JP6546361B1 - Surgery support device - Google Patents

Abstract

A surgical operation 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. A surgery support apparatus according to the present invention includes a plurality of robot arms for controlling the posture of a surgical tool inserted into a body cavity and used, a tip of one or more robot arms of the plurality of robotic arms, and a surgical tool A surgical support apparatus comprising: a gimbal mechanism rotatable about two rotation axes; and control means for controlling the motion of the plurality of robot arms in accordance with the operation by the operator, Each of the robot arms is a robot arm having three degrees of freedom in which a joint capable of rotating around a vertical axis and a joint performing a linear motion are combined, and the control means is a joint of the robot arm. The control controls the insertion angle and insertion depth of the surgical tool shaft into the body cavity, and based on the angle around the two rotation axes of the gimbal mechanism, to the body cavity of the surgical tool shaft It calculates the position of the reference point of the insertion angle and insertion depth. [Selected figure] Figure 2

Description

  The present invention relates to a surgery support device.

  In laparoscopic surgery, generally, a doctor who performs 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 vision of the operator Therefore, it is performed by a doctor (hereinafter referred to as an “assistant”) who performs traction of an organ, tension maintenance at the time of incision, and the like. A surgery support device (also referred to as a surgery support robot) used for laparoscopic surgery is required for surgery by controlling the posture of a surgical tool such as a forceps, an endoscope, or an electric knife with one or more robot arms. Some are trying to ease the number of doctors.

  For operation of the surgery support device, the console type operated by the doctor from the control unit of the surgery support device and the robot arm that holds only the endoscope control the robot arm while the surgeon performs the surgical procedure in some way There is a method to

  Conventional surgery support devices used for laparoscopic surgery can be roughly divided into those for performing operations of three persons, a surgeon, a practitioner and an assistant, and those for holding an endoscope with one arm. What plays the role of an operator, a scopist and an assistant is a console type operation support robot, and one having a plurality of robot arms disposed around and above a patient is known (Patent Document 1, Patent Document 2).

  On the other hand, there is also known a surgery support robot having only one endoscope with one robot arm (Patent Document 3). The operation 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 6-30896 A

  In the console type surgery support robot disclosed in Patent Document 1, the device size is large, and it may be difficult to optimize the positional relationship between the patient and the robot by the balance with other devices in the operating room. Although the console type may be capable of remote control in some cases, it is usual to set up the operation console in the operating room where the patient and robot are located, for observation of appearance of the patient and communication with the nurse. Has become one of the factors that The console type surgery support robot disclosed in Patent Document 2 requires a complex and large console in order to operate a large number of 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 one arm robot, the device size can also be suppressed. However, work by an assistant or the like is still required, and the robot arm approaches near a plurality of people, so a sufficient operation area of the robot arm can not be secured, or the robot arm interferes with the operator or assistant, affecting the surgical procedure. Give. Moreover, when using the operation means by voice, it can be easily imagined that it is difficult to operate as intended when operating a complicated surgical tool different from the endoscope.

  The present invention has been made in view of the above problems. That is, it is an object of the present invention to provide a surgery support device that can operate a robot arm with a simple operation without requiring a console that is difficult to install in an operating room.

In order to solve this problem, for example, the surgery support device of the present invention has the following configuration. That is, there are two robot arms interposed between a plurality of robot arms for controlling the posture of the surgical tool inserted into the body cavity and used, the distal end of one or more robot arms of the plurality of robotic arms, and the surgical tool A gimbal mechanism rotatable around the rotation axis;
And a control unit configured to control operations of the plurality of robot arms in response to an operation by the operator, wherein each of the plurality of robot arms has a joint portion rotatable around an axis in the vertical direction. The robot arm having three degrees of freedom in which the arm and the joint unit performing linear motion are combined, and the control means controls the joint unit of the robot arm to insert the shaft of the surgical instrument into the body cavity Position of the robot arm and the gimbal mechanism when the surgical tool is inserted into the body cavity or in a state where the surgical tool is inserted into the body cavity , and controlling the insertion depth and the insertion depth. 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.

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

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

  Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the drawings. The surgery support device according to the present invention includes a robot arm that controls the posture of an operation tool or an end effector inserted through a mantle tube into a body cavity of a patient. The surgery support device measures the insertion angle and the insertion depth of a surgical tool (hereinafter, also referred to as a hand-held medical tool) which is inserted into a body cavity by the operator and is actually used for surgery. And according to a measurement result, it is comprised so that the robot arm 100 for controlling the attitude | position of a surgical instrument or an end effector (it is also called a robot medical instrument collectively below) may be controlled.

(Outline of Robot Arm 100 Related to Operation Support Device)
FIGS. 1A and 1B 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 at the time of using the surgery support apparatus 200 assumed in the present embodiment. , The state of the operating table 151 is shown. The robot arm 100 according to the present embodiment is composed of two horizontal robot arms 110, one linear motion robot arm 120, and a plurality of frames (bases).

  The first frame 101 comprises active and / or passive wheels so that the patient and the robot arm 100 can be arranged 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 the direction perpendicular to the second frame 102. On the third frame 103, two three-axis horizontal articulated robot arms (simply referred to as horizontal robot arms 110) having joints having freedom in the horizontal direction are attached. Further, a 3-axis linear motion articulated robot arm (also referred to simply as a linear motion 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.

  The surgical tool manipulator 124 is attached to the tip of the horizontal robot arm 110 via a gimbal mechanism configured to be rotatable about two axes. The surgical tool 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 tool manipulator 124 includes a plurality of motors generating a plurality of independent rotational powers, and the respective powers are transmitted, for example, within the shaft of the robotic medical instrument and transmitted to the distal end of the robotic medical instrument.

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

  Similar to the horizontal robot arm 110, the linear motion robot arm 120 has a gimbal mechanism configured to be rotatable about two axes at its tip. The linear motion robot arm 120 includes an endoscope holder capable of attaching a general endoscope to a 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 degree of freedom in the horizontal direction, and the second arm 122 and the first arm 121 have a degree of freedom in horizontal rotation. Are connected by active joints. By connecting the first arm 121 to an active joint having a degree of freedom in the vertical direction (longitudinal direction of the third frame 113), 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 of the hand of the linear motion robot arm 120 can be moved three-dimensionally, and thus, into the body cavity of the endoscope (robot medical instrument) The insertion angle and insertion depth of the are controlled.

(Configuration of surgery support device 200)
In FIG. 2A and FIG. 2B, a hand-held medical instrument and a robot medical instrument are inserted into a body cavity in the functional configuration example of the surgery support apparatus 200 according to the present embodiment and the use of the surgery support apparatus 200. The situation is shown schematically. The surgery support device 200 controls the operation of the robot arm based on the operation of a surgical tool (i.e., a hand-held medical tool) used by the operator during surgery, not a general console-type master slave.

  The hand-held medical instrument 131 is a surgical instrument which the operator actually moves by hand to carry out a routine procedure, and is inserted into the body cavity through the operator-side external cannula 135 inserted into a small diameter hole opened in the abdominal wall 150 . The hand-held medical instrument 131 includes, for example, a forceps, a forceps, an electric scalpel, a suction tube, an ultrasonic coagulating and cutting device, a hemostatic device, a radiofrequency cautery device, a medical stapler, and a needle holder used by inserting into a body cavity. The operation tool operation measurement unit 132 attached to the hand-held medical instrument 131 and the operator-side insertion depth measurement unit 136 attached to the operator-side outer tube 135 measure the insertion angle and insertion depth of the hand-held medical instrument 131 with respect to the body cavity Do.

  The robot medical instrument 127 passes through the robot-side mantle tube 125 inserted in a small diameter hole made in the abdominal wall 150, and a part thereof is inserted into the body cavity. For example, the robot medical instrument 127 is, for example, a forceps, a forceps, an electric knife, a suction tube, an ultrasonic coagulating and cutting device, a hemostasis device, a radiofrequency cautery device, a medical stapler, a needle holder, It includes an endoscope, a thoracoscope, a laparoscope and the like, and its shape may be linear or have a flexion joint. In the example of the present embodiment, the linear motion robot arm 120 mounts an endoscope as the robot medical instrument 127 via the endoscope holder 114. In addition, the horizontal robot arm 110 mounts a forceps, an electronic knife or the like as the robot medical instrument 127 via the surgical instrument manipulator 124. The posture of the tip of the medical instrument such as a forceps attached via the surgical instrument manipulator 124 is controlled by driving the surgical instrument manipulator 124. In the present embodiment, the term “robot arm” refers to the surgical tool manipulator 124 included in the robot arm. Further, although the case where the robot medical instrument 127 and the surgical instrument manipulator 124 are separate bodies will be described as an example, the robotic medical instrument 127 and the surgical instrument manipulator 124 may be integrated as a surgical instrument.

  The robot-side insertion depth measurement unit 126 can detect that the robot arm has been inserted into the robot-side outer tube 125. Also, 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 sheath tube 125. The robot-side insertion depth measurement unit 126 may only have a configuration that can detect that the robot arm has been inserted into the robot-side outer tube 125. In this case, information on position and orientation can be obtained according to the output from the encoder of the robot arm. In addition, the robot-side insertion depth measurement unit 126 may be configured to be separately attached to the robot-side sheath tube 125 and the robot medical instrument 127 like a transmitter or a receiver. It may be configured to be attached only.

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

  The operator-side insertion depth measurement unit 136 includes one or more distance sensors attached to the operator-side cannula 135, and measures the insertion depth of the hand-held medical instrument 131 into the body cavity. In this embodiment, an example in which the operator-side insertion depth measurement unit 136 is attached to the operator-side sheath tube 135 will be described. However, the operator-side insertion depth measurement unit 136 may be separately attached to the operator-side sheath tube 135 and the hand-held medical instrument 131 like a transmitter or a receiver, or the hand-held medical instrument 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 entire operation of the surgery support apparatus 200 by reading out a program stored in the recording medium 204 to 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 device based on an 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 instrument according to the insertion angle and insertion depth of the shaft of the hand-held medical instrument 131 into the body cavity. The operation mode of the surgery support apparatus is a mode for operating the hand-held medical instrument 131 for treatment and actually performing the treatment (also referred to simply as a treatment mode) and a mode for operating the robot medical instrument 127 using the hand-held medical instrument 131 (Also simply referred to as robot operation mode). Also, although the details will be described later, the mode 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, for example, a switch attached to the hand-held medical instrument 131 and an operation member such as a foot switch that can be operated by the operator with a 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 select one arm to be controlled using the operation unit 202.

  Thus, according to the operation of the hand-held medical instrument 131 operated by the operator, the robot medical instrument 127 is configured to be operable, so that, in conventional laparoscopic surgery, usually three doctors perform the operation. The operator can operate the robot arm and perform the same operation while performing the same operation as an operation that manipulates a surgical tool.

(Details of 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 (of the third arm 113) of the horizontal robot arm 110 has a two-axis gimbal mechanism 301 to which the surgical tool manipulator 124 can be attached. FIG. 4 is an enlarged view of the tip (of the third arm 113) of the horizontal robot arm 110. As shown in FIG. The gimbal mechanism 301 is configured to be rotatable about the two rotation axes 401 and 402 shown in FIG. 4, and these rotation axes 401 and 402 are axes of the surgical tool shaft of the robot medical tool attached to the surgical tool manipulator 124. Intersection with 403 The gimbal mechanism 301 is a passive joint that does not have a power unit, but includes an encoder that measures rotation around each rotation axis. For example, by providing the absolute encoder with two axes, it is possible to obtain the position and orientation of the robot medical instrument 127 using forward kinematics. In addition, the horizontal robot arm 110 is an elastic mechanism (for example, a damper in the rotation direction) for suppressing the influence of the minute vibration at the time of operation and the minute movement due to the patient's breathing and stabilizing the posture and avoiding the singular posture. Or a 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 for driving the third arm 113, a non-excitation operation brake, and a reduction gear. The third arm 113 and the second arm 112 have freedom only in the horizontal direction rotation, and the third arm 113 similarly receives the power output from the third arm drive unit 302 by the timing belt 307 by the 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 where the third arm 113 and the second arm 112 are connected. Also, a bearing 304 is provided on the rotational axis of this joint.

  The first arm 111 supports the second arm 112 with a C-shaped frame. The third arm 113, the second arm 112, the surgical instrument manipulator 124, the robot, and the like are arranged by arranging the reduction gear 305 having a moment acceptable bearing on one side and arranging the auxiliary bearing 306 for the auxiliary purpose in the pair. It is possible to disperse the moment load generated from the 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 means of the drive belt 310, and the second arm 112 is connected to the joint (the third arm 113 and the second arm 112 are connected Rotate around the rotation axis of In addition, by distributing each mechanism section in the first frame 111, a large hollow structure is secured, and it is possible to attach an encoder 308 for detecting the wiring and the rotational position of the second arm 112 with respect to the first arm 111. Although the example shown in FIG. 3 arranges the reduction gear 305 which incorporated the bearing which can accept a moment in the lower part in the 1st frame 111 and makes the upper part hollow structure, these arrangements are reverse. May be

  In the present embodiment, in order to miniaturize the horizontal robot arm 110, the case where the output mechanism such as the reduction gear 305 and the second arm drive unit 309 is flat is described as an example. For example, it is possible to use a wave gear reducer or a cycloid reducer capable of high speed reduction even with a flat type, a flat type motor with an increased output of the motor itself, or a direct drive motor directly attached to a joint. The bearings used for the four revolute joints can be cross roller bearings or four-point bearings in order to be able to be configured compactly while accepting moments.

<Vertical drive joint>
FIG. 5 shows a linear motion joint portion of the horizontal robot arm 110. The translation joint is incorporated into the third frame 103. The linear motion mechanism for driving the first arm 111 is capable of sufficiently accepting the self-weight moment of the third arm 113 from the first arm 111 and the external force received by the arm, and the ball linear guide 501 for causing smooth movement is vertical Arrange two in parallel in the direction.

  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 disposed parallel to the ball linear guide 501. The drive motor 504 transmits rotational power to the timing belt 505 to drive the timing belt 505 with the timing pulley, thereby actively advancing and retracting 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 movement of the first arm 111 in the vertical direction based on the amount of movement of the drive belt 505 that has advanced and retracted. The position detection control unit 510 also includes a brake mechanism to apply a brake to maintain the posture in the operation of the support block 502 (ie, the linear motion of the horizontal robot arm 110). In the present embodiment, an example using a brake mechanism will be described, but the brake mechanism may not be used. In that case, for example, a state where the drive motor 504 generates a driving force for maintaining the posture is maintained. A counterweight 507 is connected to the power transmission plate 503 by a traction wire 506 supported by a support pulley 511.

  The counter weight 507 can suppress the output of the drive motor 504 that drives the first arm 111 to the third arm 113, the surgical tool manipulator 124, and the robot medical instrument 127 by compensating their own weights. The counterweight 507 according to the present embodiment will be described more specifically. The horizontal robot arm 110 needs to be manually moved directly for operation preparation and emergency use as well as for operation by the operator using a hand-held medical instrument. At this time, the horizontal drive joint can be easily moved by hand only by releasing the brake, but the vertical drive joint must manually hold a large weight of the horizontal robot arm 110 when releasing the brake. It does not. Therefore, the vertical drive joint unit shown in FIG. 5 is provided with a counter weight 507 for compensating the weight of each part, thereby alleviating the output to the drive part and manually moving 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 addition, in order to operate the robot arm manually, it is possible to use an assist system that outputs only the weight of the robot arm in the vertical axis direction according to a program, but when the system is down, manually move it. It can be difficult. On the other hand, the counter weight 507 also has a purpose of enabling manual movement even when a system abnormality occurs by disconnecting from the system by a logic circuit that disconnects the brake and the power supply of the motor.

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

  In addition, although the linear motion mechanism shown in FIG. 5 uses a timing belt pulley which is highly efficient so that the operation from the output side (back drive ability) can be easily performed, a ball screw with a large lead or a highly efficient slide screw is used. It may be

<Grip with brake release switch>
In addition to the self-weight compensation mechanism (counter weight 507) for manually moving the robot arm according to the situation, the horizontal robot arm 110 according to the present embodiment releases the brake for easily handling the manual operation of the robot arm. A switch 311 is provided. The brake release switch 311, as shown in FIG. 6, constitutes a grip with a switch capable of moving the robot arm in the vertical direction and in the horizontal direction while being held by one hand. As will be described later, the brake release switch 311 can be pressed from multiple directions so that the operator can press the switch with a substantially fixed 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 disposed at the tip of the third arm 113. The brake release switch 311 is provided with a switch for releasing the holding brake attached to each joint of the horizontal robot arm 110, and a cylindrical grip for the operator or the like to grip.

  The brake for maintaining the posture of the robot arm is released only while the brake release switch 311 is pressed from the viewpoint of safety. Note that, 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 this embodiment has a structure that allows the operator to keep pressing the switch stably while applying a force for moving the tip of the horizontal robot arm 110. It has become. As shown in FIG. 6 (b), the operator releases the brake release switch 311 shown in FIG. 6 (a) so that the horizontal robot arm 110 moves in the horizontal direction, and the horizontal rotation slips along with the movement. And, it is a shape that can easily apply the force in the vertical direction to the horizontal robot arm 110. In order to stably push the switch while allowing the horizontal rotation to slip, as shown in FIG. 7, the switches are circumferentially arranged on the cylindrical portion of the brake release switch 311.

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

  FIGS. 7A to 7C show the internal structure when the brake release switch 311 is viewed in the vertical direction. In the example shown in FIG. 7A, a general tact switch 701 is arranged in a circular arrangement, and the outer periphery thereof is surrounded by a lever 702 having a rotation supporting point 703. The lever 702 is more pushed in at the position farthest from the fulcrum, and the force is more easily applied in the direction in which the tact switch 701 is pushed, but the force pressing the tact switch 701 relative to the fulcrum decreases. Therefore, by arranging the set of the tact switch 701 and the lever 702 at equal intervals by three or more odd numbers, pressing the tact switch 701 with either of two fingers regardless of which direction the grip is gripped Is possible.

  Although the lever 702 is operable not only with the rotation supporting point but also in parallel toward the center of the grip, as described above, three or more odd-numbered levers should be arranged. Is desirable.

  In FIG. 7B, the tact switches 701 are arranged at equal intervals by three or more odd numbers, and the outer periphery is surrounded by the elastic resin 705, so that the tact switches 701 are pushed regardless of which direction the grip is gripped. It is something like that. In this example, the number of tact switches 701 is made larger than that of the example shown in FIG. 7A so as to have good switch sensitivity. In the example shown in FIG. 7C, a general strip-like pressure-sensitive switch 704 (having a resistance value that changes with pressure) is disposed in a cylinder, and the outer periphery is surrounded by an elastic resin 705, from which direction Even when the grip is gripped, the switch can be pressed.

<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 moved largely or after the robot medical instrument 127 is inserted into the robot-side sheath tube 125 . On the other hand, when the distal end of the robot medical instrument 127 is not inserted into the robot-side outer tube 125, the orientation of the surgical instrument manipulator 124 and the robotic medical instrument 127 is not stable because the two-axis gimbal mechanism 301 is a passive joint. . For this reason, when inserting the robot medical instrument 127 into the robot side outer tube 125, operation may become difficult.

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

  The two input switches represent only the front and back direction, and the operator can press either of the front and rear switches while giving hand support (while touching) the tip of the 2-axis gimbal mechanism 301 to issue an instruction. Can. The horizontal robot arm 110 moves the tip of the robot arm in a direction coincident with the pressed direction on the axis of the shaft of the robot medical instrument 127. Therefore, when the surgical tool manipulator 124 functions as an operation means for manually operating the two-axis gimbal mechanism 301, 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 instrument 127 and which direction the indication to the switch indicates the axial direction of the shaft. As a result, the distal end portion of the robot medical instrument 127 can be easily and smoothly inserted into the robot-side outer tube 125. In addition, even when the distal end of the robot medical instrument 127 is removed from the body cavity, using this vector operation mode makes it possible to perform the removal operation with minimal contact with the organ.

  In the above-mentioned example, although the example using brake release switch 311 and vector operation mode in horizontal robot arm 110 was explained, it is applicable also when using endoscope holder 114 or direct-acting robot arm 120.

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

(Details of linear motion robot arm)
<Linear drive joint part>
The 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 can sufficiently tolerate their own weight moment and the external force received by the linear motion robot arm 120, and can move two parallel in the horizontal direction in order to allow smooth movement. It is connected by the ball | bowl linear guide 1001 arrange | positioned.

  Driving of the third arm 123 is performed by a drive unit 1002 fixed to the second arm 122 and including a reduction gear and a motor. The other end is fixed to the end of the third arm 123 and can be linearly moved in the horizontal direction. The third arm sensor unit 1008 measures the forward and 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 a cable guide for assisting the linear movement of the wiring are disposed so as to be contained in the second arm 122 and the third arm 123. Between the two parallel ball linear guides 1001, a cable guide 1010 is provided to assist the linear movement of the wiring for connecting the signal line and the power line to the third arm 123.

  Similar to 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 to be able to attach a commonly used endoscope 1004. The use of the endoscope holder 114 adapted to the endoscope shape as needed makes it possible to attach endoscopes of various manufacturers, functions and shapes to the surgery support device. Further, near the tip of the third arm 123, a brake release switch 1011 is disposed.

  A reduction gear 1007 is provided to a first arm connection plate 1006 attached via a connection bearing 1005 capable of accepting a moment, and the power of the second arm drive motor 1012 is transmitted by a timing belt pulley to rotate in the vertical direction. Horizontal rotation is possible around the axis. A hollow speed reducer capable of accepting a moment may be directly attached to the connection portion between the first arm 121 and the second arm 122 without using the first connection plate 1006.

  The two-axis gimbal mechanism 1003 at the tip of the third arm 123 is a passive joint that does not have a power unit like the horizontal robot arm 110. However, the position of the robot medical instrument 127 is provided by including two absolute encoders. Can be determined using forward kinematics. In addition, in order to suppress the influence of micro-vibration during robot arm operation and micro movement by patient's breathing, the posture is stabilized using an elastic mechanism (damper in rotating direction, resin spring, metal spring) or auxiliary power. It may have the function of avoiding the change or the unique posture.

<Vertical drive joint>
Next, with reference to FIG. 11, the vertical drive joint of the linear motion robot arm 120 will be described. The first arm 121 is driven by a nut rotation type ball screw. Therefore, a ball screw shaft 1101 is fixed to the second frame 102, and a drive unit 1102 is provided with a nut that enables rotation, a motor for driving the same, a reduction gear, and an encoder under the first arm 121 on the drive side. Have. This nut rotation type ball screw can use a mechanical component generally used.

  Like the horizontal robot arm 110, the first arm 121 is provided with a counter weight 1103 to compensate for the weight connected by a wire, thereby suppressing the output of the motor in the drive unit 1102 and facilitating the robot arm by a manual operation in direct contact. It is possible to move to The counterweight 1103 is divided into two or more in the second frame 102 via the support pulley 1106 and the like, so that the safety of the wire can be enhanced and the overall size of the device can be effectively reduced. Movement of a cable or the like extending from the second frame 102 to the first arm 121 is assisted by a 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 the connection portion 1104, and the second arm 122 is rotatably connected at the connection portion 1104 around a vertical axis.

  By connecting the endoscope 1004 to the mechanism of the direct acting robot arm 120 shown in FIGS. 10 to 11 via the endoscope holder 114, a five-axis mechanism equivalent model as shown in FIG. 12 is obtained. By inserting the distal end portion of the endoscope having the five degrees of freedom into the robot-side sheath tube 125 attached to the patient's abdomen, the degrees of freedom of the two axes are fixed, and while viewing the insertion point as a rotation center The position of the tip of the mirror can be three-dimensionally controlled in the body cavity.

(Sharing of screw shaft)
Diseases to which laparoscopic surgery is applied are diverse, and their techniques are also diverse. The height of the operating table 151 shown in FIG. 1B can be vertically moved by about 500 mm at maximum depending on the type of operation, the type of patient, the height of the operator, and the like. The operation support apparatus according to the present embodiment can also ensure the amount of movement that can correspond to the height of the operating table that changes due to changes in the situation.

  Generally, in order to secure a wide amount of movement, the height of the entire device is increased. However, the height of the operating table is not constantly moved during the operation, but is determined by factors such as the above-mentioned operation method at the start of the operation, and there is not much movement during the operation. Therefore, in the present embodiment described below, the size of the device can be suppressed by mechanically separating and sharing the operation range that is constantly movable during surgery and the operation range that changes according to the height of the operating table. It is designed to ensure a sufficient operating range. Specifically, FIG. 13 schematically shows the relationship between 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 the horizontal robot arm 110 attached to the third frame.

  For example, in order to secure an operating range in which the displacement of the height of the operating table 151 and the operating range of the surgical tool manipulator are added to the vertical drive joint of the horizontal robot arm 110, a tall frame is required. The height of the linear motion robot arm 120 also increases. Therefore, the third frame 103 is moved up and down to adjust the height for the displacement of the height of the operating table. Then, in order to control the operation of the hand-held medical instrument 131, the two horizontal robot arms 110 (that is, the first arm 111) connected to the third frame 103 are operated in the vertical direction separately to make two strokes. Can be secured. As is apparent from FIGS. 13 and 14 (a), 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 movable back and forth. The whole can be miniaturized.

  FIG. 14B is a cross-sectional view of each frame according to the present 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 an overlapping manner while maintaining high rigidity with respect to the moment in the falling direction. Furthermore, by arranging the ball screw shaft 1101 at the center of the device and sharing the parts, downsizing of the device can be realized.

  In general, many ball screws mount a bearing at the shaft end, fix a nut on the drive side, and make a linear motion by rotating a screw shaft. On the other hand, in the present embodiment, in order to enable two linear motions (ie, linear motions of the third frame and the first arm 121) using one screw shaft 1101, a nut rotation type ball screw is used. . By sharing the screw shaft, when the third frame 103 is lifted, the first arm 121 of the linear movement robot arm 120 is also lifted following the rise, the lower limit operation range of the first arm 121 is narrowed. However, since the linear motion robot arm 120 and the first arm also match the height of the operating table 151 and do not require the lower limit operating range, 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 disadvantage such as restricting the movable range of the robot arm necessary for the operation. , Can realize miniaturization and cost reduction.

(Operation range of each robot arm)
Partial spherical ranges 1501 to 1503 shown in FIGS. 15A and 15B represent an example 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 outer tube of the patient's abdomen is inserted, and the trajectory that hits the surface of the spherical range is the arm at the position where the tip of the robot medical instrument 127 is most withdrawn from the robot side outer tube 125 It is a representation of the tip. Although the movable range of the robot arm alone is different from this, if the tip of the arm is separated from the outer tube insertion position beyond the length of the shaft of the robot medical instrument 127, the tip of the tool is pulled out of the outer tube. The spherical range shown indicates the maximum movable range of the tip of the arm when the robot medical instrument 127 is inserted.

  A space 1505 immediately above the insertion point 1504 of the robot medical instrument 127 into the mantle tube is excluded from the movable range because it has a unique posture of the two-axis gimbal mechanism 301. The linear motion robot arm 120 supporting 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, the spherical range movement range of the symmetrical shape have. In the actual technique, this movement range is not always operated, but is concentrated on the lower abdomen, upper abdomen, etc., so it is considered that the range of about half the shape of this spherical range will always be the movement range . As shown in FIG. 15 (a), since the movable range of the arm tip has a large overlap, the horizontal robot arm 110 having a symmetrical structure with respect to the vertical plane is suitable, and in order to avoid those movable ranges For the arm that can support the mirror 1004, a vertical robot arm 120 is suitable.

  In addition, the configuration for suppressing the interference of each robot arm from the movable range of the tip of the robot arm at the time of surgical instrument insertion can be performed by using a hand-held medical instrument 131 as is apparent from FIG. 1 (b) described above. Interference with the hands of the operator who operates the robot arm supporting the robot medical instrument 127 can be avoided, and at the same time, a sufficient operating range can be secured. Although the movable range of the same movable range (1503) of the linear motion robot arm 120 supporting the endoscope 1004 may include the operator's hand, the endoscope transfers the tip of the hand-held medical instrument 131. To move, the direction of the endoscope and the direction of the hand-held medical instrument 131 coincide. That is, the interference between the direction of the endoscope and the hand-held medical instrument 131 can be suppressed.

  The movable range shown in FIG. 15 is an example and does not have to be strictly in this range, and may be reduced, enlarged, or deformed in accordance with the technique etc. within the mechanical operation limit range of the robot arm.

(Failure detection system for robot arm with active joint)
The above-described surgery support apparatus 200 may further include a failure detection system for the active joint of each robot arm. In the realization of the failure detection system, servomotors having incremental encoders are used for all the motors for driving each robot arm. Further, a non-excitation operation type brake may be provided on the input side or the output side of the reduction gear, and an absolute encoder may be provided on the output side.

  In this way, when an operation instruction is given to the robot arm, it may be determined whether a difference is detected in the amount of operation on the output side with respect to the command value of the motor. When it is determined that the difference is detected, it is possible to detect a power transmission abnormality between the motor and the reduction gear, breakage of the reduction gear, and a power transmission abnormality in the final output shaft from the reduction gear. Here, the power transmission includes, for example, a gear, a timing belt pulley, a ball screw, and a wire.

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

(Initialization process)
Each robot arm of the present embodiment has a passive joint. For this reason, as described above with reference to FIGS. 9 and 12, the surgical tool is inserted into the mantle tube attached to the patient's abdomen, and the insertion point 901 is determined. The position of the tip of 127 can be calculated and specified. For example, as shown in FIG. 16, by performing initialization processing of each robot arm in a predetermined procedure, an operation of assigning the inserted outer tube and acquisition of positional information of the insertion point 901 necessary for control of the robot arm Can.

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

  In step S1701, the control unit 201 detects an instruction (for example, switch depression) by the touch of the operator on the brake release switch 311 or the vector operation switch 801 of the first robot arm 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 in accordance with 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 an 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 is pressed, the process proceeds to step S1703. If not, the process proceeds to step S1704.

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

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

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

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

  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 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 the robot arms are associated with all the robot-side sheath tubes 125, and if it is determined that the robot arms are not associated with all the robot-side sheath tubes 125, S1701. Return. On the other hand, when it is determined that the robot arm is associated with all the robot-side sheath tubes 125, the operation mode of the surgery support device is switched to the original operation mode, and the initialization process is ended.

  In addition, two methods are shown about the example of the calculation method of the insertion point 901 in S1711 of initialization process. One of the positions is a position of the robot medical instrument 127 detected by the robot-side insertion depth measurement unit which also operates as an insertion detection sensor. By doing this, the control unit 201 can calculate the position of the insertion point in the robot coordinate system using forward kinematics from each link length, surgical tool length, and joint angle.

Another method is to calculate from the posture of the surgical tool manipulator. As shown in FIG. 18, the rotation centers of the gimbal mechanism in certain two 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 center of rotation should match in each of these postures, but the position of twisting will be as shown in FIG. 18 due to the bending of the abdominal wall and the like. Therefore, in this method, a point x between these postures is used as an insertion point (rotation center).

In order to obtain the coordinates of the insertion point x, points S ₁ and S ₂ at which perpendiculars down from each straight line intersect are calculated according to the following equation.
Here, n ₁ and n ₂ represent unit vectors representing the posture of the surgical tool manipulator, and PQ ₁₁ represents a vector directed from P ₁ to Q ₁ .

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

  In step S1711, the control unit 201 calculates the position of the insertion point using one or both of the above calculation methods. Thereby, the control unit 201 specifies the position of the robot-side sheath tube 125 on the space coordinates (robot coordinate system) possessed by the surgery support device 200, and each of the positions according to the insertion angle and insertion depth of the hand-held medical instrument into the body cavity. It becomes possible to control the movement of the robot arm.

  The insertion point may fluctuate in the robot coordinate system during the operation due to a slight movement of the patient's peritoneal membrane or the like. However, in the present embodiment, since the robot arm has the 2-axis gimbal mechanism 301 of the passive joint (unlike the robot arm that supports the insertion point with a remote center of motion (RCM) mechanism), It is possible to follow and detect fine movement. When the position of the insertion point is changed, the control unit 201 executes the calculation method shown in FIG. 18 at predetermined time intervals in a loop for controlling the robot arm using a hand-held implement, thereby the robot of the insertion point 901 Deviations in the coordinate system can be corrected at any time. That is, the operation accuracy of the distal end portion of the robot medical instrument 127 can be kept high.

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

(Semi-automatic traction mode)
As described above, the surgery support apparatus 200 is used to assist the surgical procedure of the operator using a robot arm. For example, if the surgery support device 200 is used, the surgical field is secured by holding the organ with the robot medical instrument 127 and fixing it there, or the robot medical instrument 127 carries a needle thread to carry out a needle movement or the like. The endoscope can be moved to an intended position.

  Here, the semi-automatic traction mode of the surgery support device 200 will be described by way of an example in which the robot medical instrument 127 is pulled and fixed to an organ. The operator performs some kind of treatment (generally, separation etc.) on the organ, but since the robot medical instrument 127 remains spatially fixed, the separation progresses and the shape of the organ changes Then, the traction may be weakened gradually. As in the case of human being pulled as an assistant, if the pulling force on the organ can be easily adjusted according to the progress of the operation by the operator and the situation, it is possible to carry out the operation more smoothly.

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

  First, the operator controls the robot arm using, for example, a surgical instrument used for treatment, and causes the robotic 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 instrument 127 in the memory 205 from the start to the end of the operation on the robot medical instrument 127. The control unit 201 calculates a direction (referred to as a pulling direction) which has been moved immediately before the end of the operation from the recorded trajectory. However, the pulling direction may be not only the direction obtained in the last sampling but also the direction obtained by integrating or moving the movement of the tip position in a predetermined period immediately before the end of the operation.

  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 in response to the detection of the switching operation to the semiautomatic pulling mode (medical tool 127 Movement of the tip position of That is, in the normal operation mode in which the distal end position of the robot medical instrument 127 is controlled using the surgical tool, positioning of six degrees of freedom needs to be performed by operation with the surgical tool, but using the semiautomatic traction mode Adjustment of the tractive force is possible only by operating.

  The adjustment of the size and speed of moving the tip position in the pulling direction in the semi-automatic pulling mode 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. You may add it. For example, in the semi-automatic traction mode, when the control unit 201 detects that the surgical instrument held by the operator has rotated clockwise around the shaft, the control unit 201 detects that the surgical tool has been rotated counterclockwise. , May be controlled. Other methods may be used as long as the speed of 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 inserted into the body cavity and mechanically drivable can be controlled using the hand-held medical instrument 131 inserted into the body cavity. did. Then, when the operation mode of the surgery support apparatus is a mode for operating the robot arm, the operation of the robot arm is controlled in accordance with the posture of the hand-held implement. 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 becomes possible to provide a surgery support device that can operate the robot arm with a simple operation without requiring a console that is difficult to install in the operating room. In addition, the interference between the robot arm and the operator is reduced because the operator can be operated by the minimum operator.

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

  In addition, each of the structure of the surgery assistance apparatus mentioned above may be implement | achieved as a structure which was isolate | separated or integrated. In addition to the case where the control unit including one or more processors reads from the recording medium and executes the program of the computer executing the above-described processing from the recording medium, the present invention acquires the program via wired communication or wireless communication. May be included.

  DESCRIPTION OF SYMBOLS 110 ... Horizontal robot arm, 120 ... Linear motion robot arm, 126 ... Robot side insertion depth measurement part, 131 ... Hand-held medical instrument, 132 ... Surgical tool operation measurement part, 136 ... Operator side insertion depth measurement part, 201 ... Control part

Claims (4)

A plurality of robot arms that control the posture of the surgical instrument inserted into the body cavity and used;
A gimbal mechanism interposed between the tip of one or more robot arms of the plurality of robot arms and the surgical instrument and rotatable about two rotation axes;
Control means for controlling the operation of the plurality of robot arms in accordance with the operation by the operator;
Each of the plurality of robot arms is a robot arm having three degrees of freedom in which a joint capable of rotating around an axis in the vertical direction and a joint performing linear motion are combined,
The control means controls the joint portion of the robot arm to control the insertion angle and the insertion depth of the shaft of the surgical tool into the body cavity, and when the surgical tool is inserted into the body cavity or By using at least a set of the position of the tip of the robot arm and the angle around the two rotation axes of the gimbal mechanism in a state where the surgical tool is inserted into the body cavity, the body cavity of the shaft of the surgical tool The operation support device characterized by calculating the position of the insertion point used as the reference of the insertion angle to insertion, and the insertion depth. It further has an operation means for receiving an operation including a touch by the operator,
The control means controls the operation of the robot arm corresponding to the operation means such that the tip position of the surgical instrument moves in a fixed direction in response to the operation means receiving the operation including the contact. The surgery support device according to claim 1, The control means calculates the position of the insertion point of the shaft of the surgical instrument in response to the distal end of the shaft of the surgical instrument being inserted into the body cavity when the surgical instrument is not inserted into the body cavity. The surgery support device according to claim 1 or 2, wherein The said control means calculates the position of the said insertion point according to the tip of the shaft of the said surgical instrument being inserted in the outer cannula inserted in the said body cavity, It is characterized by the above-mentioned. Surgery support device.