Endoscope system, method for controlling endoscope system, and video processor

Abstract

The purpose of the present invention is to provide an endoscope system for visualizing a burning state in which a subject such as biological tissue is burnt using an energy device or the like, the endoscope system being provided with: a light source device (3) for emitting narrow-band light having a peak wavelength in a first wavelength band; an imaging element (13) that generates an imaging signal obtained by imaging light of a second wavelength band different from the first wavelength band; and a video processor (4).

Description

[0001] This application is a divisional application of the invention patent application with application number 201980055360.2 (application date is September 10, 2019, invention name is "Thermal invasion observation device, endoscope system, thermal invasion observation system, thermal invasion observation method"). Technical Field

[0002] The present invention relates to an endoscope system for visualizing a cauterization state of a subject such as a biological tissue cauterized using an energy device or the like, a control method of the endoscope system, and a video processor. Background Art

[0003] Conventionally, in medical endoscopes mainly used in the medical field, endoscope fiberscope systems equipped with a special light observation function for emphasizing and displaying an observation object by controlling the wavelength of light have generally been put to practical use.

[0004] For example, the narrow-band light observation (NBI: Narrow Band Imaging (registered trademark)) function is to achieve emphasized display of capillaries on the surface of the mucosa or fine patterns of the mucosa by irradiating a subject such as biological tissue (hereinafter referred to as the subject) with two narrow-band light wavelengths (390~445nm / 530~550nm) that is easily absorbed by hemoglobin in the blood.

[0005] In addition, the infrared light observation (IRI: Infra Red Imaging) function means that after the infrared indicator drug that easily absorbs infrared light is injected intravenously, two infrared lights (790~820nm / 905~970nm) are irradiated on the subject, thereby achieving the emphasized display of blood vessels or blood flow information deep in the mucosa that is difficult to visually confirm under normal light observation.

[0006] Furthermore, the fluorescence observation (AFI: Auto Fluorescence Imaging) function refers to the ability to emphasize and display tumor lesions and normal mucosa in different tones by irradiating the subject with excitation light (390 to 470 nm) for observing autofluorescence from biological tissues and light of a wavelength (540 to 560 nm) absorbed by hemoglobin in the blood. That is, the fluorescence observation (AFI) function is a technology that can emphasize and display tumor lesions and normal tissues in different tones by observing autofluorescence from biological mucosa.

[0007] In recent years, the use of these special light observation functions has made it easier to obtain image data for early detection of microscopic lesions such as cancer and precise diagnosis of the extent of lesions before surgery, thereby supporting doctors' precise diagnosis.

[0008] However, these previous special light observation functions mainly observe the surface of the lesion. Therefore, the range of the lesion generated on the surface of the subject can be easily grasped by visual inspection, but the depth information of the lesion is difficult to easily judge only by visual inspection.

[0009] In this regard, for example, various technologies have been proposed in the past for evaluating or estimating depth information of a lesion or damaged part based on image data obtained by a conventional special light observation function.

[0010] For example, Japanese Patent Publication No. 10-505768 discloses a burn injury evaluation device and an evaluation method thereof, wherein a doctor can quickly evaluate the range and depth of burn injury on the skin by using induced fluorescence spectroscopy based on ultraviolet light or blue light or reflectance spectroscopy based on visible light and infrared light. The burn injury evaluation device includes a plurality of light sources that respectively emit excitation light of a predetermined plurality of wavelengths, a sensor that measures the amount of response light emitted from these light sources and reflected by a subject, and a microprocessor, etc., and is configured to optically evaluate the skin of the burn site.

[0011] In addition, Japanese Patent Publication No. 2012-130506 discloses an electronic endoscope system as an optical measurement system that improves the accuracy of estimating the concentration of light-absorbing components and an optical measurement method thereof. The electronic endoscope system excites an infrared indicator drug (indocyanine green: ICG (Indocyanine green)) injected into a blood vessel by irradiating an object with excitation light, and estimates the depth of the blood vessel from the surface of the object based on an imaging signal obtained by imaging the infrared indicator drug.

[0012] Furthermore, Japanese Patent Application Publication No. 2008-229025 discloses a fluorescence observation device that can accurately diagnose a lesion by highly accurately correcting fluorescence image data acquired using a fluorescence observation function.

[0013] However, the devices disclosed in the above-mentioned Japanese Patent Publication No. 10-505768, the above-mentioned Japanese Patent Publication No. 2012-130506, the above-mentioned Japanese Patent Publication No. 2008-229025, etc., all evaluate and estimate information related to the lesion that cannot be obtained by visual observation, such as the depth information of the lesion, based on image data obtained using a special light observation function. Therefore, in these prior arts, there is a problem that it is not always possible to reliably obtain high-precision information related to the lesion.

[0014] On the other hand, in recent years, minimally invasive surgeries using endoscopes or laparoscopy have been widely performed. For example, laparoscopic endoscopic combined gastrectomy (LECS: Laparoscopy and Endoscopy Cooperative Surgery), non-exposed endoscopic wall-inversion surgery (NEWS: Non-exposed Endoscopic Wall-inversion Surgery), endoscopic submucosal dissection (ESD: Endoscopic Submucosal Dissection), etc. are widely performed.

[0015] When performing these minimally invasive surgeries, for example, an energy device such as an electric scalpel is used to perform thermal invasive operations on a subject such as a living tissue in order to mark the surgical target area, etc. In addition, during the actual surgery, the energy device such as the electric scalpel is also used to perform excision of the affected living tissue, etc.

[0016] In this case, in reality, an operator such as a doctor relies on visual observation, touch, intuition, etc. to confirm the extent of heat invasion applied to a desired part of the subject by the energy device.

[0017] Generally, when a portion of a subject such as a biological tissue that has been subjected to heat invasion is observed using normal light (white light), it is found that the surface thereof turns white.

[0018] Here, when the object to be thermally irradiated is white tissue such as fat, it is difficult to distinguish the site to which thermal irradiation is applied from a normal site to which thermal irradiation is not applied. Therefore, when searching for a site to which thermal irradiation is applied during a surgery or the like after a period of time, it is often difficult to find and thus is often missed.

[0019] Therefore, it is very difficult for a surgeon, such as a doctor, to confirm the degree of heat invasion to be applied by visual observation in real time during surgery or the like, and this is a task that requires great skill.

[0020] The present invention has been made in view of the above-mentioned circumstances, and an object thereof is to provide an endoscope system, an endoscope system control method, and a video processor for visualizing a cauterization state of a subject such as a living tissue cauterized using an energy device or the like. Summary of the invention

[0021] Means used to solve problems

[0022] In order to achieve the above-mentioned purpose, an endoscope system of one embodiment of the present invention has a light source device, which emits narrow-band light having a peak wavelength in a first band; a camera element, which generates a camera signal obtained by capturing light in a second band different from the first band; and a video processor, which is configured to perform the following processing: generate fluorescence image data based on the camera signal; calculate the fluorescence intensity in each pixel of the fluorescence image data; obtain a first index, which is an index for determining pixels in the fluorescence image data that exceed a specified fluorescence intensity; determine a first area based on the fluorescence intensity of each pixel in the fluorescence image data and the first index; and generate display image data that identifiably emphasizes the first area.

[0023] A control method for an endoscope system according to one embodiment of the present invention is that a light source device emits narrowband light having a peak wavelength in a first band, an imaging element generates an imaging signal obtained by capturing light in a second band different from the first band, a video processor generates fluorescence image data based on the imaging signal; calculates the fluorescence intensity in each pixel of the fluorescence image data; obtains a first index, which is an index for determining pixels in the fluorescence image data that exceed a specified fluorescence intensity; determines a first area based on the fluorescence intensity of each pixel in the fluorescence image data and the first index; and generates display image data that identifiably emphasizes the first area.

[0024] A video processor of one embodiment of the present invention generates fluorescence image data based on the camera signal; calculates the fluorescence intensity in each pixel of the fluorescence image data; obtains a first index, which is an index for determining pixels in the fluorescence image data that exceed a specified fluorescence intensity; determines a first area based on the fluorescence intensity of each pixel in the fluorescence image data and the first index; and generates display image data that identifiably emphasizes the first area.

[0025] According to the present invention, it is possible to provide an endoscope system for visualizing a cauterization state of a subject such as a living tissue by using an energy device or the like, a control method of the endoscope system, and a video processor. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] Figure 1 This is an external perspective view showing the overall structure of an endoscope system as a thermal invasion observation device according to one embodiment of the present invention.

[0027] Figure 2 It is shown Figure 1 A block diagram of the schematic structure of an endoscope system.

[0028] Figure 3 It is shown Figure 1A stereoscopic view of the appearance of an endoscope included in the endoscope system.

[0029] Figure 4 It is shown Figure 1 A block diagram of the main parts of the detailed structure of the control unit of the light source device of the endoscope system.

[0030] Figure 5 It is a diagram showing a first modification example of displaying a marking area based on thermal invasion in the endoscope system according to the embodiment of the present invention.

[0031] Figure 6 1 is a diagram showing a second modification example of a display example in which a subject is cauterized by thermal invasion using the endoscope system of the present embodiment and the subject including the cauterized area is observed in the fluorescence observation mode.

[0032] Figure 7 is a diagram showing an example of a display showing the depth of thermal invasion, the depth of thermal invasion being displayed according to the use of Figure 6 The thermal invasion depth information is estimated based on the calculated result of the fluorescence intensity information contained in the fluorescence image data.

[0033] Figure 8 This is a diagram showing a third modification example of a display example when a subject is cauterized by thermal invasion using the endoscope system according to one embodiment of the present invention and the subject including the cauterized area is observed in the fluorescence observation mode.

[0034] Fig. 9 This is a diagram showing another example of the third modified example of the display example in the endoscope system according to the embodiment of the present invention.

[0035] Fig.10 This is a graph showing the fluorescence intensity on a living tissue when fluorescence observation is performed at a wavelength of 480 nm after irradiation with excitation light at a wavelength of 340 nm (a wavelength suitable for visualizing a heat-affected area).

[0036] Fig.11 This is a graph showing the fluorescence intensity on a living tissue when fluorescence observation is performed at a wavelength of 530 nm after irradiation with excitation light at a wavelength of 380 nm (a wavelength suitable for visualizing a heat-affected area).

[0037] Fig.12 This is a graph showing the fluorescence intensity on a living tissue when fluorescence observation is performed at a wavelength of 550 nm after irradiation with excitation light at a wavelength of 440 nm (a wavelength suitable for visualizing a heat-affected area).

[0038] Fig.13 This is a graph showing the fluorescence intensity on the living tissue when the living tissue was irradiated with excitation light of a wavelength of 490 nm and fluorescence observation was performed at a wavelength of 650 nm (not suitable for a wavelength that visualizes a heat-affected area).

[0039] Fig.14 This is a graph showing the fluorescence intensity on a living tissue when fluorescence observation at a wavelength of 430 nm was performed after irradiation with excitation light at a wavelength of 410 nm (not suitable for a wavelength that visualizes a heat-affected area).

[0040] Fig.15 This is a graph showing the correlation between the heat invasion depth and the fluorescence intensity when fluorescence observation of the heat invasion area is performed by irradiating excitation light with a wavelength of 390 nm to 470 nm and capturing fluorescence with a wavelength of 500 nm to 640 nm. DETAILED DESCRIPTION

[0041] Hereinafter, the present invention will be described with reference to the embodiments shown in the drawings.

[0042] The drawings used in the following description are schematic drawings, and in order to show the components in sizes that can be recognized on the drawings, the dimensional relationships and scales of the components are sometimes shown differently for each component. Therefore, in the present invention, the number of components, the shape of components, the ratio of the sizes of components, the relative positional relationships of components, etc., recorded in the drawings are not limited to the illustrated methods.

[0043] The thermal invasion observation device of the present invention performs normal white light observation (WLI; white light imaging: white light imaging: white light imaging) and special light observation (fluorescence observation) on a region where thermal invasion such as burning is applied to a subject such as a biological tissue using an energy device or the like, obtains normal white light image data and fluorescence image data containing fluorescence intensity information, generates display image data in a predetermined manner based on the obtained white light image data and fluorescence image data, and displays an image represented by the display image data in various display manners using a display unit (monitor). As a result, the thermal invasion observation device of the present invention can clearly visualize the thermal invasion region due to burning.

[0044] In one embodiment described below, a medical endoscope system mainly used in the medical field is exemplified as an example of a thermal invasion observation device.

[0045] [One embodiment]

[0046] Figure 1This is an external perspective view showing the overall structure of an endoscope system as a thermal invasion observation device according to one embodiment of the present invention. Figure 2 It is shown Figure 1 A block diagram of the schematic structure of an endoscope system. Figure 3 It is shown Figure 1 A stereoscopic view of the appearance of an endoscope included in the endoscope system. Figure 4 It is shown Figure 1 A block diagram of the main parts of the detailed structure of the control unit of the light source device of the endoscope system.

[0047] like Figure 1 , Figure 2 As shown, an endoscope system 1 including a thermal invasion observation device according to an embodiment of the present invention is configured to include an endoscope 2, a light source device 3, a video processor 4, a monitor 5, and a medical cart 6 ( Figure 2 (not shown in the figure) etc.

[0048] First, if Figure 1 to Figure 3 As shown, the endoscope 2 is mainly configured to include an elongated insertion portion 11, an operation portion 12, a universal cable 17, an endoscope connector 17b, and the like.

[0049] The insertion portion 11 is a tubular member formed in an elongated tubular shape and inserted into a subject. The insertion portion 11 is formed by connecting a distal end portion 11a, a bending portion 11b, and a flexible tubular portion 11c in order from the distal end side, and has overall flexibility.

[0050] Among them, Figure 2 As shown, the front end portion 11a is internally configured with an imaging element 13 composed of an image sensor such as a CCD, an objective optical system 14 for forming an optical image of the subject on the imaging element 13, one end of an optical fiber, i.e., a light guide 15, which is inserted through the insertion portion 11, and an illumination optical system 16 as an irradiation portion for irradiating the illumination light guided by the light guide 15 toward an observation object (subject).

[0051] The bending portion 11b is a mechanism unit configured to actively bend in both up and down directions by receiving a rotation operation of a bending operation lever 12a, which is a bending operation member for performing bending operation among a plurality of operation members (described later) provided in the operation portion 12.

[0052] In addition, the type of bending portion in the endoscope to which the present invention can be applied is not limited to the above-mentioned example (a type capable of bending in two directions, up and down), and may also be a type capable of bending in four directions including the left and right directions in addition to the up and down directions (i.e., the entire circumferential direction around the axis of the insertion portion 11 through different operations in the up and down, left and right (UP and DOWN and RIGHT and LEFT) directions).

[0053] The flexible tube 11c is a tubular member formed to be flexible so as to be passively flexible. In the flexible tube 11c, in addition to the treatment instrument insertion channel (not shown), various electric signal lines 13a extending from the imaging element 13 built into the front end 11a and extending to the inside of the universal cable 17 through the inside of the operation unit 12, and a light guide 15 for guiding light emitted from a light source device 3 (described later) as an external device to an illumination optical system 16 provided on the front end surface of the front end 11a are inserted.

[0054] The operation portion 12 is connected to the base end of the insertion portion 11 and is a structural unit having a plurality of operation members, etc. The operation portion 12 is composed of the anti-bend portion 9, the grip portion 10, a plurality of operation members (12a, 12b, etc.), a treatment instrument insertion portion 12d, a suction valve 12c, etc.

[0055] The anti-bending portion 9 is a protective component that is arranged at the connection portion between the front end portion of the operating portion 12 and the base end portion of the flexible tube portion 8, and is used to prevent the flexible tube portion 8 from being unnecessarily and sharply broken when the endoscope 2 is used by covering the base end portion of the flexible tube portion 8.

[0056] The grip portion 10 is a housing portion that accommodates various components. The grip portion 10 is provided in connection with the anti-bend portion 9. The grip portion 10 is a portion that is held by a user (user) when the endoscope 2 is used.

[0057] The treatment instrument insertion portion 12d is a structural portion having a treatment instrument insertion port (not shown) for inserting various treatment instruments (not shown) and a treatment instrument insertion passage communicating with the treatment instrument insertion passage inside the operation portion 12. The treatment instrument insertion portion 12d is provided with a cover member for opening and closing the treatment instrument insertion port, and the cover member is a clamp 12e configured to be detachably attached to the treatment instrument insertion portion 12d.

[0058] In addition, if Figure 3 As shown, the operation portion 12 is provided with a bending operation lever 12a, various switches 12b, a suction valve 12c, etc. Among them, the bending operation lever 12a is an operation member for performing a bending operation of the bending portion 11b. In addition, as the various switches 12b, there are, for example, operation members for performing air supply and water supply operations, suction operations, and operation members for performing operations corresponding to the camera unit, the lighting unit, etc.

[0059] The suction valve 12c is a connection portion for connecting a suction line to a suction device (not shown).

[0060] The universal cable 17 extends on the side of the base end side of the operation portion 12. The universal cable 17 is a hollow tubular member that is flexible and extends from the operation portion 12. Figure 2 As shown, the universal cable 17 is a composite cable in which the light guide 15 , the electric signal line 13 a extending from the imaging element 13 , and the like are inserted.

[0061] A connector 17b is provided at the extended end of the universal cable 17, which is a connection terminal for connecting to other equipment. The connector 17b is provided with a light source connector 17a which is connected to the front end side in a manner that can be attached and detached to the light source device 3, an air supply and water supply plug 17d which is connected to an air supply and water supply hose (not shown) from an air supply and water supply device (not shown) as an external equipment, and the like (see Figure 1 to Figure 3 ).

[0062] In addition, an electrical connector 17c is provided on the connector 17b (see Figure 2 , Figure 3 ), the electrical connector 17c is used to connect the mirror body cable 18 electrically connected to the electrical signal line 13a (refer to Figure 1 , Figure 2 ;exist Figure 3 (not shown in the figure).

[0063] In addition, a signal connector 18a (see FIG. 1 ) is provided at the extended end of the scope cable 18 so as to be detachably connected to the video processor 4. Figure 2 ).

[0064] Next, the light source device 3 is a light source unit having a function of independently generating excitation light and white light as illumination light to be irradiated to an observation object (subject).

[0065] like Figure 2 As shown, the light source device 3 includes a control unit 21, a front panel 22, a lamp 23 as a light source, a first rotary filter 24, an aperture device 25, a second rotary filter 26, a condenser lens 27, and the like.

[0066] The control unit 21 controls the entire light source device 3 and controls the lamp 23 and the aperture device 25 based on a signal related to brightness from the video processor 4. The control unit 21 is configured to include a central processing unit (CPU), ROM, RAM, etc. The detailed structure of the control unit 21 will be described later.

[0067] The front panel 22 is provided with an observation mode switching switch 22a for switching various observation modes (white light (normal light) observation mode, fluorescence (special light) observation mode, mark confirmation mode, etc.), and other various operation switches (not shown). The operation signal from the front panel 22 is input to the control unit 21.

[0068] The observation mode switching switch 22 a is a switching switch for instructing switching between an illumination mode corresponding to a normal light observation mode and an illumination mode corresponding to a special light observation mode.

[0069] The light source device 3 is configured to generate at least white light for normal light observation and excitation light in a specific wavelength band for special light observation.

[0070] The lamp 23 is a light source for supplying illumination light to the subject, and a xenon lamp, for example, is applied. The lamp 23 is turned on and off by a drive signal from the control unit 21 .

[0071] The first rotating filter 24 is a filter for selectively emitting either the wavelength band light for normal light observation or the wavelength band light for special light observation. The first rotating filter 24 operates as follows: based on a control signal from the control unit 21, the first rotating filter 24 is rotated around its rotation axis, and a filter corresponding to the mode specified by the observation mode switching switch 22a is arranged on the optical path of the emitted light of the lamp 23.

[0072] The first rotating filter 24 is an optical filter that is inserted and removed freely in the optical path of light emitted from the lamp 23 and transmits a portion of the frequency band of light in the normal light observation mode when in the special light observation mode when inserted in the optical path.

[0073] Therefore, in the special light observation mode, the light source is constituted by the lamp 23 and the optical filter of the first rotating filter 24. That is, in the special light observation mode, the light source device 3 inserts the optical filter into the optical path and supplies the light transmitted through the optical filter to the light guide 15 as illumination light.

[0074] The aperture device 25 is a light quantity adjusting device that adjusts the light quantity of the illumination light supplied to the light guide 15. The aperture device 25 drives the aperture in a closing direction or an opening direction based on an aperture driving signal from the control unit 21, thereby adjusting the light quantity of the light emitted from the lamp 23.

[0075] The second rotary filter 26 is configured as a filter unit including, for example, an R (red) filter, a G (green) filter, and a B (blue) filter in order to emit surface sequential light.

[0076] The second rotating filter 26 rotates around its rotation axis at a predetermined rotation speed based on a control signal from the control unit 21 , and three filters of RGB are sequentially and continuously arranged on the optical path of the outgoing light of the lamp 23 .

[0077] The condenser lens 27 is an optical element for condensing the illumination light having passed through the two rotating filters ( 24 , 26 ) onto the proximal end surface of the light guide 15 .

[0078] The control unit 21 of the light source device 3 selects the first rotary filter 24 so that the filter corresponding to the observation mode switching switch 22 a is selected, and controls the aperture device 25 based on the signal related to brightness from the video processor 4 .

[0079] Furthermore, an operation signal from the front panel 22 of the light source device 3 is input to the control unit 31 , and the control unit 31 executes a process according to the function of the switch operated in the front panel 22 .

[0080] Here, use Figure 4 The detailed structure of the control unit 21 of the light source device 3 is described. Figure 4 As shown, the control unit 21 is composed of various circuits mounted on a circuit substrate. The control unit 21 is composed of various chips and circuits mounted on a substrate. The control unit 21 is composed of an FPGA (Field Programmable Gate Array) 41, a lamp driving unit 42, filter driving units 43, 44, an aperture driving unit 45, etc.

[0081] The FPGA 41 includes a CPU 41 a , a storage unit 41 b including a ROM and a RAM, and an aperture control unit 41 c .

[0082] The CPU 41 a is configured to include an illumination mode switching control unit that switches between an illumination mode corresponding to the normal light observation mode and an illumination mode corresponding to the special light observation mode based on a signal from the observation mode switching switch 22 a .

[0083] The aperture control unit 41c is a control unit that outputs an aperture drive control signal corresponding to the brightness target signal from the video processor 4. That is, the aperture control unit 41c causes the aperture device 25 as a light quantity adjustment unit to adjust the emission light quantity of the illumination light based on the brightness target signal which is a light quantity control signal generated based on the brightness of the image obtained by photographing the subject.

[0084] The brightness target signal indicates a target value of brightness, and the aperture control unit 41 c controls the aperture device 25 so that the target value indicated by the brightness target signal (abbreviated as brightness target value) becomes a predetermined reference value.

[0085] Specifically, the aperture control unit 41 c generates an aperture drive control signal for instructing the aperture device 25 to be closed or opened, depending on whether the input brightness target value is larger or smaller than a predetermined reference value, and outputs the signal to the aperture drive unit 45 .

[0086] The lamp driving unit 42 outputs a lamp driving signal for lighting the lamp 23 as a light source based on the lamp driving control signal from the FPGA 41 .

[0087] The filter driving unit 43 outputs a motor driving signal for driving a motor (not shown) for rotating the first rotary filter 24 based on the filter driving control signal for controlling the first rotary filter 24 from the FPGA 41 .

[0088] The filter driving unit 44 outputs a motor driving signal for driving a motor (not shown) for rotating the second rotary filter 26 based on the filter driving control signal for controlling the second rotary filter 26 from the FPGA 41 .

[0089] The aperture drive unit 45 outputs an aperture drive signal for driving the aperture device 25 based on the aperture drive control signal for controlling the aperture device 25 from the FPGA 41. The aperture drive unit 45 receives a current aperture value based on a detection signal from a position detector such as a potentiometer provided in the aperture device 25, and the feedback signal is input to the aperture control unit 41c.

[0090] In this way, the aperture driving unit 45 that drives the aperture device 25 based on the aperture driving control signal input from the aperture control unit 41 c constitutes a light amount adjustment unit together with the aperture device 25 and the aperture control unit 41 c.

[0091] In addition, as described above, the light source device 3 serving as a light source unit in the endoscope system 1 of the present embodiment is constructed such that a xenon lamp or the like that emits white light as normal light is used as a light source for supplying illumination light to the subject, and the white light is made to pass through the first rotating filter 24 to selectively emit band light for normal light observation and band light for special light observation.

[0092] The structure of the light source unit in the endoscope system 1 of the present invention is not limited to the above structure, and other methods are also possible. As other methods of the structure of the light source unit, for example, the following method is considered: this method is configured to prepare a plurality of light emitting diodes (LEDs) that can emit light of a specific wavelength, and appropriately switch the light emission of these plurality of light emitting diodes according to the observation mode.

[0093] Next, the video processor 4 is a processing device for controlling the entire endoscope system 1 which is the heat invasion observation device of this embodiment, and performing various data processing on various information including image data of the subject, which is an observation target object, obtained by the endoscope 2 .

[0094] like Figure 2 As shown, the video processor 4 mainly includes a control unit 31, a light adjustment unit 32, a camera driving unit 33, an image processing unit 34, a storage unit 35, and a notification unit 36.

[0095] The control unit 31 is a processing unit for controlling the entire video processor 4 and is configured to include a CPU (Central Processing Unit) for controlling the dimming unit 32, the camera driving unit 33, the image processing unit 34, etc. according to an observation mode designated by a user.

[0096] The light adjusting unit 32 generates a brightness target signal based on the luminance information (brightness information) of the image signal generated by the image processing unit 34 and displayed on the monitor 5, and supplies it to the control unit 21 of the light source device 3. The brightness target signal is, for example, a signal indicating a value determined by calculation based on the comparison result of the brightness of the image signal displayed on the monitor 5 and the brightness serving as a reference. Thus, in this embodiment, the light adjusting unit 32, together with the imaging element 13, the image processing unit 34, etc., functions as a peripheral light detection unit that detects the light amount around the distal end portion 11a of the insertion portion 11 of the endoscope 2 (around the subject as the observation object).

[0097] The imaging drive unit 33 is a circuit that outputs an imaging drive signal for driving the imaging element 13 based on an imaging drive control signal from the control unit 31 .

[0098] The image processing unit 34 has a function of receiving the image pickup signal from the image pickup element 13 and performing various image signal processing on the image pickup signal under the control of the control unit 31. In addition, the image processing unit 34 has the following functions: generating display image data for displaying an image based on the processed image signal on the monitor 5, and outputting the display image data to the monitor 5.

[0099] Specifically, the image processing unit 34 includes a fluorescence image generating unit 34 a , a white light image generating unit 34 b , an information generating unit 34 c , a display image generating unit 34 d , a thermal invasion depth calculating unit 34 e , and the like.

[0100] The fluorescence image generator 34 a is a circuit unit or program software for generating corresponding fluorescence image data based on an imaging signal obtained by the imaging element 13 of the endoscope 2 capturing fluorescence generated from a heat-affected region of the subject in response to excitation light from the light source device 3 .

[0101] The white light image generating unit 34 b is a circuit unit or program software that receives reflected light from the subject in the white light irradiated from the light source device 3 (light source unit) to the subject and generates white light image data based on an imaging signal acquired by the imaging element 13 of the endoscope 2 .

[0102] The information generating unit 34 c is a circuit unit or program software that calculates fluorescence intensity information of a predetermined region (heat-invaded region) in the fluorescence image represented by the fluorescence image data based on the fluorescence image data generated by the fluorescence image generating unit 34 a .

[0103] The information generating unit 34 c is a circuit unit or program software that further generates a fluorescence intensity information icon based on the fluorescence intensity information calculated based on the fluorescence image data generated by the fluorescence image generating unit 34 a .

[0104] The information generating unit 34 c is a circuit unit or program software that generates thermal invasion depth information based on the fluorescence intensity information calculated from the fluorescence image data generated by the fluorescence image generating unit 34 a and predetermined relationship information (described in detail later) pre-stored in the storage unit 35 described later.

[0105] In addition, the fluorescence intensity information includes the following information: thermal invasion range information indicating a thermal invasion area where the fluorescence intensity in the fluorescence image is greater than a predetermined intensity, thermal invasion degree distribution information indicating the distribution of fluorescence intensity on the surface of the subject within the thermal invasion area, and thermal invasion depth information from the surface of the subject within the thermal invasion area. The fluorescence intensity information is a plurality of information included in the fluorescence image data.

[0106] In addition, the above-mentioned fluorescence intensity information icon is a way of expressing the above-mentioned fluorescence intensity information in a way of symbolizing it through graphics or text, wherein the graphics or text are graphics or text in a way of clearly and easily visually confirming the information by type by visual inspection when the above-mentioned fluorescence intensity information is displayed on the monitor 5.

[0107] The thermal invasion depth information is information indicating the degree of deep thermal invasion in the thermal invasion region. The thermal invasion depth is information calculated based on data of a predetermined region (thermal invasion region) of the fluorescence image data and predetermined relationship information (relationship information indicating the correlation between the fluorescence intensity of the fluorescence image and the thermal invasion depth).

[0108] The display image generating unit 34 d is a circuit unit or program software that generates display image data to be displayed on the monitor 5 (display unit) based on the white-light image data and the fluorescence intensity information.

[0109] The display image generating unit 34 d is a circuit unit or program software that generates display image data for displaying the fluorescence intensity information in a superimposed and emphasized manner on the image represented by the white-light image data.

[0110] The display image generating unit 34 d is a circuit unit or program software that generates display image data in a manner such that a fluorescence intensity information icon prepared in advance is superimposed on an image represented by white-light image data.

[0111] The display image generating unit 34 d is a circuit unit or program software that generates image data for superimposing and displaying the thermal invasion depth information on a display image output to the display unit.

[0112] The heat invasion depth calculation unit 34 e is a circuit unit or program software that calculates the heat invasion depth of a predetermined area (heat invasion area) in the image area represented by the fluorescence image data based on the fluorescence image data and the relationship information stored in the storage unit 35 .

[0113] The storage unit 35 is a data storage device that stores various predetermined information data, software programs, etc. The storage unit 35 stores, for example, information data related to relationship information indicating the correlation between the fluorescence intensity in the fluorescence image and the heat invasion depth in the living tissue that generates the fluorescence intensity.

[0114] The notification unit 36 ​​is a notification information generating unit that generates notification information such as various messages (warnings, notifications, etc.) issued appropriately during the use of the endoscope system 1 , usage guidance information such as processing procedures, and support information.

[0115] The notification information generated by the notification unit 36 ​​is output to a notification device and transmitted to a user (subscriber). In this case, the notification device can be applied to a monitor 5 (display unit) that visually outputs (displays) the notification information, or a sound generating device such as a speaker that outputs the notification information as sound information.

[0116] In addition, in the present embodiment, the notification unit 36 ​​is configured to generate corresponding notification information when the value of the invasion depth of the heat invasion area calculated by the heat invasion depth calculation unit 34e reaches a predetermined depth or above, and output the notification information to the monitor 5 (display unit), thereby displaying the notification information in a predetermined area on the display screen of the monitor 5.

[0117] The notification information is mainly generated by the notification unit 36. As a different form, for example, the information generating unit 34c or the heat invasion depth calculating unit 34e may generate the notification information based on the heat invasion depth calculated by the heat invasion depth calculating unit 34e.

[0118] The monitor 5 is a display unit serving as a display device. In addition to displaying images based on various image data such as fluorescent image data or white light image data and various information associated with the displayed images, it also displays various information related to the observed object (patient medical history information, etc.) in a visually specified manner together with various setting information related to the endoscope system 1.

[0119] like Figure 1 As shown, the cart 6 includes a cart body 50 and an endoscope gantry device 51 provided in parallel with the cart body 50 .

[0120] The cart body 50 has a frame 55 that is substantially in an inverted U shape when viewed from the front. A plurality of shelves 56 are mounted on the frame 55. On one of the plurality of shelves 56, for example, the light source device 3 and the video processor 4 are placed in an overlapping manner. In addition, on each shelf 56, various other devices constituting the endoscope system 1 are placed as needed, but are not shown in the figure.

[0121] Furthermore, casters 57 for enabling the cart 6 to move on the ground are provided on the back side of the shelf 56 located at the bottom.

[0122] Furthermore, a display unit mounting arm 58 is fixedly provided on the top of the frame 55 , and the display unit 5 is mounted on the free end side of the display unit mounting arm 58 .

[0123] The endoscope stand device 51 includes a support column 60, a support column receiving portion 61 for supporting the base end side (lower end side) of the support column 60, and two hooks 62 provided on the front end side (upper end side) of the support column.

[0124] The support column 60 is formed of a rod-shaped member, which is bent in the middle so that a predetermined section on the front end side extends in the horizontal direction. In addition, a hook support portion 60 a is formed in the section of the support column 60 extending in the horizontal direction.

[0125] The support support portion 61 is fixedly provided on one side of the frame 55 (for example, on the right side of the frame 55 in the example shown in the figure). The support support portion 61 is formed in a tubular shape with an open upper end, and is formed in a manner that the base end side of the support 60 can be inserted into the inside. In addition, at the upper end of the support support portion 61, for example, a knurled thread type support fixing portion 61a is provided, and the support fixing portion 61a is used to fix the base end side of the support 60 inserted into the inside of the support support portion 61 at an arbitrary height. In addition, the structure whose description is omitted is substantially the same as the structure of the conventionally generally popular endoscope system.

[0126] The following describes the operation performed using the endoscope system 1 of the present embodiment configured as described above.

[0127] When performing minimally invasive surgery using the endoscope system 1 of the present embodiment, first, marking is performed to identify the position of a lesion to be operated on.

[0128] For example, when performing an endoscopic submucosal dissection (ESD) procedure, the following steps are performed:

[0129] (1: Confirmation) Confirm the lesion (biological tissue) under endoscopic observation.

[0130] (2: Marking) Using an electric scalpel or the like inserted through a treatment instrument insertion channel of an endoscope as an energy device, a treatment instrument is used to apply heat energy to the periphery of the lesion to burn the lesion.

[0131] (3: Local injection) Use other treatment instruments (endoscopic injection needles) to inject physiological saline or the like under the mucosa of the lesion.

[0132] (4: Incision) Use energy equipment such as electric scalpels, high-frequency knives and other treatment instruments again to incise the mucosa around the mark.

[0133] (5: Peeling of the submucosal layer) Use the same treatment instrument to peel off the lesion.

[0134] (6: Resection) Finally, use a snare or other treatment instrument to remove the lesion.

[0135] (7: Hemostasis) A hemostatic treatment is applied to the surface of the cut lesion, and the cut lesion is recovered.

[0136] In addition, the recovered lesions are subjected to microscopic examination of tissues.

[0137] In this case, heat attack by cauterization is applied in the marking step shown in (2) above and the incision step shown in (4) above.

[0138] When amino acids and sugars are heated simultaneously, a glycation reaction (Maillard reaction) occurs, and it is known that the Maillard reaction generates end products called Advanced Glycation End Products (AGEs).

[0139] That is, when a biological tissue is cauterized by an energy device, amino acids and reducing sugars in the biological tissue are heated to cause a Maillard reaction, thereby generating AGEs. In addition, it is known that AGEs contain substances having fluorescent properties as a characteristic of these AGEs.

[0140] In contrast, in the endoscope system of the present embodiment, fluorescence emitted from AGEs in the heat-affected region is observed.

[0141] In addition, as described above, AGEs are generated in a heat-affected area due to heating, but are not limited thereto and are known to exist in the human body, and are linked to aging and diseases.

[0142] For example, AGEs are said to be included in aging substances, cancer tissues, etc. Furthermore, AGEs are said to affect aging of biological tissues, wrinkles, spots, cancer, osteoporosis, Alzheimer's disease, cataracts, arteriosclerosis, diabetes, etc. Therefore, a technique for visually detecting AGEs is useful in the medical field.

[0143] It is also known that substances (AGEs) generated by heat treatment emit stronger fluorescence than autofluorescent substances originally present in biological tissues.

[0144] When the endoscope system 1 of the present embodiment is used, special light observation (fluorescence observation) is performed when the steps (2) and (4) are executed.

[0145] In this case, for example, when at least excitation light of wavelength 300nm to 400nm is irradiated, the heat-affected area can be visualized by observing (shooting) fluorescence of wavelength 400nm to 590nm. Also, when at least excitation light of wavelength 400nm to 480nm is irradiated, the heat-affected area can be visualized by observing (shooting) fluorescence of wavelength 510nm to 600nm.

[0146] Specifically, for example, Fig.10 This is a graph showing the fluorescence intensity on a living tissue when the living tissue is irradiated with excitation light having a wavelength of 340 nm and fluorescence observation is performed at a wavelength of 480 nm.

[0147] in addition, Fig.11This is a graph showing the fluorescence intensity on a living tissue when the living tissue is irradiated with excitation light having a wavelength of 380 nm and fluorescence observation is performed at a wavelength of 530 nm.

[0148] and, Fig.12 This is a graph showing the fluorescence intensity on a living tissue when the living tissue is irradiated with excitation light having a wavelength of 440 nm and fluorescence observation is performed at a wavelength of 550 nm.

[0149] exist Figure 10 to Figure 12 In each of the examples shown, the case where excitation light (300 to 400 nm) and fluorescence (400 to 590 nm) with wavelengths suitable for visualizing the heat-affected area are selected. Figure 10 to Figure 12 In the example shown in , the difference in fluorescence intensity becomes large, so it can be clearly displayed as an image.

[0150] on the other hand, Fig.13 This is a graph obtained by forming a graph of the fluorescence intensity on the biological tissue when irradiating with excitation light of a wavelength of 490nm and performing fluorescence observation at a wavelength of 650nm. Fig.14 This is a graph showing the fluorescence intensity on a living tissue when the living tissue is irradiated with excitation light having a wavelength of 410 nm and fluorescence observation is performed at a wavelength of 430 nm.

[0151] exist Fig.13 , Fig.14 In the example shown, the case where excitation light (490 nm, 410 nm) and fluorescence (650 nm, 430 nm) with wavelengths that are not suitable for visualizing the heat-affected area are selected. Fig.13 , Fig.14 In the examples shown in , the difference in fluorescence intensity is small, so it is difficult to display it clearly as an image.

[0152] Here, when fluorescence observation is performed on a subject including a region subjected to thermal attack, the region subjected to thermal attack generates fluorescence due to the excitation light from the light source device 3. When the fluorescence is captured by the imaging element 13 of the endoscope 2, the imaging signal acquired by the imaging element 13 is subjected to predetermined image processing by the fluorescence image generating unit 34a of the image processing unit 34, thereby generating fluorescence image data.

[0153] The fluorescence image data thus generated is subjected to predetermined data processing in the image processing unit 34, converted into image data in a display format, and then output to the monitor 5. Then, the monitor 5 displays a fluorescence image corresponding to the fluorescence image data and various information related thereto.

[0154] At this time, the fluorescent image displayed on the monitor 5 is a state in which the region (marked region) subjected to thermal invasion is clearly visualized relative to the surrounding region. The display at this time mainly utilizes the thermal invasion range information in the fluorescence intensity information included in the fluorescent image data.

[0155] Furthermore, for example, when performing a surgery based on laparoscopic endoscopic combined gastrectomy (LECS), first, steps (1) to (4) are performed in the same manner as in the above-mentioned ESD surgery.

[0156] In the past LECS surgery, the following steps were performed here:

[0157] (5: Perforation) After incising the lesion, perforation is performed using a needle-shaped scalpel under endoscopy.

[0158] (6: Full-thickness excision) The energy device is inserted through the perforation under laparoscopy, and full-thickness excision is performed along the peripheral incision line of ESD. At this time, it is difficult to confirm whether the energy device is on the peripheral incision line of ESD from the outside (serosa side), so it is confirmed under endoscopy.

[0159] (7: Suturing) Use an automatic suturing device under endoscopy to close the defect in the gastric wall.

[0160] However, in the endoscope system 1 of the present embodiment, the marked area marked by heat invasion to the inside (mucosal side) in the marking step (2) can also be confirmed from the outside by laparoscopic fluorescence observation.

[0161] Therefore, in the full-thickness excision step (6) above, by performing laparoscopic fluorescence observation, even without an endoscope, it is possible to confirm from the outside (serosa side) whether the energy device is on the peripheral incision line of the ESD. That is, in the full-thickness excision step (6) above, the operation can be performed only by laparoscope. Therefore, it is not necessary to perform endoscopic confirmation.

[0162] Furthermore, for example, when performing a non-exposed endoscopic wall-inversion surgery (NEWS: Non-exposed Endoscopic Wall-inversion Surgery), first, steps (1) and (2) are performed in the same manner as in the above-mentioned ESD surgery.

[0163] In previous NEWS surgeries, the following steps were performed:

[0164] (3: Second marking) Marking is performed from the outside (serosa side) under laparoscopy.

[0165] (4: Lesion resection) Local injection into the submucosal layer, and the serosal fascia layer is removed under laparoscopy.

[0166] (5: Suturing) Under laparoscopy, the lesion is pushed from the outside to the lumen side (inside) for suturing.

[0167] (6: Lesion resection) The entire layer of the lesion is resected from the inside under endoscopy.

[0168] However, in the endoscope system 1 of the present embodiment, the marked area marked by heat invasion to the inside (mucosal side) in the marking step (2) can also be confirmed from the outside by laparoscopic fluorescence observation.

[0169] Therefore, the second marking step (3) mentioned above can be omitted.

[0170] Thus, according to the endoscope system 1 of this embodiment, by performing fluorescence observation on the marked area based on thermal invasion, it is possible to clearly and easily confirm it from the outside of the object (biological tissue). Therefore, part of the internal and external coordination work and special marking methods performed in previous surgeries can be omitted, which can help simplify the surgery.

[0171] In the description of the above embodiment, an example is shown in which a fluorescent image based on fluorescent image data obtained by fluorescence observation is directly displayed on the monitor 5, thereby making it easy to visually confirm the marked area due to thermal invasion. In contrast, in the first modified example described below, by performing a predetermined image processing based on the fluorescent image data, the marked area due to thermal invasion can be more clearly confirmed.

[0172] Figure 5 It is a diagram showing a first modification example of displaying a marking area based on thermal invasion in the endoscope system according to the embodiment of the present invention.

[0173] exist Figure 5 In the figure, the frames indicated by reference numerals 5A, 5B, and 5C are display frames of the monitor 5. The display frames 5A, 5B, and 5C each show a state where a lesion 100 to be observed and a marked area (heat-affected area) 101 marked around the lesion 100 are displayed.

[0174] Here, the display frame 5A conceptually shows the display state of the target lesion 100 and its surrounding marked area (heat invasion area) 101 when normal white light observation (WLI) is performed. The setting at this time is called white light observation mode (or normal light observation mode).

[0175] In this white light observation mode ( Figure 5In the display frame 5A), the following situation is shown: the lesion 100, the surrounding marked area 101, and the surrounding normal tissue are not clearly displayed, so it is easy to miss the lesion 100 or the marked area 101.

[0176] On the other hand, the display frame 5B conceptually shows the display state of the target lesion 100 and its surrounding marked area (heat invasion area) 101 when the fluorescence observation is performed. The setting at this time is called the fluorescence observation mode.

[0177] In this fluorescence observation mode ( Figure 5 In the display frame 5B), the following situation is shown: the lesion 100 and the marked area 101 around it are clearly displayed relative to the normal tissue around them, and the lesion 100 and the marked area 101 are easy to identify.

[0178] On the other hand, this modification example has a mark confirmation mode in which a mark area 101 around the lesion 100 is displayed in a more recognizable manner so that the lesion 100 can be easily confirmed. Figure 5 The display frame 5C shows an example of the display at this time.

[0179] Here, in the marking confirmation mode, display image data to be displayed on the monitor 5 (display unit) is generated based on white light image data and fluorescence image data obtained by simultaneously performing white light observation (WLI) and fluorescence observation.

[0180] Specifically, only the image data of the region corresponding to the marked region (heat invasion region) 101 around the target lesion 100 is extracted from the fluorescence image data, and the extracted and emphasized data is generated by performing a predetermined emphasis process (e.g., contour emphasis, coloring process in the corresponding region, etc.) on the extracted data. Then, the extracted and emphasized data is overlapped and displayed on the corresponding region in the white light image data. The display image data obtained in this way is output to the monitor 5, and the displayed image is as shown in FIG. Figure 5 As shown in display frame 5C.

[0181] That is, the display frame 5C conceptually shows the display state of the target lesion 100 and the marked area (thermal invasion area) 101 around it when the mark confirmation mode is set and the area including the target lesion 100 is observed.

[0182] In this tag confirmation mode ( Figure 5 In the display frame 5C), the following situation is shown: the marked area 101 around the lesion 100 is displayed more clearly than the lesion 100 and the surrounding normal tissue, and the marked area 101 is easier to identify.

[0183] In this way, by providing a marker confirmation mode in which image processing is performed to further emphasize and display the marker region 101, the position of the lesion 100 surrounded by the marker region 101 can be reliably grasped, and omission of the lesion 100 can be suppressed.

[0184] Furthermore, if the mark confirmation mode is set, the trouble of switching to other observation modes can be eliminated, and the heat attack area can be clearly displayed while always performing observation, treatment, etc. under normal white light.

[0185] The white light observation mode, the fluorescence observation mode, and the marker confirmation mode are configured to be switchable as desired by the user by appropriately operating the observation mode switching switch 22 a of the front panel 22 as desired.

[0186] In addition, in the present embodiment, an example in which the observation mode switching switch 22 a is provided on the front panel 22 of the light source device 3 is shown, but the arrangement of the observation mode switching switch 22 a is not limited to this.

[0187] For example, the observation mode switching switch 22a may be provided on the surface of the operation unit 12 of the endoscope 2. With such a configuration, the user can appropriately switch the observation mode at a desired timing while operating the endoscope 2, which is very convenient.

[0188] In addition, the observation mode switching switch 22 a may be configured to be provided on the front panel 22 of the light source device 3 and the operation unit 12 , respectively.

[0189] In addition, in the display example of the marking mode of this modification example ( Figure 5 In the display frame 5C), the following example is shown: the extracted emphasis data generated by extracting the image data of the area corresponding to the marked area (heat invasion area) 101 is overlapped and displayed on the corresponding area of ​​the white light image data, but a different display method can also be used as described below.

[0190] For example, a fluorescence intensity information icon is generated by iconizing the generated extracted emphasis data, and the fluorescence intensity information icon is displayed overlappingly on the corresponding area of ​​the white light image data. In this case, data can be reduced by icon processing. Therefore, it is helpful to reduce the capacity of the display image data and realize a high-speed display.

[0191] In the above description, a configuration example has been shown that focuses on display of a marking area based on thermal invasion. The information used in this case mainly uses thermal invasion range information among the fluorescence intensity information included in the fluorescence image data.

[0192] The fluorescence image data acquired by the endoscope system 1 as the thermal invasion observation device of this embodiment includes more information. In each modification described below, a display example is shown in which other information such as thermal invasion degree distribution information and thermal invasion depth information is used in the fluorescence intensity information included in the fluorescence image data.

[0193] Figure 6 A second modification example of a display example is shown when a subject is cauterized by thermal invasion using the endoscope system 1 of the present embodiment and the subject including the cauterized area is observed in the fluorescence observation mode. Figure 7 This is an example of a display showing the depth of thermal attack. The depth of thermal attack is determined by using Figure 6 The estimation is performed based on the result calculated from the thermal invasion depth information contained in the fluorescence intensity information of the fluorescence image data.

[0194] As described above, the fluorescence image data obtained by fluorescence observation of the cauterization region subjected to cauterization based on thermal invasion using the endoscope system 1 of the present embodiment includes the thermal invasion degree distribution information and the thermal invasion depth information.

[0195] In contrast, in the display example of the second modified example, a display method is realized in which the distribution of the fluorescence intensity within the range of the thermal invasion region is displayed using the thermal invasion degree distribution information (see Figure 6 display frame 5D).

[0196] Figure 6 The display example shown in the figure classifies the distribution of fluorescence intensity into a plurality of regions ( Figure 6 The fluorescence intensity distribution on the surface of the object within the heat-affected region can be displayed in a visually visible manner.

[0197] Furthermore, the fluorescence intensity and the thermal invasion depth are considered to be positively correlated, and in the endoscope system 1 of the present embodiment, relationship information indicating the correlation between the fluorescence intensity and the thermal invasion depth is stored in the storage unit 35 .

[0198] For example, Fig.15 is a graph showing the correlation between fluorescence intensity and thermal invasion depth. Fig.15 In the figure, the fluorescence intensity is taken on the vertical axis. Here, the fluorescence intensity represents the brightness value (0 to 255) of the pixel of the obtained fluorescence image (no unit). By irradiating the excitation light with a wavelength of 390nm to 470nm and capturing the fluorescence with a wavelength of 500nm to 640nm, it is observed that the heat invasion depth and the fluorescence intensity when the heat invasion area is observed by fluorescence. Fig.15 The positive correlation shown.

[0199] In contrast, in the endoscope system 1 of the present embodiment, the thermal invasion depth calculation unit 34e calculates the thermal invasion depth based on the relationship information in the storage unit 35 and the thermal invasion depth information of the thermal invasion area included in the fluorescence image data obtained by fluorescence observation. Figure 7 The display mode shown is a display of the estimated depth corresponding to the distribution (110A, 110B, 110C) of the fluorescence intensity of the burn region (heat-affected region) 110 caused by the heat attack (see FIG. Figure 7 Display frame 5E).

[0200] Figure 7 The display example shown shows the invasion depth according to Figure 6 Here, reference numerals 110A, 110B, and 110C correspond to Figure 6 Reference numerals 110A, 110B, and 110C are shown to indicate distribution areas.

[0201] in addition, Figure 8 , Fig. 9 A third variation example of a display example is shown, in which a subject is cauterized by thermal invasion using the endoscope system 1 of the present embodiment and the subject including the cauterized area is observed in the fluorescence observation mode. Figure 8 , Fig. 9 The display example shown is a display example that displays the depth of thermal invasion estimated from the result of calculation using the thermal invasion degree distribution information and the thermal invasion depth information in the fluorescence intensity information included in the fluorescence image data.

[0202] exist Figure 8 In the example shown, a burn region formed on the surface of the subject in a substantially elongated shape due to thermal invasion is used as the target region. Figure 8 The reference numerals 110D and 110E represent the distribution of thermal invasiveness. Figure 8 In FIG. 5 , the numbers shown near the burn region (heat invasion region) 110 in the display frame 5F of the monitor 5 are displays of specific information on the depth of the heat invasion calculated based on the distribution information.

[0203] In addition, a standard graph 111 showing density information indicating the distribution of fluorescence intensity is configured to correspond to a predetermined area (in the display area of ​​the display frame 5F) of the display frame 5F. Figure 8 In the example shown, an area facing the display frame 5F and close to the lower edge on the right side is displayed accordingly.

[0204] Likewise, in Fig. 9 In the example shown, a burn region 110 formed in a substantially circular shape on the surface of the subject due to thermal invasion is used as the target region. Fig. 9 The reference numerals 110F, 110G, and 110H represent the distribution of thermal invasiveness. Fig. 9 In the embodiment, the specific information of the depth of the heat invasion calculated based on the distribution information is displayed in digital form near the burn area (heat invasion area) 110 in the display frame 5G of the monitor 5, which is similar to Figure 8 In addition, the graph 111 is also the same as Figure 8 The same is true for the diagram 111.

[0205] In this way, by Figure 6 to Figure 9 The display method shown shows the burn area based on the thermal invasion, and can clearly show the burn range (distribution) and the invasion range (invasion depth).

[0206] Therefore, for example, when a user (client) performs a cauterization operation using thermal invasion under an endoscope, the cauterization is performed on a region to be cauterized (a region including a target lesion, etc.) while observing an endoscopic image displayed on the monitor 5 .

[0207] At this time, in the endoscope system 1 of the present embodiment, white light observation and fluorescence observation are performed simultaneously, white light image data and fluorescence image data are obtained simultaneously, and the fluorescence intensity information (especially thermal invasion degree distribution information and thermal invasion depth information) contained in the fluorescence image data is used to implement the prescribed image signal processing, thereby making it possible to observe in real time a display image in which the burning range (distribution) and the invasion range (invasion depth) are clearly indicated.

[0208] Therefore, doctors and other operators (users) can perform surgery while always confirming the degree of invasion of the target area. At the same time, for example, during the process of performing surgery using an energy device in the body cavity of the subject, accidents such as unintentional thermal invasion of the energy device to normal areas other than the target area can be suppressed.

[0209] Furthermore, even if an unintended thermal invasion is caused to a normal area by an energy device, the extent of the thermal invasion to the unintended area can be confirmed in real time, so that repair measures can be promptly and rapidly implemented as needed. Therefore, the occurrence of postoperative complications, which were previously feared, can be prevented before they occur.

[0210] Furthermore, in the endoscope system 1 of the present embodiment, when a surgery involving cauterization by thermal invasion is performed, the thermal invasion depth calculation unit 34 e calculates the thermal invasion depth as described above.

[0211] For this purpose, the notification unit 36 ​​is provided. For example, when the thermal invasion depth calculated by the thermal invasion depth calculation unit 34e reaches a predetermined depth or above, or reaches a depth close to the predetermined depth, the notification unit 36 ​​notifies information to that effect.

[0212] In the endoscope system 1 of the present embodiment, as described above, the notification unit 36 ​​outputs the generated notification information to the monitor 5, and displays it on the display screen of the monitor 5 (display unit) as visual notification information. Figure 8 The indicator 112 is shown as such and the Figure 8 In addition to the warning display in the form shown by the label 113 (display of text information, emoticons, etc.), a warning icon or the like prepared in advance and stored in the storage unit 35 or the like may be appropriately read out and displayed.

[0213] In addition, for Figure 8 The warning display in the example shown may be developed in such a way that the operator's attention can be more easily drawn by coloring the text in red or by flashing the text.

[0214] Although illustration of a method different from this method is omitted as the notification unit 36 ​​, a sound generating device such as a speaker that outputs notification information as sound information may be applied.

[0215] However, when observing a desired region of a subject in fluorescence observation mode using the endoscope system 1 of this embodiment, autofluorescence may be emitted in a region not subjected to thermal invasion. In consideration of this, the endoscope system 1 of this embodiment can also perform the following display.

[0216] As described above, in the endoscope system 1 of the present embodiment, for example, white light observation and fluorescence observation can be performed simultaneously, and white light image data and fluorescence image data can be acquired simultaneously.

[0217] Therefore, when the endoscope system 1 is used to cauterize a desired region by thermal invasion while observing a target region of a subject, fluorescence image data before treatment by an energy device, that is, before thermal invasion is applied to a predetermined region, and fluorescence image data after the treatment are acquired.

[0218] By performing predetermined image processing based on the fluorescence image data before and after the treatment, differential data is obtained. The differential data accurately represents the difference in intensity of autofluorescence before and after the thermal attack treatment by the energy device in a noise-free manner.

[0219] In addition, as a different means, for example, the following means is also considered: when a desired area in the target organ is cauterized based on thermal invasion, differential data of the fluorescence image data of the "burned area" and the fluorescence image data of the "area adjacent to the "burned area", that is, the area that has not been burned (not burned)" are obtained.

[0220] According to this means, instead of the above-mentioned means, that is, image difference data of different time series before and after treatment is obtained, the difference of image data of the same time series on the same organ is obtained.

[0221] Generally, autofluorescence has different characteristics for each organ, so if the "burned part" and the "unburned part adjacent to the 'burned part'" are the same organ, differential data obtained from their image data can more accurately represent a clear image.

[0222] Therefore, if display image data is generated based on these difference data and the display image data is output to the monitor 5 , only the area of ​​autofluorescence generated by thermal invasion can be clearly and accurately displayed on the monitor 5 .

[0223] As described above, according to the endoscope system 1 as the heat invasion observation device of the present embodiment, the range (distribution and depth) of the burn region formed by heat invasion of the living tissue using an energy device can be easily visualized by detecting autofluorescence of the living tissue.

[0224] In addition, various image signal processing is performed with a view to recognizing the correlation between the thermal invasion depth and the fluorescence intensity, so that the surgeon (user, user) such as a doctor can confirm the range of the burn area based on the thermal invasion in real time. Therefore, by using the endoscope system 1 of this embodiment, it is possible to always reliably and easily perform a high-precision low-invasive surgery. In addition, in this case, the mark based on the thermal invasion and the confirmation of the range and degree of the burn area during the operation can be confirmed not only within the range on the surface of the biological tissue of the subject (surface distribution), but also within the range in the depth direction (depth distribution).

[0225] The present invention is not limited to the above-mentioned embodiments, and various modifications and applications can be implemented within the scope of the main purpose of the invention. In addition, in the above-mentioned embodiments, inventions of various stages are included, and various inventions can be extracted by appropriate combinations of the disclosed multiple structural elements. For example, even if several structural elements are deleted from all the structural elements shown in the above-mentioned embodiment, the problem to be solved by the invention can be solved and the effect of the invention can be obtained, and the structure in which the structural elements are deleted can also be extracted as an invention. In addition, the structural elements in different embodiments can also be appropriately combined. The present invention is not restricted by these specific embodiments except that it is limited by the attached claims.

[0226] This application is filed based on the international patent application No. PCT / JP2018 / 033457 filed in Japan on September 10, 2018 as a priority claim.

[0227] The contents disclosed in the above-mentioned basic application are cited in the specification, claims and drawings of the present application.

Claims

1. An endoscope system, characterized in that: It has: a light source device that emits narrow-band light having a peak wavelength in a first wavelength band; an imaging element that generates an imaging signal obtained by imaging light in a second wavelength band different from the first wavelength band; and A video processor configured to perform the following processing: generating fluorescence image data according to the imaging signal; Calculating the fluorescence intensity in each pixel of the fluorescence image data; obtaining a first index for identifying pixels in the fluorescence image data having a fluorescence intensity exceeding a predetermined value; determining a first region based on the fluorescence intensity of each pixel in the fluorescence image data and the first index; and Display image data in which the first region is identifiably emphasized is generated.

2. The endoscope system according to claim 1, characterized in that: The video processor acquiring a second index for identifying pixels in the fluorescence image data having a fluorescence intensity exceeding a predetermined value; determining a second region based on the fluorescence intensity of each pixel in the fluorescence image data and the second index; and generating the display image data in which the first area and the second area are identifiably emphasized, in, The second index is an index for specifying pixels having a fluorescence intensity greater than that of the first index.

3. The endoscope system according to claim 2, characterized in that: The video processor acquiring a third index for identifying pixels in the fluorescence image data having a fluorescence intensity exceeding a predetermined value; determining a third region based on the fluorescence intensity of each pixel in the fluorescence image data and the third index; and generating the display image data in which the first area, the second area, and the third area are identifiably emphasized, in, The third index is an index for specifying pixels having a fluorescence intensity greater than that of the second index.

4. The endoscope system according to claim 1, characterized in that: The video processor generating first fluorescent image data generated based on an imaging signal at a first timing and second fluorescent image data generated based on an imaging signal at a second timing respectively; extracting difference information of the fluorescence intensity that changes at the first timing and the second timing based on the first fluorescence image data and the second fluorescence image data, Determining a first region according to the difference information and the first indicator; and The display image data in which the first area is identifiably emphasized is determined.

5. The endoscope system according to claim 1, characterized in that: The fluorescence image data is obtained by capturing fluorescence generated from a heat-invaded region in a living body tissue.

6. The endoscope system according to claim 5, characterized in that: The endoscope system further includes a storage unit storing in advance relationship information indicating a correlation between the fluorescence intensity calculated based on the fluorescence image data and a thermal invasion depth in a living tissue where the fluorescence intensity is generated.

7. The endoscope system according to claim 6, characterized in that: The first wavelength band includes wavelength components from 390 nm to 500 nm.

8. The endoscope system according to claim 6, characterized in that: The second wavelength band includes wavelength components from 500 nm to 640 nm.

9. The endoscope system according to claim 6, characterized in that: The first region is heat invasion range information indicating the range of a region where heat invasion has occurred.

10. The endoscope system according to claim 9, characterized in that: The light source device emits white light, The video processor acquiring an imaging signal generated by capturing return light from a living tissue irradiated with white light, and generating white light image data based on the acquired imaging signal; as well as Display image data is generated based on the white light image data and the heat invasion range information.

11. The endoscope system according to claim 5, characterized in that: The thermally invaded region is a region that is thermally invaded and marked by cauterizing the living body tissue using an energy device.

12. The endoscope system according to claim 5, characterized in that: The video processor generating thermal invasion range information and thermal invasion degree distribution information as information related to the thermal invasion area generated based on the fluorescence intensity information calculated from the fluorescence image data; acquiring an imaging signal generated by capturing return light from a living tissue irradiated with white light, and generating white light image data based on the acquired imaging signal; as well as generating display image data based on the white light image data, the thermal invasion range information, the thermal invasion degree distribution information, and the thermal invasion depth information, in, The thermal attack range information indicates the area where the thermal attack occurs. The thermal invasion degree distribution information indicates the distribution of fluorescence intensity emitted from each site in the thermal invasion area.

13. The endoscope system according to claim 4, characterized in that: The first fluorescence image data is pre-treatment fluorescence image data before the biological tissue is treated by the energy device. The second fluorescence image data is post-treatment fluorescence image data after the living tissue is treated by the energy device.

14. A method for controlling an endoscope system, characterized in that: The light source device emits narrowband light having a peak wavelength in the first wavelength band, The imaging element generates an imaging signal obtained by imaging light in a second wavelength band different from the first wavelength band. Video Processor generating fluorescence image data according to the imaging signal; Calculating the fluorescence intensity in each pixel of the fluorescence image data; obtaining a first index for identifying pixels in the fluorescence image data having a fluorescence intensity exceeding a predetermined value; determining a first region based on the fluorescence intensity of each pixel in the fluorescence image data and the first index; and Display image data in which the first region is identifiably emphasized is generated.

15. A video processor, characterized in that: The video processor generating fluorescence image data according to the imaging signal; Calculating the fluorescence intensity in each pixel of the fluorescence image data; obtaining a first index for identifying pixels in the fluorescence image data having a fluorescence intensity exceeding a predetermined value; determining a first region based on the fluorescence intensity of each pixel in the fluorescence image data and the first index; and Display image data in which the first region is identifiably emphasized is generated.

Images