JPH0998978A - Medical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical instrument whose tip fine parts are easily and securely washed and sterilized and whose pressure sensor is improved in durability. SOLUTION: The medical instrument is equipped with a strain gauge 27 serving as a pressure sensor at a gripper 13, and has a function which sends detection information from the strain gauge 27 to an operator. The strain gauge 27 is fixed to a plate spring 26 serving as a sensor holding member which is distorted according to a contact condition with a biomedical tissue, and the plate spring 26 is detachably attached to the gripper 13.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical instrument having a force sensor, for example, in a grip of a grasping forceps and having a function of presenting information detected by the force sensor when grasping a living tissue to an operator.

[0002]

2. Description of the Related Art Conventionally, a sensor for detecting tactile or force information is attached to a medical instrument such as a grasping forceps or an endoscope which is inserted into a body cavity of a living body to measure the hardness of living tissue and the force received by the medical instrument from the living body. Is measured and presented to the operator. In particular, when a manipulator equipped with an endoscope or a treatment tool is treated by remote control, the operator cannot directly detect the force sense, and therefore the force sense detection / presentation means described above is effective.

For example, in Japanese Patent Application No. 5-354155, a distributed sensor unit having a plurality of sensors is provided with an insertion portion of a main body of a medical device into which a plurality of sensors are output. The medical device body is controlled based on the output.

That is, the sensor unit is integrally provided with the grasping forceps provided at the tip of the insertion portion of the medical instrument body, and when the sensor unit is inserted into the body cavity and the living tissue is grasped by the grasping forceps. The hardness of the tissue or the like is measured, and the medical device main body is controlled based on a plurality of pieces of detection information output from the sensor unit.

[0005]

However, in the above-mentioned conventional technique, after measuring the hardness of the living tissue and the force that the medical instrument receives from the living body, that is, after the treatment, cleaning, disinfection and sterilization of the medical instrument are performed. When doing so, it is necessary to include the sensor fixed to the tip of the medical device, so it is necessary to consider the high temperature and high humidity environment resistance of the sensor and the chemical resistance. Since the shape of the medical device becomes complicated, effective cleaning / disinfection /
There is a problem that it takes time and effort for sterilization.

The present invention has been made in view of the above circumstances, and an object thereof is to enable easy and effective cleaning, disinfection, and sterilization of a medical instrument, and improve the durability of a force sensor. Another object of the present invention is to provide a medical device capable of expanding the application range of the force sensor.

[0007]

In order to achieve the above-mentioned object, the present invention provides a medical instrument having a force sensor at its tip and having a function of presenting information detected by this force sensor to an operator. It is characterized in that the force sensor is fixed to a sensor holding member which is distorted according to a contact state with a living tissue, and the sensor holding member is detachably held on the tip end portion. After using the medical device, the force sensor and the sensor holding member can be removed from the distal end to separately perform cleaning, disinfection, and sterilization.

[0008]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 3 show the first embodiment, FIG. 1 shows a sensor unit, and FIG. 2 shows grasping forceps as a medical instrument. Reference numeral 11 shown in FIG. 3 is a forceps main body, and the forceps main body 11 is composed of a gripper 13 provided at the tip of the handle 12 and a handle 14 provided at the base end of the handle 12 for opening and closing the gripper 13. There is.

Reference numeral 15 is a cylindrical member which is inserted through the forceps main body 11. In this cylindrical member 15, there are a forceps hole 16 through which the handle 12 of the forceps main body 11 is inserted and a wire receiving hole 18 through which a lead wire 17 is inserted. Is provided. And the lead wire 17
A sensor unit 19 is connected to the tip of the.

As shown in FIGS. 1 and 2, the gripper 13 is composed of a pair of openable and closable gripping pieces 20, and a gripping surface 21 is formed with saw-tooth-shaped irregularities. Further, a rectangular groove 22 is provided in the longitudinal direction at the center of one gripping surface 21 of the pair of gripping pieces 20. The groove 22 has a trapezoidal sectional shape, and a hole 24 penetrates the back surface 25 of the gripping piece 21 from a part of the bottom surface 23 of the groove 22.

Explaining the sensor unit 19, the groove 22 is provided with thin leaf springs 26 made of stainless steel or the like, both ends of which are bent downward at equal angles.
The leaf spring 26 is fixed to the gripping piece 20 by pressing the ends 26a and 26b against both end surfaces of the groove 22 by a spring force. The leaf spring 26 has a width slightly narrower than the width of the groove 22, and the upper surface 26c thereof is formed to have the same level as the grip surface 21 of the grip piece 20.

A strain gauge 27 as force detecting means is adhered and fixed to the center of the lower surface of the leaf spring 26.
For the purpose of reinforcement and waterproofing, the upper portion of the strain gauge 27 is uniformly thinly coated with a silicone rubber adhesive 28 or the like. The lead wire 17 is connected to the strain gauge 27, and the lead wire 17 is inserted into the hole 24 and drawn out to the back surface 25. In addition, the hole 24 through which the lead wire 17 is inserted
Also, the silicone rubber adhesive 28 is applied.

FIG. 4 shows a modified example in which the pressure-sensitive conductive rubber 29 is used as the force sense detecting means. The pressure-sensitive conductive rubber 29 is held by the gripper 13 with one pressure-sensitive surface 30 of the pressure-sensitive conductive rubber 29 bonded to the lower surface of the leaf spring 26. At this time, the other pressure-sensitive surface 31 of the pressure-sensitive conductive rubber 29.
Is in contact with the bottom surface 23 of the groove 22 with almost no pressing force.

Next, the operation of the present embodiment will be described. In order to detect gripping force while performing in-vivo treatment,
First, the lead wire 17 is inserted into the hole 24 provided in the gripping piece 20 of the gripper 13, and then the leaf spring 26 is bent to press one end portion 26a against the one end surface 22a of the groove 22 and the other end portion. The sensor unit 19 is mounted in the groove 22 by sliding 26 b into the other end surface 22 b of the groove 22. The same applies when the pressure-sensitive conductive rubber 29 is used as the force sense detecting means.

The living tissue a in the body cavity is gripped by the gripper 13.
When gripping, the upper surface 26a of the leaf spring 26 comes into contact with the biological tissue a, and the central portion of the leaf spring 26 to which the strain gauge 27 is attached bends downward with the both ends 26a and 26b of the leaf spring 26 as fulcrums. Thus, the gripping force can be detected. At this time, since both end portions 26a and 26b of the leaf spring 26 receive the reaction force from the both end surfaces 22a and 22b of the groove 22 inward,
There is a case where the output of the strain gauge 27 has already been output before the living tissue a is grasped due to the central portion of the leaf spring 26 bending slightly upward. In this case, the output at that time is measured as an offset. Further, when the pressure-sensitive conductive rubber 29 is used as the force sense detecting means, the pressure-sensitive surface 30 attached to the leaf spring 26 elastically deforms when gripping the living tissue a, so that the gripping force can be detected.

On the other hand, after the in-vivo treatment is completed, the sensor unit 19 is gripped by the gripping piece 2 in the reverse order of the above-mentioned mounting procedure.
Remove from 0. After the removal, the forceps body 11 and the sensor unit 19 are separately sterilized. In particular, the leaf spring 26
It is possible to predominantly clean the deposits clogging the gap between the groove 22 and the bent portion 26d near both ends 26a and 26b.

According to this embodiment, the gripping force of the living tissue a can be detected with high sensitivity, and the sensor unit 19 and the forceps body 1 can be detected.
1 and 2 can be separately separated for cleaning and sterilization, so leaf spring 2
It is possible to surely clean and sterilize fine portions such as both end portions 26a and 26b of 6. In addition, the life of the sensor itself is improved.
In addition, it becomes easy to replace the sensor if it breaks during use.

FIG. 5 shows a second embodiment. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. The sensor unit 32 is composed of a leaf spring 33 and a strain gauge 27 bonded to the central portion of the lower surface of the leaf spring 33. The gripping piece 34 of the gripper 13 is formed of a magnetic material, and the gripping surface 34 of the gripping piece 34 is provided with a groove 36. Shallow grooves 37 are formed at both ends of the groove 36 in the longitudinal direction, and both ends 33a and 33b of the leaf spring 33 to which the strain gauge 27 is bonded are attracted to the shallow groove 37 by magnetic force. The same applies when the pressure-sensitive conductive rubber 29 is used as the force sense detecting means.

Next, the operation of the present embodiment will be described. When the living tissue a is grasped, the leaf spring 33 to which force sense means such as the strain gauge 27 and the pressure-sensitive conductive rubber 29 is attached.
Since the central portion of the is bent downward, the gripping force can be detected. After the treatment is completed, the forceps main body 11 and the sensor unit 32 can be separated by sandwiching the leaf spring 33 with tweezers or the like and lightly pulling it upward.

According to the present embodiment, in addition to the effect of the first embodiment, since the leaf spring 33 is not deformed before the grasping of the living tissue a, the strain gauge 27 does not need to be offset, so It enables accurate detection and measurement of gripping force. In addition, attachment / detachment of the forceps main body 11 and the sensor unit 32 becomes easier.

FIG. 6 shows a third embodiment. The same components as those of the first and second embodiments are designated by the same reference numerals and the description thereof will be omitted. The gripping surface 35 of the gripping piece 34 that constitutes the gripper 13
Is provided with a groove 36 as in the second embodiment,
Shallow grooves 37 are formed at both ends of the groove 36 in the longitudinal direction. A plurality of intake holes 38 are formed in the shallow groove 37, and an intake tube 39 is connected to the intake holes 38.

The suction tube 39 is led out to the back side of the gripping piece 34 and is guided to the handle 14 of the forceps body 11 through the tubular member 15, and the suction tube 39 is connected to an unillustrated suction pump. ing. On the other hand, in the sensor unit 32, both end portions 33 a and 33 b of the leaf spring 33 are attracted to the shallow groove 37 by the suction force from the intake hole 38,
It is held by the gripper 13.

Next, the operation of the present embodiment will be described. To set the sensor unit 32, the leaf spring 33 is positioned and set at both ends 33a, 33b of the groove 36 in the shallow groove 37, and the both ends 33a, 3 of the leaf spring 33 are set in the intake holes 38.
When the power of the intake pump is turned on after confirming that 3b is placed, the intake hole 3 is inserted through the intake tube 39.
8 is sucked, and both end portions 33a and 33b of the leaf spring 33 are attracted to the shallow groove 37 by its suction force.

After the treatment, the forceps main body 11 and the sensor unit 32 can be separated from each other by turning off the power of the intake pump and then lightly pulling up the leaf spring 33 with tweezers or the like. Therefore, the same effect as that of the second embodiment can be obtained.

FIG. 7 shows a fourth embodiment, and 40 is a sensor unit. This sensor unit 40 is a metal such as stainless steel formed in a cylindrical shape, and its cross-sectional shape is a thick portion 42 having a curvature slightly larger than the shape of the endoscope distal end hard portion 41, and a wall thickness that is orthogonal to the thick portion 42. It is composed of two parts, a thin part 43 having a groove formed to be thin. The strain gauge 4 is provided on the bottom surface 44 of the thin portion 43.
5, the strain gauge 45 is thinly and uniformly covered with a silicone rubber adhesive 46 as in the first embodiment.

The sensor unit 40 is fitted and held by a medical endoscope distal end hard portion 41 by a spring force. The material of the sensor unit 40 is not limited to metal, but may be plastic.
Is not limited to an endoscope, and may be attached to a small diameter probe, a catheter, or the like.

Next, the operation of this embodiment will be described. Two portions of the thin portion 43 in the sensor unit 40 are pressed inward so that the thick portion 42 having a large curvature has the same curvature as that of the endoscope distal end hard portion 41, and the sensor unit is located in front of the observation surface 47. 40 is inserted and fitted into the endoscope distal end hard portion 41 to be mounted.

When the endoscope is inserted, when the outer surface of the thin portion 43 of the sensor unit 40 attached to the endoscope distal end hard portion 41 comes into contact with living tissue, the thin portion 43 becomes very thin. As a result, bending occurs inward, and the contact force with the living tissue can be detected from the strain gauge 45.

After the observation and treatment, the tip of the tweezers is inserted into the gap between the thin portion 43 of the sensor unit 40 and the surface of the endoscope distal end hard portion 41, and the thin portion 43 of the sensor unit 40 is pushed outward. While the distal end portion of the tweezers is slid into the gap between the thick portion 42 and the endoscope distal end hard portion 41, and the tweezers is pulled toward the endoscope distal end as it is, the sensor unit 40 causes the endoscope distal end hard portion 4 to move.
Can be separated from 1. Therefore, the same effect as that of the second embodiment can be obtained.

FIG. 8 and FIG. 9 show a fifth embodiment,
47 is a sensor gripper unit. The sensor gripper unit 47 is composed of a gripper 49 of a forceps body 48 and a strain gauge 50.

A groove 53 is provided on the back surface 52 of the gripping piece 51 which constitutes the gripper 49 of the forceps main body 48. The groove 53 is provided in the central portion of the gripping piece 51 in the lengthwise direction and over the entire widthwise direction of the gripping piece 51 in the widthwise direction, and the strain gauge 50 serving as force sense detecting means is provided on the bottom surface of the groove 53.
Is glued. The upper surface of the strain gauge 50 is thinly and uniformly covered with a silicone rubber adhesive 54 or the like for moisture proof and mechanical protection.

On the base side of the gripping piece 51, the gripping surface 55
On the end surface of the terminal end of the unevenness of the
Is integrally protruded, and a fitting spring 57, which is a U-shaped member made of a leaf spring, a plastic plate, or the like, and whose tip is widened, is adhesively fixed to the tip of the removable rod 56.

On the other hand, the base end member 58 of the gripping piece 51 is provided with two square holes 59 into which the detachable rod 56 can be inserted.
At the base end of the square hole 59, a space 60 having a width slightly larger than that of the square hole 59 is formed.

Next, the operation of this embodiment will be described. The fitting spring 57 provided at the end of the attachment / detachment rod 56 is narrowed with a pair of tweezers or the like to open the front end portion of the fitting spring 57 with the fitting spring 57.
When 7 and the attachment / detachment rod 56 are inserted into the square hole 59, the fitting spring 57 engages with the space 60 and the sensor gripper unit 47 and the forceps main body 48 are coupled. In this state, the sensor gripper unit 47 and the forceps body 48 are not separated even if the sensor gripper unit 47 is slightly displaced toward the tip of the gripper 49.

The operation of gripping the living tissue a by the gripper 49 of this embodiment will be described. Since the gripping piece 51 of the gripper 49 is thinned by the groove 53, the gripper 49 is largely bent in the opening direction. Occurs. Since the strain gauge 50 is bonded to the bent portion, the gripping force can be detected. In addition to gripping, adhesion between multiple tissues, etc.
Conversely, when there is a portion to be peeled off, the gripper 49 is bent in the closing direction. Therefore, if the peeling forceps or the like is provided with a similar structure, the peeling force can be detected together.

After the procedure, when the gripper 49 is strongly pulled toward the tip side, the bent portion 57a of the fitting spring 57 slides from the contact surface 60a of the space 60 into the inner surface of the square hole 59, so that the sensor gripper unit 47 has forceps. Separated from the body 48, they can be washed and sterilized separately.

According to this embodiment, in addition to the effect of the first embodiment, since the gripping surface 55 of the gripper 49 has a large unevenness area, the gripper 49 can grip more reliably. Further, not only the gripping force but also the peeling force can be detected.

FIG. 10 shows a sixth embodiment, and 61 is a sensor gripper unit. The structure of the attachment / detachment portion of the gripper 62 of the sensor gripper unit 61 and the forceps body 48 is the same as that of the fifth embodiment, and the same components are designated by the same reference numerals and description thereof is omitted. A slit 65 is provided in the central portion of the gripping piece 64 that constitutes the gripper 62 over the entire width direction of the gripping piece 64, and the gripping piece 64 at this portion has a vertically thin wall structure.

A strain gauge 67, which is a force detection means, is adhesively fixed to the central portion of the inner surface 65a of the slit 65 near the gripping surface 66 of the gripping piece 64, and its lead wire 68 is provided.
Is inserted into a hole 70 penetrating from a part of the inner surface 65 b of the gripping piece 64, which is remote from the gripping surface 66, to the back surface 69 of the gripping piece 64. Further, for the purpose of mechanical protection and moisture protection, windows 71 on both sides of the slit 65 are provided with a moisture-proof coating 72 such as a polyparaxylylene thin film.

Next, the operation of this embodiment will be described.
When the living tissue is gripped by the gripper 62, the inner surface 65 of the gripping piece 64 that is thinned by the slit 65
When a is bent, the grip force is detected from the strain gauge 67 that is adhesively fixed to the inner surface 65a. Further, when the peeling force is detected, if the strain gauge 73 (see FIG. 10B) is adhered to the facing inner surface 65b and peeling is performed, the inner surface 65b is detected.
Is peeled upward, the peeling force is similarly detected. Also,
By sticking to both strain gauges 67 and 73 as shown in FIG. 10B, the gripping force and the peeling force can be detected at the same time.

After the treatment, the gripper 62 and the forceps main body 48 are separated by the same method as in the fifth embodiment, and they can be washed and sterilized separately. According to the present embodiment, in addition to the effect of the fifth embodiment, the strain gauge does not appear on the gripping surface 66 and the peeling surface of the gripping piece 64, so that the durability of the sensor is further improved.

According to the above-described embodiment, the following structure can be obtained. (Supplementary Note 1) A medical instrument having a force sensor at its tip and having a function of presenting information detected by the force sensor to an operator, the structure including the force sensor and the force sensor bonded and fixed. And a tip end portion that detachably holds this structure, wherein the structure itself is distorted in accordance with a contact state with a living tissue. (Supplementary Note 2) The medical device according to Supplementary Note 1, wherein the force sensor is strain detecting means. (Supplementary note 3) The medical device according to supplementary note 2, wherein the strain detecting means is a strain gauge. (Supplementary Note 4) Supplementary Note 1 wherein the force sensor is displacement detecting means
The listed medical equipment. (Supplementary note 5) The medical device according to supplementary note 4, wherein the displacement detecting means is a pressure-sensitive conductive rubber.

(Supplementary Note 6) The medical device according to Supplementary Note 1, wherein the structure is composed of an elastic member. (Supplementary Note 7) The medical device according to Supplementary Note 6, wherein the elastic member is a flat plate. (Supplementary Note 8) The medical device according to Supplementary Note 7, wherein the flat plate is made of a metal material. (Supplementary Note 9) The medical device according to Supplementary Note 7, wherein the flat plate is made of a plastic material. (Supplementary Note 10) The medical device according to Supplementary Note 6, wherein the elastic member is a cylindrical member.

(Supplementary Note 11) The medical instrument according to Supplementary Note 1, wherein the medical instrument is a grasping forceps. (Supplementary Note 12) The medical instrument according to Supplementary Note 1, wherein the medical instrument is an endoscope. (Supplementary note 13) The medical instrument according to supplementary note 1, wherein the medical instrument is an electric instrument.

(Supplementary Note 14) A force sensor is provided at the tip end,
In a medical device having a function of presenting information detected by the force sensor to an operator, the force sensor is adhesively fixed to the distal end portion, and the distal end portion has a holding means that is detachable from the medical device body. A medical instrument characterized in that the distal end portion is distorted according to a contact state with a living tissue. (Supplementary Note 15) The medical device according to Supplementary Note 14, wherein the distal end portion has a thin structure.

(Supplementary Note 16) The medical device according to Supplementary Note 15, wherein the thin-walled structure is constituted by a groove provided on the back surface of the distal end portion. (Supplementary note 17) The medical device according to supplementary note 15, wherein the thin-walled structure is configured by a hollow structure of the distal end portion. (Supplementary note 18) The medical device according to supplementary note 17, wherein the hollow structure includes a slit provided on a side surface of the distal end portion.

(Supplementary note 19) The medical device according to supplementary note 14, wherein the holding means is composed of an elastic member. (Supplementary note 20) The medical device according to supplementary note 19, wherein the elastic member is a leaf spring. (Supplementary Note 21) The medical device according to Supplementary Note 14, wherein the holding means is a magnetic force. (Supplementary note 22) The medical device according to supplementary note 14, wherein the holding means has a suction force.

(Supplementary note 23) The medical instrument according to supplementary note 14, wherein the medical instrument is a grasping forceps. (Supplementary Note 24) The medical instrument according to Supplementary Note 14, wherein the medical instrument is a peeling forceps. (Supplementary note 25) The medical instrument according to supplementary note 14, wherein the medical instrument is an electric instrument.

According to the first to sixth embodiments, the force sensor for detecting the tactile / force information received by the medical instrument from the living tissue and the medical instrument main body can be attached / detached to / from each other. Since cleaning and sterilization can be performed separately,
It is possible to easily and surely clean and sterilize the details of the tip of the medical device. Further, since the medical instrument main body and the force sensor can be washed and sterilized under different conditions, the durability of the force sensor can be improved.

Further, as shown in Japanese Patent Application No. 7-33884 as a conventional manipulator for intracorporeal surgery, a reaction force provided on the master manipulator side in response to a reaction force from the target tissue detected on the slave manipulator side. It is known to drive the presenting means to feed back the treatment state of the tissue to the operator.

This depends on the operator's judgment as to whether or not the force applied to the tissue is in the safe region, and therefore skill is required to perform the safe treatment. Moreover, there is a possibility that the slave manipulator may exert an unreasonable force on the tissue due to an erroneous operation.

In the manipulator for intracorporeal surgery, the following is to prevent an unreasonable force from being applied to the tissue to be treated even when an operator who is not accustomed to the apparatus operates it or makes an erroneous operation.

11 to 13 show a seventh embodiment, and FIG. 11 shows a manipulator for intracorporeal surgery. The slave manipulator 101 includes a robot arm 103 that supports a surgical instrument 102. The surgical instrument 102 is inserted and arranged in the body cavity z through the insertion hole y formed in the body wall x of the patient. The surgical instrument 102 includes a stereoscopic scope 104 and a pair of treatment tools 105a, 10a.
5b, and the treatment tools 105a and 105b are arranged at the left and right positions of the scope 104.

Each of the treatment tools 105a and 105b has a curved portion, and the position and the posture of the distal treatment portion can be freely selected, and these can be operated by means described later. Further, for example, strain gauges 107 are attached to the grippers 106a and 106b provided at the distal ends of the treatment tools 105a and 105b as force sensors for detecting the amount of force during tissue treatment.

A curved portion 108 is formed at the tip of the scope 104, and the visual field direction can be selected by bending the curved portion 108 by means described later. The operation of the bending portion 108 of the scope 104 and the pair of treatment tools 105a and 105b is performed by the surgical instrument 102.
This is done by an operating mechanism built into the rear end of the. A master manipulator 109, which is an operation means for operating the slave manipulator 101, is configured by a moving master arm 110, an HMD (head mount display) arm 111 provided at the tip thereof, and a pair of left and right treatment operation means arms 112a and 112b. Has been done.

A pair of left and right treatment operation means arms 112
a and 112b are the left and right treatment tools 105a and 105 described above.
It corresponds to b. Further, the arm 11 for the treatment operation means
2, 112b are provided with force-sensing actuators, which will be described later, for feeding back the amount of force applied to the grippers 106a, 106b to the operator. An HMD 113 is attached to the tip of the HMD arm 111. The HMD 113 is mounted on the operator's head to display a three-dimensional image captured by the stereoscopic observation type scope 104, and the operator can stereoscopically observe the image in the body cavity z through the HMD 113. .

Each arm connecting portion of the master manipulator 109 has a rotating structure for rotating in a specific direction, and an encoder (not shown) for detecting rotation is incorporated in the rotating portion. Then, the information obtained by each encoder is sent to the control device 114, and the HMD arm 111 and the pair of left and right treatment operation means arms 11 are provided.
The movements of 2a and 112b are determined.

A pair of right and left treatment operation means arms 112
a and 112b are the left and right treatment tools 105a and 105 described above.
When the treatment operation means arms 112a and 112b are moved, the left and right treatment tools 105a and 105b corresponding to the arms 112a and 112b are controlled so as to follow the movements. Further, when the HMD 113 is moved, the tip position and direction of the scope 104 are changed, and the observation visual field of the scope 104 and the observation visual field of the HMD 113 are controlled so as to follow and match each other. Therefore, the slave manipulator 1
01 and the master manipulator 109 are both connected to the control device 114.

The tip position of the master manipulator 101 corresponds to the tip position of the insertion portion of the scope 104,
Also, the position and orientation of the rotating part of the HMD 113 is the scope 10
4 corresponds to the deflection angle of the distal end of the insertion portion, and the treatment operation means arms 112a and 112b are further connected to the treatment tools 105a and 10a.
It is controlled to operate so as to correspond to the position of 5b.
In addition, the gripper 1 at the tip of the treatment instrument 105a, 105b
The output of the strain gauge 107 attached to 06a and 106b is connected to the control device 114.

FIG. 12 shows the master manipulator 109.
The structure of the tip of arm 112a, 112b for treatment operation means of is shown. A pair of finger hanging rings 115 and the gripping member 11
6, the pair of finger-holding rings 115 includes the gripping member 1
It is pivotally attached to the upper end of 16 via a support shaft 117 so as to be opened and closed. The opening / closing amount of the pair of finger hanging rings 115 is detected by a position sensor such as an encoder or a potentiometer as position (angle) detecting means incorporated in the grip member 116, and the detection signal is the control device 11.
4

Further, each finger ring 115 is connected to the same cylinder connecting bar 119 via a link member 118 which constitutes a pantograph. The cylinder connecting bar 119 is connected to a pneumatic cylinder 120 which is a force sense presenting actuator.

Further, the arm 112a, 1 for treatment operation means
Brake means for fixing the operation of the cylinder connecting bar 119, for example, the drum brake 121, is provided inside 12b.
Is provided.

FIG. 13 shows a block diagram of the ability presentation control. The outputs of the strain gauges 107 attached to the grippers 106a and 106b are connected to the control device 114 and input to the safety capacity determination unit 122. The safety capacity determination unit 122 uses an electropneumatic proportional valve 123 in which the input electricity quantity and air quantity are proportional.
Are connected to the brake drive circuit 124. The electro-pneumatic proportional valve 123 is connected between the pneumatic cylinder 120 and the air compressor 125, and controls the amount of force generated in the pneumatic cylinder 120.

Next, the operation of this embodiment will be described. The slave manipulator 10 is operated by an operation input means (not shown) provided in the slave manipulator 101.
1 is moved to bring the surgical instrument 102 to the position of the insertion hole y formed in the body wall x and insert it into the body cavity z. When the operator changes the position of the head in this state, the HMD arm 1
An encoder built in 11 detects a change in the position, and drives the slave manipulator 101 so that the tip position of the scope 104 follows the position of the operator's head.

When the operator changes the posture of the head,
Similarly, an encoder built in the HMD arm 111 detects a change in the posture thereof and drives the bending portion 108 of the scope 104 to follow the head direction. When the operator changes the positions of the left and right treatment operation means arms 112a and 112b or opens and closes the finger hanging ring 115,
The movement is detected by an encoder incorporated in the treatment operation means arms 112a and 112b, and the treatment instruments 105a and 105b of the surgical instrument 102 and the grippers 106a and 106b provided at the distal ends thereof are moved to the treatment operation means arm 112.
It is operated corresponding to the movements of a and 112b.

That is, when the operator moves the head, the visual field conversion corresponding to the movement can be performed, and when the arm is moved, the operation of the treatment tools 105a and 105b can be controlled to perform the tissue treatment. When performing this tissue procedure, gripper 1
The amount of force applied to 06a and 106b is detected by the strain gauge 107 and sent to the control device 114. Control device 114
Then, the electropneumatic proportional valve 123 is controlled based on the detected force amount, and the force amount generated in the pneumatic cylinder 120 is controlled.
As a result, the operator can obtain the feeling that he or she is performing the treatment directly using the surgical instrument in advance.

Here, when an operation such that an excessive force is applied to the tissue due to an operator's mistake is made, for example, the gripper 1
When the finger-holding ring 115 on the master side is fully closed while holding the tissue with 06a, 106b, the tissue will be crushed as it is, but the grippers 106a, 106b
The output of the strain gauge 107 that detects the force applied to b is monitored by the safety force determination unit 122 in the control device 114, and when the detected force exceeds the safe area, a control signal for driving the brake is output. Arm for treatment operation means 1
The movement of the cylinder connecting bar 119 in 12a and 112b is fixed.

That is, when an excessive amount of force is applied to the tissue, the surgeon fixes the finger ring 115 on the master side for controlling the movement of the grippers 106a and 106b, so that the amount of force is further applied to the tissue. Absent. The brake is released after a certain period of time, and simultaneously, the grippers 106a and 106b on the slave side are also applied to the tissue and driven in a direction in which the force amount is released.

Instead of the pneumatic cylinder 120, a linear motor or a direct drive means obtained by combining a ball screw and a rotary drive motor may be used to form the actuator. Further, instead of the strain gauge 107, a pressure sensitive conductive rubber or an optical force sensor may be used.

Further, instead of the drum brake 121,
The movement of the cylinder connecting bar 119 may be fixed by a solenoid type or magnetic type chuck. Further, a force sensor for detecting the amount of operation force of the operator may be provided on the finger ring 115 on the master side to perform bilateral control.
In that case, when a force that deviates from the safe area is applied to the tissue by the operation of the master and the brake is applied, by applying a force to the finger ring 115 in a direction in which the force on the tissue is relaxed, the force is applied in the direction in which the force is applied. Gripper 106a,
106b can be activated and treatment can continue.

According to the above embodiment, the following structure can be obtained. (Supplementary note 26) In a medical manipulator having a master manipulator operated by an operator, and a slave manipulator holding a surgical instrument and performing a movement following the operation of the master manipulator, the ability to detect the force acting on the surgical instrument Detecting means, in order to present a force to the operator according to the force detected by the force detecting means, a force indicating means provided in the master manipulator, and in accordance with the force detected by the force detecting means, the A manipulator for intracorporeal surgery, comprising a fixing means for fixing the movement of the master manipulator.

(Supplementary note 27) The manipulator for intracorporeal surgery according to supplementary note 26, wherein the surgical instrument includes grip means for treating a tissue and an endoscope for observing the inside of the body cavity. (Supplementary note 28) The manipulator for intracorporeal surgery according to supplementary note 27, wherein the force amount detecting means is a force sensor provided in the grip means. (Supplementary Note 29) The supplementary note 2 wherein the force sensor is a strain gauge
The manipulator for intracorporeal surgery according to 6. (Supplementary note 30) The manipulator for intracorporeal surgery according to supplementary note 26, wherein the force sensor is a pressure-sensitive conductive rubber.

(Supplementary Note 31) The manipulator for intracorporeal surgery according to Supplementary Note 26, wherein the force sensor is an optical force sensor. (Supplementary Note 32) The manipulator for intracorporeal surgery according to Supplementary Note 26, wherein the force presenting means is an actuator that generates a force. (Supplementary note 33) The manipulator for intracorporeal surgery according to supplementary note 32, wherein the actuator is a pneumatic cylinder. (Supplementary Note 34) The manipulator for intracorporeal surgery according to Supplementary Note 32, wherein the actuator is a linear motor.

(Supplementary note 35) The manipulator for intracorporeal surgery according to supplementary note 32, wherein the actuator comprises a ball screw and a rotary motor. (Supplementary note 36) The manipulator for intracorporeal surgery according to supplementary note 26, wherein the fixing means is a drum brake. (Supplementary note 37) The manipulator for intracorporeal surgery according to supplementary note 26, wherein the fixing means is an electric chuck.

According to the above embodiment, the master manipulator which detects the amount of force applied to the tissue to be treated by the gripper at the distal end of the treatment instrument for performing treatment in the body cavity and controls the gripper when the gripper deviates from the safety region. By fixing the movement of the operator, it is possible to prevent unreasonable force from being applied to the tissue to be treated even when an unfamiliar operator operates or makes an erroneous operation, and a safe treatment can be performed.

Further, conventionally, as disclosed in US Pat. No. 5,217,003, an insertion hole is opened in the body wall of the abdominal cavity or the like, and an endoscope or a treatment instrument is percutaneously introduced into the body cavity through the insertion hole. The endoscopic surgery which performs various treatments in a body cavity is performed by inserting into a body cavity. These techniques are
As a minimally invasive procedure that does not require a large incision, it is widely used for cholecystectomy and surgery for removing and removing part of the lung.

However, at the remote position, when the treatment tool is inserted into the body cavity of the patient, there is a problem that when grasping the organ, it is not possible to know how much force is being used to grasp the organ.

The following is endoscopic surgery which can improve the workability of the treatment work by ensuring the safety to the patient and clarifying how much the treatment tool is held. A system is shown, and a force sensor is provided in a grip portion of a treatment tool so that organ grip information in a body cavity can be transmitted to an operator.

14 to 16 show the eighth embodiment,
FIG. 14 shows a surgical manipulator system. FIG.
In the figure, 131 is an operating table for observing and treating a patient, and 132 is a patient. Bedside rails 133 are provided on both sides of the operating table 131. A treatment tool 134 for performing treatment in the body cavity of the patient 132, a treatment arm 135 for positioning the observation endoscope 135, and an observation arm 137 are detachably attached to the bedside rail 133. There is.
In addition, the treatment tool 134 and the endoscope 136 are used for the patient 132.
Is inserted into the body cavity through the insertion hole 132a formed in the body wall of the body.

The connection between the treatment arm 135 and the treatment tool 134 and the connection between the observation arm 137 and the endoscope 136 are free joint mechanisms 13 which are joints having a plurality of degrees of freedom.
It is done by 9. This is to prevent an unreasonable force from being applied to the insertion hole 132a even if the position of the insertion hole 132a is displaced due to movement of the patient 132 during surgery.

Treatment arm 135 and observation arm 1
Numeral 37 is configured so that vertical movement (b direction shown in FIG. 14), turning movement (c direction shown in FIG. 14), and expansion / contraction movement (d direction shown in FIG. 14) can be mechanically performed. Has been done. In order to realize such movement, an actuator (not shown) is arranged in the arm. As this actuator, a servo motor which is often used for positioning a robot is used.

As shown in FIG. 15, the treatment arm 135.
13 of the treatment instrument 134 attached to the tip of the
4a and the insertion portion 136a of the endoscope 136 attached to the distal end of the observation arm 137, the distal end portions thereof can be bent and driven in the directions e and f shown in FIG. Such bending drive is performed by the treatment tool 13
4 and the servo motor (not shown) provided in the servo motor housing portion 136b of the endoscope 136 are driven to insert the insertion portion 134a.
It is performed by pulling a wire (not shown) inserted and arranged in the inside.

The treatment instrument 134 and the endoscope 136 can be rotated and driven in the g direction shown in FIG.
Such rotary drive is performed by the free joint arm joint section 1
Servo motor 134 provided in 34c and 136c
This is performed by driving d and 136d to operate a rotating mechanism (not shown).

In particular, the distal forceps portion 134e of the treatment instrument 134
Is provided with an opening and closing mechanism for opening and closing the forceps portion 134e.
It is operated by driving a servomotor (not shown) provided in 4b to push and pull a robot or a wire member inserted and arranged in the insertion portion 134a.

FIG. 16 shows a forceps grip portion of the treatment tool 134. In FIG. 16, reference numeral 140 denotes a treatment tool main body, and a gripper 1 serving as a gripping unit is provided at a distal end portion of the treatment tool main body 140.
41 is provided. A link mechanism 142 has a pantograph structure for mechanically opening and closing the gripper 141.

Inner serrated grip 14 of gripper 141
A pressure sensor 143 for detecting the gripping force is attached to 1a. The pressure detected by the pressure sensor 143 is sent to the pressure detection device described later via the signal cable 144.

The pressure sensor 143 is of the electrostatic capacitance changing type, and only detects one-dimensional information indicating only the pressure applied. However, as shown in FIG. By using the distributed sensor 145, it becomes possible to detect multidimensional information such as where and how much force is applied.

That is, in FIG. 17A, the A layer and the B layer are highly flexible conductive materials, and the S layer is a pressure sensitive conductive rubber. The pressure-sensitive conductive rubber is a mixture of carbon and rubber, and the resistance value per unit area in the thickness direction changes according to the pressure distribution. FIG. 17B is an overall view of the pressure-sensitive sensor 145. In S1 and S3, electrodes (layer A) are shown.
Is connected to the positive voltage V0 through the resistor R, and in S2 and S4, the electrode (layer B) is connected to the negative voltage V0 through the resistor R. According to this configuration, the current flowing from the A layer to the B layer is obtained from the function using the voltage of the electrode (A layer) and the voltage of the electrode (B layer) as parameters, and the pressure distribution applied to the pressure sensitive sensor 145 and each It is a mechanism that the pressure at the position is required.

Although the pressure detecting means is used as the gripping force detecting means, the gripping force can be detected by using a position displacement sensor such as a strain sensor. FIG.
In the figure, the strain gauge 146 is provided on the gripper 141 of the treatment instrument 134. The strain gauge 146 is arranged on the back surface of the gripper 141. The strain gauge 146 transmits information on changes in stress applied to the gripper 141 to the signal cable 144.
Is sent to the control device side via. With this configuration,
The gripping force of the treatment tool 134 can be detected.

Now, the treatment tool 134 and the treatment arm 135.
A combination of and is referred to as a treatment slave manipulator, and a combination of the endoscope 136 and the observation arm 137 is referred to as an observation slave manipulator.

FIG. 14 shows a master arm 138 which is the input means of the slave manipulator for treatment and a head mounted display 139 (hereinafter referred to as HMD) which is the input means of the slave manipulator for observation.

The master arm 138 is composed of a plurality of link mechanisms. Each link forming the link mechanism is provided with an encoder (not shown) for position detection. This encoder can detect the movement amount of the master arm 138 by detecting the operation of each link.

An electromagnetic clutch (not shown) is attached to each arm link of the master arm 138 so that when the operator releases the master arm 138, the master arm 138 does not operate by its own weight. ing. That is, the operation of the master arm 138 is restricted by this electromagnetic clutch so that it does not move except when necessary.

When the treatment slave manipulator is actually moved in the master-slave mode, the operation of the electromagnetic clutch is controlled by stepping on the foot switch 152. That is, the operation of the master arm 138 can be locked and the locked state can be released by the foot switch 152. Here, the master-slave mode is a mode in which the movement of the master arm 138, which is an input unit, can be transmitted to the treatment slave manipulator, that is, a mode in which the treatment slave manipulator can follow the movement of the master arm 138.

On the other hand, the HMD 139 is equipped with a display (not shown) for displaying an image observed by the endoscope 136. This display is HMD139
It is provided so as to be set at the positions of the eyes of the operator when the is attached to the head of the operator. In addition, HMD139
No matter how the surgeon's head moves, the image captured by the tip of the endoscope 136 can be constantly observed by the display. HMD1 having such a configuration
According to 39, the operability is improved because it is not necessary for the operator to perform a troublesome operation such as shifting the line of sight to the TV monitor installed in the operating room during the treatment. Moreover, since the image of the patient can always be clearly observed without removing the line of sight from the affected area, safe surgery can be performed.

The spatial movement amount of the operator's head is detected by the magnetic sensor 150. The magnetic sensor 150 includes a magnetic sensor source unit 150b that generates a uniform magnetic field and a magnetic sensor sense unit 150a. Of these, the magnetic sensor sensing unit 150a is attached to the HMD 139 at substantially the center thereof.

The movement of the operator's head depends on such a magnetic sensor 1.
The magnetic field is detected by the magnetic sensor sensing unit 150a, and a uniform magnetic field generated from the magnetic sensor source unit 150b set at a predetermined location other than the HMD 139 is detected by the magnetic sensor sensing unit 150a. By processing the information of the change of the magnetic field due to the movement of the sensor unit 150b, the spatial absolute movement amount between the source unit 150b and the sense unit 150a and the Euler angle (roll, pitch, yaw) that is the inclination of the sense unit 150a is obtained. The amount of movement and the amount of tilt of the operator's head are detected.

Next, the control device 151 for controlling the operations of the treatment slave manipulator and the observation manipulator will be described. As shown in FIG. 14, the control device 151
Comprises several functional modules required to operate each of the slave manipulators.

That is, reference numeral 151a in the figure denotes the control device 15
It is a microcontroller that is a higher-level CPU that controls one functional module. Reference numeral 151e is an up-down counter for holding the operation amount of the encoder provided in the master arm 138. Of course, the up / down counter 151e has an input port for the encoder attached to the master arm 138. In addition, the up / down counter 151e is, specifically, a count value set in advance at the time of initial setting (when the power supply of the control device 151 is turned on) with respect to the relative movement amount of the master arm 138 from the encoder. It increases or decreases.

Reference numeral 151d is a magnetic sensor data interface circuit for detecting information from the magnetic sensor section 150a attached to the HMD 139. The magnetic sensor interface circuit 151d includes a magnetic sensor 1
The absolute position information of 50 and the information of the Euler angle are input from the magnetic sensor sensing unit 150a.

Reference numeral 151f is a keyboard interface section for receiving information input from the keyboard 153. Reference numeral 151i is a floppy disk drive for storing operation information of the manipulator system in the present embodiment on a floppy disk. 151h
Is a floppy disk controller for controlling the floppy disk drive 151i.
The information saved on the floppy disk is:
The operation teaching data of the observation and treatment slave manipulators can be given.

Reference numeral 151g is a foot switch interface section for detecting the input information of the foot switch 152. At this portion, it is determined whether or not the foot switch 152 is pressed.

Next, the interface of each functional module will be described. 151m shown in the controller 151 is a data bus line. The data bus line 151m sends position data from the microcontroller 151a to the control command interface 151b, reads servo section encoder feedback information on the slave arm side, and up / down counter 151.
e, a magnetic sensor movement amount interface 151d, a keyboard interface unit 151f, a foot switch interface unit 151g, a floppy disk interface unit 151h, and a force sense circuit 151v.

Reference numeral 151k is a signal line for transmitting position command data to a remote position, and is a transmission signal coupling circuit of 154a and 154b, which uses a photo coupler. Reference numeral 154c is a signal transmission line for sending data to a remote position, and adopts a line driver system of RS422 standard. Reference numeral 155a is a DSP for reading the position command data (command to move to) from the control device 151 and performing position control. 155b is a DS
The servo driver 1 uses the control calculation result obtained in P155a.
55c is an analog command line for sending to 55c and a servo section feedback encoder line. 155d is
A force sensor interface circuit for sending information from the force sensor attached to the distal end of the treatment tool 134 to the control device 151.

Reference numeral 151u designates a floppy disk drive 151i and a floppy disk drive controller 1.
It is a data line for exchanging data with 51h. 151t is an interface between the foot switch 152 and the foot switch interface section 151g. 151s is a keyboard 153
And a data line for communicating with the keyboard interface unit 151f.

In the above interface,
Although only the data bus line 151m for transferring data is shown, it goes without saying that an address bus and a control line for selecting each of the functional modules are added.

Reference numeral 151v is for taking in the pressure information from the pressure sensor 143 attached to the distal end grip portion 134e of the treatment instrument 134 through the signal line of 151w, and for calculating the pressure information in the control device 151. It is a force detection circuit for processing data.

Next, the data flow in the control device 151 will be described. Basically, in the master-slave mode, the observation slave manipulator or the treatment slave manipulator operates following the operation of the master arm 138 or the HMD 139. Since the data flow is basically the same for observation and treatment, only the data flow in the controller 151 in the master-slave mode for treatment will be described here.

First, the information of the encoder provided on the master arm 138 is read by the up / down counter 151e. The up / down counter 151e increases / decreases the movement amount with respect to the data initially set in the up / down counter 151e, so that the absolute movement amount (the movement amount of the master arm 138) can be detected. The data held in the up / down counter 151e is stored in the microcontroller 151 every sampling.
The data is fetched into a through the data bus 151m. In the microcontroller 151a, coordinate conversion processing is performed to determine how to operate each axis of the treatment slave manipulator with respect to the movement amount.

Here, in the case of observation, only the inverse coordinate conversion (conversion work for obtaining the joint variable of each link parameter output to each drive unit of the observation slave manipulator from the absolute position and inclination of the magnetic sensor 150) is performed. In the case of treatment, since the master arm 138 is composed of a plurality of links, forward coordinate conversion (coordinate conversion work for obtaining the position and orientation of the tip of the master arm 138) is performed before performing inverse coordinate conversion. It will be necessary to do. The correspondence between the operation of the master arm 138 and the operation slave manipulator will be described later.

When the coordinate conversion processing is performed and the movement amount to each arm of the treatment slave manipulator is calculated,
The command value of this movement amount is sent from the microcontroller 151a to the servo command interface circuit 151b via the data bus 151m. The signal from the servo command interface circuit 151b is sent to the DSP 155a at the remote position via the signal line 154c. The processing in the DSP 155a is performed based on a certain control law (for example, a simple algorithm such as PID control is used). The control calculation result obtained by the DSP 155a is output as an analog command value to the servo driver 155c via the analog command line 155b. This analog command value is used by the servo driver 155.
Amplified by c, the amplified output is output from the servo driver 155c to the motors of the treatment slave manipulator and the observation manipulator. As a result, a motor arranged in the treatment slave manipulator and the observation manipulator drives a mechanism on the slave side to operate the treatment slave manipulator.

Actually, when the operator moves the master arm 138 to treat a target site in the body cavity of the patient 132, the treatment tool 13 by the operation of the master arm 138.
The distal end grip portion 134e of No. 4 is opened and closed, and when the affected part is grasped, the affected part applies a force to the pressure sensor 143. Accordingly, the pressure detection circuit 151v in the control device 151 calculates how much force is currently applied to the grip portion of the treatment instrument 134, and the calculation result is displayed on the screen of the HMD 139 worn by the operator. It is designed to be operated.

In the present embodiment, the treatment tool 13
The force applied to the tip grip portion 134e of No. 4 is visually HMD1
Although it is displayed on 39, a pneumatic device is provided in a portion of the master arm 138 to be gripped by the operator, and the pneumatic device is inflated in proportion to the gripping force to give the operator a feeling of actual treatment. It is also possible to give. Here, a method of detecting the gripping force of the treatment tool by the bilateral method will be described.

FIG. 19 shows the principle of a bilateral method for detecting the grasping force of a treatment tool, which is the ninth embodiment of the present invention. Reference numeral 160 in the drawing of FIG. 19A is a treatment tool body, and a force sensor 161 is provided at the tip of the gripper. The master arm operator grip of 162 is a master actuator 16 that employs pneumatic equipment as shown in the figure.
3 is built in. This actuator 163 is connected to an air compressor 165 via a pipe 166 via an electropneumatic proportional valve 164.

The pneumatic device changes the air pressure in the master actuator 163 by opening and closing the electropneumatic proportional valve 164 by a control signal as shown in FIG. Is controlled. As the control signal, position command information from an encoder (not shown) arranged in the operator grip 162 is output to the treatment slave arm when the operator tries to perform the opening / closing operation, and the force sensor at that time is output. An output proportional to the information of 161 is output to the electropneumatic proportional valve 164. Although a proportional output is used here, it is also possible to give a gripping force to the operator with various sensations by outputting a control signal using a predetermined function.

Next, the specific operation will be described. In the master-slave mode, when the operator moves the Z axis of the coordinate system set at the tip of the master arm 138 in the dotted line direction as shown in FIG. As shown in (b), the Z axis moves along the dotted line. In short, the vector S of the slave arm 135 follows the same movement of the vector M at the tip of the master arm 138.

In order to enable such an operation, the above-mentioned coordinate conversion is performed on the microcontroller 151a side. Thereby, for example, the master arm 138
20A is moved in the Y direction in FIG. 20A, the treatment tool 134 is directed in the Y direction in FIG. 20B, and the movement amount is the same as the movement amount of the master arm 138. The distal end portion of the treatment instrument 134 is curved so that the slave (treatment) arm 135 moves.

In the observation manipulator, the observation arm 137 and the endoscope 136 operate following the operation of the HMD 139 attached to the head, similarly to the above-described operation of the treatment manipulator. For example, HMD1
39 along the dotted line from the point P shown in FIG.
When it is moved to the point (this operation corresponds to the case where the operator advances forward), the slave endoscope 1
36 is T along the dotted line from the point S shown in FIG.
Move to the point.

In particular, when the operator moves the master arm 138 to treat the target site in the body cavity of the patient 132, the treatment tool 134 by the operation of the master arm 138.
The tip gripping part 134e is opened and closed, and when the affected part is grasped, the affected part applies a force to the pressure sensor 143. As a result, the operator can perform the treatment while observing the gripping pressure of the treatment tool 134 displayed on both sides of the HMD 139. This prevents excessive grasping of the affected organ of the patient 132 during the operation. At the same time, treatment tool 1
Since the grip detection means is attached to the touch panel 34, palpation is possible.

In this embodiment, the operation manipulator system provided with the tactile sense providing means for remote control is shown, but as shown in FIG.
The functions of the DSP 155a, the analog command line 155b, the servo driver 155c, and the force sensor interface circuit 155d of FIG. Equipped inside, for observation near the patient
Treatment can also be performed.

According to the above embodiment, the following structure can be obtained. (Supplementary Note 38) A surgical manipulator for performing at least one of observation and treatment of an in-vivo tissue site, operating means for operating the operating manipulator, and operating manipulator based on control information from the operating means. And a force detection means for detecting the force applied between the biological tissue and the surgical manipulator provided in the surgical manipulator for treating the tissue part in the living body. A manipulator system for surgery, which is characterized in that

(Supplementary note 39) The surgical manipulator system according to supplementary note 38, wherein the force detecting means is a pressure sensor. (Supplementary note 40) The surgical manipulator system according to supplementary note 39, wherein the pressure sensor is of a capacitance detection system. (Supplementary Note 41) The surgical manipulator system according to Supplementary Note 39, wherein the pressure sensor is a resistance detection type. (Supplementary Note 42) The surgical manipulator system according to Supplementary Note 39, wherein the pressure sensor is a pressure distribution type sensor.

(Supplementary note 43) The surgical manipulator system according to supplementary note 38, wherein the force detecting means is a strain gauge. (Supplementary Note 44) The surgical manipulator system according to Supplementary Note 38, wherein the observation manipulator is an endoscope. (Supplementary Note 45) The surgical manipulator system according to Supplementary Note 44, further comprising an image display device for outputting the image of the endoscope.

(Supplementary Note 46) The surgical manipulator system according to Supplementary Note 45, wherein the image display device is a display device that can be mounted on the head of the operator. (Supplementary note 47) The surgical manipulator system according to supplementary note 46, wherein the information from the force detecting means is visually displayed on the image display device.

As described above, when performing observation / treatment by the remote-controlled master-slave manipulator,
Since the force information of the treatment tool can be detected, it is possible to avoid movements such as over-grabbing, which makes it possible to secure safety more than that of the conventional master-slave manipulator system, and it is also possible to palpate organs. Therefore, it is possible to maintain the safety and perform the operator's observation and treatment work as in the conventional environment.

Further, in the endoscopic surgical operation system using the master-slave manipulator, the patient can be treated by making at least one hole for inserting the treatment tool in the body wall. Reduced invasion to

[0127]

As described above, according to the present invention, the force sensor for detecting the tactile / force information received by the medical instrument from the living tissue and the medical instrument main body can be attached / detached to each other. Since cleaning and sterilization can be performed separately, cleaning and sterilization of the tip end portion of the medical device can be performed easily and reliably. Further, since the medical instrument body and the force sensor can be washed and sterilized under different conditions, there is an effect that the durability of the force sensor can be improved.

[Brief description of drawings]

1A and 1B show a sensor unit of a medical device according to a first embodiment of the present invention, FIG. 1A is a side view, and FIG.

FIG. 2 shows the same embodiment, (a) is a perspective view showing a part of the gripper, and (b) is a perspective view for explaining the action of the gripper.

FIG. 3 shows the same embodiment, (a) is a side view of the entire medical device, and (b) is a sectional view of a tubular member.

4A and 4B show a modified example of the same embodiment, FIG. 4A is a perspective view of a pressure-sensitive conductive rubber, and FIG. 4B is a perspective view for explaining the action of a gripper.

FIG. 5 shows a medical device according to a second embodiment of the present invention,
(A) is a partial perspective view of a gripper, (b) is a vertical side view of the gripper.

FIG. 6 shows a medical device according to a third embodiment of the present invention,
(A) is a partial perspective view of a gripper, (b) is a vertical side view of the gripper.

7A and 7B show a fourth embodiment of the present invention, in which FIG. 7A is a front view of a sensor unit of a medical device, and FIG.

FIG. 8 shows a gripper according to a fifth embodiment of the present invention,
(A) is a side view, (b) is a plan view.

9A and 9B show a gripper of the same embodiment, FIG. 9A is a perspective view, and FIG. 9B is a side view for explaining the action of the gripper.

FIG. 10 shows a gripper according to a sixth embodiment of the present invention, (a) and (b) are longitudinal side views, and (c) is a perspective view.

FIG. 11 is an overall configuration diagram of a manipulator system for intracorporeal surgery according to a seventh embodiment of the present invention.

FIG. 12 is a perspective view of an operation unit of the master manipulator of the same embodiment.

FIG. 13 is a block diagram of the same embodiment.

FIG. 14 is an overall configuration diagram of a surgical manipulator system according to an eighth embodiment of the present invention.

FIG. 15 is a side view of the treatment tool and the endoscope of the same embodiment.

FIG. 16 shows the gripper of the same embodiment, (a) is a side view of a state of use, (b) is a side view of the gripper, and (c) is a perspective view of the gripper.

FIG. 17 shows a modified example of the same embodiment, (a) is a sectional view of a pressure distribution type sensor, and (b) is a perspective view of the whole.

FIG. 18 is a perspective view of a forceps grasping portion showing a modified example of the same embodiment.

FIG. 19 is a principle diagram of a bilateral treatment instrument gripping force detection method according to a ninth embodiment of the present invention.

FIG. 20 is an operation explanatory view of the master-slave of the embodiment.

FIG. 21 is an overall configuration diagram of the surgical manipulator system of the same embodiment.

[Explanation of Codes] 11 ... Treatment tool main body 13 ... Gripper 26 ... Leaf spring 27 ... Strain gauge

Claims (1)

[Claims] 1. In a medical instrument having a force sensor at its tip and having a function of presenting information detected by the force sensor to an operator, the force sensor is distorted in accordance with a contact state with a living tissue. A medical device characterized in that it is fixed to a sensor holding member, and the sensor holding member is detachably held on the distal end portion.