US20040070822A1 - Surgical microscopic system - Google Patents

Abstract

Provided is a surgical observational system capable of effectively displaying, in the field of an operating microscope, a real-time image obtained by means of an ultrasonic probe, for example, and a slice image obtained by a preoperative diagnosis on the location of the distal end portion of the probe or a three-dimensional image of an affected region, in association with an actual observational image obtained by means of the microscope. The surgical operation observational system is provided with two monitors in the operating microscope for the observation of the affected region to be operated. Images on the two monitors are alternatively superposed on the optical path of the operating microscope.

Description

• This application is a division of application Ser. No. 09/663,676 filed on Sep. 18, 2000.[0001]
CROSS-REFERENCE TO RELATED APPLICATION
• This application is based upon and claims the benefit of priority from the prior Japanese Patent Applications No. 11-266687, filed Sep. 21, 1999; No. 11-288328,filed Oct. 8, 1999; No. 11-298250, filed Oct. 20, 1999; No. 11-312443, filed Nov. 2, 1999; No. 11-353212, filed Dec. 13, 1999; and No. 11-354414, filed Dec. 14, 1999, the entire contents of which are incorporated herein by reference.[0002]
BACKGROUND OF THE INVENTION
• The present invention relates to a surgical microscopic system adapted for microsurgery carried out under microscopic observation for neurosurgery, for example.[0003]
• In order to ensure higher accuracy for a neurosurgical operation that uses an operating microscope, for example, treatment based on an endoscope, ultrasonic diagnostic apparatus, or any other diagnostic technique without the use of visible light is expected to be carried out for the tissues of regions that are not accessible to the operating microscope, such as the back or inside of an affected region, accompanied by real-time observation and diagnosis. Various surgical microscopic systems have been developed to meet this requirement.[0004]
• Described in Jpn. Pat. Appln. KOKAI Publications Nos. 62-166310, 3-105305, 7-261094 are surgical observational systems in which an endoscope or the like is used to observe regions that correspond to dead angles of an operating microscope, and optical images of the observational regions are projected in the field of the microscope.[0005]
• According to these conventional surgical observational systems, however, an observational image obtained by means of the endoscope or the like is only projected on the microscopic field, so that it is difficult for an operator to identify the endoscopic image that is actually observed through the field of the microscope. In the case where this technique is applied to a diagnostic apparatus, such as an ultrasonic diagnostic apparatus, which uses no visible light, the operator can hardly grasp an actually diagnosed part of a patient's body according to an image in the observational field only. Thus, the operator can discriminate the diagnosed region by the image only if s/he ideally superposes the characteristic features of the diagnostic image and the actual observational image, based on his or her experience.[0006]
• Described in Jpn. Pat. Appln. KOKAI Publication No. 9-56669, moreover, is a surgical microscopic system with improved operativity, in which an endoscopic image or the like is displayed as a sub-picture in some other part of the microscopic field than the field portion where a main observational image is displayed. If the operator uses the system in combination with an endoscope or ultrasonic observer in this case, however, s/he is not provided with any means for grasping the region that is observed actually. Therefore, the operator can grasp the observational region only by randomly swinging the endoscope or ultrasonic probe in all directions and ideally superposing the characteristic features in comparison with a microscopic image.[0007]
• Further, a method for guiding second observational means, such as an ultrasonic probe, into the field of an operating microscope is described in Jpn. Pat. Appln. KOKAI Publication No. 6-209953. According to this conventional technique, however, there is provided no method for effectively displaying the observational image of the second observational means in the microscopic field, so that the operator can correlate the microscopic optical image and the image of the second observational means only ideally.[0008]
• Proposed in Jpn. Pat. Appln. No. 11-132688 filed by the assignee of the present invention ( , 1999, not published), furthermore, is a surgical microscopic system in which the direction of the observational field of an endoscope is indicated by an arrow or the like displayed in the field of a microscope. However, the microscopic optical image and the endoscopic image cannot be satisfactorily correlated by only indicating the observational direction in this manner. Thus, the operator can correlate these images only ideally in consideration of differences in rotation, magnification, etc. between them. If an ultrasonic observer is used as auxiliary observational means, moreover, the observational direction is not fixed, covering the circumferential angle of 360°, for example, so that it is hard to align observational image and an actual affected region.[0009]
• Described in Jpn. Pat. Appln. KOKAI Publication No. 6-205793, moreover, is a display system that displays a preoperative diagnostic image by superposition on an image of an affected region by means of a half-mirror. Since the preoperative diagnostic image is superposed on the whole affected region image in this case, however, the microscopic field is too obscure to ensure a satisfactory actual surgical operation. Therefore, this system can only determine a preoperative position for craniotomy, and cannot accurately grasp information on the inner tissue in association with the affected region on a real-time basis during the surgical operation.[0010]
• Described in Jpn. Pat. Appln. KOKAI Publication No. 9-24052, furthermore, is a method that uses fluorescent observation for the recognition of the position of a cerebral tumor, in order to extract the tumor securely under surgical microscopic observation. Although the observational tumor position can be securely recognized by this method, however, the obtained information is related only to the exposed surface of the tumor on the plane of observation at that time (during the extraction). Accordingly, information on the entire tumor (including information on inaccessible depths) inevitably depends on preoperative information.[0011]
• Further, a navigation apparatus is proposed in Jpn. Pat. Appln. No. 10-248672 (filed , 1998, not published). This navigation apparatus forms three-dimensional image data on the basis of image information from a CT scanner or MRI that is operated for a preoperative diagnosis, establishes a spatial correlation between a patient's head and the observational position of a microscope during a surgical operation, and supports the surgical operation in accordance with the three-dimensional image data. According to this navigation apparatus, the image of the entire tumor is obtained as slice image information for the observational point concerned during the surgical operation. However, only the slice image information for a focal position can be obtained on a three-dimensional observational plane of the operating microscope. Therefore, the operator must identify the position of the tumor by the slice image information with the progress of the operation.[0012]
• With the recent development and spread of microsurgery, a technique for surgical operations for minute affected regions, moreover, operating microscopes have started to be extensively used for microsurgery in a wide variety of fields including ophthalmology, neurosurgery, otolaryngology, etc. Naturally, therefore, the operating microscopes are being improved to meet various requirements that depend on operators' surgical maneuvers. Recently, surgical operations have been changed into less invasive ones in consideration of earlier rehabilitation of operated patients, so that there is a demand for the way of observation of affected regions in finer tubules. For improved accuracy and safety of surgical operations in the depths of the body cavity, furthermore, hidden regions that are inaccessible to microscopic observation are expected to made observable.[0013]
• As a technique to meet these requirements, a stereoscopic operating microscope described in Jpn. Pat. Appln. KOKAI Publication No. 62-166310, for example, is designed so that the inside of a tubule can be observed by means of first and second stereoscopic optical systems with different base line intervals. Since the two stereoscopic optical systems shares a finder optical system, moreover, an operator can alternatively observe images from the two optical systems. This stereoscopic operating microscope is provided with the stereoscopic optical system that includes the finder optical system and a pair of variable-magnification optical systems, left and right, having the same optical axis. An auxiliary stereoscopic optical system that is located near the main stereoscopic optical system includes image restoring means for reproducing an image from a solid-state image-pickup device for picking up an image of an observed object and image projecting means for guiding the image to the finder optical system of the stereoscopic optical system.[0014]
• An optical device described in Jpn. Pat. Appln. KOKAI Publications No. 3-105305 is designed so that one or both of images from two observational means of a stereoscopic operating microscope can be alternatively observed and that the operator can select the images by means of a footswitch or the like without using his or her hand.[0015]
• A system described in Jpn. Pat. Appln. KOKAI Publication No. 6-175033, moreover, is provided with position specifying means for specifying a position in or near the observational field. In this system, the relation between a reference position of an operating microscope and the position specified by means of the position specifying means is computed, and the body of the microscope is moved to the specified position.[0016]
• Described in Jpn. Pat. Appln. No. 10-319190 filed by the assignee of the present invention ( , 1998, not published), furthermore, is a system provided with drive means that causes an operating microscope and a robot manipulator to move to target positions in accordance with a preoperative diagnostic image or slice image information, thereby correlating the preoperative image and the operative field.[0017]
• If the operator uses an auxiliary optical system for tubule observation to observe dead-angle regions that are inaccessible to microscopic observation, e.g., the back side of the an aneurysm, nerves cleared of a tumor, peripheral tissues, etc., as in the prior art case mentioned before, a video image picked up by means of an endoscope or other auxiliary optical system is displayed in the microscopic field. In this case, the operator's mate sometimes may observe a similar image as s/he aspirates the marrow or blood to secure the operator's field of vision.[0018]
• FIG. 74 shows an example of the system of an operating microscope a of this type. A body b of the microscope a is provided with an operator eyepiece unit c[0019]1 and a mate eyepiece unit c2. An in-field monitor (not shown) is located in a part of the field of each of the eyepiece units c1 and c2. As shown in FIGS. 75A and 75B, indexes and sub-images e1 and e2 that are different from main images d1 and d2 of the operating microscope a are projected in the main images d1 and d2.
• An LCD driver f is connected to each in-field monitor. Further, a CCTV unit q is connected to the LCD driver f. A camera head i is connected to the CCTV unit g. An endoscopic image observed by means of an endoscope h is displayed on the respective in-field monitors of the operator and mate eyepiece units c[0020]1 and c2.
• When a conventional operating microscope apparatus is used, moreover, an operative field j as an object of a surgical operation is observed at different angles by means of the microscope body b and the endoscope h. An optical video image then caught by the endoscope h is photoelectrically converted by means of a image-pickup device (not shown) in the TV camera head i and applied as an electrical signal to the TV camera head i to be processed therein, whereupon a TV signal is outputted. This TV signal is converted into a display mode signal of a liquid crystal display device (not shown) by means of the LCD driver f. This signal is delivered to liquid crystal image display devices (not shown) of the respective in-field monitors of the operator and mate eyepiece units c[0021]1 and c2 of the microscope a. Thereupon, endoscopic images are partially displayed as the sub-images e1 and e2 on the main images d1 and d2 of the microscope a in the microscopic field, as shown in FIGS. 75A and 75B. More specifically, in the operator eyepiece unit c1 of this operating microscope apparatus, the sub-image e1, an endoscopic image, is inserted into the main image d1 in the field of the microscope a by means of the liquid crystal image display device (not shown), as shown in FIG. 75A. Likewise, in the mate eyepiece unit c2, the sub-image e2, an endoscopic image, is inserted into the main image d2 in the field of the microscope a by means of the liquid crystal image display device (not shown), as shown in FIG. 75B.
• According to this operating microscope apparatus, however, the operator and the mate have their respective observational directions. Therefore, the relation between the display position of the main image d[0022]1 in the field of the operator eyepiece unit c1 of the microscope a and the display position of the sub-image e1 in the same field is different from the relation between the display position of the main image d2 in the field of the mate eyepiece unit c2 of the microscope a and the display position of the sub-image e2 in the same field. Since the field direction of the mate is different from that of the operator, the position in the mate-side observational optical system where the in-field display image appears is inevitably different from the corresponding position in the operator-side observational optical system. Possibly, therefore, a region that can be observed through the operator-side optical system may not be able to be observed through the mate-side optical system.
• Basically, moreover, the field direction on the mate side is different from the operator-side field direction. Although the microscope images are located in correct relative positions, therefore, the positional relation between the images obtained by means of the auxiliary optical system cannot be displayed correctly. Since the mate-side observational optical system is rotatable with respect to the operator-side system, furthermore, the positional relation between the images of the auxiliary optical system goes wrong if the mate-side system is rotated. If bleeding or the like occurs in any region corresponding to a dead angle of the image of the auxiliary optical system in the mate-side field, therefore, the display position of the auxiliary optical system must be controlled manually.[0023]
• In carrying out a surgical operation with reference to a diagnostic image, furthermore, a preoperative diagnostic image, such as MRI or X-ray CT, sometimes may be display as each of the sub-images e[0024]1 and e2 on the video images in the main images d1 and d2 in the field of the microscope a. In this case, these sub-images, unlike the aforesaid video image of the auxiliary optical system, should never fail to be erect images, and the images that are accessible to the operator and the mate, individually, must be of the same type.
• In the case where the operating microscope apparatus is used in combination with a position information detector or the like, moreover, a position information detection image and a marker for the detector must be overlaid on a microscopic image. A conventional microscopic apparatus with in-field display means requires use of one combination of an optical system and a display device for the display of an image in the microscopic field and another for the display of a marker. If the image and the marker are needed simultaneously, therefore, the display device must be changed during use or one of the devices must be replaced with an alternative device.[0025]
• Conventionally, furthermore, the operator is expected to confirm the marker display of the position information detector and manually move the microscope body to the marker position. Accordingly, highly complicated maneuvers are required by a technique that uses the position information detector in combination with an auxiliary optical system such as an endoscope.[0026]
• In order to make a microsurgical operation less invasive, moreover, various pieces of image information are used during the operation. The image information may be obtained by means of an endoscope for observing regions that are inaccessible to the operating microscope or an ultrasonic observer for obtaining a slice image of the inside of tissue. Further, it may be obtained by means of a diagnostic device such as a so-called nerve monitor device for measuring the potential of nerves of a patient under the operation. To attain this, an operating microscope for the observation of an endoscopic image or the like is described in Jpn. Pat. Appln. KOKAI Publication No. 10-333047, as in Jpn. Pat. Appln. KOKAI Publication No. 62-166310.[0027]
• A microscope requires visibility adjustment or adjustment of differences in eyesight (refractive force) between observers. A technique for this visibility adjustment is described in Jpn. Pat. Appln. KOKAI Publication No. 7-281103. An operating microscope is also subjected to the visibility adjustment with every surgical operation. On the other hand, a method for measuring the refractive force of an eye is described in Jpn. Pat. Appln. KOKAI Publication No. 3-200914. In this method, however, the refractive force of an eye of a patient, not an observer, is measured by projecting an index on the eyeground and detecting light reflected by the eyeground.[0028]
• The operating microscope described in Jpn. Pat. Appln. KOKAI Publication No. 10-333047 can perform microscopic observation and endoscopic observation in one and the same field. When an endoscope is moved in an affected region, however, its distal end must be checked for the location on a microscopic image lest it damage tissue as an endoscopic image is observed. It is to be desired, therefore, that the endoscopic image should not intercept the microscopic field or should be displayed small on the microscopic image.[0029]
• When the endoscopic image is watched as a treatment or the like is carried out, on the other hand, it is expected to be wide enough. Observation based on the microscopic image is also needed to check an instrument for insertion or watch a wide range of the affected region. Thus, it is advisable to display the endoscopic image large on the microscopic image.[0030]
• In each of the operating microscopes described in Jpn. Pat. Appln. KOKAI Publications Nos. 62-166310 and 10-333047, however, the endoscopic image is displayed in a fixed position and within a fixed range in the microscopic field. Therefore, a surgical operation using the endoscope cannot easily meet the demand for both the movement of the endoscope and the treatment with reference to the endoscopic image, and the endoscopic image may be obstructive or too small for smooth treatment.[0031]
• Thus, it is hard for an operator to concentrate his or her attention on the surgical operation, so that the operator's fatigue increases, and the operation time extends. An ultrasonic diagnostic apparatus is subject to the same problems when its probe is moved or when ultrasonic observation or treatment under ultrasonic observation is carried out. Since the endoscope used under surgical microscopic observation is designed for the observation of regions corresponding to dead angles of the microscope, moreover, it should be of a squint type for observation in directions different from the direction of its insertion. If the squint-type endoscope is rotated around the direction of insertion, it ceases to be able to identify the direction of view with respect to the microscopic field. Accordingly, the operator must judge the observational direction by a tissue form displayed in the endoscopic image. Thus, it is hard for the operator to be devoted to the surgical operation, so that the operator's fatigue increases, and the operation time extends. Even when the operator is concentrating his or her attention on the observational image of the operating microscope, furthermore, s/he must also pay attention to the state of some other equipment to detect a change in the nerve monitor device, so that his or her fatigue is increased.[0032]
• On the other hand, the conventional visibility adjustment operation described in Jpn. Pat. Appln. KOKAI Publication No. 7-281103 is troublesome and lengthens the setup time before the start of operation of the operating microscope. If the operator changes during a surgical operation, moreover, the visibility must be readjusted. Usually, it is difficult to adjust the visibility with a drape for sterilization on the microscope. If the microscope is used with wrong visibility, the surgical operation is performed with the right or left eye of the operator out of focus, so that the operator is fatigued much. Further, a TV camera or 35-mm camera that is connected to the operating microscope may fail to be in focus. In this case, the refractive index of the operator's eye may be able to be measured automatically to correct the visibility by the method described in Jpn. Pat. Appln. KOKAI Publication No. 3-200914. According to this method, however, an optical system must be provided with an index projection optical system for detection and its mating light receiving optical system, so that a large-sized apparatus is required, constituting a hindrance to the surgical operation. Even if projected light has a wavelength in an invisible zone, its influence upon the observational performance of the microscope cannot be removed thoroughly, so that the efficiency of the surgical operation is lowered, and the operator is fatigued inevitably.[0033]
• A rigid scope may be used for the observation of regions corresponding to dead angles of the operating microscope in microsurgery. In this case, the observation of the dead-angle regions requires use of a so-called squint-type rigid scope for oblique observation at a fixed angle (e.g., 30°, 70° or 110°) to the observational optical axis of its eyepiece. In this rigid scope, a TV camera (image-pickup device) is connected to the eyepiece to display its observational image on a monitor screen. The rigid scope is also connected with a light guide, which is connected to a light source unit to guide illumination light to an affected region. In order to observe a region corresponding to a dead angle of the operating microscope, the rigid scope of this type is used in a very narrow space (normally about 300 mm) between the body of the microscope and the observational region. To change its squint angle, moreover, the rigid scope can be rotated throughout the angular range of 360° with respect to the direction of its insertion during a surgical operation. Thus, the operator can observe his or her desired position.[0034]
• In a rigid scope described in Jpn. UM Appln. KOKAI Publication No. 5-78201, a TV camera is connected optically to the imaging point of its eyepiece. A light guide that constitutes an illumination optical system in the rigid scope and a light guide one end of which is connected to a light source unit are connected optically to each other in a position near the eyepiece. Since the TV camera itself projects in the direction of insertion of the rigid scope, however, it may possibly interfere with the operating microscope body, depending on the direction of insertion of the scope into the body cavity, so that the operator's desired observational position is restricted inevitably. Further, the light guide that is connected to the light source unit projects substantially at right angles to the direction of insertion into the body cavity. If the operator rotates the rigid scope around the direction of insertion to change the observational direction, therefore, the light guide may get deep into the field of the microscope depending on its direction, thereby hindering the microscopic observation.[0035]
• In a rigid scope described in U.S. Pat. No. 5,168,863, moreover, cables of a TV camera that is connected to an eyepiece are guided in a direction at about 45° to its longitudinal direction (direction of insertion into the body cavity). In this case, the TV camera can somewhat be prevented from interfering with the body of an operating microscope. Nevertheless, the TV camera itself still causes interference, and the light guide extensively intercepts the microscopic field as the rigid scope rotates.[0036]
• In a rigid scope described in Jpn. UM Appln. KOKAI Publication No. 56-176703, furthermore, a reflective member for bending the observational optical axis is disposed on an observational optical system therein so that the optical axis of an eyepiece is inclined at a fixed angle to the longitudinal direction of the scope (direction of insertion into the body cavity). Since the a part of the eyepiece portion of this rigid scope is inclined at the fixed angle to the direction of insertion of the scope, a TV camera can avoid interfering with the body of an operating microscope. Since the direction of projection of a light guide is coincident with the direction of insertion into the body cavity, however, the light guide and the microscope body inevitably interfere with each other.[0037]
• A rigid scope described in Jpn. Pat. Appln. KOKAI Publication No. 11-155798, like the one described in Jpn. UM Appln. KOKAI Publication No. 56-176703, is designed so that the observational optical axis of an eyepiece is inclined at a fixed angle to its longitudinal direction (direction of insertion into the body cavity), and a light guide, which is connected to a light source unit, is connectable near the eyepiece. In either of the rigid scopes described in Jpn. UM Appln. KOKAI Publication No. 56-176703 and Jpn. Pat. Appln. KOKAI Publication No. 11-155798, however, the eyepiece and the TV cam attached thereto project long within a plane at about 90° to the direction of insertion of the rigid scope into the body cavity (i.e., region for the operator's surgical operation), so that they inevitably intercept the space for the surgical operation, thereby hindering the operation. When the operator rotates the rigid scope around the direction of insertion into the body cavity to change the observational direction, in particular, the scope moves in an arc of a circle having a radius that is equal to the sum of the respective overall lengths of the eyepiece, TV camera, cables, etc., thus constituting a great hindrance to the operation. Depending on the observational direction, moreover, the TV camera and the light guide may interfere with the operator's hand or body, so that they may possibly lower the efficiency of the surgical operation.[0038]
BRIEF SUMMARY OF THE INVENTION
• The present invention has been contrived in consideration of these circumstances.[0039]
• An object of the present invention is to improve the efficiency of a surgical operation by simultaneously displaying a plurality of pieces of information required by an operator in the field of a microscope during microsurgery so that the operator can be fed with necessary information as required.[0040]
• Another object of the invention is to display a real-time observational image of second observational means effectively in association with an observational image of first observational means in the field of the first observational means in a microscope body.[0041]
• Still another object of the invention is to provide a surgical microscopic system designed so that an operator can easily grasp the progress of an surgical operation during the operation, whereby the operation can be carried out more securely and safely.[0042]
• A further object of the invention is to provide a surgical microscopic system designed so that necessary in-field information can be appropriately offered to an operator or his or her mate, and that a required microscopic field can be easily secured during a surgical operation.[0043]
• An additional object of the invention is to provide a surgical microscopic system designed so that an operator can be devoted to a surgical operation, his or her fatigue can be eased, and the operation time can be shortened.[0044]
• Furthermore, the invention is intended to improve a rigid scope that can be inserted into the body cavity under surgical microscopic observation, thereby enabling observation at a fixed angle to the direction of insertion, to prevent the rigid scope and a TV camera or light guides connected thereto from hindering the microscopic observation or surgical treatment, and to enable an operator to observe a desired position with ease.[0045]
• In order to achieve the above objects, according to an aspect of the invention, there is provided an operating microscope apparatus comprising: at least one microscope body defining an observational field for observing an affected region; first image display means for displaying a first image in the observational field; second image display means for displaying a second image in the observational field; and image display control means for displaying independent images on the first and second image display means, individually.[0046]
• The microscope body may include an optical image displayed in the observational field. In this case, the operating microscope apparatus may comprise second observational means different from an operating microscope and selected from a group including an endoscope and an ultrasonic probe. Further, the second image display means may include an image superposition optical system for superposing an image on the optical image in the observational field. Preferably, the image display control means includes means for independently switching on and off the first and second image display means.[0047]
• In the case where the operating microscope apparatus comprises second observational means different from an operating microscope and selected from a group including an endoscope and an ultrasonic probe, the first and second images preferably include (i) a combination of an observational image obtained by means of the second observational means and an image (navigation image) indicative of the observational position or direction of the second observational means or (ii) a combination of a tumor position display marker image and a preoperative/mid-operative diagnostic image selected from a group including image-processed fluorescent observational images and the image (navigation image) indicative of the observational position or direction of the second observational means.[0048]
• According to another aspect of the invention, there is provided a surgical observational system including first observational means for observing an affected region and second observational means different from the first observational means at least in the observational direction or observational method. This system comprises detecting means for detecting the respective observational positions and directions of the first and second observational means relative to the position of the affected region; and display means for displaying an observational image of the second observational means in a given part of an observational image of the first observational means in visual correlation based on the relative positions detected by means of the detecting means. According to this surgical observational system, the image of the second observational means is correlatively displayed in a part of the observational image of the first observational means. Thus, the respective observational positions of the first and second observational means are detected on the basis of the affected region by means of an optical position detector, for example. The observational image of a corresponding portion of the second observational means can be cut out into a given position of the observational image of the first observational means to adjust the image size for display.[0049]
• Alternatively, the surgical observational system may comprise detecting means for previously storing a preoperative diagnostic image and detecting the observational position of the second observational means relative to the preoperative diagnostic image; and display means for simultaneously displaying the preoperative diagnostic image concurrent with the observational position of the second observational means and the observational image of the second observational means in the field of the first observational means in accordance with the relative positions detected by means of the detecting means. In this case, the observational position of the second observational means is detected on the basis of the affected region by means of an optical position detector, for example. The observational image of the second observational means is displayed in the field of the observational image of the first observational means, and at the same time, a part of the preoperative diagnostic image corresponding to the observational position of the second observational means is displayed in the observational field of the first observational means.[0050]
• According to this surgical observational system, at least a part of the observational image of the second observational means is displayed in the observational field of the first observational means for the observation of the affected region in a manner such that its position, size, etc. are associated with those of the observational field of the first observational means. Accordingly, the states of dead angle portions and the inside of tissue that cannot be observed by means of the first observational means can be recognized easily and securely, so that the reliability and efficiency of the surgical operation can be improved considerably.[0051]
• On the other hand, the surgical observational system may comprise detecting means for detecting the respective observational positions and directions of the first and second observational means relative to the position of the affected region; an indicator indicative of an optional position in the observational field of the first observational means; and display means capable of following the indicator and displaying an observational image for a given range in the observational field of the first observational means by superposition. According to this surgical observational system, as in the case of the system described above, the image of the second observational means can be correlatively displayed in a part of the observational image of the first observational means. An operator can operate the indicator to set an optional position in the observational field of the first observational means. The observational image of the second observational means is displayed in a given range of the indicator after is cut out and subjected to size adjustment. Thus, the affected region in the peripheral portion and the observational image of the second observational means can be correlated with ease, and treatment can be carried out smoothly, so that the efficiency of the surgical operation can be improved.[0052]
• According to still another aspect of the invention, there is provided an operating microscope apparatus for subjecting an affected region to a surgical operation, comprising: a microscope body including a stereoscopic optical system and used to observe a desired region; position computing means for detecting the position of the observational region observed through the stereoscopic optical system and computing the positional relation between the observational region and a diagnostic image of the affected region; fluorescent shooting means for shooting fluorescent images of the observational region, thereby obtaining fluorescent observational images; and display means for displaying, by superposition, the diagnostic image corresponding to the position of the observational region detected. by means of the position computing means and the fluorescent observational images obtained by means of the fluorescent shooting means.[0053]
• This operating microscope apparatus may comprise storage means for storing the fluorescent observational images. In this case, the display means displays the diagnostic image corresponding to the observational position detected by means of the position computing means and the fluorescent observational images stored in the storage means, by superposition on the observational image of the affected region. Further, the operating microscope apparatus may comprise display mode setting means capable of setting an optional display mode. In this case, the display means displays the diagnostic image corresponding to the observational position detected by means of the position computing means and the fluorescent observational images stored in the storage means, by superposition on the observational image of the affected region, in accordance with the setup state of the display mode setting means.[0054]
• According to this operating microscope apparatus, the fluorescent observational images shot by means of the fluorescent shooting means and the diagnostic image selected according to the observational position detected by means of the position computing means are displayed by superposition, so that the operator can accurately recognize the conditions of a tumor to be extracted. Thus, the operator can carry out extraction more accurately and be devoted to the extracting operation. Further, only the tumor portion can be extracted securely, so that the object for minimally invasive surgery can be achieved.[0055]
• According to the present invention, moreover, there is provided an operating microscope apparatus for subjecting an affected region to a surgical operation, comprising: a microscope body including a stereoscopic optical system and used to observe a desired region; position computing means for detecting the position of the observational region observed through the stereoscopic optical system and computing the positional relation between the observational region and a diagnostic image of the affected region; fluorescent shooting means for stereoscopically shooting fluorescent images of the observational region, thereby obtaining fluorescent observational images; storage means for storing the fluorescent observational images; image dividing means for dividing the diagnostic image corresponding to the observational position detected by means of the position computing means into two image signals having a lateral parallax; and display means for displaying the individual stored fluorescent observational images and the laterally divided diagnostic images by superposition on the observational image of the affected region.[0056]
• Likewise, there is provided an operating microscope apparatus for subjecting an affected region to a surgical operation, comprising: a microscope body including a stereoscopic optical system and used to observe a desired region; position computing means for detecting the position of the observational region observed through the stereoscopic optical system and computing the positional relation between the observational region and a diagnostic image of the affected region; fluorescent shooting means for stereoscopically shooting fluorescent images of the microscopic observational region, thereby obtaining fluorescent observational images; storage means for storing the fluorescent observational images; display mode setting means capable of setting an optional display mode; image dividing means for dividing the diagnostic image corresponding to the observational position detected by means of the position computing means into two image signals having a lateral parallax; superposing means for superposing the individual stored fluorescent observational images and the laterally divided diagnostic images on the observational image of the affected region in accordance with the setup state of the display mode setting means; and a lens tube portion having a monitor portion for displaying the individual images.[0057]
• The fluorescent shooting means may be designed for stereoscopic shooting of the fluorescent images of the observational region. In this case, the operating microscope apparatus comprises image dividing means for dividing the diagnostic image corresponding to the observational position detected by means of the position computing means into two image signals having a lateral parallax. The display means can display the individual stored fluorescent observational images and the laterally divided diagnostic images by superposition on the observational image of the affected region.[0058]
• Further, the operating microscope apparatus may comprise a lens tube portion having a monitor portion for displaying the individual images.[0059]
• Furthermore, the display means may be designed to display, by superposition, the slice image corresponding to the observational position detected by means of the position computing means and the fluorescent observational images obtained by means of the fluorescent shooting means. This operating microscope apparatus may comprise display mode setting means capable of setting an optional display mode. In this case, the display means displays the slice image corresponding to the observational position detected by means of the position computing means and the fluorescent observational images stored in the storage means, by superposition on the observational image of the affected region, in accordance with the setup state of the display mode setting means.[0060]
• According to a further aspect of the invention, there is provided an operating microscope apparatus including a plurality of eyepiece units capable of relative movement and individually having fields capable of displaying one and the same region as a main image and in-field monitors provided individually for the eyepiece units and each adapted to project an index and/or a sub-image different from the main image on a part of the field, comprising: input means for applying observation conditions to one of the eyepiece units; and observational state changing means for changing the observational state of the other eyepiece unit according to the conditions. Thus, necessary in-field information can be appropriately offered to the operator or his or her mate, and a target microscopic field can be easily secured during a surgical operation.[0061]
• Preferably, the observational state changing means includes detecting means for detecting the position of the one eyepiece unit relative to the other eyepiece unit, an in-field display control means for controlling the display position of the in-field monitor of at least the one eyepiece unit to change the observational region in accordance with the result of detection by the detecting means, shielding means for selectively intercepting the optical image of the eyepiece units, and image rotating means for rotating the image of the in-field monitor in response to the output of the position detecting means. In this case, an optimum image display method can be provided even for a fixed-direction image, such as a preoperative image, and overlay display of the index by means of a position information detector and the operation of the detector can be carried out with ease. Further, the display method can secure a satisfactory degree of freedom for the operator and the mate.[0062]
• The sub-image may be a diagnostic image. Preferably, in this case, the operating microscope apparatus comprises index manipulating means for changing the in-field index position on the diagnostic image and a position information computing unit for computing the three-dimensional position of an actual affected region relative to the position of the index displayed by means of the index manipulating means, and the position information computing unit and the in-field display control means drive the observational region of the operating microscope to the three-dimensional position.[0063]
• Preferably, the operating microscope apparatus further comprises an image processing unit for image map conversion, adapted synchronously to rotate the image of the in-field monitor and the shielding means formed of the liquid crystal device in response to the output of the relative position detecting means.[0064]
• According to an additional aspect of the invention, there is provided an operating microscope comprising: a first observational optical system for optically enlarging an affected region; a second observational optical system for observing optional image information from an external apparatus; and an eyepiece optical system for simultaneously observing observational images of the first and second observational optical systems, the second optical system including display state changing means capable of changing the display state of the image information from the external apparatus in accordance with operation information from the external apparatus. The first and second observational optical systems are different from each other.[0065]
• According to this operating microscope, if the operating state of the external apparatus is changed when the observational images of the first and second observational optical systems are simultaneously displayed, the image observed by means of the second observational means is automatically changed into a suitable state for a surgical operation. A small endoscopic image is displayed when an endoscope is moved in the affected region, for example. The displayed endoscopic image is large enough when it is watched as treatment or the like is carried out. Thus, according to this operating microscope, the display state of the display image in the microscopic field can be automatically changed in accordance with the operating state of the external apparatus, so that the operator can be devoted to the surgical operation, his or her fatigue can be eased, and the operation time can be shortened. This microscope is particularly serviceable if it is used with an ultrasonic observer for obtaining a slice image of the inside of tissue or a so-called nerve monitor device for measuring the potential of nerves of a patient under the operation, as well as the endoscope for observing regions that are inaccessible to the operating microscope.[0066]
• Further, there is provided an operating microscope comprising: a first observational optical system for enlarged-scale optical observation of an affected region; a second observational optical system for observing optional image information from an external apparatus, the second observational optical system being different from the first observational optical system, and an eyepiece optical system for simultaneously observing observational images of the first and second observational optical systems. The second optical system includes fixed-view image display means for an observer's close observation, an index projection optical system for the eyeground, and an image receiving optical system for receiving reflected light from the eyeground. The operating microscope further comprises detecting means for computing refractive force in accordance with information from the image receiving optical system and visibility adjustment drive control means for driving a visibility adjustment mechanism in accordance with information from the detecting means. According to this operating microscope, the sight or refractive force of an observing eye is measured through the second observational optical system. Based on this refractive force, the visibility adjustment drive control means automatically carries out visibility adjustment. Thus, the operating microscope can be reduced in size without lowering its observational performance, and the operator can concentrate his or her attention on the operation without fatigue.[0067]
• The display state changing means may include operation input portion for inputting the operation information from the external apparatus, optical changing means capable of optically changing the display state of the image information of the second observational optical system compared to the observational image of the first observational optical system, and control means for actuating the optical changing means in accordance with input information from the operation input portion. Preferably, the optical changing means includes magnification changing means capable of changing the magnification of the second observational optical system. According to this operating microscope, the size of each endoscopic image in the microscopic field can be changed in accordance with the movement and observational state of the endoscope. Thus, when the endoscope is moved, a small endoscopic image is displayed such that the distal end of the endoscope can be satisfactorily observed through the microscope. During endoscopic observation, on the other hand, a large image is displayed to facilitate treatment. If a squint-type endoscope for observation in directions different from the direction of insertion is used and rotated around the direction of insertion to observe regions corresponding to dead angles of the microscope, therefore, the observational direction of the endoscope compared to the microscopic field can be identified with ease.[0068]
• Preferably, the optical changing means includes magnification changing means capable of changing the magnification of the second observational optical system or display position changing means capable of changing the position of the second observational optical system relative to the first observational optical system. The magnification changing means may be lens moving means for moving a variable-magnification optical system constituting the second observational optical system. Thus, there is provided an operating microscope in which the observational direction of an endoscope compared to the microscopic image can be recognized with ease.[0069]
• The display position changing means may include rotating means for rotating the second observational means around the optical axis of the first observational means. Even when the operator is concentrating his or her attention on the observational image of the operating microscope, in this case, s/he can readily notice a change in the nerve monitor device. Thus, the operator can be devoted to the surgical operation, and his or her fatigue can be eased.[0070]
• 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.[0071]
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.[0072]
• FIG. 1 is a view showing an outline of an operating microscope for use as first observational means of a surgical observational system according to a first embodiment;[0073]
• FIG. 2 is a block diagram of the surgical observational system according to the first embodiment;[0074]
• FIG. 3 is a detailed view for illustrating a microscope body portion of the operating microscope;[0075]
• FIGS. 4A and 4B are views showing a state in which the whole surface of a first liquid crystal shutter is transmittable and a state in which a partial shading portion is provided in the shutter, respectively;[0076]
• FIGS. 5A and 5B are views showing a state in which the whole surface of a second liquid crystal shutter is interceptive and a state in which a partial transparent portion is provided in the shutter, respectively;[0077]
• FIGS. 6A and 6B are views individually showing images observed by an operator, in which FIG. 6A shows only an optical image obtained when the whole surface of the first liquid crystal shutter is transmittable, and FIG. 6B shows a state in which an image obtained by means of an ultrasonic probe is displayed in a microscopic field;[0078]
• FIG. 7A is a view showing an image obtained by means of the ultrasonic probe and displayed on a monitor;[0079]
• FIG. 7B is a view showing a state in which the image obtained by means of the ultrasonic probe is reduced to a given size;[0080]
• FIG. 8 is a block diagram of a surgical observational system according to a second embodiment;[0081]
• FIG. 9 is a detailed view for illustrating a microscope body portion of an operating microscope;[0082]
• FIGS. 10A to[0083]10C are views individually showing various states of an image in the microscopic field observed by the operator, in which FIG. 10A shows an ultrasonic image obtained by means of the ultrasonic probe, FIG. 10B shows a preoperative diagnostic image, and FIG. 10C shows the preoperative diagnostic image and the ultrasonic diagnostic image in association with an actual affected region;
• FIGS. 11A and 11B are views individually showing observational images according to the second embodiment, in which FIG. 11A shows the ultrasonic probe having its central portion extracted by means of a mixer, and FIG. 11B shows an image actually observed by the operator;[0084]
• FIG. 12 is a general block diagram of a surgical observational system according to a third embodiment;[0085]
• FIG. 13 is a view showing the way an observational image of a rigid scope for use as second observational means according to the third embodiment is displayed on a monitor;[0086]
• FIGS. 14A to[0087]14F illustrate the respective operations of first and second liquid crystal shutters according to the third embodiment, in which FIGS. 14A and 14B are views showing the relation between a shading portion and a transparent portion, FIG. 14C is a view showing a state of display on a monitor, and FIGS. 14D to14F are views similar to FIGS. 14A to14C, showing the shading portion and the transparent portion shifted in position;
• FIGS. 15A to[0088]15D show images observed by the operator according to the third embodiment and illustrate various positional relations between the image obtained by means of the rigid scope and an optical image obtained by means of the microscope;
• FIG. 16 is a view showing a configuration of an operating microscope according to a fourth embodiment of the invention;[0089]
• FIG. 17 is a view showing a configuration of an illumination system of the operating microscope;[0090]
• FIG. 18 is a view showing a configuration of an observational optical system of the operating microscope;[0091]
• FIG. 19 is a general functional block diagram of the operating microscope;[0092]
• FIG. 20 is a chart for illustrating the operation of the invention;[0093]
• FIG. 21 is a view for illustrating the way of synthesizing a fluorescent observational image and a two-dimensional preoperative slice image;[0094]
• FIG. 22 is a view showing a configuration of an observational optical system according to a fifth embodiment of the invention;[0095]
• FIG. 23 is a general functional block diagram of an operating microscope;[0096]
• FIG. 24 is a general functional block diagram of an operating microscope according to a sixth embodiment of the invention;[0097]
• FIG. 25 is a three-dimensional exterior view of a tumor;[0098]
• FIG. 26 is a view for illustrating the effect of the sixth embodiment of the invention;[0099]
• FIG. 27 is a side view showing the general external appearance of an operating microscope apparatus according to a seventh embodiment of the invention;[0100]
• FIG. 28 is a side view showing a configuration of a microscope body of the operating microscope apparatus according to the seventh embodiment;[0101]
• FIG. 29 is a schematic view of an optical system of the operating microscope apparatus according to the seventh embodiment;[0102]
• FIG. 30 is a block diagram of an electric circuit of the operating microscope apparatus according to the seventh embodiment;[0103]
• FIG. 31A is a plan view showing a state in which a mask portion is inserted in a microscopic image of an operator-side optical system of the operating microscope apparatus according to the seventh embodiment;[0104]
• FIG. 31B is a plan view showing plan view showing a state in which an endoscopic image is partially displayed on an in-field image;[0105]
• FIGS. 31C and 31D are plan views showing images obtained by rotating the images of FIGS. 31A and 31B, respectively;[0106]
• FIGS. 32A and 32B show in-field images in a state such that endoscopic images are inserted individually in operator- and mate-side microscopic images of the operating microscope apparatus according to the seventh embodiment;[0107]
• FIGS. 33A and 33B are plan views showing operatorand mate-use microscopic images, respectively, in the operating microscope apparatus according to the seventh embodiment;[0108]
• FIGS. 34A and 34B are plan views showing a mask image and a in-field display image, respectively, obtained when an index is overlaid on each microscopic image in the operating microscope apparatus according to the seventh embodiment;[0109]
• FIGS. 35A and 35B are plan views showing indexes superposed individually on the operator- and mate-use microscopic images, respectively, in the operating microscope apparatus according to the seventh embodiment;[0110]
• FIG. 36 is a schematic view of a mate-side optical system of an operating microscope apparatus according to an eighth embodiment of the invention;[0111]
• FIG. 37 is a plan view showing an outline of a drive mechanism for a microscopic image mask LCD of the operating microscope apparatus according to the eighth embodiment;[0112]
• FIG. 38A is a plan view showing an outline of a drive mechanism for a microscopic image mask LCD of an operating microscope apparatus according to a ninth embodiment of the invention;[0113]
• FIG. 38B is a plan view showing an outline of a drive mechanism for a microscopic image mask LCD of an operating microscope apparatus according to a tenth embodiment of the invention;[0114]
• FIG. 39 is a general schematic view of an operating microscope apparatus according to an eleventh embodiment of the invention;[0115]
• FIG. 40A is a plan view showing a microscopic image in an operating microscope apparatus according to the eleventh embodiment;[0116]
• FIG. 40B is a perspective view showing an index/in-field display controller;[0117]
• FIG. 41A is a plan view showing a state in which a microscopic image mask as large as an in-field display image is displayed on a microscopic image mask LCD of the operating microscope apparatus according to the eleventh embodiment;[0118]
• FIG. 41B is a plan view showing a state in which an index and a marker are displayed on the in-field display image;[0119]
• FIG. 42A is a plan view showing a microscopic image in the operating microscope apparatus according to the eleventh embodiment;[0120]
• FIG. 42B is a plan view showing a state in which an index and a marker are displayed on the microscopic image by superposition;[0121]
• FIG. 43 is a view schematically showing an outline of an operating microscope and an endoscopic apparatus according to a twelfth embodiment;[0122]
• FIG. 44 is a schematic view showing an endoscopic system along with a scope holder for supporting an endoscope shown in FIG. 43;[0123]
• FIG. 45 is a view showing an outline of a binocular tube of the operating microscope of FIG. 43;[0124]
• FIG. 46 is a view showing an observational state of the operating microscope for the case where an endoscopic image is mainly observed as a surgical operation is carried out;[0125]
• FIG. 47 is a view similar to FIG. 46, showing an observational state of the operating microscope for the case where the observational position of the endoscope is moved;[0126]
• FIG. 48 is a view similar to FIG. 43, schematically showing an outline of an operating microscope and an endoscopic system according to a thirteenth embodiment;[0127]
• FIG. 49 is a view showing an outline of a binocular tube of the operating microscope of FIG. 48;[0128]
• FIGS. 50A and 50B are views individually showing states of observation through an eyepiece optical system of the binocular tube shown in FIG. 49;[0129]
• FIG. 51 is a view illustrating a binocular tube optical system of an operating microscope according to a fourteenth embodiment;[0130]
• FIG. 52 is a view showing an outline of a in-field display controller of an operating microscope according to a fifteenth embodiment;[0131]
• FIGS. 53A and 53B are views individually showing display states in the field of an operating microscope according to a sixteenth embodiment;[0132]
• FIG. 54 is a general view of a surgical system using a rigid scope in combination with an operating microscope according to a seventeenth embodiment;[0133]
• FIG. 55 is a detailed sectional view showing the construction of the rigid scope shown in FIG. 54;[0134]
• FIG. 56 is a general view of a surgical system using a rigid scope in combination with an operating microscope according to an eighteenth embodiment;[0135]
• FIG. 57 is a detailed sectional view showing the construction of the rigid scope shown in FIG. 56;[0136]
• FIG. 58 is a view showing the configuration of the upper surface portion of a coupling portion of the rigid scope shown in FIG. 54;[0137]
• FIG. 59 is a general view of a surgical system using a rigid scope in combination with an operating microscope according to a ninth embodiment;[0138]
• FIG. 60 is a detailed sectional view showing the construction of the rigid scope shown in FIG. 59;[0139]
• FIG. 61 is a view taken in the direction of arrow X of FIG. 60;[0140]
• FIG. 62 is a perspective view of an endoscopic surgical system according to a twentieth embodiment of the invention;[0141]
• FIG. 63 is a sectional view of an instrument constituting the endoscopic surgical system of FIG. 62;[0142]
• FIG. 64 is a conceptual diagram for illustrating wire-type transmission means of the instrument;[0143]
• FIG. 65 is a perspective view showing a first operation mode of the endoscopic surgical system of FIG. 62;[0144]
• FIG. 66 is a perspective view showing a second operation mode of the endoscopic surgical system of FIG. 62;[0145]
• FIG. 67 is a perspective view showing a modification of the endoscopic surgical system of FIG. 62;[0146]
• FIG. 68 is a perspective view of an endoscopic surgical system according to a twenty-first embodiment of the invention;[0147]
• FIG. 69 is a sectional view of an instrument connecting member of the endoscopic surgical system of FIG. 68;[0148]
• FIG. 70 is a block diagram of an electric control system for the endoscopic surgical system of FIG. 68;[0149]
• FIG. 71 is a perspective view of an endoscopic surgical system according to a twenty-second embodiment of the invention;[0150]
• FIGS. 72 and 73 are views showing a prior art endoscopic surgical system;[0151]
• FIG. 74 is a schematic view showing a configuration of the principal part of a conventional operating microscope apparatus; and[0152]
• FIGS. 75A and 75B are plan views individually showing in-field images displayed in operator and mate eyepiece units, respectively, of an operating microscope of the conventional operating microscope apparatus.[0153]
DETAILED DESCRIPTION OF THE INVENTIONFIRST EMBODIMENT
• A first embodiment of the present invention will now be described in detail with reference to the accompanying drawings.[0154]
• FIG. 1 shows an outline of an operating microscope for use as first observational means of a surgical observational system according to the present embodiment. FIG. 2 is a block diagram according to the present embodiment, and FIG. 3 shows a microscope body portion of the operating microscope in detail. Further, FIGS. 4A, 4B,[0155]5A and5B show the respective operations of first and second liquid crystal shutters, and FIGS. 6A and 6B individually show images observed by an operator. FIGS. 7A and 7B show an example of a display image onmonitors40 and14.
• The surgical observational system according to the first embodiment will be described first.[0156]
• The operating microscope of the surgical observational system according to the present embodiment is provided with a[0157]stand21, which includes a base21amovable on a floor surface and asupport post21bset up on the base21a.One end of afirst arm22, which has a light source for illumination (not shown) therein, is mounted on the upper end portion of thepost21bso as to be rotatable around an axis Oa.
• One end of a[0158]second arm23 is attached to the other end of thefirst arm22, which is distant from thesupport post21b,so as to be rotatable around an axis Ob. Thesecond arm23 is a pantograph arm that is formed of a link mechanism and a balancing gas spring. The other end of thearm23 that is off thefirst arm22 can be moved vertically. Athird arm24 is attached to the other end of thesecond arm23 so as to be rotatable around an axis Oc. Further, thethird arm24 is provided with aswing arm25 that enables amicroscope body1 to swing in the anteroposterior direction along the direction of the operator's observation around an axis Od and swing in the lateral direction of the operator's body around an axis Oe. Themicroscope body1, anobservational portion2, and ahandle26 are mounted on the distal end portion of thearm25.
• In order to allow the[0159]microscope body1 to be freely positioned in a three-dimensional space, moreover, each of the individual rocking portions that are rotatable around the axes Oa to Oe is provided with a electromagnetic brake. Each rocking portion can be locked and unlocked by means of a switch (not shown) that is provided on thehandle26. Preferably, a power source unit for the electromagnetic brakes should be incorporated in thesupport post21b.
• As shown in FIG. 2, the[0160]microscope body1 is situated over an affected region P which is a portion or an area to be operated, and anindex3 for optical position detection is attached to a predetermined face of themicroscope body1. Theindex3 is fitted with a plurality of infrared LED's of the time-sharing emission type, which will not be described in detail.
• Although the[0161]microscope body1 has therein two observational optical systems for supplying luminous fluxes individually to the two eyes of the operator, only one of them will be described for simplicity.
• As shown in FIG. 3, an observational[0162]optical system10 is composed of anobjective lens4,first imaging lens6,lens7,second imaging lens8, andeyepiece9, which are arranged successively from the side of the affected region P. A half-mirror11 is interposed between thelenses7 and8 of theoptical system10. The half-mirror11 is oriented so that it can reflect a luminous flux from a direction perpendicular to the optical axis of the observationaloptical system10 toward theeyepiece9. A projectionoptical system15 is composed of alens12,third imaging lens13, and monitor14, which are arranged successively on an optical axis that extends at right angles to the optical axis of theoptical system10.
• Further, a first[0163]liquid crystal shutter16 is located on the imaging point of thefirst imaging lens6 of the observationaloptical system10, and a secondliquid crystal shutter17 on the imaging point of thethird imaging lens13 of the projectionoptical system15.
• As previously described with reference to FIG. 2, the[0164]microscope body1 is fitted with theindex3 for optical position detection. An optical position detecting member30 (hereinafter referred to as digitizer30) is provided in a required position in an operating room where it can shoot theindex3.
• The[0165]digitizer30 includes a plurality of infrared cameras, which are mounted at given spaces. Thedigitizer30 is connected to aposition detector31. Thedetector31 is connected to acomputing unit32, which is connected with amixer33 and aliquid crystal driver34. Further, theunit32 is connected with input means35 and afootswitch36. Theswitch36 is provided with an image on-off switch (not shown).
• As shown in FIG. 3, the[0166]liquid crystal driver34 is connected to the first and secondliquid crystal shutters16 and17 in themicroscope body1. Themixer33 is connected to themonitor14 in themicroscope body1.
• In FIG. 2, numeral[0167]37 denotes an ultrasonic probe that is inserted in the affected region P. Theprobe37 is fitted with anindex38 that resembles the one on themicroscope body1. Theindex38 is also fitted with a plurality of infrared LED'S of the time-sharing emission type, which will not be described in detail. However, the time-sharing emission patterns of the infrared LED's that are attached to theindex38 are different from those of the ones attached to theindex3. Theposition detector31 can detect the respective positions of the patterns separately.
• The[0168]ultrasonic probe37 is connected to anultrasonic observer39. A video output (not shown) from theobserver39 is connected to themonitor40 and themixer33.
• Referring now to FIGS.[0169]1 to7B, there will be described the operation of the surgical observational system according to the first embodiment.
• A luminous flux emitted from the light source (not shown) in the[0170]first arm22 is applied to the affected region P of a patient's body through an optical fiber (not shown) and an illumination optical system (not shown). As shown in FIG. 3, the luminous flux reflected by the affected region P lands on theobjective lens4 of themicroscope body1, is focused through thefirst imaging lens6, firstliquid crystal shutter16,lens7, half-mirror11, andsecond imaging lens8, and is subjected to enlarged-scale observation through theeyepiece9 by the operator. In this state, the whole surface of the firstliquid crystal shutter16 is transmittable, as shown in FIG. 4A. FIG. 6A shows the image that is observed by the operator in this state. This process will be mentioned later.
• On the other hand, the[0171]ultrasonic probe37 to be inserted into the affected region P may be formed of a conventional ultrasonic probe that emits an ultrasound from a rotating portion (not shown) on its distal end. The ultrasound reflected by the affected region P is received by a sensor (not shown), and a signal from the sensor is transmitted to theultrasonic observer39. Theobserver39 analyzes the signal from theultrasonic probe37 and generates an image-processed video signal that is indicative of the internal structure of the tissue in accordance with the attenuation or phase of the ultrasound based on the rotational angle of the rotating portion (not shown). Then, the video signal is delivered to themonitor40 to be displayed thereon. FIG. 7A shows the image then displayed on themonitor40. The same video signal that is delivered to themonitor40 is also delivered to themixer33.
• Further, the[0172]index3 that is attached to themicroscope body1 causes the infrared LED's (not shown) to glow in a given time-sharing pattern. Likewise, theindex38 that is attached to theultrasonic probe37 causes the infrared LED's (not shown) to glow in a time-sharing pattern different from the pattern for theindex3.
• The respective states of light emission of the[0173]indexes3 and38 are-shot by means of the infrared cameras (not shown) of thedigitizer30. The information obtained by means of thedigitizer30 is analyzed by means of theposition detector31, whereupon the respective positions and attitudes of themicroscope body1 and theultrasonic probe37 in the three-dimensional space are detected. A conventional suitable technique can be used for this optical position detection system.
• Since the affected region P is also positioned in the three-dimensional space, moreover, the[0174]position detector31 can detect the relative positions of the affected region P, microscope body1 (observational position of the operating microscope), and ultrasonic probe37 (plane for ultrasonic observation).
• As shown in FIG. 2, the position information detected by means of the[0175]position detector31 is delivered to thecomputing unit32.
• If the image on-off switch (not shown) of the[0176]footswitch36 is then off, thecomputing unit32 delivers an image-off signal to themixer33 and theliquid crystal driver34. Themixer33 outputs no image when it receives the image-off signal from thecomputing unit32. Therefore, no image is displayed on themonitor14 that is connected to themixer33. On receiving the image-off signal from thecomputing unit32, moreover, theliquid crystal driver34 delivers given outputs to the first and secondliquid crystal shutters16 and17. Thereupon, the whole surface of the firstliquid crystal shutter16 becomes transmittable, as shown in FIG. 4A. Further, the secondliquid crystal shutter17 is rendered entirely interceptive, as shown in FIG. 5A. Thus, the operator can obtain no image from themonitor1, only observing the optical image of the affected region P. FIG. 6A shows this state of observation.
• If the operator then turns on the image on-off switch of the[0177]footswitch36, an image-on signal is delivered to thecomputing unit32. In this state, thecomputing unit32 computes the position of the distal end of theultrasonic probe37 in the field of observation of the operating microscope on the basis of the detected information from theposition detector31. Further, the respective positions of themonitor14 and the first and secondliquid crystal shutters16 and17 corresponding to the distal end position are computed.
• Then, the[0178]computing unit32 calculates a signal from the input means35 and settles the size of an image in the microscopic field. The operator can freely change the image size by operating the input means35.
• Based on the result of the aforesaid computation and the signal from the input means[0179]35, thecomputing unit32 delivers a control signal to themixer33. Themixer33 converts the output image of theultrasonic observer39 into an image that has its center in a position corresponding to the distal end position of theultrasonic probe37 of themonitor14, and further generates an image signal of a reduced size set by means of the input means35. FIG. 7B shows this image signal.
• Then, the[0180]computing unit32 delivers a control signal to theliquid crystal driver34. Thedriver34 generates, on the first and secondliquid crystal shutters16 and17, a shielding portion41 (first liquid crystal shutter16) and a transparent portion42 (second liquid crystal shutter17) that have positions and sizes corresponding to the range of the reduced image that is generated by means of themixer33. This state is shown in FIG. 4B (for the first liquid crystal shutter16) and FIG. 5B (for the second liquid crystal shutter17).
• In this arrangement, only that portion of the optical observational image from the[0181]objective lens4 which corresponds to the shieldingportion41 is intercepted by means of the firstliquid crystal shutter16, and only the reduced image portion of themonitor14 is transmitted to the side of the half-mirror11 through thetransparent portion42 of the secondliquid crystal shutter17.
• Thus, the operator can observe superposed ultrasonic images on the[0182]monitor14 in a predetermined range centering around the distal end of theultrasonic probe37, among other microscopic images. If the operator moves theprobe37 within the microscopic field, the ultrasonic images also move correspondingly in the field. FIG. 6B shows this state of observation.
• If the operator operates again the image on-off switch (not shown) of the[0183]footswitch36, the ultrasonic images disappear in a moment, and the state of observation shown in FIG. 6A is restored.
• Thus, the surgical observational system according to the first embodiment can produce the following effects.[0184]
• According to the first embodiment, the operator can observe the optical observational image and ultrasonic diagnostic images in a superposed manner, and the optical observational image is superposed only partially. Therefore, the diagnostic images and the affected region can be easily correlated, and transfer to each treatment can be effected smoothly. Since the images follow the ultrasonic probe, moreover, the operator can observe a desired region without delay. In consequence, the operation time can be shortened, and the operator's fatigue can be eased.[0185]
SECOND EMBODIMENT
• A second embodiment of the present invention will now be described with reference to FIGS.[0186]8 to10C. In these drawings, like reference numerals refer to the same portions of the first embodiment, and a description of those portions is omitted.
• FIG. 8 is a block diagram according to the present embodiment, FIG. 9 shows the body of the operating microscope in detail, and FIGS. 10A to[0187]10C individually show varied states of images the operator observes.
• A surgical observational system according to the second embodiment will be described first.[0188]
• In the second embodiment, as shown in FIG. 9, a variable-scale[0189]optical system50 is interposed between anobjective lens4 and afirst imaging lens6 of amicroscope body1. A lens drive section (not shown) of theoptical system50 is provided with a sensor (not shown), which is connected to magnification detectingmeans56. As shown in FIG. 8, the detectingmeans56 is connected to acomputing unit55.
• A changeover switch (not shown) of a[0190]footswitch57, which is connected to thecomputing unit55, is connected to aposition detector54. As in the case of the first embodiment, the output of adigitizer30 is connected to theposition detector54. Theposition detector54 includes an image forming section (not shown), the image output of which is connected to amonitor53 in themicroscope body1. Afourth imaging lens52 and amirror51 are arranged successively on the emission side of themonitor53. The imaging position of thefourth imaging lens52 is substantially aligned with the reflective surface of themirror51 and the imaging plane of asecond imaging lens8. Accordingly, the operator can simultaneously observe, through aneyepiece9, a microscopic optical image formed by means of thefirst imaging lens6 and an image on themonitor53 formed by means of thefourth imaging lens52.
• The following is a description of the operation of the surgical observational system according to the second embodiment.[0191]
• As in the case of the first embodiment, the[0192]position detector54 can detect the respective positions of the point of microscope observation and the distal end of anultrasonic probe37 relative to the affected region P. Further, thedetector54 stores preoperative diagnostic images (e.g., slice images of an X-ray CT apparatus; normally, slice images in a given direction and a three-dimensional CG image constructed by joining the slice images) in its storage section (not shown). In starting observation of the ultrasonic images in the microscopic field, the operator turns on an image on-off switch (not shown) of thefootswitch57. As this is done, a signal from the sensor (not shown) of the variable-scaleoptical system50 is transmitted to themagnification detecting means56. The detecting means56 calculates the observation magnification of the microscope and delivers it to thecomputing unit55.
• Based on data from the[0193]magnification detecting means56, thecomputing unit55 sets the display size of an ultrasonic image to be projected in the microscopic field. FIG. 10A shows the state of the image the operator then observes.
• If the operator operates the changeover switch (not shown) of the[0194]footswitch57 in this state, moreover, theposition detector54 reads a preoperative diagnostic slice image corresponding to the position of the distal end portion of theultrasonic probe37 from the storage section (not shown). Then, thedetector54 superposes a marker on a region where theultrasonic probe37 is situated, and delivers the resulting image to themonitor53. As this is done, themirror51 moves from an evacuation position (not shown) to an observational position shown in FIG. 9, whereupon the operator can observe the image on themonitor53 along with a microscopic image through themirror51.
• When the operator depresses the changeover switch (not shown) once, a preoperative diagnostic slice image, such as the one shown in FIG. 10B, is displayed. In this state, the operator can observe the actual affected region and the ultrasonic diagnostic image in association with the preoperative diagnostic slice image (with the display of the ultrasonic probe position).[0195]
• If the operator depresses the changeover switch once again, the[0196]position detector54 reads the three-dimensional image of the affected region P from the storage section (not shown), and carries out rotation processing (image processing) of the three-dimensional image so that the image is aligned with the direction of actual insertion of theultrasonic probe37 into the affected region. Then, thedetector54 superposes the marker on the region and along the direction in which theprobe37 is situated, and delivers the resulting image to themonitor53. FIG. 10C shows the image the operator then observes. In this state, the operator can observe the actual affected region and the ultrasonic diagnostic image in association with the three-dimensional preoperative diagnostic image (with the display of the ultrasonic probe position and direction).
• If the operator depresses the changeover switch once again, the[0197]mirror51 moves to the aforesaid evacuation position (not shown), whereupon the operator can observes the image shown in FIG. 10A.
• The surgical observational system according to the second embodiment can produce the following effects.[0198]
• According to the second embodiment, which enjoys the same effects of the first embodiment, the display size of the ultrasonic image can be set automatically according to the observation magnification of the operating microscope. Therefore, the operator can be saved the trouble of setting the image size, so that the efficiency of surgical operations can be improved. Further, the operator can observe the preoperative diagnostic image simultaneously with the optical observational image and ultrasonic diagnostic image. Accordingly, the approximate position of the whole patient's body in the position for ultrasonic observation can be recognized with ease. Besides, the deviation between the actual affected region and the preoperative diagnostic image, which is attributable to change of the intracranial pressure after craniotomy or exclusion of tissue, can be recognized easily. Thus, accurate surgical operations can be carried out, and the results of operations can be improved.[0199]
• Although the ultrasonic diagnostic image is displayed substantially in a circular form on the[0200]monitor14 according to the second embodiment, its shape may be changed in the following manner.
• In the case of an ultrasonic probe of the same radial-scan type (in which the periphery of the probe is scanned in a circle) as in the foregoing embodiment, as shown in FIG. 11A, the central portion of the[0201]ultrasonic probe37 may be extracted by means of themixer33 as it is displayed. The range of extraction is restricted to a radius that ranges from the distal end of the ultrasonic probe to the inner wall of the tissue of the affected region that is located closest to the probe. This range can be settled by analyzing the ultrasonic image or by means of an optical position detector. FIG. 11B shows an actual image then observed by the operator.
• According to this arrangement, a microscopic optical image is displayed in a range without any object of diagnosis, extending from the ultrasonic probe to the inner wall of the tissue of the affected region, and the region to be diagnosed can be displayed securely. Accordingly, the diagnosis can be carried out in the same manner as in the second embodiment, and the distal end of the ultrasonic probe never fails to be recognized on the optical observational image. Thus, the operator can move the ultrasonic probe without switching off the display of the ultrasonic image, so that the efficiency of surgical operations can be improved.[0202]
THIRD EMBODIMENT
• A third embodiment of the present invention will now be described with reference to FIGS.[0203]12 to15D. In these drawings, like reference numerals refer to the same portions of the first and second embodiments, and a description of those portions is omitted.
• FIG. 12 is a general block diagram illustrating the present embodiment, and FIG. 13 shows an observational image of a rigid scope for use as second observational means according to the present embodiment. FIGS. 14A to[0204]14F illustrate the respective operations of first and second liquid crystal shutters according to the present embodiment, and FIGS. 15A to15D show images observed by the operator according to the present embodiment.
• A surgical observational system according to the third embodiment will be described first.[0205]
• [0206]Numeral1 denotes a body of an operating microscope that resembles the one according to the first embodiment. Themicroscope body1, like the one according to the first embodiment, is fitted with anindex3. As in the case of the second embodiment, a variable-scale optical system (not shown) of themicroscope body1 is provided with a sensor (not shown), which is connected to magnification detectingmeans56. As in the cases of the first and second embodiments, moreover, themicroscope body1 is provided with first and second liquid crystal shutters (not shown), which are connected to aliquid crystal driver34. Themicroscope body1 is provided with a monitor (not shown) that resembles the one according to the first embodiment. The monitor is connected to amixer33. Thus, the optical system in themicroscope body1 of the present embodiment is constructed substantially in the same manner as the one according to the first embodiment.
• [0207]Numeral90 denotes a 90°-squint rigid scope for use as second observational means according to the present embodiment. Therigid scope90 is connected with one end of alight guide91, the other end of which is connected to alight source92. Therigid scope90 is fitted with acamera head93 for picking up its observational image. Thecamera head93 is connected to a camera control unit94 (hereinafter referred to simply as CCU94). A first video output section (not shown) of theCCU94 is connected to amonitor95. A second video output section (not shown) of theCCU94 is connected to themixer33. Further, anindex96 for position detection is attached to given position on thecamera head93.
• A[0208]digitizer30 is located in a position such that it can shoot both theindexes3 and96 that are attached to themicroscope body1 and thecamera head93, respectively. Thedigitizer30 is connected to aposition detector31. Thedetector31 is connected to acomputing unit97. Further, themagnification detecting means56 and afootswitch81 are connected to thecomputing unit97.
• Furthermore, the[0209]computing unit97 is connected to themixer33 and theliquid crystal driver34.
• The following is a description of the operation of the third embodiment.[0210]
• As in the case of the first embodiment, the operator subjects the affected region P to enlarged-scale stereoscopic optical observation by using the[0211]microscope body1. Further, the operator uses therigid scope90 to observe outside portions as viewed through themicroscope body1 for the optical observation. More specifically, a luminous flux for observation emitted from thelight source92 is landed on thelight guide91. Thelight guide91 transmits the incident luminous flux to therigid scope90 that is connected to the other end thereof. This luminous flux is applied to the affected region P through an illumination optical system (not shown) in therigid scope90. The luminous flux reflected by the affected region P is landed on an objective lens (not shown) of therigid scope90 and focused on an image-pickup device (not shown) of thecamera head93 that is connected to the rear end of thescope90. Thecamera head93 converts the luminous flux, focused on the image-pickup device, into an electrical signal, and delivers it to theCCU94. TheCCU94 converts the electrical signal into a standardized video signal, and delivers it through its first and second video output sections (not shown).
• Thus, the image shot by means of the[0212]rigid scope90 is displayed on themonitor95 that is connected to the first video output section of theCCU94, as shown in FIG. 13. The same video signal is delivered from the second video output section of theCCU94 to themixer33 in like manner.
• Infrared cameras (not shown) of the[0213]digitizer30 are used to shoot infrared LED's (not shown) of theindexes3 and96 that are attached to themicroscope body1 and thecamera head93 of therigid scope90, respectively. As in the case of the first embodiment, the information obtained by means of thedigitizer30 is analyzed by means of theposition detector31, whereupon the respective positions and attitudes of themicroscope body1 and therigid scope90 in the three-dimensional space are detected. Since the affected region P is also positioned in the three-dimensional space, moreover, theposition detector31 can detect the position of the affected region P relatively to the respective observational positions and directions of themicroscope body1 and therigid scope90.
• The position information detected by means of the[0214]position detector31 is delivered to thecomputing unit97.
• FIG. 15A shows an image then observed by the operator. The operator observes only an optical image that is obtained by means of the[0215]body1 of the operating microscope. In this state, the first liquid crystal shutter (not shown) in themicroscope body1 is fully transmittable, while the second liquid crystal shutter (not shown) is entirely interceptive. An image then obtained by means of therigid scope90 is displayed on themonitor95.
• In starting observation of the image obtained by means of the[0216]rigid scope90 in the microscopic field, the operator turns on an image on-off switch (not shown) of thefootswitch81. The resulting signal is transmitted to thecomputing unit97. On receiving an image-on signal from thefootswitch81, thecomputing unit97 first carries out computation to display the image in a given position in the microscopic field (upper left portion of the microscopic field according to the present embodiment) and delivers command signals to theliquid crystal driver34 and themixer33. More specifically, a signal is delivered to theliquid crystal driver34 such that it controls the first and second liquid crystal shutters for the states shown in FIGS. 14A and 14B, respectively. Further, a signal is delivered to themixer33 such that the video signal from theCCU94 is reduced at a suitable scale factor computed on the basis of a signal from themagnification detecting means56 and that the image is moved to a region corresponding to a shielding portion of the second liquid crystal shutter and displayed on the monitor (not shown) in themicroscope body1 in the manner shown in FIG. 14C. FIG. 15B shows the state of the image then observed by the operator. In this state, the operator roughly positions therigid scope90 while comparing the distal end of therigid scope90 and the affected region.
• Then, in displaying the microscopic field and the field of the[0217]rigid scope90 in association with each other, the operator turns on an image shift switch (not shown) of thefootswitch81. The resulting signal is applied to thecomputing unit97. On receiving this signal, thecomputing unit97 computes the position of display of the image of therigid scope90 in the microscopic field in accordance with position information from theposition detector31 and magnification information on themicroscope body1 from themagnification detecting means56. Thus, the range of the microscopic field is calculated from the position and magnification of thebody1 of the microscope, while the distal end position and observational direction of therigid scope90 in the microscopic field is calculated from the position information of thescope90. Based on the results of these calculations, thecomputing unit97 delivers a command signal to display the image of therigid scope90 in a circular range that has its center on the observational-direction side of therigid scope90 with its distal end on a point on the diameter of the circle. More specifically, the first and second liquid crystal shutters are set for the states shown in FIGS. 14D and 14E, respectively, and the monitor (not shown) in themicroscope body1 displays the image shown in FIG. 14F. Thus, the operator can obtain the field shown in FIG. 15B in the microscopic field.
• Since the[0218]rigid scope90 is 90°-squint, moreover, the observational direction changes if it is rotated for 90° in its axial direction, for example. In this state also, the image of therigid scope90 is displayed in a circular range that has its center on the observational-direction side of therigid scope90 with its distal end on a point on the diameter of the circle, so that the field shown in FIG. 15D can be obtained.
• According to this third embodiment, the second observational means, e.g., the rigid scope or an ultrasonic observation apparatus of the front-scan type, can be effectively used in particular when an object is observed in a given direction from the distal end of the probe, and the observational image is displayed in the observational direction of the probe. Accordingly, the observational direction and position of the second observational means can be grasped with ease, and besides, the optical image of the actual affected region and the image obtained by means of the second observational means are positioned in association with each other as they are displayed. Thus, the state of the affected region can be grasped quickly and accurately.[0219]
• Although the second observational means has been described as means for observing a narrower range than the operating microscope or first observational means does, in connection with the second and third embodiments, the present invention is not limited to this arrangement. If an image of a wide range that includes the affected region is obtained by means of an X-ray CT apparatus or the like, for example, a part of the image may be cut out and projected in the microscopic field in like manner provided that the positional relations between the image, the actual affected region, and the position of the body of the microscope can be grasped. According to each of the foregoing embodiments, the image is displayed following the distal end of each probe. In the case of a wide-range image such as the aforesaid X-ray CT image, however, a cursor may be displayed in the microscopic field so that the operator can move it by means of the footswitch or the like, thereby causing the cut image to follow the cursor. Thus, the operator can observe only a desired portion of the X-ray CT image to be referred to, in association with the affected region, so that the effects of the present invention can be accomplished.[0220]
• Although the operating microscope is used as the first observational means and the image of the second observational means is superposed on the microscopic optical image according to the first to third embodiments, the present invention is not limited to this arrangement. It is to be understood that quite the same effects can be produced if the display image of the first observational means is a TV monitor.[0221]
FOURTH EMBODIMENT
• A fourth embodiment of the present invention will now be described. The following is a description of a configuration of a fluorescent image observation apparatus of an operating microscope with position detecting means that can detect the position of an affected region.[0222]
• FIG. 16 shows a configuration of the operating microscope with the position detecting means that can detect the affected region position. This configuration will be briefly described herein, since it is described in Jpn. Pat. Appln. No. 10-319190 filed by the assignee of the present invention.[0223]Numeral101 denotes the operating microscope, which comprises amicroscope body102 that constitutes an observational optical system through which anoperator108 can observe an affected region of apatient107. Themicroscope body102 is provided with anemissive index103.
• [0224]Numeral104 denotes adigitizer104, which includes twoCCD cameras105aand105bfor use as receivers and acamera support member106 for supporting these cameras. Thedigitizer104 serves as optical position detecting means that uses theCCD cameras105aand105bto detect theemissive index103 of themicroscope body102, thereby detecting the observational position of the microscope.
• FIG. 17 shows a configuration of an illumination system of the operating[0225]microscope101, and FIG. 18 shows a configuration of the observational optical system of themicroscope101. FIG. 17 is a diagram as viewed from a position A of FIG. 18.
• The illumination system shown in FIG. 17 comprises a[0226]light source109, condensing lens110,illumination lens112, andbeam splitter113. Themembers110,112 and113 serve to guide illumination light emitted from thelight source109 to the affected region P of thepatient107.
• An illumination light switching filter[0227]111 includes an illuminationlight transmitting filter111afor transmitting illumination light for the affected region P, an excitationlight transmitting filter111bfor transmitting only excitation light that is inductive to fluorescence, and adrive motor111cfor use as a switching mechanism for changing these two filters. Thus, the filter111 serves as illumination light switching means for the affected region P. Further, anobjective lens114, zoomoptical systems115L and115R, andbeam splitters116L and116R are provided for the observation of light reflected by the affected region P.
• The observational optical system shown in FIG. 18 comprises the[0228]beam splitters116L and116R andeyepieces117L and117R, as well as the zoomoptical systems115L and115R. An image from the affected region P is transmitted through thebeam splitter116L to alens118L, amirror120L, and an image-pickup device121L, which constitute a shooting system.
• An observational[0229]light switching filter119L includes an illumination light transmitting filter119L1 for transmitting the illumination light for the affected region P, a cutoff filter119L2 for cutting off the excitation light and illumination light, and a drive motor119L3 for use as a switching mechanism for changing these two filters. Thus, thefilter119L serves as observational light switching means for the affected region P.
• FIG. 19 is a general functional block diagram of the operating[0230]microscope101. In FIG. 19, themotors111cand119L3 are connected to afilter drive controller123, which can control these motors simultaneously, in response to a signal from an input switch (display mode setting means)122 for fluorescent image observation. Thefilter drive controller123 serves to control themotors111cand119L3 so that the illuminationlight transmitting filter111aof the illumination light switching filter111 and the illumination light transmitting filter119L1 of the observationallight switching filter119L are simultaneously situated on the optical axis. Thecontroller123 also serves to control themotors111cand119L3 so that the excitationlight transmitting filter111bof the illumination light switching filter111 and the cutoff filter119L2 of the observationallight switching filter119L are simultaneously situated on the optical axis. Under this control, the operation mode can be changed from a fixed-time fluorescent observation mode to a normal (visible zone) observation mode by means of a timer circuit (not shown).
• Further, the image-[0231]pickup device121L is connected to avideo signal processor128. Thedevice121L is composed of a drive processor circuit (not shown) and a video signal generator circuit (not shown). A memory (storage means)129, which can operate in response to a signal from theinput switch122, is composed of an image memory and a binary coder circuit (not shown) for binary-coding a video signal delivered from thevideo signal processor128.
• Furthermore, a workstation (hereinafter referred to as WS)[0232]125 is connected with amicroscope body controller126,digitizer124, monitor127, andmixer130. Thecontroller126 can detect and transmit information data such as the magnification, focal length, etc. of the operatingmicroscope101 that is provided with theemissive index103. Thedigitizer124 can detect the position of the affected region P by detecting theindex103. If the magnification and focus information data are changed, they are transmitted from thecontroller126 to theWS125. Thereupon, theWS125 selects a preoperative image corresponding to the operating position in consideration of the transmitted data and position information from thedigitizer124. Thedigitizer124 and theWS125 constitute position computing means.
• The[0233]mixer130, which is connected to theWS125,video signal processor128, andmemory129, serves to superpose video signals that are transmitted individually from theWS125,processor128, andmemory129, and can display the superposed video signals on amonitor131 outside the microscope body. Themixer130 and themonitor131 constitute display means.
• In the arrangement described above, the observational position of the operating microscope is detected by detecting the[0234]emissive index103 on the microscope by means of thedigitizer124 and computing the positional relation between the microscope and the detectedindex103 by means of theWS125. By doing this, the correlation with a two-dimensional preoperative tomographic image as a diagnostic image of the patient's body stored in theWS125 can be obtained (the apparatus of this type is called a navigation apparatus).
• FIG. 20 is a flowchart for illustrating the operation of the present invention. Since a method for simultaneously shooting the image based on the illumination light and the fluorescent image is described in detail in Jpn. Pat. Appln. KOKAI Publication No. 9-24052, only features of the present invention will be described in the following.[0235]
• If the[0236]input switch122 for fluorescent image observation is turned on (A1), thefilter drive controller123 controls themotors111cand119L3 (A2-1) to locate the excitationlight transmitting filter111bof the illumination light switching filter111 and the cutoff filter119L2 of the observationallight switching filter119L simultaneously on the optical axis.
• Fluorescent shooting (A[0237]3-1) is carried out in this state. Light transmitted through the excitationlight transmitting filter111bof the illumination light switching filter111 is applied to the affected region P, thereby inducing fluorescence. The illumination light and the excitation light is cut off by means of the cutoff filter119L2 of the observationallight switching filter119L, and only the detected fluorescent image induced by the affected region P is reflected by themirror120L and landed on the image-pickup device121L.
• The detected fluorescent image incident upon the image-[0238]pickup device121L is converted into a video signal by means of thevideo signal processor128 and applied to thememory129 and themixer130. The video signal that is applied to thememory129 is binary-coded (A4). Thereafter, it is applied to themixer130 and displayed as a fluorescent observational image on themonitor131.
• If the[0239]motors111cand119L3 are controlled by means of thefilter drive controller123 so that the illuminationlight transmitting filter111aof the illumination light switching filter111 and the illumination light transmitting filter119L1 of the observationallight switching filter119L are located simultaneously on the optical axis, the illumination light is applied to the affected region P, and an image of the affected region is landed on the image-pickup device121L. This illumination light is processed by means of thevideo signal processor128 and applied to themixer130.
• As this is done, a two-dimensional preoperative image that matches the observational position information (A[0240]2-2) on the affected region P obtained according to theemissive index103, which is detected by means of thedigitizer124, and the magnification and focus information data on the operatingmicroscope101, which are transmitted from themicroscope body controller126 to theWS125, is selected from ones that are previously recorded in the WS125 (A3-2) and applied to themixer130.
• The[0241]mixer130 synthesizes (superposes) the video image based on the illumination light form thevideo signal processor128, the fluorescent image binary-coded by means of thememory129, and the preoperative image selected and inputted by means of the WS125 (A5).
• In these circumstances, the[0242]filter drive controller123 selects the illuminationlight transmitting filter111aand the illumination light transmitting filter119L1 on illumination and shooting light paths, respectively. The image-pickup device121L shoots an image in a normal or visible zone. A tumor position obtained by the aforesaid fluorescent observation and a tumor position based on the two-dimensional preoperative tomographic image selected by means of theWS125 are superposed on the image of the affected region presently obtained by the operator and are displayed on themonitor131.
• FIG. 21 is a diagram for illustrating the way of synthesizing the fluorescent observational image and the two-dimensional preoperative tomographic image.[0243]
• In an[0244]entire tumor image142 as an affected region in anentire head image141 of FIG. 21, a plane image (fluorescent observational image)145a,based on a fluorescent image obtained from a certain curved surface in a surgical treatment position (exposed tumor portion144), and a two-dimensional preoperativetomographic image145b,selected as a microscopic observational position by theWS125, can be synthesized and displayed on themonitor131.
• If the operator then moves the focal center position from B to C by focusing operation, the center of observation (center of the depth of focus) can be detected by means of the[0245]digitizer124 and theWS125 so that a corresponding tomographic image can be selected and synthesized with the aforesaid fluorescent observational image. In terminating the fluorescent observation, the operator is expected to turn off theinput switch122, thereby switching off the superposed display.
• The fourth embodiment described above enjoys the following effects. Since an actual affected region has no flat surface, display of only a tomographic image as a diagnostic image in the microscopic observational position can hardly cover the state of the affected region. With use of the arrangement of the present embodiment, however, tomographic images based on the focusing operation for the present treatment position are superposed on the fluorescent observational image as they are displayed, so that the progress of a surgical operation and the conditions of a tumor can be recognized visually.[0246]
• Further, the fluorescent observational image is superposed on the two-dimensional preoperative tomographic image as it is displayed. If the surgical operation is advanced according to the preoperative tomographic image, therefore, the operator can recognize supplementary correction of the position according to the fluorescent observational image during the operation. Thus, the correction is easy.[0247]
• Since the mode for the superposed observation can be set by the input switch operation, moreover, the superposed observation can be selectively carried out as required. If only the external shape of the tumor portion is expected to be emphasized in the tomographic image from the WS, the operator can easily discriminate it by making its display color different from that of the fluorescent observational image.[0248]
FIFTH EMBODIMENT
• FIGS. 22 and 23 show a configuration according to a fifth embodiment. Since left- and right-hand observational images of an affected region are processed in the same manner, the way of processing the left-hand observational image will now be described representatively.[0249]
• As in the case of the fourth embodiment, illumination or excitation light is applied to the affected region, and an image of the affected region is obtained by means of an image-[0250]pickup device121L. Thedevice121L is connected to avideo signal processor135L for converting an image into a video signal. An output signal from theprocessor135L is applied to a left-hand memory136L. Thememory136L serves to binary-code the image, and its signal is applied to a left-hand mixer137L that can superpose a plurality of video images. Output signals from the left-hand mixer137L and a right-hand mixer137R are applied to a3D converter139 to be converted into a three-dimensional video image thereby, whereupon the video image can be displayed on a3D monitor140.
• Further, output signals from the left-hand[0251]video signal processor135L and a right-handvideo signal processor135R are applied to the3D converter139 to be converted into a three-dimensional video image thereby, and the image can be displayed on the3D monitor140.
• The[0252]WS125 can apply the three-dimensional video image to bilateral screen dividing means138, which can divide the three-dimensional video image into images with a lateral parallax. A left-hand video image is generated and applied to the left-hand mixer137L. Themixer137L is connected to a left-hand monitor134L. Further, alens133L and abeam splitter132L are arranged in order to guide the video image on themonitor134L to theeyepiece117L (see FIG. 22).
• With the arrangement described above, fluorescence is excited, and the resulting fluorescent image is delivered to left- and right-hand image-[0253]pickup devices121L and121R, as in the case of the fourth embodiment. Since video images applied to the image-pickup devices121L and121R are processed in the same manner, only the processing on the left-hand side will now be described. The fluorescent image obtained by means of the image-pickup device121L is applied to the left-handvideo signal processor135L to be converted into a video signal thereby, and applied to the left-hand memory136L and the3D converter139.
• In order to divide stereoscopic image information, based on the preoperative tomographic image information recorded in the[0254]WS125, into images with a lateral parallax, moreover, the preoperative tomographic image is applied to the bilateral screen dividing means138. In the left-hand mixer137L, a left-hand image produced by the dividing means138 is superposed on the signal from the left-hand memory136L that binary-codes the signal from the left-handvideo signal processor135L.
• A synthetic image delivered from the left-[0255]hand mixer137L is applied to the3D converter139 and the left-hand monitor134L. Theconverter139 can convert the video image from the left- and right-hand mixers137L and137R into a three-dimensional image and display the image on the3D monitor140.
• The light applied to the left-[0256]hand monitor134L is guided to theeyepiece117L via thelens133L and thebeam splitter132L.
• In this manner, the observational image of the affected region P based on the illumination light, the fluorescent observational image based on the application of the excitation light to the affected region, and the three-dimensional image based on the preoperative image can be simultaneously cast into the operator's field of vision and displayed on the[0257]3D monitor140. In this case, the present treated section information based on the fluorescent observational image is superposed three-dimensionally on a three-dimensional exterior view of a tumor (three-dimensional tumor image147), such as the one shown in FIG. 25, so that the present progress of operation for the whole tumor can be recognized. In FIG. 25, the outline is formed by a position detecting function, and broken lines represent a stereoscopic affected region image based on the fluorescent observational image.
• According to the fifth embodiment described above, the optical observational images obtained by microscopic observation are superposed, so that the present treatment position and progress of the affected region P in the whole tumor can be grasped three-dimensionally, and the direction of the treatment to be advanced thereafter can be recognized accurately. Dislocation of the preoperative tomographic image from the entire external shape can be also recognized, and it can be minutely corrected by stereoscopic observation. Thus, an environment can be provided for high-safety surgical operations.[0258]
SIXTH EMBODIMENT
• The following is a description of only differences of a sixth embodiment of the present invention from the fifth embodiment. FIG. 24 is a diagram showing a configuration of the sixth embodiment. An image signal based on illumination light incident upon a left-hand[0259]video signal processor135L is applied to a left-hand mixer137L. In the sixth embodiment, themixer137L is connected to a left-hand in-field display controller148L. Thecontroller148L is constructed in the same manner as an in-field display controller that constitutes an in-field display device (in-field display controller and lens tube portion) described with reference to FIG. 1 in Jpn. Pat. Appln. No. 10-248672. According to the sixth embodiment, the display according to the fifth embodiment is indicated and observed as an image display separate from the microscopic field.
• In the arrangement described above, the image signal based on the illumination light incident upon the left-hand[0260]video signal processor135L is applied to the left-hand mixer137L. In themixer137L, a microscopic image based on the illumination light, a fluorescent image based on excitation light, and a preoperative image selected according to the outer peripheral surface of an affected region are synthesized and applied to the left-hand in-field display controller148L. The video image applied to thecontroller148L is displayed as an in-field display image by means of the in-field display device, and only an image based on the illumination light is visible as the microscopic image.
• The sixth embodiment described above has the following effects as well as the effects of the fifth embodiments. In the microscopic image based on the illumination light, as shown in FIG. 26, an exposed[0261]tumor portion151 that cannot be recognized by the operator can be identified by being compared with the superposed in-field display image. Further, the three-dimensional shape of a tumor and the position of an affected region in the whole tumor can be grasped without screening amicroscopic image150 with the preoperative image and the fluorescent observational image.
SEVENTH EMBODIMENT
• A seventh embodiment of the present invention will now be described with reference to FIGS.[0262]27 to35B. FIG. 27 shows the general external appearance of an operatingmicroscope201 of an operating microscope apparatus according to the present embodiment. Astand202 of the operatingmicroscope201 of the present embodiment is provided with a base203 movable on a floor surface and a support post204 set up on the base203.
• Further, the support post[0263]204 is provided, on its top portion, with abody205 of the operatingmicroscope201, including an optical system for observing an affected region, and asupport mechanism206 for supporting thebody205 for movement in any desired direction. Themechanism206 is a combination of a plurality of movingarms207 for locating themicroscope body205 in a desired position.
• As shown in FIG. 28, moreover, the[0264]body205 of the operatingmicroscope201 of the present embodiment is provided with anoperator eyepiece unit208 and amate eyepiece unit209. Thebody205 is also provided with abarre1210 for rotatably holding themate eyepiece unit209. Theeyepiece unit209 can be rotated with respect to theoperator eyepiece unit208 by means of thebarre1210.
• Located near the[0265]barre1210, moreover, is aposition detecting encoder211 that detects the rotational angle of themate eyepiece unit209 with respect to theoperator eyepiece unit208 and outputs it as an electrical signal.
• FIG. 29 is a schematic view of an optical system of the[0266]body205 of the operatingmicroscope201, and FIG. 30 is a block diagram of an electric circuit of themicroscope201. As shown in FIG. 29, the optical system of thebody205 of the operatingmicroscope201 according to the present embodiment is provided with abeam splitter212 for dividing a microscopic image (incident light) into two parts for an operator-side optical system La and a mate-side optical system Lb. The light incident upon thebeam splitter212 is divided into two light beams, transmitted and reflected. The transmitted and reflected light beams, divided from the microscopic image by means of thebeam splitter212, are landed on the operator- and mate-side optical systems La and Lb, respectively.
• Further, the operator-side optical system La includes a main image display optical system La[0267]1 for displaying a main microscopic image and an in-field display optical system La2 for projecting an index and a sub-image, which is different from the main image, on a part of the microscopic field. The main image display optical system La1 is provided with anobjective lens213a,LCD214afor microscopic image masking, total-reflection mirror215a,imaging lens216a,prism217a,andeyepiece218a.TheLCD214ais located on afirst imaging point213a1 of theobjective lens213a.
• The in-field display optical system La[0268]2 is provided with an LCD (in-field monitor)219afor in-field display, imaging lens220a,prism217a,andeyepiece218a.The prism217aand theeyepiece218aare used in common in the main image display optical system La1 and the in-field display optical system La2. The microscopic image from the main image display optical system La1 and an in-field display image from the in-field display optical system La2 are superposed and landed on the side of theeyepiece218aby means of the prism217a.
• Likewise, the mate-side optical system Lb includes a main image display optical system Lb[0269]1 for displaying a main microscopic image and an in-field display optical system Lb2 for projecting an index and a sub-image, which is different from the main image, on a part of the microscopic field. The main image display optical system Lb1 is provided with an objective lens213b,LCD214bfor microscopic image masking, total-reflection mirror215b,imaging lens216b,prism217b,andeyepiece218b.TheLCD214bis located on a first imaging point213b1 of the objective lens213b.
• The in-field display optical system Lb[0270]2 is provided with an LCD (in-field monitor)219bfor in-field display,imaging lens220b,prism217b,andeyepiece218b.Theprism217band theeyepiece218bare used in common in the main image display optical system Lb1 and the in-field display optical system Lb2. The microscopic image from the main image display optical system Lb1 and an in-field display image from the in-field display optical system Lb2 are superposed and landed on the side of theeyepiece218bby means of theprism217b.
• In the operating[0271]microscope201 according to the present embodiment, an endoscopic image from anendoscope221 shown in FIG. 30 is displayed on the respective LCD's219aand219bfor in-field display of the operator- and mate-side optical systems La and Lb. ATV camera head222 is coupled to theendoscope221. ACCTV unit223 is connected to thecamera head222. The endoscopic image of theendoscope221 is picked up by means of thecamera head222, and the resulting optical video image is photoelectrically converted by means of an image-pickup device (not shown) in thecamera head222. Thereafter, the image is applied as an electrical signal to theCCTV unit223 and processed, whereupon a TV signal is outputted.
• As shown in FIG. 30, moreover, an electric circuit block of the operating[0272]microscope201 according to the present embodiment is provided with an operator-side processing system Ka and a mate-side processing system Kb. TheCCTV unit223 is connected with an in-fieldimage generator circuit224aof the operator-side processing system Ka and an in-fieldimage generator circuit224bof the mate-side processing system Kb.
• The operator-side processing system Ka is provided with a[0273]first LCD driver225afor driving theLCD214afor microscopic image masking, asecond LCD driver226afor driving theLCD219afor in-field display, a display changing circuit227a,the in-fieldimage generator circuit224a,and a microscopicimage masking processor228a.Further, the in-fieldimage generator circuit224aand the microscopicimage masking processor228aare connected with an in-field display controller (input means)229 for inputting observation conditions in which the size, position, etc. of images to be displayed on the LCD's219aand219bfor in-field display are changed.
• Furthermore, the in-field[0274]image generator circuit224aand the microscopicimage masking processor228aare connected to the input side of the display changing circuit227a.The first andsecond LCD drivers225aand226aare connected to the output side of the circuit227a.
• The output of the[0275]CCTV unit223 is applied to the in-fieldimage generator circuit224aof the operator-side processing system Ka, the output of which is applied to the display changing circuit227a.An output signal from the microscopicimage masking processor228ais also applied to the circuit227a,the output of which is applied to theLCD drivers225aand226a.Further, output signals from theLCD drivers225aand226aare applied to theLCD214afor microscopic image masking and theLCD219afor in-field display, respectively.
• The mate-side processing system Kb is provided with a[0276]third LCD driver225bfor driving theLCD214bfor microscopic image masking, afourth LCD driver226bfor driving theLCD219bfor in-field display, adisplay changing circuit227b,the in-fieldimage generator circuit224b,and a microscopicimage masking processor228a.Further, the in-fieldimage generator circuit224band the microscopicimage masking processor228bare connected with the in-field display controller229.
• In the mate-side processing system Kb according to the present embodiment, moreover, a first rotation computing circuit (observational state changing means)[0277]230 is interposed between the in-fieldimage generator circuit224band thedisplay changing circuit227b,while a second rotation computing circuit (observational state changing means)231 is interposed between the microscopicimage masking processor228band thedisplay changing circuit227b.
• The first and second[0278]rotation computing circuits230 and231 are connected to the input side of thedisplay changing circuit227b.Further, the third andfourth LCD drivers225band226bare connected to the output side of thecircuit227b.
• On the side of the mate-side processing system Kb, the output of the[0279]CCTV unit223 is applied to the in-fieldimage generator circuit224bof the mate-side processing system Kb, the output of which is applied to thedisplay changing circuit227bvia the firstrotation computing circuit230. A signal from the microscopicimage masking processor228bis also applied to thedisplay changing circuit227bvia the secondrotation computing circuit231. The output of thecircuit227bis applied to theLCD drivers225band226b.Further, output signals from thedrivers225band226bare applied to theLCD214bfor microscopic image masking and theLCD219bfor in-field display, respectively.
• The[0280]position detecting encoder211 is connected to the first and secondrotation computing circuits230 and231. An output signal from theencoder211 is applied to thecircuits230 and231, while the control output of the in-field display controller229 is applied to the in-fieldimage generator circuits224aand224band the microscopicimage masking processors228aand228b.
• The following is a description of the function of the operating[0281]microscope201. In starting the operation of the operatingmicroscope201 of the present embodiment, a microscopic image of an affected region in an operative field j (see FIG. 74) as an object of surgical operation is divided into two parts for the operator- and mate-side optical systems La and Lb by means of thebeam splitter212. The divided image for the operator-side optical system La is focused on thefirst imaging point213a1 of theobjective lens213a,whereupon amicroscopic image232afor the optical system La is formed, as shown in FIG. 31A. Further, the image for the mate-side optical system Lb, divided by means of thebeam splitter212, is focused on the first imaging point213b1 of the objective lens213b,whereupon amicroscopic image232bfor the optical system Lb is formed, as shown in FIG. 31A.
• In FIG. 30, the endoscopic image shot by means of the[0282]endoscope221 is picked up by means of thecamera head222. The resulting optical video image is photoelectrically converted by means of the image-pickup device (not shown) in thecamera head222. Thereafter, the image is applied as an electrical signal to theCCTV unit223 and processed, whereupon a TV signal is outputted. The TV signal delivered from theCCTV unit223 is applied to the respective in-fieldimage generator circuits224aand224bof the operatorand mate-side processing system Ka and Kb.
• The output signal processed in the in-field[0283]image generator circuit224aof the operator-side processing system Ka is applied to the display changing circuit227a.As this is done, the output signal from the microscopicimage masking processor228ais also applied to the circuit227a.Further, the output signal from the circuit227ais applied to theLCD drivers225aand226a.The control signals from theLCD drivers225aand226aare applied to theLCD214afor microscopic image masking and theLCD219afor in-field display, respectively.
• Since the[0284]LCD214afor microscopic image masking is located on thefirst imaging point213a1 of theobjective lens213a,amask portion233afor sub-image is inserted into a part of themicroscopic image232afor the operator-side optical system La by means of theLCD214a,as shown in FIG. 31A. As this is done, moreover, anendoscopic image234ais partially displayed on a part of the whole LCD screen of theLCD219afor in-field display, and the remaining part is left as a shieldingportion235a,as shown in FIG. 31B.
• The image of FIG. 31A that combines the[0285]microscopic image232aand themask portion233afor sub-image inserted therein and the image of FIG. 31B that combines theendoscopic image234aand the shieldingportion235aare superposed by means of the prism217a.Thereupon, a composite image238ais formed having an endoscopic image (sub-image)237ainserted in a microscopic image (main image)236a,as shown in FIG. 32A.
• The same operation on the operator side is also carried out on the mate side. More specifically, the output signal processed in the in-field[0286]image generator circuit224bof the mate-side processing system Kb is applied to thedisplay changing circuit227bthrough the firstrotation computing circuit230. As this is done, the output signal from the microscopicimage masking processor228bis also applied to thecircuit227bthrough the secondrotation computing circuit231. Further, the output signal from thecircuit227bis applied to theLCD drivers225band226b.The output signals from theLCD drivers225band226bare applied to theLCD214afor microscopic image masking and theLCD219afor in-field display, respectively.
• Since the[0287]LCD214bfor microscopic image masking is located on the first imaging point213b1 of the objective lens213b,amask portion233bfor sub-image is inserted into a part of themicroscopic image232bfor the mate-side optical system Lb by means of theLCD214b,as shown in FIG. 31A. As this is done, moreover, anendoscopic image234bis partially displayed on a part of the whole LCD screen of theLCD219bfor in-field display, and the remaining part is left as a shieldingportion235b,as shown in FIG. 31B.
• The image of FIG. 31A that combines the[0288]microscopic image232band themask portion233bfor sub-image inserted therein and the image of FIG. 31B that combines theendoscopic image234band the shieldingportion235bare superposed by means of theprism217b.Thereupon, acomposite image238bis formed having an endoscopic image (sub-image)237binserted in a microscopic image (main image)236b,as shown in FIG. 32A.
• As the in-[0289]field display controller229 is operated, the observation conditions in which the size, position, etc. of the images to be displayed on the LCD's219aand219bfor in-field display are changed are inputted. Depending on the conditions inputted by means of thecontroller229, the in-fieldimage generator circuits224aand224boutput control signals for changing the size, position, etc. of the images to be displayed on the LCD's219aand219b.
• In the microscopic[0290]image masking processors228aand228b,moreover, themask portions233aand233bare formed having the same size and position as theendoscopic images234aand234bthat are generated by means of the in-fieldimage generator circuits224aand224b,as shown in FIG. 31A. Thus, themask portion233aof FIG. 31A and theendoscopic image234aof FIG. 31B are equal in size.
• According to the present embodiment, furthermore, two images are alternatively changed by means of the display changing circuit[0291]227aby the operator's processing, and images are displayed individually on the LCD's214aand219aby means of theLCD drivers225aand226a.In the mate-side processing system, the images of FIGS. 31A and 31B, generated by means of the in-fieldimage generator circuit224band the microscopicimage masking processor228b,are subjected to map conversion in therotation computing circuits230 and231 in accordance with the output of theposition detecting encoder211 that detects the rotational angle of themate eyepiece unit209, and then rotated in the manner shown in FIGS. 31C and 31D. The images shown in FIGS. 31C and 31D are obtained by rotating the images of FIGS. 31A and 31B, respectively, for 180°.
• The mate-side image processed in this manner forms the[0292]composite image238bof FIG. 32B, which is an image obtained by rotating the composite image238aof FIG. 32A without changing the relative positions of themicroscopic images236aand2326band theendoscopic images237aand237btherein.
• The following is a description of operation for the case where preoperative diagnostic images, such as X-ray CT's, are displayed on the LCD's[0293]219aand219bfor in-field display of the operator- and mate-side optical systems La and Lb. According to the present embodiment, computer images, such as X-ray CT's (not shown), are applied to the in-fieldimage generator circuits224aand224bof FIG. 30. In this case, the output of thecircuit224bis applied directly to thedisplay changing circuit227bwithout actuating therotation computing circuits230 and231 of the mate-side processing system Kb. In consequence,composite images240aand240bare obtained includingcomputer images239aand239binserted in themicroscopic images236aand2326b,as shown in FIGS. 33A and 33B, respectively. FIGS. 33A and 33B show the operator- and mate-use composite images240aand240b,respectively. Thecomputer images239aand239b,which serve as in-field images in themicroscopic images236aand236b,are common to the operator- and mate-use composite images240aand240b,and are displayed in like manner in a fixed direction.
• FIGS. 35A and 35B show states in which indexes (markers)[0294]242aand242bare overlaid onmicroscopic images241aand241b,respectively. Themicroscopic images241aand241bare used on the operator side and on the mate side, respectively.
• Further, FIG. 34A shows a[0295]mask image243aor243boverlain by theindex242aor242b,and FIG. 34B shows an in-field display image. In this case, the mask size for themask image243aor243bis reduced to zero, so that theindex242aor242bappears as the in-field display image. Themicroscopic images241aand241bobtained in this case have theircorresponding indexes242aand242bsuperposed thereon, as shown in FIGS. 35A and 35B, respectively.
• If the[0296]mask portion233aor233bis larger than theendoscopic image234aor234bin FIGS. 31A to31D, theendoscopic image234aor234bin the field has a frame (not shown). If themask portion233aor233bis smaller than theendoscopic image234aor234b,on the other hand, the periphery of theendoscopic image234aor234bin the field is blurred.
• In the case where the[0297]endoscopic image234aor234bin the field of themicroscopic image232aor232brepresents a graphic form, such as a line or circle, the graphic form is replaced with themicroscopic image232aor232bif themask portion233aor233bhas the same shape as the in-fieldendoscopic image234aor234b.Overlay display is made if themask portion233aor233bneed not be formed.
• The arrangement described above produces the following effects. In the mate-side processing system Kb according to the present embodiment, the first[0298]rotation computing circuit230 is interposed between the in-fieldimage generator circuit224band thedisplay changing circuit227b,while the secondrotation computing circuit231 is interposed between the microscopicimage masking processor228band thedisplay changing circuit227b.Further, theposition detecting encoder211 for detecting the rotational angle of themate eyepiece unit209 with respect to theoperator eyepiece unit208 is connected to the first and secondrotation computing circuits230 and231. If themate eyepiece unit209 is rotated with respect to theoperator eyepiece unit208 with the in-field image of an auxiliary optical system projected into the microscopic field so that thecomposite image238aor238bis formed including theendoscopic image237aor237binserted in the microscopic236aor236b,as shown in FIG. 32A, therefore, the images of FIGS. 31A and 31B that are generated by means of the in-fieldimage generator circuit224band the microscopicimage masking processor228bof the mate-side processing system Kb are subjected to map conversion in therotation computing circuits230 and231 in accordance with the output of theposition detecting encoder211 that detects the rotational angle of themate eyepiece unit209, and then rotated in the manner shown in FIGS. 31C and 31D. Accordingly, thecomposite image238bof FIG. 32B is displayed on themate eyepiece unit209 with the composite image238aof FIG. 32A displayed on theoperator eyepiece unit208. If themate eyepiece unit209 is rotated with respect to theoperator eyepiece unit208, therefore, a microscopic field of the same positional relations for the operator can be continuously secured for the mate. Thus, the in-field image of the auxiliary optical system produces no dead angles in the microscopic field.
• If necessary, moreover, an image in the same direction as the one on the operator side can be projected on the in-field image of the auxiliary optical system on the mate side by a simple method, or the in-field image can be displayed with a desired size and in a free position. Further, an index such as a marker overlaid on the microscopic image, as well as the in-field image of the auxiliary optical system, can be realized by only the image processing without changing the system configuration, so that a lot of types of display and observation methods can be selected without entailing any troublesome manipulation during the surgical operation. In consequence, necessary in-field information can be properly offered to the operator or his or her mate, and the aimed microscopic field can be easily secured during the operation.[0299]
EIGHTH EMBODIMENT
• FIGS. 36 and 37 show an eighth embodiment of the present invention. In the present embodiment, the configuration of the[0300]mate eyepiece unit209 of the seventh embodiment is modified in the following manner.
• According to the present embodiment, the[0301]rotation computing circuits230 and231 in the mate-side processing system Kb of the seventh embodiment are omitted or replaced with an LCDrotating mechanism251 for rotating theLCD214bfor microscopic image masking and theLCD219bfor in-field display in the mate-side optical system Lb.
• As shown in FIG. 37, the LCD[0302]rotating mechanism251 of the present embodiment comprises a ring-shaped firstLCD driving gear252, to which theLCD214bfor microscopic image masking is fixed, and a ring-shaped secondLCD driving gear253, to which theLCD219bfor in-field display is fixed. TheLCD214bfor microscopic image masking is fixed in the ring of the firstLCD driving gear252. Likewise, theLCD219bfor in-field display is fixed in the ring of the secondLCD driving gear253.
• A[0303]gear255 is fixed to the rotating shaft of adrive motor254 of the LCDrotating mechanism251. Thegear255 is in mesh with anintermediate gear256 as well as with the secondLCD driving gear253. Further, theintermediate gear256 is in mesh with the firstLCD driving gear252. The gear ratio between thegears255 and256 is adjusted to 1:1. Thus, the first and secondLCD driving gears252 and253 can rotate in the same direction and at the same speed as thegear255 rotates.
• A[0304]motor control circuit257 is connected to thedrive motor254. Aposition detecting encoder211 is connected to thecircuit257. An output signal from theencoder211 is applied to thecircuit257, whereby the operation of themotor254 is controlled.
• The following is a description of the operation of the present embodiment arranged in this manner. If a[0305]mate eyepiece unit209 is rotated with respect to anoperator eyepiece unit208, according to the present embodiment, the output signal from theposition detecting encoder211, corresponding to the rotational angle of themate eyepiece unit209, is applied to themotor control circuit257. Thus, thecircuit257 controls the operation of thedrive motor254.
• As this is done, the[0306]motor254 causes thegear255 to rotate according to the rotational angle of themate eyepiece unit209. The secondLCD driving gear253 is rotated in association with the rotation of thegear255, and the firstLCD driving gear252 is rotated through the medium of theintermediate gear256. Since the gear ratio between thegears255 and256 is adjusted to 1:1, the first and secondLCD driving gears252 and253 rotate in the same direction and at the same speed. Accordingly, the positional relation between theLCD219bfor in-field display and theLCD214bfor microscopic image masking can be kept fixed, and image display equivalent to the one obtained by the image rotation shown in FIGS. 31C and 31D can be realized.
• According to the present embodiment, therefore, the output signal from the[0307]position detecting encoder211 that detects the rotational angle of themate eyepiece unit209 is applied to themotor control circuit257, and the operation of thedrive motor254 is controlled by means of thecircuit257. Thus, if themate eyepiece unit209 is rotated with respect to theoperator eyepiece unit208, according to the present embodiment, the LCDrotating mechanism251 is driven according to the rotational angle α themate eyepiece unit209 by means of themotor254, so that theLCD214bfor microscopic image masking and theLCD219bfor in-field display in the mate-side optical system Lb can be rotated individually. According to the present embodiment, therefore, a lot of types of display and observation methods can be selected without entailing any troublesome manipulation during the surgical operation, as in the case of the first embodiment, and besides, the in-field image can be offered without lowering the image quality during image computation for the image rotating process.
NINTH EMBODIMENT
• FIG. 38A shows a ninth embodiment of the present invention. In the present embodiment, the LCD[0308]rotating mechanism251 of the eighth embodiment is modified in the following manner.
• The LCD[0309]rotating mechanism251 of the eighth embodiment is designed so that theLCD214bfor microscopic image masking and theLCD219bfor in-field display in the mate-side optical system Lb are rotated individually by means of the gear mechanism. However, the present embodiment is provided with an LCDrotating mechanism261 that is formed of a belt drive mechanism.
• The LCD[0310]rotating mechanism261 of the present embodiment comprises a firstLCD driving pulley262, to which theLCD214bfor microscopic image masking is fixed, and a secondLCD driving pulley263, to which theLCD219bfor in-field display is fixed.
• A[0311]pulley264 is fixed to the rotating shaft of a drive motor (not shown) of the LCDrotating mechanism261. Further, anendless belt265 is passed around and between thepulley264 and the first and secondLCD driving pulleys262 and263. The driving pulleys262 and263 are equal in diameter. Thus, the first and secondLCD driving pulleys262 and263 can rotate in the same direction and at the same speed.
• As in the case of the eighth embodiment, moreover, the motor control circuit[0312]257 (see FIG. 36) is connected to the drive motor for thepulley264. Theposition detecting encoder211 is connected to thecircuit257. An output signal from theencoder211 is applied to thecircuit257, whereby the operation of the drive motor is controlled.
• The following is a description of the operation of the present embodiment arranged in this manner. If a[0313]mate eyepiece unit209 is rotated with respect to anoperator eyepiece unit208, according to the present embodiment, the output signal from theposition detecting encoder211, corresponding to the rotational angle of themate eyepiece unit209, is applied to themotor control circuit257. Thus, thecircuit257 controls the operation of the drive motor.
• As this is done, the motor causes the[0314]pulley264 to rotate according to the rotational angle of themate eyepiece unit209, and the first and secondLCD driving pulleys262 and263 are rotated in the same direction and at the same speed by means of thebelt265. Accordingly, the positional relation between theLCD219bfor in-field display and theLCD214bfor microscopic image masking can be kept fixed, and image display equivalent to the one obtained by the image rotation shown in FIGS. 31C and 31D can be realized. Thus, the present embodiment can provide the same effects of the second embodiment.
TENTH EMBODIMENT
• FIG. 38B shows a tenth embodiment of the present invention. In the present embodiment, the respective configurations of the operator- and mate-side LCD's[0315]214aand214bfor microscopic image masking of the seventh embodiment are modified in the following manner.
• As shown in FIG. 38B, the present embodiment is provided with a[0316]support frame272 that has acircular window271. Thewindow271 of theframe272 is located on thefirst imaging point213a1of theobjective lens213a.
• A[0317]shielding plate273 is movably supported on thesupport frame272 so as to cover a part of thecircular window271. Further,racks274 are formed individually on the opposite sides of theshielding plate273. Theracks275 are in mesh with drivinggears275, individually. Thegears275 are fixed to the rotating shaft of amotor276. As thegears275 rotate, the shieldingplate273 is advanced or retreated so as to cover a part of thewindow271 of theframe272.
• The following is a description of the operation of the present embodiment arranged in this manner. According to the present embodiment, the drive of the[0318]motor276 is controlled by means of a control signal delivered from in-field display range setting means (not shown). As themotor276 rotates, thegear275 rotates. In association with the rotation of thegear275, the shieldingplate273 moves in the direction of the arrow in FIG. 38B, whereupon the area of the part of thecircular window271 that is covered by thesupport frame272 is changed. Thus, the microscopic image masking area is changed.
• The arrangement described above also fulfills the same functions of the operator- and mate-side LCD's[0319]214aand214bfor microscopic image masking of the seventh embodiment. Thus, the present embodiment can provide the same effects of the seventh embodiment.
ELEVENTH EMBODIMENT
• FIGS.[0320]39 to42B show an eleventh embodiment of the present invention. FIG. 39 shows an outline of the whole system of an operatingmicroscope apparatus281 according to the present embodiment.
• The operating[0321]microscope apparatus281 of the present embodiment comprises an operatingmicroscope282 constructed substantially in the same manner as the operatingmicroscope201 of the seventh embodiment, index/in-field display controller283, position information computing means284, and position detecting means285 for detecting the position of the operatingmicroscope282.
• A[0322]stand286 of the operatingmicroscope282 of the present embodiment is provided with a base287 movable on a floor surface and asupport post288 set up on thebase287.
• Further, the[0323]support post288 is provided, on its top portion, with abody289 of the operatingmicroscope282, including an optical system for observing an affected region, and asupport mechanism290 for supporting thebody289 for movement in any desired direction. Themechanism290 is a combination of a plurality of movingarms291 for locating themicroscope body289 in a desired position.
• Furthermore, the[0324]microscope282 is connected with the index/in-field display controller283, position information computing means284, and position detecting means285. Themicroscope282 is supplied with an index/in-field display control signal292 from thecontroller283 and a position information computing meansimage signal293 and an arm driving signal294 from the computing means284.
• FIG. 40B is an exterior view of the index/in-[0325]field display controller283. Abody295 of thecontroller283 is provided with ajoystick296 and twoswitches297 and298. An index control signal283ais delivered from thecontroller283 to the position information computing means284.
• FIG. 40A shows a[0326]microscopic image299 of the operatingmicroscope282. A position information computing meansimage300 and amarker301 are displayed in the field of themicroscopic image299. Twoindexes302aand302bare displayed in theimage300.
• The following is a description of the operation of the present embodiment. According to the present embodiment, the[0327]microscope282 is supplied with the position information computing means image signal293 from the position information computing means284. Theimage signal293 is displayed as an in-field display image304 on anLCD303 for in-field display, as shown in FIG. 41B. A preoperative image, such as an X-ray CT, is displayed in the in-field display image304. Further, theindexes302aand302bare displayed in theimage304, while themarker301 is displayed on theLCD303.
• A[0328]microscopic image mask306, which is as large as the in-field display image304, is displayed on anLCD305 for microscopic image masking shown in FIG. 41A. Amicroscopic image308 shown in FIG. 42B is superposed on amicroscopic image307 shown in FIG. 42A.
• Referring to FIG. 40A, the[0329]index302ain the position information computing meansimage300, an MIR or X-ray CT diagnostic image, and themarker301 in the field of themicroscopic image299 are pointed in the same direction in the operative field.
• The[0330]joystick296 andswitches297 and298 of thecontroller283 of FIG. 40B are operated to transmit the index control signal283ato the position information computing means284. Based on this information, the control means284 transmits the image, moved to theindexes302aand302b,as shown in FIG. 40A, to themicroscope282 in response to the position information computing meansimage signal293, and displays the image in the in-field display image304 of themicroscope282.
• Further, the position information computing means[0331]284 controls thesupport mechanism290 of themicroscope282 in response to thearm driving signal294, thereby moving themicroscope body289 so that theindex302band themarker301 are situated in the same position in the operative field.
• According to the present embodiment arranged in this manner, the operator can designate his or her desired view point on a position information computing means image, and the observational position can be automatically moved to the point. Thus, the field of vision can be easily moved to a target region during the surgical operation.[0332]
TWELFTH EMBODIMENT
• FIGS.[0333]43 to47 show a twelfth embodiment of the present invention.
• FIG. 43 shows an outline of an operating[0334]microscope apparatus401 and an endoscopic apparatus according to the present embodiment. Themicroscopic apparatus401 of the present embodiment is supported on astand402. Thestand402 is provided with a base402amovable on a floor surface and asupport post402bset up on the base402a.A movingarm mechanism404 for movably supporting amicroscope body403 of themicroscopic apparatus401 is provided on the top portion of thesupport post402b.Themechanism404 is formed of a plurality of moving arms including first, second, andthird arms405,406 and407 and aswing arm408.
• One end of the[0335]first arm405 is mounted on the upper end portion of thesupport post402bfor rocking motion around an axis Oa. Thefirst arm405 has an illumination light source (not shown) therein. One end of thesecond arm406 is mounted on the other end of thefirst arm405 for rocking motion around an axis Ob.
• The[0336]second arm406 is a pantograph arm that is formed of a link mechanism and a balancing spring member, whereby themicroscope body403 can be moved in the vertical direction. Thethird arm407 is mounted on the other end of thesecond arm406 for rocking motion around an axis Oc.
• The proximal end portion of the[0337]swing arm408 is coupled to thethird arm407. Themicroscope body403, abinocular tube409 for stereoscopic observation, and ahandle410 are provided on the distal end portion of thearm408. Theswing arm408 is supported for longitudinal swinging motion such that it causes themicroscope body403 to rock in the longitudinal direction around an axis Od, which extends at right angles to the drawing plane of FIG. 43, with respect to the direction of the operator's observation, and for transverse swinging motion such that it causes themicroscope body403 to rock in the transverse direction of the operator around an Oe.
• Further, electromagnetic brakes (not shown) are provided individually on rocking portions corresponding to the axes Oa to Oe of the moving[0338]arm mechanism404, whereby the position of themicroscope body403 can be freely spatially adjusted and fixed. These brakes are designed so that their locking or free state can be freely selected by operating a switch (not shown) on thehandle410. Preferably, a light source unit (not shown) for the movingarm mechanism404 should be incorporated in thesupport post402bof thestand402, for example.
• The[0339]binocular tube409 of themicroscope body403 is formed having left- and right-hand observational optical paths for stereoscopic observation. Each of the observational optical paths of thelens tube409 is provided with an objective lens (not shown) and a variable-scale optical system (not shown).Numeral440 denotes an endoscopic system for observing dead angles of the operating microscope.
• As shown in FIG. 44, the[0340]endoscopic system440 comp arigid scope441 having an observation port axis Og at a given angle to the direction of insertion, aTV camera442 including aTV camera head442afor picking up an observational image of thescope441 and aTV controller442b,and amonitor443 connected to thecontroller442band displaying the observational image of thescope441. Therigid scope441 is fixed to abedside stay445 by means of ascope holder444.
• The[0341]scope holder444 is provided with a fixingportion446 fixed to thebedside stay445,vertical arm447, movingarms448aand448b,slantingarm449, and holdingportion450, which are connected to one another in the order named. Thearms447,448a,448band449 and the holdingportion450 are rotatable around axes Op, Og, Or, Os and Ot, respectively.Electromagnetic brakes451ato451eare provided individually at portions corresponding to these axes of rotation, whereby the position of therigid scope441 can be freely three-dimensionally adjusted and fixed.
• These electromagnetic brakes are designed so that their locking or free state can be selected by operating a[0342]switch452 on the holdingportion450. Theswitch450 and thebrakes451ato451eare connected to aholder control section453. Thecontrol section453 is provided with a driver circuit (not shown), which outputs driving signals for disengagement to thebrakes451ato451ewhile an operating signal from theswitch452 is being inputted, and a circuit that delivers the input signal from theswitch452 to an in-field display controller454 (mentioned later).
• FIG. 45 shows an outline of the[0343]binocular tube409 according to the present embodiment. Thelens tube409 is provided with a right-eye observationaloptical system411 shown in FIG. 45 and a left-eye observational optical system (not shown). FIG. 45 shows a part of the right-eyeoptical system411, viewed from the lateral of thelens tube409. Since the left-eye observational optical system is constructed in the same manner as theoptical system411 shown in FIG. 45, the following is a description of theoptical system411 only.
• The right-eye[0344]optical system411 according to the present embodiment comprises a binocular tube optical system (first observational optical system)412 for observing the observational image of the operating microscope and an image projection optical system (second observational optical system)413 for observing optional image information that is different from the observational image. The binocular tubeoptical system412 is provided with an imagingoptical system414,image rotator415,parallelogrammatic prism416, and eyepieceoptical system417. The observational image of the operating microscope, incident upon the binocular tubeoptical system412, is guided from the imagingoptical system414 to the eyepieceoptical system417 via theimage rotator415 and theprism416 in succession.
• Further, the image projection[0345]optical system413 is provided with anLCD display420 as an in-field display function, collimatingoptical system421, variable-scaleoptical system422 having a variable projection magnification, imagingoptical system423, andmovable prism424. Theprism424, which is oriented in the direction of arrow S within the plane of areflective surface424a,is movable with respect to the image projectionoptical system413 by means of amotor425a.On the other hand, the variable-scaleoptical system422 is connected so that its magnification can be changed by driving amotor425b.
• The[0346]movable prism424 and the variable-scaleoptical system422 are driven in a relation such that the image on theLCD display420 is enlarged in proportion to the depth of insertion of theprism424 in the binocular tubeoptical system412 as it is projected by means of theoptical system422.
• The image information displayed on the[0347]LCD display420 is guided to the eyepieceoptical system417 successively through the collimatingoptical system421, variable-scaleoptical system422, imagingoptical system423, andmovable prism424. The eyepieceoptical system417 ensures simultaneous observation of the observational image of the operating microscope transmitted through the binocular tubeoptical system412 and the optional image information transmitted through the image projectionoptical system413.
• [0348]Numeral454 denotes the in-field display controller (display format changing means), which is connected to theholder control section453 to which theswitch452 of thescope holder444 is connected,LCD display420,TV controller442b,andmotors425aand425b.Thecontroller454 is composed of driver circuits for themotor425afor moving theprism424 and themotor425bfor driving the variable-scaleoptical system422, control circuits for controlling the drive of the driver circuits, and a display control circuit that is supplied with a video signal from theTV controller442bof theTV camera442 and displays an image on theLCD display420.
• The observational image of the operating[0349]microscope apparatus401 ensures stereoscopic observation of an affected region through themicroscope body403 by means of the binocular tubeoptical system412 of thebinocular tube409. As this is done, themovable prism424 of the image projectionoptical system413 is on the optical path of the binocular tubeoptical system412, as shown in FIG. 45. The image of the affected region observed through therigid scope441 is picked up by means of theTV camera head442ashown in FIG. 44. This image is displayed on themonitor443 and theLCD display420 by means of theTV controller442band the in-field display controller454 shown in FIG. 45, respectively. The display image is observed through the image projectionoptical system413 and the eyepieceoptical system417.
• FIG. 46 shows a state of observation for the case where the image of the rigid scope is mainly observed as the surgical operation is carried out. In FIG. 46,[0350]numerals455 and456 denote a microscopic image and an image observed through therigid scope441, respectively. Therigid scope441 itself is displayed in themicroscopic image455.
• On the other hand, the operator can change the observational position of the[0351]rigid scope441 by depressing theswitch452 of thescope holder444 to disengage theelectromagnetic brakes451ato451f.By doing this, therigid scope441 can be freely moved in a three-dimensional manner. As this is done, theholder control section453 disengages theelectromagnetic brakes451ato451bto cancel the locked state, and delivers an ON-signal of theswitch452 to the in-field display controller454.
• On receiving this input signal, the in-[0352]field display controller454 drives themotors425aand425bto a previously stored specified extent, and the depth of insertion of themovable prism424 in the binocular tube optical system is reduced. At the same time, the magnification of the variable-scaleoptical system422 is changed into (or lowered to) a value that is settled properly for the movement of themovable prism424. Thereupon, the image observed through the eyepieceoptical system417 looks like the one shown in FIG. 47. Thus, theimage456 of the rigid scope, compared to themicroscopic image455, moves to an end of the field of vision, and is displayed in a contracted form.
• In this manner, the[0353]image456 of therigid scope441, compared to theobservational image455 of the operating microscope, is observed in a wide range in the case where the observational position of thescope441 is fixed, and in a narrow range if the observational position of thescope441 is changed (or if thescope441 is moved). When no normal rigid scope observation is carried out, a footswitch (not shown) of the microscope can be operated entirely to remove themovable prism424 from the optical path of the binocular tubeoptical system412 with ease. Thus, observation can be effected in the same manner as the observation by means of the conventional operating microscope.
• The[0354]rigid scope image456 is displayed wide on theobservational image455 of the operating microscope when it is used for a required treatment or observation, so that the treatment operation is easy. Since the display of therigid scope image456 is small while therigid scope441 is being moved, on the other hand, the state of insertion of therigid scope441 in themicroscopic image455 can be observed satisfactorily.
• According to the present embodiment, the operating state of the[0355]rigid scope441 is detected by detecting the disengagement of thescope holder444 for holding thescope441, so that the surgical operation can be smoothly carried out without requiring use of any special device for detection and its operation.
• Further, the movement of the[0356]rigid scope441 can be detected more easily than by using an optical position detector according to a thirteenth embodiment described below.
THIRTEENTH EMBODIMENT
• FIGS.[0357]48 to50B show a thirteenth embodiment.
• As is schematically shown in FIG. 48, an operating[0358]microscope apparatus401 and anendoscopic system440 according to the present embodiment are constructed in the same manner as the ones according to the twelfth embodiment, so that a detailed description of those elements is omitted. The following is a description of the optical position detector for the operatingmicroscope apparatus401 and theendoscopic system440. This optical position detector may be a conventional one.
• As shown in FIG. 48,[0359]emissive indexes460 and461 are attached to the operatingmicroscope apparatus401 and theendoscopic system440, respectively. Theindexes460 and461 can be shot by means of an illuminant image-pickup device462 that is provided with image-pickup means. Thedevice462 is connected with aposition detecting section463 for computing the position and angle of an illuminant in response to a signal from thedevice462. Theposition detecting section463 is composed of a position data computing section for amicroscope body403, a position data computing section for arigid scope441, and a position calculating section for calculating the position of therigid scope441 relative to the position of themicroscope body403. The detectingsection463 delivers information on the observational direction of the rigid scope with respect to themicroscope body403 to an in-field display controller464, which will be mentioned later.
• FIG. 49 shows an outline of a[0360]binocular tube465 according to the present embodiment.
• A binocular tube[0361]optical system412 of thebinocular tube465 is constructed in the same manner as the one according to the twelfth embodiment. Therefore, a description of thesystem412 is omitted, and the following is a description of an arrangement of an image projectionoptical system469, a unique element.
• The image projection[0362]optical system469 comprises anLCD display420 for use as an in-field display function, collimatingoptical system466, imagingoptical system467, andprism468. Image information displayed on theLCD display420 is guided to an eyepieceoptical system417 successively through the collimatingoptical system466, imagingoptical system467, andprism468.
• The image projection[0363]optical system469, which is incorporated in achassis470, is connected so that it can be rocked integrally with thechassis470 around an optical axis Of of the eyepieceoptical system417 of thebinocular tube465 by means of amotor471. The eyepieceoptical system417 ensures simultaneous observation of the observational image of the operating microscope transmitted through the binocular tubeoptical system412 and optional image information transmitted through the image projectionoptical system469.
• The in-[0364]field display controller464 is connected to theposition detecting section463 of the aforesaid optical position detector, aTV controller442b,theLCD display420, and thechassis rotating motor471. Thecontroller464 is composed of a driver circuit for thechassis rotating motor471, control circuit for controlling the drive of the driver circuit, display control circuit for theLCD display420, control circuit for controlling the rotation of themotor471 in response to a position signal from theposition detecting section463, and a display control circuit that is supplied with a video signal from theTV camera442 and displays an image on theLCD display420.
• The observational image of the operating microscope apparatus according to the thirteenth embodiment ensures stereoscopic observation of an affected region through the[0365]microscope body403 by means of the binocular tubeoptical system412 of thebinocular tube465. As this is done, themovable prism468 of the image projectionoptical system469 is on the optical path of the binocular tubeoptical system412, as shown in FIG. 49. The image of the affected region observed through therigid scope441 is picked up by means of aTV camera head442a.This image is displayed on amonitor443 and theLCD display420 by means of theTV controller442band the in-field display controller464, respectively. The display image on thedisplay420 is observed through the image projectionoptical system469 and the eyepieceoptical system417.
• During a surgical operation, the respective positions of the[0366]microscope body403 and therigid scope441 are always detected by means of a conventional optical position detector. Theposition detecting section463 obtains the direction (angle) of observation of therigid scope441 with respect to the observation direction of themicroscope body403, and delivers angle information to the in-field display controller464. In response to this angle information, thecontroller464 rotates themotor471 as required, thereby causing the image projectionoptical system469 always to rotate integrally with the chassis in the same direction as the observation direction of the rigid scope. FIGS. 50A and 50B show states that are observed by means of the eyepieceoptical system417. In this case, an image of therigid scope441 is displayed in the same direction as the observational direction (indicated by arrow B) of thescope441.
• According to the operating[0367]microscope401 of the present embodiment, theimage456 that is obtained through therigid scope441 and displayed in the field of observation is displayed in the same direction as the observational direction of the rigid scope, so that the operator can intuitively recognize the observational direction of therigid scope441. Thus, the operator can be intent on the surgical operation without suffering troublesomeness, and therefore, the operation time can be shortened.
• Since the optical position detecting means is used in the present embodiment, moreover, the system is readily compatible with a conventional navigation system that displays the respective observational positions of the surgical operation and the[0368]rigid scope441 on a diagnostic image.
• According to the present embodiment, furthermore, the optical position detecting means is used to detect the observational direction of the[0369]rigid scope441 with respect to themicroscope body403. Alternatively, however, the observational direction of therigid scope441 can be easily detected by means of an encoder or the like that is attached to a joint portion of the scope holder of the twelfth embodiment and serves as rotational angle detecting means. In this case, a simple system can be enjoyed.
FOURTEENTH EMBODIMENT
• A fourteenth embodiment will be described with reference to FIG. 51. According to the present embodiment, the operating microscope apparatus of the twelfth embodiment is modified so that the binocular tube is designed differently and its visibility is automatically adjusted to the operator's eyes.[0370]
• FIG. 51 shows an outline of a[0371]binocular tube480 according to the present embodiment. Thebinocular tube480 is provided with a binocular tube optical system (first observational optical system)412, which is similar to the one according to the first embodiment, an image projectionoptical system481 for observing optional image information that is different from an observational image, a measurement optical system487 for refractive index measurement, and a light receivingoptical system488. Theoptical systems481,487 and488 constitute a second observational means. A detailed description of the binocular tubeoptical system412, which is constructed in the same manner as the one according to the twelfth embodiment, is omitted.
• The image projection[0372]optical system481 comprises anLCD display482 for use as in-field display means, collimatingoptical system483, imagingoptical system484, andmovable prism485. Adichroic mirror486 is located on an optical path between theprism485 and the imagingoptical system484. Themovable prism485 is provided on the optical path in a manner such that it can be removed by means of a motor (not shown).
• The measurement optical system[0373]487 comprises themovable prism485, thedichroic mirror486, a half-mirror489, aslit plate490 in a position conjugate to the eyeground of a subject eye having a reference refractive force, adiffuser panel491, and a light emitting diode for emitting infrared light. Thus, the optical system487 shares some components with the image projectionoptical system481.
• The light receiving[0374]optical system488 comprises themovable prism485, thedichroic mirror486, the half-mirror489, a shieldingmember494 in a position conjugate to theslit plate490, and alight receiving element495 in a position conjugate to the pupil. Thus, theoptical system488 shares some components with the measurement optical system487.Numeral496 denotes a measurement section for computing the refractive force of the subject eye according to the light quantity distribution of thelight receiving element495. Themeasurement section496 is connected to a visibility correction motordrive control section499 and an in-field display controller500 (mentioned later), as well as to thelight emitting diode492.
• The eyepiece[0375]optical system417 ensures simultaneous observation of the observational image of the operating microscope transmitted through the binocular tubeoptical system412 and optional image information transmitted through the image projectionoptical system481. Further, theoptical system417 is designed so that it can make visibility adjustment by moving in the direction of its optical axis Of. Amotor498 can be used for the movement in the direction of the optical axis Of.Numeral499 denotes the visibility correction motor drive control section that is connected to themotor498 and the in-field display controller (mentioned later). Thecontrol section499 is provided with a driver circuit for themotor498 and a control circuit for controlling the drive of the motor. Themotor498 and the visibility correction motordrive control section499 constitute visibility correction motor drive means.
• The in-[0376]field display controller500 is connected to theLCD display482, themeasurement section496, aswitch502 that is connected to the operating microscope apparatus, a motor (not shown) for themovable prism485, and an external image apparatus. Thecontroller500 comprises a motor drive control circuit for theprism485, a display control circuit, and a driving signal output circuit for driving the measurement section. The display control circuit displays an image on theLCD display482 and displays a stored fixed-view display pattern for measurement in response to input from theswitch502.
• The observational image of the operating microscope according to the present embodiment and the image displayed on the[0377]LCD display482 are observed through the eyepieceoptical system417 in the same processes of operation of the twelfth and thirteenth embodiments. The images can be observed in the same manner as in the conventional operating microscope if themovable prism485 is removed from the optical path.
• The following is a description of visibility adjustment.[0378]
• If the operator turns on the[0379]switch502 of the operating microscope apparatus, the in-field display controller500 displays the previously stored fixed-view display pattern on theLCD display482. This image is observed through the image projectionoptical system481 and the eyepieceoptical system417 by the operator. The operator's eyes are fixed as they gaze steadily at the fixed-view display pattern. At the same time, thecontroller500 causes themeasurement section496 to start measuring the refractive force.
• The following is a description of operation for the refractive force measurement.[0380]
• In response to a signal from the[0381]measurement section496, infrared light is emitted from thelight emitting diode492. This infrared light is projected on the operator's eyeground via a slit (not shown) of theslit plate490, half-mirror489,dichroic mirror486,movable prism485, and eyepieceoptical system417. Thus, a slit image of theslit plate490 is projected on the eyeground.
• The projected infrared light is reflected by the eyeground and delivered to the[0382]light receiving element495 via the eyepieceoptical system417, themovable prism485, thedichroic mirror486, the half-mirror489, amirror493, and the shieldingmember494. Based on information on the light quantity distribution from the light receiving element, the measurement section computes the refractive force of the operator's eyes. Based on the result of this computation, the visibility correction motor drive control section causes themotor498 to rotate, thereby moving the eyepieceoptical system417 for a required distance in the direction of the optical axis Of. Thereupon, the operator's visibility adjustment is completed.
• The operating microscope of the present embodiment has a very simple construction, since the image projection optical system, which can display another image in the field, and the optical systems (measurement optical system and light receiving optical system) for measuring the refractive force share some of their components. Since the optical path separate from the one for the observational image of the operating microscope is used, moreover, the observational performance of the microscope cannot be ruined.[0383]
• Since the fixed-view display that causes the operator to gaze steadily at the image is made on the LCD display screen, furthermore, accurate measurement can be accomplished without being influenced by the focusing capability of the eyes.[0384]
• Further, the observational performance of the operating microscope cannot be lowered if the movable prism is removed from the optical path.[0385]
FIFTEENTH EMBODIMENT
• According to a fifteenth embodiment shown in FIGS.[0386]52 to53B, an image of a nerve monitor device that displays the nerve state of a patient in the field of an operating microscope during a surgical operation. The present embodiment differs from the twelfth embodiment only in the construction of the in-field display controller.
• As shown in FIG. 52, an in-[0387]field display controller510 of the present embodiment is connected to abinocular tube409 that is similar to the one according to the twelfth embodiment. Anerve monitor device511 displays a wavy image indicative of the nerve state on a monitor (not shown), and delivers a video signal for the wavy image to thecontroller510. Further, themonitor device511 is provided with abnormal signal output means through which the operator can be informed of change of the nerve state. The output means is connected to thecontroller510.
• The in-[0388]field display controller510 is composed of driver circuits for amotor425afor moving themovable prism424 of the twelfth embodiment and amotor425bfor driving the variable-scaleoptical system422, control circuits that are supplied with signals from the abnormal signal output means from thenerve monitor device511 and controls the drive of themotors425aand425b,and a display control circuit that is supplied with a video signal from themonitor device511 and displays an image on anLCD display420.
• In the operating microscope according to the present embodiment, an[0389]image515 of thenerve monitor device511 is normally displayed in the field of the operating microscope in the manner shown in FIG. 53A during the surgical operation. If the nerve state of the patient is changed during the operation, a signal is outputted from the abnormal signal output means of themonitor device511, whereupon the in-field display controller510 drives themotors425aand425bin the same manner as in the twelfth embodiment. In consequence, the nerve monitorimage515 is displayed wide, as shown in FIG. 53B.
• Thus, the operator can easily recognize the nerve state of the patient.[0390]
• According to the operating microscope of the present embodiment, therefore, the size of the display information of the nerve monitor device varies despite the operator's concentration on the surgical operation, so that the operator never overlooks the change of the patient's nerve state.[0391]
• The following is a description of rigid scope systems according to three alternative embodiments that are applicable to the surgical system described above. These embodiments are solutions to the rigid scopes described in Jpn. UM Appln. KOKAI Publications Nos. 5-78201 and 56-176703, U.S. Pat. No. 5,168,863, and Jpn. Pat. Appln. KOKAI Publication No. 11-155798. More specifically, these alternative embodiments are intended to improve a rigid scope that is adapted to be inserted into the body cavity under surgical microscopic observation and ensure observation in the direction at a given angle to the direction of insertion, to prevent the rigid scope and a TV camera and a light guide connected thereto from hindering the microscopic observation or surgical operation, and to enable the operator to observe desired positions with ease.[0392]
SIXTEENTH EMBODIMENT
• A system according to a sixteenth embodiment will now be described with reference to FIGS. 54 and 55.[0393]
• FIG. 54 shows a general configuration of a rigid scope system. In FIG. 54, numeral[0394]601 denotes a body of an operating microscope. Themicroscope body601 is held over an affected region by means of an arm stand (not shown) in a manner such that its observational direction can be changed freely.Numeral602 denotes a rigid scope, which comprises aninsert member603 adapted to be inserted into the affected region (body cavity) and having an objective lens and an internal light guide (mentioned later) fixed therein, acoupling portion604 composed of first and secondbent portions604aand604b,and agrip portion605 having an eyepiece. Symbol R designates a point of observation of therigid scope602.
• An[0395]upper surface604cof thecoupling portion604 is coated with light absorbing paint such as matte black. Thegrip portion605 has therein a camera connecting portion, which is connectable with aTV camera606 that is connected optically to an imaging lens (mentioned later).
• [0396]Numeral607 denotes an external light guide, one end of which is connected to a light source unit (not shown). Aconnector607aon the other end of thelight guide607 can be attached to and detached from alight guide mouthpiece608 that projects substantially parallel to the bending direction of the firstbent portion604a,at the upper end of theinsert portion603 of therigid scope602.
• The construction of the[0397]rigid scope602 will now be described in detail with reference to FIG. 55. Anobjective lens609 is provided in the distal end portion of theinsert portion603. Thelens609 is fixed obliquely to the distal end of theinsert portion603 so that it is inclined at a given angle α to the longitudinal direction of theinsert portion603. Aprism610 and a relayoptical system611 are also arranged in theinsert portion603. The respective optical axes of theobjective lens609 and theoptical system611 are kept at the aforesaid angle α with theprism610 between them.
• A[0398]prism612 is located in the firstbent portion604aof thecoupling portion604, whereby an observational optical axis O1 of the relayoptical system611 can be bent at about 90°. A relayoptical system613 is provided in an intermediate portion of thecoupling portion604, and aprism614 is disposed in the secondbent portion604bof thecoupling portion604. Theprism614 serves to bend the observational optical axis, bent by means of theprism612, so as to extend substantially in the longitudinal direction of theinsert portion603. Further, thegrip portion605 has therein a relayoptical system615 located on a luminous flux that is guided by means of theprism614. Animaging lens616 is disposed in the rear end portion of thegrip portion605. Thelens616 serves to focus an observational luminous flux on an image-pickup device617 of theTV camera606.
• A[0399]cable618 that is connected electrically to the image-pickup device617 of theTV camera606 is connected to a drive unit (not shown), and a TV monitor (not shown) is connected electrically to the drive unit. TheTV camera606 is detachably connected to thegrip portion605 by means of a mountingscrew portion619.
• In the vicinity of the[0400]objective lens609, an illuminatinglens620 is disposed in the distal end of theinsert portion603. The distal end of an internallight guide621 is fixed to the inside of thelens620 in a manner such that it is situated on the optical axis of thelens620 and that the respective centers of theguide621 and thelens620 are substantially aligned with each other. The illuminatinglens620 and the internallight guide621 constitute an illumination optical system according to the present embodiment. In aspace portion622 that is defined at the junction between theinsert portion603 and thecoupling portion604, thelight guide621 is fixed to thelight guide mouthpiece608 with some slack. Thelight guide mouthpiece608 is formed having a mountingscrew portion623 that serves to connect the externallight guide607 optically to the internallight guide621.
• The[0401]coupling portion604 is provided with a bearingportion624, which engages aflange625 on the rear end of theinsert portion603 so as to hold theinsert portion603 for rotation around its longitudinal central axis. The bearingportion624 and theflange625 constitute arotation mechanism portion626.
• With the arrangement described above, the operator operates the arm stand (not shown) that supports the operating[0402]microscope body601, thereby adjusting themicroscope body601 to a desired position and angle. Further, illumination light is applied to the affected region through themicroscope body601, and the affected region is subjected to enlarged-scale observation.
• Then, the observational dead-angle region R of the operating microscope in the affected region is observed by means of the[0403]rigid scope602. First, theconnector607aof the externallight guide607 is connected to thelight guide mouthpiece608 of therigid scope602, and the other end of thelight guide607 is connected to the light source unit (not shown). Further, thecable618 of theTV camera606 is connected to the drive unit (not shown).
• As shown in FIG. 54, the[0404]insert portion603 is inserted into the affected region with thegrip portion605 and theTV camera606 kept at a distance L from themicroscope body601, and theobjective lens609 is directed to a position near the observational dead-angle region R.
• The illumination light emitted from the light source (not shown) guided to the observational dead-angle region R by means of the external[0405]light guide607, internallight guide621, and illuminatinglens620. The light from the region R is transmitted through theobjective lens609,prism610, and relayoptical system611, and then bent at about 90° by means of theprism612. After it is transmitted through the relayoptical system613, moreover, the light is bent in the same direction as the longitudinal direction of theinsert portion603 by means of theprism614, and focused on the image-pickup device617 of theTV camera606 via the relayoptical system615 and theimaging lens616. A video image of the observational dead-angle region R is displayed on the TV monitor (not shown) by means of the drive unit (not shown) and observed by the operator.
• Then, in changing the observational position of the[0406]rigid scope602 from the observational dead-angle region R within a plane perpendicular to the direction of insertion of theinsert portion603, the operator operates therotation mechanism portion626 to rotate theinsert portion603 in the direction of anarrow627 shown in FIG. 55 with respect to thecoupling portion604. As this is done, the rotation of theinsert portion603 is absorbed by the slack of the internallight guide621 in thespace portion622, so that thelight guide621 can never be pulled. Thus, the observational position of therigid scope602 can be changed without changing the respective positions of thecoupling portion604 and thegrip portion605 with respect to the operatingmicroscope body601.
• As the operator's treatment advances, it sometimes may be hindered by the[0407]coupling portion604,grip portion605,TV camera606, etc. during the observation of the observational dead-angle region R. In this case, thecoupling portion604 is rotated reversely in the direction of thearrow627 with respect to theinsert portion603 by means of therotation mechanism portion626. Thus, the respective positions of thegrip portion605,coupling portion604, externallight guide607, andTV camera606 with respect to the operatingmicroscope body601 can be changed without changing the observational position of therigid scope602.
• According to the present embodiment, the[0408]grip portion605 is located at the fixed distance L from theinsert portion603 with thecoupling portion604 between them. If therigid scope602 is inserted into the affected region (body cavity) under surgical microscopic observation, therefore, themicroscope body601,grip portion605, andTV camera606 can avoid interfering with each other. Since the externallight guide607 that is connected to the light source unit is guided in the same direction as thecoupling portion604, moreover, it can be prevented from unexpectedly intercepting the microscopic field. Thus, thelight guide607 exerts no bad influence upon the microscopic observation.
• Since the length of projection of the[0409]grip portion605 and theTV camera606 within the plane of the affected region is restricted to the minimum, e.g., the distance L, furthermore, the space required by the operator's surgical operation is reasonable, and the possibility of the projecting part hindering the operation can be minimized.
• Further, the observational direction of the[0410]rigid scope602 can be changed without changing the respective positions of thegrip portion605 and theTV camera606. When the observational direction of therigid scope602 is changed, therefore, thegrip portion605 and theTV camera606 can be prevented from interfering with the operator's hands or body, and the externallight guide607 and theTV camera cable618 can be prevented from intercepting the microscopic field. Thus, the efficiency of the surgical operation cannot be lowered. Since the respective positions of thegrip portion605 and theTV camera606 can be changed without changing the observational position of therigid scope602, moreover, change of a style can be quickly tackled with the progress of the operation, so that the efficiency of the operation is improved further.
• Moreover, the[0411]upper surface604cof thecoupling portion604 is coated with light absorbing paint such as matte black. If thecoupling portion604 gets into the surgical microscopic field, therefore, the illumination light of the operating microscope can be prevented from being reflected by thecoupling portion604 and dazzling in the microscopic field.
• In connection with the present embodiment, furthermore, the coating method, e.g., matte black coating, has been described as reflection preventing means on the[0412]upper surface604cof thecoupling portion604. However, satin finish, filling, or other means for restraining reflection may be used with the same result.
• With the arrangement in which the insert portion and the grip portion are coupled by means of the coupling portion so as to bend like a crank, as in the case of the sixteenth embodiment or the embodiments mentioned later, a plurality of[0413]rigid scopes602 with different squint directions for theinsert portion603 may be prepared, or a joint structure may be provided such that a plurality of rigid scopes or insert portions with different squint directions can be attached and detached for replacement. According to the sixteenth embodiment, the squint direction is opposite to the direction of the coupling portion (and the direction of the mouthpiece for the external light guide607) against the grip portion. Alternatively, however, the direction of thecoupling portion604 or the mouthpiece for the externallight guide607 may be shifted around the axis of the insert portion. Rigid scopes of the conventional type may be available with various angular relations between the squint direction and the direction of the lateral mouthpiece for the external light guide.
SEVENTEENTH EMBODIMENT
• A system according to a seventeenth embodiment will now be described with reference to FIGS.[0414]56 to58. In the description of the present embodiment to follow, like reference numerals are used to designate the same portions of the sixteenth and seventeenth embodiments, and a description of those portions is omitted.
• FIG. 56 shows a general configuration of a rigid scope system. The present embodiment is related mainly to an arm-[0415]type stand630 for fixedly locating therigid scope602 in the operator's desired angular position.
• The arm-[0416]type stand630 for holding therigid scope602 comprises afirst arm631 that can be connected to thegrip portion605 of therigid scope602. Thefirst arm631 is connected to asecond arm632 by means of a connectingportion633 for rotation around axes O2 and O3. Likewise, thesecond arm632 is connected to athird arm634 by means of a connectingportion635 for rotation around an axis O4, and thethird arm634 is connected to astand holder636 by means of a connectingportion637 for rotation around an axis O5.
• The axis O[0417]2 is the center line of thefirst arm631 that extends at right angles to a reflected light axis O1′ (mentioned later) of therigid scope602, and the axis O3 extends at right angles to the axis O2. The axis O4 extends at right angles to the center line of thesecond arm632, while the axis O5 extends at right angles to the axis O4.
• The[0418]third arm634 is supported vertically on thestand holder636 and connected thereto for up-and-down motion. Theholder636 can be attached integrally to a side rail of an operating table (not shown).
• Each of the connecting[0419]portions633,635 and637 has an electromagnetic lock (brake, not shown) therein. The rotation around each of the axes O2 to O5 can be allowed by turning on an input switch (not shown) on the distal end of thefirst arm631, for example, and it can be prohibited by turning off the input switch.
• All of the first to[0420]third arms631,632 and634 have a hollow structure. Thecable618 of theTV camera606, an arm light guide638 (mentioned later), etc. are passed through the respective bores of these arms. Thecable618 and theguide638 are exposed downward to the outside from the lower surface of the connectingportion637. Thecable618 and the armlight guide638, like the ones according to the sixteenth embodiment, can be connected to a drive unit and a light source unit (not shown).
• The construction of the[0421]rigid scope602 will now be described in detail with reference to FIG. 57. In FIG. 57, numeral640 denotes a mirror that is fixed in the firstbent portion604aof thecoupling portion604. Themirror640 serves to bend a luminous flux, guided by theinsert portion603, at about 90° to the longitudinal direction of theinsert portion603. A relayoptical system641 is fixed in thecoupling portion604. Located in the middle of thecoupling portion604 is amirror642, which bends the luminous flux guided by theoptical system641 and guides it to theimaging lens616. Themirror642 is fixed in the secondbent portion604bof thecoupling portion604 in a manner such that an extension of the reflected light axis O1′ crosses the optical axis O1 of the relayoptical system611, which is substantially in line with the central axis of theinsert portion603, in the vicinity of theobjective lens609. The reflected light axis O1′ is substantially in line with the central axis of thegrip portion605.
• The[0422]insert portion603 is provided with an internallight guide643, which, in conjunction with the illuminatinglens620, constitutes an illumination optical system. One end of theguide643 is connected optically to thelens620. The rear end portion of theguide643 is led out in the same direction as the bending direction of the firstbent portion604ain a manner such that it is attached integrally to alight guide mouthpiece644 on the rear end of theinsert portion603 by means of asheathing645. A connectingportion646 is provided on the other end of the internallight guide643. Further, the guide.643 can be fixed to the underside of thecoupling portion604 by means ofhooks647.
• A connecting[0423]portion648 is provided on the rear end portion of thegrip portion605. The connectingportion648 engages a mountingportion649 on thefirst arm631 of the arm-type stand630, and is positioned by being fixed to thearm631 by means of a so-called click mechanism that includes agroove portion650 and a fixingball651 . Thus, therigid scope602 can be attached integrally to thestand630. TheTV camera606 can be also attached integrally to thefirst arm631 of thestand630 so that its image-pickup device617 is located in the imaging position of theimaging lens616.
• The connecting[0424]portion648 of thegrip portion605 is provided with a bearingportion652 that engages aflange653. The bearingportion652 constitutes arotation mechanism portion654 for holding thecoupling portion604 for rotation around the axis O1′.
• As mentioned before, moreover, the arm[0425]light guide638 is incorporated in the arms that constitute the arm-type stand630. One end of theguide638 is fixed by means of alight guide mouthpiece656 at the distal end of thefirst arm631. Themouthpiece656 has a mountingscrew portion657 that engages the connectingportion646 to be connected optically to the internallight guide643.
• As shown in FIG. 58, the[0426]upper surface604cof thecoupling portion604 hasslopes658 and659 that are inclined at right angles to their longitudinal direction.
• With this arrangement, the operator observes the observational dead-angle region R of the operating microscope by means of the[0427]rigid scope602, as in the case of the sixteenth embodiment. First, the operator holds thegrip portion605 of therigid scope602 and inserts thescope602 into an affected region. Then, the operator, holding thegrip portion605, turns on the input switch (not shown) on thefirst arm631. Thereupon, the electromagnetic locks in the connecting portions of the arm-type stand630 are disengaged, so that the rotation around each of the axes O2 to O5 is allowed, and therigid scope602 can be operated freely. In this state, theobjective lens609 of therigid scope602 is located on the extension of the axis O1′ that corresponds to the axis of thegrip portion605. Accordingly, the operator can insert theinsert portion603 into the affected region and locate theobjective lens609 near the observational dead-angle region R with a feeling such that the rigid scope is a conventional rod-shaped scope without thecoupling portion604 and in a manner such that thegrip portion605 and theTV camera606 are kept at the distance L from themicroscope body601, as in the case of the sixteenth embodiment.
• When the[0428]objective lens609 is located in the observational dead-angle region R, the operator then turns off the input switch on the arm-type stand630. Thereupon, the respective electromagnetic locks of the connecting portions are fixed, and therigid scope602 is fixed with theobjective lens609 kept near the region R. If thecoupling portion604 then gets into the microscopic field of themicroscope body601, as shown in FIG. 58, the illumination light from thebody601 is reflected away from the microscopic field by theslopes658 and659 of thecoupling portion604, as indicated by arrows W1 and W2 in FIG. 58.
• The illumination light emitted from the light source (not shown) is guided to the observational dead-angle region R by means of the arm[0429]light guide638, internallight guide643, and illuminatinglens620. The light from the region R is transmitted through theobjective lens609,prism610, and relayoptical system611, and then bent at about 90° by means of themirror640. After it is transmitted through the relayoptical system641, moreover, the light is bent in the direction of the axis O1′ by means ofmirror642, and focused on the image-pickup device617 of theTV camera606 via the relayoptical system615 and theimaging lens616. A video image of the observational dead-angle region R is displayed on a TV monitor (not shown) by means of the drive unit (not shown) and observed by the operator.
• Then, in changing the observational position of the[0430]rigid scope602 from the observational dead-angle region R within a plane perpendicular to the direction of insertion of theinsert portion603, the operator operates therotation mechanism portion654 to rotate thecoupling portion604 in the direction of anarrow660 shown in FIG. 57 with respect to thegrip portion605. As this is done, the internallight guide643 is rotated integrally with thecoupling portion604 around the axis O1′, since it is guided in the same direction as the bending direction of the firstbent portion604aand fixed integrally to thecoupling portion604 by means of thehooks647. Thus, the observational position of therigid scope602 can be changed without changing the respective positions of thegrip portion605,TV camera606, and arm-type stand630.
• If the operator's treatment is hindered by the[0431]grip portion605,coupling portion604,TV camera606, and arm-type stand630 during the observation of the observational dead-angle region R as it advances, as in the case of the sixteenth embodiment, thegrip portion605 is rotated reversely in the direction of thearrow660 with respect to thecoupling portion604 by means of therotation mechanism portion654. Thus, the respective positions of thegrip portion605, theTV camera606, and the arms that constitute the arm-type stand630 with respect to the operatingmicroscope body601 can be changed without changing the observational position of therigid scope602.
• Depending on the conditions of the region to be observed, moreover, the operator must change the[0432]rigid scope602 during a surgical operation. The rigid scope may be selected among ones of which the observational angle α of theobjective lens609 to the longitudinal direction of theinsert portion603 is different or the outside diameter of theinsert portion603 varies depending on the diameter of the opening of the body cavity to be penetrated thereby. In this case, the operator first loosens the mountingscrew portion657 to remove the connectingportion646 of the internallight guide643 from thelight guide mouthpiece656. Further, the operator, holding thegrip portion605 in one hand and thefirst arm631 in the other, pulls out therigid scope602 in the direction of anarrow661 from thefirst arm631. Thereupon, thegroove portion650 of the connectingportion648 is disengaged from thepin651 of thefirst arm631, and therigid scope602 is removed from thefirst arm631.
• Subsequently, a preferred rigid scope that is different from the one described above in the observational angle α and the outside diameter of the[0433]insert portion603 is attached to thefirst arm631, reversely following the aforementioned steps of procedure, and is used in the same manner as aforesaid. According to the present embodiment, thegrip portion605 is located at the fixed distance L from theinsert portion603 with thecoupling portion604 between them, as in the case of the sixteenth embodiment. Therefore, the surgicaloperation microscope body601,grip portion605, andTV camera606 can avoid interfering with one another. Further, the length of projection of thegrip portion605 and theTV camera606 within the plane of the affected region is restricted to the minimum or the distance L, and besides, the internallight guide643 is guided in the same direction as the bending direction of the firstbent portion604aand fixed to the underside of thecoupling portion604. Accordingly, the internallight guide643 can be securely prevented from wrongly intercepting the microscopic field during the surgical operation.
• Since the[0434]objective lens609 of therigid scope602 is located on the axis of thegrip portion605, moreover, the operator can adjust the observational position of the rigid scope with the same feeling of operation as that for a conventional rigid scope without thecoupling portion604, and locate theobjective lens609 more quickly and securely in the target region. Since thecable618 of theTV camera606 and the light guides are incorporated in the holding arm for fixedly holding therigid scope602 itself, furthermore, the whole rigid scope system never unduly occupies the space for the operator's surgical operation, and the efficiency of the surgical operation can be prevented from lowering.
• Since the observational direction of the[0435]rigid scope602 can be changed by only rotating thecoupling portion604 with the length L, moreover, thegrip portion605 and theTV camera606 can be prevented from interfering with the operator's hands or body when the observational direction is changed. Since the respective positions of thegrip portion605, theTV camera606, and the arms of the arm-type stand630 can be changed without changing the observational position of therigid scope602, furthermore, change of the style can be quickly tackled with the progress of the operation, so that the efficiency of the operation is improved further.
• Since the[0436]rigid scope602 can be easily replaced with a new one during the surgical operation, moreover, an optimum rigid scope can be selected according to the progress of the operation, so that the efficiency of the operation is improved additionally.
• Furthermore, the[0437]upper surface604cof thecoupling portion604 is composed of theslopes658 and659. If thecoupling portion604 gets into the field of the operating microscope, therefore, the illumination light of the operating microscope is reflected to the outside of the microscopic field and prevented from entering the field. Thus, the illumination light can be prevented from dazzling in the field of the operating microscope.
EIGHTEENTH EMBODIMENT
• A system according to an eighteenth embodiment will now be described with reference to FIGS.[0438]59 to61. In the description of the present embodiment to follow, like reference numerals are used to designate the same portions of the sixteenth to eighteenth embodiments, and a description of those portions is omitted.
• FIG. 59 shows a general configuration of a rigid scope system. In FIG. 59, numeral[0439]670 denotes an arm-type stand for holding therigid scope602. Thestand670 is obtained by modifying only the distal end portion of thefirst arm631 of the arm-type stand630 according to the seventeenth embodiment. More specifically, theTV camera606 is held in adistal end portion672 of afirst arm671, and thecable618 is housed in thearms671,632 and634 without being exposed to the outside. Thegrip portion605 of therigid scope602 is provided with acontrol knob673 for changing the observational direction.
• The[0440]rigid scope602 will now be described in detail with reference to FIG. 60. Animage guide674, formed of a light guide fiber, is fixedly incorporated in thecoupling portion604. One end of theimage guide674 is connected optically to the relayoptical system611 in theinsert portion603 at the firstbent portion604a,while the other end of theguide674 is connected optically to the relayoptical system615 in thegrip portion605 at the secondbent portion604b.
• In the present embodiment, as in the seventeenth embodiment, the[0441]objective lens609 is located in a position near the point of intersection of an extension of the optical axis O1′ of the relayoptical system615, which is substantially in line with the central axis of thegrip portion605, and the optical axis O1 of the relayoptical system611, which is substantially in line with the central axis of theinsert portion603.
• In FIG. 60, numeral[0442]675 denotes a light guide fixing portion, which serves to fix one end of the armlight guide638 in thefirst arm671. A connectinglight guide676 is held in thegrip portion605 and thecoupling portion604. One end of thelight guide676 is fixed in a connectingportion677 of thegrip portion605 so as to be connected optically to the armlight guide638. The other end portion678 of the connectinglight guide676 is circumferentially located so as to cover the outer periphery of theimage guide674 in the firstbent portion604a,and is fixed in thecoupling portion604 so as to be guided in the same direction as the bending direction of the firstbent portion604a.
• In the[0443]insert portion603, on the other hand, an internallight guide679, which is connected optically to the illuminatinglens620, is circumferentially located so as to cover the outer periphery of the relayoptical system611. In the firstbent portion604a,the internallight guide679 is circumferentially fixed so as to be connected optically to the connectinglight guide676. The illuminatinglens620, internallight guide679, and connectinglight guide676 constitutes an illumination optical system according to the present embodiment.
• Provided in the[0444]grip portion605, moreover, is acylindrical member680 that is attached to thecoupling portion604 for rotation around ashaft681. Thecylindrical member680 is coupled with the observational direction changingcontrol knob673 on thegrip portion605. As shown in FIG. 61, agear682 is provided integrally on the outer periphery of thecylindrical member680.
• In the[0445]coupling portion604, on the other hand, agear680 in mesh with thegear682 is rotatably supported on ashaft684. In the firstbent portion604a,moreover, agear686 is provided in mesh with thegear683. Thegear686, in conjunction with a bearingportion687 in the housing of thecoupling portion604, constitutes arotation mechanism portion688.
• With this arrangement, as in the cases of the sixteenth and seventeenth embodiments, the operator observes the observational dead-angle region R of the surgical microscope by means of the[0446]rigid scope602. First, the electromagnetic locks in the arm-type stand670 are disengaged with thegrip portion605 of therigid scope602 held in position, the objective lens of therigid scope602 is moved to the observational dead-angle region R, and the electromagnetic locks of thestand670 are worked again to hold and fix jrigid scope602. In this state, as in the case of the second embodiment, theobjective lens609 of therigid scope602 is located on the extension of the axis O1′ that corresponds to the axis of thegrip portion605. Accordingly, the operator can position therigid scope602 with a feeling such that the rigid scope is a conventional one without thecoupling portion604.
• Illumination light emitted from a light source (not shown) is guided to the observational dead-angle region R by means of the arm[0447]light guide638, connecting internallight guide676, and illuminatinglens620. After the light from the region R is transmitted through theobjective lens609,prism610, and relayoptical system611, it is guided to the relayoptical system615 in thegrip portion605 by means of theimage guide674 in thecoupling portion604 and focused on the image-pickup device617 of theTV camera606. Thereupon, a video image of the observational dead-angle region R is displayed on a TV monitor (not shown) by means of a drive unit (not shown) and observed by the operator.
• Then, in changing the observational position of the[0448]rigid scope602 from the region R, the operator turns the observational direction changingcontrol knob673 in the direction of anarrow690. As theknob673 rotates, thegear682 also rotates in the direction of thearrow690 around theshaft681, so that the engaginggears683 and686 also rotate. Thereupon, theinsert portion603 is rotated in its central axis or the optical axis O1 by means of therotation mechanism portion688 that is composed of thegear686 and the bearingportion687, whereby the observational direction of theobjective lens609 is changed. In this state, the internallight guide679 and the connectinglight guide676 are circumferentially connected around the relayoptical system611 that has the optical axis O1. Accordingly, there is no possibility of the light guides being pulled or the illumination light suffering a loss as theinsert portion603 rotates. Thus, the illumination light is guided to the observational region, and the observational position of therigid scope602 is changed without changing the respective positions of thegrip portion605,TV camera606, arm-type stand670, etc.
• If the operator's treatment is hindered by the[0449]grip portion605,coupling portion604,TV camera606, and arm-type stand670 during the observation of the observational dead-angle region R as it advances, the aforementioned processes of operation are carried out the other way around. Therotation mechanism portion688 is operated by means of the observational direction changingcontrol knob673 to change the observational direction of theobjective lens609. Thereafter, the arm-type stand670 is operated to redirect theobjective lens609 to the observational dead-angle region R. Then, respective positions of thegrip portion605, theTV camera606, and the arms that constitute the arm-type stand670 are changed without. moving the observational position of therigid scope602 from the region R.
• In replacing the[0450]rigid scope602 with one that is different in the observational angle and the outside diameter of the insert portion, as in the case of the seventeenth embodiment, the operator, holding thegrip portion605 in one hand and thefirst arm671 in the other, pulls out thegrip portion605 of therigid scope602 in the direction of anarrow691 from thefirst arm671. Thereupon, thegroove portion650 of the connecting portion is disengaged from thepin651 in thedistal end portion672 of thefirst arm671, and therigid scope602 is removed from the arm-type stand670.
• Then, the rigid scope that is different in the observational angle α and the outside diameter of the[0451]insert portion603 is attached to thefirst arm631, reversely following the aforementioned steps of procedure. As this is done, the connectinglight guide676 is fixed in a position (position shown in FIG. 60) where it is connected optically to the armlight guide638 by means of thegroove portion650 and thepin651.
• The present embodiment has the following effects as well as the effects of the fifth embodiments. Since the[0452]cable618 of theTV camera606 and the light guides can be incorporated in therigid scope602 and the arm-type stand670, the whole rigid scope system never unduly occupies the space for the operator's surgical operation, and cables can be prevented from coiling around the operator's hands during the operation of therigid scope602. Thus, the efficiency of therigid scope602 itself can be improved.
• Further, the observational direction of the[0453]rigid scope602 can be changed by operating the observational direction changingcontrol knob673 on thegrip portion605. Thus, the observational direction can be easily changed one-handed according to the operation of therigid scope602.
• Since the light guides need not be attached or detached when the rigid scope is replaced during a surgical operation, the rigid scope can be changed more quickly, so that the efficiency of the surgical operation is enhanced.[0454]
• According to the present embodiment, the gears are used as means for connecting the observational direction changing[0455]control knob673 and therotation mechanism portion688. It is to be understood, however, that the gears may be replaced with any other suitable motion transmitting mechanism, such as a wire belt or cam mechanism, with the same result.
• The present invention is not limited to the embodiments described herein. According to the description of the foregoing embodiments, systems of the following particulars and optional combinations thereof can be obtained at the least.[0456]
• In short, the rigid scope according to any of the sixteenth to eighteenth embodiments, having the observational optical system and the illumination optical system therein, comprises the insert portion, grip portion, and coupling portion that couples the insert and grip portions. The coupling portion includes the first and second bent portions, and the illumination optical system is guided in the same direction as the bending direction of the first bent portion.[0457]
• This rigid scope is inserted into and fixed in the affected region under surgical microscopic observation without allowing its grip portion to interfere with the body of the operating microscope. Accordingly, the TV camera, cables, etc. can be securely prevented from interfering with the microscope body or intercepting the microscopic field.[0458]
• The rigid scope may be provided with a rotation mechanism portion that can hold the insert portion and/or the grip portion for rotation with respect to the coupling portion.[0459]
• In this case, the rigid scope can be inserted into and fixed in the affected region under surgical microscopic observation without having its grip portion interfere with the body of the operating microscope, and the position of observation by means of the rigid scope can be changed without changing the position of the rigid scope with respect to the operating microscope body. Therefore, the operator can set the observational position (or direction) in the affected region and the respective positions of the TV camera, light guides, holding arm, etc. in his or her desired relation. Further, the rigid scope can be located optimally depending on the location of the operating microscope and the operator's treatment style and method, changes during the surgical operation can be quickly tackled, and besides, the efficiency of the surgical operation can be enhanced considerably.[0460]
• Moreover, a light guide that is connected to the illumination optical system may be detachably connected near the junction between the insert portion and the coupling portion.[0461]
• Furthermore, a connecting portion to which the light guide connected to the illumination optical system is detachably connected may be provided in the vicinity of the grip portion.[0462]
• Preferably, the respective central axes of the grip portion and the insert portion extend substantially parallel to each other.[0463]
• Preferably, moreover, the objective lens should be fixed in the insert portion near an extension of the central axis of the grip portion.[0464]
• The rotation mechanism portion should preferably be provided on the grip portion or the coupling portion.[0465]
• An operating portion for operating the rotation mechanism portion should preferably be provided on the grip portion.[0466]
• Reflection preventing means may be provided on the grip-portion-side surface of the coupling portion. Preferably, this preventing means is formed of a slope.[0467]
• The following is a description of an endoscopic surgical system in an alternative form.[0468]
• FIG. 72 shows the conventional endoscopic surgical system that includes a squint-type[0469]rigid scope701. This endoscopic surgical system comprises aTV camera system702 formed of aTV camera head702aand acontroller702b,monitor703 for displaying an image picked up by means of thecamera system702,light source unit704 for supplying illumination light to therigid scope701, andlight guide705. During the surgical operation, therigid scope701 is fixedly supported by means of ascope holder706. TheTV camera head702ais connected to therigid scope701 in a manner such that the lower and upper parts of the display screen of themonitor703 correspond to the deep side (distal end side) and the shallow side (hand side), respectively, with respect to the direction of insertion of therigid scope701. Anoperator700 operates aninstrument707 to perform extraction of a tumor, hemostasis, etc. while watching an endoscopic observational image on themonitor703.
• Described in Jpn. Pat. Appln. KOKAI Publication No. 7-328015, for example, is a surgical manipulator that remotely operates the instrument under endoscopic observation in place of an operator. If the operator operates this surgical manipulator, a treatment manipulator is then actuated by means of an actuator, whereupon an affected region is treated. Further, the operator gets a display device on his or her head so that s/he can watch a display image thereon as s/he operates the manipulator to carry out a surgical operation. In this case, the operator's head is detected, and the observational position of the endoscope is moved correspondingly.[0470]
• In FIG. 72, the[0471]rigid scope701 is used to observe a region on the left of theoperator700, and a rigid scope image is displayed on themonitor703. If the operator moves theinstrument707 to the right (in the direction of arrow D1) on themonitor703 while watching the image displayed on themonitor703 in these conditions, theactual instrument707 is moved forward or away from the operator (in the direction of arrow d1). If theoperator700 moves theinstrument707 to the left (in the direction of arrow B1) on themonitor703, on the other hand, theactual instrument707 is moved toward the operator (in the direction of arrow b1).
• In order to move the[0472]instrument707 on themonitor703 to the right or left (in the direction of arrow D2 or B2) as the rigid scope in the state of FIG. 72 is turned counterclockwise for 90° to observe the operator side, as shown in FIG. 73, theoperator700 is expected actually to move theinstrument707 in the opposite direction when compared to the image on themonitor703. Thus, in a surgical operation using an endoscope of which the observational direction is different from the direction of its insertion, the direction of actual movement of the instrument is not coincident with the moving direction of the instrument on the monitor. Accordingly, the operator must deliberate on the direction of the instrument to be moved while watching the monitor or confirm the moving direction by delicately moving the instrument to determine the direction in which the instrument is to be moved next. Therefore, the operation time is so long that the operator is fatigued inevitably. The operator can solve this problem by shifting his or her position relative to the affected region, depending on the observational direction of the endoscope, so that the operator's frontal direction is coincident with the observational direction. It is hard to attain this, however, since the instrument may interfere with a patient's body or some other surgical device.
• On the other hand, the system described in Jpn. Pat. Appln. KOKAI Publication No. 7-328015 is designed to detect the operator's head in moving the endoscopic field. This system, however, is large-scaled and not easy to handle. In order to change the observational position of the endoscope, moreover, the operator's body or head must be moved. Therefore, this system is an effective measure for remote-controlled operation. Since the operating room is furnished with a lot of instruments and cables, however, the use of this system in the operating room is obstructive and narrows the range of the operator's movement. If the endoscope rotates around the course of insertion, moreover, the direction of the display image observed by the operator changes inevitably. Thus, the direction in which the master manipulator is to be moved is deviated from the direction in which the manipulator for treatment moves on the display image.[0473]
• Accordingly, there is a demand for an endoscopic surgical system designed so that the manipulating direction of the instrument with respect to the operator's position is coincident with the moving direction of the instrument even if the observational direction of the endoscope is changed, whereby the operation time can be shortened, and the operator's fatigue can be eased.[0474]
• FIGS.[0475]62 to71 show embodiments of endoscopic surgical systems that can fulfill these requirements.
• The endoscopic surgical system shown in FIG. 62 comprises a[0476]rigid scope801,TV system803 formed of aTV camera head803aand acontroller803battached to the hand-side portion therigid scope801, and monitor805. Anoptical axis813 of anobjective lens802 that is provided on the distal end of therigid scope801 is inclined at an angle a to a central axis O1 of aninsert portion801aof therigid scope801. An observational image that is obtained through theobjective lens802 is picked up by means of an image-pickup device (not shown) of theTV camera head803athrough the medium of a relay optical system and an imaging optical system (not shown). TheTV camera head803acauses thecontroller803bto display the observational image on themonitor805. In FIG. 62, numeral806 denotes a light guide that is connected to a light source unit (not shown) for supplying illumination light to the field of therigid scope801. TheTV camera head803 is connected to therigid scope801 in a manner such that the lower and upper parts of the display image of themonitor805 correspond to the deep side (distal end side) and the shallow side (hand side), respectively, with respect to the direction of insertion of therigid scope801.
• In FIG. 62, numeral[0477]807 denotes a flexible scope holder for supporting therigid scope801. It is fixed to a bedside stay (not shown). Thescope holder807 supports therigid scope801 for rocking motion around the central axis O1. In FIG. 62, numeral808 denotes aninstrument808. Theinstrument808 is fixed integrally to theinsert portion801aof therigid scope801 by means of a connectingmember812. Theinstrument808 includes aninput portion809 for the operator's manipulation and anoutput portion810 that operates in response to the manipulation of theinput portion809. Further, theinstrument808 is fitted with abipolar probe811 that is adapted to arrest bleeding or coagulate blood in an affected region when a high-frequency current is supplied across electrodes. Theinstrument808 is connected to therigid scope801 in a positional relation such that theoutput portion810 extends along theoptical axis813 of thescope801 to ensure image-pickup operation by means of thescope801 at all times.
• FIGS. 63 and 64 show a specific configuration of the[0478]instrument808. As shown in FIG. 63, theinstrument808 includes alower chassis808aconnected integrally to theinsert portion801aof therigid scope801 by means of the connectingmember812,upper chassis808brockably connected to thelower chassis808a,and a joint808cthat connects the lower andupper chassis808aand808b.Theupper chassis808bcan rock around an axis O3 that extends substantially parallel to the central axis O1 of theinsert portion801aof therigid scope801.
• The[0479]input portion809 is provided with ahollow input lever815. Thelever815 includes a small-diameter grip portion815aon the hand side (operator side) and a disk-shapeddisplacement portion815bon the distal end side. Theinput lever815 is formed having anarrow hole815cand arecess815din the form of a spherical depression, located successively from the hand side in the order named. Thebipolar probe811 is inserted in thehole815c.One end of aflexible tube816, which has an inside diameter equal to the diameter of thehole815c,is connected to the terminal end of thehole815c(or the boundary between thehole815cand therecess815d). Thebipolar probe811 is inserted for axial movement in thetube816. One end of anupper support shaft817 is fixed integrally to theupper chassis808b.The other end of theshaft817, having a spherical shape, is fitted in therecess815dof theinput lever815, thereby supporting the distal end side of thelever815 so that thelever815 can tilt around its central portion T1. Theupper support shaft817 has a hollow structure that is penetrated by thetube816.
• As is also shown in FIG. 64, one end of each of four[0480]wires820ato820dis fixed to thedisplacement portion815bof theinput lever815. Thewires820ato820dare fixedly arranged at angular spaces of 90° on the circumference of a circle with a radius r around the axis O4 that passes through the central portion T1. On the other hand, one end of each of four hollowflexible hoses821ato821dis connected to that part of theupper chassis808bwhich faces thedisplacement portion815b.The positions where thehoses821ato821dare connected correspond to the four positions where thewires820ato820dare fixed, respectively. Thewires820ato820dare passed for axial movement in theircorresponding hoses821ato821d.
• The[0481]output portion810 is provided with ahollow output lever825. Thelever825 includes a small-diameter portion825aon the distal end side (affected region side) and a disk-shapeddisplacement portion825bon the side farther from the affected region. Theoutput lever825 is formed having anarrow hole825cand arecess825din the form of a spherical depression, located successively from the affected region side in the order named. Thebipolar probe811 is inserted in thehole825c.Theflexible tube816, which has the inside diameter equal to the diameter of thehole825c,is connected to the terminal end of thehole825c(or the boundary between thehole825cand therecess825d).
• One end of a[0482]lower support shaft827 is fixed integrally to thelower chassis808a.The other end of theshaft827, having a spherical shape, is fitted in therecess825dof theoutput lever825, thereby supporting thelever825 so that thelever825 can tilt around its central portion T2. Thelower support shaft827 has a hollow structure that is penetrated by thetube816.
• The respective other ends of the four[0483]wires820ato820dare fixed to thedisplacement portion825bof theoutput lever825. Thewires820ato820dare fixedly arranged at angular spaces of 90° on the circumference of a circle with the radius r around an axis O4 that passes through the central portion T1. Further, the respective other ends of thehoses821ato821dare connected to that part of thelower chassis808awhich faces thedisplacement portion825b.The positions where the other ends of thehoses821ato821dare connected correspond to the four positions where thewires820ato820dare fixed, respectively. As shown in FIG. 64, in this case, thewires820ato820dand thehoses821ato821dare fixed to thedisplacement portion825band thelower chassis808ain a manner such that the arrangement around the axis O4 on the side of theinput portion809 is rotated for 180° to realize the arrangement around the axis O5.
• The following is a description of the operation of the endoscopic surgical system constructed in this manner.[0484]
• When the[0485]rigid scope801 is directed forward from the operator side, the observational image that is picked up by means of thescope801 and theTV camera system803 is displayed on theTV monitor805, as shown in FIG. 65.
• The[0486]bipolar probe811 can be actually moved in the directions of arrows A3, B3, C3 and D3 on the screen of themonitor805 by correspondingly tilting theinput lever815 in the directions of arrows a3, b3, c3 and d3. For example, theprobe811 can be moved to the right on themonitor805 by tilting thelever815 to the right. Thus, it is necessary only that theinput lever815 be tilted in a desired direction with reference to the image on themonitor805.
• In moving the distal end of the[0487]bipolar probe811 in the direction of arrow A3 (or upward) on themonitor805, for example, theinput lever815 is moved in the direction of arrow a3 (or upward). Thereupon, thelever815 tilts around the central portion T1 with respect to theupper support shaft817, so that thewire820cis pulled to the hand side, while thewire820ais pushed out to the distal end side (or loosens). The pushedwire820aadvances in thehose821a,thereby causing theoutput lever825 to tilt in the direction of arrow a3 around the central portion T2. Thus, the distal end of thebipolar probe811 moves in the direction of arrow A3 on themonitor805. For other directions, the system operates in the same manner. More specifically, if theinput lever815 is moved in the direction of arrow b3 (or to the left), theoutput lever825 tilts in the direction of arrow b3, and thebipolar probe811 moves in the direction of arrow B3 on themonitor805. If theinput lever815 is moved in the direction of arrow c3 (or downward), theoutput lever825 tilts in the direction of arrow c3, and theprobe811 moves in the direction of arrow C3 on themonitor805. If theinput lever815 is moved in the direction of arrow d3 (or to the right), theoutput lever825 tilts in the direction of arrow d3, and theprobe811 moves in the direction of arrow D3 on themonitor805. Moreover, theoperator700 can advance or retreat thebipolar probe811 to a target region by moving it toward or away from theinput lever815. As this is done, theprobe811 advances or retreats in thetube816 so that it projects or recedes from the distal end of theoutput lever825.
• The following is a description of the operation of the[0488]instrument808 for the case where therigid scope801 is rotated counterclockwise for 90° around the axis O1 with respect to the operator700 (case where the operator's left-hand side is observed, see FIG. 66).
• If the[0489]rigid scope801 is rotated counterclockwise for 90°, as shown in FIG. 66, theinstrument808 also rotates counterclockwise for 90° in one with thescope801. Since the position of theoperator700 relative to an affected region never changes during a surgical operation, however, theoperator700 can restore theinput lever815 to be operated to the position right in front of him or her by rotating theupper chassis808bfor 90° in the direction of arrow M with respect to thelower chassis808a.Thus, theoutput lever825 is deviated at 90° from theinput lever815. Even in this case, however, theoptical axis813 of therigid scope801 and theoutput portion810 of theinstrument808 are already moved integrally with each other, so that the relation shown in FIG. 65 is maintained between the moving direction of theoutput lever825 of theinstrument808 on themonitor805 and the manipulating direction of theinput lever815. Thus, theoutput lever825 or thebipolar probe811 can be appropriately moved by tilting theinput lever815 in a desired direction to move theinstrument808 on themonitor805, only if themonitor805 is located right in front of theoperator700 and if theinput lever815 of theinstrument808 is directed frontally (or toward the operator) as it is used.
• According to the rigid scope system described above, change of the observational direction of the[0490]rigid scope801 is transmitted mechanically to theinstrument808 to change the direction of the output with respect to the input with thescope801 and theinstrument808 connected integrally with each other. Therefore, the construction of the system is simple and never hinders surgical operations. Since the manipulation of theinput portion809 is transmitted to theoutput portion810 by means of the flexible wires and hoses, moreover, the system can enjoy a simple configuration without requiring use of any complicated mechanisms.
• According to the present embodiment, the[0491]instrument808 is fixed integrally to theinsert portion801aof therigid scope801. Alternatively, however, it may be fitted on theinsert portion801aof therigid scope801, as in the case of the sheathing of a conventional endoscope, or may be formed having a bipolar probe or the like inserted therein, as in the case of the present embodiment.
• FIG. 67 shows a modification. In this modification, the[0492]scope holder807 is fixed mechanically to theupper chassis808bby means of arotation regulating member830. According to this arrangement, theinput portion809 never fails to be situated right in front of the operator if therigid scope801 is rotated around the axis O1. Thus, the operation time can be shortened.
• FIGS.[0493]68 to70 show another embodiment. In the description of the present embodiment to follow, like reference numerals are used to designate those components which are common to the present embodiment and the embodiment shown in FIGS.62 to67, and a description of those portions is omitted.
• As shown in FIG. 68, an endoscopic surgical system according to the present embodiment comprises a[0494]scope holder840 that supports therigid scope801 for sliding motion in X-, Y-, and Z-axis directions. Theholder840 is fixed to a bedside stay841a.Theholder840 includes a rigidscope connecting member842. The connectingmember842 is provided with angle detecting means843 for detecting the rotational angle of therigid scope801 compared to thescope holder840. The detecting means843, which is formed of an encoder844 (see FIG. 70), serves to detect the rotational angle of theinsert portion801aof thescope801 around the central axis O1.
• Further, this endoscopic surgical system comprises an[0495]instrument holder845 that holds theinstrument808 for sliding motion in the X-, Y-, and Z-axis directions. Theholder845, which is fixed to abedside stay841b,includes aninstrument connecting member846 for supporting theinstrument808.
• As shown in FIG. 69, the[0496]instrument connecting member846 on the distal end portion of theinstrument holder845 includes agear847 that is fixed to thelower chassis808aof theinstrument808 in a nonrotatable manner. Thegear847, along with the connectingmember846, restrains thelower chassis808afrom moving along the axis O3 and holds it for rocking motion around the axis O3 at the joint808c.On the other hand, theupper chassis808bis restrained from rocking around the axis O3 by means of apin852 that is attached to the connectingmember846.
• The[0497]instrument connecting member846 is provided with amotor848 that is fixed to a holdingmember899. Agear849 in mesh with thegear847 is fixed coaxially to an output shaft848aof themotor848. The input andoutput portions809 and810 of theinstrument808 and the mechanism for transmitting their motions are constructed in the same manner as the ones according to the first embodiment.
• As shown in FIG. 70, the[0498]encoder844 that constitutes the angle detecting means843 is connected to acontrol circuit850. Thecircuit850 is connected to amotor driver circuit851 that is connected to themotor848. In response to an input signal from theencoder844, thecontrol circuit850 delivers a given signal to thedriver circuit851 according to predetermined conditions, in order to rock theinstrument808 around the axis O3 in the same direction and at the same angle as the rotation of therigid scope801 around the central axis O1.
• The following is a description of the operation of the endoscopic surgical system constructed in this manner.[0499]
• If the[0500]rigid scope801 is rotated around the axis O1, the rotational angle of therigid scope801 compared to the rigidscope connecting member842 is detected by means of theencoder844 of the angle detecting means843, and angle information is delivered to thecontrol circuit850. Based on this angle information, thecontrol circuit850 computes the rotational angle of therigid scope801, and delivers a signal to themotor driver circuit851 to rotate theinstrument808 for the same angle. In response to this input signal, thedriver circuit851 causes themotor848 to rotate for a required amount. The rotation of themotor848 is transmitted to thelower chassis808awith thegear847 in mesh with thegear849 that is fixed coaxially to the output shaft848a,whereupon thechassis808arotates for the same angle as the rigid scope8O1. Thus, the observational direction of thescope801 and the direction of theoutput portion810 of theinstrument808 have the same relation as in the embodiment shown in FIGS.62 to67. In this state, theupper chassis808bis prevented from rotating with respective to theinstrument connecting member846 by the agency of thepin852. Therefore, the position of theinput portion809 compared to theoperator700 never changes. Accordingly, the direction of the operator's manipulation of theinstrument808 can be made to coincide with the moving direction of theinstrument808 on themonitor805. If theoutput portion810 of theinstrument808 is deviated from the range of observation as therigid scope801 rotates around the central axis O1, theinstrument808 is moved in the X-, Y-, and Z-axis directions for adjustment by means of theinstrument holder845.
• As described above, the present embodiment, unlike the embodiment shown in FIGS.[0501]62 to67, is designed so that the rotation of therigid scope801 around the direction of insertion is detected electrically, and theoutput portion810 of theinstrument808 is rotated electrically. Therefore, thescope801 and theinstrument808 can be held separately from each other, so that they can be inserted from different directions into different positions, depending on the conditions of the surgical operation. Thus, the system of the present embodiment can cope with a wide variety of styles of surgical operations.
• According to the present embodiment, moreover, the rotation of the[0502]rigid scope801 is detected by means of theencoder844. Alternatively, however, it may be detected by means of conventional optical position detecting means, which is designed so that an illuminant is connected to therigid scope801, its image is picked up by means of image-pickup means (TV camera), and the position and rotational angle of the rigid scope are computed in accordance with the resulting image-pickup signal. Thus, the position detection can be effected even without the use of any scope holder.
• FIG. 71 shows still another embodiment. The[0503]rigid scope801,TV camera system803, monitor805,scope holder840, and rotational angle detecting means for detecting the position of therigid scope801 with respect to theholder840, according to the present embodiment, are constructed in the same manner as the ones according to the foregoing embodiment, so that a description of those components is omitted. The following is a description of aninstrument863, a component of an alternative construction, only.
• In FIG. 71, numeral[0504]860 denotes a slave manipulator (hereinafter referred to as treatment manipulator) that has theinstrument863 fixed on its distal end and is attached to the bedside stay841b.Thetreatment manipulator860 is composed of afirst operating arm860afor use as a support mechanism movable in the vertical direction and turning direction, asecond operating arm860battached to thefirst arm860aand movable in the horizontal direction, and ajoint portion860cattached to the distal end portion of thesecond arm860b.Further, thetreatment manipulator860 is connected, by means of amanipulator control device861 and adirection changing circuit865, to amaster manipulator862 in a region that is accessible to the operator.
• As is generally known, the[0505]manipulator control device861 receives a signal from themaster manipulator862 and delivers a driving signal to thetreatment manipulator860 such that themanipulator860 moves in the same manner as themanipulator862 does.
• The[0506]direction changing circuit865 is connected with anencoder844 that constitutes the same angle detecting means843 as aforesaid. On receiving an input signal from theencoder844, thecircuit865 changes a signal from themanipulator control device861 according to a given transformation formula, and delivers a driving signal for changing the operating direction of thetreatment manipulator860, compared to the manipulation of themaster manipulator862, to themanipulator860.
• The first and second operating[0507]arms860aand860bof thetreatment manipulator860 have the drive structure of a manipulator of a so-called cylindrical-coordinate type, formed of vertical, turning, and horizontal operation axes e, f and g that are activated by means of actuators (not shown), such as electromagnetic motors. Alternatively, however, the operating arms may have the structure of a so-called multi-joint manipulator formed of a plurality of joint portions. Thejoint portion860cis connected to theinstrument863 so that it can be actuated by means of an actuator, such as an electromagnetic motor, to tilt theinstrument863 around two axes h and i that extend at right angles to each other.
• The following is a description of the operation of the endoscopic surgical system constructed in this manner.[0508]
• A distal end position Q of the[0509]instrument863 that is connected to thetreatment manipulator860 is known by means of themanipulator control device861, based on the respective operating positions of the vertical, turning, horizontal, and tilting axes e, f, g, h and i and the geometric dimensions of the individual members. On the other hand, the position of a point of action862aof themaster manipulator862 is obtained by computation by means of themanipulator control device861. A signal is delivered from thecontrol device861 to thedirection changing circuit865 such that the instrument distal end Q moves to the position of the point of action862aof themaster manipulator862. As in the case of the foregoing embodiment, moreover, the observational direction of therigid scope801 is detected by means of theencoder844 of the angle detecting means843 and transmitted to thedirection changing circuit865.
• Based on the signal from the[0510]encoder844, thedirection changing circuit865 computes the input signal from themanipulator control device861 according to a previously stored computational formula, and delivers a driving signal to thetreatment manipulator860 such that the manipulating direction of themaster manipulator862 is always coincident with the moving direction of theinstrument863 on themonitor805. Thus, the signal is delivered to thetreatment manipulator860 so that the moving direction of the distal end position Q of theinstrument863 displayed on the screen of themonitor805 is coincident with the manipulating direction of themaster manipulator862, as in the case of the foregoing embodiment. Thereupon, the direction of the operator's manipulation of theinstrument863 is coincident with the moving direction of theinstrument863 on themonitor805.
• According to the present embodiment, as described above, the[0511]instrument863 can be remotely manipulated by means of themaster manipulator862, so that the operator can carry out a surgical operation in any convenient position without restrictions on the location of themanipulator862. Thus, the operator can perform the operation in a more comfortable posture.
• In short, the endoscopic surgical systems described with reference to FIGS.[0512]62 to71 comprises an endoscope capable of observation in directions different from the direction of its insertion; image-pickup means connected to the endoscope and capable of picking up an observational image of the endoscope; display means for displaying information from the image-pickup means; an instrument including an input portion for an operator's manipulation, an output portion adapted to operate in response to the manipulation of the input portion, and operating direction changing means capable of changing the operating direction of the output portion with respect to the input portion; and control means adapted to operate the operating direction changing means as the direction of observation around the direction of insertion of the endoscope changes.
• In this system, the control means drives the operating direction changing means to control the operating direction of the output portion of the instrument with respect to the direction of manipulation of the input portion, in response to vertical and horizontal shifts of an affected region on the display means caused when the endoscope rotates around the direction of insertion. The operating direction of the output portion of the instrument on the display means is controlled so that it is always coincident with the direction of actual manipulation of the input portion of the instrument. Thus, if the operator manipulates the input portion of the instrument in the same direction as the direction in which the output portion of the instrument is expected to move, while watching the display means, the output portion moves in the intended or expected direction on the display means. Accordingly, the moving direction need not be considered or confirmed during the surgical operation. In consequence, the manipulation of the instrument is easy, the operation time is shortened, and therefore, the operator's fatigue can be eased.[0513]
• Preferably, the operating direction changing means includes manipulation transmitting means for transmitting the manipulation of the input portion to the output portion and a rotating portion capable of rotating the output portion around the direction of insertion of the instrument into the affected region, with respect to the input portion, and the control means includes rotation transmitting means for transmitting the rotation around the direction of insertion of the endoscope, thereby rotating the rotating portion. When the endoscope rotates around the direction of insertion, in this case, the rotation transmitting means rotates the rotating portion of the instrument. Thereupon, the output portion rotates around the direction of insertion with respect to the input portion of the instrument. In this state, the manipulation transmitting means transmits the manipulation of the input portion to the output portion, so that the operating direction of the output portion is changed with respect to the input operation.[0514]
• The manipulation transmitting means may be mechanical transmitting means.[0515]
• In the case where the rotation transmitting means is provided with a connecting member for connecting the endoscope and the instrument integrally to each other, the connecting member causes the instrument to rotate integrally with the rigid scope so that the rotating portion of the instrument rotates when the endoscope rotates around the direction of insertion. Thereupon, the output portion rotates in the direction of insertion with respect to the input portion of the instrument. In this state, the manipulation transmitting means transmits the manipulation of the input portion to the output portion, so that the operating direction of the output portion is changed with respect to the input operation.[0516]
• Preferably, the rotation transmitting means includes rotation detecting means for detecting the rotational displacement of the endoscope in the direction of insertion with respect to a given region, drive means capable of rotating the rotating portion, and electrical control means for controlling the drive of the drive means in accordance with a signal from the rotation detecting means. In this case, the rotation of the endoscope around the direction of insertion is detected by the rotation detecting means and applied to the electrical control means. Based on this input signal, the electrical control means drives the drive means to rotate the rotating portion. Thereupon, the output portion rotates in the direction of insertion with respect to the input portion of the instrument. In this state, the manipulation transmitting means transmits the manipulation of the input portion to the output portion, so that the operating direction of the output portion is changed with respect to the input operation.[0517]
• The rotation detecting means may be an encoder.[0518]
• Preferably, moreover, the rotation detecting means is provided with an optical illuminant, second image-pickup means for picking up an image of the optical illuminant, and optical position detecting means including computing means for computing the rotational angle of the endoscope in accordance with a signal from the second image-pickup means.[0519]
• The drive means may be a motor.[0520]
• The mechanical transmitting means may be provided with a first flexible member and a second flexible member capable of being displaced relatively to the first flexible member. Preferably, the first flexible member is a wire, and the second flexible member is a hose fitted on the wire.[0521]
• Further, there may be provided an endoscopic surgical system comprising an endoscope capable of lateral observation; image-pickup means connected to the endoscope and capable of picking up an observational image of the endoscope; display means for displaying information from the image-pickup means; an instrument including a master manipulator for an operator's manipulation, a slave manipulator adapted to operate in response to the manipulation, and manipulator control means for controlling the slave manipulator so that the slave manipulator operates following the master manipulator; rotation detecting means for detecting the rotational displacement of the endoscope around the direction of insertion, and manipulator operating direction changing means for controlling the operating direction of the slave manipulator in accordance with information from the manipulator control means and the rotation detecting means.[0522]
• 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.[0523]

Claims (20)

What is claimed is:

1. An observation apparatus comprising:

an optical microscope for observing an optical image of an object in a field of view of the optical microscope, the optical microscope including a first optical system for forming the optical image of the object;

a first display capable of displaying a first image which is different from the optical image;

a second optical system for optically transmitting the first image to display the first image in the field of view of the optical microscope;

a second display capable of displaying a second image which is different from the optical image and the first image, and

a third optical system for optically transmitting the second image to display the second image in the field of view of the optical microscope.

2. The observation apparatus according toclaim 1,

wherein the second optical system is configured to superpose the first image on a part of the optical image.

3. The observation apparatus according toclaim 2,

wherein the third optical system is configured to superpose the second image on a part of the optical image.

4. The observation apparatus according toclaim 1,

wherein the second optical system forms a projection optical system for projecting the first image on a part of the optical image.

5. The observation apparatus according toclaim 4,

wherein the third optical system forms a projection optical system for projecting the second image on a part of the optical image.

6. The observation apparatus according toclaim 1,

further comprising a computer electrically connected to the first display, wherein the computer controls a size of the first image displayed on the first display so as to change a size of the first image displayed in the field of view in accordance with a magnification of the optical image observed by the optical microscope.

7. The observation apparatus according toclaim 1,

wherein the first image is an image obtained by one selected from the group consisting of an endoscope, a rigid scope and an ultrasonic diagnostic apparatus.

8. The observation apparatus according toclaim 1, wherein:

the first image is an image of the object obtained by means of an observation unit selected from the group consisting of an endoscope and an ultrasonic probe; and

the first image and the second image include one of (i) a combination of the first image obtained by means of the observation unit and an image indicative of an observation position or direction of the observation unit and (ii) a combination of a preoperative/mid-operative diagnostic image selected from the group consisting of image-processed fluorescent observational images obtained by means of the observation unit and the image,indicative of the observational position or direction of the observation unit and a tumor position display marker image.

9. The observation apparatus according toclaim 1, wherein the second image is a marker image.

10. An operating microscope apparatus comprising:

an observational optical system for forming an optical image of an object including an affected region;

observational means capable of observing the optical image in a field of view of the observational optical system;

first display means for observably displaying a first image different from the optical image in the field of view of the observational means; and

second display means for observably displaying a second image different from the optical image and first image in the field of view of the observational means.

11. The operating microscope apparatus according toclaim 10, wherein the first display means includes a display which displays the first image and an image projection optical system which projects the first image into the field of view.

12. The operating microscope apparatus according toclaim 11, wherein the image projection optical system projects a part of the optical image and the first image.

13. The operating microscope apparatus according toclaim 10, wherein the second display means includes an image superposition optical system which superposes an image on a part of the optical image.

14. The operating microscope apparatus according toclaim 10, further comprising switching means which independently switches display/non-display of the first and second images of the object.

15. The operating microscope apparatus according toclaim 10, wherein:

the first image is an image of the object obtained by means of object observing means selected from the group consisting of an endoscope and an ultrasonic probe; and

the first and second images include one of (i) a combination of the first image obtained by means of the object observing means and an image indicative of an observational position or direction of the object observing means and (ii) a combination of a preoperative/mid-operative diagnostic image selected from the group consisting of image-processed fluorescent observational images and the image indicative of the observational position or direction of the object observing means and a tumor position display marker image.

16. A surgical observational system comprising:

an observational optical system for forming an optical image of an object including an affected region;

first observational means for observing the optical image;

a memory which stores a preoperative diagnostic image of the object including the affected region;

second observational means which obtains an image showing a desired area of the object, the desired area found in the optical image, the second observational means being different from the first observational means in at least one of observational direction and observational method;

detecting means which detects the relative position of the first and second observational means in three dimensions;

first display means which displays the image showing the desired area of the object obtained by the second observational means on the optical image observed by the first observational means in accordance, with the relative position of the first and second observational means in three dimensions; and

second display means which reads out the preoperative diagnostic image including the desired area from the memory and displays the preoperative diagnostic image on the optical image observed by the first observational means in accordance with the relative position of the first and second observational means in three dimensions.

17. The surgical observational system according toclaim 16, wherein the second observational means is one selected from the group consisting of an endoscope, rigid scope and ultrasonic diagnostic apparatus.

18. A surgical observational system comprising:

a first observational apparatus including a first optical system which forms an optical image of an object;

a second observational apparatus different from the first observational apparatus in at least one of observational direction and observational method, the second observational apparatus obtaining an image showing a desired area of the object, the desired area found in the optical image;

a first display capable of displaying the image showing the desired area of the object obtained by the second observational apparatus;

a second optical system optically coupled to the first optical system, the image showing the desired area of the object displayed on the first display entering into the second optical system, being superposed on the optical image and observed by the first observational apparatus;

a memory which stores a preoperative diagnostic image of the object;

a second display capable of displaying the preoperative diagnostic image;

a third optical system optically coupled to the first optical system, the image of the preoperative diagnostic image displayed on the second display entering into the third optical system, being superposed on the optical image and observed by the first observational apparatus;

a detector capable of detecting the relative position of the first and second observational apparatuses in three dimensions; and

a computer electrically connected to the first display, second display and detector, the computer controlling the display position of the image showing the desired area on the first display such that the image showing the desired area obtained by the second observational apparatus is superposed on the desired area of the optical image observed by the first observational apparatus in accordance with the result of the detection by the detector, and the computer reading out the preoperative diagnostic image including the desired area from the memory in accordance with the result of the detection and displaying it on the second display.

19. The surgical observational system according toclaim 18, wherein the second observational apparatus is one selected from the group consisting of an endoscope, rigid scope and ultrasonic diagnostic apparatus.

20. The surgical observational system according toclaim 19, wherein the computer is further capable of setting the size of the image showing the desired area, the image showing the desired area superposed on the desired area of the optical image and displayed on the first display in accordance with a magnification of the optical image observed by the first observational apparatus.

Images