JP2013231772A - Medical treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable an operator to easily recognize a state of variation during medical treatment when performing the medical treatment using a microscope.SOLUTION: A medical treatment device includes: a medical treatment data output unit which is capable of outputting medical treatment data including medical treatment information varying during medical treatment; and an eyepiece type microscope which has an objective unit and an eyepiece unit integrated into one body and visibly presents an enlarged image of an affected part to an operator. In a state where at least a part of the enlarged image is visible within the visual field of the microscope, a medical treatment information image 180 based on the medical treatment data is displayed 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.

  Other related technologies include Patent Documents 2 to 5.

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 surrounding situation. In particular, since information on the situation that has changed during the medical treatment is difficult to grasp in advance, it is significant to be able to grasp such information during the work performed while looking through the microscope apparatus.

  In this regard, in Patent Document 1, since only menu control elements or patient data prepared in advance before medical care are provided, information regarding the situation that has changed during medical care during work performed while looking into the microscope device is provided. I can't figure it out.

  Note that Patent Documents 2 to 5 do not disclose techniques related to a microscope apparatus.

  Therefore, an object of the present invention is to make it possible to easily grasp a situation that has changed during medical treatment when performing medical treatment using a microscope.

  In order to solve the above-described problem, the medical treatment apparatus according to the first aspect includes a medical data output unit capable of outputting medical data including medical information that fluctuates during medical treatment, an objective unit, and an eyepiece unit. An eyepiece type microscope that presents a magnified image of the affected area to a surgeon so as to be visible to the surgeon, and at least a part of the magnified image remains visible within the field of view of the microscope. A medical information image based on the data is displayed in the field of view.

  A second aspect is the medical medical device according to the first aspect, further comprising a superimposed image output unit that outputs the medical information image based on the medical data, and the microscope is attached to the objective unit. An optical system including an objective optical system included and an eyepiece optical system included in the eyepiece unit; and the medical information image based on an output from the superimposed image output unit is provided in the optical system as the enlarged image. An overlay display unit for displaying the images so as to be superimposed.

  A 3rd aspect is a medical medical device which concerns on a 2nd aspect, Comprising: The said microscope imaged the image expanded by the imaging optical system and the said imaging optical system as said objective unit, and expanded imaging image data And an imaging unit including an imaging unit that outputs an eyepiece type display unit as the eyepiece unit, and an enlarged captured image based on the enlarged captured image data output from the imaging unit, the medical information image Is further provided with a superimposed image processing unit that generates a display image on which is superimposed and displays the display image on the display unit.

  A fourth aspect is a medical treatment apparatus according to any one of the first to third aspects, wherein at least one of the presence / absence of display of the medical information image and the display aspect is switchable. .

  A fifth aspect is a medical medical device according to the fourth aspect, further comprising a foot controller operated by an operator's foot, and displaying the medical information image according to an output from the foot controller At least one of the presence / absence and display mode is switched.

  A sixth aspect is the medical diagnostic apparatus according to the fourth or fifth aspect, further comprising an operation panel operated by an operator's fingers, and the medical information according to an output from the operation panel Whether or not an image is displayed and at least one of display modes are switched.

  A seventh aspect is a medical treatment apparatus according to any one of the fourth to sixth aspects, and includes a voice input unit and a voice recognition unit that recognizes voice input through the voice input unit. And at least one of the presence / absence of the display of the medical information image and the display mode is switched according to the output from the voice recognition unit.

  An eighth aspect is a medical medical device according to any one of the first to seventh aspects, further comprising a root canal position measuring unit, wherein the medical data output unit includes the medical data as the medical data, Data including root canal position measurement data measured by the root canal position measurement unit is output, and a root canal position image based on the root canal position measurement data is displayed in the visual field.

  A ninth aspect is the medical medical device according to the eighth aspect, wherein the root canal position image is enlarged or reduced and displayed in accordance with a change in the root canal position measurement data.

  A tenth aspect is a medical medical device according to any one of the first to ninth aspects, further comprising a medical instrument drive unit, wherein the medical data output unit is configured to use the medical instrument as the medical data. Data including driving state data of the driving unit is output, and a driving state image based on the driving state data is displayed in the field of view.

  An eleventh aspect is a medical medical device according to the tenth aspect, and the display state of the driving state image is changed according to the change of the driving state data.

  A twelfth aspect is a medical diagnostic apparatus according to any one of the first to eleventh 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.

  A thirteenth aspect is a medical medical device according to any one of the first to twelfth aspects, further including an external imaging unit different from the microscope, and at least a part of the enlarged image is the microscope. The image picked up by the external image pickup unit is displayed in the visual field while remaining visible in the visual field.

  According to the medical treatment apparatus according to the first aspect, when the medical treatment is performed using the microscope, it is possible to easily grasp the situation that has changed during the medical treatment.

  According to the 2nd aspect, a peripheral condition can be grasped | ascertained easily, visually recognizing the direct enlarged image of an affected part.

  According to the third aspect, it is possible to generate a display image in which a medical information image is superimposed on an enlarged captured image and display the display image on the display unit. It is easy to freely adjust the relationship.

  According to the 4th aspect, since at least one of the presence or absence of a display of the said medical treatment information image and the display aspect can be switched, an appropriate display can be performed according to various situations within the visual field of a microscope.

  According to the fifth aspect, it is possible to easily switch whether or not the medical information image is displayed and at least one of the display modes by the operator's foot.

  According to the sixth aspect, at least one of the presence / absence of the medical information image and the display mode can be easily switched by the operator's fingers.

  According to the seventh aspect, at least one of the presence / absence of the medical information image and the display mode can be easily switched by utterance.

  According to the eighth aspect, the operator can recognize the root canal position image together with the magnified image obtained by the microscope.

  According to the ninth aspect, the surgeon can recognize the enlarged or reduced root canal position image according to the change in the root canal position measurement data.

  According to the tenth aspect, the surgeon can recognize the drive state image of the medical instrument drive unit together with the magnified image by the microscope.

  According to the eleventh aspect, the surgeon can recognize a driving state image whose display mode changes in accordance with the change in the driving state data.

  According to the twelfth aspect, it is possible to recognize an enlarged image and a medical treatment information image by a microscope from people around the operator.

  According to the thirteenth aspect, an image different from the microscope can be recognized while looking into the microscope.

It is the schematic which shows the medical treatment apparatus which concerns on 1st Embodiment. It is sectional drawing which shows the structure of a human tooth. It is a perspective view showing the whole medical treatment system composition concerning a 1st embodiment. It is explanatory drawing which shows the example of a use condition of the medical treatment system same as the above. It is a perspective view which shows the root canal treatment instrument as an example of a medical instrument. It is a functional block diagram of a root canal treatment instrument same as the above. 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 functional block diagram of a control unit. 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 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 care, for example, for medical care in dentistry, and includes a medical instrument 90 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 90 is a medical instrument including a medical data output unit. An example of such a medical instrument is a root canal treatment tool. The medical instrument 90 is set in the medical instrument holder unit 35 when not in use. Further, when a medical treatment is performed using the medical instrument 90, the medical device 90 is driven based on an operator's command, and is used for medical treatment at a medical treatment location under the handling of the operator.

  Here, a configuration of a tooth, which is an example of a living body that is a medical treatment target by the medical instrument 90, and a medical treatment content of the medical instrument 90 for the tooth will be described.

  FIG. 2 is a sectional view showing the structure of a human tooth. Human tooth 500 includes a crown portion 502 exposed in the oral cavity and a root portion 510 extending from crown portion 502. The surface of the root portion 510 is covered with a periodontal membrane (not shown). The crown portion 502 is composed of enamel 503, dentin 504, and the like. A medullary chamber 507 is formed in the crown portion 502. The tooth root 510 is composed of dentin 504, cementum 506, and the like, and is supported by alveolar bone 520 and gingiva 522. In the root portion 510, a root canal 512 extending along the extending direction is formed. The dental pulps 508 and 514 in the crown portion 502 and the root portion 510 are connected to blood vessels and nerves under the alveolar bone 520. The most distal portion of the root portion 510 on the alveolar bone 520 side is called the apex 511 (APEX), and the opening of the apex 511 on the alveolar bone 520 side is called the apical hole.

  As medical treatment for such teeth, for example, various operations such as root canal enlargement are performed. Such an operation is performed by appropriately adjusting the posture of the instrument, the force for operating the instrument, and the like while observing the mutual relationship between the teeth to be treated and the instrument for diagnosis.

  Moreover, when performing a medical treatment on the above-described teeth, there are cases where information that cannot be obtained or is difficult to obtain simply by visually observing a medical treatment target location may be required.

  For example, when performing root canal enlargement with a root canal treatment tool with a root canal position measurement function, measurement is performed while checking the interrelationship between the root canal enlargement file or reamer and the root apex 511. It is necessary to confirm the position of the tool tip in the root canal.

  In addition, during the medical treatment, the position of the root canal is not limited to the position in the root canal measured as described above, and the driving state of the root canal enlargement device, the driving state of the root canal washer, the bleeding state, the root It is also necessary to recognize various information such as the temperature of the tip of the tube filling device and the time required for root canal expansion.

  The medical instrument 90 is configured to be capable of outputting at least one piece of information such as the position of the medical instrument 90 relative to the medical location and the operating status of the medical instrument 90 itself.

  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.

  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, in the microscope 40, the objective unit 42U and the eyepiece unit 46U are integrated so that the surgeon P2 looks into the eyepiece unit 46U by bringing the eye P2 close to or in contact with the affected part while the objective unit 42U is disposed opposite to the affected part. By doing so, it is configured as an eyepiece type configuration that makes it possible to visually recognize an enlarged image of the affected area. Here, that the objective unit 42U and the eyepiece unit 46U are integrated means that the objective unit 42U and the eyepiece unit 46U are integrated in such a manner that the relative positional relationship is kept constant. Say.

  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 unit 46U, etc.). For this reason, it is difficult for the surgeon P2 to grasp the situation other than the image presented by the microscope 40. In particular, the medical information that varies during the medical treatment, such as the information output from the medical instrument 90, is information that cannot be grasped in advance, so that the medical information that varies during the medical treatment is recognized during observation with the microscope 40. The importance of being able to do so is great.

  Therefore, in the present embodiment and each of the following embodiments, at least a part of the magnified image by the microscope 40 remains visible in the field of view of the microscope 40, and the medical data including medical information that fluctuates during medical treatment is included. The medical information image based is displayed within the field of view of the microscope 40.

  Accordingly, the surgeon P2 can visually recognize a medical treatment information image based on medical treatment information that varies during medical treatment, in addition to the enlarged image of the affected part by the microscope 40 within the same visual field range. When performing medical care, it is possible to easily grasp medical information that fluctuates during medical treatment while looking into the microscope 40.

  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. 3 is a perspective view showing an overall configuration of a medical medical system including a medical medical device, and FIG. 4 is an explanatory diagram showing an example of a usage state of the medical medical system. FIG. 4 shows a state in which the patient P1 supported by the examination table 120 is sleeping in a supine state, and the operator P2 is treating the oral cavity, which is the affected part of the patient P1, using the microscope 140.

  The medical medical device 100 includes a medical instrument 190, a microscope 140, and a superimposed image output unit 158 of the control unit 150, and optionally further includes a medical table 120 and the like.

  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 driving mechanism 124 for moving the medical table 120 according to the medical condition for the patient P1 (see FIG. 7). 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 is operated by the foot of the operator P2 and receives operations for various operation instructions and the like with respect to the treatment 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 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 128b is attached and fixed in front of the table 128a (the side on which the operator P2 stands). The touch panel 128b is configured by a combination of a liquid crystal display device and a contact position detection device, and receives various instructions from the surgeon by detecting a pressed position corresponding to the displayed screen. The operation panel is operated by the operator's fingers. The instruction received by the touch panel 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 128b, and may be provided with an operation unit that receives various instructions by operating the fingers with respect to 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) of 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 standing in the vicinity of the medical table 120, that is, provided at a height position similar to that of the standing person's eyes. . 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.

  As described in the first embodiment, the microscope 140 is an eyepiece type microscope in which the objective unit 142U and the eyepiece unit 146U are integrated, and an enlarged image of the affected part is presented to the operator P2 so as to be visible. .

  More specifically, the microscope 140 includes an objective unit 142U including an objective optical system 142 and an eyepiece unit 146U including an eyepiece optical system 146. In the microscope 140, the objective unit 142U and the eyepiece unit 146U are integrated with the objective unit 142U facing downward and the eyepiece unit 146U facing sideways, and supported by the tip of the arm 134c. Yes. 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. In particular, since the objective unit 142U and the eyepiece unit 146U are integrated, the movement of the face of the operator P2 looking into the eyepiece unit 146U and the movement of the objective unit 142U are performed in conjunction with each other. The visual field can be easily changed with a natural feeling.

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

  Here, the microscope 140 is provided with a microphone 188 as an audio input unit. The microphone 188 is configured to collect sound produced by the operator P2. The microphone 188 may be provided at another position, for example, the medical table 120, the basin unit 130, or the like as long as the sound can be collected by the operator P2.

  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 one of external imaging units provided separately from the microscope 140. The peripheral image capturing unit 138 is configured to be able to image a part of the patient P1 supported by the medical 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 distal end portion of the arm 134b (here, in the upper portion). 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.

  In addition, the medical care system includes an instrument holder unit 135. The instrument holder unit 135 is configured to be capable of supporting a plurality of medical instruments 190 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 a medical instrument 190 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 a plurality of medical instruments 190, and the respective medical instruments 190 are accommodated in the corresponding set parts 136a and 137a. Each set unit 136a, 137a detects a set state of the medical instrument 190, and a sensor 136S as a medical instrument specifying unit for specifying the medical instrument 190 in use from the plurality of medical instruments 190 (see FIG. 3 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 190 is present, or a switch that is turned on or off by being pressed when the medical instrument 190 is present is used. A sensor or a magnetic sensor that detects whether the medical instrument 190 is present by a change in a magnetic field such as a permanent magnet provided in the medical instrument 190 can be used. 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 190 based on the output of each sensor 136S, and which medical instrument 190 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.

  Examples of the medical instrument 190 include a cutting tool such as an air turbine handpiece or a micromotor handpiece used as a root canal treatment tool, a scaler, a three-way syringe, a vacuum syringe, an oral camera, a photopolymerization irradiator, and the like. is assumed. These medical instruments 190 are used 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 one of the medical instruments 190 is configured to output medical data including medical information that fluctuates during medical care.

  FIG. 5 is a perspective view showing a root canal treatment instrument 190A as an example of a diagnosis instrument 190 capable of outputting diagnosis data including diagnosis information that fluctuates during diagnosis, and FIG. 6 is a functional block of the root canal treatment instrument 190A. FIG. In the following description, in the case where the medical instruments are described without being distinguished from each other, they are referred to as a medical instrument 190, and in the case where the description is focused on a specific root canal therapy instrument, it is referred to as a root canal therapy instrument 190A. .

  The root canal treatment instrument 190A is also referred to as a dental instrument. The root canal treatment instrument 190A expands the root canal 512 as a medical treatment for teeth, and the root canal position measurement data and driving state data are used as medical data during the root canal enlargement work. It is configured to allow output.

  That is, the root canal treatment instrument 190A has a long rod-like appearance that can be held with one hand, and a file 192 is provided at the distal end of the instrument body 191. Then, the inside of the root canal 512 is cut by the file 192 to rotate the root canal 512 by rotating the file 192 by a medical instrument drive unit 195 including an actuator (not shown) and its drive circuit.

  The medical instrument drive unit 195 is configured to be able to acquire drive state data indicating its own drive state. The driving state data is a kind of medical information data including medical information that fluctuates during medical treatment, and includes at least one of a driving output value, a torque value, and a rotational speed, for example. The drive output value, the torque value, and the rotational speed are obtained by various configurations including well-known techniques related to the motor. For example, when the motor is a DC micromotor, the torque value (load torque value) applied to the file 192 during work is obtained as a value obtained by multiplying the voltage applied to the DC micromotor by a torque constant, and rotating. The number is obtained as a value obtained by multiplying the current flowing through the DC micromotor by a rotational speed constant, and the drive output value is obtained as a value obtained by multiplying the multiplication value of these torque value and rotational speed by the constant. These values are values that vary depending on the state of the expansion operation of the root canal 512, that is, during medical treatment. In particular, when it is configured to be detected and displayed as medical data in which the rotational speed of the file 192 varies, the rotational speed of the file 192 is grasped and medical treatment is performed at an appropriate rotational speed according to the cutting position, symptom, and the like. be able to. Further, when the configuration is such that the torque applied to the file 192 is detected and displayed as fluctuating medical data, the file 192 can be quickly detected as being overloaded, so the file 192 is broken or broken. It is also possible to prevent the stagnation of treatment.

  The root canal treatment instrument 190A includes an oral electrode 193 that can be disposed in the oral cavity of a patient, and a root canal position measurement unit 196. Then, the root canal position measurement unit 196 uses the file 192 inserted into the root canal 512 as a measurement electrode to measure an electrical characteristic value such as a current value or a potential between the file 192 and the oral electrode 193. Then, the position of the tip of the file 192 in the root canal 512 is obtained from the measured electrical characteristic value. The root canal position is a distance corresponding to a root apex equivalent position or a predetermined reference position in the root canal (for example, a root apex stenosis in the root canal) or a pre-measured root canal length. It is obtained as a relative position. Such root canal position data is also a kind of medical information data including medical information that fluctuates during medical care.

  The driving state data acquired by the medical instrument driving unit 195 and the root canal position data obtained by the root canal position measuring unit are output to the outside as medical data through the medical data output unit 197 and input to the control unit 150. Is done.

  The medical data that fluctuates during medical treatment is not limited to the above example, and may be data including information that fluctuates during medical treatment, such as data output from another medical device 190.

  The root canal treatment instrument 190A includes an affected area surrounding imaging unit 198 as an external imaging unit.

  That is, an affected area imaging unit 198 including an imaging element such as a CCD and an optical system such as a lens is attached to the distal end portion of the root canal treatment instrument 190A and around the fixed portion of the file 192. The affected area imaging unit 198 is also an external imaging unit provided separately from the microscope 140. The imaging direction of the affected area imaging unit 198 substantially coincides with the axis of the file 192. When a root canal enlargement operation or the like is performed using the root canal treatment instrument 190 </ b> A, the contact area of the tooth 500 according to the file 192 is included in the imaging range of the affected area surrounding imaging unit 198. Imaged image data obtained by the affected area surrounding imaging unit 198 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 a medical information image based on medical data as a superimposed image in the field of view. In the second embodiment, the elements are an image output unit 158 that outputs a medical information image based on medical data, and a medical information image (superimposed image) based on the output from the superimposed image output unit 158 in the microscope 140. ) Will be described with an example realized by a configuration including an overlay display unit 144R that displays the enlarged image so as to be overlaid on the enlarged image.

  FIG. 7 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 128b are connected to the control unit 150, and an instruction input through the foot controller 126 and the touch panel 128b is given to the control unit 150. A voice recognition unit 189 is connected to the control unit 150. The voice recognition unit 189 performs pattern recognition or the like based on the voice data of the surgeon P2 acquired through the microphone 188, performs voice recognition processing, and gives an operation command corresponding to the recognized phrase to the control unit 150. For example, when the recognized speech phrase is recognized as “root canal position image display ON” (an example of a root canal position image will be described later), the root canal position image is turned on. Commands are given to the control unit 150. Of course, the voice recognition processing performed by the voice recognition unit 189 may be incorporated as one function of the control unit 150.

  In addition, each of the medical devices 190 and the sensors 136S provided in the set portions 136a and 137a corresponding thereto are also connected to the control unit 150. Each medical instrument 190 operates under the control of the control unit 150. Further, the output of each sensor 136S is given to the control unit 150, whereby the control unit 150 determines the removal state of each medical instrument 190. FIG. 7 illustrates a state in which the first sensor 136S is associated with the first medical instrument 190 and the second sensor 136S is associated with the second medical instrument 190. 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 an image signal output from the display unit 135a.

  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.

  Further, the control unit 150 and the microscope 140 are connected so that an image signal can be input and output between them.

  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 left eyepiece optical system 146L 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. Further, the image signal captured by the intervening imaging unit 144L is also provided to the control unit 150.

  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. 8 is a block diagram illustrating a hardware configuration example 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 156a, 156b, and an image output unit 157a. 157b and the like are configured 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 addition to the basic program, the external storage device 154 includes a superimposing image control program 154a for controlling a superposed image displayed on the superimposing display unit 144R, an instruction received by the foot controller 126, etc., and a medical table drive mechanism unit A medical instrument control program 154b for controlling the driving of 124, a medical instrument instruction program for outputting an instruction to the medical instrument 190 according to an 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 128b, the voice recognition unit 189, the medical instrument 190, and the sensor 136S via the input / output circuit 155. Further, the control unit 150 is connected to the peripheral image capturing unit 138 via the image input unit 156a, connected to the intervening image capturing unit 144L via the image input unit 156b, and superimposed display unit 144R via the image output unit 157a. 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. In addition to the operation control of the clinical table 120 and the operation control of the medical instrument 190, various processing functions for controlling the superimposed image displayed on the superimposed display unit 144R 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. 9 is a block diagram showing functions realized by execution of the superimposed image control program 154 a in the control unit 150.

  That is, the control unit 150 includes a function as the superimposed image output unit 158, a function as the medical examination table information image generation unit 159a, and a function as the medical treatment information image generation unit 159b.

  For this superimposed image output unit 158, patient information in the patient information storage unit 139 a of the server 139, data of the peripheral captured image captured by the peripheral image capturing unit 138, and peripheral imaging of the affected area by the affected peripheral imaging unit 198 Image data and microscope-captured image data by the intervening imaging unit 144L of the microscope 140 are given. 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 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 medical data including medical information from the medical instrument 190 is given to the medical information image generation unit 159b, the medical information image generation unit 159b causes the operator P2 to visually recognize the medical information based on the medical information. Are generated and provided to the superimposed image output unit 158. The medical treatment information image is information that varies during the medical treatment as described above, and in particular, information that the surgeon should grasp while the operator P2 is looking into the microscope 140. Depending on the type of the medical instrument 190, medical data may or may not be output. When this output is not output, a medical information image is not generated.

  Here, as described above, it is mainly assumed that the medical instrument 190 is the root canal treatment instrument 190A, and the rotation number and position information of the tip of the rotary tool in the root canal are output as medical information. To explain.

  When receiving the medical information, the medical information image generating unit 159b generates a medical information image corresponding to the medical information. As this medical care information image, for example, a figure representing the number of rotations or position information as a numerical value, a figure showing a level indicator showing the number of rotations or position information on the side of the scale, and the like are assumed. The original image of the medical information image is also stored in advance in the external storage device 154, and a medical information image corresponding to the medical information may be generated based on the original image. An example of this medical information image will be described later. Then, the medical information image generated by the medical 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 selection images 176 and 177, an allocation information image 172, and the like, which will be described later. The original images such as the selected images 176 and 177 and the allocation information image 172 are also stored in the external storage device 154 as images in advance. Based on the original image, based on the operation status and the like, the selected image 176, 177 and an allocation information image 172 are generated. In particular, as the allocation information image 172, an image indicating an allocation suitable for each medical instrument 190 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 190. Of the allocation information images, an image indicating an allocation suitable for each medical instrument 190 is generated as a kind of instrument related information image.

  Further, the superimposed image output unit 158 includes, as data for controlling image switching, device operation status information from the medical device 190, the foot controller 126, the touch panel 128b, the operation instruction received by the voice recognition unit 189, and the like. And the output result of the sensor 136S is given.

  The superimposed image output unit 158 superimposes one or more of a patient information image, a clinical table information image, a medical information image, a peripheral captured image, and a diseased region captured image based on the operation instruction and the output result of the sensor 136S. As image data, it outputs as needed and gives it to the overlay display part 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.

  10 and 11 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 operator P2 looks into the microscope 140, as shown in FIG. 12, an image (here, the peripheral captured image 178) corresponding to the output from the superimposed image output unit 158 can be recognized. In an area where an image corresponding to the output from the image output unit 158 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. Of course, in this step and the following steps described below, in addition to an instruction through the foot controller 126, a switching instruction through the touch panel 128b or a voice switching instruction through the voice recognition unit 189 may be performed.

  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. 13 shows 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 examination 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, the presence / absence of an image addition instruction is determined based on an operation instruction given through the foot controller 126 or the like. 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. 14 shows an example in which a clinic table information image 170, a clinic table information image 172, and a peripheral captured image 178 are 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 changed according to an instruction through the foot controller 126 or the like.

  In step S4, whether or not the medical instrument 190 has been removed is determined according to the output result of the sensor 136S. If it is determined that the medical instrument 190 has not been taken out, the process returns to step S2, and if it is determined that the medical instrument 190 has been taken out, the process proceeds to the next step S5.

  In step S5, a superimposed image display process corresponding to the extracted medical instrument 190 is performed. In step S6, if it is determined that the medical instrument 190 is stored according to the output result of the sensor 136S, the process is terminated.

  An example of the superimposed image display process corresponding to the extracted medical instrument 190 will be described. Here, an example in which the medical instrument 190 is a root canal treatment instrument 190A will be described. However, superimposed images suitable for medical care using the medical instrument 190 are displayed on the other medical instruments 190, respectively. Good.

  First, when it is determined that the medical instrument 190 has been taken out based on the output result of the sensor 136S, as shown in FIG. 11, it is selected and taken out based on the output result of the sensor 136S (that is, used) in step S21. The medical instrument 190 is identified, and an initial screen corresponding to the extracted medical instrument 190 is displayed.

  Here, a root canal treatment instrument 190A is assumed as the medical instrument 190, and in FIG. 15, as a medical information image 180, a figure (driving state image) 180a indicating the number of rotations and a root apex (APEX) are displayed. An example is shown in which a figure (root canal position image) 180b that displays the distance to the end is displayed. The figure 180a which is a driving state image and the figure 180b which is a root canal position image are values generated based on driving state data or root canal position measurement data from the root canal treatment instrument 190A. During the use of the endovascular treatment device 190A, the images are sequentially displayed based on the data output from the root canal treatment device 190A.

  In addition, when the root canal treatment instrument 190A is assumed, the affected area surrounding image captured by the affected area surrounding imaging unit 198 can be displayed as a superimposed image in the visual field range of the microscope 140 (see FIG. 18).

  In FIG. 15, a graphic indicating that the medical 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 operator P2 through the touch panel 128b or the like, an output result of the sensor 136S when the root canal treatment instrument 190A 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.

  In addition, in FIG. 15, a peripheral captured image 178 and an allocation information image 172 are also included. The allocation information image 172 of the foot controller 126 is changed to one suitable for the extracted root canal treatment instrument 190A based on the output of the sensor 136S. That is, since the root canal treatment instrument 190A 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. Here, the root canal treatment instrument 190A is provided with a light that illuminates the medical location, and the light ON command is given to the downward operation of the upper left operation reception unit 126a for the upward operation of the upper left operation reception unit 126a. On the other hand, a light OFF command is assigned. 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 root canal treatment instrument 190A is assigned to the operation reception unit 126a on the lower side of the center.

  Further, in FIG. 15, a selection image 177 is displayed. The selection image 177 includes a plurality of selection marks 177a. The plurality of selection marks 177a are marks for selecting an image to be overlaid, and are a mark “surrounding affected area” indicating an image taken by the affected area surrounding imaging unit 198 and a mark “rotation number” indicating a rotation speed image. And a mark “apex position” indicating an image of the distance to the apex (APEX). Here, the mark includes characters, but may be a stylized mark or the like. On this screen, it is possible to select from a plurality of selection marks 177a in the selection image 177 by operating the operation receiving unit 126a at the center of the foot controller 126. In the case of using the touch panel 128b, a screen similar to the main selection image 177 may be displayed on the touch panel 128b, and an instruction may be given by touching the selection screen. Further, in the case of the voice recognition unit 189, the instruction may be given by saying “display on” or “display off” after the name of each screen.

  After the initial screen is displayed, the presence / absence of an image display switching instruction is determined in step S22. The image display switching instruction here is, for example, a selection instruction for the selection mark 176a in the selection image 176 by operating the operation reception unit 126a at the center of the foot controller 126, or a plurality of selections in the selection image 177. This is performed by receiving a selection instruction for the selection mark 177a. Of course, an instruction may be received through the touch panel 128b or the voice recognition unit 189.

  If it is determined in step S22 that there is an image display switching instruction, the process proceeds to step S23, and the medical information image 180, the medical table information image 170, the peripheral captured image 178, and the allocation information image 172 are not displayed according to the content of the instruction. Display processing or additional display processing such as an X-ray image, a fluorescence image, and a pocket image is performed. 16 and 17 show an example in which the clinical table information image 170, the peripheral captured image 178, and the allocation information image 172 are not displayed.

  Note that display modes such as the size, color, display position, and the like of each image may be switched in accordance with instructions through the foot controller 126, the touch panel 128b, and the voice recognition unit 189.

  When it is determined in step S22 that there is no image display switching instruction, or after the process of step S23 is completed, the process proceeds to step S24.

  In step S24, whether or not driving of the root canal treatment instrument 190A is started is determined according to the output from the root canal treatment instrument 190A. If it is determined in this step S24 that the root canal treatment instrument 190A has not been started, the process returns to step S22. If it is determined that the root canal treatment instrument 190A has been started, the process proceeds to step S25.

  In step S25, the display of the selected images 176 and 177 is turned off. Even after the start of the driving of the root canal treatment instrument 190A, when the switching of the image display is accepted and the switching instruction of the image display is given, the switching of the image display may be performed as described above. In this state, as shown in FIG. 16, the medical treatment information image 180 is displayed in the field of view while at least a part of the enlarged image of the affected part remains visible in the field of view of the microscope 140. Therefore, the surgeon P2 can visually recognize an enlarged image of the affected area, and a graphic (an image indicating the number of rotations) 180a and a graphic (an intracanal position image) 180b included in the medical treatment information image 180. FIG. 18 shows an example in which an affected area peripheral image 181 is displayed, and FIG. 19 shows a case where all superimposed display images are turned off.

  Subsequent to step S25, the root canal position image enlargement display process (see steps S26 and S27) and the driving state image enlargement display process (see steps S28 and S29) are processed in parallel. The parallel processing may be one in which a plurality of CPUs perform parallel processing separately, or a single CPU performs sequential processing and performs pseudo parallel processing.

  In the root canal position image enlargement display process, it is determined in step S26 whether or not the root canal position measurement data satisfies a predetermined switching condition based on the output from the root canal treatment instrument 190A. The predetermined switching condition here is a condition for enlarging and displaying at least a part of the medical treatment information image in accordance with the operation status information of the root canal treatment instrument 190A. Here, the tip of the cutting tool of the root canal treatment instrument 190A Is set as the distance (for example, the distance is “1”) until it reaches the apex. The predetermined condition may be a value set in advance through the touch panel 128b or the like and stored in the external storage device 154, or a value set each time the use of the root canal treatment instrument 190A is started. May be. In this step S26, when the root canal position measurement data and the predetermined distance are the same, either YES or NO may be determined.

  If it is determined in step S26 that the in-root canal position measurement data satisfies the predetermined switching condition, that is, the tip of the cutting tool of the root canal treatment instrument 190A has approached the apex to a predetermined distance, the process proceeds to step S27. In step S27, the figure 180b which is a root canal position image is enlarged. FIG. 17 is an enlarged view of the figure 180b. Here, a part of the figure 180b, that is, a part close to the apex (APEX) in the scale is enlarged and displayed as the figure 180ba. The aspect of enlarging the root canal position image may be an aspect of enlarging a part thereof as in this example, or may be an aspect of enlarging the entire figure 180b that is the position image within the root canal. Good.

  In addition, when it determines with YES in step S26, you may change the display mode of the figure of the figure 180b which is a root canal position image. For example, the color of the figure 180b may be changed (for example, changed to a conspicuous red), blinked, changed in size, or changed in character font.

  Further, when the root canal treatment instrument 190A is removed from the tooth 500 and the tip of the cutting tool moves away from the apex, for example, it is determined that the tip of the cutting tool of the root canal treatment instrument 190A has moved away from the root apex by a predetermined distance. In some cases, the figure 180b that is the root canal position image may be reduced (that is, returned to the original figure 180b).

  In the driving state image enlargement display process, in step S28, it is determined based on the output from the root canal treatment instrument 190A whether the rotational speed data as the driving state data satisfies a predetermined switching condition. The predetermined switching condition here is also a condition for enlarging and displaying at least a part of the medical treatment information image in accordance with the operation status information of the root canal treatment instrument 190A. Here, the rotational speed of the root canal treatment instrument 190A (for example, , 100 rpm). The predetermined condition may be a value set in advance through the touch panel 128b or the like and stored in the external storage device 154, or a value set each time the use of the root canal treatment instrument 190A is started. May be. In this step S28, when the rotation speed and the rotation speed set as a predetermined condition are the same, it may be determined as YES or NO.

  If it is determined in step S28 that the rotational speed satisfies the predetermined switching condition, that is, the rotational speed of the root canal treatment instrument 190A exceeds the predetermined rotational speed set as the switching condition, the process proceeds to step S29. In step S29, the display mode of the graphic 180a indicating the rotational speed is changed. For example, the color of the figure 180a is changed (for example, changed to a conspicuous red) or blinked. Change the size, change the character font, etc.

  Note that the display mode is changed step by step, for example, when the value exceeds 80% of the rotational speed before reaching the above-mentioned rotational speed, and other colors (for example, yellow) are displayed. Also good.

  Further, when the rotational speed of the root canal treatment instrument 190A decreases and falls below a predetermined rotational speed set as the switching condition, the figure 180a is restored (that is, restored to the original black display, non-flashing image, etc.). Good.

  As the medical information image 180, in addition to the above example, as shown in FIG. 20, in addition to a graphic indicating the number of rotations, a graphic indicating the distance to the root apex, various information such as motor torque and rotational direction It may be an image 180B including a figure indicating

  According to the medical medical device 100 configured as described above, the medical information image 180 based on the medical data is in the visual field while at least a part of the magnified image remains visible in the visual field of the microscope 140. Is displayed. Therefore, the surgeon P2 can easily grasp the situation that has changed during the medical treatment when performing the medical treatment using the microscope 140.

  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 root canal treatment instrument 190A in use while looking into the microscope 140 is used. Therefore, there is an advantage that various medical treatments can be easily performed while looking into the microscope 140 as much as possible.

  In addition, since the overlay display unit 144R is provided in the middle of the optical system of the microscope 140, the surgeon P2 can view information regarding the root canal treatment instrument 190A while visually recognizing the enlarged image 160 regarding the affected part. Easy to grasp.

  In addition, since at least one of the presence / absence and display mode of the medical information image 180 can be switched, appropriate display can be performed in the field of view of the microscope 140 according to various situations.

  In the above embodiment, the medical treatment information image 180 is displayed when the root canal treatment device 190A is taken out from the medical treatment device holder unit 135. However, when the root canal treatment device 190A is driven, the medical treatment information 190A is displayed. The image 180 may be displayed.

  Specifically, since the surgeon P2 gives an instruction through the foot controller 126, the touch panel 128b, and the voice recognition unit 189, the medical information image 180 is switched as described above. Therefore, an appropriate display is displayed according to the instruction from the operator P2. Can be done.

  In addition, since the medical treatment information image 180 includes a figure 180b that is a root canal position image, the surgeon P2 can perform medical treatment while recognizing the root canal position together with the magnified image by the microscope 140. .

  Moreover, since the figure 180b which is a root canal position image is enlarged or reduced based on the root canal position data, the degree of attention of the image can be appropriately changed. Thereby, more careful handling can be promoted.

  Further, since the medical treatment information image 180 includes a graphic 180a indicating the rotational speed indicating the driving status of the root canal treatment instrument 190A, the surgeon P2 performs medical treatment while recognizing the driving status together with the magnified image by the microscope 140. be able to.

  Moreover, since the display mode of the graphic 180a indicating the rotational speed indicating the driving status of the root canal treatment instrument 190A changes according to the change in the driving status data, the degree of attention of the image can be changed as appropriate. Thereby, more careful handling can be promoted.

  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 addition, since at least one of the peripheral captured image 178 and the affected part peripheral image 181 is displayed in the visual field of the microscope 140, the operator P2 looks into the microscope 140 and is different from the magnified image obtained by the microscope 140. That is, it is possible to recognize an image in which at least one of the imaging direction and the imaging range is different from the magnified image obtained by the microscope. An image captured by another photographing handpiece may be displayed in the field of view of the microscope 140. Another captured image does not necessarily have to be a moving image, and may be a still image at a specific point in time.

  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.

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

  FIG. 21 is a functional block diagram showing the overall configuration of a medical medical system including a medical medical device. 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 as an objective unit and a display unit 248 as an eyepiece unit.

  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.

  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 again, the imaging unit 242 and the display unit 248 are integrated in a fixed positional relationship.

  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.

  The image signal from the superimposed image output unit 258 is also given to the display unit 135a.

  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. Further, since both images are combined by image processing, there is an advantage that the positional relationship between the enlarged captured image and the display image can be easily adjusted.

  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.

{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 190 is picked up from above the tray table via an arm provided at the rear of 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 40,140,240 Microscope 42U, 142U Objective unit 46U, 146U Eyepiece unit 90 Medical instrument 126 Foot controller 128b Touch panel 135a Present display part 136S Sensor 138 Peripheral image imaging part 142 Objective optical system 142L Left objective optical System 142R Right objective optical system 144 Intervening section 144L Intervening imaging section 144R Display section 146 Eyepiece optical system 146L Left eyepiece optical system 146R Right eyepiece optical system 150, 250 Control unit 154a Image control program 158, 258 Superposed image output section 159b Medical information Image generating unit 160 Enlarged image 170 Medical table information image 178 Peripheral captured image 180, 180B Medical information image 181 Affected region peripheral image 188 Microphone 189 Voice recognition unit 190 Each medical instrument 19 A Root canal treatment instrument 195 Medical instrument drive unit 196 Root canal position measurement unit 197 Medical data output unit 198 Affected area peripheral imaging unit 242 Imaging unit 244 Imaging optical system 244L Left imaging optical system 244R Right imaging optical system 246 Imaging unit 246L Left imaging Unit 246R right imaging unit 248 display unit 248L left display unit 248R right display unit

Claims (13)

A medical data output unit capable of outputting medical data including medical information that fluctuates during medical care;
An eyepiece type microscope in which the objective unit and the eyepiece unit are integrated, and an enlarged image of the affected area is presented to the surgeon so as to be visible;
With
A medical medical device in which a medical information image based on the medical data is displayed in the visual field while at least a part of the enlarged image is visible in the visual field of the microscope. The medical diagnostic device according to claim 1,
Further comprising a superimposed image output unit for outputting the medical information image based on the medical data;
The microscope is provided in the optical system including an objective optical system included in the objective unit, an eyepiece optical system included in the eyepiece unit, and based on an output from the superimposed image output unit A medical medical device comprising: an overlapping display unit that displays a medical information image so as to overlap the enlarged image. The medical diagnostic device according to claim 1,
The microscope includes, as the objective unit, an imaging optical system 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 the eyepiece unit includes an eyepiece. With a display unit of type
A superimposed image processing unit that generates a display image in which the medical information 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,
A medical medical device configured to be switchable between at least one of display and display of the medical information image. The medical medical device according to claim 4, wherein
It further comprises a foot controller operated by the surgeon's foot,
A medical medical device in which at least one of the display and the display mode of the medical information image is switched according to an output from the foot controller. The medical medical device according to claim 4 or 5,
It further comprises an operation panel operated by the operator's fingers,
A medical medical apparatus in which at least one of the display and the display mode of the medical information image is switched in accordance with an output from the operation panel. The medical medical device according to any one of claims 4 to 6,
A voice input unit; and a voice recognition unit that recognizes voice input through the voice input unit;
A medical apparatus for medical treatment in which at least one of the display and the display mode of the medical information image is switched according to an output from the voice recognition unit. The medical medical device according to any one of claims 1 to 7,
A root canal position measurement unit,
The medical data output unit outputs, as the medical data, data including root canal position measurement data measured by the root canal position measurement unit,
A medical treatment apparatus for displaying a root canal position image based on the root canal position measurement data in the visual field. The medical medical device according to claim 8, wherein
A medical medical device in which the root canal position image is displayed in an enlarged or reduced manner according to a change in the root canal position measurement data. The medical medical device according to any one of claims 1 to 9,
A medical instrument drive unit;
The medical data output unit outputs data including driving state data of the medical instrument driving unit as the medical data,
A medical medical device in which a driving state image based on the driving state data is displayed in the visual field. The medical diagnostic device according to claim 10,
A medical medical device in which a display mode of the driving state image is changed according to a change in the driving state data. The medical medical device according to any one of claims 1 to 11,
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. The medical medical device according to any one of claims 1 to 12,
Further comprising an external imaging unit different from the microscope,
A medical medical device in which an image captured by the external imaging unit is displayed in the visual field while at least a part of the enlarged image is visible in the visual field of the microscope.

Images