JP2004129956A - Endoscope holder - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope holder for restraining swinging of a video image on a display to give a comfortable visual environment to an operator. <P>SOLUTION: In conducting surgery while watching the video image projected on the display displayed by an endoscope 14 inserted in a patient, the endoscope holder holding the endoscope to be freely operated is disposed adjacently to an operating table to be freely adjusted in its position. The holder is composed of: an arm 24, the tip of which faces near above a patient; a first holding part 34 disposed in the vicinity of the tip of the arm and moved in the lateral direction by drawing a circular arc on plane coordinates substantially around a part P where the endoscope is inserted in the celom; a second holding part 36 disposed in the first holding part and moved in the vertical direction by drawing a circular arc on vertical coordinates substantially around the endoscope inserted part; and a third holding part 38 disposed in the second holding part and moved obliquely in the longitudinal direction by taking the endoscope inserted part as a passing point. The endoscope is held on the third holding part along an axial line obliquely in the longitudinal direction. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope holding device, and more particularly, to a surgeon performing endoscopic surgery while observing the image, which can minimize the shaking of an image on a display obtained by the endoscope. The present invention relates to a novel endoscope holding device capable of providing a comfortable visual environment to other medical technicians.
[0002]
[Prior art]
If a disease is found in a patient's internal organs and surgery is required by the doctor's consultation, the abdominal cavity or thoracic cavity (hereinafter referred to as the body cavity) must be incised according to the site of the affected area to perform the surgery. Become. For example, in operations on the stomach, intestine, liver, and the like, it is necessary to cut the abdomen and then suture the incised portion, and perform hospital treatment until at least the wound is closed. Such surgery requires a considerable length of incision in the abdomen and chest, depending on the case, and furthermore, the pain in the wound after the anesthesia has been cut is large, and the length of hospital stay is generally prolonged. is there.
[0003]
For this reason, recently, in order to reduce the burden on the patient, endoscopic surgery is performed depending on the condition of the affected part to be operated. In this endoscopic operation, for example, as shown in FIG. 7, an endoscope 14 incorporating a small CCD camera at a distal end is inserted into a body cavity (abdominal cavity) of a patient 12 lying on an operating table 10. Then, the images of the various internal organs obtained by the endoscope 14 are displayed on the display 16, and the surgeon performs an operation while directly viewing the images on the display. That is, at the time of the operation under the endoscope, a minimal incision necessary for inserting the endoscope into the affected part is performed, and the endoscope 14 is inserted through the cannula 18 (sleeve-shaped intubation) inserted into the opening. In addition, by injecting a necessary amount of carbon dioxide gas to swell the body cavity, the field of view and freedom of movement of the endoscope 14 are secured.
[0004]
Images of various internal organs captured by the endoscope 14 are displayed as images on a display 16, and an operator (operator) looks directly at the images while performing operations on an electric scalpel, an ultrasonic scalpel, and other suturing tools. Operate the tool and proceed with the surgery. Most of these scalpels and suturing tools are provided as an accessory to the forceps 20 that are also inserted into the body cavity near the affected part. However, separately from the forceps 20, a scalpel or a suturing tool as a single surgical tool is used. May be inserted. In addition, doctors and medical workers other than the surgeon hold the endoscope 14 by hand as an assistant during the operation. The surgeon gives a verbal instruction to the assistant according to the change in the surgical site or the site requiring observation as the operation proceeds, and the assistant moves the endoscope 14 on the display 16 under this instruction. To secure an appropriate surgical field.
[0005]
In the above-mentioned endoscopic surgery, since only small incisions (about 5 places) necessary for inserting surgical instruments such as an endoscope, forceps, and a scalpel into the body cavity of a patient are provided, pain in the wound is reduced. It has great advantages in terms of non-invasiveness and the speed of returning from hospitalization to daily life, and is expected to become the mainstream of surgical treatment in the future. On the other hand, since the operation requires precise operation of an elongated endoscope and forceps, the operation time tends to be longer than that of a large laparotomy. As described above, the operation time is generally long in the endoscopic operation, but as described above, the assistant must hold the endoscope by hand throughout the operation time. This blurring of the hand holding the endoscope immediately appears as a blurring of the image on the display, which causes inconvenience to a person who performs an operation while watching the monitor screen. Thus, the assistant in charge of holding the endoscope should focus on the mind to minimize camera shake during the surgery and strive to maintain the same unphysiological posture, resulting in numbness and trembling of the hands and fingers. It is the present situation that is suffering from physical sequelae such as.
[0006]
In addition, the endoscope holder (assistant) responds to the operator's instructions as the operation progresses, and moves the endoscope in each of the front, rear, left, right, up, and down directions (or a combined direction thereof). You need to move it. Since the movement of the endoscope at this time is also performed by hand operation, it is similar to the case of camera shake caused by holding the endoscope for a long time (even if it is not a long time, hand shake is likely to occur due to individual differences). The image on the display is liable to flicker and blur.
[0007]
Attempts have been made to replace the work of holding the endoscope by hand with mechanical holding by an assistant, and some of them have been put to practical use. For example, Patent Literature 1 and FIGS. 1, 2, and 14 attached to the literature propose that the endoscope 18 and the surgical instrument 142 are held by a robot arm having a plurality of joints. . Each joint is provided with a rotary actuator, and by driving each actuator, the arm can be moved to a position desired by the operator.
[0008]
[Patent Document 1]
Japanese Patent No. 3298013 (column 6, line 14 to column 7, line 13, FIGS. 1, 2, and 14)
[0009]
[Problems to be solved by the invention]
Since the robot arm disclosed in Patent Document 1 drives a rotary actuator provided correspondingly to a plurality of joints, the robot arm gives a required movement to an endoscope held at the tip of the arm. This does not deviate from a so-called "horizontal articulated" manipulator in terms of operation principle. However, since it is a horizontal articulated manipulator, when the endoscope is operated by operating the manipulator by an operator's instruction or remote control to change the position of the endoscope, the display on the display is changed according to the position change. There is an inconvenience that the monitor screen is very hard to see because the image is tilted or inverted.
[0010]
As described above, a so-called “endoscopic surgery support robot” that allows the endoscope to be held by the robot arm and performs a control operation by hand operation, foot operation, and other voice operation (voice operation) is a physical assistance assistant. The burden is greatly reduced, and the assistant is added to the highly required surgical operation which is originally required, so that the operator can be actively assisted. However, the support-type robot requires a high degree of freedom in order to realize multilateral support for the operator, and therefore necessarily has a horizontal articulated arm. Since such a support type robot arm imparts horizontal articulated motion by actuators provided at each joint, not only the configuration becomes extremely complicated, but also the control system becomes large-scale, so that the price of the entire system rises. There are also difficulties to do. In particular, if the system becomes expensive, no matter how effective the tool can be for endoscopic surgery, it will be a major factor preventing its widespread use.
[0011]
[Object of the invention]
The present invention has been proposed in order to appropriately solve the above-described problems, and it is possible to minimize the fluctuation of an image on a display obtained by an endoscope inserted into a body cavity of a patient, It can provide a comfortable visual environment for operators and other medical technicians who perform endoscopic surgery while watching video, and because it is extremely simple in configuration, it is possible to reduce the price and thereby spread it widely. It is an object of the present invention to provide an endoscope holding device that can achieve the above.
[0012]
[Means for Solving the Invention]
In order to overcome the above-mentioned problems and achieve the intended purpose, the present invention displays an image of various internal organs obtained by an endoscope inserted into a body cavity of a patient on an external display, and an operator displays an image on the display. In an endoscope holding device for operably holding the endoscope in accordance with an operator's instruction during an endoscopic surgical operation for performing an operation,
An arm that is arranged to be freely adjustable in proximity to the operating table and that can face the tip near the affected part of the patient,
A first holding unit that is arranged near the tip of the arm and that can move in the left-right direction by drawing an arc on plane coordinates, with a portion where the endoscope is inserted into a body cavity substantially at the center,
A second holding unit disposed on the first holding unit, the second holding unit being able to move vertically in an arc on a vertical coordinate centering on a body cavity insertion site of the endoscope;
A third holding portion disposed on the second holding portion, the third holding portion being movable obliquely in the front-rear direction with the body cavity insertion site of the endoscope as a passing point,
The endoscope is characterized in that the endoscope is configured to be held by the third holding unit along the oblique front-back direction axis.
[0013]
As described above, the automatic endoscope system using the conventional horizontal articulated manipulator is uncomfortable because the image on the display rotates or fluctuates in actual use, and it may be unpleasant at the top, bottom, left and right of the display. It has drawbacks such as a screen shift. The present invention addresses the drawbacks inherent in holding an endoscope by such a horizontal articulated manipulator, with the endoscope inserted approximately into the body cavity of the patient, The greatest feature is that the degree of freedom to move the endoscope in the front-rear direction, the left-right direction, and the diagonal up-down direction is provided. In other words, the present invention is common to Patent Document 1 in that a robot is used instead of holding an endoscope instead of an assistant, but the principle of operation is based on the operation of a polar coordinate system instead of the operation of a horizontal articulated system. It was done. The polar coordinates particularly refer to spherical coordinates. “An arbitrary point P in the space is defined by three curved surfaces, that is, a spherical surface (radius γ) centered at the origin (pole) 0, an origin at the apex and a Z axis as the principal axis. P (γ, θ, φ) ”represents the intersection represented by the angle φ between the conical surface (vertical angle 2θ) and the plane including the Z axis (ZX plane).
[0014]
As will be described later in the description of the embodiments, according to the endoscope holding device according to the present invention, when the part where the endoscope is inserted into the body cavity is imagined to be the origin 0, the endoscope is set to (1) The degree of freedom to move in the horizontal direction (φ axis) by drawing an arc on plane coordinates with the origin 0 as the center, and (2) the vertical direction (θ) by drawing an arc on the vertical coordinates with the origin 0 as the center. Axis) and (3) the degree of freedom to move obliquely in the front-rear direction (γ axis) with the origin 0 as the passing point, and the movement in each direction is monitored by the monitor screen. It is controlled by an instruction of a surgeon who observes.
[0015]
BEST MODE FOR CARRYING OUT THE INVENTION
Next, an endoscope holding device according to the present invention will be described below with reference to the accompanying drawings by way of preferred embodiments. FIG. 1 is a plan view of an endoscope holding device 22 according to the embodiment, and a main body of the device 22 is attached to an arm 24. 2 is a side view of the endoscope holding device shown in FIG. 1, FIG. 3 is an enlarged plan view of the endoscope holding device shown in FIG. 1, and FIG. 4 is a partially enlarged side view of FIG. FIG. 5 is an enlarged view of the endoscope holding device shown in FIG. 1 as viewed from the direction of arrow A.
[0016]
(About the overall configuration of the endoscope holding device)
As shown in FIGS. 1, 6 and 7, the endoscope holding device 22 according to the embodiment is attached to an arm 22 installed beside the operating table 10. That is, the arm 22 includes an upright support 26 erected at a required position close to the operating table 10, a first arm 28 pivotally supported on an upper portion of the upright support 26 and capable of horizontally turning at a required central angle, A second arm 30 pivotally supported by the first arm 28 and horizontally pivotable at a required center angle, and a third arm 32 pivotally supported by the second arm 30 and horizontally pivotable at a required central angle. It is configured. The upright support 26 is preferably movable up and down by a required distance by remotely driving a motor (not shown), so that the endoscope holding device 22 attached to the third arm 32 holds the patient 12 A required height can be set between the affected area. The upright support 26 supports the first arm 28, the first arm 28 supports the second arm 30, and the second arm 30 supports the third arm 32 such that the rotation angle can be adjusted by each joint mechanism. However, it does not provide a controlled positive drive by an actuator such as a motor. That is, the arm 22 is not in the form of a horizontal joint manipulator.
[0017]
The endoscope holding device 24 moves (1) in the spherical coordinates in a direction corresponding to the φ-axis, that is, in a horizontal direction in which an arc on plane coordinates is drawn with the part where the endoscope 14 is inserted into the body cavity substantially at the center. The first holding unit 34 that performs the movement, and (2) the movement corresponding to the θ axis in the spherical coordinates, that is, the vertical movement of the endoscope 14 by drawing an arc on the vertical coordinate with the body cavity insertion site being substantially at the center. And (3) a third holding unit 38 that performs a movement corresponding to the γ-axis in the spherical coordinates, that is, a movement in an oblique front-rear direction with the body cavity insertion site of the endoscope 14 as a passing point. It is basically composed of The endoscope 14 is held by the third holding portion 38 along the axis in the oblique front-rear direction.
[0018]
(About the first holding unit)
The first holding portion 34, which is a main element of the endoscope holding device 22, includes a first arc plate 42 that is pivotally supported substantially horizontally through a pivot pin 40 (FIG. 1) near the distal end of the third arm 32. And a first slider 44 which is guided on the first arc plate 42 and moves left and right in an arc under control. Here, as shown in FIG. 1, the first arc plate 42 is a plate that draws an arc on a plane coordinate centered on a portion P where the endoscope 14 is inserted into the body cavity of the patient, and its radius is actually The size is set to an appropriate size according to the length of the endoscope 14 used for (1). The arc length of the first arc plate 42 depends on the amount of movement required for the first slider 44 mounted on the first arc plate 42 to move left and right in an arc shape. In the embodiment, the arc angle is set to be approximately 100 °. Have been.
[0019]
As shown in FIGS. 1 and 3, the first arc plate 42 is provided with a guide portion 46 formed of an arc-shaped rail on one arc-shaped side surface on the inside, and the other circle on the outside. A rack 48 composed of an arc gear train is provided on the arc side surface. The first slider 44 has a saddle portion 50 that can move while being guided by the guide portion 46 over the arc-shaped guide portion 46. That is, the first slider 44 is mounted on the first arc plate 42 via the saddle portion 50, and performs an arc-shaped left-right movement along the arc-shaped guide portion 46. As shown in FIG. 4, the first slider 44 includes a bracket 52 extending horizontally, and a first motor 54 is arranged upside down at a required portion of the bracket 52. A first pinion gear 56 is provided on a rotation shaft of the first motor 54, and the first pinion gear 56 meshes with the arc-shaped rack 48. Accordingly, if the first motor 54 is rotated forward and backward by a command from a control system (not shown), the first pinion gear 56 meshing with the arc-shaped rack 48 is also rotated forward and reverse, and the first slider 54 is rotated. A right and left arc movement on a plane coordinate centered on the body cavity insertion site P is given to 44.
[0020]
(About the second holding unit)
The second holding part 36, which is a main element of the endoscope holding device 22, includes a second arc plate 58, which is disposed upright on the upper surface of the first slider 44 in the first holding part 34, And a second slider 60 that moves up and down under a remote control while being guided on the plate 58. Here, as shown in FIG. 4, the second arc plate 58 is a plate that draws an arc on a vertical coordinate centered on the body cavity insertion site P of the endoscope 14, and has a radius equal to the length of the endoscope 14. The size is set appropriately according to the size. Further, the arc length of the second arc plate 58 depends on the amount of movement required of the second slider 60 mounted thereon to perform vertical arc movement, and in the embodiment, the arc length is set to approximately 100 °. Is set.
[0021]
As shown in FIGS. 2 and 4, the second arc plate 58 is provided with a guide portion 62 formed of an arc-shaped rail on one inner arc-shaped side surface, and the other arc-shaped side surface formed on the outer side. Is provided with a rack 64 composed of an arcuate gear train. As shown in FIG. 3, the second slider 60 includes a saddle portion 66 that is guided by the guide portion 62 over the arc-shaped guide portion 62. That is, the second slider 60 is mounted on the second arc plate 58 via the saddle portion 66, and moves up and down in an arc shape along the arc guide portion 62. The second slider 60 includes a key-shaped bracket 68 as shown in FIG. 3, and a second motor 70 is horizontally arranged at a required position of the bracket 58. A second pinion gear 72 is provided on a rotation shaft of the second motor 70, and the second pinion gear 72 is engaged with the arc-shaped rack 64. Therefore, if the second motor 70 is rotated forward and backward by a command from the control system, the second pinion gear 72 meshing with the arc-shaped rack 64 is also rotated forward and reverse, and the second slider 60 is inserted into the body cavity insertion portion. A vertical arc movement on a vertical coordinate centered on P is given.
[0022]
(About the third holding unit)
The third holding portion 38, which is a main element of the endoscope holding device 22, is disposed on a mount portion 74 provided on the second slider 60, and is configured as a linear slider that can perform forward and backward movement diagonally downward. You. That is, as shown in FIG. 4, the third holding portion 38 is a straight pipe member, is inserted into a cylindrical through hole having a required diameter formed in the mounting portion 74, and passes through the body cavity insertion portion P at a passing point. It is slidable in the oblique front-rear direction. On one side surface of the pipe member constituting the third holding portion 38, a rack 76 composed of a linear gear train is formed in the longitudinal direction. A third motor 78 is horizontally disposed on the mount portion 74 of the second slider 60, and a third pinion gear 80 provided on a rotation shaft of the third motor 78 meshes with the linear rack 76. Therefore, if the third motor 78 is rotated in the forward or reverse direction by a command from the control system, the third pinion gear 80 meshing with the linear rack 76 is also rotated in the forward or reverse direction, and the third holding portion 38 as the linear slider is rotated. , A movement in the oblique front-rear direction with the body cavity insertion site P as a passing point.
[0023]
The endoscope 14 is configured such that a holder 82 forming a base side thereof is attached to the third holding portion 38. That is, the permanent magnet 84 is disposed on the mount portion 74, and the holder portion 82 of the endoscope 14 is attracted by the permanent magnet 84 so that the endoscope 14 can be detachably attached to the third holding portion 38. Installation is achieved. Needless to say, the endoscope 14 is attached along the axis of the third holding portion 38 extending in the oblique front-rear direction. By making the endoscope 14 detachable from the third holding portion 38 in this manner, the endoscope 14 can be removed and easily subjected to infection prevention treatment such as boiling disinfection. Further, since the endoscope 14 is merely magnetically attracted to the third holding portion 38, there is a possibility that an unreasonable force may be applied between the endoscope 14 and the affected part due to an unexpected cause during the operation. Even if the strength of the suction force is adjusted in advance, the affected part is not damaged because the endoscope 14 comes off the mount part 74.
[0024]
(About other mechanisms)
The endoscope 14 held by the third holding portion 38 is configured to be rotatable around the axis in the oblique front-rear direction so that the rotation angle can be adjusted in the circumferential direction. That is, as shown in FIGS. 3 and 5, the first gear 86 and the second gear 88 are provided in the mount 74 in which the third holder 38 as the linear slider is inserted and held. A fourth motor 92 for rotating the endoscope 14 is arranged at the rear end of the third holding portion 38 with its axis aligned. A shaft (not shown) is inserted into the third holding portion 38 made of the pipe member, and one end of the shaft is connected to the rotation shaft of the fourth motor 92, and the other end is It is connected to the first gear 86.
[0025]
In FIG. 5, the second gear 88 accommodated in the mount 74 has its teeth slightly projecting outward. A third gear 90 is also rotatably accommodated in a holder 82 of the endoscope 14 attached to the mount 74 with a permanent magnet 84, and the mirror axis of the endoscope 14 is aligned with the rotation axis of the third gear 90. Connected. When the holder portion 82 of the endoscope 14 is attached to a fixed position of the mount portion 74 via a permanent magnet 84, the second gear 88 partially projecting outward from the mount portion 74 is attached to the holder portion 82. The gear 82 meshes with the third gear 90 stored in the second gear 82. Therefore, if the fourth motor 92 is rotated forward and backward by a required angle according to a command from the control system, the endoscope 14 is also transmitted to the endoscope 14 via the gear train including the first gear 86, the second gear 88, and the third gear 90. The required angle forward / reverse rotation is provided. That is, the image obtained from the endoscope 14 can be arbitrarily rotated and stopped on the display 16 as needed by the operator.
[0026]
(Operation of the embodiment)
Next, the actual use of the endoscope holding device according to the present embodiment will be described. First, regarding the part P (this is the origin 0) where the endoscope 14 is to be inserted into the body cavity, (1) a freely movable left-right direction (φ axis) by drawing an arc on plane coordinates on the first holding unit 34. The first motor 54 that gives the degree, the second motor 70 that gives the degree of freedom to move in the vertical direction (θ axis) by drawing an arc on the vertical coordinate on the second holding part 36, and the third holding part Each of the third motors 78 that gives the degree of freedom to move in the oblique front-rear direction (γ-axis) with the portion P as a passing point is connected to an unillustrated electric power source and control circuit system. The endoscope 14 is connected to a display 16 via a cable, and images of various internal organs obtained by the endoscope 14 are displayed on a monitor screen. During the operation under the endoscope, instructions by the operator are transmitted to the first motor 54, the second motor 70, and the third motor 78 via the control circuit system by hand operation, foot operation, and other voice operations (voice operation). Is to be given.
[0027]
At the time of the operation under the endoscope, as shown in FIG. 7, an incision necessary for inserting the endoscope 14 (forceps 20) into the abdomen (chest) of the patient 12 on the operating table 10 is performed. The endoscope 14 is inserted through the cannula 18. In this case, the point P inserted into the incision together with the endoscope 14 is the origin 0 in the spherical coordinates described above. Then, the operator gives an instruction while visually confirming the image in the abdominal cavity displayed on the display 16 via the endoscope 14, and the first motor 54 and the second motor 70 are provided via the control circuit system. And the third motor 78 is driven alone or synchronously to give the first holding unit 34, the second holding unit 36, and the third holding unit 38 the desired movement.
[0028]
That is, when the first motor 54 is energized, the first holding unit 34 moves in the left-right direction (φ axis) in an arc on a plane coordinate centering on the body cavity insertion site P. When the second motor 70 is energized, the second holding unit 36 moves in the vertical direction (θ-axis) with an arc on the vertical coordinate centered on the body cavity insertion site P. When the third motor 78 is further energized, the third holding unit 38 moves obliquely in the front-rear direction (γ-axis) with the body cavity insertion site P as a passing point. The movements of the first holding unit 34, the second holding unit 36, and the third holding unit 38 are substantially centered on the site P where the endoscope 14 is inserted into the body cavity. Moreover, since the endoscope 14 is provided along the oblique front-rear direction axis of the third holding portion 38 as described above, the endoscope 14 moves according to the third holding portion 38. Accordingly, the movement obtained by combining the respective movements of the first holding unit 34, the second holding unit 36, and the third holding unit 38 is directly transmitted to the endoscope 14 as a combined movement of the φ axis, the θ axis, and the γ axis in the spherical coordinates. Given.
[0029]
As described above, since the endoscope 14 moves on spherical coordinates with the body cavity insertion site P substantially at the center, the vertical and horizontal directions of the image in the abdominal cavity captured by the endoscope 14 are always constant. Therefore, the monitor screen of the display 16 does not rotate or dance. When the third motor 78 is energized, the endoscope 14 advances or retreats into the abdominal cavity to zoom in and out on the monitor screen. In this case, however, the screen may rotate or shake. As a result, the operator or assistant watching the display 16 is not discomforted.
[0030]
By energizing the fourth motor 92, the endoscope 14 rotates in the circumferential direction about the oblique front-rear direction axis with respect to the third holding unit 38, and stops the angle freely. Can be. However, this is optional when the operator intentionally rotates the image on the display 16 to perform more detailed observation.
[0031]
【The invention's effect】
As described above, according to the endoscope holding device according to the present invention, since the spherical coordinate system is employed as the mechanism for holding the endoscope (not the horizontal joint system), the endoscope inserted into the body cavity of the patient is used. It is possible to suppress rotation and shaking of an image on a display obtained by a mirror, and to provide a comfortable visual environment to a surgeon performing endoscopic surgery and other medical technicians while watching the image. . In addition, since the configuration can be made extremely simple, the cost can be reduced, and this type of endoscope holding device useful for putting an assistant holding the endoscope by hand into other essential surgical operations is useful. Has the advantage that it can promote widespread dissemination.
[Brief description of the drawings]
FIG. 1 is a plan view of an endoscope holding device according to an embodiment, showing a state in which a device main body is attached to an arm.
FIG. 2 is a side view of the endoscope holding device shown in FIG.
FIG. 3 is an enlarged plan view of the endoscope holding device shown in FIG. 1;
FIG. 4 is a partially enlarged side view of FIG. 2;
FIG. 5 is an enlarged view of the endoscope holding device shown in FIG.
FIG. 6 is an overall perspective view of the endoscope holding device according to the embodiment, which is installed beside an operating table.
FIG. 7 is a schematic plan view showing a state in which a patient on an operating table is undergoing an endoscopic operation, and various organs obtained by the endoscope are shown on a display.
[Explanation of symbols]
10 operating table 12 patients
14 Endoscope 16 Display
18 cannula 20 forceps
22 Endoscope holding device 24 Arm
26 Upright prop 28 First arm
30 second arm 32 third arm
34 first holding unit 36 second holding unit
38 third holding part 40 pivot pin
42 1st circular plate 44 1st slider
46 Arc guide 48 Arc rack
50 Saddle part (of first slider) 52 Bracket (of first slider)
54 1st motor 56 1st pinion gear
58 second arc plate 60 second slider
62 arc guide 64 arc rack
66 Saddle part (of second slider) 68 Bracket (of second slider)
70 second motor 72 second pinion gear
74 Mounting part 76 Linear rack
78 Third motor 80 Third pinion gear
82 Holder (endoscope) 84 Permanent magnet
86 1st gear 88 2nd gear
90 Third gear P Body cavity insertion site

Claims (14)

An image of various internal organs obtained by the endoscope (14) inserted into the body cavity of the patient is displayed on the external display (16), and the operator views the image on the display (16) and performs an operation under the endoscope. In an endoscope holding device for operatively holding the endoscope (14) in accordance with instructions of an operator during a surgical operation,
An arm (24) arranged close to the operating table (10) so as to be adjustable in position and capable of facing its tip near the affected part of the patient;
A third end is disposed in the vicinity of the tip of the arm (24), and is movable in a left-right direction by drawing an arc on a plane coordinate centering on a portion (P) where the endoscope (14) is inserted into a body cavity. 1 holding unit (34),
A second holding unit disposed on the first holding unit (34) and movable vertically in an arc on a vertical coordinate centering on a body cavity insertion site (P) of the endoscope (14); (36)
A third holding portion (38) that is disposed on the second holding portion (36) and that can move obliquely in the front-rear direction with the body cavity insertion site (P) of the endoscope (14) as a passing point;
The endoscope (14) is characterized in that the endoscope (14) is held by the third holding portion (38) along the oblique front-back direction axis. The first holding portion (34) includes a first arc plate (42) having an arc on a plane coordinate centered on a body cavity insertion portion (P) of the endoscope (14), and the first arc plate. (42) The endoscope holding device according to claim 1, further comprising a first slider (44) that is guided on the upper side and performs a circular movement to the left and right under control. The first arc plate (42) includes an arc-shaped guide portion (46) on one side surface, and includes an arc-shaped rack (48) on the other side surface,
The first slider (44) includes a saddle portion (50) guided by the arc-shaped guide portion (46), and is driven by a motor that meshes with the arc-shaped rack (48) to impart an arc movement to the left and right. The endoscope holding device according to claim 2, further comprising a first pinion gear (56). The second holding portion (36) includes a second arc plate (58) having an arc on a vertical coordinate centered on a body cavity insertion site (P) of the endoscope (14), and the second arc plate. (58) The endoscope holding device according to claim 1, further comprising a second slider (60) which is guided on the upper side and moves up and down under control of an arc. The second arc plate (58) includes an arc-shaped guide portion (62) on one side surface, and includes an arc-shaped rack (64) on the other side surface,
The second slider (60) has a saddle portion (66) guided by the arc-shaped guide portion (62), and is engaged with the arc-shaped rack (64) to provide a vertical arc movement. The endoscope holding device according to claim 4, further comprising a second pinion gear (72). The endoscope holding device according to claim 1, wherein the third holding portion (38) is a linear slider disposed on the second holding portion (36) and capable of moving forward and backward in the obliquely downward direction. The third holding portion (38) as the linear slider includes a linear rack (76) on one side surface in the longitudinal direction, and a motor-driven third pinion gear (80) disposed on the second holding portion (36). 7. The endoscope holding device according to claim 6, wherein the linear slider is moved obliquely forward and backward by meshing the linear slider with the linear rack. The endoscope holding device according to claim 1, wherein the endoscope (14) is detachably held by a third holding portion (38) via a permanent magnet (84). The endoscope (14) held by the third holding portion (38) is adapted to be rotatable around the axis in the oblique front-rear direction so as to be freely adjustable in a rotation angle in a circumferential direction. The endoscope holding device according to any one of the preceding claims. The first motor (54) for driving the first pinion gear (56), the second motor (70) for driving the second pinion gear (72), and the third motor (78) for driving the third pinion gear (80) The endoscope holding device according to claim 1, wherein each electrical operation is performed according to an instruction of the operator. 11. The motor according to claim 10, wherein the instruction by the operator is given to the first, second and third motors (54, 70, 78) via an electric control system such as a hand operation, a foot operation, and a voice operation. Endoscope holding device. The arm (24) is provided with an upright support (26) erected close to the operating table (10), and a first pivotally supported upper part of the upright support (26) and capable of horizontally turning at a required central angle. An arm (28), a second arm (30) pivotally supported by the first arm (28) and capable of turning horizontally at a required central angle, and a required central angle pivotally supported by the second arm (30). The endoscope holding device according to claim 1, further comprising a third arm (32) that can be turned horizontally with the arm. The upright support (26) can be moved up and down by a required distance by driving a motor, and is required between the endoscope holding device (22) attached to the third arm (32) and the affected part of the patient. The endoscope holding device according to claim 12, wherein the height of the endoscope can be set. The endoscope holding device according to claim 1, wherein the endoscope (14) is inserted into a body cavity of the patient via a cannula (18).

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