JP3021561B2 - Surgical microscope device with observation point coordinate display function - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a surgical microscope capable of recognizing the position coordinates of an observation point.

[Problems to be solved by conventional technology and invention]

In general, surgery performed using a microscope involves CT or MRI.
(Nuclear magnetic resonance imaging) to determine the location of the affected area,
After incision of the body surface, treatment is performed by digging further to the affected part.
However, when the affected part is small or the incised opening is small, it is not possible to easily reach the affected part because it can only grasp the approximate position of the affected part when digging down, and the operation time is prolonged, You may need to start over.

Such a situation becomes a problem affecting human life particularly in organ surgery and the like, and furthermore, there is a risk that the surgery may fail. Therefore, how to reliably reach the affected area has literally been a matter of life and death in this type of surgery.

The present invention has been made in view of the above circumstances, and has as its object to provide a surgical microscope capable of accurately grasping the positional relationship between the position of an affected part and the position of an observation point currently being observed.

[Means for solving the problem]

The surgical microscope according to the present invention includes a movable section including a plurality of arms having a rotation axis, and a microscope supported by the movable section, the observation point position of which can be changed. Detecting means for detecting the rotation amount and the rotation direction of the rotation axis of each of the plurality of arms.
Computing means for calculating the coordinates of the observation point with respect to the reference point based on the detection signal from the detection means and the information for focusing the microscope, so that the coordinates of the observation point can be displayed. .

[Action]

Therefore, by displaying the position coordinates of the observation point with respect to the reference position calculated by the calculating means in the field of view of the microscope, the position of the observation point can be accurately grasped.

〔Example〕

Hereinafter, the present invention will be described in detail based on illustrated embodiments. FIG. 1 is a schematic diagram showing the overall configuration of a first embodiment of the surgical microscope according to the present invention. In the figure, 1 is a computer tomography apparatus, 2 is an image analysis unit thereof, and 3 is a first tomographic image arranged on the same plane as the imaging surface of the computer tomography apparatus 1.
The shaft 4 is a first arm connected to the first shaft 3, the second shaft 5 is provided at one end of the first arm 4, the third shaft 6 is provided at one end of the second shaft 5, and the seventh is A second arm pivotable about the three axes 6, 8 is a suspension connected to the second arm 7, 8 'is a fourth axis connected to the suspension 8, and 9 is one end of the fourth shaft 8'. The fifth axis 10 provided in the section is a focusing section for the microscope 11 connected to the fifth axis 9. The first shaft 3, the second shaft 5 and the fourth shaft 8 'are rotatable around a vertical axis for positioning the microscope 11 in the rotational direction on a horizontal plane. The fifth shaft 9 is rotatable about a horizontal axis so as to position the microscope 11 in the vertical and elevation directions. Therefore, the microscope 11 has the first axis 3, the second axis 5,
The joint of the third axis 6, the fourth axis 8 'and the fifth axis 9 and the first arm 4,
It is arranged three-dimensionally at an arbitrary position via a movable part constituted by the second arm 7 and the suspension part 8, and its optical axis can be set in an arbitrary direction.

12,13,14,15 and 16 are 1st axis 3, 2nd axis 5, 3rd axis 6, 4th axis
Detecting means such as a rotary encoder provided for the shaft 8 'and the fifth shaft 9 and capable of detecting the rotation amount and the rotation direction of each of the shafts. 11 detecting means for detecting the amount of movement in the optical axis direction, 18
Together are connected to all of these detection means, the position information of the affected part P ₀ in a patient M ₁ by signals from the image analysis device 2 have been input, the microscope by the detection signal from the detecting means 12 to 17 11 movement amount and position by calculating the position coordinates for the affected part P ₀ of the observation point P ₁ (reference point) (X,
Y, calculates a Z), L of the microscope 11 as the position information of the observation point P ₁
This is an arithmetic unit that outputs to the display unit 11a composed of an ED, LCD, or the like.
Also, a display unit 11 such as an LED or an LCD provided in the microscope 11 is provided.
a is and is able to display the coordinate observation point P ₁ according to the field of view of the operator M _2.

FIG. 2 is a cross-sectional view of the first arm 4 including the first shaft 3 and the second shaft 5 of the present embodiment. Here, 23 and 26 are the first shaft 3 respectively.
Large gears 24 and 27 fixed to the shaft end of the second shaft 5 are fixed to the shaft ends of the rotation input shafts 25 and 28 of the detecting means 12 and 13 provided on the first arm 4, respectively. And 26 are small gears that mesh with each other. Accordingly, the respective horizontal rotation angles of the first arm 4 and the second arm 7, that is, the rotation angles of the first shaft 3 and the second shaft 5, are detected by the respective detecting means 12 and 13 by gear transmission, and correspond to the respective rotation angles. The output is input to the operation unit 18.

FIG. 3 is a sectional view of the second shaft 5 including the third shaft 6 of the present embodiment. The third shaft 6 is a fitting hole provided at one end of the second shaft.
It is rotatably fitted to 29 and further fixed to a rotation input shaft 30 of the detecting means 14 fixed to one end of the second shaft 5. Therefore, the movement of the second arm 7 in the vertical plane is the rotation of the third shaft 6, and the rotation angle is directly detected by the detection means 14, and the output corresponding to the rotation angle is input to the arithmetic unit 18. It has become.

FIG. 4 is a cross-sectional view of the suspension unit 8 including the fourth shaft 8 'and the fifth shaft 9 of the present embodiment, and FIG. 5 is a focusing unit 10 in a plane parallel to the plane of FIG. FIG. Here, the fourth
The shaft 8 'is a rotation input shaft of the detecting means 15 provided on the hanging part 8.
The rotation angle of the fourth shaft 8 ′ is directly detected by the detection unit 15, and an output corresponding to the rotation angle is input to the calculation unit 18. Similarly, the fifth shaft 9 is also fixed to the rotation input shaft 32 of the detection means 16 provided in the focusing unit 10, whereby the rotation angle of the fifth shaft 9 is detected by the detection means 16, Is input to the calculation unit 18.

Reference numeral 33 denotes a male ant integrated with the microscope 11, and 34 denotes a female ant provided in the focusing unit 10.
Is guided in the optical axis direction. 35 is male ant 33
Is a pinion gear meshed with the rack gear 35 and connected to a focusing handle 37 located outside the focusing unit 10. Further, reference numeral 38 denotes a small gear fixed to the rotation input shaft 39 of the detection means 17 which can also detect the rotation amount and the rotation direction of the rotary encoder and the like provided in the focusing unit 10 while meshing with the rack gear 35. .
Therefore, when the focusing handle 37 is rotated, the pinion gear 36
The microscope 11 is moved in the optical axis direction by the rack gear 35 and the rack gear 35.
Is converted into a rotational motion by the detection means 17 and detected as a change in the rotation angle, and an output corresponding to the rotation angle is input to the calculation section 18.

FIG. 6 is a block diagram of the electric circuit of the present embodiment. Here, 39 CPU, 40 each arm length, the memory that stored information such as the working distance of the objective lens, 41 is stored the position information of the patient P ₀ from the image analysis unit 2 memory, 42 display Department
11a, which drive the display unit 11a.
Make up eight. Then, the rotation angle information from each of the detection means 12, ‥‥, and 17 is taken into the CPU 39 and calculated together with information such as each arm length and the working distance of the objective lens in the memory 40, and is converted into the information of the movement amount. You. Then, the position information and the movement amount information of the affected part P ₀ from the image analysis unit 2 which is stored in the memory 41, the position of the observation point P ₁ is calculated.
Further, the value is displayed on the display unit 11a via the display drive unit 42.

Figure 7 shows a state observation point P ₁ coordinates display in the field of view at that time. Here, X, Y, Z denotes the coordinates in FIG. 1, each numerical value indicates the position of the observation point P ₁ with respect to the affected part P ₀ in the coordinate axis of each. Especially in this case, the affected area
Shows that by observing the top of P _0.

This embodiment determines the position of the reference point from being configured as described above, after the tomography of a patient M ₁ by the computer tomography apparatus 1, apparatus of the affected part P ₀ by the image analysis device 2, and the position information of the affected part P ₀ is sent to the arithmetic unit 18. On the other hand, the first axis 3, the second axis 5, the third axis 6, the fourth axis 8 'and the fifth axis 9 and the detecting means 12, 13, 14, 15, 16 of the focusing unit 10, respectively.
And the position of the reference point of the device of the observation point P ₁ by the position information 17 is calculated, the affected area position information being compared coordinate observation point P ₁ relative to the patient part P ₀ of P ₀ is determined . Since the coordinate information of the observation point P ₁ is displayed in the visual field of the operator M _2, the operator M ₂ can recognize the exact coordinates of the observation point P ₁ with respect to the affected part P _0.

By knowing this way the operator M ₂ is a positional relationship of the observation point P ₁ with respect to the affected part P ₀ to accurately until the affected area P ₀ can be accurately and easily reached, therefore again surgery and failure risk Sex can be eliminated. In particular, during craniotomy surgery in brain surgery or the like, changes in the intracranial pressure can effectively respond to changes in the position of the affected part, and even in such a case, the affected part can be reliably reached.

FIG. 8 is a schematic diagram showing the entire configuration of a second embodiment of the surgical microscope according to the present invention. First, the basic configuration of the movable unit that supports the microscope 11 at an arbitrary position and in an arbitrary direction is the same as that of the first embodiment, and thus the description thereof is omitted. Reference numeral 3 is attached to a movable base 19. Also, 12 ', 13', 14 ', 15', 16 'and 1
7 'is the detection means 12, 13, 14, 15, 1 in the first embodiment, respectively.
Drive means with position detectors provided corresponding to 6 and 17 and having a detection function equivalent thereto, and are connected to the control unit 20. Accordingly, the control board of the coordinate observation point P ₁ of the microscope 11 which is moved via the movable portion is displayed on the display unit 11a, the control unit 20 which is capable of further inputs the coordinate observation point P ₁ 21 is connected to the control unit 20 by an input signal from the control board 21.
Calculates the positions of the axes and the focusing unit corresponding to the input coordinates, and calculates the drive means 12 ', 13', 14 ', 15', 1
A drive control signal is sent to 6 'and 17' so that the microscope 11 can be moved to a desired position via the movable part. The focusing unit 10 can be operated independently by the foot switch 43. On the other hand, the patient M ₁ is, CT or MRI
Kabusare instruction frame 22 back and forth affected area so as to indicate the position lateral direction pointing mark 22a and the affected part vertically for indication mark 22b is attached to the affected part P ₀ found covered by such,
Both of these marks 22a, the position of the affected part P ₀ is recognized by 22b.

FIG. 9 is a cross-sectional view of the first arm 4 including the first shaft 3 and the second shaft 5 of the present embodiment.

Here, the small gears 24 and 27 are fixed to rotating shafts 44 and 45 of drive means 12 'and 13' with position detectors provided on the first arm 4, respectively. Each of the driving means 12 'and 13' having received a signal from the unit 20 is driven to rotate, and the rotation angle is also detected. An output corresponding to each rotation angle is input to the control unit 20.

FIG. 10 is a cross-sectional view of the second shaft 5 including the third shaft 6 of the present embodiment, and FIG. 11 is a cross-sectional view of the hanging portion 8 including the fourth shaft 8 'and the fifth shaft 9 of the present embodiment. . The third shaft 6, the fourth shaft 8 'and the fifth shaft 9 are provided on the rotating shaft 46 of the driving means 14' with a position detector fixed to one end of the second shaft 5, and the position detection provided on the hanging portion 8. The rotating shaft 47 of the instrumented driving means 15 'and the rotating shaft 48 of the driving means 16' with a position detector are provided on the focusing unit 10, respectively, and the respective axes 6, 8 'and 9 are controlled by the control unit 20. Are driven by the respective drive means 14 ', 15' and 16 'with position detectors, and the rotation angles are also detected, and outputs corresponding to the respective rotation angles are input to the control unit 20. It has become.

FIG. 12 shows the focusing unit 10 in a plane parallel to the plane of FIG.
FIG. The small gear 38 is fixed to the rotating shaft 49 of the driving unit 17 ′ with the focusing unit position detector provided in the focusing unit 10, so that the microscope 11 receives the signal from the control unit 20. Driving means 17 'with position detector, small gear 38 and rack gear
Moved by 35, its position is also detected,
An output corresponding to the position is input to the control unit 20.

FIG. 13 is a block diagram of an electric circuit of the present embodiment. Here, control is performed by the CPU 39, the memory 40, the display drive unit 42, and the drive circuits 50, 54, and 55 that respectively drive the drive units 12 ', 16', and 17 'with position detectors. The unit 20 is constituted.
Further, the foot switch 43 causes the drive circuit 55 to operate independently. Then, the CPU 39 or the foot switch 43 having received the signal from the control board 21 drives each of the driving means with position detector 1 via each of the driving circuits 50, # 54, and 55.
Each axis is rotated by 2 ', # 16', and 17 'to move the observation point, and the focusing unit 10 is moved to perform focusing. In the same manner as in the first embodiment, the rotation angle information from the driving means 12 ',..., 17' with the position detector is taken into the CPU 39, and information such as each arm length in the memory 40, the working distance of the objective lens, etc. The calculated position information of the observation point is stored in the memory 40 again, and the position of the observation point is displayed on the display unit 11a by an input from the control board 21.

Since this embodiment is configured as described above, previously Dzu, criteria longitudinal and lateral directions the position of the affected part P ₀ by the operation of the Control Board 21 of the observation point P ₁ in accordance with the affected part longitudinal lateral direction pointing mark 22a Recognize as point coordinates and observe point
By recognizing the position of the affected part P ₀ as a reference point coordinate in the vertical direction by the operation of the P ₁ and to fit the affected area vertically for indication mark 22b Control Board 21, the reference point (the affected area
P ₀ ) is determined, and the position information of the affected part P ₀ is sent to the control unit 20. On the other hand, the current position of the observation point P ₁ is located detectors with drive means 12 ', 13', 14 ', 15', a detection signal from the 16 'and 17' is calculated by the control unit 20, the affected part P is compared with position information of ₀ of the coordinate observation point P ₁ on the basis is obtained for the patient portion P _0, the coordinate observation point P ₁ through the display unit 11a of the microscope 11 is displayed within the field of view. Moreover, the observation point P _1, when moving to a different location to be observed, by entering coordinates of a position to be observed in the control board 21, the position control section 20 of each shaft and focusing unit 10 corresponding to the mobile The control unit 20 further uses this calculation result as a drive control signal as drive means with position detectors 12 ', 13', 14 ', 15', 16 'and
Sent to 17 ', thereby the observation point P ₁ is moved to the coordinate position of the target. In this case, the focusing operation can be performed independently in the focusing unit 10 as described above.

In the case of this second embodiment, the operator M ₂ is able to reach the observation point P ₁ precisely and easily to the affected area P _0, the observation point P ₁ and the affected area P ₀ in particular the operation of the Control Board 21 If you place it in the same position as above, first focus on the body surface by focusing operation of the focusing unit 10 and then easily dig down to the affected part P ₀ only by focusing operation of the focusing unit 10 This is extremely convenient.

〔The invention's effect〕

As described above, according to the surgical microscope of the present invention, in this type of surgery using a microscope, the positional relationship between the affected part position and the observation point position currently being observed can be accurately grasped,
It is possible to reliably dig down to the affected part, to reduce the opening of the operation part, and to reach the affected part without meandering. As a result, it is possible to reduce the invasiveness and shorten the operation time. In addition, there is an advantage that even when the affected area is particularly small, it can be reliably detected and appropriate treatment can be performed.

[Brief description of the drawings]

FIG. 1 is a schematic diagram showing the overall configuration of a first embodiment of a surgical microscope having an observation point coordinate display function according to the present invention, and FIG. 2 is a first view including first and second axes of the first embodiment. FIG. 3 is a cross-sectional view of a second axis including a third axis of the first embodiment, FIG. 4 is a cross-sectional view of a suspension section including a fourth axis and a fifth axis of the first embodiment, FIG. 5 is a cross-sectional view of the focusing section taken along a plane parallel to the sheet of FIG. 1 of the first embodiment, FIG. 6 is a block diagram of an electric circuit of the first embodiment, and FIG. FIG. 8 is a diagram showing the appearance of coordinates of observation points in the visual field in FIG. 8, FIG. 8 is a schematic diagram showing the overall configuration of the second embodiment, and FIG. FIG. 10 is a cross-sectional view of a second axis including a third axis of the second embodiment. FIG. 11 is a cross-sectional view of a suspension part including a fourth axis and a fifth axis of the second embodiment. FIG. 12 is a diagram corresponding to FIG. 8 of the second embodiment. Kicking sectional view of the focusing unit in a plane parallel to the plane, FIG. 13 is a block diagram of an electrical circuit of the second embodiment. 1 ... Computed tomography apparatus, 2 ... Image analysis unit,
3 ... 1st axis, 4 ... 1st arm, 5 ... 2nd axis, 6 ...
... 3rd axis, 7 ... 2nd arm, 8 ... suspension part, 8 '...
4th axis, 9 ... 5th axis, 10 ... focusing part, 11 ... microscope,
11a: display section, 12, 13, 14, 15, 16, 17 ... detecting means, 1
2 ', 13', 14 ', 15', 16 ', 17' ... Drive means with position detector, 18 ... Calculation unit, 19 ... Base, 20 ... Control unit, 21 ...
Control board, 22 ... frame, 43 ... foot switch.

Continuation of the front page (56) References JP-A-60-2914 (JP, A) JP-A-63-216566 (JP, A) JP-A-62-101241 (JP, A) JP-A-63-296743 (JP) , A) JP-A-62-102752 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 19/00 G02B 21/24

Claims (1)

(57) [Claims] 1. A surgical microscope apparatus comprising: a movable portion including a plurality of arms having a rotation axis; and a microscope supported by the movable portion and capable of changing an observation point position. Detecting means for detecting the amount and direction of rotation of the shaft; and calculating means for calculating the coordinates of the observation point with respect to the reference point based on the detection signal from the detecting means and the information for focusing the microscope. A surgical microscope apparatus comprising: a display unit configured to display coordinates of the observation point.