JP7243975B2 - Traction force evaluation device for endoscopic surgery and endoscopic training device - Google Patents

Description

Application of Article 30, Paragraph 2 of the Patent Law 5th Surgical Education Summit, Sapporo Education and Culture Center, July 28, 2018

TECHNICAL FIELD The present invention relates to a traction force evaluation device for endoscopic surgery and an endoscopic training device . More particularly, the present invention relates to a traction force evaluation device for endoscopic surgery and an endoscopic training device used for in vivo treatment and surgical training using an endoscope .

In laparoscopic surgery, cameras and surgical instruments are inserted through a plurality of ports provided in the living body, and the operator performs various operations such as excision and incision using the surgical instruments while viewing images from the cameras. At this time, when a soft tissue such as an intestine is to be excised or incised, even if an electric scalpel or the like is pressed against the tissue, the tissue may be deformed and cannot be excised. For this reason, the intestine or the like is pulled with forceps to generate a certain amount of tension in the tissue. Also, in order to confirm the affected area, etc., the tissue is pulled to move or stretch the tissue.

In particular, in order to excise tissue with high accuracy in endoscopic surgery, it is necessary to grasp tissue with forceps and apply appropriate tension (countertraction) to the tissue. Insufficient countertraction may cause damage to surrounding tissues, nerves, etc. during excision with an electric scalpel or the like. On the other hand, if excessive countertraction is applied, bleeding may occur. Therefore, training to pull tissue with forceps is important in order to generate and stretch appropriate tension in tissue by pulling tissue with forceps.

In order to train surgeons who can excise tissue while applying appropriate countertraction by conducting such training, it is necessary to perform training to excise tissue by applying countertraction while grasping the quantitative value of countertraction applied to tissue. is necessary.

Devices for training surgical procedures using an endoscope have been developed so far, and an endoscope training system disclosed in Patent Literature 1 has been developed as a device for training tissue excision. In this endoscopic training system, a plurality of tensioned rubber bands are installed as objects to be resected in the control box. Further, it is described that cutting the rubber band can improve the technique of accurately manipulating the surgical instrument and accurately excising the tissue in the body.

JP 2013-6025 A

However, the technique of Patent Literature 1 is for cutting a rubber band to which tension is applied from the beginning, and training for generating appropriate tension in tissue cannot be performed.

At present, since there is no device for quantitatively evaluating countertraction, it is not possible to perform training for applying countertraction to excise tissue while grasping the quantitative value of countertraction applied to the tissue.

Further, as a device for supporting endoscopic surgery, a device equipped with a holder for holding forceps and the like has also been developed. When countertraction is generated by the forceps held by the holder in such a device, the holder is driven, and quantitative evaluation is important in order to control the generated countertraction. However, at present, there is no device equipped with a holder that can quantitatively evaluate countertraction.

In view of the above circumstances, the present invention relates to a traction force evaluation device for endoscopic surgery that can measure the tension applied to tissue, and an endoscopic training device that can perform training to generate appropriate tension in tissue using endoscopic instruments. .

A traction force evaluation apparatus for endoscopic surgery according to the present invention is characterized by comprising a sample holding arm having a holding portion for holding a sample, and a load measuring portion for measuring a load applied to the sample holding arm. .
The endoscopic training device of the present invention is a training device for treatment using an endoscope, and has a traction force evaluation device of the invention and a hollow treatment area in which a sample holding arm of the traction force evaluation device is arranged. and a hollow structure, wherein the hollow structure is formed with a through hole communicating between the treatment area and the outside .

According to the traction force evaluation apparatus for an endoscope of the present invention, when a specimen such as a tissue or a dummy tissue is held by the holding portion of the specimen holding arm and the specimen is pulled by the forceps, the force applied to the specimen by the load measuring portion , that is, since the pulling force by the forceps can be detected, the pulling force by the forceps can be appropriately evaluated.
According to the endoscope training apparatus of the present invention, when forceps are inserted through the through-hole of the hollow structure while a sample such as tissue or dummy tissue is held by the holding portion of the sample holding arm, the sample is held by the forceps. Can be grasped or pulled. Then, if the sample is pulled, the force applied to the sample by the load measuring unit, that is, the pulling force of the forceps can be detected, so the operation of the forceps can be properly grasped .

BRIEF DESCRIPTION OF THE DRAWINGS It is a schematic explanatory drawing of the endoscope training apparatus 1 of this embodiment, Comprising: (A) is an external view, (B) is a partial sectional view. (A) is a schematic illustration of the sample holding arm 11 that holds the sample S, and (B) is a schematic illustration of a state in which the sample holding arm 11, the joint portion 15, and the load measuring portion 16 are connected in this order. is. 1A is a schematic explanatory diagram of an endoscopic surgery assisting apparatus 100 of the present embodiment, and FIG. 1B is a block diagram showing an example of a control section 200. FIG. This is experimental data confirming the influence of the load (pulling force) applied to the tissue on the excision time. BRIEF DESCRIPTION OF THE DRAWINGS It is a schematic explanatory drawing of the endoscope training apparatus 1 of this embodiment.

The endoscopic training apparatus of the present embodiment is an apparatus for training surgical procedures such as endoscopic procedures, and is capable of appropriately training how to handle tissues using surgical instruments.

In the endoscopic training apparatus of the present embodiment, actual tissue of a living body and dummy tissue used as a tissue substitute are used as samples, but the samples to be used are not particularly limited. It is desirable to use materials that are close to the properties (softness, extensibility, strength, etc.) of actual tissue in vivo.

Moreover, the surgical instrument used for training with the endoscope training device of this embodiment is not particularly limited. For example, forceps, electric scalpel, etc. used for laparoscopic surgery, and forceps, electric scalpel, etc. used for flexible endoscope surgery can be mentioned.

In the following, the case of training for laparoscopic surgery will be explained, but in the case of a flexible endoscope, inserting the flexible endoscope into a through hole of a hollow structure described later and protruding forceps from the forceps hole Similar training can be conducted.

<Endoscope training device 1 of the present embodiment>
1 and 5, reference numeral 2 denotes the main body of the endoscopic training device 1 of this embodiment. The device body 2 is provided with a hollow structure 3 and a measuring section 10 .
The structure of the apparatus main body 2 is not particularly limited, and it is sufficient that it has a size and strength sufficient to install the hollow structure 3 and the measurement unit 10 .

<Hollow structure 3>
As shown in FIGS. 1 and 5, a hollow structure 3 is provided on the upper surface of the device main body 2 . The hollow structure 3 is composed of a hood 3a and a bottom plate 3b, and has a hollow treatment area 3h surrounded by the hood 3a and the bottom plate 3b. The hood 3a and the bottom plate 3b are made of, for example, plastic, glass, or metal such as iron, and are formed to have sufficient strength to maintain the treatment area 3h even when an external force is applied.

The hood 3a of the hollow structure 3 is provided with a plurality of through holes 3g that communicate between the treatment area 3h and the outside. The through-hole 3g is a hole having a size (for example, about 5 to 20 mm) through which an endoscope E, forceps F, or the like can be inserted. Therefore, the sample S can be handled in the hollow structure 3 by inserting an endoscope E, forceps F, or the like into the treatment area 3h through the through hole 3g.
In addition, the through hole 3g may be provided with a member that prevents the inside from being seen from the through hole 3g. For example, a sheet-like member such as a rubber film may be provided with a notch so that the forceps F or the like can be inserted through the notch although the inside cannot be seen.

<Measurement unit 10>
As shown in FIGS. 1 and 5, a measuring section 10 is provided on the upper surface of the device main body 2 on the side of the hollow structure 3 . The measuring unit 10 includes a sample holding arm 11 that holds a sample S used for training, a joint portion 15 connected to the sample holding arm 11, and a load measuring portion 16 connected to the joint portion 15. I have. The measurement unit 10 also includes a control unit 17 that processes signals from the joint unit 15 and the load measurement unit 16, and a measurement unit that displays the signals from the joint unit 15 and the load measurement unit 16 based on the signals from the control unit 17. A value display section 19 is also provided.

<Sample holding arm 11>
As shown in FIG. 2 , the sample holding arm 11 has an arm portion 13 and a holding portion 12 at the tip of the arm portion 13 . The holding part 12 has a pair of gripping claws 12a, 12a for holding the sample S. As shown in FIG. The pair of gripping claws 12a, 12a are pivotally supported at their proximal ends, and their distal ends can be moved toward and away from each other by driving force from the drive mechanism with the proximal ends as fulcrums. For example, the pair of gripping claws 12a, 12a can be moved toward and away from each other by a drive mechanism having a drive section such as a motor and a known gear mechanism. Therefore, when the tips of the pair of gripping claws 12a, 12a are moved toward and away from each other by the drive mechanism, the sample S can be sandwiched between the pair of gripping claws 12a, 12a and separated. Moreover, by adjusting the driving force of the driving mechanism, the force with which the sample S is sandwiched and held can be adjusted.

The configuration of the driving mechanism for driving the pair of gripping claws 12a, 12a is not particularly limited. Any mechanism may be used as long as it can move the pair of gripping claws 12a, 12a toward and away from each other. The method of operating the drive mechanism is also not particularly limited, and any method may be adopted. For example, the drive mechanism may be electrically connected to the control section 17 so that the drive mechanism operates according to commands from the control section 17 .

Further, the pair of gripping claws 12a, 12a may not have a driving mechanism as described above, and the tips of the pair of gripping claws 12a, 12a are separated from each other, and the sample S is held in a state of being close to each other. It is sufficient if it is designed to generate a force to For example, if the tips of the pair of gripping claws 12a, 12a are urged by a spring in a direction to approach each other, the force of the spring can hold the sample S firmly to some extent. Moreover, the sample S can be attached and detached by applying a force so that the tips of the pair of gripping claws 12a, 12a are separated from each other. Further, since it is not necessary to provide a special drive mechanism to the sample holding arm 11, the structure of the sample holding arm 11 can be simplified.

<Joint 15>
As shown in FIGS. 1 and 2, a joint portion 15 is provided at the proximal end of the arm portion 13 of the sample holding arm 11 . The joint portion 15 holds the arm portion 13 so that the axial direction can be changed and the arm portion 13 can rotate, for example, like a known universal joint. The joint portion 15 is provided with a sensor 15b for detecting changes in the angle of the arm portion 13 in the axial direction and in the rotation angle. The sensor 15b is not particularly limited, and a known inertial sensor such as an acceleration sensor or a gyro sensor can be used. For example, if an acceleration sensor such as a known 9-axis sensor is used as the sensor 15b, the movement of the arm portion 13 of the sample holding arm 11 can be detected with high accuracy. The output signal of the sensor 15b is transmitted to the control section 17. FIG.

Therefore, when the sample S held by the holding portion 12 of the sample holding arm 11 is pulled by the forceps F or the like, in what direction the force is applied to the holding portion 12 (that is, the sample S) and how it is held. The sensor 15b can detect whether the posture of the portion 12 has changed. For example, the direction in which the load measuring unit 16, which will be described later, detects force is the x-axis, and the directions perpendicular to the x-axis are the y-axis and the z-axis. In this case, the angles formed by the direction in which the sample S is actually pulled and the x-axis are θy and θz, and the force detected by the load measuring unit 16 is f(x). Then, since the x-axis direction, θy, and θz can be detected by the sensor 15b, the force F that pulled the sample S in the direction in which the sample S was actually pulled can be obtained by the following equation.

F={f(x)/cos(θy)}/cos(θz)

<Load measuring unit 16>
As shown in FIGS. 1 and 2 , a load measuring section 16 is connected to the joint section 15 so as to be rotatable with respect to the joint section 15 . For example, as shown in FIG. 2B, the load measuring section 16 holds the shaft 15a of the joint section 15 so as to be rotatable but not axially movable. The structure in which the load measuring section 16 and the joint section 15 are rotatably connected is not particularly limited. Moreover, relative rotation between the load measuring section 16 and the joint section 15 may be fixed.

The load measuring section 16 includes a sensor that detects force applied to the joint section 15 and is connected to the device main body 2 . That is, the force applied to the sample holding arm 11, in other words, the force applied to the sample S by the forceps F or the like is applied to the load measuring section 16 via the joint section 15, so the sensor of the load measuring section 16 detects the magnitude of the force. can be detected. For example, a load cell, a tension gauge, a strain gauge, a MEMS sensor, or the like can be used as the sensor of the load measuring unit 16, and any sensor that can detect the force applied to the sample S can be used. The output signal of the sensor of the load measuring section 16 is transmitted to the control section 17. FIG.

<Control unit 17>
As shown in FIG. 1, the controller 17 receives output signals from the sensor 15b of the joint 15 and the sensor of the load measuring unit 16. As shown in FIG. The control unit 17 has a function of storing the input signal and displaying the measured value on the measured value display unit 19 based on the input signal. For example, changes in time series of output signals from the sensor 15b of the joint portion 15 and the sensor of the load measuring portion 16 are displayed as they are on the measured value display portion 19 as a continuous graph, or displayed as numerical values on the measured value display portion 19. It has the function of Further, it may have a function of displaying on the measured value display section 19 in which direction and with what force the tensile force is generated.

In the endoscope training apparatus 1 of this embodiment, the sample S held by the pair of gripping claws 12a, 12a of the holding portion 12 of the sample holding arm 11 is passed through the through hole 3g of the hollow structure 3 into the treatment area 3h. It can be pulled by the inserted forceps F. Then, the force applied to the sample S by the load measuring section 16 connected to the sample holding arm 11, that is, the force of pulling the sample S by the forceps F can be detected. That is, the load applied to the sample S via the forceps F can be grasped by the load measuring unit 16 . Then, since it is possible to numerically grasp how much force the trainee applies to the sample S, it is possible to concretely present the problem of the trainee's treatment and the improvement method, and the trainee's proficiency can be quickly evaluated. can be increased to

Moreover, by using the endoscope training apparatus 1 of the present embodiment, if a skilled operator performs a treatment and the data is measured, the difference in treatment between a skilled operator and a trainee can be objectively determined. Since the results can be compared, it is possible to clarify problems in the trainee's treatment and improvement methods.

In particular, if the measuring unit 10 has the measured value display unit 19, the trainee himself/herself can learn how much force is applied to the sample S and in which direction the force is applied. You can see in real time when you are doing it. Then, it becomes easier for the trainee to understand the relationship between his or her own operation and the force actually applied to the sample S, so that the trainee's proficiency can be easily improved.

<Usage example of the endoscope training device 1 of the present embodiment>
Since the endoscope training apparatus 1 of the present embodiment has the structure as described above, the following training can be performed.

<Tension training>
First, when the sample S is held by the pair of gripping claws 12a, 12a of the holding portion 12 of the sample holding arm 11, preparation for training is completed.

In this state, the forceps F are inserted into the treatment area 3h from the through hole 3g of the hollow structure 3, and the sample S is gripped by the forceps F. As shown in FIG.

When the sample S is pulled by the forceps F, it is possible to confirm with what force the sample S is being pulled and in what direction by displaying the measured value display section 19 . In addition, although the measured value display section 19 is provided on the side surface of the main body of the measuring section 10 in FIG. 1, the place where the measured value display section 19 is provided is not particularly limited. As shown in FIG. 5, the measured value display section 19 may be provided on the upper surface of the main body of the measurement section 10 .

<Extension training>
After preparing for training in the same manner as the tensile training described above, a plurality of forceps F are inserted into the treatment area 3h through the plurality of through holes 3g of the hollow structure 3, and training for stretching the sample S is performed. can be done.

For example, two forceps F are inserted into the treatment area 3h, and the sample S is pulled by moving the two forceps F away from the holding portion 12 of the sample holding arm 11 and away from each other. Then, the sample S can be stretched into a shape with the holding portion 12 and the two forceps F as apexes. You can train yourself to be able to stretch.

<Cutting training>
If the entire holding portion 12 (or the pair of gripping claws 12a, 12a) is made of a conductive material such as metal, and the holding portion 12 (or the pair of gripping claws 12a, 12a) is grounded, extension training can be performed. It is also possible to perform training for excising the sample S while performing a tensile test.

For example, if an electric knife is inserted into the treatment area 3h from the through hole 3g while performing extension training and a tensile test, the sample S is cut by the electric knife or a part of the sample S is excised. be able to.

In order to cut or excise the sample S with an electric scalpel, it is necessary to generate an appropriate tension in the sample S to stretch or extend the sample S. In other words, if the endoscope training apparatus 1 of the present embodiment is used with the forceps F, the specimen S can be easily excised or cut by an electric scalpel if the specimen S is pulled or stretched with what kind of force and in what direction. You can actually experience what

The method for grounding the holding portion 12 is not particularly limited. The holding part 12 as a whole (or the pair of gripping claws 12a, 12a) may be connected to the device main body 2, installation structure, or the like with a lead wire or the like, or a conductive material may be attached to a portion of the holding part 12 that comes into contact with the sample S. A method of connecting the conductive material with the device main body 2, installation structure, or the like with a lead wire or the like can be adopted.

As a reference, when the sample S (VTT (Versatile Training Tissue) manufactured by Kotobukigiken Co., Ltd.) is incised using an electric scalpel while both ends are pulled, the load (pulling force) applied to the sample S is given to the excision time. confirmed the impact.
As shown in FIG. 4, it can be confirmed that the excision time is shortened as the load is increased.

In addition to the electric scalpel described above, there is also an ultrasonic coagulation/cutting device as an instrument for excising tissue. The ultrasonic coagulation and incision device is a device that incises tissue by ultrasonic vibration and suppresses bleeding by coagulating the incised portion. In the case of such an ultrasonic coagulation/cutting device, if the cutting time is too short, the tissue at the cut portion may not be sufficiently coagulated. Therefore, if excision training with an ultrasonic coagulation and incision device is performed using the endoscope training apparatus 1 of the present embodiment, the trainee can apply a load to the tissue in order to appropriately perform tissue excision and tissue coagulation. can grasp.

<Traction evaluation device>
With the endoscope training device 1 of the present embodiment, tension training, extension training, and cutting training may be performed without providing the hollow structure 3 . In this case, the training is performed in an environment different from the forceps F or the like in an actual living body. Thus, the endoscopic training apparatus 1 of the present embodiment without the hollow structure 3 corresponds to the traction force evaluation apparatus recited in the claims.

<Regarding the hollow structure 3>
In the above example, the hood 3a is provided with a plurality of through-holes 3g, but the number of through-holes 3g may be one. It is possible to pull the sample S with the forceps F even if there is only one through hole 3g.

The hood 3a can maintain the treatment area 3h even if an external force is applied if it is made of the material described above, but it may be made of a flexible material. For example, the hood 3a may be formed of a flexible sheet-like member. In this case, if a framework is provided to separate the hood 3a from the bottom plate 3b, the treatment area 3h can be formed even if the hood 3a is not strong enough.

The hood 3a may be made of a transparent material or an opaque material. If the hood 3a is made of a transparent material, it is possible to practice the operation while confirming the actual movement of the forceps F.

On the other hand, if the hood 3a is made of an opaque material, training can be carried out in an environment close to the actual treatment. In other words, if the endoscope E is inserted through the through hole 3g, the forceps F cannot be visually confirmed, but the operation can be performed while confirming the image captured by the endoscope E. Then, training can be carried out in an environment close to the actual treatment.

Even in a state where the hood 3a is made of a transparent material, the treatment may be performed while confirming the image captured by the endoscope E. In this case, since the difference between the image of the endoscope E and the visual image can be grasped, it becomes easier for a trainee with a low proficiency level to improve the proficiency level.

The bottom plate 3b may not necessarily be provided, and a hollow treatment area 3h may be formed by the upper surface of the device body 2 and the hood 3a.

<Regarding the measurement unit 10>
The measurement unit 10 does not necessarily have to insert the sample holding arm 11 into the treatment area 3h from the side surface of the hood 3a. For example, the entire measurement section 10 may be accommodated within the treatment area 3h of the hollow structure 3. FIG.

In the above example, the measurement unit 10 has the measurement value display unit 19 , but the measurement unit 10 does not necessarily have the measurement value display unit 19 . For example, data may be transferred from the control unit 17 to an external personal computer or the like via a cable or the like, and the measurement results may be displayed on a display or the like connected to the personal computer or the like.

In the above example, the joint portion 15 is provided between the sample holding arm 11 and the load measuring portion 16. However, the joint portion 15 may be provided between the load measuring portion 16 and the device main body 2. good.
Further, if only the tensile force applied to the sample S is to be detected, the joint portion 15 may not be provided.

<Sample holder>
The sample holding arm 11 and the joint portion 15 of the measuring section 10 described above can be used as an instrument for holding the sample S and the like by themselves. For example, there is little need to measure the load applied to the sample S when training to handle tissue that is not damaged by the application of force. However, in order to understand how to move the tissue and how to change or maintain the posture of the tissue, the orientation of the sample S and the order in which the sample S is moved are important. Become. Therefore, an instrument in which the sample holding arm 11 and the joint portion 15 are connected may be used as an instrument for holding the sample S when training in tissue handling as described above. Then, the motion and posture of the sample holding arm 11, that is, the motion and posture of the sample S can be grasped by the sensor 15b provided in the joint portion 15, so that the trainee can appropriately grasp his own treatment. The instrument in which the sample holding arm 11 and the joint 15 are connected corresponds to the sample holding instrument described in the claims.

This sample holding instrument is not limited to training as described above, and can be used as an instrument for holding tissue in place of the forceps F in an endoscopic surgery assisting device 100 described later during actual surgery. is also possible.

<Regarding the endoscope measurement unit 20>
As described above, when the endoscope E is inserted from the through hole 3g of the hood 3a to capture an internal image, an existing endoscope device may be used. However, the endoscope training device 1 of this embodiment itself may have the endoscope E. In this case, when training using the endoscope E, there is no need to prepare an endoscope device separately, so training using the endoscope E can be performed at any time, so the content of training and the degree of freedom in training can be increased. can be high

For example, as shown in FIGS. 1 and 5, an endoscope measuring section 20 having an endoscope E is provided in the device main body 2 . If an image display unit 21 for displaying an image taken by the endoscope E is provided in the endoscope measurement unit 20, the operation can be performed while confirming the image taken by the endoscope E. . Of course, the image display section 21 may not be provided in the endoscope measurement section 20, and the image captured by the endoscope E may be displayed on the display D or the like provided separately from the endoscope training apparatus 1. FIG.

Note that the endoscope E provided in the endoscope measurement unit 20 is not particularly limited, and a general flexible endoscope or laparoscope or the like may be used, or have only the function of taking an image. You can use things.
In addition, although the image display unit 21 is provided on the side surface of the main body of the endoscope measurement unit 20 in FIG. 1, the place where the image display unit 21 is provided is not particularly limited. As shown in FIG. 5, the image display section 21 may be provided on the upper surface of the endoscope measurement section 20 main body.

<Endoscopic Surgery Assistant Device 100 of the Present Embodiment>
In the endoscopic training device 1 described above, when the operator performs training using the endoscopic surgery assisting device 100 described later, the results of the training are stored in the control unit 17 . Further, if the data stored in the control unit 17 and the instructions from the operation controller 140 (to be described later) are associated with each other and stored in the endoscopic surgery assisting device 100, the endoscopic surgery assisting device 100 can perform a trained surgical operation. When the operator actually performs surgery, it is also possible to control the operation of the endoscopic surgery assisting apparatus 100 of this embodiment based on the data. Then, there is a possibility that the endoscopic surgery assisting device 100 of this embodiment can realize a support suitable for the orientation of the operator and the treatment method.

The endoscopic surgery assistance device 100 of this embodiment will be described below.

As shown in FIG. 3A, the endoscopic surgery assisting apparatus 100 of the present embodiment includes a robot arm 110, a drive unit 130 that drives the robot arm 110, and an operation controller that inputs the operation of the robot arm 110. 140 and a control unit 200 that controls the operation of the drive unit 130 based on a signal from the operation controller 140 .

<Operation Controller 140>
The operation controller 140 is used by a practitioner who performs endoscopic surgery to input necessary operations to the robot arm 110 of the endoscopic surgery assisting apparatus 100 of this embodiment. For example, a method of inputting the movement of the robot arm 110 by providing a plurality of foot pedals and stepping on the plurality of pedals can be used.
Note that the operation controller 140 is not limited to the stepping pedal as described above, and may be any device that allows the operator to input the motion of the robot arm 110 while performing treatment.

<Robot arm 110>
In FIG. 3A, reference numeral 111 denotes a support. A base 111b having casters or the like is provided at the lower end of the column 11, so that the floor or the like can be moved by the casters or the like.

As the base 111b of the column 11, a base plate may be provided at the lower end without providing casters or the like. By providing the base plate, the support 11 can be stably erected on the floor or the like.

A base end of a first arm 112 is connected to the upper end of the support 111 . The first arm 112 is provided so that its axial direction is substantially horizontal.

In addition, the base end of the first arm 112 may be fixed so that the first arm 112 cannot move with respect to the support 111, or may move relatively. For example, the tip of the first arm 112 may swing up and down with its base end as a fulcrum, or may rotate horizontally with its base end as a fulcrum.

The tip of the first arm 112 is connected to the tip of the second arm 113 . Specifically, the second arm 113 is provided so that its proximal end swings up and down with respect to the first arm 112 with its distal end serving as a fulcrum. For example, if one end of the swing shaft 114 is fixed to the tip of the second arm 113 and the other end of the swing shaft 114 is rotatably connected to the tip of the first arm 112, the swing shaft 114 can be As a fulcrum, the base end of the second arm 113 can be vertically swung.

The second arm 113 is provided with an instrument holding portion 115 movable along its axial direction. The instrument holding section 115 holds forceps F or the like for holding an organ such as an intestine when a surgical operation is performed using the endoscope E. As shown in FIG. The device holding portion 115 is provided movably along the axial direction of the second arm 113 by a guide rail or the like. The instrument holding portion 115 is provided with the above-described load sensor and acceleration sensor. That is, a load sensor that detects the force applied to the instrument holding section 115, in other words, the force that is applied to the forceps F held by the instrument holding section 115, and an acceleration sensor that detects the posture of the instrument holding section 115 are provided.

The method and structure for holding the forceps F and the like by the instrument holding portion 115 are not particularly limited. For example, a clamp may be provided in the instrument holding portion 115, and the forceps F or the like may be sandwiched and held by the clamp.
Also, the method of guiding the movement of the instrument holding portion 115 is not particularly limited. For example, a rail may be provided along which the instrument holding section 115 moves, or the instrument holding section 115 may be slidably attached to a shaft or the like.

<Driver 130>
The driving section 130 swings the second arm 113 of the robot arm 110 and moves the instrument holding section 115 .

<Swing of second arm 113>
As shown in FIG. 3A, an endless belt 131 is wound around the swing shaft 114 via a pulley or the like. It is wound around the pulley 133 . Therefore, by driving the drive unit, the swing shaft 114 can be rotated as the endless belt 131 is driven, and the second arm 113 can be swung as the swing shaft 114 rotates.

Note that the method for swinging the second arm 113 is not limited to the method described above. For example, a motor may be provided as a drive unit at the tip of the first arm 112, and the tip of the second arm 113 may be fixed to the main shaft of the motor. Further, the driving force of the driving portion may be transmitted to the swing shaft 114 via a speed reducer having gears.

<Movement of instrument holding part 115>
As shown in FIG. 3A, one end of a wire 135 is connected to the distal end of the instrument holding portion 115 (the distal end of the second arm 113). The other end of the wire 135 is provided with a drive unit 136 such as a winch for feeding or winding the other end of the wire 135 .

On the other hand, one end of a wire 137 is connected to the proximal end of the instrument holding portion 115 (the end on the proximal side of the second arm 113). The other end of the wire 137 is provided with a drive unit 138 such as a winch for feeding or winding the other end of the wire 137 .

With such a configuration, if the wire 137 is let out by the driving portion 138 while the wire 135 is wound by the driving portion 136, the device holding portion 115 is moved along the axial direction of the second arm 113 to the distal end side of the second arm 113. can be moved to

Conversely, if the wire 137 is wound by the driving portion 138 while the wire 135 is being drawn out by the driving portion 136, the device holding portion 115 is moved along the axial direction of the second arm 113 toward the base end side of the second arm 113. can be made

In addition, the method for moving the instrument holding portion 115 is not limited to the method described above, and various methods can be used.

For example, if the second arm 113 is tilted downward from the proximal end toward the distal end, only the wire 137 and the drive section 138 may be provided. Even in this case, if the wire 137 is wound, the device holding portion 116 can be moved toward the proximal end of the second arm 113, and if the wire 137 is let out, the device holding portion 115 will be moved by its own weight. It can be moved toward the tip of the second arm 113 .

Alternatively, only the wire 135 and the driving section 136 may be provided. In this case, a weight or the like is connected to the proximal end side of the instrument holding portion 115 so that a force that always pulls the instrument holding portion 115 toward the proximal end side is applied. Then, if the wire 135 is wound, the instrument holding part 115 can be moved toward the tip of the second arm 113, and if the wire 135 is let out, the instrument holding part 115 can be moved to the tip of the second arm 113 by the load of the weight. You can move towards it.

Further, a belt or wire is provided to rotate between the distal end and the proximal end of the second arm 113, and the instrument holding portion 115 is connected to this belt or wire. In this case, the device holding portion 115 can be reciprocated between the distal end and the proximal end of the second arm 113 by reciprocating the belt or wire between the distal end and the proximal end.

<Control unit 200>
The control section 200 controls driving of the drive section 130 described above based on an input from the operation controller 140 . Specifically, in response to an input instruction from the operation controller 140, the driving section 132 is operated to swing the second arm 113, or the driving sections 135 and 137 are operated to move the instrument holding section 115. It is something to let you.

Further, the control unit 200 stores training data that associates inputs from the driving unit 130 and the operation controller 140 when the endoscopic surgery assisting device 100 is used for training of the endoscopic training device 1 described above. remembered. That is, the operation amount, operation speed, and the like when the practitioner operates the operation controller 140 in training are associated with data (training data) of the operation state of the drive unit 130 and stored in the control unit 200 .

Outputs of a load sensor and an acceleration sensor provided in the instrument holding section 115 are input to the control section 200 . The control unit 200 also has a function of controlling the operation of the drive unit 130 by comparing the output of the load sensor and the acceleration sensor with training data. For example, when a command to move the instrument holding section 115 and pull the tissue is input from the operation controller 140, the information obtained based on the signals detected by the load sensor or the acceleration sensor and the information of the training data are combined. In comparison, it has a function of performing feedback control to control the operation of the drive unit 130 so as to pull the tissue in an appropriate direction with an appropriate force. Note that the method for controlling the operation of the drive unit 130 based on the information obtained by the control unit 200 based on the signals detected by the load sensor and the acceleration sensor and the information of the training data is not limited to feedback control, and is not particularly limited. not.

With the configuration as described above, the endoscopic surgery assisting device 100 of the present embodiment can be used to support surgery using an endoscope.
Note that the endoscopic surgery assisting device 100 of the present embodiment may be operated by the operator himself/herself, or may be operated by an assistant (referred to as an assistant) who assists the surgery.

First, forceps F and the like to be used are attached to the instrument holding portion 115 of the endoscopic surgery assisting apparatus 100 of the present embodiment. Then, the practitioner operates the operation controller 140 to move the instrument holding section 115 to which the forceps F and the like are attached to the distal end side of the second arm 113 along the axial direction of the second arm 113 . Then, the forceps F or the like can be inserted into a hole formed in the patient's body, and the tip of the forceps F or the like can be placed inside the abdominal cavity or the like.

In the endoscopic surgery assisting apparatus 100 of the present embodiment, when the instrument holding portion 115 is moved to the distal end side of the second arm 113 along the axial direction of the second arm 113, the forceps F and the like are applied to the patient's body. It should be installed in a position where it can be inserted into the formed hole.

Then, when the tip of the forceps F or the like moves to a position where a desired tissue such as an intestine can be grasped, an assistant or a practitioner operates the forceps F or the like to grasp the desired tissue.
A forceps operation unit for operating the forceps F or the like may be provided so that the operation controller 140 can operate the forceps F or the like to grip and release the tissue or the like.

Once the desired tissue is grasped, the desired tissue can be stretched or relaxed by operating the operation controller 140 by the operator. That is, by moving the forceps F or the like gripping the desired tissue toward the base end of the second arm 113 along the axial direction of the second arm 113, the desired tissue can be pulled and stretched. On the other hand, by moving the forceps F or the like gripping the desired tissue along the axial direction of the second arm 113 toward the distal end of the second arm 113, the tension applied to the desired tissue can be weakened. The desired tissue can be relaxed.

The control unit 200 controls the speed and amount of movement of the instrument holding unit 115 when the operation controller 140 is operated so that the tissue is pulled in an appropriate direction with an appropriate force. Therefore, even if the operator does not need to be unduly careful in operating the operation controller 140, the forceps F or the like can be made to move as planned by the operator. can.

Even if feedback control by the control unit 200 is not performed, if a display unit for displaying the measured values of the acceleration sensor and the load sensor is provided, the operator can operate the operation controller 140 while checking the display on the display unit. can be operated.

<Regarding the control unit 200>
In the endoscopic surgery assisting device 100 of the present embodiment, the control section that controls the operation of each section is not particularly limited. However, it is preferable to use the control unit 200 having the following functions, that is, the control unit having a dual-core lockstep circuit, because it reduces malfunctions and improves safety. In other words, compared to the case of using a control circuit with only one arithmetic circuit, the control unit 200 uses two arithmetic circuits to perform control while comparing the arithmetic results of both circuits. 200 malfunctions can be reduced. Therefore, if the controller 200 is provided in the endoscopic surgery assisting device 200, malfunction of the endoscopic surgery assisting device 200 can be reduced, and safety during surgery can be improved.

The control unit 200 will be described below.
In the following description, a case where the operation of each device of the drive unit 130 of the endoscopic surgery assisting apparatus 100 is controlled by a signal from the control unit 200 will be described as a representative.

As shown in FIG. 3B, the control unit 200 has two arithmetic circuits (CPUs) 201 and 202, two delay circuits 203 and 204, and a comparison circuit 205. FIG. It also has an error signal module 206 that performs processing when an error occurs.

In the control unit 200, the comparison circuit 205 compares the calculation result of one calculation circuit 201 and the calculation result of the other calculation circuit 202, and if the two match, the operation of the driving unit 130 is advanced. If they do not match, the operation of the driving section 130 is stopped. An example of calculation in the control unit 200 will be described below.

First, when a signal is input from the operation controller 140 or the like, the arithmetic circuit 201 executes a predetermined arithmetic operation. The calculation result of this arithmetic circuit 201 is supplied to the delay circuit 204 and transmitted to the comparison circuit 205 after a predetermined delay time (T1).

On the other hand, the signal from the operation controller 140 or the like is also supplied to the delay circuit 203, and is input from the delay circuit 204 to the arithmetic circuit 202 after a predetermined delay time (T2). Then, after a predetermined delay time (Ts) from when the arithmetic circuit 203 starts the arithmetic operation, the arithmetic circuit 202 performs the same arithmetic operation as the arithmetic circuit 201 . The calculation result of the calculation circuit 202 is sent to the comparison circuit 205 at the same time as the calculation ends.

It should be noted that the delay time (T1) during which the computation result is supplied from the computation circuit 201 to the comparison circuit 205 by the delay circuit 204 is the same as the delay time (T2) during which the signal is input to the computation circuit 202 by the delay circuit 204. The delay circuits 203 and 204 are configured such that

A comparison circuit 205 to which the calculation result of the calculation circuit 201 and the calculation result of the calculation circuit 202 are input compares both calculation results. As a result of comparing both calculation results in the comparison circuit 205, when both calculation results match, the operation of the driving section 130 is continued based on the calculation result of the calculation circuit 201 (or the calculation circuit 202). Then, the arithmetic circuits 201 and 202 perform arithmetic operations based on signals input from the operation controller 140 and the like, and the comparison circuit 205 compares both arithmetic results in the same manner as described above.

On the other hand, when the computation result of the computation circuit 201 and the computation result of the computation circuit 202 do not match, the comparison circuit 205 transmits the comparison result (error information) to the error signal module 206 . At this time, the error signal module 206 sends a command to stop the operation of the driving unit 130 to stop the operation of the driving unit 130 .

As described above, the control unit 200 performs control while comparing the calculation results of the two calculation circuits 201 and 202 using the two calculation circuits 201 and 202, compared with a control circuit using only one calculation circuit, thereby reducing malfunctions. be able to.

INDUSTRIAL APPLICABILITY The endoscope training device of the present invention is suitable as a training device for excision of tissue in a living body during treatment or surgery in a living body.

1 Endoscope Training Device 3 Hollow Structure 3h Treatment Area 3g Through Hole 11 Sample Holding Arm 12 Holding Part 15 Joint Part 16 Load Measuring Part 19 Measured Value Display Part 100 Endoscopic Surgery Auxiliary Device 110 Robot Arm 130 Driving Part 140 Operation controller 200 control unit S sample F forceps

Claims (11)

a sample holding arm having a holding portion for holding the sample;
a load measuring unit that measures the load applied to the sample holding arm ,
A holding portion of the sample holding arm is formed of a conductive material,
the holding part is grounded
A traction force evaluation device for endoscopic surgery characterized by: 2. The traction force for endoscopic surgery according to claim 1, further comprising a joint portion provided between said holding portion and said load measuring portion and/or between said load measuring portion and apparatus main body. Evaluation device . At the joint,
3. A traction force evaluation apparatus for endoscopic surgery according to claim 2, further comprising a sensor for detecting the moving direction of said sample holding arm. a sample holding arm having a holding portion for holding the sample;
a load measuring unit that measures the load applied to the sample holding arm,
a joint portion provided between the holding portion and the load measuring portion and/or between the load measuring portion and the device main body;
At the joint,
A traction force evaluation apparatus for endoscopic surgery, comprising a sensor for detecting a movement direction of the sample holding arm . A holding portion of the sample holding arm is formed of a conductive material,
the holding part is grounded
The traction force evaluation device for endoscopic surgery according to claim 4, characterized in that: 6. The traction force evaluation apparatus for endoscopic surgery according to claim 5, further comprising a measured value display section for displaying the measured value measured by the sensor of the joint. 6. The traction force evaluation apparatus for endoscopic surgery according to claim 1, further comprising a measured value display section for displaying the measured value measured by the sensor of said load measuring section. A training device for treatment using an endoscope,
A traction force evaluation device comprising: a sample holding arm having a holding portion for holding a sample; and a load measuring portion for measuring a load applied to the sample holding arm;
a hollow structure having a hollow treatment area in which the sample holding arm of the traction force evaluation device is arranged;
The hollow structure has
An endoscopic training apparatus, wherein a through hole is formed to communicate between the treatment area and the outside. 9. The endoscope training device according to claim 8, wherein a plurality of through holes are formed in said hollow structure. an endoscope for imaging the interior of the hollow structure;
10. The endoscopic training device according to claim 9, further comprising an image display section for displaying an image taken by the endoscope. The traction force evaluation device is
A traction force evaluation device for endoscopic surgery according to any one of claims 1 to 7
The endoscope training device according to claim 8, 9 or 10, characterized in that:

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