WO2015194603A1 - Active forceps - Google Patents

Abstract

　Provided is an active forceps for use in endoscopic surgery, the active forceps reducing the burden on a technician. The active forceps C2 according to one embodiment that exemplifies the present invention is provided with a main unit 1 having operation detectors 12a, 12b, a shaft unit 2 extending from the main unit 1, a treatment unit 3 provided at the distal end of the shaft unit 2, a drive means for driving the opening and closing of the treatment unit 3, and a controller 8 for controlling the actuation of the drive means. The drive means is provided with a pneumatic actuator 40 for opening and closing the treatment unit 3, and a pneumatic unit 50 for supplying air to the pneumatic actuator 40 on the basis of a command signal outputted by the controller 8. The pneumatic actuator 40 is arranged in the main unit 1, and the pneumatic unit 50 is arranged in a controller Cb which is separate from the main unit.

Description

Active forceps

The present invention relates to an active forceps used in an endoscopic operation for treating a living tissue or the like under an endoscope.

Endoscopic surgery is minimally invasive and is rapidly spreading in the medical field as a technique for reducing the burden of open surgery. Endoscopic surgery is generally performed by opening 4 to 5 holes in the abdomen, inserting a trocar, inserting a laparoscope, surgical instrument, etc., injecting gas into the abdominal cavity, and inflating it. It is a surgical method to treat the patient. For this reason, forceps for endoscopic surgery are provided with a shaft portion to be inserted into the trocar, a treatment portion that can be opened and closed on the distal end side of the shaft portion, and a proximal end side of the shaft portion that opens and closes the treatment portion. And a handle portion to be operated. As the treatment part, a grasping forceps for grasping a living tissue or a peeling forceps for peeling the adhesion part are widely used, and a scissor type which is generally operated with the thumb and middle finger (or index finger) is widely used as the handle part. It has been. An operator (including an assistant, the same shall apply hereinafter) introduces a treatment section to a target site while viewing a laparoscopic image, operates a handle section to grasp a living tissue, and introduces an endoscope introduced from another trocar Treatment such as cutting and suturing of living tissue is performed with a surgical instrument under a mirror.

As described above, the forceps are used when performing treatments such as cutting and suturing on a living tissue. However, the number of forceps that can be introduced into the body is limited in an endoscopic operation, and the forceps are gripped during the operation. It is necessary to change the site frequently, to keep the gripping state until a certain treatment is completed, or to perform some operation all the time for a long time. Further, a shaft portion of about 200 to 350 mm exists between the grip portion and the handle portion, and delicate operation is required at the grip portion located at the tip thereof. For this reason, there is a problem that the burden on the operator who operates the forceps is large.

On the other hand, an active forceps for endoscopic surgery using an electric motor as a power source for opening and closing the treatment section has been proposed (see, for example, Patent Document 1). This is because the electric motor is built in the main body with a grip that is held by the surgeon, and the rotational driving force of the electric motor is converted into a linear driving force in the axial direction of the shaft portion to open and close the treatment portion at the distal end. . An operation lever protruding from the main body is provided in front of the grip, and the electric motor is driven by swinging the operation lever with an index finger or the like. In addition, a medical manipulator having a configuration in which a plurality of artificial muscle actuators are provided inside the shaft and the tip of the shaft is bent has been proposed (see Patent Document 2).

JP 2009-189835 A JP 2010-149210 A

Certainly, according to the active forceps proposed in the above-mentioned Patent Document 1, the treatment portion is opened and closed by the power of the electric motor, so that the burden on the operator can be reduced as compared with the conventional forceps directly operated by human power. Seems to be. However, conventional forceps that use an electric motor as a drive source have a complicated mechanism for transmitting the driving force in addition to the electric motor requiring a certain volume in order to obtain a predetermined driving force. When the main body becomes large and comprehensive considerations such as handling in endoscopic surgery over a long period of time, there is a problem that the burden on the operator cannot be reduced sufficiently.

The present invention has been made in view of the above-described problems, and an object thereof is to provide an active forceps for endoscopic surgery that can further reduce the burden on an operator.

An active forceps according to an embodiment of the present invention includes a main body portion provided with an operation detector for detecting an operation of an operator, a shaft portion extending from the main body portion, and a treatment portion provided at the distal end of the shaft portion so as to be opened and closed. And a drive unit that opens and closes the treatment unit, and a control unit that outputs a command signal based on the operation signal output from the operation detector and controls the operation of the drive unit. The driving means includes a pneumatic actuator (for example, an artificial muscle unit 40, a piston, etc. in the embodiment) that opens and closes the treatment section, and a pneumatic unit that supplies gas to the pneumatic actuator based on a command signal. The actuator is disposed on the main body, and the pneumatic unit is disposed on a separate controller separately from the main body.

The controller preferably includes pressure adjusting means for adjusting and setting the pressure of the gas supplied to the pneumatic actuator (for example, the electropneumatic regulator 53, the gripping force adjuster 54, and a manually set guulator in the embodiment). .

Here, the pressure adjusting means has an electropneumatic regulator that sets the pressure of the gas supplied to the pneumatic actuator in accordance with a command signal output from the control unit, and the control unit operates the operation output from the operation detector. A command signal based on the signal can be output to the electropneumatic regulator to control the pressure of the gas supplied to the pneumatic actuator. At this time, the operation detector is a pressing force sensor for detecting the operator's pressing force, and the control unit sends a command signal based on the operation signal according to the operator's pressing force output from the operation detector to the electropneumatic regulator. Can be configured to output. Further, the control unit outputs a command signal to the pneumatic unit to supply gas to the pneumatic actuator when the operation signal output from the operation detector is a signal equal to or higher than a predetermined pressing force set in advance. It can be constituted as follows. At this time, the “predetermined pressing force” set in advance is set based on the pressing force generated when the operator intentionally presses the operation detector with the intention of opening and closing the treatment portion. . The command signal output by the control unit may be set in a plurality of steps (for example, 2 to 5 steps) or steplessly according to the pressing force of the operator detected by the operation detector. it can. Note that a minimum value and a maximum value may be provided for the gas pressure output from the pneumatic unit, and the driving force of the treatment unit may be set to change stepwise or steplessly between the two values.

The pressure adjusting means includes a pressure adjuster (for example, a gripping force adjuster 54 in the embodiment) that outputs a pressure setting signal corresponding to a pressure that is adjusted and set in advance by an operator, and a command signal output from the control unit. And an electropneumatic regulator that sets the pressure of the gas supplied to the pneumatic actuator according to the control unit, and the control unit outputs a command signal based on the pressure setting signal output from the pressure regulator to the electropneumatic regulator. The pressure of the gas supplied to the pneumatic actuator may be controlled. At this time, the pressure set in the pressure regulator can be set in a plurality of stages (for example, 2 to 5 stages, etc.) or non-stage. Further, a minimum value and a maximum value may be provided for the pressure of the gas output from the pneumatic unit, and the driving force of the treatment unit may be set to change stepwise or steplessly between the two values.

The controller may be provided with flow rate adjusting means for adjusting and setting the flow rate of gas supplied to the pneumatic actuator (for example, the speed regulator 56, the flow rate regulating valve, the speed regulator and the electromagnetic proportional control valve in the embodiment). it can.

Further, it is preferable that the pneumatic actuator is an artificial muscle unit that is deformed in response to gas supply / discharge to open and close the treatment portion. The operation detector is preferably a tactile switch.

The main body has a cylindrical or elliptical columnar grip extending in the front-rear direction in which the shaft portion is attached to the front end portion and the shaft portion extends, and the rear portion of the grip is reduced in diameter and inclined with respect to the axis of the shaft portion. And a connector portion from which a tube connecting the pneumatic actuator and the pneumatic unit is led out from the rear end, and the operation portion is located in front of the grip opposite to the connector portion across the axis of the shaft portion. It can be provided in the part.

The active forceps according to the aspect of the present invention can open and close the treatment portion by receiving power assist from the driving means with a light operating force for operating the operation detector. Furthermore, since the pneumatic unit that supplies gas to the pneumatic actuator based on the command signal is separated from the main body and disposed in a separate controller, the main body operated by the surgeon is configured to be small and lightweight. be able to. As a result, it is possible to provide an active forceps for endoscopic surgery that greatly reduces the burden on the operator.

According to the configuration in which the controller is provided with a pressure adjusting means for adjusting and setting the pressure of the gas supplied to the pneumatic actuator, the force generated by the pneumatic actuator by adjusting the supply pressure, that is, the drive for driving the treatment section The force (for example, the gripping force of the treatment portion) can be adjusted. Therefore, according to the active forceps of this configuration, the living tissue can be gently gripped with a weak gripping force or firmly fixed with a strong gripping force in accordance with the operator's intention. Furthermore, since the pressure of the gas that drives the pneumatic actuator is adjusted and set, the gripping force and the like can be controlled to be constant regardless of the opening / closing angle position of the treatment section. Accordingly, it is possible to provide an active forceps capable of grasping a living tissue with a grasping force according to an operator's intention with a simple configuration without adding a detector or the like for detecting a force acting on a treatment portion. Can do.

Here, the pressure adjustment means has an electropneumatic regulator, and the control unit outputs a command signal based on the operation signal output from the operation detector to the electropneumatic regulator to control the pressure of the gas supplied to the pneumatic actuator According to such a configuration, the surgeon can operate the treatment section with a driving force corresponding to an operation on the operation detector. Further, according to the configuration in which the operation detector is a pressing force sensor and the control unit outputs a command signal corresponding to the operator's pressing force to the electropneumatic regulator, the operator places a finger on the operation detector and applies the pressing force. By changing it, the treatment section can be operated with a driving force corresponding to the pressing force with a light operating force. Accordingly, it is possible to provide an active forceps capable of suppressing finger fatigue, which has been a problem with conventional lever-operated active forceps, and capable of operating in accordance with the operator's intention. Further, when the operation signal output from the operation detector is a signal equal to or higher than a predetermined pressing force set in advance, according to the configuration in which the control unit supplies gas to the pneumatic actuator, Only when the operation detector is pressed and operated with the intention of opening and closing the part, it opens and closes reliably according to the operator's intention, and the operator does not intend to open and close the treatment part by mistake. When touched, the treatment unit does not open or close. Therefore, it is possible to provide an active forceps with high safety and good operability.

Further, the pressure adjusting means has a pressure regulator and an electropneumatic regulator, and the control unit outputs a command signal based on the pressure setting signal output from the pressure regulator to the electropneumatic regulator and supplies it to the pneumatic actuator. According to the configuration for controlling the gas pressure, the operator can gently grip the living tissue with a weak gripping force or firmly fix the living tissue with a strong gripping force by adjusting the pressure regulator. .

In addition, according to the configuration in which the controller is provided with a flow rate adjusting means that adjusts the flow rate of the gas supplied to the pneumatic actuator, the operating speed of the pneumatic actuator, that is, the opening and closing speed of the treatment section is adjusted by adjusting the gas flow rate. can do. As a result, the operator can provide active forceps with good operability.

Also, by using an artificial muscle unit as the pneumatic actuator, the main body can be made compact and lightweight, and active forceps with high safety can be provided. In addition, by using a tactile switch as the operation detector, the main body can be made compact and lightweight, and an active forceps with good operability can be provided with a clear operational feeling.

In addition, the main body portion is formed with a grip that is attached to the front end portion of the shaft portion and extends in the front-rear direction, and the rear portion of the grip is reduced in diameter and inclined with respect to the axis of the shaft portion. And a connector portion from which a tube connecting to the pressure unit is led out. According to the configuration in which the operation portion is provided in the front portion of the grip opposite to the connector portion across the axis of the shaft portion, It is possible to provide an active forceps that is easy to handle in surgery and has good operability.

It is a schematic block diagram of the active forceps of 1st Embodiment which illustrates the aspect of this invention. It is sectional drawing which shows the structure inside the handpiece in the said active forceps. It is an external appearance perspective view of the handpiece in the said active forceps. It is sectional drawing of the operation part of the 1st composition form and the 2nd example in the above-mentioned active forceps. It is explanatory drawing for demonstrating general | schematic structure and an operation principle of an artificial muscle unit, (a) is the natural state before supplying gas to an artificial muscle unit, (b) supplies the gas of predetermined pressure to an artificial muscle unit. It is a conceptual diagram which shows the pressurized state. It is a block diagram of the said active forceps. It is explanatory drawing which illustrates the relationship between the pressing force detected by the closing operation detector, and the supply pressure set by an electropneumatic regulator. FIG. 4 is a cross-sectional view of the operation portion of the second configuration form in the active forceps, (a) is a cross-sectional view of the operation portion of the first embodiment, (b) is a cross-sectional view of the operation portion of the second embodiment, c) is a cross-sectional view of the operating portion of the third embodiment. It is sectional drawing of the operation part of the 3rd structure form in the said active forceps. It is sectional drawing of the operation part of the 4th structure form in the said active forceps. It is sectional drawing of the operation part of the 5th structure form in the said active forceps. It is a schematic block diagram of the active forceps of 2nd Embodiment which illustrates the aspect of this invention. It is sectional drawing which shows the structure inside the handpiece in the said active forceps. It is a block diagram of the said active forceps.

Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.

(First embodiment)
FIG. 1 shows a schematic configuration of an active forceps C1 of the first embodiment illustrating an aspect of the present invention, FIG. 2 is a sectional view showing the inside of the handpiece Ca in the active forceps C1, and FIG. 2 is an external perspective view of the handpiece Ca 3 shows. The active forceps C1 includes a hand piece Ca operated by an operator and a controller Cb provided separately, and is used in a state where both are connected by a signal cable 19 and a tube 59.

The handpiece Ca includes a main body portion 1 that is a base frame to which each member is attached, a shaft portion 2 that extends forward from the main body portion 1, a treatment portion 3 that can be opened and closed at the tip of the shaft portion 2, and a treatment portion. 3 includes an artificial muscle unit 40 that opens and closes 3. The controller Cb includes a pneumatic unit 50 that supplies / discharges gas to / from the artificial muscle unit 40 and a pneumatic unit 50 based on operation signals output from the operation detector 12 (12a, 12b) of the handpiece Ca. The control unit 8 is configured to output a command signal to control the opening / closing operation of the treatment unit 3 by controlling the operation of the pneumatic unit 50.

The pneumatic actuator can be configured by using various actuators that utilize gas pressure, such as a piston, an air motor, and an artificial muscle unit. In this specification, the configuration using the artificial muscle unit 40 will be mainly described. To do. Further, in this specification, for convenience of explanation, the distal end direction (left direction in FIGS. 1 and 2) of the shaft portion 2 provided with the treatment portion 3 is front, and the proximal direction (same, right direction) of the shaft portion 2 is forward. In the following description, the rear end direction of the grip 15 is referred to as the lower side, and the base end direction is referred to as the upper side.

In the main body 1, an artificial muscle unit 40 is attached to the center of the main body upper part 10 extending in the front-rear direction, and a forced release valve 49 is attached to the rear part. A grip 15 that protrudes downward from the main body upper portion 10 and is gripped by the surgeon is formed at the lower portion of the main body portion 1, and an operation portion 11 is formed between the main body upper portion 10 and the grip 15 so as to protrude forward from the grip 15. ing. The operation unit 11 is formed in a semi-cylindrical shape in a plan view. The operation unit 11 is provided with a closing operation detector 12a and an opening operation detector 12b.

Here, the operation unit 11 has a plurality of configuration forms including configurations to be described later. Therefore, first, a sheet-like pressing force sensor is used as the operation detector, and the operation unit 11A of the first configuration form in which this is provided on the outer surface side of the operation unit 11 is applied. To proceed. 1 to 3 show the operation unit 11A ₁ of the first embodiment in this configuration. Reference numerals A to E following the number 11 indicating the operation unit indicate the first to fifth configuration forms of the operation unit 11, and the subscript numerals attached to the reference signs A to E are examples in each configuration form. Indicates.

In the operation unit 11A _1, rib-like identification protrusion 11t which projects forward in the upper and lower central portion of a cylindrical operation outer surface extending in the circumferential direction is formed. The operation unit 11 partitioned vertically by the identification protrusion 11t is provided with a closing operation detector 12a in the upper first operation unit 11a and an opening operation detector 12b in the lower second operation unit 11b. . The closing operation detector 12a and the opening operation detector 12b are both thin sheet-like pressing force sensors 120 so that the pressure-sensitive region extending in the longitudinal direction on the strip-shaped flexible substrate is along the cylindrical surface of each operation unit. Arranged and bonded and fixed.

The pressing force sensor 120 is, for example, a variable resistance type pressing force sensor in which a pressure sensitive fluid is filled between two thin sheet-like electrodes, and between output terminals in proportion to the pressing force acting on the pressure sensitive region. The resistance is configured to change. By using such a pressing force sensor, the opening / closing operation can be performed with a light operation force, and a detection signal having a magnitude corresponding to the operation force can be obtained. Note that the operation detectors 12a and 12b may use other types of pressing force sensors as long as a detection signal corresponding to the pressing force acting on the operation unit can be obtained. The terminal portion of the closing operation detector 12a and the lead of the opening operation detector 12b are introduced into the main body through slit- like introduction portions 14a and 14b penetrating the operation portion 11, and terminals provided at the end portions of the leads are provided. It is connected to the control unit 8 through the signal cable 19 and the electrical connector 18a. The introduction portions 14a and 14b through which the leads are communicated are sealed with a sealant such as silicone.

FIG. 4 is a cross-sectional view of the operation unit 11A _{2 according to} the _second example of the present configuration. The operation unit 11A ₂ is configured by adding the following elements to the operation unit 11A ₁ of the first embodiment shown in FIG. In FIG. 4, the same components as those of the operation unit 11 </ b> A ₁ of the first embodiment are denoted by the same reference numerals, and redundant description is omitted. A first covering member 13a is bonded and fixed to the first operation portion 11a so as to cover the closing operation detector 12a, and a second covering member 13b is bonded and fixed to the second operation portion 11b so as to cover the opening operation detector 12b. Is done. The first covering member 13a and the second covering member 13b are thin sheet-like members having rubber elasticity. For example, butyl rubber or ethylene / propylene rubber (EPDM) with a thickness of about 0.2 to 2 mm is used as a rubber-elastic sheet-like member that is highly resistant to cleaning agents (strong alkaline detergents) used in operating rooms and can withstand sterilization temperatures ), Silicon rubber and the like.

The shaft portion 2 is formed with a hollow pipe-shaped sheath 21, a push-pull wire 22 slidably supported inside and outside the sheath 21, and a female screw for detachably attaching the shaft portion 2 to the artificial muscle unit 40. The nut 25 is mainly used. The front end side of the push-pull wire 22 is connected to the treatment members 31 and 32 of the treatment unit 3 via a link mechanism (not shown), and the rear end side of the push-pull wire 22 is connected via a terminal fitting 23 (see FIG. 5). To the artificial muscle unit 40.

The treatment section 3 is mainly composed of treatment members 31 and 32 that are pivotally supported at the distal end of the sheath 21 in the shaft section 2. The base end portions of the treatment members 31 and 32 are connected to the push-pull wire 22 via a link mechanism, and when the push-pull wire 22 is pulled backward (on the main body 1 side), the treatment member 31 and the treatment member 32 are connected. The forceps are closed by swinging in a direction approaching each other, and when the push-pull wire 22 is pushed forward, the forceps are opened by swinging in the direction in which the treatment member 31 and the treatment member 32 are separated from each other. Yes.

The shaft portion 2 is configured so that the sheath 21 can be rotated around an axis extending in the front-rear direction. The operator rotates the rotation knob 24 provided on the proximal end side of the shaft portion to rotate the sheath 21. The swinging open / close surfaces of the treatment members 31 and 32 can be adjusted and set to desired angular positions. Note that the treatment members 31 and 32 may have any suitable shape depending on the purpose and site of using the active forceps C1, for example, known forceps such as grasping forceps, peeling forceps, crushing forceps, and hemostatic forceps. It can be in the form of

The driving means for opening and closing the treatment section 3 is mainly composed of an artificial muscle unit 40 provided on the handpiece Ca side and a pneumatic unit 50 provided on the controller Cb side. FIG. 5 is an explanatory diagram for explaining the schematic configuration and operation principle of the artificial muscle unit 40, and FIG. 6 is a block diagram of the active forceps C1. 5A shows a natural state before supplying gas to the artificial muscle unit 40, and FIG. 5B shows a pressurized state where gas of a predetermined pressure is supplied to the artificial muscle unit 40.

The artificial muscle unit 40 includes a cylindrical rubber artificial muscle 41, a sliding member 42 bonded and fixed to the front end portion of the rubber artificial muscle 41, a fixing member 43 bonded and fixed to the rear end portion, a sliding member 42, A connection fitting 44 for releasably connecting the terminal fitting 23 at the rear end of the push-pull wire, a cylindrical case 45 for housing the artificial rubber muscle 41, a front cap 46 fixed to the front end of the case 45, An end cap 47 fixed to the rear end of the case 45 is formed. The case 45 is manufactured using, for example, a pipe made of a transparent resin material. Since the window portion 17 is formed in the upper portion 10 of the main body, the state of the internal rubber artificial muscle 41 can be visually recognized from the window portion 17 through the case 45. It has become.

The front cap 46 is formed with a metal support hole for slidably supporting the connecting metal 44 in the front-rear direction at the center, and a male screw part for fixing the shaft part 2 by screwing with the female screw part of the nut 25 on the outer periphery. Is formed. The end cap 47 is provided with a fixing structure such as a clip for fixing the fixing member 43, and a joint member 47a is provided at the rear end. A gas flow path communicating with the inside of the rubber artificial muscle 41 is formed at the center of the end cap 47 and the fixing member 43 so as to extend back and forth, and the gas supplied to the artificial muscle unit 40 (joint member 47a) is formed. The gas supplied to the inside of the artificial rubber muscle 41 through the gas channel and the gas supplied to the inside of the artificial rubber muscle 41 can be discharged from the artificial muscle unit 40 through the gas channel.

When no gas is supplied to the artificial muscle unit 40 and the pressure inside the rubber artificial muscle 41 is the same as the pressure outside the rubber artificial muscle 41, the peripheral surface of the rubber artificial muscle 41 is linear as shown in FIG. It is cylindrical and the sliding member 42 is located at a front end position close to the front cap 46. At this time, in the shaft portion 2, the push-pull wire 22 connected to the sliding member 42 via the connecting metal fitting 44 and the terminal metal fitting 23 is also at the front end position, and the treatment member 31 and 32 of the distal treatment portion 3 are mutually connected. The forceps are open and spaced apart.

On the other hand, when gas is supplied to the artificial muscle unit 40 and the internal pressure of the rubber artificial muscle 41 becomes higher than the surrounding pressure, the rubber artificial muscle 41 swells like a balloon, and the peripheral surface as shown in FIG. Transforms into a curved barrel. That is, the artificial rubber muscle 41 expands in the radial direction and contracts in the axial direction. Along with this deformation, the sliding member 42 moves rearward (to the right in FIG. 5), and its position is displaced from the front end position shown in FIG. 5A by the moving stroke s, as shown in FIG. 5B. Move to pressure position. At this time, in the shaft portion 2, the push-pull wire 22 is pulled backward, and the treatment portion 3 is in a closed state in which the treatment members 31 and 32 are in close contact with each other and the forceps are closed.

The artificial muscle unit 40 (joint member 47a) is detachably connected to a forced release valve 49 via a pneumatic connector 48, and the forced release valve 49 and the pneumatic unit 50 are connected by a tube 59 via a pneumatic connector 18b. Connected. The forcible release valve 49 is a manual valve that is mechanically operated by manual operation, and the artificial muscle unit 40 and the pneumatic unit 50 are connected in a normal state when the knob 49a protruding from the upper portion 10 of the main body is not pressed. When 49a is pressed, the connection between the artificial muscle unit 40 and the pneumatic unit 50 is cut off, and the gas in the artificial muscle unit 40 is released to the atmosphere. FIG. 6 illustrates a 3-port 2-position manual valve.

The pneumatic unit 50 includes a filter regulator 52 that removes dust and the like from an externally supplied gas (for example, N ₂ gas, CO ₂ gas, dry air, etc.) and outputs the gas by setting the gas to a predetermined primary pressure. The gas output from the regulator 52 is set to a supply pressure corresponding to a command signal output from the control unit 8 and output, and the gas output from the electropneumatic regulator 53 is output from the control unit 8. It is mainly composed of a flow path switching valve 55 for switching the gas supply state such as supplying to the artificial muscle unit 40 in response to a command signal, shutting it off, or opening it. A configuration using a three-port, three-position electromagnetic valve as the flow path switching valve 55 is illustrated.

In the flow path switching valve 55, an electropneumatic regulator 53 is connected to a P port (air supply port), a forced release valve 49 is connected to an A port (device connection A port), and an R port (exhaust port) is connected via a filter. Open to the atmosphere. The flow path switching valve 55 is a closed center solenoid valve, and when a command signal is not input from the control unit 8, the spool is in a neutral position as shown in the figure, and the gas flow from the pneumatic unit 50 to the artificial muscle unit 40 is shown. While the supply is cut off, the circuit on the artificial muscle unit 40 side is also closed.

The control unit 8 is connected to the closing operation detector 12a and the opening operation detector 12b at its input unit, and to the output unit is connected to the electropneumatic regulator 53 and the flow path switching valve 55. The control unit 8 outputs a command signal to the electropneumatic regulator 53 and the flow path switching valve 55 based on the operation signals output from the two operation detectors 12a and 12b, and supplies gas to the artificial muscle unit 40. The blocking / opening is controlled as follows.

Both the closing operation signal output from the closing operation detector 12a and the opening operation signal output from the opening operation detector 12b are detection signals less than a predetermined pressing force preset and stored in the control unit 8. At this time, the control unit 8 does not output a command signal for driving the flow path switching valve 55. Here, the “predetermined pressing force” preset in the control unit 8 is when the operator deliberately presses the operation detectors 12a and 12b with the intention of opening or closing the treatment unit 3. a pressing force F ₁ caused, for example, it is set based on the order of F ₁ = 2N when the pressing force detection range of the pressing force sensor and 0.2 ~ 20 N (Newton).

At this time, the spool of the flow path switching valve 55 is in the neutral position, and the P port, A port, and R port of the flow path switching valve 55 are all cut off. That is, the gas supply from the pneumatic unit 50 to the artificial muscle unit 40 is shut off, and the pneumatic circuit on the artificial muscle unit 40 side is also held closed. Therefore, the treatment portion 3 at the tip of the handpiece Ca does not operate, and the treatment portion 3 is held in a previous state, for example, the treatment members 31 and 32 are in close contact with each other and the forceps are closed. When the forceps are closed, the rubber artificial muscle 41 is inflated (see FIG. 5B), and the pneumatic circuit of the artificial muscle unit 40 to the flow path switching valve 55 is filled with a gas of a predetermined pressure. Held in a state.

When the opening operation signal output from the opening operation detector 12b is a detection signal greater than or equal to a predetermined pressing force F ₁ set and stored in advance, the control unit 8 moves the spool of the flow path switching valve 55 to the left in FIG. The command signal to move to is output. At this time, a command signal output from the control unit 8 to the flow path switching valve 55 is referred to as an open command signal, and a position state where the spool has moved to the left is referred to as an open position. In the open position, the P port of the flow path switching valve 55 is blocked, and the A port and the R port are connected. Thereby, the gas supply from the pneumatic unit 50 to the artificial muscle unit 40 is cut off, and the pneumatic circuit on the artificial muscle unit 40 side is connected to the exhaust port and held by the artificial muscle unit 40 to the flow path switching valve 55. Gas is exhausted.

Therefore, the artificial rubber muscle 41 changes from the state shown in FIG. 5B to the state shown in FIG. 5A, and in the treatment section 3, the treatment members 31, 32 are opened from the closed state where the treatment members 31, 32 are in close contact. Change to state. When the pressing force to the opening operation detector 12b is released, the control unit 8 stops outputting the opening command signal to the flow path switching valve 55. As a result, the spool of the flow path switching valve 55 returns to the neutral position, and all of the A port, P port, and R port are cut off, and the treatment section 3 is held in the closed state with the forceps open. The same applies to the case where the pressing force applied to the opening operation detector 12b is released in a state where the forceps are not completely opened, and the treatment members 31 and 32 can be held in an open state with an arbitrary relative angle.

When the closing operation signal output from the closing operation detector 12a is a detection signal equal to or higher than a predetermined pressing force F ₁ set and stored in advance, the control unit 8 places a spool on the flow path switching valve 55 to the right in FIG. The command signal to move to is output. At this time, a command signal output from the control unit 8 to the flow path switching valve 55 is referred to as a close command signal, and a position state where the spool has moved to the right is referred to as a closed position.

Also, the control unit 8 outputs a command signal for setting the supply pressure corresponding to the pressing force F detected by the closing operation detector 12a to the electropneumatic regulator 53. The command signal output from the control unit 8 to the electropneumatic regulator 53 at this time is referred to as a closing pressure command signal. The closing pressure command signal can be set in a plurality of steps (for example, 2 to 5 steps) or steplessly according to the pressing force. FIG. 7 illustrates the relationship between the pressing force F detected by the closing operation detector 12 a and the supply pressure P set by the electropneumatic regulator 53. Here, FIG. 7A shows a configuration example when the supply pressure is set in three stages, and FIG. 7B shows a configuration example when the supply pressure is set in a stepless manner. In both figures, the horizontal axis represents the operator's pressing force F detected by the closing operation detector 12a, and the vertical axis represents the supply pressure P set by the electropneumatic regulator 53 based on the closing pressure command signal.

In the configuration example (FIG. 7A) in which the supply pressure is set in three stages, the control unit 8 determines that the pressing force F detected by the closing operation detector 12a is less than F ₂ including the predetermined pressing force F ₁ (0 When ≦ F <F ₂ ), a closing pressure command signal for setting the supply pressure P to a low pressure P ₁ is output to the electropneumatic regulator 53. Further, when it is F less than ₃ or the pressing force F detected by the closing operation detector 12a are F ₂ or more (F ₂ ≦ F <F ₃₎ are closing pressure command to set the supply pressure P ₂ of the medium pressure The signal is output to the electropneumatic regulator 53. When the pressing force F detected by the closing operation detector 12a is F ₃ or more (F ₃ ≦ F), a closing pressure command signal for setting the supply pressure to a high pressure P ₃ is output to the electropneumatic regulator 53. .

The magnitudes of the pressing forces F ₂ and F ₃ are, for example, about F ₂ = 10N when the pressing force detection range of the closing operation detector 12a is 0.2N to 20N and the pressing force F ₁ is 2N. , F ₃ = about 18N. The magnitudes of the supply pressures P ₁ , P ₂ , and P ₃ are based on the gripping force generated in the treatment section 3 when the gas of each supply pressure is supplied to the artificial muscle unit 40 and the forceps are closed. It is set in three levels: weak, medium, and mirror within a range that complies with 14971 (medical devices-application of risk management to medical devices).

On the other hand, in the configuration example in which the supply pressure is set steplessly (FIG. 7B), the control unit 8 determines that the pressing force F detected by the closing operation detector 12a is equal to or less than a predetermined pressing force F ₁ (0 ≦ When F <F ₁ ), a closing pressure command signal for setting the supply pressure P to the lowest pressure P ₀ is output to the electropneumatic regulator 53. When the pressing force F detected by the closing operation detector 12a is F ₃ or more (F ₃ ≦ F), a closing pressure command signal for setting the supply pressure to the maximum pressure P ₄ is output to the electropneumatic regulator 53. To do. When the pressing force F detected by the closing operation detector 12a is between F ₁ and F ₃ (F ₁ ≦ F ≦ F ₃ ), the pressing force F is between the minimum pressure P ₀ and the maximum pressure P _4. A closing pressure command signal set to a supply pressure proportional to the pressure F is output to the electropneumatic regulator 53.

Thus, when the closing operation signal outputted from the closing operation detector 12a is a predetermined pressing force F ₁ or more detection signals, the control unit 8 outputs a closing command signal to the channel switching valve 55 spool Is moved to a closed position, and a close pressure command signal is output to the electropneumatic regulator 53 to supply a gas having a supply pressure P corresponding to the pressing force F. In the closed position, the P port and A port of the flow path switching valve 55 are connected and the R port is shut off. As a result, a gas having a pressure corresponding to the pressing force is supplied from the pneumatic unit 50 to the artificial muscle unit 40.

For this reason, the artificial rubber muscle 41 changes from the state of FIG. 5A to the state of FIG. 5B, and the treatment members 31 and 32 are brought into close contact with each other from the open state in which the treatment members 31 and 32 are separated from each other. Or it changes to the closed state which pinched | interposed the biological tissue etc. between both members. In this closed state, the force sandwiched between the treatment members 31, 32, that is, the gripping force that acts on the treatment portion 3 is determined by the pressure of the gas supplied from the pneumatic unit 50 to the artificial muscle unit 40, that is, the supply pressure. The supply pressure is set in a plurality of steps or steplessly according to the operator's pressing force F against the closing operation detector 12a. Therefore, the surgeon can appropriately adjust the gripping force acting on the treatment section 3 by adjusting the pressing force when operating the closing operation detector 12a.

To remain treatment portion 3 grips the living tissue or the like, (less than F ₁₎ releases the pressing force against the closing operation detector 12a may be. At this time, the spool of the flow path switching valve 55 returns to the neutral position, and all of the P port, A port and R port of the flow path switching valve 55 are cut off, and the pneumatic circuit on the artificial muscle unit 40 side is closed. Is kept in the state. Therefore, the treatment section 3 is held in a state when the pressing force to the closing operation detector 12a is released, that is, a state in which a living tissue or the like is gripped. The same applies when the pressing force applied to the closing operation detector 12a is released when the forceps are not completely closed, and the treatment members 31 and 32 can be held in a closed state at an arbitrary angle.

It should be noted that both the closing operation signal output from the closing operation detector 12a and the opening operation signal output from the opening operation detector 12b are detected to be greater than or equal to a predetermined pressing force F ₁ preset and stored in the control unit 8. When it is a signal, the control unit 8 does not output a command signal to the flow path switching valve 55. This is because the operator's intention to operate is not clear.

Since the active forceps C1 configured as described above uses sheet-like pressing force sensors as the operation detectors 12a and 12b that detect the operation of the operator, the operator places a finger on the operation unit. The treatment section 3 can be opened / closed simply by changing the pressing force (without finger displacement). Therefore, compared with the conventional forceps which had to swing the operation lever against the urging force to open and close the treatment portion, the operator's fatigue can be greatly reduced.

Furthermore, according to the configuration of the first embodiment (see FIG. 3) in which the operation detectors 12a and 12b are arranged on the outer surface side of the main body 1, the operator's operation force is directly applied to the operation detectors 12a and 12b. Therefore, high detection accuracy can be obtained. In addition, since the operation detectors 12a and 12b are disposed so as to be exposed to the operation unit, cleaning and sterilization can be easily performed.

On the other hand, according to the configuration of the second embodiment (see FIG. 4) in which the operation detectors 12a and 12b are arranged on the outer surface side of the main body 1 while being covered with the covering members 13a and 13b, the operation of the operator Force can be applied almost directly to the operation detectors 12a and 12b, and good operability can be obtained due to the elasticity of the covering members 13a and 13b. Further, since the operation detectors 12a and 12b are disposed in a state of being covered with the covering members 13a and 13b, it is possible to suppress the adhesion of foreign matters to the operation detectors 12a and 12b, the release of dust, and the like. Further, cleaning and sterilization can be performed easily and reliably, and the operation detector is not worn by these frequently performed operations.

Further, in the active forceps C1, an operation portion 11 that bulges forward from the grip 15 is formed between the grip 15 gripped by the operator and the upper body portion 10, and operation detectors 12a and 12b are provided in the operation portion. ing. With such a configuration, the operation detector is unintentionally pressed when operating by gripping the grip 15, such as when inserting / removing the treatment unit 3 into / from the body or adjusting the position of the treatment unit 3. There is no such thing as On the other hand, when the living tissue is gripped by the treatment section 3, the finger can be extended to the operation section 11 with the grip 15 held, and the closing operation detector 12a can be easily operated.

Further, since the identification protrusion 11t is formed on the operation unit 11, and the closing operation detector 12a and the opening operation detector 12b are disposed with the identification protrusion 11t interposed therebetween, the line of sight is not moved to the operation unit 11. The closing operation detector 12a and the opening operation detector 12b can be accurately identified (by blind touch), and a situation in which these operation detectors are erroneously operated can be prevented.

Moreover, since the artificial muscle unit 40 is disposed on the handpiece Ca side and the pneumatic unit 50 is disposed on the separate controller Cb side among the driving means for opening and closing the treatment section 3, the operator can The handpiece to be operated can be configured to be lightweight, and the burden on the operator who operates the handpiece Ca for a long time with high frequency can be greatly reduced.

The operation detector 12a, when the pressing force of the detected operator is predetermined pressing force F ₁ or more previously set by 12b, for the control unit 8 is configured to be opened and closed using the treatment unit 3, the operator When the operator performs an opening / closing operation with the intention of opening / closing the treatment section 3, the opening / closing operation is performed according to the operator's intention, and when the operator accidentally touches the operation detector, the treatment section 3 Does not work. This provides an active forceps with high safety and good operability.

Further, the control unit 8 outputs a closing pressure command signal corresponding to the pressing force of the operator to the pneumatic unit 50, and the pneumatic unit 50 supplies a gas having a pressure based on the closing pressure command signal to the artificial muscle unit 40. According to the configuration, the living tissue can be gently gripped with a weak gripping force or firmly fixed with a strong gripping force according to the operator's intention. Furthermore, since the pressure of the gas supplied to the artificial muscle unit 40 is controlled, the gripping force can be made constant regardless of the opening / closing angle position of the treatment section 3 under a certain supply pressure. As a result, it is possible to provide an active forceps that ensures safety and good operability.

Further, by providing the main body unit 1 with the forced release valve 49 that is mechanically operated by manual operation to open the treatment unit 3, an electrical / mechanical abnormality occurs in the control unit 8 and the pneumatic unit 50. Even when the treatment unit 3 is closed unintentionally or when the treatment unit 3 remains closed and does not accept the opening operation, the treatment unit 3 is immediately and forcibly forced. Can be opened. Furthermore, since the forcible release valve 49 is provided in the main body 1, the treatment section can be quickly opened with high responsiveness.

Thus, according to the active forceps C1 described above, it is possible to provide an active forceps that reduces the burden on the operator while ensuring safety for the patient and the operator.

The active forceps in the form (first configuration form) in which a sheet-like pressing force sensor is used as the operation detector and provided on the outer surface side of the operation unit 11 has been described above. Hereinafter, a sheet-type pressing force sensor is used as the operation detector, and the active forceps are provided in the operation unit 11 (second configuration), and a plunger-type pressing force sensor is used as the operation detector. Active forceps in (third configuration form), active forceps in form using switch as operation detector (fourth configuration form), active in form using switch and pressing force sensor as operation detector (fifth configuration form) The forceps will be described.

In addition, since the structure of each part except the operation part 11 is fundamentally the same, duplication description is abbreviate | omitted and only a different part is demonstrated. In addition, since the configuration of the closing operation detector and the opening operation detector is basically the same in each configuration form, the description will be made by describing the operation detector without identifying “open” and “closed”.

The operation unit 11B of the second configuration form is configured by using a sheet-like pressing force sensor as the operation detector 12 and providing this inside the operation unit 11. FIG. 8A is a cross-sectional view of the operation unit 11B ₁ of the first example in the present configuration, FIG. 8B is a cross-sectional view of the operation unit 11B ₂ of the second example in the present configuration, and FIG. ) Shows a cross-sectional view of the operation unit 11B ₃ of the third embodiment in this configuration.

The operation portion 11B ₁ of the first embodiment shown in FIG. 8 (a) has a hole (for example, a circular hole, a triangle, or a square hole) formed through the wall surface of the operation portion in the front-rear direction. An operation button 210 is inserted as a separating member that separates the inside and outside of the main body 1. The operation button 210 is manufactured using an elastic material (for example, ethylene / propylene rubber (EPDM), butyl rubber, silicon rubber, etc.). Inside the main body 1, a pressing force sensor 220 is disposed on the substrate 225 so as to be located behind the operation button 210. The pressing force sensor 220 is a variable resistance type sensor in which the resistance between the terminals changes according to the pressing force, similarly to the described pressing force sensors 12a and 12b. However, in this configuration mode, the pressure-sensitive area is a circular (button-shaped) pressure sensor in accordance with the mode of the operation button 210. That is, the pressing force sensor 220 is disposed inside the main body 1 via an operation button 210 that is an isolation member that separates the inside and outside of the main body 1, and the operator's pressing force is pressed via the operation button 210. It is transmitted to the pressure sensor 220. Then, an operation signal corresponding to the pressing force is output from the pressing force sensor 220 to the control unit 8.

The operation portion 11B ₂ of the second embodiment shown in FIG. 8 (b) has a hole (same as above) formed through the wall surface of the operation portion in the front-rear direction. A leaf spring 235 is attached as an isolation member separating the two. An operation button 230 is attached to the front side of the leaf spring 235 and protrudes forward through the hole, and a pressing force sensor 240 is attached to the rear side of the leaf spring 235. The pressing force sensor 240 is a sensor for obtaining a pressing force from deformation (strain) generated in the leaf spring 235. For example, a semiconductor strain gauge type sensor or a capacitance type sensor is used. In addition to the rubber material described above, various plastic materials and metal materials can be used for the operation buttons. In the operation unit 11B _{2 having} such a configuration, when the operator presses the operation button 230, the leaf spring 235 is elastically deformed, and the amount of deformation (the magnitude of the distortion) is detected by the pressing force sensor 240, and the plate An operation signal corresponding to the deformation amount of the spring 235, that is, the pressing force is output from the pressing force sensor 240 to the control unit 8. The pressing force sensor 240 may be configured to detect the displacement of the leaf spring 235 (or the operation button) electrically, magnetically, or optically and obtain the pressing force from the detected displacement amount. .

The operation unit 11B ₃ of the third embodiment shown in FIG. 8C is a configuration that detects the deformation amount itself of the wall surface of the operation unit, not the leaf spring. For example, as shown in the figure, an operation region 250 in which the thickness is partially reduced to reduce the elastic coefficient (the amount of deformation with respect to the pressing force is increased) is formed on the wall surface of the operation portion, and the rear surface of the operation region 250 It is comprised by arrange | positioning the pressing force sensor 260 in the side. A groove 251 for indicating the operation region 250 is carved in a circular shape on the front side of the main body 1. For this reason, when the vicinity of the operation area 250 is pressed, the operation area 250 is elastically deformed according to the pressing force. The pressing force sensor 260 is a sensor that obtains the pressing force from the deformation amount (distortion) generated in the operation region 250, and the same sensor as in the second embodiment is used. In the operation unit 11B _{3 having} such a configuration, when the operator presses the operation region 250, the operation region 250 is elastically deformed, and the amount of deformation (the magnitude of the distortion) is detected by the pressing force sensor 260. An operation signal corresponding to the deformation amount of the region, that is, the pressing force is output from the pressing force sensor 260 to the control unit 8.

As described above, the pressing force sensor is disposed inside the main body 1 and the surgeon's pressing force is transmitted to the pressing force sensor via the isolation member (the operation button 210, the leaf spring 235, the wall surface of the operation region 250). According to the configuration of the present configuration thus configured, since the pressing force sensor is disposed inside the main body via the isolation member, it is possible to block adhesion of foreign matters to the pressing force sensor and release of dust, and cleaning. And sterilization can be performed easily and steadily. This prevents the pressing force sensor from being worn by these frequently performed operations.

Next, the operation unit 11C in the third configuration form will be described with reference to FIG. The operation unit 11 </ b> C is configured using a plunger-type pressing force sensor 320 as the operation detector 12. The plunger-type pressing force sensor 320 is a sensor that detects the pressing force acting on the plunger by detecting the displacement amount of the plunger biased by the spring. The pressing force sensor 320 includes a sensor case 321, a plunger 322 slidably held by the sensor case 321 in the front-rear direction (left and right in FIG. 9), and a main spring that urges the plunger 322 forward (to the left). 323 and a displacement sensor 325 that detects the amount of displacement of the plunger 322 in the axial direction relative to the sensor case 321 are mainly configured.

That is, when the plunger 322 biased forward by the main spring 323 is pressed and moved backward against the biasing force, the pressing force acting on the plunger 322 is determined by the amount of displacement of the plunger 322 and the spring coefficient of the main spring 323. By detecting the amount of displacement of the plunger 322 by the displacement sensor 325, the pressing force acting on the plunger is derived. An operation button 326 is supported at the distal end of the plunger 322 so as to be slidable in the axial direction. The operation button 326 is urged by a sub-spring 327 that urges the operation button 326 forward, and is disposed at the front end position. The sub spring 327 is a spring whose spring coefficient is smaller than that of the main spring 323.

A hole is formed through the wall surface of the operation portion in the front-rear direction. A pressing force sensor 320 is attached to the rear surface side (inside the main body portion) of the hole portion, and the operation button 326 is inserted through the hole portion to move the front end. A part protrudes ahead and is arrange | positioned. In the operation unit 11C having such a configuration, when the operator presses the operation button 326, first, the sub spring 327 is elastically deformed to move the operation button 326 backward (invalid stroke), and the front end of the plunger 322 is the operation button. It moves with a light operating force until it engages with the bottom of 326. When the front end of the plunger 322 is engaged with the bottom of the operation button 326, thereafter, the resistance force when the operation button 326 is pressed is increased.

This resistance force is a reaction force (spring force) of the main spring 323. When the operation button 326 is pressed backward against this reaction force, the main spring 323 is elastically deformed and the plunger 322 moves backward (effective stroke). ). At this time, the displacement amount of the plunger 322 is detected by the displacement sensor 325, and the pressing force is derived from the detected displacement amount and the spring coefficient of the main spring 323. As the displacement sensor 325, a sensor of a type that detects the displacement amount of the plunger 322 electrically, magnetically, or optically can be used. The displacement amount detected by the displacement sensor 325 and the pressing force acting on the plunger are in a proportional relationship, and an operation signal corresponding to the pressing force is output from the pressing force sensor 320 to the control unit 8.

The surgeon can recognize his / her operation by the displacement of the operation button 326 to perform the pressing operation, and can surely recognize the point from the invalid stroke to the effective stroke by changing the reaction force. 8 can be clearly recognized. In addition, since there is an invalid stroke area before entering the effective stroke, it can be easily determined whether or not the operator is pressing the operation button for the opening / closing operation.

Next, the operation unit 11D of the fourth configuration form will be described with reference to FIG. The operation unit 11 </ b> D of the present configuration form is configured using a switch that detects a surgeon's pressing operation as the operation detector 12. FIG. 10 illustrates a configuration in which a hole penetrating in the front-rear direction is formed in the wall surface of the operation unit and the switch 420 is attached to the inside of the main body unit 1 as the operation unit 11D ₁ of the first example in this configuration. As the switch 420, a plunger-type limit switch whose actuator is a shaft, a limit switch whose actuator is a hinge type, or the like is preferably used. In the figure, the actuator is a plunger type limit switch, and the shaft of the actuator is inserted through the hole, and the front end portion projects forward. An operation signal is output from the switch 420 to the control unit 8 when the actuator is pressed. The surgeon can confirm the switch operation with a click feeling and can open and close the treatment section 3 with a light operating force.

Here, when the switch 420 is used as the operation detector, the operator's pressing operation can be detected, but an operation signal corresponding to the pressing force cannot be output. For this reason, it seems that it is difficult to control the forceps gripping force (gas supply pressure) in a plurality of stages according to the operation on the operation detector. However, if the following algorithm is adopted, the above setting is possible. First, in the switch 420, the operation signal output is basically an on signal or an off signal. Therefore, when the operation detector is not pressed, the operation signal is off.

Therefore, for example, when the closing operation signal is switched from the OFF state to the continuous ON state, the setting of the supply pressure by the electropneumatic regulator is set to a low pressure. On the other hand, when the closing operation signal is turned on / off / on within a predetermined time (for example, within 0.5 seconds) from the off state and then turned on continuously, that is, after the double click, the on state is turned on. In such a case, the supply pressure set by the electropneumatic regulator is set to a high pressure. If such an algorithm is adopted, the forceps gripping force can be set in a plurality of stages using an inexpensive switch having only an on / off function.

Next, the operation unit 11E of the fifth configuration form will be described with reference to FIG. The operation unit 11E includes, as the operation detector 12, a switch 520 that detects the operator's pressing operation and a pressing force sensor 530 that detects the pressing force of the operator. A hole is formed through the wall surface of the operation portion in the front-rear direction, and a switch 520 and a pressing force sensor 530 are attached to the inside of the main body portion 1. As the switch 520, a limit switch having a hinge type actuator is preferably used, and the pressure sensor 530 has a circular pressure-sensitive area (like the pressure sensor 220 described in the second embodiment of the first configuration). A button-like pressing force sensor is preferably used. An operation button 510 is attached to the tip of the actuator of the switch 520. The operation button 510 is inserted through the hole, and the front end protrudes forward.

Inside the main body 1, a pressing force sensor 530 is attached behind the operation button 510. The position of the pressing force sensor 530 in the front-rear direction is moved backward when the operation button 510 is pressed, and the rear surface of the operation button (or the rear surface of the actuator) is slightly beyond the reverse position of the limit switch. It is set so as to contact the In the operation unit having such a configuration, when the operation button 510 is pressed, the operation button 510 is first moved backward with a light operation force, and the contact of the switch 520 is reversed. At this time, the detection signal of the switch 520 is output to the control unit 8. When the pressing operation is further performed, the rear surface of the operation button 510 comes into contact with the pressing force sensor 530 and the operation reaction force increases. Thereafter, the pressing force is detected by the pressing force sensor 530 and an operation signal corresponding to the pressing force is output to the control unit 8.

The surgeon can recognize the switch operation from the click feeling of the operation button 510 to perform the pressing operation, and can surely recognize that the reaction force changes to enter the detection area of the pressing force. 8 can be clearly recognized. In addition, since the operation detection by the switch 520 is performed before entering the detection area of the pressing force, it can be easily determined whether or not the operator is pressing the operation button for the opening / closing operation.

Therefore, according to the active forceps C1 as described above, it is possible to provide an active forceps suitable for endoscopic surgery that ensures the safety of the operator and the patient and reduces the burden on the operator.

(Second Embodiment)
Next, an active forceps C2 of a second embodiment illustrating an aspect of the present invention will be described with reference to FIGS. The active forceps C2 of this embodiment is basically the same as that of the first embodiment except that the shape of the handpiece Ca including the arrangement of the operation unit 11 and the forced release valve are provided on the controller Cb side. It is comprised similarly to the active forceps C1. Therefore, in the following description, the same components as those of the active forceps C1 of the first embodiment are denoted by the same reference numerals, and a duplicate description thereof is omitted.

12 is a schematic configuration of the active forceps C2, and FIG. 13 is a cross-sectional view showing the inside of the handpiece Ca. As shown in FIG. 12, the active forceps C2 includes a hand piece Ca operated by an operator and a controller Cb provided separately, and is used in a state where both are connected. As in the first embodiment, the distal end direction (left direction in FIGS. 12 and 13) of the shaft portion 2 provided with the treatment portion 3 is the front, and the proximal direction (same, right direction) of the shaft portion 2 is the forward direction. The side (hereinafter, the lower side) where the main body 1 is bent and extended across the axis of the shaft portion 2 will be referred to as the lower side, and the opposite side will be referred to as the upper side.

The handpiece Ca includes a main body portion 1 that is a base frame to which each member is attached, a shaft portion 2 that extends forward from the main body portion 1, a treatment portion 3 that can be opened and closed at the tip of the shaft portion 2, and a treatment portion. 3 includes an artificial muscle unit 40 that opens and closes 3. The controller Cb includes a pneumatic unit 50 that supplies / discharges gas to / from the artificial muscle unit 40 and a pneumatic unit 50 based on operation signals output from the operation detector 12 (12a, 12b) of the handpiece Ca. The control unit 8 is configured to output a command signal to control the opening / closing operation of the treatment unit 3 by controlling the operation of the pneumatic unit 50.

The main body 1 is formed with a cylindrical or elliptical columnar grip 16 having a shaft portion 2 attached to the front end and extending in the front-rear direction, and a rear portion of the grip 16 being bent in a slanting downward direction while being smoothly reduced in diameter. The signal cable 19 and the connector part 18 from which the tube 59 is led out are configured. In the present embodiment, a configuration in which the connector portion 18 is detachable from the rear end of the grip 16 is illustrated. 12 and 13 illustrate a configuration in which the rear portion of the grip 16 is bent downward by 45 degrees. The grip 16 is formed with a plurality of chevron-shaped finger hooking projections 16a on the outer peripheral surface centering on the lower surface so that the operator can easily grip the grip 16 so that the gripping position does not shift or fall off.

An operation unit 11 is provided at an upper front portion of the grip 16. A closing operation detector 12a and an opening operation detector 12b are attached to the operation unit 11 side by side. As the operation unit 11, any of the operation units (11A to 11E) of the first to fifth configuration modes described above can be applied. Here, the operation unit of the fourth configuration form (11D) using a switch for detecting the operator's pressing operation is applied as the operation detector 12 (12a, 12b), and in FIG. 12 and FIG. A configuration using a seal-type tactile switch (also referred to as a tactile switch, a tactile switch, or a tact switch) having a drip-proof property is shown as the operation unit 11D ₂ of the second embodiment. Around the closing operation detector 12a and the opening operation detector 12b, a convex protective wall 11g is projected so as to surround the periphery of the plungers of both detectors, and when the operator holds the grip 16. The switch does not operate against the surgeon's intention.

The artificial muscle unit 40 is attached to the inside of the main body 1 so as to extend in the front-rear direction. The basic configuration of the artificial muscle unit 40 is the same as that of the artificial muscle unit 40 already described with reference to FIGS. On the front end side of the artificial muscle unit 40, the push-pull wire 22 of the shaft portion 2 is connected to the sliding member 42 via the coupling fitting 44 and the terminal fitting 23 (see the related description of FIGS. 1 and 5). A joint member 47 b is connected to the end cap 47 on the rear end side of the unit 40.

The connector portion 18 extends from the electrical connector 18a for releasably connecting the signal cable 19 connecting the closing operation detector 12a and the opening operation detector 12b to the control unit 8, and the joint member 47b and the pneumatic unit 50 side. A pneumatic connector 18b for detachably connecting the tube 59 is provided. A male screw portion is formed at the rear end of the grip 16, and a female screw portion is formed at the front end of the nut member 18 c in the connector portion 18. Therefore, the electrical connector 18a and the pneumatic connector 18b are connected, and the female screw portion at the front end of the nut member 18c is screwed and fastened to the male screw portion at the rear end of the grip 16, thereby controlling the closing operation detector 12a and the opening operation detector 12b. The part 8 is electrically connected, and the artificial muscle unit 40 and the pneumatic unit 50 are locked in a pneumatically connected state.

A block diagram of the active forceps C2 is shown in FIG. As can be understood by comparing FIG. 6 and FIG. 14, the active forceps C2 exemplified in the present embodiment is the same as the active forceps C1 of the first embodiment in the basic configuration. On the other hand, it differs from the active forceps C1 of the first embodiment in the following points.

First, the forcible release valve 49 is disposed not on the handpiece Ca side but on the controller Cb side. Thereby, the handpiece Ca is further reduced in size and weight, and an active forceps that is easy to handle and further reduces the operator's fatigue is realized.

Similarly to the pneumatic unit of the first embodiment, the controller Cb is provided with a regulator 52, an electropneumatic regulator 53, a flow path switching valve 55, and the like, and adjusts the pressure of gas supplied to the artificial muscle unit 40. By adjusting the gripping force adjuster 54 that adjusts and sets the gripping force generated in the treatment section 3 when the forceps are closed, and the flow rate of the gas supplied to the artificial muscle unit 40 is adjusted and set. A speed regulator 56 is provided. FIG. 14 illustrates a configuration in which a variable resistor is used as the gripping force adjuster 54 and a speed controller is used as the speed adjuster 56. The gripping force adjuster 54 is connected to the control unit 8, and a pressure setting signal corresponding to the gripping force adjusted and set by the surgeon is output to the control unit 8. The speed regulator 56 is inserted between the flow path switching valve 55 and the artificial muscle unit 40.

The control unit 8 outputs a command signal corresponding to the pressure setting signal output from the gripping force adjuster 54 to the electropneumatic regulator 53, and flows a command signal based on the operation signal detected by the operation detectors 12a and 12b. The gas is output to the path switching valve 55 and the supply / blocking / opening of the gas to the artificial muscle unit 40 is controlled as follows.

When neither the closing operation detector 12a nor the opening operation detector 12b is pressed, that is, either the closing operation signal output from the closing operation detector 12a or the opening operation signal output from the opening operation detector 12b. The control unit 8 does not output a command signal to the electropneumatic regulator 53 and the flow path switching valve 55 when the circuit is off. For this reason, the pneumatic circuit on the pneumatic unit 50 side and the pneumatic circuit on the artificial muscle unit 40 side are blocked and held in a closed state. At this time, the treatment portion 3 at the tip of the handpiece Ca is held in a conventional state, for example, the treatment members 31 and 32 are in close contact with each other and the forceps are closed.

When the opening operation detector 12b is pressed from this state and the opening operation signal is turned on, the control unit 8 instructs the flow path switching valve 55 to open based on the opening operation signal output from the opening operation detector 12b. Output a signal. Thereby, the spool of the flow path switching valve 55 moves to the open position, the A port and the R port are connected, and the gas held in the artificial muscle unit 40 to the flow path switching valve 55 is exhausted. Therefore, the artificial rubber muscle 41 changes from the state shown in FIG. 5B to the state shown in FIG. 5A. In the treatment section 3, the forceps are opened from the closed state where the treatment members 31 and 32 are in close contact with each other. 32 changes to the separated open state.

When the pressing operation to the opening operation detector 12b is released and the opening operation signal is turned off, the control unit 8 turns off the command signal for the opening command signal for the flow path switching valve 55. As a result, the spool of the flow path switching valve 55 returns to the neutral position, and the A port (device connection port), P port (intake port), and R port (exhaust port) are all cut off, and the treatment section 3 is pressed. When the operation is released, that is, the treatment members 31, 32 are separated from each other, and the forceps are opened. The same applies to the case where the pressing force against the opening operation detector 12b is released in a state where the forceps are not fully opened, and the relative angles of the treatment members 31 and 32 are held in an open state at an arbitrary angle.

When the closing operation detector 12a is pressed and the closing operation signal is turned on, the control unit 8 outputs a closing command signal to the flow path switching valve 55 based on the opening operation signal output from the opening operation detector 12a. . Further, a closing pressure command signal set to the supply pressure P corresponding to the gripping force set in the gripping force adjuster 54 is output to the electropneumatic regulator 53. As a result, the spool of the flow path switching valve 55 moves to the closed position, the P port and the A port are connected, and the supply pressure P corresponding to the gripping force set in the gripping force adjuster 54 from the pneumatic unit 50. The gas is supplied to the artificial muscle unit 40 at a flow rate corresponding to the closing speed set in the speed regulator 56.

For this reason, the artificial rubber muscle 41 changes from the state of FIG. 5A to the state of FIG. 5B, and the treatment members 31 and 32 are brought into close contact with each other from the open state in which the treatment members 31 and 32 are separated from each other. Or it changes to the closed state which pinched | interposed the biological tissue etc. between both members. At this time, the speed at which the treatment members 31 and 32 swing in the closing direction is the closing speed set in the speed regulator 56. Further, the force between the treatment members 31 and 32, that is, the force acting on the treatment portion 3 becomes the gripping force set in the gripping force adjuster 54. Therefore, the operator can adjust the closing speed of the treatment section 3 by adjusting the speed adjuster 56, and appropriately adjust the gripping force acting on the treatment section 3 by adjusting the gripping force adjuster 54. be able to.

Here, the gas supply pressure P set according to the setting of the gripping force adjuster 54 is set so as to continuously change between P ₀ and P ₄ as illustrated in FIG. 7B. can do. In addition, a toggle switch, a rocker switch, or the like can be used as the gripping force adjuster 54, and the supply pressure P can be set to change in two stages of Hi and Low depending on the state of the switch, or a multi-stage rotary Using a switch or the like, the supply pressure P can be set to change in a plurality of stages according to the angular position of the knob.

In order to maintain the state in which the treatment unit 3 grips the living tissue or the like, the pressing force to the closing operation detector 12a may be released. At this time, the spool of the flow path switching valve 55 returns to the neutral position, and all of the A port, P port, and R port are cut off, and the pneumatic circuit on the artificial muscle unit 40 side is kept closed. . Therefore, the treatment section 3 is held in a state when the pressing force to the closing operation detector 12a is released, that is, a state in which a living tissue or the like is gripped with a predetermined gripping force. The same applies when the pressing force applied to the closing operation detector 12a is released in a state where the forceps are not completely closed, and the treatment members 31 and 32 can be held in a closed state at an arbitrary angle.

The configuration using the gripping force adjuster 54 and the electropneumatic regulator 53 as the gripping force adjusting means for adjusting the gripping force generated by the treatment unit 3 has been described above. However, a manual operation regulator is used instead of the electropneumatic regulator. And the gas supply pressure P may be directly adjusted and set by a regulator. In addition, the speed controller (flow control valve with a check valve) is used as the speed adjuster 56, and the configuration for adjusting the closing speed of the treatment unit 3 is illustrated. However, a flow control valve that does not include a check valve is provided instead of the speed controller. In addition, both the closing speed and the opening speed of the treatment unit 3 may be adjusted.

The speed adjusting means for adjusting the opening / closing speed of the treatment section 3 uses an electromagnetic proportional control valve as the flow path switching valve 55 (or an electromagnetic proportional flow control valve is provided separately from the flow path switching valve 55) to adjust the speed. The device 56 may be configured using a variable resistor or various switches as described above. When the opening operation signal / closing operation signal is output from the opening operation detector 12b / closing operation detector 12a, the control unit 8 opens the valve according to the opening / closing speed set in the speed regulator 56. The command signal / closing example signal is output to the flow path switching valve 55, and the gas is discharged / supplied at a flow rate corresponding to the set opening / closing speed. The electromagnetic proportional operation may be only in the closing direction.

Further, the configuration form using the tactile switch as the operation detector 12 (12a, 12b) has been exemplified, but the operation detector 12 has been described for the operation unit 11 (11A to 11E) of the active forceps C1 of the first embodiment. Moreover, the thing of a various structure form can be applied and the effect similar to having demonstrated about each structure form can be acquired. In addition, the configuration using the artificial muscle unit has been exemplified as a configuration in which the gripping force can be adjusted and set by adjusting and setting the supply pressure of the gas. However, other configurations such as a piston with a built-in spring, a double-acting piston, an air motor, etc. You may comprise using a pneumatic actuator of a type.

According to the active forceps C2 of the second embodiment described above, the same effects as described above for the active forceps C1 of the first embodiment (including each configuration form) can be obtained. Furthermore, with the active forceps C2 of this embodiment, the following effects can be obtained.

First, the controller Cb is provided with an electropneumatic regulator 53 and a gripping force adjuster 54 as pressure adjusting means for adjusting the pressure of the gas supplied to the artificial muscle unit 40. Therefore, the operator adjusts the gripping force adjuster 54 so that the gripping force is weakened and gently gripped according to the part of the biological tissue to be gripped and the state of the tissue that is visually observed. And can be adjusted and set in advance to a desired gripping force. The controller Cb is provided with a speed regulator 56 as a flow rate adjusting means for adjusting the flow rate of the gas supplied to the artificial muscle unit 40. Therefore, the surgeon can adjust the speed adjuster 56 so that the treatment section 3 is slowly closed or rapidly closed.

Further, the main body portion 1 of the handpiece Ca includes a substantially cylindrical grip 16 extending in the front-rear direction and a connector portion 18 whose rear portion of the grip 16 is reduced in diameter and inclined obliquely downward with respect to the axis of the shaft portion 2. According to the configuration and the configuration in which the operation unit 11 is provided at the front upper part of the grip 16, it is possible to provide an active forceps that is easy to handle in an endoscopic operation and has good operability. Further, by using the tact switch as the operation detector 12 (12a, 12b), the operator can clearly recognize the operation performed by the user with a sense of click, thereby providing high safety and operability. Good active forceps can be provided.

C1 Active forceps C2 of the first embodiment Active forceps Ca of the first embodiment Handpiece Cb Controller 1 Main body portion 2 Shaft portion 3 Treatment portion 8 Control portion 11 Operation portion (11A to E Operation portions of the first to fifth configuration forms The subscript is an example)
12 operation detectors (12a closing operation detector, 12b opening operation detector)
16 Grip 18 Connector 40 Artificial muscle unit 50 Pneumatic unit 53 Electro-pneumatic regulator (pressure adjusting means)
54 Gripping force adjuster (pressure adjusting means)
56 Speed regulator (flow rate adjustment means)
59 Tube 120 Pushing force sensor 220 Pushing force sensor 240 Pushing force sensor 260 Pushing force sensor 320 Pushing force sensor 530 Pushing force sensor

Claims (10)

1. A main body provided with an operation detector for detecting the operation of the surgeon, a shaft extending from the main body, a treatment part provided at the tip of the shaft so as to be openable and closable, and opening and closing the treatment part A drive unit and a control unit that outputs a command signal based on the operation signal output from the operation detector and controls the operation of the drive unit;
   The drive means includes a pneumatic actuator that opens and closes the treatment portion, and a pneumatic unit that supplies gas to the pneumatic actuator based on the command signal,
   The active forceps, wherein the pneumatic actuator is disposed in the main body, and the pneumatic unit is disposed in a separate controller separately from the main body.
2. The active forceps according to claim 1, wherein the controller includes pressure adjusting means for adjusting and setting a pressure of a gas supplied to the pneumatic actuator.
3. The pressure adjusting unit includes an electropneumatic regulator that sets a pressure of gas supplied to the pneumatic actuator in accordance with a command signal output from the control unit,
   The control unit outputs a command signal based on an operation signal output from the operation detector to the electropneumatic regulator to control a pressure of gas supplied to the pneumatic actuator. 2. Active forceps according to 2.
4. The operation detector is a pressing force sensor that detects the pressing force of the surgeon,
   4. The active forceps according to claim 3, wherein the control unit outputs a command signal based on an operation signal corresponding to an operator's pressing force output from the operation detector to the electropneumatic regulator. 5.
5. The control unit outputs a command signal to the pneumatic unit to supply gas to the pneumatic actuator when the operation signal output from the operation detector is a signal equal to or higher than a predetermined pressing force set in advance. The active forceps according to claim 4, wherein the active forceps is supplied.
6. The pressure adjusting means includes a pressure regulator that outputs a pressure setting signal corresponding to a pressure adjusted and set in advance by an operator, and a gas pressure supplied to the pneumatic actuator according to a command signal output from the control unit And an electropneumatic regulator to set
   The control unit outputs a command signal based on the pressure setting signal output from the pressure regulator to the electropneumatic regulator, and controls the pressure of gas supplied to the pneumatic actuator. The active forceps according to claim 2.
7. The active forceps according to any one of claims 1 to 6, wherein the controller is provided with a flow rate adjusting means for adjusting and setting a flow rate of a gas supplied to the pneumatic actuator.
8. The active forceps according to any one of claims 1 to 7, wherein the pneumatic actuator is an artificial muscle unit that is deformed according to supply / discharge of gas to open and close the treatment portion.
9. The active forceps according to any one of claims 1 to 8, wherein the operation detector is a tactile switch.
10. The main body portion has a cylindrical or elliptical columnar grip extending in the front-rear direction in which the shaft portion is attached to the front end portion and the shaft portion is extended, and the rear portion of the grip is reduced in diameter and with respect to the axis of the shaft portion Having a connector part that is formed to be inclined and from which a tube connecting the pneumatic actuator and the pneumatic unit is led out from the rear end;
    The active forceps according to any one of claims 1 to 9, wherein the operation portion is provided in a front portion of the grip opposite to the connector portion across an axis of the shaft portion.
    

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