WO2018235151A1

WO2018235151A1 - Medical manipulator system

Info

Publication number: WO2018235151A1
Application number: PCT/JP2017/022634
Authority: WO
Inventors: 晃佑野川; 岸　宏亮; 千里唐澤
Original assignee: オリンパス株式会社
Priority date: 2017-06-20
Filing date: 2017-06-20
Publication date: 2018-12-27

Abstract

In order to prevent a power source from being contaminated by a bodily fluid or the like without the need for a sterile cover for covering the power source, this medical manipulator system (1) is provided with: a manipulator (3) provided with an elongated insertion part (2) equipped with a treatment part (6) at the distal end, wherein the distal end part whereof is inserted into a body, and a drive part (7) which is disposed at the proximal end of the insertion part (2) and drives the treatment part (6); a power source (4) provided with a manipulator attachment part (9) whereto the drive part (7) of the manipulator (3) is removably attached and which supplies power to the drive part (7); and a mantle tube (5) to be disposed outside the body, for covering a portion of the insertion part (2) between the drive part (7) and the distal end part which is inserted into the body. The mantle tube (5) covering the insertion part (2) of the manipulator (3) is provided on the proximal opening (5a) side with a sealing means for liquid-tightly sealing the mantle tube to the insertion part (2). The mantle tube (5) is removably attached to the power source (4).

Description

Medical manipulator system

The present invention relates to a medical manipulator system.

In a medical manipulator system including a motorized manipulator inserted into the body to treat an affected area, the manipulator is detachably provided to a power source for supplying power to the manipulator, and the entire power source including the detaching portion of the manipulator is thin film A medical manipulator system is known which prevents contamination of a power source by body fluid or the like by covering the cover with a sterile cover (see, for example, Patent Document 1).

JP, 2015-6423, A

However, in the medical manipulator system of Patent Document 1, since the sterile cover is sandwiched between the attaching / detaching portion of the power source and the manipulator, there is a disadvantage that the sterile cover is caught or broken when the power source is activated.
The present invention has been made in view of the above-described circumstances, and it is an object of the present invention to provide a medical manipulator system capable of preventing contamination of a power source by body fluid or the like without requiring a sterile cover for covering the power source. And

One aspect of the present invention is a manipulator having a treatment section at the tip and a long insertion section where the tip section is inserted into the body, and a drive section disposed at the base end of the insertion section and driving the treatment section. A power source provided with a manipulator attaching / detaching portion for detachably attaching the driving portion of the manipulator and supplying power to the driving portion; and the insertion between the driving portion and the tip portion inserted into the body And an outer tube disposed outside the body, and a seal sealing a fluid-tight state between the insertion portion and the proximal open side of the outer tube covering the insertion portion of the manipulator. A medical manipulator system is provided, wherein a means is provided and the sheath tube is removably attached to the power source.

According to this aspect, by attaching the drive unit provided to the manipulator to the manipulator attachment / detachment unit provided to the power source, power is supplied from the power source to the drive unit and disposed at the tip of the insertion unit of the manipulator It is possible to activate the treatment section to treat the target site in the body.
In this case, since the sterilization cover is not pinched between the drive part of the manipulator and the manipulator attachment / detachment part of the power source, it is possible to prevent entrapment or breakage of the sterilization cover when power is supplied from the power source.

In addition, the outer peripheral surface of the insertion portion disposed outside the body between the distal end portion of the insertion portion disposed in the insertion state in the body and the drive portion disposed on the proximal end side of the insertion portion is covered by the outer tube. At the same time, since the sealing means is provided on the opening side of the proximal end side of the mantle tube passing through the insertion portion, it is possible to prevent the liquid such as body fluid from leaking to the drive portion side from the internal space of the mantle tube. . Then, the outer peripheral surface of the outer tube that is not inserted into the body is maintained in a clean state, so the distal end portion to which the body fluid etc. adheres and the drive portion disposed on the proximal end side of the insertion portion It can be isolated to prevent the body fluid and the like from adhering to the drive unit.

In the above aspect, the manipulator attachment / detachment unit includes a moving mechanism for moving the drive unit of the attached manipulator in the direction along the longitudinal axis of the insertion unit, and the sealing means includes the outer tube and the insertion unit And movably sealed in the longitudinal direction of the insertion portion.
In this way, when the manipulator attachment / detachment part is moved by the operation of the movement mechanism, the drive part of the manipulator attached to the manipulator attachment / detachment part is moved in the direction along the longitudinal axis of the insertion part. The insertion part is moved in the longitudinal direction. Since the sealing means permits longitudinal movement of the insert relative to the mantle, movement by the movement mechanism is not impeded, and the seal between the mantle and the insertion at the proximal opening is maintained. The motive power source can be maintained in a clean state by preventing the liquid such as body fluid from dripping to the motive power source side when the insertion portion advances and retreats.

In the above aspect, movement of the insertion portion in a direction to extract the insertion portion from the proximal end opening at a predetermined relative position between the insertion portion and the outer tube at a predetermined relative position is performed. You may provide the stopper which controls.
In this way, when the insertion portion is moved in the direction to extract it from the proximal end opening of the outer tube, the movement is restricted by the stopper at a predetermined position, so the insertion portion is unintentionally pulled out of the outer tube Can be prevented.

In the above aspect, the sealing means may be a wiper member which is provided on the inner surface of the outer sleeve and wipes or handles the outer surface of the insertion portion.
In this way, when the insertion portion is pulled out from the proximal end opening of the outer tube, the outer surface of the insertion portion of the manipulator is wiped or handled by the wiper member, so that the body fluid etc. It is possible to prevent the liquid from dripping to the power source side.

In the above aspect, the distal end side outer tube covering the insertion portion from the distal end portion to the portion disposed outside the body is provided, and the distal end side outer tube and the distal end side open tube are provided in the proximal end opening of the distal end side outer tube. A distal side sealing means may be provided to seal the space between the insertion portion and the liquid tight.
In this way, the insertion portion is covered with the distal end side cannula from the distal end portion disposed in the body to the portion disposed outside the external body, and the distal end side opening means is also provided in the proximal end opening of the distal end side cannula. Since the fluid such as body fluid can not easily reach the outer tube. Thereby, the power source can be maintained in a clean state more effectively.

Further, in the above aspect, the distal end side sealing means includes two seal members for sealing the entire circumference between the distal end side outer tube and the insertion portion at intervals in the longitudinal direction of the insertion portion. A cylinder is provided with a through hole for opening the space formed between the seal members outward in the radial direction of the tip end side outer tube, and a cylinder disposed over the entire circumference with an interval in the radial direction outward of the through hole. And a closed part that covers the entire circumference between the cylindrical part and the distal end side outer peripheral tube on the proximal end side in the longitudinal direction of the insertion part with respect to the through hole.

When the treatment is performed in a state where the body cavity is pressurized and expanded, a fluid such as body fluid tends to be jetted proximally from the gap between the distal sealing means and the insertion portion by pressure. Of the two sealing members spaced apart in the longitudinal direction of the insertion portion, the space formed between the two sealing members by the through hole is opened radially outward of the distal end side outer tube, Even if liquid is spouted to the base end side more than the seal member on the tip side by applying an excessively large pressure to the seal member on the tip side, the space formed between the two seal members passes through the through hole. By discharging the liquid outward in the radial direction, the sealed state on the proximal side with respect to the seal member on the proximal side is maintained, and the liquid is prevented from being jetted to the proximal side from the seal member on the proximal side. Can. The liquid discharged radially outward from the through hole is completely between the cylindrical portion and the tip end outer ring tube at the proximal end side of the cylindrical portion disposed radially outward of the through hole and the through hole. A circumferentially occluding blockage prevents flow radially and proximally, and is expelled back toward the distal side. Thereby, the power source can be maintained in a clean state more effectively.

According to the present invention, it is possible to prevent contamination of the power source due to body fluid or the like without requiring a sterile cover for covering the power source.

BRIEF DESCRIPTION OF THE DRAWINGS It is a whole block diagram which shows the medical manipulator system which concerns on one Embodiment of this invention. In the medical manipulator system of FIG. 1, it is a figure which shows the state which removed the manipulator and the mantle tube from the motive power source. It is a longitudinal cross-sectional view which shows partially the manipulator inserted in the proximal end side opening of the outer tube of the medical manipulator system of FIG. It is a longitudinal cross-sectional view which shows the state which advanced the manipulator of FIG. 3 with respect to the mantle tube. It is a whole block diagram which shows the modification of the medical manipulator system of FIG. It is a longitudinal cross-sectional view which shows the connection part of the outer tube of the medical manipulator system of FIG. 5, and a front end side outer tube. It is a partial perspective view which shows the other modification of the medical manipulator system of FIG. It is a longitudinal cross-sectional view which shows partially the manipulator inserted in the proximal end side opening of the outer tube of the other modification of the medical manipulator system of FIG.

A medical manipulator system 1 according to an embodiment of the present invention will be described below with reference to the drawings.
The medical manipulator system 1 according to the present embodiment, as shown in FIG. 1, includes a manipulator 3 having a long insertion portion 2 inserted into the body, and a power source 4 for supplying power to the manipulator 3. And an outer tube 5 for covering the insertion portion 2.

The manipulator 3 includes a treatment unit 6 for treating an affected part at the tip of the insertion unit 2 and a drive unit 7 for driving the treatment unit 6 at the proximal end. The drive unit 7 and the treatment unit 6 are disposed along the longitudinal direction in the insertion unit 2 and are connected by one or more wires (not shown) for transmitting the driving force of the drive unit 7 to the treatment unit 6.

The power source 4 includes a base 8, and an upper surface of the base 8 includes an attachment / detachment part (a manipulator attachment / detachment part) 9 for detachably attaching the drive part 7 of the manipulator 3. The power source 4 includes a moving mechanism 10 that moves the detachable unit 9 to which the drive unit 7 of the manipulator 3 is attached in the direction along the longitudinal axis of the insertion unit 2. The moving mechanism 10 includes a guide rail (not shown) and a slider movable along the guide rail, and linearly moves the detachable portion 9.
When the drive unit 7 of the manipulator 3 is attached, the attachment / detachment unit 9 transmits, to the drive unit 7, motive power from a motor (not shown) provided in the power source 4.

As shown in FIGS. 1 and 2, the sheath tube 5 has a tubular member 11 for covering a part of the insertion portion 2 in the longitudinal direction, and a mounting portion for detachably attaching the proximal end of the tubular member 11 to the base 8. It has 12 and.
Further, as shown in FIG. 3 and FIG. 4, the outer tube 5 is a sealing member for sealing the space between the insertion portion 2 and the proximal end side opening 5 a into which the insertion portion 2 at the proximal end is inserted. (Sealing means) 13 is provided. The sealing member 13 seals the fluid-tight state between the two while allowing the longitudinal movement of the insertion portion 2 with respect to the sheath tube 5. For example, the oil seal or the outer surface of the insertion portion 2 is wiped or handled. Wiper member.

In order to treat the affected area of the patient using the medical manipulator system 1 according to this embodiment configured as described above, the insertion portion 2 of the manipulator 3 is penetrated through the outer tube 5 and the distal end side opening 5 b of the outer tube 5 The distal end side of the insertion portion 2 is made to project from the above, and the proximal end side of the insertion portion 2 is made to project from the proximal end side opening 5 a of the outer tube 5.
In this state, the insertion portion 2 exposed in front of the outer tube 5 is inserted into the body from the treatment portion 6 side, and the treatment portion 6 is disposed in the vicinity of the affected area under endoscopic observation.

Then, the drive unit 7 provided at the base end of the insertion unit 2 exposed to the base end side of the sheath tube 5 is attached to the detachable unit 9 provided at the base 8 of the power source 4 . In addition, the mounting portion 12 provided at the proximal end of the outer tube 5 is attached to the base 8.

In this state, when the detachable portion 9 is moved, the insertion portion 2 is moved in the longitudinal direction, and the position of the treatment portion 6 is adjusted. At this time, since the sheath tube 5 is fixed to the base 8, the insertion portion 2 is moved relative to the sheath tube 5, but the insertion portion is made by the seal member 13 provided in the proximal end opening 5 a of the sheath tube 5 The gap between 2 and the jacket tube 5 is maintained in a liquid tight state.
Then, the affected part can be treated by operating the motor of the power source 4 to operate the drive unit 7 and operating the treatment unit 6 at the tip of the insertion unit 2 through the wire.

Thus, according to the medical manipulator system 1 according to the present embodiment, the distal end side portion of the insertion portion 2 inserted into the body is disposed at a position apart from the detachable portion 9 to which the drive portion 7 is attached. , It is isolated by the sheath tube 5 arranged between, so that even if fluid such as a patient's body fluid flows along the insertion part 2, it is blocked by the sheath tube 5 to prevent adhesion to the power source 4 it can.

In particular, since the insertion portion 2 is movably sealed in a liquid-tight state with respect to the outer tube 5 by the sealing member 13, even if the insertion portion 2 is moved in the longitudinal direction by the movement of the detachable portion 9 The dense state is maintained, and it is possible to prevent the fluid such as the body fluid from reaching the proximal power source 4 beyond the mantle tube 5.

Also, when replacing the manipulator 3, the drive unit 7 is removed from the mounting / removal unit 9 and the mounting unit 12 is removed from the base 8, the insertion unit 2 is pulled out of the body to integrate the manipulator 3 and the outer tube 5. It can be separated from the power source 4 and moved to a location away from the power source 4 to separate the manipulator 3 and the sheath tube 5 from each other. Thereby, the power source 4 can be more reliably prevented from being contaminated by a liquid such as a patient's body fluid.

Further, unlike the conventional sterilization cover, it is not necessary to arrange between the detachable portion 9 and the drive portion 7, and the occurrence of the inconvenience that the sterile cover is caught and damaged during power transmission in the detachable portion 9 is prevented. can do.

In the medical manipulator system 1 according to the present embodiment, as shown in FIG. 5 and FIG. A part of the insertion portion 2 may be covered, and the tip end of the sheath tube 5 may further include a tip side sheath tube 14 that is detachably attached. The distal end side opening 14 a of the distal end side outer tube 14 may further include a distal end side sealing means 15.

As the distal side sealing means 15, as shown in FIG. 6, two sealing

members

16 and 17 for sealing the entire circumference between the distal side outer tube 14 and the insertion portion 2 are provided at intervals in the longitudinal direction. And a through hole 18 for opening the space formed between the

seal members

16 and 17 radially outward of the tip end side outer tube 14, and spaced outward in the radial direction of the through hole 18 over the entire circumference. An example is provided that includes a cylindrical portion 19 to be disposed, and a closed portion 20 that closes the entire circumference between the cylindrical portion 19 and the distal end side outer tube 14 on the proximal end side in the longitudinal direction than the through hole 18 can do.

When treating a patient's body cavity using the medical manipulator system 1 which concerns on this embodiment, the space in a body cavity may be expanded and a treatment may be performed by pressurizing and expanding a body cavity.
In such a case, even if the pressure in the pressurized body cavity acts in the direction of pushing out the body fluid from the body cavity by using the tip side mantle tube 14, the body fluid pushed out is the tip side mantle tube It is possible to more reliably prevent leakage from the proximal end opening 14 a of the distal end side outer sleeve 14 via the space between the insertion portion 14 and the insertion portion 2.

That is, when the pressure is excessively increased, the liquid may be ejected to the proximal end side more than the seal member 16 on the distal end side provided on the proximal end portion of the distal end side outer sleeve 14. Even in such a case, the body fluid beyond the seal member 16 on the tip side is accommodated in the space between the two

seal members

16 and 17 as shown by the arrow in FIG. The cylindrical portion 19 and the blocking portion 20 which flow radially outward but are disposed radially outward of the through hole 18 prevent ejection to the proximal end side, and return to the distal end side.
Thereby, even in the treatment performed by pressurizing the body cavity, there is an advantage that liquid such as body fluid can be more reliably prevented from adhering to the power source 4.

Since the distal end side outer tube 14 is detachably attached to the tip of the outer tube 5, when the insertion portion 2 of the manipulator 3 is pulled out from the body, the distal side outer tube 14 is separated from the outer tube 5 and the distal side outer tube 14 is a body cavity , And the assembly of the manipulator 3 and the outer tube 5 may be removed.
Moreover, although the front end side outer tube 14 was removably attached to the front end of the outer tube 5, it is not limited to this, and the front end side outer tube 14 is disposed without connecting with the outer tube 5, The cannula 14 may be fixed to the patient's body or to an external structure near the patient's back and forth.

Further, in the example shown in FIG. 6, as the through hole 18, one penetrating straight in the radial direction is illustrated, but one or more baffles (not shown) are disposed in the through hole 18 to configure a labyrinth structure , And may reduce the force of fluid such as body fluid flowing out.

Further, the insertion portion 2 is allowed to be inserted into the proximal end opening 5 a of the outer tube 5 between the outer tube 5 and the insertion portion 2 which are relatively moved, and the insertion portion 2 in the inserted state is the outer tube 5 A stopper 21 may be provided to prevent withdrawal from the proximal end opening 5a.
As the stopper 21, as shown in FIG. 7, an inner flange-like flange portion 23 disposed on the proximal end side of the seal member 13 of the outer tube 5 and having a key groove 22 in a part in the circumferential direction And a projection 24 provided in a part of the longitudinal direction 2 and capable of penetrating the key groove 22 can be mentioned.

When the outer tube 5 is attached to the insertion portion 2, the insertion portion 2 is inserted into the outer tube 5 in a state where the projection 24 is aligned with the key groove 22 and the projection 24 extends beyond the flange portion 23 at the tip end. Is rotated about its longitudinal axis by a predetermined angle. As a result, even if the insertion portion 2 is retracted with respect to the sheath tube 5, the projection 24 abuts on the flange portion 23, so that it is possible to reliably prevent further withdrawal.
And thereby, the insertion part 2 is extracted unexpectedly from the sheath tube 5, and it has an advantage that it can prevent more reliably that the power source 4 is contaminated.

Further, in the present embodiment, the insertion portion 2 may be a flexible insertion portion having flexibility, or may be a rigid insertion portion having no flexibility. When the insertion portion 2 is a soft member, the middle position in the longitudinal direction can be slackened vertically downward, and the shape can prevent the liquid such as body fluid from moving further to the proximal end side. .

Further, in the present embodiment, although the outer tube 5 and the manipulator 3 are attached so as to be movable relative to each other, when it is not necessary to move the manipulator 3 in the longitudinal direction of the insertion portion 2, an adhesive (sealing means) is used. It may be fixed in a liquid tight state.
Further, even in the case where the sheath tube 5 and the manipulator 3 are mounted so as to be able to move relative to each other, as shown in FIG. 8, by providing the expansion and contraction part 25 like a bellows, the sheath tube 5 is used as an adhesive It may be fixed in a liquid tight state by adhesion or the like (sealing means: not shown).

DESCRIPTION OF SYMBOLS 1 Medical manipulator system 2 Insertion part 3 Manipulator 4 Power source 5 Outer tube 5a Base end side opening 6 Treatment part 7 Drive part 9 Detaching part (manipulator detaching part)
10 Moving mechanism 13 Seal member (wiper member, sealing means)
14 tip side outer tube 14a base end side opening 15 tip side sealing means 16, 17 seal member 18 through hole 19 cylindrical portion 20 closed portion 21 stopper

Claims

A manipulator having a treatment section at the tip and a long insertion section into which the tip section is inserted into the body, and a drive section disposed at the base end of the insertion section and driving the treatment section;
A power source including a manipulator attaching / detaching portion for detachably attaching the drive portion of the manipulator and supplying power to the drive portion;
And an outer tube disposed outside the body covering the insertion portion between the drive portion and the tip portion to be inserted into the body.
A sealing means for sealing the space between the insertion portion and the insertion portion in a fluid tight manner is provided on the proximal end side of the outer tube covering the insertion portion of the manipulator.
The medical manipulator system to which the said sheath tube is detachably attached with respect to the said motive power source.
The manipulator attachment / detachment unit includes a movement mechanism for moving the drive unit of the attached manipulator in a direction along a longitudinal axis of the insertion unit;
The medical manipulator system according to claim 1, wherein the sealing means movably seals between the outer tube and the insertion portion in the longitudinal direction of the insertion portion.
A stopper is provided between the insertion portion and the sheath tube, for restricting movement of the insertion portion and the sheath tube in a direction of extracting the insertion portion from the proximal end opening at a predetermined relative position. The medical manipulator system according to 2.
The medical manipulator system according to any one of claims 1 to 3, wherein the sealing means is a wiper member provided on an inner surface of the outer tube to wipe or squeeze the outer surface of the insertion portion.
A distal end outer tube covering the insertion portion from the distal end portion to a portion disposed outside the body;
The distal end side opening means of the distal end side mantle tube is provided with a distal end side sealing means for sealing the space between the distal end side mantle tube and the insertion portion in a liquid tight state. Medical manipulator system.
The distal end side sealing means comprises two sealing members for sealing the entire circumference between the distal end side outer tube and the insertion portion at intervals in the longitudinal direction of the insertion portion, and between the sealing members A through hole is provided to open the space to be formed outward in the radial direction of the tip end side outer tube, and a cylindrical portion is provided over the entire circumference with an interval in the radial direction outward of the through hole, and the through hole The medical manipulator system according to claim 5, further comprising: a closed portion closing the entire circumference between the cylindrical portion and the distal end side outer circumferential tube on the proximal end side in the longitudinal direction of the insertion portion.