WO2024104926A1 - Système, procédé et programme informatique de commande médicale - Google Patents
Système, procédé et programme informatique de commande médicale Download PDFInfo
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- WO2024104926A1 WO2024104926A1 PCT/EP2023/081519 EP2023081519W WO2024104926A1 WO 2024104926 A1 WO2024104926 A1 WO 2024104926A1 EP 2023081519 W EP2023081519 W EP 2023081519W WO 2024104926 A1 WO2024104926 A1 WO 2024104926A1
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- Prior art keywords
- medical
- image capture
- capture device
- extraction
- medical image
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Classifications
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
- A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
- A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
- A61B1/000096—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope using artificial intelligence
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H30/00—ICT specially adapted for the handling or processing of medical images
- G16H30/20—ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
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- G—PHYSICS
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- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H30/00—ICT specially adapted for the handling or processing of medical images
- G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
Definitions
- the present invention relates to a medical control system, method and computer program.
- a medical system is often very complex, containing a number of different devices and pieces of equipment.
- the type of medical system and the different types of devices and pieces of equipment which are contained within that system may vary depending on how the medical system is going to be used.
- the configuration of the medical system may vary in accordance with a type of surgical operation which is going to be performed.
- Figure 1 illustrates an example apparatus which can be used in accordance with embodiments of the disclosure
- Figure 2 is a block diagram illustrating an example of a schematic configuration of an endoscopic surgery system to which embodiments of the disclosure can be applied;
- Figure 3A illustrates an example configuration of a medical facility to which embodiments of the disclosure can be applied
- Figure 3B illustrates a sequence of laparoscopic surgery
- FIG. 4 illustrates an example medical control system in accordance with embodiments of the disclosure
- Figure 5 illustrates an example image from a medical image capture device in accordance with embodiments of the disclosure
- Figure 6A illustrates an example image from a medical image capture device in accordance with embodiments of the disclosure
- FIG. 6B illustrates an example colour spectrum in accordance with embodiments of the disclosure
- Figure 7 illustrates a medical control sequence in accordance with embodiments of the disclosure
- Figure 8 illustrates a medical control sequence in accordance with embodiments of the disclosure
- Figure 9 illustrates an example implementation of a medical control system in accordance with embodiments of the disclosure.
- Figure 10 illustrates a method for a medical control system in accordance with embodiments of the disclosure.
- an apparatus 1000 (an example of an information processing apparatus) according to embodiments of the disclosure is shown.
- an apparatus 1000 is a computer device such as a personal computer, an entertainment system or a terminal connected to a server.
- the apparatus may also be a server.
- the apparatus 1000 is controlled using a microprocessor or other processing circuitry 1002.
- the apparatus 1000 may be a portable computing device such as a mobile phone, laptop computer or tablet computing device.
- the processing circuitry 1002 may be a microprocessor carrying out computer instructions or may be an Application Specific Integrated Circuit.
- the computer instructions are stored on storage medium 1004 which maybe a magnetically readable medium, optically readable medium or solid state type circuitry.
- the storage medium 1004 may be integrated into the apparatus 1000 or may be separate to the apparatus 1000 and connected thereto using either a wired or wireless connection.
- the computer instructions may be embodied as computer software that contains computer readable code which, when loaded onto the processor circuitry 1002, configures the processor circuitry 1002 to perform a method according to embodiments of the disclosure.
- an optional user input device 1006 is shown connected to the processing circuitry 1002.
- the user input device 1006 may be a touch screen or may be a mouse or stylist type input device.
- the user input device 1006 may also be a keyboard, controller, or any combination of these devices.
- the input device 1006 may be an audio input device such as microphone or the like which can receive audio instructions (sounds, speech or the like) which are provided by the user.
- a network connection 1008 may optionally be coupled to the processor circuitry 1002.
- the network connection 1008 may be a connection to a Local Area Network or a Wide Area Network such as the Internet or a Virtual Private Network or the like.
- the network connection 1008 may be connected to a server allowing the processor circuitry 1002 to communicate with another apparatus in order to obtain or provide relevant data.
- the network connection 1008 may be behind a firewall or some other form of network security.
- a display device 1010 shown coupled to the processing circuitry 1002, is a display device 1010.
- the display device 1010 although shown integrated into the apparatus 1000, may additionally be separate to the apparatus 1000 and may be a monitor or some kind of device allowing the user to visualise the operation of the system (e.g. a display screen or a head mounted display).
- the display device 1010 may be a printer, projector or some other device allowing relevant information generated by the apparatus 1000 to be viewed by the user or by a third party.
- FIG. 2 a block diagram illustrating an example of a schematic configuration of an endoscopic surgery system 5000 to which the technology according to the present disclosure can be applied is shown.
- Figure 2 illustrates a state where an operator (doctor) 5067 is conducting surgery to a patient 5071 on a patient bed 5069 using the endoscopic surgery system 5000.
- the endoscopic surgery system 5000 is constituted by an endoscope 5001, other surgical tools 5017, and a support arm device 5027 supporting the endoscope 5001, and a cart 5037 on which various devices for endoscopic surgery are mounted.
- the abdominal wall is punctured with a plurality of tubular hole-opening instruments called trocars 5025a to 5025d instead of cutting the abdominal wall to open the abdomen.
- a lens barrel 5003 of the endoscope 5001 and the other surgical tools 5017 are inserted into a body cavity of the patient 5071 through the trocars 5025a to 5025d.
- the other surgical tools 5017 an insufflation tube 5019, an energy treatment tool 5021, and forceps 5023 are inserted into the body cavity of the patient 5071.
- the energy treatment tool 5021 is a treatment tool that performs incision and peeling of a tissue, sealing of a blood vessel, or the like using high-frequency current or ultrasonic vibration.
- the illustrated surgical tool 5017 is merely an example, and various surgical tools generally used in endoscopic surgery, for example, tweezers, a retractor, and the like may be used as the surgical tool 5017.
- An image of an operation site in the body cavity of the patient 5071 captured by the endoscope 5001 is displayed on a display device 5041.
- the operator 5067 performs treatment, for example, to excise an affected site using the energy treatment tool 5021 or the forceps 5023 while viewing the image of the operation site displayed by the display device 5041 in real time.
- the insufflation tube 5019, the energy treatment tool 5021, and the forceps 5023 are supported by the operator 5067, an assistant, or the like during surgery although not illustrated.
- Figure 3A of the present disclosure illustrates an example configuration of a medical facility to which embodiments of the disclosure can be applied.
- the example medical facility illustrated in Figure 3A of the present disclosure shows a network system as may be used in a hospital. However, a similar network system may be used in other medical facilities.
- the hospital illustrated in Figure 3A comprises a number of different regions. Each of these regions is connected over a network such as the internet. Furthermore, each region may have its own network, local to that region.
- the hospital includes a server room, an office, an intensive care unit and an operating room.
- the number and type of regions are not particularly limited to this example.
- a hospital may include a number of different operating rooms (while only a single operating room is shown in this example).
- each of these different regions is connected to a network such as the internet.
- a network such as the internet.
- This enables an apparatus in a first region (such the operating room) to connect with an apparatus in a different region (such as the office).
- Data can then be transferred over the network between these different regions.
- a firewall or the like may be present between the different regions of the hospital in order to further improve security when data is transferred between the regions.
- each region may have its own network.
- the operating room in this example has its own network- the operating room (OR) network.
- the devices within the operating room can communicate with each other over this local network. Accordingly, the devices within the operating room do not need to communicate with each other over the internet.
- the devices within the operating room form an example of a medical system in accordance with embodiments of the disclosure.
- the configuration of devices inside the operating room will depend, at least in part, on the type of surgical operation which is to be performed in the operating room.
- the devices include an endoscope, a display, a microphone and speaker, a surgical light and a printer.
- the endoscope is used by a surgeon in order to capture images from inside a patient.
- the endoscope may be an endoscopic surgery system 5000 as described with reference to Figure 2 of the present disclosure.
- Images captured by the endoscope are passed to an IPC encoder.
- the IPC encoder encodes the images which have been captured by the endoscope such that they can be delivered over an IP network (such as the OR network in the operating room of this example).
- An IPC decoder may then receive the images which have been capture by the endoscope over the IP network and decode those images such that they can be displayed to the surgeon (or other person located in the operating room) on a display device.
- the images required to be displayed on the display may vary depending on the type or surgery being performed and the stage of the surgical procedure. For example, a person may have to control the display in order to change the type of images which are shown on the display depending on the stage of the surgical procedure.
- the operating room may also include one or more cameras such as IP camera in addition to the endoscope which is used by the surgeon. These IP cameras may be configured to capture an image or series of images or a specific location within the operating room.
- a number of different devices may also be included within the operating room to enable a person (such as the surgeon) to provide input and to control the medical system.
- the microphone and speaker can be used in order that a person can provide voice instructions to the system.
- a touch panel can be used in order that a person can provide touch input to control the medical system.
- a surgical light may also be included in the operating room.
- the surgical light provides light within the operating room which enables the surgeon to see the patient.
- the type of light which is required may vary depending both on the type of surgery being performed and the stage of the surgical procedure. For example, the brightness of the surgical light may have to be changed during the surgical procedure. This will be explained in more detail with reference to Figure 3B of the present disclosure.
- the operating room may also include one or more patient monitoring devices. These patient monitoring devices may be connected to the local network in the operating room (i.e. the OR network).
- the patient monitoring devices can include any device which monitors the patient and provides information on a vital sign of the patient (including body temperature, pulse rate, blood pressure, respiration rate or the like). These patient monitoring devices may have their own display. Alternatively, information from the patient monitoring device may be provided to one or more other devices within the operating room over the OR network.
- a printer can be used by a person located in the operating room to print information which has been acquired during the surgical procedure.
- the printer may be configured to print information which has been acquired from a patient monitoring device.
- the number of devices in a medical system can be large. Indeed, the number of devices in a medical system is not limited to those described with reference to the example medical system of the operating room of Figure 3A of the present disclosure. Many more devices and many more different types of devices may be present in the medical system.
- Figure 3B of the present disclosure illustrates a sequence of laparoscope surgery.
- the sequence of laparoscope surgery illustrated in Figure 3B of the present disclosure may be performed by a surgeon in an operating room such as that described with reference to Figure 3A of the present disclosure.
- the instruments for the surgical procedure are prepared. This may be performed by a medical assistant, nurse or technician before the patient and the surgeon have arrived.
- the type of preparation which is performed before the surgical procedure may depend on the type of surgical procedure which is to be performed. However, in this example situation, the preparation may include setting up at least one of the laparoscope and a suction device prior to the arrival of the patient and the surgeon.
- the patient enters the operating room and is positioned ready for the laparoscopic surgery to be performed.
- the patient may be positioned on a patient bed 5069 as described with reference to Figure 2 of the present disclosure.
- the pneumoperitoneum of the patient is set. This includes insufflation of a gas such as carbon dioxide into the peritoneal cavity of the patient, producing a pneumoperitoneum.
- the generation of a pneumoperitoneum has several advantageous benefits when laparoscopic surgery is performed.
- the pneumoperitoneum ensures adequate visualization and operative manipulation during the laparoscopic surgery.
- a camera can be inserted into the patient in step 4.
- the camera may be inserted using a direct trocar (where the trocar is first inserted followed by insertion of the camera) or using an optical trocar (where the trocar includes the camera).
- Inserting the camera into the patient enables images from within the patient to be captured. These images can then be displayed on a display device to the surgeon. Furthermore, in some examples, the images which are received from the camera may be recorded (e.g. in the form of a video recording or the like). Recording the images enables the images to be reviewed after the surgical procedure has been completed. A review of the images from the surgical procedure may be performed for training or quality purposes, for example. Thus, at step 4, the surgeon may also operate a control device in order to perform control to start recording the images.
- the camera may be necessary to change the configuration of one or more external devices (i.e. devices external to the medical image capture device). For example, once the camera has been inserted into the patient, it may be necessary to turn off the room lights or surgical lights in order that the surgeon can more easily see the display screen.
- external devices i.e. devices external to the medical image capture device.
- the surgeon - or other medical person located in the operating room - must control one or more external devices in the medical system such that these devices have the optimal configuration for the surgical procedure.
- the surgeon may then insert one or more further trocars into the patient.
- the trocar is a device which is inserted into the patient through the abdomen during laparoscopic surgery and enables other instruments to be inserted into the patient (including, for example, graspers or the like). The surgeon can therefore perform the laparoscopic surgery using tools which have been inserted into the patient through the trocar. The surgery is performed in step 7.
- the surgeon may need to perform a certain observation of the surgical site.
- the surgical procedure is a laparoscopic surgical procedure to remove a tumor
- the surgeon may wish to perform an observation of the tumor which has been removed.
- step 8 the pneumoperitoneum of the patient is reset.
- step 9 the camera is ejected from the patient.
- step 10 the tumor is extracted from the patient.
- the surgeon may then require that the configuration of one or more external devices is changed. For example, the surgeon may require that the room lights of the operating room are turned on in order that the surgeon can observe the tumor which has been removed from the patient. Therefore, the surgeon (or other person located in the operating room) may have to perform control operations in order to reconfigure the lights in the room. Having observed the tumor, the surgeon may decide that the tumor has been removed from the patient in its entirety. Alternatively, the surgeon may device that further observation of the surgical site inside the patient is required in order to ensure that the tumor has been fully removed from the patient. Moreover, even if the tumor has been fully removed, the surgeon may still require further observations to be made inside the patient and/or may need to perform certain cleaning operations to close the surgical procedure.
- step 13 the pneumoperitoneum of the patient is set.
- step 14 the camera (a type of medical image capture device) is then inserted into the patient in order that images from inside the patient can be acquired and displayed to the surgeon.
- the camera a type of medical image capture device
- the camera Once the camera has been inserted into the patient, it may be necessary to change the configuration of one or more external devices (i.e. devices external to the medical image capture device). For example, once the camera has been inserted into the patient, it may be necessary to turn off the room lights or surgical lights in order that the surgeon can more easily see the display screen. Thus, the surgeon (or other person in the operating room) must again perform control operations to reconfigure the external devices.
- external devices i.e. devices external to the medical image capture device.
- the surgeon - or other medical person located in the operating room - must control one or more external devices in the medical system such that these devices have the optimal configuration for the surgical procedure.
- the surgeon can then perform final observations and cleaning of the surgical site inside the patient body in step 16.
- step 17 the surgeon may then eject the trocars which have been inserted into the patient (having removed the instruments which have been used during the surgical procedure).
- the pneumoperitoneum of the patient can then be reset in step 18.
- step 19 the surgeon can eject the camera from the patient and perform control operations to stop the recording of the images.
- the surgeon will no longer need to see the images from the camera on the display screen. Accordingly, the surgeon can turn the lights in the operating room on in step 20.
- step 21 The surgery then ends in step 21 and the patient leaves the operating room.
- a surgeon may need to control the lights within the operating room a number of times during the surgical procedure. Indeed, the surgeon (or other person controlling the medical system) may need to control a number of different types of devices external to the medical image capture device during the surgical procedure.
- the type of external device is not particularly limited to a light as has been described with reference to Figure 3B of the present disclosure.
- the external device may also include a display device (with the display changing depending on the stage of the surgical procedure) or patient monitoring device (with different patient monitoring settings being required depending on the stage of the surgical procedure).
- a person such as the surgeon
- the complexity of controlling the medical system during the surgical procedure can increase depending on the type of the surgical procedure being performed.
- the complexity of controlling the medical system during the surgical procedure also increases with the size of the medical system and with the number of devices included within the medical system.
- FIG. 4 illustrates an example medical control system in accordance with embodiments of the disclosure.
- the medical control system 4000 illustrated in Figure 4 of the present disclosure comprises a receiving unit 4002, an analysis unit 4004 and a control unit 4006.
- the receiving unit 4002 is configured to receive image data from a medical image capture device, the medical image capture device for insertion into and/or for extraction from a patient.
- the analysis unit 4004 is configured to analyse the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- control unit 4006 of the medical control system is configured to control at least one auxiliary device external to the medical image capture device when insertion or extraction of the medical image capture device is identified.
- the medical control system 4000 of the present disclosure a more efficient way of controlling complex medical systems can be achieved.
- the medical control system is able to control at least one auxiliary device external to the medical image capture device (also referred to as an external device) when a certain event (such as insertion or extraction of the medical image capture device) has been determined.
- a certain event such as insertion or extraction of the medical image capture device
- the analysis unit and the control unit may, more generally, be implemented as circuitry of the medical control system (e.g. as processing circuitry 1002 of apparatus 1000 as described with reference to Figure 1 of the present disclosure, for example).
- the different units or processing circuitry of the medical control system may be provided in a single apparatus or device. Alternatively, different units or processing circuitry of the medical control system may be distributed over a number of different apparatuses or devices. The present disclosure is not particularly limited in this regard.
- the medical control system 4000 may further include the medical image capture device 4008 and/or at least one auxiliary device 4010 external to the medical image capture device (such as the patient monitoring device described with reference to Figure 3A of the present disclosure, a surgical light, a display device or the like).
- the present disclosure is not particularly limited in this respect.
- the apparatus 4000 comprises a receiving unit 4002 configured to receive image data from a medical image capture device, the medical image capture device for insertion into and/or for extraction from a patient.
- the surgical procedure is an endoscopic surgical procedure. That is, the surgeon is going to use an endoscope to obtain images from inside a patient.
- the endoscope may be an endoscopic surgical system 5000 as described with reference to Figure 2 of the present disclosure.
- the endoscope therefore forms a medical image capture device for insertion into and/or for extraction from a patient in accordance with the present disclosure.
- the medical image capture device for insertion into the patient may also include at least one of an arthroscope, cystoscope, hysteroscope, lasparoscope, laryngoscope, resctoscope, sinuscope, uteroscope and/or colonoscope.
- the type of medical image capture device will vary depending on the type of surgical procedure or operation which is being performed in the operating room.
- the receiving unit 4002 of the medical control system is configured to receive image data from the medical image capture device.
- the receiving unit may be configured as a network connection 1008 as described with reference to apparatus 1000 and Figure 1 of the present disclosure.
- the receiving unit 4002 may receive image data from the medical image capture device over an IP network such as the OR network which has been described with reference to Figure 3A of the present disclosure.
- IP network such as the OR network which has been described with reference to Figure 3A of the present disclosure.
- any suitable wired or wireless communication can be used in order for the receiving unit to receive image data form the medical control system.
- the receiving unit 4002 of the present disclosure may be configured to receive the image data from the medical image capture device in a substantially real time environment. This enables the medical control system to control the medical system in substantially real time in accordance with the images which have been received from the medical image capture device, thus improving the ability of the medical control system to respond to changes in the surgical environment.
- the image data which is received by receiving unit 4002 of medical control system 4000 may be still image data.
- the image data may be a series of image frames such as a video sequence.
- the present disclosure is not particularly limited in this regard.
- the resolution of the image data which is received by receiving unit 4002 may vary depending on the type of medical image capture device which is used.
- the image data can have high resolution including 4K or 8K resolution, for example.
- the image data may also comprise a number of different colour channels (such as Red, Green and Blue colour channels, for example).
- different colour channels such as Red, Green and Blue colour channels, for example.
- the image data can be passed to the analysis unit 4004 of medical control system 4000 for further analysis.
- the receiving unit 4002 may be configured to store the image data in a storage device prior to that image data being accessed by the analysis unit 4004.
- the receiving unit 4002 of the medical control system 4000 may be configured to pass the image data received form the medical image capture device directly to the analysis unit 4004 for further analysis.
- the image data which has been received can be passed also to a server (in addition to the analysis unit 4002 of medical control system 4000) for storage and subsequent analysis.
- the receiving unit 4002 may, optionally, further be configured to receive additional data from an additional data source.
- the additional data is any data received from a data source in addition to the image data from the medical image capture device.
- This additional data (which includes auxiliary data or external signals) can be used in order to further improve the accuracy and reliability of the analysis performed by the analysis unit 4004 of the medical control system when identifying insertion and/or extraction of the medical image capture device. This will be described in more detail below.
- the additional data may include at least one of: data relating to a vital sign of the patient, data relating to the pneumoperitoneum of the patient, data relating to a stage of an operation and/or data relating to a previous insertion or extraction of the medical image capture device.
- This additional data may be received from an additional device present in the medical system 4000 such as a patient monitoring device as described with reference to Figure 3A of the present disclosure. Therefore, this additional data may be received by the receiving unit 4002 over an IP network such as the OR network as described with reference to Figure 3A of the present disclosure. More generally, however, any suitable wired or wireless communication can be used by the receiving unit 4002 of the medical control system 4000 to receive the additional data.
- the image data can be analysed by the analysis unit 4004 of the medical control system 4000.
- the medical control system 4000 further comprises an analysis unit 4002 configured to analyse the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- the image data which has been received is the image data received by the receiving unit 4002 of the medical control system 4000 from the medical image capture device.
- a surgeon who is performing surgery on a patient must perform a number of operations to control external devices or auxiliary devices (such as display devices, surgical lights, room lights or the like) during the surgical operation. This increases the complexity of operation of the medical system and can make it difficult for the surgeon to focus on performing the surgery.
- This problem is particularly acute for surgical operations performed inside the patient where the surgeon receives images from inside the patient via a medical imaging device (such as a laparoscope). This is because the surgeon relies on images received from the medical imaging device in order to be able to perform the surgery. Accordingly, a particular configuration of external devices (being devices other than the imaging device) within the operating room may be required when the surgeon is performing a surgical operation inside the patient using a medical imaging device which has been inserted into the patient.
- a medical imaging device such as a laparoscope
- the analysis unit 4002 of the medical control system 4000 is configured to analyse the images which have been received in order to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- the medical control system 4000 can then perform control of the external devices in accordance with this analysis (described in more detail below).
- a patient may be located on a patient bed (such as patient bed 5069 described with reference to Figure 2 of the present disclosure). Furthermore, in this example, the pneumoperitoneum of the patient has been set and the surgeon is going to insert a laparoscope into the patient.
- the medical control system 4000 is configured to receive images from the laparoscope and analyse those images in order to identify at least one of insertion of the laparoscope into the patient or extraction of the laparoscope from the patient. That is, the inventors have realised that the images received from a medical imaging device (such as a laparoscope) during insertion or extraction of the medical imaging device from the patient are distinctive. This means that analysis of the images can be used for automatically identifying when the medical imaging device has been inserted into the patient and/or when the medical imaging device has been extracted from the patient. Thus, analysis of the images can be used by the medical control system 4000 to control the medical system (with insertion or extraction of the medical image device being a trigger for execution control commands).
- a medical imaging device such as a laparoscope
- Figure 5 illustrates an example image from a medical image capture device (medical imaging device) in accordance with embodiments of the disclosure.
- the medical imaging device is a laparoscope. Therefore, the images are images received by the medical control system 4000 from a laparoscope during surgery.
- a direct trocar is used.
- a direct trocar does not include a camera. Instead, the camera (such as the laparoscope) can be inserted once the direct trocar has been inserted.
- the present disclosure is not particularly limited in this regard to the use of a direct trocar.
- an optical trocar can also be used. The optical trocar includes the camera such that the trocar and the camera are inserted at the same time.
- the direct trocar is first inserted into the patient. This is then followed by insertion of the camera into the patient.
- concentric circles are observed in the images received from the image capture device as the camera is inserted into the patient (through the trocar).
- These concentric circles 50 can be seen in the top panel of Figure 5 as the image capture device is inserted into the patient through the trocar.
- concentric circles 52 can also be observed once the medical image capture device has passed through the trocar and is inside the patient. These can be seen in the bottom panel of Figure 5 of the present disclosure.
- the images received from the medical image capture device as it is inserted into the patient through the direct trocar are distinctive and can be used in order to identify insertion of the medical image capture device into the patient.
- Figure 6A illustrates an example image from a medical image capture device (medical imaging device) in accordance with embodiments of the disclosure.
- an optical trocar is used (being a trocar including a medical image capture device (such as a camera)).
- the images received from the medical image capture device when it is inserted using an optical trocar differ from the images received when the medical image capture device is inserted using a direct trocar. Nevertheless, the images received from the medical image capture device as it is inserted into the patient using the optical trocar are also distinctive and can be used in order to identify insertion of the medical image capture device into the patient.
- concentric circles are also observed when the images are received using a medical image capture device inserted with an optical trocar (see concentric circles 60 and 62 in the top and bottom panels of Figure 6A respectively). The presence of these concentric circles can therefore be used in order to identify insertion or extraction of the medical imaging device.
- the characteristics of the images which are received may vary depending on the layer of the body. Therefore, layer information can be used in some examples to further improve the analysis of the images when identifying insertion and/or extraction of the medical image capture device.
- the top panel of Figure 6A relates to insertion of the medical image capture device through the Rectus Fascia and Muscle.
- the bottom panel of Figure 6A relates to insertion of the medical image capture device through the Peritoneum.
- images received from the medical image capture device as it is inserted into the patient through the optical trocar are distinctive and can be used in order to identify insertion of the medical image capture device into the patient.
- the type of analysis performed by the analysis unit 4004 of the medical control system 4000 on the images received by the receiving unit 4002 from the medical image capture device is not particularly limited in accordance with embodiments of the disclosure. That is, a different type of analysis can be performed by the analysis unit 4004 of the medical control system 4000 depending on the situation to which the embodiments of the disclosure are applied.
- the analysis unit 4004 of medical control system 4000 may be configured to use at least one of: a trained model (such as a machine learning model or deep learning model) and/or colour analysis of the image data to identify insertion and/or extraction of the medical image capture device.
- a trained model such as a machine learning model or deep learning model
- colour analysis of the image data to identify insertion and/or extraction of the medical image capture device.
- a trained model can be trained on a series of images from previous surgeries showing insertion and/or extraction of the medical image capture device into the patient.
- the trained model can also be trained on simulated data showing insertion and/or extraction of the medical imaging device into the patient.
- Distinctive features within the image data (such as the presence of the concentric circles described with reference to Figures 5 and 6 of the present disclosure) will be used by the trained model to identify insertion and/or extraction of the medical image capture device.
- Use of distinctive features such as the concentric circles improves the accuracy of identification of insertion and/or extraction of the medical image capture device during surgery.
- the trained model can then be used on images received from the medical image capture device during surgery in order to identify insertion and/or extraction of the medical image capture device.
- the accuracy and efficiency of the trained model in identification of insertion and/or extraction of the medical image capture device can be improved.
- the training of the trained model can be either supervised or unsupervised.
- the training data can be labelled in order that the model is trained on a known input (the images from previous surgeries) and a known output (whether the images relate to an insertion and/or extraction of the medical image capture device).
- the model can be trained to identify insertion and/or extraction of the medical image capture device on previously unseen input on this basis.
- the data are not labelled.
- the model analyses the unlabelled data sets (images from previous surgeries) to cluster the images and discover hidden patterns within the data.
- the trained model will be able to identify insertion and/or extraction of the medical image capture device in previously unseen images during surgery.
- the analysis unit 4004 of medical control system 4000 can be configured to perform colour analysis of the image data to identify insertion and/or extraction of the medical image capture device.
- the colour analysis can be used as an alternative to or in addition with the use of the trained model.
- the image received as the medical image capture device passes through the trocar has a particular colour (silver in this example - shown in the top panel of Figure 5). Then, once the image capture device has passed through the trocar, the colour changes as the medical image capture device is inserted into the patient (red in this example - shown in the bottom panel of Figure 5). Accordingly, analysis of the colour of the images received from the medical image capture device can be used in order to identify insertion and/or extraction of the medical image capture device during surgery.
- an analysis of the colour spectrum of the image data received from the medical image capture device over time can be used in order to identify insertion and/or extraction of the medical image capture device.
- analysis unit 4004 of the medical control system 4000 can separately analyse different colour channels of the image data received from the image capture device (e.g. Red, Green and Blue channels) over time in order to identify insertion and/or extraction of the medical image capture device.
- Each of the different columns in the graph represents a different colour channel of a video recorded as an endoscope is inserted into and extracted from the patient.
- the horizontal axis represents time (with each instance of time relating to a specific video frame from the video).
- the variation in the colour spectrum can be used in order to detect insertion and/or extraction of the imaging device.
- the colour analysis can be used in order to verify identification of insertion or extraction of the image capture device (and thus reduce false positive detections).
- the analysis unit 4004 of apparatus 4000 is configured to analyse the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- the analysis unit 4004 can be configured to identify insertion and/or extraction of any type of medical image capture device into the patient, including at least one of an arthroscope, cystoscope, hysteroscope, laryngoscope, resctoscope, sinuscope, uteroscope and/or colonoscope.
- the type of medical image capture device will vary depending on the type of surgical procedure or operation which is being performed in the operating room. Each type of medical image capture device will have its own distinctive characteristics (such as the pattern of concentric circles and/or colour spectrum) which can be used by the analysis unit 4004 to identify insertion and/or extraction of the medical image capture device.
- the analysis unit 4004 may, optionally, be further configured to analyse the image data and the additional data to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- the analysis unit can be configured to analyse additional data which has been received by the receiving unit 4002 and use this additional data during the identification of at least one of the insertion and/or extraction of the image capture device.
- the analysis unit 4004 may be configured to use a result of the analysis of the additional data from the additional data source in order to verify the insertion or extraction of the medical image capture device which has been identified based on an analysis of the image data. Verification of the insertion or extraction of the medical image capture device in this manner can further improve the accuracy of identification and further suppress false positive identification of insertion and/or extraction.
- the additional data includes data relating to the pneumoperitoneum of the patient.
- This additional data may be received from a patient monitoring device over an IP network, for example.
- the analysis unit 4004 can use the state of the pneumoperitoneum of the patient in order to verify whether insertion and/or extraction of the medical image capture device. As an example, if the state of the pneumoperitoneum of the patient shows that that pneumoperitoneum has not yet been set, the analysis unit 4004 can determine that an insertion of the medical image capture device (identified by analysis of the image data which has been received) is likely a false positive. This is because the medical image capture device (such as a laparoscope) will not be inserted into the patient before the pneumoperitoneum of the patient has been set.
- the medical image capture device such as a laparoscope
- the additional data includes data relating to a previous insertion and/or extraction of the medical image capture device.
- This data may be received from a storage device based on a previous identification of insertion and/or extraction which has been performed by the analysis unit 4004 of the medical image capture device.
- the analysis unit 4004 can used the data relating to a previous insertion and/or extraction of the medical image capture device in order to verify a subsequent insertion and/or extraction of the medical image capture device.
- the subsequent insertion of the medical image capture device can be flagged for further verification and/or marked as a false positive.
- the sequence of insertion and/or extraction of the medical image capture device can be used in order to verify the analysis performed by the analysis unit 4004 of apparatus 4000, with consecutive instances of insertion or consecutive instances of extraction being determined as likely relating to a false positive (since, for example, an extraction should follow insertion before a further insertion of the medical image capture device can be performed).
- insertion and extraction of the medical image capture device should occur alternatively in the image data.
- the medical control system is configured to perform a summation of the number of insertions and extractions of the camera during the period of time after inflating the pneumoperitoneum and before deflating the pneumoperitoneum. If the summation of the insertions and extractions becomes an odd number, then a false positive must have been identified.
- additional analysis can be performed on the image data in order to identify the insertion or extraction which was a false positive.
- This additional analysis can include a manual review of the image data and/or more complex image processing techniques.
- this additional analysis can include additional data from additional data sources (such as external peripherals (such as patient monitoring devices) in order to help estimate the likelihood of a false positive).
- the additional data includes data relating to a stage of the operation.
- the data relating to the stage of the operation may be received from a room camera or the like monitoring the progress of the surgical operation.
- the data relating to the stage of the operation shows that the surgeon is using a different piece of medical equipment (relating to a different stage of the surgical operation)
- an indication of insertion or extraction of the medical image capture device into the patient can be flagged for further verification and/or marked as a false positive (i.e. if it is not expected that insertion or extraction of the medical image capture device would take place at that stage during the surgical procedure). Therefore, the data relating to the stage of the surgical operation can be used in order to verify an identification of insertion or extraction of the medical image capture device.
- Additional data relating to the vital signs of the patient can also be used by the analysis unit 4004 in order to verify identification of insertion and/or extraction of the medical image capture device. For example, a trocar will not be inserted (or extracted) when the vital sign of the patient (e.g. pulse rate) is not stable. Therefore, if insertion (or extraction) of the medical image capture device is identified when the vital sign of the patient is not stable, the insertion (or extraction) can be flagged for further verification and/or marked as a false positive.
- the vital sign of the patient e.g. pulse rate
- Verification of insertion and/or extraction of the medical image capture device in this manner can thus reduce the likelihood of false positive identification of insertion or extraction. This further improves the accuracy and reliability of the system.
- the analysis unit 4004 can use additional data which has been received by the receiving unit 4002 of the medical control system in addition to the image data from the medical image capture device in order to verify identification or insertion and/or extraction of the medical image capture device from the patient.
- the medical control system further comprises a control unit 4006 configured to control at least one auxiliary device external to the medical image capture device when insertion or extraction of the medical image capture device is identified.
- the control unit 4006 of the medical control system 4000 is configured to control the auxiliary device in accordance with identification of insertion and/or extraction of the medical image capture device. This makes it easier to control a complex medical system during surgery.
- Figure 7 illustrates a medical control sequence in accordance with embodiments of the disclosure.
- the medical control sequence illustrated in Figure 7 of the present disclosure is a medical control sequence that may be performed during laparoscopic surgery performed by a surgeon in an operating room such as the operating room described with reference to Figure 3A of the present disclosure.
- the column a of Figure 7 describes control of recording of the image data.
- the column b of Figure 7 describes control of the external devices of the medical control system.
- Steps 1 to 3 are as described with reference to Figure 3B of the present disclosure. Further description of these steps at this stage is not provided for brevity of disclosure.
- a camera can be inserted into the patient in step 4.
- the camera may be inserted using a direct trocar (where the trocar is first inserted followed by insertion of the camera) or using an optical trocar (where the trocar includes the camera).
- Inserting the camera a type of medical image capture device
- the medical control system 4000 of the present disclosure receives the images from the medical image capture device and analyses these images in order to identify insertion of the medical image capture device into the patient.
- the control unit 4006 of the medical control system can then control at least one auxiliary device external to the medical image capture device when insertion of the medical image capture device is identified.
- the medical control system identifies that the camera has been inserted into the patient and the control unit 4006 turns off the room lights or surgical lights in order that the surgeon can more easily see the images from the medical image capture device displayed on a display screen.
- automatic control of external devices can be performed in accordance with the detected insertion of the medical image capture device into the patient. This makes it easier to control the medical system and enables the surgeon to focus on the surgery which is being performed.
- the images which are received from the camera may be recorded (e.g. in the form of a video recording or the like). Recording the images enables the images to be reviewed after the surgical procedure has been completed. A review of the images from the surgical procedure may be performed for training or quality purposes, for example. Accordingly, at step 4, once the medical image capture device has been inserted into the patient, the control unit 4006 of the medical control system 4000 may be configured to automatically begin recording of the images which have been received from the medical image capture device.
- a manual control of starting the recording of the images from the medical image capture device does not need to be performed. This makes it easier to control the medical system and enables the surgeon to focus on the surgery which is being performed. Moreover, as the recording is started as soon as the medical image capture device is inserted into the patient, the risk that a portion of the medical procedure will not be recoded is reduced. Furthermore, by starting the recording of the image data when the medical image capture device is inserted, recording of irrelevant data from before the medical image capture device is inserted into the patient can be suppressed.
- the surgeon may then insert one or more further trocars into the patient.
- the trocar is a device which is inserted into the patient through the abdomen during laparoscopic surgery.
- the trocar enables other instruments to be inserted into the patient (including, for example, graspers or the like). The surgeon can therefore perform the laparoscopic surgery using tools which have been inserted into the patient through the trocar.
- the surgery is performed in step 7.
- the surgeon may need to perform a certain observation of the surgical site.
- the surgical procedure is a laparoscopic surgical procedure to remove a tumor
- the surgeon may wish to perform an observation of the tumor which has been removed.
- step 8 the pneumoperitoneum of the patient is reset.
- step 9 the camera is ejected from the patient.
- the medical control system 4000 is able to identify that the medical image capture device (the camera) has been extracted from the patient by analyzing the image data received from the image capture device. Accordingly, the control unit 4006 of the medical control system 4000 is able to control the external devices in accordance with the identified extraction of the medical image capture device. For example, the control unit 4006 can control the room lights and/or surgical lights in the operating room to turn these lights back on when extraction of the camera from the patient has been identified.
- the surgeon can easily observe the tumor once extracted from the patient as an optimal configuration of the external devices in the operating room is automatically performed once the extraction of the medical image capture device has been identified.
- a manual control of starting the recording of the images from the medical image capture device does not need to be performed. This makes it easier to control the medical system and enables the surgeon to focus on the surgery which is being performed. This improves surgical outcomes.
- the surgeon may decide that the tumor has been removed from the patient in its entirety. Nevertheless, the surgeon may device that further observation of the surgical site inside the patient is required in order to ensure that the tumor has been fully removed from the patient. Moreover, even if the tumor has been fully removed, the surgeon may still require further observations to be made inside the patient and/or may need to perform certain cleaning operations to close the surgical procedure.
- step 13 the pneumoperitoneum of the patient is set.
- step 14 the camera (a type of medical image capture device) is then inserted into the patient in order that images from inside the patient can be acquired and displayed to the surgeon.
- the medical control system 4000 of the present disclosure identifies that the camera is inserted into the patient in step 14. Accordingly, the medical control system 4000 can control the external devices (being the devices in the operating room external to the camera) in order that an optimum configuration of these devices is provided for the surgeon while performing imaging with the medical imaging capture device.
- the external devices being the devices in the operating room external to the camera
- control unit 4006 of the medical control system turns the room lights and/or surgical lights off in order that the surgeon can more easily see a display device on which images from the camera are displayed.
- the surgeon can then perform final observations and cleaning of the surgical site inside the patient body in step 16.
- step 17 the surgeon may then eject the trocars which have been inserted into the patient (having removed the instruments which have been used during the surgical procedure).
- the pneumoperitoneum of the patient can then be reset in step 18.
- step 19 the surgeon may then eject (or extract) the camera from the patient.
- the medical control system 4000 may identify that an extraction of the camera has occurred and may control the external devices in the operating room accordingly.
- the control unit 4006 may turn the room lights and/or the surgical lights on.
- the medical control system may perform control to stop recording of the images from the medical image capture device.
- a final extraction of the medical image device can be detected in a number of different ways.
- a final extraction of the medical image device can be identified by comparison with a stage of the surgical procedure. For example, if it is detected that the trocars have been removed and the pneumoperitoneum of the patient has been reset, the medical control system can identify that it is the end of the surgical procedure. Therefore, it can be determined that the subsequent extraction of the medical image device is a final extraction of the medical image capture device.
- a final extraction of the medical image device can be identified based on a number of extractions which have been detected during the surgical procedure in comparison with a plan for the surgical procedure.
- the plan for the surgical procedure may indicate that the surgeon intends to insert and extract the medical imaging device twice during the surgical procedure. Then, when the second extraction of the medical image capture device is detected, it can be determined that the extraction is a final extraction of the medical image device.
- a final extraction of the medical image capture device can be detected in accordance with a timer. That is, a timer may be started when an extraction of the medical image capture is detected. Then, the timer may count down. If a further action is not detected before the expiration of the timer (e.g. a further insertion of the medical image capture device or the like) then it can be determined that the extraction was a final extraction of the medical image capture device of the procedure. The length of the timer may be adjusted in accordance with the type of the surgery being performed, for example.
- the present disclosure is not particularly limited to these specific examples of determining whether or not the extraction is a final extraction of the surgical procedure. Any suitable processing to determine whether the extraction was a final extraction of the surgical procedure can be performed as required depending on the situation to which the embodiments of the disclosure are applied.
- Performing control to stop recording of the video when the final extraction has been detected ensures efficient use of memory, as image data from after the surgical procedure is not recorded.
- step 21 The surgery then ends in step 21 and the patient leaves the operating room.
- control of the medical system is automatically performed in accordance with the identified insertion and/or extraction of the camera from the patient. This makes it easier to control the medical system during surgery.
- the medical control system is configured to determine whether an insertion is a first insertion of a medical procedure and/or whether an extraction is a final extraction of a medical procedure and store the received image data in accordance with a determined first insertion or final extraction of the medical image capture device.
- the medical control system is configured to begin storage of the image data which has been received when an insertion is determined to be a first insertion of the medical image capture device.
- the medical control system is configured to end storage of the image data which has been received when an extraction is determined to be a final extraction of the medical image capture device.
- embodiments of the disclosure may be applied to a different type of surgery performed using a different type of medical image capture device which is inserted into or extracted from the patient.
- control of the medical system during surgery can be performed more easily and efficiently.
- control of the at least one auxiliary device external to the medical image capture device may include control of one or more of: a configuration of the auxiliary device, a setting of the auxiliary device, an operational mode of the auxiliary device, a status of the auxiliary device and/or a location of the auxiliary device.
- a configuration of the auxiliary device external to the medical image capture device can include, for example, a setting of the auxiliary device.
- the configuration of the auxiliary device may include a brightness level of the auxiliary device.
- the configuration of the auxiliary device may include a brightness of the display device, for example.
- an operational mode of the display device may include a content which should be displayed on the display device (e.g. images from the medical image capture device) and/or an arrangement of display elements on the display device.
- the location of the auxiliary device may include a location of the light and/or a location of the display device.
- the display device may be automatically moved into a location at which it can be observed by the surgeon, so that the surgeon can see the images from the medical image display device.
- control device 4006 when insertion and/or extraction of the medical image capture device has been identified is not particularly limited to these examples.
- the type of control may change in accordance with the type of the auxiliary device and the type of the surgery being performed by the surgeon, for example.
- control unit 4006 is further configured to control storage of the received image data in a storage unit when insertion or extraction of the medical image capture device is identified.
- control unit may start recording of the image data when insertion of the medical image capture device is identified.
- present disclosure is not particularly limited in this respect and other types of control of the storage of the image data may be performed in accordance with embodiments of the disclosure.
- certain metadata may be stored in accordance with the image data in the storage unit.
- the metadata may include information such as a type of trocar used during the surgical procedure (e.g. a trocar with or without a camera). This makes it easier to search and filter the recording after the surgical procedure, making it easier to use the video recording for training and quality monitoring purposes.
- Figure 8 discloses a medical control sequence in accordance with embodiments of the disclosure.
- the medical control sequence illustrated in Figure 8 of the present disclosure is a medical control sequence that may be performed during laparoscopic surgery performed by a surgeon in an operating room such as the operating room described with reference to Figure 3A of the present disclosure.
- the column b of Figure 8 describes control of external devices of the medical system.
- the column b of Figure 8 is the same as has been described with reference to Figure 7 of the present disclosure. Further discussion of column b is not provided at this stage for brevity of the disclosure.
- the columns a', c, d, e and f of Figure 8 provide an alternative control sequence to column a as described with reference to Figure 7 of the present disclosure.
- Each of columns a', c, d, e and f concern the control of storage of the image data from the medical image capture device.
- the control unit 4006 of the present disclosure starts recording of the data from the medical image capture device when insertion of the camera is detected at step 4 of the procedure.
- the recording is stopped when the camera is ejected from the patient at step 9. That is, in contrast to column a, the recording does not continue between step 9 and step 14 of the sequence. Instead, the recording is stopped at step 9 and is not started again until a further insertion of the medical image control device is identified.
- step 19 of the sequence (when a further ejection of the camera from the patient is identified). Then, the recording is stopped. As the ejection of the camera at step 19 of the sequence is the final extraction from the patient, no further recording of the image data is made in the example sequence of column a'.
- the recording of the data is automatically started on identification of each insertion of the image capture device and automatically stopped on identification of each extraction of the image capture device. This ensures that video data is only recorded whilst the image capture device is located inside the patient, thus improving the efficiency of the video recording. Moreover, as control of the recording is performed by the control unit based on the identified insertion and/or extraction, the surgeon is able to focus on the surgical procedure rather than the control of the recording device.
- the medical control system is further configured to control storage of the receiving image data in a storage unit when insertion and/or extraction of the medical image capture device is identified.
- control unit 4006 of the present disclosure starts recording of the data from the medical image capture device when insertion of the camera is detected at step 4 of the procedure.
- control unit 4006 of the medical control system is configured to perform control to perform bookmarking of the video recording when an extraction of the medical image capture device and/or an insertion of the medical image capture device between the initial insertion and the final extraction is detected.
- bookmarking of the video recording is performed at step 9 and step 14 of the sequence.
- the bookmarking of the video recording creates a bookmark in the video recording (e.g. a flag or the like) which indicates a particular event in the video recording (here, an insertion or extraction of the image capture device other than the initial insertion or final extraction of the image capture device).
- the bookmarking processing can include the generation of a chapter marker in the video recording.
- the bookmarking enables a person reviewing the video recording to immediately identify the relevant sections of the video. For example, a person reviewing the video can immediately identify the portions of the video during which the image capture device is located inside the patient. This makes it easier for a person to more efficiently review the recording of the surgical procedure. Moreover, because the control of the bookmarking is performed by the control unit 4006, the surgeon can focus on the surgery rather than operation of the medical system.
- bookmarking can be generated by the control unit 4006 at either or both of at the start of the insertion process and the end of the insertion process.
- bookmarking can be generated by the control unit 4006 at either or both of at the start of the extraction process and the end of the extraction process. Indeed, by creating a bookmark at the start and the end of the insertion process (or the start and the end of the extraction process) a person can easily identify the portion of the video content relating to insertion or extraction of the medical image capture device and review the video recording accordingly.
- manual bookmarking can be created and stored in the storage unit in addition to the bookmarking generated by the control unit 4006.
- a manual bookmark can be created in accordance with an input from a person such as the surgeon. This ensures that a person such as the surgeon can easily highlight relevant portions of the video which has been recorded.
- the combination of manual booking and automatic bookmarking performed by the control unit ensures that the surgeon can focus on the surgeon rather than operation of the medical system, while retaining flexibility and control.
- control unit 4006 may also generate an automatic bookmark to highlight key moments during the surgical procedure in accordance with input from one or more external (or auxiliary) devices such as a room camera or the like.
- control unit 4006 may also generate a bookmark when a patient enters or exits the surgery, when the surgical bed is rotated, when a surgical light is repositioned within the surgical environment or the like.
- image recognition processing may also be performed on the image received from the medical image capture device and a bookmark may be created in accordance with this image recognition processing.
- a bookmark may be created when endoscopic forceps are inserted into the body of the patient.
- Column d is similar to the sequence c which has been described with reference to Figure 8 of the present disclosure.
- the control unit 4006 is configured to record data from the medical image capture device continually as the image data is received from the medical image capture device.
- recording of the image data from the medical image capture device begins in step 1 of column d and continues until the end of the surgery in step 21 of column d. This ensures that all image data is recorded during the surgical procedure. Therefore, even in the event that an initial insertion of the image capture device is not detected, the image data will still be available in the recording unit and can be reviewed for training and quality purposes.
- control unit is configured to perform control to perform bookmarking of the video recording when each insertion and extraction of the image capture device is detected (e.g. at steps 4, 9, 14 and 19 of the sequence).
- control to perform bookmarking of the video recording when each insertion and extraction of the image capture device is detected (e.g. at steps 4, 9, 14 and 19 of the sequence).
- the medical control system is further configured to generate a flag indicating a portion of the image data corresponding to insertion or extraction of the medical image capture device and store the flag in the storage unit.
- control unit 4006 of the medical control system is configured to record the image data received from the medical image capture device during the entirety of the medical procedure. Furthermore, the medical control system 4000 is configured to perform control to create bookmarks in the recording at the location of each insertion or extraction of the medical image capture device.
- the example of column e of Figure 8 of the present disclosure further includes processing to automatically remove video which has been stored and which relates to time before the initial insertion or after the final extraction, to save storage capacity.
- the processing to remove video which has been stored and which relates to time before the initial insertion or after the final extraction can be performed at a time after the surgery has been completed. Therefore, processing demand during the surgery can be reduced. Moreover, as this data is removed only after the surgery has been completed, the processing circuitry can more easily confirm that the last extraction was the final extraction of the surgical procedure. Thus, it can be ensured that all relevant data is recorded in the storage medium.
- Column f is similar to the control sequence described with reference to column e of Figure 8 of the present disclosure. However, in contrast to column e, the video recording in column f begins only with the initial insertion of the medical image capture device. Bookmarks are then created for each subsequent insertion or extraction of the medical image capture device and recording continues until the end of the surgical procedure. Then, at a time after the surgical procedure has been completed, video data corresponding to a time after the final extraction of the image capture device is removed from the storage device. Thus, it can be ensured that all relevant data is recorded in the storage medium.
- the surgeon can focus on the surgery rather than operation of the medical system.
- the medical control system is further configured to determine whether an insertion is a first insertion of a medical procedure and/or whether an extraction is a final extraction of the medical procedure and to remove image data which has been stored in the storage unit corresponding to a time before the first insertion and/or a time after the final extraction.
- video recording patterns a, a', c, d, e and f as have been described with reference to Figures 7 and 8 of the present disclosure are specific examples of recording (and bookmarking) processing as may be performed after the detection of an insertion or extraction of the medical image capture device.
- a video recording may not necessarily be performed. This may depend on the situation to which the embodiments of the disclosure are applied.
- one pattern can be chosen depending on the surgery or mode selection by a user (e.g. by the surgeon ahead of the surgery).
- Figures 7 and 8 have been described with reference to the specific example of laparoscopic or endoscopic surgery, the present disclosure is not particularly limited in this regard.
- Other types of medical image capture devices which can be inserted into the patient (and other types of surgery) can be used or performed in accordance with embodiments of the disclosure.
- any type of medical image capture device which can be (and is suitable for) inserted into the patient or extracted from the patient can be used in accordance with embodiments of the disclosure, including at least one of an arthroscope, cystoscope, hysteroscope, laryngoscope, resctoscope, sinuscope, uteroscope and/or colonoscope.
- the type of medical image capture device will vary depending on the type of surgical procedure or operation which is being performed in the operating room.
- the medical control system 4000 of the present disclosure achieves a more efficient way of controlling complex medical systems.
- medical staff including doctors, surgeons, nurses and the like
- medical staff can control the medical system with reduced number and complexity of operations.
- medical staff including doctors, nurses, surgeons and the like can focus on the surgical procedure rather than the operation of the medical system. This improves surgical outcomes.
- Figure 9 illustrates an example implementation of a medical control system in accordance with embodiments of the disclosure.
- the medical control system illustrated in Figure 9 comprises a medical image capture device 9000.
- the medical image capture device is an endoscope.
- the endoscope may be an endoscopic surgery system 5000 as described with reference to Figure 2 of the present disclosure.
- the endoscope can be inserted into a patient in order to capture images from inside a patient.
- the images captured by endoscope 9000 are processed by an IPC encoder to encode the images according to an IP protocol in order that the images can be provided over a network.
- the endoscope captures images in three different colour bands (such as Red, Green and Blue) and provides these images as three separate video signals A, B and C over the network.
- the medical control system illustrated in Figure 9 comprises a receiving unit 9002.
- the receiving unit 9002 is configured to receive the three separate video signals A, B and C over the network.
- the receiving unit 9002 may include an IPC decoder.
- the video signals which have been received by the receiving unit 9002 are passed to an analysis unit 9004 of the medical control system.
- the analysis unit 9004 is provided in a server.
- analysis of the video signals which have been received by the receiving unit 9002 is provided on the server side.
- the analysis unit 9004 of this example comprises an Al module 9004A.
- the Al module 9004A is an artificial intelligence module.
- the Al module 9004A may be implemented as a trained model such as a trained machine learning model, for example.
- the Al module 9004A is configured to perform processing on the video signals which have been received in order to identify the insertion and/or extraction of the medical image capture device (the endoscope) from a patient. Insertion and/or extraction of the medical image capture device (the endoscope) can be performed based on a distinctive characteristic of the images.
- a signal is provided to the control unit 9006 of the medical control system to inform the control unit 9006 that insertion and/or extraction of the medical image capture device has been identified.
- the medical control system of this example include a patient monitoring device 9012.
- the patient monitoring device 9012 monitors one or more vital signs of the patient (including, for example, the pulse rate, respiration rate and blood pressure of the patient).
- Information indicative of the vital signs of the patient are then provided to the analysis unit 9004 of the medical control system.
- the vital sign may be provided to a data analysis module 9004B of the analysis unit 9004.
- the data analysis module 9004B of the analysis unit 9004 is configured to verify the insertion and/or extraction of the endoscope which has been identified by the Al module 9004A in accordance with the information indicative of the vital sign of the patient. For example, insertion and/or extraction of the endoscope will not be performed by the surgeon unless the vital signs of the patient are stable. Accordingly, if the Al module identifies an insertion (or extraction) of the endoscope at a time when the vital signs of the patient are not stable, it is likely that the insertion (or extraction) is a false positive. Therefore, the data analysis module 9004B of the analysis unit 9004 can verify the identification of the insertion and/or extraction of the endoscope from the patient. A false positive identification can then be removed in order that the control unit 9006 does not control perform control on the basis of a false positive identification.
- control unit 9006 comprises a number of sub modules related to recording control, bookmarking control and device control.
- the device control module of the control unit 9006 is configured to control external devices in accordance with an identified insertion and/or extraction of the endoscope.
- the medical control system of this example includes external devices 9010. These external devices 9010 include a monitor (a type of display device) and a surgical light.
- the monitor is used to display images from the endoscope to the surgeon. This enables the surgeon to see inside the patient. Therefore, when insertion of the endoscope is detected, the monitor can be automatically controlled by the medical control system such that an optimum configuration of the monitor is provided for the surgeon. For example, the brightness of the monitor may be controlled by the control unit such that an optimum brightness is provided for the surgeon when viewing images from the endoscope. Automatic adjustment and control of the monitor by the control unit 9006 enables the surgeon to focus on the surgery rather than operating the external devices of the medical control system.
- the surgical light is used to provide light in the operating room during the surgery so that the surgeon can see the surgical site on the patient.
- the surgeon may wish that the surgical light is turned off. This makes it easier for the surgeon to see images from the endoscope on the monitor.
- the surgical light can be automatically controlled by the medical control system such that an optimum configuration of the surgical light is provided for the surgeon. For example, the brightness of the surgical light can be reduced or the surgical light can be turned off when insertion of the endoscope is detected. Automatic adjustment and control of the surgical light by the control unit 9006 enables the surgeon to focus on the surgery rather than operating the external devices of the medical control system.
- control unit 9006 can control at least one of video recording processing and bookmarking in accordance with a detected insertion and/or extraction of the endoscope. That is, the video signals A, B and C from the endoscope can optionally, be provided to a storage unit 9008.
- the storage unit 9008 is provided in a server. Thus, data storage of the video signals from the endoscope are stored on the server side.
- the storage of the video signals by the storage unit 9008 can be controlled by the controlling unit 9008 of the medical control system.
- the video recording can be started when the first insertion of the medical procedure is detected and the video recording can be stopped when the final extraction of the endoscope form the patient is detected. This ensures that the relevant image data from the endoscope is stored. This image data can then be reviewed at a later stage for training and quality monitoring purposes.
- the control of the recording is performed by the control unit 9006, the surgeon can focus on the surgery rather than operation of the medical system.
- control unit 9006 can control bookmarking of the video recording in accordance with a detected insertion or extraction of the endoscope occurring between the first insertion and the final extraction of the surgical procedure. For example, if the surgeon extracts the endoscope part way through the surgical procedure, a bookmark can be created by the control unit 9006. A further bookmark can be created by the control unit 9006 when the endoscope is subsequently re-inserted into the patient. This enables a person who is reviewing the video recording to immediately understand the relevant portions of the video recording (relating to the times during which the endoscope is located inside the patient). Moreover, because the control of the bookmarking is performed by the control unit 9006, the surgeon can focus on the surgery rather than operation of the medical system.
- the example implementation of the medical control system of Figure 9 of the present disclosure enables end users to operate the medical control system more easily and efficiently. This is because multiple pieces of equipment (including the monitor, surgical light and recording devices) can be operated with a single action of insertion and/or extraction of the endoscope from the patient. Thus, end users do not have to operate monitors, surgical lights and recording devices separately.
- the medical control system of Figure 9 enables medical staff including doctors, nurses, surgeons and the like to focus on the surgery rather than operation of the medical system. This improves the surgical outcomes.
- a method for a medical control system is provided. An example method is illustrated with reference to Figure 10 of the present disclosure.
- the method may be performed by a control system such as the medical control system illustrated with respect to Figure 4 of the present disclosure.
- step S10000 The method starts at step S10000 and proceeds to step S10002.
- step S10002 the method comprises receiving image data from a medical image capture device, the medical image capture device for insertion into and/or extraction from a patient.
- step S10004 the method comprises analysing the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- step S10006 the method comprises controlling at least one auxiliary device external to the medical image capture device when insertion or extraction of the medical image capture device is identified.
- step S1008 The method then proceeds to and ends with step S10008.
- Embodiments of the disclosure can, more generally, be applied to any medical system where images are received from a medical imaging device which can be inserted into a patient.
- embodiments of the present disclosure are not specifically limited to use in an operating room such as that described with reference to Figure 3A of the present disclosure. Instead, more generally, embodiments of the disclosure can be applied to any medical or healthcare environment as required.
- a medical control system comprising processing circuitry configured to: receive image data from a medical image capture device, the medical image capture device for insertion into and/or for extraction from a patient; analyse the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient; and control at least one auxiliary device external to the medical image capture device when insertion or extraction of the medical image capture device is identified.
- control of the least one auxiliary device comprises control of one or more of: a configuration of the auxiliary device, an operational mode of the auxiliary device, a status of the auxiliary device and/or a location of the auxiliary device.
- control of the at least one auxiliary device is dependent on whether an insertion or an extraction of the medical image capture device is identified.
- processing circuitry is further configured to receive additional data from an additional data source and analyse the image data and the additional data to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient.
- the additional data includes at least one of: data relating to a vital sign of the patient, data relating to the pneumoperitoneum of the patient, data relating to a stage of an operation and/or data relating to a previous insertion or extraction of the medical image capture device.
- processing circuitry is further configured to use at least one of: a trained model, machine learning, deep learning and/or colour analysis of the image data to identify insertion or extraction of the medical image capture device.
- processing circuitry is further configured to store the image data which has been received in a storage unit.
- processing circuitry is further configured to generate a flag indicating a portion of the image data corresponding to insertion or extraction of the medical image capture device and store the flag in the storage unit.
- processing circuitry is further configured to determine whether an insertion is a first insertion of a medical procedure and/or whether an extraction is a final extraction of the medical procedure and to remove image data which has been stored in the storage unit corresponding to a time before the first insertion and/or a time after the final extraction.
- processing circuitry is further configured to determine whether an insertion is a first insertion of a medical procedure and/or whether an extraction is a final extraction of a medical procedure and store the received image data in accordance with a determined first insertion or final extraction of the medical image capture device.
- the medical control system according to claim any of clauses 1 to 16, further comprising the medical image capture device, wherein the medical image capture device includes: an arthroscope, cystoscope, hysteroscope, lasparoscope, laryngoscope, endoscope, resctoscope, sinuscope, uteroscope and/or colonoscope.
- the medical image capture device includes: an arthroscope, cystoscope, hysteroscope, lasparoscope, laryngoscope, endoscope, resctoscope, sinuscope, uteroscope and/or colonoscope.
- a method for a medical control system comprising causing the medical control system to perform the steps of receiving image data from a medical image capture device, the medical image capture device for insertion into and/or extraction from a patient; analysing the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient; and controlling at least one auxiliary device external to the medical image capture device when insertion or extraction of the medical image capture device is identified.
- a computer program comprising instructions which, when implemented by a computer, cause the computer to perform a method of causing a medical control system to perform the steps of: receiving image data from a medical image capture device, the medical image capture device for insertion into and/or extraction from a patient; analysing the image data which has been received to identify at least one of insertion of the medical image capture device into the patient or extraction of the medical image capture device from the patient; and controlling at least one auxiliary device external to the medical image capture device when insertion or extraction of the medical image capture device is identified.
- Described embodiments may be implemented in any suitable form including hardware, software, firmware or any combination of these. Described embodiments may optionally be implemented at least partly as computer software running on one or more data processors and/or digital signal processors.
- the elements and components of any embodiment may be physically, functionally and logically implemented in any suitable way. Indeed, the functionality may be implemented in a single unit, in a plurality of units, or as part of other functional units. As such, the disclosed embodiments may be implemented in a single unit or may be physically and functionally distributed between different units, circuitry and/or processors.
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Abstract
Un système de commande médicale est fourni, comprenant des circuits de traitement configurés pour : recevoir des données d'image provenant d'un dispositif de capture d'image médicale, le dispositif de capture d'image médicale étant conçu pour être inséré dans le patient et/ou extrait de celui-ci ; analyser les données d'image qui ont été reçues pour identifier une insertion du dispositif de capture d'image médicale dans le patient et/ou une extraction du dispositif de capture d'image médicale du patient ; et commander au moins un dispositif auxiliaire externe au dispositif de capture d'image médicale lorsque l'insertion ou l'extraction du dispositif de capture d'image médicale est identifiée.
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US20200297444A1 (en) * | 2019-03-21 | 2020-09-24 | The Board Of Trustees Of The Leland Stanford Junior University | Systems and methods for localization based on machine learning |
US20210106209A1 (en) * | 2018-07-20 | 2021-04-15 | Fujifilm Corporation | Endoscope system |
US20220011724A1 (en) * | 2020-07-10 | 2022-01-13 | Arthrex, Inc. | Endoscope insertion and removal detection system |
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US20210106209A1 (en) * | 2018-07-20 | 2021-04-15 | Fujifilm Corporation | Endoscope system |
US20200297444A1 (en) * | 2019-03-21 | 2020-09-24 | The Board Of Trustees Of The Leland Stanford Junior University | Systems and methods for localization based on machine learning |
US20220011724A1 (en) * | 2020-07-10 | 2022-01-13 | Arthrex, Inc. | Endoscope insertion and removal detection system |
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