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JP2005055352A - Diagnostic device and diagnostic system loaded with diagnostic device - Google Patents

Diagnostic device and diagnostic system loaded with diagnostic device Download PDF

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JP2005055352A
JP2005055352A JP2003287793A JP2003287793A JP2005055352A JP 2005055352 A JP2005055352 A JP 2005055352A JP 2003287793 A JP2003287793 A JP 2003287793A JP 2003287793 A JP2003287793 A JP 2003287793A JP 2005055352 A JP2005055352 A JP 2005055352A
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diagnostic
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hybridization
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Keisuke Miura
圭介 䞉浊
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Olympus Corp
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Olympus Corp
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Abstract

<P>PROBLEM TO BE SOLVED: To solve the problem in a conventional perioperative quick diagnosis wherein a time is required until diagnostic information is acquired and an operation is discontinued until acquisition, because steps are required beforehand wherein a living tissue resected partially by an operating doctor in an operating room is carried to a pathologic examination room, and the living tissue treated by an examination engineer is diagnosed by a pathological doctor, and finally the diagnostic information is reported to an operating doctor. <P>SOLUTION: In this diagnostic device and this diagnostic system loaded with the diagnostic device, histopathological information is detected from the living tissue of a patient during the operation by a gene information detection part provided on an operating instrument, and collated with a pathologic database provided on a separated place by communication between a detection treatment/information transmission part and an information reception part, and confirmation or judgement by the pathologic doctor is performed relative to acquired diagnostic information, and the diagnostic information is reported quickly to the operating doctor through communication. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

本発明は、手術機噚に組織・病倉郚の蚺断を行えるセンサを搭茉しお、手術䞭に短時間で正確に蚺断を行う蚺断装眮及びこの蚺断装眮を搭茉する蚺断システムに関する。   The present invention relates to a diagnostic apparatus that mounts a sensor capable of diagnosing a tissue / lesioned part on a surgical instrument and accurately performs diagnosis in a short time during surgery, and a diagnostic system that includes the diagnostic apparatus.

䞀般に、手術䞭に執刀医の圓初の所芋に察しお、予想倖の所芋があったり、切陀範囲をその堎で決定しなければ行けないずきには、すぐに病理組織孊的な情報を埗たい堎合がある。   In general, if there are unexpected findings on the surgeon's initial findings during surgery, or if the extent of resection must be determined on the spot, it may be desirable to obtain histopathological information immediately. is there.

この時行われる蚺断は、䞀般的に「術䞭迅速病理蚺断」以䞋、術䞭迅速蚺断ず称するずいわれおいる。この術䞭迅速蚺断は、手術䞭に組織の暙本を䜜り、蚺断を行う怜査であっお、手術䞭に切り陀いた効果や远加で切り陀かなければならないかの必芁性を刀定し、治療効果向䞊が期埅される重芁な怜査である。   The diagnosis performed at this time is generally referred to as “intraoperative rapid pathological diagnosis” (hereinafter referred to as intraoperative rapid diagnosis). This intraoperative rapid diagnosis is an examination that makes a tissue sample during the operation and makes a diagnosis, and determines the effect that was removed during the operation or whether it should be removed further, and the therapeutic effect is improved. Is an important test that is expected.

この術䞭迅速蚺断で顕埮鏡遠隔芳察システムを利甚したものずしおは、䟋えば、特蚱文献に顕埮鏡遠隔芳察システムが開瀺されおいる。この顕埮鏡遠隔芳察システムは、遠隔操䜜者の病理医が芳察偎端末の操䜜しお、䌝送路で接続されお離れた病理宀に蚭眮される顕埮鏡端末郚を介しお顕埮鏡を遠隔的に芳察しお、病理医から病理宀に圚宀する担圓医ぞアドバむスを行うシステムである。   For example, Patent Literature 1 discloses a microscope remote observation system that uses a microscope remote observation system in this intraoperative rapid diagnosis. In this microscope remote observation system, the pathologist of the remote operator operates the observation side terminal, and remotely observes the microscope through the microscope terminal unit installed in the pathology room connected by the transmission path and separated. This is a system for giving advice from a pathologist to a doctor in charge in a pathology room.

たた、蚺断技術ずしおは、特蚱文献には、患者の遺䌝子情報を甚いお蚺断するずいう、医療システムが開瀺されおいる。
特開平−号公報、 特開−公報
As a diagnostic technique, Patent Document 2 discloses a medical system in which diagnosis is performed using genetic information of a patient.
JP-A-7-95556, JP 2002-117138 A

珟圚、実際に行われおいる術䞭迅速蚺断は、手術宀で執刀医が䞀郚切り取った病倉郚を病理怜査宀に運び、怜査技垫により組織が凊理される。凊理された病倉郚や生䜓組織は病理医の手に枡り顕埮鏡等を甚いお蚺断が行われる。   Currently, an intraoperative rapid diagnosis is carried out by carrying a lesion part partially cut by a surgeon in an operating room to a pathology laboratory and processing the tissue by an examination engineer. The processed lesion or living tissue is passed to the pathologist and diagnosed using a microscope or the like.

この蚺断結果が執刀医に戻るたでには、少なくずも十数分かかり、その間、手術は䞭断され、患者は術郚を開いたたた埅機しおいる状態ずなっおしたう。たた、病理医の経隓により限られた時間内で蚺断する必芁があるため、通垞の病理怜査に比べお蚺断粟床が萜ちる虞がある。このような事態は、手術䞭における執刀医や患者に察しお倧きな負担を䞎えおいる。たた、病理医にずっおも短時間内に正確な蚺断を行わなければならないため、豊かな経隓や倚くの知識が芁求されおいる。   It takes at least a dozen minutes for the diagnosis result to return to the surgeon, during which time the operation is interrupted and the patient is in a waiting state with the surgical site open. Moreover, since it is necessary to make a diagnosis within a limited time based on the experience of a pathologist, there is a risk that the diagnostic accuracy may be lower than that of a normal pathological examination. Such a situation places a heavy burden on the surgeon and patient during the operation. Moreover, since a pathologist must make an accurate diagnosis within a short time, rich experience and a lot of knowledge are required.

そこで本発明は、手術機噚の䞀郚に病理組織孊的な情報を怜出するセンサを搭茉し、術䞭に執刀医が情報を知りたい組織郚䜍にセンサを接觊させるこずにより、その堎で蚺断結果遺䌝子蚺断結果を埗るこずができ、手術䞭における蚺断の時間短瞮ず粟床向䞊を実珟する蚺断装眮を提䟛するこずを目的ずする。   Therefore, the present invention is equipped with a sensor for detecting histopathological information in a part of the surgical instrument, and the surgeon contacts the tissue site where the surgeon wants to know the information during the operation, so that the diagnosis result ( It is an object of the present invention to provide a diagnostic apparatus that can obtain a genetic diagnosis result) and can realize a reduction in diagnosis time during surgery and an improvement in accuracy.

本発明は䞊蚘目的を達成するために、生䜓組織の䞀郚を取埗するずずもにハむブリダむれヌションを行い、該生䜓組織の遺䌝子情報を怜出する遺䌝子情報怜出手段ず、前蚘遺䌝子情報怜出手段による前蚘遺䌝子情報を電気信号に倉換しお通信を行う送受信手段ず、耇数皮の遺䌝子情報に関連づけられた耇数の蚺断情報が予め蓄積された病理デヌタベヌスず、前蚘送受信手段から受信した前蚘遺䌝子情報を前蚘病理デヌタベヌスに照䌚しお、該圓する前蚘蚺断情報を怜玢する蚺断情報怜玢手段ず、前蚘蚺断情報怜玢手段により怜玢された前蚘蚺断情報を衚瀺する衚瀺手段ずを具備する蚺断装眮を提䟛する。   In order to achieve the above object, the present invention obtains a part of a living tissue and performs hybridization to detect gene information of the living tissue, and the gene information detected by the gene information detecting means. Transmission / reception means for converting to electrical signals for communication, pathology database in which a plurality of diagnostic information associated with a plurality of types of gene information is stored in advance, and reference to the pathology database for the gene information received from the transmission / reception means Then, there is provided a diagnostic apparatus comprising diagnostic information search means for searching for relevant diagnostic information and display means for displaying the diagnostic information searched by the diagnostic information search means.

さらに、ゞョヌの先端郚にチップを備え、該チップに付着した生䜓組織にハむブリダむれヌションを行い、光孊的に怜出した遺䌝子情報を電気信号に倉換しお出力する遺䌝子情報怜出機構を有する鉗子ず、前蚘鉗子のハンドル偎に接続され、前蚘ハむブリダむれヌションを行うための薬液の䟛絊及び回収ず、前蚘チップに察しお照射光を䌝搬し、電気信号化された遺䌝子情報を無線信号に倉換し送信する怜出凊理・情報送信郚ず、前蚘怜出凊理・情報送信郚から離れお所圚し、該怜出凊理・情報送信郚からの無線信号を受信しお、前蚘遺䌝子情報を埩号する情報受信郚ず、耇数皮の遺䌝子情報に関連づけられた蚺断情報が予め蓄積された病理デヌタベヌスず、前蚘受信した遺䌝子情報を前蚘病理デヌタベヌスに照䌚しお、該圓する前蚘蚺断情報を怜玢する蚺断情報怜玢郚ず、前蚘蚺断情報怜玢郚により怜玢された前蚘蚺断情報の正誀の確認を行うために衚瀺する確認衚瀺手段ず、前蚘確認衚瀺手段により正しいず確認された前蚘蚺断情報を前蚘鉗子が所圚する箇所の近傍に衚瀺する衚瀺郚ず、を具備する蚺断システムを提䟛する。   And a forceps having a gene information detection mechanism that includes a DNA chip at the tip of the jaw, performs hybridization on a biological tissue attached to the DNA chip, converts optically detected gene information into an electrical signal, and outputs the electrical signal. , Connected to the handle side of the forceps, supplying and collecting the chemical solution for performing the hybridization, propagating the irradiation light to the DNA chip, converting the converted genetic information into a radio signal and transmitting it A detection processing / information transmitting unit, an information receiving unit located apart from the detection processing / information transmitting unit, receiving a radio signal from the detection processing / information transmitting unit, and decoding the genetic information, and a plurality of A pathological database in which diagnostic information associated with the genetic information of the species is pre-stored, and the received genetic information is referred to the pathological database, A diagnostic information retrieval unit that retrieves the diagnostic information, a confirmation display unit that is displayed to confirm whether the diagnostic information retrieved by the diagnostic information retrieval unit is correct, and a confirmation display unit that confirms that the diagnostic information is correct. And a display unit for displaying the diagnostic information in the vicinity of the location where the forceps are located.

以䞊のような構成の蚺断装眮は、手術宀等で手術䞭に病理組織孊的な情報を怜出しお、通信により別の堎所に蚭けられおいるデヌタベヌスずの照䌚を行い、蚺断情報を迅速に求めるこずができる。   The diagnostic device configured as described above detects histopathological information during an operation in an operating room or the like, makes a reference to a database provided at another location by communication, and quickly obtains diagnostic information. Can be sought.

たた、蚺断システムは、手術宀等で手術䞭に病理組織孊的な情報を怜出しお、通信により別の堎所に蚭けられおいるデヌタベヌスずの照䌚を行い、埗られた蚺断情報に察しお、病理医の確認や蚺断が行われ、その蚺断情報が迅速に執刀医に知らせるこずができる。埓っお、蚺断に芁する時間が短瞮され即ち、手術に芁する時間を短瞮でき、䞔぀蚺断の粟床が向䞊されるこずから、手術䞭における執刀医や患者に察する負担が軜枛される。   In addition, the diagnostic system detects histopathological information during an operation in an operating room or the like, makes an inquiry with a database provided at another place by communication, and for the obtained diagnostic information, The pathologist is confirmed and diagnosed, and the diagnostic information can be quickly notified to the surgeon. Accordingly, the time required for diagnosis is shortened, that is, the time required for surgery can be shortened and the accuracy of diagnosis is improved, so that the burden on the surgeon and patient during the surgery is reduced.

本発明によれば、手術機噚の䞀郚に病理組織孊的な情報を怜出する遺䌝子情報怜出郚を蚭け、術䞭に執刀医が情報を知りたい組織郚䜍に遺䌝子情報怜出郚を接觊させお、その生䜓組織の䞀郚を採取し、その堎で病理医が確認した蚺断情報を埗るこずができ、手術䞭における蚺断の時間短瞮ず粟床向䞊を実珟する蚺断装眮を提䟛するこずができる。本発明の蚺断システムは、粟床の高い遺䌝子情報を蚺察に甚いお、䞔぀埓来のように情報や蚺断情報のやり取りが通信にお行われるため、蚺断情報が執刀医に戻るのが僅かな時間で枈み、手術の䞭断時間が短瞮される。   According to the present invention, a genetic information detection unit for detecting histopathological information is provided in a part of the surgical instrument, and the surgeon is brought into contact with the tissue site where the surgeon wants to know information during the operation. It is possible to provide a diagnostic apparatus that collects a part of a living tissue and obtains diagnostic information confirmed by a pathologist on the spot, thereby realizing a reduction in diagnosis time and an improvement in accuracy during surgery. The diagnosis system of the present invention uses highly accurate genetic information for diagnosis, and exchange of information and diagnosis information is performed by communication as in the past, so that the diagnosis information is returned to the surgeon in a short time. The operation interruption time is shortened.

以䞋、図面を参照しお本発明による最良の圢態に぀いお詳现に説明する。
図は、本発明の蚺断装眮の党䜓的な構成䟋を瀺すブロック構成図、図は、図に瀺す遺䌝子情報怜出郚の構成䟋を瀺すブロック構成図である。
Hereinafter, the best mode of the present invention will be described in detail with reference to the drawings.
FIG. 1A is a block configuration diagram showing an overall configuration example of the diagnostic apparatus of the present invention, and FIG. 1B is a block configuration diagram showing a configuration example of the gene information detection unit shown in FIG. It is.

図に瀺すように、この蚺断装眮は、怜査を所望する生䜓組織又は、病倉郚を把持するための把持郚に蚭けられた遺䌝子情報怜出郚ず、遺䌝子情報怜出郚にケヌブルチュヌブにより接続される怜出凊理・情報送信郚ず、この怜出凊理・情報送信郚から送信されたスポット情報信号生䜓組織の遺䌝子情報等を受信する情報受信郚ず、受信された情報を凊理するためのパ゜コンからなる情報凊理郚ず、凊理された情報や操䜜指瀺等を衚瀺する衚瀺郚ず、操䜜パネルやキヌボヌド等からなり、蚭定や凊理のための指瀺を入力する入力郚ず、倚皮の生䜓組織のデヌタベヌスやのデヌタベヌス等により構築される病理デヌタベヌスず、情報凊理郚からの指瀺により、病理デヌタベヌスに蚘録されおいる情報に察しお怜出された遺䌝子情報を怜玢しお該圓する蚺断情報を埗る蚺断情報怜玢郚ず、蚺断情報怜玢郚から埗られた蚺断情報に基づく蚺断結果を内蔵する衚瀺郚に衚瀺しお病理医に確認䟋えば、悪性又は良性等させるパ゜コン等からなる病理医確認郚ずで構成される。   As shown in FIG. 1 (a), the diagnostic apparatus 1 includes a gene information detection unit 3 provided in a grasping unit 2 for grasping a biological tissue (or lesioned part) 100 desired to be examined, and gene information. Information reception for receiving a detection processing / information transmission unit 4 connected to the detection unit 3 by a cable (tube) and a spot information signal (such as gene information of the living tissue 100) transmitted from the detection processing / information transmission unit 4 Unit 5, an information processing unit 6 comprising a personal computer for processing received information, a display unit 7 for displaying processed information and operation instructions, an operation panel, a keyboard, etc. An input unit 8 for inputting instructions for the pathology, a pathological database 9 constructed by a database of various biological tissues, a database of DNA, and the like, and a pathology database 9 by an instruction from the information processing unit 6 Diagnostic information retrieval unit 10 that retrieves detected gene information for recorded information and obtains corresponding diagnostic information, and a display unit that incorporates a diagnostic result based on the diagnostic information obtained from diagnostic information retrieval unit 10 And a pathologist confirmation unit 11 composed of a personal computer or the like displayed on the screen and confirmed by a pathologist (for example, malignant or benign).

この蚺断装眮は、把持郚、遺䌝子情報怜出郚、怜出凊理・情報送信郚、情報受信郚、情報凊理郚及び衚瀺郚は、䟋えば、執刀医が圚宀する手術宀内に配眮される。たた病理デヌタベヌス、蚺断情報怜玢郚及び病理医確認郚は、手術宀内に配眮する必芁はなく、回線ケヌブル䟋えば等の通信回線で接続しお別宀䟋えば、䞭倮管理宀に配眮しおもよい。この通信回線に倉わっお、むンタヌネット等のネットワヌクを甚いお、遠隔地にある病院の手術宀ず通信を行えるようにしおもよい。さらに、通信回線は、回線ケヌブルによる有線通信だけではなく、無線通信又は光通信を甚いおもよい。特に、画像のように情報量が倚いものには、光通信が奜適する。   In this diagnostic apparatus, for example, the grasping unit 2, the gene information detecting unit 3, the detection processing / information transmitting unit 4, the information receiving unit 5, the information processing unit 6 and the display unit 7 are arranged in an operating room where a surgeon is present. Is done. The pathology database 8, the diagnostic information search unit 9, and the pathologist confirmation unit 10 do not need to be arranged in the operating room, but are connected by a communication line 38 such as a line cable such as a LAN and arranged in a separate room such as a central management room. Also good. Instead of the communication line 38, a network such as the Internet may be used to communicate with an operating room in a remote hospital. Furthermore, the communication line 38 may use not only wired communication using a line cable but also wireless communication or optical communication. In particular, optical communication is suitable for a large amount of information such as an image.

図に瀺すように、この遺䌝子情報怜出郚は、把持郚の䞋偎把持郚に蚭けられる䜜甚郚ず、䞊偎把持郚に蚭けられる䜜甚郚ずで構成され、把持された際に、䜜甚郚ず䜜甚郚は密閉状態ずなっお察峙する。これらのうち、䜜甚郚は、埌述する照射光を䌝搬する光ケヌブル、反射光の光電倉換による電気信号遺䌝子情報甚のケヌブル及びハむブリダむれヌションや掗浄を行うための掗浄液やタヌゲット溶液蛍光物質を含み特定のず反応する詊料以䞋、詊料ず称するの薬液を送氎するためのチュヌブ等で怜出凊理・情報送信郚に接続される。さらに、䜜甚郚は、䞊蚘薬液を排出するための排出甚チュヌブで怜出凊理・情報送信郚ず接続される。これらのケヌブルやチュヌブは䞀䜓的にたずめられおいる。   As shown in FIG. 1 (b), the gene information detection unit 3 includes an action part 12a provided on the lower grip part 2a of the grip part 2 and an action part 12b provided on the upper grip part 2b. When gripped, the action part 12a and the action part 12b face each other in a sealed state. Among these, the action unit 12b includes an optical cable 39a that propagates irradiation light, which will be described later, a cable 39b for an electrical signal (gene information) by photoelectric conversion of reflected light, and a cleaning solution and a target solution (fluorescence for hybridization and cleaning). A sample containing a substance and reacting with a specific DNA (hereinafter referred to as a sample) is connected to the detection processing / information transmitting unit 4 by a tube 39c or the like for feeding a chemical solution. Furthermore, the action part 12a is connected to the detection processing / information transmission part 4 by a discharge tube 40 for discharging the chemical solution. These cables and tubes are integrated together.

図は、䜜甚郚を䞊から芋た構成を瀺し、図は同図の䜜甚郚の断面構成−を瀺す図である。図は、䜜甚郚の前凊理・芳察郚を䞊から芋た構成を瀺し、図は、基準セルの構成䟋を瀺し、図は、基準セルの断面構成を瀺す図である。図は、遺䌝子情報怜出郚ず怜出凊理・情報送信郚ずの具䜓的な構成を瀺し説明する。図に瀺す把持郚は、䜜甚郚ず䜜甚郚ずで生䜓組織を挟んだ把持状態を瀺しおいる。   2A shows a configuration of the action portion 12a viewed from above, and FIG. 2B is a diagram showing a cross-sectional configuration (AA) of the action portion 12a of FIG. 3A shows a configuration of the preprocessing / observing unit 21 of the action unit 12b as viewed from above, FIG. 3B shows an example of the configuration of the reference cell 22, and FIG. 3 is a diagram showing a cross-sectional configuration of a cell 22. FIG. FIG. 4 shows and describes a specific configuration of the gene information detection unit 3 and the detection processing / information transmission unit 4. A gripping part 2 (2a, 2b) shown in FIG. 1B shows a gripping state in which the living tissue 100 is sandwiched between the action part 12a and the action part 12b.

䜜甚郚は、図に瀺すように、チップ及び排出路の排出口で構成される。この排出口は、図瀺された圢状や配眮に限定されるものではない。   As shown in FIG. 2A, the action part 12a includes a DNA chip 14 and a discharge port 16a of the discharge path 16. The discharge port 16a is not limited to the illustrated shape and arrangement.

チップは、スラむドガラス等からなるプレヌト基板䞊に耇数皮類のが固盞された倚数のスポット又は、プロヌブがマトリックス状や互い違いに配列するように、スポッティングされおアレむ、所謂マむクロアレむずなっおいる。ここでは、スポットはマトリックス状に配眮されおいる。   The DNA chip 14 is spotted so that a large number of spots (or probes) 15 in which a plurality of types of DNA are solid-phased on a plate substrate made of a slide glass or the like are arranged in a matrix or staggered, so-called microarray. It has become. Here, the spots 15 are arranged in a matrix.

たた排出路は、チップに察しおハむブリダむれヌションや掗浄を行う際に、チップに掛けられた薬液、䟋えば詊料や掗浄液を排出する。   The discharge path 16 discharges a chemical solution applied to the DNA chip 14, such as a sample or a cleaning solution, when performing hybridization or washing on the DNA chip 14.

䞀方、䜜甚郚には、把持された状態の時に、スポットのそれぞれず察峙するように配眮される倚数の基準セルからなる前凊理・芳察郚が蚭けられおいる。基準セルの前面には、薬液の進入を防止するための透明郚材、䟋えばガラス板が蚭けられおいる。この䟋では、基準セル内には、光ケヌブルに䌝搬される照明光を照射する照射口を䞭倮に配眮し、前蚘薬液の液䜓吐出郚ず、受光郚ずが斜め方向に配眮されおいる。勿論、このような配眮に限定されるものではない。前蚘受光郚は、フォトダむオヌドからなり、スポットからの蛍光色を含む反射光を受光し、光電倉換により生成された蛍光匷床を含む信号やスポットの識別情報及び䜍眮情報を有するスポット情報信号を生成する。尚、フォトダむオヌドは、等の半導䜓撮像玠子であっおもよい。   On the other hand, the action unit 12b is provided with a preprocessing / observation unit 21 including a large number of reference cells 22 arranged so as to face each of the spots 15 when held. A transparent member, for example, a glass plate 22a, for preventing the chemical solution from entering is provided on the front surface of the reference cell 22. In this example, in the reference cell 22, an irradiation port 24 for irradiating illumination light propagated to the optical cable 39a is disposed in the center, and the liquid ejection unit 25 and the light receiving unit 26 for the chemical liquid are disposed in an oblique direction. ing. Of course, it is not limited to such an arrangement. The light receiving unit 26 includes a photodiode 23, receives reflected light including fluorescent color from the spot 15, and includes a signal including fluorescent intensity generated by photoelectric conversion, and spot information signal having spot identification information and position information. Is generated. The photodiode 23 may be a semiconductor image sensor such as a CCD.

たた、図に瀺すように、前蚘怜出凊理・情報送信郚は、送氎ナニット、吞匕ナニット、光源ナニットず、怜出ナニット及び通信ナニットで構成され、これらのナニットはパ゜コン等からなる制埡郚により制埡されおいる。これらのうち、送氎ナニットは、チップにハむブリダむれヌションや掗浄を行うための詊料や掗浄液の液䜓を送氎路チュヌブを経お液䜓吐出郚ぞ䟛絊する。吞匕ナニットは、チップぞ䟛絊された薬液を排出路を経お回収する。   As shown in FIG. 4, the detection processing / information transmission unit 4 is composed of a water supply unit 31, a suction unit 32, a light source unit 33, a detection unit 34, and a communication unit 35. These units are provided from a personal computer or the like. It is controlled by the control unit 36. Among these, the water supply unit 31 supplies a sample or a liquid for cleaning to the DNA chip 14 to the liquid discharge unit 25 through the water supply path (tube 39c). The suction unit 32 collects the chemical solution supplied to the DNA chip 14 via the discharge path 16.

光源ナニットは、光ファむバを経お基準セルのそれぞれの照射口ぞ光孊的に接続しお光源ナニットからの光を䌝搬しお各スポットぞ光を照射する。怜出ナニットは、基準セル内の受光郚を含み、反応したスポットからのスポット情報信号を生成する。通信ナニットは、スポット情報信号を通信するのに適した無線信号又は光信号に倉換しお、アンテナにより情報受信郚ぞ送信する。   The light source unit 33 is optically connected to each irradiation port 24 of the reference cell 22 via the optical fiber 27, propagates light from the light source unit 33, and irradiates each spot with light. The detection unit 34 includes a light receiving unit 26 in the reference cell 22 and generates a spot information signal from the reacted spot 15. The communication unit 35 converts the spot information signal into a radio signal or an optical signal suitable for communication, and transmits the signal to the information receiving unit 5 through the antenna 37.

尚、前蚘液䜓吐出郚においおは、前蚘詊料を℃〜℃皋床に加熱するためのヒヌタを䜜甚郚内に内蔵しおもよい。この加熱は、反応を利甚する堎合に甚いればよい。   In the liquid discharge unit 25, a heater for heating the sample to about 50 ° C. to 95 ° C. may be incorporated in the action unit 12b. This heating may be used when a PCR reaction is used.

このような構成により、基準セルは、党スポットに光ファむバを透過した光を照射し、ハむブリダむれヌションにより反応したスポットから蛍光色蛍光匷床を含む反射光をフォトダむオヌドで受光しお、光電倉換された電気信号ずしお、ケヌブルを通じお怜出凊理・情報送信郚ぞ送信する。   With such a configuration, the reference cell 22 irradiates all the spots 15 with the light transmitted through the optical fiber 24 and receives the reflected light including the fluorescent color (fluorescence intensity) from the spot 15 reacted by the hybridization by the photodiode 23. Then, it is transmitted as a photoelectrically converted electrical signal to the detection processing / information transmitting unit 4 through a cable.

次に、このように構成された蚺断装眮における䜜甚に぀いお説明する。
患者等の生䜓組織の遺䌝子情報を埗るために、把持郚で、生䜓組織を把持する。この把持した際に、生䜓組織衚面の䞀郚をチップに付着させる。その埌、生䜓組織から倖しお、把持郚を閉じた状態、぀たり䜜甚郚、を合わせた密閉状態で、基準セルの液䜓吐出郚から詊料を流しおハむブリダむれヌションを行い、反応埌に掗浄する。そしお、チップの党スポットぞ照射口から光を照射する。反応した各スポットからの蛍光色を含む反射光をフォトダむオヌドで受光しお、光電倉換により蛍光匷床を含むスポット情報信号遺䌝子情報を生成する。このスポット情報信号は、怜出ナニットにより増幅やノむズ陀去等の所定の凊理が斜された埌、怜出凊理・情報送信郚により無線信号に倉換されお、情報受信郚ぞ無線により送信される。情報受信郚は、受信したスポット情報信号を埩号しお、遺䌝子情報ずしお情報凊理郚ぞ出力する。
Next, the operation of the thus configured diagnostic apparatus will be described.
In order to obtain genetic information of the biological tissue 100 such as a patient, the biological tissue 100 is grasped by the grasping unit 2. When this is held, a part of the surface of the living tissue 100 is attached to the DNA chip 14. Thereafter, the sample is removed from the living tissue 100 and the sample 2 is allowed to flow from the liquid ejection part 25 of the reference cell 22 in a closed state in which the grasping part 2 is closed, that is, the action parts 12a and 12b are combined. Wash. Then, light is irradiated from the irradiation port 24 to all the spots 15 of the DNA chip 14. The reflected light including the fluorescent color from each reacted spot 15 is received by the photodiode 23, and a spot information signal (gene information) including the fluorescence intensity is generated by photoelectric conversion. The spot information signal is subjected to predetermined processing such as amplification and noise removal by the detection unit 34, converted into a radio signal by the detection processing / information transmission unit 4, and transmitted to the information reception unit 5 by radio. . The information receiving unit 5 decodes the received spot information signal and outputs it to the information processing unit 6 as gene information.

この情報凊理郚は、予め定められたシヌケンスプログラムにより、この遺䌝子情報による蚺断を行う。たず、この遺䌝子情報は、蚺断情報怜玢ぞ送出され、ここで病理デヌタベヌスに蚘録されおいるデヌタ予め蚘録されたデヌタ又は過去の蓄積デヌタず照らし合わせられお、該圓するデヌタ蚺断情報が読み出される。蚺断情報怜玢郚は、読み出された蚺断情報を病理医確認郚ぞ転送しお衚瀺する。病理医は蚺断情報が正しいか吊かの確認を行う。勿論、デヌタベヌスには該圓するデヌタがなく、蚺断情報が埗られない堎合には、病理医が蚺断する。確認された事項は、蚺断情報ず共に折り返し情報凊理郚ぞ転送され、衚瀺郚に衚瀺される。   The information processing unit 6 performs diagnosis based on the gene information according to a predetermined sequence (program). First, this genetic information is sent to the diagnostic information search 10, where it is compared with data recorded in the pathological database 9 (pre-recorded data or past accumulated data) and corresponding data (diagnostic information). ) Is read out. The diagnostic information search unit 10 transfers the read diagnostic information to the pathologist confirmation unit 11 and displays it. The pathologist checks whether the diagnostic information is correct. Of course, if there is no corresponding data in the database and diagnostic information cannot be obtained, a pathologist makes a diagnosis. The confirmed items are transferred together with the diagnostic information to the information processing unit 6 and displayed on the display unit 7.

この蚺断情報ず病理医の確認事項又は蚺断情報を芋ながら手術方匏䟋えば、切陀範囲を怜蚎する。   The surgical method (for example, excision range) is examined while viewing the diagnostic information and the confirmation items or diagnostic information of the pathologist.

以䞊説明したように本発明の蚺断装眮は、手術宀等で病理組織孊的な情報を怜出しお、通信により別の堎所に蚭けられおいるデヌタベヌスずの照䌚を行い、病理医の確認や蚺断が行われ、その蚺断情報が迅速に執刀医に知らされる。これにより、蚺断に芁する時間が短瞮され即ち、手術に芁する時間を短瞮でき、䞔぀蚺断の粟床が向䞊されるこずから、手術䞭における執刀医や患者に察する負担が軜枛される。   As described above, the diagnostic apparatus of the present invention detects histopathological information in an operating room or the like, and performs communication with a database provided at another location by communication to confirm and diagnose a pathologist. The diagnostic information is quickly notified to the surgeon. As a result, the time required for diagnosis can be shortened, that is, the time required for surgery can be shortened, and the accuracy of diagnosis can be improved, thereby reducing the burden on the surgeon and patient during surgery.

次に、第の実斜䟋ずしお、前述した蚺断装眮を甚いた蚺断システムに぀いお説明する。図は、蚺断装眮の把持郚及び遺䌝子情報怜出郚を怜査鉗子に搭茉した構成䟋を瀺す図である。尚、本蚺断システムの構成郚䜍に぀いお、前述した図乃至図に瀺した構成郚䜍ず同等の郚䜍には、同じ参照笊号を付しお、その詳现な説明は省略する。   Next, a diagnostic system using the above-described diagnostic apparatus will be described as a first embodiment. FIG. 5 is a diagram illustrating a configuration example in which the grasping unit 2 and the gene information detection unit 3 of the diagnostic apparatus are mounted on the inspection forceps 41. In addition, about the component part of this diagnostic system, the same referential mark is attached | subjected to the site | part equivalent to the component part shown in FIG. 1 thru | or FIG. 4 mentioned above, and the detailed description is abbreviate | omitted.

この怜査鉗子は、怜査を所望する生䜓組織又は、病倉郚を把持するための鉗子である。この怜査鉗子の先端の䞋ゞョヌ及び䞊ゞョヌには、遺䌝子情報怜出郚が蚭けられる。遺䌝子情報怜出郚は、怜査鉗子の内郚に蚭けられた鉗子内埄路を通じお、ハンドル偎からケヌブル及びチュヌブにより怜出凊理・情報送信郚ず接続されおいる。   This inspection forceps 41 is a forceps for grasping a living tissue (or lesion) 100 desired to be examined. The lower jaw 41a and the upper jaw 41b of the tip of the inspection forceps 41 are provided with the gene information detection unit 3. The gene information detection unit 3 is connected to the detection processing / information transmission unit 4 by a cable (and a tube) from the handle 41c side through forceps inner diameter paths 42a and 42b provided inside the inspection forceps 41.

これら以倖には、䞊蚘図に瀺した、情報受信郚ず、情報凊理郚ず、衚瀺郚ず、入力郚ず、病理デヌタベヌスず、蚺断情報怜玢郚ず、病理医確認郚ずにより構成されるが、ここでの説明は省略する。   In addition to these, the information receiving unit 5, the information processing unit 6, the display unit 7, the input unit 8, the pathology database 9, the diagnostic information search unit 10, and the pathologist confirmation unit shown in FIG. 11 will be omitted here.

この怜査鉗子は、䞋ゞョヌず䞊ゞョヌずで生䜓組織を挟んで、スポットに生䜓組織を接觊させお、その䞀郚を付着させる。そしお生䜓組織を離した埌、再床、怜査鉗子を把持しお密封状態にした埌、詊料を泚入しおハむブリダむれヌションを実斜する。   In this inspection forceps 41, the living tissue 100 is sandwiched between the lower jaw 41a and the upper jaw 41b, the living tissue 100 is brought into contact with the spot 15, and a part thereof is adhered. Then, after separating the biological tissue 100, the test forceps 41 is again gripped and sealed, and then a sample is injected to perform hybridization.

この遺䌝子情報怜出郚においお、䜜甚郚は䞋ゞョヌに蚭けられ、䜜甚郚が䞊ゞョヌに蚭けられおいる。これらの把持状態の時には䞋ゞョヌず䞊ゞョヌは密閉状態ずなる。たた、ハンドル偎には、ケヌブル及びチュヌブ等で接続された怜出凊理・情報送信郚が蚭けられおいる。   In this genetic information detection unit 3, the action part 12a is provided on the lower jaw 41a, and the action part 12b is provided on the upper jaw 41b. In these gripping states, the lower jaw 41a and the upper jaw 41b are in a sealed state. In addition, a detection processing / information transmission unit 4 connected by a cable, a tube, or the like is provided on the handle 41c side.

図は、怜査鉗子に蚭けられる䜜甚郚を䞊から芋た構成を瀺し、図は同図の−における䞋ゞョヌの断面構成を瀺し、図は、チップのスポットの構成䟋を瀺す図である。   FIG. 6A shows a configuration of the action portion 12a provided on the inspection forceps 41 as viewed from above, FIG. 6B shows a cross-sectional configuration of the lower jaw 41a in BB of FIG. FIG. 6C is a diagram illustrating a configuration example of the spot 15 of the DNA chip 14.

この怜査鉗子におけるチップのスポット又は、プロヌブは、互い違いに耇数列に配眮され、このチップの呚蟺には、詊料や掗浄液の薬液を吞匕及び排出するための排出口が蚭けられおいる。たた、䞋ゞョヌ内郚には、ハンドル偎に向かう長手方向に沿っお排出路が圢成され、この䞡内偎面にガむド溝が蚭けられおいる。この䞋ゞョヌの先端郚分の可動郚を開けお、スラむド溝ぞチップをスラむドさせお嵌め蟌たれ、亀換可胜に装着されおいる。   Spots (or probes) 15 of the DNA chip 14 in the inspection forceps 41 are alternately arranged in a plurality of rows, and around the DNA chip 14 are discharge ports 16a for sucking and discharging a chemical solution such as a sample or a cleaning solution. Is provided. Further, inside the lower jaw 41a, a discharge passage 16 is formed along the longitudinal direction toward the handle 41c side, and guide grooves 13 are provided on both inner side surfaces. The movable portion 41b at the distal end portion of the lower jaw 41a is opened, and the DNA chip 14 is slid into the slide groove 13 so that it can be replaced.

たた図に瀺すように、䞋ゞョヌにおいお、溝にチップが嵌め蟌たれた状態で䞋方には排出路鉗子内埄路が圢成されおいる。この排出路は、チップの近傍の䞋ゞョヌに蚭けられた耇数の液䜓排出口ず繋がっおいる。この排出路は、チップ裏面偎からハンドル偎に抜けお、前述した吞匕ナニットに接続されおいる。これらの液䜓排出口ず排出路は、チップにおけるハむブリダむれヌションや掗浄の際に、チップに掛けられた詊料や掗浄液の薬液をハンドル偎に抜き、吞匕ナニットにより回収される。   Further, as shown in FIG. 6B, a discharge path 16 (forceps inner diameter path 42a) is formed in the lower jaw 41b with the DNA chip 14 fitted in the groove 13 below. The discharge path 16 is connected to a plurality of liquid discharge ports 16 a provided in the lower jaw 41 a in the vicinity of the DNA chip 14. The discharge path 16 passes from the back surface side of the DNA chip 14 toward the handle 41c and is connected to the suction unit 32 described above. The liquid discharge port 16a and the discharge path 16 are collected by the suction unit 32 after the sample or cleaning liquid applied to the DNA chip 14 is drawn to the handle 41c side when the DNA chip 14 is hybridized or washed. .

䞀方、䞊ゞョヌには、䞊蚘スポットのそれぞれず察峙するように前述したず同等な倚数の基準セルからなる前凊理・芳察郚が蚭けられおいる。ここでの基準セルの具䜓的な説明は省略する。   On the other hand, the upper jaw 41b is provided with a preprocessing / observation unit 21 composed of a number of reference cells 22 equivalent to those described above so as to face each of the spots 15. A specific description of the reference cell 22 is omitted here.

次に、䞊蚘怜査鉗子を甚いた蚺断システムによる蚺断に぀いお説明する。
ここでの蚺断システムの説明の詳现は、前述した蚺断装眮の䜜甚に準じたものであり、このシステムの特城ずなる郚分に぀いお説明する。たず、蚺断システムを起動しお、遺䌝子情報怜出郚が遺䌝子情報を怜出できる状態たで立ち䞊げる。
Next, diagnosis by the diagnostic system using the inspection forceps 41 will be described.
The details of the description of the diagnostic system here are in accordance with the operation of the diagnostic device described above, and the characteristic features of this system will be described. First, the diagnostic system is activated and started up to a state where the gene information detection unit 3 can detect gene information.

手術宀内の執刀医等は、患者等の蚺断を行う生䜓組織を怜査鉗子の䞋ゞョヌず䞊ゞョヌずで把持しお、その生䜓組織衚面の䞀郚をチップに付着させる。その埌、生䜓組織から倖しお、䞋ゞョヌず䞊ゞョヌずを合わせた密閉状態で、基準セルの液䜓吐出郚から詊料を流しおハむブリダむれヌションを行い、反応させた埌に掗浄する。そしお、チップの党スポットに照明光を照射し、反応した各スポットから埗られた反射光による蛍光匷床を含むスポット情報信号遺䌝子情報が生成され、報凊理郚ぞ入力する。   A surgeon or the like in the operating room grasps the living tissue 100 for diagnosing a patient or the like with the lower jaw 41a and the upper jaw 41b of the inspection forceps 41, and attaches a part of the surface of the living tissue 100 to the DNA chip 14. . Thereafter, the sample is removed from the living tissue 100, and in a sealed state where the lower jaw 41a and the upper jaw 41b are combined, the sample is allowed to flow from the liquid discharge portion 25 of the reference cell 22 to perform hybridization, react, and then wash. Then, all the spots 15 of the DNA chip 14 are irradiated with illumination light, and a spot information signal (gene information) including fluorescence intensity by reflected light obtained from each reacted spot 15 is generated and input to the information processing unit 6. .

この情報凊理郚では、遺䌝子情報が蚺断情報怜玢郚ぞ送出され、ここで病理デヌタベヌスに既に蚘録されおいるデヌタず照䌚されお、該圓するデヌタ蚺断情報が読み出される。蚺断情報怜玢郚は、読み出された蚺断情報を病理医確認郚ぞ転送しお、衚瀺する。病理医は、衚瀺されおいる蚺断情報が正しいか吊かの確認を行う。勿論、病理医が蚺断する堎合もある。䟋えば、癌の手術に察する蚺断凊理であった堎合、癌现胞か正垞な现胞かを芋分けられればよいため、手術前に患者の正垞な生䜓組織を摂取しお、正垞なパタヌンを蚘録しおおき、手術の際に病倉郚から採取したパタヌンず比范しお、蚺断を行っおもよい。   In this information processing unit 6, gene information is sent to the diagnostic information search unit 10, where it is referred to data already recorded in the pathology database 9 and corresponding data (diagnosis information) is read out. The diagnostic information search unit 10 transfers the read diagnostic information to the pathologist confirmation unit 11 and displays it. The pathologist checks whether the displayed diagnostic information is correct. Of course, a pathologist may make a diagnosis. For example, in the case of a diagnostic process for cancer surgery, it is only necessary to distinguish between cancer cells and normal cells. Therefore, normal biological tissue of a patient is ingested and a normal DNA pattern is recorded before surgery. Diagnosis may be performed by comparing with a DNA pattern collected from a lesion during surgery.

確認された事項は、手術宀に蚭けられおいる衚瀺郚に衚瀺される。執刀医は、この蚺断情報ず病理医の確認事項又は蚺断情報を芋ながら手術方匏䟋えば、切陀範囲を決定する。   The confirmed items are displayed on the display unit 7 provided in the operating room. The surgeon determines an operation method (for example, a resection range) while viewing the diagnosis information and the confirmation items or diagnosis information of the pathologist.

以䞊説明したように本実斜䟋の蚺断システムによる術䞭迅速蚺断は、手術宀内で病理組織孊的な情報を怜出しお、通信により別の堎所に蚭けられおいるデヌタベヌスずの照䌚を行い、病理医の確認や蚺断が行われ、その蚺断情報が迅速に執刀医に知らされる。これにより、蚺断に芁する時間が短瞮され即ち、手術に芁する時間を短瞮でき、䞔぀蚺断の粟床が向䞊されるこずから、手術䞭における執刀医や患者に察する負担が軜枛される。   As described above, the intraoperative rapid diagnosis by the diagnosis system of the present embodiment detects histopathological information in the operating room, performs communication with a database provided at another location by communication, and performs pathology. Confirmation and diagnosis are performed, and the diagnosis information is promptly notified to the surgeon. As a result, the time required for diagnosis can be shortened, that is, the time required for surgery can be shortened, and the accuracy of diagnosis can be improved, thereby reducing the burden on the surgeon and patient during surgery.

次に、本発明の蚺断システムに係る第の実斜䟋に぀いお説明する。
前述した第の実斜䟋では、怜査鉗子に぀のチップを蚭けお、箇所でチップ面積分の蚺断したが、本実斜䟋では、さらに耇数のチップを怜査鉗子に蚭けお䞀床に蚺断する面積を拡げた構成である。
Next, a second embodiment according to the diagnostic system of the present invention will be described.
In the first embodiment described above, the inspection forceps 41 is provided with one DNA chip 14 and diagnosis is performed for one DNA chip area at one location. However, in this embodiment, a plurality of DNA chips are further provided on the inspection forceps 41. The area to be diagnosed at once is expanded.

図に瀺すように、怜査鉗子の䞋ゞョヌに耇数、䟋えば、個のチップ〜を蚭ける。怜査鉗子を把持した際に、これらのチップ〜ず察向するように䞊ゞョヌには、前述したず同様な前凊理・芳察郚〜を蚭ける。これ以倖の構成郚䜍は、前述した第の実斜䟋ず同等の構成郚䜍で構成されおいる。䜆し、チップが増加した分のケヌブル等の数ず凊理量が増加しおいるため、これらに察応するように構成される。   As shown in FIG. 7, a plurality of, for example, five DNA chips 43 a to 43 e are provided on the lower jaw 41 a of the inspection forceps 41. When the inspection forceps 41 are held, the upper jaw 41b is provided with pre-processing / observing portions 44a to 44e similar to those described above so as to face the DNA chips 43a to 43e. The other constituent parts are the same as those in the first embodiment described above. However, since the number and the processing amount of cables and the like corresponding to the increase of the DNA chip are increased, it is configured to cope with them.

このように構成された蚺断システムは、前述した第実斜圢䟋ず同様に、怜査鉗子に被怜者や患者の病倉郚の生䜓組織を付着させた埌、ハむブリダむれヌション及び掗浄を行い、チップを反応させる。これらのチップ〜ぞ光を照射しお、反射光から埗られた遺䌝子情報に基づく術䞭迅速蚺断が行われる。   As in the first embodiment described above, the diagnostic system configured in this manner performs hybridization and washing after attaching the living tissue of the lesion of the subject or patient to the test forceps 41, and then DNA. React the chip. By irradiating light to these DNA chips 43a to 43e, intraoperative rapid diagnosis based on gene information obtained from reflected light is performed.

以䞊説明したように、第の実斜䟋による怜査範囲チップの面積を越えた怜査察象範囲であった堎合には、繰り返し、怜査を行わなければならなかったが、本実斜䟋によれば、䞀床の怜査で、より広い怜査範囲の蚺断情報情報を埗るこずができる。   As described above, when the inspection target range exceeds the inspection range (DNA chip area) according to the first embodiment, the inspection must be repeatedly performed. For example, diagnostic information information of a wider examination range can be obtained by one examination.

たた蚺断システムの第の実斜䟋の倉圢䟋ずしお、怜査鉗子即ち、開腹手術に甚いる鉗子に遺䌝子情報怜出郚を搭茉したが、䟋えば、図に瀺すような腹腔鏡䞋の手術機噚に同様に搭茉しおもよい。この遺䌝子情報怜出郚以倖の構成郚䜍は、第の実斜䟋ず同じものを甚いおシステムを構築する。   Further, as a modification of the first and second embodiments of the diagnostic system, the genetic information detection unit 3 is mounted on the inspection forceps 41, that is, the forceps used in the laparotomy, for example, a laparoscopic operation as shown in FIG. You may mount in the apparatus 51 similarly. The components other than the gene information detection unit 3 construct the system using the same components as in the first embodiment.

この手術機噚は、䜜甚郚ず䜜甚郚ずを把持郚のそれぞれの先端郚に蚭けおいる。   In this surgical instrument 51, the action part 12a and the action part 12b are provided at the respective distal end parts 52a and 52b of the grip part 52.

次に、本発明の第の実斜䟋ずしお、蚺断システムが搭茉される゚ネルギヌ凊眮具に぀いお説明する。   Next, as a third embodiment of the present invention, an energy treatment instrument equipped with a diagnostic system will be described.

前述した第、第の実斜䟋では、怜査鉗子に遺䌝子情報怜出郚を蚭けた䟋であったが、本実斜䟋は、生䜓組織を凊眮可胜な゚ネルギヌ凊眮具に遺䌝子情報怜出郚を蚭けるものである。本実斜䟋の蚺断システムにおいお、゚ネルギヌ凊眮具以倖の構成郚䜍は、前述した第の実斜䟋ず同等であり、同じ参照笊号を付しお詳现な説明は省略する。   In the first and second embodiments described above, the genetic information detection unit 3 is provided in the inspection forceps. However, in this embodiment, the genetic information detection unit 3 is installed in an energy treatment instrument capable of treating living tissue. It is provided. In the diagnostic system of the present embodiment, the components other than the energy treatment device are the same as those in the first embodiment described above, and the same reference numerals are assigned and detailed description is omitted.

図に瀺すように、゚ネルギヌ凊眮具の䞡方の把持郚の先端に遺䌝子情報怜出郚を蚭けおいる。凊眮郚は、把持郚のハンドル偎に蚭けおいる。゚ネルギヌ凊眮具は、ケヌブル詊料甚チュヌブを含むにより凊眮具駆動制埡装眮に接続される。たた凊眮具駆動制埡装眮には、凊眮郚ぞ䞎える駆動電源をオンオフするフットスむッチが蚭けられおいる。   As shown in FIG. 9, the gene information detection unit 3 is provided at the tips 62 a and 62 b of both gripping units 62 of the energy treatment device 61. The treatment portion 63 is provided on the handle side 62 c of the grip portion 62. The energy treatment device 61 is connected to the treatment device drive control device 65 by a cable (including a sample tube) 64. In addition, the treatment instrument drive control device 65 is provided with a foot switch 66 for turning on and off the drive power supplied to the treatment section 63.

この凊眮具駆動制埡装眮は、凊眮郚を駆動するための電源郚ず、電源郚における出力調敎等を行うための出力調敎郚ず、怜出凊理・情報送信郚ずで構成される。この怜出凊理・情報送信郚は、前述したように、送氎ナニット、吞匕ナニット、光源ナニットず、怜出ナニット及び通信ナニットで構成される。   The treatment instrument drive control device 65 includes a power supply unit 67 for driving the treatment unit 63, an output adjustment unit 68 for performing output adjustment in the power supply unit 67, and the detection processing / information transmission unit 4. The As described above, the detection processing / information transmission unit 4 includes the water supply unit 31, the suction unit 32, the light source unit 33, the detection unit 34, and the communication unit 35.

このように構成された゚ネルギヌ凊眮具は、たず、前述した第の実斜䟋ず同様な手順により、遺䌝子情報怜出郚を甚いお遺䌝子情報を埗る。この遺䌝子情報に基づく蚺断情報から執刀医が、その珟堎手術宀で刀断しお、凊眮郚お生䜓組織を凊眮する。   The energy treatment device 61 thus configured first obtains gene information using the gene information detection unit 63 by the same procedure as that of the first embodiment described above. The surgeon judges from the diagnosis information based on the genetic information at the site (operating room) and treats the living tissue by the treatment unit 63.

本実斜䟋によれば、遺䌝子情報に基づく蚺断情報が出された埌、盎ちに、切陀すべき範囲を切陀するこずができる。このように、珟堎で蚺断を行い、その蚺断情報に応じお盎ちに凊眮を行うこずにより、手術䞭における執刀医や患者に察する負担が軜枛されるだけでなく、蚺断情報の粟床が向䞊される。   According to the present embodiment, the area to be excised can be immediately excised after diagnosis information based on genetic information is issued. As described above, diagnosis is performed in the field, and immediate treatment is performed according to the diagnosis information, thereby not only reducing the burden on the surgeon and patient during the operation, but also improving the accuracy of the diagnosis information.

以䞊説明したように、本発明の蚺断システムを甚いるこずにより、遺䌝子情報ずいう蚺察を行う䞊で粟床の高い情報を利甚しお、䞔぀埓来のように情報や蚺断情報のやり取りが通信にお行われるため、蚺断情報が執刀医に戻るのが僅かな時間で枈み、手術の䞭断時間が短瞮される。   As described above, by using the diagnosis system of the present invention, information such as genetic information with high accuracy is used, and information and diagnostic information are exchanged by communication as in the past. Therefore, it takes only a short time for the diagnostic information to return to the surgeon, and the operation interruption time is shortened.

本発明の蚺断システムは、遺䌝子情報を甚いお患者に察しお粟床の高い蚺断を行うこずができるため、手術における病倉郚だけではなく、䟋えば、薬剀の投䞎の際に個々の患者のアレルギヌ䜓質の有無やその皮類に合わせおアレルギヌ等を発生させる虞のある薬剀を遞別するこずもできる。この情報をカヌド等に蚘録しおおくこずにより、新たな病院や新たな薬剀を投䞎する際に、このカヌドをチェックするだけで危険を回避するこずができる。   Since the diagnosis system of the present invention can make a highly accurate diagnosis for a patient using genetic information, not only a lesion in surgery but also, for example, the allergic constitution of an individual patient at the time of drug administration. Drugs that may cause allergies or the like can be selected according to the presence or absence and the type of the drug. By recording this information on an IC card or the like, danger can be avoided by simply checking this IC card when administering a new hospital or a new medicine.

たた、急患で緊急手術を行う堎合で、予めアレルギヌ等の調査を行う時間がない堎合には、手術䞭であっおも患者のを調べおアレルギヌ等の発生させる薬剀を特定し、薬剀投䞎による危険性を回避するこずができる。   Also, when emergency surgery is performed for an emergency patient and there is no time to investigate allergies in advance, the patient's DNA is examined even during the operation to identify drugs that cause allergies, etc. Risk can be avoided.

図は、本発明の蚺断装眮の党䜓的な構成䟋を瀺すブロック構成図、図は、遺䌝子情報怜出郚の構成䟋を瀺す図である。FIG. 1A is a block diagram showing an example of the overall configuration of the diagnostic apparatus of the present invention, and FIG. 1B is a diagram showing an example of the configuration of a gene information detection unit. 図は、䜜甚郚を䞊から芋た構成を瀺し、図は、䜜甚郚の断面構成を瀺す図である。FIG. 2A shows a configuration of the action portion as viewed from above, and FIG. 2B is a diagram showing a cross-sectional configuration of the action portion 12a. 図は、遺䌝子情報怜出郚における前凊理・芳察郚を䞊から芋た構成を瀺し、図は、基準セルの構成䟋を瀺し、図は、基準セルの断面構成を瀺す図である。3A shows the configuration of the preprocessing / observation unit in the gene information detection unit viewed from above, FIG. 3B shows an example of the configuration of the reference cell, and FIG. 3C shows the reference cell. FIG. 図は、怜出凊理・情報送信郚ずの具䜓的な構成を瀺し説明する。FIG. 4 shows and describes a specific configuration with the detection processing / information transmission unit 4. 第の実斜䟋ずしお、本発明の蚺断装眮を甚いた蚺断システムに぀いお説明するための図である。It is a figure for demonstrating the diagnostic system using the diagnostic apparatus of this invention as a 1st Example. 図は、第の実斜䟋の遺䌝子情報怜出郚における前凊理・芳察郚を䞊から芋た構成を瀺し、図は、基準セルの構成䟋を瀺し、図は、基準セルの断面構成を瀺す図である。6A shows the configuration of the preprocessing / observation unit in the gene information detection unit of the first embodiment viewed from above, FIG. 6B shows the configuration example of the reference cell, and FIG. c) is a diagram showing a cross-sectional configuration of a reference cell. 第の実斜䟋ずしお、本発明の蚺断装眮を甚いた蚺断システムに぀いお説明するための図である。It is a figure for demonstrating the diagnostic system using the diagnostic apparatus of this invention as a 2nd Example. 本発明の蚺断装眮を腹腔鏡䞋の手術機噚に搭茉した蚺断システムの倉圢䟋である。It is a modification of the diagnostic system which mounts the diagnostic apparatus of this invention in the surgical equipment under a laparoscope. 第の実斜䟋ずしお、本発明の蚺断装眮を甚いた蚺断システムに぀いお説明するための図である。It is a figure for demonstrating the diagnostic system using the diagnostic apparatus of this invention as a 3rd Example.

笊号の説明Explanation of symbols

 蚺断装眮、 怜査鉗子、 把持郚、 䞊偎把持郚、 䞋偎把持郚、 遺䌝子情報怜出郚、 怜出凊理・情報送信郚、 情報受信郚、 情報凊理郚、 衚瀺郚、 入力郚、 病理デヌタベヌス、 蚺断情報怜玢郚、 病理医確認郚、 䜜甚郚、 溝、 ガむド溝、 チップ、 スポット又は、プロヌブ、 排出路、 液䜓排出口、 基準セル、 フォトダむオヌド、 照射口、 液䜓吐出郚、 受光郚、 光ファむバ、 送氎ナニット、 光源ナニット、 怜出ナニット、 生䜓組織又は、病倉郚。   DESCRIPTION OF SYMBOLS 1 ... Diagnostic apparatus, 2 ... Examination forceps, 2 ... Grasp part, 2a ... Upper side grip part, 2b ... Lower side grip part, 3 ... Gene information detection part, 4 ... Detection process and information transmission part, 5 ... Information reception part, DESCRIPTION OF SYMBOLS 6 ... Information processing part, 7 ... Display part, 8 ... Input part, 9 ... Pathology database, 10 ... Diagnostic information search part, 11 ... Pathologist confirmation part, 12a, 12b ... Action part, 13 ... Groove, 13a ... Guide groove 14 ... DNA chip, 15 ... spot (or probe), 16 ... discharge path, 17 ... liquid discharge port, 22 ... reference cell, 23 ... photodiode, 24 ... irradiation port, 25 ... liquid ejection part, 26 ... light receiving 27: optical fiber, 31: water supply unit, 33: light source unit, 34: detection unit, 100: biological tissue (or lesion).

Claims (7)

生䜓組織の䞀郚を取埗するずずもにハむブリダむれヌションを行い、該生䜓組織の遺䌝子情報を怜出する遺䌝子情報怜出手段ず、
前蚘遺䌝子情報怜出手段による前蚘遺䌝子情報を電気信号に倉換しお通信を行う送受信手段ず、
耇数皮の遺䌝子情報に関連づけられた耇数の蚺断情報が予め蓄積された病理デヌタベヌスず、
前蚘送受信手段から受信した前蚘遺䌝子情報を前蚘病理デヌタベヌスに照䌚しお、該圓する前蚘蚺断情報を怜玢する蚺断情報怜玢手段ず、
前蚘蚺断情報怜玢手段により怜玢された前蚘蚺断情報を衚瀺する衚瀺手段ず、
を具備する特城ずする蚺断装眮。
Gene information detection means for obtaining a part of the living tissue and performing hybridization to detect genetic information of the living tissue;
Transmission / reception means for performing communication by converting the genetic information by the genetic information detection means into an electrical signal;
A pathological database in which a plurality of diagnostic information associated with a plurality of types of genetic information is accumulated in advance;
Diagnostic information search means for referring to the pathological database for the genetic information received from the transmission / reception means and searching for the corresponding diagnostic information;
Display means for displaying the diagnostic information retrieved by the diagnostic information retrieval means;
A diagnostic apparatus comprising:
前蚘遺䌝子情報怜出手段は、把持されたずきに密閉状態ずなる第䜜甚郚ず第䜜甚郚ずで構成され、
前蚘第䜜甚郚は、
前蚘ハむブリダむれヌションにより付着する前蚘生䜓組織ず反応可胜な耇数のスポットプロヌブを配列するチップず、
前蚘ハむブリダむれヌションを行うために前蚘チップに掛けられた薬液を排出する排出郚ず、を有し、
前蚘第䜜甚郚は、
把持されたずきに前蚘スポットのそれぞれず察峙し、前蚘チップぞ前蚘薬液を掛け、掗浄された前蚘スポットぞ照明光を照射し、その反射光を受光しお電気信号ずしお遺䌝子情報を生成する基準セルず、を有するこずを特城ずする請求項に蚘茉の蚺断装眮。
The genetic information detection means is composed of a first action part and a second action part that are in a sealed state when gripped,
The first action part is
A DNA chip for arranging a plurality of spots (probes) capable of reacting with the biological tissue attached by the hybridization;
A discharge part for discharging the chemical solution hung on the DNA chip for performing the hybridization,
The second working part is
A reference for generating genetic information as an electrical signal by facing each of the spots when held, applying the chemical solution to the DNA chip, irradiating the cleaned spot with illumination light, and receiving the reflected light The diagnostic apparatus according to claim 1, further comprising a cell.
前蚘基準セルは、
前蚘ハむブリダむれヌション及び掗浄を行うための前蚘薬液ずなる詊料及び掗浄液を前蚘スポットぞ吐出する液䜓吐出郚ず、
前蚘ハむブリダむれヌションによる反応の埌に、前蚘スポットぞ光を照射する照射口ず、
前蚘スポットぞ照射された光の反射光を受光しお、該反射光から反応したスポットの遺䌝子情報を含む電気信号を生成する受光郚ず、
で構成されるこずを特城ずする請求項に蚘茉の蚺断装眮。
The reference cell is
A liquid discharger for discharging the sample to be the chemical solution and the cleaning solution for performing the hybridization and cleaning to the spot;
An irradiation port for irradiating the spot with light after the reaction by the hybridization;
A light receiving unit that receives reflected light of the light irradiated to the spot and generates an electrical signal including genetic information of the spot reacted from the reflected light;
The diagnostic apparatus according to claim 2, comprising:
ゞョヌの先端郚にチップを備え、該チップに付着した生䜓組織にハむブリダむれヌションを行い、光孊的に怜出した遺䌝子情報を電気信号に倉換しお出力する遺䌝子情報怜出機構を有する鉗子ず、
前蚘鉗子のハンドル偎に接続され、前蚘ハむブリダむれヌションを行うための薬液の䟛絊及び回収ず、前蚘チップに察しお照射光を䌝搬し、電気信号化された遺䌝子情報を無線信号に倉換し送信する怜出凊理・情報送信郚ず、
前蚘怜出凊理・情報送信郚から離れお所圚し、該怜出凊理・情報送信郚からの無線信号を受信しお、前蚘遺䌝子情報を埩号する情報受信郚ず、
耇数皮の遺䌝子情報に関連づけられた蚺断情報が予め蓄積された病理デヌタベヌスず、
前蚘受信した遺䌝子情報を前蚘病理デヌタベヌスに照䌚しお、該圓する前蚘蚺断情報を怜玢する蚺断情報怜玢郚ず、
前蚘蚺断情報怜玢郚により怜玢された前蚘蚺断情報の正誀の確認を行うために衚瀺する確認衚瀺手段ず、
前蚘確認衚瀺手段により正しいず確認された前蚘蚺断情報を前蚘鉗子が所圚する箇所の近傍に衚瀺する衚瀺郚ず、
を具備する特城ずする蚺断システム。
A forceps having a gene information detection mechanism comprising a DNA chip at the tip of the jaw, performing hybridization on a biological tissue attached to the DNA chip, converting optically detected gene information into an electrical signal, and outputting the electrical signal;
Connected to the handle side of the forceps, supply and recovery of the chemical solution for performing the hybridization, propagate the irradiation light to the DNA chip, convert the electrical genetic information into a radio signal and transmit it A detection processing / information transmission unit;
An information receiving unit that is located away from the detection processing / information transmitting unit, receives a radio signal from the detection processing / information transmitting unit, and decodes the gene information;
A pathological database in which diagnostic information associated with multiple types of genetic information is stored in advance;
A diagnostic information search unit that queries the pathological database for the received gene information and searches for the relevant diagnostic information,
Confirmation display means for displaying the diagnostic information retrieved by the diagnostic information retrieval unit for confirming correctness;
A display unit for displaying the diagnostic information confirmed to be correct by the confirmation display means in the vicinity of the location where the forceps are located;
A diagnostic system comprising:
前蚘鉗子は、䞊ゞョヌ、䞋ゞョヌ及びこれらを開閉するハンドルにより構成され、
前蚘䞋ゞョヌに搭茉され、付着した生䜓組織にハむブリダむれヌション及び掗浄を斜しお、該生䜓組織の遺䌝子情報を怜出するための耇数のスポットが配列されたチップず、
前蚘䞋ゞョヌ内に圢成され、前蚘ハむブリダむれヌション及び掗浄を行うために前蚘チップに掛けた詊料及び掗浄液を排出する排出路ず、
前蚘䞊ゞョヌに圢成され、前蚘詊料及び前蚘掗浄液を前蚘スポットぞ吐出する液䜓吐出郚ず、
前蚘ハむブリダむれヌションによる反応の埌に、前蚘スポットぞ光を照射する照射口ず、
前蚘スポットぞ照射された光の反射光を受光しお、反応したスポットからの遺䌝子情報を含む電気信号を生成する受光郚ず、
を具備するこずを特城ずする請求項に蚘茉の蚺断システム。
The forceps is composed of an upper jaw, a lower jaw, and a handle for opening and closing them.
A DNA chip mounted on the lower jaw, on which the attached biological tissue is subjected to hybridization and washing, and a plurality of spots for detecting genetic information of the biological tissue are arranged;
A discharge path formed in the lower jaw for discharging the sample and the washing solution applied to the DNA chip for performing the hybridization and washing;
A liquid ejection part formed on the upper jaw and ejecting the sample and the cleaning liquid to the spot;
An irradiation port for irradiating the spot with light after the reaction by the hybridization;
A light receiving unit that receives reflected light of the light irradiated to the spot and generates an electrical signal including gene information from the reacted spot;
The diagnostic system according to claim 4, further comprising:
前蚘蚺断システムにおいお、
前蚘遺䌝子情報怜出機構は、゚ネルギヌ凊眮具に蚭けられおいるこずを特城ずする請求項に蚘茉の蚺断システム。
In the diagnostic system,
The diagnostic system according to claim 4, wherein the genetic information detection mechanism is provided in an energy treatment device.
前蚘蚺断システムにおいお、
前蚘遺䌝子情報怜出機構は、腹腔鏡䞋の手術機噚に蚭けられおいるこずを特城ずする請求項に蚘茉の蚺断システム。
In the diagnostic system,
The diagnostic system according to claim 4, wherein the gene information detection mechanism is provided in a laparoscopic surgical instrument.
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