Medical device, medical system, method for operating medical device, and program

Abstract

Provided are a medical device, a medical system, a method for operating the medical device, and a program with which it is possible to grasp the state of a resection sheet in a perfusate supplied into an organ. A medical device is provided with a processor that: acquires a first fluorescence image in which a target region has been captured, and a second fluorescence image in which the target region has been captured after the time at which the first fluorescence image has been captured; a drive signal generation unit that generates a drive signal for a predetermined operation with respect to the target region on the basis of first information included in the first fluorescent image and second information included in the second fluorescent image; and outputting the driving signal.

Description

Technical Field

[0001] The present disclosure relates to a medical device, a medical system, an operating method of the medical device, and a program. Background Art

[0002] Conventionally, a technique for visualizing the state of cauterization of a subject, such as biological tissue, using an energy device or the like is known in the medical field (see, for example, Patent Document 1). This technique irradiates the subject with excitation light and displays an image and information containing fluorescence image data generated based on an imaging signal acquired by capturing fluorescence generated from a heat-affected region of the subject in response to the excitation light, thereby visualizing the state of cauterization for a user, such as a surgeon.

[0003] Prior art literature

[0004] Patent Literature

[0005] Patent Document 1: International Publication No. 2020 / 054723 Summary of the Invention

[0006] Problems to be solved by the invention

[0007] In transurethral resection of bladder tumors (TUR-Bt), a surgical endoscope (resectoscope) is inserted through the patient's urethra. While observing the lesion through the endoscope's eyepiece, the surgeon uses a resection instrument, such as an energy device, to remove a specific area containing the lesion or a specific organ. Furthermore, in TUR-Bt, after resection, the resected fragments are simultaneously expelled from the bladder by draining the perfusate into the body.

[0008] However, Patent Document 1 mentioned above does not consider a method for identifying small, invisible fragments of the excised fragment within an organ such as the bladder during resection performed with a resection instrument. Consequently, the surgeon supplies perfusate to the organ for a certain period of time, thereby deeming that small, invisible fragments of the excised fragment have been expelled from the organ. Therefore, a technique is desired that allows the surgeon to identify small, invisible fragments of the excised fragment within the perfusate supplied to the organ.

[0009] The present disclosure has been made in view of the above circumstances, and an object of the present disclosure is to provide a medical device, a medical system, an operating method of the medical device, and a program that can grasp the condition of a resected fragment in a perfusate supplied into an organ.

[0010] Solutions for solving problems

[0011] In order to solve the above-mentioned problems and achieve the purpose, the medical device involved in the present disclosure includes a processor, which is driven according to the cleaning status of the object area, wherein the processor performs the following processing: obtaining a first fluorescent image of the object area and a second fluorescent image of the object area taken after the moment of taking the first fluorescent image; generating a driving signal for a prescribed action on the object area based on first information contained in the first fluorescent image and second information contained in the second fluorescent image; and outputting the driving signal.

[0012] In the medical device according to the present disclosure, in the above disclosure, the drive signal is a signal for causing the display device to display discharge information indicating a discharge status of the resected fragment removed by the resection treatment instrument within the target area.

[0013] In the medical device according to the present disclosure described above, the drive signal is a signal for controlling a perfusion device that supplies perfusion fluid to the target area.

[0014] Furthermore, in the medical device according to the present disclosure, in the above-mentioned disclosure, the first information and the second information are respectively fluorescence amounts, and the processor performs the following processing: calculating a difference between the fluorescence amount contained in the first fluorescence image and the fluorescence amount contained in the second fluorescence image; determining whether the difference is less than a prescribed value; and, if it is determined that the difference is less than the prescribed value, outputting the drive signal for causing the display device to display information indicating that discharge of the resected fragment has been completed as the discharge information.

[0015] In the medical device according to the present disclosure, in the above disclosure, the processor performs the following processing: when it is determined that the value is not less than the predetermined value, the processor outputs the drive signal for causing the display device to display information indicating that the resected fragment is being discharged as the discharge information.

[0016] Furthermore, in the medical device according to the present disclosure, in the above-mentioned disclosure, the first information and the second information are each fluorescence amounts, and the processor performs the following processing: calculating a difference between the fluorescence amounts included in the first fluorescence image and the fluorescence amounts included in the second fluorescence image; determining whether the difference is less than a predetermined value; and, if determined to be less than the predetermined value, outputting, as the signal, the drive signal for causing the perfusion device to stop supplying the perfusion fluid.

[0017] Furthermore, the medical device according to the present disclosure in the above disclosure outputs the drive signal for causing the perfusion device to supply the perfusion fluid as the signal when it is determined that the difference is not less than the predetermined value.

[0018] Furthermore, the medical system according to the present disclosure includes a light source device, an imaging device, and a medical device, wherein the light source device includes a light source that emits excitation light, the excitation light being light that excites advanced glycation end products produced by heat treatment of a target region of biological tissue; the imaging device includes an imaging element that generates a first fluorescence image and a second fluorescence image by capturing fluorescence emitted by the excitation light, the first fluorescence image being an image of the target region, and the second fluorescence image being an image of the target region captured after the first fluorescence image was captured; and the medical device includes a processor that performs the following processing: acquiring the first and second fluorescence images; generating a drive signal for a predetermined action on the target region based on first information included in the first fluorescence image and second information included in the second fluorescence image; and outputting the drive signal.

[0019] Furthermore, the medical system according to the present disclosure further includes a display device in the above disclosure, wherein the drive signal is a signal for causing the display device to display discharge information indicating a discharge status of the resected fragment removed by the resection treatment instrument within the target area.

[0020] In addition, the medical system according to the present disclosure further includes a perfusion device for supplying perfusion fluid toward the target area, and the driving signal is a signal for controlling the perfusion device.

[0021] In addition, the operating method of the medical device involved in the present disclosure is an operating method of the medical device that is equipped with a processor and is driven according to the cleaning status of the target area, wherein the processor performs the following processing: obtaining a first fluorescent image of the target area and a second fluorescent image of the target area taken after the time of taking the first fluorescent image; generating a driving signal for a prescribed action on the target area based on first information contained in the first fluorescent image and second information contained in the second fluorescent image; and outputting the driving signal.

[0022] In addition, the program involved in the present disclosure is a program executed by a medical device that has a processor and is driven according to the cleaning state of an object area, wherein the program causes the processor to perform the following processing: acquiring a first fluorescent image of the object area and a second fluorescent image of the object area that was captured after the time when the first fluorescent image was captured; generating a drive signal for a prescribed action on the object area based on first information included in the first fluorescent image and second information included in the second fluorescent image; and outputting the drive signal.

[0023] Effects of the Invention

[0024] According to the present disclosure, it is possible to understand the condition of the resected fragment in the perfusion fluid. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] Figure 1 This is a diagram showing a schematic configuration of an endoscope system according to the first embodiment.

[0026] Figure 2 This is a block diagram showing the functional configuration of the main parts of the endoscope system according to the first embodiment.

[0027] Figure 3 This is a diagram schematically showing the wavelength characteristics of the excitation light emitted by the light source unit according to the second embodiment of the first embodiment.

[0028] Figure 4 This is a diagram schematically showing the structure of a pixel portion according to Embodiment 1.

[0029] Figure 5 This is a diagram schematically showing the structure of the color filter according to Embodiment 1.

[0030] Figure 6 This is a diagram schematically showing the sensitivity and wavelength range of each filter according to the first embodiment.

[0031] Figure 7A Schematically shows the signal value of the R pixel of the image sensor according to the first embodiment.

[0032] Figure 7B Schematically showing the signal values ​​of the G pixels of the image sensor according to the first embodiment.

[0033] Figure 7C This is a diagram schematically showing the signal value of the B pixel of the image sensor according to the first embodiment.

[0034] Figure 8 This is a diagram schematically showing the structure of the cut filter according to the first embodiment.

[0035] Figure 9 This is a diagram schematically showing the transmission characteristics of the cut filter according to the first embodiment.

[0036] Figure 10 This is a flowchart showing an overview of processing executed by the control device according to the first embodiment.

[0037] Figure 11 This is a flowchart showing an overview of processing executed by the control device according to the second embodiment.

[0038] Figure 12 This is a diagram showing a schematic configuration of an endoscope system according to a third embodiment.

[0039] Figure 13 This is a block diagram showing the functional configuration of a medical device according to the third embodiment. DETAILED DESCRIPTION

[0040] The following is a method for implementing the present disclosure and the attached Figure 1 Detailed description will be given below. In addition, the present disclosure is not limited to the following embodiments. In addition, the figures referred to in the following description are merely schematic illustrations of shapes, sizes and positional relationships to the extent that the contents of the present disclosure can be understood. That is, the present disclosure is not limited to the shapes, sizes and positional relationships illustrated in the figures. Moreover, in the description of the drawings, the same parts are marked with the same figure numbers for description. In addition, as an example of the endoscope system involved in the present disclosure, an endoscope system including a rigid endoscope and a medical imaging device is described.

[0041] (Implementation Method 1)

[0042] [Structure of the endoscope system]

[0043] Figure 1 This is a diagram showing a schematic configuration of an endoscope system according to the first embodiment. Figure 1 The endoscope system 1 shown is a system used in the medical field to observe and treat biological tissues in a subject such as a living body. Figure 1 The rigid endoscope system shown in FIG. 1 is a rigid endoscope system having a rigid endoscope (insertion portion 2), but the present invention is not limited thereto and may also be an endoscope system having a flexible endoscope. Furthermore, the endoscope system 1 may also be applied to a medical microscope or medical surgical robot system that includes a medical imaging device for imaging a subject and performs surgery or treatment while displaying an observation image based on an imaging signal (image data) captured by the medical imaging device on a display device.

[0044] Furthermore, in recent years, minimally invasive treatments using endoscopes and laparoscopy have become increasingly common in the medical field. For example, widely performed minimally invasive treatments using endoscopes and laparoscopy include endoscopic submucosal dissection (ESD), laparoscopic endoscopic cooperative surgery (LECS), non-exposed endoscopic wall-inversion surgery (NEWS), and transurethral resection of the bladder tumor (TUR-bt). In these minimally invasive treatments, when performing treatments on living tissue, for example, doctors or other operators use treatment instruments such as energy devices that emit high-frequency waves, ultrasound waves, microwaves, etc. to excise the area of ​​interest (pathogenic area) containing the lesion by cauterization, or to mark the area of ​​interest (pathogenic area) containing the lesion by thermal treatment, thereby marking the surgical target area as a preliminary treatment. Furthermore, during the actual treatment, the operator also uses energy devices such as those for excision and coagulation of the subject's living tissue.

[0045] therefore, Figure 1 The endoscope system 1 shown is used when performing surgery or treatment on a subject using a treatment instrument (not shown) such as an energy device capable of performing heat treatment. Figure 1 The endoscope system 1 shown is used for transurethral resection of bladder tumor (TUR-Bt), and is used when treating a tumor (bladder cancer) or a diseased area of ​​the bladder.

[0046] Figure 1 The endoscope system 1 shown includes an insertion portion 2, a light source device 3, a light guide 4, an endoscopic camera 5 (an imaging device for an endoscope), a first transmission cable 6, a display device 7, a second transmission cable 8, a control device 9, a third transmission cable 10, an irrigation device 11, and a fourth transmission cable 12.

[0047] The insertion portion 2 is rigid or at least partially flexible and has an elongated shape. The insertion portion 2 is inserted into a subject such as a patient via a cannula. The insertion portion 2 is internally provided with an optical system such as a lens for forming an observation image.

[0048] The light source device 3 is connected to one end of the light guide 4. Under the control of the control device 9, the light source device 3 supplies illumination light to the one end of the light guide 4 to irradiate the subject. The light source device 3 is implemented using the following components: any one or more light sources such as LED (Light Emitting Diode: Light Emitting Diode) light source, xenon lamp and LD (Laser Diode: Laser Diode) semiconductor laser element; a processor as a processing device having hardware such as FPGA (Field Programmable Gate Array: Field Programmable Gate Array), CPU (Central Processing Unit: Central Processing Unit); and a memory as a temporary storage area used by the processor. In addition, the light source device 3 and the control device 9 can be as follows: Figure 1 Although the structure is set as a structure in which communication is performed individually as shown, it can also be an integrated structure.

[0049] One end of the light guide 4 is detachably connected to the light source device 3 , and the other end is detachably connected to the insertion portion 2 . The light guide 4 guides illumination light supplied from the light source device 3 from one end to the other end, and supplies the illumination light to the insertion portion 2 .

[0050] The endoscope camera head 5 is detachably connected to the eyepiece portion 21 of the insertion portion 2. Under the control of the control device 9, the endoscope camera head 5 receives the observation image formed by the insertion portion 2 and performs photoelectric conversion to generate an imaging signal (RAW data). The imaging signal is output to the control device 9 via the first transmission cable 6.

[0051] One end of the first transmission cable 6 is detachably connected to the control device 9 via a video connector 61, and the other end is detachably connected to the endoscopic camera 5 via a camera connector 62. The first transmission cable 6 transmits the imaging signal output from the endoscopic camera 5 to the control device 9, and transmits setting data and power output from the control device 9 to the endoscopic camera 5. Here, the setting data refers to control signals, synchronization signals, clock signals, and the like for controlling the endoscopic camera 5.

[0052] The display device 7 displays an observation image based on an imaging signal processed by the control device 9 and various information related to the endoscope system 1 under the control of the control device 9. The display device 7 is implemented using a display monitor such as liquid crystal or organic EL (Electro Luminescence).

[0053] One end of the second transmission cable 8 is detachably connected to the display device 7 , and the other end is detachably connected to the control device 9 . The second transmission cable 8 transmits the image signal processed by the control device 9 to the display device 7 .

[0054] The control device 9 is implemented using the following components: a processor (including hardware such as a GPU (Graphics Processing Unit), FPGA, or CPU) as a processing device; and memory as a temporary storage area used by the processor. The control device 9 comprehensively controls the operation of the light source device 3, the endoscopic camera head 5, and the display device 7 via the first transmission cable 6, the second transmission cable 8, and the third transmission cable 10, in accordance with a program stored in the memory. Furthermore, the control device 9 performs various image processing on the imaging signal input via the first transmission cable 6 and outputs it to the second transmission cable 8.

[0055] One end of the third transmission cable 10 is detachably connected to the light source device 3 , and the other end is detachably connected to the control device 9 . The third transmission cable 10 transmits control data from the control device 9 to the light source device 3 .

[0056] Under the control of the control unit 9, the perfusion device 11 supplies a sterilized perfusion fluid, such as physiological saline, into the bladder of the subject via a not-shown perfusion tube from a fluid delivery port (not shown) in the insertion portion 2. The perfusion device 11 is configured using a fluid delivery pump, a fluid discharge pump, a storage tank for storing the perfusion fluid, and a waste fluid tank for storing discharged perfusion fluid.

[0057] One end of the fourth transmission cable 12 is detachably connected to the perfusion device 11 , and the other end is detachably connected to the control device 9 . The fourth transmission cable 12 transmits control data from the control device 9 to the perfusion device 11 .

[0058] [Functional structure of the main parts of the endoscope system]

[0059] Next, the functional configuration of the main parts of the endoscope system 1 will be described. Figure 2 1 is a block diagram showing the functional configuration of the main parts of the endoscope system 1 .

[0060] [Structure of the insertion part]

[0061] First, the structure of the insertion portion 2 will be described. The insertion portion 2 includes an optical system 22 and an illumination optical system 23 .

[0062] The optical system 22 forms an image of the subject by converging reflected light from the subject, return light from the subject, excitation light from the subject, and fluorescent light emitted from thermally denatured areas thermally denatured by heat treatment with an energy device, etc. The optical system 22 is implemented using one or more lenses, etc.

[0063] The illumination optical system 23 irradiates the subject with illumination light supplied from the light guide 4. The illumination optical system 23 is implemented using one or more lenses and the like.

[0064] [Structure of light source device]

[0065] Next, a description will be given of the configuration of the light source device 3 . The light source device 3 includes a condenser lens 30 , a first light source unit 31 , a second light source unit 32 , and a light source control unit 33 .

[0066] The condenser lens 30 condenses the light emitted from the first light source unit 31 and the second light source unit 32 and emits the light toward the light guide 4 .

[0067] Under the control of the light source control unit 33, the first light source unit 31 emits white light (normal light) as visible light, thereby supplying white light as illumination light to the light guide 4. The first light source unit 31 is constructed using a collimating lens, a white LED lamp, and a driver. Alternatively, the first light source unit 31 can simultaneously emit red, green, and blue LED lamps to supply visible white light. Of course, the first light source unit 31 can also be constructed using a halogen lamp, a xenon lamp, or the like.

[0068] Under the control of the light source control unit 33, the second light source unit 32 emits excitation light within a predetermined wavelength range, which is supplied as illumination light to the light guide 4. The excitation light has a wavelength range of 400 nm to 430 nm (with a center wavelength of 415 nm). The second light source unit 32 is implemented using a collimating lens, a semiconductor laser such as a violet laser diode (LD), and a driver. Furthermore, in the first embodiment, the excitation light excites advanced glycation end products (AGEs) produced by heat treatment of biological tissue using an energy device or the like. Furthermore, when amino acids and reducing sugars are heated, a glycation reaction (Maillard reaction) occurs. The end products produced as a result of this Maillard reaction are collectively referred to as advanced glycation end products (AGEs). AGEs are known to contain substances with fluorescent properties. Specifically, AGEs are generated when biological tissue is heat treated using an energy device, where amino acids and reducing sugars in the tissue are heated and undergo a Maillard reaction. The AGEs generated by this heating can be visualized through fluorescence observation, allowing the state of heat treatment to be visualized. Furthermore, AGEs are known to emit stronger fluorescence than the autofluorescent substances naturally present in living tissue. Specifically, in Embodiment 1, the fluorescent properties of AGEs generated in living tissue by heat treatment with an energy device, etc., are utilized to visualize the thermally denatured areas caused by the heat treatment. Therefore, in Embodiment 1, the second light source unit 32 irradiates the living tissue with excitation light of blue light having a wavelength of approximately 415 nm, which excites AGEs. Thus, Embodiment 1 enables observation of a fluorescence image (thermal denaturation image) based on an imaging signal obtained by capturing fluorescence (e.g., green light with a wavelength of 490 nm to 625 nm) emitted from the thermally denatured areas by AGEs.

[0069] The light source control unit 33 is implemented using a processor having hardware such as an FPGA or a CPU, and a memory serving as a temporary storage area used by the processor. The light source control unit 33 controls the light emission timing and light emission duration of each of the first light source unit 31 and the second light source unit 32 based on control data input from the control device 9.

[0070] Here, the wavelength characteristics of the light emitted by the second light source unit 32 will be described. Figure 3 Schematically shows the wavelength characteristics of the excitation light emitted by the second light source unit 32. Figure 3 In the figure, the horizontal axis represents wavelength (nm) and the vertical axis represents wavelength characteristics. Figure 3 Middle, broken line L V represents the wavelength characteristics of the excitation light emitted by the second light source unit 32. Figure 3 In the middle, curve LB Indicates the wavelength range of blue, curve L G Indicates the wavelength range of green, curve L R Indicates the wavelength range of red.

[0071] like Figure 3 The broken line L V As shown, the second light source unit 32 emits excitation light having a central wavelength (peak wavelength) of 415 nm and a wavelength range of 400 nm to 430 nm.

[0072] [Structure of endoscope camera]

[0073] return Figure 2 , the structure of the endoscope system 1 is further described.

[0074] Next, the configuration of the endoscopic camera head 5 will be described. The endoscopic camera head 5 includes an optical system 51, a drive unit 52, an imaging element 53, a cut filter 54, an A / D converter 55, a P / S converter 56, an imaging and recording unit 57, and an imaging control unit 58.

[0075] The optical system 51 forms an image of the subject, focused by the optical system 22 of the insertion portion 2, onto the light-receiving surface of the imaging element 53. The optical system 51 is capable of changing the focal length and focus position. The optical system 51 is constructed using a plurality of lenses 511. The optical system 51 changes the focal length and focus position by moving each of the plurality of lenses 511 along the optical axis L1 via the drive unit 52.

[0076] The drive unit 52 moves the multiple lenses 511 of the optical system 51 along the optical axis L1 under the control of the imaging control unit 58. The drive unit 52 is configured using a motor such as a stepping motor, a DC motor, or a voice coil motor, and a transmission mechanism such as gears that transmits the motor's rotation to the optical system 51.

[0077] The imaging element 53 is implemented using a CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor) image sensor having a plurality of pixels arranged in a two-dimensional matrix. Under the control of the imaging control unit 58, the imaging element 53 receives the subject image (light) formed by the optical system 51 and passed through the cut filter 54, performs photoelectric conversion on the subject image, generates an imaging signal (RAW data), and outputs it to the A / D converter 55. The imaging element 53 includes a pixel unit 531 and a color filter 532.

[0078] Figure 4 Schematic diagram showing the structure of the pixel portion 531. Figure 4 As shown, the pixel portion 531 is composed of a plurality of pixels P such as photodiodes that store charges according to the amount of light. nm (n=integer greater than or equal to 1, m=integer greater than or equal to 1) are arranged in a two-dimensional matrix. The pixel unit 531 is controlled by the imaging control unit 58 to obtain a plurality of pixels P nm The pixel P in the reading area arbitrarily set as the reading object nm The image signal is read as image data and output to the A / D conversion unit 55 .

[0079] Figure 5 Schematically shows the structure of the color filter 532. Figure 5 As shown, the color filter 532 is formed of a Bayer array with 2×2 units. The color filter 532 is composed of a filter R that transmits light in the red wavelength range, two filters G that transmit light in the green wavelength range, and a filter B that transmits light in the blue wavelength range.

[0080] Figure 6 is a diagram schematically showing the sensitivity and wavelength range of each filter. Figure 6 In the figure, the horizontal axis represents wavelength (nm) and the vertical axis represents transmission characteristics (sensitivity characteristics). Figure 6 In the middle, curve L B Indicates the transmission characteristics of filter B, curve L G Indicates the transmission characteristics of filter G, curve L R Indicates the transmission characteristics of filter R.

[0081] like Figure 6 The curve L B As shown in FIG, filter B transmits light in the blue wavelength range. Figure 6 The curve L G As shown in FIG, the filter G transmits light in the green wavelength range. Figure 6 The curve L R As shown, the filter R transmits light in the red wavelength range. In the following, the filter R is arranged on the light receiving surface to form a pixel P. nm The pixel P is formed by placing the filter G on the light receiving surface. nm The pixel P is formed by placing the filter B on the light receiving surface. nm This will be described as a B pixel.

[0082] According to the imaging element 53 configured in this manner, when receiving the subject image formed by the optical system 51, Figures 7A to 7C As shown, color signals (R signal, G signal, and B signal) are generated for each of the R pixel, the G pixel, and the B pixel.

[0083] return Figure 2 , the structure of the endoscope system 1 is further described.

[0084] The cutoff filter 54 is disposed on the optical axis L1 between the optical system 51 and the imaging element 53. The cutoff filter 54 is provided on the light-receiving surface side (incident surface side) of at least the G pixel of the color filter 532, which is provided with the filter G that transmits the green wavelength range. The cutoff filter 54 blocks light in the short wavelength range including the wavelength range of the excitation light, and transmits light in the long wavelength range that is longer than the wavelength range of the excitation light.

[0085] Figure 8 Schematically shows the structure of the cut filter 54. Figure 8 As shown, the filter F constituting the cutoff filter 54 11 Configured on filter G 11 (Refer to Figure 5 ) is configured at a position where the filter G 11 The light-receiving side directly above the .

[0086] Figure 9 is a diagram schematically showing the transmission characteristics of the cut filter 54. Figure 8 In the figure, the horizontal axis represents wavelength (nm) and the vertical axis represents transmittance. Figure 8 Middle, broken line L F The transmission characteristics of the cut filter 54 are shown in FIG. NG The wavelength characteristic of fluorescence, the broken line L V Indicates the wavelength characteristics of the excitation light.

[0087] like Figure 9 As shown, the cutoff filter 54 blocks the wavelength range of the excitation light and transmits wavelengths in the long-wavelength range that are longer than the wavelength range of the excitation light. Specifically, the cutoff filter 54 blocks light in the short-wavelength range shorter than the wavelength range of 400 nm to 430 nm that includes the excitation light and transmits light in the long-wavelength range longer than the wavelength range of 400 nm to 430 nm that includes the excitation light.

[0088] return Figure 2 , continue to explain the structure of the endoscope camera 5.

[0089] Under the control of the imaging control unit 58, the A / D converter 55 performs A / D conversion processing on the analog imaging signal input from the imaging element 53 and outputs the resulting signal to the P / S converter 56. The A / D converter 55 is implemented using an A / D conversion circuit or the like.

[0090] Under the control of the camera control unit 58, the P / S converter 56 performs parallel / serial conversion on the digital camera signal input from the A / D converter 55, and outputs the parallel / serial converted camera signal to the control device 9 via the first transmission cable 6. The P / S converter 56 is implemented using a P / S conversion circuit, etc. In the first embodiment, an E / O converter that converts the camera signal into an optical signal may be provided in place of the P / S converter 56, and the camera signal may be output to the control device 9 via an optical signal. Alternatively, the camera signal may be transmitted to the control device 9 via wireless communication such as Wi-Fi (Wireless Fidelity) (registered trademark).

[0091] The image recording unit 57 records various information related to the endoscopic camera head 5 (e.g., pixel information of the image sensor 53 and characteristics of the cutoff filter 54). Furthermore, the image recording unit 57 records various setting data and control parameters transmitted from the control device 9 via the first transmission cable 6. The image recording unit 57 is configured using a nonvolatile memory or a volatile memory.

[0092] The imaging control unit 58 controls the operation of the drive unit 52, the imaging element 53, the A / D converter 55, and the P / S converter 56 based on the setting data received from the control device 9 via the first transmission cable 6. The imaging control unit 58 is implemented using the following components: a TG (Timing Generator); a processor including hardware such as an ASIC (Application Specific Integrated Circuit) or a CPU; and a memory serving as a temporary storage area used by the processor.

[0093] [Structure of control device]

[0094] Next, the configuration of the control device 9 will be described.

[0095] The control device 9 includes an S / P conversion unit 91 , an image processing unit 92 , an input unit 93 , a recording unit 94 , and a control unit 95 .

[0096] Under the control of the control unit 95, the S / P converter 91 performs serial / parallel conversion on the image data received from the endoscopic camera 5 via the first transmission cable 6 and outputs the data to the image processing unit 92. Furthermore, if the endoscopic camera 5 outputs the imaging signal via an optical signal, an O / E converter that converts the optical signal into an electrical signal may be provided in place of the S / P converter 91. Furthermore, if the endoscopic camera 5 transmits the imaging signal via wireless communication, a communication module capable of receiving wireless signals may be provided in place of the S / P converter 91.

[0097] Under the control of the control unit 95, the image processing unit 92 performs predetermined image processing on the parallel data imaging signal input from the S / P conversion unit 91 and outputs the image to the display device 7. The predetermined image processing herein includes demosaicing, white balance, gain adjustment, gamma correction, and format conversion. The image processing unit 92 is implemented using a processor as a processing device, including hardware such as a GPU or FPGA, and a memory as a temporary storage area used by the processor.

[0098] The input unit 93 receives input of various operations related to the endoscope system 1 and outputs the received operations to the control unit 95. The input unit 93 is configured using a mouse, a foot switch, a keyboard, buttons, switches, a touch panel, and the like.

[0099] The recording unit 94 is implemented using a recording medium such as a volatile memory, a nonvolatile memory, an SSD (Solid State Drive), an HDD (Hard Disk Drive), or a memory card. The recording unit 94 records data including various parameters required for the operation of the endoscope system 1. The recording unit 94 also includes a program recording unit 941 for recording various programs used to operate the endoscope system 1.

[0100] The control unit 95 is implemented using a processor comprising hardware such as an FPGA or CPU, and a memory serving as a temporary storage area for the processor. The control unit 95 comprehensively controls the various components that comprise the endoscope system 1. Specifically, the control unit 95 reads the program stored in the program storage unit 941 into the working area of ​​the memory and executes it. The processor executes the program to control the various components, thereby enabling the hardware and software to collaborate and implement functional modules that meet their intended purpose. Specifically, the control unit 95 includes an acquisition unit 951, a determination unit 952, a calculation unit 953, a determination unit 954, and an output control unit 955.

[0101] The acquisition unit 951 acquires an imaging signal generated by the endoscopic camera 5 through the insertion portion 2 .

[0102] Determining unit 952 determines first information included in the first fluorescent image. Specifically, determining unit 952 determines the fluorescence intensity of the first fluorescent image as the first information based on the pixel values ​​included in the first fluorescent image. Furthermore, determining unit 952 determines second information included in the second fluorescent image. Specifically, determining unit 952 determines the fluorescence intensity of the second fluorescent image as the second information based on the pixel values ​​included in the first fluorescent image.

[0103] The calculation unit 953 calculates the difference between the amount of fluorescence included in the first fluorescent image determined by the determination unit 952 and the amount of fluorescence included in the second fluorescent image determined by the determination unit 952. Specifically, the calculation unit 953 calculates the temporal change in the fluorescence amount as the difference based on the amount of fluorescence included in the first fluorescent image determined by the determination unit 952 and the amount of fluorescence included in the second fluorescent image determined by the determination unit 952.

[0104] The determination unit 954 determines whether the difference between the fluorescence amounts included in the first fluorescent image and the fluorescence amounts included in the second fluorescent image calculated by the calculation unit 953 is less than a predetermined value. Specifically, the determination unit 954 determines whether the change in fluorescence amount, which is the difference in fluorescence amount calculated by the calculation unit 953, is less than a predetermined value.

[0105] The output control unit 955 outputs a drive signal to the display device 7 for causing the display device 7 to display information indicating that the excision fragment removed by the excision treatment instrument within the target area has been discharged as discharge information indicating the discharge status of the excision fragment. Furthermore, the output control unit 955 outputs a drive signal to the display device 7 for causing the display device 7 to display information indicating that the excision fragment removed by the excision treatment instrument within the target area is being discharged as discharge information indicating the discharge status of the excision fragment.

[0106] 〔Control device processing〕

[0107] Next, the processing executed by the control device 9 will be described. Figure 10 It is a flowchart showing an outline of the processing executed by the control device 9 .

[0108] like Figure 10 As shown, first, the control unit 95 causes the second light source unit 32 of the light source device 3 to emit light to supply excitation light to the insertion portion 2 , thereby irradiating the excitation light toward a target area of ​​the living tissue (step S101 ).

[0109] Next, the acquisition unit 951 acquires a first fluorescent image generated by the endoscope camera 5 through the insertion portion 2 (step S102 ).

[0110] Thereafter, the decision unit 952 decides the first information included in the first fluorescent light image (step S103 ). Specifically, the decision unit 952 decides the fluorescence amount of the first fluorescent light image as the first information based on the pixel values ​​included in the first fluorescent light image.

[0111] Next, the control unit 95 causes the second light source unit 32 of the light source device 3 to emit light to supply the excitation light to the insertion portion 2 , thereby irradiating the target region of the living tissue with the excitation light (step S104 ).

[0112] Thereafter, the acquisition unit 951 acquires a second fluorescent light image generated by the endoscope camera 5 imaging the target region via the insertion portion 2 after the timing of imaging the first fluorescent light image (step S105 ).

[0113] Next, the decision unit 952 decides the second information included in the second fluorescent light image (step S106 ). Specifically, the decision unit 952 decides the fluorescence amount as the average of the pixel values ​​of the first fluorescent light image and the second fluorescent light image.

[0114] The calculation unit 953 calculates the difference between the fluorescence amount contained in the first fluorescent image determined by the determination unit 952 and the fluorescence amount contained in the second fluorescent image determined by the determination unit 952 (step S107). Specifically, the calculation unit 953 calculates the temporal change in the fluorescence amount as the difference based on the fluorescence amount contained in the first fluorescent image determined by the determination unit 952 and the fluorescence amount contained in the second fluorescent image determined by the determination unit 952. Alternatively, the calculation unit 953 may divide each of the first and second fluorescent images into multiple regions, calculate the average value of the pixel values ​​(fluorescence amount) of the pixels contained in each of the multiple regions, and then calculate the temporal change in the fluorescence amount using the average value of the same region in each of the first and second fluorescent images. Alternatively, the calculation unit 953 may calculate the temporal change in the fluorescence amount based on the distribution of the fluorescence amount in each of the first and second fluorescent images.

[0115] The determination unit 954 determines whether the change in the amount of fluorescence calculated by the calculation unit 953 is less than a predetermined value (step S108). If the determination unit 954 determines that the change in the amount of fluorescence calculated by the calculation unit 953 is less than the predetermined value (step S108: "Yes"), the control device 9 proceeds to step S109, described later. Conversely, if the determination unit 954 determines that the change in the amount of fluorescence calculated by the calculation unit 953 is not less than the predetermined value (step S108: "No"), the control device 9 proceeds to step S110, described later.

[0116] In step S109, the output control unit 955 outputs a drive signal to the display device 7, causing the display device 7 to display information indicating the completion of discharge of the excised fragment removed by the excision treatment instrument within the target area as discharge information indicating the discharge status of the excised fragment. In this case, the display device 7, in accordance with the drive signal input from the control unit 95, superimposes information indicating the completion of discharge of the excised fragment, such as characters, graphics, and symbols such as "discharge completed," on the display image input from the image processing unit 92. This allows the user to understand that the excised fragment has been removed from the target area. After step S109, the control unit 9 transfers to step S111, which will be described later.

[0117] In step S110, the output control unit 955 outputs a drive signal to the display device 7, causing the display device 7 to display information indicating that the excised fragments removed by the excision treatment instrument within the target area are being discharged as discharge information indicating the discharge status of the excised fragments. In this case, the display device 7 superimposes a display image input from the image processing unit 92 with characters, graphics, or symbols indicating that the excised fragments are being discharged, such as "excised," in accordance with the drive signal input from the control unit 95. This allows the user to understand that the excised fragments have been removed from the target area. After step S109, the control unit 9 transfers to step S111, which will be described later.

[0118] In step S111, the determination unit 954 determines whether a termination signal for terminating observation of the subject by the endoscope system 1 has been input from the input unit 93. If the determination unit 954 determines that a termination signal for terminating observation of the subject by the endoscope system 1 has been input from the input unit 93 (step S111: "Yes"), the control device 9 terminates this processing. In contrast, if the determination unit 954 determines that a termination signal for terminating observation of the subject by the endoscope system 1 has not been input from the input unit 93 (step S111: "No"), the control device 9 returns to step S101 described above.

[0119] According to the first embodiment described above, the output control unit 955 outputs a drive signal to the display device 7 for causing the display device 7 to display information indicating that the excision fragment removed by the excision treatment instrument within the target area has been expelled as discharge information indicating the discharge status of the excision fragment. This allows the status of the excision fragment in the perfusion fluid supplied to the organ to be understood.

[0120] Furthermore, according to the first embodiment, the output control unit 955 outputs a drive signal to the display device 7 for causing the display device 7 to display information indicating the resected fragment being removed by the resection treatment instrument within the discharge target area as discharge information indicating the discharge status of the resected fragment. This allows the user to grasp the status of the resected fragment in the perfusion fluid.

[0121] Furthermore, the calculation unit 953 calculates the change in the amount of fluorescence contained in the first fluorescent image determined by the determination unit 952 and the amount of fluorescence contained in the second fluorescent image determined by the determination unit 952 as the difference. However, the motion vector can also be calculated based on the first and second fluorescent images. In this case, the calculation unit 953 calculates the motion vector based on the difference information between the first and second fluorescent images. The calculation unit 953 calculates the motion vector by referring to a well-known technique for calculating (estimating) optical flow, such as the Lucas-Kanade method or the Horm-Schunk method. In this case, the determination unit 954 considers the subject with the largest motion vector calculated by the calculation unit 953 as a resection slice and determines whether the motion vector has become less than a predetermined value within the target area. Specifically, if the motion vector has become less than the predetermined value, the determination unit 954 determines that the resection slice has been removed from the target area. On the other hand, if the motion vector is not less than the predetermined value, the determination unit determines that the resection slice is being removed from the target area.

[0122] (Implementation Method 2)

[0123] Next, Embodiment 2 will be described. The endoscope system according to Embodiment 2 has the same configuration as the endoscope system 1 according to Embodiment 1 described above, but the processing executed by the control device 9 is different. Specifically, in Embodiment 1 described above, the drive signal is output to the display device 7, but in Embodiment 2, the drive signal is output to the perfusion device 11. Therefore, the processing executed by the control device included in the endoscope system according to Embodiment 2 will be described below.

[0124] 〔Control device processing〕

[0125] Figure 11 : is a flowchart showing an outline of the processing executed by the control device 9 according to the second embodiment. Figure 11 In the embodiment, the control device 9 executes steps S109A and S110A to replace the above Figure 10 Step S109 and step S110 are the same as the above steps except for this, so step S109A and step S110A will be described.

[0126] In step S109A, the output control unit 955 outputs a drive signal for causing the perfusion device 11, which is supplying perfusion fluid to the target area, to stop supplying perfusion fluid as a signal for controlling the perfusion device 11. This eliminates the need for the user to determine the state of the perfusion fluid based on empirical rules, allowing for centralized surgery on the subject. After step S109A, the control device 9 proceeds to step S111.

[0127] In step S110A, the output control unit 955 outputs a drive signal for causing the perfusion device 11 to supply perfusion fluid to the target area as a signal for controlling the perfusion device 11. As a result, the perfusion device 11 supplies perfusion fluid to the target area, allowing the operator to expel the resected fragment removed by the resection instrument. After step S110A, the control device 9 proceeds to step S111.

[0128] According to the second embodiment described above, the same effect as that of the first embodiment described above is achieved, that is, the condition of the resected fragment in the perfusate can be grasped.

[0129] (Implementation 3)

[0130] Next, Embodiment 3 will be described. In Embodiment 1, the control unit 95 of the control device 9 outputs a drive signal to the display device 7. However, in Embodiment 3, a separate medical device is provided that outputs a drive signal for driving the display device 7. The configuration of the endoscope system according to Embodiment 3 will be described below. Components identical to those of the endoscope system 1 according to Embodiment 1 are denoted by the same reference numerals, and detailed descriptions thereof will be omitted.

[0131] [Structure of the endoscope system]

[0132] Figure 12 This is a diagram showing a schematic configuration of an endoscope system according to a third embodiment. Figure 12 The illustrated endoscope system 1A includes a control device 9A instead of the control device 9 of the endoscope system 1 according to the first embodiment. In addition to the configuration of the endoscope system 1 according to the first embodiment, the endoscope system 1A further includes a medical device 13 and a fifth transmission cable 14 .

[0133] The control device 9A is implemented using the following components: a processor comprising hardware such as a GPU, FPGA, or CPU as a processing device; and a memory serving as a temporary storage area used by the processor. The control device 9A comprehensively controls the operation of the light source device 3, the endoscopic camera head 5, the display device 7, and the medical device 13 via each of the first transmission cable 6, the second transmission cable 8, the third transmission cable 10, and the fourth transmission cable 12, in accordance with a program stored in the memory. The control device 9A omits the functions of the acquisition unit 951, the determination unit 952, the calculation unit 953, the determination unit 954, and the output control unit 955 from the control unit 95 of the first embodiment described above.

[0134] The medical device 13 is implemented using the following components: a processor (e.g., a GPU, FPGA, or CPU) serving as a processing device; and a memory serving as a temporary storage area used by the processor. The medical device 13 receives various information from the control device 9A via a fifth transmission cable 14 and outputs the received information to the control device 9A. The detailed functional structure of the medical device 13 will be described later.

[0135] One end of the fifth transmission cable 14 is detachably connected to the control device 9A, and the other end is detachably connected to the medical device 13. The fifth transmission cable 14 transmits various information from the control device 9A to the medical device 13, and transmits various information from the medical device 13 to the control device 9A.

[0136] [Functional structure of medical devices]

[0137] Figure 13 16 is a block diagram showing the functional configuration of the medical device 13. The medical device 13 shown in FIG16 includes a communication I / F 131, an input unit 132, a recording unit 133, and a control unit 134.

[0138] The communication I / F 131 is an interface for communicating with the control device 9A via the fifth transmission cable 14. The communication I / F 131 receives various information from the control device 9A according to a predetermined communication standard and outputs the received information to the control unit 134.

[0139] The input unit 132 receives input of various operations related to the endoscope system 1A and outputs the received operations to the control unit 134. The input unit 132 is configured using a mouse, a foot switch, a keyboard, buttons, switches, a touch panel, and the like.

[0140] The recording unit 133 is implemented using a recording medium such as a volatile memory, a nonvolatile memory, an SSD, a HDD, or a memory card. The recording unit 133 records data including various parameters required for the operation of the medical device 13. The recording unit 133 also includes a program recording unit 133a that records various programs for operating the medical device 13.

[0141] The control unit 134 is implemented using a processor comprising hardware such as an FPGA or CPU, and a memory serving as a temporary storage area used by the processor. The control unit 134 comprehensively controls the various components comprising the medical device 13. The control unit 134 has the same functions as the control unit 95 described in the first embodiment. Specifically, the control unit 134 includes an acquisition unit 951, a determination unit 952, a calculation unit 953, a determination unit 954, and an output control unit 955.

[0142] The medical device 13 thus configured performs the same processing as the control device 9 according to the first embodiment described above, and outputs the processing results to the control device 9A. In this case, based on the processing results of the medical device 13, the control device 9A causes the image processing unit 92 to output a display image generated by the image processing unit 92 corresponding to the presence or absence of a light-emitting area within the detection range R1 of the white image, and causes the display device 7 to display the display image.

[0143] According to the second embodiment described above, the same effect as that of the first embodiment is achieved, and the user can confirm the state of thermal denaturation in a specific area.

[0144] (Other embodiments)

[0145] By appropriately combining the multiple components disclosed in the endoscope systems according to the first to third embodiments of the present disclosure, various inventions can be formed. For example, some components may be deleted from all the components described in the endoscope systems according to the embodiments of the present disclosure. Furthermore, the components described in the endoscope systems according to the embodiments of the present disclosure may be appropriately combined.

[0146] Furthermore, in the endoscope systems according to Embodiments 1 to 3 of the present disclosure, the systems are connected to each other by wires, but they may be connected wirelessly via a network.

[0147] Furthermore, in Embodiments 1 to 3 of the present disclosure, the functions of the control unit, the acquisition unit 951, the determination unit 952, the calculation unit 953, the determination unit 954, and the output control unit 955 included in the endoscope system may be provided on a server or the like that can be connected via a network. Of course, a server may be provided for each functional module.

[0148] Furthermore, in Embodiments 1 to 3 of the present disclosure, an example of application to transurethral bladder tumor resection has been described, but the present invention is not limited thereto and can be applied to various surgeries for resecting lesions using energy devices or the like, for example.

[0149] In the endoscope systems according to Embodiments 1 to 3 of the present disclosure, the aforementioned “units” can be replaced by “units” or “circuits”, etc. For example, the control unit can be replaced by a control unit or a control circuit.

[0150] Furthermore, although expressions such as "first," "afterwards," and "next" are used in the descriptions of the flowcharts in this specification to clarify the sequential relationship between the processes in the steps, the order of the processes required to implement the present invention is not solely defined by these expressions. In other words, the order of the processes in the flowcharts described in this specification can be changed within a range consistent with the order in which they are performed.

[0151] While several embodiments of the present application have been described in detail above based on the drawings, these are merely examples and the present invention can be implemented in other ways that are variously modified and improved based on the knowledge of those skilled in the art, represented by the methods described in the columns of this disclosure.

[0152] Description of Reference Numerals

[0153] 1, 1A: Endoscope system; 2: Insertion unit; 3: Light source device; 4: Light guide; 5: Endoscope camera head; 6: First transmission cable; 7: Display device; 8: Second transmission cable; 9, 9A: Control unit; 10: Third transmission cable; 11: Irrigation device; 12: Fourth transmission cable; 13: Medical device; 14: Fifth transmission cable; 21: Eyepiece unit; 22: Optical system; 23: Illumination optical system; 30: Converging lens; 31: First light source unit; 32: Second light source unit; 33: Light source control unit; 51: Optical system; 52: Drive unit; 53: Image sensor; 54: Cutoff filter Optical sheet; 55: A / D conversion unit; 56: P / S conversion unit; 57: Video recording unit; 58: Video control unit; 61: Video connector; 62: Camera connector; 91: S / P conversion unit; 92: Image processing unit; 93, 112: Input unit; 94, 113: Recording unit; 95: Output unit; 96, 114: Control unit; 111: Communication I / F; 113a, 941: Program recording unit; 511: Lens; 531: Pixel unit; 532: Color filter; 951: Acquisition unit; 952: Decision unit; 953: Calculation unit; 954: Judgment unit; 955: Output control unit.

Claims

1. A medical device comprising a processor, which is driven according to the cleaning state of a target area, wherein: The processor performs the following processing: acquiring a first fluorescent image of the object area and a second fluorescent image of the object area taken after the first fluorescent image is taken; generating a drive signal for performing a predetermined action on the target area based on first information included in the first fluorescent image and second information included in the second fluorescent image; as well as The driving signal is output.

2. The medical device according to claim 1, wherein The driving signal is a signal for causing the display device to display discharge information indicating a discharge status of the resected fragment removed by the resection treatment instrument within the target region.

3. The medical device according to claim 1, wherein The driving signal is a signal for controlling a perfusion device that supplies perfusion fluid toward the target area.

4. The medical device according to claim 2, wherein: The first information and the second information are respectively the fluorescence amount, The processor performs the following processing: calculating a difference between an amount of fluorescence contained in the first fluorescent image and an amount of fluorescence contained in the second fluorescent image; determining whether the difference is less than a specified value; and If it is determined that the value is smaller than the predetermined value, the drive signal is outputted to cause the display device to display information indicating that discharge of the excised piece has been completed as the discharge information.

5. The medical device according to claim 4, wherein When the processor determines that the value is not less than the predetermined value, the processor outputs the drive signal for causing the display device to display information indicating that the resected fragment is being discharged as the discharge information.

6. The medical device according to claim 3, wherein The first information and the second information are respectively the fluorescence amount, The processor performs the following processing: calculating a difference between an amount of fluorescence contained in the first fluorescent image and an amount of fluorescence contained in the second fluorescent image; determining whether the difference is less than a specified value; and If it is determined that the value is smaller than the predetermined value, the drive signal for causing the perfusion device to stop supplying the perfusion fluid is output as the signal.

7. The medical device according to claim 6, wherein: When it is determined that the difference is not less than the predetermined value, the drive signal for causing the perfusion device to supply the perfusion fluid is output as the signal.

8. A medical system comprising a light source device, an imaging device, and a medical device, wherein: The light source device includes a light source that emits excitation light, the excitation light being light that excites advanced glycation end products generated by heat treatment of a target area of ​​biological tissue. The imaging device includes an imaging element that generates a first fluorescent image and a second fluorescent image by capturing fluorescent light emitted by the excitation light, wherein the first fluorescent image is an image of the target area, and the second fluorescent image is an image of the target area captured after the first fluorescent image is captured. The medical device includes a processor. The processor performs the following processing: acquiring the first fluorescent image and the second fluorescent image; generating a drive signal for performing a predetermined action on the target area based on first information included in the first fluorescent image and second information included in the second fluorescent image; as well as The driving signal is output.

9. The medical system according to claim 8, wherein: It also includes a display device, The driving signal is a signal for causing the display device to display discharge information indicating a discharge status of the resected fragment removed by the resection treatment instrument within the target region.

10. The medical system according to claim 8, wherein: further comprising a perfusion device for supplying perfusion fluid toward the target area, The driving signal is a signal for controlling the perfusion device.

11. A method for operating a medical device, the medical device comprising a processor and driven according to a cleaning state of a target area, wherein: The processor performs the following processing: acquiring a first fluorescent image of the object area and a second fluorescent image of the object area taken after the first fluorescent image is taken; generating a drive signal for performing a predetermined action on the target area based on first information included in the first fluorescent image and second information included in the second fluorescent image; as well as The driving signal is output.

12. A program executed by a medical device comprising a processor and driven according to a cleaning state of a target area, wherein: The program causes the processor to execute the following processing: acquiring a first fluorescent image of the object area and a second fluorescent image of the object area taken after the first fluorescent image is taken; generating a drive signal for performing a predetermined action on the target area based on first information included in the first fluorescent image and second information included in the second fluorescent image; as well as The driving signal is output.

Images