JPH07116171A - Microscope for operation - Google Patents

Abstract

PURPOSE:To provide a microscope for an operation, which assures high operativity and enables easy observation from various angles or directions without disturbing an operator who is handling the microscope and conducting the operation. CONSTITUTION:In a microscope for an operation, which is capable of changing angles or directions for observation by revolving around a focus point P on the observation optical axis of a microscope body 1 having an optical system for observation, a stand 13 movable in X, Y, or Z directions is provided on the opposite side of the microscope body 1, and a revolving base 5 capable of freely revolving around the focus point P is provided on the stand 13.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical microscope having an observation optical system for observing an observed portion such as an operating portion.

[0002]

2. Description of the Related Art In recent years, with the development of surgical methods and surgical tools, fine surgery, so-called microsurgery, has been frequently performed. For the microsurgery, a surgical microscope including a mirror body having an observation optical system for magnifying and observing a surgical site is used, as in the case of ophthalmology and neurosurgery.

Generally, a surgical microscope is composed of a mirror body which is a microscope for magnifying and observing a surgical site, and a mount portion which is an arm mount for moving the mirror body to a desired position and angle. . It has been considered that the pedestal part moves in various ways with the advancement of surgery.

For example, Japanese Patent Application Laid-Open No. 63-296743 discloses a surgical microscope in which the focal point of the microscope is positioned and installed on an extension line connecting both base ends of an arm composed of a parallel link mechanism. Since the surgical site can be observed from various angles and directions while the focus is fixed at one point (hereinafter referred to as the gazing point), it is possible to perform the surgical site observation from the optimum angle and direction. Similar to Japanese Patent Publication Sho 49
-9378, U.S. Pat. No. 4,881,709, Swiss Pat.

[0005]

However, in the conventional surgical microscope, in order to raise and lower the body around the gazing point,
It is necessary to provide a complicated mechanism on the arm that supports the mirror body, and this mechanism is close to the surgical site, so that when operating the mirror body, it interferes with the operator and interferes with the operation.

The present invention has been made in view of the above circumstances, and its purpose is to prevent the support mechanism such as an arm for supporting the mirror body from interfering with the operation or operation of the mirror body. An object of the present invention is to provide a surgical microscope capable of changing an observation angle and an observation direction around a viewpoint and facilitating an operation by an operator.

[0007]

In order to achieve the above-mentioned object, the present invention is a surgical operation in which the observation angle and the observation direction can be changed with the gazing point on the observation optical axis of the mirror body having the observation optical system as the turning center. In the microscope for use, a turning drive means is provided at a position facing the mirror body with reference to the turning center.

As described above, since the mechanism as the turning drive means for changing the observation angle and the observation direction centering on the gazing point is provided at the position apart from the mirror body, when the operator operates the mirror body, the operation is performed again. In this case, the mechanism does not get in the way, and it can be easily observed from all angles and directions.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows a first embodiment and is an overall view of a surgical microscope. Reference numeral 1 is a mirror body having an observation optical system inside, and this mirror body 1 is provided with an eyepiece 2 and a grip 3 for turning operation. The mirror body 1 is supported on the upper end of an arm 4, and the lower end of the arm 4 is mounted on a swivel base 5.
It is fixed to the edge of. That is, the arm 4 is the mirror body 1.
It is bent to avoid the observation space 6 below
In this observation space 6, an operating table 8 for lying the patient 7 on his / her back
Can be installed.

The swivel base 5 comprises a spherical concave member 9 having a concave spherical surface portion 9a on its upper surface and a spherical convex member 10 having a convex spherical surface portion 10a fitted on the concave spherical surface portion 9a on its lower surface. . Further, the centers of the spherical radii of the concave spherical surface portion 9a and the convex spherical surface portion 10a coincide with the focal point of the mirror body 1 (hereinafter, this point is referred to as a gazing point P), and the gazing point P is also included.
The weights of the mirror body 1, the grip 3, the arm 4, and the spherical convex member 10 are distributed so that the positions of the mirror body 1, the grip 3, the arm 4, and the spherical convex member 10 coincide with each other.

Further, an iron member 11 is fixed to the surface of the convex spherical surface portion 10a of the spherical convex member 10, and an electromagnetic brake 12 is provided on the concave spherical surface portion 9a of the spherical concave member 9 so that the iron member 11 is not supplied when the electricity is not supplied. The spherical convex member 10 can be fixed via the iron convex member 10 at the time of energization, and the spherical convex member 10 can be fixed at any position where the spherical convex member 10 is rotated. .

Further, the revolving base 5 is supported by a base 13 which is movable in XY and Z directions, and constitutes a revolving drive means. Explaining the base 13, 14
Is a base, and a caster 15 is provided at the bottom. A concave portion 16 is provided in the upper portion of the base 14, and a motor 17 having a rotation axis in a horizontal direction is fixed inside the concave portion 16. The motor 17 is controlled to be turned on / off and forward / reverse rotation controlled by a foot switch (not shown). A pinion 18 is fitted to the rotary shaft of the motor 17. The pinion 18 is vertically movable in a rack 19. Meshes with. The rack 19 is fixed to an elevating member 20 which is supported by a base 14 so as to be elevatable.

A pair of convex portions 21 are integrally provided on both ends of the upper surface of the elevating member 20, and a second guide shaft 22 is provided between the convex portions 21. And this guide shaft 2
2 is provided with a movable body 23 that is movable in the X direction.

A plate-shaped supporting portion 24 is provided on the upper portion of the moving body 23, and a fitting portion 25 formed of a concave portion provided on the lower surface of the spherical concave member 9 is fitted to the supporting portion 24. . Further, V-grooves 24a and 25a along the Y direction are provided on both outer sides of the support portion 24 and both inner sides of the fitting portion 25, and the spherical concave member 9 is arranged in the Y direction between the V-grooves 24a and 25a. A ball 26 that movably supports is provided.

The movement of the moving body 23 in the X direction and the movement of the spherical concave member 9 in the Y direction are driven by a known electric drive mechanism (not shown), and this electric drive mechanism is controlled by the foot switch. It has become.
Therefore, the swivel base 5 is moved to the XY and Z directions by the base 13.
The mirror body 1 which is movable in any direction and supported by the swivel base 5 via the arm 4 is configured to be swivelable in any direction with the gazing point P as a fulcrum.

Next, the operation of the surgical microscope constructed as described above will be described. First, the patient 7 on the operating table 8
The swivel base 13 is moved in the XY directions so that the surgical site of the patient 7 can be observed, and the observation optical axis a of the mirror body 1 is moved to the surgical site of the patient 7 (attention point P).
To position. In this case, the movement in the X direction is caused by the guide shaft 2.
The moving body 23 moves with respect to 2, and the spherical concave member 9 moves with respect to the moving body 23 in the Y direction.

Next, when the motor 17 is driven by the foot switch, the elevating member 20 moves up and down with respect to the base 14 by the rack 19 that meshes with the rotating pinion 18, and the mirror body 1 moves up and down via the swivel base 5. To do. Then, the mirror body 1 is focused on the gazing point P of the surgical site.

Further, when it is desired to change the observation direction to the gazing point P of the surgical site, the electromagnetic brake 12 is energized by the foot switch, and the spherical convex member 10 is inserted through the iron member 11.
When the operator holds the grip 3 by hand and pushes and pulls the mirror body 1 in an arbitrary direction, the spherical convex member 10 spherically moves with respect to the spherical concave member 9, and the mirror body 1 is focused on. The observation direction can be changed by making a spherical movement around P.

At this time, since the gazing point P and the center of gravity of the mirror body 1, the grip 3, the arm 4, and the spherical convex member 10 are coincident with each other, the amount of operation force is very small. Further, when it is desired to rotate the mirror body 1 and fix it at an arbitrary position for observation, the iron member 11 of the spherical convex member 10 can be fixed by the electromagnetic brake 12 by turning off the electromagnetic brake 12 with the foot switch. .

In this embodiment, even if the mirror body 1 is swung around the point of gaze P, the spherical convex member 10 serving as the swivel driving means.
Is provided below the operating table 8 and the arm 4 simply connects the mirror body 1 and the spherical convex member 10, so that the circumference of the mirror body 1 is simplified, and the operability is facilitated without disturbing the surgery. . Further, since the center of rotation of the mirror body 1 and the center of gravity of the portion that rotates together with the mirror body 1 coincide with each other, the mirror body 1 can be lightly rotated, and the lock mechanism such as the electromagnetic brake 12 can be downsized. Further, since the mirror body 1 can be swiveled around the gazing point P without a complicated structure such as a link mechanism as in the conventional case, it can be provided at a low cost.

2 to 4 show a second embodiment, FIG. 2 is a configuration diagram of a surgical microscope and an operating table, and FIGS. 3 and 4 are block diagrams showing the configuration of an electric system. As shown in FIG. 2, the arm base 30 has a base 31 fixedly arranged on the floor of the operating room. A column 32 is erected on the base 31, and a first arm 34 is supported on the column 32 so as to be rotatable around a first rotation axis A33. The first arm 34 has a built-in rotary encoder A35 for detecting the rotation angle of the first arm 34 with respect to the support column 32.

A second arm 37 is rotatably supported on the first arm 34 about a second rotation axis B36. The second arm 37 includes a rotary encoder B38 for detecting a rotation angle of the second arm 37 with respect to the first arm 34.
Is built in.

A pantograph arm 40 is rotatably supported on the second arm 37 about a third rotation axis C39. The pantograph arm 4 includes the pantograph arm 4
A rotary encoder C41 for detecting the rotation angle of the zero arm with respect to the second arm 37 is incorporated.

The pantograph arm 40 is supported by a gas spring 42, and at the tip of the pantograph arm 40, a mirror body constituting portion 44 is supported via an arm portion 43. The mirror body forming section 44 has a mirror body 46 supported by the arm section 43 via a mirror body arm 45, and the eyepiece section 47, the grip 48 and the gazing point setting switch 49 are attached to the mirror body 46. Is provided.

Next, the operating table 51 on which the patient 50 is supine will be described. A base 52 of an operating table 51 is fixed to the floor of the operating room, and a moving body 53 that has the same structure as that of the first embodiment and is electrically movable in the XY directions in the horizontal plane is provided on the upper portion of the base 52. Is provided and constitutes the turning drive means.

A pedestal 54 is fixed to the upper surface of the moving body 53, and a first stepping motor 55 is provided inside the pedestal 54.
Is fixed with the rotating shaft oriented in the vertical direction, and a gear 56 is fitted to this rotating shaft. The gear 56 is an operating table rotary shaft 5 that is rotatably supported in a vertical direction on a gantry 54.
It is meshed with a gear 58 fitted to the lower end of 7.

The upper end of the operating table rotary shaft 57 projects upward from the gantry 54, and the upper end has a support plate 59 on the upper end.
A horizontal moving body 59 having a box 59b at the bottom is fixed.

A second stepping motor 60 is fixed inside the box 59b of the horizontal moving body 59 with the rotating shaft 61 facing sideways. The rotating shaft 61 is orthogonal to the axis of the operating table rotating shaft 57. ing. Further, one end of a first lever 63 constituting a crank mechanism 62 is fixed to the rotary shaft 61, and a second lever 64 connected to the other end of the first lever 63 is vertically moved to the horizontal moving body 59. It is rotatably connected to an elevating side plate 65 which is slidable in the direction.

The lifting side plate 65 is connected to a motor mount 67 provided inside at one end of the box-shaped operating table 51. A third stepping motor 68 is fixed to the motor mount 67 with its rotation axis facing sideways, and a pinion 70 is fitted to this rotation axis. Pinion 7
0 meshes with a rack 72 of an arc-shaped rack plate 71 having a radius b of which the center of curvature is the gazing point P of the surgical site.

Both end portions of the rack plate 71 are vertically slidably fitted to guide rods 73 vertically supported inside the operating table 51. A slideable ball 74 is attached to the upper and lower surfaces inside the operating table 51.

Further, a support plate 59 for the horizontal moving body 59.
A plurality of coil springs 75 are erected on a, and rollers 77 are provided on the upper ends of these coil springs 75 via a pedestal 76. These rollers 77 elastically support the lower surface of one end of the operating table 51. ing. Therefore, the horizontal moving body 59
Is horizontally movable along the lower surface of the operating table 51. A pillar 78 is provided on the lower surface of the operating table 51 at the other end, and the pillar 78 and the base 7 fixed to the floor surface of the hand.
A coil spring 80 is interposed between the coil spring 9 and the coil 9.

Next, the structure of the electric system shown in FIGS. 3 and 4 will be described. In FIG. 3, 81 is the first to third
Is a gazing point coordinate calculation unit that inputs signals from the rotary encoders A35, B38, C41 and the gazing point setting switch 49 to calculate the three-dimensional coordinates of the gazing point position observed by the operator. Reference numeral 82 denotes a drive control unit that outputs drive signals to the moving body drive unit 83 and the second stepping motor 60 based on the signal from the gazing point coordinate calculation unit 81.

A drive control unit 84 shown in FIG. 4 is provided with an operating table inclination angle input unit 85a for inputting an angle for inclining the operating table 51 around the gazing point P and a horizontal plane with the operating table 51 centering around the gazing point P. In order to input a signal from a foot switch 86 having an operating table rotation angle input section 85b for inputting an angle for rotating the inside, and to output a drive signal to the first stepping motor 55 and the third stepping motor 68. Has become.

Next, the operation of the surgical microscope constructed as described above will be described. First, the patient 50 is fixed to an arbitrary position on the operating table 51 before the operation. Then, when the operation is started and the surgical microscope is used, the mirror body component 44 is moved by horizontal rotation of the first arm 34, and the vertical movement of the pantograph arm 40 causes the mirror 46 to be focused on the surgical site for observation. .

When the operator presses the gazing point setting switch 49, the gazing point coordinate calculation unit 81 calculates the gazing point three-dimensional coordinates, and the rotational axis of the operating table rotating shaft 57 and the optical axis a of the mirror body 46 are calculated. The drive control unit 82 outputs a drive signal to the moving body driving unit 83 so that the moving body 53 and the moving body 53 move horizontally. Further, the drive control unit 82 outputs the drive signal to the second position so that the circular arc of the rack 72 coincides with the position of the distance b from the gazing point P.
When the rotation shaft 61 is rotated, the pinion 70 fixed to the elevating side plate 65 is vertically moved via the crank mechanism 62, and the rack 72 is moved.

Next, a case where the operator observes the gazing point P by changing the observation angle and the observation direction will be described. The operator wishes to observe the angle input by the operating table tilt angle input section 85a of the foot switch 86, and the drive control section 84 outputs a drive signal to the third stepping motor 68, and the pinion 70.
By rotating the rack 72 and moving the rack 72, the coil spring 75 and the coil spring 80 expand and contract, and the operating table 51 is tilted around the gazing point P for observation.

Similarly, the foot switch 8
6 is input by the operating table rotation angle input unit 85b, and a drive signal is input from the drive control unit 84 to the first stepping motor 55.
To the operating table rotary shaft 57 by the gears 56 and 58.
Is rotated to rotate the operating table 51 about the gazing point P for observation.

According to this embodiment, when the focusing point setting switch 49 is turned on with the focus of the mirror body 1 on the surgical site, the turning center point of the operating table 51 is automatically moved to the focusing point P of the mirror body 1. Therefore, the operator can change the observation angle and observation direction electrically without changing the eyepoint while holding the surgical instrument in both hands, so that the operator can perform treatment in a comfortable posture and change the observation angle and observation direction. There is no need to stop the treatment during the procedure, which shortens the operation time.

5 to 10 show a third embodiment. This embodiment is a surgical microscope that emphasizes the operability of a keyhole surgery, which is widely performed as a minimally invasive surgery. Currently, in surgery for intracranial lesions for the purpose of minimally invasive neurosurgery, the craniotomy is made as small as possible. Therefore, it must be possible to observe lesions deep inside the skull even from the small craniotomy.

FIG. 5 is a view showing the internal structure of the mirror body 135, FIG. 6 is a view showing the optical arrangement in the AA ′ arrow view of the mirror body 135 of FIG. 5, and FIG. 7 is the same AA ′. FIG. 8 is a diagram showing a mechanical arrangement in an arrow view, FIG. 8 is a block diagram showing an electric system, FIG. 9 is a diagram showing a relationship between optical axis intervals, and FIG. 10 is a diagram showing a relationship with a video signal.

The mirror body 135 will be described with reference to FIGS. The left and right observation optical paths (only one is shown) have a common objective lens 137, and the left and right observation optical paths have parallel prisms 138L and 138R, a variable-magnification optical system 139L driven by a drive mechanism (not shown), and image formation. Lens 140L
And an imaging unit 141L including a CCD is arranged at each image forming position of the image forming lens 140L.

Further, a display 146L for the left and right eyes for displaying an image constituted by the image pickup section 141L, the image processor L132 and the image processor R133 is provided, and a lens 147L, a mirror 148L and a mirror are provided on the respective optical paths thereof. 149L and an eyepiece lens 150L are provided.

As shown in FIG. 7, a parallel prism 138.
Gears 142L and 142R are fixed to L and 138R, respectively, and are provided so as to be rotatable around the observation optical axis centers L and R, respectively. Further, the parallel prism 138
The gears 142L and 142R fixed to the L and 138R mesh with each other, and the gear 142R meshes with the gear 143 fixed to the rotation shaft of the motor 144.

The configuration of the electric system will be described with reference to FIG. The image processor L132 is a CC of the imaging unit 141L.
A display built in the mirror body 135, which includes a drive circuit (not shown) configured to drive D and read data, and a video signal processing circuit (not shown) configured to form a video signal from the output signal thereof. 146L and the sync separation circuit 129 are connected. (Image processor R1
The description of 33 is omitted because it is the same. ) In the sync separation circuit 129, the image processors L, R132, 133
Of the horizontal and vertical synchronizing signals are synchronized with each other, and the synchronizing signal output is to the arithmetic circuit 130, and the video signals of the two systems are high-pass filter 125 and A / D.
They are connected via the conversion circuit 134. Motor 144
The driver 131, which is a drive circuit of the
The calculation output of is connected.

Next, the operation will be described. Left and right observation images by the objective lens 137, the parallel prisms 138L and 138R, the variable magnification optical system 139L and the imaging lens 140L are respectively taken by the image pickup section 141L, the image processor L132 and the image processor R133. Imaged by the display 14
Display on 6L. The display 146L displays an image on the left observation optical path, and the display (not shown) displays the image on the right observation optical path. By observing the image on the display 146L with the left eye through the eyepiece lens 150L and the mirrors 149L and 148L, the operator can similarly observe the image on the display with the right eye through the eyepiece lens and the mirror. Perform stereoscopic observation.

It is now assumed that the lesioned part Os deep inside the body cavity is observed from the opening Ob on the body surface at the surgical site. At this time, the distance between the left and right observation optical axes in the mirror body 135 is
It is e shown in FIGS. 6 and 9. As shown in FIG. 9, in the observation optical path on the right side, part of the light flux is eclipsed by the opening Ob, resulting in an image as shown in FIG. The image corresponding to the opening Ob is a blurred image, cut by the high-pass filter 125, and the output from the A / D conversion circuit 134 is as shown in FIG. The arithmetic circuit detects this portion c and drives and controls the motor 144 via the driver 131 to eliminate it.

The rotation of the motor 144 causes the gear 143 to rotate in the direction of g shown in FIG.
The parallel prisms 138L, 138L
8R rotates to the positions of 138L 'and 138R'. In this state, the left and right observation optical axis intervals are f as shown in FIGS. 6 and 9, and the observation can be performed without being obscured by the opening Ob.

Therefore, even in the so-called keyhole surgery for the purpose of minimally invasiveness in recent years, stereoscopic observation in various directions is possible from the small opening, and the adjustment is automatically performed during the operation. Will allow you to concentrate more on the surgery and lead to a smoother progression of the surgery.

[0049]

As described above, according to the present invention, since the mechanism for changing the observing angle and the observing direction centering on the gazing point is provided at a position apart from the mirror body, There is an effect that it can be easily observed from all angles and directions without hindering the operation and the surgery and improving operability.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a surgical microscope showing a first embodiment of the present invention.

FIG. 2 is an overall configuration diagram of a surgical microscope showing a second embodiment of the present invention.

FIG. 3 is a block diagram of an electric system of the embodiment.

FIG. 4 is a block diagram of an electric system of the embodiment.

FIG. 5 is a configuration diagram showing an internal structure of a mirror body according to a third embodiment of the present invention.

6 is a diagram showing an optical arrangement along line AA ′ in FIG.

FIG. 5 is a diagram showing a mechanical arrangement along line AA ′.

FIG. 8 is a block diagram showing an electric system of the embodiment.

FIG. 9 is a diagram showing a relationship between optical axis intervals in the example.

FIG. 10 is a diagram showing a relationship with a video signal of the same embodiment.

[Explanation of symbols]

 1 ... Mirror 5 ... Revolving base 13 ... Base

[Procedure amendment]

[Submission date] December 10, 1993

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0016

[Correction method] Change

[Correction content]

Next, the operation of the surgical microscope constructed as described above will be described. First, the patient 7 on the operating table 8
The swivel 5 is moved in the XY directions so that the surgical site can be observed, and the observation optical axis a of the mirror body 1 is positioned at the surgical site (gazing point P) of the patient 7. In this case, the movement in the X direction is caused by the guide shaft 22.
The moving body 23 moves with respect to the moving body 23, and the spherical concave member 9 moves with respect to the moving body 23 in the Y direction.

[Procedure Amendment 2]

[Document name to be corrected] Drawing

[Name of item to be corrected] Figure 2

[Correction method] Change

[Correction content]

[Fig. 2]

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Takashi Fukaya 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Hiroshi Fujiwara 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Masahiko Kinukawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. In a surgical microscope capable of changing an observation angle and an observation direction with a gazing point on an observation optical axis of a mirror body having an observation optical system as a rotation center, the rotation center is provided at a position facing the mirror body. An operating microscope, characterized by being provided with a turning drive means based on the above.