JP6053102B2 - Medical manipulator - Google Patents

Description

  The present invention relates to a medical manipulator that is used when performing a surgical operation, in particular, an endoscopic surgical operation, and a medical manipulator that can roll a distal end working unit having an end effector within an unlimited rotation range. .

  In endoscopic surgery (also called laparoscopic surgery), a plurality of holes are opened in the patient's abdomen, etc., and trocars (tubular instruments) are inserted into these holes, and then through each trocar, A laparoscope (camera) and a plurality of forceps are inserted into the body cavity. A gripper, a scissors, a blade of an electric knife, and the like are attached to the distal end portion of the forceps as an end effector for gripping a living tissue or the like.

  After the laparoscope and forceps are inserted into the body cavity, the operation is performed by operating the forceps while observing the inside of the abdominal cavity reflected on a monitor connected to the laparoscope. Since such an operation method does not require laparotomy, the burden on the patient is small, and the number of days until recovery and discharge from the operation is greatly reduced. For this reason, such an operation method is expected to expand the application field.

  Development of so-called medical manipulators as forceps inserted from trocars, in addition to general forceps that do not have joints at the tip, and those that have joints at the tip and can roll and tilt the end effector (For example, refer to Patent Document 1 below). According to such a medical manipulator, an operation with a high degree of freedom is possible in the body cavity, the procedure becomes easy, and the number of applicable cases increases.

Japanese Patent No. 4391762

  By the way, in a medical manipulator capable of performing a tilting operation (swinging operation) in which the distal end working unit bends with respect to the shaft, as a mechanism for opening and closing an end effector provided in the distal end working unit, A wire (flexible linear member) that follows the bending of the joint is placed in the joint between the distal end working unit and the end effector opens and closes by moving the wire forward and backward. It is possible to consider a configuration that performs the above.

  On the other hand, when such a configuration is adopted, when the distal end working portion bends with respect to the shaft, the wire does not bend suddenly at the joint portion but bends with a certain degree of curvature. It is assumed that the position of the wire is shifted to the bending direction side. For this reason, when the distal end working part is bent with respect to the shaft, there is a concern that the position of the distal end of the wire changes in the distal end working part and affects the opening of the end effector.

  The present invention has been made in consideration of such a problem, and in a medical manipulator in which a linear member having flexibility is disposed in a joint portion between a shaft and a distal end working portion so as to be able to advance and retract, It is an object of the present invention to provide a medical manipulator that can prevent or suppress a change in the opening degree of the end effector during the tilting operation of the operating unit.

In order to achieve the above object, a medical manipulator of the present invention has a handle, a shaft extending from the handle, an end effector capable of opening and closing, and tilting with respect to a tip portion of the shaft. A distal end working portion that is operatively coupled to the joint portion between the shaft and the distal end working portion, and at least a portion inserted through the joint portion is flexible; An opening / closing drive transmission unit that transmits a driving force for the opening / closing operation from the tip operation unit to the tip operation unit, in the vicinity of a tilt axis of the tip operation unit with respect to the shaft, the opening / closing drive transmission unit, Guide portions for guiding the opening / closing drive transmission portion are provided on both sides in the tilt direction of the distal end working portion, the guide portion is a guide roller, and the guide roller is opposed to the tilt axis. Is arranged at a position shifted to the base end side of the shaft Te, the leading end portion of the shaft, parallel to the first tongue portions of the pair projecting in the distal direction is provided with each other, groups of the distal end working unit The end portion is provided with a pair of second tongue pieces projecting in the proximal direction in parallel to each other, and one of the first tongue pieces and one of the second tongue pieces are rotatably connected. In addition, the other first tongue piece and the other second tongue piece are connected to each other so as to be rotatable, whereby the joint portion is configured, and the front end portion of the shaft is opposed to each other. A pair of support plates are provided, and the pair of support plates includes a connecting portion of one of the first tongue piece and one of the second tongue pieces, and the other first tongue piece and the other of the first tongue pieces. And the pair of first tongue pieces and the one piece. Arranged parallel to the second tongue portion of said guide rollers, characterized in that it is rotatably supported between the pair of support plates.

  According to the above configuration, when the distal end working portion is bent with respect to the shaft, the opening / closing drive transmitting portion is supported by the guide portion, so that the bent portion of the opening / closing drive transmitting portion is the tilting fulcrum of the distal end working portion. Held in the vicinity. For this reason, it is possible to suppress or prevent the tip position of the opening / closing drive transmission portion from changing in the tip working portion when the tip working portion is bent (tilted) with respect to the shaft. Therefore, it is possible to suitably maintain the state in which the object is gripped by the end effector.

In addition , even when the opening / closing drive transmission unit is moved forward and backward with the tip operating unit bent with respect to the shaft, the guide roller rotates in accordance with the forward / backward movement of the opening / closing drive transmission unit. You can move forward and backward. Therefore, the end effector can be reliably opened and closed, and the operability is excellent.
In the above-described medical manipulator, when the distal end working unit is inclined with respect to the shaft, the opening / closing drive transmission unit may be in contact with one of the guide rollers and separated from the other guide roller. Good. In the medical manipulator described above, the distal end operating unit is configured to open and close by advancing and retracting the single open / close drive transmission unit, and the guide roller includes the single open / close drive transmission unit. You may only guide.

  In the medical manipulator, the joint portion includes a pair of joint pins arranged on a tilt axis, and the opening / closing drive transmission portion includes a gap provided between the pair of joint pins. It is good to be able to move forward and backward in a direction crossing the axial direction of the pin.

  According to said structure, the arrangement space of the opening / closing drive transmission part in a joint part can be ensured easily.

  According to the medical manipulator of the present invention, it is possible to prevent or suppress a change in the opening degree of the end effector during the tilting operation of the distal end working unit.

It is a perspective view of the medical manipulator concerning one embodiment of the present invention. It is a perspective view of the state where a drive unit was removed from a handle body. It is a partial cross section side view of the handle in a medical manipulator. It is a perspective view of a front-end | tip operation | movement part. It is a disassembled perspective view of a front-end | tip operation | movement part. It is a longitudinal cross-sectional view of a front-end | tip operation | movement part. It is a longitudinal cross-sectional view of the joint part in the state where the front-end | tip action | operation part is straight with respect to a shaft, and its peripheral site | part. It is a longitudinal cross-sectional view of the joint part of the state (bending state) in which the front-end | tip operation | movement part inclined with respect to the shaft, and its peripheral site | part. It is a perspective view from the front side of a guide part and its peripheral part. It is a longitudinal cross-sectional view which shows the connection structure of a pull wire and a pull rod, and its peripheral part. It is a perspective view of a load control mechanism. 12A is a longitudinal sectional view showing the load control mechanism, FIG. 12B is a longitudinal sectional view showing the load control mechanism slightly retracted from FIG. 12A, and FIG. 12C is movable with respect to the state of FIG. 12B. It is a longitudinal cross-sectional view which shows the load control mechanism in the state where the distance of a part and a fixing | fixed part became short. It is a perspective view of a locking mechanism. 14A is a diagram illustrating the lock mechanism in the initial state, FIG. 14B is a diagram illustrating a state in which the hook member and the lever are engaged, and FIG. 14C is a diagram in which the hook member and the holding unit are engaged. FIG. 14D is a diagram illustrating a state in which the release portion has just hit the hook member. It is a perspective view of a handle. It is a perspective view which shows the arrangement | positioning structure of the wire in the handle | steering-wheel side. It is a schematic diagram which shows the arrangement | positioning structure of the wire in the handle | steering-wheel side. It is a cross-sectional view along the XVIII-XVIII line in FIG.

  DESCRIPTION OF EMBODIMENTS Hereinafter, preferred embodiments of a medical manipulator according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a perspective view showing a medical manipulator 10 according to an embodiment of the present invention. The medical manipulator 10 is a medical device for performing a predetermined treatment by holding a needle, a thread, or a part of a living body with an end effector 12 provided at the tip or touching the living body. The medical manipulator 10 can be configured as a needle driver, a grasping forceps, a monopolar electric knife, a bipolar electric knife, or the like according to the type of the end effector 12 provided at the tip.

  Below, first, the structure of the medical manipulator 10 made into embodiment of a needle driver is demonstrated roughly, and the structure of each part is demonstrated in detail after that.

  The medical manipulator 10 includes a distal end working unit 14 including an end effector 12, a handle 16 that drives the end effector 12, and a shaft 18 that couples the end effector 12 and the handle 16. The end effector 12 is a portion for performing a surgical treatment. In the illustrated example, the end effector 12 includes a pair of gripper members 60 and 61, and is configured as a gripper mechanism that opens and closes based on a predetermined opening and closing operation axis. The end effector 12 is not limited to the gripper mechanism, and may be configured as a bag or an electrode for an electric knife.

  The distal end working unit 14 including the end effector 12 can be changed in posture with respect to the shaft 18 with a plurality of degrees of freedom. In the present embodiment, the distal end working unit 14 tilts to the left and right with respect to the axis of the shaft 18 (swinging operation), and a “roll” that rotates around the longitudinal axis of the distal end working unit 14. Operation ". The tilting operation may be an operation of tilting up and down with respect to the axis of the shaft 18 instead of swinging in the left-right direction.

  The shaft 18 is a long and thin tubular member, and the hollow portion receives power necessary for opening / closing the end effector 12 and performing roll operation and tilting operation of the tip operation unit 14 on the handle 16 side. A plurality of members constituting a power transmission mechanism for transmitting from the tip to the distal end working unit 14 are inserted and arranged.

  The handle 16 includes a handle body 20 including a plurality of operation units, and a drive unit 22 that is detachable from the handle body 20 and includes a motor 38. The motor 38 is mounted on the handle body 20 while the drive unit 22 is mounted. When driven, the driving force of the motor 38 is configured to be transmitted to the distal end working unit 14. For this reason, the medical manipulator 10 discards the manipulator body including the handle body 20, the shaft 18 and the distal end working unit 14 after a predetermined number of uses, while the drive unit 22 changes the manipulator body to be connected. Can be used many times.

  In the medical manipulator 10 according to the present embodiment, the roll operation is electrically driven by the motor 38 and the tilt operation is manual drive. On the contrary, the tilt operation is electrically driven by the motor 38 and the roll operation is performed. A configuration of manual driving may be employed. In this way, since both the tilting operation and the roll operation are not electrically driven, but only one of them is driven by the drive source, the drive source is one and both are electrically driven. Compared to, it is possible to reduce the size and weight.

  The handle body 20 includes a body part 23 to which the base end of the shaft 18 is connected, a lever 24 (open / close operation part) provided on the body part 23, and a tilting wheel 26 (tilt operation part) provided on the body part 23. And a roll switch 28 (roll operation unit) provided on the body portion 23.

  The body part 23 is a part that is gripped by the user when the medical manipulator 10 is used. In the present embodiment, the body part 23 is configured in a stick shape that extends slightly longer in the axial direction of the shaft 18. The body portion 23 includes a housing 29 including an upper cover 29 a and a lower cover 29 b, and driving components such as pulleys, gears, and wires are disposed in the housing 29.

  A lever 24 for opening and closing the end effector 12 is provided below the body portion 23 so as to be swingable up and down with the tip end side as a fulcrum. In the present embodiment, the lever 24 is configured as a manual operation unit, and the operation force on the lever 24 is mechanically transmitted to the end effector 12 of the distal end working unit 14, thereby opening and closing the end effector 12. Done. Specifically, the end effector 12 is opened with the lever 24 opened, and the end effector 12 is closed when the lever 24 is closed.

  The tilting wheel 26 for tilting the distal end working unit 14 is provided in the vicinity of the center of the body portion 23 in the longitudinal direction. The tilting wheel 26 is configured as a manual operation unit, and a part of the circumferential direction is exposed from the housing 29. When the tilting wheel 26 is rotationally operated, the operating force is mechanically transmitted to the tip operating unit 14 via the tilting power transmission system provided in the handle 16 and the shaft 18, and the tip operating unit 14 is It tilts in a direction (left-right direction or up-down direction) that is not parallel to the axis of the shaft 18.

  A roll switch 28 for causing the distal end working unit 14 to roll is provided on the upper portion of the body portion 23 near the distal end. In the present embodiment, the roll switch 28 is configured as an electric operation unit that gives an operation command to the motor 38 via the controller 44. As shown in FIG. 15, the roll switch 28 includes a switch base 30, tact switches 31 a and 31 b provided on the switch base 30, a switch plate 32 tiltable with respect to the switch base 30, and a flexible material. And a switch cover 33 made of (for example, resin).

  Refer to FIG. 1 again. When the roll switch 28 is pressed, a signal corresponding to the pressed position is transmitted to the controller 44 via the connector 54 and the cable 42, and the motor 38 is driven under the control action of the controller 44. When the force is transmitted to the distal end working unit 14, the distal end working unit 14 rotates around the longitudinal axis of the distal end working unit 14. In this embodiment, when the portion on the right side of the roll switch 28 is pressed, the tip operating portion 14 rotates clockwise, and when the portion on the left side of the roll switch 28 is pressed, the tip operating portion 14 rotates counterclockwise.

  As shown in FIGS. 2 and 3, the drive unit 22 includes a housing 36, a motor 38 (drive source) disposed in the housing 36, and a drive gear 40 (pinion gear) fixed to the output shaft of the motor 38. And can be attached to and detached from the rear portion of the handle body 20. The housing 36 is a part that constitutes a housing 29 of the handle 16 together with the handle body 20 in a state where the drive unit 22 is mounted (connected) to the handle body 20. In this embodiment, the housing 36 extends in the longitudinal direction of the handle body 20. It has a slightly elongated shape. The motor 38 is fixed to the housing 36 by a motor holder. The drive gear 40 fixed to the output shaft of the motor 38 protrudes further toward the front end side than the front end of the housing 36.

  The drive unit 22 is connected to the controller 44 via a cable 42 including a power line and a signal line. The controller 44 performs power supply and drive control to the motor 38, and receives power from an external power source. When the roll switch 28 is operated, a signal corresponding to the operation is transmitted to the controller 44, and the controller 44 controls driving of the motor 38. Note that some or all of the functions of the controller 44 can be integrally mounted on the drive unit 22.

  The body 23 of the handle body 20 is provided with an opening 23a through which the drive gear 40 fixed to the output shaft of the motor 38 can pass, and the drive gear 40 enters the body 23 through the opening 23a. Is possible. When the drive unit 22 is mounted on the body portion 23 of the handle body 20, the drive gear 40 fixed to the output shaft 38 a of the motor 38 and the driven gear 128 provided in the body portion 23 mesh with each other. When the motor 38 rotates in this state, the rotational driving force of the motor 38 is transmitted to the handle body 20 side via the drive gear 40 and the driven gear 128.

  On both sides of the rear portion of the body portion 23 of the handle body 20, a handle side slide guide portion 34 extending along the longitudinal direction of the handle body 20 is provided. Unit-side slide guide portions 37 extending along the longitudinal direction of the housing 36 are provided on both sides of the front portion of the housing 36 of the drive unit 22. When connecting the drive unit 22 to the handle body 20, the drive unit 22 is moved from the rear side of the body portion 23 of the handle body 20 toward the body portion 23, and the unit side slide guide portion 37 and the handle side slide guide portion 34 are moved. And engage. Then, when the drive unit 22 is pushed into the handle body 20 to the maximum extent under the guide action of these guide portions, the drive gear 40 and the driven gear 128 mesh.

  As shown in FIG. 3, when the drive unit 22 is mounted on the handle body 20, the front outer peripheral edge of the drive gear 40 is contracted toward the front side with respect to the movement direction of the drive unit 22 with respect to the handle body 20. The rear outer peripheral edge of the driven gear 128 is formed in a tapered shape that is reduced in diameter toward the rear side.

  In the present embodiment, when the drive unit 22 is attached to the handle body 20, the movement direction of the drive unit 22 with respect to the handle body 20 is the front in the longitudinal direction of the handle body 20, and the tip side of the drive gear 40. The outer peripheral edge portion is formed in a tapered shape that decreases in diameter toward the distal end side, and the proximal end outer peripheral edge portion of the driven gear 128 is formed in a tapered shape that decreases in diameter toward the proximal end side. With this configuration, when the drive unit 22 is mounted on the handle body 20, the drive gear 40 and the driven gear 128 are guided by the guide action of the tapered shape formed on the drive gear 40 and the tapered shape formed on the driven gear 128. Is smoothly engaged, so that the mounting operation can be performed quickly.

  As shown in FIG. 3, a handle-side connector 50 is provided at the rear part of the body part 23 of the handle body 20, and a unit-side connector 52 is provided at the rear part of the drive unit 22. The handle-side connector 50 and the unit-side connector 52 are electrically connected to each other with the drive unit 22 mounted on the handle body 20. That is, the connector 54 is constituted by the handle side connector 50 and the unit side connector 52. When the roll switch 28 is operated while the handle side connector 50 and the unit side connector 52 are connected, a signal corresponding to the state of the roll switch 28 is transmitted to the controller via the connector 54 and the signal line of the cable 42. The motor 38 mounted on the drive unit 22 is driven under the control action of the controller 44.

  FIG. 4 is a perspective view showing the distal end working unit 14 connected to the distal end of the shaft 18. FIG. 5 is an exploded perspective view of the distal end working unit 14. FIG. 6 is a longitudinal sectional view of the distal end working unit 14. As shown in FIGS. 4 to 6, the distal end working unit 14 includes an end effector 12 that can be opened and closed, a hollow cylindrical rotating sleeve 56 (tip rotating body) to which the end effector 12 is fixed, and a rotating sleeve 56. And a front end side fulcrum block 58 that rotatably supports the shaft around the axis.

  The end effector 12 includes a first gripper member 60 and a second gripper member 61. The first gripper member 60 and the second gripper member 61 are connected by a pin 63 so as to be rotatable about the gripper axis Og. The jaw part 60a of the first gripper member 60 is provided with a gripping surface 60b on which a large number of unevennesses for slip prevention are formed. The jaw part 61a of the second gripper member 61 is provided with a gripping surface 61b on which a number of unevennesses for preventing slipping are formed. The base portion 60 c of the first gripper member 60 has a substantially cylindrical shape, and the base portion 61 c of the second gripper 61 is rotatably connected to the base portion 60 c by a pin 63. A gripping object such as a needle is gripped by the gripping surface 60 b of the first gripper member 60 and the gripping surface 61 b of the second gripper member 61.

  The base 61 c of the second gripper member 61 is coupled to the transmission member 64 via the link member 62. The base 61c and the link member 62, and the link member 62 and the transmission member 64 are rotatably connected by pins 65a and 65b, respectively. The transmission member 64 includes a guide tube portion 64a, a flange 64b provided at the distal end of the guide tube portion 64a, and a support arm 64c extending in parallel to each other in the distal direction from the edge of the flange 64b. 56 is arranged so as to be movable in the axial direction. A pin 65b is fitted into a pin hole 64d provided in the support arm 64c.

  A compression spring 66 is disposed between the transmission member 64 and the rotation sleeve 56. One end of the compression spring 66 abuts on the flange 64b of the transmission member 64, and the other end abuts on a stepped portion 56a (see FIG. 6) provided on the inner peripheral portion of the rotary sleeve 56. Always elastically energized.

  An end collar 68 is inserted into the transmission member 64 from the tip side. The distal end portion of the end collar 68 is configured as an engagement bulging portion 68 a that contacts and engages the distal end surface of the guide tube portion 64 a of the transmission member 64. The end collar 68 is fixed to the distal end of the pull wire 70 passed through the joint portion 17 (see FIGS. 4 and 6) between the distal end working portion 14 and the shaft 18.

  The pull wire 70 is a member that moves forward and backward in the shaft 18 and the distal end working portion 14 in accordance with the operation of the handle 16 on the lever 24. When the pull wire 70 is displaced in the proximal direction, the end collar fixed to the pull wire 70 is used. The transmission member 64 is pressed in the proximal direction by 68, whereby the transmission member 64 is displaced in the proximal direction against the urging force of the compression spring 66. As the transmission member 64 is displaced in the proximal direction, the second gripper member 61 connected to the link member 62 is rotated in a closing direction with respect to the first gripper member 60. In FIG. 6, the first gripper member 60 in a state where the gripping surface 61 b of the second gripper member 61 and the gripping surface 60 b of the first gripper member 60 are in contact with each other is indicated by phantom lines.

  When the pull wire 70 and the end collar 68 move forward from a state where the gripping surface 61b of the second gripper member 61 and the gripping surface 60b of the first gripper member 60 are in contact with each other, the transmission member is generated by the elastic force of the compression spring 66. Since 64 advances, the 1st gripper member 60 rotates in the opening direction with respect to the 2nd gripper member 61 via the link member 62, and returns to the original state. This operation is the opening / closing operation of the end effector 12.

  In the present embodiment, the end effector 12 is configured such that the first gripper member 60 is configured as a fixed portion and the second gripper member 61 is configured as a movable portion, but both gripper members 60 and 61 are configured as movable portions. It may be configured.

  The rotating sleeve 56 is fitted and fixed to the base portion 60c of the first gripper member 60 at the reduced diameter portion 56b at the tip. In the rotating sleeve 56, a bevel gear portion 56c is provided at the base end, and an annular recess 56d is provided on the distal end side of the bevel gear portion 56c. The end effector 12, the rotation sleeve 56, the transmission member 64, the end collar 68, and the compression spring 66 can be integrally rotated with respect to the distal end side fulcrum block 58 around the roll axis Or in the longitudinal direction of the distal end working unit 14. is there.

  The front end side fulcrum block 58 is composed of a semicircular upper block 71 and a semicircular lower block 72, and the upper block 71 and the lower block 72 are combined to form a hollow cylinder. The outer diameter of the distal side fulcrum block 58 is preferably 3 mm to 8 mm. In the present embodiment, the outer diameter is described as 5 mm. The inner diameter of the distal side fulcrum block 58 is preferably 2 mm to 7 mm, and in the present embodiment, it will be described as 4 mm.

  Arc-shaped projections 71 a and 72 a are provided on the inner peripheral portions of the upper block 71 and the lower block 72, respectively, and the arc-shaped projections 71 a and 72 a are engaged with the annular recess 56 d provided on the rotating sleeve 56. The rotation sleeve 56 is connected to the tip side fulcrum block 58 so as to be rotatable and not movable in the axial direction. The arc-shaped protrusions 71a and 72a have a predetermined protrusion amount (for example, 0.7 mm) toward the central axis in the longitudinal direction, and have a predetermined width (for example, 1 mm) in the longitudinal direction so that strength can be obtained. . In the present embodiment, an arc-shaped protrusion 71 a is provided on the inner peripheral portion of the semicircular upper block 71, and one arc-shaped protrusion 72 a is provided on the inner peripheral portion of the semicircular lower block 72. Not limited to this, the arc-shaped protrusion 71a may be composed of a plurality of protrusions. For example, the arc-shaped protrusions 71a may be arranged on the inner peripheral portion of the upper block 71 at intervals of 30 °. In this case, the arc-shaped protrusions 71a are constituted by three arc-shaped protrusions.

  The tip side fulcrum block 58 and the shaft side fulcrum block 59 are connected to each other by joint pins 73 and 74 so as to be rotatable around the tilt axis Oy. The shaft side fulcrum block 59 is fixed to the distal end of a hollow shaft main body 19 constituting the body portion of the shaft 18. The shaft 18 is configured by the shaft-side fulcrum block 59 and the shaft body 19.

  In the present embodiment, the tilt axis Oy is set in the vertical direction, but may be set in another direction that intersects the axis of the shaft body 19. The distal-end fulcrum block 58 includes a cylindrical portion 58a and tongue pieces 58b and 58c protruding in the proximal direction from the upper and lower portions of the proximal end of the tubular portion 58a. The shaft-side fulcrum block 59 includes a tubular portion 59a and tongue pieces 59b and 59c that protrude in the distal direction in parallel from the upper and lower ends of the distal end of the tubular portion 59a. Joint pins 73 and 74 are fitted to the tongue pieces 58 b and 58 c of the distal end side fulcrum block 58 and the tongue pieces 59 b and 59 c of the shaft side fulcrum block 59.

  As shown in FIGS. 5 to 9, a support block 76 is attached to the tip of the cylindrical portion 59 a of the shaft side fulcrum block 59. The support block 76 includes upper and lower support plates 77 and 78 that face each other in parallel, and a connecting portion 79 that connects the left and right rear ends of the support plates 77 and 78. The upper support plate 77 is provided with a pin hole 77a into which the upper joint pins 73 and 74 are inserted, and left and right pin holes 77b into which the upper ends of the two pins 84 are respectively inserted. The lower support plate 78 is provided with a hole 78a into which the reduced diameter upper end 90a of the driven pulley 90 is inserted, and left and right pin holes 78b into which the lower ends of the two pins 84 are respectively inserted.

  As shown in FIGS. 7 to 9, the pull wire 70 (opening / closing drive transmission unit 80) is in the vicinity of the tilting axis Oy with respect to the shaft 18 of the distal end working unit 14 and both sides in the tilting direction of the distal end working unit 14 (this embodiment). Guide portions 82 for guiding the pull wire 70 are provided on both the left and right sides in the embodiment. Since such a guide portion 82 is provided, when the distal end working portion 14 is bent with respect to the shaft 18, the pull wire 70 is supported by the guide portion 82, so that the bent portion of the opening / closing drive transmission portion 80 is It is held near the tilting fulcrum of the operating unit 14. For this reason, when the distal end working unit 14 is bent (tilted) with respect to the shaft 18 (see FIG. 8), it is possible to suppress or prevent the distal end of the pull wire 70 from moving forward in the distal end working unit 14. Therefore, it is possible to suitably maintain the state in which the end effector 12 holds the object.

  In the present embodiment, two guide rollers 83 as the guide portion 82 are arranged side by side in the left-right direction between the upper and lower support plates 77, 78. The guide roller 83 is supported by two pins 84 arranged in parallel to each other so as to be rotatable in the left-right direction. The pull wire 70 described above is passed between the two guide rollers 83. With this configuration, even when the opening / closing drive transmission unit 80 is moved forward / backward with the distal end working unit 14 bent with respect to the shaft 18, the guide roller 83 is moved along with the forward / backward movement of the pull wire 70 (open / close drive transmission unit 80). Since it rotates, the pull wire 70 can be smoothly advanced and retracted. Therefore, the end effector 12 can be reliably opened and closed, and the operability is excellent.

  As shown in FIG. 6, the joint portion 17 between the distal end working portion 14 and the shaft 18 has a pair of joint pins 73 and 74 disposed on the tilt axis Oy, and a part of the opening / closing drive transmission portion 80. The pull wire 70 can be moved forward and backward in a direction intersecting the axial direction of the joint pins 73 and 74 through a gap provided between the pair of joint pins 73 and 74. According to this configuration, an arrangement space for the pull wire 70 in the joint portion 17 can be easily secured.

  A bevel gear 86 (intermediate member) is rotatably supported by the joint pin 73 between the upper support plate 77 and the tongue piece 58b. The bevel gear 86 is rotatable independently of the support plate 77 and the tongue piece 58b. The tooth portion 86 a of the bevel gear 86 meshes with a bevel gear portion 56 c provided at the proximal end of the rotating sleeve 56 and a bevel gear portion 88 a provided at the tip of the gear member 88. The gear member 88 provided with the bevel gear portion 88a is a hollow cylindrical member, and the pull wire 70 is inserted into the hollow portion.

  When the gear member 88 rotates, the rotational force of the gear member 88 is transmitted to the rotary sleeve 56 via the bevel gear 86 and the bevel gear portion 86c, and the rotary sleeve 56 and the end effector 12 fixed thereto are connected to the distal end side fulcrum. The block 58 rotates about the roll axis Or. This operation is a roll operation of the tip operation unit 14.

  A driven pulley 90 is rotatably supported by a joint pin 74 between the lower support plate 78 and the tongue piece 58c. The driven pulley 90 is fixed to the inner surface of the tongue piece 58 c of the distal end side fulcrum block 58. Therefore, the driven pulley 90 and the tip side fulcrum block 58 including the tongue piece 58 c can be integrally swung with respect to the shaft side fulcrum block 59. A wire 150 for tilting operation is wound around the driven pulley 90. A part of the wire 150 is fixed to the driven pulley 90 and is disposed up to the handle 16 side through the shaft 18. Details of the arrangement structure of the wire 150 will be described later.

  When the driven pulley 90 is rotationally driven by the wire 150, the tip side fulcrum block 58 fixed to the driven pulley 90 rotates integrally with the driven pulley 90. As a result, the distal end working unit 14 including the distal end side fulcrum block 58, the rotation sleeve 56 and the end effector 12 rotates about the tilt axis Oy with respect to the shaft 18. This operation is the tilting operation of the distal end working unit 14. FIG. 8 shows a state where the distal end working unit 14 is inclined (bent) with respect to the shaft 18. The tilting operation of the distal end working unit 14 has movable ranges on the plus side (right side) and the minus side (left side), respectively, with the state where the distal end working unit 14 is straight with respect to the shaft 18 being a neutral position (reference position). In the present embodiment, the distal end working unit 14 has a movable range of + 70 ° to −70 ° with respect to the tilting motion.

  FIG. 10 is a longitudinal sectional view showing a connection structure 92 between the pull wire 70 and the pull rod 91. As shown in FIG. 10, the pull wire 70 and the pull rod 91 are relatively rotatable in a hollow shaft 89 connected to the base end of the gear member 88, and the pulling force in the base end direction of the pull rod 91 is the pull wire 70. It is connected so that it may be transmitted. Specifically, a wire collar 93 is fixed to the proximal end of the pull wire 70, a hollow outer collar 94 is fixed to the distal end of the pull rod 91, and the wire collar 93 is disposed in the outer collar 94. The wire collar 93 can rotate around the axis within the outer collar 94, but is prevented from coming out of the outer collar 94 by being caught by a reduced diameter portion 94 a provided at the tip of the outer collar 94.

  With this configuration, when the pull rod 91 is displaced in the axial direction, the pull wire 70 connected to the pull rod 91 via the connecting structure 92 is also displaced in the axial direction, so that the end effector 12 can be opened and closed. Done. In addition, since the pull wire 70 can rotate with respect to the pull rod 91 when the distal end working unit 14 performs a roll operation, the roll operation of the distal end working unit 14 is not hindered, and the pull wire 70 is twisted. This prevents the pull wire 70 from being damaged.

  As shown in FIG. 3, the pull rod 91 is inserted into the hollow shaft 89, and its base end protrudes from the base end of the hollow shaft 89. On the other hand, the lever 24 is pivotally connected to the body portion 23 at a position near the front end of the body portion 23 at the front end portion thereof. Near the tip of the lever 24, the tip of a lever rod 96 is rotatably connected, and the lever rod 96 is disposed below the body part 23 and substantially parallel to the longitudinal direction of the body part 23. . A hook holder 116 that supports a hook member 118, which will be described later, is fixed to the lower portion of the body portion 23, and a compression spring 98 is provided between the distal end surface of the hook holder 116 and the distal end enlarged diameter portion 96a of the lever rod 96. Be placed. This compression spring 98 always urges the lever rod 96 elastically in the distal direction. Therefore, the lever 24 connected to the lever rod 96 is always subjected to a force in the opening direction with respect to the body portion 23 by the elastic force of the compression spring 98.

  FIG. 11 is a perspective view of the load control mechanism 100 that transmits the driving force from the lever 24 to the opening / closing drive transmission unit 80 via the elastic member 105. 12A to 12C are vertical cross-sectional views of the load control mechanism 100 and its peripheral parts. The load control mechanism 100 is provided on a driving force transmission path between the opening / closing drive transmission unit 80 including the pull wire 70 and the pull rod 91 and the lever 24 as an operation unit.

  In the present embodiment, the load control mechanism 100 is provided at the proximal ends of the pull rod 91 and the lever rod 96, and can be displaced in the axial direction by being guided by the pull rod 91 and the locking portion 102 fixed to the pull rod 91. The movable portion 104, the support connecting body 106 fixed to the lever rod 96 and engaged with the movable portion 104, the fixed portion 108 positioned with respect to the pull rod 91 on the proximal side of the movable portion 104, and the movable portion 104 And an elastic member 105 disposed between the fixing portion 108 and an adjustment nut 110 (adjustment member) that is screwed into the pull rod 91 and whose position in the axial direction relative to the pull rod 91 is displaced by rotation.

  The locking portion 102 is fixed to the pull rod 91 so as not to be displaceable in the axial direction, and the movable portion 104 urged in the distal direction by the elastic member 105 abuts on the locking portion 102 so that the movable portion 104 is It functions as a stopper that is locked so as not to be displaced further toward the tip side. The movable portion 104 is formed in a hollow cylindrical shape, and the pull rod 91 is inserted through the hollow portion. The movable portion 104 is always urged elastically in the distal direction by the elastic member 105.

  The lower end portion of the support coupling body 106 is fixed to the base end of the lever rod 96 by screwing. Left and right arms 107 are provided on the upper side of the support connecting body 106, and the upper end portion of the support connecting body 106 is fixed to the fixing portion 108 via the pin 109 in a state where the fixing portion 108 is disposed between the left and right arms 107. To be pivotally connected to each other. In the present embodiment, the elastic member 105 is a coiled compression spring 105 </ b> A disposed outside the pull rod 91 between the movable portion 104 and the fixed portion 108. The elastic force of the compression spring 105A is compressed in the distal end working portion 14 so that the pull rod 91 is displaced in the proximal direction as the movable portion 104 is displaced in the proximal direction together with the lever rod 96. It is larger than the elastic force of the spring 66 (see FIG. 6).

  The fixing portion 108 is formed in a hollow cylindrical shape, and a flange 108a that bulges outward in the radial direction is provided at the base end thereof. One end of the compression spring 105A abuts on a stepped portion 104a provided on the movable portion 104, and the other end of the compression spring 105A abuts on the front surface of the flange. As a result, the compression spring 105 </ b> A is held between the movable portion 104 and the fixed portion 108. The fixing portion 108 is locked by coming into contact with the end face of the adjustment nut 110, and thereby positioned with respect to the pull rod 91.

  When the adjustment nut 110 is rotated, the axial position of the adjustment nut 110 with respect to the pull rod 91 is displaced. Therefore, the position of the fixing portion 108 relative to the pull rod 91 can be adjusted and positioned by the adjusting nut 110.

  The load control mechanism 100 configured as described above operates as follows. In the handle main body 20, the lever rod 96, the support coupling body 106, and the movable portion 104 are in the positions shown in FIG. This is the initial position. In this initial position, the pull rod 91 is advanced to a position where the end effector 12 is fully opened. When the user grips the lever 24 and pulls the lever 24 toward the body portion 23 (closes the lever 24), the lever rod 96, the support coupling body 106, and the movable portion 104 are displaced in the proximal direction as shown in FIG. 12B. To do. At this time, since the pull rod 91 is pulled in the proximal direction via the compression spring 105A, the movable portion 104, and the adjustment nut 110, the end effector 12 operates in the closing direction.

  When the lever 24 is further pulled toward the body portion 23 from the position where the end effector 12 has just grasped the object, the compression spring 105A is compressed between the movable portion 104 and the fixed portion 108 as shown in FIG. 12C. Thus, the movable portion 104 is displaced toward the fixed portion 108 side, that is, the base end side while the positions of the pull rod 91, the fixed portion 108, and the adjusting nut 110 are maintained. At this time, the distance between the fixed portion 108 and the movable portion 104 is shorter than the state of FIG. 12A. By such an action of the load control mechanism 100, after the object is gripped by the end effector 12, even if the lever 24 is further operated in the direction of closing the end effector 12, the compression spring 105 </ b> A is compressed and deformed, thereby opening / closing driving. It is prevented that an excessive tensile load is applied to the transmission unit 80 (overload prevention function).

  Further, according to the load control mechanism 100, the drive between the opening / closing drive transmission unit 80 and the lever 24 is performed when the distal end working unit 14 is bent with respect to the shaft 18 while the end effector 12 holds the object. When the elastic member 105 provided on the force transmission path is extended, the pull wire 70 is compensated for by the displacement in the bending direction of the pull wire 70 at the joint portion 17 between the distal end working portion 14 and the shaft 18. It is displaced in the proximal direction. For this reason, the end effector 12 does not open with the bending of the distal end working unit 14. That is, the state in which the end effector 12 grips the object can be reliably maintained (gripping maintenance function).

  Further, in the case of the present embodiment, the coil-shaped compression spring 105A is disposed so as to surround the outside of the pull rod 91 which is a part of the opening / closing drive transmission unit 80, and the fixing unit 108 is displaced in the axial direction using the pull rod 91 as a guide. Accordingly, since the displacement of the fixing portion 108 is performed smoothly, the above-described gripping maintenance function and overload prevention function can be reliably exhibited.

  In the case of this embodiment, the magnitude of the urging force of the elastic member 105 in the load control mechanism 100 can be easily adjusted by changing the position of the adjustment nut 110 with respect to the pull rod 91 constituting the opening / closing drive transmission unit 80.

  As shown in FIGS. 3 and 13, the medical manipulator 10 according to the present embodiment has a lock mechanism that can lock the lever 24 at a predetermined position with respect to the body portion 23 and can release the lock on the lever 24. 114 is provided. Specifically, the lock mechanism 114 is configured to hold the position (posture) of the lever 24 with respect to the body portion 23 when the lever 24 comes to a position where the end effector 12 is closed.

  As shown in FIG. 13, in the present embodiment, the lock mechanism 114 includes a hook holder 116 fixed to the lower portion of the body portion 23 of the handle body 20, and a hook member 118 rotatably supported by the hook holder 116. The elastic member 120 biases the hook member 118 toward the lever 24 and the holding portion 122 that engages the hook member 118 and holds the hook member 118 when the hook member 118 is rotated to a predetermined position. A through hole 116a is formed in the hook holder 116 along the longitudinal direction of the body portion 23, and a lever rod 96 is inserted into the through hole 116a so as to be displaceable in the front-rear direction.

  The hook member 118 is a member rotatably supported by the shaft portion 119 on the proximal end side of the hook holder 116, and when the lever 24 comes to a predetermined position (hereinafter referred to as “first position”), the lever 24 It is possible to engage with an engagement pin 25 provided on the. The hook member 118 includes a base portion 118a including a shaft portion 119, a hook 118b extending downward from the base end side of the base portion 118a, and left and right engaging portions 118c extending upward from the base end side of the base portion 118a. Have.

  In this embodiment, the elastic member 120 is configured in the form of a torsion spring 120 </ b> A, one end engages with a recess 116 b provided on the proximal end side of the hook holder 116, and the other end is a lateral groove provided on the hook member 118. The hook member 118 is always elastically biased toward the lever 24 side (downward) in a state of being engaged with the portion 118e. The bottom of the recess 116b provided in the hook holder 116 and the lower surface of the base 118a of the hook member 118 are in contact with each other, so that the hook member 118 is restricted from rotating further downward.

  The holding part 122 has a base plate 122a fixed to the body part 23, and left and right arms 122b extending downward from left and right ends of the base plate 122a. Each arm 122b is provided with an engaging convex portion 122c having a convex shape on the inside. When the hook member 118 is rotated to the second position closer to the body portion 23 than the first position (the position where the hook member 118 overlaps the arm portion of the holding portion in the vertical direction), the engagement convex portion 122c and the hook The hook member 118 is held by the holding portion 122 by engaging with the engaging recess 118 d provided on the outer surface of the engaging portion 118 c of the member 118. The lever 24 can be detached from the hook member 118 in a state where the hook member 118 is held by the holding portion 122.

  Further, when the lever 24 is displaced in a direction away from the body portion 23 while the hook member 118 is held by the holding portion 122, the lock mechanism 114 is displaced in conjunction with the operation of the lever 24, and It has a release portion 124 that causes the hook member 118 to be detached from the holding portion by abutting. In the present embodiment, the release portion 124 is fixed to the lever rod 96 behind the hook member 118, and moves in the front-rear direction integrally with the lever rod 96 when the lever rod 96 is displaced in the front-rear direction. . An abutting portion 126 that abuts against the hook member 118 when the lever 24 is displaced in a direction away from the body portion 23 with the hook member 118 held by the holding portion 122 is provided at the distal end side of the release portion 124.

  The lock mechanism 114 configured as described above operates as follows. In FIG. 14A, the lever 24 is in the lowest position (opened) with respect to the body portion 23, the hook member 118 is in the lowest position, and the release portion 124 is in the most retracted position. 14A, when the lever 24 is pulled toward the body portion 23 side, the engaging pin 25 provided on the lever 24 pushes the jaw 118f of the hook 118b of the hook member 118, whereby the hook member 118 is torsioned. It rotates to the body part 23 side (upward) against the elastic force of the spring 120A. Then, as shown in FIG. 14B, when the engaging pin 25 gets over the jaw 118f, the engaging pin 25 is engaged with the hook 118b. The lever 24 is elastically biased in the opening direction with respect to the body portion 23 by the compression spring 98. However, when the engagement pin 25 is engaged with the hook 118b, the lever 24 moves in the opening direction. I can't. Therefore, even if the user releases the lever 24, the position of the lever 24 with respect to the body portion 23 is maintained. That is, the lever 24 is locked.

  Thus, by locking the position of the lever 24 while the object is gripped by the end effector 12, the gripping of the object by the end effector 12 can be maintained even when the user releases the lever 24. it can. Therefore, the operation load on the user can be reduced.

  As shown in FIG. 14C, when the lever 24 is further pulled in the closing direction, the hook member 118 is pushed up by the engagement pin 25, and the engagement portion 118c of the hook member 118 and the holding portion 122 are engaged. Since the engaging force between the engaging portion 118c and the holding portion 122 is larger than the elastic force of the torsion spring 120A, the hook member 118 is not pushed down by the torsion spring 120A. The engaging pin 25 of the lever 24 can be detached from the hook member 118 in a state where the hook member 118 is held by the holding portion 122. Accordingly, when the user releases the lever 24, the lever 24 is lowered, and the lever 24 can be returned to the original position (see FIG. 14A).

  As described above, since the engagement between the hook member 118 and the lever 24 can be released only by operating the lever 24 closer to the body portion 23 from the state where the lever 24 is locked, the lever 24 is locked. Can be quickly and easily released.

  After the engagement between the engagement pin 25 of the lever 24 and the hook member 118 is released, the lever rod 96 and the release portion 124 move forward in the process of lowering the lever 24. Then, as shown in FIG. 14D, when the abutting portion 126 of the release portion 124 abuts against the hook member 118 and pushes the hook member 118 forward, the hook member 118 is thereby rotated downward, thereby holding it. The engagement between the portion 122 and the hook member 118 is released. As a result, the hook member 118 returns to the initial position shown in FIG. 14A under the biasing action of the torsion spring 120A.

  As described above, after the engagement between the lever 24 and the hook member 118 is released, the engagement between the holding portion 122 and the hook member 118 is automatically released simply by moving the lever 24 in the direction away from the body portion 23. The hook member 118 can be quickly returned to the initial position. Therefore, there is no need to perform the operation of returning the hook member 118 to the initial position, and the operability is excellent.

  Next, a mechanism related to the roll operation of the distal end working unit 14 will be described mainly with reference to FIGS. 3 and 6. In the present embodiment, the roll operation of the distal end working unit 14 is performed by transmitting the driving force of the motor 38 to the distal end working unit 14. The roll operation drive system for causing the tip operating unit 14 to perform a roll operation includes the motor 38, the drive gear 40 fixed to the motor 38, the driven gear 128 meshing with the drive gear 40, and the driven gear 128 fixed. A roll drive transmission tube 130, a bevel gear 86 that meshes with the tip of the roll drive transmission tube 130, and a rotating sleeve 56 that meshes with the bevel gear 86. In the present embodiment, the roll drive transmission tube 130 is configured by the gear member and the hollow shaft 89. Further, a rotation drive transmission unit 132 that transmits a rotation drive force from the handle 16 side to the distal end working unit 14 side by the roll drive transmission tube 130 (see also FIGS. 3 and 7), the bevel gear 86, and the rotation sleeve 56. Is configured.

  When the drive unit 22 is attached to the handle body 20 and the controller 44 is connected to the power source, when the roll switch 28 shown in FIG. 3 is pressed, the motor 38 rotates and the driving force is applied to the driving gear. 40, the driven gear 128, the roll drive transmission tube 130, the bevel gear 86, and the rotating sleeve 56 are transmitted to the distal end working unit 14. Thereby, the roll operation | movement of the front-end | tip operation | movement part 14 is performed.

  According to the medical manipulator 10 according to the present embodiment, transmission of rotational force from the handle 16 side to the distal end working unit 14 side is not performed via a wire and a pulley, but via a roll drive transmission tube 130 or the like. For this reason, the tip operating unit 14 can be rolled in an unlimited rotation range. The opening / closing drive transmission unit 80 (the pull wire 70 and the pull rod 91) is inserted and arranged inside the roll drive transmission tube 130, so that the opening / closing drive force is applied to the end effector 12 without being affected by the rotation of the roll drive transmission tube 130. Can communicate properly.

  Further, as shown in FIG. 6, the opening / closing drive transmission unit 80 has a flexible structure at the portion corresponding to the joint portion 17 (pull wire 70), so that the opening / closing driving force is appropriately applied to the end effector 12 with a simple configuration. Can communicate. Therefore, according to the medical manipulator 10, a roll operation with an unlimited rotation range can be performed while maintaining a structure capable of opening / closing and tilting the tip operating unit 14 without complicating the mechanism of the tip operating unit 14. realizable.

  Next, a mechanism related to the tilting operation of the distal end working unit 14 will be described. FIG. 15 is a perspective view of the handle 16. In FIG. 15, in order to facilitate understanding of the structure, the upper cover 29a and the tilting wheel 26 are indicated by phantom lines. The body portion 23 of the handle main body 20 has a handle 16 frame housed in a housing 29. The handle 16 frame has a first frame 134, a second frame 136, and a third frame 138.

  The first frame 134 is provided on the distal end side of the body portion 23, and the roll switch 28 is attached to the upper portion of the first frame 134. The second frame 136 is disposed adjacent to the rear of the first frame 134. The third frame 138 is disposed adjacent to the rear of the second frame 136.

  The first driving shaft 140 is fixed to the tilting wheel 26, and the tilting wheel 26 and the first driving shaft 140 rotate integrally. The first drive shaft 140 is rotatably supported by the upper cover about the vertical axis, and has a first gear 141. The first gear 141 meshes with a second gear 143 provided on the second drive shaft 142. The second drive shaft 142 is disposed on the second frame 136 in parallel with the first drive shaft 140, and has a second gear 143 and a worm gear 144 on the same axis. The second gear 143 and the worm gear 144 rotate integrally. A rotating body 146 having a worm wheel 147 that meshes with the worm gear 144 is disposed on the second frame 136 so as to be rotatable about the horizontal axis of the body portion 23.

  FIG. 16 is a perspective view (partially sectional view) showing a wire arrangement structure on the handle 16 side. FIG. 17 is a schematic view showing a wire arrangement structure on the handle 16 side.

  The rotating body 146 has a worm wheel 147 and a drive pulley 148 on the same axis. The worm wheel 147 and the drive pulley 148 rotate integrally. A wire 150 is wound around the drive pulley 148, the wire 150 is inserted into the shaft 18, and is wound around the driven pulley 90 (see FIG. 6 and the like) on the distal end side of the shaft 18.

  In the handle body 20, a first intermediate pulley 152 and a second intermediate pulley 154 are arranged on the front end side (front) of the drive pulley 148, and a wire 150 is connected to the first intermediate pulley 152 and the second intermediate pulley 154. Wrapped. The first intermediate pulley 152 and the second intermediate pulley 154 are rotatably supported by the first frame 134 by pins 155 and 156, respectively, about the vertical axis. The first frame 134 is provided with arrangement grooves 134a and 134b having a shape opened in the proximal direction for arranging the first intermediate pulley 152 and the second intermediate pulley 154 side by side.

  In the present embodiment, the handle 16 includes a first tension mechanism 158 that applies tension to one side portion of the wire 150 between the drive pulley 148 and the driven pulley 90, and a gap between the drive pulley 148 and the driven pulley 90. A second tension mechanism 164 that applies tension to the other side portion of the wire 150 is provided. The first tension mechanism 158 includes a first tension pulley 159 wound around the wire 150, a first holding unit 160 that supports the first tension pulley 159 and is displaceable, and a first holding unit 160. And a first adjusting unit 161 for adjusting and positioning the position. Similarly, the second tension mechanism 164 includes a second tension pulley 165 wound around the wire 150, a second holding portion 166 that supports the second tension pulley 165 and is displaceable, A second adjusting unit 167 that adjusts and positions the position of the holding unit 166.

  In the handle body 20, the first tension pulley 159 and the second tension pulley 165 are disposed on the base end side (rear side) of the drive pulley 148. The first tension pulley 159 and the second tension pulley 165 are supported so as to be rotatable about a horizontal axis. Specifically, the first tension pulley 159 is rotatably supported by the support shaft 170 on the distal end portion of the first holding portion 160, and the support shaft 170 is provided on the side wall of the second frame 136. A long hole 171 extending in the direction is guided to be slidable in the front-rear direction. Similarly, the second tension pulley 165 is rotatably supported on the tip of the second holding portion 166 by the support shaft 172, and the support shaft 172 is provided in the front-rear direction provided on the side wall 136a of the second frame 136. It is guided by a long hole 173 extending in a slidable manner in the front-rear direction.

  As shown in FIG. 17, the first holding portion 160 is provided with a screw hole 160a, and the screw rod 161a of the first adjustment portion 161 is screwed into the screw hole 160a. The head 161b of the first adjustment unit 161 has a larger diameter than the screw rod 161a. The screw rod 161a of the first adjustment portion 161 is inserted from the rear through a through hole provided in the rear wall 136b of the second frame 136, and the head portion 161b contacts the rear wall 136b. When the first adjustment unit 161 is rotated, the first holding unit 160 is moved in the front-rear direction by a screwing action. Therefore, by adjusting the position of the first tension pulley 159 supported by the first holding unit 160, the tension applied to one side portion of the wire 150 between the drive pulley 148 and the driven pulley 90 is adjusted. Can do.

  The second holding portion 166 is provided with a screw hole 166a, and the screw rod 167a of the second adjustment portion 167 is screwed into the screw hole 166a. The head 167b of the second adjustment unit 167 has a larger diameter than the screw rod 167a. The screw rod 167a of the second adjustment portion 167 is inserted from the rear through a through hole provided in the rear wall 136b of the second frame 136, and the head 167b comes into contact with the rear wall 136b. When the second adjusting portion 167 is rotated, the second holding portion 166 moves in the front-rear direction by a screwing action. Therefore, by adjusting the position of the second tension pulley 165 supported by the second holding portion 166, the tension applied to the other side portion of the wire 150 between the driving pulley 148 and the driven pulley 90 is adjusted. Can do.

  18 is a cross-sectional view taken along line XVIII-XVIII in FIG. As shown in FIG. 18, an annular space 21 extending along the axis of the shaft 18 is provided between the shaft 18 and the roll drive transmission tube 130, and the wire 150 is inserted into the annular space 21. . As described above, the wire 150 is wound around the driven pulley 90 (see FIG. 6) disposed at the tip of the shaft 18.

  As shown in FIG. 5, two guide grooves 19 a that guide the wire 150 are provided at different positions in the circumferential direction on the inner peripheral surface of the tip end of the shaft body 19. The shaft side fulcrum block 59 fixed to the tip of the shaft main body 19 is provided with two guide holes 59d through which the wire 150 is slidably inserted at different circumferential positions. Each guide hole 59d penetrates the cylindrical portion 59a of the shaft side fulcrum block 59 in the axial direction. As shown in FIG. 9, the wire 150 is wound around the driven pulley 90 at a portion drawn from the two guide holes 59 d.

  Next, the operation of the mechanism related to the tilting operation configured as described above will be described. When the tilting wheel 26 shown in FIG. 15 is manually rotated, the operating force is transmitted to the first drive shaft 140, the second drive shaft 142, and the rotating body 146. The rotational force transmitted to the rotator 146 drives the wire 150 wound around the drive pulley 148 provided on the rotator 146. In this case, one side portion of the wire 150 between the driving pulley 148 and the driven pulley 90 is wound around the first intermediate pulley 152 and the first tension pulley 159, and the driven pulley 90 with the driving pulley 148 The other side portion of the wire 150 is wound around the second intermediate pulley 154 and the second tension pulley 165, and is driven according to the rotation of the drive pulley 148 in a state where tension is applied. The driving of the wire 150 is output as the rotation of the driven pulley 90 at the tip of the shaft 18, whereby the tilting operation of the tip working unit 14 with respect to the shaft 18 is performed.

  The medical manipulator 10 according to the present embodiment includes the first tension mechanism 158 and the second tension mechanism 164, so that the wires 150 are individually provided on one side and the other side of the wire 150 between the driving pulley 148 and the driven pulley 90. The tension | tensile_strength can be provided with respect to wire 150 and appropriate tension can be given to the whole wire 150. Thereby, the front-end | tip operation | movement part 14 responds correctly with respect to a user's operation, and the outstanding operativity is acquired.

  In addition, since each of the first tension mechanism 158 and the second tension mechanism 164 includes tension pulleys 159 and 165, holding portions 160 and 166, and adjustment portions 161 and 167, the drive pulley 148 and the driven pulley 90 are provided. The tension of the wire 150 can be individually adjusted for one side and the other side of the wire 150. Therefore, power transmission from the driving pulley 148 to the driven pulley 90 via the wire 150 can be performed more appropriately.

  Further, in the medical manipulator 10 according to the present embodiment, the two tension pulleys 159 and 165 and the two intermediate pulleys 152 and 154 are arranged before and after the drive pulley 148 as a reference. Is efficiently arranged, and as a result, the handle 16 can be made small.

  In the medical manipulator 10, the handle 16 has a manual operation unit for performing manual operation for one of the tilting operation and the roll operation of the tip operation unit 14, and the other operation of the tilting operation and the roll operation. An electric operation unit for instructing and a drive source that operates based on an operation on the electric operation unit are provided, and a user's operation force on the manual operation unit is mechanically transmitted via the first power transmission path. The driving force of the drive source is transmitted to the tip operating unit 14 via the second power transmission path, and the tip from the manual operation unit side is provided in the middle of the first power transmission path. A one-way power transmission mechanism 176 configured to transmit power to the operating unit 14 side but not transmit power in the opposite direction is provided.

  In the present embodiment, the tilting wheel 26 corresponds to the manual operation unit, the roll switch 28 corresponds to the electric operation unit, the motor 38 corresponds to the drive source, and tilting is performed. The power transmission path (the second drive shaft 142, the rotating body 146, the wire 150, etc.) between the wheel 26 and the front end working unit 14 corresponds to the first power transmission path, and the motor 38 and the front end working unit 14 The power transmission path (such as the roll drive transmission pipe 130) between the first and second power transmission paths corresponds to the second power transmission path.

  Unlike the present embodiment, when a configuration is employed in which the tilting operation is performed by electric drive and the roll operation is performed by manual driving, power transmission between the manual operation unit for roll and the tip operation unit 14 is performed. The path corresponds to the first power transmission path, and the power transmission path between the driving source that operates based on the tilting electric operation section and the tip operating section 14 corresponds to the second power transmission path. To do.

  As shown in FIG. 17, in the present embodiment, the one-way power transmission mechanism 176 includes the worm gear 144 and the worm wheel 147 described above. In the first power transmission path, the worm wheel 147 is disposed closer to the distal end working unit 14 than the worm gear 144.

  In the medical manipulator 10 including the one-way power transmission mechanism 176, when the distal end working unit 14 is operated based on the roll switch 28, the distal end working unit 14 receives a force in the tilting operation direction due to interference on the mechanism. The unidirectional power transmission mechanism 176 blocks the transmission of power from the distal end working unit 14 side to the tilting wheel 26 side. For this reason, when operating the distal end working unit 14 based on the roll switch 28, the distal end working unit 14 does not interfere with the operability even if the user does not fix the tilting wheel 26 by hand. Excellent.

  The medical manipulator 10 achieves a reduction in size and weight by adopting a configuration in which only the roll operation is electrically driven and the tilt operation is manually driven. If both the roll operation and the tilting operation are electrically driven, the interference operation described above can be prevented by a large gear ratio (geared motor) or motor control, but one of the roll operation and the tilting operation is manually driven. In the case of a configuration in which the other is electrically driven, an interference operation preventing means using a large gear ratio (geared motor) or motor control cannot be adopted.

  On the other hand, the medical manipulator 10 can realize the prevention of the above-described interference operation by providing the above-described one-way power transmission mechanism 176 in addition to the reduction in size and weight due to the single motor 38 being mounted. .

  In the above description, the present invention has been described with reference to preferred embodiments. However, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the present invention. Needless to say.

DESCRIPTION OF SYMBOLS 10 ... Medical manipulator 12 ... End effector 14 ... End effector 16 ... Handle 18 ... Shaft 19 ... Shaft body 20 ... Handle body 22 ... Drive unit 23 ... Body part 24 ... Lever 26 ... Tilt wheel 28 ... Roll switch 38 ... Motor 40 ... Drive gear 56 ... Rotating sleeve 70 ... Pull wire 73, 74 ... Joint pin 80 ... Opening / closing drive transmission part 82 ... Guide part 83 ... Guide roller 86 ... Bevel gear 88 ... Gear member 90 ... Driving pulley 91 ... Pull rod 96 ... Lever rod 98 ... compression spring 100 ... load control mechanism 104 ... movable part 105, 120 ... elastic member 108 ... fixed part 110 ... adjustment nut 114 ... lock mechanism 118 ... hook member 122 ... holding part 124 ... release part 128 ... driven gear 130 ... Roll drive transmission tube 144 ... Worm gear 147 ... Worm wheel 148 ... Drive pulley 150 ... Wire 152 ... First intermediate pulley 154 ... Second intermediate pulley 158 ... First tension mechanism 159 ... First tension pulley 160 ... First holding part 161 ... First adjustment part 164 ... Second tension mechanism 165 ... Second tension pulley 166 ... Second holding part 167 ... Second adjustment part 176 ... One-way power transmission mechanism

Claims (4)

A handle,
A shaft extending from the handle;
A distal end working unit having an end effector capable of opening and closing, and connected to the distal end of the shaft so as to be tiltable;
It is inserted into a joint part between the shaft and the tip operating part so as to be able to advance and retreat, and at least a part inserted through the joint part has flexibility, and the opening / closing operation is performed from the handle side to the tip operating part. An opening / closing drive transmission unit for transmitting a driving force for
Guide portions for guiding the opening / closing drive transmission unit are provided in the vicinity of the tilt axis of the tip operation unit with respect to the shaft and on both sides of the opening / closing drive transmission unit in the tilting direction of the tip operation unit,
The guide portion is a guide roller,
The guide roller is disposed at a position shifted to the proximal end side of the shaft with respect to the tilt axis ,
A pair of first tongue pieces projecting in the distal direction parallel to each other are provided at the distal end of the shaft,
A proximal end portion of the distal end working portion is provided with a pair of second tongue pieces protruding in the proximal direction parallel to each other,
One of the first tongue pieces and one of the second tongue pieces are rotatably connected, and the other first tongue piece and the other second tongue piece are rotatable. To form the joint part,
A pair of support plates facing each other are provided at the tip of the shaft,
The pair of support plates includes a connection portion of one of the first tongue pieces and one of the second tongue pieces, and a connection portion of the other first tongue piece and the other second tongue piece. Between the pair of first tongue pieces and the pair of second tongue pieces,
The guide roller is rotatably supported between the pair of support plates .
A medical manipulator characterized by that. The medical manipulator according to claim 1, wherein
When the tip operating portion is inclined with respect to the shaft, the opening / closing drive transmission portion is in contact with one of the guide rollers and is separated from the other guide roller,
A medical manipulator characterized by that. The medical manipulator according to claim 1, wherein
The tip operation unit is configured to open and close by advancing and retracting the one opening / closing drive transmission unit,
The guide roller guides only one of the opening / closing drive transmission unit,
A medical manipulator characterized by that. The medical manipulator according to any one of claims 1 to 3,
The joint portion has a pair of joint pins arranged on the tilt axis,
The opening / closing drive transmission unit is capable of moving forward and backward in a direction intersecting the axial direction of the joint pin through a gap provided between the pair of joint pins.
A medical manipulator characterized by that.

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