JP2017093478A - Stereoscopic observation apparatus for surgery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a stereoscopic observation apparatus for surgery capable of supporting a large-sized monitoring device together with a lens barrel without having to increase the size of a stand device.SOLUTION: A vertical arm 5, a horizontal arm 6, and a lens barrel 15 are provided on one of right and left side faces of a stand body 3, and a monitoring device 20 is provided to the tip of an arm 19 extending to the other of the right and left side faces so that the weight balance can be achieved on the right and left with the stand body 3 as center, and even the large-sized monitoring device 20 can be supported by the comparatively small stand body 3.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a surgical stereoscopic observation apparatus.

  In the case of neurosurgery or the like, when a doctor performs an operation while observing an enlarged operation field, a surgical microscope is generally used. The doctor looks at the eyepiece of the surgical microscope and magnifies the affected area through the optical system of the surgical microscope.

  In this way, the method of magnifying the surgical field with a surgical microscope always requires the eyes to be in contact with the eyepiece, so if the microscope is tilted for observation, the doctor's neck also becomes slanted and an unreasonable posture during surgery Forced.

  Therefore, recently, as a stereoscopic observation device for surgery, instead of a surgical microscope, a stereoscopic electronic image of an affected area is photographed by a lens barrel with a built-in camera, displayed on a monitor device, and stereoscopically displayed with 3D dedicated glasses. An observation method has been proposed.

  The lens barrel is supported by the stand device so as to be movable, and the doctor can hold the lens barrel by hand and freely change the position and orientation of the lens barrel to select an optimum observation direction.

  Since it is not necessary to pay attention to the eyepiece, the doctor can operate in a free posture, and not only the doctor but also the assistant can see the same monitor device (see, for example, Patent Document 1).

JP 11-318936 A

  However, in the case of this type of stereoscopic observation apparatus, the lens barrel needs to be covered with a sterilization drape so that the vicinity of the lens barrel is touched by the hand of the doctor. Since the monitor device cannot be draped, it is installed at a position away from the lens barrel. Since the monitor device is separated from the lens barrel, a relatively large size is required to ensure the visibility of the doctor.

  Therefore, the weight of the monitor device increases as a real problem, and it is difficult to support the monitor device together with the lens barrel on the stand device due to the problem of weight balance. If the monitor device is supported on the stand device together with the lens barrel, a large and sturdy stand device is required, which compresses the space in the operating room.

  The present invention has been made paying attention to such related technology, and provides a surgical stereoscopic observation apparatus capable of supporting a large monitor device together with a lens barrel without increasing the size of a stand device. Is.

  According to the first technical aspect of the present invention, a mirror housing optical means for obtaining a stereoscopic optical image of an operative field and an imaging means for capturing a stereoscopic optical image obtained from the optical means and outputting a stereoscopic video signal. A surgical device comprising a tube, a stand device that is movable to an arbitrary position while supporting the lens barrel, and a panel-type monitor device that displays a stereoscopic image based on a stereoscopic image signal output from the imaging means A stereoscopic observation device, wherein the stand device includes a base installed on a floor, and a stand main body that is rotatable about a vertical axis with respect to the base. A vertical arm attached to the horizontal axis so that it can tilt forward and backward, and a horizontal arm with the base end pivotally supported at the upper end of the vertical arm and extending in the horizontal direction and holding the lens barrel at the distal end. The stand body Wherein the arm in and tip extending into the other of the left and right sides monitoring device is held is provided.

  According to another technical aspect of the present invention, the vertical arm and the horizontal arm have a balanced structure in which the weight of the lens barrel is offset by a counterweight.

  According to another technical aspect of the present invention, the arm is structured to be foldable in the horizontal direction.

  According to another technical aspect of the present invention, the optical unit includes at least an objective optical system and a variable magnification optical system through which a pair of left and right light beams that have passed through the objective optical system pass, and the imaging unit includes the variable magnification optical system. And a pair of left and right imaging elements that receive the light flux that has passed through the lens, and an illuminating means that can irradiate illumination light at an angle different from the optical axis of the objective optical system with respect to the surgical field.

  According to the technical aspect of the present invention, the stand main body is provided with the vertical arm, the horizontal arm, and the lens barrel on one of the left and right sides, and the monitor device is provided at the tip of the arm that extends to the other side. The weight balance on the left and right with respect to the stand body can be achieved, and even a large monitor device can be supported by a relatively small stand body. Since the stand body is rotatable about a vertical axis with respect to the base, the weight balance on the left and right is not changed even if the stand body is rotated.

  According to another technical aspect of the present invention, since the vertical arm and the horizontal arm have a balanced structure in which the weight of the lens barrel is offset by a counterweight, weight balance before and after the stand main body is also achieved. The stand device becomes more stable.

  According to another technical aspect of the present invention, since the arm is foldable in the horizontal direction, the position and orientation of the monitor device can be adjusted according to the degree of folding, and the arm is folded when not in use or transported. The monitor device can be placed in a storage state close to the stand body.

  According to another technical aspect of the present invention, since the angle of the illuminating unit is different from the optical axis of the objective optical system, the specular reflection component reflected by the operative field does not easily return directly to the objective optical system, and adversely affects the imaging unit. Can be avoided.

The front view which shows the stereoscopic observation apparatus for surgery. The side view which shows the stereoscopic observation apparatus for surgery. The perspective view which shows a lens-barrel. The perspective view which shows the internal structure of a lens-barrel. The front view which shows the internal structure of a lens-barrel. The side view which shows the internal structure of a lens-barrel.

  1 to 6 are views showing a preferred embodiment of the present invention. In the following description, X in FIG. 1 is described as the left-right direction (horizontal direction), and Y in FIG.

  The stand device 1 is installed in an operating room and includes a base 2 and a stand body 3. The base 2 has a lockable caster 4 and can move on the floor in an unlocked state, and can be fixed at a required position on the floor in a locked state.

  The stand body 3 is installed on the base 2 and is rotatable about a vertical axis V1. The stand main body 3 is pivotally supported on the left side surface so that the middle portion of the vertical arm 5 can tilt forward and backward about a horizontal axis H <b> 1 formed by a pivot point a. The vertical arm 5 is made of a casting and has a hollow shape that is long in the vertical direction.

  At the upper end of the vertical arm 5, the base end side of the horizontal arm 6 is pivotally supported by a pivot point b so as to be rotatable up and down. The lateral arm 6 is formed of a curved metal tube extending in the lateral direction. A bottom arm 7 extending rearward is provided below the vertical arm 5, and a counterweight W is attached to an end of the bottom arm 7. The end of the horizontal arm 6 and the middle part of the bottom arm 7 are connected by a vertical sub-arm 8. As a result, a vertical parallel link including the vertical arm 5 and the vertical sub-arm 8 is formed.

  The lower end of the proximal arm 9 is pivotally supported at the shaft fulcrum b above the vertical arm 5, and the middle portion of the distal arm 10 is pivotally supported at the distal end of the horizontal arm 6. The upper end of the proximal end arm 9 and the upper end of the distal end arm 10 are connected by a straight lateral sub-arm 11. Thereby, a horizontal parallel link including the horizontal arm 6 and the horizontal sub-arm 11 is formed. The proximal end arm 9 is always maintained in a vertical state by the internal structure of the vertical arm 5.

  A box 12 that is rotatable about a vertical axis V2 is provided at the lower portion of the distal arm 10. A barrel 15 is supported on the box 12 via two auxiliary arms 13 and 14. The auxiliary arm 13 has an upper end fixed to the box 12, and the other auxiliary arm 14 is L-shaped and is supported at the lower end of the auxiliary arm 13 so as to be rotatable about the oblique axis T. A lens barrel 15 is supported at the lower end of the L-shaped auxiliary arm 14 so as to be rotatable about a horizontal axis H2. The vertical axis V2, the oblique axis T, and the horizontal axis H2 intersect at one point that matches the approximate center of gravity of the lens barrel 15. The lens barrel 15 is supported by a so-called gimbal mechanism by three rotating shafts, and the direction can be freely changed by operating the handles 16 on the left and right sides of the lens barrel 15 at that position.

  As described above, the vertical arm 5 and the horizontal arm 6 including the lens barrel 15 that support the lens barrel 15 are all attached to the left side surface of the stand body 3 in FIG.

  On the top of the stand body 3, an arm 19 composed of two long and short strip-shaped arm bodies 17, 18 extends in the left-right direction (horizontal direction) around the stand body 3 to the opposite side to the vertical arm 5. ing. This positional relationship is always maintained even if the stand body 3 rotates about the vertical axis V1. The attachment part of the arm body 17 to the stand body 3 and the attachment part of the arm bodies 17 and 18 are connected to each other so as to be rotatable about a vertical axis, and can be folded in the horizontal direction but restricted in the vertical direction. Yes.

  A monitoring device 20 is supported at the tip of the arm 19. The monitor device 20 is typically a 32-inch liquid crystal panel type, and is itself rotatable about a vertical axis with respect to the tip of the arm 19. The monitor device 20 displays a stereoscopic image of the operative field R photographed by the lens barrel 15. A surgeon, an assistant, and the like can wear the dedicated glasses 21 to stereoscopically observe the stereoscopic image displayed on the monitor device 20.

  Next, the internal structure of the lens barrel 15 will be described.

  The lens barrel 15 has a structure capable of stereoscopic photographing, and has two left and right optical paths L formed therein. An objective optical system 22 composed of three lenses is provided below the lens barrel 15. On the optical axis K of the objective optical system 22 is a surgical field R that is an observation target. The objective optical system 22 can change the focal length from 300 mm to 1000 mm by moving some lenses. The objective optical system 22 has a shape in which the front and rear are cut, and an arcuate cutout 24 partitioned by a light shielding plate is formed on the rear side.

  Illumination means 25 is provided in the notch 24 in a state of being incorporated in the lens barrel 15. The optical axis S of the illumination unit 25 is set at a predetermined angle θ with respect to the optical axis K of the objective optical system 22. The illumination means 25 has a built-in LED light source, and can irradiate the white illumination light E with respect to the surgical field R from an oblique direction. Further, the angle of the illumination means 25 is changed in conjunction with the focal length of the objective optical system 22 by a rotation mechanism (not shown) so that the principal axis direction of the illumination light E always faces the center of the operative field R.

  Although the illumination means 25 is provided inside the lens barrel 15, it may be provided outside to guide the illumination light E into the lens barrel 15 by an optical fiber to illuminate the surgical field R from the lens barrel 15, or the illumination means 25 itself. May be attached to the outer surface of the lens barrel 15 to illuminate the operative field R therefrom.

  A pair of left and right variable magnification optical systems 26 along the two optical paths L are provided above the objective optical system 22. The variable magnification optical system 26 can be enlarged up to 40 times. The optical path L is guided to an image sensor (CCD) 28 through an imaging lens 27. The image sensor 28 is typically a CCD area image sensor. In this embodiment, the objective optical system 22, the variable magnification optical system 26 and the imaging lens 27 constitute an “optical means”, and the imaging element 28 constitutes an “imaging means”.

  By irradiating the surgical field R with illumination light E from the illumination means 25, reflected light from the surgical field R is introduced into the objective optical system 22. The main component of the reflected light at this time is irregularly reflected light (backscattered light), and regular reflected light (forward scattered light) including a strong reflected component is incident on the objective optical system 22 because the illumination means 25 has an angle θ. There is no direct return (see FIG. 6).

  The reflected light introduced into the objective optical system 22 passes through the variable magnification optical system 26 along the optical path L, and thereafter is received by the two image pickup devices 28, so that a left-eye image and a right-eye image having parallax with each other are obtained. can get. The left and right images having binocular parallax are combined as a stereoscopic video signal by the controller 29 and displayed on the monitor device 20. By viewing the display of the monitor device 20 with the dedicated glasses 21, stereoscopic observation of the operative field R can be performed. When imaging the operative field R with the imaging device 28, the specular reflection component in the operative field R does not directly enter the objective optical system 22 as described above, so that adverse effects on the imaging device 28 can be avoided.

  Next, an actual operation method of the stereoscopic observation apparatus in the operating room will be described.

  The lens barrel 15 is located near the operative field R, and the handle 16 is touched by the operator's hand, so that the lens barrel 15 and its peripheral part are covered with the drape 30. Specifically, it is continuously covered by the drape 30 from the lens barrel 15 to the upper side of the vertical arm 5. The monitor device 20 is located away from the lens barrel 15 by the arm 19 and is not covered by the drape 30 because the display cannot be seen if it is covered with the drape 30 itself.

  Since the arm 19 of the monitor device 20 can be folded in the horizontal direction, the position and orientation of the monitor device 20 can be set to the optimum state by adjusting the degree of folding.

  Since the monitor device 20 is located away from the stand main body 3, the monitor device 20 has a relatively large size (32 inches) in order to ensure its visibility. Therefore, although it has a certain weight, the monitor device 20 is located on the side opposite to the lens barrel 15 and the vertical arm 5 and the horizontal arm 6 which are other heavy objects by the arm 19, so that no special counterweight is provided. However, the left and right weight balance around the stand body 3 can be achieved.

  Therefore, even if the stand body 3 is not large and sturdy, both the lens barrel 15 and the monitor device 20 and the monitor device 20 can be supported in a stable state. Further, the stand body 3 supporting the lens barrel 15 and the monitor device 20 and the monitor device 20 is rotatable about the vertical axis V1 with respect to the base 2, so that the weight balance on the left and right is not changed even if the stand body 3 is rotated. There is no change in the stable support state of the lens barrel 15 and the like and the monitor device 20.

  Further, since the vertical arm 5 and the horizontal arm 6 have a balanced structure in which the weight of the lens barrel 15 is offset by the counterweight W, the weight balance is achieved around the stand body 3 not only in the left-right direction but also in the front-rear direction. The device 1 becomes more stable.

  The monitor device 20 can be placed in a storage state close to the stand body 3 by folding the arm 19 when not in use or transporting.

  In the above-described embodiment, the monitor device 20 that is viewed with dedicated glasses is taken as an example. However, the present invention is not limited to this, and a monitor device that can be stereoscopically observed with the naked eye may be used.

DESCRIPTION OF SYMBOLS 1 Stand apparatus 2 Base 3 Stand main body 5 Vertical arm 6 Horizontal arm 15 Lens barrel 19 Arm 20 Monitor apparatus 22 Objective optical system (optical means)
25 Illumination means 26 Variable magnification optical system (optical means)
27 Imaging lens (optical means)
28 Imaging device (imaging means)
a, b axis fulcrum W counterweight V1, V2 vertical axis H1, H2 horizontal axis L optical path T oblique axis R operative field K optical axis of objective optical system S optical axis of illumination means E illumination light θ angle of illumination means

Claims (4)

An optical unit that obtains a stereoscopic optical image of a surgical field, a barrel that houses an imaging unit that captures a stereoscopic optical image obtained from the optical unit and outputs a stereoscopic video signal, and an arbitrary unit while supporting the barrel A surgical stereoscopic observation apparatus comprising: a stand device movable to a position; and a panel-type monitor device that displays a stereoscopic video based on a stereoscopic video signal output from the imaging means,
The stand device includes a base installed on a floor, and a stand main body rotatable about a vertical axis with respect to the base,
A vertical arm whose middle part is attached to the left and right sides of the stand body so as to tilt forward and backward about a horizontal axis, a base end is pivotally supported at the upper end of the vertical arm, and extends in the horizontal direction, and a lens barrel at the tip A horizontal arm is provided,
A surgical stereoscopic observation device characterized in that a stand main body is provided with an arm extending to the left and right sides of the stand main body and holding a monitor device at a tip.   2. The surgical stereoscopic observation apparatus according to claim 1, wherein the vertical arm and the horizontal arm have a balanced structure in which the weight of the lens barrel is canceled by a counterweight.   3. The surgical stereoscopic observation apparatus according to claim 1, wherein the arm has a structure that can be folded in a horizontal direction. The optical means includes at least an objective optical system and a variable magnification optical system through which a pair of left and right light beams that have passed through the objective optical system pass,
The imaging means includes a pair of left and right imaging elements that receive the light beam that has passed through the variable magnification optical system,
The surgical three-dimensional object according to any one of claims 1 to 3, wherein the lens barrel is provided with illumination means capable of irradiating illumination light at an angle different from the optical axis of the objective optical system with respect to the surgical field. Observation device.

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