JPH10262987A - Surgical operation tool holder - Google Patents

Abstract

PROBLEM TO BE SOLVED: To always keep balance to a rotating moment generated at the time of fitting surgical operation tool having various weights by adjusting the reaction force canceling the rotating moment corresponding to the weight of a surgical operation tool provided in a balancing means. SOLUTION: At the time of rotating a connecting arm 11 from a vertical attitude to a horizontal attitude around a rotary shaft 04 while keeping an endoscope 19 fixed to the endscope grasping part 18 of a surgical holder 1, a moment around the rotary shaft 04 is generated by a mass from the arm 11 to the endscope 19. Large and small springs 37 and 38 are elastically deformed by being inserted and held between groove bottom parts 35b, 35c, 35c and spring fixing parts 39c and 40c due to the rotation of a cam plate 33 and its reaction force pushes the plate 33 at the position vertically away from the shaft 04 to keep balance with a moment. Then, even at the time of releasing the hand from the arm 11, the balance is kept and the arm 11 is standstill. Then, reaction force is adjusted by the fastening amount of large and small spring shafts 39 and 40.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical instrument holding device for holding, for example, a treatment tool or an endoscope inserted into a patient's abdominal cavity instead of an operator.

[0002]

2. Description of the Related Art In general, surgical procedures using a rigid medical microscope such as a laparoscope have been advanced and complicated in recent years. For this purpose, a main doctor (hereinafter, referred to as a main surgeon) who performs a procedure carries out a procedure with a treatment tool in both hands. At this time, the assistant carries out the operation in cooperation with the main operator with the treatment tool.

[0003] For this reason, the main surgeon or an assistant performing a joint operation cannot grasp the endoscope for observing the operated part in the abdominal cavity, and cannot grasp the endoscope. (Hereinafter, referred to as an endoscope holder). When the operator wants to change the observation position of the operative site, the endoscope holder can manually change the direction of the endoscope or move the endoscope forward or backward in accordance with instructions from the main surgeon or assistant. ing.

[0004] Therefore, the endoscope holder has to keep holding the endoscope during the operation, and there has been a problem that great labor is required. Furthermore, since there are various medical devices required for the operation and assistants for operating the devices, the operating room is narrow, and the presence of an endoscope holder has the problem of further reducing the space.

Therefore, an endoscope or a treatment tool inserted into a body cavity of a patient is held by an endoscope holding device or a surgical instrument holding device so that a main operator can directly operate the endoscope or the treatment tool. For example, Japanese Unexamined Patent Application Publication No. 7-227398
And Japanese Patent Application Laid-Open No. 8-266556.

[0006] In these devices, the moment due to mass, which is generated when the arm holding the surgical instrument rotates around the joint, is applied by giving a reverse moment that cancels the moment without fixing the joint. Because of the balance, the movement of the joint is smooth and the operability is good.

[0007]

However, the apparatus disclosed in Japanese Patent Application Laid-Open No. Hei 7-227398 can be balanced with surgical instruments of various weights, but requires a counterweight to increase the mass of the apparatus. However, there is a problem that the whole becomes large. Japanese Patent Application Laid-Open No. 8-266556 can reduce the size and weight, but has a problem that it cannot cope with surgical instruments of various weights because the weight that can be balanced is limited.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a surgical instrument holding device which is small and lightweight, and which can accommodate surgical instruments of various weights.

[0009]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention is configured to balance a rotational moment caused by a mass generated when an arm holding a surgical instrument rotates around a rotation axis. A moving direction converting means for converting the rotational movement into a linear movement, a linear sliding means sliding in a linear direction by the action of the moving direction converting means, and a sliding of the linear sliding means. And a balancing means for applying a reaction force for canceling the rotational moment to the linear sliding means in the direction, the balancing means being elastically changed by the movement of the linear sliding means, and And a reaction force adjusting means for arbitrarily adjusting a reaction force from the elastic means.

[0010] According to the above configuration, by adjusting the reaction force for canceling the rotational moment according to the weight of the surgical instrument provided in the balancing means, it is generated when surgical instruments of various weights are attached. It is always balanced against various rotational moments.

[0011]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 16 show a first embodiment. FIG. 1 shows a schematic configuration of a surgical instrument holding device 1, which has a mounting portion 2 which is detachably engaged with a base such as an operating table. A column 3 is erected on the mounting portion 2 along the vertical direction. Connecting rod 5 is connected via a first joint 4 rotatable about a rotation axis O ₁ of the vertical direction on the upper end of the column 3.

[0012] pivot arm 7 to the upper portion via a second joint 6 that is rotatable about an axis of rotation O ₁ and substantially perpendicular to the rotation axis O ₂ of the connecting rod 5 is connected. This second joint 6
Pivots so that the swivel arm 7 is folded on the column 3 during storage and carrying, and at the time of setting, the swivel arm 7
Are fixed so as to turn substantially horizontally.

A horizontal arm 9 is connected to the other end of the revolving arm 7 via a third joint 8 rotatable about a vertical rotation axis O ₃ . In the horizontal arm 9, that with respect to the main body 10, the connection arm 11 is rotatably supported in a substantially horizontal direction about the rotation axis O ₄ of. A raising arm 13 is connected to the other end of the connection arm 11 via a raising arm attaching / detaching portion 12, and the connection arm 11 and the raising arm 13 are connected to each other.
Is configured to be detachable in a raising arm attaching / detaching portion 12.

The other end of the raising arm 13 has a vertical rod 1
4 is connected, also in a vertical rod 14, a horizontal rod 16 via a fourth joint 15 rotatable about a rotation axis O ₅ of the substantially horizontal direction are coupled. At the other end of the horizontal rod 16, the endoscope holding portion 18 around the rotation axis O ₆ substantially perpendicular to the rotation axis O ₅ via a rotatable fifth joint 17 are connected. The endoscope holding portion 18 are rotatably supported around a rotation axis O ₇ in which the endoscope 19 to the endoscope center axis substantially coincides.

With the above configuration, the column 3 to the connecting rod 5
Is the rotation axis O ₁ , the connecting rod 5 and the swing arm 7 are the rotation axis O ₂ , the swing arm 7 to the horizontal arm 9 are the rotation axis O ₃ ,
Body 10 and connecting arm 11 in the rotation axis O _4, the vertical rods 14 to the horizontal rod 16 in the rotation axis O _5, the horizontal rod 16
The ~ endoscope holding portion 18 in the rotation axis O _6, an endoscope holding portion 18
~ Endoscope 19 are rotatably coupled to each the rotation axis O _7. The connection arm 11 to the raising arm 13 are configured to be detachable.

Next, the structure of the horizontal arm 9 will be described with reference to FIG. The connection arm 11 is rotatable with respect to the main body 10 about a substantially horizontal rotation axis O ₄ , and the rotation angle is regulated by stoppers 20 and 21 provided on the main body 10. In the present embodiment, the connection arm 11 rotates about 90 ° from the vertical posture to the horizontal posture.

Here, let us consider the moment due to the mass rotating around the rotation axis O ₄ . FIG. 3 shows the mass of the endoscope 19 as m ₁ , the mass from the connection arm 11 to the endoscope gripper 18 as m ₂ (the center of gravity is at the center), and the center of gravity of the endoscope 19 from the rotation axis O _4. Is a conceptual diagram when a distance to the vertical axis is L and an inclination angle θ of the connection arm 11 with respect to a vertical axis. This figure can be shown as in FIG. 4 by considering the masses m ₁ and m ₂ as mass points.

The moment M due to the mass, M = time _{(m 1 + m 2/2} ) × L × sinθ ... (1) tilt angle becomes equation 0 ° (connecting arm 11 is vertically positioned), the moment M is minimum When the inclination angle is 90 ° (the connecting arm 11 is in a horizontal posture), the moment is the maximum (m ₁ +
a m _2/2) × L.

As shown in the above equation, the moment M with respect to the inclination angle θ draws a non-linear sin curve as shown in FIG. Hereinafter, the structure of the horizontal arm 9 having the connection arm 11 that can be balanced with the moment M regardless of the inclination angle θ will be described.

The structure of the main body 10 will be described below with reference to FIG. 6, which is a cross section taken along the line BB 'of FIG. The box main body 22, which is a main component of the main body 10, is a part provided with two concave spaces 22a and 22b. The concave space 22a is provided with a balance mechanism as balancing means, and the concave space 22b is provided with a brake mechanism as linear sliding means. The balance mechanism and the brake mechanism will be described later.

On both sides of the box body 22, a right-side cover 23 of a plate-like member covering the two concave spaces 22a and 22b is provided.
The left cover 24 is fixed by a plurality of screws 25, for example, as shown in FIG.

[0022] the back to FIG. 6 right side cover 23 and the left cover 24, a circular hole 23a around the rotary shaft O _4, respectively, of FIG 1, and 24a are provided, made of a resin as a bearing arm bushes 26 The arm shaft 27 is rotatably supported via.

The arm shaft 27 is a shaft whose both ends are cut into a D-shape as shown in FIG. 7 which is a cross section taken along the line CC 'of FIG. D-shaped irregular hole 28a of plate 28 and left arm plate 2
The nine D-shaped holes 29a are fitted and fixed in the rotation direction of the arm shaft 27.

Referring back to FIG. 6, the right arm plate 28 and the left arm plate 29 are L-shaped bent plates.
1. Further, the right arm plate 28 and the left arm plate 29 are connected to the raising arm attaching / detaching portion 12 in the following configuration.

The deformed shaft 12a of the elevating arm attaching / detaching portion 12
The deformed hole 28b of the right arm plate 28 and the left arm plate 29
Of the bolt 3
0, the right arm plate 28, the left arm plate 29 and the raising arm attaching / detaching portion 1 are fastened together with the raising arm attaching / detaching portion 12 and fixed in the axial direction.
2 is fixed. Further, at both ends of the arm shaft 27, stoppers 31 are fixed by screws 32.

With the above construction, the right cover 23 and the left cover 24 of the main body 10 rotatably support the arm shaft 27 around the rotation axis O ₄ via the bush 26 made of resin, and Is prevented. Thus, it is rotatably supported by the rotary shaft O ₄ around the connecting arm 11 which is fixed to the arm shaft 27.

Next, the balance mechanism will be described with reference to FIG. 8, which is a cross section taken along line DD 'of the concave space 22a of FIG. A cam plate 33 is provided in the concave space 22a. The cam plate 33 is a plate-shaped member having a cam surface 33a and a deformed hole 33b, and the deformed hole 33b of the cam plate 33 is attached to the deformed shaft 27a of the arm shaft 27. The cam plate 33 and the arm shaft 2 are fitted together and fixed in the rotation direction, and are fixed in the axial direction by screws 34.
7 is fixed. Therefore, by the rotation about the rotation axis O ₄ of the connecting arm 11 which is connected to the arm shaft 27, the cam plate 33 also rotates.

FIG. 8 is a view showing the state of the cam plate 33 when the connecting arm 11 is in the horizontal position, and FIG. 9 is a view showing the state of the cam plate 33 when the connecting arm 11 is in the vertical position. The cam surface 33a of the cam plate 33 is in contact with a roller 36 provided in a spring case 35 described later.

In the concave space 22a, the spring constant is k
One large spring 37, which is an _L compression spring, and a spring constant k
Two small springs 38, which are _S compression springs, are provided in parallel. These springs have a large spring shaft 39 and a small spring shaft 40.
Are used as inner guides, and the spring case 35 is used as an outer guide.

The large spring shaft 39 has a male screw 39a and a flange 3
9b and a spring fixing portion 39c, which is screwed into the female screw 22c of the box body 22, and is fixed at a position where the flange 39b abuts on the box body 22. The end of the large spring 37 is fixed to the spring fixing portion 39c.

On the other hand, the small spring shaft 40 has a male screw 40a, a grip portion 40b, and a spring fixing portion 40c.
After being screwed into the female screw 22d, the retaining screw 41 is tightened. The spring direction of the small spring shaft 40 is the gripper 4
Until the position at which Ob contacts the box body 22 (the state of FIG. 8), the locking screw 41 is
Is configured to be movable in the axial direction within a range of a position (the state of FIG. 10) corresponding to the concave space 22a side. Spring fixing part 40
As for c, the end of the small spring 38 is fixed.

Here, the arm shaft 27 side of the spring case 35 has a U-shaped portion 35a (see also FIG. 6), and a hollow cylindrical roller 36 has a roller shaft 42 whose both ends are supported by the U-shaped portion 35a. And are rotatably supported. Roller 36
, The cam surface 33a of the cam plate 33 is in contact as described above.

Around the spring case 35, a concave space 22a is provided.
A sliding plate 43 made of resin as a linear sliding means for improving the slidability in the inside is fixed by screws 44. Further, as described above, the spring case 35 is provided with the spring accommodating groove, and the bottoms 35b, 35c, 35c of the groove come into contact with the ends of the large spring 37 and the small spring 38.

With the above configuration, when the connecting arm 11 rotates counterclockwise, the cam plate 33 also rotates counterclockwise,
The cam surface 33a of the cam plate 33 is fixed from the rotational axis O ₄ bottom 35b of the roller 36 to the roller shaft 42 to the spring case 35 to the groove at a position away l vertically, 35c, 35c to the box body 22 through the The large spring 37 and the small spring 38 supported by the large spring shaft 39 and the small spring shaft 40 are elastically deformed by pushing horizontally.

Here, the dimensions and the shape of the cam surface 33a for elastically deforming the spring will be described. The spring constant of the springs arranged in parallel is k _L for the large spring 37 and k _S for the small spring 38.
Thus, the total spring constant k of one large spring and two small springs
Is given by k = k _L + k _S (2) Further, assuming that the amount of elastic deformation of the spring is x, the reaction force F ′ generated by the elastic deformation of the spring is represented by F ′ = kx (3). Further, the reaction force F ′ pushes the cam plate 39 at a position vertically away from the rotation axis O ₄ via the roller 36, so that the moment M ′ generated by the reaction force F ′ is M ′ = F ′. l ... Equation (4) is obtained. The shape of the cam surface 33a at which the moments M and M ′ due to the mass are the same at each inclination angle θ is determined.

As described above, the two small spring shafts 40 are movable from the position shown in FIG. 10 to the position shown in FIG. 8, but the position shown in FIG. The position farthest from O ₄ in the horizontal direction) is set to a position where the two small springs 38 are not elastically deformed even when the connection arm 11 is in the horizontal posture.

FIG. 11 shows a state in which the small spring shaft 40 is tightened on only one side. In this state, the upper small spring 38 does not function, and the total spring constant k of the springs arranged in parallel is also small as k = k _L + k _S. Thus, a mechanism for adjusting the elastic force by turning on / off the function of the spring is configured.

[0038] The recessed space 22a back to FIG. 8, also rotating torque adjustment mechanism 45 is provided for adjusting the rotational torque around the rotation axis O ₄ of the arm shaft 27. FIG. 12 shows the rotation torque adjusting mechanism 45 extracted from FIG.

The rotating torque adjusting mechanism 45 includes a clamp-shaped metal friction plate 46, resin friction blocks 47 and 47 for supporting the arm shaft 27, a tightening screw 48, and a screw 4.
9,49. The screws 49, 49 connect the friction plate to the concave space 2.
2a. The friction plate 46 has a space 46a and a female screw portion 46b.
7, 47 are round shaft portions 27c of the arm shaft 27 (see also FIG. 7).
It is provided to support. A tightening screw 48 is fastened to the female screw portion 46b of the friction plate 46, and the space 46a is narrowed substantially in the vertical direction in the figure according to the amount of tightening so that the arm shaft 27 is moved through the friction blocks 47, 47. A load is applied to the outer peripheral surface to generate friction, and the rotation torque adjusting mechanism 45 is configured so that the arm shaft 11 does not rotate at a certain torque or less.

Next, the brake mechanism provided in the concave space 22b of FIG. 6 will be described. E of the concave space 22b in FIG.
FIG. 13 shows a section taken along the line −E ′. In FIG. 6, a lever arm 50 is a long prismatic member, and a lightening groove 5 for reducing the weight.
0a, 50b and a through hole 50c are provided. Press rods 51 and 52 are fixed to both ends by screw connection.

As shown in FIG. 13, a lever guide U53 and a lever guide D54 as upper and lower guides of the lever arm 50 are fixed to the box body 22 by a plurality of screws 55. A spacer 56 receiving a force in the compression direction of the lever guide U53 and the lever guide D54 is fastened and fixed together with the lever guide U53, the lever guide D54, the box body 22, and the screw 57. Spacer 5
6 is provided in the through hole 50c of the lever arm 50, and is not interfered by the movement of the lever arm 50.

As shown in FIG. 6, the lever guide U5
3. The other end of the lever guide D54 is fixed by a screw 59 with a guide connecting member 58 interposed therebetween, and similarly receives a force in the compression direction of the lever guides 53U and 54D. A pressing rod 60 is fixed to the guide connecting member 58 by screw connection.

As shown in FIG.
Is rotatably supported by a lever shaft 61 supported by the hole 53a of the lever guide U53 and the hole 54a of the lever guide D54. The lever shaft 61 is prevented from coming off in the axial direction by being connected to the stopper 62 and the screw 63. Further, between the lever arm 50 and the lever guide U53 and the lever guide D54, the height direction of the lever arm 50 (the axial direction of the lever shaft 61).
Are provided as resin supports. The notch 22e of the concave space 22b is also provided as a support in the height direction of the lever arm 50.

In the hole 53b of the lever guide U53 and the hole 54b of the lever guide D54, bushes 65, 65 are provided.
These rotatably support the shaft 66a of the joint block 66, which is a component of the third joint 8 described above.
At the end of the shaft portion 66a, there is a screw portion 66b.
By tightening 7, the shaft is compressed in the axial direction, adjusted to a constant rotational torque, and fixed. The joint block 66 has a hole 66c, and the end of the turning arm 7 is fixed by a fastening means such as a screw (not shown).

In the concave space 22b, a brake plate 68 is provided with its modified hole 68a fitted to the modified shaft portion 27b of the arm shaft 27, and the brake plate 68 rotates with the rotation of the connection arm 11. On the other hand, the brake plate 68 is
Are not fixed in the axial direction, but are slidable.

The male screw portion 69a of the F / L knob 69 is screwed into the left cover 24 fixed to the box body 22. When the F / L knob 69 is rotated in the direction of the arrow in FIG. 13, the male screw portion 69a is propelled, and in FIG. 6, the lever arm 50 is pushed downward in the figure. Further, a stopper 70 and a stopper 71 for regulating the rotation amount of the F / L knob 69, that is, the propulsion amount of the male screw portion 69a are provided.

FIG. 1 is a conceptual diagram showing the periphery of the lever arm 50 in FIG.
It is shown in FIG. In FIG. 14, the lever arm 50 has a lever shaft 61 as a fulcrum, and the driving force F _A of the male screw portion 69a of the F / L knob 69.
, A rotational moment indicated by an arrow is generated around the lever shaft 61. This moment is the lever arm 50
F _B to the pressing rod 51 and 52 provided at both ends of each of
It is configured to provide a force of F _C.

Lastly, the structure of the second joint 6 (around the rotation axis O ₂₎ will be described with reference to FIG. 15 is a F arrow in FIG. A swing arm joint 72 is connected to the swing arm 7, and a connection rod joint 73 is connected to the connection rod 5, and these constitute the second joint 6. A stopper 74 is fixed to the connecting rod joint 73. The pivot arm joint 72 has the first
Abutting portion 72a and a second abutting portion 72b.

FIG. 16 shows a cross section taken along line GG ′ of FIG. The turning arm joint 72 is provided with a tapered convex portion 72c, which is fitted into a tapered concave portion 73a of the connecting rod joint 73.

A shaft 75 is fixed to the revolving arm joint 72 by means such as a screw (not shown). The shaft 75 has a male screw portion 75a at the other end, and passes through a resin washer 76 and a knob 77. , And is fixed by being screwed into the retaining ring 78.

Next, the operation of the surgical instrument holding device configured as described above will be described. First, to describe the balancing mechanism, in the state of attaching the endoscope 19 to the endoscope holding portion 18 of the surgical holding device 1 shown in FIG. 1, the rotation axis O ₄ around the connecting arm 11 shown in FIG. 2 in the figure so that from the vertical position to a horizontal position, is rotated in the counterclockwise direction, the moment M around the rotation axis O ₄ by mass reaching the connecting arm 11 to endoscope 19 is generated. The moment M is the M = As shown in (1) (M ₁ + m _2/2)
× L × sin θ, and the moment M with respect to the rotation angle θ draws a sin curve as shown in FIG.

The rotation about the rotation axis O _{4 is performed} about the arm shaft 27 shown in FIG.
3 also rotates counterclockwise. Surface 33 of cam plate 33
a is the roller 36 to the roller shaft 42 to the bottom 35 of the groove of the spring case 35 at a position vertically away from the rotation axis O ₄ by l.
b, 35c, and 35c, a large spring shaft 39 fixed to the box body 22 and a large spring 37 supported by the small spring shaft 40
Then, the small spring 38 is pressed to be elastically deformed.

When the spring is elastically deformed, a reaction force F 'proportional to the spring constant k and the elastic linear amount x is generated as shown in the above equations (2) and (3). When the large spring shaft 39 and the two small spring shafts 40 in FIG. 8 are all tightened into the box main body 22, the rotation of the cam 33 causes the large spring 37 and the two small springs 38 to respectively reach the bottom of the groove. 35
b, 35c, 35c to spring fixing portions 39c, 40c, 40
It is elastically deformed by being sandwiched between c. That is, the large spring 37 and the two small springs 38 function.

In the state shown in FIG. 8, the total spring constant k of the springs arranged in parallel is a value obtained by adding the spring constants of the functioning large spring 37 and the two small springs 38, and k = k _L +2 k S. Become. The reaction force F 'is determined by the product of the spring constant k and the amount of elastic deformation x.

Here, since the reaction force F ′ pushes the cam plate 33 at a position vertically away from the rotation axis O ₄ by l, the moment M ′ due to the reaction force F ′ is M ′ = F′l. Become.
Here, the shape of the cam surface 33a is designed so that the moment M due to the mass and the moment M ′ due to the reaction force F ′ are balanced at any rotation angle θ.
1 is rotated to an arbitrary rotation angle θ, and the connection arm 11 is kept stationary even when the hand is released.

Here, a case where the endoscope 19 shown in FIG. 1 is replaced with a lighter one and used will be described below. The large spring shaft 39 and the two small spring shafts 40 in FIG.
When the endoscope 19 is replaced with a light one in a state where the endoscope 19 is tightened, the moment M due to the mass decreases, whereas the moment M ′ due to the reaction force F ′ of the spring does not change.
<M ', the balance is lost, and the balance cannot be obtained.

At this time, M ′ becomes smaller as M becomes smaller.
Should also be reduced. As shown in FIG. 11, the upper small spring shaft 40 is moved (in the tightening direction) until the retaining screw 41 hits the concave space 22a of the box body 22 and does not move. Small springs 38 of the spring fixing portion 40c of the case upper small spring shaft 40 above by away from the rotation axis O ₄ is elastically deformed between the bottom 35c~ spring fixing portion 40c of the groove connecting arm 11 even when the horizontal position It is not possible, that is, the upper small spring does not work.

As a result, the spring constant k becomes smaller as k = k _L + k _S , so that the reaction force F ′ (= kx) also becomes smaller.
M ≒ M '. When a lighter endoscope 19 is used, the two small springs 40 are loosened together as shown in FIG. 10 so that the two small springs 38 do not function and the overall spring constant k = k _L is reduced. It can be balanced by making it smaller.

The torque adjusting mechanism 45 shown in FIG.
By tightening the tightening screw 48 into the female screw portion 46b of the friction plate 46, the space 46a is narrowed in the vertical direction in the drawing,
A load is applied to the outer peripheral surface of the arm shaft 27 via the friction blocks 47, 47 to generate friction. Due to this friction, the arm shaft 11 does not rotate with a torque less than a certain value.

Therefore, even if M and M 'are slightly different from each other, a torque equal to or less than a predetermined value is canceled by the rotation torque adjusting mechanism 45, so that a balance can be obtained. Next, the operation of the brake mechanism will be described.

The F / L knob 69 in FIG. 13 switches between F (free) and L (lock) for rotation around the rotation axes O ₃ and O ₄ by rotating from a horizontal position to a vertical position in the figure. When the F / L knob 69 rotates from the horizontal posture to the vertical posture, the male screw portion 69a of the F / L knob 69 is screwed into the left cover 24 with a predetermined propulsive force.

As shown in FIG. 6, the male screw portion 69a presses the lever arm 50 having the fulcrum 61 with a predetermined propulsive force.
As shown in FIG. 14 as a conceptual diagram, the propulsion force F _A by the screw is applied to the lever arm 50 as a power point, and generates a moment around the lever shaft 61 as a fulcrum. This moment, each pressure rod 51 and 52 provided at both ends of the lever arms 50 F _B, empowering the F _C.

[0063] Here, the force F _B acts in the figure downwards as shown in FIG. 7, the brake plate 68 is locked by being sandwiched between the pressing rod 51 and the box body 22. Here, since the arm shaft 27 and the brake plate 68 are fixed so as not to rotate relative to each other, the arm shaft 27 is also locked, and the connection arm 11 connected thereto is also locked. Thus, rotation around the rotation axis O ₄ is locked. Incidentally, the arm shaft 27 and the brake plate 68 for axially not connected, the force F _B not transmitted to the connecting arm 11.

On the other hand, the force F _C acts upward in the figure as shown in FIG. 6, and the shaft portion 66a of the joint block 66 is locked by being pinched between the pressing rod 52 and the pressing rod 60, thereby rotating the joint block 66. axis O ₃ rotation around is locked.

When it is necessary to make the apparatus compact, for example, when carrying the apparatus, the raising arm 1 is detached from the raising arm attaching / detaching portion 12 shown in FIG.
After removing ₃ , the turning arm 7 and the horizontal arm 9 are rotated about the rotation axis O ₃ of the third joint 8 so as to be substantially parallel,
Thereafter, the turning arm 7 is rotated from the state shown in FIG.
_By turning around ₂ counterclockwise in the figure, it can be folded compactly. In FIG. 15, the second abutting portion 72b provided on the turning arm joint 72 rotates until it comes into contact with the stopper 74 provided on the connecting rod joint 73 (the position indicated by the two-dot chain line in FIG. 15).

After the rotation, as shown in FIG.
By tightening the 7, meshing by tapered protrusion 72c and the tapered recess 73a is pressed, not rotate about the rotation axis O _2. Because of the engagement by the taper, a sufficient amount of fixing force is generated even with a weak pressing force.

On the other hand, at the time of setting, the engagement of the tapered portion is released by loosening the knob 77.
By rotating the middle swing arm 7 clockwise, the first abutting portion 7 is rotated.
After the 2a is brought into contact with the stopper 74, again
By tightening the knob 77 to prevent rotation to the rotary shaft O ₂ around.

In this embodiment, a compression spring is used as an elasticity compensating element for achieving balance. However, the present invention is not limited to this, and other springs, hydraulic systems, gas pressure systems, compressed air systems, and the like may be used. .

The number of springs is not limited to three, but may be two or four or more. Further, the spring constants of the three springs of the present embodiment are two types, and one spring is always kept functioning. However, the present invention is not limited to this, and the spring constants of all three springs may be changed or three springs may be changed. By making the function ON-OFF, the spring constant may be finely changed.

In this embodiment, the unit composed of the large spring and the large spring shaft is screwed into the box body and fixed. However, the present invention is not limited to this. And the like, and may be configured to be replaceable (by a user) by a unit including a large spring and a large spring shaft having different spring constants.

Further, the spring function may be turned on and off by propelling the spring shaft by a cam or the like instead of the screw. In this embodiment, the arrangement of the springs is 3 on the same plane.
Although the two springs are arranged in parallel, they may be arranged in series. Also, a multi-start thread may be used for the thread portion of the small spring shaft and the box body so that the small spring shaft can be largely moved in the axial direction with a small rotation.

FIGS. 17 to 21 show a second embodiment.
In this embodiment, three springs are arranged in parallel on the same plane in the first embodiment, but springs are arranged on the same axis. Except that the springs are arranged on the same axis and that the function ON / OFF means of the springs is changed, it is the same as the first embodiment, so only the changed parts will be described.

A spring case 80 is provided in the concave space 79a of the box body 79. The spring case 80 is provided with a spring accommodating groove 80a, in which three compression springs 81, 82 and 83 having different diameters are accommodated coaxially. It is fixed to the bottom 80b of the groove by means such as adhesion.

The spring constants of these three compression springs 81, 82 and 83 are k _a , k _b and k _c , respectively. Further, a spring guide 84 as a guide inside the spring is fixed to the box body 79.

A spring constant adjusting knob 85 is provided outside the box body 79, and this knob 85 is attached to the box body 79.
The shaft 86 is rotatably supported by the shaft 86. Shaft 86
A C-ring 87 is fixed in the concave space 79a, and the box body 79 is sandwiched between the C-ring 87 and the spring constant adjustment knob 85, so that the box body 79 does not come off in the axial direction. A spring stopper 88 is fixed to the other end of the shaft 86.

FIG. 18 shows a cross section taken along line HH ′ of FIG. The spring stopper 88 is a member having a cutout 88a at the center of the plate. As shown in FIG. 18, when the spring constant adjusting knob 85 is in the horizontal posture, the three compression springs 81, 82, 83
Passes through the notch 88a. Here, by rotating the spring constant adjusting knob 85 counterclockwise in the figure, the spring stopper 88 rotates about the shaft 86. The spring constant adjusting knob 85 is rotated counterclockwise by 20 °, 40 °, 60 ° from a vertical position (0 °) by a clip means and a stopper (not shown).
, And rotate in increments of 20 °. FIG. 19 shows 20 °, FIG.
FIG. 21 shows the state of the spring stopper when rotated by 40 °, and FIG. 21 shows the state of the spring stopper when rotated by 60 °.

Next, the operation of the second embodiment will be described. In FIG. 18, the spring constant adjustment knob 85 is set to 2
When it is rotated counterclockwise by 0 °, the state shown in FIG. 19 is obtained. In this state, the compression spring 82 and the compression spring 83 are at positions where they can pass through the notch 88a of the spring stopper 88,
The compression spring 81 is not in a position where it can pass.

When the connection arm or cam (not shown) rotates the spring case 80 to the right in FIG. 17, only the compression spring 81 is moved to the bottom 80 of the groove of the spring case 80 as described above.
b to the spring stopper 87,
Assuming that the displacement amount is x, an output F ₁ ′ = k _ax is generated.

Here, when the moment due to mass is large such as when the endoscope is heavy, the spring constant adjusting knob 85 may be turned by 40 ° and 60 ° as shown in FIGS. As a result, the groove bottom 80b to the spring stopper 87
Spring respectively is compressed between the compression spring 81 and the compression spring 82, a compression spring 81 compression spring 82 and the compression spring 83, and the output also respectively _{(k a + k b) x} , (k a + k b
+ K _c ) x, which can cope with a large moment due to mass.

Therefore, in addition to the effects of the first embodiment, the size can be reduced by arranging the springs coaxially. Also, since the stopper is inserted in the radial direction, the O
N-OFF operation can be performed with one touch, and operability is good.

FIGS. 22 to 25 show a third embodiment.
In the present embodiment, the amount of installed force of the spring, which is always constant in the first embodiment, can be changed. The other parts are the same as those of the first embodiment, and the same parts are denoted by the same reference numerals and description thereof will be omitted.

The small spring shaft 89 shown in FIG.
a, a grip portion 89b, a spring fixing portion 89c to which the small spring 38 is fixed, and an index 89d are provided. The shaft is supported by the female screw 22d of the box body 22.

As shown in FIG. 22, in a state where the index 89d appears to be substantially coincident with the surface of the box body 22, if the connecting arm 11 is in the vertical posture, the small spring 38 is not elastically deformed, and the connecting arm 11 is As soon as it starts to tilt from the attitude to the horizontal attitude, the small spring 38 is elastically deformed. Under this condition, the installed force of the small spring 38 is “0”.

On the other hand, in a state where the index 89d extends the small spring shaft 89 from the state of FIG. 22 outward (to the right in the drawing) from the surface of the box body 22, the small spring 38 is elastic when the connecting arm 11 is in the vertical posture. Connection arm 1 not deformed
When 1 is inclined from the vertical posture to the horizontal posture and exceeds a predetermined angle (determined by the amount of pulling out the small spring shaft 89), the small spring 38
Starts elastic deformation. Under this condition, the installed force of the small spring 38 is “negative”.

Further, when the small spring shaft 89 is tightened inward from the surface of the box body 22 (to the left in the figure) from the state shown in FIG. 22 (see FIG. 23), the connection arm 11 is in the vertical posture. The small spring 38 has already been elastically deformed, and is further elastically deformed by the inclination angle of the connection arm 11. Under this condition, the installed force of the small spring 38 is “positive”. In other words, the small spring 38 has a structure in which the amount of installed power of the small spring 38 can be changed by screwing in the small spring shaft 89.

In the first and second embodiments, the state I shown in FIG.
As shown in the figure, an axis 11a for determining the posture of the connection arm 11
On the other hand, it is assumed that the entire center of gravity 19a of the rotating member extending from the connection arm 11 to the endoscope 19 is on the shaft 11a, but the entire center of gravity 19a is on the shaft 11a as in the state J or the state K. When there is no connection arm 11, the moment due to mass is not zero even when the connection arm 11 is in the vertical posture (see FIG. 25).

When the overall center of gravity 19a is on the left side of the figure with respect to the shaft 11a as in the state J in FIGS. 24 and 25, a moment due to mass has already been generated even when the shaft 11a is in a vertical posture. In such a case, as shown in FIG.
By screwing the index 89d into the box body 22,
The initial mounting force of the spring is set to “positive”, the moment generated by the spring is shaped similarly to the state J in FIG. 25, and the initial moment due to the mass can be canceled.

On the other hand, as shown in the state K in FIGS.
When the overall center of gravity 19a is on the right side in the figure with respect to 1a, the axis 1
When 1a is in the vertical position, the moment due to mass is
It occurs clockwise around ₄ . However, this moment is canceled by a stopper or the like (not shown). Then, by rotating by a predetermined angle toward the horizontal posture, the moment due to mass becomes zero. In such a case, the index 89d pulls the small spring shaft 89 out of the surface of the box body 22 (to the right in the drawing) from the state shown in FIG. Generated in the same manner as the state K in FIG. 25, the initial moment due to mass can be canceled.

[0089] Incidentally, in this state K, to the extent that the shaft 11a is 0 moment by the vertical posture-mass, moment by mass is generated in the clockwise direction about the rotation axis O _4, a spring to offset this by but moments absent, may be dealt with by increasing the friction around the rotation axis O _4, on the other hand.

Incidentally, even if the position of the center of gravity changes, it can be dealt with by adjusting the screwing amount. When the weight of the endoscope 19 is heavy, the function of the small spring is turned on in the first embodiment.
In this embodiment, the spring constant is increased. However, as in the present embodiment, the moment can be increased by increasing the initial equipment power to cope with the problem.

By raising the bottom, M by a mass at a specific angle
And it can be dealt with also increasing the friction around the rotation axis O ₄ relative to be difficult to take the corresponding balance of M 'by a spring. Therefore, even if the position of the center of gravity of the mass deviates from the predetermined position, the balance can be maintained, so that it is possible to cope with many endoscopes and the versatility is high.

Further, since the moment due to various types of mass can be balanced with a small number of springs, the device can be reduced in size and weight. According to the embodiment, the following configuration is obtained.

(Supplementary Note 1) In a surgical instrument holding device configured to balance a rotational moment caused by a mass generated when an arm holding a surgical instrument rotates about a rotation axis, the rotational motion is converted into a linear motion. A moving direction converting means for converting, a linear sliding means which slides in a linear direction by the action of the moving direction converting means, and a reaction force for canceling the rotational moment in the sliding direction of the linear sliding means. Equilibrium means to be added to the sliding means, wherein the equilibrium means is elastically changed by the movement of the linear sliding means,
A surgical instrument holding device comprising: an elastic means for generating an output serving as a reaction force of the rotational moment; and a reaction force adjusting means for arbitrarily adjusting a reaction force from the elastic means.

(Supplementary note 2) The surgical instrument holding device according to supplementary note 1, wherein the elastic force of the elastic means changes according to the sliding amount of the linear sliding means. (Supplementary note 3) The surgical instrument holding device according to Supplementary note 1, wherein the balancing means includes a plurality of elastic means. (Supplementary note 4) The surgical instrument holding device according to supplementary note 3, wherein a reaction force can be adjusted by selectively using the plurality of elastic means. (Supplementary note 5) The surgical instrument holding device according to Supplementary notes 1 to 4, wherein the elastic means is a spring. (Supplementary note 6) The surgical instrument holding device according to Supplementary notes 1 to 4, wherein the elastic means is a compression spring.

(Supplementary note 7) The surgical instrument holding device according to supplementary note 1, wherein the movement direction converting means is a cam. (Supplementary Note 8) The ratio of converting the rotational motion of the motion direction converting means into a linear motion is represented by θ, the rotational angle of the arm from a reference position with the vertical posture state of the arm as a reference position, and the sliding from the reference position. 2. The surgical instrument holding device according to claim 1, wherein x ≒ Asin θ when a linear movement amount of the means is x and a constant is A.

[0096]

As described above, according to the present invention, there is an effect that a small and lightweight surgical instrument having various weights can be used, and operability can be improved.

[Brief description of the drawings]

FIG. 1 is a schematic perspective view of an entire surgical instrument holding device according to a first embodiment of the present invention.

FIG. 2 is a view taken in the direction of arrow A in FIG. 1;

FIG. 3 shows a moment due to the mass that rotates the rotary shaft O ₄ around the same embodiment.

FIG. 4 shows the moment due to the mass that rotates the rotary shaft O ₄ around the same embodiment.

FIG. 5 is a view showing a moment with respect to a tilt angle θ in the embodiment.

FIG. 6 is a sectional view taken along line BB ′ of FIG. 2;

FIG. 7 is a sectional view taken along the line CC ′ of FIG. 6;

FIG. 8 is a cross-sectional view taken along the line DD ′ of FIG. 6, with the connecting arm in a horizontal posture.

FIG. 9 is a cross-sectional view taken along the line DD ′ of FIG. 6, with the connection arm in a vertical posture.

FIG. 10 is a sectional view taken along the line DD ′ in FIG.

FIG. 11 is a sectional view taken along the line DD ′ in FIG. 6, illustrating the operation of the spring shaft.

FIG. 12 is a sectional view of the rotation torque adjusting mechanism of the embodiment.

FIG. 13 is a sectional view taken along the line EE ′ of FIG. 6;

FIG. 14 is an explanatory diagram of the operation of the lever arm in the embodiment.

FIG. 15 is a view as seen in the direction of arrow F in FIG. 1;

FIG. 16 is a sectional view taken along the line GG ′ of FIG. 15;

FIG. 17 is a cross-sectional view of a box main body showing a second embodiment of the present invention.

FIG. 18 is a sectional view taken along the line HH ′ in FIG. 17;

FIG. 19 is a view when the spring constant adjusting knob of the embodiment is rotated by 20 °.

FIG. 20 is a view when the spring constant adjustment knob of the embodiment is rotated by 40 °.

FIG. 21 is a view when the spring constant adjusting knob of the embodiment is rotated by 60 °.

FIG. 22 shows a third embodiment of the present invention, and is a cross-sectional view in a state where a small spring shaft is loosened.

FIG. 23 is a sectional view of the same embodiment, in which a small spring shaft is tightened;

FIG. 24 shows the same embodiment, and is an explanatory view of a connection arm.

FIG. 25 shows the same embodiment, and is an explanatory view of a connection arm.

[Explanation of symbols]

 9 Horizontal arm 11 Connection arm 33 Cam plate 43 Sliding plate 37 Large spring 38 Small spring

────────────────────────────────────────────────── ───

[Procedure amendment]

[Submission date] May 29, 1997

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0029

[Correction method] Change

[Correction contents]

In the concave space 22a, the spring constant is k
One large spring 37, which is an _L compression spring, and a spring constant k
Small spring 38 which is the _S compression spring is provided to two parallel. These springs use the large spring shaft 39 and the small spring shaft 40 as inner guides, and the spring case 35 as the outer guide.

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0035

[Correction method] Change

[Correction contents]

Here, the dimensions and the shape of the cam surface 33a for elastically deforming the spring will be described. The spring constant of the springs arranged in parallel is k _L for the large spring 37 and k _S for the small spring 38.
Thus, the total spring constant k of one large spring and two small springs
Also becomes the _{k = k L + 2 k S} ... (2) wherein the spring elastic deformation of the x, reaction force F generated by the elastic deformation of the spring 'is F' becomes = kx ... (3) expression. Further, the reaction force F ′ pushes the cam plate 39 at a position vertically away from the rotation axis O ₄ via the roller 36, so that the moment M ′ generated by the reaction force F ′ is M ′ = F ′. l ... Equation (4) is obtained. The shape of the cam surface 33a at which the moments M and M ′ due to the mass are the same at each inclination angle θ is determined.

[Procedure amendment 3]

[Document name to be amended] Statement

[Correction target item name] 0042

[Correction method] Change

[Correction contents]

As shown in FIG. 6, the lever guide U5
3. The other end of the lever guide D54 is fixed by a screw 59 via a guide connecting member 58, and similarly receives a force in the compression direction of the lever guide U53 and the lever guide D54 . A pressing rod 60 is fixed to the guide connecting member 58 by screw connection.

[Procedure amendment 4]

[Document name to be amended] Statement

[Correction target item name] 0051

[Correction method] Change

[Correction contents]

Next, the operation of the surgical instrument holding device configured as described above will be described. First, to describe the balancing mechanism, in the state of attaching the endoscope 19 to the endoscope holding portion 18 of the surgical holding device 1 shown in FIG. 1, the rotation axis O ₄ around the connecting arm 11 shown in FIG. 2 in the figure so that from the vertical position to a horizontal position, is rotated in the counterclockwise direction, the moment M around the rotation axis O ₄ by mass reaching the connecting arm 11 to endoscope 19 is generated. The moment M is the M = As shown in (1) _{(m 1 + m 2/2} )
× L × sin θ, and the moment M with respect to the rotation angle θ draws a sin curve as shown in FIG.

[Procedure amendment 5]

[Document name to be amended] Statement

[Correction target item name] 0058

[Correction method] Change

[Correction contents]

As a result, the spring constant k becomes smaller as k = k _L + k _S , so that the reaction force F ′ (= kx) also becomes smaller.
M ≒ M '. Also, when using the endoscope 19 further lighter by loosening together two small spring shaft 40 as shown in FIG. 10, that two of the total so as not functioning small spring 38 spring constant k = k _L mated by decreasing manner.

[Procedure amendment 6]

[Document name to be amended] Statement

[Correction target item name] 0076

[Correction method] Change

[Correction contents]

FIG. 18 shows a cross section taken along line HH ′ of FIG. The spring stopper 88 is a member having a cutout 88a at the center of the plate. As shown in FIG. 18, the spring constant adjustment knob 85
In the vertical position, the three compression springs 81, 82, 83
Passes through the notch 88a. Here, by rotating the spring constant adjusting knob 85 counterclockwise in the figure, the spring stopper 88 rotates about the shaft 86. The spring constant adjusting knob 85 is rotated counterclockwise by 20 °, 40 °, 60 ° from a vertical position (0 °) by a clip means and a stopper (not shown).
, And rotate in increments of 20 °. FIG. 19 shows 20 °, FIG.
FIG. 21 shows the state of the spring stopper when rotated by 40 °, and FIG. 21 shows the state of the spring stopper when rotated by 60 °.

[Procedure amendment 7]

[Document name to be amended] Statement

[Correction target item name] 0078

[Correction method] Change

[Correction contents]

When the connection arm or cam (not shown) rotates the spring case 80 to the right in FIG. 17, only the compression spring 81 is moved to the bottom 80 of the groove of the spring case 80 as described above.
b between the spring stopper 88 and the spring case 80
Assuming that the displacement amount is x, an output F ₁ ′ = k _ax is generated.

[Procedure amendment 8]

[Document name to be amended] Statement

[Correction target item name] 0079

[Correction method] Change

[Correction contents]

Here, when the moment due to mass is large such as when the endoscope is heavy, the spring constant adjusting knob 85 may be turned by 40 ° and 60 ° as shown in FIGS. As a result, the groove bottom 80b to the spring stopper 88
Spring respectively is compressed between the compression spring 81 and the compression spring 82, a compression spring 81 compression spring 82 and the compression spring 83, and the output also respectively _{(k a + k b) x} , (k a + k b
+ K _c ) x, which can cope with a large moment due to mass.

[Procedure amendment 9]

[Document name to be amended] Drawing

[Correction target item name] Fig. 7

[Correction method] Change

[Correction contents]

FIG. 7

[Procedure amendment 10]

[Document name to be amended] Drawing

[Correction target item name] Fig. 8

[Correction method] Change

[Correction contents]

FIG. 8

[Procedure amendment 11]

[Document name to be amended] Drawing

[Correction target item name] Fig. 9

[Correction method] Change

[Correction contents]

FIG. 9

Claims (1)

[Claims] 1. A surgical instrument holding device configured to balance a rotational moment due to a mass generated when an arm holding a surgical instrument rotates about a rotation axis, wherein the rotational motion is converted into a linear motion. A movement direction converting means, a linear sliding means which slides in a linear direction by the action of the movement direction converting means, and a reaction force for canceling the rotational moment in the sliding direction of the linear sliding means. Equilibrium means added to the means, the equilibrium means being elastically changed by the movement of the linear sliding means, generating an output which is a reaction force of the rotational moment, and a reaction force amount from the elastic means. And a reaction force adjusting means for arbitrarily adjusting the force.