A system for determining usage of surgical instruments in Operating Room, or catheterization laboratory, as well as a corresponding method.

Description

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.

Further, it is noted that the increasing use of technology in the

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.

The complexity of Operating Room processes can be illustrated by thinking of the various requirements for safe and efficient surgery. Patients are to be prepared for surgery at the preoperative area and are to be transported timely to the

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.

On the other hand, if a surgical procedure finishes earlier than expected, the next patient may not be ready for surgery yet. The Operating Room then remains unnecessarily vacant and an entire Operating Room team has to wait for the next patient. Information on the progress of procedures inside the Operating room to adjust, i.e. improve, the planning throughout the day is currently taken care of by means of phone calls between the Operating Room team and the Operating Room scheduler or by entering the Operating Room to discuss it. Both ways are disrupting the surgical process and are therefore not desirable.

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.

One of the drawbacks of the above described scenario is that it is not practically possible to sense whether, and which, surgical instruments are being used by a surgeon or by Operating Room assistants.

Summary

It is an objective of the present disclosure to provide for a system for determining usage of surgical instruments in an Operating Room for determining when, and which, instruments are being used by a surgeon or by Operating Room assistants.

It is another objective of the present disclosure to provide for a method for determining usage of surgical instruments in an Operating Room for determining when, and which, instruments are being used by a surgeon or by Operating Room assistants.

In a first aspect, there is provided a system for determining usage of surgical instruments in an Operating Room or catheterization laboratory, wherein said system comprises: 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;

detect equipment arranged for detecting which one of said surgical instruments has been removed from said tray by:

- detecting a current characteristic in said induced light detection current;

determining which of said surgical instruments has been removed from said tray by comparing said detected current characteristic with said plurality of current characteristics in said instrument identification database.

It was one of the insights of the inventors that 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 above results in a detectable current characteristic in the induced light detection current provided by the solar panel and/or the array of photodiodes. The detected current characteristic forms, to a certain extent, a footprint for the instrument that has been removed from the tray. By comparing the detected current characteristic with a plurality of current characteristics in the instrument identification database, it may be determined which instrument has been removed. That is, each instrument has its own unique footprint, i.e. its own unique current characteristic.

The above entails that it is not required to place the instruments at predefined positions on the tray. The surgical instruments may be placed anywhere on the tray, as long as they are positioned above the array of solar cells and/or the array of photodiodes. In accordance with the present disclosure, 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. Over time, 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.

It is further noted that the instrument identification database as well as the detect equipment may be located at, or close to, the tray itself. I n an example, the instrument identification database as well as the detect equipment may be comprised by a server the cloud. In such a situation, 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.

In an example, 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.

It was the insight that the removal of a particular surgical instrument, or the placement of an instrument on top of tray, effectuates a change in the light detection current. The deviation in the light detection current can be traced back to the actual type of instrument that has been removed from, or placed on top of, the tray.

It is noted that, in accordance with the present disclosure, 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.

In an example, each identification is further associated with a particular weight, wherein said tray further comprises:

- weight equipment for measuring a weight of said surgical instruments on top of said tray;

wherein said detect equipment are further arranged for

detecting a change in a measured weight of said surgical instruments on top of said tray, and

- determining which of said surgical instruments has been removed from said tray by comparing said detected current characteristic with said plurality of current characteristics in said instrument identification database and by comparing said detected change in said measured weight with said particular weights in said instrument identification database. The advantage of the above provided example is that the determination of which surgical instrument has been removed from the tray can be made more reliable.

In a further example, the system comprises a light sensor arranged for measuring light present in said Operating Room, wherein said system further comprises:

normalize equipment arranged for normalizing said detected deviation in said current profile based on said measured light in said Operating Room.

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. As such, 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. In order to improve the accuracy of the detection process, it may be beneficial to normalize the actual light incident on the solar panel, i.e. to perform a normalization process.

In a further example, 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.

The above is counterfeited by the present example. The inventor has found that 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.

In another example, said solar panel further comprises:

a plurality of solar cells and/or photodiodes, wherein 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;

wherein each identification in said instrument identification database is associated with a particular two dimensional shape, and

wherein said detect equipment is further arranged for detecting which one of said surgical instruments has been removed from said tray by:

determining current characteristics in each of said induced cell currents;

determining, based on said determined current characteristics, a two dimensional shape of said removed instrument;

determining which of said surgical instruments has been removed from said tray by;

o comparing said determined two dimensional shape of said removed instrument with said plurality of two dimensional shapes in said instrument identification database.

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.

In order to do so, it was found to construe 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. As such, 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.

In a detailed example hereof, 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.

In a second aspect, there is provided a method for determining usage of surgical instruments in an Operating Room or catheterization laboratory using a system in accordance with any of the previous claims, wherein said method comprises:

receiving, by said array of solar cells and/or photodiodes, light present in said Operating Room thereby inducing a light detection current, wherein said light is at least partly blocked, for said array of solar cells and/or photodiodes, by said surgical instruments placed on top of said tray;

detecting, by said system, that one of said surgical instruments has been removed from said tray by:

detecting a current characteristic in said induced light detection current;

- determining which of said surgical instruments has been removed from said tray by comparing said detected current characteristic with said plurality of current characteristics in said instrument identification database.

It is noted that the advantages and definitions as disclosed with respect to the embodiments of the first aspect of the invention, being the system for determining usage of surgical instruments in an Operating Room, also correspond to the embodiments of the second aspect of the invention, being the corresponding method, respectively. In an example, 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.

In a further example, said method comprises the step of:

normalizing said detected deviation in said current profile based on said measured light in said Operating Room.

In yet a further example, said method comprises the steps of:

measuring a capacitive coupling between said solar panel and said surgical instruments placed on top of said tray, and

determining that a surgical instrument has been removed from said tray by detecting a fluctuation in said capacitive coupling.

In an example, said capacitive coupling means trigger said detect equipment for detecting which one of said surgical instruments has been removed from said tray.

In another example, the step of detecting which one of said surgical instruments has been removed from said tray by:

determining current characteristics in each of said induced cell currents;

determining, based on said determined current characteristics, a two dimensional shape of said removed instrument;

determining which of said surgical instruments has been removed from said tray by;

o comparing said determined two dimensional shape of said removed instrument with said plurality of two dimensional shapes in said instrument identification database.

In an example, 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.

In a third aspect, there is provided 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. These and other aspects of the invention will be apparent from and elucidated with reference to the embodiment(s) described hereinafter.

Brief description of the drawings

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.

Detailed description Figure 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 above described detection process is being performed using an array of solar cells and/or an array photodiodes. This is explained in more detail here below.

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.

One of the aspects of the present disclosure is that the inventors have found that 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.

It is noted that one of the surgical instruments 1 1 , 12, 13 may be removed from the tray 10. 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.

Here, it is shown that the light detection current 21 changes over time 23. In 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.

In 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.

As one can tell, 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.

Finally, in a fourth step 27, 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.

It is noted that the system may further be arranged to keep track of the total time that a particular surgical instrument has been used for recording purposes. As such, 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.

receiving 52, by said array of solar cells and/or photodiodes, light present in said Operating Room thereby inducing a light detection current, wherein said light is at least partly blocked, for said array of solar cells and/or photodiodes, by said surgical instruments placed on top of said tray;

removing 53, by a person in the operating room one of the surgical instruments present on top of the tray;

detecting, by said system, that one of said surgical instruments has been removed from said tray by:

- detecting 54 a deviation in a current profile of said induced light detection current;

determining 55 which of said surgical instruments has been removed from said tray by comparing said deviation in said current profile with said plurality of current profiles in said current profile database.

Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from a study of the drawings, the disclosure, and the appended claims. In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality. A single processor or other unit may fulfil the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. 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.