JPH08224241A - Medical manipulator - Google Patents

Abstract

PURPOSE: To attain miniaturization and light weight with a driving means of simple mechanism and to improve operability by providing a driving wire, a driven member, a wire driving means and a sliding means provided with an arc shape cross-section to convert the pulling direction of the driving wire by sliding the driving wire. CONSTITUTION: This manipulator comprises an insertion part 1 which performs a treatment in the body cavity of a patient, a driving part 2 which drives a treating kit, and a controller 3 which controls them. The opening/closing rod of the insertion part 1 is connected to an opening/closing driving wire 11, and a curved part 5 is provided with a curved driving wire 14, and the opening/ closing driving wire 11 and the curved driving wire 14 are inserted up to the driving part 2 in an insertion pipe 6. An opening/closing driving actuator 21, a curved driving actuator 25 and a wire sliding member 22 are housed in a casing 2a in which the driving part 2 is housed. The wire sliding member 22 is provided with the cross-section of a curve in circular arc shape, and a direction is changed by 90' by sliding the opening/closing driving wire 11 on the cross-section of the curve in circular arc shape.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention provides various observations by opening an insertion hole in a body wall such as an abdominal wall of a living body and percutaneously inserting an endoscope or a treatment tool into the body cavity through the insertion hole. The present invention relates to a medical manipulator for performing treatment.

[0002]

2. Description of the Related Art Endoscopic surgery is performed by opening an insertion hole in a body wall such as the abdominal wall of a living body and percutaneously inserting an endoscope or a treatment tool into the body cavity through the insertion hole. Observe and treat.

US Pat. No. 5,217,003 discloses a medical manipulator device for remotely operating an endoscope and a treatment tool in a patient's body by a manipulator for improving the operability of observation and treatment of endoscopic surgery. There is. Further, Japanese Unexamined Patent Publication No. 6-30896 discloses an observation manipulator device for operating an endoscope in a patient's body, which has a bending portion electrically driven in two degrees of freedom in up, down, left, and right directions at its tip. ing.

Further, Japanese Patent Application No. 6-131809 discloses an endoscope and a treatment instrument in a body cavity in which the distal end portion is electrically curved vertically and horizontally and the entire distal end portion is electrically rotated. Further, there is a surgical device in which an endoscope and an internal treatment device are integrated to reduce the number of holes opened in the body cavity.
No. 82 publication. Furthermore, Japanese Patent Application No. 5-27
4405 discloses a surgical device in which a plurality of treatment arms and a stereoscopic observation means are integrated and can be inserted through one insertion hole.

In an intracavity medical device having a wire-driving means, the tension of the wire is detected for compensating the play of drive transmission due to extension of the wire over time, protecting the wire from disconnection from excessive driving force, and controlling the driving force. It is effective to provide means. Japanese Patent Application Laid-Open No. 4-246322 discloses an endoscope having a distal end bent by a wire electrically driven by a motor, in which a tension detecting means is provided on the wire to control the generated force of the motor. In the configuration of the publication, the extension of the wire can be compensated by controlling the motor based on the information of the tension detecting means.

Japanese Unexamined Patent Publication (Kokai) No. 5-76482 discloses a surgical device in which an endoscope and an intracorporeal treatment device are integrated to reduce the number of holes to be opened in the body cavity and to reduce the invasion to the patient. Further, Japanese Patent Application No. 5-274405 discloses a surgical apparatus in which a plurality of treatment arms and a stereoscopic observation means are integrated and can be inserted from one insertion hole.

[0007]

However, in the manipulator for endoscopic surgery as shown in Japanese Patent Application No. 6-131809, the size of the insertion portion entering the body cavity is reduced and the insertion portion outside the body cavity is reduced. Miniaturization of the drive unit is important. Above the patient undergoing surgery, a space is required for the operator to operate various treatment tools and instruments.
In order to prevent interference with them, it is important to reduce the size of the drive part of the insertion part. In many cases, a combination of an electric motor, a reduction mechanism and a wire is used for such a manipulator or endoscope.

However, since the rotation detecting means of the motor such as the electric motor, the speed reducing mechanism and the encoder are connected in the axial direction of the electric motor, they are generally elongated in the axial direction of the electric motor, and have a long and narrow insertion portion. If they are not provided in parallel, the drive unit will become large. JP-A-6-30896
In the publication, a bevel gear is used to change the direction of the motor shaft so that the motor and the insertion portion are parallel to each other. Also, in Japanese Patent Application No. 6-131809, the motor and the insertion portion are made parallel by converting the rotation of the motor into a linear motion by using a ball screw. However, these mechanisms are complicated and the weight is increased accordingly, and it is difficult to miniaturize them.

Further, in Japanese Patent Application No. 6-131809, the rotating mechanism of the distal treatment instrument is rotated by the entire drive unit of the bending portion, but the rotation unit supports the weight of the drive unit, which makes the size larger. Have. Furthermore, JP-A-5-7648
No. 2 or Japanese Patent Application No. 5-274405, the endoscope and the one or more treatment means are integrated,
Since the driving means is provided corresponding to each degree of freedom, there is a problem that the driving unit tends to be large.

In Japanese Patent Laid-Open No. 4-246322,
The wire tension detecting means is provided on the wire between the bending portion which is the driven member and the driving means. However, since the position of the detecting means changes according to the driving of the wire, the wiring for the detecting means is made movable. There is a problem of need. In addition, it is necessary to provide a space for the detecting means in the drive unit, which causes a problem that the size is easily increased.

Japanese Patent Application No. 5-274405 discloses a surgical apparatus in which a plurality of treatment arms and a stereoscopic observation means are integrated and can be inserted through one insertion hole. However, in actual surgery, in addition to forceps,
Various treatment means such as laser probe, ultrasonic scalpel,
In addition, an auxiliary observation device such as an ultrasonic probe may be required, and the combination of treatment means is not unique. In addition, it is desirable that they can be exchanged and rearranged according to the progress of surgery.

The present invention has been made in view of the above circumstances, and it is an object of the present invention to reduce the size and weight by adopting a drive means of a drive wire while using a drive means of a simple mechanism. , To provide a medical manipulator capable of improving operability.

[0013]

Means and Actions for Solving the Problems
To achieve the above object, a drive wire, a driven member driven by the tension of the drive wire, a wire drive means for driving the drive wire, and a pulling of the drive wire by sliding the drive wire. And a sliding means having an arc-shaped cross section for changing direction. By converting the direction of the drive wire by the sliding means having an arc-shaped cross section, the wire can be driven by the wire drive means provided in parallel with the insertion portion.

[0014]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 show a first embodiment, and FIG. 1 shows the overall structure of a medical manipulator. This medical manipulator, in endoscopic surgery, in order to perform a simple and advanced treatment in the body cavity of the patient, the bending of the treatment tool,
Rotation and opening / closing can be electrically operated using an operation input device at hand.

That is, the medical manipulator includes an insertion section 1 for performing a treatment in a body cavity of a patient, a drive section 2 for driving a treatment tool, and a controller 3 for controlling the drive section 2.
It consists of and.

The insertion portion 1 is a treatment instrument 4 for treating the affected area,
The treatment tool 4 includes a bending portion 5 that changes the direction and an insertion pipe 6. As shown in FIG. 2, the insertion portion 1 is configured such that a pair of forceps pieces 7 are connected to a link 9 by a pivot pin 8 and are opened and closed by rotating the link 9. The base end of the link 9 is rotatably connected to the open / close rod 10 that moves back and forth by a connecting pin 9a.

The proximal end of the opening / closing rod 10 is connected to the opening / closing drive wire 11. The open / close rod 10 has a flange portion 1
0a, and the flange portion 10a is housed in a cylindrical case 10b. Furthermore, this case 10
A pressing spring 12 for urging the flange portion 10a toward the tip side is housed inside b.

The bending portion 5 is composed of a plurality of bending pieces 13, a bending drive wire 14 and a bias spring 15. The bending piece 13 is the opening / closing drive wire 11
And three insertion holes 16 through which the bending drive wire 14 and the bias spring 15 are inserted. Curved piece 1
3 has a convex portion 17 on one surface and a concave portion 18 on the other surface so as to be connected to the adjacent curving piece 13. The convex portion 17 and the concave portion 18 are arc-shaped projections, and the adjacent curved pieces 13 can rotate around the projections.
Further, the opening / closing drive wire 11 and the bending drive wire 14 are inserted through the insertion pipe 6 to the drive unit 2.

The drive unit 2 is housed in a casing 2a as shown in FIG. A rotary pulley 19 for rotating the entire insert portion 1, a rotary drive actuator 20 for rotating the rotary pulley 19, and an insert pipe 6 fixed to the end of the insert pipe 6 were inserted into the casing 2a. Opening / closing drive wire 11 and bending drive wire 14, opening / closing drive actuator 21 for driving opening / closing drive wire 11, bending drive actuator 25 for driving bending drive wire 14, and wire for changing the direction of opening / closing drive wire 11. The sliding member 22 is stored. Furthermore, a joystick 23 for instructing bending and rotation of the treatment instrument 4 and an operation handle 24 for operating opening and closing of the treatment instrument 4 are provided on the outer wall of the casing 2a.

Next, the drive portion of the opening / closing drive wire 11 and the rotary pulley 19 will be described with reference to FIG. Inside the casing 2a, a wire sliding member 22 as a sliding means is provided behind the rotary pulley 19. The wire sliding member 22 has an arc-shaped curved cross section,
The opening / closing drive wire 11 slides along the arcuate curved cross section of the wire sliding member 22 to change the direction by 90 ° and is guided to the first pulley 26 provided under the wire sliding member 22. It is like this. Then, the first pulley 26
The open / close drive wire 11 is fixed to one point of the pulley groove. The wire sliding member 22 has a cross section that is rotationally symmetric with respect to the axis of the insertion pipe 6.

The opening / closing drive actuator 21 has a first
The pulley 26, the motor 27, the reduction gear 28, the encoder 29 for detecting the rotation speed of the motor 27, and the potentiometer 30 for detecting the absolute rotation angle of the first pulley 26.

Two wires 31 are fixed to the rotary pulley 19 for transmitting right and left directions, and the wire 31 is connected and fixed to a second pulley 32 provided under the rotary pulley 19. . The second pulley 32 is driven by the rotary drive actuator 20, and the rotary drive actuator 20 detects the motor 27, the reduction gear 28, and the rotation speed of the motor 27 similarly to the opening / closing drive actuator 21. And a potentiometer 30 for detecting the absolute rotation angle of the first pulley 26.

The optical and magnetic encoders 2 are also provided.
9 usually has A-phase and B-phase signal lines for detecting the rotation direction, and has Z-phase signal lines for detecting each rotation. In this embodiment, the noise resistance of the signal line is increased,
Inverted phases of the A, B, and Z phases are output to enable detection at the time of disconnection. Further, since the output of the potentiometer 30 detects the resistance value of the potentiometer 30, it is easy to detect a failure such as disconnection or short circuit.

Although the drive system of the opening / closing drive wire 11 has been described above, the drive system of the bending drive wire 14 has the same structure. That is, the bending drive wire 14 is also guided by the lower part of the wire sliding member 22 by sliding the same wire sliding member 22 along the arcuate curved cross section to change the direction by 90 °. .

Next, the operation will be described. As shown in FIG. 1, when the operator operates the joystick 23, the position designated by the joystick 23 is input to the controller 3. The controller 3 converts the position into a bending angle and a rotation angle of the treatment instrument 4, and drives the bending drive actuator 25 and the rotation drive actuator 20.

The controller 3 includes a bending drive actuator 25 and an encoder 29 of the rotary drive actuator 20.
And the current to the motor 27 is controlled so that the bending angle and the rotation angle are instructed by using the information of the potentiometer 30. Further, the angle of the operation handle 24 operated by the operator is input to the controller 3. The controller 3 converts the angle into the opening / closing amount of the treatment instrument 4, and drives the opening / closing drive actuator 21 in the same manner as the bending drive actuator 25.

When the bending drive wire 25 is pulled by the bending drive actuator 25, the pulling direction of the wire 14 is bent 90 ° by the wire sliding member 22. As shown in FIG. 2, the bending drive wire 1 is resisted against the force of the bias spring 15.
4 is pulled, the bending pieces 13 are respectively bent.
The convex portion 17 is bent at a slight angle, and the entire bending is bent downward at a bending angle according to the pulling amount of the bending drive wire 14.

When the amount of pulling the bending drive wire 14 is reduced, the bending portion 5 bends upward due to the restoring force of the bias spring 15. By providing the bias spring 15 in this way, the bending angle can be controlled with one wire. Here, the shapes of the convex portion 17 and the concave portion 18 of the bending piece 13 can have the same effect even if a shape having a similar effect such as a wedge shape is used in addition to the arc shape. Further, if the bias spring 15 is composed of a single wire of a superelastic alloy having a higher elastic limit than that of a normal metal, the spring portion can be downsized and the rigidity can be increased.

When the opening / closing drive wire 11 is pulled by the opening / closing drive actuator 21, the pulling direction of the opening / closing drive wire 11 is bent by 90 ° by the wire sliding member 22.
As shown in FIG. 2, when the opening / closing drive wire 11 is pulled against the force of the pressing spring 12, the opening / closing rod 10 moves to the drive unit 2 side, and the forceps piece 7 is closed via the link 9. Further, when the pulling amount of the opening / closing drive wire 11 is reduced, the opening / closing rod 10 is moved to the treatment tool 4 side by the restoring force of the pressing spring 12, and the forceps piece 7 is opened. As described above, by using the pressing spring 12, it is possible to control the opening / closing of the treatment tool with one wire.

FIG. 4 is a view of the wire sliding member 22 seen from the direction of arrow A in FIG. 3, showing the motor 27 and the reduction gear 2.
8 rotates the second pulley 32, and the wire 31 transmits the rotation of the second pulley 32 to the rotary pulley 19. The rotation of the rotary pulley 19 causes the entire insertion portion 1 to rotate. With respect to the distance from the wire driving member 22 to the first pulley 26 and the length of the insertion portion 1, the insertion portion 1 is longer,
When the insertion portion 1 rotates, the bending drive wire 14 and the opening / closing drive wire 11 are twisted inside the insertion pipe 6,
The positions of the bending drive wire 14 and the opening / closing drive wire 11 on the wire sliding member 22 hardly change.

According to this embodiment, it is possible to approach a specific position in the body cavity from a direction that is easy to operate and to perform treatment. Further, in the present embodiment, the movement of three degrees of freedom is electrically driven, but the power transmission can be simply performed by the driving method using the bias spring and the wire. Further, by changing the driving direction of the wire with the wire sliding member 22 having an arcuate cross section, it is possible to reduce the size of the driving portion in the radial direction. Further, since the wire sliding member 22 having an arcuate cross section is in the shape of a rotating body, the two driving systems can share the same member, and the structure is simplified.

Further, in the present embodiment, the potentiometer 30 which is an absolute position detecting means is provided on the output shaft of the driving actuator, and the encoder 29 is used to control the motor 27, and each detecting means is disconnected or short-circuited. It is possible to detect the failure. Thereby, when these failures are detected, a plurality of position detecting means are provided, so that the control can be continued and the safety is improved.

FIG. 5 shows a second embodiment. In this embodiment, instead of the wire sliding member 22 shown in FIG. 3 of the first embodiment, a rotary pulley 33 is used to change the direction of the opening / closing drive wire 11. Rotating pool 3
3 is supported by a support stay 34, and a strain gauge 35 is attached to the support stay 34 as a tension detecting means.

When tension is applied to the opening / closing drive wire 11, a component of the tension is applied to the support stay 34. The deformation of the support stay 34 due to the component force is detected by the strain gauge 35, so that the tension of the opening / closing drive wire can be detected. The bending drive wire 14 is similarly configured. By detecting the tension of the opening / closing drive wire 11 and the bending drive wire 14 by the strain gauge 25, the force applied to the forceps piece 7 and the bending portion 5 can be controlled.

In the present embodiment, since the pulley is used as the wire direction changing means, the sliding resistance of the wire is small, so that the driving force can be small. Further, since the force applied to the forceps piece or the bending portion can be controlled using the tension of the wire, it is possible to perform control such that the grasped tissue is squashed or the pressing force against the surrounding tissue is below a certain limit. Further, in the drive system using the bias spring and the wire, the drive amount and the load of the drive force have a linear relationship, and the bending angle and the opening / closing angle of the forceps can be controlled by controlling the tension.

FIG. 6 shows a third embodiment. In this embodiment, an endoscope 36 in place of the treatment tool 4 shown in FIG. 1 of the first embodiment is constructed by using a bending tube 37 for the bending portion 5 which is used in a general endoscope. It is a thing. Joystick 23 for operating the bending tube 37 as an operation input means
Is provided.

The operation of the joystick 23 by the operator is converted into vertical and horizontal bending angles by the controller 3,
The bending drive actuators 113 and 114 are driven. Generally, in a bending structure using the bending tube 37, a pair of wires 38 and 39 for bending left and right, and a pair of wires 40 and 41 for bending up and down, a total of four wires are required. A horizontal drive actuator 113 and a vertical drive actuator 114 are provided to drive the pair of wires 38, 39 and 40, 41. The pair of wires 38, 39 and 40, 41 are attached to the pulleys 42 of the respective drive actuators and operate differentially.
Also in this embodiment, the wire driving member 22 having the same shape as that of the first embodiment is used to change the direction of the wire.

In this embodiment, the direction of the tip of the endoscope can be easily changed by electrically operating the bending portion of the tip. The object can be observed from any direction with respect to the rigid endoscope used in ordinary endoscopic surgery.
Since the bending portion can be operated electrically by the joystick, the operator can intuitively know the bending state in the body cavity.

Also in this embodiment, by using the wire sliding member 22 similar to that of the first embodiment, the direction of the wire is changed, so that the actuator for left and right driving and the actuator for up and down driving are inserted in the longitudinal direction of the insertion section 1. The actuator can be arranged, and the entire size can be reduced.

7 to 10 show a fourth embodiment, and FIG.
Indicates the overall configuration. The system according to this embodiment includes a master input device 44, a master-slave control device 45, a slave arm 46, and a treatment manipulator 47.

The master input device 44 detects the upper master arm 48 for detecting the position of the body of the operator D, the head master arm 49 for detecting the position of the head of the operator D, and the movement of the arm of the operator D. It is composed of a lower master arm 50. An encoder 51 is provided at the joints of these master arms 48 to 50, and the position coordinates of the body, the rotation of the head, and the movement of the arm are calculated from the output of the encoder 51 and the length of the arm.

An FMD (Face Mounted Display) 52 is fixed to the head master arm 49, and the operator D uses the liquid crystal display panels provided on the FMD 52 for the right eye and the left eye, respectively, to allow the operator D to tip the treatment manipulator 47. It is possible to stereoscopically observe the image of the 3D endoscope 53 provided in the.

The lower master arm 50 is composed of two arms A54 and B55 corresponding to the right arm and the left arm of the operator D. Arm A54 has two joints 5
6 and 57, each joint is provided with an encoder. A handle 60 for detecting the opening and closing of the hand of the operator D is provided at the tip of the arm A54. The arm B55 also has the same configuration.

The slave arm 46 is composed of a robot having three degrees of freedom: a rotary shaft 62 that rotates in the vertical direction, a vertical shaft 61 that moves up and down, and a horizontal shaft 63 that expands and contracts in the horizontal direction. At the tip of the horizontal shaft 63, the horizontal shaft 63
Has a first free joint portion 64 that is rotatable perpendicular to the first free joint portion 64 and a second free joint portion 65 that is rotatable perpendicular to the first free joint portion 64. A treatment manipulator 47 is detachably fixed to the tip of 65.

The manipulator 47 for treatment has a distal end portion 6
6, an insertion pipe section 67, and a drive section 68.
The distal end portion 66 has a 3D endoscope 53 and two bending treatment tools 69 and 70. The 3D endoscope 53 includes a bending portion 74 that is electrically operated vertically and horizontally, and two CCDs at the tip.
It has a camera 75.

The bending instrument 69, 70 has a gripper 71 and first and second bending portions 72, 73,
Each is driven electrically. Although not shown, a pipe for a channel for inserting a treatment tool such as a laser probe or an ultrasonic probe is provided through the entire length of the insertion pipe portion 67 from the drive portion 68.

8 to 10 show a manipulator 47 for treatment.
The detailed configuration of is shown. The upper part of the drive unit 68 shown in FIG. 8 is the drive mechanism 76 of the 3D endoscope 53, and the lower part is the drive mechanism 77 of the bending treatment instrument (the drive mechanism of the left treatment instrument and the drive mechanism of the right treatment instrument are symmetrical. Exists).

The right side of FIG. 9 shows the cross section at the A part of FIG. 8, and the left side shows the cross section at the B part of FIG. The bending treatment tool 69 includes two bending portions 72 and 73 and a gripper 71 having a structure similar to that of the distal end portion shown in FIG. 2 of the first embodiment.
have. The drive structure of the bending treatment instrument 69 also has the same configuration as that of the first embodiment. The first wire 80 is a drive wire for bending the first bending portion 72 upward, the second wire 81 is a drive wire for bending the second bending portion 73 downward, and the third wire The wire 82 is a drive wire for opening and closing the gripper 71.

Similarly to the first embodiment, the first to third wires 80 to 82 are changed in direction by 90 ° by the wire sliding member 22 having a shape in which an arc-shaped curve is rotated, and the fourth pulley is moved. 83, the fifth pulley 84, and the sixth pulley 85 are wound around and fixed.

The fourth pulley 83, the fifth pulley 84, and the sixth pulley 85 are fixed to the rotary shaft of an actuator 86 including an encoder 29, a motor 27, a reduction gear 28, and a potentiometer 30, and the actuator 86.
Driving the fourth to fifth pulleys 83 to 85
The first to third wires 80 to 82 wound around and fixed to the wire can be pulled to drive the first and second bending portions 72 and 73 and the gripper 71.

Further, the rotary drive actuator 9 is attached to the rotary pulley 19 for rotating the entire bending treatment tool 69.
Wire 9 for transmitting the rotation of the second seventh pulley 87
2 is wound and fixed. The bending treatment tool 70 has the same configuration as the bending treatment tool 69.

FIG. 10 shows a drive mechanism 76 of the 3D endoscope 53.
FIG. 9 is a diagram viewed from the lower side of FIG. 3D endoscope 53
A pair of fourth wires 88 and fifth wires 89 for driving the curved portion 74 to the left and right, and a pair of sixth wires 90 and seventh wires 91 for vertically driving the bending portions 74 are provided.

The portions where the fourth to seventh wires 88 to 91 interfere with other wires or built-in objects are protected by the coil pipe 93. The ends of the fourth wire 83 and the fifth wire 84 are fixed to the rotary link 96.
The fourth wire 83 and the fifth wire 84 are differentially driven by the rotation of the rotary link 96, and the bending portion 74 is laterally driven.

The rotary link 96 is a worm wheel 95.
The worm gear 94 is fixed to the shaft of an actuator 100 including an encoder 97, a motor 98, and a reduction gear 99. The sixth wire 90 and the seventh wire 91 are also driven by an actuator having the same configuration as the fourth wire 88 and the fifth wire 89.

The treatment manipulator 47 may be configured to rotate integrally. Also, the insertion pipe 6
7, the insertion portions of the bending treatment tools 69 and 70 and the 3D endoscope 53
There is provided a lotus root-shaped positioning member (not shown) for positioning the insertion part of the. The entire configuration of the present embodiment shown in FIG. 7 allows the operator D to perform observation and treatment as if he / she were inside a body cavity. The three-dimensional coordinates 101 of the body of the operator D are detected by the upper master arm 48. Based on the coordinates 101, the vertical axis 61, the rotary axis 62, and the horizontal axis 6 are arranged so that the tip portion 66 of the treatment manipulator 47 comes to the corresponding position 102.
3 is controlled by the master-slave controller 45.

Further, the bending direction 104 of the bending portion 74 of the 3D endoscope 53 is controlled by the master-slave control device 45 in response to the vertical and horizontal movements 103 of the head detected by the head master arm 49. The 3D endoscope 53
Since the image captured by is displayed on both eyes of the FMD 52, the operator D can perform observation as if he / she is inside the body cavity.

Further, the movement of the right arm of the operator D corresponds to the angles of the two joints 56 and 57 detected by the encoder provided in the lower master arm 50, and the bending treatment tool 69.
The corresponding first and second bending portions 72 and 73 of the above are driven by the master-slave control device 45. This also applies to the left arm. Further, the gripper 71 at the tip of the bending treatment tool 69 is driven by the master-slave control device 45 in response to the movement of the handle 60 of the lower master arm 50.

By using the system having the configuration of this embodiment, the 3D endoscope is driven according to the movement of the operator's head, and the bending and opening / closing of the treatment tool according to the movement of the operator's arm and hand. By being driven, the operator can perform observation and treatment as if he / she is inside the body cavity. Therefore, there is an effect that complicated treatment can be easily performed.

Further, in the ordinary endoscopic surgery, a plurality of insertion holes for inserting the endoscope for observation and the forceps for treatment into the body cavity are required. Since the endoscope for medical treatment and the treatment tool are integrated, the observation treatment can be performed only by making a hole in one place, and there is a feature that the invasion to the patient is reduced.

Further, as in the present embodiment, 3D from one location
When the endoscope and the treatment instrument are inserted, their respective movements tend to interfere with each other. However, by providing the bending treatment instrument with two curved portions in the vertical direction in alternate directions, the movement of the bending treatment instrument does not interfere with the movement of the 3D endoscope. Treatment can be performed. Further, in the present embodiment, since the operation of the two treatment tools is made to correspond to both arms of the operator, it is possible to easily perform a complicated operation such as a suture tied by coordinating the two treatment tools. You can

In this embodiment, the curvature of the 3D endoscope is
Although the bending, opening and closing, and rotation of both the left and right treatment tools are electrically driven in 10 degrees of freedom, the worm gear 94, the worm wheel 95, and the rotation link 96 are used to drive the 3D endoscope. Then, the wire sliding member 22
A compact drive unit is realized by using the direction change by.

FIG. 11 shows a fifth embodiment. In this embodiment, the drive unit and the 3D endoscope 53 of the 3D endoscope 53 shown in FIGS. 8 and 9 of the fourth embodiment, the right treatment instrument drive unit and the right curved treatment instrument 69, and the left treatment The instrument drive unit and the left-side bending treatment instrument 70 are configured by three independent units, that is, a 3D endoscope unit 105, a first treatment instrument unit 106, and a second treatment instrument unit 107.

When inserting into the body, the above three units are mounted on the insertion jig 108. This insertion jig 108
Is the base end portion 1 of each unit 105, 106, 107.
05a, 106a, 107a and the cylindrical portion 108a which can be inserted in a state of being aligned with each unit 105, 106, 1
No. 07 insertion parts 105b, 106b and 107b are aligned and inserted.

The cylindrical portion 108a of the insertion jig 108 has an engaging claw 110 as a fixture for fixing each unit 105, 106, 107, and the base of each unit unit 105, 106, 107. Ends 105a, 10
6a and 107a are provided with engagement holes 111 as means for attaching the engagement claws 110. Further, each of the units 105, 106 and 107 has a U-shaped engaging member 112a as a connecting jig for connecting with another unit.
And an engagement receiving portion 112 that engages with the engagement member 112a.
b is provided.

In the present embodiment, since the endoscope and the treatment tool can be separately connected as a unit, each can be used alone for surgery. In addition to forceps, as a treatment tool or device for endoscopic surgery,
Various types are conceivable, such as an electric scalpel, an ultrasonic scalpel, a cutting / hemostatic means such as a laser, a water / suction pipe, a suturing means such as a clip or stapler, and an ultrasonic observation probe for auxiliary diagnosis. There is an effect that a part of the units can be exchanged for those treatment tools and devices and the versatility is high.

According to the above embodiment, the following structure can be obtained. (Supplementary Note 1) A drive wire, a driven member driven by the tension of the drive wire, a wire drive means for driving the drive wire, and a pulling direction of the drive wire by sliding the drive wire. A medical manipulator, comprising: a sliding means having an arc-shaped cross section.

(Supplementary Note 2) The medical manipulator according to Supplementary Note 1, wherein the driven member is a bending means. (Supplementary Note 3) The medical manipulator according to Supplementary Note 1, wherein the driven member is a treatment means.

(Supplementary Note 4) The medical manipulator according to Supplementary Note 1, wherein the sliding means is a resin having a self-lubricating property. (Supplementary note 5) The medical manipulator according to Supplementary note 1, wherein the sliding means is a metal or a resin having a sliding portion with an anti-friction coating.

(Supplementary Note 6) A rotation having an elongated rod-shaped insertion portion and a drive portion incorporating a wire driving means, wherein the driven member is provided in the insertion portion, and the wire driving means is provided in parallel with the insertion portion. 2. The medical manipulator according to appendix 1, wherein the manipulator comprises drive means, and the pulling direction of the drive wire can be varied from vertical to parallel to the insertion portion by sliding in contact with the sliding means.

(Supplementary Note 7) The medical manipulator according to Supplementary Note 6, wherein the wire driving means has an electric motor and a pulley. (Supplementary note 8) The medical manipulator according to supplementary note 8 or 9, further comprising an insertion portion rotation driving means for rotating the rod-shaped insertion portion in the same drive portion as the wire driving means.

(Supplementary note 9) The medical manipulator according to supplementary note 8, wherein the insertion portion rotation driving means has an electric motor and a pulley. (Supplementary note 10) The medical manipulator according to supplementary note 8 or 9, wherein the sliding means has a shape rotationally symmetrical with respect to the insertion portion.

(Supplementary note 11) The medical manipulator according to any one of supplementary notes 1 to 10, further comprising urging force applying means for applying an urging force to the driven member in a direction opposite to the direction in which the driven member is driven.

(Supplementary Note 12) The medical manipulator according to Supplementary Note 11, wherein the urging force applying means is an elastic spring. (Supplementary note 13) The medical manipulator according to supplementary note 12, wherein the elastic spring is a superelastic alloy.

(Supplementary Note 14) The driving wire driving means and the driven member driven by the driving wire are provided, and the direction changing means for changing the pulling direction of the driving wire has the driving wire tension detecting means. A medical manipulator characterized in that

(Supplementary note 15) The medical manipulator according to supplementary note 14, wherein the direction changing means is a pulley. (Supplementary note 16) The medical manipulator according to supplementary note 14 or 15, wherein the direction changing means is a sliding means having an arc-shaped cross section.

(Supplementary note 17) The medical manipulator according to any one of supplementary notes 14 to 16, further comprising a drive amount detecting means for the drive wire. (Supplementary Note 18) An intracorporeal treatment device having an observation means having a detachable coupling means with a treatment means, and a treatment means having a detachable coupling means with an observation means or another treatment means.

(Supplementary Note 19) An observation means having a detachable coupling means with the insertion means, a treatment means having an insertion means and a detachable coupling means, and a plurality of observation means or treatment means and a detachable coupling means are provided. An intracorporeal treatment device comprising an insertion means having the same.

According to Supplementary Notes 1 to 7, since the insertion portion and the rotation driving means can be provided in parallel, the driving portion can be downsized and the structure of the driving portion can be simplified. According to Supplementary Notes 8 to 10, in addition to the above effects, the rotation driving unit can be downsized by realizing the rotation of the insertion unit without rotating the entire driving unit.

According to appendices 11 to 13, since the wire can be driven in two directions, the wire drive unit can have a simple structure in which one end is attached to the pulley, and the size can be reduced. It is possible. According to Supplementary Notes 14 to 16, by providing the tension detecting means in the means for varying the pulling direction of the drive wire, the tension detecting means can be fixed and can be downsized.

According to appendix 17, it is possible to compensate for the play caused by the extension of the drive wire over time, and position the observation / treatment means in the body cavity with high accuracy. According to Supplementary Note 18, by varying the treatment means depending on the type of treatment, it is possible to handle a wide range of operations. According to Supplementary Note 19, in addition to the effect of Supplementary Note 18, observation and treatment means can be easily exchanged without changing other configurations of the manipulator, so that observation and treatment means can be exchanged or the configuration can be changed intraoperatively. Is easy.

[0081]

As described above, according to the present invention, by providing the sliding means having the arc-shaped cross section for changing the pulling direction of the drive wire by sliding the drive wire, the insertion part and the drive part are driven. The means can be provided in parallel. Therefore, the structure of the drive unit can be simplified, and the medical manipulator can be downsized.

[Brief description of drawings]

FIG. 1 is an overall perspective view of a medical manipulator showing a first embodiment of the present invention.

FIG. 2 is a cross-sectional view of an insertion portion and a perspective view of a bending piece of the medical manipulator of the same embodiment.

FIG. 3 is a side view in which a part of a drive unit of the embodiment is cross-sectioned.

FIG. 4 is an arrow view from the direction of arrow A in FIG.

FIG. 5 is a side view, partly in section, of a drive section showing a second embodiment of the present invention.

FIG. 6 is an overall perspective view of a medical manipulator showing a third embodiment of the invention.

FIG. 7 is a block diagram of an intracorporeal treatment device showing a fourth embodiment of the present invention.

FIG. 8 is a vertical sectional side view of a medical manipulator showing a fifth embodiment of the present invention.

9 is a cross-sectional view of a cross section taken along a portion A and a portion B of FIG.

FIG. 10 is a vertical sectional side view of the medical manipulator of the same embodiment.

FIG. 11 is an exploded perspective view of a medical manipulator showing a sixth embodiment of the present invention.

[Explanation of symbols]

1 ... insertion part, 2 ... drive part, 4 ... treatment tool, 5 ... bending part, 1
DESCRIPTION OF SYMBOLS 1 ... Opening / closing drive wire, 14 ... Curving drive wire, 20 ... Rotational drive actuator, 21 ... Opening / closing drive actuator, 22 ... Wire sliding member, 25 ... Curving drive actuator.

Claims (1)

[Claims] 1. A drive wire, a driven member driven by the tension of the drive wire, a wire drive means for driving the drive wire, and a pulling direction of the drive wire converted by sliding the drive wire. And a sliding unit having an arc-shaped cross section.