JPH08131456A - Microscope for operation - Google Patents

Abstract

PURPOSE: To obtain a microscope for operation with high safety which never flaws an operated part by an observation means by providing a holding means for a 1st and a 2nd observation means, and limiting the motion of the holding means based on detection information from a detecting means which detects the observable state of the 2nd observation means. CONSTITUTION: When an endoscope fitting adapter 28 is moved from a storage position to an observation position to observe a dead angle position by using a hard mirror 32, a microswitch is turned OFF and its state is transmitted to a control part. Then the control part stops supplying a current to electromagnetic brakes provided at the respective rotation parts of shafts (a), (b), (d), and (f) to lock arms 21 and 24 and a mirror body 25. Then a gear 49 is also locked and an arm shaft 40 is disabled to rotate in the clockwise direction where a claw 50 and a gear 49 engage each other and able to rotate only counterclockwise; and a pantograph arm 23 can rotates only upward, but can not rotate downward.

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 means such as an endoscope capable of observing a blind spot.

[0002]

2. Description of the Related Art In recent years, with the development of surgical techniques and surgical tools, microsurgery has been frequently performed. In this microsurgery, a surgical microscope is used for magnifying and observing the surgical site.

In general, the surgical microscope has a mirror body having a binocular optical system for performing stereoscopic vision, and the mirror body can be three-dimensionally movably held by an arm attached to a gantry. It is like this.

By the way, in microsurgery in neurosurgery and otolaryngology, the operating site (affected site) is often located deep inside the body cavity, and since it is necessary to perform surgery with minimal invasiveness, it is very small in the living body. An incision is made, and the affected area is observed with a surgical microscope facing the incision. Since the affected area is observed through the minute incisions in this way, even if the observation direction of the surgical microscope is changed as much as possible, there are areas that are difficult to observe, that is, areas that become blind spots. Therefore, recently, in order to observe such a blind spot, a method using a mirror and an endoscope together is becoming widespread.

Generally, when a mirror is used, the operator inserts the mirror into a minute incision while holding the mirror with one hand to observe the blind spot with the naked eye, or The reflected image is magnified and observed with a surgical microscope through a mirror.

When an endoscope is used, the operator holds the endoscope with one hand and inserts the insertion portion of the endoscope into the minute incision hole to determine the blind spot. The image is observed directly through the eyepiece of the endoscope, or the endoscope image taken by the image pickup means built in or attached to the endoscope is observed on the TV monitor.

By the way, when observing a blind spot by using an endoscope together, particularly when using a fiberscope (flexible endoscope), the operation portion of the endoscope is held with one hand, and One hand must hold the tip of the endoscope insert. Therefore, since both hands are closed, it is very difficult to perform work such as removing surrounding tissue in order to reach the blind spot of the distal end portion of the endoscope.

Even when a rigid endoscope is used, the eyepiece of the rigid endoscope must be held with one hand for observation, resulting in poor workability, prolonged operation time, and operator fatigue. Increase. In addition to that, there is a risk that the tip of the rigid endoscope may injure the surgical site, and the surgeon was forced to perform extremely careful work.

Further, in this case, since the endoscope is used in addition to the surgical microscope, it is necessary to set many accessory devices such as a light source device for the endoscope and a TV monitor. As a result, the operating room becomes complicated and the work efficiency of the surgeon, nurse, etc. for surgery is deteriorated.

A surgical microscope designed to solve the above-mentioned drawbacks is proposed in Japanese Patent Laid-Open No. 6-196. This surgical microscope, as shown in FIG.
A microscope body 1 of a surgical microscope supported by an arm 100 of a gantry.
02 to the rigid endoscope 1 via the endoscope mounting adapter 103.
04 is attached, and the operator uses the rigid endoscope 1
This is very useful in that it is not necessary to hold the eyepiece part 04 of 04. With this configuration, the endoscope attachment adapter 103 to which the rigid endoscope 104 is attached can be rotated around the optical axis O of the mirror body 102, and when observation is performed by the rigid endoscope 104, the endoscope attachment adapter 103 is attached. By rotating the adapter 103, the rigid endoscope 104 is arranged from the retracted position to the illustrated observation position.

Further, in the publication, as shown in FIG.
A grasping arm 117 attached to a mirror body 112 of an operating microscope is provided with an endoscope insertion hole 120, and a fiberscope 118 is inserted into this hole 120, and an endoscope tip holding arm 119 and an endoscope tip holding are provided. The configuration in which the tip of the fiberscope 118 is held by the tool 110 is shown. Also in the case of this configuration, when observing a blind spot part using the fiberscope 118, it is very useful in that the operator does not need to hold the fiberscope 118.

[0012]

By the way, in the case of the conventional configuration shown in FIG. 10, since the rigid endoscope 104 needs to observe the blind spot portion of the observation visual field by the surgical microscope, its distal end is for surgical operation. It largely protrudes from the mirror body 102 of the microscope toward the operation side. Further, although the relative position between the mirror body 102 and the rigid endoscope 104 is fixed, the observation optical axis O of the mirror body 102 and the observation optical axis of the rigid endoscope 104 do not match. Therefore, when observing with the rigid endoscope 104, the surgeon operates the arm 101 of the gantry of the surgical microscope with the naked eye to move three-dimensionally, and be careful not to damage the surgical site with the rigid endoscope 104. Hard endoscope 10 while paying
The tip of 4 must be guided to a position where the blind spot of the surgical site can be observed.

Further, in the configuration of FIG. 10, when the rigid endoscope 104 is at the observation position, the tip of the rigid endoscope 104 has a larger moment with respect to the rotation axis of the arm 101 than that of the body grip 106 held by the operator. . Therefore, the operator needs to operate the lens grip 106 with extreme caution. In particular, if the arm 101 is inadvertently moved while observing a blind spot using the rigid endoscope 104, the tip of the rigid endoscope 104 may come into contact with the affected area and damage the affected area. In addition, when changing the observation position of the rigid endoscope 104 or when removing the rigid endoscope 104, the operator must take great care not to damage the surgical site with the distal end of the rigid endoscope 104.

As described above, according to the configuration of FIG. 10, when observing the surgical site with the rigid endoscope 104, the operator is required to pay close attention and a large burden, resulting in a long operation time. become.

On the other hand, in the case of the conventional configuration shown in FIG. 11, it is necessary to move the endoscope tip holding arm 119 in order to guide the tip of the fiberscope 118 to the blind spot in the observation field of view of the surgical microscope. There is. Further, also when changing the observation direction of the fiberscope 118, it is necessary to grasp the vicinity of the endoscope tip holding tool 110 by hand and operate the endoscope tip holding arm 119. In this case, since the endoscope tip holding arm 119 and the fiberscope 118 held by the same are largely projected from the body 112 toward the operation side, the tip of the fiberscope 118 and the like do not damage the operation portion. It is necessary to pay sufficient attention to the change of the alignment of the microscope and the change of the observation position of the fiberscope 118. These sensitive operations eventually interrupt the flow of surgery,
Not only is it a great burden on the operator, but it also puts a burden on the patient by extending the operation time.

The above-mentioned circumstances are not limited to endoscopes, but mirrors have similar problems.
The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide a highly safe surgical microscope that does not damage the surgical site by the observation means.

[0017]

In order to solve the above-mentioned problems, the present invention provides a first observation means for observing an object to be inspected and at least one optical system of the optical systems of the first observation means. A second observation means having non-common elements, and first and second observation means
In the surgical microscope having a holding means for movably holding the observing means of 3 in any position and direction of the three-dimensional space, a detecting means for detecting that the second observing means is in an observable state, A limiting means for limiting the movement of the holding means based on the detection information from the detecting means.

[0018]

With the above arrangement, even if the operator mistakenly moves the holding means by erroneous operation or the like while observing with the second observing means, the movement of the holding means is restricted. The surgical site is not damaged by the second observation means protruding in the observation direction.

[0019]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 show a first embodiment of the present invention. FIG. 1 shows a surgical microscope 1 according to this embodiment.
1 schematically shows the entire configuration of the above. As shown in the figure, the surgical microscope 1 has two observation means, that is, a microscope body 25 as a microscope body and a rigid endoscope (endoscope) 32 attached thereto.

One end of a horizontal arm 21 is attached to the upper end of the gantry 20 of the surgical microscope 1 so as to be rotatable about an axis a. One end of a pantograph arm 23 is rotatably attached to the other end of the horizontal arm 21 via a member 22. In this case, the pantograph arm 23
Can rotate about an axis b (vertical axis) and an axis c (horizontal axis) orthogonal to each other, as shown in the figure.

Further, one end of a mirror arm 24 is attached to the other end of the pantograph arm 23 so as to be rotatable about a vertical axis d. A mirror body 25 is supported on the mirror body arm 24 so as to be rotatable and to be elevated. That is, the mirror body 25 can rotate about the axis e that is the central axis of the mirror body arm 24, and can rotate about the axis f orthogonal to the axis e to perform the elevation motion.

Each of the rotating parts described above can be adjusted in balance by a balance adjusting part (not shown). By rotating each of the arms 21, 23, and 24 with these rotating portions, the observation position and the observation direction of the mirror body 25 can be set to a desired position and a desired orientation in the three-dimensional space.

As shown in FIG. 2, the mirror 25 has a built-in binocular optical system (not shown) whose axis is the optical axis. Further, a microscope light guide 27 is attached to the mirror body 25, and illumination light from a light source (not shown) is supplied to the mirror body 25 via the microscope light guide 27, whereby this illumination light is operated. The stereoscopic observation image of the surgical site can be obtained through the eyepiece of the mirror body 25.

An endoscope attachment adapter 28 is rotatably attached to the lower end of the mirror body 25. The adapter 28 can rotate about the optical axis center g of the binocular optical system. Further, a stopper (not shown) is provided at the lower end of the mirror body 25 to position the adapter 28 at the storage position shown by the solid line in FIG. 2 and the observation position shown by the broken line in FIG. Therefore, the endoscope mounting adapter 28 can rotate in the direction of the arrow shown in FIG. 2 between the storage position (solid line position) and the observation position (broken line position).

FIG. 3 shows details of the endoscope mounting adapter 28. As shown in the figure, the endoscope attachment adapter 28 includes an adapter body 28a that rotates with respect to the body 25, and an endoscope guide that is rotatably connected to the adapter body 28a via a ball joint 30. 31
And have. The endoscope guide 31 has an insertion hole 31a through which the insertion portion of the rigid endoscope 32 can be inserted, and the rigid endoscope 32 can be supported by inserting the insertion portion of the rigid endoscope 32 into this insertion hole 31a. It has become. In addition, the ball joint 3 of the endoscope attachment adapter 28
A knob 33 is provided at the portion of 0, and this knob 33
By loosening, the ball joint 30 can be brought into a free state, and the rigid endoscope 32 attached to the endoscope guide 31 can be directed in a desired direction. Further, an operation weight adjusting handle 34 is attached to the endoscope guide 31, and the rigid endoscope 32 is attached by the handle 34.
It is possible to adjust the weight of the sliding and rotating operations.

An endoscope light guide 35 is connected to the rigid endoscope 32 attached to the endoscope attachment adapter 28, and the illumination light from a light source device (not shown) is hardened via this light guide 35. By supplying the illumination light to the surgical site by supplying it to the mirror 32, an observation image of the surgical site can be obtained through the eyepiece of the rigid endoscope 32.

Next, the rotating mechanism of the pantograph arm 23 will be described with reference to FIGS. 4 and 5. In FIG. 4, 22 is a pantograph arm 23 and a horizontal arm 21.
It is a member that connects and. Arm shafts 40, 40 (axis c) are provided on both side surfaces of the base end portion of the pantograph arm 23 connected to the member 22 in a direction orthogonal to the longitudinal direction of the pantograph arm 23. Each of these arm shafts 4 protruding from both side surfaces of the pantograph arm 23
0 and 40 are separately fitted and supported in bearings 41 and 42 fixed to the left and right sides of the member 22, respectively, and can rotate integrally with the pantograph arm 23.

An armature 45 is located on the side of the pantograph arm 23 with respect to the bearing 41 and is slidably fitted and inserted into the arm shaft 40 protruding from one side surface of the pantograph arm 23. The armature 45 is non-rotatably attached to the arm shaft 40, and the arm shaft 40 and the pantograph arm 23.
It is designed to rotate together with. Further, the armature 45 is attached to the pantograph arm 23 by a spring 44.
Supported by.

An electromagnetic brake 43 fixed to the member 22 is arranged between the bearing 41 and the armature 45 in a state of being fitted and inserted into the arm shaft 40 and opposed to the armature 45 via a minute gap z. ing.

Such a structure is provided in all of the rotating parts which rotate about the axes a to f. Where axis a
The electromagnetic brakes provided on the rotating parts that rotate about f will be briefly described. The electromagnetic brakes (excluding the electromagnetic clutch 46 described later) of each rotating portion are electromagnetically controlled by operating a switch (not shown) of the grip 26 (see FIG. 1) attached to the mirror body 25.
That is, when the switch is in the OFF state, no current is supplied to the electromagnetic brakes of the rotary shafts a to f, so that the armatures that rotate integrally with the arms 21, 23 and 24 and the mirror body 25 are not provided. Electromagnetically attracted to the electromagnetic brake. Therefore, the rotation of each arm 21, 23, 24 and the mirror body 25 is blocked (locked). Further, when the switch is turned on, a current is supplied to each electromagnetic brake of the rotating shafts a to f, and each arm 21, 23, 2 is turned on.
4 and the armature that rotates integrally with the mirror body 25 are separated from the electromagnetic brake and become free. Therefore, each arm 21, 23, 24 and the mirror body 25 can freely move in a desired position and direction, which allows the mirror body 2 to move.
The observation position and the observation direction of 5 can be easily changed. Then, with respect to the observation position and the observation direction of the mirror body 25 thus changed, the switch is turned off again and each arm 2 is moved.
If the locks 1, 23, 24 and the mirror body 25 are held securely.

Such an operation will be specifically described below by taking the operation of the armature 45 and the electromagnetic brake 43 as an example. First, when the switch of the grip 26 is in the OFF state, no current is supplied to the electromagnetic brake 43, so that the armature 45 is electromagnetically attracted and locked by the electromagnetic brake 43 against the spring force of the spring 44. . Therefore, the arm shaft 40 and the pantograph arm 23 that rotate together with the armature 45 are prevented from rotating, and the member 22 and the pantograph arm 23 are fixed.

The locked state of the armature 45, that is, the electromagnetic attraction action of the electromagnetic brake 43 is released by turning on the switch and supplying a current to the electromagnetic brake 43. When the locked state of the armature 45 is released, the armature 45 is slid by the elastic force of the spring 44 along the axial direction of the arm shaft 40 toward the pantograph arm 23 side by a distance z and returned to its free initial position. Be done. Therefore, the pantograph arm 23 can freely rotate about the axis c.

The switch provided on the grip 26 is connected to a control unit (not shown) built in the gantry 20. Then, based on a control signal from this control unit, a cable (not shown) from a current supply source (not shown)
Electric current is supplied to the electromagnetic brake via the. Further, the switch provided on the grip 26 is normally in an OFF state, and an electromagnetic brake provided on each of the rotating shafts a to f (excluding an electromagnetic clutch 46 described later).
Is normally in a state in which no current is supplied. Therefore, each arm 21, 23, 24 and the mirror body 25 are normally in a locked state.

Further, as shown in FIG. 4, the arm shaft 40 protruding from the other side surface of the pantograph arm 23 has
The armature 47 is located closer to the pantograph arm 23 than the bearing 42 and is slidably fitted and inserted.

An electromagnetic clutch 46 fixed to the member 22 is arranged between the bearing 42 and the armature 47 in a state of being fitted and inserted into the arm shaft 40, and opposed to the armature 47 via a minute gap y. ing. As will be described later, when a current is supplied to the electromagnetic clutch 46, the armature 47 is electromagnetically attracted to the electromagnetic clutch 46.

The arm shaft 40 has an armature 47.
It is inserted into the bearing 48 fixed to the member 22 at a position closer to the pantograph arm 23. A gear 49 having teeth cut inside is rotatably attached to the inner surface of the bearing 48, and the arm shaft 40 is inserted inside the gear 49. Further, in this configuration, the armature 47 is connected to the gear 49 via the spring 52.

Details of the bearing 48 are shown in FIG. As shown in the figure, the arm shaft 40 is provided with a claw 50 which is swingable about a shaft 55. This nail 50
While rotating integrally with the arm shaft 40, the arm shaft 40
Is abutted against the inner surface of the gear 49 by a spring 51 attached to and meshes with the teeth of the gear 49. In this case, the pawl 50 is provided with the gear 49 as the arm shaft 40 rotates.
Meshes with the gear 49 in such a way that it rotates only in one direction and not in the opposite direction. That is, when the arm shaft 40 rotates in one direction (clockwise in the drawing), the gear 49 that meshes with the claw 50 also rotates in that direction with this rotation, but the arm shaft 40 rotates in the opposite direction (the drawing). When rotated in the counterclockwise direction), the meshing state between the claw 50 and the gear 49 is released, and only the claw 50 rotates.

When the arm shaft 40 rotates clockwise in the figure, the pantograph arm 23 rotates downward, and when the arm shaft 40 rotates counterclockwise in the figure, the pantograph arm 23 rotates upward.

By the way, a micro switch 29 is provided at the storage position of the endoscope mounting adapter 28 (the position shown by the solid line in FIG. 2). This micro switch 29
Is provided in the vicinity of the stopper (described above) for positioning the adapter 28 at the storage position. Further, the micro switch 29 is pressed by the adapter 28 only when the adapter 28 is located at the storage position. The operating state of the micro switch 29 controls the supply of current to the electromagnetic clutch 46.

That is, the microswitch 29 is connected to the control unit built in the gantry 20 via a cable (not shown), and when the microswitch 29 is pressed by the adapter 28 (the adapter 28 is in the storage position). When it is in the position ... ON state), the electromagnetic clutch 46
Current is not supplied to the electromagnetic clutch 46, but when the adapter 28 is removed from the storage position and the micro switch 29 is not pressed by the adapter 28 (OFF state), current is supplied to the electromagnetic clutch 46 via the control unit. That is, the electromagnetic clutch 46, unlike other electromagnetic brakes,
It is electromagnetically controlled only by turning ON / OFF the micro switch 29 regardless of ON / OFF of the switch of the grip 26.

When the micro switch 29 is in the OFF state (the adapter 28 is out of the storage position), the rotary shafts a to f excluding the electromagnetic brake 43 are turned on regardless of whether the grip 26 is turned on or off. No current is supplied to each electromagnetic brake.

Next, the operation of the surgical microscope 1 having the above configuration will be described. First, the operator inserts the adapter 28 into the living body while stereoscopically observing the surgical site using a binocular optical system (not shown) built in the mirror body 25 with the adapter 28 placed in the storage position. The affected area P is approached through the minute incision H. At this time, the operator operates the switch (not shown) provided on the grip 26 to move the gantry 20.
A signal is sent to the control unit (not shown) built in. When the switch is turned on, the control unit sets the electromagnetic brake (the electromagnetic clutch 46 that is provided in the rotating unit so that the rotating unit of the shafts a to f, which is normally in the locked state, becomes free. Except)). As a result, the armature electromagnetically attracted to the electromagnetic brake becomes free, and the operator can freely rotate the rotating parts of the axes a to f, that is, the arms 21, 23 and 24 and the mirror 24. Then, the observation position and the observation direction of the mirror body 25 can be changed to observe the desired portion of the surgical site.

In this free state, the claws 5 attached to the arm shaft 40 as the shaft c are rotated as the arm shaft 40 rotates.
0 rotates. Further, in this state, since the adapter 28 is arranged at the storage position and the micro switch 29 is turned on, no current is supplied to the electromagnetic clutch 46 built in the shaft c, and therefore the armature 47 is not moved by the electromagnetic clutch 46. Since it is in a free state without being adsorbed by the armature, the gear 49 meshing with the claw 50 can also rotate together with the arm shaft 40 without being restricted in rotation by the armature 47.

By the way, when the operative field to be observed by the operator reaches the deep inside of the body cavity, even if the observation position and the observation direction are changed by operating the arms 21, 23 and 24, the microscopic incision H causes eclipse. Blind spots that cannot be observed with a microscope appear such as the inner surface and the back of blood vessels inside. In this case, the operator
In order to observe the remaining tumor and the clipping state of the aneurysm, the blind spot is observed using the rigid endoscope 32.

When observing a blind spot using the rigid endoscope 32, first, the endoscope mounting adapter 28 is moved from the storage position to the observation position. When the endoscope mounting adapter 28 is moved from the storage position to the observation position, the micro switch 29, which has been pressed by the endoscope mounting adapter 28 until then, is switched from the ON state to the OFF state, and the state is fixed by a cable (not shown). It is transmitted to the control unit built in 20.

In the control unit, the micro switch 29 is turned on.
When the FF state is detected, the current supply to the electromagnetic brakes provided in the rotating parts of the shafts a, b, and d to f is stopped regardless of the state of a switch (not shown) installed in the grip 26. Then, each arm 21, 24 and the mirror body 2
Lock 5 At this time, the electromagnetic brake 43 installed on the shaft c is electromagnetically controlled by the ON / OFF state of the switch (not shown) installed on the grip 26 regardless of the ON / OFF state of the micro switch 29. Further, when the micro switch 29 is turned off in this way, current is supplied to the electromagnetic clutch 46 of the shaft c to which no current has been supplied, and the armature 47 that was free until then is attracted to the electromagnetic clutch 46 and locked. To be done. Therefore, the gear 49 connected to the armor chair 47 via the spring 52 is also locked.
As a result, the arm shaft 40 cannot rotate in the clockwise direction where the claw 50 and the gear 49 mesh with each other, but can rotate only in the counterclockwise direction. That is, the pantograph arm 23 can rotate only in the upward direction and cannot rotate in the downward direction.

In this state, the operator moves the endoscope mounting adapter 28 to the observation position, operates the knob 33 to free the ball joint 30, and adjusts the observation direction of the rigid endoscope 32. Next, the operator operates the operation weight adjusting handle 34 attached to the guide 31 to move the guide 3
The rigid endoscope 32 is slid up and down along 1 to guide it to a desired observation position, and the blind spot portion is observed by the rigid endoscope 32.

At this time, even if the operator / assistant or other observer mistakenly turns on the switch provided on the grip 26, as described above, the axes a, b,
Since no current is supplied to the electromagnetic brakes provided on the rotating parts of the shafts d to f, the arms 21 and 24 and the mirror 25
Holds its locked state. Further, in this case, in the shaft c, the armature 45 is brought into a free state by supplying a current to the electromagnetic brake 43 by the ON operation of the switch.
Since the current supply to 6 is continued, it remains locked. Therefore, the gear 49 connected to the armature 47 via the spring 52 is also in the locked state. That is, the pantograph arm 23 still rotates only in the upward direction, but cannot rotate in the downward direction.

As described above, in the surgical microscope 1 of this embodiment, when the endoscope mounting adapter 28 having the rigid endoscope 32 mounted is placed at the observation position, the arm (pantograph arm 23) that supports the mirror body 25. Since the rotation direction of the rigid endoscope 32 is limited only to the upward direction, the distal end of the rigid endoscope 32 is erroneously operated by the erroneous operation of the surgical microscope 1 at the time of observing the endoscope in which the rigid endoscope 32 projects from the body 25 and when the endoscope is introduced. Therefore, there is no possibility of damaging the affected area P.

Further, in this embodiment, the means (micro switch 29) for detecting the observation state by the rigid endoscope 32 is provided in the endoscope mounting adapter 28. However, the rigid endoscope is provided in the guide portion 31 in which the rigid endoscope 32 is fitted. A detection means for detecting the protrusion amount of the insertion portion of 32 may be provided, and the movement of the arm may be limited based on the detection result. That is, for example, as shown in FIG. 6, the photo interrupter 61 is provided in the guide 31 provided at the tip of the endoscope attachment adapter 28, and the light shielding plate 60 is provided in the insertion portion of the rigid endoscope 32.

In this case, the light blocking plate 60 does not block the photo interrupter 61 when the insertion portion of the rigid endoscope 32 is sufficiently retracted (when the projection amount from the mirror body 25 is small), and the rigid endoscope 32 is inserted. It is provided at a position that blocks the photo interrupter 61 when the part is located in the observation state in which it largely projects from the mirror body 25. The photo interrupter 61
Is connected to a control unit (not shown) built in the gantry 20.

Therefore, in this configuration, when the rigid endoscope 32 is fully retracted and the photo interrupter 61 is not shielded by the light shielding plate 60,
When a switch (not shown) provided on the grip 26 is pressed, electric current is supplied to the electromagnetic brakes provided on the shafts a to f, and the arms are brought into a free state. Therefore,
The mirror body 25 can be moved to a desired position.

When the rigid endoscope 32 is lowered along the guide 31 and positioned in the observing state, the photo interrupter 61 is blocked by the light blocking plate 60, so that the control unit built in the gantry 20 causes the photo interrupter 61 to operate. Is detected, and the movement of the arm is limited only to the upward direction of the axis c as in the above-described embodiment.

Further, in the present embodiment, the rigid endoscope is used as the additional observation means, but the same effect as in the above-mentioned embodiment can be obtained by using the mirror instead of the rigid endoscope. Further, in the present embodiment, the drive of the arm supporting the mirror body 25 and the rigid endoscope 32 is limited by detecting whether the rigid endoscope 32 is located at the observation position or the storage position. It is also possible to provide a proximity sensor or a contact sensor at the tip of 32 and limit the drive of the arm by the output thereof. For example, an ultrasonic sensor is provided at the tip of the rigid endoscope 32, the distance between the rigid endoscope 32 and the affected area P is detected by this ultrasonic sensor, and the movement of the arm is limited when the value approaches a predetermined distance. . Alternatively, the rigid scope 3
A touch sensor is provided at the tip of No. 2, and the touch sensor detects when the tip of the endoscope comes into contact with any object, and limits the movement of the arm only in the upward direction of the axis c as in the above-described embodiment. To do. It is obvious that this method can also obtain the same effect as that of the above-described embodiment.

As described above, when the ultrasonic sensor or the touch sensor is used, the rough orientation setting work of the rigid endoscope 32 can be performed by driving the arm of the surgical microscope 1, so that workability is improved. There is an effect that it is improved and the operation time can be shortened.

Further, when the ultrasonic sensor or the touch sensor is provided in this way, it is possible to easily detect the approaching direction or the contacting direction of the affected area. By displaying it, it becomes possible for the operator to recognize the danger in advance.

Further, a display for informing the operator that the movement of the arm is restricted may be provided within the field of view of the microscope or on the monitor. Further, the operator may be notified by sound that the movement of the arm is restricted. As a result, the operator can proceed with the operation smoothly, and there is an effect that fatigue is reduced.

7 and 8 show the second embodiment of the present invention. In the conventional configuration of FIG. 11 introduced at the beginning of this specification, if the angle operation of the tip of the fiberscope 118 is performed by an operating means (not shown) (for example, the eyepiece of the fiberscope 72), both hands are closed, It is difficult to carry out treatment. Further, even if the fiberscope 118 having the electric angle mechanism is used, the operation of the switch at hand is still unchanged, and the same problem occurs. Further, even when operating the electric angle mechanism with a foot switch or the like, it is a troublesome work to identify the electric angle mechanism from among a large number of foot switches in addition to the foot switch of the surgical microscope. Moreover, when an endoscope with an adjusting mechanism such as aiming, zooming, and dimming is used, it is necessary to adjust them in parallel with observation of a surgical microscope, which is very troublesome. It is a thing.

Therefore, the purpose of this embodiment is to provide the input means of the electric drive section of the surgical microscope 25 which is the first observation means and the input means of the electric drive section of the fiberscope which is the second observation means. It is to make them the same and to improve the operability of both.

FIG. 7 is an overall configuration diagram of the surgical microscope 1'of the present embodiment, and FIG. 8 is a block diagram of a control unit provided in the frame 20 of the surgical microscope 1 '. The same members as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted.

As shown in FIG. 7, one end of a horizontal arm 21 is attached to the upper end of the gantry 20 of the surgical microscope 1'rotatably about the axis a. The other end of the horizontal arm 21 is connected to the pantograph arm 23 via the member 22.
Has one end rotatably attached. In this case, the pantograph arm 23 can rotate about an axis b (vertical axis) and an axis c (horizontal axis) orthogonal to each other, as shown in the figure.

Further, a mirror 25 is attached to the other end of the pantograph arm 23 via an XY drive unit 80 so as to be rotatable about a vertical axis d. A grip 26 is attached to the side surface of the mirror body 25. When a switch (not shown) provided on the grip 26 is operated, an electromagnetic brake (not shown) built in the shafts a, b, c and d is activated, The fact that the mirror body 25 can be arranged at a desired position in the three-dimensional space is the same as in the first embodiment described above.

A grasping arm 75 is attached to the lower end of the mirror body 25, and the endoscope inserting hole 75a of the grasping arm 75 is attached.
A fiberscope 72 is inserted in the. The grip arm 75 is slidable between an observation position shown and a storage position not shown. Although not shown in FIG. 7, a micro switch 87 (see FIG. 8) that is pressed only when the gripping arm 75 is stored in the storage position is provided.

Further, the tip of the fiberscope 72 excluding the angle portion 73 is held by the endoscope tip holding arm 71 and the endoscope tip holder 74 provided on the gripping arm 75. The fiberscope 72 has an electric angle mechanism (not shown), and the control unit 91 (see FIG. 8) of this electric angle mechanism is built in the gantry 20.

A foot switch 81 is connected to the gantry 20. The foot switch 81 is provided with seesaw switches 83 and 84 for operating a focus mechanism (not shown) and a zoom mechanism (not shown) provided on the mirror body 25, and a joystick switch 85 for operating the XY drive device 80. ing. Each control unit 8 that controls the focus mechanism, the zoom mechanism, and the XY drive device 80.
8, 89 and 90 are built in the gantry 20 (see FIG. 8).

As shown in FIG. 8, the seesaw switch 83 for operating the focus mechanism is directly connected to the focus mechanism control section 88 built in the gantry 20, and is used for operating the zoom mechanism. The seesaw switch 83 is also directly connected to the zoom mechanism control unit 89 incorporated in the gantry 20.

The joystick switch 85 for operating the XY drive device 80 is connected to the switching circuit 86 built in the gantry 20, and the XY drive device control section 90 is connected to the normally closed side terminal of the switching circuit 86. It is connected. In addition, the electric angle mechanism control unit 91
Is connected to the normally open side terminal of the switching circuit 86. Further, the signal output of the micro switch 87 provided on the mirror body 25 is input to the switching circuit 86.

Next, the operation of the surgical microscope 1'having the above configuration will be described. First, the operator approaches the affected area using the surgical microscope 1 '. At that time, the surgeon
By gripping the grip 26 provided on the mirror body 25 and operating a switch (not shown) provided on the grip body 26, the axes a to d are freed, and the mirror body 25 is roughly positioned with respect to the observation point of the affected area. Perform proper alignment. This point is similar to the first embodiment. Further, the surgeon is required to operate the seesaw switches 83, 84 provided on the foot switch 81.
Use to change the focusing and observation magnification.

When the field of view is delicately moved, the joystick switch 85 provided on the foot switch 81 is used.
To operate. At this time, since the gripping arm 75 holding the fiberscope 72 is in the storage position, the microswitch 87 is in a pressed state, and its signal is input to the switching circuit 86 built in the gantry 20.
In this state, the contact of the switching circuit 86 is connected to the normally closed side, so that the joystick switch 85 is connected to the XY drive device controller 90. Therefore, when the operator operates the joystick switch 85, a control signal is sent to the XY drive device controller 90, and the XY drive device 80 is driven in the direction desired by the operator, so that the field of view can be delicately moved. Become.

Blind spots (such as deep inside the body cavity) that cannot be observed by the microscope 25 are observed by the fiber scope 72. In this case, first, the gripping arm 75 is moved from the storage position to the observing position shown in the drawing.
The micro switch 87 installed in No. 5 is opened, and the signal is input to the switching circuit 86 built in the gantry 20. Upon receiving this input signal, the switching circuit 86 switches the contact to the normally open side. Therefore, the joystick switch 85 is connected to the electric angle mechanism controller 91.

In this state, the operator operates the endoscope tip holding arm 71 to insert the tip portion of the fiberscope into the body cavity and observe the blind spot. When the operator wants to change the observation direction of the fiberscope 72, the joystick switch 85 is operated to send a control signal to the electric angle mechanism control unit 91. As a result, the angle portion 73 of the fiberscope 72 is driven in the direction desired by the operator, and the observation direction is changed.

When the gripping arm 75 is arranged at the observation position as described above, the driving of the horizontal arm 21 and the pantograph arm 23 is restricted in the same manner as in the first embodiment, and in addition, XY The driving of the driving device 80 is also prohibited.

As described above, in addition to the effects of the first embodiment, the surgical microscope 1'of the present embodiment has the XY drive device 8 during observation by the fiberscope 72.
Since 0 is separated from the joystick switch 85, there is no risk of erroneous operation of the XY drive device 80, and there is an effect that safety is further improved.

In addition, the surgical microscope 1'of the present embodiment has a microscope observing body 25 which is a first observing means and a second observing means for observing a blind spot which cannot be observed by the microscope observing body 25. With barrel fiberscope 72,
Further, a control unit 90 of an XY drive device 80 which is an electric field of view moving device of the microscope body 25, an electric angle control unit 91 which is an electric field of view moving device of the fiberscope 72,
A joystick switch 85, which is a common input means for outputting an operation signal to the XY drive device control unit 90 and the electric angle control unit 91, and selectively outputs the operation signal to the XY drive device control unit 90 or the electric angle control unit 91. Therefore, the operability is remarkably better than that of the configuration in which the switch provided in the eyepiece of the fiberscope 72 is operated.

Further, since the operating means 85 for operating the XY drive unit 80 of the microscope body 25 and the electric angle of the fiberscope 72, which have the same function in terms of the field-of-view moving mechanism, are integrated into one switch, that is, Since both of them can be operated by one joystick switch 85, the operator can operate them without feeling uncomfortable. In addition, when using the fiberscope 72, it is not necessary to newly provide a switch, so that the system can be configured at low cost. Further, the method of sharing the same function with one switch is applied not only to the visual field moving mechanism but also to a zooming mechanism, a focusing mechanism, an exposure mechanism of a photographing device, a dimming mechanism of a lighting device, and the like. Is also good.

Further, if the seesaw switch 83 and the seesaw switch 84 are also used for operations such as air supply / water supply / suction of the fiberscope 72 by the same method, more efficient observation can be performed. become.

FIG. 9 shows a third embodiment of the present invention. The same members as those in the first and second embodiments are designated by the same reference numerals and the description thereof will be omitted. As shown in the figure, the mirror body 25 includes an objective lens 64, a pair of zoom optical systems 62, 62, and a pair of half mirrors 79, 7.
9, a pair of imaging lenses 78, 78, and a pair of eyepieces 77, 77, which constitute a stereoscopic optical system. A TV adapter 96 is connected to an arbitrary side surface of the mirror body 25, and the TV adapter 96 receives reflected light from the half mirrors 79, 79 incorporated in the mirror body 25.

The TV adapter 96 has a built-in mirror 76. This mirror 76 is usually a half mirror 7.
It is set at a position where the reflected light from 9, 79 is reflected upward in the TV adapter 96. An imaging lens 65 and a TV camera 98 are attached to the upper surface of the TV adapter 96, and an image pickup device (not shown) of the TV camera 98 is positioned at the imaging position of the imaging lens 65.

The mirror 76 built in the TV adapter 96 operates a mirror operation knob 97 fixed to the mirror 76 between a normal position shown by a solid line in the figure and an endoscope observation position shown by a broken line in the figure. By doing so, it is possible to rotate about the shaft 99 as a fulcrum. A micro switch 95 is attached inside the TV adapter 96.
The micro switch 95 is positioned so as to be pressed only when the mirror 76 is set to the endoscope observation position.

A fiberscope 72 is attached to the lower surface of the TV adapter 96, and the observation optical axis (not shown) of the fiberscope 72 coincides with the optical axis (not shown) of the imaging lens 65. The tip of the fiberscope 72 is held by the endoscope tip holding arm 71 and the endoscope tip holder 74.

A pump 93 is connected to the fiberscope 72, and a physiological saline container 94 is attached to the pump 93. Further, the drive of the pump 93 is controlled by the pump control unit 92.

A half mirror 66 is provided in front of the light source 67. The half mirror 66 can be located on the optical axis of the light source 67 (shown by the solid line in the figure), and
It can be moved to a position deviated from the optical axis (shown by a broken line in the figure). That is, the light source 67 can be moved substantially perpendicular to the optical axis. Therefore, half mirror 6
6 is a half mirror control unit 59 for controlling the moving operation.
Is connected.

Part of the light from the light source 67 is the half mirror 6.
After passing through 6, the light enters the light guide 63 and is guided to an affected part (not shown) via the mirror body 25. Half mirror 66
The light from the light source 67 reflected by the
The light is input to a light guide (not shown) of the fiberscope 72 and guided to the tip of the fiberscope 72. The diaphragm 68 is connected to the diaphragm control unit 69.

The foot switch 81 includes a switching circuit 86.
It is connected to the. The normally closed terminal of the switching circuit 86 is connected to the focus mechanism control unit 88, the zoom mechanism control unit 89, and the XY drive device control unit 90 built in the gantry 20. The normally open terminal of the switching circuit 86 is connected to the electric angle control unit 91, the pump control unit 92, the half mirror control unit 59, and the diaphragm control unit 69. Further, the micro switch 95 is connected to the switching circuit 86 and an arm control unit (not shown) built in the gantry 20. The arm control unit controls the drive of the rotating unit of the arm (the arms shown in the first and second embodiments) that supports the mirror body 25.

Next, the operation of the surgical microscope having the above structure will be described. First, the operator observes the affected area via the microscope scope 25. At this time, all of the observation light emitted from the light source 67 enters the light guide 63, is guided to the mirror body 25, and is projected from the mirror body 25 to an affected part (not shown). The reflected light from the affected part enters the mirror body 25 through the objective lens 64 and reaches the half mirror 79 through the zoom optical system 62. 50% of the incident light that has entered the half mirror 79 is directly transmitted upward, and the remaining 50%.
% Is reflected in the lateral direction of the mirror body 25. Half mirror 7
The observation light transmitted above 9 is imaged by the imaging lens 78. Therefore, the operator can observe the image as a stereoscopic image by enlarging the image with the eyepiece lens 77.

The observation light reflected to the side of the half mirror 79 enters the TV adapter 96 and then enters the mirror 76.
Is reflected on the image forming lens 65, that is, the TV camera 98.
An image is formed on an image pickup element (not shown) built in the. That is, the same image as the microscope image observed by the operator is projected on the monitor (not shown). At this time, TV adapter 9
Since the micro switch 95 built in 6 is in an open state, this signal is input to the switching circuit 86. In this state, the contact of the switching circuit 86 remains connected to the normally closed side, so that the foot switch 81 has the focus mechanism control unit 88, the zoom mechanism control unit 89, and the XY drive device control unit 90 built in the gantry 20.
The operator can operate the focus drive unit, the zoom drive unit, and the XY drive device 80 (not shown) using the foot switch 81. Furthermore, the mirror body 2
An arm (not shown) that supports 5 can also be moved to any position in the three-dimensional space.

Next, when the operator observes the blind spot of the microscope using the fiberscope 72, the endoscope tip holding arm 71 is operated to position the tip of the fiberscope 72 at a desired observation position. Next, TV adapter 9
6 is operated to set the mirror 76 to the endoscopic observation position (the position shown by the broken line in the figure). As a result, the micro switch 95 built in the TV adapter 96 is pressed, and the signal thereof is input to the switching circuit 86. The switching circuit 86 switches the contact to the normally open side when receiving the signal that the micro switch 95 is pressed. As a result, the foot switch 81 is separated from the control units 88, 89, 90 of the microscope, and the electric angle control unit 91 and the pump control unit 9 are separated.
2, the half mirror control unit 59 and the diaphragm control unit 69, respectively.

When the half mirror controller 59 is connected to the foot switch 81, the half mirror 66 is moved along the optical axis. Therefore, the observation light that has been incident on the mirror body 25 becomes 50%, and the remaining illumination light is incident on the fiber scope 72. The illumination light that has entered the fiberscope 72 is emitted from the tip of the fiberscope 72 by a light guide unit (not shown), and observation by the fiberscope 72 is possible.

At this time, the operator sends a signal to the diaphragm control section 69 by operating the foot switch 81, and sets the diaphragm 68 provided on the illumination optical path of the fiberscope 72 to the observation site and the operator's preference. It is possible to control them together. Further, as in the second embodiment, it is possible to change the angle angle of the fiberscope 72 using the foot switch 81 via the electric angle control unit 91. Furthermore, a pump control unit 92 is provided by a foot switch.
It is also possible to send a signal to and perform work such as water supply / suction. Also in the case of the present embodiment, when the fiberscope 72 is in the observation state, the movement of the arm is restricted as in the first embodiment.

As described above, the surgical microscope of the present embodiment has the same effects as those of the first and second embodiments, and the image of the microscope 25 as the first observation means and the second image. Since it has the detection means 95 for detecting that the image of the fiberscope 72, which is the observation means, is switched, the arm can be easily locked with the output of the detection means 95.

Further, the surgical microscope of the present embodiment is operated by the detecting means 95, and switching is performed so that all operations relating to the endoscope such as light amount adjustment, water feeding, suction and the like can be performed by the foot switch 81 of the microscope. Since the operator has the means 86, the operator can operate the fiberscope 72 during endoscopic observation.
Since there is no need to hold the both hands, both hands can be devoted to surgery, which greatly improves the efficiency of surgery. Further, even when the fiberscope 72 is not used for observation, it is possible to perform water supply / suction by a simple operation using the foot switch 81 by the operator himself / herself.

The configurations described above can provide various configurations shown in the following paragraphs. 1. First observation means for observing the object to be inspected, second observation means for making at least one optical element of the optical system of the first observation means non-common, and first and second observations A detecting means for detecting that the second observing means is in an observable state in a surgical microscope having a holding means for movably holding the means in an arbitrary position and direction in a three-dimensional space, and the detecting means. And a limiting means for limiting the movement of the holding means based on the detection information from the surgical microscope.

2. 2. The surgical microscope according to claim 1, wherein the second observing means is used by protruding toward the object side with respect to the first observing means when observing the object.

3. The limiting means limits the movement of the holding means so that when the second observing means is in the observable state, the second observing means can move only in a direction substantially opposite to the protruding direction thereof. The surgical microscope according to item 2, wherein:

4. A first observation means for observing the object to be inspected,
In a surgical microscope having a second observing means capable of observing a blind spot that cannot be observed by the first observing means, a first control section for controlling an electric drive section of the first observing means, A second control unit that controls the electric drive unit of the second observation unit, an operation signal output unit that outputs an operation signal to the first control unit and the second control unit, and the operation signal An operating microscope, comprising: an output selecting unit for selectively outputting to one control unit or the second control unit.

In the construction of the fourth term, when the first observation means is used, the operation signal output means is connected to the first control means and the second observation means is used. In this case, the operation signal output means is connected to the second control means.

5. An electric drive unit of the first observation means,
The surgical microscope according to the fourth aspect, wherein the electric drive unit of the second observation means has the same function. 6. The electric drive unit of the first observing unit and the electric drive unit of the second observing unit include a visual field moving mechanism, a magnification changing mechanism, a focusing mechanism, an exposure mechanism of a photographing device, and a light adjusting mechanism of a lighting device. 5. The surgical microscope according to item 4, which is any one of the above.

7. It has a detection means for detecting which one of the first observation means and the second observation means is in the observation state, and the output selection means outputs the operation signal based on the detection information from the detection means. Item 5 or 6, wherein the output destination of the operation signal from the means is selected.
The surgical microscope according to the item.

According to the above construction, since the first and second observation means can be controlled by the same input means, not only the system can be constructed at low cost, but also the efficiency of surgery can be greatly improved.

[0100]

As described above, in the surgical microscope of the present invention, the movement of the holding means for holding the second observing means is limited when the second observing means is in the observable state. The risk of damaging the patient can be avoided by the operator's careless manipulation of the microscope. In addition, since the safety of the operation is significantly improved, the operator can concentrate on the operation work and the operation efficiency is significantly improved.

[Brief description of drawings]

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

FIG. 2 is an enlarged perspective view of a body portion of the surgical microscope of FIG.

FIG. 3 is a perspective view showing details of an adapter provided on a lower portion of a mirror body of the surgical microscope of FIG.

4 is a perspective view showing a rotating mechanism of a pantograph arm of the surgical microscope of FIG.

5 is a front view of a bearing provided in the rotating mechanism of FIG. 4. FIG.

FIG. 6 is a schematic view showing a detection means for detecting the protruding state of the rigid endoscope.

FIG. 7 is an overall configuration diagram of a surgical microscope according to a second embodiment of the present invention.

8 is a block diagram of a control unit provided in a gantry 20 of the surgical microscope of FIG.

FIG. 9 is an overall configuration diagram of a surgical microscope according to a third embodiment of the present invention.

FIG. 10 is a main part configuration diagram showing a conventional example of a surgical microscope.

FIG. 11 is a main part configuration diagram showing another conventional example of a surgical microscope.

[Explanation of symbols]

1 ... Surgical microscope 21, 23, 24 ... Arm (holding means), 25 ... Mirror body (first observation means), 29 ... Micro switch (detection means), 32 ... Hard endoscope (second observation means) .

Claims (1)

[Claims] 1. A first observing means for observing an object to be inspected, a second observing means for making at least one optical element of an optical system of the first observing means non-common, Second
In the surgical microscope having a holding means for movably holding the observing means of 3) in an arbitrary position and direction of the three-dimensional space, a detecting means for detecting that the second observing means is in an observable state, A surgical microscope comprising: a limiting unit that limits the movement of the holding unit based on the detection information from the detecting unit.