JP7595199B2 - Endoscope Information Management System - Google Patents

Description

The present invention relates to an endoscope information management system that manages information related to endoscopes.

In the medical field, examinations and surgeries using endoscopes have become commonplace. In addition, devices or systems that manage information related to endoscopes include an image management device that manages endoscopic images (Patent Document 1), a diagnosis support device that supports diagnosis (Patent Document 2), a report creation support system that supports report creation (Patent Document 3), a cleaning management system that manages the cleaning of endoscopes (Patent Document 4), and a repair information management system that manages information related to endoscope repairs (Patent Document 5).

JP 2014-053723 A JP 2012-157384 A JP 2011-072663 A JP 2015-195867 A JP 2015-099503 A

When an examination is performed using an endoscope, various related tasks arise in addition to observing or photographing the subject. For example, before the examination, there is work related to preparation for carrying out the examination that matches the order. During the examination, not only is the subject observed or photographed for the examination, but, if necessary, samples for a tissue examination (known as a biopsy) may be taken or procedures such as endoscopic surgery may be performed. After the examination, the doctor may write a report using endoscopic images. After the examination, the doctor or other medical staff may attach labels to containers in which samples are stored or clean the endoscope used for the examination.

The above-mentioned endoscopic examinations and tasks associated with endoscopic examinations are closely related to each other. Each task is performed using equipment suitable for that task. For example, an examination using an endoscope is performed using an endoscope device that includes an endoscope, a light source device, and a processor device. On the other hand, for example, a report creation device separate from the endoscope device is used to create a report. Similarly, a cleaning and disinfecting device separate from the endoscope device is used to clean an endoscope. The same is true for other related tasks.

For this reason, if the devices performing each task are not closely connected, it will be inconvenient to carry out each task. Therefore, it is desirable that some or all of the devices performing endoscopic examinations and tasks related to endoscopic examinations are closely connected.

The present invention aims to provide an endoscopy information management system that comprehensively manages information related to endoscopic examinations, enabling all or part of the series of tasks related to endoscopic examinations to be carried out smoothly.

The endoscope information management system of the present invention includes a photographing position recognition unit that recognizes the part of the subject that appears in the endoscope image, an image selection support unit that automatically selects an endoscope image to be used in a report from among multiple endoscope images using the recognition results of the photographing position recognition unit, and a patient information acquisition unit that acquires patient information to be used in the report from a patient information database.

It is preferable to have an examination information acquisition unit that acquires examination information to be used in the report from an examination information management database. It is preferable to have a discrimination unit that performs discrimination processing on the endoscopic image, and a display unit that displays the discrimination result of the discrimination unit. It is preferable that the shooting position recognition unit is capable of recognizing the shooting position in more detail than the recognition result of the shooting position recognition unit.

It is preferable that the apparatus includes a procedure recognition unit that recognizes the procedure performed on the subject in the endoscopic image, and the image selection support unit selects the endoscopic image to be used in the report using the recognition result of the procedure recognition unit. It is preferable that the apparatus includes a lesion recognition unit that recognizes the presence or absence of a lesion in the endoscopic image, and the image selection support unit selects the endoscopic image to be used in the report using the recognition result of the lesion recognition unit.

The endoscopy-related business system of the present invention can smoothly carry out part or all of the series of tasks related to endoscopic examinations.

FIG. 1 is an explanatory diagram showing a medical system for endoscopic examination. FIG. 1 is a perspective view of an endoscope device. FIG. 2 is a block diagram of a processor device. FIG. 4 is a block diagram of a first recognition processing unit. FIG. 1 is a block diagram of a label printer. FIG. 2 is a perspective view of the cleaning and disinfecting apparatus. FIG. 2 is a block diagram of the cleaning and disinfecting apparatus. FIG. 2 is a block diagram of a report creation device. 1 is a block diagram showing a configuration of an endoscope information management system. FIG. 4 is a block diagram of a test information management unit. FIG. 4 is a block diagram of a cleaning information management unit. FIG. 4 is a block diagram of a label output management unit. FIG. 2 is a block diagram of a report creation support unit. 11 is a flowchart of a preparation support operation for supporting preparation for an endoscopic examination. This is a pre-examination screen that is displayed before the start of an endoscopic examination. 10 is a flowchart showing the operations for starting an endoscopic examination. 10 is a flowchart showing operations during an endoscopic examination. This is an examination in-progress screen that is displayed during an endoscopic examination. This is a sample label. 13 is a flowchart showing an operation when performing bedside cleaning. 13 is a cleaning information input screen displayed when performing bedside cleaning. 1 is a flowchart of the main cleaning process. 1 is a display screen of a cleaning and disinfecting apparatus. 13 is a flowchart showing a report creation support operation. This is a report creation screen. This is the key image display section. This is the information input section.

[Endoscopy-related business system]
As shown in Fig. 1, the endoscope-related work system 10 is a system used for performing examination, observation, surgery, etc. of a subject using an endoscope 42 (see Fig. 2) (hereinafter referred to as endoscopic examination) and work related to the endoscopic examination. Work related to the endoscopic examination (hereinafter referred to as related work) is medical and other work other than the endoscopic examination that is required during or before and after the endoscopic examination. In other words, related work is work that accompanies the endoscopic examination, and examples of related work include printing labels to be affixed to biopsy containers, cleaning and disinfecting the endoscope 42, and creating reports.

The endoscope-related business system 10 includes an endoscope device 21, a label printer 22, a cleaning and disinfecting device 23, a report creation device 24, and an endoscope information management system 31. Of these, the label printer 22, the cleaning and disinfecting device 23, and the report creation device 24 are related business devices 26. The related business devices 26 may include devices for performing related business in addition to the label printer 22, the cleaning and disinfecting device 23, and the report creation device 24. Furthermore, the related business devices 26 may not include the label printer 22, the cleaning and disinfecting device 23, and/or the report creation device 24 if not necessary.

(1) Configuration of the Endoscope Device As shown in FIG. 2, the endoscope device 21 includes an endoscope 42, a light source device 44, a processor device 46, a monitor 48, and a console 49. The endoscope 42 captures an image of a subject. The light source device 44 generates illumination light. The processor device 46 controls the endoscope device 21 and performs image processing, etc. The monitor 48 is a display unit that displays an endoscopic image. The console 49 is an input device that performs setting input to the processor device 46, etc. The console 49 includes a device that inputs or reads information necessary for an endoscopic examination, such as the ID (identification) of a doctor who performs an endoscopic examination using the endoscope device 21 and the ID of a patient who is a subject of the endoscopic examination. For example, when the doctor's ID and the patient's ID are input using barcodes, the console 49 includes a barcode reader. When a card equipped with an IC (integrated circuit) chip (a so-called IC card) is used, the console 49 includes a card reader.

The endoscope 42 has an insertion section 42a to be inserted into the subject, an operation section 42b provided at the base end of the insertion section 42a, a bending section 42c provided at the tip side of the insertion section 42a, and a tip section 42d. The bending section 42c is bent by operating the angle knob 42e of the operation section 42b. As a result, the tip section 42d faces the desired direction. In addition to the angle knob 42e, the operation section 42b has buttons, dials, or switches used for various operations such as switching observation modes, zooming, freezing, taking still images, and supplying air or water. In addition, the endoscope 42 has an insertion port 42f for a treatment tool. The insertion port 42f is connected to a treatment tool outlet (not shown) provided at the tip section 42d via a treatment tool channel (not shown) provided inside the endoscope 42. Therefore, when a treatment tool is inserted through the insertion port 42f, the tip of the treatment tool can protrude toward the subject from the treatment tool outlet of the tip portion 42d. The treatment tool can be, for example, forceps (biopsy forceps), a snare, or a scalpel (high-frequency scalpel).

The light source device 44 includes a light source unit (not shown) that emits illumination light, and a light source control unit (not shown) that controls the operation of the light source unit. The light source unit emits illumination light that illuminates the subject, or excitation light used to emit illumination light. The light source unit includes a light source such as a laser diode (hereinafter referred to as LD), an LED (Light Emitting Diode), a xenon lamp, or a halogen lamp, and emits at least white illumination light or excitation light used to emit white illumination light. The white light includes so-called pseudo-white light that is substantially equivalent to white light in photographing the subject using the endoscope 42. The light source unit includes, as necessary, a phosphor that emits light when irradiated with excitation light, or an optical filter that adjusts the wavelength band, spectrum, or light amount of the illumination light or excitation light. In addition, the light source unit can emit light having a specific wavelength band necessary for photographing an image used to calculate biological information such as the oxygen saturation of hemoglobin contained in the subject. The light source control unit controls the timing of turning on, off, or blocking each light source that constitutes the light source unit, as well as the amount of light emitted. As a result, the light source unit can emit multiple types of illumination light with different spectra. The light source control unit also controls the light source unit in accordance with the timing of shooting.

As shown in FIG. 3, the processor device 46 includes a connection detection unit 51, an image acquisition unit 52, an image processing unit 53, a display control unit 54, an alarm unit 55, a control unit 56, and a communication unit 57.

The connection detection unit 51 detects the connection of the endoscope 42 to the processor device 46 and/or the light source device 44. In addition to detecting that the endoscope 42 is connected, the connection detection unit 51 also acquires identification information for identifying the connected endoscope 42. That is, the connection detection unit 51 functions as an identification unit for identifying the endoscope 42. The identification information for identifying the endoscope 42 is information for identifying the model of the endoscope 42 (model number, etc.) and/or information for identifying an individual endoscope 42 when there are multiple endoscopes 42 of the same model (serial number, etc.). In this embodiment, the connection detection unit 51 is a sensor that detects the connection of the endoscope 42 and acquires the identification information of the connected endoscope 42 by communicating with the endoscope 42 connected to the processor device 46 via wired or wireless communication.

The image acquisition unit 52 acquires an image (including a signal used to generate an image) from the endoscope 42. The image acquisition unit 52 has, for example, a DSP (Digital Signal Processor), a noise reduction unit, and a conversion unit (none of which are shown), and uses these to perform various processes on the acquired image as necessary.

The DSP performs various processes on the acquired image as necessary, such as defect correction, offset processing, gain correction, linear matrix processing, gamma conversion, demosaic processing, and YC conversion.

The defect correction process is a process for correcting the pixel values of pixels corresponding to defective pixels of the image sensor. The offset process is a process for reducing dark current components from an image that has been subjected to defect correction process and setting an accurate zero level. The gain correction process is a process for adjusting the signal level of each image by multiplying the offset processed image by a gain. The linear matrix process is a process for improving the color reproducibility of the offset processed image, and the gamma conversion process is a process for adjusting the brightness and saturation of the image after the linear matrix process. The demosaic process (also called isotropic process or simultaneous process) is a process for interpolating the pixel values of missing pixels, and is performed on the image after the gamma conversion process. Missing pixels are pixels that have no pixel value due to the arrangement of the color filters (because pixels of other colors are arranged in the image sensor). For example, the demosaic process generates the pixel value of the B pixel at the position of the G pixel and the R pixel by interpolating using the pixel value of the B pixel. The same applies to other colors. The YC conversion process is a process for converting the image after the demosaic process into the luminance channel Y, the color difference channel Cb, and the color difference channel Cr.

The noise reduction unit performs noise reduction processing on the luminance channel Y, the chrominance channel Cb, and the chrominance channel Cr using, for example, a moving average method or a median filter method. The conversion unit reconverts the luminance channel Y, the chrominance channel Cb, and the chrominance channel Cr after noise reduction processing back into images of each color of BGR.

The image processing unit 53 uses the image acquired by the image acquisition unit 52 to generate an image to be displayed on the monitor 48 and/or an image to be used for diagnosis, etc. The image processing unit 53 may perform image processing on the image acquired by the image acquisition unit 52 or the endoscopic image depending on the setting of the observation mode, etc. The image processing unit 53 may also output the image acquired by the image acquisition unit 52 as is without performing image processing, etc. Note that the image acquired by the image acquisition unit 52 is an endoscopic image because it is an image taken using the endoscope 42. The image generated by the image processing unit 53 is an image provided to the user by the endoscope device 21, and is therefore a so-called endoscopic image. Therefore, hereinafter, unless otherwise specified, the image acquired by the image acquisition unit 52 and/or the image generated by the image processing unit 53 will be referred to as an endoscopic image. The endoscopic image is a moving image or a still image.

The image processing unit 53 also includes a first recognition processing unit 60. The first recognition processing unit 60 performs recognition processing using the endoscopic image. Specifically, as shown in FIG. 4, the first recognition processing unit 60 includes various recognition processing units, such as an imaging position recognition unit 61, a treatment recognition unit 62, an image quality recognition unit 63, and an unimaged portion recognition unit 64.

The photographing position recognition unit 61 recognizes the photographing position using one or more endoscopic images. The photographing position is the position within the subject photographed by the endoscope 42. For example, the photographing position recognition unit 61 recognizes at least the part of the subject using the endoscopic image as the photographing position. The part of the subject is the esophagus, stomach, for example the duodenum, etc., in the upper digestive tract. The photographing position recognition unit 61 can also recognize more detailed positions. For example, when the part being observed is the stomach, the photographing position recognition unit 61 can recognize the cardia, fundus, body, angle, vestibule, anterior pylorus, and/or pylorus. In this embodiment, the photographing position recognition unit 61 recognizes the part of the subject, but does not recognize the detailed position. This is to perform the photographing position recognition process in real time.

The treatment recognition unit 62 recognizes treatment on the subject using one or more endoscopic images. Recognizing a treatment means recognizing the presence or absence of a treatment and/or the type of treatment. Treatment on the subject means collection of a specimen such as tissue for a biopsy (hereinafter referred to as biopsy), incision, resection, hemostasis, removal of residue, or other operations on the subject. Recognizing the presence or absence of a treatment includes recognition of a state in which a treatment has already been performed, recognition of a state in which a treatment is being performed, and recognition of a state in which a treatment is about to be performed. Recognizing the type of treatment means recognizing a treatment by distinguishing between biopsy, incision, resection, hemostasis, removal of residue, etc.

The treatment recognition unit 62 recognizes the treatment on the subject by recognizing the treatment tool shown in the endoscopic image. The treatment recognition unit 62 can also recognize the treatment on the subject by recognizing the treatment scar or bleeding (or cessation of bleeding) of the subject shown in the endoscopic image. In addition, the treatment recognition unit 62 can recognize the presence or absence of treatment and/or the type of treatment using information other than one or more endoscopic images. For example, if the endoscope 42 has a mechanism for detecting the insertion of a treatment tool, the detection result can be used alone or in combination with an endoscopic image to recognize the treatment. In this embodiment, the treatment recognition unit 62 recognizes the presence or absence of a biopsy by recognizing the forceps used for the biopsy (biopsy forceps) using one or more endoscopic images. Therefore, the treatment recognition unit 62 in this embodiment functions as a biopsy recognition unit that recognizes the presence or absence of a biopsy.

The treatment recognition unit 62 also recognizes or counts the number of treatments. This is to distinguish between each treatment when multiple treatments are recognized. The treatment recognition unit 62 also recognizes the location where the treatment was performed. The recognition result of the imaging position recognition unit 61 can be used to recognize the location where the treatment was performed. For example, if biopsies were performed at two locations, the treatment recognition unit 62 of this embodiment recognizes that two biopsies were performed, and recognizes the site and order in which each biopsy was performed.

The image quality recognition unit 63 recognizes the image quality of an endoscopic image using one or more endoscopic images. Recognizing image quality means recognizing the presence or absence of blurring or clouding in the endoscopic image, and/or the presence or absence of factors that degrade the image of the subject, such as residue or residual liquid in the subject. Blurring or clouding in the endoscopic image is a factor on the endoscope 42 side (the side that captures the image, not the subject). Residue or residual liquid is a factor on the subject side (the subject side, not the endoscope 42).

The unphotographed portion recognition unit 64 recognizes the unphotographed portion of the subject using one or more endoscopic images. The unphotographed portion refers to the portion of the subject that is not photographed due to the position and orientation of the tip 42d relative to the subject and the timing of photography. For example, the subject lumen may have an unphotographed portion due to the protuberance of the subject or the presence of folds (folds) generated by peristaltic movement. The unphotographed portion in the endoscopic image can be recognized, for example, by the global or local shape of the subject. In addition, the unphotographed portion recognition unit 64 can recognize and track the unphotographed portion by recognizing each of the unphotographed portions of multiple endoscopic images. In other words, the unphotographed portion recognition unit 64 can recognize that the photography position (the position of the tip 42d relative to the unphotographed portion) of an unphotographed portion of a certain endoscopic image has moved (is likely to move) to a position where the unphotographed portion cannot be properly photographed without being photographed even once after that. In this embodiment, the unphotographed portion recognition unit 64 recognizes the unphotographed portion and tracks the unphotographed portion.

The first recognition processing unit 60 and each of the above-mentioned components constituting the first recognition processing unit 60 are, for example, artificial intelligence (AI) having a learning function. Specifically, each of the components constituting the first recognition processing unit 60 is AI that has been trained using machine learning algorithms or deep learning such as neural networks (NNs), convolutional neural networks (CNNs), adaboost, and random forests. In addition, since the first recognition processing unit 60 has been trained to perform recognition processing using a specific image, even if it can perform recognition processing using other images, the accuracy of the results of the recognition processing may be low. "Having a learning function" means being able to learn, and includes having already been trained. Note that, instead of being configured with AI, some or all of the components constituting the first recognition processing unit 60 can be configured to calculate feature amounts from an image and perform detection, etc. using the calculated feature amounts.

In addition to the first recognition processing unit 60, the image processing unit 53 has a biometric information calculation unit 71. The biometric information calculation unit 71 calculates biometric information using one or more endoscopic images. Biometric information refers to quantities based on the shape, color, or other characteristics of a living subject, such as oxygen saturation, blood vessel density, length, size (area or volume), or the number or range of parts with a specific characteristic. The biometric information calculation unit 71 is activated as necessary, depending on the observation mode setting, etc.

The display control unit 54 converts the endoscopic image output by the image processing unit 53 into a format suitable for display and outputs it to the monitor 48. As a result, the monitor 48 displays the endoscopic image at least during the endoscopic examination. In addition, the display control unit 54 generates a screen used for observation or operation at each stage before the endoscopic examination (before the start of the period for photographing the subject), during the endoscopic examination (the period for photographing the subject), and after the endoscopic examination (after the end of the period for photographing the subject), and displays it on the monitor 48. At that time, the display control unit 54 can acquire information from the notification unit 55 or the communication unit 57 and display the information or information based on the information on the monitor 48. Specifically, before the endoscopic examination, the display control unit 54 displays the pre-examination screen 251 (see FIG. 15) acquired via the communication unit 57 on the monitor 48. During the endoscopic examination, the display control unit 54 may display, in addition to the endoscopic image, a warning message input by the notification unit 55 and/or information related to the examination acquired via the communication unit 57 on the monitor 48. For example, the examination in progress screen 301 (see FIG. 18). After the endoscopic examination, the display control unit 54 displays, for example, the first cleaning information input screen 401 (see FIG. 21) on the monitor 48.

The notification unit 55 issues notifications or warnings. The notification unit 55 has, for example, a speaker 72, and can issue a sound or voice from the speaker 72 to issue a notification or warning. The notification unit 55 can also issue a notification or warning by using the display of the monitor 48 via the display control unit 54, by inputting a display instruction (including an instruction to change the display) of a message or the like indicating a notification or warning to the display control unit 54. In addition, the notification unit 55 can include a lamp, etc., and can issue a notification or warning by turning the lamp on or off or changing the color, etc.

Specifically, before an endoscopic examination, if the endoscope 42 detected as connected by the connection detection unit 51 (hereinafter referred to as the connected endoscope) is different from the endoscope 42 to be used, the notification unit 55 issues a warning to that effect. Furthermore, if the connected endoscope 42 has not been cleaned and disinfected and/or a predetermined time has passed since cleaning and disinfection was completed, the notification unit 55 issues a warning to that effect. In addition, if the ID of the doctor and/or patient entered from the console 49 is different from that of the doctor and/or patient to be using the endoscopic device 21, a warning to that effect is issued.

During an endoscopic examination, the notification unit 55 notifies some or all of the information on contraindications (contraindication information), such as "biopsy prohibited." In this embodiment, the notification unit 55 notifies the contraindication information by displaying it on the monitor 48. During an endoscopic examination, the notification unit 55 also issues a warning based on the results of various recognition processes in the first recognition processing unit 60. Specifically, when the image quality recognition unit 63 recognizes a deterioration in the image quality of the endoscopic image, the notification unit 55 issues a warning indicating that the image quality has deteriorated, or a warning encouraging improvement of the image quality (for example, a display encouraging cleaning of the tip 42d). Furthermore, when the unphotographed portion recognition unit 64 recognizes the possibility that an unphotographed portion will not be photographed, a warning to that effect is issued.

After an endoscopic examination, the notification unit 55 may issue a notification or warning indicating that the primary cleaning of the endoscope 42 at the bedside (so-called bedside cleaning) has not been completed or started, and/or a notification or warning urging the primary cleaning.

The control unit 56 comprehensively controls each part of the processor device 46, as well as the endoscope 42 and the light source device 44. For example, the control unit 56 controls the synchronization of the emission of illumination light and the timing of imaging. The control unit 56 also includes a timer unit 73 that measures various times (including time) related to the endoscopic examination. Thus, the control unit 56 can measure the start and end times of the endoscopic examination, and/or the time to reach a specific site (e.g., the time to reach the ileocecal area), etc. The timer unit 73 can measure various times related to the endoscopic examination based on information input using the console 49, etc. The timer unit 73 can also use various recognition results (e.g., the recognition result of the imaging position) in the first recognition processing unit 60 to measure various times related to the endoscopic examination.

The communication unit 57 communicates with the endoscope information management system 31 via wired or wireless communication to transmit or receive information. In this embodiment, the communication unit 57 includes an information acquisition unit 74 and an information output unit 75.

The information acquisition unit 74 acquires information that can be used in the endoscopic examination to be performed from the endoscopic information management system 31. Specifically, before the endoscopic examination, the information acquisition unit 74 acquires from the endoscopic information management system 31 the results of previous endoscopic examinations (including, for example, pathological examinations), images acquired in previous endoscopic examinations, reports created in previous endoscopic examinations, and/or information about the patient on whom the endoscopic examination will be performed (information about contraindications, etc.). The display control unit 54 acquires this information via the information acquisition unit 74 and displays it on the monitor 48 as necessary.

The information output unit 75 outputs some or all of the information relating to the endoscopic examination that has been performed (endoscopic examination currently being performed) to at least the endoscope information management system 31. The information output by the information output unit 75 is, for example, an endoscopic image, the results of the recognition processing performed by each part of the first recognition processing unit 60, the biometric information calculated by the biometric information calculation unit 71, and/or various times measured by the timing unit 73. The endoscopic image etc. output by the information output unit 75 is registered in the endoscope information management system 31.

The communication unit 57 can communicate with the endoscope information management system 31 as well as the endoscope 42 or light source device 44 constituting the endoscope device 21, the related business device 26, and/or other devices, and can transmit or receive some or all of the various information described above.

(2) Configuration of the Label Printer In the endoscope-related business system 10, the label printer 22 is a printer used to create (print, etc.) an identification label (hereinafter referred to as a biopsy label 350; see FIG. 19 ) to be affixed to a container for placing tissue (specimen) collected for biopsy. The label printer 22 is connected to the endoscope information management system 31 directly or indirectly, by wire or wirelessly. As shown in FIG. 5 , the label printer 22 includes a communication unit 92, a biopsy information acquisition unit 93, and an output unit 94.

The communication unit 92 is an interface that connects directly or indirectly to the endoscope information management system 31 by wire or wirelessly. When a biopsy is performed during an endoscopic examination, the biopsy information acquisition unit 93 communicates with the endoscope information management system 31 using the communication unit 92 to automatically acquire information related to the biopsy via the endoscope information management system 31 (or directly from the processor device 46, etc. based on instructions from the endoscope information management system 31). The information related to the biopsy includes information related to the patient on whom the biopsy was performed (such as name and/or ID), information identifying each biopsy when multiple biopsies are performed (such as a number identifying the order, etc.), information related to the location where the biopsy was performed (such as the extraction site), etc.

The output unit 94 is a mechanism for printing on a label, and has a configuration similar to that of a general printer, for example. The output unit 94 automatically outputs a biopsy label 350 (see FIG. 19 ) by printing some or all of the information related to the biopsy acquired by the biopsy information acquisition unit 93 in a predetermined arrangement. The biopsy label 350 is, for example, a sticker.

In this embodiment, the label printer 22 acquires information related to the biopsy via the endoscope information management system 31. In addition, acquisition of information related to the biopsy and printing of the biopsy label are performed during the endoscopic examination. In other words, when a biopsy is performed during the endoscopic examination, the label printer 22 automatically outputs the biopsy label 350 in real time.

(3) Configuration of the Cleaning and Disinfecting Apparatus The cleaning and disinfecting apparatus 23 is an apparatus for cleaning and disinfecting the endoscope 42 used in an endoscopic examination. The endoscope 42 used in an endoscopic examination is subjected to a simple primary cleaning and/or disinfection (so-called bedside cleaning) at the bedside immediately after use to prevent clogging of the ducts due to drying of the endoscope 42, etc. In contrast, the cleaning and disinfection performed by the cleaning and disinfecting apparatus 23 is so-called secondary cleaning or main cleaning. The main cleaning performed by the cleaning and disinfecting apparatus 23 is cleaning and disinfection to make the used endoscope 42 usable again in an endoscopic examination.

As shown in FIG. 6, the cleaning and disinfecting apparatus 23 has a main body 111 having a cleaning tank 110, a lid 112 that is provided on the main body 111 so as to be freely opened and closed, a pedal 113 for opening and closing the lid 112, and a touch panel 115 that is a display and operating unit for inputting settings for cleaning and/or disinfection. In addition, the main body 111 is provided with casters 116. This allows the cleaning and disinfecting apparatus 23 to be freely moved.

As shown in FIG. 7, the cleaning and disinfecting apparatus 23 includes a cleaning tank 110, a touch panel 115, a communication unit 121, an endoscope identification unit 122, a cleaner identification unit 123, and a control unit 124.

The communication unit 121 is connected to the endoscope information management system 31 directly or indirectly, by wire or wirelessly, and transmits or receives necessary information. If the endoscope 42 has a communication function, the communication unit 121 can automatically connect to an endoscope 42 that is in the vicinity of the cleaning and disinfecting device 23 (e.g., at least within the communication range). In addition, the communication unit 121 transmits information such as the result of cleaning and disinfection, identification information of the cleaned endoscope 42, and identification information of the staff who cleaned it, to the endoscope information management system 31.

The endoscope identification unit 122 acquires information for identifying the endoscope 42 to be cleaned and disinfected (hereinafter referred to as cleaning target information). The endoscope identification unit 122 can automatically acquire the cleaning target information from the endoscope 42 connected via the communication unit 121, for example. The endoscope identification unit 122 can also acquire the cleaning target information from information input using the touch panel 115. In this embodiment, the endoscope 42 has a function of automatically connecting wirelessly to the communication unit 121 in the vicinity of the cleaning and disinfecting device 23, and the endoscope identification unit 122 automatically acquires the cleaning target information. Then, instead of the user manually inputting information using the touch panel 115, the endoscope identification unit 122 automatically inputs the acquired cleaning target information into the corresponding items of a GUI (Graphical User Interface) displayed on the touch panel 115.

The cleaner identification unit 123 acquires information (hereinafter referred to as cleaner identification information) that identifies the staff member in charge of cleaning and disinfection (hereinafter referred to as cleaner). When the cleaner's ID is input using a barcode, the cleaner identification unit 123 is a barcode reader, and when the cleaner's ID is input using an IC card, the cleaner identification unit 123 is a card reader. The cleaner identification unit 123 can acquire the cleaner information by the cleaner inputting the cleaner information using the touch panel 115. Note that, for example, if the cleaner has a communication terminal or the like that automatically connects to the cleaning and disinfecting apparatus 23 via the communication unit 121, the cleaner identification unit 123 can automatically acquire the cleaner identification information from the communication terminal via the communication unit 121. In this embodiment, the cleaner identification unit 123 automatically acquires the cleaner information.

The control unit 124 comprehensively controls the cleaning and disinfecting device 23. For example, when an instruction to start cleaning is input using the touch panel 115, the control unit 124 starts cleaning and disinfecting the endoscope 42 using the cleaning tank 110 according to the conditions input using the touch panel 115.

(4) Configuration of the report creation device The report creation device 24 is a so-called computer that is connected to the endoscope information management system 31 by wire or wirelessly, and provides a user with an interface for creating a report related to an endoscopic examination. As shown in FIG. 8, the report creation device 24 includes a display 131 that displays a report creation screen 510 (see FIG. 25), an operation unit 132 that inputs operations for creating a report using the report creation screen 510, and a communication unit 133 for communicating with the endoscope information management system 31. The operation unit 132 is, for example, a pointing device such as a keyboard and a mouse. The report creation device 24 may also be a tablet terminal in which the display 131 and the operation unit 132 are integrated. The report creation device 24 automatically or manually inputs the ID of the doctor who is the user, thereby identifying the user and logging in to the endoscope information management system 31.

(5) Configuration of the Endoscope Information Management System The endoscope information management system 31 comprehensively manages a series of information related to endoscopic examinations and smoothly links each device, etc. that constitutes the endoscope-related work system 10 by appropriately transmitting or receiving (including instructing transmission or reception) a part or all of the series of information related to endoscopic examinations to each device, etc. that constitutes the endoscope-related work system 10. As shown in Fig. 9, the endoscope information management system 31 includes an examination information management unit 151, a cleaning information management unit 152, a label output management unit 153, a report creation support unit 154, a database 156, an operation unit 157, a display 158, and a communication unit 159, etc.

(5a) Examination Information Management Unit The examination information management unit 151 manages information used in endoscopic examinations among various pieces of information (such as information about doctors and patients, endoscopic images, and recognition results) exchanged by each unit constituting the endoscope-related business system 10. Specifically, as shown in Fig. 10, the examination information management unit 151 includes an examination order acquisition unit 171, an endoscope determination unit 172, an insertion path information acquisition unit 173, a contraindication information acquisition unit 174, an image acquisition unit 175, a report acquisition unit 176, a pre-examination screen generation unit 181, an endoscope connection monitoring unit 182, and a user monitoring unit 183.

The examination order acquisition unit 171 acquires examination orders related to endoscopic examinations. An examination order is a request for an endoscopic examination, and includes information such as when, who, and what (which part and for what purpose) the endoscopic examination will be performed. The examination order can be directly input to the endoscope information management system 31. In this case, the examination order acquisition unit 171 acquires the examination order through input by a doctor or other staff member. The examination order acquisition unit 171 can also acquire examination orders from other medical business systems (for example, systems that manage examination orders within the hospital, including other departments) that are linked to the endoscope-related business system 10.

The endoscope determination unit 172 determines the endoscopic device 21 to be used for the examination order, and in particular the endoscope 42 to be used. When there are multiple endoscopic devices 21 in the hospital, determining which endoscopic device 21 (processor device 46 and light source device 44) to use for the endoscopic examination based on the examination order and managing the reservation means that the endoscopic device 21 to be used is determined for the examination order and the reservation is managed when there are multiple endoscopic devices 21 in the hospital. When there is only one endoscopic device 21 in the hospital, determining the use of the endoscopic device 21 for the examination order and managing the reservation means that the use is reserved and the reservation is not made. In addition, determining the endoscope 42 to be used means determining which endoscope to use for the endoscopic examination based on the examination order and managing the reservation when there are multiple endoscopes 42 or multiple types of endoscopes 42 (for example, when there are a nasal endoscope, an oral endoscope, and an endoscope for the lower digestive tract, etc.). When there is only one endoscope 42 (one model) in the hospital, determining the use of the endoscope 42 for the examination order and managing the reservation means that the endoscope 42 to be used is determined for the examination order and managing the reservation.

The endoscope determination unit 172 identifies the patient and the part, etc., that are the subject of the endoscopic examination based on the examination order. The endoscope determination unit 172 also determines the endoscopic device 21 and/or endoscope 42 to be used based on the patient and the part to be examined. In particular, the endoscope determination unit 172 refers to information related to past endoscopic examinations for the patient specified by the examination order, and when the patient and the part specified by the examination order are the patient and the part that have been examined by an endoscopic examination in the past, the endoscope determination unit 172 preferentially determines the use of the endoscope 42 used in the past endoscopic examination. When the endoscope 42 used in the past endoscopic examination is managed as a reservation for another examination order, the endoscope determination unit 172 preferentially determines the use of at least the same model of endoscope 42. For example, when a transnasal endoscope was used in the previous endoscopic examination, when the use of an oral endoscope and a transnasal endoscope can be reserved for the examination order of the second endoscopic examination, the use of a transnasal endoscope is prioritized. When there are multiple models of transnasal endoscopes, the use of the model used in the previous endoscopic examination is prioritized.

The insertion path information acquisition unit 173 refers to information related to past endoscopic examinations for the patient and area specified by the examination order, and acquires information related to the insertion path of the endoscope 42 when the patient and area specified by the examination order were previously examined endoscopically. For an endoscopic examination of the upper digestive tract, the insertion path is, for example, "transnasal" or "oral," and for the transnasal insertion, a distinction is made between "transnasal (right)," which is insertion from the right nostril, and "transnasal (left)," which is insertion from the left nostril.

The contraindication information acquisition unit 174 acquires information on contraindications (hereinafter referred to as contraindication information) for the patient and/or site specified by the test order by referring to information on tests already performed (diagnosis or test results and reports, etc.) for the patient and/or site specified by the test order. Contraindication information is, for example, information on allergies and information on whether biopsy is possible, etc. In this embodiment, the contraindication information acquisition unit 174 acquires at least information on whether biopsy is possible (particularly whether biopsy is prohibited) for the patient or site.

The image acquisition unit 175 acquires images obtained from endoscopic examinations and/or other examinations performed in the past for the patient specified by the examination order, depending on the settings. For example, when images obtained in past examinations are to be displayed on the pre-examination screen 251 and/or the during-examination screen 301, the image acquisition unit 175 acquires them and inserts them into the pre-examination screen 251 and/or the during-examination screen 301. In addition, by connecting to a PACS (Picture Archiving and Communication Systems), the image acquisition unit 175 can acquire ultrasound images, radiological images such as X-ray images, MRI (Magnetic Resonance Imaging) images, etc., and insert them into the during-examination screen 301, etc.

The report acquisition unit 176 acquires reports created from past endoscopic examinations and/or other examinations, etc., for the patient specified by the examination order, depending on the settings. For example, when images acquired in past examinations are to be displayed on the pre-examination screen 251 and/or the during-examination screen 301, the report acquisition unit 176 acquires them and inserts them into the pre-examination screen 251 and/or the during-examination screen 301.

The pre-examination screen generating unit 181 generates a pre-examination screen 251 to be displayed on the monitor 48 of the endoscope device 21 before the endoscopic examination. The endoscope information management system 31 locks (prohibits other users from using) the endoscope device 21 to be used by displaying the pre-examination screen 251 generated by the pre-examination screen generating unit 181 on the monitor 48 of the endoscope device 21 to be used. The pre-examination screen generating unit 181 can be provided in the processor device 46. In this case, the endoscope information management system 31 provides the processor device 46 with information necessary for generating the pre-examination screen 251.

The endoscope connection monitoring unit 182 monitors the connection of the endoscope 42 to the endoscope device 21 for which reservation management is being performed. Specifically, the endoscope connection monitoring unit 182 acquires the detection result of the connection detection unit 51 from the processor device 46. Then, when an endoscope 42 different from the endoscope 42 determined by the endoscope determination unit 172 is connected to the endoscope device 21 for which reservation management is being performed, a warning to that effect is issued using the notification unit 55 of the processor device 46. This is to support preparation for an endoscopic examination in accordance with the examination order.

The user monitoring unit 183 monitors doctors and patients who use the endoscopic device 21 for which the reservation is managed by the endoscope information management system 31. Specifically, the user monitoring unit 183 acquires the doctor and patient IDs, etc., input from the console 49 via the communication unit 57 of the processor device 46, and determines whether the doctor and patient match the examination order. If the doctor or patient is different, the user monitoring unit 183 issues a warning to that effect using the notification unit 55 of the processor device 46. This is to prevent misuse of the endoscopic device 21 for which the reservation is managed.

(5b) Cleaning Information Management Unit The cleaning information management unit 152 manages information relating to the cleaning of the endoscope 42, among various types of information exchanged between the units constituting the endoscope-related business system 10. Specifically, as shown in Fig. 11, the cleaning information management unit 152 includes a cleaning status monitoring unit 191, a primary cleaning management unit 192, and a main cleaning management unit 193.

The cleaning status monitoring unit 191 monitors the cleaning status of the endoscope 42 connected to the endoscope device 21 that is managed by the endoscope information management system 31 through reservation management. Specifically, the cleaning status monitoring unit 191 acquires the detection result of the connection detection unit 51 of the processor device 46. The cleaning status monitoring unit 191 then monitors whether the connected endoscope 42 is an endoscope 42 that has been properly cleaned, and whether it has been less than a predetermined time since cleaning was completed. If the connected endoscope 42 is an endoscope 42 that has been properly cleaned, such as an uncleaned endoscope 42, or if a predetermined time or more has passed since cleaning was completed, the connected endoscope 42 needs to be cleaned again. For this reason, the cleaning status monitoring unit 191 issues a warning to that effect using the notification unit 55 of the processor device 46.

The primary cleaning management unit 192 manages the primary cleaning performed after the endoscopy. Specifically, after the endoscopy, the primary cleaning management unit 192 displays the primary cleaning information input screen 401 on the monitor 48 via the display control unit 54. If necessary, the primary cleaning management unit 192 prompts the implementation of the primary cleaning by issuing a notification or warning using the notification unit 55 of the processor device 46, or by displaying the primary cleaning information input screen 401 on the monitor 48. In addition, the primary cleaning management unit 192 acquires information related to the primary cleaning input from the primary cleaning information input screen 401 (identification information of the person who performed the primary cleaning and status information indicating whether the cleaning was completed normally, etc.) and registers it in the database 156. In this way, the primary cleaning management unit 192 manages the primary cleaning. The information related to the primary cleaning is identification information of the person who performed the primary cleaning (the person who performed the cleaning), the date and time when the primary cleaning was performed, and status information indicating whether the primary cleaning was completed normally, etc. Registration in database 156 includes creating new records as well as merging information into existing records.

The main cleaning management unit 193 manages the main cleaning that is performed after the endoscopy is completed (more specifically, after the primary cleaning is completed). Specifically, it obtains information related to the main cleaning from the cleaning and disinfecting apparatus 23 and registers it in the database 156. In this way, the main cleaning management unit 193 manages the main cleaning. The information related to the main cleaning includes identification information of the person who performed the main cleaning (the cleaner), the date and time when the main cleaning was performed, and status information indicating whether the main cleaning was completed normally.

(5c) Label Output Management Unit The label output management unit 153 manages information relating to the production of biopsy labels among various types of information exchanged between the various units constituting the endoscope-related business system 10. Specifically, as shown in Fig. 12, the label output management unit 153 includes a biopsy monitoring unit 201 and a label printer control unit 203.

The biopsy monitoring unit 201 acquires the recognition results of the treatment recognition unit 62 (at least the recognition results related to biopsy among the recognition results of the treatment recognition unit 62) by communicating with the processor device 46 substantially in real time during the endoscopic examination. As a result, the biopsy monitoring unit 201 monitors the presence or absence of a biopsy using the recognition results of the treatment recognition unit 62. Furthermore, when the treatment recognition unit 62 recognizes a biopsy, the recognition results of the treatment recognition unit 62 include, in addition to the fact that a biopsy has been performed, the number of biopsies, the site where the biopsy was performed, and the order in which the biopsies were performed. Therefore, when the biopsy monitoring unit 201 detects that a biopsy has been performed using the recognition results of the treatment recognition unit 62, it acquires information related to the biopsies performed (the number of biopsies, the site, the order, etc.).

When the biopsy monitoring unit 201 detects that a biopsy has been performed during an endoscopic examination, the label printer control unit 203 automatically controls the label printer 22 to create a biopsy label 350 to be attached to a container for containing a specimen obtained by the biopsy. Specifically, the label printer control unit 203 inputs information related to the biopsy acquired by the biopsy monitoring unit 201 to the biopsy information acquisition unit 93, and creates a biopsy label 350 using the output unit 94. As a result, when a biopsy is performed during an endoscopic examination, the label printer 22 automatically creates a biopsy label 350. In this embodiment, when the biopsy monitoring unit 201 detects a biopsy, the label printer control unit 203 sequentially creates biopsy labels 350 related to the detected biopsies, but the label printer control unit 203 can automatically create biopsy labels 350 related to one or more detected biopsies all at once after the end of the endoscopic examination. In either case, a doctor or staff member can automatically obtain a biopsy label 350 after the end of the endoscopic examination.

(5d) Report Creation Support Unit The report creation support unit 154 manages information relating to report creation among various information exchanged by each unit constituting the endoscope-related business system 10. In this way, the report creation support unit 154 supports the creation of a report. Specifically, as shown in FIG. 13 , the report creation support unit 154 includes a report creation screen generating unit 220, a second recognition processing unit 222, an image selection support unit 223, a third recognition processing unit 224, and an item selection support unit 226.

In response to a request from the report creation device 24 connected to the endoscope information management system 31, the report creation screen generating unit 220 generates a report creation screen 510 and provides it to the report creation device 24. Specifically, when the report creation screen generating unit 220 receives a request to provide the report creation screen 510 from the report creation device 24, it collects information on a specific doctor, a specific patient, and a specific endoscopic examination (endoscopic images and other information, etc.), and generates and provides the report creation screen 510 by selecting and/or arranging the information.

The second recognition processing unit 222 performs one or more recognition processes on the endoscopic images used in the report creation screen 510 and/or the report. Specifically, the second recognition processing unit 222 includes a shooting position recognition unit 231, a treatment recognition unit 232, and a lesion recognition unit 233. The second recognition processing unit 222 and each of the above units constituting the second recognition processing unit 222 are, for example, artificial intelligence (AI) having a learning function.

The photographing position recognition unit 231 recognizes at least the part of the subject that appears in the endoscopic image acquired in one endoscopic examination. The photographing position recognition unit 231 can recognize the photographing position in more detail. For example, when the part being observed is the stomach, the photographing position recognition unit 231 can recognize the cardia, the dome, the body of the stomach, the angle of the stomach, the vestibule, the anterior pylorus, and/or the pylorus. In this embodiment, the photographing position recognition unit 231 recognizes the photographing position in more detail in addition to the part of the subject. That is, the photographing position recognition unit 61 in the first recognition processing unit 60 of the processor device 46 performs a relatively simple part recognition process, whereas the photographing position recognition unit 231 in the second recognition processing unit 222 of the report creation support unit 154 performs a relatively detailed photographing position recognition process. This is because the recognition of the photographing position during the endoscopic examination requires a quick and lightweight (low amount of calculation) recognition process in real time, while a detailed recognition result is required when creating a report, even if the processing amount and/or processing time becomes somewhat large. The photographing position recognition unit 231 can obtain and use the recognition result of the photographing position recognition unit 61 of the first recognition processing unit 60. In this embodiment, the second recognition processing unit 222 can obtain information related to the photographed part as the recognition result of the photographing position recognition unit 61 of the first recognition processing unit 60 for the endoscopic image that is the target of the recognition process. Therefore, the second recognition processing unit 222 can narrow the range of the recognition process for the part indicated by the recognition result of the photographing position recognition unit 61 of the first recognition processing unit 60 and perform recognition processing to specify the detailed photographing position. For example, if the photographed part is the stomach, it can narrow down to the detailed position of the stomach (excluding the possibility of the esophagus or duodenum) and specify the detailed photographing position (such as specifying that the photographing position is the cardia of the stomach). In this way, the photographing position recognition unit 231 can reduce the processing amount and/or the processing time by using the recognition result of the photographing position recognition unit 61 of the first recognition processing unit 60.

The treatment recognition unit 232 recognizes the treatment on the subject for the endoscopic image acquired in one endoscopic examination. The contents of the treatment that the treatment recognition unit 232 can recognize are the same as those of the treatment recognition unit 62 of the first recognition processing unit 60. In this embodiment, the treatment recognition unit 62 of the first recognition processing unit 60 recognizes biopsy, while the treatment recognition unit 232 also recognizes treatments other than biopsy. This is because the recognition process during the endoscopic examination is preferably minimal in content because it is performed in real time, whereas when creating a report, it is necessary to recognize treatments other than biopsy. The treatment recognition unit 232 can obtain and use the recognition results of the treatment recognition unit 62 of the first recognition processing unit 60. In this embodiment, the treatment recognition unit 62 of the first recognition processing unit 60 recognizes biopsy, so the treatment recognition unit 232 uses the recognition results of the treatment recognition unit 62 of the first recognition processing unit 60 for the recognition of biopsy. Then, the treatment recognition unit 232 performs recognition processing of treatments other than biopsy. This is to eliminate duplicate recognition processing and reduce the amount and time of processing.

The lesion recognition unit 233 recognizes the presence or absence of a lesion in an endoscopic image acquired in one endoscopic examination. Recognizing the presence or absence of a lesion includes not only recognizing the presence or absence of a part that is definitely a lesion, but also recognizing the presence or absence of a part that may be a lesion (benign tumor or dysplasia, etc.) and/or recognizing a part that has characteristics that may be directly or indirectly related to a lesion (redness, etc.).

The image selection support unit 223 automatically selects an endoscopic image (hereinafter referred to as a key image) to be used in the report creation screen 510 and/or the report from among a series of multiple endoscopic images acquired in one endoscopic examination, using various recognition results from the second recognition processing unit 222. Specifically, the image selection support unit 223 uses the recognition results from the shooting position recognition unit 231 to select, as a key image, an endoscopic image of at least a portion that is determined to be used in the report from among the multiple endoscopic images acquired in the endoscopic examination. The portion that is determined to be used in the report includes a portion that is practically determined to be used because it is a site where lesions tend to occur. For example, in an endoscopic examination of the upper digestive tract, this is an endoscopic image of the pylorus. In addition, when the treatment recognition unit 232 recognizes a treatment, the image selection support unit 223 selects, as a key image, some or all of the endoscopic images from the endoscopic images that recognize the treatment. Similarly, when the lesion recognition unit 233 recognizes a lesion, the image selection support unit 223 selects, as a key image, some or all of the endoscopic images from the endoscopic images that recognize the lesion. The reason why some of the endoscopic images in which a procedure or lesion is recognized are selected is to minimize the number of images that can be used in the report creation screen 510 and/or the report. The image selection support unit 223 uses the recognition result of the shooting position recognition unit 231 to identify the part photographed during the endoscopic examination, and selects a schematic diagram to be used in the report creation screen 510 and/or the report. For example, in the case of an endoscopic examination of the stomach, the image selection support unit 223 selects a schematic diagram of the stomach. The report creation screen generation unit 220 generates and provides the report creation screen 510 in which the schematic diagram selected by the image selection support unit 223 and one or more key images are automatically inserted.

The third recognition processing unit 224 performs discrimination processing on at least the endoscopic image used in the report. That is, the third recognition processing unit 224 performs discrimination processing on the key image selected by the image selection support unit 223. Discrimination processing refers to processing for recognizing symptoms (type of lesion and/or progression, etc.) of lesions, etc., shown in the endoscopic image. For this reason, the third recognition processing unit 224 has one or more discrimination units 236. The third recognition processing unit 224 has one discrimination unit 236 for each key image. Note that, if the doctor selects the key image regardless of the selection by the image selection support unit 223, the third recognition processing unit 224 performs discrimination processing on the key image selected by the doctor. Similarly, if the doctor manually reselects the key image selected by the image selection support unit 223, the third recognition processing unit 224 performs discrimination processing on the key image selected by the doctor. The third recognition processing unit 224 and each of the above components constituting the third recognition processing unit 224 are, for example, artificial intelligence (AI) having a learning function.

The item selection support unit 226 automatically selects the items to be written in the report using at least the discrimination results of the third recognition processing unit 224. The report creation screen generation unit 220 generates and provides the report creation screen 510 in which the items to be written in the report have been automatically selected. The item selection support unit 226 can further select the items to be written in the report using various recognition results of the second recognition processing unit 222.

(5e) Databases, etc. The database 156 provided in the endoscope information management system 31 includes, for example, a cleaning information management database for managing information related to the cleaning state and history of the endoscope 42, an endoscopic image database for managing endoscopic images, a patient information database for managing information related to patients, an examination information management database for managing information related to examinations of each patient, a report management database for managing reports created for various examinations including endoscopic examinations, etc. In this embodiment, the endoscope information management system 31 includes the database 156, but if some or all of the various databases described above are in an external environment connected to the endoscope-related business system 10, the endoscope information management system 31 can use a database in the external environment instead of the built-in database 156 or in addition to the built-in database 156.

The operation unit 157 of the endoscope information management system 31 is, for example, a keyboard, a mouse, and/or a touch panel, and the display 158 is a monitor or a touch panel. In this embodiment, the endoscope information management system 31 has the operation unit 157 and the display 158, but when an external terminal (such as a computer that accesses the endoscope information management system 31) is used as the operation unit 157 and the display 158, the endoscope information management system 31 can be configured not to have the operation unit 157 and/or the display 158. The communication unit 159 is a communication interface that connects directly or indirectly to each part constituting the endoscope-related business system 10 by wire or wirelessly. Each part of the endoscope information management system 31 communicates with each part of the endoscope-related business system 10 using the communication unit 159 to send and receive various information.

The following describes the operation of the endoscope-related business system 10 configured as described above, and in particular the operation of the endoscope information management system 31.

<Preparing for endoscopy>
As shown in FIG. 14, before an endoscopic examination, the endoscope information management system 31 acquires an examination order using the examination order acquisition unit 171 (step S101). When the examination order acquisition unit 171 acquires the examination order, the endoscope determination unit 172 determines the endoscope device 21 (processor device 46 and light source device 44) and the endoscope 42 to be used in the endoscopic examination related to the examination order (step S102). In addition, the endoscope information management system 31 collects information such as contraindications for the patient (step S103). Specifically, the endoscope information management system 31 acquires information on the insertion path of the endoscope 42 in the past examination of the patient using the insertion path information acquisition unit 173, and acquires contraindication information for the patient using the contraindication information acquisition unit 174. After that, the endoscope information management system 31 generates a pre-examination screen 251 using the pre-examination screen generation unit 181 and displays it on the monitor 48 (step S104).

As shown in FIG. 15, the pre-examination screen 251 has a first display section 252 that displays information about the endoscopic examination to be performed, and a second display section 253 that displays information about endoscopic examinations that have been performed in the past. The first display section 252 displays, for example, identification information 261 of the endoscope 42 to be used (model name "EGXXX" in FIG. 15), patient name 262 ("Fuji Taro" in FIG. 15), patient ID 263 ("1234567890" in FIG. 15), contraindication information 264 (information about allergies "○×△" and biopsy prohibition" regarding whether biopsy is possible in FIG. 15), and an insertion path 267 of the endoscope 42 recommended for this endoscopic examination that is determined based on past insertion paths ("transnasal (right)" in FIG. 15). The second display section 253 displays, for example, a report 268 of an endoscopic examination of the patient in the past, and/or an endoscopic image, etc.

As described above, in the endoscope-related business system 10, the endoscope information management system 31 displays information necessary for an endoscopic examination and preparation for an endoscopic examination on the monitor 48 via the pre-examination screen 251. This allows the doctor or staff preparing for the endoscopic examination to smoothly prepare for the endoscopic examination without having to refer to other materials or data. Furthermore, when starting an endoscopic examination, the doctor can obtain a list of points to be aware of during the endoscopic examination and/or information on past endoscopic examinations from the pre-examination screen 251, allowing the doctor to start the endoscopic examination safely and smoothly.

As shown in FIG. 16, when an endoscope 42 is connected to the endoscope device 21 in preparation for an endoscopic examination (step S201), the connection detection unit 51 detects this. Therefore, the endoscope connection monitoring unit 182 checks whether the connected endoscope 42 is different from the endoscope 42 to be used that was determined by the endoscope determination unit 172 (step S202). If the connected endoscope 42 is different from the endoscope 42 to be used, the endoscope connection monitoring unit 182 issues a warning to that effect using the notification unit 55 (step S210). This makes it possible to prevent an endoscope 42 that is not to be used from being used in an endoscopic examination, and as a result, the endoscopic examination can be performed safely.

When an endoscope 42 is connected to the endoscope device 21 (step S201), the endoscope information management system 31 uses the cleaning status monitoring unit 191 to check the cleaning status of the connected endoscope 42. If cleaning of the connected endoscope 42 is not completed normally (step S203: NO), or if the endoscope is not removed within a predetermined time after cleaning is completed (step S204: NO), the cleaning status monitoring unit 191 issues a warning to that effect using the notification unit 55 (step S210). This makes it possible to prevent an unclean endoscope 42 or an endoscope 42 that may be unclean from being used for endoscopic examination, and as a result, endoscopic examination can be performed safely.

In addition, when information such as the doctor and patient identification information is input in preparation for the endoscopic examination (step S205), the endoscope information management system 31 uses the user monitoring unit 183 to check the doctor and patient information entered. If the doctor and patient are not those scheduled for the examination (step S206), the user monitoring unit 183 issues a warning to that effect using the notification unit 55 (step S210). This makes it possible to prevent an endoscopic examination from being performed by a doctor or patient other than those scheduled, and as a result, the endoscopic examination can be carried out safely.

As described above, in the endoscopy-related business system 10, the endoscopic examination can be started after various checks are performed by the endoscopy information management system 31 (step S211). Therefore, the endoscopic examination can be started safely.

<Performing endoscopic examination>
As shown in Fig. 17, when the endoscopic examination is started, the endoscopic device 21 acquires an endoscopic image and displays the acquired endoscopic image on the monitor 48 by the in-examination screen 301 (step S301). As shown in Fig. 18, the in-examination screen 301 has, for example, an endoscopic image display section 311 that displays the endoscopic images 321 acquired sequentially, a contraindication information display section 312 that displays information related to the safety of the implementation of the endoscopic examination such as a "biopsy prohibited" mark 322, and a reference information display section 313 that displays reference information such as an endoscopic image 323 acquired in a past endoscopic examination and/or a report 324 of the past endoscopic examination. The endoscopic image 323 acquired in the past endoscopic examination is acquired by the image acquisition section 175 and inserted into the in-examination screen 301. In addition, the report acquisition section 176 acquires the report 324 of the past endoscopic examination and inserts it into the in-examination screen 301. Meanwhile, the photographing position recognition section 61 sequentially recognizes the photographing position for the endoscopic images 321 acquired and displayed (step S310). Therefore, when the shooting position has changed (step S312: YES), the endoscope information management system 31 appropriately updates the reference information on the examination-in-progress screen 301. For example, when displaying an endoscopic image 323 acquired in a past endoscopic examination on the reference information display unit 313, the endoscopic image 323 acquired in the past endoscopic examination and displayed on the reference information display unit 313 is updated according to the recognized shooting position. More specifically, the past endoscopic image 323 captured at a position corresponding to the captured endoscopic image 321 is displayed on the reference information display unit 313. In this way, by recognizing the shooting position and automatically updating the reference information, appropriate reference information can be referred to in real time, allowing the doctor to smoothly perform the endoscopic examination.

During the endoscopic examination, the treatment recognition unit 62 recognizes whether or not a treatment has been performed, and the endoscope information management system 31 monitors whether or not a biopsy has been performed using the biopsy monitoring unit 201. If a biopsy has been performed (step S320: YES), the biopsy monitoring unit 201 acquires information related to the biopsy (step S321), and the label printer control unit 203 automatically prints a biopsy label 350 related to the biopsy. In conventional endoscopic examinations, when a biopsy is performed, the doctor or staff inputs information related to the biopsy into the label printer 22 to create the biopsy label 350. However, in the endoscope-related business system 10, the biopsy label 350 is automatically created by performing the biopsy as described above, so that the creation of the biopsy label 350 can be performed more smoothly and conveniently than before.

As shown in FIG. 19, the biopsy label 350 includes, for example, a title such as "Specimen Label," an indication of the order in which the biopsy was performed such as "(1)," "(2)," or "(3)," an indication of the name of the patient who performed the biopsy ("Fuji Taro" in FIG. 19), the patient's ID ("1234567890" in FIG. 19), and the site where the specimen was taken ("Stomach" in FIG. 19).

In addition, during an endoscopic examination, the image quality recognition unit 63 recognizes the image quality of the acquired endoscopic image 321, and the unphotographed portion recognition unit 64 recognizes the unphotographed portion of the subject. If the image quality is not appropriate (step S330: NO), or if there is an oversight due to an unphotographed portion (step S340: NO), the notification unit 55 issues a warning to that effect and/or a notification encouraging improvement (step S350). Therefore, in the endoscope-related business system 10 equipped with the endoscope information management system 31, oversights are reduced and endoscopic images of appropriate image quality are more likely to be obtained than in conventional endoscope devices that do not have such warnings. In other words, endoscopic examinations can be carried out smoothly and reliably.

The endoscopy-related business system 10 repeatedly executes the above steps as appropriate until the examination is completed (step S360: YES).

<Cleaning of endoscope>
As shown in Fig. 20, when the endoscope 42 used at the bedside after the endoscopic examination is subjected to the primary cleaning, the endoscope information management system 31 uses the primary cleaning management unit 192 to display the primary cleaning information input screen 401 on the monitor 48 (step S401). Therefore, the doctor or staff performing the primary cleaning of the endoscope 42 can input the necessary items such as the information related to the primary cleaning on the spot after performing the primary cleaning of the endoscope 42 (step S402). Furthermore, when the input of the information related to the primary cleaning is completed, the primary cleaning management unit 192 acquires the information related to the primary cleaning, which is the input item on the primary cleaning information input screen 401 (step S403), and registers it in the database 156 (step S404). In the conventional endoscope device, the information related to the primary cleaning must be input separately using a device or system other than the endoscope device 21, but in the endoscope-related work system 10, the input and registration are completed at the site where the primary cleaning is performed, so that the work of inputting the information related to the primary cleaning can be performed more smoothly than in the conventional endoscope device.

As shown in FIG. 21, the primary cleaning information input screen 401 includes items to be entered as information related to the primary cleaning, such as identification information 411 of the endoscope 42 to be subjected to the primary cleaning ("EGXXX" in FIG. 21), identification information 412 of the cleaner who performed the primary cleaning ("Yamanaya Taro" in FIG. 21), cleaning implementation status 413 ("OK" icon indicating that the implementation has been completed in FIG. 21), waterproof cap installation status 414 ("OK" icon indicating that the cap has been installed in FIG. 21), and leak check result 415 ("No abnormality" in FIG. 21). When the cleaner presses the cleaning completion button 416, the primary cleaning management unit 192 automatically registers this information in the database 156.

As shown in FIG. 22, when the cleaning and disinfecting apparatus 23 is used to perform the main cleaning, the cleaning and disinfecting apparatus 23 automatically acquires the identification information of the endoscope 42 to be cleaned and disinfected using the endoscope identification unit 122 (step S451). The cleaning and disinfecting apparatus 23 also acquires the identification information of the cleaner who will perform the main cleaning using the cleaner identification unit 123 (step S452). The cleaning and disinfecting apparatus 23 then automatically inputs this information into the operation screen 460 displayed on the touch panel 115 (step S453).

23, the operation screen 460 displays, for example, a status display 461 showing the operating status of the cleaning and disinfecting apparatus 23, a cleaning information input field 462 for inputting information related to the main cleaning and the first cleaning, and a cleaning start button 465. In the cleaning information input field 462, it is not necessary to input the identification information 463 of the endoscope 42 performing the main cleaning and the identification information 464 of the cleaner performing the main cleaning. In addition, the cleaning and disinfecting apparatus 23 acquires information related to the first cleaning from the endoscope information management system 31 using the communication unit 121, and the input is automatically completed. Therefore, the cleaner performing the main cleaning does not need to input information related to the main cleaning and the first cleaning, but only needs to confirm the input contents (step S454) and press the cleaning start button 465 (step S455). Therefore, according to the endoscope-related business system 10, the main cleaning can be performed smoothly compared to conventional cleaning and disinfecting apparatuses that require these inputs.

When the cleaner presses the cleaning start button 465 to start the main cleaning, or when the main cleaning is completed (including when it ends abnormally), the cleaning and disinfecting apparatus 23 automatically transmits information related to the main cleaning to the endoscope information management system 31 using the communication unit 121 (step S456). As a result, the endoscope information management system 31 automatically registers the acquired information related to the main cleaning in the database 156 using the main cleaning management unit 193 (step S457). Therefore, according to the endoscope-related business system 10, the main cleaning can be carried out more smoothly than in conventional management systems that require these inputs.

<Creating reports>
When creating a report after an endoscopic examination, as shown in Fig. 24, the doctor who creates the report accesses the endoscope information management system 31 using the report creation device 24 (step S501). When accessed by the report creation device 24, the endoscope information management system 31 generates a report creation screen 510 using the report creation screen generating unit 220 and displays it on the display 131 of the report creation device 24 (step S502). At that time, the doctor specifies information that identifies the patient and/or the endoscopic examination (step S503). This is to provide an appropriate report creation screen 510 for the specific patient and endoscopic examination.

As shown in FIG. 25, the report creation screen 510 has a patient information display section 511 that displays patient information, a key image display section 512 that displays key images, etc., a report list display section 513 that displays a list of reports, and an item input section 514 that functions as an operation section for inputting information to be written in the report. Note that the display sections or operation sections related to report creation, such as the key image display section 512, report list display section 513, and item input section 514, are displayed by pressing the report attachment button 516.

As shown in FIG. 26, the key image display unit 512 has a schematic diagram field 520 that displays a schematic diagram, and a number of endoscopic image display fields 521 to 527. The endoscopic image displayed in the endoscopic display field 521 is the key image. In conventional report creation devices, the schematic diagram is manually input by the doctor, but in the endoscope-related work system 10, the endoscope information management system 31 automatically selects the schematic diagram using the second recognition processing unit 222 and the image selection support unit 223 and automatically inserts it into the schematic diagram field 520 (step S504). In conventional report creation devices, the key image is manually input by the doctor, but in the endoscope-related work system 10, the endoscope information management system 31 automatically selects the key image using the second recognition processing unit 222 and the image selection support unit 223 and automatically inserts it into the endoscopic image display fields 521 to 527 (step S504). Therefore, according to the endoscope-related work system 10, the report creation work can be performed more smoothly and quickly than in conventional report creation devices.

As shown in FIG. 27, the item input section 514 of the report creation screen 510 has, for example, a lesion site item input field 531 for inputting items related to the lesion site, a diagnosis item input field 532 for inputting items related to the diagnosis, a findings input field 533 for inputting findings, and a treatment etc. input field 534 for inputting items related to the treatment and/or specimen. Each of these item fields has an item name display section that displays the item name, and an item selection section that lists candidates for the item to be input. The item name display section also functions as an operation section that switches between displaying and hiding the item selection section.

For example, the lesion site item input field 531 includes an item name display section 540 representing the "lesion site", and a first item input field 541, a second item input field 542, a third item input field 543, a fourth item input field 544, and a fifth item input field 545. The first item input field 541 is a lesion site input field for globally selecting the imaging site, and for example, the esophagus, stomach, duodenum, and small intestine are input candidates. The second item input field 542 is an input field for items that classify the selected items of the first item input field 541, and the items listed change depending on the selected item of the first item input field 541. The third item input field 543 is an input field for items that further classify the selected items of the first item input field 541 or the second item input field 542, and the items listed change depending on the selected item of the first item input field 541 or the second item input field 542. The fourth item input field 544 is an input field for further classifying the selected items of the first item input field 541, the second item input field 542, and/or the third item input field 543, and the items listed change depending on the selected items of the first item input field 541, the second item input field 542, and/or the third item input field 543. The fifth item input field 545 is an input field for inputting supplementary information about the lesion site. For example, the diagnosis item input field 532 includes an item name display section 550 representing "diagnosis," and a first item input field 551, a second item input field 552, a third item input field 553, and a fourth item input field 554.

In conventional report creation devices, the input (selection) of the item input section 514 is manually input by a doctor. In contrast, in the endoscope-related business system 10, when the endoscope information management system 31 automatically selects a key image using the image selection support section 223, the discrimination section 236 of the third recognition processing section 224 automatically performs discrimination processing on each key image (step S505). Then, the item selection support section 226 automatically provisionally inputs some or all of the input items of the item input section 514 using the recognition result of the second recognition processing section 222 and/or the discrimination result of the third recognition processing section 224, and sets them in a selected state (step S506). That is, in the endoscope-related business system 10, a report creation screen 510 is provided in which some or all of the input items of the item input section 514 are automatically selected. Therefore, the doctor only needs to confirm the input contents (step S507) and perform an approval operation of pressing the confirmation button 519 to confirm the input contents, thereby completing the creation of the report. Therefore, the endoscopy-related business system 10 can create reports more smoothly and quickly than when the input items in the item input section 514 are manually entered. It can also prevent users from forgetting to enter items.

When the approval operation is performed on the report creation screen 510, the endoscope information management system 31 automatically registers the approved report in the database 156 (step S508).

In the above embodiment, some or all of the components shown as components of the endoscope information management system 31 can be provided in the endoscope device 21 (particularly the processor device 46), the label printer 22, the cleaning and disinfecting device 23, or the report creation device 24. In this case, the endoscope device 21 etc. has various functions of the endoscope information management system 31. Therefore, a system including the endoscope device 21 etc. having the functions of the endoscope information management system 31 constitutes the endoscope-related business system 10 of the above embodiment.

In the above embodiment, the endoscope 42 is an insertable type, but instead of the insertable type endoscope 42, a capsule endoscope that is swallowed by the subject can be used.

The information related to the primary cleaning and/or the information related to the main cleaning may include information related to the usage history indicating for whom (for which patient) the endoscope 42 was used. Therefore, the cleaning status monitoring unit 191 can monitor not only the cleaning status of the endoscope 42 but also information related to the usage history.

In the above embodiment, the hardware structure of the processing units that execute various processes among the various parts of the endoscope-related business system 10, such as the various parts of the processor device 46 and the various parts of the endoscope information management system 31, is various processors as shown below. The various processors include a CPU (Central Processing Unit), which is a general-purpose processor that executes software (programs) and functions as various processing units, a GPU (Graphical Processing Unit), a programmable logic device (PLD), which is a processor whose circuit configuration can be changed after manufacture such as an FPGA (Field Programmable Gate Array), and a dedicated electrical circuit, which is a processor with a circuit configuration designed specifically to execute various processes.

A processing unit may be configured with one of these various processors, or may be configured with a combination of two or more processors of the same or different types (for example, multiple FPGAs, a combination of a CPU and an FPGA, or a combination of a CPU and a GPU, etc.). Multiple processing units may also be configured with one processor. As an example of configuring multiple processing units with one processor, first, as represented by computers such as clients and servers, there is a form in which one processor is configured with a combination of one or more CPUs and software, and this processor functions as multiple processing units. Second, as represented by system on chip (SoC), there is a form in which a processor is used that realizes the functions of the entire system including multiple processing units with a single IC (Integrated Circuit) chip. In this way, the various processing units are configured using one or more of the above various processors as a hardware structure.

More specifically, the hardware structure of these various processors is an electrical circuit that combines circuit elements such as semiconductor elements.

10 Endoscope-related business system 21 Endoscope device 22 Label printer 23 Cleaning and disinfecting device 24 Report creation device 26 Related business device 31 Endoscope information management system 42 Endoscope 42a Insertion section 42b Operation section 42c Bending section 42d Tip section 42e Angle knob 42f Insertion port 44 Light source device 46 Processor device 48 Monitor 49 Console 51 Connection detection section 52 Image acquisition section 53 Image processing section 54 Display control section 55 Notification section 56 Control section 57 Communication section 60 First recognition processing section 61 Shooting position recognition section 62 Treatment recognition section 63 Image quality recognition section 64 Unphotographed portion recognition section 71 Biometric information calculation section 72 Speaker 73 Timer section 74 Information acquisition section 75 Information output section 92 Communication section 93 Biopsy information acquisition unit 94 Output unit 110 Cleaning tank 111 Main body 112 Lid unit 113 Pedal 115 Touch panel 116 Caster 121 Communication unit 122 Endoscope identification unit 123 Cleaner identification unit 124 Control unit 131 Display 132 Operation unit 133 Communication unit 151 Examination information management unit 152 Cleaning information management unit 153 Label output management unit 154 Report creation support unit 156 Database 157 Operation unit 158 Display 159 Communication unit 171 Examination order acquisition unit 172 Endoscope determination unit 173 Insertion path information acquisition unit 174 Contraindication information acquisition unit 175 Image acquisition unit 176 Report acquisition unit 181 Pre-examination screen generation unit 182 Endoscope connection monitoring unit 183 User monitoring unit 191 Cleaning status monitoring section 192 Primary cleaning management section 193 Main cleaning management section 201 Biopsy monitoring section 203 Label printer control section 220 Report creation screen generating section 222 Second recognition processing section 223 Image selection support section 224 Third recognition processing section 226 Item selection support section 231 Shooting position recognition section 232 Treatment recognition section 233 Lesion recognition section 236 Differentiation section 251 Pre-examination screen 252 First display section 253 Second display section 261 Identification information 262 Patient name 264 Contraindication information 267 Insertion path 268 Report 301 During examination screen 311 Endoscopic image display section 312 Contraindication information display section 313 Reference information display section 321 Endoscopic image 322 No biopsy mark 323 Endoscopic image 324 Report 350 Biopsy label 401 Primary cleaning information input screen 411 Identification information 412 Identification information 413 Cleaning implementation status 414 Waterproof cap installation status 415 Leakage check result 416 Cleaning complete button 460 Operation screen 461 Status display 462 Cleaning information input field 463 Identification information 464 Identification information 465 Cleaning start button 510 Report creation screen 511 Patient information display area 512 Key image display area 513 Report list display area 514 Item input area 516 Report attachment button 519 Confirm button 520 Schematic diagram area 521 to 527 Endoscopic image display area 531 Lesion site item input field 532 Diagnosis item input field 533 Findings input field 534 Treatment, etc. input field 540 Item name display area 541 First item input field 542 Second item input field 543 Third item input field 544 Fourth item input field 545 Fifth item input field 550 Item name display area 551 First item input field 552 Second item input field 553 Third item input field 554 Fourth item input field

Claims (6)

an imaging position recognition unit that recognizes a part of a subject appearing in an endoscopic image;
an image selection support unit that automatically selects an endoscopic image to be used in a report from among the multiple endoscopic images using a recognition result from the imaging position recognition unit;
and a patient information acquisition unit that acquires patient information to be used in the report from a patient information database. The endoscope information management system according to claim 1, further comprising an examination information acquisition unit that acquires examination information to be used in the report from an examination information management database. A discrimination unit that performs discrimination processing on the endoscopic image;
The endoscope information management system according to claim 1 , further comprising a display unit that displays a discrimination result of the discrimination unit. The endoscope information management system according to any one of claims 1 to 3, wherein the imaging position recognition unit is capable of recognizing an imaging position in more detail than the recognition result of the imaging position recognition unit. a treatment recognition unit that recognizes a treatment for a subject in the endoscopic image,
5. The endoscope information management system according to claim 1, wherein the image selection support unit selects the endoscopic images to be used in the report using the recognition results of the procedure recognition unit. a lesion recognition unit that recognizes the presence or absence of a lesion in the endoscopic image,
An endoscope information management system according to any one of claims 1 to 5, wherein the image selection support unit selects the endoscopic images to be used in the report using the recognition results of the lesion recognition unit.

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