JP6454179B2 - Posture lock device for medical devices - Google Patents

Description

  The present invention relates to a posture lock device for a medical device.

  Conventionally, when a medical device is supported on a support such as an arm so that its posture can be adjusted, a ball joint including a ball portion and a rod portion is generally widely used. It is also common practice to lock the posture of the medical device relative to the support by using an electromagnetic brake that locks the ball portion of the ball joint relative to the receiving portion of the support so as not to rotate. The electromagnetic brake consists of a shoe that can contact the outer peripheral surface of the ball part, a spring that urges the elastic force that presses the shoe against the outer peripheral surface of the ball part, and the shoe against the elastic force of the spring. And an electromagnet that generates a magnetic force to be attracted in a direction away from the outer peripheral surface of the part. When the electromagnet is energized, the shoe separates from the outer peripheral surface of the ball portion against the spring force of the spring. Thereby, the posture of the medical device can be adjusted. On the other hand, when the energization of the electromagnet is stopped, the shoe is pressed against the outer peripheral surface of the ball portion by the elastic force of the spring. The frictional force between the ball portion and the shoe prevents the ball portion from rotating due to the weight of the medical device, and locks the posture of the medical device relative to the support.

JP 2005-125056 A

  However, since it has a structure that supports the weight of the medical device only by friction caused by the spring force, it is difficult to support a relatively heavy medical device. When the lock is released, the medical device is completely free, and the load of the medical device suddenly acts on the hand of the operator who is adjusting the posture of the medical device. As a result, it becomes difficult for the operator to perform a minute positioning operation of the medical device.

  Therefore, the present invention has been made to solve the above-described problems, and an object thereof is to provide a posture lock device for a medical device that facilitates adjustment of the posture of the medical device with respect to a support.

A posture locking device for a medical device that achieves the above object includes a medical device connected to the rod portion of a ball joint including a ball portion and a rod portion, and the ball portion of the ball joint is rotated with respect to a receiving portion. And a brake mechanism that locks the posture of the medical device with respect to the support by being locked impossible. The brake mechanism includes a first brake part, a second brake part, a first switch, and a second switch. The first brake portion includes a first shoe that is freely contactable with an outer peripheral surface of the ball portion, and the ball portion is moved by pressing the first shoe against the outer peripheral surface of the ball portion. A first resistance force (f1) that resists rotation by the weight of the medical device is applied. The second brake portion includes a second shoe that can freely contact a portion of the outer peripheral surface of the ball portion that is different from a portion that contacts the first shoe, and the second shoe is attached to the ball. By pressing against the outer peripheral surface of the part, a second resistance force (f2) that resists rotation of the ball part due to its own weight is applied. The first switch selectively switches energization or de-energization of the first resistance force (f1) by the first brake unit using electromagnetic force or fluid pressure . The second switch selectively switches energization or de-energization of the second resistance force (f2) by the second brake unit. The second switch includes a second switch operating lever that switches between a position where the second shoe is pressed against the outer peripheral surface of the ball portion and a position where the second shoe is separated from the outer peripheral surface of the ball portion. When finely adjusting the posture of the medical device, only one of the first resistance force (f1) and the second resistance force (f2) is urged to lock the posture of the medical device. Sometimes, both the first resistance force (f1) and the second resistance force (f2) are energized.

  According to the posture lock device for a medical device configured as described above, the second brake portion urges the second resistance force f2 even when finely adjusting the posture of the medical device. Will not be completely free. The surgeon does not need the force to support the weight of the medical device. Therefore, since the operating force for adjusting the posture of the medical device does not increase, workability when finely adjusting the posture of the medical device is improved. Further, when the posture of the medical device is locked, since both the first resistance force f1 and the second resistance force f2 are urged, the braking force that locks the ball portion relative to the receiving portion so as not to rotate is increased. . Therefore, it is possible to stably support a relatively heavy medical device.

It is a side view which shows the magnetic stimulation treatment system incorporating this invention. It is a side view which shows the principal part of the magnetic stimulation apparatus shown by FIG. 3A (A) and 3 (B) are a plan view and a front view showing the posture lock device of the medical device in a state where the posture of the medical device is locked. It is sectional drawing which follows the 3B-3B line | wire of FIG. 3A (A). 4A (A) and 4 (B) are a plan view and a front view showing the posture lock device of the medical device in a state where the posture of the medical device is finely adjusted. It is sectional drawing which follows the 4B-4B line | wire of FIG. 4A (A). It is a side view which shows the attitude | position lock apparatus of a medical device in the state which has adjusted the attitude | position of a medical device finely. It is sectional drawing which shows the attitude | position lock apparatus of a medical device in the state which cancelled | released energization of the 1st resistance force by a 1st brake part, and cancelled | released energization of the 2nd resistance force by a 2nd brake part. . It is sectional drawing which shows the modification which increases the braking force which locks the attitude | position of a medical device. 8A and 8B are a side view and a bottom view showing the link mechanism of the arm portion of the present embodiment. It is a figure where it uses for description of the effect of the direction where a resilient force acts. It is a graph which shows an example of the arm torque diagram in this embodiment. It is a side view which shows the link mechanism of the comparative arm part which uses only a spring. It is a graph which shows an example of the arm torque diagram in contrast. It is a top view which shows the slide apparatus for medical devices. It is sectional drawing which shows the principal part of the internal structure of the post part in the slide apparatus for medical devices. It is a perspective view which shows a tension | tensile_strength provision member. It is the figure which looked at the front-end | tip part of the arm part in a magnetic stimulation apparatus from upper direction. FIG. 17A is a perspective view showing the arm portion, the coil attachment portion, and the magnetic stimulation coil in the magnetic stimulation apparatus in a state before the magnetic stimulation coil is attached to the coil attachment portion, and FIG. It is a perspective view which shows the arm part in the apparatus, the coil attachment part, and the magnetic stimulation coil in the state which attached the magnetic stimulation coil to the coil attachment part seeing from the direction different from FIG. 17 (A). 18A is a cross-sectional view taken along line 18-18 in FIG. 16, and FIG. 18B is an enlarged cross-sectional view showing a portion denoted by reference numeral 18B in FIG. 18A. 19A is a cross-sectional view taken along the line 19-19 in FIG. 16, and FIG. 19B is an enlarged cross-sectional view showing a portion denoted by reference numeral 19B in FIG. 19A.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, the following description does not limit the meaning of the technical scope and terms described in the claims. In addition, the dimensional ratios in the drawings are exaggerated for convenience of explanation, and may differ from actual ratios.

(Embodiment)
FIG. 1 is a side view showing a magnetic stimulation treatment system 10 incorporating the present invention, and FIG. 2 is a side view showing a main part of the magnetic stimulation apparatus 20 shown in FIG.

  The illustrated magnetic stimulation treatment system 10 is used in a therapy that directly stimulates the brain, which is one of the treatment methods for cranial nerve diseases such as Parkinson's disease and depression, and rehabilitation after stroke. As a therapy for directly stimulating the brain, a magnetic stimulation therapy that applies magnetic stimulation to a specific part of a patient's head, for example, repetitive transcranial magnetic stimulation (rTMS) is used. Magnetic stimulation therapy is a treatment method that stimulates nerves by inducing an electric field in the skull, and it has features such as being able to stimulate tissues without dissipating magnetic energy, and stimulating the brain more accurately and reliably. Have.

  Referring to FIG. 1, a magnetic stimulation treatment system 10 includes a magnetic stimulation device 20 that stimulates a patient's brain with magnetic energy, and a seat 30 on which the patient sits during treatment.

  The seat 30 includes a seat surface portion 31, a backrest portion 32, a foot support portion 33, a base portion 34 that supports the seat surface portion 31, and a caster 35 attached to the lower surface of the base portion 34. The seat surface portion 31, the backrest portion 32, and the foot support portion 33 are adjustable in inclination angle according to the posture of the patient. An armrest 36 is attached to the side of the seat surface portion 31. A headrest 37 for fixing the patient's head is attached to the top of the backrest 32. The sheet 30 is movable by a caster 35.

  The magnetic stimulation apparatus 20 suspends and supports a magnetic stimulation coil 21 (hereinafter also simply referred to as “coil 21”) as a medical device, a coil attachment portion 22 to which the coil 21 is attached on the lower surface side, and the coil attachment portion 22. The arm part 23, the arm attachment part 24 to which the base end part of the arm part 23 is attached, the post part 25 that supports the arm attachment part 24, and the cart part 26 to which the post part 25 is attached are provided. The medical device is not limited to the coil 21, and is a tool used in a treatment device, a diagnosis device, a research device, a test device, and the like, and a wide variety of tools that need to be adjusted in posture. included.

  The coil 21 applies magnetic stimulation to the head of the living body (patient). The coil element incorporated in the coil 21 may appropriately adopt a shape such as a circular shape, an 8-shaped shape, or a conical shape. Since the shape of the magnetic field applied to the head differs depending on the shape, for example, the shape of the coil element to be employed is selected according to the type of cranial nerve disease. Since a large current on the order of several thousand A flows through the coil element, a cooling unit (not shown) for cooling the coil element is attached around the coil element. The coil 21 is detachably attached to the coil attachment portion 22. Depending on the treatment content, the coil 21 is replaced with a coil 21 having a different shape. The cooling part of the coil 21 is connected to a chiller device 41 built in the cart part 26. The chiller device 41 supplies the cooled refrigerant to the cooling unit via the supply hose 42a. The refrigerant that has cooled the coil element is returned from the cooling unit to the chiller device 41 via the discharge hose 42b.

  The coil attachment portion 22 is suspended and supported via a ball joint 43 on the lower surface side of the distal end of the arm portion 23. The coil attachment portion 22 can adjust the posture with respect to the arm portion 23 to a desired posture by the ball joint 43. The base end portion of the arm portion 23 is attached to the arm attachment portion 24 via the joint portion 44. The arm portion 23 is rotatable in a vertical plane by the joint portion 44. The arm attachment portion 24 is attached to the post portion 25 via a bearing portion (not shown). The arm attachment portion 24 is rotatable in a horizontal plane by the bearing portion. The post portion 25 is attached to the upper surface of the cart portion 26 via a slide mechanism so as to be slidable in a direction approaching and separating from the patient (left and right direction on the paper). The arm assembly 500 is configured by the arm portion 23, the arm attachment portion 24, and the post portion 25. The arm assembly 500 slides through the slide mechanism.

  The coil with respect to the patient's head is obtained by adjusting the posture of the coil mounting portion 22 with respect to the arm portion 23, rotating the arm portion 23 in the vertical plane, rotating the arm mounting portion 24 in the horizontal plane, and sliding the post portion 25. 21 postures can be adjusted to a desired posture. Magnetic stimulation must be applied accurately to specific parts of the patient's head. For this reason, when the adjustment of the posture of the coil 21 is finished, the ball joint 43, the joint portion 44, the bearing portion, and the slide mechanism are locked in an inoperable state. Thereby, the coil 21 is positioned with high accuracy.

  In addition to the chiller device 41, the cart unit 26 includes a current supply device 45 that houses electrical components that supply a large current to the coil element, and a controller 46 that controls the operation of the entire magnetic stimulation therapy system 10. The controller 46 receives the temperature of the coil element, a signal from the chiller device 41, a signal from the current supply device 45, a biological signal acquired from the living body, and the like via the input / output unit. In order to measure a patient's electrocardiogram signal (to generate electrocardiogram data) as a biological signal, and the permeability (arterial blood oxygen saturation (hereinafter referred to as SpO2)) of red light and infrared light of blood flowing through the patient's fingertip. ), A myoelectric signal of a living body (to generate electromyogram data), and the like. From the controller 46, a signal for controlling the operation of the chiller device 41, a signal for the operation of the current supply device 45, and the like are output via the input / output unit. A monitor 47 connected to a controller 46 is attached to the cart unit 26. The monitor 47 displays the operating state of the current supply device 45, the patient's state, and the like. The controller 46 controls the operation of the current supply device 45 using the biological signal, and controls the intensity of magnetic stimulation that the coil 21 gives to the living body.

  A caster 48 is provided on the lower surface of the cart portion 26. The cart unit 26 and the magnetic stimulation device 20 can be moved by a caster 48.

  Magnetic stimulation therapy using the magnetic stimulation treatment system 10 is performed as follows.

  First, before starting treatment by magnetic stimulation therapy, the operator precisely sets the position of the coil 21 to a position suitable for treating the patient's symptoms. Whether or not the position of the coil 21 is appropriate can be confirmed by the display on the monitor 47 (part receiving magnetic stimulation).

  When the treatment is started, the controller 46 controls the current supply device 45 to supply a current to the coil 21. An electric field is induced from the coil 21 into the patient's skull, and magnetic stimulation is applied to the patient's head. By this magnetic stimulation, for example, a cranial nerve disease such as Parkinson's disease is treated. The controller 46 controls the intensity of the magnetic stimulation by changing the magnitude of the current output to the coil 21, the interval at which the current flows, and the time.

  The controller 46 displays electrocardiogram data, SpO2, electromyogram data, and the like on the monitor 47 based on the patient's biological signals (electrocardiogram signal, permeability, electromyogram signal). By seeing these displays, the surgeon can easily grasp the state of treatment and the state of the patient being treated. The operator appropriately adjusts the intensity of the magnetic stimulation according to the patient's condition while monitoring the patient's condition.

  In the magnetic stimulation therapy, as described above, it is necessary to precisely set the position of the coil 21 to a position suitable for treating the patient's symptoms. From the viewpoint of improving the workability of the work of adjusting the position of the coil 21, the following points are required for the magnetic stimulation device 20.

  First, it is easy to adjust the posture of the relatively heavy coil 21 with respect to the arm 23.

  Secondly, the arm portion 23 supporting the relatively heavy coil 21 can be operated without feeling the weight of the coil 21.

Thirdly, it is easy to adjust the position for sliding the arm assembly 500, and fourth, it is easy to replace the coil 21. Hereinafter, it demonstrates in order.
[1. Posture lock device for medical device]
First, the medical device posture locking device 100 for facilitating adjustment of the posture of the coil 21 with respect to the arm portion 23 will be described.

  In the magnetic stimulation device 20 of the present embodiment, the posture lock device 100 for a medical device is configured as follows.

  3A (A) and 3 (B) are a plan view and a front view showing the posture lock device 100 of the medical device in a state where the posture of the medical device is locked, and FIG. 3B is 3B-3B of FIG. 3A (A). It is sectional drawing which follows a line. 4A (A) and 4 (B) are a plan view and a front view showing the posture lock device 100 of the medical device in a state where the posture of the medical device is finely adjusted, and FIG. 4B is a view of 4B- of FIG. 4A (A). It is sectional drawing which follows the 4B line. FIG. 5 is a side view showing the posture lock device 100 of the medical device in a state where the posture of the medical device is finely adjusted. FIG. 6 shows the posture lock device 100 of the medical device in a state where the biasing of the first resistance force by the first brake part is released and the biasing of the second resistance force by the second brake part is released. It is sectional drawing shown.

  The posture lock device 100 (hereinafter, also referred to as “posture lock device 100”) of the medical device according to the present embodiment is briefly described as a medical device connected to the rod portion 102 of the ball joint 43 including the ball portion 101 and the rod portion 102. The device includes a brake mechanism 104 that locks the posture of the medical device relative to the support by locking the ball portion 101 of the ball joint 43 with the receiving portion 103 so as not to rotate. The brake mechanism 104 includes a first brake unit 105, a second brake unit 106, a first switch 107, and a second switch 108. The first brake unit 105 includes a first shoe 109 that is freely contactable with the outer peripheral surface of the ball unit 101, and the ball unit 101 is pressed by pressing the first shoe 109 against the outer peripheral surface of the ball unit 101. A first resistance force f1, which is resistance against rotation by the weight of the medical device, is applied. The second brake portion 106 includes a second shoe 110 that can freely come into contact with a portion of the outer peripheral surface of the ball portion 101 that is different from a portion that the first shoe 109 contacts. By pressing against the outer peripheral surface of the portion 101, a second resistance force (f2) that resists the ball portion 101 from rotating due to its own weight is applied. The first switch 107 selectively switches energization or de-energization of the first resistance force f <b> 1 by the first brake unit 105. The second switch 108 selectively switches energization or de-energization of the second resistance force f <b> 2 by the second brake unit 106. The posture locking device 100 biases only one of the first resistance force f1 and the second resistance force f2 when finely adjusting the posture of the medical device. When locking the posture of the medical device, both the first resistance force f1 and the second resistance force f2 are urged. In the present embodiment, the above “medical device” is the coil 21 used in the magnetic stimulation therapy for applying magnetic stimulation to a living body (for example, the head). However, since the coil 21 is connected to the rod portion 102 of the ball joint 43 via the coil attachment portion 22, the above “self-weight of the medical device” is equal to the weight of both the coil 21 and the coil attachment portion 22. Become. Details will be described below.

  Referring to FIG. 2, posture locking device 100 is provided at the distal end portion of arm portion 23 corresponding to a support. The coil 21 is suspended from the arm portion 23 via the ball joint 43.

  Referring to FIGS. 3A, 3B, 4A, and 4B, posture lock apparatus 100 has a hollow cylindrical casing 111, and an upper end opening is sealed by a lid member 112 having a center hole 112a. Yes. A lower plate 113 is attached to the bottom of the casing 111. The lower plate 113 is formed with a receiving portion 103 having an arc-shaped cross section that is in contact with the substantially lower half of the ball portion 101. The receiving portion 103 is formed with a through-hole 103a through which the rod portion 102 is inserted. An upper plate 114 is stored above the lower plate 113 so as to be movable toward and away from the lower plate 113. The upper plate 114 is formed with a first shoe 109 having an arc shape in cross section with which the substantially upper half of the ball portion 101 contacts. The first shoe 109 is formed with a center hole 109a through which a shaft 116 of the second brake portion 106 described later is inserted. The ball portion 101 is sandwiched between the receiving portion 103 of the lower plate 113 and the first shoe 109 of the upper plate 114. The material for forming the lower plate 113 and the upper plate 114 is not particularly limited. For example, the lower plate 113 and the upper plate 114 can be formed from a rubber material having high hardness. A spring 115 is attached between the lid member 112 and the upper plate 114 to bias the elastic force that presses the first shoe 109 against the outer peripheral surface of the ball portion 101.

  The first brake unit 105 is attached between the first shoe 109 that can freely contact the outer peripheral surface of the ball unit 101, the lid member 112, and the upper plate 114. The first shoe 109 is attached to the ball unit 101. And a spring 115 that urges a resilient force to be pressed against the outer peripheral surface. The first brake unit 105 is provided with a first resistance force f1 that resists the ball unit 101 from rotating due to the weight of both the coil 21 and the coil mounting unit 22 due to the elastic force of the spring 115. Rush.

  The 2nd brake part 106 is comprised from the toggle clamp using the toggle mechanism which is a booster mechanism. The second brake unit 106 includes a shaft 116 that passes through the center hole 109 a of the first shoe 109, and an operation lever 118 that is connected to the shaft 116 via a toggle mechanism 117. The tip of the shaft 116 shown at the lower end in the drawing is provided with a second shoe 110 that can contact the outer peripheral surface of the ball portion 101. The material for forming the second shoe 110 is not particularly limited, but can be formed from, for example, a rubber material having high hardness. The second shoe 110 is in contact with the outer peripheral surface of the ball portion 101 at a central hole 109 a formed in the first shoe 109. That is, the second shoe 110 can freely contact a portion of the outer peripheral surface of the ball portion 101 that is different from a portion that the first shoe 109 contacts. When the operation lever 118 is tilted as shown in FIGS. 3A (B), 3B, 4A (B), and 4B, the second brake unit 106 has a shaft 116 that moves the ball 116 by a toggle mechanism 117, which is a type of link mechanism. It is pushed down toward the portion 101 and urges the force that presses the second shoe 110 against the outer peripheral surface of the ball portion 101. The second brake unit 106 is a second resistor that resists rotation of the ball unit 101 due to the weight of both the coil 21 and the coil mounting unit 22 due to the force thus converted by the toggle mechanism 117. The resistance force f2 is energized.

  The first switch 107 includes a release cam 119 disposed on the lower surface side of the upper plate 114. The release cam 119 includes a rotation shaft 120, an eccentric cam 121 attached to the rotation shaft 120, and an operation lever 122 connected to the rotation shaft 120 and disposed outside the casing 111. When the operation lever 122 is rotated from the position shown in FIGS. 4A (B), 4B, and 5 to the position shown in FIGS. 3A (B) and 3B, the convex portion 121a of the eccentric cam 121 is displaced downward. . Thus, in the first brake unit 105, the first shoe 109 of the upper plate 114 is pressed against the outer peripheral surface of the ball unit 101 by the elastic force of the spring 115, and urges the first resistance force f1. On the other hand, when the operation lever 122 is rotated from the position shown in FIGS. 3A (B) and 3B to the position shown in FIGS. 4A (B), 4B, and 5, the convex portion 121a of the eccentric cam 121 is moved upward. Displace. As a result, the first brake portion 105 is applied with the first resistance force f1 because the first shoe 109 of the upper plate 114 separates from the outer peripheral surface of the ball portion 101 against the elastic force of the spring 115. Release the force.

  The second switch 108 is configured by a toggle mechanism 117 in the second brake 106. When the operation lever 118 is tilted to the position shown in FIG. 3A (B), FIG. 3B, FIG. 4A (B), or FIG. 4B, the second brake unit 106 causes the shaft 116 to face the ball unit 101 by the toggle mechanism 117. Pressed down, urges the second resistance force f2. On the other hand, when the operation lever 118 is raised to the position shown in FIG. 6, the second brake unit 106 has the second resistance force because the shaft 116 is pulled up by the toggle mechanism 117 and is separated from the outer peripheral surface of the ball unit 101. Release the energization of f2. Since the second brake unit 106 is configured by a toggle clamp, the shaft 116 easily operates by one action of tilting or raising the operation lever 118. As compared with a mode in which the knob bolt is rotated forward and backward to press and release the second shoe 110 against the outer peripheral surface of the ball portion 101, the second resistance force f2 is selectively biased or released. Switching can be performed easily and quickly.

  Although not shown, an electrical switch is connected to the first switch 107, and in conjunction with the operation of the first switch 107, other movable parts (the joint part 44, the bearing part, the slide mechanism, etc.) Lock / free can be switched. Specifically, when the first resistance force f <b> 1 is urged by the first brake unit 105, the other movable units are locked in an inoperable state in conjunction with the operation of the first switch 107. Thereby, the posture and position of the coil 21 are fixed. Conversely, when releasing the bias of the first resistance force f <b> 1 by the first brake unit 105, the other movable units are also made free to be operable in conjunction with the operation of the first switch 107. Accordingly, the posture and position of the coil 21 can be adjusted by moving the arm assembly 500. Independently of the first switch 107, a dedicated operation switch for switching lock / free of other movable parts (such as the joint part 44, the bearing part, and the slide mechanism) can be provided. When a dedicated operation switch is provided, the position of the coil 21 is adjusted by moving the other joints of the arm portion 23 while maintaining the posture of the coil 21 by urging the first resistance force f1. Is possible.

  In the present embodiment, the posture locking device 100 biases only the second resistance force f2 when finely adjusting the posture of the coil 21 (FIG. 4B), and the first resistance when locking the posture of the coil 21. Both the force f1 and the second resistance force f2 are energized (FIG. 3B). Even when the attitude of the coil 21 is finely adjusted, the coil 21 and the coil mounting portion 22 are not completely free because the second brake portion 106 urges the second resistance force f2. The surgeon does not need a force that supports the weights of both the coil 21 and the coil attachment portion 22. Therefore, since the operation force for adjusting the posture of the coil 21 does not increase, workability when finely adjusting the posture of the coil 21 is improved. Further, when the posture of the coil 21 is locked, both the first resistance force f1 and the second resistance force f2 are urged, so that the braking force that locks the ball portion 101 with respect to the receiving portion 103 so as not to rotate. Increase. Therefore, the relatively heavy coil 21 can be stably supported.

  Here, the second resistance force f <b> 2 urged when finely adjusting the posture of the coil 21 is such that both the coil 21 and the coil attachment portion 22 are located within a range where the coil 21 can move via the ball joint 43. It is preferable that it is smaller than the maximum rotational force Fmax among the rotational forces in which the ball portion 101 is rotated by its own weight. If the second resistance force f2 is equal to or greater than the maximum rotational force Fmax, the operation force for adjusting the posture of the coil 21 becomes large, and therefore the posture of the coil 21 cannot be finely adjusted. On the other hand, if the second resistance force f2 is smaller than the maximum rotational force Fmax, the coil 21 may move somewhat depending on the weight of the coil 21 and the coil mounting portion 22 depending on the posture of the coil 21, but the posture of the coil 21 is adjusted. Therefore, the workability when finely adjusting the posture of the coil 21 is improved.

  The operation will be described.

  When finely adjusting the posture of the coil 21 with respect to the arm portion 23 from the state where the posture of the coil 21 is locked, the operator applies the second resistance force f2 by the second brake portion 106 by the second switch 108. While being energized, the energization of the first resistance force f1 by the first brake unit 105 is released by the first switch 107. Specifically, the operation lever 118 of the release cam 119 is moved to the position shown in FIGS. 4A (B) and 4B while the operation lever 118 of the second brake unit 106 is tilted to the position shown in FIGS. 4A (B) and 4B. Rotate to the position shown. As a result, the second brake unit 106 biases the second resistance force f <b> 2 while the shaft 116 remains pushed down toward the ball unit 101 by the toggle mechanism 117. In the first brake part 105, the convex part 121 a of the eccentric cam 121 is displaced upward, so that the first shoe 109 of the upper plate 114 resists the elastic force of the spring 115 from the outer peripheral surface of the ball part 101. It separates and the energizing of the 1st resistance force f1 is cancelled | released.

  The surgeon sets the position of the coil 21 to a position suitable for treating the patient's symptoms. At this time, since the second brake portion 106 biases the second resistance force f2, the coil 21 and the coil mounting portion 22 are not completely free. The surgeon does not need a force that supports the weights of both the coil 21 and the coil attachment portion 22. Therefore, since the operation force for adjusting the posture of the coil 21 does not increase, workability when finely adjusting the posture of the coil 21 is improved.

  When the fine adjustment of the posture of the coil 21 is completed and the posture of the coil 21 is locked, the surgeon keeps urging the second resistance force f2 by the second brake unit 106 by the second switch 108, and The first resistance force f <b> 1 by the first brake unit 105 is biased by the first switch 107. Specifically, the operation lever 122 of the release cam 119 is moved to the position shown in FIGS. 3A (B) and 3B while the operation lever 118 of the second brake unit 106 is tilted to the positions shown in FIGS. 3A (B) and 3B. Rotate to the position shown. As a result, the second brake unit 106 biases the second resistance force f <b> 2 while the shaft 116 remains pushed down toward the ball unit 101 by the toggle mechanism 117. In the first brake part 105, the convex part 121a of the eccentric cam 121 is displaced downward, so that the first shoe 109 of the upper plate 114 is pressed against the outer peripheral surface of the ball part 101 by the elastic force of the spring 115, The first resistance force f1 is energized.

  When the posture of the coil 21 is largely changed from the state in which the posture of the coil 21 is locked, the surgeon releases the bias of the second resistance force f2 by the second brake unit 106 by the second switch 108. Then, the bias of the first resistance force f <b> 1 by the first brake unit 105 is also released by the first switch 107. Specifically, the operation lever 118 of the second brake unit 106 is raised to the position shown in FIG. 6, and the operation lever 122 of the release cam 119 is rotated to the position shown in FIG. As a result, the second brake unit 106 releases the bias of the second resistance force f2 because the shaft 116 is pulled up by the toggle mechanism 117 and is separated from the outer peripheral surface of the ball unit 101. In the first brake part 105, the convex part 121 a of the eccentric cam 121 is displaced upward, so that the first shoe 109 of the upper plate 114 resists the elastic force of the spring 115 from the outer peripheral surface of the ball part 101. It separates and the energizing of the 1st resistance force f1 is cancelled | released.

  The surgeon greatly changes the position of the coil 21. At this time, since the bias of the first resistance force f1 is released and the bias of the second resistance force f2 is released, the coil 21 and the coil attachment portion 22 are completely free. Although the surgeon needs a force to support both the weight of the coil 21 and the coil attachment portion 22, the braking force does not act, so that the workability when the posture of the coil 21 is largely changed is hindered. Absent.

  A mode is also conceivable in which the posture of the coil 21 is changed by moving the coil 21 along a guide member having a special shape, for example, a curved shape. However, when the surgeon does not use a guide member having such a special shape, it is difficult for the surgeon to perform an intuitive operation. In this embodiment, since the coil 21 is supported by the arm part 23 via the ball joint 43 used in various machines, the operation of adjusting the posture of the coil 21 can be performed intuitively.

  FIG. 7 is a cross-sectional view showing a modified example in which the braking force for locking the posture of the medical device is increased.

  In the modified example shown in FIG. 7, a range 131 where the first shoe 109 contacts and a range 132 where the second shoe 110 contacts are roughened on the outer peripheral surface of the ball portion 101. The means for roughening is not particularly limited. A desired range can be roughened by blasting, surface treatment by laser light irradiation, or the like.

  By roughening the outer peripheral surface of the ball portion 101, the frictional force between the outer peripheral surface of the ball portion 101 and the first shoe 109 and the frictional force between the outer peripheral surface of the ball portion 101 and the second shoe 110 are increased. Further, the braking force for locking the posture of the coil 21 is further increased. Therefore, the relatively heavy coil 21 can be supported more stably.

  Here, when the rod portion 102 of the ball joint 43 is most inclined with respect to the vertical direction, the first shoe 109 contacts the roughened outer peripheral surface, and the second shoe 110 is roughened. It is preferable to contact the outer peripheral surface.

  When the rod portion 102 is most inclined with respect to the vertical direction, the rotational force by which the ball portion 101 rotates due to the weights of both the coil 21 and the coil mounting portion 22 is maximized. Therefore, by setting the braking force that locks the posture of the coil 21 to be increased when it is most affected by the weights of both the coil 21 and the coil mounting portion 22, the relatively heavy coil 21 can be made more stable. It becomes possible to support.

  Another modification that increases the braking force that locks the posture of the medical device includes making the shape of the ball portion 101 of the ball joint 43 a specific shape.

  That is, the shape of the ball portion 101 of the ball joint 43 is such that the distance between the first shoe 109 and the receiving portion 103 when the rod portion 102 is inclined with respect to the vertical direction is such that the rod portion 102 is along the vertical direction. It is preferable to have a large non-spherical shape (the cross section is an ellipse) compared to the case where the

  With this configuration, the distance between the first shoe 109 and the receiving portion 103 increases when the coil 21 and the coil attachment portion 22 are easily affected by their own weight, and the outer periphery of the ball portion 101 is increased. The frictional force between the surface and the first shoe 109 increases. Therefore, by setting the braking force that locks the posture of the coil 21 to be increased, the relatively heavy coil 21 can be supported more stably.

  Similarly, the shape of the ball portion 101 of the ball joint 43 is such that the distance between the second shoe 110 and the receiving portion 103 when the rod portion 102 is inclined with respect to the vertical direction is such that the rod portion 102 is in the vertical direction. It is preferable to have a larger non-spherical shape (the cross section is an oval shape) than when located along the side.

  With this configuration, the distance between the second shoe 110 and the receiving portion 103 increases when the coil 21 and the coil attachment portion 22 are easily affected by their own weight, and the outer periphery of the ball portion 101 is increased. The frictional force between the surface and the second shoe 110 increases. Therefore, by setting the braking force that locks the posture of the coil 21 to be increased, the relatively heavy coil 21 can be supported more stably.

  As described above, according to the posture locking device 100 for a medical device of the present embodiment, the brake mechanism 104 is resistant to the ball portion 101 being rotated by the weights of both the coil 21 and the coil mounting portion 22. A first brake portion 105 that urges the first resistance force f1 and a second brake portion 106 that urges the second resistance force f2, and finely adjust the posture of the coil 21. Sometimes only the second resistance force f2 is energized, and when locking the posture of the coil 21, both the first resistance force f1 and the second resistance force f2 are energized.

  With this configuration, even when the position of the coil 21 is finely adjusted, the second brake portion 106 biases the second resistance force f2. It will not be free. The surgeon does not need a force that supports the weights of both the coil 21 and the coil attachment portion 22. Therefore, since the operation force for adjusting the posture of the coil 21 does not increase, workability when finely adjusting the posture of the coil 21 is improved. Further, when the posture of the coil 21 is locked, both the first resistance force f1 and the second resistance force f2 are urged, so that the braking force that locks the ball portion 101 with respect to the receiving portion 103 so as not to rotate. Increase. Therefore, the relatively heavy coil 21 can be stably supported.

  The second resistance force f2 urged when finely adjusting the posture of the coil 21 is caused by the weights of both the coil 21 and the coil mounting portion 22 at a position within a range in which the coil 21 can move via the ball joint 43. It is smaller than the maximum turning power (Fmax) of the turning power that the ball portion 101 rotates.

  By configuring in this way, depending on the posture of the coil 21, the coil 21 and the coil attachment portion 22 may move somewhat due to their own weights, but the operation force for adjusting the posture of the coil 21 does not increase. Workability when finely adjusting the posture of the coil 21 is improved.

  Of the outer peripheral surface of the ball portion 101, a range 131 where the first shoe 109 contacts and a range 132 where the second shoe 110 contacts are roughened.

  With this configuration, the frictional force between the outer peripheral surface of the ball part 101 and the first shoe 109 and the frictional force between the outer peripheral surface of the ball part 101 and the second shoe 110 are increased, and the posture of the coil 21 is increased. The braking force to lock is further increased. Therefore, the relatively heavy coil 21 can be supported more stably.

  When the rod portion 102 of the ball joint 43 is most inclined with respect to the vertical direction, the first shoe 109 contacts the roughened outer peripheral surface, and the second shoe 110 is the roughened outer peripheral surface. To touch.

  By configuring in this way, it is possible to set so that the braking force for locking the posture of the coil 21 is increased when it is most affected by the weights of both the coil 21 and the coil mounting portion 22. It becomes possible to support more stably.

  The shape of the ball portion 101 of the ball joint 43 is such that the distance between the first shoe 109 and the receiving portion 103 when the rod portion 102 is inclined with respect to the vertical direction is such that the rod portion 102 is positioned along the vertical direction. It has a larger non-spherical shape than when it is.

  With this configuration, the frictional force between the outer peripheral surface of the ball portion 101 and the first shoe 109 is increased when the coil 21 and the coil attachment portion 22 are easily affected by their own weights. The braking force for locking the posture can be set to increase, and the relatively heavy coil 21 can be supported more stably.

  The shape of the ball portion 101 of the ball joint 43 is such that the distance between the second shoe 110 and the receiving portion 103 when the rod portion 102 is inclined with respect to the vertical direction is such that the rod portion 102 is positioned along the vertical direction. It has a larger non-spherical shape than when it is.

  With this configuration, when the coil 21 and the coil attachment portion 22 are easily affected by their own weight, the frictional force between the outer peripheral surface of the ball portion 101 and the second shoe 110 is increased, and the coil 21 The braking force for locking the posture can be set to increase, and the relatively heavy coil 21 can be supported more stably.

  The coil 21 is suspended from the arm portion 23 via the ball joint 43.

  By comprising in this way, it becomes possible to support stably the attitude | position of the coil 21 which receives a suspension load.

  As a medical instrument, it is the magnetic stimulation coil 21 used in the magnetic stimulation therapy which gives a magnetic stimulation to a biological body (for example, head).

  With this configuration, the posture of the coil 21 can be finely adjusted, and the position of the coil 21 can be set to a position suitable for treating the patient's symptoms.

  The posture lock device 100 of the medical device is not limited to the configuration described above, and can be modified as appropriate.

  The configurations of the first brake unit 105 and the second brake unit 106 are not limited to the above-described configurations, and the first resistance force f1 and the second resistance force that act as a braking force on the ball portion 101 of the ball joint 43. As long as f2 can be energized, an appropriate configuration can be operated. For example, a spring may be used instead of the shaft 116 of the second brake unit 106. Further, in addition to forming the resistance force using the spring force of the spring, the resistance force may be formed using electromagnetic force or fluid pressure.

The first switch 107 and the second switch 108 are not limited to manual configurations, and selectively switch energizing or deactivating the resistance force using electromagnetic force or fluid pressure. May be.
[2. Link mechanism of arm unit 23]
Next, a description will be given of a link mechanism of the arm portion 23 that allows the second arm portion 23 supporting the coil 21 to be operated without feeling the weight of the coil 21.

  Conventionally, when a medical device is supported on one end of a rotatable arm provided in a medical device, a counterweight is attached to the other end of the arm to balance the weight of the entire arm. By balancing the weight of the entire arm, the medical device can be held at a fixed position and can be operated without feeling the weight of the medical device.

  However, in the configuration in which the counterweight is attached to the other end of the arm, the medical device becomes large and the weight also increases. Further, although a system using a spring instead of the counterweight is also used, it is difficult to achieve a balance because the holding torque changes according to the arm angle.

  Therefore, in the magnetic stimulation apparatus 20 of the present embodiment, the weight of the entire arm is balanced by using a spring instead of the counterweight, contributing to the reduction in size and weight of the magnetic stimulation apparatus 20, and the balance of the arm. The link mechanism of the arm part 23 for facilitating is configured as follows.

  8A and 8B are a side view and a bottom view showing the link mechanism of the arm portion 23 of the present embodiment. FIG. 9 is a diagram for explaining the effect in the direction in which the elastic force acts, and FIG. 10 is a graph showing an example of an arm torque diagram in the present embodiment. FIG. 11 is a side view showing the link mechanism of the proportional arm portion 23 using only the spring, and FIG. 12 is a graph showing an example of the arm torque diagram in the proportional relation.

  Referring to FIGS. 11 and 12, the torque Tam for holding the arm part 23 at a certain position (hereinafter referred to as “arm holding torque”) is when the center of gravity of the arm part 23 is in a horizontal position with the arm rotation shaft 201. Becomes a peak. As the arm portion 23 is lowered or raised from this position, the arm holding torque decreases.

  As shown by a symbol “*” in FIG. 12, the method of supporting the arm portion 23 with a spring (coil spring, gas spring, etc.) in a proportional manner increases the force supported by the spring as the arm portion 23 is lowered. There is a drawback that the arm holding torque and the spring support torque Tspring 2 cannot be balanced. When the joint brake of the arm part 23 is released, the arm part 23 jumps up by the force of the spring, and the operability becomes very bad when trying to align the coil with the treatment position.

  Referring to FIG. 8, the link mechanism of arm portion 23 of the present embodiment has a configuration in which Term is approximately equal to Tsspring. In general, the link mechanism of the arm portion 23 is an arm portion 23 to which a medical device is attached, a non-rotating arm attachment portion 24 to which the arm portion 23 is rotatably attached around an arm rotation shaft 201, and a variable length rod. 202 and a fixed-length rod 203. The variable-length rod 202 includes a resilient member 204 that urges a resilient force to return to the pushed force, and the total length is variable. The fixed length rod 203 has a fixed overall length. One end 202a of the variable length rod 202 is rotatably attached to the arm mounting portion 24, and the other end 202b of the variable length rod 202 is rotatably connected to one end 203a of the fixed length rod 203. The other end 203b of the fixed length rod 203 is attached to the arm portion 23 so as to move around the arm rotation shaft 201 as the arm portion 23 rotates. Then, when the center of gravity of the arm portion 23 is in a horizontal position with the arm rotation shaft 201, the acting direction Y of the elastic force is set so as to be the tangential direction of the rotation track x4 in which the other end of the fixed length rod 203 is movable. is there. The medical device is a coil 21 used in magnetic stimulation therapy that applies magnetic stimulation to a living body (for example, the head). Details will be described below.

  The elastic member 204 of the variable length rod 202 is constituted by, for example, a compression spring. The resilient member 204 can also be composed of a gas spring.

  A shaft in which one end 202a of the variable length rod 202 is connected to the arm mounting portion 24 is referred to as a “spring fixed shaft x1”. The other end 202b of the variable length rod 202 is connected to one end 203a of the fixed length rod 203 and can move freely. This axis is called "spring free axis x2." The other end 203 b of the fixed length rod 203 is movable as the arm portion 23 rotates. This axis is referred to as “spring movable axis x3”. The rotation trajectory in which the other end of the fixed-length rod 203 is movable is referred to as “spring movable shaft rotation trajectory x4”.

  When the acting direction Y of the elastic force coincides with the tangential direction of the spring movable shaft rotation trajectory x4, all the elastic force can be used as the rotational torque, so that it is most efficient. When the arm portion 23 rotates from the position, the acting direction Y of the elastic force is shifted from the tangential direction, and the tangential force is decreased. For example, as shown in FIG. 9, when the angle is shifted by 60 ° from the tangential direction, half of the elastic force becomes the spring support force.

  By using the fixed long rod 203 and providing the spring movable shaft in the vicinity of the arm rotation shaft 201, the direction of action of the elastic force can be greatly changed when the arm portion 23 rotates.

  When the arm center-of-gravity angle becomes negative, the required arm holding torque becomes small. Therefore, when the effect of the direction in which the elastic force acts is larger than the increase of the elastic force, the spring support torque also decreases.

  The spring support torque Tsspring is expressed by equation (1).

Tsspring = r · kδL · cos θ (1)
here,
r: Spring movable shaft rotation orbit radius,
k: spring constant,
δL: Spring expansion / contraction length,
θ: Spring operating angle.

  When the center of gravity of the arm portion 23 is moved from the horizontal position (θ0), assuming that the spring expansion / contraction length is δL ′ and the spring operating angle is θ ′, the spring is arranged so as to satisfy the expression (2), thereby FIG. As described above, the link mechanism of the arm portion 23 with the term “Tarm” substantially equal to “Tsspring” can be realized.

kδL ′ · cos θ ′ / kδL · cos | θ0 | <1 (2)
As described above, according to the link mechanism of the arm portion 23 of the present embodiment, the one end 202a of the variable length rod 202 including the elastic member 204 is rotatably attached to the arm attachment portion 24, and the variable length rod 202 is attached. The other end 202b of the fixed length rod 203 is rotatably connected to one end 203a of the fixed length rod 203, and the other end 203b of the fixed length rod 203 is movable around the arm rotation shaft 201 as the arm portion 23 rotates. As shown, it is attached to the arm portion 23. Then, when the center of gravity of the arm portion 23 is in a horizontal position with the arm rotation shaft 201, the direction of action of the elastic force is set to be the tangential direction of the rotation trajectory in which the other end 203b of the fixed length rod 203 is movable. . In addition, by providing a damper for imparting a frictional force and resistance of the arm rotation shaft 201, it becomes possible to allow the tangential direction.

  By comprising in this way, the holding torque according to the angle of the arm part 23 can be obtained, and the arm part 23 which can be operated without feeling the weight of the suspension load can be realized. The above-mentioned correspondence can be easily realized at the depression angle. In addition, the magnetic stimulation device 20 can be easily reduced in size and weight as compared with a method using a counterweight.

  As a medical instrument, it is the magnetic stimulation coil 21 used in the magnetic stimulation therapy which gives a magnetic stimulation to a biological body (for example, head).

With this configuration, the arm portion 23 to which the coil 21 is attached can be operated without feeling weight, and the position of the coil 21 can be easily set to a position suitable for treating the patient's symptoms. it can.
[3. Slide device 300 for medical device]
Next, a description will be given of a third slide device 300 for a medical device that facilitates adjustment of a position for sliding the arm assembly 500.

  Conventionally, in a medical device including an arm assembly including an arm and a post portion that supports the arm, the arm assembly is slid to adjust the front-rear position of a medical device attached to the arm.

  However, depending on the degree of tilt of the medical device, unlocking the position of the arm assembly may cause the arm assembly to slide unexpectedly. Even when the medical device is relatively heavy, when the arm assembly is unlocked, the arm assembly may unexpectedly slide toward the center of gravity of the arm. When such unexpected slide movement occurs, troubles occur in the alignment of the medical device.

  Therefore, in the magnetic stimulation device 20 of the present embodiment, the slide device 300 for a medical device is configured as follows.

  13 is a plan view showing a slide device 300 for a medical device, FIG. 14 is a cross-sectional view showing the main part of the internal structure of the post portion 25 in the slide device 300 for a medical device, and FIG. 15 shows a tension applying member. It is a perspective view shown.

  The slide device 300 (hereinafter also referred to as “slide device 300”) for a medical device according to the present embodiment is briefly described as a slide table 301, a belt member 302, one or a plurality of roller members 303, and a tension applying member. 304. The slide table 301 is attached with an arm assembly 500 to which a medical device is attached. The arm assembly 500 includes a post portion 25 that supports the arm portion 23, and a medical device is attached to the arm portion 23. The belt member 302 is disposed along the moving direction of the slide table 301. The roller member 303 is provided on the slide table 301, and the belt member 302 is stretched over the roller member 303. The tension applying member 304 applies tension to the belt member 302 that is stretched around the roller member 303. Then, the belt member 302 stretched around the roller member 303 biases the slide table 301 with a load against the slide movement. The medical device is a coil 21 used in magnetic stimulation therapy that applies magnetic stimulation to a living body (for example, the head). Details will be described below.

  Referring to FIG. 13, slide table 301 moves in the left-right direction in the figure. The slide device 300 includes two linear guides 305 that guide the slide movement of the slide table 301. The slide table 301 is placed so as to straddle the two linear guides 305. The belt member 302 extends in parallel with the linear guide 305.

  Referring to FIG. 14, a plurality (three in the illustrated example) of roller members 303 are rotatably attached to the slide table 301. The three roller members 303 have two idle pulleys 303a and 303b and one brake pulley 303c. A braking pulley 303c is arranged at an upper position between the two idle pulleys 303a and 303b, and is arranged in a triangular shape. The idle pulleys 303a and 303b may not be provided, but by increasing the idle pulleys, a load for sliding movement can be easily applied. The belt member 302 is lifted upward from the two idle pulleys 303a and 303b and is stretched over the brake pulley 303c. The belt member 302 is formed of a timing belt that can be engaged with a roller member 303 (idle pulleys 303a and 303b, brake pulley 303c). As the belt member 302, an appropriate type of belt can be used as long as no slip occurs with respect to the roller member 303, and the belt member 302 is not limited to a timing belt. For example, a flat belt that can be engaged with the roller member 303 by a frictional force may be used.

  At least one brake pulley 303c of the plurality of roller members 303 includes a lock mechanism 306 that stops its rotation. In the case of one roller member, the roller member is provided with a lock mechanism 306. The lock mechanism 306 is composed of, for example, an electromagnetic brake provided with an electromagnetic clutch. When the electromagnetic brake is energized, the lock is released and the brake pulley 303c rotates freely. When the energization to the electromagnetic brake is stopped, the lock is activated and the brake pulley 303c stops its rotation. The position of the slide table 301 can be locked by stopping the rotation of the roller member 303 (braking pulley 303c) including the lock mechanism 306 by the lock mechanism 306. The brake pulley 303c and the idle pulleys 303a and 303b rotate as the slide table 301 moves.

  Referring to FIG. 15, the tension applying member 304 applies tension to the belt member 302 that is stretched around the plurality of roller members 303. The tension applying member 304 includes a slider 310 to which an end portion of the timing belt 302 is fixed, and a drive unit 311 that moves the slider 310 along a direction parallel to the linear guide 305. The other end of the timing belt 302 is fixed. The slider 310 includes a lower plate 312 having a long hole 312 a and an upper plate 313 screwed to the lower plate 312. The lower plate 312 is formed with an engagement hole (not shown) with which the peak portion 302a of the timing belt 302 is engaged. The end of the timing belt 302 is fixed to the slider 310 by sandwiching the end of the timing belt 302 between the lower plate 312 and the upper plate 313 and screwing the upper plate 313 to the lower plate 312. A guide pin 315 fastened to the base 314 of the slide device 300 is inserted into the long hole 312a of the lower plate 312. The slider 310 is guided by a guide pin 315 and is movable along a direction parallel to the linear guide 305. The drive unit 311 has an adjustment bolt 316 that is fixed to the base 314 of the slide device 300 and fastened to the flange portion 313 a of the upper plate 313. When the adjustment bolt 316 is turned to move the slider 310 toward the drive unit 311, tension can be applied to the timing belt 302. When the adjustment bolt 316 is rotated in the opposite direction to move the slider 310 to the side opposite to the driving unit 311, the tension applied to the timing belt 302 can be reduced.

  The tension applying member 304 is configured to freely adjust the tension applied to the timing belt 302. The tension is adjusted by adjusting the moving position of the slider 310 by turning the adjusting bolt 316 in the appropriate direction. By adjusting the strength of the tension applied to the timing belt 302 by the tension applying member 304, the magnitude of the load with respect to the slide movement of the slide table 301 can be adjusted. Since the magnitude of the load with respect to the slide movement can be adjusted, the operating force when the arm assembly 500 is slid can be adjusted to a desired magnitude.

  The operation will be described.

  When adjusting the position of the coil 21, when the arm assembly 500 is moved forward or backward with respect to the patient, the locking mechanism 306 of the brake pulley 303c is released, and the arm assembly 500 is slid back and forth. Adjust the front / rear position.

  At this time, the timing belt 302 is bent using the three pulleys 303a, 303b, and 303c in a state where the tension is applied. Due to the bent timing belt 302, a load against the slide movement is urged on the slide table 301. Since a moderately large load is urged to the slide table 301, the operator can slide the arm assembly 500 with a good operation feeling.

  Even when the magnetic stimulation device 20 is used with a slight inclination, a moderately large load is urged to the slide table 301, so even if the locking mechanism 306 of the brake pulley 303c is released, The arm assembly 500 does not slide unexpectedly. The coil 21 is a relatively heavy medical tool, and the center of gravity of the arm portion 23 is closer to the distal end side. Even in such a case, since a moderately large load is urged to the slide table 301, even if the lock mechanism 306 of the brake pulley 303c is released, the arm toward the center of gravity of the arm portion 23 The assembly 500 does not slide unexpectedly. Since such unexpected slide movement does not occur, there is no trouble in the alignment of the coil 21 and the like.

  When the alignment of the coil 21 is completed and the slide position of the arm assembly 500 is determined, the lock mechanism 306 stops the rotation of the brake pulley 303c. As a result, the position of the slide table 301 is locked.

  As described above, according to the slide device 300 for the medical device of the present embodiment, the slide table 301, the belt member 302, one or a plurality of roller members 303, and the tension applying member 304 are included. The belt member 302 stretched around the roller member 303 (303a, 303b, 303c) urges the slide table 301 to load against the slide movement.

  With this configuration, an appropriate load is applied to the slide table 301, so that the operator can slide the arm assembly 500 with a good operation feeling. Even when the magnetic stimulation device 20 is used with a slight inclination or when the position of the center of gravity of the arm portion 23 is close to the distal end side, a moderately large load is urged to the slide table 301. Thus, the arm assembly 500 does not slide unexpectedly. Since the unexpected slide movement can be prevented, the coil 21 can be accurately aligned.

  The tension applying member 304 is configured to be capable of adjusting the tension to be applied, and by adjusting the strength of the tension applied to the belt member 302 by the tension applying member 304, the magnitude of the load with respect to the slide movement can be adjusted.

  By configuring in this way, the magnitude of the load with respect to the slide movement can be adjusted, so that the operating force when the arm assembly 500 is slid can be adjusted to a desired magnitude.

  The tension applying member 304 adjusts the strength of the tension applied to the belt member 302 by moving the holding position of the belt member by turning the adjustment bolt 316.

  With this configuration, it is possible to easily adjust the strength of the tension applied to the belt member 302 simply by turning the adjustment bolt 316. Therefore, the magnitude of the load with respect to the slide movement can be easily adjusted, and the operating force when the arm assembly 500 is slid can be easily adjusted to a desired magnitude.

  The belt member 302 is formed of a belt (timing belt or flat belt) that can be engaged with the roller member 303, and the brake pulley 303c includes a lock mechanism 306. By stopping the rotation of the brake pulley 303c by the lock mechanism 306, The position of the slide table 301 can be locked.

  With this configuration, the arm assembly 500 can be easily locked at an arbitrary position after the arm assembly 500 is slid.

  As a medical instrument, it is the magnetic stimulation coil 21 used in the magnetic stimulation therapy which gives a magnetic stimulation to a biological body (for example, head).

  With this configuration, the arm assembly 500 can be slid back and forth and locked, and the position of the coil 21 can be set to a position suitable for treating the patient's symptoms.

  The slide device 300 for the medical device is not limited to the above-described configuration, and can be appropriately modified.

For example, although the aspect which changes the position of the one end part of the timing belt 302 as the tension | tensile_strength provision member 304 was shown, it is not limited to this. Tension may be applied to the timing belt 302 by a configuration in which the shaft of the brake pulley 303c is moved upward while the positions of both ends of the timing belt 302 are fixed. Moreover, the magnitude | size of the tension | tensile_strength to provide can also be adjusted by comprising the axial position of the brake pulley 303c so that adjustment is possible to an up-down direction.
[4. Coil 21 attachment / detachment device 400]
Next, a fourth attachment / detachment device 400 that facilitates replacement of the coil 21 will be described.

  In the magnetic stimulation therapy, it is necessary to select the shape of the coil element to be employed according to the type of cranial nerve disease, and it is required that the coil attached to the magnetic stimulation device can be easily replaced.

  However, in the conventional magnetic stimulation apparatus, the actual situation is that the mechanism for easily exchanging the coil is not considered.

  Therefore, in the magnetic stimulation apparatus 20 of the present embodiment, the attachment / detachment apparatus 400 for the coil 21 is configured as follows.

  FIG. 16 is a view of the distal end portion of the arm portion 23 in the magnetic stimulation device 20 as viewed from above. FIG. 17A illustrates the arm portion 23, the coil attachment portion 22, and the magnetic stimulation coil 21 in the magnetic stimulation device 20. FIG. 17B is a perspective view showing the state before the magnetic stimulation coil 21 is attached to the coil attachment portion 22, and FIG. 17B shows the arm portion 23, the coil attachment portion 22, and the magnetic stimulation coil 21 in the magnetic stimulation device 20. It is a perspective view shown in the state where magnetic stimulation coil 21 was attached to coil attachment part 22 seeing from a different direction from A). 18A is a cross-sectional view taken along line 18-18 in FIG. 16, FIG. 18B is an enlarged cross-sectional view showing a portion denoted by reference numeral 18B in FIG. 18A, and FIG. 16 is a cross-sectional view taken along the line 19-19, and FIG. 19B is an enlarged cross-sectional view showing a portion 19B in FIG.

  The magnetic stimulation coil 21 attaching / detaching device 400 (hereinafter also referred to as “the coil 21 attaching / detaching device 400”) of the present embodiment is briefly described. And a coil attachment portion 22 that is supported by the arm portion 23 and attaches the magnetic stimulation coil 21, a first engagement portion 401, a second engagement portion 402, a lock portion 403, and a release portion 404. The first engagement portion 401 is formed on the coil 21 and has a rail shape. The second engagement portion 402 is formed in the coil attachment portion 22 and has a rail shape that can be engaged with the first engagement portion 401 by sliding the first engagement portion 401 relatively. The lock part 403 maintains the state in which the first engagement part 401 and the second engagement part 402 are engaged. The release unit 404 releases the state where the first engagement unit 401 and the second engagement unit 402 are engaged in the lock unit 403. Details will be described below.

  As described above, the coil attachment portion 22 is configured to be adjustable in posture with respect to the arm portion 23. By adjusting the posture of the coil attachment portion 22 with respect to the arm portion 23, the posture of the coil 21 attached to the coil attachment portion 22 with respect to the arm portion 23 is adjusted. By interposing the coil mounting portion 22, it is not necessary to provide a posture adjusting mechanism such as a ball joint in the coil 21 itself, and the coil 21 can be reduced in size and weight.

  With reference to FIGS. 16 to 19, the first engaging portion 401 is formed on the upper surface of the casing of the coil 21, and the second engaging portion 402 is formed below the casing of the coil mounting portion 22. The first engaging portion 401 and the second engaging portion 402 have rail shapes that can be engaged with each other by sliding relatively (see FIGS. 17A, 18A, and 18B). The reason why the first engaging portion 401 and the second engaging portion 402 are rail-shaped is that the coil 21 is relatively heavy.

  The lock portion 403 includes a claw portion 405 formed on one of the first engagement portion 401 and the second engagement portion 402 (in the illustrated example, the second engagement portion 402), and the first engagement portion 401 and the second engagement portion 402. It has the recessed part 406 which the claw part 405 fits in the other (in the example of illustration, the 1st engaging part 401) of the engaging part 402 (refer FIG. 19 (A) (B)).

The release unit 404 includes a push unit 407 that relatively separates the first engagement unit 401 and the second engagement unit 402. The first engaging portion 401 and the second engaging portion 402 are relatively separated by the pressing portion 407, thereby releasing the fitting between the claw portion 405 and the concave portion 406 (FIG. 17B and FIG. 19). (See A) and (B))
The push portion 407 is held by the coil attachment portion 22 so as not to fall off (see FIGS. 19A and 19B). Even when the coil 21 is not attached, the push portion 407 does not fall off from the coil attachment portion 22.

  The pressing portion 407 contacts the second engaging portion 402 of the coil attachment portion 22 without contacting the first engaging portion 401 of the coil 21, and separates the second engaging portion 402 from the first engaging portion 401. (See FIGS. 19A and 19B). The length along the pressing direction of the pressing portion 407 is set to a length dimension that does not contact the first engaging portion 401 of the coil 21.

  The forming material of the first engaging part 401, the second engaging part 402, the lock part 403, and the releasing part 404 is preferably a non-metallic material. This is because no metal such as a screw or a coil spring is used to fix the coil 21, so there is no possibility of adversely affecting the performance of the coil 21.

  The operation will be described.

  When replacing the coil 21 already attached to the coil attachment portion 22, the pushing portion 407 of the release portion 404 is pushed (see FIGS. 17B, 19A, and 19B). The pressing portion 407 contacts the second engaging portion 402 of the coil attachment portion 22 without contacting the first engaging portion 401 of the coil 21, and separates the second engaging portion 402 from the first engaging portion 401. Let Thereby, the fitting between the claw portion 405 and the concave portion 406 is released. Even if the pushing portion 407 is pushed in, it does not come into contact with the first engaging portion 401 of the coil 21, so that the coil 21 is not pushed out simultaneously with the disengagement between the first engaging portion 401 and the second engaging portion 402. . Therefore, the unexpected drop-off of the coil 21 from the coil attachment part 22 can be prevented in advance. The surgeon extracts the coil 21 from the coil attachment portion 22 (see FIG. 17A).

  The surgeon relatively slides the first engagement portion 401 of the new coil 21 along the second engagement portion 402 of the coil attachment portion 22 (FIGS. 17A and 18A). See B)). When sliding to a predetermined position, the claw portion 405 of the second engagement portion 402 fits into the recess 406 of the first engagement portion 401. Thereby, the lock part 403 maintains the state in which the first engagement part 401 and the second engagement part 402 are engaged.

  As described above, the attachment / detachment device 400 for the coil 21 according to the present embodiment includes the coil 21, the coil attachment portion 22, the first engagement portion 401 formed on the coil 21 and having a rail shape, and the coil attachment portion 22. A second engagement portion 402 having a rail shape that can be engaged with the first engagement portion 401 by sliding the first engagement portion 401 relatively, a lock portion 403, and a release portion 404 are formed. Have.

  With this configuration, the coil 21 can be easily moved to the coil attachment portion 22 by sliding the first engagement portion 401 of the coil 21 along the second engagement portion 402 of the coil attachment portion 22 relatively. Can be attached to. The lock portion 403 maintains the state where the first engagement portion 401 and the second engagement portion 402 are engaged, so that the coil 21 does not fall off. When the coil 21 is replaced, the release portion 404 releases the state in which the first engagement portion 401 and the second engagement portion 402 are engaged, so that the coil 21 can be easily extracted. Since the first engagement portion 401, the second engagement portion 402, the lock portion 403, and the release portion 404 can be made of a non-metallic material, the performance of the coil 21 is not adversely affected.

  The lock portion 403 includes a claw portion 405 of the second engagement portion 402 and a recess portion 406 of the first engagement portion 401, and the release portion 404 is connected to the first engagement portion 401 and the second engagement portion by the push portion 407. The fitting between the claw portion 405 and the concave portion 406 is released by relatively separating the joint portion 402 from each other.

  By configuring in this way, the lock part 403 can easily maintain the state where the first engagement part 401 and the second engagement part 402 are engaged, and the release part 404 is provided with the first engagement part 401 and the second engagement part 402. The state in which the engaging portion 402 is engaged can be easily released.

  The pushing portion 407 is held by the coil attachment portion 22 so as not to fall off.

  With this configuration, even when the coil 21 is not attached, the pushing portion 407 does not fall off from the coil attachment portion 22.

  The pressing portion 407 contacts the second engaging portion 402 of the coil attachment portion 22 without contacting the first engaging portion 401 of the coil 21, and separates the second engaging portion 402 from the first engaging portion 401. I am letting.

  With this configuration, even when the pushing portion 407 is pushed in, the pushing portion 407 does not come into contact with the first engaging portion 401 of the coil 21, so that the first engaging portion 401 and the second engaging portion 402 are simultaneously disengaged. The coil 21 is not pushed out. Therefore, the unexpected drop-off of the coil 21 from the coil attachment part 22 can be prevented in advance.

  The coil attachment portion 22 is configured to be capable of adjusting the posture with respect to the arm portion 23, and the posture of the coil 21 attached to the coil attachment portion 22 with respect to the arm portion 23 is adjusted by adjusting the posture of the coil attachment portion 22 with respect to the arm portion 23. Is adjusted.

  By configuring in this way, it is not necessary to provide the coil 21 itself with a mechanism for adjusting the posture, such as a ball joint, with the coil mounting portion 22 interposed, and the coil 21 can be reduced in size and weight.

  The forming material of the first engaging portion 401, the second engaging portion 402, the lock portion 403, and the releasing portion 404 is a non-metallic material.

  By configuring in this way, no metal such as a screw or a coil spring is used to fix the coil 21, so there is no possibility of adversely affecting the performance of the coil 21.

10 Magnetic stimulation treatment system,
20 magnetic stimulator,
21 Magnetic stimulation coil (medical device),
22 Coil mounting part,
23 Arm part (support),
24 Arm mounting part,
25 Post section,
26 Cart part,
30 seats,
43 Ball joint,
100 medical device posture locking device,
101 ball part,
102 Rod part,
103 receiving part,
104 brake mechanism,
105 first brake part,
106 second brake part,
107 first switch,
108 second switch,
109 first shoe,
110 Second shoe,
118 Operation lever (second switch operation lever)
122 Operation lever,
131 Range where the first shoe contacts,
132 Range where the second shoe contacts,
f1 first resistance,
f2 second resistance force,
Fmax The maximum rotational power among the rotational powers in which the ball portion is rotated by the weight of the medical device,
201 arm rotation axis,
202 variable length rod,
202a, one end of a variable length rod,
202b, the other end of the variable length rod,
203 fixed length rod,
203a, one end of a fixed length rod,
203b, the other end of the fixed length rod,
204 bullet member,
300 slide device for medical device,
301 slide table,
302 Timing belt (belt member),
303 roller member,
303a, 303b idle pulley,
303c braking pulley,
304 tension applying member,
305 linear guide,
306 lock mechanism,
400 Coil attachment / detachment device,
401 first engaging portion,
402 second engaging portion,
403 lock part,
404 release part,
405 nails,
406 recess,
407 push section,
500 Arm assembly.

Claims (8)

A medical device connected to the rod portion of a ball joint comprising a ball portion and a rod portion;
A brake mechanism that locks the posture of the medical device relative to the support by locking the ball portion of the ball joint so as not to rotate with respect to the receiving portion;
The brake mechanism is
A first shoe that is freely contactable with the outer peripheral surface of the ball portion is provided, and the ball portion is rotated by its own weight by pressing the first shoe against the outer peripheral surface of the ball portion. A first brake portion that urges a first resistance force (f1) that is resistance to
A second shoe that can freely contact a portion of the outer peripheral surface of the ball portion that is different from a portion that contacts the first shoe, and presses the second shoe against the outer peripheral surface of the ball portion; A second brake portion that urges a second resistance force (f2) that resists rotation of the ball portion due to the weight of the medical device;
A first switch that selectively switches energization or de-energization of the first resistance force (f1) by the first brake unit using electromagnetic force or fluid pressure ;
A second switch that selectively switches energization or de-energization of the second resistance force (f2) by the second brake unit,
The second switch includes a second switch operation lever that switches between a position where the second shoe is pressed against the outer peripheral surface of the ball portion and a position where the second shoe is separated from the outer peripheral surface of the ball portion,
When finely adjusting the posture of the medical device, only one of the first resistance force (f1) and the second resistance force (f2) is energized,
When locking the posture of the medical device, the posture lock device for the medical device is formed by urging both the first resistance force (f1) and the second resistance force (f2).   The first resistance force (f1) or the second resistance force (f2) biased when finely adjusting the posture of the medical device is within a range in which the medical device can move via the ball joint. The posture lock device for a medical device according to claim 1, wherein the device is smaller than a maximum rotational force (Fmax) among rotational forces in which the ball portion is rotated by the weight of the medical device at the position of.   The posture of the medical device according to claim 1 or 2, wherein a range in which the first shoe contacts and a range in which the second shoe contacts in the outer peripheral surface of the ball portion are roughened. Locking device.   When the rod portion of the ball joint is most inclined with respect to the vertical direction, the first shoe is in contact with the roughened outer peripheral surface, and the second shoe is roughened. The posture lock device for a medical device according to claim 3, wherein the posture lock device is in contact with an outer peripheral surface.   The shape of the ball portion of the ball joint is such that the distance between the first shoe and the receiving portion when the rod portion is inclined with respect to the vertical direction is such that the rod portion is positioned along the vertical direction. The posture locking device for a medical device according to any one of claims 1 to 4, wherein the device has a non-spherical shape that is larger than when the medical device is used.   The shape of the ball part of the ball joint is such that the distance between the second shoe and the receiving part when the rod part is inclined with respect to the vertical direction is such that the rod part is positioned along the vertical direction. The posture locking device for a medical device according to any one of claims 1 to 5, wherein the posture locking device has a non-spherical shape that is larger than when the medical device is used.   The medical device posture locking device according to any one of claims 1 to 6, wherein the medical device is suspended from a support via the ball joint.   The posture lock device for a medical device according to any one of claims 1 to 7, wherein the medical device is a magnetic stimulation coil used in magnetic stimulation therapy for applying magnetic stimulation to a living body.