JP2010178988A - Medical apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical apparatus used over a long period of time by preventing deterioration of insert performance of an insert part and a curving performance of a curving part due to increase in the length of the insert part caused by pulling an angle wire to repeatedly curve the curving part. <P>SOLUTION: In this medical apparatus, a manipulator 40 includes: the insert part 45 configured by an active curving part 43 including a plurality of joints 47a, 47b, and an insert part forming tube 46 having flexibility; the angle wire 49 penetrating through the interior of the insert part 45; a driving connecting part 44 provided at the proximal end of the insert part 45 and removably attached to a driving unit 60 having a motor 70; and a coil pipe 48 disposed in the insert part 45, with one end thereof fixed in the driving connecting part 44 and with the other end thereof fixed in the curving part 43. The insert part forming tube 46 constituting the insert part 45 includes: an adjusting mechanism part constructed by a tube receiving member 50 with an adjust hole 51, which is movably held on the driving connecting part 44, and a holding screw 52. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical instrument that causes a bending operation of a bending portion included in an insertion portion by pulling an angle wire inserted into the insertion portion.

  In recent years, for example, a master-slave type medical manipulator device has been used for the purpose of improving the operability of a treatment tool used in endoscopic surgery. A master-slave type medical manipulator device has also been devised for a treatment instrument that is used by being inserted into a treatment instrument channel of an endoscope.

  In a medical manipulator device, the position and posture of a treatment section provided at the tip of a manipulator having a plurality of joints are changed by operating a master-slave device that is a trajectory input means. Examples of the treatment unit include a hand arm, forceps, and an electric knife.

  As shown in FIG. 1, an articulated manipulator (hereinafter abbreviated as a manipulator) 1 inserted through a treatment instrument channel of an endoscope includes a treatment section 2, a bending section 3, a drive connection section 4 and the like in order from the distal end side. ing. In the manipulator 1, the insertion portion 5 extends from the shaft center 5 a of the shaft connecting the treatment portion 2 and the joint piece 3 a constituting the bending portion 3 to the distal end surface 5 b of the drive connection portion 4. It comprises a bending portion 3 and an insertion portion forming tube 6. The insertion portion forming tube 6 has a predetermined flexibility so that it can smoothly pass through the treatment instrument channel. In addition, the treatment part 2 of this figure is a hand arm for holding | grip.

  The bending portion 3 is constituted by, for example, joint pieces 3a, 3b, 3c, and 3d provided on the distal end side of the insertion portion forming tube 6. The joint pieces 3a, 3b, 3c, and 3d are rotatably connected to each other to form a pitch drive joint 7a and a yaw drive joint 7b.

  The drive connection portion 4 includes an internal space, and a plurality of angle wires 9 are disposed in the space. The angle wire 9 passes through the plurality of coil pipes 8 and extends into the space. The tip of each coil pipe 8 is firmly fixed to a predetermined position on the inner peripheral surface of the joint piece 3d shown in FIG. 2 with solder or the like (only one coil pipe is shown in the figure). On the other hand, the base end portion of each coil pipe 8 is fixed to a coil pipe receiver 12 provided in the drive connection portion 4 by solder or the like as shown in FIGS. Each coil pipe receiver 12 is fixed to the coil pipe support member 11. As shown in FIG. 2, each coil pipe 8 is inserted into the insertion portion forming tube 6 in a relaxed state in consideration of the insertion property of the insertion portion 5 into the treatment instrument channel.

  The distal end portion of the insertion portion forming tube 6 is integrally fixed to the tube receiver 3d1 formed on the joint piece 3d constituting the rearmost portion of the bending portion 3, for example, by thread winding adhesion or the like. The proximal end portion of the insertion portion forming tube 6 is firmly fixed to the tube receiving member 4a by adhesion or the like, and the tube receiving member 4a is fixed to the drive connecting portion 4 integrally by soldering or the like.

  The tip of the angle wire 9 inserted through the coil pipe 8 is fixed to a predetermined position with solder or the like so as to bend each joint 7a, 7b. An intermediate portion of each angle wire 9 is wound around a pulley 13. The pulley 13 includes a spur gear 14 on the outer peripheral surface thereof.

  The coil pipe support member 11 is fixed to a partition plate 15 that divides the drive connection portion 4 or the internal space into two, and the pulley 13 is rotatably supported by the partition plate 15. Pulleys 13 corresponding to the joints are also provided on the back side of the partition plate 15, and angle wires 9 are wound around the pulleys 13.

  The pulley 13H is a pulley for opening and closing the hand arm that is the treatment section 2. Reference numeral 10 denotes a cover. The cover 10 is fixed to one side of the drive connecting portion 4 and the back side thereof. The spur gear 14 of the pulley 13 is configured to be exposed on the proximal end side of the drive connection portion 4 to which the cover 10 is attached.

  The drive connection unit 4 is detachably attached to a manipulator drive unit (not shown). The manipulator drive unit is provided with a drive motor (not shown) that rotates each pulley 13. The driving force of the drive motor is transmitted to the spur gear 14 exposed on the base end side of the drive connecting portion 4 through a gear train (not shown).

  That is, when the drive motor in the manipulator drive unit is driven, the pulley 13 rotates with the drive, and the angle wire 9 is pulled and loosened. The joint angles of the joints 7a and 7b gradually change as the angle wires 9 are moved by the rotation of the drive motor. And the position and attitude | position of the treatment part 2 change with the change of the joint angle of each joint 7a, 7b.

  Specifically, when the pulley 13 rotates and the angle wire 9 is pulled, the slackened angle wire 9 inserted through the coil pipe 8 is gradually pulled and changed into a tense state. At this time, the coil pipe 8 that has been loosened as indicated by the solid line in FIG. 2 is also released from the slack with the tension of the angle wire 9 and changes toward the state indicated by the two-dot chain line as indicated by the arrow.

  When the angle wire 9 is in a tensioned state, the coil pipe 8 is disposed in a compressed state between the joint piece 3d and the coil pipe receiver 12, as shown in FIG. As described above, since both ends of the coil pipe 8 are fixed to the joint piece 3d and the coil pipe receiver 12, the force in the direction of the arrow A, that is, the coil pipe is applied to each fixed part of each coil pipe 8, respectively. A reaction force against the compression force of 8 acts.

  When a force in the direction of arrow A acts on the fixing portion, the influence of the force is such that the distal end portion is fixed to the tube receiver 3d1 of the joint piece 3d and the proximal end portion is fixed to the drive connecting portion 4 via the tube receiving member 4a. In addition, a force for extending the tube length is applied to the insertion portion forming tube 6.

  And by the fact that a plurality of coil pipes 8 are provided and the position and posture of the treatment section 2 are repeatedly changed, the insertion section forming tube 6 is also given a force to repeatedly extend the tube length. . Then, the length of the insertion portion forming tube 6 is gradually extended. As a result, the length of the insertion portion 5 constituted by the insertion portion forming tube 6 and the bending portion 3 is increased by the dimension L.

  Then, the relationship between the length of the insertion portion 5 and the length of the coil pipe 8 changes, and the relationship between the length of the insertion portion 5 and the length of the angle wire 9 changes. Specifically, when the length of the coil pipe 8 becomes shorter than the length of the insertion portion forming tube 6, the amount of slack in the insertion portion forming tube 6 of the coil pipe 8 decreases as indicated by a two-dot chain line. To do. On the other hand, when the angle wire 9 is pulled in order to change the position and posture of the treatment portion 2 because the length of the angle wire 9 is longer than the length of the original insertion portion 5, the tension applied to the angle wire 9 is increased. Increase from a preset value.

  And the malfunction which insertability falls with the reduction | decrease amount of slack in the insertion part formation tube 6 of the coil pipe 8 arises. On the other hand, when the tension applied to the wire increases, the bending performance that the treatment portion 2 is difficult to change to a desired position and posture may be deteriorated, or the angle wire 9 breaks due to excessive tension being applied. May occur.

  In order to eliminate such a situation, it is conceivable that the hardness (Young's modulus) of the insertion portion forming tube 6 is set high to eliminate the elongation due to the reaction force of the coil pipe 8.

  Note that Patent Document 1 discloses a cover-type endoscope that ensures airtightness between the endoscope cover and the cover endoscope and prevents the proximal support of the endoscope cover from hindering movement during examination. A mirror is shown. In this cover-type endoscope, a fixing groove having a plurality of holes is provided in a fixing part extending from the base end part of the endoscope cover, and the operation part of the cover endoscope can be rotated in the hole. It has a flat pin. By configuring the cover-type endoscope in this way, when the endoscope cover is attached to the cover endoscope, the pin is selectively disposed in any hole portion of the fixing groove, and the inside of the hole portion is By rotating the pin in a predetermined direction, the endoscope cover fixing part is fixed to the cover endoscope pin so that it does not move in the forward / backward or rotational direction. It is possible to secure the airtightness between the endoscope and the cover endoscope and to attach the endoscope cover to the cover endoscope.

JP-A-8-206057

  However, by reducing the amount of looseness of the coil pipe, there is a possibility that the insertion property of the insertion portion configured by inserting a plurality of coil pipes into the treatment instrument channel may be lowered. On the other hand, when the hardness of the insertion portion forming tube is set high, the flexibility of the insertion portion forming tube is impaired, and the insertion property of the insertion portion into the treatment instrument channel may be reduced as described above. appear.

  The present invention has been made in view of the above circumstances, and by pulling an angle wire and repeatedly bending the bending portion, the length of the insertion portion is increased, and the insertability of the insertion portion and the bending performance of the bending portion are increased. It is an object to provide a medical device that can be used for a long period of time.

The medical device according to the present invention includes an insertion portion formed of an active bending portion having a plurality of joints and a flexible insertion portion forming tube continuously provided in the active bending portion, and the insertion portion is inserted into the insertion portion. An angle wire that changes the joint angle of each, and a drive connecting portion that is detachably attached to a drive unit that is provided at a proximal end portion of the insertion portion and that has a drive portion that generates a driving force that pulls and loosens the angle wire. A plurality of coil pipes having one end portion fixed in the drive connection portion and the other end portion fixed in the bending portion and being loosened in the insertion portion, through which the angle wire is inserted. A medical device,
The insertion portion forming tube constituting the insertion portion includes an adjustment mechanism portion that holds the insertion portion forming tube so as to be movable with respect to the drive connection portion.

  According to this configuration, when the coil pipe is tensioned and compressed in accordance with the tension of the angle wire, the insertion portion forming tube is extended by the force acting on the fixed portions at both ends from the coil pipe to be inserted. The length of the part becomes longer. At this time, when the insertion portion forming tube is moved to the drive connection portion side by the adjustment mechanism portion, the elongated insertion portion is adjusted to the original length.

  According to the present invention, by pulling the angle wire and repeatedly bending the bending portion, the length of the insertion portion is lengthened, and the insertion performance of the insertion portion and the bending performance of the bending portion are prevented from being lowered. A medical device that can be used for a long time can be realized.

1 to 3 are related to a conventional example, and FIG. 1 is a perspective view illustrating the configuration of an articulated manipulator. Insertion section sectional view for mainly explaining an angle wire for bending the bending section, a coil pipe through which the angle wire is inserted, and an insertion section forming tube Sectional drawing explaining the insertion part provided with the insertion part formation tube by which the length dimension was extended by L dimension 4 to 14 relate to the first embodiment of the present invention, and FIG. 4 is a diagram illustrating an endoscope system including an articulated manipulator as a medical device. The perspective view explaining the structure of an articulated manipulator The schematic diagram explaining the manipulator insertion part provided with the adjustment mechanism which adjusts the length dimension of the extended insertion part formation tube, and hold | maintains the length of an insertion part to predetermined length VII-VII line sectional view of FIG. The perspective view explaining a manipulator drive unit Sectional drawing explaining the internal structure of a manipulator drive unit The figure explaining the effect | action of an adjustment mechanism part 11 and 12 relate to another configuration of the adjustment mechanism unit, and FIG. 11 is a diagram illustrating the configuration of the adjustment mechanism unit with the adjustment ring. The figure explaining the effect | action of an adjustment mechanism part with an adjustment ring 13 and 14 relate to another configuration of the adjustment mechanism unit, and FIG. 13 is a diagram illustrating a configuration in which the adjustment mechanism unit is provided inside the drive connection unit. The figure explaining the effect | action of the adjustment mechanism part provided in the inside of a drive connection part 15 to 21 are related to a second embodiment of the present invention, and FIG. 15 is a manipulator including an adjustment mechanism that absorbs the extension of the insertion portion forming tube and maintains the length of the insertion portion at a predetermined length. Figure explaining XVI-XVI sectional view of FIG. XVII-XVII line sectional view of FIG. Schematic diagram explaining the state where the insertion portion forming tube is extended and the clip is in contact with the inner peripheral surface of the click hole The figure explaining the state which the insertion part formation tube is extended further and the clip has penetrate | invaded the movement groove | channel The figure explaining the state which the insertion part formation tube is extended further and the clip is moving toward the click hole which adjoins the inside of a movement groove The figure explaining the state arrange | positioned at the click hole which the clip passed along the inside of the movement groove | channel by the elastic force of the latching | locking part, and was provided next FIGS. 22 and 23 relate to a third embodiment of the present invention, and FIG. 22 illustrates an adjustment mechanism having another configuration that absorbs the extension of the insertion portion forming tube and maintains the length of the insertion portion at a predetermined length. Explaining a manipulator equipped with The figure explaining the effect | action of an adjustment mechanism part FIG. 24 illustrates a manipulator including an adjustment mechanism having another configuration for absorbing the elongation of the insertion portion forming tube and maintaining the length of the insertion portion at a predetermined length according to the fourth embodiment of the present invention. Figure

Embodiments of the present invention will be described below with reference to the drawings.
4 to 14 relate to the first embodiment of the present invention, FIG. 4 is a diagram illustrating an endoscope system including an articulated manipulator as a medical device, and FIG. 5 is a perspective view illustrating a configuration of the articulated manipulator. FIG. 6 is a schematic diagram for explaining a manipulator insertion portion provided with an adjustment mechanism portion that adjusts the length of the extended insertion portion forming tube and holds the length of the insertion portion at a predetermined length, and FIG. FIG. 8 is a perspective view illustrating the manipulator drive unit, FIG. 9 is a cross-sectional view illustrating the internal configuration of the manipulator drive unit, and FIG. 10 is a diagram illustrating the operation of the adjustment mechanism. .

  As shown in FIG. 4, an endoscope system 20 is connected to an endoscope 30, for example, two types of articulated manipulators (hereinafter abbreviated as “manipulators”) 40 and 41 that are medical devices, and manipulators 40 and 41. A plurality of manipulator drive units (hereinafter abbreviated as drive units) 60A, 60B, master slave devices 80, 81 for instructing the position and posture of the treatment section 42 included in the manipulators 40, 41, and a control device 90. Configured.

  The endoscope 30 includes a plurality of (for example, two) treatment instrument channels (not shown) in the endoscope insertion section 31, and the operation section 32 includes a first treatment instrument introduction port 33 communicating with the treatment instrument channel, A second treatment instrument introduction port 34 is provided.

  As shown in FIGS. 4 and 5, the manipulator 40 includes a treatment portion 42, an active bending portion 43, and a drive connection portion 44 in order from the distal end side. In this manipulator 40, a cylindrical convex portion (hereinafter, abbreviated as a convex portion) constituting the distal end portion of the drive connecting portion 44 from the shaft center 45a of the shaft connecting the treatment portion 42 and the joint piece 43a constituting the bending portion 43. The insertion portion 45 extends up to the distal end surface 50f of 44a. That is, the insertion portion 45 includes the bending portion 43 and the insertion portion forming tube 46, and is set to a predetermined length in advance.

The insertion portion forming tube 46 has a predetermined flexibility so that it can smoothly pass through the treatment instrument channel. In addition, each insertion portion of the manipulators 40 and 41 is led out from a channel opening provided at a distal end portion of the endoscope insertion portion 31 via the first treatment instrument introduction port 33 or the second treatment instrument introduction port 34. It is configured to be.
In addition, the treatment part 42 of the manipulator 40 shown in this figure is a hand arm for gripping, and the treatment part 42 of the manipulator 41 is an electric knife.

  The bending portion 43 is constituted by, for example, joint pieces 43a, 43b, 43c, and 43d provided on the distal end side of the insertion portion forming tube 46. The joint pieces 43a, 43b, 43c, and 43d are connected to each other so as to be rotatable, and are configured as a pitch drive joint 47a and a yaw drive joint 47b.

  In the internal space of the drive connection portion 44, a plurality of angle wires 49 are provided that extend through the plurality of coil pipes 48. The tip of each coil pipe 48 is fixed at a predetermined position on the inner peripheral surface of the joint piece 43d shown in FIG. On the other hand, the base end portion of each coil pipe 48 is fixed to a coil pipe receiver 55 fixed to a coil pipe support member 54 provided in the drive connection portion 44 as shown in FIGS. Yes. Each coil pipe 48 is inserted in a loosened and loosened state in the insertion portion forming tube 46 as shown in FIG. That is, the length of the coil pipe 48 is set in advance so as to be inserted into the insertion portion 45 with a slack.

  The distal end portion of the insertion portion forming tube 46 is integrally fixed to a tube receiver 43d1 formed on the joint piece 43d that constitutes the rearmost portion of the bending portion 43. On the other hand, the proximal end portion of the insertion portion forming tube 46 is fixed to the inner peripheral surface of the tube receiving member 50 that also serves as an adjustment mechanism portion and an attachment portion. The proximal end surface of the insertion portion forming tube 46 is substantially flush with the proximal end surface of the tube receiving member 50.

  On the outer peripheral surface of the tube receiving member 50, for example, a plurality of adjustment holes 51 are arranged, for example, at equal intervals in the longitudinal axis direction at 120 ° intervals in the circumferential direction. The adjustment hole 51 is formed in a predetermined diameter size and shape. In the adjustment hole 51, the tip end portion of the holding screw 52 constituting the adjustment mechanism portion is engaged. The holding screw 52 is screwed into a female screw portion 53 formed in a through hole that communicates the outer peripheral surface and the inner peripheral surface of the convex portion 44 a of the drive connecting portion 44. For example, three female screw portions 53 are provided on the outer periphery of the convex portion 44 a so as to face the adjustment hole 51 at intervals of 120 degrees, for example. The central axis of the through hole is orthogonal to the longitudinal axis of the convex portion 44a.

  According to this configuration, the tube receiving member 50 is disposed in the inner hole of the convex portion 44 a, and the distal end portion of the holding screw 52 is engaged with the adjustment hole 51. Then, the tube receiving member 50 is held integrally without moving in the axial direction of the drive connecting portion 44 and without rotating in the circumferential direction. That is, the insertion portion forming tube 46 is attached to the drive connection portion 44 via the tube receiving member 50.

  When the tube receiving member 50 is attached to the drive connection portion 44, the holding screw 52 is engaged with the adjustment hole 51 located on the proximal end surface side of the insertion portion forming tube 46 in the initial state.

  Further, a plurality of adjustment holes 51 are provided in the circumferential direction, but one adjustment hole 51 may be provided. Further, the interval between the plurality of adjustment holes 51 provided in the circumferential direction is not limited to 120 °, and may be 180 °, 90 °, 60 °, or the like.

  Furthermore, although the structure which provides the adjustment hole 51 in the tube receiving member 50 is shown, it is set as the structure which provides an internal thread part instead of an adjustment hole, and screw-fixes the tube receiving member 50 to the convex part 44a of the drive connection part 44. Also good.

  The tip end of the angle wire 49 inserted through the coil pipe 48 is fixed at a predetermined position so as to bend each joint 47a, 47b. An intermediate portion of each angle wire 49 is wound around a pulley 56. The pulley 56 is a pulley with a spur gear provided with a spur gear 56g on its outer peripheral surface as shown in FIG.

  The coil pipe support member 54 is fixed to the drive connecting portion 44 or the partition plate 57 shown in FIG. 5 that divides the internal space into two, and the pulley 56 is a shaft fixed to the partition plate 57 as shown in FIG. It is rotatably supported by the portion 57a. For example, two pulleys 56 are provided on the rear surface side of the partition plate 57, and an angle wire 49 is wound around each pulley 56. Reference numeral 56a denotes a shaft body, which is rotatably attached to the shaft portion 57a.

  The pulley 56H is a pulley for opening and closing a hand arm that is the treatment portion 42. Therefore, the pulley 56H is not necessary for the drive connection portion 44 of the manipulator 41 having an electric knife that does not require an opening / closing operation.

  Further, reference numeral 58 in FIG. 5 denotes a cover, which is fixed to one side of the drive connecting portion 44 and the back side thereof. The spur gear 56g of the pulley 56 is exposed on the base end side of the drive connecting portion 44 to which the cover 58 is attached (see FIG. 9). Reference numeral 58a denotes a click hole, which is provided with a locking portion provided in a later-described lever (see reference numeral 67 in FIGS. 8 and 9) constituting the drive unit 60A. Reference numeral 44b denotes a guide, which is composed of a convex portion. The guide 44b engages with a guide groove (see reference numeral 65 in FIG. 8) provided in a connecting portion insertion port (see reference numeral 64 in FIGS. 8 and 9) which constitutes the drive unit 60A.

  The drive connection portion 44 of the manipulator 40 is detachably attached to the drive unit 60A, and the drive connection portion 44 of the manipulator 41 is detachably attached to the drive unit 60B. The drive unit 60A is provided with a drive motor (not shown) that rotates the pulleys 56, 56H, and the drive unit 60B is provided with a drive motor (not shown) that rotates the pulleys 56.

Here, the configuration of the drive units 60A and 60B will be described.
The difference between the drive unit 60A and the drive unit 60B is the presence or absence of a transmission mechanism for transmitting the driving force to the pulley 56H. Therefore, the configuration of the drive unit 60B will be described with reference to FIGS.

  As shown in FIGS. 8 and 9, the drive unit 60 </ b> B includes a base portion 61, an advance / retreat portion 62, a roll portion 63, and a plurality of drive motors. The base portion 61 of the drive unit 60B is configured to be attached to a unit fixture (not shown).

  The advancing / retreating portion 62 constitutes a linear motion joint that can freely advance and retract as indicated by an arrow B with respect to the base portion 61. Specifically, a feed screw mechanism 71 is provided in the base portion 61. The feed screw mechanism 71 is operated by a first motor fixed to a motor support (not shown). When the advance / retreat part 62 including the roll part 63 is advanced or retracted, the treatment part 42 of the manipulators 40 and 41 moves forward or backwards.

  The roll part 63 is rotated around the roll shaft 63a to constitute a roll drive joint. The roll part 63 is rotatable with respect to the advance / retreat part 62 as indicated by an arrow C. The roll part 63 is operated by a second motor fixed to a motor support part (not shown). When the roll part 63 rotates with respect to the advance / retreat part 62, the insertion part 45 extending from the drive connection part 44 rotates around the roll shaft 63a.

The drive unit 60B has a drive connection portion arrangement space 63b, and the roll portion 63 includes a connection portion insertion port 64 communicating with the arrangement space 63b. The insertion slot 64 is provided with a guide groove 65 into which the guide portion 44b is engaged. In the vicinity of the insertion port 64, a connection holding device 66 is provided that prevents the drive connection 44 disposed in the arrangement space 63b from dropping off. The holding device 66 is provided with a lever 67 that can be moved forward and backward.
As shown in FIG. 9, when the connection between the manipulator 41 and the drive unit 60B is completed, the drive connection portion 44 is disposed in the arrangement space 63b. At this time, the locking portion 67a integrated with the lever 67 is disposed in the click hole 58a by the urging force of the spring 67b. In this connection completion state, the rotation transmission gear mechanism 69 that is a gear train fixed to the motor support base 68 provided in the arrangement space 63b and the spur gear 56g provided in the pulley 56 mesh with each other.

  The motor support base 68 is provided with a plurality of wire pulling motors (hereinafter abbreviated as “wire motors”) 70 as drive units for generating a driving force. When the wire motor 70 is driven, the rotation is transmitted to the spur gear 56g exposed to the base end side of the drive connecting portion 44 via the gear 70a and the gear mechanism 69. Then, the pulley 56 rotates, and with the rotation of the pulley 56, the angle wire 49 is pulled and loosened, and the joint angles of the joints 47a and 47b gradually change. As a result, the position and posture of the treatment unit 42 change.

  The master / slave devices 80, 81 include an operation arm 82 corresponding to the bending portion 43 of the manipulators 40, 41. That is, for example, when the bending portion 43 is composed of 4 joints, the operation arm 82 is also composed of 4 joints, and when the bending portion 43 is composed of 3 joints, the operation arm 82 is also composed of 3 joints. The operation arm 82 is manually operated by an operator.

  When changing the position or posture of the treatment section 42 of the manipulators 40 and 41, the surgeon manually operates the operation arm 82 to give a trajectory plan. When the operation arm 82 is operated, the master-slave devices 80 and 81 convert the three-dimensional physical displacement of the operation arm 82 into an electrical signal and output a trajectory planning signal to the control device 90.

The control device 90 includes a CPU 91 that is a control unit. The control device 90 includes various switches and connection units. A cable 72 extending from each of the drive units 60A and 60B and a cable 83 extending from each of the master slave devices 80 and 81 are connected to each connection portion. When the trajectory planning signal is input to the control device 90, the CPU 91 obtains joint angle trajectories of the joints 47a and 47b constituting the bending portion 43 by calculation processing, and the wire motor 70 provided in the drive units 60A and 60B. A drive signal for driving is output to the drive units 60A and 60B. The operation of the manipulators 40 and 41 having the tube receiving members 50 provided in the endoscope system 20 will be described.
When performing the treatment by inserting the manipulators 40 and 41 into the treatment instrument channel of the endoscope 30, the operator appropriately operates the operation arm 82 of the master slave devices 80 and 81 to treat the treatment unit 42 of the manipulators 40 and 41. The position or posture of the camera is changed.

  When changing the position or posture of the treatment section 42, one of the motors 70 in the drive units 60A and 60B is driven. Then, as the motor 70 is driven, the corresponding pulley 56 is rotated, and the angle wire 49 is pulled and loosened. Then, the angle wire 49 is tensed and a predetermined tension is applied, and the joint angles of the joints 47a and 47b are gradually changed to change the position and posture of the treatment section 2.

  As the angle wire 49 is pulled, the angle wire 49 in the coil pipe 48 changes from a loose state to a tensioned state by being gradually pulled. That is, the loosened slack of the coil pipe 48 as shown in FIG. 6 is gradually eliminated, and the coil pipe 48 is tensioned without slack between the joint piece 43d and the coil pipe receiver 55 as shown by a two-dot chain line. And arranged in a compressed state.

  Since both ends of the coil pipe 48 are fixed to the joint piece 43d and the coil pipe receiver 55, respectively, a force in the direction of arrow D, that is, a compressive force of the coil pipe 48 is applied to each fixed part of the coil pipe 48. Reaction force acts. Then, one end portion of the insertion portion forming tube 46 is fixed to the tube receiver 43d1 of the joint piece 43d, and the other end portion of the insertion portion forming tube 46 is held on the convex portion 44a by the holding screw 52. Under the influence of the force in the arrow D direction, the flexible insertion portion forming tube 46 is stretched little by little. That is, the length of the insertion portion 45 constituted by the insertion portion forming tube 46 and the bending portion 43 is extended.

  As the length dimension of the insertion portion forming tube 46 is extended, the insertion portion length increases, and the tension applied to the angle wire 49 pulled to change the position and posture of the treatment portion 2 increases. Go. Then, it becomes difficult for the treatment section 42 to change to a desired position and posture. In other words, the responsiveness of the treatment unit 42 with respect to the operation of the operation arm 82 decreases.

  When the surgeon feels that the responsiveness of the treatment section 42 is lowered, the holding screw 52 is loosened as shown by a broken line as shown in FIG. 10, and then the tube receiving member 50 is adjusted by one adjustment hole 51. Move in the direction of the drive connection 44. Then, the extension of the insertion portion forming tube 46 is eliminated, and the length of the insertion portion 45 constituted by the insertion portion forming tube 46 and the bending portion 43 is adjusted to the original length. That is, the extension of the insertion portion forming tube 46 is canceled by the movement of the tube receiving member 50 toward the proximal end. Accordingly, when an operation for changing the position or posture of the treatment section 42 is performed, the tension applied to the angle wire 49 is returned to a predetermined range, and the responsiveness of the treatment section 42 is restored to the original state.

  In this manner, the base end portion of the insertion portion forming tube 46 is fixed to the tube receiving member 50 in which the plurality of adjustment holes 51 are arranged, and the tube receiving member 50 is screwed into the female screw portion 53 formed in the convex portion 44a. The tube receiving member 50 is fixedly held to the drive connecting portion 44 by the holding screws 52 thus formed. For this reason, the length of the insertion portion 45 can be adjusted by moving the position of the tube receiving member 50 relative to the convex portion 44 a toward the drive connection portion 44 by the amount of the adjustment hole 51. Then, when an operation for changing the position or posture of the treatment section 42 is performed, the tension applied to the angle wire 49 is prevented from exceeding a specified range.

  That is, whenever the operator feels a decrease in responsiveness, the tube receiving member 50 is moved in the direction of the drive connecting portion 44 by one adjustment hole 51 and one hole to adjust the length of the insertion portion forming tube 46. The tension applied to the angle wire 49 can be prevented from increasing, and the position or posture of the treatment portion 42 can be changed stably by the angle wire 49 over a long period of time.

  In the above-described embodiment, the proximal end portion of the insertion portion forming tube 46 is fixed to the tube receiving member 50 having the adjustment hole 51, and the tube receiving member 50 is fixed to the convex portion 44 a of the drive connecting portion 44. By holding by 52, the length of the extended insertion portion forming tube 46 can be adjusted. However, the adjustment mechanism that adjusts the length of the extended insertion portion forming tube 46 is not limited to this configuration, and may have the configurations shown in FIGS.

  11 and 12 relate to another configuration of the adjustment mechanism, FIG. 11 is a diagram illustrating the configuration of the adjustment mechanism with the adjustment ring, and FIG. 12 is a diagram illustrating the operation of the adjustment mechanism with the adjustment ring.

  As shown in FIG. 11, the adjustment mechanism portion of the present embodiment is an adjustment mechanism portion with an adjustment ring, and includes a tube receiving member 50 </ b> A, an adjustment ring 101, a ring retainer 102, and an anti-rotation screw 103. It is configured.

  The base end portion of the insertion portion forming tube 46 is fixed to the inner peripheral surface of the tube receiving member 50A. The tube receiving member 50A includes a flange 104 at a predetermined position in the middle of the outer periphery. A male screw portion 105 is provided on the outer peripheral surface of the tube receiving member 50 </ b> A on the tip side from the flange 104. On the other hand, an internal thread portion 106 is provided on the proximal end side from the flange 104. An anti-rotation screw 103 is screwed into the female screw portion 106.

The adjustment ring 101 has a cylindrical shape and includes a central through hole 107 into which the proximal end side portion can be inserted from the flange 104 of the tube receiving member 50A.
The adjustment ring 101 has an internal space 108 in which the flange 104 is slidably disposed, and the front end surface side of the flange 104 abuts on the bottom surface thereof. An internal thread portion 109 is formed on the inner peripheral surface constituting the internal space 108. The female screw portion 109 of the adjustment ring 101 is configured to be screwed into a male screw portion 44c formed on the outer periphery of the convex portion 44a. The insertion portion forming tube 46 is attached to the drive connection portion 44 by screwing the female screw portion 109 of the adjustment ring 101 with the male screw portion 44c of the convex portion 44a.

  The ring presser 102 is also cylindrical and includes a central through hole 110 through which the insertion portion forming tube 46 can be inserted. The ring retainer 102 is formed with a female screw portion 111 that is screwed into the male screw portion 105. By screwing and fixing the ring retainer 102 to the male threaded portion 105 of the tube receiving member 50A, the adjustment ring 101 is disposed so as to be rotatable with respect to the tube receiving member 50A, and the tube receiving member 50A is moved backward to be internally threaded. The part 109 and the male screw part 44c are prevented from being unscrewed.

A long hole 44d, which is an elongated through hole in the longitudinal axis direction, is formed in the convex portion 44a formed with the male screw portion 44c. An anti-rotation screw 103 is disposed in the long hole 44d. The width dimension of the long hole 44 d is wider by a predetermined dimension than the diameter dimension of the head of the rotation prevention screw 103. As a result, the tube receiving member 50 </ b> A is held without rotating in the circumferential direction of the drive connecting portion 44.
Other configurations are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

The operation of the adjustment mechanism unit of this embodiment will be described.
When an operator or the like feels a decrease in the responsiveness of the treatment section 42, the adjustment ring 101 is rotated in a predetermined direction. Then, as shown in FIG. 12, since the female thread portion 109 of the adjustment ring 101 is screwed into the male thread portion 44c in advance, the adjustment ring 101 moves in the direction of arrow E parallel to the longitudinal axis. As the adjustment ring 101 moves in the direction of arrow E, the bottom surface of the internal space 108 comes into contact with the flange 104, and then the tube receiving member 50A is moved in the direction of arrow E without rotating in the circumferential direction together with the adjustment ring 101. To go.

That is, the extension of the insertion portion forming tube 46 is canceled by moving the tube receiving member 50 </ b> A as in the above-described embodiment, and the length of the insertion portion 45 configured by the insertion portion forming tube 46 and the bending portion 43. Returns to its original length. Therefore, when an operation for changing the position or posture of the treatment section 42 is performed, the tension applied to the angle wire 49 is returned to a predetermined range, and the responsiveness of the treatment section 42 is restored to the original state.

  Thus, by fixing the proximal end portion of the insertion portion forming tube 46 to the tube receiving member 50A that is movable in the longitudinal axis direction by the rotation of the adjusting ring 101, the tube receiving member 50A is rotated along with the rotation of the adjusting ring 101. It is possible to obtain the same operation and effect as the above-described embodiment by adjusting the length of the insertion portion 45 by moving in the direction of the drive connection portion 44.

  13 and 14 relate to another configuration of the adjustment mechanism, FIG. 13 is a diagram illustrating a configuration in which the adjustment mechanism is provided inside the drive connection, and FIG. 14 is an adjustment provided inside the drive connection. It is a figure explaining the effect | action of a mechanism part.

  In the embodiment described above, the operator rotates the adjustment ring 101 to move the tube receiving member 50A in the direction of the drive connecting portion 44, or loosens the holding screw 52, and then the tube receiving member 50 is adjusted to the adjustment hole 51. The extension of the insertion portion forming tube 46 is canceled by moving in the direction of the drive connecting portion 44 by the amount. That is, the length of the insertion portion 45 can be easily adjusted by a user such as an operator. For this reason, the operations of the manipulators 40 and 41 may change depending on the adjustment state.

  As shown in FIG. 13, the adjustment mechanism portion of the present embodiment is configured to be provided inside the drive connection portion, and mainly includes a tube receiving member 50 </ b> B, an adjustment nut 121, and an anti-rotation screw 103. Has been.

  The tube receiving member 50B has the proximal end portion of the insertion portion forming tube 46 fixed to the inner peripheral surface thereof. The tube receiving member 50B includes a flange 122 at the tip. A male screw portion 123 is provided on the outer peripheral surface of the base end portion of the tube receiving member 50B. An adjustment nut 121 is screwed into the male screw portion 123.

  A nut arrangement recess 44e in which the adjustment nut 121 is arranged is formed on the base end face side of the projection 44a of the drive connection portion 44. The opening on the base end face side of the placement recess 44e is closed by a pair of lid members 124. The lid member 124 includes a fixed plate portion 125 and an opening closing portion 126. The fixed plate portion 125 is disposed in the notch groove 44f of the drive connection portion 44 and is fixed by a screw (not shown). By fixing the fixing plate portion 125 to the notch groove 44 f, the base end surface opening is blocked by the opening blocking portion 126. The recess 44h formed in the notch groove 44f is a moving space for the tube receiving member 50B.

  The cover 58 is disposed so as to cover the fixing plate portion 125 of the lid member 124 after each lid member 124 is fixed to the notch groove 44f, and is connected to the drive connection portion 44 by a fastening member (not shown). It is fixed.

A wrench hole 127 in which a grid wrench (not shown) is disposed is formed on the side surface of the adjustment nut 121. The adjustment nut 121 is screwed to the male screw portion 123 of the tube receiving member 50B.
Other configurations are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

The operation of the adjustment mechanism unit of this embodiment will be described.
In the manipulators 40 and 41 of the present embodiment, when an operator or the like feels a decrease in the responsiveness of the treatment unit 42, he / she requests maintenance. An operator who performs maintenance first removes the cover 58 from the drive connection portion 44, and then removes the pair of lid members 124. Then, the side surface of the adjustment nut is exposed.

  Next, the operator sets a square wrench in the wrench hole 127 and rotates the adjustment nut 121 in a predetermined direction. Then, as shown in FIG. 14, the tube receiving member 50 </ b> B moves in the direction of the arrow F parallel to the longitudinal axis without moving the adjustment nut 121. That is, the extension of the insertion portion forming tube 46 is canceled by moving the tube receiving member 50B as in the above-described embodiment, and the length of the insertion portion 45 configured by the insertion portion forming tube 46 and the bending portion 43 is cancelled. Will return to its original length. During this operation, the operator appropriately performs an operation for bending the bending portion 43 to measure the tension when the angle wire 49 is pulled. Then, when the tension reaches a predetermined set value, the movement of the tube receiving member 50B is stopped. Thereafter, the operator attaches the lid member 124 and the cover 58 to the drive connection portion 44. This completes the maintenance of the manipulator 40.

  As described above, the base end portion of the insertion portion forming tube 46 is fixed to the tube receiving member 50 </ b> B that is movable in the longitudinal axis direction by the rotation of the adjustment nut 121, and the adjustment nut 121 is provided in the drive connection portion 44. Thus, the length adjustment of the insertion portion 45 can be led from the user to the manufacturer. As a result, the responsiveness of the treatment section of the manipulator after maintenance adjustment becomes the same as the initial state. Other operations and effects are the same as those of the above-described embodiment.

  In the above-described embodiment, when the operator or the like feels a decrease in the responsiveness of the treatment section 42, the user himself adjusts the length of the insertion section 45 or requests maintenance. That is, the timing for performing adjustment or the timing for requesting maintenance differs depending on the operator.

  In order to eliminate such a situation, for example, the drive units 60A and 60B are provided with a detection unit for detecting a current value output to each motor 70 or a load applied to the motor. When the current value output to any of the motors 70 exceeds a predetermined value, the detection device outputs a notification signal to the CPU 91 to issue a buzzer (not shown), for example. The surgeon or the like is notified that the tension applied to the angle wire 49 is increased by the buzzer being reported, that is, the position of the tube receiving members 50 and 50A is adjusted, or the manipulator having the tube receiving member 50B. It can be recognized that there is a timing for requesting maintenance of 40 and 41. This makes it possible to make the adjustment timing and the maintenance request timing constant.

  In the above description, the current value output to the motor 70 is detected to notify the adjustment timing and the like, but a strain gauge is provided as a detection unit for detecting the tension of the angle wire 49 in the drive units 60A and 60B. The detection result may be output to the CPU 91, the tension applied to the angle wire 49 may be determined, and the timing requesting adjustment or maintenance may be notified to the surgeon or the like.

  15 to 21 are related to a second embodiment of the present invention, and FIG. 15 is a manipulator including an adjustment mechanism that absorbs the extension of the insertion portion forming tube and maintains the length of the insertion portion at a predetermined length. 16 is a cross-sectional view taken along line XVI-XVI of FIG. 15, FIG. 17 is a cross-sectional view taken along line XVII-XVII of FIG. 15, and FIG. 18 is an inner peripheral surface of the click hole when the insertion portion forming tube is extended. FIG. 19 is a diagram illustrating a state in which the insertion portion forming tube is further extended and the clip has entered the moving groove, and FIG. 20 is a diagram in which the insertion portion forming tube is further extended. FIG. 21 is a diagram illustrating a state in which the clip is moving toward the click hole adjacent in the movement groove, and FIG. 21 is arranged in the click hole adjacent to the clip by passing through the movement groove by the elastic force of the locking portion. Explain the status It is a diagram.

  As shown in FIGS. 15 to 17, for example, the manipulator 40 according to the present embodiment includes an adjustment mechanism configured to include a tube receiving member with clip 50 </ b> C and a sliding support 44 j. The tube receiving member with clip 50 </ b> C is composed of, for example, a metal tubular tube receiving portion 130 and a resin clip 132, for example.

  The clip 132 includes a locking part 133 and a shaft part 134. The shaft portion 134 is a fixed portion, and this fixed portion is fixedly provided in a mounting hole 131 formed in the tube receiving portion 130 and protrudes therefrom. The locking portion 133 is configured to be sequentially disposed in click holes 44k1, 44k2, 44k3, and 44k4, which will be described later, of the sliding support portion 44j formed on the convex portion 44a.

  The locking portion 133 is an urging portion, and includes a slit 135 that allows the locking portion 133 to be elastically deformed. The width dimension W and the depth dimension D of the slit 135 are set so as to have a predetermined elastic force. The elastically deformable locking portion 133 has an outer shape of the first dimension d1 (see FIG. 18) in a state where no load is applied to the locking portion 133, and the width is determined by the load acting on the locking portion 133. It is deformed to a second dimension (not shown) where W is in close contact. Thereafter, when the load acting on the locking portion 133 is removed, the first dimension d1 is restored again.

  The sliding support portion 44j is elongated, parallel to the longitudinal axis of the convex portion 44a, and includes a plurality of click holes 44k1, 44k2, 44k3, 44k4, and a moving groove 44m (hereinafter, click grooves are also denoted by reference numerals). 44j)). The moving groove 44m communicates adjacent click holes.

  The tube receiving member 50C to which the proximal end portion of the insertion portion forming tube 46 is fixed is slidably attached to the convex portion 44a by engaging the locking portion 133 with the click hole 44k1. At this time, the outer shape of the locking portion 133 is the first dimension d1.

  Note that a curved surface is chamfered at an intersection (ridgeline) between the click hole and the moving groove. By chamfering the intersecting portion, the movement of the locking portion 133 from the click hole to the moving groove and the movement from the moving groove to the click hole are smoothly and continuously performed. Further, when the clip 132 is fixed to the attachment hole 131, the slit 135 is installed in parallel to the longitudinal axis of the click groove 44j.

With reference to FIGS. 18-21, the effect | action of the tube receiving member 50C with a clip is demonstrated.
As described above, when the angle wire 49 is pulled along with the rotation of the pulley 56, the insertion portion forming tube 46 is affected by the force in the arrow D direction shown in FIG. And the insertion part formation tube 46 is extended little by little in the arrow G direction parallel to a longitudinal axis. In the present embodiment, the clip-attached receiving member 50C provided at the proximal end portion of the insertion portion forming tube 46 is moved in the arrow G direction. And as shown in FIG. 18, the latching | locking part 133 of the clip 132 contact | abuts to the internal peripheral surface of the click hole 44k1.

  When the insertion portion forming tube 46 is further extended, the force for moving the clip-attached tube receiving member 50C in the arrow G direction increases. That is, the pressing force with which the inner peripheral surface of the click hole 44k presses the locking portion 133 of the clip 132 increases. As the pressing force increases, the locking portion 133 is gradually crushed against the urging force of the locking portion 133. That is, the width dimension of the slit 135 is made narrower than W, and the locking portion 133 gradually enters the moving groove 44m as shown in FIG.

  As the insertion portion forming tube 46 is further extended, the clip 132 moves toward the click hole 44k2 in the moving groove 44m with the locking portion 133 being crushed as shown in FIG. .

  That is, as the length of the insertion portion forming tube 46 extends, the clip-attached tube receiving member 50 </ b> C moves in the arrow G direction and absorbs the extension of the insertion portion forming tube 46. As a result, the length of the insertion portion forming tube 46 is extended, but the length dimension of the insertion portion 45 is maintained at a predetermined dimension set in advance.

  Thereafter, the insertion portion forming tube 46 is further extended, whereby the clip 132 starts to enter the click hole 44k2. Then, the force with which the inner peripheral surface of the click hole 44k2 presses the locking portion 133 of the clip 132 gradually decreases. And as shown in FIG. 21, the clip 132 returns to the original external shape by the elastic force which the latching | locking part 133 has, and is arrange | positioned in the click hole 44k2.

  Thereafter, the clip 132 moves from the click hole 44k2 to the click holes 44k3 and 44k4 while repeating the above-described operation. Until the clip 132 reaches the click hole 44k4 after the length of the insertion portion forming tube 46 is extended, the length dimension of the insertion portion 45 is not extended but is maintained at a predetermined predetermined size. . When the user visually recognizes that the clip 132 has reached the click hole 44k4, the user stops using the manipulator 40 and requests maintenance.

  In this way, the clip-attached tube receiving member 50C having the clip 132 is provided at the proximal end portion of the insertion portion forming tube 46, and the engaging portion 133 constituting the clip 132 is configured as an urging portion that can be elastically deformed. And the clip 132 is arrange | positioned in the click groove | channel 44j provided with a some click hole and a movement groove | channel parallel to the longitudinal axis of the convex part 44a. As a result, as the insertion portion forming tube 46 extends, the clip 132 of the clip receiving tube receiving member 50C arranged in the click hole 44k1 of the click groove 44j gradually moves toward the click hole 44k4, and the insertion portion It can prevent that the length dimension of the insertion part 45 becomes long when the formation tube 46 is extended. Therefore, according to the manipulator of the present embodiment, the length of the insertion portion 45 is maintained at a predetermined dimension without the operator performing adjustment work. Further, when an operation for changing the position or posture of the treatment section 42 is performed, the tension applied to the angle wire 49 is always within a specified range.

  FIGS. 22 and 23 relate to a third embodiment of the present invention, and FIG. 22 illustrates an adjustment mechanism having another configuration that absorbs the extension of the insertion portion forming tube and maintains the length of the insertion portion at a predetermined length. FIG. 23 is a diagram for explaining the operation of the adjustment mechanism unit.

  As shown in FIG. 22, for example, the manipulator 40 according to the present embodiment includes an adjustment mechanism unit including a spring-loaded tube receiving member 50 </ b> D and an anti-rotation positioning screw 141. As for tube receiving member 50D, the base end part of the insertion part formation tube 46 is fixed to the internal peripheral surface. The tube receiving member 50D includes a flange 142 at the distal end portion of the outer peripheral portion. In the tube receiving member 50 </ b> D, a compression spring 140, which is a pressing spring that constitutes an urging portion, is disposed on the outer periphery of the flange 142 on the base end surface side. The spring constant of the compression spring 140 is set in consideration of the force acting on the insertion portion forming tube 46 from the coil pipe 48. The tube receiving member 50D includes a female screw portion 143 at a predetermined position on the outer peripheral surface of the midway portion. An anti-rotation positioning screw 141 is screwed into the female screw portion 143.

  A long hole 44d, which is a through hole elongated in the longitudinal axis direction, is formed in the convex portion 44a. An anti-rotation positioning screw 141 is disposed in the long hole 44d. The width dimension of the long hole 44d is wider by a predetermined dimension than the diameter dimension of the head of the rotation prevention positioning screw 141.

Then, the tube receiving member 50D to which the proximal end portion of the insertion portion forming tube 46 is fixed has the rotation preventing positioning screw 141 screwed into the female screw portion 143 through the long hole 44d in a state where the compression spring 140 is disposed on the outer periphery. By combining, the drive connecting portion 44 is slidably attached to the convex portion 44a without rotating in the circumferential direction. At this time, the tube receiving member 50D is moved in the direction of the curved portion by the biasing force of the compression spring 140, whereby the rotation preventing positioning screw 141 comes into contact with the distal end surface of the long hole 44d. In this contact state, the length of the insertion portion 45 is set to a predetermined length.
Other configurations are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

The operation of the adjustment mechanism unit of this embodiment will be described.
As described above, when the angle wire 49 is pulled along with the rotation of the pulley 56, the insertion portion forming tube 46 is affected by the force in the direction of the arrow D shown in FIG. And the insertion part formation tube 46 is extended little by little in the arrow G direction parallel to a longitudinal axis. In the present embodiment, the spring-supported receiving member 50 </ b> D provided at the proximal end portion of the insertion portion forming tube 46 is moved in the arrow G direction against the urging force of the compression spring 140.

  When the insertion portion forming tube 46 is further extended, the force for moving the spring-loaded tube receiving member 50D in the arrow G direction increases. Then, the spring-supported receiving member 50D is further moved in the arrow G direction against the urging force of the compression spring 140.

  That is, as the length of the insertion portion forming tube 46 extends, the compression spring 140 is compressed and the spring-loaded tube receiving member 50D moves in the direction of arrow G to absorb the extension of the insertion portion forming tube 46. As a result, the length of the insertion portion forming tube 46 is extended, but the length dimension of the insertion portion 45 is maintained at a predetermined dimension set in advance.

  Thereafter, when the insertion portion forming tube 46 is further extended, the compression spring 140 of the spring-loaded tube receiving member 50D approaches a close contact state as shown in FIG. In the manipulator 40 of the present embodiment, the length of the insertion portion 45 is not expanded until the compression spring 140 is brought into close contact with the length of the insertion portion forming tube 46, and is set to a predetermined value. Maintained in dimensions. The user stops using the manipulator 40 and requests maintenance before the compression spring 140 comes into close contact.

  In this manner, the spring-loaded tube receiving member 50 </ b> D in which the compression spring 140 is disposed is provided at the proximal end portion of the insertion portion forming tube 46. Then, the spring-loaded tube receiving member 50D is slidably disposed on the convex portion 44a. Thus, as the insertion portion forming tube 46 extends, the compression spring 140 of the spring-loaded tube receiving member 50D is compressed and moves in a direction to absorb the extension of the insertion portion forming tube 46. As a result, it is possible to prevent the length of the insertion portion 45 from becoming longer due to the insertion portion forming tube 46 extending. According to the manipulator of this embodiment, the same operation and effect as those of the second embodiment can be obtained.

  FIG. 24 illustrates a manipulator including an adjustment mechanism having another configuration for absorbing the elongation of the insertion portion forming tube and maintaining the length of the insertion portion at a predetermined length according to the fourth embodiment of the present invention. FIG.

  As shown in FIG. 24, for example, the manipulator 40 of the present embodiment includes an adjustment mechanism portion in the insertion portion forming tube 46. The insertion portion forming tube 46 includes a first tube 151 provided on the distal end side, a second tube 152 provided on the proximal end side, and a tube joint 153 with a spring that serves both as an adjustment mechanism portion and an attachment portion. ing. The distal end portion of the first tube 151 is fixed to the bending portion 43.

  The flexibility of the second tube 152 is higher than that of the first tube, and the base end portion thereof is fixed to the tube receiving member 50E, and the tube receiving member 50E is fixed to the convex portion 44a. The spring-loaded tube joint 153 is made of hard resin or metal, and is made of metal in this embodiment.

  The spring-loaded tube joint 153 includes a first joint 154, a second joint 155, and a compression spring 159. The first joint 154 has a straight shape, and the second joint 155 has a stepped shape. The first joint 154 is slidably disposed on the outer periphery of the small diameter portion 156 of the second joint 155. In the present embodiment, one end of the first joint 154 is fixed to the base end of the first tube 151, and one end of the second joint 155 is fixed to the distal end of the second tube 152.

  An anti-rotation positioning pin 157 is fixed at a predetermined position of the small diameter portion of the second joint 155. A long hole 158 is formed in the base end portion of the first joint 154, which is an elongated through hole parallel to the longitudinal axis and in which the rotation preventing positioning pin 157 is disposed. A compression spring 159, which is a push spring constituting the biasing portion, is disposed on the outer periphery of the small diameter portion 156 of the second joint 155. The spring constant of the compression spring 159 is set in consideration of the force acting on the insertion portion forming tube 46 from the coil pipe 48.

The first joint 154 is slidably connected to the second joint 155 without rotating in the circumferential direction of the second joint 155. Specifically, the first joint 155 is disposed in the small-diameter portion 156 so as to crush the compression spring 159 disposed in the small-diameter portion 156 of the second joint 155, and then the anti-rotation positioning pin 157 is inserted into the long hole 158. The first joint 154 and the second joint 155 are connected to each other by being fixed to the small-diameter portion 156. In this connected state, the rotation preventing positioning pin 157 abuts on the base end surface of the long hole 158 by the urging force of the compression spring 159. In this state, the length of the insertion portion 45 is set to a predetermined length.
The operation of the adjustment mechanism unit of this embodiment will be described.
As described above, when the angle wire 49 is pulled along with the rotation of the pulley 56, the insertion portion forming tube 46 is affected by the force in the arrow D direction shown in FIG. And in this embodiment, the 1st tube 151 of the insertion part formation tube 46 is extended little by little in the arrow H direction parallel to a longitudinal axis. Then, the first joint 154 provided at the base end portion of the first tube 151 is moved in the arrow H direction against the urging force of the compression spring 159.

  When the first tube 151 is further extended, the force for moving the first joint 154 in the arrow H direction increases. Then, the first joint 154 is further moved in the arrow H direction against the urging force of the compression spring 159.

  That is, as the length of the first tube 151 constituting the insertion portion forming tube 46 increases, the compression spring 159 is compressed and the first joint 154 moves in the direction of the arrow H to absorb the extension of the first tube 151. To do. As a result, the length of the insertion portion forming tube 46 is extended, but the length dimension of the insertion portion 45 is maintained at a predetermined dimension set in advance.

  Thereafter, the first tube 151 of the insertion portion forming tube 46 is further extended, and thus the compression spring 159 approaches a close contact state. In the manipulator 40 of the present embodiment, the length of the insertion portion 45 is not expanded until the compression spring 159 is brought into close contact with the length of the insertion portion forming tube 46, and is set to a predetermined value. Maintained in dimensions. The user stops using the manipulator 40 and requests maintenance before the compression spring 159 comes into close contact.

  As described above, the insertion portion forming tube 46 is constituted by the first tube 151, the second tube 152, and the spring-loaded tube joint 153, and the spring-equipped tube joint 153 is constituted by the first joint 154 and the second joint 155. Then, the first joint 154 and the second joint 155 are slidably connected by disposing a compression spring 159. As a result, as the first tube 151 of the insertion portion forming tube 46 extends, the first joint 154 of the spring-loaded tube joint 153 moves in a direction to absorb the extension of the insertion portion forming tube 46 while compressing the compression spring 159. I will do it. As a result, the same operations and effects as those of the third embodiment can be obtained.

  In the present embodiment, one end portion of the first joint 154 is fixed to the proximal end portion of the first tube 151, and one end portion of the second joint 155 is fixed to the distal end portion of the second tube 152. One end of the first joint 154 may be fixed to the distal end of the second tube 152, and one end of the second joint 155 may be fixed to the proximal end of the first tube 151.

  The medical device described above is a manipulator that is inserted into a treatment instrument channel provided in an endoscope. However, the medical device is not limited to the one inserted into the treatment instrument channel, and the insertion portion is inserted into a blood vessel or a body cavity as a single unit, and the insertion portion is composed of an active bending portion and a flexible insertion portion forming tube. The present invention can also be applied to a catheter or the like that is operated with an angle wire in which an active bending portion is inserted into a coil pipe.

  The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

DESCRIPTION OF SYMBOLS 20 ... Endoscopy system 30 ... Endoscope 31 ... Endoscope insertion part 32 ... Operation part
33 ... Treatment instrument introduction port 34 ... Treatment instrument introduction port 40, 41 ... Manipulator 42 ... Treatment part 43 ... Active bending part 44 ... Drive connection part 44a ... Convex part 45 ... Insertion part 45a ... Axis center 46 ... Insertion part forming tube 47a ... Pitch drive joint 47b ... Yaw drive joint 48 ... Coil pipe 49 ... Angle wire 50 ... Tube receiving member 50f ... Tip surface 51 ... Adjustment hole 52 ... Holding screw 53 ... Female screw part 54 ... Coil pipe support member 55 ... Coil pipe 56 ... Pulley 56a ... Shaft body 56g ... Spur gear 57 ... Partition plate plate 57a ... Shaft part 58 ... Cover 58a ... Click hole 60A, 60B ... Drive unit 70 ... Motor for wire pulling
80, 81 ... Master / slave device 82 ... Operation arm 90 ... Control device

Claims (11)

An active bending portion having a plurality of joints and an insertion portion formed of a flexible insertion portion forming tube provided continuously with the active bending portion, and inserted into the insertion portion, thereby changing the joint angle of the joint. An angle wire, a drive connection portion detachably attached to a drive unit provided at a proximal end portion of the insertion portion and generating a drive force that pulls and loosens the angle wire, and one end portion of the drive connection In a medical device comprising: a plurality of coil pipes that are fixed in a portion, the other end portion is fixed in the bending portion and arranged in a slack state in the insertion portion, and the angle wires are inserted therein.
The medical device characterized in that the insertion portion forming tube constituting the insertion portion includes an adjustment mechanism portion that holds the insertion portion forming tube so as to be movable with respect to the drive connection portion.   The adjustment mechanism portion also serves as an attachment portion for attaching a tube receiving member fixed to an end portion of the insertion portion forming tube to the drive connecting portion, and the tube receiving member is held and moved with respect to the drive connecting portion. The medical device according to claim 1, which is possible. The adjustment mechanism section is
A tube receiving member fixed to an end of the insertion portion forming tube and provided with a plurality of adjustment holes arranged at equal intervals in the longitudinal axis direction on the side peripheral surface;
A holding screw in which a tip end portion is disposed in the adjustment hole by screwing into an internal thread portion communicating the inner peripheral surface and the outer peripheral surface formed in the drive connection portion;
The medical device according to claim 2, comprising: The adjustment mechanism portion is fixed to an end portion of the insertion portion forming tube, and an anti-rotation screw disposed on an outer peripheral surface in a flange and a long hole formed in the drive connection portion to prevent circumferential rotation. A tube receiving member having an internally threaded portion to be screwed;
An internal space provided with an inner peripheral surface formed with a female screw portion that is rotatably arranged on the tube receiving member and screwed into a male screw portion formed on the drive connection portion, and a bottom surface that comes into contact with the flange. A cylindrical adjustment ring,
A ring restraint fixed to the tube receiving member to prevent the adjustment ring from falling off the tube receiving member;
The medical device according to claim 2, comprising: The adjustment mechanism portion is fixed to an end portion of the insertion portion forming tube, and an anti-rotation screw that is disposed in an elongated hole formed in the drive connection portion and prevents circumferential rotation is screwed onto the outer peripheral surface. A tube receiving member provided with a female screw portion and provided with a male screw portion at one end;
An adjustment nut which is arranged in a nut arrangement part formed in the drive connection part and is screwed into a male screw part of the tube receiving member;
The medical device according to claim 2, comprising:   Furthermore, the detection part which detects the electric current value output to the said drive part, or the load concerning the said drive part, or the tension | tensile_strength of the said angle wire is provided, The detection part of Claim 1-5 characterized by the above-mentioned. The medical device according to any one of the above.   The adjustment mechanism portion also serves as an attachment portion for attaching a tube receiving member fixed to an end portion of the insertion portion forming tube to the drive connecting portion, and the tube receiving member is connected to the drive connecting portion via an urging portion. 2. The medical device according to claim 1, wherein the medical device is slidably disposed on the medical device. The adjustment mechanism section is
A tube receiving member with a clip, comprising: a tubular tube receiving portion fixed to an end of the insertion portion forming tube; and a clip having a locking portion that is the urging portion protruding from the outer peripheral portion of the tube receiving portion;
A click hole formed in the drive connection portion, in which the inner peripheral surface and the outer peripheral surface are communicated and parallel to the longitudinal axis of the drive connection portion, and the locking portion in a state where no load is applied, and A sliding support portion including a moving groove in which the locking portion deformed by a load is disposed;
The medical device according to claim 7, comprising: The adjustment mechanism section is
A predetermined anti-rotation positioning screw that is fixed to the end portion of the insertion portion forming tube and is disposed in a long hole formed in the outer peripheral surface of the flange and formed in the drive connection portion to prevent circumferential rotation. A female screw portion formed at a position, and an outer peripheral surface between the flange and the front end surface of the drive connection portion, urge the flange toward the curved portion, and the angle wire is tensioned 3. A spring-loaded tube receiving member comprising a compression spring having a spring constant that is compressed by a force acting on a fixed portion of the coil pipe when the coil pipe is compressed and tensioned. Medical device according to. The adjustment mechanism part is provided in the middle part of the insertion part forming tube,
A first tube having one end fixed to the curved portion;
A second tube disposed on the other end of the first tube, the other end of which is fixed to the drive connecting portion via a tube receiving member; and a spring with which the first tube and the second tube are connected Tube fittings,
The medical device according to claim 1, comprising: Spring tube fittings
A first joint having a straight hole and a long hole parallel to the longitudinal axis in which an anti-rotation positioning pin is disposed at the end;
A second joint having a stepped shape, a rotation positioning pin arranged in a long hole of the first joint being fixed, and having a small-diameter portion inserted through the first joint;
It is arranged at the narrow diameter part of the second joint, urges the first joint, and the angle wire is tensioned, and the coil pipe is compressed and tensioned, thereby acting on the fixing part of the coil pipe. A compression spring having a spring constant that is compressed by the force
The medical device according to claim 10, comprising:

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