EP3659151A1 - Dispositif et procédé de liaison et d'évaluation d'informations de données cliniques dans un appareil médical - Google Patents

Dispositif et procédé de liaison et d'évaluation d'informations de données cliniques dans un appareil médical

Info

Publication number
EP3659151A1
EP3659151A1 EP18759243.1A EP18759243A EP3659151A1 EP 3659151 A1 EP3659151 A1 EP 3659151A1 EP 18759243 A EP18759243 A EP 18759243A EP 3659151 A1 EP3659151 A1 EP 3659151A1
Authority
EP
European Patent Office
Prior art keywords
data
medical device
patient
medical
information
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.)
Pending
Application number
EP18759243.1A
Other languages
German (de)
English (en)
Inventor
Peter WESTERHOFF
Julia GRUNDMANN
Yves Köth
Matthias Hildebrand
Hans-Joachim CAPPUIS
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.)
WOM World of Medicine GmbH
Original Assignee
WOM World of Medicine GmbH
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
Priority claimed from DE102017007100.4A external-priority patent/DE102017007100A1/de
Application filed by WOM World of Medicine GmbH filed Critical WOM World of Medicine GmbH
Publication of EP3659151A1 publication Critical patent/EP3659151A1/fr
Pending legal-status Critical Current

Links

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
    • G16H40/60—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
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/015—Control of fluid supply or evacuation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/317—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for bones or joints, e.g. osteoscopes, arthroscopes
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00225—Systems for controlling multiple different instruments, e.g. microsurgical systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00477—Coupling
    • A61B2017/00482—Coupling with a code
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
    • A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6009—General characteristics of the apparatus with identification means for matching patient with his treatment, e.g. to improve transfusion security
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6018—General characteristics of the apparatus with identification means providing set-up signals for the apparatus configuration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M3/00—Medical syringes, e.g. enemata; Irrigators
    • A61M3/02—Enemata; Irrigators
    • A61M3/0204—Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity

Definitions

  • the area of application is the use of data from networked devices in minimally invasive, surgical OP, patient data and / or previous experience
  • the solution according to the invention relates to concepts for device-internal use of comprehensive networking in the clinical environment of surgical interventions
  • Imaging device any energy-powered or non-powered device used for diagnostic or therapeutic interaction with the human or animal body.
  • the state of the art related to the field of minimally invasive surgery currently comprises a device system of several individual components. Access for medical devices to the patient's surgical site is through a trocar-optic combination.
  • the trocar is the seal against the body shell with a defined access for instruments and can be tightly closed by valves.
  • the trocar is connected via a hose system with a pumping device.
  • this pump device or fluid pump is in surgical procedures in body joints or other body cavities (for example, bladder, rectum, uterus, joints, abdominal cavity or other artificially created or natural openings in the human body) flushing medium (liquid or gaseous) on the
  • Hose connection pumped for expansion in the operation area.
  • a trocar is used for the access of the instruments, of which at least one is used for the supply of the gaseous medium and often another for the discharge of the gaseous medium.
  • the inlet and outlet also takes place via tube systems and is controlled by a pumping device or an insufflator.
  • Pumping devices is to build up and maintain a defined pressure in the field of operation while a desired volumetric flow rate can be adjusted. There are a few, purely technical parameters available for the control of the pumping devices. A current challenge is therefore the pressure in the
  • WO 2009/032134 describes a method and apparatus for transporting data from an implanted medical device via a wireless connection to a network to which servers, medical stations and programming stations are connected. This breaks down into several inventions, of which the method in claims 38-41, whereby a mutual authentication of a portable patient communication device and a remote server and after successful
  • WO 2014/040175 discloses a server-based biosignal transmission
  • Disadvantages also result from the fact that there are widespread and openly defined interfaces for medical devices, above all in the field of imaging methods, with which patient data and image data can be transmitted, namely HL7 and DICOM. These are not technically designed to allow device operation or to exchange information from devices in an operating room. Points such as time-critical data provision or even real-time capability as well as alarm management are not implemented.
  • Communication protocols may be present in the medical devices.
  • Device configuration and the setpoint adjustment are done so far purely manually by clinical personnel based on personal experience or manufacturer information.
  • WO 2015/069 182 A1 describes a supplement to the control device of a
  • WO 2015/069182 describes a method in which the measured blood pressure value is multiplied by a correlation factor in order to determine the blood pressure of the vessels there (true perfusion pressure) which controls the delivery pressure of the pumping device.
  • the difference to the solution described in this document according to the invention thus lies in a communication layer between two independent and not necessarily originating from the same manufacturer medical devices that exchange data to such a control according to the teaching of
  • the patient therapy is improved by a patient-specific control of relevant physiological state variables compared to the previous state.
  • An aid for device setting or a warning display which can give context-sensitive recommendations for action, is only possible to a very limited extent in medical devices.
  • Device tuning can only be done via additional selection of usage scenarios, such as the body region and the type of a procedure, for example via a selection in the device, a knee surgery and therapeutic intervention.
  • Systems that use sensors and thus recognize a context are known from other areas, which are not operational in medicine because of the complex contexts. The use of vital parameters recorded outside the device for the generation of warnings or recommended actions is not known.
  • EP2662106B1 describes an insufflation device which has both a dissection mode and an insufflation mode.
  • Insufflation device has an insufflator and a measuring, control and
  • Control device for the controlled and regulated output of the gas.
  • the insufflator is fluidly connected via a gas supply line to a pneumatic tissue dissection probe.
  • the tissue dissection probe is electronically connected to the measurement, control and regulation device. It is a switching device is provided which is designed to switch the regulated and
  • An independent claim is for one Method for alternating insufflation of gas into a body cavity and pneumatic dissection simultaneously with an insufflation device.
  • WO2015 / 161965 describes the control of a medical device by means of different operating modes based on sensor data.
  • the invention relates to a mobile medical device (1) with a portable operating unit, which has a housing (10) with a plurality of differently oriented or positioned
  • the operating unit comprises a position sensor device (3) which detects the orientation (x, y, z) of the housing (10) with respect to a reference value and generates sensor data accordingly.
  • Operating modes can be selectively activated by the control device (5) according to the sensor data.
  • WO2007 / 065237 describes an insufflator operation which automatically switches to a safety mode when there is no regular monitoring signal (page 5 lines 1-3).
  • DE19904090 describes a method and a device for automatic control and administration (including for documentation purposes) of
  • program-controlled medical devices The focus of the patent is on the networking and communication of devices with a bus system (CANopen).
  • the medical devices act as slaves and the master computer as master, which can control all medical devices.
  • the devices can not control each other or exchange data with each other.
  • Functions include a macro recorder to define a combination of devices, a maintenance and service analysis at startup, a log-in file for specific documentation functions, a
  • Error logging and handling Also described is a structure in a double ring structure, a ring-star structure or a ring-ring structure.
  • EP1995679 describes a device and a method for networking and central operation as well as data transmission for documentation purposes and / or control or parameter adaptation of at least one device which is during a medical intervention is used.
  • Central is a database that is based on a
  • Control unit an external accessible via networks server or a read-only volume is kept.
  • EP1995679 describes that device parameters, or
  • Device actions are triggered by a signal automatically generated by a sensor.
  • a device presetting is automatically adopted - due to which sensors and what cause this is not executed.
  • Each transfer of the database contents into a device is necessarily linked in EP1995679 with a physician approval, ie the actuation of a confirmation element.
  • EP1995679 describes that data of the patient (age, height, weight, existing or already recognized diseases, anatomical
  • EP 2763064 A2 describes an insulin pump with a configurator for setting operating parameters of the insulin pump.
  • the solution according to the invention provides for the use of medical and technical measured values which are already available in the operating theater through other device systems.
  • the invention teaches a medical device for use in minimally invasive surgery (MIC) containing
  • the interface transmitting measurement data and / or patient data
  • At least one storage unit which received the over the interface
  • At least one arithmetic unit in the other medical device connected via the interface which calculates the operating parameters of the medical device based on the measurement data and / or the patient data, wherein the calculation of the operating parameters takes place taking into account apriori data selected according to a predetermined criterion the regulation of the operating parameters of the medical device on the calculated
  • the object which fulfills the solution according to the invention is a crosslinking of
  • the solution according to the invention can also be understood as the provision of a medical device (fluid pump) which, depending on the situation, is an ideal one
  • ⁇ the ideal surgical support consists of the combination of optimal operating modes and the appropriate disposables, Is defined ⁇ the operation mode in each case by the pressure fluid flow, the control parameters and the adjustment range,
  • ⁇ selecting the optimal mode is either patient or intervention dependent
  • pressurized reservoir is also according to the invention.
  • the automatic mode selection or a new protective mode primarily affect the following customer benefits: a) User-friendliness
  • the prerequisite is the provision of data interfaces to sources of information in the operational environment, such as the hospital information system or the
  • the solution according to the invention includes a
  • Data classes e.g., patient type, operation type
  • the setpoint recommendations and controller presets of the medical devices improve patient therapy and flow into an assistance system to support the clinical Personnel.
  • Patient therapy is thereby significantly improved, for example, by reducing bleeding and / or preventing unwanted tissue damage due to excessive pressure in the operating area.
  • the assistance system supports the surgeon with customized recommendations based on patient data and technical measurements.
  • source and control parameters of insufflators and pumps in the inim-invasive surgery in the medical device are changed directly or indirectly by data input, whereby an improved device function is ensured, which improves the view in the surgical field, reduces bleeding, and the burden on the patient's circulation minimized.
  • the device systems used during the procedure should be automatically recognized by means of identification methods.
  • action recommendations for the surgeon are generated from all available apriori data.
  • According to the invention is also a self-adjustment of the equipment used, which relieves the medical staff of technical processes and the therapy optimized patient-specific. All collected information, setpoint recommendations and settings should be transferred to the intraoperative phase.
  • Disposables e.g., tubing set
  • the expanded exchange of information between the device systems in the clinical-operative environment is used directly for optimizing the control technology of the individual medical devices.
  • Automated information processing analyzes and classifies patient and device data and derives device parameters and device behavior.
  • Classification procedure corresponds to established procedures and for everyone
  • Scope a suitable classifier structure is created. The training and the validation of the classifier takes place before the implementation in the
  • Medical device or even during the medical procedure or following the medical procedure by e.g. learning systems using data from the clinical environment.
  • process information is collected, analyzed and used for other networked medical subsystems
  • the area of application of the planned expert system may include further functional units in the operating room.
  • the most important area of anesthesia greatly benefits from a constantly updated experience system and the connections to other clinical devices and systems.
  • Data from the anamnesis and device discovery allows device configurations to be automatically selected. These settings can be optimized for each individual patient to the respective therapy and thus improve preoperatively minimally invasive surgery. The same applies to setpoint specifications such as the pressure in the operating area.
  • the relevant device parameters are currently used by assuming various operating states (flow rates and delivery pressures in fluid pumps) in order to determine the relevant variables (flow resistance) or in advance to compare measured sizes. This method is based on the
  • a provision of the device identifications from the surgical planning system, a labeling of the medical devices with RFID chips (wireless data transmission) or a visual recognition by image processing of connected devices or other methods can be carried out to determine the device settings resulting from the use
  • the fallback level in the medical device ensures that it also assumes a safe state in the event of missing or failing procedures
  • Assistance system is available to medical personnel in the pre- and intraoperative phase and relieves them of technical procedures.
  • the clinical personnel are given recommendations for action by an inventive assistance system, such as increasing an initial target pressure recommendation or the target pressure and / or indicating critical conditions, such as a longer-term one high pressurization or high storage of fluid in the body.
  • a special operating mode or hose eg, with humidification or heating
  • the devices of the MIC are integrated into the self-organizing communication network.
  • Pre-sorting based on clinical expertise divides the apriori data into data classes (e.g., patient type, operation type).
  • data classes e.g., patient type, operation type.
  • a set of rules for the regulator presetting for pressure control is used.
  • Possible apriori knowledge is e.g. the type of surgery, anonymized patient parameters such as age, height, weight, etc. or
  • One embodiment of automated information processing is to evaluate data accumulated during the procedure by a patient vital parameter analyzer or analysis method. This has the task, for example, the pressure in the operating area exactly the blood pressure in the surrounding tissue
  • the optimal setpoint for the pressure in the operating area is determined from the vital parameters of the patient before the surgical procedure.
  • the age of the patient is an influencing variable to from general biomechanical conditions, such as the pressure-resistance of
  • Joint capsule so the filling pressure before a crack occurs to determine a target value for the pressure in the operating area. Also during the surgical procedure vital parameters of the patient are used, for example, from the diastolic blood pressure or another value associated therewith to determine setpoints for example, the pressure in the operating area.
  • the core element of the control loop ie the method of adaptation to the individual patient, the inclusion of
  • Contextual information provided through the networked data In a certain OP context, in the regulation of pressure by means of a
  • Dual roller pump is the peripheral condition maintaining a of
  • One aspect represents the setpoint adjustment for the pressure in the operating area.
  • the intraoperatively measured blood pressure value, the body temperature, the heart rate or data from the anesthesia are taken into account.
  • the setpoint recommendation is constantly adapted to the individual state during the operation.
  • Another aspect is the consideration of vital parameters in the
  • Vital parameters a control variable estimate is influenced, whereby additional information is included as controlled variables.
  • multivariate regression analysis is used.
  • Data sources can be used universally for a variety of regulatory structures.
  • the specifications of the preoperative regulator presetting should be checked and, if necessary, adjusted to ensure optimal therapy.
  • the regulatory optimization of medical devices takes the form of
  • Regulator presets and setpoint recommendations.
  • a controller setting is done so far only by technical
  • HIL hardware-in-line, i. that technical representations of the operating environment by means of active elements with a background control simulate the operating theater situation and reactions to device actions as identical as possible. This allows controlled and documented environmental conditions against which the device control can be reproducibly optimized.
  • SVMs Support Vector Machines
  • Standard computer systems are currently characterized by a strict separation of the real and virtual worlds.
  • Future MIC system solutions will be characterized by intelligent surgical units with networked system components, intelligent sensors and actuators. The widely used embedded systems today do not meet these requirements.
  • Future MIC system solutions will strengthen the networking and intelligent control of diverse physical and virtual single systems. This can only succeed if the paradigm shift from centrally controlled processes to holistic approaches is carried out involving all available and usable sources of information.
  • cyber-physical systems consist of networked and autonomously coordinated system components. These components grow together into an automatically interacting, intelligent system environment and merge integratively with reality. By definition, they are complex and consist of many heterogeneous and partly autonomous components and modules. Therefore, there is a need to create common definitions, standards, and intelligent interfaces for MICs to safely and successfully operate medical device systems for MICs through integrated management technologies.
  • Also according to the invention is a reliable and time-efficient method for identifying the medical devices used for the operation. For example, in the field of arthroscopy, the flow properties of the used
  • Dual roller pump, the hose unit and the trocar-optic combination are determined, whereby an increase in the regulator quality in the intraoperative phase by taking into account Apriori knowledge, for example, the use of prior art flow characteristics of the identified medical devices.
  • the detection of used devices is mostly done manually by the medical staff.
  • manufacturers identify their own accessories by suitable devices, such as e.g. RFID.
  • the automated device recognition of all applicable medical devices requires reliable
  • Correlations derive a causality. If this does not succeed, there is a risk of deriving incorrect recommendations for action.
  • the determined causalities become provided according to the invention for use in the device adaptation (including setpoint specifications, accessory recommendations, controller method selection, recommended actions) in the medical device.
  • an assistance system is provided to the surgeon during each stroke
  • the networked medical device can also be used for less time-consuming surgical documentation.
  • the background is that experiences about performed operations are not sufficiently evaluated, documented and published. This is also due to missing data, which makes the networked medical device to one
  • Memory unit can output for subsequent evaluation.
  • the device according to the invention consists of a medical device which is connected via an interface to the hospital network, for example a secure network connection with medical devices in the operating theater, measurement data from sensors, information about the patient who is treated with the medical device, and operating parameters of the medical devices can exchange.
  • Medical device includes a storage unit, wherein the data to be assigned to each case of treatment are collected and stored in a structured manner. In the event that operating parameters or patient data are only partially transmitted, e.g.
  • the device becomes a record
  • Medical device will also resort to this fallback level in case of missing or interrupted connection.
  • the medical device contains a computer unit, which due to higher-level rules and / or the evaluation of the Interface incoming data calculates operating parameters and applies these for their control / regulation.
  • One type of such calculation may be a simple correlation of the incoming data sets existing in the medical device.
  • Other links and calculations according to the prior art, which provide operating parameters for the further operation of the medical device, are also according to the invention.
  • data can be sent to an external database or expert system which can be reached via the interface, and operating parameters can be transmitted back.
  • Fluid pump that introduces a pressure in an artificial or created body cavity to dilate.
  • This may be a fluid-filled body cavity, such as in urology, hysteroscopy, arthroscopy, and procedures where tissue is disrupted to allow access to certain regions and implants, such as in total extraperitoneal hernia repair.
  • a fluid-filled body cavity such as in urology, hysteroscopy, arthroscopy, and procedures where tissue is disrupted to allow access to certain regions and implants, such as in total extraperitoneal hernia repair.
  • the intracavitary pressure by the use of suction or therapy devices that remove tissue, quickly lowered, causing the body cavity to shrink.
  • the communication from the aspirating therapy devices that they are activated, via the aforementioned interfaces can allow the liquid pump to respond quickly, because the pressure drop can otherwise be assigned to a suction situation with delay. Also according to the invention is the strength of the
  • the task of the fluid pump is to keep the field of view clear, e.g. Bleeding through opened blood vessels and capillaries. This can be done by a tamponade effect, ie by a generated fluid back pressure to the local blood pressure in the opened vessels. At the same time should be avoided to squeeze the expansion fluid by pressure in the blood vessels.
  • the fluid pump receives the measured blood pressure of the patient, the local blood pressure at the body cavity is calculated by calculation, and the local blood pressure and / or the transmitted blood pressure are directly processed as a control parameter for the pressure in the body cavity.
  • Patient data including, for example, the inclusion of the patient's age on the maximum allowable pressure values of the fluid pump or the body mass index calculated from weight and height, which corresponds to the weight of the abdominal wall in the case of
  • Expansion of the abdominal cavity is taken into account as a parameter for increasing the setpoint pressure.
  • the operating parameters of the medical devices influenced by the invention are the fluid pressure generated by the pump and / or the fluid flow generated, that is to say the quantity which is conveyed per unit of time.
  • the regulation of the fluid temperature which can be done with insufflator by special air hoses and fluid pumps by accessories, which introduces heat into the flushing medium. This accessory may also be controlled by the temperature values determined by external sensors, e.g. also connected to the vital monitor are controlled.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • General Business, Economics & Management (AREA)
  • Epidemiology (AREA)
  • Business, Economics & Management (AREA)
  • Primary Health Care (AREA)
  • Optics & Photonics (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
  • Medical Treatment And Welfare Office Work (AREA)

Abstract

L'invention concerne un dispositif médical à utiliser en chirurgie mini-invasive (MIC). Jusqu'à présent la chirurgie mini-invasive (MIC) se trouve, en tant que solution appareil, isolée des composants interconnectes de la salle d'opération. Le personnel médical spécialisé doit être aidé, dans le réglage d'appareil par un système d'assistance, par une meilleure intégration des appareils utilisés pour la MIC (p. ex. insufflateurs, pompes, caméras, moniteurs) dans le déroulement d'opération global ainsi que par une approche ouverte, indépendante du fabricant, de collecte d'informations, d'évaluation des informations et d'optimisation de processus basée sur les informations. De nombreuses informations peuvent être saisies ou recueillies déjà durant la phase préopératoire, avant l'intervention chirurgicale même, pour être mises à disposition pour la phase intraopératoire. Simultanément, une première personnalisation du diagnostic ou de la thérapie pour le patient respectif peut être réalisée sur la base de ces données.
EP18759243.1A 2017-07-28 2018-07-10 Dispositif et procédé de liaison et d'évaluation d'informations de données cliniques dans un appareil médical Pending EP3659151A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE102017007100.4A DE102017007100A1 (de) 2017-07-28 2017-07-28 Vorrichtung und Verfahren zur Informationsverknüpfung und -auswertung von klinischen Daten in einem medizinischen Gerät
DE102017012063 2017-12-29
PCT/DE2018/000210 WO2019020136A1 (fr) 2017-07-28 2018-07-10 Dispositif et procédé de liaison et d'évaluation d'informations de données cliniques dans un appareil médical

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US20200168326A1 (en) 2020-05-28
JP7208217B2 (ja) 2023-01-18
CN110945596A (zh) 2020-03-31
JP2020529875A (ja) 2020-10-15
CN110945596B (zh) 2023-11-17

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