JPH06196A - Microscope for operation - Google Patents

Abstract

PURPOSE:To constitute the microscope in such a manner that the microscope is brought to a position not hindering an observer cooperatively with the movement of an endoscope to its use position in the case of combination use of the microscope and the endoscope. CONSTITUTION:This microscope has a means 11 for cooperatively bringing the other to the position not hindering the observer when either one of the microscope (first observation optical system) 5 and the endoscope (second observation optical system) 9 is brought to the use position, a means for detecting which of the observation optical systems exists in the use position and selecting means 23, 24 which act to introduce illuminating light to the observation optical system existing in the use position from a common light source device 27 by the output from this detecting means.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical microscope for performing a combination of magnifying observation of a surgical site with a microscope and observation of a blind spot with an endoscope.

[0002]

2. Description of the Related Art In recent years, microsurgery has been frequently performed with the development of surgical techniques and surgical tools. In the microsurgery, a surgical microscope is used to magnify and observe the surgical site. By the way, in neurosurgery and otolaryngology, the operation site is often deep inside the body cavity, and there are so-called blind spots that are difficult to observe even when the observation direction of the microscope is changed. Had used mirrors and endoscopes.

When a mirror is used, an observer (operator) holds the mirror with one hand and inserts the mirror into a body cavity to observe a blind spot, or performs microscopic observation through the mirror. When an endoscope is used, it has been devised to attach the endoscope to a surgical microscope in order to save the labor of holding the endoscope by hand.

For example, FIG. 12 shows an example in which an endoscope (c) is attached to a mirror body (a) of a surgical microscope via an adapter (b). In this case, by observing the microscope or the endoscope, the observer somewhat eased the switching between the enlarged observation of the surgical site and the observation of the blind spot, but again because the illumination light is supplied. A light source device for recording and a recording device for educational purposes and conference presentations, etc. are provided in both devices, and the observer is forced to operate in a limited environment to occupy the work space, and work efficiency is still preferable. It wasn't something.

[0005]

As described above, when a mirror is used for microscopic observation of a blind spot, the mirror requires a certain area. Therefore, when the aperture is very small, it is difficult to insert it. It takes a lot of work, and even if you can insert it,
Blood may adhere to the mirror surface, making observation difficult. Furthermore, when performing microscope observation through a mirror, the observer must adjust the position of the microscope and the mirror at the same time as the position of the surgical site in order to search for a desired place, which is very time-consuming. Work efficiency is significantly reduced.

When an endoscope, particularly a flexible endoscope, is used, the observer holds the eyepiece with one hand and holds the tip with the other hand, so that both hands are blocked, so It becomes impossible to perform work such as removing surrounding tissue in order to reach the target observation object with the mirror tip. In addition, in order to free both hands of the observer, for example, when a special arm is attached to the operating table and the endoscope is grasped, the microscope body of the surgical microscope is used to switch from the microscope observation to the endoscope observation. After moving the arm supporting the endoscope to a position where it does not interfere with the observation of the endoscope, the arm holding the endoscope must be brought to the observer's wrist.

Since the microscope for the assistant and the recording device are attached to the microscope, it is necessary to be very careful when moving the device on the operating part, and the arm of the operating microscope is moved. In order to do so, it is necessary to move the surgical equipment around the operating table, which is very time-consuming, and the operation time becomes long especially when the microscope observation and the endoscope observation are frequently switched. Therefore, the fatigue of the observer increases and the burden on the patient also increases.

Further, it goes without saying that the arms for supporting the microscope and the endoscope are separately configured, which is expensive, and further, since there are various surgical instruments around the operating table, the periphery of the operating table. Becomes more complicated and work efficiency is reduced.

Further, in the structure in which the endoscope is attached to the microscope body of the microscope through the adapter as in the above-mentioned conventional example, some of the above problems can be solved, but the endoscope is close to the body. Therefore, it may interfere with the surgery under the microscope, and the attachment of the assistant's microscope and imaging device to the mirror body may be restricted, which may interfere with the care of the assistant.
There is a problem that the original function and performance of the surgical microscope cannot be fully exhibited.

Further, when the endoscope is inserted into the surgical site, the observer alternately looks at the surgical site with the naked eye and looks through the eyepiece of the endoscope. Is fixed by the above-mentioned endoscope attachment adapter, so there is no choice but to look alternately by moving the head to the eyepiece portion,
At this time, if there is a mirror near the endoscope, the observer's head may hit the mirror, or the microscope may interfere with the naked eye, so it is not possible to insert the endoscope into the surgical site. It becomes very difficult to do.

Further, as described above, a light source device for supplying illumination light to the surgical microscope and the endoscope or a light guide or a video photographing device for guiding the illumination light from the light source device to the surgical microscope or endoscope. Since the recording devices and the cables connecting them are respectively provided, the operating room becomes more complicated, the working space is reduced, and the working efficiency is significantly reduced.

The present invention provides a surgical microscope which is brought to a position where the microscope does not interfere with the observer in conjunction with the movement of the endoscope to the use position, and further, the working space of the operating room. It is intended to ensure that the endoscope can be used without lowering work efficiency.

[0013]

A surgical microscope according to the present invention observes a surgical site through a first observation optical system for observing the surgical site and an objective lens different from the first observation optical system. The second observation optical system is characterized in that the observer is provided with means for moving the finder of one observation optical system to the rear of the other observation optical system.

Further, there is provided a detection means for detecting the position moved by the movement means or which observation optical system the observer has brought into use, and both observation optical systems are based on the detection information. It is provided with means for selecting a lighting device and a photographing device to be shared by the two.

[0015]

Since the present invention has the above-mentioned configuration, the finder portion of the other observation optical system is brought in conjunction with the movement of the finder of the one observation optical system in a position not disturbing the observer. Further, it has a detection means for detecting the position moved by the moving means or which of the two observation optical systems has been brought to the use position by the observer, and based on the output from the detection means A work space is secured and work efficiency is improved by providing a selecting means for selecting to connect the illumination device or the photographing device commonly used for the observation optical system to the observation optical system brought to the use position. It is a thing.

[0016]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment according to the present invention will be described with reference to FIGS. 1 and 2 are configuration diagrams when a rigid endoscope is attached to the body of a surgical microscope. FIG. 1 shows the usage state of the microscope, and FIG. 2 shows the usage state of the rigid endoscope. FIG. 3 is a view showing a mounting state of the microswitch, FIG. 4 is a block diagram of the light source device and the recording device, and FIG. 5 is a configuration diagram of the light source device.

Reference numeral 1 is a microscope body, 2 is a lens barrel having an interpupillary adjustment mechanism attached to the exit side of the mirror body, and 3 is an eyepiece, which is a pair of lens barrels for enabling stereoscopic viewing. It is attached to 2. Reference numeral 4 denotes an objective lens attached so as to face the entrance side of the mirror body 1, that is, the surgical site, and a microscope (first observation optical system) 5 is provided by the mirror body 1, the lens barrel 2, the eyepiece 3 and the objective lens 4. It is configured.

Reference numeral 6 denotes an arm tip portion of the surgical microscope, which is supported by a mount portion (not shown) so as to be movable three-dimensionally. Reference numeral 7 denotes a depression / elevation operation arm mounted between the arm tip 6 and the mirror body 1. The microscope (first observation optical system) 5 is orthogonal to the axis O ₁ and the axis O _1. It is held so as to be rotatable about an axis O ₂ perpendicular to the plane of the drawing. Reference numeral 8 denotes a depression / elevation operation handle attached to the first observation optical system 5, and the depression / elevation operation arm 7 can be rotated by operating the handle 8.

Reference numeral 9 denotes a rigid endoscope (second observation optical system) having an eyepiece lens 10, which is rotatable about an observation optical axis O ₃ of the microscope 5 via an endoscope attachment adapter 11. Is attached to the microscope 5. The rigid endoscope 9 has a built-in illumination optical system so that the illumination light transmitted from the light source device 27 (FIG. 5) described later via the light guide 12 can be guided to the surgical site P. A television camera that records an observation image through a beam splitter (not shown)
13 is installed. On the other hand, the mirror body 1 also has a built-in illumination optical system (not shown) so that the illumination light transmitted from the light source device 27 via the light guide 14 can be guided to the surgical site P. Furthermore, a television camera that records an observation image on the mirror body 1 via a beam splitter (not shown)
15 is installed.

FIG. 3 shows a microscope 5 and an endoscope mounting adapter 11
3 shows the details of the mounting part (partially sectional view). In the figure, 16 is a mounting portion of an endoscope mounting adapter 11 which is integrally mounted on the microscope body 1 of the microscope 5, 16a is an outer peripheral groove provided in the mounting portion 16, and 17 is a peripheral groove 16a of the mounting portion 16. The rotating part of the endoscope mounting adapter 11 which is movably mounted, 18 is a protrusion formed on the rotating part 17, 19 is a microswitch fixed to the mounting part 16, and the rotating part 17 is the microscope body of the microscope 5. The protrusion 18 is arranged so as to come into contact with and actuate the microswitch 19 when rotated about the observation optical axis O ₃ of 180 from the position shown in the figure.

The structure of the light source device 27 will be described with reference to FIGS. The micro switch 19 is a selector control circuit 28
The selector control circuit 28 is connected to the mirror drive control circuit.
29, and the output end of the mirror drive control circuit 29 is connected to the mirror drive solenoid 23. On the other hand, the selector control circuit 28 is connected to the selector 30, and based on the outputs from the selector 30 and the selector control circuit 28, the television camera 15,
One of the movie signals A and B from 13 is selected and the video signal C is sent to the video deck 32 and the monitor 33 via the amplifier circuit 31.
Is configured to output.

Since the first embodiment is configured as described above, when magnifying and observing a surgical site with a microscope, the observer holds the handle 8 and holds the three-dimensional arm (not shown) and the elevation / depression operation arm 7. By operating, the depression angle of the body 1 is set to 3
It is changed dimensionally and the observation optical axis O ₃ is aligned with the surgical site P.
At this time, the rigid endoscope 9 is positioned on the rear side of the microscope 5 with respect to the observer so that the rotating portion 17 of the endoscope mounting adapter 11 is positioned.
Rotate.

In this case, since the micro switch 19 is separated from the projection 18 and is in the OFF state as shown in FIG. 3, there is no output from the selector control circuit 28, and as shown in FIG. The movable mirror 24 provided at is located at the position shown by the solid line, and the selector 30 selects the television camera 15 for recording a microscope observation image. The light emitted from the light source 22 is guided to the mirror body 1 via the light guide 14 and illuminates the surgical site P via the illumination optical system of the microscope 5. The reflected light from the operation part P is guided to the mirror body 1, travels through a pair of observation optical paths not shown, is split by a half prism not shown provided in the body 1, and the transmitted light further passes through the pair of observation optical paths. Then, the light enters the lens barrel 2, and a pair of eyepieces 3 stereoscopically observe a microscope image of the surgical site P by an observer or the like.

On the other hand, the reflected light reflected by the half prism advances to the television camera 15 through the light guide,
The video signal A converted into the video signal A is amplified by the amplifier circuit 31 in the selector 30 into the video signal C of two systems, recorded by the video deck 32, and simultaneously projected by the monitor 33. To be done. In addition, in FIG. 5, 26 is an optical axis of illumination light.

Next, when the observer observes and treats a so-called blind spot portion such as a pore that becomes a blind spot under the microscope observation in the operation portion P, the endoscope mounting adapter rotating portion shown in FIG. 3 is used. The 17 is rotated by 180 ° around the observation optical axis O ₃ of the microscope 5, and the rigid endoscope 9 is moved to the front side of the microscope 5 with respect to the observer. At this time, the observer operates the three-dimensional arm (not shown) and the elevation / depression operation arm 7 with the handle 8 to change the depression / elevation angle of the mirror body 3 in a three-dimensional manner, as in the case of the microscope observation, and the rigid endoscope The observation optical axis (not shown) of the mirror 9 is aligned with the blind spot of the surgical site P.

As described above, the rotating part for the endoscope mounting adapter
17 rotates 180 degrees around the mounting part 16,
The protrusion 18 provided on the 17 contacts the micro switch 19, and the micro switch 19 is turned on. When the micro switch 19 is turned on, the selector control circuit 28 outputs an operation signal to the mirror drive control circuit 29, and the mirror drive control circuit 29 sends a drive signal to the mirror drive solenoid 23 attached to the light source device 27. Output.

The mirror driving solenoid 23 rotates the movable mirror 24 around the rotation axis O ₄ based on the driving signal, and
Bring it to the position indicated by the broken line in. Further, in this state, the selector control circuit 28 shown in FIG. 4 outputs an operation signal to the selector 30, and based on this operation signal, the selector 30 selects the television camera 13 for recording the rigid endoscope observation image. The light emitted from the light source 22 is reflected by the movable mirror 24,
Further, the light is reflected by the fixed mirror 25, guided to the rigid endoscope 9 via the light guide 12, and illuminates the blind spot portion of the surgical site P via the illumination optical system of the rigid endoscope 9.

The reflected light from the surgical site P travels along the observation light path in the rigid endoscope 9, is split by a half prism (not shown) provided in the rigid endoscope 9, and the transmitted light further travels in the observation light path. Then, the eyepiece 10 allows an observer or the like to observe an observation image of a blind spot portion of the surgical site P. Further, the reflected light reflected by the half prism advances to the television camera 13 and is converted into a video signal B, and the video signal B which is a rigid endoscope observation image is selected in the selector 30 and further amplified.
A video signal C of two systems is amplified by 31 and recorded by the video deck 32, and at the same time displayed on the monitor 33.

Next, a second embodiment of the present invention will be described with reference to FIGS. The same members or parts as those in the first embodiment described above are designated by the same reference numerals, and the description thereof will be omitted. Reference numeral 40 denotes a support arm, which is attached to the arm tip portion 6 of the three-dimensional arm of the surgical microscope. Reference numeral 41 denotes an endoscope, which has an eyepiece lens 42 and has an illumination optical system including a light guide and an observation optical system including an image guide.

Reference numeral 43 is a gripping arm attached to one end of the support arm 40, and the eyepoint of the microscope 5 and the eyepoint of the endoscope 41 are arranged at positions symmetrical with respect to the central axis O ₅ of the support arm 40. So that both are retained and the central axis O ₅
It is a gripping arm that holds it rotatably around.

FIG. 7 shows details of the mounting portions of the support arm 40 and the gripping arm 43. Reference numeral 44 denotes a light guide, and one end of the light guide 44 is fixed to the tip of the support arm 40, and the other end is attached to a light source device (not shown). A cable 45 has one end fixed to the tip of the support arm 40 and the other end connected to a recording device (not shown) for transmitting a video signal. Reference numeral 46 is a cable, one end of which is connected to the television camera 15 which records an image observed by a microscope, and the other end of which is attached to the pointing arm 40. Reference numeral 47 is a connection terminal provided at the fixed end of the support arm 40, and reference numeral 48 is a rotating member that is integrally attached so as to rotate as the gripping arm 43 rotates.

Reference numeral 49 denotes an endoscope tip holding tool for fixing the tip portion of the endoscope 41, 50 denotes an endoscope tip holding arm, which is mounted between the gripping arm 43 and the endoscope tip holding tool 49. The endoscope tip holder 49 is installed and held at a three-dimensional free position.

Reference numeral 51 denotes a cable attached to the endoscope 41, which is connected to the television camera 13 for recording an observation image of the endoscope 41 and fixed to a rotating member 47 provided in the support arm 40. And serve to transmit the video signal.

A light guide attached to the endoscope 41
The other end of 12 is connected to one end of a light guide 44 so as to transmit the illumination light emitted from the light source of the light source device. Further, when the rotating member 48 further rotates around the rotation axis O ₅ and rotates by 180 ° from the position shown in the figure, the other end of the light guide 12 attached to the endoscope 41 also has the other end.
The illumination light emitted from the light source in the light source device is transmitted by connecting to one end of 44.

A cable 46 attached to the TV camera 15 attached to the mirror body 1 is connected to the rotary member 48, and a connection terminal 47 is provided at one end of the cable 45 and the cable 45 for transmitting a video signal. When the rotary member 48 reaches a position rotated by 180 ° from the position shown in the figure around the rotation axis O ₅ , the position is fixed at a position electrically connected via the and 52. TV camera mounted on mirror 41
The cable 51 attached to the cable 13 is electrically connected to the cable 45 via the connection terminals 53 and 47 provided at one ends of the both in order to transmit the video signal.

FIG. 8 shows a detailed structure of the endoscope tip holder 49. A holding frame 54 holds the housing 55 rotatably around the optical axis center axis O ₆ of the endoscope 41, and is attached to the endoscope tip holding arm 50. Reference numeral 56 denotes a guide member provided in the housing 55, which is configured to slide in the housing 55 in a direction perpendicular to the central axis O _{6 of the} endoscope 41 by the reaction force of the elastic member 57. It has a hole 59 through which the tip of the endoscope 41 passes.

Further, reference numeral 58 is a switch portion provided on the guide member 56, which is for performing the above-mentioned sliding movement. Reference numeral 60 denotes a hole provided in the housing 55, which is set so as to match the position of the hole 59 when the guide member 56 slides as described above.

FIG. 9 shows a detailed structure of the endoscope tip holding arm 50. 61 is a mounting arm.
One end of 61 is attached to the gripping arm 43, and the other end has a housing 63 forming a ball joint 62. Reference numeral 64 is a tip arm having one end attached to the endoscope tip holder 49 and the other end having a ball 65 forming a ball joint 62. Reference numeral 66 is a holder attached to the housing 63 so as to hold the ball 65 in the housing 63 so as not to move freely and to slide in the housing 63 with respect to some external force.

When magnifying the surgical site with a microscope,
As shown in FIGS. 6 and 7, the surgical microscope includes a light guide 44 connected to a light source device (not shown), and a light guide fixed to the rotating member 48 and the other end attached to the mirror body 1.
14 and 14 are in an optically connected state, and further, the mirror body 1
The connection terminal 52 of the cable 46 connected to the TV camera 15 attached to the computer and the connection terminal 47 of the cable 45 connected to the recording device (not shown) are connected.

The light emitted from the light source in the light source device (not shown) is guided to the tip of the support arm 40 via the light guide 44, and further to the mirror body 1 via the light guide 14.
The surgical site P is illuminated via the illumination optical system of the microscope. Similar to the first embodiment, the light flux of the surgical site P is guided to the mirror body 1 and the observer or the like stereoscopically observes the microscopic image of the surgical site P, and at the same time, it advances to the television camera 15 and the video signal A. Is converted to. A video signal A, which is an image observed by a microscope, is guided to a recording device (not shown) through a cable 46 and a cable 45, amplified by an amplifier circuit (not shown), and then recorded by a video deck (not shown). It is projected.

Next, when the observer observes and treats a blind spot in the surgical site P under a microscope, the grasping arm 43 is rotated 180 ° around the central axis O ₅ of the support arm 40. The endoscope 41 is arranged on the observer side (not shown). At this time, the eye point of the endoscope 41 is at the same position as the eye point of the microscope 5 before the rotation. The observer moves the distal end arm 64 of the endoscope distal end holding arm 50 three-dimensionally around the ball joint 62 to place and hold the endoscope distal end holder 49 near the surgical site P, and further Endoscope tip holder 49
By pushing the switch portion 58 of the guide portion 56, the guide portion 56 slides in the housing 55, and the hole portion 59 of the guide member 56.
And the hole 60 of the housing 55 are aligned with each other, and the distal end of the endoscope 41 is movable in the observation optical axis direction.

In this way, the distal end of the endoscope is aligned with the blind spot of the surgical site P and the switch 58 is opened, so that the guide member 56 is restored by the elastic force of the elastic member 57 to the housing 55 again.
The inside of the endoscope 41 is slid and moved to the state shown in FIG. In addition, the housing 55 is
It is rotated about the central axis O ₆ of 41, and the distal end portion of the endoscope is bent by a known bending operation means as shown by the broken line in FIG. 8 to change its observation direction. The observer adjusts the position, angle, etc. of the distal end portion of the endoscope 41 to the blind spot portion of the surgical site P by the series of operations described above.

By the rotation of the gripping arm 43, the tip of the light guide 44 and the tip of the light guide 12 connected to the endoscope 41 are optically connected. In addition, the endoscope 41
The connection terminal 53 of the cable 51 connected to the TV camera 13 attached to the cable and the connection terminal 51 of the cable 45 are connected.

Then, the light emitted from the light source in the light source device (not shown) is guided to the tip of the support arm 40 via the light guide 44, and further to the endoscope 41 via the light guide 12 for endoscope. The blind spot of the surgical site P is illuminated via the illumination optical system in the mirror 41. The light flux of the surgical site P travels through the observation optical system in the endoscope 41 and is split by a half prism (not shown) provided in the endoscope 41, and the transmitted light further travels in the observation optical path by the eyepiece lens 42. An observer or the like observes an observation image of the blind spot portion of the surgical site P.

The reflected light travels to the television camera 13 and is converted into a video signal B. A video signal B, which is an endoscopic observation image, is guided to a recording device (not shown) via a cable 51 and a cable 45, amplified by an amplifier circuit (not shown), and then recorded by a video deck (not shown). Is projected by.

Next, a third embodiment of the present invention will be described with reference to FIGS.
It will be described based on 1. Also in this case, the same reference numerals are used for the same members or parts as those in the first and second embodiments, and the description thereof will be omitted. The microscope body 1 of the microscope 5 of this embodiment has a variable power optical system 71, and the endoscope is avoided by avoiding the variable power optical system 71.
An endoscope insertion hole 72 for inserting 41 is provided. Further, the lens barrel 2 has an interpupillary adjustment mechanism attached to the exit side of the mirror body 1, and is provided with an endoscope insertion hole so that the endoscope 41 can be inserted while avoiding an observation optical system (not shown). There is.

Further, instead of the lens barrel 2, a lens barrel having no insertion hole 72 can be attached. 73 is a grip portion of the endoscope 41
An eyepiece 42 of the endoscope 41 is attached to a bearing 75 so that the eyepiece 42 of the endoscope 41 can be rotationally moved to the eyepiece 3 side of the lens barrel 2 around the central axis O ₇ of the axis 73. This bearing
75 is attached to the upper surface of the lens barrel 2 so that the eyepiece 42 of the endoscope 41 can be located closer to the observer than the eyepiece 3 of the microscope by the rotating operation of the grip portion 74 of the endoscope 41. . Reference numeral 76 is a proximity sensor attached to the eyepiece lens 42 of the endoscope 41.

In this embodiment, the endoscope tip holding arm 50 is used.
Is attached to the elevation operation arm 7, and the light source device and the recording device (not shown) have the same configuration as in the first embodiment, but the proximity sensor 76 is used in this embodiment in place of the microswitch 19. . That is, when an observer looks into the eyepiece lens 42 of the endoscope 41, a control signal is output to the selector control circuit 28. The other points are the same as those in the first embodiment.

When magnifying and observing the surgical site with a microscope, the observer sets the eyepiece lens 42 of the endoscope 41 at the position shown by the solid line in FIG. Since this position corresponds to the OFF state of the microswitch 19 in the first embodiment, the light emitted from the light source 22 in the light source device 27 in FIG.
Is guided to the mirror body 1 via the, and the surgical site P is illuminated via the illumination optical system of the microscope. Further, the light flux of the surgical site P is guided to the mirror body 1 so that an observer or the like stereoscopically observes the microscope observation image of the surgical site P, and at the same time, it proceeds to the television camera 15 and is recorded by a video deck (not shown) and displayed on a monitor. Be done.

Next, when the observer needs to observe and operate the surgical site P using the endoscope, the observer holds the grip portion 74 of the endoscope 41 around the axis O ₇ with the microscope 5. The eyepiece lens 3 is rotationally moved to the side of the eyepiece 3 and is operated so as to be arranged at the position of the chain double-dashed line shown in FIG. In this state, the eyepiece 42 of the endoscope 41
Is arranged closer to the observer than the eyepiece 3 of the microscope. When an observer looks into the eyepiece lens 42 of the endoscope 41, a control signal is output from the proximity sensor 76 to the selector control circuit 28.

Since this state corresponds to the ON state of the micro switch 19 in the first embodiment, the light emitted from the light source in the light source device (not shown) is shown in the endoscope 41 in the figure via the light guide 12. Not guided to the light guide, endoscope 41
The blind spot part of the surgical site P is illuminated via the illumination optical system. Further, the reflected light from the surgical site P is guided to the observation optical system of the endoscope 41, and at the same time that the observer observes the observation image of the blind spot portion of the surgical site P, a part thereof is transmitted to the television camera 13. Proceed, recorded by VCR, and projected on monitor.

In the first embodiment, switching between enlarged observation of the surgical site with a microscope and observation of the blind spot of the surgical site with the endoscope can be easily performed by using the endoscope mounting adapter 11, and the illumination light can be used. The monitor image can be switched by the operation of the endoscope mounting adapter 11. Further, since the endoscope attachment adapter 11 can be attached to most of the surgical microscopes currently used, its versatility is extremely high.

In the second embodiment, switching between magnified observation of the surgical site with a microscope and observation of the blind spot part of the surgical site with an endoscope can be easily performed by rotating the gripping arm 43. Since the images can be switched in accordance with the turning operation of the gripping arm, the structure is extremely simple and economical.

Since the distal end portion of the endoscope to be inserted into the surgical site is held and fixed by the endoscope distal end holding arm 50 having the endoscope distal end holder 49 and the ball joint 62, the surgical region is fixed to the endoscope. There is no need to hold the tip by hand, both hands are free, and processing etc. can be done quickly and safely. Further, even if the tip of the endoscope accidentally touches the surgical site, the risk of the distal end of the endoscope sticking to the surgical site can be avoided by the action of the holder of the ball joint.

Further, since the eye point during the microscope observation and the eye point during the endoscope observation are arranged at the same position, the observer can observe the magnified observation of the microscope and the blind spot portion of the endoscope. Since it is possible to operate in the same posture without changing the posture, fatigue is reduced and labor is reduced.

In the third embodiment, switching between the enlarged observation of the surgical site with the microscope and the observation of the blind spot of the surgical site with the endoscope is performed by using the grip portion 74 of the endoscope mounted on the lens barrel of the microscope. This can be easily performed by rotating the lens around a rotation axis provided on the lens barrel, and since the structure near the microscope body is extremely simple, the use of the endoscope does not hinder the operation.

When an observer who does not use the endoscope uses the surgical microscope, only the lens barrel needs to be replaced. Therefore, the surgical microscope to which the endoscope is attached and the endoscope are mounted. Since it is not necessary to prepare two surgical microscopes including a unique operating microscope and no special arm is required, the operating microscope can be economically implemented without a simple configuration.

[0058]

As described above, according to the surgical microscope of the present invention, the observer can perform the magnified observation of the surgical site by the microscope and the observation of the blind spot by the endoscope by a simple switching operation. In addition, a single operation of the observer may bring the endoscope to a position where it does not interfere with the observation of the microscope and a position where the microscope does not interfere with the operation of the endoscope during the observation, so that the operation may be performed. It can be done easily and quickly, and the progress of surgery preparation and surgery will be smooth. In addition, since both hands of the observer are free and unconstrained during microscopic observation and endoscopic observation, various treatments can be performed safely and smoothly.

Further, it is not necessary to separately provide an illumination device for supplying illumination light to the microscope and the endoscope, a recording device for recording the microscope image and the endoscope image, and the working space in the operating room is reduced. It is possible to prevent surgery and not be forced to operate in a confined environment. Moreover, since the connection of the illumination device and the recording device can be switched in association with the switching between the microscope and the endoscope, the operation is simplified and the work burden on the observer is further reduced, and the work efficiency is improved. Can contribute to improvement.

[Brief description of drawings]

FIG. 1 is a configuration diagram showing a usage example of a surgical microscope according to a first embodiment of the present invention.

FIG. 2 is a configuration diagram showing a usage example of the endoscope in the first embodiment of the present invention.

FIG. 3 is a diagram showing a mounting state of the micro switch according to the first embodiment of the present invention.

FIG. 4 is a block diagram of a light source device and a recording device according to the first embodiment of the present invention.

FIG. 5 is a configuration diagram of a light source device according to the first embodiment of the present invention.

FIG. 6 is a configuration diagram showing a usage example of a surgical microscope according to a second embodiment of the present invention.

FIG. 7 is a configuration diagram showing details of attachment portions of a support arm and a gripping arm in a second embodiment of the present invention.

FIG. 8 is a configuration diagram showing details of an endoscope tip holder according to a second embodiment of the present invention.

FIG. 9 is a configuration diagram showing details of an endoscope tip holding arm according to a second embodiment of the present invention.

FIG. 10 is an overall configuration diagram of a surgical microscope according to a third embodiment of the present invention.

FIG. 11 is a configuration diagram showing details of a lens barrel and a mirror body in a third embodiment of the present invention.

FIG. 12 is a configuration diagram showing an example of use of a conventional surgical microscope.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Mirror body 2 Lens barrel 3 Eyepiece lens 4 Objective lens 5 Microscope (1st observation optical system) 6 Arm tip part 7 Depression operation arm 8 Depression operation handle 9 Hard endoscope (2nd observation optical system) 10 Eyepiece lens 11 Endoscope mounting adapter 12, 14 Light guide 13, 15 TV camera 16 Mounting part 17 Rotating part 18 Projection part 19 Micro switch 21 Housing 22 Light source 23 Solenoid 24 Movable mirror 25 Fixed mirror 26 Illumination optical axis 27 Light source device 28 Selector control Circuit 29 Mirror drive control circuit 30 Selector 31 Amplification circuit 32 Video deck 33 Monitor 40 Support arm 41 Endoscope 42 Eyepiece 43 Grasping arm 44 Light guide 45, 46, 51, Cable 47, 52, 53 Connection terminal 48 Rotating member 49 Endoscope tip holder 50 Endoscope Tip holding arm 54 Holding frame 55 Housing 56 Guide portion 57 Elastic member 58 Switch portion 59, 60 Hole portion 61 Mounting arm 62 Ball joint 63 Housing 64 Tip arm 65 Ball 71 Variable magnification optical system 72 Endoscope insertion hole 73 Shaft 74 Grip Part 75 Bearing 76 Proximity sensor

─────────────────────────────────────────────────── ───

[Procedure amendment]

[Submission date] August 24, 1992

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0006

[Correction method] Change

[Correction content]

When an endoscope, particularly a flexible endoscope, is used, the observer holds the eyepiece with one hand and holds the tip with the other hand, so that both hands are blocked, so It becomes impossible to perform work such as removing surrounding tissue in order to reach the target observation object with the mirror tip. In addition, in order to free both hands of the observer, for example, when a special arm is attached to the operating table and the endoscope is grasped, the microscope body of the surgical microscope is used to switch from the microscope observation to the endoscope observation. After moving the arm that supports the endoscope to a position that does not interfere with the observation of the endoscope, the arm holding the endoscope must be brought to the observer's hand.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0021

[Correction method] Change

[Correction content]

The structure of the light source device 27 will be described with reference to FIGS. The micro switch 19 is a selector control circuit 28
The selector control circuit 28 is connected to the mirror drive control circuit.
29, and the output end of the mirror drive control circuit 29 is connected to the mirror drive solenoid 23. On the other hand, the selector control circuit 28 is connected to the selector 30, and the selector 30 is based on the output from the selector control circuit 28.
One of the movie signals A and B from 13 is selected and the video signal C is sent to the video deck 32 and the monitor 33 via the amplifier circuit 31.
Is configured to output. Reference numeral 22 denotes a light source fixed to the housing 21 and connected to a power source (not shown), and 24 denotes the mirror driving solenoid 23 about an axis O ₄ perpendicular to the plane of the drawing.
A movable mirror that can be rotated at an angle of 45 ° by means such as 25, a fixed mirror 25 fixed to the housing 21, and a connecting portion 20 for attaching the light guide 14 of the microscope 5 and the light guide 12 of the rigid endoscope 9, respectively. is there.

[Procedure 3]

[Document name to be amended] Statement

[Name of item to be corrected] 0024

[Correction method] Change

[Correction content]

On the other hand, the reflected light reflected by the half prism advances to the television camera 15 and is converted into a video signal A,
The video signal A, which is a microscope observation image, is amplified into a two-system video signal C by an amplifier circuit 31 in the selector 30, recorded by a video deck 32, and simultaneously projected by a monitor 33. In addition, in FIG. 5, 26 is an optical axis of illumination light.

[Procedure amendment 4]

[Document name to be amended] Statement

[Name of item to be corrected] 0030

[Correction method] Change

[Correction content]

Reference numeral 43 denotes a gripping arm attached to one end of the support arm 40, which is an eyepoint of the microscope 5 and the endoscope 41.
Hold both of them so that their eye points are arranged at positions symmetrical with respect to the central axis O ₅ of the support arm 40, and
It is a gripping arm that holds it so as to be rotatable around ₅ .

[Procedure Amendment 5]

[Document name to be amended] Statement

[Correction target item name] 0034

[Correction method] Change

[Correction content]

Light guide attached to the microscope 5
The other end of 14 is connected to one end of a light guide 44 so as to transmit the illumination light emitted from the light source of the light source device. Further, when the rotating member 48 further rotates around the rotation axis O ₅ and rotates by 180 ° from the position shown in the figure, the other end of the light guide 12 attached to the endoscope 41 also has the other end.
The illumination light emitted from the light source in the light source device is transmitted by connecting to one end of 44.

[Procedure correction 6]

[Document name to be amended] Statement

[Correction target item name] 0046

[Correction method] Change

[Correction content]

Next, a third embodiment of the present invention will be described with reference to FIGS.
It will be described based on 1. Also in this case, the same reference numerals are used for the same members or parts as those in the first and second embodiments, and the description thereof will be omitted. The microscope body 77 of the microscope 79 of this embodiment has a variable power optical system 71, and the endoscope is avoided by avoiding the variable power optical system 71.
An endoscope insertion hole 72 for inserting 41 is provided. The lens barrel 78 has an interpupillary adjustment mechanism attached to the exit side of the mirror body 77, and an endoscope insertion hole is provided so that the endoscope 41 can be inserted while avoiding the observation optical system (not shown). There is.

[Procedure Amendment 7]

[Document name to be amended] Statement

[Correction target item name] 0047

[Correction method] Change

[Correction content]

Further, instead of this lens barrel 78, a lens barrel having no insertion hole 72 can be attached. 73 is a grip portion of the endoscope 41
An eyepiece 42 of the endoscope 41 is attached to a bearing 75 so that the eyepiece 42 of the endoscope 41 can be rotationally moved to the eyepiece 3 side of the lens barrel 78 around the center axis O ₇ of the axis 73. This bearing
75 is attached to the upper surface of the lens barrel 78 so that the eyepiece 42 of the endoscope 41 can be positioned closer to the observer than the eyepiece 3 of the microscope by the rotation operation of the grip 74 of the endoscope 41. . Reference numeral 76 is a proximity sensor attached to the eyepiece lens 42 of the endoscope 41.

[Procedure Amendment 8]

[Document name to be amended] Statement

[Correction target item name] 0049

[Correction method] Change

[Correction content]

When magnifying and observing the surgical site with a microscope, the observer sets the eyepiece lens 42 of the endoscope 41 at the position shown by the solid line in FIG. Since this position corresponds to the OFF state of the microswitch 19 in the first embodiment, the light emitted from the light source 22 in the light source device 27 in FIG.
It is guided to the mirror body 77 via the, and illuminates the surgical site P via the illumination optical system of the microscope. In addition, the light flux of the surgical site P is guided to the mirror body 77 to allow the observer or the like to stereoscopically observe the microscope observation image of the surgical site P, and at the same time, it proceeds to the television camera 15 and is recorded by a video deck (not shown) and displayed on a monitor. Be done.

[Procedure Amendment 9]

[Document name to be amended] Statement

[Correction target item name] 0050

[Correction method] Change

[Correction content]

Next, when the observer needs to observe and operate the operation part P using the endoscope, the observer holds the grip portion 74 of the endoscope 41 around the axis O ₇ under the microscope 79. The eyepiece lens 3 is rotationally moved to the side of the eyepiece 3 and is operated so as to be arranged at the position of the chain double-dashed line shown in FIG. In this state, the eyepiece 42 of the endoscope 41
Is arranged closer to the observer than the eyepiece 3 of the microscope. When an observer looks into the eyepiece lens 42 of the endoscope 41, a control signal is output from the proximity sensor 76 to the selector control circuit 28.

[Procedure Amendment 10]

[Document name to be amended] Statement

[Correction target item name] 0053

[Correction method] Change

[Correction content]

In the second embodiment, switching between magnified observation of the surgical site with a microscope and observation of the blind spot part of the surgical site with an endoscope can be easily performed by rotating the gripping arm 43. The switching of images can also be performed in accordance with the turning operation of the gripping arm, and the structure is extremely simple and economical.

[Procedure Amendment 11]

[Document name to be amended] Statement

[Correction target item name] Explanation of code

[Correction method] Change

[Correction content]

[Explanation of symbols] 1,77 Mirror body 2,78 Lens barrel 3 Eyepiece 4 Objective lens 5,79 Microscope (first observation optical system) 6 Arm tip 7 Depression operation arm 8 Depression operation handle 9 Rigid endoscope (Second observation optical system) 10 Eyepiece lens 11 Endoscope mounting adapter 12,14 Light guide 13,15 TV camera 16 Mounting part 17 Rotating part 18 Projection part 19 Micro switch 21 Housing 22 Light source 23 Solenoid 24 Movable mirror 25 Fixed Mirror 26 Illumination optical axis 27 Light source device 28 Selector control circuit 29 Mirror drive control circuit 30 Selector 31 Amplifying circuit 32 Video deck 33 Monitor 40 Support arm 41 Endoscope 42 Eyepiece 43 Grasping arm 44 Light guide 45, 46, 51, Cable 47, 52, 53 Connection terminal 48 Rotating member 49 Endoscope End holder 50 End tip holding arm of endoscope 54 Holding frame 55 Housing 56 Guide portion 57 Elastic member 58 Switch portion 59, 60 Hole portion 61 Mounting arm 62 Ball joint 63 Housing 64 Tip arm 65 Ball 71 Variable magnification optical system 72 Internal view Mirror insertion hole 73 Shaft 74 Grip 75 Bearing 76 Proximity sensor ───────────────────────────────────── ────────────────

[Procedure amendment]

[Submission date] August 24, 1992

[Procedure Amendment 1]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 10

[Correction method] Change

[Correction content]

[Figure 10]

[Procedure Amendment 2]

[Document name to be corrected] Drawing

[Name of item to be corrected] Figure 11

[Correction method] Change

[Correction content]

FIG. 11

Claims (2)

[Claims] 1. A surgical microscope having a first observation optical system for observing an operation part and a second observation optical system for observing the operation part through an objective lens different from the first observation optical system. 2. A surgical microscope, comprising: means for moving the finder of one observation optical system to the rear of the other observation optical system for the observer. 2. A detection means for detecting which of the two observation optical systems has been brought to a use position by the moving means, and an illuminating device shared by both the observation optical systems based on information from the detection means, or The surgical microscope according to claim 1, further comprising: a selecting unit that selects to connect the imaging device to the observation optical system brought to the use position.