JP2008113697A - Inserting part operation unit - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To solve such problems as a fear of making the operation complicate by requiring an operator to take more time in making himself well used to the operation of the inserting part and a fear of making the inserting part 10 act not intended by the operator 2 as caused by such a complication of the operation, sudden actions of patients 3 and acts of inevitability that may happen accidentally. <P>SOLUTION: The inserting part operation unit 1 has the body 30 of an inserting part operation device which holds the inserting part 10 when the operator 2 inserts into the patient 3 the inserting part 10 which is advanced into or retracted (inserted or pulled off) from the lumen of the patient 3 or twisted to adjust the degree of the insertion of the inserting part 10 (for example, degree of advancement or retraction or degree of twisting) and a control unit 50 for controlling the inserting part operation device body 30. This enables the operator 2 to handily insert, pull off or twist the inserting part 10 as intended without spoiling operability. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an insertion portion operating device that operates an insertion portion that is advanced and retracted and twisted relative to a lumen.

  In general, for example, in an apparatus in the medical field, an endoscope is provided with an insertion portion that is inserted into a body cavity (for example, a lumen). This apparatus performs observation and treatment in a body cavity by inserting an insertion portion into the body cavity.

An endoscope insertion apparatus provided with such an insertion portion is disclosed in Patent Document 1 and will be briefly described below.
In this endoscope insertion apparatus, an insertion part to be inserted into an observation target part, an advance / retreat rotation identification means formed on the outer surface of the insertion part, and an advance / retreat rotation identification means of the insertion part are disposed so as to be able to advance / retreat. An operating member that is provided, a detecting unit that is provided on the operating member and detects a forward / backward rotation amount of the operating member with respect to the insertion portion based on a forward / backward rotation identifying unit; Driving means.

  The surgeon slides (moves forward and backward) the operation member with respect to the insertion portion when the insertion portion is advanced and retracted. The detection means provided in the operation member detects the advance / retreat amount of the operation member based on the advance / retreat rotation identification means. The detection means transmits the detected detection signal to the drive means, and the drive means inserts or removes (advances / retreats) the insertion portion from the observation target site based on the detection signal.

  The surgeon slides (rotates) the operation member with respect to the insertion portion when rotating the insertion portion. The detection means provided in the operation member detects the rotation amount of the operation member based on the advance / retreat rotation identification means. The detection means transmits the detected detection signal to the drive means, and the drive means rotates the insertion portion based on the detection signal.

Thus, when the surgeon moves the insertion portion forward / backward or rotates, the endoscope insertion apparatus causes the detection means to read the advance / retreat operation or drive operation of the operation member via the advance / retreat rotation identification means ( The insertion portion is moved back and forth or rotated according to the detection result.
JP 2000-107123 A

  In the endoscope insertion device disclosed in Patent Document 1 described above, the insertion portion is indirectly advanced / retracted or rotated by operating the operation member. As a result, depending on the operator, it takes time to get used to the operation, and there is a possibility that the operation becomes complicated because the operation feeling is different from the method of actually inserting by manual operation.

  Therefore, the present invention has been made in view of the above circumstances, and an object thereof is to provide an insertion portion operating device that is a simple operation mechanism and does not impair the operability for an operator.

  In order to achieve the object, the present invention detects a manipulation amount applied to an insertion portion of an endoscope that is manipulated when it is advanced or retracted or twisted with respect to a lumen, and is detected by the detection unit. And a controller that controls the operation of the insertion / retraction of the insertion portion or the twisting of the insertion portion with respect to the lumen according to the operated amount.

  ADVANTAGE OF THE INVENTION According to this invention, it is a simple operation mechanism and can provide the insertion part operation apparatus which does not impair the operativity for an operator.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
The first embodiment will be described with reference to FIGS.
FIG. 1 is a schematic perspective view when the insertion portion operating device according to the present embodiment is used. FIG. 2 is a schematic side view of the insertion portion operating device shown in FIG. FIG. 3 is a schematic front view of the insertion unit operating device shown in FIG. 1. FIG. 4 is a schematic front view of the insertion unit operating device main body when the rotating unit shown in FIG. 3 is rotated. FIG. 5 is a schematic top view of the insertion unit operating device main body when the rotating unit shown in FIG. 3 is rotated. FIG. 6 is a schematic top view of the insertion portion operating device when the insertion portion is inserted into the insertion portion operating device main body shown in FIG. 3 (the rotation portion is not shown). FIG. 7 is a schematic perspective view of the holding mechanism. FIG. 8 is a schematic AA sectional view of the holding mechanism shown in FIG. FIG. 9 is a schematic perspective view of the force sensor. 10 is a schematic BB cross-sectional view of the insertion portion operating device shown in FIG. FIG. 11A is a schematic perspective view showing the inside of the insertion portion operating device main body (showing the positional relationship among the insertion portion, the roller pair, the rotation amount sensor, and the holding mechanism pair). 11B and 11C are modified examples of the roller pair. 12 is a CC schematic cross-sectional view of the insertion portion operating device main body shown in FIG. FIG. 13 is a control diagram schematically showing the control mechanism of the present embodiment. FIG. 14A to FIG. 14D are views showing the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into the patient. FIG. 15 is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is removed from the patient. FIG. 16 is a flowchart showing the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into the patient. FIG. 17A to FIG. 17C are views showing the operation of the insertion unit operating device main body when the insertion unit is twisted.

  In this embodiment, the direction in which the insertion portion 10 advances / retreats (insertion or removal) is the X-axis direction, and the direction perpendicular to the X-axis direction (the direction in which the friction urging member 38 urges the insertion portion 10) is Y. The direction orthogonal to the axial direction, the X-axis direction, and the Y-axis direction is taken as the Z-axis direction.

The insertion section operating device 1 will be described with reference to FIGS. 1 and 2.
As shown in FIG. 1, in the insertion portion operating device 1, an operator 2 is advanced or retracted (inserted or removed) or twisted (rotated) into a lumen of a patient 3 as an insertion target portion as a main portion. When inserting the insertion portion 10 of an endoscope such as an elongated tube, which is a soft insertion body, into the patient 3, for example, the insertion portion 10 is held, and the operation amount of the insertion portion 10 (for example, the amount of advancement / retraction or twist) An insertion unit operating device main body 30 that adjusts the operation of the insertion unit 10 (for example, advancement / retraction and twisting) and a control unit 50 that controls the insertion unit operating device main body 30 are provided. An operation unit 70 having a switch (not shown) is provided on the proximal side of the proximal end (one end) of the insertion portion 10 of the endoscope. The other end of the operation unit 70 is connected to a light source device (not shown) or a monitor (not shown) that displays an image taken by the insertion unit 10 inserted into the patient 3.

  The insertion part 10 is advanced and retracted (inserted and removed) and twisted with respect to the patient 3 by being grasped by the operator 2.

  The insertion portion operating device main body 30 can be movably disposed in the vicinity of the patient 3 on the bed 4, for example, which is a first placement member on which the patient 3 to which the insertion portion 10 is inserted is placed. Specifically, it is preferable that the insertion portion operating device main body 30 is disposed in the vicinity of the patient 3 and on the bed 4. As shown in FIGS. 1 and 2, when the patient 3 places the head 3 a on the pillow 5 as the second arrangement member, the insertion portion operating device main body 30 is on the pillow 5 and the patient 3. It is suitable that it is arrange | positioned in the vicinity.

  The control unit 50 is configured separately from the insertion unit operation device main body 30 and may be arranged on the bed 4 as with the insertion unit operation device main body 30, but as shown in FIGS. 1 and 2. It is preferable that the insertion unit operating device main body 30 be placed vertically below the side of the bed 4 or between the legs of the bed 4. As a result, more space is provided in the vicinity of the insertion unit operating device main body 30, so that the operator 2 can ensure the operability for the insertion unit 10.

  The control unit 50 is a control unit in the insertion unit operating device 1, and includes a force sensor 39 that is a first detection unit, a rotation amount sensor 41 that is a second detection unit, and a rotation that is a third detection unit. The amount sensor 42 and the holding mechanism pair 31 that holds the insertion unit 10 are included in the insertion unit operation device main body 30.

Next, the insertion portion operating device main body 30 will be described in detail with reference to FIGS.
As shown in FIGS. 3 to 6, the insertion unit operating device body 30 includes a holding mechanism pair 31 (holding mechanisms 31 a and 31 b) that holds the insertion unit 10, and the insertion unit 10 is inserted into or removed from the patient 3. When the insertion portion 10 is twisted by the operator 2 and the roller pair 32 (rollers 32a and 32b) which are rotating portions that rotate in direct contact with the insertion portion 10, the insertion portion 10 is directly contacted. Thus, a roller pair 33 (rollers 33a and 33b), which is a rotating unit that rotates, and a rotating unit 34 that rotates with respect to the insertion unit operating device main body 30 are provided. Further, the rotating portion 34 is provided with one side (33b) of the roller pair 33. The roller pairs 32 and 33 are also contact portions that directly contact the insertion portion 10.

  As shown in FIG. 4, the rotation part 34 rotates around the fulcrum 34a. Inserted because the space between both pairs of the holding mechanism pair 31 and the space between both pairs of the roller pair 32 communicate upward when the rotating portion 34 rotates and the contact point 35 moves away from the grounding portion 36. The unit 10 is placed on one of the roller pair 33 (roller 33a). Thereby, the insertion part 10 is arrange | positioned in the space pinched | interposed into both pairs of the holding mechanism pair 31, and is pinched | interposed into the roller 32a and the roller 32b. When the rotating part 34 is rotated and the contact point 35 is grounded to the grounding part 36, the insertion part 10 is further sandwiched between the roller 33a and the roller 33b. The insertion portion 10 can be twisted about the X-axis direction and can be advanced and retracted along the X-axis direction. A state when the insertion unit 10 is sandwiched between the holding mechanism pair 31 will be described later.

Next, the holding mechanism pair 31 will be described with reference to FIGS.
Here, since the configurations of the holding mechanism 31a and the holding mechanism 31b are the same, only the holding mechanism 31b will be described.
The holding mechanism 31 b includes a motor 37, a screw part 40 that rotates when the motor 37 is driven, a force sensor 39 that is a first detection part disposed in the head part 48 of the screw part 40, and a force sensor. A friction urging member 38 that abuts on 39 is provided.

  Although not shown, the head portion 48 of the screw portion 40 is restricted from moving in the rotational direction, and moves forward and backward along the axis of the screw portion 40 when the screw portion 40 rotates. When the motor 37 is driven, the screw portion 40 rotates, and the head portion 48 advances and retreats along the axis of the screw portion 40, whereby the force sensor 39 and the friction biasing member 38 move along the Y-axis direction. To do. When moved, the friction urging member 38 urges by directly contacting the insertion portion 10. Thus, the friction biasing member 38 is also a contact portion that directly contacts the insertion portion 10.

  The holding mechanism pair 31 holds the insertion portion 10 by driving the motor 37 and biasing the friction biasing member 38 toward the insertion portion 10. The friction urging member 38 is adjusted by the motor 37 to urge the insertion portion 10.

  The force sensor 39 detects an urging force when the friction urging member 38 urges the insertion portion 10, and when the insertion portion 10 is advanced or retracted or twisted when urged, the force urging force is applied to the insertion portion 10. An insertion force generated when the insertion portion 10 is inserted from a frictional force generated in the member 38, a removal force generated when the insertion portion 10 is removed, and a rotational force (twisting force) generated when the insertion portion 10 is rotated. To detect.

  The insertion force, the removal force, and the twisting force vary depending on the operation amount that is directly applied to the insertion portion 10. Therefore, the force sensor 39 detects the operation amount directly applied to the insertion portion 10 from the insertion force, the removal force, and the twisting force. As described above, the force sensor 39 indirectly contacts the insertion portion 10 via the friction biasing member 38 to detect the operation amount.

  As shown in FIG. 9, an insertion force and an extraction force are generated in the advancing / retreating direction (X-axis direction) of the insertion portion 10, and a biasing force is generated in the direction in which the friction biasing member 38 biases the insertion portion 10 (Y-axis direction). A twisting force is generated in the direction of twisting the insertion portion 10.

  Further, as shown in FIGS. 10 to 12, in the roller pair 32, either one of the rollers 32a and 32b is provided with a second detection unit that detects the rotation amount (for example, rotation speed, rotation angle, angular acceleration) of the roller. A certain rotation amount sensor 41 is provided. In the present embodiment, a rotation amount sensor 41 is provided coaxially with the roller 32a. As shown in FIG. 11A, in the roller pair 33, one of the rollers 33a and 33b is provided with a rotation amount sensor 42 as a third detection unit for detecting the rotation amount of the roller pair 33. . In the present embodiment, a rotation amount sensor 42 is provided coaxially with the roller 33a.

  As shown in FIG. 11A, the roller 33a and the rotation amount sensor 42 are supported by a support member 47. Although not shown, the roller 33 b and the holding mechanism pair 31 are also supported by the support member 47.

  A groove 28 is formed on the outer peripheral surface of the roller pair 32 in parallel with the axial direction (Z-axis direction). A groove 29 is formed on the outer peripheral surface of the roller pair 33 in parallel with the axial direction (X-axis direction). Thereby, the friction in the circumferential direction becomes larger than the friction in the axial direction. When the insertion portion 10 advances and retreats, a large advancing / retreating force can be applied to the insertion portion 10 by the circumferential friction of the roller pair 32. In the roller pair 33, the groove 29 is formed in parallel with the advancing / retreating direction. Therefore, a large frictional force is not generated in the roller pair 33 and the insertion portion 10 in the advance / retreat direction, and it does not become an obstacle during advance / retreat. The opposite is true when twisting. Note that the grooves 28 and 29 are omitted in the other drawings, not shown.

  In this embodiment, the grooves 28 and 29 are provided on the surfaces of the roller pairs 32 and 33. However, the present invention is not limited to this. For example, the roller 33b may be provided with a plurality of protrusions 26 parallel to the axial direction (X-axis direction) as shown in FIG. 11B. Further, for example, as shown in FIG. 11C, the roller 33b may be provided with a plurality of convex concave portions 27 parallel to the axial direction (X-axis direction). Of course, these may be combined. In this way, when the insertion portion 10 is advanced / retracted or twisted, a large frictional force is not generated and no obstacle occurs, and if a large advance / retreat force or twisting force can be applied to the insertion portion 10, the roller pairs 32, 33 are applied. The member provided is not limited.

  As shown in FIG. 12, the rollers 32 a and 32 b are each supported by a support member 44. The support member 44 is provided with, for example, a spring 43 that is an urging member. This spring 43 is attached to the insertion portion operating device main body 30. The spring 43 biases the support member 44. Thereby, the roller 32a and the roller 32b hold the insertion portion 10 by the biasing force generated by the spring 43. The spring 43 is not shown in the other drawings for the sake of simplicity.

The amount of rotation of the rollers 32 a and 33 a varies depending on the amount of operation applied directly to the insertion unit 10. Therefore, the rotation amount sensors 41 and 42 detect the operation amount directly applied to the insertion portion 10 from the rotation amount of the rollers 32a and 33a. Thus, the rotation amount sensors 41 and 42 indirectly contact the insertion unit 10 via the rollers 32a and 33a to detect the operation amount.
Next, the control mechanism of this embodiment will be described with reference to FIG.
The control unit 50 is provided with a control controller 51, an input / output board 52, a first amplifier 53, and an encoder 54.
The controller 51 controls driving of the motor 37 via the input / output board 52 and the first amplifier 53.

  The input / output board 52 detects the rotation amount of the roller pair 32 detected by the rotation amount sensor 41 when the insertion portion 10 moves forward and backward, and the rotation amount sensor 42 when the insertion portion 10 is twisted. The rotation amount of the roller pair 33, the rotation amount (encoder value) of the motor 37 detected by the encoder 54 when the motor 37 rotates, and the biasing force by the friction biasing member 38 detected by the force sensor 39. The insertion force, removal force, and twisting force of the insertion portion 10 detected by the force sensor 39 are input. The rotation amount, urging force, insertion force, removal force, and twisting force input to the input / output board 52 are input to the controller 51.

  The controller 51 calculates the advance / retreat amount of the insertion portion 10 from the rotation amount of the roller pair 32 and the twist amount of the insertion portion 10 from the rotation amount of the roller pair 33 as described above.

  The controller 51 increases or decreases the rotation signal by the first amplifier 53 via the input / output board 52 so that the biasing force applied to the friction biasing member 38 indicated by the arrow is constant while referring to the encoder value of the motor 37. Then, the drive of the motor 37 is controlled as described above. Thus, the insertion portion 10 is held by the holding mechanism pair 31 with a constant urging force. The urging force indicated by the arrow is detected by the force sensor 39 as described above and is input to the controller 51.

  Further, the controller 51 is provided with a determination unit 55 (details will be described later) and a setting unit 56 that presets a first set value α and a second set value β that are in a predetermined range. The first set value α and the second set value β can be arbitrarily set.

Next, with reference to FIG. 14A, FIG. 14B, FIG. 14C, and FIG. 14D, operation | movement of the insertion part operation device main body at the time of making a patient insert an insertion part is demonstrated.
As described above, when the rotation part 34 is rotated and the contact point 35 is separated from the grounding part 36, the insertion part operating device body 30 is opened so that the insertion part 10 is placed on the roller 33a from above. . Accordingly, the insertion portion 10 is held between the holding mechanism pair 31 and is held between the roller pair 32. Further, when the rotating portion 34 is rotated and the contact point 35 is grounded to the grounding portion 36, the insertion portion 10 is further sandwiched between the roller pair 33. At that time, the controller 51 controls the holding operation. That is, the controller 51 drives the motor 37 so that the urging force is constant as described above, and urges (tightens) the friction urging member 38 to the insertion portion 10. As a result, the controller 51 causes the holding mechanism pair 31 to hold the insertion portion 10 (the insertion portion 10 is held by the insertion portion operating device body 30 by a constant biasing force).

  In this state, when the surgeon 2 inserts the insertion portion 10 into the patient 3 as shown in FIG. 14A, an insertion force is generated between the holding mechanism pair 31 and the insertion portion 10. The force sensor 39 detects this insertion force. The detected insertion force is output to the input / output board 52. Until the insertion force reaches the first set value α, the insertion portion 10 is urged by the friction urging member 38.

  When the surgeon 2 further inserts the insertion unit 10 into the patient 3 and the insertion force exceeds the first set value α set in advance by the setting unit 56, the controller 51 includes the input / output board 52, The motor 37 is driven via the first amplifier 53. As a result, the controller 51 releases the urging (tightening) of the insertion portion 10 by the friction urging member 38 as shown in FIG. 14B. When the surgeon 2 further inserts the insertion portion 10 into the patient 3, the insertion portion 10 easily advances toward the patient 3.

  At this time, the roller pair 32 rotates due to friction with the insertion portion 10. A rotation amount sensor 41 provided coaxially with the rotating roller 32 a outputs the rotation amount of the roller 32 a to the controller 51 via the input / output board 52. As described above, the rotation amount is, for example, a rotation speed, a rotation angle, or an angular acceleration. The determination unit 55 can determine the advance / retreat state of the insertion unit 10 by detecting the rotation amount. Specifically, as shown in FIG. 14B, in this embodiment, when the roller 32a rotates clockwise and the roller 32b rotates counterclockwise, the insertion portion 10 is inserted (hereinafter, the insertion portion 10 is inserted). The determination unit 55 determines that the direction in which the rollers 32a and 32b rotate is positive rotation). In this embodiment, when the roller 32a rotates counterclockwise and the roller 32b rotates clockwise, the insertion portion 10 is removed (hereinafter, the rollers 32a and 32b rotate when the insertion portion 10 is removed). The determination unit 55 determines that the rotation direction is negative rotation). Thereby, as described above, the controller 51 can also calculate the advance / retreat amount of the insertion unit 10 from the rotation amount. When the rotation amount (for example, the rotation speed θ) of the roller 32a exceeds the second set value β, the biasing (tightening) state of the insertion portion 10 by the friction biasing member 38 is released as described above. Maintained.

  When the surgeon 2 stops the insertion of the insertion portion 10 into the patient 3 (the insertion force becomes 0), the rotation amount (for example, the rotation speed θ) of the roller 32a decreases as shown in FIG. 14C. When the determination unit 55 determines that the rotation amount of the roller 32a is less than the second set value β, the controller 51 considers that the insertion force of the insertion unit 10 has become 0 in response to the determination result. At that time, the controller 51 controls the holding operation. That is, the controller 51 drives the motor 37 via the input / output board 52 and the first amplifier 53 to bias (tighten) the friction biasing member 38 to the insertion portion 10.

  As shown in FIG. 14D, similarly to FIG. 14A, the insertion portion 10 is again urged (tightened) by the friction urging member 38 and is sandwiched and held by the holding mechanism pair 31. As a result, the controller 51 causes the holding mechanism pair 31 to hold the insertion unit 10, and the holding state of the insertion unit 10 by the holding mechanism pair 31 is maintained.

  When the surgeon 2 removes the insertion portion 10 from the patient 3, an extraction force is generated between the holding mechanism pair 31 and the insertion portion 10 as shown in FIG. The force sensor 39 detects this removal force. The detected removal force is output to the input / output board 52. Also in this case, the insertion portion 10 is urged by the friction urging member 38 until the removal force reaches the first set value α as in the case of insertion.

  When the surgeon 2 further removes the insertion portion 10 from the patient 3 and the removal force exceeds the first set value α, the controller 51 sends a motor via the input / output board 52 and the first amplifier 53. 37 is driven. As a result, the controller 51 releases the urging (tightening) of the insertion portion 10 by the friction urging member 38 as shown in FIG. 14B. Further, when the operator 2 further causes the patient 3 to remove the insertion portion 10, the insertion portion 10 is easily extracted from the patient 3.

  The operation after the surgeon 2 stops removing the insertion portion 10 from the patient 3 is the same as the operation after the surgeon 2 stops the insertion of the insertion portion 10 from the patient 3 and is omitted here. .

Next, the operation of the insertion portion operating device main body when inserting the insertion portion into the patient will be described with reference to the flowchart shown in FIG.
The determination unit 55 determines whether or not the insertion force exceeds the first set value α (Step 1). When the determination unit 55 determines that the insertion force exceeds the first set value α (Step 1: Yes), the controller 51 drives the motor 37 via the input / output board 52 and the first amplifier 53. Let As a result, the biasing (tightening) of the insertion portion 10 by the friction biasing member 38 is released, and the holding state of the insertion portion 10 by the holding mechanism pair 31 is released (Step 2). In this state, as described above, the roller pair 32 rotates due to friction with the insertion portion 10. The rotation amount sensor 41 outputs the rotation amount (for example, rotation speed θ) of the roller 32 a to the controller 51 via the input / output board 52. At that time, the determination unit 55 determines whether or not the rotation amount exceeds the second set value β (Step 3). If the determination unit 55 determines that the amount of rotation exceeds the second set value β (Step 3: Yes), it is considered that the insertion unit 10 is inserted, and the process returns to Step 2 and is performed by the friction biasing member 38. The open state to the insertion part 10 is maintained. When the determination unit 55 determines that the rotation amount has decreased the second set value β (Step 3: No), the controller 51 stops the insertion of the insertion unit 10 by the operator 2 with respect to the patient 3. (The insertion force has become 0). At that time, the controller 51 controls the holding operation. That is, the controller 51 drives the motor 37 via the input / output board 52 and the first amplifier 53 to bias (tighten) the friction biasing member 38 to the insertion portion 10. As a result, the controller 51 causes the holding mechanism pair 31 to hold the insertion unit 10 and maintains the holding state of the insertion unit 10 by the holding mechanism pair 31 (Step 4). This completes the operation. If the determination unit 55 determines that the insertion force is lower than the first set value α (Step 1: No), the process proceeds to Step 4.

  Note that the flowchart of the operation of the insertion portion operation apparatus main body 30 when the insertion portion 10 is removed from the patient 3 is omitted because the insertion force in FIG.

  Next, with reference to FIG. 17A, FIG. 17B, and FIG. 17C, operation | movement of the insertion part operation device main body at the time of twisting an insertion part is demonstrated.

  Since the operation until the insertion unit 10 is held by the insertion unit operating device body 30 has been described above, the description thereof will be omitted.

  In this state, when the surgeon 2 twists the insertion portion 10 as shown in FIG. 17A, a twisting force is generated between the holding mechanism pair 31 and the insertion portion 10. The force sensor 39 detects this twisting force. The detected twisting force is output to the input / output board 52.

  When the surgeon 2 further twists the insertion portion 10 and the twisting force exceeds the first set value α, the controller 51 drives the motor 37 via the input / output board 52 and the first amplifier 53. . As a result, as shown in FIG. 17B, the biasing (tightening) of the insertion portion 10 by the friction biasing member 38 is released, and the holding state of the insertion portion 10 by the holding mechanism pair 31 is released. In this state, the surgeon 2 can easily twist the insertion portion 10.

  At this time, the roller pair 33 rotates due to friction with the insertion portion 10. A rotation amount sensor 42 provided coaxially with the rotating roller 33 a outputs the rotation amount of the roller 33 a to the controller 51 via the input / output board 52. The amount of rotation is, for example, a rotation speed, a rotation angle, or an angular acceleration. The determination unit 55 can determine the twisting direction of the insertion unit 10 (clockwise or counterclockwise in FIG. 17A) by detecting the rotation amount. Specifically, when the roller 33a rotates counterclockwise, the determination unit 55 determines that the insertion unit 10 is twisted clockwise. When the roller 33a rotates clockwise, the determination unit 55 determines that the insertion unit 10 is twisted counterclockwise. When the rotation amount (for example, the rotation speed θ) of the roller 33a exceeds the second set value β, the urging (tightening) state of the insertion portion 10 by the friction urging member 38 is released as described above. Maintained.

  When the surgeon 2 stops the twist of the insertion portion 10, the rotation amount (for example, the rotation speed θ) of the roller 33a decreases. When the determination unit 55 determines that the rotation amount of the roller 33a is less than the second set value β, the controller 51 stops the twist of the insertion unit 10 by the operator 2 (the twisting force of the insertion unit 10 is reduced). 0). At that time, the controller 51 controls the holding operation as in the case of insertion as described above. That is, the controller 51 drives the motor 37 via the input / output board 52 and the first amplifier 53 to bias (tighten) the friction biasing member 38 to the insertion portion 10. As a result, the controller 51 causes the holding mechanism pair 31 to hold the insertion portion 10 as shown in FIG. 17C, and the holding state of the insertion portion 10 by the holding mechanism pair 31 is maintained. If the determination unit 55 determines that the twisting force is lower than the first set value α, the holding state of the insertion unit 10 by the holding mechanism pair 31 is maintained.

  Note that the flowchart of the operation of the insertion portion operating device main body 30 when twisting the insertion portion 10 is omitted because only the insertion force in FIG. 16 replaces the twisting force.

  As described above, the present embodiment determines whether or not the insertion force, the removal force, and the twisting force have exceeded the first set value α when the insertion portion 10 is advanced / retracted or twisted. The holding state by the pair 31 is released. If not, the controller 51 controls the holding operation to hold it by the holding mechanism pair 31 to fix the movement of the insertion portion 10. Thereby, this embodiment prevents unintentional movement of the insertion part 10 for the surgeon 2 due to, for example, sudden movement of the patient 3 lower than the first set value α or accidental force majeure. Can do. Therefore, this embodiment can be easily inserted, removed, and twisted so that the operator 2 intends the insertion portion 10 without impairing the operability for the operator 2 by a simple operation mechanism.

  In the present embodiment, when the insertion portion 10 is advanced or retracted or twisted, if the insertion force, removal force, or twisting force is lower than the second set value β, the insertion mechanism 10 is held again by the holding mechanism pair 31, The movement of the insertion portion 10 is fixed. Accordingly, in this embodiment, since the insertion portion 10 is automatically fixed so as not to move, for example, after the surgeon 2 has finished insertion, removal, and twisting, the insertion for the surgeon 2 is performed as described above. Unintentional movement of the unit 10 can be prevented.

  Moreover, this embodiment arrange | positions the insertion part operating device main body 30 in the pillow 5, and is the insertion port at the time of inserting the insertion part 10 in the patient 3, for example, the height from the mouth to the pillow 5, and the insertion part operating device main body. The height of the insertion part 10 through which 30 is inserted and the pillow 5 can be made substantially the same. As a result, the operator 2 can smoothly insert the insertion portion 10 into the lumen.

  In this embodiment, as shown in FIG. 18, the friction urging member 38 is detachable from the insertion portion operating device main body 30. For example, when the surgeon 2 removes the insertion portion 10 from the body of the patient 3, the body fluid or mucus of the patient 3 may adhere to the insertion portion 10. Therefore, this body fluid or mucus may adhere to the friction biasing member 38 through the insertion portion 10. Therefore, in this embodiment, by making the friction urging member 38 detachable, the operator 2 can remove and clean only the part to which body fluid or mucus adheres. As a result, this embodiment can reuse the clean friction urging member 38. The screw portion 40 is provided with a waterproof member 45. The waterproof member 45 prevents water droplets or the like from adhering to the motor 37 and the support member 49 when the friction urging member 38 is washed. The friction urging member 38 may be disposable without being washed.

  For the same reason, as shown in FIG. 19, the roller 32a is also detachable from the insertion portion operating device main body 30. A waterproof member 45 is provided on the shaft portion 46 of the rotation amount sensor 41. The waterproof member 45 prevents water droplets or the like from adhering to the rotation amount sensor 41 and the support member 44 when washed.

  Although not shown, the roller 33a is also detachable from the insertion section operating device main body 30. Further, a waterproof member 45 is provided at the shaft portion of the rotation amount sensor 42. The waterproof member 45 prevents water droplets or the like from adhering to the rotation amount sensor 42 and the support member 47 when washed.

  In the present embodiment, the roller 32b and the roller 33b are also detachable from the insertion unit operating device main body 30, so that, for example, when the roller 32b and the roller 33b are removed, the roller 32b and the roller 33b can be cleaned or replaced with an unused one. Roller pairs 32, 33 can be used.

  In this embodiment, only the friction biasing member 38 and the roller pairs 32 and 33 that are in direct contact with the insertion portion 10 are detachable from the insertion portion operating device main body 30, but the other contact portions that are in contact with the insertion portion 10 are detachable. You may make it the structure which makes it possible.

Next, a second embodiment according to the present invention will be described in detail with reference to FIGS. The same parts as those in the first embodiment described above are denoted by the same reference numerals, and detailed description thereof is omitted.
FIG. 20 is a diagram showing the characteristic part of the present embodiment, and shows the internal positional relationship of the insertion unit operating device body (shows the positional relationship of the insertion unit, roller pair, rotation amount sensor, holding mechanism pair, and motor). It is a schematic perspective view. FIG. 21 is a control diagram schematically showing the control mechanism of the present embodiment. FIG. 22A to FIG. 22C are views showing the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into a patient. FIG. 23 is a flowchart showing the operation of the insertion unit operating device body when the insertion unit is inserted into or removed from the patient.

  Since the configuration other than the insertion portion operating device main body 30 in the present embodiment is the same as that in the first embodiment described above, detailed description thereof will be omitted.

  As shown in FIG. 20, the roller pair 32 is provided with a motor 60 that is a drive unit that rotates the roller 32a. The motor 60 is also an auxiliary unit that assists the advance / retreat operation of the insertion unit 10 by rotating the roller 32a when the insertion unit 10 advances / retreats. The roller 32a, the motor 60, and the rotation amount sensor 41 are arranged on the same axis. The motor 60 may rotate the roller 32b. That is, the motor 60 may rotate at least one of the rollers 32a and 32b.

  Similarly, the roller pair 33 is provided with a motor 61 which is a drive unit for rotating the roller 33a. The motor 61 is also an auxiliary portion that assists the twisting operation of the insertion portion 10 by rotating the roller 33a when the insertion portion 10 is twisted. The roller 33a, the motor 61, and the rotation amount sensor 42 are arranged on the same axis. The motor 61 may rotate the roller 33b. That is, the motor 61 may rotate at least one of the rollers 33a and 33b.

Next, the control mechanism of the present embodiment will be described with reference to FIG.
In the configuration of the control mechanism of the present embodiment, a second amplifier 57 and a third amplifier 58 are added to the configuration of the control mechanism of the first embodiment described above.

  The controller 51 of this embodiment controls the driving of the motor 37 via the input / output board 52 and the first amplifier 53. Similarly, the driving of the motor 60 is controlled via the input / output board 52 and the second amplifier 57. Similarly, the driving of the motor 61 is controlled via the input / output board 52 and the third amplifier 58.

  The input / output board 52 detects the rotation amount of the roller pair 32 detected by the rotation amount sensor 41 when the insertion portion 10 moves forward and backward, and the rotation amount sensor 42 when the insertion portion 10 is twisted. The rotation amount of the roller pair 33, the rotation amount (encoder value) of the motor 37 detected by the encoder 54 when the motor 37 rotates, and the biasing force by the friction biasing member 38 detected by the force sensor 39. The insertion force, removal force, and twisting force of the insertion portion 10 detected by the force sensor 39 are input. The rotation amount, urging force, insertion force, removal force, and twisting force input to the input / output board 52 are input to the controller 51.

  The controller 51 can also calculate the advance / retreat amount of the insertion portion 10 from the rotation amount of the roller pair 32 and the twist amount of the insertion portion 10 from the rotation amount of the roller pair 33.

  The controller 51 increases or decreases the rotation signal by the first amplifier 53 via the input / output board 52 so that the urging force indicated by the arrow becomes constant while referring to the encoder value of the motor 37, as described above. The driving of the motor 37 is controlled. Thus, the insertion portion 10 is held by the holding mechanism pair 31 with a constant urging force. The urging force indicated by the arrow is detected by the force sensor 39 as described above and is input to the controller 51. Further, the controller 51 increases or decreases the rotation signal by the second amplifier 57 via the input / output board 52 based on the rotation amount, biasing force, insertion force, removal force, and twisting force input from the input / output board 52. Thus, the drive of the motor 60 is controlled. Thereby, the insertion portion 10 is assisted by the motor 60 to advance and retract. Similarly, the controller 51 controls the driving of the motor 61 by increasing / decreasing the rotation signal by the third amplifier 58. Thereby, the insertion portion 10 is assisted by the motor 61 in the twisting operation.

Next, with reference to FIG. 22A, FIG. 22B, and FIG. 22C, operation | movement of the insertion part operation device main body at the time of making a patient insert an insertion part is demonstrated.
Since the operation until the insertion unit 10 is held by the insertion unit operating device main body 30 is the same as that in the first embodiment, a description thereof will be omitted.
In this state, as shown in FIG. 22A, when the surgeon 2 inserts the insertion portion 10 into the patient 3, an insertion force is generated between the holding mechanism pair 31 and the insertion portion 10. The force sensor 39 detects this insertion force. The detected insertion force is output to the input / output board 52. Until the insertion force reaches the first set value α, the insertion portion 10 is urged by the friction urging member 38.

  When the surgeon 2 further inserts the insertion portion 10 into the patient 3 and the insertion force exceeds the first set value α, the controller 51 transmits the motor via the input / output board 52 and the first amplifier 53. 37 is driven. As a result, the controller 51 releases the urging (tightening) of the insertion portion 10 by the friction urging member 38 as shown in FIG. 22B.

  At this time, the roller pair 32 rotates due to friction with the insertion portion 10. A rotation amount sensor 41 provided coaxially with the rotating roller 32 a outputs the rotation amount of the roller 32 a to the controller 51 via the input / output board 52. The amount of rotation is, for example, a rotation speed, a rotation angle, or an angular acceleration. The determination unit 55 can determine the advance / retreat state of the insertion unit 10 by detecting the rotation amount. Specifically, when the roller pair 32 is rotating forward, the determination unit 55 determines that the insertion unit 10 is inserted. When the roller pair 32 rotates negatively, the determination unit 55 determines that the insertion unit 10 has been removed.

At that time, the controller 51 controls an auxiliary operation for the insertion operation or the extraction operation. When the roller 32a rotates by inserting the insertion unit 10, the rotation amount (for example, the rotation speed θ) of the roller 32a is always the same as the constant value θ1 set in the setting unit 56 in advance. The controller 51 outputs an instruction to the second amplifier 57 via the input / output board 52. The second amplifier 57 drives the motor 60 so that the rotation speed θ is the same as the constant value θ1. As described above, the controller 51 assists the insertion operation of the insertion unit 10 or the removal operation by the motor 60. In the present embodiment, the motor 60 can be driven with the torque instructed by the controller 51 by using the second amplifier 57 as a torque control amplifier.
The controller 51 also controls an auxiliary operation for the twisting operation as described above. The controller 51 assists the twisting operation of the insertion portion 10 with the motor 61.

  Even if the surgeon 2 stops inserting the insertion portion 10 into the patient 3 (when the insertion force is 0), the control controller so that the rotation amount (for example, the rotation speed θ) of the roller 32a becomes the above-described constant value θ1. The torque that 51 gives to the motor 60 is referred to as torque T0. This torque T0 can be arbitrarily set. The controller 51 always stores this torque T0. Further, when the surgeon 2 inserts the insertion portion 10 into the patient 3 (an insertion force is applied), an insertion force is applied to the torque T0. At that time, the controller 51 needs to drop the torque T0 from the torque T0 to the torque T so that the rotation amount (for example, the rotation speed θ) of the roller 32a becomes the above-described constant value θ1 by the sum of the torque T0 and the insertion force. The greater the insertion force, the smaller the torque T. Accordingly, the determination unit 55 determines whether or not the state in which the operator 2 is inserting the insertion unit 10 is maintained by determining whether or not the torque T is smaller than the torque T0.

  When the torque T increases and becomes substantially the same as the torque T0, the determination unit 55 determines that the surgeon 2 stops the insertion of the insertion unit 10 into the patient 3 (the insertion force becomes 0). In this case, as shown in FIG. 22C, the controller 51 stops driving the motor 60 via the input / output board 52 to stop the rotation of the roller 32a. Further, the controller 51 drives the motor 37 via the input / output board 52. The insertion portion 10 is again urged (tightened) by the friction urging member 38 and is sandwiched and held by the holding mechanism pair 31. Thereby, the insertion part 10 is held by the insertion part operating device main body 30.

  The operation of the insertion portion operating device main body 30 when the surgeon 2 removes the insertion portion 10 from the patient 3 is omitted because the insertion force in FIGS. 22A to 22C is replaced by the removal force.

  The operation of the insertion portion operating device main body 30 when the surgeon 2 twists the insertion portion 10 is omitted because only the insertion force in FIGS. 22A to 22C is replaced by the twisting force.

  Next, the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into or removed from the patient will be described with reference to the flowchart shown in FIG.

  The determination unit 55 determines whether the insertion force or the removal force has exceeded the first set value α (Step 11). When the determination unit 55 determines that the insertion force or the extraction force exceeds the first set value α (Step 11: Yes), the controller 51 passes through the input / output board 52 and the first amplifier 53. The motor 37 is driven. As a result, the biasing (tightening) of the insertion portion 10 by the friction biasing member 38 is released, and the holding state of the insertion portion 10 by the holding mechanism pair 31 is released (Step 12). In this state, as described above, the roller pair 32 rotates due to friction with the insertion portion 10. A rotation amount sensor 41 provided coaxially with the rotating roller 32 a outputs the rotation amount of the roller 32 a to the controller 51 via the input / output board 52. At that time, the determination unit 55 determines whether or not the roller 32a is rotating forward from the rotation amount (Step 13). If the determination unit 55 determines that the roller 32a is rotating forward (Step 13: Yes), it is considered that the insertion unit 10 is inserted. At that time, as described above, the controller 51 assists the insertion operation of the insertion portion 10 by the motor 60 (Step 14). If the determination unit 55 does not determine that the roller 32a is rotating forward (Step 13: No), the controller 51 considers that the roller 32a is rotating negatively and assumes that the insertion unit 10 has been removed. . At that time, as described above, the controller 51 assists the removal operation of the insertion portion 10 by the motor 60 (Step 15).

  Next, the determination unit 55 determines whether or not the torque T is smaller than the torque T0 (Step 16). If the determination unit 55 determines that the torque T is smaller than the torque T0, the process returns to Step 12, and the open state to the insertion unit 10 by the friction urging member 38 is maintained. When the determination unit 55 determines that the torque T is substantially the same as the torque T0 (Step 16: No), the controller 51 considers that the insertion force or the removal force has become zero. In this case, the controller 51 stops driving the motor 60 via the input / output board 52 and the second amplifier 57 to stop the rotation of the roller 32a (Step 17). As a result, the controller 51 ends the assist of the insertion operation or the extraction operation of the insertion unit 10.

  Further, similarly to the first embodiment, the controller 51 controls the holding operation. That is, the controller 51 drives the motor 37 via the input / output board 52 and the first amplifier 53 to bias (tighten) the friction biasing member 38 to the insertion portion 10. As a result, the controller 51 causes the holding mechanism pair 31 to hold the insertion portion 10 and maintains the holding state of the insertion portion 10 by the holding mechanism pair 31 (Step 18). This completes the operation. In addition, when the determination part 55 discriminate | determines that insertion force or extraction force has decreased the 1st setting value (alpha) (Step11: No), it progresses to Step18.

  Note that the flowchart of the operation of the insertion portion operating device main body when twisting the insertion portion is omitted because the insertion force and removal force in FIG. 23 are merely replaced with the twisting force. In this case, the rotation amount sensor 42 detects the twisting direction of the insertion portion 10 (whether it is rotating clockwise or counterclockwise), and the twisting operation is assisted by the motor 61. Further, the torque applied to the motor 61 is set to the torque T0 as described above. As described above, the determination unit 55 determines whether or not the operator 2 is twisting the insertion unit 10 by determining whether or not the torque T is smaller than the torque T0. When the torque T is smaller than the torque T0, the controller 51 causes the holding mechanism pair 31 to hold the insertion portion 10 as described above, and the holding state of the insertion portion 10 by the holding mechanism pair 31 is maintained.

  As described above, the present embodiment determines whether the insertion force, the removal force, and the twisting force have exceeded the first set value α when the insertion portion 10 is advanced / retracted or twisted as in the first embodiment. If it exceeds, the holding state by the holding mechanism pair 31 is released. If not, the controller 51 controls the holding operation to hold it by the holding mechanism pair 31 to fix the movement of the insertion portion 10. Thereby, this embodiment prevents unintentional movement of the insertion part 10 for the surgeon 2 due to, for example, sudden movement of the patient 3 lower than the first set value α or accidental force majeure. Can do. Therefore, this embodiment can be easily inserted, removed, and twisted so that the operator 2 intends the insertion portion 10 without impairing the operability for the operator 2 by a simple operation mechanism.

  Further, when the biasing force by the holding mechanism pair 31 is released, the determination unit 55 in the present embodiment advances and retracts the insertion unit 10 from the rotation direction of the roller pair 32 (whether it is inserted or removed). The rotation direction of the twist is determined from the rotation direction of the roller pair 33. In the present embodiment, by driving the motors 60 and 61 from the determination result, the advancement / retraction operation and the twisting operation of the insertion portion 10 can be assisted. Thus, the surgeon 2 can easily insert, extract, and rotate the insertion portion 10 as intended.

Next, a third embodiment according to the present invention will be described in detail with reference to FIGS. The same parts as those in the first embodiment described above are denoted by the same reference numerals, and detailed description thereof is omitted. In the present embodiment, since the configurations of the control unit 50 and the operation unit 70 are the same as those in the first embodiment described above, they are not shown, and detailed descriptions thereof are also omitted.
FIG. 24 is a schematic perspective view when the insertion portion operating device according to the present embodiment is used. FIG. 25 is a schematic front view of the insertion portion operating device main body shown in FIG. 24 as viewed from the patient side. FIG. 26 is a schematic perspective view of the insertion portion operating device main body shown in FIG. 24 as viewed from the operator side. 27A to 27E are views showing the operation of the insertion portion operating device main body when the insertion portion is inserted into the patient. FIG. 28 is a flowchart showing the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into or removed from the patient. FIG. 29A thru | or FIG. 29C are figures which show operation | movement of the insertion part operating device main body at the time of twisting an insertion part. FIG. 30 is a flowchart showing the operation of the insertion unit operating device body when twisting the insertion unit.

  As shown in FIGS. 24 to 26, the insertion portion operating device main body 30 includes a support portion 62 that supports a motor 73 that drives the drive mechanism 63, and the insertion portion 10 for inserting, removing, or twisting the insertion portion 10. A drive mechanism 63 for holding and a twisting mechanism portion 64 for twisting the insertion portion 10 by rotating the drive mechanism 63 for holding the insertion portion 10 are provided.

  The drive mechanism 63 is provided with a roller pair 32 (32a, 32b), which is a rotating portion that rotates when the insertion portion 10 is inserted into or removed from the patient 3, and coaxially with the roller 32a. 32a is a drive unit that rotates, and is provided coaxially with the roller 32b and the motor 60 that is an auxiliary unit that assists the insertion or removal of the insertion unit 10 by rotating the roller 32a. The rotation amount sensor 41, the roller pair 32, and the motor 60 that are the same as those of the embodiment are held, and the drive mechanism main body 66 that is a gear portion in which the groove portion 65 is provided on the outer peripheral surface, the roller pair 32, and the motor 60 are held. A sliding portion 67 provided on the surface of the drive mechanism main body 66 on the side opposite to the surface being provided is provided.

  The sliding part 67 is substantially semi-cylindrical. The sliding portion 67 is provided with a pin insertion portion 69 into which the pin 71 is inserted on the outer peripheral surface 68. On the inner peripheral surfaces of the drive mechanism main body 66 and the sliding portion 67, a groove (not shown) is provided in parallel with the axial direction (X-axis direction). This groove can obtain the same effect as the groove 29 described above.

  A twist mechanism 64 is provided below the drive mechanism 63. The twisting mechanism portion 64 is provided with a receiving portion 75 having an opening 72 having a long hole shape in the Y-axis direction. The receiving part 75 faces the sliding part 67. The receiving portion 75 is formed in a substantially semi-cylindrical shape substantially the same as the outer peripheral surface of the sliding portion 67. The sliding portion 67 is placed on the receiving portion 75, and the axes of the sliding portion 67 and the receiving portion 75 are substantially coincident with each other. After the sliding portion 67 is placed on the receiving portion 75, the pin 71 is inserted into the pin insertion portion 69 provided on the outer peripheral surface of the sliding portion 67 through the opening 72 so as to penetrate the opening 72. The Thereby, the sliding part 67 and the receiving part 75 are assembled.

  The sliding part 67 has a substantially semi-cylindrical shape coaxial with the receiving part 75. The sliding portion 67 can slide (turn) with respect to the receiving portion 75. At that time, the pin 71 inserted in the pin insertion portion 69 moves in the opening 72 along the opening 72. For this reason, the rotation range of the sliding portion 67 is defined by the shape of the opening 72.

  The groove portion 65 is configured to mesh with the gear portion 74 by placing the sliding portion 67 on the receiving portion 75. As a result, when the motor 73 rotates, the entire drive mechanism 63 placed on the twisting mechanism portion 64 is rotated via the gear portion 74.

  The drive mechanism 63 is a rotating part that rotates with respect to the twisting mechanism part 64 when a driving force is transmitted from the motor 73 via the gear part 74 and the groove part 65 by driving the motor 73. This assists the insertion part 10 in being twisted. The motor 73 is an auxiliary unit that assists the twisting of the insertion unit 10 by rotating the drive mechanism 63. When the drive mechanism 63 is rotated, the pin 71 is inserted into the pin insertion portion 69 so that the operation range (rotation range) of the drive mechanism 63 is defined as described above. The motor 73 is provided with an encoder (not shown) that detects the rotation amount of the motor 73.

  The amount of rotation of the roller 32b varies depending on the amount of insertion and removal applied to the insertion unit 10. Therefore, the rotation amount sensor 41 detects the insertion amount and the removal amount applied to the insertion unit 10 from the rotation amount of the roller 32b. As described above, the rotation amount sensor 41 indirectly contacts the insertion portion 10 via the rollers 32a and 33a to detect the insertion amount and the removal amount.

  The drive mechanism main body 66 is provided with a rotation amount sensor (not shown) that detects the rotation amount (for example, the rotation speed, the rotation angle, and the angular acceleration) of the drive mechanism main body 66. The amount of rotation of the drive mechanism main body 66 varies depending on the amount of twist applied to the insertion portion 10. Therefore, the rotation amount sensor detects the amount of twist applied to the insertion unit 10 from the rotation amount of the drive mechanism main body 66. As described above, the rotation amount sensor detects the amount of twist by contacting the insertion portion 10 indirectly via the drive mechanism main body 66.

  The control mechanism in the present embodiment is the same as that in the first embodiment and the second embodiment described above, and a detailed description thereof will be omitted.

  Next, with reference to FIG. 27A, FIG. 27B, FIG. 27C, FIG. 27D, and FIG. 27E, operation | movement of the insertion part operation device main body at the time of making a patient insert an insertion part is demonstrated.

  When no insertion force is generated in the insertion unit 10 (for example, the operator 2 does not insert the insertion unit 10 into the patient 3), the controller 51 maintains the roller pair 32 in the state shown in FIG. 27A. This position is referred to as the origin position. As described above, the insertion portion 10 is held by the drive mechanism 63 via the roller pair 32.

  Next, when the surgeon 2 pushes the insertion portion 10 into the patient 3, an insertion force is generated on the insertion portion 10. At that time, as shown in FIG. 27B, the controller 51 drives the motor 60 to generate torque and maintains the origin position so that the insertion portion 10 is not pushed in until the insertion force exceeds a predetermined value. .

  Next, when the surgeon 2 further inserts the insertion portion 10 into the patient 3 and the insertion force exceeds a predetermined value and overcomes the torque, as shown in FIG. 27C, the roller pair 32 rotates and the rotation amount from the origin position is reached. (For example, rotational speed, rotational angle, angular acceleration) are shifted. At this time, the determination unit 55 can determine the advance / retreat state of the insertion unit 10 from the rotation amount detected by the rotation amount sensor 41. As described above, in detail, when the roller pair 32 is rotating forward, the determination unit 55 determines that the insertion unit 10 is inserted. When the roller pair 32 rotates negatively, the determination unit 55 determines that the insertion unit 10 has been removed.

  Next, when the surgeon 2 further inserts the insertion portion 10 into the patient 3 and the rotation amount exceeds the first set value γ set in the preset setting portion 56, the controller 51 inserts Controls auxiliary operation for operation or removal operation. The first set value γ can be set arbitrarily. Therefore, the controller 51 drives the motor 60. At this time, as shown in FIG. 27D, the motor 60 rotates the roller 32 a in the same direction as the advancing / retreating direction of the insertion unit 10 based on the determination result from the determination unit 55. For example, if the insertion unit 10 is inserted, the controller 51 rotates the roller pair 32 forward to assist the insertion operation. For example, if the insertion part 10 is removed, the controller 51 negatively rotates the roller pair 32 to assist the removal.

  Therefore, the controller 51 causes the motor 60 to generate torque in the same direction as the insertion force, and assists the insertion operation or the extraction operation of the insertion portion 10. At this time, this torque is controlled by a controller 51 (not shown) so as to maintain a preset value.

  Next, when the surgeon 2 stops inserting the insertion portion 10 into the patient 3 (the insertion force becomes 0), the rotation amount (for example, the rotation speed θ) of the roller 32b decreases. When the determination unit 55 determines that the rotation amount of the roller 32b is less than the second set value δ set in the setting unit 56, the controller 51 receives the determination result and the insertion force of the insertion unit 10 is 0. Therefore, the driving of the motor 60 is stopped. The second set value δ can be arbitrarily set. At that time, as shown in FIG. 27E, the controller 51 sets the position where the roller pair 32 is stopped as a new origin position. Further, the controller 51 causes the drive mechanism 63 to hold the insertion unit 10 via the roller pair 32. This returns to the state of FIG. 27A.

  Next, the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into or removed from the patient will be described with reference to the flowchart shown in FIG.

  When the surgeon 2 inserts the insertion portion 10 into the patient 3 and the insertion force exceeds a predetermined value, or when the surgeon 2 causes the insertion portion 10 to be removed from the patient 3 and the removal force exceeds the predetermined value, The determination unit 55 determines whether or not the rotation amount of the roller pair 32 exceeds the first set value γ (Step 21). When the determination unit 55 determines that the rotation amount exceeds the first set value γ (Step 21: Yes), the roller pair 32 rotates and deviates from the origin position by the rotation amount.

  In this state, as described above, the roller pair 32 rotates due to friction with the insertion portion 10. A rotation amount sensor 41 provided coaxially with the rotating roller 32 b outputs the rotation amount of the roller 32 b to the controller 51 via the input / output board 52. At that time, the determination unit 55 determines whether or not the roller 32b is rotating forward from the rotation amount (Step 22). If the determination unit 55 determines that the roller 32b is rotating forward (Step 22: Yes), it is considered that the insertion unit 10 is inserted. At that time, as described above, the controller 51 assists the insertion operation of the insertion portion 10 by the motor 60 (Step 23). If the determination unit 55 does not determine that the roller 32b is rotating forward (Step 22: No), it is considered that the roller 32b is rotating negatively and the insertion unit 10 is removed. At that time, as described above, the controller 51 assists the removal operation of the insertion portion 10 by the motor 60 (Step 24).

  Next, the determination unit 55 determines whether or not the rotation amount (for example, the rotation speed θ) of the roller pair 32 is greater than a preset second setting value δ (Step 25).

  If the determination unit 55 determines that the rotation amount exceeds the second set value δ (Step 25: Yes), it is considered that the insertion unit 10 has been inserted or removed, and the process returns to Step 22. Thereby, the insertion operation | movement with respect to the insertion part 10 or extraction operation | movement is assisted. When the determination unit 55 determines that the rotation amount has decreased the second set value δ (Step 25: No), the controller 2 allows the operator 2 to insert or remove the insertion unit 10 from the patient 3. Is considered to have stopped. Therefore, the controller 51 stops driving the motor 60. Thereby, the rotation of the roller 32a stops (Step 26).

  At that time, the controller 51 causes the drive mechanism 63 to hold the insertion portion 10 via the roller pair 32 and maintains the holding state. As a result, the position where the roller 32a is stopped becomes a new origin position (Step 27).

  In Step 21, when the determination unit 55 determines that the rotation amount does not exceed the first set value γ (Step 21: No), the process proceeds to Step 27.

  Next, with reference to FIG. 29A, FIG. 29B, and FIG. 29C, operation | movement of the insertion part operation device main body at the time of twisting an insertion part is demonstrated.

  When the twisting force is not generated in the insertion portion 10 (for example, the operator 2 does not twist the insertion portion 10), the drive mechanism main body 66 is kept stationary. This position is referred to as the origin position.

  The drive mechanism main body 66 is provided with a motor 60. As shown in FIG. 29A, when the surgeon 2 twists the insertion portion 10 from a stationary state, the drive mechanism main body 66 also starts to rotate in response to the twist of the insertion portion 10. At that time, different moments are generated around the rotation center depending on the rotation angle. For example, as shown in FIG. 29A, a moment Mθ1 is generated at the position of the angle θ1. In order for the drive mechanism main body 66 to remain stationary at the angle θ1, the insertion portion operating device main body 30 needs to generate a torque Tθ1 that balances the moment Mθ1 in the motor 73.

  In this way, the insertion portion operating device main body 30 sets the torque Tθ corresponding to the angle θ and causes the motor 73 to generate it. This setting is performed, for example, every 5 °, and the same value may be used for the range of ± 2.5 °. In addition, you may calculate | require mathematically from the structure (For example, arrangement | positioning of the component provided in the drive mechanism main-body part 66, weight, etc.).

  When the surgeon 2 twists the insertion portion 10 further from the angle θ <b> 1 by the deviation angle Δθ <b> 1, the drive mechanism main body 66 also starts to rotate in response to the twist of the insertion portion 10. When the deviation angle Δθ1 from the angle θ1 exceeds a preset first setting value α, the determination unit 55 determines that the surgeon 2 is twisting the insertion unit 10. Therefore, the insertion portion operating device main body 30 drives the motor 73 in a direction in which the deviation angle Δθ1 is further increased. At that time, the insertion portion operating device main body 30 further generates a torque tθ1 in addition to the torque Tθ1 for just stopping the motor 73 as shown in FIG. 29B. The added torque tθ1 assists the operator 2 in twisting.

  This torque tθ1 is a value corresponding to the deviation angle Δθ1, and may be set in advance as, for example, several tens% of the torque Tθ1 corresponding to the angle θ1.

  Thus, since the surgeon 2 is assisted by the motor 73 when twisting the insertion portion 10, the burden of the twisting operation is reduced. Further, the insertion portion operating device main body 30 measures the rotation amount of the motor 73 with an encoder (not shown) provided in the motor 73.

  When the surgeon 2 gradually decreases the force for twisting the insertion portion 10, the force for rotating the drive mechanism main body 66 is only the torque of the motor 73. Further, when the surgeon 2 stops twisting the insertion portion 10, the rotation amount (for example, the rotation speed θ) of the drive mechanism main body portion 66 decreases. When the determination unit 55 determines that the rotation amount of the drive mechanism main body 66 is less than the second set value δ, the insertion unit operating device main body 30 receives the determination result and the twisting force of the insertion unit 10 becomes zero. (Surgery 2 has stopped twisting). As a result, the insertion section operating device main body 30 drives the motor 73 to stop the driving of the motor 73. At that time, as shown in FIG. 29C, the insertion portion operating device main body 30 drives the motor 73 to generate a static torque Tθ2 corresponding to the angle θ2, and maintains the drive mechanism main body 66 at this position. The drive mechanism 63 is stationary while holding the insertion portion 10 via the roller pair 32. Thereby, this position becomes a new origin position.

  Next, the operation of the insertion portion operating device main body when the insertion portion is twisted will be described with reference to the flowchart shown in FIG.

  In a state in which the drive mechanism main body 66 is located at the origin position, the operator 2 twists the insertion portion 10. At that time, the determination unit 55 determines whether or not the deviation angle Δθ1 of the drive mechanism main body 66 exceeds the first set value α set in the setting unit 56 (Step 31). When the determination unit 55 determines that the deviation angle Δθ1 exceeds the first set value α (Step 31: Yes), the determination unit 55 determines that the drive mechanism main body 66 is rotated forward from the detection result of the rotation amount sensor. It is determined whether or not the drive mechanism main body 66 is rotating clockwise in FIG. 29 (Step 32).

  If the determination unit 55 determines that the drive mechanism main body 66 is rotating forward (Step 32: Yes), the determination unit 55 is inserted in the X-axis direction (as viewed from the operator 3 side) in FIG. It is determined that the portion 10 is twisted counterclockwise. In FIG. 29, the controller 51 drives the motor 73 to rotate the gear portion 74 counterclockwise. Accordingly, the controller 51 assists the counterclockwise (left) twisting operation of the insertion portion 10 (Step 33). If the discriminating unit 55 does not discriminate that the drive mechanism main body 66 is rotating forward (Step 32: No), the discriminating unit 55 is viewed in the X-axis direction in FIG. It is determined that the insertion portion 10 is twisted clockwise. In FIG. 29, the controller 51 drives the motor 73 so as to rotate the gear portion 74 clockwise. Thereby, the controller 51 assists the clockwise (right) twisting operation of the insertion portion 10 (Step 34).

  Next, the determination unit 55 determines whether or not the rotation amount (for example, the rotation speed θ) of the drive mechanism main body 66 is larger than a second set value δ preset in the setting unit 56 (Step 35).

  If the determination unit 55 determines that the rotation amount exceeds the second set value δ (Step 35: Yes), the insertion unit 10 is regarded as being twisted, and the process returns to Step 32 to assist the twisting operation with respect to the insertion unit 10. Is done. When the determination unit 55 determines that the rotation amount is lower than the second set value δ (Step 35: No), the determination unit 55 regards the surgeon 2 as stopping the twisting of the insertion unit 10. Therefore, the controller 51 stops the driving of the motor 73 (Step 36). As a result, the rotation of the drive mechanism main body 66 stops.

At that time, the insertion portion operating device main body 30 drives the motor 73 to generate a static torque Tθ2 corresponding to the angle θ2. As a result, the drive mechanism 63 stands still with the insertion portion 10 held via the roller pair 32. As a result, this position becomes a new origin position (Step 37).
In Step 31, when the determination unit 55 determines that the deviation angle Δθ1 does not exceed the first set value α (Step 31: No), the process proceeds to Step 36.

Thus, in this embodiment, since the drive mechanism 63 also serves as a holding mechanism that holds the insertion portion 10 via the roller pair 32, the insertion portion 10 is inserted, removed, and twisted by controlling the drive mechanism 63. Can do. Thereby, since this embodiment can reduce a structural member compared with 1st Embodiment, it can be made cheap.
Further, in the present embodiment, when the insertion unit 10 is inserted, removed, and twisted, the insertion operation, the removal operation, and the twisting operation can be assisted by driving the motor 60 and the motor 73.

  Further, the present invention is not limited to the above-described embodiments and modifications as they are, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Further, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment.

FIG. 1 is a schematic perspective view when the insertion unit operating device according to the first embodiment is used. FIG. 2 is a schematic side view of the insertion portion operating device shown in FIG. FIG. 3 is a schematic front view of the insertion unit operating device shown in FIG. 1. FIG. 4 is a schematic front view of the insertion unit operating device main body when the rotating unit shown in FIG. 3 is rotated. FIG. 5 is a schematic top view of the insertion unit operating device main body when the rotating unit shown in FIG. 3 is rotated. FIG. 6 is a schematic top view of the insertion portion operating device when the insertion portion is inserted into the insertion portion operating device main body shown in FIG. 3 (the rotation portion is not shown). FIG. 7 is a schematic perspective view of the holding mechanism. FIG. 8 is a schematic AA sectional view of the holding mechanism shown in FIG. FIG. 9 is a schematic perspective view of the force sensor. 10 is a schematic BB cross-sectional view of the insertion portion operating device shown in FIG. FIG. 11A is a schematic perspective view showing the inside of the insertion portion operating device main body (showing the positional relationship among the insertion portion, the roller pair, the rotation amount sensor, and the holding mechanism pair). FIG. 11B is a modification of the roller pair. FIG. 11C shows a modified example of the roller pair. 12 is a CC schematic cross-sectional view of the insertion portion operating device main body shown in FIG. FIG. 13 is a control diagram schematically showing the control mechanism of the present embodiment. FIG. 14A is a diagram illustrating an operation of the insertion unit operating device main body when the insertion unit is inserted into a patient. FIG. 14B is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 14C is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 14D is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 15 is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is removed from the patient. FIG. 16 is a flowchart showing the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into the patient. FIG. 17A is a diagram illustrating the operation of the insertion unit operating device body when twisting the insertion unit. FIG. 17B is a diagram illustrating the operation of the insertion unit operating device body when twisting the insertion unit. FIG. 17C is a diagram illustrating an operation of the insertion unit operating device body when twisting the insertion unit. FIG. 18 is a schematic side view showing the periphery of the force sensor in the holding mechanism. FIG. 19 is a schematic side view showing the periphery of the roller. FIG. 20 is a diagram showing a characteristic part of the second embodiment, and shows an internal positional relationship of the insertion unit operating device main body (the positional relationship between the insertion unit, the roller pair, the rotation amount sensor, the holding mechanism pair, and the motor). It is a schematic perspective view. FIG. 21 is a control diagram schematically showing the control mechanism of the present embodiment. FIG. 22A is a diagram illustrating an operation of the insertion unit operating device main body when the insertion unit is inserted into a patient. FIG. 22B is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 22C is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 23 is a flowchart showing the operation of the insertion unit operating device body when the insertion unit is inserted into or removed from the patient. FIG. 24 is a schematic perspective view when the insertion unit operating device according to the third embodiment is used. FIG. 25 is a schematic front view of the insertion portion operating device main body shown in FIG. 24 as viewed from the patient side. FIG. 26 is a schematic perspective view of the insertion portion operating device main body shown in FIG. 24 as viewed from the operator side. FIG. 27A is a diagram illustrating an operation of the insertion portion operation apparatus main body when the insertion portion is inserted into a patient. FIG. 27B is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 27C is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is inserted into a patient. FIG. 27D is a diagram illustrating an operation of the insertion portion operation apparatus main body when the insertion portion is inserted into the patient. FIG. 27E is a diagram illustrating an operation of the insertion-portion operation apparatus main body when the insertion portion is inserted into a patient. FIG. 28 is a flowchart showing the operation of the insertion portion operation apparatus main body when the insertion portion is inserted into or removed from the patient. FIG. 29A is a diagram illustrating an operation of the insertion unit operating device main body when the insertion unit is twisted. FIG. 29B is a diagram illustrating the operation of the insertion unit operating device body when twisting the insertion unit. FIG. 29C is a diagram illustrating an operation of the insertion unit operation device main body when the insertion unit is twisted. FIG. 30 is a flowchart showing the operation of the insertion unit operating device body when twisting the insertion unit.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Insertion part operation apparatus, 2 ... Surgeon, 3 ... Patient, 3a ... Head, 4 ... Bed, 5 ... Pillow, 10 ... Insertion part, 26 ... Projection part, 27 ... Convex recessed part, 28 ... Groove, 29 ... Groove, 30 ... insertion unit operation device body, 31 ... holding mechanism pair, 31a ... holding mechanism, 31b ... holding mechanism, 32 ... roller pair, 32a ... roller, 32b ... roller, 33 ... roller pair, 33a ... roller, 33b ... Roller 34 ... rotating part 34a ... fulcrum 35 ... contact point 36 ... grounding part 37 ... motor 38 ... friction biasing member 39 ... force sensor 40 ... screw part 41 ... rotation amount sensor 42 ... Rotation amount sensor 43... Spring 44. Support member 45. Waterproof member 46. Shaft portion 47. Support member 48. Head portion 50. Control unit 51 Control controller 52 Input / output board 53 ... first amplifier, 54 ... encoder, 55 ... size Part 56... Setting part 57 57 second amplifier 58. Third amplifier 60 motor 61 61 motor 62 support part 63 drive mechanism 64 twist mechanism 65 groove ... Drive mechanism main body part 67 ... Sliding part 68 ... Outer peripheral surface 69 ... Pin insertion part 70 ... Operating part 71 ... Pin 72 ... Opening part 73 ... Motor 74 ... Gear part 75 ... Receiving part .

Claims (13)

A detection unit that detects an operation amount applied to an insertion unit of an endoscope that is operated when the tube is advanced or retracted or twisted;
A control unit that controls the operation of the advancement / retraction of the insertion unit with respect to the lumen or the twisting according to the operation amount detected by the detection unit;
An insertion portion operating device characterized by comprising:   The insertion unit operation device according to claim 1, wherein the detection unit detects the operation amount directly applied to the insertion unit when the insertion unit is operated.   The detection unit includes an insertion force for inserting the insertion unit into the lumen, a removal force for removing the insertion unit from the lumen, a twisting force for twisting the insertion unit, and operating the insertion unit. The insertion portion operating device according to claim 2, wherein the operation amount is detected such as a speed at which the insertion portion is operated, an acceleration at which the insertion portion is operated, and an angle at which the insertion portion is operated.   The insertion unit operation device according to claim 1, wherein the detection unit detects the operation amount by indirectly contacting the insertion unit.   The insertion unit operating device according to claim 1, wherein the control unit controls a holding operation for holding the insertion unit and an auxiliary operation for assisting an advance / retreat operation or a twisting operation of the insertion unit. . A holding mechanism for holding the insertion portion;
6. The insertion unit operation device according to claim 5, wherein the control unit causes the holding mechanism to hold the insertion unit when the operation amount applied to the insertion unit is within a predetermined range. The drive unit further assists the advancement / retraction operation or twisting operation of the insertion unit,
6. The insertion unit operation device according to claim 5, wherein the control unit drives the drive unit when the operation amount applied to the insertion unit exceeds a predetermined range.   The insertion unit operation according to claim 7, wherein the driving unit is a rotation unit that assists the advance / retreat operation or the twisting operation of the insertion unit by rotating in direct contact with the insertion unit. apparatus.   The insertion unit operating device according to claim 7, wherein the driving unit also serves as the holding mechanism.   The insertion portion operating device according to claim 1, wherein the insertion portion operating device is arranged on an arrangement member for arranging an insertion target portion having the lumen.   The insertion unit operation device according to claim 1, wherein the control unit is configured separately from the detection unit, and is disposed vertically below the detection unit.   The insertion unit operation device according to claim 1, further comprising a contact unit that directly contacts the insertion unit and is detachable from the insertion unit operation device.   The contact portion is an urging portion that urges the insertion portion by directly contacting the insertion portion, or a rotation portion that rotates when directly contacting the insertion portion. The insertion unit operating device according to claim 12.

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