WO2020008652A1

WO2020008652A1 - Support device and surgery assistive system

Info

Publication number: WO2020008652A1
Application number: PCT/JP2018/025795
Authority: WO
Inventors: 優基中島; 晃徳須田; 荒井　大; 佑典青柳
Original assignee: 株式会社ニコン
Priority date: 2018-07-06
Filing date: 2018-07-06
Publication date: 2020-01-09

Abstract

This support device is capable of supporting a microscope equipped with an imaging unit. This support device comprises an installation section whereon the microscope is installed, and an arm holding the installation section, wherein the arm is disposed at a position that is outside the field-of-view region of an observation image when the observation image obtained from the microscope is being viewed by a user from the front side of the microscope.

Description

Support device and operation support system

技術 The technology of the present disclosure relates to a support device and a surgery support system.

Japanese Patent Application Laid-Open No. 2004-329762 discloses a microscope provided with a microscope supported via a lens body support, and moving means for moving the microscope in the vertical direction, so that the operator can freely move the lens body to an arbitrary position. An operating microscope capable of being operated is disclosed. In recent years, an operation microscope including a camera for imaging an affected part and a display unit for displaying the captured image has been used.

A support device according to a first aspect of the technology of the present disclosure is a support device that can support a microscope including an imaging unit, and an installation unit on which the microscope is installed, and an arm that holds the installation unit, An arm that is arranged at a position outside a field of view for the observation image while a user is viewing the observation image obtained from the microscope from the front side of the microscope.

A support device according to a second aspect of the technology of the present disclosure is a support device capable of supporting a microscope including an imaging unit, and a mounting unit in which the microscope is movably mounted, and a direction intersecting a vertical direction. An arm having a first arm portion extending from the installation portion, and a second arm portion extending from the first arm portion in a direction crossing upward with respect to a direction in which the first arm portion extends.

A support device according to a third aspect of the technology of the present disclosure is a support device that can support a microscope including an imaging unit, and includes an installation unit on which the microscope is installed, a top plate that holds the installation unit, and It has one or more legs that support the top plate from below, and deviates from the field of view for the observation image while the user is viewing the observation image obtained from the microscope from the front side of the microscope. And a table arranged at a different position.

A support device according to a fourth aspect of the technology of the present disclosure is a support unit that can support a microscope including an imaging unit, and in which a user is viewing an observation image obtained from the microscope from the front side of the microscope. And a support portion entirely disposed at a position outside the visual field region for the observation image.

A surgery support system according to a fifth aspect of the technology of the present disclosure includes a support device according to any one of the first aspect to the fourth aspect, the microscope, and an image based on an operation field light incident on the microscope. And a display control unit that causes the display unit to display.

FIG. 1 is a front view configuration diagram illustrating an example of an overall configuration of a surgery support system according to a first embodiment. FIG. 1 is a plan view showing an example of an overall configuration of a surgery support system according to a first embodiment. FIG. 1 is a side view configuration diagram illustrating an example of an overall configuration of a surgery support system according to a first embodiment. It is a front view block diagram which shows an example of a structure of the installation part contained in the support apparatus of the surgery assistance system which concerns on 1st Embodiment. FIG. 2 is a plan view configuration diagram illustrating an example of a configuration of an installation unit included in a support device of the surgery support system according to the first embodiment. It is a block diagram showing an example of the electric system composition of the microscope for surgery supported by the support device of the surgery support system concerning a 1st embodiment. It is a flowchart which shows the work procedure at the time of using the support device of the surgery assistance system which concerns on 1st Embodiment. It is a front view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 2nd Embodiment. It is a front view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 3rd Embodiment. It is a front view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 4th Embodiment. It is a side view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 4th Embodiment. It is a side view block diagram showing an example of the whole operation support system composition concerning a 5th embodiment. It is a side view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 6th Embodiment. It is a top view block diagram showing an example of the whole operation support system composition concerning a 6th embodiment. It is a front view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 7th Embodiment. It is a side view block diagram showing an example of the whole operation support system composition concerning a 7th embodiment. It is a front view block diagram which shows an example of the whole structure of the surgery assistance system which concerns on 8th Embodiment. It is a front view block diagram showing an example of the whole operation support system composition when the position of the base included in the support device of the operation support system according to the eighth embodiment is changed. It is a front view block diagram which shows the 1st modification of the whole structure of the surgery assistance system which concerns on 1st and 2nd embodiment. It is a front view schematic structure figure showing the 2nd modification of the whole operation support system concerning a 1st and 2nd embodiment. It is a front view schematic block diagram showing the 3rd modification of the whole composition of the surgery support system concerning a 1st and 2nd embodiment. It is a front view schematic block diagram which shows the 4th modification of the whole structure of the surgery assistance system which concerns on 1st and 2nd embodiment. It is a side view schematic structure figure showing the 1st modification of the whole operation support system composition concerning a 7th embodiment. It is a front view schematic block diagram showing the 2nd modification of the whole operation support system composition concerning a 7th embodiment. It is a front view schematic block diagram which shows the modification of the whole structure of the surgery assistance system which concerns on 8th Embodiment. It is a side view schematic configuration diagram showing a modification of the configuration supporting the display included in the surgery support system according to the first, second, third, sixth, seventh, and eighth embodiments. It is a side view schematic block diagram which shows the modification of the structure which supports the display contained in the surgery assistance system which concerns on 4th Embodiment. It is a schematic shape figure showing the 1st example of a sectional view shape of an arm. It is a schematic shape figure showing the 2nd example of a section view shape of an arm. It is a schematic shape figure showing the example of the 3rd mode of the section view shape of an arm. It is a schematic shape figure showing the 4th example of a section view shape of an arm. It is a schematic shape figure which shows the 5th example of a cross section shape of an arm. FIG. 25 is a schematic front view showing a first modification of the configuration for supporting the display included in the surgery support system shown in FIG. 24. FIG. 25 is a schematic front view showing a second modification of the configuration for supporting the display included in the surgery support system shown in FIG. 24. FIG. 26 is a schematic front view showing a first modification of the configuration for supporting the display included in the surgery support system shown in FIG. 25. FIG. 26 is a schematic front view showing a second modification of the configuration for supporting the display included in the surgery support system shown in FIG. 25. It is a front view schematic configuration diagram showing an example of a case where the user is located on the temporal side of the patient in the surgery support system shown in the first embodiment. FIG. 3 is a schematic plan view showing an example of a case where the user is located on the temporal side of the patient in the surgery support system shown in the first embodiment. It is a front view block diagram which shows the 1st modification of the structure of the installation part contained in the support apparatus of the surgery assistance system which concerns on embodiment. It is a front view configuration diagram showing a second modification of the configuration of the installation section included in the support device of the surgery support system according to the first to eighth embodiments. A plan view showing a first arrangement example which is an example of a positional relationship between the surgical microscope and the arm body moving mechanism when the orientation of the surgical microscope in the horizontal plane and the direction of the arm body moving mechanism in the horizontal plane deviate from each other. FIG. A plan view showing a second arrangement example which is an example of a positional relationship between the surgical microscope and the arm body moving mechanism when the orientation of the surgical microscope in the horizontal plane and the direction of the arm body moving mechanism in the horizontal plane deviate from each other. FIG. A plan view showing a third arrangement example which is an example of a positional relationship between the surgical microscope and the arm body moving mechanism when the orientation of the surgical microscope in the horizontal plane and the direction of the arm body moving mechanism in the horizontal plane deviate from each other. FIG. FIG. 40 is a plan view showing an example of the positional relationship between the surgical microscope and the arm body moving mechanism when the misalignment shown in each of FIGS. 37 to 39 is eliminated. 6 is a flowchart illustrating an example of a flow of a control process according to the embodiment. FIG. 4 is a conceptual diagram showing an example of a mode in which a control program stored in a storage medium is installed on an operating microscope. It is a front view schematic structure figure showing the modification of the support device concerning a 1st embodiment. It is a front view schematic configuration diagram showing a modified example of a display and a caster base provided with a swivel mechanism used in the surgery support system according to the embodiment. It is a front view schematic structure figure showing the 2nd modification of the support device concerning a 1st embodiment.

Hereinafter, an example of an embodiment according to the technology of the present disclosure will be described with reference to the accompanying drawings.

First, the meanings of terms used in the following description in the present embodiment will be described.

In the following description, “CPU” indicates an abbreviation of “Central Processing Unit”. Further, in the following description, the RAM refers to an abbreviation of “Random @ Access @ Memory”. Further, in the following description, ROM refers to an abbreviation of “Read @ Only @ Memory”. In the following description, the I / F indicates an abbreviation of “Interface”. In the following description, EL indicates an abbreviation of “Electro-Luminescence”.

In the following description, the ASIC is an abbreviation of “Application \ Specific \ Integrated \ Circuit”. In the following description, FPGA indicates an abbreviation of “Field-Programmable Gate Array”. In the following description, SSD indicates an abbreviation of “Solid \ State \ Drive”. In the following description, DVD-ROM is an abbreviation of “Digital \ Versatile \ Disc \ Read \ Only \ Memory". In the following description, USB indicates an abbreviation of “Universal \ Serial \ Bus”.

直 In the following description, “right angle” refers to an angle obtained by intersecting a horizontal line and a vertical line. In the following description, the angle described as “right angle” is not necessarily a right angle, and may be shifted as long as it is within an allowable error.

[First Embodiment]
As an example, as shown in FIGS. 1 to 3, the surgery support system 10 includes a surgical microscope 12, a display 14, and a support device 16. The surgery support system 10 is an example of the “surgery support system” or the “image display system” according to the technology of the present disclosure. The display 14 is an example of the “display unit” according to the technology of the present disclosure. Furthermore, the support device 16 is an example of a “support device” according to the technology of the present disclosure. The surgical microscope 12 is an example of a “microscope” according to the technology of the present disclosure.

The surgery support system 10 includes an ophthalmic surgery support system applied to the surgery or observation of the eye 18A of the patient 18 or a surgical support system applied to the surgery or observation of the affected area of the patient 18. Including. A patient 18 who is a subject of a surgery by the surgery support system 10 is placed on an operating table 20 in a operable posture. The operable posture refers to, for example, a state of lying on the back. The user 22 faces the patient 18 and the surgical microscope 12 placed on the operating table 20 in an operable posture in a posture in which the patient 18 and the surgical microscope 12 are looked down from the top of the patient 18.

Here, the user 22 indicates, for example, a surgeon, but the technology of the present disclosure is not limited to this. For example, the user 22 may be an assistant who assists the surgeon from the side or behind the surgeon.

The operating microscope 12 has an objective lens 24. The objective lens 24 has an objective surface 24A directed outside the operating microscope 12. The objective surface 24A includes the lens surface closest to the operation field 26 side among the lens surfaces of the objective lens 24. The objective surface 24A includes an incident surface on which observation light reflected on a predetermined portion of the patient 18 is incident, or includes a lens surface on which reflected light from the operation field 26 is incident.

The operating microscope 12 is arranged so that the object plane 24A is located in front of the operating field 26 and below the line of sight of the user 22 located at the top of the patient 18. That is, the line of sight of the user 22 is in a region vertically above the operating microscope 12 supported by the support device 16.

The operating microscope 12 arranged in this way captures the surgical field light, which is the reflected light with respect to the surgical field 26, from the objective lens 24, and generates a surgical field image based on the captured surgical field light. Here, the eye 18A as a surgical target is illustrated as the surgical field 26. However, the present invention is not limited to this. The surgical field 26 is, for example, an area including the eye 18A and the periphery of the eye 18A. Alternatively, only the region that has been recognized by the user 22 as a lesion in the eye 18A may be used. For example, the operative field 26 may be an area determined by the user 22 as an observation target. The operation field image is an example of the “observation image” according to the technology of the present disclosure.

(4) The display 14 displays various information. The display 14 includes a liquid crystal display or an organic EL display. The display 14 is installed on the upper surface of a caster table 28 having a gate shape as viewed from the user 22 side. The caster table 28 includes a top plate 28A and

legs

28B and 28C. A caster 28D is provided on the bottom surface of the leg 28B, and a caster 28E is provided on the bottom surface of the leg 28C. The top plate 28A is formed along a horizontal plane. The top plate 28A is supported by a leg 28B from one end and supported by a leg 28C from the other end. Therefore, the outline shape of the caster table 28 is a gate shape in a front view due to the top plate 28A and the

legs

28B and 28C.

The caster table 28 is arranged at the user front position P. Here, the user front position P refers to a position that is located in front of the user 22 and straddles the operating table 20 and the patient 18 placed on the operating table 20 in an operable posture. For example, in the caster table 28, the abdomen of the patient 18 is located directly below the top plate 28A, the leg 28B is located on one side of the abdomen of the patient 18, and the leg 28C is located on the other side of the abdomen of the patient 18. It is arranged to be located.

術 An operation field image of the patient 18 obtained from the operation microscope 12 is displayed on the horizontally long rectangular screen 14A of the display 14. The operative field image refers to an image indicating the operative field 26. The surgical field image is generated based on the surgical field light captured by the surgical microscope 12 via the objective lens 24. The display 14 has a screen frame 14B. The screen frame 14B is an outer frame of the screen 14A and holds the screen 14A.

では In the first embodiment according to the technology of the present disclosure, the operative field image is displayed as a live view image on the entire screen 14A of the display 14, but this is merely an example. For example, on the screen 14A, a screen on which an operation field image is displayed as a live view image and a screen on which information other than the operation field image is displayed may be arranged. Information other than the operative field image includes, for example, patient information and a past image. The patient information refers to text information that can specify the patient, such as the name, age, and gender of the patient 18. The past image refers to, for example, an image obtained by imaging a lesion of the patient 18 before the operation.

The support device 16 is a device that can support the surgical microscope 12. The support device 16 includes a base 30, a support arm 32, an installation part 36, and a moving part 38.

The outer surface of the support device 16, that is, the surface exposed to the outside of the support device 16 is a surface that suppresses noise light such as reflected light. In this case, the reflected light is reduced on the surface exposed to the outside of the support device 16. The outer surface of the support device 16 is given a color that suppresses reflection of light that hinders the user 22 from visually recognizing the operative field image, as compared to a case where the support device 16 is formed of, for example, a glossy surface or white. In the support device 16 according to the technology of the present disclosure, the outer surface of the support device 16 is colored black. However, the technology of the present disclosure is not limited to this, and at least the surface that enters the field of view of the user 22 is colored black. Just fine. The color adopted as the color of the outer surface of the support device 16 may be a color other than black, and is a color derived from a test result such as a sensory test as a color that suppresses reflected light that hinders visual recognition of an operation field image. I just need. Further, the outer surface of the support device 16 may be formed of a material that absorbs not only coloring but also light.

The support arm 32 is an arm that can support the operation microscope 12. In the first embodiment according to the technology of the present disclosure, the support arm 32 can support the operating microscope 12 by holding the installation section 36. The entire support arm 32 is obtained from the surgical microscope 12, and the surgical field image displayed on the screen 14 A is viewed by the user 22 from the front side of the surgical microscope 12. Is located at a position deviating from the visual field region FV (see FIGS. 1 to 3) for. The user 22 visually recognizes the operation field image through a space vertically above the operation microscope 12. Here, the visual field region FV refers to a space region for the screen 14A in the visual field of the user 22 when the user 22 is viewing the screen 14A from the front side of the surgical microscope 12. The visual field region FV is determined based on the positional relationship between the pupil of the user 22 and the screen 14A.

The support arm 32 is an example of the “arm” according to the technology of the present disclosure. Further, the support arm 32 is an example of a “support section” according to the technology of the present disclosure.

The support arm 32 is a multi-joint arm having a support arm body 37 and an extension arm 39. The shape of the support arm body 37 is a half-rectangular frame when viewed from the front side of the surgical microscope 12 during an operation or in an observation state. For example, when the support arm main body 37 is viewed from the user 22 side in a state where the user 22 directly faces the screen 14A on the upper side of the surgical microscope 12 in a front view, the shape of the support arm main body 37 is a half rectangular frame shape. It is.

The support arm main body 37 is formed by bending a first vertical arm portion 37A, a second vertical arm portion 37B, a first horizontal arm portion 37C, and a second horizontal arm portion 37D. For example, the support arm main body 37 is formed in a shape bent at a right angle or a predetermined angle, and includes a first vertical arm portion 37A, a second vertical arm portion 37B, a first horizontal arm portion 37C, and a plurality of bent nodes. And the second horizontal arm portion 37D. Each of the first vertical arm portion 37A, the second vertical arm portion 37B, the first horizontal arm portion 37C, and the second horizontal arm portion 37D is formed in a cylindrical shape.

The support arm main body 37 is integrally formed from one end to the other end in the order of a first vertical arm portion 37A, a first horizontal arm portion 37C, a second vertical arm portion 37B, and a second horizontal arm portion 37D. . The term “formed integrally” as used herein refers to, for example, being formed by integral molding or being integrated by welding, and means that the bent portion is fixed. I do. The first vertical arm portion 37A is one end portion of the support arm main body 37 and extends in the vertical direction. The second vertical arm portion 37B is the other end portion of the support arm main body 37 and extends in the vertical direction.

一端 One end 37A1 of the first vertical arm 37A is connected to one end 37B1 of the second vertical arm 37B via the first horizontal arm 37C. That is, one end 37A1 of the first vertical arm 37A is connected to one end 37C1 of the first horizontal arm 37C, and the other end 37C2 of the first horizontal arm 37C is connected to one end 37B1 of the second vertical arm 37B. Are linked. The other end 37B2 of the second vertical arm 37B is connected to one end 37D1 of the second horizontal arm 37D. The second horizontal arm portion 37D extends horizontally from the installation portion 36, and the second vertical arm portion 37B extends vertically from one end 37D1 of the second horizontal arm portion 37D. The tip of the support arm main body 37, that is, the other end 37D2 of the second horizontal arm portion 37D is connected to the installation portion. The operating microscope 12 is movably installed on the installation section 36. The first vertical arm 37A, the second vertical arm 37B, the first horizontal arm 37C, and the second horizontal arm 37D include a microscope-side moving mechanism 46 and a setting unit 36 (or the operating microscope 12) described later. And is located between. In addition, for example, the length of the second horizontal arm portion 37D is formed to be longer than the length of the first vertical arm portion 37A.

The first vertical arm 37A, the second vertical arm 37B, the first horizontal arm 37C, and the second horizontal arm 37D are examples of the “plurality of arms” according to the technology of the present disclosure. The second horizontal arm portion 37D is an example of a “first arm portion” according to the technology of the present disclosure. The second vertical arm 37B is an example of a “second arm” according to the technology of the present disclosure. The first horizontal arm portion 37C is an example of a “third arm portion” according to the technology of the present disclosure. The other end 37D2 is an example of “one end of the first arm unit” according to the technology of the present disclosure. The one end 37D1 is an example of “the other end of the first arm unit” according to the technology of the present disclosure. The other end 37B2 is an example of “one end of the second arm” according to the technology of the present disclosure. The one end 37B1 is an example of “the other end of the second arm unit” according to the technology of the present disclosure. The other end 37C2 is an example of “one end of the third arm unit” according to the technology of the present disclosure.

In the example shown in FIG. 1, one end 37A1 of the first vertical arm portion 37A is connected to one end 37C1 of the first horizontal arm portion 37C. However, the technology of the present disclosure is not limited to this, and the first vertical arm portion 37A is not limited thereto. May be connected to one end 37C1 of the first horizontal arm portion 37C. That is, a portion on the one end 37A1 side of the first vertical arm portion 37A may be connected to a portion on the one end 37C1 side of the first horizontal arm portion 37C.

Further, in the example shown in FIG. 1, the other end 37C2 of the first horizontal arm portion 37C is connected to one end 37B1 of the second vertical arm portion 37B, but the technology of the present disclosure is not limited to this, and The other end 37C2 of the horizontal arm 37C may be connected to the one end 37B1 of the second vertical arm 37B. That is, the portion on the other end 37C2 side of the first horizontal arm portion 37C may be connected to the portion on the one end 37B1 side of the second vertical arm portion 37B.

Further, in the example illustrated in FIG. 1, the other end 37B2 of the second vertical arm portion 37B is connected to one end 37D1 of the second horizontal arm portion 37D. However, the technology of the present disclosure is not limited to this, and the second disclosure is not limited thereto. The other end 37B2 of the vertical arm 37B may be connected to the one end 37D1 of the second horizontal arm 37D. That is, the portion on the other end 37B2 side of the second vertical arm portion 37B may be connected to the portion on the one end 37D1 side of the second horizontal arm portion 37D. Further, in the example illustrated in FIG. 1, the other end 37D2 of the second horizontal arm portion 37D is connected to the installation portion 36, but the technology of the present disclosure is not limited thereto, and the other end of the second horizontal arm portion 37D. The 37D2 side may be connected to the installation section 36. That is, a portion on the other end 37D2 side of the second horizontal arm portion 37D may be connected to the installation portion 36. The second horizontal arm portion 37D extends from the setting portion 36 in an intersecting direction (for example, an orthogonal direction) that intersects the ground in a vertical direction. The direction in which the second horizontal arm 37D extends is such that the other end 37B2 is connected to the second horizontal arm 37D and the one end 37B1 is directed upward from the other end 37B2 in the vertical direction. Extends from the second horizontal arm portion 37D in a direction crossing upward. The second horizontal arm portion 37D extends in a direction different from the front surface of the surgical microscope 12 from the installation portion 36 in a direction perpendicular to the installation portion 36, and the second vertical arm portion 37B is connected to the surgical microscope 12 Are formed to extend in a direction away from the later-described objective surface 24A.

The extension arm section 39 supports the support arm main body 37 by being connected to the support arm main body 37 via a microscope-side moving mechanism 46 described below from a position further upward from the screen 14A than the support arm main body 37. The general appearance of the extension arm 39 is a bent shape, and is divided into a third vertical arm 39A, a fourth vertical arm 39B, a first inclined arm 39C, and a second inclined arm 39D. Each of the third vertical arm portion 39A, the fourth vertical arm portion 39B, the first inclined arm portion 39C, and the second inclined arm portion 39D is formed in a cylindrical shape.

The extension arm section 39 is an articulated arm, and includes a first arm displacement mechanism 25 and a second arm displacement mechanism 27. The third vertical arm 39A and the first inclined arm 39C are connected via the first arm displacement mechanism 25. The first inclined arm 39C and the second inclined arm 39D are connected via the second arm displacement mechanism 27.

The third vertical arm 39A is one end of the extension arm 39 and extends in the vertical direction. The fourth vertical arm 39B is the other end of the extension arm 39 and extends in the vertical direction. One end 39A1 of the third vertical arm 39A is connected to one end of the fourth vertical arm 39B via the first arm displacement mechanism 25, the first inclined arm 39C, the second arm displacement mechanism 27, and the second inclined arm 39D. 39B1. The first inclined arm portion 39C is inclined upward from one end 39A1 to the first arm displacement mechanism 25. The second inclined arm portion 39D is inclined downward from the second arm displacement mechanism 27 to one end 39B1 of the fourth vertical arm portion 39B.

The first inclined arm 39C is provided in the first arm displacement mechanism 25 so as to be able to swing vertically along one end 39A1 of the third vertical arm 39A. That is, the first arm displacement mechanism 25 causes the first inclined arm 39C to pitch with respect to the third vertical arm 39A. The pitching of the first inclined arm portion 39C by the first arm displacement mechanism 25 is realized manually, but is not limited thereto, and may be realized electrically.

The second inclined arm portion 39D is provided in the second arm displacement mechanism 27 so as to be capable of swinging in the vertical and horizontal directions with one end 39C1 of the first inclined arm portion 39C as a base point. That is, the second arm displacement mechanism 27 causes the second inclined arm portion 39D to pitch and yaw with respect to the first inclined arm portion 39C. The pitching and yawing of the second inclined arm portion 39D by the second arm displacement mechanism 27 are realized by a manual method, but are not limited thereto, and may be realized by an electric method.

In the examples shown in FIGS. 1 to 3, an articulated arm is given as an example of the extension arm 39, but the technology of the present disclosure is not limited to this. For example, from one end to the other end of the extension arm 39, the third vertical arm 39A, the first inclined arm 39C, the second inclined arm 39D, and the fourth vertical arm 39B are integrally formed in this order. May be.

1 to 3 illustrate the first arm displacement mechanism 25 and the second arm displacement mechanism 27, the technique of the present disclosure is not limited to this, and Only one of the first arm displacement mechanism 25 and the second arm displacement mechanism 27 may be applied.

The moving unit 38 moves the support arm 32. The moving unit 38 includes a horizontal plane moving mechanism 40 and a height adjusting mechanism 42, and moves the support arm 32 by operating at least one of the horizontal plane moving mechanism 40 and the height adjusting mechanism 42. The horizontal plane moving mechanism 40 is an example of the “cross plane moving mechanism” according to the technology of the present disclosure. The height adjustment mechanism 42 is an example of a “height adjustment mechanism” according to the technology of the present disclosure.

The horizontal plane moving mechanism 40 moves the support arm 32 along the horizontal plane. The horizontal plane moving mechanism 40 includes a base side rotating mechanism 44 and a microscope side moving mechanism 46. The movement of the support arm 32 along the horizontal plane is realized by operating at least one of the base rotation mechanism 44 and the microscope movement mechanism 46.

The microscope-side moving mechanism 46 includes a rotating mechanism 48 for turning and an arm body moving mechanism 50. The turning rotation mechanism 48 and the base side rotation mechanism 44 cause the extension arm 39 to yaw. The operations of the turning rotation mechanism 48 and the base rotation mechanism 44 are manually realized. The operation of the arm body moving mechanism 50 is realized by receiving power supplied from a power supply source 114 (see FIG. 6) described later. Note that the turning rotation mechanism 48 and the base-side rotation mechanism 44 are examples of the “yaw mechanism” and the “overall yaw mechanism” according to the technology of the present disclosure. Further, the operations of the turning rotation mechanism 48 and the base-side rotation mechanism 44 may be realized by electric power. Further, the operation of the arm body moving mechanism 50 may be realized manually.

The arm body moving mechanism 50 moves the support arm body 37 along a horizontal plane. The arm body moving mechanism 50 includes an arm body sliding mechanism 52 and an arm body rotating mechanism 54. The movement of the support arm body 37 along the horizontal plane is realized by operating at least one of the arm body slide mechanism 52 and the arm body rotation mechanism 54. The arm body slide mechanism 52 is an example of the “cross-plane slide mechanism” according to the technology of the present disclosure. The arm body moving mechanism 50 is disposed above the surgical microscope 12 in the vertical direction (eg, in a direction away from the ground upward). Thus, the operating microscope 12 is supported in a state of being suspended by the support arm 32.

The base 30 is formed in a column shape. At the lower end of the base 30, a plurality of casters 31 are provided. The base-side rotation mechanism 44 is formed in a bottomed cylindrical shape with an upper opening, and is provided at the upper end 30 B of the base 30. A third vertical arm portion 39A is inserted into the base rotation mechanism 44 from above vertically. The base-side rotation mechanism 44 holds the third vertical arm portion 39A rotatably in the direction of the arc arrow A, thereby holding the entire extension arm portion 39 as yawable with the third vertical arm portion 39A as a rotation axis. ing.

The height adjustment mechanism 42 is formed in a bottomed cylindrical shape with an open top, and is provided at the upper end 30 B of the base 30. A base rotation mechanism 44 is fitted into the height adjustment mechanism 42 from above vertically. The height adjustment mechanism 42 holds the base-side rotation mechanism 44 so as to be movable by sliding in multiple stages along the vertical direction. Therefore, the base-side rotation mechanism 44 fitted in the height adjustment mechanism 42 slides in multiple stages along the vertical direction by receiving an external force from vertically above. The “external force from vertically above” here refers to, for example, an external force by the user 22. That is, the operation of the height adjustment mechanism 42 is realized manually. Here, the case where the operation of the height adjustment mechanism 42 is manually realized is illustrated, but the technology of the present disclosure is not limited to this, and the operation of the height adjustment mechanism 42 is realized electrically. You may do so.

多 The multi-step sliding in the height adjustment mechanism 42 is realized, for example, by the height adjustment mechanism 42 having a plurality of stoppers (not shown). In this case, the plurality of stoppers are provided on the inner peripheral surface of the height adjusting mechanism 42 along the vertical direction. Each of the plurality of stoppers expands and contracts in the horizontal direction according to a pressing force generated from the outer peripheral surface of the base rotation mechanism 44 to the inner peripheral surface of the height adjustment mechanism 42 by receiving an external force from vertically above. The base-side rotation mechanism 44 slides in multiple stages along the vertical direction.

Note that, here, a multi-step slide is illustrated, but the present invention is not limited to this, and a stepless continuous slide may be used. Sliding the base-side rotating mechanism 44 steplessly in the vertical direction requires a vertical movement against the frictional force generated by the contact between the inner peripheral surface of the height adjusting mechanism 42 and the outer peripheral surface of the base-side rotating mechanism 44. This is realized by pushing or pulling the base side rotation mechanism 44 in the direction.

The turning mechanism 48 includes a bearing 48A and a base 48B. The base 48B is a rectangular plate in plan view. A bearing 48A is provided on the upper surface of the base 48B. The bearing 48A is formed in a bottomed cylindrical shape whose upper part is opened. A fourth vertical arm portion 39B is inserted into the bearing 48A from above vertically. The bearing 48A holds the fourth vertical arm 39B rotatably in the direction of the arc B to hold the entire extension arm 39 together with the base 30 in a yawable manner with the fourth vertical arm 39B as a rotation axis. ing.

The arm main body slide mechanism 52 is provided on the lower surface of the base 48B so as to be slidable and movable along each of four directions orthogonal to each other in a horizontal plane. Note that the “four directions” referred to here are an upward direction U (see FIG. 3), a downward direction D (see FIG. 3), and a leftward direction L when viewed from the patient 18 placed on the operating table 20 in a operable posture. (See FIG. 1) and rightward direction R (see FIG. 1).

The arm body rotation mechanism 54 is provided in the arm body slide mechanism 52, and is formed in a bottomed cylindrical shape with an open bottom. The base end of the support arm main body 37, that is, the other end of the first vertical arm portion 37A is inserted into the arm main body rotation mechanism 54 from below vertically. The arm main body rotation mechanism 54 holds the first vertical arm portion 37A so as to be rotatable in the direction of the arc C, thereby holding the whole of the support arm main body 37 in a yawable manner with the first vertical arm portion 37A as a rotation axis. ing. The arm body rotation mechanism 54 causes the entire support arm body 37 to yaw with respect to the extension arm 39. Note that the arm body rotation mechanism 54 is an example of a “yaw mechanism” and a “partial yaw mechanism” according to the technology of the present disclosure. The arm body rotation mechanism 54 is disposed between the arm body slide mechanism 52 and the support arm body 37.

設置 As an example, as shown in FIG. 4, the installation section 36 includes an installation section main body 58. The installation portion main body 58 is formed in a semi-rectangular frame shape when viewed from the front. Here, the “front view” mode refers to a mode viewed from the user 22 side. The installation portion main body 58 is divided into a first horizontal plate 58A, a second horizontal plate 58B, and a vertical plate 58C. Each of the first horizontal plate 58A, the second horizontal plate 58B, and the vertical plate 58C is a rectangular parallelepiped thin plate.

The installation section main body 58 is integrally formed from one end to the other end in the order of the first horizontal plate 58A, the vertical plate 58C, and the second horizontal plate 58B. Each of the upper surface 58A1 and the lower surface 58A2 of the first horizontal plate 58A is a horizontal plane. Each of the upper surface 58B1 and the lower surface 58B2 of the second horizontal plate 58B is also a horizontal plane. The first horizontal plate 58A and the second horizontal plate 58B are arranged at a position where the upper surface 58A1 of the first horizontal plate 58A and the lower surface 58B2 of the second horizontal plate 58B face each other in the vertical direction.

The vertical plate 58C is formed along the vertical direction, and connects the base end 58A3 of the first horizontal plate 58A and the base end 58B3 of the second horizontal plate 58B.

The installation unit 36 holds the operating microscope 12 at at least a portion of the housing 64 thereof, and holds the operating microscope 12 in a vertically rotatable manner. The “vertical rotation” here means so-called pitching. The installation section 36 holds the surgical microscope 12 so as to be able to rotate laterally. The “lateral rotation” here means so-called yawing. In the embodiment according to the technology of the present disclosure, yawing, pitching, and rolling of the surgical microscope 12 refer to operations when the surgical microscope 12 is viewed from the front.

The installation unit 36 holds the operating microscope 12 slidably in the direction of the normal line N of the objective surface 24A of the operating microscope 12. The installation section 36 holds the operating microscope 12 slidably along the XY plane. Here, the “XY plane” refers to a plane perpendicular to the normal line N of the objective plane 24A of the operating microscope 12. The term “vertical” as used herein refers to not only a perfect vertical but also a vertical in a sense including an allowable error.

The installation section 36 includes a vertical rotation shaft 60, a horizontal rotation mechanism 62, an intersecting plane slide mechanism 68, and a normal direction slide mechanism 70 as a moving mechanism of the installation section 36 for moving the operating microscope 12. The operations of the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross-plane slide mechanism 68, and the normal direction slide mechanism 70 are realized by receiving power supplied from a power supply source 114 described later.

Here, an example in which the operations of the vertical rotation shaft 60, the horizontal rotation mechanism 62, the intersecting plane slide mechanism 68, and the normal direction slide mechanism 70 are realized by electric motors is described. It is not limited to. Some or all of the operations of the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross-plane slide mechanism 68, and the normal direction slide mechanism 70 may be manually performed.

(4) The housing 64 of the surgical microscope 12 is formed in a rectangular parallelepiped shape in which the aspect ratio in the front view is larger than the height in the horizontal direction. The upper surface 64A of the housing 64 is disposed at a position facing the lower surface 58B2 of the second horizontal plate 58B and in parallel with the lower surface 58B2. The lower surface 64B of the housing 64 is arranged at a position facing the upper surface 58A1 of the first horizontal plate 58A and parallel to the upper surface 58A1. As an example, as shown in FIG. 5, the housing 64 is held by the installation part main body 58 so as to be able to rotate laterally in the direction of the arc arrow F while protruding from the installation part main body 58. In the lower surface 64B of the housing 64, the objective lens 24 is disposed at a position protruding from the installation section main body 58, and as an example, the objective surface 24A is exposed from the lower surface 64B as shown in FIG.

一端 One end of the vertical rotation shaft 60 is supported by the other end 37D2 of the second horizontal arm portion 37D so as to be vertically rotatable. The other end of the vertical rotation shaft 60 is supported by the vertical plate 58C so as to be vertically rotatable.

The normal direction slide mechanism 70 holds the operating microscope 12 so as to be slidable in the direction of the normal line N of the objective surface 24A. In the example shown in FIG. 4, the other end of the vertical rotation shaft 60 is held so as to be slidable in the normal direction N with respect to the normal direction slide mechanism 70.

The cross plane slide mechanism 68 includes a first cross plane slide mechanism 68A and a second cross plane slide mechanism 68B.

The horizontal rotation mechanism 62 includes a first rotation shaft 62A and a second rotation shaft 62B, and holds the operation microscope 12 so as to be able to rotate in the horizontal direction. One end of a first rotating shaft 62A is fixed to the center of the upper surface 64A of the housing 64. The “central portion of the upper surface 64A of the housing 64” here includes, for example, a portion of the upper surface 64A corresponding to the center of gravity of the operating microscope 12. Here, the “center of gravity” means a center of gravity including an allowable error in addition to a perfect center of gravity. The first rotation shaft 62A is arranged at a position where the axis of the first rotation shaft 62A is along the normal line N and coincides with the center of gravity of the operating microscope 12.

他端 The other end of the second rotating shaft 62B is fixed to the center of the lower surface 64B of the housing 64. The “central portion of the lower surface 64B of the housing 64” referred to here includes a portion of the lower surface 64B corresponding to the center of gravity of the operating microscope 12. The second rotation shaft 62B is disposed at a position where the axis of the second rotation shaft 62B is along the normal line N and coincides with the center of gravity of the operating microscope 12. Further, the second rotation shaft 62B is arranged at a position where the axis of the second rotation shaft 62B and the axis of the first rotation shaft 62A coincide.

他端 The other end of the first rotation shaft 62A is rotatably held by a first cross-plane slide mechanism 68A. The other end of the second rotation shaft 62B is held by a second intersecting plane slide mechanism 68B.

The first cross-plane slide mechanism 68A holds the first rotation shaft 62A so as to be slidable along the XY plane. The second intersecting plane slide mechanism 68B holds the second rotation shaft 62B slidably along XY. The first cross-plane slide mechanism 68A and the second cross-plane slide mechanism 68B allow the operating microscope 12 to move within the movable range by sliding the first rotation shaft 62A and the second rotation shaft 62B in the same direction along the XY plane. Slide along the XY plane. Here, the “movable range” refers to a slidable range in the XY plane.

として As an example, as shown in FIG. 6, the operating microscope 12 includes an imaging unit that acquires an image of an observation target. The imaging unit according to the present embodiment includes a compound-eye imaging device 78. Observation light, which is light reflected by the observation target, enters the operating microscope 12. The operating microscope 12 captures, from the objective lens 24, the surgical field light, which is the light reflected at a site 80 corresponding to the tissue forming the surgical field 26, of the body tissue of the patient 18, and converts the captured surgical field light into a compound eye. The part 80 is imaged by being imaged by the image sensor 78. The operating microscope 12 captures an image of the part 80 to acquire an image indicating the part 80 as an operation field image. In addition, here, although "operation field light" is described as an example of "observation light" according to the technology of the present disclosure, the technology of the present disclosure is not limited thereto, and is used for an observation target other than the site 80. Observation light, which is reflected light, may be incident on the surgical microscope 12.

The compound-eye imaging device 78 generates and outputs images corresponding to each of a plurality of directions by imaging the part 80 from a plurality of directions. In the first embodiment according to the technology of the present disclosure, the plurality of directions refers to two directions. The two directions refer to, for example, the gaze directions of the right and left eyes of a human. In the example shown in FIG. 6, the compound-eye imaging device 78 includes a first imaging device 78A and a second imaging device 78B, and each of the first imaging device 78A and the second imaging device 78B has a portion 80 from two directions. Is imaged.

In the following, for convenience of explanation, an operation field image obtained by imaging the region 80 by the first imaging device 78A is referred to as a first image, and a surgical image obtained by imaging the region 80 by the second imaging device 78B. The field image is called a second image. In the following, for convenience of description, when it is not necessary to distinguish and describe the first image sensor 78A and the second image sensor 78B, they are simply referred to as “image sensors” without reference numerals.

In the first embodiment according to the technology of the present disclosure, a CCD image sensor is applied as an example of an imaging device. However, the technology of the present disclosure is not limited thereto, and another image sensor such as a CMOS image sensor is applied. May be.

The operating microscope 12 includes a first illumination device 81, a second illumination device 82, a first imaging optical system 84, a second imaging optical system 86, a first image signal processing circuit 88, a second image signal processing circuit 90, And an image sensor driver 92. The surgical microscope 12 includes a bus line 94, a CPU 96, a ROM 98, a RAM 100, a receiving device 102, a communication I / F 104, a drive driver 106, a display control unit 108, an image memory 110, and an image processing unit 112.

The first image signal processing circuit 88 is connected to the first image sensor 78A and the bus line 94. The second image signal processing circuit 90 is connected to the second image sensor 78B and the bus line 94. The image sensor driver 92 is connected to the first image sensor 78A, the second image sensor 78B, and the bus line 94.

The CPU 96, the ROM 98, the RAM 100, the receiving device 102, the communication I / F 104, the drive driver 106, and the display control unit 108 are connected to the bus line 94.

第 A first imaging optical system 84 is provided between the first imaging element 78A and the objective lens 24. The first illumination device 81 emits the first illumination light to the portion 80 via the objective lens 24. The first illumination light emitted from the first illuminating device 81 is reflected at the portion 80, and the first operative field light, which is the light reflected at the portion 80, enters the first imaging optical system 84 via the objective lens 24. I do. The first imaging optical system 84 forms an image of the incident first operation field light on a light receiving surface of the first image sensor 78A. The first image sensor 78A generates and outputs a first image signal based on the first operation field light.

第 A second imaging optical system 86 is provided between the second imaging element 78B and the objective lens 24. The second illumination device 82 emits the second illumination light to the part 80 via the objective lens 24. The second illumination light emitted from the second illumination device 82 is reflected at the site 80, and the second operating field light, which is the light reflected at the site 80, enters the second imaging optical system 86 via the objective lens 24. I do. The second imaging optical system 86 forms an image of the incident second operation field light on a light receiving surface of the second image sensor 78B. The second image sensor 78B generates and outputs a second image signal based on the second operation field light.

The CPU 96 is a control unit that controls the entire operation support system 10. The ROM 98 is a memory in which various programs and various parameters are stored in advance. The RAM 100 is a memory used as a work area when executing various programs.

The image sensor driver 92 is connected to the first image sensor 78A and the second image sensor 78B, and supplies a drive pulse to each of the first image sensor 78A and the second image sensor 78B under the control of the CPU 96. Each pixel of the first image sensor 78A and the second image sensor 78B is driven according to a drive pulse supplied by the image sensor driver 92.

The first image signal processing circuit 88 reads out one frame of the first image signal from the first image sensor 78A for each pixel under the control of the CPU 96. The first image signal processing circuit 88 performs various processes such as correlated double sampling, gain adjustment, and A / D conversion on the read first image signal. The first image signal processing circuit 88 converts the first image signal digitized by performing various processes on the first image signal to a specific frame rate (for example, a number) specified by a clock signal supplied from the CPU 96. (10 frames / sec) to the image memory 110 for each frame.

The second image signal processing circuit 90 reads the second image signal for one frame from the second image sensor 78B for each pixel under the control of the CPU 96. The second image signal processing circuit 90 performs various processes such as correlated double sampling, gain adjustment, and A / D conversion on the read second image signal. The second image signal processing circuit 90 converts the digitized second image signal by performing various processes on the second image signal for each frame at a specific frame rate specified by a clock signal supplied from the CPU 96. To the image memory 110.

The image memory 110 temporarily holds the first image signal input from the first image signal processing circuit 88 and the second image signal input from the second image signal processing circuit 90.

The image processing unit 112 acquires the first image signal and the second image signal for each frame at a specific frame rate from the image memory 110, and performs gamma correction on the acquired first image signal and second image signal. Various processing such as luminance / color difference conversion and compression processing are performed. Further, the image processing unit 112 outputs the first image signal and the second image signal subjected to various processes to the display control unit 108 at a specific frame rate for each frame. Further, the image processing unit 112 outputs the first image signal and the second image signal subjected to various processes to the CPU 96 in response to a request from the CPU 96. The CPU 96 performs a predetermined process on the input first image signal and second image signal, and outputs the processed first image signal and second image signal to a predetermined output destination.

The display control unit 108 is connected to the display 14 and controls the display 14 under the control of the CPU 96. The display control unit 108 outputs the first image signal and the second image signal input from the image processing unit 112 to the display 14 at a specific frame rate for each frame.

The display 14 is configured to display a first image signal indicated by the first image signal and a second image signal indicated by the second image signal based on the first image signal and the second image signal input at a specific frame rate from the display control unit 108. Is displayed as a live view image. In a state where the first image and the second image are displayed on the display 14 as a live view image, the user 22 observes the live view image through polarized glasses to view the operative field 26 in a stereoscopic live view. It can be recognized as an image.

The receiving device 102 has a plurality of foot switches, a touch panel, various hard keys, and the like, and receives a plurality of instructions from the user 22. The plurality of instructions include a plurality of mechanism operation instructions for operating the moving unit 38. The plurality of mechanism operation instructions are received by, for example, a plurality of foot switches. The plurality of foot switches are operated by the user 22 or an assistant.

Note that a manual input device and / or a voice input device may be used together with at least one of the plurality of foot switches. Instead of a plurality of foot switches, a manual input type input device and / or a voice input type input device may be applied. Examples of the input device of the manual input method include a touch panel, a handle, a dial, a cross key, and / or a mouse. The input device of the voice input method refers to, for example, a microphone. In this case, the CPU 96 analyzes the sound collected by the microphone, and controls the power supply source 114 via the drive driver 106 according to the analysis result.

The plurality of mechanism operation instructions include, for example, an arm body slide instruction, an arm body rotation instruction, a pitching instruction, a yawing instruction, a cross plane slide instruction, and a normal direction slide instruction.

The arm body slide instruction includes, for example, an instruction to start the operation of the arm body slide mechanism 52, an instruction to stop the operation of the arm body slide mechanism 52, and an instruction to slide the support arm body 37.

The arm body rotation instruction includes, for example, an instruction to start the operation of the arm body rotation mechanism 54, an instruction to stop the operation of the arm body rotation mechanism 54, and an instruction of a direction to yaw the entire support arm body 37.

The pitching instruction includes, for example, an instruction to start the rotation of the vertical rotation shaft 60, an instruction to stop the rotation of the vertical rotation shaft 60, and an instruction of a direction in which the surgical microscope 12 is pitched. The direction in which the operating microscope 12 is pitched refers to, in other words, the rotation direction of the vertical rotation shaft 60.

The yawing instruction includes, for example, an instruction to start the operation of the horizontal rotation mechanism 62, an instruction to stop the operation of the horizontal rotation mechanism 62, and an instruction to yaw the operating microscope 12. In other words, the direction in which the operating microscope 12 is yawed refers to the rotation direction of the first rotation shaft 62A and the second rotation shaft 62B.

The cross plane slide instruction includes, for example, an instruction to start the operation of the cross plane slide mechanism 68, an instruction to stop the operation of the cross plane slide mechanism 68, and an instruction of a direction in which the surgical microscope 12 is slid.

The normal direction slide instruction is, for example, an instruction to start the operation of the normal direction slide mechanism 70, an instruction to stop the operation of the normal direction slide mechanism 70, or any one of the directions in which the operating microscope 12 is moved along the normal line N. Instructions for moving in the direction.

The drive driver 106 is connected to the power supply 114 and controls the power supply 114 under the control of the CPU 96. The power supply source 114 includes a plurality of motors, and supplies power to the arm body moving mechanism 50, the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross plane slide mechanism 68, and the normal direction slide mechanism 70. Each of the plurality of motors included in the power supply source 114 is connected to the arm body slide mechanism 52, the arm body rotation mechanism 54, the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross plane slide mechanism 68, and the normal direction slide mechanism 70. Assigned individually. Each of the arm body slide mechanism 52, the arm body rotation mechanism 54, the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross plane slide mechanism 68, and the normal direction slide mechanism 70 includes a plurality of motors included in the power supply source 114. It operates by receiving power from the corresponding motor.

The operations of the arm body slide mechanism 52, the arm body rotation mechanism 54, the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross plane slide mechanism 68, and the normal direction slide mechanism 70 are controlled by the power supply source 114 by the drive driver 106. Is controlled by

The CPU 96 controls the plurality of motors included in the power supply source 114 by controlling the drive driver 106 in accordance with the mechanism operation instruction received by the receiving device 102.

The communication I / F 104 performs transmission and reception of various kinds of information by communicating with an external communication device (not shown) installed outside under the control of the CPU 96. That is, the communication I / F 104 receives the information transmitted from the external communication device, and outputs the received information to the CPU 96 via the bus line 94. In addition, the communication I / F 104 transmits information input from the CPU 96 via the bus line 94 to the external communication device. As an example of the external communication device, there is at least one of a personal computer (not shown), a server (not shown), and a smart device (not shown).

Next, the operation of the portion of the surgery support system 10 relating to the technology of the present disclosure will be described with reference to the flowchart in FIG.

Note that, for convenience of description, the following description is based on the premise that the caster table 28 is already arranged at the user front position P as shown in FIGS. 1 to 3 as an example. Also, in the following, for convenience of explanation, as shown in FIGS. 1 to 3 as an example, the screen 14A is displayed in a posture in which the user 22 stands on the top of the patient 18 placed on the operating table 20 in an operable posture. The following description is based on the premise that the user is facing directly.

In the following, for convenience of explanation, a live view image showing the operation field 26 is displayed on the screen 14A. As an example, as shown in FIGS. 1 to 3, the user 22 visually recognizes the screen 14A in the visual field region FV. It is assumed that this is the case. In the following, for convenience of explanation, description will be made on the assumption that the operative field 26 is stereoscopically viewed by the user 22 through the live view image. The following description is based on the premise that one assistant is located in the left direction L (see FIG. 1) or the right direction R (see FIG. 1) of the patient 18 in addition to the user 22. In the following, for convenience of explanation, the description will be made on the assumption that the base 30 of the support device 16 is already arranged on one side of the operating table 20.

In the work procedure shown in FIG. 7, first, in step 150, the user 22 or the assistant operates the arm body rotation mechanism 54 to support the assistant at the position where the assistant stands during surgery and on the opposite side of the patient 18. The arm body 37 is moved. The operation of the arm body rotation mechanism 54 is realized by receiving an arm body rotation instruction from the user 22 or an assistant by the reception device 102 and driving the power supply source 114 in accordance with the arm body rotation instruction received by the reception device 102. Is done.

When the assistant's standing position at the time of surgery is the right direction R side of the patient 18, the user 22 or the assistant operates the arm body rotation mechanism 54 to position the entire support arm body 37 on the outer periphery of the screen frame 14B. Further, the support arm main body 37 is positioned on the left direction L side of the patient 18. In the example shown in FIG. 1, a state is shown in which the support arm main body 37 is positioned on the left direction L side of the patient 18 when the assistant stands during the operation on the right direction R side of the patient 18. Conversely, when the assistant's standing position during the operation is on the left side L of the patient 18, the user 22 or the assistant operates the arm body rotation mechanism 54 to move the entire support arm body 37 to the outer periphery of the screen frame 14B. And the support arm main body 37 is positioned on the right direction R side of the patient 18.

In the next step 152, the user 22 activates the moving unit 38 so that the lower surface 58A2 (see FIGS. 3 and 4) is positioned in front of the patient 18's face, and the setting unit 36 is positioned in front of the user 22. The position of the support arm main body 37 is adjusted so as to be positioned below the eyes of the user 22 on the side.

When adjusting the position of the support arm main body 37 in the height direction, for example, the user 22 manually operates the height adjustment mechanism 42. When the user 22 adjusts the position of the support arm body 37 along the horizontal plane, for example, the user 22 controls the base-side rotation mechanism 44, the turning rotation mechanism 48, the arm body slide mechanism 52, and the arm body rotation mechanism 54. Activate.

The operations of the base-side rotation mechanism 44 and the turning rotation mechanism 48 are manually implemented by the user 22. The operation of the arm body slide mechanism 52 is realized by receiving an arm body slide instruction from the user 22 by the reception device 102 and driving the power supply source 114 in accordance with the arm body slide instruction received by the reception device 102. . The operation of the arm body rotation mechanism 54 is realized by receiving an arm body rotation instruction from the user 22 by the reception device 102 and driving the power supply source 114 in accordance with the arm body rotation instruction received by the reception device 102. .

By operating the moving unit 38 in this manner, as shown in FIGS. 1 and 3 as an example, the user visually recognizes the operation field image displayed on the screen 14 A from the front side of the surgical microscope 12. In this state, the entire support arm 32 is disposed at a position outside the visual field region FV. Further, the entire installation section 36 is arranged at a position deviating from the visual field region FV. As a result, the entire surgical microscope 12 is also arranged at a position deviating from the visual field region FV. Further, the operation field image is displayed through the operation microscope 12 from the side of the user 22 facing the operation microscope 12.

In the next step 154, the user 22 moves the object plane 24A to a position directly facing the operation field 26 by operating the vertical rotation shaft 60, the horizontal rotation mechanism 62, and the cross plane slide mechanism 68.

Here, when the user 22 moves the surgical microscope 12 in the pitching direction, the user 22 operates the vertical rotation shaft 60. The operation of the vertical rotation shaft 60 is realized by receiving a pitching instruction from the user 22 by the receiving device 102 and driving the power supply source 114 according to the pitching instruction received by the receiving device 102.

When the user 22 causes the surgical microscope 12 to yaw, the user 22 operates the lateral rotation mechanism 62. The operation of the horizontal rotation mechanism 62 is realized by receiving a yawing instruction from the user 22 by the receiving device 102 and driving the power supply source 114 in accordance with the yawing instruction received by the receiving device 102.

When the user 22 slides the surgical microscope 12 along the XY plane, the user 22 operates the cross-plane slide mechanism 68. The operation of the cross plane slide mechanism 68 is realized by receiving a cross plane slide instruction from the user 22 by the reception apparatus 102 and driving the power supply source 114 in accordance with the cross plane slide instruction received by the reception apparatus 102. .

In the next step 156, the user 22 adjusts the position of the operating microscope 12 in the height direction by operating the normal direction slide mechanism 70. Here, the normal direction sliding mechanism 70 operates by receiving a normal direction sliding instruction from the user 22 by the receiving device 102 and driving the power supply source 114 according to the normal direction sliding instruction received by the receiving device 102. It is realized by doing.

Here, a case has been described in which the work proceeds in the order of step 152 ⇒ step 154 ⇒ step 156. However, of the work procedures shown in FIG. 7, the procedures of step 152, step 154, and step 156 may be interchanged. good.

As described above, in the surgery support system 10, the support device 16 includes the support arm 32 and the installation unit 36. The operating microscope 12 is installed on the installation section 36. The support arm 32 holds the installation section 36, and the entire support arm 32 is disposed at a position outside the visual field FV of the user 22. Therefore, in a state where the operation field 26 is observed by the operation microscope 12, the support device 16 moves the operation field 26 while the user 22 visually recognizes the operation field image displayed on the screen 14 A from the front side of the operation microscope 12. The operating microscope 12 can be held so as not to block the visual field region FV for the image. Further, since the entire support arm 32 is disposed at a position outside the visual field region FV of the user 22, the user 22 ensures better visibility compared to a case where some obstacle enters the visual field region FV. be able to. As described above, according to the present embodiment, in a state where the surgical field image is visually recognized from the front side of the surgical microscope 12 using the surgical microscope 12 supported by the support device 16, the user is supported by the support device 16. A large visual recognition space can be secured between the image 22 and the operation field image.

In addition, in the surgery support system 10, the entire support arm 32 is located on the outer periphery of the screen frame 14B. Therefore, the visibility of the user 22 on the screen 14 A is better than when the member supporting the surgical microscope 12 and the screen frame 14 B overlap when viewed from the user 22 side.

In the surgery support system 10, the support arm main body 37 is formed along the outer periphery of the screen frame 14B as shown in FIG. 1 as an example. Thereby, the visual discomfort caused by the difference in shape between the screen frame 14B and the support arm body 37 is reduced as compared with the case where the support arm body 37 is formed independently of the outer periphery of the screen frame 14B. You.

Further, in the surgery support system 10, as shown in FIG. 1 as an example, the support arm main body 37 includes a second horizontal arm portion 37D and a second vertical arm portion 37B extending from the second horizontal arm portion 37D in the vertical direction. Have. That is, the operating microscope 12 is supported by the second horizontal arm portion 37D and the second vertical arm portion 37B in a state where the visual field region FV is secured. In other words, the support arm 32 is arranged at a position outside the visual field region FV of the user 22, so that the user 22 ensures better visibility compared to a case where some obstacle enters the visual field region FV. be able to.

In the surgery support system 10, the other end 37D2 of the second horizontal arm portion 37D is connected to the installation portion 36, and the other end 37B2 of the second vertical arm portion 37B is connected to one end 37D1 of the second horizontal arm portion 37D. Have been. Thus, the installation section 36 is supported by the second horizontal arm section 37D and the second vertical arm section 37B in a state where the viewing area FV is secured.

In the surgery support system 10, the other end 37D2 of the second horizontal arm portion 37D is connected to the installation portion 36, and the other end 37B2 of the second vertical arm portion 37B is connected to one end 37D1 of the second horizontal arm portion 37D. Have been. Further, the other end 37C2 of the first horizontal arm portion 37C is connected to one end 37B1 of the second vertical arm portion 37B. Thus, the installation section 36 is supported by the second horizontal arm section 37D, the second vertical arm section 37B, and the first horizontal arm section 37C in a state where the viewing area FV is secured.

手術 In the surgery support system 10, the shape of the support arm main body 37 from the front side of the surgical microscope 12 is a half-rectangular frame. Therefore, the operating microscope 12 is supported by the support arm main body 37 in a state where the visual field region FV is secured.

手術 In the surgery support system 10, the moving unit 38 is provided in the support device 16. Therefore, the user 22 can arrange the support arm 32 at a position convenient for the user 22 by operating the moving unit 38.

移動 In the surgery support system 10, the moving unit 38 includes the horizontal plane moving mechanism 40. The user 22 operates the horizontal plane moving mechanism 40 to move the support arm 32 along the horizontal plane. Thereby, the user 22 can arrange the support arm 32 at a position convenient for the user.

In addition, in the surgery support system 10, the horizontal plane moving mechanism 40 includes the turning rotation mechanism 48 and the base side rotation mechanism 44. The user 22 causes the support arm 32 to yaw by operating the turning rotation mechanism 48 and the base-side rotation mechanism 44. Thereby, the user 22 can arrange the support arm 32 at a position convenient for the user.

In addition, in the surgery support system 10, the support device 16 includes an articulated arm having a support arm main body 37 and an extension arm 39. The support device 16 includes an arm body rotation mechanism 54. The user 22 operates the turning rotation mechanism 48 and the base rotation mechanism 44 to yaw the support arm main body 37 together with the extension arm 39, and operates the arm main body rotation mechanism 54 to cause the support arm main body 37 to operate. The extension arm 39 is yawed. Thereby, the user 22 can arrange the support arm 32 at a position convenient for the user.

In addition, in the surgery support system 10, the support device 16 includes the arm body moving mechanism 50. The arm body moving mechanism 50 includes an arm body sliding mechanism 52. The user 22 operates the arm body slide mechanism 52 to move the support arm body 37 upward U (see FIG. 3), downward D (see FIG. 3), leftward L (see FIG. 1), and rightward. Slide to R (see FIG. 2). Thereby, the user 22 can arrange the support arm 32 at a position convenient for the user.

移動 In the surgery support system 10, the moving unit 38 includes the height adjusting mechanism 42. The user 22 changes the position of the extension arm 39 in the height direction by operating the height adjustment mechanism 42. As a result, the position of the support arm 37 in the height direction also changes. Thereby, the user 22 can arrange the support arm 32 at a position convenient for the user.

In addition, in the operation support system 10, the installation unit 36 holds the operation microscope 12 in a vertically rotatable manner. The installation section 36 has a vertical rotation shaft 60. The user 22 pitches the installation unit main body 58 by operating the vertical rotation shaft 60. With the pitching of the installation section main body 58, the surgical microscope 12 is also pitched. Thereby, the user 22 can arrange the surgical microscope 12 at a position convenient for the user.

In the operation support system 10, the installation unit 36 holds the operation microscope 12 so as to be able to rotate laterally. The installation section 36 includes a horizontal rotation mechanism 62. The user 22 laterally rotates the operating microscope 12 by operating the lateral rotation mechanism 62. Thereby, the user 22 can arrange the surgical microscope 12 at a position convenient for the user.

In addition, in the surgery support system 10, the installation section 36 includes the normal direction slide mechanism 70. The user 22 slides the installation section main body 58 in the direction of the normal line N by operating the normal direction slide mechanism 70. Thereby, the user 22 can arrange the surgical microscope 12 at a position convenient for the user.

In addition, in the surgery support system 10, the installation section 36 includes the cross-plane slide mechanism 68. The user 22 slides the operating microscope 12 along the XY plane by operating the cross-plane slide mechanism 68. Thereby, the user 22 can arrange the surgical microscope 12 at a position convenient for the user.

Furthermore, in the surgery support system 10, the outer surface of the support device 16 is formed on a surface that suppresses reflected light. Therefore, the user 22 can suppress the visibility of the operative field image from being deteriorated due to the reflected light on the outer surface of the support device 16 as compared with the case where the outer surface of the support device 16 is formed with a glossy surface or white. can do.

[Second embodiment]
In the above-described first embodiment, an example in which the support arm body 37 is formed in a semi-rectangular frame shape has been described. However, in the second embodiment according to the technology of the present disclosure, a shape different from the support arm body 37 is used. The support device 202 provided with the support arm main body 206 will be described. In the second embodiment according to the technology of the present disclosure, the same components as those described in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the described components will be described.

として As an example, as shown in FIG. 8, the surgery support system 200 according to the second embodiment of the present disclosure differs from the surgery support system 10 in that a support device 202 is provided instead of the support device 16. The support device 202 is different from the support device 16 in that a support arm 204 is provided instead of the support arm 32. The support arm 204 differs from the support arm 32 in that a support arm body 206 is provided instead of the support arm body 37. Note that the support arm 204 is an example of the “arm” and the “support portion” according to the technology of the present disclosure.

支持 The shape of the support arm main body 206 from the front side of the surgical microscope 12 is L-shaped, and is formed along the outer periphery of the screen frame 14B. The support arm main body 206 includes a horizontal arm portion 206A and a vertical arm portion 206B. The horizontal arm 206A extends from the installation section 36 in the horizontal direction. The vertical arm 206B extends in the vertical direction.

一端 One end 206A1 of the horizontal arm 206A is connected to the vertical plate 58C of the installation section main body 58 via the vertical rotation shaft 60 shown in FIG. One end 206B1 of the vertical arm 206B is connected to the other end 206A2 of the horizontal arm 206A.

基 The base end of the vertical arm 206B is inserted into the arm body rotation mechanism 54 from below vertically. The other end 206B2 of the vertical arm portion 206B is held by the arm body rotation mechanism 54 so as to be rotatable in the direction of the arc C. That is, the arm main body rotation mechanism 54 holds the whole of the support arm main body 206 in a yawable manner with the vertical arm portion 206B as a rotation axis.

In the support device 202, the entire support arm 204 is arranged at a position outside the visual field region FV. When the support arm main body 206 is viewed from the user 22 side, the support arm main body 206 is arranged along the outer periphery of the screen frame 14B. Then, the vertical arm portion 206B is arranged along one side surface of the screen frame 14B, and the horizontal arm portion 206A is arranged along the bottom surface of the screen frame 14B. Further, the entire installation section 36 is arranged at a position outside the viewing area FV. In the example illustrated in FIG. 8, the setting unit 36 and the operating microscope 12 are located below the eyes of the user 22, and the user 22 is viewing the screen 14 A through the setting unit 36 and the operating microscope 12.

In the second embodiment according to the technology of the present disclosure, similarly to the first embodiment, the user 22 or the assistant operates the arm main body rotation mechanism 54 so that the assistant's standing position during surgery and the patient's position What is necessary is just to move the support arm main body 206 to a position on the opposite side with respect to.

As described above, in the surgery support system 200, in the observation state of the operation field 26, the shape of the support arm main body 206 from the front view side of the operation microscope 12 is L-shaped. Therefore, the operating microscope 12 is supported by the support arm main body 206 in a state where the visual field region FV is secured.

[Third embodiment]
In the above-described first embodiment, an example in which the support arm body 37 is formed in a semi-rectangular frame shape has been described. However, in the third embodiment according to the technology of the present disclosure, a shape different from the support arm body 37 is used. The support device 302 including the support arm main body 306 will be described. In the third embodiment according to the technology of the present disclosure, the same components as those described in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the described components will be described.

As an example, as illustrated in FIG. 9, the surgery support system 300 according to the third embodiment of the present disclosure differs from the surgery support system 10 in that a support device 302 is provided instead of the support device 16. The support device 302 is different from the support device 16 in that the support device 304 includes a support arm 304 instead of the support arm 32 and that the support device 302 includes an installation portion 307 instead of the installation portion 36.

The support arm 304 is different from the support arm 32 in that a support arm body 306 is provided instead of the support arm body 37. Note that the support arm 304 is an example of the “arm” and the “support portion” according to the technology of the present disclosure.

The installation unit 307 is different from the installation unit 36 in that an installation unit main body 308 is provided instead of the installation unit main body 58. The installation part main body 308 is different from the installation part main body 58 in that it has a first horizontal plate 308A instead of the first horizontal plate 58A and that it has a second horizontal plate 308B instead of the second horizontal plate 58B. . Further, the installation part main body 308 is different from the installation part main body 58 in that an installation vertical body 308C is further provided.

Each of the first horizontal plate 308A, the second horizontal plate 308B, and the opposed vertical plate 308C is a rectangular parallelepiped thin plate. The first horizontal plate 308A and the second horizontal plate 308B are arranged at positions facing each other along the direction of the normal line N. One end of a first horizontal plate 308A is connected to one end of the vertical plate 58C, and one end of a second horizontal plate 308B is connected to the other end of the vertical plate 58C.

The opposed vertical plate 308C is disposed at a position facing the vertical plate 58C with the operating microscope 12 interposed therebetween. The other end of the first horizontal plate 308A is connected to one end of the opposed vertical plate 308C, and the other end of the second horizontal plate 308B is connected to the other end of the opposed vertical plate 308C.

(4) The shape of the support arm main body 306 from the front side of the surgical microscope 12 is a rectangular frame, and is formed along the outer periphery of the screen frame 14B. In other words, the rectangular frame shape can be said to be a frame shape. Here, a rectangular frame shape is illustrated, but the present invention is not limited to this, and may be a circular frame shape or a polygonal frame shape other than a rectangle.

The support arm main body 306 further includes a third horizontal arm 306A, a third vertical arm 306B, and a fourth horizontal arm 306C, as compared to the support arm main body 37. Each of the third horizontal arm section 306A, the third vertical arm section 306B, and the fourth horizontal arm section 306C is also a first vertical arm section 37A, a second vertical arm section 37B, a first horizontal arm section 37C, and a second horizontal arm section. Like the arm part 37D, it is formed in a cylindrical shape.

The third horizontal arm section 306A, the third vertical arm section 306B, and the fourth horizontal arm section 306C are connected to the second horizontal arm section 37D, the second vertical arm section 37B, via the axis of the first vertical arm section 37A. And the first horizontal arm portion 37C. That is, the third horizontal arm 306A is in a line-symmetrical positional relationship with the second horizontal arm 37D, the third vertical arm 306B is in a line-symmetrical positional relationship with the second vertical arm 37B, and the fourth The horizontal arm 306C is in a line-symmetrical positional relationship with the first horizontal arm 37C.

一端 One end 306A1 of the third horizontal arm 306A is connected to the opposed vertical plate 308C of the installation section main body 308. One end 306B1 of the third vertical arm 306B is connected to the other end 306A2 of the third horizontal arm 306A. One end 306C1 of the fourth horizontal arm 306C is connected to the other end 306B2 of the third vertical arm 306B. The other end 306C2 of the fourth horizontal arm 306C is connected to one end 37A1 of the first vertical arm 37A.

In the support device 302, the entire support arm 304 is arranged at a position deviating from the visual field region FV. Further, the entire installation section 307 is arranged at a position deviating from the visual field region FV. In the example illustrated in FIG. 9, the setting unit 307 and the surgical microscope 12 are located below the eyes of the user 22, and the user 22 is viewing the screen 14 A through the setting unit 307 and the surgical microscope 12.

Also, when viewing the support arm main body 306 from the user 22 side, the support arm main body 306 is disposed along the outer periphery of the screen frame 14B. The second vertical arm portion 37B is arranged along one side surface of the screen frame 14B, and the third vertical arm portion 306B is arranged along the other side surface of the screen frame 14B. The second horizontal arm portion 37D and the third horizontal arm portion 306A are arranged along the bottom surface of the screen frame 14B. The first horizontal arm section 37C and the fourth horizontal arm section 306C are arranged along the upper surface of the screen frame 14B. That is, when the support arm main body 306 is viewed from the user 22 side, the support arm main body 306 is disposed so as to surround the screen frame 14B together with the installation section 307.

As described above, in the operation support system 300, in the observation state of the operation field 26, the shape of the support arm main body 306 from the front view side of the operation microscope 12 is a rectangular frame shape. Therefore, the operating microscope 12 is supported by the support arm main body 306 in a state where the visual field region FV is secured.

[Fourth embodiment]
In the above-described first embodiment, the state in which the installation unit 36 is suspended from above by the support arm 32 has been described as an example. However, in the fourth embodiment according to the technology of the present disclosure, the installation unit 36 is moved from the side. The case of supporting will be described. In the fourth embodiment according to the technology of the present disclosure, the same components as those described in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the described components will be described.

As an example, as illustrated in FIGS. 10 and 11, the surgery support system 400 according to the fourth embodiment of the present disclosure includes a support device 402 instead of the support device 16 as compared with the surgery support system 10, and And the caster base 28 is not provided. The support device 402 differs from the support device 16 in that it has a base 404 in place of the base 30 and in that it has a support arm 406 in place of the support arm 32. The support arm 406 is an example of an “arm” and a “support” according to the technology of the present disclosure.

キャ A caster 401 is provided on the lower surface 404A of the base 404. When the user 22 or the assistant applies an external force, for example, in the horizontal direction to the base 404, the casters 401 rotate, and the base 404 moves on the floor surface FL.

The support arm 406 is supported by the base 402. The support arm 406 is formed in a cylindrical shape. When the base 402 is disposed on one side of the operating table 20, the support arm 406 extends from the base 402 toward the user 22 in the horizontal direction. The installation part 36 is attached to the tip of the support arm 406.

An arm moving mechanism 408 is provided on the upper part 410 of the base 404. The arm moving mechanism 408 has a function corresponding to the function of the arm body moving mechanism 50 described in the first embodiment. The arm moving mechanism 408 holds the support arm 406 so as to be slidable and yawable. The arm moving mechanism 408 includes an arm slide mechanism 412 and an arm turning mechanism 414. The arm slide mechanism 412 holds the arm turning mechanism 414, and receives the power supplied from the power supply source 114 to move the arm turning mechanism 414 to the left direction L, the right direction R, the upward direction U, and the downward direction. Selectively slide with respect to D.

The arm turning mechanism 414 holds the one end 406A of the support arm 406 so as to be able to rotate laterally, and yaw the support arm 406 by receiving the power supplied from the power supply source 114. Although not shown here, the base end of the support arm 406 is attached to the arm turning mechanism 414 via the first arm displacement mechanism 25 described in the first embodiment. That is, the support arm 406 is pitched by operating the first arm displacement mechanism 25 with respect to the arm turning mechanism 414, similarly to the first inclined arm section 39C described in the first embodiment. Here, an example in which the support arm 406 is attached to the first arm displacement mechanism 25 has been described, but the technology of the present disclosure is not limited to this, and the first arm displacement mechanism 25 may not be provided.

横 A horizontal rotation mechanism 413 is provided on the upper part 410 of the base 404 so as to be capable of horizontal rotation. The horizontal rotation mechanism 413 is provided with a display support frame 415. The display support frame 415 is a bent rod-shaped member.

Although not shown here, the bent portion of the display support frame 415 operates similarly to the first arm displacement mechanism 25 or the second arm displacement mechanism 27 described in the first embodiment. A displacement mechanism may be applied. Hereinafter, for convenience of description, a displacement mechanism that operates in the same manner as the first arm displacement mechanism 25 is referred to as a first displacement mechanism, and a displacement mechanism that operates in the same manner as the second arm displacement mechanism 25 is referred to as a second displacement mechanism.

When the first displacement mechanism displacement mechanism is applied to the bent portion of the display support frame 415, the portion of the display support frame 415 on the display 14 side from the bent portion is operated by operating the first displacement mechanism. Be pitched. When the second displacement mechanism is applied to the bent portion of the display support frame 415, the portion of the display support frame 415 on the display 14 side from the bent portion is pitched by operating the second displacement mechanism. And yawed.

The display support frame 415 may be formed integrally without applying the first displacement mechanism or the second displacement mechanism to the bent portion of the display support frame 415.

一端 One end of the display support frame 415 is held by the horizontal rotation mechanism 413. The other end of the display support frame 415 is fixed to the back of the display 14. The horizontal rotation mechanism 413 yaw the display support frame 415 by receiving the power supplied from the power supply source 114.

In the support device 402, the entire support arm 406 is disposed at a position outside the visual field region FV. The support arm 406 extends from one side of the operation field 26 toward the user 22. When the support arm main body 406 is viewed from the user 22 side, the support arm main body 406 is arranged along the outer periphery of the screen frame 14B. Further, the support arm main body 406 is arranged along the bottom surface of the screen frame 14B.

In the surgery support system 400 configured as described above, the user 22 or the assistant moves the support arm main body 406 along the horizontal plane by operating the arm moving mechanism 408 to position the surgical microscope 12. Then, the user 22 performs the final positioning with respect to the surgical microscope 12 by operating the vertical rotation shaft 60, the horizontal rotation mechanism 62, the intersecting plane slide mechanism 68, and the normal direction slide mechanism 70.

As described above, in the surgery support system 300, the support arm 406 extends toward the user 22 from the side of the operation field 26 or the operation field image. Therefore, the operating microscope 12 is supported by the support arm main body 406 in a state where the field of view FV is secured.

[Fifth Embodiment]
In the above-described first embodiment, an example has been described in which the member that supports the surgical microscope 12 and the member that supports the display 14 are separate bodies. However, in the fifth embodiment according to the technology of the present disclosure, a surgical operation is performed. A case where the microscope for use 12 and the display 14 are integrally supported will be described. In the fifth embodiment according to the technology of the present disclosure, the same components as those described in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the described components will be described.

As an example, as shown in FIG. 12, the surgery support system 500 according to the fifth embodiment of the present disclosure includes a support device 501 instead of the support device 16 as compared to the surgery support system 10, and a caster table. 28 is different. The support device 501 is different from the support device 16 in that a support portion 504 is provided instead of the support arm 32. The support 504 is an example of the “support” according to the technology of the present disclosure.

The support section 504 includes a display support arm 505, a display board 506, a protruding arm 508, and a vertical slide mechanism 510.

The display board 506 is a rectangular parallelepiped plate member extending in the vertical direction, and the display 14 is fixed to the front surface 506A. The schematic appearance of the display support arm 505 is a bent shape. The display support arm 505 is an articulated arm, and includes the first arm displacement mechanism 25 and the second arm displacement mechanism 27 described in the first embodiment. The base end 505A of the display support arm 505 extends in the vertical direction. The base end 505A is inserted into the base side rotation mechanism 44 from above vertically. The base-side rotation mechanism 44 holds the base end 505A rotatably in the direction of the arc arrow A, thereby holding the entire support 504 as yawable with the base end 505A as a rotation axis.

先端 The tip 505B of the display support arm 505 is fixed to the back 506B of the display board 506. The display support arm 505 supports the screen 14A on the front side of the user 22 in a posture facing the operating microscope 12. Here, the posture directly facing the operating microscope 12 is, for example, as shown in FIG. 12, a state in which the patient stands on the top of the patient 18 placed on the operating table 20 in an operable posture. Refers to a posture including a posture directly facing the microscope for use 12.

The display support arm 505 is provided with a first arm displacement mechanism 25 and a second arm displacement mechanism 27 between a base end 505A and a tip end 505B. The entire display support arm 505 is formed to be bent via the first arm displacement mechanism 25 and the second arm displacement mechanism 27. A part of the display support arm 505 from the first arm displacement mechanism 25 to the second arm displacement mechanism 27 is inclined upward with respect to the ground, and a part from the second arm displacement mechanism 27 to the tip part 505B is on the ground. It is inclined downward.

The portion of the display support arm 505 from the first arm displacement mechanism 25 to the second arm displacement mechanism 27 is similar to the first inclined arm section 39C described in the first embodiment, in that the first arm displacement mechanism 25 is used. Actuation causes pitching. The portion of the display support arm 505 from the second arm displacement mechanism 27 to the distal end portion 505B operates the second arm displacement mechanism 27 similarly to the second inclined arm section 39D described in the first embodiment. And pitching and yawing.

Note that a tilt mechanism that can tilt the display 14 in the up, down, left, and right directions may be provided on the back surface 506B of the display board 506 to which the distal end portion 505B of the display support arm 505 is fixed.

A vertical slide mechanism 510 is provided below the front surface 506A of the display board 506. The protruding arm 508 extends horizontally from the vertical slide mechanism 510 toward the user 22, and the distal end of the protruding arm 508 is connected to the vertical plate 58 C of the installation unit 36 (see FIG. 4). . The installation section 36 is arranged by the protruding arm 508 on the near side of the user 22 and below the viewing area FV, which is a position deviated from the viewing area FV.

基 The base end 508A of the protruding arm 508 is fitted into the vertical slide mechanism 510. The vertical sliding mechanism 510 slides the protruding arm 508 in the predetermined first movable range in the vertical direction by receiving the power supplied from the power supply source 114. Here, the predetermined first movable range refers to a movable range in which the installation section 36 is not allowed to enter the visual field region FV when the protruding arm 508 is slid in the vertical direction.

In the support device 501, the entire support portion 504 is arranged at a position outside the visual field region FV. In the support section 504, the display support arm 505 supports the screen 14 A on the front side of the user 22 facing the operating microscope 12, and the protruding arm 508 supports the installation section 36. In addition, the protruding arm 508 protrudes toward the user 22 from a vertically lower region of the display 14, that is, a lower portion of the front surface of the display board 506.

Therefore, according to the surgery support system 500, the user 22 requires more time to adjust the position of the setting unit 36 with respect to the display 14, as compared to the case where the member supporting the display 14 and the member supporting the setting unit 36 are separated. Can be reduced.

[Sixth embodiment]
In the above-described first embodiment, an example in which the support arm main body 37 extends from one side of the screen 14A to the front of the patient 18 is described. However, in the sixth embodiment according to the technology of the present disclosure, the support arm main body 37 is below the screen 14A. A case where the operating microscope 12 is held by the arm that passes through the side will be described. In the sixth embodiment according to the technology of the present disclosure, the same components as those described in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the described components will be described.

As an example, as illustrated in FIGS. 13 and 14, the surgery support system 600 according to the sixth embodiment of the present disclosure differs from the surgery support system 10 in having a support device 602 instead of the support device 16. . The support device 602 is different from the support device 16 in that a support arm 603 is provided instead of the support arm 32. The support arm 603 differs from the support arm 32 in that a support arm body 604 is provided instead of the support arm body 37. Note that the support arm 603 is an example of the “arm” and the “support portion” according to the technology of the present disclosure.

The support arm body 604 extends from the back of the operative field image to the lower side under the operative field image, and protrudes from the lower side of the operative field image toward the user 22. In the example shown in FIGS. 13 and 14, the support arm main body 604 extends below the screen 14A where the operation field image is displayed as a live view image, and projects from the lower side of the screen 14A to the user 22 side. For example, the support arm 604 extends below the screen frame 14B and protrudes from the lower side of the screen frame 14B toward the user 22 by slipping through the caster table 28.

13 and 14, the operation field image is displayed on the display 14, but the technique of the present disclosure is not limited to this. For example, the operation field image is displayed on a space using a mapping technique. Is projected and formed, the support arm main body 604 is extended from the back of the operative field image formed in the space to the lower side under the operative field image and from the lower side of the operative field image to the user 22 side. What is necessary is just to make it protrude.

The support arm body 604 includes a vertical arm 604A and a horizontal arm 604B. The vertical arm 604A is a cylindrical member extending in the vertical direction. The horizontal arm portion 604B is a cylindrical member extending in the horizontal direction, and protrudes toward the user 22 through the caster table 28. One end 604A1 of the vertical arm 604A is connected to the other end 604B2 of the horizontal arm 604B. The other end 604A2 of the vertical arm 604A is inserted into the arm body rotation mechanism 54 from below vertically. The arm body rotation mechanism 54 holds the vertical arm 604A so as to be rotatable around the axis of the vertical arm 604A.

一端 One end 604B1 of the horizontal arm portion 604B is connected to the center of the vertical width of the vertical plate 58C of the installation portion main body 58 via the vertical rotation shaft 60 shown in FIG. In the example shown in FIG. 13, the installation section 36 is arranged such that the vertical plate 58C is located closer to the caster table 28 than the horizontal rotation mechanism 62 is. In other words, when viewed from the user 22, the vertical plate 58 C is located on the back side of the horizontal rotation mechanism 62. In this case, when the vertical rotation shaft 60 is operated, the operation microscope 12 is rolled while viewing the operation microscope 12 from the user 22 side.

In the example illustrated in FIG. 13, the vertical plate 58 C is positioned closer to the caster table 28 from the user 22 than the horizontal rotation mechanism 62, but the technology of the present disclosure is not limited to this. For example, as shown in FIG. 12, the installation section 36 may be arranged in a state where the horizontal rotation mechanism 62 and the vertical plate 58C are arranged side by side as viewed from the user 22. In this case, the horizontal arm 604B may be connected to the vertical plate 58C in the same manner as the protruding arm 508 is connected to the vertical plate 58C as shown in FIG. In this way, the operating microscope 12 can be pitched by the vertical rotation shaft 60. Also, as shown in FIG. 13, even if the installation section 36 is arranged so that the vertical plate 58C is located closer to the caster table 28 than the horizontal rotation mechanism 62, the surgical microscope 12 can be pitched. is there. That is, in this case, by connecting the horizontal arm 604B to the side surface of the vertical plate 58C via the vertical rotation shaft 60 shown in FIG. 5, the surgical microscope 12 can be pitched by the rotation of the vertical rotation shaft 60. .

In the support device 602, the entire support arm 603 is arranged at a position deviated from the visual field region FV. Therefore, the support device 602 can hold the operating microscope 12 so as not to block the visual field region FV. Further, since the support arm 603 does not block the visual field region FV, the visibility of the user 22 on the screen 14A is better than when the member supporting the surgical microscope 12 enters the visual field region FV.

{Circle around (4)} The support arm body 604 protrudes toward the user 22 from below the screen 14A under the screen 14A. Therefore, since the support arm main body 604 does not block the viewing area FV, the visibility of the user 22 on the screen 14A is better than when the member supporting the installation unit 36 enters the viewing area FV.

As an example, as shown in FIG. 13, the installation section 36 and the surgical microscope 12 are also located vertically below the field of view FV. Therefore, since the setting part 36 and the surgical microscope 12 do not block the visual field FV, the visibility of the user 22 on the screen 14A is better than when the setting part 36 and the surgical microscope 12 enter the visual field FV. become.

[Seventh embodiment]
In the above-described first embodiment, an example in which the support arm 32 extends from the base 30 that is the columnar member to the front of the patient 18 is described. However, in the seventh embodiment according to the technology of the present disclosure, a gate-shaped member is provided. A case where the operating microscope 12 is held using a table will be described. In the seventh embodiment according to the technology of the present disclosure, the same components as those described in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the described components will be described.

As an example, as illustrated in FIGS. 15 and 16, the surgery support system 700 according to the seventh embodiment of the present disclosure differs from the surgery support system 10 in having a support device 702 instead of the support device 16. . The support device 702 is different from the support device 16 in that the support device 702 includes a table 704 with a moving mechanism instead of the base 30, the support arm 32, and the moving unit 38. The table 704 with a moving mechanism is an example of a “table” according to the technology of the present disclosure.

テーブル The shape of the front side of the table 704 with the moving mechanism is a gate shape. The table with movement mechanism 704 includes a table body 706, a movement mechanism 708, and a protruding arm 710.

The table body 706 includes a plate-shaped upper portion and

legs

704A and 704B. The plate-shaped upper portion is supported from below vertically by

leg portions

704A and 704B. FIGS. 15 and 16 show a top plate 704C as an example of the plate-like upper portion. A caster 704D is attached to a lower end 704A1 of the leg 704A, and a caster 704E is attached to a lower end 704B1 of the leg 704B. The contour of the top plate 708 in a plan view is rectangular, and the shape of the top plate 708 is a thin plate formed along a horizontal plane. The upper end 704A2 of the leg 704A is connected to one end 704C1 of the top plate 708, and the upper end 704B2 of the leg 704B is connected to the other end 704C2 of the top plate 708. That is, both ends of the top plate 708 in the longitudinal direction in plan view are supported from below by the

legs

704A and 704B.

天 The top plate 704C is an example of the “top plate” according to the technology of the present disclosure. The

legs

704A and 704B are an example of “one or more legs” according to the technology of the present disclosure. Here, the

legs

704A and 704B are illustrated, but the technology of the present disclosure is not limited thereto, and three or more legs may be used.

The table 704 with the moving mechanism is arranged so that the top plate 704C is located below the display 14 via the top plate 28A of the caster stand 28. Further, the table body 706 is arranged so as to straddle the operating table 20 and the patient 18 placed on the operating table 20 in a operable posture.

突出 A projecting arm 710 is provided on a front surface 704C3 of a top plate 704C of the table main body 706 via a moving mechanism 708. Note that the front surface 704C3 refers to a surface facing the user 22 among the outer surfaces of the top plate 704C.

移動 A moving mechanism 708 is provided on the front surface 704C3 (see FIG. 16) of the top plate 704C of the table body 706. The base end 710A of the protruding arm 710 is fitted into the moving mechanism 708. The protruding arm 710 extends in the horizontal direction from the moving mechanism 708 toward the user 22, and a distal end 710 B of the protruding arm 710 is connected to the vertical plate 58 C of the installation section main body 58. The installation section 36 is disposed by the protruding arm 710 on the near side of the user 22 and below the viewing area FV, which is a position deviated from the viewing area FV.

The moving mechanism 708 receives the power supplied from the power supply source 114 to slide the projecting arm 710 in the vertical direction within the predetermined second movable range. Here, the predetermined second movable range refers to a movable range in which the installation section 36 is not allowed to enter the visual field region FV when the protruding arm 710 is slid in the vertical direction.

In the support device 702, the entire table with a moving mechanism 704 is arranged at a position outside the visual field region FV. Here, the position deviating from the visual field region FV indicates the lower side of the visual field region FV. According to the supporting device 702 configured as described above, similarly to the supporting device 16, the operating microscope 12 can be held so as not to block the visual field region FV. In other words, the entire table 704 with the moving mechanism is arranged at a position outside the visual field region FV, so that the visibility of the user 22 on the screen 14A is smaller than when any obstacle enters the visual field region FV. Become good.

Further, since the protruding arm 710 is arranged at a position offset from the top plate 704C to the near side of the user 22, the user 22 and the assistant can operate the surgical microscope 12 more easily than when the surgical microscope 12 is installed in the top plate 704C. The approach to the field 26 becomes easier.

[Eighth Embodiment]
In the seventh embodiment, the table 704 with a moving mechanism in a front view is illustrated. However, in the eighth embodiment according to the technology of the present disclosure, a table 804 with a cantilever in a front view is described. In the eighth embodiment according to the technology of the present disclosure, the same components as those described in the first and seventh embodiments are denoted by the same reference numerals, and description thereof will be omitted. Components that are different from the components described in the embodiment will be described.

として As an example, as illustrated in FIG. 17, the surgery support system 800 according to the eighth embodiment of the present disclosure differs from the surgery support system 700 in having a support device 802 instead of the support device 702. The support device 802 is different in that it has a table 804 with a moving mechanism instead of the table 704 with a moving mechanism. The table 804 with a moving mechanism is an example of a “table” according to the technology of the present disclosure.

テーブル The shape of the front side of the table with a movement mechanism 804 is cantilevered. In other words, the cantilever shape can be said to be a semi-portion shape. The table with a moving mechanism 804 includes a base 806, a moving mechanism 808, and a plate-like upper part. In the example shown in FIG. 17, a protruding arm 810 is cited as an example of a plate-like upper portion. The “cantilever shape” here is realized by the upper part of the base 806 supporting the base end 810A of the protruding arm 810 via the moving mechanism 808. The base 806 is an example of a “leg” according to the technology of the present disclosure. The protruding arm 810 is an example of a “top plate” according to the technology of the present disclosure.

The base 806 includes a base main body 812 and casters 814. The base body 812 is formed in a column shape. A caster 814 is attached to the lower surface 812A of the base body 812. A moving mechanism 808 is provided above the base body 812.

基 The base end 810A of the protruding arm 810 is fitted into the moving mechanism 808. The protruding arm 810 extends horizontally from the moving mechanism 808 toward the user 22, and the distal end 810 B of the protruding arm 810 is connected to the vertical plate 58 C of the installation section main body 58. The installation section 36 is arranged on the near side of the user 22 by the protruding arm 810 and below the viewing area FV, which is a position deviated from the viewing area FV.

基 The base end 810A of the protruding arm 810 is fitted into the moving mechanism 808. The moving mechanism 808 slides the protruding arm 810 in the vertical direction within the predetermined third movable range by receiving the power supplied from the power supply source 114. Here, the predetermined third movable range refers to a movable range in which the installation section 36 is not allowed to enter the viewing area FV when the protruding arm 810 is slid in the vertical direction.

支持 The thus configured support device 802 is disposed between the user 22 and the caster table 28. Thereby, the user 22 in a posture directly facing the surgical microscope 12 can visually recognize the screen 14A through the surgical microscope 12.

支持 The support device 802 is arranged so that the objective surface 24A of the surgical microscope 12 faces the operation field 26. When the assistant is located on one side of the patient 18, the support device 802 positions the base 806 on the other side of the patient 18.

Since the base 806 has the casters 814, it is selectively changed to, for example, a position P1 shown in FIG. 17 and a position P2 shown in FIG. 18 according to the standing position of the assistant. The position P1 indicates the position where the base 806 is arranged when the assistant is located on one side of the patient 18, and the position P2 indicates the base 806 when the assistant is located on the other side of the patient 18. Indicates the position where is placed. In other words, the position P2 indicates a position indicating one side of the patient 18, and the position P1 indicates a position indicating the other side of the patient 18.

As described above, the table 804 with a moving mechanism is formed in a cantilevered shape. Therefore, according to the table 804 with the moving mechanism, the assistant is located on the opposite side to the base 806 via the operating table 20, so that the assistant can use the member that supports the surgical microscope 12 from both sides. , The approach to the operative field 26 becomes easier.

In each of the above embodiments, the case where the operative field image is displayed in the entire area of the screen 14A has been described, but the technology of the present disclosure is not limited to this. For example, the operation field image may be displayed on a partial screen that is a screen of a partial area in the screen 14A.

In this case, all of the

support arms

32, 204, 304, 406, 603, the support portion 504, and the tables with

movement mechanisms

704, 804 may be arranged at positions outside the visual field region FV. When the operation field image is filled and displayed in the entire area of the partial screen, each of the

support arms

32, 204, 304, 406, 603, the support section 504, and the tables 704, 804 with a moving mechanism is operated by the operator. It is arranged on the outer periphery of the field image, that is, on the outer periphery of the partial screen. When the operation field image is filled and displayed in the entire region of the partial screen, each of the

support arms

32, 204, 304, 406, and 603, the support unit 504, and the tables with

movement mechanisms

704 and 804 is operated. It is formed along the outer periphery of the field image, that is, along the outer periphery of the partial screen. When a black or white non-display area is formed along the inner periphery of the partial screen and the operative field image is displayed surrounded by the non-display area, the

support arms

32, 204, 304, 406, 603, the support section Each of the table 504 and the tables with

movement mechanisms

704 and 804 may be arranged so as to be superimposed on the non-display area of the partial screen. Further, in each of the above-described embodiments, a region or a space in which an operation field image is displayed may be applied instead of the screen 14A, or an area or a space in which an operation field image is displayed in addition to the screen 14A. Is also good.

「The“ viewing area FV ”here includes a spatial area for the partial screen in the user's 22 view in a state where the user 22 is viewing the partial screen from the front side of the surgical microscope 12. Further, the visual field region FV here is determined according to the positional relationship between the pupil of the user 22 and the partial screen. In the following, when it is not necessary to distinguish the

support arms

32, 204, 304, 406, 603, the support portion 504, and the tables with

movement mechanisms

704, 804, the reference numeral is used as a "support portion" without a reference numeral. Name.

In each of the above embodiments, the surgical microscope 12 is movably installed with respect to the installation section 36, but the technology of the present disclosure is not limited to this. The operating microscope 12 may be fixed to the installation section 36.

では In the first and second embodiments, an example in which the

support arm bodies

37 and 206 are suspended via the base 30 and the extension arm 39 has been described, but the technology of the present disclosure is not limited to this. For example, as shown in FIG. 19, the arm main body moving mechanism 50 may be installed on the ceiling CE in the room, and the support arm 850 may be suspended from the arm main body moving mechanism 50. The support arm 850 is different from the support arm body 37 in that a vertical arm 850A is provided instead of the first vertical arm 37A. The vertical arm portion 850A differs from the first vertical arm portion 37A only in that it is longer in the vertical direction.

In the example shown in FIG. 19, the shape of the contour formed along the outer periphery of the screen frame 14B by the second vertical arm portion 37B, the first horizontal arm portion 37C, and the second horizontal arm portion 37D matches the shape of the surgical microscope 12. Although it has a semi-rectangular frame shape when viewed from the front side, the technology of the present disclosure is not limited to this. For example, it may be L-shaped as shown in FIG. 8 or rectangular frame as shown in FIG. Further, for example, a rail portion movable in one direction or a plurality of directions may be provided on the ceiling CE, and the arm body moving mechanism 50 may be provided on the rail portion.

Further, examples of the support arm that replaces the support arm 850 include the support arm 860 illustrated in FIG. 20, the support arm 870 illustrated in FIG. 21, and the support arm 880 illustrated in FIG. The

support arms

860 and 870 are arms formed by bending a plurality of times, and the support arm 880 is an arm having a curved portion.

As an example, as shown in FIGS. 20 to 22, all of the

support arms

860, 870, and 880 are out of the visual field region FV in the front view of the surgical microscope 12 or in the observation state of the operation field 26. Placed at the right position.

として As an example, as shown in FIG. 20, the support arm 860 includes

linear arm portions

860A and 860B in addition to the vertical arm portion 850A. Each of the

linear arms

860A and 860B extends linearly and is formed in a cylindrical shape. The support arm 860 has a plurality of bent portions by connecting the vertical arm portion 850A and the

linear arm portions

860A and 860B. In the example shown in FIG. 20, there are bent portions between the vertical arm portion 850A and the linear arm portion 860B and between the linear arm portion 860A and the linear arm portion 860B.

一端 One end of the linear arm 860A is connected to the vertical plate 58C of the installation part 36 via the vertical rotation shaft 60 shown in FIG. The linear arm portion 860A is inclined upward in a direction away from the vertical plate 58C. One end of the linear arm 860B is connected to the other end of the linear arm 860A. The linear arm portion 860B is inclined upward from the other end of the linear arm portion 860A toward one end of the vertical arm 850 at an angle different from the upward inclination angle of the linear arm portion 860A. One end of the vertical arm 850A is connected to the other end of the linear arm 860B.

In the example illustrated in FIG. 20, the linear arm 860A is an example of the “first arm” according to the technology of the present disclosure, and the linear arm 860B is “second arm” according to the technology of the present disclosure. And the vertical arm 850A is an example of the “third arm” according to the technology of the present disclosure.

As an example, as shown in FIG. 21, the support arm 870 includes

linear arm portions

870A, 870B, 870C, and 870D in addition to the vertical arm portion 850A. Each of the

linear arms

870A, 870B, 870C, 870D extends linearly and is formed in a cylindrical shape.

The support arm 870 has a plurality of bent portions by connecting the vertical arm portion 850A and the

linear arm portions

870A, 870B, 870C, 870D. In the example shown in FIG. 21, first to fourth bent portions are shown. The first bent portion is between the vertical arm 850A and the linear arm 870D. The second bending point is between the linear arm 870C and the linear arm 870D. The third bent portion is between the linear arm 870B and the linear arm 870C. The fourth bent portion is between the linear arm 870A and the linear arm 870B.

一端 One end of the linear arm portion 870A is connected to the vertical plate 58C of the installation portion 36 via the vertical rotation shaft 60 shown in FIG. The linear arm portion 870A is inclined upward in a direction away from the vertical plate 58C. One end of the linear arm 870B is connected to the other end of the linear arm 870A. The linear arm portion 870B is inclined upward from the other end of the linear arm portion 870A toward one end of the linear arm portion 870C at an angle different from the upward inclination angle of the linear arm portion 870A. One end of the linear arm 870C is connected to the other end of the linear arm 870B. The linear arm portion 870C is inclined upward from the other end of the linear arm portion 870B toward one end of the linear arm portion 870D at an angle different from the upward inclination angle of each of the

linear arm portions

870A and 870B. One end of the linear arm 870D is connected to the other end of the linear arm 870C. The linear arm 870D extends horizontally from the other end of the linear arm 870C toward one end of the vertical arm 850A. One end of the vertical arm 850A is connected to the other end of the linear arm 870D.

として As an example, as shown in FIG. 22, the support arm 880 includes a curved arm 880A in addition to the vertical arm 850A. The curved arm portion 880A is curved, and the shape of the curved arm portion 880A from the front side of the operating microscope 12 is a C-shape. One end of the curved arm section 880A is connected to the vertical plate 58C of the installation section 36 via the vertical rotation shaft 60 shown in FIG. One end of the vertical arm 850A is connected to the other end of the curved arm 880A.

The shapes of the

support arms

860, 870, and 880 described above are merely examples, and any shape may be used as long as the support arms are entirely disposed at positions outside the visual field region FV.

例 In the example shown in FIG. 19, the support arm 850 is suspended from the ceiling CE, but the technology of the present disclosure is not limited to this. For example, the support arm 850 may be suspended from a beam, and the entire support arm 850 may be disposed at a position outside the viewing region FV. Further, the support arm may be protruded from the side wall in the room, and the entire support arm may be disposed at a position outside the viewing area FV.

Further, in the seventh embodiment, the supporting device 702 having the table 704 with the moving mechanism is illustrated, but the technology of the present disclosure is not limited to this. For example, the supporting device 890 illustrated in FIG. Technology is established.

As an example, as shown in FIG. 23, the support device 890 includes the caster table 28 and the arm 900. The arm 900 may be provided on the front surface 28A1 of the top plate 28A of the caster stand 28. The arm 900 is an arm that holds the installation section 36. The arm 900 includes a protruding arm section 902 and a moving mechanism 904. The moving mechanism 904 is attached to the front surface 28A1. The protruding arm 902 is formed in a cylindrical shape. One end of the protruding arm 902 is fitted into the moving mechanism 904. The moving mechanism 904 receives the power supplied from the power supply source 114 to selectively move the protruding arm 902 in the vertical and horizontal directions. Note that the moving mechanism 904 may be operated manually.

The other end of the protruding arm portion 902 is connected to the installation section via the vertical rotation shaft 60 shown in FIG. 4 so that the operating microscope 12 installed on the installation section 36 is pitched or rolled with respect to the installation section main body 58. It is connected to the main body 58.

According to the support device 890 shown in FIG. 23, since the caster base 28 also functions as a base supporting the arm 900, it is possible to contribute to the reduction in the number of components required for holding the installation unit 36.

In the example illustrated in FIG. 23, the support device 702 is an example of the “support device” according to the technology of the present disclosure. The arm 900 is an example of an “arm” and a “support” according to the technology of the present disclosure.

In the above-described seventh embodiment, the supporting device 702 having the table 704 with the moving mechanism has been exemplified. However, the technology of the present disclosure is not limited to this. For example, the supporting device 920 illustrated in FIG. Holds.

として As an example, as shown in FIG. 24, the supporting device 920 is different from the supporting device 702 in that the supporting device 920 includes a table 922 with a moving mechanism instead of the table 704 with a moving mechanism. The table with a moving mechanism 922 is different from the table with a moving mechanism 704 in that it does not have the

casters

704D and 704E and that it has

legs

924A and 924B instead of the

legs

704A and 704B.

The table 922 with the moving mechanism is arranged between the caster table 28 and the user 22 on the operating table 20. The leg 924A is different from the leg 704A in that the length in the vertical direction is shorter. The leg 924B is different from the leg 804B in that the length is shorter. The leg 924A and the leg 924B are arranged on the operating table 20 at a position where the table body 706 straddles the patient 18 placed on the operating table 20 in an operable posture. The bottom surface 924A1 of the leg portion 924A and the bottom surface 924B1 of the leg portion 924B are positioned opposite to each other across the patient 18 in a direction crossing the patient 18 placed on the operating table 20 in an operable posture. It is arranged on the upper surface 20A. The length of the

legs

924A and 924B is a length that positions the entire table 704 with the moving mechanism and the entire installation section 36 vertically below the viewing area FV.

スライド A slide mechanism 926 is provided on the upper surface 20A of the operating table 20. The slide mechanism 926 supports the

legs

924A and 924B, and slides the table 922 with the moving mechanism in a direction in which the patient 18 placed on the operating table 20 is traversed in an operable posture. The slide movement by the slide mechanism 926 is realized by receiving the power supplied from the power supply source 114, but is not limited thereto, and may be realized manually.

ディスプレイ In the example shown in FIG. 24, the display 14 is supported by the caster base 28, but the technology of the present disclosure is not limited to this. The display 14 may be installed on a table of the table 922 with a moving mechanism. In the example shown in FIG. 29, a pedestal 1000 is installed on a table of a table 922 with a moving mechanism, and the display 14 is fixedly installed on the pedestal 1000.

As an example, as shown in FIG. 30, the display 14 may be supported by an arm 1002 provided at one end of the table of the table 922 with a moving mechanism. In the example shown in FIG. 30, the arm 1002 includes a vertical arm 1002A and a horizontal arm 1002B. The vertical arm 1002A extends in the vertical direction, and the horizontal arm 1002B extends in the horizontal direction. One end of the vertical arm 1002A is connected to one end of the table of the table 922 with a moving mechanism, and one end of the horizontal arm 1002B is connected to the other end of the vertical arm 1002A. The other end of the horizontal arm unit 1002B is fixed to the side surface or the back surface of the display 14, so that the display 14 is supported by the arm 1002 vertically above the table of the table 922 with the moving mechanism.

Note that one end of the vertical arm 1002A may be attached to the upper end of the table of the table 922 with the moving mechanism so as to be yawable and adjustable in the height direction. Further, the vertical arm 1002A and the horizontal arm 1002B may be connected via the second displacement mechanism described in the fourth embodiment. Thus, the display 14 can be yawed or pitched by operating the second displacement mechanism.

In the above-described eighth embodiment, the supporting device 802 having the table 804 with the moving mechanism has been exemplified. However, the technology of the present disclosure is not limited thereto. For example, the supporting device 930 illustrated in FIG. Holds.

として As an example, as shown in FIG. 25, the support device 930 is different from the support device 802 in that a table 932 with a moving mechanism is provided instead of the table 804 with a moving mechanism. The table with moving mechanism 932 is different from the table with moving mechanism 804 in that a table 934 is provided instead of the base 806.

The base 934 is different from the base 806 in that it does not include the casters 814 and is smaller in height and thinner than the base 806. The table with moving mechanism 932 is disposed between the caster table 28 and the user 22 on the operating table 20. The base 934 is disposed on the operating table 20 to one side of the patient 18 placed on the operating table 20 in an operable posture. The height of the base 934 is a height at which the entire table 932 with the moving mechanism and the entire installation section 36 are positioned vertically below the viewing area FV.

スライド A slide mechanism 936 is provided on the upper surface 20A of the operating table 20. The slide mechanism 936 supports the base 934, and slides the table with moving mechanism 932 in a direction in which the patient 18 placed on the operating table 20 is traversed in an operable posture. The slide motion by the slide mechanism 936 is realized by receiving the power supplied from the power supply source 114, but is not limited thereto, and may be manually performed.

In the example shown in FIG. 25, the display 14 is supported by the caster base 28, but the technology of the present disclosure is not limited to this. The display 14 may be provided on a table of the table 932 with a moving mechanism. In the example shown in FIG. 31, the pedestal 1004 is installed on the table of the table 932 with the moving mechanism, and the display 14 is fixedly installed on the pedestal 1004.

As an example, as shown in FIG. 32, the display 14 may be supported by an arm 1006 provided at one end of the table of the table 922 with a moving mechanism. In the example shown in FIG. 32, the arm 1006 includes a vertical arm 1006A and a horizontal arm 1006B. The vertical arm 1006A extends in the vertical direction, and the horizontal arm 1006B extends in the horizontal direction. One end of the vertical arm 1006A is connected to one end of a table of the table 932 with a moving mechanism, and one end of the horizontal arm 1006B is connected to the other end of the vertical arm 1006A. The other end of the horizontal arm unit 1006B is fixed to the side surface or the back surface of the display 14, so that the display 14 is supported by the arm 1006 vertically above the table of the table 932 with the moving mechanism.

Note that one end of the vertical arm 1006A may be attached to the upper end of the table of the table 932 with the moving mechanism so as to be yawable and adjustable in the height direction. Further, the vertical arm portion 1006A and the horizontal arm portion 1006B may be connected via the second displacement mechanism described in the fourth embodiment. Thus, the display 14 can be yawed or pitched by operating the second displacement mechanism.

In the above embodiments, the case where the user 22 visually recognizes the screen 14A through the surgical microscope 12 has been described, but the technology of the present disclosure is not limited to this. For example, the operation field image may be visually recognized by the user 22 on the operation microscope 12. As a means for displaying an operation field image on the operation microscope 12 (for example, including a space above the operation microscope 12), a tablet terminal capable of communicating with the operation microscope 12 by wire or wirelessly is exemplified.

In each of the above embodiments, the case where the operative field image is displayed on the display 14 has been described, but the technology of the present disclosure is not limited to this. For example, an operation field image may be stereoscopically displayed on a wall surface in a room or a space on the upper surface side of the surgical microscope 12 by projection mapping.

In each of the above embodiments, a case has been described where the user 22 recognizes the live view image indicating the operation field 26 in a stereoscopic manner through polarized glasses, but the technology is not limited to this. For example, the user 22 observes the screen 14A in which the first image and the second image are alternately displayed as the live view images through glasses with a liquid crystal shutter, and stereoscopically displays the live view image showing the operation field 26. You may make it recognize visually. In this case, the glasses with a liquid crystal shutter have liquid crystal shutters in each of the left-eye lens and the right-eye lens, and the left-eye lens is synchronized with the switching of the display between the first image and the second image. What is necessary is just to operate the liquid crystal shutter and the liquid crystal shutter of the lens for the right eye.

As another means, a lenticular sheet having right and left eye cylindrical lenses formed in a strip shape is attached to the screen 14A, and a live view image is provided to the user 22 via the lenticular sheet. There is a means for observation. In this case, each of the first image and the second image is cut into strips according to the right-eye and left-eye cylindrical lenses. An image obtained by dividing the first image is displayed on a screen corresponding to each position of the right-eye cylindrical lens in the screen 14A, and a screen corresponding to each position of the left-eye cylindrical lens in the screen 14A is displayed. Then, an image obtained by dividing the second image is displayed.

(4) The live view image may be stereoscopically viewed by the user 22 using a means called a binocular viewer. In the binocular viewer, the first image and the second image are arranged side by side in the screen 14A, and the first image is displayed by the optical system in the left and right optical paths arranged between the screen 14A and the eyes of the user 22. By putting the second image in the left eye of the user 22 and the right image of the user 22, it is possible to make the user 22 stereoscopically recognize the live view image.

In the above embodiments, the case where the operation field image is stereoscopically viewed by the user 22 has been described, but the operation field image may be visually recognized as a two-dimensional image by the user 22.

In each of the above embodiments, various members extending in the vertical direction are illustrated, but the technology of the present disclosure is not limited to this, and various members illustrated as members extending in the vertical direction are allowed in the vertical direction. It may extend in a direction deviated within a given error. The error allowed in the vertical direction may be an error allowed in design.

In the above embodiments, the “horizontal direction” is exemplified, but the technology of the present disclosure is not limited to this, and may be a direction intersecting the vertical direction. Further, in each of the above embodiments, the “horizontal plane” is exemplified, but the technology of the present disclosure is not limited thereto, and may be a plane that intersects the vertical direction. The angle intersecting with the vertical direction may be any angle within an allowable error in design.

In each of the above embodiments, an ophthalmologic operation targeting the eye portion 18A has been described as an example. However, the technology of the present disclosure is not limited thereto, and involves the use of a surgical microscope such as an otolaryngology or a neurosurgery operation. Applicable for surgery.

In each of the above embodiments, an example has been described in which the entire support portion is arranged on the outer periphery of the screen frame 14B, but the technology of the present disclosure is not limited to this. For example, a part or the whole of the arm holding the setting unit 36 may be positioned so as to be superimposed on the screen frame 14B within a range that does not overlap the operation field image. In this case, there is an example in which the arm is arranged at a position outside the visual field region FV and protrudes from the lower end of the screen frame 14B toward the user 22.

In the first, second, third, sixth, seventh, and eighth embodiments, the caster table 28 is illustrated, but the technology of the present disclosure is not limited to this, and the display is performed without using the caster table 28. 14 may be supported by an arm. As an example, as shown in FIG. 26, the support 3100 may be fixed to the base 30, and the display support arm 505 illustrated in FIG. 12 may be provided at the upper end of the support 3100. Also in this case, as in the example shown in FIG. 12, the first arm displacement mechanism 25 and the second arm displacement mechanism 27 are applied to the display support arm 505, but the technology of the present disclosure is not limited to this. For example, the display support arm 505 may be integrally formed without applying the first arm displacement mechanism 25 and the second arm displacement mechanism 27 to the display support arm 505.

In the fourth embodiment, an example in which the display 14 is supported by the display support frame 415 has been described, but the technology of the present disclosure is not limited to this. For example, as shown in FIG. 27, a caster stand 28 may be applied instead of the display support frame 415. That is, for example, similarly to the first embodiment, the display 14 may be installed on the caster table 28.

In each of the embodiments described above, an example in which some of the arms such as the support arm 37 and the extension arm portion 39 are formed in a hollow cylindrical shape in a cross-sectional view as illustrated in FIG. 28A has been described. However, the technology of the present disclosure is not limited to this. For example, at least a part of the arms described in each of the above embodiments may be formed in a solid columnar shape in cross section, as shown in FIG. 28B as an example. In addition, at least some of the arms described in each of the above embodiments may be formed in a solid quadrangular prism shape in cross section, as shown in FIG. 28C as an example. In addition, at least a part of the arms described in each of the above embodiments may be formed in a hollow quadrangular prism shape in cross section, as shown in FIG. 28D as an example. Further, at least a part of the arms described in each of the above embodiments may have a shape in which one side wall is cut off in a hollow rectangular column in a cross-sectional view as shown in FIG. 28E as an example. As an example, as shown in FIGS. 28A, 28D, and 28E, it is possible to reduce the weight of the arm by making the cross-sectional shape of the arm hollow. The cross-sectional shapes shown in FIGS. 28A to 28E are merely examples, and at least some of the arms described in the above embodiments may have other cross-sectional shapes.

In each of the above embodiments, a case has been described in which the user 22 faces the screen 14A in a posture in which the user 22 stands upright on the parietal side of the patient 18 placed on the operating table 20 in a operable posture. It is not limited to this. For example, as shown in FIGS. 33 and 34, the user 22 may be located on the temporal side of the patient 18. An example of a case where the user 22 is located on the temporal side of the patient 18 is a case where an ear incision is performed.

In each of the above embodiments, the example in which the installation portion main body 58 is formed by the first horizontal plate 58A, the second horizontal plate 58B, and the vertical plate 58C has been described, but the technology of the present disclosure is not limited thereto. Not done. As an example, as shown in FIG. 35, the second horizontal plate 58B may be omitted. In this case, the operating microscope 12 is supported by the second rotation shaft 62B so as to be able to rotate laterally. Further, as an example, as shown in FIG. 36, the first horizontal plate 58A may be omitted. In this case, the operating microscope 12 is supported by the first rotation shaft 62A so as to be able to rotate laterally.

By the way, the layout of various devices included in the surgery support system 10 is changed according to the surgical technique applied to the patient 18 placed on the operating table 20 in an operable posture and / or the standing position of the assistant. Further, when the position of the surgical microscope 12 is adjusted in order for the user 22 to visually recognize the operation field 26 or for the user 22 to place the head lens in the optical path for the observation of the eye, when viewed from the front of the user 22 The orientation of the arm body moving mechanism 50 in the horizontal plane does not match the orientation of the surgical microscope 12 in the horizontal plane.

In this case, the surgical microscope 12 is arranged so as to match the front of the user 22 and the front of the surgical microscope 12, but the arm of the support device 16 needs to be rotated according to the layout of various devices.

For example, as shown in FIGS. 37 to 39, the arm main body moving mechanism 50 has a direction XY1 in the horizontal plane of the operating microscope 12 when the front of the operating microscope 12 is viewed from the front side of the user 22. The direction XY2 in the horizontal plane is shifted. In the example shown in FIG. 37, the user 22 wants to move the surgical microscope 12 rightward when viewed from the user 22 side, but the positional displacement between the arm body moving mechanism 50 and the surgical microscope 12 in the horizontal plane. As a result, the operating microscope 12 moves to the lower right in front view with respect to the paper surface of FIG. Here, the “positional displacement between the arm body moving mechanism 50 and the operating microscope 12 in the horizontal plane” means that the directions XY1 and XY2 do not match.

In the example shown in FIG. 38, the user 22 wants to move the surgical microscope 12 rightward when viewed from the user 22 side, but the arm body moving mechanism 50 and the surgical microscope 12 in a horizontal plane. Due to the displacement, the surgical microscope 12 moves downward in the front view with respect to the plane of FIG. Further, in the example shown in FIG. 39, the user 22 wants to move the surgical microscope 12 rightward when viewed from the user 22 side, but the arm body moving mechanism 50 and the surgical microscope 12 in the horizontal plane. Due to the displacement, the surgical microscope 12 moves to the left in a front view with respect to the paper surface of FIG. 39.

Therefore, in the surgery support system 10, the arm body moving mechanism 50 is supported by the base 48B so as to be able to rotate laterally. That is, as shown in FIG. 43 as an example, a direction adjusting mechanism 55 is provided on the base 48B, and the direction adjusting mechanism 55 receives the power supplied from the power supply source 114, and thereby the arm body moving mechanism. Rotate the entire 50 sideways. The direction adjusting mechanism 55 may be configured as a part of the arm body moving mechanism 50. For example, the arm body rotating mechanism 54 of the arm body moving mechanism 50 may be configured to be used as the direction adjusting mechanism 55.

(4) As a work procedure for changing the layout of the support arm body 37 by changing the direction of the arm body moving mechanism 50, for example, first, the support device 16 is installed in the operating room (step 1). Next, the operating microscope 12 is set at a working position on the eye of the patient 18 (step 2). Next, the surgical microscope 12 is arranged at a position where the front of the surgical microscope 12 faces the user 22 in a state where the directions XY1 and XY2 match (step 3). By operating the direction adjusting mechanism 55, the entire arm main body moving mechanism 50 is rotated sideways, and the layout of the support arm main body 37 is changed (step 4).

In order to realize the above step 4 by control by a computer, in the surgery support system 10, as shown in FIG. 6, for example, a control program PG is stored in the ROM 98 in advance. The CPU 96 expands the control program PG from the ROM 98 to the RAM 100 and executes the expanded control program PG.

(4) When the control program PG is executed by the CPU 96, the control process is executed by the CPU 96 as shown in FIG. 41 as an example.

In the control process shown in FIG. 41, first, in step 2001, the CPU 96 determines whether or not the position of the surgical microscope 12 has changed. The change in the position of the surgical microscope 12 means that the direction XY1 of the surgical microscope 12 has been changed by at least the horizontal rotation mechanism 62 of the horizontal rotation mechanism 62 and the cross-plane slide mechanism 68, for example. Further, the direction of the surgical microscope 12 includes a moving position after movement such as rotation, or an angle of rotation during lateral rotation. The rotation angle of the operating microscope 12 can be detected by an angle detector provided in the horizontal rotation mechanism 62. For example, the angle detector is a rotary encoder. The position of the housing of the surgical microscope 12 may be changed.

In this case, the CPU 96 obtains the angle at which the direction XY1 has been changed based on the detection result by the angle detector. Note that the technology of the present disclosure is not limited to this. For example, even if the CPU 96 acquires the angle at which the direction XY1 has been changed based on the number of drive pulses to the motor used for changing the direction of the surgical microscope 12 Good.

If it is determined in step 2001 that the position of the surgical microscope 12 has not changed, the determination is negative and the control process proceeds to step 2004. If the position of the surgical microscope 12 has changed in step 2001, the determination is affirmative, and the processing by the CPU 96 proceeds to step 2002.

In step 2002, the CPU 96 causes the arm body moving mechanism 50 to follow the movement of the surgical microscope 12 based on the angle at which the direction of the surgical microscope 12 has been changed, and then the processing by the CPU 96 proceeds to step 2004. That is, the direction XY1 and the direction XY2 are matched by laterally rotating the entire arm body moving mechanism 50 at the angle required for changing the direction XY1. The term “match” here refers to a match in a sense including an allowable error in addition to a perfect match.

The movement of the arm body moving mechanism 50 to the movement of the surgical microscope 12 is realized by operating the direction adjusting mechanism 55 under the control of the CPU 96. That is, the CPU 96 controls the power supply source 114 via the power driver 106 to operate the direction adjusting mechanism 55, and by operating the direction adjusting mechanism 55, causes the arm main body moving mechanism 50 to operate the operating microscope 12. Follow the movement.

In step 2004, the CPU 96 determines whether or not an end condition, which is a condition for ending the control processing, is satisfied. As an example of the end condition, there is a condition that an instruction to end the control process has been received by the receiving device 102.

If it is determined in step 2004 that the termination condition is not satisfied, the determination is negative and the process proceeds to step 2001. If the termination condition is satisfied in step 2004, the determination is affirmative, and the CPU 96 terminates the control processing.

When the control process is executed by the CPU 96 in this manner, as shown in FIG. 40 as an example, the arm main body moving mechanism 50 moves in the direction intended by the user 22, so that the surgical microscope is moved in a direction not intended by the user 22. It is possible to avoid occurrence of a situation in which 12 moves. As described above, the control unit 96 controls the arm body moving mechanism 50 (eg, the direction adjustment mechanism 55, the arm body slide mechanism 52, or the arm body rotation mechanism 54) and the installation unit 36 based on the orientation of the surgical microscope 12. It can be controlled so that the moving mechanism (for example, the vertical rotation shaft 60, the horizontal rotation mechanism 62, the cross plane slide mechanism 68, or the normal direction slide mechanism 70) is driven in conjunction with the movement mechanism.

In addition, in the examples shown in FIGS. 37 to 41, an example in which the arm body moving mechanism 50 follows the movement of the surgical microscope 12 has been described, but the technology of the present disclosure is not limited thereto. For example, when the direction of the arm main body moving mechanism 50 is changed prior to the operation microscope 12, the operating microscope 12 may be made to follow the movement of the arm main body moving mechanism 50. That is, the CPU 96 may control the horizontal rotation mechanism 62 so that the direction XY1 matches the direction XY2. The control of the horizontal rotation mechanism 62 is realized by the CPU 96 controlling the power supply source 114 via the drive driver 106. The CPU 96 determines the direction of the arm body moving mechanism 50 based on the number of drive pulses to the motor used for changing the direction of the arm body moving mechanism 50 and / or the detection result obtained by an angle detector (for example, a rotary encoder). To get the changed angle.

In addition, here, the case where the direction of the arm main body moving mechanism 50 is changed by the direction adjusting mechanism 55 has been illustrated, but the technology of the present disclosure is not limited thereto. For example, when the direction of the support arm body 37 is changed by the arm body rotation mechanism 54, the operation microscope 12 is moved by the movement of the support arm body 37 so that the direction of the support arm body 37 and the direction XY1 continue to match. You only have to follow. In this case, the CPU 96 controls the horizontal rotation mechanism 62 so that the direction of the support arm main body 37 and the direction XY1 match, thereby causing the operation microscope 12 to follow the movement of the support arm main body 37.

In addition, in the example shown in FIG. 3, the case where the control program PG is read from the ROM 98 is illustrated, but it is not always necessary to store the control program PG in the ROM 98 from the beginning. For example, as shown in FIG. 42, the control program PG may be first stored in an arbitrary portable storage medium 2500 such as an SSD, a USB memory, or a DVD-ROM. In this case, the control program PG in the storage medium 2500 is installed on the surgical microscope 12, and the installed control program PG is executed by the CPU 96.

In addition, the control program PG is stored in a storage unit such as another computer or a server device connected to the surgical microscope 12 via a communication network (not shown), and the control program PG responds to a request for the surgical microscope 12. It may be installed after being downloaded accordingly. In this case, the installed control program PG is executed by the CPU 96.

In the example illustrated in FIG. 41, an example in which the control process is realized by a software configuration using a computer has been described, but the technology of the present disclosure is not limited thereto. For example, the control process may be executed only by a hardware configuration such as an FPGA or an ASIC, instead of the software configuration using a computer. The control process may be executed by a combination of a software configuration and a hardware configuration.

The method of adjusting the direction using the direction adjusting mechanism 55 has been exemplified as a modification of the first embodiment. However, the technology of the present disclosure is not limited to this. Applicable to the embodiment having the mechanism 50.

In each of the above embodiments, the first image signal processing circuit 88, the second image signal processing circuit 90, the image sensor driver 92, the bus line 94, the CPU 96, the ROM 98, the RAM 100, the receiving device 102, the communication I / F 104, the driving driver Although the embodiment in which the 106, the display control unit 108, the image memory 110, and the image processing unit 112 are incorporated in the surgical microscope 12 has been described, the technology of the present disclosure is not limited thereto. First image signal processing circuit 88, second image signal processing circuit 90, image sensor driver 92, bus line 94, CPU 96, ROM 98, RAM 100, receiving device 102, communication I / F 104, drive driver 106, display control unit 108, image All or at least a part of the memory 110 and the image processing unit 112 may be provided outside the surgical microscope 12.

In each of the above embodiments, an example in which the display 14 is supported by the caster table 28 by mounting the display 14 on the caster table 28 and an example in which the display 14 is supported by the arm are described. It is not limited to. For example, the display 14 may be supported by a swivel stand. In this case, the display 14 makes a horizontal swing motion by operating a swivel mechanism 57 (see FIG. 44) which is an example of the screen horizontal rotation mechanism according to the technology of the present disclosure. The swing motion of the display 14 in the horizontal direction is generally called a swivel. As an example, as shown in FIG. 44, the swivel mechanism 57 is provided at the center of the top plate 28A of the caster table 28, and rotatably supports the center of the lower end surface of the screen frame 14B.

The swivel mechanism 57 is effective when used in, for example, the process of step 2002 of the control process shown in FIG. That is, the display 14 is swiveled by operating the swivel mechanism 57 in the same manner as the arm body moving mechanism 50 is made to follow the movement of the operating microscope 12 by executing the processing of step 2002 shown in FIG. . Thereby, even when the direction of the surgical microscope 12 is changed, the screen 14A can be positioned in front of the user 22.

In addition, the method using the swivel mechanism 57 has been illustrated as a modified example of the first embodiment, but the technology of the present disclosure is not limited to this, and the direction adjustment mechanism 55 can be applied in each of the embodiments. It can be applied to the embodiment.

例 In the example shown in FIG. 43, the direction adjusting mechanism 55 is illustrated, but the technique of the present disclosure can be realized without the direction adjusting mechanism 55. For example, instead of the direction adjusting mechanism 55, the arm body rotating mechanism 54 may be linked to the movement of the surgical microscope 12. Conversely, the operation microscope 12 may be linked to the movement of the arm body rotation mechanism 54. In this case, the CPU 96 may move the surgical microscope 12 by driving the horizontal rotation mechanism 62.

In the first embodiment, the support arm main body 37 is exemplified as a rigid member formed integrally, but the technology of the present disclosure is not limited to this, and the support arm main body 37 may be moved in one direction or in a plurality of directions. It may be formed to be stretchable.

では In the example shown in FIG. 45, the support arm main body 37 includes the

joints

11, 13, 15, and 17, which are examples of the “displacement mechanism (displacement unit, expansion and contraction unit)” according to the technology of the present disclosure. Each of the

joints

11, 13, 15, and 17 connects the adjacent cylindrical members so as to be able to expand and contract. In the example illustrated in FIG. 45, each of the first vertical arm portion 37A, the second vertical arm portion 37B, the first horizontal arm portion 37C, and the second horizontal arm portion 37D is a “microscope according to the technology of the present disclosure. Supporting member ".

The joint 11 is provided on the first vertical arm portion 37A, and the first vertical arm portion 37A expands and contracts in the vertical direction via the joint 11. The extended state and the contracted state of the first vertical arm portion 37A are held by a stopper or a brake (not shown) provided on the joint 11.

The joint 13 is provided on the first horizontal arm portion 37C, and the first horizontal arm portion 37C expands and contracts in the horizontal direction via the joint 13. The extended state and the contracted state of the first horizontal arm portion 37C are held by a stopper or a brake (not shown) provided on the joint 13.

The joint 15 is provided on the second vertical arm portion 37B, and the second vertical arm portion 37B expands and contracts in the vertical direction via the joint 15. The extended state and the contracted state of the second vertical arm portion 37B are held by a stopper or a brake (not shown) provided on the joint 15.

The joint 17 is provided on the second horizontal arm 37D, and the second horizontal arm 37D expands and contracts in the horizontal direction via the joint 17. The extended state and the contracted state of the second horizontal arm portion 37D are held by a stopper or a brake (not shown) provided on the joint 15.

Therefore, for example, when the size of the contour of the display 14 in front view changes, the first vertical arm portion 37A, the second vertical arm portion 37B, and the first horizontal arm so that the support arm main body 37 does not enter the visual field region FV. One or more of the portion 37C and the second horizontal arm portion 37D may be expanded and contracted.

Further, when the size of the contour of the display 14 when viewed from the front changes, the first vertical arm portion 37A and the second vertical arm 37A so that the support arm main body 37, the installation portion 36, and the operating microscope 12 do not enter the field of view FV. One or more of the arm 37B, the first horizontal arm 37C, and the second horizontal arm 37D may be expanded and contracted.

As a result, even when the size of the outline of the display 14 when viewed from the front changes, the user 22 can ensure better visibility as compared with the case where some obstacle enters the visual field region FV. it can. In addition, the outline of the display 14 when viewed from the front corresponds to the size of the outline of the screen frame 14B when viewed from the front.

For example, even when the size of the outline of the screen 14A in a front view changes, the first vertical arm 37A, the second vertical arm 37B, and the first horizontal arm are arranged so that the support arm main body 37 does not enter the visual field region FV. 37C and one or more of the second horizontal arm portions 37D may be expanded and contracted.

When the size of the outline of the screen 14A in a front view changes, the first vertical arm portion 37A and the second vertical arm portion 37A prevent the support arm main body 37, the installation portion 36, and the operation microscope 12 from entering the visual field region FV. One or more of the arm 37B, the first horizontal arm 37C, and the second horizontal arm 37D may be expanded and contracted.

Thus, even when the size of the outline of the screen 14A in the front view changes, the user 22 can secure better visibility compared to the case where some obstacle enters the visual field region FV. it can. In addition, the outline of the screen 14A in a front view corresponds to the size of the outline of the screen frame 14B in a front view. Here, the size of the front-view outline of the screen 14A is illustrated, but the present invention is not limited thereto, and the case where the size of the front-view outline of the operative field image displayed by the mapping technique changes may be used. However, it is only necessary to respond similarly.

In the example illustrated in FIG. 37, the displacement mechanism is incorporated in the support arm main body 37, but the technology of the present disclosure is not limited to this. For example, a displacement mechanism (for example, a joint) is incorporated into each of the

support arm bodies

206, 306, 604, the

support arms

406, 860, 870, 880, the protruding

arms

508, 710, 810, and the protruding arm unit 902 described above. It may be. Note that a displacement mechanism may be incorporated in the extension arm 39. In this case, for example, the displacement mechanism may be incorporated in at least one of the third vertical arm portion 39A, the fourth vertical arm portion 39B, the first inclined arm portion 39C, and the second inclined arm portion 39D. The user 22 may activate the displacement mechanism when the size of the screen 14A, the screen frame 14B, or the contour of the surgical field image changes.
In the example shown in FIG. 37, an example in which the support arm main body 37 is manually expanded and contracted has been described. However, for example, the support arm receives power supplied from the power supply source 114 under the control of the CPU 96. The main body 37 may be expanded and contracted.

All publications, patent applications, and technical standards referred to in this specification are to the same extent as if each individual publication, patent application, or technical standard was specifically and individually stated to be incorporated by reference. Incorporated by reference in the book.

に関し Regarding the above embodiments, the following supplementary notes are further disclosed.

(Appendix 1)
A support device (16) capable of supporting an operating microscope (12),
An installation part (36) on which the operating microscope (12) is installed, wherein the operating microscope (12) is mounted along a plane intersecting the normal (N) of the object plane (24A) of the operating microscope (12). An installation part (36) for holding the orientation so as to be changeable,
Arms (32, 37) for holding an installation portion (36);
An arm body moving mechanism (50) for moving the arm body, a direction adjusting mechanism (55) capable of adjusting the direction of the arm body moving mechanism (50),
When the direction of the operating microscope (12) is changed, a control unit (96) that controls the direction adjusting mechanism (55) so that the direction of the arm body moving mechanism (50) matches the direction of the operating microscope (12). )When,
A support device including.
In the above support device (16), the arm (32, 37) allows the user (22) to visually recognize the operative field image obtained from the operating microscope (12) from the front side of the operating microscope (12). In the state in which it is located, it is arranged at a position out of the visual field region for the operation field image.
Further, the control section (96) controls the direction of the arm body moving mechanism (50) by moving the directions of the arms (32, 37) based on the direction of the surgical microscope (12).

(Appendix 2)
A support device (16) capable of supporting an operating microscope (12),
An installation part (36) on which the operating microscope (12) is installed, wherein the operating microscope (12) is mounted along a plane intersecting the normal (N) of the object plane (24A) of the operating microscope (12). An installation part (36) for holding the orientation so as to be changeable,
An arm (32, 37) holding the installation section (32), and a user (22) visually recognizes an operation field image obtained from the operation microscope (12) from the front side of the operation microscope (12). An arm (32, 37) arranged at a position deviating from the visual field region for the operation field image in the state;
An arm body moving mechanism (50) for moving the body of the arm;
A lateral rotation mechanism (68) for laterally rotating the surgical microscope;
A direction adjusting mechanism (55) capable of adjusting the direction of the arm body moving mechanism (50),
When the direction of the arm body moving mechanism (50) is changed, the control unit () controls the horizontal rotation mechanism (68) so that the direction of the surgical microscope (12) is adjusted to the direction of the arm body moving mechanism (50). 96),
A support device including.

(Appendix 3)
A support device (16) capable of supporting an operating microscope (12),
An installation part (32) on which the operating microscope (12) is installed, wherein the operating microscope (12) is placed along a plane intersecting the normal line (N) of the object plane (24A) of the operating microscope (12); An installation part (32) for holding the orientation so as to be changeable,
An arm (32) holding an installation part (32), in a state where a user (22) visually recognizes an operation field image obtained from an operation microscope (12) from the front side of the operation microscope (12). An arm (32) arranged at a position deviating from the visual field region for the operative field image;
An arm body rotation mechanism (54) for horizontally rotating the body of the arm;
A control unit (96) for controlling the arm body rotation mechanism (54) so that when the direction of the operation microscope (12) is changed, the direction of the arm (32) is adjusted to the direction of the operation microscope (12); ,
A support device including.

(Appendix 4)
A support device (16) capable of supporting an operating microscope (12),
An installation part (32) on which the operating microscope (12) is installed, wherein the operating microscope (12) is placed along a plane intersecting the normal line (N) of the object plane (24A) of the operating microscope (12); An installation part (32) for holding the orientation so as to be changeable,
An arm (32) holding an installation part (32), in a state where a user (22) visually recognizes an operation field image obtained from an operation microscope (12) from the front side of the operation microscope (12). An arm (32) arranged at a position deviating from the visual field region for the operative field image;
An arm body rotation mechanism (54) for horizontally rotating the body of the arm;
A lateral rotation mechanism (68) for laterally rotating the surgical microscope;
When the direction of the main body of the arm is changed by the arm main body rotation mechanism (54), the control section (68) controls the horizontal rotation mechanism (68) so that the direction of the operating microscope (12) is adjusted to the direction of the main body of the arm. 96),
A support device including.

(Appendix 5)
The support device according to any one of supplementary notes 1 to 4, wherein the control unit (96) is a processor.

(Appendix 6)
Supplementary device according to any one of supplementary notes 1 to 5,
A screen (14A) on which a surgical field image obtained from the operating microscope (12) is displayed,
A screen horizontal rotation mechanism (57) for horizontally rotating the screen (14A),
The control unit (96) controls the screen horizontal rotation mechanism (57) so that the orientation of the screen (14A) matches the orientation of the surgical microscope (12) when the orientation of the surgical microscope (12) is changed. Surgery support system or image display system.

(Appendix 7)
A user (22) visually recognizes an operation field image obtained from the operating microscope (12) from the front side of the operating microscope (12), which is a support part (37) that can support the operating microscope (12). A support portion (37) which is entirely disposed at a position deviating from a visual field region (FV) for an operation field image in a state where
A displacement mechanism (11, 13, 15, 17) for expanding and contracting the support portion (37);
A support device (16) comprising:

(Appendix 8)
A support device (16) according to attachment 7,
A screen (14A) on which a surgical field image obtained from the operating microscope (12) is displayed, comprising:
In accordance with a change in the size of the contour of the screen (14A), the displacement mechanism (11, 13, 15, 17) is operated so that the entire support portion is arranged at a position deviating from the field of view (FV). How to use the system.

Claims

A support device capable of supporting a microscope including an imaging unit,
An installation unit where the microscope is installed,
An arm that holds the installation portion, and is disposed at a position outside a field of view for the observation image in a state where a user is viewing an observation image obtained from the microscope from the front side of the microscope. Arm and
A support device including.
2. The support device according to claim 1, wherein the entire arm is located at an outer periphery of the observation image, at a screen frame holding a screen on which the observation image is displayed, or at an outer periphery of the screen frame.
The support device according to claim 2, wherein the main body of the arm is formed along an outer periphery of the observation image, the screen frame, or an outer periphery of the screen frame.
4. The support device according to claim 1, wherein the arm extends from a side of the observation image toward the user. 5.
The support according to any one of claims 1 to 4, wherein the arm extends from a rear side of the observation image to a lower side below the observation image and projects from a lower side of the observation image to the user side. apparatus.
A support device capable of supporting a microscope including an imaging unit,
An installation unit in which the microscope is movably installed,
A first arm portion extending from the installation portion in a direction intersecting with the vertical direction; a second arm portion extending from the first arm portion in a direction intersecting upward with respect to a direction in which the first arm portion extends; An arm having
A support device including.
The support device according to claim 6, wherein the arm is formed by bending a plurality of arms including the first arm and the second arm.
One end of the first arm portion is connected to the installation portion,
8. The support device according to claim 6, wherein one end of the second arm is connected to the other end of the first arm. 9.
The support device according to claim 8, wherein the arm further includes a third arm portion extending from the second arm portion in a direction intersecting a direction in which the second arm portion extends.
The support device according to claim 9, wherein the arm is formed by bending a plurality of arms including the first arm, the second arm, and the third arm.
One end of the first arm portion is connected to the installation portion,
One end of the second arm is connected to the other end of the first arm,
The support device according to claim 10, wherein one end of the third arm is connected to the other end of the second arm.
The support device according to any one of claims 1 to 11, wherein a shape of a main body of the arm from a front side of the microscope is a half-frame shape, a frame shape, or an L-shape.
The support device according to any one of claims 1 to 12, further comprising a moving unit configured to move the arm.
The support device according to claim 13, wherein the moving unit has a cross plane moving mechanism that moves the arm along a cross plane with respect to a vertical direction.
The support device according to claim 14, wherein the cross-plane moving mechanism includes a yawing mechanism that yaws the arm.
The arm extends to the support arm main body from a position further away from the microscope than the support arm main body that supports the microscope, and supports the support arm main body by being connected to the support arm main body. An extended arm portion, and an articulated arm having at least
16. The yawing mechanism has at least one of a partial yawing mechanism for yawing the support arm main body with respect to the extension arm portion and a total yawing mechanism for yawing the support arm main body with the extension arm portion. The support device according to claim 1.
The support device according to any one of claims 14 to 16, wherein the cross plane moving mechanism includes a cross plane slide mechanism that slides the arm along the cross plane.
The support device according to any one of claims 13 to 17, wherein the moving unit includes a height adjustment mechanism that adjusts a position of the arm in a height direction.
A support device capable of supporting a microscope including an imaging unit,
An installation unit where the microscope is installed,
A top plate that holds the installation portion, and one or more legs that support the top plate from below, in a state where a user is viewing an observation image obtained from the microscope from the front side of the microscope; A table arranged at a position outside the visual field for the observation image,
A support device including.
The legs are plural,
20. The support device according to claim 19, wherein the front side of the table has a gate shape.
20. The support device according to claim 19, wherein the front side of the table has a cantilever shape.
22. The support device according to claim 19, wherein the installation portion protrudes from the top plate toward the user.
The support device according to any one of claims 1 to 5, wherein the entire installation portion is disposed at a position outside the visual field region.
The support device according to any one of claims 1 to 23, wherein the installation unit holds the microscope in a vertically rotatable manner.
The support device according to any one of claims 1 to 24, wherein the installation unit holds the microscope so that the microscope can be rotated horizontally.
26. The supporting device according to claim 1, wherein the installation unit slidably holds the microscope in a direction normal to an objective surface of the microscope.
27. The support device according to claim 1, wherein the installation unit slidably holds the microscope along a plane intersecting a normal to an objective surface of the microscope.
A support part capable of supporting a microscope having an imaging part, wherein the observation image obtained from the microscope is located out of a visual field for the observation image in a state where the user is visually recognizing the observation image from the front side of the microscope. A support device including a support portion which is entirely disposed on the support device.
29. The support device according to claim 28, wherein the support unit further supports a screen on which the observation image is displayed on a front side of the user facing the microscope.
30. The support according to any one of claims 1 to 5, 29 to 23, 28, and 29, wherein the entirety of the microscope is arranged at a position outside the field of view. apparatus.
The observation image is displayed from the user side facing the microscope through the microscope from the user side, and the observation image is displayed through the microscope. The support device according to claim 30.
The support device according to any one of claims 1 to 31, wherein an outer surface that suppresses reflected light is formed.
The support device according to any one of claims 1 to 32, further comprising a displacement mechanism that expands and contracts a member that supports the microscope.
The support device according to any one of claims 1 to 18, further comprising: a control unit that controls the direction of the arm so as to match the direction of the microscope when the direction of the microscope is changed.
A support device according to any one of claims 1 to 34,
Said microscope;
A display control unit configured to display an image based on observation light incident on the microscope,
Surgery support system including: