JP2013190766A - Medical treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable an operator to easily recognize information relating to a medical treatment instrument being used when performing medical treatment using a microscope.SOLUTION: A medical treatment device includes a medical treatment instrument holder unit allowing a plurality of medical treatment instruments to be set thereto, a medical treatment instrument specification part which specifies one of the plurality of medical treatment instruments which is being used, and an eyepiece microscope which presents an enlarged image 160 of an affected part of a patient supported on a treatment table so that an operator can view the enlarged image. The medical treatment device displays an instrument-relevant information image (for example, an assignment information image 172, an instrument operation state information image 180, or the like) indicative of information relevant to at least one medical treatment instrument specified by the medical treatment instrument specification part, out of the plurality of medical treatment instruments, in a visual field of the microscope as a superposed image while keeping at least a part of the enlarged image 160 viewable within the visual field.

Description

  The present invention relates to a technique for providing an image obtained by a microscope apparatus to an operator or the like.

  Japanese Patent Application Laid-Open No. 2004-228688 discloses a technique for displaying a menu control element (for example, a selection menu) or data related to a patient as an insertion image in a visual field image of a microscope apparatus.

  Patent Document 2 discloses a technique for displaying a real-time image of a diseased part imaged by an imaging camera attached to a dental instrument and medical data so as to be visible at substantially the same time within a substantially same visual field range. . Examples of medical data include root canal length measurement data, driving state data, and X-ray images.

  Patent Document 3 discloses a technique for measuring the length from a predetermined reference position to the apex based on a CT image of a tooth taken before treatment, and displaying the tip position of the root canal treatment instrument in real time during treatment. It is disclosed.

  Patent Document 4 discloses a technique that includes an intra-root canal imaging fiber and a tooth periphery imaging scope and selectively or simultaneously displays both captured images.

  Patent Document 5 discloses a technique for displaying root canal length measurement results and the like on a tooth schematic diagram.

Special table 2011-523100 gazette JP 2009-153785 A JP 2011-030637 A JP 2004-065623 A JP 2008-110141 A

  By the way, a microscope apparatus may be used for medical treatment of details such as root canals. In this case, since the surgeon is working while looking through the microscope apparatus, it is difficult to grasp the state of the medical instrument.

  In this regard, in Patent Document 1, since only menu control elements or patient data are provided, it is still difficult to grasp the state of the medical instrument.

  Patent Document 2 merely displays root canal length measurement data, driving state data, X-ray images, and the like as information related to a specific medical instrument on a real-time image of an affected area. However, during the medical examination, the medical instrument is changed as appropriate. In such a case, it is difficult to grasp the state of the changed medical instrument at any time.

  Patent Documents 3 and 5 merely display the tip position of the root canal treatment instrument or the root canal length measurement result as information on a specific medical instrument. For this reason, it is difficult to simultaneously grasp the site to be treated and the medical device, and it is difficult to grasp the state of the changed medical device as needed.

  In the scope for imaging around the teeth in Patent Document 4, the state of the medical instrument itself cannot be grasped.

  Therefore, an object of the present invention is to make it possible to easily grasp information relating to a medical instrument in use when performing medical care using a microscope.

  In order to solve the above-described problem, a medical medical device according to a first aspect includes a medical device holder unit that can set a plurality of medical devices, and a medical device specification that identifies a medical device in use from among the plurality of medical devices And an eyepiece type microscope that presents an enlarged image of the affected area of the patient supported by the medical table to the operator so that at least a part of the enlarged image can be visually recognized within the field of view of the microscope In this state, a device related information image indicating information on at least one of the plurality of medical devices specified by the medical device specifying unit is displayed in the field of view as a superimposed image.

  A second aspect is a medical diagnostic apparatus according to the first aspect, and includes a superimposed image output unit that outputs the instrument-related information image as the superimposed image according to the output of the medical instrument specifying unit. The microscope further includes an optical system including an objective optical system and an eyepiece optical system, and is provided in the optical system, and superimposes the superimposed image based on an output from the superimposed image output unit on the enlarged image. And an overlay display unit for displaying.

  A 3rd aspect is a medical medical device which concerns on a 1st aspect, Comprising: The said microscope imaged the image expanded by the imaging optical system and the said imaging optical system, and output the expansion captured image data And an eyepiece type display unit, and generates a display image in which the superimposed image is superimposed on an enlarged captured image based on the enlarged captured image data output from the imaging unit. The image processing apparatus further includes a superimposed image processing unit that displays the display image on the display unit.

  A fourth aspect is a medical medical device according to any one of the first to third aspects, and includes the medical table that supports the patient as a component, and the medical table includes an operator's A foot controller operated by a foot and capable of operating at least one of the plurality of medical devices is provided, and in response to receiving an operation start command for any of the plurality of medical devices through the foot controller Then, an instrument related information image indicating information related to the medical instrument for which the operation start command has been accepted is displayed in the field of view as a superimposed image.

  A 5th aspect is a medical medical device which concerns on any one 1st-4th aspect, Comprising: The magnitude | size of the at least one part of the instrument relevant-information image regarding at least 1 thing of said some diagnostic instruments Are changed during the display.

  A sixth aspect is a medical medical device according to any one of the first to fifth aspects, and displays a medical information image indicating medical information in the field of view as an additional superimposed image.

  A seventh aspect is the medical diagnostic apparatus according to any one of the first to sixth aspects, wherein an external display unit capable of displaying an image according to an image displayed in the field of view of the microscope is provided. Further prepare.

  According to the medical medical device which concerns on a 1st aspect, when performing medical care using a microscope, the information regarding the medical instrument in use can be grasped | ascertained easily without taking an eye from a microscope.

  According to the 2nd aspect, the information regarding a medical device can be grasped | ascertained easily, visually recognizing the direct enlarged image of an affected part about an affected part.

  According to the third aspect, since the display image in which the superimposed image is superimposed on the enlarged captured image is generated and this display image is displayed on the display unit, the degree of freedom in installing the display unit is excellent.

  According to the 4th aspect, since the instrument related information image regarding the medical instrument is displayed according to the operation start of a medical instrument, it is convenient.

  According to the 5th aspect, since the magnitude | size of an appliance relevant information image is changed during the display, the attention degree of an image can be changed suitably.

  According to the sixth aspect, the surgeon can easily grasp medical information when performing medical care using a microscope.

  According to the 7th aspect, the magnified image and medical treatment information image by a microscope can be recognized also from surrounding people other than an operator.

It is the schematic which shows the medical treatment apparatus which concerns on 1st Embodiment. It is a perspective view which shows the whole structure of the medical treatment system containing the medical treatment apparatus which concerns on 2nd Embodiment. It is explanatory drawing which shows the example of a use condition of a medical treatment system. It is a functional block diagram which shows the whole structure of a medical treatment system. It is a block diagram which shows the hardware structural example of a control unit. It is a block diagram which shows the function implement | achieved by execution of a control program. It is a flowchart which shows the process in a superimposition image output part. It is a flowchart which shows the process in a superimposition image output part. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a figure which shows the example of an observation image by a microscope. It is a flowchart which shows the other process in a superimposition image output part. It is a functional block diagram which shows the whole structure of the medical treatment system which concerns on 3rd Embodiment.

{First embodiment}
Hereinafter, the medical treatment apparatus according to the first embodiment will be described. FIG. 1 is a schematic view showing a medical diagnostic apparatus 10 according to the first embodiment.

  The medical medical device 10 is a device used for medical treatment, for example, for medical treatment in dentistry, and includes a medical device holder unit 35, a medical device specifying unit 36S, and an eyepiece type microscope 40. . In each of the following embodiments, description will be made with an example in which a medical treatment assumption in dentistry is assumed. However, the medical medical device 10 can also be applied to various medical devices for otolaryngology using a microscope.

  The medical instrument holder unit is configured so that a plurality of medical instruments 18 can be set. As the medical instrument 18, for example, a cutting tool such as an air turbine handpiece and a micromotor handpiece, a scaler, a three-way syringe, a vacuum syringe, an oral camera, a photopolymerization irradiator, and the like are assumed. These medical instruments 18 are provided for a medical practice for the patient P1 and operate based on a driving instruction or a handling operation by the operator P2. The medical instrument holder unit has a plurality of holes or concave set portions to which each medical instrument 18 can be individually attached. Each set unit and the medical instrument 18 are associated with each other in advance, and accordingly, the predetermined medical instrument 18 is set to the predetermined set unit.

  The medical instrument specifying unit 36 </ b> S is configured to be able to specify one in use from among the plurality of medical instruments 18. As the medical instrument specifying unit 36S, for example, a sensor that is provided corresponding to each set unit and detects the presence or absence of the medical instrument in each set unit can be used. As the sensor, an optical sensor, a micro sensor, or the like can be used.

  The eyepiece-type microscope 40 is configured to present an enlarged image of the affected part (here, the oral cavity) of the patient P1 supported by the medical table 20 to the operator P2 so as to be visible.

  Here, the medical table 20 is a part that supports the patient P1. The medical table 20 preferably supports the patient P1 in a posture suitable for medical treatment. Here, since dentistry is assumed, the examination table 20 is configured to support the patient P1 in a posture in which the patient P1 is laid on his / her back. The medical table 20 may or may not be included as a component of the medical medical device 10. In the latter case, the medical medical device 10 is manufactured, sold, etc. in a form in which the medical table 20 is omitted so that it can be provided to an operator who has already purchased the medical table 20. Used in a form applied to the medical table 20.

  The microscope 40 may present an optically magnified image so as to be directly visible to the operator, or an image captured by an imaging element or the like may be displayed on a liquid crystal display device or the like. The image of the affected area may be presented to the operator so as to be visible.

  However, the microscope 40 is configured as an eyepiece type that allows the operator P2 to view the magnified image of the affected part by looking into the eyepiece part 42 with the eyes approaching or contacting each other. ing. When the surgeon P2 observes using such a microscope 40, many areas around the center of the visual field are occupied by the image presented by the microscope 40 and its peripheral part (eyecap of the eyepiece 42, etc.). . For this reason, it is difficult for the surgeon P2 to grasp the situation other than the image presented by the microscope 40.

  Therefore, in the present embodiment, at least a part of the magnified image of the affected part remains visible within the field of view of the microscope 40 and is being used by the medical instrument specifying unit 36S among the plurality of medical instruments 18. The instrument-related information indicating the information related to at least one medical instrument 18 specified as "" is displayed in the field of view of the microscope 40 as a superimposed image. As the instrument-related information, information that is preferable to know when operating the medical instrument 18 while the operator P2 looks into the microscope 40, for example, information on the operation of the medical instrument 18, the operation of the medical instrument 18 Information on the situation is assumed, and more specific examples will be described later.

  Accordingly, the surgeon P2 can visually recognize the instrument-related information separately from the enlarged image of the affected area by the microscope 40 within the same visual field range. Information on the medical equipment can be easily grasped.

  Hereinafter, more specific second and third embodiments will be described on the premise of the first embodiment.

{Second Embodiment}
Hereinafter, the medical treatment apparatus according to the second embodiment will be described.

  FIG. 2 is a perspective view showing an overall configuration of a medical medical system including a medical medical device, and FIG. 3 is an explanatory diagram showing an example of a usage state of the medical medical system. FIG. 3 shows a state in which the patient P1 supported by the medical table 120 is lying on his / her back and the operator P2 observes the oral cavity, which is the affected part of the patient P1, using the microscope 140.

  The medical treatment system includes a treatment table 120, an instrument holder unit 135, a sensor 136S, a microscope 140, and a control unit 150. In the present embodiment, the medical treatment apparatus 100 includes an instrument holder unit 135, a sensor 136S, a microscope 140, and a superimposed image output unit 158 of the control unit 150, and optionally further includes a treatment table 120 and the like. Prepare.

  The medical table 120 includes a base 121 and a seat unit 122. The base 121 is set on the floor surface and supports the seat portion 122 at a position above the floor surface. The seat portion 122 is a portion that supports the patient P1 in a sitting posture or a posture in which the patient P1 is laid on his / her back, and includes a seat portion 122a, a back portion 122b, and a headrest 122c. The seat part 122a is supported on the base 121, and the back part 122b is connected to one side of the seat part 122a so that the posture can be changed. The headrest 122c is provided at the upper end portion of the back portion 122b so that the posture can be changed and extended / contracted.

  The medical table 120 is provided with a medical table drive mechanism for moving the medical table 120 according to the medical condition for the patient P1 (see FIG. 4). Here, the medical table drive mechanism 124 includes an elevation drive mechanism and a back tilt drive mechanism. The raising / lowering drive mechanism part is built in the base 121, and the seat part 122 raises / lowers by driving of this raising / lowering drive mechanism. Moreover, the back part tilt drive mechanism part is incorporated in the seat part 122, and changes the inclination posture of the back part 122b. In addition, the medical table drive mechanism unit 124 may be incorporated in the seat unit 122 and may include a headrest tilt drive mechanism that changes the tilt posture of the headrest 122c.

  The medical table 120 is provided with a foot controller 126. The foot controller 126 is an operation unit that receives operations for various operation instructions and the like for the clinical table 120. In the present embodiment, the foot controller 126 includes six operation reception units 126a, and receives various instructions from the operator through each operation reception unit 126a. Here, the foot controller 126 is configured to be able to accept operation instructions to various medical instruments described later. The instruction received by the foot controller 126 is input to the control unit 150. The control unit 150 controls the operation of the medical table driving mechanism 124 based on the instruction, and gives operation instructions to various medical instruments.

  In addition, a tray table 128 and a basin unit 130 are provided around the medical table 120.

  The tray table 128 includes a table 128a and a touch panel unit 128b. The table 128a is supported on the medical table 120 through an arm so that the position of the table 128a can be changed. The touch panel portion 128b is attached and fixed to the front of the table 128a (the side on which the operator P2 stands). The touch panel unit 128b is configured by a combination of a liquid crystal display device, a contact position detection device, and the like, and receives various instructions from the operator by detecting a pressed position corresponding to the displayed screen. It is. The instruction received by the touch panel unit 128b is also input to the control unit 150. Of course, the tray table 128 may include a plurality of switches instead of or in addition to the touch panel unit 128b, and may be provided with an operation unit that receives various instructions by operating each switch.

  The basin unit 130 includes a spitton 132, an assistant hanger 137, and a pole 134a. Here, the basin unit 130 is provided on the opposite side of the tray table 128 with the medical table 120 interposed therebetween.

  The Spitton 132 includes a water faucet that supplies water when rinsing the oral cavity and a saliva bowl.

  The pole 134a is erected adjacent to the basin unit 130, and includes a plurality (here, two) arms 134b and 134c. In the middle of the pole 134a, a display unit 135a configured by a liquid crystal display device or the like is provided.

  Various information is displayed on the display unit 135a based on the image signal output from the control unit 150. Here, based on the image signal from the control unit 150, the same content as the image displayed in the field of view of the microscope 140 can be displayed on the display unit 135a. It is preferable that the display unit 135a is provided for presenting information to a medical assistant in the vicinity of the medical table 120, that is, provided at the same height as the eyes of the medical assistant in the vicinity. . But the display part 135a may be provided in other places, such as a place suitable for the visual recognition by the patient P1.

  The plurality of arms 134b and 134c extend so as to branch in two directions from the upper end of the pole 134a. Each arm 134b, 134c is an arm whose posture can be changed. An illuminating device 135b such as a surgical light is provided at the tip of the arm 134b. A microscope 140 is provided at the tip of the arm 134c. Then, by changing the postures of the arms 134b and 134c in different directions, the illumination device 135b can perform illumination from a location different from the position where the microscope 140 is disposed.

  Of course, the basin unit 130 and the pole 134a may be provided at other locations such as a part of the medical table 120 and a wall surface.

  The microscope 140 is an eyepiece type microscope as described in the first embodiment, and a magnified image of the affected part (herein the oral cavity) of the patient P1 supported by the examination table 120 is visually recognized by the operator P2. It is configured to present as possible.

  More specifically, the microscope 140 includes an objective optical system 142 and an eyepiece optical system 146. The microscope 140 is supported by the distal end portion of the arm 134c with the eyepiece optical system 146 oriented sideways and the objective optical system 142 directed downward. The microscope 140 is used in a state of being disposed above the affected part (oral cavity) of the patient P1 supported by the medical table 120. In this state, when the surgeon P2 looks into the eyepiece optical system 146 from the lateral direction, an enlarged image is presented to the surgeon P2. The microscope 140 is provided with a handle 140h, and the operator P2 can easily change the position of the microscope 140 by grasping the handle 140h.

  The microscope 140 may be supported by another support member, or may be supported by the operator P2 itself.

  Further, in the present medical treatment system, a peripheral image capturing unit 138 that captures a peripheral image is provided. The peripheral image imaging unit 138 is an imaging camera including a solid-state imaging device and the like, and is configured to be able to image a part of the patient P1 supported by the examination table 120 and other than the affected part. Here, the peripheral image capturing unit 138 is provided in the lighting device 135b provided at the tip of 134b (here, in the upper part). And at least a part of the patient can be photographed. Here, since the peripheral image capturing unit 138 is provided in the illumination device 135b, it is possible to easily capture an illuminated bright image. However, since the illumination destination by the illumination device 135b and the area to be imaged by the peripheral image capturing unit 138 do not necessarily match, the peripheral image capturing unit 138 can change the posture with respect to the illumination device 135b (that is, change of the imaging region). Is possible). Further, the peripheral image capturing unit 138 may be provided at a different location from the lighting device 135b.

  The instrument holder unit 135 is configured to be capable of supporting a plurality of medical instruments 18 so that they can be stored and taken out. Here, the instrument holder unit 135 includes instrument holders 136 and 137. The instrument holders 136 and 137 are configured to be capable of supporting and accommodating the medical instrument 18 used for medical care.

  Here, an instrument holder 136 is provided in front of and one side of the table 128a. The instrument holder 137 is supported by the basin unit 130 via an arm. The instrument holders 136 and 137 include set parts 136a and 137a corresponding to the plurality of medical instruments 18, and each of the medical instruments 18 is accommodated in the corresponding set parts 136a and 137a. Each set unit 136a, 137a detects a set state of the medical instrument 18, and a sensor 136S as a medical instrument identifying unit for identifying the medical instrument 18 in use from the plurality of medical instruments 18 (see FIG. 2 is shown only partially, see FIG. As the sensor 136S, an optical sensor using inspection light that is shielded or reflected when the medical instrument 18 is present, or a sensor that uses a switch that is turned on or off by being pressed when the medical instrument is present. Alternatively, it is possible to use a magnetic sensor or the like that detects whether a medical instrument is present by a change in a magnetic field such as a magnet provided in the medical instrument. The output of the sensor 136S provided in each of these set portions 136a and 137a is given to the control unit 150. Thereby, the control unit 150 recognizes the timing of taking out and storing each medical instrument 18 based on the output of each sensor 136S, and which medical instrument 18 is taken out from the instrument holders 136 and 137 and used. Can be determined.

  Of course, the instrument holders 136 and 137 may be provided at other locations, for example, the treatment table 120.

  As the medical instrument 18, for example, a cutting tool such as an air turbine handpiece and a micromotor handpiece, a scaler, a three-way syringe, a vacuum syringe, an oral camera, a photopolymerization irradiator, and the like are assumed. These medical instruments 18 are provided for a medical practice for the patient P1 and operate based on a driving instruction or a handling operation by the operator P2.

  At least a part of the medical instrument 18 outputs operation status information indicating its own operation status as necessary. For example, when the medical instrument 18 has a rotation drive unit such as a dental cutting medical instrument, the operation state information may include the rotation speed, or a voltage value or a current value corresponding to the rotation speed. Further, for example, in the medical instrument 18, the root canal is enlarged as a medical treatment for teeth, and the position of the distal end portion of the root canal expanding tool in the root canal can be measured during the root canal enlargement work. There is something. In such a case, it is preferable that the operation status information includes position information of the tip of the root canal enlargement tool in the root canal. In other words, the operation status information is a kind of related information of the medical instrument 18 and includes information indicating the relationship between the medical instrument 18 and the affected part in addition to information on the state of the medical instrument 18 itself. Thus, the operating status information output from the medical instrument 18 is input to the control unit 150.

  The medical medical device includes a microscope 140 and an element that causes the microscope 140 to display an information image regarding the medical instrument 18 in use as a superimposed image in the field of view. In the second embodiment, the element is an output from the superimposed image output unit 158 in the superimposed image output unit 158 that outputs an information image related to the medical instrument in use as the superimposed image data, and the microscope 140. An example realized by a configuration including a superimposed display unit 144R that displays a superimposed image based on the image to be superimposed on the enlarged image will be described.

  FIG. 4 is a functional block diagram showing the overall configuration of the medical treatment system. As shown in the figure, the foot controller 126 and the touch panel unit 128b are connected to the control unit 150, and an instruction input through the foot controller 126 and the touch panel unit 128b is given to the control unit 150. Each medical device 18 and each sensor 136 </ b> S provided in the set portions 136 a and 137 a corresponding thereto are also connected to the control unit 150. Each medical instrument 18 operates under the control of the control unit 150. Further, the output of each sensor 136 </ b> S is given to the control unit 150, whereby the control unit 150 determines the removal state of each medical instrument 18. In FIG. 4, the first sensor 136 </ b> S is associated with the first medical instrument 18, and the second sensor 136 </ b> S is associated with the second medical instrument 18. The medical table driving mechanism 124 is also connected to the control unit 150. Under the control of the control unit 150, the medical table driving mechanism 124 operates and the medical table 120 moves up and down or tilts. The peripheral image capturing unit 138 is also connected to the control unit 150, and captured image data captured by the peripheral image capturing unit 138 is given to the control unit 150. The display unit 135a is also connected to the control unit 150 and performs display based on the image signal output from the control unit 150.

  Here, the medical treatment system includes a server 139 including a patient information storage unit 139a, and the server 139 is connected to the control unit 150 so as to be communicable. The patient information storage unit 139a is configured by a storage device such as a hard disk device, and stores patient information acquired in advance. The patient information is information related to medical care acquired in advance in association with each patient. In addition to medical chart information including the name of the patient, medical condition, etc., X-rays such as X-rays of the affected area taken in advance are taken. ), A fluorescence image of the affected part taken in advance, an image showing a measurement result of the periodontal pocket measured in advance, and the like. The control unit 150 can acquire the patient information stored in the patient information storage unit 139a as necessary.

  The control unit 150 and the microscope 140 are connected so that an image signal output from the control unit 150 can be input to the microscope 140.

  The microscope 140 includes an objective optical system 142, an eyepiece optical system 146, and an interposition part 144. Here, the microscope 140 is a binocular microscope. Therefore, the objective optical system 142 includes a right objective optical system 142R and a left objective optical system 142L, and the eyepiece optical system 146 includes the right eyepiece optical system 146R and the left eyepiece. An optical system 146L. Such a binocular microscope has an advantage that the affected part is easily stereoscopically viewed.

  The right objective optical system 142R includes at least one optical lens. The right objective optical system 142R is disposed to face the affected area, and forms a real image of the observation target portion P on the opposite side of the affected area. The right eyepiece optical system 146R also includes at least one optical lens. The right eyepiece optical system 146R is a portion arranged to face the right eye of the operator P2, and enlarges the real image generated by the right objective optical system 142R to the eye (right eye) of the operator P2. provide. The right objective optical system 142R and the right eyepiece optical system 146R constitute an optical system for the right eye that enlarges the observation target portion P and presents it to the operator as a whole.

  The left objective optical system 142L includes at least one optical lens. The left objective optical system 142L is disposed to face the affected area, and forms a real image of the observation target portion P on the opposite side of the affected area. The left eyepiece optical system 146L also includes at least one optical lens. The left eyepiece optical system 146L is a portion disposed to face the left eye of the operator P2, and enlarges the real image generated by the left objective optical system 142L to the eye (left eye) of the operator P2. provide. The left objective optical system 142L and the right eyepiece optical system 146R constitute an optical system for the left eye that enlarges the observation target portion P and presents it to the operator as a whole.

  The interposition part 144 includes an overlay display part 144R and an intervening imaging part 144L.

  The superimposed display unit 144R is provided in the optical system for the right eye, and is configured to be able to display a superimposed image based on an output from a superimposed image output unit 158 described later so as to be superimposed on an optical enlarged image. Has been. The overlay display unit 144R includes, for example, a configuration in which the overlay image is displayed on a transmissive liquid crystal display device inserted in the middle of the optical system, and the overlay on a half mirror inserted in the middle of the optical system. A configuration for projecting a combined image or the like can be employed. Then, in a state where the superimposed image is superimposed on the optically magnified image by the superimposed display unit 144R, the operator P2 performs the overlaying while visually recognizing the optical magnified image that is transmitted through the superimposed display unit 144R. The superimposed image displayed on the display unit 144R can be visually recognized.

  The intervening imaging unit 144L is a part that captures an image of the observation target part P observed with the microscope. As the intervening imaging unit 144L, for example, a configuration in which a half mirror is inserted in the middle of the optical system and an image reflected toward the side by the half mirror is captured by the imaging element can be employed. An image captured by the intervening imaging unit 144L is recorded in a recording unit 144La configured with a flash memory, a hard disk device, and the like.

  However, it is not essential that the microscope includes the optical system for both eyes as described above. Further, it is not essential that the intervening imaging unit 144L is provided.

  FIG. 5 is a block diagram showing an example of the hardware configuration of the control unit 150. The control unit 150 includes a CPU 151, a ROM (Read Only Memory) 152, a RAM (Randam Access Memory) 153 as a main storage unit, an external storage device 154, an input / output circuit unit 155, an image input unit 156, an image output unit 157, and the like. It is constituted by a general computer interconnected via a bus line. The ROM 152 stores a program for starting the control unit 150 and the like. The RAM 153 is used as a work area when the CPU 151 performs processing according to the description of the program. In the external storage device 154, in addition to the basic program, a superimposition image control program 154a for controlling a superimposition image displayed on the superposition display unit 144R, and an examination table drive mechanism unit 124 according to instructions received by the foot controller 126. The medical table control program 154b for controlling the driving of the medical device, the medical device instruction program for outputting the instruction to the medical device 18 in accordance with the instruction received by the foot controller 126, and the like are stored. The external storage device 154 only needs to be configured by a non-temporary nonvolatile storage device (hard disk device, flash memory, or the like).

  Further, the control unit 150 is connected to the medical table drive mechanism unit 124, the foot controller 126, the touch panel unit 128b, the medical instrument 18, and the sensor 136S via the input / output circuit 155, and captures peripheral images via the image input unit 156. Connected to the unit 138 and connected to the overlay display unit 144R via the image output unit 157. The control unit 150 is connected to the intervening imaging unit 144L via the image input unit 156b and is connected to the display unit 135a via the image output unit 157b.

  Then, the CPU 151 as the main control unit executes the programs 154a and 154b stored in the external storage device 154 in cooperation with each other, and the procedure described in the programs 154a and 154b according to an instruction from the outside. By executing the arithmetic processing according to the above, various processing functions for controlling the superimposed image displayed on the superimposed display unit 144R in addition to the operational control of the clinical table 120 and the operational control of the medical instrument 18 are realized. The processing as the superimposed image output unit for controlling the superimposed image displayed on the superimposed display unit 144R will be described in detail later. Each program 154a, 154b may be described as one program. Further, some or all of the functions performed by the control unit 150 may be realized by hardware using a dedicated logic circuit or the like.

  FIG. 6 is a block diagram showing functions realized by the execution of the superimposed image control program 154 a in the control unit 150.

  In other words, the control unit 150 includes a function as the superimposed image output unit 158, a function as the examination table information image generation unit 159a, and a function as the appliance operation status information image generation unit 159b.

  The superimposed image output unit 158 is provided with the patient information in the patient information storage unit 139a of the server 139 and the data of the peripheral captured image captured by the peripheral image capturing unit 138. In the present embodiment, it is assumed that the patient information is an X-ray image of the affected area, a fluorescent image of the affected area, and an image indicating a measurement result of the periodontal pocket (hereinafter simply referred to as a pocket image). Further, it is assumed that the peripheral image capturing unit 138 images the upper body of the patient P1 from above.

  In addition, when the clinic table information is given to the clinic table information image generation unit 159a, the clinic table information image generation unit 159a has the clinic table information for making the surgeon P2 visually recognize the clinic table information based on the clinic table information. An image is generated and given to the superimposed image output unit 158. The medical table information is information related to the medical table 120, and is particularly preferably information that should be grasped by the surgeon while the surgeon P2 is looking into the microscope 140. Here, description will be made assuming that the clinical table information is information indicating whether or not the operation mode by the clinical table drive mechanism 124 is a microscope mode and whether or not the movement of the clinical table 120 is locked. .

  Note that the above is based on the premise that there are at least three operation modes of the examination table drive mechanism unit 124: the normal mode, the microscope mode, and the stop mode. The normal mode is a mode in which it is assumed that the operator P2 is used in a state in which no treatment is performed and the operator P2 does not look into the microscope 140, and according to an operation to the foot controller 126, the examination table drive mechanism unit 124 is used. Operates the medical table 120 quickly. The microscope mode is a mode that is assumed to be used in a state where the operator P2 is looking into the microscope 140 during non-treatment, and according to an operation to the foot controller 126, the examination table drive mechanism unit 124. Operates the medical table 120 slowly. Thereby, the surgeon P2 can easily focus the microscope 140 and the like. That is, in this mode, the examination table 120 can be moved by an operation suitable for use of the microscope 140. The stop mode is a mode that is assumed to be used during treatment, and the examination table 120 is maintained in a locked state. Therefore, even if the foot controller 126 is operated by mistake, the medical table driving mechanism 124 does not operate the medical table 120, and the medical table 120 maintains the stopped state. The mode is switched by operating the foot controller 126 or the touch panel unit 128b.

  Upon receiving the clinical table information indicating which mode it is from the clinical table control program 154b that controls the operation of the clinical table 120, the clinical table information image generation unit 159a displays the clinical table information image corresponding to the microscope mode or the stop mode. Generate. An example of this medical table information image will be described later. The clinical table information image is not particularly limited as long as it is generated as a display graphic that allows the operator P2 to visually recognize the status of the clinical table 120. For example, it may be a symbolic figure indicating one of the modes, or a character itself. The image that is the basis of the clinical table information image is stored in advance in the external storage device 154 as an image, and the image is called according to each mode, and the clinical table information image is generated based on the image. Good. The medical table information image generated by the medical table information image generation unit 159a is given to the superimposed image output unit 158.

  Further, when the operation status information of the medical instrument 18 is given to the instrument operation status information image generation unit 159b, the instrument operation status information image generation unit 159b causes the operator P2 to visually recognize the operation status based on the operation status information. Appliance operation status information image is generated and provided to the superimposed image output unit 158. The instrument operation status information image is a kind of information (apparatus related information) related to the medical instrument 18, and is particularly information that the operator should grasp while the operator P2 is looking into the microscope 140. Depending on the type of the medical instrument 18, there are cases where the operation status information is output and there is no output, and if there is no this output, the instrument operation status information image is not generated.

  Here, it is assumed that the medical instrument 18 is a dental cutting medical instrument, and outputs the rotation speed and position information of the tip of the rotary tool in the root canal as the operation status information. The operating status information output from the medical instrument 18 is given to the appliance operating status information image generation unit 159b.

  Upon receiving the operating status information, the appliance operating status information image generation unit 159b generates an appliance operating status information image corresponding to the operating status information. As this appliance operation status information image, for example, a figure representing the rotation speed or position information as a numerical value, a figure showing a level indicator indicating the rotation speed or position information on the side of the scale, and the like are assumed. The original image of the appliance operating status information image is also stored in advance in the external storage device 154 as an image, and an appliance operating status information image corresponding to the operating status information is generated based on the original image. It is good to do so. An example of the appliance operation status information image will be described later. Then, the examination table information image generated by the appliance operating state information image generation unit 159b is given to the superimposed image output unit 158.

  The superimposed image output unit 158 is also configured to be able to output a selection image 176, an allocation information image 172, etc., which will be described later. The original images such as the selected image 176 and the allocation information image 172 are also stored in the external storage device 154 as images in advance. Based on the original image, the selected image 176, An allocation information image 172 is generated. In particular, as the allocation information image 172, an image indicating an allocation suitable for each medical instrument 18 is generated in addition to an image indicating the allocation pointed out in the operation of the clinical table drive mechanism unit 124. The image indicating the appropriate assignment is generated as an image indicating information related to the medical instrument 18. Of the allocation information images, an image indicating allocation suitable for each medical device 18 is generated as a kind of device-related information image.

  In addition, the superimposed image output unit 158 is supplied with the instrument operation status information from the medical instrument 18, the operation instruction received by the foot controller 126 and the output result of the sensor 136S as data for controlling the image switching. It is done.

  Based on the operation instruction and the output result of the sensor 136S, the superimposed image output unit 158 superimposes one or more of the patient information image, the examination table information image, the instrument operation status information image, and the peripheral captured image, as superimposed image data. Are output as necessary and given to the overlay display unit 144R. In addition, the superimposed image output unit 158 outputs data of the selected image and the allocation information image as necessary at a predetermined timing, and provides the data to the superimposed display unit 144R. The superimposed image output unit 158 also outputs a display unit image signal obtained by superimposing the superimposed image on the microscope image, and provides the display unit 135a with the display unit image signal. Accordingly, the display unit 135a displays an image obtained by superimposing the superimposed image output from the superimposed image output unit 158 on the microscope image captured by the intervening imaging unit 144L. A display having the same content as the display observable in the visual field range can be visually recognized through the display unit 135a.

  7 and 8 are flowcharts showing processing in the superimposed image output unit 158.

  As shown in the figure, when the operator P2 operates the use start switch of the microscope 140 and starts using the microscope 140, the superimposed image output unit 158 outputs an initial screen signal as shown in step S1. The initial screen is displayed on the superimposed image output unit 158 of the microscope 140. The initial screen preferably includes at least one of the captured image and the examination table information image. Here, an example including a peripheral captured image will be described. When the surgeon P2 looks into the microscope 140, as shown in FIG. 9, an image corresponding to the output from the superimposed image output unit 158 can be recognized, and the output from the superimposed image output unit 158 is output. In a region where a corresponding image is not displayed, an enlarged image 160 of the affected part (here, a tooth in the oral cavity) can be recognized.

  After the initial screen is displayed, in step S2, the presence / absence of an image switching instruction is determined. That is, the presence / absence of an image switching instruction is determined based on an operation instruction given through the foot controller 126. Here, through the foot controller 126, the selection mark 176a in the selection image 176 is selected and determined for the display mark, and the display mark is selected and determined for the selection mark 176a. Entered. If it is determined in step S2 that there is no image switching instruction, the process proceeds to step S3. If it is determined that there is an image switching instruction, the process proceeds to step S10.

  In step S10, the image is switched. FIG. 10 illustrates an example in which the peripheral captured image 178 is switched to an image of the foot controller 126 (including the allocation information image 172 and the clinical table information image 170). Thereafter, the process proceeds to step S3.

  Here, the switched screen includes an examination table information image 170 (here, “microscope ON” is displayed). The surgeon P2 can recognize that the microscope is ON, that is, the microscope mode, by observing the clinic table information image 170.

  In addition, the examination table information image 170 is displayed in a state of being superimposed on the allocation information image 172 of the operation reception unit 126a of the foot controller 126. In the allocation information image 172, each operation reception unit 126a is schematically represented. A tilt command of the back 122b of the examination table 120 is assigned to the upward operation of the upper left operation receiving unit 126a, and an upright command of the back 122b is assigned to the downward operation of the upper left operation receiving unit 126a. An upward command of the seat unit 122 of the medical table 120 is assigned to the upward operation of the upper right operation receiving unit 126a, and a lowering command of the seat unit 122 is assigned to the downward operation of the upper right operation receiving unit 126a. The surgeon P2 can operate the treatment table 120 slowly in the microscope mode by operating these operation receiving units 126a.

  Further, selection is assigned to the operation accepting unit 126a in the center, and an option on the screen can be selected by operating the operation accepting unit 126a. Here, a selection image 176 is displayed on the overlay display unit 144R. The selection image 176 includes a plurality of selection marks 176a. The plurality of selection marks 176a are marks for selecting an image to be overlaid, and a mark “patient state” indicating a peripheral captured image and an “radiogram” indicating an X-ray image that is one of the patient information images. A mark “fluorescence” indicating a fluorescent image which is one of the patient information images, a mark “pocket” indicating an image indicating the measurement result of the periodontal pocket, which is one of the patient information images, and a foot And a mark “foot controller” indicating the allocation information image 172 of the controller 126. Here, the mark includes characters, but may be a stylized mark or the like. On this screen, the operation accepting unit 126a at the center can select from a plurality of selection marks 176a in the selection image 176.

  Further, determination is assigned to the operation reception unit 126a in the lower center, and the selection can be determined by pressing the operation reception unit 126a after the selection. Here, the operation receiving unit 126a corresponding to the currently displayed or selected image is displayed in a thick frame.

  In the above case and in each of the following cases, the enlarged image 160 of the affected area is superimposed on the image (in this case, the superimposed display section 144R) within the visual field observed by the operator P2 with the microscope 140. The size of each overlapping image is set so that it is recognized as an area larger than the image displayed by (1).

  In step S3, it is determined whether there is an instruction to add an image. That is, based on the operation instruction given through the foot controller 126, the presence / absence of an image addition instruction is determined. Here, an instruction to add an image is input by selecting and determining the selection mark 176a in the selection image 176 other than the display mark through the foot controller 126. If it is determined in step S3 that there is no instruction to add an image, the process proceeds to step S4. If it is determined that there is an instruction to add an image, the process proceeds to step S11.

  In step S11, an image is added. FIG. 11 shows an example in which the peripheral captured image 178 is additionally displayed. Thereafter, the process proceeds to step S4.

  By the processes in steps S2, S10, S3, and S11, a plurality of the superimposed images can be switched in accordance with the output from the foot controller 126.

  In step S4, the presence or absence of removal of the medical instrument 18 is determined according to the output result of the sensor 136S. If it is determined that the medical instrument 18 has not been removed, the process returns to step S2. If it is determined that the medical instrument 18 has been removed, the process proceeds to the next step S5.

  In step S5, the medical device 18 selected and extracted (that is, in use) based on the output result of the sensor 136S is specified, and the device operation status information image 180 and the device related information image corresponding to the medical device 18 are specified. An allocation information image 172 is displayed. Here, a dental cutting medical instrument is assumed as the medical instrument 18. FIG. 12 shows an example in which a figure 180a indicating the number of rotations as a numerical value and a figure 180b indicating the distance to the apex (APEX) are displayed as the instrument operation status information image 180. In FIG. 12, a graphic indicating that the clinical table 120 is in a locked state (graphical key) is displayed as the clinical table information image 170. This figure is a figure that is displayed based on an operation input in a locked state performed by the surgeon P2 through the touch panel unit 128b, an output result of the sensor 136S when the medical instrument 18 is taken out, or the like. The original image of the figure is also stored in advance in the external storage device 154 as an image, and is generated according to the operation input based on the original image and output from the superimposed image output unit 158. It is displayed on the overlay display unit 144R.

  Also, the allocation information image 172 of the foot controller 126 is changed to one suitable for the extracted medical instrument 18 based on the output of the sensor 136S. That is, since the medical instrument 18 selected and taken out based on the output result of the sensor 136S is specified, the assigned information image 172 corresponding to the medical instrument is switched to. Here, a light for illuminating a medical location is provided in the medical instrument 18, and a light ON command is given for an upward operation on the upper left operation reception unit 126a, and a downward operation on the upper left operation reception unit 126a. Is assigned a light off command. A water injection ON command is assigned to the upward operation of the upper right operation reception unit 126a, and a water injection OFF command is assigned to the downward operation of the upper right operation reception unit 126a. In addition, a drive ON command for the medical instrument 18 is assigned to the operation reception unit 126a on the lower center side.

  In the next step S6, it is determined whether or not there is an image switching instruction. That is, the presence / absence of an image switching instruction is determined based on an operation instruction given through the foot controller 126. Here, through the foot controller 126, the selection mark 176a in the selection image 176 is selected and determined for the display mark, and the display mark is selected and determined for the selection mark 176a. Entered. If it is determined in step S6 that there is no image switching instruction, the process proceeds to step S7. If it is determined that there is an image switching instruction, the process proceeds to step S12.

  In step S12, the image is switched. For example, when it is instructed in step S6 that the peripheral captured image 178 should be switched to an X-ray image or the like that is one of the patient information images, the peripheral captured image 178 is switched to the X-ray image. By executing the processes of steps S6 and S12, a medical information image indicating medical information can be displayed in the field of view as an additional superimposed image in accordance with the output from the foot controller 126.

  In step S7, it is determined whether or not there is an enlargement switching setting related to the selected medical device 18, and if it is determined that there is an enlargement switching setting, the process proceeds to step S8. To do. The enlargement switching setting is a condition for enlarging and displaying at least a part of the appliance operating status information image 180 in accordance with the operating status information of the medical appliance 18, and here, the medical appliance 18 is a dental cutting medical appliance. Assuming that the distance until the tip of the cutting tool reaches the apex is set. The enlargement switching setting may be a value set in advance through the touch panel unit 128b or the like and stored in the external storage device 154, or may be a value set in step S7. Depending on the type of the medical instrument 18, enlargement switching itself may not be necessary. In such a case, setting for enlargement switching itself is not performed (cannot be input).

  Before and after Step S7, various settings related to the operation of the medical instrument 18 other than the switching of images may be performed. In this case, depending on the type of the medical instrument 18, an operation command for the medical instrument 18 may be received after various settings relating to the operation of the medical instrument 18 are completed.

  Thereafter, when the surgeon P2 holds the medical instrument 18 with his / her hand while operating the foot controller 126 with his / her hand, he / she performs the medical treatment or the like on the affected area, as shown in FIG. Based on this, the appliance operating status information image changes. Here, the figure 180a and the figure 180b which show each change according to the rotation speed of the medical instrument 18, and the distance fluctuation | variation to a root apex. In addition, when it is not necessary to switch images during medical treatment using the medical instrument 18, it is preferable not to display the selection image 176 in order to widen the display area of the affected area. FIG. 13 also shows an example in which the selection image 176 is not displayed when the operation of the medical instrument 18 is started.

  In step S8, it is determined whether or not an enlargement switching setting condition is satisfied. If it is determined that the condition is satisfied, the process proceeds to step S9. Here, based on the instrument operating status information, it is determined whether the distance to reach the apex is less than a threshold set as an enlargement switching setting condition, and when it is determined that the distance is less than the threshold, Proceed to step S9.

  In step S9, the appliance operation status information image 180 is enlarged and displayed. FIG. 14 shows an example in which a graphic 180b (a graphic displaying the distance to the apex) that is a part of the appliance operation status information image 180 is displayed in an enlarged manner. Thereby, the surgeon P2 can recognize the approach to the cutting location, and can perform more careful treatment by looking at the enlarged figure 180b near the root apex.

  And the process regarding display switching is complete | finished. Next, in order to perform medical care using another medical device 18, the processing may be repeated after returning to step S1 or step S4.

  Note that, in addition to the above example, as the instrument operating state information image 180 when the medical instrument 18 is a dental cutting medical instrument, as shown in FIG. 15, a figure indicating the number of rotations and a distance to the apex are shown. It may be an appliance operation status information image including figures showing various information such as motor torque and rotation direction in addition to the figures shown.

  FIG. 16 shows an example of an image displayed in step S5 when a scaler is assumed as the medical instrument 18. In this case, a fluorescence image 182 that is one of the patient information images is displayed as an image suitable for the scaler. Of course, the fluorescence image may be switched to an image showing the measurement result of the periodontal pocket by the processing in steps S6 and S12. In FIG. 16, as one type of appliance related information, a power-up command is assigned to the upward operation of the upper left operation receiving unit 126a, and a power down command is assigned to the downward operation of the upper left operation receiving unit 126a. ing. A water injection ON command is assigned to the upward operation of the upper right operation reception unit 126a, and a water injection OFF command is assigned to the downward operation of the upper right operation reception unit 126a. In addition, a drive ON command for the medical instrument 18 is assigned to the operation reception unit 126a on the lower center side. In this case, the decision to switch images may be assigned to another operation receiving unit 126a. Alternatively, a drive ON command for the medical instrument 18 may be assigned to another slide switch or the like, and the same assignment as described above may be maintained for the determination of image switching.

  FIG. 17 shows an example of an image that is switched and displayed in step S10. Here, as one type of medical information, a fluorescent image 182 photographed with an oral camera is displayed. Thereby, the surgeon P2 can grasp in advance the location of tartar, plaque, and the like based on the fluorescence image.

  In this manner, based on the output of the sensor 136S, the fluorescent image 182 as a medical information image indicating medical information can be displayed in the field of view as an additional superimposed image according to the extracted medical instrument 18. it can. Of course, these medical information images can be displayed by switching to a fluorescence image 182 and an X-ray image.

  According to the medical medical device configured as described above, according to the selection of the medical instrument 18, as the relevant information suitable for the medical instrument 18, the instrument related information such as the instrument operation status information image or the allocation information image 172, etc. Since the image is displayed, the surgeon P2 can easily grasp the information regarding the medical instrument 18 in use separately from the enlarged image 160 of the affected part by the microscope 140, and can perform the medical treatment more appropriately.

  In particular, when the eye is taken away from the microscope 140, there is a problem that it takes time to focus again. In this embodiment, the state of the medical instrument 18 in use while looking into the microscope 140 is present. Since grasping | ascertaining can be performed, there also exists an advantage that it is easy to perform various medical treatments, looking into the microscope 140 as much as possible.

  Further, since the overlay display unit 144R is provided in the middle of the optical system of the microscope 140, the surgeon P2 can easily view information on the medical instrument 18 while viewing the direct magnified image 160 for the affected part. I can grasp.

  In addition, since the size of some appliance-related information images is changed during the display, the degree of attention of the images can be changed as appropriate. Thereby, more careful handling can be promoted.

  In addition, in the said embodiment, although the change of the magnitude | size during a display was performed by comparing the position of the front-end | tip part of the rotary tool in a root canal, and a predetermined setting value, the case where rotation is made into a reverse direction other than that For example, the image may be enlarged in association with an operation on the instrument.

  In addition, since the medical treatment information image indicating the medical treatment information is displayed in the visual field as an additional superimposed image, the surgeon P2 can easily grasp the medical treatment information when performing medical treatment using the microscope 140. In addition to the above, medical information may be used as the medical information image.

  In this embodiment, a peripheral captured image 178 that is a part of the patient supported by the medical table 120 and other than the affected part, a medical table information image 170 that shows information about the medical table 120, and the like are also included in the microscope 140. Since it is displayed in the field of view, the operator P2 can easily grasp the surrounding situation and the status of the medical table.

  Thereby, for example, even when the patient P1 complains of pain or the like with facial expressions or hand movements, it can be easily handled. In addition, when the patient P1 moves unexpectedly, the position of the affected part moves greatly within the field of view of the microscope 140, and there is a risk that the position of the affected part may be lost. Easy to grasp the direction. For this reason, there is an advantage that it is difficult to lose sight of the position of the affected part.

  Further, it is possible to easily grasp the operation mode (microscope mode or lock mode) of the medical table 120 while looking into the microscope 140 and easily operate the medical table 120.

  Of course, the medical treatment apparatus may be configured to display only one of the peripheral captured image 178 and the treatment table information image 170, or these images may not be displayed.

  Note that the processing for switching the image is not necessarily performed by the control unit 150. Separately, a control unit that performs image switching control may be provided, and the control unit may perform the switching control in cooperation with a control unit that performs operation control of the examination table 120 or the like. In this case, the control unit that performs image switching control may be incorporated in the tray table 128 or may be incorporated in the microscope 140.

  Further, the images to be overlaid can be easily switched by the operation by the foot controller 126.

  In addition, since the selection image 176 including the selection mark 176a is displayed in the field of view, it is possible to easily select an image to be superimposed using the selection mark 176a.

  Further, since the magnified image 160 of the affected area is visually recognized larger than the image superimposed on it within the field of view, the magnified image 160 of the affected area can be well recognized.

  In addition, since an image obtained by superimposing the superimposed image output from the superimposed image output unit 158 on the microscope image captured by the intervening imaging unit 144L is displayed on the display unit 135a, a medical assistant or the like can A display having the same content as the display that can be observed in the visual field range of the microscope 140 can be visually recognized.

  The presence or absence of the display on the display unit 135a may be switched according to an instruction through the touch panel 128b or the like.

  In the above-described embodiment, the example in which the instrument operation status information image 180 is displayed immediately after the selection of the medical instrument 18 has been described, but this is not necessarily required.

  Instead of the process shown in FIG. 8, the process shown in FIG. 18 may be performed.

  That is, first, in step S25, the medical instrument 18 selected and extracted (that is, in use) based on the output result of the sensor 136S is specified, and the assigned information image is used as the instrument related information image corresponding to the medical instrument 18 172 is displayed. Here, unlike step S5, the appliance operating state information image 180 is not displayed.

  Subsequent steps S26, S27 and S32 are the same as steps S6, S7 and S12.

  If it is determined in step S32 that enlargement switching is set, the process proceeds to step S28.

  In step S28, based on the operation instruction given through the foot controller 126, it is determined whether or not the operation of the medical instrument 18 has started. Here, if it is determined that the operation accepting unit 126a associated with the start of operation of the medical instrument 18 has been operated, the process proceeds to the next step S29.

  In step S29, a device operation status information image 180 is additionally displayed as a device related information image corresponding to the medical device 18 being selected and extracted (that is, in use) identified based on the output result of the sensor 136S. After this, the process proceeds to the next step S30.

  Steps S30 and S31 are the same as S8 and S9 described above, and then the process ends.

  If it is determined in step S32 that there is no enlargement switching setting, the process proceeds to step S33.

  Step S33 and the next step S34 are the same as steps S28 and S29, and thereafter, the process is terminated.

  Of course, after steps S31 and S34, in order to perform medical treatment using another medical instrument 18, the process may be repeated after returning to step S1 or step S4.

  According to this modification, in response to the reception of the operation start command for any one of the plurality of medical devices 18 through the foot controller 126, the device related information graphic indicating the information related to the medical device for which the operation start command is received is displayed. Since it is displayed in the field of view of the microscope 140 as a superimposed image, the microscope image can be displayed in a relatively wide area until then, and the instrument related information figure can be visually recognized after the actual operation of the medical instrument 18 is started. Can be convenient.

{Third embodiment}
A medical treatment apparatus according to the third embodiment will be described.

  FIG. 19 is a functional block diagram showing the overall configuration of a medical care system including a medical care apparatus. In the description of the present embodiment, the same components as those described in the second embodiment will be denoted by the same reference numerals, and the description thereof will be omitted. The description will focus on differences from the second embodiment.

  A first part of the medical care system different from the medical care system of the second embodiment is a microscope 240.

  That is, the microscope 240 includes an imaging unit 242 and a display unit 248.

  The imaging unit 242 includes an imaging optical system 244 and an imaging unit 246.

  The imaging optical system 244 includes a right imaging optical system 244R and a left imaging optical system 244L, and the imaging unit 246 includes a right imaging unit 246R and a left imaging unit 246L.

  The right imaging optical system 244R includes at least one optical lens. The right imaging optical system 244R is disposed to face the affected area and enlarges the affected area. The right imaging unit 246R includes an imaging element and the like, captures an image enlarged by the right imaging optical system 244R, and outputs an image signal.

  The left imaging optical system 244L includes at least one optical lens. The left imaging optical system 244L is disposed to face the affected area and enlarges the affected area. The left imaging unit 246L includes an imaging element and the like, captures an image enlarged by the left imaging optical system 244L, and outputs an image signal.

  Accordingly, the captured image data is output from the imaging unit 242 separately for the right eye and the left eye. The captured image data for the left and right eyes are input to the superimposed image output unit 258. The image signal from the superimposed image output unit 258 is also given to the display unit 135a.

  Display unit 248 includes a right display portion 248R and a left display portion 248L. The right display unit 248R and the left display unit 248L are configured by a liquid crystal display device or the like, and are disposed at positions suitable for observation for the right eye and the left eye, respectively. The left and right eye display image data output from the superimposed image output unit 258 is displayed separately on the right display unit 248R and the left display unit 248L. Then, the surgeon P2 can observe the affected part by visually recognizing the right display part 248R with the right eye and visually recognizing the left display part 248L with the left eye.

  The display unit 248 is an eyepiece type display unit in the same manner as described above. Therefore, when the operator P2 looks into the display unit 248, it is difficult to directly observe the surroundings.

  Here, an example in which the imaging unit 242 and the display unit 248 are integrated will be described. However, the imaging unit 242 and the display unit 248 are not necessarily required and may be separated. For example, the imaging unit 242 may be disposed above the affected area, and the display unit 248 may be mounted near the eye of the operator P2.

  Further, the control unit 250 is configured such that the function of the superimposed image output unit 158 is deleted from the control unit 150 in the second embodiment, and instead, the superimposed image output unit 258 is incorporated in the microscope 240. .

  The superimposed image output unit 258 is configured by a general computer including a CPU, a ROM, a RAM, an external storage device 154, and the like. A captured image of the peripheral image capturing unit 138 is input to the superimposed image output unit 258, and various information necessary for the switching process of the superimposed image is given.

  In addition to the processing function of the superimposed image output unit 158 in the second embodiment, the superimposed image output unit 258 receives an image to be output from the superimposed image output unit 158 and the imaging unit 242. And a processing function (superimposed image processing unit) that synthesizes the image data for the left and right eyes and outputs an image obtained by superimposing an image indicating appliance-related information on the image captured by the imaging unit 242. Note that the superimposed image may be superimposed on the left and right eye images, or may be superimposed on only one image.

  Note that one image data from the superimposed image output unit 258 is input to the recording unit 244La and recorded.

  The display unit 248 displays an image in which the same superimposed image as that in the second embodiment is superimposed on the observation image of the affected area. Thereby, the surgeon P2 can recognize a superimposed image such as an image indicating the medical instrument related information in addition to the observation image of the affected part.

  Further, since the same image is also displayed on the display unit 135a, a medical assistant or the like can recognize the same image as described above through the display unit 135a.

  The same effects as those of the above embodiments can also be obtained by the medical medical device configured as described above.

  Furthermore, by recording a superimposed image by the recording unit, it can be used for explanation to a patient after medical examination, confirmation of treatment, guidance, and the like.

  In particular, according to the present embodiment, since the imaging unit 242 and the display unit 248 only need to be connected in a manner capable of transmitting signals, there is an advantage that the degree of freedom of installation of the display unit 248 is excellent.

{Modifications}
In addition, each structure demonstrated in said each embodiment etc. and its modification can be combined suitably as long as there is no contradiction mutually.

  In addition to the components described in the above embodiments, the superimposed image includes an external diagnostic device that monitors biological information such as blood pressure and heart rate, a timer that indicates the time during which the microscope is used, and a patient. The medical chart information or the like may be displayed.

  Alternatively, a flying arm type tray table may be used in which the medical instrument 18 is picked up and used from above the tray table via an arm provided behind the tray table. In this case, the sensor 136S may be a type of sensor that detects the movement of the arm portion.

  Furthermore, in the medical treatment apparatus described in the present embodiment, communication between the microscope, the treatment table, the foot controller, and the like may be wired or wireless.

  As described above, the present invention has been described in detail. However, the above description is illustrative in all aspects, and the present invention is not limited thereto. It is understood that countless variations that are not illustrated can be envisaged without departing from the scope of the present invention.

DESCRIPTION OF SYMBOLS 10,100 Medical treatment apparatus 18 Medical instrument 20, 120 Medical table 35, 135 Medical instrument holder unit 36S Medical instrument specific part 40, 140, 240 Microscope 126 Foot controller 135a Display part 136, 137 Instrument holder 136a, 137a Set part 136S Sensor 139a Patient information storage unit 142 Objective optical system 142L Left objective optical system 142R Right objective optical system 144 Intervening unit 144R Display unit 146 Eyepiece optical system 146L Left eyepiece optical system 146R Right eyepiece optical system 150 Control unit 154 External storage device 154a Image control Program 158 Superimposed image output unit 159b Appliance operation status information image generation unit 160 Enlarged image 172 Allocation information image 176 Selection image 180 Appliance operation status information image 182 Fluorescence image 242 Imaging unit 24 An imaging optical system 244L left imaging optical system 244R right imaging optical system 246L left imaging unit 246R right imaging unit 248 display unit 248L left display unit 248R right display unit 250 the control unit 258 superimposing the image output unit P1 patients P2 caster

Claims (7)

A medical instrument holder unit capable of setting a plurality of medical instruments;
A medical device identifying unit for identifying a medical device in use from among a plurality of medical devices;
An eyepiece type microscope that presents an enlarged image of the affected area of the patient supported by the medical table to the surgeon, and
With
Device-related information indicating information on at least one of the plurality of medical devices specified by the medical device specifying unit while at least a part of the magnified image is visible in the field of view of the microscope A medical treatment apparatus for displaying an information image in the field of view as a superimposed image. The medical diagnostic device according to claim 1,
In accordance with the output of the medical instrument specifying unit, further comprising a superimposed image output unit that outputs the instrument related information image as the superimposed image,
The microscope is provided in the optical system including an objective optical system and an eyepiece optical system, and displays the superimposed image based on the output from the superimposed image output unit so as to be superimposed on the enlarged image. A medical medical device comprising an overlapping display unit. The medical diagnostic device according to claim 1,
The microscope includes an imaging unit including an imaging optical system and an imaging unit that captures an image magnified by the imaging optical system and outputs enlarged captured image data, and an eyepiece type display unit.
A superimposed image processing unit that generates a display image in which the superimposed image is superimposed on an enlarged captured image based on the enlarged captured image data output from the imaging unit, and causes the display unit to display the display image; Medical medical device provided. The medical medical device according to any one of claims 1 to 3,
The medical table that supports the patient is provided as a component, and the medical table is provided with a foot controller that is operated by an operator's foot and that can operate at least one of the plurality of medical devices.
In response to acceptance of an operation start command for any of the plurality of medical instruments through the foot controller, an instrument related information image indicating information on the medical instrument for which the operation start instruction is accepted is used as a superimposed image. A medical device that displays in the field of view. The medical medical device according to any one of claims 1 to 4, wherein
A medical medical device in which a size of at least a part of a device-related information image related to at least one of the plurality of medical devices is changed during the display. The medical medical device according to any one of claims 1 to 5,
A medical treatment apparatus that displays a medical treatment information image indicating medical treatment information within the field of view as an additional superimposed image. The medical medical device according to any one of claims 1 to 6,
A medical medical device further comprising an external display unit capable of displaying an image corresponding to an image displayed in the field of view of the microscope.

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