JP2001204738A - Navigation system for medical operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a navigation system for medical operation which displays the position of an endoscope image on a biological tissue in using of the endoscope, synthesized and display the shapes of treating devices on the picture of the biological tissue, prevents a part deviated from a microscope image from damaging the biological tissue inadvertently, and unnecessitates taking new calibration again so as to improve efficiency in the medical operation. SOLUTION: The position of the treating devices such as a treating tool 33, the endsocope 34 are measured by a position detecting sensor 36, the distance from the tip of the insertion part 34a of the endoscope 34 to the object 48 as an operation part is measured, and biological image information measured in advance is stored. Positional information from the sensor 36, distance information and biological image information are synthesized into an image by an image synthesizing circuit 39 to be displayed on the screen of a TV monitor 44.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention navigates the direction in which surgery is performed by displaying the position of a treatment instrument such as a surgical instrument used on biological image information displayed on a display unit. To a surgical navigation system.

[0002]

2. Description of the Related Art Conventionally, for example, Japanese Patent Application Laid-Open No. Hei 5-30507
No.3, such as CT (computer
ized tomography) and MRI (magnetic resonance)
Imaging) tomographic images are synthesized by a computer and displayed in a tomographic or stereoscopic display on a display such as a monitor, and the shape of treatment tools used for surgery and treatment equipment such as endoscopes are calibrated in advance. By attaching a marker for position detection to those devices and detecting the position by infrared rays from the outside, the position of the device used on the above-mentioned biological image information can be displayed. A device for navigating the direction in which an operation is advanced by synthesizing and displaying the position of a brain tumor has been developed.

Further, Japanese Patent Publication No. 6-43893 and Japanese Patent Publication No. 3-28686 disclose the position of a subject,
A technique for recognizing a shape is shown. Alternatively, Japanese Unexamined Patent Publication No. Hei 7-26194 discloses an operation microscope capable of picture-in-picture conversion of an endoscope image into a microscope image.

[0004] In addition, for TV monitors and head-mounted displays, using an image mixer,
The operation of combining and displaying a plurality of images in a desired shape can be easily performed.

[0005]

However, the above-mentioned conventional structure has the following problems. (1) It is not possible to display at which part of the living body the living tissue viewed by the endoscope image displayed on the monitor is located.

(2) A treatment tool generally used for treatment of a surgical site in a patient's body or a treatment device such as an endoscope is represented by a simplified rod-shaped mark on a screen of a microscope image of a monitor. Is displayed. As a result, the shape of the treatment device cannot be accurately displayed, and particularly when a part of the treatment device deviates from the microscope image, a portion that deviates from the microscope image may come into contact with living tissue. is there. In such a case, the living tissue may be inadvertently damaged.

(3) When a plurality of treatment devices are prepared in advance and the treatment is performed while replacing the treatment device to be used, the calibration must be performed again each time the treatment device to be used is replaced. . Therefore, there is a problem that it is difficult to perform the operation efficiently because the replacement work of the treatment equipment is troublesome.

The present invention has been made in view of the above circumstances, and has as its object to display the position of an image obtained as an endoscope image on a living tissue when an endoscope is used. In addition, the shape of a treatment instrument such as a treatment tool or an endoscope to be used can be synthesized and displayed on an image of a living tissue. Can be prevented from coming into contact with the instrument, and even if the treatment tool to be used or the treatment equipment such as an endoscope is exchanged, there is no need to perform a new calibration, and the operation can be efficiently performed. An object of the present invention is to provide a surgical navigation system.

[0009]

According to the first aspect of the present invention, there is provided a position measuring section for measuring a position of a treatment instrument used for treatment of an operation section in a patient's body, and an insertion section inserted into the patient's body. An endoscope having a distance measuring means for measuring a distance from a distal end to a target of the operative site, an image information display unit for displaying image information of an operative site in the patient, and biological image information measured in advance And a position information from the position measurement unit, distance information from the distance measurement unit, and biological image information recorded in advance in the storage unit, and the image information display unit A surgical navigation system comprising an image information synthesizing unit for displaying on a screen. According to the first aspect of the present invention, the position of the treatment device used for treatment of the operative site in the patient's body is measured by the position measurement unit, and the distal end of the insertion unit inserted into the patient's body is used to measure the position of the operative site. The distance to the target is measured by the distance measuring means of the endoscope. Further, the storage unit holds the pre-measured biological image information, and synthesizes the image information with the position information from the position measurement unit, the distance information from the distance measurement unit, and the biological image information recorded in the storage unit in advance. The images are combined by the unit and displayed on the screen of the image information display unit.

According to a second aspect of the present invention, the image information synthesizing section has means for storing the shape of the treatment device in advance, and the information on the position and the shape of the treatment device is recorded in advance. 2. The surgical navigation system according to claim 1, wherein the biometric image information is synthesized and displayed on the screen of the image information display unit so that the shape and position of the device can be distinguished. is there. And claim 2
In the invention of the above, the shape of the treatment device is stored in advance in the image information synthesizing unit, and the position and shape information of the treatment device and the pre-recorded biological image information are synthesized and displayed on the screen of the image information display unit. The display is such that the shape and position of the device can be distinguished.

According to a third aspect of the present invention, there is provided a position measuring section for measuring a position of a treatment instrument used for treatment of an operating portion in a patient's body, An endoscope having a distance measuring unit that measures a distance to a target, an image information display unit that displays image information of an operating unit in the body of the patient, and a storage unit that holds biological image information measured in advance. An image that combines position information from the position measurement unit, distance information from the distance measurement unit, and biological image information recorded in advance in the storage unit, and displays the image on the screen of the image information display unit An information synthesizing unit, and a plurality of treatment instruments are appropriately and selectively exchanged and used for treatment of an operation part in a patient's body, and at a predetermined set position from the tip of each treatment instrument, Note that a marker has been provided for the position measurement It is a surgical navigation system that. According to the third aspect of the present invention, the position of the treatment instrument used for treatment of the operative site in the patient's body is measured by the position measuring unit, and the target of the operative site is measured from the distal end of the insertion unit inserted into the patient's body. The distance to the object is measured by a distance measuring means of the endoscope. Further, the storage unit holds the pre-measured biological image information, and synthesizes the image information with the position information from the position measurement unit, the distance information from the distance measurement unit, and the biological image information recorded in the storage unit in advance. The images are combined by the unit and displayed on the screen of the image information display unit.
Further, when a plurality of treatment devices are selectively exchanged and used as appropriate for a treatment of an operation part in a patient's body, the position measurement unit is operated by a marker at a predetermined set position from the tip of each treatment device. The type of equipment for use can be identified.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of an entire surgical microscope system using the surgical navigation system of the present embodiment. FIG.
Among them, 1 is an operating microscope installed in an operating room, 2 is a mirror body of the operating microscope 1, and 61 is an operating bed on which a patient 32 is placed. Here, the gantry 3 of the surgical microscope 1 is provided with a base 4 that can move on the floor surface and a column 5 that stands on the base 4. The gantry 3 of the operating microscope 1 is arranged on the distal end side of the operating bed 61 in the operating room (for example, on the side of the bed 61 where the head 32a of the patient 32 is located).

Further, a support mechanism 62 for supporting the mirror body 2 of the surgical microscope 1 so as to be movable in an arbitrary direction is provided on the upper portion of the column 5. The support mechanism 62 includes a first arm 6, a second arm 7, and a third arm 8. Here, an illumination light source (not shown) is built in the first arm 6. One end of the first arm 6 is attached to the upper part of the support 5 so as to be rotatable about a substantially vertical axis O1.

Further, the other end of the first arm 6 has a second
One end of the arm 7 is rotatably mounted about a substantially vertical axis O2. The second arm 7 is formed by a pantograph arm including a link mechanism and a spring member for balance adjustment, and is movable in the vertical direction.

On the other end of the second arm 7, one end of a third arm 8 is mounted rotatably about a substantially vertical axis O3. The other end of the third arm 8 is connected to the mirror body 2 of the operating microscope 1. In addition, this third
The arm 8 is rotatably supported on two axes O4 and O5 in directions substantially orthogonal to each other on a substantially horizontal plane. The mirror body 2 is supported by the third arm 8 so as to be able to elevate in the front-rear direction with respect to the operator's observation direction about the axis O4 and to be able to elevate the operator in the left-right direction about the axis O5. ing.

The rotation axes O1 to O5 of the support mechanism 62
Each of the bearing portions is provided with an electromagnetic brake (not shown). This electromagnetic brake is connected to an electromagnetic brake power supply circuit (not shown) built in the column 5. Further, this electromagnetic brake power supply circuit is connected to a switch 10 provided on a grip 9 integrally fixed to the mirror body 2 as shown in FIG.

The rotation axis O is controlled by the switch 10.
The electromagnetic brakes 1 to O5 are turned on and off. Here, for example, when the switch 10 is turned on, the electromagnetic brake of each of the rotating shafts O1 to O5 is turned off, whereby the support mechanism 62 is held in the unlocked state, and the mirror body 2 is spatially free. Position adjustment can be performed. When the switch 10 is turned off, the electromagnetic brakes of the rotating shafts O1 to O5 are turned on, the support mechanism 62 is switched to the locked state, and the position of the mirror body 2 is fixed. .

FIG. 3 shows a schematic configuration of the mirror body 2 of the operating microscope 1. The mirror body 2 is provided with one objective lens 11 and a pair of left and right observation optical systems 14A and 14B. Here, the left and right observation optical systems 14
On the observation optical axes of A and 14B, the variable power optical system 12, left and right imaging lenses 13a and 13b, and left and right eyepieces 14 are provided.
a and 14b are arranged in order. The stereoscopic observation optical system is constituted by the pair of left and right observation optical systems 14A and 14B.

The imaging planes of the imaging lenses 13a and 13b are set so as to be located at the focal positions of the eyepieces 14a and 14b, respectively. Note that 1 in FIG.
Reference numeral 6 denotes a position sensor for detecting the lens position of the objective lens 11. Here, the objective lens 11 is connected to a motor (not shown) and supported so as to be movable in the optical axis direction. The position of the objective lens 11 in the optical axis direction can be detected by the position sensor 16.

In the system of the operating microscope 1 according to the present embodiment, as shown in FIG. 4, a treatment tool 33 (for example, a bipolar set, an ultrasonic suction device, forceps, etc.) used for the operation at the same time as the operating microscope 1 is used. ) And a treatment device such as an endoscope 34 are also used. Further, the surgical navigation system according to the present embodiment includes a substantially C-shaped head frame 35 surrounding the head 32 a of the patient 32, a treatment tool 33 used for treatment of an operating part in the body of the patient 32, A position detection sensor (position measurement unit) 36 that measures the position of a treatment device such as a mirror 34 is provided.

Here, the head frame 35 is mounted on the patient 32.
Is fixed to the skull. Further, the head frame 35 is fixed to the operating bed 61 by a fixing frame (not shown) so as not to move.

The head frame 35 has a plurality of head frame markers 37 arranged side by side. As the head frame marker 37, an active type that emits infrared rays or a passive marker that is a simple projection is arbitrarily selected and used.

Further, the position detecting sensor 36 is connected to a position and each set value calculating circuit 38. An image synthesizing circuit (image information synthesizing unit) 39 is further connected to this position and each set value calculating circuit 38. The image synthesizing circuit 39 includes a storage device 4 such as a storage unit of a workstation, for example.
0, various input devices (controllers) such as a keyboard 41, a mouse 42, a touch pen 43, and a laser pointer (not shown), and various display devices (image information display units) such as a TV monitor 44 and a head mount display 45. ) Are connected.

The head frame 35 is mounted on the head 32a of the patient 32 before the operation. Then, a tomographic image of a living body is captured by MRI, CT, or the like with the head frame 35 mounted, and biological image data 46 captured at this time is recorded in the storage device 40. As a result, the position data of the head frame 35 is combined with the biological image data 46, and subsequent navigation can be performed with the head frame 35 as a reference.

Further, the position detection sensor 36 includes a head frame marker 37 of the head frame 35 described above,
It has an infrared sensor adapted to the type of another marker described later, and the position (direction) of each marker can be detected depending on how the plurality of markers are captured.

An endoscope 34 for observing the inside of a living body is connected to a proximal operation portion 34b at the base end of an elongated insertion portion 34a inserted into the body of a patient. This operation unit 3
4b is provided with a plurality of endoscope markers 47,
The effect is the same as that of the head frame marker 37.
Then, by performing calibration in advance, the endoscope marker 47 is detected by the position detection sensor 36,
The relative position and orientation of the endoscope 34 with respect to the head frame 35 are grasped.

Further, the arrangement of a plurality of endoscope markers 47,
Alternatively, the type of the endoscope 34 can be specified by a combination of active and passive. For this reason, data such as the shape, the viewing direction, and the surface angle of the endoscope 34 which have been input in advance are read out, and the display device such as the TV monitor 44 and the head mount display 45 displays the outer shape and the viewing angle of the endoscope 34. The direction, angle of view, etc. are displayed.

At the base end of the insertion section 34a of the endoscope 34, a model identification marker 49 is provided. And
The model identification marker 49 makes it possible to determine which model the endoscope 34 is (for example, data for each model such as oblique or direct view, some angles of view, shape dimensions, etc.). . The model identification marker 49 is, for example, a color,
Alternatively, identification by number or the like is performed, and the position detection sensor 3
6, the position and type are determined.

Further, current endoscopes are generally provided with a focus adjustment function, a zoom function, and the like in many cases. Therefore, the setting data of these functions of the endoscope 34 of the present embodiment is sent to the position and setting value calculation circuit 38, and is used for constructing a navigation image.

Further, the endoscope 34 compatible with the surgical navigation system according to the present embodiment employs, for example, the use of spot light disclosed in Japanese Patent Application Laid-Open No. 3-28686, which has already been applied by the present applicant. It has a distance detecting function (distance measuring means) using an ultrasonic sensor or the like. Then, as shown in FIG. 6, the distance S1 between the distal end of the insertion portion 34a of the endoscope 34 and the target (target of the surgical site) 48 can be measured.

Further, as shown in FIG. 2, the operating microscope 1 used simultaneously with the endoscope 34 has a plurality of signal members at predetermined positions on the side surface of the mirror body 2.
The two microscope markers 18a, 18b, 18c are integrally fixed. These microscope markers 18a, 18
As b and 18c, an active type that emits infrared rays or a passive marker that is a simple protrusion is arbitrarily selected and used. The position detection sensor 36 detects these microscope markers 18a, 18b, 18c.
Is detected by detecting the relative position between the head frame 35 and the mirror body 2 and the rotation angle of each arm as variables, and the relative position between the head frame 35 by the microscope markers 18a to 18c. Can be grasped.

It should be noted that a bipolar centrifuge, an ultrasonic suction device,
The head frame marker 37 is also used for the treatment tool 33 such as forceps.
Also, a treatment tool marker 50 having the same configuration as the endoscope marker 47 is provided.

Next, the operation of the above configuration will be described.
At the time of using the navigation system for surgery of the present embodiment, the biological image data 46 which is photographed in advance before surgery.
Is transmitted from the storage device 40 to the image synthesizing circuit 39, and an image serving as a reference is constructed. The image at this time may be a 3D image, a 2D image (front / side / top) as described later,
They may be combined as needed. The 3D image is not particularly limited in its display format as long as the three-dimensional structure inside the skull (brain) can be determined, and may be a wire frame image or a skeleton three-dimensional display.

Thereafter, the surgeon 51 holds the grip 9 of the mirror body 2 of the operating microscope 1 and presses the switch 10 to release the electromagnetic brake built in the axes O1 to O5, and moves the mirror body 2 Position the focal point at the observation site of the surgical site.

Further, at the time of observation with the operating microscope 1, the light beam emitted from the operative site enters the mirror 2. At this time, the light beam incident on the mirror body 2 from the objective lens 11 is changed by the variable magnification optical thread 12, the imaging lenses 13a and 13b, and the eyepiece 1
The operator 51 observes the operative site at a desired magnification by being transmitted through 4a and 14b. When the focal position after observation is not correct, the objective lens 11 is driven by a motor (not shown) to perform focusing.

During observation with the operating microscope 1, the position detecting sensor 36 detects the microscope markers 18 a on the mirror body 2,
18b and 18c are detected, the detection signals are transmitted to the position and each set value calculation circuit 38, and the signals are processed to detect the position and the posture of the mirror body 2 in the living body coordinate system.

Further, the objective lens 1 is detected by the position sensor 16.
1 is transmitted to the position and each set value calculation circuit 38. At this time, the position and each set value calculation circuit 38 calculates the relative position of the focal position with respect to the mirror body 2 from the position information of the objective lens 11. Further, the position of the focal position in the living body coordinate system is calculated from the position and orientation of the mirror body 2 in the living body coordinate system and the relative position of the focal position with respect to the mirror body 2. Further, an output signal from the position / set value calculation circuit 38 is input to an image synthesis circuit 39, and the TV monitor 44
Alternatively, on a display device such as the head mount display 45, the three-dimensional image data and the focal position are superimposed and displayed on the biological coordinate system on the image.

By the above operation, the surgeon 43 looks at the screen of the display device such as the TV monitor 44 and the head mount display 45, and focuses on the image of the surgical site based on the three-dimensional image data displayed on this screen. An image on which the position is superimposed can be observed. And this TV
By observing the display images of the display device such as the monitor 44 and the head mount display 45, the observation position of the microscope 1 can be known on the image based on the three-dimensional image data.

At the time of surgery, a treatment instrument 33 and a treatment device such as an endoscope 34 are inserted into the operative portion of the patient's head 32a. Here, for example, when the treatment tool 33 is inserted into the operative site, the position of the head frame 35 is detected by the position detection sensor 36, and reference three-dimensional coordinates are set. Subsequently, the position of the treatment tool 33 is detected with respect to the reference three-dimensional coordinates, and the type of each treatment tool 33 is recognized as described above. Transmit data. Then, the shape data of the treatment tool 33 stored in the storage device 40 in advance is read and transmitted to the image synthesis circuit 39.

When the endoscope 34 is used as a treatment device, the data is transmitted to the image synthesizing circuit 39 as in the case of the treatment tool 33, and the endoscope image is also transmitted.

The data of the mirror 2 of the surgical microscope 1 is also transmitted to the image synthesizing circuit 39 as described above.
Then, a microscope image is also transmitted to the image synthesizing circuit 39, and a brain image having no blind spots is constructed by synthesizing with the above-mentioned endoscope image and the image with the above-mentioned biological image data 46.

Further, on the image of the brain, the shape data and the position data of each of the treatment tools 33 and the endoscope 34 described above are synthesized. Here, the synthesized image is a TV monitor 44,
The image is displayed on a display device such as the head mount display 45, and is picture-in-picture as needed in a microscope image described later.

These controls are performed by the keyboard 41,
Alternatively, the instruction is given by a controller such as a mouse 42, a touch pen 43, and a laser pointer (not shown).

FIG. 7 shows a display example of the display screen of the TV monitor 44. Here, the TV monitor 44
A 3D display unit 52 is arranged on the left half of the display screen of
The operative part of the patient's head 32a is displayed in 3D. Furthermore, T
A top image display unit 53, a side image display unit 54, and a front image display unit 55 are arranged at the upper right part of the display screen of the V monitor 44, and a microscope image display unit 56 is arranged at the lower right part of the display screen. . The 2D image of the upper surface image of the operative part of the patient's head 32a and the side image display unit 54 are displayed on the upper surface image display unit 53.
Is a 2D image of a side view of the operative portion of the patient's head 32a, and the front image display portion 55 is a 2D image of a front view of the operative portion of the patient's head 32a.
A 2D image of a microscope image of the surgical site of the patient's head 32a is displayed on the D image / microscope image display unit 56, respectively.

The 3D display unit 52 uses a display by a wire frame, and displays a three-dimensional display by synthesizing a state of craniotomy inside the 3D display unit 52 and an object (such as a tumor). Furthermore,
The used endoscope 34 and the like are displayed in a three-dimensional outline, and the insertion state, the positional relationship with the object 48, the contact state with the surrounding biological tissue, and the like can be determined. The top image display unit 53, the side image display unit 54, and the front image display unit 55 also show 2D images synthesized in the same manner.
You can check it more reliably.

In the microscope image display section 56, the state of the object 48, which is originally blind and cannot be seen from the mirror body 2 of the surgical microscope 1, is displayed on the endoscope 34 and the surgical microscope 1 described above. Of the object, the focal position, the distance S1 to the object, the zoom setting, the endoscope image, and the like are analyzed and combined and displayed. Further, an endoscope image display unit 57 is disposed above the microscope image display unit 56. The endoscope image display section 57 displays an endoscope image from the endoscope 34.

Therefore, the above configuration has the following effects. That is, in the present embodiment, when the endoscope 34 is used on the display screen of the TV monitor 44, the position of the image obtained as the endoscope image on the living tissue can be displayed.

Further, the treatment instrument 33 to be used and the endoscope 3
4 is stored, and the actual shape of the treatment device is synthesized and displayed on the biological tissue image on the display screen of the TV monitor 44. Also, it is possible to prevent a part of the treatment device such as the endoscope 34 from deviating from, for example, a microscope image and inadvertently contacting the living tissue.

A plurality of endoscope markers 47 are provided on the operation section 34b of the endoscope 34, and a treatment tool marker 50 is provided on the treatment tool 33, and the arrangement of the markers 47 and 50 or a combination of active and passive is provided. Thus, the type of the endoscope 34 and the treatment tool 33 can be specified, so that even if the treatment tool 33 to be used or the treatment equipment such as the endoscope 34 is replaced, calibration is newly performed. The need can be eliminated.

FIG. 8 shows a second embodiment of the present invention. In the present embodiment, the configuration of the display screen displayed on the eyepiece of the mirror body 2 of the surgical microscope 1 of the first embodiment (see FIGS. 1 to 7) is changed as follows.

That is, the operating microscope 1 of the present embodiment.
A microscope image display screen 72 for displaying a microscope image actually obtained by the mirror body 2 of the surgical microscope 1 on the microscope image display screen 71 of the eyepiece of the mirror body 2 of the first embodiment, Similarly, an object virtual display unit 73 that virtually displays the object 48
Are provided.

Further, an arbitrary image can be displayed together with a picture-in-picture on the object virtual display section 73 of the microscope image display screen 71. For example, the position can be confirmed by 3D display or an endoscopic image is displayed. You can do it.

Therefore, in the present embodiment, during the operation, the operator who is watching the microscope image display screen 71 of the eyepiece of the mirror body 2 of the surgical microscope 1 is required to keep his / her eye from the eyepiece. There is an effect that the image can be confirmed.

FIG. 9 shows a third embodiment of the present invention. In this embodiment, as the endoscope 34 used together with the surgical microscope 1 of the first embodiment (see FIGS. 1 to 7), a plurality of insertion portions 34a having different effective lengths are used. Are provided with endoscopes 34A and 34B.

That is, in this embodiment, the length of the insertion portion 34a1 of one endoscope 34A is smaller than the length of the insertion portion 34a1 of the other endoscope 34A.
The length of the 4B insertion portion 34a2 is set to be larger. Then, the insertion portion 34a of the endoscope 34A
1 is an endoscope marker 4 at a fixed set position L1 from the tip.
7a is arranged. Further, similarly, an endoscope marker 47b is disposed at a fixed set position L2 from the distal end of the insertion portion 34a2 of the endoscope 34B. Here, the endoscope 3
The installation position L1 of the endoscope marker 47a of the insertion section 34a1 on the 4A side and the installation position L2 of the endoscope marker 47b of the insertion section 34a2 on the endoscope 34B side are set to the same position.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the installation positions L1 and L2 of the endoscope markers 47a and 47b of the two types of endoscopes 34A and 34B are set to the same position, so that the two types of endoscopes 34A and 34B are used. Even if it is replaced during surgery, it can be used immediately without re-calibration.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Appendix 1) means for measuring the position of the equipment to be used;
An endoscope having a distance detecting means for measuring the distance from the tip to the target, and having an image information display means, and synthesizing the position information, the distance information, and pre-recorded biological image information, A position display device having a function of displaying on a screen.

(Additional Item 2) The apparatus has means for measuring the position of the device to be used, means for storing the shape of the device in advance, and means for displaying image information, and information on the position and shape of the device. And a position display device that combines biological image information recorded in advance and displays the shape and position of the device on a screen in a distinguishable manner.

(Additional Item 3) In the position measuring device for measuring the position of the device to be used and the position display device for displaying the position of the device by synthesizing the position information and the biological image information recorded in advance. When there are a plurality of devices, by providing a marker for identifying the measuring means at a prescribed position from the tip thereof, even if the device to be used is replaced, the position from the marker to the tip is always constant. some stuff.

(Additional Item 4) In the additional item 1, the display contents may be two-dimensional or three-dimensional biological image information, position information of the endoscope, and a biological tissue located at the center of the visual field of the endoscope. Which can display the position of the endoscope image in the biological tissue.

(Supplementary note 5) In Supplementary note 2, wherein the display content is a combination of two-dimensional or three-dimensional biological image information and two-dimensional or three-dimensional shape information of the device to be used, and A device that can display device position.

(Additional Item 6) In the additional item 3, the type of the device to be used can be determined by the mounting position or type of the marker.

(Additional Item 7) Additional Items 1 to 3 and Additional Items 4 to
6. The apparatus according to 6, wherein the image information can be arbitrarily inserted or combined into a microscope image of a surgical microscope and displayed.

(Conventional Techniques of Supplementary Items 1 to 3) Conventionally, as described in Japanese Patent Application Laid-Open No.
Composes tomographic images from images and MRI with a computer and displays them in tomographic or three-dimensional form, and also pre-calibrates the shapes of treatment tools and endoscopes and other equipment used for surgery, and provides position detection markers on those equipment. The position of the equipment used is displayed on the above-mentioned biological image information by detecting the position from outside using infrared light, etc., and the position of the brain tumor is combined with the microscope image and displayed, especially in brain surgery etc. And there were devices to navigate the direction of the surgery.

Further, Japanese Patent Publication No. 6-43893 and Japanese Patent Publication No. 3-2
It has been practiced to recognize the position and shape of a subject, such as 8686. Alternatively, there has been an operation microscope capable of picture-in-picture conversion of an endoscope image into a microscope image as disclosed in Japanese Patent Application Laid-Open No. Hei 7-261094.

In addition, in a TV monitor, a head mounted display, or the like, a plurality of images can be synthesized and displayed in a desired form by easily using an image mixer.

(Problems to be Solved by Additional Items 1 to 3)
The problem to be solved by the present invention is a problem of the prior art. -It is not possible to display in which part of the living body the living tissue viewed in the endoscope image is located.・ Generally used instruments such as treatment tools and endoscopes can only display a bar-shaped simplified display on the screen, and cannot display the shape, so parts that deviate from the microscope image in particular are not prepared Damage to living tissue cannot be prevented.・ You must recalibrate each time you change the equipment you use. It is to try to solve this point.

(Effects of Additional Items 1 to 3) The effects of the present invention are as follows: When an endoscope is used, the position of an image obtained as an endoscope image on biological tissue can be displayed. . -By storing the shape of the treatment tool or endoscope, etc., used, and combining and displaying the actual shape on the biological tissue image, for example, parts of the biological tissue inadvertently deviating from the microscope image To prevent damage.・ Eliminates the need to re-calibrate even if the instrument used, such as the treatment tool or endoscope, is replaced. That is.

[0069]

According to the present invention, the position of the treatment instrument is measured by the position measuring section, and the distance from the tip of the insertion section of the endoscope inserted into the patient's body to the target of the operation section is measured by the distance. The storage unit stores the biological image information measured by the measurement unit and measured in advance, and the position information from the position measurement unit, the distance information from the distance measurement unit, and the biological image information recorded in the storage unit in advance. Are synthesized by the image information synthesizing unit and displayed on the screen of the image information display unit. Therefore, when an endoscope is used, the position of the image obtained in the endoscope image on the biological tissue is Can be displayed.Furthermore, the shape of a treatment instrument such as a treatment tool or an endoscope to be used can be synthesized and displayed on an image of a living tissue. Damage living tissue easily It is possible to prevent the door, and a treatment instrument to be used, by replacing the treatment equipment such as an endoscope, there is no need to take heart calibration operation can proceed it is efficiently a.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire surgical microscope system using a surgical navigation system according to a first embodiment of the present invention.

FIG. 2 is a front view showing a mirror of the surgical microscope according to the first embodiment;

FIG. 3 is a schematic configuration diagram of the inside of a mirror body of the operating microscope according to the first embodiment;

FIG. 4 is a schematic configuration diagram of the entire surgical navigation system according to the first embodiment;

FIG. 5 is a perspective view showing a configuration of a main part of the navigation system for surgery according to the first embodiment;

FIG. 6 is a longitudinal sectional view of a main part showing a use state of the endoscope corresponding to the surgical navigation system according to the first embodiment;

FIG. 7 is an explanatory diagram illustrating a display example of a display device in the navigation system for surgery according to the first embodiment;

FIG. 8 is a plan view showing a microscope image of an eyepiece of a surgical microscope according to a second embodiment of the present invention.

FIG. 9 is a side view showing a plurality of endoscopes having different effective lengths used in the surgical navigation system according to the third embodiment of the present invention.

[Explanation of symbols]

1 Operating Microscope 33 Treatment Tool (Treatment Equipment) 34 Endoscope (Treatment Equipment) 36 Position Detection Sensor (Position Measurement Unit) 39 Image Synthesis Circuit (Image Information Synthesis Unit) 40 Storage Device (Storage Unit) 44 TV Monitor (Image information display section) 45 Head mount display (Image information display section)

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Masahiro Kudo 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Hitoshi Karasawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Masaaki Ueda 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industries Co., Ltd. (72) Keiji Shioda 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Koji Shimomura, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Takeaki Nakamura, 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. F term (reference) 2F065 AA04 AA06 AA20 AA21 AA37 BB05 BB27 BB29 CC00 CC16 EE00 FF04 HH 04 LL04 LL05 PP01 PP05 PP11 PP21 PP22 PP24 QQ00 QQ24 SS02 SS03 SS13 TT02 4C061 HH52 HH56 JJ11 NN05 WW04 WW13 5C054 AA01 AA05 CA04 CC07 EA01 EA05 EA07 EH01 FA00 FC12 FE12 GB02 HA12

Claims (3)

[Claims] 1. A position measuring unit for measuring a position of a treatment device used for treatment of an operation site in a patient's body, and a distance from a distal end of an insertion unit inserted into the patient's body to a target of the operation unit. An endoscope having a distance measuring means for measuring the position of the patient, an image information display unit for displaying image information of an operating part in the body of the patient, a storage unit for holding biological image information measured in advance, and the position measuring unit The position information from the, distance information from the distance measurement means, and the biological image information recorded in advance in the storage unit, the image information synthesis unit to display on the screen of the image information display unit A navigation system for surgery, comprising: 2. The image information synthesizing section has means for storing the shape of the treatment device in advance, and information on the position and shape of the treatment device, and biological image information recorded in advance. 2. The surgical navigation system according to claim 1, wherein the information is combined and displayed on the screen of the image information display unit so that the shape and position of the device can be distinguished. 3. A position measuring unit for measuring a position of a treatment instrument used for treatment of an operation part in a patient, and a distance from a tip of the insertion part inserted into the patient to a target of the operation part. An endoscope having a distance measuring unit for measuring the distance, an image information display unit for displaying image information of an operation unit in the body of the patient, a storage unit for holding biological image information measured in advance, and the position measuring unit The position information from the distance information from the distance measurement unit, the image information synthesis unit that combines the biological image information recorded in advance in the storage unit, and displays on the screen of the image information display unit A plurality of treatment devices are appropriately and selectively exchanged and used for treatment of an operation part in a patient's body, and the position measurement unit is identified at a predetermined set position from a tip of each treatment device. For surgery characterized by the provision of markers for performing Navigation system.