JPH09149877A - Endoscope holding device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent the interference of an arm and a linking mechanism, etc., with an operator and the obstruction of the movement of a hand by installing a means for supporting an endoscope moving mechanism at the center part position of an operation table extended from a base part. SOLUTION: The installation part 161 of this endoscope holding device is provided with a moving mechanism supporting arm 168 extended from the base part 167 to the center part of the operation base and the endoscope moving mechanism 164 is supported at the center part position of the operation table by it. The respective arms 175-178 and counter weight 202, etc., of the linking mechanism part 173 of the endoscope moving mechanism 164 are arranged in a direction deviating from the direction for connecting an attachment position where the base part 167 of the endoscope holding device is attached to a side rail and the position of an endoscope insertion hole pierced on the abdominal wall part of a patient. Thus, at the time of operating a treatment implement such as forceps or the like, the danger that the respective arms 175-178 and counter weight 202, etc., of the linking mechanism 173 of the endoscope moving mechanism 164 interfere with the operator and obstruct the movement of the hand of the operator is eliminated and the operability of an endoscope 162 is improved.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope holding device which is mainly used in endoscopic surgery and mechanically holds an endoscope.

[0002]

2. Description of the Related Art Generally, a base portion of an endoscope holding device is arranged on one side of an operating table. The base is provided with, for example, a detachable fixing part that is detachably attached and fixed to a side rail disposed on one side of the operating table, and a mounting part that is installed on the floor surface in the operating room. ing.

Further, in the conventional endoscope holding apparatus, a multi-joint type arm in which a plurality of arms are flexibly connected through joints between the base portion and the holding portion for holding the endoscope. A mechanism and a movement operation mechanism of the endoscope, such as a parallel link mechanism in which four links are rotatably connected, are connected to each other.

Then, the bending angle of each arm of the articulated arm mechanism is changed, or each link element of the parallel link mechanism is moved in parallel to change the shape of the entire parallel link mechanism. When the field of view of the endoscope is changed during a surgical operation, the insertion angle and the insertion direction of the endoscope are changed.

[0005]

By the way, when the conventional endoscope holding device is used in endoscopic surgery, the endoscope is different depending on the location of the surgical site, for example, the abdomen or the chest. By changing the position where the base of the holding device is attached to the side rail, the operability of the moving operation mechanism is the best and the endoscope is used in a wide movable range.

However, in the above-mentioned conventional structure, the mounting position for mounting the base portion of the endoscope holding device on the side rail and the position of the insertion hole of the body wall for inserting the endoscope into the body of the patient. Since each arm of the movement operation mechanism, the link mechanism, and the like are extended in the direction connecting the two, a surgeon standing near the operating table reaches for the operation part and operates a treatment tool such as forceps. At this time, each arm of the movement operation mechanism, the link mechanism, or the like may interfere with the surgeon or may interfere with the movement of the surgeon's hand.

Further, since each arm of the moving operation mechanism, the link mechanism and the like are likely to interfere with the operator, the bending angle of each arm of the articulated arm mechanism can be changed sufficiently, or each link of the parallel link mechanism can be changed. There is a problem that it is difficult to move the elements in parallel to change the shape of the entire parallel link mechanism. Therefore, even if the mounting position for mounting the base of the endoscope holding device to the side rail is changed, the insertion angle and the insertion direction of the endoscope can be changed when changing the field of view of the endoscope during endoscopic surgery. There is a case where the movable range when changing is insufficient, and it is difficult to improve the operability of the endoscope.

The present invention has been made in view of the above circumstances, and an object thereof is that when operating a treatment tool such as forceps, each arm of a moving operation mechanism, a link mechanism, or the like interferes with an operator. An object of the present invention is to provide an endoscope holding device that can improve the operability of the endoscope without the possibility of disturbing the movement of the operator's hand.

[0009]

SUMMARY OF THE INVENTION The present invention is an endoscope moving mechanism including a plurality of arms and joints between an installation unit installed on a floor or an operating table and a holding unit for holding an endoscope. In the endoscope holding device provided with, in the installation section,
A base portion used for mounting on the floor or the operating table, and a movement extending from the base portion to the central portion of the operating table and supporting the endoscope moving mechanism at the central portion position of the operating table. And mechanism supporting means.

With the above structure, the endoscope moving mechanism is supported at the central position of the operating table by the moving mechanism supporting means of the installation section, so that the operator standing beside the operating table interferes with the endoscope moving mechanism. The endoscope that opens the endoscope to the patient is prevented by holding the endoscope holding portion at a position close to the insertion hole of the endoscope that is opened near the center of the operating table. The endoscope can be easily moved in various directions while being inserted into the insertion hole of, and an even range can be moved in any direction.

[0011]

BEST MODE FOR CARRYING OUT THE INVENTION A first embodiment of the present invention will be described below with reference to FIGS. 1 (A) to 9 (B). FIG.
(A), (B) shows the schematic structure of the whole endoscope holding | maintenance apparatus of this Embodiment. As shown in FIG. 1 (B), this endoscope holding device is provided with bases 3 attached to side rails 2 arranged on both sides of the operating table 1.

The base part 3 is provided with two mounting parts 4 fixed to the left and right side rails 2 and a horizontal rod (guide member) 5 connecting the left and right mounting parts 4, 4. There is. Here, both ends of the horizontal rod 5 are bent in a substantially L shape, and vertical moving rods 6 are formed respectively.

Further, the left and right mounting portions 4 are each shown in FIG.
As shown in, the lower end of the vertical rod 7 extending in the vertical direction is rotatably attached. FIG. 2A shows a mounting state of the mounting portion 4 on the side rail 2 and a mounting state of the vertical rod 7 mounted on the mounting portion 4, respectively. Here, a side rail insertion groove 8 into which the side rail 2 is inserted and a fixing member accommodation hole 9 formed in the lateral direction of the side rail insertion groove 8 are formed inside the mounting portion 4.

Further, as shown in FIG. 2B, a circular large-diameter mounting hole 10 is formed in the vertical rod 7. Further, on the upper side of the mounting hole 10, a plurality of circular pin holes 11 having a smaller diameter than the mounting hole 10 for angle adjustment are arranged in an arc shape along the mounting hole 10.

Further, on the outer surface of each of the left and right mounting portions 4, a cylindrical protruding portion 12 inserted into the mounting hole 10 of the vertical rod 7 and one angle adjusting pin 13 for adjusting the angle of the vertical rod 7. Are projected respectively. The angle adjusting pin 13 is selectively inserted into any one of the plurality of pin holes 11 of the vertical rod 7.

Further, the in-cylinder space of the protruding portion 12 of the mounting portion 4 is formed so as to penetrate to the fixing member accommodating hole 9. A female screw portion 14 is formed on the inner peripheral surface of the cylinder of the protruding portion 12 of the mounting portion 4.

A fixed handle 15 is arranged outside the vertical rod 7. A male screw portion 16 is provided so as to project from the axial center portion of the fixed handle 15. This male thread 1
6 is screwed into the female screw portion 14 of the mounting portion 4.

Further, the tip of the male screw portion 16 of the fixed handle 15 extends into the fixed member accommodation hole 9. Further, the disc spring member 17 and the pressure contact body 18 housed in the fixing member housing hole 9 are screwed and fixed to the tip end portion of the male screw portion 16 by a fixing screw 19.

By screwing the fixed handle 15 in the forward direction, the pressure contact body 18 is moved to the side rail 2.
Side rail insertion groove 8 in the mounting portion 4
The mounting portion 4 is fixed to the side rail 2 in a state where the side rail 2 is sandwiched between one groove wall portion and the pressure contact body 18. In this case, a disc spring member 17 is provided between the tip of the male screw portion 16 of the fixed handle 15 and the pressure contact body 18, and when the fixed handle 15 is screwed in, the rail width of the side rail 2 is different. The side rail 2 is sandwiched regardless of the position.

Further, when the fixed handle 15 is screwed in, the vertical rod 7 is pressed against the outer wall surface of the mounting portion 4 by the fixed handle 15 at the same time. Therefore, with the pin hole 11 at an appropriate position aligned with the angle adjusting pin 13 of the mounting portion 4, by screwing the fixed handle 15 in the forward direction, the vertical rod 7 is desired on the outer wall surface of the mounting portion 4. Fixed at the mounting angle of. The vertical rod 7
The mounting angle of is properly set according to the position of the pin hole 11 into which the angle adjusting pin 13 is inserted, and can be fixed to the angle adjusted stepwise.

Further, as shown in FIG. 3, the vertical rods 7 of the left and right mounting portions 4 are formed with rod insertion holes 20 into which the vertical moving rods 6 at both ends of the horizontal rod 5 are inserted. The entire horizontal rod 5 is supported so as to be vertically movable in a state in which the vertically movable rod 6 vertically moves in the rod insertion hole 20 of the vertical rod 7.

The vertical rod 7 has a rod insertion hole 20.
A height adjusting mechanism 21 is provided for fixing the height of the vertically moving rod 6 that moves up and down in a stepwise manner. The height adjusting mechanism 21 is provided with a fixing pin inserting hole 22 formed in the vertical rod 7 in a direction orthogonal to the rod inserting hole 20 and a height fixing pin 23 inserted into the fixing pin inserting hole 22. Has been. Here, the fixing pin insertion hole 22 is formed so as to penetrate between the outer surface of the vertical rod 7 and the rod insertion hole 20. A large-diameter hole portion 24 having a larger diameter than the height fixing pin 23 is formed on the side of the fixed pin insertion hole 22 that communicates with the rod insertion hole 20.

An operating knob 25 arranged outside the fixing pin insertion hole 22 is connected to one end of the height fixing pin 23. Further, a large-diameter engaging portion 26 that can be inserted into the large-diameter hole portion 24 is formed at the other end of the height fixing pin 23.

Further, the height fixing pin 2 is provided in the large diameter hole 24.
A coil spring 27 wound around 3 is provided. Then, the height fixing pin 23 is urged by the spring force of the coil spring 27 in a direction projecting to the rod insertion hole 20 side.

A plurality of ring-shaped, two in the present embodiment, two engaging grooves 28 are formed at the lower end of the vertically moving rod 6. When the height of the vertically moving rod 6 is adjusted, the height fixing pin 23 is provided in either one of the two engaging grooves 28.
The vertical movement rod 6 is fixed at a predetermined height by inserting and engaging the engaging portion 26 of. Therefore, the height of the vertical movement rod 6 can be adjusted stepwise according to the position of the engagement groove 28 with which the engagement portion 26 of the height fixing pin 23 is engaged.

The vertical movement rod 6 has a rod insertion hole 2
A stopper 29 having a diameter larger than 0 is attached. The stopper 29 comes into contact with the peripheral portion of the upper end opening of the rod insertion hole 20 to regulate the lower limit position of the vertical movement rod 6.

A moving operation mechanism mounting portion 30 is provided at a substantially central portion of the horizontal rod 5, that is, a portion corresponding to a position near the central portion of the operating table 1. As shown in FIG. 1A, a multi-joint arm type movement operation mechanism 32 for movably supporting an endoscope 31 is attached to the movement operation mechanism attachment portion 30.
Is mounted at the base end.

The moving operation mechanism 32 includes a rotating arm 33.
The first to third swivel arms 34, 35, 36 and the connecting arm 37 are provided. Here, the rotating arm 33 is extended in a substantially vertical direction. The lower end of the rotary arm 33 is rotatably connected to the movement operation mechanism mounting portion 30. Further, at the upper end of the rotating arm 33, the base end of the first turning arm 34 is attached to the first joint part 3.
It is connected via 8 so as to be bendable. Further, the base end portion of the second swivel arm 35 is flexibly connected to the tip end portion of the first swivel arm 34 via a second joint portion 39, and similarly, the tip end portion of the second swivel arm 39 is connected. A proximal end portion of the third swivel arm 36 is flexibly connected via a third joint 40. As a result, the first to third swivel arms 34, 35, 36 are connected to the first to third joint parts 38, 3 respectively.
It is possible to turn around 9 and 40 respectively.

The rotating arm 33 and the first to third swiveling arms 34, 35 and 36 are formed by hollow skeleton members. The first joint 38 between the rotary arm 33 and the first swivel arm 34 incorporates a balance mechanism 41 having the configuration shown in FIG.

As shown in FIG. 4, the balance mechanism 41 includes a first spiral spring 42a, which is a spiral spiral leaf spring, housed in a rotary arm 33, and a first swivel arm 3.
And a second spiral spring 42b housed inside. Here, the center portion of the first spiral spring 42a is provided with a support pin 43 that is installed between both side surfaces of the rotary arm 33.
It is fixed to a. Similarly, the second spiral spring 42
The central portion of b is fixed to a support pin 43b that is provided between both side surfaces of the first turning arm 34.

Further, the connecting shaft 4 between the rotary arm 33 and the first turning arm 34 is provided around the first joint 38.
Two fixing pins 45a and 45b are fixed in the vicinity of 4. Further, in the first turning arm 34, the wire stopper 46a of the first spiral spring 42a and the rotating arm 3 are provided.
3b has a wire stopper 4 for the second spiral spring 42b.
6b are fixed.

Further, one end of a connecting wire 47a is attached to the outer end of the first spiral spring 42a. The other end of the connecting wire 47a is hooked on the fixing pin 45a, bent, and then fixed to the wire stopper 46a. Similarly, one end of the connecting wire 47b is attached to the outer end of the second spiral spring 42b. The other end of the connecting wire 47b is hooked on the fixing pin 45b, bent, and then fixed to the wire stopper 46b.

Further, a second joint 39 between the first swivel arm 34 and the second swivel arm 35, and a third joint portion 39 between the second swivel arm 35 and the third swivel arms 36 are provided. The joint portion 40 also has a built-in balance mechanism 41 having the same structure as the balance mechanism 41 of the first joint portion 38.

In this embodiment, the moving operation mechanism 3
The joint parts 3 of the first to third joints are held by the weights of all the connecting parts of the endoscope 31 and the movement operation mechanism 32 held by
First to third for the turning motion acting on 8, 39, 40
It is possible to fix the endoscope 31 in a balanced and stationary state by giving a reaction force by each of the spiral springs 42a and 42b of the balance mechanism 41 built in each of the joint portions 38, 39 and 40.

Further, FIG. 5 shows the internal structure of the shaft supporting portion of the moving operation mechanism mounting portion 30 for rotatably supporting the rotating arm 33. Here, the movement operation mechanism mounting portion 30 is provided with an insertion hole 48 penetrating in the vertical direction. A rotary shaft 49 protruding from the lower end of the rotary arm 33 is rotatably inserted into the insertion hole 48.

Further, the moving operation mechanism mounting section 30 is provided with a rotational force amount adjusting mechanism section 50 for adjusting the weight of the rotation of the rotating arm 33, that is, the amount of force required to rotate the rotating arm 33. Here, the movement operation mechanism mounting portion 30 is provided with a screw hole 51 penetrating to the insertion hole 48 in a direction perpendicular to the insertion hole 48. A large-diameter hole portion 52 is formed in the connecting portion of the screw hole 51 with the insertion hole 48.

Further, the adjusting screw 53 of the torque adjusting mechanism 50 is screwed into the screw hole 51 of the moving operation mechanism attaching portion 30. A rotational force amount adjusting dial 54 is attached to the outer end portion of the adjusting screw 53. The rotational force amount adjusting dial 54 is arranged outside the moving operation mechanism mounting portion 30.

Further, a small-diameter support shaft portion 55 is projectingly provided on the tip end portion of the adjusting screw 53. A disc spring 56 and a pressure contact member 57 are mounted on the support shaft 55 so as to be movable in the axial direction along the support shaft 55. Further, a fixing screw 58 is attached to the tip end surface of the support shaft portion 55 to prevent the press-contact body 57 from falling off from the support shaft portion 55. Here, the pressure contact body 57 is biased by the spring force of the disc spring 56 in the direction in which it is pressed toward the insertion hole 48.

In order to adjust the weight of the rotating arm 33, the rotational force amount adjusting dial 54 is rotated. At this time, the adjusting screw 53 is screwed along the screw hole 51 in accordance with the rotating operation of the rotating force adjusting dial 54, and the pressure contact body 57 at the tip of the adjusting screw 53 is pressed against the rotating shaft 49 of the rotating arm 33. Therefore, by adjusting the screwing amount of the adjusting screw 53 by rotating the rotating force amount adjusting dial 54, the frictional force between the pressure contact member 57 and the rotating shaft 49 is adjusted to adjust the rotating force amount of the rotating shaft 49. be able to.

The base end of the connecting arm 37 is detachably attached to the tip of the third swivel arm 36. Here, as shown in FIG. 7, a male screw portion 59 is formed at the tip portion of the third turning arm 36. A linear guide groove 60 for positioning is provided on the tip surface of the male screw portion 59.
Are formed.

Further, an arm rotation block 61 is attached to the base end of the connecting arm 37. On the outer surface of the arm rotation block 61, a cable stopper 62 for tying and holding the cables of the endoscope 31 is provided. The cable stop 62 is formed by a flexible spiral wire having at least two turns.
Therefore, the cables do not come off after the cables are entangled with the cable stopper 62.

Further, as shown in FIG. 6, a rotation shaft 63 which is a rotation center of the connection arm 37 is rotatably connected to the arm rotation block 61. The rotating shaft 63 is arranged parallel to the connecting arm 61.

A third shaft is provided at one end of the rotary shaft 63.
A cylindrical rotating screw 64 for connection with the revolving arm 36 is attached rotatably and axially. A female screw portion 65 that is screwed to the male screw portion 59 of the third swivel arm 36 is formed on the inner peripheral surface of the rotary screw 64 in the cylinder.

Further, one end of the rotary shaft 63 is extended in the cylinder of the rotary screw 64. An engaging protrusion 66 that engages with the guide groove 60 of the male screw portion 59 is formed on the extending portion of the rotating shaft 63. When the connecting arm 37 is connected to the third swivel arm 36, the engaging protrusion 66 on the connecting arm 61 side is engaged and positioned in the guide groove 60 of the male screw portion 59 of the third swivel arm 36. In this state, the rotary screw 64 is rotationally operated, and the female screw portion 65 of the rotary screw 64 is screwed into the male screw portion 59 of the third swivel arm 36.

Here, the rotary screw 64 is made of a slidable plastic material such as polyetheretherketone. Therefore, the rotary screw 64 is attached to the third swing arm 36.
The rotary screw 64 can be smoothly and gently screwed in when screwed into the male screw portion 59. Furthermore, the male screw part 59
The engaging portion between the guide groove 60 and the engaging protrusion 66 on the side of the connecting arm 61 prevents the connecting arm 37 from moving when the rotating screw 64 is screwed into the male screw portion 59 of the third turning arm 36.

A small-diameter support shaft 67 is provided at the other end of the rotary shaft 63, and a male screw 68 is formed at the tip of the support shaft 67. An O-ring 69 serving as a bias means is disposed on the support shaft portion 67 in a state of being sandwiched between a pair of bearings 70, and a ring-shaped collar 71 is disposed.

A turning force adjusting dial 72 is screwed onto the male screw portion 68. This torque adjustment dial 72
A screw hole 73 into which the male screw portion 68 is screwed is formed in the axial center portion of the. Further, a pressure contact portion 74, which is in pressure contact with the collar 71, is provided at the inner end portion of the rotational force adjusting dial 72 so as to project.

Then, the adjusting dial 72 is screwed into the rotary shaft 63 and pressed against the O-ring 69, so that the frictional force between the arm rotary block 61 and the rotary shaft 63 is adjusted. As a result, it is possible to adjust the amount of torque required to rotate the connecting arm 37 with respect to the central axis of the third swivel arm 36 in accordance with the rotation operation of the torque adjustment dial 72.

Further, an endoscope holding portion 75 is provided at the tip of the connecting arm 37. As shown in FIG. 8, the endoscope holding portion 75 is provided with an adapter receiving member 76 fixed to the distal end portion of the connecting arm 37 and an adapter 77 holding the endoscope 31. The adapter 77 is detachably connected to the adapter receiving member 76.

Here, the adapter 77 is provided with a substantially L-shaped adapter body 78 as shown in FIG. 9B. A ring plate 79, which is one L-shaped component of the adapter main body 78, is provided with an endoscope mounting portion 80 to which the endoscope 31 is detachably mounted. Further, protrusions 82 are provided on both sides of the fixed hook 81, which is the other L-shaped component of the adapter body 78. further,
A guide hole 83 is formed substantially in the center of the fixed hook 81 of the adapter body 78.

Further, the fixed hook 81 of the adapter body 78
A concave guide groove 84 is formed below the guide hole 83 on the outer surface of the
Are formed. At the inner bottom of the guide groove 84, a substantially arcuate guide surface 85 is formed whose depth gradually decreases from the lower surface of the adapter body 78 toward the guide hole 83.

Further, the adapter receiving member 76 is provided with a receiving member main body 86. An adapter guide 87 is rotatably supported on one side surface of the receiving member body 86. An insertion groove 88 into which the fixed hook 81 of the adapter 77 is inserted is formed in the adapter guide 87 according to the outer shape of the fixed hook 81 of the adapter 77.

In this case, a notch 89 communicating with the insertion groove 88 is formed at the center of the outer surface of the adapter guide 87. Guide portions 90 for guiding the protrusions 82 on both sides of the fixed hook 81 of the adapter 77 are formed on both sides of the cutout 89.

Further, a release knob 91 shown in FIG. 9A is arranged at the central portion of the receiving member main body 86. An engagement portion 92 is formed at the tip of the release knob 91 so as to be disengageably engaged with the guide hole 83 of the adapter 77.
The release knob 91 is supported by the receiving member main body 86 so as to be capable of projecting and retracting toward the insertion groove 88 side of the adapter guide 87. Further, the receiving member body 86 has a release knob 91.
A spring member 93 for urging the engaging portion 92 in a direction projecting toward the insertion groove 88 side of the adapter guide 87 is attached.

When mounting the adapter 77 on the adapter receiving member 76, the fixing hook 81 of the adapter 77 is inserted into the insertion groove 88 of the adapter receiving member 76. At this time, the engagement portion 92 of the release knob 91 is held in a state of being projected toward the insertion groove 88 side of the adapter guide 87 by the spring force of the spring member 93. And
When the fixed hook 81 of the adapter 77 is inserted into the insertion groove 88 of the adapter receiving member 76, the engaging portion 92 of the release knob 91 is inserted into the guide groove 84 of the adapter body 78.

In this state, the engaging portion 92 of the release knob 91 slides along the guide surface 85 of the guide groove 84 as the fixed hook 81 is pushed along the insertion groove 88, and at the same time, the release knob 91 moves. The engaging portion 92 is gradually pushed outward in the insertion groove 88 of the adapter guide 87. Then, when the fixed hook 81 reaches the end position of the insertion groove 88 and the adapter 77 is mounted on the adapter receiving member 76, the engaging portion 92 of the release knob 91 gets over the groove end portion of the guide groove 84, and the spring member 93. The urging force of the release knob 9
The engaging portion 92 at the tip of No. 1 projects and engages with the guide hole 83. By thus engaging the engaging portion 92 of the release knob 91 with the guide hole 83 of the adapter main body 78, the fixing hook 81 of the adapter 77 is prevented from being pulled out from the insertion groove 88 of the adapter receiving member 76. It has become so. Therefore, the adapter receiving member 76 can be easily inserted by one insertion operation of inserting the fixed hook 81 into the insertion groove 88.
The adapter 77 can be attached to the.

Further, the release knob 91 is pulled to the left in FIG. 9 (A) to pull out the engaging portion 92 of the release knob 91 from the guide hole 83 of the adapter body 78, whereby the release knob 91 is engaged. The engagement between the mating portion 92 and the guide hole 83 of the adapter body 78 is released, and the adapter receiving member 76 is released.
The fixing hook 81 of the adapter 77 can be pulled out from the insertion groove 88 of.

Next, the operation of the above configuration will be described.
When using the endoscope holding apparatus of the present embodiment, first, the left and right mounting portions 4 and 4 of the base portion 3 are attached to the side rails 2 on both sides of the operating table 1, respectively. At this time, the mounting angle of the vertical rod 7 with respect to the left and right mounting portions 4 and 4 is appropriately set depending on the position of the pin hole 11 into which the angle adjusting pin 13 is inserted. Then, the left and right mounting portions 4 and 4 are fixed to the side rails 2 at predetermined mounting positions by the screwing operation of the fixed handle 15, and at the same time, the vertical rod 7 is fixed to the left and right mounting portions 4 and 4 at a predetermined mounting angle. To be done.

Then, the vertical moving rods 6 at both ends of the horizontal rod 5 are inserted into the rod insertion holes 20 of the vertical rod 7, respectively, and the vertical moving rod 6 is moved to a predetermined height by operating the operating knob 25 of the height adjusting mechanism 21. It is fixed in the adjusted position. At this time, the moving operation mechanism attaching portion 30 of the base portion 3 is arranged at a position near the center of the operating table 1 as shown in FIG.

Thereafter, the base end portion of the multi-joint arm type movement operation mechanism 32 is attached to the movement operation mechanism attachment portion 30. When the moving operation mechanism 32 is attached, the moving operation mechanism 3
The rotary shaft 49 of the second rotary arm 33 is inserted into the insertion hole 48 of the movement operation mechanism mounting portion 30. At this time, the connecting arm 37 of the movement operation mechanism 32 is held in a state of being removed from the third turning arm 36.

Next, as shown in FIGS. 1A and 1B, the sterilized cover 9 is attached to the entire base 3 and the moving operation mechanism 32.
Put 4 on. Then, with the sterilized cover 94 covering the entire base 3 and the movement operating mechanism 32, the connecting arm 37 is connected to the third swivel arm 36 of the movement operating mechanism 32.
Are linked. Subsequently, the adapter 77 to which the endoscope 31 is previously attached is attached to the adapter receiving member 76 of the connecting arm 37.
Linked to

After the connection of the adapter 77 is completed,
The endoscope 31 is used after the rotational force amount and the turning force amount of each part of the movement operation mechanism 32 are adjusted so that the endoscope 31 can be moved with an appropriate force. Thus, the first to third joints 38, 39, 40 of the movement operation mechanism 32, the balance mechanism of the rotating portion, and the weighting are used to move the endoscope 31 to a desired state, and then the hand is released. The endoscope 31 is stopped at the position.

Therefore, the above configuration has the following effects. That is, since the movement operation mechanism attachment portion 30 is arranged at the substantially central portion of the horizontal rod 5 of the base portion 3 of the endoscope holding device, the base end of the movement operation mechanism 32 attached to the movement operation mechanism attachment portion 30. The part can be arranged at a portion corresponding to a position near the center of the operating table 1. Therefore, for example, when operating a treatment tool such as forceps while observing the inside of a patient with the endoscope 31, interference between the operator 95 standing beside the operating table 1 and the movement operation mechanism 32 of the endoscope 31 is prevented. Can be prevented. Further, the movement operation mechanism 32 does not interfere with the movement of the operator's hand, and the operability of the endoscope 31 can be improved.

Further, the endoscope 3 is provided at a position near the center of the operating table 1.
Since the moving operation mechanism 32 of No. 1 can be arranged, the endoscope 31 opened to the patient placed near the center of the operating table 1
The endoscope 31 can be held at a position close to the insertion hole. Therefore, with the endoscope 31 inserted in the insertion hole of the endoscope 31 opened in the patient, the endoscope 31 can be easily moved in various directions, and the endoscope 31 can be moved in an equal range in any direction. It can be held in a movable state.

The horizontal rod 3 is provided in the left-right direction of the operating table 1.
May be configured to be movable in parallel. Furthermore, the endoscope holding device according to the present embodiment is not limited to the endoscope 31, and may be a treatment tool such as forceps or another surgical instrument.

Further, FIGS. 10A to 10E show a second embodiment of the present invention. This is a modification of the configuration of the movement operation mechanism mounting portion 30 in the base portion 3 of the endoscope holding device according to the first embodiment.

That is, in the present embodiment, FIG.
As shown in (A) and (B), the horizontal rod 5 of the base 3 is provided with a slide block 101 that is movable in the axial direction, and this slide block 101 has the same moving operation as that of the first embodiment. The configuration is such that the base end of the mechanism 32 is attached.

Here, the slide rod 102 is fixed to the upper surface of the slide block 101. The slide rod 102 has an insertion hole 48 (see FIG. 5) similar to that of the movement operation mechanism attachment portion 30 of the first embodiment. Then, the moving operation mechanism 32 is inserted in the insertion hole 48.
The rotary shaft 49 at the lower end of the rotary arm 33 is rotatably inserted. Further, this slide rod 102 has a rotational force amount adjusting mechanism 50 having the same configuration as that of the first embodiment.
Is provided. Then, this rotational force amount adjusting mechanism section 5
By rotationally operating the rotational force amount adjusting dial 54 of 0, the rotational operation force amount of the rotating shaft 49 can be adjusted.

Further, FIGS. 10C and 10D show a schematic structure of the slide block 101. An upper jaw 103 is laterally projected from the upper end of the slide block 101. A fixed handle mounting hole 104 is formed in the upper jaw 103.

Further, a lower jaw member 105 is arranged below the upper jaw portion 103 so as to be opposed to each other. The lower jaw member 105 is supported movably in the vertical direction along a concave guide groove 106 formed in the slide block 101.

Further, the lower jaw member 105 is formed with a screw hole portion 107 extending vertically. A male screw portion 109 protruding from the shaft center portion of the fixed handle 108 is screwed into the screw hole portion 107.

The upper end of the male screw portion 109 is the upper jaw portion 1.
No. 03 of the fixed handle is extended to the upper side through the fixed handle mounting hole 104. Further, the flange portion 1 having a diameter larger than that of the fixed handle mounting hole 104 is provided on the upper end portion of the male screw portion 109.
10 are formed. As a result, the fixed handle 10
Reference numeral 8 is rotatably supported in a fixed handle mounting hole 104 of the upper jaw 103.

As the fixed handle 108 rotates, the lower jaw member 105 is vertically moved. Note that the male screw portion 109 of the fixed handle 108 has a thread groove oppositely cut. Therefore, when the fixed handle 108 is turned to the right, the lower jaw member 105 advances toward the upper jaw 103. The horizontal rod 5 is sandwiched and fixed between the upper jaw portion 103 and the lower jaw member 105. The other parts have the same configuration as in the first embodiment, and the same parts as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted.

Therefore, in the above structure, the slide block 101 is moved along the horizontal rod 5 of the base 3 so that the mounting position of the base end portion of the movement operation mechanism 32 is adjusted to the axis of the horizontal rod 5. It can be adjusted along the direction. Therefore, the mounting position of the base end portion of the moving operation mechanism 32 can be adjusted more finely than in the first embodiment.

11A to 11D show the third embodiment of the present invention. In this, the endoscope holding device is provided with a one-sided supporting type base portion 121 attached to the side rail 2 arranged on one side of the operating table 1.

As shown in FIG. 11B, a side rail insertion groove 122 into which the side rail 2 is inserted is formed in the base 121, and the base 121 is fixed to the side rail 2. Two fixed handles 123 are attached.

Further, a vertical movement rod support member 124 is attached between the two fixed handles 123 of the base 121. A vertical movement rod 125 is supported on the vertical movement rod support member 124 so that the height thereof can be adjusted in the vertical direction.

Further, one end of the first turning arm 126 of the movement operating mechanism 141 is rotatably connected to the upper end of the vertically moving rod 125 via the first joint 127. The first swivel arm 126 is set to have a length such that the tip of the first swivel arm 126 reaches the center of the operating table 1 when it is straightened.

At the other end of the first turning arm 126, one end of the second turning arm 128 is connected to the second joint 129.
Is rotatably connected via a. Further, the base end side of the connecting arm 37 of the first embodiment is detachably attached to the other end of the second turning arm 128.

A turning force amount adjusting dial 130 having the same structure as the rotating force adjusting dial 72 shown in FIG. 6 is attached to the first joint 127. The amount of force required for turning the first turning arm 126 can be adjusted by the turning force amount adjusting dial 130. Further, the amount of operating force of the second swivel arm 128 is set to an appropriate value by the balance mechanism having the same configuration as the balance mechanism 41 of FIG.

FIG. 11D shows a height adjusting mechanism 131 for the vertical movement rod 125 built in the vertical movement rod support member 124. Here, the vertical movement rod 12
A spring support member 132 disposed in the vertical movement rod support member 124 is provided at the lower end portion of 5. The spring support member 132 has a fixing pin 135 fixed to the center of two spiral springs 133 and 134 arranged vertically.
136 is attached.

Further, the outer end portion of the upper spiral spring 133 is connected to the vertical moving rod support member 12 via the connecting wire 137.
Wire stopper 1 attached to one side of the upper opening of 4
It is fixed at 38. Furthermore, the lower spiral spring 1
The outer end of 34 is fixed to a wire stopper 140 attached to the other side of the upper end opening of the vertically movable rod support member 124 via a connecting wire 139. As a result, the upper and lower spiral springs 133, 134 that generate a constant force for the vertical movement rod 125 irrespective of the number of rotations balance the portion of the movement operation mechanism 141 beyond the first swivel arm 126. It is possible to stand still. That is, the height of the movement operation mechanism 141 can be arbitrarily adjusted with respect to the base 121.

Therefore, in the above-mentioned structure, the moving operation mechanism 141 of the endoscope 31 is provided with the one-sided supporting base 121.
The height can be adjusted so that the movement operation mechanism 141 has an appropriate height with respect to the surgical site.

12A and 12B show the fourth embodiment of the present invention. This is because the third swivel arm 128 of the third embodiment has a third joint 151.
The third swivel arm 152 is rotatably connected via
The base end side of the connecting arm 37 of the first embodiment is detachably attached to the third turning arm 152. Also in this case, the same effect as that of the third embodiment can be obtained.

Further, FIGS. 13 to 19 show a fifth embodiment of the present invention. FIG. 13 shows a schematic configuration of the entire endoscope holding device of the present embodiment. In this endoscope holding device, a mounting portion 161 installed on an operating table and a holding portion for holding an endoscope 162 are provided. 163, and an endoscope moving mechanism 164 disposed between the installation portion 161 and the holding portion 163.
Are provided.

Furthermore, as shown in FIG. 18, the side rail 1 disposed on one side of the operating table 165 is installed in the installation portion 161.
A cantilevered base unit 167 attached to 66, and an endoscope moving mechanism 164 that extends from the base unit 167 to the central portion of the operating table 165 and is located at the central portion of the operating table 165.
A moving mechanism supporting arm (moving mechanism supporting means) 1 for supporting
68 are provided.

Here, an insertion groove 169 into which the side rail 166 is inserted is formed on the lower surface of the base portion 167. Then, with the side rail 166 inserted in the insertion groove 169 of the base 167, the base 167 is slidably mounted along the side rail 166 on one side of the operating table 165.

Further, a pair of left and right fixed handles 170 are arranged on the outer surface of the base part 167. A fixing screw to be screwed into a screw hole (not shown) formed in the outer wall surface of the insertion groove 169 in the base portion 167 is fixed to the axial center portion of the fixed handle 170. Then, each fixed handle 170 is supported on the outer surface of the base portion 167 in a state where the tip end of the fixed screw of each fixed handle 170 can contact the side rail 166.

A projecting portion 171 projecting upward is formed in the central portion of the base portion 167. The outer end of the moving mechanism supporting arm 168 is fixed to the upper end of the protruding portion 171.

Further, an endoscope moving mechanism 164 is detachably attached to the inner end of the moving mechanism supporting arm 168. In this case, as shown in FIG. 15, the inner end of the moving mechanism supporting arm 168 has a through hole 168 penetrating in the vertical direction.
a is drilled. The endoscope moving mechanism 164 is provided with a vertical rod 172 inserted into the through hole 168a of the moving mechanism supporting arm 168.

Further, at the upper end of the vertical rod 172, the support member 1 of the link mechanism portion 173 composed of a parallelogram link is provided.
74 are connected. Here, in the link mechanism portion 173, an upper rod 175 and a lower rod 176, which are a pair of parallel horizontal arms extending in a substantially horizontal direction, and a pair of parallel turning arms 177, 178 extending in a vertical direction. And a first joint 179 that rotatably connects the upper rod 175 and the upper end of the one swivel arm 177, and the upper rod 1
75 and the second joint 180 that rotatably connects the upper end of the other swing arm 178, and the swing arm 177.
A third joint 181 that rotatably connects the lower end of the lower rod 176 with one end of the lower rod 176, and the lower end of the swivel arm 178 and the other end of the lower rod 176 rotatably. A bearing member 182, which is a fourth joint portion to be connected, is provided.

The end of the upper rod 175 opposite to the end on the first joint 179 side has the second joint 180.
The holding portion 163 of the endoscope 162 is connected to the extending portion.

The endoscope holding portion 163 is provided with a holding adapter 184 and a connecting arm 185. Here, at the base end of the connecting arm 185, as shown in FIG.
An arm rotation block 186 is provided as shown in FIG. This arm rotation block 186 has a connecting arm 18
A rotary shaft 187, which serves as a rotary shaft of No. 5, is rotatably connected. The rotating shaft 187 is connected to the connecting arm 18.
5 are arranged in parallel.

Further, a cylindrical rotating screw member 18 for connection with the upper rod 175 is provided on the tip end side of the rotating shaft 187.
8 is attached so as to be movable back and forth in the axial direction. Further, a small diameter portion 189 and a screw portion 190 are formed on the base end portion of the rotating shaft 187. Further, an O-ring 191 as a bias means is disposed in the small diameter portion 189 in a state of being sandwiched between a pair of bearings 192, and
A collar 193 is provided.

Further, a rotary operation force adjusting dial 194 is disposed at the base end of the rotary shaft 187. The screw portion 190 of the rotary shaft 187 is screwed into the screw hole 194a formed in the axial center portion of the dial 194. Therefore, the pair of bearings 192, the O-ring 191, and the collar 193 are supported in a state of being sandwiched between the adjusting dial 194 and the connecting portion of the rotating shaft 187 with the arm rotating block 186.

Then, the adjustment dial 194 is screwed into the rotary shaft 187, and the O-ring 191 is pressure-welded,
A frictional force between the arm rotation block 186 and the rotation shaft 187 is adjusted to adjust the amount of rotation operation force.

FIG. 17 shows the construction of the attachment / detachment portion between the connecting arm 185 and the upper rod 175 of the link mechanism portion 173. Here, the connecting arm 185 of the upper rod 175
A male screw portion 195 is provided on the attaching / detaching portion. Further, a linear guide groove 19 is formed on the tip surface of the male screw portion 195.
6 are formed.

The upper rod 1 is attached to the rotary screw member 188.
A screw hole that is screwed with the male screw portion 195 of 75 is formed. Furthermore, a protrusion 197 having a shape corresponding to the guide groove 196 of the male screw 195 is provided at the tip of the rotary shaft 187.
Has been fixed. The protrusion 197 is connected to the connecting arm 18
It is arranged inside the rotary screw member 188 on the fifth side. Then, the protrusion 197 of the rotary screw member 188 is engaged with the guide groove 196 of the male screw portion 195.

Here, the rotary screw member 188 is made of a slidable plastic material such as polyether or ether ketone. Therefore, when the rotary screw member 188 is screwed into the male screw portion 195 of the rod 175, the rotary screw member 188 is smoothly and quietly screwed into the male screw portion 195 of the rod 175.
Can be screwed into.

Further, the engagement between the guide groove 196 of the male screw portion 195 and the protrusion 197 of the rotary shaft 187 prevents the connecting arm 185 from moving when the rotary screw member 188 is screwed into the male screw portion 195 of the upper rod 175. There is.

The arm rotation block 186 has a TV.
A cable stop 198 is provided for entwining and fastening the camera cable and the light guide cable.
The cable stop 198 is formed by at least two turns of a flexible spiral wire. Therefore, the cables will not come off after the cables are entangled with the cable stopper 198.

The holding adapter 184 has the same structure as the endoscope holding portion 75 of the first embodiment (see FIGS. 8 and 9A and 9B). That is, the holding adapter 184 of this embodiment is provided with the adapter attaching / detaching portion 199 and the holding adapter 200 corresponding to the adapter receiving member 76 and the adapter 77 of the first embodiment. Here, the adapter attaching / detaching part 199 is connected to the connecting arm 185.
It is fixed to the tip of the. The holding adapter 200 of the endoscope 162 is detachably connected to the adapter attaching / detaching portion 199. Further, the adapter attaching / detaching portion 199 is provided with a release knob 20 for releasing the engagement of the holding adapter 200.
1 is provided.

Further, the link mechanism portion 173 composed of a parallelogram link has a holding portion 163 to which an endoscope 162 is attached.
Two counter weights 202 and 203 are arranged in a balanced state with respect to each other. Here, the first counterweight 202 is the shaft 20 of the lower rod 176.
It is mounted so as to be movable along 4. Furthermore, the second
The counter weight 203 is attached to the support member 174 coaxially with the swivel arm 178 and movably along a guide arm 205 arranged on the opposite side of the swivel arm 178.

FIG. 14 shows the structure of the connecting portion between the upper end portion of the vertical rod 172 and the supporting member 174 of the link mechanism portion 173. Here, small-diameter shaft portions 206 and 207 having a diameter reduced by one step are formed at both ends of the support member 174.

Further, a through hole 208 coaxial with the rotation axis O ₂ of the revolving arm 178 is formed at the axial center of the support member 174. A slide shaft 209 is fitted in the through hole 208. This slide shaft 20
A flange 210 is formed at one end portion of 9, and a male screw portion 211 is formed at the other end portion.

Also, one small diameter shaft portion 2 of the support member 174.
An elongated hole 212 that is long in the axial direction of the support member 174 is formed in 06. Furthermore, a key groove 213 is formed on the slide shaft 209 at a position corresponding to the small diameter shaft portion 206. A key 214 is engaged with the key groove 213 through the long hole 212 of the small diameter shaft portion 206. And
The slide shaft 209 is slidably supported by the support member 174 without rotating on the rotation axis O ₂ .

Further, one small-diameter shaft portion 2 of the supporting member 174.
A bearing member 182 of a revolving arm 178 is rotatably connected to 06. Further, one end of a lower rod 176 is rotatably connected to the other small diameter shaft portion 207 of the support member 174.

Further, the bearing member 182 of the swing arm 178.
The rotation force amount adjusting dial 2 for adjusting the weight of the rotation of the rotating arm 178 with respect to the support member 174 is provided outside the
15 are provided.

A screw hole 216 is formed at the axial center of the adjusting dial 215. The male screw portion 211 of the slide shaft 209 is screwed into the screw hole 216 of the adjustment dial 215.

Further, the shaft portion 217 of the adjustment dial 215 is provided.
An opening 218 into which each component for adjusting the amount of torque is incorporated is formed at the tip of the. The components for adjusting the amount of rotational force include a disc spring 219 which is a bias means of the adjustment dial 215, a bearing 220, a collar 221 which is pressed against the outer peripheral surface of the bearing member 182, and a bearing 220.
And a stopper 222. Each component for adjusting the amount of rotational force is incorporated in the tip end opening 218 of the shaft portion 217 of the adjustment dial 215.

Further, the height adjusting mechanism 21 of the first embodiment for fixing the height of the vertical rod 172 which moves up and down in the through hole 168a at the inner end of the moving mechanism supporting arm 168 stepwise (see FIG. 3)) and a height adjusting mechanism 223 having the same configuration.
And a rotational force amount adjustment mechanism section 224 for adjusting the rotational operation force amount of the vertical rod 172. Note that FIG.
Among them, 225 is an operation knob of the height adjusting mechanism 223, 226.
Is a rotary power amount adjusting dial of the rotary power amount adjusting mechanism section 224.

Further, FIG. 15 shows a rotational force amount adjusting mechanism section 224.
FIG. Here, a mounting hole 227 of the rotational force amount adjusting mechanism portion 224 is formed in the moving mechanism supporting arm 168 in a direction perpendicular to the through hole 135. A screw hole 228 is formed on the outer end side of the mounting hole 227. Further, a large diameter hole 229 having a diameter larger than that of the screw hole 228 is formed on the inner end side of the mounting hole 227.

Further, a male screw portion 231 is formed on the shaft portion 230 of the rotational force amount adjusting dial 226. The male screw portion 231 is screwed into the screw hole portion 228 of the mounting hole 227.

Further, a small diameter portion 232 is formed at the tip of the male screw portion 231 of the rotational force adjustment dial 226. The small diameter portion 232 is inserted into the center opening of the ring-shaped disc spring 233 and the center opening of the press contact body 234.

A fixing screw 235 is fixed to the tip surface of the small diameter portion 232. The disc spring 233 and the pressure contact body 234 are rotatably supported between the fixing screw 235 and the male screw portion 231 of the rotational force adjustment dial 226.

Then, the male screw portion 231 of the rotational force adjusting dial 226 is connected to the screw hole 22 of the moving mechanism supporting arm 168.
8 and screwing it into the pressure-contacting body 23 at the tip of the male screw portion 231.
Press 4 onto the bottom of the vertical rod 172. At this time,
By adjusting the screwing amount of the male screw portion 231 in accordance with the rotation operation of the rotational force adjustment dial 226, the frictional force between the pressure contact body 234 and the vertical rod 172 is adjusted to adjust the rotational operation force amount of the vertical rod 172. You can

Next, the operation of the above configuration will be described.
When the endoscope holding device according to the present embodiment is used, the operating table 1
The endoscope holding device of the present embodiment is set in 65 as follows. First, the base portion 167 is moved along the side rail 166 on one side of the operating table 165, and the fixed handle 170 is rotated while the base portion 167 is aligned at the optimum position as shown in FIG. Therefore, the base part 16
7 is fixed to the side rail 166.

In this state, subsequently, the endoscope moving mechanism 164 is set on the moving mechanism supporting arm 168 of the base portion 167, and the endoscope holding portion 163 is connected to the endoscope moving mechanism 164. The endoscope 162 is attached to the endoscope holding portion 163.

Note that FIG. 18 shows an example of a usage state of the endoscope holding device of the present embodiment. In FIG.
H indicates a patient on the operating table 165. FIG. 19 shows an initial state of the endoscope holding device when the endoscope holding device according to the present embodiment is set on the operating table 165.

Here, the initial state of the endoscope holding device is shown in FIG.
9 is defined as a state in which the endoscope 162 is vertically inserted into the endoscope insertion hole H ₁ formed in the abdominal wall portion of the patient H as indicated by a solid line.

When the treatment with the endoscope 162 is started, the endoscope 162 is moved in any direction with the portion of the endoscope insertion hole H ₁ of the patient H as a fulcrum. At this time, the entire endoscope moving mechanism 164 rotates about the vertical rod 172 following the movement operation of the direction of the endoscope 162, and the link mechanism portion 173 of the endoscope moving mechanism 164 is optional. It transforms into a parallelogram.

Therefore, the following effects can be obtained with the above structure. That is, the installation unit 161 of the endoscope holding device
Is provided with a moving mechanism supporting arm 168 extending from the base portion 167 to the central portion of the operating table 165, and the moving mechanism supporting arm 168 supports the endoscope moving mechanism 164 at the central portion position of the operating table 165. Therefore, the position where the base portion 167 of the endoscope holding device is attached to the side rail 166 and the position of the endoscope insertion hole H ₁ drilled in the abdominal wall portion of the patient H deviate from the direction of connection. Each arm 175 of the link mechanism part 173 of the endoscope moving mechanism 164
~ 178, the counterweight 202, etc. can be arranged. Therefore, when operating a treatment tool such as forceps, the arms 175 to 178 of the link mechanism unit 173 of the endoscope moving mechanism 164, the counterweight 202, and the like interfere with the operator P or the operator P's hand. Since there is no danger of disturbing the movement of the side rail 16 as in the conventional example shown in FIGS. 24 and 25.
6, each arm 175 of the link mechanism portion 173 of the endoscope moving mechanism 164 in the direction connecting the mounting position for mounting the endoscope 6 and the position of the insertion hole H ₁ of the body wall for inserting the endoscope 162 into the body of the patient H. An operator P standing beside the operating table 165 compared with the case where the 178 and the counterweight 202 are extended.
The interference with the endoscope moving mechanism 164 can be reduced, and the operability of the endoscope 162 can be improved.

24 and 25 show the conventional state of the endoscope holding apparatus and the initial state of the endoscope holding apparatus, respectively, in comparison with FIGS. 18 and 19 of the present embodiment. 24 and 25, portions corresponding to those of FIGS. 18 and 19 of the present embodiment are designated by the same reference numerals, and description thereof will be omitted here.

Further, in this embodiment, the base portion 167 is provided with the protruding portion 171 protruding upward, and the outer end portion of the moving mechanism supporting arm 168 is provided at the upper end portion of the protruding portion 171. Since it is fixed, the operating table 16 can be used when the endoscope holding device is used.
The entire endoscope moving mechanism 164 can be arranged on the upper side of the position 5 at a position sufficiently distant from the patient H.

Further, in the present embodiment, the endoscope insertion hole H ₁ opened in the patient H placed near the center of the operating table 165.
The holding portion 163 of the endoscope 162 can be held at a position close to. Therefore, in the initial state in which the endoscope 162 is inserted into the endoscope insertion hole H ₁ opened in the patient along the vertical direction, the link operation amount of the link mechanism portion 173 of the endoscope moving mechanism 164 (the lower rod 176 and The angle α between the swing arm 178 (see FIG. 19)) is smaller than the link actuation amount of the conventional link mechanism 173 (the angle β between the lower rod 176 and the swing arm 178 (see FIG. 25)) ( α <β). As a result, in the initial state, the endoscope 162 can be moved in various directions more easily than in the related art, and an even range can be moved in any direction.

Further, in the present embodiment, the operation range of the endoscope 162 centering on the endoscope insertion hole H ₁ is expanded due to the small link operation amount of the link mechanism portion 173 in the initial state.

Further, in the present embodiment, the counterweight 202 can be arranged at a position distant from the operator P, so the operator P does not care about the interference with the counterweight 202 of the endoscope holding device. There is also the effect of being able to concentrate on the treatment.

20 and 21 (A) show a sixth embodiment of the present invention. In this embodiment, the outer end portion of the moving mechanism support arm 168 is rotated to the upper end portion of the protruding portion 171 of the base portion 167 of the endoscope holding device according to the fifth embodiment (see FIGS. 13 to 19). Adjustment dial 2 that is connected as much as possible and that adjusts the amount of rotational force of the connecting portion between the projecting portion 171 of the base portion 167 and the moving mechanism supporting arm 168.
41 is provided. In addition, this adjustment dial 24
The adjusting mechanism of the rotating force by 1 has the same structure as the adjusting mechanism of the rotating force by the adjusting dial 215 of the fifth embodiment (see FIG. 14).

Further, in this embodiment, the length of the moving mechanism supporting arm 168 is set longer than that in the fifth embodiment. The other parts are the same as those in the fifth embodiment (Fig. 13-
(See FIG. 19).

Therefore, the following effects can be obtained with the above configuration. That is, the outer end portion of the moving mechanism support arm 168 is rotatably connected to the upper end portion of the protruding portion 171 of the base portion 167, and the length of the moving mechanism support arm 168 is sufficiently longer than that in the fifth embodiment. Since it is set to be long, the mounting position of the base portion 167 can be selected in various ways. Therefore, the endoscope holding device can be used in a wide range of operations without feeling uncomfortable. For example, during obstetrics and gynecology surgery,
Even when the base portion 167 is attached to the head H ₂ side of the patient H as shown in (A), the link mechanism portion 173 can be arranged sufficiently close to the endoscope insertion hole H ₁ . Other effects are the same as those of the fifth embodiment.

FIG. 21B shows the endoscope holding device according to the seventh embodiment of the present invention. This embodiment is different from the endoscope holding apparatus of the sixth embodiment (see FIGS. 20 and 21A) in that the counterweight is provided on the opposite side of the moving mechanism supporting arm 168 with respect to the rotation center of the adjustment dial 241. 251 is provided and this counterweight 2
51 is set so as to balance with the total weight of the link mechanism portion 173, the connecting arm 185, the endoscope holding portion 163, the moving mechanism support arm 168, and the endoscope 162.
Other parts are the same as those in the sixth embodiment.

Therefore, with the above-described structure, the same effect as that of the sixth embodiment can be obtained, and in particular, in the present embodiment, the movement mechanism support arm 168 of the moving mechanism supporting arm 168 is particularly arranged with respect to the rotation center of the adjusting dial 241. Since the link weight 173, the connecting arm 185, the endoscope holding portion 163, the moving mechanism supporting arm 168, and the counterweight 251 that balances the total weight of the endoscope 162 are provided on the opposite side, the adjustment dial 24
This is effective in simplifying the structure of the rotational force amount adjusting mechanism centered on 1 and reducing the size and improving the durability.

FIG. 22 shows an endoscope holding device according to the eighth embodiment of the present invention. In this embodiment, the endoscope holding mechanism of the fifth embodiment (see FIGS. 13 to 19) is provided with an endoscope moving mechanism 261 configured by combining two parallelogram links.

That is, in the endoscope moving mechanism 261 of this embodiment, the first parallelogram link 262 formed by the link mechanism portion 173 of the fifth embodiment and the newly installed second parallel link 262 are provided. A quadrilateral link 263 is provided. Here, the first parallelogram link 262 is connected to the lower ends of the pair of revolving arms 177 and 178 of the fifth embodiment, and the upper ends of the connecting members 264 and 265 that extend downward. There is.

The second parallelogram link 263 has a pair of upper and lower rods 266 and 267, which are parallel horizontal arms extending in a substantially horizontal direction, and a pair of parallel arms extending in a vertical direction. Swivel arms 268 and 269 are provided. Here, the upper rod 266 and the lower rod 26
7, the connecting member 264 of the first parallelogram link 262 is provided on the side of the connecting portion with the first parallelogram link 262.
Connecting members 270 and 271 having substantially the same structure as 265 are connected to each other.

Further, the joint portion 27 is provided between the upper rod 266 of the second parallelogram link 263 and the revolving arm 268.
2. The lower rod 267 and the turning arm 268 are rotatably connected to each other via a joint 273.

Further, the connecting members 270 and 271 of the second parallelogram link 263 and the first parallelogram link 2 are connected.
There are three joints 2 between the connecting members 264 and 265 of 62.
74, 275, 276 (the joint 276 is not shown) and a supporting member 174 are rotatably connected to each other.

The first parallelogram link 262 corresponding to the lower rod 176 of the fifth embodiment is formed by the connecting members 270 and 271 of the second parallelogram link 263.
A lower rod is formed. In addition, the connecting members 264 and 265 of the first parallelogram link 262 cause the second
Of the parallelogram link 263 is formed with a swivel arm 269 on the side of a connecting portion with the first parallelogram link 262.

Therefore, in the two parallelogram links 262 and 263 of the endoscope moving mechanism 261 of this embodiment, the connecting members 270 and 27 of the second parallelogram link 263 are used.
1 and the connecting member 26 of the first parallelogram link 262.
4,265 and three joints 274,275,276
And the support member 174 are integrally configured as a common element. As in the fifth embodiment, the entire two parallelogram links 262 and 263 of the endoscope moving mechanism 261 can be rotated about the central axis of the vertical rod 172 on the vertical plane including the vertical rod 172. is there.

Further, the second parallelogram link 263 has two sets of counter weights 277 and 278 in a state of being balanced with respect to the holding portion 163 on which the endoscope 162 is mounted.
Are arranged. Here, the first counterweight 277 is attached so as to be movable along the shaft 279 of the lower rod 267. Further, the second counterweight 278 is attached so as to be movable along a guide arm 280 extending below the turning arm 268. The two pairs of counterweights 2 according to the present embodiment
Reference numerals 77 and 278 are for balancing the entire system including the endoscope 162 and the TV camera (not shown) with respect to the central axis of the vertical rod 172.

Therefore, in the present embodiment, since two sets of counterweights 277 and 278 can be arranged almost above the base 167 by the second parallelogram link 263, the use of the endoscope holding device can be improved. There is no risk that the counterweights 277, 278 will be placed above the patient. Therefore, there is no possibility that the counterweights 277 and 278 interfere with the patient H on the operating table 165 to limit the operation range of the endoscope 162.

Further, in this embodiment, the counter weights 277 and 278 themselves are lighter than the other embodiments,
Since it is small, interference with the operator is negligible. The other effects are similar to those of the fifth embodiment.

Further, the structure of the balance mechanism using the spiral springs 42a and 42b inside the joint of the first embodiment (see FIG. 4) moves the endoscope of the endoscope holding apparatus of the present embodiment. The same effect can be obtained by configuring the mechanism 261.

23 (A) to 23 (C) show a ninth embodiment of the present invention. The fifth embodiment is the fifth embodiment.
23C, which is attached to the side rails 166 of the operating table 165, in the installation section 161 of the endoscope holding apparatus of the embodiment (see FIGS. 13 to 19), and the base section unit 301 shown in FIG. The intermediate support unit 3 shown in FIG. 23B that is detachably connected to the base unit 301.
02 is provided.

Here, in the base unit 301, a support leg portion 303 is laterally extended at the central portion of the outer surface of the base portion 167 of the fifth embodiment. This support leg 30
A through hole 304 penetrating in the vertical direction is formed in the hole 3. The base portion 167 of this embodiment is not provided with the protruding portion 171 of the base portion 167 of the fifth embodiment.

Further, the intermediate support unit 302 is integrally provided with the moving mechanism support arm 168 of the fifth embodiment and the standing leg portion 305 corresponding to the projecting portion 171 of the base portion 167 of the fifth embodiment. Has been unitized as a unit. A vertical rod 306 is fixed to the lower end of the standing leg 305 of the intermediate support unit 302. This vertical rod 3
Like the lower end portion of the vertical rod 172 of the endoscope moving mechanism 164, a plurality of ring-shaped engaging grooves 307, in the present embodiment, two engaging grooves 307 are formed in 06. Then, the vertical rod 306 of the intermediate support unit 302 and the endoscope moving mechanism 1
The vertical rods 172 of 64 are appropriately and selectively inserted into the through holes 304 of the support legs 303 of the base unit 301 so that they can be inserted and removed.

Further, the supporting leg portion 3 of the base unit 301
03 is inserted into the through hole 304, and the through hole 304
Vertical rod 3 of the intermediate support unit 302 that moves up and down in the
06 or the height adjustment mechanism 21 having the same configuration as the height adjustment mechanism 21 (see FIG. 3) of the first embodiment for fixing the height of either the vertical rod 172 of the endoscope moving mechanism 164 in a stepwise manner. The rotational force amount adjustment mechanism unit 22 of the fifth embodiment that adjusts the rotational operation force amount of the mechanism 223 and the vertical rod 306 (or the vertical rod 172) inserted in the through hole 304.
4 (see FIG. 15), which has the same structure as the rotational force amount adjusting mechanism 3
08 is provided. In addition, in FIG.
Reference numeral 9 is an operation knob of the height adjusting mechanism 223, and 310 is a rotating force amount adjusting dial of the rotating force amount adjusting mechanism unit 308.

Then, when the endoscope holding apparatus of this embodiment is used, the following two usage states are appropriately selected. Here, in the first usage state, the vertical rod 306 of the intermediate support unit 302 is inserted into the through hole 304 of the support leg portion 303 of the base unit 301, and the base unit 301 and the intermediate support unit 302 are integrated. It is used in the assembled state. In this case, the vertical rod 172 of the endoscope moving mechanism 164 is used while being inserted into the through hole 168a of the moving mechanism supporting arm 168 of the intermediate supporting unit 302.

The second state of use is the base unit 3
The vertical rod 172 of the endoscope moving mechanism 164 is directly inserted into the through hole 304 of the supporting leg 303 of No. 01.

Therefore, the following effects are obtained in this embodiment. That is, when the intermediate support unit 302 is required due to the surgical technique, the number of operators, the space in the operating room, etc., the base unit 301 can be selected by selecting the first usage state.
, The intermediate support unit 302, and the endoscope moving mechanism 164
The endoscope holding device can be used in the state of being combined with.
Here, if the intermediate support unit 302 is not necessary, the second
By selecting the usage state of the intermediate support unit 3
The endoscope holding device can be used with 02 omitted. Therefore, in the present embodiment, the required configuration can be selected according to the purpose of the operator and the environment of the facility to be used, so that the endoscope holding device can be used in an appropriate size. Therefore, it is possible to save space. The other effects are similar to those of the fifth embodiment.

The present invention is not limited to the above embodiment, and it goes without saying that various modifications can be made without departing from the gist of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows.

(Additional Item 1) An installation unit installed on a floor or an operating table, a holding unit for holding an endoscope, a moving mechanism including a plurality of arms connecting the installation unit and the holding unit, and a joint unit. And a movable portion with respect to the holding portion, the mounting portion or the holding means includes an element extending in a substantially horizontal direction having a length sufficient to reach the vicinity of the center of the operating table when the apparatus is installed. An endoscope holding device, wherein the holding means is provided.

(Additional Item 2) An additional item is characterized in that the installation portion includes a rod-shaped member extending substantially horizontally having a length sufficient to reach the vicinity of the center of the operating table, and the holding means is attached to the member. 1 holding device.

(Additional Item 3) The holding device according to Additional Item 2, comprising means for changing the position of the rod-shaped member with respect to the operating table. (Additional Item 4) The holding device according to Additional Item 2, further including means for changing a mounting position of the holding means with respect to the rod-shaped member.

(Additional Item 5) The holding device according to Additional Item 1, wherein the holding means has an arm element extending substantially horizontally having a length sufficient to reach the vicinity of the center of the operating table, and a moving mechanism is provided at the tip end portion thereof.

(Additional Item 6) The holding device according to additional item 5, further comprising means for changing the position of the arm element with respect to the operating table. (Operation of Supplementary Items 5 and 6) The holding means is configured so that the moving mechanism comes to the tip of the arm element extending in the direction traversing the operating table so that the moving mechanism can be moved near the position of the endoscope insertion hole of the patient. By doing so, a wider range of motion can be obtained and it will not interfere with the surgeon.

(Additional Item 7) A base portion arranged on at least one side of the operating table and a holding portion for holding the endoscope are connected via the movement operation mechanism of the endoscope. In the endoscope holding device, a guide member extending at least between one side of the operating table and a position near the center of the operating table is provided, and the guide member corresponds to the position near the center of the operating table in the guide member. An endoscope holding device in which a base end portion of the movement operation mechanism is disposed in a portion.

(Purpose of Supplementary Note 7) When operating a treatment tool such as forceps, each arm of the moving operation mechanism, the link mechanism, etc. interferes with the surgeon or interferes with the movement of the surgeon's hand. An object of the present invention is to provide an endoscope holding device that can improve the operability of the endoscope without fear.

(Operation of Supplementary Note 7) The proximal end portion of the movement operation mechanism is arranged in a portion corresponding to the central position of the operating table, and the holding portion of the endoscope is arranged in the central position of the operating table. This prevents the surgeon standing beside the operating table from interfering with the operation mechanism of the endoscope, and allows the operator to view the endoscope near the center of the operating table and close to the insertion hole of the endoscope. By holding the holding part of the endoscope, it is easy to move the endoscope in various directions with the endoscope inserted in the insertion hole of the endoscope opened in the patient, and an equal range can be set in any direction. It can be moved.

(Additional Item 8) An installation unit installed on a floor or an operating table, a holding unit for holding an endoscope, and a moving mechanism composed of a plurality of arms and joints connecting the holding unit. In at least an endoscope holding device, the installation portion is configured by a base portion used for attachment and a moving mechanism arrangement portion extending from the base portion to a central portion of the operating table. Endoscope holding device.

(Additional Item 9) The endoscope holding device according to Additional Item 8, wherein the moving mechanism includes a counterbalance mechanism including at least one parallelogram link and a counterweight. (Additional Item 10) The endoscope holding device according to Additional Item 8, wherein the moving mechanism includes a counterbalance mechanism including at least two parallelogram links and at least one counterweight.

(Additional Item 11) The endoscope holding device according to Additional Items 9 and 10, wherein the moving mechanism arranging portion is rotatably connected to the base portion. (Additional Item 12) The endoscope holding device according to Additional Items 9, 10, and 11, wherein the moving mechanism arranging section is detachable from the base section.

(Additional remark 13) The moving mechanism arranging portion is provided with at least a counterweight for balancing with the moving mechanism, the holding portion and the endoscope.
1, 12 endoscope holding device.

[0164]

According to the present invention, in the installation portion, the base portion used for mounting on the floor or the operating table and the base portion extending from the base portion to the central portion of the operating table are located at the central portion of the operating table. Since the moving mechanism supporting means for supporting the endoscope moving mechanism is provided in
When operating a treatment tool such as forceps, there is no risk that the arms of the movement operation mechanism or the link mechanism will interfere with the surgeon or interfere with the movement of the surgeon's hand, and the operability of the endoscope is improved. Can be improved.

[Brief description of the drawings]

FIG. 1A is a side view showing a schematic configuration of an entire endoscope holding device according to a first embodiment of the present invention, and FIG. 1B is a plan view of the endoscope holding device according to the same embodiment.

2A is a vertical cross-sectional view showing a mounting state of a mounting portion of the endoscope holding device of the first embodiment, and FIG. 2B is a vertical rod of the endoscope holding device of the embodiment. The side view which shows the locking hole of an angle fixing pin.

FIG. 3 is a vertical cross-sectional view showing a state in which a vertical movement rod is inserted into a vertical rod of the endoscope holding device according to the first embodiment.

FIG. 4 is a perspective view showing a structure of a balance mechanism inside a first joint portion according to the first embodiment.

FIG. 5 is a vertical cross-sectional view showing an internal configuration of a shaft support portion of the movement operation mechanism mounting portion according to the first embodiment.

FIG. 6 is a side view showing a partial cross section of a connecting portion of a rotary shaft of the arm rotating block according to the first embodiment.

FIG. 7 is a perspective view showing a connecting portion between a third swing arm and a connecting arm according to the first embodiment.

FIG. 8 is a perspective view showing an endoscope holding portion according to the first embodiment.

9A is a cross-sectional view showing the internal structure of the adapter receiving member according to the first embodiment, and FIG. 9B is a sectional view taken along line 9B- of FIG. 9A.
9B sectional view taken on the line.

FIG. 10 shows a second embodiment of the present invention,
(A) is a side view of the endoscope holding device, (B) is a perspective view showing a fixing portion of the moving operation mechanism, (C) is a side view showing a mounting state of a fixed handle of a slide block, and (D) is ( 10D-10D line sectional view of (C), (E) is 1 of (C).
Sectional view of line 0E-10E.

FIG. 11 shows a third embodiment of the present invention,
(A) is a front view showing a fixing portion of a guide member of an endoscope holding device, (B) is a side view thereof, (C) is a plan view thereof, and (D) is a main portion showing a fixing portion of a vertically moving rod. FIG.

FIG. 12 shows a fourth embodiment of the present invention,
(A) is a side view of the endoscope holding device, (B) is a side view showing a connected state of the swivel arm.

FIG. 13 is a perspective view showing an endoscope holding device according to a fifth embodiment of the present invention.

FIG. 14 is a vertical cross-sectional view showing the structure of a connecting portion between a vertical rod and a support member of a link mechanism portion of an endoscope holding device according to a fifth embodiment.

FIG. 15 is a vertical cross-sectional view showing a schematic configuration of a rotational force amount adjusting mechanism portion of an endoscope holding device according to a fifth embodiment.

FIG. 16 is a vertical cross-sectional view showing a partial cross-section of the internal structure of an arm rotation block of the endoscope holding device according to the fifth embodiment.

FIG. 17 is a perspective view showing a connecting portion between a connecting arm and an upper rod of the endoscope holding device according to the fifth embodiment.

FIG. 18 is a plan view showing a usage state of the endoscope holding device according to the fifth embodiment.

FIG. 19 is a schematic configuration diagram showing an initial state of the endoscope holding device according to the fifth embodiment.

FIG. 20 is a perspective view showing an endoscope holding device according to a sixth embodiment of the present invention.

FIG. 21 (A) is a plan view showing a usage state of the endoscope holding device according to the sixth embodiment, and FIG. 21 (B) is a perspective view showing the endoscope holding device according to the seventh embodiment of the present invention. Fig.

FIG. 22 is a perspective view showing an endoscope holding device according to an eighth embodiment of the present invention.

FIG. 23 shows a ninth embodiment of the present invention,
(A) is a perspective view showing a link mechanism portion of the endoscope holding device,
(B) is a perspective view showing an intermediate support unit of the endoscope holding device, and (C) is a perspective view showing a movement operation mechanism mounting portion of the endoscope holding device.

FIG. 24 is a plan view showing a usage state of a conventional endoscope holding device.

FIG. 25 is a schematic configuration diagram showing an initial state of a conventional endoscope holding device.

[Explanation of symbols]

 1,165 Operating table 3,167 Base part 5 Horizontal rod (moving mechanism supporting means) 31,162 Endoscope 32,164 Moving mechanism 75,163 Endoscope holding part 161 Installation part 168 Moving mechanism supporting arm (moving mechanism) Support means)

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Akihiro Taguchi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Inventor Takashi Fukaya 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Yoshinao Daimei 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. An installation unit installed on a floor or an operating table,
In an endoscope holding device in which an endoscope moving mechanism including a plurality of arm portions and joint portions is arranged between a holding portion that holds an endoscope, the installation portion, to the floor or an operating table. A base part used for attachment and a moving mechanism supporting means extending from the base part to the central part of the operating table and supporting the endoscope moving mechanism at the central part position of the operating table are provided. An endoscope holding device characterized by the above.