Endoscope system and method for controlling endoscope system

Abstract

This endoscope system comprises: an endoscope having an insertion part in which an imaging element is disposed at the distal end; a plurality of pressure sensors for detecting pressure applied to the outer circumferential surface of the insertion part, the plurality of pressure sensors being disposed along the axial direction of the insertion part; an air supply device for supplying air from the distal end of the insertion part through an air supply pipeline extending to the distal end of the insertion part; and a processor. The processor: acquires pressure measurement values outputted from the plurality of pressure sensors; specifies a reference sensor on the basis of the pressure measurement values, said reference sensor being a pressure sensor serving as a reference; and generates assistance information obtained by processing the pressure measurement value in accordance with the position of the reference sensor.

Description

Endoscope system and control method for endoscope system

[0001] The present invention relates to an endoscope system and a control method for an endoscope system.

[0002] Gastroesophageal reflux disease (GERD) is a pathological condition caused by the reflux of stomach contents, including a large amount of stomach acid, into the esophagus. Conventionally, an endoscopic system using an endoscope has been proposed as a system for diagnosing gastroesophageal reflux disease (see, for example, Patent Document 1). In the endoscopic system described in Patent Document 1, an insertion section of an endoscope is inserted into the stomach, the endoscope is set to be able to image the gastric cardia, and air is blown into the stomach. The endoscopic system then evaluates the function of the lower esophageal sphincter based on pressure changes within the stomach detected during gas blowing into the stomach and the state of the gastric cardia observed from the image captured using the endoscope.

[0003] International Publication No. 2021 / 166127

[0004] However, in diagnosing gastroesophageal reflux disease, it is necessary to evaluate not only the function of the lower esophageal sphincter but also the motility function of the esophagus. Therefore, in addition to the examination using the endoscopic system described in Patent Document 1, it is necessary to additionally evaluate the motility function of the esophagus using, for example, a high-resolution manometry (HRM) examination. This high-resolution manometry examination cannot be performed with the endoscopic system described in Patent Document 1. Therefore, in addition to the examination using the endoscopic system described in Patent Document 1, it is necessary to perform the high-resolution manometry examination using a separate examination device, which places a burden on the subject.

[0005] Therefore, there is a demand for a technology that can diagnose gastroesophageal reflux disease while reducing the burden on the subject. Specifically, by arranging multiple pressure sensors along the axial direction of the insertion section on the outer surface of the insertion section of the endoscope and detecting pressure fluctuations from the upper esophageal sphincter side to the lower esophageal sphincter side, the motility function of the esophagus can be evaluated using an endoscope system.

[0006] However, when pressure is detected using multiple pressure sensors, the positional relationship between each pressure sensor and the subject's esophagus is not fixed, so there has been a demand for technology that can easily identify the position in the subject's digestive tract at which the pressure sensor's measurement value is detecting pressure.

[0007] The present invention has been made in consideration of the above, and aims to provide an endoscopic system that can output support information that corresponds to the positional relationship between a pressure sensor and the subject's digestive tract, and a control method for an endoscopic system.

[0008] In order to solve the above-mentioned problems and achieve the object, the endoscopic system of the present invention comprises an endoscope having an insertion section with an imaging element arranged at the tip, a plurality of pressure sensors that detect the pressure applied to the outer surface of the insertion section, the plurality of pressure sensors being arranged along the axial direction of the insertion section, an air supply device that supplies air from the tip of the insertion section via an air supply pipe that extends to the tip of the insertion section, and a processor, wherein the processor acquires pressure measurement values ​​output from the plurality of pressure sensors, identifies a reference sensor that is the pressure sensor that serves as a reference based on the pressure measurement values, and generates support information by processing the pressure measurement values ​​according to the position of the reference sensor.

[0009] The control method for an endoscopic system according to the present invention is a control method for an endoscopic system comprising an endoscope having an insertion section with an imaging element arranged at the tip, a plurality of pressure sensors that detect pressure applied to the outer peripheral surface of the insertion section, the plurality of pressure sensors being arranged along the axial direction of the insertion section, an air supply device that supplies air from the tip of the insertion section via an air supply pipe extending to the tip of the insertion section, and a processor, and causes the processor to acquire pressure measurement values ​​output from the plurality of pressure sensors, identify a reference sensor that is the pressure sensor that serves as a reference based on the pressure measurement values, and generate support information that processes the pressure measurement values ​​according to the position of the reference sensor.

[0010] According to the present invention, it is possible to realize an endoscope system and a control method for an endoscope system that can output support information that associates the positional relationship between a pressure sensor and the digestive tract of a subject.

[0011] FIG. 1 is a diagram illustrating a configuration of an endoscopic system according to an embodiment. FIG. 2 is a diagram illustrating a configuration of an endoscopic system according to an embodiment. FIG. 3 is a diagram illustrating the configuration and arrangement of a pressure sensor. FIG. 4 is a diagram illustrating a method for diagnosing gastroesophageal reflux disease according to an embodiment. FIG. 5 is a diagram illustrating a method for diagnosing gastroesophageal reflux disease according to an embodiment. FIG. 6 is a diagram illustrating a method for diagnosing gastroesophageal reflux disease according to an embodiment. FIG. 7 is a diagram illustrating a method for diagnosing gastroesophageal reflux disease according to an embodiment. FIG. 8 is a diagram illustrating a method for diagnosing gastroesophageal reflux disease according to an embodiment. FIG. 9 is a diagram illustrating a display example of diagnostic support information. FIG. 10 is a diagram illustrating a display example of diagnostic support information. FIG. 11 is a diagram illustrating a display example of diagnostic support information. FIG. 12 is a diagram illustrating a method for specifying a positional relationship between a pressure sensor and the lower esophageal sphincter. FIG. 13 is a diagram illustrating a method for specifying a positional relationship between a pressure sensor and the lower esophageal sphincter. FIG. 14 is a diagram illustrating a method for specifying a positional relationship between a pressure sensor and the lower esophageal sphincter.

[0012] Hereinafter, a mode for carrying out the present invention (hereinafter referred to as an embodiment) will be described with reference to the drawings. Note that the present invention is not limited to the embodiment described below. Furthermore, in the description of the drawings, the same parts are given the same reference numerals.

[0013] 1 and 2 are diagrams showing the configuration of an endoscopic system 1 according to an embodiment. The endoscopic system 1 is used in the medical field and is a system for diagnosing gastroesophageal reflux disease in a subject using an endoscope 2. As shown in FIGS. 1 and 2 , the endoscopic system 1 includes an endoscope 2, a light source device 3, a processing device 4, a display device 5, an air supply device 6, a gastric pressure measuring device 7, and a microphone 8.

[0014] In this embodiment, the endoscope 2 is a so-called flexible endoscope. A portion of the endoscope 2 is inserted into a living body, captures images of the living body, and outputs image signals generated by the image capture. As shown in FIG. 1 , the endoscope 2 includes an insertion section 21, an operation section 22, and a universal cord 23.

[0015] The insertion section 21 is a section that has at least a portion that is flexible and is inserted into a living body. As shown in Figures 1 and 2, the insertion section 21 includes a tip section 24, a freely bendable bending section 25 (Figure 1) that is composed of a plurality of bending pieces, and a long, flexible flexible tube section 26 (Figure 1) that is connected to the base end side of the bending section 25. An imaging element 244 (Figure 2) is built into the tip section 24. The insertion section 21 is inserted into a body cavity of a subject, and captures an image of a subject, such as biological tissue, that is located in a position that is not accessible by external light, using the imaging element 244.

[0016] Here, pressure sensors PS1 to PS36 that detect pressure applied to the outer peripheral surface are provided on the outer peripheral surface of the insertion portion 21. The detailed configuration and arrangement of the pressure sensors PS1 to PS36 will be described later in "Configuration and Arrangement of Pressure Sensors."

[0017] The operation unit 22 is connected to the base end portion of the insertion section 21. The operation unit 22 receives various operations for the endoscope 2. As shown in Fig. 1 , the operation unit 22 includes a bending knob 221 for bending the bending section 25 in the up-down and left-right directions, a treatment tool insertion section 222 that extends from the operation unit 22 to the tip of the insertion section 21 and inserts treatment tools such as biopsy forceps, an electric scalpel, and an examination probe into the body cavity of the subject, an air supply conduit 223 (Fig. 2) that extends from the operation unit 22 to the tip of the insertion section 21 and supplies air into the body cavity of the subject, and a plurality of switches 224 for operating peripheral devices such as the air supply device 6 and a water supply device (not shown).

[0018] The universal cord 23 incorporates at least a light guide 241 ( FIG. 2 ) and a cable assembly 245 ( FIG. 2 ) that bundles one or more signal lines. The light guide 241 is made of glass fiber or the like and serves as a light guide path for light emitted by the light source device 3. As shown in FIG. 1 , the universal cord 23 branches at the end opposite to the end connected to the operation unit 22. The branched ends of the universal cord 23 are provided with a connector 231 that is detachable from the light source device 3 and a connector 232 that is detachable from the processing device 4. A portion of the light guide 241 extends from the end of the connector 231. The universal cord 23 transmits illumination light emitted from the light source device 3 to the distal end 24 via the connector 231 (light guide 241), the operation unit 22, and the flexible tube portion 26. The universal cord 23 also transmits image signals captured by an image sensor 244 provided in the distal end 24 to the processing device 4 via the connector 232. The cable assembly 245 includes a signal line for transmitting an image signal, a signal line for transmitting a drive signal for driving the image sensor 244, and a signal line for transmitting and receiving information including unique information related to the endoscope 2 (image sensor 244). Note that, in this embodiment, the signal lines are described as transmitting electrical signals, but they may also be used to transmit optical signals, or may be used to transmit signals between the endoscope 2 and the processing device 4 by wireless communication.

[0019] The output end side of the light guide 241 is inserted into the tip portion 24. As shown in Fig. 2, the tip portion 24 includes an illumination lens 242, an optical system 243 for collecting light, and an image sensor 244 that is provided at the imaging position of the optical system 243 and receives the light collected by the optical system 243, photoelectrically converts the light into an electrical signal, and performs predetermined signal processing.

[0020] The optical system 243 is configured using one or more lenses, and forms an observation image on the light receiving surface of the image sensor 244. The optical system 243 may have an optical zoom function that changes the angle of view and a focus function that changes the focus.

[0021] The image sensor 244 photoelectrically converts light from the optical system 243 to generate an electrical signal (image signal). The image sensor 244 is configured with a plurality of pixels arranged in a matrix, each of which has a photodiode that accumulates an electric charge according to the amount of light and a capacitor that converts the electric charge transferred from the photodiode into a voltage level. The image sensor 244 photoelectrically converts light incident on each pixel via the optical system 243 to generate an electric signal, sequentially reads out the electric signals generated by pixels arbitrarily designated as readout targets among the plurality of pixels, and outputs the electric signals as an image signal. The image sensor 244 is realized, for example, using a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor.

[0022] For ease of explanation, the image signal generated by the image sensor 244 capturing an image will be referred to as a captured image below.

[0023] Here, the endoscope 2 has a memory (not shown) that stores execution programs and control programs for the image sensor 244 to execute various operations, as well as data including identification information of the endoscope 2. The identification information includes the endoscope 2's unique information (ID), model year, specification information, transmission method, etc. The memory may also temporarily store captured images generated by the image sensor 244.

[0024] As shown in FIG. 2 , the light source device 3 includes a light source unit 31 , an illumination control unit 32 , and a light source driver 33 .

[0025] The light source unit 31 emits light under the control of the illumination control unit 32. The light source unit 31 emits light having a wavelength band of visible light (white light (illumination light)). The light source unit 31 is realized using any light source such as an LED (Light Emitting Diode) light source, a laser light source, a xenon lamp, or a halogen lamp. The light source unit 31 may also include one or more lenses. The light generated by the light source unit 31 passes through the light guide 241 and the illumination lens 242 and is emitted from the tip of the tip unit 24 toward the subject.

[0026] The light emitted from the light source unit 31 is not limited to white light, but may be narrowband light having light in a specific wavelength band, or may be excitation light that excites substances contained in the object of observation.

[0027] The light source driver 33 supplies current to the light source unit 31 under the control of the illumination control unit 32, thereby causing the light source unit 31 to emit light.

[0028] The processing device 4 corresponds to a processor according to the present invention. As shown in FIG. 2 , the processing device 4 includes an image processing unit 41, a synchronization signal generating unit 42, an input unit 43, a control unit 44, and a storage unit 45.

[0029] Under the control of the control unit 44, the image processing unit 41 performs predetermined image processing on the captured image received from the endoscope 2 to generate an endoscopic image.

[0030] Examples of image processing performed by the image processing unit 41 include optical black subtraction processing (clamping processing), white balance adjustment processing, demosaic processing, color correction matrix processing, gamma correction processing, YC processing that converts RGB signals into luminance color difference signals (Y, Cb / Cr signals), digital gain adjustment that multiplies by digital gain, noise removal, and filter processing that emphasizes structure.

[0031] Furthermore, under the control of the control unit 44, the image processing unit 41 generates first support information based on a signal relating to pressure (gastric pressure information) detected by the gastric pressure measuring device 7.

[0032] Furthermore, under the control of the control unit 44, the image processing unit 41 generates second support information based on signals (esophageal support information) related to pressure detected by the pressure sensors PS1 to PS36.

[0033] Furthermore, under the control of the control unit 44, the image processing unit 41 generates third support information based on a signal relating to a belching sound (belching sound information) collected by the microphone 8.

[0034] The image processing unit 41 then generates diagnostic support information for diagnosing gastroesophageal reflux disease based on the endoscopic image and the first to third support information. The diagnostic support information is output to the display device 5 and displayed on the display device 5.

[0035] Details of the first to third support information and the diagnostic support information will be explained in the section "Display Examples of Diagnostic Support Information" below.

[0036] The image processing unit 41 described above is configured using a general-purpose processor such as a CPU (Central Processing Unit) or a dedicated processor such as various arithmetic circuits that execute specific functions, such as an ASIC (Application Specific Integrated Circuit).

[0037] The synchronization signal generation unit 42 generates a clock signal (synchronization signal) that serves as a reference for the operation of the processing device 4, and outputs the generated synchronization signal to the light source device 3, the image processing unit 41, the control unit 44, and the endoscope 2. Here, the synchronization signal generated by the synchronization signal generation unit 42 includes a horizontal synchronization signal and a vertical synchronization signal. Therefore, the light source device 3, the image processing unit 41, the control unit 44, and the endoscope 2 operate in synchronization with each other using the generated synchronization signal.

[0038] The input unit 43 is realized using a keyboard, a mouse, a switch, and a touch panel, and accepts various operations for instructing the operation of the endoscope system 1. The input unit 43 may include a switch provided on the operation unit 22 or a portable terminal such as an external tablet computer.

[0039] The control unit 44 is configured using a general-purpose processor such as a CPU or a dedicated processor such as an ASIC or various arithmetic circuits that execute specific functions.

[0040] The storage unit 45 stores various programs executed by the control unit 44 and data including various parameters necessary for the processing of the control unit 44. The various programs can be recorded on computer-readable recording media such as a hard disk, flash memory, CD-ROM, DVD-ROM, or flexible disk and widely distributed. The various programs can also be obtained by downloading them via a communications network. The communications network referred to here is realized by, for example, an existing public line network, a LAN (Local Area Network), a WAN (Wide Area Network), or the like, and can be wired or wireless.

[0041] The storage unit 45 having the above configuration is realized using a ROM (Read Only Memory) in which various programs and the like are pre-installed, and a RAM, hard disk, and the like for storing calculation parameters and data for each process.

[0042] In this embodiment, the light source device 3 and the processing device 4 are provided in separate housings, but this is not limiting, and they may be provided integrally in the same housing.

[0043] The display device 5 displays the display image received from the processing device 4 (image processing unit 41) via the video cable. The display device 5 is configured using a monitor such as a liquid crystal or organic EL (Electro Luminescence) monitor.

[0044] The gas supply device 6 adjusts the pressure of gas supplied from a gas supply source (not shown, for example, a carbon dioxide gas cylinder) to a predetermined pressure and discharges the gas from the tip of the insertion section 21 into the space where the tip is located through the gas supply conduit 223. As shown in Fig. 1, the gas supply device 6 includes a gas supply unit 61, a flow rate measurement unit 62, and a control unit 63.

[0045] Although not specifically shown, the gas supply unit 61 includes a primary pressure reducer, a secondary pressure reducer, and a flow control valve. These primary pressure reducer, secondary pressure reducer, and flow control valve are connected in this order by an air supply conduit made of silicone, fluororesin, or the like. Gas supplied from a gas supply source (not shown) passes through the air supply conduit, in this order, through the primary pressure reducer, secondary pressure reducer, and flow control valve. After being adjusted to a predetermined pressure and flow rate, the gas is discharged from the air supply tube TU ( FIG. 1 ) via the flow rate measuring unit 62. The control unit 63 controls the flow control valve provided in the gas supply unit 61 to adjust the flow rate of gas supplied to the endoscope 2 to a predetermined value. The flow control valve is, for example, a type of electromagnetically driven valve, and is configured as an adjustment valve using an electromagnetic coil in the drive unit. The opening degree of the valve unit is controlled by controlling the position of the plunger depending on the magnitude of the current flowing through the electromagnetic coil, thereby adjusting the flow rate of gas flowing through the air supply conduit to a predetermined value.

[0046] The gastric pressure measuring device 7 corresponds to an internal pressure sensor according to the present invention. This gastric pressure measuring device 7 detects the pressure inside the space where the tip is located via a pressure measurement probe 71 inserted to the tip of the insertion section 21 through the treatment tool insertion section 222. A signal (hereinafter referred to as gastric pressure information) related to the pressure (hereinafter referred to as gastric pressure) detected by the gastric pressure measuring device 7 is output to the processing device 4.

[0047] The microphone 8 is placed on the throat of the subject and collects belching sounds (burping sounds) emitted from the esophagus of the subject. The signal related to the belching sounds collected by the microphone 8 (hereinafter referred to as belching sound information) is output to the processing device 4.

[0048] [Configuration and Arrangement of Pressure Sensors] Figure 3 is a diagram illustrating the configuration and arrangement of pressure sensors PS1 to PS36. Pressure sensors PS1 to PS36 detect pressure using known techniques, and are configured using, for example, solid-state pressure sensors, semiconductor piezo-resistance diffusion pressure sensors, or capacitance-type pressure sensors. As shown in Figure 3, pressure sensors PS1 to PS36 according to this embodiment are circular pressure sensors provided around the entire circumference in the rotational direction around a central axis along the axial direction of the insertion section 21. Note that pressure sensors PS1 to PS36 are not limited to circular pressure sensors, and point-type pressure sensors provided only around a portion of the entire circumference in the rotational direction may also be used.

[0049] 3, a total of 36 pressure sensors PS1 to PS36 are arranged on the outer peripheral surface of the insertion section 21 at 1 cm intervals along the axial direction of the insertion section 21. The pressure sensors PS1 to PS36 may be arranged directly on the outer peripheral surface of the insertion section 21, or may be arranged on the outer peripheral surface of an overtube through which the insertion section 21 of the endoscope 2 is inserted. In the following description, the pressure sensors are arranged in the order of pressure sensors PS1, PS2, ..., PS36 from the distal end side of the insertion section 21. The pressure sensors PS1 to PS36 are also arranged closer to the proximal end (toward the operation section 22) than the bendable bending section 25 of the insertion section 21. As a result, when the insertion section 21 is inserted into the stomach and the bending section 25 is bent, the pressure sensors PS1 to PS36 are arranged at positions that detect contraction pressures and relaxation pressures at various locations inside the esophagus from the upper esophageal sphincter to the lower esophageal sphincter.

[0050] The number of pressure sensors is not limited to 36, and may be, for example, 6 or more, 12 or more, or even more.

[0051] Here, the pressure sensors may be spaced a predetermined distance from one or more other nearest pressure sensors. Optionally, the pressure sensors may be spaced at substantially equal intervals. The intervals may be 3 cm or less, such as 2 cm or less, for example 1 cm, or even less than 1 cm.

[0052] Furthermore, the pressure sensors PS1 to PS36 may be arranged in a region including at least the lower esophageal sphincter in the insertion portion 21. Optionally, the pressure sensors may be arranged in a region along the axial direction of the insertion portion 21, for example, at intervals of 4 cm, e.g., at intervals of 8 cm, for example, at intervals of 25 cm, for example, at intervals of 36 cm, or in a region longer than 36 cm.

[0053] The signals relating to the pressures detected by the pressure sensors PS1 to PS36 described above (hereinafter referred to as esophageal assistance information) are output to the processing device 4.

[0054] [Method for Diagnosing Gastroesophageal Reflux Disease] Next, a method for diagnosing gastroesophageal reflux disease will be described. FIGS. 4 to 8 are diagrams illustrating a method for diagnosing gastroesophageal reflux disease according to an embodiment. Specifically, FIG. 4 is a flowchart illustrating the method for diagnosing gastroesophageal reflux disease. FIG. 5 is a cross-sectional view showing the vicinity of the gastric cardia, illustrating steps S1 to S3. For ease of explanation, FIG. 5 omits illustration of pressure sensors PS1 to PS36 provided on the outer peripheral surface of the insertion section 21. FIGS. 6 and 7 are diagrams illustrating the structures of the stomach and esophagus. FIG. 6 is a cross-sectional view showing the structures of the stomach and esophagus. FIG. 7 is a view of the stomach and esophagus as viewed from the outside. FIG. 8 is a diagram illustrating images captured in Phases 1 to 3, which correspond to dynamic changes that occur when air is supplied to the stomach (during pneumoperitoneum).

[0055] First, a user such as a doctor inserts the insertion portion 21 into the subject through a natural opening such as the mouth or nose, and introduces the insertion portion 21 into the stomach through the esophagus, as shown in FIG. 5 (step S1).

[0056] After step S1, a user such as a doctor operates (bends) the bending knob 221 to set the field of view to include the gastric cardia (step S2). In step S2, in response to the operation of the bending knob 221, the insertion section 21 is set into a J-shape with the tip pointing toward the gastric cardia, as shown in FIG. 5. In this state, the pressure sensors PS1 to PS36 are disposed at positions that detect contraction pressure and relaxation pressure at various locations inside the esophagus from the upper esophageal sphincter to the lower esophageal sphincter. For this reason, the pressure sensors PS1 to PS36 are disposed closer to the base end than the bendable bending section 25 of the insertion section 21.

[0057] After step S2, a user such as a doctor operates switch 224 to start supplying air from the air supply device 6 to the stomach through the air supply conduit 223 (step S3). In Fig. 5, the state in which intragastric pressure increases due to air supply is represented by a hollow arrow.

[0058] When gas is supplied to the stomach (pneumoperitoneum), if the subject is healthy, the dynamic changes shown below occur in Phases 1 to 3. Before explaining Phases 1 to 3, the structure of the stomach and esophagus will be described with reference to Figures 6 and 7.

[0059] The intramural anti-reflux barrier complex (IM-ARB complex), which is part of the anti-reflux mechanism at the gastroesophageal junction, is composed of three main components: the collar sling muscle fibers (Figure 7), the clasp muscle fibers (Figure 7), and the lower esophageal sphincter (Figures 6 and 7).

[0060] The Collar Sling Muscle Fibers are obliquely arranged muscles along the greater curvature of the stomach (Figure 6) and are arranged in a sling-like fashion to surround the upper part of the stomach (Figure 7). These Collar Sling Muscle Fibers tighten the gastric cardia to prevent reflux of gastric contents into the esophagus. From inside the stomach, the Collar Sling Muscle Fibers can be seen as the gastroesophageal flap valve (Figure 6). The gastroesophageal flap valve (GEFV) is a protrusion within the gastroesophageal junction formed by the acute angle between the esophagus and the gastric cardia and is a type of mucosal flap valve (MFV). The MFV located at the gastroesophageal junction is called the gastroesophageal flap valve. The MFV is a flap-shaped portion of the mucosa. The gastroesophageal flap valve changes shape with the expansion and contraction of muscles such as the Collar Sling Muscle Fibers and Clasp Muscle Fibers.

[0061] Clasp muscle fibers are located on the lesser curvature side of the stomach (Figure 6) and consist of a circular muscle layer. These clasp muscle fibers tighten the gastric cardia to prevent the reflux of stomach contents into the esophagus.

[0062] The lower esophageal sphincter (LES) is a ring of muscle located at the junction of the esophagus and stomach that normally contracts to close the esophagus and prevent stomach contents from refluxing.

[0063] Phase 1 begins with the amount of gas sent into the stomach being 0. During Phase 1, the gastroesophageal flap valve and the longitudinal folds of the lesser curvature are observed, as shown in Figures 8(a) and 8(b). The longitudinal folds of the lesser curvature are mucosal folds that extend vertically along the inner wall of the stomach. Their shape changes with the expansion and contraction and relaxation of muscles such as clasp muscle fibers, and they gradually stretch and flatten as intragastric pressure increases. Note that the esophageal mucosa is not observed during Phase 1. During Phase 1, as the amount of gas sent into the stomach increases, the longitudinal folds of the lesser curvature are stretched, the gastroesophageal flap valve gradually flattens, and the crura open, as shown in Figure 8(b). However, the esophageal mucosa is not observed.

[0064] In other words, in Phase 1, it is possible to evaluate the valve function (anti-reflux mechanism) of the stomach structure formed by the gastroesophageal flap valve and the longitudinal folds of the lesser curvature.

[0065] Phase 2 occurs after Phase 1. In Phase 2, as shown in FIG. 8(c), the esophageal mucosa is observed beyond the squamocolumnar junction (SCJ) in FIG. 6). The SCJ is the intersection of the esophageal squamous epithelium at the gastroesophageal junction (GEJ) and the gastric columnar epithelium, marking the boundary between different epithelial cells in the digestive tract. The GEJ is located near the border between the esophagus and the stomach and is composed of various anatomical components that form a barrier to prevent reflux of gastric contents. The GEJ also includes collar sling muscle fibers, clasp muscle fibers, the lower esophageal sphincter, the gastroesophageal flap valve, and the SCJ. If the subject is healthy, the scope holding sign (SHS) is observed. The SHS refers to the phenomenon in which the insertion tube 21 is held in place by contraction of the lower esophageal sphincter when intragastric pressure increases. The state shown in FIG. 8(c) is the SHS.

[0066] That is, in Phase 2, it becomes possible to evaluate the valve function (anti-reflux mechanism) of the lower esophageal sphincter.

[0067] Phase 3 occurs after Phase 2. In Phase 3, intragastric pressure exceeds the contractile force of the lower esophageal sphincter, causing the lower esophageal sphincter to relax. In Figure 8(d), the arrow indicates that gas leaks into the esophagus (producing a belching sound) due to the relaxation of the lower esophageal sphincter. If the subject is healthy, peristaltic waves will subsequently descend from the upper esophagus, and SHS will be observed again.

[0068] That is, in Phase 3, it becomes possible to evaluate the acid clearance function due to esophageal peristalsis.

[0069] After step S3, a user such as a doctor determines whether the state corresponds to the above-mentioned Phase 1 based on the diagnostic support information displayed on the display device 5, and evaluates the valve function (state of the gastric cardia) based on the structure of the stomach side (step S4).

[0070] After step S4, a user such as a doctor determines whether or not the state corresponds to the above-mentioned Phase 2 based on the diagnostic support information displayed on the display device 5, and evaluates the valve function of the lower esophageal sphincter (the state of the lower esophageal sphincter) (step S5).

[0071] After step S5, a user such as a doctor determines whether or not the patient is in a state corresponding to the above-mentioned Phase 3 based on the diagnostic support information displayed on the display device 5, and evaluates the acid clearance function due to esophageal peristalsis (the state of peristaltic movement in the esophagus) (step S6).

[0072] Details of the diagnostic assistance information will be explained later in the section "Display Examples of Diagnostic Assistance Information."

[0073] After step S6, a user such as a doctor diagnoses gastroesophageal reflux disease based on the evaluation results of steps S4 to S6 (step S7).

[0074] [Display Examples of Diagnostic Support Information] Next, the diagnostic support information will be described. FIGS. 9 to 11 are diagrams illustrating display examples of the diagnostic support information I0. Specifically, FIG. 9 is a diagram illustrating an example of the diagnostic support information I0 displayed on the display device 5 when the subject is a healthy individual. FIG. 10 is a diagram illustrating an example of the diagnostic support information I0 displayed on the display device 5 when the subject is suspected of having gastroesophageal reflux disease. FIGS. 11(a) to 11(c) are diagrams illustrating examples of the first to third support information I2 to I4 constituting the diagnostic support information I0 when the subject is a healthy individual. FIGS. 11(d) to 11(f) are diagrams illustrating examples of the first to third support information I2 to I4 constituting the diagnostic support information I0 when the subject is suspected of having gastroesophageal reflux disease.

[0075] 9 to 11 , the processing device 4 generates an endoscopic image I1 by performing predetermined image processing on the captured image received from the endoscope 2 during gastric insufflation by the gastric pressure measuring device 6. The processing device 4 also generates first support information I2 based on intragastric pressure information detected by the gastric pressure measuring device 7 during gastric insufflation. The processing device 4 also generates second support information I3 based on esophageal pressure information detected by the pressure sensors PS1 to PS36 during gastric insufflation. The processing device 4 also generates third support information I4 based on belching sound information collected by the microphone 8 during gastric insufflation. The processing device 4 then generates diagnostic support information I0 for diagnosing gastroesophageal reflux disease (GERD) based on the endoscopic image I1, the first to third support information I2 to I4, and time information I5 related to the time during which gas was insufflated into the stomach by the gas insufflation device 6 (hereinafter referred to as pneumoperitoneum time).

[0076] Here, the processing device 4 processes the captured image, intragastric pressure information, esophageal pressure information, and eructation information in a time-synchronized manner based on the synchronization signal generated by the synchronization signal generating unit 42. The processing device 4 also processes the esophageal pressure information detected by the pressure sensors PS1 to PS36 in a time-synchronized manner based on the synchronization signal.

[0077] 9 to 11 , the first support information I2 includes a pressure waveform I21 that indicates a change in pressure (intragastric pressure) due to an increase in intragastric pressure caused by air being supplied to the stomach by the air supply device 6. Furthermore, as shown in Figures 9 and 10 , the first support information I2 also includes a current intragastric pressure (Current IGP) I22, a maximum intragastric pressure (Maximum IGP) I23 during the increase in intragastric pressure, and a basal intragastric pressure (Basal IGP) I24 before the increase in intragastric pressure. The first support information I2 is not limited to the pressure waveform I21, the current intragastric pressure I22, the maximum intragastric pressure I23, and the basal intragastric pressure I24, but may also include the pressure difference between the maximum intragastric pressure I23 and the basal intragastric pressure I24, or a pressure gradient obtained by dividing the pressure difference by the pneumoperitoneum time.

[0078] The current gastric pressure I22, the maximum gastric pressure I23 when the gastric pressure increases, and the basal gastric pressure I24 before the gastric pressure increase may be represented in any suitable manner, such as a bar graph, a line graph, a contour graph, or other representation, or an appropriate combination of these.

[0079] As shown in Figures 9 to 11, the second support information I3 includes a pressure waveform I31 that indicates changes in pressure detected by the pressure sensors PS1 to PS36. In this embodiment, the pressure waveform I31 is configured as a pressure topography, as shown in Figures 11(c) and 11(f). Specifically, the pressure topography (pressure waveform I31) is a diagram in which the horizontal axis represents time and the changes in pressure detected by the pressure sensors PS1 to PS36, which are respectively arranged from the upper esophageal sphincter side to the lower esophageal sphincter side, are expressed as a color pattern from above to below the vertical axis.

[0080] The color patterns shown in Figures 11(c) and 11(f) may, for example, use blue to represent low pressure ranges and red to represent high pressure ranges. The time representation shown on the horizontal axis may move horizontally along the time dimension to indicate the passage of time during the time interval during which the displayed pressure values ​​were measured. For example, the rightmost end of the time representation may correspond to the most recent time during the time interval displayed in the time representation, while the leftmost end may represent the earliest time. To indicate the passage of time during the time interval, the time representation may continuously move left on the screen, thereby allowing the user to observe the representation of the pressure measured in the esophagus over time. This continuous leftward movement allows the user to see the change in pressure (if any) at the displayed location over time and the occurrence of an event that caused the change in pressure (e.g., relaxation of the lower esophageal sphincter or peristalsis in the esophagus).

[0081] Furthermore, information indicating the positions within the esophageal tract where the pressure sensors PS1 to PS36 are located may be added to the pressure topography (pressure waveform I31). For example, markers indicating the positions of the upper esophageal sphincter and the lower esophageal sphincter may be added to the vertical axis.

[0082] Furthermore, even if the pressure measurements detected by the number of pressure sensors PS1 to PS36 may be detected at discrete positions, the pressure measurements can be made quasi-continuous in the spatial dimension. The pressure measurements can be made quasi-continuous by including interpolated pressure values ​​in the pressure measurements. Based on the quasi-continuous pressure measurements, a quasi-continuous visual representation (e.g., having a smooth transition) can be provided. Any of the appropriate visual representations described below may be quasi-continuous.

[0083] 9 and 10, the second support information I3 includes a basal LES pressure I32 detected by pressure sensors PS1 to PS36 arranged on the lower esophageal sphincter side before the increase in intragastric pressure. Note that the second support information I3 is not limited to the pressure waveform I31 and the basal pressure I32, and may include the maximum and minimum pressure values ​​detected by the pressure sensors PS1 to PS36.

[0084] 9 to 11, the third support information I4 includes a waveform I41 of an aspiration sound based on the aspiration sound information detected by the microphone 8. Also, the third support information I4 includes a maximum sound pressure of the aspiration sound detected by the microphone 8, as shown in FIGS.

[0085] A user such as a doctor then checks the diagnostic support information I0 displayed on the display device 5 and diagnoses gastroesophageal reflux disease in the subject.

[0086] In step S4, a user such as a doctor checks the diagnostic support information I0 displayed on the display device 5, determines whether the state corresponds to Phase 1, and evaluates the valve function due to the structure of the stomach. For example, if the subject is healthy, the pressure waveform I21 will be a sloped pressure waveform as shown in (a) of Figure 11. On the other hand, if the subject is suspected of having an abnormality, the pressure waveform I21 will be a flat pressure waveform as shown in (d) of Figure 11. For this reason, a user such as a doctor checks, for example, the endoscopic image I1 and the first support information I2 that constitute the diagnostic support information I0, and evaluates the valve function due to the structure of the stomach.

[0087] In step S5, a user such as a doctor checks the diagnostic support information I0 displayed on the display device 5, determines whether or not the state corresponds to Phase 2, and evaluates the valve function of the lower esophageal sphincter. For example, if the subject is healthy, the SHS is observed and the contraction pressure of the lower esophageal sphincter is also observed. Therefore, a user such as a doctor checks, for example, the endoscopic image I1 and the first and second support information I2 and I3 constituting the diagnostic support information I0 to evaluate the valve function of the lower esophageal sphincter.

[0088] In step S6, a user such as a doctor checks the diagnostic support information I0 displayed on the display device 5, determines whether the state corresponds to Phase 3, and evaluates the acid clearance function due to esophageal peristalsis. For example, if the subject is healthy, belching occurs and the lower esophageal sphincter relaxes when the intragastric pressure is approximately 19 mmHg (see (a) to (c) of FIG. 11). On the other hand, if the subject is suspected of having an abnormality, the lower esophageal sphincter relaxes when the intragastric pressure is approximately 14 mmHg. Furthermore, if the subject is healthy, peristalsis in the esophagus is observed (see (c) of FIG. 11), and the SHS is again observed. For example, on the pressure topography (pressure waveform I31), it can be seen that as time progresses (the peristaltic movement moves to the right on the time axis, and the representation itself moves to the left), the contraction pressure in each part of the esophagus progresses from the upper to the lower part (from the upper esophageal sphincter to the lower esophageal sphincter).

[0089] On the other hand, if the subject is suspected of having an abnormality, no peristaltic movement is observed in the esophagus ((f) in FIG. 11). For this reason, a user such as a doctor will check, for example, the endoscopic image I1 and the first to third pieces of support information I2 to I4 that make up the diagnostic support information I0, to evaluate the acid clearance function due to esophageal peristalsis.

[0090] Then, in step S7, if a user such as a doctor suspects an abnormality in any of the valve function due to the stomach structure, the valve function due to the lower esophageal sphincter, and the acid clearance function due to esophageal peristalsis evaluated in steps S4 to S6, the user will diagnose that gastroesophageal reflux disease is suspected.

[0091] 9 and 10 includes diagnostic result information I6. The diagnostic result information I6 is information related to the diagnostic result obtained by automatically diagnosing whether or not the subject has gastroesophageal reflux disease (whether or not there is a suspicion of gastroesophageal reflux disease) by the processing device 4 based on the captured image, intragastric pressure information, esophageal pressure information, and belching sound information. The diagnostic result information I6 includes an evaluation result I61 that evaluates which phase the current phase is, an evaluation result I62 that evaluates whether or not the subject is in a state corresponding to each of Phases 1 to 3, and a diagnostic result I63 that evaluates whether or not there is gastroesophageal reflux disease (whether or not there is a suspicion of gastroesophageal reflux disease) based on the evaluation result I62.

[0092] The processing device 4 stores in memory the captured image, gastric pressure information, esophageal pressure information, and eructation information, which are processed in a time-synchronized manner based on the synchronization signal. That is, the captured image and various support information can be referenced in a time-synchronized state. Therefore, for example, a user such as a doctor can view the endoscopic image at a time specified by the user, as well as the various support information at that time.

[0093] [Method for Determining the Positional Relationship Between Pressure Sensors and the Lower Esophageal Sphincter] Next, a method for determining the positional relationship between the pressure sensors and the lower esophageal sphincter will be described. FIGS. 12 to 14 are diagrams illustrating a method for determining the positional relationship between the pressure sensors PS1 to PS36 and the lower esophageal sphincter. Specifically, FIG. 12 is a flowchart showing a method for determining the positional relationship between the pressure sensors PS1 to PS36 and the lower esophageal sphincter. FIG. 13 is a diagram showing pressure measurements of the pressure sensors PS1 to PS36 before gas is delivered from the gas delivery device 6. FIG. 14 is a diagram showing pressure measurements of the pressure sensors PS1 to PS36 during gas delivery from the gas delivery device 6. The horizontal axes in FIGS. 13 and 14 correspond to the pressure sensors PS1 to PS36 arranged along the axial direction of the insertion section 21, from the stomach side to the esophagus side.

[0094] First, a user such as a doctor executes the processes of steps S1 and S2 in the same manner as in Fig. 4. As a result, the insertion section 21 is set in a J-shape with the tip pointing toward the gastric cardia, as shown in Fig. 5. In this state, the pressure sensors PS1 to PS36 are arranged at positions that detect contraction pressure and relaxation pressure at various locations inside the esophagus from the upper esophageal sphincter to the lower esophageal sphincter.

[0095] After step S2, the processing device 4 calculates the measured values ​​P of the pressure sensors PS1 to PS36 before the air is sent from the air sending device 6. ｉ (i is an integer between 1 and 36 corresponding to one of the pressure sensors PS1 to PS36) is acquired (step S11).

[0096] After step S11, the processing device 4 calculates the measured values ​​P of the pressure sensors PS1 to PS36 before the air is sent from the air sending device 6. ｉ 13, before the gas supply device 6 supplies gas, the reference value of the gastric pressure P ｇ Since there is no increase, the measured value P ｉ This pressure is called the reference pressure P ｅ The reference value P ｅ is the measured value P ｉ However, any arbitrarily chosen measurement value P ｉ The reference value P ｅ It may also be possible to use the following.

[0097] After step S12, the user such as a doctor operates the switch 224 to start supplying gas from the gas supply device 6 to the inside of the stomach through the gas supply conduit 223 (step S13). When the user such as a doctor operates the switch 224, gas is supplied in stages from the gas supply device 6. Gas is supplied in a certain number of steps, and the pressure measurement value P ｉ By acquiring this information, it is possible to precisely observe pressure changes. Also, if a large amount of air is insufflated at once, causing the lower esophageal sphincter to relax, it may not be possible to accurately identify the location of the lower esophageal sphincter, but this is prevented by insufflation in stages.

[0098] After step S13, the processing device 4 receives the measured values ​​P of the pressure sensors PS1 to PS36 during the supply of air from the air supply device 6.ｉ is acquired (step S14).

[0099] After step S14, the processing device 4 calculates the measured values ​​P ｉ About P ｉ -P ｉ＋１ It is determined whether or not the condition ΔP is satisfied (step S15). Note that ΔP is a predetermined value set in advance, and the gastric pressure P ｇ can be considered to have risen sufficiently, and the intragastric pressure P ｇ is set so as not to exceed the contractile force of the lower esophageal sphincter. ｉ -P ｉ＋１ The relational expression >ΔP may be satisfied for any one pair of adjacent pressure sensors.

[0100] In step S14, the processing device 4 ｉ -P ｉ＋１ If it is determined that >ΔP does not hold (step S15: No), the processing device 4 repeats the process of step S15.

[0101] On the other hand, in step S14, the processing device 4 ｉ -P ｉ＋１ If it is determined that the gas pressure P is greater than the gas pressure P (step S15: Yes), the processing device 4 stops the gas supply from the gas supply device 6 to the stomach (step S16). ｇ On the other hand, the internal pressure does not increase on the esophageal side of the lower esophageal sphincter. Then, the measured value P ２ and the measured value P ３ ) in P ｉ -P ｉ＋１ >ΔP holds.

[0102] After step S16, the processing device 4 receives the measured pressure P ｉ and the reference pressure value P ｅ The amount of change between the pressure and the reference sensor is calculated, and the reference sensor is identified based on the amount of change (step S17). ｇ Since increases, the measured value P ｉ and the reference pressure value Pｅ On the other hand, the internal pressure does not increase on the esophageal side of the lower esophageal sphincter, so the measured value P ｉ and the reference pressure value P ｅ The amount of change does not change.

[0103] In the case of FIG. 14, the processing device 4 calculates the measured value P ｉ and the reference pressure value P ｅ The measured value P １ , P ２ It can be considered that the pressure sensors PS1 and PS2 that detected the measurement value P are located on the distal side of the lower esophageal sphincter, that is, inside the stomach. ｉ and the reference pressure value P ｅ The measured value P ３ It can be assumed that the pressure sensors PS3 to PS36 that detected this are located on the proximal side of the lower esophageal sphincter, that is, inside the esophagus.

[0104] The reference sensor is, for example, the pressure sensor located closest to the lower esophageal sphincter toward the distal end of the insertion portion 21. That is, in the case of Fig. 14, the processing device 4 identifies the pressure sensor PS2 as the reference sensor.

[0105] After step S17, the processing device 4 generates second support information by processing the pressure measurement values, with the area distal to pressure sensor PS2 (the reference sensor) representing the stomach and the area proximal to pressure sensor PS3 representing the esophagus (step S18). Thereafter, the processing device 4 executes the processes of steps S3 to S7 shown in FIG. 4 to generate support information by processing the pressure measurement values ​​according to the positions of the reference sensors.

[0106] The processing device 4 may, for example, display on the display device 5 a message informing the user that the reference sensor is the pressure sensor PS2 as support information. The processing device 4 may also, for example, superimpose the position of the lower esophageal sphincter on the pressure waveform I31, which is the second support information I3. The processing device 4 may also perform various evaluations using the pressure measurement value distal to the pressure sensor PS2, which is the reference sensor, as the gastric pressure and the pressure measurement value proximal to the pressure sensor PS3 as the esophageal pressure, and output the evaluation results as support information. The processing device 4 may also, for example, extract and output esophageal peristalsis from the pressure topography (pressure waveform I31).

[0107] The present embodiment described above has the following advantages. According to the present embodiment, a reference sensor is identified based on pressure measurement values, and support information is generated by processing the pressure measurement values ​​according to the position of the reference sensor. Therefore, support information that associates the positional relationship between the pressure sensors PS1 to PS36 and the digestive tract of the subject can be output.

[0108] Other Embodiments Although the embodiments for carrying out the present invention have been described above, the present invention should not be limited to only the above-described embodiments.

[0109] In the embodiment, an example has been described in which gas is supplied stepwise from the gas supply device 6 in step S13, but this is not limiting. When a user such as a doctor operates switch 224, gas may be supplied in a short pulse-like manner from the gas supply device 6, and pressure fluctuations may be observed. By applying pulsed air to the lower esophageal sphincter, the diffusion and convergence of pressure waves can be grasped in detail, and the precise pressure characteristics of the lower esophageal sphincter can be observed.

[0110] Similarly, when a user such as a doctor operates switch 224, two independent air supply channels may be used to supply or inhale air to the stomach side and the esophagus side, respectively. The two independent air supply channels may be, for example, the air supply conduit 223 of the insertion section 21 of the endoscope 2 and an air supply conduit provided in an overtube through which the insertion section 21 of the endoscope 2 is inserted. Then, by placing one tip inside the stomach and the other tip inside the esophagus, and setting one to high pressure and the other to low or negative pressure (inhalation), a pressure difference can be created, thereby improving the accuracy of detecting the position of the lower esophageal sphincter.

[0111] In the above-described embodiment, the present invention has been described as a technology capable of identifying the position of the lower esophageal sphincter, but this is not limited to this. For example, the present invention can also identify the positions of the major sphincters present in the human digestive tract. Specifically, the present invention can identify the position of the external anal sphincter.

[0112] DESCRIPTION OF SYMBOLS 1 Endoscope system 2 Endoscope 3 Light source device 4 Processing device 5 Display device 6 Air supply device 7 Gastric pressure measuring device 8 Microphone 21 Insertion section 22 Operation section 23 Universal cord 24 Tip section 25 Bending section 26 Flexible tube section 31 Light source section 32 Lighting control section 33 Light source driver 41 Image processing section 42 Synchronization signal generation section 43 Input section 44 Control section 45 Memory section 61 Air supply section 62 Flow rate measurement section 63 Control section 71 Pressure measurement probe 221 Bending knob 222 Treatment tool insertion section 223 Air supply conduit 224 Switch 231, 232 Connector 241 Light guide 242 Illumination lens 243 Optical system 244 Image pickup element 245 Collective cable I0 Diagnosis support information I1 Endoscopic image I2 First support information I21 Pressure waveform I22 Current gastric pressure I23 Maximum gastric pressure I24 Basal gastric pressure I3 Second support information I31 Pressure waveform I32 Basal pressure I4 Third support information I41 Waveform I5 Time information I6 Diagnosis result information I61, I62 Evaluation result I63 Diagnosis result PS1 to PS36 Pressure sensor TU Air supply tube

Claims

1. An endoscopic system comprising: an endoscope having an insertion section with an imaging element disposed at the tip; a plurality of pressure sensors that detect pressure applied to the outer peripheral surface of the insertion section, the plurality of pressure sensors being disposed along the axial direction of the insertion section; an air supply device that supplies air from the tip of the insertion section via an air supply pipe that extends to the tip of the insertion section; and a processor, wherein the processor acquires pressure measurement values ​​output from the plurality of pressure sensors, identifies a reference sensor that is the pressure sensor that serves as a reference based on the pressure measurement values, and generates support information by processing the pressure measurement values ​​according to the position of the reference sensor.

2. The endoscope system according to claim 1, wherein the processor processes the pressure measurements detected by the plurality of pressure sensors in a time-synchronized manner.

3. The endoscope system according to claim 1, wherein the processor calculates a reference pressure value based on the pressure measurement value before gas is supplied from the gas supply device.

4. An endoscope system according to claim 3, wherein the processor calculates the amount of change between the measured pressure value during gas supply from the gas supply device and the reference pressure value.

5. The endoscope system according to claim 4, wherein the processor identifies the reference sensor based on the amount of change.

6. The endoscope system of claim 1, wherein the pressure sensor is a solid-state pressure sensor.

7. The endoscope system according to claim 1, wherein the pressure sensor is a semiconductor piezo-resistive diffusion pressure sensor.

8. The endoscope system according to claim 1, wherein the pressure sensor is a capacitance type pressure sensor.

9. The endoscope system according to claim 1, wherein the reference sensor is the pressure sensor located closest to the lower esophageal sphincter on the distal end side of the insertion section.

10. The endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the proximal side of the bendable bending portion of the insertion section.

11. The endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer circumferential surface of the insertion section at intervals of 4 cm along the axial direction of the insertion section.

12. The endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer circumferential surface of the insertion section at intervals of 8 cm along the axial direction of the insertion section.

13. The endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer circumferential surface of the insertion section at intervals of 25 cm along the axial direction of the insertion section.

14. An endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer peripheral surface of the insertion section at equal intervals along the axial direction of the insertion section.

15. An endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer peripheral surface of the insertion section at intervals of 2 cm or less along the axial direction of the insertion section.

16. The endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer peripheral surface of the insertion section at intervals of 1 cm along the axial direction of the insertion section.

17. The endoscope system according to claim 1, wherein the plurality of pressure sensors are arranged on the outer peripheral surface of the insertion section at 36 locations at 1 cm intervals along the axial direction of the insertion section.

18. An endoscope system according to claim 1, wherein the processor generates the support information by processing the pressure measurement values, with the distal side of the reference sensor representing the stomach and the proximal side of the reference sensor representing the esophagus.

19. The endoscope system according to claim 1, further comprising an overtube through which the insertion section of the endoscope is inserted, and the plurality of pressure sensors are disposed on the outer peripheral surface of the overtube.

20. A control method for an endoscopic system comprising: an endoscope having an insertion section with an imaging element arranged at the tip; a plurality of pressure sensors that detect pressure applied to the outer peripheral surface of the insertion section, the plurality of pressure sensors being arranged along the axial direction of the insertion section; an air supply device that supplies air from the tip of the insertion section via an air supply pipe that extends to the tip of the insertion section; and a processor, the control method for an endoscopic system comprising: causing the processor to acquire pressure measurement values ​​output from the plurality of pressure sensors; identify a reference sensor that is the pressure sensor that serves as a reference based on the pressure measurement values; and generate support information by processing the pressure measurement values ​​according to the position of the reference sensor.

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