JP5010356B2 - Surgery support device - Google Patents

Description

  The present invention relates to a surgical operation support apparatus that takes out a desired surgical tool to a predetermined position in accordance with an operator's instruction in endoscopic surgery or the like, and stores a used surgical tool from a predetermined return position into a predetermined storage position. .

In recent years, endoscopic surgery has attracted attention and has been widely used as a surgical means in which invasion on a patient's body has been alleviated, and recovery after surgery is quick and scars are small.
In such endoscopic surgery, a surgical tool called forceps is usually used. There are various types of forceps depending on their use, and various proposals have been made to further spread the use (for example, Patent Documents 1 to 3).

On the other hand, since endoscopic surgery uses a large number (usually 10 to 20) of forceps during surgery, other doctors, assistants, or nurses usually perform doctors (surgeons and surgeons). The forceps to be used are selected and handed according to the surgeon's instructions, and the used forceps are received from the surgeon and stored in a predetermined position.
However, the forceps replacement operation is a simple but cumbersome operation, which forces an assistant (doctor, assistant, nurse, etc.) to perform extra work other than the original operation, and the amount of work for the assistant is reduced. This increases the operating cost.
Therefore, an apparatus for performing forceps replacement work without an assistant has already been proposed (for example, Patent Document 4).

  FIG. 5 is an external view of the surgical instrument disclosed in Patent Documents 1 to 3, (A) is a mounting gun for a surgical clip of Patent Document 1, (B) is a medical suturing device of Patent Document 2, ( C) is an active forceps for endoscopic surgery. These surgical tools 1 are common in that the distal end portion 2, the intermediate portion 3 and the operation portion 4 are connected in series in a straight line, and the intermediate portion 3 is formed of an elongated hollow tube.

  As shown schematically in FIG. 6, the surgical support method of Patent Document 4 is operated by an operator instructing a specific forceps 50 necessary for the operation by voice during an abdominal surgery under an endoscope. The surgical support robot 60 installed in the vicinity of the table responds to the voice instruction, selects a specific forceps 50 from among a number of prepared forceps 50, and performs the surgical support to send the forceps 50 to the operator. is there.

  Further, as schematically shown in FIG. 7, the surgical support robot of Patent Document 4 has a stand 51 that can be movably installed in the vicinity of the operating table, and a required number of forceps 50 provided on the stand 51 can be attached and detached. A holder 52 to be held, an arm 54 for picking up a desired forceps 50 from a forceps 50 provided on the stand 51 and held by the holder 52, and releasing the forceps 50 after inserting the forceps 50 to an operator, and a desired forceps 50 A voice recognition control means (not shown) for outputting an indexing command for the forceps 50 in response to the voice instruction of the surgeon to be identified and outputting an operation command for the arm 54, and the voice instruction by the operator Composed of composite video generation means (not shown) for synthesizing the video of the tip shape of the specific forceps 50 with the surgical video under the endoscope and displaying it on the display, Thus is obtained by adapted to perform the indexing operation of the desired forceps 50 to one of the holder 52 or arm 54.

JP-A-8-98841, “Surgical clip mounting gun” JP-A-9-98976, “medical suturing device” JP 2003-144448 A, “Active forceps for endoscopic surgery” JP 2006-122473 A, “Surgery Support Method and Surgery Support Robot that Performs This”

  In Patent Document 4 described above, the forceps collecting means 64 for receiving the used forceps 50 is further provided on the stand 51, and the arm 54 is re-positioned at a predetermined position of the holder 62 after picking up the forceps 50 received by the forceps collecting means 64. It is proposed to perform a return operation to hold.

In this embodiment, for example, the forceps collecting means 64 is configured as a horn-shaped forceps receiving member that is supported in the vicinity of the base portion of the stand 51 and opens upward, and the opening portion is used by the surgeon for the used forceps 50. It is most suitable for throwing with the handle up and is directed to a position that does not interfere with the operation of the operator.
Further, when the used forceps 50 is returned to the forceps collecting means 64, the handle of the forceps 50 is positioned above the horn-shaped opening and the arm 54 can allow the forceps 50 to be collected. The handle base can be exposed to the operating area of the arm 54. Therefore, when the used forceps 50 are collected, the arm 54 is moved downward and horizontally swiveled toward the forceps collecting means 64, and the hand 58 grips the handle base of the forceps 50 and then is lifted and horizontally swung to place the forceps 50 in the holder 52. It was made to hold | maintain to the clip 56 prescribed | regulated.

  Further, the forceps collecting means 64 described above is configured in a horn shape as an example. However, if the forceps 50 after use is shaped so that the operator can return it to a predetermined collection position without hindrance, various types of forceps collecting means 64 may be used. For example, instead of a horn-shaped forceps receiving member, it is provided on the support plate and extends obliquely upward in the radial direction, and the distal end is moved to an operation region where the operator can easily return the forceps. In this case, it has been proposed to set a V-shaped groove whose cross section is open upward.

  However, as a result of actually manufacturing and testing the above-described surgery support robot, the inventors of the present invention have revealed the following problems.

A surgical tool for endoscopic surgery is composed of a tip part, an intermediate part, and an operation part that are linearly connected in series. Particularly, since the operation part is large and heavy, it is difficult to stably hold it during storage or movement. .
When the forceps collecting means 64 configured in a horn shape is used as in the embodiment of Patent Document 4, there is a possibility that the tip portion 2 made precisely is damaged.
Further, since the operation unit 4 is large and heavy, it is easy to move within the forceps collecting means 64 and it is difficult to stabilize it at the same position.
Furthermore, since the forceps 50 take-out posture and the collection posture are greatly different, the control for moving the arm 54 downward and horizontally is complicated, and it is almost impossible to realize.

Therefore, instead of the horn-shaped forceps receiving member 64, a saddle-shaped member having a distal end facing an operation region in which the operator can easily return the forceps is set, and the saddle-shaped member is set to a V-groove whose cross section is opened upward. Even in that case, it was difficult to collect the forceps 50 into the holder 52.
In other words, if the forceps are arranged at a position where they do not interfere with the arm 54, the operating area of the arm 54 becomes large, and the entire apparatus becomes large enough to interfere with the operation. Further, since the forceps 50 is a long body, it is easy to move due to disturbance, and may be dropped when it is held, and it is difficult to recover it in a stable state.
When the longitudinal direction position of the forceps is shifted, there is a problem that the position to return to the storage device varies.
In other words, when the forceps is supported at two points, the position of the return device is changed depending on the position of the center of gravity of the forceps. When holding it with a finger member and carrying it to the storage device, the swinging arm simply rotates, so that there is a problem in that the shift becomes a vertical shift in the storage device as it is.

  The present invention has been developed to solve the above-described problems. That is, an object of the present invention is to provide a large number of heavy and heavy surgical tools including a distal end portion, an intermediate portion, and an operation portion such as forceps, and to smoothly hold a desired surgical device in accordance with instructions from the operator. The surgical tool can be easily returned in the vicinity of the take-out position, and the surgical tool can be reliably removed from the predetermined return position to the predetermined storage position without variation. An object of the present invention is to provide a surgical operation support device that can be smoothly recovered while being held.

According to the present invention, there is provided a surgical support device for storing and exchanging a surgical tool comprising a distal end portion, an intermediate portion, and an operation portion that are connected in series in a straight line, and the intermediate portion is formed of an elongated hollow tube,
A storage device having a plurality of holding tools for holding the surgical tools individually and detachably without interfering with each other, and capable of positioning each of the holding tools at a predetermined pickup position;
A moving device for removing the surgical tool at the pick-up position from the storage device, moving to a predetermined take-out position and releasing;
A return device in proximity to the removal position and holding the surgical tool after use;
The storage device includes two upper and lower disks each having the plurality of holders spaced in the circumferential direction at the same position in the vertical direction, and the two disks are synchronously driven to rotate around a vertical axis. A rotation drive device that holds the middle part of the surgical tool vertically by a pair of holders at the same position in the vertical direction,
The moving device includes a gripping device for releasably gripping an intermediate portion of the surgical tool positioned at the pickup position between the two disks, and a swinging drive of the gripping device to the predetermined extraction position within a vertical plane. And a horizontal table capable of turning the swing arm about a vertical axis,
The return device includes an operation side support that supports the operation unit side of the intermediate part of the surgical instrument, a distal end support that supports the distal end side of the intermediate part, and an intermediate part supported by the distal end support And a rising prevention device for preventing the rising of
The operation-side support tool and the distal-end-side support tool are used when the gripping device is swung horizontally or downward from the horizontal position from the take-out position, swung horizontally by a predetermined angle, and then swung upward from horizontal. , Positioned so as to be able to grip the middle part of the surgical tool between the operation side support tool and the tip side support tool,
The moving device is provided with a surgical operation support device in which a used surgical tool is taken out from a return device and attached to a holder at the pickup position.

Further, a horizontal guide that supports the tip side support tool to be movable in the horizontal direction;
An interlocking mechanism that horizontally moves the tip side support tool in conjunction with a horizontal turning of the gripping device at a predetermined angle;
The axis line of the used surgical tool supported by the operation side support tool and the tip side support tool is positioned on the vertical axis of the horizontal table.

  According to the above configuration of the present invention, the storage device has a plurality of holding tools for holding each of the surgical tools independently and detachably without interfering with each other. Since the middle part of the surgical tool is vertically held by a pair of upper and lower holders, even if the operation part is composed of a tip part, an intermediate part and an operation part such as forceps, the operation part is large and heavy. Many can be stored with the operation unit facing up.

  In addition, since the moving device takes out the surgical tool at the pickup position from the storage device, moves it to the predetermined take-out position and releases it, so that the desired surgical tool is securely held in accordance with the surgeon's instruction and is smoothly placed in the same position. It can be taken out.

  Further, the return device close to the take-out position holds the used surgical tool, and the moving device takes the used surgical tool from the return device and attaches it to the pick-up position holding tool. The operator can easily return the used surgical tool, and can be smoothly collected while securely holding the surgical tool from the return position to the predetermined storage position.

Moreover, according to a preferred embodiment, the return device includes the anti-lifting device that prevents the intermediate portion supported by the distal-end-side support member that supports the distal-end portion side of the intermediate portion of the surgical tool after use. Even when the operation part is large and heavy, it is possible to prevent the intermediate part supported by the distal end side support from being lifted and to be stabilized at the same position.
In addition, the surgical tool after use is placed on the operation side support tool and the distal end side support tool, and the intermediate part side end surface of the operation part is positioned by the operation side support tool. Since the swinging arm only rotates when the holder is held by the gripping device and carried to the storage device, it can be accommodated in the storage device without any deviation.

Further, the operation side support device includes a horizontal guide that supports the tip side support member so as to be movable in the horizontal direction, and an interlocking mechanism that horizontally moves the tip side support member in conjunction with the horizontal turning of the gripping device at a predetermined angle. Since the axis of the used surgical tool supported by the distal end side support tool is positioned on the vertical axis of the horizontal table, the operation side support tool can be obtained only by swinging the swing arm by the moving device and turning the horizontal table. The intermediate part of the surgical tool between the distal end side support tool and the tip side support tool can be gripped by the gripping device.
Accordingly, the orientation of the gripping device can be fixed so as to grip the intermediate portion of the surgical instrument at a predetermined removal position, and the gripping device itself does not need to be swung or swiveled, and is easy to control.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings. In each figure, common portions are denoted by the same reference numerals, and redundant description is omitted.

As illustrated in FIG. 5, the surgical instrument 1 targeted by the present invention includes a distal end portion 2, an intermediate portion 3, and an operation portion 4 that are linearly connected in series, and the intermediate portion 3 is an elongated hollow tube. Become. The distal end portion 2 is a scalpel, scissors, clip, or the like used in endoscopic surgery, and operates by manual or electric operation of the operation portion 4. The intermediate part 3 is preferably a straight pipe having the same diameter, but the diameter may be partially different. The operation unit 4 is usually large and heavy, and the entire center of gravity is located near the operation unit.
Such a surgical tool 1 is, for example, forceps for endoscopic surgery, but the present invention is not limited to this, and may be other surgical tools. Moreover, the surgical tool illustrated in patent documents 1-3 may be sufficient.

FIG. 1 is an overall side view of the surgery support apparatus of the present invention, and FIG. 2 is an overall plan view thereof.
As shown in FIGS. 1 and 2, the surgery support device of the present invention includes a storage device 10, a moving device 20, and a return device 30.

  The storage device 10 includes a plurality of holding tools 12 that hold a plurality of surgical tools 1 independently and detachably without interfering with each other, and each holding tool 12 can be positioned at a predetermined pickup position A. Yes.

In this example, the storage device 10 includes two upper and lower disks 14 a and 14 b and a rotation drive device 16.
In this example, the holding tool 12 is made of an elastic member having a vertical U groove, the opening side of the U groove is configured to be slightly narrower than the intermediate part 3 of the surgical instrument 1, and the intermediate part 3 is fitted into the U groove and pressed inside. As a result, the holder 12 is slightly bent to accommodate the intermediate portion 3 therein, and the elastic member is prevented from falling off due to its own weight or the like.
The holder 12 may not be attached to the disks 14a and 14b, and the disks 14a and 14b themselves may be elastic members having vertical U grooves.

A plurality of (12 × 2 = 24 in FIG. 1 and FIG. 2) holders 12 are attached to the outer surfaces of the upper and lower two disks 14a and 14b at intervals in the circumferential direction. The tool 12 is located at the same position in the vertical direction, and the middle part 3 of the surgical tool is held vertically by a pair of upper and lower holding tools 12.
In addition, this invention is not limited to this structure, The intermediate part 3 of the surgical tool hold | maintained by a pair of upper and lower holders 12 may incline inside or outside with respect to the vertical.

In this example, the upper and lower two disks 14a and 14b are fixed to the same rotating shaft 15 and supported so as to be rotatable around the vertical axis Z1. The rotation driving device 16 can rotationally drive the rotating shaft 15 to position an arbitrary holding tool 12 holding each surgical tool 1 at a predetermined pickup position A.
This positioning means may be positioning using a limit switch or numerical control.

  The moving device 20 takes out the surgical tool 1 at the pick-up position A from the storage device 10, moves it to a predetermined take-out position B and releases it (“take-out function”), and returns the used surgical tool 1 to the return device 30. And a function of attaching to the holder 12 at the pickup position 10 (“collection function”).

  In this example, the moving device 20 includes a gripping device 22, a swing arm 24, and a horizontal table 26.

The gripping device 22 includes a pair of finger members 22a that move in directions opposite to each other in the direction orthogonal to the paper surface in FIG. 1 and an actuator 23 that drives the opening and closing thereof. The finger member 22a has a concave groove extending vertically so as to hold the intermediate portion 3 of the surgical instrument 1 at the pickup position A vertically. Further, the actuator 23 is, for example, a solenoid, which securely holds the intermediate portion 3 of the surgical instrument 1 when the finger member 22a is closed, and widens the interval wider than the outer diameter of the intermediate portion 3 when released.
With this configuration, the grasping device 22 can releasably grasp the intermediate portion 3 of the surgical instrument 1 located at the pickup position A between the two disks 14a and 14b.
The gripping device 22 also has a mechanism for holding it with an elastic member, like the holder 12, and when the operator takes out the surgical instrument 1 after taking out the surgical instrument 1 as shown in FIG. It will be in a state where it is slightly opened and held by an elastic body.
That is, if the actuator 23 is closed, the surgical tool 1 cannot be taken out, and if it is fully opened, it cannot be held and the surgical tool 1 falls, so that the actuator 23 is slightly opened and held by an elastic body. An elastic member similar to the holder 12 is incorporated in the gripping device 22.
The elastic member is in a direction in which the finger member 22a is closed, and the surgical instrument 1 is held by an elastic body in a state where the actuator is slightly opened. However, the deformation stroke of the elastic body is limited, and the elastic body is configured not to act on the surgical instrument 1 when the actuator is opened to a certain extent.

The swing arm 24 has a gripping device 22 fixed to one end, and is swing-driven by a drive device (not shown) around the horizontal axis H at the other end. With this configuration, the gripping device 22 can be driven to swing to a predetermined extraction position B within a vertical plane including the pickup position A and the extraction position B.
The positioning means during the swing may be positioning using a limit switch or numerical control.
There is also a rotation axis H2 parallel to the H axis between the swing arm 24 and the actuator 23, and the swing arm 24 can swing slightly (for example, about 20 degrees) about the rotation axis H2. (For example, a movement that does not cause the return device 30 and the arm 24 to interfere with each other).

The horizontal table 26 is a horizontal plate to which the support portion of the swing arm 24 is fixed. The horizontal table 26 is turned around a vertical axis Z2 by a turning drive device 27 and can be positioned at a predetermined position.
This positioning means may be positioning using a limit switch or numerical control.

As shown in FIG. 2, the return device 30 moves upward from the swinging vertical surface in the figure so as not to interfere with the swinging arm 24 swinging in the vertical surface including the pickup position A and the take-out position B. It is provided at a shifted position.
The return device 30 is close to the take-out position B and has a function of holding the surgical tool 1 after use.
In this example, the return device 30 includes an operation-side support tool 32, a tip-side support tool 34, and a floating prevention device 36.

  3A is a view taken in the direction of arrow C in FIG. 1, and FIG. 3B is a view taken in the direction of arrow D in FIG.

As shown in FIG. 3A, the operation side support tool 32 is fixed to a distal end portion of a support beam 31 that is disposed obliquely so that the operation side is elevated via a support fitting 33, and the intermediate part of the surgical tool 1 after use. 3 side of the operation unit is supported.
In this example, the operation side support tool 32 has a V-shaped cutout at the top, and has a concave groove into which the intermediate part 3 of the surgical tool 1 is loosely fitted at the lower end of the cutout. In this figure, reference numeral 41 denotes a photoelectric switch, which detects the intermediate portion 3 of the surgical instrument 1 and outputs a control signal.
The shapes of the operation-side support tool 32 and the support fitting 33 are not limited to this example, and may be other shapes as long as the intermediate part 3 of the surgical tool 1 can be supported.

As shown in FIG. 3B, the distal end side support tool 34 is attached to the distal end side of the support beam 31 via support fittings 35a and 35b, and supports the distal end side of the intermediate part 3 of the surgical instrument 1 after use. . In this example, the distal end side support tool 34 has a V-shaped notch at the upper part, and has a concave groove into which the intermediate part 3 of the surgical tool 1 is loosely fitted at the lower end of the notch.
In addition, the shape of the front end side support tool 34 is not limited to this example, Other shapes may be sufficient as long as the intermediate part 3 of the surgical tool 1 can be supported.

The levitation prevention device 36 has a claw portion 36 a that is urged in the horizontal direction above the concave groove of the distal end side support tool 34, and the intermediate portion 3 of the surgical instrument 1 supported by the concave groove of the distal end side support tool 34. It is designed to prevent the rise of. The claw portion 36a is retracted by pressing the intermediate portion 3 of the surgical instrument 1 downward to allow the passage of the intermediate portion 3, and conversely, when the intermediate portion 3 is pulled upward, it corresponds to its own weight. It resists against the above and swings upward about the rotation shaft 36b to allow the intermediate portion 3 to pass through it.
A stopper 46 is provided in the vertically downward direction of the ascent prevention device 36.
With this configuration, even when the operation unit is large and heavy, it is possible to prevent the intermediate unit 3 supported by the distal end side support 34 from being lifted and to be stabilized at the same position.
In addition, this invention is not limited to a floating prevention apparatus by this structure, You may use another structure (for example, the holder 12 mentioned above) as long as the floating of the intermediate part 3 can be prevented.

  In FIG. 3B, the support fitting 35b is attached to the support fitting 35a via a horizontal guide 42, and this horizontal guide 42 guides the support fitting 35b to which the tip side support 34 is attached so as to be movable in the horizontal direction. The horizontal guide 42 includes a guide rail 42a and a linear bearing 42b.

4A and 4B are operation explanatory views of the device of the present invention, in which FIG. 4A is before the turning of the moving device, and FIG. 4B is after the turning.
As shown in FIG. 4A, the return device 30 further includes an interlocking mechanism 44 that horizontally moves the distal end side support tool 34 in conjunction with the horizontal turning of the gripping device 22 (the swing arm 24) at a predetermined angle. In this example, the interlocking mechanism 44 includes a cam follower 44a that contacts the side surface of the swing arm 24 and a lever 45 that swings horizontally around a fulcrum 45a. The opposite end surface of the lever 45 is in contact with the support bracket 35b described above, and moves the support bracket 35b in the horizontal direction.
As shown in FIG. 3B, the fulcrum 45a is fixed to the support fitting 35a.
With this configuration, as shown in FIG. 4B, the axis line of the used surgical instrument 1 supported by the operation side support tool 32 and the distal end side support tool 34 can be positioned on the vertical axis Z <b> 2 of the horizontal table 26. .

  That is, from the state before turning in FIG. 4A, the gripping device 22 is swung horizontally from the take-out position B or below the horizontal and turned horizontally by a predetermined angle, and the state after turning in FIG. 4B is obtained. At this position, by swinging the swing arm 24 upward from the horizontal, the intermediate portion 3 of the surgical instrument 1 between the operation side support tool 32 and the distal end side support tool 34 is moved as shown by a thin line in FIG. Each is positioned so that it can be gripped by the gripping device 22.

Hereinafter, the operation of the above-described apparatus of the present invention will be described with reference to FIG.
The surgical instrument 1 after use is placed on the operation side support tool 32 and the distal end side support tool 34. As the structure of the operation side support tool 32 and the tip side support tool 34, the above-described V-groove structure is preferable.

  An anti-lifting device 36 (anti-back unit) is attached to the distal support 34, and the surgical instrument 1 is fixed to the operation support 32 and the distal support 34 by the weight of this portion. The anti-back unit 36 restricts only movement in one direction by an internal lever mechanism. Since the surgical tool 1 is long, it is easily moved when an external force is applied to the end portion, and it is difficult to place it in a balanced manner on the receiver, but it can be easily placed and stably held by these mechanisms. Can do.

The front end side support tool 34 and the anti-back unit 36 are attached to the support fitting 35b and guided by a horizontal guide 42 so as to be horizontally movable. The support fitting 35b is pulled in one direction (the right direction in FIG. 3B) by the tension spring 43. In addition, a cam floor is attached to the linear bearing 42b so that the linear bearing smoothly moves horizontally.
A stopper 47 is provided in the direction in which the support fitting 35b is pulled by the tension spring 43.

  In FIG. 4A, a cam follower 44a is attached to the tip of the lever 45. When the cam follower 44a contacts the side surface of the swing arm 24, the lever 45 rotates around the fulcrum 45a as shown in FIG. 4B. Then, the support fitting 35b to which the tip side support tool 34 and the anti-back unit 36 are attached is moved in one direction (downward in FIG. 5B).

  When the surgical instrument 1 is placed on the operation side support tool 32 and the distal end side support tool 34, the surgical tool 1 is regulated by the weight of the anti-back unit 3. When the swing arm 24 goes to pick up the surgical instrument 1 held by the return device 30, the swing arm 24 first contacts the cam follower 44a. Therefore, when the swing arm 24 turns, the lever 45 rotates. As a result, the distal end side support 34 rotates in the reverse direction as shown in FIG. 4B and approaches the swing arm 24. When the swing arm 24 rotates sufficiently, the surgical tool 1 overlaps the swing arm 24 on a plane as shown in FIG. 4B.

  Thereafter, the swing arm 24 swings perpendicularly to the paper surface in FIG. 4B, so that the swing arm 24 becomes parallel to the surgical tool 1, and the surgical tool 1 can be gripped by the gripping device 22. After gripping with the gripping device 22, the swing arm 24 further swings perpendicularly to the paper surface in FIG. 4B. Since the surgical instrument 1 is supported only by the weight of the anti-back unit 36 with respect to the swing arm 24, it is easy to remove it from the return device 30 by the gripping device 22. When the swing arm 24 moves sufficiently, the anti-back unit 36 rotates about the rotation shaft 36b. Therefore, when the swing arm 24 moves sufficiently, the restriction can be removed.

  Note that the above-described operation support device of the present invention is preferably controlled using a known computer or sequencer, and the input is preferably performed by the operator's voice input.

  As described above, according to the configuration of the present invention, the storage device 10 includes the plurality of holding tools 12 that hold the plurality of surgical tools 1 independently and detachably without interfering with each other. According to the embodiment, since the intermediate part 3 of the surgical tool is vertically held by the pair of upper and lower holders, the operation part is composed of a tip part, an intermediate part and an operation part such as forceps. Even a large and heavy surgical tool can be stored in large numbers with the operation unit facing up.

  Further, since the moving device 20 takes out the surgical tool 1 at the pickup position A from the storage device 10 and moves to the predetermined take-out position B for release, the desired surgical tool is securely held by the operator's instruction. It can be smoothly taken out at the same position (predetermined take-out position B).

  Furthermore, the return device 30 close to the take-out position B holds the used surgical tool 1, and the moving device 20 takes the used surgical tool 1 from the return device 30 to the pick-up position A holding tool 12. Since it is attached, the surgeon can easily return the used surgical tool 1 in the vicinity of the take-out position B, and can be smoothly collected while reliably holding the surgical tool from the return position to a predetermined storage position.

Further, according to a preferred embodiment, the return device 30 floats to prevent the intermediate portion 3 supported by the distal end side support tool 34 that supports the distal end portion side of the intermediate portion 3 of the surgical instrument 1 after use from rising. Since the prevention device 36 is provided, even when the operation unit is large and heavy, it is possible to prevent the intermediate portion supported by the distal end side support from being lifted and to be stabilized at the same position.
Further, the used surgical instrument 1 is placed on the operation side support tool 32 and the distal end side support tool 34, and the intermediate part side end surface of the operation unit 4 is positioned by the operation side support tool 32, so that the longitudinal direction of the surgical tool 1 Even when the position does not shift and is held by the gripping device 22 and carried to the storage device 10, the swinging arm 24 only rotates, so that it can be accommodated in the storage device 10 without being shifted.

Furthermore, a horizontal guide 42 that supports the tip side support tool 34 so as to be movable in the horizontal direction, and an interlocking mechanism 44 that horizontally moves the tip side support tool 34 in conjunction with the horizontal turning of the gripping device 22 at a predetermined angle. Since the axis line of the used surgical tool 1 supported by the operation side support tool 32 and the tip side support tool 34 is positioned on the vertical axis Z2 of the horizontal table 26, the swinging arm 24 is swung by the moving device 20. The intermediate portion 3 of the surgical instrument 1 between the operation side support tool 32 and the distal end side support tool 34 can be gripped by the gripping device 22 only by turning the horizontal table 26.
Therefore, the gripping device 22 can fix the orientation so as to grip the intermediate part 3 of the surgical instrument 1 at the predetermined take-out position A, and it is not necessary to swing or turn the gripping device 22 itself. Easy.

  In addition, this invention is not limited to the Example and embodiment mentioned above, Of course, it can change variously in the range which does not deviate from the summary of this invention.

It is a whole side view of the surgery assistance apparatus of this invention. 1 is an overall plan view of a surgery support apparatus according to the present invention. FIG. 2 is a C arrow view and a D arrow view of FIG. 1. It is operation | movement explanatory drawing of the apparatus of this invention. It is an external view of the surgical instrument disclosed by patent documents 1-3. It is a schematic diagram of the surgery assistance method of patent document 4. FIG. 10 is a schematic diagram of a surgery support robot of Patent Document 4.

Explanation of symbols

1 surgical tool (forceps), 2 tip part, 3 middle part, 4 operation part,
10 storage devices, 12 holders, 14a, 14b discs,
15 rotation shaft, 16 rotation drive device,
20 moving device, 22 gripping device, 22a finger member, 23 actuator,
24 swing arm, 26 horizontal table, 27 swivel drive,
30 return device, support beam, 32 operation side support, 33 support bracket,
34 tip side support tool, 35a, 35b support bracket, 31 support beam,
36 anti-floating device (anti-back unit), 36a claw portion, 36b rotating shaft,
41 photoelectric switch, 42 horizontal guide, 42a guide rail,
42b linear bearing, 43 tension spring,
44 interlocking mechanism, 44a cam follower,
45 lever, 45a fulcrum, 46, 47 stopper

Claims (2)

A surgical support device for storing and exchanging a surgical tool comprising a distal end portion, an intermediate portion, and an operation portion that are linearly connected in series, and an intermediate portion that is an elongated hollow tube,
A storage device having a plurality of holding tools for holding the surgical tools individually and detachably without interfering with each other, and capable of positioning each of the holding tools at a predetermined pickup position;
A moving device for removing the surgical tool at the pick-up position from the storage device, moving to a predetermined take-out position and releasing;
A return device in proximity to the removal position and holding the surgical tool after use;
The storage device includes two upper and lower disks each having the plurality of holders spaced in the circumferential direction at the same position in the vertical direction, and the two disks are synchronously driven to rotate around a vertical axis. A rotation drive device that holds the middle part of the surgical tool vertically by a pair of holders at the same position in the vertical direction,
The moving device includes a gripping device for releasably gripping an intermediate portion of the surgical tool positioned at the pickup position between the two disks, and a swinging drive of the gripping device to the predetermined extraction position within a vertical plane. And a horizontal table capable of turning the swing arm about a vertical axis,
The return device includes an operation side support that supports the operation unit side of the intermediate part of the surgical instrument, a distal end support that supports the distal end side of the intermediate part, and an intermediate part supported by the distal end support And a rising prevention device for preventing the rising of
The operation-side support tool and the distal-end-side support tool are used when the gripping device is swung horizontally or downward from the horizontal position from the take-out position, swung horizontally by a predetermined angle, and then swung upward from horizontal. , Positioned so as to be able to grip the middle part of the surgical tool between the operation side support tool and the tip side support tool,
The said movement apparatus takes out the used surgical tool from a return apparatus, and attaches it to the holding tool of the said pick-up position, The surgery assistance apparatus characterized by the above-mentioned. A horizontal guide for supporting the distal end side support so as to be movable in the horizontal direction;
An interlocking mechanism that horizontally moves the tip side support tool in conjunction with a horizontal turning of the gripping device at a predetermined angle;
The axis of the operating side support and the tip-side support member in supported surgical instrument after use, is positioned on the vertical axis of the horizontal table, surgery supporting system according to claim 1, characterized in that.

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