Medical system and navigation method

Abstract

This medical system comprises: a tip-end information acquisition unit that, for a tip-end part of a medical device inserted in vivo, acquires tip-end rotation information related to rotational operation of the tip-end part; and a base-end information acquisition unit that, for a base-end part of the medical device which is operated by an operator, acquires base-end rotation information related to rotational operation of the base-end part.

Description

[Technical field]

[0001] The present invention relates to a medical system and a navigation method. [Background technology]

[0002] There are known techniques for grasping the position of medical devices such as guidewires and catheters in a living body. For example, Patent Document 1 discloses a technique for providing a magnetized region at the tip of a medical device and determining the position of the tip of the medical device using measurements from a detector head placed outside the body. For example, Patent Document 2 discloses a technique for providing an electrode at the tip of a catheter and determining the position of the tip of the catheter using a current distribution generated by passing a current between the electrode and the tip, which is placed outside the body. Patent Document 3 discloses a technique for acquiring the rotation of the base end of a medical device by fixing a gyroscope sensor for measuring the angular position and rotation angle of the base end to the base end of the medical device. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Special Publication No. 2019-520129 [Patent Document 2] JP 2012-125579 A [Patent Document 3] JP 2019-171074 A Summary of the Invention [Problem to be solved by the invention]

[0004] In a procedure such as percutaneous coronary intervention (PCI), an operator needs to deliver a medical device to a specific blood vessel (hereinafter also referred to as a "target blood vessel") that has a lesion such as stenosis or blockage in a complex and intricate vascular network. For this reason, an operator gives a small curve to the tip of the medical device and selects a desired blood vessel that will reach the target blood vessel while rotating the tip of the medical device. However, while the outer diameter of the medical device is very small, the medical device has a long outer shape with a length of about several meters. Therefore, it is known that the rotation at the base end is not directly transmitted to the tip, in other words, loss torque occurs.

[0005] Conventionally, the surgeon has operated the medical device by the sense of hand and experience while considering such loss torque, which has led to problems that the procedure takes time and effort, and the surgeon is required to have high skills. In this regard, the techniques described in Patent Documents 1 and 2 do not take into consideration the rotation of the distal end and proximal end of the medical device. In addition, the technique described in Patent Document 3 does not take into consideration the rotation of the distal end of the medical device, and does not take into consideration the above problems caused by the loss torque of the medical device. Note that such problems are common to all medical devices, such as catheters and guidewires, that are inserted into each organ (biological duct) in the human body, such as the vascular system, lymphatic system, biliary system, urinary system, respiratory system, digestive system, secretory glands, and reproductive organs.

[0006] The present invention has been made to solve at least some of the above-mentioned problems, and aims to provide a medical system capable of acquiring rotational movement of the base end and the tip end of a medical device. [Means for solving the problem]

[0007] The present invention has been made to solve at least part of the above-mentioned problems, and can be realized in the following forms.

[0008] (1) According to one aspect of the present invention, a medical system is provided, comprising: a tip information acquisition unit that acquires tip rotation information regarding a rotational movement of a tip portion of a medical device inserted into a living body, and a base end information acquisition unit that acquires base end rotation information regarding a rotational movement of a base end of the medical device operated by a surgeon.

[0009] According to this configuration, the tip information acquisition unit can acquire quantitative tip rotation information regarding the rotational motion of the tip of the medical device. Similarly, the base end information acquisition unit can acquire quantitative base end rotation information regarding the rotational motion of the base end of the medical device. That is, according to this configuration, a medical system capable of acquiring the rotational motion of the base end and the rotational motion of the tip of the medical device can be provided. Therefore, by using the acquired rotational motions of the base end and the tip in various ways, it is possible to contribute to improving the accuracy and efficiency of the procedure. For example, the acquired rotational motions of the base end and the tip may be directly presented to the surgeon, or may be used to derive the rotational motion of the tip following the rotational motion of the base end.

[0010] (2) The medical system of the above form may further include a correspondence relationship derivation unit that uses the base end rotation information and the tip end rotation information to determine a correspondence relationship between the rotational motion of the base end of the medical device and the rotational motion of the tip end of the medical device following the rotational motion of the base end, and a required operation output unit that outputs a required operation of the base end of the medical device that is estimated for a target operation of the tip end of the medical device using the correspondence relationship derived by the correspondence relationship derivation unit. According to this configuration, the correspondence derivation unit can derive a correspondence between the rotational motion of the base end of the medical device and the rotational motion of the tip end of the medical device following the rotational motion of the base end by using quantitative base end rotation information and tip end rotation information. In addition, the required operation output unit can estimate and output a "required operation of the base end of the medical device" that takes into account the loss torque of the medical device by using the correspondence derived by the correspondence derivation unit. Here, the "required operation of the base end of the medical device" is a required operation of the base end estimated for a target operation of the tip end of the medical device, in other words, it means an estimation of what operation the surgeon should perform on the base end of the medical device when trying to perform an arbitrary target operation on the tip end of the medical device. As a result, according to this configuration, a medical system can be provided that can output a required operation of the base end of the medical device estimated for a target operation of the tip end of the medical device, thereby improving the accuracy and efficiency of the procedure.

[0011] (3) In the medical system of the above form, the requested operation output unit outputs, as the requested operation, an operation of the base end of the medical device that is estimated for a target operation of the tip required to move the position of the tip in the cross-sectional direction within the blood vessel from a current position to a target position by rotational operation of the tip of the medical device, and the medical system further includes a target position acquisition unit that acquires position information of the target position, and the tip information acquisition unit further acquires tip position information representing the current position of the tip, and the requested operation output unit may output the requested operation using the position information of the target position and the tip position information. According to this configuration, the medical system further includes a target position acquisition unit that acquires position information of a target position of the tip of the medical device, and the tip information acquisition unit acquires tip position information representing the position of the tip of the medical device. Therefore, the request operation output unit can specify a target position of the tip of the medical device in a cross-sectional direction in the blood vessel by the position information of the target position. Similarly, the request operation output unit can specify a current position of the tip of the medical device in a cross-sectional direction in the blood vessel by the tip position information. As a result, the request operation output unit can specify a target operation of the tip required to move the position of the tip of the medical device from the current position to the target position, and can output a request operation required for this target operation.

[0012] (4) In the medical system of the above aspect, the required operation output unit may output, as the required operation, a rotation direction and a rotation angle of the base end portion of the medical device. According to this configuration, the required operation output section outputs the rotation direction and rotation angle of the base end portion of the medical device as the required operation, so that the required operation content can be clearly presented to the surgeon.

[0013] (5) In the medical system of the above aspect, the correspondence deriving unit may further derive the correspondence using information on a shape of the blood vessel and information on a physical property of the medical device. According to this configuration, the correspondence deriving unit further derives the correspondence using information on the shape of the blood vessel and information on the physical properties of the medical device, so that the accuracy of the obtained correspondence can be improved, and as a result, the accuracy of the estimation of the required operation for the target operation in the required operation output unit can be improved.

[0014] (6) In the above-mentioned medical system, The aboveThe medical device may have a holder attached to its base end, the holder having a hollow main body having an insertion path for the medical device, a holding portion provided within the insertion path for holding the base end of the medical device, and a detection device for detecting information relating to the rotational movement of the base end of the medical device held by the holding portion, and the base end information acquisition unit may acquire the information detected by the detection device as the base end rotation information. According to this configuration, the holder is configured as a so-called torquer having a hollow main body, a gripping part for gripping the proximal end of the medical device, and a detection device. The proximal end information acquisition unit acquires information detected by the detection device of the holder (torquer) as proximal end rotation information, so that the function related to the proximal end information acquisition unit in the medical system can be easily constructed.

[0015] (7) In the medical system of the above form, the holding device further has a motor that rotates the base end of the medical device gripped by the gripping portion, and a control portion that controls the driving of the motor, and the request operation output portion transmits the request operation to the control portion, and the control portion may control the driving of the motor in accordance with the received request operation. According to this configuration, the holder further includes a motor that rotates the base end of the grasped medical device, and a controller, and the controller controls the driving of the motor in response to the request operation received from the request operation output unit, thereby providing a medical system that can automatically operate the base end of the medical device in response to the request operation.

[0016] (8) In the medical system of the above aspect, a magnetic sensor is further provided, and the medical device is The above The tip may have a first magnetized portion provided at the tip and a second magnetized portion provided on the base end side of the first magnetized portion, wherein the magnetic sensor detects magnetic fields generated from the first magnetized portion and the second magnetized portion, and the tip information acquisition portion may calculate the tip rotation information using the magnetic field detected by the magnetic sensor. According to this configuration, the medical device has a magnetized first magnetization section and a second magnetization section, and the medical system further includes a magnetic sensor that detects magnetic fields generated from the first magnetization section and the second magnetization section. The tip information acquisition section calculates tip rotation information using the magnetic field detected by the magnetic sensor, so that the function related to the tip information acquisition section in the medical system can be easily constructed.

[0017] The present invention can be realized in various forms, for example, in the form of an information processing device, a holder, a medical device, an examination device, a system including these devices, a computer program that realizes the functions of these devices and systems, a server device for distributing the computer program, a non-transitory storage medium on which the computer program is stored, etc. [Brief description of the drawings]

[0018] [Figure 1] FIG. 1 is an explanatory diagram illustrating a configuration of a medical system. [Diagram 2] FIG. 2 is an explanatory diagram illustrating the configuration of a guide wire. [Diagram 3] FIG. 2 is an explanatory diagram illustrating a configuration of a holder. [Figure 4] 4 is an explanatory diagram illustrating a cross-sectional configuration taken along line AA in FIG. 3. [Diagram 5] 13 is a flowchart illustrating an example of a navigation process. [Figure 6] 1 is an explanatory diagram showing the state of the tip of a guidewire inside a blood vessel. FIG. [Figure 7] FIG. 6 is a diagram illustrating steps S22 to S28 in FIG. [Figure 8] 11 shows another example of an image output to the display screen. [Figure 9] FIG. 11 is an explanatory diagram illustrating the configuration of a medical system according to a second embodiment. [Figure 10] 10 is a flowchart showing an example of a navigation process according to a second embodiment. [Figure 11]FIG. 11 is an explanatory diagram illustrating the configuration of a medical system according to a third embodiment. [Figure 12] 13 is an explanatory diagram illustrating the configuration of a holder according to a third embodiment. FIG. [Figure 13] 13 is a flowchart showing an example of a navigation process according to a third embodiment. [Figure 14] FIG. 13 is an explanatory diagram illustrating the configuration of a medical system according to a fourth embodiment. [Figure 15] FIG. 13 is an explanatory diagram illustrating the configuration of a medical system according to a fifth embodiment. [Figure 16] 13 is a flowchart showing an example of a navigation process according to a fifth embodiment. [Figure 17] FIG. 13 is an explanatory diagram illustrating the configuration of a medical system according to a sixth embodiment. [Figure 18] 23 is a flowchart showing an example of a navigation process according to a sixth embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0019] First Embodiment FIG. 1 is an explanatory diagram illustrating an example of the configuration of a medical system 1. The medical system 1 is a device used for treatment or diagnosis of a living body (here, a human body) 90, and can output a required operation of a base end of a medical device that is estimated with respect to a target operation of a tip end of the medical device. Here, the "target operation" is any operation set for the tip end of the medical device, and an example of such an operation is "an operation for positioning the tip end of the medical device at the center of a blood vessel in the transverse cross-sectional direction of the blood vessel." Moreover, the "required operation" indicates what operation the surgeon should perform on the base end of the medical device when attempting to perform the above-mentioned target operation, and an example of such an operation is "an operation for rotating the base end of the medical device 90 degrees to the left."

[0020] The medical system 1 includes a magnetic sensor array 10, a guidewire 20 as a medical device, a holder 30 attached to the base end of the guidewire 20, an X-ray imaging device 40, a computer 50, a monitor 60, and an operation unit 70.

[0021] The magnetic sensor array 10 is a device for detecting the strength and direction of the magnetic field generated by the human body 90 and the guide wire 20. The magnetic sensor array 10 has a plurality of magnetic sensors 11 arranged vertically and horizontally in a matrix. The magnetic sensors 11 are detection elements for detecting biomagnetic field information, and may be, for example, a GSR (GHz-Spin-Rotation Sensor) sensor, a magnetoresistance effect element (MR), a magneto-impedance element (MI), or a superconducting quantum interference element (SUQUID).

[0022] The magnetic sensor array 10 is disposed near the center of a bed 95 on which a human body 90 lies. The magnetic sensor array 10 may be configured to be attached to the human body 90 during treatment or diagnosis. The magnetic sensor array 10 may be configured to be attached to the human body 90 during treatment. For example, the magnetic sensor array 10 may be configured in a belt shape and wrapped around the human body 90, or in a clothing or hat shape. In these cases, the magnetic sensors 11 may be arranged along the shape of the human body 90. The magnetic sensor array 10 may be configured in the shape of two or more plates and three-dimensionally arranged on one or both of the front and back surfaces of the human body, and one or both of the side surfaces.

[0023] FIG. 2 is an explanatory diagram illustrating the configuration of the guidewire 20. FIG. 2 illustrates X, Y, and Z axes that are mutually orthogonal. The X axis corresponds to the longitudinal direction of the guidewire 20, the Y axis corresponds to the height direction of the guidewire 20, and the Z axis corresponds to the width direction of the guidewire 20. The left side (-X axis direction) of FIG. 2 is called the "tip side" of the guidewire 20 and each component, and the right side (+X axis direction) of FIG. 2 is called the "base end side" of the guidewire 20 and each component. In addition, of both ends in the longitudinal direction (X axis direction) of the guidewire 20 and each component, one end located on the tip side is called the "tip" and the other end located on the base side is called the "base end". In addition, the tip and its vicinity are called the "tip portion", and the base end and its vicinity are called the "base end portion". The tip side is inserted into the living body, and the base side is operated by an operator such as a doctor.

[0024] The guidewire 20 is a device that is inserted into a blood vessel of a human body 90 and advances through the blood vessel prior to a catheter or the like. The guidewire 20 includes a main body portion 25, a first magnetized portion 21, a second magnetized portion 22, and a distal tip 24. The main body portion 25 has an elongated outer shape and is a member formed from any resin material or any metal material. The main body portion 25 may be composed of only a core shaft, or may be composed of a core shaft and a coil body.

[0025] The first magnetized portion 21 is provided on the distal end of the main body 25, closer to the base end than the distal tip 24 and closer to the distal end than the second magnetized portion 22. The first magnetized portion 21 is a substantially cylindrical or columnar member made of a permanent magnet. The first magnetized portion 21 is brazed, bonded, or welded to the main body 25. The second magnetized portion 22 is provided on the distal end of the main body 25, closer to the base end than the first magnetized portion 21, at a position spaced apart from the first magnetized portion 21. The second magnetized portion 22 is a substantially cylindrical or columnar member made of a permanent magnet, similar to the first magnetized portion 21, and is brazed, bonded, or welded to the main body 25. At least one of the first magnetized portion 21 and the second magnetized portion 22 may be formed by magnetizing a part of the main body 25. The distal tip 24 is a flexible resin member provided at the distal end of the main body 25.

[0026] Here, the guidewire 20 has a very small outer diameter, but a long outer shape with a length of about several meters. Therefore, it is known that the rotation at the base end is not transmitted as it is to the tip end, in other words, loss torque occurs. The occurrence of loss torque means that the rotation R1 of the tip end of the guidewire 20 is smaller than the rotation R2 applied to the base end of the guidewire 20 by the surgeon. In the medical system 1 of this embodiment, a correspondence relationship between the rotation R2 of the base end of the guidewire 20 and the rotation R1 of the tip end of the guidewire 20 following the rotation R2 is derived. Then, the medical system 1 can use this correspondence relationship to estimate the required operation for the above-mentioned target operation, taking the loss torque into consideration. In this embodiment, the guidewire 20 is given as an example of a medical device, but any device such as a catheter or an endoscope may be used as the medical device.

[0027] FIG. 3 is an explanatory diagram illustrating the configuration of the holder 30. FIG. 3 illustrates X, Y, and Z axes that are mutually orthogonal. The X axis corresponds to the longitudinal direction of the holder 30, the Y axis corresponds to the height direction of the holder 30, and the Z axis corresponds to the width direction of the holder 30. The left side (-X axis direction) of FIG. 3 is called the "tip side" of the holder 30 and each component, and the right side (+X axis direction) of FIG. 3 is called the "base end side" of the holder 30 and each component. In addition, of both ends in the longitudinal direction (X axis direction) of the holder 30 and each component, one end located on the tip side is called the "tip" and the other end located on the base side is called the "base end". In addition, the tip and its vicinity are called the "tip portion", and the base end and its vicinity are called the "base end portion". The XYZ axes in FIG. 2 correspond to the XYZ axes in FIG. 3.

[0028] Fig. 4 is an explanatory diagram illustrating a cross-sectional configuration taken along line AA in Fig. 3. The configuration of holder 30 will be described with reference to Figs. 3 and 4. Holder 30 is a so-called torquer that is attached to the proximal end of guidewire 20. As shown in Fig. 3, holder 30 includes a main body portion 31, a gripping portion 32, a motion sensor 33, an internal connection portion 34, a substrate 35, and a connection portion 36.

[0029] The main body 31 is hollow and has an insertion path 30L for the guidewire 20 inside. The main body 31 has a handle 311 and a tubular portion 312. The handle 311 has openings at the tip and base ends, and is a hollow, approximately cylindrical shape having an inner cavity communicating both openings inside. The base end of the main body 25 of the guidewire 20 is inserted from the opening 311o at the tip of the handle 311 (FIG. 3: outline arrow). The tip of the tubular portion 312 is inserted into the opening at the base end of the handle 311 and brazed, bonded, or welded. A portion of the tip side of the handle 311 has a reduced diameter shape in which the outer diameter is reduced from the base end side to the tip side. However, the handle 311 does not have to have a reduced diameter shape, and the entire handle 311 may have a reduced diameter shape. As shown in FIG. 4, the handle 311 has a convex portion 313 in which a portion of the outer circumferential surface is raised outward. The convex portion 313 can increase the frictional force between the surgeon's hand and the handle portion 311, and can improve the torque transmission force from the surgeon's hand to the holder 30.

[0030] As shown in FIG. 3, the tubular portion 312 has an opening at each of the tip and base end, and is a hollow, approximately cylindrical shape having an inner cavity that communicates both openings on the inside. From the opening 312o at the base end of the tubular portion 312, the connection portion 36 extends to the outside (FIG. 3). The tubular portion 312 has a substantially constant outer diameter from the tip to the base end, but the tubular portion 312 may have a reduced diameter shape like the handle portion 311. The outer diameter, inner diameter, and length in the longitudinal direction of the handle portion 311 and the tubular portion 312 can be determined arbitrarily. The handle portion 311 and the tubular portion 312 may be formed as separate members and joined together as shown in the figure, or may be formed integrally. The handle portion 311 and the tubular portion 312 can be formed of any resin material. The outer peripheral surface of the handle portion 311 and the convex portion 313 may be formed of elastic rubber, thermoplastic elastomer (TPE), or the like in order to further improve frictional force.

[0031] The gripping portion 32 is provided in the insertion path 30L at a position corresponding to the inside of the handle portion 311. As shown in FIG. 4, the gripping portion 32 grips the base end portion (main body portion 25 in FIG. 4) of the guidewire 20 inserted into the insertion path 30L. The gripping portion 32 has a first gripping portion 321 and a second gripping portion 322 disposed at a distance SP from the first gripping portion 321. The distance SP can be made smaller (white arrow in FIG. 4) by rotating the handle portion 311 clockwise (black arrow in FIG. 4). On the other hand, the distance SP can be made larger by rotating the handle portion 311 counterclockwise. In this manner, the gripping portion 32 grips and fixes the base end portion of the guidewire 20.

[0032] The motion sensor 33 is attached to the gripping portion 32. As is well known, the motion sensor 33 is configured by combining an acceleration sensor and a gyro sensor, and can detect the movement (acceleration, rotational angular velocity, etc.) of the base end of the guidewire 20 gripped by the gripping portion 32. Hereinafter, the rotational angular velocity of the rotation about the main body portion 25 as the central axis (in other words, the rotation about the X-axis as the central axis) detected by the motion sensor 33 will also be referred to as "base end rotation information". Note that the base end rotation information may also include the acceleration of the base end of the guidewire 20 detected by the motion sensor 33 and other information detectable by the motion sensor 33.

[0033] The internal connection portion 34 is a wiring that electrically connects the motion sensor 33 and the substrate 35. The substrate 35 is a substrate that amplifies the detection signal of the motion sensor 33 and performs AD conversion (analog / digital conversion) of the detection signal by the motion sensor 33. The substrate 35 outputs the detection value of the motion sensor 33 after AD conversion to the computer 50 via the connection portion 36. The connection portion 36 is a wiring that electrically connects the substrate 35 and the computer 50. The internal connection portion 34, the substrate 35, and a portion of the connection portion 36 are each housed inside the cylindrical portion 312.

[0034] Returning to Fig. 1, the explanation will be continued. The X-ray imaging device 40 is a device for acquiring an X-ray image of a human body 90. The X-ray imaging device 40 includes an X-ray tube device, an X-ray high voltage device, and an X-ray flat panel detector. The X-ray tube device receives a high voltage output from the X-ray high voltage device and irradiates an X-ray beam. The X-ray flat panel detector converts the X-ray beam received from the X-ray tube device into an electrical signal, and performs A / D (analog / digital) conversion to generate an X-ray image.

[0035] The computer 50 is a device that controls the entire medical system 1, and is electrically connected to each of the magnetic sensor array 10, the holder 30, the X-ray imaging device 40, the monitor 60, and the operation unit 70. The computer 50 includes a CPU, a ROM, and a RAM (not shown), and realizes each function of the main control unit 51, the tip information acquisition unit 52, the base end information acquisition unit 53, the correspondence derivation unit 54, the target position acquisition unit 55, and the required operation output unit 56 by expanding a computer program stored in the ROM into the RAM and realizing it by the CPU. The main control unit 51 transmits and receives information to and from the magnetic sensor array 10, the holder 30, the X-ray imaging device 40, the monitor 60, and the operation unit 70, and controls the entire medical system 1.

[0036] The tip information acquisition unit 52 acquires information regarding the rotational motion of the tip of the guidewire 20. Hereinafter, the information regarding the rotational motion of the tip of the guidewire 20 is also referred to as "tip rotation information". The tip information acquisition unit 52 also acquires information representing the current position of the tip of the guidewire 20. Hereinafter, the information representing the current position of the tip of the guidewire 20 is also referred to as "tip position information". The tip information acquisition unit 52 acquires tip rotation information and tip position information using magnetic field information acquired by the magnetic field information acquisition unit 521 and an X-ray image acquired by the X-ray image acquisition unit 522. Details will be described later. The magnetic field information acquisition unit 521 controls the magnetic sensor array 10 to acquire magnetic field information generated by the human body 90 and the guidewire 20. The X-ray image acquisition unit 522 controls the X-ray imaging device 40 to acquire an X-ray image of the human body 90.

[0037] The proximal end information acquisition unit 53 acquires information on the rotational motion of the proximal end of the guidewire 20 (proximal end rotation information) from the motion sensor 33 of the holder 30.

[0038] The correspondence deriving unit 54 executes a derivation step, which will be described later, using the tip rotation information acquired by the tip information acquiring unit 52 and the base end rotation information acquired by the base end information acquiring unit 53. In the derivation step, the correspondence deriving unit 54 determines a correspondence between the rotational motion of the base end of the guidewire 20 and the rotational motion of the tip end of the guidewire 20 that follows the rotational motion of the base end. This will be described in detail later.

[0039] The target position acquisition unit 55 acquires position information of the target position of the tip of the guidewire 20. Here, the target position of the tip of the guidewire 20 means a position in a blood vessel where the surgeon intends to place the tip of the guidewire 20. In this embodiment, an operation of moving the tip of the guidewire 20 from a current position to a target position is defined as a "target operation" of the tip of the guidewire 20. Details will be described later.

[0040] The required operation output unit 56 uses the correspondence derived by the correspondence derivation unit 54, the position information of the target position acquired by the target position acquisition unit 55, and the tip position information acquired by the tip information acquisition unit 52 to determine a required operation for the base end of the guidewire 20, and outputs the determined required operation. As described above, the "required operation" indicates what operation the surgeon should perform on the base end of the medical device when attempting to perform the above-mentioned target operation. Details will be described later.

[0041] The monitor 60 is a display unit having a display screen 61, and is configured with a liquid crystal display or the like. The medical system 1 may have a display unit other than the monitor 60. For example, the medical system 1 may have smart glasses having a display screen, or may have a projector that projects an image. The operation unit 70 is configured with any means, such as a keyboard, an operation button, a touch panel, a foot switch, a voice recognition device, or the like. The operation unit 70 is operated when the surgeon switches the display content of the display screen 61.

[0042] 5 is a flowchart showing an example of the navigation process. The navigation process is a process for outputting a required operation for the base end of the guidewire 20, and is executed cooperatively by the main control unit 51, the tip information acquisition unit 52, the base end information acquisition unit 53, the correspondence deriving unit 54, the target position acquisition unit 55, and the required operation output unit 56. The navigation process may be executed at any timing, for example, when a predetermined application implemented in the computer 50 is started.

[0043] In step S10, the proximal end information acquisition unit 53 acquires proximal end rotation information. Specifically, the proximal end information acquisition unit 53 acquires a rotational angular velocity of the rotation about the main body portion 25 of the proximal end of the guidewire 20 as the central axis from the motion sensor 33 of the holder 30, and sets the rotational angular velocity as the proximal end rotation information.

[0044] In step S12, the correspondence deriving unit 54 determines whether the base end of the guidewire 20 has rotated. This determination can be made using the base end rotation information acquired in step S10. If the base end has not rotated (step S12: NO), the correspondence deriving unit 54 transitions the process to step S10 and causes the base end information acquisition unit 53 to acquire base end rotation information again. If the base end has rotated (step S12: YES), the correspondence deriving unit 54 transitions the process to step S14.

[0045] In step S14, the tip information acquisition unit 52 acquires tip rotation information. The tip rotation information acquired in step S14 is caused by the rotation of the tip of the guidewire 20 following the rotation of the base end of the guidewire 20 in step S10. Specifically, the tip information acquisition unit 52 acquires the tip rotation information by the following steps a1 to a3. (a1) The magnetic field information acquiring unit 521 of the tip information acquiring unit 52 controls the magnetic sensor array 10 to acquire magnetic field information from the magnetic sensor array 10. This magnetic field information includes the strength and direction of a magnetic field that is a combination of the biomagnetic field generated by the human body 90 and the magnetic field generated by the first magnetized portion 21 and the second magnetized portion 22 of the guide wire 20 inserted into the human body 90. (a2) The X-ray image acquiring unit 522 of the tip information acquiring unit 52 controls the X-ray imaging device 40 and acquires an X-ray image from the X-ray imaging device 40. (a3) The tip information acquiring unit 52 obtains the rotational angular velocity of the tip of the guidewire 20 about the main body 25 as the central axis from the acquired magnetic field information and X-ray image. Here, the tip information acquiring unit 52 distinguishes and identifies the change in the magnetic field of the first magnetized unit 21 and the change in the magnetic field of the second magnetized unit 22 contained in the magnetic field information, thereby enabling accurate grasping of the three-dimensional movement (rotational movement, forward and backward movement) of the tip of the guidewire 20. Note that when the first magnetized unit 21 and the second magnetized unit 22 (magnetic source) of the guidewire 20 are permanent magnets, the magnetic strength measurement value does not change due to factors (mainly time) other than the relative distance between the first magnetized unit 21 and the second magnetized unit 22 on the X-ray image and the magnetic sensor array 10. Therefore, the tip information acquisition unit 52 can identify the first magnetization unit 21 and the second magnetization unit 22 as magnetic sources that move in conjunction with the operation of the guidewire 20 rather than the pulsation of the heart 92, in other words, as magnetic sources that move in conjunction with the movement (rotational movement, back and forth movement) of the tip of the guidewire 20.

[0046] In step S16, the correspondence deriving unit 54 derives a correspondence between the rotational motion of the base end of the guidewire 20 and the rotational motion of the tip end of the guidewire 20 following the rotational motion of the base end. The correspondence deriving unit 54 may derive the correspondence by using, for example, any of the methods exemplified as the following methods b1 and b2. (b1) The correspondence deriving unit 54 learns the correspondence between the rotational motion of the base end of the guidewire 20 and the rotational motion of the tip end following this, using a well-known machine learning method, with the base end rotation information acquired in step S10 and the tip end rotation information acquired in step S14 as teacher data. In this case, the correspondence is realized in various modes (e.g., a regression line, a neural network model, etc.) according to the learning method adopted in the correspondence deriving unit 54. (b2) The correspondence deriving unit 54 acquires a plurality of pairs of the base end rotation information acquired in step S10 and the tip end rotation information acquired in step S14. The correspondence deriving unit 54 derives a correspondence between the rotational motion of the base end of the guidewire 20 and the corresponding rotational motion of the tip end from the acquired plurality of pairs by any statistical method (for example, by averaging the differences).

[0047] After deriving the correspondence relationship, the correspondence relationship deriving unit 54 stores the obtained correspondence relationship in a storage unit (not shown). The correspondence relationship deriving unit 54 may repeatedly execute the process from step S10 to step S14 or the process from step S10 to S16 until a sufficient number of teacher data are obtained. Steps S10 to S16 are also referred to as a "deriving step." In the following description, a case where the correspondence relationship is derived using method b1 will be illustrated.

[0048] In step S20, the tip information acquiring unit 52 acquires tip position information. Specifically, the tip information acquiring unit 52 identifies the current position of the tip of the guidewire 20 by using the magnetic field information acquired by the magnetic field information acquiring unit 521 and the X-ray image acquired by the X-ray image acquiring unit 522. Details are the same as steps a1 to a3 in step S14.

[0049] 6 is an explanatory diagram showing the state of the tip of the guidewire 20 in a blood vessel 91. As shown in the figure, the tip of the guidewire 20 may be given a small curved shape (may be pre-shaped) in order to improve blood vessel selectivity during use. In the example of FIG. 6, the base end side of the guidewire 20 is on the central axis SC of the blood vessel 91, while the curved tip is located away from the central axis SC of the blood vessel 91. Note that the xyz axes shown in FIG. 6 do not correspond to the XYZ axes in FIG. 2 and FIG. 3.

[0050] Fig. 7 is a diagram for explaining steps S22 to S28 in Fig. 5. Note that the xyz axes shown in Fig. 7 do not correspond to the XYZ axes in Figs. 2 and 3. In step S22 in Fig. 5, the target position acquisition unit 55 acquires the target position. Specifically, the target position acquisition unit 55 acquires the target position by the following steps c1 to c3. Note that steps c1 to c3 described below illustrate the target position for positioning the tip of the guidewire 20 at the center of the blood vessel 91 in the case illustrated in Fig. 6. (c1) The target position acquisition unit 55 acquires the contour of the blood vessel 91 in which the tip of the guidewire 20 is located, using the magnetic field information acquired by the magnetic field information acquisition unit 521 and the X-ray image acquired by the X-ray image acquisition unit 522. (c2) The target position acquisition unit 55 acquires a cross-section 91s (Figure 7) of the blood vessel 91 at the position where the tip of the guidewire 20 is located, using the acquired contour of the blood vessel 91 and the current position of the tip of the guidewire 20 based on the tip position information acquired in step S20. (c3) The target position acquisition unit 55 sets the acquired center Gs of the cross section of the blood vessel 91 as the "target position." By changing steps c1 to c3, the target position acquisition unit 55 can set any position, such as a position where a lesion is present in the blood vessel 91 or a position where a treatment such as ablation is to be performed in the heart 92, as the target position.

[0051] In step S24, the required operation output unit 56 calculates the difference between the tip position and the target position. Specifically, the required operation output unit 56 calculates the difference between the current position 24s (FIG. 7) of the tip of the guidewire 20 based on the tip position information acquired in step S20 and the target position Gs (FIG. 7) of the tip of the guidewire 20 acquired in step S22. In the example of FIG. 7, it can be seen that the tip position 24s is separated from the target position Gs by a distance Ls in the +z-axis direction.

[0052] In step S26, the required operation output unit 56 calculates a required operation from the difference obtained in step S24. Specifically, the required operation output unit 56 calculates the required operation by the following steps d1 and d2. (d1) The required operation output unit 56 determines a target operation of the tip portion of the guidewire 20 required to eliminate the difference determined in step S24 (in other words, to bring the tip position 24s closer to the target position Gs). (d2) The required operation output unit 56 derives, with reference to the correspondence derived in the derivation step, the operation content (required operation) required for the base end of the guidewire 20 in order to perform the target operation determined in step d1 for the tip end of the guidewire 20. For example, when the correspondence is realized by a neural network model (hereinafter also referred to as an "NN model"), if the target operation for the tip end of the guidewire 20 is input to the NN model, the required operation required for performing the input target operation is obtained as the output of the NN model.

[0053] In step S28, the required operation output unit 56 outputs the obtained required operation. Specifically, the required operation output unit 56 generates and outputs an image, a sound, or the like for indicating the content of the required operation to the surgeon. For example, the required operation output unit 56 can generate a guide image IM shown in FIG. 7 and display it on the monitor 60. The guide image IM in FIG. 7 includes a model image IM1 showing the state of the tip of the guidewire 20 and a model image IM2 showing the required operation. The model image IM1 includes an image showing a cross section 91s of the blood vessel 91 acquired in step S22, an image showing a center Gs of the cross section of the blood vessel 91 acquired in step S22, and an image showing a current position 24s of the tip of the guidewire 20 acquired in step S20. The model image IM2 includes an image showing the retainer 30 and information M showing the rotation direction of the base end of the guidewire 20. 1 and , and information M2 indicating the rotation angle of the proximal end of the guidewire 20. Note that "XX" in information M2 means an arbitrary numerical value. Information M1 and information M2 correspond to a "requested operation".

[0054] FIG. 8 shows another example of the image IM output on the display screen 61. FIG. 8(A) shows a first modified example of the image IM, and FIG. 8(B) shows a second modified example of the image IM. As shown in FIG. 8(A), the requested operation output unit 56 may display only the model image IM2 on the monitor 60. In the model image IM2, only the information M1 may be displayed on the screen, and the information M2 may be provided by other means such as voice. The information M1 may also be omitted. As shown in FIG. 8(B), the requested operation output unit 56 may display only the model image IM1 on the monitor 60. In this case, the requested operation output unit 56 provides the information M2 by other means such as voice in order to convey the requested operation to the surgeon.

[0055] As described above, according to the medical system 1 of the first embodiment, the tip information acquisition unit 52 can acquire quantitative tip rotation information regarding the rotational motion of the tip of the guidewire 20 (medical device). Similarly, the base end information acquisition unit 53 can acquire quantitative base end rotation information regarding the rotational motion of the base end of the guidewire 20. That is, according to the medical system 1, it is possible to provide a medical system 1 capable of acquiring the rotational motion of the base end and the rotational motion of the tip of the guidewire 20. Therefore, by using the acquired rotational motions of the base end and the tip in various ways, it is possible to contribute to improving the accuracy and efficiency of the procedure. For example, the acquired rotational motions of the base end and the tip may be directly presented to the surgeon. In addition, the acquired rotational motions of the base end and the tip may be used to derive the rotational motion of the tip following the rotational motion of the base end (in other words, to obtain a correspondence relationship) as described in the first embodiment.

[0056] According to the medical system 1 of the first embodiment, the correspondence deriving unit 54 can derive a correspondence between the rotational motion of the base end of the guidewire 20 and the rotational motion of the tip end of the guidewire 20 following the rotational motion of the base end by using quantitative base end rotation information and tip end rotation information (FIG. 5: deriving step). Then, the required operation output unit 56 can estimate and output a "required operation of the base end of the guidewire 20" that takes into account the loss torque of the guidewire 20 by using the correspondence derived by the correspondence deriving unit 54 (FIGS. 7 and 8). Here, the "required operation of the base end of the guidewire 20" is a required operation of the base end estimated with respect to a target operation of the tip end of the guidewire 20, in other words, an estimate of what kind of operation the surgeon should perform on the base end of the guidewire 20 when performing an arbitrary target operation on the tip end of the guidewire 20. As a result, according to the first embodiment of the medical system 1, a medical system 1 can be provided that is capable of outputting a required operation of the base end of the guidewire 20 that is estimated with respect to a target operation of the tip end of the guidewire 20, thereby improving the accuracy and efficiency of the procedure.

[0057] Moreover, the medical system 1 of the first embodiment further includes a target position acquisition unit 55 that acquires position information of a target position of the tip of the guidewire 20 (medical device), and the tip information acquisition unit 52 acquires tip position information representing the position of the tip of the guidewire 20. Therefore, the required operation output unit 56 can specify the target position Gs of the tip of the guidewire 20 in the cross-sectional direction in the blood vessel 91 by the position information of the target position. Similarly, the required operation output unit 56 can specify the current position 24s of the tip of the guidewire 20 in the cross-sectional direction in the blood vessel 91 by the tip position information. As a result, the required operation output unit 56 can specify a target operation of the tip required to move the position of the tip of the guidewire 20 from the current position 24s to the target position Gs, and can output a required operation for this target operation.

[0058] Furthermore, according to the medical system 1 of the first embodiment, the required operation output unit 56 outputs the rotation direction and rotation angle of the base end of the guidewire 20 (medical device) as the required operation, so that the required operation content can be clearly presented to the surgeon.

[0059] Furthermore, in the medical system 1 of the first embodiment, the holder 30 attached to the base end of the guidewire 20 (medical device) is configured as a so-called torquer having a hollow main body 31, a gripping part 32 that grips the base end of the guidewire 20, and a motion sensor 33 (detection device) (FIG. 3). The base end information acquisition unit 53 acquires information detected by the motion sensor 33 of the holder 30 (torquer) as base end rotation information, so that the function related to the base end information acquisition unit 53 in the medical system 1 can be easily constructed.

[0060] Furthermore, in the medical system 1 of the first embodiment, the guidewire 20 (medical device) has a magnetized first magnetized portion 21 and a second magnetized portion 22, and the medical system 1 further includes a magnetic sensor array 10 (magnetic sensor) that detects magnetic fields generated from the first magnetized portion 21 and the second magnetized portion 22. The tip information acquisition unit 52 calculates tip rotation information using the magnetic field detected by the magnetic sensor array 10, so that the function related to the tip information acquisition unit 52 in the medical system 1 can be easily constructed.

[0061] <Second embodiment> 9 is an explanatory diagram illustrating the configuration of a medical system 1A of the second embodiment. In the second embodiment, the accuracy of the correspondence by the correspondence derivation unit 54 can be further improved. The medical system 1A includes a computer 50A instead of the computer 50 in the configuration described in the first embodiment. The computer 50A includes a correspondence derivation unit 54A instead of the correspondence derivation unit 54, and further includes a blood vessel shape information storage unit 58 and a device physical property information storage unit 59.

[0062] The blood vessel shape information storage unit 58 stores information representing the shape of a blood vessel 91 extending from at least the insertion point of the guidewire 20 in the human body 90 to a target location to which the tip of the guidewire 20 is to be reached. The information representing the shape of the blood vessel 91 may include, for example, the curved shape of the blood vessel 91, the thickness of the blood vessel 91, and the like. The blood vessel shape information storage unit 58 may be created by performing image analysis on an X-ray image acquired by the X-ray imaging device 40. The blood vessel shape information storage unit 58 may also be created from an image acquired by a computed tomography (CT) device or a magnetic resonance imaging (MRI) device (not shown).

[0063] The device physical property information storage unit 59 stores information representing the physical properties of the guidewire 20. The information representing the physical properties of the guidewire 20 may include, for example, the rigidity of the guidewire 20, the torque transmissibility of the guidewire 20, the elasticity of the guidewire 20, etc. The device physical property information storage unit 59 can use values ​​obtained in advance by experiments or the like, or catalog values, for the guidewire 20 used in the procedure.

[0064] FIG. 10 is a flowchart showing an example of the navigation process of the second embodiment. In FIG. 10, after step S14 is completed, steps S17 and S18 are executed. Also, step S16A is executed instead of step S16 described in the first embodiment. In step S17, the correspondence deriving unit 54A acquires information on the shape of the blood vessel 91 in the vicinity of the tip of the guidewire 20 (curved shape, thickness, etc.) from the blood vessel shape information storage unit 58. In step S18, the correspondence deriving unit 54A acquires information on the physical properties of the guidewire 20 (rigidity, torque transmissibility, elasticity, etc.) from the device physical property information storage unit 59. In step S16A, the correspondence deriving unit 54A derives the correspondence using the base end rotation information acquired in step S10, the tip end rotation information acquired in step S14, and further the information on the shape of the blood vessel 91 acquired in step S17 and the information on the physical properties of the guidewire 20 acquired in step S18. In this way, the correspondence deriving unit 54A can derive the correspondence in a state in which the shape of the blood vessel 91 and the physical properties of the guidewire 20 are taken into consideration.

[0065] In this way, the correspondence deriving unit 54A may derive the correspondence by adding at least one of information on the shape of the blood vessel 91 and information on the physical properties of the guidewire 20 acquired in step S18. The correspondence deriving unit 54A may also derive the correspondence by adding other information not described above. For example, the dominant hand of the surgeon, the shape of the tip of the guidewire 20, the shape size, etc. can be used as the other information. In this way, the same effect as in the first embodiment can be achieved. Furthermore, according to the medical system 1A of the second embodiment, the correspondence deriving unit 54A further derives the correspondence by using information on the shape of the blood vessel 91 and information on the physical properties of the guidewire 20 (medical device), so that the accuracy of the correspondence obtained by the correspondence deriving unit 54A can be improved. As a result, the accuracy of the estimation of the required operation for the target operation in the required operation output unit 56 can be improved.

[0066] <Third embodiment> 11 is an explanatory diagram illustrating the configuration of a medical system 1B of a third embodiment. In the third embodiment, the guidewire 20 can be automatically operated in response to a required operation output by a required operation output unit 56. The medical system 1B includes a holder 30B instead of the holder 30 and a computer 50B instead of the computer 50 in the configuration described in the first embodiment. The computer 50B includes a required operation output unit 56B instead of the required operation output unit 56.

[0067] 12 is an explanatory diagram illustrating the configuration of a holder 30B of the third embodiment. In addition to the configuration described in the first embodiment, holder 30B further has a motor M. Motor M is connected to gripper 32, and rotates gripper 32 in the YZ axis direction (direction of black arrow in FIG. 4) by supplying power from a power source (not shown). When gripper 32 rotates, the base end of guidewire 20 gripped by gripper 32 also rotates. Motor M is also connected to a board 35 (controller) that controls the driving of motor M.

[0068] Fig. 13 is a flowchart showing an example of the navigation process of the third embodiment. In Fig. 13, step S30 is executed instead of step S28 described in the first embodiment. In step S30, the required operation output unit 56B transmits the required operation obtained in step S26 to the holder 30B. The board 35 of the holder 30B that receives the required operation drives the motor M according to the content of the required operation to rotate the gripper 32 and the guidewire 20. As a result, the proximal end of the guidewire 20 can be operated without the operator's operation, and a more delicate rotation operation can be realized compared to manual operation.

[0069] In this way, the motor M may be built into the holder 30B, and the required operation output unit 56B may transmit the required operation to the holder 30B. In the third embodiment, the operator may be able to switch between automatic operation (a configuration in which the motor M is driven) and manual operation (a configuration in which the motor M is not driven). In this way, the same effect as in the first embodiment can be achieved. Furthermore, according to the medical system 1B of the third embodiment, the holder 30B further has a motor M that rotates the base end of the grasped guidewire 20 (medical device) and a board 35 (control unit), and the board 35 controls the driving of the motor M in response to the required operation received from the required operation output unit 56B. Therefore, a medical system 1B that can automatically operate the base end of the guidewire 20 in response to the required operation can be provided.

[0070] <Fourth embodiment> 14 is an explanatory diagram illustrating the configuration of a medical system 1C of a fourth embodiment. In the fourth embodiment, a configuration different from that of the first embodiment can perform the same processing as that of the first embodiment. The medical system 1C includes a guidewire 20C instead of the guidewire 20, a CT device 40C instead of the X-ray imaging device 40, and a computer 50C instead of the computer 50 in the configuration described in the first embodiment.

[0071] The guidewire 20C includes a conductor 29 instead of the first magnetized portion 21 and the second magnetized portion 22 in the configuration described in the first embodiment. The conductor 29 is electrically connected to the high-frequency generator 45 via the holder 30. The high-frequency generator 45 is a device that supplies a high-frequency current to the guidewire 20C. The high-frequency generator 45 supplies a current for position detection to the conductor 29, thereby generating a magnetic field from the conductor 29. The guidewire 20C may be configured to be capable of ablating biological tissue by receiving a high-frequency current from the high-frequency generator 45. In this case, the distal tip 24 may be formed of a conductive material and electrically connected to the high-frequency generator 45, and then a current-carrying counter electrode plate may be provided outside (or at the distal end of a catheter housing the guidewire 20C). The high-frequency generator 45 also supplies a high-frequency current to the current-carrying counter electrode plate.

[0072] The CT device 40C includes a tube that emits X-rays and an arc-shaped detector that detects X-rays inside a gantry (frame). The CT device 40C generates CT images showing the shapes of the human body 90 and the heart 92 by rotating the tube 360 ​​degrees around the human body 90 lying on the bed 95, and outputs the CT images to the computer 50.

[0073] The computer 50C has a tip information acquisition section 52C instead of the tip information acquisition section 52 in the configuration described in the first embodiment. The tip information acquisition section 52C has a magnetic field information acquisition section 521C and a CT image acquisition section 522C. The magnetic field information acquisition section 521C acquires the first magnetic field information and the second magnetic field information as the magnetic field information. Here, the "first magnetic field information" includes the strength and direction of the biomagnetic field generated by the human body 90. The magnetic field information acquisition section 521C acquires the detection value of the magnetic sensor array 10 in a state where no current is supplied to the conductor 29 (in other words, a state where no magnetic field is generated from the conductor 29), and sets it as the first magnetic field information. The "second magnetic field information" includes the strength and direction of the magnetic field obtained by combining both the biomagnetic field generated by the human body 90 and the magnetic field generated by the conductor 29 of the guidewire 20C inserted into the human body 90. The magnetic field information acquisition section 521C acquires a detection value of the magnetic sensor array 10 in a state where a current is supplied to the conductor 29 (in other words, a state where a magnetic field is generated from the conductor 29), and sets the detection value as second magnetic field information.

[0074] The tip information acquisition unit 52C acquires tip rotation information by the following steps e1 to e3, instead of the steps a1 to a3 described in the first embodiment. (e1) The magnetic field information acquisition unit 521C of the tip information acquisition unit 52C controls the magnetic sensor array 10 to acquire the first magnetic field information and the second magnetic field information. The magnetic field information acquisition unit 521C acquires the strength and direction of the magnetic field generated by the conductor 29 of the guidewire 20C by comparing the first magnetic field information with the second magnetic field information. Hereinafter, this is also referred to as "device magnetic field information." (e2) The CT image acquiring section 522C of the tip information acquiring unit 52C controls the CT device 40C to acquire a CT image from the CT device 40C. (e3) The tip information acquiring unit 52C obtains the rotational angular velocity of the tip of the guidewire 20 about the main body portion 25 as the central axis, from the acquired device magnetic field information and CT image.

[0075] In this way, the tip information acquisition unit 52C may acquire tip rotation information by a method different from that of the first embodiment. The conductor 29 of the guidewire 20 and the CT device 40C described in the fourth embodiment are merely examples, and the tip information acquisition unit 52C can acquire tip rotation information of the guidewire 20C by using various well-known means. For example, the tip information acquisition unit 52C may acquire tip rotation information by using an MRI image acquired by an MRI device instead of a CT image. Even in this way, the same effect as in the first embodiment can be achieved.

[0076] <Fifth embodiment> 15 is an explanatory diagram illustrating the configuration of a medical system 1D of a fifth embodiment. In the fifth embodiment, a required operation of the base end of the guidewire 20 can be obtained without determining a target position of the tip end of the guidewire 20. The medical system 1D includes a computer 50D instead of the computer 50 in the configuration described in the first embodiment. The computer 50D does not include a target position acquisition unit 55, and includes a required operation output unit 56D instead of the required operation output unit 56.

[0077] FIG. 16 is a flowchart showing an example of the navigation process of the fifth embodiment. In FIG. 16, steps S20 to S26 are not executed, and step S28D is executed instead of step S28. In step S28D, the required operation output unit 56D uses the correspondence derived in the derivation process to obtain a required operation of the base end of the guidewire 20, which is estimated to be necessary to perform a predetermined target operation on the tip end of the guidewire 20. The predetermined target operation may be determined in advance or may be specified by the surgeon. In the illustrated example, an "operation to rotate the tip end of the guidewire 20 by 60 degrees" is illustrated as an example of the predetermined target operation. The required operation output unit 56D outputs the obtained required operation M3 by voice. The required operation output unit 56D may display the obtained required operation on the monitor 60, or may display it on a display unit built into another device such as the holder 30.

[0078] In this way, the required operation output unit 56D may obtain a required operation of the base end portion of the guidewire 20 according to a predetermined target operation, without determining a target position of the tip end portion of the guidewire 20. Even in this way, the same effect as in the first embodiment can be obtained. Moreover, according to the medical system 1D of the fifth embodiment, the processing contents in the computer 50D can be simplified to reduce the processing load of the computer 50D.

[0079] Sixth embodiment 17 is an explanatory diagram illustrating the configuration of a medical system 1E of a sixth embodiment. In the sixth embodiment, the derivation process is not performed, and the rotational motion of the base end and the tip end of the guidewire 20 is presented to the surgeon as is. The medical system 1E includes a computer 50E instead of the computer 50 in the configuration described in the first embodiment. The computer 50E does not include the correspondence relationship derivation unit 54, the target position acquisition unit 55, and the required operation output unit 56 described in the first embodiment.

[0080] FIG. 18 is a flow chart showing an example of the navigation process of the sixth embodiment. In FIG. 18, steps S16 to S26 are not executed, and step S40 is executed instead of step S28. In step S40, the main controller 51 outputs a set of the base end rotation information acquired in step S10 and the tip end rotation information acquired in step S14. The output may be displayed on the monitor 60 or may be output by voice. From the set of the output base end rotation information and tip end rotation information, the surgeon can know how much the tip end side will rotate when the base end side of the guidewire 20 is rotated. As a result, it is possible to contribute to improving the accuracy and efficiency of the procedure.

[0081] In this way, the medical system 1E does not include the correspondence deriving unit 54, the target position acquiring unit 55, and the required operation output unit 56 described in the first embodiment, and the processes (steps S16 to S26) realized by these functional units may be omitted. Even in this way, it is possible to provide a medical system 1E that can acquire the rotational motion of the base end and the rotational motion of the tip end of the guidewire 20 (medical device), and therefore the acquired rotational motions of the base end and the tip end can be used in various ways to improve the accuracy and efficiency of the procedure.

[0082] <Modifications of this embodiment> In the above embodiment, a part of the configuration realized by hardware may be replaced by software, and conversely, a part of the configuration realized by software may be replaced by hardware. Furthermore, the present invention is not limited to the above embodiment, and can be embodied in various aspects without departing from the gist of the present invention, and for example, the following modifications are also possible.

[0083] [Variation 1] In the first to sixth embodiments, the configurations of the medical systems 1, 1A to 1E are illustrated. However, the configuration of the medical system 1 can be modified in various ways. For example, in the medical system 1, at least some of the magnetic sensor array 10, the X-ray imaging device 40, the computer 50, the monitor 60, and the operation unit 70 may be configured as an integrated device. For example, at least some of the functional units (main control unit 51, tip information acquisition unit 52, base end information acquisition unit 53, correspondence relationship derivation unit 54, target position acquisition unit 55, and required operation output unit 56) included in the computer 50 may be provided in other devices (such as a PC or a medical device) connected via a network. In this case, the computer 50 can execute navigation processing in cooperation with the other devices by transmitting and receiving information to and from the other devices via the network.

[0084] For example, the tip information acquisition unit 52 may acquire information (tip rotation information) on the rotational motion of the tip end of the guidewire 20 by a means other than the means described above. Similarly, the base end information acquisition unit 53 may acquire information (base end rotation information) on the rotational motion of the base end of the guidewire 20 by a means other than the means described above. Specifically, for example, at least one of the tip rotation information and the base end rotation information may be input by the surgeon through the operation unit 70, or may be transmitted from another device (such as a PC or a medical device) connected via a network. For example, the correspondence derivation unit 54 may derive the correspondence by a means other than the means b1 and b2 described above. Specifically, for example, a relational database may be created in which the base end rotation information acquired in step S10 and the tip rotation information acquired in step S14 are associated with each other, and this database may be used as the correspondence.

[0085] For example, at least one of the first magnetized portion 21 and the second magnetized portion 22 of the guidewire 20 may be omitted. For example, the guidewire 20 may have a third magnetized portion and a fourth magnetized portion provided apart from the first magnetized portion 21 and the second magnetized portion 22. For example, the medical system 1 may be configured using a catheter instead of the above-mentioned guidewire 20. In this case, the same as the first to sixth embodiments described above can be achieved by providing a magnetized portion and a conductor at the tip of the catheter and attaching the holder 30 to the base end of the catheter. In addition, a medical device other than a catheter, such as an endoscope, may be used.

[0086] [Variation 2] In the above first to sixth embodiments, an example of the navigation process has been described. However, the navigation process can be modified in various ways, and the order of the steps to be executed may be changed, some steps may be omitted, or other steps not described may be executed. For example, the order of execution of step S20 and step S22 may be interchanged. For example, the derivation process of steps S10 to S16 and step S20 and subsequent steps may be executed on different days. In this case, the process of step S20 and subsequent steps may be executed with the correspondence relationship already derived, thereby saving time.

[0087] [Variation 3] The configurations of the medical systems 1, 1A to 1E of the first to sixth embodiments and the configurations of the modifications 1 and 2 may be appropriately combined. For example, in the medical system 1 described in the third to fifth embodiments, the derivation method described in the second embodiment (learning taking into account the blood vessel shape information storage unit 58 and the device physical property information storage unit 59) may be adopted. For example, in the configurations described in the fourth and fifth embodiments, the automatic operation of the base end of the guidewire 20 described in the third embodiment may be adopted. For example, in the configurations described in the fifth and sixth embodiments, the method of detecting tip rotation information described in the fourth embodiment may be adopted.

[0088] Although the present aspect has been described above based on the embodiment and modified examples, the above-mentioned embodiment of the aspect is intended to facilitate understanding of the present aspect and does not limit the present aspect. The present aspect may be modified or improved without departing from the spirit and scope of the claims, and equivalents are included in the present aspect. Furthermore, if a technical feature is not described as essential in this specification, it may be deleted as appropriate. [Explanation of symbols]

[0089] 1,1A~1E…Medical System 10...Magnetic sensor array 11...Magnetic sensor 20,20C…Guidewire 21...First magnetization part 22…Second magnetization part 24…Tip 25…Main body 29...Conductor 30,30B…Holder 31…Main body 32...Gripping part 33...Motion sensor 34…Internal connection 35...Substrate 36…Connection 40…X-ray imaging device 40C…CT device 45...High frequency generator 50,50A~50D...Computer 51...Main control unit 52,52C…Advanced information acquisition unit 53…Proximal information acquisition unit 54, 54A…Correspondence derivation section 55…Target position acquisition unit 56,56B,56D…Request operation output section 58...Vessel shape information storage unit 59...Device property information storage unit 60…Monitor 61…Display screen 70...Operation unit 90...Human body 91...Vessel 92...Heart 95…Bed 311…Handle section 312…Cylindrical part 313…Convex part 321...First gripping part 322...Second gripping part 521, 521C…Magnetic field information acquisition unit 522...X-ray image acquisition unit 522C...CT image acquisition unit

Claims

1. 1. A health care system comprising: a tip information acquisition unit that acquires tip rotation information regarding a rotational operation of a tip of a medical device that is inserted into a living body; A base end information acquisition unit that acquires base end rotation information regarding a rotation operation of a base end of the medical device operated by a surgeon; a correspondence relationship deriving unit that derives a correspondence relationship between a rotational motion of the base end of the medical device and a rotational motion of the tip end of the medical device that follows the rotational motion of the base end, using the base end rotation information and the tip end rotation information; a required operation output unit that outputs a required operation of the base end portion of the medical device, the required operation being estimated for a target operation of the tip end portion of the medical device, using the correspondence relationship derived by the correspondence relationship derivation unit; Equipped with The medical system, wherein the correspondence deriving unit further derives the correspondence using information on the shape of the blood vessel and information on the physical properties of the medical device.

2. 2. The medical system of claim 1, the required operation output unit outputs, as the required operation, an operation of the base end portion of the medical device that is estimated for a target operation of the distal end portion required to move a position of the distal end portion in a cross-sectional direction in a blood vessel from a current position to a target position by a rotation operation of the distal end portion of the medical device, The medical system further includes a target position acquisition unit that acquires position information of the target position, The tip information acquisition unit further acquires tip position information representing a current position of the tip, The required operation output unit outputs the required operation using position information of the target position and the tip position information.

3. The medical system according to claim 1 or 2, A medical system, wherein the required operation output unit outputs, as the required operation, a rotation direction and a rotation angle of the base end portion of the medical device.

4. The medical system according to any one of claims 1 to 3, further comprising: the medical device having a retainer attached to the proximal end; The holder is a hollow body having an insertion path for the medical device; a gripping portion provided in the insertion path and configured to grip the base end portion of the medical device; a detection device that detects information regarding a rotational movement of the base end portion of the medical device gripped by the gripping portion, The base end information acquisition unit acquires information detected by the detection device as the base end rotation information.

5. 5. The medical system of claim 4, The holder further includes: a motor that rotates the proximal end of the medical device gripped by the gripping portion; A control unit that controls the driving of the motor, the operation request output unit transmits the operation request to the control unit; The control unit controls driving of the motor in response to the received request operation.

6. The medical system according to any one of claims 1 to 5, further comprising: A magnetic sensor is provided. The medical device comprises: a first magnetized portion provided at the tip portion and magnetized; a second magnetized portion provided on a base end side of the first magnetized portion and magnetized; the magnetic sensor detects a magnetic field generated from the first magnetized portion and the second magnetized portion; The tip information acquisition unit calculates the tip rotation information using a magnetic field detected by the magnetic sensor.

7. 1. A method of navigation comprising: acquiring tip rotation information regarding a rotational movement of a tip of a medical device inserted into a living body; A step of acquiring base end rotation information regarding a rotational movement of a base end of the medical device operated by a surgeon; deriving a correspondence relationship between a rotational motion of the base end of the medical device and a rotational motion of the tip end of the medical device that follows the rotational motion of the base end, using the base end rotation information and the tip end rotation information; outputting a required operation of the proximal end portion of the medical device, the required operation being estimated for a target operation of the distal end portion of the medical device, using the correspondence relationship derived in the deriving of the correspondence relationship; Run A navigation method, wherein the step of deriving the correspondence further comprises deriving the correspondence using information on the shape of the blood vessel and information on the physical properties of the medical device.

Images