JP2020032080A - Controller - Google Patents

Abstract

To provide a controller capable of inhibiting a state in which an irradiation part is strongly pressed to a patient's body from being generated.SOLUTION: A controller controls a percutaneous treatment device. The controller comprises a load acquisition unit, an index determination unit, and an evacuation unit. The load acquisition unit acquires, using a sensor, a load applied to an irradiation part of the percutaneous treatment device by a patient's body. The index determination unit determines whether or not the load or an index, a variation in the load, exceeds a previously set index threshold. The evacuation unit keeps the irradiation part away from the patient's body by taking as a necessary condition the index determination unit determining that the index exceeds the index threshold.SELECTED DRAWING: Figure 1

Description

  The present disclosure relates to a control device.

  Conventionally, a HIFU (High Intensity Focused Ultrasound) treatment system is known. The HIFU treatment system includes an irradiation unit that irradiates an ultrasonic wave. The ultrasonic waves emitted from the irradiation unit converge on the focal point. Before irradiating the ultrasonic waves, the operator moves the irradiation unit so that the irradiation position of the ultrasonic waves coincides with the target irradiation position. The target irradiation position is an affected part to be treated. A HIFU treatment system is disclosed in US Pat.

Japanese Patent No. 5998017

  The patient's body may move after the irradiator has begun irradiating ultrasound or during preparation for irradiation. When the patient's body moves, the irradiation unit is in a state of being strongly pressed against the patient's body (hereinafter referred to as a pressed state). The present disclosure provides a control device that can suppress the occurrence of a pressing state even after the irradiation unit starts irradiating an ultrasonic wave or when a patient's body moves during preparation for irradiation.

  One aspect of the present disclosure is a control device for controlling a percutaneous treatment device, wherein the control device is configured to use a sensor to obtain a load applied by a body of a patient to an irradiation unit of the percutaneous treatment device. A load acquisition unit, an index determination unit configured to determine whether the load, or an index that is a change amount of the load, exceeds a preset index threshold, and the index exceeding the index threshold. And an evacuation unit that moves the irradiation unit away from the patient's body, as a necessary condition that the index determination unit makes a judgment.

  The control device according to one aspect of the present disclosure can suppress the occurrence of the pressing state even after the irradiation unit starts irradiating the ultrasonic wave or when the patient's body moves during preparation for irradiation.

FIG. 2 is an explanatory diagram illustrating a configuration of a treatment system 1. FIG. 2 is a block diagram illustrating an electrical configuration of the treatment system 1. FIG. 3 is a block diagram illustrating a functional configuration of a control device 3. 6 is a flowchart illustrating a process executed by the control device 3. FIG. 9 is an explanatory diagram illustrating an example of time-series data of an index I. 6 is a flowchart illustrating a process executed by the control device 3. 6 is a flowchart illustrating a process executed by the control device 3.

Exemplary embodiments of the present disclosure will be described with reference to the drawings.
1. Configuration of Treatment System 1 The configuration of the treatment system 1 will be described with reference to FIGS. As shown in FIGS. 1 and 2, the treatment system 1 includes a control device 3, a HIFU control unit 5, an ultrasonic diagnostic unit 7, a robot control unit 9, a robot arm 11, a tip unit 13, a monitoring unit A force sensor 15 and a respiratory rate measurement sensor 16 are provided.

  As shown in FIG. 2, the control device 3 includes a microcomputer having a CPU 17 and a semiconductor memory such as a RAM or a ROM (hereinafter, referred to as a memory 19). Each function of the control device 3 is realized by the CPU 17 executing a program stored in a non-transitional substantial recording medium. In this example, the memory 19 corresponds to a non-transitional substantial recording medium storing a program. When this program is executed, a method corresponding to the program is executed. The control device 3 may include one microcomputer or a plurality of microcomputers.

  As shown in FIG. 3, the control device 3 includes a load acquisition unit 101, an index determination unit 103, a retreat unit 105, a cycle determination unit 107, an upper limit determination unit 109, a respiration rate measurement unit 111, A cycle setting unit 113, a set time determination unit 115, and an irradiation end unit 117 are provided.

  The technique for realizing the functions of each unit included in the control device 3 is not limited to software, and some or all of the functions may be realized using one or a plurality of hardware. For example, when the above function is implemented by an electronic circuit that is hardware, the electronic circuit may be implemented by a digital circuit, an analog circuit, or a combination thereof.

  The HIFU control unit 5 includes an amplifier of a HIFU irradiation unit 33 described later. The HIFU control unit 5 starts and stops the irradiation of the ultrasonic wave by the HIFU irradiation unit 33. Further, the HIFU control unit 5 adjusts the output of the ultrasonic wave irradiated by the HIFU irradiation unit 33.

  The ultrasonic diagnostic unit 7 acquires an ultrasonic image using a diagnostic probe 35 described later. The ultrasound image is an image representing the inside of the patient 34. The ultrasonic diagnostic unit 7 has a monitor 8. The ultrasonic diagnostic unit 7 can display an ultrasonic image on the monitor 8.

  The robot controller 9 controls the operation of the robot arm 11. As shown in FIG. 1, the base 27 of the robot arm 11 is fixed to a table 29. The distal end unit 13 and the monitoring force sensor 15 are attached to the distal end portion 31 of the robot arm 11. The robot arm 11 can change the positions of the tip unit 13 and the monitoring force sensor 15 by operating. The robot arm 11 can press a water bag 37, which will be described later, of the tip unit 13 against the body of the patient 34. The patient 34 lies on a bed 36.

  The tip unit 13 includes a HIFU irradiation unit 33, a diagnostic probe 35, a water bag 37, an operation unit 39, and an operation force sensor 41. The HIFU irradiator 33 irradiates the ultrasound of the focus to the body of the patient 34. The tip unit 13 and the HIFU controller 5 correspond to a percutaneous treatment device. A percutaneous treatment device is a device that irradiates ultrasonic waves, radiation, and the like to the inside of a patient from the outside. The tip unit 13 corresponds to an irradiation unit. The water bag 37 is located between the HIFU irradiation unit 33 and the patient 34. The water bag 37 is pressed against the patient 34.

The diagnostic probe 35 creates an ultrasound image representing the inside of the patient 34 using ultrasound. The diagnostic probe 35 sends an ultrasonic image to the ultrasonic diagnostic unit 7.
The operation unit 39 is a handle that can be gripped by the operator 43. The operation unit 39 is operated by the operator 43. The operation force sensor 41 detects the magnitude and direction of the force applied to the operation unit 39 by the operator 43. The robot controller 9 operates the robot arm 11 according to the magnitude and direction of the force detected by the operation force sensor 41.

The monitoring force sensor 15 detects a load applied by the body of the patient 34 to the distal end unit 13. The respiration rate measurement sensor 16 measures the respiration rate of the patient 34.
2. Process Executed by Control Device 3 A process executed by the control device 3 when the HIFU irradiating unit 33 irradiates an ultrasonic wave will be described with reference to FIGS. The control device 3 repeatedly executes this process at predetermined time intervals. In step 1 in FIG. 4, the load obtaining unit 101 obtains the load applied by the body of the patient 34 to the distal end unit 13 using the monitoring force sensor 15. The obtained load is defined as an initial load F0.

In step 2, the load acquisition unit 101 acquires the load applied by the body of the patient 34 to the distal end unit 13 using the monitoring force sensor 15. The obtained load is defined as a load F.
In Step 3, the load acquisition unit 101 calculates the index I. The index I is an absolute value of a value obtained by subtracting the initial load F0 obtained in step 1 from the load F obtained in step 2 immediately before. Index I corresponds to the amount of change in load.

  In step 4, the upper limit determination unit 109 determines whether or not the index I calculated in step 3 is equal to or less than a preset upper limit Th1. If it is determined that the index I is equal to or less than the upper limit value Th1, the process proceeds to step S5. When it is determined that the index I exceeds the upper limit Th1, the process proceeds to step 9.

  In step 5, the index determination unit 103 determines whether or not the index I calculated in step 3 is equal to or less than a preset index threshold Th2. The index threshold Th2 is smaller than the upper limit Th1. The index threshold value Th2 is, for example, 20N. If it is determined that the index I is equal to or less than the index threshold Th2, the process proceeds to step 6. If it is determined that the index I exceeds the index threshold Th2, the process proceeds to step S8.

  In step 6, the set time determination unit 115 determines whether the set time has elapsed since the start of the ultrasonic irradiation. If it is determined that the set time has elapsed, the process proceeds to step 7. If it is determined that the set time has not elapsed, the process proceeds to step 2.

In step 7, the irradiation end unit 117 ends the irradiation of the ultrasonic wave.
In step 8, the cycle determination unit 107 determines whether or not the time-series data of the index I periodically changes at a preset respiratory cycle. The time-series data of the index I is data obtained by arranging a plurality of indices I calculated by the process of step 3 executed a plurality of times in the order of the calculated times. FIG. 5 shows an example of the time-series data of the index I.

  The respiratory cycle is a numerical range of the cycle set to include the respiratory cycle of the patient 34. The respiratory cycle is, for example, in a range from 1.5 seconds to 10 seconds. The control device 3 can set the respiratory cycle as follows, for example. The respiration rate measurement unit 111 measures the respiration rate of the patient 34 using the respiration rate measurement sensor 16. The respiratory cycle setting unit 113 converts the measured respiratory rate into a respiratory cycle of the patient 34. The respiratory cycle setting unit 113 sets the range of the respiratory cycle so as to include the respiratory cycle of the patient 34.

  If it is determined that the time-series data of the index I changes periodically in the respiratory cycle, the process proceeds to step 6. When it is determined that the time-series data of the index I does not periodically change in the respiratory cycle, the process proceeds to step 9. As a case where it is determined that the time-series data of the index I does not periodically change in the respiratory cycle, there is a case where the time-series data of the index I does not periodically change. Further, as a case where it is determined that the time-series data of the index I does not periodically change in the respiratory cycle, the time-series data of the index I changes periodically, but the change cycle is outside the range of the respiratory cycle. It may be.

In step 9, the retreat unit 105 stops the irradiation of the ultrasonic wave.
In step 10, the retreat unit 105 moves the robot arm 11 to move the tip unit 13 away from the body of the patient 34. The moving direction of the distal unit 13 when moving the distal unit 13 away from the body of the patient 34 is opposite to the moving direction when the distal unit 13 approaches the patient 34 immediately before. The retreat unit 105 moves the tip unit 13 until the value of the load F acquired by the load acquisition unit 101 becomes equal to or less than a preset threshold.

3. Effect of Control Apparatus 3 (1A) The index I may increase when the body of the patient 34 moves. The control device 3 moves the tip unit 13 away from the body of the patient 34 on condition that the index I exceeds the index threshold Th2. Therefore, the control device 3 can suppress the occurrence of the pressing state even when the body of the patient 34 moves.

  (1B) The index I may increase due to the breathing of the patient 34. When the index I is increased by the breathing of the patient 34, the necessity to move the tip unit 13 away from the patient 34 is low. When the index I is increased due to the respiration of the patient 34, the necessity of stopping the ultrasonic irradiation is low.

  When the index I is increased by the respiration of the patient 34, the time-series data of the index I changes periodically with the respiratory cycle. Even if the index I exceeds the index threshold I, the control device 3 does not move the distal end unit 13 away from the body of the patient 34 if the time-series data of the index I changes periodically in the respiratory cycle.

Therefore, when the index I is increased due to the breathing of the patient 34, the control device 3 can suppress the tip unit 13 from moving away from the body of the patient 34. In addition, the control device 3 can suppress stopping the irradiation of the ultrasonic wave when the index I is increased due to the breathing of the patient 34.
For example, assume that the index I is calculated at time t1 shown in FIG. The index I at this time exceeds the threshold index Th2 and is smaller than the upper limit Th1. The time-series data of the index I immediately before the time t1 changes periodically in the respiratory cycle due to the respiration of the patient 34. In this case, the control device 3 makes an affirmative determination in step 4, makes a negative determination in step 5, and makes an affirmative determination in step 8. As a result, the control device 3 does not retract the tip unit 13.

  Further, for example, it is assumed that the index I is calculated at time t2 shown in FIG. The index I at this time exceeds the threshold index Th2 and is smaller than the upper limit Th1. The time-series data of the index I immediately before the time t2 changes irregularly. The reason why the time-series data of the index I changes irregularly is not the breathing of the patient 34 but, for example, the body motion of the patient 34. In this case, the control device 3 makes an affirmative determination in step 4, makes a negative determination in step 5, and makes a negative determination in step 8. As a result, the control device 3 stops the irradiation of the ultrasonic wave in the step 9 and retracts the tip unit 13 in the step 10.

  (1C) When the index I exceeds the upper limit value Th1, the control device 3 controls the distal end unit 13 regardless of whether the time-series data of the index I changes periodically in the respiratory cycle. Move away from the patient's body. Therefore, the control device 3 can suppress occurrence of a remarkable pressing state.

  For example, it is assumed that the index I is calculated at time t3 shown in FIG. The index I at this time exceeds the upper limit Th1. In this case, the control device 3 makes a negative determination in step 4 described above. As a result, the control device 3 stops the irradiation of the ultrasonic wave in the step 9 and retracts the tip unit 13 in the step 10.

  (1D) The control device 3 measures the respiratory rate of the patient 34. Then, the control device 3 sets a respiratory cycle based on the measured respiratory rate. Therefore, the control device 3 can set a respiratory cycle suitable for the patient 34.

  (1E) When the body of the patient 34 moves and is pressed, the irradiation position may be shifted from the target irradiation position. When moving the distal end unit 13 away from the body of the patient 34, the control device 3 stops the irradiation of the ultrasonic waves. For this reason, the control device 3 can suppress the irradiation of the ultrasonic wave to the position deviating from the target irradiation position.

(1F) The moving direction of the tip unit 13 when the tip unit 13 is moved away from the body of the patient 34 is opposite to the moving direction when the tip unit 13 approaches the patient 34 immediately before. Therefore, the control device 3 can more reliably suppress the occurrence of the pressing state.
<Second embodiment>
1. Differences from the First Embodiment The basic configuration of the second embodiment is the same as that of the first embodiment, and therefore the differences will be described below. The same reference numerals as in the first embodiment denote the same components, and refer to the preceding description.

In the first embodiment described above, the processing shown in FIG. 4 is executed. On the other hand, the second embodiment differs from the first embodiment in that the processing shown in FIG. 6 is executed.
2. Process Performed by Control Device 3 A process performed by the control device 3 when the HIFU irradiating unit 33 irradiates an ultrasonic wave will be described with reference to FIG. The control device 3 repeatedly executes this process at predetermined time intervals.

Steps 11 to 13 are the same as steps 1 to 3 in the first embodiment.
In step 14, the index determination unit 103 determines whether the index I calculated in step 13 is equal to or less than a preset index threshold Th2. When it is determined that the index I is equal to or smaller than the index threshold Th2, the process proceeds to step S15. When it is determined that the index I exceeds the index threshold Th2, the process proceeds to step S17.

Steps 15 to 19 are the same as steps 6 to 10 in the first embodiment.
3. According to the second embodiment described in detail above, the effects (1A), (1B), (1D), and (1E) of the above-described first embodiment are achieved.
<Third embodiment>
1. Differences from the First Embodiment The third embodiment has the same basic configuration as that of the first embodiment, and therefore the differences will be described below. The same reference numerals as in the first embodiment denote the same components, and refer to the preceding description.

In the first embodiment described above, the processing shown in FIG. 4 is executed. On the other hand, the third embodiment differs from the first embodiment in that the processing shown in FIG. 7 is executed.
2. Process Executed by Control Device 3 A process executed by the control device 3 when the HIFU irradiating unit 33 emits an ultrasonic wave will be described with reference to FIG. The control device 3 repeatedly executes this process at predetermined time intervals.

Steps 21 to 23 are the same as steps 1 to 3 in the first embodiment.
In step 24, the index determination unit 103 determines whether or not the index I calculated in step 23 is equal to or less than a preset index threshold Th2. When it is determined that the index I is equal to or smaller than the index threshold Th2, the process proceeds to step S25. When it is determined that the index I exceeds the index threshold Th2, the process proceeds to step 27.

The processing of steps 25 to 28 is the same as the processing of steps 6, 7, 9, and 10 in the first embodiment.
3. According to the third embodiment described in detail above, the effects (1A), (1D), and (1E) of the above-described first embodiment are achieved.
<Other embodiments>
Although the embodiments of the present disclosure have been described above, the present disclosure is not limited to the above embodiments, and can be implemented with various modifications.

  (1) In the first embodiment, the index I may be the load F obtained in the step 2. Even when the index I is the load F, the effects of the first embodiment can be obtained. In the second embodiment, the index I may be the load F acquired in the step 12. Even when the index I is the load F, the effect of the second embodiment can be obtained. In the third embodiment, the index I may be the load F obtained in step 22. Even when the index I is the load F, the effects of the third embodiment can be obtained.

  (2) In the first to third embodiments, when the control unit 3 moves the distal end unit 13 away from the body of the patient 34, the control unit 3 moves the distal end unit 13 until the amount of movement of the distal end unit 13 reaches a preset value. May be. The preset value can be, for example, 1 to 100 mm.

(3) In the first to third embodiments, the range of the respiratory cycle may be a fixed range.
(4) In the first to third embodiments, the moving direction of the distal end unit 13 when moving the distal end unit 13 away from the body of the patient 34 may be a direction in which the distal end unit 13 moves along the axial direction of the HIFU irradiation unit 33. . Also in this case, the control device 3 can more reliably suppress the occurrence of the pressing state.

  (5) In the first to third embodiments, another percutaneous treatment device may be used instead of the HIFU irradiation unit 33. Other percutaneous treatment devices include, for example, a radiation irradiation device.

  (6) In the first embodiment, when a negative determination is made in step 5, the process may always proceed to step 9. Also in this case, the control device 3 can achieve the effects (1A) and (1C) to (1F) of the first embodiment.

  (7) In the first to third embodiments, the above-described processing may be performed before starting irradiation of ultrasonic waves. The state before the start of the ultrasonic irradiation includes, for example, a state in which the tip unit 13 is in contact with the body of the patient 34, but the ultrasonic irradiation has not yet started.

(8) In the first to third embodiments, the control device 3 may move the distal end unit 13 away from the body of the patient 34 while continuing the irradiation of the ultrasonic wave.
(9) In the first to third embodiments, the control device 3 may stop the irradiation of the ultrasonic wave without moving the distal end unit 13 away from the body of the patient 34.
(10) A plurality of functions of one component in the above embodiment may be realized by a plurality of components, or one function of one component may be realized by a plurality of components. . Also, a plurality of functions of a plurality of components may be realized by one component, or one function realized by a plurality of components may be realized by one component. Further, a part of the configuration of the above embodiment may be omitted. Further, at least a part of the configuration of the above-described embodiment may be added to or replaced with the configuration of another above-described embodiment. It should be noted that all aspects included in the technical idea specified by the language described in the claims are embodiments of the present disclosure.

  (11) In addition to the control device described above, a treatment system including the control device as a component, a program for causing a computer to function as the control device, a non-transitional actual recording medium such as a semiconductor memory storing the program, The present disclosure can be realized in various forms such as a control method of a treatment system.

DESCRIPTION OF SYMBOLS 1 ... treatment system, 3 ... control apparatus, 5 ... HIFU control part, 7 ... ultrasonic diagnostic part, 8 ... monitor, 9 ... robot control part, 11 ... robot arm, 13 ... tip unit, 15 ... monitoring force sensor, 16: respiratory rate measurement sensor, 17: CPU, 19: memory, 27: base, 29: base, 31: tip, 33: HIFU irradiation unit, 34: patient, 35: diagnostic probe, 36: bed, 37 ... Water bag 39 operating unit 41 operating force sensor 43 operator 101 load obtaining unit 103 index determining unit 105 evacuation unit 107 cycle determining unit 109 upper limit determining unit 111: respiration rate measurement unit, 113: respiration cycle setting unit, 115: set time judgment unit, 117: irradiation end unit

Claims (7)

A control device for controlling a percutaneous treatment device,
Using a sensor, a load acquisition unit configured to acquire a load applied to the irradiation unit of the percutaneous treatment device by a patient's body,
An index determination unit configured to determine whether the load, or an index that is a change amount of the load, exceeds a preset index threshold,
As a necessary condition that the index determination unit determines that the index has exceeded the index threshold, a retreat unit that moves the irradiation unit away from the patient's body,
A control device comprising: The control device according to claim 1,
The index time series data further includes a cycle determination unit configured to determine whether or not periodically changing in a preset respiratory cycle,
The evacuation unit is that the index determination unit determines that the index exceeds the index threshold, and that the cycle determination unit determines that the time series data does not periodically change in the respiratory cycle. As a necessary condition, a control device for moving the irradiation unit away from the body of the patient. The control device according to claim 2, wherein
The index further includes an upper limit determination unit configured to determine whether or not an upper limit has been set in advance so as to be larger than the index threshold,
The control device, wherein when the upper limit determining unit determines that the index exceeds the upper limit, the retreat unit moves the irradiation unit away from the patient's body regardless of the determination result of the cycle determining unit. The control device according to claim 2 or 3,
A respiratory rate measurement unit configured to measure the respiratory rate of the patient,
Based on the respiratory rate measured by the respiratory rate measurement unit, a respiratory cycle setting unit configured to set the respiratory cycle,
A control device further comprising: The control device according to any one of claims 1 to 4,
The control device, wherein the retreat unit stops irradiation of the percutaneous treatment device when the irradiation unit is moved away from the body of the patient. The control device according to any one of claims 1 to 5,
The control device, wherein the retreat unit moves the irradiation unit in a direction opposite to a moving direction when the irradiation unit approached the patient immediately before moving the irradiation unit away from the patient's body. The control device according to any one of claims 1 to 5,
The control device, wherein the retreat unit moves the irradiation unit along an axial direction of the irradiation unit when moving the irradiation unit away from the patient's body.

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