Medical assistance system, endoscope system, and medical assistance method

Abstract

A medical assistance system (100) includes an examination situation information acquisition section (170), a sedative necessity determination section (180), and an assistance information generation section (150). The examination situation information acquisition section acquires examination situation information related to a situation of an endoscopic examination using an endoscope. The sedative necessity determination section performs a sedative necessity determination based on the examination situation information. The assistance information generation section generates assistance information for a user based on a result of the sedative necessity determination.

Description

Technical Field

[0001] This invention relates to a medical assistance system, an endoscope system, and a medical assistance method. Background Technology

[0002] As shown in Non-Patent Document 1, it is known that in the past, during endoscopic examinations, doctors would administer sedatives to patients based on the presence or absence of pain reported by the patient.

[0003] Existing technical documents

[0004] Non-patent literature

[0005] Non-patent document 1: "Endoscopic diagnosis and treatment of sedation and sedation (2nd edition)" Impurities of the Japanese Society of Digestive Endoscopy, Vol.62(9), Sep.2020 Summary of the Invention

[0006] The problem the invention aims to solve

[0007] In the aforementioned prior art, the doctor receives a message from the patient to decide whether to use a sedative. Therefore, the following problem exists: sometimes a sedative cannot be used when the patient is enduring pain and does not send a message, or when the doctor does not notice the patient's pain message.

[0008] Solution for solving the problem

[0009] One aspect of this disclosure relates to a medical assistance system, comprising: an examination status information acquisition unit that acquires examination status information related to the status of an endoscopic examination performed using an endoscope; a sedative need determination unit that determines whether a sedative is needed based on the examination status information; and an assistance information generation unit that generates assistance information for a user based on the sedative need determination result.

[0010] Another aspect of this disclosure relates to an endoscopy system, comprising: an endoscope for endoscopic examination; an examination status information acquisition unit that acquires examination status information related to the status of the endoscopic examination performed using the endoscope; a sedative need determination unit that determines whether a sedative is needed based on the examination status information; and an auxiliary information generation unit that generates auxiliary information for a user based on the sedative need determination result.

[0011] Another aspect of this disclosure relates to a medical assistance method, comprising: acquiring examination status information related to the status of an endoscopic examination performed using an endoscope; determining the need for a sedative based on the examination status information; and generating assistance information for a user based on the determination of the need for a sedative. Attached Figure Description

[0012] Figure 1 It is the first structural example of a medical support system.

[0013] Figure 2 This is a second structural example of a medical support system.

[0014] Figure 3 This is an example of the third structure of a medical support system.

[0015] Figure 4 This is a structural example of an endoscope system.

[0016] Figure 5 This is a structural example of an endoscope and an endoscope shape acquisition sensor.

[0017] Figure 6 This is an illustrative diagram of endoscopic procedures.

[0018] Figure 7 This is the first detailed structural example of a medical support system.

[0019] Figure 8 This is an illustrative diagram of the large intestine.

[0020] Figure 9 This is an example of a shape change in the endoscope insertion section.

[0021] Figure 10 This is an illustration of pain conditions.

[0022] Figure 11 This is an illustration of pain conditions.

[0023] Figure 12 This is an illustration of pain conditions.

[0024] Figure 13 This is an illustration of pain conditions.

[0025] Figure 14 This is an illustration of pain conditions.

[0026] Figure 15 This is an explanatory diagram illustrating the identification of pain conditions corresponding to the amount of displacement.

[0027] Figure 16 This is a flowchart of the processing performed by the medical assistance system in the first detailed structural example.

[0028] Figure 17 This is a flowchart illustrating the identification of pain conditions and the corresponding determination of whether sedation is needed based on the identification results.

[0029] Figure 18 This is a flowchart illustrating a specific example of pain condition identification.

[0030] Figure 19 This is the second detailed structural example of a medical support system.

[0031] Figure 20 This is a flowchart of the processing performed by the medical assistance system in the second detailed structural example.

[0032] Figure 21 This is the third detailed structural example of a medical support system.

[0033] Figure 22 This is the fourth detailed structural example of a medical support system.

[0034] Figure 23 This is the fifth detailed structural example of a medical support system.

[0035] Figure 24 This is a diagram illustrating specific examples of pain identification. Detailed Implementation

[0036] The present embodiment will now be described. Furthermore, the present embodiment described below does not unduly limit the scope of the claims. Additionally, the structures described in this embodiment are not necessarily all essential components of this disclosure.

[0037] 1. Structural Example

[0038] Here, a basic structural example of the medical assistance system in this embodiment will be described. A detailed structural example of the medical assistance system, and the correspondence between the detailed structural example and the basic structural example, will be described later.

[0039] Figure 1 This is a first structural example of a medical assistance system 100. The medical assistance system 100 includes an examination status information acquisition unit 170, a sedative need determination unit 180, and an assistance information generation unit 150.

[0040] The examination status information acquisition unit 170 acquires examination status information related to the status of an endoscopic examination performed using an endoscope. The examination status information can be anything that allows for determining the examination status, such as information that allows determining the insertion status of the endoscope insertion device. Additionally, the examination status information may include information about examination conditions related to the examination environment or the patient, or input pain information input from outside the medical assistance system 100 via a message from the patient. The examination status information acquisition unit 170 outputs examination status information DSI. This output examination status information DSI may be the examination status information acquired by the examination status information acquisition unit 170 itself, information obtained by processing the acquired examination status information, or a combination thereof.

[0041] The sedative need determination unit 180 determines whether a sedative is needed based on examination status information. A sedative is a drug that calms agitation, such as a drug that relieves pain experienced by the patient through sedation. The sedative need determination unit 180 determines that a sedative is needed when the examination status shown in the examination status information indicates that a sedative is required; otherwise, it determines that a sedative is not needed. The sedative need determination unit 180 outputs a sedative need determination result SYN. ​​The need determination result SYN is not limited to information indicating whether a sedative is needed; for example, it could be information indicating the degree to which a sedative is needed.

[0042] The auxiliary information generation unit 150 generates auxiliary information for the user based on the SYN result of the sedation requirement determination. Specifically, if the requirement determination indicates that sedation is needed, the auxiliary information generation unit 150 generates auxiliary information indicating that sedation is needed. Conversely, if the requirement determination indicates that sedation is not needed, the auxiliary information generation unit 150 either does not generate auxiliary information or generates auxiliary information indicating that sedation is not needed. Auxiliary information indicating that sedation is not needed may include information describing the operation, behavior, or condition. The operation refers to the endoscopic operation corresponding to the examination or insertion status, such as the pull operation and right torque operation during N-loop release. The behavior refers to the actions taken by the medical personnel or patient based on the examination or insertion status, such as manual compression or changing position. The condition refers to the examination status or the insertion status of the endoscope, such as N-loop formation, endoscopic insertion deflection, or intestinal stretching.

[0043] The user is a medical professional operating the endoscope used in the examination, or an assistant assisting that professional. Alternatively, the user may be a device that automatically or semi-automatically inserts or removes the endoscope insertion section. The auxiliary information indicates what operation or action should be performed next, such as information indicating the use or disuse of sedation, information indicating the endoscopic procedure to be performed next, or information indicating temporary cessation or termination of the examination. The auxiliary information generation unit 150 can display text, symbols, or images corresponding to the auxiliary information on the endoscope system's display device, or can output control signals to the insertion / removal device to perform the actions or processes indicated by the auxiliary information.

[0044] According to this embodiment, the medical assistance system 100 can infer situations requiring sedation and generate auxiliary information indicating the use of sedation based on its inference. For example, even if the patient endures pain without sending a signal, or if the doctor does not notice the patient's pain signal, the medical assistance system 100 can still infer these situations and guide the use of sedation.

[0045] The examination status information is at least one of the following: endoscopic image recognition information, insertion site shape information, operation recognition information, patient facial expression information, pain signaling information, endoscope type information, and patient information. Furthermore, "at least one of the following: endoscopic image recognition information, insertion site shape information, operation recognition information, patient facial expression information, pain signaling information, endoscope type information, and patient information" is a combination of endoscopic image recognition information, insertion site shape information, operation recognition information, patient facial expression information, pain signaling information, endoscope type information, patient information, or any two or more of these.

[0046] Endoscopic image recognition information refers to the recognition results of endoscopic images during endoscopic examinations. In other words, endoscopic image recognition information is obtained through image recognition processing of endoscopic images. An endoscopic image is an image captured by an endoscope. Specifically, an endoscopic image is a series of frames from a moving image captured by an endoscope.

[0047] The insertion part shape information is information about the shape of the endoscope insertion part, which is obtained, for example, by the insertion part shape observation device described later. The endoscope insertion part is the portion of an endoscope that is inserted into the body; in this embodiment, it is the insertion part of a flexible endoscope used for the digestive tract, etc.

[0048] Operation identification information is information about changes in at least one of the shape and position of the endoscope insertion section. That is, operation identification information is the temporal change in at least one of the shape and position of the endoscope insertion section caused by operating the endoscope. For example, the shape of the insertion section is constantly observed by an insertion section shape observation device, and the insertion section shape information is output in a time series. Operation identification information is obtained based on the changes in the time series output insertion section shape information over time.

[0049] Patient facial expression information refers to information related to the patient's facial expressions during endoscopic examination. Specifically, a camera captures the patient's facial expressions, and an expression recognition unit identifies whether the captured facial expression indicates pain, outputting the result as pain signaling information. Pain signaling information originates from a signaling device operated by the patient or medical personnel. Specifically, the signaling device is a device that the patient or medical personnel can operate based on the patient's pain level, such as a switch or touch panel. Furthermore, the camera, expression recognition unit, and signaling device can be individually included in the medical assistance system 100 or located externally to the medical assistance system 100.

[0050] Endoscope type information refers to information about the type of endoscope insertion part used in endoscopic examinations. The physical characteristics of the endoscope insertion part, such as its thickness or rigidity, vary depending on the type of endoscope. For example, an endoscope stores an ID indicating its model, and the endoscope type information can be obtained by retrieving this ID. Based on the physical characteristics of the endoscope insertion part, such as its thickness or rigidity, there are variations in the ease of pain induction or the level of pain. By obtaining the endoscope type information, the sedative need determination unit 180 can appropriately determine whether a sedative is needed based on the physical characteristics of the endoscope insertion part, such as its thickness or rigidity.

[0051] Patient information may include details such as the patient's gender, physique, body type, or medical history. For example, as described later, patient information can be obtained from information stored in an electronic medical record card. Alternatively, medical personnel may input patient information into the medical assistance system 100. The ease of pain occurrence or pain level varies depending on the patient's gender, physique, body type, or medical history. By obtaining patient information, the sedative need determination unit 180 can appropriately determine whether a sedative is needed based on the patient's gender, physique, body type, or medical history.

[0052] According to this embodiment, it is possible to infer whether a sedative is needed based on various acquired information, thus enabling a more appropriate inference of whether a sedative is required. That is, it is possible to determine various inspection conditions related to insertion status or inspection conditions based on the acquired information, and to appropriately guide the need for a sedative based on these various inspection conditions.

[0053] The examination status information acquisition unit 170 classifies the insertion status of the endoscope based on at least one of endoscope image recognition information, insertion part shape information, and operation recognition information, and outputs examination status information including the classification results. The sedative need determination unit 180 determines whether sedatives are needed based on the insertion status shown in the classification results.

[0054] The insertion status of an endoscope refers to the prescribed insertion status that occurs during an endoscopic examination. This is determined by factors such as a predetermined insertion point position, variations in that position, a predetermined insertion point shape, variations in that shape, prescribed endoscopic manipulation, or any combination of two or more of these. For example, colonoscopy employs insertion methods such as the loop method and the axis-holding shortening method. Each insertion method has its own insertion status, including the insertion point shape and manipulation that occur as the insertion process progresses. The subsequent procedures for each insertion status are predetermined, and certain insertion statuses within these statuses can easily cause pain.

[0055] The examination status information acquisition unit 170 determines whether an insertion condition among a plurality of insertion conditions is met based on at least one of endoscopic image recognition information, insertion part shape information, and operation recognition information. The plurality of insertion conditions includes insertion conditions requiring the use of sedatives. If the determined insertion condition meets the criteria for requiring sedatives, the sedative-needing determination unit 180 determines that a sedative-needing condition is required.

[0056] According to this embodiment, since the insertion status of the endoscope is classified, the sedation need determination unit 180 can determine whether sedation is needed by determining whether the insertion status is one that requires sedation. Furthermore, as described above, insertion statuses that are prone to causing pain during endoscopic examinations are predetermined; therefore, by setting these insertion statuses as candidates for classification, it is possible to determine whether an insertion status requires sedation.

[0057] The aforementioned operation identification information may include information on the shape displacement of the endoscope insertion section, i.e., insertion section shape displacement information. In this case, the inspection status information acquisition unit 170 performs the aforementioned classification based on the insertion section shape information and the insertion section shape displacement information. Shape displacement is the displacement of the shape of the endoscope insertion section before and after the shape change. The shape displacement information may include information on the displacement direction, information on the displacement magnitude, or both.

[0058] Due to the shape change of the endoscope insertion section during operation, pain may sometimes occur corresponding to this shape displacement. According to this embodiment, by classifying based on the shape displacement information of the insertion section, it is possible to identify situations requiring sedation that occur corresponding to the shape displacement of the endoscope insertion section.

[0059] As described above, the insertion part shape displacement information may include information about the magnitude of the shape displacement, i.e., the shape displacement amount information. The inspection status information acquisition unit 170 performs the above classification based on the insertion part shape information and the shape displacement amount information.

[0060] There exists a situation where, during a certain insertion, pain occurs if the magnitude of the shape displacement exceeds a predetermined value. According to this embodiment, by classifying based on the shape displacement amount information, it is possible to identify situations requiring sedatives that arise corresponding to the shape displacement exceeding the predetermined value.

[0061] Figure 2 This is the second structural example of the medical assistance system 100. Figure 2 The medical assistance system 100 also includes a pain condition recognition unit 130. Furthermore, descriptions of components identical to those already described are appropriately omitted.

[0062] The pain condition recognition unit 130 obtains pain condition information (PSI) to identify whether the patient is experiencing pain based on examination condition information. The sedative need determination unit 180 determines whether a sedative is needed based on the pain condition information. The pain condition information (PSI) is the result of pain condition recognition, such as the presence or absence of pain, the estimated level of pain, or a combination thereof. "Patient experiencing pain" is not limited to actual pain; any situation that estimates pain is possible is acceptable. More specifically, situations prone to pain are predetermined, and when the situation identified based on the examination condition information (DSI) matches the predetermined situation, it is identified as "patient experiencing pain." Alternatively, when pain conditions are identified based on pain signaling information or patient facial expression information, it is identified as "patient experiencing pain" when pain signaling information or patient facial expression information indicating pain is input.

[0063] According to this embodiment, guidance can be provided regarding the need for sedation, taking into account the patient's pain during endoscopic examination. That is, by having medical personnel determine the use of sedation based on the auxiliary information provided in this embodiment, the pain situation can be identified when the patient experiences pain or before the patient experiences pain, thereby alleviating or preventing the pain situation in advance.

[0064] The pain conditions described above are not limited to the mere presence or absence of pain. Specifically, the pain condition recognition unit 130 can also identify pain conditions by distinguishing between conditions with different levels of pain, different frequencies of pain, or different levels of ease of avoiding pain.

[0065] Pain level is the degree of pain experienced by a patient in a pain condition when it is detected. For example, the pain level may change based on the amount of displacement of the endoscope insertion section in a particular insertion position. In this case, the pain level is determined based on the amount of displacement. Alternatively, if the pain level changes based on the insertion position, a correspondence is established between each insertion position and the pain level, and when a particular insertion position is detected, the pain level corresponding to that insertion position is output.

[0066] The frequency of pain is the frequency at which a patient experiences pain, such as the number of times a pain condition is detected per unit of time. This frequency can be either the frequency of repeated occurrences of the same insertion condition or the frequency of a mixture of multiple insertion conditions. For example, the medical assistance system 100 includes a memory (not shown), and the pain condition recognition unit 130 stores pain condition information (PSI) in the memory and detects the frequency of pain by referring to the pain condition information PSI stored in the memory.

[0067] Regarding the ease of avoiding pain, it is determined based on whether there is an operation to relieve pain or an operation to avoid pain in each pain situation. For example, in a certain insertion situation, if there is no operation to relieve pain or an operation to avoid pain, the ease of avoiding pain is low. Conversely, in a certain insertion situation, if there is an operation to avoid pain, the ease of avoiding pain is high. Furthermore, in a certain insertion situation, if there is an operation to relieve pain but no operation to avoid pain, the ease of avoiding pain is moderate. For example, by storing information indicating the ease of avoiding pain in a memory (not shown) corresponding to each pain situation, the pain situation recognition unit 130 can determine the ease of avoiding pain by referring to the information indicating the ease of avoiding pain corresponding to that pain situation when it recognizes a pain situation.

[0068] Figure 3 This is an example of the third structure of the medical assistance system 100. In Figure 3 In this system, the medical assistance system 100 includes a past examination information acquisition unit 190. Furthermore, descriptions of components identical to those already described are appropriately omitted.

[0069] The past examination information acquisition unit 190 acquires information related to past endoscopic examinations, namely, past examination information KJH. The sedative need determination unit 180 determines whether sedation is needed based on the past examination information KJH. Specifically, when the sedative need determination unit 180 acquires auxiliary information that prompts the performance of a prescribed pain avoidance procedure as past examination information KJH, it determines that sedation is needed.

[0070] Past examination information (KJH) refers to past examination information concerning the same site as the site being examined this time. Past examination information (KJH) includes at least one of the following: the result of determining the need for sedation during a past examination, the content of auxiliary information, endoscopic image recognition information, insertion site shape information, and operation recognition information. Past examination information (KJH) can be examination information obtained from the same patient as the patient undergoing the current examination, or it can be examination information obtained from multiple patients in the past. For example, by logging the examination status information (DSI), the result of determining the need for sedation (SYN), and auxiliary information as a log in storage device 191, past examination information (KJH) can be obtained by referring to this previously recorded log. Figure 3 The illustration shows an example where the storage device 191 is located outside the medical assistance system 100, but the storage device 191 may also be located inside the medical assistance system 100.

[0071] Furthermore, the second and third structural examples can be combined. In this case, the pain condition recognition unit 130 may identify the pain condition based on the examination condition information DSI and the past examination information KJH to obtain pain condition information PSI, and the sedative need determination unit 180 may determine whether a sedative is needed based on the obtained pain condition information PSI.

[0072] Furthermore, the processing of the medical assistance system 100 described above can be implemented as a medical assistance method as follows. The entity implementing the medical assistance method is not limited to the medical assistance system 100, but can be various systems or devices such as the endoscope system described later. The medical assistance method includes: acquiring examination status information (DSI) related to the status of an endoscopic examination performed using an endoscope; determining the need for sedation based on the examination status information DSI; and generating assistance information for the user based on the sedation need determination result (SYN).

[0073] Furthermore, some or all of the processing of the medical assistance system 100 described above can be implemented through a program. In this case, the medical assistance system 100 can be configured as follows.

[0074] The medical assistance system 100 includes a memory for storing information and a processor for performing actions based on the information stored in the memory. The information includes, for example, programs and various data. The program describes some or all of the functions of the examination status information acquisition unit 170, the past examination information acquisition unit 190, the pain condition recognition unit 130, the sedative need determination unit 180, and the auxiliary information generation unit 150. The processor executes this program to implement some or all of the functions of the examination status information acquisition unit 170, the past examination information acquisition unit 190, the pain condition recognition unit 130, the sedative need determination unit 180, and the auxiliary information generation unit 150.

[0075] The processor includes hardware that can include at least one of circuitry for processing digital signals and circuitry for processing analog signals. For example, the processor can be composed of one or more circuit devices or one or more circuit elements mounted on a circuit board. The one or more circuit devices are, for example, ICs. The one or more circuit elements are, for example, resistors, capacitors, etc. The processor can be, for example, a CPU (Central Processing Unit). However, the processor is not limited to a CPU; various processors such as GPUs (Graphics Processing Units) or DSPs (Digital Signal Processors) can be used. Additionally, the processor can be an integrated circuit device such as an ASIC (Application Specific Integrated Circuit) or an FPGA (Field Programmable Gate Array). Furthermore, the processor can include amplifier circuits, filter circuits, etc., for processing analog signals. The memory can be semiconductor memory such as SRAM or DRAM, or a register, or a magnetic storage device such as a hard disk drive, or an optical storage device such as an optical disc drive. For example, the memory stores computer-readable commands, which, when executed by the processor, enable the functions of various parts of the medical assistance system 100 to be implemented as processing. The commands here can be commands that make up a set of commands for a program, or commands that instruct the processor's hardware circuitry to perform actions.

[0076] Furthermore, the aforementioned program can be stored, for example, in a non-transitory information storage medium that is readable by a computer. This information storage medium can be implemented, for example, an optical disc, a memory card, an HDD, or a semiconductor memory. The semiconductor memory is, for example, ROM or non-volatile memory.

[0077] 2. Endoscopic system

[0078] The following is a detailed structural example. Figure 4 This is a structural example of an endoscope system 400 that includes a medical assistance system 100. The endoscope system 400 includes an endoscope device 300 and an insertion shape observation device 200.

[0079] The endoscope device 300 includes an endoscope 10, a light source device 330, a signal processing device 310, and a display device 320. The endoscope 10, also referred to as the endoscope body, is inserted into the patient's body to take images of the patient's internal organs. The light source device 330 generates and controls illumination light, which is guided by a light guide to the tip of the endoscope 10 and emitted from the tip. The signal processing device 310 generates endoscopic images by processing the image signals output from the endoscope 10. Additionally, the signal processing device 310 acquires information such as the ID of the endoscope 10 as endoscope type information. The display device 320 displays the endoscopic images generated by the signal processing device 310.

[0080] The insertion shape observation device 200 includes an endoscope shape acquisition sensor 20, a main body device 210, and a display device 220. The endoscope shape acquisition sensor 20 detects the magnetic field of a source coil disposed at the endoscope insertion portion. The main body device 210 acquires the position and shape of the endoscope insertion portion based on the detection signal from the endoscope shape acquisition sensor 20, and outputs an image representing the position and shape of the endoscope insertion portion to the display device 220. The display device 220 displays the image output by the main body device 210. The display device 220 and display device 320 are also referred to as monitors and are liquid crystal display devices, etc. Alternatively, a single display device can be provided in the endoscope system 400, which is shared by the endoscope device 300 and the insertion shape observation device 200.

[0081] The medical assistance system 100 is installed in the main unit 210. Endoscopic images and endoscope type information from the signal processing device 310, as well as information on the position and shape of the endoscope insertion portion acquired by the main unit 210, are input to the medical assistance system 100. Furthermore, the medical assistance system 100 can be installed at any location within the endoscope system 400.

[0082] Figure 5 This is an example of the structure of the endoscope 10 and the endoscope shape acquisition sensor 20. For example... Figure 5 As shown, the endoscope 10 includes an operation section 12, an endoscope insertion section 14, and a source coil 18.

[0083] The endoscope insertion section 14 is flexible and elongated, and includes a rigid section 16 at its front end and a flexible section 15 capable of angle manipulation. The rigid section 16 is provided with an imaging device, an illumination lens, a water inlet, an air inlet, and forceps jaws, etc.

[0084] The operating unit 12 is a device for the user to operate the endoscope 10, and includes, for example, a handle, an angle operation knob, and air / water supply buttons. Figure 6The diagram illustrates the operation of the endoscope. The endoscope insertion part 14 is inserted by pushing the handle along the long side of the insertion part 14 as shown in A1. This is called a push operation. The endoscope insertion part 14 is pulled out by pulling the handle along the long side of the insertion part 14. This is called a pull operation. The endoscope insertion part 14 is rotated circumferentially by rotating the handle as shown in A2. This is called a torque operation. When viewed from the handle towards the endoscope insertion part 14, clockwise torque operation is called right torque operation, and counterclockwise torque operation is called left torque operation. The bending part 15 of the endoscope insertion part 14 bends vertically and horizontally by operating the angle operation knob as shown in A3 and A4. This is called angle operation. The vertical angle operation and the horizontal angle operation can be performed independently.

[0085] Source coil 18 generates a magnetic field. For example, multiple source coils 18 are arranged at predetermined intervals in the endoscope insertion section 14. The endoscope shape acquisition sensor 20 detects the magnetic field from each source coil 18, and the main body 210 of the insertion shape observation device 200 detects the position of each source coil 18 based on its detection signal, thereby detecting the position of each part of the endoscope insertion section 14. In addition, the main body 210 detects the shape of the endoscope insertion section 14 based on the detected positions of the multiple source coils 18. Furthermore, the sensing method for insertion shape observation is not limited to using a magnetic field; for example, it can also use electromagnetic waves, ultrasound, or light.

[0086] 3. Example of the first detailed structure of a medical assistance system

[0087] Figure 7 This is a first detailed structural example of a medical assistance system 100. The medical assistance system 100 includes an information acquisition unit 140, a condition recognition unit 120, a sedative need determination unit 180, and an assistance information generation unit 150. In this structural example, for example, a portion of the information acquisition unit 140 and the recent condition determination unit 121 correspond to... Figures 1-3 The inspection status information acquisition unit 170, a part of the information acquisition unit 140, and the time series status determination unit 122 correspond to Figure 3 The past inspection information acquisition unit 190. Furthermore, for constituent elements that are identical to those already described, their descriptions are appropriately omitted.

[0088] The following describes an example of a medical assistance system 100 including a pain condition recognition unit 130, but if... Figure 1As shown, the pain condition recognition unit 130 is not mandatory. That is, it is not necessary to recognize the pain condition; it is sufficient to recognize the condition requiring a sedative. In the following, the pain condition recognition unit 130 identifies the pain condition based on the most recent condition information TYK and the time-series condition information JIK, and the sedative need determination unit 180 determines whether a sedative is needed based on this pain condition. However, it can be configured as follows: the pain condition recognition unit 130 is omitted, and the sedative need determination unit 180 determines whether a sedative is needed based on the most recent condition information TYK and the time-series condition information JIK.

[0089] The information acquisition unit 140 acquires various information IFINs to be used in pain condition identification. The information IFINs may be, for example, endoscopic images, insertion device shape information, input pain information, endoscope type information, patient information, past examination information, or any combination of two or more of them.

[0090] The condition recognition unit 120 identifies the recent condition, time series condition, and pain condition based on the information IFIN, and outputs the recent condition information TYK, the time series condition information JIK, and the pain condition information PSI. The condition recognition unit 120 includes a recent condition determination unit 121, a time series condition determination unit 122, and a pain condition recognition unit 130.

[0091] The recent status determination unit 121 identifies the current insertion status of the endoscope based on information such as the endoscope image or insertion part shape information, and outputs the result as recent status information TYK. "Current" not only refers to the current instant, but also includes the most recent time including the current time. Regarding the most recent time, for example, when determining the current operation or operation process based on a series of insertion part movements, it is sufficient to identify the length of the degree of the series of insertion part movements.

[0092] The time-series condition determination unit 122 identifies the insertion condition in a time-series manner based on information such as past examination information, including past condition identification results, and outputs the results as time-series condition information JIK. "Past" refers to the period before the "most recent time" mentioned above, which can be either within the current endoscopic examination or the previous endoscopic examination.

[0093] The pain condition recognition unit 130 identifies conditions that are prone to pain or have already caused pain based on the recent condition information TYK and the time-series condition information JIK, and outputs the results as pain condition information PSI. The pain condition recognition unit 130 uses not only the recent condition information TYK but also the time-series condition information JIK, thereby determining the current pain condition based on past recognition results.

[0094] The sedative need determination unit 180 determines whether a sedative is needed based on the pain condition identified by the pain condition recognition unit 130. That is, when the sedative need determination unit 180 identifies a pain condition that requires a sedative, it outputs a sedative need determination result SYN; when it does not identify a pain condition that requires a sedative, it outputs a sedative need determination result SYN.

[0095] The auxiliary information generation unit 150 generates auxiliary information corresponding to the need for sedatives based on the SYN result of the sedative need determination. It can guide whether sedatives are needed based on the pain condition, thereby relieving pain or preventing pain from occurring in advance.

[0096] As an example, the condition recognition unit 120 and the sedative need-or-notation unit 180 are implemented using machine learning methods such as neural networks. Specifically, a memory (not shown) stores a program describing an inference algorithm and the parameters used in that algorithm as information for the learned model. Furthermore, the processor processes based on the information from the learned model. That is, the processor uses the parameters stored in memory to execute the program, thereby performing the processing of the condition recognition unit 120 and the sedative need-or-notation unit 180. Moreover, the condition recognition unit 120 and the sedative need-or-notation unit 180 can be implemented by a single learned model, or they can each be implemented by a separate learned model. It is also possible that only a portion of the condition recognition unit 120 and the sedative need-or-notation unit 180 are implemented by a learned model. Furthermore, when the condition recognition unit 120 is implemented by a learned model, the condition recognition unit 120 can be implemented entirely by a single learned model, or the recent condition determination unit 121, the time-series condition determination unit 122, and the pain condition recognition unit 130 can each be implemented by a separate learned model. Alternatively, only a portion of the recent condition determination unit 121, the time-series condition determination unit 122, and the pain condition recognition unit 130 can be implemented by a learned model.

[0097] As an inference algorithm, a neural network can be used, for example. The weight coefficients of the connections between nodes in a neural network are parameters. A neural network includes an input layer that receives input data, an intermediate layer that processes the data input through the input layer, and an output layer that outputs the recognition result based on the results of the operations output from the intermediate layer. The inference algorithm is not limited to neural networks and can employ various machine learning techniques for recognition processing. Taking the case where the condition recognition unit 120 is implemented entirely by a learned model as an example, the learning process will be explained. In this case, the input data is information IFIN, and the recognition results are recent condition information TYK, time-series condition information JIK, and pain condition information PSI. The learning device that performs the learning process is, for example, an information processing device such as a PC. The learning device generates a learned model by inputting training data into the learning model and feeding back the learning model based on its recognition results. The training data includes multiple sets of data, each set including input data and positive response data. The positive response data is the recognition result that should be obtained for the input data, and is prepared in advance by medical personnel, etc.

[0098] The following describes an example of applying the medical assistance system 100 to a colonoscopy, but the application of the medical assistance system 100 is not limited to colonoscopy. Furthermore, the use of sedatives will be referred to as tranquilization below.

[0099] Examples of recent status information TYK (a) to (c) and an example of time series status information JIK (d) are shown.

[0100] (a) The recent situation determination unit 121 obtains the following information by performing image recognition processing on the endoscope image.

[0101] a1: The location where the endoscope insertion part is located. Figure 8 This is an illustrative diagram of the large intestine. From the cecum to the anus, the large intestine consists of the ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, SDJ (sigmoid-descending colon junction), sigmoid colon, and rectum. The area near the hepatic flexure is also called the right colon, and the area near the splenic flexure is also called the left colon. SDJ is an abbreviation for Sigmoid Descending Colon Junction, which is the boundary between the sigmoid colon and the descending colon. The location is identified by utilizing the different features of the image based on the location. Furthermore, the length of the portion of the endoscope inserted into the patient can be obtained based on the shape information of the insertion point, and the location can be estimated based on this insertion length.

[0102] a2: Optimal distance, straight tubular shape, redness, or residue. Optimal distance and straight tubular shape refer to the distance between the tip of the insertion section and the intestinal wall in the axial shortening method. The optimal distance can be achieved through suction, pushing, or pulling operations; it's the best distance between the insertion section and the intestinal wall that allows for the folding of the intestinal wall through angular manipulation, torque manipulation, or both. Achieving the optimal distance eliminates the need for pushing operations when traversing the folds, thus suppressing pain caused by pushing. Straight tubular shape refers to a non-optimal distance, where the tip of the insertion section is far from the intestinal wall. Redness refers to the state where the tip of the insertion section is in contact with the intestinal mucosa, resulting in a reddish image. Residue refers to the presence of water or other residue on the intestinal wall.

[0103] a3: Intestinal motility. Intestinal motility refers to forward and backward movement, translation, rotation, or peristalsis. Forward and backward movement refers to the relative movement of the endoscope insertion point and the intestinal tract along the optical axis. Translation refers to the relative movement of the endoscope insertion point and the intestinal tract in a direction orthogonal to the optical axis. Rotation refers to the relative rotation of the endoscope insertion point and the intestinal tract around the optical axis as a central axis. Peristalsis is the movement performed by the large intestine to move its contents.

[0104] a4: Suction or inhalation. Suction refers to drawing gas from the large intestine. Suction draws the intestinal wall towards the tip of the insertion site. Inhalation refers to delivering gas into the large intestine. Inhalation causes the large intestine to distend, and the intestinal wall moves away from the tip of the insertion site.

[0105] (b) The recent condition determination unit 121 obtains the following information by recognizing the shape information of the insertion part.

[0106] b1: The shape of the endoscope insertion section. The "shape" here refers to the shape at a certain moment.

[0107] b2: Types of loops in the LOOP method. Additionally, the shape changes of the endoscope insertion section during, before, and after the LOOP method. Loop types include N-loops, α-loops, reverse α-loops, and γ-loops, identified by the shape of the loop formed by the endoscope insertion section. Figure 9 This is an example of the shape change of the endoscope insertion section. Here, the shape change during N-loop release is used as an example. The LOOP method is used when passing the endoscope insertion section through the sigmoid colon. When the N-loop is formed, the endoscope insertion section is approximately N-shaped. By performing a pulling operation, the N-loop is gradually released, and when released, the endoscope insertion section is approximately straight. Midway through release, the endoscope insertion section becomes a shape between approximately N-shaped and approximately straight. By recognizing this shape change, it can be identified that the N-loop has been properly released.

[0108] b3: Shape changes of the endoscopic insertion section during, before, and after the axial shortening technique. The axial shortening technique is used when passing the endoscopic insertion section through the sigmoid colon. The axial shortening technique traverses the folds of the intestinal wall through angular manipulation, folds the folds through torque manipulation, and passes through the sigmoid colon by repeating these operations. The shape changes resulting from these operations are detected.

[0109] b4: Shape changes of the endoscopic insertion site during transverse colon manipulation. Transverse colon manipulation refers to the shortening of the mid-transverse colon. Similar to the LOOP method, the shape changes resulting from the transverse colon manipulation are detected.

[0110] b5: Deflection of the endoscopic insertion section, or stretching of the intestinal wall caused by the endoscopic insertion section. Deflection of the endoscopic insertion section refers to the insertion section deflecting midway during the pushing operation, while the tip remains stationary. Stretching of the intestinal wall caused by the endoscopic insertion section refers to the stretching of the intestinal wall between the pushed portion and the fixed colon of the large intestine due to the pushing of the free colon by the endoscopic insertion section. Figure 8 In traditional Chinese medicine, the free colon consists of the sigmoid colon and transverse colon, while the fixed colon consists of the rectum, ascending colon, and descending colon.

[0111] (c) The recent situation determination unit 121 obtains the following operation identification information based on the shape displacement of the endoscope insertion part.

[0112] c1: When performing the axial holding shortening method, LOOP method, or shortening, can push, pull, torque, or angle operations be performed? The direction and amount of displacement of the endoscope insertion section, or both, are used to determine whether pain occurs during or while performing the operation.

[0113] (d) The time series condition determination unit 122 obtains the following information based on past inspection information.

[0114] d1: Previously generated auxiliary information, image recognition results, shape recognition results, or operation recognition information. This information is obtained by accessing previously checked information accumulated in the storage device.

[0115] Let's take "a4: aspiration or exhalation" as an example to illustrate the relationship between the above information and sedation.

[0116] The pain conditions described later (1) or (3) are related to suction. When a movement of the intestinal wall approaching the tip of the endoscope due to suction is observed, it is not necessary to approach the intestinal wall by means of potentially painful operations such as pushing or pulling. Therefore, the likelihood of pain is lower when there is a movement of the intestinal wall approaching the tip of the endoscope due to suction. On the other hand, when such a movement is not observed, it is necessary to approach the intestinal wall by means of potentially painful operations such as pushing or pulling. Therefore, in this case, the likelihood of pain due to subsequent operations is higher.

[0117] Therefore, the examination status information acquisition unit 170 acquires examination status information DSI related to whether the intestinal wall has moved closer to the tip of the endoscope due to endoscopic aspiration. The sedative need determination unit 180 determines that a sedative is needed when endoscopic aspiration has been performed but the intestinal wall has not moved closer to the tip of the endoscope.

[0118] According to this embodiment, when it is detected that the suction is ineffective, that is, when no movement of the intestinal wall approaching the tip of the endoscope due to suction is observed, it is determined that pain may easily occur, and the sedative need determination unit 180 can promote sedation in advance.

[0119] The pain condition (23) described later is related to the distension of the intestinal tract caused by the insufflation of air. Pain occurs when a large amount of air is delivered into the large intestine by insufflation, causing the intestinal tract to swell. Therefore, when it is recognized that the intestinal tract is distended due to insufflation, the pain condition recognition unit 130 determines that there is a possibility of pain, and the sedative need determination unit 180 prompts sedation.

[0120] Next, the pain status identified based on the aforementioned recent status information TYK and time-series status information JIK will be explained.

[0121] The sedation need determination unit 180 determines that sedation is needed when, based on the examination status information DSI, it identifies a situation causing pain due to the stretching of the large intestine wall, pain due to the traction of the mesentery, pain due to the pressure of the endoscopic insertion section on the intestinal wall, or pain due to the relationship between the fixed colon and the endoscopic insertion section. "The relationship between the fixed colon and the endoscopic insertion section" refers to a relationship where the endoscopic insertion section pushes or pulls on the fixed colon due to endoscopic manipulation. Furthermore, this relationship is not estimated based on force, but rather on the position, shape, positional displacement, or shape displacement of the endoscopic insertion section.

[0122] The four conditions described above are the main insertion conditions that cause pain in patients during colonoscopy. The pain condition recognition unit 130 can identify the pain condition by recognizing these insertion conditions.

[0123] Specific examples of pain conditions are shown (1) to (23).

[0124] (1) The situation in which a pushing operation was performed when there was no loop. This painful situation is the insertion situation in which the intestinal wall is stretched by a pushing operation before a loop is formed.

[0125] (2) The situation where a right torque operation is performed during the reverse α loop. The reverse α loop is released by a left torque operation, but if a right torque operation is performed in the opposite case, the loop is not released, which may cause pain. The insertion situation in which the reverse α loop is not released due to this right torque operation is the painful situation.

[0126] (3) The situation in which a pushing operation was performed when there was a loop. This painful situation is the insertion situation in which the intestinal wall is stretched by a pushing operation when an N loop has been formed.

[0127] (4) A situation where an upward pushing operation was performed near the SDJ, either ventrally or cephalad, using endoscopic angle manipulation. Figure 10 The diagram illustrates the pain condition. The SDJ is located near the boundary between the sigmoid colon and the descending colon; therefore, when upward pressure occurs near the SDJ, the descending colon, which acts as a fixed part of the colon, is compressed, potentially causing pain. The position of the source coil 18, located at the endoscope insertion section 14, is detected based on the position of the endoscope shape acquisition sensor 20. Therefore, the ventral and cephalic directions under the detected insertion section shape can be determined based on the relative positional relationship between the patient and the endoscope shape acquisition sensor 20.

[0128] (5) A situation in which an upward pushing operation is performed near the SDJ by torque and angle manipulation of the endoscope. Similar to (4), pain may occur because the descending colon, which is the fixed colon, is pushed.

[0129] (6) The procedure was performed with the endoscope insertion point bent near the SDJ. This painful situation is caused by the insertion near the fixed colon, i.e., near the SDJ, where the fixed colon is pushed. For example, the procedure was performed at an angle, such as when forming the N loop.

[0130] (7) A pulling operation was performed when the endoscope had a haptic. Figure 11 The diagram illustrates this pain condition. Here, the α loop is used as an example, but other loops may also be used. The α loop is released by a right-hand torque operation. When a pull operation is performed during the formation of the α loop, the loop is not released, which may cause pain.

[0131] (8) A pulling operation performed when there is no loop. This painful situation is an insertion situation in which the pull operation is performed without forming a loop, resulting in excessive pulling or pulling in the wrong direction.

[0132] (9) Operation performed while adhesions are present. This painful situation is characterized by a portion of the endoscope insertion point becoming stuck in the intestinal wall during a pulling operation. It is suspected that there is an adhesion at the stuck portion of the intestinal wall. For example, the tip of the endoscope insertion point may be stuck by an adhesion. In this case, the tip remains stationary during a pulling operation, while the shape of other parts changes. Alternatively, the endoscopic image may not change. This painful situation can be identified by recognizing these conditions.

[0133] (10) A situation in which an upward pushing operation is performed near the boundary between the fixed colon and the free colon by pushing or pulling operations. The boundary between the fixed colon and the free colon is the SDJ or splenic flexure. Similar to (4), pain may occur due to the compression of the fixed colon.

[0134] (11) The condition of performing a pushing operation on the splenic flexure. Since the diaphragm is located on the cephalic side of the splenic flexure, the splenic flexure may be pushed to the diaphragm due to the pushing operation, which may cause pain.

[0135] (12) The endoscope insertion tip is located in any of the splenic flexure, transverse colon, or hepatic flexure, and a pushing operation is performed when a reloop is formed in the sigmoid colon. Figure 12 The diagram illustrates this painful condition. Here, an example is shown where the tip of the endoscope insertion point is located within the splenic flexure. During a pushing operation to pass through the splenic flexure, the insertion point near the sigmoid colon may sometimes flex while the tip is blocked by the flexure. This flexed portion of the insertion point near the sigmoid colon is called a reloop. In this situation, if a pushing operation is performed to a certain degree, the degree of reloop increases, resulting in stretching of the intestinal wall. This painful condition can be identified by recognizing that the tip of the endoscope insertion point remains stationary while the reloop has undergone a certain degree of displacement.

[0136] (13) The endoscope insertion tip is located in any of the splenic flexure, transverse colon, or hepatic flexure, and a pulling operation is performed when dealing with relooping in the sigmoid colon. Figure 13 The diagram illustrates this pain condition. Here, an example is shown where the tip of the endoscope insertion point is located in the splenic flexure. The loop is released by a pulling operation, but pain may occur if the pulling operation is performed while the flexure at the tip of the insertion point is stuck by the upper end of the descending colon. This pain condition can be identified by the difference between the movement of the tip of the insertion point and the movement of other parts, just as in (12).

[0137] (14) The situation where the left colon is pushed upward from the splenic flexure by endoscopic manipulation. Figure 14 The diagram illustrates this painful condition. The splenic flexure is pushed upwards by performing a pushing operation with the endoscopic insertion point touching it. This may result in stretching of the left colon or pressure towards the diaphragm.

[0138] (15) The shortening operation results in the splenic flexure being pulled downwards from the descending colon toward the anus or the right colon being bounced upwards toward the head. When the shortening operation is performed in the middle section, the anterior end of the insertion part of the right colon rises toward the head, and the insertion part near the splenic flexure descends toward the anus. As a result, the ascending colon, which is the fixed colon, is pulled or the descending colon, which is the fixed colon, is pushed, which may cause pain.

[0139] (16) The splenic flexure is pushed upwards towards the head by a pushing operation during mid-segment insertion. When there is an endoscopic insertion point in the area of ​​transverse colon prolapse, it is possible to push the insertion point near the splenic flexure upwards by a pushing operation, thereby flexing the splenic flexure towards the head.

[0140] (17) During the shortening operation, the right colon is pulled to the left ventral side by angular manipulation.

[0141] (18) The liver flexure is pushed upward by angular manipulation.

[0142] (19) The condition in which the liver flexure is pushed upward by the pushing operation.

[0143] (20) When the tip of the endoscope insertion part is in the hepatic flexure, the splenic flexure is pushed upward by the pushing operation.

[0144] (21) After reaching the hepatic flexure, the splenic flexure is pulled toward the anus by a pulling operation.

[0145] (22) The splenic flexure is pulled toward the anus by the pulling operation at the splenic flexure.

[0146] (23) The condition of intestinal distension due to gas delivery.

[0147] Furthermore, the pain condition recognition unit 130 can recognize a pain condition when the displacement exceeds a predetermined value under various conditions. This can be achieved as follows: Figure 15 As shown, under the condition described in (3) above, when the N-loop is detected and the displacement of the loop protrusion is greater than or equal to a predetermined value, it is determined to be a pain condition. The degree of extension varies depending on the displacement, so when the displacement reaches a certain degree of extension, a pain condition is identified.

[0148] Furthermore, the pain condition recognition unit 130 can determine the pain level based on the amount of displacement in various situations. For example, in Figure 15In this process, when the displacement of the loop portion is greater than or equal to a first predetermined value, it is determined to be a first level of pain; when the displacement of the loop portion is greater than a second predetermined value, it is determined to be a second level of pain. When the second predetermined value is greater than the first predetermined value, it indicates that the pain of the second level of pain is stronger than the pain of the first level of pain.

[0149] Figure 16 This is a flowchart of the processing performed by the medical assistance system 100 in the first detailed structural example. Furthermore, in this flowchart, steps S53 and S55-S57 correspond to... Figure 1 The determination of whether or not a sedative is needed is explained in the text.

[0150] In step S51, the information acquisition unit 140 acquires information IFIN. In step S52, the condition recognition unit 120 determines the presence or absence of a pain condition based on the information IFIN. Furthermore, when the condition recognition unit 120 determines that it is a pain condition, it outputs pain level information, pain frequency information, pain type information, and previously presented auxiliary information as pain condition information PSI. The pain type information indicates which of the pain conditions (1) to (23) described above applies.

[0151] In step S53, the sedative need determination unit 180 determines whether the pain level is stronger than the specified level.

[0152] In step S53, when the sedative need determination unit 180 determines that the pain level is stronger than a predetermined level, in step S54, the sedative need determination unit 180 determines that sedation is needed, and the auxiliary information generation unit 150 generates auxiliary information indicating the use of sedation. That is, when an unbearable level of pain is identified, sedation is indicated.

[0153] In step S53, if the sedative need determination unit 180 determines that the pain level is weaker than a predetermined level, in step S55, the sedative need determination unit 180 determines the frequency of pain. Specifically, the sedative need determination unit 180 determines whether the pain occurs multiple times or whether the duration of the pain is longer than a predetermined time.

[0154] In step S55, if the sedative need determination unit 180 determines that the frequency of pain is high or the duration of pain is longer than a predetermined time, in step S54, the sedative need determination unit 180 determines that sedation is needed, and the auxiliary information generation unit 150 generates auxiliary information indicating the use of sedation. That is, in cases where the pain level is weak but the frequency of pain is high or the duration of pain is long, sedation is indicated.

[0155] If, in step S55, the sedative need determination unit 180 determines that the number of times the pain occurs is single, or that the duration of the pain is shorter than a predetermined time, then in step S56, the sedative need determination unit 180 determines the type of pain. Specifically, the sedative need determination unit 180 determines whether there is a pain avoidance operation in the painful condition identified in step S52.

[0156] In step S56, when the sedative need determination unit 180 determines that there is no pain avoidance operation, in step S54, the sedative need determination unit 180 determines that sedation is needed, and the auxiliary information generation unit 150 generates and presents auxiliary information for using sedation.

[0157] In step S56, when the sedative need determination unit 180 determines that there is an avoidance operation to avoid pain, in step S57, the sedative need determination unit 180 determines whether the same avoidance operation has been performed in the past.

[0158] In step S57, when the sedative need determination unit 180 determines that the same avoidance operation has been performed in the past, in step S54, the sedative need determination unit 180 determines that sedation is needed, and the auxiliary information generation unit 150 generates auxiliary information to present the use of sedation.

[0159] In step S57, if the sedation need determination unit 180 determines that the same avoidance operation has not been presented before, in step S58, the sedation need determination unit 180 determines that sedation is not needed, and the auxiliary information generation unit 150 generates auxiliary information that presents the avoidance operation corresponding to the pain condition identified in step S52. That is, when the pain level is weak and the frequency or duration of pain is low, avoidance operations are basically implemented through the surgeon's endoscopic operation, manual pressure by the assistant, or changes in the patient's position.

[0160] However, depending on the type of pain, there are pains for which there is no avoidance action. For example, the pain condition described above (9) does not require avoidance action. In this case, sedation is used. Additionally, there are cases where the current pain has occurred in the past, and avoidance action is performed at that time. In this case, the currently identified pain is pain that cannot be completely prevented even with avoidance action, or pain that is difficult to prevent, therefore sedation is used.

[0161] The content presented in step S54 is, for example, "Frequent pain. Sedation is recommended." This indicates that the use of sedation would be better.

[0162] When sedation is used, as presented in step S54, information about the pain condition identified in step S52, or information about the pain determined through steps S53 and S55-S57, can be recorded on the electronic medical record card.

[0163] Figure 17 This is a flowchart illustrating specific examples of pain condition identification and the determination of whether sedation is needed based on the identification results. Here, the axis-holding shortening method is used as an example for explanation, and the processing flow corresponding to each insertion method or each pain condition (1) to (23) described above is set in advance.

[0164] In step S61, the nearest situation determination unit 121 determines whether it is the optimal distance based on the information IFIN.

[0165] In step S61, when the nearest situation determination unit 121 determines that it is the optimal distance, in step S62, the pain condition recognition unit 130 determines whether it is a pain condition based on the insertion status recognized by the nearest situation determination unit 121 and the time series situation determination unit 122. In step S62, if the pain condition recognition unit 130 determines that it is not a pain condition, in step S63, the sedative need-or-not determination unit 180 determines that sedation is not needed. In step S62, if the pain condition recognition unit 130 determines that it is a pain condition, in step S70, the sedative need-or-not determination unit 180 performs... Figure 16 The determination of whether or not sedation is needed is shown in S53 and S55 to S57.

[0166] If the most recent condition determination unit 121 determines that the distance is not optimal in step S61, then in step S65, the pain condition recognition unit 130 determines whether it is a pain condition based on the insertion condition recognized by the most recent condition determination unit 121 and the time series condition determination unit 122. If the pain condition recognition unit 130 determines that it is not a pain condition in step S65, then in step S66, the sedative need determination unit 180 determines that sedation is not needed. If the pain condition recognition unit 130 determines in steps S65 and S67 that the pulling operation is a pain condition when it is not a loop, then in steps S68 and S69, the pain condition recognition unit 130 determines that the optimal distance cannot be reached during the pulling operation, and determines that although the optimal distance can be reached through the pushing operation, pain may occur during the pushing operation. In step S70, the sedative need determination unit 180... Figure 16 The determination of whether or not sedation is needed is shown in S53 and S55 to S57.

[0167] Figure 18 This is a flowchart illustrating a specific example of pain condition identification. Here, as... Figure 24 As shown, the example of pain caused by stretching in the sigmoid colon will be used for illustration.

[0168] In step S31, the recent situation determination unit 121 determines the location of the endoscope insertion part based on the endoscope image and the insertion part shape information. Specifically, the recent situation determination unit 121 performs image recognition of the endoscope image and shape recognition of the insertion part shape information, and determines the location of the endoscope insertion part based on the image recognition results and shape recognition results.

[0169] In step S31, when the recent condition determination unit 121 determines that the endoscope insertion part is located in a location other than the sigmoid colon, in step S32, the pain condition recognition unit 130 determines that the pain condition is in another location.

[0170] In step S31, when the most recent condition determination unit 121 determines that the endoscope insertion part is present in the sigmoid colon, in step S33, the most recent condition determination unit 121 determines whether the endoscope insertion part is in an extended shape. Here, an extended shape is as follows: Figure 24 As shown, it is a cane shape that bulges towards the head and bends towards the left side of the abdomen.

[0171] In step S33, when the recent condition determination unit 121 determines that it is not an extended shape, in step S34, the pain condition recognition unit 130 determines that it is another type of pain condition.

[0172] When the most recent condition determination unit 121 determines that the shape is extended in step S33, in step S35, the most recent condition determination unit 121 determines whether extension has occurred. Specifically, the most recent condition determination unit 121 determines extension based on the following: the endoscope insertion part is displaced towards the head while maintaining an extended shape; the endoscope image stops or retracts in the extended region identified by the most recent identification information; or both.

[0173] If the recent condition determination unit 121 determines that no stretching has occurred in step S35, the pain condition recognition unit 130 determines that no pain caused by stretching has occurred in step S36, and the sedative need determination unit 180 determines that sedation is not needed.

[0174] When the recent condition determination unit 121 determines that stretching has occurred in step S35, the pain condition recognition unit 130 determines in step S37 whether the stretching exceeds a threshold. Specifically, the pain condition recognition unit 130... Figure 24 As shown, determine whether the displacement of the convex portion of the endoscope insertion section exceeds the threshold.

[0175] In step S37, when the pain condition recognition unit 130 determines that the stretching has not exceeded the threshold, in step S36, the pain condition recognition unit 130 determines that no pain caused by the stretching has occurred, and the sedative need determination unit 180 determines that sedation is not needed.

[0176] In step S37, when the pain condition recognition unit 130 determines that the stretching exceeds the threshold, in step S38, the pain condition recognition unit 130 determines that pain caused by the stretching has occurred, and the sedative need determination unit 180 proceeds. Figure 16 The determination of whether or not sedation is needed is shown in S53 and S55 to S57.

[0177] 4. Example of a second detailed structure of a medical assistance system

[0178] Figure 19 This is a second detailed structural example of a medical assistance system 100. The medical assistance system 100 includes an image acquisition unit 141, an endoscope shape acquisition unit 142, a condition recognition unit 120, a sedative need determination unit 180, and an assistance information generation unit 150. In this structural example, for example, the image acquisition unit 141, the endoscope shape acquisition unit 142, and the recent condition determination unit 121 correspond to... Figures 1-3 The inspection status information acquisition unit 170 and the time series status determination unit 122 correspond to Figure 3 The past inspection information acquisition unit 190. Furthermore, for constituent elements that are identical to those already described, their descriptions are appropriately omitted.

[0179] The pain information acquisition unit 500 is included in the endoscopy system 400. For example, if the medical assistance system 100 is included in the insertion shape observation device 200, the pain information acquisition unit 500 may be included in the insertion shape observation device 200.

[0180] The pain information acquisition unit 500 includes a transmitting device 510 that can be operated by a patient or medical personnel according to the patient's pain status. The transmitting device 510 is, for example, a switch or a touch panel. Taking the case where the patient operates the switch as an example, the patient holds the switch and presses it when pain occurs. The pain status recognition unit 130 recognizes the occurrence of pain based on the information from the switch, and the sedative need determination unit 180 determines whether a sedative is needed based on the recognition result. The switch can be a single-pole switch or a two-pole switch with varying intensity. The switch can only transmit the presence or absence of pain, or it can transmit information other than the presence or absence of pain, such as intensity or duration of pain. Alternatively, a nurse or other assistant can hold the switch and press it on behalf of the patient when they complain of pain.

[0181] Additionally, the pain information acquisition unit 500 may include a camera that captures the patient's facial expressions, and pain can be identified by recognizing that the captured image shows a painful expression. Furthermore, the pain information acquisition unit 500 may include a microphone that captures the patient's voice, and pain can be identified by recognizing that the patient is complaining of pain based on the voice. The output signal of the transmitting device 510, the facial expression recognition result, or the voice recognition result are input as pain information INPN to the condition recognition unit 120.

[0182] The image acquisition unit 141 acquires an endoscope image by receiving an endoscope image sent by the signal processing unit 310 of the endoscope device 300. The endoscope shape acquisition unit 142 acquires the position and shape of the endoscope insertion part based on the detection signal from the endoscope shape acquisition sensor 20. The endoscope image, as well as the information on the position and shape of the endoscope insertion part, are input to the condition recognition unit 120 as information IFIN.

[0183] Figure 20 This is a flowchart of the processing performed by the medical assistance system 100 in the second detailed structural example.

[0184] In step S11, the auxiliary information generation unit 150 determines whether the pain condition recognition unit 130 has detected a pain condition based on internal information. Internal information refers to input pain information (INPN) not sent by the patient or medical personnel. Figure 18 In the example, it is the endoscope image acquired by the image acquisition unit 141, the insertion part shape information acquired by the endoscope shape acquisition unit 142, the recent status information TYK output by the recent status determination unit 121, the time series status information JIK output by the time series status determination unit 122, or any combination of two or more of them.

[0185] In step S11, when the pain condition recognition unit 130 detects a pain condition based on internal information, in step S16, the auxiliary information generation unit 150 determines whether the pain condition recognition unit 130 has detected a pain condition based on external information. External information refers to input pain information (INPN) sent by the patient or medical personnel.

[0186] In step S16, if the pain condition recognition unit 130 does not detect a pain condition based on external information, in step S17, the sedative need determination unit 180 determines that sedation is not needed.

[0187] In step S16, when the pain condition recognition unit 130 detects a pain condition based on external information, in step S18, the pain condition recognition unit 130 logs the detected pain condition in the memory. In step S19, when the detected pain condition meets any of the above-mentioned pain conditions (1) to (23), the pain condition recognition unit 130 updates the determination criteria for the qualified pain condition. For example, if a pain condition is detected by threshold determination of displacement, the threshold is updated. In step S15, the sedative need determination unit 180 performs... Figure 16 The determination of whether sedation is needed is shown in S53 and S55 to S57. When it is determined in step S15 that sedation is needed, in step S14, the auxiliary information generation unit 150 causes the display device 220 to display auxiliary information indicating the use of sedation.

[0188] If the pain condition recognition unit 130 does not detect a pain condition based on internal information in step S11, the auxiliary information generation unit 150 determines in step S12 whether the pain condition recognition unit 130 has detected a pain condition based on external information.

[0189] If the pain condition recognition unit 130 does not detect a pain condition based on external information in step S12, the sedative need determination unit 180 determines in step S13 that sedation is not needed.

[0190] In step S12, when the pain condition recognition unit 130 detects a pain condition based on external information, the pain condition is recorded in step S20. For example, the pain condition is recorded on an electronic medical record card. When the pain condition recognition unit 130 identifies a pain condition (1) to (23) that does not conform to the above-mentioned pain conditions based on external information, the pain condition is recorded as patient-specific pain, thereby enabling the identification of patient-specific pain conditions if the same pain condition occurs again in the current examination or in subsequent examinations. Next, when it is determined in step S15 that sedation is required, in step S14, the auxiliary information generation unit 150 causes the display device 220 to display auxiliary information indicating the use of sedation.

[0191] 5. Examples of the third and fourth detailed structures of a medical assistance system

[0192] Figure 21 This is a third detailed structural example of the medical assistance system 100. The medical assistance system 100 includes an image acquisition unit 141, an endoscope shape acquisition unit 142, a patient information acquisition unit 143, an endoscope information acquisition unit 144, a condition recognition unit 120, a sedative need determination unit 180, and an auxiliary information generation unit 150. Figure 22This is a fourth detailed structural example of the medical assistance system 100. The fourth detailed structural example is a structural example that further adds a pain information acquisition unit 500 to the third detailed structural example. In the third and fourth detailed structural examples, for example, the image acquisition unit 141, the endoscope shape acquisition unit 142, the recent condition determination unit 121, a portion of the patient information acquisition unit 143, and the endoscope information acquisition unit 144 correspond to... Figures 1-3 The examination status information acquisition unit 170, a part of the patient information acquisition unit 143, and the time series status determination unit 122 correspond to Figure 3 The past inspection information acquisition unit 190. Furthermore, for constituent elements that are identical to those already described, their descriptions are appropriately omitted.

[0193] The electronic medical record card 600 accumulates patient information related to the patient's attributes. The electronic medical record card 600 is stored in a storage device, for example, located outside the endoscopy system 400, and the patient information acquisition unit 143 retrieves the electronic medical record card 600 from this storage device.

[0194] Patient information includes, for example, the patient's physique, sex, age, medical history, body fat percentage, or any combination of two or more of these. Physique includes BMI, height, weight, or any combination of two or more of these. Depending on these patient attributes, the predisposition to pain or the pain threshold may differ. For example, there may be cases where thin women are prone to pain, or men experience pain when extending their arms 50mm toward their head in the N-loop. By identifying pain conditions based on patient information, and appropriately recognizing the patient's inherent pain profile, the need for appropriate sedation can be determined.

[0195] In addition, patient information can include past examination information. This includes the insertion method used, the time taken until completion, whether pain occurred, the insertion trajectory, the type of endoscope used, whether sedation was administered, or any combination of two or more of these. By identifying pain patterns based on this past examination information, the patient's inherent pain condition can be appropriately identified, thus enabling a determination of whether appropriate sedation is needed.

[0196] The endoscope information acquisition unit 144 acquires endoscope type information from the signal processing unit 310 of the endoscope device 300. The diameter of the endoscope insertion part varies depending on the type of endoscope. Therefore, the pain that is likely to occur may differ depending on the type of endoscope. Therefore, by identifying the pain condition based on the endoscope type information, the different pain conditions depending on the type of endoscope can be appropriately identified, thus enabling the determination of whether appropriate sedation is needed.

[0197] 6. Example of the fifth detailed structure of a medical assistance system

[0198] Figure 23 This is the fifth detailed structural example of the medical assistance system 100. The medical assistance system 100 includes an image acquisition unit 141, an endoscope shape acquisition unit 142, a patient information acquisition unit 143, an endoscope information acquisition unit 144, a condition recognition unit 120, a sedative need determination unit 180, and an assistance information generation unit 150. Furthermore, descriptions of components identical to those already described are appropriately omitted.

[0199] The auxiliary information generation unit 150 can control the automatic insertion and removal device 700 by outputting auxiliary information AST to the control device 710 of the automatic insertion and removal device 700. The automatic insertion and removal device 700 is a robot that automatically or semi-automatically inserts or removes an endoscope, and the control device 710 is a device that controls the robot. The auxiliary information AST is output as a control signal to the control device 710. When the sedative need determination unit 180 determines that sedation is needed, the auxiliary information generation unit 150 can output a control signal, for example, to stop the operation of the automatic insertion and removal device 700.

[0200] The embodiments and their variations have been described above, but this disclosure is not limited to each embodiment and its variations. During implementation, the constituent elements can be modified and specified without departing from the spirit of the disclosure. Furthermore, multiple constituent elements disclosed in the above embodiments and variations can be appropriately combined. For example, several constituent elements can be deleted from all the constituent elements described in each embodiment and variation. Moreover, constituent elements described in different embodiments and variations can be appropriately combined. In this way, various modifications and applications can be made without departing from the spirit of the disclosure. Additionally, terms described at least once in the specification or drawings along with broader or synonymous terms can be replaced with those different terms in any part of the specification or drawings.

[0201] Explanation of reference numerals in the attached figures

[0202] 10: Endoscope; 12: Operating unit; 14: Endoscope insertion unit; 15: Bending part; 16: Rigid part; 18: Source coil; 20: Endoscope shape acquisition sensor; 100: Medical assistance system; 120: Status recognition unit; 121: Recent status determination unit; 122: Time series status determination unit; 130: Pain status recognition unit; 140: Information acquisition unit; 141: Image acquisition unit; 142: Endoscope shape acquisition unit; 143: Patient information acquisition unit; 144: Endoscope information acquisition unit; 150: Auxiliary information generation unit; 170: Examination status information acquisition unit; 180: Sedative need determination unit; 190: Past examination information acquisition unit ; 191: Storage device; 200: Insertion shape observation device; 210: Main device; 220: Display device; 300: Endoscopic device; 310: Signal processing device; 320: Display device; 330: Light source device; 400: Endoscopic system; 500: Information acquisition unit; 510: Transmitting device; 600: Electronic medical record card; 700: Automatic insertion and removal device; 710: Control device; AST: Auxiliary information; DSI: Examination status information; INPN: Input pain information; JIK: Time series status information; KJH: Past examination information; PSI: Pain status information; SYN: Need / not need determination result; TYK: Recent status information.

Claims

1. A medical auxiliary system, characterized in that, Including processors, The processor is configured to perform the following processes: Obtain examination status information related to the status of endoscopic examinations performed using an endoscope; Pain status information is obtained by identifying pain status based on the examination status information. This pain status is a pre-determined situation in which the patient is prone to pain during the endoscopic examination or a situation in which pain actually occurs. The need for sedatives is determined based on the pain information. as well as Based on the determination of whether or not the sedative is needed, auxiliary information is generated for the user. Specifically, the pain conditions are identified by distinguishing between conditions with different levels of pain, different frequencies of pain, or different levels of ease of avoiding pain. The examination status information includes at least one of the following: endoscopic image recognition information, insertion part shape information, operation recognition information, patient expression information, pain signaling information, endoscope type information, and patient information. The endoscopic image recognition information is information on the recognition results of the endoscopic image. The insertion part shape information is information on the shape of the endoscopic insertion part. The operation recognition information is information on changes in at least one of the shape and position of the endoscopic insertion part. The patient expression information is information related to the patient's expression during the endoscopic examination. The pain signaling information is information from the transmitting device operated by the patient or medical personnel. The endoscope type information is information on the type of endoscopic insertion part used in the endoscopic examination. The patient information is information related to the patient's attributes.

2. The medical auxiliary system according to claim 1, characterized in that, The processor classifies the insertion status of the endoscope based on at least one of endoscopic image recognition information, insertion part shape information, and operation recognition information during the endoscopic examination, and outputs the examination status information including the classification results. The endoscopic image recognition information is information based on the recognition results of the endoscopic image, the insertion part shape information is information on the shape of the endoscopic insertion part, and the operation recognition information is information on changes in at least one of the shape and position of the endoscopic insertion part. The processor determines whether the sedative is needed based on the insertion status shown in the classification results.

3. The medical auxiliary system according to claim 2, characterized in that, The operation identification information includes information on the shape displacement of the endoscope insertion section, i.e., the insertion section shape displacement information. The processor performs the classification based on the insertion part shape information and the insertion part shape displacement information.

4. The medical auxiliary system according to claim 3, characterized in that, The shape displacement information of the insertion part includes information about the magnitude of the shape displacement, i.e., the amount of shape displacement information. The processor performs the classification based on the shape information of the insertion part and the shape displacement information.

5. The medical auxiliary system according to claim 1, characterized in that, When the processor determines that the sedative is needed in the need-or-not determination, it generates auxiliary information indicating that the sedative is needed.

6. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, a situation where pain is caused by the stretching of the intestinal wall, the traction of the mesentery, the pressure of the endoscope insertion portion on the intestinal wall, or the relationship between the fixed part of the large intestine and the endoscope insertion portion, that the sedative is required.

7. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, a pushing operation is performed near the boundary between the sigmoid colon and the descending colon, involving an upward push towards the ventral or cephalic side, using the angle of the endoscope, it determines that the sedative is needed.

8. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, a cephalic upward push operation is performed near the boundary between the sigmoid colon and the descending colon via torque and angle operations of the endoscope, it determines that the sedative is required.

9. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, that an operation has been performed with the endoscope insertion portion bent near the boundary between the sigmoid colon and the descending colon, it determines that the sedative is required.

10. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies a pulling operation performed when the endoscope has a loop based on the inspection status information, it determines that the sedative is needed.

11. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, that the tip of the endoscope insertion section is present in any of the splenic flexure, transverse colon, or hepatic flexure, and a push operation was performed when a reloop was formed in the sigmoid colon, it determines that the sedative is required.

12. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, that the tip of the endoscope insertion section is present in any of the splenic flexure, transverse colon, or hepatic flexure, and a pulling operation has been performed when dealing with the re-loop in the sigmoid colon, it determines that the sedative is required.

13. The medical auxiliary system according to claim 1, characterized in that, When the processor identifies, based on the examination status information, that the left colon is pushed upward from the splenic flexure by the pushing operation of the endoscope, it determines that the sedative is needed.

14. The medical auxiliary system according to claim 1, characterized in that, The processor acquires examination status information related to whether the intestinal wall has moved closer to the tip of the endoscope due to suction. The processor determines that the sedative is needed when the endoscope has been aspirated but the intestinal wall is not close to the tip of the endoscope.

15. The medical auxiliary system according to claim 1, characterized in that, The processor acquires information related to past endoscopic examinations, i.e., past examination information. The processor determines whether the sedative is needed based on the past inspection information.

16. An endoscope system, characterized in that, include: An endoscope, used for endoscopic examinations; as well as processor, The processor is configured to perform the following processes: Obtain examination status information related to the status of the endoscopic examination performed using the endoscope; Pain status information is obtained by identifying pain status based on the examination status information. This pain status is a pre-determined situation in which the patient is prone to pain during the endoscopic examination or a situation in which pain actually occurs. The need for sedatives is determined based on the pain information. as well as Based on the determination of whether or not the sedative is needed, auxiliary information is generated for the user. Specifically, the pain conditions are identified by distinguishing between conditions with different levels of pain, different frequencies of pain, or different levels of ease of avoiding pain. The examination status information includes at least one of the following: endoscopic image recognition information, insertion part shape information, operation recognition information, patient expression information, pain signaling information, endoscope type information, and patient information. The endoscopic image recognition information is information on the recognition results of the endoscopic image. The insertion part shape information is information on the shape of the endoscopic insertion part. The operation recognition information is information on changes in at least one of the shape and position of the endoscopic insertion part. The patient expression information is information related to the patient's expression during the endoscopic examination. The pain signaling information is information from the transmitting device operated by the patient or medical personnel. The endoscope type information is information on the type of endoscopic insertion part used in the endoscopic examination. The patient information is information related to the patient's attributes.

Images