WO2024095985A1

WO2024095985A1 - Epidural anesthesia assistance system, epidural anesthesia training method, and display device control method

Info

Publication number: WO2024095985A1
Application number: PCT/JP2023/039166
Authority: WO
Inventors: 金幸川前; 達哉早坂; 和晴河野; 祐太小森谷
Original assignee: 国立大学法人山形大学
Priority date: 2022-10-31
Filing date: 2023-10-30
Publication date: 2024-05-10
Also published as: JP2024065792A

Abstract

The present invention provides, inter alia, an epidural anesthesia assistance system that improves blind epidural puncture and increases the safety and swiftness of epidural puncture. The present invention relates to an epidural anesthesia assistance system for assisting in epidural puncture, said epidural anesthesia assistance system comprising a goggle-type display device provided with: a transmissive display unit disposed in the front direction of the eyes of a user; and an output processing unit that, when the user views a human body model or a patient's back through the transmissive display unit, outputs a first aerial image showing at least a portion of the spine to the transmissive display unit such that the first aerial image is displayed in a position corresponding to the human body model or the patient's back.

Description

Epidural anesthesia support system, epidural anesthesia training method, and display device control method

The embodiments disclosed in this specification relate to an epidural anesthesia support system, an epidural anesthesia training method, and a method for controlling a display device.

Epidural anesthesia is used in conjunction with general anesthesia during surgery of the chest, abdomen, pelvis, or lower extremities. The analgesic effect of epidural anesthesia is superior to that of paravertebral nerve blocks, and recent studies have shown that epidural anesthesia used during surgery can reduce postoperative cognitive dysfunction and postoperative stress responses.

On the other hand, epidural anesthesia is a highly challenging procedure. The clinician administering epidural anesthesia must feel the tip of the epidural needle with their fingers and "walk" their fingertip to pinpoint the location of the epidural needle. In this way, the clinician is performing the "walking" technique blindly. For this reason, when administering epidural anesthesia, the clinician needs not only anatomical knowledge but also experience and intuition.

The incidence of difficulty or inability to insert an epidural catheter during epidural anesthesia is approximately 7%, and reaches approximately 26% among anesthesia trainees. Difficulty inserting an epidural catheter can cause pain to the patient over time, and multiple epidural punctures cause localized pain to the patient. Furthermore, if the patient is unable to remain still during the puncture, the risk of nerve damage due to the epidural puncture increases, and there are cases where the epidural puncture procedure must be interrupted.

For this reason, methods for performing epidural anesthesia safely and accurately have been sought for many years. For example, Patent Document 1 and Non-Patent Document 1 describe an epidural puncture simulator for learning epidural puncture techniques.

JP 2002-132138 A

However, the human body model (epidural puncture simulator) described in Patent Document 1 and Non-Patent Document 1 only provides a method for learning blind epidural puncture. As such, the conventional human body model does not improve blind epidural puncture, nor does it further improve the safety and speed of epidural puncture.

The epidural anesthesia support system, epidural anesthesia training method, and display device control method disclosed in this specification make it possible to improve blind epidural puncture and increase the safety and speed of epidural puncture.

The disclosed epidural anesthesia support system is an epidural anesthesia support system for supporting epidural anesthesia, and includes a goggle-type display device including a human body model that mimics at least a part of a human body that is the subject of epidural anesthesia training, a transparent display unit installed in front of the user's eyes, and an output processing unit that outputs a first aerial image to the transparent display unit so that, when the user looks at the human body model through the transparent display unit, a first aerial image showing at least a part of the spine is displayed at a corresponding position on the human body model.

Furthermore, in the disclosed epidural anesthesia support system, it is preferable that the human body model has a spine model that mimics at least a part of the spine, and the output processing unit outputs the first aerial image based on three-dimensional object data generated from a CT image of the spine model acquired by a CT device.

Furthermore, in the disclosed epidural anesthesia support system, it is preferable that the output processing unit outputs the second aerial image to the transparent display unit so that, when the user views the human body model through the transparent display unit, the second aerial image indicating at least one of the skin puncture point of the epidural needle used in epidural anesthesia, the puncture angle of the epidural needle, and the epidural space puncture point of the epidural needle is displayed at the corresponding position on the human body model.

Furthermore, in the disclosed epidural anesthesia support system, it is preferable that the human body model has a spine model that mimics at least a part of the spine, the output processing unit outputs a first aerial image and a second aerial image based on three-dimensional object data generated from a CT image of the spine model inserted with the epidural needle acquired by a CT device, and the epidural needle is inserted into the spine model so as to satisfy medically appropriate skin puncture point, puncture angle, and epidural space puncture point.

The disclosed epidural anesthesia support system is an epidural anesthesia support system for supporting epidural anesthesia, and includes a goggle-type display device that includes a transparent display unit installed in front of the user's eyes, and an output processing unit that outputs an aerial image to the transparent display unit so that, when the user looks at the human body through the transparent display unit, an aerial image showing at least a part of the human body's spine is displayed at a corresponding position on the human body.

Furthermore, in the disclosed epidural anesthesia support system, it is preferable that the goggle-type display device allows the user wearing it to imagine an aerial image, and after imagining the aerial image, the user removes the goggle-type display device and performs epidural anesthesia as usual.

The disclosed epidural anesthesia training method is an epidural anesthesia training method for training epidural anesthesia using the disclosed epidural anesthesia support system, and includes a step of displaying a first aerial image on a goggle-type display device to allow a user wearing the goggle-type display device to insert an epidural needle used in epidural anesthesia into a human body model.

The disclosed epidural anesthesia training method is an epidural anesthesia training method for training epidural anesthesia using the disclosed epidural anesthesia support system, and includes the steps of: displaying a first aerial image on a goggle-type display device to allow a user wearing a goggle-type display device to insert an epidural needle into a spinal model attached to a human body model; acquiring a CT image of the spinal model inserted by the user with the epidural needle; and displaying the skin puncture point, puncture angle, and epidural space puncture point of the epidural needle in the spinal model inserted by the user with the epidural needle.

In addition, it is preferable that the disclosed epidural anesthesia training method further includes a step in which the user puts on a goggle-type display device, visualizes the first aerial image, and then removes the goggle-type display device and inserts an epidural needle into the human body model.

The disclosed control method is a control method for a display device having an image acquisition unit, a storage unit, and a transparent display unit, in which the display device stores in the storage unit first three-dimensional object data showing at least a part of the shape of the surface of a specific human body, and second three-dimensional object data showing at least a part of the spine of the specific human body, and displays on the transparent display unit an aerial image showing at least a part of the spine of the specific human body based on the second three-dimensional object data, based on an image of the specific human body acquired by the image acquisition unit and the first three-dimensional object data.

The disclosed epidural anesthesia support system, epidural anesthesia training method, and display device control method make it possible to improve blind epidural puncture and increase the safety and speed of epidural puncture.

1 is a schematic diagram for explaining an example of an overview of an epidural anesthesia support system. FIG. FIG. 1 is a diagram illustrating an example of a schematic configuration of a human body model. FIG. 13 is a schematic diagram showing an example of a method for generating a lumbar spine model inserted with an epidural needle. FIG. 2A is a perspective view showing an example of the appearance of a wearable device, and FIG. 2B is a diagram showing an example of a schematic configuration of the wearable device. FIG. 1A is a schematic diagram showing an example of a three-dimensional object, and FIG. 1B is a diagram showing an example of an aerial image displayed on a wearable device. FIG. 13 is a schematic diagram for explaining images resulting from epidural needle puncture training. FIG. 13 is a diagram showing an example of an operation flow of an epidural anesthesia training method.

Various embodiments of the present invention will be described below with reference to the drawings. However, please note that the technical scope of the present invention is not limited to these embodiments, but extends to the inventions described in the claims and their equivalents.

(Outline of Epidural Anesthesia Support System 1)
1 is a schematic diagram for explaining an example of an overview of an epidural anesthesia support system 1. The epidural anesthesia support system 1 includes a human body model 2 and a wearable device 3. The human body model 2 has a main body section 21 that imitates a human body, and a skin section 22 that imitates at least a part of the skin on the back of the human body. The main body section 21 has a housing section 23 that houses a spine model 24 that imitates at least a part of a spine.

The wearable device 3 is a goggle-type display device that can be worn on the head of a user (such as a doctor or medical intern). A transparent display unit is installed in the wearable device 3 so that it is positioned directly in front of the eyes of the user wearing it. The wearable device 3 has an MR (Mixed Reality) function that displays various aerial images on the transparent display unit.

As shown in FIG. 1(b), the wearable device 3 displays an aerial image A1 of the spine model 24 at a corresponding position of the human body model 2 when a user wearing the wearable device 3 views the human body model 2 through the transparent display unit. For example, the wearable device 3 stores three-dimensional object data of a three-dimensional object D1 indicating the shape of the surface of the human body model 2 and three-dimensional object data of a three-dimensional object D2 indicating the shape of the surface of the spine model 24. The wearable device 3 also stores the relative positional relationship between the three-dimensional object D1 and the three-dimensional object D2. The wearable device 3 reads out the three-dimensional object data of the three-dimensional object D1, recognizes the shape of the human body model 2 using a known MR function, and specifies the position of the human body model 2 in real space. The wearable device 3 displays the aerial image A1 on the transparent display unit based on the position of the human body model 2 in real space, the relative positional relationship between the three-dimensional object D1 and the three-dimensional object D2, and the three-dimensional object data of the three-dimensional object D2. For example, the aerial image A1 is a hologram (stereoscopic image) corresponding to the three-dimensional object D2 and is an example of a first aerial image.

If the spine model 24 is an imitation of the lumbar vertebrae, the wearable device 3 displays an aerial image A1 showing the lumbar vertebrae at the position of the spine model 24 contained within the human body model 2 when the user wearing the wearable device 3 views the human body model 2 through the transparent display unit. This allows the user wearing the wearable device 3 to view the aerial image A1 displayed at a position corresponding to the spine model 24 contained within the human body model 2 through the transparent display unit.

Note that the aerial image A1 is not limited to being displayed based on the three-dimensional object data of the three-dimensional object D2 showing the surface shape of the spine model 24. For example, the aerial image A1 may be displayed based on three-dimensional object data showing the surface shape of at least a part of the spine that is generated by a trainer operating an information processing device (such as a personal computer (PC)) capable of executing an application program for generating three-dimensional object data. The trainer is a person who provides training in epidural puncture to trainees, such as medical interns.

As described above with reference to FIG. 1, the epidural anesthesia support system 1 has a wearable device 3 that displays an aerial image A1 showing at least a part of the spine of a human body model 2 at a position corresponding to at least a part of the spine. In this way, the epidural anesthesia support system 1 makes it possible to visualize the area to be targeted for epidural puncture, improving blind epidural puncture and making it safer and more rapid.

The above explanation of FIG. 1 is merely for the purpose of deepening understanding of the contents of the present invention. The present invention is specifically embodied in the following embodiments, and may be embodied in various modified forms without substantially departing from the principles of the present invention. All such modified forms are included within the scope of the present invention and the disclosure of this specification.

(Human body model 2)
2 is a diagram showing an example of a schematic configuration of the human body model 2. The human body model 2 has a spine model 24, a skin portion 22, a cord portion 25, and the like.

The main body 21 shown in FIG. 2 has a waist portion that imitates the waist of a human body. The main body 21 is not limited to a waist portion, and may further have a back portion that imitates the back of a human body, and/or a buttocks that imitates the buttocks of a human body. The main body 21 may also have only one of the back portion and the buttocks. The main body 21 may also include models that imitate other parts of the human body (for example, a neck portion that imitates a neck, an upper arm portion that imitates an upper arm, and/or a thigh portion that imitates a thigh, etc.).

The skin portion 22 is made of soft synthetic resin that mimics the skin and subcutaneous tissue, and is configured so that the softness and feel when palpated by a user is similar to that of human skin. The storage portion 23 is a groove provided on the back surface of the human body model 2, and stores the spine model 24.

The spine model 24 is a model that simulates at least the spinous processes and the epidural space. The spine model 24 shown in FIG. 2(b) is a model that simulates the lumbar vertebrae of the spine. The spine model 24 is not limited to a model that simulates the lumbar vertebrae, and may be a model that simulates the cervical vertebrae, thoracic vertebrae, or sacral vertebrae. The spine model 24 may also be a model that simulates two or more of the cervical vertebrae, thoracic vertebrae, lumbar vertebrae, and sacral vertebrae.

The spine model 24 is housed in the housing 23 (FIG. 2(b)) and covered by the skin 22 (FIG. 2(a)) so that it cannot be seen by the user. A user who does not wear the wearable device 3 cannot see the spine model 24, and therefore blindly trains in epidural puncture using the human body model 2. In this way, the human body model 2 is a model that imitates at least a part of a human body that is the subject of epidural anesthesia training, and the spine model 24 is a model that imitates at least a part of a spine that is housed in the human body model 2 and that is the subject of epidural puncture in epidural anesthesia. Details of the spine model 24 will be described later.

The code section 25 is, for example, a QR code (registered trademark), and is associated with the three-dimensional object data of each of the three-dimensional objects D1 and D2. Other barcode information such as an AR marker may also be used as the code section 25. The method of using the code section 25 will be described later.

As a component of the human body model 2 other than the cord unit 25, for example, a known epidural puncture simulator ("Lumbar/Epidural Puncture Simulator Lumbar-kun IIA", March 18, 2022, Kyoto Scientific Co., Ltd., [searched September 1, 2022], Internet <URL: https://www.kyotokagaku.com/jp/products_data/m43b_02/?utm_source=YT&utm_medium=L&utm_campaign=TR>) may be used.

(Spine model 24 with epidural needle N inserted)
3 is a schematic diagram showing an example of a method for generating a spine model 24 punctured with an epidural needle N. The spine model 24 punctured with an epidural needle N is used to create three-dimensional object data. The epidural needle N punctured into the spine model 24 corresponds to three-dimensional object data for displaying an aerial image A2 showing at least one of the skin puncture point of the epidural needle N, the puncture angle of the epidural needle N, and the epidural space puncture point of the epidural needle N. The spine model 24 punctured with the epidural needle N is created by a trainer. The aerial image A2 is an example of a second aerial image.

As shown in FIG. 3A, the spine model 24 has a spinous process portion 241, a transparent portion 242, and an epidural space portion 243. The spinous process portion 241 is a model of a spinous process and is made of synthetic resin having the same hardness as a spinous process. The transparent portion 242 is made of transparent silicon or the like configured to generate a sense of resistance similar to that of an interspinous ligament when the epidural needle N is punctured, and the punctured epidural needle N can be visually confirmed. Note that when the epidural needle N is punctured into the transparent portion 242, the puncture position of the epidural needle N on the upper surface of the transparent portion 242 may be referred to as the skin puncture point. The epidural space portion 243 is a hollow tubular body that constitutes the epidural space. In the example shown in FIG. 3, the upper side of the epidural space portion 243 is a model of the ligamentum flavum, and the point where the epidural needle N punctured into the transparent portion 242 reaches the upper side of the epidural space portion 243 is the epidural space puncture point.

Next, as shown in FIG. 3(b), the trainer inserts the epidural needle N into the spine model 24. The epidural needle N is inserted into the spine model 24 so as to satisfy medically appropriate skin puncture point, puncture angle, and epidural space puncture point. The puncture angle is the deviation angle θ between a straight line passing through the skin puncture point and the epidural space puncture point and an axis passing upward in FIG. 3(b).

Next, as shown in FIG. 3(c), the trainer cuts the epidural needle N extending from the upper side of the epidural space portion 243, thereby completing the spine model 24 punctured with the epidural needle N. Note that the spine model 24 punctured with the epidural needle N may be in the state in which the epidural needle N is inserted before cutting (FIG. 3(b)).

(3D object data)
An example of a method for creating three-dimensional object data will be described below. The trainer places the spine model 24, into which the epidural needle N has been inserted, in the human body model 2, and obtains a CT image of the human body model 2 using a CT (Computed Tomography) device (not shown).

Next, the training officer uses an information processing device (not shown) such as a PC capable of executing a three-dimensional object data generation application program to generate three-dimensional object data for three-dimensional object D1 and three-dimensional object data for three-dimensional object D2 from the CT image of the human body model 2. A well-known application program ("Unity Pro" (registered trademark)) may be used as the three-dimensional object data generation application program.

For example, for each CT image of the human body model 2, the information processing device identifies pixel P1 corresponding to the surfaces of the main body portion 21 and the skin portion 22, pixel P2 corresponding to the surface of the spinous process portion 241 and/or the epidural space portion 243 of the spine model 24, and pixel P3 corresponding to the surface of the epidural needle N. Next, the information processing device uses the identified pixels P1 to P3 in all CT images to generate three-dimensional object data by a known conversion process. The three-dimensional object data of the three-dimensional object D1 is generated based on pixel P1, and the three-dimensional object data of the three-dimensional object D2 is generated based on pixel P2. Furthermore, the three-dimensional object data of the three-dimensional object D3 indicating the shape of the surface of the epidural needle N is generated based on pixel P3.

The three-dimensional object D3 is not limited to one that indicates the shape of the surface of the epidural needle N itself. For example, the three-dimensional object D3 may be a spherical object that corresponds to the skin puncture point of the epidural needle N, or a spherical object that indicates the epidural space puncture point of the epidural needle N. In addition, the line segment object that corresponds to the epidural needle N may be designed as an arrow. In this case, the direction of the arrow is the puncture direction. The three-dimensional object D3 may include multiple objects of each of the examples given above.

(Wearable device 3)
FIG. 4(a) is a perspective view showing an example of the wearable device 3, and FIG. 4(b) is a diagram showing an example of a schematic configuration of the wearable device 3. The wearable device 3 is a goggle-type display device that can be worn on the head of a user, and has an MR (Mixed Reality) function of displaying various aerial images on a half mirror unit 36 installed in the front direction (x direction) of the eyes of the user wearing the device. In order to realize such functions, the wearable device 3 includes a communication I/F 31, a storage unit 32, a sensor acquisition unit 33, a video output unit 34, a processing unit 35, a half mirror unit 36, an environmental sensor 37, a depth sensor 38, and the like. As the wearable device 3, a known MR HMD (Head Mounted Display) (for example, "Microsoft HoloLens 2", [searched on September 1, 2022], Internet <URL: https://www.microsoft.com/ja-jp/hololens/>) may be used.

The communication I/F 31 includes a communication interface circuit that performs wireless communication with an access point of a wireless LAN (Local Area Network) (not shown) based on the wireless communication method of the IEEE (The Institute of Electrical and Electronics Engineers, Inc.) 802.11 standard. The communication I/F 31 receives three-dimensional object data transmitted by wireless communication from an information processing device. The communication I/F 31 may also establish a wireless signal line with a base station (not shown) using the LTE (Long Term Evolution) method, a fifth generation (5G) mobile communication system, or the like, via a channel assigned by the base station, and perform communication with the base station. The communication I/F 31 may also have an interface circuit for performing short-range wireless communication according to a communication method such as Bluetooth (registered trademark), and may receive radio waves from the information processing device. The communication I/F 31 may also include a communication interface circuit for a wired LAN. This allows the wearable device 3 to acquire three-dimensional object data (three-dimensional object data of three-dimensional object D1, three-dimensional object data of three-dimensional object D2, and three-dimensional object data of three-dimensional object D3) from the information processing device via the communication I/F 31.

The storage unit 32 is, for example, a semiconductor memory device such as a ROM (Read Only Memory) or a RAM (Random Access Memory). The storage unit 32 stores an operating system program, a driver program, an application program, data, and the like used for processing in the processing unit 35. The driver programs stored in the storage unit 32 include a communication device driver program that controls the communication I/F 31, an output device driver program that controls the video output unit 34, an environmental sensor device driver program that controls the environmental sensor 37, and a depth sensor device driver program that controls the depth sensor 38. The application programs stored in the storage unit 32 are various control programs for realizing the MR function in the processing unit 35. Furthermore, the storage unit 32 stores three-dimensional object data acquired from the information processing device (three-dimensional object data of three-dimensional object D1, three-dimensional object data of three-dimensional object D2, and three-dimensional object data of three-dimensional object D3).

The sensor acquisition unit 33 has a function of acquiring various sensor data from the environmental sensor 37 and the depth sensor 38 and passing it to the processing unit 35. The video output unit 34 has a function of projecting a hollow image onto the half mirror unit 36 using a holographic optical element based on display data for displaying the hollow image.

The processing unit 35 is a processing device that loads the operating system program, driver program, and application program stored in the storage unit 32 into memory and executes the instructions contained in the loaded programs. The processing unit 35 is, for example, an electronic circuit such as a CPU (Central Processing Unit), an MPU (Micro Processing Unit), or a DSP (Digital Signal Processor), or a combination of various electronic circuits. In FIG. 4(b), the processing unit 35 is illustrated as a single component, but the processing unit 35 may also be a collection of multiple physically separate processors.

The processing unit 35 executes various commands included in the control program, thereby functioning as a recognition unit 351 and an output processing unit 352. The functions of the recognition unit 351 and the output processing unit 352 will be described later.

The half mirror unit 36 is an example of a translucent display unit that is placed in front of the user's eyes when the wearable device 3 is worn by the user. The half mirror unit 36 displays the hollow image projected from the video output unit 34. This allows the user to view the displayed hollow image superimposed on the real world in the user's line of sight.

The environmental sensor 37 has an optical lens and an image sensor. The optical lens focuses the light beam from the subject on the imaging surface of the image sensor. The image sensor is a CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor), and outputs an image of the subject imaged on the imaging surface. The environmental sensor 37 creates still image data in a specified file format from the image generated by the image sensor, and outputs it as environmental sensor data. When outputting the environmental sensor image data, the environmental sensor 37 may associate the image data with the time of acquisition. The environmental sensor 37 also passes the environmental sensor data to the processing unit 35 at specified time intervals (e.g., one second).

The depth sensor 38 is, for example, a pair of infrared sensors. The depth sensor 38 outputs an infrared image, measures distances corresponding to multiple points on the surface of the object from the output infrared image using a known active stereo method, and outputs depth data (distance data) corresponding to each of the multiple points. The depth sensor 38 passes the depth data to the processing unit 35 at predetermined time intervals (for example, one second).

Below, an example of the functions of the recognition unit 351 and the output processing unit 352 is described.

Each time the recognition unit 351 receives environmental sensor data from the environmental sensor 37 and depth data from the depth sensor 38, it estimates its own position and generates three-dimensional mesh data of the surfaces of surrounding objects using the well-known SLAM (Simultaneous Localization and Mapping) technology.

The recognition unit 351 also determines whether or not the code portion 25 is included in the image shown by the environmental sensor data from the environmental sensor 37. If the recognition unit 351 determines that the code portion 25 is included in the image, it acquires three-dimensional object data corresponding to the code portion 25 and passes it to the output processing unit 352. The recognition unit 351 also calculates the orientation (e.g., a three-dimensional unit vector) and distance of the code portion 25 relative to the wearable device 3 based on the size and shape of the code portion 25 in the image. Note that a known calculation method (e.g., JP 2016-57758 A) may be used as the process of calculating the orientation and distance of the target object based on the size and shape of a reference display object such as the code portion 25.

The output processing unit 352 calculates three-dimensional objects D1, D2, and D3, which are three-dimensional objects D1 based on the three-dimensional object data acquired from the recognition unit 351, and which are rotated and resized based on the orientation and distance of the code portion 25 acquired from the recognition unit 351. FIG. 5(a) is a schematic diagram showing an example of three-dimensional objects D1, D2, and D3. Note that FIG. 5(a) includes the code portion 25 for the purpose of explanation, but the acquired three-dimensional object data does not necessarily need to include object data corresponding to the code portion 25.

The output processing unit 352 intermittently aligns the 3D mesh data of the surface of the object corresponding to the human body model 2 output from the recognition unit 351 with the identified 3D object D1, and passes the display data (projection data) of the aerial image A1 corresponding to the 3D object D2 and the aerial image A2 corresponding to the 3D object D3 to the video output unit 34.

The user can view the real world ahead while viewing the aerial images A1 and A2 based on the display data (projection data) created in this manner on the half mirror unit 36. FIG. 5(b) is a diagram showing an example of the aerial images A1 and A2 displayed on the half mirror unit 36. Thereafter, the aerial images A1 and A2 are displayed moving and/or rotating according to the result of alignment between the 3D mesh data of the surface of the object corresponding to the human body model 2 and the identified 3D object D1, which is intermittently performed by the recognition unit 351.

The user trains to insert the epidural needle N into the human body model 2 while wearing the wearable device 3 on which the aerial images A1 and A2 are displayed. After the training is completed, the trainer removes the punctured spine model 24 from the human body model 2 after the user has inserted the epidural needle N, and obtains a CT image using a CT device. Then, using an information processing device, the trainer generates and displays an image of the result of the puncture training, which includes both an image R1 of the epidural needle N that satisfies the medically appropriate skin puncture point, puncture angle, and epidural space puncture point, and an image R2 of the epidural needle N inserted by the user.

6 is a diagram for explaining the result image of the puncture training of the epidural needle N. FIG. 6(a) is a diagram showing the top surface of the spine model 24, and the position indicating the skin puncture point is displayed. In FIG. 6(a), the position of the "x" is the position indicating the skin puncture point of the image R1, and the position of the "o" is the position indicating the skin puncture point of the image R2. FIG. 6(b) is a diagram seen from the side of the spine model 24, and the puncture angle is displayed. In FIG. 6(b), an image R1 of the epidural needle N and an image R2 of the epidural needle N are displayed. FIG. 6(c) is a diagram showing the upper surface of the epidural space portion 243, and the position indicating the epidural space puncture point is displayed. In FIG. 6(c), the position of the "x" is the position indicating the epidural space puncture point of the image R1, and the position of the "o" is the position indicating the epidural space puncture point of the image R2. In this way, it is possible to present to the user an image R1 of the epidural needle N that satisfies the medically appropriate skin puncture point, puncture angle, and epidural space puncture point, and an image R2 of the epidural needle N that has been punctured by the user.

FIG. 7 shows an example of the operational flow of the epidural anesthesia training method.

First, when the user looks at the human body model 2 through the half mirror unit 36 after putting on the wearable device 3, the aerial image A1 and/or the aerial image A2 is displayed on the half mirror unit 36 (step S101).

Next, the user performs a first training session in which the epidural needle N is inserted into the human body model 2 while wearing the wearable device 3 on which the aerial image A1 and the aerial image A2 are displayed (step S102). During the first training session, the user imagines the aerial image A1 and/or the aerial image A2 displayed by the wearable device 3.

Next, after the user has inserted the epidural needle N for the first time, the trainer removes the punctured spine model 24 from the human body model 2 and obtains a CT image using the CT scanner (step S103).

Next, the user performs a second training session of inserting the epidural needle N into the human body model 2 without wearing the wearable device 3 (step S104).

Next, after the user inserts the epidural needle N for the second time, the trainer removes the punctured spine model 24 from the human body model 2 and obtains a CT image using the CT device (step S105).

Then, the trainer uses an information processing device to generate and display an image of the results of the puncture training, which includes both an image R1 of the epidural needle N that satisfies the medically appropriate skin puncture point, puncture angle, and epidural space puncture point, and an image R2 of the epidural needle N inserted by the user (step S105), and the epidural anesthesia training method is completed.

As described above in detail, the epidural anesthesia support system 1 of this embodiment has a wearable device 3 that displays an aerial image A1 showing the spine at a position corresponding to the spine of the human body model 2. In this way, the epidural anesthesia support system 1 makes it possible to visualize the area to be targeted for epidural puncture, improving blind epidural puncture and making it safer and more rapid.

(Variation 1)
Note that the present invention is not limited to the present embodiment. For example, the epidural anesthesia support system 1 does not need to include the human body model 2. In this case, the wearable device 3 projects an aerial image A1 onto the half mirror unit 36 so that, instead of the human body model 2, the aerial image A1 showing at least a part of the spine of a human body such as a patient is displayed at a position corresponding to at least a part of the spine of the human body.

For example, the trainer uses a CT device (not shown) to obtain a CT image of the human body (patient). Next, the trainer uses an information processing device (not shown) such as a PC capable of executing a three-dimensional object data generation application program to generate, from the CT image of the human body, three-dimensional object data of a three-dimensional object D1 showing at least a part of the shape of the surface of the human body (e.g., the torso (back, waist, and buttocks) etc.) and three-dimensional object data of a three-dimensional object D2 showing the shape of at least a part of the spine of the human body. In this case, the trainer manually generates three-dimensional object data of a three-dimensional object D3. The storage unit 32 stores the three-dimensional object data of the three-dimensional object D1, the three-dimensional object data of the three-dimensional object D2, and the three-dimensional object data of the three-dimensional object D3 obtained from the information processing device.

The storage unit 32 stores the shape of the three-dimensional object D1 and the code portion 25 displayed on a sheet member placed on the back of the human body in association with each other. In a case where the sheet member on which the code portion 25 is displayed is not provided on the human body, the storage unit 32 stores the shape of the three-dimensional object D1 and the position of at least some characteristic parts of the vertebrae of the human body in association with each other. The three-dimensional object data of the three-dimensional object D1 is an example of first three-dimensional object data, and the three-dimensional object data of the three-dimensional object D2 is an example of second three-dimensional object data. In addition, at least some characteristic parts of the vertebrae of the human body associated with the shape of the three-dimensional object D1 are, for example, the seventh cervical vertebra (vertebral eminence) and the anterior superior iliac spine.

When the sheet member on which the code portion 25 is displayed is placed on the human body, the recognition unit 351 calculates the orientation (e.g., a three-dimensional unit vector, etc.) and distance of the code portion 25 relative to the wearable device 3 using a known calculation method based on the size and shape of the code portion 25 in the image shown by the environmental sensor data from the environmental sensor 37. The output processing unit 352 then calculates three-dimensional objects D1, D2, and D3, which are three-dimensional objects D1 based on the three-dimensional object data acquired from the recognition unit 351 and have been rotated and resized based on the orientation and distance of the code portion 25 acquired from the recognition unit 351.

When a sheet member on which the code portion 25 is displayed is not placed on the human body, the recognition unit 351 recognizes the position of at least some of the characteristic parts of the vertebrae of the human body, and identifies the human body based on the relative position of the characteristic parts and the shape of the surface of the torso of the human body. For example, the recognition unit 351 determines whether or not at least some of the characteristic parts of the vertebrae of the human body are included in the image shown by the environmental sensor data from the environmental sensor 37. The environmental sensor 37 is an example of an image acquisition unit. When the recognition unit 351 determines that at least some of the characteristic parts of the vertebrae of the human body are included in the image, it acquires a three-dimensional object D1 associated with the position of the characteristic parts and passes it to the output processing unit 352. In addition, the recognition unit 351 calculates the orientation (e.g., a three-dimensional unit vector, etc.) and distance of the characteristic parts relative to the wearable device 3 based on the position of at least some of the characteristic parts of the vertebrae in the image using a known calculation method. The output processing unit 352 calculates three-dimensional object D1, three-dimensional object D2, and three-dimensional object D3, which are three-dimensional object D1 based on the three-dimensional object data acquired from the recognition unit 351, and which have been rotated and resized based on the orientation and distance of the characteristic points acquired from the recognition unit 351.

Then, the output processing unit 352 intermittently performs alignment between the three-dimensional mesh data of the surface of the object corresponding to the human body model 2 output from the recognition unit 351 and the three-dimensional object D1, while passing the display data (projection data) of the aerial image A1 corresponding to the three-dimensional object D2 and/or the aerial image A2 corresponding to the three-dimensional object D3 to the video output unit 34. In this way, the epidural anesthesia support system 1 and the wearable device 3 can superimpose the aerial image A1 and/or the aerial image A2 corresponding to the spine of the human body on the human body, encouraging the user to understand the shape of the spine of the human body and allowing the user to imagine the aerial image A1 and/or the aerial image A2 displayed by the wearable device 3. After imagining the aerial image A1 and/or the aerial image A2, the user can remove the wearable device 3 and perform epidural anesthesia as usual.

Furthermore, in the first modification, when the human body (patient) performs an action that deforms the surface of the lumbar region (such as "twisting the waist" or "bending the waist"), the three-dimensional object D2 of the corresponding spine may be deformed in accordance with the change in the lumbar surface of the human body. For example, multiple points of the three-dimensional object D2 may be associated with the position of the three-dimensional object D1 immediately adjacent to each point, and the output processing unit 352 may deform the three-dimensional object D1 in synchronization with the deformation of the lumbar region of the human body, and move the multiple corresponding points of the three-dimensional object D2 to follow the deformation of the three-dimensional object D1, thereby deforming the aerial image A1 corresponding to the spine.

(Variation 2)
In step S104 of the epidural anesthesia training method shown in Figure 7, the user may perform a second training session of inserting the epidural needle N into the human body model 2 while wearing the wearable device 3 displaying the aerial images A1 and A2.

Reference Signs List 1 Epidural anesthesia support system 2 Human body model 21 Main body 22 Skin 23 Storage section 24 Spinal model 241 Spinous process section 242 Transparent section 243 Epidural space section 25 Cord section 3 Wearable device 31 Communication I/F
32 Memory unit 33 Sensor acquisition unit 34 Video output unit 35 Processing unit 351 Recognition unit 352 Output processing unit 36 Half mirror unit 37 Environmental sensor 38 Depth sensor N Epidural needle

Claims

1. An epidural anesthesia support system for supporting epidural anesthesia, comprising:
A human body model imitating at least a part of a human body that is a training subject for epidural anesthesia;
A transmissive display unit disposed in front of a user's eyes;
an output processing unit that outputs the first aerial image to the transmissive display unit so that, when the user views the human body model through the transmissive display unit, the first aerial image showing at least a part of a spine is displayed at a corresponding position on the human body model; and
An epidural anesthesia support system comprising:
the human body model has a spine model that imitates at least a part of the spine,
The epidural anesthesia support system according to claim 1 , wherein the output processing unit outputs the first aerial image based on three-dimensional object data generated from a CT image of the spine model acquired by a CT device.
The epidural anesthesia support system according to claim 1, wherein the output processing unit outputs the second aerial image to the transparent display unit so that, when the user views the human body model through the transparent display unit, the second aerial image showing at least one of the skin puncture point of the epidural needle used in the epidural anesthesia, the puncture angle of the epidural needle, and the epidural space puncture point of the epidural needle is displayed at a corresponding position on the human body model.
the human body model has a spine model that imitates at least a part of the spine,
the output processing unit outputs the first aerial image and the second aerial image based on three-dimensional object data generated from a CT image of the spine model into which the epidural needle is inserted, the CT image being acquired by a CT device;
The epidural anesthesia support system of claim 3 , wherein the epidural needle is inserted into the spinal model to satisfy medically appropriate skin puncture points, puncture angles, and epidural space puncture points.
1. An epidural anesthesia support system for supporting epidural anesthesia, comprising:
A transmissive display unit disposed in front of a user's eyes;
an output processing unit that outputs the aerial image to the transmissive display unit so that, when the user views a human body through the transmissive display unit, an aerial image showing at least a part of a spine of the human body is displayed at a corresponding position of the human body;
An epidural anesthesia support system comprising:
the goggle-type display device allows the user wearing the goggle to visualize the aerial image;
The epidural anesthesia support system according to claim 5 , wherein the user removes the goggle-type display device after imaging the aerial image and performs epidural anesthesia as usual.
An epidural anesthesia training method for training epidural anesthesia using the epidural anesthesia support system according to any one of claims 1 to 4, comprising:
displaying the first aerial image on the goggle-type display device so that the user wearing the goggle-type display device can insert an epidural needle used for epidural anesthesia into the human body model;
Epidural anesthesia training method including:
a step in which the user wears the goggle-type display device to image the first aerial image, and then removes the goggle-type display device and inserts the epidural needle into the human body model;
8. The epidural anesthesia training method of claim 7, further comprising:
5. An epidural anesthesia training method for training epidural anesthesia using the epidural anesthesia support system according to claim 2 or 4, comprising:
displaying the first aerial image on the goggle-type display device so that the user wearing the goggle-type display device can insert an epidural needle into the spine model attached to the human body model;
acquiring a CT image of the spine model into which the epidural needle is inserted by the user;
displaying a skin puncture point, a puncture angle, and an epidural space puncture point of the epidural needle in the spinal model where the epidural needle has been punctured by the user;
Epidural anesthesia training method including:
a step in which the user wears the goggle-type display device to image the first aerial image, and then removes the goggle-type display device and inserts the epidural needle into the human body model;
10. The epidural anesthesia training method of claim 9, further comprising:
A method for controlling a display device including an image acquisition unit, a storage unit, and a transmissive display unit, comprising:
The display device,
storing in the storage unit first three-dimensional object data representing at least a portion of a shape of a surface of a specific human body and second three-dimensional object data representing at least a portion of a spine of the specific human body;
displaying, on the transmissive display unit, an aerial image showing at least a part of a spine of the specific human body based on the second three-dimensional object data, based on the image of the specific human body acquired by the image acquisition unit and the first three-dimensional object data;
A control method comprising: