US20010055062A1 - Operation microscope - Google Patents

Abstract

There is disclosed an operation microscope in which an observing and displaying means of an operating instrument are selected, and an endoscope image for observing a dead angle of the microscope and a navigation image are selectively displayed in a microscope observation field, so that a tomographic image, three-dimensionally constructed image, and the like can be selectively displayed in a display screen in accordance with a treatment position displayed in a monitor or an observation position of the operation microscope.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• This application is based upon and claims the benefit of priority from the prior Japanese Patent Applications No. 2000-119995, filed Apr. 20, 2000; No. 2000-180224, filed Jun. 15, 2000; No. 2000-191476, filed Jun. 26, 2000; No. 2000-193223, filed Jun. 27, 2000; and No. 2000-194807, filed Jun. 28, 2000, the entire contents of all of which are incorporated herein by reference.[0001]
BACKGROUND OF THE INVENTION
• The present invention relates particularly to an operation microscope for use in a surgical operation of a fine portion in cranial nerve surgery, and the like.[0002]
• In conventional cranial nerve surgery, to absolutely perform a delicate operation, an operation microscope for stereoscopically enlarging an image of a portion being subjected to the operation has been utilized in many cases. Furthermore, in recent years, to certainty carry out an operation, endoscope observation is performed in a conventional operation concurrently with the operation microscope. Therefore, it has been desired that an operation microscope observation image and an endoscope observation image can be simultaneously observed in a field of view of the operation microscope. Moreover, it has also been desired that not only the operation microscope observation image, endoscope observation image, and nerve monitor information but also preoperative CT and MR images can be simultaneously observed during the operation.[0003]
• Examples of a known prior art include Jpn. Pat. Appln. KOKAI Publication Nos. 9-56669, 11-258514 and Published Japanese Patent No. 11-288328. In these publications, at least a part of an observation image of a second observation means is displayed as an in-field display image in a field of the microscope observation image as first observation means for observing the operative portion. For example, a liquid crystal filter is used to shield the microscope observation image, an image is projected into the shielded portion, and the observation image of the second observation means can be displayed in an arbitrary position in a field of the microscope observation image. Thereby, a dead angle portion which cannot be observed with the microscope observation image and a state inside a body tissue can be recognized by the observation image of the second observation means.[0004]
• However, in the aforementioned prior art, since the size or the like of the in-field display image displayed in the field of the microscope observation image cannot be freely changed, the image display itself can possibly interfere with the orientation handling of endoscope observation. Furthermore, since the observation image of the second observation means cannot be observed as a large image, there is a problem that the observation image of the second observation means cannot be as finely observed as the large image.[0005]
BRIEF SUMMARY OF THE INVENTION
• The present invention has been developed in consideration of the aforementioned situations, and an object thereof is to provide an operation microscope by which an endoscope observation image for observing a dead angle of a microscope observation image, image information of a microscope or endoscope observation position by a navigation apparatus, and image information such as an endoscope observation direction are displayed alone or as an arbitrary combination thereof. An operating person can obtain desired image information in accordance with an operational situation, and an operation can be efficiently carried out.[0006]
• To achieve the aforementioned object, according to the present invention, there is provided an operation microscope provided with a microscope body including an optical eyepiece system for stereoscopically observing an operative portion of a surgical operation, and[0007]
• a microscope image observer for observing an observation image formed for stereoscopic observation by the microscope body, the operation microscope comprising:[0008]
• a plurality of image forming sections for forming images other than the observation image of the microscope image observer;[0009]
• an image display for selectively displaying the respective images of the plurality of image forming sections in the microscope image observer;[0010]
• a display driver for controlling display states of the plurality of images formed by the plurality of image forming sections independently of one another; and[0011]
• an operator for controlling an operation of the display driver.[0012]
• Moreover, in the present invention, the plurality of image forming sections form the images other than the observation image of the microscope image observer, and the image display selectively displays the respective images of the plurality of image forming sections in the microscope image observer. In this case, the operator controls the operation of the display driver, and controls the display states of the plurality of images formed by the plurality of image forming sections independently of each other.[0013]
• Therefore, according to the present invention, images other than the observation image of the microscope image observer, such as an endoscope observation image for observing a dead angle of a microscope, image information of a microscope or endoscope observation position by a navigation apparatus, and a plurality of pieces of image information such as endoscope observation direction image information, are displayed alone or as an arbitrary combination thereof. An operating person can obtain appropriate image information in accordance with the operating situation, and the surgical operation can be efficiently carried out.[0014]
• Additional objects and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out hereinafter.[0015]
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING
• The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate presently preferred embodiments of the invention, and together with the general description given above and the detailed description of the preferred embodiments given below, serve to explain the principles of the invention.[0016]
• FIG. 1 is a diagram showing an optical constitution of a binocular eyepiece lens tube in an operation microscope according to a first embodiment of the present invention.[0017]
• FIG. 2 is a side view showing a left side observation optical system in the binocular eyepiece lens tube of the operation microscope of the first embodiment.[0018]
• FIG. 3 is a longitudinal sectional view of an overlay display unit in the operation microscope of the first embodiment.[0019]
• FIG. 4 is a perspective view showing an LCD optical system in the operation microscope of the first embodiment.[0020]
• FIG. 5 is a block diagram of a control system of an XY table in the operation microscope of the first embodiment.[0021]
• FIG. 6 is a schematic constitution view of the entire operation microscope system in the first embodiment.[0022]
• FIG. 7 is a process explanatory view showing a first image display state of a field of microscope observation in the operation microscope of the first embodiment.[0023]
• FIG. 8 is a process explanatory view showing a second image display state of the microscope observation field in the operation microscope of the first embodiment.[0024]
• FIG. 9 is a monitor block diagram of a nerve monitor in the operation microscope according to a second embodiment of the present invention.[0025]
• FIG. 10 is a flowchart of a monitor display in the operation microscope of the second embodiment.[0026]
• FIG. 11 is a process explanatory view showing the first image display state of the microscope observation field in the operation microscope of the second embodiment.[0027]
• FIG. 12 is a process explanatory view showing the second image display state of the microscope observation field in the operation microscope of the second embodiment.[0028]
• FIG. 13 is a block diagram showing a main constitution in the operation microscope according to a third embodiment of the present invention.[0029]
• FIG. 14 is a process explanatory view showing an image display state of the microscope observation field in the operation microscope of the third embodiment.[0030]
• FIG. 15 is a flowchart showing the image display state of the microscope observation field in the operation microscope according to a fourth embodiment of the present invention.[0031]
• FIG. 16 is a diagram showing a menu display in the operation microscope of the fourth embodiment.[0032]
• FIG. 17 is a process explanatory view showing an image display state of the microscope observation field in the operation microscope of the fourth embodiment.[0033]
• FIG. 18 is a longitudinal sectional view of an overlay display unit in the operation microscope of a fifth embodiment of the present invention.[0034]
• FIG. 19 is a process explanatory view showing an image display state of the microscope observation field in the operation microscope of the fifth embodiment.[0035]
• FIG. 20 is a block diagram showing a main constitution of a bipolar treatment apparatus in the operation microscope of the fifth embodiment.[0036]
• FIG. 21 is a schematic constitution diagram showing the entire system of an operation microscope apparatus according to a sixth embodiment of the present invention.[0037]
• FIG. 22 is a perspective view showing a scope holder in the operation microscope apparatus of the sixth embodiment.[0038]
• FIG. 23 is a schematic constitution diagram of a microscope body in the operation microscope apparatus of the sixth embodiment.[0039]
• FIG. 24 is a block diagram showing a control system in the operation microscope apparatus of the sixth embodiment.[0040]
• FIG. 25 is a diagram showing the microscope observation field in the operation microscope apparatus of the sixth embodiment.[0041]
• FIG. 26A is an explanatory view showing a first image selection state by a switch detector in the operation microscope apparatus of the sixth embodiment.[0042]
• FIG. 26B is an explanatory view showing a second image selection state by a switch detector in the operation microscope apparatus of the sixth embodiment.[0043]
• FIG. 27 is a diagram showing the microscope observation field during fixing of the scope holder in the operation microscope apparatus of the sixth embodiment.[0044]
• FIG. 28 is a diagram showing the microscope observation field during moving of the scope holder in the operation microscope apparatus of the sixth embodiment.[0045]
• FIG. 29 is a block diagram showing the control system of the operation microscope apparatus according to a seventh embodiment of the present invention.[0046]
• FIG. 30A is an explanatory view showing the first image selection state by the switch detector in the operation microscope apparatus of the seventh embodiment.[0047]
• FIG. 30B is an explanatory view showing the second image selection state by the switch detector in the operation microscope apparatus of the seventh embodiment.[0048]
• FIG. 31 is a diagram showing the microscope observation field during fixing of the scope holder in the operation microscope apparatus of the seventh embodiment.[0049]
• FIG. 32 is a diagram showing the microscope observation field during moving of the scope holder in the operation microscope apparatus of the seventh embodiment.[0050]
• FIG. 33 is a block diagram of the control system in the operation microscope apparatus according to an eighth embodiment of the present invention.[0051]
• FIG. 34 is a schematic constitution diagram showing a usage state of an ultrasonic probe in the operation microscope apparatus of the eighth embodiment.[0052]
• FIG. 35A is an explanatory view showing the image selection state during ultrasonic observation in the operation microscope apparatus of the eighth embodiment.[0053]
• FIG. 35B is an explanatory view showing the image selection state during discontinuation of ultrasonic observation in the operation microscope apparatus of the eighth embodiment.[0054]
• FIG. 36 is a diagram showing the microscope observation field during discontinuation of ultrasonic observation in the operation microscope apparatus of the eighth embodiment.[0055]
• FIG. 37 is a diagram showing the microscope observation field during ultrasonic observation in the operation microscope apparatus of the eighth embodiment.[0056]
• FIG. 38 is a block diagram of the control system in the operation microscope apparatus according to a ninth embodiment of the present invention.[0057]
• FIG. 39 is a diagram showing the microscope observation field during use of an endoscope in the operation microscope apparatus of the ninth embodiment.[0058]
• FIG. 40 is a diagram showing the microscope observation field whilst using the ultrasonic probe in the operation microscope apparatus of the ninth embodiment.[0059]
• FIG. 41 is a plan view of a foot switch in the operation microscope apparatus of the ninth embodiment.[0060]
• FIG. 42 is a process explanatory view of an XY switch when an endoscope observation image is displayed in the microscope observation field in the operation microscope apparatus of the ninth embodiment.[0061]
• FIG. 43 is a process explanatory view of the XY switch when an ultrasonic probe observation image is displayed in the microscope observation field in the operation microscope apparatus of the ninth embodiment.[0062]
• FIG. 44 is a block diagram of the control system of the operation microscope apparatus according to a tenth embodiment of the present invention.[0063]
• FIG. 45 is a diagram showing one example of a superimposed display state of the microscope observation field in the operation microscope apparatus of the tenth embodiment.[0064]
• FIG. 46 is a diagram showing another example of the superimposed display state of the microscope observation field in the operation microscope apparatus of the tenth embodiment.[0065]
• FIG. 47 is a diagram showing one example of the microscope observation field in the operation microscope apparatus according to an eleventh embodiment of the present invention.[0066]
• FIG. 48 is a diagram showing another example of the microscope observation field in the operation microscope apparatus of the eleventh embodiment.[0067]
• FIG. 49 is a front view showing the microscope body of the operation microscope apparatus according to a twelfth embodiment of the present invention.[0068]
• FIG. 50 is a block diagram of the control system of the operation microscope apparatus of the twelfth embodiment.[0069]
• FIG. 51 is a diagram showing one example of the microscope observation field in the operation microscope apparatus of the twelfth embodiment.[0070]
• FIG. 52 is a diagram showing another example of the microscope observation field in the operation microscope apparatus of the twelfth embodiment.[0071]
• FIG. 53A is a schematic constitution diagram of a main part of a rigid endoscope used together with the operation microscope according to a thirteenth embodiment of the present invention.[0072]
• FIG. 53B is a schematic constitution diagram showing a scale generation apparatus in the operation microscope of the thirteenth embodiment.[0073]
• FIG. 54 is a schematic constitution diagram of the main part showing a state in which an insertion member tip end of the rigid endoscope used together with the operation microscope of the thirteenth embodiment is inserted into a pore of the portion subjected to the operation.[0074]
• FIG. 55 is a plan view showing image information in which an emission index is displayed in the observation image of the rigid endoscope used together with the operation microscope of the thirteenth embodiment.[0075]
• FIG. 56 is a plan view showing the image information in which no emission index is displayed in the operation image of the rigid endoscope of the thirteenth embodiment.[0076]
• FIG. 57 is a plan view showing the image information only of the emission index in the operation microscope of the thirteenth embodiment.[0077]
• FIG. 58 is a plan view showing the image in which the emission index and a scale character is superposed onto each other in the same screen of the observation image of the rigid endoscope in the operation microscope of the thirteenth embodiment.[0078]
• FIG. 59 is a plan view showing the observation image of the operation microscope displayed in a field of view of the operation microscope according to the thirteenth embodiment, and the image in which the scale having an appropriate length with respect to a diameter of microscope field of view and the character are displayed in the observation image of the rigid endoscope displayed in a sub-screen.[0079]
• FIG. 60 is a plan view showing a case in which the display of the scale in the operation microscope field of the thirteenth embodiment and the character indicating the length of the scale is deleted.[0080]
• FIG. 61 is a schematic constitution diagram showing the entire system of the operation microscope according to a fourteenth embodiment of the present invention.[0081]
• FIG. 62 is a schematic constitution diagram of the optical system in the microscope body in the operation microscope of the fourteenth embodiment.[0082]
• FIG. 63 is a schematic constitution diagram showing a connection state of a workstation in the operation microscope of the fourteenth embodiment.[0083]
• FIG. 64 is a plan view showing an image in which a preoperative image is displayed in the sub-screen in the microscope observation image displayed in a field of view of an eyepiece in the operation microscope of the fourteenth embodiment.[0084]
• FIG. 65 is a perspective view showing a conical character generated by the workstation in the operation microscope of the fourteenth embodiment.[0085]
• FIG. 66 is a plan view showing an image in which the character is superposed in the microscope observation image in the operation microscope of the fourteenth embodiment.[0086]
• FIG. 67A is a schematic constitution diagram showing a main part of the rigid endoscope used together with the operation microscope according to a fifteenth embodiment of the present invention.[0087]
• FIG. 67B is a plan view showing three emission indexes attached to the rigid endoscope.[0088]
• FIG. 68 is a schematic constitution diagram showing the inside of the rigid endoscope in the operation microscope of the fifteenth embodiment.[0089]
• FIG. 69 is a schematic constitution diagram showing peripherals of the rigid endoscope in the operation microscope of the fifteenth embodiment.[0090]
• FIG. 70 is a schematic constitution diagram of the main part showing a state in which the insertion member tip end of the rigid endoscope used together with the operation microscope of the fifteenth embodiment is inserted into the pore of the portion subjected to the operation.[0091]
• FIG. 71 is a plan view showing an image in which the observation image of the rigid endoscope is displayed in the sub-screen of the observation image of the operation microscope according to the fifteenth embodiment.[0092]
• FIG. 72 is a plan view showing an image in which the character is superposed in the observation image of the rigid endoscope in the operation microscope of the fifteenth embodiment.[0093]
• FIG. 73 is a perspective view of the microscope body in the operation microscope according to a sixteenth embodiment of the present invention.[0094]
• FIG. 74 is a perspective view of the entire operation microscope apparatus of the sixteenth embodiment.[0095]
• FIG. 75 is a control block diagram of the operation microscope apparatus of the sixteenth embodiment.[0096]
• FIG. 76 is an explanatory view showing an ultrasonic observation state in the operation microscope apparatus of the sixteenth embodiment.[0097]
• FIG. 77 is a flowchart showing an ultrasonic observation process in the operation microscope apparatus of the sixteenth embodiment.[0098]
• FIG. 78A is a diagram showing one example of the microscope observation field in which the microscope image of the ultrasonic probe in the operation microscope apparatus of the sixteenth embodiment is displayed.[0099]
• FIG. 78B is a diagram showing another example of the microscope observation field in which the microscope image of the ultrasonic probe in the operation microscope apparatus of the sixteenth embodiment is displayed.[0100]
• FIG. 79 is a longitudinal sectional view of the tip end of the ultrasonic probe according to a seventeenth embodiment of the present invention.[0101]
• FIG. 80 is a control block diagram of the seventeenth embodiment.[0102]
• FIG. 81 is a diagram showing a first ultrasonic observation state of the seventeenth embodiment.[0103]
• FIG. 82 is a diagram showing a second ultrasonic observation state of the seventeenth embodiment.[0104]
• FIG. 83 is a diagram showing a third ultrasonic observation state of the seventeenth embodiment.[0105]
• FIG. 84 is a constitution diagram of the entire microscope body section of the operation microscope according to an eighteenth embodiment of the present invention.[0106]
• FIG. 85 is a diagram of a cross section as seen along arrow A in FIG. 84, showing an internal optical constitution of the binocular eyepiece lens tube of the eighteenth embodiment.[0107]
• FIG. 86 is a side view showing a left side optical observation system of the operation microscope of the eighteenth embodiment.[0108]
• FIG. 87 is a longitudinal side sectional view of an eye distance adjustment mechanism of the binocular eyepiece lens tube in the operation microscope of the eighteenth embodiment.[0109]
• FIG. 88 is a sectional view taken along line[0110]88-88 of FIG. 87.
• FIG. 89 is a perspective view showing a housing constitution of an eye distance adjustment section in the operation microscope of the eighteenth embodiment.[0111]
• FIG. 90 is a diagram showing arrangement (movement) of an optical eyepiece system when eye distance adjustment is performed in the operation microscope of the eighteenth embodiment.[0112]
• FIG. 91 is a diagram showing an image display state in the operation microscope observation field of the eighteenth embodiment.[0113]
DETAILED DESCRIPTION OF THE INVENTION
• Respective embodiments of the present invention will be described hereinafter with reference to the drawings.[0114]
• FIG. 1 to FIG. 8 show a first embodiment. FIG. 1 shows an internal optical system constitution of a binocular eyepiece lens tube of an operation microscope[0115]101 (see FIG. 6), and FIG. 2 is a diagram showing a left side optical observation system of FIG. 1. Additionally, a right side optical observation system of the binocular eyepiece lens tube has the same constitution as that of the left optical observation system of FIG. 2, and only the constitution of the left side optical observation system of FIG. 2 will be described here.
• As shown in FIG. 1, a fixed[0116]housing7, and amovable housing16 are disposed in a microscope body104 (see FIG. 6) of the binocular eyepiece lens tube of theoperation microscope101 of the present embodiment. A pair of left and rightimage forming lenses8a,8bare disposed inside the fixedhousing7. The respectiveimage forming lenses8a,8bare optically connected to a firstoptical observation system1A. Additionally, besides the first observationoptical system1A, a plurality of optical observation systems, for example, two optical observation systems, as described later in the present embodiment (second and third observationoptical systems1B and1C) are incorporated in themicroscope body104 of the binocular eyepiece lens tube of the present embodiment.
• Moreover, mirrors[0117]9a,9bfor reflecting left and right observation fluxes incident via theimage forming lenses8a,8boutwardly by 90° are disposed in the first observationoptical system1A.Image rotator prisms10a,10bare disposed on outgoing light axes of themirrors9a,9b.Prisms11a,11bfor reversing each observation flux by 180° are disposed behind theimage rotor prisms10a,10b. Furthermore,triangular prisms12a,12bfor reflecting the outgoing light axes from theprisms11a,11bin parallel with left and right observation light axes OL, OR by an optical eyepiece system described later are disposed/fixed behind the reversing prisms. First, intermediateimage forming points13a,13bat which images are formed by theimage forming lenses8a,8bare positioned behind thetriangular prisms12a,12b.
• Here, upper surfaces of[0118]prisms14a,14bas light guiding means, as described later, are disposed so as to be aligned substantially on the same plane in the vicinity of the first intermediateimage forming points13a,13b. Furthermore,relay lenses15a,15bfor relaying the images are disposed/fixed behind the first intermediateimage forming points13a,13b.
• Moreover, the[0119]prisms11a,11b,triangular prisms12a,12b, andrelay lenses15a,15bare contained in themovable housing16. Themovable housing16 is rotatably connected to the fixedhousing7 viaconnection members17a,17bso as to be rotatable around a rotation axis O, that is, the incident light axes of theprisms11a,11b.
• Furthermore, each of the[0120]rotator prisms10a,10bcan rotate centering on the rotation axis O by an angle of ½ with respect to rotation of themovable housing16 to the fixedhousing7 by a cam mechanism (not shown).
• Additionally, a pair of left and right eye[0121]distance adjustment housings4a,4bare disposed on respective outgoing light paths from the left andright relay lenses15a,15bin themovable housing16.Parallel prisms18a,18bas reflection members are contained in these eyedistance adjustment housings4a,4b. AS shown in FIG. 2, incident reflection surfaces19a,19band outgoing reflection surfaces20a,20bare disposed in the respectiveparallel prisms18a,18b.
• Here, images transmitted via the[0122]relay lenses15a,15bfrom the first intermediateimage forming points13a,13bare formed on second intermediateimage forming points21a,21bfrom outgoing reflection surfaces20a,20bof theparallel prisms18a,18bin the eyedistance adjustment housings4a,4b.
• Moreover, the pair of left and right eye[0123]distance adjustment housings4a,4bare connected to left andright eyepiece housings5a,5b. Moreover, the images formed on the second intermediateimage forming points21a,21bare guided to a pair ofoptical eyepiece systems22a,22bcontained in theeyepiece housings5a,5b, and observation light axes OR, OL as microscope optical observation images of the firstoptical observation system1A are constituted.
• Furthermore, the eye[0124]distance adjustment housings4a,4bare connected to themovable housing16 such that thehousings4a,4bcan rotate around axes substantially corresponding to the outgoing light axes (vertical direction in FIG. 2) from thetriangular prisms12a,12b. Here, as shown in FIG. 2,stoppers23a,23bare attached to connection members of the eyedistance adjustment housings4a,4bwith respect to themovable housing16. Moreover, the eyedistance adjustment housings4a,4bare supported by therespective stoppers23a,23bsuch that thehousings4a,4bare immobile in an axial direction with respect to themovable housing16. Additionally, the present structure andparallel prisms18a,18bconstitute a so-called G ten top eye distance adjustment mechanism.
• Moreover, as shown in FIG. 2, a[0125]second eyepiece housing30 for containing the second observationoptical system1B is disposed outside the eyedistance adjustment housings4a,4bin the first observationoptical system1A.
• The second[0126]optical observation system1B is constituted as follows. FIG. 2 only shows the left light path, because the right light path is similar in structure to the left light path.Numeral31adenotes a small-sized LCD monitor, controlled by adisplay controller46 described later (see FIG. 5), for displaying an image of an endoscope or the like as an electronic image. This small-sized LCD monitor31ais disposed/fixed between the eyedistance adjustment housing4aand themovable housing16 disposed below the housing.
• [0127]Reference numerals32a,33adenote an optical relay system disposed on an outgoing light axis O2L from the LCD monitor31a, and aprism34afor reflecting the light axis O2L substantially by 90° is disposed inside.
• Moreover, numeral[0128]35adenotes a prism for deflecting the light axis reflected by theprism34ain a direction of an observation light axis OL. A second optical eyepiece system36ais optically disposed/connected on the outgoing light axis O2L of theprism35a. Moreover, the observation light axes OL and O2L intersect each other in the vicinity of an emission pupil position. Thereby, an operating person changes a state in which a line of sight is turned in a direction of the observation light axis OL and a state in which the line of sight is turned in a direction of the outgoing light axis O2L of theprism35ain the same place, and can observe different display screens. Here, when the operating person turns the line of sight in the direction of the observation light axis OL, the operating person can observe a microscope optical observation image of the firstoptical observation system1A. Moreover, when the line of sight is turned in the direction of the outgoing light axis O2L of theprism35a, the state can be changed to a second observation state for observing a display image W1 of the LCD monitor31a.
• Furthermore, the[0129]operation microscope101 of the present embodiment is provided with anoverlay display unit81 for overlaying/displaying image data such as character data and an arrow in the observation image of theoperation microscope101 as shown in FIG. 3. Theoverlay display unit81 includes amicroscope body82 disposed in the light axis of the observation image of theoperation microscope101. Themicroscope body82 contains an opticalobjective system83 and variable poweroptical system84, and a pair of left and right light paths are disposed. Here, a variable focus mechanism and focal distance detecting sensor are disposed in the opticalobjective system83. Furthermore, a variable power mechanism and variable power detecting sensor are disposed in the variable poweroptical system84.
• Furthermore, a[0130]half mirror85 and image insertionoptical system86 as light path insertion means are disposed in themicroscope body82 of theoverlay display unit81. The opticalimage insertion system86 combines fluxes emitted from a displayingmonitor87 of anavigation apparatus59 as an afocal flux, and allows the afocal flux to be incident upon thehalf mirror85. Additionally, numeral87adenotes the cable for transmitting an image signal to theimage superimposing monitor87 from thenavigation apparatus59. The image data such as the character data and arrow are displayed in theimage superimposing monitor87.
• Moreover, in the[0131]half mirror85 of theoverlay display unit81, the observation image of theoperation microscope101 is sent toward themicroscope body104 of the binocular eyepiece lens tube while the image data such as the character data and arrow displayed in theimage superimposing monitor87 are overlaid/displayed in the observation image of theoperation microscope101 incident from the opticalobjective system83.
• Furthermore, left and right LCD[0132]optical systems26a,26bare disposed as the thirdoptical observation system1C for display in a field of view in side positions of theprisms14a,14bin themovable housing16. FIG. 4 is a perspective view of the LCDoptical systems26a,26b. The respective LCDoptical systems26a,26bare provided with a pair of small-sized LCD monitors24a,24b, controlled by a controller (not shown), for displaying the image of the endoscope or the like, andimage forming lenses25a,25bas optical projection systems disposed on the outgoing light axes of the respective LCD monitors24a,24b. Furthermore, these components are arranged/fixed in such a manner that the images of the LCD monitors24a,24bare formed on the upper surfaces of theprisms14a,14b. Here, one LCD monitor24a,image forming lens25a, andprism14aconstitute, for example, the left side LCDoptical system26a. Furthermore, the other LCD monitor24b,image forming lens25b, andprism14bconstitute the right side LCDoptical system26b.
• Additionally, the LCD[0133]optical systems26a,26bare integrally fixed to a fixingplate27. This fixingplate27 is provided withholes27a,27bfor avoiding fluxes. The fixingplate27 is fixed onto an XY table28aas drive means. The XY table28ais disposed so that the table can move in XY directions on a plane crossing at right angles to the light axes of the LCDoptical systems26a,26b.
• FIG. 5 shows a perspective view showing an internal constitution of the XY table[0134]28aand a block diagram of a control system. In the XY table28aan X table29aand Y table29bare disposed so that the tables can move in x and Y directions crossing at right angles to each other. The X table29ais provided with arack29a1 and shaft bearing29a2. Therack29a1 meshes with apinion gear71afixed to a rotation shaft of anX table motor70a. Moreover, aguide shaft72ais passed through the shaft bearing29a2. TheX table motor70aandguide shaft72aare fixed to the Y table29bas described later. Furthermore, the fixingplate27 is fixed onto the X table29a.
• The Y table[0135]29bis provided with arack29b1 and shaft bearing29b2. Therack29b1 meshes with a pinion gear74afixed to a rotation shaft of a Y table motor73a. Moreover, aguide shaft75ais passed through the shaft bearing29b2.
• The X and[0136]Y table motors70aand73ainclude encoders, and are electrically connected to a control system described later. That is, theX table motor70ais connected to amotor drive circuit41, and the encoder is connected to an X tableposition detection circuit42. Moreover, the Y table motor73ais connected to amotor drive circuit43, and the encoder is connected to a Y tableposition detection circuit44. Furthermore, themotor drive circuit41, x tableposition detection circuit42,motor drive circuit43 and Y tableposition detection circuit44 are connected to an XY table controller45.
• On the other hand, a controller[0137]51 is operation input means, actuated by the operating person. The controller51 includes four-direction XY switches52 for actuating the XY table28ain four XY directions,observer selection switch53, anddisplay selection switch54.
• The controller[0138]51 is connected to thedisplay controller46. Thedisplay controller46 is connected to the XY table controller45. Thedisplay controller46 is connected to animage conversion circuit37 and in-field image selector38. The in-field image selector38 is connected to anendoscope TV camera58 andnavigation apparatus59. Moreover, theimage conversion circuit37 is connected to the LCD monitor24avia adisplay drive circuit65 and further to theLCD monitor24bvia adisplay drive circuit66.
• The[0139]display controller46 is further connected to animage selector39 for observing the image and a navigation image superimposingimage selector40. The image observingimage selector39 is also connected to theendoscope TV camera58 andnavigation apparatus59. Furthermore, the navigation image superimposingimage selector40 is connected to thenavigation apparatus59 and also to anerve monitor100.
• The image observing[0140]image selector39 is connected to one (left light path) LCD monitor31 via adisplay drive circuit67, and further to the other (right light path) LCD monitor31 via adisplay drive circuit68. Moreover, the navigation image superimposingimage selector40 is connected to the displayingmonitor87 of thenavigation apparatus59 via adisplay drive circuit69.
• Moreover, FIG. 6 is a perspective view showing a constitution of the entire system of an operation microscope apparatus. As shown in FIG. 6, the operation microscope apparatus includes the[0141]operation microscope101 having a solid microscope,endoscope121 formed of a rigid endoscope for obtaining an observation image other than the observation image of theoperation microscope101, and displayingmonitor141 as display means for displaying the observation images of theoperation microscope101 andendoscope121.
• Moreover, a[0142]base102,balance arm103 disposed on an upper part of thebase102, andmicroscope body104 supported by thebalance arm103 are disposed in theoperation microscope101. Additionally, the respective first to thirdoptical observation systems1A to1C shown in FIG. 1 and FIG. 2 are incorporated in themicroscope body104.
• Here, the[0143]balance arm103 includes a plurality of movable arms, and sixrotation axes105ato105f. Furthermore, the respective rotation axes105ato105fare provided with electromagnetic locks (not shown) for switching a locking state in which rotation positions of the respective rotation arms of thebalance arm103 are fixed and an unlocked state in which the locked rotation positions are released. Moreover, themicroscope body104 is supported in such a manner that themicroscope body104 can move in a spatial position centering on the respective sixrotation axes105ato105fof the respective rotation arms of thebalance arm103 with a switching operation for locking/unlocking the electromagnetic locks.
• Moreover, the[0144]microscope body104 includes asensor arm106 and agrip107 for controlling a position of themicroscope body104. Thegrip107 is provided with respective operation switches for focus adjustment, variable power operation, and arm operation.
• Furthermore, the[0145]operation microscope101 incorporates a microscope body controller111 andarm controller112. The respective switches of thegrip107 are connected to the microscope body controller111 andarm controller112. Additionally, the microscope body controller111 andarm controller112 are connected to afoot switch113 including respective switches for focus adjustment and variable power operation similarly as the respective switches of thegrip107.
• Moreover, the[0146]endoscope121 is supported by ascope holder122 attached to an operating table (not shown). Thisscope holder122 is constituted by an articulated arm including a plurality ofmovable arms123. Joints among the respectivemovable arms123 are rotatably connected to one another. Moreover, theendoscope121 is movably supported by thescope holder122.
• Furthermore, each rotary member of the[0147]scope holder122 is provided with electromagnetic locking for switching a locking state in which rotation positions of therespective rotation arms123 of thescope holder122 are fixed and an unlocked state in which the locked rotation positions are released. Moreover, theendoscope121 is supported so that theendoscope121 can move with a switching operation for locking/unlocking the electromagnetic locks.
• Moreover, the electromagnetic lock of each rotation member is connected to a[0148]scope holder controller124. Furthermore, aswitch122A for actuating the electromagnetic lock is disposed on a tip end of thescope holder122. Theswitch122A is connected to thescope holder controller124. Additionally, aTV camera125 and substantially V-shapedendoscope sensor arm126 are attached to theendoscope121.
• Furthermore, a[0149]digitizer134 as a photographing apparatus for detecting observation positions of theoperation microscope101 andendoscope121 is disposed. Thedigitizer134 detects thesensor arm106 of theoperation microscope101 and thesensor arm126 in theendoscope121, and thenavigation apparatus59 calculates the correlation of the information with a reference index attached to a patient's head (not shown), to detect the observation positions of theoperation microscope101 andendoscope121.
• The[0150]digitizer134 is connected to thenavigation apparatus59. Thenavigation apparatus59 incorporates a memory for diagnosing the image, and also includes correlation processing means with respect to image diagnosis. Furthermore, thenavigation apparatus59 is connected to thedisplay monitor141, and aninterface unit136. Additionally, image information obtained by thedigitizer134 is inputted to thenavigation apparatus59, and thenavigation apparatus59 calculates the correlation of the information with a reference index attached to the patient's head.
• An action of the present embodiment constituted as described above will next be described. During use of the system of the operation microscope apparatus of the present embodiment, the operating person actuates the[0151]balance arm103 of theoperation microscope101 to dispose/fix themicroscope body104 in a desired position. Subsequently, themovable housing16 is rotated around the axial direction centering on the rotation axis O, and theoptical eyepiece systems22a,22bare disposed near the operating person's eyes. In this case, theimage rotator prisms10a,10bin the fixedhousing7 are rotated by ½ of the rotation of themovable housing16 around the rotation axis O.
• In this state, an operated portion is observed by the[0152]operation microscope101. In this case, light emitted from the operated portion is incident upon theimage forming lenses8a,8bof the firstoptical observation system1A via an optical magnification system (not shown) in themicroscope body104. Left and right fluxes are passed through theimage rotator prisms10a,10b, and rotation of the image is corrected by rotating themovable housing16 around the axis O. Subsequently, the light is reflected by theprisms11a,11bandtriangular prisms12a,12b, and images are formed in the first intermediateimage forming points13a,13b.
• Subsequently, the light is transmitted via the[0153]relay lenses15a,15b, and reflected by theparallel prisms18a,18b. Thereafter, the image is again formed in the second intermediate image forming point. Then, the image is guided to theoptical eyepiece systems22a,22b. Therefore, when the operating person looks into theoptical eyepiece systems22a,22b, stereoscopic observation of the microscope image is performed at a desired scaled-up magnification.
• Moreover, when a distance between the left and right observation light axes OL and OR deviates from an operating person's eye distance and stereoscopic observation is impossible, the eye[0154]distance adjustment housings4aand4bare rotated around an axes substantially agreeing with the outgoing light axes from thetriangular prisms12a,12bwith respect to themovable housing16. Thereby, so-called eye distance adjustment is performed in order to adjust the left and right observation light axes OL, OR in accordance with the operating person's eye distance.
• On the other hand, when the endoscope observation image and images of CT, MR, and the like are to be observed simultaneously with the microscope image, the operating person actuates the controller[0155]51, so that desired image data is displayed in the LCD monitors24a,24bof the thirdoptical observation system1C. In this case, the light emitted by the LCD monitors24a,24bis formed into the images on the upper surfaces of theprisms14a,14bby theimage forming lenses25a,25b. Since the upper surfaces of theprisms14a,14bare in the vicinity of the first image forming point, the image data of the LCD monitors24a,24b, for example, an endoscope image M is displayed on a microscope observation field O as shown by a first image display state of FIG. 7.
• Here, when the endoscope image M is displayed on the microscope observation field O, the following process is performed. First, the endoscope TV camera[0156]58 (endoscope image) and navigation apparatus59 (navigation image) are selected by thedisplay selection switch54 of the controller51.
• Subsequently, while the endoscope TV camera[0157]58 (endoscope image) is selected by thedisplay selection switch54, theobserver selection switch53 of the controller51 is turned ON. In this case, as shown by the first image display state of FIG. 7, a part of the microscope observation field O is cut, and the endoscope image M is displayed in this cut part. Then, the four-direction switch52 is in a step mode, and turned OFF to obtain a free mode. In this state, when the four-direction switch52 is selectively turned ON, the XY table28ais driven in an arbitrary direction and the position of the endoscope image M on the microscope observation field O can be moved in the desired direction.
• For example, when the[0158]X table motor70ais driven via themotor drive circuit41 by operating the four-direction switch52, thepinion gear71arotates. Here, for the X table29a, the bearing29a2 is supported by theguide shaft72afixed to the Y table29b. Therefore, therack29a1 moves in the X direction along theguide shaft72awith the rotation of thepinion gear71a. Thereby, the fixingplate27afixed onto the X table29aalso moves, and theprism14amoves in the X direction on the first intermediateimage forming point13a. As a result, the endoscope image M moves in the X direction.
• Moreover, when the Y table motor[0159]73ais driven via themotor drive circuit43 by operating the four-direction switch52, the pinion gear74arotates. For the Y table29b, the bearing29b2 is supported by theguide shaft75afixed to the X table29a. Therefore, therack29b1 moves in the Y direction along theguide shaft75awith the rotation of the pinion gear74a. Thereby, the fixingplate27afixed onto the Y table29balso moves, and theprism14amoves in the Y direction on the first intermediateimage forming point13a. As a result, the endoscope image M moves in the Y direction.
• Moreover, when the[0160]observer selection switch53 anddisplay selection switch54 of the controller51 are operated, as shown in FIG. 7, the endoscope observation image M for observing a dead angle of themicroscope101, image P of theendoscope121 observed in the microscope observation field O, and perspective direction (arrow) R of theendoscope121 by navigation can selectively be displayed in the microscope observation field O. In this case, a tomographic image or a three-dimensionally constructed image is displayed in the display screen W1 of the LCD monitors31a,31bof the secondoptical observation system1B in accordance with treatment positions displayed in the LCD monitors24a,24bof the third observationoptical system1C, or the observation position of theoperation microscope101.
• That is, three-directional images (respective tomographic image information of sagital, coronal and axial directions)[0161]140ato140cin accordance with the treatment positions, or the observation positions of theoperation microscope101, and a three-dimensionally constructed image (3D)140dprepared based on the tomographic images are displayed in the display screen W1 of the LCD monitors31a,31bof the secondoptical observation system1B. The three-dimensionally constructedimage140dis based on the detection of a microscope observation position, and is a superimposed image of a target (a set pathologically changed portion) indicating an observation point, observation direction, and pre-operation or another simulation result. Additionally, adata display area140eof a microscope observation position detection apparatus is disposed beside the display screen W1 of the LCD monitors31a,31b.
• Therefore, the microscope observation image of the operated portion by the first[0162]optical observation system1A and display images of the LCD monitors24a,24bcan simultaneously be observed through theoptical eyepiece systems22a,22bof theoperation microscope101. In this case, when the operating person looking into theoptical eyepiece systems22a,22bcasts eyes in an oblique direction, for example, in an outgoing light axis O2L direction from the LCD monitors31a,31bof the second observationoptical system1B as shown in FIG. 2, the operating person can observe the displayed screen W1 on the LCD monitors31a,31bof the secondoptical observation system1B disposed under the microscope observation field O by theoptical eyepiece systems22a,22bof theoperation microscope101 in FIG. 7. Moreover, the three-dimensionally constructedimage140dis displayed in the LCD monitors24a,24bof the thirdoptical observation system1C, and characters (3D) are displayed in the display images of the LCD monitors24a,24b.
• Moreover, the state can be changed to the second image display state of the microscope observation field O shown in FIG. 8 by operating the[0163]observer selection switch53 anddisplay selection switch54 of the controller51. Additionally, FIG. 8 shows a case in which a tumor outline shape display S constituted by a pre-operative diagnosis image obtained by thenavigation apparatus59 is selectively displayed. Here, the observed image P of theendoscope121, tumor outline shape display S by the preoperative diagnosis image by thenavigation apparatus59, and image displayed in the displayingmonitor87 of thenavigation apparatus59, that is, the oblique direction (arrow) R of theendoscope121 are superimposed/displayed in the microscope observation field O. Furthermore, the three-dimensionaltomographic images140ato140c, in accordance with the treatment position by the LCD monitors24a,24bor the observation position of the operation microscope, and the three-dimensionally constructed image (3D)140dare displayed in a part of the microscope observation field O. Moreover, the endoscope image M of theendoscope121 of that time is displayed in the display screen W1 on the LCD monitors31a,31bof the secondoptical observation system1B.
• Then, the following effect is produced in the aforementioned constitution. That is, in the[0164]operation microscope101 of the present embodiment, the firstoptical observation system1A, the additional two optical observation systems (second and thirdoptical observation systems1B and1C), and furtheroverlay display unit81 are disposed in themicroscope body104 of the binocular eyepiece lens tube. Moreover, the operating person stereoscopically observes the microscope image of the operated portion by the firstoptical observation system1A of theoperation microscope101 by looking into theoptical eyepiece systems22a,22b. Furthermore, the endoscope image M displayed in the LCD monitors24a,24bof the thirdoptical observation system1C can be displayed in a part of the microscope observation field O as shown by the first image display state of FIG. 7. In this case, the tomographic image in accordance with the treatment position displayed in the LCD monitors24a,24bof the thirdoptical observation system1C, or the observation position of theoperation microscope101, and the three-dimensionally constructed image can simultaneously be displayed in the display screen W1 of the LCD monitors31a,31bof the secondoptical observation system1B. Furthermore, the character data, and image data such as the arrow can be overlaid/displayed in the observation image of theoperation microscope101 by theoverlay display unit81 if necessary. Therefore, when the operating person manually operates theobserver selection switch53 anddisplay selection switch54 of the controller51 in accordance with operation situations in theoperation microscope101 of the present embodiment, for example, the endoscope observation image M for observing the dead angle of themicroscope101, image information of the microscope and endoscope observation positions by thenavigation apparatus59, and a plurality of pieces of image information such as the endoscope observation direction can be obtained alone or as an arbitrary combination thereof and can simultaneously be displayed. Since desired image information can be obtained in this manner, the operation can efficiently and effectively be carried out.
• As described above, two display units are provided, each comprising one LCD monitor and one image selector. One of the display units displays an image that has parallax with respect to the image displayed by the other display unit. Hence, the display units cooperate to display a three-dimensional image. Nonetheless, it may be suffices to use only one display unit. In this case, a two-dimensional image will be displayed, not a three-dimensional image.[0165]
• Moreover, FIG. 9 to FIG. 12 show a second embodiment of the present invention. The second embodiment is obtained by changing the constitution of the[0166]operation microscope101 of the first embodiment (see FIG. 1 to FIG. 8) as follows.
• That is, in the second embodiment, an image input function from the nerve monitor[0167]100 as an operation diagnosis apparatus for checking a function of a cranial nerve is added to the constitution of theoperation microscope101 of the first embodiment. Furthermore, waveform monitor means for monitoring a waveform of the nerve monitor100 is disposed, the result is used to change the display state of the nerve monitor100 in accordance with the state of the waveform monitor means, and the waveform can be displayed in the microscope observation field O.
• FIG. 9 is a block diagram for monitoring the[0168]nerve monitor100. Here, a settinginput section151 is connected to animage converter153 via acomparison calculator152. The nerve monitor100 is connected to thecomparison calculator152 andimage converter153. Furthermore, thecomparison calculator152 is connected to adisplay controller154 connected to theimage converter153.
• FIG. 10 is a flowchart of a nerve monitor display. FIG. 11 shows the first image display state of the microscope observation field O. As shown in FIG. 10, in step S[0169]1 a display state is set via the settinginput section151, and it is checked in step S2 as to whether or not an amplitude frequency per unit time decreases. If YES in the step S2, a process shifts to step S3 to display a monitored waveform in the displayingmonitor87.
• Moreover, if NO in step S[0170]3, the process advances to the next step S4. It is checked in step S4 whether a peak value is not more than a preset value. If YES in step S4, the monitored waveform is displayed in the displayingmonitor87 in the next step S5. If NO in step S4, the process returns to step S2.
• FIG. 11 shows a state in which characters “NERVE” are superimposed/displayed in the microscope observation field O of the[0171]operation microscope101, and a waveform Q of the nerve monitor100 is displayed as an electronic image in the display screen W1 of the LCD monitor31. Therefore, when the operating person looks into theoptical eyepiece systems22a,22bof theoperation microscope101 in this state, the operating person can observe the three-directionaltomographic images140ato140cin accordance with the observation position of theoperation microscope101, further the three-dimensionally constructedimage140dand the image P of theendoscope121 in the microscope observation field O. Furthermore, when the operating person looking into theoptical eyepiece systems22a,22bcasts eyes in the direction of the outgoing light axis O2L from the LCD monitors31a,31bof the secondoptical observation system1B, the operating person can observe the monitored waveform Q of the electronic image displayed in the display screen W1 of the LCD monitors31a,31b.
• Therefore, according to the[0172]operation microscope101 of the second embodiment, when the vicinity of the cranial nerve is treated, the image can easily be monitored by the nerve monitor100, and the operation can be certainty carried out.
• FIG. 12 shows the second image display state different from the state of FIG. 11. Here, the image P of the[0173]endoscope121 and the waveform Q of the nerve monitor100 can be simultaneously displayed in the microscope observation field O, and additionally the endoscope image M by theendoscope121 is displayed in the field. In this case, the three-directionaltomographic images140ato140c, and three-dimensionally constructedimage140dare simultaneously displayed in the display screen W1 of the LCD monitors31a,31bin accordance with the observation position of the operation microscope.
• Moreover, when the operating person looks into the[0174]optical eyepiece systems22a,22bof theoperation microscope101 in the state of FIG. 12, the operating person can simultaneously observe the image P of theendoscope121 and waveform Q of the nerve monitor100 in the microscope observation field O, and can additionally observe the endoscope image M in the field. Furthermore, when the operating person looking into theoptical eyepiece systems22a,22bcasts eyes in the outgoing light axis O2L direction from the LCD monitors31a,31bof the secondoptical observation system1B, the operating person can observe the three-directionaltomographic images140ato140cin accordance with the observation position of theoperation microscope101, and further, the three-dimensionally constructedimage140din the display screen W1 of the LCD monitors31a,31b.
• Therefore, also in this case, when the vicinity of the cranial nerve is treated, the image can easily be monitored by the nerve monitor[0175]100, and the operation can be certainty carried out.
• Moreover, FIG. 13 and FIG. 14 show a third embodiment. The third embodiment is constituted by adding the following function of the constitution of the[0176]operation microscope101 of the first embodiment (see FIG. 1 to FIG. 8).
• That is, the third embodiment additionally includes a function of transmitting a microscope observation image O photographed in an operating theater to a conference room outside the operating room, so that input image information can be displayed in an image display of the[0177]microscope101 in the operating theater by pen touch input in an external conference room. Thereby, an instruction can directly be given to the operating person who is carrying out the operation from an external conference room.
• In FIG. 13, numeral[0178]155 denotes an operating theater, and156 denotes a conference room. The rooms are partitioned by awall157. The microscope observation image of theoperation microscope101 photographed in theoperating theater155 is transmitted to amonitor160 via animage synthesis apparatus159 of theconference room156 from aninterface158. Thereby, as shown in FIG. 14, the microscope observation image O of theoperation microscope101 is displayed in themonitor160 of theconference room156.
• Moreover, the[0179]image synthesis apparatus159 is provided with a pentype input tool161. Moreover, when aninstruction image162 is inputted into themonitor160 by pen touch from the pentype input tool161, theinstruction image162 is displayed in the LCD monitors31a,31bof the secondoptical observation system1B in theoperation microscope101. Thereby, an operator in theconference room156 can give an instruction to the operating person in theoperating theater155.
• Therefore, in the third embodiment, when the operating person looking into the[0180]optical eyepiece systems22a,22bof theoperation microscope101 casts eyes in the outgoing light axis O2L direction from the LCD monitors31a,31bof the secondoptical observation system1B, the person can easily and precisely receive theinstruction image162 from an experienced doctor displayed in the display screen W1 of the LCD monitors31a,31band can take the necessary steps depending on the circumstances.
• FIG. 15 to FIG. 17 show a fourth embodiment. The fourth embodiment is constituted by changing the constitution of the[0181]operation microscope101 of the first embodiment (see FIG. 1 to FIG. 8) as follows.
• That is, in the fourth embodiment, as shown in FIG. 17, an operation inputting menu screen is overlaid/displayed in the microscope observation field o of the[0182]operation microscope101 of the first embodiment, and the display image can selectively be operated.
• FIG. 15 is a menu process flowchart, FIG. 16 is a menu display state into PinP, and FIG. 17 is a menu superimposed display state.[0183]
• In the fourth embodiment, during a process of overlaying/displaying the menu screen for inputting the process into the microscope observation field O of the[0184]operation microscope101, the process shown in the flowchart of FIG. 15 is performed. First, it is judged in step S1 whether or not a menu SW is turned ON by the foot switch or the like. If YES in step S1, the process advances to step S2. If NO in step S1, the process returns to a start.
• It is judged in step S[0185]2 whether or not PinP is displayed. If YES, the process advances to step S3 to judge whether or not overlay display is being displayed. If YES in step S3, the process advances to step S4 to synthesize a menu and overlay/display an operation inputting menu screen in the microscope observation field O. If NO in step S3, the process advances to step S5 to overlay/display the menu.
• If NO in step S[0186]2, the process advances to step S6 to display the menu in PinP. Subsequently, the process advances to step S7, and the controller51 is operated to move a cursor. Furthermore, after the menu display is changed by inputting the process in the next step S8, EXIT is selected in step S9 to end the process.
• Therefore, as shown in FIG. 17, characters “MENU” and a menu content are overlaid/displayed in the microscope observation field O. Additionally, the three-directional[0187]tomographic images140ato140c, corresponding to the observation position of theoperation microscope101, and the three-dimensionally constructedimage140dare displayed in the field. Furthermore, the endoscope image M from theendoscope121 is simultaneously displayed in the LCD monitors31a,31bof the secondoptical observation system1B. Therefore, when the operating person looking into theoptical eyepiece systems22a,22bof theoperation microscope101 casts eyes in the outgoing light axis O2L direction from the LCD monitors31a,31bof the secondoptical observation system1B, the person can observe the endoscope image M displayed in the display screen W1 of the LCD monitors31a,31b.
• The operating person can select the display of PinP, overlaid/displayed image, and image observation in the microscope observation field O. Therefore, the operation can be carried out, while efficiently selecting, displaying and observing the necessary image information.[0188]
• FIG. 18 to FIG. 20 show a fifth embodiment. The fifth embodiment is constituted by changing the constitution of the[0189]operation microscope101 of the first embodiment (see FIG. 1 to FIG. 8) as follows. FIG. 18 is a sectional view showing a modification example of theoverlay display unit81 shown in FIG. 3, FIG. 19 is a view showing the microscope observation field, and FIG. 20 is a block diagram of a bipolar treatment apparatus.
• That is, in the fifth embodiment, as shown in FIG. 18, a TV camera[0190]image pickup device171 is disposed on an opposite side of theLCD monitor87 via thehalf mirror85 and animage forming lens170 in themicroscope body82 of theoverlay display unit81.
• In the fifth embodiment, as shown in FIG. 19, a TV camera[0191]image pickup range172 by the TV cameraimage pickup device171 is set to be different from animage superimposing range173 in which the image is superimposed, and theimage superimposing range173 is set to be larger than the TV cameraimage pickup range172. Moreover, a VTR recording situation is confirmed/displayed, and a treatment apparatus information is displayed in aninformation display range174 which is not photographed by a TV camera.
• As the treatment apparatus, for example, a[0192]bipolar treatment tool175 for warm/hot treatment is used as shown in FIG. 20. Thebipolar treatment tool175 is connected to acontroller177 including afoot switch176. Thecontroller177 is connected to adisplay controller179 via aninterface178. Moreover,VTR180 is also connected to thedisplay controller179 via aninterface181.
• In this constitution, during image recording by the[0193]VTR180, information only required during the operation, such as characters “REC”, is displayed in theinformation display range174, and information also required after the operation, such as an output state of thebipolar treatment tool175, can be displayed in the TV cameraimage pickup range172.
• Therefore, in the fifth embodiment, when the operating person looks into the[0194]optical eyepiece systems22a,22bof theoperation microscope101, the person can confirm a recording state in the VTR, a state of the treatment apparatus, and the like in the microscope observation field O.
• FIG. 21 to FIG. 28 show a sixth embodiment. FIG. 21 is a schematic constitution diagram of the entire system of the operation microscope apparatus. In an[0195]operation microscope201, abase204 movable on a floor surface, and asupport205 vertically disposed on thebase204 form astand203. Furthermore, one end of afirst arm206 including a light source (not shown) is attached to an upper part of thesupport205 so as to be rotatable centering on an axis O1.
• Furthermore, the other end of the[0196]first arm206 is attached to one end of asecond arm207 rotatably centering on an axis O2. Thesecond arm207 is a pantograph arm constituted of a link mechanism and balance adjusting spring member, and vertically moves. The other end of thesecond arm207 is attached to one end of athird arm208 rotatably centering on an axis O3. The other end of thethird arm208 is connected to amicroscope body202. Here, thethird arm208 can support themicroscope body202 so that themicroscope body202 can move back and forth centering on an axis O4 with respect to an operating person's observation direction, and can move in an operating person's horizontal direction centering on an axis O5.
• Furthermore, rotating members (joints) in the rotation axes O[0197]1 to O5 are provided with electromagnetic brakes (not shown) in order to arbitrarily adjust and fix a spatial position of themicroscope body202. The electromagnetic brake is connected to an electromagnetic brake power source circuit (not shown) incorporated in thesupport205.
• Additionally, an[0198]LED control apparatus209 is disposed in the operating theater. TheLED control apparatus209 is connected to ameasurement apparatus210. Themeasurement apparatus210 is connected to aworkstation212 via an A/D converter211. Theworkstation212 is connected to amonitor213. Moreover, pre-operative tomographic image data prepared by image diagnosis apparatuses (not shown) such as CT and MRI, and three-dimensional data constructed again by processing the tomographic image data are recorded in theworkstation212. Furthermore, numeral214 denotes an operating person,215 denotes an assistant, and216 denotes a patient.
• [0199]Numeral217 denotes a digitizer (optical position detection apparatus) for detecting a position of the sensor arm disposed in themicroscope body202 in a three-dimensional coordinate. Thedigitizer217 is constituted as a receiving member by acamera support member219 and stand220 for fixing twoCCD cameras218a,218b, and installed in the operating theater. Moreover, a reference position sensor is disposed on thepatient216.
• FIG. 22 shows a scope holder apparatus. The apparatus is provided with an[0200]endoscope221 formed of a rigid endoscope, and ascope holder224 for holding theendoscope221. Theendoscope221 is provided with aninsertion member222 to be inserted into a body cavity. A base end of theinsertion member222 is provided with aconnection member223 connected to thescope holder224.
• Moreover, the[0201]scope holder224 is disconnectably connected to theconnection member223 of theendoscope221. Thescope holder224 is constituted by animage pickup unit225 for picking up the observation image obtained by theendoscope221, a holdingarm226 for holding theendoscope221 via theimage pickup unit225, and anattachment member227 detachably attached to a side rail of an operating bed, for example, shown in FIG. 21.
• The[0202]attachment member227 of thescope holder224 is formed by an attachment membermain body228a, and a base228bextended from the attachment membermain body228a. A hook-shapedengagement member229 to be hooked/attached to the operating bed side rail is attached to the attachment membermain body228a.
• A fixing[0203]knob230 is attached to the attachment membermain body228a. This fixingknob230 is screwed and attached to the attachment membermain body228a, and includes a screw member extending toward theengagement member229. Therefore, when theengagement member229 is hooked on the side rail and the fixingknob230 is fastened, the attachment membermain body228acan be fixed to the side rail.
• A[0204]vertical arm231 constituting the holdingarm226 is rotatably attached to the base228bof theattachment member227. Thisvertical arm231 vertically extends upward from the base228b, and can rotate centering on a first vertical axis O6 corresponding to a longitudinal direction axis.
• Moreover, an[0205]adjustment knob232 for adjusting a rotating force amount of thevertical arm231 centering on the first axis O6 is screwed and attached to the base228b. One end of afirst link arm234 constituting the holdingarm226 is rotatably attached to an upper end of thevertical arm231 via a joint233. In this case, thefirst link arm234 can rotate centering on a second axis O7 crossing at right angles to the first axis O6.
• One end of a[0206]second link arm236 is rotatably attached to the other end of thefirst link arm234 via a joint235. In this case, thesecond link arm236 can rotate centering on a third axis O8 parallel to the second axis O7, and can rotate centering on a fourth axis O9 crossing at right angles to the third axis O8. Moreover, theimage pickup unit225 can be rotatably attached to the other end of thesecond link arm236 via a joint235a. In this case, theimage pickup unit225 can rotate centering on a fifth axis O10 crossing at right angles to the fourth axis O9.
• An optical lighting system of the[0207]endoscope221 is connected to alight guide cable237 passed through thescope holder224. Thelight guide cable237 is connected to alight source apparatus238. Moreover, an optical observation system of theendoscope221 is connected to aTV cable239 passed through thescope holder224. TheTV cable239 is connected to amonitor241 via acamera control unit240.
• FIG. 23 shows a[0208]binocular lens tube251 incorporated in themicroscope body202 of theoperation microscope201. Left and right observation light paths for stereoscopic observation are constituted in thebinocular lens tube251. Moreover, an objective lens (not shown) and variable power optical system (not shown) are disposed as the left and right observation light paths in themicroscope body202.
• A right-eye[0209]optical observation system251A and a left-eye optical observation system (not shown) are disposed in thebinocular lens tube251. Additionally, FIG. 23 shows a constitution of a part of the right-eye observationoptical system251A seen from the side surface of thebinocular lens tube251. The left-eye optical observation system of thebinocular lens tube251 is constituted similarly to the right-eyeoptical observation system251A, and a description thereof is omitted.
• Moreover, a binocular lens tube[0210]optical system252 for guiding the observation image of theoperation microscope201, and an opticalimage projection system253 for observing arbitrary image information different from the observation image are disposed in the right-eyeoptical observation system251A of the present embodiment. Here, an opticalimage forming system254,image rotator255,parallelogram prism256, andoptical eyepiece system257 are disposed in the optical binocularlens tube system252. The observation image of theoperation microscope201 incident upon the optical binocularlens tube system252 is guided to theoptical eyepiece system257 via theimage rotator255 andparallelogram prism256 in order from the opticalimage forming system254.
• Furthermore, the optical[0211]image projection system253 is constituted of a fixedmember258 which is immobile with respect to eye distance adjustment of thebinocular lens tube251, and amovable member259 moving integrally with an eyepiece image surface which moves during the eye distance adjustment of thebinocular lens tube251. Here, the fixedmember258 is constituted of anLCD display260,mirror261,optical collimating system262, andprism263. Furthermore, themovable member259 is constituted of a fixedprism264, opticalimage forming system265, andmovable prism266. Themovable prism266 is disposed on the light path so that the prism can be inserted or detached by a mechanism moving motor (not shown). Moreover, the arbitrary image information displayed in theLCD display260 is guided to theoptical eyepiece system257 via themirror261,optical collimating system262,prism263, fixedprism264, opticalimage forming system265, andmovable prism266 in order.
• Furthermore, the observation image of the[0212]operation microscope201 transmitted via the binocular opticallens tube system252, and arbitrary image information transmitted via the opticalimage projection system253 can simultaneously be observed in the eyepieceoptical system257.
• Additionally, an in-field[0213]display operating switch267 is disposed in a grip (not shown) of theoperation microscope201. Thisswitch267 is connected to anoperation input circuit268 constituted by a logic circuit.
• This[0214]operation input circuit268 is connected to an in-field display controller269, and to animage selector271 as image signal selection means via adisplay image controller270. Here, the in-field display controller269 is constituted of a drive control circuit of a motor (not shown) for controlling insertion/detachment of themovable prism266 incorporated in thebinocular lens tube251, and a display control circuit of theLCD display260. Furthermore, an output signal from theswitch267 is inputted into theoperation input circuit268, and a selecting operation signal outputted from theoperation input circuit268 is inputted to the in-field display controller269 andimage selector271.
• Moreover, the[0215]image selector271 is connected to animage calculation processor272, and alarge screen LCD274 via anLCD driver273. Furthermore, a position detection display image signal outputted from theimage calculation processor272 and an image signal outputted from theLCD driver273 are inputted to theimage selector271. Additionally, the image signal selected by theimage selector271 is sent to the in-field display controller269.
• Furthermore, a second[0216]image display unit275 with a second optical observation system contained therein is disposed adjacent to theoptical eyepiece system257 in thebinocular lens tube251 of the sixth embodiment. The second optical observation system is constituted as follows. FIG. 23 shows only a left light path of the second optical observation system.Numeral276 denotes a small sized LCD monitor, controlled by a controller (not shown), for displaying the image of the endoscope or the like as the electronic image.
• Furthermore, a[0217]prism277 for reflecting the light axis O2L substantially by 90°, and a plurality ofrelay lenses278,279 are disposed on the outgoing light axis O2L from theLCD monitor276.
• Additionally, numeral[0218]280 denotes a prism for deflecting the light axis reflected by theprism277 in the direction of the observation light axis OL. A secondoptical eyepiece system281 is optically disposed/connected on the outgoing light axis O2L of theprism280. Moreover, the observation light axes OL and02L intersect each other in the vicinity of an emission pupil position. Additionally, numeral282 denotes an eyepiece housing in which the second optical observation system of the secondimage display unit275 including the secondoptical eyepiece system281 is integrally contained.
• Furthermore, as shown in FIG. 24, the[0219]image calculation processor272 is connected to anoperation switch283 disposed in theconnection member223 of theendoscope221 via aswitch detector284.
• As shown in FIG. 25, a[0220]small screen285a, as an in-field display screen, is superimposed onto a part of amicroscope observation field285 displayed in theoptical eyepiece system257 of thebinocular lens tube251. Furthermore, alarge screen287 displayed in the secondimage display unit275 is disposed in the vicinity of themicroscope observation field285. Additionally, anendoscope observation image286 is displayed in thesmall screen285aof themicroscope observation field285, and the electronic image by theLCD monitor276 is displayed in thelarge screen287.
• Moreover, the[0221]operation switch283 locks and unlocks the arm of thescope holder224, and selects the images displayed in thelarge screen287 andsmall screen285ain accordance with the state of theswitch detector284 as shown in FIG. 26A or FIG. 26B.
• Furthermore, when the[0222]operation switch283 of thescope holder224 is on (during movement), as shown in FIG. 28, the endoscope image P is displayed in themicroscope observation field285, and theendoscope observation image286 is displayed in thesmall screen285a. In this case, a state in which nothing is displayed is held in thelarge screen287. Additionally, when theoperation switch283 of thescope holder224 is off (during fixing), as shown in FIG. 27, the endoscope image P is displayed in themicroscope observation field285, and theendoscope observation image286 is displayed in thelarge screen286. In this case, the state in which nothing is displayed is held in thesmall screen285a.
• Additionally, the following effect is achieved in the aforementioned constitution. That is, in the sixth embodiment, a fixed/released state of the[0223]scope holder224 is detected by theswitch detector284, and display modes of a plurality of display images can be changed for in-field display of themicroscope observation field285 in accordance with the fixed/released state of thescope holder224. Therefore, since the in-field display screen of themicroscope observation field285 can be automatically changed in accordance with a usage state of thescope holder224 without troubling the operating person, an operating time can be shortened, and fatigue of the operating person can be reduced. When thescope holder224 moves, the endoscope image P is displayed in themicroscope observation field285, and theendoscope observation image286 is displayed in thesmall screen285a. Therefore, the operating person can simultaneously see the endoscope image and microscope observation image without moving the line of sight. In this case, nothing is displayed in thelarge screen287. Therefore, no display image of thelarge screen287 is possibly emitted into the eyes of the operating person who observes a moving state of thescope holder224 in themicroscope observation field285, and thescope holder224 can smoothly be moved.
• Furthermore, when the[0224]scope holder224 is fixed, the microscope observation image is not interrupted by thesmall screen285a, and therefore the microscope observation image can be clearly and easily observed.
• FIG. 29 to FIG. 32 show a seventh embodiment. The seventh embodiment is based on the system constitution of the operation microscope apparatus of the sixth embodiment, and is constituted by adding an image linked with navigation to the display mode. Additionally, the same constituting components as those of the sixth embodiment (see FIG. 21 to FIG. 28) are denoted by the same reference numerals, and description thereof is omitted.[0225]
• FIG. 29 is a block diagram of the control system. As shown in FIG. 29, a[0226]camera control unit288 is connected to theimage calculation controller272, and adigitizer289 andmicroscope body controller290 are connected to theimage calculation controller272 via aworkstation291.
• Moreover, in the seventh embodiment, during locking/unlocking of the arm of the[0227]scope holder224 by theoperation switch283, the image to be displayed in the large andsmall screens287 and285ais selectively changed in accordance with the state of theswitch detector284. The image is set to be selected as shown in FIG. 30A when thescope holder224 is fixed, and as shown in FIG. 30B when thescope holder224 moves.
• Moreover, in the seventh embodiment, when the[0228]operation switch283 of thescope holder224 is turned on, and the state of movement of thescope holder224 is detected by theswitch detector284, as shown in FIG. 32, the endoscope image P is displayed in themicroscope observation field285 of theoperation microscope201, and theendoscope observation image286 is displayed in thesmall screen285a. In this case, nothing is displayed in thelarge screen287. Additionally, the observation position of thescope holder224 can be displayed in thelarge screen287 during operation of the scope holder224 (FIG. 32).
• Furthermore, when the[0229]operation switch283 of thescope holder224 is off (during fixing), as shown in FIG. 31, the endoscope image P is observed in themicroscope observation field285, a pre-operative image and scope holder observation position are displayed in thesmall screen285a, and theendoscope observation image286 is displayed in thelarge screen287.
• Additionally, the following effect is achieved in the aforementioned constitution. That is, in the seventh embodiment, since the screen can automatically be changed in accordance with the usage state of the[0230]scope holder224 without troubling the operating person, the operating time can be shortened, and the fatigue of the operating person can be reduced.
• When the[0231]scope holder224 moves, as shown in FIG. 32, the endoscope image P is displayed in themicroscope observation field285 of theoperation microscope201, and theendoscope observation image286 is displayed in thesmall screen285a. Therefore, the operating person can simultaneously see the endoscope image and microscope image without moving the line of sight. In this case, nothing is displayed in thelarge screen287. Therefore, no display image of thelarge screen287 is possibly emitted into the eyes of the operating person who observes the moving state of thescope holder224 in themicroscope observation field285, and thescope holder224 can be smoothly moved.
• Furthermore, when the[0232]scope holder224 is fixed, as shown in FIG. 31, the endoscope image P is observed in themicroscope observation field285, the preoperative image and scope holder observation position are displayed in thesmall screen285a, and theendoscope observation image286 is displayed in thelarge screen287. Therefore, the preoperative image and the endoscope image can be observed at the same time without interrupting the microscope observation.
• FIG. 33 to FIG. 37 show an eighth embodiment. The eighth embodiment is constituted by adding an[0233]ultrasonic observation apparatus300 to the system constitution of the operation microscope apparatus of the sixth embodiment (see FIG. 21 to FIG. 28) and seventh embodiment (see FIG. 29 to FIG. 32). In the present constitution, an observation/non-observation state of theultrasonic observation apparatus300 is detected, and the display modes of a plurality of display images for the display in themicroscope observation field285 are changed in accordance with the detected state. Additionally, in FIG. 33 to FIG. 37, the same constituting components as those of the sixth and seventh embodiments are denoted by the same reference numerals and description thereof is omitted.
• FIG. 33 is a block diagram of an ultrasonic observation control system. The[0234]ultrasonic observation apparatus300 is connected to ultrasonic drive means303 including amotor301 andencoder302. Anultrasonic probe304 is disconnectably connected to the ultrasonic drive means303. Theultrasonic observation apparatus300 includes afoot switch305. Theultrasonic observation apparatus300 is connected to theimage calculation processor272 via adrive detector306. Moreover, the image to be displayed in in-field display means is selected and displayed based on a detection result of a drive state of theultrasonic observation apparatus300 detected by thedrive detector306.
• FIG. 34 shows a state in which the[0235]ultrasonic probe304 is inserted into a patient's operating field, and an affected portion in the operating field is observed by theultrasonic probe304.
• Moreover, during the use of the[0236]ultrasonic probe304 of the eighth embodiment, thedrive detector306 detects the drive state of theultrasonic observation apparatus300. Moreover, when thefoot switch305 is turned on and theultrasonic observation apparatus300 is driven, that is, when an ultrasonic observation state is detected by thedrive detector306, the state of the apparatus is changed as shown in FIG. 35A. That is, the preoperative image (ultrasonic observer plane image) is displayed in thesmall screen285ain themicroscope observation field285, and an ultrasonic observation image N is displayed in thelarge screen287. Furthermore, when thefoot switch305 is turned off and theultrasonic observation apparatus300 is stopped, that is, when an ultrasonic observation discontinued state is detected by thedrive detector306, the state of the apparatus is changed as shown in FIG. 35B. That is, the preoperative image (the entire head image) is displayed in thesmall screen285ain themicroscope observation field285, and the ultrasonic observation image N is displayed in thelarge screen287.
• Moreover, in the eighth embodiment, when the ultrasonic observation state is detected by the[0237]drive detector306, as shown in FIG. 37, the preoperative image (ultrasonic observer plane image) is displayed in thesmall screen285ain themicroscope observation field285, and the ultrasonic observation image N is displayed in thelarge screen287.
• Furthermore, when the ultrasonic observation discontinued state is detected by the[0238]drive detector306, as shown in FIG. 36, the preoperative image (the entire head image) is displayed in thesmall screen285ain themicroscope observation field285, and the ultrasonic observation image N is displayed in thelarge screen287. Additionally, the position of an ultrasonic probe or a tomographic image direction is displayed in the preoperative image.
• Therefore, in the eighth embodiment, since the screen displayed in the[0239]small screen285aandlarge screen287 in themicroscope observation field285 can be automatically changed in accordance with the usage state of theultrasonic probe304 without troubling the operating person during use of theultrasonic probe304, the operating time can be shortened, and the fatigue of the operating person can be reduced during use of theultrasonic probe304. Moreover, during ultrasonic observation, the microscope observation image can be compared with the ultrasonic observation image N without discontinuing the microscope observation. Furthermore, in a case other than ultrasonic observation, the position of theultrasonic probe304 is confirmed, and theultrasonic probe304 can be positioned in a position desired by the operating person.
• FIG. 38 to FIG. 43 show a ninth embodiment. The ninth embodiment is constituted by changing the system constitution of the operation microscope apparatus of the eighth embodiment (see FIG. 33 to FIG. 37) as follows. Additionally, in FIG. 38 to FIG. 43, the same constituting components as those of the eight embodiment are denoted by the same reference numerals, and description thereof is omitted.[0240]
• In the constitution of the ninth embodiment, a function of a[0241]foot switch310 is allotted to control the image source, in accordance with the image source (endoscope, ultrasonic wave, and the like) selected for the in-field display of themicroscope observation field285. That is, when a plurality of apparatuses, for example, the endoscope and ultrasonic probe are used together, the image source is changed by thefoot switch310 of the operation microscope without selecting the image source displayed in the in-field display means.
• As shown in FIG. 38, the[0242]foot switch310 of the operation microscope according to the ninth embodiment includes anXY switch311 and amode changeover switch312. Thefoot switch310 is connected to anoperation signal processor313, and theoperation signal processor313 is connected to astand controller314 andmicroscope body controller315 of the operation microscope.
• The[0243]operation signal processor313 is connected to theendoscope221 via acamera control unit316 andlight source apparatus317. Furthermore, theoperation signal processor313 is connected to theultrasonic probe304 via theultrasonic observation apparatus300 and ultrasonic drive means303.
• Moreover, the[0244]camera control unit316 is connected to animage signal processor319 via a firsttone correction circuit318. Theultrasonic observation apparatus300 is connected to theimage signal processor319 via a secondtone correction circuit320. Theimage signal processor319 is connected to theimage calculation processor272, and theoperation signal processor313.
• Furthermore, when the[0245]endoscope221 is used, the image is displayed in the in-field display means via the firsttone correction circuit318, and theimage signal processor319 detects that the endoscope image is displayed in the in-field display means.
• In this state, when the operating person turns on the[0246]mode changeover switch312 of thefoot switch310, theoperation signal processor313 changes to endoscope control from operation microscope control. Moreover, when theXY switch311 of thefoot switch310 is turned on, zoom, focus, and light source of theendoscope221 can be adjusted. This also applies to ultrasonic observation. When the operating person turns on themode changeover switch312 of thefoot switch310, theoperation signal processor313 changes to ultrasonic probe control from the operation microscope control.
• Therefore, since the observation apparatus can be operated without selecting the image source, the operating person is not troubled. Moreover, even when the[0247]endoscope221 andultrasonic probe304 are used as the observation apparatus, color reproduction is performed in accordance with the observation apparatus and in-field display means. Therefore, as it is unnecessary to change the setting for the display, the operating time can be shortened, and the operating person's fatigue can be reduced.
• FIG. 39 and FIG. 40 show the[0248]microscope observation field285. When theendoscope221 is used, as shown in FIG. 39, the endoscope image P is observed in thefield285, and the endoscope observation image M is superimposed/displayed in thesmall screen285a.
• Moreover, when the[0249]ultrasonic probe304 is used, as shown in FIG. 40, an ultrasonic probe image R is observed in thefield285, and the ultrasonic probe observation image N is displayed in thesmall screen285a.
• FIG. 41 shows the[0250]foot switch310, FIG. 42 shows a process content when the endoscope observation image M is displayed in themicroscope observation field285, and FIG. 43 shows a content when the ultrasonic probe observation image N is displayed in themicroscope observation field285.
• Here, when the endoscope observation image M is displayed in the[0251]microscope observation field285, theXY switch311 of thefoot switch310 is operated as shown in FIG. 42.
• X+: endoscope zoom-up[0252]
• X−: endoscope zoom-down[0253]
• Y+: endoscope light amount up[0254]
• Y−: endoscope light amount down[0255]
• Moreover, when the ultrasonic probe observation image N is displayed in the[0256]microscope observation field285, theXY switch311 of thefoot switch310 is operated as shown in FIG. 43.
• X+: scan start[0257]
• X−: scan stop[0258]
• Y+: display image right rotation[0259]
• Y−: display image left rotation[0260]
• FIG. 44 to FIG. 46 show a tenth embodiment. The tenth embodiment is constituted by adding the[0261]LCD driver273 for display in the large screen andLCD274 for the large screen to the system constitution of the operation microscope apparatus of the ninth embodiment (see FIG. 38 to FIG. 43) as shown in FIG. 44. Furthermore, a tone setting table321 for performing color reproduction of the large screen of the in-field display means in accordance with the small screen is added.
• In the tenth embodiment, as shown in FIG. 45, the endoscope image P is observed in the[0262]microscope observation field285, and the endoscope observation image M is superimposed/displayed in thesmall screen285aas a part of thefield285. In this case, nothing is displayed in thelarge screen287.
• Furthermore, in FIG. 46 both the endoscope image P and the ultrasonic probe image R are observed in the[0263]microscope observation field285, the endoscope observation image M is superimposed/displayed in thesmall screen285aas a part of the field, and the ultrasonic image N is displayed in thelarge screen287. In this case, color reproduction of thelarge screen287 is performed in accordance with thesmall screen285aby the tone setting table321.
• Moreover, FIG. 47 and to FIG. 48 show an eleventh embodiment. In addition to the system constitution of the operation microscope apparatus of the ninth embodiment (see FIG. 38 to FIG. 43), in the constitution of the eleventh embodiment, an identification mark is displayed in an image to which a function of the foot switch[0264]310 (see FIG. 41) is allotted. Furthermore, in the eleventh embodiment, every time themode changeover switch312 of thefoot switch310 is pressed, an endoscope operation, ultrasonic observation apparatus operation, and operation microscope operation are changed thereamong.
• Moreover, in the eleventh embodiment, as shown in FIG. 47, both the endoscope image P and the ultrasonic probe image R are observed in the[0265]microscope observation field285, the endoscope observation image M is superimposed/displayed in thesmall screen285a, and the ultrasonic image N is displayed in thelarge screen287. In this state, a mark F is displayed in a part of the endoscope observation image M to indicate that the image is controlled by thefoot switch310.
• Furthermore, in FIG. 48, both the endoscope image P and the ultrasonic probe image R are observed in the[0266]microscope observation field285, the endoscope observation image M is superimposed/displayed in thesmall screen285a, and the ultrasonic image N is displayed in thelarge screen287. Here, the mark F is displayed in a part of the ultrasonic image N of thelarge screen287 to indicate that the image is controlled by thefoot switch310.
• FIG. 49 to FIG. 52 show a twelfth embodiment. In the constitution of the twelfth embodiment, an[0267]endoscope holding hook331 for hooking and holding theendoscope221 is disposed in amicroscope body330 of the operation microscope shown in FIG. 49, it is detected whether or not theendoscope221 is held by the holdinghook331, and the operation microscope and in-field display apparatus are controlled. Here, a holdingswitch332 is disposed in a fixed portion of theendoscope holding hook331. Moreover, when theendoscope221 is hooked and held onto thehook331 of themicroscope body330, the holdingswitch332 is turned on.
• Moreover, FIG. 50 is a block diagram of the control system of the operation microscope. Here, the holding[0268]switch332 is connected to thestand controller314 andmicroscope body controller315 via asignal transmitter333. Thestand controller314 is connected to respectiveelectromagnetic brakes334 disposed in arm joints. Themicroscope body controller315 is connected to a variable poweroptical system driver335 of a variable poweroptical system336. Furthermore, thesignal transmitter333 is connected to thecamera control unit316 andlight source apparatus317, and to theimage calculation processor272 via anoperation input circuit337.
• Furthermore, when the operating person removes the[0269]endoscope221 from thehook331, the holdingswitch332 is turned on, and a signal flows to thestand controller314 via thesignal transmitter333. Thereby, the respectiveelectromagnetic brakes334 operate to lock the respective arms. Additionally, the variable poweroptical system driver335 operates via themicroscope body controller315 so that a magnification of the variable poweroptical system336 is minimized. Thelight source apparatus317 andcamera control unit316 of theendoscope221 are started up to obtain a state in which endoscope observation is possible.
• Therefore, when the[0270]endoscope221 is unused, that is, when theendoscope221 is held by thehook331, and even when the operation microscope stand is moved, theendoscope221 is prevented from contacting or breaking the operation microscope. Moreover, since theendoscope221 can be set without troubling the operating person, the operating person's fatigue can be reduced, and the operating time can also be shortened.
• Additionally, FIG. 51 shows the[0271]microscope observation field285 of a state in which theendoscope221 is caught by thehook331, theendoscope221 is unused and the variable poweroptical system336 has a maximum magnification. Moreover, FIG. 52 shows themicroscope observation field285 of a state in which theendoscope221 is used and the variable poweroptical system336 has a minimum magnification. Here, the endoscope image P is displayed in themicroscope observation field285, and the endoscope observation image M is superimposed/displayed in thesmall screen285a.
• Moreover, FIG. 53A to FIG. 60 show a thirteenth embodiment of the present invention. In the thirteenth embodiment, a[0272]rigid endoscope434 used together with anoperation microscope401 as shown in FIG. 54 is constituted as shown in FIG. 53A. Atip end slope439 obliquely intersecting an insertion axis (center line) O1 of aninsertion member435 is formed in a tip end of theinsertion member435 of therigid endoscope434. Here, an intersection angle between acenter line02 of thetip end slope439 and the insertion axis O1 of theinsertion member435 is set to a constant angle α.
• Furthermore, an[0273]objective lens441, alighting lens442, and two projection windows (projection means)443,444 are disposed in thetip end slope439. Thereby, the observation light axis O2 of theobjective lens441 is set to intersect the insertion axis O1 of theinsertion member435 at the constant intersection angle α.
• Moreover, a relay lens (not shown) is disposed in the[0274]insertion member435. Furthermore, theobjective lens441, relay lens, andeyepiece member437 are optically connected to one another.
• Furthermore, a tip end of a light guide cable (not shown) is disposed opposite to a lens surface inside the[0275]lighting lens442. A base end of the light guide cable is connected to alight guide base438 disposed at a base end of theinsertion member435 as shown in FIG. 54.
• One end of a[0276]light guide445 is connected to thelight guide base438. The other end of thelight guide445 is connected to a light source apparatus (not shown). Moreover, a lighting light emitted from the light source apparatus is guided to the light guide cable of thelight guide base438 from thelight guide445, and an operative portion P is irradiated with the lighting light guided by the light guide cable from thelighting lens442.
• Moreover, a[0277]TV camera447 for photographing the observation image of therigid endoscope434 is connected to theeyepiece member437 of therigid endoscope434. One end of acamera cable448 is connected to theTV camera447. The other end of thecamera cable448 is connected to an input end of a camera control unit (CCU)449 (shown in FIG. 53B) for converting an electric signal of the observation image photographed by therigid endoscope434 to an image signal.
• One[0278]projection window443 of twoprojection windows443,444 of thetip end slope439 in theinsertion member435 of therigid endoscope434 is disposed on a base end of thetip end slope439, and theother projection window444 is disposed on a tip end of thetip end slope439.
• Furthermore, one end of a[0279]light guide cable451 for guiding an irradiation light for an index to twoprojection windows443,444 is connected into theinsertion member435. The other end of thelight guide cable451 is disposed in a part which is opposite to areflective mirror452 from an axial direction of theinsertion member435.
• Additionally, in the[0280]light guide base438, animage forming lens453 is disposed in a part opposite to thereflective mirror452 from a direction crossing at right angles to an axial direction of theinsertion member435. Furthermore, two laser diodes (light emission means)454 as a light source for guiding the indexing irradiation light to theprojection windows443,444 are disposed in the light source apparatus. Additionally, the indexing irradiation light emitted from twolaser diodes454 in the light source apparatus is guided to theimage forming lens453 of thelight guide base438 via thelight guide445. Furthermore, light guide means455 for guiding the respective indexing irradiation lights to twoprojection windows443,444 via thereflective mirror452 andlight guide cable451 is constituted. Since respective constitutions of the light guide means455 for guiding the indexing irradiation light to twoprojection windows443,444 are the same, only theprojection window444 side light guide means455 is shown in FIG. 53A.
• Here, laser diodes having different wavelengths are used in two[0281]laser diodes454 in the light source apparatus. Thereby, the indexing irradiation lights having different colors are guided to therespective projection windows443,444, theprojection windows443,444 emit the indexing irradiation lights having different colors, and emission indexes459a,459bare projected as shown in FIG. 55.
• Moreover, a laser[0282]diode operation circuit456 is connected to thelaser diode454. The laserdiode operation circuit456 is connected to a laserdiode lighting switch457. Furthermore, when twolaser diodes454 in the light source apparatus are turned on, the irradiation light as the index is guided in parallel with the observation light axis O2 of theobjective lens441 from twoprojection windows443,444 of thetip end slope439 in theinsertion member435 of therigid endoscope434, and the emission indexes459a,459bare projected to the operative portion P.
• Furthermore, in the thirteenth embodiment, a[0283]scale generation apparatus461 is disposed for generating scales S1, S2 having appropriate lengths, and characters indicating the lengths with respect to a field diameter of the microscope field in an observation image K1 of theoperation microscope401 displayed in a field of an eyepiece lens410 of aneyepiece lens tube433 of theoperation microscope401, and an observation image E1 (in-field display image) of therigid endoscope434 displayed in a sub-screen N inserted into the microscope observation image K1 as shown in FIG. 59.
• In the[0284]scale generation apparatus461, a control circuit is connected to theCCu449 of theoperation microscope401 as shown in FIG. 53B. Changeover means462 connected to theCCU449 is disposed in the control circuit. The changeover means462 is connected to the laserdiode operation circuit456,first memory463, andsecond memory464. Here, the changeover means462 has a function of detecting an operation state of the laserdiode operation circuit456, and changing an outputting memory to either thefirst memory463 or thesecond memory464, and a function of transmitting the image signal.
• Furthermore, a[0285]subtraction circuit465 for subtracting information of the first andsecond memories463 and464 is connected to thefirst memory463 andsecond memory464. Thesubtraction circuit465 is connected to aworkstation466.
• The[0286]workstation466 is connected to: amixer467 for synthesizing the image signal; animage calculation processor432; amicroscope body controller468 for detecting focus and magnification information of amicroscope body402 of theoperation microscope401 and transmitting the detected information to theworkstation466; and aswitch469 for turning off the scale display displayed in the field of theoperation microscope401. Moreover, amonitor470 is connected to theCCU449 via themixer467.
• Operation of the thirteenth embodiment constituted as described above will next be described. In the thirteenth embodiment the[0287]operation microscope401 andrigid endoscope434 are used together as shown in FIG. 54. Moreover, therigid endoscope434 is inserted into the operative portion P, and a tip end of therigid endoscope434 is brought to the operative portion P in a desired position.
• In this case, the observation image of the operative portion P observed by the[0288]rigid endoscope434 is guided to theeyepiece member437 via theobjective lens441 and relay lens, formed on the image pickup device in theTV camera447, and converted to an electric signal. This electric signal is transmitted to theCCU449 via thecamera cable448, and converted to an image signal by theCCU449. Moreover, an output signal from theCCU449 is transmitted to themonitor470 via themixer467, and the observation image of therigid endoscope434 photographed by theTV camera447 is displayed in themonitor470. In this case, the light emitted from theprojection windows443,444 of thetip end slope439 of theinsertion member435 of therigid endoscope434 is projected to a wall surface A of the operative portion P. Moreover, an operatingperson458 who looks into the eyepiece lens410 of theeyepiece lens tube433 of theoperation microscope401 observes an image in accordance with an insertion position of therigid endoscope434 inserted in the operative portion P.
• Moreover, when the operating[0289]person458 wants to know the length of therigid endoscope434 in the field, and the length of theoperation microscope401 in the microscope field, the following operation is performed. First, when thelaser diode454 is not on, thelaser diode454 is lit. In this case, when the laserdiode lighting switch457 is turned on, the output signal from the laserdiode operation circuit456 is inputted to the changeover means462. Thereby, the changeover means462 detects that the laserdiode operation circuit456 is in an operation state, and information outputted from the changeover means462 is stored in thefirst memory463.
• In this case, image information M[0290]0 (observation image of therigid endoscope434 photographed by the TV camera447) in which emission indexes459a2,459b2 are displayed in an observation image E1 of therigid endoscope434 as shown in FIG. 55 is transmitted to theCCU449. Subsequently, the image information M0 of FIG. 55 is inputted to thefirst memory463 via the changeover means462. Thereby, screen information for one screen displayed in themonitor470 is recorded as a unit in thefirst memory463.
• Subsequently, the[0291]laser diode454 is turned off by the laserdiode lighting switch457. During the off operation of the laserdiode lighting switch457, the operation of the laserdiode operation circuit456 is stopped. Moreover, when the changeover means462 detects that the laserdiode operation circuit456 is not operating, an output of the changeover means462 is switched to asecond memory464 side.
• In this case, image information M[0292]1 in which the emission indexes459a2,459b2 are not displayed in the observation image E1 of therigid endoscope434 as shown in FIG. 56 is transmitted to theCCU449. Subsequently, the image information M1 of FIG. 56 is inputted to thesecond memory464 via the changeover means462. Thereby, the screen information for one screen displayed in themonitor470 is recorded as the unit in thesecond memory464, similar to thefirst memory463.
• Moreover, when the image information M[0293]1 for a first screen is stored in thesecond memory464, the information is transmitted to thesubtraction circuit465. Thesubtraction circuit465, having received the information, takes the image information M0 for the last screen stored in thefirst memory463. Therefore, the image information M0 of the operative portion P during LD lighting and the image information M1 during LD non-lighting are inputted to thesubtraction circuit465.
• Subsequently, the[0294]subtraction circuit465 performs subtraction processing of the image information M1 and M0. Therefore, image information M2 only of the emission indexes459a2,459b2 can be obtained because of a difference between lighting and non-lighting of theLD454 on the output side of thesubtraction circuit465. The image information M2 is transmitted to theworkstation466 from thesubtraction circuit465.
• Furthermore, field size data of the[0295]rigid endoscope434 by a lighting position of theLD454 is recorded beforehand in theworkstation466. Subsequently, when the image information M2 from thesubtraction circuit465 is inputted to theworkstation466, a field size of therigid endoscope434 is calculated in accordance with the emission indexes459a2,459b2 of the image information M2.
• Subsequently, a character indicating the shorter scale S[0296]2 is prepared from the calculated field diameter in theworkstation466. The character of the scale S2 is transmitted to theimage calculation processor432 andmixer467. In this case, themixer467 synthesizes the output signals from theCCU449 andworkstation466. Then, the synthesized image signal is transmitted to themonitor470 from themixer467. Thereby, as shown in FIG. 58, an image in which the emission indexes459a2,459b2 and the character of the scale S2 are superposed/displayed in the same screen is displayed in the observation image E1 of therigid endoscope434.
• Moreover, the[0297]microscope body controller468 transmits the magnification and focus information of themicroscope body402 of theoperation microscope401 to theworkstation466. Furthermore, theworkstation466 calculates the field diameter of the observation image K1 of theoperation microscope401 based on the output signal of themicroscope body controller468.
• Furthermore, the[0298]workstation466 generates the scale S1 having an appropriate length and the character indicating the length with respect to the calculated field diameter of the observation image K1 of theoperation microscope401. Here, the generated scale S1 and character are transmitted as the image signal to theimage calculation processor432. As shown in FIG. 59, images (microscope observation image, and infield display image) are obtained in which the scales S1, S2 having appropriate lengths, and characters indicating the lengths with respect to the field diameter of the microscope field are displayed in the observation image K1 of theoperation microscope401 displayed in the field of the eyepiece lens410 of aneyepiece lens tube433 of theoperation microscope401, and the observation image E1 of therigid endoscope434 displayed in the sub-screen N inserted into the microscope observation image K1. Therefore, the operating person can recognize the field size of the observation image K1 of theoperation microscope401 and the field size of the observation image E1 of therigid endoscope434 by observing the microscope observation image and in-field display image of FIG. 59. The operating person can move therigid endoscope434 or obtain size information of the operative portion P based on the recognized sizes.
• Moreover, when the[0299]switch469 is pressed, theworkstation466 does not transmit the image observation image of the scales S1, S2 and characters indicating the scale lengths to theimage calculation processor432. As shown in FIG. 60, the usual observation image K1 of theoperation microscope401, and the in-field display image of the observation image E1 of therigid endoscope434 displayed in the sub-screen N inserted into the microscope observation image K1 are displayed.
• Therefore, the following effect is achieved in the aforementioned constitution. That is, in the thirteenth embodiment, there is provided the[0300]scale generation apparatus461 for generating the scales S1, S2 having appropriate lengths, and characters indicating the lengths with respect to the field diameter of the microscope field in the observation image K1 of theoperation microscope401 displayed in the field of the eyepiece lens410 of theeyepiece lens tube433 of theoperation microscope401, and the observation image E1 of therigid endoscope434 displayed in the sub-screen N inserted into the microscope observation image K1 as shown in FIG. 59. Therefore, correlation between the field diameter of the observation image K1 of theoperation microscope401 and the field diameter of the in-field display by the observation image E1 of therigid endoscope434 can be obtained.
• Consequently, the operating[0301]person458 gazes at the field of the observation image K1 of theoperation microscope401 displayed in the field of the eyepiece lens410 of theeyepiece lens tube433 of theoperation microscope401, and thereafter observes the observation image E1 of therigid endoscope434 as the in-field display image displayed in the sub-screen N. Even in this case, the operating person can easily grasp the size of the operative portion P in the display image, select the appropriaterigid endoscope434 in accordance with the field, and objectively grasp a movement amount of therigid endoscope434 during observation.
• Moreover, the size of the affected part of the operative portion P can be accurately known by visually confirming the character of the scale S[0302]2 in the observation image E1 of therigid endoscope434, and the character of the scale S1 in the observation image K1 of theoperation microscope401. Therefore, information such as the patient's condition and worsening degree can be brought to the attention of the operatingperson458. Therefore, the operating time is further shortened, and burdens on the operating person and patient are effectively reduced.
• Furthermore, FIG. 61 to FIG. 66 show a fourteenth embodiment of the present invention. In the system of the[0303]operation microscope401 of the fourteenth embodiment, as shown in FIG. 61, a digitizer (observation position detection means)481 for detecting the position of themicroscope body402 is disposed. Moreover, anemission index482 by which thedigitizer481 detects a three-dimensional coordinate of themicroscope body402 is attached to themicroscope body402. Here, as shown in FIG. 61, thedigitizer481 is disposed on a base side of a bed403 (e.g., feet side of apatient404 on the bed403) in the operating theater.
• This[0304]digitizer481 is constituted of twoCCD cameras483a,483bas receiving members, acamera support member484 for fixing positions of therespective CCD cameras483a,483b, and astand485. Moreover, therespective CCD cameras483a,483bare connected to a workstation (character preparation means)486 via a measurement apparatus (not shown) and A/D converter. Preoperative tomographic image data from an image diagnosis apparatus (not shown) such as CT or MRI, and data (preoperative diagnosis image) three-dimensionally re-constructed by processing the tomographic image data are stored in a storage section incorporated in theworkstation486.
• Moreover, as shown in FIG. 62, the fourteenth embodiment incoporates an in-field[0305]image insertion apparatuses487a,487bfor inserting the image into the field of theoperation microscope401. Theapparatuses487aand487bare identical in structure. In the in-field image insertion apparatus487a, as shown in FIG. 62, ahalf mirror488ais disposed between animage forming lens409aand a variable poweroptical system408ain the microscope body402a. Furthermore, an LCD (character display means)489afor displaying the image signal, and alens490afor leading the image to thehalf mirror488aare disposed. Additionally, left and right opposite-eyeoptical observation systems407A and407B are similarly constituted (see FIG. 62).
• Furthermore, as shown in FIG. 63, the[0306]LCDs489a,498bare connected to theworkstation486 via anLCD drivers491a,491bfor driving theLCDs489a,489b. Theworkstation486 is connected to a microscope body controller (observation position detection means)492 for detecting magnification and focus information of themicroscope body402, a foot switch (not shown) to which anLCD display switch493 for turning ON/OFF image signal display in theLCDs489a,489bare attached, and theimage calculation processor432. Here, themicroscope body controller492 is disposed in themicroscope body402. Additionally, as shown in FIG. 62, afocus knob495 is disposed in themicroscope body402.
• Operation of the fourteenth embodiment constituted as described above will next be described. In the fourteenth embodiment, when the[0307]operation microscope401 is used, the operatingperson458 moves themicroscope body402, adjusts the focus and magnification of the left and right opposite-eyeoptical observation systems407A,407B, and observes the operative portion P.
• Moreover, when an[0308]operating person458 turns on a foot switch427 during observation by theoperation microscope401, in-field display of theoperation microscope401 starts. At the start of the in-field display, an image selector (not shown) selects a preoperative image corresponding to a focus position of themicroscope body402 from theworkstation486. Thereby, the in-fieldimage insertion apparatus487 displays a preoperative image R1 corresponding to the focus position of themicroscope body402 of theoperation microscope401 in the sub-screen N in the observation image K1 of theoperation microscope401 displayed in the field of the eyepiece lens410 of theoperation microscope401 as shown in FIG. 64.
• Furthermore, the magnification and focus information of the left and right opposite-eye[0309]optical observation systems407A,407B detected by themicroscope body controller492, and position information of themicroscope body402 detected by thedigitizer481 are transmitted to theworkstation486 during observation by theoperation microscope401. A substantiallyconical character496 is generated based on the information as shown in FIG. 65. Additionally, upper and lower ends of thecharacter496 indicate a focus depth range.
• In the[0310]character496, a focusposition display ring497 indicating the focus position of the left and right opposite-eyeoptical observation systems407A,407B is displayed in the entire outer peripheral surface of a cone. Furthermore,graduations498 are displayed at constant intervals on front and back parts of the focusposition display ring497.
• Subsequently, when the operating[0311]person458 turns on theLCD display switch493 of the foot switch to start the display of theLCDs489a,489b, theworkstation486 sends operation signals for starting the operation of theLCD drivers491a,491band the image signal of the generatedcharacter496 to theLCDs driver491a,491b.
• In this case, the[0312]LCDs driver491a,491btransmits the operation signal to theLCDs489a,489b, starts the operation of theLCDS489a,489b, and transmits the image signals of thecharacter496 to theLCDs489a,489b. Thereby, thecharacter496 is displayed in theLCDs489a,489b.
• Furthermore, the[0313]character496 displayed in theLCDs489a,489bis reflected by the half mirrors488a,488bvia thelenses490a,490b, and transmitted to theeyepiece lenses410a,410bside through theimage forming lenses409a,409b. Thereby, as shown in FIG. 66, thecharacter496 is superposed onto the observation image K1 of theoperation microscope401 displayed in the field of theeyepiece lenses410a,410b, and reaches the eyes of the operatingperson458. Additionally, in FIG. 66, part X of thecharacter496 contacts an operative surface, and the focusposition display ring497 is disposed above the operative surface.
• In this case, the operating[0314]person458 confirms the position of thecharacter496, and moves the position of the focusposition display ring497 downward. Moreover, the operatingperson458 confirms a deviation of the preoperative image by a navigation technique displayed in the in-field display screen from the operative surface. Additionally, even when the operative surface is above the focusposition display ring497, the same applies.
• Moreover, when the operating[0315]person458 changes an observation field, and adjusts the magnification and focus, themicroscope body controller492 transmits the changed position, magnification and focus information to theworkstation486. Theconical character496 including the focusposition display ring497 of the left and right opposite-eyeoptical observation systems407A,407B andgraduations498 on the front and back parts of the ring is newly generated based on the new information. Thereafter, thecharacter496 is superposed and displayed in the observation image K1 of theoperation microscope401 displayed in the field of theeyepiece lenses410a,410bas described above.
• Moreover, when the display of the[0316]character496 is unnecessary, theLCD display switch493 is pressed. Then, theworkstation486 emits the operation signal for ending the operation of theLCD drivers491a,491b, and theLCD drivers491a,491bhaving received the signal ends the display operation of theLCDs489a,489b. Thereby, the operation of theLCD drivers491a,491bends.
• In this case, the following effect is achieved in the aforementioned constitution. That is, in the fourteenth embodiment, the operating[0317]person458 checks a deviation size of the focusposition display ring497 of thecharacter496 displayed in the observation image K1 of theoperation microscope401 displayed in the field of theeyepiece lenses410a,410bfrom thegraduations498 by which thecharacter496 seems to overlap the operative surface. Thereby, a deviation amount between the focus position of the left and right opposite-eyesoptical observation systems407A,407B and the operative surface can be confirmed. Therefore, focus can easily be adjusted to an object surface without depending on an eye adjustment function of the operatingperson458, and the focus position can effectively be adjusted.
• The process of moving the[0318]microscope body402, changing the magnification of the left and right opposite-eyeoptical observation systems407A,407B and adjusting the focus many times is troublesome for theoperating person458. Therefore, when the operative surface is in the focus depth of the left and right opposite-eyeoptical observation systems407A,407B, the operation is supposedly continued. In this case, since the preoperative image of the navigation technique deviates from the operative surface, the deviation can effectively be confirmed by visually observing thecharacter496.
• The[0319]character496 may be composed of two images that have parallax to each other. If so, the LDC monitors489aand489bwill cooperate to display a three-dimensional image.
• FIG. 67A to FIG. 72 show a fifteenth embodiment of the present invention. The fifteenth embodiment is constituted by changing the system constitution of the[0320]operation microscope401 of the fourteenth embodiment (see FIG. 61 to FIG. 66) as follows.
• That is, in the system of the[0321]operation microscope401 according to the fifteenth embodiment, arigid endoscope501 shown in FIG. 67A is used together. Additionally, a peripheral constitution of theoperation microscope401 is substantially similar to that of FIG. 61. Additionally, in the constitution of thedigitizer481, theemission index482 attached to themicroscope body402 of theoperation microscope401, and threeemission indexes502ato502cattached to therigid endoscope501 can be distinguished and detected as shown in FIG. 67B.
• Moreover, the[0322]rigid endoscope501 includes a thin longitudinal straighttubular insertion member503 to be inserted into a body cavity as shown in FIG. 67A. Agrip member504 andlight guide base505 are disposed on a base end of theinsertion member503.
• Furthermore, as shown in FIG. 67B, three[0323]emission indexes502a,502b,502care disposed on the upper surface of thegrip member504 of therigid endoscope501. Furthermore, one end of alight guide506 is connected to the lightguide base member505. The other end of thelight guide506 is connected to a light source apparatus507.
• Moreover, as shown in FIG. 68, an[0324]objective lens508 is disposed in the tip end of theinsertion member503 inside therigid endoscope501. Furthermore, arelay lens509 is disposed inside theinsertion member503.
• Furthermore, in the[0325]grip member504, aprism510 is disposed opposite to therelay lens509 on a connection member side with theinsertion member503, and a pair of left andright CCDs511a,511bare disposed in the other end of the grip member. Additionally, areflective mirror512aand image forming lens513aare successively disposed between theprism510 and theleft CCD511a, and areflective mirror512bandimage forming lens513bare also successively disposed between theprism510 and theright CCD511b. Here, the left and rightreflective mirrors512a,512bare disposed on opposite sides of theprism510.
• Additionally, the observation image incident from the[0326]objective lens508 on the tip end of theinsertion member503 is transmitted toward thegrip member504 through therelay lens509. The transmitted observation image is reflected and branched to two light paths by theprism510. One light reflected by theprism510 is formed into the image by theCCD511avia the image forming lens513afrom thereflective mirror512a, and the other light reflected by theprism510 is formed into the image by the CCD51bvia theimage forming lens513bfrom thereflective mirror512b. Moreover, the observation images observed via therigid endoscope501 are converted and outputted as the electric signals via theseCCDs511a,511b.
• Moreover, one end of a[0327]cable514 is connected to thegrip member504. The other end of thecable514 is connected to a camera control unit (CCU)515. Output signals from theCCDs511a,511bare transmitted to theCCU515 via thecable514.
• Furthermore, as shown in FIG. 69, one input end of a left mixer[0328]516afor superposing the image signal, and one input end of aright mixer516bare connected to theCCU515. Each of the left andright mixers516aand516bis provided with two input ends and one output end. Additionally, theworkstation486 is connected to the other input end of the left mixer516aand the other input end of theright mixer516b.
• Moreover, the output ends of the left and[0329]right mixers516aand516bare connected to input ends of a3D converter518 for calculating/processing a flat image signal and preparing a three-dimensional image. Output ends of the3D converter518 are connected to a3D monitor519 for displaying the three-dimensional image and animage calculation processor520.
• Furthermore, the[0330]digitizer481 for specifying the position of therigid endoscope501 is connected to theworkstation486. Additionally, acharacter display switch521, themicroscope body controller492 for detecting the magnification and focus information of themicroscope body402 of theoperation microscope401, and amonitor522 are connected to theworkstation486.
• Operation of the fifteenth embodiment constituted as described above will next be described. In the fifteenth embodiment, when the[0331]operation microscope401 andrigid endoscope501 are used together as shown in FIG. 70, the operatingperson458 moves themicroscope body402 of theoperation microscope401 to a desired position, sets the microscope body in the observation position of the operative portion P, and fixes therigid endoscope501 in a position desired by the operating person.
• In this case, the observation image by the[0332]rigid endoscope501 is passed through therelay lens509 from the tip-end objective lens508, and divided into two light paths by theprism510. Moreover, some of the light reflected by theprism510 is formed into the image by theCCD511avia the image forming lens513afrom thereflective mirror512a, and some of the light reflected by theprism510 is formed into the image by theCCD511bvia theimage forming lens513bfrom thereflective mirror512b. Furthermore, the observation image formed on theCCDs511a,511bis converted into an electric signal.
• Moreover, the electric signals outputted from the[0333]CCDs511a,511bare inputted to theCCU515, and the image signals outputted from twoCCDs511a,511bare separated from each other. Furthermore, the two image signals are separately inputted to the left andright mixers516aand516b, three-dimensionally converted by the3D converter518 to form stereoscopic endoscope observation images, and inputted to theimage calculation processor520 and3D monitor519, so that the endoscope image can be observed.
• Furthermore, when the operating person presses an in-field display operation switch (not shown), disposed on the foot switch, for starting in-field display, the image selector selects the endoscope observation image inputted from the[0334]3D converter518 via theimage calculation processor520. As shown in FIG. 71, the sub-screen N is inserted into the microscope field (observation image K1 of the operation microscope401), and the observation image E1 of therigid endoscope501 is displayed in the sub-screen N.
• Furthermore, when the[0335]rigid endoscope501 is used, thedigitizer481 detects theemission indexes502a,502b,502cof therigid endoscope501, and a position detection signal is transmitted to theworkstation486. Here, theworkstation486 performs a calculation processing based on the position detection signal, and defines the position of therigid endoscope501.
• Additionally, the magnification and focus information from the[0336]microscope body controller492, and the position information of themicroscope body402 from thedigitizer481 are transmitted to theworkstation486. Theworkstation486 calculates the observation position of themicroscope401 based on the information. Furthermore, theworkstation486 selects the preoperative image corresponding to the calculated observation position of themicroscope401, and themonitor522 displays the preoperative image.
• Moreover, when the operating[0337]person458 presses thecharacter display switch521, theworkstation486 generates thecharacter496 indicating the focus of the left and rightoptical observation systems407A,407B of themicroscope401 and the length scale of themicroscope401 before and after focus with respect to the direction of the observation light axis O based on the calculated observation position of themicroscope401.
• Furthermore, in the[0338]workstation486, arithmetic operation is performed so that the focus position of the left and rightoptical observation systems407A,407B of themicroscope401 can be displayed in the observation field of therigid endoscope501. The image signal provided with horizontal parallax is constructed in order to display thecharacter496 in the position.
• The image signal provided with the horizontal parallax is inputted to the left and[0339]right mixers516a,516b, and superimposed onto the observation image E1 of therigid endoscope501. Here, the superimposed left and right signals are further superimposed by the3D converter518, and the superimposed image signal is transmitted to theimage calculation processor520 and displayed in the3D monitor519 as shown in FIG. 72. Thereby, thecharacter496 indicating the focus position of the respectiveoptical observation systems407A,407B of themicroscope401 is displayed in the field of therigid endoscope501 used together with theoperation microscope401.
• Then, an effect similar to that of the fourteenth embodiment is obtained in the aforementioned constitution. Additionally, in the fifteenth embodiment, the[0340]character496 indicating the focus position of the left and rightoptical observation systems407A,407B of themicroscope401 is displayed in the field of therigid endoscope501 used together with theoperation microscope401. Therefore, while the operatingperson458 observes the observation image of therigid endoscope501, the person can effectively confirm the position of the image selected by the navigation technique in the observation image of therigid endoscope501.
• Moreover, FIG. 73 to FIG. 78 show a sixteenth embodiment. FIG. 73 is a perspective view of a[0341]microscope body604 of anoperation microscope601, and FIG. 74 is a constitution diagram of the entire system of the operation microscope apparatus. As shown in FIG. 74, the operation microscope apparatus includes theoperation microscope601 provided with a solid microscope.
• The[0342]operation microscope601 includes astand602, abalance arm603 disposed on an upper part of thestand602, and themicroscope body604 supported by thebalance arm603. Here, thebalance arm603 includes a plurality of movable arms, and sixrotation axes605ato605f. Furthermore, the respective rotation axes605ato605fare provided with electromagnetic locks (not shown) for switching a locked state in which the rotation positions of the respective rotation arms of thebalance arm603 are fixed and an unlocked state in which the locked rotation positions are released. Moreover, themicroscope body604 is supported in such a manner that themicroscope body604 can move in the spatial position centering on the respective sixrotation axes605ato605fof the respective rotation arms of thebalance arm603 with the switching operation for locking/unlocking the electromagnetic locks.
• Moreover, as shown in FIG. 74, the[0343]microscope body604 includes acenter arm606 and agrip607 for controlling the position of themicroscope body604. Thegrip607 is provided with respective operation switches for focus adjustment, variable power operation, and arm operation.
• Furthermore, the[0344]operation microscope601 incorporates a microscope body controller611 andarm controller612. The respective switches of thegrip607 are connected to the microscope body controller611 andarm controller612. Additionally, the microscope body controller611 andarm controller612 are connected to afoot switch613 including respective switches for focus adjustment and variable power operation similarly as the respective switches of thegrip607.
• Moreover, the microscope body controller[0345]611 andarm controller612 are connected to anavigation apparatus615 via aninterface unit614. Amonitor616 for navigation is disposed on thenavigation apparatus615.
• The[0346]navigation apparatus615 is connected to adigitizer617. Furthermore, the image information from thedigitizer617 is inputted to thenavigation apparatus615, and thenavigation apparatus615 calculates a correlation with a reference index attached to a patient's head.
• As shown in FIG. 73, an[0347]eyepiece lens tube608 and aprobe holder609 are disposed in themicroscope body604. In theeyepiece lens tube608, an in-field image displaying monitor and optical projection system for displaying the image in the microscope observation field are disposed (FIG. 75 shows asmall screen display631aof a left eye monitor). Moreover, a monitor and an optical overlay system for overlaying/displaying the image information in the microscope optical observation image are disposed. Furthermore, a microscope observation field monitor and a second image observing optical eyepiece system different from the microscope optical eyepiece system are disposed.
• Furthermore, an[0348]ultrasonic probe620 is disposed in theprobe holder609. Theultrasonic probe620 is constituted of astraight pipe621, anultrasonic transmitting cap622 disposed on a tip end of thestraight pipe621, and ahandle member623 disposed on a base end of thestraight pipe621. Asensor arm623ais disposed in thehandle member623.
• Moreover, the[0349]ultrasonic probe620 is connected to anultrasonic observation apparatus625 shown in FIG. 75 via aflexible tube624. Additionally, the operating person can hold thehandle member623 and insert a part of theultrasonic transmitting cap622 of theultrasonic probe620 into anoperative portion610.
• FIG. 75 is a control block diagram of the[0350]operation microscope601. In anoperation input section639, a four-direction switch640, adisplay switch641 andfirst display642, and aselection switch643 andsecond display644 are disposed. Theoperation input section639 is connected to aselector637 via adisplay controller638. Thenavigation apparatus615 andultrasonic observation apparatus625 are connected to theselector637.
• Here, a left-side (left-eye) eyepiece section in the[0351]eyepiece lens tube608 of themicroscope body604 is displayed/constituted. A right-side (right-eye) eyepiece section is also disposed, but description thereof is omitted.
• [0352]Numeral630aof FIG. 75 denotes a left-eye microscope observation field. Theselector637 is connected to a firstdisplay drive controller634afor driving thesmall screen display631aas a left-eye field image display, a seconddisplay drive controller635afor driving an overlay display632afor an image superimposing display and a third display drive controller636afor driving alarge screen display633afor another image observation.
• Operation of the sixteenth embodiment constituted as described above will next be described. FIG. 76 shows a normal ultrasonic observation state of the[0353]ultrasonic probe620. During ultrasonic observation, theultrasonic probe620 is inserted into theoperative portion610, and an ultrasonic wave is radiated to all peripheries by 360 degrees via the tip-endultrasonic transmitting cap622. In this case, the ultrasonic wave reflected by atumor portion610aof theoperative portion610 is received by a sensor (not shown) of theultrasonic probe620 and transmitted to theultrasonic observation apparatus625.
• The[0354]ultrasonic observation apparatus625 analyzes the signal transmitted from theultrasonic probe620, processes the image, and displays a tumor tomographic image in themicroscope observation field630a. Additionally, in this case, a microscope image L of theultrasonic probe620 inserted into themicroscope observation field630ais also displayed.
• FIG. 77 is a flowchart of an automatic ultrasonic observation by the[0355]ultrasonic probe620. As shown in FIG. 77, in step S1 theultrasonic probe620 is inserted into themicroscope observation field630a. Subsequently, in step S2 a navigation image is displayed in thesmall screen display631ain themicroscope observation field630a. Thereafter, in the next step S3 the ultrasonic image is displayed in thelarge screen display633a.
• Therefore, as shown in FIG. 78A, the navigation image (three-dimensionally constructed[0356]image 3D) displayed in thesmall screen display631ain themicroscope observation field630a, and the ultrasonic image displayed in thelarge screen display633aare simultaneously displayed together with the microscope image L of theultrasonic probe620 displayed in themicroscope observation field630a.
• Moreover, it is judged in the next step S[0357]4 whether or not there is an input of theselection switch643. If YES, the process advances to the next step S5. In the step S5, screens to be displayed in thesmall screen display631ain themicroscope observation field630aand in thelarge screen display633aare changed in accordance with an input state of theselection switch643. Here, a state in which the navigation image is displayed in thelarge screen display633aand the ultrasonic image is displayed in thesmall screen display631ais selected. Then, as shown in FIG. 78B, the ultrasonic image is displayed in thesmall screen display631ain themicroscope observation field630ain which the microscope image L of theultrasonic probe620 is displayed. The navigation image (three-directional tomographic image, respective sagital, coronal and axial tomographic image information, and three-dimensionally constructedimage 3D prepared based on the information) is displayed in thelarge screen display633a.
• Then, the following effect is achieved in the aforementioned constitution. That is, according to the sixteenth embodiment, during use of the[0358]ultrasonic probe620, the ultrasonic image from theultrasonic probe620 is displayed in themicroscope observation field630aas it is. Additionally, an “outer shape display” in which position correlation in themicroscope observation field630ais obtained via thenavigation apparatus615 is superimposed onto an optical image. Then, the navigation image and ultrasonic image can simultaneously be observed in themicroscope observation field630a.
• Furthermore, the screens to be displayed in the[0359]small screen display631ain themicroscope observation field630aand in thelarge screen display633a, and the overlay display can be changed in accordance with the input state of theselection switch643. Therefore, the image of theultrasonic probe620, and the navigation image can be displayed in an optimum state whilst the operation progresses. Therefore, the operating person can obtain high-resolution tomographic image information in accordance with the operational situation, and can efficiently carry out the operation. Additionally, when theultrasonic probe620 is inserted, the image may be ON, or the image may be replaced.
• FIG. 79 to FIG. 83 show a seventeenth embodiment. The seventeenth embodiment is constituted by changing the constitution of the operation microscope apparatus of the sixteenth embodiment (see FIG. 73 to FIG. 78) as follows. Additionally, the same constituting components as those of the sixteenth embodiment are denoted with the same reference numerals, and description thereof is omitted.[0360]
• FIG. 79 is a longitudinal sectional view of a tip end of an[0361]ultrasonic probe650 according to the seventeenth embodiment. In theultrasonic probe650 anultrasonic transmitting cap652 is disposed on a tip end of aprobe pipe651. Aflexible shaft653 is passed through theprobe pipe651, and the tip end of the shaft extends into theultrasonic transmitting cap652.
• Moreover, in the[0362]ultrasonic transmitting cap652, an ultrasonicpiezoelectric transducer654 is fixed to theflexible shaft653. Amirror655 for reflecting the ultrasonic wave is disposed opposite to the ultrasonicpiezoelectric transducer654 in such a manner that the mirror can advance or retreat. Themirror655 can be moved forward or backward by operation of a hand operator.
• FIG. 80 is a control block diagram of the operation microscope apparatus. An image[0363]display direction display656 is disposed between theultrasonic observation apparatus625 and theselector637. This display is connected to anavigation apparatus615a. Other constitutions are the same as those of the sixteenth embodiment.
• Operation of the seventeenth embodiment constituted as described above will next be described. First, when ultrasonic observation is performed by the[0364]ultrasonic probe650, themirror655 is moved beforehand in the axial direction in accordance with an ultrasonic observation type. In FIG. 79, a position of themirror655 is set to either a solid-line position or a dotted-line position. Here, for example, when themirror655 is moved to the solid-line position in FIG. 79, themirror655 is set in a position retreating from the ultrasonicpiezoelectric transducer654. In this state, theultrasonic probe650 is inserted into theoperative portion610. Subsequently, when theultrasonic probe650 reaches a target portion, the probe is driven.
• During driving of the[0365]ultrasonic probe650, the ultrasonic wave outputted from the ultrasonicpiezoelectric transducer654 is radiated to all peripheries by 360 degrees via theultrasonic transmitting cap652. In this case, the ultrasonic wave reflected by thetumor portion610aof theoperative portion610 is received by the sensor (not shown) of theultrasonic probe650 and transmitted to theultrasonic observation apparatus625. Thereby, the tomographic image of a horizontal direction in the tip end of theultrasonic probe650 is observed.
• Here, the[0366]ultrasonic observation apparatus625 analyzes the signal transmitted from theultrasonic probe650, processes the image, and displays the ultrasonic observation image. This ultrasonic observation image is displayed as the tumor tomographic image in thelarge screen display633aof themicroscope observation field630ain FIG. 81. Additionally, the navigation image (three-directional tomographic image, respective sagital, coronal and axial tomographic image information, and three-dimensionally constructedimage 3D prepared based on the information) is displayed in thesmall screen display631atogether with the microscope image L of theultrasonic probe650 in themicroscope observation field630a.
• In FIG. 81, M denotes image information of a tumor tissue of a pathologically changed portion in the[0367]ultrasonic probe650. An outer shape of the tumor portion is extracted, and superimposed on the microscope observation image. In this case, the tumor tissue can similarly be superimposed/displayed based on the preoperative diagnosis image using the navigation apparatus. On the other hand, the display in the image by theultrasonic probe650 includes a tumor tissue position change (brain shift) under operation, and the entire tumor image can be grasped correctly. Additionally, for the image information M of the tumor tissue of the pathologically changed portion, only a color Doppler image may be extracted/displayed in order to see a blood flow state.
• Moreover, when the[0368]mirror655 of theultrasonic probe650 is moved to the dotted-line position in FIG. 79, themirror655 is set in a position opposite to the ultrasonicpiezoelectric transducer654. In this state, theultrasonic probe650 is inserted into theoperative portion610. Subsequently, when theultrasonic probe650 reaches the target portion, the probe is driven.
• During driving of the[0369]ultrasonic probe650, the ultrasonic wave outputted from the ultrasonicpiezoelectric transducer654 is reflected forward by themirror655, and radiated to the front of theultrasonic transmitting cap652. In this case, the ultrasonic wave reflected by thetumor portion610aof theoperative portion610 is received by the sensor (not shown) of theultrasonic probe650 and transmitted to theultrasonic observation apparatus625. Subsequently, theultrasonic observation apparatus625 analyzes the signal transmitted from theultrasonic probe650, processes the image, and displays the tumor tomographic image in thelarge screen display633aas shown in FIG. 82. Furthermore, the navigation image (three-dimensionally constructedimage 3D) is displayed in thesmall screen display631atogether with the microscope image L of theultrasonic probe650 in themicroscope observation field630a.
• Moreover, when an image display direction is reversed by the image[0370]display direction display656, as shown in FIG. 83, the direction of the tumor tomographic image displayed in thelarge screen display633acan horizontally be changed. Therefore, when theultrasonic probe650 for observing the tomographic image of a front direction is used, the tomographic image is displayed in accordance with the insertion direction of the probe.
• Therefore, according to the seventeenth embodiment, in addition to the effect similar to that of the operation microscope apparatus of the sixteenth embodiment, the image display direction can be changed in accordance with the insertion direction of the[0371]ultrasonic probe650 for forward scanning. This facilitates recognition of the position of the ultrasonic image, and the operation can be securely carried out.
• FIG. 84 to FIG. 91 show an eighteenth embodiment. FIG. 84 is a constitution diagram of the entire microscope body of the operation microscope, FIG. 85 is a diagram of a binocular eyepiece lens tube as seen along arrow A in FIG. 84, showing an internal optical constitution of the tube, FIG. 86 is a side view showing a left side optical observation system in FIG. 85, FIG. 87 is a diagram showing details of an eye distance adjustment mechanism of the binocular eyepiece lens tube, FIG. 88 is a sectional view taken along line[0372]88-88 of FIG. 87, FIG. 89 is a diagram showing a housing constitution of an eye distance adjustment section, FIG. 90 is a diagram showing arrangement (movement) of the optical eyepiece system when eye distance adjustment is performed, and FIG. 91 is a diagram showing an image display state in the observation field of the operation microscope.
• An entire constitution of an[0373]operation microscope body701 will be described with reference to FIG. 84. Thisoperation microscope body701 includes a pair of left and right optical observation systems. Atip end702 of theoperation microscope body701 is attached to a stand arm (not shown), and can be disposed/fixed in a three-dimensionally free position.
• Moreover, an[0374]eyepiece lens tube703 is disposed in theoperation microscope body701. Theeyepiece lens tube703 similarly includes a pair of left and right optical systems for receiving left and right observation fluxes emitted from themicroscope body701. Furthermore, theeyepiece lens tube703 is provided with a pair of left and right eyedistance adjustment housings704a,704bincluding a parallel prism described later.
• A pair of left and right[0375]first eyepiece housings705a,705bincluding a first optical eyepiece system described later are attached on an operating person's eye side of the eyedistance adjustment housings704a,704b. Furthermore, in the constitution, a second pair of left andright eyepiece housings706a,706bincluding a second optical observation system described later can integrally be attached to thefirst eyepiece housings705a,705b.
• A constitution of the[0376]eyepiece lens tube703 will next be described with reference to FIG. 85 and FIG. 86. A fixedhousing707 is integrally attached to themicroscope body701 via aconnection member708. A pair of left and rightimage forming lenses709a,709bare disposed in the fixedhousing707. Theimage forming lenses709a,709bare optically connected to the optical observation system (not shown) of themicroscope body701. Moreover, the left and right observation fluxes emitted from themicroscope body701 are incident upon theimage forming lenses709a,709b.
• Furthermore, mirrors[0377]710a,710bfor reflecting the fluxes incident through theimage forming lenses709a,709boutwardly by 90° are disposed inside theimage forming lenses709a,709b.Image rotator prisms711a,711bare disposed on outgoing light axes of the respective mirrors710a,710b.
• [0378]Prisms712a,712bfor reversing the opposite observation fluxes by 180° are disposed behind theimage rotator prisms711a,711b. Furthermore,triangular prisms713a,713bare optically disposed/fixed behind the prisms. Additionally, the outgoing light axes from therespective prisms712a,712bare reflected in parallel to observation light axes OL, OR by the first optical eyepiece system described later by thetriangular prisms713a,713b. Theseprisms712a,712b, andtriangular prisms713a,713bare contained in amovable housing714.
• The[0379]movable housing714 can rotate around an axis O, that is, incident light axes to theprisms712a,712bvia aconnection member700. Moreover, theimage rotator prisms711a,711bcan rotate centering on the axis O by an angle of ½ of an angle of rotation of themovable housing714 with respect to the fixedhousing707 by a cam mechanism (not shown).
• Moreover,[0380]parallel prisms715a,715bare contained in the eyedistance adjustment housings704a,704b. As shown in FIG. 86, theparallel prisms715a,715binclude incident reflection surfaces716a,716band outgoing reflection surfaces717a,717b. Furthermore, the fluxes from the outgoing reflection surfaces717a,717bof the respectiveparallel prisms715a,715bare led to a first pair of left and rightoptical eyepiece systems718a,718bcontained in therespective eyepiece housings705a,705b. This constitutes the left and right observation light axes OL, OR of the microscope optical observation image observed by the first pair of left and rightoptical eyepiece systems718a,718b.
• Moreover, the second optical observation system contained in the[0381]second eyepiece housings706a,706b(only one second eyepiece housing706ais shown in FIG. 86) is constituted as follows. FIG. 86 shows only the left light path, but the right light path is similarly constituted.Bent sections720a,720bbent substantially in L shapes are formed in lower parts of thesecond eyepiece housings706a,706b. Thebent sections720a,720bare disposed between the second eyepiece housings and themovable housing714 disposed under the eyedistance adjustment housings704a,704b.
• Moreover, small-sized LCD monitors[0382]721a,721bare disposed in terminal ends of the respectivebent sections720a,720b. The endoscope image is displayed as the electronic image in each of the small-sized LCD monitors721a,721bby control from a controller (not shown).
• Furthermore,[0383]prisms723a,723bfor reflecting outgoing light axes OMa, OMb from the LCD monitors721a,721bare disposed in connection sections with the respectivebent sections720a,720bin thesecond eyepiece housings706a,706b. Additionally,optical relay systems722a,722bare disposed before and afterrespective prisms723a,723bon the outgoing light axes OMa, OMb from the LCD monitors721a,721b.
• Moreover,[0384]prisms724a,724bfor deflecting the light axes reflected by theprisms723a,723bin directions of the observation light axes OL, OR are disposed on upper ends of thesecond eyepiece housings706a,706b. Furthermore, secondoptical eyepiece systems725a,725bare optically disposed/connected on outgoing light axes O2L, O2R of therespective prisms724a,724b. Additionally, the observation light axes OL and O2L, or OR and O2R intersect each other in the vicinity of the emission pupil position.
• A constitution of an eye distance adjustment mechanism will next be described with reference to FIG. 87. Only shows the left light path in FIG. 87, but the right light path is similarly constituted as described above. Here, a[0385]cylindrical member730ais integrally attached to a lower end of the eyedistance adjustment housing704a. Thiscylindrical member730ais attached to the fixedhousing714 so that the body can rotate around incident light axis O1 of theparallel prism715a, and a so-called G ten top eye distance adjustment mechanism is constituted.
• Moreover, a[0386]gear731ais integrally attached to thecylindrical member730a. Furthermore,washers732a,733aare attached on opposite sides of thegear731ain an outer periphery of thecylindrical member730a. Here, onewasher732ais inserted between thegear731aand themovable housing714, and theother washer733ais inserted between thegear731aand the eyedistance adjustment housing704a.
• Moreover, a first[0387]idle gear734ameshes with thegear731a. The firstidle gear734ais supported so as to be rotatable around ashaft735aattached to the eyedistance adjustment housing704a. Furthermore, a secondidle gear737ameshes with the firstidle gear734a. The secondidle gear737ais similarly supported to be rotatable around ashaft738aattached to the eyedistance adjustment housing704a. Additionally,washers736a,739aare inserted between theidle gears734a,737aand the eyedistance adjustment housing704a, respectively.
• Furthermore, a[0388]gear740ais integrally attached to thebent section720aof the second eyepiece housing706a. Thegear740ameshes with theidle gear737a.
• Additionally, the[0389]gear731ais constituted of the same number of teeth and modules as those of thegear740a. That is, a transmission mechanism of a gear mechanism with a reduction ratio of 1 is constituted by thegears731a,740aandidle gears734a,737a.
• Moreover, a[0390]connection portion741aprojects from a side portion of the second eyepiece housing706a. Theconnection portion741ais integrally connectable to aconnection mount742aof thefirst eyepiece housing705a. Furthermore, while theconnection portion741ais connected to theconnection mount742a, a position relation is constituted such that a rotation center of thegear740aagrees with the observation light axis OL of the firstoptical eyepiece system718a.
• Furthermore, a cylindrical member[0391]743ais integrally disposed on a lower end of thefirst eyepiece housing705a. A center axis of the cylindrical member743aagrees with the observation light axis OL. Furthermore, awasher744 is inserted between thefirst eyepiece housing705aand the eyedistance adjustment housing704aaround the cylindrical member743a.
• Additionally, as shown in FIG. 88, the[0392]connection portion741aof the second eyepiece housing706ais formed in a male dovetail sectional shape which is broadened toward a tip end and gradually narrowed toward a root side. Moreover, engagingslopes745aare formed on opposite sides of theconnection portion741a.
• Furthermore, a female dovetail shaped engagement groove corresponding to the male dovetail sectional shape of the[0393]connection portion741ais formed in theconnection mount742aof thefirst eyepiece housing705a. Moreover, apressing pin746 is attached to a side portion of thefirst eyepiece housing705a. Amale screw747 is formed on a tip end of thepressing pin746. Furthermore, themale screw747 of thepressing pin746 can be detachably attached to theslope745aof theconnection portion741a.
• Operation of the eighteenth embodiment will next be described. The operating person operates the stand arm (not shown) and disposes/fixes the[0394]microscope body701 in a desired position. Furthermore, themovable housing714 of theeyepiece lens tube703 is rotated around the axis O, and the firstoptical eyepiece systems718a,718bare disposed in an operating person's eye positions. In this case, theimage rotator prisms711a,711bin the fixedhousing707 of theeyepiece lens tube703 are rotated by ½ with respect to the rotation of the movable housing around the axis O.
• A light emitted from the operative portion is incident upon the[0395]image forming lenses709a,709bvia an optical magnification system (not shown) in themicroscope body701. In this case, the left and right fluxes are passed through theimage rotator prisms711a,711b, and, by the rotation of themovable housing714 around the axis O, the rotation of the image is corrected. Thereafter, the fluxes are reflected by thetriangular prisms713a,713b, passed through theparallel prisms715a,715b, and led to the firstoptical eyepiece systems718a,718b. The operating person performs stereoscopic observation at a desired enlargement magnification.
• On the other hand, when the endoscope observation image, and the CT or MR image are simultaneously observed with the microscope observation image, the operating person operates a control unit (not shown), and displays the desired electronic image in the LCD monitors[0396]721a,721b. In this case, the lights emitted from the LCD monitors721a,721bare passed through theoptical relay systems722a,722b. Furthermore, the light axes OMa, OMb are bent substantially in parallel to the observation light axes OL, OR by theprisms723a,723b. Subsequently, through theprisms724a,724b, light axes O2L, O2R forming an angle α with the observation light axes OL, OR are led to the secondoptical eyepiece systems725a,725b. Thereby, as shown in FIG. 91, the observation image by the secondoptical eyepiece systems725a,725b, that is, anelectronic image751 by the LCD monitor is displayed below anoptical observation image750 by the firstoptical eyepiece system718a,718b. The operating person can observe the electronic image similarly as the optical image only by turning the line of sight downward substantially by the angle of α without largely moving the face.
• Subsequently, when the operating person observes the operative portion straight on, the person turns both eyes to a front side of the[0397]lens eyepiece tube703 away from the first and secondoptical eyepiece systems718a,718b,725a,725b. In this case, the second optical observation systems contained in thesecond eyepiece housings706a,706bpartially enter the lower parts of the eyedistance adjustment housings704a,704bby theprisms723a,723b. Therefore, the operating person moves the face only to avoid the projections of thesecond eyepiece housings706a,706b, and observes the operative portion straight on.
• Eye distance adjustment performed by the operating person to align the emission pupils of the[0398]eyepiece lens tube703 with the operating person's left and right pupil positions will next be described. First, the operating person adjusts the distance between the observation light axes OL and OR to match their eyes by changing a distance between the left and right observation light axes OL and OR of the firstoptical eyepiece systems718a,718bto L1 from L in FIG. 90. In this case, the left and right eyedistance adjustment housings704a,704bare rotated in the directions of arrows B and G. Then, thegear731aof the left light path eyedistance adjustment housing704asimilarly rotates in the direction B. A rotary force is applied to thegear740aof the second eyepiece housing706ain a direction of an arrow F successively via the firstidle gear734aand secondidle gear737a. Thereby, thefirst eyepiece housing705aand second eyepiece housing706aof the left light path are rotated by the same angle (β in FIG. 90) as that of the eyedistance adjustment housing704ain a direction of an arrow H centering on a center line Oa of thecylindrical member730a.
• Similarly, the[0399]first eyepiece housing705bandsecond eyepiece housing706bof the right light path are also rotated in the direction of the arrow H by the angle β. That is, parallel states of the firstoptical eyepiece systems718a,718b, and the secondoptical eyepiece systems725a,725bare held. The horizontal light axis interval is changed to L1 from L. Therefore, the operating person can observe both the microscope observation image and the electronic observation image with opposite eyes.
• Subsequently, in a case in which the operating person requires no electronic image, when the[0400]male screw747 of thepressing pin746 disposed on thefirst eyepiece housing705ais loosened, the pressure of thepressing pin746 on theslope745aof theconnection portion741ais released. Therefore, theconnection portion741acan be detached from theconnection mount742a, and the second eyepiece housing706acan be detached from thefirst eyepiece housing705a.
• Moreover, similarly for the[0401]second eyepiece housing706bof the right light path, when themale screw747 of thepressing pin746 is similarly loosened, the second eyepiece housing can be removed from thefirst eyepiece housing705b. Therefore, in the case in which no electronic image is necessary, it is possible to observe the operative portion in an enlarged size with an operation feeling similar to that of the usual binocular eyepiece lens tube without being limited by thesecond eyepiece housings706a,706b.
• Therefore, the following effect is achieved in the aforementioned constitution. That is, in the eighteenth embodiment, the[0402]second eyepiece housings706a,706bcan easily be removed from thefirst eyepiece housings705a,705bas desired by the operating person. Therefore, it is easy to use only the first optical observation system as the usual optical observing observation lens tube.
• Additional advantages and modifications will readily occur to those skilled in the art. Therefore, the invention in its broader aspects is not limited to the specific details and representative embodiments shown and described herein. Accordingly, various modifications may be made without departing from the spirit or scope of the general inventive concept as defined by the appended claims and their equivalents.[0403]

Claims (25)

What is claimed is:

1. An operation microscope having a microscope body including an optical eyepiece system for stereoscopically observing an operative portion of a surgical operation, said microscope comprising:

a microscope image observer for observing an observation image formed for stereoscopic observation by the microscope body;

a plurality of image forming sections for forming images other than the observation image of said microscope image observer;

an image display for selectively displaying the respective images of said plurality of image forming sections in said microscope image observer;

a display driver for controlling display states of the plurality of images formed by said plurality of image forming sections independently of one another; and

a controller for controlling an operation of the display driver.

2. The operation microscope according to

claim 1

, wherein said image display comprises:

an in-field display for displaying the image of any one of said image forming sections in a field of the observation image of said microscope image observer; and

an out-of-field display for displaying the image of said image forming section other than the image of said in-field display outside the field of the observation image of said microscope image observer.

3. The operation microscope according to

claim 2

, wherein said in-field display is formed by a small screen display, formed by cutting a part of the field of the observation image of said microscope image observer, for displaying another image formed by said image forming section in the cut part.

4. The operation microscope according to

claim 2

, wherein said in-field display is formed by an image superimposing section for superimposing and displaying the image other than said observation image in the field of the observation image of said microscope image observer.

5. The operation microscope according to

claim 2

, wherein said in-field display comprises:

a small screen display, formed by cutting a part of the field of the observation image of said microscope image observer, for displaying another image formed by said image forming section in the cut part; and

an image superimposing section for superimposing and displaying the image other than said observation image and the display image of said small screen display in the field of the observation image of said microscope image observer.

6. The operation microscope according to

claim 1

, wherein said image display comprises:

an in-field display for displaying the image of any one of said image forming sections in a field of the observation image of said microscope image observer, and

said in-field display comprises:

a small screen display, formed by cutting a part of the field of the observation image of said microscope image observer, for displaying another image formed by said image forming section in the cut part; and

an image superimposing section for superimposing and displaying the image other than said observation image and the image of said small screen display in the field of the observation image of said microscope image observer.

7. The operation microscope according to

claim 1

, wherein said display driver comprises:

an image selector for selecting respective display images of said plurality of image forming sections;

a display controller for displaying the image selected by said image selector in said corresponding image display; and

an operation input section for operating said display controller and the image selector.

8. The operation microscope according to

claim 7

, wherein said operation input section comprises:

detection means for detecting an image source state of said plurality of image forming sections; and

an automatic controller for automatically controlling at least one of said display controller and said image selector based on a detection result of the detection means.

9. The operation microscope according to

claim 1

, wherein said plurality of image forming sections comprise:

an endoscope image forming section for forming the observation image by an endoscope;

a navigation image forming section, provided with a diagnosis image memory apparatus incorporated therein, for forming a navigation image by a navigation apparatus including correlation processing means for calculating a correlation between the diagnosis image and the observation image of said microscope image observer;

an image data forming section for forming character data and various image data such as an arrow; and

an operation information data forming section for forming operation information data for displaying operation information of said operator.

10. The operation microscope according to

claim 5

, wherein said display driver comprises an XY driver for driving said small screen display in an XY direction in XY coordinates crossing at right angles to each other in the field of the observation image of said microscope image observer, and

said controller comprises:

an XY direction operation switch for operating said XY driver in said XY direction;

an image selection switch for selecting the respective images of said plurality of image forming sections; and

a display selection switch for selecting said image display.

11. The operation microscope according to

claim 7

, wherein said image forming section comprises a nerve monitor for inspecting a function of a cranial nerve, and displaying an inspection result with a waveform, and

said image selector comprises waveform monitor means of said nerve monitor, and changes a display state of said nerve monitor in accordance with a state of the waveform monitor means.

12. The operation microscope according to

claim 3

, wherein said microscope is connected to an external operation input section disposed outside an operating theater, and comprises a data transmitter for displaying an instruction from said external operation input section in said small screen display.

13. The operation microscope according to

claim 7

, wherein said image forming section comprises a menu image forming section for forming a menu image by which an image to be displayed in said image display is selected, and

said image selector comprises a selection section of a menu display position for selecting a display place of said menu image in accordance with the display state of the image displayed in said image display.

14. The operation microscope according to

claim 4

, wherein said microscope comprises a TV camera for picking up the observation image of said microscope image observer,

an image pickup range of said TV camera is set to be smaller than an image superimposing range of said image superimposing section, and

said display driver superimposes information necessary after the surgical operation in said camera image pickup range, and displays information necessary only during the surgical operation outside said camera image pickup range.

15. The operation microscope according to

claim 2

, wherein said microscope comprises:

a holder for movably supporting said microscope body; and

a holder fixing section for fixing a moving position of the holder in such a manner that the moving position can be fixed or released, and

said image display changes a display mode of a plurality of display images of said in-field display in accordance with a state of said holder fixing section.

16. The operation microscope according to

claim 2

, wherein said image forming section comprises an ultrasonic observation image forming section for forming an image indicating an observation result of an ultrasonic observation apparatus, and

said image selector detects an observation/non-observation state of said ultrasonic observation apparatus, and changes a display mode of a plurality of display images of said in-field display in accordance with the state.

17. The operation microscope according to

claim 6

, wherein said microscope comprises a foot switch for controlling an operation, and

said display driver allots a function of said foot switch to image source control in accordance with an image source selected by said in-field display.

18. The operation microscope according to

claim 17

, wherein said display driver comprises a display for displaying an identification mark in the image to which the function of said foot switch is allotted in accordance with the image source selected by said in-field display.

19. The operation microscope according to

claim 6

, wherein said microscope body comprises an endoscope holding hook for holding an endoscope so that the endoscope is attachable or detachable, and

said display driver detects whether or not said endoscope is held by said endoscope holding hook and controls said image display.

20. The operation microscope according to

claim 2

, wherein said image forming section comprises a scale display for calculating an image scale of said endoscope and displaying the image scale in said in-field display.

21. The operation microscope according to

claim 20

, wherein said scale display calculates a scale of the observation image of said microscope image observer and overlays and displays the scale in the observation image of said microscope image observer.

22. The operation microscope according to

claim 20

, wherein said scale display comprises a stereoscopic index display for displaying a stereoscopic index in said in-field display.

23. The operation microscope according to

claim 9

, wherein said image forming section displays an image of an ultrasonic probe and said navigation image in said image display with a progress of the surgical operation when said ultrasonic probe is used.

24. The operation microscope according to

claim 23

, wherein said ultrasonic probe changes an image display direction in accordance with an insertion direction of the ultrasonic probe of a front scan.

25. The operation microscope according to

claim 2

, wherein said out-of-field display is disconnectably connected to said microscope body.

Images