JP2001104335A - Surgical observation system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To effectively display within the field of view of a first observing means an image observed in real time by a second observing means, while correlating the image with an image observed by the first observing means. SOLUTION: This surgical observation system has a surgical microscope 1 for observing a portion A to be operated on, and an ultrasonic probe 37 differing from the surgical microscope 1 in at least either one of observing direction or method. The observing positions and directions of the surgical microscope 1 and the ultrasonic probe 37 relative to the portion A to be operated on are detected, and an image observed by the ultrasonic probe 37 is displayed on a predetermined portion of an image observed by the surgical microscope 1, while the former is visually correlated with the latter according to the detection result.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical observation system suitable for an operation under a microscope such as neurosurgery.

[0002]

2. Description of the Related Art For example, in order to perform more accurate surgery when performing an operation using an operating microscope in neurosurgery or the like, not only endoscopes but also diagnostic techniques other than visible light such as ultrasonic diagnostic equipment are used. It has been desired to proceed with the treatment while observing / diagnosing, in real time, tissue at a site that cannot be seen with a surgical microscope on the back side or inside of the operation part.

[0003] JP-A-62-166310, JP-A-3-105305, and JP-A-7-2610.
No. 94 discloses a surgical observation system in which a blind spot of a surgical microscope is observed with an endoscope or the like, and an optical image of the observation unit is projected into a visual field of the surgical microscope. However, in these conventional surgical observation systems, the image observed by an endoscope or the like is simply projected into the field of view of the microscope, so that the surgeon can view the endoscope image actually observed through the field of view of the microscope. It was difficult to determine which part of the observation image. In addition, when this technology is applied to a diagnostic device that does not use visible light, such as an ultrasonic diagnostic device, the operator can grasp which part of the patient is actually diagnosing from only the image in the observation field of view. It was almost impossible. Other than relying on the surgeon's experience to judge the characteristic part of the diagnostic image and the actual observation image by superimposing them in the head, the diagnostic part could not be grasped from such an image.

Japanese Patent Application Laid-Open No. 9-56669 discloses that, when an image obtained by an endoscope or the like is displayed in a field of view of a microscope, a position other than a portion where a main observation image observed by an operator is displayed. A surgical microscope system having improved operability by displaying an image by an endoscope or the like as a child screen is disclosed. However, in this case, there is no means for grasping where the surgeon is observing when using the endoscope and the ultrasonic observation device together. Therefore, the endoscope or ultrasonic probe can be unnecessarily swung back and forth and left and right to compare the microscope image and superimpose the characteristic parts in the surgeon's head, and the observation site can be grasped only by making a judgment. Did not.

Further, Japanese Patent Application Laid-Open No. 6-209953 discloses a method for guiding a second observation means such as an ultrasonic probe into the field of view of a surgical microscope. However, in this conventional technique, there is no method for effectively displaying the observation image of the second observation means in the visual field of the microscope, and therefore, the surgeon can copy the optical image of the microscope and the image of the second observation means to the head. There was no choice but to make a correlation.

[0006] Further, in Japanese Patent Application No. 11-132688,
A surgical microscope system has been proposed in which the observation field direction of the endoscope is displayed in the visual field of the microscope with an arrow or the like. In this manner, merely by indicating the observation direction, the microscope optical image and the endoscope image are displayed. Not enough to correlate. That is, the operator has only to judge in the head by the correlation based on the rotation of the image of the endoscope image with respect to the microscope optical image, the difference in magnification, and the like. When an ultrasonic observation device is used as the auxiliary observation means, the observation direction is not constant, for example, 36
Since the circumference is 0 °, it is difficult to align the observation image and the actual surgical site on this display.

In the display system disclosed in Japanese Patent Application Laid-Open No. 6-205793, a preoperative diagnostic image is displayed by being superimposed on an operative image by a half mirror. Are superimposed, making it difficult to see the field of view of the microscope, and hindering the actual surgical operation. Therefore, this system can only determine the craniotomy position before the operation, and it is not possible to correlate the tissue information at the back thereof with the operation part accurately and in real time during the operation.

The present invention has been made in view of the above-mentioned circumstances, and an object of the present invention is to provide a real-time observation image of the second observation means within the field of view of the first observation means. The effective display is made in correlation with the observation image of the means.

[0009]

In order to achieve the above object, a surgical observation system according to claim 1 comprises a first observation means for observing a surgical site, the first observation means, an observation direction and an observation. A second observation means different from at least one of the methods in the surgical observation system, wherein the observation position and direction of the first observation means and the observation position and direction of the second observation means are respectively relative to the operation site. Detecting means for detecting the position, and display means for visually correlating and displaying the observation image of the second observation means with a predetermined portion of the observation image of the first observation means based on the detection result. It is characterized by having.

According to a second aspect of the present invention, there is provided a surgical observation system, wherein the first observation means observes a surgical site, and the second observation means differs from the first observation means in at least one of an observation direction and an observation method. Detecting means for detecting the relative position of the observation position of the second observation means with respect to the preoperative diagnostic image, and matching the observation position of the second observation means based on the detection result. It is characterized by having a display means for simultaneously displaying a preoperative diagnostic image and an observation image of the second observation means within the field of view of the first observation means.

Further, in the surgical observation system according to the third aspect, the first observation means for observing the surgical site, and the second observation means in which at least one of the observation direction and the observation method is different from the first observation means. And an observation position and direction of said first observation means and said second observation means.
Detecting means for detecting the relative position of the observation position and direction of the observation means with respect to the surgical site; an indicator for indicating an arbitrary position within the observation field of view of the first observation means; And display means for superimposing and displaying the observation image of the second observation means in the observation field of view of the first observation means.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS <First Embodiment> A first embodiment of the present invention will be described below in detail with reference to the drawings. FIG. 1 shows the entire configuration of a surgical microscope as a first observation means in the surgical observation system according to the present embodiment. FIG. 2 shows a block diagram in the present embodiment, and FIG. 3 shows the mirror body of the surgical microscope in detail. 4 and 5 show the operation of the first liquid crystal shutter and the second liquid crystal shutter, respectively, and FIG. 6 shows an image observed by the operator. FIG. 7 shows an example of a display image on the monitor 40 and the monitor 14.

First, the configuration of the surgical observation system according to the first embodiment will be described. The surgical microscope of the surgical observation system according to the present embodiment includes a pedestal 21 having a base 21a movable on a floor surface and a support 21b erected on the base 21a, and an upper end of the support 21b. , One end of a first arm 22 having a built-in illumination light source (not shown) is attached to be rotatable about an axis Oa.

The other end of the first arm 22, that is, the column 2
One end of the second arm 23 is attached to an end separated from the end 1b so as to be rotatable about an axis Ob. The second arm 23 is formed as a pantograph-shaped arm by a link mechanism and a gas spring for balance adjustment, and can move the other end separated from the first arm 22 in the vertical direction. A third arm 24 is attached to the other end of the second arm so as to be rotatable about an axis Oc. Further, the third arm 24 has an axis Od.
There is provided an elevating arm 25 which enables the operator to vertically elevate the mirror 1 with respect to the observation direction of the mirror body 1 in the front-back direction and to elevate the operator in the left-right direction about the axis Oe. The mirror body 1, the observation unit 2, and the handle 26 are provided at the tip of the raising arm 25.

Further, in order to be able to freely adjust the position of the mirror body 1 in the three-dimensional space, each of the rotating portions that rotate around these axes Oa to Oe is not shown. An electromagnetic brake is provided, and a switch (not shown) provided on the handle 26 is formed so that an operation of locking / freezing these rotating portions can be performed. It is preferable that the power supply section of these electromagnetic brakes is built in the support 21b.

As shown in FIG. 2, the mirror 1 is located above the operative site A, and an index 3 for optical position detection is attached to a predetermined surface of the mirror 1. Indices 3 include:
A plurality of time-division light-emitting infrared rays LE not described in detail
D is attached.

Although two observation optical systems for supplying light beams to the left and right eyes of the operator are provided inside the mirror body 1, only one observation optical system will be described for the sake of simplicity. I do. As shown in FIG. 3, the observation optical system 10 includes an objective lens 4, a first imaging lens 6, a lens 7, a second imaging lens 8, And a lens 9. The observation optical system 10
Half mirror 1 between lens 7 and second imaging lens 8
1 is inserted. The half mirror 11 is attached in a direction to reflect a light beam from a direction perpendicular to the optical axis of the observation optical system 10 toward the eyepiece lens 9. A lens 12, a third imaging lens 13, and a monitor 14, which are sequentially arranged on an optical axis perpendicular to the optical axis of the observation optical system 10, constitute a projection optical system 15.

Further, the first imaging lens 6 of the observation optical system 10
The first liquid crystal shutter 16 is provided at the image forming point of the projection optical system 15, and the second liquid crystal shutter 16
A liquid crystal shutter 17 is provided.

As described with reference to FIG. 2, the index 1 for optical position detection is attached to the mirror body 1, and the optical position detection is performed at a required position in the operating room where the index 3 can be photographed. A member 30 (hereinafter, referred to as a digitizer 30) is provided.

The digitizer 30 has a plurality of infrared cameras (not described in detail), and these infrared cameras are attached at predetermined intervals. This digitizer 30
Is connected to the position detecting device 31. The position detecting device 31 is connected to a calculating unit 32, and the calculating unit 3
2, a mixer 33 and a liquid crystal driver 34 are connected. The input unit 35 and the foot switch 36 are connected to the calculation unit 32. The foot switch 36 is provided with an image on / off switch (not shown).

As shown in FIG. 3, the liquid crystal driver 34 includes:
The first liquid crystal shutter 16 and the second liquid crystal shutter 17 built in the mirror body 1 are connected. The mixer 33
It is connected to a monitor 14 built in the mirror 1.

Reference numeral 37 in FIG. 2 denotes an ultrasonic probe inserted into the operative site A. An index 38 similar to that attached to the mirror body 1 is attached to the ultrasonic probe 37. A plurality of infrared LEDs (not described in detail) of a time-division luminescence type are attached to the index 38, but the time-division luminescence pattern of the plurality of infrared LEDs attached to the index 38 is The position detecting device 31 is different from the one attached to the index 3 of the mirror body 1 and can detect each position separately.

The ultrasonic probe 37 is connected to an ultrasonic observation device 39. A video output (not shown) of the ultrasonic observation device 39 is connected to the monitor 40 and the mixer 33.

Next, referring to FIG. 1 to FIG.
The operation of the surgical observation system according to the embodiment will be described. A light beam emitted from a light source device (not shown) built in the first arm 22 is applied to the operative site A of the patient via an optical fiber (not shown) and an illumination optical system (not shown). The luminous flux reflected at the operation site A is, as shown in FIG.
The incident light from the objective lens 4 of the mirror body 1 and the first imaging lens 6
The image is formed via the first liquid crystal shutter 16, the lens 7, the half mirror 11, and the second imaging lens 8, and is magnified and observed by the operator through the eyepiece 9. At this time, the entire state of the first liquid crystal shutter 16 is in a transmissive state as shown in FIG. FIG. 6A shows an image observed by the operator at this time. This operation will be described later.

On the other hand, the ultrasonic probe 37 inserted into the surgical site A can be formed by a known ultrasonic probe that emits ultrasonic waves from a rotating portion (not shown) at the tip of the probe. Then, the ultrasonic wave reflected from the operation site is received by a sensor (not shown), and the signal is transmitted to the ultrasonic observation device 39. The ultrasonic observation device 39 analyzes a signal transmitted from the ultrasonic probe 39 and obtains a video signal obtained by performing image processing on the internal structure of the tissue based on the attenuation / phase of the ultrasonic wave due to the rotation angle of the rotating unit (not shown). It is created, output to the monitor 40, and displayed. The image projected on the monitor 40 at this time is shown in FIG. This monitor 4
The same video signal that is output to 0 is also output to the mixer 33.

The index 3 attached to the mirror 1 is
A plurality of infrared LEDs (not shown) are emitted in a predetermined pattern in a time-division manner. Similarly, the ultrasonic probe 3
The indicator 38 attached to 8 also emits a plurality of infrared LEDs (not shown) in a different pattern from the indicator 3 in a time-division manner.

The light emitting states of these indices 3 and 38 are photographed by a plurality of infrared cameras (not shown) of the digitizer 30. Information captured by the digitizer 30 is analyzed by the position detecting device 31 and the mirror 1 and the ultrasonic probe 38 are analyzed.
Is detected in the three-dimensional space. This optical position detection method can use an appropriate known technique.

Further, since the position of the operation part A is also positioned in the three-dimensional space, the position detecting device 31 includes the operation part A, the mirror 1 (observation position of the surgical microscope), and the ultrasonic probe 3.
8 (observation plane with ultrasonic waves).

As shown in FIG. 2, the position detection information detected by the position detecting device 31 is sent to the arithmetic section 32. At this time, assuming that an image on / off switch (not shown) of the foot switch 36 is off, the arithmetic unit 32
Outputs an image-off signal to the mixer 33 and the liquid crystal driver 34. Upon receiving the image-off signal from the arithmetic unit 32, the mixer 33 does not output an image. Therefore, the monitor 14 connected to the mixer 33 is in a state where no image is projected. When the liquid crystal driver 34 receives the image-off signal from the arithmetic unit 32, the first liquid crystal shutter 16
And a predetermined output to the second liquid crystal shutter 17. Upon receiving this output, the first liquid crystal shutter 16 operates as shown in FIG.
As shown in FIG. Further, the second liquid crystal shutter 17 is in a completely light-shielded state shown in FIG. Therefore, the image of the monitor 14 does not reach the operator,
The operator observes only the optical image of the operative site A. This observation state is shown in FIG.

Next, when the operator turns on the image on / off switch provided on the foot switch 36, this signal is sent to the arithmetic section 32. In this state, the operation unit 32
Calculates the position of the tip of the ultrasonic probe 38 within the observation field of view of the surgical microscope based on the detection information from the position detection device 31. In addition, the position of the monitor 14 corresponding to the tip position and the positions of the first liquid crystal shutter 16 and the second liquid crystal shutter 17 are calculated.

Next, the arithmetic section 32 calculates the signal from the input means 35 and determines the size of the image in the microscope field of view. The operator can change the image to an arbitrary size by operating the input unit 35.

The operation section 32 outputs a control signal to the mixer 35 based on the operation result and the signal from the input means 35. That is, the mixer 35 converts the output image of the ultrasonic observation device 39 into an image centered on the position corresponding to the distal end position of the ultrasonic probe 38 on the monitor 14, and reduces the image to the size set by the input unit 35. Generate an image signal. This image signal is shown in FIG.

Next, the arithmetic section 32 outputs a control signal to the liquid crystal driver 34. That is, the liquid crystal driver 34
Are the first liquid crystal shutter 16 and the second liquid crystal shutter 1
7, a light-shielding portion 41 (first liquid crystal shutter 16) and a light-transmitting portion 42 (second liquid crystal shutter 17) having a position / size corresponding to the range of the reduced image generated by the mixer 35 are generated. This state is shown in FIG. 4B (first liquid crystal shutter 16) and FIG. 5B (second liquid crystal shutter 17).
Are shown below.

As a result, the optical observation image incident from the objective lens 4 is blocked by the first liquid crystal shutter 16
Only the portion 1 is shielded from light, and only the reduced image portion of the monitor 14 is transmitted to the half mirror 11 side through the transmission portion 42 of the second liquid crystal shutter 17.

That is, the monitor 14 is located within a predetermined range centered on the tip of the ultrasonic probe 37 in the microscope observation image.
Are superimposed and the operator observes. When the operator moves the ultrasonic probe 37 within the visual field of the microscope, the ultrasonic image also moves within the visual field.
This observation state is shown in FIG.

When the surgeon operates the image on / off switch (not shown) of the foot switch 36 again, the ultrasonic image disappears instantaneously and returns to the observation state shown in FIG.

Therefore, according to the surgical observation system of the first embodiment, the following effects can be obtained.

In the first embodiment, the surgeon can superimpose the optical observation image and the ultrasonic diagnostic image at the same time and observe the image, and superimposes a part of the optical observation image. Not only is it easy to correlate the image with the surgical site, but the transition to treatment can be performed smoothly. In addition, since the image follows the ultrasonic probe, the operator can immediately observe the part he wants to observe. As a result, the operation time is shortened and the operator's fatigue is reduced.

<Second Embodiment> Next, a second embodiment of the present invention will be described with reference to FIGS. In the figure, the first
The same parts as those of the embodiment are denoted by the same reference numerals, and description thereof will be omitted. FIG. 8 shows a block diagram in the present embodiment, FIG. 9 shows the mirror body of the surgical microscope in detail, and FIG.
Indicates the state of the image observed by the operator.

First, the configuration of the surgical observation system according to the second embodiment will be described. In the second embodiment, as shown in FIG. 9, a variable power optical system 50 is inserted between the objective lens 4 of the mirror body 1 and the first imaging lens 6. A sensor (not shown) is provided in a lens driving unit (not shown) of the variable power optical system 50, and this sensor is connected to magnification detecting means 56. This magnification detecting means 56
Is connected to the calculation unit 55 as shown in FIG.

A change-over switch (not shown) of the foot switch 57 connected to the arithmetic section 55 is connected to the position detecting device 54. The output of the digitizer 30 is connected to the position detecting device 54 in the same manner as in the first embodiment. The position detection device 54 has an image generation unit (not shown), and this image output is connected to a monitor 53 built in the mirror body 1 as shown in FIG. On the exit side of the monitor 53, a fourth imaging lens 52 and a mirror 51 are sequentially arranged. The imaging position of the fourth imaging lens 52 substantially coincides with the reflection surface of the mirror 51, and the imaging position approximately coincides with the imaging surface of the second imaging lens 8. Therefore, the surgeon needs the eyepiece 9
, The microscope optical image formed by the second imaging lens 6 and the image of the monitor 53 formed by the fourth imaging lens 52 can be simultaneously observed.

Next, the operation of the surgical observation system according to the second embodiment will be described. Position detecting device 54
Detects the microscopic observation point and the relative position of the distal end of the ultrasonic probe 37 with respect to the operation part A, as in the case of the first embodiment. The position detection device 54 is a preoperative diagnostic image (for example, a slice image of an X-ray CT device or the like), and can normally use a slice image from a predetermined direction and a CG image in which this slice image is three-dimensionally constructed. ) Is stored in a storage unit (not shown). When the operator wants to observe an ultrasonic image within the visual field of the microscope, an image on / off switch (not shown) provided on the foot switch 57 is turned on. At this time, a signal from a sensor (not shown) provided in the variable power optical system 50 is sent to the magnification detecting means 56, which calculates the observation magnification of the microscope and outputs it to the arithmetic unit 55.

The calculation section 55 sets the display size of the ultrasonic image projected in the visual field of the microscope based on the data from the magnification detecting means 56. The state of the image observed by the operator at this time is shown in FIG.

When the surgeon operates a changeover switch (not shown) provided on the foot switch 57 in this state, the position detecting device 54 slices the preoperative diagnostic image of the portion where the tip of the ultrasonic probe 37 is located. The image is read from a storage unit (not shown), and a marker is superimposed on a portion where the ultrasonic probe 37 is located, and is output to the monitor 53. At this time, the mirror 51 moves from the retracted position (not shown) to the observation position shown in FIG. 9, and the operator can observe the image on the monitor 53 via the mirror 51 at the same time as the microscope observation image.

When the operator presses a changeover switch (not shown) once, a slice image of a preoperative diagnostic image is displayed as shown in FIG. 10B. In this state, the surgeon can correlate the slice image of the preoperative diagnostic image (with ultrasonic probe position display) with the actual surgical site and the ultrasonic diagnostic image and observe the image.

When the operator presses a changeover switch (not shown) again, the position detecting device 54 reads out a three-dimensional construction image of the operation part from a storage part (not shown) and inserts the actual ultrasonic probe 37 into the operation part A. The rotation processing (image processing) of the three-dimensional construction image is performed so as to match the direction, and the marker is superimposed on the position and direction of the ultrasonic probe 37 and output to the monitor 53. The image observed by the operator at this time is shown in FIG. In this state, the surgeon can correlate and observe the three-dimensional reconstructed image of the preoperative diagnostic image (with the ultrasonic probe position / direction display) and the actual surgical site and ultrasonic diagnostic image.

When the surgeon presses the changeover switch (not shown) again, the mirror 51 moves to the retracted position (not shown), and the operator observes the image shown in FIG.

According to the surgical observation system of the second embodiment, the following effects can be obtained. In the second embodiment, in addition to the effects shown in the first embodiment, the display size of the ultrasonic image is automatically set according to the observation magnification of the surgical microscope, so that the operator has to perform the trouble of setting each time. Omission, which leads to an increase in the efficiency of the operation. In addition, the surgeon can simultaneously observe the preoperative diagnostic image in addition to the optical observation image / ultrasonic diagnostic image, so that not only can the operator easily confirm the approximate position of the ultrasonic observation position in the entire patient but also after the craniotomy It is possible to easily recognize the difference between the actual operative site and the preoperative diagnostic image based on the intracranial pressure change and the deformation due to the exclusion of the tissue at the time of the operation, so that an accurate operation can be performed and the operation result is improved.

Although the ultrasonic diagnostic image is displayed on the monitor 14 in a substantially circular shape in the second embodiment,
The following modifications are also conceivable. That is, when a radial scan type ultrasonic probe similar to that of the above-described embodiment (a method of scanning the periphery of the probe in a circular shape) is used, as shown in FIG. May be displayed with the center portion of the image being hollowed out.
The area to be hollowed out is a radius from the tip of the ultrasonic probe to the inner wall of the tissue closest to the probe in the surgical site. This range can be determined by performing image analysis of an ultrasonic image.
Further, it can be determined by an optical position detecting device. An actual observation image of the operator at this time is shown in FIG.

According to this, the microscope optical image is displayed in the range from the ultrasonic probe to the inner wall of the tissue of the operative site where there is no diagnostic object, and the diagnostic site is reliably displayed. The operation can be performed in the same manner as the form, and the tip of the ultrasonic probe can always be confirmed on the optical observation image. improves.

<Third Embodiment> Next, a third embodiment of the present invention will be described in detail with reference to FIGS. Portions similar to those of the first and second embodiments are denoted by the same reference numerals and description thereof is omitted. FIG. 12 is an overall block diagram in the present embodiment, FIG. 13 shows an observation image of a rigid endoscope as a second observation means in the present embodiment, and FIG. 14 is a first liquid crystal shutter and a second liquid crystal in the present embodiment. The operation of the shutter is shown, and FIG. 15 shows an observation image of the operator in the present embodiment.

First, the configuration of the surgical observation system according to the third embodiment will be described. Reference numeral 1 denotes a mirror body of an operating microscope similar to that of the first embodiment. The index 3 is attached to the mirror body 1 as in the first embodiment. A variable power optical system (not illustrated) of the mirror body 1 is provided with a sensor (not illustrated) as in the second embodiment, and the sensor (not illustrated) is connected to magnification detecting means 56. Further, the mirror body 1 is provided with a first liquid crystal shutter and a second liquid crystal shutter (not shown) as in the first and second embodiments, each of which is connected to a liquid crystal driver 34. The mirror 1 is provided with a monitor (not shown) similar to the first embodiment, and the monitor (not shown) is connected to the mixer 33. That is, the optical system inside the mirror body 1 in the present embodiment is almost the same as in the first embodiment.

Reference numeral 90 denotes a 90 ° oblique rigid scope, which is the second observation means of the present embodiment. One end of a light guide 91 is connected to the rigid endoscope 90.
The other end of 1 is connected to a light source 92. The rigid endoscope 90 includes a camera head 93 for capturing an observation image of the rigid endoscope.
Is installed. The camera head 93 is connected to a camera control unit 94 (hereinafter, simply referred to as CCU 94). A first video output unit (not shown) of the CCU 94 is connected to the monitor 95. CCU94
Is connected to a mixer 33 (not shown). At a predetermined position of the camera head 93, an index 96 for position detection is attached.

The digitizer 30 is installed at a position where both the index 3 attached to the mirror body 1 and the index 96 attached to the camera head 93 can be imaged. The digitizer 30 is connected to the position detecting device 31. The position detection device 31 is connected to the calculation unit 97. The arithmetic unit 97 includes a magnification detecting means 56 and a foot switch 8.
1 is connected. Further, the arithmetic section 97 is connected to the mixer 33 and the liquid crystal driver 34.

The operation of the third embodiment is as follows. The surgeon performs stereoscopic optical magnification observation of the surgical site A using the mirror body 1 as in the first embodiment. Further, the surgeon observes a portion that becomes an outer angle in the optical observation using the mirror body 1 using the rigid endoscope 90. That is, the observation light flux emitted from the light source 92 is incident on the light guide 91. The light guide 91 transmits the incident light beam to the rigid endoscope 90 connected to the other end. This light beam is applied to the operation site A through an illumination optical system (not shown) built in the rigid endoscope 90. The light beam reflected by the operation section A enters through an objective lens (not shown) of the rigid endoscope 90, and is connected to the camera head 9 connected to the rear end of the rigid endoscope 90.
An image is formed on an image sensor 3 (not shown). Camera head 9
Reference numeral 3 converts the light flux formed on the image sensor (not shown) into an electric signal and outputs the electric signal to the CCU 94. The CCU 94 converts the electric signal into a standardized video signal, and outputs it from a first video output unit and a second video output unit (not shown).

Therefore, an image photographed by the rigid endoscope 90 is displayed on the monitor 95 connected to the first video output unit (not shown) of the CCU 94 as shown in FIG. Also,
The same video signal is similarly output from the second video output unit (not shown) of the CCU 94 to the mixer 33.

Incidentally, an infrared camera (not shown) of the digitizer 30 includes an index 3 attached to the mirror body 1,
Index 9 attached to camera head 93 of rigid endoscope 90
6, an infrared LED (not shown) is photographed. Information captured by the digitizer 30 is analyzed by the position detection device 31 as in the first embodiment, and the position and orientation of the mirror 1 and the rigid mirror 90 in the three-dimensional space are detected. In addition, since the position of the operative part A is also positioned in the three-dimensional space, the position detection device 31 determines the operative part A, the observation position and the observation direction of the mirror 1, and the observation position and the observation direction of the rigid endoscope 90. This means that the respective relative positions have been detected.

The position detection information detected by the position detecting device 31 is sent to the calculating section 97. An image observed by the operator at this time is shown in FIG. The surgeon observes only the optical image obtained by the mirror 1 of the surgical microscope. At this time, the first liquid crystal shutter (not shown) built in the mirror body 1 is in a completely transmitting state, and the second liquid crystal shutter (not shown) is in a completely light shielding state. At this time, the image from the rigid endoscope 90 is displayed on the monitor 95.

Here, when the surgeon observes the image obtained by the rigid endoscope 90 in the visual field of the microscope, the surgeon operates the foot switch 81.
(Not shown) is turned on. This signal is transmitted to the operation unit 97. Arithmetic unit 97
Receives an image-on signal from the foot switch 81, first performs an arithmetic operation to display an image at a predetermined position in the microscope field of view (upper left of the microscope field of view in the present embodiment),
An instruction signal is output to the liquid crystal driver 34 and the mixer 33. That is, a signal is output to the liquid crystal driver 34 so that the first liquid crystal shutter controls the state shown in FIG. 14A and the second liquid crystal shutter controls the state shown in FIG. 14B. Also, the CCU is supplied to the mixer 33.
The video signal from 94 is reduced to an appropriate magnification calculated based on the signal from the magnification detecting means 56, and the image is moved to a portion corresponding to the light-shielding portion of the second liquid crystal shutter, and is not shown in the mirror 1 A signal is output for display on a monitor (FIG. 14C). At this time, the state of the image observed by the operator is shown in FIG. In this state, the surgeon roughly positions the rigid endoscope 90 while comparing the distal end of the rigid endoscope 90 with the operation part.

Next, when the surgeon correlates and displays the observation field of view of the microscope and the observation field of view of the rigid endoscope 90, an image movement switch (not shown) of the foot switch 81 is turned on. This signal is input to the operation unit 97. Upon receiving this signal, the arithmetic unit 97 displays an image of the rigid endoscope 90 in the microscope observation field based on the position information from the position detecting device 31 and the magnification information of the mirror 1 from the magnification detecting means 56. Calculate the position. That is, the observation range of the microscope field of view is calculated from the position and the magnification of the microscope body 1, and the tip position and the observation direction of the rigid scope 90 in the microscope field of view are calculated from above the position of the rigid scope 90. Based on this calculation result, the arithmetic unit 97 sends the rigid mirror 90 to the liquid crystal driver 34 and the mixer 33 in a circular range having the center of the rigid mirror 90 on the observation direction side with the tip position of the rigid mirror 90 as one point. An instruction signal is output in order to display the image. That is, the first liquid crystal shutter is set as shown in FIG. 14 (D), the second liquid crystal shutter is set as shown in FIG. 14 (E), and the monitor (not shown) built in the mirror body 1 is shown in FIG. A display is performed as shown in FIG. This allows the surgeon to
A visual field as shown in FIG. 15B can be obtained within the visual field of the microscope.

Since the rigid endoscope 90 has a 90 ° oblique view, for example, when the rigid endoscope 90 is rotated by 90 ° in the axial direction, the observation direction changes. Also in this case, the image of the rigid endoscope 90 is displayed in a circular range having the distal end of the rigid end point as one point and its center on the observation direction side, so that a field of view as shown in FIG. Becomes

The third embodiment is particularly effective when the second observation means is observing a predetermined direction from the tip of the probe, such as a rigid endoscope or a forward scan type ultrasonic observation apparatus. Since the observation image is displayed in the direction, not only the observation direction and the position of the second observation means can be easily grasped, but also the optical image of the actual surgical site and the image by the second observation means are correlated in position. Since it is displayed, it is possible to quickly and accurately grasp the condition of the surgical site.

In the second to third embodiments, the second observation means is described as a means for observing a smaller area than the surgical microscope which is the first observation means, but the present invention is not limited to this. It is not something to be done. For example, X-ray CT
When an image of a wide area including the operative site is obtained by the device or the like, if the positional relationship between the image and the actual operative site, and the position of the microscope body can be grasped, a part of the image is cut out and similarly placed in the microscope field of view. It may be projected. In each embodiment, the image is displayed following the tip of each probe.
When the image is a wide range image such as a line CT image, a cursor may be displayed in the field of view of the microscope, and the operator may move the cursor with a foot switch or the like so that the cut-out image follows the cursor. As a result, the surgeon can observe only the X-ray CT image of the part to be referred to in association with the operative site, and can achieve the effects of the present invention.

In the first to third embodiments, an operating microscope is used as the first observation means, and the image of the second observation means is superimposed on the microscope optical image. However, the present invention is not limited to this. Not something. That is, it is clear that the same effect can be obtained even if the display image of the first observation means is a TV monitor.

According to the above description, at least the features listed below as additional notes are obtained.

<Supplementary Notes> In a surgical observation system having a first observation unit for observing a surgical site and a second observation unit different from the first observation unit in at least one of an observation direction and an observation method, an observation position of the first observation unit Detecting means for detecting the relative position of the observation position and direction of the second observation means with respect to the surgical site, and the observation image of the second observation means based on the detection result. A display means for visually correlating and displaying a predetermined portion of the image.

(Operation of the First Item) This operation observation system displays an image of the second observation means in correlation with a part of the observation image of the first observation means. The observation position and the observation position of the first observation means are detected by an optical position detection device or the like with reference to the operative site, and the predetermined position of the observation image of the first observation means is set at a predetermined position of the second observation means. The observation image is cut out, and the image size is adjusted and displayed.

2. In a surgical observation system having first observation means for observing a surgical site and second observation means different from the first observation means in at least one of an observation direction and an observation method, an observation position of the second observation means Detecting means for detecting a relative position with respect to the preoperative diagnostic image, a preoperative diagnostic image corresponding to the observation position of the second observing means based on the detection result, and an observation image of the second observing means in the first observation. Display means for simultaneously displaying within the field of view of the means.

(Operation of the Second Item) The image of the second observation means is displayed in correlation with a part of the observation image of the first observation means, and the observation position of the second observation means is optically detected. The position is detected based on the operative site by a device or the like, and the observation image of the second observation unit is displayed within the field of view of the observation image of the first observation unit, and the observation position of the second observation unit is the position of the preoperative diagnosis image. The corresponding part is simultaneously displayed in the observation field of view of the first observation means.

3. In a surgical observation system having a first observation unit for observing a surgical site and a second observation unit different from the first observation unit in at least one of an observation direction and an observation method, an observation position of the first observation unit Detection means for detecting the relative position of the observation position and direction of the second observation means with respect to the surgical site, and an indicator for indicating an arbitrary position within the observation field of view of the first observation means;
Display means for following the indicator and displaying the observation image of the second observation means in a predetermined range in a superimposed manner within the observation field of view of the first observation means.

(Operation of the Third Item) The image of the second observation means is displayed in correlation with a part of the observation image of the first observation means, and the operator operates the pointer to perform the first observation. An arbitrary position is set within the observation field of view of the means, and the observation image of the second observation means is
The image is cut out to a predetermined range of the pointer, adjusted in image size and the like, and displayed.

4. 4. The surgical observation system according to the above item 3, wherein the indicator is a predetermined part of the second observation means.

5. The surgical observation system according to any one of claims 1 to 4, wherein the second observation means is an endoscope or a rigid endoscope.

6. The surgical observation system according to any one of the above items 1 to 4, wherein the second observation means is an ultrasonic diagnostic apparatus.

7. 6. The display device according to claim 6, further comprising a display unit that displays an image to be superimposed by the ultrasonic diagnostic apparatus so as to follow a probe tip portion of the ultrasonic observation apparatus projected onto the first observation unit.
The surgical observation system according to the above section.

8. 8. The surgical observation system according to claim 7, further comprising display means for displaying the superimposed image by cutting out a predetermined range of the probe tip.

9. The surgical observation system according to any one of claims 1 to 3, further comprising a setting unit that sets an image size of the second observation unit to be superimposed.

10. The surgical observation system according to claim 9, wherein the setting unit is a unit that sets an image size according to at least an observation magnification of the first observation unit.

11. 4. The surgical observation system according to claim 3, wherein the pointer is a cursor provided in a field of view of the first observation unit.

12. The surgical observation system according to any one of the above items 1 to 11, wherein the first observation means is a surgical microscope.

[0081]

As is apparent from the above, according to the present invention,
At least a part of the observation image of the second observation means is displayed in the observation visual field of the first observation means for observing the operative site, with the observation visual field of the first observation means correlated with the position / size and the like. Therefore, it is possible to easily and surely recognize the blind spot and the state inside the tissue that cannot be observed by the first observation means, and the reliability and efficiency of the operation are greatly improved.

Further, since the observation image of the second observation means is superimposed on a part of the observation image of the first observation means, it is possible to easily correlate the surgical image around and the observation image of the second observation means. The procedure can be performed smoothly, and the efficiency of the operation is improved.

[Brief description of the drawings]

FIG. 1 is a first view of a surgical observation system according to a first embodiment;
The figure which shows the whole structure of the surgical microscope which is an observation means.

FIG. 2 is a block diagram of a surgical observation system according to the first embodiment.

FIG. 3 is a detailed explanatory view of a mirror portion of the surgical microscope.

4A and 4B illustrate an operation of a first liquid crystal shutter, in which FIG. 4A is a diagram illustrating a state in which the entire surface is arranged in a transmissive state, and FIG.

5A and 5B show an operation of a second liquid crystal shutter, in which FIG. 5A is a diagram in which the entire surface is arranged in a light-shielding state, and FIG.

6A and 6B show images observed by an operator, wherein FIG. 6A shows only an optical image when the entire surface of the first liquid crystal shutter is in a transmission state, and FIG. FIG.

7A and 7B show examples of images displayed on each monitor, in which FIG. 7A shows an image displayed on the monitor by the ultrasonic probe, and FIG. 7B shows a state in which the image displayed by the ultrasonic probe is reduced to a predetermined size. Figure.

FIG. 8 is a block diagram of a surgical observation system according to a second embodiment.

FIG. 9 is a detailed view of a mirror portion of the surgical microscope.

10A and 10B show various states of images in a microscope visual field observed by an operator, FIG. 10A shows an ultrasonic image displayed by an ultrasonic probe, FIG. 10B shows a preoperative diagnostic image,
(C) is a diagram in which a preoperative diagnostic image and an ultrasonic diagnostic image are correlated with an actual operation site.

FIG. 11 shows an observation image in the second embodiment, and (A)
FIG. 3B is a view showing a center portion of an ultrasonic probe extracted by a mixer, and FIG. 3B is an actual observation image of an operator.

FIG. 12 is an overall block diagram of a surgical observation system according to a third embodiment.

FIG. 13 is a diagram showing a state in which an observation image of a rigid endoscope, which is a second observation unit, in the third embodiment is displayed on a monitor.

FIGS. 14A and 14B show the operation of a first liquid crystal shutter and a second liquid crystal shutter in a third embodiment, wherein FIGS. 14A and 14B show the relationship between a light-shielding portion and a transmissive portion, and FIG. Diagrams showing displayed states, (D) to (F)
FIGS. 7A to 7C are diagrams similar to FIGS. 7A to 7C in a state where the positions of the light shielding unit and the transmission unit have been moved.

FIG. 15 shows an observation image of an operator in the third embodiment,
The figure which shows various positional relationships between the image by a rigid endoscope and the optical image by a microscope from (A) to (D).

[Explanation of symbols]

1 ... mirror body, 2 ... observation unit, 3, 38, 96 ... index, 4,
6, 8, 9, 13, 52 ... lens, 10 ... observation optical system,
11 Half mirror, 14, 40, 53, 95 Monitor, 16, 17 Liquid crystal shutter, 21 Stand, 22,
23, 24, 25: arm, 26: handle, 30: digitizer, 31, 54: position detecting device, 32, 55, 9
7 arithmetic unit, 33 mixer, 34 liquid crystal driver, 3
6, 57, 81: Foot switch, 37: Ultrasonic probe, 39: Ultrasonic observation device, 41: Light shielding unit, 42: Transmission unit, 50: Variable optical system, 51: Mirror, 56: Magnification detecting means, 90 … Rigid endoscope, 91… light guide, 92… light source, 94… CCU.

 ────────────────────────────────────────────────── ─── Continued on the front page (72) Inventor Masahiko Kinukawa F-term (reference) 4C301 AA02 BB03 BB28 BB30 DD11 DD18 EE20 FF05 FF26 GA06 GD02 HH53 2-43-2, Hatagaya, Shibuya-ku, Tokyo JB32 KK07 KK08 KK12 KK13 KK25 KK27 LL20 5B057 AA07 BA02 BA03 BA05 BA15 CD05 CE08

Claims (3)

[Claims] A first observation means for observing a surgical site;
In a surgical observation system having at least one of an observation direction and an observation method different from the first observation means, and a second observation means, the observation position and direction of the first observation means and the observation position of the second observation means Detecting means for detecting a relative position to the surgical site with respect to the direction and direction, and, based on the detection result, converting the observation image of the second observation means into a predetermined portion of the observation image of the first observation means. And a display means for displaying in correlation with the operation observation system. 2. A first observation means for observing a surgical site,
In a surgical observation system having at least one of an observation direction and an observation method that is different from the first observation means, a relative position of an observation position of the second observation means with respect to a preoperative diagnostic image is detected. Detection means, and display means for simultaneously displaying a preoperative diagnostic image corresponding to the observation position of the second observation means and an observation image of the second observation means in the visual field of the first observation means based on the detection result, A surgical observation system comprising: 3. A first observation means for observing a surgical site,
In a surgical observation system having at least one of an observation direction and an observation method different from the first observation means, and a second observation means, the observation position and direction of the first observation means and the observation position of the second observation means Detecting means for detecting the relative position of the first and second observing means in the observation field of view and direction, and an indicator for designating an arbitrary position within the observation field of view of the first observing means; Display means for superimposing and displaying an observation image of the means in the observation field of view of the first observation means.