WO2013018897A1 - 術具及び医療用マニピュレータ - Google Patents
術具及び医療用マニピュレータ Download PDFInfo
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- WO2013018897A1 WO2013018897A1 PCT/JP2012/069868 JP2012069868W WO2013018897A1 WO 2013018897 A1 WO2013018897 A1 WO 2013018897A1 JP 2012069868 W JP2012069868 W JP 2012069868W WO 2013018897 A1 WO2013018897 A1 WO 2013018897A1
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- WIPO (PCT)
- Prior art keywords
- treatment
- rotation shaft
- surgical instrument
- main body
- shaft portion
- Prior art date
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/37—Master-slave robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B46/00—Surgical drapes
- A61B46/10—Surgical drapes specially adapted for instruments, e.g. microscopes
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
- B25J—MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
- B25J13/00—Controls for manipulators
- B25J13/02—Hand grip control means
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06F—ELECTRIC DIGITAL DATA PROCESSING
- G06F3/00—Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
- G06F3/01—Input arrangements or combined input and output arrangements for interaction between user and computer
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
- A61B2017/00482—Coupling with a code
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2931—Details of heads or jaws with releasable head
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2946—Locking means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B46/00—Surgical drapes
- A61B46/20—Surgical drapes specially adapted for patients
- A61B46/23—Surgical drapes specially adapted for patients with means to retain or hold surgical implements
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S901/00—Robots
- Y10S901/02—Arm motion controller
- Y10S901/06—Communication with another machine
- Y10S901/08—Robot
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S901/00—Robots
- Y10S901/02—Arm motion controller
- Y10S901/09—Closed loop, sensor feedback controls arm movement
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S901/00—Robots
- Y10S901/30—End effector
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
- Y10T29/49826—Assembling or joining
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T74/00—Machine element or mechanism
- Y10T74/18—Mechanical movements
- Y10T74/18056—Rotary to or from reciprocating or oscillating
Definitions
- the present invention relates to a surgical instrument and a medical manipulator.
- This application claims priority based on US Patent Application No. 61 / 515,203 filed in the United States on August 4, 2011, the contents of which are incorporated herein by reference.
- a master-slave type medical manipulator including a master manipulator operated by an operator and a slave manipulator that operates based on a signal emitted from the master manipulator is known.
- Such a medical manipulator is attached with a surgical instrument having a treatment section for performing a treatment on a treatment target site by remote operation.
- Patent Document 1 discloses a medical manipulator that can be used by replacing a plurality of treatment sections suitable for treatment with respect to an arm of one slave manipulator.
- An object of the present invention is to provide a surgical instrument and a medical manipulator that allow a treatment section to be attached and detached with a simple configuration and that have high cleanability.
- One aspect of the present invention is a surgical instrument for performing treatment on a treatment target site, a cylindrical long member having a longitudinal axis, a treatment portion connected to the long member, and the long member And a connecting part that detachably connects the treatment part, and the connecting part includes a first turning shaft part provided on the elongated member and a second turning part provided on the treatment part.
- a first rolling guide portion provided with a shaft portion, an arc-shaped portion provided on the elongated member and having a center coaxially with the first rotation shaft portion; and the second rotation shaft provided on the treatment portion.
- a second rolling guide portion having a rolling guide portion provided with an arc-shaped portion having a center coaxially with the portion, the rolling guide portion being in rolling contact with the first rolling guide portion, and the first rotation shaft portion, A locking portion that locks the second rotation shaft portion, and the first rotation shaft portion and the second rotation shaft portion.
- a surgical instrument characterized in that it is removable.
- the locking portion is connected to the first rotation shaft portion and is engageable with the second rotation shaft portion, and the main body portion is provided separately from the main body portion.
- the main body has a groove that engages with the annular member to define a moving direction of the annular member, and the lock member has a part of the groove and moves relative to the main body.
- the groove provided in the lock member and the groove provided in the main body portion are in communication with each other, switching between the open state and the bundling state is possible.
- the treatment portion may be held in the bundled state with respect to the long member.
- the surgical instrument of the above aspect includes a treatment instrument piece provided in the treatment section and operable, a treatment tool piece operation joint for connecting the elongated member and the treatment tool piece, and operating the treatment tool piece.
- a moving member coupled to the treatment tool piece operating joint, wherein the treatment tool piece operating joint is connected to the moving member and rotates about a predetermined rotation center.
- One rotation member coaxial with the second rotation shaft portion, or in a direction opposite to the first rotation member for operation with a position closer to the rotation shaft portion than the second rotation shaft portion as a rotation center
- a second rotating member for operation connected to the first rotating member for operation so as to relatively rotate, a link for converting the rotational force of the second rotating member for operation into the operation of the treatment instrument piece, And the treatment tool piece operating joint is attached and detached at the connecting portion. It may be detachable between the second pivot member for the operation with the first rotating member for the operation.
- the treatment tool piece may have a pair, and the operation of the treatment tool piece may be opening and closing of the pair of treatment tool pieces.
- Another aspect of the present invention includes the above-described surgical instrument, a slave manipulator to which the surgical instrument is attached and having at least one joint, and a master manipulator that issues an operation command for driving the joint of the slave manipulator.
- a medical manipulator provided.
- the treatment tool and medical manipulator of the present invention can be attached and detached with a simple configuration.
- FIG. 1 is an overall view of a medical manipulator including a surgical instrument according to an embodiment of the present invention. It is a perspective view which shows the structure of a part of the surgical instrument. It is explanatory drawing which shows the structure of a part of the surgical instrument. It is explanatory drawing which shows the structure of a part of the surgical instrument. It is explanatory drawing which shows the structure of a part of the surgical instrument. It is explanatory drawing which shows the structure of a part of the surgical instrument. It is a disassembled perspective view which shows the structure of the treatment part in the surgical instrument. It is a figure for demonstrating the bending operation
- FIG. 1 is an overall view of a medical manipulator provided with the surgical instrument of the present embodiment.
- FIG. 2 is a perspective view showing a configuration of a part of the surgical instrument.
- 3 to 5 are explanatory views showing a part of the configuration of the surgical instrument.
- FIG. 6 is an exploded perspective view showing a configuration of a treatment portion in the surgical instrument.
- 7 to 9 are views for explaining the bending operation of the treatment portion in the surgical instrument.
- FIGS. 3 to 5 and FIGS. 7 to 9 are schematic diagrams for explaining the configuration of the present embodiment, and the shape of the members may not be shown strictly correspondingly.
- the surgical instrument 1 is attached to the medical manipulator 100 as a part of the medical manipulator 100.
- the medical manipulator 100 includes a master manipulator 101, a control device 110, and a slave manipulator 120.
- the master manipulator 101 functions as a master that transmits the movement of the operator's operation to the slave manipulator 120, and includes a master display unit 102 such as a liquid crystal display device and an operation unit 103 that the operator holds and operates. With. An operation performed on the operation unit 103 of the master manipulator 101 is input to the control device 110.
- the control device 110 includes a master-side control device 111 that receives an input from the master manipulator 101 and a slave-side control device 112 that outputs a drive signal to the slave manipulator 120.
- the master-side control device 111 generates an operation command for operating the slave manipulator 120 based on the input from the master manipulator 101, and outputs it to the slave-side control device 112.
- the slave side control device 112 generates a drive signal for driving the slave manipulator 120 based on the operation command issued from the master side control device 111 and outputs the drive signal to the slave manipulator 120.
- the slave manipulator 120 has a slave arm 121 that operates in accordance with a drive signal from the slave-side control device 112, and the surgical instrument 1 of this embodiment is attached to the slave arm 121.
- a treatment instrument for performing a surgical operation, an endoscope apparatus, and the like can be attached to the slave manipulator 120.
- the surgical instrument 1 is a medical instrument for performing a treatment on a treatment target site.
- the surgical instrument 1 includes a long member 2, a treatment unit 6, a connecting unit 10, and a drive control unit 45.
- the side where the treatment unit 6 is provided in the surgical instrument 1 will be described as the distal side
- the side where the drive control unit 45 is provided in the surgical instrument 1 will be described as the proximal side.
- the long member 2 is a cylindrical member having a longitudinal axis.
- the long member 2 may be flexible or rigid depending on the configuration of the slave arm 121 to be attached. In the present embodiment, an example in which the long member 2 is rigid is shown.
- a connecting rod 3 (moving member) for operating the treatment section 6 is disposed inside the long member 2.
- the connecting rod 3 has one end connected to a bending double joint 11 described later and the other end connected to the drive control unit 45, and one end connected to an opening / closing joint 27 described later and connected to the drive control unit 45. And an open / close rod 5 having the other end connected thereto.
- the treatment unit 6 is provided to treat a treatment target site.
- the treatment section 6 is a forceps having a pair of forceps pieces 7a and 7b that can be opened and closed and a cover 8 that holds the forceps pieces 7a and 7b, as shown in FIGS.
- the pair of forceps pieces 7a and 7b are connected to each other by a shaft-like member 9 that serves as a rotation shaft of the forceps pieces 7a and 7b.
- the connecting part 10 connects the long member 2 and the treatment part 6 together.
- the connecting portion 10 includes a bending double joint 11 for bending the treatment portion 6 with respect to the long member 2 and an opening / closing joint 27 for opening / closing the pair of forceps pieces 7a and 7b.
- the bending double joint 11 includes a first fitting tooth portion 12 fixed to the distal end of the long member 2, a first rotating shaft portion 13 connected to the distal end of the long member 2, A second rotation shaft portion 14 extending in parallel with the one rotation shaft portion 13 and connected to the treatment portion 6, a second fitting tooth portion 15 fixed to the treatment portion 6, and the treatment portion 6 for the long member 2. And a locking portion 16 for switching the connection state.
- the first fitting tooth portion 12 has gear-like teeth on the circumference around the rotation center of the first rotation shaft portion 13. Further, the second fitting tooth portion 15 has gear-like teeth on the circumference around the rotation center of the second rotation shaft portion 14, and meshes with the first fitting tooth portion 12.
- the 1st fitting tooth part 12 and the 2nd fitting tooth part 15 have a tooth
- the second fitting tooth portion 15 can move while rotating along the circumference of the first fitting tooth portion 12. In addition, it replaces with the 1st fitting tooth part 12 and the 2nd fitting tooth part 15, and the plate-shaped member which an outer peripheral part contacts mutually with a frictional force and rotates relatively may be provided.
- engagement of a gearwheel was shown, it is necessarily limited to the structure which frictionally contacts by meshing
- two rubber rollers (which have a large frictional force) that are not in meshing frictional contact with each other, such as a configuration in which two rubber rollers are in frictional contact, rotate between two rotating bodies without slipping each other. It may be a mechanism capable of
- the first rotation shaft portion 13 and the second rotation shaft portion 14 are axes that are parallel to each other and whose rotation centers extend in a direction orthogonal to the extension line of the longitudinal axis of the long member 2.
- the locking portion 16 includes a main body portion 17, an annular member 19, and a lock member 21.
- the main body portion 17 keeps the distance between the first fitting tooth portion 12 and the second fitting tooth portion 15 constant.
- the bending rod 4 of the connecting rod 3 is connected to the main body portion 17. By moving the bending rod 4 back and forth in the longitudinal axis direction of the long member 2, the main body portion 17 rotates around the first rotation shaft portion 13. As a result, the second turning shaft portion 14 turns with the first turning shaft portion 13 as the turning center.
- the main body portion 17 is connected to the first rotation shaft portion 13 so as to be rotatable relative to the first rotation shaft portion 13 and cannot be removed. Further, the main body portion 17 can be engaged with the second rotation shaft portion 14 so that the treatment portion 6 is in a predetermined mounting direction with respect to the main body portion 17, and with respect to the second rotation shaft portion 14. Detachable.
- the main body portion 17 is provided with a guide 18 for defining the moving direction of the annular member 19.
- the guide 18 has a groove formed on the outer surface of the main body portion 17 so as to extend in one direction.
- a protrusion 20 formed on the annular member 19 enters the groove serving as the guide 18. Thereby, the annular member 19 moves along the groove.
- the annular member 19 is provided separately from the main body portion 17, and binds the main body portion 17 and the second rotating shaft portion 14. That is, a part of the main body part 17 and a part of the second rotating shaft part 14 are both inserted into the annular member 19, and the main body part 17 and the second rotating shaft part 14 are connected by the annular member 19. Bundled together.
- the annular member 19 is formed with a protrusion 20 that enters a groove (guide 18) formed in the main body portion 17.
- the treatment portion 6 When the annular member 19 is disposed at a position where the main body portion 17 and the second rotating shaft portion 14 are bound, the treatment portion 6 is connected to the long member 2 (hereinafter referred to as “bound state”). ) Further, when the annular member 19 is disposed at a position away from the position where the main body portion 17 and the second rotating shaft portion 14 are bound, the treatment portion 6 can be removed from the long member 2 (hereinafter referred to as “open”). Will be referred to as a “state”).
- the lock member 21 is provided to switch between the above-described bundling state and open state.
- the lock member 21 has a groove 22 that can communicate with a groove (guide 18) formed in the main body portion 17.
- the groove 22 formed in the lock member 21 has a function of regulating the moving direction of the annular member 19 as a part of the guide 18 formed in the main body portion 17.
- the lock member 21 can be rotated around the rotation center of the first rotation shaft portion 13.
- the lock member 21 rotates the first rotation shaft portion 13 with respect to the main body portion 17 when a predetermined or greater rotational force is applied to the lock member 21 as an external force around the rotation center of the first rotation member. It is relatively rotatable around the center of movement. That is, when the operator rotates the lock member 21, the lock member 21 is rotated relative to the main body portion 17, and the groove 22 formed in the lock member 21 and the guide 18 formed in the main body portion 17 The communication state of can be switched. Note that the lock member 21 operates integrally with the main body 17 in a state where the external force for rotating the lock member 21 is not applied.
- the annular member 19 is connected to the groove 22 formed in the lock member 21 and the guide formed in the main body portion 17. 18 can move freely along the line 18.
- the annular member 19 cannot enter the groove 22 formed in the lock member 21.
- the treatment portion 6 is connected to the long member 2 as described above. It is kept in a state.
- the opening / closing joint 27 is connected to the opening / closing rod 5 and rotates about the same axis as the first rotation shaft 13, and the first opening / closing gear 23.
- the opening / closing second gear 24 that rotates about the same axis as the second rotating shaft portion 14, the rack 25 that is connected to the opening / closing second gear 24, and the link that connects the rack 25 and the forceps piece 7a. It has the element 26a and the link element 26b which connects the rack 25 and the forceps piece 7b.
- the configuration in which the first opening / closing gear 23 and the second opening / closing gear 24 are brought into frictional contact with the meshing of the gears is shown. Absent.
- two rubber rollers (which have a large frictional force) that are not in meshing frictional contact with each other, such as a configuration in which two rubber rollers are in frictional contact, rotate between two rotating bodies without slipping each other.
- It may be a mechanism capable of In the link elements 26 a and 26 b shown in FIG. 6, the traction force transmitted from the opening and closing rod 5 via the opening and closing first gear 23 and the opening and closing second gear 24 shown in FIG. 7 is transmitted through the rack 25.
- the link elements 26a and 26b convert the advance / retreat operation of the rack 25 into the opening / closing operation of the forceps pieces 7a and 7b.
- the link element 25 of the opening / closing joint 27 constitutes a toggle mechanism, and the gripping force of the forceps pieces 7a, 7b increases exponentially as the forceps pieces 7a, 7b move in the closing direction. It is like that.
- the drive control unit 45 shown in FIG. 1 includes an actuator 46 that moves the connecting rod 3 (the bending rod 4 and the opening / closing rod 5) forward and backward in the longitudinal axis direction of the long member 2, and a detection unit that detects the operation amount of the actuator 46. 47.
- the drive control unit 45 operates according to the drive signal output from the slave-side control device 112.
- the detection unit 47 detects the operation amount of the actuator 46 and outputs it to the slave-side control device 112. Thereby, the operation of the actuator 46 in the drive control unit 45 is feedback-controlled.
- the surgical instrument 1 is used in a state where the treatment portion 6 and the long member 2 are connected to each other at the bending double joint 11 and the opening / closing joint 27.
- the surgical instrument 1 can also remove the treatment portion 6 from the long member 2 and attach another treatment portion 6 to the long member 2. For example, it is possible to perform treatment while exchanging different types of treatment units 6, or to replace the treatment unit 6 in which an operation inconvenience or the like has occurred with another new treatment unit 6 to continue the treatment.
- the bending double joint 11 can be operated by the forward / backward movement of the bending rod 4 by the actuator 46. Further, the opening / closing joint 27 can be operated independently of the bending double joint 11 by the forward / backward movement of the opening / closing rod 5 by the actuator 46.
- the operation of the bending double joint 11 will be described.
- the second rotating shaft portion 14 turns around the first rotating shaft portion 13 as a turning center. Operate.
- the second fitting tooth portion 15 since the second fitting tooth portion 15 is engaged with the first fitting tooth portion 12 provided in the bending double joint 11, the second fitting tooth portion 15 has the second rotating shaft portion 14. It rotates as the center of rotation.
- the second fitting tooth portion 15 rotates around the second rotation shaft portion 14 while the second rotation shaft portion 14 performs a turning operation with the first rotation shaft portion 13 as a turning center.
- the direction of the pair of forceps pieces 7a and 7b changes. At this time, the pair of forceps pieces 7a and 7b does not open and close.
- the main body portion 17 is moved at an angle corresponding to the ratio between the radius of the first fitting tooth portion 12 and the radius of the second fitting tooth portion 15.
- the radius of the first fitting tooth portion 12 is r1
- the radius of the second fitting tooth portion 15 is r2
- the rotation angle of the main body portion 17 is ⁇
- the rotation angle of the treatment portion 6 is ⁇
- r2 ( ⁇ ) r1 ⁇ (1)
- ⁇ ⁇ (r1 + r2) / r2 ⁇ ⁇ (2)
- ⁇ 2 ⁇ It becomes.
- the main body portion 17 is moved 45 degrees around the first rotation shaft portion 13, the second fitting tooth portion 15 provided on the treatment portion 6 side is 90 degrees with respect to the first fitting tooth portion 12. Will tilt. That is, since it is a speed increasing mechanism, the amount of angular movement of the main body portion 17 can be reduced relative to the amount of angular movement of the treatment portion 6 intended.
- 10 to 14 are perspective views for explaining the attaching / detaching operation of the treatment section 6.
- the lock member 21 is rotated relative to the main body portion 17 to form the groove 22 formed in the lock member 21 and the main body portion 17.
- the guide 18 is changed from the non-communication state (see FIG. 10) to the communication state (see FIG. 11). This can be easily performed, for example, by inserting a flathead screwdriver into the groove 22 formed in the lock member 21 and turning the lock member 21.
- the annular member 19 forms the groove 22 of the lock member 21 from the second rotating shaft portion 14 side. It can pass through and move to the first rotating shaft portion 13 side.
- FIG. 12 when the operator moves the annular member 19 toward the first rotation shaft portion 13, the binding between the second rotation shaft portion 14 and the main body portion 17 is released, and FIG. 13 and FIG.
- FIG. 14 the second rotating shaft portion 14 and the treatment portion 6 connected to the second rotating shaft portion 14 are detached from the main body portion 17.
- the treatment section 6 is removed from the long member 2 regardless of the bending state of the bending double joint 11 and the opening / closing joint 27. Can do.
- the main body portion 17 and the second rotation shaft portion 14 are bound together by the annular member 19, so that the treatment portion 6 can be configured with a simple configuration. Can be attached to and detached from the long member 2.
- the number of components added to make the treatment section 6 detachable is small compared to the technique described in Patent Document 1.
- the orientation of the treatment section 6 is long.
- the parts of the joint part that change with respect to the scale member 2 can be used for attaching and detaching the treatment portion 6. For this reason, in the operation part and medical manipulator 100 of this embodiment, the number of parts which increase with respect to a structure in case the treatment part 6 is detachable is small.
- FIG. 15 is a perspective view showing the configuration of the present modification.
- FIG. 16 is a perspective view for explaining the operation of this modification.
- the main body portion 17 instead of the configuration in which the main body portion 17 and the second rotation shaft portion 14 are detachable, the main body portion 17 includes a distal side member 17A and a proximal side member 17B. Can be separated.
- the distal member 17A is formed with a claw portion 48 that engages with the proximal member 17B.
- the proximal member 17B is formed with a recess 49 into which the claw portion 48 of the distal member 17A enters.
- the claw portion 48 and the concave portion 49 constitute a locking portion 16 that locks the first rotating shaft portion 13 and the treatment portion 6 in the same manner as the locking portion 16 described in the above embodiment. .
- the proximal side member 17B and the distal side member 17A are slightly elastically deformed, and the claw portion 48 is formed in the concave portion 49. Get in. Thereby, the treatment portion 6 is locked to the long member 2.
- the number of parts is further smaller than in the above-described embodiment.
- the operation of the treatment tool piece has been described by taking the operation of opening and closing the forceps pieces 7a and 7b, which are a pair of treatment tool pieces, as an example, but is not limited thereto.
- it may be an operation of bending (turning) one treatment tool piece.
- the treatment tool piece may be a medical instrument other than the forceps piece.
- FIG. 17 is a perspective view showing the configuration of this modification.
- FIG. 18 is a cross-sectional view for explaining the configuration of this modification.
- a treatment portion 6 having an electric knife electrode 50 is provided instead of the treatment portion 6 having the forceps pieces 7 a and 7 b.
- the long member 2 is provided with a lead wire 51 electrically connected to the electrode 50 of the electric knife.
- the lead wire 51 and the electrode 50 are connected via a plug 52 that detachably connects the lead wire 51 and the electrode 50.
- the treatment part 6 of this modification does not need to be connected to the joint 27 for opening / closing, and does not need to have the joint 27 for opening / closing.
- the opening / closing joint 27 and the opening / closing rod 5 may not be provided. Even with such a configuration, the same effects as those of the above-described embodiment can be obtained.
- the present invention can be used as a surgical instrument and a medical manipulator.
- the field in which the present invention can be used is not limited to the medical field.
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Abstract
Description
本願は、2011年8月4日に、米国に出願された米国特許出願第61/515203号に基づき優先権を主張し、その内容をここに援用する。
特許文献1に記載の医療用マニピュレータにおいては、処置部がスレーブマニピュレータに対して着脱可能であるので、洗浄及び滅菌等のメンテナンスが容易である。しかしながら、処置部が着脱可能となる構成を実現するために部品点数が多くなってしまうので、特許文献1に記載の医療用マニピュレータは処置部の構造が複雑であり、必ずしも洗浄性が向上したとは言えない。
本発明の目的は、処置部を簡易な構成で着脱可能とし、洗浄性が高い術具及び医療用マニピュレータを提供することである。
術具1は、医療用マニピュレータ100の一部として、医療用マニピュレータ100に取り付けられている。
まず、本実施形態の医療用マニピュレータ100の構成について説明する。図1に示すように、医療用マニピュレータ100は、マスタマニピュレータ101と、制御装置110と、スレーブマニピュレータ120とを備える。
マスタ側制御装置111では、マスタマニピュレータ101からの入力に基づいて、スレーブマニピュレータ120を動作させるための操作指令を生成し、スレーブ側制御装置112へと出力する。
スレーブ側制御装置112では、マスタ側制御装置111から発せられた操作指令に基づいて、スレーブマニピュレータ120を駆動させるための駆動信号を生成し、スレーブマニピュレータ120へと出力する。
術具1は、処置対象部位に対して処置を行うための医療器具である。図1及び図2に示すように、術具1は、長尺部材2と、処置部6と、連結部10と、駆動制御部45とを備える。
以下、術具1において処置部6が設けられている側を遠位側、術具1において駆動制御部45が設けられている側を近位側として説明を行なう。
図3及び図7に示すように、長尺部材2の内部には、処置部6を動作させるためのコネクティングロッド3(移動部材)が配されている。コネクティングロッド3は、後述する屈曲用ダブルジョイント11に一端が連結され駆動制御部45に他端が連結された屈曲用ロッド4と、後述する開閉用ジョイント27に一端が連結され駆動制御部45に他端が連結された開閉用ロッド5とを有する。
なお、本実施形態では、第一嵌合歯部12と第二嵌合歯部15とを歯車の噛み合いで摩擦接触させる構成を示したが、必ずしも歯車の噛み合いで摩擦接触させる構成に限定されるものではない。例えば、歯車の噛み合いによる摩擦接触に代えて摩擦接触される歯車の噛み合いがない2つのゴムローラ(摩擦力が大きい)を摩擦接触させる構成などのように2つの回転体間が互いに滑らずに回転転がりができる機構にしてもよい。
本体部17は、第一嵌合歯部12と第二嵌合歯部15との間の距離を一定に保つ。本体部17には、コネクティングロッド3のうち屈曲用ロッド4が接続されている。屈曲用ロッド4を長尺部材2の長手軸方向に進退動作させることにより、本体部17は、第一回動軸部13回りに回動する。これにより、第二回動軸部14は、第一回動軸部13を旋回中心として旋回動作する。
本体部17には、環状部材19の移動方向を規定するためのガイド18が設けられている。本実施形態では、ガイド18は、本体部17の外面に一方向に延びて形成された溝を有している。ガイド18となる溝には、環状部材19に形成された突起20が入り込む。これにより、溝に沿って環状部材19が移動する。
なお、本実施形態では、開閉用第一ギア23と開閉用第二ギア24とを歯車の噛み合いで摩擦接触させる構成を示したが、必ずしも歯車の噛み合いで摩擦接触させる構成に限定されるものではない。例えば、歯車の噛み合いによる摩擦接触に代えて摩擦接触される歯車の噛み合いがない2つのゴムローラ(摩擦力が大きい)を摩擦接触させる構成などのように2つの回転体間が互いに滑らずに回転転がりができる機構にしてもよい。
図6に示すリンク要素26a,26bは、図7に示す開閉用第一ギア23及び開閉用第二ギア24を介して開閉用ロッド5から伝わる牽引力が、ラック25を通じて伝達される。リンク要素26a、26bは、ラック25の進退動作を、を鉗子片7a,7bの開閉動作に変換する。
本実施形態では、開閉用ジョイント27のリンク要素25は、トグル機構を構成しており、各鉗子片7a,7bが閉じる方向へ移動するに従って指数関数的に鉗子片7a,7bの把持力が高まるようになっている。
術具1は、屈曲用ダブルジョイント11及び開閉用ジョイント27において処置部6と長尺部材2とが連結された状態で使用される。また、術具1は、長尺部材2から処置部6を取り外して、別の処置部6を長尺部材2に取り付けることもできる。例えば、異なる種類の処置部6を交換しながら処置を行ったり、動作の不都合等が生じた処置部6を別の新たな処置部6に取り替えて処置を継続することができる。
屈曲用ダブルジョイント11は、アクチュエータ46による屈曲用ロッド4の進退動作によって動作させることができる。また、開閉用ジョイント27は、アクチュエータ46による開閉用ロッド5の進退動作によって、屈曲用ダブルジョイント11とは独立して動作させることができる。
開閉用ロッド5を進退移動させることなく屈曲用ロッド4を進退移動させると、図3ないし図5に示すように、第二回動軸部14は第一回動軸部13を旋回中心として旋回動作する。このとき、屈曲用ダブルジョイント11に設けられた第一嵌合歯部12には第二嵌合歯部15が噛み合っているので、第二嵌合歯部15は第二回動軸部14を回動中心として回動する。第一回動軸部13を旋回中心として第二回動軸部14が旋回動作しながら第二嵌合歯部15が第二回動軸部14回りに回動することにより、処置部6における一対の鉗子片7a,7bの向きが変化する。また、このとき、一対の鉗子片7a,7bは開閉動作しない。
例えば、第一嵌合歯部12の半径をr1、第二嵌合歯部15の半径をr2、本体部17の回動角度をθ、処置部6の回動角度をφとすると、
r2(φ-θ)=r1θ ・・・(1)
φ={(r1+r2)/r2}θ ・・・(2)
たとえば、本実施形態のように、第一嵌合歯部12の半径r1と、第二嵌合歯部15の半径r2との比率が1:1の場合(r1=r2)は、
φ=2θ
となる。したがって、第一回動軸部13を中心に本体部17を45度動かせば、処置部6側に設けられた第二嵌合歯部15は、第一嵌合歯部12に対して90度傾くことになる。つまり、増速機構となるため、本体部17の角度移動量を目的とする処置部6の角度移動量に対して少なくできる。
図10ないし図14は、処置部6の着脱動作を説明するための斜視図である。
処置部6を長尺部材2から取り外す必要がある場合には、ロック部材21を本体部17に対して相対回転させることにより、ロック部材21に形成された溝22と本体部17に形成されたガイド18とを、非連通状態(図10参照)から連通状態(図11参照)へと変更する。これは、例えば、ロック部材21に形成された溝22にマイナスドライバーを差し込んでロック部材21を回すことによって容易に行なうことができる。
なお、本実施形態では、屈曲用ダブルジョイント11がどのような屈曲状態にあっても、また開閉用ジョイント27がどのような開閉状態にあっても、長尺部材2から処置部6を取り外すことができる。
処置部6を長尺部材2に取り付けるときは、第一嵌合歯部12と第二嵌合歯部15とが噛みあい、開閉用第一ギア23と開閉用第二ギア24とが噛み合うように処置部6を位置決めして、第二回動軸部14に本体部17を係合させ、さらに第二回動軸部14と本体部17とを環状部材19により結束する。その後、ロック部材21を本体部17に対して回転させて、ロック部材21に形成された溝22と本体部17に形成されたガイド18とを非連通状態とする。
これにより、長尺部材2に取り付けられた処置部6が使用可能となる。
次に、本実施形態の変形例について説明する。図15は、本変形例の構成を示す斜視図である。図16は、本変形例の作用を説明するための斜視図である。
図15に示すように、本変形例では、本体部17と第二回動軸部14とが着脱可能である構成に代えて、本体部17が遠位側部材17Aと近位側部材17Bとに分離可能である。
図15及び図16に示すように、遠位側部材17Aには、近位側部材17Bに係合する爪部48が形成されている。近位側部材17Bには、遠位側部材17Aの爪部48が入り込む凹部49が形成されている。爪部48と凹部49とによって、上述の実施形態で説明した係止部16と同様に第一回動軸部13と処置部6とを係止状態とする係止部16が構成されている。
また、本変形例では上述の実施形態よりもさらに部品点数が少ない。
なお、上述の変形例を含む実施形態では、処置具片の動作として、一対の処置具片である鉗子片7a、7bを開閉させる動作を例にとって説明したが、これに限るものではない。例えば、一つの処置具片を屈曲(回動)させる動作であっても良い。また、処置具片は、鉗子片以外の医療器具であってもよい。
次に、本実施形態の他の変形例について説明する。図17は本変形例の構成を示す斜視図である。図18は本変形例の構成を説明するための断面図である。
図17及び図18に示すように、本変形例では、鉗子片7a,7bを有する処置部6に代えて、電気メスの電極50を有する処置部6が設けられている。
また、長尺部材2には、電気メスの電極50に電気的に接続されるリード線51が設けられている。リード線51と電極50とは、リード線51と電極50とを着脱可能に連結するプラグ52を介して接続されている。なお、本変形例の処置部6は、開閉用ジョイント27に接続されている必要はなく、開閉用ジョイント27を有している必要はない。また、本変形例では、開閉用ジョイント27及び開閉用ロッド5を有していなくてもよい。
このような構成であっても、上述の実施形態と同様の効果を奏する。
例えば、上述の第二回動軸部を有しておらず第一回動軸部において屈曲する処置部が採用されていてもよい。
また、本発明は、本発明の要旨を逸脱しない範囲の設計変更等も含む。
2 長尺部材
3 コネクティングロッド
4 屈曲用ロッド
5 開閉用ロッド
6 処置部
7a,7b 鉗子片
8 カバー
9 軸状部材
10 連結部
11 屈曲用ダブルジョイント
12 第一嵌合歯部(第一転がりガイド部)
13 第一回動軸部
14 第二回動軸部
15 第二嵌合歯部(転がりガイド部;第二転がりガイド部)
16 係止部
17 本体部
17A 遠位側部材
17B 近位側部材
18 ガイド
19 環状部材
20 突起
21 ロック部材
22 溝
23 開閉用第一ギア(第一転がりガイド部)
24 開閉用第二ギア(転がりガイド部;第二転がりガイド部)
25 ラック
26a、26b リンク要素
27 開閉用ジョイント
45 駆動制御部
46 アクチュエータ
47 検知部
48 爪部
49 凹部
50 電極
51 リード線
52 プラグ
100 医療用マニピュレータ
101 マスタマニピュレータ
102 マスタ表示部
103 操作部
110 制御装置
111 マスタ側制御装置
112 スレーブ側制御装置
120 スレーブマニピュレータ
121 スレーブアーム
Claims (6)
- 処置対象部位に対して処置を行う術具であって、
長手軸を有する筒状の長尺部材と、
前記長尺部材に連結された処置部と、
前記長尺部材と前記処置部とを着脱可能に連結する連結部と、
を備え、
前記連結部は、
前記長尺部材に設けられた第一回動軸部と、
前記処置部に設けられた第二回動軸部と、
前記長尺部材に設けられ前記第一回動軸部と同軸上に中心を有する円弧状部を備えた第一転がりガイド部と、
前記処置部に設けられ前記第二回動軸部と同軸上に中心を有する円弧状部を備えた転がりガイド部を有し当該転がりガイド部が前記第一転がりガイド部と転がり接触する第二転がりガイド部と、
前記第一回動軸部と前記第二回動軸部とを係止状態とする係止部と、
を有し、
前記第一回動軸部と前記第二回動軸部との間で着脱される
ことを特徴とする術具。 - 請求項1に記載の術具であって、
前記係止部は、
前記第一回動軸部に接続されており且つ前記第二回動軸部に係合可能な本体部と、
前記本体部と別体に設けられ前記本体部と前記第二回動軸部とを結束する環状部材と、
前記環状部材が前記本体部と前記第二回動軸部とを結束する位置に配される結束状態と、前記環状部材が前記本体部と前記第二回動軸部とを結束する位置から外れた位置に配される開放状態とを切り替えるためのロック部材と、
を有する
ことを特徴とする術具。 - 請求項2に記載の術具であって、
前記本体部は、前記環状部材と係合して前記環状部材の移動方向を規定する溝を有し、
前記ロック部材は、前記溝の一部を有し前記本体部に対して相対移動可能であり、
前記ロック部材に設けられた溝と前記本体部に設けられた溝とが連通状態であるときに前記開放状態と前記結束状態との切替が可能であり、前記結束状態において前記ロック部材に設けられた溝と前記本体部に設けられた溝とが非連通状態であるときに前記長尺部材に対して前記処置部は前記結束状態で保持される
ことを特徴とする術具。 - 請求項2又は3に記載の術具であって、
前記処置部に設けられ動作可能な処置具片と、
前記長尺部材と前記処置具片とを連結する処置具片動作用ジョイントと、
前記処置具片を操作するために前記処置具片動作用ジョイントに連結された移動部材と、
をさらに備え、
前記処置具片動作用ジョイントは、
前記移動部材と連結され所定の回動中心周りに回動する動作用第一回動部材と、
前記第二回動軸部と同軸若しくは前記第二回動軸部よりも前記回動軸部に近い位置を回動中心として前記動作用第一回動部材と逆周りに相対回転するように前記動作用第一回動部材に連結された動作用第二回動部材と、
前記動作用第二回動部材の回転力を前記処置具片の動作に変換するリンクと、
を有し、
前記処置具片動作用ジョイントは、前記連結部における着脱により、前記動作用第一回動部材と前記動作用第二回動部材との間で着脱される
ことを特徴とする術具。 - 請求項4に記載の術具であって、
前記処置具片は一対有し、前記処置具片の動作は、前記一対の処置具片の開閉である
ことを特徴とする術具。 - 請求項1から5のいずれか一項に記載の術具と、
前記術具が取り付けられ少なくとも1つの関節を有するスレーブマニピュレータと、
前記スレーブマニピュレータの前記関節を駆動させるための操作指令を発するマスタマニピュレータと、
を備えた医療用マニピュレータ。
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PCT/JP2012/069868 WO2013018897A1 (ja) | 2011-08-04 | 2012-08-03 | 術具及び医療用マニピュレータ |
EP12820056.5A EP2740433B1 (en) | 2011-08-04 | 2012-08-03 | Surgical implement and medical treatment manipulator |
CN201280037095.3A CN103732173B (zh) | 2011-08-04 | 2012-08-03 | 手术器具和医疗用机械手 |
JP2013526968A JP6010027B2 (ja) | 2011-08-04 | 2012-08-03 | 術具及び医療用マニピュレータ |
US13/566,023 US9161772B2 (en) | 2011-08-04 | 2012-08-03 | Surgical instrument and medical manipulator |
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CN103732173A (zh) | 2014-04-16 |
US20130066333A1 (en) | 2013-03-14 |
EP2740433A4 (en) | 2015-04-29 |
CN103732173B (zh) | 2016-03-09 |
EP2740433A1 (en) | 2014-06-11 |
EP2740433B1 (en) | 2016-04-27 |
US9161772B2 (en) | 2015-10-20 |
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