JP2017176534A - Excluder and exclusion apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To address strong desire to detect a contact state between an excluder and an organ of a human body in terms of safely performing exclusion.SOLUTION: The excluder according to the present disclosure, includes: an exclusion part for excluding an organ of a human body; and a detection part for detecting a contact state between the exclusion part and the organ of the human body. According to the present disclosure, the detection part can detect the contact state between the excluder and the organ of the human body. Thereby, the exclusion can be safely performed. Needless to add, the effects of the present disclosure are not confined thereto.SELECTED DRAWING: Figure 1

Description

  The present disclosure relates to an exclusion device and an exclusion device.

  For example, as disclosed in Patent Document 1, a repellent is known as an instrument for assisting human surgery. A repellent device is a device that excludes human organs. By performing such exclusion, the surgical field can be developed.

JP 2011-239857 A

  However, the technique disclosed in Patent Document 1 cannot detect the contact state between the repellent element and a human organ.

  For this reason, it has been strongly demanded to detect the contact state between the retraction element and a human organ from the viewpoint of performing retraction more safely.

  According to the present disclosure, an exclusion device is provided that includes an exclusion unit that excludes a human organ, and a detection unit that is provided in the exclusion unit and detects a contact state between the exclusion unit and the human organ.

  According to this indication, an exclusion device provided with the above-mentioned exclusion element and an analysis part which analyzes an output value which a detection part outputted is provided.

  According to the present disclosure, it is possible to detect the contact state between the repellent element and the human organ by the detection unit.

  As described above, according to the present disclosure, it is possible to detect a contact state between an extrudate and a human organ. Note that the above effects are not necessarily limited, and any of the effects shown in the present specification, or other effects that can be grasped from the present specification, together with or in place of the above effects. May be played.

It is explanatory drawing which shows the external appearance of the exclusion apparatus which concerns on 1st Embodiment of this indication. It is explanatory drawing which shows the detailed structure of the pressure sensor which concerns on the same embodiment. FIG. 3 is a cross-sectional view taken along the line AA ′ of FIG. 2. It is explanatory drawing which shows the other example of a pressure sensor. It is explanatory drawing which shows the other example of a pressure sensor. FIG. 6 is a cross-sectional view taken along the line AA ′ of FIG. 5. It is explanatory drawing explaining the example which provided sensors other than a pressure sensor in the repellent element. It is a functional block diagram of an exclusion apparatus. It is explanatory drawing which shows the correspondence of the elapsed time from a surgery start, and the pressure which an extrudate receives. It is explanatory drawing explaining the usage example of an exclusion apparatus. It is explanatory drawing which shows the external appearance of the exclusion apparatus which concerns on 2nd Embodiment of this indication. It is a functional block diagram of an exclusion apparatus. It is explanatory drawing which shows the external appearance of the exclusion apparatus which concerns on 3rd Embodiment of this indication. It is a functional block diagram of an exclusion apparatus.

  Hereinafter, preferred embodiments of the present disclosure will be described in detail with reference to the accompanying drawings. In addition, in this specification and drawing, about the component which has the substantially same function structure, duplication description is abbreviate | omitted by attaching | subjecting the same code | symbol.

The description will be made in the following order.
1. 1. First embodiment 1-1. Overall configuration of the exclusion device 1-2. Extruder Configuration 1-3. Detailed configuration of pressure sensor 1-4. Other examples of pressure sensor 1-5. Examples of sensors other than pressure sensors 1-6. Configuration of analysis apparatus 1-7. Example of use Second embodiment 2-1. Overall configuration of the exclusion device 2-2. Configuration of analysis device 2-3. Configuration of arm device 2-4. Usage example 3. Third Embodiment 3-1. Overall configuration of the exclusion device 3-2. Configuration of analysis apparatus 3-3. Configuration of arm device 3-4. Configuration of master device 3-5. Example of use

<1. First Embodiment>
(1-1. Overall configuration of the exclusion device)
First, based on FIG. 1, the whole structure of the exclusion apparatus 1 which concerns on 1st Embodiment is demonstrated. The exclusion device 1 includes an exclusion device 10, an analysis device 30, and a display device 50. The repellent element 10 and the analysis device 30 are connected by a communication cable 2, and the analysis device 30 and the display device 50 are connected by a communication cable 3. Of course, these may be wirelessly connected.

(1-2. Extruder Configuration)
Next, the configuration of the repellent element 10 will be described with reference to FIGS. The repellent element 10 relieves a human organ 110 (see FIG. 10), and includes a grip 11, a shaft 12, a retraction part 13, and a pressure sensor 20 (detection part). An operator of the retraction element 10 (for example, an operator's assistant) operates the retraction element 10 with the grip 11. That is, in the first embodiment, the repellent element 10 is directly operated by the operator.

  The shaft 12 is provided at the tip of the grip 11, and an exclusion portion 13 is provided at the tip of the shaft 12. The exclusion part 13 is a part that excludes the organ 110 of the patient. The exclusion unit 13 includes a plurality of exclusion pieces 15. In this manner, the repellent element 10 excludes the patient's organ 110 by the plurality of relieving pieces 15 provided at the tip of the shaft 12. In the example illustrated in FIG. 1, the number of the exclusion pieces 15 is three, but the number of the exclusion pieces 15 is not limited to this.

  Furthermore, the configuration of the extruding element 10 is not limited to this example. That is, the first embodiment (and second to third embodiments described later) can be applied to all types of repellent elements. For example, the exclusion element 10 may be a balloon-type exclusion element, or may be an exclusion element in which a ring-shaped exclusion portion 13 is formed at the tip of the shaft 12. Further, the repellent element 10 may be a snake retractor.

  As shown in FIG. 2, the exclusion piece 15 includes a skeleton portion 15 a that is a skeleton of the exclusion piece 15 and a covering portion 15 b that covers the skeleton portion 15 a. The skeleton part 15a is made of, for example, metal, and the covering part 15b is made of a flexible material, such as silicon. Of course, the configuration of the pressure relief piece 15 is not limited to this example.

  Each pressure relief piece 15 is provided with a pressure sensor 20. The pressure sensor 20 detects the pressure that the exclusion unit 13 receives from the patient organ 110 as an example of a contact state between the exclusion unit 13 (more specifically, the exclusion piece 15) and the patient organ 110. In other words, the pressure sensor 20 detects the pressure applied to the organ 110 of the patient by the exclusion unit 13. The pressure that the exclusion unit 13 applies to the patient's organ 110 is extremely important from the viewpoint of performing the exclusion safely. This is because if the pressure is too large, the patient's organ 110 may be adversely affected. Therefore, it is necessary to keep the pressure applied to the patient's organ 110 by the exclusion unit 13 within an appropriate range (that is, not adversely affecting the patient's organ 110). In the first embodiment, the pressure can be detected by the pressure sensor 20. Further, as will be described later, the pressure is displayed on the display device 50. Therefore, the operator can keep the pressure within an appropriate range without relying on the operator's intuition and experience.

  Note that the surface area of the exclusion piece 15 may be increased from the viewpoint of reducing the pressure applied to the patient's organ 110 from the exclusion section 13. However, since this device alone is not sufficient, it is preferable to use the pressure sensor 20 together.

(1-3. Detailed configuration of pressure sensor)
Next, a detailed configuration of the pressure sensor 20 will be described based on FIGS. 2 and 3. The pressure sensor 20 is provided over almost the entire length direction of each pressure relief piece 15. Therefore, the pressure sensor 20 can detect the pressure in almost the entire region of the displacement piece 15 in the length direction. That is, the pressure sensor 20 can measure a change in pressure due to a difference in contact position between the exclusion piece 15 and the patient's organ 110, that is, a pressure distribution. Of course, the pressure sensor 20 may be provided only in a part of the exfoliation piece 15. For example, the pressure sensor 20 may be provided only in a place where the pressure from the organ 110 of the patient is most easily received (for example, the central portion of the pressure piece 15). Further, the pressure sensor 20 may be provided only on one of the pressure relief pieces 15. However, safer pressure removal is possible by detecting the pressure distribution. Therefore, it is preferable that the pressure sensor 20 is arranged as shown in FIG.

  Specifically, the pressure sensor 20 includes a plurality of strain sensors 21 and a hollow portion 22 corresponding to each strain sensor 21. The hollow portion 22 is a portion that functions as a diaphragm of the strain sensor 21, and is provided in the skeleton portion 15a. The cavity 22 is preferably present for each strain sensor 21, but is not necessarily limited thereto. The strain sensor 21 detects the strain of the cavity portion 22 that is generated when the exclusion piece 15 contacts the organ 110 of the patient. The distortion of the cavity portion 22 corresponds to the pressure that the exclusion portion 13 applies to the organ 110 of the patient. Therefore, the strain sensor 21 detects the pressure that the exclusion unit 13 applies to the organ 110 of the patient. The output value of the strain sensor 21 is input to the analysis device 30 through the communication cable 2.

(1-4. Other examples of pressure sensor)
The pressure sensor 20 may be any sensor that can detect the pressure applied to the organ 110 of the patient by the exclusion unit 13. Therefore, the configuration is not limited to the examples shown in FIGS. Therefore, another example of the pressure sensor 20 will be described next. FIG. 4 shows another example of the pressure sensor 20. In this example, the pressure sensor 20 is an optical fiber type pressure sensor (for example, an FBG (Fiber Bragg Grating) sensor), and is provided in the skeleton 15 a of the exfoliation piece 15. The output value of the pressure sensor 20 is input to the analysis device 30 through the communication cable 2. For example, the pressure distribution can be measured by installing FBG sensors at a plurality of locations on each of the pressure relief pieces 15.

  5 and 6 show still another example of the pressure sensor 20. In the example shown in FIG. 5, the pressure sensor 20 includes a plurality of balloons 24 disposed between the skeleton part 15 a and the covering part 15 b, an air introduction pipe 25 that introduces air into each balloon 24, and an air introduction pipe 25. And an air pressure sensor 27 provided at the front end. An air introduction device (not shown) is provided at the rear end of the air introduction pipe 25. That is, in this example, it can be considered as an example in which the repellent element 10 shown in FIG. 2 and the balloon-type repellent element are combined. The air pressure sensor 27 may be installed on the rear end side of the air introduction tube 25. In many cases, the space on the rear end side is wider than the space on the front end side of the air introduction tube 25. For this reason, when the air pressure sensor 27 is installed on the rear end side of the air introduction tube 25, it is often easy to install the air pressure sensor 27.

  The balloon 24 is inflated by the air supplied from the air introduction tube 25 and excludes the organ 110 of the patient. The skeleton 15a has a hollow structure, and the air introduction tube 25 is connected to each balloon 24 through the hollow portion 15c of the skeleton 15a. The air pressure sensor 27 detects a change in the pressure inside the balloon caused by the balloon 24 coming into contact with the organ 110 of the patient. The output value of the air pressure sensor 27 is input to the analysis device 30 through the communication cable 2. In the example of FIGS. 5 and 6, since the plurality of balloons 24 are arranged over almost the entire length direction of the exfoliation piece 15, the pressure distribution can be measured as in the example shown in FIG. 2. . Although various examples of the pressure sensor 20 have been listed above, the pressure sensor 20 is not limited to these examples.

(1-5. Examples of sensors other than pressure sensors)
In addition to the pressure, various states are conceivable as the contact state between the exclusion unit 13 and the organ 110 of the patient. Therefore, a sensor other than the pressure sensor 20 may be provided in the exclusion unit 13. An example of such a sensor is a biosensor. An example is shown in FIG. In the example shown in FIG. 7, a pulse oximeter 26 is provided on the relieving piece 15 as a sensor other than the pressure sensor 20. The pulse oximeter 26 measures SpO ₂ , that is, arterial oxygen saturation. By measuring SpO ₂ , it is possible to detect the presence or absence of a blood flow disorder due to exclusion. Still other sensors include blood flow sensors, temperature sensors, enzyme sensors, and the like. That is, the exclusion unit 13 may optionally be provided with a sensor that detects a contact state between the exclusion unit 13 and the patient's organ 110. The blood flow sensor can detect the presence or absence of a blood flow disorder due to exclusion. The temperature sensor can measure the temperature of the organ 110. When any adverse effect occurs in the organ 110 due to the exclusion, the temperature of the organ 110 may change. The temperature sensor can detect such a temperature change. Here, the temperature of the organ 110 can be considered as an example of deep body temperature. The deep body temperature includes bladder temperature, rectal temperature, esophageal temperature, blood temperature, tympanic temperature, and the like. These temperatures are easily accessible from outside the body. In the present embodiment, by providing a temperature sensor in the exclusion unit 13, it is possible to measure the temperature of a place that is difficult to access from outside the body, that is, the organ temperature. Such temperature information can be expected to be used not only for the purpose of safely performing exclusion but also for various uses during surgery. The enzyme sensor detects an enzyme. For example, when excluding the pancreas, an enzyme sensor capable of detecting amylase is used. Thereby, when pancreatic juice leaks due to exclusion, the enzyme sensor can detect the leakage of pancreatic juice. As described above, various types of biosensors other than the pressure sensor 20 can be provided. A plurality of types of sensors may be used in combination.

(1-6. Configuration of analysis apparatus)
Next, the configuration of the analysis device 30 will be described with reference to FIGS. 1 and 8. The analysis device 30 includes an analysis unit 31 and a storage unit 32. In FIG. 1, the analysis device 30 is configured separately from the repellent element 10, but may be integrally formed with the repellent element 10.

  The analysis unit 31 analyzes the output value given from the pressure sensor 20 to obtain a specific value of the pressure that the exclusion unit 13 gives to the organ 110 of the patient, that is, the pressure value. The analysis unit 31 stores the acquired pressure value in the storage unit 32. Here, the analysis unit 31 may accumulate the pressure value in the storage unit 32. Specifically, the analysis unit 31 may cause the storage unit 32 to store pressure change data indicating a correspondence relationship between the time from the start of exclusion and the pressure value. An example of pressure aging data is shown in FIG. A graph L2 in FIG. 9 shows the correspondence between the time from the start of exclusion and the pressure value.

  In addition, when the pressure sensors 20 are provided at a plurality of locations of the exclusion unit 13 (for example, as shown in FIG. 2), the analysis unit 31 can acquire a pressure distribution as a pressure value. The analysis unit 31 stores the pressure distribution in the storage unit 32. For example, the analysis unit 31 may arrange a plot indicating the measurement position on the xy plane, and change the display mode (color, size, etc.) of this plot according to the pressure value. That is, the analysis unit 31 may create a pressure distribution map. Furthermore, the analysis unit 31 may create pressure change data for this pressure distribution. In this case, the analysis unit 31 may create a graph L <b> 2 illustrated in FIG. 9 for each measurement position of the pressure sensor 20. Moreover, the analysis part 31 may change the display mode of the plot in a pressure distribution map with time.

  The storage unit 32 stores various types of information necessary for processing of the analysis device 30, such as a program. Further, the storage unit 32 stores the pressure value obtained by the analysis by the analysis unit 31. When the analysis unit 31 creates pressure aging data or a pressure distribution map, the storage unit 32 also stores these data.

  Furthermore, the storage unit 32 may store an upper limit value of the pressure value. That is, if the pressure value is too large, there may be some adverse effects on the organ 110 of the patient. Therefore, there can be an upper limit for the pressure value. Although the determination method of an upper limit is not specifically limited, For example, the following method is mentioned. That is, the surgeon or the like observes the progress of the patient after the operation, and if there is no problem, the pressure value stored in the storage unit 32 may be set as the upper limit value. Further, when pressure change data is stored in the storage unit 32 as a pressure value, the surgeon or the like may use the pressure value indicated by the pressure change data as the upper limit value. In this case, the upper limit value is given as a value corresponding to the time from the start of exclusion, that is, as upper limit change data. An example of the upper limit aging data is shown in FIG. A graph L1 in FIG. 9 shows the correspondence between the time from the start of exclusion and the upper limit value. Further, the upper limit value may vary depending on factors such as the patient's age, sex, physique, and organ 110 type. Therefore, the surgeon or the like may set an upper limit value for each of these elements. Further, when a pressure distribution is given as the pressure value, the surgeon or the like may create an upper limit distribution map indicating the upper limit value distribution. In the upper limit value distribution map, for example, plots indicating measurement positions are arranged in an xy plane, and the display mode of each plot differs depending on the upper limit value.

  Further, when the pressure value exceeds the upper limit value, the analysis unit 31 may store the time point when the pressure value exceeds the upper limit value in the storage unit 32. Further, when the pressure distribution is given as the pressure value, the analysis unit 31 may store the position where the pressure value exceeds the upper limit value in the storage unit 32.

  The analysis unit 31 displays the pressure value and the upper limit value stored in the storage unit 32 on the display device 50. Specifically, the analysis unit 31 outputs image information indicating the pressure value and the upper limit value to the display device 50 via the communication cable 3. The display device 50 displays the given image information. For example, when the pressure aging data and the upper limit aging data are stored in the storage unit 32, the analysis unit 31 may display them on the display device 50. More specifically, the analysis unit 31 may superimpose and display the graphs L1 and L2 illustrated in FIG. Further, when the pressure distribution map and the upper limit distribution map are stored in the storage unit 32, the analysis unit 31 may display these on the display device 50. Thereby, the operator of the pressure exclusion element 10 can easily determine whether or not the current pressure value exceeds the upper limit value.

  Even when the pressure value does not exceed the upper limit value, the analysis unit 31 is in a case where the time change amount of the pressure value exceeds a predetermined value (that is, when the pressure value increases instantaneously). That may be displayed on the display device 50. In this case, the repellent element 10 is vigorously applied to the organ 110. Therefore, even if the pressure value is small, some adverse effects on the organ 110 may occur. Further, the analysis unit 31 may store in the storage unit 32 the point in time when the amount of change in pressure value with time exceeds a predetermined value.

  The analysis unit 31 displays the pressure value, the upper limit value, and the like during the operation, but displays the pressure value, the upper limit value, and the like at an arbitrary timing (for example, when requested by an operator or the like). May be displayed. Thereby, the surgeon or the like can more easily analyze the surgical result.

  The analysis unit 31 may present the pressure value and the upper limit value stored in the storage unit 32 to the operator of the repellent element 10 in another manner. For example, the analysis unit 31 may present the pressure value and the upper limit value to the operator of the repellent element 10 by voice. In this case, an audio output device (such as a speaker) may be connected to the analysis device 30. The analysis unit 31 may read the numerical values of the pressure value and the upper limit value from the voice output device, or may sound an alarm when the pressure value exceeds the upper limit value. Further, the analysis unit 31 may present the pressure value and the upper limit value to the operator, the operator of the repellent element 10 or the like by vibration or the like. Specifically, the analysis unit 31 may vibrate the grip 11 when the pressure value exceeds the upper limit value. In this case, a vibration device may be built in the grip 11. In any aspect, the operator of the repellent element 10 can easily determine whether or not the current pressure value exceeds the upper limit value.

Further, when other types of sensors are provided in the exclusion unit 13, the analysis unit 31 may analyze output values given from these sensors. The analyzing unit 31, the values obtained by the analysis (e.g., SpO ₂ and the like described above) may be displayed on the display device 50.

  The analysis device 30 can be configured by, for example, a processor such as a CPU (Central Processing Unit) or a DSP (Digital Signal Processor), or a microcomputer on which these processors are mounted. And the process of the analyzer 30 is performed when a processor performs the signal processing according to a predetermined program.

(1-7. Usage example)
Next, the usage example of the exclusion apparatus 1 is demonstrated based on FIG. In this use example, the exclusion device 1 is used for minimally invasive surgery (specifically, endoscopic surgery). Specifically, the operator of the retraction element 10 passes the trocar 60 (cylindrical member) through the skin 100 of the patient's abdomen. Thereby, an opening is formed in the skin 100. Next, the operator of the retraction element 10 inserts the retraction element 10 through the trocar 60 into the patient's body. On the other hand, a separate endoscope is inserted into the patient's body, and the captured image is displayed on the display device 50. Processing of the captured image given from the endoscope may be performed by the analysis device 30 or may be performed by another control device. The operator of the retraction element 10 brings the exclusion part 13 into contact with the organ 110 to be excluded while referring to the captured image displayed on the display device 50. Thereafter, the operator of the retraction element 10 uses the retraction unit 13 to relieve the organ 110. On the other hand, the pressure sensor 20 detects the pressure applied to the organ 110 by the exclusion unit 13. Then, the pressure sensor 20 outputs an output value corresponding to the pressure value to the analysis device 30. The analysis unit 31 acquires the pressure value by analyzing the output value. The analysis unit 31 stores the acquired pressure value in the storage unit 32 and displays the pressure value on the display device 50. The analysis unit 31 also displays the upper limit value on the display device 50 when the upper limit value is stored in the storage unit 32. Further, when the pressure aging data and the upper limit aging data are stored in the storage unit 32, the analysis unit 31 displays these data on the display device 50. The display position is not particularly limited, but it is preferable not to hinder the visibility of the captured image from the endoscope. Therefore, the display position of the pressure value or the like is preferably the end of the display surface of the display device 50 or the like.

  As described above, according to the first embodiment, the pressure sensor 20 detects the pressure applied to the patient's organ 110 from the exclusion unit 13. And the analysis part 31 acquires a specific pressure value by analyzing the output value given from the pressure sensor 20. FIG. Then, the analysis unit 31 displays the pressure value on the display device 50. Therefore, the operator of the repellent element 10 can keep the pressure within an appropriate range without relying on the operator's intuition and experience. For example, the operator can know whether or not the pressure value is likely to reach the upper limit value before the pressure value reaches the upper limit value. Then, the operator can relax the pressure relief before the pressure value actually reaches the upper limit value. Therefore, the operator can perform the exclusion more safely (in other words, in a friendly manner). Furthermore, it is possible to more reliably prevent adverse effects on the organ 110 without the operator's knowledge.

  Further, the analysis unit 31 stores the pressure value in the storage unit 32. The analysis unit 31 may store the temporal change and distribution of the pressure value in the storage unit 32. Further, the storage unit 32 stores an upper limit value of the pressure value. Therefore, the surgeon can refer to the information stored in the storage unit 32 when analyzing the surgical result. For example, when there is a time point when the pressure value exceeds the upper limit value, the surgeon or the like can easily grasp such time point. That is, the surgeon or the like can easily grasp the type of processing to be improved in the surgery (in this case, the pressure of exclusion is too large), the time when the processing has occurred, and the like.

  Further, the analysis unit 31 displays an upper limit value in addition to the pressure value. More specifically, the analysis unit 31 displays the pressure value and the upper limit value in comparison. Therefore, the operator can more easily grasp whether the current pressure value does not exceed the upper limit value. Therefore, the operator can perform the exclusion more safely.

  Further, the analysis unit 31 displays the change in the pressure value on the display device 50. More specifically, the analysis unit 31 displays the change or distribution of the pressure value over time on the display device 50. Thereby, the operator can grasp | ascertain more easily whether the present pressure value is not over the upper limit. Therefore, the operator can perform the exclusion more safely.

<2. Second Embodiment>
(2-1. Overall configuration of the exclusion device)
Next, a second embodiment will be described. First, based on FIG. 11, the whole structure of the exclusion apparatus 1 which concerns on 2nd Embodiment is demonstrated. The exclusion device 1 according to the second embodiment is obtained by adding an arm device 400 to the exclusion device 1 according to the first embodiment. The arm device 400 includes an arm 420, and the repellent element 10 is attached to the tip of the arm 420. The arm device 400 and the analysis device 30 are connected by a communication cable 4. These may be wirelessly connected. The operator of the repellent element 10 uses the arm 420 to indirectly operate the repellent element 10.

(2-2. Configuration of analysis device)
Next, the configuration of the analysis device 30 will be described with reference to FIG. The analysis device 30 includes an analysis unit 31 and a storage unit 32. The functions of the analysis unit 31 and the storage unit 32 are the same as those in the first embodiment. The analysis unit 31 performs a process of outputting the pressure value and the upper limit value to the arm control unit 431 in addition to the process of the first embodiment.

(2-3. Configuration of arm device)
Next, the configuration of the arm device 400 will be described with reference to FIGS. 11 and 12. The arm device 400 includes an arm 420 and an arm control device 430.

  The arm 420 includes a plurality of joint portions 421a to 421d and a plurality of links 422a to 422d that connect the joint portions 421a to 421d. Of course, the number of joints and links is not limited to the example of FIG.

  The links 422a to 422d are rod-shaped members. The link 422a connects the joint part 421a and the joint part 421b. Here, the joint portion 421 a is provided in the arm control device 430. The link 422b connects the joint part 421b and the joint part 421c. The link 422c connects the joint part 421c and the joint part 421d. The link 422d is provided in the joint portion 421d. The grip 11 of the repellent element 10 is fixed to the tip of the link 422d.

  Each of the joint portions 421a to 421d incorporates a drive unit 300 shown in FIG. The drive unit 300 includes, for example, an actuator, a torque sensor, and an encoder. The drive unit 300 preferably further includes a brake mechanism. The joint portions 421a to 421d rotate when the actuator is driven. And the link connected to the front end side of joint part 421a-421d rotates in response to rotation of a joint part. For example, the link 422a rotates in conjunction with the rotation of the joint portion 421a. The rotation direction of the joint parts 421a to 421d is set for each joint part 421a to 421d. The operation of the actuator is controlled by the arm control device 430.

  The torque sensor is provided on the output shaft of the actuator (that is, the shaft that rotates the joint portions 421a to 421d). The torque sensor can detect torque applied from the actuator to the output shaft, and can detect external force applied to the output shaft from the outside. Here, examples of the external force include a force applied to the arm 420 by the operator of the repellent element 10, torque provided from a link provided on the distal end side of the joint portions 421a to 421d, and the like. The output value of the torque sensor is output to the arm control unit 431. The encoder measures the rotation angle of the output shaft. The output value of the encoder is output to the arm control unit 431. For example, the brake mechanism stops the rotation of the output shaft when the arm 420 is not energized.

  The arm control device 430 includes an arm control unit 431 and a storage unit 432. The arm control unit 431 controls the operation of the arm 420. As a control method of the arm 420, force control is preferably used in consideration of the operability of the arm 420. Specifically, the arm controller 431 moves the arm 420 in the direction of the force applied to the arm 420 when the operator of the repellent element 10 directly touches the arm 420 and applies a force. Specifically, when the operator of the repellent element 10 directly touches the arm 420 and applies force, the output values of the torque sensors built in the joint portions 421a to 421d vary. The arm control unit 431 recognizes the direction and magnitude of the force applied to the arm 420 by the operator based on the fluctuation of the output value given from each torque sensor. Then, the arm control unit 431 controls each driving unit 300 based on the recognition result. As a result, the arm 420 moves in the direction of the force applied to the arm 420.

  Here, in the second embodiment, the pressure value and the upper limit value of the repellent element 10 are given to the arm control unit 431. The arm control unit 431 performs the following processing based on these pieces of information.

  First, the arm control unit 431 calculates an upper limit value of the force that the link 422d applies to the repellent element 10 (hereinafter, this upper limit value is also referred to as an “arm force upper limit value”) based on the upper limit value of the pressure value. For example, the arm control unit 431 may calculate the arm force upper limit value on the assumption that the entire surface of one side of each exclusion piece 15 contacts the organ 110. In this case, the arm force upper limit value is obtained by multiplying the upper limit value of the pressure value by the total area of one side of each of the pressure relief pieces 15. Of course, the measuring method of the arm force upper limit value is not limited to this example.

Then, the arm control unit 431 drives the arm 420 based on the force given from the operator of the repellent element 10, while monitoring the output value given from the torque sensor of the joint part 421d. When the output value from the torque sensor reaches the arm force upper limit value, the arm control unit 431 does not move the arm 420 in the same direction any more. Specifically, when a force in the same direction is further applied to the arm 420 by the operator of the repellent element 10, the arm control unit 431 generates a force in the reverse direction on the arm 420. That is, the arm control unit 431 controls each driving unit 300 so that such a force is generated in the arm 420. Thereby, the arm control part 431 presents that the pressure value has reached the upper limit value to the operator of the repellent element 10 (in this case, force sense presentation).
Thus, the arm control unit 431 compares the external force detected by the torque sensor of the joint unit 421d with the arm force upper limit value. That is, the arm control unit 431 considers that a force corresponding to the external force detected by the torque sensor of the joint portion 421d acts on the organ 110 from the arm 420. Of course, the parameter compared with the arm force upper limit value is not limited to this example. For example, the arm control unit 431 may calculate the resultant force of the external force detected by these torque sensors based on output values given from the torque sensors of the joint portions 421b to 421d. Then, the arm control unit 431 may compare the resultant force with the arm force upper limit value. In this case, the arm control unit 431 considers that a force corresponding to the resultant force of the external force detected by the torque sensors of the joint portions 421b to 421d acts on the organ 110 from the arm 420.
Furthermore, the arm control unit 431 may set a control activation value smaller than the arm force upper limit value, and perform the following control based on the control activation value. The magnitude of the control activation value is not particularly limited, but may be, for example, about 60 to 80% of the arm force upper limit value, more specifically about 70%. Then, the arm control unit 431 drives the arm 420 based on the force given from the operator of the repellent element 10, while monitoring the output value given from the torque sensor of the joint part 421d. Note that the monitoring target may be the resultant force described above. Then, when the output value given from the torque sensor of the joint part 421d becomes less than the control activation value, the arm control part 431 drives the arm 420 based on the force given from the operator of the repellent element 10. On the other hand, when the output value given from the torque sensor of the joint part 421d is equal to or greater than the control activation value, the arm control unit 431 applies a force proportional to (output value from the torque sensor−control activation value). Is generated in the arm 420 in the direction opposite to the operation direction by the operator. That is, the arm control unit 431 controls each driving unit 300 so that such a force is generated in the arm 420. The force in the reverse direction may not be a magnitude proportional to (output value from torque sensor−control activation value). For example, the arm controller 431 may generate the force in the reverse direction steeply. In this case, the arm control unit 431 can generate a repulsive force in the arm 420 before the pressure value of the repellent element 10 reaches the upper limit value.

  Thereby, the operator of the repellent element 10 can operate the arm 420 without being aware of the upper limit value of the pressure value. This is because the operator can grasp that the pressure value has reached the upper limit value when a repulsive force is applied from the arm 420. Further, when control using the control activation value is performed, the operator can recognize the repulsive force before the pressure value of the repellent element 10 reaches the upper limit value. Further, when the operator feels the repulsive force and further operates the arm 420 in the same direction, the operator receives a larger repulsive force. For this reason, the operator can recognize more reliably that the pressure value is approaching the upper limit value. Thereby, in 2nd Embodiment, it can prevent more reliably that a pressure value exceeds an upper limit.

  Furthermore, when the pressure value given from the analysis unit 31 reaches the upper limit value, the arm control unit 431 may urgently stop the arm 420 regardless of the above processing. At this time, the arm controller 431 preferably fixes the arm 420 by a brake mechanism. Thereby, it can prevent more reliably that a pressure value exceeds an upper limit.

  The arm control unit 431 may perform position control instead of force control. In the position control, the operator of the repellent element 10 designates the posture of the arm 420 by some method (for example, an input operation using a master device described later). Then, the arm control unit 431 matches the posture of the arm 420 with the posture specified by the operator. The posture of the arm 420 is specified by output values from the encoders provided in the joint portions 421a to 421d. In this case, the arm control unit 431 can perform the same processing as the above-described processing based on the position of the repellent element 10. That is, the arm control unit 431 measures the displacement amount of the retraction element 10 toward the organ 110 after the retraction element 10 contacts the organ 110. Here, it is possible to determine that the retraction element 10 has contacted the organ 110 based on, for example, an output value given from the torque sensor of the joint part 421d, an output value given from the pressure sensor 20 provided in the exclusion part 13 or the like. It is. This is because the output value from the torque sensor varies when the repellent element 10 contacts the organ 110. Then, the arm control unit 431 applies a spring / damper model to the organ 110 (that is, the organ 110 is assumed to be an elastic body), and the displacement of the retraction element 10 toward the organ 110 is determined. Based on this, the repulsive force from the organ 110 is calculated. This repulsive force corresponds to the force that the link 422d applies to the repellent element 10. Therefore, when the repulsive force from the organ 110 reaches the arm force upper limit value, the arm control unit 431 prevents the arm 420 from moving further in the same direction.

  The storage unit 432 stores information necessary for the operation of the arm control device 430, such as a program. The arm control device 430 can be configured by a processor such as a CPU (Central Processing Unit) and a DSP (Digital Signal Processor), or a microcomputer on which these processors are mounted. Then, when the processor executes signal processing and control processing according to a predetermined program, the processing of the arm control device 430 is executed.

(2-4. Usage example)
Next, the usage example of the exclusion apparatus 1 is demonstrated based on FIG. Also in this use example, the retraction device 1 is used for minimally invasive surgery as in the first embodiment. However, the operator of the repellent element 10 operates the repellent element 10 using the arm 420. Specifically, the operator of the retraction element 10 passes the trocar 60 (cylindrical member) through the skin 100 of the patient's abdomen. Thereby, an opening is formed in the skin 100. Next, the operator of the repellent element 10 moves the repellent element 10 to the vicinity of the trocar 60 by operating the arm 420. Next, the operator inserts the retraction element 10 through the trocar 60 into the patient's body.

  The operator of the retraction element 10 brings the exclusion part 13 into contact with the organ 110 to be excluded while referring to the captured image displayed on the display device 50. Thereafter, the operator of the retraction element 10 uses the retraction unit 13 to relieve the organ 110. On the other hand, the pressure sensor 20 detects the pressure that the exclusion unit 13 applies to the organ 110. Then, the pressure sensor 20 outputs an output value corresponding to the pressure value to the analysis device 30. The subsequent analysis unit 31 performs the same processing as in the first embodiment. For example, the analysis unit 31 displays the pressure value and the upper limit value on the display device 50. Further, the analysis unit 31 outputs the pressure value and the upper limit value to the arm control unit 431.

  The arm control unit 431 monitors the output value given from the torque sensor of the joint portion 421d while driving the arm 420 according to the operation of the operator of the repellent element 10. When the output value from the torque sensor reaches the arm force upper limit value, the arm control unit 431 does not move the arm 420 in the same direction any more. Specifically, when a force in the same direction is further applied to the arm 420 by the operator of the repellent element 10, the arm control unit 431 generates a force in the reverse direction on the arm 420. That is, the arm control unit 431 controls each driving unit 300 so that such a force is generated in the arm 420. That is, the arm control unit 431 presents to the operator of the repressor 10 that the pressure value has reached the upper limit value (in this case, a force sense is presented). Therefore, the operator can operate the arm 420 without being aware of the upper limit value of the pressure value.

  According to the second embodiment, the exclusion device 1 includes the arm 420. Therefore, the operator of the repellent element 10 can indirectly operate the repellent element 10 by operating the arm 420.

  Furthermore, the arm control unit 431 controls the arm 420 based on the pressure value and the upper limit value. Specifically, the arm control unit 431 controls the arm 420 so that the pressure value is equal to or lower than the upper limit value. Therefore, it can prevent more reliably that a pressure value exceeds an upper limit. Further, when the pressure value reaches the upper limit value, the arm control unit 431 notifies the operator via the arm 420. Specifically, the arm control unit 431 performs force sense presentation by causing the arm 420 to generate a repulsive force. Thus, the operator can operate the arm 420 without being aware of the upper limit value of the pressure value. Further, the display device 50 displays the same content as in the first embodiment. Therefore, the operator can perform the exclusion more safely.

<3. Third Embodiment>
(3-1. Overall Configuration of Exclusion Device)
Next, a third embodiment will be described. First, based on FIG. 13, the whole structure of the exclusion apparatus 1 which concerns on 3rd Embodiment is demonstrated. The exclusion device 1 according to the third embodiment is obtained by adding a master device 500 to the exclusion device 1 according to the second embodiment. Master device 500 and arm control device 430 are connected by communication cable 5. These may be wirelessly connected. Master device 500 is used to operate arm 420. That is, the operator U of the repellent element 10 may directly operate the arm 420 by touching the arm 420 or may indirectly operate the arm 420 using the master device 500.

(3-2. Configuration of analysis apparatus)
Next, the configuration of the analysis device 30 will be described with reference to FIG. The analysis device 30 includes an analysis unit 31 and a storage unit 32. The functions of the analysis unit 31 and the storage unit 32 are the same as those in the second embodiment. The analysis unit 31 may output the pressure value and the upper limit value to the master control unit 511.

(3-3. Configuration of arm device)
Next, the configuration of the arm device 400 will be described with reference to FIGS. 13 and 14. The arm device 400 includes an arm 420 and an arm control device 430. The configurations and functions of the arm 420 and the arm control device 430 are the same as those in the second embodiment. Furthermore, the arm control unit 431 can perform the following processing.

  That is, the arm control unit 431 controls the arm 420 based on the operation information given from the master control unit 511. The control method may be force control or position control. In the case of force control, the operation information includes information related to the magnitude and direction of the force applied to the input operation arm 520 by the operator of the retraction element 10. In the case of position control, information on the posture of the input operation arm 520 is included.

  Furthermore, when the pressure value reaches the upper limit value, the arm control unit 431 does not move the arm 420 in the same direction any more. Further, the arm control unit 431 outputs presentation instruction information for instructing the operator that the pressure value has reached the upper limit value, to the master control unit 511.

(3-4. Configuration of master device)
Next, the configuration of the master device 500 will be described with reference to FIGS. 13 and 14. The master device 500 includes an input operation arm 520 and a master control device 510.

  The input operation arm 520 includes a plurality of joint portions 521a to 521d and a plurality of links 522a to 522d that connect the joint portions 521a to 521d. Of course, the number of joints and links is not limited to the example of FIG. That is, the input operation arm 520 has a shape in which the arm 420 is reduced. Accordingly, the functions of the joint portions 521a to 521d and the links 522a to 522d are substantially the same as those of the joint portions 421a to 421d and the links 422a to 422d.

  That is, the links 522a to 522d are rod-shaped members. The link 522a connects the joint part 521a and the joint part 521b. Here, the joint portion 521 a is provided in the master control device 510. The link 522b connects the joint part 521b and the joint part 521c. The link 522c connects the joint part 521c and the joint part 521d. The link 522d is provided in the joint portion 521d.

  Each of the joint portions 521a to 521d has a built-in operation driving portion 600 shown in FIG. The operation drive unit 600 includes, for example, an actuator, a torque sensor, and an encoder. The joint portions 521a to 521d rotate when the actuator is driven. And the link connected to the front end side of joint part 521a-521d rotates in response to rotation of a joint part. For example, the link 522a rotates in conjunction with the rotation of the joint portion 521a. The rotation directions of the joint portions 521a to 521d correspond to the joint portions 421a to 421d. The operation of the actuator is controlled by the master control unit 511.

  The torque sensor is provided on the output shaft of the actuator (that is, the shaft that rotates the joint portions 521a to 521d). The torque sensor can detect torque applied from the actuator to the output shaft, and can detect external force applied to the output shaft from the outside. Here, examples of the external force include a force applied to the input operation arm 520 by the operator of the repellent element 10, a torque provided from a link provided on the distal end side of the joint portions 521a to 521d, and the like. The output value of the torque sensor is output to the master control unit 511. The encoder measures the rotation angle of the output shaft. The output value of the encoder is output to the master control unit 511. Further, the joint portions 521a to 521d may be provided with a brake mechanism similar to the arm 420.

  The master control device 510 includes a master control unit 511 and a storage unit 512. The master control unit 511 controls the operation of the input operation arm 520. Note that force control is preferably used as the control method of the input operation arm 520. Specifically, when the operator of the repellent element 10 touches the input operation arm 520 and applies a force, the master control unit 511 moves the input operation arm in the direction of the force applied to the input operation arm 520. 520 is moved. A specific control method is the same as that of the arm device 400. Further, the master control unit 511 generates operation information regarding the magnitude and direction of the force applied by the operator to the input operation arm 520 and outputs the operation information to the arm control unit 431. As a result, the arm control unit 431 can control the force of the arm 420.

  Note that the master control unit 511 may output the posture of the input operation arm 520 (more specifically, the value of the encoder in the joint units 521a to 521d) to the arm control unit 431 as operation information. In this case, the arm control unit 431 can control the position of the arm 420.

  Further, when the presentation instruction information is given from the arm control unit 431, the master control unit 511 presents to the operator via the input operation arm 520 that the pressure value has reached the upper limit value. Thereby, the arm control part 431 can show an operator that the pressure value has reached the upper limit value via the input operation arm 520. For example, the master control unit 511 controls the operation driving unit 600 to vibrate the input operation arm 520. That is, the master control unit 511 presents that the pressure value has reached the upper limit value to the operator of the repellent element 10 (in this case, a force sense presentation). Similar to the arm 420, a force in the direction opposite to the operation direction may be generated in the input operation arm 520.

  Thereby, the operator of the repellent element 10 can operate the arm 420 without being aware of the upper limit value of the pressure value. The operator grasps that the pressure value has reached the upper limit when the input operation arm 520 vibrates or receives a reverse force (ie, repulsive force) from the input operation arm 520. Because it can. Thereby, in 3rd Embodiment, it can prevent more reliably that a pressure value exceeds an upper limit.

  Furthermore, when the pressure value given from the analysis unit 31 reaches the upper limit value, the master control unit 511 vibrates the input operation arm 520 regardless of whether the presentation instruction information is received from the arm control unit 431 or not. May be. Thereby, it can prevent more reliably that a pressure value exceeds an upper limit.

  The storage unit 512 stores information necessary for the operation of the master control device 510, such as a program. The master control device 510 can be configured by a processor such as a CPU (Central Processing Unit) and a DSP (Digital Signal Processor), or a microcomputer on which these processors are mounted. Then, when the processor executes signal processing and control processing according to a predetermined program, processing of the master control device 510 is executed.

  Note that the configuration of the master device 500 is not limited to the examples of FIGS. 13 and 14. The master device 500 may be any device that can operate the arm 420. For example, the master device 500 may have an operation lever. Further, the input operation arm 520 may not include the operation driving unit 600. In this case, the input operation arm 520 only needs to be able to output information related to its posture and perform some kind of driving (vibration or the like described above). That is, the joint portions 521a to 521d only need to have an encoder and some kind of driving device (for example, a driving device capable of vibration). In this case, the master control unit 511 outputs information regarding the posture of the input operation arm 520 to the arm control unit 431 as operation information.

(3-5. Usage example)
Next, the usage example of the exclusion apparatus 1 is demonstrated based on FIG. Also in this use example, the retraction device 1 is used for minimally invasive surgery as in the first embodiment. However, the operator of the repellent element 10 operates the repellent element 10 using the arm 420. The operator may directly operate the arm 420 by touching the arm 420 or may indirectly operate the arm 420 using the master device 500. Specifically, the operator of the retraction element 10 passes the trocar 60 (cylindrical member) through the skin 100 of the patient's abdomen. Thereby, an opening is formed in the skin 100. Next, the operator of the repellent element 10 moves the repellent element 10 to the vicinity of the trocar 60 by operating the arm 420. Next, the operator inserts the retraction element 10 through the trocar 60 into the patient's body.

  The operator of the retraction element 10 brings the exclusion part 13 into contact with the organ 110 to be excluded while referring to the captured image displayed on the display device 50. Thereafter, the operator of the retraction element 10 uses the retraction unit 13 to relieve the organ 110. On the other hand, the pressure sensor 20 detects the pressure that the exclusion unit 13 applies to the organ 110. Then, the pressure sensor 20 outputs an output value corresponding to the pressure value to the analysis device 30. The subsequent analysis unit 31 performs the same processing as in the second embodiment. For example, the analysis unit 31 displays the pressure value and the upper limit value on the display device 50. Further, the analysis unit 31 outputs the pressure value and the upper limit value to the arm control unit 431.

  Then, the arm control unit 431 drives the arm 420 in accordance with the operation of the repellent element 10 by the operator. As described above, this operation may be performed directly on the arm 420 or may be performed indirectly using the master device 500. When the master device 500 is used, the master device 500 outputs operation information to the arm control unit 431. On the other hand, the arm controller 431 monitors the output value given from the torque sensor of the joint 421d. When the output value from the torque sensor reaches the arm force upper limit value, the arm control unit 431 does not move the arm 420 in the same direction any more. Further, the arm control unit 431 outputs presentation instruction information to the master control unit 511. When the presentation instruction information is given, the master control unit 511 vibrates the input operation arm 520. Since the arm 420 may be directly operated, the arm control unit 431 may generate a repulsive force in the arm 420 as in the second embodiment. Therefore, the operator can operate the arm 420 without being aware of the upper limit value of the pressure value.

  According to the third embodiment, the arm control unit 431 controls the arm 420 based on the operation information given from the master control unit 511. Furthermore, the arm control unit 431 can present via the input operation arm 520 that the pressure value has reached the upper limit value. Thus, the operator can operate the arm 420 without being aware of the upper limit value of the pressure value. Further, the display device 50 displays the same content as in the first embodiment. Therefore, the operator can perform the exclusion more safely.

  The preferred embodiments of the present disclosure have been described in detail above with reference to the accompanying drawings, but the technical scope of the present disclosure is not limited to such examples. It is obvious that a person having ordinary knowledge in the technical field of the present disclosure can come up with various changes or modifications within the scope of the technical idea described in the claims. Of course, it is understood that it belongs to the technical scope of the present disclosure.

  Further, the effects described in the present specification are merely illustrative or exemplary and are not limited. That is, the technology according to the present disclosure can exhibit other effects that are apparent to those skilled in the art from the description of the present specification in addition to or instead of the above effects.

The following configurations also belong to the technical scope of the present disclosure.
(1)
An exclusion part that excludes human organs;
An exclusion device provided in the exclusion portion, and comprising a detection portion that detects a contact state between the exclusion portion and the organ of the human body.
(2)
The extruding element according to (1), wherein the detecting unit detects, as the contact state, a pressure that the excluding unit receives from the organ of the human body.
(3)
Extruder as described in (2) above,
An exclusion device, comprising: an analysis unit that analyzes an output value output by the detection unit.
(4)
The exclusion device according to (3), wherein the analysis unit performs control to present a pressure value obtained by the analysis.
(5)
The relieving device according to (4), wherein the analysis unit performs control to present an upper limit value of the pressure value.
(6)
The said analysis part is an exclusion apparatus of the said (5) description which performs control which compares and presents the said pressure value and the upper limit of the said pressure value.
(7)
The exclusion device according to any one of (4) to (6), wherein the analysis unit performs control to present a change in a pressure value obtained by the analysis.
(8)
The exclusion device according to (7), wherein the analysis unit performs control to present a change with time of the pressure value.
(9)
The said analysis part is an exclusion apparatus as described in said (7) or (8) which performs control which shows distribution of the said pressure value.
(10)
The exclusion apparatus according to any one of (3) to (9), further including a storage unit that stores a pressure value obtained by the analysis.
(11)
The exclusion apparatus according to any one of (3) to (10), further including an arm that holds the exclusion element.
(12)
The exclusion apparatus according to (11), further including a control unit that controls the arm based on a pressure value obtained by analysis by the analysis unit.
(13)
The exclusion device according to (12), wherein the control unit controls the arm so that the pressure value is equal to or less than an upper limit value of the pressure value.
(14)
When the pressure value reaches the upper limit value of the pressure value, the control unit presents, via the arm, that the pressure value has reached the upper limit value of the pressure value, (13) The described exclusion device.
(15)
The control device according to (13) or (14), wherein the control unit controls to stop the arm when the pressure value reaches an upper limit value of the pressure value.
(16)
The said control part is an exclusion apparatus of any one of said (12)-(15) which controls the said arm based on the operation information given from the input operation part.
(17)
When the pressure value reaches the upper limit value of the pressure value, the control unit presents, via the input operation unit, that the pressure value has reached the upper limit value of the pressure value. 16) The exclusion apparatus as described.
(18)
The exclusion device according to any one of (12) to (17), wherein the control unit controls the force of the arm.

DESCRIPTION OF SYMBOLS 1 Exclusion device 10 Exclusion element 13 Exclusion part 15 Exclusion piece 20 Pressure sensor 30 Analysis apparatus 31 Analysis part 32 Memory | storage part 50 Display apparatus 400 Arm apparatus 300 Drive part 420 Arm 430 Arm control apparatus 431 Arm control part 432 Storage part 500 Master apparatus 520 Input operation arm 510 Master control device 511 Master control unit 512 Storage unit 600 Operation drive unit

Claims (18)

An exclusion part that excludes human organs;
An exclusion device provided in the exclusion portion, and comprising a detection portion that detects a contact state between the exclusion portion and the organ of the human body.   The extruding element according to claim 1, wherein the detecting unit detects, as the contact state, a pressure that the excluding unit receives from the organ of the human body. Extruder according to claim 2,
An exclusion device, comprising: an analysis unit that analyzes an output value output by the detection unit.   The exclusion device according to claim 3, wherein the analysis unit performs control to present a pressure value obtained by the analysis.   The exclusion device according to claim 4, wherein the analysis unit performs control to present an upper limit value of the pressure value.   The exclusion device according to claim 5, wherein the analysis unit performs control to compare and present the pressure value and an upper limit value of the pressure value.   The exclusion device according to claim 4, wherein the analysis unit performs control to present a change in pressure value obtained by the analysis.   The exclusion device according to claim 7, wherein the analysis unit performs control to present a change with time of the pressure value.   The exclusion device according to claim 7, wherein the analysis unit performs control to present a distribution of the pressure value.   The exclusion apparatus according to claim 3, further comprising a storage unit that stores a pressure value obtained by the analysis.   The exclusion apparatus according to claim 3, further comprising an arm that holds the exclusion element.   The exclusion apparatus according to claim 11, further comprising a control unit that controls the arm based on a pressure value obtained by analysis by the analysis unit.   The exclusion device according to claim 12, wherein the control unit controls the arm so that the pressure value is equal to or less than an upper limit value of the pressure value.   The control unit presents, via the arm, that the pressure value has reached the upper limit value of the pressure value when the pressure value reaches the upper limit value of the pressure value. Exclusion device.   The exclusion device according to claim 13, wherein the control unit controls the arm to stop when the pressure value reaches an upper limit value of the pressure value.   The exclusion device according to claim 12, wherein the control unit controls the arm based on operation information given from an input operation unit.   The control unit presents, via the input operation unit, that the pressure value has reached the upper limit value of the pressure value when the pressure value has reached the upper limit value of the pressure value. 16. The exclusion device according to 16.   The exclusion device according to claim 12, wherein the control unit controls the force of the arm.

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