Surgical microscope with stand and method for configuring a stand

A stand for a surgical microscope includes a digiscope and an imaging unit which are interconnected and mounted on an arm of the stand at a joint rotatably about an axis of rotation. The digiscope and the imaging unit are arranged on a bridge such that a fixed spatial relationship, in particular a distance larger than zero between the digiscope and the imaging unit during a relative movement between the digiscope and the patient is maintained. A method for configuring a stand with a bridge includes determining distances between eyes of a surgeon and the imaging unit, between the surgeon and an operating field, between the receptacle of the digiscope and the operating field, and between the imaging unit and the receptacle of the digiscope, and determining a length of the bridge to optimally set a distance from the surgeon to the patient and the imaging unit for the surgeon.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to German patent application DE 10 2019 112 153.1, filed May 9, 2019, the entire content of which is incorporated herein by reference.

TECHNICAL FIELD

The disclosure relates to a surgical microscope with a stand and a method for configuring a stand.

BACKGROUND

In microsurgery and, specifically, in ophthalmology, the eyepieces of the microscope for observing the operating field are being replaced ever more frequently by two video cameras and a stereoscopic screen. In the process, the video cameras record the operating field through the imaging optical unit of the microscope and the stereoscopic screen displays the recorded images. The advantages of these digital microscopes, which are also referred to as digiscopes, include ergonomically improved conditions for the surgeon, multifaceted options for digital image processing and augmenting the image and improved options for the training of future surgeons. Surgical microscopes currently available on the market employ relatively large screens with a size of up to 55″. However, these are disadvantageous in that they are located on a separate stand and therefore require a lot of space in the usually small operating theatres. What applies in general is that the 3D impression of a 3D screen is only optimal at a certain relative spatial position, i.e., at a certain distance and at a certain angle in relation to the observer, which is referred to as the “sweet spot”. This relative spatial position is set when specifying the screen and is taken into account during the manufacturing process, with the three-dimensional impression of the representation only even being provided in a realistic fashion in a very narrow range around this “sweet spot”. During the use of the 3D screen, this distance between the surgeon and the 3D screen and the lateral and vertical angles (swivelling and inclining) of the 3D screen should therefore be maintained as optimally as possible in relation to the viewing direction of the observer.

In the case of cataract operations, in particular, which often only take approximately 15 to 20 minutes, the used apparatuses have to be repositioned relatively frequently with a new patient. The high patient throughput requires this procedure to be at high speed. As a result of arranging the screen on an additional stand, the surgical microscope and the screen have to be moved in order to align the screen at the optimal distance and angle with respect to the surgeon again, affecting the speed of the procedure in disadvantageous fashion.

U.S. Pat. No. 7,841,979 B2 describes an arrangement in which the microscope is connected to the screen by way of a kinematic system. When one of the two elements is moved, the kinematic system moves the other element along. This arrangement is disadvantageous in that a movement of the microscope or of the screen relative to the patient alters the distance between the microscope and the screen, which has a negative effect on the ergonomics and the alignment of the screen with respect to the surgeon, and hence on the image quality.

The patent application NL 1039675 describes a structure in which a microscope is integrated in a screen and securely connected to the latter, and the angle of the microscope is determined by the angle of the screen, which is intended to emulate the view through an eyepiece. A substantial disadvantage of this arrangement consists of either the screen being able to be positioned in an ergonomic position and at an optimum distance from the surgeon or the microscope being able to be advantageously arranged over the operating field, but both of these actions cannot be performed at the same time.

SUMMARY

It is an object of the present disclosure to provide an apparatus which solves the above-described disadvantages of the related art. A further object of the disclosure is to provide a method for configuring such an apparatus.

This object is achieved by a surgical microscope and a method for configuring a surgical microscope as described herein.

A surgical microscope according to an aspect of the disclosure includes a digiscope and an imaging unit, wherein the digiscope and the imaging unit are interconnected and mounted on an arm of a stand, at a first joint so as to be rotatable about an axis of rotation. According to an aspect of the disclosure, the digiscope and the imaging unit are arranged on a bridge for ensuring a fixed, non-zero distance between the digiscope and the imaging unit in the case of a relative movement between the digiscope and the patient. As a result, the digiscope can be brought quickly from one position to another position without having to reset the distance between the imaging unit, which may be embodied as a 3D monitor, for example, and the surgeon in the process. Here, the distance between the digiscope and the imaging unit is understood to mean the distance in a horizontal direction, in particular in the viewing direction on the imaging unit. The viewing direction is understood to mean the direction from which a viewer must gaze in order to obtain an optimal impression of the illustrated image.

In particular, the bridge can include the joint which results in a compact yet at the same time flexible structure.

Furthermore, the imaging unit can be arranged on a straight line from the receptacle of the digiscope through the axis of rotation of the joint. This is advantageous in that the surgeon can assume an ergonomic body posture during an operation.

Additionally, the joint can be arranged between the digiscope and the imaging unit. As a result, the surgical microscope can have a very compact embodiment, which may be advantageous in the usually small operating theatres.

Furthermore, the joint can be arranged on a continuation of the straight line through the receptacle of the digiscope and the imaging unit, i.e., behind the imaging unit from the point of view of the digiscope. In conjunction with the joints and arms of the stand, the digiscope can be pushed to the position desired by the surgeon.

Furthermore, the distance between the digiscope and the imaging unit can lie between 0.2 meters (m) and 0.8 m and, in particular, the distance between the imaging unit and the digiscope can be adjustable. Here, the distance depends, for example, on the size and style of the employed monitor and the preferences of the surgeon. After the distance has been set, the latter can be secured, as a result of which the digiscope can be set for different surgeons. Here, setting the distance can be embodied in manual fashion or with the assistance of motors. Should the distance be set by motor, the distances can be stored in a controller and the distances stored in advance can be set, even automatically, when needed.

In one exemplary embodiment of the disclosure, the imaging unit can be mounted so as to be twistable about at least one axis perpendicular to the longitudinal axis of the bridge. As a result, it is also possible to set the angle of the imaging unit in addition to the distance and adapt these to the preference of the surgeon. Here, too, motor-driven and/or automatic setting of the imaging unit is conceivable in addition to simple manual setting.

Furthermore, the bridge can include a second joint, which divides the bridge into two segments. The receptacle of the digiscope can be arranged at the end of the first segment distant from the joint and the imaging unit can be arranged at the end of the second segment distant from the joint. The second joint allows the position between the digiscope and the imaging unit to be altered.

In particular, the two segments of the bridge divided by the joint can be embodied in such a way that they are arranged in parallel and above one another. Firstly, this can advantageously reduce the spatial requirements of the surgical microscope to a minimum, for example when the surgical microscope is not in use. Secondly, the position of the segments in relation to the second arm can be interchanged, i.e., the digiscope can be moved from one side to the side of the imaging unit and vice versa, without the bridge having to be rotated about the first joint in the process. Here, it is possible to advantageously use the space above the second arm of the stand and no additional space is required in front of the surgical microscope for changing the positions.

Additionally, the second joint can be locked in the position in which the longitudinal axes of the two segments extend parallel to the longitudinal axis of the bridge. This allows the arrangement of the digiscope and the imaging unit that is advantageous for the operation of the surgical microscope to be set easily and said arrangement is simultaneously secured in this layout. In the locked position, the bridge can then be rotated about the first joint without changing the distance and the angle of the two components with respect to one another.

Furthermore, the bridge can be embodied in such a way that it can be rotated through at least 180° without moving an arm and/or the stand. The arrangement of the digiscope and the imaging unit in relation to the stand can thus be reversed without moving the stand and/or an arm of the stand, as described further above. In the case of a new patient, this may lead to significant shortening of the conversion times and makes a movement of the stand and/or of the operating table or chair superfluous, advantageously improving the use of the available space.

A method according to an aspect of the disclosure for configuring a stand of a surgical microscope with a bridge, on which a receptacle for a digiscope and a connector for an imaging unit are disposed, wherein the bridge is mounted on an arm of the stand, at a first joint so as to be rotatable about an axis of rotation, includes the following method steps:(a) determining a first optimal distance between eyes of a surgeon and the imaging unit;(b) determining a second distance between the surgeon and an operating field;(c) determining a third distance between the receptacle of the digiscope and the operating field;(d) determining a fourth distance between the imaging unit and the receptacle of the digiscope; and(e) determining a length of the bridge such that the distance from the surgeon to the patient and the imaging unit is optimally set for the surgeon.

In particular, the imaging unit can be embodied as a 3D screen. At a certain distance A, the 3D screen can very faithfully reproduce the images of the operating field, which were recorded by the two cameras in the digiscope and processed into a 3D image in a control unit. In this case, the optimal distance A can be set within a certain range during the production of the screen.

Furthermore, the distance between the surgeon and the operating field can be determined on the basis of the ergonomic posture during an operation and the 95% percentile of the relevant body parts of the surgeon, in particular the forearm length.

Additionally, the distance between digiscope and imaging unit can lie between 0.2 m and 0.8 m.

DESCRIPTION OF EXEMPLARY EMBODIMENTS

FIG. 1shows a surgical microscope1, which includes a digital microscope, a so-called digiscope20. Furthermore, the surgical microscope1includes a stand2with a foot3, on which a column4is arranged in rotatably mounted fashion. A first end of a first arm5, which could be embodied, for example, as a scissor arm or else as a rigid carrying arm, is arranged on the column4via a first stand joint7. Here, the stand joint7facilitates a rotation of the arm5around the longitudinal axis of the column4. Via a second stand joint8, a first end of a second arm6is arranged at the other end of the first arm5, said second arm being rotatably mounted about the stand joint8in the same plane as the first stand joint7. At its second end, the second arm6includes a first bridge joint11, on which a bridge10is rotatably mounted. A digiscope20in a receptacle21is arranged at one end of the bridge10and an imaging unit, embodied as a 3D screen30, on a connector31is arranged at the other end of the bridge10. The surgical microscope1is aligned on a patient42lying on a table43in such a way that the digiscope20is arranged over an operating field44, which includes an eye (not illustrated) of the patient42. Here, the imaging unit30is arranged on the bridge10in such a way that the viewing angle41and the distance A between the eyes of the surgeon40and the imaging unit30, which is embodied as a 3D screen30, are optimal. The 3D screen30can be embodied as an autostereoscopic or polarization-based 3D screen30, with any other technology for 3D representation also being able to be used. Moreover, the distance B between the surgeon40and the operating field44, the distance C between the operating field44and the receptacle21of the digiscope20and the distance D from the receptacle21of the digiscope20are illustrated, the distances being relevant in the method, described inFIG. 5, for designing the length E of the bridge. The surgical microscope1illustrated inFIG. 1is only an exemplary embodiment in which the disclosure can be implemented. In other exemplary embodiments of surgical microscopes, the stand2can be embodied as a wall mount or ceiling mount, for example.

FIG. 2shows a detailed view of the stand2, in which the bridge10is depicted on the first bridge joint11on the second arm6of the stand2. At its one end, the bridge10includes the receptacle21for the digiscope20, wherein the receptacle21comprises a joint22and an adapter23, with which the digiscope20is fastened to the bridge10. The joint22is embodied in such a way that the digiscope20can be twisted about the longitudinal axis16of the bridge10and about the axis, perpendicular to the longitudinal axis16, running into the plane of the drawing. Alternatively, the digiscope20can also be rigidly connected to the bridge10, with the digiscope20in that case being positioned by way of the kinematic mechanism of the stand2. The digiscope20includes an imaging optical unit24and two cameras25, which record the operating field44through the imaging optical unit24. A controller, not illustrated, calculates a 3D image, which is displayed on the imaging unit30, from the images of the two cameras25. The connector31for the imaging unit30is arranged at the other end of the bridge10. The connector31includes a carriage32, on which the connector31can be moved in the direction of the longitudinal axis16of the bridge10and can be locked on the bridge10. An arm33is arranged on the carriage32, said arm being aligned substantially perpendicular to the bridge10and including a joint34at its upper end, the latter connecting the arm33and an adapter35for the imaging unit30. The joint34is embodied in such a way that the imaging unit30can be twisted about two axes that are perpendicular to the longitudinal axis16of the bridge10and to one another. As a result, it is advantageously possible to set the distance and the lateral and vertical angles of the imaging unit30in relation to the surgeon (not illustrated) to the optimal values for a 3D representation. The entire bridge10can be moved and positioned by the kinematic mechanism provided by the joints7and8and arms5and6of the stand2and by a rotation of the bridge10about the axis of rotation16, with the distance between the digiscope20and the imaging unit30remaining constant. Since, as a rule, the distance B between the surgeon40(not illustrated) and the operating field44is constant for a surgeon and the digiscope20is advantageously arranged over the operating field44, the distance A between the eyes of the surgeon40(not illustrated) and the imaging unit30also remains at a distance and an angle optimal for the 3D imaging. As a result of the joint22at the receptacle21of the digiscope20, the angle and the distance of the imaging unit30from the surgeon40(not illustrated) are also maintained when the surgeon40changes the angle between the digiscope20and the bridge10.

FIGS. 3A and 3Bshow further detailed views of the bridge10, which is arranged with the first bridge joint11on the second arm6of the stand2. In this exemplary embodiment, the bridge10includes a second bridge joint embodied as a folding joint12, which connects a first segment13with the digiscope20to a second segment14with the imaging unit30. In the shown exemplary embodiment, the second joint12is arranged above the first joint11, with an arrangement in the opposite sequence also possibly being advantageous if, for example, the stand2is embodied as a ceiling mount. Alternatively, the second joint12can also be arranged at a different position of the bridge10than the first joint11.

FIG. 3Ashows the bridge10in a position in which the longitudinal axes17and18of the two segments13and14are aligned in the direction of the longitudinal axis16of the bridge10and in which the two segments include an angle of approximately 180°, i.e., in the position in which the bridge10with the digiscope20and the imaging unit30is advantageously aligned during an operation. The second joint12, which is rotatable about the same axis of rotation19as the first joint11, furthermore includes a locking mechanism15, which is embodied to lock the second joint12in the position illustrated inFIG. 3A. The locking mechanism15can also be embodied for locking in further advantageous positions of the second joint12.

FIG. 3Bshows a position in which the two segments13and14with the digiscope20and the imaging unit30are arranged above one another with an identical alignment of the longitudinal axes17and18, i.e., where said axes include an angle of approximately 0°. Advantageously, the locking mechanism15of the second joint12is embodied in such a way that it can also lock the joint12in this position, which can also be referred to as a parked position. Furthermore, the bridge10is embodied in such a way that, in the parked position, the two segments13and14can be swiveled about the axis of rotation19of the bridge over the second arm6of the stand2with the first joint11, leading to minimal spatial requirements when the surgical microscope1is not in use. By way of example, this allows the surgical microscope1to be pushed against a wall.

FIGS. 4A and 4Bshow an illustration of a 180° rotation of the digiscope20and of the imaging unit30, which has to be carried out within a few minutes, for example when changing from one patient to another patient.

FIG. 4Ashows the bridge10in an arrangement in which the digiscope20is arranged on the left side and the imaging unit30is arranged on the right side of the illustration or of the second arm6of the stand2. The two segments13and14are embodied in such a way that they can be arranged above one another, i.e., the two segments can also be rotated past one another without collision. The two arrows, not labelled separately, show the directions of rotation of the two segments13and14about the axis of rotation19of the second bridge joint12, in which said segments are rotated after the locking mechanism15of the second joint12was released.

FIG. 4Bshows the bridge10following the 180° rotation, i.e., in a position in which the digiscope20is arranged on the right side and the imaging unit30is arranged on the left side of the second arm6of the stand2. Here, the locking mechanism15is embodied in such a way that the second joint12can be locked in the two positions illustrated inFIGS. 4A and 4B. The segments13and14can also be embodied as shown inFIGS. 3A and 3Bsuch that twisting through 360° about the axis of rotation19of the first bridge joint11is possible, which also facilitates a quick change of the arrangement through 180°, as shown inFIGS. 4A and 4B, without a second bridge joint12.

FIG. 5describes a possible method according to the disclosure for configuring a stand2.

In a first method step50, the optimal distance A from the eyes of the surgeon40to the imaging unit30is determined.

In a second method step51, the distance B from the surgeon40to the operating field44is determined.

In a third method step52, the distance C between the receptacle21of the digiscope20and the operating field44is determined.

In a fourth method step53, the distance D between the imaging unit30and the receptacle21of the digiscope20is determined.

In a fifth method step, the length E of the bridge10is determined in such a way that the distance from the surgeon40to the patient42and the imaging unit30is optimally set for the surgeon40.

It is understood that the foregoing description is that of the exemplary embodiments of the disclosure and that various changes and modifications may be made thereto without departing from the spirit and scope of the disclosure as defined in the appended claims.

LIST OF REFERENCE NUMERALS