Instruction transmission device, instruction transmission system, surgical system and instruction transmission method

Abstract

The invention describes an instruction transmission device (2, 10, 20, 2M, 20a). The instruction transmission device (2, 10, 20, 2M, 20a) comprises: a sensor unit (3a, 3b, 3c, 20, 71, 81) for detecting the movement of an operator (P); a fixing unit (2a) for fixing the sensor unit (3a, 3b, 3c, 20, 2M, 20a) on the operator (P); an evaluation unit (4, 15) for evaluating the detected movement of the operator (P) and identifying instructions (IB, ASB, KB) based on the detected movement; and an instruction transmission unit (5, 7) for transmitting a control instruction (SB) to a medical device (50) to be operated based on the identified instruction (IB, ASB, KB). An instruction transmission system (70, 80) is also described. A surgical system is also described. In addition, an instruction transmission method is described.

Description

Technical Field

[0001] The present invention relates to an instruction transmission device, an instruction transmission system, and an instruction transmission method. Background Art

[0002] With the aid of modern imaging methods, two-dimensional or three-dimensional image data are usually generated in medicine, which can be used to visualize the imaged examination object and, moreover, also for other applications.

[0003] Examples of modern imaging medical technology methods are computed tomography (CT), magnetic resonance tomography, the use of so-called PET scanners and X-ray imaging with the aid of C-arm systems.

[0004] In order to ensure the safety of the patient, it is proposed in all the methods that the imaging medical diagnosis can only be started when a qualified operator, such as a medical technical assistant (MTA), a radiologist or a doctor, indicates the activation of the device by means of a manual input. The traditional mechanism for manually inputting the activation instruction into the medical device is a switch, a key or a key and a button, wherein the switch, the key, the key and the button are usually directly arranged on or at the medical device. Alternatively, the activation mechanism mentioned can also be connected to the medical device via a cable connection or an electromagnetic radio connection. In addition, there may be an additional interface for interaction between the operator and the medical device, such as a key, a touch screen or a particularly common mechanical unit or electromechanical unit that can be operated by the operator by hand or foot, such as a foot switch. The input unit mentioned is usually part of an operating module.

[0005] In addition, there is also the problem of cleaning and disinfecting the operating elements in order to reduce the spread of diseases in the clinical area. Conventional operating modules are usually located on the floor and can therefore easily become dirty, contaminated with organic matter, especially body fluids, and can also be easily damaged by tripping.

[0006] For operation, the operator usually has to be in close proximity to such an operating module, such as a foot switch. As a result, when the operator wants to activate a specific medical device, the operator is bound to a specific position. A typical operating module for activating medical devices is a foot switch. However, the following problem is associated with such common foot switches: the foot switch requires at least one electrical line for power supply or data transmission, which runs on the floor of the examination room or operating room and is a tripping hazard for medical personnel.

[0007] Furthermore, joysticks are also used, for example, to operate a C-arm. By means of the joystick, a continuously variable variable of the movement can be changed, ie, for example, a small deflection can be carried out at a low speed and a large deflection can be carried out at a high speed.

[0008] Joysticks are also used to control motion sequences in the automotive industry, air traffic and robotics. For example, such joysticks can be arranged at the working height of a seated person and are not subject to as much soiling as units located on the floor. However, joysticks have the disadvantage that the user must use his hands to operate the device so that neither hand is free at the same time, for example to examine or treat a patient.

[0009] In addition, other devices with wireless links that can be operated by hand or by foot are also used to activate medical technology devices. However, in the case of wireless remote control by hand, the devices also have the disadvantage that the operator has no hands free for other interactions.

[0010] Mobile foot-operated devices are also used, which are connected via radio to the medical system to be controlled. Switching operations are mainly carried out using foot switches, such as, for example, switching radiation on and off or moving the examination table.

[0011] In the case of such devices, there are no cables that are a tripping hazard, nor is it necessary to use the hands to operate the mobile foot-operated device. However, if a plurality of such mobile foot-operated devices are spread out on the floor, the foot-operated device itself is a tripping hazard in this case. The above-mentioned hygiene problems also arise in the case of wireless transmission.

[0012] In addition to operating the electromechanical switch element for activating or deactivating the medical device, it is also desirable that the operator can also control other functions of the medical device. Examples of this are scrolling through images or browsing through image sequences, changing image contrast, zooming in or out in the image display, or changing other parameters specific to the modality.

[0013] It is also desirable to ensure the operation of safety-related functions by a second channel that is independent of the first operating channel. For example, the operation of the movement or radiation trigger of the medical technology device by the foot switch can be additionally confirmed by voice control, camera-based monitoring of a predetermined posture, or HF-based monitoring. For example, the gesture identified by the image detection can be made visible by the movement of the operator's hand or finger, wherein the gesture can represent grasping, releasing, moving or zooming. For example, the movement of the foot or toe can control the increase, slowing down, movement to the left or movement to the right of the speed. Eye movements to the left, right, upward or downward can represent direction determination. Head movements to the left or right can also be used for direction changes. In addition, in the case of controlling the action by gesture, feedback can be provided by a tactile signal, for example in the form of vibration, so as to confirm the triggering of the desired action to the operator.

[0014] By means of gesture control, the operator can simultaneously control the medical device and treat the patient. This can be achieved by not having to change position to operate the input device in order to trigger an action of the medical device. In this way, the operator can trigger an action without losing focus on the current treatment activity. When the operator needs his hands or eyes for treating the patient or operating another medical device, the operator can also control the medical device by providing instructions, for example, by foot movements. Medical technicians can also be saved in this simultaneous method approach. Summary of the invention

[0015] The object of the present invention is therefore to provide an operation and activation of medical technology equipment with improved safety against accidents and reduced effort for ensuring hygiene in the examination area, which can be carried out safely and comfortably even while simultaneously carrying out a treatment of a patient.

[0016] According to the present invention, the object is achieved by an instruction transmission device according to the present invention, an instruction transmission system according to the present invention, a surgical system according to the present invention, and an instruction transmission method according to the present invention.

[0017] The instruction transmission device according to the present invention has a sensor unit for detecting the body movement of the operator. Such a sensor unit includes at least one sensor. The sensor is set up to detect movement. Such movement can be determined, for example, by one or more acceleration measurements or by measuring mechanical deformation. The movement can follow a pre-defined movement pattern for generating instruction information. The sensor unit and / or even the entire instruction transmission device is fastened to the operator by a fixing unit. It should be mentioned here that the instruction transmission device is also preferably set up to not only process the sensor data of the internal sensor unit, but also additionally receive the sensor data of the external sensor and evaluate it. The fixing unit enables the sensor unit, preferably the instruction transmission device, to be used as an embedded system, which the operator always carries with him, without the operator having to hold the control unit, for example a joystick.

[0018] Part of the command transmission device according to the invention is also an evaluation unit for evaluating the detected movements of the operator and for recognizing the command based on the detected movements. The evaluation unit preferably comprises a so-called ultra-low-power microcontroller, which can be operated with a small amount of energy, for example by an autonomous energy generation system arranged at or in the command transmission device.

[0019] The sensor data detected by the sensor, preferably the movements of the operator detected by the sensor unit, are analyzed by the evaluation unit. The evaluation unit classifies the detected movement as follows: whether it is an intentional movement or an unintentional movement. This classification can be carried out, for example, by comparing the detected movement with one or more reference movements, each of which is associated with a specific instruction. The sensor unit therefore comprises an electromechanical component, by means of which the movements of the operator can be detected. If the instruction is recognized or identified, a control instruction based on the identified instruction, for example the identified instruction itself, is transmitted to the medical-technical device to be operated by the instruction transmission unit, which is also part of the instruction transmission device according to the invention.

[0020] Therefore, the instruction transmission device according to the present invention is configured as a mobile device in the form of a so-called "smart wearable device" that the operator always carries with him. Part or all of the instruction transmission device can be configured as a so-called embedded system, which is designed specifically for manipulating medical technology equipment through motion. The operator of the medical technology device can advantageously control the operating process through any predetermined motion. It is thus possible to achieve the completion of multiple tasks in parallel. For example, the operator can check the patient with his hands and control the medical technology device, such as an imaging medical technology device, with another body part at the same time. In addition, the operator always carries an input unit in the form of the instruction transmission device according to the present invention, so that the instruction transmission device does not cause obstacles or become a dust collector to anyone, and when the operator wants to transmit instructions, the operator does not have to look for the instruction transmission device.

[0021] Thus, hygiene regulations in examination rooms or operating rooms can also be more easily complied with, since the operating elements can be soiled less easily and, in the best case, each person has his own command transmission device, they are only used by one person in each case. Furthermore, since the functions of the medical device can be operated or manipulated contactlessly, the risk of cross-infection between the individual operators through contact infection can be avoided. Furthermore, the use of a command transmission device that can be carried around the body allows different medical devices to be operated in the same way.

[0022] The operating switches of different types of mechanical devices generally have different properties with respect to their position, their pressure points, the force required for operation and the functions realized by the operation. By means of the rearrangement of the input interface relative to the user according to the invention, a more intuitive operation with a uniform and cross-device operating concept can now be achieved. Due to the displacement of the input interface towards the body of the operator, the user's attention can also be kept on the current parallel activities during the operation of the medical technology device. For example, it is not necessary to divert attention from the patient in order to operate the medical technology device. Therefore, in the case of safety-related treatment steps that require full concentration, additional personnel who are responsible for the operation of the medical technology device in parallel are advantageously not required.

[0023] For example, similar functions can be triggered in the same way or with the same gesture in different devices, without the user having to look for the corresponding differently configured operating elements on the various differently structured devices. In this way, the familiarization time is reduced. For example, it is unnecessary to familiarize yourself with different user interfaces of different medical technology devices, because similar functions can always be controlled in the same way by the same body movements. By means of the command transmission device according to the invention, the operation of the medical technology device is advantageously integrated intuitively into the workflow. In addition, if the evaluation unit is designed to be programmable, multiple use and reusability for different applications is also possible.

[0024] The command transmission system according to the present invention has a first command transmission device according to the present invention with gesture recognition. The first command transmission device according to the present invention is fixed to the operator and is configured as a master device for bidirectional data exchange with at least one slave device. That is, according to the master-slave principle, the first command transmission device according to the present invention acts as a master. Therefore, commands can only be transmitted when command transmission is enabled via the first command transmission device according to the present invention.

[0025] Furthermore, the gesture sensor unit of the first command transmission device is activated, ie the first command transmission device reacts to the gesture control and is set up to transmit the determined command, preferably the initialization command, to the second command transmission device, preferably according to the invention.

[0026] Preferably, the second instruction transmission device according to the invention is also part of the instruction transmission system according to the invention and is arranged remotely from the operator, preferably at the medical-technical device to be operated. The second instruction transmission device is designed as a slave device for bidirectional data exchange with the master device and comprises an evaluation unit, which comprises at least one subunit for recognizing the content of the instruction based on the sensor data. The evaluation unit preferably comprises a gesture recognition unit, which is activated at a certain distance from the operator to detect the gesture of the operator. The evaluation unit also preferably comprises a speech recognition unit with speech recognition capabilities for recognizing the speech content based on the acoustic sensor data.

[0027] Therefore, the evaluation unit has the ability to detect the gestures or acoustic information of the operator at a certain distance from the operator. The function can be activated from the first command transmission device configured as the main device. Therefore, the second command transmission device preferably also includes a voice recognition capability, by means of which the voice command can be evaluated by the operator. In addition, the second command transmission device is set up to receive the instructions received by the first command transmission device, such as voice instructions, and transmit the control instructions to the medical technology device based on the instructions or operate the medical technology device based on the received instructions. Advantageously, the second command transmission device can first be initialized to be ready for reception by the instructions provided by the first command transmission device according to the present invention, for example, in a manner initiated by the movement or gesture of the operator. Subsequently, the operator controls the medical technology device by additional control instructions, which are either directly generated, for example, by voice instructions or gestures, or directly generated by the second command transmission device detecting voice instructions or gestures, or by the first command transmission device detecting the additional instructions and then transmitting the detected additional instructions to the second command transmission device, and then the second command transmission device operates the medical technology device according to the received or detected instructions.

[0028] The described two-stage method approach advantageously makes it possible to achieve increased reliability in the operation of the medical device, since the medical device can only be controlled if an initialization command has been previously provided by the operator.

[0029] The surgical system according to the invention comprises an imaging medical technology device for monitoring the operation of a patient. In particular, the surgical area located in the patient's interior can be shown by means of the imaging medical technology device before or during the operation. The surgical system according to the invention also comprises a surgical device. Such a surgical device can, for example, include equipment for minimally invasive surgery, instruments for treating and monitoring patients, such as monitoring of the most important body functions, and an operating table. The surgical system according to the invention also comprises an instruction transmission device according to the invention or an instruction transmission system according to the invention, which is set up to transmit control instructions to the imaging medical technology device and / or to control the imaging medical technology device by means of the instructions.

[0030] Advantageously, with the surgical system according to the invention, in addition to performing the surgery, medical imaging can also be performed by the same person, wherein the surgeon, for example, uses his hands to perform the surgery, tracks and monitors the surgical process in the patient's interior with his eyes on the screen of the medical imaging device, and simultaneously controls the imaging with the aid of another body part. The surgeon thus does not have to take his eyes off the screen in order to operate the medical imaging device and does not have to interrupt the surgical process. For example, the surgeon can dynamically adjust the positioning of the image display, the image parts and the area to be imaged during the surgical process in order to obtain an optimal display for the corresponding subsection of the surgery.

[0031] In the command transmission method according to the present invention, the movement of the operator is detected by a gesture recognition unit provided at the operator, the operator's command is recognized based on the detected movement, and the recognized command is transmitted to the medical device to be operated.

[0032] The instruction transmission method according to the present invention shares the advantages of the instruction transmission device according to the present invention.

[0033] The essential components of the command transmission device according to the invention can be designed for the most part in the form of software components. This relates in particular to parts of the evaluation unit and the command transmission unit.

[0034] Basically, however, the components can also be partially implemented, in particular when particularly fast calculations are involved, in the form of software-supported hardware, such as an FPGA, etc. Likewise, the required interfaces can be designed as software interfaces, for example if only data are received from other software components. However, the interfaces can also be designed as hardware-structured interfaces that are controlled by suitable software.

[0035] The implementation in software has the advantage that even when the required hardware, such as sensor units and fixture units, is retrofitted, a data processing device that is still in use can be easily set up by a software update to operate in the manner according to the invention. In this regard, the object is also achieved by a corresponding computer program product having a computer program that can be directly loaded into a storage device of a data processing device and includes program segments in order to carry out all the steps of the method according to the invention when the computer program is executed in the data processing device.

[0036] In addition to the computer program, such a computer program product may optionally include additional components such as, for example, documentation and / or additional components, and also hardware components such as, for example, a hardware key (dongle, etc.) for using the software.

[0037] A computer-readable medium, such as a memory stick, a hard disk or other transportable or fixedly mounted data carrier, on which program segments of a computer program are stored that are readable and executable by a data processing device, such as a computing unit, can be transported to a storage device of a data processing device and / or stored at the data processing device. For this purpose, the computing unit can have, for example, one or more cooperating microprocessors or the like.

[0038] The dependent claims and the following description each contain particularly advantageous designs and improvements of the invention. In this context, claims of one claim category can also be improved in a similar manner to dependent claims of another claim category. Furthermore, within the scope of the invention, different embodiments and different features of the claims can also be combined into new embodiments.

[0039] The sensor unit of the instruction transmission device according to the present invention preferably includes an internal gesture sensor unit for gesture recognition. The internal gesture sensor unit should be understood as a gesture sensor unit arranged in the clothing of the operator or in an object worn by the operator, that is, integrated into the object. Gesture recognition usually involves a targeted movement of a person, by means of which the person wants to transmit information, preferably a control command. Such a gesture can, for example, include a person's movement with one or two hands, with one or two feet, with one or two legs, with one or two eyes, or a head movement. The gesture can also include a pre-defined combination and / or sequence of one or more of the mentioned movements. Advantageously, the sensor unit is not visible from the outside or is protected from the outside, so that the operator is not hindered during his movement and the gesture sensor unit is well protected from mechanical damage. For example, the internal gesture sensor unit can be arranged in clothing. The gesture of the person carrying the instruction transmission device can be advantageously detected automatically and used to operate the medical technology device.

[0040] Gesture recognition can preferably be used to detect and recognize "intentional" movements. For example, if such "intentional" movements are recognized based on the movement pattern, instructions for preparing actions can be provided, for example. For example, voice input can be enabled to provide differentiated instructions for controlling medical technology devices.

[0041] In order to further increase the reliability with regard to the improved detection probability of the operation of the medical-technical device, the predetermined movement pattern can have a movement pattern of a so-called "unmistakable, intentional" movement. In order to make the recognition of the command particularly reliable, such "unmistakable, intentional" movement can include more complex movement sequences that cannot be easily confused with random natural movements. For example, the corresponding movement pattern can include tapping of the foot in a predetermined sequence, for example, tapping on the tiptoe, on the heel, on the tiptoe, or multiple tapping with the heel.

[0042] In order to achieve very reliable command transmission, it is particularly preferred to distribute multiple motion sensors at different body parts. For example, at least one sensor or even a complete command transmission device can be integrated in two shoes of a person. With the help of this arrangement, complex motion sequence patterns of two feet can be generated and recognized. For example, more complex motion patterns are also feasible by arranging motion sensors on multiple individual toes. Through this increase in the complexity of the control, on the one hand, the safety when recognizing commands based on body movements can be improved, and on the other hand, differentiated and more complex commands or command sequences can also be transmitted, thereby enabling detailed remote control of medical technology equipment.

[0043] Gesture recognition can preferably take place by detecting a movement of the sensor unit or a mechanical action on the sensor unit.

[0044] Binary actions such as, for example, switching on or off can be detected or triggered by a piezoelectric ceramic of the sensor unit as an alternative to a mechanical switch.

[0045] Larger and arbitrary changes of the action to be performed, such as, for example, a movement upwards or downwards or to the left or to the right, can be realized, for example, with the aid of an acceleration measuring device.

[0046] Furthermore, devices for measuring plastic deformation or changes in magnetic fields can also be used as sensor units.

[0047] The fixing unit of the instruction transmission device according to the present invention is preferably configured to fix the posture sensor unit on or in clothing, preferably in shoes. Therefore, the fixing unit can be integrated into clothing, preferably integrated into the sole of the shoe, and particularly preferably integrated into the shoe as an insole. The fixing unit of the instruction transmission device according to the present invention is preferably configured as a recess in the sole of the shoe. Particularly preferably, the fixing unit is configured to be removable or replaceable, for example, as a textile covering. The instruction transmission device can be advantageously worn almost passively by the operator, and the operator does not have to actively care about the instruction transmission device, for example, it is not necessary to grasp the instruction transmission device. Therefore, the limbs of the operator, especially the hands, can be used for tasks to be performed in parallel. When the instruction transmission device is integrated into the shoe or when the instruction transmission device is fastened to the shoe, compared with the control by hand, the possibility of widening and better comfort are obtained, because the hands are free for parallel activities. Therefore, the posture shoe sensor can realize additional degrees of freedom or design possibilities for the workflow of medical examinations. In particular, multiple actions can be controlled or executed in parallel. An example of manipulation within the scope of this workflow is the manipulation of image display in medical technology imaging methods. In this case, for example, the viewing angle or a zoom effect can be controlled by means of gestures, and an examination or treatment of the patient can be prepared or carried out manually in parallel.

[0048] The command transmission unit of the command transmission device according to the invention preferably also includes a radio transmission unit for transmitting the identified command to the medical device to be operated. Advantageously, the command transmission can be carried out wirelessly, so that no interfering transmission cables are required, which may be a source of interference for personnel or a potential cause of accidents, for example.

[0049] The instruction transmission device according to the invention preferably has an energy generation and storage unit, which is set up to generate electrical energy from the motion energy of the operator. This process is also called "energy harvesting (relative to German: Energieernten)" and involves obtaining a small amount of electrical energy for a mobile device with low electrical power from sources such as ambient heat, vibrations or air flows. The structure used to generate the energy is also called a nanogenerator. In the case of wireless technology, energy harvesting avoids the limitations caused by wired power supply or batteries. The energy generation and storage unit is preferably configured as an internal electronic energy generation and storage unit, which preferably has a piezoelectric ceramic that converts the energy of motion, such as the energy of the walking motion of the user wearing it, into electrical energy and stores it.

[0050] Particularly preferably, the command transmission device according to the invention is designed in such a way that the sensor unit comprises an acoustic sensor unit and the evaluation unit comprises a speech recognition unit for recognizing and interpreting the voice commands of the operator. By means of speech recognition, the voice is available for automatic data detection, so that data input can be performed by voice in order to operate the medical device. Voice commands can advantageously transmit more complex content than gestures. In addition, it is not necessary to memorize the marked gestures in order to operate the medical device. It is particularly advantageous for the operator to have his limbs, in particular his hands, free for activities to be performed in parallel.

[0051] The command transmission device is also preferably designed so that the internal gesture recognition recognizes one of the following functional commands:

[0052] - scrolling through images or browsing through a sequence of such images on an image display device of a medical technical apparatus,

[0053] - change the image contrast,

[0054] - Zoom in or out the image display,

[0055] - Change certain parameters of medical technology equipment.

[0056] In parallel with another activity, an image display or an adjustment of another parameter of the medical device can advantageously be carried out by means of gestures, without the operator being distracted from his main activity thereby.

[0057] The command transmission device according to the invention is preferably designed to transmit haptic feedback to an operator in response to a recognized command. The operator advantageously receives information that his command has been recognized and transmitted.

[0058] For this tactile feedback, the command transmission device according to the invention preferably comprises an actuator that can perform a mechanical movement, by means of which a signal is transmitted to the operator: the command provided by the movement, preferably the gesture, has been recognized and forwarded by the command transmission device. This movement of the actuator can, for example, include vibrations that are transmitted to the body of the operator and are tactilely perceived by the operator. Since the operating switch is not in contact with the movement or gesture, no mechanical feedback caused by the switch mechanism due to pressure points or reaction forces relative to the operating behavior occurs, so it is advantageous to supplement the traditional non-tactile remote control by means of movement or gesture, so that the person who performs the control movement, preferably the gesture, obtains a tactile impression similar to that when directly operating the switch or key. Since the command transmission device is directly fastened to the body part that performs the control movement, the feedback is provided at the part of the body of the operator who performs the control movement, which corresponds to the experience of the traditional control process caused by direct mechanical operation by hand or by operation by means of another body part.

[0059] Thus, when operating a medical device remotely, the operator does not have to get used to the tactile aspects of the process. Furthermore, due to the preferably immediate tactile feedback, the operator does not have to wait for the execution of his action in order to determine whether his control command has been recognized and only then repeat the control movement if necessary. Thus, by direct feedback, the operator saves time and can determine in the absence of immediate feedback that the control movement was not recognized and immediately repeat the control movement or, if necessary, continue with another control movement without time delay if the operator receives immediate feedback.

[0060] The second command transmission device of the command transmission system according to the invention is preferably configured to detect and recognize the voice commands of the operator after the voice recognition unit is activated, and to transmit the control commands to the medical device based on the recognized voice commands. The activation can preferably be carried out by the command transmitted by the first command transmission device, for example based on the gesture of the operator. This achieves a certain protection function. That is, it is ensured that the voice commands are also provided for controlling the medical device.

[0061] For example, a gesture recognition unit or a voice recognition unit may include the capability to recognize confirmation signals for:

[0062] - Radiation trigger,

[0063] -Magnetic field trigger,

[0064] - Movement of medical technology equipment.

[0065] From a formal legal point of view, exposure to X-rays is a physical injury and is therefore permitted only with the patient's consent.

[0066] Triggering the gradient for an MRT recording may cause acoustic physical damage, since without hearing protection the recording may be perceived as very loud.

[0067] Damage caused by motorized medical devices, such as examination tables or mobile C-arms, should be excluded by safety technology.

[0068] Thus, by means of a two-stage control with initiation or activation of the command transmission, the patient is advantageously protected from unintentional injuries due to increased radiation exposure, magnetic field exposure or mechanical effects caused by movements of the medical device.

[0069] The gesture recognition unit of the first command transmission device of the command transmission system according to the present invention is also preferably designed to detect one of the following gestures:

[0070] - Grasp, release, zoom, move with your hands or fingers,

[0071] - Eye movements to the left, right, up, down, blinking,

[0072] -Movement of the head to the left or right.

[0073] The command space and the input possibilities can advantageously be expanded with the aid of the described gestures. Some gestures with the aid of other body parts are particularly well suited to specific workflows. All the input possibilities listed here are considered to be significant advantages: apart from wearing special glasses equipped with a camera and an acceleration sensor, no special equipment, such as sensor gloves, etc., has to be worn or placed on the person. This does not restrict the user's freedom of movement and previous habits, since the sensor system for detecting movements is adapted to the user, rather than the user being adapted to the sensor system for detecting movements.

[0074] The first command transmission device of the command transmission system according to the invention is preferably configured to transmit tactile feedback to an operator in response to a recognized command. The operator advantageously receives information that his command has been recognized and transmitted. BRIEF DESCRIPTION OF THE DRAWINGS

[0075] The invention is described and explained in detail below based on the exemplary embodiments shown in the drawings.

[0076] The accompanying drawings show:

[0077] Figure 1 A schematic diagram of a shoe with two instruction transmission devices according to an embodiment of the present invention is shown,

[0078] Figure 2 A schematic diagram showing an instruction transmission device according to an embodiment of the present invention is shown.

[0079] Figure 3 A schematic diagram of a second instruction transmission device of an instruction transmission system according to an embodiment of the present invention is shown, wherein the second instruction transmission device is configured as a fixedly installed receiving device and an actuator device.

[0080] Figure 4 A schematic diagram showing a posture-shoe sensor according to an embodiment of the present invention is shown,

[0081] Figure 5 A schematic diagram showing a computer tomography system having an instruction transmission system according to an embodiment of the present invention is shown.

[0082] Figure 6 A flowchart illustrating a method for transmitting instructions according to an embodiment of the present invention is shown.

[0083] Figure 7 A schematic diagram showing an instruction transmission system according to an embodiment of the present invention is shown.

[0084] Figure 8 A schematic diagram of an instruction transmission system according to an embodiment is shown. DETAILED DESCRIPTION

[0085] exist Figure 1 1 shows a shoe 1 with two command transmission devices 2 according to an embodiment of the present invention. The command transmission devices 2 are designed as wireless shoe sensors and are respectively integrated into the sole via a fixing unit 2a, which respectively surrounds the command transmission device 2. The movement of the shoe 1 is controlled by the command transmission device 2 via the sensor (see Figure 2 Based on the evaluation, commands are generated, which are transmitted to the medical device so that the control, in particular switching on or off of the medical device, can be achieved in a remotely controlled manner without the operator having to approach the medical device himself or using his hands for the switching process.

[0086] Figure 2Schematically shown in the figure is a command transmission device 2 according to an embodiment of the present invention. The command transmission device 2 includes a plurality of sensors 3a, 3b, 3c for detecting motion or other physical information. The sensors 3a, 3b, 3c can, for example, respectively include pressure sensors, which measure voltage changes in response to the action of external mechanical forces. The generated sensor signal is transmitted to an evaluation unit 4, for example a microcontroller 4 with ultra-low energy consumption, which is also part of the command transmission device 2. The microcontroller 4 generates a command signal based on the sensor signal. The command transmission device 2 also includes a transmitting-receiving unit, in the simplest case an RF transmitter 5, and includes an antenna 7 for transmitting a command signal generated based on the expression of the operator's intention determined by the evaluation unit 4.

[0087] The transmitting / receiving unit 5 can also be used as an interface for receiving additional external sensor signals transmitted by an external unit to the command transmission device 2. For example, an external acoustic sensor unit and an external image data acquisition unit can detect information about the operator's voice expression and movement or posture changes and transmit them to the command transmission device 2.

[0088] In addition to the sensor data detected by the internal sensors 3 a , 3 b , 3 c , the acoustic data and the image data can then be evaluated by the evaluation unit 4 in order to determine the intended expression of the operator.

[0089] Furthermore, the command transmission device 2 comprises an internal electronic energy generation and energy storage unit 6. The energy generation and energy storage unit 6 comprises a piezoelectric ceramic element, by means of which electrical energy is generated by the action of mechanical forces on the element and can be stored. For example, the movement of a shoe, a leg or an arm can be used to generate electrical energy within the scope of a so-called energy harvesting process. The electrical energy is then stored in an electrical energy storage device, such as a capacitor or a battery, and is used to supply electrical energy to the microcontroller 4 or the evaluation unit 4, the transmitter 5 and the sensors 3a, 3b, 3c.

[0090] Figure 3 The fixed installation receiving device 10 of the instruction transmission system according to an embodiment of the present invention is illustrated in FIG. Figure 5 )include Figure 2 The instruction transmission device 2 shown in Figure 3 The fixedly installed receiving device 10 shown in FIG. The fixedly installed receiving device 10 is arranged, for example, in a medical device, such as Figure 5At the CT system 50 shown in . The fixedly mounted receiving device 10 includes a wireless receiving unit 11 and an actuator system 12. The wireless receiving unit 11 includes an antenna 13 and a receiver 14, such as an RF receiver, for receiving a command signal from a command transmission device 2 mounted on the shoe 1. In addition, the wireless receiving unit 11 also includes a microcontroller 15, which is configured to evaluate the command signal received from the wireless receiving unit 11. Based on the command signal, an initialization command IB is provided to the actuator system 12. The actuator system 12 includes a system microcontroller 1 and an actuator 17. The system microcontroller 16 receives the initialization command IB and transmits a control command to the actuator or switch, operating the actuator or the switch to start the operation of the medical imaging device.

[0091] exist Figure 4 A schematic diagram of a posture-shoe sensor 20 according to an embodiment of the present invention is illustrated in FIG. The posture-shoe sensor 20 comprises an inertial sensor mechanism 21, with the aid of which acceleration, rotation or magnetic field can be measured. Such a sensor mechanism may, for example, comprise a component in which a so-called MEMS is integrated in an IC and which provides a serial interface to a microcontroller. The detected sensor signal is transmitted from the inertial sensor mechanism 21 to a microcontroller 22 which consumes particularly little energy. The microcontroller 22 generates a posture command signal based on the sensor signal generated by the inertial sensor mechanism 21, and transmits the posture command signal to a transmitting-receiving unit 5, which is also part of the posture-shoe sensor 20.

[0092] The transmitting and receiving unit 5 generates an initialization command signal, which is transmitted to a fixedly mounted receiving device by means of an antenna 7. A part of the posture shoe sensor 20 can also be provided, for example, in the form of a Figure 2. In addition, the gesture-shoe sensor 20 also includes a unit 25 for transmitting tactile feedback to the operator. If the operator provides an initialization command by means of a gesture, the inertial sensor system 21 detects the movement and transmits the detected sensor signal to the microcontroller 22. The microcontroller 22 evaluates the sensor signal, and in the case where the microcontroller recognizes the gesture representing the initialization command, the microcontroller outputs the corresponding command signal to the transmitting-receiving unit 5 and additionally transmits the control signal to the unit 25 for transmitting tactile feedback. Subsequently, the unit 25 for transmitting tactile feedback generates a mechanical signal, such as a vibration movement, by means of which the operator or the wearer of the gesture-shoe sensor 20 is informed that the command generated by him by the gesture has been recognized and forwarded. Then, for example, the input for the medical imaging device is enabled by means of the command. Subsequently, the operator can switch on and set the X-ray tube by another gesture, for example by hand movement, eye movement or head movement. The mentioned gestures are detected, for example, by an image recording unit and received and evaluated by a fixedly mounted receiving unit arranged at the medical imaging device. By controlling gestures by means of the gesture shoe sensor 20, the control process can advantageously be made more reliable, so that no control that could harm the patient is carried out unintentionally.

[0093] Figure 5 A computer tomography system 50 according to an embodiment of the present invention is shown. The computer tomography scanner shown here has a recording unit 57, which includes a radiation source 58 in the form of an X-ray source and a radiation detector 59 in the form of an X-ray detector. The recording unit 57 rotates around a system axis 55 during the recording of the X-ray projections, and the X-ray source 58 emits radiation 52 in the form of X-rays during the recording. The X-ray source 58 is an X-ray tube. The X-ray detector 59 is a line detector with a plurality of lines.

[0094] When recording the projection, the patient 53 lies on the examination bed 56. The examination bed 56 is connected to the bed base 54 so that the bed base supports the examination bed 56 together with the patient 53. The examination bed 56 is designed to move the patient 53 along the recording direction through the opening 60 of the recording unit 57. The recording direction is usually provided by the system axis 55 oriented in the z direction. When recording the X-ray projection, the recording unit 57 rotates around the z-axis. In the example described, the patient's body axis is the same as the system axis 55. Both axes are on the Z axis of the three-dimensional Cartesian coordinate system. In the case of spiral recording, the examination bed 56 continuously moves through the opening 60, while the recording unit 67 rotates around the patient 53 and records the X-ray projection. Thereby, the X-ray draws a spiral line on the surface of the patient 53.

[0095] The X-ray image recording device 51 has a computer 62, which is connected to a display unit 61, for example, for a graphic display of the X-ray recording, and is connected to an input unit 67. The display unit 61 can be, for example, an LCD screen, a plasma screen or an OLED screen. It can also be a touch-sensitive screen, which is also configured as an input unit 67. Such a touch-sensitive screen can be integrated into the imaging device or configured as part of a mobile device. The input unit 67, for example, is a keyboard, a mouse, a so-called "touch screen", or also a microphone for voice input. The input unit 67 can also be set up to recognize the user's movements and convert them into corresponding instructions. For example, with the help of the input unit 67, the selected reference data set can be modified by the user.

[0096] The computer 62 is connected to the rotatable recording unit 57 for data exchange. On the one hand, control signals for X-ray image recording are transmitted from the computer 62 to the recording unit 57 via a connecting line 64, and on the other hand, the recorded projection data are transmitted to the computer 62 for image reconstruction. The connecting line 64 is realized in a known manner in a wired or wireless manner.

[0097] The computer 62 has a computing unit 66. The computing unit 66 is designed as an image processing unit or an image data processing unit. The computing unit is set up to perform data processing steps related to the method according to the present invention. The computing unit 66 can work together with a computer-readable data carrier 63, in particular to receive and process instructions and control imaging through a computer program with program code. In addition, the computer program can be stored on a machine-readable carrier in a callable manner. In particular, the machine-readable carrier can be a CD, DVD, Blu-ray disc, memory stick or hard disk. The computing unit 66 can be configured in the form of hardware or in the form of software. For example, the computing unit 66 is configured as a so-called FPGA (abbreviation of "Field programmable Gate Array (Field Programmable Gate Array)") or includes an arithmetic logic unit.

[0098] exist Figure 5 Also shown is a command transmission system 70 having a sending unit 2M and a receiving unit 2S (see Figure 7Details in). The receiving unit 2S is designed as a slave circuit in the form of a radio interface as part of the computer 62). The sending unit 2M is integrated into the shoe 1 of the operator P and is implemented as a master circuit. The operator P can now enable the voice recognition function of the receiving unit 2S designed as a slave circuit by a movement sequence of the shoe 1. The operator P then provides voice commands that are received and interpreted by the receiving unit 2S. Based on the interpretation, the receiving unit 2S generates commands for executing functions, such as, for example, browsing images or changing contrast. In order to implement the commands, the switch 12 acting as an actuator can also be operated by the receiving unit 2S. For example, the switch 12 is used to trigger the radiation caused by the radiation source 58.

[0099] Figure 6 6.1 shows a flowchart 600 illustrating a method for transmitting an instruction according to an embodiment of the present invention. In step 6.1, the movement of the operator P is detected by the first instruction transmitting device 2M provided at the operator P. For example, an experienced radiologist who happens to examine a patient with his hands stands next to a mobile C-arm device. Since the radiologist examines the patient with his hands at the same time, he currently has no hands free to operate the C-arm device for imaging the patient P. Therefore, the radiologist wears a C-arm device that has been installed in one or both of his shoes 1. Figure 1 and Figure 2 The first instruction transmission device 2M is initialized in the so-called master mode, that is, in the master mode, only the electronic sensor for motion recognition is activated, but the voice recognition is deactivated, because in the embodiment, the first instruction transmission device 2M is only used to enable the voice recognition of the second instruction transmission device 2M with the same structure set at the C-arm device.

[0100] In addition, in step 6.II, the detected movement of the operator, i.e., the movement of the radiologist in the specific embodiment, is evaluated and instructions are identified based on the detected movement. The movement of the operator P can, for example, include a foot tapping sequence of three foot tapping movements. In the specific embodiment, the instruction relates to an enable instruction, by means of which the second instruction transmission device 2S is switched to be ready to receive the voice instruction of the radiologist. Then, in step 6.III, the identified instruction is wirelessly transmitted to the second instruction transmission device 2S, which is arranged at the medical technology device to be operated, in the case of the C-arm device. Then, in step 6.IV, the activation of the voice recognition of the second instruction transmission device 2S is performed. In step 6.V, the second instruction transmission device 2S detects the voice instruction provided by the radiologist and evaluates the voice instruction by internal voice recognition. For example, the word "turn the page" or "previous image" or "next image" is recognized. The instruction is interpreted as an instruction for turning pages between multiple image data sets by the second instruction transmission device 2S, but only when the gesture instruction described in step 6.II is performed and recognized, the instruction is interpreted as an instruction for turning pages between multiple image data sets by the second instruction transmission device, and in step 6.VI, the corresponding control instruction is transmitted wirelessly or via a cable to the image display unit of the C-arm device, and the control instruction is used to switch back and forth between different image data sets. By means of the two-stage method, unintentional triggering of actions can be avoided.

[0101] exist Figure 7 FIG. 7 schematically shows an instruction transmission system 70 according to an embodiment of the present invention. Figure 5 Such an instruction transmission system 70 is used in the system 50 shown in FIG. Figure 7 The instruction transmission system 70 shown in FIG. 7 includes a transmitting unit 2M fixed to the clothing of the operator P, such as shoes, and a receiving unit 2S installed on an imaging medical technology system (not shown). The structure of the transmitting unit 2M largely corresponds to Figure 2 The structure of the instruction transmission device 2 illustrated therein is shown in FIG. Figure 2 Like the command transmission device 2 shown in FIG. 1 , the sending unit 2M also has an energy generation and storage unit 6 in the form of an energy collection unit, with the help of which the movements of the operator P are converted into electrical energy and can also store the electrical energy.

[0102] Additionally, Figure 7The transmitting unit 2M shown in the figure comprises a speech recognition unit 4a, by means of which acoustic sensor signals can be checked for content information, i.e. in terms of words and sentences, which are detected, for example, by an external acoustic sensor unit and transmitted to the speech recognition unit 4a via a transmitting-receiving unit 5. However, the transmitting unit 2M is now designed as a master unit and is used to initialize a two-stage command sequence, by means of which a safety-critical control of the medical device can be carried out in a protected manner. Therefore, the speech recognition unit 4a is not required in the transmitting unit 2M installed as a master unit, and is therefore not enabled. However, advantageously, a component 2S constructed in a largely similar manner to the transmitting unit 2S can be used as a receiving unit 2S, in which the described functions for evaluating acoustic information and for speech recognition are applied. The receiving unit 2S differs from the transmitting unit 2M in that the energy supply device 6a of the receiving unit is not based on motion utilization (Bewegungsverwertung), because the receiving unit 2S is firmly arranged at the medical device, so that the motion energy cannot be used to generate electrical energy. The energy supply device 6a installed on the receiving unit 2S can include a battery unit or a mains connection, for example. The receiving unit 2S is also connected to the actuator unit 12 via a data transmission line. The actuator unit 12 includes a system microcontroller 16 and, for example, a switching device 17, by means of which functions of the medical device can be triggered.

[0103] Figure 7The instruction transmission system 70 shown in FIG. 1 works as follows: If an operator P wants to trigger a function of a medical device, the operator first moves his foot in a predetermined manner. For example, the operator taps once with his heel, taps once with his toes, and taps once again with his heel. The sensor signals of the pressure sensors 3a, 3b, 3c of the transmitting unit 2M triggered by the movement are transmitted to the evaluation unit 4 of the transmitting unit 2M. Now, the evaluation unit 4 of the transmitting unit 2M is identified based on the detected sensor signals, so that the voice recognition 4a of the receiving unit 2S should be enabled. Therefore, the initialization instruction IB is transmitted to the radio unit 5 of the receiving unit 2S via the radio unit 5 or the antenna 7 of the radio unit. The receiving unit 2S evaluates the received initialization instruction IB through its evaluation unit 4 and enables the voice recognition unit 4a of the receiving unit, because the receiving unit now expects the voice instruction ASB next. For this, the operator P provides the voice instruction ASB, for example, the operator wants to cause the radiation triggering of the medical device with the help of the word "energy switch on". The voice command ASB is now detected by the acoustic sensor unit 71, which is part of the receiving unit 2M, for example a microphone, and is transmitted to the voice recognition unit 4a of the evaluation unit 4 of the receiving unit 2S. The voice recognition unit 4a of the receiving unit 2S now determines the content of the voice command ASB provided by the operator P. In this case, the radiation triggering to be carried out is determined. Therefore, the control command SB is transmitted to the actuator unit 12 via the data transmission unit 5 for the radiation triggering. Therefore, the safety-critical radiation triggering is only carried out when two unrelated commands generated in different ways are provided in a short time in succession, so that unintentional switching on of the irradiation can be avoided.

[0104] exist Figure 8 Detailed Description of the Invention An instruction transmission system 80 according to an alternative embodiment of the present invention is shown in FIG. Figure 8 The instruction transmission system 80 shown in Figure 7 The command transmission system 70 shown in FIG. 7 also includes a sending unit 20a and a receiving unit 20b. The sending unit 20a is configured as a master unit, that is, the sending unit 20a is used to control command detection through the receiving unit 20b configured as a slave unit.

[0105] exist Figure 8 The sending unit 20a used in the instruction transmission system 80 shown in FIG. 1 is similar in structure to Figure 4 The posture shown in the -shoe sensor 20. In particular, Figure 8The transmission unit 20a shown in the figure comprises an inertial sensor 21, by means of which a gesture, i.e. a movement of a shoe, can be detected by measuring acceleration and measuring rotational movement. The transmission unit 20a comprises a plurality of different sensors 3a, 3b, 3c, 21, so that it can react flexibly to different input types, and an evaluation unit 4, which is used to evaluate the sensor signals and to associate the command content with a recognized movement of the operator, a voice command or a visually recognized gesture or posture. The transmission unit 20a has a pressure sensor unit 3a, 3b, 3c, by means of which a weight shift of the foot, for example a weight shift to the toe or heel, can be detected. In addition, as already mentioned, the transmission unit 20a comprises an inertial sensor unit 21, by means of which an accelerated movement of the shoe can be detected. In addition, the transmission unit 20a comprises a voice recognition unit 4a, which is part of the evaluation unit 4 and by means of which a voice command can be recognized based on acoustic measurement data. The acoustic measurement data can be received, for example, by an acoustic sensor 71, for example a microphone, via the transceiver unit 5 and evaluated by the speech recognition unit 4a. Figures 1 to 7 The variants shown in FIG. Figure 8 The transmission unit 20a shown in the figure comprises an image analysis unit 4b, which is part of the evaluation unit 4 and is used to recognize gestures of an operator in image data which are captured, for example, by an external camera 81 and subsequently evaluated by the image analysis unit 4b of the transmission unit 20a.

[0106] also, Figure 8 The sending unit 20a shown in FIG. Figure 4 The shoe sensor 20 shown in FIG. 1 also comprises a unit 25 for transmitting tactile feedback. If the operator P moves his shoe or performs another movement that can be detected by one of the sensors described, in order to enable the gesture recognition function or voice recognition function of the receiving unit 20 b, the sensor signal is evaluated by the evaluation unit 4 of the transmitting unit 20 a and information associated with the signal is determined.

[0107] In the case where the evaluation unit recognizes a gesture or voice command representing an initialization command IB, the evaluation unit 4 of the transmission unit 20a outputs the corresponding command signal to the transmission-receiving unit 5 and additionally transmits the control signal HS to the unit 25 for transmitting tactile feedback. Subsequently, the unit 25 for transmitting tactile feedback generates a mechanical signal, for example a vibration movement VB, by means of which the operator P or the wearer of the gesture-shoe sensor is informed that the command IB generated by the operator or wearer by gesture and / or voice command has been recognized and forwarded. Then, for example, the input for the medical imaging device is enabled by means of the command IB. Subsequently, the operator P can trigger the function of the medical imaging device by another gesture, for example by a hand movement or an eye or head movement or a voice command or a combination thereof.

[0108] For example, an initialization command IB is determined, by means of which the visual gesture recognition 4b and the speech recognition 4a of the evaluation unit 4 of the receiving unit 20b are to be enabled. After the receiving unit 20b, which is designed in a substantially similar manner to the transmitting unit 20a, has received the initialization command IB via its transmitting-receiving unit 5 and enabled the speech recognition unit 4a and the image analysis unit 4b of the receiving unit, the operator P can perform a gesture, for example a head movement KB, and at the same time issue a speech command ASB. The head movement KB is detected by the external camera 81 and transmitted to the transmitting-receiving unit 5 of the receiving unit 20b. The speech command is detected by the microphone integrated into the receiving unit 20b and transmitted to the speech recognition unit 4a of the receiving unit 20b.

[0109] The microcontroller 4 of the transmission unit 20a also evaluates the sensor signals of the sensors 3a, 3b, 3c and, in the case where the microcontroller recognizes a gesture representing an initialization command IB, the microcontroller outputs a corresponding command signal to the transmission-reception unit 5 and additionally transmits a control signal HS to the unit 25 for transmitting tactile feedback. The unit 25 for transmitting tactile feedback then generates a mechanical signal, for example a vibration movement VB, by means of which the operator or the wearer of the gesture-shoe sensor 20a is informed that the command generated by the operator or the wearer by the gesture has been recognized and forwarded. Then, for example, an input for a medical imaging device is enabled by means of the command. The operator can then switch on and set the X-ray tube by another gesture, for example by a hand movement or an eye or head movement and possibly a simultaneous voice command.

[0110] The receiving unit 20b is constructed similarly to the transmitting unit 20a, but lacks a plurality of different sensors 3a, 3b, 3c, 21, since these are not necessary for the receiving function. In addition, the receiving unit 20a comprises a speech recognition unit 4a, by means of which, for example, voice commands can be received or detected and evaluated by a microphone 71. Similar to the transmitting unit 20a, Figure 8 The receiving unit 20b shown in the figure also includes an image analysis unit 4b, which is used to evaluate image data of an external optical sensor unit, such as a camera 81. With the help of the camera 81, for example, the gesture of the operator P can be detected and then evaluated by the evaluation unit 4 or the image analysis unit 4b of the receiving unit 20b. If the gesture and the voice command are now recognized by the image analysis unit 4b or the voice recognition unit 4a of the receiving unit 20b, the action command is forwarded to the actuator unit 12, which triggers the function of the medical imaging device. For this purpose, the actuator unit includes a system microcontroller 16 and, for example, a switching device 17, with the help of which the function of the medical device can be triggered.

[0111] Finally, it is pointed out again that the method and the device described above relate only to preferred embodiments of the invention and that the invention can be modified by a person skilled in the art without departing from the scope of the invention, which in this respect is defined by the claims. Therefore, the method and the instruction transmission device are first explained based on a system for recording medical image data. However, the invention is not limited to applications in the medical field, but the invention can also be applied in principle to the recording of images for other purposes. For reasons of completeness, it is also pointed out that the use of the indefinite article "a" or "an" does not exclude that the features involved can also exist multiple times. Similarly, the term "unit" does not exclude that it consists of a plurality of components that can also be distributed spatially.

Claims

1. A command transmission system, comprising: - a first instruction transmission device (2M, 20a), wherein the first instruction transmission device (2M, 20a) has: - a sensor unit (3a, 3b, 3c, 21, 71, 81) for detecting the movement of an operator (P), - a fixing unit (2a), the fixing unit (2a) being used for fixing the sensor unit (3a, 3b, 3c, 21, 71, 81) and / or the first instruction transmission device on the operator (P), an evaluation unit (4, 4a, 4b, 15, 22) for evaluating the detected movements of the operator (P) and for identifying instructions (IB, ASB, KB) based on the detected movements, - a command transmission unit (5, 7) for transmitting a control command to a medical device (50) to be operated based on the recognized command (IB, ASB, KB), wherein the sensor unit (3a, 3b, 3c, 21) comprises an internal gesture sensor unit for gesture recognition, - a master device configured for bidirectional communication with at least one slave device, - activating the gesture sensor unit (3a, 3b, 3c, 21), and - a device for transmitting the determined instruction (IB) to a second instruction transmission device (2S, 20b), - The second instruction transmission device (2S, 20b), which - is located away from said operator (P), - a slave device configured for bidirectional data exchange with a master device, - having an evaluation unit (4), said evaluation unit (4) comprising at least one of the following subunits: a gesture recognition unit (4b) which is activated at a distance from the operator (P) to detect a movement or gesture of the operator (P), - a speech recognition unit (4a) having speech recognition capabilities, and - is set up to receive the command (IB) received by the first command transmission device (2M, 20a) and to transmit a control command (SB) to the medical device (50) based on the received command (IB).

2. The instruction transmission system according to claim 1, wherein gesture recognition is performed by detecting the movement of the sensor unit (3a, 3b, 3c, 21) or a mechanical action on the sensor unit (3a).

3. The instruction transmission system according to claim 1 or 2, wherein the fixing unit (2a) of the first instruction transmission device is configured to fix the posture sensor unit (3a, 3b, 3c, 21) on or in clothing.

4. The command transmission system according to claim 1 or 2, wherein the fixing unit (2a) of the first command transmission device is configured to fix the posture sensor unit (3a, 3b, 3c, 21) in the shoe (1).

5. The instruction transmission system according to claim 4, wherein the fixing unit (2a) of the first instruction transmission device constitutes a recess in the sole of the shoe (1).

6. An instruction transmission system according to claim 1 or 2, wherein the instruction transmission unit (5, 7) of the first instruction transmission device has a radio transmission unit (5, 7), and the radio transmission unit (5, 7) is used to transmit the identified instruction (IB) to the medical technology device (50) to be operated.

7. The instruction transmission system according to claim 1 or 2, wherein the first instruction transmission device also has an energy generation and storage unit (6).

8. The command transmission system according to claim 7, wherein the energy generation and storage unit (6) is configured to generate electrical energy from the movement energy of the operator (P).

9. The instruction transmission system according to claim 1 or 2, wherein: - the sensor unit (71) of the first instruction transmission device comprises an acoustic sensor unit, and The evaluation unit (4, 15, 22) of the first command transmission device comprises a speech recognition unit (4a) for recognizing and interpreting the speech commands of the operator (P).

10. The instruction transmission system according to claim 1 or 2, wherein the internal gesture recognition of the first instruction transmission device recognizes one of the following functional instructions: - scrolling the image on an image display device of the medical technology device (50), - Changing parameters of the medical device (50).

11. The instruction transmission system according to claim 10, wherein: - the first instruction transmission device (2, 2M, 20a) is configured to: - Recognize the gesture that initiates the voice command (ASB), - based on the identified gesture, initializing the start of operation of the second instruction transmission device (2S, 20b), - the second instruction transmission device (2S, 20b) is configured to: - receiving an initialization instruction (IB) from said first instruction transmission means (2M, 20a), - activating the voice recognition unit (4a) and / or the gesture recognition unit (4b) based on the initialization instruction (IB).

12. A command transmission system according to claim 11, wherein the second command transmission device (2M, 20b) is configured to detect and recognize the voice command (ASB) of the operator (P) after activating the voice recognition unit (4a), and transmit the control command (SB) to the medical technology device (50) based on the recognized voice command (ASB).

13. The instruction transmission system according to claim 11, wherein the gesture recognition unit (4b) or the voice recognition unit (4a) includes a capability for recognizing the following confirmation signals: - Radiation trigger, - moving the medical device (50).

14. The instruction transmission system according to claim 11, wherein the gesture recognition unit (4b) is configured to detect one of the following gestures: - Grasp, release, zoom, move with your hands or fingers, - Eye movements to the left, right, up, down, blinking, -Movement of the head to the left or right.

15. The command transmission system according to claim 11, wherein the first command transmission device (2M, 20a) is configured to transmit tactile feedback to the operator (P) in response to a recognized command.

16. The instruction transmission system according to claim 1, wherein the second instruction transmission device (2S, 20b) is arranged at the medical technology device (50) to be operated.

17. A surgical system comprising: - Imaging medical technology device (50), - surgical devices, - A command transmission system according to any one of claims 1 to 16, which is designed to transmit control commands (SB) to the imaging medical technology device (50).

18. A command transmission method, comprising the following steps: - detecting the movements of the operator by means of a sensor unit of the first command transmission device, wherein the sensor unit and / or the first instruction transmission device is fixed to the operator by means of a fixing unit, - evaluating the detected movements of the operator by means of an evaluation unit of the first command transmission device and recognizing a command based on the detected movements, - transmitting a control command to the medical device to be operated based on the recognized command by means of the command transmission unit of the first command transmission device, in o the sensor unit comprises an internal and activated gesture sensor unit for gesture recognition, ○The first instruction transmission device is designed as a master device for bidirectional communication with at least one slave device and is configured to transmit the determined command to a second command transmission device, ○The second instruction transmission device: · Set away from the operator, · configured as a slave device for bidirectional data exchange with a master device, · having an evaluation unit, the evaluation unit comprising at least one of the following subunits: a gesture recognition unit (4b), which is activated at a distance from the operator (P) to detect a movement or gesture of the operator (P), a speech recognition unit (4a) having speech recognition capabilities, and - receiving, by means of said second instruction transmission means, said instruction (IB) transmitted by said first instruction transmission means, and - Based on the received command (IB), a control command (SB) is transmitted to the medical device.

19. The instruction transmission method according to claim 18, wherein the second instruction transmission device (2S, 20b) is arranged at the medical technical device (50) to be operated.

20. A computer program product, comprising a computer program, wherein the computer program is directly stored in a storage device of an instruction transmission system, and wherein the computer program product comprises a program segment so that when the computer program is executed in the instruction transmission system, all steps of the method according to claim 18 or 19 are executed.

21. A computer-readable medium on which a program segment readable and executable by a computing unit is stored, so that when the program segment is executed by the computing unit, all steps of the method according to claim 18 or 19 are performed.

Images