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WO2019070117A1 - Système pour déterminer l'utilisation d'instruments chirurgicaux dans une salle d'opération ou un laboratoire de cathétérisation, ainsi que procédé correspondant - Google Patents

Système pour déterminer l'utilisation d'instruments chirurgicaux dans une salle d'opération ou un laboratoire de cathétérisation, ainsi que procédé correspondant Download PDF

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Publication number
WO2019070117A1
WO2019070117A1 PCT/NL2018/050646 NL2018050646W WO2019070117A1 WO 2019070117 A1 WO2019070117 A1 WO 2019070117A1 NL 2018050646 W NL2018050646 W NL 2018050646W WO 2019070117 A1 WO2019070117 A1 WO 2019070117A1
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WO
WIPO (PCT)
Prior art keywords
tray
surgical instruments
accordance
determining
instrument
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/NL2018/050646
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English (en)
Inventor
Alberto Andres OCAMPO RIOS
John Paulo IDÁRRAGA MUÑOZ
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Topic Ip3 BV
Original Assignee
Topic Ip3 BV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Topic Ip3 BV filed Critical Topic Ip3 BV
Publication of WO2019070117A1 publication Critical patent/WO2019070117A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/40—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/30—Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments
    • A61B50/33—Trays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90—Identification means for patients or instruments, e.g. tags
    • A61B90/98—Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
    • G01B11/00—Measuring arrangements characterised by the use of optical techniques
    • G01B11/24—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures
    • G01B11/2433—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures for measuring outlines by shadow casting
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
    • G01B7/00—Measuring arrangements characterised by the use of electric or magnetic techniques
    • G01B7/28—Measuring arrangements characterised by the use of electric or magnetic techniques for measuring contours or curvatures
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0804—Counting number of instruments used; Instrument detectors
    • A61B2090/0805—Counting number of instruments used; Instrument detectors automatically, e.g. by means of magnetic, optical or photoelectric detectors
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Definitions

  • the present disclosure is directed to scheduling of Operating Rooms in a hospital.
  • An Operating Room is a complex dynamic environment due to variety of surgeries that are to be performed in such a room. Further, the Operating Room should be able to cope with unexpected events such as emergency surgeries and unexpected progress of certain procedures.
  • Operating Room such as information technology, monitoring and surgical devices to assist surgical procedures, present benefits but also contributes to the complexity by adding more parameters and possibilities of actions thereby making the situation harder to oversee.
  • Operating Room An entire surgical team has to be scheduled, consisting of one or more surgeons, Operating Room nurses, nurse anaesthetists and possibly personnel in training.
  • the Operating Room itself has to be ready for use as well.
  • the Operating Room needs to be cleaned, the air pressure kept at the required level, and the technical equipment ready to use. This means that the required surgical devices have to be present, correctly maintained and checked for well-functioning. Additionally, a complete and sterile set of surgical instruments has to be delivered and prepared for use. Last but not least, information about patients, progress and outcome of procedures may need to be exchanged, digitally, across different departments of the hospital.
  • One of the issues of suboptimal performance of an Operating Room is related to the scheduling thereof. Accurate prediction of a duration of certain procedures is difficult, which has an effect on the scheduling of the operating Room. In case certain procedures in the Operating Room run late, i.e. take more time than initially suspected, this may influence many other processes inside a hospital. For example, subsequent procedures may be postponed or even cancelled. This causes undesirable longer waiting times for patients and an overload of the pre- operative holding area.
  • One of the concepts to deal with the above described scenario is to use sensors on the equipment used in an Operating Room. Based on the sensed data, predictions can be made whether certain procedures are on schedule or if they run late.
  • a system for determining usage of surgical instruments in an Operating Room or catheterization laboratory comprising: a tray for placing said surgical instruments on top thereof, wherein said tray comprises an array of solar cells and/or photodiodes, which are arranged for receiving light present in said Operating Room thereby inducing a light detection current,
  • an instrument identification database comprising a plurality of identifications of surgical instruments, wherein each identification is associated with a particular unique current characteristic
  • an array of solar cells and/or an array of photodiodes can be used for determining when, and which, surgical instruments are removed from the tray. Instruments that lay on top of the tray block light. As such, the solar panel may yield less power, i.e. current, whenever objects are on top of the tray. The yield of a solar panel, and/or an array of photodiodes, is increased whenever a surgical instrument is removed from the tray as the solar panel, and/or the array of photodiodes, then gets more exposed to the light in the Operating Room. That is, there is no longer a blockage of light from the instrument that has been removed from the tray.
  • the detected current characteristic forms, to a certain extent, a footprint for the instrument that has been removed from the tray.
  • a surgical instrument may be a surgical tool for performing specific procedures during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it.
  • a surgical instrument may be a surgical tool for performing specific procedures during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it.
  • many different kinds of surgical instruments and tools have been developed. Some surgical instruments are designed for general use in surgery, while others are designed for a specific procedure or surgery.
  • instrument identification database as well as the detect equipment may be located at, or close to, the tray itself.
  • the instrument identification database as well as the detect equipment may be comprised by a server the cloud.
  • the system may comprise transmit equipment for transmitting the determined current characteristic, or at least the key aspects thereof, to the server in the cloud.
  • said detected current characteristic resembles an increase in said light detection current, thereby indicating that one of said instruments has been removed from said tray.
  • the system may comprise an array of solar cells and/or an array of photodiodes. Both of these types of devices have a different output for differing light intensity incident thereon.
  • each identification is further associated with a particular weight
  • said tray further comprises:
  • the system comprises a light sensor arranged for measuring light present in said Operating Room, wherein said system further comprises:
  • the inventor has found that it may be beneficial to provide the system with a light sensor for normalization purposes.
  • the light incident on the tray and the solar panel may not need to be uniform day by day, or even hour by hour.
  • the magnitude of the current characteristic in the light detection current due to the removal of a particular surgical instrument from the tray does not need to be same each time.
  • it may be beneficial to normalize the actual light incident on the solar panel i.e. to perform a normalization process.
  • the solar panel comprises:
  • capacitive coupling means arranged for measuring a capacitive coupling between said solar panel and said surgical instruments placed on top of said tray, wherein said capacitive coupling means are arranged for determining that a surgical instrument has been removed from said tray by detecting a fluctuation in said capacitive coupling.
  • the above described example is beneficial as it may reduce the amount of false positives of the system. For example, shadows occurring on the solar panel due to, for example, people walking around in the Operating Room may cause false positives. In case such a shadow causes a decrease in the light detection current, which decrease in current resembles a particular current characteristic, the system may determine that a particular surgical instrument has been placed back on the tray while in practice this is not the case. The decrease in current is then caused by, for example, the surgeon and/or the assistant walking around the Operating Room.
  • capacitive coupling may be used for determining whether the decrease in light detection current is caused by the removal of a surgical instrument or that it is caused by environment factors like people walking around in the Operating Room.
  • the surgical instruments comprise, in most cases, metal.
  • Deviations in the capacitive coupling between the surgical instruments and the solar panel may be used for determining that one or more surgical instruments have been removed from the tray or have been placed on top of the tray. Once this has been determined, the actual detection process of detecting which instrument has been removed from the panel, or has been placed on top of the tray, may be initiated. As such, the capacitive coupling aspect may form a trigger for the detection process.
  • said solar panel further comprises:
  • each of said plurality of solar cells and/or photodiodes is arranged to induce a cell current, wherein a summation of said cell currents equals said light detection current;
  • each identification in said instrument identification database is associated with a particular two dimensional shape
  • said detect equipment is further arranged for detecting which one of said surgical instruments has been removed from said tray by:
  • the inventors have found that, besides the effect in the light detection current caused by the removal of a surgical instrument, the dimensional shape of the removed instrument may be used for even more accurately determining which instrument has been taken off from the solar panel.
  • the solar panel in such a way that it consists of a plurality of solar cells.
  • a particular surgical instrument may then cover a plurality of solar cells.
  • the yield of these covered solar cells is reduced due to the surgical instrument laying on top thereof.
  • Each instrument may leave its own foot print on the solar cells. That is, each shape of the surgical instruments ensure that different solar cells are covered, and thus that the yield of different solar cells is affected.
  • the amount of solar cells that are affected, as well as the orientation of these solar cells with respect to each other, indicate a particular two dimensional shape of the instrument laying on top thereof. As such, the inventors have found to use this concept to determine which of the instruments has been removed from the tray.
  • each of said plurality of solar cells comprises a surface area of at most 25 square millimetre, preferably at most 10 square millimetre, even more preferably at most 5 square millimetre.
  • the inventors have found that a surface area of at most 25 square millimetre is sufficient to more accurately determine the shape of the instrument that has been removed from the solar panel, i.e. from the respective solar cells.
  • said detected current characteristic resembles an increase in said light detection current, thereby indicating that one of said instruments has been removed from said tray.
  • said method comprises the step of:
  • said method comprises the steps of:
  • said capacitive coupling means trigger said detect equipment for detecting which one of said surgical instruments has been removed from said tray.
  • the step of detecting which one of said surgical instruments has been removed from said tray by:
  • each of said plurality of solar cells comprises a surface area of at most 25 square millimetre, preferably at most 10 square millimetre, even more preferably at most 5 square millimetre.
  • a computer program product comprising computer readable instructions, which, when executed by a processor, accomplish said processor to perform the method in accordance with any of the method examples as provided above.
  • Figure 1 discloses an overview of a system in accordance with the present disclosure.
  • Figure 2 discloses an example of a light detection current in accordance with the present disclosure.
  • Figure 3 discloses a flow chart of a method in accordance with the present disclosure.
  • FIG. 1 discloses an overview of a system 1 in accordance with the present disclosure.
  • the present disclosure is directed to a situation in which sensed data is being used for determining whether, and when, particular surgical instruments are being used. As such, the inventors found a solution which entails that the use or particular instruments can be detected without modifying those particular instruments.
  • the instruments do not need to be altered, these can be off the shelf instruments.
  • the system 1 is thus to be used inside an Operating Room of an hospital and comprises a tray 10 for placing surgical instruments 1 1 , 12, 13 on top thereof.
  • the tray comprises an array of solar cells 9 and/or photodiodes 9, which are arranged for receiving light present in the Operating Room thereby inducing a light detection current.
  • the array of solar cells 9 and/or photodiodes 9 are suitable to produce differentiating outputs based on incident artificial light.
  • the output of the array of solar cells 9 and/or photodiodes 9 depends on the amount of, and the shape of, the surgical instruments 1 1 , 12, 13 that lay on top of the tray. That is, those surgical instruments 1 1 , 12, 13 block the incident artificial light such that the output of the array of solar cells 9 and/or photodiodes 9 reduces.
  • the output of the array of solar cells 9 and/or photodiodes 9 increases once a surgical instrument 1 1 , 12, 13 has been removed from the tray, as that particular surgical instrument 1 1 , 12, 13 does no longer block the light incident on the tray.
  • the system 1 further comprises a current profile database 5 comprising a plurality of identifications of surgical instruments, wherein each identification is associated with a particular unique current profile.
  • the plurality of identifications of surgical instruments i.e. the current profiles, may be inputted, manually, into the database, or may be generated using a sort calibration process.
  • the surgical instrument as indicated with reference numeral 1 1 is known as a Backhaus towel clamp which is used for, for example, grasping tissue, securing towels or drapes and holding or reducing small bone fractures.
  • the surgical instruments as indicated with reference numeral 12 and 13 are known as a dissecting scissors, wherein a first dissecting scissor 12 has a straight end, and wherein a second dissecting scissor 13 has a curved end. As one can tell, the shapes of these surgical instruments 1 1 , 12, 13 differ with respect to each other.
  • Detect equipment 3 present in the system 1 , is arranged for detecting which one of the surgical instruments 1 1 , 12, 13 has been removed from the tray by detecting a deviation in a current profile of the induced light detection current and by determining which one of the surgical instruments has been removed from the tray 10 by comparing the detected deviation in the current profile with the plurality of current profiles in the current profile database 5.
  • the array of solar cells 9 and/or photodiodes 9 is shown, in figure 1 , as a matrix. It may be beneficial to place the solar cells and/or the photodiodes 9 closely to each other such that a high resolution two-dimensional image may be obtained from the outputs. Such a high resolution two-dimensional image may be beneficial for determining which one of the surgical instruments has been removed from the tray by comparing the generation two-dimensional image with images provided in the database 5.
  • the database 5, the detect equipment 3 and a memory 4 may be comprised in a single housing 2, may be construed as embedded hardware, dedicated hardware or anything alike. It is noted that, additionally, the system 1 may comprise a light sensor 8 for measuring light present in the operating room, wherein the system further comprises calibrate equipment 6 arranged for normalizing the detected deviation in the current profile based on the measured light in the operating room.
  • Figure 2 discloses an example of a light detection current 21 in accordance with the present disclosure.
  • the vertical axis denotes the light detection current 22 and the horizontal axis denotes the time 23.
  • the light detection current 21 changes over time 23.
  • a first step 24 the light detection current increases from about 0,68 mA to about 0,78 mA. This is an indication that a particular surgical instrument has been removed from the tray.
  • Such a deviation in the light detection current i.e. roughly 0, 1 mA, is correlated with the plurality of current profiles in the current profile database to determine which one of the surgical instruments has been removed from the tray 10.
  • a second step 25 the output of the array of solar cells and/or the array of photodiodes decreases. This is an indication that a particular surgical instrument has been placed back again on the tray 10. In this particular situation, it is assumed that the total projected surface of the surgical instrument is larger than the total projected surface of the surgical instrument corresponding to the first step 24.
  • the magnitude of the output corresponding to the third step 26 equals the magnitude of the output corresponding to the second step 25. This means that the surgical instrument that has been removed from the tray in step 25 is placed back on the tray in step 26. It is noted that the particular surgical instrument does not need to be placed back on the tray at exactly the same position.
  • a further surgical instrument is removed from the tray as the deviation in the magnitude of the output of the solar cells and/or photodiodes is different from the ones corresponding to the steps 24, 25 and 26.
  • the system may further be arranged to keep track of the total time that a particular surgical instrument has been used for recording purposes.
  • the surgical instrument corresponding to step 25 is used for about two second before it was placed back. This may be an indication that a person in the operating room took that particular surgical instrument by mistake, and placed it back on top of the tray once the mistake had been identified by himself/herself.
  • Figure 3 discloses a flow chart of a method in accordance with the present disclosure.
  • the method 51 is directed to the determination of the usage of surgical instruments in an Operating Room using a system in accordance with any of the examples as provided above.
  • the method comprises the subsequent steps.
  • a computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid- state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems. Any reference signs in the claims should not be construed as limiting the scope thereof.

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Abstract

L'invention concerne un système permettant de déterminer l'utilisation d'instruments chirurgicaux dans une salle d'opération, ledit système comprenant un plateau pour placer lesdits instruments chirurgicaux sur celui-ci, ledit plateau comprenant un réseau de cellules solaires et/ou de photodiodes, qui sont agencées pour recevoir la lumière présente dans ladite salle d'opération, ce qui permet d'induire un courant de détection de lumière, une base de données de profil de courant comprenant une pluralité d'identifications d'instruments chirurgicaux, chaque identification étant associée à un profil de courant unique particulier et un équipement de détection agencé pour détecter quel instrument chirurgical a été retiré dudit plateau en détectant un écart dans un profil de courant dudit courant de détection de lumière induit et déterminer lequel desdits instruments chirurgicaux a été retiré dudit plateau par comparaison dudit écart détecté dans ledit profil de courant avec ladite pluralité de profils de courant dans ladite base de données de profil de courant.
PCT/NL2018/050646 2017-10-03 2018-10-01 Système pour déterminer l'utilisation d'instruments chirurgicaux dans une salle d'opération ou un laboratoire de cathétérisation, ainsi que procédé correspondant Ceased WO2019070117A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL2019660A NL2019660B1 (en) 2017-10-03 2017-10-03 A system for determining usage of surgical instruments in an Operating Room, or catheterization laboratory, as well as a corresponding method.
NL2019660 2017-10-03

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Publication Number Publication Date
WO2019070117A1 true WO2019070117A1 (fr) 2019-04-11

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WO (1) WO2019070117A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4943939A (en) * 1988-08-29 1990-07-24 Rocklin Hoover Surgical instrument accounting apparatus and method
US20040186683A1 (en) * 2003-03-20 2004-09-23 Boris Farber Method and equipment for automated tracking and identification of nonuniform items
US20130091679A1 (en) * 2011-10-13 2013-04-18 Oliver Gloger Device And Method For Assembling Sets Of Instruments
US20130336554A1 (en) * 2012-06-14 2013-12-19 Prezio Health Methods and systems for identifying, marking, and inventorying large quantities of unique surgical instruments
US20150190202A1 (en) * 2012-08-08 2015-07-09 Aesculap Ag Device and method for simultaneously identifying a plurality of surgical instruments
WO2017011646A1 (fr) * 2015-07-14 2017-01-19 Smith & Nephew, Inc. Identification d'instrumentation et système de réassort
US20180204323A1 (en) * 2017-01-16 2018-07-19 The Aga Khan University Detection of surgical instruments on surgical tray

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4943939A (en) * 1988-08-29 1990-07-24 Rocklin Hoover Surgical instrument accounting apparatus and method
US20040186683A1 (en) * 2003-03-20 2004-09-23 Boris Farber Method and equipment for automated tracking and identification of nonuniform items
US20130091679A1 (en) * 2011-10-13 2013-04-18 Oliver Gloger Device And Method For Assembling Sets Of Instruments
US20130336554A1 (en) * 2012-06-14 2013-12-19 Prezio Health Methods and systems for identifying, marking, and inventorying large quantities of unique surgical instruments
US20150190202A1 (en) * 2012-08-08 2015-07-09 Aesculap Ag Device and method for simultaneously identifying a plurality of surgical instruments
WO2017011646A1 (fr) * 2015-07-14 2017-01-19 Smith & Nephew, Inc. Identification d'instrumentation et système de réassort
US20180204323A1 (en) * 2017-01-16 2018-07-19 The Aga Khan University Detection of surgical instruments on surgical tray

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