US 20060015008 A1
A video recording and image capture device for documenting surgical procedures that includes a main board for executing a plurality of software, a multimedia interface operable to receive a video signal and process it into an MPEG layer stream, the video interface connected on a first bus to the main board, a hard drive to record an MPEG layer stream as a file, an optical media drive to write an MPEG layer stream as a file, the hard drive and the optical media drive operably connected on a second bus, the bus being vertically stacked and connected to the main board, and a touchscreen interactive for user control, connected to the main board on a second bus to control the video interface.
1. A device for medical video recording comprising:
a digital media; and
an imager in communication with said endoscope, said imager converting energy received from said endoscope to signals that are contemporaneously stored onto said digital media.
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Applicant claims priority benefits under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 60/410,456 filed Sep. 13, 2002.
The invention relates generally to device for video recording and image capture, and more particularly to such a device for image based documentation of surgical procedures. The invention also relates to means to process signals into an MPEG layer stream.
The maxim that “a picture is worth a thousand words” is more true than ever in image based documentation of surgical procedures. There patients' lives and physicians' reputations are at stake. The early history of image based documentation is littered with crude attempts at utilizing photographic film to capture anatomical curiosities and groundbreaking surgical advances for teaching purposes. However, little attempt was made to provide documentation of routine cases. Average patients simply did not merit this special consideration.
With the advent of analog cameras coupled to fiber optics, physicians began displaying some surgical patient images on video monitors in the operating room. This was especially true in endoscopic surgeries where physicians peer inside patients' body cavities normally only viewable with open surgery. Attempts made to systematically record all patient procedures on videotape required large and cumbersome archives of videotapes.
Although analog cameras are still used, solid state image cameras coupled to endoscopes and other medical instruments are now standard. These cameras produce images in digital format. Such format allows convenient and efficient image transfer, review, and archival.
One method for archiving digital images is suggested in U.S. Pat. No. 6,067,075 to Pelanek. Therein, a workstation is disclosed for transferring and archiving patient images previously stored in the memory of diagnostic equipment. However, this method does not disclose contemporaneously saving images in a permanent location, meaning that the equipment is subject to “downtime” as data is extracted from its memory.
Once image data has been extracted and archived it must be made available to those in a position to best make use of it, the treating physician. Ironically in a circular manner, the person to whom eventual delivery of images is made is the same person who used the diagnostic equipment to record the images in the first place who must now await it being made available to him. Thus, it would be advantageous to the physician to have the data available at the conclusion of the surgical procedure or series of surgeries. Consequently, equipment downtime for data extraction also is eliminated increasing efficiency of equipment and facility utilization.
Image data availability, however, is only of value when the data can be read and images displayed readily. Thus, exotic and unusual methods of storing and reading image data chain physicians. Most convenient are displays in NTSC and PAL standards and devices that can play image data on these displays. NTSC is the common television standard in the U.S., while PAL standards predominate in Europe and in parts of Asia. Additionally, most convenient for medical personal, is for images and video to be viewable utilizing common off-the-shelf optical media players (i.e. set-top DVD players) and/or standard personal computers.
U.S. Pat. No. 5,045,955 to Ikeda discloses an apparatus coupled to a digital tape drive for recording and reproducing high-definition medical images having specific analog matrix exceeding that of NTSC or PAL standards. Typically, these images can only be produced by specialized imaging equipment and can only be viewed on highly specialized monitors. They are incompatible with NTSC or PAL standards and thus are inapplicable to the use of documenting procedures where analog or digital cameras provide a video signal to be displayed.
Other suggestions have been made to integrate images into a medical setting. Therein, imaging is primarily related to diagnosis rather than documentation; resulting in files solely consisting of visually relevant components and omitting narration by the treating physician.
Suggestions to incorporate equipment in surgical suites fail to consider issues relevant to logistics of placing equipment. Surgical suites include a plurality of equipment. Vertically stacking equipment in shelves, i.e. racking, advantageously conserves space. However, this limits the readily available user-operator access to front face plates. Equipment that incorporates space saving advantages while providing maximum user-operator access, therefore, is highly desired.
Therefore, what is desired is a device that produces and saves a surgical documentary recording file that incorporates both video and audio to a transportable and common media contemporaneously during the surgery.
What is also desired is a device that formats a video signal into a plurality of video formats for display, displays an image stream, and allows a user to capture still images and save same as a still graphic file to the same media as the documentary recording file.
It is further desired that the device and the parts that the user interacts with are convenient and accessible.
Also, it is desired that the device is capable of “feed through” of real-time video signals to a plurality of display devices, in a plurality of video formats, when the device is in a standby mode, when the device is off, or in the event when the device malfunctions.
Further, what is desired is an interactive tutorial which allows a user to manipulate the files saved.
These and other objectives are met by the embodiments of the present invention.
In accordance with one embodiment, a device for medical video recording includes an endoscope, and an imager for converting energy such as electromagnetic energy, direct current energy and the like, which is received from said endoscope to signals that are contemporaneously stored onto said media.
In accordance with one embodiment of the invention, a device is provided that encodes a video signal into a documentary recording file formatted in an MPEG-2 layer.
In accordance with one embodiment of the invention, a multimedia interface to process a video signal and audio signal into a first and second digital data stream having common characteristics is provided.
In accordance with one embodiment of the invention, a recording mode for recording a video stream during a surgical procedure is provide for surgical documentation.
In accordance with one embodiment of the invention, a means for a video signal to be displayed by a display unit during recording mode, or when the device is in a standby mode, or when the device is off, or when the device has malfunction, is provided.
In accordance with one embodiment of the invention, an archival mode is provided for review, edit and playback of a documentary recording file and graphic file.
In accordance with one embodiment of the invention, a medical instrument having touch screen control includes a touch screen for entering control commands, a processor for receiving the control commands and for generating control signals to operate the medical instrument, a housing for enclosing the processor. The touch screen is movable between a first position protected by the housing and second position extended from the housing for entry of the control commands.
In accordance with one embodiment of the invention, a multimedia interface for processing a video signal for recording video into a multiple frame layer includes a controller for an inter-ic bus for providing a multiple master digital connection, an analog to digital converter for converting a video signal to a first digital stream, the converter operably connected to the inter-ic bus, a video compression and decompression integrated circuit for encoding the first digital stream into a second digital stream having frames and decoding a second digital stream, the video compression and decompression integrated circuit operably connected to the inter-ic bus a programmable buffer for selectively saving frames handled by the controller, the buffer operably connected to the controller and the video compression and decompression integrated circuit and the buffer inserting the frame into the second digital stream for decoding.
In accordance with one embodiment of the invention, a method for recording an MPEG layer file for documenting surgical procedures while displaying an MPEG layer stream and n number selecting still image files corresponding to the MPEG layer stream, includes the steps of providing a first digital data stream comprising a video signal, providing a second digital data stream comprising an audio signal, multiplexing an MPEG layer data stream from the first and second digital data stream, streaming the MPEG layer data stream to a hard drive and an optical media drive operably connected on a vertically stacked bus, writing the MPEG layer stream to the hard drive and the optical media drive, displaying the MPEG layer stream on a display unit, selecting n number of frames from the MPEG layer stream, converting n frames to n still image files, and multiplexing the output signal to the display unit by adding n still image files.
The terms “communicate”, “communicating” and “communication” as used herein include both conveying data from a source to a destination, as well as delivering data to a communications medium, system or link to be conveyed to a destination. The term “communication” as used herein means the act of communicating or the data communicated, as appropriate.
The invention and its particular features and advantages will become more apparent from the following detailed description considered with reference to the accompanying drawings.
FIGS. 3 depicts a rear panel elevation view of a Video Recording and Image Capture Device of
The present invention will be described as used in connection with one or more endoscopes. It will be understood that other applications may be used equally effectively. Various frame displays and icons having particular graphical representations are described in connection with the functions of the present invention. It will be understood that other graphical representations may be used equally effectively in communicating to users the function performed therein.
Herein, image and image stream refer to the perception of the user utilizing their audiovisual capabilities; an image stream may also include an auditory component. Video signal, digital signal, analog signal, data stream, or the like refer to electrical signals in the present invention and electrical equipment operably connected and/or associated with the present invention.
As user 10 manipulates endoscope 15, user 10 controls camera head 20 with camera control unit (CCU) 30 and observes image stream 25 on a display unit, for example external video screen 35. Imager 100 is operably connected to CCU 30 to receive video signal 300. Device is also operably connected to external video screen 35, microphone 40, printer 45, and network 50 through standard ports. In one embodiment, imager 100 is operably connected to camera head 20 to receive video signal 300 and control camera head 20, obviating the need for CCU 30.
As user 10 examines and treats patient 5, imager 100 is recording a digital data stream representing image stream 25 on optical media drive (OMD) 125 (see
Upon encountering a situation requiring further investigation, user 10 utilizes an image capture mode to save and freeze a first image from image stream 25 for further investigation. Using imager 100, a second image substantially like the first image can be superimposed on image stream 25. Upon encountering further situations that attracts the attention of user 10, a plurality of second images substantially corresponding to respective first images found of interest can be saved and concurrently superimposed on image stream 25. A file corresponding to second image can be printed with printer 45 and/or forwarded over network 50 to other persons for consultation.
Power supply 110 is connected to an AC power supply with an electric cord at power port 110 a located on chassis back panel 105 b. When power switch 110 b of chassis front panel 105 c is engaged, power supply 110 provides suitable power to components of imager 100. Power supply 110 conforms to IEC 601-1 isolation requirements, provides power meeting medical grade standards of 145 Watts, includes a power correction factor, and is capable of automatically handling automatically an AC voltage range of 100 to 250 VAC, 50-60 Hz.
Microprocessor main board (MMB) 115 executes software and includes a central processor unit (“processor”), random access memory, a plurality of expansion slots, a BIOS chip, and on-board sound and graphics capabilities on a footprint convenient for chassis 105. Therein, it may be that an Intel Pentium III with a processing speed of at least 800 MHz; an Intel 815 chip set; at least three (3) PCI and one (1) AGP slot; SDRAM of at least 128 MB; on-board AGP graphics; and a flash upgradeable BIOS chip wherein a customized logo may be loaded, is provided on an ATX motherboard. Further, MMB 115 preferably includes port panel 115 a to connect to other devices and or networks via serial, parallel, USB and ethernet, and to connect to mouse, keyboard, and video monitor; a Intel 40-pin DVO motherboard connector, or similar, and support for the connector.
Hard drive (HDD) 120 and optical media drive (OMD) 125 maybe IDE or Enhanced IDE (alternatively IDE) compatible data storage media drives operably connected MMB 115 by a vertically stacked IDE bus 116. HDD 120 maybe a magnetic hard drive having at least 40 Gigabytes of storage and minimal access time, as such a drive from Maxtor having EIDE access time of 8.0 ms, 7200 rpm disk speed is preferred. OMD 125 is preferably a DVD+RW drive capable of reading and writing data to an optical media disk, such as a compact disk (CD) and/or a digital versatile disk (DVD).
Communication interface 130 is any kind of network or proprietary communications interface. Therein, for example, a network card that is capable of interfacing with the Karl Storz®, Inc. Storz Communication Bus (SCB) is preferred.
Multimedia interface 135 connects to MMB 115 via a Peripheral Component Interconnect (PCI) local bus to provide record and write image stream 25 originating from camera head 20. Speaker 140 is housed in chassis 105 and provides auditory capabilities for imager 100.
Digital video interface 150 is operably connected to MMB 115 to create a video signal conforming to the digital visual interface (DVI) standard. Therein, a digital video interface 150 is preferably physically implemented as a printed circuit board having an Intel 40-pin DVO connector, or similar, to MMB 115 and a DVI-D output connector in expansion slot 105 d.
A touchscreen 145 is provided as illustrated on
Touchscreen 145 is advantageously housed in tray 105 a (see
TAS 146 allows user 10 to advantageously use the space available when equipment is racked. User 10 presses a button or other releasing mechanism to release touchscreen 145 and slides touchscreen 145 away from chassis 105 and out of tray 105 a as indicated by the arrows as depicted in accordance with one embodiment of the present invention in
Platform 144 may be of any suitable design to hold touchscreen 145 even when placed at an angle from horizontal. Touchscreen 145 is operative with imager 100 through cables and connectors.
Rails 143 a and 143 b have stops 143 c (only partially shown for clarity) operable with tracks 147 a and 147 b to prevent advancing touchscreen 145 beyond a predetermined point.
TAS 146 includes on or more hinge 142, such as edged hinge 142 a and 142 b, or center hinge 143 c a center hinge as depicted in accordance with one embodiment of the present invention in
Resident on multimedia interface 135 is an Inter-IC bus operatively controlled by controller 200. Controller 200 implements the Inter-IC bus as a multi-master bus to connect circuits to PCI interface 210. Router 220 is provided as a field programmable gate array and has programmable read only memory that is accessible via a port, such as a JTAG port.
In recording mode, imager 100 receives the input of video signal 300 and audio signal 315 and contemporaneously encodes both signals while writing the data stream to HDD 120 (see
Video signal 300 is received by multimedia interface 135 as analog video signal 304 i or digital video signal 306 i in input ports located in expansion slot 105 d (see
A relay 205 is operative to bypass video signal 300 to an exit port corresponding to the input port for display by an external monitor when imager 100 is not powered or imager 100 is in standby mode. Therein, relay 205 includes a receiver for receiving a sense signal from software to indicate that the recording mode is engaged. If the sense signal is not received with a predetermined time, video signal 300 is bypassed. If imager 100 is not powered, a default mode of relay 205 bypasses the signal to the corresponding port, i.e. video signal 300 input on the S-video input is bypassed to an S-video output port.
Analog video signal 304 i is received using composite video input or S-Video input. If analog video signal 304 i is received when imager 100 is not electrically powered or recording mode is not engaged, video signal 300 is bypassed using bypass relay 205. Received analog video signal 304 i is digitized using analog to digital converter 240. Therein, the NTSC or PAL standard analog video signal 304 i is digitized to first internal data stream, digital data stream (DDS) 310. A digitized data stream having 4:2:2 luminance to chrominance (YUV) pixels is preferred. Other data stream configurations may also be used. In particular, a data stream having 8:2:2 YUV may be advantageously used in connection with CCU 30 (see
Digital video signal 306 i is received using the SDI digital video signal input. If digital video signal 306 i is received when imager 100 is not electrically powered or recording mode is not engaged, video signal 300 is bypassed using bypass relay 205. Received signal 306 i is processed by SDI receiver 250 and converted to a first internal data stream, DDS 310. A digitized data stream having a 4:2:2 luminance to chrominance (YUV) pixels is preferred; although other data stream configurations may also be used. DDS 310 is streamed via router 220 to V-codec 230 where it is encoded.
Inputs for audio signal 314 i originating from a stereo line and audio signal 316 i originating from microphone 40 are provided for recording a desired audio signal such as dictation. Both inputs may be combined to create a single audio signal 315 or used individually. Audio signal 315 is received by audio compression and decompression integrated circuit (A-codec) 260 and converted to a second internal data stream, digital data stream for audio (DDSA) 312, and passed to automatic gain control 270 disposed on the Inter-IC bus. DDSA 312 is then streamed to V-codec 230.
V-codec 230 is provided as embedded software, preferably operating on a LINUX or UNIX embedded platform, on one or more integrated circuits on the Inter-IC bus and operatively connected to controller 200. Also operatively connected are one or more buffer memories, such as SDRAM integrated circuits. Configuration settings of V-codec 230 are stored on an associated erasable electronic programmable read only memory (EEPROM or EPROM) circuit, or similar. The embedded software of V-codec 230 executes an algorithm to decode and/or encode a Motion Picture Experts Group (MPEG) layer, such as MPEG, MPEG-2 and/or MPEG-4, data stream (MDS) 320. MDS 320 advantageously utilizes high compression rates achieved by using an index frame and noting a sequence of changes to that index frame in subsequent images. Therein, MDS 320 is comprised of a stream of frames 322.
Algorithms of this type are known to execute file formatting appropriate for CD-R and a plurality of DVD media storage and play. Typically, MDS 320 is preferred to encode in a file format designated as “VOB” applicable to DVD+RW media storage and play. It should be appreciated that the present invention may be adapted readily to utilize other compression and decompression algorithms.
V-codec 230 multiplexes DDS 310 and DDSA 312 into MDS 320 which is then streamed to MMB 115. From there, MDS 320 is streamed to HDD 120 and to OMD 125 via vertically stacked IDE bus 116. Therein, HDD 120 writes MDS 320 to a magnetic disk and streams a copy to OMD 125 for writing to an optical disk such as a CD-R or DVD media to create contemporaneous documentary recording file while the surgery is being conducted by user 10. If the write process on OMD 125 is interrupted or fails, a backup copy resides on HDD 120 for a subsequent write attempt after the conclusion of the surgery.
A means for a video signal to be displayed by a display unit during recording mode is provided. The display unit may be external video screen 35 or touchscreen 145.
Touchscreen 145 is operable to receive a video signal in digital visual interface (DVI) format, and an embodiment of video screen 35, external video screen 35 b having touchscreen capabilities, is operable to receive a video signal in digital visual interface (DVI) format or analog monitor format. Therein, MMB 115 streams a copy of MDS 320 to resident AGP graphics support and/or DVI graphics support and digital video interface 150 for output to touchscreen 145 and video screen 35 b as required by the active output.
Image capture mode is provided for saving a frame 322 (see
Frame buffer 295 can be implemented as an integrated circuit, capable of storing and identifying a plurality n of frames 322 corresponding to maximum number n frames capable of being stored according to the buffer size (hereinafter frame 322, designating the first frame 322 stored, frame 322 2 the second . . . , and frame 322 n the last frame stored). As shown, identification may be implemented by designating a first-in-first-out order, or similar order. Upon receipt of frame 322 1, buffer 295 forwards a copy to router 220. Router 220 multiplexes frame 322, with DDS 310 and streams the combined signal to the active output port for display as combined image. As described further herein in connection with image capture mode, user 10 is able to manipulate the position and size of the combined image within image stream 25 and on a display unit.
A copy of frame 322 1 is saved to HDD 120, preferably in file format Joint Picture Experts Group JPEG layer corresponding to the MPEG layer such as MPEG, MPEG-2 and/or MPEG-4 layer, as a graphic file. A software application for conversion to other formats such as “TIFF,” “BMP,” and/or “FPX”, or similar, is provided.
Upon additional instruction by user 10 to capture further images, further corresponding frames 322 are saved in the manner described. Therein, frame 322 2 is multiplexed with frame 322 1 and DDS 310 and the combined signal streamed to the active output for display on a display unit.
An archival mode is provided for review, edit and playback of documentary recording file and a graphic file. Therein, the recording file is accessed and a digital data stream corresponding to MDS 320 is read from media of HDD 120 and/or OMD 125 and is streamed to V-codec 230 and is decompressed into a digital data stream corresponding to DDS 310. The decompressed digital data stream is then routed to the active port for display or transferred to MMB 115 for display on a display unit.
Upon powering of imager 100, it is in standby mode and page 410 is shown as depicted in
Surgical information block 600 includes fields for biographical patient information, identity of treating physician, and additional information as may be convenient and necessary. If the field requires an alpha-numeric entry, alpha-numeric keyboard page 420 is displayed on top of page 410, as depicted in
To place device in recording mode to record a video file to a disk properly loaded in OMD 125, user 10 touches the designated icon, here illustrated as icon 632, in control panel icon 630. In response, icon 632 may change design, such as becoming highlighted. Concurrently, in image panel 620, image 25 is displayed in image window 624 and image status bar 622 displays confirmation of recording and elapsed recording as depicted in
To mute audio recording or conversely engage audio recording, user 10 touches the designated icon, here illustrated as icon 636, in control panel 630. In response, icon 636 may change design, such as becoming highlighted. To reverse the action, user 10 touches icon 636 which in response may change design, preferably returning to its previous design.
To capture an image that is being displayed in image window 624, user 10 touches the designated icon, here illustrated as icon 634, in control panel 630 and imager 100 is placed in image capture mode and the instruction is processed as described above. In response, icon 634 may change design, such as becoming highlighted, and a confirmation message that the desired action is being performed will be displayed. Similarly, image capture mode can be accessed if user 10 engages the appropriate control on CCU 30 to capture image 26 that is being displayed in image window 624. Instruction is processed as described above and icon 634 may change design, such as becoming highlighted, and a confirmation message that the desired action is being performed will be displayed.
To allow user 10 to monitor available resources on a multimedia disc, multimedia status 610 includes fields identifying the remaining capacity of disc and the number of images captured and the length of time of image stream 25 recorded.
The archival mode is accessible from control panel 630 to review and/or manipulate saved documentary recording files and graphics file. User 10 touches the designated icon, here illustrated as icon 638, and review page 440 is displayed as depicted in
Therein, a graphic file may be printed to printer 45 located in the surgical suite so that it is immediately available for review by user 10. Software is provided to enlarge and view and manipulate the graphic file such as providing visual contrast, inserting a scaled file object corresponding to a physical prosthesis and thus determining whether such prosthesis fits patient 5.
In accordance with one embodiment of the present invention, sensor 318 (see
In accordance with one embodiment of the present invention, a system for speech recognition is provided for user 10 interaction with imager 100. Microphone 40 receives user 10 voice commands, which are routed to speech recognition module 319. Speech recognition module 319 is software that executes on Microprocessor main board (MMB) 115 to receive voice signals that control the medical instrument.
In accordance with one embodiment of the present invention, database module 321 provides a database server and/or database management application that is operatively provided to enable user 10 to access, manage and/or update data in imager 100. Database module 321 is software that executes on Microprocessor main board (MMB) 115 to establish control signals to operate the hard drive and the optical media drive.
In accordance with one embodiment of the present invention, expert system 323 is provided wherein characteristics of video signal 300 meeting predetermined characteristics are automatically brought to the attention of user 10 and/or saved as graphic files 810. Expert system 323 is software that executes on Microprocessor main board (MMB) 115 to generate control signals to operate the medical instrument.
In accordance with one embodiment of the invention, a stereoscopic module 324 is provided for associating a plurality of video signals 300 with each other, as such providing stereoscopic images on a display unit. Stereoscopic module 324 is software that executes on Microprocessor main board (MMB) 115 to associate a plurality of files to provide stereoscopic images on a multimedia interface.