JP2011104275A - Medical instrument holder - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope-holder by which an operator of an endoscope can easily operate the endoscope, and surgery of a surgeon is protected from interruption due to manipulation of the operator, when the surgeon performs surgery near the endoscope. <P>SOLUTION: In an endoscope-holder 1, a grip portion 29a which is a holder is equipped with a remote controller 37 which is a separating member capable of separating from the grip portion 29a. In addition, the remote controller 37 is equipped with an advancing and receding switch 39 which allow an endoscope 2 to advance and recede. Since the remote controller 37 can be away from the grip portion 29a, the operator of the endoscope manipulates the advancing and receding switch 39 at a place distant from a surgeon 22, when the surgeon 22 performs surgery near an endoscope 2, i.e., near the grip portion 29a. Thereby the operator allows the endoscope 2 to advance and recede without interrupting surgery of the surgeon 22. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical instrument holding device that holds a medical instrument such as an endoscope.

  In general, in laparoscopic surgery using an endoscope, an endoscope for observing the inside of the abdominal cavity is held by a dedicated assistant (hereinafter referred to as an endoscope holder). When changing the observation position and angle of view of the surgical site, the endoscope holder manually changes the direction of the endoscope according to instructions from the operator or an assistant who performs treatment in cooperation with the operator. The operation of moving back and forth in the insertion direction is performed. For this reason, the endoscope holder has to keep holding the endoscope during the operation, and there is a problem that a great effort is required.

  In order to solve this problem, Patent Document 1 discloses an endoscope holding device that holds an endoscope inserted into a body cavity of a patient. If this endoscope holding device is used, it is not necessary to hold the endoscope by the endoscope holder, and the endoscope holder is responsible for the operation of the endoscope (hereinafter referred to as the endoscope holder). I will call it an endoscope operator.) The endoscope holding device of Patent Literature 1 includes a free lock switch that releases the fixation of the joint portion of the arm, and a joystick that moves the endoscope. Here, the free lock switch is disposed in the vicinity of a grip portion where the endoscope operator grips the endoscope holding device. The joystick is provided at the foot as a foot switch.

JP 2005-137770 A

  In the endoscope holding device of the above-mentioned patent document 1, since the free lock switch that is the operation target and the joystick are arranged at positions apart from each other, the endoscope operator needs to operate using both hands and feet. . For this reason, the operation of the endoscope becomes complicated.

  Therefore, for example, the joysticks are arranged in the vicinity of the free lock switch. Thus, the endoscope operator can operate both the free lock switch and the joystick. For this reason, the operation of the endoscope becomes easy.

  However, in this case, when the operator is performing surgery in the vicinity of the endoscope, the endoscope operator operates the endoscope in the vicinity of the operator. For this reason, the operation of the operator may be hindered by the operation of the endoscope operator.

  The present invention has been made paying attention to the above problems, and the object of the present invention is that the endoscope operator can easily operate the endoscope and the operator can operate the endoscope. It is an object of the present invention to provide an endoscope holding apparatus in which an operation of an operator is not hindered by an operation of an endoscope operator when an operation is performed in the vicinity.

  To achieve the above object, the present invention provides a holding part for holding a medical instrument, a gripping part that is disposed in the vicinity of the holding part and that is gripped by a medical instrument operator during a movement operation of the medical instrument, A first input means provided in the gripper; a separation member detachably attached to the attachment / detachment portion of the gripper; and a second input provided in the separation member; And a medical instrument holding device.

  In this medical instrument holding device, a separation member that can be separated from the grip portion is provided. The separation member is provided with second input means for moving, operating, etc. the medical instrument. Since the separating member can be separated from the grasping part, when the surgeon performs an operation near the medical instrument, that is, near the grasping part, the medical instrument operator operates the second input means at a place away from the operator. To do. As a result, the medical instrument can be moved and operated without hindering the surgeon's surgical operation.

  The medical instrument holding device further includes an arm portion that supports the holding portion so as to be movable in a three-dimensional space and has a plurality of joint portions, and the first input means fixes the plurality of joint portions. It is preferable that a joint fixing release means for releasing is provided. The arm portion includes a tip arm portion disposed on the holding portion side and a root arm portion disposed on the side opposite to the holding portion, and the joint portion fixing release means includes the tip portion. You may release fixation of the said joint part of an arm part.

  Preferably, the medical instrument holding device further includes a holding unit moving unit that moves the position of the holding unit, and the second input unit includes an input unit to the holding unit moving unit.

  In addition, the medical instrument is an endoscope, and the medical instrument holding device further includes an endoscope operation input unit actuating unit that operates an endoscope operation input unit that performs the operation of the endoscope. The second input means preferably includes an input means to the endoscope operation input unit actuating means. Here, the endoscope may be an endoscope with a bending portion including a bending portion, and the endoscope operation input portion may include a bending lever that performs a bending operation of the bending portion. The endoscope operation input unit may include an image enhancement button that performs a process of enhancing an image captured by the endoscope.

  In addition, the medical instrument is an endoscope, and the medical instrument holding device further operates an accessory operation input unit that operates an accessory operation input unit that operates an accessory attached to the endoscope. It is preferable that the second input unit includes an input unit to the accessory operation input unit actuating unit. Here, the accessory may be a cleaning sheath for cleaning the distal end portion of the endoscope, and the accessory operation input unit may include a water supply button provided on the cleaning sheath.

  According to the present invention, the endoscope operator can easily operate the endoscope, and when the operator performs an operation near the endoscope, the endoscope operator can operate the endoscope. It is possible to provide an endoscope holding apparatus in which an operator's surgical operation is not hindered.

1 is a schematic diagram showing an endoscope holding apparatus according to a first embodiment of the present invention. Arrow view seen from the direction of arrow A ₁ in FIG. 1. The front view which shows the arrangement | positioning state of the apparatus visually observed from the surgeon during operation using the endoscope holding | maintenance apparatus which concerns on 1st Embodiment. The front view which shows the front-end | tip arm part of the endoscope holding | maintenance apparatus which concerns on 1st Embodiment. The front view which shows the movement state of the endoscope performed by the front-end | tip arm part of the endoscope holding | maintenance apparatus which concerns on 1st Embodiment. Arrow view seen from the direction of arrow A ₂ in Fig. 4A. The top view which shows the structure of the vicinity of the endoscope holding means of the endoscope holding apparatus which concerns on 1st Embodiment. The top view which shows the state which left | separated the remote control from the grip part of the vicinity of the endoscope holding means of the endoscope holding apparatus which concerns on 1st Embodiment. Arrow view seen from the direction of arrow A ₃ in FIG. 6A. Schematic which shows the state which separated the remote control from the grip part of the endoscope holding | maintenance apparatus which concerns on 1st Embodiment. The top view which shows the structure of the vicinity of the endoscope holding means of the endoscope holding apparatus which concerns on the 2nd Embodiment of this invention. The top view which shows the state which the bending part curved in the L direction of the vicinity of the endoscope holding means of the endoscope holding apparatus which concerns on 2nd Embodiment. Arrow view seen from the direction of arrow A ₄ in FIG. 9A. The block diagram which shows the image processing system of the endoscope holding | maintenance apparatus which concerns on 2nd Embodiment. (A) is a schematic diagram showing an image in a state where an operation using a bending switch is performed, and (B) is an operation performed using a bending switch, which is displayed on the monitor of the endoscope holding device according to the second embodiment. Schematic which shows the image in a state without. Sectional drawing which shows the state by which the water supply button of the washing | cleaning sheath which is an attachment with which the endoscope which concerns on the 3rd Embodiment of this invention is attached is not pushed. Sectional drawing which shows the state by which the water supply button of the washing | cleaning sheath which is an accessory with which the endoscope which concerns on 3rd Embodiment was mounted | worn was pushed. The top view which shows the structure of the vicinity of the endoscope holding means of the endoscope holding apparatus which concerns on 3rd Embodiment. Arrow view seen from the direction of arrow A ₅ in FIG. The front view which shows the state by which the water supply button was pushed near the endoscope holding means of the endoscope holding apparatus which concerns on 3rd Embodiment. The front view which shows the structure of the vicinity of the endoscope holding means of the endoscope holding apparatus which concerns on the 4th Embodiment of this invention. The front view which shows the state by which the image emphasis button was pushed near the endoscope holding means of the endoscope holding apparatus which concerns on 4th Embodiment.

(First embodiment)
A first embodiment of the present invention will be described with reference to FIGS. Figure 1 is a diagram showing an endoscope holding device 1 which is a medical instrument holding apparatus of the present embodiment, FIG. 2 is a diagram viewed from the direction of arrow A ₁ in FIG. 1. As shown in FIG. 1, the endoscope holding device 1 holds a rigid endoscope 2 that is a medical instrument. The endoscope 2 includes an insertion portion 2 a that is inserted into the body cavity of the patient 3. The endoscope 2 incorporates an image sensor such as a CCD (not shown). The body cavity image captured by the image sensor is displayed on a display means such as the monitor 7.

  The endoscope holding apparatus 1 includes a distal arm part 4, a root arm part 5, and a gantry part 6. The distal arm portion 4 has a plurality of joint portions and supports the endoscope 2 so as to be movable in a three-dimensional space. The root arm portion 5 has a plurality of joint portions, and supports the tip arm portion 4 so as to be movable in a three-dimensional space. The gantry 6 is movable with respect to the floor surface and supports the root arm 5. The gantry 6 is provided with a monitor arm 8 that supports the monitor 7.

  As shown in FIG. 2, the gantry 6 includes a plurality of casters 9 for movement. The gantry 6 is provided with a storage 12. The storage unit 12 stores a CCU (camera control unit) 10 for projecting an imaging signal from the endoscope 2 on the monitor 7, a light source device 11 for supplying illumination light to the endoscope 2, and the like.

As shown in FIG. 1, the root arm portion 5 includes a vertical arm 13 erected on the gantry portion 6. The vertical arm 13 supports one end of the horizontal arm 14 so as to be rotatable around the vertical axis O ₁ . The other end of the horizontal arm 14, rotatably supports the vertical arm 15 in the vertical axis O ₂ around. The vertical arm 15 is provided with two horizontal shafts O ₃ and O ₄ arranged vertically. The vertical arm 15 supports one end of the lower arm 16 and the upper arm 17 so as to be rotatable about horizontal axes O ₃ and O ₄ , respectively. The other ends of the lower arm 16 and the upper arm 17 are connected to two horizontal shafts O ₅ and O ₆ disposed on the top and bottom provided on the vertical arm 18, respectively. With such a configuration, a known parallelogram link is configured by the arms 15 to 18 and the horizontal axes O _{3 to} O ₆ . Here, an elastic member 19 such as a spring is attached to the vertical arm 15 and the lower arm 16. By the elastic member 19, the rotation moment caused by the weight of the tip side including the parallelogram link generated about a horizontal axis O _3, are offset.

As shown in FIGS. 1 and 2, a vertical arm 18 rotatably supports the upper end of the vertical arm 20 around the vertical axis O _7. Further, one end of the straight arm 21 is fixed to the lower end of the vertical arm 20. The other end of the linear arm 21 is connected to the tip arm portion 4. Here, the position of the straight arm 21 in the vertical direction is configured such that the vertical arm 20 side is high and the tip arm portion 4 side is low. FIG. 3 is a diagram illustrating an arrangement state of the device viewed from the operator 22 during the operation. As shown in FIG. 3, when the operator 22 observes the monitor 7 by changing the position of the straight arm 21 in the vertical direction between the vertical arm 20 side and the distal arm part 4 side, the monitor 7 The straight arm 21 is difficult to block. Further, the right hand 23 of the operator 22 is difficult to hit the linear arm 21.

As shown in FIGS. 1 and 2, the vertical arm 20 is provided with a free lock switch 38 b which is a joint portion fixing release means for releasing the fixation of the joint portion of the root arm portion 5. An electromagnetic brake (not shown) provided on the shafts O _{1 to} O ₇ is operated by the free lock switch 38b to _one of a free state that is a non-braking state and a locked state that is a braking state. Note that the fixation of the joint portion of the root arm portion 5 is not necessarily performed by the free lock switch 38b, and may be performed, for example, by weighting by predetermined friction.

4A to 5 are views showing the configuration of the distal arm portion 4. As shown in FIG. As shown in FIGS. 4A and 5, the straight arm 21 of the root arm portion 5 supports the bending arm 24 of the tip arm portion 4 so as to be rotatable around the vertical axis O ₈ . The bending arm 24 is provided with two horizontal axes O ₉ and O ₁₀ arranged vertically. The bending arm 24 supports one ends of the rotating arm 25 and the rotating arm 26 so as to be rotatable around the horizontal axes O ₉ and O ₁₀ , respectively. Midway portions between both end portions of the rotary arms 25 and 26 are connected to two upper and lower horizontal axes O ₁₁ and O ₁₂ provided on the vertical arm 27, respectively. The horizontal axis O ₁₁ is provided at the upper end of the vertical arm 27, and the horizontal axis O ₁₂ is provided in the middle between both ends of the vertical arm 27. The other ends of the rotary arms 25 and 26 are connected to two upper and lower horizontal axes O ₁₃ and O ₁₄ provided on the vertical arm 28, respectively. The horizontal axis O ₁₃ is provided at the upper end of the vertical arm 28, and the horizontal axis O ₁₄ is provided in the middle between both ends of the vertical arm 28. The other ends of the vertical arms 27 and 28 are connected to horizontal axes O ₁₅ and O ₁₆ provided in the endoscope holding means 29. With such a configuration, the arms 24 to 28, the endoscope holding section 29 and the horizontal axis _O 9 _{~ O 16,} constitute a known parallelogram linkage. Here, the rotary arm 25 is provided with a weight 30. The weight 30, the moment the tip including a parallelogram link that occurs about a horizontal axis O ₉ side is canceled.

Further, an electromagnetic brake (not shown) is provided on at least one of the horizontal axes O _{9 to} O ₁₆ and the vertical axis O ₈ . These brakes are unlocked by a free lock switch 38a (see FIG. 6A) described later. Here, since the moment on the tip side around the horizontal axis O ₉ is canceled by the weight 30, the tip arm portion 4 is balanced even when the brakes of the vertical axis O ₈ and the horizontal axes O _{9 to} O ₁₆ are released. It is in a stable state.

As shown in FIG. 4A, the endoscope 2 is held by an endoscope holding means 29. The endoscope 2 is arranged in a state where the vertical axis O ₈ and the axis of the insertion portion 2 a of the endoscope 2 intersect at an intersection 31. As shown in FIG. 4B, even when the brake is released, the distal arm 4 moves in a turning motion (arrow C in FIG. 4B) and an inclination motion (in FIG. 4B) around the intersection 31 of the endoscope 2. It is constrained to a state where only arrow D) can be performed (point lock).

  6A to 7 are views showing a configuration in the vicinity of the endoscope holding means 29. FIG. As shown in FIGS. 6A and 7, the endoscope holding means 29 is provided with a holding unit 32 that is a holding unit for holding the endoscope 2. The hold part 32 is supported so as to be movable in the axial direction of the insertion part 2 a of the endoscope 2 with respect to the endoscope holding means 29. The endoscope holding means 29 is formed with a groove-shaped guide portion 33 that guides the hold portion 32. Inside the hold unit 32, a motor 34 is provided in a state attached to the hold unit 32. A pinion gear 35 is fixed to the rotation shaft of the motor 34. A rack 36 is provided inside the endoscope holding means 29. The pinion gear 35 meshes with the rack 36.

As shown in FIGS. 6A and 7, the endoscope holding means 29 includes a grip portion 29 a that is a grip portion that is gripped when the endoscope 2 is moved. The grip portion 29 a is disposed in the vicinity of the hold portion 32, that is, in the vicinity of the endoscope 2. The grip portion 29a is provided with a remote controller 37 that is a separating member that can be separated from the grip portion 29a. As shown in FIG. 6B, the remote controller 37 is detachably attached to the attachment / detachment portion 29b of the grip portion 29a. The grip portion 29a is provided with a free lock switch 38a which is a joint portion fixing release means for releasing the fixation of the tip arm portion 4 as a first input means. The free lock switch 38a, the brake provided in the axial _O 8 _{~ O 16} (not shown) is operated.

  The remote controller 37 is provided with an advancing / retreating switch 39 for moving the holding unit 32 in the axial direction of the endoscope 2 as a second input means. By the advance / retreat switch 39, the motor 34 built in the hold unit 32 is rotationally driven, and the pinion gear 35 fixed to the motor 34 rotates. Due to the rotation of the pinion gear 35, the pinion gear 35 moves in the axial direction of the endoscope 2 with respect to the rack 36. As a result, the motor 34 connected to the pinion gear 35 moves together with the pinion gear 35, and the hold unit 32 to which the motor 34 is attached moves forward and backward. When the “F” side of the advance / retreat switch 39 is pressed, the hold unit 32 moves in the F (forward) direction. On the other hand, when the “B” side of the advance / retreat switch 39 is pressed, the hold unit 32 moves in the B (retreat) direction. Due to the movement of the holding unit 32, the endoscope 2 held by the holding unit 32 moves forward and backward in the axial direction. As described above, the motor 34, the pinion gear 35, and the rack 36 constitute a holding unit moving unit that moves the holding unit 32.

  Further, as shown in FIG. 6B, the remote controller 37 is connected to the grip portion 29a via the cable 40. With this configuration, as shown in FIG. 8, the remote controller 37 can be removed from the grip portion 29a and operated. Thereby, even when the operator 22 performs an operation in the vicinity of the endoscope 2, that is, in the vicinity of the grip portion 29 a, the endoscope operator moves in the axial direction of the endoscope 2 at a position away from the operator 22. It is possible to move forward and backward.

Next, the operation of the endoscope holding device 1 according to this embodiment will be described. When performing an operation using the endoscope holding apparatus 1, first, the endoscope 2 is fixed to the holding unit 32 as shown in FIG. 6A. Then, the “B” side of the advance / retreat switch 39 of the remote control 37 attached to the grip portion 29a is pressed. The motor 34 is rotationally driven by the advance / retreat switch 39, and the pinion gear 35 fixed to the motor 34 rotates. Due to the rotation of the pinion gear 35, the pinion gear 35 moves in the axial direction of the endoscope 2 with respect to the rack 36. Thereby, the motor 34 moves with the pinion gear 35, and the holding | maintenance part 32 moves to a B direction. At this time, the distal end portion of the insertion portion 2a of the endoscope 2, to place the endoscope 2 at a position slightly back from below the vertical axis O ₈ shown in FIG. 4A. Then, by horizontally moving the base arm portion 5 shown in FIG. 1, the vertical axis O ₈ is inserted into the hole for inserting the endoscope 2 into the patient 3 (not shown, formed by a trocar previously punctured on the body wall of the patient). Place directly above the trocar hole. Thereafter, the root arm portion 5 is vertically moved so that the distal end portion of the insertion portion 2a of the endoscope 2 is adjusted to the height of the entrance of the trocar hole.

When inserting the insertion portion 2a of the endoscope 2 into the body cavity of the patient 3, the endoscope operator presses the free lock switch 38a while holding the grip portion 29a shown in FIG. 6A. While pushing the free lock switch 38a is fixed around the axis _O 8 _{~ O 16} shown in FIG. 4A is released. For this reason, by operating only the distal arm 4, the endoscope 2 can only perform a turning motion and a tilting motion around the intersection 31. At this time, since the root arm portion 5 is kept in a state in which the joint portion is not released, the surgeon 22 can observe the screen of the monitor 7 without being blocked by the root arm portion 5. (See FIG. 3).

  Then, after the insertion portion 2a of the endoscope 2 is brought into a posture along the direction of the trocar hole, the “F” side of the advance / retreat switch 39 shown in FIG. 6A is pushed. The pinion gear 35 fixed to the motor 34 is rotated by the advance / retreat switch 39. Due to the rotation of the pinion gear 35, the pinion gear 35 moves in the axial direction of the endoscope 2 with respect to the rack 36. As a result, the motor 34 moves together with the pinion gear 35. By the movement of the motor 34, the hold part 32 moves in the F direction, and the insertion part 2a of the endoscope 2 is inserted into the trocar hole. And it confirms that the insertion direction of an endoscope is correct, and stops pushing the free lock switch 38a. As a result, the joint portion of the distal arm 4 is fixed, and the insertion direction of the endoscope 2 is fixed. Then, the endoscope 2 is moved only by the operation of the advance / retreat switch 39, and the insertion portion 2a is inserted into the body cavity. When the endoscope 2 reaches a desired observation distance, the operation of the advance / retreat switch 39 is stopped to complete the insertion of the insertion portion 2a of the endoscope 2.

When changing the observation direction of the endoscope 2 in the body cavity, the free lock switch 38a is pushed with the grip portion 29a held. At this time, since the moment on the tip side around the horizontal axis O ₉ is canceled by the weight 30, the tip arm portion 4 is balanced even when the brakes of the vertical axis O ₈ and the horizontal axes O _{9 to} O ₁₆ are released. It is in a stable state. Further, as shown in FIG. 4B, even when the brake is released, the distal arm 4 is constrained to a state in which only the turning motion and the tilting motion about the intersection 31 of the endoscope 2 can be performed. (Point lock). Here, the intersection point 31 is an intersection point between the vertical axis O ₈ and the axis of the insertion portion 2 a of the endoscope 2, and is arranged in the vicinity of the trocar hole on the body surface of the patient 3 when the endoscope 2 is inserted. Since the intersection point 31 which is the center of the turning motion and the tilting motion is located in the vicinity of the trocar hole, the load on the body wall of the patient 3 is reduced by the operation of changing the visual field. For this reason, it is difficult to give a burden to the patient.

  As shown in FIG. 1, when the operator 22 performs an operation in the vicinity of the endoscope 2, that is, in the vicinity of the grip portion 29a, the endoscope operator extends the hand to the grip portion 29a to perform the operation. Thus, the surgical operation of the operator 22 is hindered. Therefore, as shown in FIG. 8, in the endoscope holding device 1, the remote controller 37 is removed from the grip portion 29 a, and the endoscope operator operates the advance / retreat switch 39 shown in FIG. 6A at a place away from the operator 22. Thus, the endoscope 2 can be moved back and forth without hindering the surgical operation of the operator 22.

  Therefore, the endoscope holding device 1 configured as described above has the following effects. That is, in the endoscope holding device 1, a remote controller 37 that is a separation member that can be separated from the grip portion 29a is provided in the grip portion 29a that is a grip portion. The remote controller 37 is provided with an advance / retreat switch 39 for moving the endoscope 2 forward and backward. Since the remote controller 37 can be separated from the grip portion 29a, when the operator 22 performs an operation in the vicinity of the endoscope 2, that is, in the vicinity of the grip portion 29a, the endoscope operator is located away from the operator 22. The advance / retreat switch 39 is operated. Thereby, the endoscope 2 can be moved back and forth without hindering the surgical operation of the operator 22.

(Second Embodiment)
Next, a second embodiment of the present invention will be described with reference to FIGS. 9A to 11A and 11B. In the present embodiment, the configuration is changed from the first embodiment as follows. In addition, the same code | symbol is attached | subjected about the part which has the same function as 1st Embodiment, and the same function, and the description is abbreviate | omitted.

  9A to 10A are diagrams showing a configuration in the vicinity of the endoscope holding means 29 of the endoscope holding apparatus 1 according to the present embodiment. In the present embodiment, the endoscope 51 with a bending portion in which a bending portion 51b is disposed at the distal end of the insertion portion of the rigid endoscope is used. As shown in FIGS. 9A and 10A, the endoscope holding means 29 holds an endoscope 51 with a bending portion. The endoscope 51 with a bending portion includes a rigid insertion portion 51a, a bending portion 51b disposed on the distal end side of the rigid insertion portion 51a, and an operation portion 51c disposed on the proximal end side of the rigid insertion portion 51a. Prepare. The bending portion 51b is softer than the rigid insertion portion 51a and is bent. As shown in FIG. 10A, the endoscope 51 with a bending portion is provided with a UD (up / down) bending lever 52 and an RL (right / left) bending lever 53 which are endoscope operation input portions. The UD curve lever 52 and the RL curve lever 53 are arranged approximately 180 ° apart from each other in the direction around the axis of the endoscope 51 with a bending portion. By inclining the UD bending lever 52, the bending portion 51b performs a bending operation in the UD direction. Similarly, by inclining the RL bending lever 53, the bending portion 51b performs a bending operation in the RL direction.

  As shown in FIG. 9A, a UD adapter 54 is attached to the UD bending lever 52. The UD adapter 54 is supported so as to be movable in the directions of arrows U and D in FIG. 9A. An RL adapter 55 is attached to the RL bending lever 53. The RL adapter 55 is supported so as to be movable in the directions of arrows L and R in FIG. 9A. As shown in FIG. 10A, a bending unit 56 for moving the UD adapter 54 and the RL adapter 55 is fixed to the holding unit 32 that holds the endoscope 51 with a bending unit. As shown in FIG. 9A, a UD motor 57 and an RL motor 58 are provided inside the bending unit 56. Pinion gears 59 and 60 are provided on the rotation shafts of the UD motor 57 and the RL motor 58, respectively. The UD motor 57 and the RL motor 58 include encoders 91 and 92 (see FIG. 10B), respectively. The encoders 91 and 92 can detect the rotation angle of the UD motor 57 and the RL motor 58. A rack 61 is formed on the UD adapter 54, and a rack 62 is formed on the RL adapter 55. The racks 61 and 62 mesh with the pinion gears 59 and 60, respectively.

  As shown in FIGS. 9A and 10A, the grip portion 29a is provided with a remote control 63 that is a separating member that can be separated from the grip portion 29a. The remote controller 63 is detachably attached to the attachment / detachment portion 29b of the grip portion 29a, similarly to the remote control 37 of the first embodiment. The remote controller 63 is provided with a bending switch 64 as a second input means for bending the bending portion 51b of the bending portion-equipped endoscope 51 in the UD direction and the RL direction. The UD motor 57 and the RL motor 58 inside the bending unit 56 are rotationally driven by the bending switch 64. As the UD motor 57 rotates, the pinion gear 59 fixed to the UD motor rotates. The rack 61 moves relative to the pinion gear 59 by the rotation of the pinion gear 59. As a result, the UD adapter 54 moves together with the pinion gear 59. When the bending switch 64 is pushed to the “U” side, the UD adapter 54 moves in the direction of arrow U in FIG. 9A. When the bending switch 64 is pushed to the “D” side, the UD adapter 54 moves in the direction of arrow D in FIG. 9A. Thereby, the UD bending lever 52 of the endoscope 51 with a bending portion is operated, and the bending portion 51b is bent in the UD direction. As described above, the UD motor 57, the pinion gear 59, and the rack 61 constitute the endoscope operation input unit operating means that operates the UD bending lever 52.

  The RL direction is the same as the UD direction, and the pinion gear 60 fixed to the RL motor 58 is rotated by the rotational drive of the RL motor 58 inside the bending unit 56. As the pinion gear 60 rotates, the rack 62 moves relative to the pinion gear 60. As a result, the RL adapter 55 moves with the rack 62. When the bending switch 64 is pushed to the “R” side, the RL adapter 55 moves in the direction of arrow R in FIG. 9A. When the bending switch 64 is pushed to the “L” side, the RL adapter 55 moves in the direction of arrow L in FIG. 9A. Thereby, the RL bending lever 53 of the endoscope 51 with a bending portion is operated, and the bending portion 51b is bent in the RL direction. For example, as shown in FIG. 9B, when the RL bending lever 53 is operated in the L direction, the bending portion 51b is bent in the L direction. As described above, the RL motor 58, the pinion gear 60, and the rack 62 constitute the endoscope operation input unit operating means that operates the RL bending lever 53.

  FIG. 10B is a diagram showing an image processing system of the endoscope holding apparatus 1, and FIGS. 11A and 11B are diagrams showing images displayed on the monitor 7. As shown in FIG. 10B, the UD motor 57 and the RL motor 58 include encoders 91 and 92 that detect the rotation angles of the motors 57 and 58, respectively. The encoders 91 and 92 are connected to the state image generating unit 93. The state image generation means 93 calculates the bending angle of the bending portion 51b based on information from the encoders 91 and 92. Then, a bending angle image 65 as shown in FIG. The state image generating unit 93 is connected to the image switching unit 94. The image switching means 94 is connected to the bending switch 64 and the mixer 95. The image switching means 94 controls the output of the bending angle image 65 to the mixer 95 according to the operation state of the bending switch 64. That is, when an operation is performed using the bending switch 64, the bending angle image 65 is output to the mixer 95. On the other hand, when the operation is not performed by the bending switch 64, the bending angle image 65 is not output to the mixer 95. The mixer 95 is connected to a CCU (camera control unit) 10 and a monitor 7. The mixer 95 combines the endoscopic image from the CCU 10 and the bending angle image 65 from the image switching unit 94 and displays the synthesized image on the monitor 7. With such a configuration, when an operation is performed using the bending switch 64, the bending angle image 65 is superimposed on the endoscopic image of the monitor 7 as shown in FIG. When a predetermined time elapses after the operation with the bending switch 64 is completed, the bending angle image 65 is not displayed on the monitor 7 as shown in FIG.

  Next, the operation of the endoscope holding device 1 according to this embodiment will be described. When performing an operation using the endoscope holding apparatus 1, first, as in the first embodiment, the grip portion 29a shown in FIGS. 9A and 10A is held, and the endoscope 51 with a bending portion is attached to the patient 3. Insert into the body cavity. Then, a bending operation for bending the bending portion 51b of the endoscope with bending portion 51 in the UD direction and the RL direction is performed. For example, when the bending portion 51b is bent in the L direction, the bending switch 64 shown in FIGS. 9A and 10A is pushed to the L side, and the RL motor 58 is rotationally driven. By the rotational drive of the RL motor 58, the pinion gear 60 fixed to the RL motor 58 rotates. As the pinion gear 60 rotates, the rack 62 moves relative to the pinion gear 60, and the RL adapter 55 moves in the L direction. Thereby, the RL bending lever 53 of the endoscope 51 with a bending portion is operated in the L direction, and the bending portion 51b is bent in the L direction as shown in FIG. 9B. Note that the bending operation in the UD direction is the same as that in the RL direction, and thus the description thereof is omitted.

  When the surgeon 22 performs an operation near the endoscope 51 with a curved portion, that is, near the grip portion 29a, the remote controller 63 is removed from the grip portion 29a and the endoscope operation is performed as in the first embodiment. The person operates the bending switch 64 shown in FIG. 9A at a place away from the operator 22. Thus, the bending operation of the endoscope 51 with a bending portion can be performed without hindering the surgical operation of the operator 22.

  Therefore, the endoscope holding device 1 configured as described above has the following effects. That is, in the endoscope holding device 1, the grip part 29a that is a grip part is provided with a remote controller 63 that is a separation member that can be separated from the grip part 29a. The remote control 63 is provided with a bending switch 64 that performs the bending operation of the bending portion 51b of the endoscope 51 with a bending portion. Since the remote controller 63 can be separated from the grip portion 29a, when the operator 22 performs an operation in the vicinity of the endoscope 51 with a bending portion, that is, in the vicinity of the grip portion 29a, the endoscope operator is separated from the operator 22. The bending switch 64 is operated at a different place. Thus, the bending operation of the bending portion 51b can be performed without hindering the surgical operation of the surgeon 22.

  In the present embodiment, the bending operation of the bending portion 51b can also be performed by the remote controller 63, so that more operations can be performed away from the operator 22.

(Third embodiment)
Next, a third embodiment of the present invention will be described with reference to FIGS. 12A to 14B. In the present embodiment, the configuration is changed from the first embodiment as follows. In addition, the same code | symbol is attached | subjected about the part which has the same function as 1st Embodiment, and the same function, and the description is abbreviate | omitted.

  12A and 12B are diagrams illustrating a configuration of a cleaning sheath 71 that is an accessory attached to the endoscope 2. The cleaning sheath 71 removes dirt from the distal end of the insertion portion 2a of the endoscope 2. As shown in FIG. 12A, the outer peripheral surface of the insertion portion 2 a of the endoscope 2 is covered with the cleaning sheath insertion portion 71 a of the cleaning sheath 71. A cleaning sheath proximal end portion 71b is disposed on the proximal end side of the cleaning sheath insertion portion 71a. Inside the cleaning sheath insertion portion 71a, a water supply conduit 72 having a distal end opened at the distal end of the insertion portion 2a of the endoscope 2 through an opening 72a is provided. The proximal end portion of the water supply conduit 72 extends to the cleaning sheath proximal end portion 71b. The cleaning sheath proximal end portion 71b is provided with a water supply button 73 that is an accessory operation input unit. The water supply button 73 is formed with a water supply conduit 73a, a flange portion 73b, and a retaining portion 73c. A water supply conduit 74 is provided in the proximal end portion of the water supply button 73 of the cleaning sheath proximal end portion 71b. One end of a water supply tube 75 is connected to the water supply line 74. The other end of the water supply tube 75 is connected to a water supply source (not shown).

  As shown in FIG. 12A, when the water supply button 73 is not pressed, the water supply button 73 is urged in the direction of arrow E by the compression spring 76. Thereby, between the water supply pipeline 72 and the water supply pipeline 74 is interrupted | blocked, and the water supply pipeline 72 and the water supply pipeline 74 will be in the state which is not connected. On the other hand, as shown in FIG. 12B, in a state where the water supply button 73 is pressed, the water supply line 72 and the water supply line 74 communicate with each other via the water supply line 73 a of the water supply button 73. For this reason, the water from the water supply source is supplied to the distal end of the insertion portion 2a of the endoscope 2 through the water supply tube 75, the water supply conduit 74, the water supply conduit 73a, and the water supply conduit 72.

  FIG. 13 to FIG. 14B are diagrams showing a configuration in the vicinity of the endoscope holding means 29 of the endoscope holding apparatus 1. As shown in FIGS. 13 and 14A, a cleaning operation unit 77 is fixed to the holding unit 32 that holds the endoscope 2. Inside the cleaning operation unit 77, a solenoid 78 which is an accessory operation input unit operating means for operating the water supply button 73 is provided. The solenoid 78 is disposed above the water supply button 73.

  As shown in FIGS. 13 and 14A, the grip portion 29a is provided with a remote control 79 that is a separating member that can be separated from the grip portion 29a. The remote controller 79 is detachably attached to the attachment / detachment portion 29b of the grip portion 29a, similarly to the remote control 37 of the first embodiment. The remote control 79 is provided with a water supply switch 80 for driving the solenoid 78 as the second input means. As shown in FIG. 14B, when the water supply switch 80 is being pressed, the pressing portion 78a of the solenoid 78 protrudes downward. At this time, the pressing portion 78a of the solenoid 78 pushes the flange portion 73b of the water supply button 73 of the cleaning sheath 71, and operates the water supply button 73 downward. As a result, the water supply pipe 72 and the water supply pipe 74 communicate with each other via the water supply pipe 73a of the water supply button 73, and water can be supplied. On the other hand, as shown in FIG. 14A, when the water supply button 73 is not pressed, the pressing portion 78a of the solenoid 78 is retracted to a position where the flange portion 73b is not pressed.

  Next, the operation of the endoscope holding device 1 according to this embodiment will be described. When performing an operation using the endoscope holding apparatus 1, first, as in the first embodiment, the grip portion 29a shown in FIGS. 13 and 14A is held, and the endoscope 51 with a bending portion is attached to the patient 3. Insert into the body cavity. And dirt adheres to the tip of insertion part 2a of endoscope 2, and when performing cleaning, water supply switch 80 shown in Drawing 13 and Drawing 14A is pushed. By the operation with the water supply switch 80, as shown in FIG. 14B, the pressing portion 78a of the solenoid 78 of the cleaning operation unit 77 protrudes downward. Thereby, the flange part 73b of the water supply button 73 of the cleaning sheath 71 is pushed downward.

  As shown in FIG. 12A, the cleaning sheath 71 has a water supply conduit 72 whose end is opened at the distal end of the insertion portion 2 a of the endoscope 2 by the opening 72 a, and a water supply conduit 73 a formed on the water supply button 73. A water supply pipe 74 is provided. The water supply pipe 74 is connected to a water supply tube 75 connected to a water supply source (not shown). In a state where the water supply button 73 is not pressed, the water supply button 73 is urged by the compression spring 76 in the direction of arrow E in FIG. For this reason, the water supply pipe 72 and the water supply pipe 74 are not in communication with each other, and water supply from the water supply source is not performed. On the other hand, as shown in FIG. 12B, when the flange 73b of the water supply button 73 is pressed, the water supply pipe 72 and the water supply pipe 74 are communicated with each other via the water supply pipe 73a. Water can be supplied to the distal end of the insertion portion 2a of the endoscope 2, and dirt is removed. When the dirt removal at the distal end of the insertion portion 2a of the endoscope 2 is completed, the water supply button 73 is released from the pressed state, so that the space between the water supply pipeline 72 and the water supply pipeline 74 is as shown in FIG. 12A. It will be in the state which does not communicate. Thereby, the water supply to the front-end | tip of the insertion part 2a of the endoscope 2 stops.

  When the surgeon 22 performs an operation near the endoscope 2, that is, near the grip portion 29a, the remote controller 79 is removed from the grip portion 29a as in the first embodiment, and the endoscope operator operates the surgery. The water supply switch 80 shown in FIG. 13 is operated at a place away from the person 22. Thus, water can be supplied to the distal end of the insertion portion 2a without hindering the surgical operation of the operator 22.

  Therefore, the endoscope holding device 1 configured as described above has the following effects. In other words, in the endoscope holding device 1, the grip portion 29a that is a grip portion is provided with a remote controller 79 that is a separation member that can be separated from the grip portion 29a. The remote controller 79 is provided with a water supply switch 80 for supplying water to the distal end of the insertion portion 2a of the endoscope 2. Since the remote controller 79 can be separated from the grip portion 29a, when the operator 22 performs an operation in the vicinity of the endoscope 2, that is, in the vicinity of the grip portion 29a, the endoscope operator is located away from the operator 22. The water supply switch 80 is operated. Thus, water can be supplied to the distal end of the insertion portion 2a without hindering the surgical operation of the operator 22.

  In the present embodiment, the operation of the cleaning sheath 71 that is an accessory attached to the endoscope 2 can also be performed by the remote control 79, so that more operations are performed at a location away from the operator 22. be able to.

(Fourth embodiment)
Next, a fourth embodiment of the present invention will be described with reference to FIGS. 15A and 15B. In the present embodiment, the configuration is changed from the first embodiment as follows. In addition, the same code | symbol is attached | subjected about the part which has the same function as 1st Embodiment, and the same function, and the description is abbreviate | omitted.

  FIG. 15A and FIG. 15B are diagrams showing a configuration in the vicinity of the endoscope holding means 29 of the endoscope holding apparatus 1. As illustrated in FIG. 15A, the endoscope 2 is provided with an image enhancement button 101 that is an endoscope operation input unit. When the image enhancement button 101 is activated, a process for enhancing the image displayed on the monitor 7 is performed. An image enhancement operation unit 102 is fixed to the hold unit 32 that holds the endoscope 2. Inside the image enhancement operation unit 102, a solenoid 103, which is an endoscope operation input unit actuating means for actuating the image enhancement button 101, is provided. The solenoid 103 is disposed above the image enhancement button 101.

  As shown in FIG. 15A, the grip portion 29a is provided with a remote controller 104 that is a separating member that can be separated from the grip portion 29a. The remote controller 104 is detachably attached to the attachment / detachment portion 29b of the grip portion 29a, similarly to the remote control 37 of the first embodiment. The remote control 104 is provided with an image enhancement switch 105 that drives the solenoid 103 as a second input means. As shown in FIG. 15B, when the image enhancement switch 105 is being pressed, the pressing portion 103a of the solenoid 103 protrudes downward. At this time, the pressing portion 103a of the solenoid 103 presses the flange portion 101b of the image enhancement button 101 of the endoscope 2 to actuate the image enhancement button 101 downward. Thereby, the process which emphasizes an image is performed. On the other hand, as shown in FIG. 15A, when the image emphasis button 101 is not pressed, it is attached in the direction of arrow G in FIG. 15A by a compression spring (not shown) like the water supply button 73 of the third embodiment. It is energized. For this reason, the pressing portion 103a of the solenoid 103 is retracted to a position where the flange portion 101b is not pressed.

  Next, the operation of the endoscope holding device 1 according to this embodiment will be described. When performing an operation using the endoscope holding apparatus 1, first, as in the first embodiment, the grip portion 29 a shown in FIG. 15 is grasped, and the endoscope 51 with a bending portion is placed in the body cavity of the patient 3. Insert into. Then, when the process of enhancing the image displayed on the monitor 7 is performed, the image enhancement switch 105 shown in FIG. 15A is pressed. By the operation with the image enhancement switch 105, as shown in FIG. 15B, the pressing portion 103a of the solenoid 103 of the image enhancement operation unit 102 protrudes downward. As a result, the flange portion 101b of the image enhancement button 101 is pressed downward. Thereby, the process which emphasizes an image is performed. When the image processing is completed, the image enhancement button 101 is released from the pressed state.

  When the surgeon 22 performs an operation near the endoscope 2, that is, near the grip portion 29a, the remote controller 104 is removed from the grip portion 29a as in the first embodiment, and the endoscope operator operates the surgery. The image enhancement switch 105 shown in FIG. 15A is operated at a location away from the person 22. As a result, it is possible to perform processing for enhancing the image without hindering the surgical operation of the operator 22.

  Therefore, the endoscope holding device 1 configured as described above has the following effects. That is, in the endoscope holding device 1, the grip unit 29a that is a gripping part is provided with a remote controller 104 that is a separating member that can be separated from the grip part 29a. The remote controller 104 is provided with an image enhancement switch 105 that performs processing for enhancing an image displayed on the monitor 7. Since the remote controller 104 can be separated from the grip portion 29a, when the operator 22 performs an operation in the vicinity of the endoscope 2, that is, in the vicinity of the grip portion 29a, the endoscope operator is located away from the operator 22. The image enhancement switch 105 is operated. As a result, it is possible to perform processing for enhancing the image without hindering the surgical operation of the surgeon 22.

  In the present embodiment, the remote controller 104 can also perform processing for enhancing the image displayed on the monitor 7, so that more operations can be performed at a place away from the operator 22.

(Modification)
In the above-described embodiment, the grip portion 29a and the remote control 37 are connected by the cable 40. However, the present invention is not limited to this, and may be configured to be wirelessly transmitted using, for example, infrared rays. Further, the remote controller 37 and the grip portion 29a may be connected by an extendable connecting means such as a magic hand. By using the magic hand, the remote controller 37 can be arranged at a position away from the grip portion 29a without the endoscope operator holding the remote controller 37.

  In the above-described embodiment, the holding unit 32 is moved in the axial direction of the endoscope 2 by the holding unit moving unit configured by the motor 34, the pinion gear 35, and the rack 36. Any configuration in which the position 32 moves is acceptable.

  In the above-described embodiment, the endoscope operation input unit for performing the operation of the endoscope is displayed on the bending levers 53 and 54 and the monitor 7 for performing the bending operation of the bending portion 51b of the endoscope 51 with a bending portion. The image enhancement button 101 for performing the process of enhancing the image to be emphasized has been described as an example, but the present invention is not limited to this.

  In the above-described embodiment, the water supply button 73 of the cleaning sheath 71 that cleans the distal end portion of the endoscope 2 is taken as an example of the accessory operation input unit that operates the accessory attached to the endoscope. However, the present invention is not limited to this.

  Moreover, in the above-mentioned embodiment, although the root arm part 5 is supported by the mount part 6 which can move with respect to a floor surface, the structure by which the root arm 5 is suspended from a ceiling may be sufficient.

  Furthermore, in the above-described embodiment, the endoscope is described as an example of the medical instrument, but the present invention is not limited to this.

  The embodiments of the present invention have been described above. However, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the present invention.

  DESCRIPTION OF SYMBOLS 1 ... Endoscope holding device, 2 ... Endoscope, 2a ... Insertion part, 22 ... Operator, 29 ... Endoscope holding means, 29a ... Grip part, 29b ... Detachable part, 32 ... Hold part, 37 ... Remote control 38a ... Free lock switch, 39 ... Advance / retreat switch.

Claims (9)

A holding part for holding a medical device;
A gripping part disposed in the vicinity of the holding part, and gripped by a medical instrument operator when the medical instrument is moved;
First input means provided in the grip portion;
A separation member that is detachably attached to the attachment / detachment portion of the gripping portion and can be disposed at a position separated from the gripping portion;
A second input means provided on the spacing member;
A medical instrument holding device comprising: Furthermore, the holding unit is supported movably in a three-dimensional space, and includes an arm unit having a plurality of joints,
The medical device holding apparatus according to claim 1, wherein the first input unit includes a joint unit fixing release unit that releases the fixation of the plurality of joint units. Furthermore, a holding unit moving means for moving the position of the holding unit is provided,
The medical instrument holding apparatus according to claim 1, wherein the second input means includes an input means to the holding unit moving means. The medical instrument is an endoscope;
Furthermore, an endoscope operation input unit actuating means for activating an endoscope operation input unit for operating the endoscope is provided,
The medical instrument holding apparatus according to claim 1, wherein the second input unit includes an input unit to the endoscope operation input unit actuating unit. The medical instrument is an endoscope;
Furthermore, an accessory operation input unit actuating means for actuating an accessory operation input unit for operating an accessory attached to the endoscope is provided,
The medical instrument holding apparatus according to claim 1, wherein the second input unit includes an input unit to the accessory operation input unit actuating unit. The endoscope is an endoscope with a bending portion provided with a bending portion,
The medical instrument holding device according to claim 4, wherein the endoscope operation input unit includes a bending lever that performs a bending operation of the bending unit.   The medical instrument holding apparatus according to claim 4, wherein the endoscope operation input unit includes an image enhancement button that performs a process of enhancing an image captured by the endoscope. The accessory is a cleaning sheath for cleaning the distal end portion of the endoscope,
The medical instrument holding apparatus according to claim 6, wherein the accessory operation input unit includes a water supply button provided on the cleaning sheath. The arm portion includes a tip arm portion disposed on the holding portion side and a root arm portion disposed on the opposite side of the holding portion,
The medical instrument holding device according to claim 2, wherein the joint portion fixing release means releases the fixation of the joint portion of the tip arm portion.

Images