JP2020065904A - Surgery assistance apparatus - Google Patents

Abstract

To provide a surgery assistance apparatus that does not require a console, whose installation in an operation room is difficult, and is capable of manipulating a robot arm by a simple manipulation.SOLUTION: A surgery assistance apparatus according to the present invention comprises: a plurality of robot arms that control a posture of a surgical tool that is inserted into a body cavity for use; a gimbal mechanism that is interposed between a tip end of at least one robot arm among the plurality of robot arms and the surgical tool, and is rotatable around two rotation axes; and control means for controlling operations of the plurality of robot arms according to manipulation by an operator. Each of the plurality of robot arms is a robot arm having three degrees of freedom where a joint part rotatable around an axis in a vertical direction and a join part performing a direct-acting movement are combined with each other. The control means controls an insertion angle and an insertion depth of a shaft of the surgical tool into the body cavity by controlling the joint parts of the robot arms, and calculates positions of reference points of the insertion angle and the insertion depth of the shaft of the surgical tool into the body cavity on the basis of angles around the two rotation axes of the gimbal mechanism.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a surgery support device.

  Laparoscopic surgery is generally performed by a doctor who performs an incision, excision, and suturing of an organ (hereinafter referred to as "operator"), a doctor who holds an endoscope (hereinafter referred to as "scopist"), and the field of view of the operator. Therefore, it is performed with a doctor (hereinafter, referred to as an "assistant") who pulls organs and maintains tension during incision. A surgical support device (also called a surgical support robot) used for laparoscopic surgery is required for surgery by controlling the posture of surgical tools such as forceps, an endoscope, and an electric scalpel with one or more robot arms. Some are trying to reduce the number of doctors.

  For operation of the surgery support device, a console type that is operated by a doctor from the control unit equipped with the surgery support device and a robot arm that holds only the endoscope are used by the surgeon to control the robot arm while performing a surgical procedure. There is a method to do.

  Conventional surgical support devices used for laparoscopic surgery can be roughly classified into those that perform the operations of three operators, a scoopist, and an assistant, and those that hold the endoscope with one arm. It is known that a console-type surgery support robot plays a role of an operator, a scopist, and an assistant, and a plurality of robot arms are arranged around the patient or above the patient (Patent Documents 1 and 2).

  On the other hand, there is also known a surgery support robot in which one robot arm has only an endoscope (Patent Document 3). The surgery support robot disclosed in Patent Document 3 does not require a console for operation, and a method in which an operator or an assistant operates by voice is used.

JP, 2011-4880, A JP, 2017-104455, A JP-A-6-30896

  The console-type surgery support robot disclosed in Patent Document 1 has a large device size, and it may be difficult to optimize the positional relationship between the patient and the robot due to the balance with other devices in the operating room. In addition, the console type may be remotely controllable, but in order to observe the patient's appearance and communicate with the nurse, it is common to install an operation console in the operating room where the patient and robot are located. Has become one of the factors that pressure. The console-type surgery support robot disclosed in Patent Document 2 requires a complicated and large-sized console in order to operate many articulated robot arms even when the device size is reduced.

  In the surgery support robot disclosed in Patent Document 3, since the operation target is the one-arm robot, the device size can be suppressed. However, it still requires work by an assistant, etc., and the robot arm approaches a plurality of humans, so it is not possible to secure a sufficient robot arm operation area, or the robot arm interferes with the surgeon or assistant and affects the surgical procedure. Will be given. Further, when using a voice operation means, it can be easily imagined that it is difficult to operate a complicated surgical instrument different from an endoscope as intended.

  The present invention has been made in view of the above problems. That is, an object of the present invention is to provide a surgery support device that does not require a console that is difficult to install in an operating room and that can operate a robot arm with a simple operation.

In order to solve this problem, for example, the surgery support device of the present invention has the following configuration. That is, a plurality of robot arms that control the posture of the surgical instrument that is inserted into the body cavity and that is interposed between the distal ends of one or more robot arms of the plurality of robot arms and the surgical instrument are provided. A gimbal mechanism that can rotate around the rotation axis,
A surgery support apparatus comprising: a control unit that controls the operations of the plurality of robot arms in accordance with an operation by an operator, wherein each of the plurality of robot arms is a joint unit rotatable about a vertical axis. Is a robot arm having three degrees of freedom, which is a combination of a joint part that performs linear motion, and the control means controls the joint part of the robot arm to insert an angle of the shaft of the surgical instrument into the body cavity. And the insertion depth is controlled, and the position of the insertion angle of the shaft of the surgical instrument into the body cavity and the position of the reference point of the insertion depth are calculated based on the angles around the two rotation axes of the gimbal mechanism. Is characterized by.

  ADVANTAGE OF THE INVENTION According to this invention, it becomes possible to provide the surgery assistance apparatus which can operate a robot arm by a simple operation, without requiring the console which is difficult to install in an operating room.

The figure which shows an example of the whole structural example of the surgery assistance apparatus which concerns on this invention. The functional configuration example (a) of the surgery support device according to the present embodiment, and a diagram schematically showing how a handheld medical device and a robot medical device are inserted into a body cavity when the surgery support device is used (b). The figure which shows the detailed structural example of the horizontal robot arm which concerns on this embodiment. The figure which expanded the tip part of the horizontal robot arm which concerns on this embodiment. The figure which shows the structural example of the linear motion joint part which the horizontal robot arm which concerns on this embodiment has. The figure explaining the grip with a brake release switch which concerns on this embodiment. The figure which shows the internal structure example at the time of seeing the brake release switch which concerns on this embodiment from the vertical direction. The figure which shows the example of the input switch by the side of the surgical instrument manipulator for the vector operation mode which concerns on this embodiment. The figure which shows the mechanism equivalent model of the horizontal robot arm which concerns on this embodiment. The figure which shows the detailed structural example of the linear motion robot arm which concerns on this embodiment. The figure which shows the structural example of the vertical drive joint part of the linear motion robot arm which concerns on this embodiment. The figure which shows the mechanism equivalent model of the linear motion robot arm which concerns on this embodiment. The figure which shows typically the relationship between the two frames which concern on this embodiment, and the 1st arm of a linear motion robot arm. The figure which shows in detail the relationship between the two frames which concern on this embodiment, and the 1st arm of a linear motion robot arm. The figure explaining the movable range of the arm tip part of each robot arm which concerns on this embodiment. The figure explaining the initialization which concerns on this embodiment. Flowchart showing a series of operations of the initialization process according to the present embodiment The figure explaining the method of calculating the position of the insertion point which concerns on this embodiment.

  Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the drawings. The surgery support apparatus according to the present invention has a robot arm that controls the posture of the surgical instrument or the end effector inserted through the outer tube into the body cavity of the patient. The surgery support device measures an insertion angle and an insertion depth of a surgical instrument (hereinafter, also referred to as a hand-held medical instrument) which is inserted into a body cavity by an operator and is actually used for surgery. The robot arm 100 for controlling the posture of the surgical instrument or the end effector (hereinafter, also referred to as a robot medical instrument) is configured to be controlled according to the measurement result.

(Outline of Robot Arm 100 Related to Surgery Support Device)
1 (a) and 1 (b) respectively show an outline of a robot arm 100 according to a surgery support apparatus according to the present invention, and a patient and an operator when using the surgery support apparatus 200, which is assumed in the present embodiment. , The operating table 151 is shown. The robot arm 100 according to this embodiment includes two horizontal robot arms 110, one linear motion robot arm 120, and a plurality of frames (bases).

  The first frame 101 includes active wheels, passive wheels, or both so that the patient and the robot arm 100 can be placed at an appropriate distance. The second frame 102 is a frame fixed on the first frame 101, and the third frame 103 is connected by a component having a degree of freedom only in a direction perpendicular to the second frame 102. Two triaxial horizontal articulated robot arms (simply referred to as horizontal robot arm 110) having joints having horizontal degrees of freedom are attached to the third frame 103. Further, a triaxial direct acting articulated robot arm (also simply referred to as a direct acting robot arm 120) is connected to the tip of the third frame 103 by a component having a degree of freedom only in the vertical direction.

  A surgical instrument manipulator 124 is attached to the distal end of the horizontal robot arm 110 via a gimbal mechanism configured to be rotatable about two axes. The surgical instrument manipulator 124 is a drive device for controlling the position and orientation of the distal end portion of the robot medical instrument with respect to the robot medical instrument whose insertion angle and insertion depth into the body cavity are controlled by the horizontal robot arm 110. The surgical instrument manipulator 124 includes a plurality of motors that generate a plurality of independent rotational powers, and the respective powers are transmitted, for example, in the shaft of the robot medical device to be transmitted to the distal end portion of the robot medical device.

  In the horizontal robot arm 110, the first arm 111 and the second arm 112 are connected by an active joint having a degree of freedom only for horizontal rotation, and the second arm 112 and the third arm 113 are also only free for horizontal rotation. Connected with active joints with a certain degree. The first arm 111 has an active joint having a degree of freedom in the vertical direction (long axis direction of the third frame 103), so that the second arm 112 and the third arm 113 can be moved in the vertical direction. As a result, the robot medical instrument connected to the surgical instrument manipulator on the hand of the horizontal robot arm 110 can be moved three-dimensionally, and thus the insertion angle and the insertion depth of the robot medical instrument into the body cavity are controlled. A more detailed structure of the horizontal robot arm will be described later.

  Like the horizontal robot arm 110, the linear motion robot arm 120 has a gimbal mechanism at the tip thereof so as to be rotatable about two axes. The linear motion robot arm 120 includes an endoscope holder to which a general endoscope can be attached to the gimbal mechanism. In the linear motion robot arm 120, the third arm 123 and the second arm 122 are connected by an active joint having a horizontal degree of freedom, and the second arm 122 and the first arm 121 have a horizontal degree of freedom. Connected by active joints. The first arm 121 is connected to an active joint having a degree of freedom in the vertical direction (long axis direction of the third frame 113), so that the second arm 122 and the third arm 123 can be moved in the vertical direction. . As a result, the endoscope (robot medical instrument) connected to the endoscope holder 114 at the end of the linear motion robot arm 120 can be moved three-dimensionally, and thus the endoscope (robot medical instrument) can be moved into the body cavity. The insertion angle and the insertion depth are controlled.

(Structure of the surgery support device 200)
2 (a) and 2 (b), a functional configuration example of the surgery support apparatus 200 according to the present embodiment and a handheld medical instrument and a robot medical instrument inserted in the body cavity when the surgery support apparatus 200 is used. The situation is shown schematically. The surgery support apparatus 200 controls the operation of the robot arm based on the operation of a surgical tool (that is, a hand-held medical device) used by an operator during the operation, not a general console-type master-slave.

  The hand-held medical instrument 131 is a surgical instrument that the surgeon actually moves by hand to perform a normal procedure, and is inserted into the body cavity through the surgeon-side mantle tube 135 that is inserted into a small-diameter hole formed in the abdominal wall 150. . The handheld medical device 131 includes, for example, forceps, a constrictor, an electric knife, a suction tube, an ultrasonic coagulation / incision device, a hemostatic device, a radiofrequency ablation device, a medical stapler, and a needle holder that are inserted into a body cavity and used. A surgical instrument movement measuring unit 132 attached to the handheld medical instrument 131 and an operator side insertion depth measuring unit 136 attached to the operator's outer sheath tube 135 measure an insertion angle and an insertion depth of the handheld medical instrument 131 with respect to a body cavity. To do.

  The robot medical device 127 passes through the robot side outer tube 125 inserted into the small-diameter hole formed in the abdominal wall 150, and a part thereof is inserted into the body cavity. For example, the robot medical device 127 is, for example, a forceps, a forceps, an electric knife, an aspiration tube, an ultrasonic coagulation / incision device, a hemostatic device, a radiofrequency ablation device, a medical stapler, a needle holder, which is used by being inserted into a body cavity. It includes an endoscope, a thoracoscope, a laparoscope, and the like, and may have a linear shape or a flexion joint. In the example of the present embodiment, the linear motion robot arm 120 is equipped with an endoscope serving as a robot medical instrument 127 via the endoscope holder 114. Further, the horizontal robot arm 110 is equipped with forceps, an electronic scalpel or the like as the robot medical instrument 127 via the surgical instrument manipulator 124. A medical instrument such as forceps attached through the surgical instrument manipulator 124 has its tip position controlled by driving the surgical instrument manipulator 124. In the present embodiment, when the robot arm is simply referred to, the surgical instrument manipulator 124 is included in the robot arm. Further, the case where the robot medical instrument 127 and the surgical instrument manipulator 124 are separate bodies will be described as an example, but the robot medical instrument 127 and the surgical instrument manipulator 124 may be integrated as a surgical instrument.

  The robot-side insertion depth measuring unit 126 can detect that the robot arm has been inserted into the robot-side outer tube 125. Further, the depth of insertion of the robot medical instrument 127 controlled by the horizontal robot arm 110 or the linear motion robot arm 120 into the body cavity is measured by one or more distance sensors attached to the robot side outer tube 125. The robot-side insertion depth measuring unit 126 may have only a configuration capable of detecting that the robot arm has been inserted into the robot-side outer tube 125. In this case, the position / orientation information can be obtained according to the output from the encoder of the robot arm. Further, the robot-side insertion depth measuring unit 126 may be configured to be separately attached to the robot-side outer tube 125 and the robot medical instrument 127, like a transmitter or a receiver, or to the robot medical instrument 127. It may be configured to be attached only.

  The surgical instrument motion measurement unit 132 includes, for example, one or more sensors of an acceleration sensor, an ultrasonic sensor, a geomagnetic sensor, a laser sensor, an optical motion capture sensor, or a combination thereof, and reads the surgical instrument actions of three to six axes. In the present embodiment, the surgical instrument movement measuring unit 132 measures, for example, the insertion angle of the handheld medical device operated by the operator into the body cavity.

  The operator-side insertion depth measuring unit 136 includes one or more distance sensors attached to the operator-side outer tube 135, and measures the insertion depth of the handheld medical device 131 into the body cavity. In the present embodiment, an example in which the operator-side insertion depth measuring unit 136 is attached to the operator-side outer tube 135 will be described. However, the operator-side insertion depth measuring unit 136 may be configured to be separately attached to the operator-side outer tube 135 and the handheld medical device 131, like a transmitter or a receiver, or may be a handheld medical device. It may be configured to be attached only to 131.

  The control unit 201 includes one or more processors such as a CPU or a GPU, and controls the overall operation of the surgery support apparatus 200 by reading the program stored in the recording medium 204 into the memory 205 and executing the program. The control unit 201 also functions as a switching unit that switches the operation mode of the surgery support apparatus based on the operation on the operation unit 202. It also functions as control means for controlling the operation of the robot arm so as to control the posture of the robot medical device according to the insertion angle and the insertion depth of the shaft of the handheld medical device 131 into the body cavity. The operation mode of the surgery support device is a mode in which the hand-held medical instrument 131 is operated for treatment to actually perform the treatment (also simply referred to as a treatment mode) and a mode in which the hand-held medical instrument 131 is used to operate the robot medical instrument 127. (Also referred to as a robot operation mode). Further, as will be described later in detail, it includes a mode in which the operator operates the robot arm by an operation including contact with the robot arm.

  The operation unit 202 includes an operation member such as a switch attached to the handheld medical device 131 or a foot switch that can be operated by the operator with his / her foot. The operation unit 202 may further include a voice input system capable of voice operation input instead of the switch. The control unit 201 changes the operation mode in the surgery support apparatus 200, changes the arm to be controlled, and changes the information displayed on the display unit 203 according to the input from the operation unit 202. For example, the operator can use the operation unit 202 to select one arm to be controlled.

  As described above, by configuring the robot medical instrument 127 to be operable in accordance with the operation of the handheld medical instrument 131 operated by the operator, in the conventional laparoscopic surgery, usually three doctors perform an operation, It is possible for an operator to perform the same operation by operating the robot arm while the operation is similar to the operation of operating a surgical tool.

(Details of the horizontal robot arm 110)
<Horizontal drive joint>
Details of the horizontal robot arm 110 will be described with reference to FIGS. 3 to 8. As shown in FIG. 3, the distal end portion (of the third arm 113) of the horizontal robot arm 110 has a biaxial gimbal mechanism 301 to which the surgical instrument manipulator 124 can be attached. FIG. 4 is an enlarged view of the tip portion (of the third arm 113) of the horizontal robot arm 110. The gimbal mechanism 301 is configured to be rotatable around two rotating shafts 401 and 402 shown in FIG. 4, and these rotating shafts 401 and 402 are axes of the surgical instrument shaft of the robot medical instrument attached to the surgical instrument manipulator 124. Intersect with 403. The gimbal mechanism 301 is a passive joint that does not have a power unit, but includes an encoder that measures rotation about each rotation axis. For example, it is possible to obtain the position and orientation of the robot medical instrument 127 by using forward kinematics by providing both absolute encoders. In addition, the horizontal robot arm 110 has an elastic mechanism (for example, a damper in the rotation direction) for suppressing the influence of microvibration during the operation and the minute movement due to the breathing of the patient, and having the function of stabilizing the posture and avoiding the peculiar posture. Or resin spring, metal spring) or auxiliary power can be used.

  The third arm drive unit 302 in the second arm 112 includes a drive motor that drives the third arm 113, a non-excitation actuated brake, and a speed reducer. The third arm 113 and the second arm 112 have a degree of freedom only in the horizontal rotation, and the third arm 113 receives the power output from the timing belt 307 from the third arm drive unit 302 by the same timing pulley. Active rotation can be performed. The second arm 112 has a third arm sensor unit 303 for measuring the rotation of the third arm 113 with respect to the second arm. The third arm sensor unit 303 includes an encoder and other sensors for detecting the rotational position around the rotation axis of the joint portion connecting the third arm 113 and the second arm 112. A bearing 304 is provided on the rotary shaft of this joint.

  The first arm 111 supports the second arm 112 with a frame having a C-shaped structure. By arranging a speed reducer 305 having a bearing capable of allowing a moment on one side, and arranging an auxiliary bearing 306 for auxiliary purpose on the pair, a third arm 113 and a second arm 112, a surgical instrument manipulator 124, and a robot are arranged. It is possible to disperse the moment load generated from the own weight of the medical device 127 and the external force. The second arm drive unit 309 in the first frame 111 transmits the power for rotating the second arm 112 by the drive belt 310 to connect the second arm 112 to the joint portion (connection between the third arm 113 and the second arm 112). Part) rotation axis. Moreover, a large hollow structure is ensured by distributing the respective mechanical parts in the first frame 111, and it is possible to attach an encoder 308 that detects the wiring and the rotational position of the second arm 112 with respect to the first arm 111. In the example shown in FIG. 3, the speed reducer 305 having a bearing capable of accepting a moment is arranged in the lower portion of the first frame 111, and the upper portion has a hollow structure. However, these arrangements are opposite. May be.

  In this embodiment, in order to downsize the horizontal robot arm 110, a case where the output mechanism such as the speed reducer 305 and the second arm drive unit 309 is a flat type is described as an example. For example, it is possible to use a wave gear reducer or a cycloid reducer capable of high deceleration even with a flat type, a flat type motor having an increased output of the motor itself, or a direct drive motor directly attached to a joint portion. As the bearings used for the four rotary joints, cross roller bearings and four-point bearings can be used in order to allow the bearings to accept moments and be made compact.

<Vertical drive joint>
FIG. 5 shows the linear motion joint section of the horizontal robot arm 110. This linear motion joint portion is incorporated in the third frame 103. The linear motion mechanism that drives the first arm 111 is provided with a ball linear guide 501 for allowing the moment of self-weight of the third arm 113 from the first arm 111 and the external force received by the arm to be sufficiently allowed and for smooth movement. Place two parallel to each other.

  The first arm 111 is fixed to a support block 502 attached to the ball linear guide 501. A timing belt 505 is fixed to a power transmission plate 503 extending from a support block 502 supporting the first arm 111, and is arranged so as to be parallel to the ball linear guide 501. The drive motor 504 transmits the rotational power to the timing belt 505 and drives the timing belt 505 by the timing pulley, thereby actively moving the support block 502 supporting the first arm in the vertical direction. At this time, the position detection control unit 510 includes an encoder and measures the amount of vertical movement of the first arm 111 based on the amount of movement of the drive belt 505 that has moved forward and backward. Further, the position detection control unit 510 includes a brake mechanism, and applies a brake so as to maintain the posture during the operation of the support block 502 (that is, the linear motion of the horizontal robot arm 110). In the present embodiment, an example in which the brake mechanism is used will be described, but the brake mechanism may not be used. In that case, for example, the state in which the drive motor 504 generates the driving force for maintaining the posture is maintained. A counterweight 507 is connected to the power transmission plate 503 by a pulling wire 506 supported by a support pulley 511.

  The counterweight 507 can suppress the output of the drive motor 504 that drives the first arm 111 to the third arm 113, the surgical instrument manipulator 124, and the robot medical instrument 127 by compensating for their own weights. More specifically, the counterweight 507 according to this embodiment will be described. The horizontal robot arm 110 needs to be directly movable not only by an operator using a hand-held medical instrument but also by a surgical preparation or an emergency. At this time, the horizontal drive joint can be easily moved by hand only by releasing the brake, but the vertical drive joint has to manually hold a large weight of the horizontal robot arm 110 when the brake is released. I won't. Therefore, the vertical drive joint shown in FIG. 5 is provided with a counter weight 507 for compensating the weight of each component, so that the output to the drive component can be eased and the robot arm can be moved manually without feeling the weight of the robot arm. It is possible. The use of the counterweight 507 is not essential, and a constant load spring may be used.

  In order to operate the robot arm manually, an assist system that outputs only the weight of the robot arm in the vertical axis direction by a program is possible, but if the system goes down, it can be moved manually. It can be difficult. On the other hand, the counterweight 507 also has a purpose of enabling manual movement even when a system abnormality occurs by disconnecting the counterweight 507 from the system by a logic circuit that releases the brake and supplies power to the motor.

  The third frame 113 includes a cable guide 509 for connecting the signal line and the power line to the third arm 113 between two ball linear guides 501 arranged in parallel to assist the linear movement of the wiring.

  The linear motion mechanism shown in FIG. 5 uses a highly efficient timing belt pulley so that the operation (back drive ability) from the output side can be easily performed. However, a ball screw with a large lead or a highly efficient sliding screw is used. May be

<Grip with brake release switch>
In addition to the weight compensation mechanism (counterweight 507) for manually moving the robot arm according to the situation, the horizontal robot arm 110 according to the present embodiment is provided with a brake release for easily handling the manual operation of the robot arm. A switch 311 is provided. As shown in FIG. 6, the brake release switch 311 constitutes a grip with a switch that can move the robot arm in the vertical direction and the horizontal direction while holding it with one hand. As will be described later, the brake release switch 311 is provided from multiple directions so that the operator can press the switch in a substantially constant posture even if the robot arm changes to various postures with respect to the operator. The switch can be pressed.

  The brake release switch 311 is arranged at the tip of the third arm 113. The brake release switch 311 includes a switch for releasing the holding brake attached to each joint of the horizontal robot arm 110, and a cylindrical grip for an operator to hold.

  The brake for maintaining the posture of the robot arm is released only while the brake release switch 311 is pressed for safety. Instead of the brake, the driving force for maintaining the posture may be temporarily reduced. In order to realize such a brake, the brake release switch 311 according to the present embodiment has a structure in which the operator can continue to press the switch stably while applying a force for moving the tip of the horizontal robot arm 110. Has become. The brake release switch 311 shown in FIG. 6 (a) is moved by the operator as shown in FIG. 6 (b) by the operator's hand to move the horizontal robot arm 110 in the horizontal direction, and the sliding of the horizontal rotation accompanying the movement. The shape is such that a vertical force can be easily applied to the horizontal robot arm 110. As shown in FIG. 7, the switch is circumferentially arranged in the cylindrical portion of the brake release switch 311 in order to stably push the switch while allowing the horizontal rotation slip.

  The brake of the brake release switch 311 according to the present embodiment has a cylindrical shape, and it is assumed that an operator holds the brake so that the operator holds the thumb and middle finger or the thumb and forefinger. In this case, in order to allow the grip to rotate when the horizontal robot arm 110 is moved in the horizontal direction, there is provided a mechanism capable of reacting a contact sandwiched by two fingers substantially in parallel from any direction. The operator can also grasp the brake release switch 311 so as to cover the entire brake release switch 311 (five fingers contact the cylindrical portion).

  7A to 7C show the internal structure of the brake release switch 311 when viewed from the vertical direction. In the example shown in FIG. 7A, a general tact switch 701 is arranged in an equal circle, and its outer circumference is surrounded by a lever 702 having a rotation fulcrum 703. The lever 702 has a large amount of push-in at a position farthest from the fulcrum, and a force tends to be applied in a direction to push the tact switch 701. However, when approaching the rotation fulcrum, the force pushing the opposed tact switch 701 becomes smaller. Therefore, by arranging a set of the tact switch 701 and the lever 702 with an odd number of three or more at equal intervals, it is possible to press the tact switch 701 with either of two fingers regardless of which direction the grip is gripped. Is possible.

  It should be noted that the lever 702 is not limited to the one having a rotation fulcrum, and the lever 702 can be operated in parallel toward the grip center, but it is possible to arrange an odd number of levers of three or more as described above. Is desirable.

  In FIG. 7B, the tact switches 701 are arranged at equal intervals with an odd number of three or more, and the outer circumference of the tact switches 701 is surrounded by an elastic resin 705, so that the tact switches 701 are pressed no matter which direction the grip is gripped. It was done like this. In this example, the number of tact switches 701 is made larger than that in the example shown in FIG. 7A so as to have good switch sensitivity. In the example shown in FIG. 7C, a general strip-shaped pressure sensitive switch 704 (whose resistance value changes due to pressurization) is arranged in a cylinder, and the outer circumference thereof is surrounded by an elastic resin 705 so that the direction The switch can be pushed even if the grip is gripped.

<Vector operation mode>
The brake release switch 311 shown in FIGS. 6 and 7 facilitates the operation of the robot arm when the horizontal robot arm 110 is largely moved or after the robot medical instrument 127 is inserted into the robot-side outer tube 125. . On the other hand, in the state where the distal end portion of the robot medical instrument 127 is not inserted into the robot-side outer tube 125, the biaxial gimbal mechanism 301 is a passive joint, and therefore the orientations of the surgical instrument manipulator 124 and the robot medical instrument 127 are not stable. . Therefore, the operation may be difficult when the robot medical instrument 127 is inserted into the robot-side outer tube 125.

  Therefore, in the present embodiment, two input switches are provided on the side of the surgical instrument manipulator 124, which is the tip of the biaxial gimbal mechanism 301 as shown in FIG. 8, and the entire robot arm can be operated based on the operation on the input switches. It has a vector operation mode.

  The two input switches represent only the front-rear direction, and the operator pushes one of the front-rear switches to give an instruction while supporting (contacting) the tip of the biaxial gimbal mechanism 301 by hand. You can The horizontal robot arm 110 moves the tip of the robot arm in a direction that matches the pushed direction on the axis of the shaft of the robot medical device 127. Therefore, the surgical instrument manipulator 124 functions as an operating unit for manually operating the biaxial gimbal mechanism 301, so that the traveling direction of the entire robot arm can be determined. In other words, the horizontal robot arm 110 controls the operation according to the axial direction of the shaft of the robot medical device 127 and whether the instruction to the switch indicates the axial direction of the shaft. This allows the distal end of the robot medical device 127 to be easily and smoothly inserted into the robot-side outer tube 125. Further, even when the tip of the robot medical instrument 127 is removed from the body cavity, by using this vector operation mode, it is possible to perform the removal operation with the contact with the organ minimized.

  In the above example, the example in which the brake release switch 311 and the vector operation mode are used in the horizontal robot arm 110 has been described, but the present invention is also applicable to the case where the endoscope holder 114 or the linear motion robot arm 120 is used.

  The mechanism described above with reference to FIGS. 3 to 5 becomes a 5-axis mechanism equivalent model shown in FIG. 9 by connecting the surgical instrument manipulator 124 and the robot medical instrument 127 to the mechanism. By inserting the distal end portion of the robot medical instrument 127 having five-axis degrees of freedom into the outer tube attached to the abdomen of the patient, the two-axis degrees of freedom are fixed. Therefore, it becomes possible to three-dimensionally control the position of the distal end portion of the robot medical device 127 within the body cavity of the patient while using the insertion point 901 as a reference point for the insertion depth and the insertion angle.

(Details of linear motion robot arm)
<Direct drive joint>
Details of the linear motion robot arm 120 will be described with reference to FIGS. 10 to 12. As shown in FIG. 10, the third arm 123 and the second arm 123 have two parallels in the horizontal direction in order to sufficiently allow the self-weight moment and the external force received by the linear motion robot arm 120 and to make a smooth motion. Are connected by a ball linear guide 1001 arranged in the.

  The third arm 123 is driven by a drive unit 1002 fixed to the second arm 122 side and including a speed reducer and a motor. The other end is fixed to the end of the third arm 123 and can be moved linearly in the horizontal direction. The third arm sensor unit 1008 measures the forward / backward movement of the third arm 123 based on the change of the third arm drive belt 1009 driven by the drive unit 1002. The timing belt pulley and the cable guide for assisting the linear movement of the wiring are arranged so as to be included in the second arm 122 and the third arm 123. A cable guide 1010 for connecting the signal line and the power line to the third arm 123 is provided between the two ball linear guides 1001 arranged in parallel to assist the linear movement of the wiring.

  As with the horizontal robot arm 110, a biaxial gimbal mechanism 1003 having an encoder is attached to the tip of the third arm 123, and the endoscope holder 114 can be attached on the axis thereof. The endoscope holder 114 is configured so that a generally used endoscope 1004 can be attached to it. By using the endoscope holder 114 adapted to the shape of the endoscope as necessary, it is possible to attach endoscopes of various manufacturers, functions, and shapes to the surgery assistance device. A brake release switch 1011 is arranged near the tip of the third arm 123.

  The first arm connection plate 1006 attached via the connection bearing 1005 that allows the moment is equipped with the speed reducer 1007, and the power of the second arm drive motor 1012 is transmitted by the timing belt pulley, thereby rotating in the vertical direction. It is possible to rotate in the horizontal direction around the axis. It should be noted that a speed reducer having a hollow structure capable of allowing a moment may be directly attached to the connecting portion between the first arm 121 and the second arm 122 without the first connecting plate 1006.

  The biaxial gimbal mechanism 1003 at the tip of the third arm 123 is a passive joint that does not have a power unit similar to the horizontal robot arm 110, but the position of the robot medical device 127 can be increased by including both absolute encoders. Can be determined using forward kinematics. In addition, in order to suppress the effects of minute vibrations during robot arm movement and minute movements caused by patient breathing, an elastic mechanism (damper, resin spring, metal spring in the rotation direction) or auxiliary power is used to stabilize the posture. It may have a function of avoiding the eccentricity and peculiar posture.

<Vertical drive joint>
Next, with reference to FIG. 11, the vertical drive joint portion of the linear motion robot arm 120 will be described. The first arm 121 is driven by a nut rotation type ball screw. Therefore, the ball screw shaft 1101 is fixed to the second frame 102, and a drive unit 1102 including a nut that enables rotation, a motor that drives the nut, a motor, a speed reducer, and an encoder is provided under the first arm 121 that is the drive side. Have. For this nut rotation type ball screw, generally used mechanical parts can be used.

  Like the horizontal robot arm 110, the first arm 121 is equipped with a counter weight 1103 for compensating its own weight, which is connected by a wire, so that the output of the motor in the drive unit 1102 can be suppressed and the robot arm can be easily operated by direct contact. Allows you to move to. The counterweight 1103 is divided into two or more parts on the second frame 102 via the support pulley 1106 and the like, so that the safety of the wire is improved and the size of the entire device is reduced. The movement of the cable or the like extending from the second frame 102 to the first arm 121 is assisted by the cable guide 1105. The use of the counterweight 1103 is not essential, and a constant load spring may be used.

  The first arm 121 is connected to the second arm 122 via a connecting portion 1104, and the second arm 122 is connected to the connecting portion 1104 so as to be rotatable about a vertical axis.

  By connecting the endoscope 1004 to the mechanism of the linear motion robot arm 120 shown in FIGS. 10 to 11 via the endoscope holder 114, a 5-axis mechanism equivalent model as shown in FIG. 12 is obtained. By inserting the endoscope distal end portion having this five-axis degree of freedom into the robot-side outer tube 125 attached to the patient's abdomen, the two-axis degree of freedom is fixed, and the insertion point is used as the center of rotation for endoscopy. The position of the tip of the mirror can be controlled three-dimensionally within the body cavity.

(Sharing of screw shaft)
There are a wide variety of diseases to which laparoscopic surgery is applied, and the surgical procedures are also diverse. The height of the operating table 151 shown in FIG. 1 (b) may be vertically movable up to about 500 mm depending on the operation method, the patient's body type, the height of the operator, and the like. The surgical operation support apparatus according to the present embodiment can also secure an operation amount that can cope with the operating table height that changes according to changes in the situation.

  Generally, the height of the entire device is increased in order to secure a wide operation amount. However, the height of the operating table does not always move during the operation, but is determined by factors such as the above-mentioned operation method at the start of the operation, and the movement during the operation is not so large. Therefore, in the present embodiment described below, the operation range that is always movable during the operation and the operation range that is changed according to the height of the operating table are mechanically separated and shared, thereby suppressing the device size. It is designed to ensure a sufficient operating range. Specifically, FIG. 13 schematically shows the relationship between the two frames (the second frame 102 and the third frame 103) and the first arm 121 of the linear motion robot arm 120 according to the present embodiment. . Further, FIG. 14A shows a state in which the horizontal robot arm 110 is attached to the third frame.

  For example, if an attempt is made to secure an operation range in which the displacement of the height of the operating table 151 and the operation range of the surgical instrument manipulator are added to the vertical drive joint portion of the horizontal robot arm 110, a tall frame is required. The height of the linear motion robot arm 120 also becomes high. Therefore, for displacement of the height of the operating table, the third frame 103 is moved up and down to adjust the height. Then, in order to control the operation of the handheld medical device 131, two horizontal robot arms 110 (that is, the first arms 111) connected to the third frame 103 are individually operated in the vertical direction so that a two-step stroke is performed. Can be secured. As is clear from FIG. 13 and FIG. 14A, the third frame 103 and the first arm 121 of the linear motion robot arm 120 are attached to a common support member so as to be able to move forward and backward, so that not only the height direction but also the device The whole can be miniaturized.

  FIG. 14B shows a cross-sectional view of each frame according to this embodiment. The third frame 103 and the first arm 121 of the linear motion robot arm 120 are U-shaped so that they can be arranged in a stack while maintaining high rigidity with respect to the moment in the tilting direction. Furthermore, by arranging the ball screw shaft 1101 in the center of the device and sharing the parts, the device can be downsized.

  In general, many ball screws have a bearing attached to the shaft end, a nut is fixed to the driving side, and a screw shaft is rotated to make a linear motion. On the other hand, in the present embodiment, a nut rotation type ball screw is used in order to enable two linear motions (that is, linear motions of the third frame and the first arm 121) by using one screw shaft 1101. . By sharing the screw shaft, when the third frame 103 moves up, the first arm 121 of the linear motion robot arm 120 also moves up, so that the lower limit operation range of the first arm 121 becomes narrow. However, since the first arm of the linear motion robot arm 120 does not need the lower limit operation range according to the height of the operating table 151, no practical problem occurs. That is, in the linear motion of the third frame and the first arm 121, sharing one screw shaft 1101 does not cause a practical inconvenience that restricts the movable range of the robot arm necessary for the surgery. Therefore, it is possible to realize the miniaturization and the cost reduction that are well known.

(Operating range of each robot arm)
Partial spherical ranges 1501 to 1503 shown in FIGS. 15A and 15B represent examples of the movable range of the arm tip of each robot arm when the robot medical instrument 127 is inserted into the body cavity. The center of this spherical range is the position where the mantle tube of the patient's abdomen is inserted, and the trajectory corresponding to the surface of the spherical range is the arm at the position where the tip of the robot medical instrument 127 is most pulled out from the robot side mantle tube 125. It is a representation of the tip. Although the movable range of the robot arm alone is different from this, when the arm tip is separated from the mantle tube insertion position by more than the length of the shaft of the robot medical instrument 127, the surgical instrument tip part is pulled out from the mantle tube. The spherical range shown indicates the maximum movable range of the arm tip when the robot medical device 127 is inserted.

  The space 1505 immediately above the insertion point 1504 of the robot medical device 127 into the outer tube is excluded from the movable range because it has a peculiar posture of the biaxial gimbal mechanism 301. The linear motion robot arm 120 that supports the endoscope 1004 also has a similar movable range (for example, 1503), but in order to minimize the interference of the movable range with the horizontal robot arm 110, a symmetrical spherical range operating range. have. In actual surgery, this operating range is not always operated, but it is concentrated on the lower abdomen, upper abdomen, etc., so it is considered that the range of the shape that is about half of this spherical range will be the continuous operating range. . As shown in FIG. 15 (a), since the movable ranges of the arm tip portions are often overlapped with each other, the horizontal robot arm 110 having a symmetrical structure with respect to the vertical plane is suitable. The vertical robot arm 120 is suitable as an arm capable of supporting the mirror 1004.

  Further, as is clear from FIG. 1B, the configuration for suppressing the interference of each robot arm from the movable range of the distal end portion of the robot arm at the time of inserting the surgical tool is performed by using the handheld medical instrument 131. Therefore, it is possible to avoid the interference with the hand and arm of the operator who operates the robot arm that supports the robot medical instrument 127, and at the same time to secure a sufficient operation range. Note that the linear motion robot arm 120 supporting the endoscope 1004 may include the hand side on the operator side in the same movable range (1503), but the endoscope moves the distal end of the hand-held medical instrument 131. Since it moves like this, the direction of the endoscope and the direction of the handheld medical device 131 match. That is, the interference between the direction of the endoscope and the handheld medical device 131 can be suppressed.

  It should be noted that the movable range shown in FIG. 15 is an example, and it is not necessary to be strictly within this range, and it can be reduced, expanded, or deformed within the mechanical operation limit range of the robot arm in accordance with a surgical technique or the like.

(Robot arm failure detection system with active joints)
The surgery support apparatus 200 described above may further include a failure detection system for the active joint portion of each robot arm. To realize the failure detection system, servo motors with incremental encoders are used for all the motors that drive each robot arm. Further, a non-excitation actuated brake may be provided on the input side or the output side of the speed reducer, and an absolute encoder may be provided on the output side.

  With this configuration, when the operation instruction is given to the robot arm, it may be determined whether or not a difference in the operation amount on the output side with respect to the command value of the motor is detected. When it is determined that the difference is detected, it is possible to detect power transmission abnormality between the motor and the speed reducer, damage to the speed reducer, and power transmission abnormality at the final output shaft from the speed reducer. The power transmission here includes, for example, a gear, a timing belt pulley, a ball screw, and a wire.

  On the other hand, even when the robot arm is in the standby state where no operation instruction is given, when an external force is given to the robot arm, the difference between the output encoder and the motor encoder can be detected. Therefore, it is determined whether a difference is detected between the output side encoder and the motor encoder when an external force is applied, and when it is determined that a difference is detected, an abnormality such as external contact of the robot arm is detected.

(Initialization process)
Each robot arm of this embodiment has a passive joint. Therefore, as described above with reference to FIGS. 9 and 12, by inserting the surgical instrument into the mantle tube attached to the abdomen of the patient and determining the insertion point 901, for example, the control unit 201 causes the robot medical device in the body cavity. The position of the tip of 127 can be calculated and specified. For example, as shown in FIG. 16, by performing initialization processing on each robot arm in a predetermined procedure, work for allocating the inserted outer tube and position information of the insertion point 901 necessary for controlling the robot arm are obtained. You can

  A series of operations of the initialization process will be described with reference to FIG. The operation in the initialization mode shown in FIG. 17 is executed by the control unit 201 loading a program stored in the recording medium 204 into the memory 205 and executing the program. The initialization process is started in a state where the operation mode of the surgery support apparatus is set to the initialization mode in advance by an operation of the operation unit 202 (for example, a foot switch) by the operator.

  In step S <b> 1701, the control unit 201 detects an instruction (for example, switch depression) by the operator's contact with the brake release switch 311 or the vector operation switch 801 of the first robot arm that is not inserted into the robot side outer tube 125.

  In step S1702, the control unit 201 controls the robot arm corresponding to the initialization mode. The control unit 201 may switch to either the brake release mode or the vector operation mode included in the initialization mode according to the pressed switch. For example, when the brake release switch 311 is pressed, the control unit 201 sets the operation mode to the brake release mode and controls the robot arm to release the brake of the target robot arm. When the vector operation switch 801 is pressed, the control unit 201 switches the operation mode to the vector operation mode and controls the robot arm according to the instruction to the vector operation switch 801.

  In step S1703, the control unit 201 determines whether the brake release switch 311 or the vector operation switch 801 of another robot arm is pressed in the initialization mode for the specific robot arm. If the control unit 201 determines that the brake release switch 311 or the vector operation switch 801 of another robot arm has been pressed, the process proceeds to step S1703, and if not, the process proceeds to step S1704.

  In step S1704, the control unit 201 displays, on the display unit 203, a message warning that the robot arm should be moved for each robot arm in the initialization mode. This warning is not limited to the one displayed on the display unit 203, and a warning sound may be generated from a voice output unit (not shown) or tactile feedback may be given to another operated robot arm.

  In step S1705, the control unit 201 monitors the insertion of the robot medical device 127 into the robot-side mantle tube 125 based on the output from the robot-side insertion depth measuring unit 126.

  In step S1706, the control unit 201 controls the operation of the robot arm in response to a manual operation by the operator (an operation on the grip including the brake release switch 311 or an operation on the vector operation switch 801), and the robot medical instrument 127 is covered with the robot-side mantle. Insert into tube 125.

  In step S1707, the control unit 201 detects that the robot-side insertion depth measuring unit 126 has inserted the robot medical device 127 into the robot-side outer tube 125 that has not been inserted. In step S1708, the control unit 201 associates the manually operated robot arm with the robot side outer tube 125 that has detected insertion.

  In step S1709, the control unit 201 determines whether the robot arm has been removed from the robot-side outer tube 125 based on the signal from the associated robot-side outer tube 125. If it is determined that the robot arm has been removed, the process proceeds to S1710, and if not, the process proceeds to S1711. In step S1710, the control unit 201 displays a warning message on the display unit 203 so as not to remove the robot arm until the initialization process is completed.

  In step S1711, the control unit 201 calculates the position of the insertion point 901. The calculation of the position of the insertion point will be described later. In step S1712, the control unit 201 determines whether all the robot-side mantle tubes 125 are associated with the robot arms. If it is determined that all robot-side mantle tubes 125 are not associated with the robot arms, the control unit 201 proceeds to step S1701. Return. On the other hand, when it is determined that the robot arms are associated with all the robot-side outer tubes 125, the operation mode of the surgical operation support device is switched to the original operation mode, and the initialization process ends.

  Two methods are shown as examples of the method of calculating the insertion point 901 in S1711 of the initialization processing. One is that the position of the robot medical instrument 127 detected by the robot-side insertion depth measuring unit that also operates as an insertion detection sensor is the insertion point. By doing so, the control unit 201 can calculate the position of the insertion point in the robot coordinate system from the link length, the surgical tool length, and the joint angle using forward kinematics.

Another method is to calculate from the posture of the surgical instrument manipulator. As shown in FIG. 18, the rotation centers of the gimbal mechanism in two given postures are P ₁ and Q ₁ , and the tip coordinates of the robot medical instrument 127 at that time are P ₂ and Q ₂ . Ideally, the centers of rotation should be the same in each of these postures, but due to the bending of the abdominal wall, etc., the positions are twisted as shown in FIG. Therefore, in this method, the point x between these postures is used as the insertion point (center of rotation).

In order to obtain the coordinates of the insertion point x, the points S ₁ and S _{2 at} which the perpendiculars drawn from the respective straight lines intersect are calculated according to the following formula.
Here, n ₁ and n ₂ are unit vectors representing the posture of the surgical instrument manipulator, and PQ ₁₁ is a vector from P ₁ to Q ₁ .

Once the points S ₁ and S ₂ are found, the point x between them is
Can be asked according to. Even when obtaining the position of the rotation center from more postures, it is possible to obtain intermediate points by the same method as the method obtained here and average them to be used as the rotation center.

  In step S1711, the control unit 201 calculates the position of the insertion point by using one or both of the above calculation methods. As a result, the control unit 201 identifies the position of the robot-side mantle tube 125 on the spatial coordinates (robot coordinate system) of the surgery support apparatus 200, and determines each position according to the insertion angle and the insertion depth of the handheld medical device into the body cavity. It becomes possible to control the operation of the robot arm.

  The insertion point may change in the robot coordinate system during the operation due to slight movement of the patient's peritoneum. However, in this embodiment, since the robot arm has the biaxial gimbal mechanism 301 of the passive joint, the insertion point (unlike the robot arm that supports the insertion point by the RCM (Remote Center of Motion) mechanism) It is possible to follow and detect minute movements. When the position of the insertion point changes, the control unit 201 executes the calculation method shown in FIG. 18 at a predetermined time interval in the loop for controlling the robot arm using the hand-held surgical tool, so that the robot at the insertion point 901 is moved. The deviation in the coordinate system can be corrected at any time. That is, the operation accuracy of the tip of the robot medical device 127 can be kept high.

  The operator-side mantle tube 135 may be performed by a method different from the method of specifying the position of the insertion point of the robot-side mantle tube 125, but may be performed by using a robot arm inserted into the robot-side mantle tube 125. Good. For example, after initializing the robot-side outer tube 125 corresponding to each robot arm, one of the two robot medical instruments 127 is removed from the assigned outer tube and inserted into the operator-side outer tube 135. By doing so, it is possible to acquire the position information of the operator-side outer tube 135 in the robot coordinate system.

(Semi-automatic towing mode)
As described above, the surgery support device 200 is used to assist the surgeon's surgical procedure with the robot arm. For example, when the surgery support device 200 is used, the robot medical instrument 127 holds an organ and fixes it in place to secure an operative field, or the robot medical instrument 127 holds a needle thread to perform needle operation or the like. , The endoscope can be moved to the intended position.

  Here, the semi-automatic pulling mode of the surgery support apparatus 200 will be described by taking as an example a state in which the robot medical instrument 127 pulls an organ and is fixed. The operator performs some kind of treatment (generally, cutting, etc.) on the organ, but since the robot medical device 127 remains spatially fixed, the cutting progresses and the shape of the organ changes. Then, the traction force may gradually weaken. Similar to when a human pulls as an assistant, if the pulling force on the organ can be easily adjusted according to the progress and situation of the surgery by the operator, the surgery can be performed more smoothly.

  Therefore, in the semi-automatic traction mode of the surgery support apparatus 200, the traction force when using the robot medical device 127 can be easily adjusted. It should be noted that although the operator uses the switch attached to the hand-held medical device 131 included in the operation unit 202 to switch the operation mode of the surgery support apparatus 200 to the semi-automatic traction mode, the operation will be described as an example, but other operation means. May be used, and switching is not limited to a physical switch, but may be based on voice recognition or gesture recognition.

  First, the surgeon controls the robot arm by using, for example, a surgical tool used for treatment, and causes the robot medical instrument 127 to pull the organ. At this time, the control unit 201 temporarily records the trajectory of the tip coordinates of the robot medical device 127 in the memory 205 from the start to the end of the operation on the robot medical device 127. The control unit 201 calculates the direction (referred to as the pulling direction) that was moving immediately before the end of the operation, from the recorded locus. However, the pulling direction is not limited to the direction obtained by the last sampling, and may be the direction obtained by integrating or averaging the movement of the tip position in the predetermined period immediately before the end of the operation.

  In response to the detection of the switching operation to the semi-automatic pulling mode, the control unit 201 controls the robot arm so that the tip coordinates of the robot medical instrument 127 move only in a certain direction that matches the pulling direction (the medical instrument 127. Limit the movement of the tip position). That is, in the normal operation mode in which the distal end position of the robot medical instrument 127 is controlled using a surgical tool, it is necessary to perform positioning with 6 degrees of freedom by operating the surgical tool. The traction force can be adjusted simply by operating.

  In the semi-automatic pulling mode, adjustment of the size and speed of moving the tip position in the pulling direction is not limited to the operation using the surgical tool, but a foot switch or the like of the operation unit 202 may be used, or a new switch or the like may be used. You can add more. For example, in the semi-automatic traction mode, the control unit 201 increases the traction force when it detects that the surgical instrument held by the operator has rotated right around the shaft, and weakens the traction force when it detects that the surgical instrument has rotated left. , May be controlled. Other methods may be used as long as the speed with one degree of freedom can be changed.

  As described above, in the surgery support apparatus according to the present embodiment, the posture of the robot medical instrument 127 that is inserted into the body cavity and can be mechanically driven can be controlled using the handheld medical instrument 131 that is inserted into the body cavity. did. Then, when the operation mode of the surgery support device is a mode of operating the robot arm, the operation of the robot arm is controlled according to the posture of the hand-held surgical instrument. On the other hand, when the operation mode is the manual operation mode, the operation of the robot arm is controlled according to the manual operation on the robot arm. By doing so, it is possible to provide a surgery support device that does not require a console that is difficult to install in the operating room and that can operate the robot arm with a simple operation. Further, since it can be operated by a minimum number of operators, interference between the robot arm and the operator is reduced.

  Further, the frame for mounting the horizontal robot arm and the vertical movement of the linear motion robot arm are realized by using a common supporting member. By doing so, it becomes possible to reduce the size and cost of the surgery support device.

  It should be noted that each of the configurations of the surgery support device described above may be realized as a separated or integrated configuration. Further, the present invention is applicable to a case where a control unit including one or more processors reads and executes a program of a computer that executes the above-described processing, and obtains the program via wired communication or wireless communication. This may be included in the case of executing the above.

  110 ... Horizontal robot arm, 120 ... Linear motion robot arm, 126 ... Robot-side insertion depth measuring unit, 131 ... Handheld medical instrument, 132 ... Operation tool operation measuring unit, 136 ... Surgeon-side insertion depth measuring unit, 201 ... Control unit

In order to solve this problem, for example, the surgery support device of the present invention has the following configuration. That is, a plurality of robot arms that control the posture of the surgical instrument that is inserted into the body cavity and that is interposed between the distal ends of one or more robot arms of the plurality of robot arms and the surgical instrument are provided. A gimbal mechanism that can rotate around the rotation axis,
A surgery support apparatus comprising: a control unit that controls the operations of the plurality of robot arms in accordance with an operation by an operator, wherein each of the plurality of robot arms is a joint unit rotatable about a vertical axis. Is a robot arm having three degrees of freedom, which is a combination of a joint part that performs linear motion, and the control means controls the joint part of the robot arm to insert an angle of the shaft of the surgical instrument into the body cavity. And the insertion depth, and the position of the tip of the robot arm and the two of the gimbal mechanism when the surgical instrument is inserted into the body cavity or in the state where the surgical instrument is inserted into the body cavity . by using a set of the angle around the rotation axis at least, calculate the insertion angle and serving as a reference of the insertion point position of the insertion depth into the body cavity of the shaft of the surgical instrument To, characterized in that.

Claims (7)

A plurality of robot arms that control the posture of the surgical tool inserted into the body cavity and used,
A gimbal mechanism that is interposed between the tip of one or more robot arms of the plurality of robot arms and the surgical instrument, and is rotatable about two rotation axes;
A control means for controlling the operation of the plurality of robot arms according to an operation by an operator,
Each of the plurality of robot arms is a robot arm having three degrees of freedom, which is a combination of a joint part rotatable about a vertical axis and a joint part performing a linear motion.
The control means controls an insertion angle and an insertion depth of the shaft of the surgical instrument into the body cavity by controlling a joint portion of the robot arm, and controls an angle around the two rotation axes of the gimbal mechanism. Based on the above, the position of the reference point of the insertion angle and the insertion depth of the shaft of the surgical instrument into the body cavity is calculated. Further comprising operation means for receiving an operation including contact by the operator,
The control means controls the operation of the robot arm corresponding to the operating means such that the distal end position of the surgical instrument moves in a certain direction in response to the operation including the contact being received by the operating means. The surgical operation support apparatus according to claim 1, wherein:   When the surgical instrument is not inserted into the body cavity, the control means determines an insertion angle of the shaft of the surgical instrument into the body cavity in response to the tip of the shaft of the surgical instrument being inserted into the body cavity. The surgery support apparatus according to claim 1 or 2, wherein the position of the reference point of the insertion depth is calculated.   The control means, in response to the tip of the shaft of the surgical instrument being inserted into the mantle tube inserted into the body cavity, sets the reference point of the insertion angle and the insertion depth of the shaft of the surgical instrument into the body cavity. The surgical operation support apparatus according to claim 3, wherein a position is calculated. A plurality of robot arms that control the posture of the surgical tool inserted into the body cavity and used,
A control means for controlling the operation of the plurality of robot arms according to an operation by an operator,
The plurality of robot arms are
A first arm attached to a linearly movable joint that can advance and retreat in the vertical direction, a second arm that is connected to the first arm by a joint that rotates around an axis in the vertical direction, and a second arm that is vertical to the second arm. A first robot arm having a third arm connected to the second arm at a joint that rotates about an axis;
A second arm that includes a fourth arm that can move back and forth in the vertical direction, a fifth arm that moves by rotation about an axis in the vertical direction, and a sixth arm that is attached to the fifth arm and that can move in the horizontal direction A surgical support device, comprising: a robot arm.   It has a first base to which the linear motion joint is attached and a second base to which the fourth arm is attached, and the first base is attached to the second base so as to be able to move back and forth in the vertical direction. The surgery support device according to claim 5.   The surgery support device according to claim 6, wherein the first base and the fourth arm move forward and backward along a common vertical axis.