JP2011072732A - Medical observation system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an medical observation system which is favorable to sample an object in a body cavity with a simple operation, while suppressing a load on a patient. <P>SOLUTION: The medical observation system includes: an optical fiber for transmitting scanning light and emitting the light from an emission end; optical scanning means for vibrating a part in the neighborhood of the emission end, so as to allow the scanning light emitted from the emission end to scan a subject within a prescribed scanning range during a first period; image signal detecting means for receiving the reflection light of the scanning light from the subject and detecting an image signal; optical tweezer means for trapping the object in the subject to a part in the neighborhood of the focal position of the optical scanning means by focusing prescribed continuous light on the subject via the optical fiber and the optical scanning means during a second period for attenuating the vibration in the neighborhood of the emission end, so as to move the object to a prescribed position; and attachment means where the object is attached by pressurization against the prescribed position. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical observation system that performs both object observation and object collection using a scanning medical probe that optically scans a subject by resonating the tip of an ultrafine optical fiber.

  As a method for collecting peripheral cells in tissue, for example, as described in Patent Document 1, a small incision is made in the abdomen, a needle-like treatment tool is inserted into the abdominal wall, and the treatment tool is made to hit the peripheral cells. A percutaneous method of pulling out is known. In this case, the operation of the treatment tool is performed while fluoroscopically observing the inside of the abdominal wall using an X-ray image diagnostic apparatus or an ultrasonic image diagnostic apparatus. Another form of cell collection method is to cut the abdomen and insert the laparoscope into the abdominal wall, then insert the needle-like treatment tool into the abdominal wall through the laparoscope, hit the treatment tool to the peripheral cell and pull it out The method is known. In this form of cell collection method, the treatment tool is operated while directly observing the inside of the abdominal wall using a laparoscope.

JP 2000-316867 A

  The former method of collecting cells points out the disadvantage that the surgeon is required to have a skilled technique and experience because it is necessary to operate the treatment tool while performing fluoroscopic observation (in a state where the inside of the abdominal wall cannot be directly observed). In the latter cell collection method, since the channel through which the treatment tool is inserted is indispensable for the laparoscope, it is difficult to design the diameter of the laparoscope to be small, which is disadvantageous for realizing a minimally invasive to the patient. is there. Furthermore, in any cell collection method, it is necessary to cut the abdomen, and there is a problem that the burden on the patient is great.

  The present invention has been made in view of the above circumstances, and an object thereof is to provide a medical observation system suitable for collecting an object in a body cavity by a simple operation while suppressing a burden on a patient. It is to be.

  A medical observation system according to an embodiment of the present invention that solves the above problems includes a light source that emits predetermined scanning light, and an optical fiber that transmits the scanning light emitted from the light source and emits the light from the emission end. The optical scanning means for vibrating the vicinity of the exit end of the optical fiber so that the scanning light emitted from the exit end of the optical fiber scans the subject within a predetermined scanning range during the first period, and from the subject of the scanning light Image signal detecting means for detecting an image signal by receiving reflected light of the optical fiber, and a predetermined continuous light through the optical fiber and the optical scanning means during the second period for attenuating vibration in the vicinity of the exit end of the optical fiber. The optical tweezers are trapped in the vicinity of the focal position of the optical scanning means by condensing the object on the subject and moved to a predetermined position, and the optical tweezers are pressed against the predetermined position. A system characterized in that it has a deposition means an object that has moved are attached by means.

  When the medical observation system according to the present invention is used, since the objects are collected at a predetermined place, a skillful operation of accurately moving the treatment tool to hit the object accurately is unnecessary. The surgeon can collect the object by a simple operation of pressing the attaching means against the subject after the object is collected at a specific place. Moreover, since there is no need for an abdominal incision, the burden on the patient is greatly reduced. In the medical observation system according to the present invention, instead of abdominal incision or the like, an optical configuration (optical fiber and optical scanning means) for imaging and object collection is inserted from the mouth or the like. However, this optical configuration has a small diameter without a large-sized component such as a solid-state imaging device or a treatment instrument channel. Therefore, the burden on the patient when inserting the optical configuration is very small.

  Here, the predetermined position is, for example, a position where the vibration of the optical fiber converges and stops. Alternatively, it may be the center of the scanning range.

  For example, the adhering means is formed so as to be positioned outside the optical path of the optical scanning means in the absence of an external load, and is configured to be in close contact so as to be deformed and cover a predetermined position when pressed against the subject. Have.

  The medical observation system according to the present invention may further include a frame that accommodates the optical scanning unit. In this case, the attaching means is composed of a bellows-like tube and a gel-like adhesive. The bellows-like tube is, for example, bonded and fixed so that its base end covers the entire outer wall near the tip of the frame, and is formed to be extendable in the pressing direction. The gel-like adhesive is applied to at least a part of the inner wall of the bellows-like tube.

  The medical observation system according to the present invention may further include light source control means for controlling the light source so that the scanning light is emitted during the first period and the continuous light is emitted during the second period. Good.

  The medical observation system according to the present invention includes a pixel arrangement determining unit that determines a pixel arrangement of image information represented by each image signal according to the detection timing of the image signal by the image signal detecting unit, and the determined pixel An image creation means for creating an image by spatially arranging each image information according to the arrangement may be used.

  The predetermined continuous light may be light having a higher output than, for example, scanning light.

  ADVANTAGE OF THE INVENTION According to this invention, the medical observation system suitable for extract | collecting the target object in a body cavity by simple operation, suppressing the burden with respect to a patient is provided.

It is a figure showing roughly composition of a medical observation system of an embodiment of the present invention. It is a block diagram which shows the structure of the processor of embodiment of this invention. It is a sectional side view which shows the typical internal structure of the insertion flexible part front-end | tip of the scanning medical probe of embodiment of this invention. It is a figure for demonstrating the spot formed on a to-be-photographed object. It is a figure for demonstrating the relationship between the image information detected in the timing T, and a pixel address. It is a figure for demonstrating the collection method of the peripheral cell using the medical observation system of embodiment of this invention. It is a block diagram which shows the structure of the processor of another embodiment. It is a figure for demonstrating the collection | recovery method of the peripheral cell using the medical observation system of another embodiment.

  Hereinafter, a medical observation system according to an embodiment of the present invention will be described with reference to the drawings.

  FIG. 1 is a diagram schematically showing a configuration of a medical observation system 1 of the present embodiment. As shown in FIG. 1, the medical observation system 1 has a scanning medical probe 100. The scanning medical probe 100 has an insertion flexible portion 130 that is sheathed by a flexible outer sheath 132. The surgeon directly inserts the insertion flexible portion 130 into the patient's body cavity from the distal end (hereinafter referred to as “insertion flexible portion distal end 130a”), and guides the insertion flexible portion distal end 130a to the vicinity of the subject. Alternatively, in order to smoothly guide the insertion flexible portion distal end 130a to the vicinity of the subject, the insertion flexible portion 130 is inserted into the body cavity with a guide wire or the like.

  A proximal operation portion 150 for operating the scanning medical probe 100 is provided at the proximal end of the insertion flexible portion 130. The vicinity of the root of the insertion flexible portion distal end 130 a is configured to be bent by remote operation by the hand operation portion 150. When the vicinity of the base of the insertion flexible portion distal end 130a is bent and the direction of the insertion flexible portion distal end 130a is changed, the imaging range by the scanning medical probe 100 is moved. A connector part 110 is provided at the base end of the universal cable 160 extending from the hand operation part 150.

  The bending mechanism incorporated in the scanning medical probe 100 is the same as the bending mechanism of a general electronic scope, and the distal end of the insertion flexible portion is pulled by pulling the operation wire in conjunction with the operation of the hand operation portion 150. It is configured to bend the vicinity of the root of 130a. The bending mechanism of the scanning medical probe 100 is not shown in each drawing for the sake of simplicity.

  The medical observation system 1 has a processor 200. The processor 200 drives and controls the scanning medical probe 100 and generates an image signal based on the observation light acquired by the scanning medical probe 100, and the scanning medical probe in a body cavity where natural light does not reach. The integrated processor includes a light source device that emits scanning light through the probe 100. In another embodiment, the signal processing device and the light source device may be configured separately. The processor 200 has a connector part 210. When the connector part 110 is inserted into the connector part 210, the scanning medical probe 100 and the processor 200 are optically and electrically connected.

  FIG. 2 is a block diagram illustrating a configuration of the processor 200. In FIG. 2, in order to clarify the connection relationship between the scanning medical probe 100 and the processor 200, the configuration of the connector unit 110 is also schematically shown.

  The processor 200 includes laser light sources 230R, 230G, and 230B that oscillate laser beams corresponding to the R, G, and B wavelengths as light sources for scanning the subject. The light source is not limited to the laser light source, and may be another type of light source such as an LED (Light Emitting Diode).

  The processor 200 has a timing controller 240 that comprehensively controls the signal processing timing of each circuit of the processor 200. The timing controller 240 outputs a predetermined modulation control signal to each driver circuit of the light source drivers 232R, 232G, and 232B. The light source drivers 232R, 232G, and 232B directly modulate the laser light sources 230R, 230G, and 230B, respectively, according to the input modulation control signal. Specifically, each driver circuit causes currents having the same amplitude and phase to flow through the corresponding laser light sources in accordance with the modulation control signal. Laser light sources 230R, 230G, and 230B are pulsed light having the same intensity corresponding to R, G, and B wavelengths (hereinafter referred to as “R pulsed light”, “G pulsed light”, and “B pulsed light”). Oscillates at synchronized timing.

  The R pulse light, G pulse light, and B pulse light oscillated from each laser light source enter the optical coupler 234. The optical coupler 234 combines and emits each incident pulsed light in a state where the phases are aligned. Hereinafter, for convenience of description, the pulsed light combined by the optical coupler 234 is referred to as “coupled pulsed light”.

  The combined pulse light emitted from the optical coupler 234 enters the incident end 112a of the single mode fiber 112 included in the scanning medical probe 100. The single mode fiber 112 is accommodated in the insertion flexible portion 130 from the connector portion 110 to the insertion flexible portion distal end 130a. The coupled pulsed light incident on the incident end 112a propagates by repeating total reflection inside the single mode fiber 112.

  FIG. 3 is a side sectional view showing a schematic internal structure of the insertion flexible portion distal end 130a. Hereinafter, in describing the configuration of the scanning medical probe 100, for convenience, the longitudinal direction of the scanning medical probe 100 is defined as the Z direction, and the two directions orthogonal to the Z direction and orthogonal to each other are defined as the X direction and the Y direction. Define. According to this definition, for example, FIG. 3 is a cross-sectional view of the insertion flexible portion distal end 130 a in the YZ plane including the central axis AX of the scanning medical probe 100.

  As shown in FIG. 3, the scanning medical probe 100 is not mounted with large-sized components such as a solid-state imaging device. The outer diameter of the insertion flexible portion 130, which is the insertion portion of the scanning medical probe 100, is substantially defined by the outer sheath 132, and compared with the outer diameter of a general electronic scope on which a solid-state imaging device or the like is mounted. It is extremely thin. That is, the scanning medical probe 100 achieves even lower invasiveness than a general electronic scope.

  An inner sheath 134 having an outer diameter smaller than that of the outer sheath 132 is coaxially disposed inside the outer sheath 132. In an annular space defined by the inner wall of the outer sheath 132 and the outer wall of the inner sheath 134, a plurality of detection fibers 136 are uniformly arranged over the entire circumference. The plurality of detection fibers 136 are bundled at the end side inside the connector unit 110, and constitute a single optical fiber bundle 136B.

  A support body 138 is provided inside the inner sheath 134. The tip 112c of the single mode fiber 112 is inserted through the through hole of the support 138 and supported in a cantilever state. A biaxial (X-axis and Y-axis) piezoelectric actuator 140 supported by a support 138 is bonded to the base of the distal end portion 112c. The piezoelectric actuator 140 has a pair of X-axis electrodes and a pair of Y-axis electrodes formed on a piezoelectric body. The ends of each X-axis electrode and each Y-axis electrode are connected to electric wires (not shown) accommodated in the connector portion 110. When the connector part 110 and the connector part 210 are connected, the piezoelectric actuator 140 is connected to the X-axis driver 236X and the Y-axis driver 236Y of the processor 200 via electric wires.

  The timing controller 240 outputs predetermined drive control signals to the driver circuits of the X-axis driver 236X and the Y-axis driver 236Y. The X-axis driver 236X applies an AC voltage X between the X-axis electrodes of the piezoelectric actuator 140 in accordance with the drive control signal to resonate the piezoelectric body in the X direction. In accordance with the drive control signal, the Y-axis driver 236Y applies an AC voltage Y having the same frequency as the AC voltage X and orthogonal in phase to the Y-axis electrode of the piezoelectric actuator 140 to resonate the piezoelectric body in the Y direction. . The AC voltages X and Y are respectively defined as voltages that gradually increase at a constant rate and reach effective values (X) and (Y) over time (X) and (Y).

  The exit end 112b of the single mode fiber 112 is a surface that approximates the XY plane by combining the kinetic energy in the X and Y directions by the piezoelectric actuator 140 (hereinafter referred to as “XY approximate surface”). It rotates so that a spiral pattern may be drawn around the central axis AX. The rotation trajectory of the injection end 112b becomes larger in proportion to the applied voltage, and draws a trajectory of a circle having the largest diameter when the AC voltage having the effective values (X) and (Y) is applied.

  The coupled pulsed light is emitted from the emission end 112b of the single mode fiber 112 during the period from the start of application of AC voltage to the piezoelectric actuator 140 until the application is stopped (that is, the period corresponding to time (X) or (Y)). to continue. Hereinafter, for convenience of explanation, this period is referred to as a “sampling period”.

  After the elapse of the sampling period, the application of the AC voltage to the piezoelectric actuator 140 is stopped, and the vibration of the tip 112c of the single mode fiber 112 is attenuated. The circular motion of the exit end 112b on the XY approximate plane converges with the vibration attenuation of the tip 112c of the single mode fiber 112, and stops on the central axis AX after a predetermined time. Hereinafter, for convenience of explanation, the period from the end of the sampling period to the stop of the injection end 112b on the central axis AX (more precisely, the calculation required to stop to guarantee the stop on the central axis AX) A period slightly longer than the above time) is referred to as a “braking period”. A period corresponding to one frame includes a sampling period and a braking period. In order to shorten the braking period, a reverse phase voltage may be applied to the piezoelectric actuator 140 in the initial stage of the braking period to actively apply the braking torque.

  A condensing optical system 142 is disposed in front of the exit end 112 b of the single mode fiber 112. The combined pulse light emitted from the emission end 112b is condensed by the condensing optical system 142 to form a spot Si on the subject. The spot diameter is extremely small, for example, on the order of several microns.

FIG. 4 is a diagram for explaining the spots Si (i = 1 to n) formed on the subject. In order to obtain one image, the scanning medical probe 100 divides n spots Si into spots S ₁ , S ₂ , S ₃ ,... So as to draw a spiral pattern SP on the subject during one sampling period. , formed in this order _{S n-2, S n-} 1, S n. The interval between the spots Si is determined depending on the motion speed of the exit end 112b of the single mode fiber 112, the modulation frequency of each laser light source, and the like. The spiral pattern SP is a virtual scanning locus drawn on the assumption that continuous light is scanned on the subject instead of pulsed light.

  The position (trajectory) of the exit end 112b of the single mode fiber 112 on the XY approximate plane during the sampling period is obtained in advance as a result of repeated experiments. Further, the relationship between the position of the emission end 112b and the position in the imaging range (scanning range) where the spot Si will be formed on the subject when the combined pulse light is emitted at each position is also calculated in advance. Yes. Furthermore, the relationship between the spot formation position within the imaging range and the pixel position when imaging by detecting the reflected pulse light from each spot formation position is also calculated in advance. Based on the known information, the timing controller 240 controls the X-axis driver 236X and the Y-axis driver 236Y (that is, controls the AC voltage applied to the piezoelectric actuator 140) and controls the light source drivers 232R, 232G, and 232B. Each of (that is, modulation control of each laser light source during the sampling period) is repeated at a cycle according to the frame rate.

  The reflected pulse light of the light that forms the spot Si on the subject enters the incident end 136a of the detection fiber 136. The reflected pulsed light incident on the incident end 136a propagates by repeating total reflection inside the detection fiber 136. An exit end 136b of the detection fiber 136 (optical fiber bundle 136B) is coupled to the optical separator 238 of the processor 200 via a connecting portion between the connector part 110 and the connector part 210.

  The optical fiber bundle 136B is merely a bundle of about several tens (for example, 80) of detection fibers 136. Therefore, the optical fiber bundle 136B has a much smaller diameter than an optical fiber bundle of a general electronic scope or fiberscope (for example, an optical fiber bundle in which several hundred to thousands of optical fibers are bundled). In this embodiment, at least one detection fiber 136 is required. When the number of detection fibers 136 is one, the diameter of the scanning medical probe 100 can be further reduced.

  The optical separator 238 separates the reflected pulsed light from the optical fiber bundle 136B into reflected pulsed light of R, G, and B wavelengths, and outputs them to the photodetectors 250R, 250G, and 250B.

  As described above, the combined pulse light is guided by the single single mode fiber 112 and irradiates the subject. Therefore, the amount of reflected pulse light reflected on the subject is very small. In order to detect such weak light reliably and with low noise, a high-sensitivity photodetector such as a photomultiplier tube is employed for each photodetector of the photodetectors 250R, 250G, and 250B.

  The photodetectors 250R, 250G, and 250B photoelectrically convert the received reflected pulse light of each wavelength to generate an analog electric signal and output it to a subsequent circuit. The analog electric signal corresponding to the reflected pulse light of each wavelength is sampled and held, and converted into a digital signal sequence by the A / D converters 252R, 252G, and 252B. The converted digital signal sequence is input to a DSP (Digital Signal Processor) 254.

  The DSP 254 is configured based on the above-described known information, the position in the imaging range where the spot Si of the combined pulse light is formed (according to another aspect, the address of the pixel constituting the image), and each spot Si The conversion table which linked | related the timing T when the reflected pulsed light from A is detected is hold | maintained. The DSP 254 monitors the digital signal sequence from each A / D converter while referring to the conversion table, and converts the signal corresponding to each wavelength at each timing T to the image signal (that is, the A / D converter 252R) at each pixel address. From the A / D converter 252G is detected as a G-color luminance value, and a signal from the A / D converter 252B is detected as a B-color luminance value). The DSP 254 buffers the detected image signal of each pixel address in the frame memory FM.

The relationship between the image signal detected at each timing T and the pixel address will be specifically described with reference to FIG. Here, for convenience of explanation, the finally generated image is replaced with a simple image having a 19 × 19 pixel arrangement. The DSP 254 refers to the conversion table and detects an image signal corresponding to each wavelength at the timing t ₁ corresponding to the spot S ₁ . The DSP 254 buffers the image signal corresponding to each detected wavelength in the frame memory FM in association with the pixel address (10, 10). Image signals corresponding to each wavelength at timings T ₂ , T _3, ... Corresponding to the subsequent spots S ₂ , S ₃ ,. Are sequentially buffered in the frame memory FM in association with. Frame memory FM, the image signal of one frame (all pixels) corresponding to the spot _S 1 to S _n generated by DSP254 is buffered.

  The DSP 254 generates, for example, predetermined masking data for a pixel address that does not have an image signal corresponding to each wavelength, and buffers it in the frame memory FM. The DSP 254 reads out the image signal buffered in the frame memory FM and outputs it to the encoder 256 in accordance with the timing control by the timing controller 240.

  The encoder 256 converts the input image signal into a video signal conforming to a predetermined standard and outputs the video signal to the monitor 300. As a result, a color image of the subject consisting of R, G, and B colors is displayed on the monitor 300. The white balance, brightness, etc. of the image displayed on the monitor 300 can be adjusted by operating the operation panel 260.

  By the way, in the conventionally known medical observation system, the braking period is only a period for converging the vibration of the single mode fiber and returning the exit end to the initial position. However, in the medical observation system 1 of the present embodiment, this braking period is effectively used in order to collect an object (for example, peripheral cells of the lung). It should be noted that whether or not the processing for collecting peripheral cells using the braking period can be executed by a setting operation on the operation panel 260 can be selected.

  6 (a) to 6 (c) are diagrams for explaining a method for collecting peripheral cells using the medical observation system 1. Like FIG. 3, a schematic view of the distal end 130a of the insertion flexible portion is schematically shown. The internal structure is shown in a side sectional view. Peripheral cells are indicated by black dots in each of FIGS. 6 (a) to 6 (c). As shown in FIGS. 6A to 6C, the tube end of the outer sheath 132 is bonded and fixed so that the base end of the bellows-shaped tube 144 covers the entire periphery of the tube end. Yes. The bellows-like tube 144 has a bellows shape that can expand and contract in the direction of the central axis AX. Gel adhesive 146 is applied to a partial region of the inner wall of the bellows-shaped tube 144. As shown in FIG. 6A, the bellows-like tube 144 and the adhesive 146 are designed to be positioned outside the optical path of the combined pulsed light and the reflected pulsed light in an initial state where the object is not in contact with the subject. The combined pulsed light and reflected pulsed light are not shielded.

  In the medical observation system 1, as a pretreatment for collecting peripheral cells, the peripheral cells scattered in the scanning range are drawn to a specific place during the braking period using the principle of optical tweezers. Here, the optical tweezers is a technique for trapping an object by irradiating the object (for example, minute dielectric particles or cells of about several tens of nanometers to several tens of micrometers) with laser light. In order to trap an object using the optical tweezer technology, first, a laser beam having a predetermined wavelength (for example, a wavelength shorter (shorter than the size (length) of the object)) is brought near the object by an objective lens. Collect light. Part of the laser light condensed near the object is reflected and partially refracted on the object surface. At this time, the laser beam condensed in the vicinity of the object, that is, the photon which is a particle has momentum. For this reason, the change in the momentum of the photon due to reflection or refraction is converted into a force for trapping the object (hereinafter referred to as “trap force”) according to the law of conservation of momentum. The trapping force basically acts on the object as a force in a direction of drawing near the focal position of the objective lens. Therefore, the object is trapped near the focal position of the objective lens. When the irradiation position of the laser beam is moved, the focal position of the objective lens is also moved. Also at this time, the trapping force continues to act toward the vicinity of the focal position of the objective lens. Therefore, the object is also moved by the action of the trapping force. That is, when the optical tweezer technology is used, not only the object can be trapped but also the object can be freely operated (moved).

  As a specific pre-processing using the optical tweezer technology, the timing controller 240 is in a braking period (more precisely, from the start of attenuation of the single mode fiber 112 until the exit end 112b stops on the central axis AX). Period), any one of the laser light sources 230R, 230G, and 230B is controlled to oscillate continuous light (hereinafter referred to as “trap laser light”). Which light source is controlled to be oscillated is determined in consideration of, for example, the influence on the living tissue due to the irradiation of the laser light and the size of the trap target. The output of the trapping laser beam is higher than the output during the sampling period, and is preferably about several mW to 10 mW, for example. Note that, during the irradiation period of the trapping laser light, as shown in FIG. 6A, the optical path of the trapping laser light is secured by avoiding contact between the bellows-like tube 144 or the adhesive 146 and the subject.

  As a modification, a dedicated laser light source that oscillates the trapping laser beam and a photodetector that detects the trapping laser beam reflected by the subject may be provided separately. As the dedicated laser light source, for example, an Nd: YAG laser having a wavelength of 1064 nm generally used in the optical tweezer technology is assumed. The dedicated laser light source and the photodetector are coupled by providing an optical coupler in the middle of the single mode fiber 112 and the optical fiber bundle 136B, respectively. Alternatively, an optical fiber patch cord is additionally wired between the single mode fiber 112 and the optical coupler 234, and between the optical fiber bundle 136B and the optical separator 238, respectively. A coupler may be provided for coupling.

During the braking period, the trapping laser beam scans the subject so as to draw a locus similar to the spiral pattern SP shown in FIG. 4 from the outer periphery toward the inner periphery, as opposed to during the sampling period. Peripheral cells scattered within the scanning range, move from the outer periphery to the inner periphery of the trapped by scanning locus by trapping laser beam, a end point vicinity (vicinity spots S ₁ in FIG. 4 of the scanning locus, hereinafter, " Collected at “cell collection location”). The vibration during the braking period of the single mode fiber 112 at this time may be naturally damped, or may be precisely controlled by driving the piezoelectric actuator 140. In the latter case, the peripheral cells can be collected at a desired position within the scanning range by scanning the trapping laser beam along a desired locus.

  As shown in FIG. 6B, when the scanning medical probe 100 is pushed in the direction of the central axis AX at the stage where the peripheral cells are collected at the cell collection position, the bellows-like tube 144 is moved in the direction of the central axis AX. Folded or compressed. At the same time, the adhesive 146 is in close contact with the subject while expanding so as to be crushed toward the surface of the subject by compressing the application area on the bellows-like tube 144 and pressing it against the subject. The adhesive 146 is designed to have a size and a position sufficient to cover the cell collection position when the scanning medical probe 100 is pressed against the subject. Accordingly, the peripheral cells collected at the cell collection position adhere to the adhesive 146 pressed against the subject. As shown in FIG. 6C, the scanning medical probe 100 is moved away from the subject and then extracted outside the body, whereby peripheral cells attached to the adhesive 146 are collected.

  According to the present embodiment, since the objects are collected at a specific place, a skillful operation of accurately moving the treatment tool and hitting the object accurately is unnecessary. The operator collects the object by a simple operation of pressing the scanning medical probe 100 against the subject while directly visualizing the object using the scanning medical probe 100 after the objects are collected at a specific place. be able to. For example, even when the object moves due to the pulsation of the subject, the surgeon operates the scanning medical probe 100 so that the object is positioned at the approximate center of the screen, and then moves the scanning medical probe 100 to the subject. The object can be collected by a simple operation of pressing on the object. Discovery of an object by the scanning medical probe 100 is easy because the objects are collected at a specific location.

  Moreover, according to this embodiment, since it is not necessary to cut | disconnect an abdominal part etc., the burden with respect to a patient is reduced significantly. In the medical observation system 1, the scanning medical probe 100 is inserted from the mouth or the like instead of the abdominal incision. However, the scanning medical probe 100 has a small diameter without a large-sized component such as a solid-state imaging device or a treatment instrument channel. For this reason, the burden on the patient when the scanning medical probe 100 is inserted is extremely small.

  The above is the description of the embodiment of the present invention. The present invention is not limited to the above-described configuration, and various modifications can be made within the scope of the technical idea of the present invention. For example, the adhesive 146 may be applied not only to one place in the bellows-like tube 144 but also to a plurality of places.

  FIG. 7 is a block diagram similar to FIG. 2 showing the configuration of the processor 200z of another embodiment. FIG. 8 is a view for explaining a method of collecting peripheral cells in another embodiment, and is a side sectional view similar to FIG. 6A showing a schematic internal structure of the insertion flexible portion distal end 130az. is there. In another embodiment, the same or similar components as those of the above-described embodiment are denoted by the same or similar reference numerals, and description thereof is omitted.

  Another embodiment of a medical observation system is configured to capture a confocal image. Specifically, the timing controller 240 performs modulation control of the laser light source 230z via the light source driver 232z. For the oscillation frequency of the laser light source 230z, for example, a band that acts as excitation light on the subject is selected.

  During the sampling period, pulsed light corresponding to each pixel is oscillated from the laser light source 230z. The pulsed light oscillated by the laser light source 230z enters the condensing optical system 142z through the single mode fiber 112z. Here, the condensing optical system 142z functions as a confocal pinhole that extracts only the reflected light from the condensing point of the irradiated light beam on the subject, while the exit end 112bz of the single mode fiber 112z functions as a point light source. Designed to be The reflected light (fluorescence) from the subject that is two-dimensionally scanned from the inner periphery to the outer periphery of the spiral pattern SP enters the exit end 112bz. The fluorescence incident on the exit end 112bz propagates through the single mode fiber 112z and propagates to the optical path branched from the pulsed light (excitation light) by the optical separator 238z. The fluorescence whose optical path is branched is detected by the photodetector 250z and converted into an analog electric signal. The A / D converter 252z converts an analog electric signal into a digital signal sequence. The DSP 254 assigns pixel addresses to the digital signal sequence according to the detection timing, and buffers an image signal for one frame corresponding to each pixel in the frame memory FM. The encoder 256 converts the buffered image signal into a video signal that conforms to a predetermined standard, and outputs the video signal to the monitor 300. Thereby, the confocal image is displayed on the monitor 300.

  On the other hand, the timing controller 240 drives and controls the laser light source 230z ′ via the light source driver 232z ′ during the braking period. A laser beam for trapping (continuous light) is emitted from the laser light source 230z '. The trapping laser light scans the subject two-dimensionally from the outer periphery to the inner periphery of the spiral pattern SP via the single mode fiber 112z and the condensing optical system 142z. For this reason, the peripheral cells scattered within the scanning range are trapped by the trapping laser light, moved from the outer periphery to the inner periphery of the scanning locus, and collected at the cell collection position. Similarly to the above-described embodiment, the operator can collect peripheral cells by performing a simple operation of collecting the peripheral cells at the cell collection position and then pressing the scanning medical probe 100 against the subject. Note that the reflected light of the trapping laser light is blocked by a predetermined optical filter disposed in the optical path, and thus is not detected by the photodetector 250z.

  In another embodiment, since the inner sheath 134 and the detection fiber 136 can be omitted from the components, the scanning medical probe 100 can be further reduced in diameter. For this reason, the burden reduction with respect to the patient at the time of inserting the scanning medical probe 100 in a body cavity is achieved.

1 Medical Observation System 100 Scanning Medical Probe 144 Bellows Tube 146 Adhesive 200 Processor 240 Timing Controller 254 DSP

Claims (8)

A light source that emits predetermined scanning light;
An optical fiber that transmits the scanning light emitted from the light source and emits the light from the emission end;
Optical scanning means for vibrating the vicinity of the emission end so that the scanning light emitted from the emission end scans the subject within a predetermined scanning range during the first period;
Image signal detecting means for receiving reflected light from the subject of the scanning light and detecting an image signal;
During a second period in which vibration near the exit end is attenuated, a predetermined continuous light is condensed on the subject via the optical fiber and the optical scanning means, thereby scanning the object in the subject. Optical tweezer means for trapping near the focal position of the means and moving it to a predetermined position;
An attaching means to which the moved object is attached by being pressed to the predetermined position;
A medical observation system characterized by comprising:   The medical observation system according to claim 1, wherein the predetermined position is a position where vibration of the optical fiber converges and stops.   The medical observation system according to claim 1, wherein the predetermined position is a center of the scanning range.   The adhering means is formed so as to be located outside the optical path of the optical scanning means in the absence of an external load, and when pressed against the subject, the adhering means is deformed so as to cover the predetermined position. The medical observation system according to any one of claims 1 to 3, wherein the medical observation system is characterized. A frame housing the optical scanning means;
Further comprising
The attaching means includes
A bellows-like tube that can be expanded and contracted in the pressing direction, the base end of which is adhesively fixed so as to cover the entire outer wall near the distal end of the frame body;
A gel-like adhesive applied to at least a partial region of the inner wall of the bellows-like tube;
The medical observation system according to any one of claims 1 to 4, characterized by comprising: Light source control means for controlling the light source to emit the scanning light during the first period and to emit the continuous light during the second period;
The medical observation system according to any one of claims 1 to 5, further comprising: Pixel arrangement determining means for determining a pixel arrangement of image information represented by each image signal in accordance with the detection timing of the image signal by the image signal detecting means;
Image creating means for spatially arranging the image information according to the determined pixel arrangement to create an image;
The medical observation system according to any one of claims 1 to 6, further comprising:   The medical observation system according to any one of claims 1 to 7, wherein the predetermined continuous light is light having an output higher than that of the scanning light.

Images