The invention relates to a stereo endoscope having an elongated shaft and a sensor unit comprising two flat image sensors which are arranged symmetrically about a central rotational axis of the shaft.
Minimally invasive endoscopic surgery of the human or animal body is performed using endoscopes with a long or respectively elongated shaft that is introduced into the interior of or respectively a cavity in the body through a body opening existing or created for this purpose before surgery. Since the operative field in the body cavity cannot be viewed directly from the outside, known endoscopes enable a view of the body cavity to be treated. For this purpose, conventional endoscopes have an optical system with one or more lenses on the distal tip of the endoscope shaft that direct light from the body cavity into the endoscope. The endoscope shaft can have an arrangement of lenses such as rod lenses by means of which light is guided out of the body cavity to the proximal end of the endoscope, that is, to the end that is held and used by the operator or surgeon.
In the proximal region of the endoscope, for example on a handle, there is an eyepiece with an ocular, that is, an optical system, from which exits the light entering the distal tip of the endoscope. Such an ocular can be used for direct observation with a naked eye brought up to the eyepiece.
An alternative possibility is to connect a camera head to the eyepiece on the proximal end of the endoscope which camera head has its own optical system that guides the light exiting the ocular to a flat optical matrix sensor such as a CCD chip or a CMOS chip. The image recorded by the optical matrix sensor can for example be displayed on a monitor and saved, if necessary, so that it can be retrieved later, if necessary, and displayed.
In video endoscopy systems, it is alternatively known to insert an image sensor in the distal tip of the shaft of the endoscope next to an optical system, and the image or respectively video signals are electronically transmitted.
Endoscopes and endoscopic instruments are used in the surgery of human or animal bodies within narrow spaces. Frequently, sections of tissue which are essential to life or functioning are directly adjacent to the parts of tissue to be operated on. Consequently, it is fundamentally important for the performing surgeon to have well-functioning hand-eye coordination and orientation when using an endoscope.
Most current systems offer a flat, two-dimensional impression of the operative field so that potential training for hand-eye coordination is restricted. The perception and estimation of distances and relative spatial relationships is difficult in comparison to the direct viewing of an operative field.
A three-dimensional representation of the operative field promises an improvement in this regard given the achievable plasticity of the reproduced image. Stereo endoscopic systems are already known. The known approach of generating a three-dimensional view of the operative field by means of a single endoscope is substantially based on the implementation of two image channels in the endoscope. Since the two image channels at the tip of the endoscope are slightly apart from each other due to the narrow design of endoscopes, it is possible to depict a three-dimensional visual range of a few millimeters to centimeters in front of the tip of the endoscope. This is sufficient in most applications.
In many cases, endoscopes have a rigid shaft. In order to cover the largest possible viewing angle within the interior of the body, such endoscopes are equipped with a side view. For this purpose, they have a mirror, prism or other optical deflective element that directs the viewing angle to the side by 30°, 45°, 70° or a desired different angle. For example, with a side viewing angle of 45°, the effective field of vision includes both the 0° direction along the extension of the shaft as well as an orthogonal 90° angle. In order to see the largest possible spatial angle, such an endoscope is rotated about its longitudinal axis.
In contrast to photography where the line of the horizon between the sky and earth is normally depicted horizontally, for example in pictures of landscapes, there are no pictorial references in the recorded image in endoscopy that could provide the surgeon with information on whether the displayed image has the same orientation with reference to his own orientation in space or is, for example, upside down. From the image, the surgeon therefore cannot be sure of the horizon position of the image. If the horizon position in the image, which is determined by the orientation of the image sensors within space, deviates from the position of the surgeon, it makes it difficult for the surgeon to orient himself and use the endoscope. Directed movements of the endoscope cause the image to shift in the wrong direction. The use of the endoscope is disorienting in a manner similar to a cursor on a computer screen being influenced by the movement of a computer mouse which is, for example, held twisted at a 90° angle or another angle.
In the case of monoscopic endoscopes, a camera head with an image sensor is attached to the endoscope eyepiece by means of a coupling that allows the endoscope to be rotated relative to the camera head in order to retain the horizon position for the surgeon. If such rotational decoupling is not possible, the surgeon quickly becomes disoriented due to the rotation of the image together with the rotation of the direction of view of the endoscope.
Such rotational decoupling is not used with known stereo video endoscopy systems since separating the lens groups in the endoscope shaft forming the optical image channels would cause the lens groups of the two image channels of the endoscope shaft to move away from the corresponding lens groups and image sensors in the camera head when the shaft is rotated. By rotating 90°, any overlap would disappear and no image could be seen.
Consequently, the image sensors are not rotatably decoupled from the optical image channels or respectively lens groups in known stereo endoscopy systems.
The horizon position of the image is lost when the endoscope is rotated on its longitudinal axis. A solution to this problem is described in the German patent application No. 10 2010 041 847.1 by the applicant entitled “Sensor unit for a stereo endoscope and stereo endoscopy system” with the same priority, to which reference is expressly made.
In addition to the loss of the horizon position of the image itself, there is an additional problem which is due to the function of stereo endoscopy itself. This function is based on the principle that two image channels are arranged offset by a certain distance along a baseline analogous to the eyes of the viewer. The baseline typically runs horizontally so that one image channel views from the right and the other from the left. The images of both channels are presented by a suitable viewing system only to the right or respectively left eye, and the images are processed in the brain of the viewer into three-dimensional perception.
When the endoscope is rotated, the position of the baseline rotates independent of the alignment of the image sensor. Even though the individual images of both channels can retain the horizon position by correspondingly rotating the image sensors on their midpoint, one channel looks down and the other looks up, for example, when the endoscope is rotated 90°. However, the brain of the viewer of the image does not receive any information on the actual position of the baseline; furthermore, this information could not be processed since the corresponding situation cannot occur physiologically.
By rotating the endoscope, the three-dimensional impression of the image is lost, and in a worst case, it can cause the perception of double images, headaches and dizziness which constitutes undesirable stress on the physician during endoscopic surgery.
The object of the present invention therefore is to provide a stereo endoscope and stereo endoscopy system that allows an operator or a surgeon a three-dimensional depiction of the operative field with a stable horizon position during minimally invasive surgery, even when the direction of view of the endoscope changes.
This object is achieved by a stereo endoscope having an elongated shaft and a sensor unit comprising two flat image sensors which are arranged symmetrically about a central rotational axis of the shaft, and which is further developed in that the lateral direction of view of the stereo endoscope which deviates from a central 0° direction of view is variably adjustable and/or changeable independent of the orientation of the image sensors relative to each other.
In particular, the position of the baseline is meant by “the orientation of the image sensors relative to each other”.
Within the context of the invention, the endoscope is generally a sideways-looking endoscope with a direction of view that is changed by rotating about the longitudinal axis of the endoscope, or an endoscope with a flexible shaft that can assume the 0° direction of view aligned in the longitudinal direction of the endoscope, and can assume lateral directions of view deviating therefrom.
Since according to the invention the orientation of the image sensors relative to each other and the lateral direction of view of the stereo endoscope are variably adjustable and/or changeable independent of each other, the adjustment of the line of site is decoupled from the orientation of the image sensors and hence from horizon positions. For the first time, it is therefore possible for a surgeon or operator to select any direction of view that can be depicted by the endoscope without losing the stereoscopic, that is plastic, impression of the operative field and the horizon position of the depicted image. Orientation within the operative field is thereby retained.
The sensor unit is advantageously arranged on a distal tip of the shaft, or in a proximally arranged camera head. In both cases, it is possible to decouple the selected direction of view from the orientation of the image sensors relative to each other.
In an advantageous embodiment of the stereo endoscope according to the invention, the elongated shaft is designed as a rigid shaft the distal end of which has a viewing window which is inclined relative to the longitudinal axis of the shaft and is connected within the shaft to one or two optical deflective elements, especially prisms or reflecting prisms, wherein at least one distal section of the shaft with the viewing window, and the optical deflective element(s), rotate about axes that are aligned parallel to the longitudinal axis of the shaft to adjust or change the lateral direction of view. The sensor unit with the image sensors is preferably also arranged on the tip of the rigid shaft. Alternatively, two rod lens systems are provided parallel to each other, or a common rod lens system forming both channels is provided in the shaft, whereas the sensor unit is arranged in a camera head. This embodiment according to the invention describes an endoscope that has a rigid shaft and a lateral viewing angle which in particular is permanently set. The direction of view is changed by rotating the distal deflective element of the endoscope about the longitudinal axis of the shaft.
Prisms, reflecting prisms and mirrors serve as the optical deflective elements. It is also possible to use movable mirrors that enable a variably adjustable, lateral viewing angle. In such a case of mirrored incident light, it is advantageously provided that the images are reflected again when reproducing the image, in particular about a central, vertical midline of the individual images.
When the corresponding stereo endoscope is rotated about its longitudinal axis, the inclined or respectively sloped viewing window is also rotated so that its direction of inclination also changes. The optical deflective elements rotate in the same direction, in particular when they are prisms with a front surface that is also inclined. If they have an inclined front surface, the viewing window and the front surface of the deflective element remain preferably parallel during rotation.
In a preferred further development, each image sensor is assigned its own optical deflective element, wherein the optical deflective element assigned to an image sensor is rotatable relative to the image sensor about a rotational axis that runs in particular through the midpoint of the image sensor. The combinations of the deflective element and image sensor are, in this case, designed in pairs and execute equivalent movements. The respective axial distance between the image sensor and the deflective element and any lenses or optical systems arranged therebetween does not change during rotation.
When the shaft rotates about its longitudinal axis, preferably only the optical deflective elements rotate synchronously about their respective own central axes, whereas the image sensors do not rotate. The optical deflective elements also do not rotate relative to the image sensors about the central longitudinal axis of the shaft. In this case, no more light from the optical deflective elements would reach their assigned image sensors.
Since the axial position of the viewing window changes relative to the two nonrotating or independently rotating image sensors when the shaft rotates and the inclined viewing window associatedly rotates about the central longitudinal axis of the shaft when changing the direction of view, it is preferably provided that each image sensor is movable along the axial direction of the shaft together with the optical deflective element assigned to the image sensor, in particular including the lenses arranged therebetween, wherein in particular the two image sensors are axially movable in an opposite direction to each other. This compensates the axial component of the rotation of the inclined viewing window.
When the inclined viewing window is rotated, the image sensors and optical deflective elements also relatedly shift axially. This is preferably designed so that the axial movement of the image sensors and the optical deflective elements assigned to them are coupled to the rotary movement of the shaft for changing the direction of view such that the distances between the optical deflective elements and the viewing window remain the same.
As a consequence of this axial shift, the absolute distances between centers of the image sensors change during a rotation. To an individually limited extent, this can be compensated by the human perceptual system without losing the three-dimensional perception. In order to compensate for this variation in the distance between the two image sensors, a radial distance between the image sensors can be changed with the optical deflective elements assigned to them in each case in an advantageous further development, wherein in particular a change in the optical distance is coupled to the axial movement of the image sensors such that the distance of the image sensors perpendicular to the direction of view remains constant.
In another advantageous embodiment of the stereo endoscope according to the invention it is provided that an individual optical deflective element is provided that, in particular, is connected to the viewing window, or comprises the viewing window, wherein the distal end of the shaft together with the optical deflective element can be rotated relative to the sensor unit in order to adjust or change the direction of view of the stereo endoscope, wherein the sensor unit and the image sensors retain their orientation and radial and axial position independent of the rotation of the optical deflective element. In this case, instead of two optical deflective elements, there is only one large optical deflective element, i.e., a mirror, prism or a reflecting prism provided that supplies both image sensors with incident light. In this case, it is unnecessary for the image sensors and/or other components to be axially shiftable. However, a certain amount of axial shiftability can be provided in this case as well and, if applicable, radial shiftability of the image sensors relative to each other in order to compensate for differences in the sections of the path of light directed to the image sensors.
The radial and/or axial shiftability of the image sensors and the optical deflective elements as well as the optical systems or lenses which may be arranged therebetween can be realized either mechanically, for example by means of gear mechanisms, or by electronic actuators such as piezoelectric elements, ultrasonic motors or the like, which are controlled by a control apparatus in the stereo endoscope, or in a stereo endoscopy system.
In another advantageous embodiment of the endoscope according to the invention, the shaft is designed as a flexible shaft, and the sensor unit—that in particular looks directly forward—is arranged in the distal tip, wherein the shaft is designed to adjust or change a lateral direction of view deviating from a central 0° direction of view in at least one plane in a controllable and flexible manner. Corresponding endoscopes are known that can assume a 0° direction of view as well as a lateral direction of view by bending the flexible shaft. An example of this is disclosed in EP 1 681 013 A1. With such an endoscope, the distal tip of the endoscope can be variably controlled in different directions of view in one or more swivel planes.
Use is particularly easy when the shaft is designed to be controllable and flexible in precisely one plane, wherein an azimuth angle can be adjusted by rotating the shaft. This yields particularly robust and easily controllable endoscope guidance. Since the orientation of the image sensors relative each other can be uncoupled from the plane in which the shaft is controlled, the horizon position is retained even after the stereo endoscope is rotated about the longitudinal axis of the shaft. When the shaft is flexible, rotation about the longitudinal axis means rotation about the longitudinal axis of, for example, a handle used by the surgeon to operate the endoscope.
In all cases it is preferably provided that the sensor unit is rotatable relative to the shaft as a whole, wherein a rotation of the shaft to adjust or change the direction of view of the stereo endoscope can be compensated by rotating the sensor unit in the shaft in the opposite direction. A “sensor unit” is to be understood as the functional unit of the image sensors and, if applicable, the associated optical systems and optical deflective elements that can also comprise the viewing window when there is a single optical deflective element. This can be a block or assembly, however, in the context of the invention, a sensor unit can also be understood in that individual components of the sensor unit are driven or controlled so that they move synchronized and/or in the same direction. In the context of the invention, the term “sensor unit” is therefore to be understood as a functional unit with or without a structural unit.
In an advantageous further development it is provided that each image sensor is rotatable about a rotational axis that runs through the center of the image sensor and runs parallel to the longitudinal axis of the shaft. This embodiment is described in German patent application No. 10 2010 041 847.1 entitled “Sensor unit for a stereo endoscope and a stereo endoscopy system” by the applicant and has the same priority as the present application, and its disclosed content is fully incorporated by reference in the present application. In addition it is preferably provided that the image sensors can be rotated relative to each other about the longitudinal axis of the shaft.
This further development enables the individual components of the sensor unit to be independently designed. Both the rotation of the image sensors about their respective central rotational axis as well as the rotation of the image sensors relative to each other about the central longitudinal axis of the shaft, as well as any radial and/or axial movements, are controlled independent of each other, yet synchronized with each other. This also makes it possible to keep the orientation of the individual image sensors constant, or respectively adjustable and constant, whereas the position relative to each other about the longitudinal axis of the endoscope shaft is variably adjusted.
In a preferred further development, a manually-operated or electrical drive is provided for rotating the sensor unit, image sensors, optical deflective elements and/or a section of the shaft which comprises the viewing window. A manually-operated drive comprises for example a control ring on the handle that is connected to the components to be rotated and moved by means of cables, rods or gear drives or other known mechanical measures. Piezoelectric motors, ultrasonic motors, miniature electric motors and the like are suitable electric drives.
For this purpose, a control apparatus is preferably provided in the stereo endoscope, or in the stereo endoscopy system beyond the one in the stereo endoscope, that controls the electric drives for rotating or respectively moving the individual components.
An orientation sensor is preferably provided by means of which an orientation of the sensor unit and/or image sensors can be specified within space, wherein in particular the regulation of the orientation and/or the spatial position of the sensor unit and/or image sensors is provided by means of signals from the orientation sensor. The signals from the orientation sensor are preferably used to keep the image sensors in a stable horizon position while regulating the rotation.
The stable horizon position corresponds, for example, to the direction of gravity or a direction that is desired and set by the operating surgeon and that is kept constant by means of the signals of the orientation sensor, even when the direction of view of the stereo endoscope changes. The preferably provided control apparatus can be operated by the operator and/or supplied with orientation data from an orientation sensor. A combination of these two designs enables the operator or surgeon to select a preferred orientation that can be maintained with the assistance of the orientation sensor and the control apparatus during surgery.
The object addressed by the invention is consequently also achieved by a stereo endoscopy system comprising the above-described stereo endoscope according to the invention as well as an image evaluating and reproducing apparatus, in particular a monitor and/or a computer system with a monitor that is/are designed to reproduce a stereoscopic video image. A stereo endoscopy system according to the invention also comprises equipment such as shutter glasses or glasses with polarized lenses, if applicable. Furthermore, the stereo endoscopy system comprises a control apparatus for setting desired recording and reproduction parameters, including in particular the horizon position.
All of the cited features, properties and advantages of the subject matter of the invention, i.e. the stereo endoscope according to the invention and stereo endoscopy system according to the invention, apply without restriction to all other subject matter of the invention.
The invention will be described below without restricting the general inventive idea using exemplary embodiments that refer to the drawings, and regarding any details according to the invention which are not explained further in the text reference is expressly made to the drawings. In the figures:
In the following figures, equivalent or similar elements or respectively corresponding parts are provided with the same reference numbers so that a corresponding re-introduction is omitted.
The representation portrayed in
Electrical cables 6 are also schematically portrayed which supply the image sensor 5 with power and send the obtained image data to an evaluation apparatus (not shown). The shaft 1a has an orientation sensor 9 which monitors the orientation of the shaft in space. The position of the orientation sensor 9 is located in the circumferential direction of the shaft 1a approximately where the inclined viewing window 2 is axially most withdrawn. The specific arrangement of the orientation sensor 9 is freely selectable. A dot-dashed central rotational axis 8 of the shaft 1a is also portrayed. Schematically portrayed at the proximal end are supply and data cables 7.
b) shows the stereo video endoscope 1 in the same state as in
c) and 1d) show a different situation in which the stereo video endoscope 1 looks sideways to the left wherein it is assumed that the image sensor 5 supplies image information for a left eye, whereas the image sensor 5′ supplies image information for a right eye. In comparison to the situation shown in
a) to 1d) each show that the active surface for recording image information only takes up the central part of the viewing window 2. The unused surface is employed to illuminate the operative field by means of lighting elements (not shown). These can be fiberglass bundles that guide light from a lamp (not shown) to the distal tip of the shaft 1a, or for example LED luminaries.
a) shows a situation in which the optical components are viewed from the side. Given that the image sensor 5 supplies image information for the left eye, the direction of view of the stereo video endoscope 11 is directed downward. The same situation is viewed from below in
c) shows an altered situation in which the stereo video endoscope 11 looks sideways to the left.
An endoscope with rod lenses can be designed analogous to
The stereo video endoscope 21 has a handle 25 with a rotary ring 26 for adjusting the horizon position of the image sensors (not shown), and a flexible proximal section 27 which controls the bending of the flexible distal section 22. Rotating the shaft about the longitudinal axis at the site of the handle 25 causes the viewing angle to change and changes the horizon position of the two image sensors which are arranged behind the entry lenses 24, 24′ in
The direction of view is adjusted by rotating the stereo video endoscope 21 about its central rotational axis or respectively longitudinal axis 8′ both when the shaft is flexibly controllable in different directions, and when pivoting only occurs in a single plane. In the latter case,
b) shows that the sensor unit with the portrayed entry lenses 24, 24′ is rotated back in the opposite direction, and the horizon position is assumed, wherein the swivel plane with the swivel direction 28 remains unchanged in comparison to
All of the cited features including those only found in the drawings, as well as individual features that are disclosed in combination with other features, are considered essential to the invention by themselves and in combination. Embodiments according to the invention can be realized by the individual features, or a combination of several features.
1 Stereo video endoscope
1
a Shaft
2 Viewing window
3, 3′ Prism
4, 4′ Lens assembly
5, 5′ Image sensor
6, 6′ Electrical cable
7 Supply and data cable
8, 8′ Central rotary axis
9 Orientation sensor
11 Stereo video endoscope
11
a Shaft
12 Viewing window
13 Prism
21 Stereo video endoscope
22 Flexible distal shaft section
23 Distal section with optical sensor unit
24, 24′ Entry lenses
25 Handle
26 Rotary ring
27 Proximal flexible section
28 Swivel direction
29 Front surface of the shaft
Number | Date | Country | Kind |
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10 2010 041 857.9 | Oct 2010 | DE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP11/04573 | 9/12/2011 | WO | 00 | 3/10/2013 |