JP2009195623A - Endoscopy system, examination supporting apparatus, and endoscopy method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To reliably prevents medical accidents accompanying the use of inappropriate treatment instruments without troubling examination staffs. <P>SOLUTION: A CPU106 of a processor reads out patient information of a target patient from an information managing server 16 when being directed to start an examination. The CPU106 reads out contraindicated information 120a corresponding to the target patient from a contraindicated information DB 114 based on the patient information. The CPU106 which reads out the contraindicated information 120a reads type information 84 stored in an RFID tag 78 of the treatment instrument 60 inserted into an instrument channel port by a tag reader 80. The CPU106 determines whether the use of the treatment instrument 60 inserted into the instrument channel port is prohibited or not from the contraindicated information 120b and the type information 84 which are read out. Then, when the CPU106 determines that the use of the treatment instrument 60 is prohibited, it makes a decision that the treatment instrument 60 is inappropriate for the target patient and informs the staff of it. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention provides an endoscope inspection system that performs an inspection using an endoscope provided with an insertion channel through which a treatment tool is inserted, an inspection support device that supports an inspection using the endoscope, and the endoscope The present invention relates to an endoscopic inspection method in which an inspection is performed using a mirror.

For example, in a medical examination system represented by an electronic endoscope system, various proposals for eliminating medical accidents have been made (see Patent Documents 1 to 5). In Patent Document 1, an RFID tag is provided in an endoscope, and a tag reader is provided in a high-frequency ablation device, and it is determined whether the endoscope is compatible with the high-frequency ablation device. Displayed on the panel. In Patent Literature 2, an identification code is attached to an endoscope and an accessory, and the suitability of the accessory is determined, and a warning is displayed if the accessory is not suitable. In Patent Document 3, medical orders are systematized and collectively managed by a server. Information on an RFID tag provided on a treatment tool or a wristband of a patient is read and compared with a medical order of a server to determine suitability. Patent Document 4 discloses a medical management system that collectively manages information including contraindications for patients. In Patent Document 5, when a tag is provided on a tray for storing an endoscope, information on the tag is read by a reader of the cleaning / disinfecting apparatus, and the suitability of the combination of the endoscope and the cleaning / disinfecting apparatus is determined. Is displaying a warning.
JP 2003-088534 A Japanese Patent Laid-Open No. 2005-058450 JP 2004-348717 A JP 2006-338521 A JP 2006-296882 A

  In an endoscopic examination, an operator lists necessary treatment tools before the examination, prepares them in advance in a cart tray, and starts the examination. At this time, some treatment tools used for endoscopic treatment should be refrained from use depending on the constitution or medical history of the patient to be examined. For example, when a puncture needle is used for a patient who is using an anticoagulant, bleeding from the insertion site of the puncture needle may be difficult to stop. Thus, there is a concern that using a treatment tool that is not appropriate for a patient to be examined may lead to a medical accident.

  However, whether or not each treatment tool is appropriate for the patient has to be confirmed with reference to the patient's medical record and the like, which is very troublesome for the inspection staff who prepares each treatment tool. Even if the inspection staff performs confirmation, an inappropriate treatment tool is prepared due to oversight or the like, and as a result, a medical accident may occur.

  In addition, for example, when a treatment instrument for the lower digestive tract is used for the examination of the upper digestive tract, the same problem as described above occurs even when a treatment instrument that is not appropriate for the examination content is used. . For this reason, in medical facilities, there is a strong demand for ensuring that medical accidents associated with the use of inappropriate treatment tools can be reliably prevented without requiring labor for inspection staff.

  In response to such a request, Patent Document 1 can prevent problems caused by performing high-frequency treatment on an endoscope that does not support high-frequency treatment, but use of a treatment tool that is not appropriate for the target patient. No consideration is given to preventing this. In Patent Document 2, it is possible to determine whether or not the endoscope and the treatment tool are compatible, but it is not possible to determine whether or not the treatment tool is appropriate for the patient and the examination content.

  In Patent Document 3, an unsuitable treatment tool is used in the event that the reading by the PDA is forgotten or the treatment tool is accidentally placed on the cart after confirming that it is not appropriate. Therefore, the occurrence of medical accidents cannot be reliably prevented.

  In Patent Document 4, no consideration is given to preventing use of a treatment tool that is not appropriate for a patient. In Patent Document 5, it is possible to reliably prevent an endoscope from being set in an unsuitable cleaning / disinfecting apparatus, but no consideration is given to preventing the use of an inappropriate treatment tool.

  The present invention has been made in view of the above-described problems, and it is an object of the present invention to reliably prevent medical accidents associated with the use of an inappropriate treatment instrument without requiring labor for inspection staff.

  In order to achieve the above object, an endoscope inspection system according to the present invention includes an endoscope provided with an insertion channel through which a treatment tool is inserted, and type information of the treatment tool inserted into the insertion channel. A reading unit that reads from the type information storage unit provided in the instrument, and a determination unit that determines whether or not the treatment instrument inserted into the insertion channel is appropriate based on the type information read by the reading unit; And a notifying means for notifying the determination result of the determining means.

  In addition, it includes contraindication information storage means for storing contraindication information in which information indicating a medical history or constitution and the type of the treatment tool prohibited to be used are associated with the information, and the determination means includes a patient's subject to be examined. Based on the contraindication information and the type information, it is determined whether or not the use of the treatment tool inserted through the insertion channel is prohibited. If the treatment tool is prohibited, the treatment tool becomes an inspection target. It is preferable to determine that it is not appropriate for the patient.

  In addition, patient information storage means for storing patient information representing the patient's personal information is provided, and the determination means reads patient information of the patient to be examined from the patient information storage means, and examines the patient based on the patient information. Preferably, the contraindication information corresponding to the patient to be read out from the contraindication information storage means.

  Furthermore, a treatment tool information storage unit that stores treatment tool information in which examination contents and types of treatment tools necessary for the examination are associated is provided, and the determination unit includes the treatment corresponding to the examination contents input in advance. While reading the instrument information from the treatment instrument information storage means, confirm whether or not the type indicated by the type information is included in the treatment instrument information, and if not included, the inserted through the insertion channel It is preferable to determine that the treatment tool is not appropriate for the examination content.

  The endoscope includes an insertion portion that is inserted into a body cavity of a patient, and an imaging element that captures image light incident through an observation window provided at a distal end of the insertion portion. A treatment tool that identifies the endoscope model based on the identification information for identifying the endoscope model, and notifies the direction in which the treatment tool enters the angle of view of the image sensor according to the model. It is preferable to provide an approach direction notifying means.

  Preferably, the type information storage means is an RFID tag, and the reading means is a tag reader that communicates wirelessly with the RFID tag.

  Furthermore, the examination support apparatus of the present invention that supports the examination using the endoscope provided with the insertion channel through which the treatment tool is inserted provides the treatment tool with type information of the treatment tool inserted into the insertion channel. A reading means for reading from the type information storage means, a determination means for determining whether or not the treatment instrument inserted through the insertion channel is appropriate based on the type information read by the reading means, and the determination means And a notifying means for notifying the determination result.

  Note that the endoscope inspection method of the present invention in which an inspection is performed using an endoscope provided with an insertion channel through which a treatment tool is inserted, includes the type information of the treatment tool inserted through the insertion channel in the treatment tool. A step of reading from the type information storage unit provided in the reading unit, a step of determining by the determination unit whether or not the treatment instrument inserted through the insertion channel is appropriate based on the read type information, And a step of notifying the determination result of the determination means by the notification means.

  In the present invention, the type information of the treatment tool inserted into the insertion channel is read from the type information storage means provided in the treatment tool, it is determined whether the treatment tool is appropriate based on the read type information, and the determination result Was announced. Thereby, the inspection staff who prepares a treatment tool can know whether or not each treatment tool is appropriate without performing confirmation based on a medical record or the like. There is no worry about oversight. Therefore, according to the present invention, it is possible to surely prevent a medical accident associated with the use of an inappropriate treatment instrument without requiring labor for the inspection staff.

  FIG. 1 is an explanatory diagram schematically showing a configuration of an endoscopic inspection system 2 constructed in a medical facility such as a hospital. The endoscopic examination system 2 includes an endoscopic examination apparatus 10, an examination reservation management server 12, a medical department terminal 14, an information management server 16, an image server 18, and a LAN (Local Area) that interconnects them. Network) 20. The endoscopic examination apparatus 10 is installed in the endoscopic examination room 4. The endoscopy device 10 acquires an endoscopic image obtained by photographing the inside of a patient's body cavity. The examination reservation management server 12 manages schedule data 22 indicating the reservation status of the endoscopic examination in the endoscopic examination room 4.

  The medical department terminal 14 is installed in a medical department 6 such as surgery or internal medicine. The medical department terminal 14 is used when a patient is examined. A doctor enrolled in the medical department 6 uses the medical department terminal 14 when, for example, displaying a medical image such as an endoscopic image to explain a medical condition to a patient, or inputting a medical examination result into an electronic medical record. To do. The information management server 16 manages various information in the medical facility. The image server 18 stores various medical images such as an endoscopic image taken by the endoscopic inspection apparatus 10. Note that a plurality of the endoscopic examination apparatus 10, the medical department terminal 14, and the servers 12, 16, and 18 may be provided in the endoscopic examination system 2.

  As a result of the examination of the patient, the doctor in charge of the examination accesses the examination reservation management server 12 as necessary, and reserves an endoscopic examination for the patient. Examination staff such as doctors, technicians, and nurses in charge of endoscopy access the examination reservation management server 12 to check the reservation status of the endoscopy, and perform endoscopy according to the appointment To do.

  For endoscopy, in addition to observation for confirming the presence or absence of a lesion, for example, hemostasis treatment for stopping bleeding in a body cavity, biopsy treatment for collecting a part of cells / tissues in the body cavity Also included are endoscopic procedures such as excision procedures for excising lesions such as polyps and varicose veins, and removal of foreign substances that have entered the body cavity.

  The information management server 16 is, for example, a HIS (Hospital Information System) server or an electronic medical record server. The information management server 16 stores and manages various types of information such as patient information, medical information, examination information, and accounting information for each patient. The patient information represents personal information of each patient, and includes, for example, patient name, patient ID, current address, date of birth, age, sex, family structure, past history, and presence of allergies.

  The medical information is information on medical care for the patient, and includes, for example, a medical date, medical department, name of injury, diagnosis result, treatment period, type and amount of medication, prescription pharmacy name, and the like. The treatment period is a period of going to a medical facility for the same injury or illness. The examination information is information such as a medical image taken at the time of diagnosis, and includes, for example, an examination date, an examination device, an examination method, an examination site, and the like. Further, the accounting information includes, for example, examination costs, medication costs, examination costs, and information indicating whether insurance is applied.

  The image server 18 is a so-called PACS (Picture Archiving and Communication System for medical application) server. In addition to the endoscopic image from the endoscopic examination apparatus 10, the image server 18 includes, for example, a medical image sent from another medical facility via a network or a medium, or contrast of symptoms. The reference images used are stored. Each medical image stored in the image server 18 is read to the medical department terminal 14 or the like as necessary, and used for image diagnosis, explanation to a patient, and the like.

  When making a reservation for an endoscopic examination, as shown in FIG. 2, first, the examination appointment management server 12 is requested to transfer the schedule table via the medical department terminal 14. Upon receiving the schedule table transfer request, the examination reservation management server 12 configures the schedule table based on the schedule data 22 and transfers it to the requesting medical department terminal 14. When receiving the schedule table from the examination reservation management server 12, the medical department terminal 14 displays the schedule table on a monitor (not shown).

  When the schedule table is displayed on the monitor, the doctor who is enrolled in the medical department 6 selects a vacant reservation frame from the schedule table. Then, the examination reservation information 24 including the patient name, the patient ID, the examination content, the appointment date and time, the doctor ID of the reserved doctor who requests the examination is created, and the created examination appointment information 24 is stored in the examination appointment management server 12. Send. Upon receiving the examination reservation information 24, the examination reservation management server 12 updates the schedule data 22 based on the examination reservation information 24. As described above, a new inspection reservation is applied to the selected reservation frame.

  The examination contents included in the examination reservation information 24 include, for example, an upper digestive tract examination such as observation of the pharynx, esophagus, stomach, and duodenum, biopsy, etc., and lower digestive tract examination such as observation of the small intestine, large intestine, and rectum, biopsy, etc. And endoscopic treatments such as hemostasis treatment, excision treatment, and foreign substance removal. The information included in the examination reservation information 24 is not limited to the above.

  FIG. 3 is a front view schematically showing the configuration of the endoscopic inspection apparatus 10. The endoscopy device 10 includes an electronic endoscope 30 that images a patient's body cavity, a processor 32 that generates an endoscopic image, a light source unit 34 that emits illumination light that illuminates the body cavity, and an endoscope. And a monitor 36 for displaying an image. The electronic endoscope 30 includes an insertion portion 38 that is inserted into a body cavity of a patient, and an operation portion 40 that is connected to the proximal end portion of the insertion portion 38. The electronic endoscope 30 is connected to the processor 32 and the light source unit 34 via a universal cord 42 extending from the operation unit 40.

  The processor 32, the light source unit 34, and the monitor 36 are assembled in a movable cart 44. The cart 44 includes a top tray 46 on which various instruments and medicines are placed when performing endoscopy, and shelf boards 48 and 50 for placing the processor 32 and the light source unit 34, respectively. A hanger 52 for hanging the electronic endoscope 30 and a column 54 for holding the monitor 36 are provided. The top tray 46 is provided at the upper end of the cart 44 and is configured to be detachable from the cart 44 so that cleaning and replacement can be easily performed when the medicine is spilled and becomes dirty. The column 54 is configured in a substantially cylindrical shape, and includes a rotation mechanism that directs the screen of the monitor 36 in an arbitrary direction and a height adjustment mechanism that adjusts the height of the screen.

  The cart 44 is further provided with a keyboard 56. The keyboard 56 is slidably attached between a position stored in the cart 44 so as to be covered by the top tray 46 and a position protruding forward of the cart 44 so as to expose each key. The keyboard 56 is electrically connected to the processor 32 and is used when inputting character information, operation instructions, and the like to the processor 32.

  When performing endoscopy, a plurality of treatment tools 60 are placed on the top tray 46 as shown in FIG. The treatment tool 60 is packaged in a bag 62 made of polyethylene or the like after being sterilized and sterilized. The treatment instrument 60 is placed on the top tray 46 in a state of being packaged in a bag 62, and is taken out from the bag 62 and used immediately before. Thereby, contamination of the treatment tool 60 is prevented. The treatment tool 60 is a well-known medical instrument used for endoscopic treatment such as biopsy forceps, grasping forceps, clip forceps, basket forceps, puncture needle, snare, spray tube, balloon catheter, and the like.

  As shown in FIG. 5, the treatment tool 60 is used by being inserted into a forceps port 70 provided in the operation unit 40 of the electronic endoscope 30. The treatment instrument 60 inserted through the forceps port 70 passes through the insertion channel formed in the insertion portion 38, and the distal end portion 60 a formed in various shapes according to the type thereof is applied to the distal end surface 38 a of the insertion portion 38. It is exposed from the formed forceps outlet 72. Thereby, endoscopic procedures such as hemostasis and excision of a lesion are performed. In addition to the forceps outlet 72, the distal end surface 38a of the insertion portion 38 has an observation window 74 for taking in image light from the observation site, and an illumination window 76 for irradiating illumination light from the light source unit 34. Is provided.

  Further, as shown in FIG. 5, an RFID tag 78 is embedded in the vicinity of the distal end of the treatment instrument 60. The RFID tag 78 stores type information 84a (see FIG. 6) indicating the type of the treatment instrument 60 such as a biopsy forceps or a grasping forceps. The type information 84a may be information that can indirectly specify the type of the treatment instrument 60, such as a product name or a model number. The RFID tag 78 may be attached to the surface of the treatment instrument 60. However, there is a concern that it may be peeled off only by being attached to the surface. For this reason, the RFID tag 78 is preferably embedded as described above.

  As shown in FIG. 6, the operation unit 40 of the electronic endoscope 30 is provided with an antenna 79 for reading the type information 84 a from the RFID tag 78 provided on the treatment instrument 60. The antenna 79 is provided near the forceps opening 70. The antenna 79 is connected to a tag reader 80 provided in the processor 32 via a universal cord 42 or the like. When the treatment tool 60 is inserted into the forceps opening 70, the tag reader 80 reads the type information 84a from the RFID tag 78 of the treatment tool 60 via the antenna 79.

  The RFID tag 78 includes a wireless communication circuit 82 that wirelessly communicates data with the tag reader 80 via antennas 79 and 81, a memory 83 that stores type information 84a, and a control circuit 85 that controls these. The power supply circuit 86 of the RFID tag 78 generates electric power from electromagnetic waves received by the antenna 81 by electromagnetic induction. That is, the RFID tag 78 is a so-called passive tag that operates by receiving power from the tag reader 80. Of course, the RFID tag 78 may be an active tag.

  FIG. 7 is a block diagram schematically showing an electrical configuration of the electronic endoscope 30 and the processor 32. The electronic endoscope 30 is provided with a CCD 90 that captures image light incident through the observation window 74 and a ROM 92 that stores scope identification information 94 for identifying the model of the electronic endoscope 30. Yes. The scope identification information 94 includes, for example, the model name, model number, manufacturer, date of manufacture, etc. of the electronic endoscope 30. The scope identification information 94 is read by the processor 32 after connecting the electronic endoscope 30 and the processor 32 via the universal code 42. Note that the information included in the scope identification information 94 is not limited to the above.

  The CCD 90 is connected to an amplifier (hereinafter referred to as AMP) 100 provided in the processor 32 and a CCD driver 101. The AMP 100 amplifies the imaging signal output from the CCD 90 with a predetermined gain, and outputs the amplified signal to a correlated double sampling / programmable gain amplifier (hereinafter referred to as CDS / PGA) 102.

  The CDS / PGA 102 outputs the image pickup signal output from the AMP 100 as R, G, B image data that accurately corresponds to the accumulated charge amount of each cell of the CCD 90, amplifies the image data, and an A / D converter (Hereinafter referred to as A / D) 103. The A / D 103 converts the analog image data output from the CDS / PGA 102 into digital image data. The image processing unit 104 performs various types of image processing on the image data digitized by the A / D 103 and outputs the image data to the monitor 36 as an endoscopic image.

  A CCD driver 101 for driving the CCD 90 is connected to a timing generator (hereinafter referred to as TG) 105. The TG 105 is connected to a CPU 106 that comprehensively controls each unit of the processor 32. The TG 105 inputs a timing signal (clock pulse) to the CCD driver 101 under the control of the CPU 106. Based on the input timing signal, the CCD driver 101 controls the readout timing of the accumulated charge of the CCD 90, the shutter speed of the electronic shutter of the CCD 90, and the like. Connected to the CPU 106 is an HDD 107 that stores various programs for controlling the processor 32. The CPU 106 controls each unit of the processor 32 by reading a predetermined program from the HDD 107 and sequentially processing the program.

  In addition to the HDD 107, the CPU 106 includes a tag reader 80, a keyboard 56, a mouse 108 as a well-known pointing device, a speaker 109 for outputting sound, and a LAN interface (hereinafter referred to as I / O) for connecting the processor 32 to the LAN 20. 110, etc.) are connected. The CPU 106 is connected to the image processing unit 104 and inputs various control signals to the image processing unit 104. Thereby, various operation screens other than the endoscopic image are displayed on the monitor 36.

  In the HDD 107, DBs such as an icon information database (hereinafter referred to as DB) 112 and contraindication information DB 114 are constructed. In the icon information DB 112, as shown in FIG. 8, icons indicating the model number (scope model number) of the electronic endoscope 30 and the direction in which the treatment tool 60 exposed from the forceps outlet 72 enters the angle of view of the CCD 90. A plurality of icon information 118 associated with 116 is stored. The direction in which the treatment tool 60 enters the angle of view of the CCD 90 varies depending on the model of the electronic endoscope 30 depending on the positional relationship between the forceps outlet 72 and the observation window 74, the arrangement of the CCD 90, and the like. When performing the endoscopic treatment by inserting the treatment tool 60 through the forceps port 70, if the treatment tool 60 enters the angle of view from an unexpected direction, the orientation of the insertion portion 38 must be changed. It becomes a factor to reduce the work efficiency.

  In order to prevent such a decrease in work efficiency, the CPU 106 of the processor 32 searches the icon information DB 112 based on the model number included in the scope identification information 94 read from the ROM 92 of the electronic endoscope 30, and displays the corresponding icon 116. Read out and display on the monitor 36. Thereby, since the operator is informed of the direction to enter the angle of view of the treatment instrument 60, it is possible to prevent a decrease in working efficiency of the operator as described above.

  Each icon 116 is represented by, for example, a combination of a substantially circular symbol 116a indicating the angle of view of the CCD 90 and a substantially rectangular symbol 116b indicating the treatment instrument 60 entering the angle of view. That is, the icon 116 on the first line in FIG. 8 indicates that the treatment instrument 60 enters from the lower right direction of the angle of view of the CCD 90. Further, the icon 116 on the second line in FIG. 8 indicates that the treatment instrument 60 enters from the upper left direction of the angle of view of the CCD 90. The shape of each icon 116 is not limited to the above.

  As shown in FIG. 9, the contraindication information DB 114 stores a plurality of contraindication information 120a associating information indicating the medical history or constitution with the type of the treatment instrument 60 that is prohibited from being used. For example, if a puncture needle is used for a patient who is using an anticoagulant for the prevention or treatment of thromboembolism associated with myocardial infarction or stroke, bleeding from the insertion site of the puncture needle cannot be stopped easily. It may lead to a big medical accident. For this reason, the contraindication information 120a records, for example, “thromboembolism” or “anticoagulant” in the information indicating the medical history or constitution, and records “puncture needle” in the type of the treatment instrument 60 prohibited from being used, Associate these with each other. Thereby, for example, by searching the contraindication information DB 114 based on the past history included in the patient information, the treatment tool 60 that should not be used for the patient can be easily derived.

  When an endoscopic examination is performed in the medical department 6, the keyboard 56 and the mouse 108 are operated to access the examination reservation management server 12 from the processor 32. Then, the schedule table is received from the examination reservation management server 12, and a predetermined examination reservation is selected from the schedule table. Thereby, an endoscopic examination (hereinafter referred to as the examination) for the selected examination appointment is started.

  When the start of endoscopic examination is instructed by selecting a predetermined examination reservation, the CPU 106 of the processor 32 displays the endoscopic image 122 shown in FIG. In the endoscope image 122, an icon 116 corresponding to the electronic endoscope 30 connected to the processor 32 is displayed in an overlapping manner. As described above, the CPU 106 reads out the scope identification information 94 from the ROM 92 of the electronic endoscope 30 and searches the icon information DB 112 based on the model number included in the scope identification information 94 to thereby display the corresponding icon 116. The image is superimposed on the endoscopic image 122 and displayed. In addition, in FIG. 10, the endoscopic image 122 of the state which inserted the insertion part 38 in the body cavity is shown.

  When the start of the endoscopic examination is instructed, the CPU 106 accesses the information management server 16 as shown in FIG. 11, and based on the patient ID included in the examination appointment information 24 of the selected examination appointment. The information management server 16 is searched. Then, patient information of a patient (hereinafter referred to as a “target patient”) to be examined in the examination is read from the information management server 16. The CPU 106 that has read the patient information accesses the contraindication information DB 114, and searches the contraindication information 120a corresponding to the target patient based on the patient information.

  The search for the contraindication information 120a is performed, for example, by extracting a predetermined keyword from the patient information and comparing the keyword with information indicating a medical history or constitution included in each contraindication information 120a. For example, when the patient information records that prevention or treatment of thromboembolism is being performed, the CPU 106 extracts thromboembolism as a keyword. Then, comparison is performed as described above, and when the contraindication information 120a in which thromboembolism is recorded is found in the information indicating the medical history or constitution, it is determined that the contraindication information 120a corresponds to the target patient.

  When the CPU 106 finds the contraindication information 120a corresponding to the target patient by the search, the CPU 106 reads the contraindication information 120a from the contraindication information DB 114 and places it in the CPU 106 as the contraindication information 120b. The CPU 106 that has read the contraindication information 120b instructs the tag reader 80 to start reading the type information 84a. When the tag reader 80 is instructed to start reading by the CPU 106, the tag reader 80 outputs a radio wave having a predetermined frequency from the antenna 79. Then, in response to the treatment instrument 60 being inserted into the forceps port 70, wireless communication is performed with the RFID tag 78 of the treatment instrument 60, and the type information 84 a is read from the RFID tag 78. When the tag reader 80 reads the type information 84a, it inputs the type information 84b to the CPU 106.

  When receiving the type information 84b from the tag reader 80, the CPU 106 determines whether or not the use of the treatment instrument 60 inserted through the forceps opening 70 is prohibited based on the contraindication information 120b and the type information 84b corresponding to the target patient. Make a decision. The determination as to whether or not use is prohibited is performed by confirming whether or not the type of the treatment instrument 60 indicated by the type information 84b is included in the contraindication information 120b. When the type indicated by the type information 84b is not included in the contraindication information 120b, the CPU 106 determines that the treatment tool 60 is not prohibited from being used. On the other hand, when the type indicated by the type information 84b is included in the contraindication information 120b, the CPU 106 determines that the use of the treatment instrument 60 is prohibited.

  If the CPU 106 determines that the use of the treatment instrument 60 is prohibited as a result of the determination as described above, the warning window 124 is displayed so as to overlap the endoscope image 122 as shown in FIG. Then, the operator is informed that the use of the treatment tool 60 is prohibited. The warning window 124 is provided with an OK button 126 for instructing that the warning window 124 has been confirmed. The CPU 106 hides the warning window 124 in response to the OK button 126 being clicked.

  Next, the operation of the endoscopy system 2 configured as described above will be described with reference to the flowchart shown in FIG. When performing an endoscopic inspection, the inspection staff firstly connects the clean electronic endoscope 30 that has been cleaned and disinfected, confirms the operation of the endoscopic inspection apparatus 10, and inspects the treatment instrument 60 and the medicine. Preparation for inspection such as preparation of equipment necessary for the inspection. The prepared treatment tool 60 and medicine are placed on the top tray 46 of the cart 44.

  The inspection staff receives the schedule table from the inspection reservation management server 12, selects a predetermined inspection reservation from the schedule table, instructs the start of the inspection, and the inspection preparation is completed. Thereafter, the operator operates the electronic endoscope 30. When the CPU 106 of the processor 32 is instructed to start the examination, the monitor 36 displays an endoscopic image 122 (see FIG. 11A) including an icon 116 corresponding to the electronic endoscope 30 connected to the processor 32. To display. The surgeon confirms the endoscope image 122 photographed by the electronic endoscope 30 by looking at the monitor 36 and confirms the direction in which the treatment instrument 60 enters the angle of view. As a result, a reduction in work efficiency of the surgeon due to the treatment tool 60 entering the angle of view from an unexpected direction is prevented.

  Further, when the start of the examination is instructed, the CPU 106 displays the endoscopic image 122 and reads patient information of the target patient from the information management server 16 as shown in FIG. When reading the patient information, the CPU 106 accesses the contraindication information DB 114, and searches the contraindication information 120a corresponding to the target patient based on the patient information. Here, when there is no contraindication information 120a corresponding to the target patient, there is no concern that the use of the treatment instrument 60 is prohibited. For this reason, when the CPU 106 determines that there is no corresponding contraindication information 120a, the CPU 106 continues the state in which only the endoscopic image 122 is displayed until the examination is finished.

  On the contrary, if the CPU 106 determines that there is the corresponding contraindication information 120a, the CPU 106 reads the contraindication information 120a from the contraindication information DB 114, places it as the contraindication information 120b in the CPU 106, and instructs the tag reader 80 to start reading the type information 84a. . The tag reader 80 starts reading in response to an instruction from the CPU 106, and reads the type information 84a from the RFID tag 78 of the treatment instrument 60 when the treatment instrument 60 is inserted into the forceps port 70. When the type information 84a is read, the type information 84b is input to the CPU 106.

  When receiving the type information 84b from the tag reader 80, the CPU 106 determines whether or not the use of the treatment instrument 60 inserted through the forceps opening 70 is prohibited based on the contraindication information 120b and the type information 84b corresponding to the target patient. Make a decision. When the CPU 106 determines that the use is prohibited, the CPU 106 displays a warning window 124 (see FIG. 10B) on the endoscopic image 122, outputs a warning sound from the speaker 109, and is inserted into the forceps port 70. The surgeon is notified that the use of the treatment tool 60 is prohibited.

  Thus, by notifying that the use of the treatment tool 60 is prohibited, it is possible to prevent a medical accident caused by using the treatment tool 60 that should not be used for the target patient. . Further, as shown in FIG. 10B, by displaying a warning window 124 overlaid on the endoscopic image 122, it is possible to prevent the inspection from being continued without noticing the display of the warning window 124, thereby preventing a medical accident. Can be prevented more reliably. Further, since the CPU 106 makes a determination and notifies the result, there is no worry of taking time and effort to the operator.

  When the surgeon confirms that the use of the treatment tool 60 is prohibited by a warning sound from the warning window 124 or the speaker 109, the surgeon pulls out the treatment tool 60 from the forceps opening 70. Thereafter, the mouse 108 is operated, and the OK button 126 provided in the warning window 124 is clicked. In response to clicking on the OK button 126, the CPU 106 hides the warning window 124, stops the warning sound from the speaker 109, and ends the notification to the operator.

  On the other hand, if the CPU 106 determines that the use of the treatment tool 60 is not prohibited, the CPU 106 continues the state in which only the endoscopic image 122 is displayed (see FIG. 10A) and causes the operator to perform the examination. . Further, when the contraindication information 120b corresponding to the target patient is read, the CPU 106 repeats the above processing every time the treatment tool 60 is inserted into the forceps port 70 until the examination is completed.

  In the above embodiment, the contraindication information DB 114 is searched based on the patient information, and the contraindication information 120a corresponding to the target patient is read out. On the contrary, various types of information read through the tag reader 80 The contraindication information DB 114 may be searched based on 84b and the contraindication information 120a corresponding to the target patient may be read out.

  In the above embodiment, the icon 116 is displayed so as to be superimposed on the endoscope image 122, but the icon 116 may not be superimposed on the endoscope image 122. However, if the icon 116 is superimposed on the endoscopic image 122, it is possible to minimize the movement of the operator's line of sight, so that the operator is informed of the direction to enter the angle of view of the treatment instrument 60, and the work efficiency is improved. It is possible to further enhance the effect of preventing the decrease in the above. The position of the icon 116 on the endoscopic image 122 may be an arbitrary position, but it is preferable to arrange the icon 116 at a position that does not interfere with the observation of the endoscopic image 122, such as four corners. Furthermore, in the above-described embodiment, the direction of entering the angle of view of the treatment instrument 60 is notified by the icon 116. However, the notification of the approach direction is not limited to this, and may be, for example, text or voice. Good.

  In the above-described embodiment, the warning window 124 is displayed so as to be superimposed on the endoscope image 122. However, the warning window 124 may not be superimposed on the endoscope image 122. However, as described above, by displaying the warning window 124 over the endoscope image 122, it is possible to prevent the operator from continuing the examination without noticing the display of the warning window 124. It is preferable to display them in an overlapping manner.

  In the above embodiment, the operator is notified by the warning window 124 and the warning sound from the speaker 109. However, the notification to the operator is not limited to this, for example, a warning lamp is turned on. You may make it.

  In the above embodiment, the antenna 79 is provided in the electronic endoscope 30 and the tag reader 80 is provided in the processor 32. However, the present invention is not limited to this. For example, the tag reader 80 itself is provided in the electronic endoscope 30. It may be. Moreover, in the said embodiment, although the RFID tag 78 was shown as a classification information storage means, a classification information storage means is not restricted to this, For example, a barcode etc. may be sufficient.

  Furthermore, in the above-described embodiment, the electronic endoscope 30 is shown as an endoscope. However, the endoscope is not limited to this, and for example, an ultrasonic endoscope, a fluorescent endoscope, an optical coherence tomometer, or the like. An (OCT) endoscope or the like may be used. In the above-described embodiment, the CCD 90 is shown as the image sensor. However, the image sensor is not limited to this, and may be a CMOS image sensor, for example. In the above embodiment, the patient information is acquired by accessing the information management server 16. However, the present invention is not limited to this, and for example, the operator can input patient information via the keyboard 56 or the like. May be.

  Next, a second embodiment of the present invention will be described. Note that the same functions and configurations as those of the above embodiment are denoted by the same reference numerals, and detailed description thereof is omitted. As shown in FIG. 13, the processor 130 of this embodiment has a treatment instrument information DB 132 in the HDD 131. The treatment tool information DB 132 is a collection of treatment tools 60 required for endoscopic examination for each examination content. For example, as shown in FIG. 14, the treatment instrument information DB 132 stores a plurality of treatment instrument information 133 a in which the name of the examination content is associated with the type of each treatment instrument 60 necessary for the examination content. Thus, when performing a predetermined endoscopic examination, the treatment tool information DB 132 is searched based on the examination content, and the treatment tool information 133a corresponding to the examination content is read, so that each treatment necessary for the examination is performed. The tool 60 can be easily derived.

  When the start of the endoscopic examination is instructed by selecting a predetermined examination reservation, the CPU 135 of the processor 130 monitors the endoscopic image 122 (see FIG. 10A) as in the first embodiment. 36. When the start of the endoscopic examination is instructed, the CPU 135 accesses the treatment instrument information DB 132 as shown in FIG. 15, and based on the examination contents included in the examination appointment information 24 of the selected examination appointment. The treatment tool information DB 132 is searched. Then, the treatment instrument information 133a corresponding to the examination content of the examination is read from the treatment instrument information DB 132 and placed in the CPU 135 as the treatment instrument information 133b.

  The CPU 135 that has read the treatment tool information 133b instructs the tag reader 80 to start reading the type information 84a. When the reading start is instructed from the CPU 135, the tag reader 80 outputs a radio wave having a predetermined frequency from the antenna 79. Then, in response to the treatment instrument 60 being inserted into the forceps port 70, wireless communication is performed with the RFID tag 78 of the treatment instrument 60, and the type information 84 a is read from the RFID tag 78. When the tag reader 80 reads the type information 84a, the type information 84b is input to the CPU 135.

  When the CPU 135 receives the type information 84b from the tag reader 80, the CPU 135 determines based on the treatment tool information 133b and the type information 84b whether or not the treatment tool 60 inserted through the forceps port 70 corresponds to the examination. . This determination is performed by confirming whether or not the type indicated by the type information 84b read via the tag reader 80 is included in the type of each treatment tool 60 indicated by the treatment tool information 133b.

  When the type indicated by the type information 84b is included in the type of each treatment tool 60 indicated by the treatment tool information 133b, the CPU 135 corresponds to the treatment tool 60 inserted through the forceps opening 70. Is determined. On the other hand, when the type indicated by the type information 84b is not included in the type of each treatment tool 60 indicated by the treatment tool information 133b, the CPU 135 corresponds the treatment tool 60 inserted through the forceps opening 70 to the inspection. Judge that it is not a thing.

  When the CPU 135 determines that the treatment tool 60 inserted through the forceps opening 70 is not compatible with the examination, the CPU 135 displays a warning window 136 on the endoscopic image 122 as shown in FIG. The operator is informed that an unsupported treatment tool 60 has been inserted into the forceps port 70. The warning window 136 is provided with an OK button 138 for instructing that the warning window 136 has been confirmed. The CPU 135 hides the warning window 136 in response to the OK button 138 being clicked.

  For example, when an endoscopic examination of the upper gastrointestinal tract is performed, there is a concern that a medical accident may occur if the treatment tool 60 for the lower gastrointestinal tract is used. Therefore, by notifying that the treatment instrument 60 that does not support the examination has been inserted into the forceps port 70 as described above, a medical accident or the like associated with the use of the treatment instrument 60 that is not appropriate for the examination content can be obtained. It can be surely prevented.

  On the other hand, when the CPU 135 determines that the treatment tool 60 inserted through the forceps opening 70 is compatible with the examination, the CPU 135 continues the state in which only the endoscopic image 122 is displayed (see FIG. 10A). Let the surgeon perform the examination.

  Next, the operation of the second embodiment will be described with reference to the flowchart shown in FIG. An operator who performs an endoscopic examination, after preparing for an examination, receives a schedule table from the examination reservation management server 12, selects a predetermined examination reservation from the schedule table, and instructs the start of the examination. When instructed to start the examination, the CPU 135 of the processor 130 displays the endoscopic image 122 (see FIG. 10A) on the monitor 36.

  Further, when the start of the examination is instructed, the CPU 135 displays the endoscopic image 122 and, as shown in FIG. 15, the treatment instrument information 133a corresponding to the examination content of the examination is displayed. Is stored in the CPU 135 as contraindication information 133b. When reading the treatment tool information 133b, the CPU 135 instructs the tag reader 80 to start reading the type information 84a. The tag reader 80 starts reading in response to an instruction from the CPU 135, and reads the type information 84 a from the RFID tag 78 of the treatment tool 60 when the treatment tool 60 is inserted into the forceps port 70. When the type information 84a is read, the type information 84b is input to the CPU 135.

  When the CPU 135 receives the type information 84b from the tag reader 80, the CPU 135 determines based on the treatment tool information 133b and the type information 84b whether or not the treatment tool 60 inserted through the forceps port 70 corresponds to the examination. . If the CPU 135 determines that the treatment instrument 60 inserted into the forceps opening 70 is not compatible with the examination, the CPU 135 displays a warning window 136 (see FIG. 16) on the endoscopic image 122 and warns from the speaker 109. A sound is output to notify the surgeon that the treatment instrument 60 not corresponding to the examination has been inserted into the forceps port 70. Thereby, a medical accident or the like due to the use of the treatment tool 60 that is not appropriate for the examination content is surely prevented. In addition, since the CPU 135 makes a determination and notifies the result, there is no worry that the operator or the like is troublesome.

  When the surgeon confirms that the treatment tool 60 does not support the examination by a warning sound from the warning window 136 or the speaker 109, the surgeon pulls out the treatment tool 60 from the forceps opening 70. Thereafter, the mouse 108 is operated, and the OK button 138 provided in the warning window 136 is clicked. In response to the click of the OK button 138, the CPU 135 hides the warning window 136, stops the warning sound from the speaker 109, and ends the notification to the operator.

  On the other hand, when the CPU 135 determines that the treatment tool 60 inserted through the forceps opening 70 is compatible with the examination, the CPU 135 continues the state in which only the endoscopic image 122 is displayed (see FIG. 10A). Let the surgeon perform the examination. In addition, when the contraindication information 120b corresponding to the target patient is read, the CPU 135 repeats the above processing every time the treatment tool 60 is inserted into the forceps port 70 until the examination is completed.

  In the present specification, the embodiments have been described separately, but the use of the treatment instrument 60 inserted through the forceps opening 70 is prohibited by combining the first embodiment and the second embodiment. It may be determined simultaneously whether or not it corresponds to the inspection. As a result, it is possible to reliably prevent medical accidents associated with the use of the treatment tool 60 that is not appropriate for the target patient and the use of the treatment tool 60 that is not appropriate for the examination content.

  Further, in each of the above embodiments, the icon information DB 112, the contraindication information DB 114, and the treatment tool information DB 132 are constructed in the HDDs 107 and 131. However, the DBs 112, 114, and 132 are not limited to this, for example, the power is shut off. Alternatively, it may be a storage device composed of a semiconductor memory that holds the memory. Further, it may be stored in a recording medium such as a CD or a DVD or a memory card such as a compact flash (registered trademark) or an SD card and read out. Further, it may be constructed in a server connected to the LAN 20. In each of the above embodiments, the CPU 106 and 135 read out the information such as the contraindication information 120a, the treatment tool information 133a, and the patient information. However, the present invention is not limited to this. You may make it perform to an operator etc.

  Further, in each of the above-described embodiments, the AMP 100, the CDS / PDA 102, and the A / D 103 are illustrated as being included in the processor devices 32 and 130, but may be included in the electronic endoscope 30. Further, the AMP 100, the CDS / PDA 102, and the A / D 103 may be provided outside the electronic endoscope 30 and the processor devices 32 and 130 as separate adapters. In addition, the AMP 100 and the CDS / PDA 102 and the A / D 103 may be separated and included in a plurality of apparatuses. For example, the AMP 100 and the CDS / PDA 102 are included in the electronic endoscope 30, and the A / D 103 is included in the processor device 32, 130 may be included. Further, the AMP 100 may be included in the electronic endoscope 30, and the CDS / PDA 102 and the A / D 103 may be included in the processor devices 32 and 130.

  Further, in each of the above embodiments, the tag reader 80 is shown as being included in the processor devices 32 and 130, but the tag reader 80 may be provided outside the processor devices 32 and 130.

  Further, in each of the above embodiments, the CPU 135 reads out the contraindication information 120a in the contraindication information DB 114 and performs control based on the contraindication information 120b placed in the CPU 135, but the contraindication information DB 114 is used instead of the read out contraindication information 120b. The contraindication information 120a may be used.

  Further, in each of the above embodiments, it has been shown that the CPU 135 reads the treatment tool information 133a in the treatment tool information DB 132 and performs control based on the treatment tool information 133b placed on the CPU 135, but instead of the read treatment tool information 133b. Alternatively, the treatment tool information 133a in the treatment tool information DB 132 may be used.

  Further, in each of the above-described embodiments, the information is acquired by accessing the examination reservation management server 12 and reading out the examination reservation information 24 including the patient ID, the examination contents, and the like. Instead, the operator may be allowed to input such information.

  In each of the above embodiments, the example in which the present invention is applied to the endoscopic examination system 2 constructed in one medical facility has been shown. However, the present invention is not limited to this, and for example, a plurality of units Connect multiple medical facilities such as connecting the core hospital of the region with the endoscopic examination device 10 to other hospitals and clinics via the Internet so that other hospitals and clinics can apply to the central hospital for examination reservations. You may apply to the system constructed | assembled by connecting with a network. In each of the above embodiments, the endoscopic inspection apparatus 10 is shown as an inspection support apparatus. However, the inspection support apparatus is not limited to this, and may be configured as an apparatus different from the endoscopic inspection apparatus 10. Good.

It is explanatory drawing which shows the structure of an endoscopy system roughly. It is explanatory drawing which shows an example of the procedure of the inspection reservation of an endoscopic inspection. It is a front view which shows the structure of an endoscopic inspection apparatus schematically. It is a perspective view which shows the state by which the treatment tool was mounted in the top tray. It is explanatory drawing which shows the use condition of a treatment tool. It is explanatory drawing which shows the structure of a RFID tag roughly. It is a block diagram which shows roughly the electrical structure of an electronic endoscope and a processor. It is explanatory drawing which shows an example of a structure of icon information DB. It is explanatory drawing which shows an example of a structure of contraindication information DB. It is explanatory drawing which shows the example of a display of an endoscopic image. It is explanatory drawing which shows roughly the procedure of determination whether the use of a treatment tool is prohibited. It is a flowchart which shows roughly the procedure of the process which determines whether use of a treatment tool is prohibited. It is a block diagram which shows the example which provided treatment tool information DB in the processor. It is explanatory drawing which shows an example of a structure of treatment tool information DB. It is explanatory drawing which shows roughly the procedure of determination whether a treatment tool is a thing corresponding to a test | inspection. It is explanatory drawing which shows the example which displayed the warning window which alert | reports that the treatment tool not corresponding to a test | inspection was inserted on the endoscopic image. It is a flowchart which shows roughly the procedure of the process which determines whether a treatment tool is a thing corresponding to a test | inspection.

Explanation of symbols

2 Endoscopic inspection system 10 Endoscopic inspection device (inspection support device)
16 Information management server (patient information storage means)
30 Electronic endoscope (endoscope)
36 Monitor (notification means, treatment instrument approach direction notifying means)
60 treatment tool 70 forceps port 78 RFID tag (type information storage means)
80 Tag reader (reading means)
90 CCD (imaging device)
92 ROM (identification information storage means)
94 Scope identification information 106, 135 CPU (determination means)
109 Speaker (notification means)
114 Contraindication information DB (Contraindication information storage means)
116 icon 132 treatment tool information DB (treatment tool information storage means)

Claims (8)

An endoscope provided with an insertion channel through which a treatment tool is inserted;
Reading means for reading the type information of the treatment tool inserted into the insertion channel from the type information storage means provided in the treatment tool;
Based on the type information read by the reading means, determination means for determining whether or not the treatment instrument inserted into the insertion channel is appropriate;
An endoscopy system comprising: an informing unit for informing a determination result of the determining unit. Contained in contraindication information storage means for storing information indicating a medical history or constitution and incompatible information associated with the type of the treatment tool prohibited to use for these,
The determination means determines whether or not the use of the treatment instrument inserted into the insertion channel is prohibited based on the contraindication information of the patient to be examined and the type information, and is prohibited. In this case, the endoscopic examination system according to claim 1, wherein the treatment instrument is determined not to be appropriate for a patient to be examined. Patient information storage means for storing patient information representing the patient's personal information,
The determination unit reads patient information of a patient to be examined from the patient information storage unit, and reads the contraindication information corresponding to the patient to be examined from the contraindication information storage unit based on the patient information. The endoscopy system according to claim 2. A treatment tool information storage means for storing treatment tool information in which examination contents and types of treatment tools necessary for examination are associated with each other,
The determination means reads out the treatment tool information corresponding to the examination content input in advance from the treatment tool information storage means and confirms whether or not the type indicated by the type information is included in the treatment tool information. The endoscope according to any one of claims 1 to 3, wherein when it is not included, the treatment instrument inserted into the insertion channel is determined not to be appropriate for the examination content. Mirror inspection system. The endoscope includes an insertion portion that is inserted into a body cavity of a patient, and an imaging element that captures image light incident through an observation window provided at a distal end of the insertion portion,
The endoscope model is identified based on the identification information for identifying the endoscope model, and the direction in which the treatment instrument enters the angle of view of the image sensor is notified according to the model. The endoscopic examination system according to any one of claims 1 to 4, further comprising a treatment instrument approach direction notifying unit.   The endoscopy system according to any one of claims 1 to 5, wherein the type information storage means is an RFID tag, and the reading means is a tag reader that wirelessly communicates with the RFID tag. . In an examination support apparatus for supporting examination using an endoscope provided with an insertion channel through which a treatment tool is inserted,
Reading means for reading the type information of the treatment tool inserted into the insertion channel from the type information storage means provided in the treatment tool;
Based on the type information read by the reading means, determination means for determining whether or not the treatment instrument inserted into the insertion channel is appropriate;
An inspection support apparatus comprising: an informing unit for informing a determination result of the determining unit. In an endoscopic inspection method for performing an inspection using an endoscope provided with an insertion channel through which a treatment tool is inserted,
Reading the type information of the treatment instrument inserted into the insertion channel with a reading unit from the type information storage unit provided in the treatment instrument;
Based on the read type information, a step of determining whether or not the treatment tool inserted through the insertion channel is appropriate, and
And a step of notifying the determination result of the determination means by a notification means.

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