WO2003017858A1

WO2003017858A1 - Endoscope retaining and transport unit

Info

Publication number: WO2003017858A1
Application number: PCT/EP2002/007809
Authority: WO
Inventors: Manfred Selig; Rudolf Ullrich
Original assignee: Forschungszentrum Karlsruhe Gmbh
Priority date: 2001-08-23
Filing date: 2002-07-13
Publication date: 2003-03-06
Also published as: DE10141226C1

Abstract

The invention relates to an endoscope retaining and transport unit for retaining, guiding and rotationally and transversally moving a shaft of an endoscope or surgical instrument. The inventive unit comprises a housing, a rotationally driven drive sleeve mounted in the housing, which comprises interior bolts and elevations and a rear-end toothed section, two sliding sleeves inserted one behind the other in the drive sleeve and comprising a peripheral periodically cyclic groove for guiding the bolts. Said groove counterrotates in synchronicity with respect to the groove of the other sliding sleeve and is linked therewith via a drive pin and with a toothed crown wheel via a coupling pin. The toothed crown wheel can be displaced between a position in which the toothing of the toothed crown wheel and the drive pin engage, and a position in which the coupling pin is inserted in the housing. The unit is further provided with one clamping device per sliding sleeve, which acts upon the endoscope shaft and which is activated by the elevations on the drive sleeve, one of the clamping devices being activated in every position.

Description

Endoscope holder and transport unit

The present invention relates to an endoscope holding and transport unit as a component of an endoscope guide system for holding, guiding and for rotating and transversely and transversely moving a shaft of an endoscope or surgical instrument, preferably for use in minimally invasive surgery according to the first claim.

In minimally invasive surgery, the surgeon visually monitors the intervention using endoscopes, which are introduced into the patient's body via an incision. In general, the endoscopes inserted into the patient's body, as well as other instruments, are held by a surgical assistant and positioned and moved at the request of the interventional surgeon.

Motivated by the particularly limited space available in minimally invasive surgery and the potential savings for hospital staff, manual and motorized guide systems for endoscopes and other instruments for minimally invasive surgery have been developed in the past in addition to numerous tripods.

One component of such an endoscope guide system is the endoscope holding and transport unit. In this, the endoscope is held, guided and, depending on the concept, moved together with certain components of the endoscope holding and transport unit.

DE 196 09 034 C2 describes, by way of example, a possible endoscope guide concept in which the endoscope is firmly clamped in a holder and, together with it, in a ner slide guide is moved laterally around the endoscope axis by motor or manually.

In a second endoscope guide concept, depicted in WO 94/03113, the endoscope guide only serves as a passive holder for the endoscope, the required movements on the part of the endoscope guide system, in the exemplary embodiment cited, being able to be implemented by a robot arm.

By contrast, motor-driven endoscope holding and transport units, in which an endoscope inserted into the endoscope holding and transport unit can be moved transversely and rotationally about its longitudinal axis without a holder that moves with the endoscope and without a separate slide guide or guideway, are not known.

The object of the present invention is therefore to propose an endoscope holding and transport unit described in the introduction, in which the drive units act frictionally directly on the cylindrical endoscope shaft when the endoscope is moved in the endoscope holding and transport unit.

The main advantage of using drive units that act directly on the endoscope shaft is that there is no need for additional slide guides or guideways. As is also shown in DE 196 09 034 C2, their length is directed to the required total travel range for the endoscope, which places an enormous restriction on the surgeon's range of motion.

In addition, the endoscope is moved laterally or rotated without moving the endoscope holding and transport unit in the endoscope holding system. Only the endoscope is thus moved, while the endoscope holding and transport unit and the endoscope holding system remain stationary. This means that all movements take place in a particularly advantageous manner in the immediate field of vision of the intervening surgeon, which not only keeps his working area intact, but also does not distract the surgeon from movements in the entire endoscope holding system during the procedure.

In principle, the endoscope holding and transport unit can also be used for all surgical instruments that have an instrument shaft that is suitable as a guide.

To achieve the object, the invention proposes the features set out in claim 1. Further advantageous features which further develop the invention can be seen in the characterizing parts of the subclaims.

Details are explained in more detail below and with reference to FIGS. 1 to 7, which represent a possible embodiment of the endoscope holding and transport unit. Show it:

1 is a sectional drawing of the endoscope holding and transport unit,

2 a to d, using a sectional drawing, the movement sequences during a translatory movement of the endoscope in the endoscope holding and transport unit,

3 a and b on the basis of a sectional drawing, the movement sequences during a rotary movement of the endoscope in the endoscope holding and transport unit, and

4 shows the side view of the endoscope holding and transport unit installed in a holder 22 with drive 24, switch 28 and the fork 25. As shown in FIG. 1, the endoscope holding and transport unit consists of a tubular housing 1 with the separately attached upper and lower end pieces 2 and 3, in which a split (see FIG. 1) or undivided drive sleeve 4 that can be rotated coaxially in the housing with two bolts 5 and 6 protruding into the interior of the drive sleeve, the two bolts 5 positively engaging in one groove 7 of the upper feed sleeve 8 and the two bolts 6 positively engaging in one groove 9 of the lower feed sleeve 10. The two feed sleeves 8 and 10 are each inserted coaxially to the housing 1 in the drive sleeve, each have a central bore as a bearing for the endoscope shaft 11. The upper and lower feed sleeves 8 and 10 are also coupled to one another with a connecting pin 12 in such a way that they can be moved away from or towards one another on the endoscope shaft 11, but cannot rotate relative to one another about the endoscope shaft 11. The upper feed sleeve 8 and also the lower feed sleeve 10 can also be secured against an undesired rotational movement in the housing 1 by one or more inserted coupling pins 13, which are firmly inserted into a ring gear 18 and can be positively inserted into the upper end piece 2.

The rotary movement of the drive sleeve 4 is motor-controlled by a drive unit, not shown in FIG. 1 (see FIG. 4), namely driven by a gear 21 for the undivided drive sleeve 4 or, as shown in FIGS. 1 to 3, by two gear wheels 21 when using a split drive sleeve 4. The gears engage from outside through recesses in the housing 1 in a corresponding end toothing on the outer surface of the drive sleeve 4.

At this point it should already be pointed out that in the case of a construction with split drive sleeve 4, a syn- The two drive sleeve parts must run in a suitable manner in the housing, preferably via a synchronous drive of both drive sleeve parts. The divided drive sleeve thus functionally represents a unit corresponding to the undivided drive sleeve. In contrast, the two drive sleeve parts can only be rotated relative to one another in order to change the endoscope or the surgical instrument. Fig. 1 shows specifically this design, in which each of the two drive sleeve parts is driven by its own gear 21.

The coupling pin 13 is firmly inserted into a plate gear 18 which, with reference to FIG. 1, can be moved up or down by means of a circumferential groove 19 with a fork (not shown). If the ring gear 18 is pushed downward, the ring gear 18 engages positively via a toothing 20 in the end face of the drive sleeve 4 and couples the rotary rotary movements of the feed sleeves 8 and 10 with the drive sleeve 4 via pins 12 and 13 pushed the ring gear 18 upwards, the positive connection between ring gear 18 and drive sleeve 4 is released. On the other hand, the coupling pin 13 is positively inserted by the ring gear 18 into a recess in the upper cover 2, whereby the feed sleeves 8 and 10 via the pins 12 and 13 is arranged against rotation in the housing.

The grooves 7 and 9 are sinusoidal or a cyclic curve with alternating upper and lower horizontal areas (= dead centers, similar to a plateau) with continuous transitions between these areas following and encircling in the upper and lower feed sleeve 8 and 10, one Phase of the cyclic curve curve in the exemplary embodiment corresponds to 180 °, ie half a revolution. Depending on the embodiment, phase lengths of 360 ° and angles which can be multiplied by an integer of 360 ° are also suitable. Here is the course of the curve the groove 7 is always arranged opposite to the curve of the groove 9, which is always guaranteed by the coupling of the feed sleeves 8 and 10 via the connecting pin 12. By rotating the drive sleeve 4 with the pins 5 and 6 engaging in the grooves 7 and 9, the feed sleeves 8 and 10 are cyclically pushed back and forth on the end occipital shaft 11 in the event of a blocking of the rotational movements by the pins 12 and 13, ie cyclically pushed against and pushed against each other.

Furthermore, the upper and lower feed sleeves 8 and 10 each have a circumferential groove in the central bore for receiving an O-ring 14 or 15 made of rubber or plastic and an adjustable clamping device 16 or 17 arranged around the latter. In the exemplary embodiment, each of these clamping devices consists of a clamping jaw, which is pushed over elevations on the inner surface of the drive sleeve by a relative rotation of the drive sleeve 4 to the clamping device 16 or 17. In this way, the clamping jaw is pressed onto the O-ring underneath and onto the endoscope shaft 11, with which it is secured against slipping in the respective feed sleeve. The elevations on the inner surface of the drive sleeve 4 are arranged such that exactly one of the two clamping devices 16 and 17 is always pressed in in any relative angular position of the drive sleeve relative to the feed sleeves 8 and 10. A transition of the activation from one to the other clamping device 16 or 17 takes place when the bolts 5 and 6 engage in horizontal regions of the grooves 7 and 9 with reference to FIG. 1. Each clamp is active over half a phase of the cyclically running grooves 7 and 9, ie in each case via a transition from the top and bottom dead center of the cyclic course. In the case of the design with an undivided drive sleeve, the endoscope or surgical instrument is always replaced by pulling out the endoscope shaft against the friction of an O-ring pressed onto the endoscope shaft via a clamping device. In contrast, in the case of the design with a divided drive sleeve, the two drive sleeve parts can be rotated relative to one another with the purpose of deactivating both clamping devices 16 and 17, so that the endoscope shaft 11 can be pulled out of the feed sleeves 8 and 10 with little friction.

To prevent internal contamination of the endoscope holding and transport unit, the upper and lower end pieces can each be provided with a wiper ring, through which the endoscope shaft is pushed and cleaned with the O-rings before reaching the feed sleeves (not shown in the figures).

2 a to d show the movement sequence in the endoscope holding and transport unit during a lateral displacement of the endoscope shaft 11 in the endoscope holding and transport unit on the basis of sectional drawings, which correspond in the detail shown in FIG. 1. They also show the same components mentioned above.

In the event of a lateral displacement, the ring gear 18 is always pushed upwards, with which the coupling pin 13 engages in the upper cover 2 (cf. FIG. 2 a). The two feed sleeves 8 and 10 are thus decoupled from the drive sleeve 4. Furthermore, the clamping jaw of the lower clamping device 17 is clamped in FIG. 2 a, with which the lower feed sleeve 10 is fixed on the endoscope shaft 11 by the O-ring 15. Fig. 2 a specifies the point in time at which the two feed sleeves 8 and 10 were just pushed apart by the bolts 5 and 6 running in the grooves 7 and 9, while the endoscope shaft 11 was carried along by the clamping device 17 with the feed sleeve 10. The associated directions of movement are highlighted in FIG. 2a, as in the following figures, by arrows.

In Fig. 2 b, the drive sleeve 4 has already been turned a little further, the feed sleeves and the endoscope shaft do not move and the bolts 5 and 6 are in the region of the dead center of the cyclical curve profile of the grooves 7 and 9, respectively Clamping device 17 released again and the upper clamping device 16 tightened for this. The elevations on the inner surface of the drive sleeve 4 are coordinated so that the release of the clamping device 17 takes place at the same time as the clamping device 16 is tightened.

In the next step of the translational movement, when the upper clamping device 16 is clamped, the feed sleeves 8 and 10 are pushed together, the upper clamping device 16 taking the endoscope shaft 11 with it (see arrows). Here, too, the feed sleeves are positively guided via the bolts 5 and 6 engaging in the grooves 7 and 9 when the drive sleeve 4 is rotated further.

The fourth sub-cycle of the translatory feed movement of the endoscope shaft 11 is shown in FIG. 2 d. Feed sleeves and the endoscope shaft do not move and the bolts 5 and 6 are located in the region of the dead center of the cyclical curve profile of the grooves 7 and 9, so that the two feed sleeves are pushed together. In this position, the upper clamping device 16 is released again and the lower clamping device 17 is tightened again. The elevations on the inner surface of the drive sleeve 4 are also coordinated here in such a way that the clamping device 16 is released simultaneously with the clamping of the clamping device 17. From this position, the feed sleeves 8 and 10 are separated again by turning the drive sleeve 4 further. pushed as already explained with reference to FIG. 2a.

Just by the direction of rotation of the drive sleeve 4 in the housing 1, d. H. without any further measure or adjustment, the direction of advance of the endoscope shaft 11 is determined. In the event of a change in the direction of rotation of the drive sleeve 4, the processes described with reference to FIGS.

3 a and b show, using sectional drawings, which correspond to FIGS. 1 and 2 a to d in the detail shown, the endoscope holding and transport unit during a rotational rotary movement of the endoscope shaft 11 in the endoscope holding and transport unit.

In contrast to the processes involved in a translatory movement, in the endoscope holding and transport unit, in the case of a rotary rotary movement, the disk gear wheel 18 is shifted downward with reference to FIGS. 3 a and b, so that the pin 13 is pulled out of the recess in the upper end piece 2 and that Plate gear 18 is pushed onto the upper end face of the drive sleeve 4 and connected in a form-fitting manner via the toothing 20. Thus, drive sleeve 4 and the feed sleeves 8 and 10 are now coupled to one another, whereby, as described above, it is always ensured by construction that one of the two clamping devices 16 and 17 is tensioned and the endoscope shaft 11 is frictionally fixed in one of the two feed sleeves 8 and 10 , This switching can take place in any relative angular position of the drive sleeve 4 to the feed sleeves 8 and 10, both with feed sleeves pushed together (FIG. 3 a) and with feed sleeves pushed apart (FIG. 3 b). Thus, the rotational movement, which is transmitted from the drive via the gear or gears 21 to the drive sleeve 4, from there without further translation via the coupling pin 13 to the upper feed sleeve 8 and from there either via the clamping device 16 and the O-ring 14 or via the driver pin 12 to the lower feed sleeve 10, and from this via the clamping device 17 and the O-ring 15 to the endoscope shaft 11 without further translation.

Finally, FIG. 4 shows the side view of the endoscope holding and transport unit installed in a holder 22 and passively mounted via the bearings 23. The preferably electric or pneumatic drives 24 for the drive sleeve 4 as well as the pneumatic switch 28, which has two pressure bellows acting against each other, are firmly attached to the housing 1 and pivot with the endoscope holding and transport unit. A fork 25 is controlled via the pneumatic switch 28, which is controlled via two flexible control lines 29. The fork 25 is rotatably mounted on a fixed bearing 27 and transmits the movements of the switch 28 via an engagement 26 through a recess in the housing 1 to the ring gear 18. Instead of the pneumatic switch 28, electromagnetic or mechanical switching devices are also suitable.

Reference symbol list:

1 housing

2 upper end piece

3 lower end piece

4 drive sleeve

5 bolts

6 bolts

7 groove

8 Upper feed sleeve

9 groove

10 lower feed sleeve

11 endoscope shaft

12 drive pin

13 coupling pin

14 O-ring

15 O-ring

16 clamping device

17 clamping device

18 plate gear

19 groove

20 teeth

21 gear

22 bracket

23 bearings

24 drive

25 levers

26 intervention

27 fixed bearings

28 Pneumatic switch

29 control line

Claims

Claims:

1. Endoscope holding and transport unit as a component of an endoscope guide system for holding, guiding and for rotating and transverse movement of a shaft of an endoscope or surgical instrument, consisting of a housing which is arranged concentrically around the shaft and elements for the suspension of the endoscope holding and transport unit in the endoscope guide system, a tubular drive sleeve (4), which is rotatably driven concentrically to the shaft and is inserted in the housing (1), the inner surface of which has bolts (5, 6) and elevations projecting inwards and an end face with teeth (20), two feed sleeves (8, 10) which can be pushed onto the shaft one after the other and inserted into the drive sleeve, each with an outer circumferential, a periodically cyclic curve with upper and lower areas with continuous transitions between these areas, each of which is synchronously opposite to the respective groove Another groove runs for the positive guidance of the bolts (5, 6) in the feed sleeves (8, 10), which runs parallel to the shaft with one another and one of the two feed sleeves on its other side via a driver pin (12) loosely inserted into the feed sleeves is connected to a disk gear (18) pushed concentrically on the shaft via a coupling pin (13) firmly inserted therein, the disk gear (18) in the housing between a position in which the toothing (20) of the disk gear (18) and the Drive sleeve (4) is pushed together in a form-fitting manner, and another position in which the end of the coupling pin (13) facing away from the feed sleeves is positively inserted into the housing can be switched, One clamping device (16, 17), each acting on the shaft, inserted into a circumferential groove on the inner surfaces of the two feed sleeves (8, 10), each consisting of an O-ring (14, 15) and a clamping jaw, which can be opened by Elevations on the inner surface of the drive sleeve (4) can be activated and released again by pushing down the elevations, the elevations being designed in such a way that with each relative rotational angle position between the drive sleeve (4) and the coupled feed sleeves (8, 10) one of the two clamping devices is always present (16, 17) is activated and a transition of the active clamping from one to the other clamping device only takes place if the distance between the two feed sleeves (8, 10) is minimal or maximum to each other and the clamping between said minimum and maximum distance always remains active.

2. Endoscope holding and transport unit according to claim 1, characterized in that the drive sleeve is divided in the area between the bolts (5) and the bolts (6) and the two individual drive sleeve parts each have their own drive, but synchronously with each other via a gear (21) can be driven.

3. Endoscope holding and transport unit according to claim 1 or 2, characterized in that the clamping devices in the feed sleeves are protected against contamination on the shaft by wiper rings.