Remote surgical support system and operating device for supervising physicians
The remote surgical support system facilitates communication and annotation during surgery by integrating manipulator arms and voice communication devices, addressing the limitations of existing systems and enhancing surgical support.
Patent Information
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- MEDICAROID CORP
- Filing Date
- 2022-09-28
- Publication Date
- 2026-07-29
AI Technical Summary
Existing remote surgery support systems do not allow for effective communication between a supervising physician and a clinical engineer located in a separate facility, and they lack the ability for the supervising physician to perform annotations during surgery.
A remote surgical support system with manipulator arms, physician-side and supervising physician-side operating devices, and voice communication devices that enable the supervising physician to perform annotations and communicate with the physician during surgery, while allowing a clinical engineer to interact via an external network.
Enables the supervising physician to perform annotations and communicate with the physician during surgery, and allows a clinical engineer to interact with the physician, improving surgical support and reducing the physical burden on the supervising physician.
Smart Images
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Abstract
Description
Technical Field
[0001] This invention relates to a remote surgery support system and an instructor-side operation device, and particularly to a remote surgery support system and an instructor-side operation device in which a doctor and an instructor perform voice communication.
Background Art
[0002] Conventionally, a remote surgery support system in which a doctor and an instructor perform voice communication has been known (see, for example, Patent Document 1).
[0003] The medical robot system (remote surgery support system) of Patent Document 1 includes a surgeon master control station operated by a surgeon performing surgery, a slave cart having a plurality of slave robot mechanisms, and an instructor master control station operated by an instructor. In this medical robot system, the surgeon and the instructor perform voice communication using a headset between the surgeon master control station and the instructor master control station. Further, the instructor performs telescribing to generate an illustration superimposed on an image of an anatomical structure using a touch screen connected to the instructor master control station.
Prior Art Documents
Patent Documents
[0004]
Patent Document 1
Non-Patent Documents
[0005]
Non-Patent Document 1
Summary of the Invention
Problems to be Solved by the Invention
[0006] However, Patent Document 1 does not mention placing the instructor master control station in a separate facility from the surgeon master control station and slave cart, and using them via a network. Furthermore, if the instructor master control station is installed in a separate facility from the surgeon master control station and slave cart, and "remote surgical support" as described in the remote surgery guidelines (Non-Patent Document 1) is to be performed via a network, a clinical engineer must be present on the side of the instructor. However, the instructor master control station in Patent Document 1 is configured so that the instructor communicates using a headset, which allows the instructor to communicate with the surgeon during surgery and perform telestation (annotation), but has the problem that the clinical engineer cannot communicate with the surgeon.
[0007] This invention was made to solve the above-mentioned problems, and one of its objectives is to provide a remote surgical support system and a control device for the supervising physician that enables the supervising physician to perform annotations while communicating with the physician during surgery, and also enables a clinical engineer, who is positioned as a remote surgical staff member on the supervising physician's side, to communicate with the physician. [Means for solving the problem]
[0008] A remote surgical support system according to the first aspect of this invention comprises: a first manipulator arm installed in a first facility and holding a first surgical instrument; a second manipulator arm installed in the first facility and holding a second surgical instrument; a third manipulator arm installed in the first facility and holding an endoscope; a physician-side operating device installed in the first facility for a physician to operate the first to third manipulator arms; a physician-side operating device installed in a second facility different from the first facility for a supervising physician to operate the first to third manipulator arms via an external network; and one or more control devices, wherein the physician-side operating device is A first switching device that switches the operating authority for controlling the first to third manipulator arms between the physician's operating device and the supervising physician's operating device, It comprises a first display device for displaying endoscopic images acquired by the endoscope, and a first audio communication device, and the supervising physician's control device is A second switching device that switches operating authority between the physician's control device and the supervising physician's control device,A second display device for displaying endoscopic images transmitted via an external network; a second voice communication device positioned so that a supervising physician can communicate with the first voice communication device while viewing the endoscopic images displayed on the second display device; a touch panel display device that displays endoscopic images transmitted via an external network and accepts instruction input for generating annotation images; and the first voice communication device. and second voice communication device The system includes a third voice communication device positioned closer to the touch panel display device than the second display device for voice communication, and one or more control devices display annotation images superimposed on the endoscopic image on the first display device based on instruction input received by the touch panel display device.
[0009] In the remote surgical support system according to the first aspect of this invention, as described above, a touch panel display device that displays endoscopic images transmitted via an external network and accepts instruction input for generating annotation images, and a first voice communication device for voice communication, 2nd A third voice communication device is provided, positioned closer to the touch panel display device than the main display device. One or more control devices are configured to display annotation images superimposed on the endoscopic image on the first display device, based on instruction input received by the touch panel display device. This allows voice communication between the third voice communication device and the first voice communication device, and enables the touch panel display device to receive instruction input, allowing the supervising physician to perform annotations while interacting with the physician during surgery. Furthermore, since voice communication is possible between the third voice communication device and the first voice communication device, a clinical engineer positioned as a remote surgical staff member on the supervising physician's side can interact with the physician. As a result, it is possible for the supervising physician to perform annotations while interacting with the physician during surgery, and for a clinical engineer positioned as a remote surgical staff member on the supervising physician's side to interact with the physician.
[0010] The supervising physician's operating device according to the second aspect of this invention includes a physician's operating device, a first manipulator arm for holding a first surgical instrument, a second manipulator arm for holding a second surgical instrument, and a third manipulator arm for holding an endoscope, and is installed at a second facility different from the first facility in order to operate the first to third manipulator arms of a surgical system installed at the first facility via an external network, wherein the physician's operating device is A first switching device that switches the operating authority for controlling the first to third manipulator arms between the physician's operating device and the supervising physician's operating device, The system comprises a first display device for displaying endoscopic images acquired by the endoscope, and a first audio communication device, and the supervising physician's operating device is A second switching device that switches operating authority between the physician's control device and the supervising physician's control device, A second display device for displaying endoscopic images transmitted via an external network; a second voice communication device positioned so that a supervising physician can communicate with the first voice communication device while viewing the endoscopic images displayed on the second display device; a touch panel display device that displays endoscopic images transmitted via an external network and accepts instruction input for generating annotation images; and the first voice communication device. and second voice communication device The system includes a third voice communication device positioned closer to the touch panel display device than the second display device for voice communication, and the supervising physician's control device transmits the instruction input received by the touch panel display device to the physician's control device via an external network in order to overlay the annotation image onto the endoscopic image and display it on the first display device.
[0011] In the second aspect of this invention, the supervising physician's operating device includes, as described above, a touch panel display device that displays endoscopic images transmitted via an external network and accepts instruction input for generating annotation images, and a first voice communication device for voice communication. 2ndA third voice communication device is provided, positioned closer to the touch panel display device than the main display device. The supervising physician's control device is configured to transmit instruction input received by the touch panel display device to the physician's control device via an external network, in order to display the annotation image on the first display device. This allows voice communication between the third voice communication device and the first voice communication device, and enables the touch panel display device to receive instruction input, allowing the supervising physician to perform annotation while interacting with the physician during surgery. Furthermore, since voice communication is possible between the third voice communication device and the first voice communication device, a clinical engineer positioned as a remote surgical staff member on the supervising physician's side can interact with the physician. As a result, a supervising physician's control device can be provided that allows the supervising physician to perform annotation while interacting with the physician during surgery, and also allows a clinical engineer positioned as a remote surgical staff member on the supervising physician's side to interact with the physician. [Effects of the Invention]
[0012] According to the present invention, it is possible for a supervising physician to perform annotations while communicating with the physician during surgery, and for a clinical engineer positioned as a remote surgical staff member on the supervising physician's side to communicate with the physician. [Brief explanation of the drawing]
[0013] [Figure 1] This figure shows the configuration of a remote surgery support system according to one embodiment. [Figure 2] This figure shows the configuration of a surgical robot according to one embodiment. [Figure 3] This diagram shows the configuration of a physician-side operating device (supervising physician-side operating device) according to one embodiment. [Figure 4] This is a diagram showing the configuration of a remote surgery support system according to one embodiment. [Figure 5] This figure shows a scope-type display device for a remote surgical support system according to one embodiment. [Figure 6] This is a block diagram showing the configuration of a control device for an information sharing device according to one embodiment. [Figure 7] It is a diagram showing an endoscopic image with an annotation image superimposed according to one embodiment. [Figure 8] It is a diagram for explaining a request for switching operation authority of a surgical robot according to one embodiment. [Figure 9] It is a diagram for explaining a notification of a request for switching operation authority according to one embodiment. [Figure 10] It is a diagram for explaining a response to a request for switching operation authority according to one embodiment. [Figure 11] It is a diagram for explaining the display of operation authority according to one embodiment. [Figure 12] It is a flowchart for explaining control processing related to switching of operation authority according to one embodiment. [Figure 13] It is a block diagram showing the configuration of a remote surgery support system according to a modification example. [[ID=2...]]
Embodiments for Carrying Out the Invention
[0014] Hereinafter, embodiments embodying the present invention will be described based on the drawings.
[0015] Referring to FIGS. 1 to 12, the configuration of a remote surgery support system 100 according to one embodiment will be described.
[0016] As shown in Figure 1, the remote surgical support system 100 comprises a surgical robot 1 installed near the operating table 101 on which patient P is placed, a physician-side control device 2 for physician A1 to operate the surgical robot 1, and a supervising physician-side control device 3 for supervising physician A2 to operate the surgical robot 1 via an external network N. The surgical robot 1 and physician-side control device 2 are installed at Facility 1 B1. The supervising physician-side control device 3 is installed at Facility 2 B2, which is different from Facility 1 B1. At Facility 1 B1, an assistant A3 is positioned near the surgical robot 1 as part of the surgical staff. Also at Facility 1 B1, an information sharing device 4 is installed for sharing information with assistant A3. At Facility 2 B2, a clinical engineer A4 is positioned near the supervising physician-side control device 3 as part of the remote surgical staff.
[0017] As shown in Figure 2, the surgical robot 1 comprises one manipulator arm 11 for holding an endoscope 5 and multiple (three) manipulator arms 12 for holding surgical instruments 6. The endoscope 5 images the surgical site inside the patient P. The surgical instruments 6 have end effectors such as forceps attached to their tips. In addition, the physician's control device 2 and the supervising physician's control device 3 are provided for operating the manipulator arms 11 and 12. Note that the manipulator arm 11 This is an example of the "third manipulator arm" in the claims, and is a manipulator arm 12 is , special This is an example of the "first manipulator arm" and "second manipulator arm" within the scope of the claims. Furthermore, surgical instrument 6 is an example of the "first surgical instrument" and "second surgical instrument" in the claims.
[0018] The surgical robot 1 is located in the operating room of Facility B1. The surgical robot 1 also includes a medical cart 13, a positioner 14, and an arm base 15. The surgical robot 1 is configured to be movable by the medical cart 13. The medical cart 13 is equipped with a control device 16 that controls the operation of the surgical robot 1. The control device 16 controls the operation of the surgical robot 1 based on commands input to the physician's operating device 2 or the supervising physician's operating device 3. The control device 16 includes a processing unit such as a CPU that executes a program, and a storage unit such as a memory in which the program is stored. Note that the control device 16 is an example of "one or more control devices" in the claims.
[0019] Furthermore, the medical trolley 13 is equipped with an input device 17. The input device 17 is configured to accept commands for movement and posture changes of the manipulator arm 11, manipulator arm 12, positioner 14, and arm base 15, primarily for preparing for surgery before the procedure.
[0020] The positioner 14 is composed of, for example, a 7-axis articulated robot. The positioner 14 is also positioned on a medical trolley 13. The positioner 14 moves the arm base 15. Specifically, the positioner 14 is configured to move the position of the arm base 15 in three dimensions.
[0021] The arm base 15 is attached to the tip of the positioner 14. The arm base 15 has a relatively long rod shape (elongated shape). The manipulator arms 11 and 12 are each attached to the arm base 15 at their bases. The arm base 15, manipulator arms 11, and manipulator arms 12 are used covered with a sterile drape.
[0022] As shown in Figure 1, the physician-side operating device 2 is located, for example, inside or outside the operating room of the first facility B1. The physician-side operating device 2 also comprises a physician-side operating device body 2a. As shown in Figure 3, the physician-side operating device body 2a comprises an operating handle 21, a foot pedal 22, a touch panel 23, a scope-type display device 24, an armrest 25, a voice communication device 26, a sensor 27, a control device 28, and a support arm 30. The operating handle 21 is an example of the "first operating handle" in the claims. The touch panel 23 is an example of the "switching device" in the claims. The scope-type display device 24 is an example of the "first display device" in the claims. The voice communication device 26 is an example of the "first voice communication device" in the claims.
[0023] The operating handle 21 constitutes an operating handle for the operator (physician A1) to input commands. The operating handle 21 is provided for the operator (physician A1) to operate the manipulator arms 11 and 12 (endoscope 5 and surgical instrument 6). The operating handle 21 also receives the amount of manipulation applied to the manipulator arms 11 and 12 (endoscope 5 and surgical instrument 6). The operating handle 21 includes a pair of operating handles: a left-handed operating handle 21L operated by the operator's (physician A1) left hand, and a right-handed operating handle 21R operated by the operator's (physician A1) right hand. The operating handle 21L is used to operate the surgical instrument 6 held on one manipulator arm 12, and the operating handle 21R is used to operate the surgical instrument 6 held on the other manipulator arm 12.
[0024] Furthermore, the operating handle 21 modifies (scales) the movement of the endoscope 5 and surgical instruments 6 in relation to the amount of manipulation received by the operating handle 21. For example, if the movement scaling factor is set to 1 / 2, the endoscope 5 and surgical instruments 6 are controlled to move a distance equal to half the movement distance of the operating handle 21. This allows for precise and detailed surgical procedures to be performed accurately.
[0025] The foot pedal 22 includes multiple pedals for performing functions related to the endoscope 5 and surgical instruments 6. These multiple pedals include, for example, a coagulation pedal, a cutting pedal, a camera pedal, and a clutch pedal. The multiple pedals are operated by the operator's (physician A1) feet. When the camera pedal is operated, the endoscope 5 held by the manipulator arm 11 can be moved using the operating handle 21. At this time, the endoscope 5 is operated and moved using both the operating handle 21L and the operating handle 21R. The touch panel 23 accepts setting operations related to the physician's operating device 2. The touch panel 23 is located on the armrest 25. The scope-type display device 24 displays the endoscopic image G1 (see Figure 7) acquired by the endoscope 5. The scope-type display device 24 is an immersive display device that allows only the operator (physician A1) to view the displayed image. The operator (physician A1) operates the operating handle 21 and the foot pedal 22 while visualizing the affected area using the scope-type display device 24. The support arm 30 supports the scope-type display device 24 so that its height can be adjusted to match the face height of the operator, such as physician A1.
[0026] The armrest 25 is formed in a bar shape and is configured so that the operator (doctor A1) can rest their arm on it when operating the operating handle 21. The voice communication device 26 is positioned so that the operator (doctor A1) can communicate with the voice communication device 36 of the supervising physician's operating device 3 (described later) while looking into the scope-type display device 24. Specifically, the voice communication device 26 is positioned near the operator's (doctor A1) head when the operator (doctor A1) is looking into the scope-type display device 24. The voice communication device 26 is integrally mounted on the scope-type display device 24 and its height can be adjusted integrally by the support arm 30.
[0027] Sensor 27 is configured to detect whether the scope-type display device 24 is in use and being looked into. Sensor 27 is positioned to detect the operator's (doctor A1) head when the operator (doctor A1) is looking into the scope-type display device 24. Sensor 27 is integrally mounted on the scope-type display device 24. Control device 28 controls the operation of the doctor's operating device 2. Control device 28 includes a processing unit such as a CPU that executes a program and a storage unit such as memory where the program is stored.
[0028] The physician-side operating device 2 has been described above, but the supervising physician-side operating device 3 has a similar structure to the physician-side operating device 2. That is, as shown in Figure 4, the supervising physician-side operating device 3 comprises the supervising physician-side operating device main body 3a. The supervising physician-side operating device main body 3a comprises an operating handle 31, a foot pedal 32, a touch panel 33, a scope-type display device 34, an armrest 35, an audio communication device 36, a sensor 37, a control device 38, and a support arm. The scope-type display device 34 displays the endoscopic image G1 (see Figure 7) transmitted via the external network N (see Figure 1). In addition, the physician-side operating device 2 and the supervising physician-side operating device 3 have basically the same specifications, but they are used by switching between normal mode and remote mode via the touch panel 23 (33). Note that the operating handle 31 is an example of the "second operating handle" in the claims. Furthermore, the scope-type display device 34 is an example of the "second display device" in the claims. Furthermore, the touch panel 33 is an example of the "switching device" in the claims. Also, the voice communication device 36 is an example of the "second voice communication device" in the claims.
[0029] In this embodiment, as shown in Figures 1 and 4, the supervising physician's operating device 3 includes a touch panel display device 51 that displays the endoscopic image G1 (see Figure 7) transmitted via the external network N and receives instruction input for generating an annotation image G2 (see Figure 7), and a voice communication device 52 positioned closer to the touch panel display device 51 than the scope-type display device 34 for voice communication with the voice communication device 26. Furthermore, the control device 38 of the supervising physician's operating device 3 transmits the instruction input received by the touch panel display device 51 to the physician's operating device 2 via the external network N in order to display the annotation image G2 on the scope-type display device 24. In addition, the control device 43 of the information sharing device 4, which will be described later, displays the annotation image G2 based on the instruction input received by the touch panel display device 51 superimposed on the endoscopic image G1 on the scope-type display device 24, as shown in Figure 7. This allows voice communication between the voice communication device 52 and the voice communication device 26, and enables the touch panel display device 51 to accept instruction input, thereby allowing supervising physician A2 to perform annotations while conversing with physician A1 during surgery. Furthermore, since voice communication is possible between the voice communication device 52 and the voice communication device 26, clinical engineer A4, who is positioned as a remote surgical staff member on supervising physician A2's side, can converse with physician A1. As a result, supervising physician A2 can perform annotations while conversing with physician A1 during surgery, and clinical engineer A4, who is positioned as a remote surgical staff member on supervising physician A2's side, can converse with physician A1. In addition, since supervising physician A2 can perform annotations without looking into the scope-type display device 34, the physical burden on supervising physician A2 is reduced compared to when supervising physician A2 performs annotations while looking into the scope-type display device 34. Supervising physician A2 can also converse with physician A1 by communicating voice between the voice communication device 36 and the voice communication device 26. Furthermore, supervising physician A2 can also communicate with clinical engineer A4 by using voice communication between voice communication device 36 and voice communication device 52. This allows supervising physician A2 to communicate with physician A1 as well as with clinical engineer A4, who is positioned on supervising physician A2's side.The control device 43 is an example of "one or more control devices" as defined in the claims.
[0030] The touch panel display device 51 and the voice communication device 52 are positioned near the main body 3a of the supervising physician's control device 3a as annotation units independent of the main body 3a of the supervising physician's control device 3a. The touch panel display device 51 is, for example, a flat panel display device with touch panel functionality. Supervising physician A2 uses their finger or a stylus for the touch panel to input instructions into the touch panel display device 51, thereby generating an annotation image G2 with a shape corresponding to the input. The annotation image G2 may be, for example, a line, a circle, or an arrow.
[0031] Furthermore, in this embodiment, as shown in Figures 4 and 5, the voice communication device 26, voice communication device 36, and voice communication device 52 each include a microphone (261, 361, 521) and a speaker (262, 362, 522). This allows for easy voice communication (voice input and output) by the voice communication devices 26, 36, and 52. The microphone 261 (361, 521) receives voice input. The speaker 262 (362, 522) outputs sound. Also, as shown in Figure 5, the speaker 262 (362) is positioned close to the operator's ear when the operator (physician A1 or supervising physician A2) is looking into the scope-type display device 24 (34). The microphone 261 (361) is positioned close to the operator's mouth when the operator (physician A1 or supervising physician A2) is looking into the scope-type display device 24 (34). Furthermore, the microphone 261 (361) and speaker 262 (362) are integrally arranged in the scope-type display device 24 (34).
[0032] Furthermore, in this embodiment, the voice communication device 52 is integrally arranged with the touch panel display device 51. This saves space for both the voice communication device 52 and the touch panel display device 51 compared to when the voice communication device 52 is arranged separately from the touch panel display device 51. The voice communication device 52, for example, has a microphone 521 and a speaker 522 built into the touch panel display device 51. Note that in Figure 1, the touch panel display device 51 and the voice communication device 52 are shown separately.
[0033] Furthermore, in this embodiment, the supervising physician's control device 3 (supervising physician's control device main unit 3a) is equipped with an interface 39 (see Figure 4) for connecting external devices. The touch panel display device 51 is also connected to the supervising physician's control device 3 (supervising physician's control device main unit 3a) via the interface 39. This allows the voice communication device 52 and the touch panel display device 51 to be connected to an external network N via the supervising physician's control device 3 (supervising physician's control device main unit 3a). As a result, the communication configuration can be simplified. The interface 39 is a terminal capable of inputting and outputting image data and audio data. The touch panel display device 51 is connected to the interface 39 via a cable capable of inputting and outputting image data and audio data. The touch panel display device 51 and the voice communication device 52 input and output image data and audio data via the interface 39.
[0034] Furthermore, the physician-side operating device 2, like the supervising physician-side operating device 3, is equipped with an annotation unit. Specifically, the physician-side operating device 2 includes a touch panel display device 61 that displays the endoscopic image G1 (see Figure 7) and accepts instruction input for generating the annotation image G2 (see Figure 7), and a voice communication device 62 positioned closer to the touch panel display device 61 than the scope-type display device 24 for voice communication with voice communication devices 36 and 52. By providing the touch panel display device 61, bidirectional annotation can be performed between physician A1 and supervising physician A2 during surgery. In addition, by providing the voice communication device 62, physician A1 can also perform annotation while communicating with supervising physician A2 during surgery.
[0035] The touch panel display device 61 and the voice communication device 62 are positioned near the physician's operating device 2a as annotation units independent of the physician's operating device 2a. The touch panel display device 61 is, for example, a flat panel display device with touch panel functionality. Physician A1 uses their finger or a touch panel pen to input instructions to the touch panel display device 61, thereby generating an annotation image G2 in a shape corresponding to the input. The annotation image G2 may be, for example, a line, a circle, or an arrow.
[0036] Furthermore, the voice communication device 62 includes a microphone 621 and a speaker 622. The microphone 621 receives voice input. The speaker 622 outputs voice. The voice communication device 62 is also integrally arranged with the touch panel display device 61. For example, the microphone 621 and speaker 622 of the voice communication device 62 are built into the touch panel display device 61. Note that in Figure 1, the touch panel display device 61 and the voice communication device 62 are shown separately.
[0037] Furthermore, the physician-side control device 2 (physician-side control device main unit 2a) is equipped with an interface 29 (see Figure 4) for connecting external devices. The touch panel display device 61 is also connected to the physician-side control device 2 (physician-side control device main unit 2a) via interface 29. Interface 29 is a terminal capable of inputting and outputting image data and audio data. The touch panel display device 61 is connected to interface 29 via a cable capable of inputting and outputting image data and audio data. The touch panel display device 61 and the audio communication device 62 input and output image data and audio data via interface 29.
[0038] As shown in Figures 1 and 4, the information sharing device 4 is a movable monitor cart. The information sharing device 4 includes a display device 41 for displaying endoscopic images G1 (see Figure 7) acquired by the endoscope 5 (see Figure 2), and a voice communication device 42 for voice communication with the voice communication device 26 of the physician's control device 2. The information sharing device 4 is positioned closer to the surgical robot 1 than the physician's control device 2. This allows assistant A3, positioned as surgical staff near the surgical robot 1, to view the endoscopic images G1 and interact with physician A1. The voice communication device 42 is also capable of voice communication with both voice communication device 36 and voice communication device 52. This allows the conversation between assistant A3 and physician A1, positioned as surgical staff near the surgical robot 1, to be heard by supervising physician A2 and clinical engineer A4. Assistant A3 can also interact with supervising physician A2 and clinical engineer A4. The voice communication device 42 also includes a microphone 421 and a speaker 422. The microphone 421 accepts audio input. The speaker 422 outputs audio. The display device 41 is, for example, a flat panel display device. Note that the display device 41 is described in the "Claim of the Patent" 3 This is an example of a "display device." Furthermore, the voice communication device 42 is an example of the "fourth voice communication device" within the scope of the claims.
[0039] Furthermore, a control device 43 is located in the information sharing device 4. The control device 43 performs image processing on the endoscopic image G1 and the annotation image G2. The control device 43 includes a processing unit such as a CPU that executes a program and a storage unit such as a memory where the program is stored. In this embodiment, the control device 43 is located in the first facility B1. As shown in Figures 6 and 7, the control device 43 overlays the annotation image G2 based on instruction input from the touch panel display device 51 and / or the annotation image G2 based on instruction input from the touch panel display device 61, which are received via the external network N, onto the endoscopic image G1 and displays them on the scope-type display device 24. This eliminates the need to separately locate a control device 43 in the second facility B2 to perform image processing to overlay the annotation image G2 onto the endoscopic image G1, thus simplifying the configuration of the second facility B2.
[0040] The control device 43 displays the same image on each of the following displays: the scope-type display device 24, the scope-type display device 34, the display device 41, the touch panel display device 51, and the touch panel display device 61. In other words, the same endoscopic image G1, or an endoscopic image G1 with the same annotation image G2 superimposed, will be displayed on each of the following displays: the scope-type display device 24, the scope-type display device 34, the display device 41, the touch panel display device 51, and the touch panel display device 61.
[0041] Furthermore, voice communication devices 26, 36, 42, 53, and 62 are capable of communicating with each other via voice.
[0042] Furthermore, in this embodiment, as shown in Figures 3 to 5, the supervising physician's operating device 3 is equipped with a sensor 37 that detects whether or not the scope-type display device 34 is in use and being peered into, as described above. The control device 16 prohibits the operation of the manipulator arms 11 and 12 by the operating handle 31 when the sensor 37 does not detect that the device is in use, and permits the operation of the manipulator arms 11 and 12 by the operating handle 31 when the sensor 37 detects that the device is in use. As a result, if the device is not in use, even if supervising physician A2 unintentionally touches the operating handle 31, it is possible to prevent the manipulator arms 11 and 12 from being operated. The control device 16 prohibits the operation of the manipulator arms 11 and 12 by not accepting input from the operating handle 31 when the sensor 37 does not detect that the device is in use. The control device 16 also permits the operation of the manipulator arms 11 and 12 by accepting a predetermined input from the operating handle 31 when the sensor 37 detects that the device is in use.
[0043] The same applies to the physician's operating device 2. Specifically, the control device 16 prohibits the operation of the manipulator arms 11 and 12 by the operating handle 21 when the sensor 27 does not detect that the device is in use, and when the sensor 27 detects that the device is in use, it accepts a predetermined input from the operating handle 21, thereby allowing the operation of the manipulator arms 11 and 12 by the operating handle 21.
[0044] Furthermore, in this embodiment, the physician-side operating device 2 and the supervising physician-side operating device 3 are equipped with a switching device for switching the operating authority for operating the surgical robot 1. This allows for easy switching of operating authority using the switching device at the desired time. In addition, in this embodiment, the switching device is located on the armrests 25 and 35. This allows the switching device to be placed in a position that is easy for physician A1 and supervising physician A2 to operate (a position where they can easily rest their hands). As a result, the operation of switching operating authority can be easily performed. The switching device is a touch panel 23 (33) located on the armrest 25 (35).
[0045] Furthermore, in this embodiment, the control device 16 allows the input of annotation image G2 via the touch panel display device 51 when the physician-side operating device 2 has the authority to operate it. As a result, when the physician-side operating device 2 operates the surgical robot 1, the annotation image G2 from the touch panel display device 51 can be displayed on the scope-type display device 24 (and other display devices).
[0046] Furthermore, in this embodiment, the control device 16 prohibits the acceptance of instruction input via the touch panel display device 51 when the supervising physician's operating device 3 has operational authority. This prevents the supervising physician from inputting instructions for annotation images G2 via the touch panel display device 51 when operating the surgical robot 1 using the supervising physician's operating device 3. As a result, when supervising physician A2 operates the surgical robot 1, they can concentrate on operating the surgical robot 1.
[0047] The same applies to annotation image G2 via the touch panel display device 61. Specifically, the control device 16 allows instruction input for annotation image G2 via the touch panel display device 61 when the supervising physician's operating device 3 has operational authority. Conversely, the control device 16 prohibits acceptance of instruction input via the touch panel display device 61 when the physician's operating device 2 has operational authority.
[0048] As shown in Figures 8 to 10, the physician-side control device 2 and the supervising physician-side control device 3 send a request to switch control authority from the person without control authority to the person with control authority. When the person with control authority approves the request, control authority is switched from the person with control authority to the person without control authority. This allows control authority to be switched only after obtaining approval from the person with control authority, thus preventing unintended changes in control authority.
[0049] As shown in Figure 8, when switching operating authority between the physician's operating device 2 and the supervising physician's operating device 3, the one of the two operating devices that does not have operating authority displays indicators 71 and 72 on the touch panel (23, 33) to allow the user to choose whether or not to send an operating authority switch request. If the indicator 71 for sending an operating authority switch request is selected on the touch panel (23, 33) by the one of the two operating devices that does not have operating authority, the user sends the operating authority switch request to the one of the two operating devices that does have operating authority via the external network N.
[0050] As shown in Figure 9, the person with operating authority over either the physician's control device 2 or the supervising physician's control device 3 notifies the system that a request to switch operating authority has been received. For example, the person with operating authority over either the physician's control device 2 or the supervising physician's control device 3 displays an endoscopic image G1 on the scope-type display device (24, 34) with a display 73 superimposed to notify the system that a request to switch operating authority has been received. The process of superimposing the display 73 onto the endoscopic image G1 is performed by the control device 43.
[0051] Furthermore, as shown in Figure 10, the person with operating authority over either the physician's control device 2 or the supervising physician's control device 3 displays indicators 74 and 75 on the touch panel (23, 33) to allow the user to choose whether or not to approve the request to switch operating authority. If the person with operating authority over either the physician's control device 2 or the supervising physician's control device 3 selects indicator 74 on the touch panel (23, 33) to approve the request to switch operating authority, they transfer the operating authority to the person who does not have operating authority over either the physician's control device 2 or the supervising physician's control device 3.
[0052] Furthermore, if the person with operating authority over one of the physician-side operating devices 2 or the supervising physician-side operating device 3 selects display 75 on the touch panel (23, 33) to reject the request to switch operating authority, the physician-side operating device 2 or the supervising physician-side operating device 3 that does not have operating authority will send a notification of rejection of the switch operating authority to the person without operating authority over one of the physician-side operating device 2 or the supervising physician-side operating device 3. In this case, the person without operating authority over one of the physician-side operating device 2 or the supervising physician-side operating device 3 will notify that they have received the notification of rejection of the switch operating authority. For example, the person without operating authority over one of the physician-side operating device 2 or the supervising physician-side operating device 3 will display an endoscopic image G1 on the scope-type display device (24, 34) with a display superimposed to notify that they have received the notification of rejection of the switch operating authority.
[0053] Furthermore, as shown in Figure 11, the physician-side control device 2 and the supervising physician-side control device 3 display an indicator 76 to show that they have operating authority when they do. For example, the physician-side control device 2 and the supervising physician-side control device 3 display the endoscopic image G1 with the indicator 76 superimposed on it on the scope-type display device (24, 34). The process of superimposing the indicator 76 onto the endoscopic image G1 is performed by the control device 43.
[0054] Referring to Figure 12, the control process for switching operating authority will be explained based on a flowchart. Here, we will describe an example where the supervising physician's operating device 3 has operating authority, and the operating authority is switched from the supervising physician's operating device 3 to the physician's operating device 2. Note that each process in the flowchart is performed by the control device 28 of the physician's operating device 2 or the control device 38 of the supervising physician's operating device 3.
[0055] As shown in Figure 12, in step S1, the touch panel 23 is operated, sending a request to switch control authority from the physician's control device 2 to the supervising physician's control device 3. In step S2, the supervising physician's control device 3 is notified that it has received the request to switch control authority. In step S3, the supervising physician's control device 3 decides whether to approve or reject the request to switch control authority. If the touch panel 33 is operated and the request to switch control authority is rejected, the process proceeds to step S4. In step S4, the supervising physician's control device 3 sends a notification to the physician's control device 2 that the request to switch control authority has been rejected. In step S5, the physician's control device 2 displays a notification that it has received the notification to reject the request to switch control authority. The control process then ends.
[0056] Furthermore, if, in step S3, the touch panel 33 is operated and the user chooses to approve the request to switch control authority, the process proceeds to step S6. In step S6, control authority is transferred from the supervising physician's control device 3 to the physician's control device 2. Then, in step S7, control authority is granted to the physician's control device 2. Finally, the control process is completed.
[0057] [Differentiation] It should be noted that the embodiments disclosed herein are illustrative and not restrictive in all respects. The scope of the present invention is defined by the claims rather than by the description of the embodiments above, and further includes all modifications (exceptions) within the meaning and scope equivalent to the claims.
[0058] For example, in the above embodiment, an example was shown in which both the physician-side operating device and the supervising physician-side operating device are equipped with annotation units (touch panel display device and voice communication device), but the present invention is not limited to this. For example, only the supervising physician-side operating device may be equipped with annotation units (touch panel display device and voice communication device).
[0059] Furthermore, although the above embodiment shows an example in which the control processing of the present invention is performed by multiple control devices, the present invention is not limited thereto. For example, the control processing of the present invention may be performed by a single control device.
[0060] Furthermore, although the above embodiment shows an example in which a scope-type display device is provided as the first display device of the present invention, the present invention is not limited thereto. For example, a flat panel display device other than a scope-type display device may be provided as the first display device of the present invention.
[0061] Furthermore, while the above embodiments show examples in which the first and second voice communication devices of the present invention are voice communication devices integrally arranged with the scope-type display device, the present invention is not limited thereto. For example, the first and second voice communication devices of the present invention may be voice communication devices separate from the scope-type display device.
[0062] Furthermore, although the above embodiment shows an example in which a third voice communication device is integrally arranged with the touch panel display device as the third voice communication device of the present invention, the present invention is not limited thereto. For example, a separate voice communication device may be provided as the third voice communication device of the present invention. That is, a separate voice communication device including a microphone and a speaker may be provided as the third voice communication device of the present invention. Also, when a separate third voice communication device is provided from the touch panel display device, the third voice communication device and the touch panel display device may each be connected to the supervising physician's operating device via different interfaces.
[0063] Furthermore, although the above embodiment shows an example in which both the physician-side operating device and the supervising physician-side operating device are equipped with a switching device, the present invention is not limited to this. For example, only one of the physician-side operating device or the supervising physician-side operating device may be equipped with a switching device.
[0064] Furthermore, although the above embodiment shows an example where the switching device is a touch panel located on the armrest, the present invention is not limited to this. For example, the switching device may be a switch located on the armrest. Also, the switching device does not have to be located on the armrest. For example, the switching device may be a changeover switch provided on the first operating handle of the physician's operating device and / or the second operating handle of the supervising physician's operating device. In this case, the physician and / or supervising physician can easily switch operating authority using a switch at hand.
[0065] Furthermore, in the above embodiment, an example was shown in which the control device 16 prohibits the acceptance of instruction input via the touch panel display device 51 when the supervising physician's operating device 3 has operating authority, and the control device 16 prohibits the acceptance of instruction input via the touch panel display device 61 when the physician's operating device 2 has operating authority. However, the present invention is not limited to this. For example, the control device 16 may permit the acceptance of instruction input via the touch panel display device 51 when the supervising physician's operating device 3 has operating authority, and the control device 16 may permit the acceptance of instruction input via the touch panel display device 61 when the physician's operating device 2 has operating authority. Regardless of whether the supervising physician's operating device 3 and the physician's operating device 2 have operating authority, the control device 16 permits the acceptance of instruction input for annotation images G2 via the touch panel display device 51 and the touch panel display device 61, thereby facilitating information sharing using the touch panel display device 51 and the touch panel display device 61.
[0066] Furthermore, in the above embodiment, an example was shown in which an endoscopic image G1 with display 73 superimposed on it is displayed on a scope-type display device (24, 34) as a means of notifying that a request to switch operating authority has been received, but the present invention is not limited thereto. For example, notification can be made using sound or voice via an audio communication device as a means of notification.
[0067] Furthermore, while the above embodiment shows an example in which an information sharing device is equipped with a voice communication device, the present invention is not limited thereto. For example, a voice communication device may be provided in a surgical robot as an alternative to the voice communication device of the information sharing device. In the modified example shown in Figure 13, the surgical robot 1 is equipped with a voice communication device 18 for voice communication with the voice communication device 26 of the physician's control device 2. This also allows an assistant A3, positioned as surgical staff near the surgical robot 1, to communicate with physician A1. In another modified example, the voice communication device 18 is capable of voice communication with both the voice communication device 36 and the voice communication device 52. This also allows the conversation between assistant A3, positioned as surgical staff near the surgical robot 1, and physician A1 to be heard by supervising physician A2 and clinical engineer A4. Assistant A3 can also communicate with supervising physician A2 and clinical engineer A4. The voice communication device 18 also includes a microphone 181 and a speaker 182. The microphone 181 receives voice input. The speaker 182 outputs sound. The voice communication device 18 is an example of the "fifth voice communication device" in the claims.
[0068] Furthermore, although the above embodiment shows an example in which the supervising physician's control device 3 is installed in the second facility B2, the present invention is not limited thereto. In the present invention, a physician's control device and a surgical robot are placed in the second facility B2, and when the normal mode is selected from the mode selection, the surgical robot in the second facility B2 is operated by the physician's control device in the second facility B2, and when the remote mode is selected from the mode selection, the physician's control device in the second facility B2 is made to function as a supervising physician's control device, and the surgical robot in the first facility B1 is operated by the physician's control device in the second facility B2.
[0069] [Pattern] Those skilled in the art will understand that the exemplary embodiments described above are specific examples of the following embodiments.
[0070] (Item 1) A surgical robot installed in the first facility, equipped with a first manipulator arm for holding an endoscope and a second manipulator arm for holding surgical instruments, A physician-side operating device installed in the first facility for a physician to operate the first manipulator arm and the second manipulator arm, A second facility, different from the first facility, is installed, and includes a physician-side control device for a supervising physician to operate the surgical robot via an external network, It comprises one or more control devices, The physician-side operating device is A first display device for displaying endoscopic images acquired by the aforementioned endoscope, First voice communication device and It comprises a first operating handle for operating the first and second manipulator arms, The aforementioned operating device on the supervising physician's side is, A scope-type display device for displaying the endoscopic image transmitted via the external network, A second operating handle for the supervising physician to operate the first and second manipulator arms, A second voice communication device is positioned so that the supervising physician can communicate with the first voice communication device while looking through the scope-type display device, A touch panel display device that displays the endoscopic image transmitted via the external network and accepts instruction input for generating an annotation image, The system includes a third voice communication device, which is positioned closer to the touch panel display device than the scope-type display device, for voice communication with the first voice communication device, A remote surgery support system in which one or more control devices superimpose the annotation images based on the instruction input received by the touch panel display device onto the endoscopic image and display them on the first display device.
[0071] (Item 2) The remote surgical support system according to item 1, wherein the physician-side operating device and / or the supervising physician-side operating device are equipped with a switching device for switching the operating authority for operating the surgical robot.
[0072] (Item 3) The remote surgical assistance system according to item 2, wherein the switching device is a changeover switch provided on the first operating handle and / or the second operating handle.
[0073] (Item 4) The physician-side operating device and / or the supervising physician-side operating device are equipped with an armrest, The switching device is located on the armrest and is part of the remote surgical support system described in item 2.
[0074] (Item 5) The remote surgical support system according to any one of items 2 to 4, wherein the one or more control devices prohibit the acceptance of instruction input via the touch panel display device when the supervising physician's operating device has the authority to operate.
[0075] (Item 6) The remote surgical support system according to any one of items 2 to 4, wherein the one or more control devices permit the acceptance of the instruction input via the touch panel display device, regardless of whether the supervising physician's operating device has the authority to operate.
[0076] (Item 7) The remote surgical support system according to any one of items 1 to 6, wherein the second voice communication device and the third voice communication device are capable of communicating with each other via voice.
[0077] (Item 8) The first, second, and third voice communication devices each include a microphone and a speaker, as described in any one of items 1 to 7, for the remote surgical support system.
[0078] (Item 9) The third voice communication device is integrally arranged with the touch panel display device, and is part of the remote surgery support system according to any one of items 1 to 8.
[0079] (Item 10) The aforementioned supervising physician's control device is equipped with an interface for connecting external devices, The remote surgical support system according to any one of items 1 to 9, wherein the third voice communication device and / or the touch panel display device are connected to the supervising physician's operating device via the interface.
[0080] (Item 11) A second display device for displaying the endoscopic image acquired by the endoscope, An information sharing device comprising a first voice communication device for the physician's operating device and a fourth voice communication device for voice communication is installed in the first facility. The remote surgical support system according to any one of items 1 to 10, wherein the information sharing device is positioned closer to the surgical robot than the physician's operating device.
[0081] (Item 12) The remote surgical support system according to item 11, wherein the fourth voice communication device is capable of voice communication with both the second voice communication device and the third voice communication device.
[0082] (Item 13) The remote surgical support system according to any one of items 1 to 12, wherein the surgical robot comprises a fifth voice communication device for voice communication with the first voice communication device of the physician-side operating device.
[0083] (Item 14) The remote surgical support system according to item 13, wherein the fifth voice communication device is capable of voice communication with both the second voice communication device and the third voice communication device.
[0084] (Item 15) The remote surgical support system according to any one of items 1 to 14, wherein the one or more control devices are located in the first facility and the annotation images based on the instruction input received via the external network are superimposed on the endoscopic image and displayed on the first display device.
[0085] (Item 16) The supervising physician's operating device is equipped with a sensor that detects whether or not the scope-type display device is in use and being looked into. A remote surgical assistance system according to any one of items 1 to 15, wherein one or more control devices prohibit the operation of the first and second manipulator arms by the second operating handle when the operating state is not detected by the sensor, and permit the operation of the first and second manipulator arms by the second operating handle when the operating state is detected by the sensor.
[0086] (Item 17) A surgical system including a physician-side operating device and a surgical robot installed at the first facility, and for operating the surgical robot via an external network, a supervising physician-side operating device installed at a second facility different from the first facility, The surgical robot comprises a first manipulator arm for holding an endoscope and a second manipulator arm for holding surgical instruments. The physician-side operating device comprises a first display device for displaying endoscopic images acquired by the endoscope, a first audio communication device, and a first operating handle for operating the first and second manipulator arms. The aforementioned operating device on the supervising physician's side is, A scope-type display device for displaying the endoscopic image transmitted via the external network, A second operating handle for operating the first and second manipulator arms, A second voice communication device is positioned so that the supervising physician can communicate with the first voice communication device while looking through the scope-type display device, A touch panel display device that displays the endoscopic image transmitted via the external network and accepts instruction input for generating an annotation image, The system includes a third voice communication device, which is positioned closer to the touch panel display device than the scope-type display device, for voice communication with the first voice communication device, The supervising physician's operating device transmits the instruction input received by the touch panel display device to the physician's operating device via the external network in order to superimpose the annotation image onto the endoscopic image and display it on the first display device. [Explanation of Symbols]
[0087] 1. Surgical robot 2. Physician's Control Device 3 Instructor side operating device 4 Information sharing device 5 Endoscope 6 Surgical instruments (First and second surgical instruments) 11 Manipulator Arm (No. 3 (Manipulator arm) 12 Manipulator Arms (No. 1st and 2nd (2 manipulator arms) 16 Control device (one or more control devices) 18. Voice communication device (5th voice communication device) 21 Operating handle (first operating handle) 23. Touch panel (switching device) 25 Armrest 24. Scope-type display device (first display device) 26. Voice communication device (first voice communication device) 31 Operating handle (second operating handle) 33. Touch panel (switching device) 34 Scope-type display device (Second display device) 35 Armrest 36. Voice communication device (second voice communication device) 37 Sensor 39 Interfaces 41 Display device (No. 3 display device) 42. Voice communication device (4th voice communication device) 43 Control device (one or more control devices) 51 Touch panel display device 52. Voice communication device (third voice communication device) 100 Remote surgical support systems 261, 361, 521 microphones 262, 362, 522 speakers A1 Doctor A2 Instructor B1 Facility 1 B2 Facility 2 G1 Endoscopic image G2 Annotation Images N External Network
Claims
1. The first manipulator arm, installed in the first facility, holds the first surgical instrument, A second manipulator arm, installed in the first facility and holding a second surgical instrument, A third manipulator arm, installed in the first facility and used to hold an endoscope, A physician-side operating device installed in the first facility for a physician to operate the first to third manipulator arms, A second facility, different from the first facility, is installed, and includes a physician-side operating device for the supervising physician to operate the first to third manipulator arms via an external network, It comprises one or more control devices, The physician-side operating device comprises a first switching device for switching the operating authority for operating the first to third manipulator arms between the physician-side operating device and the supervising physician-side operating device, a first display device for displaying endoscopic images acquired by the endoscope, and a first voice communication device. The aforementioned operating device on the supervising physician's side is, A second switching device for switching the operating authority between the physician-side operating device and the supervising physician-side operating device, A second display device for displaying the endoscopic image transmitted via the external network, A second voice communication device is positioned so that the supervising physician can communicate with the first voice communication device while viewing the endoscopic image displayed on the second display device. A touch panel display device that displays the endoscopic image transmitted via the external network and accepts instruction input for generating an annotation image, The system includes a third voice communication device positioned closer to the touch panel display device than the second display device for voice communication with the first voice communication device and the second voice communication device, A remote surgery support system in which one or more control devices superimpose the annotation images based on the instruction input received by the touch panel display device onto the endoscopic image and display them on the first display device.
2. The physician-side operating device includes a first armrest on which the first switching device is located. The remote surgical support system according to claim 1, wherein the supervising physician's operating device comprises a second armrest on which the second switching device is located.
3. The first switching device is a first touch panel or a first switch located on the first armrest, The remote surgical support system according to claim 2, wherein the second switching device is a second touch panel or a second switch located on the second armrest.
4. The physician-side operating device is equipped with a plurality of first operating handles for operating the first to third manipulator arms. The remote surgical support system according to claim 1, wherein the supervising physician's operating device is equipped with a plurality of second operating handles for the supervising physician to operate the first to third manipulator arms.
5. The first switching device is a first switching switch provided on the first operating handle, The remote surgical support system according to claim 4, wherein the second switching device is a second switching switch provided on the second operating handle.
6. The remote surgery support system according to claim 1, wherein the first, second, and third voice communication devices each include a microphone and a speaker.
7. The remote surgery support system according to claim 1, wherein the third voice communication device is integrally arranged with the touch panel display device.
8. The aforementioned supervising physician's control device is equipped with an interface for connecting external devices, The remote surgical support system according to claim 1, wherein the third voice communication device and / or the touch panel display device are connected to the supervising physician's operating device via the interface.
9. The remote surgical assistance system according to claim 1, comprising a surgical robot supporting the first to third manipulator arms.
10. An information sharing device is installed in the first facility, comprising a third display device for displaying the endoscopic images acquired by the endoscope, and a fourth voice communication device for communicating with the first voice communication device, the second voice communication device, and the third voice communication device of the physician's operating device. The remote surgical support system according to claim 9, wherein the information sharing device is positioned closer to the surgical robot than the physician-side operating device.
11. The remote surgical support system according to claim 1, wherein one or more control devices are configured to display an indication on the first display device and the second display device, respectively, that they have the authority to operate.
12. The second display device is a scope-type display device which is an immersive display device that allows only the operator to view the displayed endoscopic image, The remote surgery support system according to claim 1, wherein the second voice communication device is integrally arranged with the scope-type display device.
13. The remote surgical support system according to claim 1, wherein one or more control devices are located in the first facility, and the annotation images based on the instruction input received via the external network are superimposed on the endoscopic image and displayed on the first display device.
14. The second display device is a scope-type display device, which is an immersive display device that allows only the operator to view the displayed endoscopic image. The supervising physician's operating device is equipped with a sensor that detects whether or not the scope-type display device is in use and being looked into. The remote surgical support system according to claim 4, wherein one or more control devices prohibit the operation of the first to third manipulator arms by the second operating handle when the supervising physician's operating device has the authority to operate and the usage state is not detected by the sensor, and permit the operation of the first to third manipulator arms by the second operating handle when the supervising physician's operating device has the authority to operate and the usage state is detected by the sensor.
15. A physician-side operating device, a first manipulator arm for holding a first surgical instrument, a second manipulator arm for holding a second surgical instrument, and a third manipulator arm for holding an endoscope, comprising a first-person operating device, a first-person operating device, and a second operating device, installed at a second facility different from the first facility, for operating the first to third manipulator arms of a surgical system installed at the first facility via an external network, The physician-side operating device comprises a first switching device for switching the operating authority for operating the first to third manipulator arms between the physician-side operating device and the supervising physician-side operating device, a first display device for displaying endoscopic images acquired by the endoscope, and a first voice communication device. The aforementioned operating device on the supervising physician's side is, A second switching device for switching the operating authority between the physician-side operating device and the supervising physician-side operating device, A second display device for displaying the endoscopic image transmitted via the external network, A second voice communication device is positioned so that the supervising physician can communicate with the first voice communication device while viewing the endoscopic image displayed on the second display device, A touch panel display device that displays the endoscopic image transmitted via the external network and accepts instruction input for generating an annotation image, The system includes a third voice communication device positioned closer to the touch panel display device than the second display device for voice communication with the first voice communication device and the second voice communication device, The supervising physician's operating device transmits the instruction input received by the touch panel display device to the physician's operating device via the external network in order to superimpose the annotation image onto the endoscopic image and display it on the first display device.