JP2008017903A - Endoscope holding device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope holding device detecting the load applied to the part of an endoscope inserted into a body cavity and the contact with an organ at an end of the endoscope. <P>SOLUTION: The endoscope holding device 10 is composed of an arm to bring the distal end of the endoscope 11 to the upper part of the affected region of a patient; a first holding part disposed at the front end of the arm to be moved to the right or left in a circular arc on the flat plane around the body cavity insertion part of the endoscope 11; a second holding part disposed in the first holding part to be moved in the vertical direction in a circular arc on the vertical plane around the body cavity insertion part of the endoscope 11; and a third holding part 28 disposed in the second holding part to be moved diagonally forward/backward with the body cavity insertion part of the endoscope as a passing point. A knuckle part 55 which rotates around a horizontal axis is supported in the third holding part 28, and a holder part 58 which rotates around a vertical axis is supported in the knuckle part 55 via a ball plunger 57. The endoscope 11 is held in the holder part 58 via a tactile sensor 61. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an endoscope holding apparatus capable of detecting a load applied to a body cavity and an organ of a patient in an operation using the endoscope.

  When there is a disease in various internal organs of a patient, an operation is performed by incising the abdominal cavity or chest cavity (hereinafter referred to as a body cavity) according to the site of the affected part. When performing such an operation, an endoscopic operation is performed in order to reduce the burden on the patient. In this endoscopic operation, for example, an endoscope incorporating a small CCD camera at the tip is inserted into a body cavity of a patient who is supine on an operating table, and images of internal organs obtained by the endoscope are displayed. On the display, the surgeon performs the operation while directly viewing the image on the display. That is, when performing an endoscopic operation, perform the minimum incision necessary for inserting the endoscope into the affected area, and insert the endoscope through a cannula (sleeve-shaped intubation) inserted into the opening, In addition, by injecting a necessary amount of carbon dioxide gas to expand the body cavity, the field of view and freedom of movement of the endoscope are ensured.

  Endoscopic surgery requires only a small incision (about 5 places) necessary to insert surgical tools such as an endoscope, forceps, and scalpel into the patient's body cavity, and low pain at the wound. (Non-invasive) and superiority in terms of speed of return from hospitalization to daily life, etc., are expected to become the mainstream of future surgical treatment. On the other hand, since the operation requires precise operation of an elongated endoscope and forceps, the operation time tends to be longer than that of a large laparotomy. As described above, in an endoscopic operation, the operation time is generally long. However, as described above, the assistant must hold the endoscope by hand throughout the operation time.

  In addition, the endoscope holder immediately moves the endoscope in front and rear, left and right, and up and down directions of the affected area (or a combined direction thereof) in response to an instruction from the surgeon as the operation progresses. There is a need. At this time, the endoscope is also moved manually. Therefore, an attempt has been made to replace the work of holding the endoscope by the hand with a mechanical holding, and an automatic endoscope system has been proposed (for example, see Patent Document 1). That is, an endoscope and a surgical instrument are held by a robot arm having a plurality of joints. Each joint is provided with a rotary actuator, and by driving each actuator, the arm can be moved to a position desired by the operator.

However, since the automatic endoscope system described in Patent Document 1 is a horizontal articulated manipulator, when the manipulator is operated to change the position of the endoscope, the image on the display is shaken, There is a problem in that the configuration is complicated because the actuators provided at each joint perform horizontal articulated motion. In order to solve such a problem, the present applicant has already proposed an endoscope holding apparatus (see, for example, Patent Document 2). That is, the endoscope holding apparatus can move in the vertical direction around the first insertion part that can move in the left-right direction around the part where the endoscope is inserted into the body cavity and the part that is inserted into the body cavity. The second holding unit and a third holding unit that can move in an oblique front-rear direction with a portion inserted into the body cavity as a passing point are provided, and the endoscope is held by the third holding unit. The endoscope is configured to be movable in the left-right direction, the up-down direction, and the oblique front-rear direction.
Japanese Patent No. 3298013 (page 3, page 4, FIG. 1, FIG. 2 and FIG. 14) JP 2004-129956 A (2nd and 3rd pages)

  However, the endoscope holding device described in Patent Document 2 is configured so as to be freely movable in a three-dimensional direction. When the deviation occurs, the result is that the direction of the endoscope deviates from the target position. In that case, an unexpected load is applied to the site where the endoscope is inserted into the body cavity. When the load is small, the operation using the endoscope is not hindered, but depending on the degree of the load, the operation using the endoscope may be hindered. For this reason, it is required to detect the degree of load in order to cope with such a load.

  Accordingly, an object of the present invention is to provide an endoscope holding device that can detect a load applied to a site where an endoscope is inserted into a body cavity and contact of an endoscope end with an organ. is there.

  In order to achieve the above object, an endoscope holding apparatus according to claim 1 is an endoscope holding apparatus for holding an endoscope inserted into a body cavity of a patient in an endoscopic operation. An arm that can be adjusted in the vicinity of the operating table and that can face the distal end of the endoscope near the upper part of the affected area of the patient, and is disposed at the front end of the arm. A first holding part that is movable in the left-right direction while drawing a circular arc on a plane centering on a part inserted into the body cavity, and disposed in the first holding part, with the body cavity insertion part of the endoscope as the center A second holding part that can move in an up-down direction while drawing an arc on a vertical plane, and is arranged in the second holding part, and is movable in an oblique front-rear direction with the body cavity insertion site of the endoscope as a passing point A third holding portion, and the endoscope includes a tactile sensor containing a coiled carbon fiber with respect to the third holding portion. It is characterized in that it has configured to be movably held along the oblique longitudinal axis through the sub.

  An endoscope holding apparatus according to a second aspect of the present invention is the endoscope holding apparatus according to the first aspect, wherein the third holding portion supports a knuckle portion that rotates about a horizontal axis, and the knuckle portion includes A holder portion that rotates about a vertical axis is supported, and an endoscope is held on the holder portion via a tactile sensor.

  An endoscope holding apparatus according to a third aspect of the present invention is the endoscope holding apparatus according to the first or second aspect, wherein the tactile sensor is formed by dispersing coiled carbon fibers in resin or rubber. It is characterized in that the force received from the direction can also be detected.

  An endoscope holding apparatus according to a fourth aspect of the present invention is the endoscope holding apparatus according to the second or third aspect, wherein the holder portion is supported by a knuckle portion via a ball plunger. To do.

According to the present invention, the following effects can be exhibited.
In the endoscope holding apparatus according to the first aspect of the present invention, the endoscope is held movably along the axis in the oblique front-rear direction via a tactile sensor containing a coiled carbon fiber with respect to the third holding portion. Yes. For this reason, when a deviation occurs in any of the left-right direction, the up-down direction, and the oblique front-rear direction in the setting of the endoscope, or when the end of the endoscope comes into contact with the organ, When the endoscope is moved, a load is applied to the part or organ into which the endoscope is inserted into the body cavity, and at the same time, stress is also applied to the tactile sensor of the third holding unit, and the stress includes a coiled carbon fiber. It is detected by the sensor. Therefore, it is possible to detect the load applied to the site where the endoscope is inserted into the body cavity and the contact of the end of the endoscope with the organ.

  In the endoscope holding apparatus according to the second aspect of the present invention, the third holding portion supports a knuckle portion that rotates about the horizontal axis, and the knuckle portion includes a holder portion that rotates about the vertical axis. The endoscope is supported by the holder portion via a tactile sensor. Therefore, the endoscope can rotate around the horizontal axis and the vertical axis. Therefore, in addition to the effect of the invention according to claim 1, it is possible to reduce the load applied to the site where the endoscope is inserted into the body cavity.

  In the endoscope holding device according to the third aspect of the present invention, the tactile sensor is formed by dispersing the coiled carbon fiber in resin or rubber, and is configured to be able to detect the force received from any direction. In addition to the effects of the invention according to claim 1 or 2, it is possible to cope with loads applied in all directions.

  In the endoscope holding device according to the fourth aspect of the present invention, since the holder portion is supported by the knuckle portion via the ball plunger, the holder portion is subjected to a load greater than the load that can be supported by the ball plunger. When added, the holder comes off the knuckle. Therefore, in addition to the effect of the invention according to claim 2 or claim 3, the support of the holder portion that supports the endoscope from the knuckle portion can be released.

DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, embodiments that are considered to be the best of the present invention will be described in detail with reference to the drawings.
(Overall configuration of endoscope holding device)
As shown in FIG. 10, in the operation using the endoscope 11, the endoscope 11 incorporating a small CCD camera is inserted into the body cavity of the patient 13 who is supine on the operating table 12, and the endoscope 11 is displayed on the display 14 while the surgeon 15 located on the side of the operating table 12 visually recognizes the image on the display 14. In this operation, the assistant 16 is advanced while assisting the operator 15. When performing an operation with the endoscope 11, a minimum incision necessary for inserting the endoscope 11 into the affected part is performed, the endoscope 11 is inserted through the cannula 17 inserted into the opening, and carbon dioxide gas is supplied. By injecting the required amount to expand the body cavity, the visual field and freedom of movement of the endoscope 11 are ensured. In addition, forceps 18 and the like are inserted into a cannula 17 inserted into another opening in the vicinity of the affected part.

  In such an operation, the endoscope 11 is held by the endoscope holding device 10 of the present embodiment until the operation is completed, and the instruction of the surgeon 15 accompanying the progress of the operation is held by the endoscope holding device 10. In response, the endoscope 11 is appropriately moved in the front / rear, left / right, up / down directions of the affected area, or the direction of synthesis thereof.

  As shown in FIGS. 6, 7, and 9, the endoscope holding device 10 is attached to an arm 19 installed beside the operating table 12. That is, the arm 19 includes an upright support 20 that is erected at a required position close to the operating table 12, a first arm 21 that is pivotally supported on the upper part of the upright support 20 and can be turned horizontally at a required central angle, The second arm 22 is pivotally supported by the first arm 21 and can turn horizontally at a required central angle. As shown in FIGS. 7 and 8, the upright support column 20 has a pinion gear 24 meshed with a rack 23 provided on the side thereof, and a motor 25 is connected to the pinion gear 24. The rotational drive is converted into the vertical motion of the upright support column 20. Thereby, the endoscope holding device 10 attached to the second arm 22 can set a required height with the affected part of the patient 13. The upright support 20 pivots the first arm 21 and the first arm 21 pivots the second arm 22 so that the rotation angle can be adjusted by each joint mechanism. Positive driving is not given. That is, the arm 19 is not in the form of a horizontal joint system manipulator.

As shown in FIGS. 6 and 7, the endoscope holding device 10 includes a first holding part 26, a second holding part 27, and a third holding part 28. The first holding unit 26 moves in the left-right direction to draw a circular arc on a horizontal plane around the part where the endoscope 11 is inserted into the body cavity, that is, the body cavity insertion part P. The second holding unit 27 moves in the vertical direction while drawing an arc on a vertical plane around the body cavity insertion site P of the endoscope 11. The third holding unit 28 moves in an oblique front-rear direction with the body cavity insertion site P of the endoscope 11 as a passing point. And the endoscope 11 is hold | maintained at the 3rd holding | maintenance part 28 along the axis line of the diagonal front-back direction.
(Configuration of the first holding unit 26)
As shown in FIGS. 4 and 5, the first holding portion 26 includes a first arc plate 30 pivoted substantially horizontally via a pivot pin 29 near the tip of the second arm 22, and the first arc plate 30. The first slider 32 is guided by a first rail 31 on the arc plate 30 and moves in an arc-like left-right direction under control. Here, the first arc plate 30 is a plate body that draws an arc on a plane centering on the body cavity insertion site P, and the radius thereof is an appropriate dimension according to the length of the endoscope 11 that is actually used. Set to The arc length of the first arc plate 30 depends on the amount of movement required for the first slider 32 that is mounted on the arc plate and moves left and right, and in this embodiment, the arc angle is approximately 100 °. It is set as follows.

The first arc plate 30 is provided with an arc-shaped first rail 31 projecting on the inner peripheral portion and an arc-shaped rack 33 formed of an arc-shaped gear train on the outer peripheral portion. The first slider 32 includes a saddle portion 34 that can move while being guided by the first rail 31 across the first rail 31. In other words, the first slider 32 is supported on the first arc plate 30 via the saddle portion 34, and moves in an arc-shaped left and right direction along the first rail 31. The first slider 32 includes a horizontally extending bracket 35, and the first motor 36 is disposed upside down at a required portion of the bracket 35. A first pinion gear 37 is provided on the rotating shaft of the first motor 36, and the first pinion gear 37 is engaged with the arc-shaped rack 33. Accordingly, when the first motor 36 is rotated forward and backward in response to a command from a control device (not shown), the first pinion gear 37 is also rotated forward and backward, via the arc-shaped rack 33 and the first rail 31 of the first arc plate 30. The first slider 32 is configured to give a left-right arc movement on a plane centering on the body cavity insertion site P (two-dot chain line in FIG. 6).
(Configuration of the second holding unit 27)
As shown in FIGS. 4 and 5, the second holding portion 27 includes a second arc plate 38 disposed upright on the upper surface of the first slider 32 in the first holding portion 26, and the second arc plate. 38, and a second slider 39 that moves up and down in a circular arc under remote control while being guided on the top. Here, the second arc plate 38 is a plate body that draws an arc on a vertical plane centering on the body cavity insertion site P of the endoscope 11, and the radius thereof is an appropriate dimension according to the length of the endoscope 11. Set to The arc length of the second arc plate 38 depends on the amount of movement required for the second slider 39 mounted on the arc plate and moves up and down, and in this embodiment, the arc length is approximately 100 °. Is set to

The second arc plate 38 has a second rail 40 projecting on the inner arc-shaped side surface thereof and an arc-shaped rack 41 formed of an arc-shaped gear train on the outer arc-shaped side surface. The second slider 39 includes a saddle portion 43 that is guided by the second rail 40 across the second rail 40. That is, the second slider 39 is mounted on the second arc plate 38 via the saddle portion 43 and moves up and down in an arc shape along the second rail 40. The second slider 39 includes a bowl-shaped bracket 44, and a second motor 45 is horizontally disposed at a required position of the bracket 44. A second pinion gear 46 is provided on the rotation shaft of the second motor 45, and the second pinion gear 46 meshes with the arcuate rack 41. Therefore, if the second motor 45 is rotated forward and backward in response to a command from the control device, the second pinion gear 46 also rotates forward and backward, and the body cavity insertion site P is centered on the second slider 39 via the arc-shaped rack 41. It is comprised so that the up-and-down circular arc movement on a vertical surface may be provided (two-dot chain line of FIG. 7).
(Configuration of the third holding unit 38)
As shown in FIG. 4, a pair of holding pins 48 protrude from the second slider 39. A linear slider 50 having a guide hole 49 through which the holding pin 48 is inserted is held by the pair of holding pins 48 so as to be movable back and forth.

  As shown in FIGS. 1 to 3, a linear rack 51 is provided on the bottom surface of the linear slider 50, and a pinion gear 53 that is rotated by a third motor 52 (see FIG. 6) is engaged and supported by a pair of holding pins 48. In such a state, it is configured to be movable diagonally in the front-rear direction. A support shaft 54 as a horizontal shaft is supported at the front end portion of the linear slider 50, and an inverted U-shaped knuckle portion 55 configured to be rotatable about the support shaft 54 is supported. A pair of upper and lower female screw holes 56 are formed at the opening end of the knuckle portion 55, and a ball plunger 57 constituting a pair of vertical shafts is screwed therein.

  As shown in FIG. 2, a circular hole 59 is formed in the center of the holder portion 58 for holding the endoscope 11, and a pipe support 60 having a T-shaped cross section is formed in the circular hole 59. It is mounted in a state where a cylindrical tactile sensor 61 is interposed. A through hole 62 is formed at the center of the pipe support 60, and the cylindrical endoscope 11 is inserted into the through hole 62. As shown in FIG. 3, a conical support hole 63 is formed in the center of the upper and lower surfaces of the holder portion 58, and the ball 64 of the ball plunger 57 screwed into the female screw hole 56 of the knuckle portion 55 is formed. It has come to be supported. The ball plunger 57 allows the holder portion 58 to rotate about the vertical axis with respect to the knuckle portion 55. Accordingly, the holder portion 58 and the endoscope 11 can be rotated about the horizontal axis and the vertical axis, and can follow the stress when the endoscope 11 receives stress in a direction other than the oblique front-rear direction. .

  The tactile sensor 61 is constituted by a sensor element containing a coiled carbon fiber, preferably formed by dispersing the coiled carbon fiber in a resin or rubber as a matrix, and can detect stress received from any direction. It is configured. The sensor element is configured by laminating a plurality of layers such as a single layer, two layers, or three layers. In the case of a laminated structure, each layer is configured so that the type of matrix, hardness, etc., or the type, content, etc. of coiled carbon fiber are different. It becomes possible to detect pressure (stress).

  The tactile sensor 61 includes the sensor element, an oscillation circuit that oscillates a reference signal, a phase shift unit as a detection unit and a signal adjustment unit, and a detection unit as a detection unit. The oscillation circuit is connected to the sensor element through a sensor driver circuit, and the sensor element is connected to the detection unit through a phase shift unit.

  A small change in stress applied to the sensor element changes the inductance (L), capacitance (C, capacitance), and electrical resistance (R, resistance) of the sensor element, and the sensor output signal changes due to the change. . The change in the sensor output signal is detected by quadrature detection in the detection unit. For this reason, the change tendency and change amount of an inductance, an electrostatic capacitance, and an electrical resistance are calculated | required. Therefore, the tactile sensor 61 can detect a minute change in stress applied to the sensor element.

  The matrix is a dielectric, has a capacitance (C), and acts as a capacitor. As the resin as the matrix, silicone resin, urethane resin, epoxy resin, copolymer resin of styrene and thermoplastic elastomer, or the like is used. As the rubber, silicone rubber, urethane rubber or the like is used. The hardness of the matrix is important for improving the sensitivity of the tactile sensor 61. When a silicone resin or silicone rubber having excellent elasticity is used as the matrix, the contact pressure can be expanded and contracted even with a minute contact pressure. Can be detected with high sensitivity. On the other hand, when a hard silicone resin, urethane resin, copolymer resin of styrene and thermoplastic elastomer, etc. are used, it will not expand or contract unless it is a large contact pressure, and the sensitivity of the tactile sensor element is low, but it has a wide contact pressure range. Can be detected.

  Specifically, the hardness of the matrix is preferably JIS A hardness (JIS K6301), preferably 10 to 100, and more preferably 15 to 50. When the JIS A hardness is less than 10, the matrix becomes too soft, and noise detection becomes large, which is not preferable. On the other hand, when the JIS A hardness exceeds 100, the matrix becomes too hard, the propagation property of the contact pressure is poor, and the detection sensitivity is lowered.

  As the coiled carbon fiber, a single wound coiled carbon fiber, a double wound coiled carbon fiber, a superelastic coil, a mixture thereof, or the like is used. The coiled carbon fiber has stretchability (elasticity), and the expansion and contraction changes the electrical characteristics such as inductance (L), capacitance (C), and electrical resistance (R). Tactile pressure can be detected. For example, when the coiled carbon fiber is stretched, the L, C, and R increase, and when contracted, the L, C, and R decrease. Specifically, when the coiled carbon fiber is stretched by 4 mm, L increases by 0.1 mH, C increases by 600 pF, and R increases by 4.5 kΩ. When the coiled carbon fiber is contracted and returned to its original length, L, C, and R return to their original values with good reproducibility. When the coiled carbon fiber is dispersed in the matrix, when contact pressure is applied from the outside, the matrix first expands and contracts, and then the coiled carbon fiber expands and contracts, so the contact pressure applied to the coiled carbon fiber through the matrix The values of L, C, and R change based on.

  The single-winding coiled carbon fiber is configured such that the diameter of one coil is 0.01 to 50 μm, the pitch of the coil is 0.01 to 10 μm, and the length of the coil is 0.1 to 10 mm. . From the viewpoint of ease of manufacture and the like, the diameter of the coil is preferably 0.1 to 10 μm, and the pitch is preferably 0.1 to 10 μm. The coiled carbon fiber is formed such that a coil having a certain thickness extends in a spiral manner with a single winding at a certain pitch (interval). For this reason, the single-wound coiled carbon fiber is excellent in elasticity and easily deforms with respect to the contact pressure from any direction, so that the contact pressure from any direction can be detected with high sensitivity.

  On the other hand, in the case of a double-wound coiled carbon fiber, the two coils extend in a spiral shape in close contact with each other, and thus have a substantially cylindrical shape as a whole, and a cavity is formed at the center. The double-wound coiled carbon fiber is configured to have a diameter of 0.01 to 50 μm, a pitch of almost 0, and a length of 0.1 to 10 mm. Double-wound coiled carbon fibers have poor elasticity and are not easily displaced when subjected to contact pressure.

  A superelastic coil is a coil having a large coil diameter and a small wire diameter, and having a higher elasticity. Specifically, the superelastic coil is configured such that the coil diameter is 5 to 50 μm, the coil pitch is 0.1 to 10 μm, and the coil length is 0.3 to 5 mm. The winding direction of the coiled carbon fiber may be either clockwise (right-handed) or counterclockwise (left-handed) around the coil axis.

  The content of the coiled carbon fiber is preferably 0.1 to 50% by mass in the matrix, and more preferably 1 to 10% by mass. When the content is less than 0.1% by mass, the ratio of the coiled carbon fiber in the matrix is small, and the sensitivity of the tactile sensor 61 based on the coiled carbon fiber is lowered. On the other hand, when the content exceeds 50% by mass, the ratio of the coiled carbon fiber in the matrix becomes too high and becomes hard, the sensitivity of the tactile sensor 61 decreases, and the moldability and the like tend to deteriorate. Show.

As a method for dispersing the coiled carbon fiber in the matrix, the following method is adopted.
1) A method in which coiled carbon fibers are added to a matrix, stirred and dispersed uniformly, defoamed, poured into a mold, and then press-molded. This method is employed when a silicone resin is used as the matrix.

  2) A method in which a plasticizer is added to matrix pellets, heated and melted, coiled carbon fiber is added thereto, and the mixture is stirred and dispersed uniformly, then poured into a mold, pressurized, cooled and solidified. . This method is employed when a copolymer resin of styrene and a thermoplastic elastomer is used as a matrix.

  3) A method in which a matrix is heated and melted, coiled carbon fibers are added thereto, and the mixture is stirred and dispersed uniformly, then poured into a mold, pressurized, cooled and solidified. This method is employed when a gel resin is used as a matrix.

  In the tactile sensor 61 formed by blending a coiled carbon fiber with the matrix, when receiving stress from the outside, the matrix expands and contracts, the capacitance (C) changes, and the coiled carbon fiber expands and contracts. Inductance (L), capacitance (C), and electrical resistance (R) change. And both resonate resonatingly, the electrical characteristic of the whole tactile sensor 61 changes remarkably, and the stress from the outside can be detected.

  In this case, the matrix of the tactile sensor 61 acts as a capacitance (C) component, and the coiled carbon fiber acts as an LCR resonance circuit, so that mechanical mechanical variation is converted into electrical variation. For this reason, the voltage of the LCR resonance circuit fluctuates, and the fluctuation is measured by the LCR measurement device. At this time, the coiled carbon fiber functions in a complex resonance manner through the matrix. Therefore, the tactile sensor 61 can sufficiently detect a minute change in stress and can detect a wide range of tactile pressures.

A first motor 36 that gives the first holding part 26 freedom in moving in the left-right direction, a second motor 45 that gives the second holding part 27 freedom in moving up and down by drawing an arc on a vertical plane, and a second motor 45 The third motor 52 that gives the 3 holding portion 28 the freedom to move obliquely in the front-rear direction is connected to a power source and a control device (not shown). The endoscope 11 is connected to the display 14 via a cable, and images of internal organs obtained by the endoscope 11 are displayed on a monitor screen. Then, in the endoscopic operation, an instruction from the operator 15 is given to the first motor 36, the second motor 45, and the third motor 52 through the control device by hand operation, foot operation, or other voice operation. It has become.
(Operation of the embodiment)
Next, an operation when the endoscope holding apparatus according to this embodiment is used will be described.

  Now, when performing an operation using the endoscope 11, an incision necessary for inserting the endoscope 11 and the forceps 18 into the abdomen of the patient 13 on the operating table 12, for example, is performed. The endoscope 11 is inserted through one cannula 17. The operator 15 gives instructions to the assistant 16 while visually confirming the image in the abdominal cavity displayed on the display 14 via the endoscope 11, so that the first motor 36, The two motors 45 and the third motor 52 are driven singly or synchronously, and desired operations are given to the first holding unit 26, the second holding unit 27, and the third holding unit 28.

  That is, when the first motor 36 is operated, the first holding part 26 moves in the left-right direction while drawing a circular arc on a plane around the body cavity insertion site P. When the second motor 45 is actuated, the second holding unit 27 moves in the vertical direction while drawing an arc on a vertical plane with the body cavity insertion site P as the center. Further, when the third motor 52 is actuated, the third holding portion 28 moves forward or backward in the diagonally forward and backward directions with the body cavity insertion site P as a passing point.

  Accordingly, the combined movement of the first holding unit 26, the second holding unit 27, and the third holding unit 28 is directly given to the endoscope 11 as a combined movement in the left-right, up-down, and diagonally front-back directions. In this case, the endoscope 11 is held by the holder part 58 in the third holding part 28 via the tactile sensor 61 containing a coiled carbon fiber. For this reason, when a deviation occurs in any of the left-right direction, the up-down direction, and the oblique front-rear direction in the operation setting of the endoscope 11, a load is applied to the body cavity insertion site P when the endoscope 11 moves obliquely forward. At the same time, stress is applied to the tactile sensor 61 through the endoscope 11.

The stress applied to the tactile sensor 61 is propagated to the matrix of the tactile sensor 61 and the matrix expands and contracts to change the capacitance (C), and the coiled carbon fiber in the matrix expands and contracts to generate inductance (L), The capacitance (C) and electric resistance (R) change. As a result, the matrix and the coiled carbon fiber act in a resonant manner, and the electrical characteristics of the entire tactile sensor 61 are significantly changed to detect the stress. Then, the signal detected by the touch sensor 61 is transmitted to the control device, the third motor 52 is stopped, and the movement of the endoscope 11 is stopped. When the stress is excessive, the holder portion 58 supported by the ball plunger 57 with respect to the knuckle portion 55 is detached from the knuckle portion 55 together with the endoscope 11 and falls.
(Summary of effects of embodiment)
The effects exhibited by the above embodiment will be described collectively below.

  In the endoscope holding device 10 of the embodiment, the endoscope 11 is held so as to be movable along the oblique front-rear direction axis via the tactile sensor 61 containing a coiled carbon fiber with respect to the third holding portion 28. ing. Therefore, the load applied by the endoscope 11 to the body cavity insertion site P and the load when the end of the endoscope 11 contacts the organ can be detected by the tactile sensor 61. Therefore, based on the signal detected by the touch sensor 61, the third motor 52 can be stopped by the control device. As a result, even if an unreasonable force is generated between the endoscope 11 and the affected part due to an unexpected cause during the operation, or even when the end of the endoscope 11 contacts the organ, the affected part is not damaged. .

  The knuckle portion 55 that rotates about the horizontal axis is supported by the third holding portion 28, and the holder portion 58 that rotates about the vertical axis is supported by the knuckle portion 55, and the holder portion 58 The endoscope 11 is held by a tactile sensor 61. Therefore, the endoscope 11 can be rotated around the horizontal axis and the vertical axis. Therefore, the load applied to the body cavity insertion site P by the endoscope 11 can be reduced.

  The tactile sensor 61 is formed by dispersing a coiled carbon fiber in resin or rubber, and is configured to be able to detect a force received from any direction, and therefore can handle loads from all directions.

  Since the holder portion 58 is supported by the knuckle portion 55 via the ball plunger 57, the holder portion 58 is knuckle portion when a load greater than the load that can be supported by the ball plunger 57 is applied to the holder portion 58. It comes out of 55. Therefore, the support of the holder portion 58 that supports the endoscope 11 can be released from the knuckle portion 55, and the endoscope 11 can be dropped together with the holder portion 58.

In addition, the said embodiment can also be changed and implemented as follows.
The tactile sensor 61 can be provided on the support portion of the holder portion 58 by the ball plunger 57 and the support portion of the knuckle portion 55 by the support shaft 54.

In addition, the tactile sensor 61 can be provided between the endoscope 11 and the pipe support 60.
Furthermore, the tactile sensor 61 can be provided at a plurality of locations to increase the stress detection sensitivity.

The pinion gear 24 of the upright support column 20 may be engaged with a worm and a worm gear so that the upright support column 20 does not descend from a set height.
The arm 19 may be provided with an angle adjusting mechanism that tilts the arm 19 obliquely up and down.

  A metal thin film such as gold or copper may be formed on the surface of the coiled carbon fiber in order to enhance conductivity, and the sensitivity and stability of the tactile sensor 61 can be improved. In addition to coiled carbon fibers, vapor grown fibers (VGCF), carbon nanofibers, carbon powders, metal powders, dielectric powders, piezoelectric powders and the like can also be blended in the matrix.

  The endoscope 11 held by the third holding unit 28 can also be configured to be able to rotate with the rotation angle adjustable in the circumferential direction around the axis line in the oblique front-rear direction by the meshing relationship of the gears. .

Further, the technical idea that can be grasped from the embodiment will be described below.
(1) The third holding portion is configured by a linear slider which is disposed in the second holding portion and can move forward and backward in the obliquely downward direction. The endoscope holding device according to any one of the above. When comprised in this way, in addition to the effect of the invention which concerns on any one of Claims 1-4, the structure of a 3rd holding | maintenance part can be simplified.

  (2) The linear slider includes a linear rack on one side surface in the longitudinal direction, and a third pinion gear driven by a motor disposed in the second holding portion is engaged with the linear rack, so that the linear slider is inclined. The endoscope holding apparatus according to the technical idea (1), wherein the endoscope holding apparatus is configured to move in the front-rear direction. In such a configuration, in addition to the effect of the invention according to the technical idea (1), the linear slider can be moved in a stable state.

The disassembled perspective view which shows the 3rd holding | maintenance part of the endoscope holding apparatus in embodiment. The front view which partially fractures | ruptures and shows the part holding the endoscope in an endoscope holding | maintenance apparatus. The fragmentary sectional side view which shows the part holding the endoscope in an endoscope holding | maintenance apparatus. The partial top view which shows a part fracture | rupture and shows the part holding the endoscope in an endoscope holding | maintenance apparatus. The partial front view which shows a part fracture | rupture and shows the part holding the endoscope in an endoscope holding | maintenance apparatus. The top view which shows the whole endoscope holding | maintenance apparatus. The front view which shows the whole endoscope holding | maintenance apparatus. The partial top view which shows the part of the upright support | pillar of an endoscope holding | maintenance apparatus. The perspective view which shows the whole endoscope holding | maintenance apparatus. The top view which shows the state which performs surgery using the endoscope hold | maintained at the endoscope holding | maintenance apparatus.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope holding device, 11 ... Endoscope, 12 ... Operating table, 13 ... Patient, 19 ... Arm, 26 ... 1st holding part, 27 ... 2nd holding part, 28 ... 3rd holding part, 54 ... A support shaft as a horizontal axis, 55 ... a knuckle part, 57 ... a ball plunger as a vertical axis, 58 ... a holder part, 61 ... a tactile sensor.

Claims (4)

An endoscope holding device for holding an endoscope inserted into a body cavity of a patient in an endoscopic operation,
An arm which is arranged close to the operating table and can be adjusted in position, and can be placed at the front end of the arm near the upper part of the affected area of the patient, and the endoscope is inserted into the body cavity. A first holding part that is movable in the left-right direction while drawing a circular arc on a plane centering on the part to be positioned, and a vertical plane centering on the body cavity insertion part of the endoscope A second holding part that can move in the vertical direction, and a third holding part that is arranged in the second holding part and that can move in an obliquely front-rear direction with the body cavity insertion site of the endoscope as a passing point The endoscope is configured to be held movably along the axis in the oblique front-rear direction via a tactile sensor containing a coiled carbon fiber with respect to the third holding part. Endoscope holding device. The third holding portion supports a knuckle portion that rotates about a horizontal axis, and the knuckle portion supports a holder portion that rotates about a vertical axis, and the holder portion includes a tactile sensor. The endoscope holding apparatus according to claim 1, wherein the endoscope is held. 3. The tactile sensor according to claim 1, wherein the tactile sensor is formed by dispersing a coiled carbon fiber in a resin or rubber, and is configured to detect a force received from any direction. Endoscope holding device. The endoscope holding apparatus according to claim 2 or 3, wherein the holder part is supported by a knuckle part via a ball plunger.

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