JPH07328015A - Surgical manipulator system - Google Patents

Abstract

PURPOSE:To conduct surgery with an endoscope in the feeling of laparotomy by providing a system with a second slave manipulator moved after the movement of a sensor and an endoscope fixed to the second slave manipulator and displaying an image on a display device. CONSTITUTION:When a surgeon operates a master manipulator, the first slave manipulator 5 is moved after it, and holding forceps 14 inserted into a body cavity can be operated. A head mount display 12 serving as a display device and a three-dimensional digitizer 11 serving as a position detecting sensor are fixed to the head section of the surgeon. When the surgeon moves the head section, the second slave manipulator 7 is moved after the movement of the digitizer 11, an endoscope 6 fixed to it displays the image of a surgical field on the display 12, and the surgeon can conduct surgery with the holding forceps 14 while observing the displayed image in the ambience as if he is in the body cavity.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope in which an insertion hole is opened in a body wall such as an abdominal wall and an endoscope or a treatment tool is percutaneously inserted into a body cavity through the insertion hole to perform treatment. The present invention relates to a manipulator system for surgery used in lower surgery.

[0002]

2. Description of the Related Art Conventionally, an endoscopic view has been made in which a body wall such as an abdominal wall is provided with an insertion hole, and an endoscope or a treatment tool is percutaneously inserted into the body cavity through the insertion hole to perform various treatments in the body cavity. Mirror surgery is performed. Such an operation method is widely performed as a minimally invasive operation that does not require a large incision, such as a cholecystectomy operation and an operation of removing and removing a part of the lung.

Further, there is a surgical manipulator which is equipped with an endoscope and a treatment tool, operates the endoscope and the treatment tool by remote control, and performs surgery on behalf of the operator, for example, US Pat. No. 52.
No. 17003. In such a manipulator for surgery, an insertion section including an endoscope and a treatment tool usually has a multi-joint structure, and each joint section is operated by an actuator to facilitate an approach to a target site in a body cavity. .

In addition, when a surgical manipulator equipped with an endoscope and a treatment instrument inserts the insertion portion into the body cavity and moves the insertion portion to a target site in the body cavity, the insertion portion passes through the insertion hole in the body wall. The mechanically supported structure is Japanese Patent Application No. 5-28.
No. 5206.

[0005]

By the way, in the above-mentioned endoscopic surgery, an endoscope or a treatment tool inserted into a body cavity through an insertion hole formed in a body wall has a wide range within the body cavity. It is desirable to be able to work with. However, the endoscope and the treatment tool that can be operated by the operator with one hand have a linear shape with few degrees of freedom, and even if the endoscope or the treatment tool reaches the target position, the treatment or observation can be performed at the desired orientation. It was difficult to do.

[0006] For example, it is desirable to hook the needle at a right angle to the suture line when trying to hook the needle to an organ or the like by the treatment tool at the time of suturing. However, the flexibility of the treatment tool is insufficient. Sometimes it was difficult.

This problem is solved by using the above-mentioned surgical manipulator provided with an insertion portion having a multi-joint structure having a high degree of freedom. In this case, however, the work is performed at a desired position and at a desired orientation. When the insertion part of the multi-joint structure is operated, the joint part may come into contact with an organ other than the intended one and give an excessive force.

Also in Japanese Patent Application No. 5-285206, since the insertion portion can be mechanically adjusted so as to pass through the insertion hole, unless the patient moves, no excessive force is applied to the insertion hole. , If the patient moves,
There is a possibility that the insertion portion may apply an unreasonable force to the insertion hole.

The present invention has been made by paying attention to the above-mentioned circumstances, and the purpose thereof is that the treatment can be performed in the presence of being in a body cavity so that the endoscope can be operated like a laparotomy. An object of the present invention is to provide a manipulator system for surgery that enables lower surgery.

[0010]

In order to achieve the above object, the present invention provides a master manipulator set in an area that can be operated by an operator and a master manipulator set to access an operating field. A first slave manipulator that performs a movement following an operation, a surgical instrument that is fixed to the first slave manipulator and is inserted into a body cavity, a display device that is fixed to the operator's head, and an operator's head. A part fixed to the display unit or the display device, a second slave manipulator that moves following the movement of the sensor, and an endoscope that is fixed to the second slave manipulator and displays the image on the display device. And a mirror.

[0011]

[Operation] When the operator operates the master manipulator,
Following this, the first slave manipulator operates, the surgical instrument inserted in the body cavity can be operated, and the display device and the sensor are fixed to the operator's head. When moving the part, the second slave manipulator operates following the movement of the sensor, and the endoscope fixed to the second slave manipulator displays the image of the surgical field on the display device, and the operator Can be treated with a surgical instrument while observing the image displayed on the display device.

[0012]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 show a first embodiment, and FIG. 1 is an overall configuration diagram. In FIG. 1, 1 is an operating table, and 2
Is a patient. A bedside rail 3 is provided on both side walls of the operating table 1, and a first slave manipulator (hereinafter, a treatment manipulator 5) to which a surgical instrument (hereinafter, referred to as a treatment instrument 4) is fixed is provided on the left side of the bedside rail 3.
However, a second slave manipulator (hereinafter, referred to as an observation manipulator 7) to which the endoscope 6 capable of stereoscopic observation is fixed is attached to the right side.

The treatment manipulator 5 and the observation manipulator 7 both serve as a support mechanism, which are first motion shafts 5a and 7a which are vertically and pivotally moved, and which are provided on the first motion shafts 5a and 7a and horizontally. It is composed of second operating shafts 5b and 7b which operate and joint portions 5c and 7c as joint parts provided at the tip ends of the second operating shafts 5b and 7b. Further, the treatment manipulator 5 is connected via a treatment manipulator control device 8 to a master manipulator 9 installed in an area where an operator can operate.

Further, the observation manipulator 7 is connected to a three-dimensional digitizer 11 as a position detecting sensor via an observation manipulator control device 10, and the three-dimensional digitizer 11 is fixed to the operator's head. Is fixed to the head mounted display 12 as. The three-dimensional digitizer 11 may be directly fixed to the operator's head, or a joystick or a key switch may be used instead of the master manipulator 9 and the three-dimensional digitizer 11.

The first operation shafts 5a, 7a and the second operation shafts 5b, 7b of the treatment manipulator 5 and the observation manipulator 7 are moved up and down a and turned b by an actuator (not shown) such as an electromagnetic motor. , The driving structure of the so-called cylindrical coordinate type manipulator having the horizontal c movement axis is provided, but the so-called multi-joint type manipulator structure having a plurality of joints may be used.

A CCD camera 13 is provided as an observation means at the tip of the insertion portion 6a of the endoscope 6. The image obtained by this CCD camera 13 can be observed by the head mounted display 12, but it may be a TV monitor. Further, in place of the CCD camera 13, an optical system image transmitting means such as a relay lens is provided in the insertion portion 6a, a camera is attached to the base end portion of the insertion portion 6a, and further, the optical system image transmitting means is provided. It is also possible to have two systems and to mount two cameras at the base end of the insertion portion 6a to enable stereoscopic observation.

Further, the grasping forceps 14 as a treatment means is provided at the distal end portion of the insertion portion 4a of the treatment instrument 4, but a scalpel, a suture instrument or the like may be used. Also, the insertion portion 5a
An actuator (not shown) that mainly opens and closes the grasping forceps 14 is provided at the proximal end of the.

The connecting portions 5c and 7c have the same structure,
The connecting portion 7c of the observing manipulator 7 will be described. The connecting portion 7c is configured as shown in FIG. That is, the second
A fitting hole 16 is concentrically formed in the support arm tip portion 15 of the operating shaft 7b, and a shaft portion 18 is rotatably supported in the fitting hole 16 via a bearing 17. The shaft portion 18 is integrally provided with a bifurcated bearing support portion 19, and the bearing support portion 19 is provided with a bearing 20 in a direction perpendicular to the bearing 17. The bearing 20 is rotatably supported by an insertion portion mounting portion 21 as a joint shaft. Therefore, the insertion portion attachment portion 21 is configured to be rotatable with two degrees of freedom at the point d intersecting the insertion portion center line. Insertion part attachment part 2
A mounting hole 22 is provided in the shaft center portion of the endoscope 1. The insertion portion 6a of the endoscope 6 is inserted into the mounting hole 22 and is fixed by a nut (not shown).

Next, the operation of the surgical manipulator system will be described. As shown in FIG. 3 and FIG. 4, the positions of the joint lower ends 36 of the joints 5c and 7c between the first operating shafts 5a and 7a and the second operating shafts 5b and 7b are the upper and lower a, the swivel b, Each movement position of the horizontal c and the second movement axis 5b,
Due to the geometrical dimensions of 7b, it is known in manipulator controllers 8,10.

As shown in FIG. 3 (a), the lower end 36 of the connecting portion is moved into the insertion hole 2a formed on the body surface without the insertion portions 4a, 6a of the treatment instrument 4 and the endoscope 6 being attached. Positioning is performed (step S1 in FIG. 4). Since the position of the lower end 36 of the connecting portion and the position of the insertion hole 2a coincide with each other due to the alignment, the lower end 36 of the connecting portion at this time is recognized as the position of the insertion hole 2a and stored in the memory of the manipulator control device 8, 10. It is stored (step S2 in FIG. 4).

Further, the lower end 36 of the connecting portion is operated so as to be separated from the insertion hole 2a (step S3 in FIG. 4), and FIG.
As shown in, the insertion portions 4a and 6a are inserted into the attachment holes 22 of the coupling portions 5c and 7c, and further into the insertion hole 2a (step S4 in FIG. 4). At this time, as shown in FIG. 3C, the insertion portions 4a and 6a are fixed to the mounting holes 22 with nuts.

The position of the action point 37a such as the focus of the objective lens at the tip of the insertion portion 6a of the endoscope 6 or the action point 37b of the grasping forceps 14 at the tip of the insertion portion 4a of the treatment instrument 4 or the like.
Is the first movement axis 5a, 7a and the second movement axis 5b,
7b position, insertion hole 2a position and size, and action point 3
It is geometrically determined by the dimensions up to 7a and 37b (step S5 in FIG. 4). This is calculated by the manipulator control devices 8 and 10.

On the other hand, the operating point 9a of the master manipulator 9, for example, the center 11a of the three-dimensional digitizer 11 of the head mount display 12 or the position of the tip 9b of the operating portion of the master manipulator 9, is calculated by the manipulator control device 8, The master manipulator 9 operates so that the positions of the action points 9a of the master manipulator 9 and the positions of the action points 37a, 37b of the insertion portions 4a, 6a coincide with each other (step S6 in FIG. 4).

Inserts 4a and 6a and second operating shafts 5b and 7
Since b is coupled by the two-degree-of-freedom rotatable coupling portions 5c and 7c, even if the patient moves and the position of the insertion hole 2a shifts, an unreasonable force is not exerted on the insertion hole 2a.

The points of action 37a and 37b of the insertion portions 4a and 6a are passed through the fixed insertion hole 2a and inside the body cavity.
However, in order to position it at an arbitrary position, an operating means with at least 5 degrees of freedom was required. However, according to this embodiment, an operating means with 3 degrees of freedom allows this, and therefore the structure is simple. . Further, because of the cylindrical coordinate type manipulator, the length of the portion where the rear ends of the second operation shafts 5b and 7b project in the horizontal direction is smaller than the bed size, and at the same time, the first
Since it does not depend on the movement of the movement axes 5a and 7a, it does not interfere with the surgeon or nurse around the bedside.

FIG. 5 shows a second embodiment, in which the connecting portion 5c,
It is a modification of 7c. The support arm tip portion 15 is provided with a spherical bearing 23 having a degree of freedom that is rotatable in three directions around the point e, and the spherical bearing 23 is provided with an insertion portion attachment portion 25 having an attachment hole 24. . Then, similarly to the first embodiment, the insertion portions 4a, 6a of the treatment tool 4 or the endoscope 6 are inserted into the mounting holes 24 and fixed by nuts (not shown).

FIG. 6 shows a third embodiment, in which the connecting portion 5c,
It is a modification of 7c. A bearing support hole 26 is provided in the support arm tip portion 15 in a direction orthogonal to the axial direction, and a shaft portion 28 is rotatably supported in the bearing support hole 26 via a bearing 27.

On the other hand, a fitting hole 31 is formed in the insertion portion mounting portion 30 having the mounting hole 29, and the tip portion of the shaft portion 28 is rotatably supported in the fitting hole 31 via a bearing 32. Has been done. The first shaft 33 and the second shaft 34 are orthogonal to each other, and the second shaft 34 and the insertion portion central axis 35 are orthogonal to each other,
It is a structure in which the first shaft 33 and the insertion portion central shaft 35 do not intersect. Also in this embodiment, as in the first embodiment, the insertion portion 4a or 6a is inserted into the mounting hole 29,
It is fixed by a nut (not shown).

According to the coupling structure shown in the third embodiment, since the distance L between the first shaft 33 and the insertion portion central axis 35 is large, when the first shaft 33 rotates, the insertion portions 4a, 6a and The tips of the second operation shafts 5b and 7b are less likely to interfere with each other,
The rotation range of the shaft 33 can be set large, and thus the insertion portion 4
The action points at the tips of a and 6a can be moved in a wide range.
If you move the position of the head while looking at the stereoscopic image displayed on the head mount display 12, the observation position (operative field) of the endoscope 6 that can be stereoscopically observed moves following the movement of the head. The person can feel as if they are inside the body cavity. Further, when the master manipulator 9 is operated while the stereoscopic image displayed on the head mount display 12 is viewed and the observation manipulator 7 is operated, the treatment can be performed in a realistic sensation of being inside a body cavity. With this feeling, endoscopic surgery becomes possible.

FIGS. 7 and 8 show a fourth embodiment in which observation or treatment can be performed from any position and direction in the body cavity without exerting an excessive force on the insertion hole on the body surface of the patient. It is a manipulator system for surgery,
The same components as those of the first embodiment are designated by the same reference numerals and the description thereof will be omitted.

Insertion portions 4a, 6 of the treatment instrument 4 and the endoscope 6
A curved portion 40 is provided at the tip of a. Curved part 4
0 has a bending motion mechanism having two degrees of freedom, and has insertion portions 4a and 6a.
It is driven by an actuator 41 provided at the base end of the. A wire is used as the power transmission means of the actuator 41. The insertion portions 4a, 6a have an operating shaft 42 that rotates around this central axis, and
1 is driven, and power is transmitted by the drive transmission means 43 such as a spur gear or a timing belt to rotate.

Inserts 4a, 6a and second operating shafts 5b, 7
Since b is connected by the two-degree-of-freedom rotatable connecting portions 5c and 7c, even if the patient 2 moves and the position of the insertion hole 2a shifts, an unreasonable force is not applied to the insertion hole 2a.

The points of action 37a, 37b of the insertion portions 4a, 6a are passed through the fixed insertion hole 2a and inside the body cavity.
However, in order to position the robot so that it takes an arbitrary position and posture, at least eight degrees of freedom of movement means are required.
According to this embodiment, since the operation means having 6 degrees of freedom is possible, the structure is simple.

Further, because of the cylindrical coordinate type manipulator, the length of the portion where the rear ends of the second operation shafts 5b and 7b project in the horizontal direction is smaller than the bed size, and at the same time, the first operation shafts 5a and Since it does not depend on the movement of 7a, it does not interfere with the surgeon or nurse around the bedside.

According to the above-mentioned embodiment, the following structure can be obtained. (1) A master manipulator set in an area that can be operated by an operator, a first slave manipulator that performs a movement following the operation of the master manipulator set to access the operative field, and the first manipulator. A surgical instrument fixed to the slave manipulator and inserted into the body cavity, a display device fixed to the operator's head, a sensor fixed to the operator's head or the display device, and following the movement of the sensor A second slave manipulator performing the above movement, and fixed to the second slave manipulator,
An operating manipulator system comprising an endoscope for displaying the image on the display device.

(2) A master manipulator set within an area that can be operated by an operator, a slave manipulator that follows the operation of the master manipulator set to access the operative field, and the slave manipulator. A surgical manipulator system, comprising: a surgical instrument fixed and inserted into a body cavity.

(3) A slave manipulator, an endoscope fixed to the slave manipulator and inserted into a body cavity, and a display device fixed to the head of an observer to display an image obtained by the endoscope. An observation manipulator system comprising: a sensor fixed to an observer's head or the display device; and a manipulator control device that controls the slave manipulator by following the movement of the sensor.

(4) The first slave manipulator is a procedural manipulator having a motion axis that moves vertically, pivotally and horizontally.
The surgical manipulator system described.

(5) The second slave manipulator is an observing manipulator having an operating axis that operates in vertical, turning, and horizontal directions (1).
The surgical manipulator system described.

(6) The surgical instrument according to (1) or (2), characterized in that the surgical instrument is a treatment instrument having a treatment section such as grasping forceps, a scalpel or a suturing instrument at the tip of the insertion section. Manipulator system.

(7) The surgical manipulator system according to (1), wherein the endoscope is a stereoscopic endoscope capable of stereoscopically observing a surgical field. (8) The manipulator system for surgery according to (1), wherein the display device is a head mount display.

(9) The surgical manipulator system according to (1), wherein the sensor is a three-dimensional digitizer. According to the above (1), when the operator operates the master manipulator, the first slave manipulator operates following the operation of the master manipulator, and the surgical instrument inserted into the body cavity can be operated. Since the display device and the sensor are fixed to the head of the person, when the operator moves the head, the second slave manipulator operates following the movement of the sensor and is fixed to the second slave manipulator. The endoscope thus displayed displays an image of the operative field on the display device, and the operator can treat with a surgical instrument while observing the image displayed on the display device. Therefore, since the treatment can be performed in the presence of being inside a body cavity, endoscopic surgery can be performed with the sensation of laparotomy.

(10) An insertion portion to be inserted into the body cavity through an insertion hole provided on the body surface, a means provided at the tip of the insertion portion for at least one of observation and treatment, and the insertion provided outside the body. Support mechanism for the section, driving means for operating the support mechanism, joint section having at least one degree of freedom for rotation at the mounting portion of the insertion section to the support mechanism, and control means for controlling the driving means. And a manipulator system for surgery, comprising: an operating means for operating the support mechanism.

(11) The surgical manipulator system according to (10), wherein the mounting portion has a rotatable degree of freedom around a vector that is not parallel to the longitudinal direction of the insertion portion. (12) The manipulator system for surgery according to (10), wherein the support mechanism has an operation shaft that can move in a vertical direction, a turning direction, and a horizontal direction.

(13) The surgical instrument according to (10), wherein the insertion portion has a bending portion provided at a distal end of the insertion portion, and an operating means provided at a base end portion of the insertion portion to operate the bending portion. Manipulator system.

(14) The first step of inserting the insertion portion into the body cavity through the insertion hole provided on the body surface, the second step of obtaining and storing the position of the insertion hole, and the position of the insertion hole. It has a third step of obtaining the position and / or posture of the insertion portion from the position of the movement axis, and a fourth step of operating the position and / or posture of the insertion portion based on the position information obtained from the operating means. A manipulator system for surgery, which is characterized in that

(15) The support mechanism has at least one joint shaft that is rotatable in the attachment portion of the insertion portion,
(10) The manipulator system for surgery according to (10), wherein the center of each joint axis intersects with the center of the insertion portion at one point.

(16) The support mechanism has at least one joint shaft that is rotatable in the attachment portion of the insertion portion,
(10) The manipulator system for surgery according to (10), in which at least one joint axis does not intersect with the center of the insertion portion.

According to the above configuration (10), the distal end of the insertion portion of the endoscope, the treatment tool or the like can be placed at any position and / or in the body cavity without exerting an unreasonable force on the insertion hole on the body surface. It is possible to perform observation and / or treatment while taking a posture. Therefore, there is an effect that it has a sufficient degree of freedom to perform observation and treatment in the body cavity, and that it does not give an unreasonable force by contacting organs other than the target during those operations.

[0050]

As described above, according to the present invention, when the operator operates the master manipulator, the first slave manipulator follows the operation of the master manipulator, and the surgical instrument inserted into the body cavity. Since the display device and the sensor are fixed to the operator's head, when the operator moves the head, the second slave manipulator operates following the movement of the sensor. The endoscope fixed to the second slave manipulator displays the image of the operative field on the display device, and the operator can perform treatment with the surgical instrument while observing the image displayed on the display device. Therefore, since the treatment can be performed in the presence of being inside a body cavity, endoscopic surgery can be performed with the sensation of laparotomy.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a surgical manipulator system showing a first embodiment of the present invention.

FIG. 2 is a cross-sectional plan view showing the structure of the joint portion of the embodiment.

FIG. 3 is an operation explanatory view of the same embodiment.

FIG. 4 is a flowchart showing an operation procedure of the embodiment.

FIG. 5 is a vertical cross-sectional front view showing the structure of a coupling portion showing a second embodiment of the present invention.

FIG. 6 is a cross-sectional plan view showing a structure of a coupling portion showing a third embodiment of the present invention.

FIG. 7 is an overall configuration diagram of a surgical manipulator system showing a fourth embodiment of the present invention.

FIG. 8 is an explanatory view of the operation of the same embodiment.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Operating table, 2 ... Patient, 4 ... Treatment tool, 5 ... Manipulator for treatment, 6 ... Endoscope, 7 ... Manipulator for observation,
8, 10 ... Manipulator operating device, 9 ... Master manipulator, 11 ... Three-dimensional digitizer, 12 ... Head mount display.

Claims (1)

[Claims] 1. A master manipulator set within an area that can be operated by an operator, a first slave manipulator configured to follow an operation of the master manipulator set to access a surgical field, and the first slave manipulator. No. 1 slave manipulator, a surgical instrument to be inserted into a body cavity, a display device fixed to the operator's head, a sensor fixed to the operator's head or the display device, and movement of the sensor A manipulator system for surgery, comprising: a second slave manipulator that moves in accordance with the above; and an endoscope that is fixed to the second slave manipulator and that displays the image on the display device.