WO2019194173A1 - Medical projector support structure - Google Patents

Medical projector support structure Download PDF

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Publication number
WO2019194173A1
WO2019194173A1 PCT/JP2019/014612 JP2019014612W WO2019194173A1 WO 2019194173 A1 WO2019194173 A1 WO 2019194173A1 JP 2019014612 W JP2019014612 W JP 2019014612W WO 2019194173 A1 WO2019194173 A1 WO 2019194173A1
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Prior art keywords
medical
medical projector
cover
arm
projector
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PCT/JP2019/014612
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French (fr)
Japanese (ja)
Inventor
悦朗 波多野
隆士 新田
智 瀬尾
勝之 中村
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国立大学法人京都大学
三鷹光器株式会社
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Application filed by 国立大学法人京都大学, 三鷹光器株式会社 filed Critical 国立大学法人京都大学
Priority to JP2020512256A priority Critical patent/JP7233655B2/en
Publication of WO2019194173A1 publication Critical patent/WO2019194173A1/en

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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
    • 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
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B90/35—Supports therefor

Definitions

  • the present invention relates to a support structure for a medical projector.
  • Patent Document 1 Medical devices such as microscopes and cameras used in surgery are supported by the tip of a support arm that extends laterally from a stand device installed on the floor.
  • a holding arm having a plurality of rotating shafts is attached to the tip of the support arm, and a medical device is fixed to the tip of the holding arm (see, for example, Patent Document 1).
  • Related technology is exemplified in Japanese Patent Publication No. 2017-6620 (Patent Document 1).
  • a medical projector has been developed that takes a fluorescent image of an organ at a surgical site, visualizes it, and projects it directly onto the organ using a projection mapping technique. Since such a medical projector has a heat generating portion inside, it is necessary to reliably discharge the internal heat to the outside using the support structure of the medical projector.
  • a pipe-shaped holding arm having a bifurcated branch end from the middle is provided at the tip of a support arm extending in the lateral direction of a stand device installed on the floor. Attached so as to be rotatable around a first rotation axis that matches the axis of the axis, and rotates between both ends on the distal end side of the holding arm around a second rotation axis that is orthogonal to the first rotation axis of the support arm.
  • a free cylindrical part is attached, and the outer ring part of the ring bearing in which a plurality of rolling elements are interposed between the outer ring and the inner ring is fixed to the cylindrical part, and a cover is provided inside the ring bearing and outside the frame.
  • a medical projector that irradiates light from the lower surface with a hollow structure provided, and is fixed to the inner ring portion of the ring-shaped bearing, and is arranged so as to be rotatable about the central axis of the ring-shaped bearing.
  • a cutout portion having a width corresponding to the cylindrical portion is formed around the side surface of the cover of the medical projector, and a flange having a circular outer edge is formed outward from the upper and lower ends of the cutout portion,
  • a ring plate slidable on the flange is provided on the upper and lower ends of the cylindrical portion, the space between the cylindrical portion and the cover is made the same space as the inside of the cover, an air intake is formed in a part of the cover, and a medical projector The inside air can be discharged from an opening formed in the cylindrical portion through a holding arm.
  • the support arm has a pipe shape communicating with the holding arm, an exhaust pump is provided inside the support arm, and the air in the medical projector is passed through the holding arm and the support arm. It is characterized by being able to discharge to the outside.
  • FIG. 3 is a sectional view taken along the line SA-SA in FIG. Sectional drawing which follows the SB-SB line
  • FIG. 6 is a cross-sectional view taken along the line SD-SD shown in FIG.
  • FIG. 1 A preferred embodiment of the present invention will be described with reference to FIGS.
  • the front-rear and left-right directions are as shown in FIG.
  • the stand device 1 installed on the floor in the operating room includes a stand body 2 that can be rotated horizontally on the base.
  • a parallel link mechanism R including a front arm 3 and a rear arm 4 is supported on the stand body 2 so as to be rotatable about a rotation shaft 5 set in the middle of the front arm 3.
  • the upper side of the parallel link mechanism R is formed by the rear portion of the support arm 6, and the support arm 6 extends forward as it is.
  • the lower side of the parallel link mechanism R is formed by a front portion of the lower arm 7, the lower arm 7 extends rearward as it is, and a counterweight 8 is attached to the rear end.
  • the rear arm 4 and the support arm 6 communicate with each other in a pipe shape.
  • An exhaust pump 21 is built in the support arm 6.
  • a holding arm 9 whose tip is branched in a bifurcated manner is attached.
  • the holding arm 9 is attached so as to be rotatable about a first rotation axis X that matches the axis of the support arm 6.
  • the holding arm 9 is also pipe-shaped and communicates with the support arm 6.
  • a ring-shaped cylindrical portion 11 is attached between the end portions 10 of the holding arm 9 which are bifurcated.
  • the cylindrical portion 11 is rotatably attached to the end portion 10 in a state where the maximum diameter portion is centered on a second rotation axis Y orthogonal to the first rotation axis X.
  • a medical projector 18 is disposed inside the ring-shaped bearing 13.
  • the medical projector 18 is a substantially rectangular parallelepiped and has a hollow structure in which a cover 23 is provided on an internal frame 22.
  • An air intake 24 is formed at the top of the cover 23.
  • a notch 25 having a width corresponding to the cylindrical portion 11 is formed.
  • a flange 37 having a circular outer edge is formed outward from both upper and lower ends of the notch 25.
  • a synthetic resin ring plate 38 slidable on the flange 37 is provided, and the space between the cylindrical portion 11 and the cover 23 is made the same space as the inside of the cover 23.
  • a plurality of convex portions 12 are formed on the inner surface of the cylindrical portion 11 along the circumferential direction.
  • a ring-shaped bearing 13 is mounted on the convex portion 12.
  • the ring-shaped bearing 13 has a structure in which a plurality of rollers (rolling elements) 16 are interposed between the outer ring 14 and the inner ring 15, and the outer ring 14 is fixed to the convex portion 12 with screws 17.
  • a plurality of mounting parts 19 are fixed around the side surface, and the tip ends are fixed to the inner ring 15 of the ring-shaped bearing 13 with screws 20 from below.
  • the center axis Z of the ring-shaped bearing 13 is orthogonal to the first rotation axis X and the second rotation axis Y, and the medical projector 18 is rotatable with respect to the cylindrical portion 11 and the outer ring 14 about the center axis Z. .
  • An operation handle 26 is attached to the left and right of the lower end of the medical projector 18 (the handle 26 is not shown in FIG. 5).
  • the operation handle 26 is for operating the electromagnetic clutch and the medical projector 18 in each rotating part of the stand device 1.
  • the illumination 27 irradiates white light H to illuminate the surgical site at hand of Dr. D from all directions, and eliminates the fact that the surgical site becomes dark due to the shadow of Dr. D's hand.
  • the medical projector 18 supported by the stand device 1 at a position higher than the head of the doctor D takes a fluorescent part from the organ G during the operation of the patient P, visualizes it, and projects it onto the organ G in real time. It is a device for.
  • a window 29 is formed on the lower surface of the medical projector 18, and an excitation light illumination 30 that emits excitation light E having a specific wavelength is provided around the window 29. Since there is the excitation light illumination 30 around the window 29, the excitation light E can be applied to the organ G from all directions.
  • a light branching means 31 that partially transmits and reflects light directly above the window 29.
  • a projector unit 32 and a camera unit 33 are provided inside.
  • a fluorescence camera 34 and a visible light camera 35 are provided inside the camera unit 33, and optical filter means (not shown) for separating the fluorescence and visible light is also provided.
  • the patient P is preliminarily administered with a fluorescent reagent safe for the human body.
  • the operating light 36 in the operating room is basically turned off (it may be turned on depending on the fluorescence intensity).
  • the excitation light illumination 30 irradiates the organ G at the surgical site with the excitation light E having a specific wavelength. Then, in the operative field including the organ G, a blood flow or a lymph vessel flow or a tumor under the surface of the tissue that cannot be seen with the naked eye emits light as the fluorescent light emitting portion F.
  • the reflected light A from the surgical field including the fluorescence from the fluorescent light emitting unit F is taken into the medical projector 18 through the window 29 and guided to the camera unit 33.
  • the camera unit 33 separates the reflected light A into fluorescence and visible light, and the fluorescence is captured by the fluorescence camera 34 and the visible light is captured by the visible light camera 35.
  • the fluorescent image B captured by the fluorescent camera 34 is visualized and sent to the projector unit 32, and is projected from the projector unit 32 to the organ G through the light branching means 31 through the window 29.
  • This is projection mapping in which the fluorescent image B is projected onto the organ G in real time. Due to the real-time projection, the deformation and movement of the organ G can be followed without any time difference, and the doctor D can perform an operation with reference to the fluorescent image B projected onto the organ G.
  • the electromagnetic clutch of the rotating part of the stand device 1 is released by operating while holding the operation handle 26, and the medical projector 18 is moved up and down as a whole. Alternatively, it can be moved back and forth and left and right.
  • the medical projector 18 rotates with the holding arm 9 about the first rotation axis X, rotates with the ring-shaped bearing 13 about the second rotation axis Y, and rotates about the central axis Z of the ring-shaped bearing 13 Therefore, the projection direction can be arbitrarily changed.
  • the medical projector 18 can be rotated around the central axis Z in a state where the space between the flanges is sealed. it can.
  • the end portion 10 communicating with the pipe-shaped holding arm 9 communicates with the internal space of the cover 23 through an opening 41 formed in the cylindrical portion 11.
  • the holding arm 9 and the support arm 6 communicate with each other, and the support arm 6 and the rear arm 4 also communicate with each other.
  • the rear arm 4 is also pipe-shaped and communicates with the support arm 6, and the lower end is open.
  • a communication path 40 is formed in the connecting portion 39 between the rear arm 4 and the lower arm 7.
  • the space between the cutout portion and the cylindrical portion formed in the cover of the medical projector is made the same space as the inside of the cover, and the portion made the same space is used. Since the air inside the medical projector is discharged from the holding arm to the outside, the heat inside the cover can be discharged together with the air.
  • the support arm also has a pipe shape, and the air in the medical projector can be discharged to a position away from the medical projector via the support arm.

Abstract

The area between a cylindrical part (11) and a cutout (25) formed in a cover (23) of a medical projector (18) is formed so as to be the same space as the interior of the cover (23). This shared space portion is used to reliably vent heat and air N from the interior of the medical projector (18) to the outside through a retaining arm (9). In addition, a support arm 6 is imparted with a pipe shape to allow air (N) to be vented to a position separate from the medical projector (18).

Description

医療用プロジェクターの支持構造Support structure for medical projector
　本発明は医療用プロジェクターの支持構造に関する。 The present invention relates to a support structure for a medical projector.
　手術で使用される顕微鏡やカメラ等の医療機器は、フロアに設置されたスタンド装置から横方向に延びる支持アームの先端部に支持される。支持アームの先端部には複数の回転軸を有する保持アームが取付けられ、その保持アームの先端に医療機器が固定される（例えば、特許文献１参照）。関連技術は日本国特許公開公報特開２０１７－６６２０号（特許文献１）に例示される。 Medical devices such as microscopes and cameras used in surgery are supported by the tip of a support arm that extends laterally from a stand device installed on the floor. A holding arm having a plurality of rotating shafts is attached to the tip of the support arm, and a medical device is fixed to the tip of the holding arm (see, for example, Patent Document 1). Related technology is exemplified in Japanese Patent Publication No. 2017-6620 (Patent Document 1).
　顕微鏡やカメラ等の医療機器はそれ自体が多くの熱を発生する構造ではないため、特別な排熱構造を必要としないが、近年では内部に発熱部を備えた大型の医療機器も開発されている。例えば、手術部位の臓器における蛍光画像を撮影し、それを可視画像化してプロジェクションマッピング技術により臓器に直接投影する医療用プロジェクターが開発されている。このような医療用プロジェクターは内部に発熱部を有するため、医療用プロジェクターの支持構造を利用して内部の熱を外部へ確実に排出する必要がある。 Since medical devices such as microscopes and cameras do not themselves generate a lot of heat, they do not require a special heat-dissipating structure, but in recent years, large-scale medical devices with internal heating elements have also been developed. Yes. For example, a medical projector has been developed that takes a fluorescent image of an organ at a surgical site, visualizes it, and projects it directly onto the organ using a projection mapping technique. Since such a medical projector has a heat generating portion inside, it is necessary to reliably discharge the internal heat to the outside using the support structure of the medical projector.
　本発明によれば、医療用プロジェクターの内部の熱を外部へ確実に排出することができる医療用プロジェクターの支持構造を提供することができる。 According to the present invention, it is possible to provide a support structure for a medical projector that can reliably discharge the heat inside the medical projector to the outside.
　本発明の第１の技術的側面によれば、フロアに設置されたスタンド装置の横方向に延びる支持アームの先端部に、途中から先端側が二股状に分岐したパイプ形状の保持アームを、支持アームの軸心に合致した第１回転軸を中心に回転自在に取付け、保持アームの先端側の両方の端部間に、支持アームの第１回転軸に直交する第２回転軸を中心にして回転自在な円筒部を取付け、該円筒部に、外輪と内輪との間に複数の転動体を介在させたリング状ベアリングの外輪部分を固定し、リング状ベアリングの内部に、フレームの外側にカバーを設けた中空構造で下面より光線を照射する医療用プロジェクターを、リング状ベアリングの内輪部分に固定した状態で、リング状ベアリングの中心軸を中心にして回転自在に配置した医療用プロジェクターの支持構造であって、前記医療用プロジェクターのカバーの側面周囲に円筒部に相応する幅の切欠部を形成すると共に該切欠部の上下両端から外側へ向けて外縁が円形のフランジを形成し、円筒部の上下端部に前記フランジに摺動自在なリング板を設けて、円筒部とカバーとの間をカバー内部と同一空間化し、カバーの一部に空気取入口を形成すると共に医療用プロジェクター内の空気を円筒部に形成した開口から保持アームを介して排出可能としたことを特徴とする。 According to the first technical aspect of the present invention, a pipe-shaped holding arm having a bifurcated branch end from the middle is provided at the tip of a support arm extending in the lateral direction of a stand device installed on the floor. Attached so as to be rotatable around a first rotation axis that matches the axis of the axis, and rotates between both ends on the distal end side of the holding arm around a second rotation axis that is orthogonal to the first rotation axis of the support arm. A free cylindrical part is attached, and the outer ring part of the ring bearing in which a plurality of rolling elements are interposed between the outer ring and the inner ring is fixed to the cylindrical part, and a cover is provided inside the ring bearing and outside the frame. A medical projector that irradiates light from the lower surface with a hollow structure provided, and is fixed to the inner ring portion of the ring-shaped bearing, and is arranged so as to be rotatable about the central axis of the ring-shaped bearing. A cutout portion having a width corresponding to the cylindrical portion is formed around the side surface of the cover of the medical projector, and a flange having a circular outer edge is formed outward from the upper and lower ends of the cutout portion, A ring plate slidable on the flange is provided on the upper and lower ends of the cylindrical portion, the space between the cylindrical portion and the cover is made the same space as the inside of the cover, an air intake is formed in a part of the cover, and a medical projector The inside air can be discharged from an opening formed in the cylindrical portion through a holding arm.
　本発明の第２の技術的側面によれば、支持アームを保持アームと連通するパイプ形状として、支持アームの内部に排気ポンプを設け、医療用プロジェクター内の空気を保持アーム及び支持アームを介して外部へ排出可能としたことを特徴とする。 According to the second technical aspect of the present invention, the support arm has a pipe shape communicating with the holding arm, an exhaust pump is provided inside the support arm, and the air in the medical projector is passed through the holding arm and the support arm. It is characterized by being able to discharge to the outside.
スタンド装置に支持された医療用プロジェクターを示す斜視図。The perspective view which shows the medical projector supported by the stand apparatus. スタンド装置に支持された医療用プロジェクターを示す側面図。The side view which shows the medical projector supported by the stand apparatus. 医療用プロジェクターの内部構造を示す説明図。Explanatory drawing which shows the internal structure of a medical projector. 医療用プロジェクターのカバーの構造を示す斜視図。The perspective view which shows the structure of the cover of a medical projector. 医療用プロジェクターを示す下面図。The bottom view which shows a medical projector. 医療用プロジェクターを示す斜視図。The perspective view which shows a medical projector. リング状ベアリングを示す分解斜視図。The disassembled perspective view which shows a ring-shaped bearing. カバーと保持アームを示す断面図。Sectional drawing which shows a cover and a holding arm. 図２中矢示ＳＡ－ＳＡ線に沿う断面図。FIG. 3 is a sectional view taken along the line SA-SA in FIG. 図２中矢示ＳＢ－ＳＢ線に沿う断面図。Sectional drawing which follows the SB-SB line | wire shown by the arrow in FIG. リング状ベアリングを示す断面図。Sectional drawing which shows a ring-shaped bearing. 図５中矢示ＳＣ－ＳＣ線に沿う断面図。Sectional drawing which follows the SC-SC line shown by the arrow in FIG. 図５中矢示ＳＤ－ＳＤ線に沿う断面図。FIG. 6 is a cross-sectional view taken along the line SD-SD shown in FIG.
　本発明の好適な実施形態を図１～図１３に基づいて説明する。以下において前後左右の方向性は図１に示された通りである。 A preferred embodiment of the present invention will be described with reference to FIGS. In the following, the front-rear and left-right directions are as shown in FIG.
　手術室内のフロア上に設置されているスタンド装置１は、ベース上で水平方向に回転自在なスタンド本体２を備えている。スタンド本体２には、前アーム３及び後アーム４を含む平行リンク機構Ｒが、前アーム３の途中に設定された回転軸５を中心にして回転自在に支持されている。 The stand device 1 installed on the floor in the operating room includes a stand body 2 that can be rotated horizontally on the base. A parallel link mechanism R including a front arm 3 and a rear arm 4 is supported on the stand body 2 so as to be rotatable about a rotation shaft 5 set in the middle of the front arm 3.
　平行リンク機構Ｒの上辺は支持アーム６の後側部分により形成され、支持アーム６はそのまま前方へ延びている。平行リンク機構Ｒの下辺は下アーム７の前側部分により形成され、下アーム７はそのまま後方へ延び、後端にはカウンタウェイト８が取付けられている。後アーム４及び支持アーム６はパイプ形状で互いに連通している。支持アーム６の内部には排気ポンプ２１が内蔵されている。 The upper side of the parallel link mechanism R is formed by the rear portion of the support arm 6, and the support arm 6 extends forward as it is. The lower side of the parallel link mechanism R is formed by a front portion of the lower arm 7, the lower arm 7 extends rearward as it is, and a counterweight 8 is attached to the rear end. The rear arm 4 and the support arm 6 communicate with each other in a pipe shape. An exhaust pump 21 is built in the support arm 6.
　支持アーム６の先端部には、途中から先端側が二股状に分岐した保持アーム９が取付けられている。保持アーム９は支持アーム６の軸心に合致した第１回転軸Ｘを中心に回転自在に取付けられている。この保持アーム９もパイプ形状で、支持アーム６と連通している。 At the tip of the support arm 6, a holding arm 9 whose tip is branched in a bifurcated manner is attached. The holding arm 9 is attached so as to be rotatable about a first rotation axis X that matches the axis of the support arm 6. The holding arm 9 is also pipe-shaped and communicates with the support arm 6.
　保持アーム９の二股状に分岐した先端側の端部１０間にはリング状の円筒部１１が取付けられている。円筒部１１はその最大直径部分が、第１回転軸Ｘに直交する第２回転軸Ｙを中心にした状態で、端部１０に対して回転自在に取付けられている。 A ring-shaped cylindrical portion 11 is attached between the end portions 10 of the holding arm 9 which are bifurcated. The cylindrical portion 11 is rotatably attached to the end portion 10 in a state where the maximum diameter portion is centered on a second rotation axis Y orthogonal to the first rotation axis X.
　リング状ベアリング１３の内部には医療用プロジェクター１８が配置されている。医療用プロジェクター１８は概略直方体で、内部のフレーム２２にカバー２３を設けた中空構造をしている。カバー２３の頂部には空気取入口２４が形成されている。カバー２３の側面周囲には円筒部１１に相応する幅の切欠部２５が形成されている。またこの切欠部２５の上下両端からは外側へ向けて外縁が円形のフランジ３７が形成されている。 A medical projector 18 is disposed inside the ring-shaped bearing 13. The medical projector 18 is a substantially rectangular parallelepiped and has a hollow structure in which a cover 23 is provided on an internal frame 22. An air intake 24 is formed at the top of the cover 23. Around the side surface of the cover 23, a notch 25 having a width corresponding to the cylindrical portion 11 is formed. Further, a flange 37 having a circular outer edge is formed outward from both upper and lower ends of the notch 25.
　円筒部１１の上下端部には前記フランジ３７に摺動自在な合成樹脂製のリング板３８が設けられ、円筒部１１とカバー２３との間をカバー２３の内部と同一空間化している。 At the upper and lower ends of the cylindrical portion 11, a synthetic resin ring plate 38 slidable on the flange 37 is provided, and the space between the cylindrical portion 11 and the cover 23 is made the same space as the inside of the cover 23.
　円筒部１１の内面には複数の凸部１２が円周方向に沿って形成されている。この凸部１２上にリング状ベアリング１３が取付けられている。リング状ベアリング１３は、外輪１４と内輪１５との間に複数のコロ（転動体）１６を介在させた構造で、その外輪１４がネジ１７により凸部１２に固定されている。 A plurality of convex portions 12 are formed on the inner surface of the cylindrical portion 11 along the circumferential direction. A ring-shaped bearing 13 is mounted on the convex portion 12. The ring-shaped bearing 13 has a structure in which a plurality of rollers (rolling elements) 16 are interposed between the outer ring 14 and the inner ring 15, and the outer ring 14 is fixed to the convex portion 12 with screws 17.
　その側面の周囲に複数の取付部品１９が固定されており、その先端部がリング状ベアリング１３の内輪１５に下側からネジ２０により固定されている。リング状ベアリング１３の中心軸Ｚは前記第１回転軸Ｘ及び第２回転軸Ｙと直交し、医療用プロジェクター１８はこの中心軸Ｚを中心に円筒部１１及び外輪１４に対して回転自在となる。 A plurality of mounting parts 19 are fixed around the side surface, and the tip ends are fixed to the inner ring 15 of the ring-shaped bearing 13 with screws 20 from below. The center axis Z of the ring-shaped bearing 13 is orthogonal to the first rotation axis X and the second rotation axis Y, and the medical projector 18 is rotatable with respect to the cylindrical portion 11 and the outer ring 14 about the center axis Z. .
　医療用プロジェクター１８の下端部には操作ハンドル２６が左右にそれぞれ取付けられている（図５ではハンドル２６の図示省略）。この操作ハンドル２６はスタンド装置１の各回転部における電磁クラッチや医療用プロジェクター１８を操作するためのものである。 An operation handle 26 is attached to the left and right of the lower end of the medical projector 18 (the handle 26 is not shown in FIG. 5). The operation handle 26 is for operating the electromagnetic clutch and the medical projector 18 in each rotating part of the stand device 1.
　医療用プロジェクター１８の側面部には、その下端周囲に７つの照明２７が異なる長さの支持バー２８により医療用プロジェクター１８から放射方向に離れた状態で且つ円周状に並んだ状態で配置されている。この照明２７は白色光Ｈを照射してドクターＤの手元の手術部位をあらゆる方向から照らして、ドクターＤの手の陰により手術部位が暗くなることを解消するためのものである。 On the side surface of the medical projector 18, seven illuminations 27 are arranged around the lower end of the medical projector 18 in a state of being separated from the medical projector 18 in a radial direction and arranged circumferentially by a support bar 28 having different lengths. ing. The illumination 27 irradiates white light H to illuminate the surgical site at hand of Dr. D from all directions, and eliminates the fact that the surgical site becomes dark due to the shadow of Dr. D's hand.
　スタンド装置１によりドクターＤの頭部より高い位置に支持された医療用プロジェクター１８は患者Ｐの手術中の臓器Ｇから蛍光部分を撮影して、それを可視画像化してリアルタイムで臓器Ｇに投影するための装置である。医療用プロジェクター１８の下面には窓２９が形成され、その周囲には特定波長の励起光Ｅを発する励起光照明３０が設けられている。窓２９の周囲に励起光照明３０があるため、励起光Ｅを臓器Ｇに対してあらゆる方向から照射することができる。 The medical projector 18 supported by the stand device 1 at a position higher than the head of the doctor D takes a fluorescent part from the organ G during the operation of the patient P, visualizes it, and projects it onto the organ G in real time. It is a device for. A window 29 is formed on the lower surface of the medical projector 18, and an excitation light illumination 30 that emits excitation light E having a specific wavelength is provided around the window 29. Since there is the excitation light illumination 30 around the window 29, the excitation light E can be applied to the organ G from all directions.
　医療用プロジェクター１８の内部には窓２９の真上に光を部分的に透過・反射する光分岐手段３１が設けられている。更に内部にはプロジェクター部３２とカメラ部３３が設けられている。カメラ部３３の内部には蛍光カメラ３４と可視光カメラ３５が設けられており、蛍光と可視光に分離する図示せぬ光学フィルタ手段も設けられている。 In the inside of the medical projector 18, there is provided a light branching means 31 that partially transmits and reflects light directly above the window 29. Further, a projector unit 32 and a camera unit 33 are provided inside. A fluorescence camera 34 and a visible light camera 35 are provided inside the camera unit 33, and optical filter means (not shown) for separating the fluorescence and visible light is also provided.
　患者Ｐには予め人体に安全な蛍光試薬が投与される。手術室内の無影灯３６は基本的に消灯する（蛍光強度によっては点灯する場合もある）。励起光照明３０から特定波長の励起光Ｅを手術部位の臓器Ｇに照射する。すると臓器Ｇを含む術野において、肉眼では見えない組織表面下の血管やリンパ管の流れ或いは腫瘍等が蛍光発光部Ｆとして発光する。その蛍光発光部Ｆからの蛍光を含む術野からの反射光Ａを窓２９から医療用プロジェクター１８の内部に取入れてカメラ部３３に導く。カメラ部３３では反射光Ａを蛍光と可視光に分離し、蛍光は蛍光カメラ３４で、可視光は可視光カメラ３５で撮影する。 The patient P is preliminarily administered with a fluorescent reagent safe for the human body. The operating light 36 in the operating room is basically turned off (it may be turned on depending on the fluorescence intensity). The excitation light illumination 30 irradiates the organ G at the surgical site with the excitation light E having a specific wavelength. Then, in the operative field including the organ G, a blood flow or a lymph vessel flow or a tumor under the surface of the tissue that cannot be seen with the naked eye emits light as the fluorescent light emitting portion F. The reflected light A from the surgical field including the fluorescence from the fluorescent light emitting unit F is taken into the medical projector 18 through the window 29 and guided to the camera unit 33. The camera unit 33 separates the reflected light A into fluorescence and visible light, and the fluorescence is captured by the fluorescence camera 34 and the visible light is captured by the visible light camera 35.
　蛍光カメラ３４で撮影された蛍光画像Ｂは可視画像化されてプロジェクター部３２へ送られ、プロジェクター部３２から光分岐手段３１を介して窓２９より臓器Ｇに投影される。蛍光画像Ｂが臓器Ｇにリアルタイムで投影されるプロジェクションマッピングとなる。リアルタイムの投影のため、臓器Ｇの変形や移動にも時差なく追従し、ドクターＤはその臓器Ｇに投影された蛍光画像Ｂを参考にして手術を行うことができる。 The fluorescent image B captured by the fluorescent camera 34 is visualized and sent to the projector unit 32, and is projected from the projector unit 32 to the organ G through the light branching means 31 through the window 29. This is projection mapping in which the fluorescent image B is projected onto the organ G in real time. Due to the real-time projection, the deformation and movement of the organ G can be followed without any time difference, and the doctor D can perform an operation with reference to the fluorescent image B projected onto the organ G.
　手術中に医療用プロジェクター１８の投影方向を変更する場合は、操作ハンドル２６を握りながら操作することにより、スタンド装置１の回転部分の電磁クラッチをフリーにして、医療用プロジェクター１８を全体的に上下或いは前後左右に移動させることができる。そして医療用プロジェクター１８が、第１回転軸Ｘを中心に保持アーム９ごと回転し、第２回転軸Ｙを中心にリング状ベアリング１３ごと回転し、リング状ベアリング１３の中心軸Ｚを中心に回転するため、投影方向を任意に変更することができる。 When changing the projection direction of the medical projector 18 during the operation, the electromagnetic clutch of the rotating part of the stand device 1 is released by operating while holding the operation handle 26, and the medical projector 18 is moved up and down as a whole. Alternatively, it can be moved back and forth and left and right. The medical projector 18 rotates with the holding arm 9 about the first rotation axis X, rotates with the ring-shaped bearing 13 about the second rotation axis Y, and rotates about the central axis Z of the ring-shaped bearing 13 Therefore, the projection direction can be arbitrarily changed.
　医療用プロジェクター１８のフランジ３７と、円筒部１１のリング板３８とが摺動自在なため、その間の空間を密閉化した状態で、医療用プロジェクター１８を中心軸Ｚを中心にして回転させることができる。 Since the flange 37 of the medical projector 18 and the ring plate 38 of the cylindrical portion 11 are slidable, the medical projector 18 can be rotated around the central axis Z in a state where the space between the flanges is sealed. it can.
　図８に示す如く、パイプ状の保持アーム９と連通している端部１０は円筒部１１に形成した開口４１を介してカバー２３の内部空間と連通している。保持アーム９と支持アーム６も連通し、支持アーム６と後アーム４も連通している。後アーム４もパイプ形状で、支持アーム６と連通しており、下端は開放されている。後アーム４と下アーム７との連結部３９には連通路４０が形成されている。 As shown in FIG. 8, the end portion 10 communicating with the pipe-shaped holding arm 9 communicates with the internal space of the cover 23 through an opening 41 formed in the cylindrical portion 11. The holding arm 9 and the support arm 6 communicate with each other, and the support arm 6 and the rear arm 4 also communicate with each other. The rear arm 4 is also pipe-shaped and communicates with the support arm 6, and the lower end is open. A communication path 40 is formed in the connecting portion 39 between the rear arm 4 and the lower arm 7.
　従って、支持アーム６内の排気ポンプ２１を操作ハンドル２６によりＯＮにすると、カバー２３内の空気Ｎが端部１０及び保持アーム９を介して吸引されると共に新たな空気Ｎが頂部の空気取入口２４から医療用プロジェクター１８内に導入される。そして医療用プロジェクター１８内の空気Ｎは内部の熱と共に、保持アーム９、支持アーム６、後アーム４を経て、後アーム４の下端より外部へ排出される。 Therefore, when the exhaust pump 21 in the support arm 6 is turned on by the operation handle 26, the air N in the cover 23 is sucked through the end portion 10 and the holding arm 9, and new air N is introduced into the top air intake port. 24 is introduced into the medical projector 18. The air N in the medical projector 18 is discharged to the outside from the lower end of the rear arm 4 through the holding arm 9, the support arm 6, and the rear arm 4 together with the internal heat.
　本発明の第１の技術的側面によれば、医療用プロジェクターのカバーに形成された切欠部と円筒部との間をカバー内部と同一空間化して、その同一空間化された部分を利用して、医療用プロジェクターの内部の空気を保持アームから外部へ排出するため、カバー内部の熱を空気と一緒に外部へ排出することができる。 According to the first technical aspect of the present invention, the space between the cutout portion and the cylindrical portion formed in the cover of the medical projector is made the same space as the inside of the cover, and the portion made the same space is used. Since the air inside the medical projector is discharged from the holding arm to the outside, the heat inside the cover can be discharged together with the air.
　本発明の第２の技術的側面によれば、支持アームもパイプ形状として、医療用プロジェクター内の空気を支持アームを介して医療用プロジェクターから離れた位置に排出することができる。 According to the second technical aspect of the present invention, the support arm also has a pipe shape, and the air in the medical projector can be discharged to a position away from the medical projector via the support arm.
　（米国指定）
　本国際特許出願は米国指定に関し、２０１８年４月３日に出願された日本国特許出願第２０１８－０７１３２４号について米国特許法第１１９条（ａ）に基づく優先権の利益を援用し、当該開示内容を引用する。 (US designation)
This international patent application is related to designation in the United States, and the benefit of the priority right under US Patent Act 119 (a) for Japanese Patent Application No. 2018-071324 filed on April 3, 2018 is incorporated herein by reference. Cite the contents.

Claims (2)

  1. 　フロアに設置されたスタンド装置の横方向に延びる支持アームの先端部に、途中から先端側が二股状に分岐したパイプ形状の保持アームを、支持アームの軸心に合致した第１回転軸を中心に回転自在に取付け、
    　保持アームの先端側の両方の端部間に、支持アームの第１回転軸に直交する第２回転軸を中心にして回転自在な円筒部を取付け、
    　該円筒部に、外輪と内輪との間に複数の転動体を介在させたリング状ベアリングの外輪部分を固定し、
    　リング状ベアリングの内部に、フレームの外側にカバーを設けた中空構造で下面より光線を照射する医療用プロジェクターを、リング状ベアリングの内輪部分に固定した状態で、リング状ベアリングの中心軸を中心にして回転自在に配置した医療用プロジェクターの支持構造であって、
    　前記医療用プロジェクターのカバーの側面周囲に円筒部に相応する幅の切欠部を形成すると共に該切欠部の上下両端から外側へ向けて外縁が円形のフランジを形成し、円筒部の上下端部に前記フランジに摺動自在なリング板を設けて、円筒部とカバーとの間をカバー内部と同一空間化し、
    　カバーの一部に空気取入口を形成すると共に医療用プロジェクター内の空気を円筒部に形成した開口から保持アームを介して排出可能としたことを特徴とする医療用プロジェクターの支持構造。     At the tip of the support arm that extends in the lateral direction of the stand device installed on the floor, a pipe-shaped holding arm with a tip bifurcated from the middle is centered on the first rotation axis that matches the axis of the support arm. Mount freely,
    A cylindrical portion that is rotatable about a second rotation axis that is orthogonal to the first rotation axis of the support arm is attached between both ends on the distal end side of the holding arm,
    Fixing the outer ring portion of the ring bearing in which a plurality of rolling elements are interposed between the outer ring and the inner ring to the cylindrical portion;
    A medical projector that irradiates light from the bottom with a hollow structure with a cover on the outside of the frame inside the ring bearing, fixed to the inner ring part of the ring bearing, with the center axis of the ring bearing as the center A support structure for a medical projector disposed in a freely rotatable manner,
    A notch having a width corresponding to the cylindrical portion is formed around the side surface of the cover of the medical projector, and a flange having a circular outer edge is formed outward from the upper and lower ends of the notched portion. Provide a slidable ring plate on the flange, make the space between the cylindrical part and the cover the same space as the inside of the cover,
    A support structure for a medical projector, wherein an air intake is formed in a part of the cover and air inside the medical projector can be discharged from an opening formed in a cylindrical portion through a holding arm.
  2. 　支持アームを保持アームと連通するパイプ形状として、支持アームの内部に排気ポンプを設け、医療用プロジェクター内の空気を保持アーム及び支持アームを介して外部へ排出可能としたことを特徴とする請求項１記載の医療用プロジェクターの支持構造。 The pipe shape that communicates the support arm with the holding arm is provided with an exhaust pump inside the support arm so that the air in the medical projector can be discharged to the outside through the holding arm and the support arm. 1. A support structure for a medical projector according to 1.
PCT/JP2019/014612 2018-04-03 2019-04-02 Medical projector support structure WO2019194173A1 (en)

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US20210321076A1 (en) * 2020-01-14 2021-10-14 Karl Storz Se & Co. Kg Optical observation instrument

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JPH06269461A (en) * 1993-03-18 1994-09-27 Mitaka Koki Co Ltd Heat dissipating structure of stand device
JP2004057614A (en) * 2002-07-30 2004-02-26 Olympus Corp Observation apparatus for surgery
WO2016162913A1 (en) * 2015-04-06 2016-10-13 日立マクセル株式会社 Lighting device
JP2017006620A (en) * 2015-06-23 2017-01-12 三鷹光器株式会社 Stereoscopic observation device for surgery

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH06269461A (en) * 1993-03-18 1994-09-27 Mitaka Koki Co Ltd Heat dissipating structure of stand device
JP2004057614A (en) * 2002-07-30 2004-02-26 Olympus Corp Observation apparatus for surgery
WO2016162913A1 (en) * 2015-04-06 2016-10-13 日立マクセル株式会社 Lighting device
JP2017006620A (en) * 2015-06-23 2017-01-12 三鷹光器株式会社 Stereoscopic observation device for surgery

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20210321076A1 (en) * 2020-01-14 2021-10-14 Karl Storz Se & Co. Kg Optical observation instrument
US11770514B2 (en) * 2020-01-14 2023-09-26 Karl Storz Se & Co. Kg Optical observation instrument

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