JP4229664B2 - Microscope system - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a microscope system that performs a procedure such as surgery under observation with a microscope.
[0002]
[Prior art]
Surgery using a surgical microscope enlarges the surgical site at a high magnification and performs fine surgery using various surgical tools. As the operation progresses, and complicated operations such as peeling of the thin film, excision of the tumor, and hemostasis are sequentially required, the operator frequently proceeds with the operation while changing the surgical instrument.
[0003]
However, if the magnification of the microscope is high, it is difficult to smoothly guide a medical instrument (also called a surgical instrument) in the observation field of view. It had to be guided and hindered the progress of the operation.
[0004]
In order to solve such a problem, a surgical microscope capable of alternately switching two predetermined magnifications, ie, a high magnification and a low magnification, which are set in advance by a switch operation has been put into practical use and is publicly known. In this case, however, a switch operation is required every time the magnification is changed, and it has not been fully automated.
[0005]
That is, the switch operation is very troublesome while requiring a fine work at a high magnification. In addition to this, the following technique is disclosed as a surgical microscope in which an operator can control magnification without using limbs.
[0006]
Japanese Patent Laid-Open No. 11-501403 discloses a technique capable of detecting the operator's line of sight and controlling the magnification and the like.
Japanese Patent Application Laid-Open No. 6-114077 discloses a technique capable of controlling the magnification by a voice uttered by an operator.
[0007]
Japanese Patent Application Laid-Open No. 4-165322 discloses a technique capable of controlling the magnification by detecting the distance between the operator and the microscope.
Japanese Patent Laid-Open No. 2000-83965 discloses a surgical microscope provided with display means for displaying a peripheral image of the surgical site around an observation optical system for observing the surgical site.
[0008]
[Patent Document 1]
Japanese National Patent Publication No. 11-501403
[0009]
[Patent Document 2]
JP-A-6-114077
[0010]
[Patent Document 3]
JP-A-4-165322
[0011]
[Patent Document 4]
JP 2000-83965 A
[0012]
[Problems to be solved by the invention]
However, in the example in which the line of sight is detected and the magnification is controlled, since the operation is performed with the line of sight away from the surgical site, it is impossible to keep an eye on the surgical site and hinder the flow of surgery. In addition, the periphery of the microscope body becomes complicated, leading to an increase in size and cost.
In the control of the magnification by voice, there is a time lag from the start of the voice of the operator to the start of the control, and the operation flow is hindered in a surgical scene where a quick treatment is required. Also, since the voice recognition rate is not 100%, there is a possibility of malfunction, which is troublesome.
[0013]
In an example in which the magnification is controlled by detecting the distance between the face and the mirror, the magnification changes unless the distance between the face and the mirror is kept constant, and there is a problem that the surgeon's fatigue is large.
In the example in which an image around the surgical site is displayed around the field of view, it is very effective for putting in and out the surgical instrument, but this leads to an increase in the size and cost of the mirror.
[0014]
(Object of invention)
The present invention has been made in view of the above-described points, and an object of the present invention is to provide a microscope system in which a treatment instrument such as a surgical instrument can be easily inserted into and removed from an operation part or the like.
It is another object of the present invention to provide a microscope system in which a treatment instrument can be easily taken in and out of an operation site and the like, and is small and inexpensive.
[0015]
[Means for Solving the Problems]
  A microscope capable of observing the subject;
  An observation area changing means capable of reducing and enlarging the observation area of the microscope;
  A treatment instrument having a functional unit capable of performing a predetermined treatment in the observation region of the microscope;
  A relative position detecting means capable of detecting a relative positional relationship between the functional unit and the microscope;
  Observation area control means for controlling the observation area changing means in accordance with the positional relationship detected by the relative position detection means.When
With
  The relative position detecting means includes
  Imaging means capable of imaging the functional unit arranged in the observation area;
  A relative position calculating unit that calculates a relative position between the functional unit and the microscope by analyzing an image of the functional unit captured by the imaging unit;
TheHaveThus, since the observation region can be changed according to the positional relationship between the functional part of the treatment instrument and the microscope by the relative position detection means, the treatment instrument can be smoothly introduced into the surgical part or the like of the subject. Can do.
[0016]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
(First embodiment)
1 to 5 relate to the first embodiment of the present invention, FIG. 1 shows the overall configuration of the surgical microscope system of the first embodiment, and FIG. 2 shows the configuration of the main part of FIG. 3 shows the vicinity of the surgical site, FIG. 4 shows an observation visual field corresponding to the state of FIG. 3, and FIG. 5 shows a flowchart of the contents of the operation.
[0017]
As shown in FIG. 1, a surgical microscope system 1 according to a first embodiment of the present invention includes a surgical microscope 2 and a patient 4 under observation by an optical system built in a body 3 of the surgical microscope 2. Navigation device including a forceps 6 as a treatment tool (treatment instrument) for performing a treatment on the surgical part 5 and a digitizer 9 for detecting position information of position markers 7 and 8 provided on the body 3 and the forceps 6, respectively. 10, a magnification setting unit 11 for setting the magnification of the optical system built in the mirror body 3, and a magnification changing control unit 12 for controlling the magnification of the optical system based on information from the navigation device 10. .
[0018]
The surgical microscope 2 has an arm 14 having 6 degrees of freedom attached to a gantry 13 and a mirror body 3 attached to the tip of the arm 14. 12, the magnification control unit 12 is connected to a workstation (abbreviated as WS in the drawing) 16 constituting a navigation device 10 with a foot switch 15 for performing a magnification operation and the like and a digitizer 9. .
[0019]
In addition, the forceps 6 for performing treatment on the surgical section 5 is, for example, in the shape of tweezers in the illustrated example, and a distal end portion is provided with a treatment function portion for performing treatment (medical action) such as excision and hemostasis. An operator grasps the end-side grasping portion and performs treatment such as excision.
[0020]
In addition, a position marker 8 is provided at the rear end of the forceps 6 to detect the position and posture of the forceps 6, more specifically, the position and posture of a treatment function unit (abbreviated as a functional unit) of the forceps 6. It is.
[0021]
The position marker 8 is formed of, for example, a plurality of (magnetic field generating) coils that generate a magnetic field, and the position of each coil is detected by a detection coil in which the magnetic field generated by each coil is built in the digitizer 9, and a plurality of coils are used. Accordingly, it is possible to detect the tip portion provided with the functional portion that is the detection target position that is different from the position where the actual coil is provided by a predetermined distance.
Similarly, the position marker 7 is formed of a plurality of coils. In this case, the detection target position can be set to, for example, the center position of the observation visual field by the optical system of the mirror body 3.
[0022]
Then, the workstation 16 calculates relative position information from the position information of the mirror body 3 detected by the digitizer 9 and the position information of the functional part or the tip part of the forceps 6, and sends it to the magnification control unit 12.
[0023]
As shown in FIG. 2, the mirror body 3 includes, for example, an objective lens 21 having a large aperture that is common to the left and right sides, and is disposed on the left and right optical paths so as to face the objective lens 21, and the magnification is variable (in other words, the observation range). A pair of variable magnification optical systems 22L and 22R that can be enlarged and reduced), a pair of imaging lenses 23L and 23R that perform imaging, and left and right optical images formed by the imaging lenses 23L and 23R. A pair of eyepieces 24L and 24R for magnifying observation are sequentially arranged.
[0024]
A motor 25 is attached to the pair of variable magnification optical systems 22L and 22R via a variable magnification mechanism (not shown), and the magnification of the pair of variable magnification optical systems 22L and 22R can be changed by rotationally driving the motor 25. It is like that. The motor 25 is rotationally driven by a drive signal from a drive unit 26 that constitutes the magnification control unit 12.
[0025]
An encoder 27 is attached to the variable magnification optical systems 22L and 22R via a variable magnification mechanism (not shown), and the magnification at which the variable magnification optical systems 22L and 22R are set is calculated from the output signal of the encoder 27. Can do. The output signal of the encoder 27 constitutes the zoom control unit 12 and is input to a calculation (& control) unit 28 that performs calculation and control. The calculation unit 28 sets the magnification at which the zoom optical systems 22L and 22R are set. calculate.
[0026]
In addition, by performing an instruction operation for setting a predetermined magnification to be set by the magnification setting means 11, the instruction signal is input to the calculation unit 28, and the calculation unit 28 generates a drive signal via the drive unit 26. Then, the motor 25 is rotationally driven to set the variable magnification optical systems 22L and 22R to a predetermined magnification set by the magnification setting means 11.
[0027]
In this case, when the output signal of the encoder 27 is input to the calculation unit 28, the magnification changing optical systems 22L and 22R refer to the actually set magnification, and when the magnification is set to a predetermined magnification, the calculation is performed. The unit 28 stops outputting the drive signal to the drive unit 26. The variable magnification optical systems 22L and 22R are set to a predetermined magnification.
[0028]
Further, an operation signal when a zoom up switch or a zoom down switch of a foot switch (abbreviated as FS in the drawing) 15 is operated is input to the arithmetic unit 28, and the operation unit 28 receives the operation signal via the drive unit 26 corresponding to the operation signal. Thus, by controlling the rotational drive operation of the motor 25 and operating the foot switch 15, the variable magnification optical systems 22L and 22R can be set to a desired magnification.
[0029]
In the present embodiment, further, relative position information of the mirror body 3 and the distal end portion of the forceps 6 as a treatment tool for performing a treatment on the surgical section 5 is input from the workstation 16 to the calculation unit 28. The relative position information is within a preset threshold value (more specifically, a value near the boundary where the distal end portion of the forceps 6 is out of the observation field when the variable magnification optical systems 22L and 22R are set at a high magnification). Monitor for the presence.
[0030]
Then, when the threshold value is exceeded from the state set within the threshold value (that is, when moving from the vicinity of the surgical part 5 to the side beyond the boundary of the observation visual field), the calculation unit 28 is connected via the drive unit 26. The operation of the motor 25 is controlled, and a control operation for setting the magnifications of the variable magnification optical systems 22L and 22R to a predetermined magnification or a minimum magnification state is performed.
Even when the threshold value is exceeded and within the threshold value, the calculation unit 28 controls the operation of the motor 25 via the drive unit 26 to set the magnifications of the variable magnification optical systems 22L and 22R to a high desired magnification. The control operation to be set can also be performed.
[0031]
The operation of the present embodiment having such a configuration will be described below.
Observation is performed when the surgeon moves the arm 14 to perform an operation using the surgical microscope 2 so that the body 3 faces the surgical part 5 and the surgical part 5 is viewed through the eyepieces 24L and 24R. The position is set to a desired position where the treatment can be easily performed (by the forceps 6 or the like), specifically, a position where the surgical site 5 can be observed in a focused state at the center position of the observation field.
[0032]
At this time, in the initial state, the zoom magnifications of the variable magnification optical systems 22L and 22R are set to the minimum magnification, and the output signal of the encoder 27 is output to the calculation unit 28. The digitizer 9 detects the position of the marker 7 attached to the mirror body 3, and the navigation device 10 detects the position of the mirror body 3 with respect to the surgical part 5.
[0033]
Next, the surgeon brings the forceps 6 close to the surgical part 5 in order to proceed with the operation. The digitizer 9 detects the position of the marker 8 attached to the forceps 6, and the navigation device 10 detects the position of the distal end portion (functional portion) of the forceps 6 with respect to the operation portion 5. That is, the navigation device 10 detects the relative position of the tip of the mirror body 3 and the forceps 6.
[0034]
The navigation device 10 transmits the information on the relative position to the calculation unit 28 built in the magnification control unit 12. At this stage, the magnification of the variable magnification optical systems 22L and 22R is the lowest magnification, so that the operator can smoothly guide the forceps 6 to the surgical site 5.
[0035]
Next, since a finer treatment is required as the operation progresses, the surgeon operates a zoom-up switch (not shown) of the foot switch 15 to set the zoom optical systems 22L and 22R to a desired magnification.
[0036]
That is, an operation signal obtained by operating the zoom-up switch of the foot switch 15 is transmitted to the calculation unit 28 of the magnification control unit 12, converted into a drive signal by the calculation unit 28, and output to the drive unit 26.
[0037]
Accordingly, the drive unit 26 drives the motor 25, and the zooming optical systems 22L and 22R are driven in the zoom-up direction via a zooming mechanism (not shown), so that a desired (high magnification) suitable for performing a fine treatment. The magnification can be set. By increasing the magnification, the observation area is reduced more than before the magnification is increased.
The surgeon performs treatment such as peeling of the thin film at the desired magnification. The state at this time is shown in the solid line state of FIG. 3 and FIG.
[0038]
Next, when the surgeon changes the forceps 6 to a bipolar knife (not shown) in order to stop the bleeding part when the surgeon performs a treatment such as peeling at the surgical part 5, the surgeon removes the forceps 6 from the surgical part 5. keep away.
[0039]
Information on the relative position between the body 3 and the distal end portion of the forceps 6 is transmitted from the navigation device 10 to the calculation unit 28, and the calculation unit 28 sets the relative position (relative distance) value to a preset threshold value (more specifically, Is monitoring whether or not the forceps 6 are within the boundary (outside the observation field of view) with the variable magnification optical systems 22L and 22R set at a high magnification. When performing an operation of replacing with another treatment tool, the relative position between the mirror body 3 and the distal end portion of the forceps 6 exceeds a threshold value.
[0040]
As described above, when the relative position between the mirror body 3 and the distal end portion of the forceps 6 exceeds the threshold value, the calculation unit 28 sets the magnifications of the variable magnification optical systems 22L and 22R to the drive unit 26 in a low magnification state. (Hereinafter, this signal is referred to as a zoom-down signal). In other words, as in the case where the surgeon operates the zoom down switch of the foot switch 15, the calculation unit 28 performs a control operation for setting the magnifications of the variable magnification optical systems 22L and 22R to a low magnification state (from the navigation device 10). Automatically based on relative position information.
[0041]
That is, the driving unit 26 drives the motor 25 to drive the zoom optical systems 22L and 22R in the zoom-down direction via a zoom mechanism (not shown). When the magnification detection signal from the encoder 27 reaches the minimum magnification, the calculation unit 28 stops outputting the zoom-down signal, and the drive of the motor 25 is stopped.
[0042]
Accordingly, when the surgeon moves the distal end portion of the forceps 6 away from the operation portion 5, the variable magnification optical systems 22L and 22R are set to the minimum magnification. The state at this time is shown in the broken line state of FIG. 3 and FIG.
The broken line in FIG. 4B schematically shows the range of the desired magnification as a high magnification by the operator in the observation field of the minimum magnification. By changing the magnification, the observation range (observation region) Can be enlarged or reduced.
[0043]
Next, when the surgeon brings a bipolar knife (not shown) close to the surgical section 5, the observation magnification is set to the minimum magnification, and therefore, the surgeon can be brought close smoothly. A marker is also attached to a bipolar knife (not shown), and the navigation apparatus 10 detects the relative position between the mirror 3 and the tip of the bipolar knife.
[0044]
When the relative position (relative distance) between the mirror body 3 and the tip of the bipolar knife is equal to or less than a predetermined threshold, the calculation unit 28 increases the magnification of the variable magnification optical systems 22L and 22R with respect to the drive unit 26. ) Output a zoom-up signal and drive the motor 25 in the zoom-up direction.
[0045]
The calculation unit 28 monitors the magnification information from the encoder 9 and outputs a zoom-up signal until the desired magnification set by the operator before reaching the desired magnification before the distal end of the forceps 6 is removed from the vicinity of the surgical unit 5. When it reaches, the zoom-up signal output is stopped.
[0046]
As a result, the surgeon can smoothly perform hemostasis using a bipolar knife (not shown) at a desired magnification.
[0047]
Further, the surgeon can set a predetermined magnification that is not the minimum magnification by using the magnification setting means 11. The magnification information set by the magnification setting means 11 is transmitted to the calculation unit 28, and the zoom-down operation that is driven when the operator removes the distal end portion of the forceps 6 from the vicinity of the operation portion 5 is stopped at a predetermined magnification. I can do it. A series of this operation flow is shown in FIG.
[0048]
As shown in FIG. 1, when performing an operation using the surgical microscope system 1, the operator sets the magnification in the initial state of the surgical microscope 2 by the magnification setting means 11 in the first step S <b> 1.
[0049]
That is, when a predetermined magnification value to be set is input from a keyboard or the like constituting the magnification setting means 11, the calculation unit 28 controls the rotation of the motor 25 via the drive unit 26, and the zoom optical systems 22L and 22R. Is set to the input predetermined magnification. This operation can be omitted, and when this operation is not performed, the magnification of the surgical microscope 2 in the initial state is set to the minimum magnification.
[0050]
Then, the surgical site 5 is observed in this (lowest or low) magnification state, and the surgeon brings the forceps 6 closer to the surgical site 5 in the observed state. As described above, the forceps 6 can be smoothly guided to the surgical site 5 because it is in a state of low magnification (minimum or).
[0051]
Then, after being guided to the vicinity of the surgical site 5, the operator operates the zoom-up switch of the foot switch 15 as shown in step S2 so that a fine treatment can be easily performed, and the zooming optical systems 22L and 22R are operated. The magnification is set to a desired magnification that is a high magnification.
[0052]
In this case, when an operation of stepping on the zoom-up switch is performed, the operation signal is input to the calculation unit 28. The calculation unit 28 receives the operation signal and rotationally drives the motor 26 via the drive unit 26, thereby changing the magnification optical system. The magnifications of 22L and 22R are set to desired magnifications on the high magnification side.
[0053]
Specifically, the magnification change mechanism is driven by the motor 26 so that the magnification of the magnification change optical systems 22L and 22R is set to the high magnification side until the operation of stepping on the zoom-up switch is stopped. Then, the set desired magnification value when the operation of stepping on the zoom-up switch is stopped is stored in a storage unit (not shown) of the calculation unit 28.
[0054]
As shown in step S <b> 3, the relative position of the tip of the mirror body 3 and the forceps 6 is detected by the navigation device 10, and information on the detected relative position is always input to the calculation unit 28. In the drawing, for simplification, the relative positions of the distal ends of the mirror body 3 and the forceps 6 are abbreviated as the relative positions of the mirror body 3 and the forceps 6.
[0055]
Then, as shown in step S4, the calculation unit 28 sets the relative position value to a preset threshold value (more specifically, in a state where the desired magnification of a high magnification is set, and the forceps 6 is near the boundary of the observation visual field. Value).
[0056]
Then, from the calculation result, as shown in step S5, it is determined whether or not the distal end portion of the forceps 6 is in the observation visual field. If it is determined that it is within the observation field of view, the process returns to step S3. Note that it is also possible to return to S2 instead of step S3 and proceed to step S3 after the foot switch 15 can set a different desired magnification.
This state is a high-magnification state, and a fine treatment can be performed.
[0057]
On the other hand, when the treatment with the forceps 6 is finished and an attempt is made to replace the forceps 6 with another forceps, the forceps 6 is moved in a direction to remove from the observation field. If it is determined that the image is out of the observation field, the process proceeds to step S6.
[0058]
In step S6, the calculation unit 28 determines (by initial setting) whether or not a predetermined magnification is set. If it is determined that the predetermined magnification is set, the calculation unit 28 generates a zoom-down signal, and step S7. As shown in FIG. 4, the magnification of the variable magnification optical systems 22L and 22R is controlled to be set to a predetermined magnification, and the process proceeds to step S9.
[0059]
On the other hand, if it is determined that the predetermined magnification is not set, the calculation unit 28 generates a zoom-down signal and controls to set the magnifications of the variable magnification optical systems 22L and 22R to the minimum magnification as shown in step S8. The process proceeds to step S9.
In the case of step S7 or S8, the low magnification state is set, so that the approach to the surgical section 5 side can be smoothly performed by replacing with another forceps.
[0060]
In step S <b> 9, the navigation device 10 detects the relative position between the mirror body 3 and the distal end portion of the forceps, and outputs it to the calculation unit 28. As shown in step S10, the calculation unit 28 calculates whether the tip of the forceps is within the field of view at the desired magnification based on the output. Based on the calculation result, the calculation unit 28 moves the forceps into the field of view as shown in step S11. Judge whether there is a tip.
[0061]
As a result of the determination, if it is within the field of view, a zoom-up signal is generated as shown in step S12 to control the variable magnification optical systems 22L and 22R to a desired magnification, and then the process returns to step S3. On the other hand, if it is determined that it is not within the field of view, the process returns to step S9, and processing for detecting the relative position between the mirror body 3 and the tip of the forceps is performed.
[0062]
This embodiment which operates in this way has the following effects.
In the present embodiment, the navigation apparatus 10 is used to detect the relative distance between the mirror 3 and the distal end of the treatment instrument, and the observation magnification is automatically controlled according to the state, so a special apparatus is used. It is possible to realize a system that can easily insert and remove the treatment tool near the surgical site without adding and without increasing the size of the mirror body 3.
[0063]
In the above description, the case where an operation is performed using the forceps 6 as a treatment tool or a treatment instrument has been described. However, in addition to the forceps 6, an observation means such as an endoscope or an ultrasonic probe, that is, a treatment tool that performs an observation treatment. It can also be applied to.
Therefore, the predetermined treatment by the treatment tool includes actions such as grasping in addition to treatment such as excision of the subject with the forceps 6 or the like, and observation treatment for optically or acoustically observing.
[0064]
In the above description, means for changing the magnification of the optical system is used as the observation area changing means. However, the observation area (observation area) can be increased by widening the CCD imaging range with a microscope using an imaging means such as a CCD. ) May be changed.
[0065]
In addition, even with a normal microscope, the observation range may be changed by simply moving the housing, or the observation area may be extended by expanding the field stop. .
Even in such a case, as described above, there is an effect that the treatment tool can be easily taken in and out near the surgical site.
[0066]
(Second Embodiment)
Next, a second embodiment of the present invention will be described with reference to FIGS. Only parts different from the first embodiment will be described.
The surgical microscope system 1B according to the present embodiment includes a zoom lens 3 in the surgical microscope 2 shown in FIG. 1 between the variable magnification optical systems 22L and 22R and the imaging lenses 23L and 23R as shown in FIG. The beam splitters 31L and 31R are provided.
[0067]
An imaging device 34 is arranged in the reflection direction of the beam splitter 31R via an adapter 33 with a built-in imaging lens 32, and an optical image equivalent to the optical image formed by the imaging lens 23 is converted into the imaging lens 32. As a result, an image is formed on the image sensor 34.
[0068]
On the image pickup surface of the image pickup element 34, an optical image that almost matches the visual field range when the operator looks into the eyepiece lens 24R is set. That is, the visual field range observed by the surgeon and the imaging range by the imaging device 34 are almost equivalent (or can be replaced).
[0069]
The image sensor 34 is connected to an image analysis unit 35, and an image captured by the image sensor 34 is input. The image analysis unit 35 analyzes the image captured by the image sensor 34. The image analysis means 35 is connected to the calculation unit 28 of the magnification control unit 12.
[0070]
Further, as shown in FIG. 7, the distal end portion (functional portion) of the forceps 36 that performs the treatment is provided with, for example, a unique color of the forceps 36, specifically, a green color marker (green) 37. Other forceps (not shown) are provided with, for example, a blue marker (blue) at the tip so that the tip can be identified by its color. That is, in the present embodiment, the treatment instrument is provided with a color index, and the presence or absence of the treatment instrument and the identification of the treatment instrument are performed using the color index.
[0071]
In the first embodiment, the navigation device 10 detects the relative position between the housing 3 and the distal end of the forceps 6, and the calculation unit 28 refers to the detection output to control the observation magnification of the surgical microscope 2. However, in the present embodiment, an image captured by the image sensor 34 is input to the image analysis unit 35, and the image analysis unit 35 performs image analysis for extracting a color marker, and the image analysis result is used as a calculation unit. The calculation unit 28 is configured to control the observation magnification according to the analysis result.
[0072]
For this reason, in this Embodiment, the navigation apparatus 10 in 1st Embodiment and the position markers 7 and 8 are not provided. Other configurations are the same as those of the first embodiment.
[0073]
Next, the operation of this embodiment will be described.
The operator uses the magnification setting means 11 to set a predetermined magnification for each forceps before the operation. In this case, a predetermined magnification is set corresponding to the color markers (green) and (blue) unique to each forceps.
[0074]
When the surgeon has set the forceps 36 in the vicinity of the surgical section 5, a color marker (green) 37 provided at the tip of the forceps 36 is imaged by the image sensor 34. The video signal captured by the image sensor 34 is transmitted to the image analysis means 35. The image analysis means 35 analyzes the video signal photographed by the image sensor 34 and extracts a color marker (green) 37 from the video signal.
[0075]
The image analysis unit 35 determines whether or not there is a color marker (green) 37 within the imaging range, and transmits the information to the calculation unit 28. When the color marker (green) 37 is within the imaging range, the calculation unit 28 sends a zoom-up signal to the drive unit 26 so as to drive the variable magnification optical systems 22L and 22R to a desired magnification set by the operator with the foot switch 15. Output. This state is shown in FIG.
[0076]
When the color marker (green) 37 is out of the imaging range, a zoom-down signal is output to the drive unit 26 so as to drive the variable magnification optical systems 22L and 22R to the predetermined magnification set by the magnification setting unit 11.
This state is shown in FIG. The broken line in FIG. 8B schematically shows the field of view of the operator's desired magnification within the field of view of the predetermined magnification.
[0077]
When a surgeon approaches a distal end of a different forceps (not shown) close to the surgical section 5, a different color marker (blue) is used for the distal end of the forceps to set a magnification according to the type of forceps. You can
[0078]
In other words, when using a peeling forceps (blue color marker) and a bipolar (green color marker) together, it is possible to use a high-magnification peeling operation and a medium-magnification hemostasis operation when performing zoom-up control after insertion of the forceps. is there.
[0079]
In this case, magnification information (magnification (high magnification) set by the operator with the foot switch 15 using the peeling forceps at the time of the peeling operation) and magnification (medium magnification) set by the surgeon with the foot switch 15 using the bipolar at the time of hemostasis operation ( By storing the magnification information from the encoder 27 in a memory (not shown), it is possible to set the magnification according to the type of forceps set near the surgical site 5.
[0080]
FIG. 9 shows a flowchart of a typical operation example of the present embodiment.
As shown in step S31, the magnification setting means 11 sets a predetermined magnification. In this case, since a color marker is provided at the tip of each forceps, it can be set to a different predetermined magnification for each color marker. This initial setting process can be omitted, and in this case, the predetermined magnification is the lowest magnification.
[0081]
Then, the distal end portion of the forceps to be used first is brought close to the operation portion 5. In that case, when it is inserted within the imaging range of the imaging element 34, the distal end side of the forceps is also imaged. In the observation state, the operator confirms that the distal end side of the forceps is set near the surgical site 5, and when performing a fine treatment, the operator steps on the foot switch 15 to change the magnification to the desired magnification as shown in step S32. The double optical systems 22L and 22R are set.
[0082]
As shown in step S33, the image captured by the image sensor 34 is input to the image analysis unit 35, and the image analysis unit 35 performs image analysis to determine whether there is a color marker in the imaging range (in a state set to a desired magnification). To do.
[0083]
The analysis result is sent to the calculation unit 28, and the calculation unit 28 determines whether there is a color marker in the imaging range as shown in step S34. If it is determined that there is a color marker within the imaging range, the calculation unit 28 uses the information on the desired magnification that has been set for each color marker detected as shown in step S35 (inside the calculation unit 28 or the like). And return to step S33.
[0084]
On the other hand, when it is determined that there is no color marker in the imaging range, the calculation unit 28 determines whether or not a predetermined magnification has been set in the initial setting, as shown in step S36. If the predetermined magnification is not set, the calculation unit 28 generates a zoom-down signal and sets the variable magnification optical systems 22L and 22R to the minimum magnification as shown in step S37.
[0085]
On the other hand, if the predetermined magnification is set, the process further proceeds to step S38, and the calculation unit 28 determines the color of the color marker. Then, the variable magnification optical systems 22L and 22R are set to a predetermined magnification set in the initial setting corresponding to the determined color.
[0086]
Specifically, when the color marker color is green, the calculation unit 28 generates a zoom-down signal and, as shown in step S39, the predetermined magnification set by the green forceps (this is the predetermined magnification (green)). And a variable magnification optical system 22L, 22R are set in step S41.
[0087]
If the color marker color is blue, the calculation unit 28 generates a zoom-down signal and, as shown in step S40, a predetermined magnification set by the blue forceps (this is abbreviated as a predetermined magnification (blue)). The variable magnification optical systems 22L and 22R are set in step S41, and the process proceeds to step S41.
In this state, the visual field range is wide, and when another treatment is performed, the forceps is replaced with a forceps suitable for the treatment.
[0088]
Even in this state, as shown in step S41, the image analysis means 35 performs image analysis to determine whether or not there is a color marker within the field of view of the desired magnification. Then, the analysis result is sent to the calculation unit 28, and the calculation unit 28 determines whether or not there is a color marker within the range as shown in step S42.
[0089]
If it is determined that there is no color marker within the range, the process returns to step S41. On the other hand, if it is determined that there is a color marker within the range, the process proceeds to step S43, where the calculation unit 28 reads out information on the desired magnification corresponding to the color marker detected from the memory, and the magnification optical system is set to that magnification. Set. Thereafter, the process returns to step S33.
[0090]
The present embodiment has the following effects.
In the present embodiment, since the color marker provided on the forceps is used as the relative position detection means, the position marker that is bulky on the forceps is not added (that is, the operability is better) and the first embodiment. A system having the same effect can be realized, and forceps operation is not hindered. Moreover, since the set magnification (both desired magnification and predetermined magnification) can be controlled depending on the type of forceps, an optimum magnification can be set according to the forceps used.
[0091]
Further, as a modification of the present embodiment, a priority order of a predetermined magnification may be set according to each color marker. For example, a bipolar (not shown) that performs hemostasis is given high priority, and a suction tube (not shown) that sucks the surgical site is given low priority.
[0092]
When the surgeon uses a suction tube and a bipolar together at a desired magnification, the observation field of view is as shown in FIG. In this state, if the bipolar tube is pulled out (drawn) from the surgical site (observation field of view) to change the bipolar to another forceps while leaving the suction tube in the surgical site, the bipolar priority is set high. The variable magnification optical systems 22l and 22R are driven and set to the set predetermined magnification. This state is shown in FIG.
In this state, when the hemostasis is urgently needed, the bipolar can be immediately inserted to set the drive to a desired magnification.
[0093]
When a suction tube with a lower priority is pulled out from the surgical site (desired magnification range) while the bipolar is pulled out, the variable power optical systems 22L and 22R are driven and set to a predetermined magnification set for the suction tube. In this case, since no surgical tool is inserted in the surgical site, the surgical tool can be quickly introduced by providing a wider field of view. This state is shown in FIG. A series of this flow is shown in FIG.
[0094]
As shown in step S51 of FIG. 11, the magnification setting means 12 sets a predetermined magnification for each forceps. In this case, the marker color is different for each type of forceps, and priority is set for each forceps. For example, a high priority is set for bipolar and a low priority is set for suction tube.
[0095]
In the next step S52, the variable magnification optical systems 22L and 22R are set to a desired magnification by the foot switch 15. Further, as shown in step S53, the image analysis unit 35 performs image analysis to determine whether there is a color marker within the imaging range of the imaging device.
The analysis result is sent to the calculation unit 28, and the calculation unit 28 determines whether or not there is a high priority color marker within the range, as shown in step S54.
[0096]
If it is determined that there is a high priority color marker in the range, the process returns to step S53. On the other hand, if it is determined that there is no high priority color marker in the range, the process proceeds to step S55, and the calculation unit 28 determines whether or not there is a lower priority color marker.
[0097]
If it is determined that there is a low priority color marker, the variable magnification optical systems 22L and 22R are set to a predetermined magnification (high priority) as shown in step S56, and the process proceeds to step S58. On the other hand, if it is determined that there is no low priority color marker, the variable magnification optical systems 22L and 22R are set to a predetermined magnification (low priority) as shown in step S57, and the process proceeds to step S58.
[0098]
In step S58, the image analysis means 35 performs image analysis to determine whether or not there is a color marker within the visual field range of the desired magnification. The analysis result is sent to the calculation unit 28, and the calculation unit 28 determines whether or not there is a high priority color marker within the range, as shown in step S59.
[0099]
If it is determined that there is a high priority color marker, the variable magnification optical systems 22L and 22R are set to move to the desired magnification (high priority) as shown in step S60, and the process returns to step S53. On the other hand, if it is determined that there is no high priority color marker, it is determined whether or not there is a lower priority color marker as shown in step S61.
[0100]
If it is determined that there is no low priority color marker, the process returns to step S58. Conversely, if it is determined that there is a low priority color marker, the desired magnification (low priority) is set as shown in step S62. After moving the variable magnification optical systems 22L and 22R to (degree), the process returns to step S58.
[0101]
According to this modification, it is possible to realize a system that has the same effects as those of the first embodiment in consideration of the priority and that has better operability.
As described in the first embodiment, the present invention can also be applied to a treatment instrument other than the forceps 36 or a treatment instrument such as an endoscope for observation.
[0102]
(Third embodiment)
Next, a third embodiment of the present invention will be described with reference to FIGS. FIG. 12 shows a main part of a surgical microscope system 1C according to the third embodiment of the present invention. In this surgical microscope system 1C, an infrared sensor 43 including an infrared emitter 41 and an infrared receiver 42 is attached to the lower surface of the body 3 of the surgical microscope 2 of the first embodiment. 42 detection signals are input to the analysis unit 44.
[0103]
Further, as shown in FIG. 13, a reflection marker 46 that reflects infrared rays is attached to, for example, the rear end of the forceps 45 used for performing the treatment. Therefore, the infrared light receiver 42 receives the infrared light reflected by the reflection marker 46 of the forceps 45, and the analysis unit 44 to which the detection signal is input analyzes from the detection signal, and the distal end portion of the mirror body 3 and the forceps 45. The relative position is detected.
[0104]
Information on the relative position is transmitted to the calculation unit 28. The calculation unit 28 controls the variable magnification optical systems 22L and 22R based on information from the analysis unit 44. Other configurations are the same as those of the first embodiment.
[0105]
Next, the operation of this embodiment will be described.
When the operator inserts the forceps 45 into the surgical site, the infrared light emitted from the infrared light emitter 41 is reflected by the reflection marker 46 provided on the forceps 45 and enters the infrared light receiver 42. The signal of the reflection marker 46 incident on the infrared light receiver 42 is transmitted to the analysis unit 44, and the relative position between the mirror 3 and the distal end portion of the forceps 32 is detected.
[0106]
The analysis unit 44 transmits the relative position information to the calculation unit 28. When the operator removes the distal end portion of the forceps 45 from the surgical site, the infrared light receiver 42 does not receive the reflection signal of the reflection marker 46, so that the relative position information becomes indefinite.
[0107]
This information is also transmitted to the calculation unit 28. When the relative position between the body 3 and the distal end portion of the forceps 45 is detected, the calculation unit 28 sets the variable magnification optical systems 22L and 22R to a desired magnification set by the operator with the foot switch 15, and the relative position is indefinite. In this case, control is performed so that the variable magnification optical systems 22L and 22R are set to the minimum magnification or the predetermined magnification set by the magnification setting means 11.
[0108]
The present embodiment has the following effects.
In this embodiment, since an infrared sensor is used as the relative position detecting means, a system having the same effect as that of the first embodiment can be realized at a very low cost.
[0109]
In addition, it can also comprise using an ultrasonic sensor instead of using an infrared sensor. Further, not only the position of the distal end portion of the forceps 45 but also other predetermined positions may be detected. The same applies to the mirror side.
In addition, embodiments that partially combine the above-described embodiments and the like also belong to the present invention.
[0110]
[Appendix]
1. The microscope system according to claim 1, wherein the functional unit has a color index.
[0111]
2. The relative position detection means is an imaging means capable of imaging the functional unit arranged in the observation area;
The microscope system according to appendix 1, further comprising color analysis means capable of identifying a color of the color index by analyzing an image of the color index of the functional unit captured by the imaging means.
[0112]
3. The microscope system according to claim 1, wherein the observation region changing unit is a variable magnification optical system.
[0113]
4). A microscope capable of observing the subject;
An observation area changing means capable of reducing and enlarging the observation area of the microscope;
A medical instrument having a functional unit capable of performing a predetermined treatment in the observation region of the microscope;
Relative position detection means capable of detecting a relative positional relationship between the microscope and a predetermined position of the functional unit,
An observation area control means for controlling the observation area changing means in accordance with the positional relationship detected by the relative position detection means;
A microscope system comprising:
[0114]
5). An observation optical system that performs magnified observation of the surgical site;
A variable magnification optical system that changes the observation magnification of the observation optical system,
A surgical instrument for performing surgical procedures, etc.
Position detecting means for detecting a relative position of the surgical instrument with the observation optical system;
A surgical microscope comprising: a control unit that performs drive control of the zoom optical system according to a detection result of the position detection unit.
[0115]
6). In Appendix 5,
The surgical microscope according to claim 1, wherein the position detecting means is a navigation device that detects positions of an observation optical system and a surgical instrument in a predetermined coordinate space.
7. In Appendix 5,
The position detection means includes a marker provided on a surgical instrument,
Imaging means for imaging the marker provided in the middle of the observation optical system;
A surgical microscope comprising image analysis means for detecting a relative position between the surgical instrument and an observation optical system from an image taken by the imaging means.
[0116]
8). In Appendix 5,
The position detection means includes sensor output means provided in either the observation optical system or a surgical instrument,
Sensor receiving means provided in either the observation optical system or the surgical instrument;
A surgical microscope comprising: a calculation means for calculating a relative position between the observation optical system and a surgical instrument from a detection state of the sensor receiving means.
9. In Appendix 8,
The surgical microscope characterized in that the sensor output means and the sensor receiving means are ultrasonic sensors or infrared sensors.
[0117]
10. In Appendix 5,
When the surgical instrument is in the observation field of view of the observation optical system, the control unit sets the variable magnification optical system to the first magnification set by the operator, and the surgical tool is out of the field of view of the observation optical system. A surgical microscope characterized in that if it is, a minimum magnification or a preset second magnification (lower than the first predetermined magnification) is set.
11. In Appendix 10,
The control unit includes a magnification determination unit that performs drive control from the lowest magnification to the second magnification when the first magnification of the variable magnification optical system is higher than a predetermined threshold value. Surgical microscope characterized by.
[0118]
12 In Appendix 10,
The position detection means includes identification means for identifying each of a plurality of surgical tools inserted into the surgical site, and at least the first detection unit according to the identification result of the identification means and the position detection result of the position detection means. A surgical microscope, comprising: a magnification setting means for setting any one of the magnification and the second magnification.
[0119]
【The invention's effect】
According to the present invention, since the observation area of the microscope is controlled in accordance with the insertion / extraction of a treatment instrument such as forceps from the surgical site, the insertion of the treatment instrument into the surgical site is particularly facilitated, such as surgery. Contributes to improved efficiency. Further, it has a very high effect that the structure is simple, small and inexpensive.
[Brief description of the drawings]
FIG. 1 is an overall configuration diagram of a surgical microscope system according to a first embodiment of the present invention.
FIG. 2 is a block diagram showing a configuration of a main part of FIG.
FIG. 3 is a view showing the vicinity of an operation site.
4 is a diagram showing an observation visual field corresponding to the state of FIG. 3;
FIG. 5 is a flowchart showing the contents of an operation.
FIG. 6 is a block diagram showing a configuration of a main part of a surgical microscope system according to a second embodiment of the present invention.
FIG. 7 is a diagram showing a forceps provided with color markers.
FIG. 8 is a diagram showing an observation visual field.
FIG. 9 is a flowchart showing the contents of a typical operation.
FIG. 10 is a diagram showing an example of an observation visual field in a modified example.
FIG. 11 is a flowchart showing the contents of a typical operation in a modified example.
FIG. 12 is a block diagram showing a configuration of a main part of a surgical microscope system according to a third embodiment of the present invention.
FIG. 13 shows a forceps provided with a reflective marker.
[Explanation of symbols]
1. Surgery microscope system
2. Surgery microscope
3 ... Mirror body
5 ... Surgery
6 ... Forceps
7, 8 ... Position marker
9 ... Digitizer
10. Navigation device
11: Magnification setting means
12 ... Scaling control unit
15 ... Foot switch
16 ... Workstation
21 ... Objective lens
22L, 22R ... Variable magnification optical system
23L, 23R ... Imaging lens
24L, 24R ... Eyepiece
25 ... Motor
26 ... Drive unit
27 ... Encoder
28 ... Calculation unit

Claims (4)

A microscope capable of observing the subject;
An observation area changing means capable of reducing and enlarging the observation area of the microscope;
A treatment instrument having a functional unit capable of performing a predetermined treatment in the observation region of the microscope;
A relative position detecting means capable of detecting a relative positional relationship between the functional unit and the microscope;
An observation area control means for controlling the observation area changing means in accordance with the positional relationship detected by the relative position detection means ;
With
The relative position detecting means includes
Imaging means capable of imaging the functional unit arranged in the observation area;
A relative position calculating unit that calculates a relative position between the functional unit and the microscope by analyzing an image of the functional unit captured by the imaging unit;
Microscope system characterized by having a.   The microscope system according to claim 1, wherein the observation region control unit changes the observation region to a predetermined size in order to control the observation region change unit and observe the functional unit. The function part provided in the treatment instrument is provided with an index that can be imaged by the imaging means.
The microscope system according to claim 1 or 2, wherein The indicator has a unique identification color for each treatment instrument,
The observation area control means sets an observation magnification according to a magnification set in advance for each recognized identification.
The microscope system according to claim 3.

Images