JP2005058378A - Operation observation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an operation observation system easily superimposedly displaying three-dimensional ultrasonic images of an ultrasonic observation device observing the tissue inside of an operative site on an optical microscopic observation image of the operative site. <P>SOLUTION: This operation observation system is provided with a microscope mirror body 4 displaying the optical observation image of the operative site, an ultrasonic probe 20 insertable into the operative site, and the ultrasonic observation device 9 producing the ultrasonic image of the tissue inside of the operative site. This operation observation system produces a three-dimensional ultrasonic image with an index correlating the positional relation between the index which shows the insertion position of the operative site on the ultrasonic image produced by the ultrasonic observation device, and the optical microscopic observation image; and the three-dimensional ultrasonic image with the index is superimposedly displayed on the optical microscopic observation image. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a surgical observation system including a surgical microscope or an ultrasonic observation device used in combination with an endoscope, particularly in neurosurgery.

  Conventionally, in the field of neurosurgery, in order to perform a delicate and accurate operation, a surgical microscope that magnifies and observes a surgical site is often used. Further, an endoscope is used together with a surgical microscope, or an endoscope is used alone instead of a surgical microscope.

  In addition, it is also desirable that information such as CT images and MR images of the surgical site before surgery and nerve monitor during surgery can be observed simultaneously in real time. It is desired to be able to observe in real time.

  For such a request, the observation position and direction of the surgical microscope with respect to the surgical site and the relative position of the observation position and direction of the ultrasonic probe of the ultrasonic observation apparatus are detected, and based on this detection result, There has been proposed a surgical observation system including an ultrasonic observation apparatus for real-time auxiliary observation that displays an ultrasonic observation image in a predetermined range of an observation image obtained by a surgical microscope. Reference 1).

  Further, in the observation image by the surgical microscope, in-field display means for allowing the surgeon to display the tomographic image information by the ultrasonic probe in the observation image of the surgical microscope in accordance with the state of the operation, and the tomographic image of the surgical site There has been proposed a surgical microscope provided with an ultrasonic probe that generates an observation position and an observation position detection means for detecting an observation position by the ultrasonic probe (see, for example, Patent Document 2).

Furthermore, an attachment mechanism for connecting an ultrasonic probe provided with a drive unit for moving the ultrasonic probe relative to the arm mechanism that can move freely in a spatial position is provided, so that the three-dimensional super There has also been proposed an ultrasonic observation system that obtains a sound image, simplifies the internal configuration of the ultrasonic probe, and reduces the outer diameter (for example, see Patent Document 3).
JP 2001-104335 A. JP 2002-619 A. JP 2002-34980 A.

  In the field of neurosurgery, an ultrasonic observation apparatus is frequently used for confirming the state of blood vessels in the brain before a surgical procedure, and confirming obstacles such as blood vessels in the direction of treatment progress during a surgical procedure.

  However, since an image generated by the ultrasonic observation apparatus is a tomographic image, a certain amount of experience is required for decoding the image. Therefore, it is desired to generate a three-dimensional ultrasound image that is anatomically easy to decode.

  In response to this demand, the surgical microscopes proposed in Patent Documents 1 and 2 described above have a two-dimensional ultrasonic tomography of the surgical site using an ultrasonic observation device compared to the surgical site being observed with the surgical microscope. The direction and position information of the image and the operation orientation of the ultrasonic observation apparatus can be obtained.

  When a three-dimensional image that can be easily decoded by this ultrasonic observation apparatus is generated, it is necessary to accurately detect the relative movement of the ultrasonic probe using a scope holder proposed in Patent Document 3. is there. For this reason, there has been a problem that the overall configuration of an ultrasonic observation system used in combination with a surgical microscope becomes large and complicated, resulting in an increase in cost.

  The present invention has been made by paying attention to such a situation, and can be used in combination with a surgical microscope or an endoscope without increasing the size and complexity of a surgical observation system. Therefore, an object of the present invention is to provide a surgical observation system that can be easily generated, can be added with an orientation for generating an ultrasonic observation image, and can perform surgery efficiently.

  The surgical observation system of the present invention includes an observation unit having an observation optical system for displaying an enlarged observation optical image of an operation part, and an ultrasonic wave that can be inserted and installed in the operation part and generates an ultrasonic image inside the tissue of the operation part. An observation means, an index generation means for detecting an insertion and installation position of the ultrasonic observation means in the surgical site, and generating an index indicating the insertion and installation position; an index generated by the index generation means; An image processing unit that generates an indexed ultrasonic image by correlating a positional relationship with an ultrasonic image generated by the sound wave observation unit, and an observation unit that observes the indexed ultrasonic image generated by the image processing unit And a superimposing display means capable of superimposing and displaying on at least a part of the observation optical image of the surgical site displayed on the optical system.

  The image processing means of the surgical observation system of the present invention is configured to determine an insertion position of the ultrasonic observation means into the surgical site from the index generated by the image index generation means and the ultrasonic image generated by the ultrasonic observation means. The three-dimensional ultrasonic image shown is generated. The ultrasonic observation means of the surgical observation system of the present invention includes a first housing means that has an ultrasonic transducer and can be inserted into the surgical site, and is connected to the proximal end of the first housing means. And an ultrasonic probe having rigid second housing means whose other end is connected to the gripping part, and coupling means for movably coupling the first housing means and the second housing means. It is characterized by.

  With the surgical observation system of the present invention, the surgeon can perform an operation by correlating and displaying the ultrasonic image generated by the ultrasonic observation means for observing the inside of the tissue of the surgical site with the observation optical image of the surgical site. Correlation between the observation optical image of the part and the ultrasonic image is facilitated, and delicate surgical processing such as neurosurgery is facilitated.

  According to the present invention, a three-dimensional ultrasonic image can be easily constructed from a two-dimensional ultrasonic image obtained by an ultrasonic observation apparatus having an ultrasonic probe used in combination with a surgical microscope or an endoscope, In addition, the operation orientation of the observation image by the ultrasonic observation apparatus can be added, and the surgeon can effectively perform delicate surgical treatment.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. A first embodiment of the surgical observation system according to the present invention will be described with reference to FIGS. 1 to 3.

  FIG. 1 is a perspective view showing a relationship between a body of a surgical microscope and an ultrasonic probe of the surgical observation system according to the present invention, FIG. 2 is a block diagram showing a schematic configuration of the surgical observation system according to the present invention, and FIG. These are block diagrams which show the structure regarding the ultrasonic image of 1st embodiment of the surgical observation system which concerns on this invention.

  As shown in FIG. 2, the surgical observation system of the present invention is an ultrasonic observation apparatus having a surgical microscope 1 for observing a surgical part to be treated and an ultrasonic probe 20 for generating an ultrasonic tomographic image of the surgical part. It consists of nine.

  The surgical microscope 1 includes a gantry 2, a balance arm 3 disposed on the gantry 2, and a microscope body (hereinafter simply referred to as a “body”) 4 supported by the balance arm 3. Yes.

  The balance arm 3 is provided with a plurality of movable arms and six rotation axes 5a to 5f. Each of the rotating shafts 5a to 5f is provided with an electromagnetic lock (not shown) that switches between a locked state that fixes the movable position of each movable arm and an unlocked state that unlocks the movable position. As the electromagnetic lock is locked / unlocked, the movable arm of the balance arm 3 is moved about the six rotation axes 5a to 5f, so that the mirror body 4 is spatially moved. It can be done freely.

  The mirror body 4 is provided with a sensor arm 6 for detecting the position and moving direction of the mirror body 4 and a grip 7 for operating the position of the mirror body 4. Although not shown, the grip 7 is provided with a plurality of operation switches for adjusting the focus of the observation optical system built in the mirror body 4, operating the zoom magnification, and operating the balance arm 3.

  The surgical microscope 1 has a built-in mirror control unit 11 and an arm control unit 12. A plurality of operation switches provided on the grip 7 are connected to the mirror control unit 11 and the arm control unit 12. Further, a foot switch 13 having switches for focus adjustment, zoom magnification operation and the like is connected to the lens body control unit 11 and the arm control unit 12 in the same manner as a plurality of operation switches provided on the grip 7.

  The mirror control unit 11 is connected to the navigation device 15 via the interface unit 14. A digitizer 17 and a navigation monitor 16 are connected to the navigation device 15.

  The navigation device 15 calculates a correlation between a reference index attached to the patient's head detected by the digitizer 17, a sensor arm 6 of the mirror body 4, and a sensor arm 23 a provided on an ultrasonic probe 20 described later. It is supposed to be.

  The ultrasonic observation apparatus 9 drives and controls the ultrasonic probe 20 and generates an ultrasonic image based on the ultrasonic waves transmitted and received by the ultrasonic probe 20. The generated ultrasonic image is displayed on the ultrasonic monitor 10 and displayed together with the position information of the ultrasonic probe 20 from the navigation device 15 and the microscope optical image of the observation optical system of the surgical microscope 1. An ultrasonic image is generated.

  As shown in FIG. 1, the mirror body 4 includes a binocular eyepiece tube 8 having a predetermined observation visual field range and a probe holding portion 38. Since the internal configuration of the eyepiece tube 8 is substantially the same as the surgical microscope apparatus disclosed in Japanese Patent Laid-Open No. 2000-70284, detailed description thereof is omitted. The binocular eyepiece tube 8 of the mirror body 4 has a built-in observation optical system 18 (described later) composed of a plurality of lenses having a predetermined observation visual field range, and receives a microscope optical image of an operation part in the observation visual field range. The surgeon looks directly from the tube 8 in an enlarged manner.

  In addition, on the eyepiece tube 8, an ultrasonic image generated by the ultrasonic observation device 9 can be displayed superimposed on the microscope optical image or can be displayed side by side.

  The probe holding unit 38 holds the ultrasonic probe 20 in a detachable manner. The ultrasonic probe 20 to be attached to and detached from the probe holding portion 38 includes a first housing 21 having an ultrasonic transducer 24 built in a tip thereof, and a rigid substantially connected to the base end of the first housing 21. A straight pipe 22 which is a second housing having a cylindrical shape, a handle portion 23 connected to the base end portion of the straight pipe 22, and a base end of the handle portion 23 via the flexible tube 37, The ultrasonic observation apparatus 9 is connected. A sensor arm 23 a is provided on the handle portion 23 of the ultrasonic probe 20.

  In the ultrasonic probe 20, the operator grasps the handle portion 23 and inserts the distal end portion of the first housing 21 into the operation portion 40.

  Next, the configuration of the ultrasonic observation apparatus 9 and the configuration related to the display control of the ultrasonic image of the mirror body 4 will be described with reference to FIG.

  The ultrasonic observation unit 9 drives the ultrasonic transducer 24 provided at the tip of the first housing 21 of the ultrasonic probe 20 to oscillate the ultrasonic wave in the surgical part 40 and reflects it from the surgical part 40. An ultrasonic observation unit 25 that performs predetermined signal processing based on ultrasonic waves to generate a two-dimensional ultrasonic image, and an ultrasonic monitor 10 that displays a two-dimensional ultrasonic image formed by the ultrasonic observation unit 25; The ultrasonic wave to be superimposed and displayed on the microscope optical image based on the position data of the ultrasonic probe 20 output from the navigation device 15, the position data of the mirror 4, the zoom magnification and the focus distance data from the mirror controller 11, and the like. An image coordinate calculation unit 28 for calculating index coordinates of an image, an ultrasonic image generated by the ultrasonic observation unit 25, and index coordinate data of an ultrasonic image calculated by the image coordinate calculation unit 28 An image processing unit 26 that generates a superimposed ultrasonic image to be superimposed and displayed on the microscope optical image of the mirror body 4, and an image memory 27 that stores the superimposed ultrasonic image data and index coordinate data generated by the image processing unit 26. It is made up of.

  The mirror body 4 has an observation optical system 18 in which a plurality of lenses for magnifying and observing the surgical site is combined. The zoom motor 31 for zoom driving for adjusting the zoom magnification of the observation optical system 18 and its zoom state A zoom encoder 32 for detecting, a focus driving focus motor 31 for adjusting the focus of the observation optical system 18 and a focus encoder 34 for detecting the focus distance are provided. The zoom motor 31 and the focus motor 33 are driven and controlled by the mirror control unit 11, and detection information of the zoom encoder 32 and the focus encoder 34 is output to the mirror control unit 11. In addition, a switch (not shown) provided on the handle 7 and the foot switch 13 are connected to the lens body control unit 11 to perform switch operation input.

  Various control information by the mirror control unit 11 is output to the navigation device 15 via the interface unit 14.

  Further, the mirror body 4 is superposed and displayed by an LCD that optically superimposes and displays the ultrasonic image generated by the image processing unit 26 of the ultrasonic observation device 9 on the microscope optical image of the observation optical system 18. A monitor 30c and an LCD driver 29c for driving the superimposed display monitor 30c are provided.

  The mirror body 4 is shown for the left side (for the left eye) of the binocular eyepiece tube 8, and the right side (for the right eye) is omitted because it is the same as the left side.

  The operation of the surgical observation system having such a configuration will be described with reference to FIGS. 5 is a plan view showing an observation image in the first embodiment of the surgical observation system according to the present invention, and FIG. 7 is a diagram of the ultrasonic observation apparatus in the first embodiment of the surgical observation system according to the present invention. It is a flowchart explaining an effect | action.

  As shown in FIG. 5, the ultrasonic probe 20 is inserted into the surgical part 40 with respect to the microscope optical image 30 in the observation field observed by the observation optical system 18 of the eyepiece tube 8, and an ultrasonic observation apparatus is used. The ultrasonic image reproduced and displayed on the superimposed display monitor 30c is superimposed and displayed via the LCD driver 29c of the mirror body 4 based on the ultrasonic image signal generated in step 9. That is, the ultrasonic image displayed on the superimposed display monitor 30 c is observed from the eyepiece portion of the eyepiece tube 8 while being superimposed on the microscope optical image 30 of the observation optical system 18.

  The ultrasonic image displayed on the superimposition display monitor 30c is detected by the zoom encoder 32 and the focus encoder 34, and the ultrasonic control device 9 of the ultrasonic control device 9 via the interface unit 14 and the navigation device 15 from the lens body control unit 11. Information such as the zoom magnification and focus distance of the observation optical system 18 supplied to the image coordinate calculation unit 28, the sensor arm 6 of the mirror body 4, the sensor arm 23a of the ultrasonic probe 20, and the digitizer 17, respectively. Based on the position information, the image coordinate calculation unit 28 calculates the insertion position of the ultrasonic probe 20 into the surgical field 30 of the first housing 21 with respect to the microscope optical image 30 of the observation optical system 18. An index 36 indicating the orientation of the first housing 21 of the ultrasonic probe 20 with respect to the two-dimensional ultrasonic image signal generated by the ultrasonic observation unit 25 in the image processing unit 26 using the calculation result, An ultrasonic image signal including a slice interval index 35 for sound wave observation is generated, stored in the image memory 27, and a three-dimensional ultrasonic image is generated based on a plurality of ultrasonic images generated for each of the plurality of slice interval indexes 35. Generated and displayed on the superimposed display monitor 30c via the LCD driver 29c.

  Thereby, an ultrasonic image is superimposed and displayed on the microscope optical image 30 observed from the eyepiece portion of the eyepiece tube 8 of the mirror body 4.

  That is, the ultrasonic probe 20 is inserted into the surgical part 40, and ultrasonic waves are radiated forward from the ultrasonic transducer 24 of the first housing 21 installed according to the index 36, and obtained from the reflected waves of the ultrasonic waves. The two-dimensional ultrasonic tomographic image of the obtained surgical unit 40 is constructed by the ultrasonic observation unit 25 and the image processing unit 26 to construct a three-dimensional ultrasonic image in which the positional relationship with the microscope optical image 30 is correlated. Then, the generated three-dimensional ultrasonic image is displayed on the superimposed display monitor 30c that is visible from the observation optical system 18 of the mirror body 4.

  The generation operation of the three-dimensional ultrasonic image of the ultrasonic observation apparatus 9 will be described with reference to FIG. In step S1, the ultrasonic observation device 9 acquires information such as the zoom magnification and the focus distance of the observation optical system 18 from the lens body control unit 11 of the mirror body 4 via the navigation device 15 and the interface unit 14. To do. Based on the zoom magnification and focus distance information of the observation optical system 18 acquired in step S1, the tomographic slice interval d required for constructing the three-dimensional ultrasonic image generated by the ultrasonic probe 20 and the ultrasonic observation unit 25 is set. In step S2, calculation is performed.

  When the tomographic slice interval d in step S2 is calculated, in step S3, the two-dimensional ultrasonic image generated by the ultrasonic observation unit 25 is added with the index 35 of the tomographic slice interval d generated in step S2. The sound wave image is displayed on the superimposed display monitor 30c.

  Next, in step S4, the two-dimensional image Pn generated by the ultrasonic probe 20 at the first position of the slice interval d set in step S3 is acquired, and the reference when the two-dimensional image Pn is acquired in step S5. The spatial coordinates of the ultrasonic probe 20 with respect to the index are recorded in the image memory 27. Next, in step S6, the index 35 displayed on the superimposed display monitor 30c in step S3 is updated with the slice interval d. When the position update of the index 35 in step S6 is performed, the process returns to step S4, and the secondary image acquisition of the index position of the slice interval d whose position is updated and the process of recording the spatial coordinates in step S5 are performed n times. Repeatedly executed.

  That is, in steps S4 to S6, a two-dimensional image P is acquired for each slice interval d set and displayed in steps S2 and S3, and the image memory together with the spatial coordinates of the ultrasonic probe 20 when the two-dimensional image P is acquired. 27.

  Steps S4 to S6 are executed n times, and using the acquired two-dimensional images P0 to Pn and the respective spatial coordinates, a three-dimensional ultrasonic image is constructed in step S7 and is displayed on the superimposed display monitor 30c. Display.

  As described above, the surgical observation system according to the present invention uses the ultrasonic probe 20 freehand without using a scope holder for moving the ultrasonic probe in the vertical direction and the axial direction, and can easily perform a three-dimensional operation. A two-dimensional ultrasound slice image P for constructing an ultrasound image can be acquired.

  Further, the ultrasonic image obtained by the ultrasonic probe 20 can be displayed on the microscope optical image 30 as it is. Furthermore, by obtaining and superimposing the positional correlation with the microscope optical image 30 via the navigation device 15, the microscope optical image 30 can be easily correlated with the ultrasonic image and the surgical part 40, and the surgical treatment can be executed smoothly.

  Of the indicators 35 for the slice interval d, an indicator 36 indicating the initial installation position for capturing a two-dimensional image is fixed to the leftmost portion of the image screen displayed on the monitor, for example, the observation slice interval indicator 35. The index 36 may be updated and displayed in the right direction in order from the left side of the monitor screen.

  Alternatively, a setting switch (not shown) may be used to designate the position of the index 36 indicating the position at which the series of two-dimensional images are first captured in the observation slice interval index 35 according to the operator's preference.

  Further, even when the operator arbitrarily selects an index from among the observation slice interval indices 35 and starts to capture an image, the image capture coordinates are determined by the navigation device 15 and the image processing unit 26, and the second and subsequent optimum times are determined. The image capture order may be indicated by the index 36, and the calculation may be performed even when the operator has arbitrarily determined the image capture order.

  In addition, when the n two-dimensional slice images P are sequentially acquired, the navigation device 15 and the image processing unit 26 determine whether or not the first housing 21 is appropriately overlapped with the index 36, and the index 36 is displayed. The operator can be notified on the screen or by sound.

  Alternatively, when the coordinates of the two-dimensional slice image P acquired by the surgeon are inappropriate, it is possible to make a determination by the navigation device 15 and the image processing unit 26 and to provide a function or the like that can notify the image acquisition correction. Conceivable.

  Furthermore, it is also possible to superimpose and display a CT image or an MR image on a microscope optical image instead of the ultrasonic image of the ultrasonic observation apparatus of the present embodiment.

  Next, the configuration of the second embodiment of the surgical observation system according to the present invention will be described with reference to FIGS. 4 and 6. FIG. 4 is a block diagram showing a configuration relating to an ultrasonic image in the second embodiment of the surgical observation system according to the present invention, and FIG. 6 shows an observation image in the second embodiment of the surgical system according to the present invention. FIG. The same parts as those in FIG. 3 are denoted by the same reference numerals, and detailed description thereof is omitted.

  The relationship and schematic configuration of the microscope body and the ultrasonic observation apparatus of the surgical observation system according to the second embodiment are the same as those in FIGS.

  The difference between the surgical observation system of the second embodiment and the first embodiment described above is that the ultrasonic probe 20 generated by the image processing unit 26 of the ultrasonic observation apparatus 9 is different from the first embodiment described above, as shown in FIG. The ultrasonic image signal including the position index is output to the LCD driver 29a of the mirror body 4 and the mixer 19.

  On the other hand, as shown in FIG. 6, the mirror body 4 is composed of an LCD that superimposes and displays an ultrasonic image on a part of the field of the microscope optical image 30 observed by the observation optical system 18 of the eyepiece tube 8. An in-field image display monitor 30a and an out-of-field image display monitor 30b which is observable by the observation optical system 18 and is displayed adjacently outside the field of the microscope optical image 30 are provided.

  The in-view image display monitor 30a is supplied with the three-dimensional ultrasonic image signal generated by the image processing unit 26 via the LCD driver 29a. The out-of-view image display monitor 30b is picked up by the mixer 19 with an imaging device 40 including an ultrasonic tomographic image signal from the image processing unit 26 and a CCD or the like provided in the observation optical system 18, An image signal obtained by mixing the observation image signal generated by the camera control unit (CCU) 39 is supplied via the LCD driver 29b.

  The image pickup device 40 takes in a part of a microscope optical image from the middle of the observation optical system 18 and photoelectrically converts it to generate an image pickup signal. The CCU 39 controls the drive of the image pickup device 40 and the image pickup device 40. A standard image signal is generated by performing predetermined signal processing on the image pickup signal generated by photoelectric conversion.

  The mixer 19 mixes the standard tomographic image signal generated by the CCU 19 with the ultrasonic tomographic image signal generated by the image processing unit 26, and the monitor 30b for out-of-field image display via the LCD driver 29b. To be displayed.

  4 shows the left eye (for left eye) of the binocular eyepiece tube 8, and the right eye (for right eye) is omitted because it is the same as the left eye.

  The operation of the surgical observation system according to the second embodiment will be described with reference to FIG. An ultrasonic image displayed on the in-field image display monitor 30a is superimposed and displayed on a part of the field of view of the microscope optical image 30 when the surgical part 40 is observed by the observation optical system 18 of the eyepiece tube 8. It is like that. The out-of-field image display monitor 30 b is displayed adjacent to the microscope optical image 30 of the observation optical system 18 and can be observed from the observation optical system 18.

  The image processing unit 26 of the ultrasonic observation device 9 is detected by the mirror control unit 11 of the mirror 4 on the basis of the ultrasonic image signal generated by the ultrasonic observation unit 25 and the navigation unit and the interface unit 14. 15 and the index coordinates such as the installation position of the ultrasonic probe 20 in the surgical unit 40 generated by the image coordinate calculation unit 28, a three-dimensional navigation image signal indicating the insertion direction of the ultrasonic probe 20 is generated. The image is displayed on the visual field image display monitor 30a via the LCD driver 29a.

  Further, a three-dimensional ultrasonic tomographic image signal including an index 36 indicating the orientation of the first housing 21 of the ultrasonic probe 20 from the image processing unit 26 and a slice interval index 35 for ultrasonic observation is supplied to the mixer 19. The mixer 19 picks up images with the image pickup device 40, mixes and generates the image signals generated by the CCU 39, and displays them on the out-of-field image display monitor 30b via the LCD driver 29b.

  Accordingly, the insertion direction of the ultrasonic probe 20 displayed on the in-field image display monitor 30a in a part of the field of the microscope optical image 30 observed from the eyepiece portion of the eyepiece tube 8 of the mirror body 4 is observed. Is displayed in a superimposed manner, and has an index 36 and a slice slice interval index 35 of the ultrasonic probe 20 displayed on the out-of-field image display monitor 30b adjacent to the outside of the field of view of the microscope optical image 30. A three-dimensional ultrasonic tomographic image is displayed.

  Accordingly, the surgeon uses the observation optical system 18 of the mirror body 4 to observe the microscope optical image 30 of the surgical section 40, the ultrasonic image of the surgical section 40 displayed on the in-field image display monitor 30 a and the out-of-field image display monitor 30 a. The image can be observed in real time. That is, a three-dimensional navigation image of the ultrasonic probe 20, a three-dimensional ultrasonic tomographic image including an index 36 indicating the direction of the ultrasonic probe 20 and an index 35 indicating a slice interval can be easily generated and displayed.

  The method for generating the three-dimensional image displayed on the visual field inside / outside image display monitors 30a and 30b is the same as the processing described with reference to FIG.

  Furthermore, the ultrasonic observation system of the second embodiment has the same effect as the surgical observation system of the first embodiment described above.

  The surgical observation system of the present invention has been described based on a combination example of a surgical microscope for observing a surgical site and an ultrasonic observation apparatus for generating an ultrasonic image inside the tissue of the surgical site. An endoscope can be used instead of the microscope for use. Further, instead of the ultrasonic image obtained by the ultrasonic observation apparatus, a CT image, an MR image, or the like can be used.

  Further, in order to further increase the correlation between the acquired ultrasonic image and the naked eye observation image, the slice cross section of the ultrasonic image may be aligned with the observation image and superimposed.

  That is, a slice cross-sectional image is created by the image processing unit 26 according to the position of the probe 23 with respect to the observation image detected by the navigation device 15, the viewing angle and the viewing direction defined by the probe 23. The slice cross-sectional image may be created by cutting out an image from the ultrasonic image from the ultrasonic observation unit 25. The slice cross-sectional image creates two images viewed from the left-right parallax direction of the microscope. The slice section layer is sent to the LCD driver 29b via the mixer 19, and is displayed as a three-dimensional slice section image having left and right parallax on the left and right LCD monitors 30b.

  Accordingly, the surgeon can visually grasp the slice cross section of the ultrasonic image with respect to the observation image, and thus has an advantage that the correlation is easily obtained.

  Next, a modification of the ultrasonic probe of the surgical observation system according to the present invention will be described with reference to FIGS. FIG. 8 is a plan view showing a first modification of the ultrasonic probe used in the surgical observation system according to the present invention, and FIG. 9 shows a second modification of the ultrasonic probe used in the surgical observation system according to the present invention. It is a top view.

  The ultrasonic probe 20 used in the surgical observation system according to the present invention has a proximal end side of the first housing 21 in which the ultrasonic transducer 24 is disposed at the distal end as shown in FIGS. The straight pipe 22 which is a substantially linear and rigid cylindrical second housing is disposed.

  On the other hand, in order to improve the adhesiveness between the ultrasonic transducer 24 of the ultrasonic probe 20 and the surgical part 40 to be observed, as shown in FIG. An articulated movable portion is provided at the joint between the housing 21 and the straight pipe 22 having a hard, substantially cylindrical shape. As shown in FIG. 9, an elastic bent portion that can be bent elastically in the vertical and horizontal directions is provided at a joint portion between the first housing 21 and the straight pipe 22 having a substantially rigid cylindrical shape.

  8 and 9, the movement of the first housing 21 is detected at the joint between the first housing 21 and the straight pipe 22 of the ultrasonic probe 20, such as a rotary encoder (not shown). The orientation of the ultrasonic probe 20 can be attached by installing the sensor and acquiring the orientation information of the ultrasonic transducer 24 of the ultrasonic probe 20.

  Thereby, even when the opening part is narrow, especially in the operation of the neurosurgery area, and the movable range of the straight pipe 22 is severely limited with respect to the surgical part 40 having a complicated shape (undulation), The first housing 21 can be moved in accordance with the inclination of the surgical part 40, the adhesion between the ultrasonic transducer 24 and the observation object can be improved, and the angle of view where the adhesion is poor and an image cannot be obtained can be narrowed. The angle of view of the ultrasonic transducer 24 can be used effectively.

  Next, another modified example of the surgical observation system according to the present invention will be described with reference to FIGS. FIG. 10 is a plan view showing a first modification using the superimposing display monitor, in-field image display monitor, or out-of-field image display monitor of the surgical observation system according to the present invention, and FIG. It is a top view which shows the 2nd modification using the monitor for superimposition display, the monitor for image display in a visual field, or the monitor for image display outside a visual field of the surgical observation system which concerns on this.

  Generally, the operation method of this type of surgical observation system is operated in accordance with the operation procedure described in the operation manual. It takes a lot of time to learn the operation method of this surgical observation system based on the operation manual and to master the operation.

  Therefore, the surgical observation system of the present invention is provided with a memory in which description data of an operation method (not shown) is stored, and an explanation description of a desired operation method is displayed for the superimposed display from the operation method data stored in the memory. The image is displayed on the monitor 30c, the in-field image display monitor 30a, and the out-of-field image display monitor 30b.

  For example, as shown in FIG. 10A, an instruction for handling the ultrasonic observation unit 9 is displayed, or as shown in FIG. 10B, an instruction input panel for use operation of the ultrasonic observation unit 19 is used. Display methods. Further, as shown in FIG. 11, explanations of observation methods for various ultrasonic images are displayed.

  This enables the surgeon to easily and surely perform ultrasonic observation by reading out and displaying the desired use operation description and observation explanation description as necessary during operation of the ultrasonic observation system. It is possible to provide an ultrasonic observation system with high instruction of surgical observation.

[Appendix]
According to the embodiment of the present invention described in detail above, the following configuration can be obtained.

(Appendix 1) Observation means having an observation optical system for displaying a magnified observation optical image of the surgical site;
Ultrasonic observation means that can be inserted and installed in the surgical site, and generates an ultrasonic image inside the tissue of the surgical site;
An index generation means for detecting an insertion and installation position of the ultrasonic observation means in the surgical site, and generating an index indicating the insertion and installation position;
An image processing unit that correlates a positional relationship between the index generated by the index generation unit and the ultrasonic image generated by the ultrasonic observation unit to generate an indexed ultrasonic image;
Superimposition display means capable of superimposing and displaying at least a part of the observation optical image of the surgical site displayed on the observation optical system of the observation means the indexed ultrasonic image generated by the image processing means;
Surgical observation system characterized by comprising.

  (Additional remark 2) The said image processing means is a three-dimensional which shows the insertion position to the said operation part of the ultrasonic observation means from the parameter | index produced | generated by the said index production | generation means and the ultrasonic image produced | generated by the said ultrasonic observation means. The surgical observation system according to appendix 1, wherein an ultrasonic image is generated.

  (Additional remark 3) The said ultrasonic observation means is equipped with the ultrasonic transducer | vibrator, is connected with the 1st housing means which can be inserted in an operation part, and the base end of this 1st housing means, and the other end is hold | gripped And an ultrasonic probe having rigid second housing means coupled to the portion, and coupling means for movably coupling the first housing means and the second housing means. The surgical observation system according to 1.

(Additional remark 4) It has the observation means which can observe an operation part, the superimposition display means which can superimpose and display an image on at least one part of the display part of the said observation means, and the insertion part which can be inserted in the said operation part, In a surgical observation system consisting of an ultrasonic observation device capable of observing the inside,
The superimposed display means includes an image generation means capable of generating an index indicating an installation position of the insertion portion of the ultrasonic observation apparatus at an operation part, and the observation means and an observation image of the index or the ultrasonic observation apparatus A surgical observation system characterized by having a detecting means for correlating the positional relationship between the two.

(Additional remark 5) The said ultrasonic observation apparatus is an ultrasonic probe which consists of an operator or the holding part which can be hold | maintained at a holder, and the insertion part which incorporates the ultrasonic transducer | vibrator in the front-end | tip, and can be inserted in an operation part. Have
The insertion portion of the ultrasonic probe includes a first housing in which the ultrasonic transducer is incorporated,
A second housing having a rigid, substantially cylindrical shape connected to the grip portion and connected to the base end of the first housing;
The surgical observation system according to claim 1, further comprising: a coupling unit that movably couples the first housing and the second housing.

  (Supplementary note 6) The surgical observation system according to supplementary note 4, wherein the superimposition display unit is an overlay display unit that superimposes on the optical observation image of the observation unit.

  (Supplementary note 7) The surgical observation system according to supplementary note 4, wherein the superimposing display means is a separate visual field display means for displaying an image in an optical observation image of the observation means.

  (Supplementary note 8) The surgical observation system according to supplementary note 4, wherein the index indicates an installation position of the insertion portion when a desired cross section is scanned in the surgical field with the ultrasonic observation apparatus.

  (Supplementary note 9) The surgical observation system according to supplementary note 4, wherein the index is automatically updated for each scan of the ultrasonic observation apparatus when a plurality of cross sections are continuously scanned.

  (Supplementary note 10) The surgical observation system according to supplementary note 9, wherein the index of the position to be scanned with the ultrasonic probe also indicates at least the indicated position next to the current indicated position or all indicated positions.

  (Supplementary note 11) The surgical observation system according to any one of Supplementary note 9 or 10, wherein the position scanned by the ultrasonic probe is a position based on data from a surgical support navigation system.

  (Supplementary note 12) The surgical observation system according to supplementary note 5, wherein the coupling means has a mechanical joint structure.

  (Additional remark 13) The said observation means consists of structures by an elastic body, The surgical observation system of Additional remark 5 characterized by the above-mentioned.

  (Supplementary note 14) The surgical observation system according to supplementary note 5, wherein the coupling means is movable and controllable by an operator from a grasping portion of an ultrasonic probe.

  (Supplementary Note 15) The surgical observation according to Supplementary Note 5, wherein the coupling unit includes a coupling unit angle detection unit and a coupling unit angle display unit that measure and display an angular displacement amount of the coupling unit. system.

The perspective view which shows the relationship between the microscope body of the surgical microscope of the surgical observation system which concerns on this invention, and an ultrasonic probe. 1 is a block diagram showing a schematic configuration of a surgical observation system according to the present invention. The block diagram which shows the structure regarding the ultrasonic image of 1st embodiment of the surgical observation system which concerns on this invention. The block diagram which shows the structure regarding the ultrasonic image in 2nd embodiment of the surgical observation system which concerns on this invention. The top view which shows the observation image in 1st embodiment of the surgical observation system which concerns on this invention. The top view which shows the observation image in 2nd embodiment of the system for surgery which concerns on this invention. The flowchart explaining the effect | action of the ultrasonic observation apparatus in 1st embodiment of the surgical observation system which concerns on this invention. The top view which shows the 1st modification of the ultrasonic probe used for the surgical observation system which concerns on this invention. The top view which shows the 2nd modification of the ultrasonic probe used for the surgical observation system which concerns on this invention. The top view which shows the 1st modification using the monitor for superimposition display of the surgical observation system which concerns on this invention, the monitor for image display in a visual field, or the monitor for image display outside a visual field. The top view which shows the 2nd modification using the monitor for superimposition display, the monitor for image display in a visual field, or the monitor for image display outside a visual field of the surgical observation system which concerns on this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Surgical microscope 4 Microscope body 9 Ultrasonic observation apparatus 11 Mirror body control part 14 Interface unit 15 Navigation apparatus 20 Ultrasonic probe 25 Ultrasonic observation part 26 Image processing part 27 Image memory 28 Image coordinate calculation part 29 LCD driver 30 LCD monitor
Attorney Susumu Ito

Claims (3)

An observation means having an observation optical system for displaying an enlarged observation optical image of the surgical site;
Ultrasonic observation means that can be inserted and installed in the surgical site, and generates an ultrasonic image inside the tissue of the surgical site;
An index generating means for detecting an insertion and installation position of the ultrasonic observation means in the surgical site and generating an index indicating the insertion and installation position;
An image processing unit that correlates a positional relationship between the index generated by the index generation unit and the ultrasonic image generated by the ultrasonic observation unit to generate an indexed ultrasonic image;
Superimposition display means capable of superimposing and displaying at least a part of the observation optical image of the surgical site displayed on the observation optical system of the observation means the indexed ultrasonic image generated by the image processing means;
Surgical observation system characterized by comprising.   The image processing means includes a three-dimensional ultrasonic image indicating an index generated by the index generating means and an insertion position of the ultrasonic observation means into the surgical site from the ultrasonic image generated by the ultrasonic observation means. The surgical observation system according to claim 1, wherein the surgical observation system is generated.   The ultrasonic observation means includes an ultrasonic transducer built in, and is connected to a first housing means that can be inserted into the surgical site, a proximal end of the first housing means, and the other end connected to the grasping portion. 2. An ultrasonic probe comprising: rigid second housing means; and coupling means for movably coupling the first housing means and the second housing means. Surgical observation system.

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