JP3803152B2 - Surgical endoscope device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a surgical endoscope apparatus used for observing the inside of a patient during surgery.
[0002]
[Prior art]
In recent years, a technique has been adopted in which surgery is performed without making a large incision simply by making a small hole for inserting a surgical tool into a body cavity and a small hole for inserting an endoscope. Endoscopic devices have been developed.
[0003]
As such a surgical endoscope apparatus, a system in which an endoscope observation image obtained by a so-called rigid endoscope is picked up by a solid-state image pickup device and displayed on a television monitor is used.
[0004]
FIG. 11 schematically shows a state in which a conventional operating room for performing such an operation using a thoracoscope, that is, a so-called thoracoscopic operation is viewed from above, and a patient 91 is placed on an operating table 90. TV monitors 92 and 93 for displaying an endoscopic observation image are placed on the left and right sides of the operating table.
[0005]
[Problems to be solved by the invention]
In the conventional system as described above, the endoscope 94 and the assistant 95 standing on both sides of the operating table are respectively displayed on the television monitors 92 and 93 on the opposite side of the operating table 90. Surgery is performed while viewing the observation image.
[0006]
However, in such a system, as shown in FIG. 12, the direction A of the line of sight of the operator 94 is significantly different from the operation area B, and the operation is performed while looking at the direction different from the place where the operation is actually performed. There is a drawback that the surgeon is stressed out because of a strong sense of incongruity. Reference numeral 96 denotes a rigid endoscope (thoracoscope).
[0007]
Therefore, an object of the present invention is to provide a surgical endoscope apparatus that allows an operator to perform an operation without discomfort while observing the endoscope while looking at the direction of the surgical region.
[0008]
[Means for Solving the Problems]
In order to achieve the above object, the surgical endoscope apparatus of the present invention displays an endoscope observation image obtained by an endoscope for observing the inside of a patient on an operating table on a television monitor apparatus. In the surgical endoscope apparatus described above, the television monitor is arranged right above the operating table with a space for a patient to enter the operating table.
[0009]
Note that the screen of the television monitor may be directed upward, and the television monitor may be a liquid crystal display. The television monitor may be movable in the vertical direction and fixed at an arbitrary position.
[0010]
The television monitor may be retractable from a position directly above the operating table, the television monitor may be attached to the tip of an arm, and the arm may be raised upward. And the said arm is supported by the support | pillar, It is good to move to the up-down direction along the said support | pillar, and to fix it in arbitrary positions.
[0011]
Further, the endoscope may be a rigid endoscope having a rigid insertion portion, and the rigid endoscope is attached to the tip of the second arm, and the arm is moved along the support column. It may be possible to move in the vertical direction and fix at an arbitrary position. Note that a solid-state imaging device for capturing an endoscopic observation image may be disposed in the distal end portion of the rigid insertion portion.
[0012]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
1, 2, and 3 are a side view, a plan view, and a front view of an operating room in which the surgical endoscope apparatus of the present invention is used. Here, an example in which the present invention is applied to thoracoscopic surgery is shown, but it may be applied to other operations such as laparoscopic surgery.
[0013]
A trocar 3 is passed through a small hole in the chest wall of a patient 2 laid sideways on the operating table 1, and an insertion portion of a rigid thoracoscope 4 for observing the inside of the thoracic cavity is attached to the trocar 3. Has been passed. Reference numeral 10 denotes a trocar for inserting the surgical tool into the body cavity.
[0014]
As shown in FIG. 4, as the thoracoscope 4, a solid-state imaging device 6 made of, for example, a charge coupled device (CCD) is arranged at the imaging position of the subject by the objective optical system 5 arranged at the distal end of the insertion portion. A so-called electronic rigid mirror is used, and an endoscopic observation image is picked up by the solid-state image pickup device 6. Reference numeral 7 denotes a light guide fiber bundle for illumination.
[0015]
As the thoracoscope 4 used in such an operation, one having an effective length of the insertion portion as short as about 30 to 100 mm and a wide viewing angle of about 120 ° to 140 ° is used, which is shown in FIG. As described above, the surface of the objective optical system 5 can be cleaned by ejecting water from the tip of the catheter 9 that has passed through the guide channel 8.
[0016]
Returning to FIG. 2, the surgeon 11 and the assistant 12 stand separately on the left and right of the operating table 1, and an anesthesiologist 13 and a nurse 14 stand around the operating table 1. Reference numeral 16 denotes a table on which a surgical tool is placed, and reference numeral 17 denotes a monitor such as an electrocardiograph or a sphygmomanometer for the anesthesiologist 13 to check.
[0017]
Reference numeral 18 denotes a video processor / light source device for processing an imaging signal output from the solid-state imaging device 6 of the thoracoscope 4 and supplying illumination light to the light guide fiber bundle 7. It is put on the cart put in.
[0018]
However, as shown in FIG. 6, the video processor / light source device 18 may be accommodated in a support box 19 suspended from the ceiling by the arm 21. In this case, if the universal joints 22 and 23 are arranged at both ends of the arm 21, the position of the video processor / light source device 18 can be freely changed.
[0019]
Returning to FIGS. 1, 2, and 3 again, a television monitor 25 for displaying an endoscopic observation image imaged by the solid-state imaging device 6 of the thoracoscope 4 is disposed directly above the chest of the patient 2. .
[0020]
As the television monitor 25, a liquid crystal display that does not require a thickness is used, and a display surface is placed at a height of about 140 cm from the floor with a gap of, for example, about 5 cm to 15 cm between the patient and the patient. It is arranged upward.
[0021]
As shown in FIG. 1, the television monitor 25 and the thoracoscope 4 are arranged at the ends of arms 32 and 33 that are attached so as to extend laterally to a column 31 that is erected on the operating table 1. . 2 and 3, the arms 32 and 33 are not shown.
[0022]
FIG. 7 shows a support mechanism for supporting the television monitor 25 and the thoracoscope 4.
The column 31 is fixed to the operating table 1 by a fastener 35 that is tightened with a screw to fix the object. The bases of the two arms 32 and 33 are also fixed to the column 31 by manual screws 34 and 35, respectively, and the screws 34 and 35 are loosened to freely change the fixing height of the arms 32 and 33 with respect to the column 31. be able to.
[0023]
The base of the thoracoscope 4 is fixed to the holder 37 by a fixing screw 38. The holder 37 is fixed to the tip of the lower arm 33 with a manual screw 39, and the holder 37 can be detached from the arm 33 by loosening the screw 39.
[0024]
8a is an entrance of the guide channel 8 of the thoracoscope 4, and 41 and 42 are between the solid-state imaging device 6 of the thoracoscope 4 and the video processor / light source device 18, and between the TV monitor 25 and the video processor / light source device 18. It is the signal cable which connects between.
[0025]
As shown in FIGS. 8 and 9, a support frame 32a is formed at the tip of the upper arm 32, and the television monitor 25 is fixed to the support frame 32a by a manual screw 40 or the like.
[0026]
With such a configuration, as shown in FIG. 1 and FIG. 3, the television monitor 25 is arranged directly above the surgical region B with a space for the patient 2 to enter the operating table 1. For the surgeon 11, the observation direction A of the television monitor 25 substantially coincides with the operation region B, and the surgery can be performed while watching the television monitor 25 without a sense of incongruity.
[0027]
A hinge-like joint 45 is provided in the middle of the arm 32 to which the television monitor 25 is attached. FIG. 10 is an enlarged view of the portion. The arm 32 can be rotated upward about the shaft 451, and the arm 32 can be fixed at an arbitrary rotational position by tightening the stopper screw 452. can do.
[0028]
Therefore, as shown by a broken line in FIG. 1, when it is not necessary to view the television monitor 25, the arm 32 can be rotated to raise the television monitor 25 upward.
[0029]
The present invention is not limited to the above-described embodiment. For example, as shown by a broken line in FIG. 3, the television monitor 25 is slightly tilted so that the screen of the television monitor 25 faces the operator 11. It may be arranged in such a manner that it can be arranged or rotated. A flexible endoscope may be used as the endoscope.
[0030]
【The invention's effect】
According to the present invention, the television monitor is placed right above the operating table with an interval between the patient and the operating table, so that the operator can observe the endoscope while viewing the direction of the operating area. Surgery can be performed without any sense of incongruity, and it will not cause stress even if you perform surgery for a long time.
[Brief description of the drawings]
FIG. 1 is a schematic side view of an operating room in which a surgical endoscope apparatus according to an embodiment of the present invention is used.
FIG. 2 is a schematic plan view of an operating room in which the surgical endoscope apparatus according to the embodiment of the present invention is used.
FIG. 3 is a schematic front view of an operating room in which the surgical endoscope apparatus according to the embodiment of the present invention is used.
FIG. 4 is a longitudinal sectional view of the distal end of the insertion portion of the thoracoscope of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 5 is a perspective view of the distal end of the insertion portion of the thoracoscope of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 6 is a front sectional view of a video processor / light source device support device of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 7 is a side view partially showing a support mechanism of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 8 is a plan sectional view of a television monitor portion of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 9 is a side sectional view of a television monitor portion of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 10 is a partially enlarged perspective view of a support mechanism of the surgical endoscope apparatus according to the embodiment of the present invention.
FIG. 11 is a schematic plan view of an operating room where a conventional surgical endoscope apparatus is used.
FIG. 12 is a schematic front view of an operating room in which a conventional surgical endoscope apparatus is used.
[Explanation of symbols]
1 Operating table 2 Patient 3 Rigid endoscope (thoracoscope)
11 Surgeon 25 TV monitor 31 Post 32, 33 Arm 45 Joint

Claims (4)

A surgical endoscope apparatus which so that the endoscope observation image obtained by the rigid endoscope is displayed on a television monitor for viewing the patient's body on the operating table,
The TV monitor is fixed to the distal end portion of the first arm, the base end portion of which is supported horizontally so that the support table is erected on the operating table so that the position can be arbitrarily changed in the vertical direction. The first monitor and the operating table are arranged such that the screen of the TV monitor is arranged directly above the operating table and can be fixed to the support column while arbitrarily changing the position in the vertical direction. A surgical endoscope apparatus, wherein the rigid endoscope is fixed to a distal end portion of a second arm whose base end portion is supported horizontally at a position therebetween. The television monitor surgical endoscope apparatus according to claim 1, wherein a freely retracted from the position just above the operating table. The surgical endoscope apparatus according to claim 2 , wherein the first arm on which the television monitor is fixed to a distal end portion can be lifted upward. The endoscope observation image the solid-state imaging device endoscope apparatus for surgery according to claim 1, wherein is disposed within the distal end of the rigid endoscope for imaging the.

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