CN117897117A - Mounting tool for holding - Google Patents

Abstract

In order to perform an operation appropriately and promptly using an optimum surgical instrument corresponding to a patient's body shape, a patient site, a patient state, and the like, there is provided a holding fixture for an operation support device (1) having a plurality of connecting arms (9, 10, 11) and a holder (3) supported by the connecting arms, and for holding a surgical instrument (80) having a head (82) to the holder (3), the holding fixture comprising: a spacer (28) detachably attached to the bracket; and an adapter (37) detachably attached to the partition for fitting the head, the adapter being provided as a grip portion gripped by an operator in a state where the head is fitted.

Description

Mounting tool for holding

Technical Field

The present invention relates to the technical field of holding fixtures for surgical auxiliary devices.

Background

In recent years, surgical operations using surgical auxiliary devices are becoming popular. The surgical assist device includes a plurality of coupling arms that are rotatably or rotatably coupled in sequence, and the coupling arms are operated by a driving force of a driver or the like, and a holder for holding surgical instruments is coupled to the coupling arms at one end in the coupling direction. Endoscopes, forceps, and the like are used as surgical instruments according to the type and condition of the surgery.

In the surgical assist device, when the plurality of connecting arms are rotated or pivoted in predetermined directions, the position and posture of the surgical instrument are changed in accordance with the movement of the connecting arms, and the surgical operation is performed by the surgical instrument held by the holder.

A surgical operation using the above-described surgical assist device is generally performed by an operator (doctor) remotely operating the surgical assist device installed in an operating room by a master-slave system. In such a surgical operation, a pivot point is set as a reference point for the position and posture of the surgical instrument.

The pivot point is located at a position that is substantially coincident with an incision formed in a body cavity of a patient for insertion of a surgical instrument, and with a trocar in the case of a trocar. Therefore, in a state where the surgical instrument is inserted into the body cavity of the patient, the position and posture of the surgical instrument are controlled so that a part of the surgical instrument always passes through the pivot point, and the load on the tissue in the vicinity of the body surface of the patient is prevented by passing the part of the surgical instrument through the pivot point, thereby ensuring safety.

In addition, in the surgical operation, an operator or an assisting person may hold the surgical instrument manually to operate the surgical instrument. For example, when a surgical instrument is inserted into a body cavity of a patient, or when a condition of the body cavity is imaged or observed in an inserted state, the surgical instrument may be manually operated.

In the above-described surgical assist device, the surgical instrument is held by being attached to the holder via the spacer and the adapter (for example, refer to patent document 1). There are cases where a plurality of types of adapters having different shapes and sizes are prepared, and in this case, the most suitable type is selected and used according to the size, shape, and the like of the surgical instrument.

In operation, the operation assisting device is covered with a covering cover for separating the cleaning region from the unclean region, and the space inside the covering cover is kept as the cleaning region. In a state where the surgical auxiliary device is covered with the covering cover, the partition is attached to the holder from the outside of the covering cover, and the adapter to which the surgical instrument is attached to the partition, so that the surgical instrument is held to the holder via the partition and the adapter.

Prior art literature

Patent literature

Patent document 1: japanese patent No. 6795162

Disclosure of Invention

Problems to be solved by the invention

However, there are various types of surgical instruments according to functions and the like, but there are types having different sizes and shapes even for the types having the same function. For example, an endoscope used as a surgical instrument includes: an insertion portion that is inserted into a body cavity of a patient; and a head portion connected to the insertion portion, the insertion portion being formed in a shaft shape having a diameter of 5mm to 10mm, for example, and having a small difference in shape and size, but the head portion often has a large difference in shape and size.

In such a surgical instrument, since the difference in shape and size of the insertion portion is small, even when an arbitrary endoscope is used manually, the insertion portion can be gripped to facilitate operations and the like without any discomfort, and thus an operator can ensure good operability.

However, when the insertion portion is gripped and operated, since the insertion portion has a small diameter and each portion such as a lens is disposed therein, if an excessive force is applied to the insertion portion, the internal structure may be affected and the lens may be damaged. In addition, when the insertion portion is gripped and operated, the gripped portion cannot be inserted into the body cavity of the patient, and accordingly, the amount of insertion of the insertion portion into the body cavity of the patient is limited, and the state of the affected part or the like may not be accurately grasped, which may prevent the operation.

On the other hand, in the operation, it is necessary to perform the operation appropriately and promptly using an optimum surgical instrument according to the body type of the patient, the affected part, the affected state, and the like.

Accordingly, the purpose of the holding fixture of the present invention is to perform an operation properly and promptly without impeding the operation.

Solution for solving the problem

The present invention relates to a holding fixture for a surgical assist device including a plurality of connecting arms and a holder supported by the connecting arms, wherein the holding fixture is configured to hold a surgical instrument having a head to the holder, and the holding fixture includes: a partition detachably attached to the bracket; and an adapter detachably attached to the partition for fitting the head, the adapter being provided as a grip portion gripped by an operator in a state where the head is fitted.

Thus, the head can be held via the adapter in a state where the spacer is attached to the bracket, the adapter is attached to the spacer, and the head is attached to the adapter.

ADVANTAGEOUS EFFECTS OF INVENTION

According to the present invention, the head can be held via the adapter in a state in which the holder is attached with the spacer, the adapter is attached to the spacer, and the surgical instrument having a different shape or size can be used depending on the adapter, so that the operation can be performed appropriately and promptly without impeding the operation.

Drawings

Fig. 1 is a schematic perspective view showing an embodiment of the holding fixture according to the present invention, and fig. 2 to 24 are schematic perspective views showing a state of use of the surgical auxiliary device.

Fig. 2 is a schematic perspective view of the surgical assist device.

Fig. 3 is an exploded perspective view of the bracket.

Fig. 4 is a sectional view showing a lock mechanism and the like.

Fig. 5 is a sectional view showing a state in which the partition is locked by the locking mechanism.

Fig. 6 is a perspective view showing a state in which the stent and the device main body are covered with the cover, together with the partition.

Fig. 7 is a perspective view of the separator.

Fig. 8 is a front view of the separator.

Fig. 9 is a sectional view showing a state in which the partition is mounted to the bracket via the cover.

Fig. 10 is an exploded perspective view of the adapter.

Fig. 11 is a perspective view of an adapter.

Fig. 12 is a front view of the first member.

Fig. 13 is a bottom view of the first member.

Fig. 14 is a front view of the second member.

Fig. 15 is a top view of the second member.

Fig. 16 is a cross-sectional view of the adapter.

Fig. 17 is an exploded perspective view showing the surgical instrument and the adapter.

Fig. 18 is a sectional view showing a state in which an assembled part of the surgical instrument is assembled to the adapter.

Fig. 19 is a sectional view showing a state in which the adapter is mounted to the partition and the partition is mounted to the bracket.

Fig. 20 is a perspective view showing an adapter, a spacer, and a bracket for indicating the mounting direction.

Fig. 21 is a perspective view showing the adapter and the partitioning member in a state where the second member is mounted to the partitioning member.

Fig. 22 is a sectional view showing a state in which the adapter is locked to the partition.

Fig. 23 is a sectional view showing a state in which the adapter is locked to the partition in a direction different from fig. 22.

Fig. 24 is a cross-sectional view showing a state in which the lock of the adapter to the partition is released in the same position as fig. 23.

Detailed Description

The manner in which the holding fixture of the present invention is implemented will be described below with reference to the accompanying drawings.

The embodiments described below show examples of the types of application of the surgical assist device according to the present invention to be used by being fixed to an operating table. However, the application range of the surgical assist device according to the present invention is not limited to the type to be used by being fixed to an operating table, and the present invention can be applied to the type to be used by being installed on the floor or the like of an operating room, or the type to be used by being installed on the ceiling or wall surface of an operating room.

The directions of the front, rear, upper, lower, left, and right shown below are merely for convenience of description, and the implementation of the present invention is not limited to these directions.

< schematic Structure of surgical auxiliary device and the like >

First, the outline structure of the operation support device 1 and the like will be described (see fig. 1 and 2).

In the operating room, an operating table 100 is provided, and a patient 200 lies on the operating table 100 in a supine state, for example. A fixing rail 100a is provided on a side portion of the operating table 100. An incision 202 is formed in a body cavity 201, such as an abdominal wall 201a, of the patient 200. During a surgical operation, a part of a surgical instrument described later is inserted into the incision 202. Incision 202 is a small hole into which a portion of a surgical instrument is inserted.

The surgical auxiliary device 1 has a device body 2 and a stand 3. One motor, not shown, and a plurality of pneumatic actuators, not shown, are disposed in the device body 2, for example.

The apparatus main body 2 includes: a fixed base 4 that can be fixed to the operating table 100; and an arm body 5 connected to the fixed base 4.

The fixed base 4 has: a substantially rectangular parallelepiped base body 6, and predetermined mechanisms and the like are provided inside the base body 6; a base 7 rotatably supported by the base body 6; and a clamp 8 protruding from the base body 6. The clamp 8 has an upper clamping portion 8a and a lower clamping portion 8b, and at least one of the upper clamping portion 8a and the lower clamping portion 8b is movable in a direction to separate from and contact with the other.

An air intake pipe, not shown, protrudes from the surface of the base body 6 opposite to the surface on which the clamp 8 is provided. The air suction pipe is connected to the compressor via a suction pipe. Thus, compressed air is supplied from the compressor into the fixed base 4. The compressed air supplied to the inside of the fixed base 4 flows through the inside of the fixed base 4 toward the inside of the arm 5, and is used as a driving force for operating each part of the arm 5.

The surgical auxiliary device 1 clamps the upper clamping portion 8a and the lower clamping portion 8b of the clamp 8 from above and below the fixing rail 100a, thereby fixing the clamp to the operating table 100.

Further, for example, the operation support device 1 can be transported by a carriage (stage) by attaching the fixed base 4 to the carriage (not shown), and in a state of being transported to a sterilization room and subjected to a sterilization process, the carriage is transported to an operation room for performing an operation.

The base 7 is rotatably supported by the base body 6 about a shaft S1 extending in the vertical direction as a fulcrum, and a part of the base 7 is located above the upper surface of the fixed base 4. The base 7 is rotated with respect to the fixed base 4 by, for example, a driving force of a motor.

The arm body 5 has a first connecting arm 9, a second connecting arm 10, and a third connecting arm 11. The number of the connecting arms in the arm body 5 is not limited to three, and may be two or four or more if a plurality of connecting arms are used.

One end portion in the longitudinal direction of the first connecting arm 9 is provided as a first connecting portion 9a, and the other end portion in the longitudinal direction is provided as a second connecting portion 9b. The first connecting portion 9a of the first connecting arm 9 is connected to the base 7, and the first connecting arm 9 is rotatable with respect to the base 7 about the axis S2 extending in the horizontal direction as a fulcrum. The first link arm 9 is rotated relative to the base 7 by, for example, an air pressure driver that operates with compressed air supplied from a compressor.

One end portion in the longitudinal direction of the second connecting arm 10 is provided as a first connecting portion 10a, and the other end portion in the longitudinal direction is provided as a second connecting portion 10b. The first connecting portion 10a of the second connecting arm 10 is connected to the second connecting portion 9b of the first connecting arm 9, and the second connecting arm 10 is rotatable with respect to the first connecting arm 9 about the axis S3 extending in the horizontal direction as a fulcrum. The second connecting arm 10 is rotated relative to the first connecting arm 9 by, for example, an air pressure driver that operates with compressed air supplied from a compressor.

One end portion in the longitudinal direction of the third connecting arm 11 is provided as a first connecting portion 11a, and the other end portion in the longitudinal direction is provided as a second connecting portion 11b. The second connection portion 11b is constituted by two arm portions, for example. The first connecting portion 11a of the third connecting arm 11 is connected to the second connecting portion 10b of the second connecting arm 10, and the third connecting arm 11 is rotatable with respect to the second connecting arm 10 about an axis S4 as a fulcrum, the axis S4 extending in a direction orthogonal to the axis S3. The third connecting arm 11 is, for example, a part that performs free rotation operation as follows: the rotation is performed by the self weight or other actions of the first connecting arm 9, the second connecting arm 10, etc., without using an external driving force such as a driving force of a motor or an air pressure driver.

< specific Structure of stent, etc.)

Next, a specific structure and the like of the bracket 3 will be described (see fig. 2 to 5).

The bracket 3 is rotatably supported (coupled) to the second coupling portion 11b of the third coupling arm 11 (see fig. 2). The bracket 3 is formed in a substantially cylindrical shape, and a middle portion in the longitudinal direction (axial direction) of the bracket 3 is connected to the second connecting portion 11b. The bracket 3 is rotatable with respect to the third connecting arm 11 about an axis S5, the axis S5 extending in a direction orthogonal to the axis S4. The bracket 3 is, for example, a part that performs free rotation operations as follows: the rotation is performed by the self weight or other actions of the first connecting arm 9, the second connecting arm 10, the third connecting arm 11, etc., without using an external driving force such as a driving force of a motor or a pneumatic driver.

A part of the holder 3 is rotatable, and the holder 3 has: a base cylinder 12 which does not rotate; a rotating portion 13 rotatably supported by the base cylinder portion 12; and a coupling cylinder 14 attached to the base cylinder 12 (see fig. 3).

A shaft support hole, not shown, is formed in the base cylinder 12 so as to penetrate in the axial direction.

The rotating unit 13 includes: a shaft portion 15, a part of the shaft portion 15 being inserted into the shaft support hole of the base cylinder portion 12; an operation portion 16 coupled to one axial end portion of the shaft portion 15; and a detachable portion 17 coupled to the other end portion of the shaft portion 15 in the axial direction. The rotation section 13 is rotatable about an axis S6 with respect to the base cylinder section 12 and the coupling cylinder section 14, the axis S6 being orthogonal to the axis S5. For example, the rotating unit 13 may be rotated by an air pressure driver that operates with compressed air supplied from a compressor, and the rotating unit 13 may be rotated manually.

The shaft portion 15 has an insertion hole 15a extending in the axial direction. The shaft portion 15 is formed with a first arrangement recess 15b and a second arrangement recess 15c each opening on the outer peripheral surface (see fig. 4 and 5). The first disposition concave portion 15b and the second disposition concave portion 15c are formed on opposite sides with the insertion hole 15a interposed therebetween, and a part of the second disposition concave portion 15c communicates with the insertion hole 15a.

In the shaft portion 15, shaft insertion holes 18 extending in a direction orthogonal to the insertion hole 15a are formed on both sides of the insertion hole 15a, respectively, and one end of the shaft insertion hole 18 communicates with the first disposition recess 15b and the other end communicates with the second disposition recess 15 c. In the shaft insertion hole 18, a substantially half portion on the side communicating with the first arrangement concave portion 15b is formed as a large diameter portion 18a, and a substantially half portion on the side communicating with the second arrangement concave portion 15c is formed as a small diameter portion 18b. An annular spring receiving surface 18c facing the first arrangement concave portion 15b is formed between the large diameter portion 18a and the small diameter portion 18b.

The lock mechanism 19 is supported by the shaft portion 15. The lock mechanism 19 has a base member 20, a pair of spring support shafts 21, and a lock member 22.

The base member 20 has: a substantially flat plate-shaped plate portion 20a; and pressed portions 20b protruding from portions of the plate portion 20a other than both end portions. The base member 20 is disposed so that a part thereof is inserted into the first disposition recess 15b.

A pair of spring support shafts 21 are mounted on both end portions of the plate portion 20a, respectively. A portion of the spring support shaft 21 near one end in the axial direction is attached to the plate portion 20a, and a portion other than both end portions in the axial direction is inserted into the shaft insertion hole 18. The compression coil spring 23 is supported by the spring support shaft 21, and both ends of the compression coil spring 23 are respectively pressed by the plate portion 20a and the spring receiving surface 18 c.

The lock member 22 is located in the second disposition recess 15c, and the other end portion in the axial direction of the spring support shaft 21 is attached to both end portions of the lock member 22. The lock member 22 is biased toward the base member 20 by the biasing force of the compression coil spring 23. Thus, in a state where no force against the urging force is applied to the compression coil spring 23, both end portions of the lock member 22 are pressed by the shaft portion 15, and a part of the portion between the both end portions is located in the insertion hole 15a.

A switching button 16a (see fig. 3) is disposed in the operation unit 16. The switching button 16a has a function of switching the driving force for rotating the rotating portion 13.

The outer peripheral surface of the attaching/detaching portion 17 is formed as a peripheral surface, and the attaching/detaching portion 17 has a coupling groove 17a that opens in the axial direction. The coupling groove 17a is formed in a rectangular shape. The insertion hole 15a of the shaft portion 15 communicates with the coupling groove 17a, and the opening of the coupling groove 17a is larger in size than the opening of the insertion hole 15a.

The coupling tube portion 14 is formed in a substantially cylindrical shape, and the coupling tube portion 14 is attached to the base tube portion 12 in a state of covering the shaft portion 15 and the attachment/detachment portion 17. The coupling tube portion 14 is supported (coupled) to the second coupling portion 11b of the third coupling arm 11.

An unlock button 14a is disposed in the coupling tube 14. An upper end portion of a spring member, not shown, is attached to a lower surface of the unlock button 14a. The unlock button 14a is operated, thereby pressing the pressed portion 20b of the base member 20 against the urging force of the compression coil spring 23 via the spring member. However, the pressed portion 20b can be pressed when the unlock button 14a is operated only in a state where the lock mechanism 19 is located in the same phase as the unlock button 14a in the rotation direction of the shaft portion 15. When the pressed portion 20b is pressed, the spring support shaft 21 and the lock member 22 move integrally with the base member 20, and become the following state: a part of the lock member 22 that was located in the insertion hole 15a is located in the second disposition recess 15c, and the entire lock member 22 is located in the second disposition recess 15c.

In the holder 3, the rotating portion 13 can be manually rotated in a state where the switching button 16a is operated. On the other hand, in a state where the switching button 16a is not operated, the rotating portion 13 can be rotated by the driving force of the air pressure driver.

The shaft portion 15 and the attachment/detachment portion 17 are rotated integrally by a user of the operation support device 1, for example, an operator (operator) such as a doctor or an assistant, manually rotating the operation portion 16, and thereby rotating the rotation portion 13 with respect to the base tube portion 12 and the coupling tube portion 14.

As described above, in the surgical assistance device 1, since each part is configured to be rotatable or pivotable about six axes from the axis S1 to the axis S6, the degree of freedom in the direction and position (posture) of the surgical instrument held by the holder 3 is high, and the surgery can be performed rapidly with high accuracy. In particular, since the shaft S4 is orthogonal to the shaft S5 by performing a free rotation or turning operation on the shafts S4 and S5, the load on the tissue near the body surface of the patient 200 can be reduced when the direction or position of the surgical instrument inserted into the incision 202 is changed, or when the direction or position of the incision 202 is changed due to the breathing state of the patient 200 or the like.

In the surgical assist device 1, the rotation of the arm 5 on the axis S1 at the position farthest from the surgical instrument is performed by the driving force of the motor, and the rotation or turning of the arm 5 on the axes S2, S3, and S6 closer to the surgical instrument than the axis S1 is performed by the driving force of the air pressure driver.

Therefore, in the position close to the surgical instrument, the arm 5 is operated by the driving force of the air pressure driver having a smaller load on the patient 200 than the driving force of the motor, so that the load on the tissue in the vicinity of the body surface of the patient 200 can be further reduced.

Further, the load on the tissue in the vicinity of the body surface of the patient 200 can be reduced by rotating or turning the arm 5 by the driving force of the air pressure driver more than by rotating the arm 5 by the driving force of the motor.

In addition, in the operation support device 1, an ultrasonic motor such as a piezoelectric motor that can perform positioning with high accuracy may be used instead of the motor or the air pressure driver. By using the ultrasonic motor, power saving and downsizing of the operation support device 1 can be achieved.

< Structure of cover etc.)

Next, a structure of the cover 24 covering the device main body 2 and the stand 3 will be described (see fig. 6).

At the time of surgery, the device body 2 and the stent 3 are covered with the sterilized cover 24 in a sterilized state.

The cover 24 has: a film-like cover 25; a cover 26 mounted to the cover 25; and a plurality of rolled bands 27, a part of the plurality of rolled bands 27 being joined to the cover 25 by adhesion or the like.

The cover 25 is formed of a transparent resin material. The cover 26 is constituted by a fitting base 26a and a closing piece 26b, the fitting base 26a is fitted to one end (front end) of the bracket 3 in the longitudinal direction, and the closing piece 26b is held by the fitting base 26 a. One end of the rolled strip 27 is joined to the cover 25.

The cover 24 covers the device body 2 and the stand 3. Thus, the apparatus main body 2 and the holder 3 are covered with the cover 24 in a state of being positioned inside the cover 25. The cover 26 is attached to the front end portion of the coupling tube portion 14 in the bracket 3 in a state where the device main body 2 and the bracket 3 are covered with the cover 24.

In a state where the apparatus main body 2 and the stand 3 are covered with the cover 24, the plurality of rolled tapes 27 are wound around the outer surface of the cover 25 at respective positions and fastened by a fixing member or the like, not shown. Thus, the cover 25 is prevented from rolling up or the like by the rolling belt 27, and the device main body 2 and the holder 3 are kept covered by the cover 24.

In a state where the fixing base 4 of the apparatus main body 2 is fixed to the fixing rail 100a of the operating table 100 by the clamp 8, the fixing base 4 is fixed to the fixing rail 100a, and for example, the entire fixing base 4 including the clamp 8 is covered with the cover 24. However, the portion of the fixed base 4 other than the clamp 8 may be covered with the cover 24.

< Structure of separator, etc.)

Next, the structure of the separator 28 attached to the bracket 3 and the like will be described (see fig. 5, 7, 8, and 9). The spacer 28 rotates together with an adapter described later attached to the spacer 28 along with the rotation of the rotating portion 13 in the bracket 3, but in the following description of the spacer 28 and the adapter, the direction in which the spacer 28 is attached to the bracket 3 is referred to as the rear direction, and the front-rear, up-down, and left-right directions are shown.

The spacer 28 is detachably attached to the bracket 3 in the front-rear direction (see fig. 5 and 9). The separator 28 is formed of a resin material, and the separator 28 has: a first locking portion 29 having a circular shape and being provided on the bracket 3; an insertion portion 30 protruding rearward from the first locking portion 29; and a pair of second locking portions 31 protruding forward from the first locking portion 29 (see fig. 7 and 8).

The outer diameter of the first locking portion 29 is formed to be substantially the same size as the outer diameter of the coupling tube portion 14 in the bracket 3. The first locking portion 29 is constituted by a circular plate-shaped closing plate portion 32 and a pair of groove forming protrusions 33 protruding forward from the closing plate portion 32, respectively. A laterally long locking hole 32a is formed in an upper end portion of the closing plate portion 32, for example. The pair of groove protrusions 33 are formed in a shape protruding from the closing plate portion 32 on both sides of the locking hole 32a in the longitudinal direction and approaching each other as facing downward.

The insertion portion 30 is constituted by a coupling portion 34 and a shaft-shaped insertion protrusion 35, the coupling portion 34 is continuous with the first locking portion 29 and is formed in a rectangular block shape, and the insertion protrusion 35 protrudes rearward from the coupling portion 34. The rear end portion of the insertion protrusion 35 is provided with a breaking protrusion 35a having a tip pointed shape. A recessed locked portion 35b that opens downward is formed at a middle portion of the insertion protrusion 35 in the front-rear direction.

The second locking portion 31 protrudes forward from a portion of the groove forming protrusion 33 other than the upper end portion. The inner ends of the pair of second locking portions 31 in the lateral direction are located inward of the pair of groove protrusions 33. The second locking portion 31 is formed with a protrusion insertion groove 31a that opens forward and upward. The second locking portion 31 is provided with an insertion protrusion 31b located in the protrusion insertion groove 31a. The insertion protrusion 31b is provided to be continuous with one of the right and left wall surfaces forming the protrusion insertion groove 31a. The opposite sides of the pair of second locking portions 31 are formed as opposed faces 31c inclined so as to approach each other as facing downward. The space between the pair of opposed surfaces 31c is formed as a pluggable space 31d and is formed as an isosceles trapezoid-shaped space having a lower side shorter than an upper side.

The spacer 28 is formed with an engagement groove 36, and the engagement groove 36 is surrounded by the closing plate 32, the groove forming protrusion 33, and the rear end of the second locking portion 31. A pair of engaging groove portions 36 are formed on the left and right, and the engaging groove portions 36 are inclined so as to approach each other as facing downward, and the inclination angle is the same as that of the opposite face 31 c.

The spacer 28 configured as described above is attached to the bracket 3 via the cover 26 in a state where the device main body 2 and the bracket 3 are covered with the cover 24 (see fig. 9). When the spacer 28 is attached to the bracket 3 via the cover 26, the closing piece 26b of the cover 26 is pierced by the breaking protrusion 35a of the insertion portion 30, and the insertion portion 30 penetrates the cover 26.

In the insertion portion 30 penetrating the cover 26, the coupling portion 34 is inserted into the coupling groove 17a of the attaching/detaching portion 17 in the bracket 3, and the insertion protrusion 35 is inserted into the insertion hole 15a of the shaft portion 15 in the bracket 3.

When the insertion protrusion 35 is inserted into the insertion hole 15a, the lower surface of the insertion protrusion 35 slides on the upper surface of the lock member 22 in the lock mechanism 19, and the lock member 22 moves downward against the biasing force of the compression coil spring 23 together with the base member 20 and the spring support shaft 21. When the insertion protrusion 35 is inserted into the inner side of the insertion hole 15a and the locked portion 35b is located directly above the lock member 22, the lock member 22 moves upward together with the base member 20 and the spring support shaft 21 by the urging force of the compression coil spring 23, and the lock member 22 is inserted into the locked portion 35b (see fig. 5 and 9). Thus, the partition 28 is mounted to the bracket 3 and locked to the bracket 3 by the locking mechanism 19.

In a state where the partitioning member 28 is locked to the bracket 3, the first locking portion 29 is pressed to the cover 26 from the front, and the space inside the cover 24 is closed from the front side by the partitioning member 28.

In this way, in a state where the partition 28 is attached to the bracket 3, the partition 28 is locked to the bracket 3 by the locking mechanism 19, and therefore, the partition 28 can be restrained from being unintentionally displaced with respect to the bracket 3, and the space inside the cover 24 can be reliably maintained by the partition 28 in a state where the space is closed by the partition 28.

As described above, the unlocking button 14a of the bracket 3 is operated in a state where the partition 28 is locked to the bracket 3, whereby the locking member 22 moves downward and is pulled out from the locked portion 35b, and the lock of the partition 28 is released. Thus, the separator 28 can be removed from the bracket 3.

< construction of adapter, etc.)

Next, a structure and the like of the adapter 37 attached to the spacer 28 will be described (see fig. 10 to 16).

The adapter 37 is detachably attached to the partitioning member 28, and is configured by combining a first member 38 and a second member 39 in the up-down direction (see fig. 10 and 11).

The first member 38 is formed of a resin material, and has: a first housing portion 40 that opens forward and downward; a coupling protrusion 41 protruding rearward from the first housing portion 40; and a first locking engagement portion 42 continuous with the rear surface of the coupling protrusion 41 (see fig. 10, 12, and 13).

The first housing portion 40 has a top surface portion 43 facing in the up-down direction, a pair of side surface portions 44 facing in the left-right direction, and a rear surface portion 45 facing in the front-rear direction. An operation portion arrangement hole 43a is formed in the top surface portion 43. Two insertion slits 45a are formed in the rear surface portion 45 so as to be separated from each other in the left-right direction, and the insertion slits 45a are opened downward and penetrate in the front-rear direction. The portion between the two insertion slits 45a in the rear surface portion 45 is provided as a closing portion 45b.

The corner portion of the side surface portion 44 continuous with the rear surface portion 45 is formed in a shape protruding downward, and this portion is provided as a restricting projection 46.

The coupling projections 47 protrude downward from the pair of side surfaces 44, respectively. The coupling protrusion 47 is formed in a substantially plate shape facing in the lateral direction, and has an engagement claw 47a protruding outward in the lateral direction at a lower end portion.

In the first member 38, the first receiving portion 48 protrudes from the inner surface throughout a position from the front end portion of the top surface portion 43 to the front end portions of the pair of side surface portions 44. The end surface of the first receiving portion 48 in the protruding direction is constituted by, for example, a flat surface 48a and a plurality of curved surfaces 48 b.

In the first member 38, two first pressing protrusions 49 protruding downward from the inner surface of the top surface portion 43 are provided separately from each other. At least the distal end portion of the first pressing projection 49 may be formed of a flexible material having a large elastic force.

The first locking engagement portion 42 is formed in a substantially plate shape facing in the front-rear direction, and the lower end 42a is located below the coupling protrusion 41. The lower end of the first locking engagement portion 42 is positioned substantially coincident with the lower end of the rear surface portion 45 in the up-down direction. The first locking engagement portion 42 is formed in a substantially fan-like shape, and has a shape that reduces in width in the lateral direction as it goes downward. The left and right side edges of the first locking engagement portion 42 are provided as engagement projections 42b.

A pair of slits 42c opening upward are formed in a left-right separation at a substantially half portion of the upper side of the first locking engagement portion 42, and a portion between the slits 42c is provided as a plate-shaped locked piece 50. The locked piece 50 is elastically deformable in the front-rear direction with reference to the lower end portion, and has a locking protrusion 50a protruding rearward in the middle portion in the up-down direction. The upper end of the locked piece 50 is located above the other portions of the first locking engagement portion 42. A space 50b that allows the locked piece 50 to deform forward is formed between the locked piece 50 and the rear surface of the coupling protrusion 41.

The second member 39 is formed of a resin material, and has: a second housing portion 51 that opens in the front-rear direction and upward; a pair of second locking engagement portions 52 protruding rearward from the second housing portion 51 and provided as protruding portions (see fig. 10, 14, and 15).

The second housing portion 51 has a flat bottom surface portion 53 partially formed in a vertical direction, a pair of lateral surface portions 54 facing in the left-right direction, and a pair of projecting surface portions 55 projecting from rear end portions of the lateral surface portions 54 in directions toward each other.

The front end portion of the bottom surface portion 53 is provided with a flat plate portion 56 facing in the up-down direction, and a portion of the bottom surface portion 53 other than the flat plate portion 56 is provided with a concave portion 57 opening upward. The concave portion 57 has a bottom portion 57a provided as a central portion in the front-rear, left-right, and a portion continuous with the periphery of the bottom portion 57a is provided as an inclined portion 57b. The bottom 57a is formed in a flat plate shape facing in the up-down direction, and is located at the lowermost of the concave portions 57. The inclined portion 57b is inclined so as to be displaced upward as it is away from the bottom portion 57 a.

The lateral surface portion 54 is formed with a coupling recess 58. The coupling recess 58 is composed of an inserted portion 58a and an engagement hole 58b, the inserted portion 58a is opened upward and inward in the left-right direction, and the engagement hole 58b communicates with the lower end portion of the inserted portion 58 a. The engagement hole 58b extends in the front-rear direction and penetrates in the left-right direction.

In the second member 39, the second receiving portion 59 protrudes from the inner surface extending from the flat plate portion 56 of the bottom surface portion 53 to the lower end portion of the front end portions of the pair of cross-sectional portions 54, and the end surface of the second receiving portion 59 in the protruding direction has a plurality of flat surfaces 59a arranged in the left-right direction, for example.

In the second member 39, two second pressing protrusions 60 protruding upward from the inner surface of the bottom surface 53 are provided so as to be separated from each other. At least the distal end portion of the second pressing projection 60 may be formed of a flexible material having a large elastic force.

The second locking engagement portions 52 protrude rearward from the upper ends of the pair of protruding face portions 55. An insertion groove 52a is formed at a position closer to the front end of the second locking engagement portion 52. The inserted groove 52a opens upward and downward and outward in the left-right direction.

The second member 39 has an opening 61 formed therein, and the opening 61 extends from a portion between the pair of projecting surface portions 55 to the inclined portion 57b of the concave portion 57. In the opening 61, a portion extending between the face portions 55 is a first portion 61a, and a portion formed in the inclined portion 57b is a second portion 61b.

The pair of engaging protrusions 47 are inserted into the pair of engaging recesses 58, respectively, whereby the first member 38 and the second member 39 configured as described above are vertically coupled (see fig. 11 and 16). When the engaging projection 47 is inserted into the engaging recess 58, the engaging claw 47a slides on the surface where the inserted portion 58a is formed, the engaging projection 47 is elastically deformed, and when the engaging claw 47a reaches the engaging hole 58b, the engaging projection 47 is elastically restored, whereby the engaging claw 47a is inserted into the engaging hole 58b and engaged. The engagement claw 47a is inserted into the engagement hole 58b and engaged, whereby the first member 38 is coupled with the second member 39.

Further, a pair of engaging recesses may be formed in the first member 38, and a pair of engaging protrusions may be provided in the second member 39.

In a state where the first member 38 is coupled to the second member 39, the first portion 61a of the opening 61 is closed by the closing portion 45b of the rear surface portion 45. At this time, the base ends of the pair of second locking engagement portions 52 of the second member 39 are respectively inserted into the insertion slits 45a of the first member 38, and the portions other than the base ends are located rearward of the rear surface portion 45.

In the state where the first member 38 and the second member 39 are coupled, the pair of restricting projections 46 are located outside the second locking engagement portion 52 in the lateral direction, and the restricting projections 46 are in contact with or in close proximity to the second locking engagement portion 52.

In this way, in the second member 39, the pair of second locking engagement portions 52 separated in the direction in which the pair of engaging recesses 58 are aligned are provided as the protruding portions, and the first member 38 is provided with the pair of restricting projections 46 that respectively come into contact with or come close to the pair of second locking engagement portions 52 from the outside.

Accordingly, since the displacement of the pair of cross-sectional portions 54 in the direction of separating from each other, in which the coupling concave portions 58 are formed, is restricted by the restricting projection 46, the engagement of the engaging claw 47a with the engaging hole 58b is not unintentionally released, and a stable coupling state of the first member 38 and the second member 39 can be ensured.

On the other hand, the engagement of the engagement claw 47a with the engagement hole 58b can be released by applying a force to the pair of side portions 44 of the first member 38 from the outer surface side to elastically deform the side portions 44 in the direction to approach each other. In this way, the first member 38 and the second member 39 are separated in the vertical direction in a state in which the engagement of the engagement claw 47a with the engagement hole 58b is released, whereby the engagement of the first member 38 and the second member 39 can be released.

< Structure of surgical Instrument >

Next, an example of the structure of the surgical instrument 80 mounted on the adapter 37 will be described (see fig. 17).

The surgical instrument 80 is provided as a scope member having an endoscope, for example, and the surgical instrument 80 includes: an insertion portion 81 in which a plurality of lenses, not shown, are disposed; a head 82 coupled to one end of the insertion portion 81; and a light guide 83 coupled to a portion of the insertion portion 81 near one end.

A cable 84, which is a signal line and a power line, not shown, is connected to the head 82, and a light connecting line, not shown, for guiding light is connected to the light guide 83.

The outer shape of the head 82 is larger than the diameter of the insertion portion 81, and a portion of the head 82 other than the distal end portion is provided as a surgical instrument body 85. An imaging element, not shown, is disposed inside the surgical instrument main body 85. The surgical instrument main body 85 includes: a fitted portion 85a fitted to the adapter 37; and a cable connection portion 85b protruding from a rear end portion in a lower surface of the fitted portion 85 a. The cable connection portion 85b protrudes obliquely rearward and downward from the fitted portion 85a, and the cable connection portion 85b is connected to the cable 84.

In the head 82, an operation portion 86 is disposed on the upper surface side of the surgical instrument body 85. By operating the operation unit 86, the operator or the like can perform, for example, start of photographing, end of photographing, change or adjustment of photographing conditions, adjustment of illumination intensity, and the like.

A focusing ring 87 is provided on the front side of the surgical instrument main body 85 in the head 82. The operator or the like can perform focus adjustment on the image or the image by performing a rotation operation on the focus adjustment ring 87. A fixing ring 88 is provided on the front side of the focusing ring 87 of the head 82. The insertion portion 81 can be fixed in a state of being coupled to the head 82 by rotating the fixing ring 88 in one direction in a state where one end portion of the insertion portion 81 is inserted into the head 82. Conversely, by rotating the fixing ring 88 in the opposite direction, the insertion portion 81 can be removed from the head 82.

At least the distal end portion of the insertion portion 81 of the surgical instrument 80 is inserted into the body cavity 201 from the incision 202 formed in the patient 200. In a state where the insertion portion 81 is inserted into the body cavity 201, illumination light is irradiated from the distal end portion of the insertion portion 81, and the state of the inside of the body cavity 201 is imaged by the imaging element.

In the above description, the surgical instrument 80 is shown as an example of a mirror member having an endoscope, and other surgical instruments such as forceps and scissors may be attached to the adapter 37 in addition to the surgical instrument 80.

< fitting of surgical instruments to adapter >

Next, the assembly of the surgical instrument 80 to the adapter 37 is described (see fig. 17 to 19).

The surgical instrument 80 is mounted on the adapter 37 (see fig. 18 and 19) by sandwiching the mounted portion 85a and the cable connection portion 85b of the surgical instrument body 85, except for the distal end portion, between the first member 38 and the second member 39 in a state of being covered up and down.

In a state where the surgical instrument main body 85 is mounted on the adapter 37, the plane 48a of the first receiving portion 48 in the first member 38 and the three planes 59a of the second receiving portion 59 in the second member 39 are in point contact or line contact with the outer peripheral surface in the front end portion of the mounted portion 85 a. At this time, the pair of first pressing protrusions 49 of the second member 39 and the pair of second pressing protrusions 60 of the second member 39 are in point contact or line contact with the portion of the surgical instrument main body 85 near the rear end.

Thus, the surgical instrument main body 85 is fitted to the adapter 37 in a state pressed by the first member 38 and the second member 39 from the surroundings at four points in the front side and four points in the rear side, thereby being fitted to the adapter 37 in a stable state.

In particular, since the first member 38 is provided with the plurality of first pressing projections 49 for pressing the surgical instrument body 85 and the second member 39 is provided with the plurality of second pressing projections 60 for pressing the surgical instrument body 85, the surgical instrument body 85 is mounted on the adapter 37 in a state pressed by the plurality of first pressing projections 49 and the plurality of second pressing projections 60, and the surgical instrument 80 can be mounted on the adapter 37 in a stable state.

Further, since the buffers may be attached to the distal ends of the first pressing projection 49 and the second pressing projection 60, respectively, and the surgical instrument body 85 is attached to the adapter 37 in a state pressed by a plurality of buffers by attaching the buffers, the surgical instrument 80 can be attached to the adapter 37 in a stable state regardless of the machining tolerance of the adapter 37 and the surgical instrument 80. As the cushioning material, various materials such as cloth, rubber, and sponge can be used.

In a state where the surgical instrument main body 85 is mounted on the adapter 37, the distal end portion of the cable connection portion 85b protrudes from the second portion 61b of the opening 61 (see fig. 19).

In addition, in a state where the surgical instrument main body 85 is mounted on the adapter 37, the operation portion 86 is positioned in the operation portion placement hole 43a of the first member 38, and the operation portion 86 can be operated. At this time, since the surgical instrument body 85 is mounted on the adapter 37, the focus ring 87 and the fixing ring 88 on the front side of the surgical instrument body 85 are located outside the adapter 37. Thus, the operator or the like can operate the focus ring 87 and the fixing ring 88 in a state where the surgical instrument main body 85 is mounted on the adapter 37.

On the other hand, the first member 38 and the second member 39 are separated upward and downward by releasing the engagement of the engagement claw 47a with the engagement hole 58b, whereby the surgical instrument main body 85 can be removed from the adapter 37.

< mounting and dismounting of adapter to partition >

Next, the attachment and detachment of the adapter 37 to and from the spacer 28 will be described (see fig. 19 to 24).

The adapter 37 is attached to the spacer 28 in a direction perpendicular to the attaching/detaching direction of the spacer 28 to the bracket 3 (see fig. 20). Specifically, as described above, the spacer 28 is attached to the bracket 3 in the front-rear direction, while the adapter 37 is attached to the spacer 28 in the up-down direction. The first member 38 and the second member 39 of the adapter 37 are individually attached to and locked to the partition 28 as follows.

In addition, the adapter 37 can be attached to the spacer 28 in a state where the surgical instrument 80 is attached to the adapter 37. However, the second member 39 may be attached to the spacer 28 and locked, and then the surgical instrument body 85 of the surgical instrument 80 may be attached to the second member 39, and the first member 38 may be coupled to the second member 39 and attached to and locked to the spacer 28.

The second member 39 moves downward with respect to the spacer 28, and the pair of second locking engagement portions 52 are inserted into the pair of projection insertion grooves 31a (see fig. 21) of the spacer 28 from above. At this time, the insertion protrusion 31b of the second locking portion 31 is inserted into the inserted groove 52a of the second locking engagement portion 52, and the second member 39 is locked to the spacer 28. In a state where the second member 39 is locked to the spacer 28, the second locking engagement portion 52 is inserted into the protrusion insertion groove 31a, whereby the second member 39 is restricted from being displaced in the left-right direction, and the insertion protrusion 31b is inserted into the inserted groove 52a, whereby the second member 39 is restricted from being moved in the front-rear direction.

Further, a projection insertion groove and an insertion projection may be formed in the second locking engagement portion 52, and an insertion groove may be formed in the second locking portion 31.

As with the second member 39, the first member 38 moves downward with respect to the partitioning member 28, and the pair of engagement projections 42b of the first locking engagement portions 42 are inserted into the pair of engagement groove portions 36 of the partitioning member 28 from above. At this time, the locking protrusion 50a of the locked piece 50 slides on the front surface of the closing plate portion 32 in the partitioning member 28, and the locked piece 50 is elastically deformed toward the space 50b side. When the first member 38 moves downward relative to the second member 39, and the locking protrusion 50a reaches the locking hole 32a of the closing plate portion 32, the locking protrusion 50a is inserted into and locked to the locking hole 32a, whereby the first member 38 is locked to the spacer 28 (see fig. 19, 22, and 23).

Further, a locking hole may be formed in the locked piece 50, and a locking protrusion may be provided in the first locking portion 29.

The first member 38 is restricted from being displaced upward, downward, forward, backward, leftward and rightward in a state locked to the partitioning member 28. At this time, the first member 38 is coupled to the second member 39, and the displacement of the second member 39 in the up-down direction with respect to the separator 28 is also restricted.

In a state where the adapter 37 is attached to and locked to the partitioning member 28, the end 42a of the first locking engagement portion 42 protrudes downward from the engagement groove 36.

The adapter 37 may be moved downward with respect to the spacer 28 in a state in which the first locking engagement portion 42 is inserted from the front side into the pluggable space 31d formed between the pair of second locking portions 31 and the second locking engagement portion 52 is located at a position directly above the second locking portions 31. In this way, the second locking engagement portion 52 is inserted into the projection insertion groove 31a from above and the engagement projection 42b is inserted into the engagement groove 36 from above, and the locking projection 50a is inserted into and engaged with the engagement hole 32a, whereby the adapter 37 is locked to the spacer 28.

When the adapter 37 is locked to the partition 28, the surgical instrument 80 fitted to the adapter 37 is held by the holder 3 via the adapter 37 and the partition 28. The spacer 28 and the adapter 37 are used for the surgical assist device 1 having the holder 3, and are configured to mount the surgical instrument 80 and hold the surgical instrument 80 to the holding fixture 70 of the holder 3, the surgical instrument 80 having the head 82 coupled to the insertion portion 81.

On the other hand, in the adapter 37, the locking piece 50 is pressed from the rear to elastically deform toward the space 50b, and the locking protrusion 50a is pulled out from the locking hole 32a, so that the locking of the adapter 37 to the spacer 28 is released. When the locking piece 50 is pressed to release the locking of the adapter 37 to the spacer 28, the adapter 37 moves upward with respect to the spacer 28, and the second locking engagement portion 52 is pulled out from the projection insertion groove 31a and the engagement projection 42b is pulled out from the engagement groove 36, whereby the adapter 37 is removed from the spacer 28.

At this time, as described above, in a state where the adapter 37 is attached to the partitioning member 28, the end 42a of the first locking engagement portion 42 protrudes downward from the engagement groove portion 36, so the end 42a can be pressed from below. Thus, for example, even when the rear surface of the first locking engagement portion 42 is in close contact with the front surface of the first locking portion 29 of the spacer 28 and the friction force therebetween is high, the contact state between the first locking engagement portion 42 and the first locking portion 29 can be released by pressing the end portion 42a from below, and the adapter 37 can be easily and reliably removed from the spacer 28.

The first locking engagement portion 42 has a pair of engagement projections 42b, and is formed in a shape in which the distance between the engagement projections 42b decreases in the direction of mounting the adapter 37 to the partitioning member 28, and a pair of engagement grooves 36 in which the distance decreases in the direction of mounting the adapter 37 to the partitioning member 28 are formed in the first locking portion 29, and the pair of engagement projections 42b are inserted into the pair of engagement grooves 36, respectively, whereby the first member 38 of the adapter 37 is locked to the partitioning member 28.

Accordingly, the adapter 37 is moved upward with respect to the partitioning member 28 until the outer edge of the engagement projection 42b in the first locking engagement portion 42 is positioned at the rear side of the pluggable space 31d, whereby the adapter 37 can be removed from the partitioning member 28 (see fig. 24). In a state in which the adapter 37 is moved upward to such a position, the first locking engagement portion 42 can be pulled out from the pluggable space 31d to the front side, and the adapter 37 can be removed from the partition 28.

By removing the adaptor 37 from the spacer 28 in this way, the amount of movement of the adaptor 37 upward with respect to the spacer 28 is minimized, and the cable connection portion 85b protruding obliquely downward rearward from the second portion 61b of the opening 61 and the cable 84 connected to the cable connection portion 85b are less likely to contact the lower surface of the spacer 28 and the lower surface of the bracket 3.

Thus, the cable connection portion 85b, the cable 84 are not easily damaged, and the adapter 37 can be properly removed from the partition 28.

When the adapter 37 is removed from the spacer 28, the adapter 37 is moved by a distance shorter than the length of the engagement projection 42b, whereby the engagement of the engagement projection 42b with the engagement groove 36 can be released, and the adapter 37 can be removed from the spacer 28 easily and quickly.

< use of surgical auxiliary device, etc.)

As described above, in a state where the spacer 28 is attached to the holder 3, the adapter 37 is attached to the spacer 28, and the surgical instrument 80 is mounted on the adapter 37, for example, the operator (doctor) remotely operates and uses the surgical assist device 1 in a master-slave manner. At this time, at least the distal end portion of the insertion portion 81 of the surgical instrument 80 is inserted into the body cavity 201 from the incision 202 formed in the patient 200, and a surgical operation, imaging of an affected part, and the like are performed.

In the surgical operation using such a surgical assist device 1, the surgical instrument 80 may be manually operated by an operator or an assisting person, but in the surgical assist device 1, the surgical instrument 80 may be operated by holding the adapter 37, and the adapter 37 is attached to the surgical instrument body 85 of the head 82. Thus, the adapter 37 functions as a grip portion gripped by an operator or the like.

In addition, in a state where the surgical instrument main body 85 is mounted on the adapter 37, the operation portion 86 located in the operation portion arrangement hole 43a of the first member 38 can be operated from the outside of the adapter 37, and the focus ring 87 located on the front side of the adapter 37 can also be operated, so that a good use state of the surgical instrument 80 can be ensured.

In addition, in the case of using surgical instruments during surgery, the types, shapes, and sizes of surgical instruments used are different depending on the content, method, and the like of surgery, but in such a case, adapters having different shapes and sizes are selected and used in accordance with the surgical instruments used. However, even with such adapters having different shapes and sizes, the basic structure such as the lock structure of the spacer 28 and the structure of the two members joined together is the same structure as that of the adapter 37.

< summary >

According to the above, the surgical assist device 1 is provided with: a spacer 28 detachably attached to the bracket 3; and an adapter 37 detachably attached to the spacer 28 for fitting the head 82, the adapter 37 being provided as a grip portion gripped by an operator in a state where the head 82 is fitted.

Accordingly, in a state in which the spacer 28 is attached to the holder 3, the adapter 37 is attached to the spacer 28, and the head 82 is attached to the adapter 37, the head 82 can be held via the adapter 37, and the surgical instrument 80 having a different shape or size can be used according to the adapter 37, so that the operation can be performed appropriately and promptly without impeding the operation.

The holder 3 is provided with the locking mechanism 19, the partitioning member 28 is provided with a locked portion 35b to be locked by the locking mechanism 19 to the holder 3, and first and second locking portions 29 and 31 for locking the adapter 37, and the adapter 37 is provided with first and second locking engagement portions 42 and 52, and the first and second locking engagement portions 42 and 52 can be locked to the partitioning member 28 by the first and second locking portions 29 and 31, respectively.

Thus, the spacer 28 is locked to the holder 3 by the locking mechanism 19 and the adapter 37 is locked to the spacer 28 by the first locking portion 29 and the second locking portion 31, so that the spacer 28 is mounted to the holder 3 in a stable state and the adapter 37 is mounted to the spacer 28 in a stable state, and the surgical instrument 80 can be held to the holder 3 in a stable state via the adapter 37 and the spacer 28.

Further, the locking protrusion 50a is inserted into the locking hole 32a by the elastic force of the locking piece 50, whereby the adapter 37 is locked to the spacer 28.

Accordingly, the elastically deformed locked piece 50 is elastically restored, and the locking protrusion 50a is inserted into the locking hole 32a, so that the adapter 37 is locked to the spacer 28, and therefore, the locking operation of the adapter 37 to the spacer 28 and the unlocking operation of the adapter 37 to the spacer 28 can be easily and promptly performed.

In the holding fixture 70, the mounting direction of the spacer 28 to the bracket 3 and the mounting direction of the adapter 37 to the spacer 28 are set to be different from each other.

Accordingly, since the spacer 28 and the adapter 37 are attached to the bracket 3 and the spacer 28 in different directions, it is possible to prevent one of the spacer 28 and the adapter 37 from being unintentionally detached when the other is removed. In particular, since the spacers 28 and the adapters 37 are attached to the brackets 3 and 28 in the orthogonal directions, the attachment directions of the adapters 37 to the spacers 28 and the attachment directions of the spacers 28 to the brackets 3 are clear, and the attachment directions of the adapters 37 to the spacers 28 and the attachment of the spacers 28 to the brackets 3 are not easily recognized erroneously, so that the attachment work of the adapters 37 to the spacers 28 and the attachment work of the adapters 28 to the brackets 3 can be performed appropriately and reliably.

The holding fixture 70 has the following structure: the first member 38 and the second member 39 are combined to thereby constitute the adapter 37, and the first member 38 and the second member 39 are locked to the partition 28, respectively.

Accordingly, since the second member 39 is locked to the spacer 28 in a state in which the first member 38 is removed from the spacer 28 and the coupling of the first member 38 and the second member 39 is released, the surgical instrument 80 can be held by the second member 39 locked to the spacer 28, and the surgical instrument 80 can be prevented from falling off in a state in which the coupling of the first member 38 and the second member 39 is released.

Further, the bracket 3 is provided with a locking mechanism 19, and the partition 28 is provided with a locked portion 35b for being locked to the bracket 3 by the locking mechanism 19, a first locking portion 29 for locking the first member 38, and a second locking portion 31 for locking the second member 39.

Thus, the partition 28 is locked to the bracket 3 by the locking mechanism 19 and the adapter 37 is locked to the partition 28 by the first locking portion 29 and the second locking portion 31, so that the partition 28 is mounted to the bracket 3 in a stable state and the adapter 37 is mounted to the partition 28 in a stable state, whereby the surgical instrument 80 can be fitted to the adapter 37 in a stable state.

Description of the reference numerals

200: a patient; 201: a body cavity; 1: a surgical assistance device; 3: a bracket; 9: a first connecting arm; 10: a second connecting arm; 11: a third connecting arm; 28: a partition; 29: a first locking portion; 31: a second locking portion; 32a: a locking hole; 35b: a locked portion; 36: an engagement groove portion; 37: an adapter; 38: a first member; 39: a second member; 42: a first locking engagement portion; 42a: an end portion; 42b: an engagement protrusion; 46: a restricting protrusion; 47: a coupling protrusion; 49: a first crush lobe; 50: a locked piece; 50a: a locking protrusion; 52: a second locking engagement portion (protruding portion); 58: a joining recess; 60: a second pressing protrusion; 70: a holding fixture; 80: surgical instruments; 81: an insertion section; 82: a head.

Claims (5)

1. A holding fixture for a surgical assist device having a plurality of connecting arms and a holder supported by the connecting arms, the holding fixture being for holding a surgical instrument having a head to the holder, the holding fixture comprising:

a partition detachably attached to the bracket; and

An adapter detachably mounted to the partition for assembling the head,

the adaptor is provided with a grip portion to be gripped by an operator in a state where the head is attached.

2. The holding fixture according to claim 1, wherein,

a locking mechanism is arranged on the bracket,

the partition is provided with a locked portion for being locked to the bracket by the locking mechanism and a locking portion for locking the adapter,

the adapter is provided with a locking engagement portion that can be locked to the partitioning member by the locking portion.

3. The holding fixture according to claim 2, wherein,

the mounting direction of the adapter to the partitioning member is set to a direction orthogonal to the direction in which the partitioning member and the adapter are arranged,

the locking engagement portion has a pair of engagement projections, and is formed in a shape in which a distance between the pair of engagement projections decreases as the mounting direction is toward the mounting direction,

a pair of engaging groove portions whose distance decreases toward the mounting direction are formed in the locking portion,

the pair of engagement projections are inserted into the pair of engagement groove portions, respectively, whereby the adapter is locked to the partitioning member.

4. The holding fixture according to claim 3, wherein,

in a state where the adapter is locked to the spacer, the end portions on the installation direction side of the locking engagement portions protrude from the pair of engagement groove portions.

5. The holding fixture according to any one of claim 2 to 4, wherein,

the locking engagement portion is provided with an elastically deformable locked piece,

a locking protrusion is provided on the locked piece,

a locking hole is formed in the locking portion,

the locking protrusion is inserted into the locking hole due to the elastic force of the locked piece, whereby the adapter is locked to the partitioning member.