JP5843990B1 - Pre-cleaning kit for surgery support robot instrument - Google Patents

Abstract

After using an instrument operation for a surgical support robot, it is possible to reliably prevent sticking and drying of attached contaminants until they are used for a washing machine by simply being fitted to the tip side of the shaft. An effective pre-cleaning kit is provided to release and remove from the equipment surface. A pre-cleaning kit K includes a cylindrical container 1 that contains a cleaning liquid L, a cap 2 that has an insertion port 2a and that is attached to an opening 1a of the cylindrical container 1, and is loaded inside the cap 2. The seal ring 3 and the easy-to-break film body 4 that seals the insertion opening 2a of the cap 2 from the inside. The inner diameter d3 of the seal ring 3 is set to be slightly smaller than the shaft diameter d0 of the instrument 20, breaks through the fragile film body 4 at the tip of the jaw 24 of the instrument 20 through the insertion port 2a, and the tip of the shaft 22 By inserting the side into the cylindrical container 1, the tip end side of the shaft 22 is immersed in the cleaning liquid L in the cylindrical container 1, and the space between the shaft 22 and the cap 2 is sealed by the seal ring 3. [Selection] Figure 5

Description

  The present invention relates to a preliminary cleaning kit to be attached to an instrument (forceps) after use in a surgical operation via a surgical support robot.

  In recent years, there are an increasing number of cases of performing minimally invasive surgery under an endoscope using a surgical support robot. For example, a typical American Vintu (registered trademark) surgical system of Intuitive Surgical is a patient cart that has a surgical support robot placed beside the operating table, and a surgeon console that remotely controls the operation of the surgical support robot. It consists of a vision cart that processes the image of the operative field with a 3D endoscope and sends it to the surgeon console. The surgeon looks at the image of the operative field and moves with both hands and both feet holding the master controller. Each instrument (referred to as Endo Wrist instrument) and 3D endoscope held by the support robot can be freely operated (Patent Document 1, Non-Patent Document 1). As shown in FIG. 7, the surgery support robot R includes a support tower 11 erected on a pedestal 10, and three arms 12 on which the respective instruments 20 are mounted extend sideways. One arm 13 to which the endoscope 14 is attached extends forward, the arms 12 and 13 can turn and bend, and each instrument 20 is moved by an actuator portion 12a at the tip of the arm 12. It is possible to move forward and backward and tilt.

  As shown in FIG. 8, the instrument 20 has a round shaft 22 projecting from a small box-shaped housing 21, and a jaw 24 that opens and closes via a wrist 23 that can bend and stretch at the tip of the shaft 22. A plurality of wires (not shown) are provided through the interior of the shaft 22 between the housing 21 and the wrist 23 to bend and extend the wrist 23 and rotate each piece of the jaw 24. The shaft 22 itself is also configured to be rotatable. The housing 21 incorporates a force transmission mechanism that converts the driving force transmitted through the arm 12 of the surgery support robot R into the operations of the shaft 21, the wrist 23, and the jaw 24. As shown in FIG. 8B, the rear side of the housing 21 controls the rotation of the shaft 22, the bending and stretching of the wrist 23, the rotation of one piece of the jaw 24, and the rotation of the other piece of the jaw 24. A disk-shaped interface disk 25 with protrusions is rotatably arranged, and a plurality of interface pins 26 protrude. Further, as shown in FIG. 8A, a cleaning liquid inlet 27 communicating with the shaft 22 is opened at the rear end surface of the housing 21. The diameter d0 of the shaft 22 is generally about 8 mm, and the length from the base end of the shaft 22 to the tip of the jaw 24 is about 40 to 50 cm.

  The jaw 24 of the instrument 20 has various forms according to operations such as picking, cutting, scraping, and suturing tissue as exemplified by reference numerals 24A to 24D in FIGS. 9 (a) to 9 (d). There are two types of open / close type. In any of the jaw forms, the wrist 23 and the jaw 24 are accommodated in a virtual cylinder in which the outer periphery of the shaft 22 is extended in a state where the wrist 24 is closed in a posture along the axial direction of the shaft 22. Is set to The jaw 24A in FIG. 9A is for picking a small part, the jaw 24B in FIG. 9B is for scissors-type cutting, and the jaw 24C in FIG. 9C is a perforated type for gripping a large part, (d) The jaw 24D is for scraping.

JP 2014-223552 A

Internet URL: http://hospinfo.tokyo-med.ac.jp/davinci/function/master.html (2015/4/1), Surgical support robot “Da Vinci” thorough dissection | Tokyo Medical University Hospital.

  The instrument attached to the arm of the surgical support robot as described above can be reused up to approximately 10 times by removing it after use and cleaning it, but the structure of the movable parts of the wrist and jaw is very Due to its complexity, many medical facilities are concerned about cleanliness when reused. Although there is a cleaning procedure recommended by the manufacturer for the cleaning, in addition to performing manual cleaning (manual cleaning operation) and then performing main cleaning with a cleaning machine, the types of cleaning machines are not uniform, so cleaning There are concerns about variations in cleanliness depending on the workers and the type of washing machine.

  Therefore, as a result of recovering the instrument after ten times use from a plurality of medical facilities and measuring the residual protein, the present inventors have noticeable contamination of the movable part of the wrist and jaw, the wire and the wire running groove part, etc. However, there was no difference in the cleaning performance depending on the manufacturer and model of the washer, and the elapsed time from the end of the operation until the main washing by the washer and the work situation of the manual washing greatly affect the cleanliness. It has been suggested. That is, if the time from the end of the operation to the use of the washing machine becomes long, the contaminants adhere to the surface of the equipment and become difficult to remove, and manual washing is difficult to standardize due to individual differences. .

  In view of the above-described circumstances, the present invention provides an instrument for a surgical support robot that is simply attached to the distal end side of a shaft after the surgical use, and adheres contaminants until it is used in a washing machine. It is an object of the present invention to provide a pre-cleaning kit that can prevent the drying reliably and can effectively remove and remove contaminants from the surface of the equipment.

If the means for achieving the above-mentioned object is shown with reference numerals in the drawings, the invention of claim 1 shows the shaft 22 of the instrument 20 after being used for the surgical operation via the operation support robot R. A pre-cleaning kit K for a surgical support robot instrument fitted to the distal end side including a wrist 23 and a jaw 24, and a cylindrical container 1 made of a transparent or translucent synthetic resin containing a cleaning liquid L; A cap 2 that has an insertion port 2a on the surface and is attached to the opening 1a of the cylindrical container 1; a seal ring 3 that has elasticity and is loaded inside the cap 2; The fragile film body 4 is configured to seal the insertion port 2a from the inside, and the fragile film body 4 is formed between the annular wall 2c around the insertion port 2a of the cap 2 and the seal ring 3 at the periphery thereof. It is pinched between, installation The diameter d2 of the insertion port 2a of the cap 2 is set larger than the shaft diameter d0 of the instrument 20, and the inner diameter d3 of the seal ring 3 is set slightly smaller. The tip 22 of the shaft 22 is immersed in the cleaning liquid L in the cylindrical container 1 by inserting the breakable film 4 into the cylindrical container 1 from the insertion opening 2a of the cap 2 at the tip of the jaw 24. In addition, the shaft 22 and the cap 2 are configured to be sealed by the seal ring 3.

  According to a second aspect of the present invention, in the pre-cleaning kit K of the first aspect, the cylindrical container 1 is configured such that the inner diameter d1 on the bottom side on which the wrist 23 and the jaw 24 of the instrument 20 are arranged is 1.5. It is assumed to be set to 2.5 times.

  According to a third aspect of the invention, in the preliminary cleaning kit K of the first or second aspect, the cylindrical container 1 is made of an ultrasonically permeable synthetic resin.

  According to a fourth aspect of the present invention, in the preliminary cleaning kit according to any one of the first to third aspects, the easily breakable membrane body 4 is made of a water-insoluble synthetic resin having a thickness of 0.04 to 0.1 mm.

  According to a fifth aspect of the present invention, in the preliminary cleaning kit according to any one of the first to fourth aspects, the cleaning liquid L is a cleaning water containing a proteolytic enzyme.

Next, effects of the present invention will be described with reference numerals in the drawings. First, the pre-cleaning kit K for a surgical support robot instrument according to the invention of claim 1 is provided at the tip of the shaft 22 for the instrument 20 after being used for a surgical operation via the surgical support robot R. The easily breakable film body 4 is pierced at the tip of the jaw 24 and inserted into the cylindrical container 1 to be fitted to the tip side of the shaft 22. Thereby, the instrument 20 after use is in a state in which the tip side of the shaft 22 including the wrist 23 and the jaw 24 is always immersed in the cleaning liquid L in the cylindrical container 1 until it is used for the main cleaning by the cleaning machine. Therefore, regardless of the length of the elapsed time, it is possible to reliably prevent the attached contaminants from being fixed and dried, and to open and close the jaw 22 under the cleaning action of the cleaning liquid L, to bend and stretch the wrist 23, to rotate the shaft 22, etc. By performing this operation, it is possible to effectively release and remove contaminants from the surface of the equipment, including the amount that has entered the gap of the movable part, and it is stable and high even if manual cleaning is omitted. Cleanliness is obtained. In addition, since the cylindrical container 1 is transparent or semi-transparent, the open / close state of the jaw 22 and the bending / extending state of the wrist 23 can be visually recognized from the outside. Further, in this preliminary cleaning kit K, since the insertion opening 2a of the cap 2 is sealed with the easily breakable film body 4 in the unused state, the tip of the jaw 24 of the instrument 20 to be applied is rounded. Even if it has a shape, it can be easily inserted through the insertion opening 2a through the easily breakable membrane body 4 and inserted into the cylindrical container 1, and the seal ring 3 automatically inserts between the inserted shaft 22 and the cap 2. Since it is sealed, it can be fitted to the tip end side of the shaft 22 in a state where it is not pulled out by its own weight. Further, the preliminary cleaning kit K can procure each constituent material at low cost and is easy to assemble and manufacture.

  According to the preliminary cleaning kit K according to the invention of claim 2, the inner diameter d1 on the bottom side where the wrist 23 and the jaw 24 of the instrument 20 in the cylindrical container 1 are arranged is set to a specific multiple with respect to the shaft diameter d0. Therefore, in the presence of an appropriate amount of the cleaning liquid L, the opening / closing operation of the jaw 24 and the bending / extending operation of the wrist 23 can be increased in the state of being attached to the instrument 20, and the liberation / removal of contaminants from the device surface can be promoted accordingly. There is an advantage.

  According to the preliminary cleaning kit K according to the invention of claim 3, since the cylindrical container 1 is made of an ultrasonically permeable synthetic resin, the manual cleaning is not performed and the preliminary cleaning kit K is mounted. A high degree of cleaning can be achieved by applying the instrument 20 to an ultrasonic cleaner.

  According to the preliminary cleaning kit K according to the invention of claim 4, since the easily breakable film body 4 is made of a water-insoluble synthetic resin having a specific thickness, the tip of the jaw 24 of the instrument 20 to be applied has a rounded shape. Even if it exists, while being able to break through more easily, the reliable liquid-tight sealing property in an unused state is obtained.

  According to the preliminary cleaning kit K according to the invention of claim 5, since the cleaning liquid L is cleaning water containing a proteolytic enzyme, the protein-based dirt adhered to the instrument 20 is removed before being supplied to the cleaning machine. It can be effectively decomposed and removed.

It is a top view which shows the state which fitted the preliminary | backup cleaning kit of this invention to the surgery assistance robot instrument. It is a perspective view of the preliminary cleaning kit. It is a disassembled perspective view of the preliminary cleaning kit. It is a longitudinal cross-sectional view by the side of the cap of the preliminary washing kit. The operation of fitting the pre-cleaning kit to the instrument is shown, (a) is a longitudinal sectional view of the stage where the easily breakable membrane body is pierced with the tip of the instrument jaw, and (b) the tip of the instrument shaft. It is a longitudinal cross-sectional view of the state which inserted the side in the cylindrical container. It is a front perspective view which shows an example of the surgery assistance robot which equipped the arm with the instrument. It is a top view which shows an example of an instrument. The housing of an instrument is shown, (a) is a rear view, (b) is a rear view. The front end side of an instrument is shown, (a)-(d) is a side view which illustrates the form from which a jaw differs.

  Embodiments of a preliminary cleaning kit according to the present invention will be specifically described below with reference to the drawings. Note that the preliminary cleaning kit in the embodiment exemplifies the instrument 20 shown in FIG. 7 that is removed after the operation from the arm of the above-described surgery support robot R shown in FIG. 6 as an application target.

  As shown in FIG. 1, the preliminary cleaning kit K is fitted to the distal end side including the list 23 and the jaw 24 of the shaft 22 of the surgery support robot instrument 20, as shown in FIGS. 2 and 3. A cylindrical container 1 made of a cylindrical transparent or translucent synthetic resin, and a synthetic resin cap 2 that has an insertion port 2a on the top surface and is attached to the opening 1a of the cylindrical container 1; A perforated disk-shaped seal ring 3 that is elastically loaded inside the cap 2 and a circular fragile film body 4 that seals the insertion port 2a of the cap 2 from the inside. Has been. Although not shown in FIGS. 1 and 2, a predetermined amount of the cleaning liquid L (see FIG. 5) is stored in the cylindrical container 1 in advance.

As shown in FIG. 4, in this preliminary cleaning kit K, by screwing and tightening a female screw 2b provided on the inner periphery of the cap 2 to a male screw 1b provided on the outer periphery on the opening 1a side of the cylindrical container 1, with the seal ring 3 is pinched between the insertion opening 2a around the annular wall portion 2c of the open edge 1c and the cap 2 of the cylindrical container 1, an easily between the annular wall portion 2c and the sealing ring 3 The peripheral portion of the rupturable film body 4 is clamped and fixed, and the inside of the cylindrical container 1 in an unused state is liquid-tightly sealed by the easily breakable film body 4. In addition, in order to reduce the sliding contact resistance when the seal ring 3 is inserted into the cap 2, gear-shaped irregularities 3 b are formed on the outer periphery thereof.

  Here, the inner diameter d1 of the cylindrical container 1 is preferably in the range of 1.5 to 2.5 times the shaft diameter d0 of the instrument 20 (see FIG. 7). Further, the diameter d2 of the insertion port 2a of the cap 2 is set larger than the shaft diameter d0, and the inner diameter d3 of the seal ring 3 is set slightly smaller than the shaft diameter d0. For example, when the shaft diameter d0 is generally about 8 mm, d1 is preferably about 12 to 20 mm, d2 is about 10 to 15 mm, and d3 is about 6 to 7.5 mm. Moreover, the length of the cylindrical container 1 is about 10-20 cm.

  The synthetic resin that forms the cylindrical container 1 is not particularly limited as long as it has shape retention as a cylindrical container and is not affected by the cleaning liquid L, but the instrument 20 is subjected to ultrasonic cleaning described later. In some cases, those with high ultrasonic permeability are recommended. Examples of this ultrasonically transparent synthetic resin include polyether ether ketone, polyphenylene sulfide, polysulfone, polyether sulfone, polyarylate, polyetherimide, polyamide, polycarbonate, polyethylene terephthalate, polyphenylene ether, polybutylene terephthalate, poly Examples include vinyl chloride, polyethylene, polypropylene, polystyrene, ABS resin, AS resin, acrylic resin, phenol resin, urea resin, melamine resin, epoxy resin, polyurethane, polymethacrylate, polyvinyl acetate, and ebonite.

  Moreover, as the easily breakable film body 4, any film may be used as long as it has a sealing property to prevent the cleaning liquid L from leaking and can be pierced at the tip of the jaw 24 of the instrument 20. A film or sheet made of a water-insoluble synthetic resin having a thickness of .about.0.1 mm is preferable. If it is too thick, the fragility is insufficient, and if it is too thin, there is a concern that it may be broken unintentionally and leaked. Suitable water-insoluble synthetic resins for use in the fragile film body 4 include silicone rubber, polyethylene, polypropylene, polycarbonate, polyethylene terephthalate, polyimide, triacetate, polyphenylene sulfide, aramid resin, polyethylene naphthalate, acrylic resin, and fluorine resin. Resin, polyvinyl chloride (soft, hard), polystyrene, polyvinyl alcohol, vinylon, regenerated cellulose, polyolefin resin, ionomer resin, polyamide, polyethersulfone, polyurethane, polyphenylene ether, polyetheretherketone, polymethylpentene resin, Examples include polybutylene terephthalate, cycloolefin, and biodegradable tarpaulin.

  Furthermore, the material of the seal ring 3 is not particularly limited as long as it is an elastic polymer material. For example, natural rubber, styrene butadiene rubber, isoprene rubber, butadiene rubber, chloroprene rubber, acrylonitrile / butadiene rubber, butyl rubber, ethylene Propylene rubber, ethylene / propylene / diene rubber, urethane rubber, silicone rubber, fluorine rubber, chlorosulfonated polyethylene, chlorinated polyethylene, acrylic rubber, polysulfide rubber, epichlorohydrin rubber, and the like are suitable.

  On the other hand, the cleaning liquid L contains various surfactants, proteolytic enzymes, lipolytic enzymes, carbohydrate-degrading enzymes, etc., and an aqueous solution containing proteolytic enzymes is particularly preferable. There are many types of proteolytic enzymes, any of which can be used, but serine-type alkaline prostheses are particularly recommended. The surfactant may be nonionic, anionic, cationic, or amphoteric, but preferably has a low foaming property. In addition, a bactericidal agent, a cleaning aid, a metal corrosion inhibitor, an organic solvent, or the like may be added to the cleaning liquid L. There are many types of organic solvents, but glycerin is preferred. Further, the water content of the cleaning liquid L is preferably 50% by weight or more.

  In order to fit the preliminary cleaning kit K having the above configuration to the instrument 20, as shown in FIG. 5A, the wrist 23 of the instrument 20 is in a posture along the axial direction of the shaft 22 and the jaw 24 In a state where the two are closed, it is only necessary to insert the distal end side of the shaft 22 into the cylindrical container 1 from the insertion port 2a of the cap 2 without removing the cap 2. By this insertion operation, the easily breakable film body 4 is pierced at the tip of the jaw 24 of the instrument 20, and then the distal end side of the shaft 22 including the wrist 23 with the jaw 24 at the head is pushed out while the seal ring 3 is expanded. Although it enters the container 1, the insertion may be stopped before the tip of the jaw 24 reaches the inner bottom of the cylindrical container 1 as shown in FIG.

  Thus, while the tip end side of the shaft 22 of the instrument 20 inserted into the cylindrical container 1 is mostly immersed in the cleaning liquid L whose liquid level has risen, the space between the inserted shaft 22 and the cap 2 is between them. While being automatically sealed by the seal ring 3, the preliminary cleaning kit K itself is held in a state in which it does not drop out of the instrument 20 by its own weight by the tightening force of the seal ring 3 against the shaft 22. In the state where the preliminary cleaning kit K is mounted, the cleaning liquid L also enters the inside of the front end side of the shaft 22, but the cleaning liquid injection port 27 [see FIG. 8 (a)], it is recommended to inject the cleaning solution with a syringe or the like.

  Thus, the instrument 20 after the operation using the pre-cleaning kit K is placed in the cylindrical container 1 until the distal end side of the shaft 22 including the wrist 23 and the jaw 24 is used for the main cleaning by the cleaning machine. Since it is kept in a state of being constantly immersed in the cleaning liquid L in the inside, regardless of the length of the elapsed time, it is possible to reliably prevent the adhering contaminants from being fixed and dried. This also protects the jaw 24 part in the transport process to the site where the main cleaning is performed. Further, when the preliminary cleaning kit K is mounted, that is, under the cleaning action of the cleaning liquid L, the jaw 22 is opened / closed as shown by the phantom line and the solid line in FIG. By performing operations such as rotating 22 the contaminants can be effectively separated and removed from the surface of the equipment, including the amount that has entered the gap of the movable part, so conventional manual cleaning is omitted. Even so, high cleanliness can be stably obtained. In addition, since the cylindrical container 1 is transparent or semi-transparent, the open / close state of the jaw 22 and the bending / extending state of the wrist 23 can be visually recognized from the outside.

  In particular, if the inner diameter d1 of the cylindrical container 1 is set in a range of 1.5 to 2.5 times the shaft diameter d0 of the instrument 20 as described above, the jaw 24 Since the opening / closing operation and the bending / extending operation of the wrist 23 can be sufficiently increased, there is an advantage that the liberation / removal of contaminants from the surface of the equipment can be further promoted. In the embodiment, the cylindrical container 1 is illustrated as a cylindrical container having a substantially constant inner diameter. However, in order to obtain the advantages, the jaw 24 and the wrist 23 of the instrument 20 are disposed. What is necessary is just to set the inner diameter d1 of the bottom part side to the said range with respect to the shaft diameter d0 at least, for example, the form which the bottom part side swelled may be sufficient. Moreover, if the cylindrical container 1 is formed of an ultrasonically permeable synthetic resin, the instrument 20 is placed on an ultrasonic cleaner without manual cleaning and with the preliminary cleaning kit K attached. Since the degree of cleaning can be achieved, there is an advantage that the labor required for cleaning can be remarkably reduced as compared with the prior art. Further, the preliminary cleaning kit K can procure each constituent material at low cost and is easy to assemble and manufacture.

  On the other hand, in the embodiment, as the applied instrument 20, the jaw 24 has a pointed shape as an example, but for example, the tips 24C and 24D shown in FIGS. 9C and 9D are rounded. Even if it has a certain shape, it can be easily inserted through the easily breakable film body 4 into the cylindrical container 1 without requiring a large force. In particular, if the fragile film body 4 is made of a water-insoluble synthetic resin having a thickness of 0.04 to 0.1 mm as described above, even if the tip of the jaw 24 has a round shape. Thus, it can be more easily pierced, and reliable liquid-tight sealing in an unused state can be obtained. Furthermore, if washing water containing a proteolytic enzyme is used as the washing liquid L, protein stains adhering to the instrument 20 can be effectively decomposed and removed before being used in a washing machine.

  In addition, although the screwing type cap 2 is illustrated in the preliminary cleaning kit K of the embodiment, the cap 2 may be press-fitted into the opening 1 a of the cylindrical container 1. In addition, in the present invention, various design changes can be made in addition to the embodiment, such as the outer shape of the cylindrical container 1 and the cap 2, the outer peripheral shape of the seal ring 3, and the structure of the housing 21 of the instrument 20 to be applied. is there.

DESCRIPTION OF SYMBOLS 1 Cylindrical container 1a Opening part 2 Cap 2a Insertion port 3 Seal ring 4 Fragile membrane 20 Instrument 22 Shaft 23 List 24 Jaw d0 Shaft diameter d1 Inner diameter of cylindrical container d2 Inner diameter d3 Inner diameter of seal ring K Preliminary cleaning kit L Cleaning liquid R Surgery support robot

Claims (5)

A pre-cleaning kit that fits to the distal end side with a list of shafts and jaws for an instrument after use in a surgical operation via a surgical support robot,
A cylindrical container made of a transparent or translucent synthetic resin that contains the cleaning liquid, a cap that has an insertion port on the top surface and is attached to the opening of the cylindrical container, has elasticity, and has a resilient It is composed of a seal ring that is loaded on the inside, and a frangible membrane that seals the insertion port of the cap from the inside,
The fragile membrane body is sandwiched between the annular wall portion around the insertion opening of the cap and the seal ring at the periphery thereof,
The diameter of the insertion port of the cap is set larger than the shaft diameter of the instrument, and the inner diameter of the seal ring is set slightly smaller,
By inserting the tip end side of the shaft of the instrument from the insertion opening of the cap into the cylindrical container by breaking through the easily breakable membrane body at the tip of the jaw, the tip end side of the shaft is placed in the cylindrical container. A pre-cleaning kit for a surgical assisting robot instrument, which is soaked in the cleaning solution and sealed between the shaft and the cap by the seal ring.   The surgical support robot instrument according to claim 1, wherein the cylindrical container is configured such that an inner diameter of a bottom side on which a list of instruments and a jaw are arranged is set to 1.5 to 2.5 times the shaft diameter. Pre-cleaning kit.   The pre-cleaning kit for a surgery support robot instrument according to claim 1 or 2, wherein the cylindrical container is made of an ultrasonically permeable synthetic resin.   The pre-cleaning kit for a surgical support robot instrument according to any one of claims 1 to 3, wherein the easily breakable film body is made of a water-insoluble synthetic resin having a thickness of 0.04 to 0.1 mm.   The surgical cleaning robot instrument pre-cleaning kit according to any one of claims 1 to 4, wherein the cleaning liquid is cleaning water containing a proteolytic enzyme.

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