JP2016131787A - Abdominoscope and abdominoscope surgery system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To solve a problem that an abdominoscope needs to be operated using both hands, thereby complicating the operation, and requires an operator to take a limited posture since the abdominoscope cannot be used by one hand.SOLUTION: An abdominoscope includes: a camera 1 acquiring an image of a subject; camera moving parts 2, 3 enabling an angle of the camera 1 to be displaced in at least four directions; and an operation part 5 allowing an operator to input a displacing instruction of the angle of the camera in at least four directions. The camera moving parts 2, 3 displace the angle of the camera in accordance with the displacing instruction of the angle of the camera input to the operation part by the operator.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a laparoscope and a laparoscopic surgical system.

  In recent years, laparoscopic surgery has been prominent. This operation is performed by inserting a dedicated endoscope (laparoscope) into a body through a small hole formed in the abdominal surface of the patient. Compared with conventional open surgery, laparoscopic surgery has advantages such as (1) less pain after surgery and less noticeable surgical marks, (2) less bleeding, and (3) early discharge after surgery. .

  In normal laparotomy, it was possible for two people, the surgeon (the surgeon performing the operation) and the first assistant (the surgeon supporting the third and fourth hands), but in laparoscopic surgery A scopist (surgeon with a laparoscope, hereinafter sometimes referred to as an “operator”) as a photographer who continues to photograph a surgical site with a laparoscope is required. Also, in laparoscopic surgery, it is not possible to perform surgery while looking directly at the site to be operated, and the role of the scorpist is important because surgery is performed while confirming the image displayed by the laparoscope on a monitor. Nonetheless, due to the recent shortage of surgeons, the scorpist who plays the role of the “surgeon's eyes” to accurately display the lesions must be left to the initial trainee who does not fully understand the details of the operation.

  Patent Document 1 describes a laparoscope whose tip is bent in order to direct the direction of the camera to the surgical site. In recent years, a laparoscope has been sold that includes a lever for moving the angle of the camera attached to the distal end of the laparoscope in two directions left and right and a lever for moving the camera in two directions up and down.

JP 2003-265402 A

  In the above-described laparoscope having two levers, it is difficult to intuitively understand the relationship between how the two levers are moved and the angle of the laparoscopic tip, and thus skillful operation is required. During surgery, it may be necessary to hold the laparoscope at a position on the right or left side as viewed from the scorpist, depending on the progress of the surgery and the patient's condition. However, the laparoscope always uses both hands. Since the two levers must be operated, it is difficult to operate with a laparoscope away from the right or left side as viewed from the scoop. Therefore, in such a case, the scorpist moves the position while communicating with the operator and operates the laparoscope, but there is a problem that smooth progress of the operation is hindered.

  In order to solve the above problems, according to one aspect of the present invention, a laparoscope, a camera that acquires an image of a subject, and a camera movable unit that can displace the angle of the camera in at least four directions And an operation unit that allows an operator to input a displacement instruction in at least four directions of the camera angle, and the camera movable unit responds to the camera angle displacement instruction input by the operator to the operation unit. The camera angle was displaced.

  Furthermore, it is desirable that the operation unit has a touch pad or a lever that is displaced in at least four directions of up, down, left, and right.

  Furthermore, it is desirable that the lever can be stopped at a certain angle.

  Furthermore, it is desirable that the camera movable unit displaces the angle of the camera stepwise.

  Furthermore, it is desirable that the camera movable unit includes a vertical camera movable unit capable of displacing the camera angle in the vertical direction and a horizontal camera movable unit capable of displacing the camera angle in the left-right direction. .

  Furthermore, it is desirable that the camera movable portion is configured to displace the camera angle by pulling the wire with a motor.

  According to another aspect of the present invention, a laparoscopic surgery system can displace at least four angles of a camera that acquires an image of a subject, a display device that displays an image acquired by the camera, and a camera. A movable camera unit and an operation unit that allows an operator to input displacement instructions in at least four directions of the camera angle, and the camera according to the camera angle displacement instruction input to the operation unit by the operator It was assumed that the movable part displaces the angle of the camera.

  According to the present invention, the angle of the camera attached to the distal end portion of the laparoscope can be adjusted in the vertical and horizontal directions as intended by the operator by intuitive operation. In addition, since the camera angle can be operated in the up / down / left / right directions with one hand, the camera angle can be appropriately operated even if the camera must be used in an unreasonable position depending on the situation of surgery.

FIG. 3 is a diagram schematically showing a part of a laparoscope of Example 1. FIG. 3 is a diagram illustrating an operation unit according to the first embodiment. It is a figure which shows the angle change of the camera of Example 1. FIG. It is a figure which shows typically the operation principle of the left-right direction movable part of Example 1. FIG. It is a figure which shows the state which the left-right direction movable part of Example 1 displaced to the right direction. FIG. 6 is a diagram illustrating an operation unit according to a second embodiment. FIG. 10 is a diagram illustrating an operation unit according to a third embodiment. FIG. 10 is a diagram illustrating an operation unit according to a fourth embodiment. It is a figure which shows the place which is operating the operation lever of Example 4 with a thumb. It is a figure which shows the outline when the operation part of Example 5 is seen from diagonally upward (camera reference position). It is a figure which shows the outline when the operation part of Example 5 is seen from diagonally upward (camera angle 45 degree displacement). It is a figure which shows the outline when the operation part of Example 5 is seen from the top.

  Examples of the present invention will be described below, but the embodiments of the present invention are not limited to the examples described below.

  FIG. 1 is a schematic diagram showing a part of a laparoscope according to a first embodiment of the present invention. A laparoscope refers to an endoscopic instrument that is inserted into the abdominal cavity from the body surface skin. A camera (not shown) is attached to a camera attachment portion (tip portion) 1 at the distal end of the laparoscope, and a surgical site that is a subject in front of the camera is photographed to obtain moving image information. The laparoscopic camera mounting portion 1 is inserted into the abdominal cavity of the patient during the operation, and the camera images the surgical site. Then, the image information acquired by the camera is displayed by a display device (not shown). The surgeon operates the surgical tool while viewing the surgical site of the patient displayed on the display device and the distal end of the surgical tool held by the surgeon, and performs appropriate treatment on the surgical site. The angle of the camera and the camera mounting portion 1 is displaced in the vertical direction and the horizontal direction in accordance with an operation instruction from the operator in the operation unit 5 (see FIG. 3). FIG. 1 shows a state where the camera is displaced to the right by an angle θ °. The vertically movable unit 2 moves in the vertical direction in response to an operation instruction from the operator at the operation unit 5. Further, the left-right movable unit 3 moves in the left-right direction in response to an operation instruction from the operator on the operation unit 5. The movable part support part 4 supports the left-right direction movable part 3. In this embodiment, the vertically movable portion 2 and the horizontally movable portion 3 are separately provided and connected to realize the vertical and horizontal movement of the camera. However, the movable portion can be vertically and horizontally moved by one movable portion. You may comprise as follows.

  FIG. 2 is a diagram showing the operation unit 5. The shape of the operation unit 5 of this embodiment is a circle, but it may be a circle or a rectangle. The operation unit 5 receives an instruction for operating the camera angle in at least four directions, in this embodiment, up, down, left, and right directions by the movement of one hand of the operator. The operation unit 5 is provided with a touch pad for recognizing a position touched with the right thumb 6 or the like, for example. When the thumb 6 is placed at the center 41, it is the home position (reference position), and the displacement angle of the vertically movable portion 2 and the horizontally movable portion 3 is 0 °. The movable part 3 and the movable part support part 4 are in a straight line. When the thumb 6 is moved in the direction above the central portion 51, the angle of the tip 1 is displaced upward, and when the thumb 6 is moved in the direction below the central portion 51, the angle of the camera is displaced downward. The same applies to the left-right operation of the camera. The angular displacement from the home position of the camera increases as the thumb 6 is placed at a position far from the center 1.

  In the present embodiment, the upper part of the operation unit 5 in FIG. 2 is the upward direction area. However, depending on the operator, there are cases where it is easier to operate by setting the upper part as the downward direction area. It is desirable to add a function that can be selected.

  FIG. 3 is a diagram illustrating a change in the angle of the laparoscopic camera according to the first embodiment. A camera lens 11 is attached to the tip of the camera attachment portion 1. The angle of the camera can be freely moved up, down, left, and right by appropriately moving the position at which the right thumb 6 is in contact with the operation unit 5 constituted by a touch pad. For example, an angle obtained by combining up, down, left and right directions such as 45 ° in the downward direction and 30 ° in the left direction can be easily and intuitively adjusted by an operation using only the right thumb.

  FIG. 4 is a diagram schematically showing the operation principle of the left / right movable unit 4. A rod 7 is rotatably supported on the shaft 8. A helical spring (coil spring) 9, which is an elastic body, is attached to one end of the rod 7, and the other end of the spring 9 is attached to a spring fixing portion. Is pulling. The left-right direction movable part 3 is fixed to the upper part of the shaft 8, and the left-right direction movable part 3 is displaced to the left and right with respect to the movable part support part 4 according to the rotation of the shaft 8. A wire 11 is attached to the other end of the rod 7, and the wire 11 is attached to a cylindrical wire take-up portion 12 so as to be rewound. The wire winding unit 12 is connected to a shaft of a motor (not shown), and can wind the wire 11 by the rotation of the motor. When an instruction to displace the left-right movable unit 3 in the right direction 15 is input to the operation unit 5, the motor is rotated and the wire winding unit is rotated counterclockwise in the direction of the arrow 13. Then, the wire 11 is pulled in the direction of the arrow 14, the rod 7 rotates counterclockwise, and the left-right direction movable part 3 is displaced in the direction of the arrow 15. A motor rotation shaft angle detection sensor (not shown) is attached to the motor to detect the motor rotation shaft angle. The angle of the motor rotation shaft is adjusted so that the rotation shaft angle becomes the target angle. FIG. 5 is a diagram illustrating a state in which the left-right direction movable unit 3 is displaced in the right direction. The operation principle of the up-and-down direction movable part 2 is also the same as the operation principle of the above-described left-and-right direction movable part.

  In this way, the camera angle can be moved in at least four directions, in this embodiment, up, down, left, and right in response to camera angle operation instructions in at least four directions, in this embodiment, up, down, left, and right directions with one hand from the operation unit 5. it can.

  With regard to the movable range of the camera angle, if the operator is a beginner, the patient's organs or the like may be damaged if the operator can move the camera angle to a very large angle. Therefore, it is conceivable to limit the movable angle, for example, the camera can only move up to an angle of 60 °.

  In the laparoscope of the present embodiment, even when the laparoscope must be held with an unreasonable posture depending on the progress of the operation, the angle of the laparoscope camera can be operated in the vertical and horizontal directions with one hand.

  FIG. 6 is a diagram illustrating the stepped operation unit 5 according to the second embodiment. The operation unit 5 is configured by a touch pad as in the first embodiment. In the first embodiment, the angle of the tip 1 can be moved steplessly up and down, left and right, but it is better if the movable angle is determined in three steps, for example, 30 °, 45 °, and 60 °. May be easy for the scorpist to follow the instructions of the person. In FIG. 6, for example, when the surgeon is instructed by the surgeon to “move to the lower right 45 ° of the camera”, the scorpist may touch somewhere in the 42 area. According to this configuration, the angle of the distal end portion 1 can be accurately adjusted to an angle to be adjusted as compared with the first embodiment.

  FIG. 7 shows an example in which operation buttons 53 are arranged on the operation unit 5. If the lower button is pressed once, the angle of the tip 1 is displaced downward by 15 °. For example, when the camera angle is to be displaced 30 ° downward and 30 ° to the right, the lower button is pressed twice and the right button is pressed twice. You may press the lower right button twice. According to this method, the angle of the camera can be adjusted to a desired angle more accurately than the method of the first embodiment.

  FIG. 8 is a diagram illustrating an example in which the operation lever 54 is used in the operation unit 5. The operation lever 54 can be operated in any direction, and the angle of the camera is displaced in the vertical and horizontal directions according to the movement of the operation lever 54.

  FIG. 9 is a diagram showing the operating lever 54 being operated with the thumb 6. In this embodiment, when the operation lever 54 is pulled forward, the angle of the camera is displaced upward.

  10 and 11 are diagrams illustrating an outline when the operation unit of the fifth embodiment is viewed obliquely from above. In FIG. 10, the operation lever 54 stands upright at 90 °, and in this state, the camera angle is located at the reference position. The operation lever 54 is in the groove 17 of the attachment 16. The attachment is detachable from the operation unit. In FIG. 11, the operation lever 54 is displaced by 45 °, and the angle of the camera is also displaced by 45 ° in response to this displacement. The angle of the operation lever 54 is stopped at an angle of 30 °, 45 °, and 60 ° by a ratchet mechanism. In this embodiment, a ratchet mechanism is used, but even if the ratchet mechanism is not used, the operation lever 54 may be stopped at a fixed angle.

  FIG. 13 is a schematic diagram illustrating the operation unit according to the fifth embodiment as viewed from above. The groove 17 rotates 360 °, but, like the operation lever, the position of the rotation angle is a multiple of 30 ° (0 °, 30 °, 60 °,...) By the ratchet mechanism. It comes to stop at. Although the ratchet mechanism is used in the present embodiment, the rotation angle may be stopped at a constant angle without using the ratchet mechanism.

  Thus, since the operation lever 54 stops at a fixed angle, the scoop can easily adjust the camera angle and fix the camera angle at an appropriate position.

  The present invention can be industrially used as a laparoscope and a laparoscopic surgical system.

1 Camera mount (tip)
2 Vertically movable part 3 Horizontally movable part 4 Movable part support part 5 Operation part 6 Thumb 7 Bar 8 Shaft 9 Spring 11 Wire 12 Wire winding part 51 Center part 53 Operation button 54 Operation lever

Claims (8)

A camera that captures the image of the subject,
A camera movable unit capable of displacing the angle of the camera in at least four directions;
An operation unit that allows an operator to input displacement instructions in at least four directions of the camera angle;
The laparoscope, wherein the camera movable unit displaces the angle of the camera in response to an instruction for displacement of the camera angle input by the operator to the operation unit.   The laparoscope according to claim 1, wherein the operation unit includes a touch pad.   The laparoscope according to claim 1, wherein the operation unit includes a lever that is displaced in at least four directions.   The laparoscope according to claim 3, wherein the lever can be stopped at a constant angle.   The laparoscope according to claim 1, wherein the camera movable unit displaces the angle of the camera in a stepwise manner.   2. The camera movable unit according to claim 1, wherein the camera movable unit includes a vertical camera movable unit capable of displacing a camera angle in a vertical direction and a horizontal camera movable unit capable of displacing a camera angle in a horizontal direction. Laparoscope characterized by that.   The laparoscope according to claim 1, wherein the camera movable unit displaces an angle of the camera by pulling a wire with a motor. A camera that captures the image of the subject,
A display device for displaying an image acquired by the camera;
A camera movable unit capable of displacing the angle of the camera in at least four directions;
An operation unit that allows an operator to input displacement instructions in at least four directions of the camera angle;
A laparoscopic surgery system, wherein the camera movable unit displaces the angle of the camera in response to an instruction for displacement of the camera angle input by an operator to the operation unit.