Endoscopy support system, operation method of the endoscopy support system

Abstract

To facilitate endoscopic re-access to lesions or potential lesions. [Solution] The display control unit 37 and the recording control unit 38 each acquire, during an endoscopic examination, the first endoscopic shape when the tip of the endoscope is located at a predetermined site, the endoscopic image taken during the endoscopic examination, and the second endoscopic shape when the endoscopic image was taken. The recording control unit 38 may record the first endoscopic shape, the endoscopic image, and the second endoscopic shape in the storage device 43. The display control unit 37 may simultaneously display the first endoscopic shape and the second endoscopic shape on the display device 41.

Description

Technical Field

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[0001] The present disclosure relates to an endoscopy support system for assisting an operator in endoscopy and a method of operating the endoscopy support system.

Background Art

[0002] In colonoscopy, in order to facilitate future procedures and follow-up observations after the procedure, when a lesion (e.g., a polyp or cancer) is confirmed, it is common to record where the confirmed lesion is located. In this regard, a method has been proposed in which a lesion detected by AI during colonoscopy is marked at a corresponding location on a colon schematic diagram (see, for example, Patent Document 1).

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] Since the colon is easily deformed, even when the position of a lesion is recorded by the above method, there are cases where it is difficult to identify the position of the lesion when the endoscope is reinserted at a later date.

[0005] The present disclosure has been made in view of such a situation, and an object thereof is to provide a technique for facilitating re-access to a lesion or a lesion candidate with an endoscope.

Means for Solving the Problems

[0006] To solve the above problems, an endoscopic examination support system according to one aspect of the present disclosure comprises one or more processors having hardware. The processor acquires, during an endoscopic examination, a first endoscopic shape when the tip of the endoscope is located at a predetermined site, an endoscopic image taken during the endoscopic examination, and a second endoscopic shape when the endoscopic image was taken.

[0007] Another aspect of this disclosure is an endoscopic examination support method. This method acquires, in an endoscopic examination, a first endoscopic shape when the tip of the endoscope is located at a predetermined site, an endoscopic image taken during the endoscopic examination, and a second endoscopic shape when the endoscopic image was taken.

[0008] Furthermore, any combination of the above components, as well as conversions of the expressions of this disclosure between methods, apparatus, systems, recording media, computer programs, etc., are also valid as aspects of this disclosure. [Brief explanation of the drawing]

[0009] [Figure 1] This figure shows the overall system configuration related to colonoscopy according to the embodiment. [Figure 2] This figure shows an example of an endoscope used in this embodiment. [Figure 3] This figure shows an example configuration of an endoscopic examination support system according to an embodiment. [Figure 4] This figure shows an example screen 1 displayed on the display device. [Figure 5] This figure shows example screen 2 displayed on the display device. [Figure 6] This figure shows example 3 of the screen displayed on the display device. [Figure 7] This figure shows example screen 4 displayed on an display device. [Figure 8] This figure shows example screen 5 displayed on the display device. [Figure 9] This figure shows example screen 6 displayed on the display device. [Figure 10]Figures 10(a)-(c) show examples of multiple endoscope shapes displayed using triangular projection from three directions. [Figure 11] This figure shows an example of a bird's-eye view perspective of the three-dimensional endoscopic shape when it reaches the cecum. [Figure 12] This flowchart shows the operation of the endoscopic examination support system according to the embodiment at the end of the examination. [Figure 13] This flowchart shows the operation of the endoscopic examination support system according to the embodiment when confirming examination information. [Modes for carrying out the invention]

[0010] This embodiment relates to colonoscopy. In colonoscopy, an endoscope is inserted to the cecum, and lesion screening, detailed examination of lesions, and treatment of lesions are performed upon withdrawal. If a lesion is found, its location is recorded to facilitate subsequent treatment and follow-up observation. Furthermore, even if treatment is not performed for reasons such as the examination revealing no lesion, follow-up observation may be conducted to see if the area becomes diseased, and the location of that area may be recorded as a potential lesion.

[0011] In the pathological diagnosis following lesion screening during colonoscopy, if treatment is deemed necessary, it is routinely performed to re-access lesions or potential lesions found in the previous examination. This re-access may be performed by the same physician, a different physician, or even at a different facility.

[0012] However, the large intestine is about 1 to 1.5 m in length and is easily deformed. In particular, depending on the insertion method during insertion, the insertion length from the anus to the same lesion varies greatly. Even when the same doctor attempts it, it may not be easily re-accessible. From a professional perspective, re-access may be done at another facility, but it is even more difficult for other doctors to re-access. Although a schematic diagram of the large intestine and the approximate lesion location may be described in the referral letter, it often happens that the lesion cannot be found even when re-accessing according to the schematic diagram. Therefore, the information on the lesion location exchanged between doctors and facilities is only for reference. From the above, it is required to show the lesion location or the lesion candidate location with good reproducibility.

[0013] FIG. 1 is a diagram showing the overall system configuration related to colonoscopy according to an embodiment. In this embodiment, an endoscope system 10, an endoscope 11, a light source device 15, an endoscope insertion shape observing device (UPD: Endoscope Position Detecting Unit) 20, a colonoscopy support system 30, a display device 41, an input device 42, and a storage device 43 are used. The endoscope 1, according to this embodiment, is a colonoscope inserted into the large intestine of a subject (patient).

[0014] The endoscope 11 includes a lens and a solid-state imaging device (for example, a CMOS image sensor, a CCD image sensor, or a CMD image sensor). The solid-state imaging device converts the light condensed by the lens into an electrical signal and outputs it to the endoscope system 10 as an endoscope image (electrical signal). The endoscope 11 includes a forceps channel. The operator (doctor) can perform various procedures during the colonoscopy by passing a treatment tool through the forceps channel.

[0015] The light source device 15 includes a light source such as a xenon lamp and supplies observation light (white light, narrow-band light, fluorescence, near-infrared light, etc.) to the distal end portion of the endoscope 11. The light source device 15 also incorporates a pump for sending water and air to the endoscope 11.

[0016] The endoscope system 10 controls the light source device 15 and processes the endoscopic images input from the endoscope 11. The endoscope system 10 is equipped with functions such as narrow band imaging (NBI), red dichromatic imaging (RDI), texture and color enhancement imaging (TXI), and extended depth of field (EDOF).

[0017] In narrow band imaging, by irradiating light of specific wavelengths of purple (415 nm) and green (540 nm) that are strongly absorbed by hemoglobin in the blood, an endoscopic image in which capillaries and fine structures on the mucosal surface are emphasized can be obtained. In red dichromatic imaging, by irradiating light of specific wavelengths of three colors (green, amber, red), an endoscopic image in which the contrast of deep tissues is emphasized can be obtained. In texture and color enhancement imaging, an endoscopic image is generated in which the three elements of "structure", "color tone", and "brightness" of the mucosal surface under normal light observation are optimized. In extended depth of field, by synthesizing two images focused on near and far distances respectively, an endoscopic image with a wide focus range can be obtained.

[0018] The endoscope system 10 outputs the endoscopic image processed from the endoscopic image input from the endoscope 1十一, or the endoscopic image input from the endoscope 11 as it is, to the endoscope examination support system 30.

[0019] The endoscopic insertion shape observation device 20 is a device for observing the three-dimensional shape of the endoscope 11 inserted into the lumen of the subject. A receiving antenna 20a is connected to the endoscopic insertion shape observation device 20. The receiving antenna 20a is an antenna for detecting the magnetic field generated by a plurality of magnetic coils built into the endoscope 11.

[0020] Figure 2 shows an example of an endoscope 11 used in this embodiment. The endoscope 11 has an elongated tubular insertion section 11a made of a flexible material and an operating section 11e connected to the base end of the insertion section 11a. The insertion section 11a has a rigid tip section 11b, a curved section 11c, and a flexible tube section 11d, from the tip side to the base end side. The base end of the rigid tip section 11b is connected to the tip of the curved section 11c, and the base end of the curved section 11c is connected to the base end of the flexible tube section 11d.

[0021] The operating section 11e has a main body 11f from which a flexible tube section 11d extends, and a gripping section 11g connected to the base end of the main body section 11f. The gripping section 11g is grasped by the operator. A universal cord, including an imaging electrical cable and a light guide, extends from the insertion section 11a and is connected to the endoscope system 10 and the light source device 15.

[0022] The rigid tip section 11b is the tip of the insertion section 11a and also the tip of the endoscope 11. The rigid tip section 11b houses a solid-state image sensor, illumination optics, observation optics, etc. Illumination light emitted from the light source device 15 propagates along the light guide to the tip surface of the rigid tip section 11b and is irradiated from the tip surface of the rigid tip section 11b toward the object to be observed inside the lumen.

[0023] The curved section 11c is formed by connecting nodal rings along the longitudinal axis of the insertion section 11a. The curved section 11c bends in a desired direction in response to the operator's operation input to the operating section 11e, and the position and orientation of the rigid tip section 11b change according to this bending.

[0024] The flexible tube section 11d is a tubular member extending from the main body section 11f of the operating section 11e, possessing the desired flexibility and bending in response to external force. The operator inserts the insertion section 11a into the subject's large intestine while bending the curved section 11c and twisting the flexible tube section 11d.

[0025] Multiple magnetic coils 12 are arranged inside the insertion section 11a along the longitudinal direction at predetermined intervals (for example, 10 cm intervals). Each magnetic coil 12 generates a magnetic field when current is supplied to it. The multiple magnetic coils 12 function as position sensors to detect the positions of each part of the insertion section 11a.

[0026] Returning to Figure 1, the receiving antenna 20a receives magnetic fields emitted from multiple magnetic coils 12 built into the insertion section 11a of the endoscope 11 and outputs them to the endoscope insertion shape observation device 20. The endoscope insertion shape observation device 20 applies the magnetic field strength of each of the multiple magnetic coils 12 received by the receiving antenna 20a to a predetermined position detection algorithm to estimate the three-dimensional position of each of the multiple magnetic coils 12. The endoscope insertion shape observation device 20 generates the three-dimensional endoscope shape of the insertion section 11a of the endoscope 11 by performing curve interpolation on the estimated three-dimensional positions of the multiple magnetic coils 12.

[0027] The reference plate 20b is attached to the subject (for example, the subject's abdomen). The reference plate 20b is equipped with a position sensor for detecting the subject's posture. For example, a 3-axis accelerometer or a gyroscope can be used as the position sensor. In Figure 1, the reference plate 20b is connected to the endoscope insertion shape observation device 20 by a cable, and the reference plate 20b outputs 3D posture information indicating the posture of the reference plate 20b (i.e., the posture of the subject) to the endoscope insertion shape observation device 20.

[0028] Furthermore, multiple magnetic coils, similar to the multiple magnetic coils 12 built into the insertion section 11a of the endoscope 11, may be used as the body position sensor placed on the reference plate 20b. In this case, the receiving antenna 20a receives the magnetic field emitted from the multiple magnetic coils placed on the reference plate 20b and outputs it to the endoscope insertion shape observation device 20. The endoscope insertion shape observation device 20 applies the magnetic field strength of each of the multiple magnetic coils received by the receiving antenna 20a to a predetermined posture detection algorithm to generate three-dimensional posture information indicating the posture of the reference plate 20b (i.e., the posture of the subject).

[0029] The endoscope insertion shape observation device 20 changes the generated 3D endoscope shape in accordance with changes in 3D posture information. Specifically, the endoscope insertion shape observation device 20 changes the 3D endoscope shape in a way that cancels out changes in 3D posture information. As a result, even if the subject's position is changed during the endoscopic examination, the endoscope shape can always be recognized from a specific viewpoint (for example, a viewpoint that looks at the subject's abdomen perpendicularly from the front of the abdomen).

[0030] The endoscope insertion shape observation device 20 can obtain the insertion length, which indicates the length of the portion of the endoscope 11 inserted into the large intestine, and the elapsed time since the endoscope 11 was inserted into the large intestine (hereinafter referred to as the insertion time). For example, the endoscope insertion shape observation device 20 measures the insertion length using the position at the time the operator inputs the examination start operation to the input device 42 as the starting point, and measures the insertion time from that timing. Alternatively, the endoscope insertion shape observation device 20 may estimate the position of the anus from the generated 3D endoscope shape and the difference in magnetic field strength between the magnetic coil inside the body and the magnetic field coil outside the body, and use the estimated position of the anus as the starting point for the insertion length.

[0031] Furthermore, an encoder may be installed near the anus of the subject in order to measure the insertion length with high precision. The endoscope insertion shape observation device 20 detects the insertion length based on the position of the anus, using the signal from the encoder as the reference point.

[0032] The endoscope insertion shape observation device 20 outputs the 3D endoscope shape after body position correction based on 3D posture information, along with the insertion length and insertion time, to the endoscopy support system 30.

[0033] The endoscopic examination support system 30 generates support information for endoscopic examinations based on the endoscopic images input from the endoscopic system 10 and the endoscopic shape input from the endoscopic insertion shape observation device 20, and presents it to the operator. The endoscopic examination support system 30 also generates endoscopic examination history information based on the endoscopic images input from the endoscopic system 10 and the endoscopic shape input from the endoscopic insertion shape observation device 20, and records it in the storage device 43.

[0034] The display device 41 is equipped with an LCD monitor or an OLED monitor and displays images input from the endoscopic examination support system 30. The input device 42 is equipped with a mouse, keyboard, touch panel, etc., and outputs operation information entered by the operator, etc., to the endoscopic examination support system 30. The storage device 43 is equipped with a storage medium such as an HDD or SSD and stores endoscopic examination history information generated by the endoscopic examination support system 30. The storage device 43 may be a dedicated storage device attached to the endoscopic system 10, a database on an in-hospital server connected via the in-hospital network, or a database on a cloud server.

[0035] Figure 3 shows an example configuration of the endoscopic examination support system 30 according to an embodiment. The endoscopic examination support system 30 may be constructed using a dedicated processing unit for endoscopic examination support, or it may be constructed using a general-purpose server (which may be a cloud server). Furthermore, the endoscopic examination support system 30 may be constructed using any combination of a dedicated processing unit for endoscopic examination support, a general-purpose server (which may be a cloud server), and a dedicated image diagnostic device. In addition, the endoscopic examination support system 30 may be constructed integrally with the endoscopic system 10.

[0036] The endoscopic examination support system 30 includes an endoscope shape acquisition unit 31, an endoscope image acquisition unit 32, an operation information acquisition unit 33, an image recognition unit 34, a reference position determination unit 35, a recording timing determination unit 36, a display control unit 37, and a recording control unit 38. These components can be implemented in hardware terms by any at least one processor (e.g., CPU, GPU), memory (e.g., DRAM), or other LSI (e.g., FPGA, ASIC), and in software terms by a program loaded into memory, etc., but here we are describing functional blocks that are realized through the cooperation of these components. Therefore, it will be understood by those skilled in the art that these functional blocks can be implemented in various ways by hardware alone, software alone, or a combination thereof.

[0037] The endoscope shape acquisition unit 31 acquires the endoscope shape from the endoscope insertion shape observation device 20. The endoscope shape also includes information on insertion length and insertion time. The endoscope image acquisition unit 32 acquires endoscope images from the endoscope system 10.

[0038] The image recognition unit 34 has multiple machine learning models for detecting the location of the large intestine, the state of the lumen of the large intestine, and lesions from endoscopic images. These multiple machine learning models are generated by machine learning using a supervised dataset consisting of numerous endoscopic images, each annotated with various locations, states, and lesions. Annotations are provided by annotators with specialized knowledge, such as physicians. Machine learning can utilize deep learning techniques such as CNN, RNN, and LSTM.

[0039] The parts of the large intestine can be broadly classified, in order from the anal side, into the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, and cecum. The image recognition unit 34 can input endoscopic images into a site learning model to detect parts of the large intestine from the endoscopic images. In this case, the image recognition unit 34 may identify the parts based on the detection results of multiple endoscopic images that are consecutive in time series. For example, if the same part is detected in a set number of frames or more out of 30 or 60 consecutive endoscopic images, the image recognition unit 34 will identify that part as the officially detected part.

[0040] The image recognition unit 34 may also identify the location by considering the spatial relationship of the detected site or the shape of the endoscope obtained from the endoscope insertion shape observation device 20. For example, the image recognition unit 34 determines whether the direction of movement of the endoscope 11 is the insertion direction (anus → cecum) or the withdrawal direction (cecum → anus). In the case of insertion, if a left colic flexure is detected, the image recognition unit 34 switches the detection site from the descending colon to the transverse colon, and if a right colic flexure is detected, it switches the detection site from the transverse colon to the ascending colon. In the case of insertion, if a right colic flexure is detected, the image recognition unit 34 switches the detection site from the ascending colon to the transverse colon, and if a left colic flexure is detected, it switches the detection site from the transverse colon to the descending colon.

[0041] Furthermore, the image recognition unit 34 may improve the accuracy of site detection by considering the three-dimensional position of the hard tip portion 11b (hereinafter referred to as the endoscope tip) based on the endoscope shape obtained from the endoscope insertion shape observation device 20. For example, if the position of the endoscope tip estimated from the endoscope shape and the position of the detected site based on image recognition are inconsistent, the image recognition unit 34 discards the detection result based on image recognition.

[0042] Furthermore, the image recognition unit 34 can input endoscopic images into a lumen state learning model to determine the lumen state from the endoscopic images. For example, the image recognition unit 34 can detect the presence or absence of folds above a predetermined height and the presence or absence of diverticula. The image recognition unit 34 can also input endoscopic images into a lesion learning model to detect candidate lesions from the endoscopic images.

[0043] The image recognition unit 34 may also check the image quality of the endoscopic image prior to recognizing the target image. The image recognition unit 34 excludes endoscopic images that it determines to have poor image quality (e.g., blur, out of focus, brightness abnormalities (e.g., halation)) from the target image recognition.

[0044] The reference position determination unit 35 determines the endoscope shape to be the reference position from the endoscope shape continuously acquired from the endoscope insertion shape observation device 20. The reference position is determined to be the position reached when the deepest part is reached during a colonoscopy. Normally, the deepest part during a colonoscopy is the cecum. However, depending on the operator, the endoscope 11 may be inserted all the way to the ileum. Also, depending on the subject, it may not be possible to insert the endoscope 11 all the way to the cecum, and the ascending colon may be the deepest part during a colonoscopy.

[0045] The reference position determination unit 35 determines, for example, the position at which the insertion length obtained from the endoscope insertion shape observation device 20 reaches its maximum length as the position at which the deepest part is reached. Alternatively, the reference position determination unit 35 may determine the position at which the deepest part is reached as the position where the cecum is detected in the endoscopic image taken by the image recognition unit 34. Alternatively, the reference position determination unit 35 may determine the position at which the deepest part is reached as the position at which the operator inputs the insertion completion operation to the input device 42.

[0046] The recording timing determination unit 36 ​​determines the recording timing for the endoscopic image and the endoscopic shape. For example, the recording timing determination unit 36 ​​determines the timing when the operator presses the capture button (release button) on the control unit 11e as the recording timing. If a microphone is installed in the operator's pharynx or elsewhere, the operator can also indicate the recording timing by voice. Alternatively, the recording timing determination unit 36 ​​may determine the timing of capturing the endoscopic image in which a lesion candidate has been detected by the image recognition unit 34 as the recording timing.

[0047] The recording timing determination unit 36 ​​may also automatically determine the recording timing based on predetermined rules. Automatic recording of endoscopic images and endoscope shapes is used to generate an examination digest. Generally, in colonoscopy, observation and procedures are performed while the endoscope 11 is inserted to the cecum and then withdrawn toward the anus. The recording timing determination unit 36 ​​may, for example, set the recording timing each time the insertion length increases by a predetermined interval (for example, several centimeters). Alternatively, the recording timing determination unit 36 ​​may set the recording timing each time a predetermined time has elapsed since withdrawal.

[0048] The recording timing determination unit 36 ​​may change the frequency of automatic recording according to the site or intraluminal condition detected by the image recognition unit 34. For example, the recording timing determination unit 36 ​​increases the frequency of automatic recording when passing through a site where lesions are likely to occur. The recording timing determination unit 36 ​​also increases the frequency of automatic recording when passing through an area with poor intraluminal conditions. Furthermore, sites where the frequency of automatic recording is to be increased may be set in advance based on the subject's medical history and epidemiological findings.

[0049] The recording timing determination unit 36 ​​may determine the recording timing to be at least one or all of the following: timing based on the operator's operation, timing based on the detection of a lesion candidate by the image recognition unit 34, and timing based on automatic settings.

[0050] When displaying examination information including endoscopic images, the display control unit 37 can simultaneously display two endoscopic shapes on the display device 41: the endoscopic shape at the deepest point and the endoscopic shape at a specific recording timing. The display control unit 37 may also display the two endoscopic shapes when a predetermined operation is input to the input device 42. The display control unit 37 may display the two endoscopic shapes aligned on a single graph, or they may be displayed side by side on two separate graphs.

[0051] The display control unit 37 can display two endoscope shapes in real time during the examination. If a lesion candidate is detected by the image recognition unit 34 during the examination, the display control unit 37 superimposes a mark surrounding the lesion candidate on the endoscope image in which the lesion candidate was detected. This reduces the risk of missing lesions. An alert sound may also be output from the speaker.

[0052] Incidentally, during an endoscopic examination, the subject may change position according to the operator's instructions or move slightly on their own. Position changes are performed to facilitate the insertion and observation of the endoscope 11. As a result, the position and orientation of the endoscope may shift relative to the coordinate space based on the position and orientation of the examination room or examination table (bed).

[0053] In contrast, in the example shown in Figure 1, a reference plate 20b was attached to the subject to detect the subject's position and orientation, and the position and orientation of the endoscope shape were corrected based on the detection results. However, there are many cases in which colonoscopy is performed without using the reference plate 20b. Even in such cases, if the insertion length is greater than a predetermined value, the position and orientation of the endoscope shape can be corrected by matching the endoscope shape with the arrangement model of the colon lumen. This is particularly effective during withdrawal, as the shape of the insertion section 11a will generally match the arrangement of the colon lumen. This correction may be performed with the endoscope insertion shape observation device 20 or with the endoscopy support system 30.

[0054] The recording control unit 38 records examination information, including endoscopic images acquired during the examination, in the storage device 43, associating the endoscopic shape at the deepest point with the endoscopic shape at at least one recording timing. Since the endoscopic shape at the deepest point is common for each case, it is sufficient to record it in a way that is associated with the case. The format of the data of the endoscopic shape to be recorded is not restricted. For example, it may be a mathematical formula for calculating the shape, point cloud data to show the shape, or image data viewed from one or more directions.

[0055] When a physician reviews the examination information after an endoscopic examination, the examination information recorded in the storage device 43 is read into the endoscopic examination support system 30. The display control unit 37 displays two types of endoscope shapes on the display device 41: the endoscope shape at the time of reaching the deepest point, which is associated with the examination information, and the endoscope shape at at least one recording timing. In some cases, the examination information may be selected, formatted, or transferred to another database before being displayed on the monitor of another PC. In that case as well, the two types of endoscope shapes—the endoscope shape at the time of reaching the deepest point and the endoscope shape at at least one recording timing—are displayed on the monitor simultaneously.

[0056] In this way, the display control unit 37 and the recording control unit 38 can each acquire, during an endoscopic examination, the first endoscopic shape when the tip of the endoscope is located at a predetermined site, the endoscopic image taken during the endoscopic examination, and the second endoscopic shape when the endoscopic image was taken. This makes it possible to present the endoscopic image simultaneously with the second endoscopic shape when the endoscopic image was taken and the first endoscopic shape when the tip of the endoscope is located at a predetermined site. The first and second endoscopic shapes are different shapes from each other. The predetermined site may be the deepest part during the endoscopic examination. In this case, the endoscopic shape when the tip of the endoscope is located at the deepest part during the endoscopic examination can be determined as the first endoscopic shape. The predetermined site may be the cecum. In this case, the first endoscopic shape can be determined when the deepest part during the endoscopic examination is the cecum.

[0057] During a colonoscopy, the insertion portion 11a of the endoscope 11 is inserted into the winding intestinal tract of the large intestine. At this time, the position of the unfixed portion of the intestinal tract changes or expands and contracts within the body, so even in the same patient, the insertion shape of the endoscope 11 may change depending on the doctor, the insertion technique, or from examination to examination. However, the internal position of portions fixed to the patient's body, such as the ascending colon and descending colon, does not change significantly. The cecum, which is the end of the large intestine, is at the end of these fixed portions and its position within the body changes little.

[0058] The cecum is the deepest part of the large intestine and is the target area for physicians during colonoscopy. In practice, the endoscope 11 is sometimes inserted all the way to the ileum, the end of the small intestine, but the cecum is one of the sites that can serve as a relatively stable reference point during examination, as it is located at the end of the ascending colon, which is the fixed part. In addition, in cases where insertion to the cecum is not possible due to insertion difficulties, the deepest part can serve as one of the reference points.

[0059] Knowing the insertion shape of the insertion section 11a of the endoscope 11 up to the cecum or the deepest part allows for confirmation of the individual differences in the arrangement of the patient's large intestine tract and the degree of endoscope 11 insertion during the examination. Therefore, it is effective to define the shape of the endoscope when the tip of the endoscope is located in the cecum or the deepest part as the first endoscope shape.

[0060] On the other hand, when withdrawing the endoscope 11 from the deepest part, for example, the cecum, even if the intestinal tract was inserted in a bent shape, the bent portion is straightened and the degree of bending is reduced. As a result, the intestinal tract at the time of withdrawal becomes a shape with less bending, while still being based on its original arrangement. It is thought that the shape and arrangement of the intestinal tract becomes more stable compared to when it was inserted. At that time, it is thought that the tip of the insertion portion 11a of the endoscope 11 follows a route or traces a path with less variation compared to when it was inserted. Furthermore, even if the route or trace traced by the tip of the insertion portion 11a of the endoscope 11 does not become a single, fixed, stable one, it is thought that the route or trace is generally determined by the shape of the insertion portion 11a of the endoscope 11 when it reaches the cecum.

[0061] The reference position determination unit 35 determines that the tip of the endoscope is located at a predetermined location based on at least one of the endoscopic image, the shape of the endoscope, and the insertion length of the endoscope. The display control unit 37 and the recording control unit 38 each acquire the shape of the endoscope when the tip of the endoscope is located at the predetermined location as the first endoscope shape. In this case, the first endoscope shape can be acquired automatically. Alternatively, the display control unit 37 and the recording control unit 38 may each acquire the shape of the endoscope at the time when the reference position determination unit 35 acquires the endoscope insertion completion signal based on the operator's operation as the first endoscope shape. In this case, the first endoscope shape that matches the operator's intention can be acquired.

[0062] The recording control unit 38 can associate the first endoscope shape, the captured endoscope image, and the second endoscope shape corresponding to the endoscope image, and record them in the storage device 43. This makes it possible to present the endoscope image after the examination simultaneously with the second endoscope shape at the time the endoscope image was captured and the first endoscope shape when the endoscope tip was located at a predetermined site.

[0063] The display control unit 37 can simultaneously display the first endoscope shape and the second endoscope shape on the display device 41. This allows the operator or physician to intuitively grasp the relative position of the second endoscope shape when the endoscopic image was taken. In this case, the display control unit 37 can display the first endoscope shape and the second endoscope shape on a single graph. This allows the operator or physician to grasp the relative position of the second endoscope shape when the endoscopic image was taken more accurately. Furthermore, the display control unit 37 can simultaneously display the first endoscope shape, the second endoscope shape, and the endoscopic image corresponding to the second endoscope shape on the display device 41. This allows the operator or physician to simultaneously grasp the endoscopic image and the relative position of the second endoscope shape when the endoscopic image was taken.

[0064] As a result, at the time of withdrawal, the positions of the tips of the first and second endoscope shapes on the intestinal tract are displayed with relatively good reproducibility. Therefore, based on the first endoscope shape positioned deeper and its tip position, the position and placement of the tip of the second endoscope shape within the intestinal tract can be confirmed with relatively good reproducibility from the position of the second endoscope shape at the point of withdrawal. These results can be confirmed during and after the examination. Therefore, it can serve as position identification information when recording the location of lesions, etc. during the examination, and as reproducible guide information when approaching the same lesions, etc. in subsequent examinations and procedures. In particular, by using images taken when the second endoscope shape is in place, the position identification and re-approach of lesions, etc. become easier, and it becomes possible to reliably determine that it is in that location.

[0065] Furthermore, even if the second endoscopic shape is obtained during the insertion of the endoscope 11, recording it in comparison with the shape at the deepest point or when reaching the cecum, as a record of insertion in difficult-to-insert areas, is useful for individual examinations and patient records, as it allows for confirmation of the tip position, insertion shape, and events at that position.

[0066] Figure 4 shows an example screen 1 displayed on the display device 41. The following example screen is intended for use when a physician checks examination information after an examination, but similar screen displays are possible during the examination. During the examination, each time the operator takes an endoscopic image, the endoscopic image and the shape of the endoscope at the time of acquisition are added to the screen.

[0067] In Screen Example 1, the endoscope shape B1 at the time of cecum arrival and multiple endoscope shapes B2-B8 at the time of imaging are displayed simultaneously on a graph positioned in the center. The display control unit 37 aligns and displays a specific part of the endoscope shape B1 with specific parts of the multiple endoscope shapes B2-B8. The specific part may be the part of the subject to which the endoscope 11 is inserted (in the case of a colonoscopy, the anus). This allows the multiple endoscope shapes B2-B8 (second endoscope shapes) at the time of imaging to be positioned in a manner consistent with reality, relative to the endoscope shape B1 (first endoscope shape) at the time of cecum arrival. Marks C1-C8 indicating the imaging position are added to the tips of the endoscope shape B1 at the time of cecum arrival and the multiple endoscope shapes B2-B8 at the time of imaging, respectively.

[0068] Multiple endoscopic images A1-A8 are displayed surrounding a graph positioned in the center. Endoscopic image A1 in the lower left is the image taken when the endoscopic probe reached the cecum, and multiple endoscopic images A2-A8 are arranged clockwise in order of withdrawal direction. Each of the endoscopic images A1-A8 displays the insertion length and insertion time (elapsed time from the start of insertion).

[0069] The display control unit 37 acquires multiple endoscopic images A2-A8 and multiple endoscopic shapes B2-B8 corresponding to each of the multiple endoscopic images A2-A8, and displays the multiple endoscopic images A2-A8 and the multiple endoscopic shapes B2-B8 simultaneously with the endoscopic shape B1 on the display device 41. By displaying the multiple endoscopic images A2-A8, the multiple endoscopic shapes B2-B8 (second endoscopic shapes), and the endoscopic shape B1 (first endoscopic shape) in a list, it becomes easier for the operator or physician to grasp the overall picture of the endoscopic examination.

[0070] If the endoscope insertion shape observation device 20 does not perform correction for changes in the subject's body position, the display control unit 37 estimates the changes in the subject's position and orientation from the acquired changes in the endoscope shape, and based on the estimation results, performs alignment and orientation adjustment of the endoscope shape B1 and the multiple endoscope shapes B2-B8. The display control unit 37 simultaneously displays the endoscope shape B1 and the multiple endoscope shapes B2-B8 after alignment and orientation adjustment on the display device 41. This makes it possible to always display the endoscope shape from a specific viewpoint (for example, a viewpoint that looks perpendicular to the subject's abdomen from the front) while positioning the endoscope shape B1 when it reaches the cecum (first endoscope shape) and the multiple endoscope shapes B2-B8 at the time of imaging (second endoscope shapes) in a position that reflects reality.

[0071] In the example shown in Figure 4, potential lesions are detected in three endoscopic images A2, A3, and A6. Marks D2, D3, and D6, which circle the respective potential lesions, are superimposed on the three endoscopic images A2, A3, and A6. Among the marks C1-C8 that indicate the shooting locations of multiple endoscopic shapes B1-B8, marks C1, C4-C5, and C7-C8 that indicate the shooting locations of endoscopic shapes B1, B4-B5, and B7-B8 associated with endoscopic images A1, A4-A5, and A7-A8 in which no potential lesions were detected are displayed as circles, while marks C2, C3, and C6 that indicate the shooting locations of endoscopic shapes B2, B3, and B6 associated with endoscopic images A2, A3, and A6 in which potential lesions were detected are displayed as stars.

[0072] The display control unit 37 acquires endoscopic images A2, A3, and A6 in which lesion candidates were detected, and the endoscopic shapes B2, B3, and B6 at the time the endoscopic images A2, A3, and A6 were taken. This allows for the acquisition of highly important endoscopic images and their endoscopic shapes as display targets. The display control unit 37 simultaneously displays the endoscopic shapes B2, B3, and B6, along with marks C2, C3, and C6 indicating the detection of lesion candidates located at the tip of the endoscopic shapes B2, B3, and B6, on the display device 41. This makes it easier for operators and physicians to understand the location where the endoscopic images in which lesion candidates were detected were taken.

[0073] The example shown in Figure 4 illustrates the shape of the endoscope as seen from a ceiling perspective, with the subject in a supine position on the examination table. As will be discussed later, the shape of the endoscope may also be displayed from two or three different viewpoints, or from an oblique angle as a perspective view. Displaying the shape of the endoscope at the time of withdrawal in this way makes it possible to clearly show the location within the colon lumen where the tip of the endoscope is located.

[0074] Figure 5 shows an example screen 2 displayed on the display device 41. Example screen 2 is an example screen that appears when an endoscope image A7 is selected by a user, such as a physician, via click or touch operation, as shown in Example screen 1 in Figure 4. The left side of the screen displays the endoscope image A7 that the user has focused on, and the right side of the screen displays a single graph that simultaneously plots the endoscope shape B7 at the time of image acquisition and the endoscope shape B1 at the time of cecal inclusion. Below the graph, the insertion length at the time of image acquisition (18 cm) and the insertion length at the time of cecal inclusion (68 cm) are displayed. Note that the graph on the right and the table of insertion lengths may be displayed only when a predetermined operation is performed on the endoscope image A7 by the user, in order to simplify the screen display.

[0075] The display control unit 37 displays the endoscopic image A7 selected by the user from a plurality of endoscopic images A2-A8, and the endoscopic shape B7 corresponding to the selected endoscopic image A7, on the display device 41 simultaneously with the endoscopic shape B1. This makes it possible to generate a screen that focuses on the information of the endoscopic image of interest to the user. In this case, the display control unit 37 may also display the insertion length corresponding to the endoscopic shape B1 and the insertion length corresponding to the endoscopic shape B7 on the display device 41 simultaneously with the endoscopic shape B1 and the endoscopic shape B7. Displaying the insertion length simultaneously increases the amount of information presented to the user. The display control unit 37 may also display the insertion time corresponding to the endoscopic shape B1 and the insertion time corresponding to the endoscopic shape B7 on the display device 41 simultaneously with the endoscopic shape B1 and the endoscopic shape B7. Displaying the insertion time simultaneously increases the amount of information presented to the user.

[0076] Figure 6 shows an example screen 3 displayed on the display device 41. In example screen 3, only the endoscopic shape B11 at the time of cecum arrival is displayed on the three-dimensional graph located in the center. Multiple endoscopic images A11-A21 are displayed surrounding the graph located in the center. Multiple endoscopic images A11-A21 may be thumbnail images. Endoscopic image A11 in the lower left is the endoscopic image at the time of cecum arrival, and multiple endoscopic images A12-A21 are arranged clockwise in order of withdrawal direction. Marks C11-C21 indicating the respective shooting positions of the multiple endoscopic images A11-A21 are added to the endoscopic shape B11 at the time of cecum arrival.

[0077] Figure 7 shows an example screen 4 displayed on the display device 41. Example screen 4 is an example screen that is displayed when the user selects endoscopic image A18 in example screen 3 shown in Figure 6. On the left side of the screen, the endoscopic image A18 that the user has focused on is displayed, and on the right side of the screen, a single graph is displayed that simultaneously plots the endoscopic shape B18 at the time of capturing endoscopic image A18 and the endoscopic shape B11 at the time of reaching the cecum. Below the graph, the insertion length (23 [cm]) at the time of capturing endoscopic image A18 is displayed. Note that the example screens shown in Figure 6 and Figure 7 may be displayed on a single screen.

[0078] The display control unit 37 can switch between a first display mode in which the endoscope shape B11, multiple endoscope images A11-A21, and marks C11-C21 indicating the respective shooting positions of the multiple endoscope images A11-A21 placed on the endoscope shape B11 are displayed on the display device 41, and a second display mode in which the endoscope image A18 selected by the user, the endoscope shape B18 corresponding to the selected endoscope image A18, and the endoscope shape B11 are simultaneously displayed on the display device 41. This improves the user's visibility or operability.

[0079] Figure 8 shows an example screen 5 displayed on the display device 41. In example screen 5, the insertion length line E1 generated by straightening the endoscope shape B11 at the time of cecal inclusion shown in Figure 6 is displayed, and multiple endoscope images A11-A21 are displayed above the insertion length line E1, parallel to the insertion length line E1. Multiple endoscope images A11-A21 may be thumbnail images. The leftmost endoscope image A11 is the endoscope image at the time of cecal inclusion, and multiple endoscope images A12-A21 are arranged to the right in order of withdrawal direction. Marks C11-C21 indicating the respective shooting positions of the multiple endoscope images A11-A21 are added to the insertion length line E1. When the user selects any of the endoscope images A11-A21, the screen transitions to an example screen as shown in Figure 7.

[0080] The display control unit 37 can switch between a third display mode, in which the endoscope shape B11, multiple endoscope images A11-A21, and marks C11-C21 indicating the respective shooting positions of the multiple endoscope images A11-A21, which are arranged on an insertion length line E1 generated by straightening the endoscope shape B11, and the second display mode. This improves the user's visibility and operability.

[0081] Figure 9 shows an example screen 6 displayed on the display device 41. In example screen 6, an insertion time line E2 is displayed, which is generated by straightening the endoscope shape B11 at the time of cecum arrival shown in Figure 6. Above the insertion time line E2, multiple endoscope images A11-A21 are displayed parallel to the insertion time line E2. The multiple endoscope images A11-A21 may be thumbnail images. The leftmost endoscope image A11 is the endoscope image at the time of cecum arrival, and multiple endoscope images A12-A21 are arranged to the right in order of withdrawal direction. Marks C11-C21 indicating the timing of each image A11-A21 are added to the insertion time line E2. In the example shown in Figure 9, the insertion time at the time of cecum arrival is 4:26 elapsed from the start of insertion, and the insertion time is counted up from there until withdrawal is complete. When the user selects any of the endoscope images A11-A21, the screen transitions to an example screen as shown in Figure 7.

[0082] The display control unit 37 can switch between a fourth display mode, in which the endoscope shape B11, multiple endoscope images A11-A21, and marks C11-C21 indicating the respective acquisition timings of the multiple endoscope images A11-A21, which are placed on an insertion time line E2 generated by straightening the endoscope shape B11, on the display device 41, and the second display mode described above. This improves the user's visibility and operability.

[0083] Figures 10(a)-(c) show examples of multiple endoscope shapes displayed using triangulation projection from three directions. In Figures 10(a)-(c), the subject is in a supine position, with the y-direction being the longitudinal direction, the x-direction being the short-direction, and the z-direction being the thickness direction. Figure 10(a) shows an example of plotting multiple endoscope shapes on an xy coordinate system. The left side of the x-axis represents the direction of the right abdomen, the right side of the x-axis represents the direction of the left abdomen, the upper side of the y-axis represents the direction of the chest, and the lower side of the y-axis represents the direction of the feet. Figure 10(b) shows an example of plotting multiple endoscope shapes on a zy coordinate system. The left side of the z-axis represents the direction of the abdomen, the right side of the z-axis represents the direction of the back, the upper side of the y-axis represents the direction of the chest, and the lower side of the y-axis represents the direction of the feet. Figure 10(c) shows an example of plotting multiple endoscope shapes on an xz coordinate system. The left side of the x-axis represents the direction of the right abdomen, the right side of the x-axis represents the direction of the left abdomen, the upper side of the z-axis represents the direction of the abdomen, and the lower side of the z-axis represents the direction of the back.

[0084] Figure 11 shows an example of a bird's-eye perspective view of the 3D endoscopic shape B31 upon reaching the cecum. In the figure, a coordinate system is used with the origin at the position corresponding to the anus, which is the starting point for insertion into the body. The coordinate system also has scales representing actual dimensions. The viewpoint direction and scale can be changed as appropriate by the operator to confirm the 3D endoscopic shape B31. In addition, multiple endoscopic shapes taken during imaging, as shown in Figure 4, may also be displayed simultaneously on the same 3D graph. Furthermore, the method of setting the coordinate system and displaying dimensions can be anything. For example, the display of the coordinate system may be omitted, the origin may not be set to the position of the anus, the display of dimensions may be omitted, or only the scale may be displayed.

[0085] Figure 12 is a flowchart showing an example of the operation of the endoscopic examination support system 30 according to the embodiment at the end of the examination. The recording control unit 38 acquires the shape of the endoscope when it reaches the deepest point (S10). The recording control unit 38 acquires multiple endoscopic images taken by the operator and multiple endoscopic shapes corresponding to the timing of each image (S11). The recording control unit 38 associates the shape of the endoscope when it reaches the deepest point, the multiple endoscopic images taken by the operator, and the multiple endoscopic shapes corresponding to the timing of each image, and records them in the storage device 43 (S12).

[0086] Figure 13 is a flowchart illustrating an example of the operation of the endoscopic examination support system 30 according to the embodiment when confirming examination information. The display control unit 37 reads from the storage device 43 the endoscope shape at the time of reaching the deepest point, multiple endoscope images taken by the operator, and multiple endoscope shapes corresponding to the timing of each image, which are recorded in association with the storage device 43 (S20). The display control unit 37 displays a digest of the read endoscope images on the display device 41 (S21). The display control unit 37 displays the endoscope image selected by the user, the endoscope shape corresponding to that endoscope image, and the endoscope shape at the time of reaching the deepest point on the display device 41 (S22).

[0087] As described above, according to this embodiment, by simultaneously displaying the shape of the endoscope when it reaches the deepest point and the shape of the endoscope at the time of imaging, it becomes easier to re-access the lesion or candidate lesion with the endoscope 11. The operator can more accurately grasp the location of the lesion or candidate lesion within the colonic lumen, and re-access becomes easier. Furthermore, by adopting the various display modes described above, the user's visibility or operability can be improved.

[0088] The present disclosure has been described above based on several embodiments. These embodiments are illustrative, and it will be understood by those skilled in the art that various modifications are possible in combinations of their components and processing processes, and that such modifications are also within the scope of the present disclosure.

[0089] In the above embodiment, an example was described in which the shape of the endoscope is estimated by incorporating multiple magnetic coils into the endoscope 11. However, the shape of the endoscope may also be estimated by incorporating multiple shape sensors into the endoscope 11. The shape sensor may be, for example, a fiber sensor that detects the bending shape from the curvature of a specific location using an optical fiber. The fiber sensor may have, for example, an optical fiber arranged along the longitudinal direction of the insertion section 11a, and the optical fiber may be provided with multiple photodetectors along its longitudinal direction. Detection light is supplied to the optical fiber from a detection light emitter, and the shape of the endoscope is estimated based on the change in the amount of light detected by each photodetector as the detection light propagates through the optical fiber. [Explanation of Symbols]

[0090] 10...Endoscope system, 11...Endoscope, 11a...Insertion section, 11b...Hard tip section, 11c...Bending section, 11d...Flexible tube section, 11e...Operation section, 11f...Main body section, 11g...Gripping section, 12...Magnetic coil, 15...Light source device, 20...Endoscope insertion shape observation device, 20a...Receiving antenna, 20b...Reference plate, 30...Endoscope examination support system, 31...Endoscope shape acquisition unit, 32...Endoscope image acquisition unit, 33...Operation information acquisition unit, 34...Image recognition unit, 35...Reference position determination unit, 36...Recording timing determination unit, 37...Display control unit, 38...Recording control unit, 41...Display device, 42...Input device, 43...Storage device.

Claims

1. This is an endoscopic examination support system, One or more processors having hardware, Equipped with a storage medium that stores the program, The processor reads the program and executes the program to obtain the first endoscope insertion section shape when the endoscope is positioned at a predetermined location during an endoscopic examination. The first endoscope insertion section shape is determined to be the endoscope shape that should be used as the reference position. The endoscopic images taken during the aforementioned endoscopic examination are acquired, The shape of the endoscope at the time the aforementioned endoscope image was taken is acquired as the shape of the second endoscope insertion section. The shape of the first endoscope insertion section, the endoscope image, and the shape of the second endoscope insertion section are recorded in association with each other on the storage medium. When the user selects the endoscopic image, the second endoscope insertion section shape corresponding to the selected endoscopic image and the first endoscope insertion section shape are displayed on the display device. Endoscopy support system.

2. The aforementioned processor, A first mode in which the shape of the first endoscope insertion section, a plurality of the endoscope images, and the shooting positions of the endoscope images are simultaneously displayed on the display device, The system has a second mode in which the endoscope image selected by the user, the second endoscope insertion section shape corresponding to the endoscope image, and the first endoscope insertion section shape are simultaneously displayed on the display device. The endoscopic examination support system according to claim 1.

3. The aforementioned processor, The endoscopic examination support system according to claim 2, wherein the system switches from the first mode to the second mode when the user selects the endoscopic image.

4. The aforementioned processor, The shape of the first endoscope insertion section, the endoscope image, and the shape of the second endoscope insertion section are simultaneously displayed on the display device. The endoscopic examination support system according to claim 1, wherein when an endoscopic image is selected by the user, the second endoscopic insertion section shape corresponding to the selected endoscopic image and the first endoscopic insertion section shape are simultaneously displayed on the display device.

5. The aforementioned processor, The shape of the first endoscope insertion section is linearized and displayed on the display device. The endoscopic examination support system according to claim 1, which displays the endoscopic image on the display device in association with the insertion length.

6. The aforementioned processor, The shape of the first endoscope insertion section is linearized and displayed on the display device. The endoscopic examination support system according to claim 1, which displays the endoscopic image on the display device in relation to the insertion time.

7. The aforementioned processor, The endoscopic examination support system according to claim 1, wherein the position of the endoscope when it reaches the deepest part in the endoscopic examination is defined as the reference position.

8. The aforementioned processor, The endoscopic examination support system according to claim 1, wherein the cecum is the reference position.

9. The aforementioned processor, The endoscopic examination support system according to claim 1, wherein the position and orientation of the first endoscope insertion section shape and the second endoscope insertion section shape are aligned based on the acquired change in the shape of the second endoscope insertion section.

10. The aforementioned processor, The endoscopic examination support system according to claim 1, which detects candidate lesions from the endoscopic image and displays the endoscopic image in which the candidate lesions were detected and the shape of the second endoscopic insertion section on the display device.

11. A method for operating an endoscopic examination support system, The endoscope shape acquisition unit acquires the first endoscope insertion section shape when the endoscope is positioned at a predetermined location. The reference position determination unit determines the shape of the endoscope to be the first endoscope insertion section shape, The endoscopic image acquisition unit acquires endoscopic images taken during endoscopic examinations. The endoscope shape acquisition unit acquires the shape of the endoscope when the endoscope image is taken as the shape of the second endoscope insertion section. The recording control unit records the shape of the first endoscope insertion section, the endoscope image, and the shape of the second endoscope insertion section in association with each other on a storage medium. When the user selects the endoscope image, the display control unit displays the shape of the second endoscope insertion section corresponding to the selected endoscope image and the shape of the first endoscope insertion section on the display device. How to operate the endoscopic examination support system.

12. The display control unit, A first mode in which the shape of the first endoscope insertion section, a plurality of the endoscope images, and the shooting positions of the endoscope images are simultaneously displayed on the display device, The system has a second mode in which the endoscope image selected by the user, the second endoscope insertion section shape corresponding to the endoscope image, and the first endoscope insertion section shape are simultaneously displayed on the display device. A method for operating the endoscopic examination support system according to claim 11.

13. The display control unit, The method for operating an endoscopy support system according to claim 12, wherein the system switches from the first mode to the second mode when the user selects the endoscope image.

14. The display control unit, The shape of the first endoscope insertion section, the endoscope image, and the shape of the second endoscope insertion section are simultaneously displayed on the display device. The method for operating an endoscopy support system according to claim 11, wherein when an endoscope image is selected by the user, the second endoscope insertion section shape corresponding to the selected endoscope image and the first endoscope insertion section shape are simultaneously displayed on the display device.

15. The display control unit, The shape of the first endoscope insertion section is linearized and displayed on the display device. A method for operating an endoscopic examination support system according to claim 11, which displays the endoscopic image on the display device in association with the insertion length.

16. The display control unit, The shape of the first endoscope insertion section is linearized and displayed on the display device. A method for operating an endoscopic examination support system according to claim 11, which displays the endoscopic image on the display device in relation to the insertion time.

17. The aforementioned reference position determination unit, A method for operating an endoscopic examination support system according to claim 11, wherein the position of the endoscope when it reaches the deepest part in the endoscopic examination is defined as the reference position.

18. The aforementioned reference position determination unit, A method for operating the endoscopic examination support system according to claim 11, wherein the cecum is the reference position.

19. The display control unit, A method for operating an endoscope examination support system according to claim 11, wherein the positional alignment and orientation of the first endoscope insertion section shape and the second endoscope insertion section shape are performed based on the acquired change in the shape of the second endoscope insertion section.

20. The display control unit, A method for operating an endoscopic examination support system according to claim 11, which involves detecting a candidate lesion from the endoscopic image and displaying the endoscopic image in which the candidate lesion was detected and the shape of the second endoscopic insertion section on the display device.

Images