WO2016208485A1 - 手術用顕微鏡装置及び手術用顕微鏡システム - Google Patents
手術用顕微鏡装置及び手術用顕微鏡システム Download PDFInfo
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- WO2016208485A1 WO2016208485A1 PCT/JP2016/067937 JP2016067937W WO2016208485A1 WO 2016208485 A1 WO2016208485 A1 WO 2016208485A1 JP 2016067937 W JP2016067937 W JP 2016067937W WO 2016208485 A1 WO2016208485 A1 WO 2016208485A1
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- arm
- microscope
- unit
- length
- support
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/20—Surgical microscopes characterised by non-optical aspects
- A61B90/25—Supports therefor
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/0004—Microscopes specially adapted for specific applications
- G02B21/0012—Surgical microscopes
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- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/24—Base structure
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B7/00—Mountings, adjusting means, or light-tight connections, for optical elements
- G02B7/001—Counterbalanced structures, e.g. surgical microscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/373—Surgical systems with images on a monitor during operation using light, e.g. by using optical scanners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
- A61B2090/5025—Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism
- A61B2090/504—Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism with a counterweight
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
- A61B2090/506—Supports for surgical instruments, e.g. articulated arms using a parallelogram linkage, e.g. panthograph
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/36—Microscopes arranged for photographic purposes or projection purposes or digital imaging or video purposes including associated control and data processing arrangements
- G02B21/362—Mechanical details, e.g. mountings for the camera or image sensor, housings
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/36—Microscopes arranged for photographic purposes or projection purposes or digital imaging or video purposes including associated control and data processing arrangements
- G02B21/368—Microscopes arranged for photographic purposes or projection purposes or digital imaging or video purposes including associated control and data processing arrangements details of associated display arrangements, e.g. mounting of LCD monitor
Definitions
- the present disclosure relates to a surgical microscope apparatus and a surgical microscope system.
- a microscope apparatus for magnifying and observing a surgical site has been used in a surgical operation that targets a fine region such as neurosurgery.
- the microscope apparatus is configured such that a microscope unit is supported by an arm unit (support unit) (for example, Patent Documents 1 and 2).
- the microscope apparatus Since the surgical part can be a very small area, the microscope apparatus is required to be able to adjust the position of the microscope part with high accuracy in order to observe the position desired by the operator. Therefore, as exemplified by the microscope apparatuses described in Patent Documents 1 and 2, the support unit that supports the microscope unit is often configured as a balance arm having a counterweight (counter balance). By configuring the support portion as a balance arm, the surgeon can move the microscope unit as if he / she was operating under zero gravity, and the operability of the surgeon can be improved.
- the microscope part of the microscope apparatus described in Patent Documents 1 and 2 is an optical type, and the operator directly looks into the eyepiece provided in the microscope part and observes the surgical part.
- a style hereinafter referred to as an overhead style
- an optical microscope apparatus for convenience
- the structure of the support unit is designed on the assumption that it is used in an overhead style
- a microscope apparatus that includes an imaging element and an electronic imaging microscope unit that can electronically image a surgical part.
- a microscope apparatus including an electronic imaging microscope unit hereinafter also referred to as an electronic imaging microscope apparatus for the sake of convenience
- an image of the surgical part taken by the microscope unit is displayed on a display device installed in the operating room. The surgeon performs the operation while observing the image of the surgical part displayed on the display device.
- the electronic imaging microscope section is not required to have an eyepiece or the like, and is therefore smaller and lighter than the optical microscope section.
- the eyepiece unit must be located at a position accessible by the operator, so that the movable range required for the microscope unit is substantially limited.
- the microscope section requires a wider range of motion so that the surgical site can be imaged from all directions.
- the support unit and the microscope unit may be arranged so as not to obstruct the view of the operator who observes the display device as much as possible. Desired.
- the configuration of the microscope unit, the movable range required for the support unit, the usage mode, and the like are different between the electronic imaging microscope device and the optical microscope device. Therefore, even if the configuration of the support portion in the optical microscope apparatus designed on the assumption of use in the overhead style is applied to the electronic imaging microscope apparatus as it is, the configuration is not necessarily suitable for the electronic imaging microscope apparatus. Not necessarily.
- a new and improved surgical microscope apparatus and surgical microscope system capable of further improving the convenience of the operator by providing a support unit more suitable for an electronic imaging microscope apparatus. Propose.
- a microscope unit that images a surgical part of a patient on an operating table and outputs a video signal
- a support unit that supports the microscope unit at a distal end, the support unit from the distal end side
- the first arm the second arm that supports the base end of the first arm at the tip so as to be rotatable about a first rotation axis that is orthogonal to the vertical direction and the front-rear direction, and a substantially vertical direction from the floor surface
- a column portion that supports the proximal end of the second arm at the distal end so as to be rotatable around a second rotation axis that is orthogonal to the vertical direction and the front-rear direction.
- the support portion is arranged such that the length of the second arm, which is the length between the first rotation shaft and the second rotation shaft, is substantially vertical to the optical axis of the microscope portion. Between the optical axis of the microscope section and the first rotation axis Configured to be longer than the length of said first arm is a length of surgical microscope apparatus is provided.
- a microscope device including a microscope unit that images a surgical part of a patient on an operating table and outputs a video signal, and a support unit that supports the microscope unit at a distal end, and the video signal
- a display device that displays an image based on the first rotation of the support unit in order from the distal end side, and a first rotation of the first arm at the distal end perpendicular to the vertical direction and the front-rear direction.
- a second arm that is pivotally supported about an axis, and extends substantially vertically from the floor surface, and has a proximal end of the second arm at a distal end around a second rotation axis that is perpendicular to the vertical direction and the front-rear direction.
- the second arm having a length between the first rotation shaft and the second rotation shaft when the support portion is considered to be configured by a support portion rotatably supported.
- the optical axis of the microscope section is almost vertical
- a surgical microscope system configured to be longer than a length of the first arm, which is a length between the optical axis of the microscope unit and the first rotation axis when arranged to be Provided.
- the support portion of the surgical microscope apparatus is configured such that the length of the second arm is longer than the length of the first arm. Therefore, when photographing the surgical site with the microscope during surgery, it is possible to secure a wider movable range in the vertical direction of the microscope while keeping the first arm substantially horizontal.
- an image of the surgical site taken by the microscope is displayed on a display device installed in the operating room, and the surgeon observes the video of the surgical site displayed on the display device. Since the operation is performed while the first arm is held substantially horizontally, the operator's work space and the operator's field of view are secured, and the convenience of the operator can be further improved.
- FIG. 5 is an explanatory diagram for explaining a range of a maximum value r 2max of a rotation angle r 2 of the second arm with respect to the support column shown in FIG. 4. It is explanatory drawing for demonstrating the horizontal required reach distance (WH) in an electronic imaging type microscope apparatus. It is explanatory drawing for demonstrating the perpendicular
- the microscope apparatus mainly includes a microscope section, a support section that supports the microscope section at the tip, and a base section that supports the base end of the support section.
- directions are defined as follows. That is, in the following description, a direction perpendicular to the floor surface on which the microscope apparatus is installed is defined as the z-axis direction.
- the z-axis direction is also referred to as the vertical direction or the vertical direction.
- a direction perpendicular to the z-axis direction and extending in the support portion as viewed from the base portion is defined as an x-axis direction.
- the x-axis direction is also referred to as the front-rear direction. Furthermore, a direction orthogonal to the x-axis direction and the z-axis direction is defined as a y-axis direction. It can be said that the y-axis direction is a direction orthogonal to the vertical direction and the front-rear direction. A direction parallel to the xy plane is also referred to as a horizontal direction.
- the side on which the microscope unit is provided is also referred to as the distal end side or the distal end portion, and the side closer to the base portion is the proximal end side or proximal end portion.
- the support portion is divided into three parts, a first arm, a second arm, and a support portion, for convenience ( (Refer also to FIG.
- the first arm is a part located on the most distal side among these parts.
- a microscope unit is provided on the distal end side of the first arm.
- the proximal end of the first arm is supported by the distal end of the second arm so as to be rotatable around a first rotation axis that is parallel to the y-axis (that is, perpendicular to the vertical direction and the front-rear direction).
- the first arm is a portion between the optical axis of the microscope unit and the first rotation axis when the microscope unit is arranged so that the optical axis of the microscope unit is substantially vertical.
- the column portion is the most proximal portion of the support portion, extends in a substantially vertical direction from the floor surface, and at the distal end, the proximal end of the second arm is parallel to the y-axis (that is, the vertical direction and the front-rear direction are mutually opposite). It is supported so as to be rotatable about a second rotation axis (perpendicular).
- the second arm is a part located between the first arm and the support column. It can be said that the second arm is a portion between the first rotation axis and the second rotation axis.
- the second rotation axis between the support column and the second arm and the first rotation axis between the second arm and the first arm are both in the y-axis direction, that is, the vertical direction and the front-rear direction. Since the directions are orthogonal, the rotation angle of the second arm with respect to the column portion on the second rotation axis and the rotation angle of the first arm with respect to the second arm on the first rotation axis are controlled, so that The position of the microscope unit in the (xz plane) is determined. Further, the length (H) of the first arm (that is, the distance (H between the optical axis of the microscope unit and the first rotation axis when the optical axis of the microscope unit is arranged so as to be substantially vertical). )), The length (V) of the second arm (that is, the distance (V) between the first rotation shaft and the second rotation shaft and the length (T) of the support column) The movable range of the microscope unit is determined.
- the length (H) of the first arm, the length (V) of the second arm, and the length (T) of the support column are important parameters indicating the structure of the support unit and the movable range of the microscope unit. It is. Therefore, in the following, it is assumed that the support portion is constituted by the first arm, the second arm, and the support column portion, and the configuration of the support portion will be described with particular attention to the lengths of these three portions. In the following description, for convenience, the name “length of the support column (T)” is used, but the length (T) is actually the length from the floor surface to the second rotation axis. That is, it means the length of the support column including the base.
- FIG. 1 is a diagram showing a state of surgery using an existing optical microscope apparatus.
- a surgeon 820 is performing a surgical operation on a patient 830 lying on an operating table 840 using a microscope apparatus 810.
- the microscope apparatus 810 is an optical microscope apparatus, and an optical microscope section 801 for magnifying and observing a patient's surgical part (head in the illustrated example), and a support part 803 that supports the microscope part 801 at the tip. And a base portion 805 that supports the base end of the support portion 803.
- the support portion 803 is configured as a balance arm having a counterweight.
- the microscope unit 801 is directed toward the surgical site of the patient 830 during surgery, and the operator 820 looks into the eyepiece of the microscope unit 801 and is magnified by the microscope unit 801 to an appropriate magnification. Operate while directly observing the image of the surgical site.
- the optical microscope unit 801 since the optical microscope unit 801 has a configuration such as an eyepiece unit, the optical microscope unit 801 is larger and heavier than an electronic imaging microscope unit described later. Therefore, in order to support the microscope unit 801, the support unit 803 is also increased in size and weight. Since the weight of the counterweight is designed so that the balance of the support portion 803 is maintained as a whole, when the support portion 803 is enlarged, the counterweight is also enlarged in order to maintain the balance. The entire device becomes larger.
- the microscope apparatus 810 is preferably arranged at a position where the base portion 805 is further away from the operating table 840, and from that position, the support portion 803 passes over the operator 820 and the operating table 840 is placed. It can be configured to stretch to the vicinity. That is, as shown in the figure, the microscope apparatus 810 is mainly used in a style in which the operator 820 enters under the support part 803 and observes the surgical part, that is, an overhead style.
- the support portion 803 is configured so that the first arm 807a is relatively long so that the operator 820 can enter under the support portion 803. If the first arm 807a is long, the weight of the first arm 807a increases accordingly, so that the counterweight is further increased in size and the entire apparatus is further increased in size.
- the optical microscope apparatus 810 it is necessary to increase the size of the support unit 803 in order to support the optical microscope unit 801 and to enable use in an overhead style. . As a result, since the counterweight is also increased, the configuration of the entire apparatus tends to be increased.
- the movable range of the microscope unit 801 (the range that the microscope unit 801 can reach) depends on the length of the first arm 807a, the length of the second arm 807b, and the length of the support column 807c. If the length of the second arm 807b is increased in order to ensure it, the structure of the support portion 803 will become larger and the counterweight will become very large. Therefore, in the microscope apparatus 810, the second arm 807b is configured to be relatively short and the height direction (z-axis direction) in order to achieve both the securing of the movable range of the microscope unit 801 and the reduction of the counterweight. ) Has a relatively long support portion 807c.
- the length of the first arm 807 a is H
- the length of the second arm 807 b is V
- the column portion according to a request from the configuration and usage of the microscope unit 801.
- the support portion 803 is configured to satisfy “H> V and T> V” or “H> T> V”.
- the operator looks into the eyepiece provided in the microscope unit 801 and observes the surgical part. Therefore, the posture of the operator at the time of observation depends on the position of the eyepiece (that is, the microscope The posture of the portion 801).
- the operator also needs to change the posture in accordance with the change in the posture of the microscope unit 801, and it cannot be said that the convenience is high.
- the observable range is practically limited, and is required from the microscope. The movable range was also limited.
- the image of the surgical part taken by the microscope part is displayed on a display device installed in the operating room, and the surgeon displays the image of the surgical part displayed on the display unit. Operate while observing. Therefore, there is no restriction on the relative positional relationship between the surgeon and the microscope section, and the surgical section can be observed from all angles, and the surgeon can observe the surgical section in a more comfortable posture. it can. Thus, according to the electronic imaging microscope device, the convenience of the operator can be further improved.
- the structure of the support part suitable for the electronic imaging microscope apparatus is not necessarily the same as the support part 803 in the optical microscope apparatus 810 described above.
- the size can be greatly reduced as compared with the optical microscope unit 801. Therefore, in the electronic imaging type microscope apparatus, the configuration of the support section that supports the microscope section and the counterweight can be further reduced in size, and the overall configuration of the apparatus may be reduced in size. If the apparatus can be miniaturized, even if the base portion is installed at a position closer to the operating table, the operation of the operator and other medical staff is not hindered. Therefore, it is assumed that the electronic imaging microscope apparatus is installed and used closer to the operating table, and is not necessarily assumed to be used in an overhead style.
- the movable range required for the microscope unit 801 is substantially limited to a part of the region from the positional relationship between the eyepiece unit and the operator.
- an electronic imaging microscope device can observe a surgical site from any angle, a wider movable range is required for the microscope unit.
- the support unit and the microscope unit are arranged so that the view of the operator who observes the display device is not blocked as much as possible. It is required to be done. If the configuration corresponding to the overhead style is applied to the electronic imaging microscope device, the distal end portion of the support portion and the microscope portion should be positioned so as to be suspended from above the operator in front of the operator's eyes. Therefore, even if the microscope unit is small, the support unit and the microscope unit are likely to obstruct the operator's field of view. Therefore, in an electronic imaging type microscope apparatus, it is considered that use in an overhead style in which the microscope unit is positioned in front of the operator's eyes is not an optimal usage method.
- the configuration of the microscope unit, the movable range required for the microscope unit, the usage mode, and the like differ between the electronic imaging microscope device and the optical microscope device. Therefore, when the configuration of the support portion in the optical microscope apparatus as described with reference to FIG. 1 is applied as it is to the electronic imaging microscope apparatus, the configuration is not necessarily the electronic imaging microscope apparatus. It may not be suitable for, and may reduce the convenience of the surgeon.
- the support portion is configured to improve the convenience for the surgeon. It was requested. Therefore, the inventors of the present invention have arrived at the present disclosure as a result of intensive studies on a configuration that is more suitable for an electronic imaging microscope device and that can further improve the convenience of the surgeon.
- a preferred embodiment of the present disclosure that has been conceived by the present inventors will be described in detail.
- FIGS. 2 to 8 show a design concept of support part of microscope apparatus according to this embodiment.
- FIG. 2 is a diagram illustrating a state of surgery using an electronic imaging microscope device. Referring to FIG. 2, a surgeon (not shown) is performing a surgical operation on a patient 730 lying on an operating table 740 using a microscope apparatus 710.
- the microscope apparatus 710 is an electronic imaging microscope apparatus, and includes an electronic imaging microscope section 701 for magnifying and observing a patient's surgical part (abdominal part in the illustrated example), and a support unit that supports the microscope part 701 at the tip. 703 and a base portion 705 that supports the base end of the support portion 703.
- the support part 703 has a counterweight and is comprised as a balance arm.
- FIG. 2 also shows a display device 760 for displaying an image of the surgical part taken by the microscope unit 701. The surgeon performs an operation while observing the image of the surgical part displayed on the display device 760.
- the display device 760 is installed so as to be positioned substantially in front of the operator when performing an operation in a standing position.
- the microscope unit 701 is located below the display device 760 (side closer to the surgical site). Preferably it is located. On the other hand, in order to ensure a working space where the surgeon performs various treatments on the surgical site, a certain amount of space is required for the space between the microscope unit 701 and the surgical site.
- the first arm 707a extends downward from the microscope unit 701 while the microscope unit 701 is positioned below the display device 760 in order to ensure visibility (indicated by a broken line in the figure).
- the work space is limited by the first arm 707a.
- the first arm 707a when the first arm 707a extends upward from the microscope unit 701 while the microscope unit 701 is positioned below the display device 760 in order to secure a field of view (the first line indicated by a broken line in the drawing). In the case of a state such as one arm 707e), the first arm 707a blocks the view of the operator who views the display device 760.
- the support unit is arranged so that the first arm 707a is substantially horizontal when the operation part is imaged by the microscope unit 701. 703 is preferably configured.
- FIG. 3 is a schematic diagram illustrating the movable range of the microscope unit 701.
- the movable range 750 of the microscope unit 701 is illustrated with hatching.
- the detailed illustration of the microscope unit 701 is omitted, and it is simply indicated by a circle.
- the movable range 750 of the microscope unit 701 can be an area sandwiched between two arcs having different radii.
- the radius of these arcs, that is, the size of the movable range 750 of the microscope unit 701 depends on the length (H) of the first arm 707a and the length (V) of the second arm 707b.
- the length (H) of the first arm 707a is the vertical direction of the microscope unit 701. It does not contribute to the movable range, and the movable range depends on the length (V) of the second arm 707b. Accordingly, for example, as in the optical microscope apparatus 810 described above, the support portion 703 is configured such that the length (H) of the first arm 707a is longer than the length (V) of the second arm 707b. (That is, when V is relatively short), the movable range in the vertical direction of the microscope unit 701 is greatly limited.
- the support unit 703 is configured to move the microscope unit 701 greatly in the vertical direction.
- the first arm 707a cannot be kept horizontal, and the first arm 707a may interfere with the operator's field of view or the operator's work space like the first arms 707d and 707e shown in FIG.
- the microscope unit 701 is positioned immediately above the operating table 740.
- the height of the operating table 740 differs between the standing position and the sitting position.
- the height of the region where the portion 701 can be located is also different. Accordingly, if the movable range in the vertical direction of the microscope unit 701 is narrow, it is difficult to cope with both the operation in the standing position and the operation in the sitting position.
- the support portion 703 is preferably configured such that the length (V) of the second arm 707b is longer than the length (H) of the first arm 707a. That is, the condition required for the support portion 703 to handle both the standing position operation and the sitting position operation while keeping the first arm 707a substantially horizontal (hereinafter referred to as “condition according to use mode” for convenience). 1) is expressed as (Condition 1) below.
- the first arm 707a is kept substantially horizontal, and both the operation in the standing position and the operation in the sitting position are supported. In this case, the distance between the support column 707c and the operating table 740 is adjusted.
- the movable range 750 of the microscope unit 701 is higher as it is closer to the column 707c, and is lower as it is farther from the column 707c. Therefore, when performing an operation in the standing position, the use range 751 (the use area 751 in the standing position) of the microscope unit 701 during the operation in the standing position at a higher position is included in the movable range 750.
- the microscope apparatus 710 may be installed such that the column part 707c is positioned closer to the operating table 740.
- the operating table 740 is maintained while keeping the first arm 707a substantially horizontal. Since the microscope unit 701 can be arranged at a higher position immediately above the microscope unit 701, the microscope unit 701 can be arranged in the standing use area 751.
- the column portion is used so that the movable range 750 includes the use region 752 (the sitting use region 752) of the microscope unit 701 at the time of the operation in the lower position.
- the microscope apparatus 710 can be installed such that 707c is located relatively far from the operating table 740. If the posture of the support portion 703 is adjusted so that the second arm 707b is inclined further toward the operating table 740 with the support column 707c being relatively far from the operating table 740, the first arm 707a is kept substantially horizontal.
- the microscope unit 701 can be disposed at a lower position immediately above the operating table 740, the microscope unit 701 can be disposed in the sitting use area 752.
- FIG. 4 is an explanatory diagram for explaining conditions according to usage modes.
- FIG. 4 schematically illustrates the positional relationship between the support unit 703 and the operating table 740 of the microscope apparatus 710.
- the microscope unit 701 is shown in a simplified manner as in FIG.
- FIG. 5 is an explanatory diagram for explaining maximum range r 2max of (rotation angle r 2 of the second rotation shaft) rotation angle r 2 of the second arm 707b with respect to strut 707c shown in FIG. 4 is there.
- the height of the objective lens provided in the vicinity of the lower end of the microscope unit 701 at the time of surgery in the standing position (hereinafter also referred to as standing height) is Z 1
- the height of the objective lens of the microscope unit 701 at the time of surgery in the sitting position (hereinafter, sitting position also referred to as height) and Z 2.
- the objective lens of the microscope unit 701 is positioned at the standing height Z 1 with the second arm 707b extending in a substantially vertical direction, 2 as arms 707b objective lens of the microscope section 701 in a state inclined by a predetermined angle r 2 with respect to the column portion 707c (rotation state) may be located in the sitting position height Z 2, support portion 703 is configured Just do it.
- the second arm 707b from a state in which extending in a substantially vertical direction, in the case of changing the state of being rotated by a predetermined angle r 2 with respect to the column portion 707c, an objective lens of the microscope 701
- the support portion 703 may be configured so that it can change in the height direction by an amount of change (Z 1 ⁇ Z 2 ) between the standing height Z 1 and the sitting height Z 2 .
- the support portion 703 can be configured to satisfy the following (Condition 2) and (Condition 3).
- variation Z 1 -Z 2 of the standing height Z 1 and the sitting position height Z 2 becomes at least 200 (mm) degree.
- the range that Z 1 -Z 2 can take is preferably about 200 (mm) ⁇ Z 1 -Z 2 ⁇ about 400 (mm).
- FIG. 5 schematically shows the second arm 707b, and the force applied to the tip of the second arm 707b when moving the microscope unit 701 is indicated by a thick arrow, and the second arm 707b is caused by the force.
- the direction of rotation is illustrated by thin line arrows. As shown in FIG.
- the r 2max Preferably takes a range of about 45 ° ⁇ r 2max ⁇ about 60 °.
- the support portion 703 is configured so as to satisfy the conditions shown in the above (Condition 1) to (Condition 3) based on the conditions according to the usage mode.
- the support unit 703 of the microscope apparatus 710 is required to be configured so that the movable range of the microscope unit 701 satisfies a desired range.
- the movable range of the microscope unit 701 includes the length (H) of the first arm 707a, the length (V) of the second arm 707b, the length (T) of the support column 707c, and the first range with respect to the second arm 707b.
- the movable range of the microscope unit 701 can be increased.
- the support portion 703 is increased in size and the configuration of the entire apparatus is also increased in size.
- the electronic imaging microscope unit 701 can be configured to be smaller and lighter than the optical microscope unit 801. Therefore, the entire configuration of the microscope apparatus 710 can be further reduced. Therefore, in order to take advantage of the advantage, it is not preferable that the apparatus is enlarged even if a wider movable range can be obtained.
- the support portion 703 of the microscope apparatus 710 is configured so that the microscope portion 701 has a desired movable range while keeping a small size.
- conditions required for the support unit 703 in order that the microscope unit 701 has a desired movable range while maintaining a small size hereinafter also referred to as “conditions due to movable range and downsizing”.
- the movable range required for the microscope unit 701 is the reachable distance from the support column 707c required for the objective lens of the microscope unit 701 in the horizontal direction (hereinafter referred to as the horizontal required reach distance (WH)), and the vertical range. It is defined by the reachable distance from the floor surface required for the objective lens of the microscope unit 701 in the direction (hereinafter referred to as the vertical required reachable distance (WV)). If the objective lens of the microscope unit 701 can pass through a position on the space corresponding to the horizontal required reach distance (WH) and the vertical required reach distance (WV), the microscope unit 701 has a sufficient movable range. I can say that.
- the support unit 703 determines the position on the space corresponding to the horizontal required reach distance (WH) and the vertical required reach distance (WV) of the microscope unit 701. It is preferable that the objective lens is configured to pass therethrough.
- FIG. 6 is an explanatory diagram for explaining the horizontal required reach distance (WH) in the electronic imaging microscope apparatus.
- FIG. 7 is an explanatory diagram for explaining the vertical required reach distance (WV) in the electronic imaging microscope apparatus.
- FIG. 6 illustrates a situation in which the situation at the time of surgery is viewed from directly above
- FIG. 7 illustrates a situation in which the situation at the time of surgery is viewed from the horizontal direction.
- FIG. 6 also shows an assistant 721 for assisting the operation in addition to the operator 720 performing the operation.
- the horizontal required reach distance (WH) is determined based on the positional relationship between the microscope apparatus 710 and the operating table 740, more specifically, the distance between the support column 707c and the operating table 740. It is determined so that it can be located almost directly above.
- the position where the microscope apparatus 710 can be installed is determined.
- the horizontal required reach distance (WH) may be determined so that the objective lens of the microscope unit 701 can reach substantially directly above the surgical site from the installation position.
- the position of the operator 720 and the like described above can change depending on the mode of surgery.
- the display device 760a when the assistant 721 is at a position facing the operator 720, the display device 760a can be arranged in an oblique direction as seen from the operator, as shown in the figure, but the position where the assistant 721 faces the operator 720 is shown. If not, the display device 760b (indicated by a two-dot chain line in the figure) may be arranged at a position facing the operator. Therefore, it is preferable that the distance WH is determined so as to be compatible with various surgical modes while appropriately changing the position of the operator 720 or the like in accordance with the assumed surgical mode.
- the present inventors have studied a general operation mode.
- horizontal required reach (WH) It has been found that the microscope unit 701 can be moved to a position that can correspond to all surgical modes at least in the horizontal direction by configuring the support unit 703 so as to satisfy about 800 (mm).
- the numerical value is merely an example, and the distance WH can be appropriately determined according to the mode of surgery that is supposed to be actually performed.
- the required vertical reach distance (WV) includes the height (B) of the operating table 740, the body height in the vertical direction of the patient 730 lying on the operating table 740 (hereinafter simply referred to as the body height of the patient 730), and the microscope unit 701. Is determined so that the objective lens of the microscope unit 701 can be arranged at a position where an appropriate image can be taken almost directly above the surgical unit. Specifically, if the value of the WV is determined so that the distance WV is substantially equal to the total value of the height (B) of the operating table 740, the body height of the patient 730, and the WD of the microscope unit 701. Good.
- the microscope unit 701 As shown in FIG. 7, at the time of imaging, the patient 730 (surgical unit) and the operating table 740 are positioned on the optical axis of the microscope unit 701 in the vertical direction. Therefore, if the distance WV is determined so as to be substantially equal to the total value of the height (B) of the operating table 740, the body height of the patient 730, and the WD of the microscope unit 701, the microscope unit 701 appropriately determines the surgical site. It will be arranged so that it can shoot.
- the surgical part is photographed from an oblique direction, but when the microscope part 701 is moved so as to photograph the surgical part from different angles while the WD of the microscope part 701 is constant, The microscope unit 701 moves on a hemisphere centered on the surgical site, and when the surgical site is photographed from above as shown in the figure, the height of the objective lens of the microscope unit 701 is the highest, so in this case If the support portion 703 is configured so as to satisfy the WV, other postures can be realized.
- the WD of the microscope unit 701 corresponds to the focal length of the objective lens provided in the vicinity of the lower end of the microscope unit 701, when the focal length is variable, the maximum and minimum values of the focal length are set.
- the distance WV is preferably determined in consideration of the value (that is, the maximum value and the minimum value of WD).
- the numerical value is merely an example, and the distance WV can be appropriately determined according to the size of the operating table 740 assumed to be actually used, the optical characteristics of the microscope unit 701, and the like.
- the support portion 703 is configured to satisfy
- the vertical required reach (WV) is determined assuming a surgical operation in a standing position.
- the operation in the standing position has a higher height (B) of the operating table 740 and the position of the use region of the microscope unit 701 than the operation in the sitting position. . That is, the vertical operation range required for the microscope unit 701 is wider in the standing operation than in the sitting operation (that is, the required vertical reach distance (WV) is longer). Accordingly, if the vertical required reach distance (WV) is obtained assuming an operation in a standing position, it is possible to cope with an operation in a sitting position where only a shorter required vertical reach distance (WV) is required.
- the microscope device 710 is installed at a position farther from the operating table 740 and the second arm 707b is inclined more toward the operating table 740.
- the microscope unit 701 can be arranged at a lower position.
- the support portion 703 is preferably configured such that the microscope portion 701 has the above-described movable range while maintaining a small size.
- the movable range of the microscope unit 701 includes the length (H) of the first arm 707a, the length (V) of the second arm 707b, the length (T) of the support column 707c, and the second. It depends on the rotation angle r 1 of the first arm 707a relative to the arm 707b and the rotation angle r 2 of the second arm 707b relative to the support column 707c.
- the upper limit value of the length of each part of the support unit 703 is such that when the microscope apparatus 710 is installed near the operating table 740, the microscope apparatus 710 does not interfere with the operations of the operator and other medical staff. Can be determined.
- the movable range of the rotation angle r 1 and the rotation angle r 2 is such that the microscope unit 701 is movable as described above (condition 4) in the support unit 703 configured to satisfy the upper limit value in which the length of each unit is determined. What is necessary is just to set so that the range may be satisfy
- the support portion 703 is configured so as to satisfy the following (Condition 5) and (Condition 6), thereby satisfying the movable range shown in the (Condition 4) and a relatively small size. It has been found that a microscope device 710 is feasible.
- the support portion 703 is configured so as to satisfy the conditions shown in the above (Condition 4) to (Condition 6) from the movable range and the conditions due to downsizing.
- FIG. 8 is an explanatory diagram for explaining the horizontal required reach distance (WH) in the optical microscope apparatus.
- FIG. 8 similarly to FIG. 1, the surgeon 820 performs an operation on a patient 830 lying on the operating table 840 using the optical microscope device 810. .
- FIG. 8 also shows an assistant 821 who assists the operation in addition to the operator 820 who performs the operation.
- the microscope apparatus 810 is installed at a position relatively distant from the operating table 840. Therefore, the horizontal required reach distance (WH) is the electronic imaging microscope apparatus 710. Becomes longer than the distance WH (800 (mm) in the above example). Further, as described above with reference to FIG. 1, in the optical microscope apparatus 810, the surgeon 820 enters the support unit 803 and the operation is performed, so that the vertical required reach distance (WV) is also electronic imaging. It becomes longer than the distance WV (1600 (mm) in the above example) in the microscope apparatus 710 of the type.
- the length required for the support portion 703 in order to realize a desired movable range is much shorter than that of the optical microscope device 810. If the support portion 703 is short, the weight of the support portion 703 is reduced correspondingly, and the counterweight can be reduced in size. Therefore, according to the electronic imaging type microscope apparatus 710, it is possible to achieve both the downsizing of the apparatus and the securing of a desired movable range.
- the movable range of the joint portion corresponding to the rotation angle r 2 is 0 ° to 50 °.
- the movable range of the joint corresponding to the rotation angle r 1 is about ⁇ 40 ° to + 40 °.
- the movable range of the rotation angle in the existing optical microscope apparatus 810 is about r 1 + r 2 ⁇ 130 °.
- the microscope apparatus 710 is installed near the operating table 740, the microscope unit 701 and the support unit 703 of the microscope apparatus 710 should be covered with a bag-like drape. become.
- the entire microscope apparatus 710 is to be draped, a large drape is required. Therefore, the drape is usually only applied to portions corresponding to the first arm 707a and the second arm 707b, and the column is supported. The part corresponding to the portion 707c is often exposed. Therefore, if the length (T) of the support column 707c is longer than the height (B) of the operating table 740, there is a possibility that the clean area is affected by the support column 707c.
- the upper part of the operating table 740 is a clean area, but the area below the operating table 740 is an unclean area. Therefore, if the length (T) of the support column 707c is shorter than the height (B) of the operating table, even if the microscope apparatus 710 is installed close to the operating table 740, the clean area is affected by the support column 707c. There is no fear.
- the support portion 703 is preferably configured to satisfy the following (Condition 7).
- the height (B) of a commonly used operating table 740 is about 800 (mm). Therefore, for example, the support portion 703 can be preferably configured such that the length (T) of the support column portion 707c is shorter than 800 (mm).
- required by the support part 703 shall also be called “conditions by an installation position" for convenience.
- the support unit 703 is configured to be smaller while securing the movable range of the microscope unit 701 that can handle various surgical modes.
- WV vertical required distance
- the support portion 703 is configured to satisfy at least the above (Condition 1). More specifically, the support portion 703 may be configured to further satisfy the above (Condition 2) and (Condition 3). Accordingly, the first arm 707a can be kept substantially horizontal during the operation, so that the operator's work space and the operator's field of view can be secured, and the convenience of the operator can be further improved. . At this time, since the first arm 707a can be kept substantially horizontal in both the standing operation and the sitting operation, the operator's work space and the operator's field of view are ensured regardless of the operation mode. It becomes possible.
- the movable range and the conditions due to the miniaturization that is, the above (Condition 4)).
- the support part 703 can be configured to satisfy the above (condition 6)).
- the support portion 703 can be configured to satisfy the condition according to the installation position (that is, the above (condition 7)). Therefore, since it becomes possible to install the microscope apparatus 710 closer to the operating table 740 while ensuring a clean area, it is possible to further reduce the size of the support portion 703 and further reduce the size of the entire apparatus. can do.
- the upper limit value of the length (V) of the second arm 707b can be determined. If the upper limit value of V is determined, the upper limit value of the length (H) of the first arm 707a is determined from the above (condition 1), and the length (T) of the column portion 707c is determined from the above (condition 3). The lower limit of can be determined. Further, regarding the length (T) of the column portion 707c, the upper limit value can also be determined from the above (Condition 7). Specific values of H, V, and T are determined so as to satisfy the above (condition 4) to (condition 6) within the determined range of H, V, and T.
- the above numerical value of 2000 (mm) is calculated so that the minimum movable range required for the microscope unit 701 can be realized.
- the lower limit value of H + V + T can be a larger value.
- H + V + T> about 2100 (mm) is satisfied.
- the support portion 703 is preferably configured.
- the support unit 703 may be configured to satisfy H + V + T> about 2200 (mm). It turned out to be preferable.
- the present inventors have explained the result of actually designing the configuration of the support portion 703 that can satisfy the above-described conditions.
- FIG. 9 is a diagram illustrating a configuration example of the microscope system according to the present embodiment.
- the microscope system 1 supports a microscope unit 110, and includes a microscope apparatus 10 that images a patient's surgical part by the microscope part 110, and a surgical part imaged by the microscope apparatus 10. And a display device 20 for displaying video.
- the surgeon observes the surgical site while referring to the video imaged by the microscope device 10 and displayed on the display device 20, and performs various treatments on the surgical site.
- the display device 20 displays an image of the surgical site of the patient imaged by the microscope device 10.
- the display device 20 is installed in a place where it can be visually recognized by an operator, such as a wall surface of an operating room.
- the type of the display device 20 is not particularly limited. Examples of the display device 20 include various known displays such as a CRT (Cathode Ray Tube) display device, a liquid crystal display device, a plasma display device, and an EL (Electro-Luminescence) display device.
- An apparatus may be used.
- the imaging unit 111 is configured as a stereo camera and / or is compatible with high-resolution imaging
- the display device 20 performs 3D display corresponding to each.
- the display device 20 does not necessarily have to be installed in the operating room, and is mounted on a device worn by the surgeon such as a head mounted display (HMD) or a glasses-type wearable device. May be.
- HMD head mounted display
- glasses-type wearable device May be.
- the microscope apparatus 10 includes a microscope unit 110 for magnifying and observing a surgical site of a patient, a support unit 120 (arm unit 120) that holds the microscope unit 110, and one end of the support unit 120 connected to each other.
- movement of the microscope apparatus 10 are provided.
- the microscope apparatus 10 is a surgical microscope apparatus for magnifying and observing a patient's surgical site during surgery.
- the base unit 130 supports the microscope unit 110 and the support unit 120.
- the base part 130 includes a pedestal 131 having a plate shape and a plurality of casters 132 provided on the lower surface of the pedestal 131.
- One end of the support unit 120 is connected to the upper surface of the gantry 131, and the microscope unit 110 is connected to the other end (tip) of the support unit 120 extending from the gantry 131.
- the microscope apparatus 10 is configured to be in contact with the floor surface via a caster 132 and movable on the floor surface by the caster 132.
- the microscope unit 110 is configured by a microscope body for magnifying and observing a patient's surgical site.
- the optical axis direction of the microscope unit 110 substantially coincides with the z-axis direction.
- the microscope unit 110 has a configuration corresponding to an electronic imaging microscope, and includes a cylindrical part 112 having a substantially cylindrical shape, and an imaging unit 111 provided in the cylindrical part 112.
- the imaging unit 111 includes an optical system such as an objective lens and a zoom lens, and an imaging element that captures an image of a subject (that is, an operation part) using light that has passed through the optical system.
- the length of the microscope unit 110 in the optical axis direction (more precisely, the length from the connecting portion between the first arm 290a and the microscope unit 110 to be described later to the lower end of the microscope unit 110) is, for example, about 210 mm. Hereinafter, it is more preferably about 200 mm or less.
- a cover glass for protecting the imaging unit 111 is provided on the opening surface at the lower end of the cylindrical portion 112.
- a light source is also provided inside the cylindrical portion 112, and illumination light is emitted from the light source to the subject through the cover glass during photographing. The reflected light from the subject of the illumination light is incident on the imaging unit 111 through the cover glass, whereby a signal (video signal) related to the image of the surgical site is acquired by the imaging unit 111.
- various known imaging elements such as a CCD (Charge Coupled Device) sensor and a CMOS (Complementary Metal-Oxide-Semiconductor) sensor may be applied as the imaging element of the imaging unit 111.
- the imaging unit 111 may be configured as a so-called stereo camera including a pair of imaging elements. In this case, 3D display of the video imaged by the imaging unit 111 is possible.
- the imaging unit 111 is configured to be able to support high-resolution imaging of 4K or more (for example, 4K (the number of horizontal pixels 3840 ⁇ the number of vertical pixels 2160) or 8K (the number of horizontal pixels 7680 ⁇ the number of vertical pixels 4320)). May be. In this case, the state of the surgical part can be displayed more clearly on the display device 20, and a smooth operation can be performed. If the imaging unit 111 is compatible with high-resolution imaging, a more immersive feeling can be obtained by using a display device 20 having a size of 55 inches or more. Various known configurations can also be applied to the optical system of the imaging unit 111. Furthermore, the imaging unit 111 can be equipped with various functions that are generally provided in an electronic imaging type microscope unit, such as an AF (Auto Focus) function and an optical zoom function.
- AF Auto Focus
- the video signal acquired by the microscope unit 110 is transmitted to the control device 140, and the control device 140 performs various image processing such as gamma correction and white balance adjustment.
- image processing such as enlargement and inter-pixel correction related to the electronic zoom function may be further performed.
- the image signal subjected to the image processing is transmitted to the display device 20 provided in the operating room, and the image of the surgical site is appropriately enlarged to a desired magnification by the optical zoom function and / or the electronic zoom function, for example. Displayed.
- the communication between the control device 140 and the display device 20 may be realized by various known wired or wireless methods.
- the microscope unit 110 may be provided with a processing circuit for performing the above-described image processing, and the above-described image processing may not be performed by the control device 140 but may be performed by the processing circuit of the microscope unit 110. Good.
- image information after image processing is appropriately performed in the processing circuit mounted on the microscope unit 110 can be transmitted from the microscope unit 110 to the display device 20 provided in the operating room.
- communication between the microscope unit 110 and the display device 20 may be realized by various known wired or wireless methods.
- the microscope unit 110 is provided with various switches for controlling the operation of the microscope unit 110.
- the microscope unit 110 includes a zoom switch 151 (zoom SW 151) and a focus switch 152 (focus SW 152) for adjusting imaging conditions of the microscope unit 110, and an operation for changing the operation mode of the support unit 120.
- a mode change switch 153 (operation mode change SW 153) is provided.
- the surgeon can adjust the magnification and the focal length of the microscope unit 110 by operating the zoom SW 151 and the focus SW 152, respectively. Further, the surgeon can switch the operation mode of the support unit 120 to either the fixed mode or the free mode by operating the operation mode change SW 153.
- the fixed mode is an operation mode in which the position and posture of the microscope unit 110 are fixed by restricting rotation of each rotation shaft provided in the support unit 120 by a brake.
- the free mode is a state in which rotation on each rotation shaft provided in the support unit 120 is freely possible by releasing the brake, and the position and posture of the microscope unit 110 can be adjusted by direct operation by the operator.
- Operation mode means an operation in which the operator holds the microscope unit 110 by hand and moves the microscope unit 110 directly.
- the operation mode of the support unit 120 is in the free mode while the operator presses the operation mode change SW 153, and the operation mode of the support unit 120 is fixed while the operator releases the operation mode change SW 153. It becomes a mode.
- these switches are not necessarily provided in the microscope unit 110.
- a mechanism for accepting an operation input having a function equivalent to those of the switches may be provided in the microscope apparatus 10, and the specific configuration of the mechanism is not limited.
- these switches may be provided in other parts of the microscope apparatus 10.
- commands corresponding to these switches may be remotely input to the microscope apparatus 10 using an input device such as a remote controller.
- the cylindrical portion 112 of the microscope unit 110 is illustrated as a simple cylindrical member in FIG. 9, but in reality, the cylindrical portion 112 is easily grasped by an operator.
- the shape may be devised.
- the free mode an operation in which the operator moves the microscope unit 110 while directly holding the tubular unit 112 with a hand can be assumed.
- the surgeon performs an operation of moving the microscope unit 110 while pressing the operation mode change SW 153
- the shape of the cylindrical portion 112 and the arrangement position of the operation mode change SW 153 are the same as those in the free mode. It can be appropriately determined in consideration of the operability of the operator.
- the arrangement positions of the zoom SW 151 and the focus SW 152 may be appropriately determined in consideration of the operator's operability.
- the control device 140 includes, for example, a processor such as a CPU (Central Processing Unit) or a DSP (Digital Signal Processor), or a control board on which both of these processors and storage elements are mounted. By executing the process, the operation of the microscope apparatus 10 is controlled.
- a processor such as a CPU (Central Processing Unit) or a DSP (Digital Signal Processor), or a control board on which both of these processors and storage elements are mounted.
- control device 140 controls the operation of the support unit 120 described above by controlling the driving of the brakes provided at the joints of the support unit 120 in accordance with the operator's operation input via the operation mode change SW 153.
- the control device 140 appropriately drives the optical system of the imaging unit 111 of the microscope unit 110 in accordance with an operation input from the operator via the zoom SW 151 and the focus SW 152, and the magnification and focal length of the microscope unit 110. It has a function to adjust.
- the control device 140 has a function of performing various types of image processing on the video signal captured by the microscope unit 110 and transmitting the processed video signal to the display device 20 provided in the operating room.
- the control device 140 is provided as a different configuration from the microscope unit 110, the support unit 120, and the base unit 130, and is connected to the base unit 130 by a cable.
- the present embodiment is such an example. It is not limited.
- a processor, a control board, or the like that realizes the same function as that of the control device 140 may be disposed in the base unit 130.
- the control device 140 and the microscope unit 110 may be integrally configured by incorporating a processor, a control board, and the like that realize the same function as the control device 140 into the microscope unit 110.
- the support unit 120 holds the microscope unit 110, moves the microscope unit 110 three-dimensionally, and fixes the position and posture of the microscope unit 110 after the movement.
- the support part 120 is configured as a balance arm having six degrees of freedom.
- the present embodiment is not limited to such an example, and the support unit 120 may be configured to have other different numbers of degrees of freedom.
- the support unit 120 is configured as a balance arm, and the microscope unit 110 and the support unit 120 as a whole have a balanced moment, so that the microscope unit 110 can be moved with a smaller external force, and the operation of the operator The sex can be further improved.
- the support unit 120 includes six rotation axes (first axis O 1 , second axis O 2 , third axis O 2 , fourth axis O 4 , fifth axis O 5, and sixth axis corresponding to six degrees of freedom. O 6 ) is provided.
- members constituting each rotation shaft are collectively referred to as a rotation shaft portion.
- the rotating shaft portion can be configured by a bearing, a shaft that is rotatably inserted into the bearing, a brake that restricts rotation of the rotating shaft, and the like.
- a parallelogram link mechanism 240 described later can also be regarded as one of the rotating shaft portions.
- the support portion 120 includes a first rotation shaft portion 210, a second rotation shaft portion 220, a third rotation shaft portion 230, a fourth rotation shaft portion 240, a fifth rotation shaft portion 250, and a sixth rotation shaft corresponding to each rotation shaft.
- Portion 260 and the first arm portion 271, the second arm portion 272, the third arm portion 273, and the fourth arm portion 274 that are rotatably connected to each other by the first rotating shaft portion 210 to the sixth rotating shaft portion 260.
- a counterweight 280 for balancing the moments of the microscope unit 110 and the support unit 120 as a whole.
- the fourth rotating shaft portion 240 corresponds to the parallelogram link mechanism 240.
- the first rotating shaft portion 210 has a substantially cylindrical shape, and is arranged at the proximal end portion of the cylindrical portion 112 of the microscope portion 110 so that the central axis thereof substantially coincides with the central axis of the cylindrical portion 112 of the microscope portion 110. Connected.
- the first rotating shaft part 210 supports the microscope part 110 in a rotatable manner with the direction substantially coincident with the optical axis of the microscope part 110 as a rotating axis direction (first axis O 1 direction).
- first axis O 1 is provided as a rotation axis substantially parallel to the z axis.
- a part of the imaging unit 111 of the microscope unit 110 is stored in a cylindrical casing that forms the first rotating shaft unit 210. That is, the microscope unit 110 and the first rotating shaft unit 210 are configured as an integral member. However, this embodiment is not limited to such an example, and the first rotating shaft part 210 and the microscope part 110 may be configured as separate members.
- the first rotating shaft portion 210 is connected to the tip of a first arm portion 271 that extends in a direction substantially perpendicular to the first axis O 1 . Further, the proximal end of the first arm portion 271, a first arm portion 271 rotatably stretching direction substantially parallel to the direction of the first arm portion 271 as a rotation axis direction (second axis O 2 direction) A second rotating shaft portion 220 to be supported is provided.
- the second axis O 2 is a rotation axis that is substantially perpendicular to the first axis O 1, and is provided as a rotation axis that is substantially parallel to the y axis in the example shown in FIG.
- the position of the microscope unit 110 in the x-axis direction is adjusted by the rotation of the microscope unit 110 and the first arm unit 271 about the second axis O 2 by the second rotation shaft unit 220.
- the second rotating shaft part 220 is connected to the tip of a second arm part 272 that extends in a direction substantially perpendicular to the first axis O 1 and the second axis O 2 . Further, the base end side of the second arm portion 272 is bent in an approximately L shape, and a direction substantially parallel to the extending direction of the portion corresponding to the long side of the second arm portion 272 is located at a position corresponding to the bent short side.
- the rotation axis direction (third axis O 3 direction) as the third rotating shaft 230 a second arm portion 272 is rotatably supported is provided.
- the third axis O 3 is a rotation axis substantially perpendicular to the first axis O 1 and the second axis O 2, and is provided as a rotation axis substantially parallel to the x axis in the example shown in FIG.
- the microscope section 110 of the third shaft O 3 as the rotation axis, since the first arm portion 271 and the second arm portion 272 is pivoted, adjusted y-axis direction position of the microscope 110 Will be.
- the support unit 120 is configured to control the posture of the microscope unit 110 by controlling the rotation about the second axis O 2 and the third axis O 3, respectively. That is, the second rotation shaft part 220 and the third rotation shaft part 230 may be rotation shaft parts that define the posture of the microscope unit 110.
- the distal end of the upper side of the parallelogram link mechanism 240 is connected to the proximal end side of the third rotating shaft part 230.
- the parallelogram link mechanism 240 includes four arms (arms 241, 242, 243, 244) arranged in a parallelogram shape, and four joints provided at positions corresponding to substantially the apexes of the parallelogram. (Joint portions 245, 246, 247, 248).
- the tip end of an arm 241 that extends in a direction substantially parallel to the third axis O 3 is connected to the third rotating shaft portion 230.
- a joint portion 245 is provided near the distal end of the arm 241
- a joint portion 246 is provided near the proximal end.
- the joints 245 and 246 are connected to the ends of the arms 242 and 243, respectively, so as to be rotatable about rotation axes (fourth axis O 4 ) substantially parallel to each other and substantially perpendicular to the extending direction of the arm 241.
- joint portions 247 and 248 are provided at the base ends of the arms 242 and 243, respectively.
- the joint portions 247 and 248 are respectively connected to the distal end and the proximal end of the arm 244 so as to be rotatable about the fourth axis O 4 and substantially parallel to the arm 241.
- the four joint portions constituting the parallelogram link mechanism 240 have rotation axes (fourth axis O 4 ) in substantially the same direction that are substantially parallel to each other, and are interlocked with each other around the fourth axis O 4.
- the fourth axis O 4 is provided as a rotation axis substantially parallel to the y axis. That is, the parallelogram link mechanism 240 is configured to have a plurality of joint portions that are arranged at different positions and rotate in conjunction with each other on the rotation shaft in the same direction, and transmits the operation at one end to the other end. Act as a mechanism.
- the configuration on the tip side of the parallelogram link mechanism 240 (that is, the microscope unit 110, the first rotating shaft unit 210, the second rotating shaft unit 220, the third rotating shaft unit). 230, the first arm portion 271 and the second arm portion 272) are transmitted to the base end side of the parallelogram link mechanism 240.
- a parallelogram linkage 240 pivotally A fifth rotating shaft portion 250 to be supported.
- the fifth axis O 5 is a rotation axis substantially parallel to the fourth axis O 4, and is provided as a rotation axis substantially parallel to the y axis in the example shown in FIG.
- a distal end of a third arm portion 273 extending in the z-axis direction is connected to the fifth rotating shaft portion 250, and the microscope portion 110, the first arm portion 271, the second arm portion 272, and the parallelogram link mechanism.
- 240 is configured to be rotatable with respect to the third arm portion 273 with the fifth axis O 5 as a rotation axis via the fifth rotation shaft portion 250.
- the third arm portion 273 has a substantially L-shaped shape, and the base end side thereof is bent so as to be substantially parallel to the floor surface.
- a sixth rotation shaft capable of rotating the third arm portion 273 around a rotation axis (sixth axis O 6 ) orthogonal to the fifth axis O 5.
- Unit 260 is connected.
- the sixth axis O 6 is provided as a rotation axis substantially parallel to the z axis.
- the sixth rotation shaft portion 260 is configured integrally with a fourth arm portion 274 that extends in the vertical direction. That is, the distal end of the fourth arm portion 274 is connected to a surface substantially parallel to the floor surface of the base end of the third arm portion 273. Further, the base end of the fourth arm portion 274 is connected to the upper surface of the gantry 131 of the base portion 130.
- the microscope unit 110, the first arm unit 271, the second arm unit 272, the parallelogram link mechanism 240, and the third arm unit 273 pass the sixth axis O 6 through the sixth rotation shaft unit 260. It rotates with respect to the base part 130 as a rotation axis.
- the arm 244 constituting the lower side of the parallelogram link mechanism 240 is formed to be longer than the arm 241 constituting the upper side, and the third rotating shaft portion 230 of the parallelogram link mechanism 240 of the arm 242 is formed. An end located diagonally to the connected portion extends to the outside of the parallelogram link mechanism 240. A counterweight 280 is provided at the end of the extended arm 244.
- the counterweight 280 is arranged on the tip side from itself (that is, the microscope unit 110, the first rotating shaft unit 210, the second rotating shaft unit 220, the third rotating shaft unit 230, the first arm unit 271, The mass of the second arm portion 272 and the parallelogram link mechanism 240) so that the rotational moment generated around the fourth axis O 4 and the rotational moment generated around the fifth axis O 5 can be offset.
- the placement position has been adjusted.
- the arrangement position of the fifth rotation shaft portion 250 is adjusted so that the center of gravity of each component arranged on the tip side of the fifth rotation shaft portion 250 is located on the fifth axis O 5 . Furthermore, the arrangement position of the sixth rotation shaft portion 260 is adjusted so that the center of gravity of each component arranged on the tip side of the sixth rotation shaft portion 260 is located on the sixth axis O 6 .
- the support unit 120 can be used as the microscope unit 110 and the support unit.
- the whole 120 can be configured as a balance arm in which moments are balanced.
- the support unit 120 is configured as a balance arm, when the surgeon tries to move the microscope unit 110 by direct operation, the microscope unit 110 is moved with a smaller external force as if it is under zero gravity. It can be moved. Therefore, user operability can be improved.
- the counterweight 280 may be detachable. For example, when several types of counterweights 280 having different masses are prepared and the configuration arranged on the tip side of the parallelogram link mechanism 240 is changed, according to the change, A counterweight 280 that can cancel the rotational moment may be appropriately selected.
- Brakes that restrict the rotation of the first rotation shaft portion 210 to the sixth rotation shaft portion 260 are provided on the first rotation shaft portion 210 to the sixth rotation shaft portion 260 of the support portion 120, respectively. Since the parallelogram link mechanism 240 has four joint portions (joint portions 245 to 248) that rotate in conjunction with each other, the brake for the parallelogram link mechanism 240 is applied to at least one of these four joint portions. It only has to be provided. The driving of these brakes is controlled by the control device 140. Under the control of the control device 140, these brakes are released all at once, so that the operation mode of the support portion 120 shifts to the free mode. Similarly, the brakes are driven all at once under the control of the control device 140, so that the operation mode of the support portion 120 shifts to the fixed mode.
- the various brakes used for a general balance arm may be applied, and the specific mechanism is not limited.
- these brakes may be mechanically driven or may be electromagnetic brakes that are electrically driven.
- the configuration corresponding to the first arm part 271 to the joint part 245 of the upper side (arm 241) of the parallelogram link mechanism 240 is the first arm 290 a and the parallelogram link.
- the configuration corresponding to the upper side (arm 241) of the mechanism 240 to the fifth rotating shaft portion 250 is the second arm 290b, and the configuration from the fifth rotating shaft portion 250 to the base end of the fourth arm portion 274 is the column portion 290c.
- the support unit 120 is configured such that the first arm 290a, the second arm 290b, and the support column 290c satisfy at least the above (condition 1) (ie, V> H). Further, the support unit 120 may be configured to further satisfy the other (Condition 2) to (Condition 7). Thereby, the microscope apparatus 10 may be configured to exhibit the effects as described above (2. Design concept of the support portion of the microscope apparatus according to the present embodiment).
- the length (T) of the column portion 290 c means the distance from the floor surface to the fifth rotation shaft portion 250.
- the specific configuration example of the microscope apparatus 10 according to the present embodiment has been described above with reference to FIG.
- the configuration of the microscope apparatus 10 according to the present embodiment is not limited to such an example.
- the microscope apparatus 10 may be configured to satisfy the above-described conditions, and the specific configuration thereof may be arbitrary.
- FIG. 10 is a diagram illustrating a surgical operation in a standing position using the microscope apparatus 10 according to the present embodiment.
- FIG. 10 a state in which an operator 320 performs an operation in a standing position on a patient 330 lying on an operating table 340 using the microscope apparatus 10 is illustrated.
- the surgical part of the patient 330 is photographed by the microscope unit 110 of the microscope apparatus 10, and an image of the photographed surgical part is displayed on the display device 20.
- the surgeon 320 performs an operation while observing the image of the surgical part displayed on the display device 20.
- Surgical operations are mainly performed in clinical departments such as orthopedics and cardiac surgery.
- the operator 320 In a standing operation, the operator 320 often has a relatively large working space. Therefore, the microscope unit 110 that images the surgical site is also arranged at a relatively high position.
- the entire microscope apparatus 10 When starting surgery, the entire microscope apparatus 10 is moved close to the operating table 340 using a caster. At this time, the microscope apparatus 10 is arranged so as to be located as close to the operating table 340 as possible.
- the microscope apparatus 10 since the microscope apparatus 10 can be configured in a small size, even if the microscope apparatus 10 is arranged near the operating table 340, it is difficult to hinder the operation of the operator 320 and the like.
- the microscope apparatus 10 since the length (T) of the support column 290c can be configured to be shorter than the height (B) of the operating table 340, the microscope apparatus 10 is disposed near the operating table 340. However, there is no risk that the clean area above the operating table 340 is affected.
- the height (B) of the operating table 340 used for the operation in the standing position is, for example, about 800 (mm).
- the operator 320 depresses the operation mode change SW 153 while grasping the grasping portion of the microscope unit 110 to release the brakes provided in the first rotation shaft portion 210 to the sixth rotation shaft portion 260, and the free operation mode. That is, the microscope unit 110 is brought into a freely movable state. The operator 320 moves the microscope unit 110 so that the field of view of the microscope unit 110 is aligned with the surgical unit while observing the image taken by the microscope unit 110 displayed on the display device 20, and then the operation mode change SW153. The attitude of the microscope unit 110 and the support unit 120 is fixed by releasing (that is, changing the operation mode to the fixed mode).
- the support unit 120 can be configured so that the movable range of the microscope unit 110 satisfies the desired movable range, so the operator 320 places the microscope unit 110 at a position where a desired image can be obtained. Can be moved.
- the microscope apparatus 10 is configured such that the length (V) of the second arm 290b is longer than the length (H) of the first arm 290a, the microscope apparatus 10 is placed near the operating table 340.
- the microscope unit 110 can be placed at a higher position while keeping the first arm 290a substantially horizontal. That is, the microscope unit 110 can be arranged in a use region in the operation in the standing position.
- the first arm 290a is kept substantially horizontal, the first arm 290a does not interfere with the operator's 320 working space and the operator's 320 field of view, and the working space and the field of view can be suitably secured. .
- the support portion 120 is configured such that the length (V) of the second arm 290b is longer than the length (H) of the first arm 290a, so that It is possible to secure the working space of the surgeon 320 and the field of view of the surgeon 320 while arranging the microscope unit 110 at a higher position at which a sufficient working space can be secured in the surgery.
- the operator 320 operates the zoom SW 151 and the focus SW 152 to adjust the magnification and the focal length of the image photographed by the microscope unit 110.
- the surgeon 320 starts treatment while observing the adjusted image.
- FIG. 11 is a diagram showing a state of surgery in the sitting position using the microscope apparatus 10 according to the present embodiment.
- FIG. 11 a state in which the surgeon 320 is performing an operation in a sitting position on a patient 330 lying on the operating table 340 using the microscope apparatus 10 is illustrated.
- the sitting operation only the installation position of the microscope apparatus 10 and the posture of the support unit 120 are different from those in the standing operation, and other procedures are the same as those in the standing operation. Therefore, in the description of the use example of the microscope apparatus 10 in the operation in the sitting position below, detailed description will be omitted for items that overlap with the operation in the standing position, and only different items will be mainly described. .
- the entire microscope apparatus 10 When starting surgery, the entire microscope apparatus 10 is moved close to the operating table 340 using a caster. At this time, the microscope apparatus 10 is installed at a position farther from the operating table 340 than during the operation in the standing position.
- the surgeon 320 moves the microscope unit 110 so that the field of view of the microscope unit 110 is aligned with the surgical site while observing the display device 20 in the same manner as the operation in the standing position, and the microscope unit 110 and the support unit 120 are moved.
- Fix posture the microscope apparatus 10 is configured such that the length (V) of the second arm 290b is longer than the length (H) of the first arm 290a, so that the microscope apparatus 10 is separated from the operating table 340.
- the microscope part 110 By adjusting the posture of the support part 120 so that the second arm 290b is tilted toward the operating table 340, while maintaining the first arm 290a substantially horizontal, the microscope part 110 is positioned at a lower position, That is, it can arrange
- the support unit 120 is configured such that the length (V) of the second arm 290b is longer than the length (H) of the first arm 290a.
- the microscope unit 110 is arranged at different heights while keeping the first arm 290a substantially horizontal. Is possible. Accordingly, it is possible to cope with both the operation in the standing position and the operation in the sitting position where the height of the use area is different from each other.
- the first arm 290a is kept substantially horizontal in both cases of standing and sitting, so that the working space of the surgeon 320 and the field of view of the surgeon 320 are ensured regardless of the mode of surgery. It becomes possible to do.
- the operator 320 When the postures of the microscope unit 110 and the support unit 120 are fixed, the operator 320 operates the zoom SW 151 and the focus SW 152 to adjust the magnification and the focal length of the image captured by the microscope unit 110. The surgeon 320 starts treatment while observing the adjusted image.
- FIG. 12 is a diagram illustrating an example of the state of the microscope apparatus 10 according to the present embodiment at the time of storage. Since the microscope apparatus 10 is configured such that the length (V) of the second arm 707b is longer than the length (H) of the first arm 707a, the support unit 120 has a height (length in the vertical direction). ) Is relatively high, and the width (the length in the horizontal direction) is relatively small. Therefore, by setting the support part 120 in the folded state, the width of the support part 120 can be further reduced, and the microscope apparatus 10 can be stored in a small space.
- FIG. 13 is a diagram illustrating a configuration example of a microscope apparatus according to a modification in which a rotating shaft portion is added to the support portion. Note that the microscope apparatus according to this modification shown in FIG. 13 corresponds to the microscope apparatus 10 described with reference to FIG. 9 to which a seventh rotation shaft portion 270 described later is added. Therefore, in the following description of this modification, detailed description of items that are the same as those in the above-described embodiment will be omitted, and only items that are different will be mainly described.
- the microscope apparatus 10a has a further rotation axis (seventh axis O 7) other than the first axis O 1 to the sixth axis O 6 with respect to the microscope apparatus 10 shown in FIG. ) Corresponds to those provided.
- the arm 242 extending in the substantially vertical direction of the parallelogram link mechanism 240 is divided into two members (arm 242a and arm 242b) in the extending direction. .
- a seventh rotating shaft portion 270 is provided.
- the microscope apparatus 10a according to the present modified example has the seventh rotation shaft portion at a position corresponding to the connection portion between the second arm 290b and the support column part 290c with respect to the microscope apparatus 10 according to the above-described embodiment.
- 270 corresponds to the one provided.
- the seventh rotation shaft portion 270 supports the arm 242a so as to be rotatable with respect to the arm 242b.
- the arm 242a is rotated about the seventh axis O 7 by the seventh rotary shaft 270, arm 242, it operates as threaded along its extending direction.
- the seventh rotation shaft portion 270 is a rotation shaft portion that supports the second arm 290b so as to be rotatable around a rotation axis parallel to the extending direction of the second arm 290b, and the seventh rotation shaft portion 270.
- the first arm 290a and the first arm 290a from the portion where the seventh rotation shaft portion 270 of the second arm 290b is provided operate so as to twist along the extending direction of the second arm 290b.
- the brake provided in the seventh rotating shaft portion 270 can be in a constantly operating state regardless of the operation on the operation mode change SW 153. Therefore, when the surgery is performed according to the normal procedure as described in (4-1. Examples of use in the operation in the standing position) and (4-2. Examples of use in the operation in the sitting position). The rotation at the seventh rotation shaft portion 270 does not occur.
- the seventh rotation shaft portion 270 is provided with a seventh axis operation switch 276 (seventh axis operation SW 276) for operating the brake of the seventh rotation shaft portion 270. Then, when the seventh axis operation SW 276 is pressed by the operator, the brake of the seventh rotation shaft portion 270 is released.
- the operator rotates the first arm 290a and / or the second arm 290b around the seventh axis O 7 while pressing the seventh axis operation SW 276, so that the position of the microscope unit 110 is In the fixed state, the posture of the support portion 120a can be changed as appropriate.
- the first arm 290a may interfere with the operator who observes the display device 20, or the second arm 290b may be used by the operator. May be hindered by the surgeon's work.
- the surgeon operates the seventh axis steering SW276, the arm 242a rotates about the seventh axis O 7, twisting of the distal end side of the second arm 290b configured and the first arm 290a
- the positions of the second arm 290b and the first arm 290a can be changed so as not to hinder the surgeon.
- the configuration of the microscope apparatus 10a according to the modified example in which the rotating shaft portion (seventh rotating shaft portion 270) is added to the support portion 120a has been described above with reference to FIG.
- the microscope unit 110 is moved so that the field of view of the microscope unit 110 is aligned with the surgical site, and the placement of the microscope unit 110 is determined. It is possible to appropriately change the posture of the support portion 120a so as not to hinder. Accordingly, the microscope apparatus 10a that is more convenient for the operator can be provided.
- FIG. 14 is a diagram illustrating a configuration example of a microscope apparatus according to a modified example in which an electrical component is mounted on a base portion. Note that the microscope apparatus according to the present modification shown in FIG. 14 corresponds to the microscope apparatus 10 described with reference to FIG. 9 to which an electrical component 133 described later is added. Therefore, in the following description of this modification, detailed description of items that are the same as those in the above-described embodiment will be omitted, and only items that are different will be mainly described. For the sake of simplicity, FIG. 14 shows a simplified configuration of the microscope apparatus similar to FIGS.
- the microscope apparatus 10b corresponds to the microscope apparatus 10 shown in FIG. 9 in which the configuration of the base unit 130 is changed.
- the base unit 130a of the microscope apparatus 10b includes a platform 131 having a plate shape, a plurality of casters 132 provided on the lower surface of the platform 131, an electrical component 133 mounted on the upper surface of the platform 131, Have
- the electrical component 133 is configured by a control board, for example, and has the same function as the control device 140 in the microscope apparatus 10 shown in FIG. That is, it can be said that the microscope apparatus 10b is configured such that the control apparatus 140 shown in FIG. 9 is configured integrally with the base portion 130a.
- the electrical unit 133 is, for example, brake control in each rotating shaft unit, drive control of the imaging unit 111 in the microscope unit 110, and / or signal processing (that is, image processing) for a video signal acquired by the microscope unit 110, and the like.
- signal processing that is, image processing
- the electrical unit 133 has a relatively high height on the rear side of the pedestal 131 (the side on which the counterweight is provided in the support unit 120), and on the front side of the pedestal 131 (the side on which the microscope unit 110 is provided in the support unit 120). ) Is configured to be relatively low.
- the support column 290c is disposed at a position where the height of the electrical component 133 on the front side of the gantry 131 is lower so that the base end is connected to the upper surface of the electrical component 133. That is, in the microscope apparatus 10b, the base end of the support column part 290c can be connected to the front side of the gantry 131 as compared to the above-described embodiment.
- the electrical component 133 is provided on the entire surface of the pedestal 131, but the electrical component 133 is provided only on the rear side of the pedestal 131, and on the front side of the pedestal 131 with respect to the upper surface of the pedestal 131. Then, the base end of the column portion 290c may be directly connected.
- the support column 290c is disposed closer to the operating table than the configuration in which the base end of the support column 290c is connected to the approximate center of the top surface of the gantry 131. Will be. Therefore, the length (H) of the first arm 290a can be further shortened, and the device can be further miniaturized.
- the configuration of 10b can be reduced in size.
- the base portion 130a is configured such that the column portion 290c is moved to the front side of the pedestal 131, and many configurations of the electrical component 133 are mounted on the rear side, which is a vacant area, the support portion 120 is configured.
- the height of is hardly changed compared to the above embodiment. That is, the configuration of the microscope apparatus 10b can be efficiently downsized without causing an increase in the size of the apparatus due to the mounting of the electrical unit 133 on the base part 130a.
- the base portion 130a may be configured to belong to the unclean area, but the electrical component 133 is configured such that the height on the rear side of the gantry 131 is relatively high and the height on the front side of the gantry 131 is relatively low.
- the electrical equipment part 133 which is an unclean area can be further away from the upper part of the operating table, that is, the clean area. Therefore, it is possible to mount the electrical component 133 on the base portion 130a without increasing the risk of the clean area being affected.
- the support unit 120 of the microscope apparatus 10 by configuring the support unit 120 of the microscope apparatus 10 so that the microscope unit 110 can be positioned below the display device 20 with the first arm 290a maintained substantially horizontal during the operation, The view of the surgeon was secured.
- this embodiment is not limited to this example.
- the support unit 120 may be configured so that the microscope unit 110 can be positioned above the display device 20 during surgery. Even in this case, since the microscope unit 110 does not exist at a position that obstructs the view of the operator who views the display device 20, the view of the operator is not obstructed and the operation portion is clearly observed. An effect similar to that of the above-described embodiment can be obtained.
- the support unit 120 is configured so that the microscope unit 110 can be positioned below the display device 20 as in the above embodiment, a situation in which the microscope unit 110 hinders the operator's field of view can be avoided. Since the microscope unit 110 is positioned closer to the surgeon, there is a possibility that the microscope unit 110 and the support unit 120 may interfere with the operator's work space depending on the surgical procedure or the like. In contrast, by configuring the support unit 120 so that the microscope unit 110 can be positioned above the display device 20 as described above, the microscope unit 110 and the support unit 120 interfere with the operator's work space. This may make it more difficult to improve the convenience of the surgeon.
- Such a configuration of the support portion 120 can be realized by making the length (T) of the column portion 290c longer in the microscope apparatus 10 according to the embodiment. Thereby, it becomes possible to arrange
- the microscope unit 110 is an electronic imaging type microscope unit, and its position is not constrained unlike an optical microscope unit on the premise that the operator directly looks into the eyepiece from the eyepiece. Therefore, by making the focal length longer, the WD can be made longer than the optical microscope unit. Therefore, even when the microscope unit 110 is arranged at a higher position in this way, it is possible to observe the surgical site.
- the support unit 120 is configured so that the microscope unit 110 can be positioned above the display device 20 because the microscope unit 110 of the electronic imaging type is included.
- the microscope unit 110 can be positioned above the display device 20 at the time of surgery.
- a microscope apparatus having the configured support part 120 will be described.
- FIG. 15 is a diagram illustrating a configuration example of a microscope apparatus according to a modification in which the length (T) of the support column is configured to be longer.
- the display device 20 and the patient 330 lying on the operating table 340 are shown together.
- FIG. 15 shows a preferable posture of the microscope apparatus 10c according to the present modification at the time of surgery in the sitting position.
- the microscope apparatus according to this modification is the same as the microscope apparatus 10 according to the above-described embodiment described with reference to FIG. 9 except that the length (T) of the support column 290c is different as described above. Because of having the configuration, in FIG. 15, for the sake of simplicity, the microscope apparatus according to this modification is illustrated in a simplified manner. In FIG. 15, for comparison, the microscope apparatus 10 according to the above-described embodiment is schematically illustrated by a two-dot chain line so as to overlap the microscope apparatus according to the present modification.
- a microscope unit 110 for magnifying and observing a surgical part of a patient a support unit 120b that holds the microscope unit 110, and one end of the support unit 120b are connected.
- the microscope apparatus 10 c is also provided with a control device 140 that controls the operation of the microscope apparatus 10 c, similarly to the microscope apparatus 10. Since the configuration and functions of the microscope unit 110, the base unit 130, and the control device 140 are the same as those of the microscope device 10 described above, detailed description thereof is omitted.
- the configuration and function of the support unit 120b are substantially the same as the configuration and function of the support unit 120 of the microscope apparatus 10. However, as described above, the support portion 120b is configured such that the length (T) of the column portion 290c is longer than the column portion 290c of the support portion 120.
- the display device 20 is installed so that the display device 20 can be positioned substantially in front of the surgeon at a lower position than the above embodiment, for example, in a sitting position. obtain.
- the support column 290c has such a length that the microscope unit 110 can be disposed above the display device 20 even during a surgical operation in a sitting position where the microscope unit 110 is disposed at a lower position. It is comprised so that it may have.
- the first arm 290a is kept in a substantially horizontal state. This is because the state in which the first arm 290a is substantially horizontal is the state in which the first arm 290a hardly disturbs the visual field of the operator who visually recognizes the display device 20, as in the above embodiment.
- the operator can observe the display device 20 from the space between the patient 330 and the microscope unit 110 during the operation in the sitting position, and thus the microscope unit 110 and the support unit 120b are operated. The situation where the person's view is obstructed can be avoided.
- the microscope unit 110 is configured to have a longer focal length and a longer WD than the above-described embodiment.
- the height position of the microscope unit 110 is in the sitting position while keeping the first arm 290a substantially horizontal in accordance with the height of the operating table 340 becoming higher. It is appropriately adjusted to a position higher than that at the time of surgery. Accordingly, the microscope unit 110 is disposed above the display device 20 even during a standing operation, and the microscope unit 110 and the support unit 120b do not hinder the operator's field of view.
- the switching of perioperative posture at the time of posture and standing at surgery in sitting position by changing the rotation angle r 2 of the second arm 290b with respect to the support portion 290c It may be performed by.
- the posture at the time of the operation in the sitting position is such that the microscope apparatus 10c is arranged so that the base part 130 can be positioned relatively far from the operating table 340, and the second arm with respect to the column part 290c. This can be realized by tilting 290b at a relatively large angle (ie, relatively increasing the rotation angle r 2 ).
- the microscope apparatus 10c is arranged so that the base part 130 can be positioned relatively close to the operating table 340, and the second arm 290b is compared with the column part 290c. It can be realized by tilting at a small angle (that is, by making the rotation angle r 2 relatively small).
- the configuration of the support portion 120b of the microscope apparatus 10c on the tip side of the support column 290c is the same as that of the support section 120 of the microscope apparatus 10 according to the above embodiment. That is, in the support part 120b, the configuration of the counterweight 280 and the like on the front end side with respect to the column part 290c can be configured to be relatively small like the above embodiment. As described above, in the microscope apparatus 10c, although the height (T) of the column portion 290c is increased, the overall height of the apparatus is larger than that of the above embodiment, but the lateral size of the entire apparatus is about. The same miniaturization as in the above embodiment can be suitably maintained.
- the configuration of the support portion 120b according to this modification can also be designed based on the design concept substantially similar to that of the above embodiment. However, since the length (T) of the column portion 290c needs to be longer, the above (condition 1) to (condition 7) are partially changed.
- the “conditions according to usage modes” are the same as in the above embodiment. That is, the support portion 120b according to the present modification can be configured to satisfy the above (Condition 1) to (Condition 3).
- the length (T) of the support column 290c is preferably shorter than the height (B) of the operating table 340, Even if the length (T) of the support column 290c is longer than the height (B) of the operating table 340, it is sufficient to secure a clean area by performing a treatment such as covering the support column 290c with drape. Is possible. Therefore, in this modification, in order to further improve the convenience for the operator, the upper limit of the length (T) of the support column 290c is not defined by the height (B) of the operating table 340. To do.
- the conditions for configuring the support portion 120b are the above (condition 1) to the above (condition 4), the above (condition 5 '), and the above (condition 6).
- the support portion 120b is configured to satisfy at least the above (Condition 1).
- 120b may be configured to further satisfy the above (Condition 2) and (Condition 3).
- the first arm 290a can be kept substantially horizontal during the operation, so that the operator's field of view can be ensured more reliably and the convenience of the operator is further improved. Can be made.
- the first arm 290a can be kept substantially horizontal in both the standing operation and the sitting operation, it is possible to secure a working space for the operator regardless of the operation mode. .
- 120b may be configured to further satisfy the above (Condition 4), (Condition 5 '), and (Condition 6).
- the microscope apparatus 10c can be reduced in size while ensuring a sufficient movable range of the microscope unit 110 that can cope with various surgical procedures, the convenience of the operator can be further improved.
- the upper limit value of the length (V) of the second arm 290b can be determined from the above (Condition 2). If the upper limit value of V is determined, the upper limit value of the length (H) of the first arm 290a is determined from the above (Condition 1), and the length (T) of the column portion 290c from the above (Condition 3). The lower limit of can be determined. Within the determined range of H, V, and T, specific values of H, V, and T are determined so as to satisfy (Condition 4), (Condition 5 ′), and (Condition 6). Go.
- mm) as a result of the actual design of the support portion 120b by the present inventors, the length (H) of the first arm 290a, the length (V) of the second arm 290b, and the length (T) of the support column 290c. In general, it was found that the following relationship can be satisfied.
- the position of the microscope unit 110 is relatively higher than the microscope apparatus 10 according to the above-described embodiment by increasing the length (T) of the support column 290c. Therefore, in order to position the microscope unit 110 at an appropriate position during surgery in the sitting position, it is necessary to tilt the second arm 290b more greatly with respect to the support column 290c. Therefore, in this modification, the value of the maximum value r 2max of the rotation angle r 2 of the second arm 290b relative to the support column 290c can be changed as compared with the above embodiment.
- the support portion 120b is configured so as to satisfy all of the above (Condition 1) to (Condition 4), (Condition 5 ′), and (Condition 6), while in the sitting position. It was found that the maximum value r 2max of the rotation angle r 2 is preferably in the range of about 45 ° ⁇ r 2max ⁇ about 65 ° in order to appropriately cope with the operation.
- the microscope unit 110 has a length in the optical axis direction (more precisely, a length from the connection portion between the first arm 290a and the microscope unit 110 to the lower end of the microscope unit 110). ) Is, for example, about 200 mm or less. Even if the support unit 120b is configured so that the microscope unit 110 can be positioned above the display device 20 while keeping the first arm 290a in a substantially horizontal state, if the size of the microscope unit 110 is too large, There is a possibility that good observation of the display device 20 may be hindered by the microscope unit 110. In this modification, it is possible to ensure the operator's field of view more reliably by configuring the microscope unit 110 to be relatively small in this manner.
- FIG. 16 is a diagram showing a state of the operation in the sitting position using the microscope apparatus 10c according to the present modification.
- FIG. 16 a state in which an operator 320 is performing an operation in a sitting position on a patient 330 lying on the operating table 340 using the microscope apparatus 10 c is illustrated.
- the surgical part of the patient 330 is photographed by the microscope unit 110 of the microscope apparatus 10c, and an image of the photographed surgical part is displayed on the display device 20.
- the surgeon 320 performs an operation while observing the image of the surgical part displayed on the display device 20.
- the operator 320 in the operation in the sitting position, the operator 320 can perform the operation in the space below the first arm 290a, that is, the operation in the overhead style.
- the microscope unit 110 since the microscope unit 110 can be positioned higher than in the above embodiment, a space for the operator 320 to enter is created below the first arm 290a, and surgery in such an overhead style is possible.
- the microscope apparatus 10c is not installed so that the support portion 120b extends from the front or side of the operator 320 toward the operator 320. The space in front of the eyes can be secured more.
- the operation procedure of the microscope apparatus 10c in the operation in the sitting position is substantially the same as the operation procedure of the microscope apparatus 10 described in the above (4-2. Usage example in the operation in the sitting position). Detailed description thereof will be omitted.
- the entire microscope apparatus 10c is moved near the operating table 340 using a caster. At this time, the microscope apparatus 10c is installed at a position farther from the operating table 340 than in the case of performing an operation in a standing position.
- the operator 320 depresses the operation mode change SW 153 while grasping the grasping portion of the microscope unit 110 to release the brakes provided in the first rotation shaft portion 210 to the sixth rotation shaft portion 260, and the free operation mode. That is, the microscope unit 110 is brought into a freely movable state.
- the operator 320 moves the microscope unit 110 so that the field of view of the microscope unit 110 is aligned with the surgical unit while observing the image taken by the microscope unit 110 displayed on the display device 20, and then the operation mode change SW153. (I.e., change the operation mode to the fixed mode) to fix the posture of the microscope unit 110 and the support unit 120b.
- the microscope apparatus 10c is configured such that the length (T) of the support column 290c of the support unit 120b is longer, and thus the microscope unit 110 is disposed at a higher position than in the above-described embodiment. be able to.
- the microscope unit 110 can be disposed above the display device 20.
- the microscope apparatus 10c is configured such that the length (V) of the second arm 290b is longer than the length (H) of the first arm 290a.
- the first arm 290a is kept substantially horizontal, as described above.
- the microscope unit 110 can be arranged at a higher position.
- the operator 320 operates the zoom SW 151 and the focus SW 152 to adjust the magnification and the focal length of the image captured by the microscope unit 110.
- the microscope unit 110 is configured to have a relatively long focal length. Therefore, even when the microscope unit 110 is disposed at a higher position as described above, A clear image focused on the operative site can be obtained.
- the operator 320 sits in a space below the first arm 290a, and starts treatment while observing the image of the display device 20 from the space between the surgical part of the patient 330 and the microscope part 110. That is, surgery is started in an overhead style.
- the microscope unit 110 can be disposed above the display device 20 while keeping the first arm 290a substantially horizontal, so that the field of view of the operator 320 is the microscope unit. The operation can be performed more smoothly without being blocked by 110.
- the usage example of the microscope apparatus 10 in the operation in the sitting position has been described.
- the rotation angle r 2 of the second arm 290b with respect to the support portion 290c What is necessary is just to make it smaller and to arrange
- the microscope unit 110 can be arranged at a position suitable for the operation in the standing position in accordance with the increase in the operating table 340 compared to the operation in the sitting position.
- the first arm 290a is kept substantially horizontal and the microscope unit 110 can be disposed above the display device 20, it is possible to avoid a situation where the field of view of the operator 320 is blocked by the microscope unit 110. .
- the optical microscope apparatus 810 is premised on the use in an overhead style, and the support portion of the optical microscope apparatus 810 is used.
- Applying the configuration 803 as it is to an electronic imaging microscope device is not necessarily an appropriate configuration for the electronic imaging microscope device.
- the configuration of the entire apparatus can be further reduced in size. Therefore, as in the above-described embodiment, it is possible to configure a more compact microscope apparatus 10 that does not assume use in an overhead style.
- the microscope apparatus 10c can cope with an overhead-style operation during an operation in a sitting position while keeping the overall size of the apparatus smaller than that of the optical microscope apparatus 810. .
- the microscope apparatus 10 c includes the electronic imaging type microscope unit 110, the WD of the microscope unit 110 can be made larger than that of the optical microscope unit 801. Accordingly, the microscope apparatus 10c is configured so that the microscope unit 110 can be positioned above the display device 20 when used in an overhead style, that is, the microscope unit 110 is not positioned in front of the operator's eyes. It becomes possible. According to such a configuration, the microscope unit 110 does not interfere with the operator's field of view even when used in an overhead style.
- the size of the microscope unit 110 itself is smaller than that of the optical microscope unit 801, and the support unit 120b and the counterweight can be downsized.
- the size can be made smaller than that of the optical microscope apparatus 810.
- the length (T) of the support column 290c is made longer without changing the configuration on the tip side of the support column 290c. Since the arrangement of the microscope unit 110 is realized, the support unit 120b and the counterweight can be suitably downsized.
- the degree of freedom of the arrangement of the microscope apparatus 10c that is, the degree of use in the operation can be improved while realizing the downsizing of the entire apparatus.
- the convenience of the operator 320 can be further improved.
- the operation in the overhead style using the microscope apparatus 10c according to the present modification can be suitably limited to a surgery performed in a sitting position such as a brain surgery. Even if the microscope apparatus 10c is to be used in an overhead style even in a standing operation, the support section 120b becomes relatively large even though the microscope section 110 can be reduced in size, so that the optical microscope apparatus is relatively large. This is because it may be difficult to receive the advantage that the entire apparatus can be made smaller than 810.
- the microscope apparatus is not used in the overhead style at the time of surgery in the standing position, but on the front side of the operator 320 or on the side of the operator 320, for example, in the same manner as in the usage mode shown in FIG. 10c may be installed.
- the microscope apparatuses 10, 10 a to 10 c described above may be equipped with a video vibration suppression mechanism that suppresses the vibration of the video imaged by the microscope unit 110. By mounting such an image vibration suppression mechanism, a more stable image of the surgical site can be obtained, and the operation can be performed more smoothly.
- the first rotation shaft portions 210 to 210 of the support portions 120, 120a, and 120b are used for the purpose of suppressing the vibration of the microscope portion 110 itself.
- a mechanical vibration suppression mechanism provided in each of the six rotation shaft portions 260 and / or a video vibration correction mechanism that corrects vibration of a captured image when the microscope unit 110 vibrates may be provided.
- the mechanical vibration suppression mechanism is, for example, a dynamic vibration absorber, and includes a vibration damping member such as a damper, and can suppress vibration in each rotating shaft portion.
- FIG. 17 is a diagram illustrating a configuration example of a mechanical vibration suppressing mechanism that can be provided in each rotation shaft portion.
- the vibration suppression mechanism 401 is provided between the cylindrical first member 403 and the second member 405 and suppresses transmission of vibration between these members. It has a function.
- the second member 405 (the weight side member 405) is axially (in the figure) inside the cylindrical first member 403 (the vibration suppression target member 403) that is the vibration suppression target.
- the two are connected by being slidably fitted in the middle and up and down directions.
- a viscoelastic member 407 and a spring 409 are provided as a viscous resistance element between the vibration suppression target member 403 and the weight side member 405.
- the vibration suppression mechanism 401 is a dynamic vibration absorber that includes the viscoelastic member 407 and the spring 409.
- the viscoelastic member 407 is made of a rubber material such as silicon rubber or urethane rubber, and has both mechanical properties and properties as a spring element.
- the viscoelastic member 407 and the spring 409 have a function of expanding and contracting in the axial direction in accordance with the vibration of the vibration suppression target member 403 and the weight side member 405 and attenuating the vibration.
- the natural frequency of the vibration suppression mechanism 401 is determined according to the characteristics of the viscoelastic member 407 and the spring 409, and this natural frequency substantially matches the natural frequency of the support portions 120, 120a, and 120b that are the vibration control targets. In that case, the vibration damping effect can be maximized. Therefore, the vibration suppression mechanism 401 may be configured to be able to replace the viscoelastic member 407 and the spring 409 with ones having different characteristics.
- the vibration suppression mechanism 401 is appropriately adjusted so that the natural frequency of the vibration suppression mechanism 401 substantially matches the natural frequency of the support parts 120, 120a, 120b. It can be configured and a great vibration control effect can be obtained.
- FIG. 18 is a diagram showing another configuration example of a vibration suppressing mechanism that can be provided in each rotating shaft portion.
- the vibration suppression mechanism 451 is provided between the substantially rod-shaped first member 453 and the second member 455 and suppresses vibration transmission between these members.
- the connection end of the first member 453 is provided with a concave receiving seat 459 formed of an elastic member capable of absorbing vibration such as rubber.
- a shaft portion 457 having an outer diameter thinner than other portions is provided at the connection end of the second member 455.
- the first member 453, the seat 459, and the shaft portion 457 are fixed by the screw 461 in a state where the shaft portion 457 of the second member 455 is inserted into the recess of the seat 459, so that the first The member 453 and the second member 455 are connected.
- the seat 459 can constitute a vibration suppressing mechanism 451 that absorbs vibration.
- an elastic member capable of absorbing vibration such as rubber may be interposed between the screw 461 and the first member 453, and vibration is generated by the seat 459 and the elastic member.
- a suppression mechanism 451 may be configured.
- the seat 459 has a concave shape, all vibrations in the three axial directions can be suitably suppressed.
- the vibration suppression mechanism 451 it is possible to more effectively suppress the vibration generated in one of the first member 453 and the second member 455 from being transmitted to the other.
- the image vibration correction mechanism either an electronic correction mechanism or an optical correction mechanism can be used.
- the electronic correction mechanism detects the vibration state of the image pickup unit 111 and, based on the vibration state detected at the stage of image processing for the video signal acquired by the image pickup element of the image pickup unit 111, The vibration of the image is corrected by correcting the capturing position of the observation light for each pixel.
- the optical correction mechanism detects the vibration state of the imaging unit 111 and moves the position of the optical system (for example, a lens or the like) or the imaging element of the imaging unit 111 based on the detected vibration state.
- the vibration state of the imaging unit 111 may be detected by providing a vibration sensor in the microscope unit 110, or the captured video is buffered for a certain period of time, and the latest video is compared with the previous video. It may be done by doing.
- image vibration correcting mechanisms for example, various known ones that are generally used in the technical field of camera shake correction in an imaging apparatus such as a digital camera can be used, and thus detailed description thereof is omitted.
- the video vibration suppression mechanism that can be mounted on the microscope apparatus 10, 10a to 10c has been described above.
- the microscope apparatus 10c according to the modified example in which the length (T) of the support column is longer as described above, the microscope unit 110 is positioned higher than the other microscope apparatuses 10, 10a, and 10b. It is arranged so that its WD becomes larger. Therefore, in the microscope apparatus 10c, the influence of the vibration of the microscope unit 110 on the captured image may be larger than that of the other microscope apparatuses 10, 10a, and 10b. Therefore, by providing the above-described image vibration suppression mechanism for the microscope apparatus 10c, the effect of obtaining a stable image can be obtained more remarkably.
- a microscope unit that images a surgical part of a patient on an operating table and outputs a video signal; and a support unit that supports the microscope unit at a distal end.
- One arm a second arm that supports the base end of the first arm at the tip end thereof so as to be rotatable about a first rotation axis that is perpendicular to the vertical direction and the front-rear direction, and extends substantially vertically from the floor surface.
- the support portion when it is assumed that the support portion is configured to support a base end of the second arm at a tip end thereof so as to be rotatable around a second rotation axis perpendicular to the vertical direction and the front-rear direction.
- the length of the second arm which is the length between the first rotating shaft and the second rotating shaft, when the optical axis of the microscope unit is arranged substantially vertically.
- the length between the optical axis of the microscope unit and the first rotation axis. Configured to be longer than the length of the first arm, the surgical microscope apparatus.
- the length of the second arm is V
- the rotation angle of the second arm with respect to the support column is r 2
- the height of the microscope unit from the floor surface during a standing operation is Z 1
- the sitting position When the height from the floor surface of the microscope unit at the time of surgery in Z is Z 2 , the length V, the rotation angle r 2 , the height Z 1, and the height Z 2 are Z 1 ⁇
- the surgical microscope apparatus according to (1) which satisfies a relationship represented by Z 2 ⁇ V (1-cos (r 2 )).
- the length V, the rotation angle r 2 , the height Z 1, and the height Z 2 satisfy the relationship represented by 200 (mm) ⁇ V (1-cos (r 2 ))
- the support unit has a position in the space where the distance from the support column in the horizontal direction is about 800 (mm) and the distance from the floor in the vertical direction is about 1600 (mm).
- the surgical microscope apparatus according to any one of (1) to (4), wherein the surgical microscope apparatus is configured to pass through.
- the support portion is configured so that a total length of the first arm, a length of the second arm, and a length of the support column is smaller than 2500 (mm).
- the rotation angle r 1 and the rotation angle r 2 are The surgical microscope apparatus according to (5) or (6), wherein the relationship shown by about 130 ° ⁇ r 1 + r 2 ⁇ about 180 ° is satisfied.
- the maximum value WD max of the working distance of the microscope section satisfies the relationship represented by about 400 (mm) ⁇ WD max ⁇ about 600 (mm), and the surgical operation according to any one of the above (10) Microscope device.
- the support portion is configured such that a sum of a length of the first arm, a length of the second arm, and a length of the support column is greater than 2000 (mm). (1) The surgical microscope apparatus according to any one of (11) to (11).
- the surgical microscope apparatus according to any one of (1) to (12), wherein the support portion is configured as a balance arm.
- the second arm corresponds to a parallelogram link mechanism that constitutes the support portion.
- the second arm can be rotated around a rotation axis parallel to the extending direction of the second arm at a position corresponding to a connection portion between the second arm and the support column.
- a rotating shaft portion to be supported is provided.
- an electrical component that performs signal processing in the surgical microscope apparatus is mounted, and on the upper surface of the base portion, the proximal end of the support portion is The surgical microscope apparatus according to any one of (1) to (15), which is connected to a front side of the electrical component.
- a microscope apparatus including a microscope unit that captures an image of a surgical part of a patient on an operating table and outputs a video signal, and a support unit that supports the microscope unit at a tip, and displays an image based on the video signal.
- a display device and the support portion rotates in order from the distal end side around the first arm and the first rotational axis perpendicular to the vertical direction and the front-rear direction at the distal end of the first arm at the distal end.
- a second arm that can be supported, and extends substantially vertically from the floor surface, and a base end of the second arm is supported at the tip so as to be rotatable around a second rotation axis that is perpendicular to the vertical direction and the front-rear direction.
- the support portion has a length of the second arm that is a length between the first rotation shaft and the second rotation shaft. Arranged so that the optical axis of the microscope section is substantially vertical
- the microscope unit length is the first configured to be longer than the length of the arm, the surgical microscope system between the optical axis first rotary shaft of the time that was.
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Abstract
Description
1.本開示に至った背景
1-1.既存の光学式の顕微鏡装置についての検討
1-2.電子撮像式の顕微鏡装置についての考察
2.本実施形態に係る顕微鏡装置の支持部の設計思想
2-1.使用態様から要請される条件
2-2.可動範囲及び小型化から要請される条件
2-3.設置位置から要請される条件
2-4.条件のまとめ
2-5.支持部の具体的な設計例
3.顕微鏡装置の構成例
4.顕微鏡装置の使用例
4-1.立位での手術における使用例
4-2.座位での手術における使用例
5.変形例
5-1.支持部に回転軸部が追加された変形例
5-2.ベース部に電装部が追加された変形例
5-3.支柱部の長さ(T)がより長く構成される変形例
5-3-1.顕微鏡装置の概要
5-3-2.顕微鏡装置の概略構成
5-3-3.支持部の設計思想
5-3-4.支持部の具体的な設計例
5-3-5.顕微鏡装置の使用例
5-4.映像振動抑制機構を有する変形例
6.補足
本開示の好適な一実施形態について説明するに先立ち、本開示の目的及び効果をより明確なものとするために、本発明者らが本開示に想到した背景について説明する。
図1を参照して、本発明者らが、既存の光学式の顕微鏡装置について検討した内容について説明する。図1は、既存の光学式の顕微鏡装置を用いた手術の様子を示す図である。図1を参照すると、術者820が、顕微鏡装置810を用いて、手術台840上に横臥している患者830に対して手術を行っている様子が図示されている。
近年、小型で高解像度の撮像素子が容易に入手できるようになり、顕微鏡装置においては、上述したような光学式の顕微鏡部801ではなく、撮像素子により術部を電子的に撮像することが可能な、電子撮像式の顕微鏡部を備えるものが開発されている。
本開示の好適な一実施形態に係る顕微鏡装置の具体的な構成について説明する前に、図2-図8を参照して、本実施形態に係る顕微鏡装置の支持部の設計思想について説明する。本実施形態に係る顕微鏡装置の具体的な構成例については、下記(3.顕微鏡装置の構成例)で改めて説明する。なお、以下に示す図2-図8では、簡単のため、顕微鏡装置の支持部を図示する際に、当該支持部を簡略化し、その第1アーム、第2アーム及び支柱部のみを概略的に図示している。
図2は、電子撮像式の顕微鏡装置を用いた手術の様子を示す図である。図2を参照すると、術者(図示せず)が、顕微鏡装置710を用いて、手術台740上に横臥している患者730に対して手術を行っている様子が図示されている。
V>H
Z1-Z2<V(1-cos(r2))
Z2>Vcos(r2)+T
顕微鏡装置710の支持部703には、顕微鏡部701の可動範囲が所望の範囲を満たすように構成されることが求められる。ここで、顕微鏡部701の可動範囲は、第1アーム707aの長さ(H)、第2アーム707bの長さ(V)、支柱部707cの長さ(T)、第2アーム707bに対する第1アーム707aの回転角度r1(第1の回転軸の回転角度r1)、及び支柱部707cに対する第2アーム707bの回転角度r2(第2の回転軸の回転角度r2)に依存するため、これらの値を大きくすれば、顕微鏡部701の可動範囲を大きくすることができる。しかしながら、これらの値を必要以上に大きくしてしまうと、支持部703が大型化し、装置全体の構成も大型化してしまう。上述したように、顕微鏡装置710には、電子撮像式の顕微鏡部701を光学式の顕微鏡部801よりも小型、軽量に構成することができるため、顕微鏡装置710全体の構成をより小型化することができるという利点があるため、当該利点を活かすためには、たとえより広い可動範囲を得ることができたとしても、装置が大型化することは好ましくない。
顕微鏡部701の対物レンズが、WH=約800(mm)、かつWV=約1600(mm)である空間上の位置を通過する。
H+V+T<約2500(mm)
約130°<r1+r2<約180°
好ましくは、約150°<r1+r2<約180°
更に好ましくは、約170°<r1+r2<約180°
上述したように、電子撮像式の顕微鏡部701は、光学式の顕微鏡部801よりも小型、軽量に構成することができるため、顕微鏡装置710全体の構成をより小型化することができる。従って、顕微鏡装置710を、手術台740のより近くに設置することが可能になる。
T<B
以上説明した3つの条件についてまとめる。
目的:
第1アーム707aを略水平に保ちつつ、立位での手術及び座位での手術の双方に対応する(顕微鏡部701の上下方向における可動範囲をより広く確保する)。
支持部に求められる条件:
(条件1)
V>H
(条件2)
Z1-Z2<V(1-cos(r2))
(条件3)
Z2>Vcos(r2)+T
目的:
多様な手術態様に対応し得る顕微鏡部701の可動範囲を確保しつつ、支持部703をより小型に構成する。
(条件4)
顕微鏡部701の対物レンズが、適切な映像を撮影するために要求される到達距離である、水平要求到達距離(WH)(例えば、WH=約800(mm))、及び鉛直要求到達距離(WV)(例えば、WV=約1600(mm))に対応する空間上の位置を通過する。
(条件5)
H+V+T<約2500(mm)
(条件6)
約130°<r1+r2<約180°
好ましくは、約150°<r1+r2<約180°
更に好ましくは、約170°<r1+r2<約180°
目的:
顕微鏡装置710を手術台740のより近くに設置しつつ、清潔域を確保する。
支持部に求められる条件:
(条件7)
T<B
本発明者らは、上記の各条件を満たし得る支持部703の構成について実際に設計を行った。ここでは、一例として、使用態様による条件、前記可動範囲及び小型化による条件、並びに上記設置位置による条件を満たすように(すなわち、上記(条件1)-上記(条件7)を満たすように)支持部120を構成する場合における設計結果について説明する。
H+V+T>約2000(mm)
H<T<V
約800(mm)<V<約1000(mm)
約600(mm)<H<約800(mm)
図9を参照して、以上説明した(条件1)-(条件7)を満たし得る、本実施形態に係る顕微鏡装置の具体的な構成例について説明する。図9は、本実施形態に係る顕微鏡システムの一構成例を示す図である。
表示装置20は、上述したように、顕微鏡装置10によって撮影された患者の術部の映像を表示する。表示装置20は、例えば手術室の壁面等、術者によって視認され得る場所に設置される。表示装置20の種類は特に限定されず、表示装置20としては、例えばCRT(Cathode Ray Tube)ディスプレイ装置、液晶ディスプレイ装置、プラズマディスプレイ装置、EL(Electro-Luminescence)ディスプレイ装置等、公知の各種の表示装置が用いられてよい。なお、後述するように、撮像部111がステレオカメラとして構成される場合、及び/又は高解像度の撮影に対応したものである場合には、表示装置20としては、それぞれに対応して、3D表示可能なもの、及び/又は高解像度の表示が可能なものが用いられ得る。また、表示装置20は、必ずしも手術室内に設置されなくてもよく、ヘッドマウントディスプレイ(HMD:Head Mounted Display)や眼鏡型のウェアラブルデバイスのように、術者が身に付けて使用するデバイスに搭載されてもよい。
顕微鏡装置10は、患者の術部を拡大観察するための顕微鏡部110と、顕微鏡部110を保持する支持部120(アーム部120)と、支持部120の一端が接続され顕微鏡部110及び支持部120を支持するベース部130と、顕微鏡装置10の動作を制御する制御装置140と、を備える。顕微鏡装置10は、手術中に患者の術部を拡大観察するための手術用顕微鏡装置である。
ベース部130は、顕微鏡部110及び支持部120を支持する。ベース部130は板状の形状を有する架台131と、架台131の下面に設けられる複数のキャスター132と、を有する。架台131の上面に支持部120の一端が接続され、架台131から延伸される支持部120の他端(先端)に顕微鏡部110が接続される。また、顕微鏡装置10は、キャスター132を介して床面と接地し、当該キャスター132によって床面上を移動可能に構成されている。
顕微鏡部110は、患者の術部を拡大観察するための顕微鏡鏡体によって構成される。図示する例では、顕微鏡部110の光軸方向は、z軸方向と略一致している。顕微鏡部110は、電子撮像式の顕微鏡に対応する構成を有しており、略円筒形状を有する筒状部112と、筒状部112内に設けられる撮像部111と、から構成される。また、撮像部111は、対物レンズ、ズームレンズ等の光学系と、当該光学系を通過した光により被写体(すなわち術部)の像を撮影する撮像素子と、から構成される。なお、顕微鏡部110の光軸方向の長さ(より厳密には、後述する第1アーム290aと顕微鏡部110との接続部から、当該顕微鏡部110の下端までの長さ)は、例えば210mm程度以下、より好ましくは200mm程度以下である。
制御装置140は、例えばCPU(Central Processing Unit)やDSP(Digital Signal Pocessor)等のプロセッサ、又はこれらのプロセッサと記憶素子等がともに搭載された制御基板等によって構成され、所定のプログラムに従った演算処理を実行することにより、顕微鏡装置10の動作を制御する。
支持部120は、顕微鏡部110を保持し、顕微鏡部110を3次元的に移動させるとともに、移動後の顕微鏡部110の位置及び姿勢を固定する。本実施形態では、支持部120は、6自由度を有するバランスアームとして構成されている。ただし、本実施形態はかかる例に限定されず、支持部120は他の異なる数の自由度を有するように構成されてもよい。支持部120をバランスアームとして構成し、顕微鏡部110及び支持部120全体としてモーメントの釣り合いが取れた構成とすることにより、より小さい外力で顕微鏡部110を移動させることが可能となり、術者の操作性をより向上させることができる。
図10-図12を参照して、以上説明した顕微鏡装置10の使用例について説明する。なお、図10-図12では、簡単のため、図9に示す顕微鏡装置10を簡略化して図示している。
まず、図10を参照して、立位での手術における顕微鏡装置10の使用例について説明する。図10は、本実施形態に係る顕微鏡装置10を用いた立位での手術の様子を示す図である。
次に、図11を参照して、座位での手術における顕微鏡装置10の使用例について説明する。図11は、本実施形態に係る顕微鏡装置10を用いた座位での手術の様子を示す図である。
以上説明した実施形態に関する、いくつかの変形例について説明する。
図13を参照して、支持部に回転軸部が追加された変形例に係る顕微鏡装置の構成について説明する。図13は、支持部に回転軸部が追加された変形例に係る顕微鏡装置の一構成例を示す図である。なお、図13に示す本変形例に係る顕微鏡装置は、図9を参照して説明した顕微鏡装置10に対して、後述する第7回転軸部270が追加されたものに対応する。従って、以下の本変形例についての説明では、上述した実施形態と重複する事項については詳細な説明を省略し、相違する事項についてのみ主に説明することとする。
図14を参照して、ベース部に電装部が搭載された変形例に係る顕微鏡装置の構成について説明する。図14は、ベース部に電装部が搭載された変形例に係る顕微鏡装置の一構成例を示す図である。なお、図14に示す本変形例に係る顕微鏡装置は、図9を参照して説明した顕微鏡装置10に対して、後述する電装部133が追加されたものに対応する。従って、以下の本変形例についての説明では、上述した実施形態と重複する事項については詳細な説明を省略し、相違する事項についてのみ主に説明することとする。なお、簡単のため、図14では、図10-図12にならって、顕微鏡装置の構成を簡略化して図示している。
(5-3-1.顕微鏡装置の概要)
上述した実施形態では、手術時に第1アーム290aが略水平を保った状態で顕微鏡部110が表示装置20よりも下方に位置し得るように、顕微鏡装置10の支持部120を構成することにより、術者の視界を確保していた。ただし、本実施形態はかかる例に限定されない。例えば、手術時に顕微鏡部110が表示装置20よりも上方に位置し得るように、支持部120が構成されてもよい。この場合であっても、表示装置20を見る術者の視界を遮る位置には顕微鏡部110が存在しないこととなるため、当該術者の視界が妨げられず、明りょうに術部を観察することができるという、上記実施形態と同様の効果を得ることができる。
本変形例に係る顕微鏡装置の構成について説明する。なお、本変形例に係る顕微鏡装置の構成は、支柱部290cの長さ(T)がより長く変更されること以外は、上記実施形態に係る顕微鏡装置10の構成と同様である。従って、以下の本変形例に係る顕微鏡装置の構成についての説明では、重複する事項については説明を省略する。
本変形例に係る支持部120bの構成も、上記実施形態と略同様の設計思想によって設計され得る。ただし、支柱部290cの長さ(T)をより長くする必要があることから、上記(条件1)~上記(条件7)が一部変更される。
H+V+T<約2600(mm)
本発明者らは、上記実施形態と同様に、上記の各条件を満たし得る本変形例に係る支持部120bの構成について実際に設計を行った。ここでは、一例として、上記(条件1)~上記(条件4)、上記(条件5’)、及び上記(条件6)を全て満たすように支持部120bを構成する場合における設計結果について説明する。
H+V+T>約2000(mm)
約800(mm)<V<約1000(mm)
約600(mm)<H<約800(mm)
約800(mm)<T<約1000(mm)
図16を参照して、本変形例に係る顕微鏡装置10cの使用例について説明する。図16は、本変形例に係る顕微鏡装置10cを用いた座位での手術の様子を示す図である。
以上説明した顕微鏡装置10、10a~10cには、顕微鏡部110によって撮影された映像の振動を抑制する映像振動抑制機構が搭載されてもよい。かかる映像振動抑制機構が搭載されることにより、より安定的な術部の映像を得ることができ、手術をより円滑に行うことが可能になる。
以上、添付図面を参照しながら本開示の好適な実施形態について詳細に説明したが、本開示の技術的範囲はかかる例に限定されない。本開示の技術分野における通常の知識を有する者であれば、特許請求の範囲に記載された技術的思想の範疇内において、各種の変更例または修正例に想到し得ることは明らかであり、これらについても、当然に本開示の技術的範囲に属するものと了解される。
(1)手術台上の患者の術部を撮影し、映像信号を出力する顕微鏡部と、先端において前記顕微鏡部を支持する支持部と、を備え、前記支持部が、先端側から順に、第1アームと、先端において前記第1アームの基端を鉛直方向及び前後方向と互いに直交する第1の回転軸まわりに回動可能に支持する第2アームと、床面から略鉛直方向に延伸し、先端において前記第2アームの基端を鉛直方向及び前後方向と互いに直交する第2の回転軸まわりに回動可能に支持する支柱部と、によって構成されるとみなした場合に、前記支持部は、前記第1の回転軸と前記第2の回転軸との間の長さである前記第2アームの長さが、前記顕微鏡部の光軸が略鉛直になるように配置された際における当該顕微鏡部の光軸と前記第1の回転軸との間の長さである前記第1アームの長さよりも長くなるように構成される、手術用顕微鏡装置。
(2)前記第2アームの長さをV、前記支柱部に対する前記第2アームの回転角度をr2、立位での手術時における前記顕微鏡部の床面からの高さをZ1、座位での手術時における前記顕微鏡部の床面からの高さをZ2とした場合に、当該長さV、当該回転角度r2、当該高さZ1及び当該高さZ2が、Z1-Z2<V(1-cos(r2))で示す関係を満たす、前記(1)に記載の手術用顕微鏡装置。
(3)前記長さV、前記回転角度r2、前記高さZ1及び前記高さZ2が、200(mm)<V(1-cos(r2))で示す関係を満たす、前記(2)に記載の手術用顕微鏡装置。
(4)前記支柱部の長さをT、前記支柱部に対する前記第2アームの回転角度をr2、座位での手術時における前記顕微鏡部の床面からの高さをZ2とした場合に、当該長さV、当該回転角度r2及び当該高さZ2が、Z2>Vcos(r2)+Tで示す関係を満たす、前記(1)~(3)のいずれか1項に記載の手術用顕微鏡装置。
(5)前記支持部は、水平方向における前記支柱部からの距離が約800(mm)であり鉛直方向における床面からの距離が約1600(mm)である空間上の位置を、前記顕微鏡部が通過するように構成される、前記(1)~(4)のいずれか1項に記載の手術用顕微鏡装置。
(6)前記支持部は、前記第1アームの長さ、前記第2アームの長さ、及び前記支柱部の長さの合計が、2500(mm)よりも小さくなるように構成される、前記(5)に記載の手術用顕微鏡装置。
(7)前記第2アームに対する前記第1アームの回転角度をr1、前記支柱部に対する前記第2アームの回転角度をr2とした場合に、当該回転角度r1及び当該回転角度r2が、約130°<r1+r2<約180°で示す関係を満たす、前記(5)又は(6)に記載の手術用顕微鏡装置。
(8)前記支持部は、前記支柱部の長さが前記手術台の高さよりも短くなるように構成される、前記(1)~(7)のいずれか1項に記載の手術用顕微鏡装置。
(9)前記支柱部の長さは、800(mm)よりも短い、前記(8)に記載の手術用顕微鏡装置。
(10)前記支柱部の長さTは、約800(mm)<T<約1000(mm)で示す関係を満たす、前記(5)に記載の手術用顕微鏡装置。
(11)前記顕微鏡部の作動距離の最大値WDmaxは、約400(mm)≦WDmax≦約600(mm)で示す関係を満たす、前記(10)のいずれか1項に記載の手術用顕微鏡装置。
(12)前記支持部は、前記第1アームの長さ、前記第2アームの長さ、及び前記支柱部の長さの合計が、2000(mm)よりも大きくなるように構成される、前記(1)~(11)のいずれか1項に記載の手術用顕微鏡装置。
(13)前記支持部は、バランスアームとして構成される、前記(1)~(12)のいずれか1項に記載の手術用顕微鏡装置。
(14)前記第2アームは、前記支持部を構成する平行四辺形リンク機構に対応する、前記(1)~(13)のいずれか1項に記載の手術用顕微鏡装置。
(15)前記支持部には、前記第2アームと前記支柱部との接続部位に対応する位置に、前記第2アームの延伸方向と平行な回転軸まわりに前記第2アームを回動可能に支持する回転軸部が設けられる、前記(1)~(14)のいずれか1項に記載の手術用顕微鏡装置。
(16)前記支持部の基端を支持するベース部の上面に、前記手術用顕微鏡装置における信号処理を実行する電装部が搭載され、前記ベース部の上面において、前記支持部の基端は、前記電装部よりも前方側に接続される、前記(1)~(15)のいずれか1項に記載の手術用顕微鏡装置。
(17)前記電装部は、前記ベース部の上面において、後方側が前方側よりも高くなるように構成される、前記(16)に記載の手術用顕微鏡装置。
(18)手術台上の患者の術部を撮影し映像信号を出力する顕微鏡部と、先端において前記顕微鏡部を支持する支持部と、を備える顕微鏡装置と、前記映像信号に基づく映像を表示する表示装置と、を備え、前記支持部が、先端側から順に、第1アームと、先端において前記第1アームの基端を鉛直方向及び前後方向と互いに直交する第1の回転軸まわりに回動可能に支持する第2アームと、床面から略鉛直方向に延伸し、先端において前記第2アームの基端を鉛直方向及び前後方向と互いに直交する第2の回転軸まわりに回動可能に支持する支柱部と、によって構成されるとみなした場合に、前記支持部は、前記第1の回転軸と前記第2の回転軸との間の長さである前記第2アームの長さが、前記顕微鏡部の光軸が略鉛直になるように配置された際における当該顕微鏡部の光軸と前記第1の回転軸との間の長さである前記第1アームの長さよりも長くなるように構成される、手術用顕微鏡システム。
10、710、810 顕微鏡装置
20、760 表示装置
110、701、801 顕微鏡部
120、703、803 支持部(アーム部)
130705、805 ベース部
131 架台
132 キャスター
140 制御装置
210 第1回転軸部
220 第2回転軸部
230 第3回転軸部
240 第4回転軸部(平行四辺形リンク機構)
250 第5回転軸部
260 第6回転軸部
241、242、243、244 アーム
245、246、247、248 関節部
271 第1アーム部
272 第2アーム部
273 第3アーム部
274 第4アーム部
290a、707a、807a 第1アーム
290b、707b、807b 第2アーム
290c、707c、807c 支柱部
320、720、820 術者
330、730、830 患者
340、740、840 手術台
Claims (18)
- 手術台上の患者の術部を撮影し、映像信号を出力する顕微鏡部と、
先端において前記顕微鏡部を支持する支持部と、
を備え、
前記支持部が、先端側から順に、第1アームと、先端において前記第1アームの基端を鉛直方向及び前後方向と互いに直交する第1の回転軸まわりに回動可能に支持する第2アームと、床面から略鉛直方向に延伸し、先端において前記第2アームの基端を鉛直方向及び前後方向と互いに直交する第2の回転軸まわりに回動可能に支持する支柱部と、によって構成されるとみなした場合に、
前記支持部は、前記第1の回転軸と前記第2の回転軸との間の長さである前記第2アームの長さが、前記顕微鏡部の光軸が略鉛直になるように配置された際における当該顕微鏡部の光軸と前記第1の回転軸との間の長さである前記第1アームの長さよりも長くなるように構成される、
手術用顕微鏡装置。 - 前記第2アームの長さをV、前記支柱部に対する前記第2アームの回転角度をr2、立位での手術時における前記顕微鏡部の対物レンズの床面からの高さをZ1、座位での手術時における前記顕微鏡部の対物レンズの床面からの高さをZ2とした場合に、当該長さV、当該回転角度r2、当該高さZ1及び当該高さZ2が、Z1-Z2<V(1-cos(r2))で示す関係を満たす、
請求項1に記載の手術用顕微鏡装置。 - 前記長さV、前記回転角度r2、前記高さZ1及び前記高さZ2が、200(mm)<V(1-cos(r2))で示す関係を満たす、
請求項2に記載の手術用顕微鏡装置。 - 前記支柱部の長さをT、前記支柱部に対する前記第2アームの回転角度をr2、座位での手術時における前記顕微鏡部の対物レンズの床面からの高さをZ2とした場合に、当該長さV、当該回転角度r2及び当該高さZ2が、Z2>Vcos(r2)+Tで示す関係を満たす、
請求項1に記載の手術用顕微鏡装置。 - 前記支持部は、水平方向における前記支柱部からの距離が約800(mm)であり鉛直方向における床面からの距離が約1600(mm)である空間上の位置を、前記顕微鏡部の対物レンズが通過するように構成される、
請求項1に記載の手術用顕微鏡装置。 - 前記支持部は、前記第1アームの長さ、前記第2アームの長さ、及び前記支柱部の長さの合計が、2500(mm)よりも小さくなるように構成される、
請求項5に記載の手術用顕微鏡装置。 - 前記第2アームに対する前記第1アームの回転角度をr1、前記支柱部に対する前記第2アームの回転角度をr2とした場合に、当該回転角度r1及び当該回転角度r2が、約130°<r1+r2<約180°で示す関係を満たす、
請求項5に記載の手術用顕微鏡装置。 - 前記支持部は、前記支柱部の長さが前記手術台の高さよりも短くなるように構成される、
請求項1に記載の手術用顕微鏡装置。 - 前記支柱部の長さは、800(mm)よりも短い、
請求項8に記載の手術用顕微鏡装置。 - 前記支柱部の長さTは、約800(mm)<T<約1000(mm)で示す関係を満たす、
請求項5に記載の手術用顕微鏡装置。 - 前記顕微鏡部の作動距離の最大値WDmaxは、約400(mm)≦WDmax≦約600(mm)で示す関係を満たす、
請求項10に記載の手術用顕微鏡装置。 - 前記支持部は、前記第1アームの長さ、前記第2アームの長さ、及び前記支柱部の長さの合計が、2000(mm)よりも大きくなるように構成される、
請求項1に記載の手術用顕微鏡装置。 - 前記支持部は、バランスアームとして構成される、
請求項1に記載の手術用顕微鏡装置。 - 前記第2アームは、前記支持部を構成する平行四辺形リンク機構に対応する、
請求項1に記載の手術用顕微鏡装置。 - 前記支持部には、前記第2アームと前記支柱部との接続部位に対応する位置に、前記第2アームの延伸方向と平行な回転軸まわりに前記第2アームを回動可能に支持する回転軸部が設けられる、
請求項1に記載の手術用顕微鏡装置。 - 前記支持部の基端を支持するベース部の上面に、前記手術用顕微鏡装置における信号処理を実行する電装部が搭載され、
前記ベース部の上面において、前記支持部の基端は、前記電装部よりも前方側に接続される、
請求項1に記載の手術用顕微鏡装置。 - 前記電装部は、前記ベース部の上面において、後方側が前方側よりも高くなるように構成される、
請求項16に記載の手術用顕微鏡装置。 - 手術台上の患者の術部を撮影し映像信号を出力する顕微鏡部と、先端において前記顕微鏡部を支持する支持部と、を備える顕微鏡装置と、
前記映像信号に基づく映像を表示する表示装置と、
を備え、
前記支持部が、先端側から順に、第1アームと、先端において前記第1アームの基端を鉛直方向及び前後方向と互いに直交する第1の回転軸まわりに回動可能に支持する第2アームと、床面から略鉛直方向に延伸し、先端において前記第2アームの基端を鉛直方向及び前後方向と互いに直交する第2の回転軸まわりに回動可能に支持する支柱部と、によって構成されるとみなした場合に、
前記支持部は、前記第1の回転軸と前記第2の回転軸との間の長さである前記第2アームの長さが、前記顕微鏡部の光軸が略鉛直になるように配置された際における当該顕微鏡部の光軸と前記第1の回転軸との間の長さである前記第1アームの長さよりも長くなるように構成される、
手術用顕微鏡システム。
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JP2019166414A (ja) | 2019-10-03 |
US20180168767A1 (en) | 2018-06-21 |
JP6267401B2 (ja) | 2018-01-31 |
JP2018081315A (ja) | 2018-05-24 |
JP6764006B2 (ja) | 2020-09-30 |
US10898290B2 (en) | 2021-01-26 |
CN107735046A (zh) | 2018-02-23 |
EP3315090A1 (en) | 2018-05-02 |
US20210093411A1 (en) | 2021-04-01 |
US11850103B2 (en) | 2023-12-26 |
JP6552592B2 (ja) | 2019-07-31 |
EP3315090B1 (en) | 2020-12-30 |
JPWO2016208485A1 (ja) | 2018-02-22 |
CN107735046B (zh) | 2021-04-30 |
EP3315090A4 (en) | 2019-04-10 |
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