JP2000312685A - Microscope system for operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a microscope system for operation capable of improving operation efficiency and reducing the burden of an operator by confirming a position to be observed in a part to be observed during the observation of a microscope for operation and improving operability for obtaining position information in a detected operating part space in the case of using a plurality of observing devices and treatment devices together. SOLUTION: This system is provided with a photographing device 34 for detecting the observation positions of a microscope 1 for operation and a hard mirror 21 and a position operating device 35 for merging the observation positions of the microscope 1 for operation and the hard mirror 21 and the image information of the observed part, detecting the change of the observation position on the basis of the detected result of the photographing device 34, selectively processing the observation position information in the observation parts of the microscope 1 for operation and the hard mirror 21 and displaying the result on a monitor 41.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical microscope apparatus for performing microscopic observation of a surgical site in a surgical operation.

[0002]

2. Description of the Related Art In general, the use of not only an operating microscope but also endoscopic observation in a surgical operation is increasing at present. In this case, there is a problem how to enable the operator to detect the position of the surgical microscope, endoscope, and other instruments in the operation space and provide information.

Conventionally, in a so-called optical observation position detection system, a plurality of index light emitting means (hereinafter, referred to as LEDs) for projecting an infrared index on an observation means such as a surgical microscope or a rigid endoscope are attached, and infrared light is emitted by each LED. Is received by a TV camera or the like to measure its three-dimensional spatial coordinates.

[0004] Further, there are the following (1) to (4) as conventional techniques of a surgical microscope apparatus for performing microscopic observation of a surgical site in a surgical operation. (1) Japanese Patent Application Laid-Open No. 8-38506: Microscope for surgery, (2) WO95 / 07055
No .: Microscope for surgery, (3) JP-A-5-305073
Patent Document: Position detection device for insertion tool, (4) Japanese Patent Application No. 10-2
No. 48672: image information observation with a surgical microscope.

[0005] (1) and (2) describe "observation position detection" in an operating microscope. Here, the correlation between the operating microscope and the operating space (operating space constructed from preoperative diagnostic image information) is correlated to detect the microscope observation position at the surgical site.

[0006] Similarly, in (3), endoscopic observation at a surgical site and position detection of a treatment tool are performed.
In (4), in (1) and (2) above, there is shown an apparatus for detecting a change in the observation position and observing the image information of the detected position in the visual field of the microscope.

As described above, detection of the observation position of the surgical microscope,
Detection of the observation position of the endoscope and detection of the position of the treatment tool are performed by various methods. However, these are performed individually to the last, and each piece of information is individually displayed in the operation space.

During an actual surgical operation, an operator selects a surgical microscope to be used, an observation device of an endoscope, and a treatment tool, performs the position detection, and obtains position information. I have to. Here, usually, in a position detection system, position detection is performed in response to an operation input, and calculation and display of a spatial position are performed.

[0009]

In the above-mentioned conventional configuration, when the endoscope observation is used together with the operation microscope observation, either the observation position of the operation microscope or the observation position of the endoscope is used. Whether the observation position should be detected or the operator needs to make settings in accordance with the operation situation. In this case, since the observation position of the endoscope is adjusted while observing the surgical microscope, it is very troublesome to switch the setting of the observation device to be detected at each position. For this reason, there is a problem that the operability of the operation of obtaining the position information in the detected operation space is low, and the operation efficiency is reduced.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances. It is an object of the present invention to enable a user to confirm an observation position at an observation site while observing a surgical microscope and to use a plurality of observation devices and treatments. When using the device together, improve the operability to obtain the position information in the detected operative space,
It is an object of the present invention to provide a surgical microscope apparatus capable of improving the operation efficiency and reducing the burden on the operator.

[0011]

SUMMARY OF THE INVENTION The present invention provides a first observation means constituted by an operating microscope having a stereo microscope and a second observation for obtaining an observation image different from the observation image of the first observation means. An operating position detecting means for detecting an observing position of the first and second observing means in a surgical microscope apparatus comprising means and display means for displaying observation images of the first and second observing means; The observation position detection means performs integration processing of the observation positions in the first and second observation means and the image information of the observation site, and performs the first and second observations based on the detection results of the observation position detection means. The change of the observation position of the observation means of
Display position adjusting means for selectively processing the observation position information at the observation site of the first and second observation means according to the detection result and displaying the observation image on the display means. It is a surgical microscope apparatus. When performing surgery using the first observation means of the surgical microscope and the second observation device such as an endoscope, the operation of changing the observation site of the first observation means and the second observation device is performed. When performing both, the position of the observation device selected (changed) by the operation of changing the observation position is detected by the observation position detection means, and based on the detection result, the position of the observation unit is compared with the image of the surgical site by the display position adjustment means. The integration process is performed so that the observation position is detected and displayed.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of the entire system of the surgical microscope apparatus according to the present embodiment. The operating microscope apparatus according to the present embodiment includes an operating microscope (first observation unit) 1 having a stereoscopic microscope,
A rigid microscope 21 as a second observation means for obtaining an observation image different from the observation image of the surgical microscope 1, and a display monitor (display means) for displaying the observation images of the surgical microscope 1 and the rigid mirror 21 41 are provided.

The operating microscope 1 is provided with a gantry 2, a balance arm 3 disposed above the gantry 2, and a microscope body 4 supported by the balance arm 3.

Here, the balance arm 3 is provided with a plurality of movable arms and six rotating shafts 5a to 5f. Further, a balance arm 3 is provided on each of the rotating shafts 5a to 5f.
An electromagnetic lock (not shown) is provided for switching between a locked state in which the movable arm is rotated and a unlocked state in which the locked position is unlocked. The microscope body 4 is supported so as to be spatially movable about the six rotating shafts 5a to 5f of the movable arms of the balance arm 3 with the switching operation of locking / unlocking the electromagnetic lock. I have.

The microscope body 4 incorporates an objective optical system (not shown), a variable power optical system, and an eyepiece optical system, each of which has a pair of left and right optical paths. Here, the objective optical system is provided with a focus variable mechanism and a focal length detection sensor (not shown). Further, the zoom optical system is provided with a zoom mechanism and a magnification detection sensor (not shown).

The mirror body 4 is provided with a sensor arm 6 and a grip 7 for operating the position of the mirror body 4 as shown in FIG. The grip 7 is provided with operation switches (not shown) for focus adjustment, zooming operation, and arm operation.

Further, as shown in FIG.
Above, a plurality of LEDs 8a, 8b, 8c are provided as index light emitting means for emitting an index made of, for example, infrared light. Here, as shown in FIG. 3, the sensor arm 6 has a plurality of recesses 6a for mounting LEDs.
Each LED 8a, 8 is provided on the inner bottom of the recess 6a.
b, 8c are provided respectively.

Further, an adhesive member 9 as a drape fixing means made of an adhesive material, for example, silicone rubber, is provided on the outer peripheral portion of each concave portion 6a of the sensor arm 6.
a, 9b, 9c are pasted. And mirror 4
When the drape 10 as a sterilization cover is attached to the sensor arm 6, the adhesive member 9 on the outer peripheral portion of each recess 6a of the sensor arm 6
The drape 10 is stuck to a, 9b, 9c and fixed.

The operating microscope 1 has a mirror control unit 11.
And an arm control unit 12. 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 and zooming operation as well as switches for the grip 7 is also connected to the mirror controller 11 and the arm controller 12.

The lens body control section 11 is composed of drive control circuits for variable focus and variable power (not shown), and a circuit for calculating the focal length and magnification. Here, the focal length / magnification calculation circuit of the lens body control unit 11 is connected to each of a focal length detection sensor and a magnification detection sensor. Further, the lens body control unit 11 has a calculation unit including a focal length detection sensor and a magnification detection sensor.

Further, the arm control section 12 comprises a drive control circuit. The arm control unit 12 includes a balance arm 3
The electromagnetic locks provided on each of the rotating shafts 5a to 5f are connected. The lens body control unit 11 and the arm control unit 12 together with a power supply unit and a light source unit (not shown) constitute an electric system incorporated in the balance arm 3.

The rigid endoscope 21 is supported by a scope holder 22 mounted on an operating table (not shown).
The scope holder 22 is composed of an articulated arm having a plurality of movable arms 23, and joints between the movable arms 23 are rotatably connected to each other. The rigid endoscope 21 is movably supported and fixed by the scope holder 22.

Further, each rotating portion of the scope holder 22 is switched between a locked state in which the rotating position of each movable arm 23 of the scope holder 22 is fixed and an unlocked state in which the rotating position is unlocked. An electromagnetic lock is provided. The rigid endoscope 21 is movably supported by the operation of switching the lock / unlock of the electromagnetic lock of the scope holder 22.

The electromagnetic locks of the rotating parts are connected to a scope holder drive control unit 24, respectively. Further, a switch 22A for operating the electromagnetic lock is provided at the tip of the scope holder 22. This switch 22A is connected to the scope holder drive control unit 24.

The rigid endoscope 21 of the present embodiment has a TV set.
A camera 25 and a rigid-scope sensor arm 26 are mounted. The sensor arm 26 for the rigid endoscope is provided with a substantially V-shaped arm main body 27 as shown in FIG.
As shown in FIG. 5, a plurality of substantially circular protrusions 28a, 28b, 28c are provided on the surface of the arm body 27. As shown in FIG.

Further, each of the projections 28a, 28b, 28c
As shown in FIG. 5, a plurality of recesses 29 for mounting LEDs are formed in the center of the. And, this concave portion 29
LEDs 30a, 30b, 30c are attached to the inner bottom of the.

A sterilizable cap 31 constituting a drape fixing member is detachably engaged with the outer peripheral surface of each of the projections 28a, 28b, 28c. A hole 32 is provided in the center of the sterilization cap 31. Then, the drape 3 which is a sterilization cover is attached to the rigid endoscope 21.
When the drape 3 is attached, the sterilization cap 31 is engaged with the outer peripheral surfaces of the projections 28a, 28b, 28c in a state where the drape 33 is put on the sensor arm 26 for the rigid endoscope as shown in FIG. 33 is fixed to the sensor arm 26 for the rigid endoscope.

Further, the surgical microscope apparatus according to the present embodiment is provided with a photographing device (observation position detecting means) 34 for detecting the observation position of the surgical microscope 1 and the rigid endoscope 21. The photographing device 34 includes a light-emitting index of the LEDs 8a, 8b, and 8c of the sensor arm 6 in the mirror body 4 of the operating microscope 1 and an LED 30 of the sensor arm 26 in the rigid mirror 21.
The observation positions of the surgical microscope 1 and the rigid endoscope 21 are detected by detecting the light emission indices a, 30b, and 30c.

The photographing device 34 is connected to a position calculating device (display position adjusting means) 35. The position calculation device 35 has a built-in memory device for a diagnostic image, and also has a correlation processing unit with the diagnostic image. Further, a display monitor 41 and an interface unit 36 are connected to the position calculating device 35. And the photographing device 3
4 is input to the position calculation device 35, and the position calculation device 35 calculates a correlation with a reference index provided on the patient's head (not shown).

The interface unit 36 is connected to the mirror controller 11, the arm controller 12, and the scope holder drive controller 24. And
A data signal from the lens body control unit 11, an arm control unit 12,
An operation signal from the scope holder drive control unit 24 is input to the interface unit 36. It should be noted that each of the interface units 36 has a data memory corresponding to an operation signal, and in this data memory, corresponding device information is set in advance as sensor arm information.

Next, the operation of the above configuration will be described.
When using the surgical microscope apparatus of the present embodiment, the surgeon performs a treatment while stereoscopically observing the operation site using the stereoscopic optical system of the microscope body 4 of the surgical microscope 1.

When the switch for unlocking the electromagnetic lock provided on the grip 7 of the mirror body 4 is turned on, when the operation signal is input to the arm control unit 12, it is provided on each of the rotating parts of the balance arm 3. The locked electromagnetic lock is released. Therefore, the operation of changing the position of the mirror body 4 supported by the balance arm 3 becomes possible.

In this state, when an operation of changing the observation position of the lens body 4 is performed, the selection notification of the sensor arm 6 output from the arm control section 12 and the mirror output from the lens body control section 11 are performed. The focal length information of the body 4 is transmitted to the position calculation device 35 via the interface unit 36.

At this time, the LED 8a of the sensor arm 6,
8 b and 8 c are detected by the photographing device 34. And
Correlation calculation with a reference index provided on the head is performed by the position calculation device 35 based on the information of the interface unit 36. As a result, a correlation process with a three-dimensional image space based on a preoperative diagnostic image photographed in advance together with the index is performed and displayed on the monitor 41. From the image information on the monitor 41, the surgeon can obtain information on the current observation position of the microscope 1 in the operative part space of the head.

In this microscopic operation, observation of the blind spot, for example, the back side of the blood vessel and the side view direction, may be performed using the rigid endoscope 21 in the microscopic observation. In this case, the adjustment of the observation position of the rigid endoscope 21 is performed under microscope observation.

When using the rigid endoscope 21, the switch 22 at the tip of the scope holder 22 is checked while checking the observation image of the microscope 1 and the image of the endoscope 21 from the TV camera 25.
When A is turned on, the electromagnetic lock provided on each rotating portion of the scope holder 22 is released. Therefore, the operation of changing the position of the rigid endoscope 21 supported by the scope holder 22 becomes possible.

In this state, if the operation of changing the position of the rigid endoscope 21 is performed, an operation signal from the scope holder control unit 24 in accordance with the operation of the scope holder 22 is transmitted via the interface unit 36 to the position calculation unit 35. Sent to At this time, information on the length, observation direction, and focal length of the rigid endoscope 21 set as sensor arm information of the rigid endoscope sensor arm 26 is transmitted. The surgical microscope 1 is also used for observation of the rigid endoscope 21.
As in the case of the observation, the observation position of the rigid endoscope 21 is displayed on the monitor 41 in a correlated manner with the three-dimensional surgical site, and the operator can obtain image information of the observation position of the rigid endoscope 21.

In general, prior to the operation, the operator covers the surgical microscope 1 and the rigid endoscope 21 with drapes 10 and 33, which are sterilization covers, in order to maintain a sterilized state at the operation site. Here, at the time of putting the drape 10 on the mirror 4 of the operating microscope 1, the operator pulls the drape 10 up and down and left and right in the vicinity of the sensor arm 6 so that the drape 10 does not wrinkle. Put on. At this time, the adhesive member 9 provided on the outer surface of the sensor arm 6
a, 9b, and 9c are pasted with the drape 10. As a result, the drape 10 is securely fixed to the mirror body 4 side by the adhesive members 9a, 9b, 9c in a state where the drape 10 is pulled substantially smoothly, so that the drape 10 is wrinkled on the surface facing the LEDs 8a, 8b, 8c. Can be prevented.

Further, the gripping portion of the rigid endoscope 21 (TV camera 2)
In order to sterilize the drape 33 on the rigid endoscope 21 for the purpose of sterilizing the mounting portion 5), the surgeon similarly operates the drape 33.
The drape 33 is put on the rigid endoscope 21 while pulling up and down and right and left without wrinkling. Here, the sterilized cap 31 which has been sterilized in advance is fitted into the projections 28a, 28b, 28c of the rigid endoscope sensor arm 26, respectively. At this time, the drape 33 is pulled up, down, left and right between the inner peripheral surface of the sterilization cap 31 and the outer peripheral surfaces of the protrusions 28a, 28b, 28c. Therefore, at the position of the hole 32 of the sterilization cap 31, the drape 33 is securely fixed to the sensor arm 26 without wrinkling.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the operator simply performs the operation of changing the observation position of the surgical microscope 1 or the rigid endoscope 21 (scope holder 22), and the changed observation position of the observation device is detected by the imaging device 34. The display on the display monitor 41 is automatically performed. Therefore, by simply setting the information of the observation device according to the sensor arm 6 attached to the observation device in advance, during observation of the surgical microscope 1,
The latest information can always be displayed on the display monitor 41 without specially setting the observation position of the observation device. Alternatively, the position of the rigid endoscope 21 can be easily confirmed. As a result, when using the rigid endoscope 21 while observing the surgical microscope 1, the operability of obtaining the position information in the detected operation space is improved, the operation efficiency is improved, and the burden on the operator is reduced. Can be.

In this embodiment, the starting point is the operation of the support device of the observation device (the microscope 1, the rigid endoscope 21). As a modified example, the rigid endoscope 21 alone or the ultrasonic image diagnostic device is used. If a switch is provided, it is also possible to provide a switch on the grip portion and perform the position detection and display processing by operating the switch.

Further, in this embodiment, when the drape 10 is put on the mirror body 4 of the operating microscope 1, the adhesive member 9 of the sensor arm 6 is pulled while pulling the drape 10 up and down and right and left.
With simple operations such as sticking to the drapes 10a, 9b and 9c, wrinkles of the drape 10 on the sensor arm 6 at positions facing the LEDs 8a, 8b and 8c can be reliably prevented.
0 can prevent the irregular reflection of infrared light.

Further, when the drape 33 is fixed to the rigid mirror sensor arm 26, the sterilization cap 3 which can be attached to the rigid mirror sensor arm 26 from outside the drape 33 is used.
Since 1 is used, the surgeon can easily put the drape 33 on the rigid endoscope 21 as usual without paying extra attention when putting the drape 33 on the rigid endoscope 21. Further, the sterilization cap 31 is connected to the LED of the sensor arm 26.
Projection 28 to which 30a, 30b, 30c is attached
a, 28b, 28c
The drape 33 at the position facing the EDs 30a, 30b, and 30c can be prevented from wrinkling, and irregular reflection of infrared light by the drape 33 can be reliably prevented.

As an alternative to the sterilization cap 31,
For example, a similar effect can be obtained as long as the drape 33 can be securely fixed to the sensor arm 26 from above the drape 33 such as a magnet member or a push pin member.

Furthermore, the method of fixing the drape 10 to the sensor arm 6 of the mirror body 4 of the surgical microscope 1 and the method of fixing the drape 33 to the sensor arm 26 for the rigid endoscope are performed in reverse configurations. It goes without saying that a similar effect can be obtained.

FIGS. 6 to 9A to 9C show a second embodiment of the present invention. According to the present embodiment, desired position image information relating to a surgical site can be observed in the microscope observation field of the operating microscope 1 with respect to the system of the operating microscope apparatus according to the first embodiment, and dissection can be performed more effectively. It is configured to use in combination with an in-field observation device that can obtain biological information.

That is, in this embodiment, the binocular tube 51 shown in FIG. 6 is combined with the microscope body 4 of the operating microscope 1 of the operating microscope apparatus of the first embodiment. The binocular tube 51 has left and right observation optical paths for stereoscopic observation. An objective lens (not shown) and a variable power optical system (not shown) are provided on the left and right observation optical paths of the binocular tube 51, respectively.

FIG. 6 shows a schematic configuration of the binocular tube 51 in the operating microscope 1 according to the present embodiment. The binocular tube 51 includes a right-eye observation optical system 51A shown in FIG.
A left-eye observation optical system (not shown) is provided.
FIG. 6 shows the configuration of the right-eye observation optical system 51A viewed from the side of the binocular tube 51. This binocular tube 5
The left-eye observation optical system 1 is a right-eye observation optical system 5 shown in FIG.
The configuration is the same as 1A, and the description thereof is omitted here.

Further, the observation optical system 5 for the right eye according to the present embodiment.
1A, a binocular tube optical system 52 for guiding an observation image of the surgical microscope 1 and an image projection optical system 53 for observing arbitrary image information different from the observation image are provided. Here, the binocular tube optical system 52 includes an imaging optical system 54, an image rotator 55, a parallelogram prism 56, and an eyepiece optical system 57.
Are provided. Then, the observation image of the surgical microscope incident on the binocular tube optical system 52 is transmitted from the imaging optical system 54,
Image rotator 55 and parallelogram prism 56
Are sequentially guided to the eyepiece optical system 57.

The image projection optical system 53 includes a binocular tube 51.
Fixed part 58 which is immovable with respect to the interpupillary distance adjustment, and the binocular tube 51
And a moving unit 59 that moves integrally with the eyepiece image plane that moves with the eye width adjustment. Here, the fixed portion 58 has an LCD display 60 as an in-view display function.
, A mirror 61, a collimating optical system 62, and a prism 63. Further, the moving section 59 includes a fixed prism 64, an imaging optical system 65, and a movable prism 66.
It is composed of The movable prism 66 is provided so as to be freely inserted and removed on the optical path by a motor of a moving mechanism (not shown). The arbitrary image information displayed on the LCD display 60 is transmitted to the mirror 61 and the collimating optical system 6.
2, prism 63, fixed prism 64, imaging optical system 6
5. Light is guided to the eyepiece optical system 57 via the movable prism 66 in order.

Further, the eyepiece optical system 57 can simultaneously observe the observation image of the surgical microscope 1 sent via the binocular tube optical system 52 and arbitrary image information sent via the image projection optical system 53. It has become.

The grip 7 (see FIG. 1) of the surgical microscope 1 is provided with an in-field display operation switch 67. This switch 67 is connected to an operation input circuit section 68 composed of a logic circuit.

An interface unit 69 similar to the interface unit 36 of the first embodiment, an in-view display controller 70, and an image selector 71 as image signal selection means are further connected to the operation input circuit 68. Have been. Here, the in-field display controller 70 is a movable prism 6 built in the binocular tube 51.
6, a drive control circuit of a motor (not shown) for controlling the insertion and removal of the motor, and a display control circuit of the LCD display 60. Output signals from the switch 67 and the interface unit 69 are input to the operation input circuit section 68, and selection operation signals output from the operation input circuit section 68 are input to the in-view display controller 70 and the image selector 71, respectively. It is supposed to be.

The image selector 71 is connected to the position calculating device 35 and the TV camera 25 for a rigid endoscope. The image selector 71 includes the position calculation device 35.
Detection display image signal output from TV and TV for rigid endoscope
An image signal output from the camera 25 is input. Further, the image signal selected by the image selector 71 is sent to the display controller 70 in the visual field.

FIG. 7 shows a state in which a drape 72 as a sterilizing cover is put on the mirror body 4 of the operating microscope 1 according to the present embodiment. Here, a plurality of ring-shaped double-sided tapes 7 as drape fixing means are provided on the inner surface of the drape 72.
3a to 73c are provided. Here, each of the double-sided tapes 73a to 73c is attached to the LE provided on the sensor arm 6.
D8a, 8b, 8c are arranged at positions facing each other.

When the drape 72 is mounted on the mirror body 4, as shown in FIG.
The double-sided tapes 73a to 73c on the inner surface of the drape 72 are attached and fixed to the outer peripheral portion of the concave portion 6a for mounting the EDs 8a, 8b, 8c.

Next, the operation of the above configuration will be described.
In the present embodiment, at the time of surgery, the operating part is stereoscopically observed by the binocular tube optical system 52 of the binocular tube 51 of the operating microscope 1. At this time, since the prism 66 of the image projection optical system 53 is held in a state of being moved to the retracted position retracted from the optical path of the binocular tube optical system 52, the optical observation of the surgical site is performed by looking through the eyepiece optical system 57. Only the image is observed.

When the surgeon obtains diagnostic image information of the operative site within the microscope observation field of view during the operation, the grip 7 (see FIG. 1) of the surgical microscope 1 is used for display operation within the field of view. The switch 67 is turned on. The operation of the switch 67 is detected by the operation input circuit section 68.

At this time, the selection operation signal output from the operation input circuit 68 is input to the in-view display controller 70 and the image selector 71, respectively. The display controller 70 in the visual field receives an operation signal from the operation input circuit 68, drives a drive motor (not shown) of the movable prism 66, and sets the movable prism 66 to the binocular tube optical system 5.
2 on the optical path. At this time, the control signal output from the display controller 70 in the visual field further controls the LC
Image display control of the D display 60 is performed.

The display image on the LCD display 60 is sent to the eyepiece optical system 57 via the image projection optical system 53. As a result, the display image of the LCD display 60 is displayed in an overlapping state within the microscope optical observation field of view by the eyepiece optical system 57. Therefore, by looking through the eyepiece optical system 57, the microscope optical observation image of the surgical site and the LCD display 60 are displayed. And the display image 35 can be observed at the same time. At this time, as shown in the first embodiment, observation position information by the position calculation device 35 in microscope observation and an image of the rigid endoscope TV camera 25 can be observed.

In particular, when the operation of the balance arm 3 is performed by the grip 7 at the time of observation with the surgical microscope, the lock of each rotating portion of the balance arm 3 is released and the balance arm 3 becomes free. At this time, the operation signal of the balance arm 3 is sent from the interface unit 69 to the position calculating device 35, and the position calculating process is performed as in the first embodiment. Then, the observation position is displayed as image information on the monitor 41 as surgical site space information.

At this time, the interface unit 69
Is also transmitted to the operation input circuit 68 in the same manner. The operation input circuit 68 receives the signal and sends an operation signal to the image selector 71 and the display controller 70 in the visual field. Here, in the image selector 71,
The image information of the observation position from the position calculation device 35 is selected. Then, the in-view display controller 70 drives the movable prism 66 and displays the image signal from the image selector 71 on the LCD display 60. As a result, the surgeon obtains an observation image as shown in FIG.
Here, microscope observation position display image information 75 is inserted in the microscope observation optical image 74.

While the operator continues the operation of changing the observation position, the operation signal is continued from the interface unit 69 so that the above control is continued. At this time, when the microscope observation site is determined and blind spot observation is performed using the rigid endoscope 21, the switch 22A at the distal end of the scope holder 22 is used.
Will be turned on.

Here, when determining the observation site of the rigid endoscope 21 under the observation of the microscope 1, information of the rigid endoscope 21 is transmitted from the interface unit 69 to the position calculating device 35. Then, the observation site and direction information of the rigid endoscope 21 are displayed on the monitor 41 as image information, and further transmitted to the image selector 71. At this time, an observation image shown in FIG. 9B is obtained. Here, the observation position detection image information 76 of the rigid endoscope 21 is displayed and observed in the microscope observation optical image 74.

In the operation input circuit 68, similarly,
The observation site information of the rigid endoscope 21 is displayed in the visual field of the microscope 1. At this time, the surgeon uses the rigid microscope 2
The operation is performed while observing the image information 76 such as the perspective direction in the visual field by the position calculation device 35 while directly viewing the front end of the device 1.

Thereafter, when the switch 22A at the tip of the scope holder 22 is turned off, the scope holder 2
2 while the rotational position of each movable arm 23 is fixed, and the image display of the rigid endoscope TV camera 25 is performed. At this time, an observation image shown in FIG. 9C is obtained. here,
In the microscope observation optical image 74, a rigid endoscope image 77 is displayed and observed. During the operation of changing the position of the rigid endoscope 21, it is also possible to switch to the rigid endoscope image 77 for observation.

In addition, as in the first embodiment, the surgeon drapes 7 for the purpose of sterilizing the body 4 of the operating microscope 1.
2 is put on the mirror body 4. At the time of putting the drape 72 on the mirror body 4, the operator first peels off the release paper (not shown) of the double-sided tapes 73a to 73c attached to the inner surface of the drape 72.

Next, the drape 72 is put on the mirror body 4 while taking care that the double-sided tapes 73a to 73c do not adhere to the inner surface of the drape 72, and the double-sided tape 73a is attached near the sensor arm 6 for mounting the LED 8a. Recess 6
a. Similarly, other double-sided tape 73
b and 73c are attached to the outer periphery of the recess 6a for mounting the LEDs 8b and 8c.

As a result, the drape 72 is fixed to the mirror body 4 while being attached to the sensor arm 6 by the double-sided tapes 73a, 73b, 73c.
It is possible to prevent the drape 72 from being wrinkled on the surface facing the a, 8b, 8c.

Therefore, the above configuration has the following effects. That is, in the present embodiment, during the operation of changing the observation site with the surgical microscope 1 and further with the rigid endoscope 21,
Position information at the operation site is continuously obtained within the visual field of the microscope 1. Therefore, the operator can check the microscope observation position display image information 75 in the microscope observation optical image 74 as needed, so that an anatomical orientation can be easily obtained, which leads to a reliable operation.

In addition, the position information can be automatically obtained according to the observation device that changes the observation region, and the rigid endoscope 2 can be used.
In the case of 1, the switch 22 at the tip of the scope holder 22
After the fixation by the OFF operation of A, the image is switched to a state in which the rigid endoscope image 77 is displayed in the microscope observation optical image 74 as shown in FIG. You can focus on the treatment.

Further, when the rigid endoscope 21 is used, the operator is presented with a position of the oblique direction which is difficult for the surgeon to understand, and then switches to the TV image, so that the surgeon can easily obtain the anatomical orientation. Observation and operation of the rigid endoscope 21 are facilitated.

Further, a double-sided tape 7 is provided on the inner surface of the drape 72.
3a, 73b, and 73c are provided, and each of the double-sided tapes 73a, 73
3b, 73c, the drape 72 is attached to the outer periphery of each LED 8a, 8b, 8c provided in the sensor arm 6, and the LED 8
Prevention of wrinkling of the drape 72 at a position facing a, 8b, 8c can be achieved. Therefore, the irregular reflection of the infrared light by the drape 72 can be prevented, so that the disposable drape 72 can be used, and a special configuration on the sensor arm 6 side is not required. Therefore, there is an effect that the conventional sensor arm 6 can cope with the problem.

Furthermore, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Additional Item 1) An operating microscope having a stereoscopic microscope as a first observation unit, and a second observation unit different from the observation image, and an observation position detection unit of the 1/2 observation unit. Image processing means for performing integration processing of the observation position and the image information of the observation site in the 1/2 observation means by the observation position detection means, and observation position variable detection means in the 1/2 observation means; Means for selectively processing and displaying observation position information on the observation site in accordance with the detection.

(Additional Item 2) An operating microscope having a stereo microscope, an observation position detecting means for detecting an observation position of the operating microscope, an index light emitting means for emitting an index to the observation position detecting means, An operation microscope apparatus comprising: a sterilization cover attachable to the operation microscope; and fixing means for preventing relative movement of the indicator light emitting means and the sterilization cover.

(Additional Item 3) An operating microscope having a stereoscopic microscope as first observation means and a second observation means different from the observation image are provided, and the stereoscopic microscope includes a microscope observation image and an arbitrary image. Has a mirror that can observe information at the same time,
An observation position detection unit of the ２ observation unit, an image processing unit for integrating the observation position and the image information of the observation site in the 観 察 observation unit by the observation position detection unit, And a means for selectively processing observation position information on an observation site in accordance with the detection, and displaying and observing the information on a microscope body according to the detection. Surgical microscope equipment. : Described in the second embodiment (Additional Item 4) An operating microscope having a stereoscopic microscope as first observation means and a second observation means different from the observation image are provided, and the stereoscopic microscope is provided with a microscope A mirror capable of simultaneously observing an observation image and arbitrary image information;
An observation position detection means of the observation means, an image processing means for integrating the observation position and the image information of the observation site in the half observation means by the observation position detection means, and the half observation Observation position variable detection means in the means, according to the detection, selectively processing the observation position information on the observation site, means for displaying and observing on the microscope body, and the observation position information on the observation site during the detection period Means for selectively processing and displaying and observing on a microscope body. : Described in the second embodiment (Supplementary note 5) An operating microscope having a stereoscopic microscope, and the stereoscopic microscope has a mirror body capable of simultaneously observing a microscope observation image and arbitrary image information. Observation position detecting means in the, the image processing means for integrating the observation position and the image information of the observation site by the observation position detection means,
Observation position variable detection means, according to the detection, selectively process the observation position information at the observation site, and display and observe with the microscope body, and selectively use the observation position information at the observation site during the detection period. And means for continuing to display and observe with a microscope body. : Described in the first embodiment (Additional Item 6) The surgical microscope apparatus according to Additional Item 5, wherein the observation position variable detection means detects a movement operation of an observation device. : Described in the first embodiment (Appendix 7) Observation means for observing an operation part, observation position detection means for detecting an observation position of the observation means, and an index for the observation position detection means Indicator light emitting means for emitting light, a sterilization cover attachable to the observation means, fixing means for preventing relative movement of the indicator light emitting means and the sterilization cover,
A surgical microscope apparatus comprising: : Description of the first embodiment (Appendix 8) The surgical microscope apparatus according to Appendix 7, wherein the fixing means is formed of a suction member. : Described in the first embodiment (Appendix 9) The surgical microscope apparatus according to Appendix 7, wherein the fixing means comprises a sterilizable cap. : Description of the first embodiment (Appendix 10) The surgical microscope apparatus according to Appendix 7, wherein the fixing means is made of a double-sided tape. : Second
(Additional Item 11) The surgical microscope apparatus according to additional item 7, wherein a fixing means is provided on the sterilization cover. The present invention relates to a surgical microscope apparatus capable of confirming an observation position at an observation site during a surgical microscope observation. Conventional technology (1)
JP-A-8-38506: A surgical microscope apparatus,
(2) WO95 / 07055: surgical microscope device,
(3) Japanese Patent Application Laid-Open No. Hei 5-305073: Position detecting device for insertion tool, and (4) Japanese Patent Application No. Hei 10-248672: Observation of image information using a surgical microscope.

(1) and (2) describe "detection of observation position" in an operating microscope. The correlation between the operating microscope and the operating space (operating space constructed from preoperative diagnostic image information) is correlated to detect the microscope observation position at the surgical site.

(3) Similarly, endoscope observation and position detection of the treatment tool are performed.

(4) An apparatus for detecting a change in the observation position in the above (1) and (2) and observing the image information of the detected position in a microscope visual field.

At present, not only an operating microscope but also an endoscope observation is increasingly used in an operation.
In this case, it is an issue how to enable the operator to detect the position of the surgical microscope, endoscope, and other instruments in the operative space and provide information.

Detection of the observation position of the surgical microscope, detection of the observation position of the endoscope, and detection of the position of the treatment tool are performed. However, these are performed individually to the last, and each piece of information is individually displayed in the operation space.

In addition, the surgeon selects an operating microscope, an endoscope observation device, and a treatment tool to be used, and performs the position detection to obtain position information.

(Problem to be Solved by Additional Item 1) Normally, in a position detection system, position detection is performed according to an operation input, and spatial position calculation and display are performed. When endoscopic observation is used together with surgical microscope observation, the operator must set which observation position should be detected in accordance with the operation situation. In this case, since the endoscope observation position is adjusted during the operation microscope observation, it is extremely troublesome to set an observation device to be position-detected one by one.

(Purpose of Supplementary Item 1) When a plurality of observation devices and further a treatment device are used together, the operability of obtaining positional information in the detected operative space is improved, the operation efficiency is improved, and the burden on the operator is increased. It is intended for reduction.

(Means for Solving the Problem in Additional Item 1)
An operation microscope having a stereoscopic microscope as a first observation unit, and a second observation unit different from the observation image,
An observation position detection unit of the ２ observation unit, an image processing unit for integrating the observation position and the image information of the observation site in the 観 察 observation unit by the observation position detection unit, A surgical microscope apparatus comprising: an observation position variable detection unit in a half observation unit; and a unit configured to selectively process and display observation position information on an observation site in accordance with the detection.

(Operation of Supplementary Item 1) When the surgeon performs an operation using a surgical microscope or a second observation device such as an endoscope, the operation of changing the observation site is performed using the operation microscope or the endoscope. Perform with mirror. Detecting the observation position change operation, detecting the position of the selected (changed) observation device,
Based on the detection result, integration processing with the image of the operative site is performed, and the observation position is detected and displayed.

(Effect of Supplementary Item 1) According to the present invention, when a plurality of observation means are used, image integration and position detection at an operation site are performed only by performing observation position changing operations. . Therefore, while the operator concentrates on observation and treatment, the operator can always obtain the latest position information and can be free from troublesome work such as selecting an observation device. Since the burden on the device of the surgeon can be reduced, the operator can concentrate on the original operation, and reliable information can be obtained.

(Prior Art of Supplementary Item 2) (5) There is a German Patent No. 19640993. 2. Description of the Related Art Conventionally, in a so-called optical observation position detection system, a plurality of observation means such as a surgical microscope and a rigid microscope are attached to a plurality of observation means, and infrared light is received by an index light emitting means (hereinafter referred to as an LED) for projecting an infrared index by a TV camera or the like. By doing so, the three-dimensional space coordinates are measured. Further, the surgical microscope or rigid endoscope is used by being entirely covered with a sterile cover called a drape for the purpose of maintaining a sterilized state at the operation site. However, for example, the drape covered on the mirror body of the surgical microscope is wrinkled on the surface due to its properties such as vinyl, and the wrinkles cause the infrared light emitted from the LED to undergo irregular reflection, and the three-dimensional measurement described above. It had an adverse effect as an error.

In order to solve this problem, in (1), a portion where the LED is to be mounted is a sterilizable sensor arm,
A method is disclosed in which the drape can be attached to the mirror body of the surgical microscope previously covered with the drape from outside. In this method, a cable provided on the sensor arm for supplying power to the LED or controlling the light emission pattern is wired inside the mirror body, and only the electrical contacts connected to the cable are connected to the mirror body. It is exposed on the outer periphery. On the other hand, an electric contact connected to the LED is disposed on the sensor arm at a position corresponding to the electric contact of the mirror body, and the sensor arm is attached to the mirror body so that the electric contact is a drape. It is configured to break the opposing portion and to be electrically connected to the electric contact provided on the mirror body.

(Problem to be Solved by Additional Item 2) The drape, which is a sterile cover, is replaced every time surgery is performed. For this reason, according to German Patent No. 19640993, it is necessary to attach and detach the sensor arm from the mirror body for each operation. In such a case, the electric contacts are also attached and detached in accordance with attachment and detachment of the sensor arm to and from the mirror body, so that the contacts are worn, and there is a possibility that contact failures may occur due to long-term use. .

For the purpose of preventing this contact failure, a method of connecting a cable to the sensor arm and sterilizing the entire cable is conceivable. In this case, however, the cable creeps around the outer periphery of the drape. There is a high possibility that the hand may be caught or the like, leading to disconnection or damage to the sensor arm. In addition, when the sensor arm is attached to the mirror body, the cable may be suddenly dropped on an unclean area such as the floor, and the sensor arm may be attached to the mirror body without notice and even the drape may be unclean.

As described above, in order to energize the electrical contact between the sensor arm and the mirror body, it is necessary to break a part of the drape. There is a problem that the mirror is exposed from the gap between the arm and the mirror, and a part of the mirror is exposed from the drape.

(Purpose of Supplementary Item 2) Observation can be performed without obscuring the drape of a plurality of observation means such as an operating microscope and a rigid endoscope, and without deteriorating the durability of the sensor arm to which the LED is attached. It is an object of the present invention to prevent irregular reflection due to drape of infrared light by an LED attached to the means, and to prevent occurrence of an error in three-dimensional spatial position measurement of the observation means by a position detection system.

(Means for Solving the Problem in Additional Item 2)
An operating microscope having a stereoscopic microscope, an observation position detecting means for detecting an observation position of the operating microscope, an index light emitting means for emitting an index to the observation position detecting means, and attachable to the operating microscope A surgical microscope apparatus comprising: a sterilizing cover; and fixing means for preventing relative movement of the indicator light emitting means and the sterilizing cover.

(Operation of Supplementary Item 2) When the operator puts the sterilizing cover on the operating microscope, the operator fixes the sterilizing cover around the indicator light emitting means provided on the operating microscope without wrinkling by fixing means. Is done.

(Effect of Additional Item 2) In addition, irregular reflection of the luminescence index due to wrinkles around the luminescence index of the sterilization cover (drape) which is put on the observation means for sterilization can be reliably prevented, and the observation position by the position calculation device can be prevented. Of the spatial coordinate detection accuracy can be prevented from deteriorating. However, since highly accurate and reliable information can be obtained as a position calculation device, it greatly contributes to improvement of surgery as a support device.

[0097]

According to the present invention, observation position detection means for detecting the observation positions of the first observation means and the second observation means, and the observation in the first and second observation means by the observation position detection means. Performing integration processing of the position and the image information of the observation site, detecting changes in the observation positions of the first and second observation units based on the detection result of the observation position detection unit;
A plurality of observation units are used because an observation image display position adjustment unit for selectively processing the observation position information of the observation sites of the first and second observation units in accordance with the detection results and displaying the observation image on the display unit is provided. At this time, the image integration and the position detection in the operation part are performed only by performing the operation of changing the observation position. Therefore, while the operator concentrates on observation and treatment, the operator can always obtain the latest position information and is free from troublesome work such as selecting an observation device. Since it is possible to concentrate on the operation and obtain reliable information, it is possible to improve the operation as a support device.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire system of a surgical microscope apparatus according to a first embodiment of the present invention.

FIG. 2 is a perspective view showing a main configuration of a sensor arm in the surgical microscope apparatus according to the first embodiment;

FIG. 3 is a cross-sectional view illustrating a state where the drape is mounted on the sensor arm in the surgical microscope apparatus according to the first embodiment;
-X-ray sectional view.

FIG. 4 is a perspective view showing a main configuration of a sensor arm for a rigid endoscope in the surgical microscope apparatus according to the first embodiment;

FIG. 5 is a sectional view taken along the line YY in FIG. 4 showing a state in which a sterilization cap of the sensor arm for the rigid endoscope is mounted in the surgical microscope apparatus according to the first embodiment;

FIG. 6 is a schematic configuration diagram illustrating a main part configuration of a surgical microscope apparatus according to a second embodiment of the present invention.

FIG. 7 is a perspective view of a main part showing a state where a drape is mounted on a sensor arm in the surgical microscope apparatus according to the second embodiment;

FIG. 8 is a sectional view taken along line ZZ of FIG. 7;

FIG. 9 is a view for explaining the observation field of view of the surgical microscope in the surgical microscope apparatus according to the second embodiment. FIG. 9 (A) shows a state in which microscope observation position display image information is inserted into a microscope observation optical image. (B) is a plan view showing a state where the observation position detection image information of the rigid endoscope is displayed on the microscope observation image, and (C) is a plan view showing a state where the rigid endoscope image is displayed on the microscope observation image. .

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Surgical microscope (1st observation means) 21 Rigid endoscope (2nd observation means) 34 Imaging device (observation position detection means) 35 Position calculation device (display position adjustment means) 41 Display monitor (display means)

Claims (1)

[Claims] A first observation unit configured by an operating microscope having a stereoscopic microscope; a second observation unit configured to obtain an observation image different from an observation image of the first observation unit; An operation microscope apparatus comprising: a display unit for displaying an observation image of a second observation unit; an observation position detection unit for detecting an observation position of the first and second observation units; Integrating the observation position in the first and second observation means with the image information of the observation site, and performing the integration of the observation position of the first and second observation means based on the detection result of the observation position detection means. A display position of an observation image which detects a change, selectively processes observation position information at observation sites of the first and second observation means according to the detection result, and displays the observation image on the display means. Surgical microscope apparatus characterized by comprising a settling unit.