JP2006122473A - Method for supporting operation and operation supporting robot to execute the method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To execute such operation supporting acts as selecting specific forceps based on a spoken command by an operator from a large number of forceps in a celiac operation under an endoscope, and holding out the selected forceps to the operator. <P>SOLUTION: An operation supporting robot comprises a stand 12 to be set near an operation table 14, a holder 22 mounted on the stand for detachably holding a necessary number of forceps, an arm 24 mounted on the stand for picking up desired forceps from the forceps 20 held by the holder 22 and releasing the forceps after holding out the forceps to the operator, a voice recognition control means 28 for outputting a command to deduce the specified forceps in response to the spoken command of the operator to specify the desired forceps and outputting a command to the arm to operate, and a composite image generating means 30 for composing the image of the shape of the distal end of the specific forceps specified in the spoken command by the operator with the image of the operation under the endoscope and displaying the composite image in a display 16. Either the holder or the arm is made to deduce the desired forceps according to the deduction command accompanying the spoken command. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a surgical support method and a surgical support robot for performing the method. More specifically, the present invention relates to a voice instruction from a large number of forceps required for an abdominal surgery under an endoscope. The present invention relates to a medical-related technique capable of selecting a specific forceps based on the selected forceps and performing a surgical support act of presenting the forceps to an operator.

  For example, when performing surgery related to the patient's abdominal disease, depending on the location and extent of the disease, endoscopic surgery instead of laparotomy may reduce the invasion on the patient's body, and There are many advantages such as quick recovery and small scars. For this reason, recently, a training system for endoscopic abdominal surgery has been established, and it is likely to become more widespread in the future.

In this endoscopic operation, the patient's abdomen is cut small and 3 to 4 holes are made, and the endoscope and various forceps are correspondingly attached to the hollow sleeves (cannulas) inserted into the respective holes. Insert and perform intra-abdominal surgery. A CCD imaging device is incorporated in the endoscope, and an image (operating field) of the internal organs captured by the imaging device is displayed on a display installed on the other side of the operating table. The tip of the forceps has a shape that functions as an electric knife, tweezers, or other scissors depending on the purpose of use, such as incision or excision of the surgical site, picking up or expanding the internal organs, cutting sutures, etc. It is used for various operations. The surgeon inserts the endoscope into the affected area, and a doctor, a nurse, or the like as an assistant holds the endoscope and secures the visual field during the operation. The insertion and operation of the forceps into the affected area are performed by the surgeon and a doctor as an assistant.
JP 2004-129956 A

  In endoscopic surgery, various types of forceps are used as the operation progresses, so the assistant who manages many forceps selects specific forceps from the forceps in the tray according to the verbal instructions from the operator. The task of handing the forceps to the surgeon is shared. However, the task of selecting a specific forceps from a large number of forceps groups and handing the specified forceps to an operator is difficult in an endoscopic surgical work environment that requires a high level of skill and experience. It's simple and requires little skill.

  In this way, selection of forceps and handing them to the operator (and returning the used forceps) can be regarded as simple work, but on the other hand, since it is extremely important work for smoothly performing surgery, This is handled by doctors and nurses who have sufficient medical knowledge or are undergoing training. For this reason, although it is an assistant role, it is necessary to secure personnel with expertise in the person in charge of managing the forceps, which leads to an increase in the cost of the operation. Also, the situation that spurs the overall shortage of personnel in the medical system because they must be gathered for one endoscopic operation, even though they can be used for other operations Has reached.

  Therefore, the inventors of the present application changed the way of thinking to the current situation in which the selection and handing work of forceps peculiar to the above-mentioned endoscopic surgery relied on a specialist, I found the beginning of the solution by grasping it as an "operated surgery support act". In other words, when looking at the overall flow of endoscopic surgery, most of them require highly skilled and experienced human skills, but now robot control technology and voice recognition control technology have advanced. If so, under the instruction by the operator's voice, the specified forceps are selectively taken out from the prepared forceps group and the forceps are inserted to the vicinity of the operating area of the operator. It came to be judged that it could be robotized. In this case, the present invention further includes the concept of returning the forceps used by the operator to a predetermined forceps set position for reuse, as part of the operation support operation by robotization. .

  The surgical support method according to the present invention solves the problems of the shortage of personnel and the increase in cost associated with handing over forceps inherent in the endoscopic surgery described above, and suitably achieves the intended purpose. When performing an abdominal cavity operation, the surgeon instructs a specific forceps necessary for the operation by voice, so that a surgical support robot installed in the vicinity of the operating table responds to the voice instruction, and a number of prepared in advance It is characterized in that a specific forceps is selected from the forceps, and a surgical support is performed in which the forceps are sent to an operator.

Similarly, in order to solve the above-mentioned problems inherent in endoscopic surgery and achieve the desired purpose suitably, a surgery support robot according to the present invention includes a stand that can be movably installed in the vicinity of an operating table,
A holder provided on the stand, for detachably holding a required number of forceps;
An arm that is provided on the stand and picks up a desired forceps from the forceps held in the holder, and then releases the forceps after inserting the forceps into an operator;
A voice recognition control means for outputting an instruction command for the instructed forceps and outputting an operation command to the arm in response to an operator's voice instruction for specifying a desired forceps;
Composed of a video image of the shape of the tip of a specific forceps voiced by the surgeon, and a composite video generation means for synthesizing the video with the surgical video under the endoscope and displaying it on the display.
According to an indexing command accompanying the voice instruction, either the holder or the arm is configured to perform a desired forceps indexing operation.

  According to the operation support robot according to the present invention, the selection and delivery operation of forceps, which is an indispensable operation in the endoscopic operation, but does not necessarily have to be performed by a medical worker, is robotized. Thus, it becomes possible to direct a person who has advanced medical knowledge such as a doctor or a nurse who was engaged in the work to a medical work by an original manpower. As a result, if the observation is limited to a specific endoscopic operation, the number of medical technicians waiting and engaging in the operation can be reduced, and the cost required for each operation can be reduced. become. In addition, reducing the number of personnel in the operating room will also improve negative factors such as air pollution in the surgical environment, and the personnel who floated due to robotization will be directed to other highly specialized medical operations. It can also contribute to relieving chronic labor shortages.

  Next, the operation support method according to the present invention and the operation support robot for carrying out the same will be described below with reference to the accompanying drawings by giving preferred practical examples.

  1 and 2 are perspective views showing an outline of an operation room in which the operation support robot 10 according to the present invention is introduced, and FIG. 3 is a schematic perspective view of the operation support robot 10. The operation support robot 10 has a stand 12 with casters as will be described later, and is moved and installed at an appropriate position close to the operation table 14 shown in FIGS. 1 and 2 immediately before the endoscopic operation. A display 16 such as a liquid crystal panel is provided on the opposite side of the operating table 14, and an affected part (operating field) imaged by an endoscope (not shown) inserted into the abdominal cavity of the patient on the operating table is displayed on the display 16. Is projected on the screen. In the case of endoscopic surgery, a team consisting of a surgeon (hereinafter referred to as the surgeon) as the main person in charge and an assistant or other nurse who is in charge of operating the forceps and assisting the surgeon is qualified. Is done.

  In the present invention, the surgeon instructs a specific forceps by voice in accordance with the progress of the endoscopic surgery, and the surgery support robot 10 responds to the voice instruction by selecting a specific forceps 20 from a group of forceps having various tip shapes. Is selected, and the medical support that picks up the forceps 20 and sends it to the surgeon's hand is performed to reduce the labor.

(About the overall structure of the invention)
As shown in FIG. 3, the surgical operation support robot 10 according to the embodiment attaches and detaches a stand 12 that is movable by a caster 18 and a number of forceps 20 that are provided on the stand 12 and have various tip shapes according to applications. A holder 22 that is freely held, and an arm that is also provided on the stand 12 and operates according to a voice instruction to be described later to pick up a required forceps 20 from the holder 22 and then releases the forceps 20 to an operator. 24 and the control unit 26 shown in FIG.

  The control unit 26 of FIG. 7 is incorporated in, for example, a personal computer (not shown), and is supported by the holder 22 in response to a voice instruction that the operator specifies a desired forceps 20 via a microphone. An indexing command for the forceps 20 is output. The control unit 26 includes voice recognition control means 28 for outputting a required operation command to the arm 24, and an operator gives a voice instruction to the display 16 (the surgical field by the endoscope is displayed). A synthesized image generating means 30 is also provided for synthesizing and displaying the tip shape of the specific forceps 20 together with the surgical field. Thus, the surgeon can visually confirm the tip shape of the specific forceps 20 instructed by the operator. The display 16 is a menu format in which, for example, the tip shapes of a plurality of forceps 20 are combined and displayed in a menu form in order of frequency of use, and the surgeon visually identifies the necessary forceps 20 from the video. Also good.

  In the illustrated embodiment, the holder 22 holding a number of forceps 20 rotates with respect to the arm 24, and the specific forceps 20 is indexed to a fixed position where the arm 24 is most easily picked up. Since the relationship between the arm 24 and the arm 24 is relative, the structure may be reversed. That is, a configuration in which the arm 24 performs an indexing operation with respect to the holder 22 holding a number of forceps 20 and then the specific forceps 20 is picked up by the arm 24 is also included in the scope of the present invention. is there.

(About the stand)
The stand 12 includes, for example, an elevator 32 that can be raised and lowered by operating a foot pedal and set to a desired height, and a support plate 34 that is horizontally disposed on the top of the elevator 32. A holder 22 and an arm 24, which will be described later, are mounted on the upper surface of the support plate 34, and a drive mechanism for the holder 22 and the arm 24 is disposed on the lower surface of the support plate 34 as shown in FIG. ing.

(About holder)
As shown in FIGS. 4 and 5, the holder 22 includes a disc 36 having a required thickness, clips 38 provided at end portions in the circumferential direction of the disc 36 at a required interval, and a back surface of the disc 36. The hollow cylinder 40 is provided at the center and extends coaxially, and a first gear 42 having a required diameter provided on a lower end flange of the hollow cylinder 40. A shaft portion (sheath) 20a of the forceps 20 is detachably fitted and attached to each of the clips 38, and as shown in FIG. 6, is held down with its tip portion directed downward. .

  In addition, an identification code, for example, a barcode, to which data for identifying and managing the type and the like (which may include manufacturer, material, and other specifications) is attached to an appropriate position of each forceps 20. It is read by a reader 68 described later and is stored and held in the control unit 26. As the identification code, a recognition code such as a QR code is appropriately adopted and used in addition to the barcode. Each clip 38 around the disk 36 is also assigned a code that matches the identification code assigned to each forceps 20, and the cord management is performed so that the corresponding forceps 20 is held by the determined clip 38. Has been made. However, as shown in FIGS. 3 and 4, the recognition code attached to each forceps 20 is fixed by fixing a leader 68 to a pole 39 standing on a support plate 38 and rotating a holder 22 that functions as a forceps magazine. Can be read. When configured in this way, the forceps 20 may be set in any clip 38 on the holder 22.

  A support shaft 44 is arranged upright on the support plate 34 of the stand 12, and the hollow cylindrical body 40 of the holder 22 is extrapolated to the support shaft 44 so that the holder 22 can be rotated around the support shaft 44. It comes to be able to support. As shown in FIG. 4, for example, a servo motor 46 is arranged upright on the back side of the support plate 34, and the output shaft of the speed reducer 48 driven by the servo motor 46 extends vertically above the support plate 34. The second gear 50 is provided at the tip. The second gear 50 meshes with the first gear 42 of the holder 22, and gives a required indexing rotation to the holder 22 according to a command output from the control unit 26. The minimum indexing angle with respect to the holder 22 is a rotation angle obtained by dividing the entire circumference angle by the number of clips 38 that detachably hold the forceps 20.

The illustrated holder 22 has a second number of clips 38 provided in the circumferential direction in the same manner in the vicinity of the middle of the hollow cylinder 40 separately from the disk 36 provided at the top of the hollow cylinder 40. The disc 52 is provided. This is because the sheath 20a of the forceps 20 is long, and the sheath 20a is held and stabilized by the corresponding clips 38 in the upper and lower disks 36 and 52, respectively. In some cases, the second disk 52 may be omitted. Although the mechanism is not shown, the clips 38 provided on the upper and lower disks 36 and 52 are synchronously opened or returned to confirm the approach of the arm 24 described later and release the holding forceps 20. The forceps 20 are closed synchronously so as to be chucked. However, in order to simplify the mechanism, the clip 38 may not be provided with opening / closing power means, and the clip 38 may be elastically biased in the closing direction by a spring.

  The holder 22 is always supported so as to be rotatable in the circumferential direction by extrapolating the hollow cylindrical body 40 to a support shaft 44 erected on the stand 12. It can be completely removed from the stand 12 and sent for sterilization treatment. For this reason, it is sufficient to cover the stand 12 itself with a drape or the like.

(About the arm)
In particular, as shown in FIGS. 3 and 4, an arm 24 adjacent to the holder 22 at a required interval is provided on the support plate 34 of the stand 12. The arm 24 basically includes an arm main body 54 and a hand 58 provided at the upper end portion thereof via a wrist 56, and the lower end portion of the arm main body 54 is pivotally supported by a trunnion 60.

  As shown in FIG. 4, an arm drive mechanism 62 is provided on the back side of the support plate 34 to give the arm 24 operations with various degrees of freedom. For example, the arm main body 54 is given a horizontal turn and a vertical turn with respect to the support plate 34 within a required angle range. The hand 58 is configured to be openable and closable, and can be rotated in a vertical direction, a horizontal direction, and a turning direction (twisting) with respect to the arm main body 54 via a wrist 56, and the hand 58 can be grasped. The handle base can be clamped and unclamped. Since the opening / closing mechanism is not much different from that used in existing robot arms, detailed description thereof is omitted. The hand 58 is detachably attached to the arm 24 together with the wrist 56 by a simple operation. Therefore, after the operation, the hand 58 can be detached from the arm 24 and subjected to sterilization. Further, the hand 58 may be detachably provided on a wrist 56 provided at the tip of the arm 24 so that only the hand 58 is subjected to a subsequent sterilization process.

  By giving the above-mentioned degree of freedom, the hand 58 provided at the upper end of the arm body 54 is swung up and moved vertically by a required angle toward the specific forceps 20 indexed at a fixed position of the holder 22. Then, the forceps 20 gripped by the hand 58 is pushed out to the operator and then swung downward in the vertical direction while turning in the horizontal direction by a required angle. That is, the arm 24 according to the embodiment performs vertical and horizontal turning with respect to the support plate 34, vertical turning / horizontal turning and turning direction (twisting) the hand 58 has with respect to the arm main body 54, and opening / closing operation of the hand 58. And 6 degrees of freedom. Of course, considering the manufacturing cost and the degree of user-friendliness from the field, etc., it can be configured as an articulated arm with more freedom, or the hand 58 can be attached to the arm body 54 in view of cost constraints. A mechanism for vertically turning may be omitted. However, in general, if the degree of freedom on the arm side is increased, the configuration of other peripheral devices can be simplified. Conversely, if the degree of freedom on the arm side is reduced, the configuration of other peripheral devices needs to be complicated.

(About forceps recovery means)
When the arm 24 picks up the specific forceps 20 from the holder 22 and puts it out to the operator, the operator receives the forceps 20 and uses it immediately. However, the used forceps 20 can be used again as long as the same operation is performed. Since it is acceptable, a means for temporarily receiving the used forceps 20 is required. In the present embodiment, the forceps collecting means 64 having the shape shown in FIG. 4 is used for this forceps collecting application. For example, the forceps collecting means 64 is configured as a horn-shaped forceps receiving member that is supported near the base of the stand 12 and opens upward, and the operator throws the used forceps 20 with the handle up. And is directed to a position that does not interfere with the operation of the surgeon at all.

  When the used forceps 20 is returned to the forceps collecting means 64, the handle of the forceps 20 is positioned above the horn-shaped opening and the arm 24 is allowed to collect the forceps 20. As a result, the handle base can be exposed to the operating region of the arm 24. Therefore, when the used forceps 20 is collected, the arm 24 is moved downward and horizontally swiveled toward the forceps collecting means 64, and after the hand 58 holds the handle base of the forceps 20, the arm 58 is raised and horizontally swung to move the forceps 20. The clip is held on a predetermined clip 38 of the holder 22. At this time, the identification code provided on the forceps 20 is read by, for example, a reader disposed on the hand 58 and is definitely returned to the fixed position of the holder 22. Further, as described above, the reader 68 may be provided on the pole 39 on the fixed side, and when the forceps 20 is returned to the holder 22, the recognition code may be sequentially read and confirmed by the reader 68.

  The forceps collecting means 64 is arranged so that the hand 58 of the arm 24 can easily pick up the used forceps 20 from the forceps collecting means 64 in balance with the degree of freedom given to the arm 24. A mechanism for moving forward / backward or moving up / down toward the operation area may be provided. Accordingly, even when the degree of freedom of the arm 24 is low, the used forceps 20 can be collected smoothly. Further, the forceps collecting means 64 described above is configured in a horn shape as an example. However, if the forceps 20 after use is shaped so that the operator can return it to a predetermined collection position without hindrance, various types of forceps may be used even if they are not horn-shaped. The forceps receiving member can be employed. For example, instead of a horn-shaped forceps receiving member, a hook-shaped member provided on the support plate 34 and extending obliquely upward in the radial direction so that the distal end faces an operation region where the operator can easily return the forceps may be used. . It is proposed that the saddle-shaped member in this case is set to a V-shaped groove whose cross section is open upward.

(About the control unit)
FIG. 7 receives various inputs related to the surgery support robot 10 according to the embodiment, gives various outputs to the robot 10 to select and insert the forceps 20, and displays the composite image on the display 16. It is a block diagram which shows the control part 26 which sends out. As outlined above, the control unit 26 is incorporated in the personal computer and includes the voice recognition control means 28 and the synthesized video generation means 30 therein. For example, a microphone 66 set in the vicinity of the operator's mouth, a reader 68 for reading the recognition code, and other outputs of the image sensor (camera) 70 for capturing the distal end image of the forceps 20 are input to the input terminal of the control unit 26. The terminal is connected. Note that the connection between the microphone 66, the reader 68, and the like and the control unit 26 may be any of wired connection using a cable, wireless LAN, and the like. As the microphone 66, a bone-conduction type is recommended for increasing the degree of voice recognition, but other types may be used. In addition, the output terminal of the control unit 26 includes a display 16 for compositing and displaying an endoscopic surgical field and forceps tip image, a controller (or sequencer) 72 for giving various operation commands to the surgery support robot 10, and other confirmation sounds for various commands. Each input terminal of the speaker 74 that outputs is connected. As for the connection between the output terminal and the input terminal, either wired or wireless connection is selectively used as appropriate.

(Voice recognition control)
The voice recognition control means 28 built in the control unit 26 receives a forceps selection instruction by voice from the operator via the microphone 66 and the sound board 76. The voice recognition control means 28 includes a voice recognition engine 78 and a robot control command unit 80 as voice recognition software. The voice recognition engine 78 checks whether the voice is from a specific surgeon, for example, by collating it with a pre-stored operator's real voice pattern or the like, and instructed by the voice. The contents (for example, instructions for the first forceps, the second forceps, etc.) are specifically recognized and grasped. Then, the digital code assigned to the specific forceps recognized by the voice recognition engine 78 is sent to the robot control command unit 80. The robot control command unit 80 analyzes the input digital code and outputs a corresponding instruction to the controller 72. The controller 72 performs a forceps indexing operation of the holder 22 and specific forceps by the arm 24. 20 pick-ups and an operation of sending out to the surgeon are instructed. The series of operation flows will be described later with reference to the flowcharts of FIGS. 9 and 10.

(About composite video generation)
The composite image generation means 30 incorporated in the control unit 26 includes a code such as a forceps number read by the reader 68 and an actual tip portion (for example, tweezers-like or This is a software that synthesizes the image. That is, the tip image of each forceps 20 is previously captured by the image sensor 70 and registered in the composite image generating means 30 together with a code corresponding to the forceps 20. In addition, a surgical field image from an endoscope camera (not shown) is captured by a video capture board 82 built in the control unit 26, and then a tip image of a specific forceps 20 that is voiced by the operator in the synthesized image generation means 30. Are combined with the code and the combined image is displayed on the display 16.

  For example, as shown in FIG. 8, the composite image displayed on the display 16 has a operative field captured in real time by an endoscope as a main screen, and a composite image composed of the tip shape of the forceps 20 and the forceps number below the main screen. Is displayed as a sub-screen. In this case, the forceps tip shape may be a menu display of a plurality of forceps 20 such as forceps numbers 1 to 4, or only the tip shape and number of the forceps 20 specified by the operator are displayed alone. You may do it. However, the former menu display has an advantage that the operator can visually confirm and select from the menu screen on the display 16 even if the operator does not store the shapes and corresponding numbers of all the forceps 20.

  Further, the control unit 26 includes a voice synthesis engine 84, and can make a voice confirmation / denial / non-existence notification to the speaker 74 via the sound board 76. Of course, it is not necessary to make all the synthesized speech, and a simple confirmation sound may be emitted. In addition to sound and sound for confirmation and warning, light, vibration, or the like may be added.

(About a series of robot operations)
Next, a series of operations of the surgery support robot 10 according to the embodiment will be described with reference to a flowchart of FIG. However, the operation according to this flowchart is an example that can be considered within the range of the above-described degrees of freedom of the arm 24, the indexing operation of the holder 22, and the control content incorporated in the control unit 26 among various possible movements. It is as.

  When starting an endoscopic operation, it is assumed that the forceps 20 required for the operation are fitted and held (set) corresponding to each clip 38 of the holder 22. The identification code attached to the forceps 20 is read in advance by the reader 68, and an image of the forceps tip shape is stored in the composite video generation means 30 of the control unit 26.

  In step S1 of the flowchart of FIG. 9, the reader 68 confirms whether all the forceps 20 are set in the holder 22 in order, and if YES (Yes), waits for a voice instruction from the operator in step S2. However, since the reader 68 performs confirmation to sequentially check the forceps 20 with the recognition code, it is not an essential requirement that the forceps 20 are set in the holder 22 in order. On the other hand, if the confirmation result is NO (No), a warning by voice is given in step S3 to alert the operation personnel. The confirmation in step S1 is performed by, for example, providing a leader 68 on the pole 39 standing on a fixed portion near the rotating region of the holder 22, and rotating the holder 22 once to hold the forceps 20 held on each clip 38. This is done by reading the identification code, but is not limited to this.

  When the surgeon instructs the specific forceps 20 by voice through the microphone 66 during the voice instruction standby in step S2 (step S4), the tip shape and forceps number of the specified forceps 20 are displayed on the display 16 in step S5. Is synthesized and displayed, and an artificial voice or confirmation sound for confirming the instruction issued to the forceps 20 is output from the speaker 74. In this case, the necessary number of forceps 20 may be displayed in a menu on the display 16 together with the corresponding number in advance, and the operator may give a voice instruction after viewing the specific forceps 20 from the menu. As stated. In addition, the combined display of the forceps tip shape on the display 16 is performed by the composite video generation means 30 of the control unit 26, and the voice confirmation operation is performed by the voice recognition control means 28.

  Next, in step S6, the rotary indexing of the holder 22 is performed, and the forceps 20 specified by the voice by the operator is brought to a fixed position where the arm 24 is most easily picked up. In terms of control, the indexing rotation of the servo motor 46 is executed by an instruction from the control unit 26 via the controller 72. In step S7, for example, the identification code attached to the specific forceps 20 that has been indexed and stopped by the reader 68 is read to check whether the desired forceps 20 has been indexed. If so, the process returns to step S6 and is executed again. If the result is YES, the process proceeds to step S8, where a required drive command is output from the controller 72 to the arm drive mechanism 62, indexed to a fixed position of the holder 22, and directed to the specific forceps 20 waiting. 24 is moved, and the forceps 20 is clamped (gripped) by the hand 58. In addition, since the control part 26 has memorize | stored beforehand in which clip 38 in the holder 22 the forceps 20 is set, the said step S6 may be abbreviate | omitted.

  Next, in step S9, it is confirmed whether the hand 58 has securely grasped the forceps 20. If the result is NO, the gripping by the hand 58 is re-executed in step S8, and if the result is YES, step S10. Then, the arm 24 is pivoted and the specific forceps 20 is put out to the operator's hand. In order to confirm the grasping of the forceps by the hand 58, for example, a pressure sensor such as a strain gauge may be provided in the hand 58, and an electrical signal accompanying a change in pressure of the sensor may be output to the control unit 26. Further, instead of the tactile sensor as described above, a noncontact contact sensor such as a photo sensor may be provided for checking forceps.

  Next, in step S11, it is confirmed whether or not the operator actually holds the forceps 20 that has been pushed out by the pivoting operation of the arm 24. If the result is YES, the hand 58 is opened to release the grip on the forceps 20. . If the result is NO, step S11 is executed again. This step S11 is necessary when handing the specific forceps 20 to the surgeon. For example, the hand 58 is opened when a predetermined time elapses (for example, 3 seconds) after the forceps 20 is pushed out to the operator's hand. For example, it is conceivable that a pressure change when the surgeon touches the forceps 20 with a hand is detected by the pressure sensor and the hand 58 is opened. In addition, it replaces with the control which sets time passage as a function, arrangement | positioning of a pressure sensor, etc., by adding the mechanical structure, operation | movement by which an operator removes the forceps 20 pushed out to the hand by hand, this forceps 20 may be removed from the hand 58. As an example, a finger (not shown) that elastically biases the hand 58 in the direction of closing the hand 58 is provided in the finger-like hand 58 at all times. When the hand 58 reaches a predetermined forceps delivery position and stops, the hand 58 is slightly opened against the elasticity of the spring in response to a required positioning completion signal. The opening / closing is set to such an extent that the hand 58 is lightly grasped by the hand 58 and can be easily removed when the surgeon picks up the hand 20 and moves it. When the forceps 20 are removed from the hand 58, a required sensor detects “no forceps”, the hand 58 is completely opened against the spring force, and returns to the next forceps removal position.

  In any case, it is assumed that necessary measures are taken in advance so that the hand 58 is not inadvertently opened and the forceps 20 is removed. In step S12, it is confirmed whether the forceps 20 has been handed over to the operator, that is, whether the hand 58 has released the grasping of the forceps 20, and if the result is NO, step S12 is re-executed. If the result is YES, in step S13, the arm 24 is returned to the required standby position as the origin and stopped, and the cycle ends.

(About the flow to return used forceps)
In the endoscopic operation, even if the forceps 20 once used can be used repeatedly during the operation, the operation support robot 10 according to the embodiment provides the forceps 20 by providing the forceps collecting means 64. The holder 22 can be returned to a fixed position. FIG. 10 is a flowchart showing whether or not the used forceps 20 is recovered by the forceps recovery means 64 in step S14. If there is no forceps 20, the arm 24 is set at the origin standby position in step S19. Continue to wait. If the forceps 20 has been recovered by the forceps recovery means 64, the arm 24 moves to recover the forceps in step 15, and the hand 58 holds the forceps 20. In this case, whether or not the used forceps 20 has been recovered by the forceps recovery means 64 can be easily confirmed by employing, for example, an imaging means (camera) or other various sensors and sending the output to the control unit 26. The illustration is omitted.

  In step S16, it is confirmed whether or not the hand 58 has grasped the forceps 20 collected by the forceps collecting means 64. If the result is NO, step S16 is re-executed. If the result is YES, the process proceeds to the next step 17 to move the arm 24 toward the fixed position of the holder 22. At this time, the holder 22 is indexed and rotated, and the clip 38 that has been waiting for the collected forceps 20 is brought to a fixed position to hold the forceps 20. As described above, for example, the holding of the forceps 20 can be reconsidered when the opened clip 38 detects the approach of the arm 24 to a predetermined position and closes.

  In step S18, after the clip 38 is held again by the clip 38, it is checked whether or not the hand 58 has released the holding. If the result is NO, step S18 is executed again. If a result is YES, it will progress to step S19, will return the arm 24 to the standby position of an origin, and will wait for the next operation | movement.

  As described above, according to the surgical operation support robot according to the present invention, it is possible to robotize forceps selection and handing work in the case of endoscopic surgery. Therefore, it is possible to divert to other medical work, and as a result, it is possible to reduce the number of medical technicians waiting and engaging in the operation, and to reduce the operation cost. It can also contribute to the elimination of chronic labor shortages in various medical services.

It is the perspective view which observed the operating room which introduced the surgery assistance robot which concerns on the Example of this invention from the diagonally upper front side of the operating table. It is the perspective view which observed the operation room which introduce | transduced the surgery assistance robot which concerns on an Example from the operator's back diagonally upward side. It is a schematic perspective view of a surgery support robot. It is a side view of a surgery support robot. It is a top view of a surgery assistance robot. It is an expansion perspective view of the holder in a surgery support robot. It is a block diagram which shows the control part of a surgery assistance robot. It is explanatory drawing which displays a forceps as a menu on a display. It is a flowchart figure which shows a series of operation | movement of the surgery assistance robot which concerns on an Example. It is a flowchart figure which shows a series of operation | movement which returns the used forceps of the surgery assistance robot which concerns on an Example to the fixed position of a holder.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Surgery support robot 12 Stand 14 Operating table 16 Display 18 Caster 20 Forceps 20a Sheath 22 Holder 24 Arm 26 Control part 28 Voice recognition control means 30 Synthetic image generation means 32 Elevator 34 Support plate 36 Disc 38 Clip 39 Pole 40 Hollow cylinder 42 first gear 44 support shaft 46 servo motor 48 speed reducer 50 second gear 52 second disc 54 arm main body 56 wrist 58 hand 60 trunnion 62 arm drive mechanism 64 forceps collecting means 66 microphone 68 reader 70 imaging element (camera) 72 Controller 74 Speaker 76 Sound board 78 Speech recognition engine 80 Robot control command part 82 Video capture board 84 Speech synthesis engine

Claims (10)

  When performing an abdominal surgery under an endoscope, the surgeon instructs the specific forceps (20) necessary for the operation by voice, so that the operation support robot (10) installed in the vicinity of the operating table (14) In response to a voice instruction, a specific forceps (20) is selected from a number of forceps (20) prepared in advance, and surgical support is provided to send the forceps (20) to an operator. Surgery support method to do. A stand (12) that can be movably installed in the vicinity of the operating table (14);
A holder (22) provided on the stand (12) and detachably holding a required number of forceps (20);
The desired forceps (20) is picked up from the forceps (20) provided on the stand (12) and held by the holder (22), and the forceps (20) is inserted into the operator before the forceps (20) An arm (24) for releasing,
In response to the operator's voice instruction to specify the desired forceps (20), the voice recognition control outputs an instruction command for the instructed forceps (20) and outputs an operation command to the arm (24). Means (28);
Composed of an image of the tip shape of a specific forceps (20) voiced by the surgeon, and a synthesized image generation means (30) for displaying the image on the display (16) with the operation image under the endoscope,
A surgical operation support robot configured to cause either the holder (22) or the arm (24) to perform an indexing operation of a desired forceps (20) in accordance with an indexing command accompanying the voice instruction.   The surgery support robot according to claim 2, wherein the holder (22) rotates relative to the arm (24) to index the forceps (20) specified by a voice instruction of an operator.   The operation support robot according to claim 2, wherein the arm (24) rotates relative to the holder (22) to index the forceps (20) specified by a voice instruction of the operator.   Each of the forceps (20) includes an identification code for identifying and managing information unique to the forceps (20), and the corresponding identification code read by the reader (68) provided on the stand (12), The surgical operation support robot according to claim 2, wherein the synthesized image generating means (30) is configured to synthesize the tip shape image of the forceps (20).   The stand (12) is provided with a forceps collecting means (64) for receiving used forceps (20), and the arm (24) picks up the forceps (20) received by the forceps collecting means (64), The surgical operation support robot according to claim 2, wherein a return operation for re-holding the holder (22) at a predetermined position is performed.   The operation support robot according to claim 6, wherein the forceps collecting means (64) includes a forceps receiving member that opens toward an operation region of the operator, and the used forceps (20) is collected by the forceps receiving member.   The surgery support robot according to claim 2, wherein the holder (22) is detachably provided on the stand (12) and is used for a subsequent sterilization process.   The arm (24) includes a hand (58) for picking up and releasing the forceps (20), and the hand (58) is provided detachably with respect to the arm (24) to be used for subsequent sterilization processing. The surgical operation support robot according to claim 2. The arm (24) includes a hand (58) for picking up and releasing the forceps (20), and the hand (58) is detachably provided on a wrist (56) provided at the tip of the arm (24). The surgical operation support robot according to claim 2, which is subjected to a subsequent sterilization treatment.

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