JP4472361B2 - Medical instrument holding device and medical instrument holding system. - Google Patents

Description

  The present invention relates to a medical instrument holding device and a medical instrument holding system for moving and fixing a medical instrument to a desired position with respect to an operation site.

  2. Description of the Related Art Conventionally, a method for treating a surgical site while adjusting the position of a medical instrument relative to the surgical site has been used. As an example of an apparatus for performing such a method, there is an endoscope holding apparatus disclosed in Patent Document 1 in the field of endoscopic surgery, for example.

  This endoscope holding device has a holding portion that holds an endoscope. This holding part is connected to the tip of the arm part. This arm part is formed by connecting a plurality of arms to each other via a joint part so as to be rotatable. The three-dimensional movement of the endoscope is possible by the relative rotation of the arms around the three rotation axes. Further, the endoscope can be tilted with three degrees of freedom by relative rotation of the arms around the other three rotation axes. The joint portion is provided with braking means for restricting the rotation of the arms connected to each other via the joint portion.

After holding the endoscope by the holding unit, the restriction by the braking means is released, and the holding unit is manually operated to move the endoscope to a desired position. Thereafter, the relative rotation of the arm is restricted by the braking means, and the endoscope is fixed at that position. In this way, the endoscope can be moved and fixed at a desired position.
JP 2001-258903 A

  In the surgical operation, various medical instruments are usually used in addition to the medical instruments held by the medical instrument holding device. In the field of neurosurgery, for example, a surgical microscope held by a medical instrument holding device, an endoscope connected to the medical instrument holding device, an energy treatment tool, and the like are used at the same time. In such a case, the periphery of the surgical site becomes complicated, and it is necessary to change the arrangement of the medical instrument holding device.

  Here, in the endoscope holding device of Patent Document 1, there are joint portions other than the joint portions related to the three-dimensional movement of the endoscope and the inclination with three degrees of freedom. With such a joint portion, it seems that it is theoretically possible to change the arrangement of the arm portion without changing the position of the endoscope. However, it is impossible to perform such an operation by a human manual operation, and the position of the endoscope always changes. For this reason, it is necessary to reset the position of the endoscope. Furthermore, when the endoscope is inserted into a narrow surgical site such as a hole provided in the head, etc., the endoscope is operated to prevent the surgical site from being damaged by the movement of the endoscope. After pulling out from the part and rearranging the arm part, the endoscope must be inserted into the surgical site again. Thus, the operation of the surgeon becomes complicated. As a result, the operation time is prolonged, and the operator's fatigue and the burden on the patient are increased.

  The present invention has been made paying attention to the above-mentioned problems, and the object of the present invention is to provide a medical instrument holding device and a medical instrument that can shorten the operation time and reduce the fatigue of the surgeon and the burden on the patient. It is to provide a retention system.

According to the first aspect of the present invention, there is provided a holding unit for holding a medical instrument having an observation optical system having an optical axis, an arm part for moving and fixing the holding part to a desired position, and an attitude of the optical axis of the medical instrument. Detection means for detecting the optical axis parameter shown , and drive control means for driving the arm unit to move the medical instrument in the optical axis direction while keeping the optical axis parameter constant. It is a medical instrument holding device.

According to a second aspect of the present invention, the medical instrument is an endoscope, the holding unit includes an imaging unit, the endoscope is attached to and detached from the imaging unit, and the endoscope is attached to the imaging unit. Provided with an optical axis that substantially coincides with the optical axis of the endoscope, and when the endoscope is mounted, the observation image obtained by the endoscope is imaged to observe inside the surgical site. The medical instrument holding device according to claim 1, wherein when the endoscope is detached, macro observation of the periphery of the surgical site is performed .

According to a third aspect of the present invention, the detection unit detects a focus parameter indicating a focus position of the imaging unit, and the drive control unit drives the arm unit to hold the focus parameter constant. The medical device holding apparatus according to claim 2, wherein the imaging unit is moved .
According to a fourth aspect of the present invention, the arrangement of the arm portion is changeable, the detection means detects a position and posture parameter indicating a position and posture of the medical instrument, and the drive control means includes the arm portion. The medical device holding device according to claim 1, wherein the position of the arm unit is changed while the position and posture parameters are held constant by driving the device.
According to a fifth aspect of the present invention, the arm portion is a plurality of arms, and the plurality of arms are provided with the holding portion provided at a tip arm of the plurality of arms, and the arms are relative to each other. A joint part that is connected to each other so as to be rotatable or rotatable, and an expansion / contraction part that is provided on at least one of the arms and that can expand and contract the arm, and the medical instrument holding device releases the arm part A switching operation unit for performing a switching operation between a state and a fixed state, and a drive operation unit for driving the arm unit, wherein the drive control means is provided in the joint unit, and It is possible to switch between a release state in which both the arms connected to each other via a joint portion can be rotated or rotated relatively and a fixed state in which the arms can be relatively rotated or rotated. The joint braking part and the joint part A joint drive unit capable of relatively rotating or rotating both the arms connected to each other via the joint unit, and an expansion / contraction operation of the arm provided in the expansion / contraction unit and provided with the expansion / contraction unit. According to an operation to the extendable drive unit and the switching operation unit, the joint braking unit is switched between a released state and a fixed state, and the arm unit is switched between a released state and a fixed state, and the driving operation is performed. According to the operation of the part, the joint drive part is driven to rotate or rotate both the arms relatively, and the telescopic drive part is driven to extend / contract the arm to keep the parameter constant. The medical device holding device according to claim 1, further comprising a control unit that drives the arm unit while driving the arm unit.
According to a sixth aspect of the present invention, the detection means is a rotation or rotation amount detection that detects a relative rotation or rotation amount of both the arms provided at the joint portion and connected to each other via the joint portion. An expansion / contraction amount detection unit that detects an expansion / contraction amount of the arm provided in the expansion / contraction unit, and the rotation or rotation amount detected by the rotation or rotation amount detection unit; A calculation unit that calculates the parameter based on the expansion / contraction amount detected by the expansion / contraction amount detection unit, and the control unit holds the parameter constant based on an operation to the drive operation unit. 6. The medical instrument holding device according to claim 5, wherein the amount of rotation or rotation that drives the arm portion and the amount of expansion / contraction are calculated.
According to a seventh aspect of the present invention, the medical instrument holding device further includes a counter balance portion, and the counter balance portion is connected to the arm portion so as to be movable with respect to the arm portion, and the arm. A weight driving unit that moves the counterweight with respect to the unit, and the control unit drives the weight driving unit to move the arm unit when the expansion / contraction unit is expanded / contracted. The medical instrument holding device according to claim 6, wherein the balance of the medical device holding device is maintained by moving the counterweight.
An invention of claim 8 is a medical instrument holding system comprising the medical instrument holding apparatus according to any one of claims 1 to 7 and the medical instrument.

  According to the present invention, it is possible to shorten the operation time and reduce the fatigue of the operator and the burden on the patient.

  Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of a medical instrument holding system 1 of the present embodiment. The medical instrument holding system 1 has a medical instrument holding device 2. The medical instrument holding device 2 has an installation unit 4 installed on a floor or the like. The lower end portion of the support column 6 is fixed to the upper surface of the installation portion 4. The column 6 extends in the vertical direction. The lower end portion of the first arm 10 is connected to the upper end portion of the column 6 via the first joint portion 8. The first arm 10 extends in the direction in which the column 6 extends. The first arm 10 is rotatable with respect to the support column 6 in the direction around the axis about its own central axis (hereinafter referred to as the first rotation axis O1).

  One end portion of the second arm 14 is connected to the upper end portion of the first arm 10 via the second joint portion 12. The second arm 14 is rotatable with respect to the first arm 10 about a second rotation axis O2 that passes through the second joint portion 12 and is perpendicular to the first rotation axis O1.

  One end of a third arm 18 is connected to the other end of the second arm 14 via a third joint 16. The third arm 18 extends in the direction in which the second arm 14 extends. Further, the third arm 18 is rotatable with respect to the second arm 14 about its own central axis (hereinafter referred to as a third rotation axis O3) in the direction around the axis. As will be described later, the third arm 18 is a telescopic arm that is telescopic.

  One end portion of the fourth arm 22 is connected to the other end portion of the third arm 18 via the fourth joint portion 20. The fourth arm 22 is rotatable with respect to the third arm 18 about a fourth rotation axis O4 that passes through the fourth joint portion 20 and is parallel to the second rotation axis O2.

  One end of a fifth arm 26 is connected to the other end of the fourth arm 22 via a fifth joint 24. The fifth arm 26 extends in the direction in which the fourth arm 22 extends. Further, the fifth arm 26 is rotatable about the center axis thereof (hereinafter referred to as a fifth rotation axis O5) with respect to the fourth arm 22 in the direction around the axis. As will be described later, the fifth arm 26 is a telescopic arm that is telescopic.

  One end of a sixth arm 30 is connected to the other end of the fifth arm 26 via a sixth joint 28. The sixth arm 30 is rotatable with respect to the fifth arm 26 about a sixth rotation axis O6 that passes through the sixth joint portion 28 and is perpendicular to the fifth rotation axis O5. In addition, one end portion of the seventh arm 34 is connected to the other end portion of the sixth arm 30 via the seventh joint portion 32. The seventh arm 34 is rotatable with respect to the sixth arm 30 about its own central axis (hereinafter referred to as the seventh rotation axis O7) in the direction around the axis. The seventh rotation axis O7 is perpendicular to the fifth and sixth rotation axes O6. Here, an arm portion 36 is formed by the support and the first to seventh arms 6, 10, 14, 18, 22, 26, 30, 34.

  At the other end portion of the seventh arm 34, a holding portion 40 that holds the rigid endoscope 38 is disposed. A holding hole 42 is formed in the holding portion 40, and a rigid endoscope 38 is detachably inserted into the holding hole 42. The holding unit 40 is provided with a free switch 44 that operates first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, and 106 described later.

  On the other hand, the support 6 is provided with an electrical system box 46 that houses the electrical system. A switch unit 48 for changing the arrangement of the arm unit 36 is connected to the electrical box 46. The switch unit 48 includes an X + switch 50, an X− switch 52, a Y + switch 54, and a Y− switch 56. These X + switch 50, X-switch 52, Y + switch 54, and Y-switch 56 change the arrangement of the arm portion 36 in the X + direction, the X-direction, the Y + direction, and the Y-direction, which will be described below. belongs to.

  Here, as shown in FIG. 1, the direction parallel to the first rotation axis O1 from the first joint portion 8 to the second joint portion 12 is defined as the Y + direction, and the opposite direction of the Y + direction is defined as Y. -Direction. A direction parallel to the second rotation axis O2 and forming the right hand system with the Y + direction is defined as an X + direction, and a direction opposite to the X + direction is defined as an X− direction. The coordinate system A formed by the Y + direction, the Y− direction, the X + direction, and the X− direction is rotated together with the first arm 10 by the rotation of the first arm 10 with respect to the column 6.

  With reference to FIG. 2, the structure of the 1st thru | or 7th joint part 8, 12, 16, 20, 24, 28, 32 is demonstrated. A first electromagnetic brake 58, a first encoder 60, a first motor 62, and a first electromagnetic clutch 64 are disposed in the first joint portion 8. The first electromagnetic brake 58 electrically restricts the rotation of the first arm 10 with respect to the column 6. Further, the first encoder 60 detects the amount of rotation of the first arm 10 relative to the column 6. The first motor 62 rotates the first arm 10 with respect to the column 6. Further, by operating / stopping the first electromagnetic clutch 64, the output of the first motor 62 is transmitted / interrupted to the first arm 10.

  The configurations of the second to seventh joint portions 12, 16, 20, 24, 28, and 32 are the same as the configuration of the first joint portion 8. That is, the second to seventh joint portions 12, 16, 20, 24, 28, and 32 are respectively connected to the second to seventh electromagnetic brakes 66, 74, 82, 90, 98, 106, and the second to seventh. Encoders 68, 76, 84, 92, 100, 108, second to seventh motors 70, 78, 86, 94, 102, 110, and second to seventh electromagnetic clutches 72, 80, 88, 96. , 104, 112.

  A detailed configuration of the third arm 18 will be described with reference to FIG. The third arm 18 has a first sub arm 114 connected to the third joint portion 16. A second sub arm 118 is connected to the other end of the first sub arm 114 via a first extendable portion 116.

  The first telescopic part 116 has an eighth motor 120 fixed to the first sub arm 114. The eighth motor 120 is provided with an eighth encoder 122 for detecting the amount of rotation of the eighth motor 120. A spur gear 126 is connected to the output shaft 124 of the eighth motor 120. The spur gear 126 is engaged with a gear portion 130 disposed at one end portion of the telescopic drive shaft 128. The telescopic drive shaft 128 extends in the longitudinal direction of the third arm 18 in the third arm 18. One end side of the telescopic drive shaft 128 is supported by the first sub-arm 114 so as to be rotatable about the center axis of the first sub-arm 114 around the axis.

  On the other hand, a feed gear 131 is formed on the other end side of the telescopic drive shaft 128 in the longitudinal direction of the telescopic drive shaft 128. The feed gear 131 is meshed with a receiving gear portion 132 extending in the longitudinal direction of the second sub arm 118 inside the second sub arm 118. Further, a rotation restricting portion 134 is disposed between the first sub arm 114 and the second sub arm 118. The rotation restricting portion 134 is for restricting the rotation of the second sub arm 118 relative to the first sub arm 114 in the direction around the axis about the center axis of the second sub arm 118.

  FIG. 4 shows a detailed configuration of the fifth arm 26. The configuration of the fifth arm 26 is the same as the configuration of the fourth arm 22. That is, the fifth arm 26 includes third and fourth sub-arms 136 and 138 and a second extendable part 140. The second expansion / contraction section 140 includes a ninth motor 142, a ninth encoder 144, an output shaft 146, a spur gear 148, an expansion / contraction drive shaft 150, a gear section 152, a delivery gear 154, a receiving gear section 156, and a rotation restriction section 158. Have

  FIG. 5 shows a schematic configuration of the entire control system of the medical instrument holding device 2. The control system of the medical instrument holding device 2 includes an arm control unit (control unit) 160 as a main control unit. A free switch 44, a switch unit 48, an electromagnetic brake drive unit 162, a calculation unit 164, a motor drive unit 166, and an electromagnetic clutch drive unit 168 are connected to the arm control unit 160. Further, the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 are connected to the electromagnetic brake driving unit 162. First to ninth encoders 60, 68, 76, 84, 92, 100, 108, 122, 144 are connected to the calculation unit 164. First to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142 are connected to the motor drive unit 166. First to seventh electromagnetic clutches 64, 72, 80, 88, 96, 104, and 112 are connected to the electromagnetic clutch drive unit 168.

  The free switch 44 is configured to output an ON / OFF signal to the arm control unit 160. The arm control unit 160 outputs a drive signal to the electromagnetic brake drive unit 162 when an ON signal is input by the free switch 44. The electromagnetic brake driving unit 162 operates the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, and 106 when a drive signal is input.

  The first to ninth encoders 60, 68, 76, 84, 92, 100, 108, 122, 144 output the detected rotation amount or rotation amount to the calculation unit 164. The calculation unit 164 is based on the amount of rotation or amount of rotation input from the first to ninth encoders 60, 68, 76, 84, 92, 100, 108, 122, 144, and the rigid endoscope 38 (see FIG. 1). , The same applies to the following).

  In other words, the calculation unit 164 records information on the shapes of the first to seventh arms 10, 14, 18, 22, 26, 30, and 34 (see FIG. 1, the same applies hereinafter). Further, the calculation unit 164 is based on the rotation amount or the rotation amount input from the first to seventh encoders 60, 68, 76, 84, 92, 100, 108, and the first to seventh joint portions 8, 12, 16, 20, 24, 28, 32 (see FIG. 1, hereinafter the same), the relative positions of the first to seventh arms 10, 14, 18, 22, 26, 30, 34 connected to each other The relationship is calculated. Then, based on the rotation amounts input from the eighth and ninth encoders 122 and 144, the calculation unit 164 calculates the expansion amounts of the first and second expansion and contraction units 116 and 140 (see FIG. 1, the same applies hereinafter). It comes to calculate. Furthermore, information regarding the relative positional relationship of the rigid endoscope 38 with respect to the holding unit 40 when the rigid endoscope 38 is held by the holding unit 40 (see FIG. 1, hereinafter the same) is recorded in the calculation unit 164. Yes.

  From the above information and calculation results, the calculation unit 164 calculates parameters regarding the position of the rigid endoscope 38. In this embodiment, a spatial position parameter indicating the spatial position of the rigid endoscope 38 and an attitude parameter indicating the attitude of the rigid endoscope 38 are used as such parameters. The calculation unit 164 outputs the calculated parameters to the arm control unit 160.

  Here, the first to ninth joint portions 8, 12, 16, 20, 24, 28, 32 are obtained by the first to ninth encoders 60, 68, 76, 84, 92, 100, 108, 122, 144. And the first to seventh arms 6, 10, 14, 18, 22, 26, 30, 34, and the first and second extendable portions 116, 140. An arrangement detector for detecting a relative arrangement between the first to fourth sub-arms 114, 118, 136, and 138 (see FIG. 1, the same applies hereinafter) connected to each other is formed. And the detection means which detects the parameter regarding the position of a medical instrument is formed by the arrangement | positioning detection part and the calculating part 164. FIG.

  The switch unit 48 outputs an operation signal to the arm control unit 160. The arm control unit 160 is configured to change the arrangement of the arm unit 36 and the first to seventh arms 6, 6 while maintaining the spatial position parameter and the posture parameter constant according to the input operation signal. The relative rotation amounts and rotation amounts of 10, 14, 18, 22, 26, 30, and 34, and the expansion and contraction amounts of the first and second extendable portions 116 and 140 are calculated. The arm control unit 160 then rotates the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142 so as to realize the calculated rotation amount, rotation amount, and expansion / contraction amount. And the rotation speed is calculated. Based on the calculated rotation direction and rotation speed of the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, the arm control unit 160 sends a drive signal to the motor driving unit 166. It is designed to output. The motor drive unit 166 operates the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142 based on the drive signal.

  The arm control unit 160 outputs a drive signal to the motor drive unit 166 and simultaneously outputs a drive signal to the electromagnetic clutch drive unit 168. As for this drive signal, the outputs of the first to seventh motors 62, 70, 78, 86, 94, 102, 110 are transmitted to the first to seventh arms 10, 14, 18, 22, 26, 30, 34. In this manner, the first to seventh electromagnetic clutches 64, 72, 80, 88, 96, 104, 112 are operated. Further, the arm control unit 160 outputs a drive signal to the electromagnetic brake drive unit 162 at the same time as outputting a drive signal to the motor drive unit 166 and the electromagnetic clutch drive unit 168. The first to seventh arms 10, 14, 18, 22, 26, 30 and 34 are relatively driven by the first to seventh motors 62, 70, 78, 86, 94, 102 and 110. The first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 are operated so as to be rotated or rotated.

  Here, the motor drive unit 166, the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, the electromagnetic clutch drive unit 168, and the first to seventh electromagnetic clutches 64 are provided. , 72, 80, 88, 96, 104, 112, relative rotation and rotation of the first to seventh arms 10, 14, 18, 22, 26, 30, 34 calculated by the arm control unit 160. And the drive part which implement | achieves the expansion-contraction of the 1st and 2nd expansion-contraction parts 116 and 140 is formed. The drive unit and the arm control unit 160 form drive control means for driving the arm unit 36 to change the arrangement of the arm unit 36 while keeping the parameters constant.

  The electromagnetic brake driving unit 162, the calculation unit 164, the arm control unit 160, the electromagnetic clutch driving unit 168, and the motor driving unit 166 described above are housed in the electrical system box 46 (see FIG. 1).

  Next, the operation of the medical instrument holding system 1 of the present embodiment having the above configuration will be described. When performing a surgical operation using the medical instrument holding device 2, first, the medical instrument holding device 2 is installed so that the surgical part falls within the movable range of the holding unit 40. Next, the rigid endoscope 38 is inserted into the holding hole 42, and the rigid endoscope 38 is held by the holding portion 40.

  Then, the holding unit 40 is held by the operator's hand, and the free switch 44 is turned on. As a result, the free switch 44 outputs an ON signal to the arm control unit 160, and the arm control unit 160 outputs a drive signal to the electromagnetic brake drive unit 162. And the electromagnetic brake drive part 162 operates the 1st thru | or 7th electromagnetic brake 58,66,74,82,90,98,106. As a result, the braking action of the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 is released.

  When the braking action of the first electromagnetic brake 58 is released, the first arm 10 can rotate about the first rotation axis O <b> 1 around the axis with respect to the support 6. In addition, when the braking action of the second electromagnetic brake 66 is released, the second arm 14 is rotatable with respect to the first arm 10 about the second rotation axis O2. When the braking action of the fourth electromagnetic brake 82 is released, the fourth arm 22 can rotate about the fourth rotation axis O4 with respect to the third arm 18. A combination of rotation or rotation about the first, second and fourth rotation axes O1, O2 and O4 enables the three-dimensional movement of the rigid mirror 38.

When the brake action of the fifth electromagnetic brake 90 is released, the fifth arm 26 can rotate about the fifth rotation axis O5 around the axis with respect to the fourth arm 22. When the brake action of the sixth electromagnetic brake 98 is released, the sixth arm 30 can rotate about the sixth rotation axis O6 with respect to the fifth arm 26. When the brake action of the seventh electromagnetic brake 106 is released, the seventh arm 34 can rotate about the seventh rotation axis O7 around the axis with respect to the sixth arm 30. The rigid mirror 38 can be tilted with three degrees of freedom by a combination of rotation or rotation with respect to the fifth to seventh rotation axes O5, O6, and O7.
Further, when the braking action of the third electromagnetic brake 74 is released, the third arm 18 can rotate around the third axis about the third rotation axis O3 with respect to the second arm 14.

  In this state, the rigid endoscope 38 is placed at a desired position with respect to the surgical site, and the free switch 44 is turned off. As a result, the braking action of the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 is activated, and the rigid endoscope 38 is fixed at that position. In this state, the surgical site is observed with the rigid endoscope 38. For example, the rigid endoscope 38 is inserted into a hole formed in the head, and the inside of the head is observed. During the observation of the surgical site, it may be necessary to change the arrangement of the arm portion 36 in order to perform a surgical operation smoothly. In this case, the arrangement of the arm portion 36 is changed as described below.

  In addition, the support | pillar and 1st thru | or 9th arm 6,10,14,18,22 regarding the 1st, 2nd, and 4th thru | or 7th rotating shaft O1, O2, O4, O5, O6, O7. The combination of the relative rotation or rotation of 26, 30, and 34 enables three-dimensional movement of the rigid endoscope 38 and inclination of three degrees of freedom. Further, the third arm 18 can rotate around the third rotation axis O3 with respect to the second arm 14 about the axis. For this reason, the arrangement of the arm portion 36 can be changed without changing the spatial position parameter and the posture parameter of the rigid endoscope 38.

  Hereinafter, a case where the arrangement of the arm portion 36 is changed in the Y + direction as indicated by an arrow C in FIG. 6 will be described. As indicated by a broken line in FIG. 6, in the initial state, the second to fifth arms 14, 18, 22, and 26 are arranged substantially linearly.

  When the arrangement of the arm portion 36 is changed in the Y + direction, the Y + switch 54 is operated. When the Y + switch 54 is operated, the calculation unit 164 calculates the spatial position parameter and the posture parameter and inputs them to the arm control unit 160. The spatial position parameter and the posture parameter are calculated as follows.

  The first to seventh encoders 60, 68, 76, 84, 92, 100, 108 are connected to each other via the first to seventh joint parts 8, 12, 16, 20, 24, 28, 32. The relative rotation amount and rotation amount of the supporting column and the first to seventh arms 6, 10, 14, 18, 22, 26, 30, 34 are detected. The eighth and ninth encoders 122 and 144 detect the rotation amounts of the eighth and ninth motors 120 and 142. Then, the first to ninth encoders 60, 68, 76, 84, 92, 100, 108, 122, 144 output the detected rotation amount or rotation amount to the calculation unit 164.

  The calculation unit 164 is based on the amount of rotation or the amount of rotation input from the first to seventh encoders 60, 68, 76, 84, 92, 100, 108, and the first to seventh joints 8, 12, 16, 20, 24, 28, 32 calculates the relative positional relationship between the struts connected to each other and the ends of the first to seventh arms 6, 10, 14, 18, 22, 26, 30, 34. To do. The computing unit 164 is connected to the first and second extendable units 116 and 140 based on the rotation amounts input from the eighth and ninth encoders 122 and 144. The relative positional relationship between the end portions of the sub arms 114 and 118 and the third and fourth sub arms 136 and 138 is calculated.

  Based on the above calculation results, information on the shapes of the first to seventh arms 10, 14, 18, 22, 26, 30, 34, and information on the relative positional relationship of the rigid endoscope 38 with respect to the holding unit 40, calculation is performed. The unit 164 calculates a spatial position parameter and a posture parameter.

  On the other hand, when the Y + switch 54 is operated, an operation signal is input to the arm controller 160. When an operation signal is input, the arm control unit 160 changes the arrangement of the arm unit 36 in the Y + direction while keeping the spatial position parameter and the posture parameter constant, The relative rotation amounts and rotation amounts of 14, 18, 22, 26, 30, and 34, and the extension amounts of the first and second extension portions 116 and 140 are calculated. Then, the arm control unit 160 rotates and rotates the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142 so as to realize the calculated rotation amount and expansion / contraction amount. Calculate speed. Furthermore, the arm control unit 160 controls the motor driving unit 166 based on the calculated rotation direction and rotation speed of the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142. A drive signal is output.

  At the same time, the arm control unit 160 outputs a drive signal for operating the first to seventh electromagnetic clutches 64, 72, 80, 88, 96, 104, 112 to the electromagnetic clutch drive unit 168. Further, the arm control unit 160 outputs a drive signal for operating the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 to the electromagnetic brake drive unit 162.

  As a result, the first to seventh electromagnetic clutches 64, 72, 80, 88, 96, 104, 112 are operated, and the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 is activated, and the first to seventh motors 62, 70, 78, 86, 94, 102, 110 are driven. As a result, the first to seventh arms 10, 14, 18, 22, 26, 30, 34 are relatively rotated or rotated, and the first and second extendable portions 116, 140 are expanded / contracted. In this way, the arrangement of the arm portion 36 is changed in the Y + direction.

The expansion / contraction operation of the first expansion / contraction part 116 will be described more specifically. When the eighth motor 120 is rotated, the spur gear 126 is rotated, and the gear portion 130 of the telescopic drive shaft 128 is rotated. As a result, the telescopic drive shaft 128 is rotated in the direction around its own axis, and the feed gear 131 is rotated. The rotation restricting portion 134 restricts the rotation of the second sub arm 118 relative to the first sub arm 114, so that the second sub arm 118 approaches or is separated from the first sub arm 114 by the feed gear 131. Thus, the 1st expansion-contraction part 116 is expanded-contracted. The expansion / contraction operation of the second expansion / contraction part 140 is the same.
When the arm portion 36 has a desired arrangement, the Y + switch 54 is turned OFF. As a result, the first to ninth motors 62, 70, 78, 86, 94, 102, 110, 120, 142 are stopped. Also, the first to seventh electromagnetic clutches 64, 72, 80, 88, 96, 104, 112 are stopped, and the first to seventh electromagnetic brakes 58, 66, 74, 82, 90, 98, 106 are stopped. Is stopped. As a result, the change in the arrangement of the arm portion 36 is stopped. Finally, the arrangement of the arm portion 36 is changed in the Y + direction as shown by a solid line in FIG.

  It is also possible to operate the X + switch 50 or the X− switch 52 and the Y + switch 54 or the Y− switch 56 at the same time. FIG. 7 shows a case where the X-switch 52 and the Y-switch 56 are operated simultaneously to change the arrangement of the arm portion 36 in the X-direction and the Y-direction. The arrangement of the arm part 36 indicated by a broken line in FIG. 7 corresponds to the arrangement of the arm part 36 indicated by a solid line in FIG. From this state, as indicated by an arrow D in FIG. 7, the arrangement of the arm portion 36 is changed in the X-direction and the Y-direction. The arrangement changed in this way is the arrangement of the arm portion 36 indicated by a solid line in FIG.

  Therefore, the above configuration has the following effects. In the arm portion 36, in addition to the degree of freedom enabling the three-dimensional movement of the rigid endoscope 38 and the inclination of three degrees of freedom, the third arm 18 has a third rotational axis O3 with respect to the second arm 14. It can be rotated around the axis around the center. Further, the arm control unit 160 changes the arrangement of the arm unit 36 while keeping the spatial position parameter and the posture parameter constant, and the first to seventh motors 62, 70, 78, 86, 94, 102, The rotation direction and rotation speed of 110 are calculated. The first to seventh motors 62, 70, 78, 86, 94, 102, 110 are driven at the calculated rotation direction and rotation speed, and the first to seventh arms 10, 14, 18, 22, 26, 30, and 34 are relatively rotated or rotated. For this reason, it is possible to change the arrangement of the arm portion 36 while keeping the spatial position parameter and the posture parameter constant, which is impossible by manual operation. Therefore, it is possible to perform the operation efficiently, shortening the operation time, and reducing the operator's fatigue and the burden on the patient.

  The arm portion 36 includes first and second extendable portions 116 and 140. These first and second extendable portions 116 and 140 are expanded and contracted when the arrangement of the arm portion 36 is changed. For this reason, the freedom degree of arrangement | positioning of the arm part 36 is large.

  Note that the medical instrument holding device 2 of the present embodiment may be provided with a buzzer that emits a warning sound or a lamp that is lit when the arrangement of the arm portion 36 cannot be changed. The case where the arrangement of the arm portion 36 cannot be changed means that the first to seventh arms 10, 14, 18 in the first to seventh joint portions 8, 12, 16, 20, 24, 28, 32 are used. , 22, 26, 30, 34 when the relative rotation or rotation reaches the limit of rotation or rotation, or when the first and second expansion / contraction portions 116, 140 reach the expansion / contraction limit, etc. It is. By providing such a buzzer or lamp, the operability of the medical instrument holding device 2 is improved.

  8 to 11 show a second embodiment of the present invention. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. The medical instrument holding system 169 of this embodiment differs from the medical instrument holding system 1 of the first embodiment only in the following configuration.

  The first arm 172 of the medical instrument holding device 170 has a configuration that can be expanded and contracted similarly to the third arm 18. That is, as shown in FIG. 9, the first arm 172 includes a fifth sub arm 174, a sixth sub arm 176, and a third expansion / contraction part 178. The third expansion / contraction part 178 includes a tenth motor 180, a tenth encoder 182, an output shaft 184, a spur gear 186, an expansion / contraction drive shaft 188, a gear part 190, a sending gear 192, a receiving gear part 194, and a rotation restricting part 196. Have

  FIG. 10 shows a schematic configuration of the entire control system of the medical instrument holding device 170. A tenth encoder 182 is connected to the arithmetic unit 198. A tenth motor 180 is connected to the motor drive unit 166.

  The tenth encoder 182 is configured to output the detected rotation amount to the calculation unit 198. The calculation unit 198 records information on the shapes of the fifth and sixth sub arms 174 and 176. Further, the arithmetic unit 198 is based on the rotation amount input from the tenth encoder 182, and the fifth and sixth sub arms 174 and 176 (which are connected to each other in the third expansion / contraction unit 178 (see FIG. 9)). The relative positional relationship of FIG. 9) is calculated. In addition to the information and calculation results shown in the first embodiment, the calculation unit 198 calculates a spatial position parameter and a posture parameter based on the above information and calculation results.

  The arm control unit 160 controls the first to seventh arms 172, 14, 18, 22, 26, 30, 34 to change the arrangement of the arm unit 36 while keeping the spatial position parameter and the posture parameter constant. The relative rotation amount and rotation amount, and the expansion / contraction amounts of the first to third expansion / contraction portions 116, 140, 178 are calculated. In addition, the arm control unit 160 includes the first to tenth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, 180 that realize the calculated rotation amount, rotation amount, and expansion / contraction amount. The rotation direction and rotation speed are calculated. Then, the arm control unit 160 determines the motor driving unit based on the calculated rotation direction and rotation speed of the first to tenth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, 180. A drive signal is output to 166. The motor drive unit 166 operates the first to tenth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, 180 based on the drive signal.

  Next, the operation of the medical instrument holding system 169 of the present embodiment having the above configuration will be described. The operation of the medical device holding system 169 of the present embodiment is basically the same as the operation of the medical device holding system 1 of the first embodiment. As shown by the arrow E in FIG. 11, when the switch unit 48 is operated to change the arrangement of the arm unit 36 without changing the spatial position parameter and posture parameter of the rigid endoscope 38, the first to first In addition to the relative rotation and rotation of the seven arms 172, 14, 18, 22, 26, 30, and 34, and the expansion and contraction of the first and second expansion / contraction portions 116 and 140, the third expansion / contraction portion 178 The expansion and contraction of is performed. The expansion / contraction operation of the third expansion / contraction part 178 is the same as the expansion / contraction operation of the first expansion / contraction part 116.

  Therefore, the above configuration has the following effects in addition to the effects of the first embodiment. The arm part 36 is obtained by adding a third extendable part 178 to the arm part 36 of the medical instrument holding device 170 of the first embodiment. The third expansion / contraction part 178 is expanded / contracted when the arrangement of the arm part 36 is changed. For this reason, the freedom degree of arrangement | positioning of the arm part 36 is further enlarged.

  12 to 15 show a third embodiment of the present invention. The same components as those in the second embodiment are denoted by the same reference numerals and description thereof is omitted. As shown in FIG. 12, the holding unit 40 of the medical device holding apparatus 200 of the medical device holding system 199 of this embodiment is integrally provided with an imaging unit (observation optical system) 202 for performing macro observation. ing. A rigid mirror (observation optical system) 38 is detachably attached to the imaging unit 202. The switch unit 204 is provided with an R + switch 206 and an R− switch 208 that change the arrangement of the arm unit 36.

  Detailed configurations of the rigid endoscope 38 and the imaging unit 202 will be described with reference to FIG. A connecting portion 210 is disposed at the proximal end portion of the rigid endoscope 38. The connecting portion 210 is detachably attached to the distal end portion of the imaging unit 202. The imaging unit 202 is provided with a detection switch (not shown) that is turned on when the rigid endoscope 38 is connected.

  An objective lens 212 is disposed at the distal end of the rigid endoscope 38. A relay lens group 214 is disposed behind the objective lens 212. The imaging unit 202 is provided with an imaging lens 216 and a CCD 218. The imaging lens 216 forms an observation image on the CCD 218. The direction of the optical axis of the rigid endoscope 38 attached to the imaging unit 202 and the direction of the optical axis of the imaging unit 202 are the same. The imaging unit 202 is connected to an image display device (not shown).

  Referring to FIG. 12 again, in the medical instrument holding device 200 according to the present embodiment, the positions of the optical axes of the rigid endoscope 38 and the imaging unit 202 are shown as parameters relating to the position of the medical instrument, in addition to the spatial position parameter and the posture parameter. The optical axis parameter and the focus parameter indicating the focal position of the imaging unit 202 are used.

  When the rigid endoscope 38 is connected to the imaging unit 202 and the detection switch is turned ON, and the X + switch 50, the X− switch 52, the Y + switch 54, or the Y− switch 56 is operated, The calculation unit and the arm control unit select a spatial position parameter and a posture parameter as parameters. Then, the arm control unit moves the arrangement of the arm unit 36 in the X + direction, the X− direction, the Y + direction, or the Y− direction while keeping the spatial position parameter and the posture parameter constant as in the second embodiment. The rotational directions and rotational speeds of the first to tenth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, and 180 are calculated.

  When the rigid endoscope 38 is connected to the imaging unit 202 and the detection switch is turned on, and the R + switch 206 or the R− switch 208 is operated, the calculation unit and the arm control unit use the light as a parameter. Axis parameters are selected. Then, the arm control unit moves the imaging unit 202 while keeping the optical axis parameter constant. The first to tenth motors 62, 70, 78, 86, 94, 102, 110, 120, 142, 180 rotation directions and rotation speeds are calculated.

  The rigid endoscope 38 is not connected to the imaging unit 202, the detection switch is turned off, and the X + switch 50, the X− switch 52, the Y + switch 54, or the Y− switch 56 is operated. In some cases, the calculation unit and the arm control unit select a focus parameter as a parameter. The arm control unit moves the imaging unit 202 in the X + direction, the X− direction, the Y + direction, or the Y− direction while keeping the focus parameter constant. , 78, 86, 94, 102, 110, 120, 142, 180 are calculated.

  Next, the operation of the medical device holding system 199 of the present embodiment having the above configuration will be described. First, the rigid endoscope 38 is attached to the imaging unit 202. As a result, the detection switch is turned on. In this state, as in the second embodiment, the rigid endoscope 38 is inserted into the surgical site such as the head. The objective lens 212 of the rigid endoscope 38 is disposed at a position facing the observation target. A light beam from the observation target enters the objective lens 212 and enters the imaging lens 216 via the relay lens group 214. Then, the light beam from the observation target is imaged on the CCD 218 by the imaging lens 216. An image picked up by the CCD 218 is displayed on an image display device.

  To change the arrangement of the arm portion 36, the X + switch 50, the X-switch 52, the Y + switch 54, or the Y-switch 56 is operated. As a result, the calculation unit and the arm control unit select the spatial position parameter and the posture parameter as parameters. As in the second embodiment, the arrangement of the arm portion 36 is changed in the X + direction, the X− direction, the Y + direction, or the Y− direction while keeping the spatial position parameter and the posture parameter constant.

  Assume that the arm portion 36 is arranged as indicated by a broken line in FIG. When the R-switch 208 is turned on, the calculation unit and the arm control unit select the optical axis parameter as a parameter. Then, the arrangement of the arm portion 36 is changed, and the rigid endoscope 38 and the imaging unit 202 are moved in the direction from the rigid endoscope 38 toward the imaging unit 202 without changing the arrangement of the optical axis, as indicated by the arrow F. The When the R-switch 208 is turned OFF, the change in the arrangement of the arm portion 36 is stopped, and the movement of the rigid endoscope 38 and the imaging unit 202 is stopped.

  Thereafter, the rigid endoscope 38 is removed from the imaging unit 202. The imaging unit 202 remains oriented in the direction of the surgical site. The arrangement of the arm portion 36 at this time is shown by a solid line in FIG. In this state, the imaging unit 202 performs macro observation around the surgical site.

  When performing observation with the rigid endoscope 38 again, the rigid endoscope 38 is attached to the imaging unit 202. Then, the R + switch 206 is turned on. As a result, the arrangement of the arm portion 36 is changed, and the rigid endoscope 38 and the imaging unit 202 are moved in the direction from the imaging unit 202 toward the rigid endoscope 38 without changing the arrangement of the optical axes. Then, the rigid endoscope 38 is inserted into the surgical site.

  On the other hand, when the imaging unit 202 performs macro observation around the surgical site, there are cases where it is desired to change the direction of macro observation by the imaging unit 202. In such a case, the X + switch 50, the X− switch 52, the Y + switch 54, or the Y− switch 56 is operated. As a result, the calculation unit and the arm control unit select a focus parameter as a parameter. Then, the arrangement of the arm unit 36 is changed, and the imaging unit 202 is moved in the X + direction, the X− direction, the Y + direction, or the Y− direction without changing the focal position. For example, when the arm part 36 is arranged as shown by a broken line in FIG. 15, when the Y + switch 54 is operated, the arm part 36 is arranged as shown by a solid line in FIG. Changed.

  Therefore, the above configuration has the following effects in addition to the effects of the first embodiment. The rigid endoscope 38 is detachably attached to an imaging unit 202 that can perform macro observation. Here, the direction of the optical axis of the rigid endoscope 38 attached to the imaging unit 202 matches the direction of the optical axis of the imaging unit 202. Further, by operating the switch unit 204, the rigid endoscope 38 and the imaging unit 202 are moved closer to or away from the operation site without changing the arrangement of the optical axes. For this reason, it is possible to switch between the arrangement of the arm unit 36 for performing observation with the rigid endoscope 38 and the arrangement of the arm unit 36 for performing macro observation with the imaging unit 202 by a one-touch operation by the switch unit 204. Yes. Further, when switching between observation with the rigid endoscope 38 and macro observation with the imaging unit 202, it is not necessary to adjust the observation direction of the macro observation of the imaging unit 202. Therefore, the operation time can be shortened.

  16 to 24 show a fourth embodiment of the present invention. FIG. 16 is a diagram showing an overall schematic configuration of the medical instrument holding system 223 of the present embodiment. The medical instrument holding system 223 includes a medical instrument holding device 224. An installation table 228 detachably attached to a side rail 226 attached to the operating table is disposed at the proximal end of the medical instrument holding device 224. The installation base 228 is slidable with respect to the side rail 226 when being attached to the side rail 226. The installation base 228 can be fastened and fixed to the side rail 226 by a fixing screw (not shown).

  A support base 230 protrudes from the side of the installation base 228. The lower end of the first arm 234 is connected to the other end of the support base 230 via the first joint 232. The first arm 234 has a crank shape and is formed of a horizontal portion extending horizontally from the first joint portion 232 and a vertical portion extending vertically upward from the other end of the horizontal portion. Further, the first arm 234 can be eccentrically rotated with respect to the support base 230 around the first rotation axis O <b> 1 extending in the vertical direction through the first joint portion 232.

  A central portion of the second arm 238 is connected to an upper end portion of the first arm 234 via a second joint portion 236. The second arm 238 is rotatable with respect to the first arm 234 about a second rotation axis O2 that passes through the second joint portion 236 and is perpendicular to the first rotation axis O1. The second arm 238 is a substantially cylindrical member.

  The third arm 240 is inserted through the second arm 238. The third arm 240 is connected to the second arm 238 via a third joint portion 241 (see FIG. 18). Further, the third arm 240 is rotatable about the center axis thereof (hereinafter, referred to as a third rotation axis O3) with respect to the second arm 238 in the direction around the axis.

  The third arm 240 forms a parallelogram-shaped link mechanism together with the fourth to sixth arms 242, 244 and 246. That is, one end portion of the third arm 240 is pivotally supported by one end portion of the fifth arm 244, and the other end portion of the third arm 240 is pivotally supported by one end portion of the sixth arm 246. ing. One end of the fourth arm 242 is pivotally supported by the other end of the fifth arm 244, and the other end of the fourth arm 242 is pivoted by the other end of the sixth arm 246. It is supported. The third arm 240 and the fourth arm 242 are arranged in parallel, and the fifth arm 244 and the sixth arm 246 are arranged in parallel. The third to sixth arms 240, 242, 244, and 246 always maintain a parallelogram shape.

  Here, the third arm 240 is connected to the fifth arm 244 via the fourth joint portion 248. The fifth arm 244 is rotatable with respect to the third arm 240 about a fourth rotation axis O4 that passes through the fourth joint portion 248 and is perpendicular to the third rotation axis O3.

  A seventh arm 252 is connected to an end portion of the fifth arm 244 on the side of the pivotal support portion of the third arm 240 via a fifth joint portion 250. The base end side of the seventh arm 252 extends so as to extend the fifth arm 244. In addition, the base end side of the seventh arm 252 can rotate about the center axis of the seventh arm 244 (hereinafter referred to as a fifth rotation axis O5) about the axis. The seventh arm 252 has a crank shape, and the distal end side of the seventh arm 252 is rotated with respect to the fifth rotation axis O5.

  One end portion of the eighth arm 256 is connected to the other end portion of the seventh arm 252 via the sixth joint portion 254, and the other end portion of the eighth arm 256 is connected to the seventh arm portion 252. A ninth arm 260 is connected through the joint portion 258. A holding unit 40 is disposed on the ninth arm 260. The configurations of the eighth arm 256, the ninth arm 260, and the holding unit 40 are the same as the configurations of the sixth arm 30, the seventh arm 34, and the holding unit 40 of the first embodiment. Further, the holding unit 40 includes a holding hole 42 and a free switch 44 having the same configuration as the holding hole 42 and the free switch 44 of the first embodiment. Here, an arm portion 262 is formed by the first to ninth arms 234, 238, 240, 242, 244, 246, 252, 256, 260.

  A screw shaft 264 extends from the sixth arm 246 toward the pivot of the fourth arm 242 from the pivot of the third arm 240. A counterweight 266 is screwed onto the screw shaft 264. The counterweight 266 can move in the axial direction of the screw shaft 264. The counterweight 266 is an equilibrium weight for canceling the rotational moment around the fourth rotation axis O4 due to the weight of the holding unit 40 and the rigid endoscope 38 and maintaining an equilibrium state. The positions and weights of the first to ninth arms 234, 238, 240, 242, 244, 246, 252, 256, 260 and the counterweight 266 are around the first to seventh rotation axes O1,. Are distributed so that their rotational moments are offset.

  On the other hand, the installation base 228 houses an electrical system. A switch unit 263 having the same configuration as that of the first embodiment for changing the arrangement of the arm unit 262 is connected to the installation base 228. Here, a direction parallel to the first rotation axis O1 and going from the first joint portion 232 side to the second joint portion 236 side is defined as a Y + direction, and a direction opposite to the Y + direction is defined as a Y− direction. A direction parallel to the second rotation axis O2 and forming the right hand system with the Y + direction is defined as an X + direction, and a direction opposite to the X + direction is defined as an X− direction. The coordinate system B formed by the Y + direction, the Y− direction, the X + direction, and the X− direction is rotated together with the first arm 234 by the rotation of the first arm 234 with respect to the support base 230.

  The configuration of the first to seventh joint portions 232, 236, 241, 248, 250, 254, and 258 will be described with reference to FIG. In the first joint portion 232, a first electromagnetic brake 268, a first encoder 270, a first motor 272, and a first electromagnetic clutch 274 are disposed. The first electromagnetic brake 268 electrically restricts the rotation of the first arm 234 with respect to the support base 230. Further, the first encoder 270 detects the amount of rotation of the first arm 234 relative to the support base 230. The first motor 272 rotates the first arm 234 with respect to the support base 230. Further, by operating / stopping the first electromagnetic clutch 274, the output of the first motor 272 is transmitted / cut off to the first arm 234.

  The configurations of the second to seventh joint portions 236, 241, 248, 250, 254, and 258 are the same as the configuration of the first joint portion 232. That is, the second to seventh joint portions 236, 241, 248, 250, 254, and 258 are respectively connected to the second to seventh electromagnetic brakes 276, 284, 292, 300, 308, 316, and the second to seventh. Encoders 278, 286, 294, 302, 310, 318, second to seventh motors 280, 288, 296, 304, 312, 320, and second to seventh electromagnetic clutches 282, 290, 298, 306. , 314, 322.

  The configuration of the second and third arms 238 and 240 will be described in detail with reference to FIGS. 18 and 19. As shown in FIG. 18, the second joint 241 is disposed on the second arm 238. With the third joint portion 241, the third arm 240 is rotatable about the third rotation axis O <b> 3 about the third rotation axis O <b> 3 with respect to the second arm 238, and with respect to the second arm 238. The third arm 238 is connected to the second arm 238 so as not to slide in the axial direction of the third rotating shaft O3.

  The third arm 240 has a first sub-arm 324 connected to the second arm 238. One end portion of the first sub arm 324 is connected to one end portion of the second sub arm 328 via the first extendable portion 326, and the other end portion of the second sub arm 328 is connected to the fifth arm 244. It is connected to the. On the other hand, the other end portion of the first sub arm 324 is connected to one end portion of the third sub arm 332 via the second telescopic portion 330, and the other end portion of the third sub arm 332 is connected to the sixth sub arm 332. It is connected to the arm 246.

  As shown in FIG. 19, the first telescopic portion 326 has an eighth motor 334. The eighth motor 334 is fixed inside the first sub arm 324. The eighth motor 334 is provided with an eighth encoder 335. A spur gear 338 is connected to the output shaft 336 of the eighth motor 334. The spur gear 338 is meshed with a gear portion 342 disposed at an intermediate portion of the telescopic drive shaft 340. The telescopic drive shaft 340 extends in the longitudinal direction of the third arm 240. An intermediate portion of the telescopic drive shaft 340 is supported inside the first sub arm 324 so as to be rotatable about the axis of the first sub arm 324 about its own axis.

  On the other hand, first and second feed gears 344 and 346 are formed on both ends of the telescopic drive shaft 340 in the longitudinal direction of the telescopic drive shaft 340, respectively. The first and second feed gears 344 and 346 extend in the longitudinal direction of the second and third sub arms 328 and 332 inside the second and third sub arms 328 and 332, respectively. The first and second receiving gear portions 348 and 350 are engaged with each other.

  The first and second feed gears 344 and 346 and the first and second receiving gear portions 348 and 350 are the third arms by the fourth to sixth arms 242, 244 and 246 (see FIG. 16). When the telescopic drive shaft 340 is rotated to one side with respect to the first sub arm 324 due to the restriction of both ends of 240, the first and second telescopic portions 326 and 330 are extended by the same distance and rotated to the other. In this case, the first and second stretchable portions 326 and 330 are formed to be shrunk by the same distance.

  As shown in FIG. 20, the fourth arm 242 has basically the same configuration as the third arm 240 of the first embodiment. That is, the fourth arm 242 includes fourth and fifth sub-arms 352 and 354 and a third extendable part 356. The third expansion / contraction part 356 includes a ninth motor 358, a ninth encoder 360, an output shaft 362, a spur gear 364, an expansion / contraction drive shaft 366, a gear part 368, a feed gear 370, and a receiving gear part 372. However, since both ends of the fourth arm 242 are restricted by the third, fifth, and sixth arms 240, 244, and 246 (see FIG. 16), the third sub-arm 352 and the fourth sub-arm 354 In the meantime, the rotation restricting portion 134 is not disposed.

  As shown in FIG. 21, the seventh arm 252 has the same configuration as the fifth arm 244 of the first embodiment. That is, the seventh arm 252 includes sixth and seventh sub-arms 374 and 376 and a fourth extendable portion 378. The sixth sub arm 374 has a crank shape. The fourth expansion / contraction part 378 includes a tenth motor 380, a tenth encoder 382, an output shaft 384, a spur gear 386, an expansion / contraction drive shaft 388, a gear part 390, a feed gear 392, a receiving gear part 394, and a rotation restriction part 396. Have

  The configuration of the counter balance unit 398 disposed on the sixth arm 246 will be described with reference to FIG. The counter balance unit 398 includes an eleventh motor 400 disposed inside the sixth arm 246. An eleventh encoder 402 that detects the amount of rotation of the eleventh motor 400 is disposed in the eleventh motor 400. A spur gear 404 is connected to an output shaft (not shown) of the eleventh motor 400. The spur gear 404 is meshed with a gear 406 formed on one end side of the screw shaft 264. The screw shaft 264 extends within the sixth arm 246 in the longitudinal direction of the sixth arm 246. One end side of the screw shaft 264 is slidably supported by the sixth arm 246 in the sixth arm 246. On the other hand, the other end side of the screw shaft 264 protrudes from the sixth arm 246. On the other end side of the screw shaft 264, a screw portion 408 is formed. A counterweight 266 is screwed onto the screw portion 408.

  FIG. 23 shows an overall schematic configuration of a control system of the medical instrument holding device 224 of the present embodiment. The medical instrument holding device 224 includes a calculation unit 410, an arm control unit 412, a motor drive unit 414, an electromagnetic brake drive unit 416, and an electromagnetic clutch drive unit 418. These have the following functions in addition to the functions of the calculation unit 164, arm control unit 160, motor drive unit 166, electromagnetic brake drive unit 162, and electromagnetic clutch drive unit 168 (see FIG. 5) of the first embodiment. .

  Similar to the first embodiment, the arm control unit 412 calculates a change in the arrangement of the arm unit 262 so as to keep the spatial position parameter and the posture parameter constant. At this time, the arm controller 412 includes the first to third extendable parts 326 and 330 so that the third to sixth arms 240, 242, 244 and 246 (see FIG. 16) maintain a parallelogram shape. 356 (see FIG. 16) is calculated. That is, the expansion / contraction amount of the third expansion / contraction part 356 is calculated from the expansion / contraction amount of the first expansion / contraction part 326 and the total expansion / contraction amount of the second expansion / contraction part 330.

  On the other hand, the eleventh encoder 402 outputs the detected amount of rotation of the eleventh motor 400 to the calculation unit 410. The calculation unit 410 calculates the relative positional relationship of the counterweight 266 with respect to the sixth arm 246 based on the input rotation amount. Then, the calculation unit 410 outputs the calculated positional relationship to the arm control unit 412.

  The arm control unit 412 calculates the relative arrangement of the counterweight 266 with respect to the sixth arm 246 so as to maintain the equilibrium state of the medical device holding device 224 when the arrangement of the arm unit 262 is changed. It has become. Further, the arm control unit 412 calculates the rotation amount and rotation speed of the eleventh motor 400 so as to realize the calculated relative positional relationship, and outputs a drive signal to the motor drive unit 414. Yes. The motor drive unit 414 drives the eleventh motor 400 based on the input drive signal. That is, the counter balance unit 398 (see FIG. 22) and the arm control unit 412 form counter balance means for maintaining the overall balance of the medical instrument holding device 224.

  Next, the operation of the medical instrument holding system 223 of the present embodiment having the above configuration will be described. First, the medical instrument holding device 224 is attached to the side rail 226 of the operating table. That is, the installation base 228 is engaged with the side rail 226 and disposed at a position appropriate for the surgical operation. Then, a fixing screw (not shown) is tightened to fix the installation base 228 to the side rail 226.

  Next, the rigid endoscope 38 is inserted into the holding hole 42, and the rigid endoscope 38 is held by the holding portion 40. And the holding | maintenance part 40 is hold | maintained by an operator's hand and a free switch is turned ON. As a result, the braking action of the first to seventh electromagnetic brakes 268, 276, 284, 292, 300, 308, 316 is released.

  When the braking action of the first electromagnetic brake 268 is released, the first arm 234 can rotate about the first rotation axis O1 with respect to the support base 230. In addition, when the braking action of the second electromagnetic brake 276 is released, the second arm 238 can rotate about the second rotation axis O2 with respect to the first arm 234. When the brake action of the fourth electromagnetic brake 292 is released, the fifth arm 244 can rotate about the fourth rotation axis O4 with respect to the third arm 240. That is, the parallelogram shape formed by the third to sixth arms 240, 242, 244, and 246 can be deformed. The combination of the rotation about the first and second rotation axes O1 and O2 and the deformation of the parallelogram shape enables the three-dimensional movement of the rigid mirror 38.

  As in the first embodiment, when the braking action of the fifth to seventh electromagnetic brakes 300, 308, 316 is released, the relative rotation or rotation of the seventh to ninth arms 252, 256, 260 is performed. With the combination, the rigid endoscope 38 can be tilted with three degrees of freedom. Further, when the braking action of the third electromagnetic brake 284 is released, the third arm 240 can rotate around the third axis about the third rotation axis O3 with respect to the second arm 238.

  In this state, the rigid endoscope 38 is placed at a desired position with respect to the surgical site. At this time, the first to ninth rotating shafts O1,... According to the weight of the first to ninth arms 234, 238, 240, 242, 244, 246, 252, 256, 260, the holding unit 40, the rigid endoscope 38,. The rotational moment around O7 is canceled by the counterweight 266, and the equilibrium state of the medical instrument holding device 224 is maintained.

  After placing the rigid endoscope 38, the free switch 44 is turned off. As a result, the braking action of the first to seventh electromagnetic brakes 268, 276, 284, 292, 300, 308, 316 is activated. As a result, the rigid endoscope 38 is fixed at that position. In this state, the surgical site is observed with the rigid endoscope 38. During the observation of the surgical part, the arrangement of the arm part 262 is changed as necessary as described below.

  The support base 230 and the first to ninth arms 234, 238, 240, 242, and 244 related to the first, second, and fourth to seventh rotation axes O1, O2, O4,. A combination of relative rotation or rotation of 246, 252, 256, and 260 enables three-dimensional movement of the rigid endoscope 38 and inclination with three degrees of freedom. Further, the third arm 240 can rotate about the third rotation axis O3 around the axis with respect to the second arm 238. For this reason, it is possible to change the arrangement of the arm portion 262 without changing the spatial position parameter and the posture parameter of the rigid endoscope 38.

  Hereinafter, a case where the arrangement of the arm part 262 is changed in the Y + direction will be described. As indicated by broken lines in FIG. 24, in the initial state, the second to ninth arms 238, 240, 242, 244, 246, 252, 256, and 260 are arranged substantially linearly as a whole. When the arrangement of the arm portion 262 is changed in the Y + direction, the Y + switch 54 is operated. The action of the arm part 262 at this time is basically the same as the action of the arm part 262 of the first embodiment. Below, the expansion / contraction operation | movement of the 1st thru | or 3rd expansion-contraction part 326,330,356 and the operation | movement of the counter balance part 398 are demonstrated.

  The first and second expansion / contraction parts 326 and 330 are expanded and contracted as follows. When the eighth motor 334 is rotated in the third arm 240, the spur gear 338 is rotated and the gear portion 342 of the telescopic drive shaft 340 is rotated. As a result, the telescopic drive shaft 340 is rotated in the direction around its own axis, and the first and second feed gears 344 and 346 are rotated. Both ends of the third arm 240 are restricted by the fourth to sixth arms 242, 244, 246, and the second and third sub-arms 324, 328, 332 are the same distance from the first sub-arm 324. Approached or separated. That is, the first and second expandable portions 326 and 330 are expanded and contracted by the same amount.

  The third expansion / contraction part 356 is expanded / contracted as follows. When the ninth motor 358 is rotated in the fourth arm 242, the spur gear 364 is rotated and the gear portion 368 of the telescopic drive shaft 366 is rotated. As a result, the telescopic drive shaft 366 is rotated in the direction around its own axis, and the feed gear 370 is rotated. Both ends of the fourth arm 242 are restricted by the third, fifth, and sixth arms 240, 244, and 246, and the fifth sub arm 354 approaches or separates from the fourth sub arm 352, The expansion / contraction part 356 is expanded / contracted. Here, the expansion / contraction amount of the third expansion / contraction part 356 is equal to the sum of the expansion / contraction amount of the first expansion / contraction part 326 and the expansion / contraction amount of the second expansion / contraction part 330. The expansion / contraction operation of the fourth expansion / contraction part 378 is the same as the expansion / contraction operation of the second expansion / contraction part 140 of the fifth arm 26 of the first embodiment.

  The counter balance unit 398 operates as follows. When the arrangement of the arm unit 262 is changed, the arm control unit 412 calculates the relative arrangement of the counterweight 266 with respect to the sixth arm 246 so as to keep the medical instrument holding device 224 in an equilibrium state. . Further, the arm control unit 412 calculates the rotation amount and rotation speed of the eleventh motor 400 so as to realize the calculated relative positional relationship. The arm control unit 412 outputs a drive signal to the motor drive unit 414 based on the calculated rotation amount and rotation speed.

The eleventh motor 400 is rotated by the motor driving unit 414 at the calculated rotation amount and rotation speed. As a result, the spur gear 404 connected to the eleventh motor 400 is rotated, and the gear 406 is slid in the longitudinal direction of the screw shaft 264. Then, the screw shaft 264 is moved in the longitudinal direction of the sixth arm 246 with respect to the sixth arm 246. As a result, the counterweight 266 is moved in the longitudinal direction of the sixth arm 246 with respect to the sixth arm 246, and the equilibrium state of the medical instrument holding device 224 is maintained regardless of the change in the arrangement of the arm portion 262. .
In this way, as indicated by the solid line in FIG. 24, the arrangement of the arm portions 262 is changed in the Y + direction.

  Thus, the above configuration has the following effects in addition to the effects of the first embodiment. A screw shaft 264 extends from one end of the sixth arm 246, and a counterweight 266 is screwed to the screw shaft 264. The screw shaft 264 is slidable in the longitudinal direction of the sixth arm 246. When the arrangement of the arm unit 262 is changed, the arm control unit 412 calculates the relative arrangement of the counterweight 266 with respect to the sixth arm 246 so as to maintain the equilibrium state of the medical instrument holding device 224, and the motor A drive signal is output to the drive unit 414. In accordance with this drive signal, the eleventh motor 400 is driven to move the screw shaft 264, that is, the counterweight 266. For this reason, in the counterbalance type arm portion 262, even when the arrangement of the arm portion 262 is changed, the medical instrument holding device 224 is always held in an equilibrium state.

  In the above embodiment, the rigid endoscope 38 is used as a medical instrument. However, the present invention may be applied to a medical instrument holding device for holding other medical devices such as an energy processing tool and a surgical microscope.

Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional remark item 1-1) The said parameter contains the space position parameter which shows the space position of the said medical device, The medical device holding | maintenance apparatus of Claim 1 characterized by the above-mentioned.

(Additional remark item 1-2) The said parameter contains the attitude | position parameter which shows the attitude | position of the said medical instrument, The medical instrument holding | maintenance apparatus of Claim 1 characterized by the above-mentioned.

(Additional Item 1-3) The connection part is a joint part that connects the arms so as to be relatively rotatable or rotatable, or an expansion / contraction part that connects the arms so that the distance between the arms can be extended and contracted. The medical instrument holding device according to claim 2, wherein

(Additional Item 1-4) The arm unit includes a counter balance unit for maintaining a balance of the entire medical device holding device against a change in the arrangement of the arm unit by the drive control unit. The medical instrument holding device according to claim 1.

(Additional Item 1-5) The medical instrument includes an observation optical system for observing a surgical site, and the parameter includes an optical parameter related to an optical position of the observation optical system. Item 4. The medical device holding system according to Item 3.

(Additional Item 1-6) The medical instrument holding system according to Additional Item 1-5, wherein the optical parameter includes an optical axis parameter indicating a position of an optical axis of the observation optical system.

(Additional Item 1-7) The medical instrument holding system according to Additional Item 1-5, wherein the optical parameter includes a focus parameter indicating a position of a focal point of the observation optical system.

(Appendix 2-1)
A holding part for holding a medical device;
A plurality of arm portions on which at least one of the medical instruments can be fixedly disposed at a predetermined position;
A plurality of joints for fixedly arranging the medical device at the predetermined position;
Position detecting means for detecting the position of the medical instrument and the posture of the arm part;
Medical instrument position parameter holding means for holding in the medical instrument holding position;
In a medical instrument holding device having
The position of the medical instrument and the posture of the arm unit detected by the position detection means;
From the medical device position parameter held in the medical device holding position,
A calculation unit that calculates the rotation angle of each joint of the plurality of joints and the amount of expansion and contraction of the arm that can be expanded and contracted among the plurality of arm units;
A control unit that drives and controls each joint and the telescopic arm based on the calculation result;
A medical instrument holding device comprising:

(Appendix 2-2)
The medical instrument holding device according to appendix 2-1, wherein the medical instrument position parameter held by the holding means is a posture of the medical instrument.

(Appendix 2-3)
The medical instrument holding device according to appendix 2-1, wherein the medical instrument position parameter held by the holding means is a position of the medical instrument.

(Appendix 2-4)
A holding part for holding the medical device;
A medical instrument holding device having a plurality of joints and a plurality of arms for fixedly arranging the medical instrument in a desired space;
In the position detection means for detecting the relative position of the medical instrument and the posture of the arm part,
The medical device holding device includes at least one extendable telescopic arm portion;
Based on the position detection means, a calculation unit for calculating the rotation amount of the joint and the expansion / contraction amount of the expansion / contraction arm unit,
A medical device holding apparatus comprising: a control unit that drives and controls each joint and the telescopic arm based on the calculation result.

(Appendix 2-5)
The medical instrument holding device according to appendix 2-4, wherein the calculation unit calculates the rotation amount of the joint and the expansion / contraction amount of the expansion / contraction arm with the position and posture of the medical instrument unchanged.

(Appendix 2-6)
The medical instrument holding device according to Additional Item 2-4 or 2-5, wherein the medical instrument holding device is a counterbalance type.

(Appendix 2-7)
The medical device holding device according to Additional Item 2-6, wherein the counterbalance type medical device holding device controls the balance in conjunction with expansion and contraction of the balance arm portion.

(Appendix 2-8)
The medical instrument holding device according to any one of additional items 2-4 to 2-7, wherein the medical instrument is an endoscope.

(Appendix 2-9)
The medical instrument holding device includes an imaging lens and an imaging element connected to at least the observation optical system of the endoscope, and is configured to be detachable from the endoscope. The medical instrument holding device according to 2-8.

(Appendix 2-10)
The medical instrument holding device according to any one of appendices 2-8 and 2-9, wherein the calculation unit performs movement control in a scope direction with an endoscope posture unchanged.

(Appendix 2-11)
The medical instrument holding device according to appendix 10, wherein the calculation unit calculates the rotation amount of the joint and the expansion / contraction amount of the telescopic arm based on the position of the tip of the medical instrument recorded in advance.

(Appendix 2-12)
The medical instrument holding apparatus according to any one of additional items 2-4 to 2-11, wherein the medical instrument holding apparatus includes input means for controlling the plurality of joints and the plurality of arms.

(Appendix 2-13)
The medical instrument holding device according to any one of items 2-4 to 2-12, wherein the calculation unit includes a recording unit.

  Provided are a medical instrument holding device and a medical instrument holding system for moving and fixing a medical instrument to a desired position with respect to an operation part, which can reduce an operator's fatigue and a burden on a patient by shortening an operation time. .

The figure which shows schematic structure of the whole medical device holding | maintenance system of 1st Embodiment of this invention. Explanatory drawing for demonstrating the 1st thru | or 7th joint part and 1st and 2nd expansion-contraction part of the medical device holding | maintenance apparatus of 1st Embodiment of this invention. The figure which shows the 3rd arm of the medical device holding | maintenance apparatus of 1st Embodiment of this invention. The figure which shows the 5th arm of the medical device holding | maintenance apparatus of 1st Embodiment of this invention. The figure which shows schematic structure of the control system of the medical device holding | maintenance apparatus of 1st Embodiment of this invention. The figure which shows the change of arrangement | positioning of the arm part of the medical device holding | maintenance apparatus of 1st Embodiment of this invention. The same figure as FIG. The figure which shows schematic structure of the whole medical device holding | maintenance system of 2nd Embodiment of this invention. The figure which shows the 1st arm of the medical device holding | maintenance apparatus of 2nd Embodiment of this invention. The figure which shows schematic structure of the control system of the medical device holding | maintenance apparatus of 2nd Embodiment of this invention. The figure which shows the change of arrangement | positioning of the arm part of the medical device holding | maintenance apparatus of 2nd Embodiment of this invention. The figure which shows schematic structure of the whole medical device holding | maintenance system of 3rd Embodiment of this invention. The figure which shows the rigid endoscope and imaging unit of the medical device holding | maintenance system of 3rd Embodiment of this invention. The figure which shows the change of arrangement | positioning of the arm part of the medical device holding | maintenance apparatus of 3rd Embodiment of this invention. The same figure as FIG. The figure which shows schematic structure of the whole medical device holding | maintenance system of 4th Embodiment of this invention. Explanatory drawing for demonstrating the 1st thru | or 7th joint part and the 1st thru | or 4th expansion-contraction part of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The front view which shows the some arm of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The figure which shows the 3rd arm of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The figure which shows the 4th thru | or 6th arm of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The figure which shows the 5th thru | or 7th arm of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The figure which shows the 6th arm and counterbalance part of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The figure which shows schematic structure of the control system of the medical device holding | maintenance apparatus of 4th Embodiment of this invention. The figure which shows the change of arrangement | positioning of the arm part of the medical device holding | maintenance apparatus of 4th Embodiment of this invention.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 2 ... Medical instrument holding device, 36 ... Arm part, 38 ... Medical instrument, 40 ... Holding part, 60, 68, 76, 84, 92, 100, 108, 122, 144, 164 ... Detection means, 62, 70, 78 , 86, 94, 102, 110, 120, 142, 160, 166... Drive control means.

Claims (8)

A holding unit for holding a medical instrument having an observation optical system including an optical axis ;
An arm part for moving and fixing the holding part to a desired position;
Detecting means for detecting an optical axis parameter indicating the attitude of the optical axis of the medical instrument ;
Drive control means for driving the arm unit and moving the medical instrument in the optical axis direction while maintaining the optical axis parameter constant;
A medical instrument holding device comprising:   The medical instrument is an endoscope;
  The holding unit has an imaging unit,
  The imaging unit includes an optical axis that substantially matches the optical axis of the endoscope when the endoscope is attached and detached and the endoscope is attached, and the endoscope is attached To take an observation image obtained by the endoscope and perform observation inside the surgical site, and when the endoscope is removed, perform macro observation around the surgical site,
  The medical instrument holding device according to claim 1, wherein   The detecting means detects a focus parameter indicating a focus position of the imaging unit;
  The drive control means drives the arm unit to move the imaging unit while keeping the focus parameter constant.
  The medical instrument holding device according to claim 2, wherein   The arrangement of the arm portion can be changed,
  The detection means detects a position and posture parameter indicating a position and posture of the medical instrument,
  The drive control means drives the arm unit to change the arrangement of the arm unit while maintaining the position and posture parameters constant.
  The medical instrument holding device according to claim 1, wherein   The arm portion is a plurality of arms, and the holding portion is provided at a tip arm of the plurality of arms, and the plurality of arms and the both arms can be rotated or rotated relatively. A joint portion connected to each other, and an expansion / contraction portion provided on at least one of the arms and capable of expanding and contracting the arm,
  The medical instrument holding device further includes a switching operation unit for switching the arm unit between a released state and a fixed state, and a drive operation unit for driving the arm unit,
  The drive control means includes a release state in which both the arms provided in the joint portion and connected to each other via the joint portion can be rotated or rotated relative to each other, and both the arms are relatively rotated or rotated. A joint braking portion that can be switched between a fixed state in which rotation is impossible, and a joint that is provided in the joint portion and is capable of relatively rotating or rotating both the arms connected to each other via the joint portion. A drive unit, an expansion / contraction drive unit provided in the expansion / contraction unit and capable of extending / contracting the arm provided with the expansion / contraction unit, and the joint braking unit in a released state and a fixed state in accordance with an operation to the switching operation unit. The arm unit is switched between a released state and a fixed state by switching between the two, and the joint driving unit is driven to relatively rotate or rotate both the arms according to the operation to the driving operation unit. With expansion and contraction By driving the moving portion by elastic actuating the arm, for driving the arm portion while holding the parameters constant, has a control unit, a
  The medical instrument holding device according to any one of claims 1 to 4, wherein   The detection means includes a rotation or rotation amount detection unit that detects a relative rotation or rotation amount of the arms that are provided in the joint unit and are connected to each other via the joint unit, and a telescopic unit. Detected by the expansion / contraction amount detection unit that detects the expansion / contraction amount of the arm provided with the expansion / contraction unit, the rotation or rotation amount detected by the rotation or rotation amount detection unit, and the expansion / contraction amount detection unit A calculation unit that calculates the parameter based on the amount of expansion / contraction performed,
  The control unit calculates the rotation or rotation amount and the expansion / contraction amount so as to drive the arm unit while keeping the parameter constant based on an operation to the drive operation unit.
  The medical instrument holding device according to claim 5, wherein   The medical instrument holding device further includes a counter balance unit,
  The counter balance unit includes a counter weight connected to the arm unit so as to be movable with respect to the arm unit, and a weight driving unit that moves the counter weight with respect to the arm unit,
  The control unit drives the weight driving unit to move the counterweight with respect to the arm unit when the expansion / contraction unit is expanded / contracted to maintain the balance of the medical device holding device,
  The medical instrument holding apparatus according to claim 6, wherein   The medical instrument holding device according to any one of claims 1 to 7,
  The medical device;
  A medical device holding system comprising:

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