JP2001046399A - Microscopic device for operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent the flawing of the tissue with the front end of an endoscope and to enable an operator to carry out safe and easy operation by computing the movable range of a stand arm in accordance with the three-dimensional images synthesized in accordance with the signal from a navigation device and the result of the measurement from an image measuring means and controlling the movement. SOLUTION: The three-dimensional observation image data of the real time observation part from a three-dimensional image data forming device 56 is inputted in addition to the three-dimensional image data synthesized with the data relating to the position of a oblique-viewing endoscope 2 from a position computing unit 58 and the diagnosis data signal before the operation of the patient from a pre-operation diagnosis data preservation device 60 to a variable range computing unit 62. The variable range computing unit 62 compares the data relating to the position of the oblique-viewing endoscope 2 and the three-dimensional image data of the observation part from the three-dimensional image data forming device 56 in real time. If there is a possibility that the front end of the oblique-viewing endoscope 2 comes into contact with the important tissue, a movement limit signal for limiting the movement of the arm is outputted to an arm drive controller 63 of the stand 3.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

The present invention relates to a surgical microscope apparatus.

[0002]

2. Description of the Related Art Conventionally, a surgical microscope apparatus is disclosed in, for example, JP-A-7-59723, JP-A-8-173449 and JP-A-8-511715. In addition, a conventional technique that is particularly characterized by a gantry arm of a surgical microscope apparatus is disclosed in JP-A-7-16239 and JP-A-9-182759.

[0003]

SUMMARY OF THE INVENTION Incidentally, Japanese Patent Application Laid-Open No.
In the technology disclosed in JP-A-59723, only the endoscope attachment portion is movable in response to a change in the observation position of the endoscope, but the microscope is supported in order to observe a deep surgical site. Both the arm and the endoscope must be operated simultaneously. Operating the two arms at the same time while looking through the microscope during the operation not only causes interruption of the operation but also requires a great deal of concentration, thereby causing fatigue of the operator.

Further, according to the technique disclosed in Japanese Patent Application Laid-Open No. 7-173449, it is not possible to introduce a diagnostic image into a surgical site that becomes a blind spot when observed with a surgical microscope. The information of the diagnostic image is useful for the operator only in the blind spot where the information on the operation is scarce, but cannot be applied by the technique disclosed in this publication. Further, according to the technique disclosed in this publication, since a surgical route is constructed from a diagnostic image to guide the surgical microscope, the operator cannot arbitrarily modify the position of the surgical microscope according to the current situation, and the There is a problem that surgery must be performed from the position.

[0005] Also, Japanese Patent Application Laid-Open No. 8-511715 also has a problem that a diagnostic image cannot be introduced into an operative site that becomes a blind spot when observed with a surgical microscope. Also,
Although the target tumor tissue can be emphasized and imaged, it is not possible to emphasize the easily damaged normal tissue around the tumor and image it.Therefore, surgery is performed so that normal tissues other than the tumor are not affected. In order to carry out, it is necessary to concentrate more than necessary. Therefore, a great deal of fatigue is given to the operator.

Further, in the technique disclosed in Japanese Patent Application Laid-Open No. H8-16239, the lock of the gantry arm can be released even in a state where the balance has been lost, so that the mirror body moves rapidly, and There is a problem that the operation is hindered. In addition, since many steps must be taken at the time of balance adjustment, if the balance is lost during the operation and readjustment is performed, there is a problem that the operation time becomes longer or the operation is interrupted.

Also, in the technique disclosed in Japanese Patent Application Laid-Open No. 9-182759, the lock of the gantry arm can be released while the balance is lost, so that the mirror body moves rapidly and the operation is hindered. Problem.
In addition, since each joint must be fixed with a lock pin at the time of balance adjustment, intraoperative balance adjustment is not possible, and the operator must perform surgery in a state where the balance is lost.

The present invention has been made in view of the above circumstances, and aims to obtain useful information for surgery, and to prevent the tissue from being hurt by the endoscope endoscope. An object of the present invention is to provide a surgical microscope apparatus capable of performing a simple and easy operation.

[0009]

SUMMARY OF THE INVENTION In order to solve the above-mentioned problems, the present invention provides a stereoscopic observation means for observing a surgical site three-dimensionally, and a movable mount for holding the stereoscopic observation means three-dimensionally. A surgical microscope apparatus having an arm, a stereoscopic image capturing unit provided in the stereoscopic observation unit and capturing a stereoscopic image obtained by the stereoscopic observation unit, and three-dimensional measurement of an image captured by the stereoscopic image capturing unit , A storage device for storing a preoperative diagnostic image, and a position measuring device for measuring an observation position by the stereoscopic observation means, and the preoperative diagnostic image is matched with the current observation position. A navigation device for forming a three-dimensional image data signal; and an image synthesizing means for synthesizing a three-dimensional image based on a signal from the navigation device and a measurement result from the image measuring means. Movable range calculating means for calculating a movable range of the gantry arm based on the three-dimensional image synthesized by the image synthesizing means; and a gantry arm for controlling movement of the gantry arm based on a calculation result of the movable range calculating means. And control means.

[0010]

Embodiments of the present invention will be described below with reference to the drawings.

FIGS. 1 to 4 show a first embodiment of the present invention. As shown in FIG. 1, the surgical microscope apparatus according to the present embodiment includes a surgical microscope (first observation unit) 1,
The microscope 1 includes a squinting endoscope (second observation means) 2 for observing a blind spot or the like in an observation field of view of the microscope 1.

As shown in FIG. 2, the operating microscope 1 is provided with a gantry 3. The gantry 3 includes a base 4 that can move on the floor surface, and a column 5 that is erected substantially at the center of the base 4. The column 5 is provided with a first drive unit 17. The first drive unit 17 includes a motor 6 for rotating the upper end of the gantry 3 around the rotation axis Oa, a motor-side gear 7 and a column-side gear 8 for transmitting rotation, and a fixed member for regulating rotation. And an encoder 10 for detecting a rotation angle.

A counterbalance type operation arm unit 11 is provided at the upper end of the column 5.
The operation arm unit 11 has a deformable first parallelogram link 16. The first parallelogram link 16 includes four first to fourth rotatably disposed links.
Of the joints 12, 13, 14, 15.

Further, in order to electrically rotate the first parallelogram link 16 with respect to the column 5 about the rotation axis Ob, a connecting portion between the first joint 12 and the fourth joint 15 includes:
A second drive unit 18 is provided. The second drive unit 18 includes a motor for rotating the first parallelogram link 16 about the rotation axis Ob, a motor-side gear and a joint-side gear for transmitting rotation, and a fixed member for regulating rotation. And an encoder for detecting the rotation angle.

Similarly, the column 5 and the first joint 1
2 is provided with a third drive unit 19 that enables rotation about the rotation axis Oc.
The connecting portion between the joint 14 and the fifth joint 20 has a rotating shaft O
Fourth drive unit 2 enabling rotation about d
1 is provided.

At the tip of the fifth joint 20, four fifth joints
A deformable second parallelogram link 25 comprising eight to eight joints 20, 22, 23, 24; and a deformable second parallel link 25 comprising four seventh to tenth joints 23, 24, 26, 27. Three parallelogram links 28 are provided.
Similarly, in this case, the seventh joint 23 and the ninth joint 26 are connected to each other so that the second parallelogram link 25 and the third parallelogram link 28 can be electrically rotated about the rotation axis Oe. A fifth drive unit 29 is provided at the joint of. The drive unit 29 includes a motor for rotating the second parallelogram link 25 and the third parallelogram link 28 around the rotation axis Oe, and a motor-side gear and a joint-side gear for transmitting the rotation. , A fixing electromagnetic brake for regulating rotation, and an encoder for detecting a rotation angle.

A joint unit of an eleventh joint 30 and a tenth joint 27 connected to the microscope 1 has a sixth drive unit 31 for enabling rotation of a parallelogram link about a rotation axis Of. Are arranged. The sixth drive unit 31 also includes a motor, a motor-side gear and a joint-side gear for transmitting the rotation of the motor, an electromagnetic brake for fixing the rotation, and an encoder for detecting the rotation angle. Be composed. Operation grips 32a and 32b are connected to the left and right of the eleventh joint 30, respectively.

All of the first to sixth drive units 17, 18, 1 are attached to the pair of left and right operation grips 32a, 32b.
Operation switch 3 for operating 9, 21, 29, 31
3a and 33b are provided respectively. Each of the operation switches 33a and 33b includes a joystick (not shown) having four degrees of freedom and a seesaw switch (not shown) having two degrees of freedom.

The gantry 5 has a foot switch 34 for operating all of the first to sixth drive units 17, 18, 19, 21, 29, 31; a light source device for illumination (not shown); All of the first to sixth drive units 17, 1
8, 19, 21, 29, 31 and a power supply unit for supplying power to the operating microscope 1 are provided.
The foot switch 34 includes a joystick (not shown) having four degrees of freedom and a seesaw switch (not shown) having two degrees of freedom.

FIG. 3 shows the configuration of the optical system of the operating microscope 1. As shown in the drawing, the mirror body of the surgical microscope 1 includes a perspective endoscope 2, a removable left and right common objective lens 35, and a pair of left and right variable magnification observation optical systems 36a and 36.
b, a pair of left and right beam splitters 3 for splitting the observation light
7a and 37b are provided respectively. Above the pair of left and right beam splitters 37a and 37b, a pair of left and right half mirrors 38a and 38b that can be inserted into and removed from the observation optical path.
, A pair of left and right imaging lenses 39a and 39b, and a pair of left and right eyepieces 40a and 40b, respectively. The left and right observation light emitted from the eyepieces 40a and 40b is transmitted to the left and right eyes Ea of the operator. , Eb.

On the other hand, a pair of left and right TV imaging lenses 41a and 41b, total reflection mirrors 42a and 42b, and an image sensor 43a as stereoscopic image imaging means are provided on the optical axis divided by the beam splitters 37a and 37b. 43b are sequentially arranged. Also, the half mirrors 38a and 38b
A pair of left and right imaging lenses 4
4a, 44b, total reflection prisms 45a, 45b, and in-view display image monitors 46a, 46b are provided, respectively. Further, the operating microscope 1 is provided with an illumination optical system (not shown) and a light guide (not shown) for guiding light from the light source device.

The oblique endoscope 2 has an insertion portion to be inserted into a body cavity of a patient. In this insertion portion, an objective lens 47, a reflection prism 48, a relay lens 49a,
49b and 49c are provided, and a microscope mounting unit 50 is connected to the upper end thereof. The total length of the oblique endoscope 2 is set equal to the focal length of the objective lens 35.

The microscope mounting unit 50 is composed of a pupil splitting prism 51 and total reflection prisms 52a and 52b.
36b. The oblique endoscope 2 is also provided with an illumination optical system (not shown) and a light guide (not shown) for guiding light from the light source device.

Further, the surgical microscope apparatus according to the present embodiment has an electric control system shown in FIG. As shown, the electric control system has processors 53a and 53b as image measuring means to which image sensors 43a and 43b provided on the left and right sides of the surgical microscope 1 are respectively connected.
The processors 53a and 53b include the imaging devices 43a and 43b
The circuit is configured to generate a signal from the device as an image signal. The processors 53a and 53b are connected to each other by the signal line 5.
4, and a synchronization signal is input from the processor 53a to the processor 53b.

Video signals from the processors 53a and 53b are input to a 3D converter 55 and a 3D image data generator 56, respectively. The 3D converter 55 is composed of a circuit for exchanging left and right image signals in a frame-sequential manner at a fixed cycle, and converts the output signal of the three-dimensional observation image 64b (see FIG. 4) into 2D and 3D images.
D is displayed on the 2D / 3D monitor 57 capable of displaying D. Also,
The 3D image data generation device 56 includes processors 53a, 5
The circuit is configured to generate a three-dimensional observation image data signal by calculating the difference between the video signals from 3b.

On the other hand, the output signal from the encoder 10 provided in the first drive unit 17 of the gantry 3 and the other five drive units 18 and
Output signals from encoders provided in 19, 21, 29 and 31 are input to a position calculating device 58 as position measuring means. Position calculation device 58
Is constituted by a circuit for calculating the position of the surgical microscope 1 from the six encoder outputs.

The data signal relating to the position from the position calculating device 58 is used together with a diagnostic data signal from the preoperative diagnostic data storage device 60 in which image data from a CT or MRI device, which are preoperative diagnostic images, are stored. Generator 59
To be sent to

The image generating device 59 is configured to generate a three-dimensional diagnostic image by selecting an image of a part corresponding to the observation position of the operating microscope 1 from the preoperative diagnostic data storage device 60.

The three-dimensional diagnostic image generated by the image generating device 59 is sent to the image synthesizing device 61, which is an image mixer, together with the real-time three-dimensional observation image data from the 3D image data generating device 56. It is designed to be synthesized with the data image 65 (see FIG. 4). The three-dimensional data image 65 is then sent to the 3D converter 55. Then, the 3D converter 55 converts the left and right images in a frame-sequential manner into a 2D / 3D monitor 5.
7 is output. Also, the three-dimensional data image 65 synthesized by the image synthesizing device 61 into one three-dimensional image data
Is also input to the in-view display monitors 46a and 46b and the movable range calculation device 62, respectively.

The movable range calculating device 62 is provided with the image synthesizing device 6.
The movable range of the arm is set from the three-dimensional data image 65 generated by step 1, and the setting signal is input to the arm drive control device 63 provided on the gantry 3.

Next, the operation of the surgical microscope apparatus having the above configuration will be described.

First, when observing the operative site Q (see FIG. 3) with the surgical microscope 1, the objective lens 35 (see FIG. 3) is attached to the tip of the surgical microscope 1, and a switching mechanism (not shown) is used. Half mirrors 38a, 38b
Is retracted to the position shown by the dotted line in FIG.

Illumination light emitted from the operating microscope 1 from a light source device (not shown) via a light guide and an illumination optical system is converged on the operative site Q by the objective lens 35. The reflected light from the operative section Q enters the objective lens 35, and is converted into a desired observation magnification of the operator by a pair of left and right variable magnification observation optical systems 36a and 36b, and then is converted into beam splitters 37a and 3a.
7b.

Each of the beam splitters 37a and 37b splits the left and right light beams into two systems. Beam splitter 3
The light beams transmitted through 7a and 37b are imaged once by a pair of left and right imaging lenses 39a and 39b, then enlarged by eyepiece lenses 40a and 40b, and incident on the operator's left and right eyes Ea and Eb. . Thereby, the surgeon can perform a stereoscopic observation of the operative site Q.

Next, a case in which the operation portion P is observed by the oblique endoscope 2 will be described.

When observing a deep part (operated portion P) in a body cavity, which cannot be observed by itself, the surgical microscope 1 uses the microscope endoscope 2 instead of the objective lens 35 to mount the oblique endoscope 2. It is mounted on the operating microscope 1.

Illumination light emitted from a not-shown light source device via the light guide from the distal end of the oblique endoscope 2 irradiates the operative site P. The reflected light from the operative portion P is incident on an objective lens 47 provided at the distal end of the oblique endoscope 2, and is provided with a reflecting prism 48 and relay lenses 49a, 49b,
49c.
It is split into book observation light.

The two divided observation lights are guided to the operating microscope 1 by a pair of total reflection prisms 52a and 52b. The two observation lights guided into the operating microscope 1 are converted into an operator's desired observation magnification by a pair of right and left magnification observation optical systems 36a and 36b, and then converted into beam splitters 37a and 37a.
37b.

In the beam splitters 37a and 37b, the left and right light beams are split into two systems. One of the split light beams passes through the half mirrors 38a and 38b,
The image is formed once by a pair of left and right imaging lenses 39a and 39b, enlarged by eyepieces 40a and 40b, and incident on Ea and Eb, which are the left and right eyes of the operator. Thus, the surgeon can perform a stereoscopic observation of the operative site P. On the other hand, a pair of left and right beam splitters 37a, 37b
The other observation light divided by the TV imaging lens 41a,
After the projection magnification is determined by 41b, the total reflection mirror 4
The light is guided to the left and right image pickup devices 43a and 43b by 2a and 42b, respectively.

Next, the electrical processing of the observation light incident on the imaging devices 43a and 43b will be described with reference to FIGS.

The observation light incident on the imaging devices 43a and 43b is converted into an electric signal and then converted into an electric signal.
a, 53b and converted into left and right image signals. At this time, the left and right processors 53a and 53b
, The left and right image signals that are scanned in the same cycle are formed. The left and right image signals are divided into two systems and input to the 3D converter 55 and the 3D image data generation device 56, respectively.

The 3D converter 55 converts the left and right images into a three-dimensional observation image 64b in which the left and right images are exchanged in a frame-sequential manner at a fixed interval, and outputs the image to a 2D / 3D monitor. The 2D / 3D monitor receives not only the three-dimensional observation image 64b but also a synchronizing signal for image exchange from the 3D converter 55, and drives a liquid crystal shutter (not shown) according to the synchronizing signal, and the polarized light synchronized with the left and right image signals. The output monitor image is output. An observer other than the surgeon can observe a monitor image corresponding to each of the left and right eyes by wearing polarizing glasses (not shown), and thus can observe a monitor image having a three-dimensional effect.

On the other hand, when the operator wants to change the observation position, he operates the foot switch 34 as an input device or the operation switches 33a and 33b provided on the left and right operation grips 32a and 32b. Specifically, when the operator wants to move the observation site in a plane perpendicular to the observation optical axis of the operation microscope 1, the operator operates a joystick (not shown) having four degrees of freedom, When it is desired to move the observation site in the observation optical axis direction of the microscope for use, a seesaw switch (not shown) having two degrees of freedom is operated.
These operation signals are input to an arm drive control device 63 provided on the gantry 3, and the arm drive control device 63 drives the motor 6 in the first drive unit 17 of the column 5 based on these operation signals. Control. At this time, since electric power is also supplied to the electromagnetic brake 9 from a power supply unit (not shown), the rotational force of the motor 6 is transmitted by the motor-side gear 7 and the column-side gear 8, and the column 5 rotates at an arbitrary angle. Similarly, the drive units 18, 19, 21, and 21 in the remaining five directions provided in the operation arm unit 11 are provided.
The operators 9 and 31 perform the same operation, so that the surgeon can electrically change the observation direction in any direction with six degrees of freedom.

In conjunction with this operation, the encoder 10 provided in the first drive unit 17 detects the rotation angle of the column 5 and inputs the detection signal to the position calculating device 58. Similarly, the drive units 18, 19, and 2 in the remaining five directions provided in the operation arm unit 11 are provided.
Since 1, 29 and 31 operate in the same manner, the rotation angle information of all six degrees of freedom is input to the position calculating device 58. This means that the position of the distal end of the oblique endoscope 2 attached to the distal end of the operating microscope 1 is constantly measured.

On the other hand, a diagnostic data signal before the operation of the patient is input to the image generating device 59 from the preoperative diagnostic data storage device 60, and a data signal relating to the position of the oblique endoscope 2 is input to the position calculating device 58. Is entered from The image generating device 59 matches a preoperative diagnostic image of the patient with the current observation position from the two data signals, generates a three-dimensional image data signal, and emphasizes a specific part of the data. The three-dimensional image data signal processed by the above is input to the image synthesizing device 61. That is, a three-dimensional image data signal in which a particularly important tissue (e.g., nerve or blood vessel) is emphasized is input from the image generation device 59 to the image synthesis device 61.

The image synthesizing device 61 includes an image generating device 59.
In addition to the three-dimensional image data signal from, the real-time three-dimensional observation image data of the observation part from the 3D image data generation device 56 is input. The image synthesizing device 61 mixes these two image data, that is, a three-dimensional data image 65 in which an important tissue is emphasized and whose direction coincides with the part of the observation position at the same time (see FIG. 4). Are output to the 3D converter 55, the pair of left and right in-view display monitors 46a and 46b, and the movable range calculation device 62. In addition, the 3D converter 55 receives this, and outputs to the 2D / 3D monitor 57 an image in which the left and right images are exchanged in a frame-sequential manner at a fixed cycle. Therefore, an observer other than the surgeon operates an input switch (not shown) to combine a simple three-dimensional observation image 64b (see FIG. 4) from the 3D converter 55 on the 2D / 3D monitor 57 with image synthesis. 3D data image 65 from device 61
(See FIG. 4) and a three-dimensional observation data composite image 66b (see FIG. 4) obtained by combining the two can be selectively observed.

On the other hand, left and right in-view display monitors 46a,
Three-dimensional data image 65 input and displayed at 46b
Are the total reflection prisms 45a and 45b and the imaging lens 44
After reaching the surgical microscope 1 via the a and 44b, the directions and directions thereof are converted by the half mirrors 38a and 38b, and then combined with the optical three-dimensional observation image 64a. This combined image is combined once by a pair of left and right imaging lenses 39a and 39b, then enlarged by eyepieces 40a and 40b, and is incident on the operator's left and right eyes Ea and Eb. That is, the surgeon can observe the three-dimensional observation data composite image 66a in which the optical three-dimensional observation image 64a and the three-dimensional data image 65 are composited.

When the three-dimensional data image 65 (see FIG. 4) is input from the image synthesizing device 61 to the movable range calculating device 62, the position of the oblique endoscope 2 from the position calculating device 58 is determined. In addition to the three-dimensional image data in which the data and the preoperative diagnostic data signal of the patient from the preoperative diagnostic data storage device 60 are combined, a 3D image data generating device 56
, Three-dimensional observation image data of a real-time observation part is input. The movable range calculation device 62 includes data relating to the position of the oblique endoscope 2 and a 3D image data generation device 56.
Is compared in real time with the three-dimensional observation image data of the observation part, and when there is a position that is not a space on the three-dimensional observation image data, that is, the tip of the endoscope 2 for squint comes into contact with important tissue. If there is a possibility, a movement restriction signal for restricting the movement of the arm is output to the arm drive control device 63 of the gantry 3. The movement restriction signal is transmitted to the operation switch 33 provided on the foot switch 34 and the operation grips 32a and 32b so that the operator can change the observation position.
The priority is given to a signal output when a or 33b is operated (the circuit is configured in such a manner). Therefore, even when the surgeon moves the squint endoscope 2 just below the important tissue or performs an erroneous operation input, the distal end portion of the squint endoscope 2 does not damage the important tissue. .

As described above, according to the surgical microscope apparatus according to the present embodiment, even when the surgeon observes a blind spot in a body cavity, an optical three-dimensional observation image and an important tissue section can be obtained. Can be observed. Since the operation is performed while always grasping the position of the important tissue, the safety of the operation is dramatically improved. In addition, optical bleeding, such as when bleeding from tissue occurs, etc.
Even when the three-dimensional observation image cannot be recognized, 3
The operation can be reliably advanced by the dimensional data image.

Further, in this embodiment, when the surgeon observes the blind spot of the operating microscope 1 using the oblique endoscope 2, except for a safe area which does not affect the important tissue at all. The moving range is automatically restricted so that the gantry arm cannot move. Therefore, the operation can be safely and reliably performed.

In neurosurgery, since the intracranial pressure changes before and after craniotomy of the skull, the actual position of the brain parenchyma often moves relative to the preoperative diagnostic image. In the embodiment, since three-dimensional observation image data of a real-time observation site is input, the operation can be performed while always grasping the current tissue position even when the brain parenchyma moves.

Also, in this embodiment, even if the surgeon makes an erroneous operation input and is likely to affect important tissues, the erroneous operation can be canceled beforehand. In such a situation, the operation can be safely and reliably performed.

Further, in this embodiment, since the focal length of the objective lens 35 and the length of the oblique endoscope 2 are made common, when used as a normal surgical microscope 1 without using the endoscope 2. In this case, complicated adjustment is not required, and the device can be used simply by exchanging the objective lens 35 and the oblique endoscope 2.

In the present embodiment, the oblique endoscope 2 is taken as an example, but it goes without saying that the same effect can be exerted in a direct-view endoscope.

FIGS. 5 to 7 show a second embodiment of the present invention. Note that, in the present embodiment, the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

As shown in FIG. 5, the surgical microscope apparatus according to the present embodiment is a surgical microscope (first observation means).
1 and a perspective endoscope (second observation means) 2 for observing a blind spot or the like in the observation field of the microscope 1.

FIG. 6 shows the overall configuration of the surgical microscope 1. As shown in the figure, the linkage between the gantry 3 of the surgical microscope 1 and the operation arm unit 11 is the same as that of the first embodiment. A horizontal balance adjusting weight 101 is rotatably disposed on the second joint 13. In addition, the second joint 13 is provided with a motor-side gear 102 and a motor 103 that are engaged with the outer peripheral surface of the horizontal balance adjustment weight 101 and interlock therewith. A third drive unit 1 provided for rotation about the rotation axis Oc
9 is provided with a horizontal balance detection sensor 111.

The fourth joint 15 is provided with a vertical balance adjusting weight 104 rotatably. Also, the fourth
The joint 15 is provided with a motor-side gear 105 that meshes with and works with the outer peripheral surface of the vertical balance adjustment weight 104, and a motor 106. A second drive unit 18 provided for rotation about the rotation axis Ob
, A vertical balance detection sensor 110 is provided. The G joint 23 has a tilt direction balance adjusting weight 10
7 is rotatably arranged.

The seventh joint 23 is provided with a motor-side gear 108 meshing with the outer peripheral surface of the tilt direction balance adjusting weight 107 and interlocking therewith, and a motor 109. Also,
The fourth drive unit 21 provided for rotation about the rotation axis Od has a tilt direction balance detection sensor 1
12 are provided.

On the other hand, the surgical microscope 1 is provided with an endoscope holder 113, an endoscope driving pulley 114, and a motor 115 for electrically driving the oblique endoscope 2. . The foot switch 34 includes a joystick (not shown) having four degrees of freedom and seesaw switches A and B (not shown) having two degrees of freedom. The operation switches 33a and 33b provided in the operation grips 32a and 32b, respectively, include joysticks (not shown) having four degrees of freedom and seesaw switches A 'and B' (not shown) having two degrees of freedom.
And an arm free / lock switch (not shown).

As shown in FIG. 8, the foot switch 3
Driving signals from the seesaw switches B and B 'provided on the operation switch 4 and the operation switches 33a and 33b are input to the motor 115 via the arm drive control device 63. Also, input signals from joysticks, arm free / lock switches, and seesaw switches A and A 'provided on the foot switch 34 and the operation switches 33a and 33b are also input to the arm drive control device 63. Further, the operating microscope 1 is provided with three or more position detection LEDs 118a.

On the other hand, in the oblique endoscope 2, a light guide 117 for supplying illumination light from the image pickup device 116 and a light source device (not shown) and a position detecting LED 118b are provided.
(Three or more) are provided.

The configuration of the optical system of the operating microscope 1 is the same as that of the first embodiment in which the objective lens 35 is mounted, and therefore detailed description is omitted.

FIG. 5 shows a surgical microscope apparatus according to this embodiment.
The electric control system shown in FIG. FIG. 7 shows an image generated by each means. In this electric control system, a signal from the imaging element 116 connected to the eyepiece of the oblique endoscope 2 is connected to be input to the processor 120. An endoscope observation image 124 (see FIG. 7) output from the processor 120 is a pair of left and right processors 53 which are image signals captured by the operating microscope 1.
a and 53b together with the image signal from the
Enter 1 The image signal from the image mixer 121 is configured to be input to both the 3D image data generating device 56 and the 3D converter 55.

On the other hand, position detecting LEDs 118a, 118 provided on the operating microscope 1 and the oblique endoscope 2
b blinks and emits light at a constant cycle by a drive circuit (not shown) provided in the position calculation device 58.

Further, the position detecting LEDs 118a, 118
The light emitted from b is received by the two imaging elements 122a and 122b provided in the digitizer 119, and the position information of the surgical microscope 1 and the perspective microscope 2 is input to the position calculation device 58.

The position data from the position calculating device 58 is transmitted to the gantry 3 via the image generating device 59, the image synthesizing device 61 and the movable range calculating device 62 together with the diagnostic image data signal from the preoperative diagnostic data storage device 60. Input to the provided arm drive control device 63. The video signal generated by the image synthesizing device 61 is also input to the 3D converter 55 and a pair of left and right in-view display monitors 46 a and 46 b provided in the surgical microscope 1.

The horizontal balance detection sensor 111, the vertical balance detection sensor 110, and the tilt balance detection sensor 112 provided on the gantry 3 and the operation arm unit 11 are composed of pressure sensors for detecting the pressure between the joints. ing. Also, signals from the balance detection sensors in each direction are input to the arm drive control device 63 via the movable range calculation device 62, and then the motors 103, 1
06,109.

Next, the operation of the surgical microscope apparatus having the above configuration will be described.

First, the operation when the operating microscope 1 is used alone will be described.

The operation performed by the operating microscope 1 until the observation image of the operative site Q enters the left and right eyes Ea and Eb of the operator is the same as in the first embodiment, and therefore the description is omitted here. I do.

The gantry 3 and the operation arm unit 11 of the operating microscope 1 are rotated by a horizontal balance adjusting weight 101 and a vertical balance adjusting weight 104 on a rotation axis Oc.
An equilibrium is maintained around it. At the same time, an equilibrium state is maintained around the rotation axis Od by the tilt direction balance adjusting weight 107. Therefore, the operating microscope 1 has 3
It is in a dimensionally balanced state.

When the operator wants to change the observation position of the operating microscope 1, the foot switch 34 as an input device is used.
Alternatively, among the operation switches 33a and 33b provided on the left and right operation grips 32a and 32b, an arm free / lock switch (not shown) is operated. This operation signal is transmitted to an arm drive control device 63 provided in the gantry 3.
From the first drive unit 17 to the sixth drive unit 31 provided in the gantry 3 and the operation arm unit. become.

In this state, since the six drive units from the first drive unit 17 to the sixth drive unit 31 can freely move, the operator can operate the operation grip 3.
By directly operating the 2a and 32b by hand, the surgical microscope 1 can be directed in any direction.

Subsequently, after the operating microscope 1 has been moved to a desired position, the arm free / lock switches of the operation switches 33a and 33b are released. As a result, the operation stop signal is input to the arm drive control device 63 provided in the gantry 3, from which the first drive unit 17 provided in the gantry 3 and the operation arm unit to the sixth drive control unit 63 Since it is transmitted to an electromagnetic brake (not shown) built in the six drive units up to the drive unit 31,
Six drive units from the first drive unit 17 to the sixth drive unit 31 are fixed.

In this state, since the six drive units from the first drive unit 17 to the sixth drive unit 31 cannot move at all, the surgical microscope 1 is fixed on the spot.

The operation when the operating microscope 1 is operated electrically is the same as that of the first embodiment, and the description is omitted here.

Next, a case in which the operation part which is a blind spot of the operating microscope 1 is observed using the oblique endoscope 2 will be described with reference to FIGS.
A description will be given based on FIG.

The operator inserts the endoscope for oblique view 2 into the endoscope holder 1.
Insert into 13. Illumination light emitted from the distal end of the oblique endoscope 2 via a light source device and a light guide 117 (not shown) irradiates the operation site. The reflected light from the operative part is incident on the distal end of the oblique endoscope 2 and forms an image on the image sensor 116 by an objective lens (not shown), a reflecting prism, a relay lens, and an imaging lens. The observation light incident on the image sensor 116 is converted into an electric signal, guided to the processor 120, converted into an endoscope observation image 124, and input to the image mixer 121. In addition, the image mixer 43 of the operating microscope 1 is provided in the image mixer 121.
Left and right image signals imaged by a and 43b and synchronized by the signal line 54 are also input from the processors 53a and 53b.

The image mixer 121 divides an endoscope / microscope composite observation image 123 obtained by synthesizing a part of a surgical microscope image into a perspective endoscope image and divides the image into two systems.
The data is input to both the converter 55 and the 3D image data generating device 56. The 3D converter 55 is connected to input a signal to the 2D / 3D monitor 57 after converting the left and right images into a three-dimensional observation image in which the left and right images are exchanged in a frame sequence at a fixed interval.

Here, the 2D / 3D monitor 57 also receives a synchronizing signal for image exchange from the 3D converter 55 at the same time, drives a liquid crystal shutter (not shown) according to this signal, and performs polarized light synchronized with the left and right image signals. Output monitor image. An observer other than the surgeon can observe a monitor image corresponding to each of the left and right eyes by wearing polarizing glasses (not shown), and thus can observe a monitor image having a three-dimensional effect.

Next, when the operator operates the oblique endoscope 2 to change the observation position, the operator operates the foot switch 34 as an input device or the operation switch 33a provided in the operation grips 32a and 32b. , 33b having two degrees of freedom (not shown) are operated. The operation signal is input to the arm drive control device 63 and then to the motor 115, and the rotational force moves the oblique endoscope 2 in the insertion direction through the endoscope driving pulley 114.

With the movement of the oblique endoscope 2, the position of the center of gravity at the tip of the operation arm unit 11 moves. In this state, a torsional moment is applied to the fifth joint 20, which is the center of the rotation axis Od. Since the tilt direction balance detection sensor 112 is constituted by a pressure sensor, the torsion moment is detected, and the fact that the arm drive control device 63 is in an unbalanced state is electrically input. The arm drive control device 63 rotates the motor 109 according to the electric signal. The rotational force of the motor 109 moves the tilt direction balance adjusting weight via the motor-side gear 108. This operation is continued until the tilt direction balance detection sensor 112 cannot detect the torsional moment, that is, the arm is balanced.

Further, in the balance correcting mechanism, when the oblique endoscope 2 is replaced with a non-illustrated oblique endoscope having another observation angle, that is, the weight of the surgical microscope 1 as a whole is changed. Also applies. In the vertical balance adjustment, a connection portion between the fourth joint 15 and the first joint 12, that is, a torsional moment around the rotation axis Ob is detected. Vertical balance detection sensor 1
10 detects the torsional moment and electrically inputs to the arm drive control device 63 that it is in an unbalanced state,
The motor 106 is rotated. The rotational force of the motor 106 is
The balance weight for vertical adjustment is moved via the motor-side gear 105. This operation is continued until the vertical balance detecting sensor 110 cannot detect the torsional moment. For horizontal balance adjustment, support 5
And the connection with the first joint 12, that is, the rotation axis O
Detect the torsional moment around c. Similarly, the horizontal balance detection sensor 111 detects the torsional moment and electrically inputs the non-balanced state to the arm drive control device 63 to rotate the motor 103. The rotational force of the motor 103 moves the horizontal balance adjustment weight via the motor-side gear 102. This operation is continued until the horizontal balance detecting sensor 111 cannot detect the torsional moment.

Only when the three balance detecting sensors are detecting the torsional moment and outputting an electric signal, that is, during balance adjustment or unbalance, the arm drive control device 63 operates the surgical microscope device. Is determined to be unbalanced. In the arm drive control device 63, the operator determines whether the unbalanced state is present by operating the foot switch 34 as an input device or the operation switches 33 a and 3 provided in the operation grips 32 a and 32 b.
The circuit is configured to give priority to an input when an arm free / lock switch (not shown) 3b is operated. For this reason, the first drive unit 17 to the sixth drive unit
The electromagnetic clutch (not shown) built in all six drive units of the drive unit 31 cannot be released at the time of imbalance.

However, in the arm drive controller 63, a joystick and a seesaw switch A (not shown) provided on the foot switch 34 as an input device, or operation switches 33a and 33b provided in the operation grips 32a and 32b. No restrictions are imposed on the input from the joystick and the seesaw switch A '(not shown) at the time of imbalance. For this reason, the surgeon can perform the electric arm operation even when the arm is in the unbalanced state.

As described above, even when the surgeon moves the oblique endoscope 2 or replaces the oblique endoscope 2 with a non-illustrated oblique endoscope having another observation angle, the surgical microscope can be used. The device will always be balanced in three dimensions.

As the operating microscope 1 and the oblique endoscope 2 move, the position calculating device 58 blinks at a constant cycle, and the position detecting LEDs 118a and 118b are composed of at least three or more LEDs. Light emitted from the image sensor 122 provided in the digitizer 119
a and 122b, and input to the position calculation device 58. The position calculating device 58 constantly measures the positions of the surgical microscope 1 and the oblique endoscope 2 based on the principle of so-called triangulation.

On the other hand, a preoperative diagnostic data signal of the patient from the preoperative diagnostic data storage device 60 is input to the image generating device 59, and a data signal relating to the position of the surgical microscope 1 is output from the position calculating device 58. Is entered. The image generating device 59 includes a circuit that generates a three-dimensional image data signal by matching a pre-operative diagnostic image of the patient with the current observation position from these two data signals, and a circuit that emphasizes a specific part of the data. Thus, the processed three-dimensional image data signal is input to the image synthesizing device 61. Therefore, the three-dimensional image data signal is output with emphasis on particularly important tissues (nerves, blood vessels, and the like).

Since the real-time three-dimensional image data of the observed part from the 3D image data generating device 56 is input to the image synthesizing device 61, a mixture of these two image data, that is, important data A 3D data image 125 in which the tissue is emphasized and whose direction coincides with the position of the observation position at the same time is replaced by a 3D converter 55 in which the left and right images are switched in a frame-sequential manner at a fixed cycle, and a 2D image is obtained. / 3D monitor 57, a pair of left and right display monitors 46a and 46b in the visual field and a movable range calculating device 62
To three systems.

An observer other than the surgeon can use the 2D / 3D monitor 5
7, a three-dimensional observation image 123b, which is a stereoscopic image from the 3D converter 55, or a three-dimensional data image 125 from the image synthesizing device 61, or both, by switching between an input selector switch (not shown) and the image mixer 121. The user can select and observe any one of the four types of images of the three-dimensional observation data composite image 126b in which the image and the endoscope observation image 124 are composited.

On the other hand, the left and right in-view display monitors 46a,
The three-dimensional data image 125 displayed on 46b or the endoscope observation images 124 and 3
An image obtained by combining both of the two-dimensional data images 125 reaches the inside of the surgical microscope 1 via the total reflection prisms 45a and 45b and the imaging lenses 44a and 44b, and the half mirror 38
a and 38b. Half mirror 38a,
After changing the direction and direction of the three-dimensional image at 38b, the three-dimensional image is combined with the optical three-dimensional observation image 123a, and a pair of left and right imaging lenses 39a and 39b and eyepieces 40a and 40b are combined.
Is imaged once and enlarged, and the light enters Ea and Eb, which are the left and right eyes of the surgeon, to enable stereoscopic observation.

Therefore, the operator emphasizes important tissues from the optical three-dimensional observation image 123a and the operator's diagnostic image,
It is possible to observe a three-dimensional observation data composite image 126 obtained by adding the endoscope observation image 124 to the three-dimensional data image 125 in which the observation direction and the part are matched.

Also, the 3 output from the image synthesizing device 61
The dimensional data image 125 is also input to the movable range calculation device 62. The movable range calculation device 62 converts the data on the position of the oblique endoscope 2 from the position calculation device 58 and the three-dimensional image data synthesized from the preoperative diagnosis data signal of the patient from the preoperative diagnosis data storage device 60. In addition, 3D
Three-dimensional observation image data of a real-time observation region from the image data generation device 56 is input. For this reason,
In the movable range calculation device 62, data on the position of the oblique endoscope 2 is compared in real time with the three-dimensional observation image data of the observation site from the 3D image data generation device 56,
For a position that is not a space on the three-dimensional observation image data, that is, when there is a possibility that the distal end of the squint endoscope 2 may come into contact with an important tissue, a movement restriction signal for restricting the movement of the arm is transmitted to the gantry 3 Is input to the arm drive control device 63.

The movement restriction signal is transmitted to the foot switch 34 and the operation grips 32a, 32 so that the operator can change the observation position.
The circuit is configured to give priority to signals from the operation switches 33a and 33b provided on the 2b and an arm free / lock switch (not shown). For this reason, even when the surgeon moves the endoscope for strabismus 2 just below the important tissue by electric power, or performs an erroneous operation input, the arm is limited to movement only in the safe space area. Therefore, the distal end portion of the squint endoscope 2 does not damage important tissues.

Similarly, even when the operator manually moves the arm, the arm is limited to movement only in a safe space area. , The electromagnetic clutches (not shown) incorporated in all six drive units from the first drive unit 17 to the sixth drive unit 31 are fixed. For this reason, the distal end of the oblique endoscope 2 does not damage important tissues even when the arm is manually operated.

As described above, according to the surgical microscope apparatus according to the present embodiment, even when the operator observes a blind spot in a body cavity, an optical three-dimensional observation image and an important tissue section can be obtained. Can be observed. Since the operation is performed while always grasping the position of the important tissue, the safety of the operation is dramatically improved. In addition, even when an optical three-dimensional observation image cannot be recognized due to, for example, bleeding from tissue or the like, the operation can be reliably performed using the three-dimensional data image. In addition to this, even when the surgeon is observing the blind spot of the surgical microscope using the oblique endoscope, the gantry arm is electrically operated except in a safe area that does not affect the important tissue at all. It is possible to automatically limit the moving range so as not to move. Also,
Even if the surgeon performs erroneous operation input and is likely to affect important tissues, it is possible to cancel the erroneous operation beforehand, so in any surgical situation,
It is possible to safely and reliably proceed with the operation.

In addition, since the operating microscope apparatus can be directly operated by the operator's hand, the operator can quickly guide the operating microscope to an arbitrary position. Similarly, even in the case of manual operation, even when the operator performs a blind spot observation of an operating microscope using a squinting endoscope, the squinting is performed in a safe area that does not affect important tissues at all. Limit the movement of the endoscope. If the surgeon makes an erroneous operation input and is likely to affect important tissues, the electromagnetic clutch provided in the arm is fixed in advance. Therefore, even in the case of manual operation,
The gantry arm can automatically limit the range of movement to within the safe area.

Further, even when the balance of the surgical microscope apparatus itself is broken by the operation of the oblique endoscope 2 or the like, the balance state can be automatically corrected. Further, in the unbalanced state, the electromagnetic clutch cannot be released, and there is no possibility that the operating microscope 1 or the oblique endoscope 2 will move suddenly when the visual field is changed, and will not injure the operation part. However, even when the electromagnetic clutch cannot be disengaged, it can be moved electrically, so that it does not hinder the progress of the operation at all.

In this embodiment, the oblique endoscope is used as an example, but it goes without saying that the same effect can be obtained with a direct-view endoscope.

FIGS. 8 and 9 show a third embodiment of the present invention. Note that, in the present embodiment, the same components as those in the first and second embodiments are denoted by the same reference numerals, and description thereof is omitted.

FIG. 8 shows a schematic configuration of the entire surgical microscope apparatus according to the present embodiment. Also in this surgical microscope apparatus, a surgical microscope (first observing means) 1 and a perspective endoscope (second observing means) for observing a blind spot in the observation field of the microscope 1 2 are provided.

FIG. 9 shows the overall configuration of the surgical microscope 1. The linkage between the gantry 3 and the operation arm unit 11 of the surgical microscope 1 is the same as that of the second embodiment.

A horizontal balance adjusting weight 101 is rotatably disposed on the second joint 13. Similarly, the fourth joint 15 has a vertical balance adjusting weight 104.
However, the seventh joint 23 has a tilt direction balance adjusting weight 1.
07 is rotatably arranged. A horizontal balance detection sensor 111 is provided on the rotation axis Oc. Similarly, a vertical balance detection sensor 110 is arranged on the rotation axis Ob, and a tilt balance detection sensor 112 is arranged on the rotation axis Od.

Further, the support 5 is provided with a balance state display device 202 for displaying the balance state of the surgical microscope apparatus. Foot switch 34 and operation grip 3
Operation switch 33 provided in each of 2a and 32b
Reference numerals a and 33b denote an arm-free / lock switch (not shown) that energizes the circuit only when pressed.

On the other hand, the operating microscope 1 has an oblique endoscope 2, an ultrasonic probe 201 and an ultrasonic driving device 203.
Is provided. The ultrasonic probe 201 is configured so that the oblique endoscope 2 and the insertion section move in the insertion direction in conjunction with each other.

The configuration of the optical system of the operating microscope 1 is such that the objective lens 35 is mounted in the first embodiment, the left and right imaging devices 43a and 43b, and the total reflection mirrors 42a and 42 are provided.
b, since the configuration is the same as that when the TV imaging lenses 41a and 41b are removed, detailed description is omitted.

The operating microscope apparatus of this embodiment is also provided with an electric control system shown in FIG. Here, the same components as those in the second embodiment are denoted by the same reference numerals, and detailed description is omitted.

In this electric control system, a signal from the image sensor 116 connected to the eyepiece of the oblique endoscope 2 is connected to be input to the processor 120. The endoscope observation image generated by the processor 120 is input to the image synthesizing device 61.

The ultrasonic probe 201 scans the vibrator at the distal end (not shown) in the thrust direction and the radial direction by the ultrasonic driving device 203, and inputs an electric signal to the ultrasonic image generating device 204 to output a two-dimensional image signal. Accumulate. In the ultrasonic image generation device 204, the stored 2
By superimposing the two-dimensional image signals, they are generated as three-dimensional image data and input to the image synthesizing device 61.

The horizontal balance detection sensor 111, the vertical balance detection sensor 110, and the tilt balance detection sensor 112 provided on the gantry 3 and the operation arm unit 11 are constituted by pressure sensors for detecting the pressure between the joints. ing. Further, the signals from the balance detection sensors in each direction are input to the arm drive control device 63 via the movable range calculation device 62, and then input to the balance status display device 202 to display the balance status of the surgical microscope device. I do.

Next, the operation of the surgical microscope having the above configuration will be described.

First, the operation when the operating microscope 1 is used alone will be described.

The operation performed by the operating microscope 1 until the observation image of the operative site Q is incident on the left and right eyes Ea and Eb of the operator is the same as in the first embodiment, and therefore the description is omitted here. I do.

The gantry 3 and the arm unit 11 of the operating microscope 1 are also kept in a balanced state as in the second embodiment, and the operating microscope 1 is in a three-dimensional balanced state. The operation when the operator changes the observation position of the operating microscope 1 is the same as that of the second embodiment.

Next, a case where the operation part which is a blind spot of the surgical microscope 1 is observed using the oblique endoscope 2 will be described with reference to FIGS. 8 and 9. FIG.

First, the surgeon inserts the oblique endoscope 2 into the endoscope holder 113. Illumination light emitted from the distal end of the oblique endoscope 2 via a light source device and a light guide 117 (not shown) irradiates the operation site. The reflected light from the operative part is incident on the distal end of the oblique endoscope 2 and forms an image on the image sensor 116 by an objective lens (not shown), a reflecting prism, a relay lens, and an imaging lens. Image sensor 1
The observation light incident on 16 is converted into an electric signal, guided to the processor 120, converted into an endoscopic observation image, and input to the image synthesizing device 61.

On the other hand, the ultrasonic probe 201, which is in contact with the vicinity of the operative site via a liquid such as a physiological saline solution (not shown) in conjunction with the oblique endoscope 2 by the ultrasonic driving device 203, has a distal end (not shown). The vibrator is scanned in the thrust direction and the radial direction, and an electric signal is input to the ultrasonic image generation device 204 to accumulate a two-dimensional image signal. The ultrasonic image generating device 204 generates the three-dimensional image data by superimposing the stored two-dimensional image signals, and inputs the generated three-dimensional image data to the image synthesizing device 61.

On the other hand, when the operator attempts to change the observation position of the operating microscope 1, the foot switch 3 as an input device
4 or an arm free / lock switch (not shown), which is an operation switch 33a, 33b provided on the left and right operation grips 32a, 32b. This operation signal is transmitted to an arm drive control device 63 provided in the gantry 3.
From the first drive unit 17 to the sixth drive unit 31 provided in the gantry 3 and the operation arm unit. become.

In this state, since the six drive units from the first drive unit 17 to the sixth drive unit 31 can freely move, the operator can operate the operation grip 3.
By directly operating the 2a and 32b by hand, the surgical microscope 1 can be directed in any direction.

Subsequently, after the operating microscope 1 has been moved to a desired position, the arm free / lock switches (not shown), which are the operation switches 33a and 33b, are released. As a result, the operation stop signal is input to the arm drive control device 63 provided in the gantry 3, from which the first drive unit 17 provided in the gantry 3 and the operation arm unit to the sixth drive control unit 63 Since the power is transmitted to the electromagnetic brakes (not shown) built in the six drive units up to the drive unit 31, the six drive units from the first drive unit 17 to the sixth drive unit 31 are fixed.
In this state, since the six drive units from the first drive unit 17 to the sixth drive unit 31 cannot move at all, the surgical microscope 1 is fixed in place.

Next, a case in which the operative portion serving as a blind spot of the operating microscope 1 is observed using the oblique endoscope 2 will be described with reference to FIGS. 8 and 9. FIG.

When the operator operates the oblique endoscope 2 to change the observation position, the operator uses his / her own hand to operate the oblique endoscope 2.
And move it in the insertion direction. With the movement of the oblique endoscope 2, the position of the center of gravity at the tip of the operation arm unit 11 moves. In this state, a torsional moment is applied to the fifth joint 20, which is the center of the rotation axis Od. Since the tilt direction balance detection sensor 112 is constituted by a pressure sensor, the torsion moment is detected, and the non-balance state is electrically input to the arm drive control device 63 and the balance state display device 202. The balance state display device 202 turns on a light emitting unit (not shown) to externally display that the surgical microscope apparatus is in an unbalanced state. Therefore, the surgeon or the operating staff rotates the tilt direction balance adjusting weight 107 so that this display is turned off, so that the tilt direction balance detection sensor 112 cannot detect the torsional moment, that is, the arm balance is obtained. Make adjustments.

As the oblique endoscope 2 moves, the position of the center of gravity of the tip of the operation arm unit 11 moves. In this state, a torsional moment is applied to the fifth joint 20, which is the center of the rotation axis Od. Since the tilt direction balance detection sensor 112 is constituted by a pressure sensor, the torsion moment is detected, and the non-balance state is electrically input to the arm drive control device 63 and the balance state display device 202. The balance state display device 202 turns on a light emitting unit (not shown) to externally display that the surgical microscope apparatus is in an unbalanced state.

Therefore, the surgeon or the operating staff rotates the tilt direction balance adjusting weight 107 so that this display is turned off, and the tilt direction balance detection sensor 11
2 is adjusted so that the torsion moment cannot be detected, that is, the arm is balanced.

The display of the unbalanced state by the balance state display device 202 is performed when the oblique endoscope 2 is replaced with a non-illustrated oblique endoscope having another observation angle.
That is, the present invention is also applied to a case where the weight of the surgical microscope 1 has changed. In the vertical balance adjustment, a connection portion between the fourth joint 15 and the first joint 12;
That is, the torsional moment about the rotation axis Ob is detected. The vertical balance detection sensor 110 detects the torsional moment and electrically inputs the non-balanced state to the arm drive control device 63 and the balance state display device 202. In the balance state display device 202,
Similarly, the light emitting means (not shown) is turned on, and the fact that the surgical microscope apparatus is in an unbalanced state is displayed outside.

In the horizontal balance adjustment, the connection between the support 5 and the first joint 12, that is, the torsional moment about the rotation axis Oc is detected. Similarly, the horizontal balance detection sensor 111 detects the torsional moment and electrically inputs the non-balance state to the arm drive control device 63 and the balance state display device 202. The balance state display device 202 similarly turns on a light emitting unit (not shown) to externally display that the surgical microscope apparatus is in an unbalanced state.

Therefore, in this case as well, the surgeon or the operating staff rotates the vertical balance adjusting weight 104 and the horizontal balance adjusting weight 101 appropriately so that this display is turned off, and the vertical balance detecting sensor 110 And horizontal balance detection sensor 111
Is adjusted so that the torsion moment cannot be detected, that is, the arm is balanced.

Only when the three balance detection sensors are detecting the torsional moment and outputting an electric signal, that is, during balance adjustment or unbalance, the arm drive control device 63 is operated by the surgical microscope device. Is determined to be unbalanced. In the arm drive control device 63, the operator determines whether the unbalanced state is present by operating the foot switch 34 as an input device or the operation switches 33 a and 3 provided in the operation grips 32 a and 32 b.
The circuit is configured to give priority to an input when an arm free / lock switch (not shown) 3b is operated. For this reason, the first drive unit 17 to the sixth drive unit
The electromagnetic clutch (not shown) built in all six drive units of the drive unit 31 cannot be released at the time of imbalance.

As described above, even when the operator moves the oblique endoscope 2 or replaces the oblique endoscope 2 with a non-illustrated oblique endoscope having another observation angle, the balance state display is performed. The balance can be easily adjusted according to the device 202.

Further, the operating microscope 1 and the oblique endoscope 2
The operation of detecting the position is also the same as that of the above-described second embodiment, and thus the description of the iron is omitted.

The image synthesizing device 61 receives the three-dimensional image data signal, the real-time three-dimensional image data of the observed part from the ultrasonic image generating device 204 and the observation image (2D) of the oblique endoscope 2. Therefore, a three-dimensional data image obtained by mixing these three image data, that is, an image in which an important tissue is emphasized and whose direction coincides with the position of the observation position at the same time, is taken as a pair of left and right visual fields. The data is output to two systems: the internal display monitors 46a and 46b and the movable range calculation device 62.

On the other hand, the left and right in-view display monitors 46a,
The three-dimensional data image displayed on 46b is synthesized with the endoscope observation image by the image synthesizing device 61, passes through the total reflection prisms 45a and 45b and the imaging lenses 44a and 44b, and enters the inside of the surgical microscope 1. And the half mirror 38a,
38b. Half mirrors 38a, 38
b, the three-dimensional image is converted from the direction
A pair of left and right imaging lenses 39 are synthesized with the three-dimensional observation image.
a, 39b and the eyepieces 40a, 40b form an image once and are enlarged to be E and the left and right eyes of the operator.
When the light is incident on a and Eb, stereoscopic observation becomes possible.

Therefore, the operator emphasizes important tissues from the optical three-dimensional observation image and the operator's diagnostic image, matches the observation direction with the site, and combines the important tissue with the endoscopic observation image. It is possible to observe the dimensional observation data composite image.

[0135] Also, the 3
The dimensional data image is also input to the movable range calculation device 62. The movable range calculating device 62 is a three-dimensional image data synthesized by the data on the position of the oblique endoscope 2 from the position calculating device 58 and the preoperative diagnostic data signal of the patient from the image preoperative diagnostic data storage device 60. In addition, 3 of the real-time observation region from the ultrasonic image generation device 204
One-dimensional ultrasonic image data is input. Therefore, in the movable range calculation device 62, the data from the image generation device 59 obtained by adding the data regarding the position of the oblique endoscope 2 from the position calculation device 58 and the preoperative diagnostic data storage device 60 are added.
By comparing the three-dimensional image data and the three-dimensional ultrasonic image data of the observation site in real time, a position that is not a space on the three-dimensional ultrasonic image data, that is, the distal end of the oblique endoscope 2 becomes an important tissue. When there is a possibility of contact with the arm, a movement restriction signal for restricting the movement of the arm is input to the arm drive control device 63 in the gantry 3.

This movement restriction signal is transmitted to the foot switch 34 or the operation grips 32a, 3 so that the operator can change the observation position.
The circuit is configured to give priority to a signal from an arm free / lock switch (not shown), which is operation switches 33a and 33b provided in 2b. For this reason, even when the surgeon moves the endoscope for strabismus 2 just below the important tissue, or when an erroneous operation input is performed,
The distal end of the squint endoscope 2 does not damage important tissues.

As described above, according to the surgical microscope according to the present embodiment, the effects of the second embodiment can be realized at low cost. Further, even when the operation microscope apparatus itself is out of balance by operating the oblique endoscope 2 or the like, a warning of an unbalanced state can be issued beforehand. In addition, since the three-dimensional ultrasonic diagnostic apparatus is used to acquire a real-time three-dimensional diagnostic image of the operative site, the microscope itself can be configured to be compact, and the operative site becomes optically poor due to bleeding of the patient. In this case, the operation can be reliably performed. In addition, since the electromagnetic clutch cannot be released in the unbalanced state, the operation of the arm in a state where the balance is lost is prevented, and the surgical microscope 1 and the oblique endoscope 2 suddenly change when the visual field is changed. There is no possibility of injuring the moving operation part.

According to the technical contents described above, the following various configurations can be obtained.

[0139] 1. In a surgical microscope having a stereoscopic observation unit for observing an operation part and a gantry arm for holding the stereoscopic observation unit three-dimensionally, a stereoscopic image imaging unit provided in the stereoscopic observation unit, and the stereoscopic image imaging unit Image measuring means for performing three-dimensional measurement according to the means, a navigation device comprising a preoperative diagnostic image and a position measuring means provided in the three-dimensional observation means, and synthesizing a three-dimensional image from the navigation device and the image measuring means. Image combining means; movable range calculating means for calculating a moving range of the gantry arm according to the image combining means; and gantry arm controlling means for controlling movement of the gantry arm according to the movable range calculating means. And surgical microscope.

2. The surgical microscope according to claim 1, wherein an image of the image combining unit is displayed in a stereoscopic observation unit. 3. First observation means for observing an operation part, second observation means for observing the operation part or its vicinity, and a gantry arm for holding the first and second observation means three-dimensionally A surgical microscope having: a three-dimensional image capturing means provided in the first observation means; an image measuring means for performing three-dimensional measurement according to the three-dimensional image capturing means; A navigation device including a position measurement unit provided in the second observation unit;
Image combining means for combining a three-dimensional image from the navigation device and the image measuring means, movable range calculating means for calculating the moving range of the gantry arm according to the image combining means, and movement of the gantry arm according to the movable range calculating means And a gantry arm control means for controlling the operation of the microscope.

4. The three-dimensional image capturing means is at least one
4. The surgical microscope according to claim 1, comprising at least one image pickup device (CCD). 5. The surgical microscope according to claim 1, wherein the three-dimensional image capturing unit is a three-dimensional ultrasonic observation unit. 6. The surgical microscope according to claim 3, wherein the image of the image combining unit is displayed in the first observation unit.

7. The surgical microscope according to claim 3, wherein the second observation means is an endoscope. 8. First observation means for observing an operation part, second observation means for observing the operation part or its vicinity, and a gantry arm for holding the first and second observation means three-dimensionally And an operation microscope having at least a balance detecting means for detecting a balance of the gantry arm in the direction of one degree of freedom, comprising a gantry arm control means for controlling movement of the gantry arm according to the balance detection means. Surgical microscope.

9. 9. The operating microscope according to claim 8, wherein the gantry arm control means limits movement of the gantry arm during balance adjustment of the gantry arm. 10. 9. The surgical microscope according to claim 8, wherein the gantry arm control means limits movement of the gantry arm to electric only during balance adjustment of the gantry arm.

(Purpose of paragraphs 1 and 2) In an operation performed using a surgical microscope and an endoscope in combination, a diagnostic image (particularly one in which important tissue information is emphasized) and information on a current surgical site are displayed. In addition to being able to superimpose and observe in real time, the movement of the gantry arm near the important tissue is limited to a safe area, so that the tip of the endoscope does not damage the tissue,
It is an object of the present invention to provide a surgical device capable of performing safe and easy surgery.

(Effect of the First Item) According to the present configuration, the surgeon can observe an image obtained by superimposing a diagnostic image emphasizing important tissues on an actual microscope / endoscopic observation image. Therefore, it becomes possible to safely perform the operation of the endoscope, which had been forced to be performed within a limited field of view, electrically while grasping the correlation with the important tissue. In addition, when operating the endoscope in the vicinity of important tissue, the movement of the arm is restricted outside the range where safe endoscopic observation is possible, making it possible to perform endoscopic observation extremely safely Becomes Furthermore, even in the event that the surgeon performs an erroneous operation that is likely to damage the patient, the movement of the arm is similarly restricted to a range other than the range that allows safe endoscopic observation, There is no possibility of damaging the surgical site. For this reason, it is effective in dramatically improving the safety of the operation and greatly shortening the operation time.

(Purpose of paragraphs 3 to 7) In an operation performed using a surgical microscope and an endoscope in combination, a diagnostic image (particularly one in which important tissue information is emphasized) and information on a current surgical site are displayed. Can be superimposed and observed in real time, and the movement of the gantry arm can be restricted to a safe area in the vicinity of the important tissue. Further, when the balance state of the gantry arm is deteriorated, the operation of the gantry arm is limited to electric only until the balance correction is automatically completed, thereby providing a surgical instrument capable of performing a safe and easy operation. Is the purpose.

(Effect of item 3) According to the present configuration, the surgeon can observe an image obtained by superimposing a diagnostic image emphasizing an important tissue on an actual microscope / endoscopic observation image. Therefore, it becomes possible to safely perform the endoscope operation, which had been forced to be performed within a limited field of view, by electric or direct hand while grasping the correlation with the important tissue. In addition, when operating the endoscope in the vicinity of important tissue, the movement of the arm is restricted outside the range where safe endoscopic observation is possible, making it possible to perform endoscopic observation extremely safely Becomes Further, the imbalance of the arm due to the operation of the endoscope can be automatically detected and corrected, so that a sudden movement of the endoscope caused by the imbalance of the arm can be prevented. Furthermore,
Even in the event that the surgeon performs an erroneous operation likely to damage the patient, similarly, the movement of the arm by motor is restricted to a range other than the range where the endoscope observation can be performed safely. In addition, the arm can be automatically fixed even during manual operation. Therefore, there is no possibility of damaging the operation site. This is also effective in dramatically improving the safety of the operation and greatly reducing the operation time.

(Purpose of paragraphs 8 to 10) In an operation performed using an operating microscope and an endoscope in combination, a diagnostic image (particularly information on important tissue is emphasized) and information on the current surgical site Can be superimposed in real time and observed.
In the vicinity of the important tissue, the movement of the gantry arm can be restricted to a safe area. Also, if the balance state of the gantry arm is deteriorated, it is displayed to that effect, and by limiting the movement of the gantry arm until the balance correction is completed, it is intended to provide a surgical instrument that can perform a safe and easy operation. is there.

(Effect of Item 8) According to this configuration, even when performing an operation by attaching an endoscope to an operating microscope,
An imbalance of the arm due to the operation of the endoscope is automatically detected and displayed, and the manual movement of the arm is restricted until the balance is corrected. For this reason, it is possible to prevent a sudden movement of the endoscope caused by the imbalance of the arm. This is effective in dramatically improving the safety of surgery.

[0150]

As described above, according to the surgical microscope of the present invention, useful information for the operation can be obtained, and the tissue is not damaged by the endoscope endoscope. Can be performed.

[Brief description of the drawings]

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

FIG. 2 is a configuration diagram of a microscope of the surgical microscope apparatus of FIG.

FIG. 3 is a configuration diagram of an optical system of the microscope in FIG. 2;

FIG. 4 is an image generated by the surgical microscope apparatus of FIG. 1;

FIG. 5 is an overall configuration diagram of a surgical microscope apparatus according to a second embodiment of the present invention.

FIG. 6 is a configuration diagram of a microscope of the surgical microscope apparatus of FIG. 5;

FIG. 7 is an image generated by the surgical microscope apparatus of FIG. 5;

FIG. 8 is an overall configuration diagram of a surgical microscope apparatus according to a third embodiment of the present invention.

9 is a configuration diagram of a microscope of the surgical microscope apparatus of FIG.

[Description of Signs] 1 ... Surgical microscope (stereoscopic observation means) 2 ... Perspective endoscope (stereoscopic observation means) 3 ... Mount 11 ... Operation arm unit 43a, 43b ... Imaging element (stereoscopic image imaging means) 53a, 53b ... Processor (image measuring means) 58 ... Position calculating device (position measuring means) 60 ... Preoperative diagnostic data storage device 61 ... Image synthesizing device (image synthesizing means) 62 ... Movable range calculating device (movable range calculating means) 63 ... Arm Drive control device (gantry arm control means)

──────────────────────────────────────────────────続 き Continued on the front page (51) Int.Cl. ⁷ Identification symbol FI Theme coat ゛ (Reference) H04N 7/18 H04N 7/18 M // H04N 13/02 13/02 13/04 13/04 (72) Inventor Takashi Fukaya 2-43-2 Hatagaya, Shibuya-ku, Tokyo F-term in Olympus Optical Co., Ltd. (reference) 2H052 AA13 AB19 AB24 AB25 AB26 AD05 AD32 AF01 AF14 AF22 AF25 5C054 AA01 CC07 FD01 FE13 GA00 GB01 HA12 5C061 AA03 AA11 AB06 AB08 AB14

Claims (1)

[Claims] 1. A surgical microscope apparatus having a stereoscopic observation means for stereoscopically observing an operation part, and a movable gantry arm for holding the stereoscopic observation means in three dimensions. A three-dimensional image capturing means for capturing a three-dimensional image obtained by the three-dimensional observation means; an image measuring means for performing three-dimensional measurement of an image captured by the three-dimensional image capturing means; and a storage for storing a preoperative diagnostic image A navigation device comprising a device and position measuring means for measuring an observation position by the stereoscopic observation means, forming a three-dimensional image data signal in which a preoperative diagnostic image is matched with a current observation position; and Image synthesizing means for synthesizing a three-dimensional image based on a signal of the image measuring means and a measurement result from the image measuring means; and a three-dimensional image synthesized by the image synthesizing means. Surgery, comprising: a movable range calculating means for calculating a movable range of the gantry arm based on the following; and a gantry arm controlling means for controlling movement of the gantry arm based on the calculation result of the movable range calculating means. Microscope equipment.