JPH06209902A - Palpation device - Google Patents

Abstract

PURPOSE:To provide a palpation device by which the palpation information of internal organs in a deep region distant from the surface of the body can be accurately reproduced. CONSTITUTION:A palpation device is provided with a palpation probe 3 capable of being introduced into the body in which a tactual sensor 2 to be touched on the internal organs inside the body is provided, and also is provided with tactual sense presentation part 7 for presenting the tactual sense in accordance with the physical condition of the internal organs detected by the tactual sensor 2 by processing the signals from the tactual sensor 2 by means of a signal processing part 5 and in accordance therewith by operating a tactual-sense presentation actuator driving part 6.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a palpation device for indirectly palpating an organ or the like of a patient.

[0002]

2. Description of the Related Art Knowing the physical quantity such as the shape and size of a lesion, its hardness, etc. is often an important aid in the diagnosis of the disease. Even if it is not possible to quantitatively know the size and hardness of a lesion, palpation has been widely performed as a simple method for knowing the approximate state of the lesion.

However, in this palpation, the doctor touches the surface of the patient's body and determines the state of the internal organs by the tactile sensation of the patient. Therefore, reliable palpation can be applied only to a region close to the body surface. I couldn't. Further, it is impossible to perform palpation unless the patient directly faces the patient, and the feeling of palpation can be recognized only by the doctor.

[0004]

The conventional palpation is limited to a site near the body surface, and the deeper the site, the more difficult the accurate diagnosis is. Even if it is possible to palpate deep internal organs by laparotomy, this will cause too much damage to the patient. In addition, it was impossible to perform palpation without directly facing the patient. Furthermore, displaying or saving palpation data was originally unthinkable.

The present invention has been made in view of the above problems, and its purpose is to be able to accurately reproduce the palpation information of an organ at a deep part apart from the body surface, and to obtain it from a patient. It is an object of the present invention to provide a palpation device that allows palpation information to be obtained even at a remote place and that palpation data can be easily displayed and stored.

[0006]

In order to solve the above-mentioned problems, the present invention provides a tactile probe that can be introduced into the body with a tactile sensor unit that is applied to an internal organ of a body, and a signal processing unit that changes the tactile sensor unit from the tactile sensor unit. The tactile examination device is provided with a tactile sense presenting unit that processes the signal and presents a tactile sense according to the physical state of the internal organ detected by the tactile sense sensor unit by operating the tactile sense presenting actuator drive unit. According to this, it is possible to accurately reproduce the palpation information of the organ in the deep part away from the body surface, and also to obtain the palpation information at a place apart from the patient, and to obtain the palpation data. It is also easy to display and save.

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIGS. 1 to 7 are for explaining a first embodiment of the present invention. FIG. 1 shows the system of the palpation apparatus according to this embodiment divided into functional blocks. The position sensor 1 and the tactile sensor 2 are provided at the tip portion of a palpation probe 3 described later. The device body 4 includes a signal processing unit 5 that processes signals transmitted from both the sensors 1 and 2 and a haptic sense actuator driving unit 6. The tactile sense presenting actuator drive unit 6 drives the tactile sense presenting unit 7. Further, the palpation device is provided with a display device 8 which receives a signal from the signal processing section 5 and displays the physical state of the palpation site as an image on a screen.

The palpation probe 3 can be inserted into the body directly or through an endoscope or the like. As shown in FIG. 2, the above-mentioned position sensor 1 is provided at the most distal end of the tactile probe 3, and the above-mentioned tactile sensor 2 is also provided at the lower surface portion of its tip. The position sensor 1 is composed of, for example, a magnetic sensor or the like, and detects the position occupied by the tip portion of the palpation probe 3 and the amount of movement thereof by a commonly known means.

As shown in FIG. 3, the tactile sensor 2 comprises a large number of pressure sensors arranged in a matrix, and the reaction force received by each pressure sensor is individually detected to obtain a palpation signal. Further, as shown in FIG. 4, each pressure sensor constitutes a sensor unit 9 with a switch IC having a code number, and each sensor unit 9 is connected to a signal line 10. These sensor unit 9 and signal line 1
0 is manufactured as one integrated chip in a semiconductor integrated circuit by a semiconductor manufacturing process. Then, on the surface of the tactile sensor 2, the detection portions of the individual pressure sensors are arranged in a matrix as shown in FIG.

The tactile sensor 2 has a signal line 10
When the signal of the code number is received through the signal line, the detection signal of the corresponding pressure sensor is transmitted to the above-described signal processing unit 5 through the signal line 10. The detection signals of the respective pressure sensors of the tactile sensor 2 are sequentially extracted at high speed and sent to the signal processing unit 5, and tactile information of the entire range of the tactile sensor 2 is obtained instantaneously.

Therefore, when the tactile probe 3 is inserted into the body directly or through an endoscope, and the tactile sensor 2 is pressed against the affected part 11 of the internal organ as shown in FIG.
The signal of the tactile sensor 2 at this time is transmitted to the signal processing unit 5. The signal processing unit 5 processes the signal and displays an image of the physical state of the diagnostic region A1 of the affected area 11 against which the tactile sensor 2 is pressed on the screen of the display device 8. That is, first, the image as shown in FIG. 5A is displayed. That is, normally, the hard portion h and the soft portion s are displayed separately by, for example, color coding. The image of the first diagnosis area A1 is stored and continuously displayed as it is.

Then, when the position of the tactile probe 3 is moved to some extent and the tactile sensor 2 is pressed again against a different second diagnostic area A2 in the affected area 11, the same image is displayed, but the amount of movement at that time is also displayed. Is obtained by the position sensor 1, so the image in the state of the second diagnostic region A2 is shifted by the corresponding direction and amount, and the image as shown in FIG. Are displayed continuously.
By repeating this operation, the affected area 11 over a wide area
The status of can be displayed. Therefore, it is possible to know the difference in the shape, size and hardness of the affected part 11 and the distribution state thereof. Further, when the detected hardness levels are finely divided and the colors are displayed by color, the hardness distribution and change status can be known in more detail.

Next, the cuffed belt 21 provided with the tactile sense providing section 7 will be described with reference to FIGS. 6 and 7. The belt 21 is provided with so-called magic tapes 23 and 24 on the inner surface of one end and the outer surface of the other end.
24 Comrades are locked together. An airtight cavity (not shown) is formed inside the belt 21, and an air supply tube 25 is connected to the cavity. The belt 21 can be inflated by sending air into the cavity from a manual pump or the like (not shown) through the air supply tube 25.

Therefore, the belt 21 is wrapped around the doctor's finger 26, the ends thereof are overlapped with each other, and the velcro tape 23,
24 are fastened to each other, and after that, air is fed into the cavity of the belt 21 through the air feeding tube 25, and the belt 21 is inflated, the belt 21 tightens the finger 26, and the entire inner surface thereof is appropriately pressed to the finger 26. Adhere with pressure.

On the other hand, the tactile sense presenting portion 7 is provided on the inner surface of the belt 21 wound around the finger 26 in this manner. The tactile sense presentation unit 7 is made of a flexible film 27, and the actuator drive unit 6 made up of a plurality of thermal expansion actuators 28 is provided on the back side of the film 27. The actuator driving unit 6 is also formed by arranging the operating units of the plurality of thermal expansion actuators 28 in a matrix form corresponding to the arrangement of the pressure sensors in the tactile sensor 2. The thermal expansion actuator 28 is, for example,
It is composed of a thermal expansion member having a heater 29, and when the heater 29 is energized, the thermal expansion member is heated according to the amount of energization and expands correspondingly. The thermal expansion member of each thermal expansion actuator 28 is the film 27 of the tactile sense presentation unit 7.
The side is a free end and the other end is fixed to the support frame 30. Then, the free end side portion of the thermal expansion member of the thermal expansion actuator 28 serves as an operating portion and pushes the flexible film 27 of the tactile sense presentation portion 7 from the back side according to the expansion amount.

The signal processing unit 5 processes the signal transmitted from the tactile sensor 2 to selectively energize each heater 29 of the tactile sense providing actuator driving unit 6. This energization signal is transmitted through the actuator signal line 31. The thermal expansion member of the thermal expansion actuator 28 energized by the heater 29 expands according to the amount of energization, and the tactile sense presentation unit 7 corresponding to this expands.
Individually press the portions of the membrane 27 of. Membrane 27 of tactile presentation unit 7
Presses the belly of the operator's finger 26 in accordance with the physical state of the internal organ detected by the tactile sensor 2 and gives the finger 26 a feeling of palpation. The tactile sense presentation unit 7 presents a tactile sense according to the physical state of the internal organ detected by the tactile sensor 2. Since the signal processing unit 5 processes the signal transmitted from the tactile sensor 2 to drive the tactile presentation actuator driving unit 6, the tactile presentation unit 7 may be separated from the tactile sensor 2. By transmitting the tactile information as a signal, even a doctor in a remote place can perform a palpation.

The tactile probe 3 may have a rod-like shape as described above, or may have a shape such that the affected part is pinched and a tactile sensor is provided at the pinched part. Further, by changing the length, shape, and the like of the palpation probe 3 according to the position of the affected part to be palpated, it is possible to palpate a site that was conventionally impossible to palpate.

8 to 11 are for explaining the second embodiment of the present invention. FIG. 8 shows an operation unit 36 provided on the hand side (outside the body) of the palpation probe 35 in the palpation device according to the present embodiment, and the operation unit 36 includes a tactile sense presentation unit for presenting tactile sense. FIG. 9 shows a palpation probe 35.
The tactile sensor unit 37 provided on the tip side (inside the body) of FIG.

The operating portion 36 shown in FIG.
Of the pair of first arms 41a, 41b slidable in the direction along the longitudinal axis of each of the first arms 41a, 41b,
The tips of the second arms 42a and 42b are individually pivoted to the rear ends of the second arms 42a and 42b, and the tips of the third arms 43a and 43b are individually connected to the rear ends of the second arms 42a and 42b. Is pivotally attached to. The first arm 41a, the second arm 42a, and the third arm 43a are connected in a row to form a first arm row 44a, and the first arm 41b,
The second arm 42b and the third arm 43b are connected to form a second arm row 44b.

The second arm 42a and the third arm 43a of the first arm row 44a are hung by the index finger 38 of the operator's hand, while the second arm of the second arm row 44b. The thumb 39 of the same hand is hung on the second arm 43b and the third arm 43b, and the pair of arm rows 44a and 44b are sandwiched between the forefinger 38 and the thumb 39 for operation.

The first arms 41a and 41b are provided with a guide slot 45 formed therein and a guide pin 4 fitted therein.
6 is slidably guided along the longitudinal axis of the palpation probe 35. The first tension wire 51 is connected to the first arm 41a on one side, and the second tension wire 52 is connected to the first arm 41b on the other side to follow the first arms 41a and 41b. It is designed to be operated. A first pulley 47 is integrally fixed and attached to the second arm 42a on the pivot shaft of the second arm 42a. A second pulley 48 is integrally fixed to and attached to the second arm 42b on the pivot axis of the other second arm 42b. The third tension wire 5 is attached to the first pulley 47.
The third and fourth tension wires 54 are hooked from opposite sides, and their respective tips are fixed to the first pulley 47. A fifth tension wire 55 and a sixth tension wire 56 are hung on the second pulley 48 from opposite sides, and their respective ends are fixedly connected to the second pulley 48.

A third pulley 49 is integrally fixed to and mounted on the pivot shaft of one of the third arms 43a. The fourth pulley 50 is integrally fixed to the third arm 43b and attached on the pivot shaft of the other third arm 43b. The third pulley 49 has a seventh tension wire 57 and an eighth tension wire 57.
Tension wires 58 are hung from the opposite side, and their respective ends are fixedly connected to the third pulley 49.
A ninth tension wire 59 and a tenth tension wire 60 are hooked on the fourth pulley 50 from opposite sides, and their respective tips are fixedly connected to the fourth pulley 50.

Further, as shown in FIG. 10, the first to tenth tension wires 51 to 60 are individually pulled by the motors M _{1 to} M ₁₀ , and the tension wires 51 to 60 are individually pulled.
The tension of each is a tension meter (sensor) T _{1 to} T
Detected individually by ₁₀ . The detection signals of the respective tension meters T _{1 to} T ₁₀ are sent to the control unit 61, and the respective motors M _{1 to} M ₁₀ are individually driven by the commands of the control unit 61, whereby the respective tension wires 51 to 6 are driven.
The tension of 0 is adjusted as described later, and the operation unit 36 as the tactile sense presentation actuator drive unit is operated.

Further, as shown in FIG. 9, the tactile sensor section 37
Has a proportional configuration corresponding to the operation unit 36 described above. That is, the pair of first arms 41a ', 41 slidable in the direction along the longitudinal axis of the probe 35.
b'and the rear ends of the second arms 42a ', 42b' are individually pivoted to the tips of the first arms 41a ', 41b', and the second arms 42a ', 42b'. The rear ends of the third arms 43a 'and 43b' are individually pivotally attached to the front ends of the. The first arm 41a ', the second arm 42a', and the third arm 43a 'are connected in a row to form a first arm row 44a', and the first arm 41b 'and the second arm are also formed. 42b 'and the third arm 43
b'is connected to form a second arm row 44b '.

The first arms 41a 'and 41b' are slidably guided along the longitudinal axis of the palpation probe 35 by the guide slot 45 'formed therein and the guide pin 46' fitted therein. Also, the first one
The first tension wire 51 'is connected to the arm 41a' of the second arm 41a ', and the second tension wire 52' is connected to the other first arm 41b '. A first pulley 47 ′ has a second pulley 42 ′ on the pivot axis of the second arm 42 a ′.
It is fixed and attached integrally with a '. The second pulley 48 is mounted on the pivot axis of the other second arm 42b '.
′ Is integrally fixed and attached to the second arm 42b ′. Then, the third tension wire 53 'and the fourth tension wire 54' are hooked from the opposite side to the first pulley 47 ', and their respective tips are fixed to the first pulley 47'. A fifth tension wire 55 'and a sixth tension wire 56' are hooked on the second pulley 48 'from opposite sides, and the respective tips are fixedly connected to the second pulley 48'. .

A third pulley 49 'is mounted on the pivot shaft of one of the third arms 43a' so as to be integrally fixed to the third arm 43a '. A fourth pulley 50 'is integrally fixed to the third arm 43b' and mounted on the pivot shaft of the other third arm 43b '. Then, the seventh tension wire 57 'and the eighth tension wire 58' are hung from the opposite side to the third pulley 49 ', and each tip thereof is fixedly connected to the third pulley 49'. ing. Further, a ninth tension wire 59 'and a tenth tension wire 60' are hooked on the fourth pulley 50 'from opposite sides, and the respective tips are attached to the fourth pulley 50'.
Is fixedly connected to.

The portions of the second arm 42a 'and the third arm 43a' in one arm row 44a 'and the second arm 42 in the other arm row 44b'.
An organ such as a blood vessel 62 can be sandwiched between b'and a portion of the third arm 43b '.

Further, as shown in Figure 10, first to tenth of tension wires 51'～60' motor M ₁ respectively'~M
Individually pulled by ₁₀ 'and each tension wire 5
Tension 1'～60' are detected by the respective tension meter (sensor) T _{1'~T 10} '. The detection signals of the respective tension meters T ₁ ′ to T ₁₀ ′ are transmitted to the control unit 61, the respective motors M ₁ ′ to M ₁₀ ′ are driven by the control unit 61, and the respective tension wires 51 ′ to
Adjust the tension of 60 'as described below. That is, the control unit 61 operates the grip portion of the tactile sensor unit 37 so that it has the same shape as the operation unit 36.

Then, the palpation probe 35 in the palpation device is introduced into the body directly or through an endoscope (not shown), and the tactile sensor 37 is guided to the affected organ. And
As shown in FIG. 9, the blood vessel 62 may be sandwiched between the second arm 42a 'and the third arm 43a' and the second arm 42b 'and the third arm 43b'. Position it. The control unit 61 adjusts the tensions of the tension wires 51 ′ to 60 ′ of the grip portion of the tactile sensor unit 37 by the motors M ₁ ′ to M ₁₀ ′ so that the operation unit 36 and the tactile sensor unit 37 have the same shape. To do. The driving amount at this time is the tension meters T _{1 to} T ₁₀ and T ₁ ′ to T ₁₀ ′.
Is calculated by the control unit 61 in response to the detection signal. Here, the grip of the tactile sensor unit 37 is moved like the operation unit 36. The operation unit 36 is operated to sandwich the blood vessel 62 between the grips of the tactile sensor unit 37.

By the way, when the blood vessel 62 is sandwiched between the grips of the tactile sensor unit 37 as shown in FIG. 9, the shape of the grips may not be the same as the shape of the operation unit 36.
That is, the tension of each tension wire 51'-60 'will be different from what was planned. The tensions at this time are detected by the tension meters (sensors) T ₁ ′ to T ₁₀ ′, respectively, and this time, on the contrary, the motors M _{1 to} M ₁₀ are arranged so that the operating portion 36 has the same shape as the grip portion of the tactile sensor portion 37. To drive.
The operation unit 36 is operated by a signal detected by such a tactile sensor means, and a tactile sensation corresponding to the physical state of the internal organ is presented thereto. The operation unit 36 constitutes a tactile sense presentation unit that presents a tactile sense according to the physical state of the internal organs.

That is, the operator holds the arm row 44.
When receiving the reaction force from a and 44b, the blood vessel 6 directly
You get the feeling that you are holding 2. In addition, the operation unit 36
When a finger is moved like scissors operation or is moved back and forth or up and down as a whole, the grip portion of the tactile sensor unit 37 also moves accordingly, and the tactile sense changes from the change of the reaction force obtained by the operation unit. It is possible to know the approximate shape and hardness of the object gripped by the grip of the sensor unit 37. That is, although the finger of the hand does not directly touch the blood vessel 62,
As shown by 1, it is possible to obtain a feeling as if the blood vessel 62 was directly grasped by the finger of the hand.

12 and 13 show a modification of the palpation apparatus according to the second embodiment described above. This corresponds to a portion of the second arm 42a and the third arm 43a of the first arm row 44a of the operating portion 36, and a portion of the second arm 42b and the third arm 43b of the second arm row 44b. A plurality of air actuators 71 are attached to each outer surface, and each of the air actuators 71 touches the surfaces of the corresponding index finger 38 and thumb 39 of the operator's hand holding the operating portion 36, and the generated pressure is applied to the fingers. It is given to 38 and 39.

The second arm 42a 'and the third arm 43a' in the first arm row 44a 'of the tactile sensor unit 37, and the second arm 42b' and the third arm 42b 'in the second arm row 44b'. A plurality of tactile pressure sensors 72 are attached to each inner surface of the arm 43b 'of each of the arms 43b', and each tactile pressure sensor 72 has a blood vessel 62 held by the tactile sensor portion 37.
Touch the surface of and detect its pressure. Then, each air actuator 71 of the operation portion 36 swells and is driven so as to generate a pressure corresponding to the pressure. Therefore, according to this, in addition to the above-mentioned feeling of grasping the blood vessel 62, a feeling of partial hardness thereof can be obtained, and a detailed and detailed palpation can be performed.

14 and 15 show still another modification of the palpation apparatus according to the second embodiment. This is the first arm 41 in the operation unit 36 and the tactile sensor unit 37.
a, 41b, 41a', the motor M _1, M ₂ slides 41b' through the pinion rack mechanism 75, M ₁ ', M
Driven by ₂ '. In addition, the first arms 41a, 4
Between 1a ′ and the second arms 42b, 42b ′, the second arms 42a, 42a ′ and the third arms 43b, 43b ′.
Motor M ₃ ~M ₆ relative rotation between, M _{3'~M 6}
Drive with ´. Motor _{M 1 ~M 6, M 1'~M} 6 ' movement of each encoder _{E 1 ~E 6, E 1'~E} 6' is detected by controlling the driving amount. That is, these movements are detected and controlled by the control unit 61 shown in FIG.
From the change in the reaction force obtained by operating the operation unit 36 by moving the operation unit 36 and the tactile sensor unit 37 as described above, the approximate shape and hardness of the object held by the holding unit of the tactile sensor unit 37, etc. You can know. Then, the finger of the hand is a blood vessel 6
Despite not directly touching 2, the operator feels as if he or she were directly grasping the blood vessel 62 with the fingers as shown in FIG.

Third Embodiment of the Present Invention FIG. 17 and FIG.
8 will be described. In particular, this embodiment deals with the fact that there are a plurality of treatment tools corresponding to the palpation probe and the operation is considerably troublesome if they are used at the same time. In addition, it deals with the inconvenience that the operator cannot leave the patient during the operation.

The operating section and a plurality of treatment sections are wirelessly communicated with each other, a signal designating a treatment section to be operated and an operation command signal are transmitted from the operation section, and the treatment section gives a feeling to the treatment object. It sends a signal to indicate multiple treatment tools.
The operation can be performed with one operation unit, and the treatment can be performed even if the patient and the operator are far from each other, and a sense of the object to be treated can be obtained.

That is, FIG. 17 shows the operation section, and FIG. 18 shows a plurality of treatment sections.

The operation section 70 includes a handle 71, a selection switch 72a for selecting the use of each treatment tool described later, a switch 72b for adjusting the amount of force (feeling given to the operator) given to the handle 71, and a power switch 72c. A power source unit 73, a transmission unit 74 for transmitting a signal to each treatment instrument, a reception unit 75 for receiving a transmission signal from each treatment instrument, and an operation state of the handle 71 (conversion data of an encoder 78 described later) are selected. As a command signal to the treatment instrument of 7
The signal processing unit 7 transmits the signal from the No. 4 and extracts and decodes the signal from the selected treatment tool from the received signals of the receiving unit 75.
6, a motor 77 connected to the rotating shaft of the handle 71 and responding to the decoding result of the signal processing unit 76, and an encoder 78 for converting the rotation angle of the motor 78 based on the operation of the handle 71.

The treatment tool 80 includes a forceps 81 to be inserted into a body wall 89, a motor 82 for moving the forceps 81, a wire 83 connecting a rotating shaft of the motor 82 and a rotating shaft of the forceps 81, and a power source. Of the signals received by the section 84, the receiving section 85 for receiving a transmission signal from the operating section 70, the transmitting section 86 for transmitting a signal to the operating section 70, and the receiving signals of the receiving section 85, those transmitted to the treatment instrument Extract and decode and forceps 81
The state (the conversion data of the encoder 88 based on the rotation angle of the motor 82) is transmitted from the transmission unit 86 as a command signal to the operation unit 70, and the rotation angle of the motor 82 based on the state of the forceps 81 is data-converted. It consists of an encoder 88.

There are two treatment tools 80, the transmission and reception frequencies of which are different from each other.
Is a gripping forceps, and the forceps 81 on the right side of the drawing is a peeling forceps.

According to such a configuration, one operation unit 7
With 0, either one of the two treatment tools 80 can be selected and moved. Further, the operator can obtain a feeling of movement of the treatment instrument 80 through the handle 71 of the operation unit 70.

A modification of the third embodiment is shown in FIG. In this, the treatment tool is divided into a main body 91 and two operating portions 92, and both are connected by a cable 93 to a connector. Then, the power cord 94 is led out from the main body 91 and connected to an outlet in the operating room.

Therefore, even if the operator and the patient are separated from each other, the two operating portions 92 can be remotely operated by the operating portion 70. Moreover, by attaching and detaching the connector, it is possible to replace it with the actuating portion 92 having the desired type of forceps.

A fourth embodiment of the present invention is shown in FIGS.
3 will be described. In particular, this embodiment
In a slave manipulator system, it is possible to transmit the senses of the master side and the slave side by enlarging / reducing the senses via the control unit, but there is a dead region in the human sensory organs that operate the master, It deals with the problem that excessive force is applied or excessive displacement is applied when operating in the area.

In a master-slave manipulator system in which a slave arm having a driving means and a state detecting means and a master arm having a braking means and a state detecting means communicate with each other via the control means, Is provided with an offset circuit for offsetting the braking amount of the braking means, and the control means is connected to the adjusting means for adjusting the offset amount so as to offset the insensitive area of the operator so that a complete operation can be performed from the initial operation. ing.

That is, FIG. 20 shows a block diagram of the control system of the slave arm (corresponding to the palpation probe) and the master arm of the surgical manipulator.

When the operator operates the master arm 101,
The actuator 112 of the slave arm 111 is controlled according to the displacement amount. The slave arm 111 is opened and closed by the actuator 112, and holds the blood vessel 113, for example. At this time, the hardness of the blood vessel 113 is detected by the tactile sensor 114, and the displacement of the slave arm 111 is detected by the displacement sensor 115. This hardness and displacement information is fed back to the control system 116 and sent to the control system 103 to control the electromagnetic brake 102 of the master arm 101. Therefore, the operator can operate while feeling the hardness and displacement of the blood vessel 113 via the master arm 101.

By the way, the hardness and displacement of the blood vessel are delicate, and if the same amount is fed back to the master arm 101 as it is, the operator cannot feel it.
Further, even if the displacement is simply enlarged and transmitted, the initial hardness becomes a dead zone region of the human sense and cannot be felt by the operator. Therefore, if the surgeon is operating in the dead zone,
It may damage the living body. Moreover, the feeling of operation is ten people and ten colors, and even setting does not match the feeling of all operators.

Therefore, the adjusting unit 105 is connected to the control system 103 as an external input means, and the operator inputs the gain amount (amplification amount) and the offset amount so as to match his sense. In this case, the control system 103 performs gain and offset according to the input, as shown in FIG. 21, to match with the control system 116.

FIG. 22 shows the relationship between the force and displacement on the slave arm 111 side, and FIG. 23 shows the relationship between the force and displacement on the master arm 101 side. On the master arm 101 side,
The dead zone is offset and the force is transmitted to the operator in an expanded state.

As described above, by providing the adjusting section 105, the operator can make adjustments according to his or her sense level, and by providing the offset, from the moment the operator touches the master arm 101. The hardness of the living body can be sensed, and safe operation can be performed on the living body.

A modification of this fourth embodiment is shown in FIG. This is provided by additionally providing a dummy master arm 120 corresponding to the master arm 101 and a dummy slave arm 121 corresponding to the slave arm 111.

In this case, the operator operates the dummy master arm 120 before operating the master arm 101, and tries to grasp the reference test piece 122 with the dummy slave arm 121. Dummy master arm 120 and dummy slave arm
The displacement of the force with 121 is the same size. Reference test piece at this time
The hardness of 122 is detected by the tactile sensor 123, and the displacement of the dummy slave arm 121 is detected by the displacement sensor 124. This hardness and displacement information is displayed in the control system 10 as shown in FIG.
It is sent to the setting unit of 3, and the gain amount (amplification amount) and the offset amount are automatically set there.

As the standard test piece 122, various hardnesses are prepared, and the operator will select one that suits his or her feelings.

In this case, there is an advantage that the adjustment according to one's own sense level can be easily performed.

In the fourth embodiment, the slave arm
Relationship between force and displacement on 111 side, and master arm 10
The relationship between force and displacement on the 1st side was set linearly, but for example, the relationship between force and displacement on the slave arm 111 side was set linearly as shown in FIG. 26, and on the master arm 101 side. The relationship between the force and the displacement may be set as a curve as shown in FIG. There are two types of this curve, a type that bulges upward and a type that dents downward, and either of them can be selected.

The type that bulges upward has a wide range of force in the region of initial deformation, and the range of force becomes narrower as the deformation progresses. On the contrary, in the concave type, the range of force in the region of initial deformation is narrow, and the range of force becomes wider as the deformation progresses.

The type that bulges upward is suitable for handling fragile items in the initial deformation region. The type that is recessed below
It is suitable for handling things that break after a certain amount of deformation.

A fifth embodiment of the present invention will be described with reference to FIG. In particular, in this embodiment, although there is one in which the bending portion of the endoscope is moved by an actuator, the operator cannot feel the reaction force generated when the bending portion comes into contact with the outside. There is.

A wire for bending a medical flexible tube, an actuator for driving the wire, a sensor for detecting the tension of the wire, an operation section for determining a bending angle, and a joint for this operation section. The actuator for the operating section and the circuit section for using the value of the tension of the wire for controlling the actuator for the operating section are provided.

At the tip of the endoscope, there is a curved portion (corresponding to a palpation probe) 131 which is a flexible tube. This bend 1
31 has a curved top 132, which is an indexing wire 133.
The bending portion 131 can be bent by being indexed by. The index wire 133 is covered with a sheath 134,
It is introduced into the operation unit 135.

In the operating portion 135, the indexing wire 133 is passed through the pulley mechanism 136 and the speed reducer 137 to allow the angle motor 13 to move.
It is connected to 8 rotating shafts. A decoder 139 for detecting a rotation angle is attached to the motor 138. The pulley mechanism 136 has a pair of tension sensors (piezoelectric elements) 136a for detecting the tension applied to the index wire 133.

A control unit 140 includes a CPU 141, a tension sensor detection circuit 142, an angle motor drive circuit 143, an encoder detection circuit 144, and a joystick position detection circuit 145.
, A joystick drive circuit 146.

A joystick 150 for bending operation is connected to the control section 140. This joystick
150 has an actuator 151 and a potentiometer 152 for position detection.

When the bending portion 131 receives a reaction force from the object 160, the tension of the wire 133 increases. This is detected by the tension sensor (piezoelectric element) 136a. Joystick 150
When is operated, the operated position is detected, and the required operation amount of the motor 138 is calculated from the detection result. The drive voltage corresponding to the required operation amount is the angle motor drive circuit 14
It is output from 3, which causes the motor 138 to operate.
The rotation angle of the motor 138 is detected by the encoder 139 and sent to the CPU 141 via the encoder detection circuit 144. C
In PU141, the motor 13 based on the output of encoder 139
The rotation angle of 8 is compared with the position of the joystick 150, and the required motion amount is calculated from the deviation between the two.

The command of the required operation amount is also supplied to the joystick drive circuit 146, and thereby the joystick is driven.
A reaction force is added to the operation of 150. At this time, the position gain K, which means the ratio of the required operation amount to the deviation, is
It is corrected according to the tension F obtained by the tension sensor 136a.
This is shown in FIGS. 31 and 32.

That is, by increasing the characteristic of the position gain K to the tension F to the right, the reaction force to the joystick 150 increases as the tension F increases. This corresponds to a so-called bilateral control force conversion type.

Although the bending portion 131 of the endoscope has been described as an example, it can be similarly applied to an instrument using the grasping forceps 170 shown in FIG. 29 in place of the bending portion 131. In this case, grasping forceps 17
A motor 172 is connected to 0 and an encoder 173 for detecting a rotation angle is provided on the motor 172. Then, the reaction force when the grasping forceps 170 grasps the object 160 is applied to the wire 13
The tension applied to 3 is detected, and the tension is transmitted to the grasping forceps 170 via the motor 172.

The sixth embodiment of the present invention will be described with reference to FIG. In particular, in this embodiment, in the endoscope with the electric angle, in order to avoid the risk of damaging the living body due to over-angled, a sensor for detecting contact with the living body is provided near the tip of the endoscope. It has been proposed to add the one, and according to this, a warning sound for contact between the living body and the endoscope,
Although it can be known by notification of light, sound, etc., it deals with the fact that it is not possible to convey the feeling of contact such as the contact pressure and contact distribution.

A plurality of minute depressions are formed on the outer periphery near the tip of the endoscope (corresponding to the palpation probe), the first electrode arranged so as to close the entrance of each depression, and each depression. The second electrode arranged on the bottom surface, means for individually measuring the capacitance between the first and second electrodes in each depression, and the surgeon as information on the magnitude of the capacitance of each depression. It is provided with a means for transmitting the information about the contact between the distal end portion of the endoscope and the living body to the operator including the contact pressure and the contact distribution to enhance the safety and operability of the operation.

That is, as shown in FIG. 33, a large number of depressions are formed on the outer peripheral portion of the endoscope tip portion 181 having an observation / illumination function.
182 are arranged. In FIG. 34, a signal described later obtained from each depression 182 is measured by the measuring unit 183, and the result is displayed as pressure information on the display unit 184 to notify the operator.

A method of measuring the depression 182 will be described.
The first electrode 185 of each well 182 is grounded to a common ground. Second electrodes 186 are arranged on the bottom surface of each recess 182, and these second electrodes 186 are electrically connected to the measuring section 183 by a signal line 187.

When the endoscope tip portion 181 is pressed by the living body 187, the first electrode 185 provided in the depression 182 existing in the portion pressed against the living body 187 is bent by the pressure, and the first electrode 18
The space sandwiched between 5 and the second electrode 186 is deformed and its volume is changed. This change in volume is captured by the measuring unit 183 as a change in capacitance between the first electrode 185 and the second electrode 186, and detected as a pressure change. Further, since the amount of deformation of the first electrode 185 varies depending on the pressing force, the capacitance also varies and can be detected by the measuring unit 183. Further, since the plurality of depressions 182 are arranged, the spatial distribution of pressure can be measured by measuring the capacitance of each depression 182.

FIG. 35 shows the means for measuring the change in capacitance in the measuring section 183. An alternating voltage is applied between the first electrode 185 and the second electrode 186 by an AC power supply 188. In this circuit, a voltmeter 191 is arranged in parallel and an ammeter 192 is arranged in series, and the first electrode 185 and the second electrode 18 are respectively arranged.
The voltage V between 6 and the value of the current I flowing into each electrode 185, 186 are measured. Based on the values of V and I, the calculation unit 193 calculates the magnitude Z of the impedance between the electrodes 185 and 186 (= V /
Find the absolute value of I). In this circuit, the absolute value of the impedance magnitude Z is approximately 1 / (ω · C), where ω is the angular frequency of the AC power supply and C is the capacitance between the electrodes. The capacitance C can be uniquely obtained by measuring the absolute value of the size Z. Since the change in capacitance is a change in pressure, the calculation result of the calculation unit 193 is displayed on the display unit 184 as a pressure value.

In the display section 184, as shown in FIG.
The pressure value at each depression 182 on the screen 201
The pressure distribution and the magnitude of the pressure are visually informed to the operator by connecting with.

Therefore, it is possible to make the operator recognize the pressure of the distal end portion of the endoscope against the living body together with the spread and strength, and it is safe and excellent in operability. It also has an unprecedented effect of palpation of the body using an endoscope.

A modification of the display unit 184 is shown in FIG. The minute piezoelectric elements 212 are arranged on the inner surface of the finger sack 211 in the same manner as the arrangement of the depressions 182 in the endoscope tip portion 181, and each piezoelectric element 212 corresponds to each depression 182. Hollow
The pressure information at 182 depends on the magnitude of the pressure.
Converted to the magnitude of the voltage applied to 2. When the voltage is applied, each piezoelectric element 212 expands and presses the portion of the operator's fingertip 213 in which the finger sack 211 is placed, where the piezoelectric element 212 exists. By performing the same operation independently for each piezoelectric element 212, the magnitude and distribution of the contact pressure received by the endoscope tip portion 181 can be transmitted to the operator's fingertip 213 as it is, and as a result, the operator You can feel as if your fingertip 213 became the endoscope tip 181. As a side effect of this modification, not only visual observation can be performed by an endoscope but also palpation inside the patient's body can be performed.

FIG. 38 shows a case where grasping forceps is used instead of the endoscope tip portion 181. An array of depressions 182 is provided in the grasping member 222 at the tip of the grasping forceps 221, and the grasping force with respect to the living tissue grasped by the grasping member 222 is detected as pressure. As a result, a safe operation can be performed without inadvertently grasping the living tissue with a strong force and causing it to sit down or bleeding. Further, by using the grasping forceps 221 under the laparoscope, it is possible to perform palpation inside the patient's body without opening the abdomen like the endoscope.

In the sixth embodiment and its modification, the depression 182, the first electrode 185, and the second electrode 186.
Can also be manufactured using a semiconductor manufacturing process such as sputtering. In this case, each recess 182
Can be arranged on the order of several μm, so that pressure information with very good spatial resolution can be obtained.

The seventh embodiment of the present invention will be described with reference to FIG. In particular, this embodiment proposes a treatment instrument in which a gripping forceps or the like is provided with a sensor for detecting the gripping force, and means for transmitting the gripping force to the operator is used. Since the configuration in which the surgeon adjusts is not included, it is difficult to accurately grasp the grasping force because the sensory characteristics of each surgeon to be used are different.

A medical device which is inserted into a body cavity to drive diagnosis and treatment of a living tissue, and a tactile sensor provided in a body cavity drive section, and an operation of an external operation section based on a signal from the tactile sensor. In the force control mechanism, the operator is provided with an adjusting unit for inputting and adjusting the above operating force, and it is possible to transmit the gripping force, etc. according to the sensory characteristics of each operator, for more accurate operation. I try to transmit power.

That is, the gripping forceps sheath 232 and the peeling forceps sheath 233 are detachably attached to the operating portion 231. The operation unit 231 has an adjustment button 234 and a handle 23.
5 are provided. Cable 236
Alternatively, the cable 237 can be detachably connected.
The other end of the cable 237 is connected to the controller 238.
The controller 238 is provided with an adjustment button 239 and is connected to one end of a cable 240. Cable 240
The other end of is connected to the foot switch 241. Adjustment of the controller 238 can also be performed from the remote control input unit 242. The cables 236 and 237 are configured to use only one of them.

The internal structure is shown in FIG.

The opening / closing operation of the handle 235 is detected by the encoder 251 as a rotation amount. The signal from the encoder 251 is sent to the control unit 252 and drives the actuator 253. The actuator 253 is composed of a linear drive type motor or the like, and pushes and pulls the wire 254 to open and close the stripper 256. Stripper
The opening / closing of 256 is detected by the encoder 257 as the rotation amount. This rotation amount is sent to the control unit 252 and the encoder 25
It is compared with the signal of 1 and feedback control of the opening / closing amount is executed.

A pressure sensitive sensor 258 is provided on the outer peripheral surface of the peeler 256 to detect the pressure when the living tissue is pushed open. The signal of this sensor is sent to the control unit 259 and drives the actuator 253. The actuator 253 is composed of a rotary motor or the like, and brakes the open / close shaft of the handle 235. That is, the movement of the handle 235 is braked according to the magnitude of the pressure applied to the tissue by the pressure sensor 258 (the brake acts on the side where the handle 235 is opened).

The sheath 233 and the operating portion 231 are connected to each other by the connecting portion 26.
Although it is detachably connected at 0, it has connection contacts for each signal and drive line. In addition, a battery power source 261 is provided in the operation unit 231, and drive power is supplied via each control unit. The adjustment button 234 of the operation unit 231 can adjust the amplification degree, amplification characteristic, initial value, etc. of the pressure-sensitive signal of the control unit 259.

With such a configuration, the sensitivity can be easily adjusted according to the sensory characteristics of each operator, and more accurate operation force can be transmitted. Moreover, since the respective sheaths are detachably attached to the operating portion 231, only one operating portion can be provided and the price of the system can be reduced.

FIG. 41 shows a modification of the seventh embodiment. Here, the magnet 26 is attached to the sheath side of the connecting portion 260.
2, the Hall element 263 is placed on the operation unit 231 side, and the magnetic force thereof is detected by the detection circuit 264.

By changing the magnetic force of the magnet 262 for each sheath, the type of the sheath is discriminated, and the controller 259 sets the adjustment of the adjustment button 234 in a predetermined pattern.

FIG. 42 shows another modification. Here, a pattern determined for each operator is used as a memory medium such as a magnetic card.
Record in 5 and insert into the operation part 231. The reading unit 266 reads this pattern and sets the adjustment pattern of the control unit 259.

The eighth embodiment of the present invention will be described with reference to FIG. This embodiment is an example of application to a snare treatment tool, in which a sheath 273 is projected from a channel 272 of an endoscope 271 and a probe 274 is fastened with a snare wire 275.
The operation unit 276 has an adjustment button 277 and a handle 278.

The internal structure is shown in FIG.

On the sheath 273 side, there is a strain sensor 279 attached to the snare wire 275, and the pulling force of this wire is detected by the control unit 280. In the connection part 281, the connector 282 on the wire side and the connector on the rod 283 side of the handle 278 are connected.
284 is connected. Strain sensor 285 on the rod 283 side
Is attached, and the control unit 280 detects the pulling force of the rod 283.

After comparing the tensions of the strain sensors 279 and 285, the actuator 286 is driven to brake the roller 287. That is, the braking force is applied to the pulling operation of the handle 278 according to the tightening force of the polybe 274.

The role of the adjusting button 277 is the same as that of the seventh embodiment. Applying high-frequency current to the snare wire 275
From the high frequency power line 289 of the cable 288. The high-frequency conducting wire 289 is connected to the connector 284 and electrically connected to the snare wire 275 via the connector 282. In addition,
The rod 283 and the conducting wire 289 are electrically connected.

With this configuration, the same effect as that of the seventh embodiment can be obtained.

[0097]

As described above, according to the present invention, a tactile probe that can be introduced into the body is provided with a tactile sensor unit applied to an internal organ, and a signal processing unit processes a signal from the tactile sensor unit, and in response to this, It is a tactile examination device provided with a tactile sense presenting unit that presents a tactile sense according to the physical state of the internal organs detected by the tactile sense sensor unit by operating the tactile presenting actuator drive unit. The palpation information of the organ can be accurately reproduced, and
The palpation information can be obtained even at a location away from the patient, and the palpation data can be easily displayed and saved.

[Brief description of drawings]

FIG. 1 is a block diagram of a system configuration of a palpation device according to a first embodiment of the present invention.

FIG. 2 is a perspective view of a tip portion of the palpation probe of the first embodiment in a usage state.

FIG. 3 is a bottom view of the tip portion of the palpation probe of the first embodiment.

FIG. 4 is a circuit configuration diagram of a tactile sensor in the tactile probe of the first embodiment.

FIG. 5 is an explanatory diagram of a screen of the display device according to the first embodiment.

FIG. 6 is a perspective view of the tactile sense providing belt according to the first embodiment.

FIG. 7 is a sectional view showing a state in which the belt is worn on a finger.

FIG. 8 is an explanatory diagram showing a configuration of an operation unit of the palpation probe in the palpation device according to the second embodiment of the present invention.

FIG. 9 is an explanatory diagram showing a configuration of a tactile sensor unit of a palpation probe in the palpation device according to the second embodiment.

FIG. 10 is an explanatory diagram showing a configuration of an electric circuit system in the palpation device according to the second embodiment.

FIG. 11 is an explanatory diagram showing a state where a blood vessel is directly picked by a hand.

FIG. 12 is an explanatory diagram showing a configuration of an operation unit of a palpation probe in a modification of the palpation device according to the second embodiment of the present invention.

FIG. 13 is an explanatory diagram showing a configuration of a tactile sensor unit of a palpation probe in a modification of the palpation device according to the second embodiment.

FIG. 14 is an explanatory diagram showing a configuration of an operation unit of a palpation probe in still another modification of the palpation device according to the second embodiment of the present invention.

FIG. 15 is an explanatory view showing a configuration of a tactile sensor unit of a tactile probe in still another modification of the tactile examination apparatus according to the second embodiment.

FIG. 16 is an explanatory diagram showing a configuration of an electric circuit system in another modification of the palpation device according to the second embodiment.

FIG. 17 is a configuration diagram of an operation unit according to a third embodiment of the present invention.

FIG. 18 is a configuration diagram of each treatment portion according to the third embodiment.

FIG. 19 is a configuration diagram of a modification of the third embodiment.

FIG. 20 is a configuration diagram of a fourth embodiment of the present invention.

FIG. 21 is a main part configuration diagram of a control system according to the fourth embodiment.

FIG. 22 is a diagram showing a relationship between force and displacement of the slave arm according to the fourth embodiment.

FIG. 23 is a diagram showing a relationship between force and displacement of the master arm according to the fourth embodiment.

FIG. 24 is a configuration diagram of a modification of the fourth embodiment.

FIG. 25 is a main part configuration diagram of a control system according to a modification.

FIG. 26 is a diagram showing a relationship between force and displacement of a slave arm according to still another modification of the fourth embodiment.

FIG. 27 is a view showing the relationship between the force and displacement of the master arm in the same modification.

FIG. 28 is a configuration diagram of a fifth embodiment of the present invention.

FIG. 29 is a configuration diagram of grasping forceps which is also a modification of the fifth embodiment.

FIG. 30 is a configuration diagram of a gripping operation unit in the same modification.

FIG. 31 is a main-part configuration diagram of a control unit according to a fifth embodiment and a modification thereof.

FIG. 32 is an F- in the fifth embodiment and its modification.
Explanatory drawing of K characteristic.

FIG. 33 is a configuration diagram of a main part of a sixth embodiment of the present invention.

FIG. 34 is an internal configuration diagram of the distal end portion of the endoscope of the sixth embodiment.

FIG. 35 is a block diagram of the measuring means in the sixth embodiment.

FIG. 36 is a diagram showing a display example of the display unit according to the sixth embodiment.

FIG. 37 is a configuration diagram of a modified example of the display unit in the sixth embodiment.

FIG. 38 is a configuration diagram of grasping forceps according to a modified example of the sixth embodiment.

FIG. 39 is a configuration diagram of a seventh embodiment of the present invention.

FIG. 40 is an internal configuration diagram of the essential parts of the seventh embodiment.

FIG. 41 is a main part configuration diagram of a modified example of the seventh embodiment.

FIG. 42 is a main-portion configuration diagram of still another modification of the seventh embodiment.

FIG. 43 is a configuration diagram of an eighth embodiment of the present invention.

FIG. 44 is an internal configuration diagram of an essential part of the eighth embodiment.

[Explanation of symbols]

2 ... tactile sensor, 3 ... tactile probe, 5 ... signal processor,
6 ... Tactile presentation actuator drive section, 7 ... Tactile presentation section.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Kuniaki Kamami 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Hiroki Hibino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shuichi Takayama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Kenji Yoshino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Hideyuki Adachi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Yuichi Ikeda 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Tatsuya Yamaguchi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olin Scan Optical Industry Co., Ltd. in the (72) inventor Yasuhiro Ueda Shibuya-ku, Tokyo Hatagaya 2-chome No. 43 No. 2 Olympus Optical Industry Co., Ltd. in

Claims (1)

[Claims] 1. A tactile probe that can be introduced into the body, a tactile sensor unit provided on the tactile probe and applied to an internal organ of the body, and a signal for processing a signal from the tactile sensor unit and operating a tactile sense actuator driving unit. A tactile examination apparatus comprising: a processing unit; and a tactile sense presenting unit that presents a tactile sense according to a physical state of an internal organ detected by the tactile sense actuator driving unit by the tactile sense actuator driving unit.