JP2009018027A - Device for operating endoscopic surgical instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To simplify a structure of a device for operating endoscopic surgical instruments. <P>SOLUTION: The device for operating endoscopic surgical instruments is configured by combining various machine elements in a manner that movements of an operating part 4 held by a surgeon on a horizontal surface are transmitted to a proximal end part 7, which is found outside a body cavity, of a surgical instrument 5 inserted into the body cavity through a hole on a body surface 50 as the movements in the reverse direction and that the movements of the operating part in the vertical direction are transmitted to the proximal end part as the movements in the same direction. A part which transmits the movements of the operating part on the horizontal surface to the proximal end part as the movements in the opposite direction is configured as a symmetric motion mechanism, and a part which transmits the movements of the operating part in the vertical direction to the proximal end part as the movements in the same direction is configured as a separate linear motion mechanism which is separated from the symmetric motion mechanism. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an apparatus for remotely operating a surgical instrument such as an endoscope, forceps, and manipulator used when performing an operation under an endoscope such as a laparoscope or a thoracoscope.

  Conventionally, a gallbladder extraction operation or the like is performed by an endoscopic surgical operation (see, for example, Patent Document 1). As shown in FIG. 10, this endoscopic operation is performed by making a hole in the body surface 50 of the patient, attaching a trocar 50a to the hole, and inserting the surgical instrument 51 into the body cavity through the trocar 50a. . The surgeon projects an image from an endoscope (not shown) inserted into the body cavity on the monitor in the same manner as the surgical instrument 51, and operates the surgical instrument 51 while viewing the monitor image.

  However, in such an endoscopic operation, the movement of the proximal end portion 54 of the shaft 52 of the surgical instrument 51 that has gone out of the body cavity from the trocar 50a and the movement of the distal end portion 53 that has entered the body cavity are included. When attention is paid, the motion component in the shaft axial direction (z direction) has substantially the same direction, but the motion component in the direction perpendicular to the shaft 52 has the distal end portion 53 in contrast to the motion of the proximal end portion 54 in the x and y directions. The movements in the −x and −y directions are opposite to each other. This is because the movement of the manual operation unit outside the body cavity is opposite to the movement of the surgical tool 51 in the vicinity of the affected part, and the operability of the surgical tool 51 is poor for the surgeon and skill is required. There were problems such as becoming.

  Conventionally, a surgical robot system has been proposed in order to solve such a reverse motion problem (see, for example, Patent Documents 2 and 3). As shown in FIG. 11, this surgical robot system includes a master robot 61 and a slave robot 60 that exchange information 63 and 64, and the surgeon connects the distal end portion of the surgical instrument 51 to the master robot 61. When a desired motion command is given as the motion 53, a robot control unit (not shown) calculates the reverse motion of the proximal end portion 54 of the surgical instrument 51 and gives the motion command to the slave robot 60. Reference numeral 62 indicates an operator's hand.

  That is, since the slave robot 60 gives a motion having a reverse motion component to the proximal end portion 54 that has come out of the body cavity of the surgical instrument, the distal end portion 53 in the body cavity automatically performs the same motion as the motion commanded by the operator. Therefore, the operability of the surgical tool 51 is improved for the surgeon.

  However, in this surgical robot system, the master robot 61 and the slave robot 60 occupy a large volume, and both the robots 61 and 60 have a complicated motion mechanism having 6 degrees of freedom or more. Since sensors, actuators, software, and the like for control must be provided, the entire system requires a large installation space and is extremely complicated and expensive. In addition, there are significant incidental burdens such as ensuring safety and disinfecting methods.

  The present inventor has devised an operating device for a surgical instrument using only mechanical elements as means for solving this problem (see Non-Patent Document 1).

  As shown in FIG. 12, this operating device uses a hard transmission mechanism made up of mechanical elements such as gears and links in place of the master robot 61 and slave robot 60, and swivels on the operating table 1 etc. on a horizontal plane. The base 6 is connected to the base 6, and a pair of meshing gears 35, 35 are vertically held on the base 6, and the other pair of meshing gears 36, 36 are coaxially connected to the pair of gears 35, 35. The parallel gear mechanism composed of four links 20, 21, 20a, 20b is connected to one overlapping gear 35, 36, and the other four links 22, 23, 36 are connected to the other overlapping gear 35, 36. It is configured by connecting a parallel motion mechanism composed of 22a and 22b. From each parallel motion mechanism, one link 20, 22 extends long in the opposite direction, and a steering unit 2 that is gripped by an operator is provided at the tip of one link 20, and a surgical tool is provided at the tip of the other link 22. The base end portions 3 of the ten shafts 11 are connected.

  According to this operating device, when the surgeon moves the control unit 2 in the x, y, and z directions, the base end 3 moves in the -x, -y, and z directions, and the shaft 11 of the surgical instrument 10 moves to the body. As a result of operating the trocar 50a attached to the hole in the surface 50 as a fulcrum, the distal end portion 12 of the shaft 11 moves in the same x, y, and z directions as the operator operates.

  Further, the present inventor has devised the operating device shown in FIG. 13 as a modification of the operating device shown in FIG.

  This operating device has five links 32, 33a, 33b, 34, 37 configured to be able to translate in the Z direction within a vertical plane, and these links 32, 33a, 33b, 34, 37 are connected to each other. Are connected to each other by a horizontal pivot 38. Of these five links 32, 33 a, 33 b, 34, 37, both ends of the upper link 32 project in opposite directions beyond the pivot 38, and the proximal end portion 3 of the surgical instrument 10 is at one projecting end. The control stick 39 is connected to the other protruding end. The control stick 39 hangs down in parallel with the shaft 11 of the surgical instrument 10, and the control section 2 that the operator holds is provided at the lower end of the control stick 39.

  The lower left and right links 33a and 33b are connected by a joint 44 that allows rotation and slippage. The left and right links 33a and 33b are connected to a base 41 via a horizontal pivot 40. The base 41 is supported by a bearing 42 that extends horizontally and parallel to the upper and lower links 32, 33a, and 33b, so that the base 41 can be rotated in a plane perpendicular to the upper and lower links 32, 33a, and 33b. . A trocar-shaped tubular member 43 through which the control stick 39 passes is attached to an extension portion of the axis of the base 41 extending to the control stick 39. The cylindrical member 43 is provided symmetrically with the trocar 50a attached to the patient.

  Accordingly, when the operator moves the control unit 2 of the control stick 39 in the x and y directions, the proximal end portion 3 of the surgical instrument 5 moves in the −x and −y directions, and as a result, the distal end portion of the surgical instrument 10. 12 moves in the x and y directions that are the same as the operator's steering direction. Further, when the operator moves the control part 2 of the control stick 39 in the z and −z directions, the left and right link parts 33a and 33b rotate around the pivot 40 by the action of the joint 44. The base end portion 3 also moves in the z and −z directions. Accordingly, the distal end portion 12 of the surgical instrument 10 also moves in the z and −z directions in the same manner as the control portion 2.

JP 2006-150105 A (FIG. 8) JP 2002-159509 A JP 2007-29232 A Shigeyuki Shimachi et al., “A Proposal of Reverse Motion Problem for Surgical Operation in Laparoscopic Surgery”, Proceedings of the 41st General Meeting and Lecture Meeting of the Japan Society of Mechanical Engineers Tohoku Branch, March 14, 2006, A-41

  The surgical instrument operating device shown in FIG. 12 published by the present inventor uses a line symmetric mechanism, and the gears 35 and 36 mainly function to obtain line symmetric motion. Therefore, it is necessary to reduce the backlash of the gears 35 and 36 in order to accurately transmit the operation of the operator to the surgical instrument. However, if the backlash is reduced, the entire mechanism becomes larger and heavier. In addition, since this line symmetric mechanism moves the surgical instrument 10 in the vertical direction via the gear mechanism, there is a problem that a large space is required in the extending direction of the shaft 11 of the surgical instrument 10, that is, in the z direction. is there.

  The surgical instrument operating device shown in FIG. 13 is obtained by omitting the gear of the surgical instrument operating device shown in FIG. 12, but still requires a large space in the extending direction of the surgical instrument shaft, that is, in the z direction. And

  An object of the present invention is to provide means capable of solving such various problems.

  In order to solve the above problems, the present invention employs the following configuration.

  That is, in the invention according to claim 1, the surface substantially perpendicular to the shaft (8) of the surgical instrument (5) inserted into the body cavity through the hole of the body surface (50) is a horizontal plane, and the operator has a control unit ( The movement of 4) on the horizontal plane is transmitted to the proximal end (7) outside the body cavity of the shaft (8) as a reverse movement, and the movement of the control section (4) in the direction perpendicular to the horizontal plane On the horizontal plane of the control section (4) in the operating device for an endoscopic surgical tool configured by combining various mechanical elements so as to transmit the movement to the base end section (7) in the same direction. The part that transmits the movement at the base end part (7) as the reverse direction movement is configured as a symmetrical movement mechanism, and the vertical movement of the control part (4) is the same as the base end part (7). The part that transmits the movement in the direction is a separate An operating device endoscopic surgical tool, characterized in that it is configured as a line motion mechanism.

  As described in claim 2, in the operating device for an endoscopic surgical tool according to claim 1, the movement of the control unit (4) on the horizontal plane is reversed to the base end (7). The portion to be transmitted as can be developed and arranged on a horizontal plane as a symmetric motion mechanism.

  As described in claim 3, in the operation device for an endoscopic surgical tool according to claim 1 or 2, the symmetric motion mechanism can be a link mechanism.

  As described in claim 4, in the operation device for an endoscopic surgical tool according to claim 3, the link mechanism is a pantograph, and the movement of the control unit (4) is expanded or extended to the base end (7). It can be reduced and transmitted.

  As described in claim 5, in the operating device for an endoscopic surgical tool according to claim 1 or 2, the symmetric motion mechanism is a winding transmission mechanism, and the one pulley (57) is operated. The part (4) may be connected, and the base end (7) may be connected to the other pulley (59).

  As described in claim 6, in the operating device for an endoscopic surgical tool according to claim 3 or 4, the two links (16, 17) passing through the symmetry axis or the symmetry center of the link mechanism. ) Is divided into the control part (4) side and the base end part (7) side with respect to the symmetry axis or the symmetry center, and the inner and outer double support shafts are provided at the symmetry axis or the symmetry center. The other link (16) is connected to the upper and lower sides of one support shaft (24a) in a stepped manner, and the other divided link (17) is connected to the upper and lower portions of the other support shaft (24b) in a stepped manner. The support shaft (24b) is connected to the horizontal arm (27) of the linear motion mechanism via the bearing (26), so that the control portion (4) and the base end portion (7) are symmetrical or symmetric. It is possible that the center of can be crossed to the opposite side.

  As described in claim 7, in the operation device for an endoscopic surgical tool according to claim 5, the pulleys (57, 59) are connected to both ends through the symmetry axis or the symmetry center of the winding transmission mechanism. The supported link (66a, 66b) is divided into a control part (4) side and a base end part (7) side with respect to the axis of symmetry or the center of symmetry. Support shafts (24a, 24b) are provided, and the divided links (66a, 66b) are connected to the top and bottom of one support shaft (24b) in a stepped manner, and the ends of the other support shaft (24a) are connected to the both ends. The intermediate pulleys (86, 85) connected to the pulleys (57, 59) are fixed, and the outer support shaft (24b) is connected to the horizontal arm (27) of the linear motion mechanism via the bearing (26). By doing so, the control part (4) and the base end part (7) are The center of the universal shaft or symmetric can be made that can exceed the other side.

  As described in claim 8, in the operating device for an endoscopic surgical tool according to any one of claims 1 to 7, the torsional motion in the control section (4) is moved to the base end section (7). And a torsional transmission mechanism that transmits the torsional motion to the surgical tool and is attached to the symmetric motion mechanism.

  As described in claim 9, in the operating device for an endoscopic surgical tool according to any one of claims 1 to 8, the surgical tool can be a multi-degree of freedom manipulator.

  According to the present invention, in an endoscopic surgical operation, the movement of the distal end portion of the surgical instrument in the body cavity that is displayed on the monitor screen by the camera attached to the endoscope is controlled by the operator's control unit (4). Therefore, the surgeon can perform the operation with the same feeling as performing an operation while looking at his / her hand. Various mechanical elements that transmit the movement of the control unit (4) on the vertical plane to the base end (7) as movement in the same direction are symmetrical movement mechanisms as linear movement mechanisms that move the symmetrical movement mechanism in the vertical direction. Therefore, the structure of the apparatus is simplified.

  In addition, since the surgical instrument is moved via a symmetric motion mechanism or a linear motion mechanism, force is easily transmitted between the surgical tool and the control unit (4), so that the distal end of the surgical tool in the body cavity contacts the affected part. There is an effect that the sense of doing it is transmitted to the surgeon and it becomes easier to perform the operation.

  In addition, when various mechanical elements that transmit the movement of the control unit (4) on the horizontal plane to the base end (7) as reverse movements are deployed and arranged on the horizontal plane as a symmetric motion mechanism, The size of the device in the direction perpendicular to the horizontal plane can be reduced.

BEST MODE FOR CARRYING OUT THE INVENTION

  Hereinafter, embodiments for carrying out the invention will be described with reference to the drawings.

<Embodiment 1>
As shown in FIG. 1, this endoscopic surgical instrument operating device has a horizontal plane that is substantially perpendicular to the shaft 8 of the surgical instrument 5 inserted into the body cavity through the hole in the body surface 50, and the operator has a hand 62. The movement on the horizontal plane of the control unit 4 operated in step (1) is transmitted as a reverse movement to the base end 7 outside the body cavity of the shaft 8, and the movement of the control unit 4 in the direction perpendicular to the horizontal plane is based on the movement. It is constituted by combining various machine elements so as to transmit the end portion 7 as movement in the same direction.

  In addition, since the average direction of the shaft 8 of the surgical instrument 5 in the motion posture of the surgical instrument is not necessarily the vertical direction, here, a plane generally perpendicular to the average surgical instrument shaft direction is referred to as a horizontal plane, The direction perpendicular to the horizontal plane is called the vertical direction, and this apparatus will be described.

  The control unit 4 is provided with a lever 4 a and the like that the operator holds with the hand 62. When the operator applies force to the control unit 4 with the hand 62, the control unit 4 moves freely in the x, y, and z directions.

  In this case, the surgical instrument 5 is a manipulator having several degrees of freedom of movement, and the distal end portion 9 of the shaft 8 is a forceps piece having a pair of jaws, and is located at a position outside the body cavity of the shaft 8. The proximal end portion 7 of the surgical instrument 5 is provided with a drive unit that applies various motions to the distal end portion 9 of the surgical instrument 5.

  A cylindrical trocar 50a is attached to the hole in the body surface 50, and the distal end portion 9 of the shaft 8 is inserted into the body cavity from the trocar 50a. The base end portion 7 of the shaft 8 is outside the body cavity and is connected to the side opposite to the control portion 4 of the operating device via a universal joint 13.

  Various mechanical elements that transmit the movement of the control unit 4 on the horizontal plane to the base end portion 7 as reverse movement on the horizontal plane are deployed and arranged on the horizontal plane as a point-symmetric movement mechanism. Specifically, the various mechanical elements are various links, and the point-symmetric motion mechanism is configured as a link mechanism using these links.

  In this link mechanism, six links 14, 15, 16, 17, 18, and 19 are arranged on substantially the same horizontal plane so that two parallelograms are connected in a point-symmetric manner, and are symmetrical. The intersections of the two links 16 and 17 which are the centers of the two are supported by a vertical support shaft 24 orthogonal to the horizontal plane, and the adjacent links 14, 15, 16, 17, 18 and 19 are pin-shaped pivots 25. It is comprised by connecting with. Further, the two links 14 and 18 having a point-symmetrical positional relationship project in opposite directions beyond the pivot axis 25, and the control unit 4 is provided at the projecting end of one link 18, and the other link 14 projects. The surgical tool 5 is connected to the end. As a result, when the operator moves the control unit 4 in the x and y directions in the horizontal plane, the link mechanism operates in a point-symmetric manner, and the proximal end portion 7 of the surgical instrument 5 moves in the -x and -y directions. As a result, the distal end portion 9 of the surgical instrument 5 moves in the x and y directions, which are the same as the operator's steering direction.

  The link mechanism as the point-symmetric movement mechanism is divided into two parts, the control unit 4 side and the base end 7 side, with the center of symmetry as a boundary, and is connected stepwise above and below the support shaft 24 that is the center of symmetry. The That is, the two links 16 and 17 passing through the symmetry center of the link mechanism are divided into the control portion side and the base end portion with respect to the symmetry center, and the inner and outer double support shafts 24a and 24b are located at the symmetry center. Is provided. The divided links 16a and 16b are connected to the upper and lower sides of one support shaft 24a in a stepped manner, and the other divided links 17a and 17b are connected to the upper and lower portions of the other support shaft 24b in a stepped manner. Accordingly, the two links 16a, 16b, 17a, and 17b passing through the center of symmetry are connected by the support shafts 24a and 24b, respectively, and are integrated in the same manner as before the division, and the operator places the control unit 4 in the horizontal plane. When moving in the x and y directions, the proximal end portion 7 of the surgical instrument 5 moves in the opposite directions -x and -y.

  In a normal case, the length of the link is determined so that both the control portion 4 and the base end portion 7 can pass through the axis of the support shaft 24.

  Various mechanical elements that transmit the movement of the steering unit 4 on the vertical plane to the base end part 7 in the same direction are configured as a linear motion mechanism that moves the point-symmetric motion mechanism in the vertical direction. That is, the outer support shaft 24 b is connected to the horizontal arm 27 of the linear motion mechanism via the bearing 26. Of course, the movement of the inner and outer support shafts 24a and 24b in the vertical direction with respect to the bearing 26 is stopped by known means.

  The linear motion mechanism does not necessarily have to be an exact linear motion, and is configured, for example, by arranging a parallel motion mechanism formed by combining various links that perform approximate linear motion on a vertical plane. This parallel motion mechanism has a swing link 28 that can reciprocate in the vertical direction, and the horizontal arm 27 is fixed to the swing link 28. Further, a tension spring 31 for balancing the own weight is spanned between the swing link 28 and a fixed link 29 serving as a base of the parallel motion mechanism via horizontal cylindrical shafts 30, 30. 31, the tip of the horizontal arm 27 is always held at a constant height. The fixed link 29 is fixed to an operating table, for example. Accordingly, when the surgeon moves the control unit 4 in the z and −z directions against the tensile force of the tension spring 31, the surgical instrument 5 similarly moves in the z and −z directions.

  According to this linear motion mechanism, an approximate linear motion is made beyond the horizontal arm 27, but a true linear motion can also be achieved by employing another linear motion mechanism.

  In this way, the link mechanism as a point-symmetrical movement mechanism is divided into the control part 4 side and the base end part 7 side with respect to the center of symmetry and arranged in a stepwise manner, and the intermediate support shaft 24 is placed in the horizontal arm. 27, the control unit 4 and the base end 7 can cross the symmetrical center, that is, the support shaft 24 to the opposite side, so that the surgical instrument 5 can be moved over a wide range, and the operation of the operation can be performed. The area will increase.

  Next, the operation of the endoscopic surgical instrument operating device having the above-described configuration will be described.

  The fixed link 29 in the linear motion mechanism of this operating device is connected to the operating table.

  A hole is made in the patient's body surface 50 on the operating table, and the trocar 50a is attached thereto. The shaft 8 of the surgical instrument 5 is passed through the trocar 50a, and the distal end portion 9 is inserted into the body cavity. And the base end part 7 of the surgical instrument 5 is connected to the end of the link 14 of the point-symmetrical movement mechanism via the universal joint 13.

  Although not shown, the endoscope is similarly inserted into the body cavity of the patient, and an image from the endoscope is displayed on the monitor.

  When the surgeon holds the lever 4a of the control unit 4 with the hand 62 and moves the control unit 4 in the x and y directions during the operation, the base end portion 7 of the surgical instrument 5 is -x,-via the point-symmetric motion mechanism. Moving in the y direction, the shaft 8 of the surgical instrument 5 performs a turning motion with the trocar 50a as a fulcrum. As a result, the distal end portion 9 of the surgical instrument 5 moves in the same direction as the operation direction of the operator, ie, the x and y directions, and performs the same movement as the movement of the operator's hand 62.

  When the operator holds the lever 4a of the control unit 4 and moves the control unit 4 in the z and −z directions, the entire point-symmetric motion mechanism moves in the z and −z directions via the linear motion mechanism. The distal end portion 9 of the surgical instrument 5 also moves in the same direction as the operation direction of the operator, ie, the z and −z directions, and performs the same movement as the movement of the operator's hand 62.

  Thereby, the movement of the distal end portion 9 in the body cavity of the surgical instrument 5 viewed by the surgeon through the monitor becomes the same as the movement of the hand 62 of the surgeon, the operability of the surgical instrument 5 by the surgeon is improved, and the surgery is performed. Proceed smoothly.

  Note that the bending operation, opening and closing operation, etc., of the forceps piece that is the distal end portion 9 of the surgical instrument 5 are generated by an electric signal or the like generated by an operator operating a switch or the like (not shown) attached to the control portion 4. It is done by being transmitted to.

<Embodiment 2>
As shown in FIG. 2, in the second embodiment, as in the first embodiment, the portion that transmits the movement of the control unit 4 on the horizontal plane to the base end portion 7 as the reverse movement is a vertical support. Unlike the first embodiment, this point symmetric motion mechanism is provided with six links 46, 47, 48, 49, 55. However, unlike the first embodiment, the point symmetric motion mechanism is centered on the axis 67. , 56 is configured as a pantograph. And the crossing part in the two links 47 and 49 of a center part is supported by the vertical spindle 67 as a symmetrical center.

  Accordingly, when the control unit 4 is set on the long link 46 side and the base end 7 is set on the short link 56 side, the movement of the control unit 4 is reduced and transmitted to the base end 7. On the contrary, when the control unit 4 is set on the short link 56 side and the base end portion 7 is set on the long link 46 side, the movement of the control unit 4 is transmitted to the base end portion 7 in an enlarged manner.

  In a normal case, the length of the link is determined so that both the control portion 4 and the base end portion 7 can pass through the axis of the support shaft 67.

  When the operator moves the control unit 4 in the z and −z directions by connecting the arm 27 of the linear motion mechanism to the vertical support shaft 67 in the same manner as in the first embodiment, the surgical tool 5 is also the same. It moves in the z and -z directions.

  In the second embodiment, the same parts as those in the first embodiment are denoted by the same reference numerals, and redundant description is omitted.

<Embodiment 3>
As shown in FIG. 3, in this third embodiment, unlike the first and second embodiments, the symmetrical movement mechanism is configured as a winding transmission mechanism, and a lever 58 having the control unit 4 is connected to one pulley 57. The lever 65 having the base end portion 7 is connected to the other pulley 59 in a point-symmetric manner with the control portion 4. Both pulleys 57 and 59 are pivotally supported at both ends of the horizontal link 66 so as to be horizontally rotatable, and the horizontal link 66 is pivotally supported by a vertical spindle 68 at the center thereof. An endless winding member 69 such as a wire or a belt is stretched between the pulleys 57 and 59 in parallel.

  As a result, when the operator moves the control unit 4 in the x and y directions with the hand 62 during the operation, the proximal end portion 7 of the surgical instrument 5 moves in the -x and -y directions via the point-symmetric motion mechanism, The shaft 8 of the surgical instrument 5 performs a turning motion with the trocar 50a as a fulcrum. As a result, the distal end portion 9 of the surgical instrument 5 moves in the same direction as the operation direction of the operator, ie, the x and y directions, and performs the same movement as the movement of the operator's hand 62.

  In a normal case, the length of the link is determined so that both the control portion 4 and the base end portion 7 can pass through the axis of the support shaft 68.

  When the operator moves the control unit 4 in the z and −z directions by connecting the arm 27 of the linear motion mechanism to the vertical support shaft 68 in the same manner as in the first embodiment, the surgical instrument 5 is also the same. It moves in the z and -z directions.

  In the third embodiment, the same parts as those in the first and second embodiments are denoted by the same reference numerals, and a duplicate description is omitted.

<Embodiment 4>
As shown in FIG. 4, in the fourth embodiment, as in the first embodiment, the point-symmetrical transmission in which the movement of the control unit 4 on the horizontal plane is transmitted to the base end portion 7 as the reverse movement on the horizontal plane. Although the movement mechanism is deployed and arranged on the horizontal plane as a link mechanism, unlike the first embodiment, this link mechanism has a horizontal plane such that the four links 70, 71, 72, 73 form one parallelogram. It is configured by being placed on top.

  Specifically, adjacent links 70, 71, 72, 73 are connected to each other via a pivot 25, and the center of one link 71 is supported by a vertical support shaft 75 orthogonal to the horizontal plane. It is constituted by being done. Each link 70, 73 on both sides of the link 71 protrudes in the opposite direction beyond the pivot axis 25, and the control unit 4 is placed at the protruding end of one link 70 having a point-symmetrical positional relationship with the support shaft 75 as the center of symmetry. Is provided, and the proximal end portion 7 of the surgical instrument 5 is connected to the protruding end of the other link 73. As a result, when the operator moves the control unit 4 in the x and y directions in the horizontal plane, the link mechanism operates in a point-symmetric manner, and the proximal end portion 7 of the surgical instrument 5 moves in the -x and -y directions. As a result, the distal end portion 9 of the surgical instrument 5 moves in the x and y directions, which are the same as the operator's steering direction.

  In a normal case, the length of the link is determined so that both the control portion 4 and the base end portion 7 can pass through the axis of the support shaft 75.

  Further, by connecting the arm 27 of the linear motion mechanism in the first embodiment to the vertical support shaft 75, when the operator moves the control unit 4 in the z and −z directions, the distal end portion 9 of the surgical instrument 5. Will also move in the z and -z directions.

  In addition, in Embodiment 4, the same part as Embodiments 1-3 is shown with the same code | symbol, and the overlapping description is abbreviate | omitted.

<Embodiment 5>
As shown in FIG. 5, in the fifth embodiment, the endless winding member 69 in the third embodiment is point-symmetric with respect to the center of symmetry of the axis 68 of the support shaft 68 in which the pair of moving elements 74 and 76 is vertical. Are linked together. The moving elements 74 and 76 are in contact with a link 66 holding the pulleys 57 and 59 via a rolling element 77 such as a roller. Of course, the sliders 74 and 76 may be sliders that are in sliding contact with the link 66. The pair of movers 74 and 76 are provided with the control portion 4 and the base end portion 7 via levers 58 and 65, respectively.

  As a result, when the surgeon holds the control unit 4 with the hand 62 and moves it in the x and y directions during the operation, the proximal end portion 7 of the surgical instrument 5 moves in the -x and -y directions via the point symmetrical motion mechanism. Then, the shaft 8 of the surgical instrument 5 performs a turning motion with the trocar 50a as a fulcrum. As a result, the distal end portion 9 of the surgical instrument 5 moves in the same direction as the operation direction of the operator, ie, the x and y directions, and performs the same movement as the movement of the operator's hand 62.

  Further, by connecting the arm 27 of the linear motion mechanism in the first embodiment to the vertical support shaft 68, when the operator moves the control unit 4 in the z and −z directions, the surgical tool 5 is similarly z. , -Z direction.

  In the fifth embodiment, the same parts as those of the other embodiments are denoted by the same reference numerals, and redundant description is omitted.

<Embodiment 6>
As shown in FIG. 6, in the sixth embodiment, the torsional motion in the control unit 4 is transmitted to the base end 7 to the link mechanism which is the point-symmetrical motion mechanism in the fourth embodiment, and the surgical tool 5 is twisted. A torsional transmission mechanism that moves is attached.

  This torsion transmission mechanism has a link 70 having a control unit 4, an intermediate link 71, and a link 73 having a base end portion 7, and each of the control unit 4 and the three links 70, 71, 73 in the above three links. Pulleys 78, 79, 80, 81 are respectively attached to the pivot 25 of the connecting portion and the base end portion 7, and endless winding members 82, 83 such as wires are provided between the adjacent pulleys 78, 79, 80, 81. , 84 are sequentially passed.

  As a result, when the operator moves the control unit 4 in the x and y directions with the hand 62 during the operation, the proximal end portion 7 of the surgical instrument 5 moves in the -x and -y directions via the point-symmetric motion mechanism, The shaft 8 of the surgical instrument 5 performs a turning motion with the trocar 50a as a fulcrum. As a result, the distal end portion 9 of the surgical instrument 5 moves in the same direction as the operation direction of the operator, ie, the x and y directions, and performs the same movement as the movement of the operator's hand 62. When the surgeon turns the pulley 78 of the control unit 4, this torsional motion is transmitted to the pulley 81 of the base end 7 via the endless winding members 82, 83, 84 and other pulleys 79, 80. . As a result, the surgical instrument 5 performs a twisting motion, and the distal end portion 9 rotates around the axis of the shaft 8 by an angle intended by the operator.

  In a normal case, the length of the link is determined so that both the control portion 4 and the base end portion 7 can pass through the axis of the support shaft 75.

  Further, by connecting the arm 27 of the linear motion mechanism in the first embodiment to the vertical support shaft 75, when the operator moves the control unit 4 in the z and −z directions, the surgical tool 5 is similarly z. , -Z direction.

  In addition, in Embodiment 6, the same part as Embodiment 1-5 is attached | subjected and shown, and the overlapping description is abbreviate | omitted.

<Embodiment 7>
As shown in FIGS. 7 and 8, in the seventh embodiment, the point-symmetrical movement mechanism is configured as a winding transmission mechanism as in the third embodiment, but unlike the third embodiment, the winding transmission mechanism. The horizontal links 66a and 66b with the pulleys 57 and 59 pivotally supported at both ends through the center of symmetry are divided into the base end 7 side and the control unit 4 side with respect to the center of symmetry. A double support shaft 24 is provided, and the divided horizontal links 66b and 66a are connected to the top and bottom of the outer support shaft 24b in a stepped manner, and the pulleys 59 and 57 at both ends are connected to the top and bottom of the inner support shaft 24a. The intermediate pulleys 86 and 85 to be tied are fixed.

  A lever 58 having a base end 7 is integrally connected to one pulley 57 via a pivot 87, and a lever 65 to which the control unit 4 is connected is connected to the other pulley 59 via a pivot 88. Connected together. Between the pulleys 57 and 59 and the intermediate pulleys 85 and 86, endless winding members 69a and 69b such as wires and belts are respectively hung in parallel.

  The outer support shaft 24b is connected to a horizontal arm 27 of a linear motion mechanism through a bearing 26. This linear motion mechanism is a true linear motion mechanism, and has a moving element 45 that is movable in the axial direction of the shaft 8 of the surgical instrument 5, that is, a vertical direction, and an arm 27 is connected to the moving element 45. The moving element 45 has its own weight balanced by an urging force of a spring or the like (not shown) and is always held at a constant height.

  Accordingly, when the operator holds the lever 4a of the control unit 4 with the hand 62 and moves the control unit 4 in the x and y directions during the operation, the proximal end portion 7 of the surgical instrument 5 is − It moves in the x and -y directions, and the shaft 8 of the surgical instrument 5 performs a turning motion with the trocar 50a as a fulcrum. Then, the distal end portion 9 of the surgical instrument 5 moves in the same direction as the x and y directions that are the operation directions of the operator, and performs the same movement as the movement of the hand 62 of the operator. Further, when the operator moves the control unit 4 in the z and −z directions, the surgical tool 5 similarly moves in the z and −z directions.

  In a normal case, the length of the link is determined so that both the control portion 4 and the base end portion 7 can pass through the axis of the support shaft 24.

  As is apparent from FIG. 8, this symmetric motion mechanism has a vertical difference between the control unit 4 side and the base end 7 side with respect to the horizontal arm 27 of the linear motion mechanism. The symmetrical center whose end 7 is the support shaft 24 can be crossed to the opposite side.

  As shown in FIGS. 7 and 8, in the seventh embodiment, as in the sixth embodiment, the torsional motion in the control unit 4 is transmitted to the base end portion 7 to cause the surgical instrument 5 to perform the torsional motion. A transmission mechanism is attached to the symmetrical movement mechanism.

  This torsion transmission mechanism includes a pulley 81 pivotally supported at the distal end of a lever 65 having a control portion 4, a pulley 78 attached to a pivot 94 that connects the base end portion 7 to the lever 58, and the above-mentioned stepwise horizontal link 66a. , 66b, the pulleys 79, 80 held on the pivots 87, 88 of the pulleys 57, 59 supported by bearings, and the center of the inner support shaft 24a rotatably passing through the shaft center of the inner support shaft 24a. Transmission pulleys 90 and 91 are respectively fixed to the lower end and the lower end of the support shaft 24c. Then, endless winding members 82, 92, 93, 84 such as wires are wound around the pulleys 78, 79, 90, 91, 80, 81 in order.

  Accordingly, when the surgeon holds the other lever 4b in the control unit 4 with the hand 62 and applies a twisting motion around the z-axis to the pulley 81, this twisting motion is caused by the endless winding members 84, 93, 92, 82 and It is transmitted to the pulley 78 of the base end portion 7 through various pulleys 81, 80, 91, 90 and 79. As a result, the surgical instrument 5 performs a twisting motion, and the distal end portion 9 rotates around the axis of the shaft 8 by an angle intended by the operator.

  9 shows a modified example of the transmission mechanism shown in FIG. 8. In this modified example, the horizontal links 66a and 66b are connected to the inner support shaft 24a, and the control unit 4 and the base end 7 are moved in a point-symmetric manner. Pulleys 57 and 59 for transmission are fixed to the outer support shaft 24b.

  In addition, in Embodiment 7, the same parts as those in the other embodiments are denoted by the same reference numerals, and redundant description is omitted.

  Although the present invention is configured as described above, the present invention is not limited to the above-described embodiment, and various modifications can be made within the scope of the gist of the present invention. For example, the surgical tool may be a forceps, an endoscope, an electric knife, or the like in addition to a multi-degree-of-freedom manipulator.

It is a perspective view which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 1 of this invention. It is a skeleton figure which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 2 of this invention. It is a skeleton figure which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 3 of this invention. It is a skeleton figure which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 4 of this invention. It is a skeleton figure which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 5 of this invention. It is a top view which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 6 of this invention. It is a perspective view which shows the outline of the operating device of the endoscopic surgical tool which concerns on Embodiment 7 of this invention. FIG. 8 is a vertical sectional view taken along a link of the operating device for the endoscopic surgical tool shown in FIG. 7. FIG. 9 is a vertical sectional view of a modification of the operating device for the endoscopic surgical tool shown in FIG. 8. It is explanatory drawing which shows the conventional endoscopic surgery. It is explanatory drawing which shows the conventional robot system for surgery. It is explanatory drawing which shows an example of the conventional endoscopic operation tool operating device. It is explanatory drawing which shows the other example of the conventional endoscopic operation tool operating device.

Explanation of symbols

4: Steering part 5: Surgical tool 7: Base end part 8: Shaft 16, 17, 66a, 66b: Link 24a, 24b: Support shaft 26: Bearing 27: Horizontal arm 50: Body surface 57, 59: Pulley 86, 85 : Intermediate pulley

Claims (9)

  The surface substantially perpendicular to the shaft of the surgical instrument inserted into the body cavity through the hole in the body surface is the horizontal plane, and the movement of the operator's control unit on the horizontal plane is transferred to the base end of the shaft outside the body cavity. An endoscope configured by combining various mechanical elements so as to transmit the movement in the reverse direction as a movement in the direction perpendicular to the horizontal plane of the control unit to the base end as the movement in the same direction. In the operating device for the lower surgical tool, a portion that transmits the movement of the control unit on the horizontal plane to the base end as a reverse movement is configured as a symmetric motion mechanism, and the vertical movement of the control unit is controlled. An operating device for an endoscopic surgical tool, wherein a portion that transmits the movement in the same direction to the base end portion is configured as a separate linear motion mechanism separated from the symmetrical motion mechanism.   The operation device for an endoscopic surgical tool according to claim 1, wherein a portion that transmits the movement of the control unit on the horizontal plane to the base end as a reverse movement is deployed and arranged on the horizontal plane as a symmetric motion mechanism. An operating device for an endoscopic surgical tool characterized by that.   The operating device for an endoscopic surgical tool according to claim 1 or 2, wherein the symmetric motion mechanism is a link mechanism.   The operation device for an endoscopic surgical tool according to claim 3, wherein the link mechanism is a pantograph, and the movement of the control unit is transmitted to the base end portion in an enlarged or reduced manner. Operation device for surgical tools under the mirror.   The operation device for an endoscopic surgical tool according to claim 1 or 2, wherein the symmetric motion mechanism is a winding transmission mechanism, a steering part is connected to one pulley, and a base end part is connected to the other pulley. An operation device for an endoscopic surgical tool characterized by being connected.   The operation device for an endoscopic surgical instrument according to claim 3 or 4, wherein the two links passing through the symmetry axis or the symmetry center of the link mechanism are connected to the control unit side with respect to the symmetry axis or the symmetry center. It is divided into the base end side, and the inner and outer double support shafts are provided at the symmetry axis or the center of symmetry, and one of the divided links is connected in steps above and below one support shaft, and the other is separated Are connected to the other support shaft in a stepwise manner, and the outer support shaft is connected to the horizontal arm of the linear motion mechanism via a bearing, so that the control portion and the base end portion are connected to the symmetrical axis. Alternatively, an operating device for an endoscopic surgical tool characterized in that the center of symmetry can be crossed to the opposite side.   6. The operating device for an endoscopic surgical instrument according to claim 5, wherein the link having the pulley supported at both ends through the symmetry axis or the symmetry center of the winding transmission mechanism is operated with the symmetry axis or the symmetry center as a boundary. It is divided into a part side and a base end part side, and inner and outer double support shafts are provided at the symmetry axis or the center of symmetry, and the divided links are connected in steps above and below one support shaft, Intermediate pulleys connected to the pulleys at both ends are fixed to the upper and lower sides of the support shaft, respectively, and the outer support shaft is connected to the horizontal arm of the linear motion mechanism via a bearing, so that the control unit and the base end are connected. An operating device for an endoscopic surgical tool, characterized in that a part can cross the symmetry axis or the center of symmetry on the opposite side.   The operation device for an endoscopic surgical tool according to any one of claims 1 to 7, wherein a torsional transmission mechanism for transmitting a torsional motion in a control part to a base end part to cause the surgical tool to twist is symmetrical. An operation device for an endoscopic surgical tool, which is attached to an exercise mechanism.   The operation device for an endoscopic surgical tool according to any one of claims 1 to 8, wherein the surgical tool is a multi-degree-of-freedom manipulator.

Images