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CN-122003201-A - Image guided endoscope withdrawal control

CN122003201ACN 122003201 ACN122003201 ACN 122003201ACN-122003201-A

Abstract

Systems, devices, and methods for creating and using personalized segment-specific endoscope evacuation plans to guide an endoscopic procedure are disclosed. An endoscope system includes an endoscope and a controller circuit. The endoscope includes an imaging system to obtain images or video streams of different segments of anatomical structures within a patient during an endoscopic procedure. The controller circuit may analyze the image or video stream to generate image or video features for each of the different segments of the anatomical structure. Based on the image or video features, the controller circuit may generate an endoscope withdrawal plan that includes target or proposed segment-specific endoscope withdrawal parameter values for each of the segments. The user or robotic system may be provided with an endoscope evacuation plan to facilitate manual or robotic evacuation of the endoscope.

Inventors

  • Sailesh Kangjie Di
  • LIU DAWEI
  • Michael. Ryan

Assignees

  • 捷锐士阿希迈公司(以奥林巴斯美国外科技术名义)

Dates

Publication Date
20260508
Application Date
20240911
Priority Date
20230912

Claims (20)

  1. 1. An endoscope system, comprising: an endoscope comprising an imaging system configured to obtain images or video streams of different segments of a patient's anatomy during an endoscopic procedure comprising insertion and subsequent withdrawal of the endoscope in the anatomy, and The controller circuitry may be configured to control the operation of the controller circuitry, the controller circuit is configured to: Analyzing the obtained image or video stream to generate endoscopic image or video features for each of the different segments of the anatomical structure; Generating an endoscope withdrawal plan based at least in part on the endoscope image or video features, the endoscope withdrawal plan including targeted or suggested segment-specific endoscope withdrawal parameter values for each of the different segments of the anatomical structure, and The endoscope evacuation plan is provided to a user or robotic system to facilitate manual or robotic evacuation of the endoscope.
  2. 2. The endoscope system of claim 1, wherein the target or proposed segment-specific endoscope withdrawal parameter values comprise a target segment-specific endoscope Withdrawal Speed Limit (WSL) for each of the different segments of the anatomical structure.
  3. 3. The endoscope system of any of claims 1-2, wherein the target or proposed segment-specific endoscope withdrawal parameter value comprises a target segment-specific endoscope Withdrawal Time Limit (WTL) for each of the different segments of the anatomical structure.
  4. 4. An endoscope system according to any of claims 1-3, wherein said endoscope is a colonoscope for use in a colonoscopy procedure, Wherein the imaging system is configured to obtain images or video streams from each of the different colon segments during the colonoscopy procedure.
  5. 5. The endoscope system of any of claims 1-4, wherein determining the target or proposed segment-specific endoscope withdrawal parameter value comprises determining a first target segment-specific endoscope withdrawal parameter for a first segment of the anatomical structure using at least the endoscope image or video feature generated from an image or video stream obtained prior to the endoscope being withdrawn beyond the first segment during the manual or robotic withdrawal of the endoscope.
  6. 6. The endoscope system of claim 5, wherein the image or video stream obtained before the endoscope reaches the first section comprises an image or video stream obtained during the insertion of the endoscope in the anatomical structure.
  7. 7. The endoscope system of any of claims 1-6, wherein the controller circuit is configured to: Performing anomaly detection including detecting one or more anomalies in each of the different segments based at least in part on the endoscopic image or video features, and The target or proposed segment-specific endoscope withdrawal parameter values for each of the different segments are determined based at least in part on the results of the anomaly detection.
  8. 8. The endoscopic system of claim 7, wherein the abnormality detection includes identifying one or more of the presence or absence, type, size, shape, location, or number of pathological tissue or obstruction mucosa.
  9. 9. The endoscope system of any of claims 7-8, wherein the controller circuit is configured to detect the one or more anomalies using a first trained Machine Learning (ML) model trained to establish correspondence between (i) an endoscopic image or video stream or features extracted therefrom, and (ii) one or more anomaly features.
  10. 10. The endoscope system of any of claims 7-9, wherein the controller circuit is configured to determine the target or proposed segment-specific endoscope withdrawal parameter values for each of the different segments by applying a result of the anomaly detection to a second trained Machine Learning (ML) model trained to establish correspondence between (i) one or more anomaly characteristics, and (ii) target or proposed segment-specific endoscope withdrawal parameter values.
  11. 11. The endoscope system of claim 10, wherein the controller circuit is configured to: determining an anomaly score based on the type, size, shape, location, or number of anomalies, and Determining the target or suggested segment-specific endoscope withdrawal parameter values for each of the different segments by applying the determined anomaly score to the second trained ML model.
  12. 12. The endoscope system of any of claims 1-11, wherein the controller circuit is configured to generate the endoscope withdrawal plan further using one or more of: image or video streams and clinical data from previous endoscopic procedures; Patient information and medical history, or Preoperative imaging study data.
  13. 13. The endoscope system of any of claims 1-12, wherein the controller circuit is configured to display a graphical representation of the endoscope withdrawal plan on a user interface, the graphical representation comprising depictions of different segments of the anatomical structure, each different segment being color coded or gray coded to indicate a respective target or suggested segment-specific endoscope withdrawal parameter value.
  14. 14. The endoscope system of claim 13, wherein the controller circuit is configured to: determining a position of the endoscope in a different one of the different segments of the anatomical structure in substantially real time based at least in part on the endoscopic image or video feature; Registering the position of the endoscope to a pre-generated template of the anatomical structure, and The position of the endoscope in the one of the different segments is displayed on the user interface as an overlay on the graphical representation of the endoscope withdrawal plan.
  15. 15. The endoscope system of claim 2, wherein the controller circuit is configured to: measuring the speed of endoscope withdrawal in one of the different segments of the anatomy, and When the measured endoscope withdrawal speed deviates from the target segment-specific endoscope WSL for the one of the different segments by a certain margin, an alert is generated to the user and a suggestion is provided to adjust the withdrawal speed to substantially conform to the target segment-specific endoscope WSL.
  16. 16. The endoscope system of any of claims 2 or 15, comprising the robotic system configured to robotically withdraw the endoscope, and wherein the controller circuit is configured to: measuring the speed of endoscope withdrawal in one of the different segments of the anatomy, and When the measured endoscope withdrawal speed deviates from the target segment-specific endoscope WSL for the one of the different segments by a certain margin, a control signal is generated to the robotic system to automatically adjust the withdrawal speed to substantially conform to the target segment-specific endoscope WSL.
  17. 17. The endoscope system of any of claims 2 and 15-16, wherein the controller circuit is configured to: identifying an abnormal segment from the different segments based at least in part on the endoscopic image or video feature, and During the manual or robotic withdrawal of the endoscope and before the endoscope reaches the identified abnormal segment, a visual indicator of the abnormal segment is displayed on a user interface and a reminder is generated to the user to withdraw the endoscope at a speed lower than a speed of the target segment-specific endoscope WSL for the identified abnormal segment.
  18. 18. A method of planning the withdrawal of an endoscope from a patient's anatomy during an endoscopic procedure, the method comprising: obtaining images or video streams of different segments of the anatomical structure during an insertion phase of the endoscopic procedure using an imaging system associated with the endoscope; Analyzing the obtained image or video stream to generate endoscopic image or video features for each of the different segments of the anatomical structure; Generating an endoscope withdrawal plan based at least in part on the endoscope image or video features, the endoscope withdrawal plan including targeted or suggested segment-specific endoscope withdrawal parameter values for each of the different segments of the anatomical structure, and The endoscope evacuation plan is provided to a user or robotic system to facilitate manual or robotic evacuation of the endoscope.
  19. 19. The method of claim 18, wherein the targeted or suggested segment-specific endoscope withdrawal parameter values comprise a targeted segment-specific endoscope Withdrawal Speed Limit (WSL) or a targeted segment-specific endoscope Withdrawal Time Limit (WTL) for each of the different segments of the anatomical structure.
  20. 20. The method according to any one of claims 18 to 19, comprising determining a first target segment specific endoscope withdrawal parameter for the first segment of the anatomical structure using at least the endoscope image or video feature generated from an image or video stream obtained during the manual or robotic withdrawal of the endoscope before the endoscope was withdrawn beyond a first segment.

Description

Image guided endoscope withdrawal control Priority statement The present application claims priority from U.S. provisional patent application Ser. No. 63/582,026 filed on 9/12 of 2023, the contents of which are incorporated herein by reference. Technical Field This document relates generally to endoscopic medical systems, and more particularly to systems and methods for image guided evacuation of an endoscope during an endoscopic procedure. Background Endoscopes have been used in a variety of clinical procedures including, for example, procedures such as illuminating, imaging, detecting and diagnosing one or more disease states, providing fluid delivery (e.g., saline or other agents via a fluid channel) toward an anatomical region, providing access (e.g., via a working channel) to one or more therapeutic or biological material collection devices for sampling or treating an anatomical region, and providing aspiration channels for collecting fluids (e.g., saline or other agents). Examples of such anatomical regions may include the gastrointestinal tract (e.g., esophagus, stomach, duodenum, cholangiopancreatic duct, intestine, colon, etc.), renal regions (e.g., kidneys, ureters, bladder, urethra), and other internal organs (e.g., reproductive system, sinus cavities, submucosal regions, respiratory tract), etc. Some endoscopes include a working channel through which an operator may aspirate, place a diagnostic or therapeutic device (e.g., a brush, biopsy needle, or forceps, a stent, a basket, or a balloon) or perform minimally invasive procedures such as sampling or removal of unwanted tissue (e.g., benign or malignant strictures) or foreign matter (e.g., stones). Some endoscopes may be used with laser or plasma systems to deliver energy to an anatomical target (e.g., soft or hard tissue or stones) to achieve a desired treatment. For example, lasers have been used in tissue ablation, coagulation, vaporization, fragmentation and lithotripsy applications to break up stones in the kidneys, gall bladder, ureters and other stone forming areas, or to ablate large stones into smaller fragments. The endoscopic procedure includes an insertion phase in which the endoscope is passed through a natural orifice and into the body cavity until the target site is reached, and a subsequent withdrawal phase in which the endoscope is carefully withdrawn from the body. Diagnostic or therapeutic procedures (e.g., biopsies or removal of certain abnormal or pathological tissue or foreign bodies) may occur at the target anatomy or during withdrawal. For example, a colonoscopy procedure involves passing a colonoscope through the anus and all the way to the beginning of the colon (known as the cecum). During withdrawal, the colon segment may be examined and polyps of certain sizes detected during insertion may be removed (polypectomy). Colonoscopy and diagnosis and treatment of polyps have been used to reduce the incidence and mortality of colorectal cancer. Disclosure of Invention The colonoscopic withdrawal time during colonoscopy is an important quality metric, especially for negative procedures. To ensure adequate examination and treatment time, the lowest criteria for withdrawal times of more than 6 minutes to the ideal criteria for withdrawal times of more than 10 minutes have been reported as colonoscopy quality assurance criteria. Longer withdrawal times may increase the Adenoma Detection Rate (ADR). In order to ensure sufficient examination time and to prevent the colonoscope from being withdrawn too quickly, a speedometer or the like has been proposed to display the withdrawal speed. However, the withdrawal speed limit or withdrawal time threshold for assessing withdrawal during an endoscopic procedure is typically predetermined, e.g., based on generally accepted criteria (e.g., at least six minutes or at least ten minutes). These "universal" withdrawal criteria are highly generalized criteria that are determined without consideration of the unique circumstances presented by the individual processes. For example, a target withdrawal time of more than 6 minutes is a quality indicator of a non-outcome colonoscopy for an average risk patient with complete colon. This includes patients who have not previously undergone surgical resection and have not undergone a biopsy or polypectomy. In the case of a patient with colon cancer or a patient under monitoring's colon (e.g., due to a polyp previously identified and/or resected from a past colonoscopy procedure for a particular patient), such a general evacuation criterion may be less effective or suboptimal. Additionally, if the bowel in one or more colon segments is poorly prepared, the universal withdrawal time may be ineffective, in which case the endoscopist may need to diligently withdraw, slowly clean the bowel along the way, and ensure complete mucosal examination to avoid any hidden polyps. In addition to inter-patient variations in withdrawal time requirements, such as due to