ES2374234A1 - SYSTEM OF ANALYSIS AND MANAGEMENT OF SURGICAL IMAGES. - Google Patents

Abstract

Surgical image management and analysis system. A surgical image management and analysis system is described that allows monitoring and recording in real time all the activity of an operating room or complex medical-surgical environment by integrating images or video signals from of the devices commonly used in the operating room, video signals from computers and computer equipment used in the operating room, images from radiological studies and data from the medical history from hospital networks or conventional media and signals from conventional video cameras, without interfering in clinical activity.

Description

Image analysis and management system Surgical

Object of the invention

The present invention describes a system of analysis and management of surgical images (SAGIQ) that allows monitor and record in real time all the activity of a operating room or complex medical-surgical environment by integrating i) images (video signals) from devices commonly used in the operating room (surgical microscopes, ultrasound, endoscopes, browsers, X-ray equipment, computerized tomographs and resonators, respirators, ...), ii) video signals from computers and computer equipment for use in the operating room (systems intraoperative neurophysiological monitoring as electroencephalographs and electromyographs), images of the studies radiological and clinical history data from networks hospital or conventional supports and iii) signals (images) of conventional video cameras, without interfering with the activity clinical, as well as dynamically manage in real time the video signals from different cameras and surgical devices, so that each professional present in The operating room can choose which image to display at each moment. Also, combinations of multiple images can be generated (video signals) on the same screen, in real time, and both images from cameras like those from devices and the combined image can be sent to different monitors installed in the operating room or outside it, for retransmission or internet connection. The presented system It also allows you to integrate audio signals from microphones available inside the operating room, generating a signal mixed for shipping abroad as well as receiving in the operating room Audio signals from outside.

Background of the invention

There are surgical operations in which a large number of professionals intervene, each of whom is responsible only for a part of the intervention, and for both the medical-surgical information that each of them required to carry out their work is different. This medical-surgical information can understand both data provided by elements such as respirators, ultrasound scanners, etc. as real images of the operation itself (endoscopes, surgical microscopes, ...). However, frequently the access to such medical-surgical information is hindered by the large number of people and devices present in the operating room that interfere with the communication lines of the professionals with each other. For this reason, it is usual to have video cameras that collect information from different aspects of the operations. However, there may still be problems with accessibility to medical-surgical information in specific moments of the interventions. Additionally, it is useful for subsequent evaluation and / or real-time operations recording the information provided by the cameras or by other elements for further analysis, as well as offering the possibility of transmitting the operation live for viewing Instant by students or other doctors and professionals. In long-term surgical interventions, ergonomics in the vision of multiple demanding image sources is a factor very important to minimize observer visual fatigue (surgeons, anesthesiologists, nurses and other professionals). Also, in interventions with multiple teams of professionals working simultaneously in the operating room, coordination and synchrony between them it is greatly improved if everyone has the possibility to observe, in real time, the activities that go taking place developed by the other professionals.

To solve these problems, there are some surgical image management systems that centralize all the information on a device in order to improve its accessibility. An example of a background of the invention is the design and assembly project of the University of California (UCLA) and RBB Architects Inc. of the so-called "operating rooms of the future "in a new hospital, referred to in the` `Annual Seminal on Imaging and Informatics (Arrowhead, California, 2004), where describes a device that allows centralized control by the surgeon of all devices and the use of multiple flat screens in the operating room. However, it is inferred from the description of this system that is a digitized system, with control and operation by computer systems of very High cost and benefits. These operating room systems integrated are the so-called "smart operating rooms" in which the centralized control systems of the equipment are integrated into the architectural design of operating rooms.

Some more known systems are Endoalpha (Olympus), the Averpit (Steris), the Patient-Aware OR (Karl Storz and LiveData), the BrainSuite NET (Brainlab), the Hybrid Rooom (Phillips in cooperation with Steris, Skytron and Brainlab), the Skyvision (Skytron) or Smart OR (ConMed), among others. Without However, these systems have the following drawbacks Main:

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They are fixed systems, that is, they cannot be moved from operating rooms to others according to the needs of the institution and / or the professionals.

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Be it deals with extremely specific systems, which does not allow change the use of the system according to the nature of the invention (neurosurgery, fetal surgery, general surgery, etc.)

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They require a deployment time elevated, from the moment the installation of the system until its start months go by.

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The investment, both in facilities and in training, is very high.

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Is it so based on software management, which makes them extremely dependent on specialized operators and systems integrated communication, but not always integrable in others information systems.

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Is it so based on the acquisition of solution packs that include the integration of sources and data but also the sources themselves of images and data.

Finally, the applicants here invention are the holders of the patent P2264845. This patent describes a system of analysis and management of surgical images formed by two modules to which the various are connected Image and signal generating devices.

Consequently, there is still a need for a system that allows adequate control and access to all surgical information in an operating room and at the same time Simple, economical and versatile.

Description of the invention

The system of the present invention allows monitor and record in real time all the activity of a operating room by integrating the images provided by the usual operating room and video camera systems conventional, without interfering with clinical activity and without require advanced technological knowledge. In addition, a important advantage of the present invention is that it is transferable, since physically it is a system mounted on a platform with wheels that can be moved from an operating room to another depending on the specific needs of each intervention surgical This feature avoids the need to have a single operating room specially adapted for the use of this invention, so it can be used in interventions consecutive in different operating rooms, even separated by considerable distances, unlike existing systems Because of its enormous complexity, they are permanently installed.

In addition, the system of the present invention is compact, although with a modular structure that allows to distinguish control elements of viewing elements, so that possible incidents in any of the internal devices not Affect the rest. Note that the viewing union with control It could lead to a total system shutdown in case of failure.

Another important advantage of the system invention is the possibility of allowing both digital connections as analog. Although digital systems have tested their versatility and comfort widely compared to analog systems, the current reality in the system development environment of the invention, the Spanish health system, dictates that the immense most of the available equipment are analog in nature in their connections. The ease and low cost of connecting the equipment Existing is a very significant factor.

System control during Surgical interventions are performed using a remote control connected by cable and, eventually, by a support computer through a standard pointing device (mouse), although the Computer is not essential for its operation. The information is presented graphically on a screen above the system, thereby reducing complexity and allowing Dynamic real-time management of video signals from different sources so that each professional can Choose at any moment what image you need to visualize. Analogously, The system allows to integrate and control input audio signals and exit from the operating room. Also, thanks to the possibility of configure the entire system only once, stability is ensured over time in the task of recording as many interventions as desired, without the need for complicated prior or subsequent processes that hinder work inside the operating room.

The invention describes an analysis system and surgical image management that manages 12 PAL and 4 channels VGA channels containing surgical or environment information complex medical-surgical. Such information medical-surgical may consist of images or optical signals (from microscope, endoscope, cameras surgical field, helmet microcameras, environment cameras or any other type of camera that generates a video signal from output), radiological (images or computerized tomography data, MRI, ultrasound, browsers, emission tomography of positrons or any other techniques) and data (signals of monitoring systems, such as anesthesia monitors and neurophysiology such as electroencephalographs, electromyographs, stimulators or others). The system includes the following elements:

- A VGA / PAL conversion device that converts the 4 source VGA channels into 4 PAL channels. May it is a single device with 4 inputs / outputs, or Four devices arranged in parallel.

- A video switching matrix of 16 channels, preferably a Sierra Lassen XL model, which receives the 12 source PAL channels and the 4 outgoing PAL channels of the VGA / PAL conversion device and sends them to PAL channels of certain output. This device is manageable by staff doctor to choose which images to send to the output channels, by example using a remote control and / or using a PC support for.

- A multiple image processor, preferably a Kaleido-Alto model, connected to 10 of the output PAL channels of the switching matrix video, which produces a multiple digital video image that contains simultaneously the corresponding 10 images and sends it to a multichannel monitor for viewing. Multiple digital video It can be in any of the VGA, DVI, SDI or similar formats. Since the images transmitted by each of said 10 channels PAL output of the switching matrix are configurable by the medical staff, the system allows to create the combination of 10 images that best fit each need.

- Six monitors connected to the remaining 6 output PAL channels of the video switching matrix, and that allow medical staff to view images in real time of these channels. In a manner similar to that described above, the medical staff can choose which images contain said 6 channels PAL output of the switching matrix, so that each Professional has real-time access to the image that most interest in every moment. The monitors can be arranged in inside the operating room, or send the signal abroad, by example to a classroom or a conference room, for training or divulgation.

- A recording device, which stores the multiple digital video image and an output channel of the switching matrix, leaving the images stored for further consultation or study. Preferably, the system of the invention comprises an additional screen that allows the two channels being recorded to be displayed, both at the input and output of the recording equipment. This configuration not only allows you to know at any time what images are being recorded, but also to access previously recorded images even during the operation itself if necessary. The recording equipment is preferably formed by two professional hard disk video recorders, each of which respectively stores the video files of the previous PAL channel and the multiple digital video channel on a removable hard disk that can be accessed later by port
USB

According to a preferred embodiment, the system It also includes a support personal computer (PC) connected to the video switching matrix and multiple image processor to allow its handling and configuration in real time. Even without he, the professionals present in the operating room can operate the switching matrix and multiple image processor to choose from what image is displayed on each of the monitors based on your needs at all times, since the analysis system of the present invention is designed so that it can function in Support computer independent way. This computer, without However, it facilitates the creation of new operating scenarios and the management of the different elements (video matrix and generator multiple image).

In addition, according to a preferred embodiment of the invention, the system comprises a remote control that Allows remote operation of the video switching matrix.

Additionally, the system of the invention It has an audio management device that incorporates a front connection of audio inputs and outputs with possibility of silencing them. They connect to this device management of audio inputs from the operating room and the outside, allowing two-way communication between the two scenarios The device also has line outputs for attack speakers both in the operating room and outside it, as well as from an additional recording system that stores all the signals of Audio. The connection circuits of the audio management device They are completely independent of the video ones.

The system also contains a subsystem of modular wiring for connection with the different elements that They provide the signals of the input channels. This wiring, formed by at least two branches of cables, collected under tube and with termination in junction boxes, it allows the system to be deployed quickly and easily in unusual environments.

This system also allows its use in reduced spaces since it can outsource most of the imaging systems that do not necessarily require introduction in the operating room, as human neurophysiology teams, seconds surgical or anesthetic teams or coordinate with other teams surgical in other operating rooms in cases of combined surgeries (twins, transplants, bank surgeries ...). This concept allows, therefore, to optimize spaces and times surgical, expensive and scarce elements at the same time maximum, without the need for additional investments and on time real.

Finally, although they are not described explicitly, it is understood that the system also includes all the necessary wiring to make the connections between the different elements that compose it, as well as power supplies, transformers, etc. necessary to feed those elements.

Brief description of the drawings

Fig. 1 shows a scheme of the system of analysis and management of surgical images according to the present invention

Fig. 2 shows a perspective view of the system of the present invention where the picture of connections.

Fig. 3 shows a wiring view of the system of the present invention where the connections.

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Preferred Embodiment of the Invention

An example of a system is described below. (1) in accordance with the present invention with reference to the attached figures. The system (1) is designed to receive 12 signals in PAL format and 4 in VGA format, represented in the part top of the figure, coming from all devices common operating room and intraoperative use, such as surgical microscopes (conventional or helmet), endoscopes, ultrasound scanners, respirators, neurophysiology systems, equipment radiology, surgical field cameras, environment camera operating room and computer, with both video and VGA outputs. Some entries may be duplicated (for example, ultrasound scanners and respirators) to allow simultaneous monitoring of surgeries fetal with mother and two fetuses ("twin" interventions). In In any case, an example configuration of the inputs for a particular case could be:

VGA1

Respirator.

VGA2

Echograph

VGA3

Computer with CT / RM study.

VGA4

ICP neurophysiological monitoring.

PAL1

Endoscope

PAL2

Helmet Microscope

PAL3

Environment camera

PAL4

Exoscope

PAL5

Surgical Field Camera

PAL6

Browser.

PAL7-12

Channels for additional use.

These signals, once transformed the four VGA signals in PAL signals via the conversion device VGA / PAL (2), constitute the inputs to a switching matrix of video (3) Sierra Lassen XL model, which in turn transmits them to the Departures chosen by professionals for viewing well to through the multichannel display (M7) or through any of the screens (M1 ... M6). To do this, the switching matrix of Video (3) can be operated using a remote control (7) or a support PC (not shown). Next, 10 output PAL channels of the video switching matrix (3) are sent to the processor of multiple image (4) Kaleido-Alto, which groups them into a single channel in multiple digital video format to show the 10 images chosen through the multi-channel display (M7). By on the other hand, the remaining 6 PAL output channels of the array of Video switching (3) are sent to the screens (M1 ... M6).

Therefore, as mentioned above in this document, the image seen in each of the 6 screens (M1 ... M6) can be changed at any time using the remote control (7). In this way, during the development of the intervention, each professional has in front the most appropriate image in every moment. Some professionals, such as instrumentalists, they need the image of the surgical field (in order to give the material to surgeons more efficiently). Others, like their own surgeons, anesthesiologists or other professionals need to see in real time different images during the intervention (endoscopes, neurophysiology signals, radiological images obtained previously, or substantial history safety data digital clinic such as laterality, pathological studies or allergies, or respirator or ultrasound signals). In addition, others professionals, such as neurophysiologists or anesthesiologists, need to access the image of the work area of the surgeons Also, the images that make up the image output Multiple are also configurable via PC or remote control. distance (7). An example of the use that could be given to each of The output images is as follows:

M1

Screen for surgeons.

M2

Anesthesia screen

M3

Screen for players.

M4

Screen for neurophysiology.

M5

Screen for public outside the operating room.

M6

Connection to web video server.

M7

Multiple digital image

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In addition, a recording equipment (5) stores the images corresponding to the multiple image channel and one of the channels (in this example it is the channel "Screen of surgeons ", corresponding to the M1 screen), being able to later recover these recordings for various uses, such as demonstrations, courses, seminars, etc. In this example, the team Recording (5) consists of two professional recorders of Hard disk video accessible via USB port. Has been represented also the screen (M8) that shows the images of the channels that both the input and output of the equipment are being recorded recording (4), and allowing access to stored material previously.

In addition, an audio management system (9) incorporates four inputs, two microphone (MIC1, MIC2) and two of line (L1, L2), as well as two outputs (A1, A2) with line level to be connected to powered speakers. In addition, the mixture All audio is recorded along with the multiple image. All the Channels can be disabled manually.

The connection circuits of the management system Audio (9) are completely independent of the circuits of connection (8) corresponding to the video, as shown in Fig. 2. Also shown in Fig. 2 is the transferable platform with wheels on which the system (1) is arranged, which is equipped of a handle (10) adjustable in height for easy transport by hospital staff

Claims (13)

1. Surgical imaging analysis and management system (1), which receives 12 PAL channels and 4 VGA channels containing surgical information, characterized in that it comprises the following elements:

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a VGA / PAL conversion device (2) that converts the 4 channels Source VGA on 4 PAL channels;

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a 16-channel video switching matrix (3) receiving 12 source PAL channels and the 4 outgoing PAL channels of the device VGA / PAL conversion (2) and selectively sends them to 12 channels PAL output;

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nail screens (M1 ... M6) respectively connected to 6 PAL channels of output of the video switching matrix (3), which allow the medical staff visualize images in real time corresponding;

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a Multiple image processor (4) connected to the remaining 10 output PAL channels of the video switching matrix (3), which creates a multiple digital video signal containing said 10 PAL channels and sends them to a multichannel monitor (M7) for display; Y

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a recording equipment (5), configured to store the image of Multiple digital video and a PAL channel output from the array of switching (3).

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2. Image analysis system and management (1) surgical devices according to claim 1, further comprising a PC connected to the video switching matrix (3) and to the Multiple image processor (4) for easy handling and setting. 3. System (1) of analysis and image management surgical according to any of the claims above, which also includes a remote control (7) that allows medical staff to manage the video switching matrix (3) to decide which images are shown in the screens (M1 ... M6) and / or multichannel display (M7). 4. System (1) of analysis and agreement management with any of the preceding claims, wherein the equipment of recording (5) comprises a first recording unit (G1) arranged to store an output PAL channel of the array of video switching (3) and a second recording unit (G2) arranged to store the multiple digital image. 5. System (1) of analysis and agreement management with claim 4, further comprising an additional screen (M8) connected to the input and output of each of the units recording (G1, G2). 6. System (1) of analysis and agreement management with any of the preceding claims, which in addition it comprises an audio management system (9) with two inputs of microphone (MIC1, MIC2) and two line inputs (L1, L2), as well as two outputs with line level (A1, A2) that allows retransmission real-time surgical interventions, as well as the bidirectional communication between the operating room and outside. 7. System (1) of analysis and agreement management with claim 6, wherein the connection circuits of the Audio management system device (9) are independent of video connection circuits (8). 8. System (1) of analysis and agreement management with any of claims 6-7, wherein the audio input and output of the audio generation system (9) They are silent. 9. System (1) of analysis and agreement management with any of claims 6-8, wherein the Mixing the different audio inputs is recorded along with the Multiple digital image video. 10. Analysis and management system (1) according to any of the preceding claims, characterized in that it additionally comprises a modular wiring subsystem formed by at least two cable branches collected under a pipe and terminated in connection boxes, which allows deployment The system quickly and easily in unusual environments. 11. System (1) of analysis and agreement management with any of the preceding claims, which is arranged on a transferable platform. 12. System (1) of analysis and agreement management with claim 11, further comprising a handle (10) for facilitate transport 13. System (1) of analysis and agreement management with any of the preceding claims, wherein the signal of Multiple digital video is a VGA, DVI or SPI signal.