준 절제범위에 비해 축소시킬 수 있음을 입증하였다.In order to prove more effective when the shape of the electronic tag (RFID) is cylindrical, an example and a comparative example were set as shown in Table 1 below to analyze the sensing distance and detection range for each thickness of the barrier. In addition, experiments have demonstrated that the ablation range can be reduced compared to the standard ablation range.
[표 1]TABLE 1
Figure PCTKR2019010606-appb-I000001
Figure PCTKR2019010606-appb-I000001
실험에서 사용되는 원통형 전자태그(실시예)는 도 3 및 도 4에 도시된 바와 같고, 평면형 전자태그(실시예)는 도 5에 도시된 바와 같다.Cylindrical electronic tags (examples) used in the experiments are as shown in Figs. 3 and 4, and planar electronic tags (examples) are as shown in Fig. 5.
두 형상의 전자태그 모두, 돼지 위의 상체부(cardia)와 전정부(antrum) 총 2개의 위치에서 측정하였고, 대장(colon)은 얇은(thin) 부분과 두꺼운(thick) 부분, 총 2개의 위치에서 상기 클립감지기(20)에 의해 상기 표식클립(10)이 감지되는 가장 먼 거리를 측정하였고, 각 부위의 두께도 함께 측정하여 두께와 감지 거리 사이의 상관관계를 분석하였다.Both types of electronic tags were measured at two positions, the cardia and anterior part of the pig, and the colon was a total of two positions, thin and thick. In the clip sensor 20 was measured the farthest distance that the marker clip 10 is detected, the thickness of each part was also measured to analyze the correlation between the thickness and the sensing distance.
실시예의 경우, 부착되는 표면적이 좁으므로, 상기 표식클립(10)의 위치를 기준으로 각 부위의 4방향 위, 아래, 좌, 우 점이 각각 수직 교차하도록 설정하여, 각 25회씩 상기 표식클립(10)이 감지되는 가장 먼 거리를 측정하였고, 비교예의 경우, 부착되는 표면적이 넓으므로, 각 25회씩 측정하였다.In the case of the embodiment, since the surface area to be attached is narrow, the up, down, left, right points of each direction based on the position of the marker clip 10 is set so as to vertically cross each, the marker clip (10 times each) ) The longest distance is detected, and in the comparative example, since the surface area to be attached is wide, it was measured 25 times each.
1) 비교예1) Comparative Example
실험한 결과, 비교예의 경우, 위장의 상체부 부위가 7mm로 가장 두껍고, 얇은 대장 부분이 2mm로 가장 얇은 것으로 나타났다. 전자태그(RFID)가 인식되는 최장 거리는 장벽의 두께에 따라 다르게 측정되었으며, 가장 가까운 거리가 7mm이었고 가장 먼 거리는 22mm이었다. 하기 표 2의 결과에서 보듯이, 장벽의 두께가 증가할수록 최대감지거리는 감소하는 상관성이 나타났다.As a result of the experiment, in the comparative example, the upper part of the stomach was thickest with 7 mm, and the thin intestine was thinnest with 2 mm. The longest distance at which RFID was recognized was measured differently depending on the thickness of the barrier, the closest distance was 7mm and the longest distance was 22mm. As shown in the results in Table 2 below, the maximum sensing distance was correlated with increasing thickness of the barrier.
[표 2]TABLE 2
Figure PCTKR2019010606-appb-I000002
Figure PCTKR2019010606-appb-I000002
도 6의 상관 회귀분석 그래프를 참조하면, 안테나 코일의 형태가 평면이므로 장벽이 두꺼울수록 평면형 전자태그의 중심 근접부에서 인식이 되었음을 알 수 있다.Referring to the correlation regression graph of FIG. 6, since the shape of the antenna coil is flat, the thicker the barrier, the closer the center of the planar electronic tag is to be recognized.
2) 실시예2) Example
실험한 결과, 실시예의 경우, 하기 표 3의 결과에서 보듯이, 비교예의 실험 결과(표 2)에 비해 감지 거리의 편차가 더 작음을 알 수 있다. 전정부가 다른 부위와 차이가 더 나타나는 이유는 위의 가장 두꺼운 부위이기 때문에, 실험 상태에서는 위 내부가 팽창되어 있지 않고 협착이 되어 있는 상태로, 원통형 전자태그(RFID)의 설치 각도가 상대적으로 많이 기울어져서 이러한 결과가 나온 것으로 유추할 수 있다.As a result of the experiment, in the case of the Example, as shown in the results of Table 3, it can be seen that the deviation of the sensing distance is smaller than the experimental results (Table 2) of the comparative example. The reason why the antrum is more different from other parts is because it is the thickest part of the stomach. In the experimental state, the inside of the stomach is not expanded and narrowed, and the installation angle of the cylindrical RFID is relatively large. It can be inferred that this result is tilted.
[표 3]TABLE 3
Figure PCTKR2019010606-appb-I000003
Figure PCTKR2019010606-appb-I000003
복강경 수술 시 병변의 촉지 지점으로부터 외부로 절제 표준 거리(일본 기준, 20 내지 50mm)만큼 원형으로 절제하므로, 수술 시 감지된 점으로부터 타원의 면적을 평가하는 것이 기존의 절제 면적과의 비교가 합리적이라 할 수 있다. 따라서, 상하좌우의 최대감지거리를 이용하여 타원을 유도하여 절제 면적에 대한 평가를 시행하였다.During laparoscopic surgery, the ablation of the oval from the palpation point of the lesion to the outside is performed by a standard distance (20 to 50 mm). Therefore, it is reasonable to evaluate the area of the ellipse from the point detected during surgery. can do. Therefore, an ellipse was derived using the maximum sensing distance of the top, bottom, left and right to evaluate the area of ablation.
도 7의 그래프는 검출 점 상측과 하측, 좌측과 우측 점은 서로 수직으로 교차하게 실험 시 설정하였으므로, 이 축들이 타원의 장축과 단축과 각각 평행하다고 가정하고 도출된 타원이다. 각 유도된 타원들의 장축과 단축 길이, 면적을 하기 표 4에 나타내었다. 감지거리범위가 최대 12.5 mm, 최소 5.0 mm로 모두 기존 수술 절제 기준 20 내지 50 mm보다 작은 경향을 보이고 있다. 실험에서 코일의 반경이 6 mm인 것을 사용하였는데, 측정된 감지거리범위는 이 반경을 제외한 것이고, 절제할 때는 코일의 반경이 포함된 최대 18.5 mm이 정확한 감지거리범위가 될 것이므로, 절제 표준 범위(20 내지 50 mm)의 표준 범위의 1/2 수준으로 기존이 비해 절제 면적을 1/4로 줄일 수 있을 것이다. 비교예 실험 결과에서는 평면 형태의 전자태그의 경우 내장의 벽이 두꺼울수록 감지 거리가 작아지는 경향을 보였지만, 실시예 실험 결과에서는 감지범위 내에 있는 타원의 면적이 두께와 상관없이 대체로 일정함을 하기 표 4로부터 확인할 수 있었다.The graph of FIG. 7 is an ellipse derived assuming that these axes are parallel to the long axis and short axis of the ellipse since the upper and lower detection points and the left and right points cross each other perpendicularly. The long axis, short axis length, and area of each derived ellipse are shown in Table 4 below. Sensing range is up to 12.5 mm, at least 5.0 mm, all tend to be smaller than the existing surgical resection 20 to 50 mm. In the experiment, the coil radius was 6 mm, and the measured sensing distance range was excluded this radius. When cutting, the maximum sensing distance range of 18.5 mm including the coil radius would be the accurate sensing distance range. 20 to 50 mm) of the standard range can be reduced to 1/4 the ablation area compared to the conventional level. In the experimental results of the comparative example, in the case of the planar electronic tag, the thicker the wall of the interior, the detection distance tended to be smaller. It was confirmed from 4.
[표 4]TABLE 4
Figure PCTKR2019010606-appb-I000004
Figure PCTKR2019010606-appb-I000004
도 8에 도시된 바와 같이, 평면형(A)의 경우에는 토러스 또는 중간에 구멍이 뚫린 구와 같은 형태로 높이방향으로 갈수록 면적이 작아져 두께에 따라 감지 범위가 달라졌지만, 원통형(B)의 경우에는 면적이 비교적 일정하게 나타났다. 최대감지거리보다 얇은 내장 벽에서는 두께에 상관없이 감지 범위가 일정하기 때문에, 후에 감지 거리가 가변적인 클립감지기(20)를 설계할 때에도 편의가 높을 것으로 예상된다. 다만, 원통형 전자태그(RFID)일 경우, 기울어짐에 따라 편차가 나타날 수 있다. 도 7의 전정부 그래프를 살펴보면 위장 벽이 두꺼운 전정부에 설치된 전자태그가 기울어져서, 타원의 단축이 타부분에 비해 짧은 것으로 유추할 수 있다.As shown in FIG. 8, in the case of the plane type A, the area decreases in the height direction in the form of a torus or a sphere with a hole in the middle thereof, and thus the detection range varies depending on the thickness. The area is relatively constant. Since the sensing range is constant regardless of thickness in the embedded wall thinner than the maximum sensing distance, it is expected that the convenience will be high even when designing the clip sensor 20 having a variable sensing distance later. However, in the case of a cylindrical electronic tag (RFID), the deviation may appear as it is tilted. Looking at the graph of the front government of FIG. 7 it can be inferred that the short of the ellipse is shorter than the other parts because the electronic tag installed in the thick front government camouflage wall is inclined.
실제 원통형 전자태그의 감지범위는 도 8의 C에 도시된 바와 같이 원통 양끝이 둥근 형태로 끝부분이 잘린 경우일 것이다. 다만, 이러한 경우에도 범위는 실제 수술 시 절제 표준보다 작은 범위이므로 유효한 결과로 볼 수 있다. 그러나, 실험은 위 내부가 팽창한 상태가 아닌 협착된 상태로 이루어졌으므로, 실제 수술 시에는 큰 영향이 없을 것으로 사료된다.The detection range of the actual cylindrical electronic tag may be a case in which the ends of the cylindrical ends are cut off as shown in FIG. 8C. In this case, however, the range is smaller than the standard of ablation at the time of actual surgery, so it can be regarded as a valid result. However, since the experiment was performed in a constricted state rather than in the expanded state, it is expected that there will be no significant effect in actual surgery.
따라서, 본 발명에 따른 본 발명의 복강경 수술용 병변 감지 시스템은 도 9에 도시된 바와 같이, 클립감지기(20)를 이용하여 용이하게 감지할 수 있도록 술자는 위 장벽에 원통형 표식클립(10)을 설치할 수 있을 것이다.Therefore, the laparoscopic surgical lesion detection system of the present invention according to the present invention, as shown in Figure 9, so that the operator can easily detect using the clip sensor 20 cylindrical marker clip 10 on the stomach barrier You can install it.
다음으로, 상기 클립감지기(20)는 상기 표식클립(10)의 상기 원통형 전자태그(RFID)와 상호유도하여 상기 표식클립(10)을 감지하는 장치로써, 본 발명에서는 상기 표식클립(10)의 감지가 가능한 최대감지거리를 조정할 수 있도록 마련된다.Next, the clip detector 20 is a device for detecting the marker clip 10 by inducing with the cylindrical electronic tag (RFID) of the marker clip 10, in the present invention of the marker clip 10 It is designed to adjust the maximum detectable distance.
상기 클립감지기(21)는 직접 발생시키는 전자기파를 이용하는 축전(Capacitive) 방식으로 통신이 이루어진다. 이는 직접 발생시키는 자기장이 전자태그에 의해 변화가 나타나는 신호로 통신이 이루어지는 유도(Inductive) 방식에 비해 설계가 간편하며, 감지거리를 다양하게 설계할 수 있는 장점이 있다. 더욱 구체적으로, 상기 클립감지기(21)는 축전(Capacitive) 방식 중 내부의 코일 유도계수의 크기를 이용하여 응답의 특성을 변화시키는 방식으로 설계될 수 있다.The clip detector 21 communicates in a capacitive manner using directly generated electromagnetic waves. This is a simpler design than the inductive method in which a magnetic field generated directly by the electronic tag changes the communication, and has a merit of designing various sensing distances. More specifically, the clip detector 21 may be designed in a manner of changing a response characteristic by using a magnitude of an internal coil induction coefficient among capacitive methods.
상기 클립감지기(20)는 도 10 및 도 11에 도시된 바와 같이, 상기 안테나코일(211)과, 상기 안테나코일(211)의 접점과 연결되며 일 방향으로 연장되도록 배치되는 안테나전선(212)을 포함하는 안테나(21); 및 상기 안테나(21)의 단부에 연결되는 본체(22);를 포함한다.As shown in FIGS. 10 and 11, the clip detector 20 includes an antenna wire 212 connected to the antenna coil 211 and a contact point of the antenna coil 211 and disposed to extend in one direction. An antenna 21 comprising; And a main body 22 connected to an end of the antenna 21.
상기 안테나코일(211)은 상기 안테나(21)에서 상기 본체(22)로부터 제일 멀리 떨어져 있는 끝단에 위치되며, 상기 표식태그(10)의 상기 코일(11)과 상호 유도된다.The antenna coil 211 is located at the end farthest from the main body 22 in the antenna 21, and mutually induced with the coil 11 of the mark tag 10.
상기 안테나전선(211)은 상기 안테나코일(211)로부터 상기 본체(22) 사이를 전기적으로 연결하며, 도 12에 도시된 바와 같이, 두 개의 접점(212a, 212b)으로 상기 안테나코일(211)과 접한다. 두 개의 접점(212a, 212b)은 이동 가능한 이동접점(212a)과 고정접점(212b)으로 구분되며, 이에 대해서는 후술할 다이얼(223)과 같이 상세히 설명하기로 한다.The antenna wire 211 is electrically connected between the antenna coil 211 and the main body 22. As shown in FIG. 12, the antenna wire 211 is connected to the antenna coil 211 through two contacts 212a and 212b. Contact The two contacts 212a and 212b are divided into a movable contact 212a and a fixed contact 212b, which will be described in detail as shown in the dial 223 to be described later.
상기 본체(22)는 원 단면 형상으로 관통되어 형성되는 손잡이부(221); 상기 전자태그(RFID)를 감지하기 위한 전자태그감지회로(222); 및 상기 안테나전선(212)과 연결되는 동력전달장치(미도시)가 내부에 구비되고, 최대감지거리에 따라 다수 개의 모드가 표시되어 상기 다수 개의 모드 중 한 개로 선택될 수 있는 다이얼(223);을 포함한다.The main body 22 has a handle portion 221 is formed through the circular cross-sectional shape; An electronic tag detecting circuit (222) for detecting the electronic tag (RFID); And a dial 223 having a power transmission device (not shown) connected to the antenna wire 212 therein, and displaying a plurality of modes according to the maximum sensing distance so as to be selected as one of the plurality of modes. It includes.
상기 손잡이부(221)는 수술 시에 상기 클립감지기(20)를 복강경 수술에서 사용하는 어댑터 튜브에 삽입하여 상기 표식클립(10)을 감지할 때, 수술자가 사용하기 편리하도록 설계된다.The handle part 221 is designed to be easy for the operator to use when the clip detector 20 is inserted into the adapter tube used in laparoscopic surgery at the time of surgery to detect the marker clip 10.
상기 전자태그감지회로(222)는 상기 안테나코일(211)이 상기 표식클립(10)의 코일(11)로 인해 상호유도되어 상기 표식클립(10)을 감지할 수 있는 구조로 형성된다.The electronic tag detection circuit 222 has a structure in which the antenna coil 211 is induced by the coil 11 of the marker clip 10 to detect the marker clip 10.
상기 다이얼(223)은 최대감지거리에 따라 다수 개의 모드가 표시되어 수술자에 의해 상기 다수 개의 모드 중 한 개로 선택될 수 있는데, 상기 다이얼(223)의 모드가 선택되면, 상기 동력전달장치에 의해 상기 안테나전선(212)과 연결되는 상기 안테나코일(211)과 접하는 상기 이동접점(212a)이 이동된다. 도 12에 도시된 바와 같이, 상기 안테나코일(211)은 상기 이동접점(212a)외에도 상술한 상기 고정접점(212b)과 접하기 때문에, 상기 이동접점(212a)이 이동하게 되면, 상기 안테나코일(211)의 감은 횟수가 변하게 되어, 이에 따라 상기 안테나코일(211)의 유도계수도 함께 변하므로, 최종적으로 상기 클립감지기(20)가 상기 표식클립(10)을 가장 먼 거리에서 감지할 수 있는 최대감지거리를 변화시킬 수 있는 것이다.The dial 223 may be displayed in a plurality of modes according to the maximum sensing distance, and may be selected by the operator as one of the plurality of modes. When the mode of the dial 223 is selected, the power transmission device selects the mode. The movable contact 212a in contact with the antenna coil 211 connected to the antenna wire 212 is moved. As shown in FIG. 12, since the antenna coil 211 is in contact with the fixed contact 212b described above in addition to the movable contact 212a, when the movable contact 212a moves, the antenna coil ( Since the number of turns of 211 is changed, the induction coefficient of the antenna coil 211 also changes accordingly, so that the clip detector 20 can finally detect the marker clip 10 at the longest distance. It can change the distance.
여기서, 상기 동력전달장치는 기어 등 상기 이동접점(212a)을 밀고 당겨 이동시킬 수 있는 장치이면 통상의 기술자가 적절히 선택할 수 있다.Here, the power transmission device may be appropriately selected by those skilled in the art as long as the power transmission device is a device capable of pushing and pulling the movable contact 212a.
최대감지거리를 정확하게 설정하기 위해서, 상기 최대감지거리와 상기 안테나코일(211)의 유도계수 사이의 정량화된 관계식을 도출하는 것이 바람직할 것이다.In order to accurately set the maximum sensing distance, it may be desirable to derive a quantified relation between the maximum sensing distance and the induction coefficient of the antenna coil 211.
상기 표식클립(10)의 상기 최대감지거리에 따른 상기 안테나코일(211)의 상기 유도계수는 하기의 수학식 1 내지 수학식 3에 의해 도출될 수 있다.The induction coefficient of the antenna coil 211 according to the maximum sensing distance of the marker clip 10 can be derived by the following equations (1) to (3).
[수학식 1][Equation 1]
Figure PCTKR2019010606-appb-I000005
Figure PCTKR2019010606-appb-I000005
여기서,
Figure PCTKR2019010606-appb-I000006
은 최대감지거리에서의 신호세기,
here,
Figure PCTKR2019010606-appb-I000006
Is the signal strength at the maximum sensing distance,
Figure PCTKR2019010606-appb-I000007
는 상기 안테나코일의 중심으로부터 상기 전자태그의 코일 중심까지의 거리,
Figure PCTKR2019010606-appb-I000007
Is the distance from the center of the antenna coil to the center of the coil of the electronic tag,
Figure PCTKR2019010606-appb-I000008
는 사용하는 전자기파 주파수의 파장길이,
Figure PCTKR2019010606-appb-I000008
The wavelength length of the electromagnetic wave frequency used,
Figure PCTKR2019010606-appb-I000009
는 전자기파가 한 개의 파장을 진행할 수 있는 신호세기,
Figure PCTKR2019010606-appb-I000009
Is the signal strength at which an electromagnetic wave can travel one wavelength,
Figure PCTKR2019010606-appb-I000010
는 회로에 의해 감쇠되는 신호세기,
Figure PCTKR2019010606-appb-I000010
Is the signal strength attenuated by the circuit,
Figure PCTKR2019010606-appb-I000011
는 안테나 회로에 의해서 얻는 이득이다.
Figure PCTKR2019010606-appb-I000011
Is the gain obtained by the antenna circuit.
특히,
Figure PCTKR2019010606-appb-I000012
은 일반적으로 RLC 회로의 차단 신호 세기인 -20dB로 설정한다.
Especially,
Figure PCTKR2019010606-appb-I000012
Is typically set to -20dB, the blocking signal strength of the RLC circuit.
[수학식 2][Equation 2]
Figure PCTKR2019010606-appb-I000013
Figure PCTKR2019010606-appb-I000013
여기서,
Figure PCTKR2019010606-appb-I000014
는 광속(299,792,458 m/s),
here,
Figure PCTKR2019010606-appb-I000014
Is the speed of light (299,792,458 m / s),
Figure PCTKR2019010606-appb-I000015
는 안테나 회로의 공진주파수이다.
Figure PCTKR2019010606-appb-I000015
Is the resonant frequency of the antenna circuit.
[수학식 3][Equation 3]
Figure PCTKR2019010606-appb-I000016
Figure PCTKR2019010606-appb-I000016
여기서,
Figure PCTKR2019010606-appb-I000017
은 상기 안테나코일의 유도계수,
here,
Figure PCTKR2019010606-appb-I000017
Is the induction coefficient of the antenna coil,
Figure PCTKR2019010606-appb-I000018
는 축전기의 전기용량이다.
Figure PCTKR2019010606-appb-I000018
Is the capacitance of the capacitor.
구체적으로 살펴보면, 상기 [수학식 1]의
Figure PCTKR2019010606-appb-I000019
은 신호 세기 감소량을 의미하는 것으로, 이를 적용하여 원하는 거리
Figure PCTKR2019010606-appb-I000020
에서 최소한의 신호 세기를 구할 수 있다. 즉, 원하는 거리
Figure PCTKR2019010606-appb-I000021
가 설정되면, 상기 [수학식 1]로부터 사용하는 전자기파 주파수의 파장길이
Figure PCTKR2019010606-appb-I000022
을 도출할 수 있고, 도출된
Figure PCTKR2019010606-appb-I000023
은 상기 [수학식 2]로부터 안테나 회로의 공진주파수
Figure PCTKR2019010606-appb-I000024
을 도출할 수 있으며, 도출된
Figure PCTKR2019010606-appb-I000025
은 상기 [수학식 3]으로부터 변수인 안테나코일의 유도계수
Figure PCTKR2019010606-appb-I000026
을 구할 수 있는 것이다.
Looking specifically, the [Equation 1]
Figure PCTKR2019010606-appb-I000019
Denotes the amount of signal strength reduction, and the applied distance is applied to the desired distance.
Figure PCTKR2019010606-appb-I000020
The minimum signal strength can be obtained from. That is, the desired distance
Figure PCTKR2019010606-appb-I000021
When is set, the wavelength length of the electromagnetic wave frequency used from Equation 1
Figure PCTKR2019010606-appb-I000022
Can be derived,
Figure PCTKR2019010606-appb-I000023
Is the resonance frequency of the antenna circuit from Equation 2 above.
Figure PCTKR2019010606-appb-I000024
Can be derived
Figure PCTKR2019010606-appb-I000025
Is the induction coefficient of the antenna coil as a variable from [Equation 3]
Figure PCTKR2019010606-appb-I000026
Can be obtained.
상기 [수학식 1] 내지 상기 [수학식 3]에 따라, 기설정된 최대감지거리를 만족하는 도출된 상기 안테나코일(211)의 상기 유도계수를 이용하면, 상기 다이얼(223)에 의해 상기 안테나전선(212a) 이동접점이 이동하는 범위를 정확히 설정할 수 있을 것이다.According to Equation 1 to Equation 3, when the induction coefficient of the antenna coil 211 derived to satisfy a preset maximum sensing distance is used, the antenna wire is connected by the dial 223. (212a) It may be possible to accurately set the moving range of the moving contact.
상술한 바와 같이 최대감지거리가 가변인 상기 클립감지기(20)는 수술자가 환자의 병변 부위 크기 또는 중증 정도에 따라서 모드를 선택할 수 있을 것이다. 구체적으로, 병변 부위 크기가 작고 초기 증상이면, 최대감지거리를 최소화하도록 유도 계수를 감소시켜, 더욱 병변 부위 가까이에서 수술을 할 수 있도록 상기 다이얼(223)을 조절할 것이나, 반면에 병변 부위 크기가 크고 중증이면, 최대감지거리를 최대화하도록 유도 계수를 증가시키는 방식으로 상기 다이얼(223)을 조절할 것이다.As described above, the clip detector 20 having a variable maximum sensing distance may select a mode according to the size or severity of the lesion site of the patient. Specifically, if the lesion site size is small and the initial symptom, the induction coefficient is reduced to minimize the maximum detection distance, so that the dial 223 may be adjusted to allow surgery near the lesion site, while the lesion site size is large. If severe, the dial 223 will be adjusted in a manner that increases the induction coefficient to maximize the maximum sensing distance.
한편, 상기 클립감지기(20)는 도 13에 도시된 바와 같이, 상기 전자태그감지회로(222)를 감지하면 UDP(User Program Protocol)를 기반으로 PC와 통신하도록 구성될 수 있다. 따라서, 상기 클립감지기(20)는 상기 표식클립(10)을 감지할 때 비프음을 출력시키도록 구성되어, 수술자가 연결된 모니터 화면을 보지 않고도 상기 표식클립(10)의 감지 여부, 즉 병변의 위치를 용이하게 파악할 수 있다.Meanwhile, as illustrated in FIG. 13, the clip detector 20 may be configured to communicate with a PC based on a user program protocol (UDP) when the electronic tag detection circuit 222 is detected. Therefore, the clip detector 20 is configured to output a beep when detecting the marker clip 10, so that the operator can detect the marker clip 10 without looking at the connected monitor screen, that is, the position of the lesion. Can be easily identified.
한편, 통신은 상기 클립감지기(20)의 MCU를 UDP Client, PC를 UDP server로 이루어지며, 사이의 통신 속도는 테스트 결과 평균 1ms 이하이고, 이는 전자태그 감지에 영향을 미치지 않을 속도이다. 더 나아가, 상기 클립감지기(20)는 PC와 무선통신으로 이루어질 수 있다.On the other hand, the communication is made of the MCU of the clip sensor 20 UDP client, PC to the UDP server, the communication speed between the average of 1ms or less as a test result, which is a speed that will not affect the electronic tag detection. Furthermore, the clip detector 20 may be made in wireless communication with a PC.
상술한 본 발명의 기술적 구성은 본 발명이 속하는 기술분야의 당업자가 본 발명의 그 기술적 사상이나 필수적 특징을 변경하지 않고서 다른 구체적인 형태로 실시될 수 있다는 것을 이해할 수 있을 것이다.It will be understood by those skilled in the art that the above-described technical configuration of the present invention can be implemented in other specific forms without changing the technical spirit or essential features of the present invention.
그러므로 이상에서 기술한 실시예들은 모든 면에서 예시적인 것이며 한정적인 것이 아닌 것으로서 이해되어야 하고, 본 발명의 범위는 상기 상세한 설명보다는 후술하는 특허청구범위에 의하여 나타나며, 특허청구범위의 의미 및 범위 그리고 그 등가 개념으로부터 도출되는 모든 변경 또는 변형된 형태가 본 발명의 범위에 포함되는 것으로 해석되어야 한다.Therefore, the above-described embodiments are to be understood in all respects as illustrative and not restrictive, and the scope of the present invention is indicated by the appended claims rather than the detailed description, and the meaning and scope of the claims and their All changes or modifications derived from an equivalent concept should be construed as being included in the scope of the present invention.
[부호의 설명][Description of the code]
A : 표식클립이 설치된 위장 부위A: gastrointestinal site with marker clip
B : 내시경과 클립감지기가 내장된 수술용 탐지침B: Surgical probe with built-in endoscope and clip detector
C : 절제기구C: ablation apparatus
10 : 표식클립10: Marker clip
11 : 코일11: coil
20 : 클립감지부20: clip detection unit
21 : 안테나21: antenna
211 : 안테나코일211: antenna coil
212 : 안테나전선212: antenna wire
212a : 안테나전선(이동접점)212a: Antenna wire (mobile contact)
212b : 안테나전선(고정접점)212b: Antenna wire (fixed contact)
22 : 본체22: main body
221 : 손잡이부221: handle portion
222 : 전자태그감지회로222: electronic tag detection circuit
223 : 다이얼223 dial
224 : MCU224: MCU
24 : 데이터선정부24: data selection
30 : 감별부30: discrimination unit

Claims (5)

  1. 수술하고자 하는 병변에 인접하게 배치되며, 상기 병변의 위치를 비접촉인 방식으로 확인할 수 있도록 전자태그(RFID)가 탑재되는 표식클립; 및A marker clip disposed adjacent to the lesion to be operated and mounted with an electronic tag (RFID) so as to check the position of the lesion in a non-contact manner; And
    상기 전자태그를 감지하는 안테나코일을 포함하여, 촉지하지 않고 상기 표식클립을 감지할 수 있도록 구성되는 클립감지기;를 포함하고,And a clip detector configured to detect the marker clip without palpation, including an antenna coil detecting the electronic tag.
    상기 클립감지기는 상기 표식클립의 감지가 가능한 최대감지거리를 조정할 수 있도록 마련되는 것을 특징으로 하는 복강경 수술용 병변 감지 시스템.The clip detector is a laparoscopic surgical lesion detection system, characterized in that it is provided to adjust the maximum detection distance capable of detecting the marker clip.
  2. 제1항에 있어서,The method of claim 1,
    상기 표식클립은 원통형으로 형성되는 것을 특징으로 하는 복강경 수술용 병변 감지 시스템.The marker clip is a laparoscopic surgical lesion detection system, characterized in that formed in a cylindrical shape.
  3. 제1항에 있어서,The method of claim 1,
    상기 클립감지기는,The clip detector,
    상기 안테나코일과, 상기 안테나코일의 접점과 연결되며 일 방향으로 연장되도록 배치되는 안테나전선을 포함하는 안테나; 및An antenna including an antenna wire connected to the antenna coil and a contact point of the antenna coil and arranged to extend in one direction; And
    상기 안테나의 단부에 연결되며, 원 단면 형상으로 관통되어 형성되는 손잡이부를 포함하는 본체;를 포함하고,A main body connected to an end of the antenna and including a handle portion formed to penetrate through a circular cross-sectional shape,
    상기 본체는,The main body,
    상기 전자태그를 감지하기 위한 전자태그감지회로; 및An electronic tag detection circuit for detecting the electronic tag; And
    상기 안테나전선과 연결되는 동력전달장치가 내부에 구비되고, 최대감지거리에 따라 다수 개의 모드가 표시되어 상기 다수 개의 모드 중 한 개로 선택될 수 있는 다이얼;을 포함하는 것을 특징으로 하는 복강경 수술용 병변 감지 시스템.Laparoscopic surgical lesions, comprising: a power transmission device connected to the antenna wire is provided therein, a plurality of modes are displayed according to the maximum sensing distance, and the dial can be selected from one of the plurality of modes. Detection system.
  4. 제3항에 있어서,The method of claim 3,
    상기 다이얼의 모드가 선택되면, 상기 동력전달장치에 의해 상기 안테나전선과 연결되는 상기 안테나코일과 접하는 상기 접점이 이동되고, 이에 따라 상기 안테나코일의 유도계수가 변화되어 상기 표식클립의 상기 최대감지거리가 조정되는 것을 특징으로 하는 복강경 수술용 병변 감지 시스템.When the mode of the dial is selected, the contact point in contact with the antenna coil connected to the antenna wire by the power transmission device is moved, and accordingly the induction coefficient of the antenna coil is changed so that the maximum sensing distance of the marker clip is changed. Laparoscopic surgical lesion detection system characterized in that is adjusted.
  5. 제4항에 있어서,The method of claim 4, wherein
    기설정된 상기 표식클립의 상기 최대감지거리에 따른 상기 안테나코일의 상기 유도계수는 하기의 수학식 1 내지 수학식 3에 의해 도출되어, The induction coefficient of the antenna coil according to the maximum detection distance of the predetermined marker clip is derived by the following Equations 1 to 3,
    [수학식 1][Equation 1]
    Figure PCTKR2019010606-appb-I000027
    Figure PCTKR2019010606-appb-I000027
    여기서,
    Figure PCTKR2019010606-appb-I000028
    은 최대감지거리에서의 신호세기,
    here,
    Figure PCTKR2019010606-appb-I000028
    Is the signal strength at the maximum sensing distance,
    Figure PCTKR2019010606-appb-I000029
    는 상기 안테나코일의 중심으로부터 상기 전자태그의 코일 중심까지의 거리,
    Figure PCTKR2019010606-appb-I000029
    Is the distance from the center of the antenna coil to the center of the coil of the electronic tag,
    Figure PCTKR2019010606-appb-I000030
    는 사용하는 전자기파 주파수의 파장길이,
    Figure PCTKR2019010606-appb-I000030
    The wavelength length of the electromagnetic wave frequency used,
    Figure PCTKR2019010606-appb-I000031
    는 전자기파가 한 개의 파장을 진행할 수 있는 신호세기,
    Figure PCTKR2019010606-appb-I000031
    Is the signal strength at which an electromagnetic wave can travel one wavelength,
    Figure PCTKR2019010606-appb-I000032
    는 회로에 의해 감쇠되는 신호세기,
    Figure PCTKR2019010606-appb-I000032
    Is the signal strength attenuated by the circuit,
    Figure PCTKR2019010606-appb-I000033
    는 안테나 회로에 의해서 얻는 이득이고,
    Figure PCTKR2019010606-appb-I000033
    Is the gain obtained by the antenna circuit,
    [수학식 2][Equation 2]
    Figure PCTKR2019010606-appb-I000034
    Figure PCTKR2019010606-appb-I000034
    여기서,
    Figure PCTKR2019010606-appb-I000035
    는 광속(299,792,458 m/s),
    here,
    Figure PCTKR2019010606-appb-I000035
    Is the speed of light (299,792,458 m / s),
    Figure PCTKR2019010606-appb-I000036
    는 안테나 회로의 공진주파수이고,
    Figure PCTKR2019010606-appb-I000036
    Is the resonant frequency of the antenna circuit,
    [수학식 3][Equation 3]
    Figure PCTKR2019010606-appb-I000037
    Figure PCTKR2019010606-appb-I000037
    여기서,
    Figure PCTKR2019010606-appb-I000038
    은 상기 안테나코일의 유도계수,
    here,
    Figure PCTKR2019010606-appb-I000038
    Is the induction coefficient of the antenna coil,
    Figure PCTKR2019010606-appb-I000039
    는 축전기의 전기용량이며,
    Figure PCTKR2019010606-appb-I000039
    Is the capacitance of the capacitor,
    상기 기설정된 최대감지거리와 상기 도출된 상기 안테나코일의 상기 유도계수를 이용하여 상기 다이얼에 의해 상기 접점이 이동되는 범위를 설정하는 것을 특징으로 하는 복강경 수술용 병변 감지 시스템.Laparoscopic surgical lesion detection system, characterized in that for setting the range that the contact is moved by the dial using the predetermined maximum detection distance and the derived induction coefficient of the antenna coil.
PCT/KR2019/010606 2018-08-28 2019-08-21 Lesion sensing system for laparoscopic surgery WO2020045883A1 (en)

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JP2009072518A (en) * 2007-09-25 2009-04-09 Fujinon Corp Wireless electronic endoscope system
KR20140024786A (en) * 2012-08-20 2014-03-03 (주) 네톰 System for searching rfid tag and method therefor
JP2017074358A (en) * 2015-10-15 2017-04-20 地方独立行政法人 大阪府立病院機構 Rf tag marker, luminescent marker, and detector thereof
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