WO2020121763A1 - Holding device, and driving system for flexible endoscope - Google Patents

Holding device, and driving system for flexible endoscope Download PDF

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Publication number
WO2020121763A1
WO2020121763A1 PCT/JP2019/045430 JP2019045430W WO2020121763A1 WO 2020121763 A1 WO2020121763 A1 WO 2020121763A1 JP 2019045430 W JP2019045430 W JP 2019045430W WO 2020121763 A1 WO2020121763 A1 WO 2020121763A1
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WO
WIPO (PCT)
Prior art keywords
holding
holding member
wheel
holding device
tubular portion
Prior art date
Application number
PCT/JP2019/045430
Other languages
French (fr)
Japanese (ja)
Inventor
誠 橋爪
真哉 小野木
龍 中楯
勉 岩佐
西村　浩一
菜穂子 山村
Original Assignee
国立大学法人九州大学
ジョンソン・エンド・ジョンソン株式会社
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Application filed by 国立大学法人九州大学, ジョンソン・エンド・ジョンソン株式会社 filed Critical 国立大学法人九州大学
Publication of WO2020121763A1 publication Critical patent/WO2020121763A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes

Definitions

  • the present invention relates to a holding device for holding a medical device having a tubular portion such as an endoscope and a drive system for a flexible endoscope having the holding device.
  • Patent Document 1 discloses a technique relating to a holding device that holds a tubular portion of a medical instrument such as a flexible endoscope so that the tubular portion of the medical instrument can be moved back and forth.
  • Patent Document 1 discloses a shaft roller 90 as a holding device that holds a tubular portion of the medical device in a retractable manner.
  • the shaft roller 90 includes sheaves 92A and 92B that hold the tubular portion 64 of the endoscope so as to be capable of advancing and retracting. By rotating the sheaves 92A and 92B, the tubular portion 64 of the endoscope is axially moved. To move to.
  • the grooves 93A and 93B of the sheaves 92A and 92B are said to enhance the frictional force between the tubular portions 64 of the endoscope by rubber coating or the like so that the tubular portions 64 of the endoscope do not slip (Patent Document 1). 1 paragraph 0053, FIG. 6B).
  • the tubular portion 64 of the endoscope can be held so as to be able to advance and retreat in the axial direction, and the tubular portion of the endoscope can be controlled by controlling the rotation of the sheaves 92A and 92B. It is possible to control the feed amount of 64 in the axial direction.
  • the tubular portion 64 of the endoscope cannot be rotated around its axis. In use, the endoscope may require a "twisting motion" or rotation of the tubular portion of the endoscope about its axis.
  • Such a rotating mechanism causes an increase in size and cost of the device.
  • power for driving the endoscope to rotate about the major axis of the tubular portion and power for driving the entire shaft roller 90 to rotate are required.
  • Two motors are required, and a control mechanism that moves the two motors in coordination is also required.
  • the rotations of the two motors do not cooperate for some reason, a strong twist is applied to the tubular portion, which may damage the endoscope.
  • it is desirable that the axial roller 90 is disposed near the patient to prevent the tubular portion of the endoscope from meandering outside the patient's body, but the rotational trajectory of the axial roller 90 is large near the patient.
  • the present invention is a holding device that holds a tubular portion of a medical instrument such as a flexible endoscope so that the tubular portion can be moved back and forth, without rotating the holding device itself, of the tubular portion of the medical instrument.
  • An object of the present invention is to provide a holding device capable of allowing a twisting motion.
  • a holding device for holding a medical device having a tubular portion, wherein the tubular portion is moved forward and backward relative to the holding device in a longitudinal direction thereof, with respect to a rotational direction about the longitudinal direction.
  • a holding device that includes a holding member that holds a rotatable member.
  • (Structure 2) A wheel member in which the holding member holds the tubular portion so as to be sandwiched by a first holding member and a second holding member, and the first holding member has a rotation axis in a direction substantially orthogonal to the longitudinal direction.
  • the second holding member is a wheel member having a rotation axis in a direction substantially orthogonal to the longitudinal direction, and a small rotating body having an axis substantially parallel to a tangent line of the outer circumference as a rotation axis on its outer circumference.
  • (Structure 4) A small rotating body of a wheel member included in the first holding member and a wheel included in the second holding member when holding the tubular portion so as to be sandwiched by the first holding member and the second holding member.
  • the first holding member and the second holding member each include at least two wheel members, and when the tubular portion is held by the first holding member and the second holding member, Among the small rotating bodies of the plurality of wheel members included in the first holding member and the small rotating bodies of the plurality of wheel members included in the second holding member, at least three small rotating bodies are always in contact with the tubular portion. 10.
  • the holding device according to any one of configurations 3 to 9, which is configured to.
  • (Configuration 20) 20 The holding device according to any one of configurations 2 to 19, wherein the small rotating body has a spindle shape or a barrel shape.
  • (Configuration 24) A drive system for a flexible endoscope, comprising the holding device according to any one of configurations 1 to 23.
  • the tubular portion of the medical instrument is held in the longitudinal direction relative to the holding device so as to be rotatable in the rotational direction about the longitudinal direction.
  • the twisting operation can be allowed in the tubular portion of the medical device without rotating the holding device itself.
  • FIG. 1 is a schematic diagram showing a drive system for a flexible endoscope according to an embodiment of the present invention.
  • Perspective view showing the internal mechanism of the holding device Front view showing the internal mechanism of the holding device
  • Bottom view showing the internal mechanism of the holding device The figure which shows the holding member with which a holding device is equipped.
  • the figure which shows the wheel member with which a holding member is equipped.
  • Plan view showing the disk member Perspective view showing the disc member
  • the figure which shows the structure of the holding member of the other example of a holding device The figure which shows the structure of the holding member of the other example of a holding device. The figure which shows the structure of the holding member of the other example of a holding device. The figure which shows the example which provided the holding device with the wiping part for wiping the tubular part of an endoscope.
  • FIG. 1 is a schematic diagram showing a drive system for a flexible endoscope according to an embodiment of the present invention.
  • the drive system 100 for a flexible endoscope has, as its rough structure, a main body 101, an operating portion 102, an arm portion 103, an endoscope mounting portion 104, and a bending arm 105. And a holding device 1.
  • the drive system 100 for a flexible endoscope is a system for supporting an operation of an inspection or a treatment using the flexible endoscope 2 which is a medical instrument having a tubular portion, and an endoscope is installed inside the endoscope mounting portion 104.
  • the mirror 2 is attached and used.
  • the endoscope attachment portion 104 is fitted with an operation portion of the endoscope 2 or an air supply/water supply/suction button, an operation dial, or the like (not particularly shown) provided in the endoscope 2, and the buttons and the like. It has a drive unit that drives an operation dial and the like.
  • the endoscope mounting portion 104 also has a drive portion for driving the endoscope 2 so as to rotate (arrow in FIG. 1), whereby the tubular portion 21 of the endoscope 2 is lengthened. It can be rotated around an axis with the direction as the axis.
  • the operation unit 102 is a user interface for operating the endoscope 2.
  • the main body 101 has a control unit that performs control processing for driving the endoscope mounting unit 104 and the drive unit of the holding device 1 in response to a signal based on an operation on the operation unit 102.
  • a caster is provided below the main body 101 so that the entire apparatus can be moved.
  • the arm portion 103 is rotatable with respect to the main body portion 101, and the arm is configured to be extendable/contractible in its longitudinal direction (not particularly shown). Thereby, the arrangement positions of the endoscope 2 and the holding device 1 can be adjusted appropriately.
  • the bending arm 105 is an arm to which the holding device 1 is attached, and has a bending portion in the middle of the arm.
  • the holding device 1 is used, for example, on the bed on which the patient is lying and near the mouth and anus of the patient.
  • FIG. 2 is a perspective view of the holding device 1 viewed from the base end side of the arm.
  • the holding device 1 holds the tubular portion 21 of the endoscope 2 relative to the longitudinal direction so as to control the delivery amount and advances and retracts the tubular portion 21 relative to the longitudinal direction with respect to the rotational direction about the longitudinal direction. Is a device that holds it rotatably.
  • the holding device 1 advances and retracts the tubular portion 21 by rotating the holding member while holding the tubular portion 21 of the endoscope 2 between the holding members 11A and 11B equipped with wheel members, and at the same time, the longitudinal portion It is rotatably held in the direction of rotation about the direction.
  • the holding members 11A and 11B are rotating members, and are covered by a wheel portion cover 16 for reducing the inclusion of an object such as an end of surgical operation in the rotating portion during endoscopic examination or treatment. Further, it is entirely covered by the main body case 11.
  • FIGS. 4 and 5 are views showing the internal mechanism of the holding device 1 without the main body case 11 and the like.
  • FIG. 3 is a perspective view seen from the arm proximal end side
  • FIG. 4 is a front view
  • FIG. 5 is a bottom view. Is.
  • the holding device 1 includes a fixed block 1A and a slide block 1B.
  • the slide block 1B is configured to be slidable with respect to the fixed block 1A, and the gap between the holding member 11A and the holding member 11B can be narrowed or widened between the lock position and the release position.
  • Each component of the fixed block 1A is attached to the frame 12A, and is a motor M for driving the holding members 11A and 11B, a holding member 11A, and a power transmission mechanism from the motor M to the holding member 11A.
  • Gears G1 to G5, a rotary shaft 15, a slide lock mechanism 18A that locks the slide while maintaining a gap, a lock release lever 14 that unlocks the slide lock mechanism 18A, and the like are provided.
  • the drive circuit for controlling the motor M is provided in the arm portion 103 via the wiring, but the drive circuit may be located easily.
  • Each component of the slide block 1B is attached to the frame 12B, and the holding member 11B, the gears G6 and G7 that are power transmission mechanisms from the motor M to the holding member 11B, the slide lock mechanism 18B, and the slide block 1B.
  • the gear G1 provided on the rotation shaft of the motor M meshes with the reduction gear G2.
  • the reduction gear G2 is non-rotatably attached to the rotary shaft 15 together with the bevel gear G3.
  • the rotating shaft 20A of the holding member 11A is detachably attached to the shaft holder 19A and is non-rotatably attached.
  • a gear G4, which is a bevel gear, is non-rotatably attached to the lower end of the shaft holder 19A, and the rotation of the motor M is transmitted to the holding member 11A by meshing the gear G4 with the gear G3.
  • a gear G6, which is a bevel gear, and a gear G5, which meshes with the gear G6 slidably and non-rotatably, are formed on the distal end side (slide block 1B side) of the rotary shaft 15.
  • the gear G5 is formed in the longitudinal direction of the rotary shaft 15 so as to have a length equal to or longer than the sliding amount of the slide block 1B with respect to the fixed block 1A.
  • a hole that meshes with the gear G5 is formed in the center of the gear G6, so that the gears G5 and G6 mesh slidably and non-rotatably.
  • the holding member 11B is detachably attached to the shaft holder 19B and is non-rotatably attached.
  • a gear G7 which is a bevel gear, is non-rotatably attached to the lower end of the shaft holder 19B, and the rotation of the motor M is transmitted to the holding member 11B when the gears G6 and G7 mesh with each other.
  • the rotating shaft 20B of the holding member 11B is rotated in the opposite direction.
  • the rotation link mechanism is configured such that the rotation of the holding member 11A and the rotation of the holding member 11B are opposite to each other and the rotations are synchronized while the distance between the holding members 11A and 11B is variable.
  • the slide lock mechanism 18A provided in the fixed block 1A has a hook that engages with the slide lock mechanism 18B on the tip side (slide block 1B side).
  • the base end side of the slide lock mechanism 18A is rotatably attached to the frame 12A, and the front end side of the slide lock mechanism 18A rotates in the direction of the bottom surface of the holding device 1.
  • the slide lock mechanism 18B provided in the slide block 1B has a hook that engages with the slide lock mechanism 18A on the tip side (fixed block 1A side), and has a mechanism that rotates in the upper surface direction of the holding device 1. ..
  • the hook of the slide lock mechanism 18A is lowered, the hook of the slide lock mechanism 18A is raised, and the slide block 1B approaches the fixed block A.
  • the hooks of the slide lock mechanism 18A and the hooks of the slide lock mechanism 18B come to the position where they mesh with each other, the two hooks are engaged with each other by the torsion coil springs arranged in the rotation shaft of each slide lock so that both hooks return to their original positions. And is locked. Thereby, the distance between the holding member 11A and the holding member 11B is fixed at a predetermined distance.
  • the slide lock mechanism 18A slides the lock release lever 14 in a direction away from the slide block 1B to reach a position where the hooks of the slide lock mechanism 18A and the slide lock mechanism 18B are disengaged from each other.
  • the hooks are arranged to hang down on the bottom surface side of the holding device 1. Therefore, the lock can be released by operating the lock release lever 14.
  • the slide block 1B slides away from the fixed block 1A by the action of the compression spring installed between the slide block 1B and the bottom frame 12C, and the holding member 11A and the holding member 11B. The intervals can be widened.
  • the holding member 11A has a rotary shaft 20A that is in the vertical direction when the holding device 1 is placed on a horizontal plane, and the wheel member 10 arranged above and below the rotary shaft 20A.
  • I have two. That is, the holding member 11A includes two wheel members 10 arranged in parallel on the same rotation axis. The individual wheel members 10 have the same structure. The two wheel members 10 are non-rotatably attached to the rotary shaft 20A.
  • a spacer 30 ⁇ /b>A is provided between the upper and lower two-stage wheel members 10 to maintain the space therebetween. Due to the size relationship between the small rotating body 10R and the medical device, the spacer 30A may be omitted if it is unnecessary.
  • the above-described configuration of the holding member 11A is the same for the holding member 11B.
  • FIG. 7 is a perspective view showing the wheel member 10.
  • the wheel member 10 has a plurality of barrel-shaped or spindle-shaped small rotating bodies 10R on the outer circumference of the disk member 10D, the axis of rotation of which is substantially parallel to the tangent line of the outer circumference.
  • five small rotating bodies 10R are used as an example.
  • a stack of a plurality of wheel members 10 is generally called an "omni wheel” and is used as a wheel that enables movement in multiple directions.
  • the outer peripheral shape of the small rotating body 10R is substantially the same as the arc of a circle contacting the outer periphery of the wheel member 10, when the wheel member 10 is viewed from the direction perpendicular to the surface of the disc member,
  • the shape of the outer circumference is substantially circular.
  • the small rotating body 10R has a barrel-shaped or spindle-shaped through-hole at the center of its long axis, and a shaft serving as a rotation axis is inserted through the through-hole and is configured to be rotatable around the rotation axis. ing.
  • the small rotating body and the rotating shaft of the small rotating body may be integrally formed or fixed to each other, and a bearing that rotatably receives the rotating shaft may be formed on the disk member.
  • the disk member and the rotary shaft of the small rotating body are preferably formed of a metal member such as stainless steel, brass, or titanium, and of these, stainless steel is preferable.
  • a metal member such as stainless steel, brass, or titanium
  • synthetic resin such as polyethylene, polypropylene, ABS, vinyl chloride, nylon, synthetic rubber such as silicone rubber and urethane rubber, and metal such as stainless steel can be considered. When repeatedly used, it is preferably one that can withstand steam sterilization.
  • the material of the small rotating body is preferably a non-slip material in order to suppress slippage in the long axis direction between the small rotating body and the tubular portion, and silicone is preferable.
  • the surface of the small rotating body may be provided with a non-slip shape such as non-slip, embossing or sandblasting.
  • 8 is a plan view showing the disk member 10D
  • FIG. 9 is a perspective view.
  • the disk member 10D has a joint portion 10D1 for fixing the shaft that is the rotation axis of the small rotating body 10R at the position that is the apex of the pentagon.
  • each side of the pentagon is formed in a shape capable of receiving the small rotating body 10R.
  • an example is given in which the shape is along the outer circumference of the small rotating body 10R.
  • a recess for receiving the shaft is formed in the joint portion 10D1, and the shaft is fitted into the recess and fixed by welding or the like. That is, at the joint portions 10D1 adjacent to each other, both ends of the shaft, which is the rotation axis of the small rotating body 10R, are fixed, whereby the small rotating body 10R is rotatably attached to the disc member 10D.
  • the shaft is fixed to the disk member 10D by welding or the like as an example here, the shaft may be detachable.
  • FIG. 10 is a schematic view showing the holding members 11A and 11B in a state where the tubular portion 21 of the endoscope 2 is held.
  • the slide block 1B is configured to be slidable with respect to the fixed block 1A, and the slide block 1B is opened between the holding member 11A and the holding member 11B.
  • the tubular portion 21 of the endoscope 2 is attached and detached.
  • the slide block 1B is slid so as to be closed to hold the above-mentioned lock.
  • the tubular portion 21 of the endoscope 2 is held so as to be sandwiched by the member 11A and the holding member 11B (FIG. 10).
  • the holding member 11A and the holding member 11B each include two wheel members 10 each having a rotation axis in a direction substantially orthogonal to the longitudinal direction of the tubular portion 21, and a total of four wheel members 10.
  • the tubular portion 21 is held so as to surround it.
  • FIG. 11 is a schematic cross-sectional view for explaining a state in which the tubular portion 21 of the endoscope 2 is held.
  • the holding member 11A includes two wheel members 10 arranged vertically, and the wheel member 10 in the upper stage and the wheel member 10 in the lower stage are arranged so as to be out of phase with each other.
  • the small rotating body 10R of one wheel member 10 and the joint portion 10D1 of the other wheel member 10 are arranged to face each other. Thereby, at least one of the small rotating bodies included in the holding member 11A is in contact with the tubular portion 21.
  • This structure is the same for the holding member 11B.
  • the joint portion 10D1 of the wheel member 10 of the holding member 11A is arranged so as to face the small rotating body 10R of the wheel member 10 of the holding member 11B, and the joint portion 10D1 of the wheel member 10 of the holding member 11B. Are arranged so as to face the small rotating body 10R of the wheel member 10 of the holding member 11A.
  • the small rotating body 10R of the two wheel members 10 included in the holding member 11A and the two wheel members 10 included in the holding member 11B are configured to be in contact with the tubular portion 21 without fail. The conditions under which at least three small rotating bodies 10R always contact the tubular portion 21 in this manner will be described below.
  • Wheel member diameter D [mm] Number of small rotating bodies Nr Small rotating body angle ⁇ [deg] Joint angle ⁇ [deg] Joint length l >5 [mm]
  • the small rotating body angle ⁇ is the angle (center angle) that one small rotating body occupies on the outer periphery of the wheel member, and the joint angle ⁇ is one joint existing between the small rotating bodies.
  • the angle 10D1 occupies the outer circumference of the wheel member (center angle).
  • a circle C indicated by an alternate long and short dash line in FIG. 8 is a circle in contact with the outer periphery of the wheel member, and is also a line in contact with the outer periphery of the small rotating body 10R.
  • the diameter D of the wheel member is the diameter of the circle C
  • the joint length 1 is the length of the arc on the circle C formed by the central angle ⁇ .
  • the length 1 that one joint occupies on the outer circumference of the wheel member is expressed by Equation 3 by the joint angle ⁇ and the diameter D of the wheel member.
  • Equation 4 Considering concrete manufacturing means such as welding of the shaft which is the rotating shaft of the small rotating body, the minimum distance required for the outer periphery of the wheel member is about 5 [mm] per joint. Substituting 5 [mm] for the part length l, ⁇ is expressed by Equation 4.
  • the number Nr of small rotating bodies is Nr ⁇ 5.96 [pcs] Becomes That is, when the joining portion is not contracted (when it is 5 [mm] or more), the number condition of the small rotating bodies for the three small rotating bodies to always support the tubular portion 21 is 5 or less.
  • the diameter D of the wheel member is preferably small, and at most about 60 mm. In this case, when the number condition of the small rotating bodies is similarly calculated from the equations 4 and 2, ⁇ 9.54 [deg] and Nr ⁇ 9.42 [pcs].
  • the diameter D of the wheel member is more preferably 50 mm or less, and in this case, ⁇ 11.45 [deg] and Nr ⁇ 7.85 [pcs]. Therefore, the number Nr of the small rotating bodies is preferably 3 to 9, more preferably 3 to 7, and most preferably 3 to 5. In addition, in order to satisfy the number condition, it is more preferable that the number of the small rotating bodies is large, since the medical device can easily rotate around the long axis.
  • the holding device 1 of the present embodiment holds the tubular portion 21 of the endoscope 2 so as to sandwich the tubular portion 21 with the two holding members 11A and 11B having the two wheel members 10.
  • the rotation of the holding member 11A and the holding member 11B are interlocked with each other, whereby the four wheel members 10 are interlocked with each other to rotate and thereby move the tubular portion 21 back and forth in the longitudinal direction. That is, the delivery amount is controllably held in the longitudinal direction of the tubular portion 21.
  • the small rotating body 10R arranged on the outer periphery of the wheel member 10 can passively rotate, when the rotational force around the axis is applied to the tubular portion 21, the small rotating body 10R rotates, The tubular portion 21 is rotatable about its axis. Therefore, when a rotational force about the longitudinal axis is applied to the tubular portion 21 by the rotation of the endoscope 2 by the endoscope mounting portion 104 (see FIG. 1), the small rotating body 10R passively rotates and the tubular portion is rotated. Allows twisting drive for 21.
  • the holding device provided in the drive system 100 for the flexible endoscope is described, and the "twisting motion" is driven by the drive system 100 for the flexible endoscope as an example.
  • the "twisting motion" is driven by the drive system 100 for the flexible endoscope as an example.
  • it can also be used when performed by a person.
  • the forward/backward movement of the tubular portion can be electrically controlled by the holding member to adjust the feed amount and be fixed at a desired position, and the twisting movement necessary for insertion/treatment is performed by the operator in the medical device.
  • the medical device can be rotated while being held by simply applying a rotating force.
  • the wheel members 10 of the holding members 11A and 11B are arranged so that at least three small rotating bodies 10R are always in contact with the tubular portion 21 in the portion holding the medical device.
  • the tubular portion 21 can be stably held without restraining the axial rotation of the tubular portion 21 and causing no slippage in the back-and-forth movement.
  • the wheel member may be detachably attached to the holding member.
  • the wheel member detachable By making the wheel member detachable, it is possible to easily wash and sterilize only the portion of the endoscope that comes into contact with the tubular portion (that is, the portion to which the patient's body fluid can adhere). Also, it is possible to handle tubular parts with different diameters by exchanging with wheel members of different diameters or exchanging spacers for holding the gap between the upper and lower two-stage wheel members with different heights.
  • the holding member may be configured to be detachable from the holding device.
  • the holding member includes the holding member 11A and the holding member 11B as an example, but the number of holding members may be increased.
  • FIG. 12 shows an example in which a plurality of holding members are arranged in the longitudinal direction of the tubular portion. In this way, by disposing a plurality of holding members in the longitudinal direction, the number of small rotating bodies that come into contact with the tubular portion of the endoscope is increased, so that the holding force at the time of forward/backward movement can be increased.
  • there are support points at a plurality of locations apart from each other in the longitudinal direction of the tubular portion of the endoscope it becomes easy to define the insertion angle of the tubular portion of the endoscope into the natural opening of the patient such as the mouth and anus.
  • FIGS. 13(a) and 13(b) show an example in which one holding member is configured as a sliding member that slidably holds a tubular portion of a medical device such as an endoscope. ..
  • the holding member 11A-3 in FIGS. 13A and 13B has basically the same configuration as the holding member 11A in the present embodiment.
  • the holding member 11B-3 is a wall-shaped member that is provided so as to face the holding member 11A-3 and that holds the tubular portion of the endoscope with the holding member 11A-3.
  • a sliding holding member S formed of a member having a low friction in relation to the surface of the tubular portion and having a concave portion for holding the tubular portion. It is provided.
  • the material of the slide holding member S include fluororesins such as Teflon (registered trademark), synthetic resins such as polyethylene, polypropylene and ABS, and metals such as SUS members that have been surface-treated to improve sliding. Among them, a fluororesin such as Teflon (registered trademark) having particularly good sliding property is preferable.
  • the holding member including the wheel member can be integrated into one, so that the entire holding device can be made smaller.
  • FIGS. 13(a) and 13(b) show an example in which a plurality of holding members are arranged in the longitudinal direction of the tubular portion in the examples of FIGS. 13(a) and 13(b).
  • FIG. 15 shows an example of a holding device having a wiping portion for wiping the lubricating gel on the surface of the tubular portion.
  • the wiping portion 17 is provided on the patient side of the holding members 11A and 11B, or on both the patient side and the hand side of the holding members 11A and 11B.
  • the wiping portion 17 is provided with a member W made of, for example, a sponge or a rubber member for removing gel or water from the surface of the medical device. Since the patient's body fluid adheres to this member W, it is more preferable that it can be replaced. In this way, by removing the lubricating gel and the water on the surface of the tubular portion, it is possible to reduce unintended slippage due to the movement of the tubular portion in the long axis direction due to the reduction in the holding force.
  • a member W made of, for example, a sponge or a rubber member for removing gel or water from the surface of the medical device. Since the patient's body fluid adheres to this member W, it is more preferable that it can be replaced. In this way, by removing the lubricating gel and the water on the surface of the tubular portion, it is possible to reduce unintended slippage due to the movement of the tubular portion in the long axis direction due to the reduction in the holding force.
  • the holding members 11A and 11B are provided with wheel members that are coaxially installed in parallel in two steps, but the present invention is not limited to this.
  • the wheel of the holding member 11A-3 It is also acceptable to have a single stage member.
  • the holding member may be provided with three or more stages of wheel members.
  • the tubular portion of the medical device typified by an endoscope can be held in the longitudinal direction thereof to advance and retreat and can be freely rotated about the longitudinal axis, it is retained.
  • the wheel members provided on the members need not be provided coaxially or in parallel. Further, the wheel members having different diameters may be mixed and used. Further, wheel members having different configurations exemplified below may be mixed and used. Even when the diameter of the wheel member provided on the holding member 11A is different from the diameter of the wheel member provided on the holding member 11B, the gear of the gear that transmits the rotational force to each of the holding members 11A and 11B. By appropriately setting the ratio, the rotation of the holding member 11A and the rotation of the holding member 11B can be synchronized with each other so that they rotate in opposite directions and the peripheral velocities on the outer circumference of the wheel member become equal.
  • the small rotating bodies have the same size, and the small rotating bodies are evenly provided on the outer periphery of the wheel, but the small rotating bodies have different sizes. It may be arranged on the outer periphery of.
  • the positional relationship between the slide block 1B and the fixed block 1A that is, the distance between the holding members 11A and 11B
  • the present invention is not limited to this.
  • a biasing mechanism that biases the opposing holding members toward each other is provided, and when holding the tubular portion of the endoscope, a biasing force that constantly narrows the interval between the holding members is generated. Good.

Abstract

Provided is a holding device which can hold a tubular part of a medical tool, such as a flexible endoscope, in a forward and backward movable manner, and which can give the tubular part a twisting movement without the need to rotate the holding device itself.　A holding device 1 for holding a tubular part of a medical tool, such as a flexible endoscope, in a forward and backward movable manner, the holding device being provided with a holding member (11A, 11B) which can hold the tubular part rotatably in a rotation direction around the length direction while moving the tubular part forward and backward relatively in the length direction.

Description

保持装置及び軟性内視鏡の駆動システムHolding device and drive system for flexible endoscope
　本発明は、内視鏡等の管状部を有する医療用器具を保持するための保持装置及びこれを有する軟性内視鏡の駆動システムに関する。 The present invention relates to a holding device for holding a medical device having a tubular portion such as an endoscope and a drive system for a flexible endoscope having the holding device.
　軟性内視鏡などの管状部を有する医療用器具の使用時において、当該医療用器具の管状部を進退可能に保持する保持装置に関する技術が、特許文献１によって開示されている。
　特許文献１には、当該医療用器具の管状部を進退可能に保持する保持装置としての軸ローラ９０が開示されている。軸ローラ９０は、内視鏡の管状部６４を挟んで進退可能に保持するシーブ９２Ａ、９２Ｂを備えており、シーブ９２Ａ、９２Ｂを回転させることによって、内視鏡の管状部６４をその軸方向に移動させるものである。シーブ９２Ａ、９２Ｂの溝９３Ａ、９３Ｂは、内視鏡の管状部６４が滑らないように、ラバーコーティング等によって内視鏡の管状部６４との間の摩擦力を高めるとされている（特許文献１の段落００５３、ＦＩＧ．６Ｂ）。 Patent Document 1 discloses a technique relating to a holding device that holds a tubular portion of a medical instrument such as a flexible endoscope so that the tubular portion of the medical instrument can be moved back and forth.
Patent Document 1 discloses a shaft roller 90 as a holding device that holds a tubular portion of the medical device in a retractable manner. The shaft roller 90 includes sheaves 92A and 92B that hold the tubular portion 64 of the endoscope so as to be capable of advancing and retracting. By rotating the sheaves 92A and 92B, the tubular portion 64 of the endoscope is axially moved. To move to. The grooves 93A and 93B of the sheaves 92A and 92B are said to enhance the frictional force between the tubular portions 64 of the endoscope by rubber coating or the like so that the tubular portions 64 of the endoscope do not slip (Patent Document 1). 1 paragraph 0053, FIG. 6B).
米国特許出願公開第２０１４／０２９６６３３号明細書US Patent Application Publication No. 2014/0296633
　特許文献１の軸ローラ９０によれば、内視鏡の管状部６４をその軸方向に進退可能に保持することができ、シーブ９２Ａ、９２Ｂの回転を制御することによって、内視鏡の管状部６４の軸方向の送り出し量を制御することができる。
　しかしながら、特許文献１の軸ローラ９０の構成においては、内視鏡の管状部６４のみをその軸回りに回転させることができない。内視鏡は、その使用時において、“ひねり動作”即ち内視鏡の管状部を軸回りに回転させることを要する場合がある。これに対し、特許文献１の軸ローラ９０では、シーブ９２Ａ、９２Ｂによって内視鏡の管状部６４が滑らないように保持されているため、内視鏡の管状部６４のみにひねり動作を与えることができない。内視鏡の管状部６４にひねり動作を与えるためには、内視鏡の管状部６４を挟み込んでいる軸ローラ９０そのものを回転させる必要がある。即ち、軸ローラ９０そのものを回転させるための回転機構が必要となる。当該回転機構は、内視鏡の管状部６４の軸を中心として軸ローラ９０を回転させることが望まれるため、軸ローラ９０を回転させるための軌道がある程度大きくならざるを得ない。このような回転機構は装置の大型化や高コスト化を招くことになる。
　また、“ひねり動作”を電動化しようとした場合、内視鏡を管状部の長軸周りに回転駆動する動力と、軸ローラ９０全体を回転駆動させる動力が必要であり、一軸の動作に対してモータが２つ必要になり、２つのモータを協調して動かす制御機構も必要となる。その上、２つのモータの回転が何らかの理由で協調しなかった場合には、管状部に強いねじりが加わり、内視鏡が破損する危険がある。
　加えて、軸ローラ９０は、内視鏡の管状部が患者体外で蛇行するのを防ぐため、患者の近くに配置されることが望まれるが、患者の近くで軸ローラ９０の回転軌道が大きくなると、患者への接触のおそれがある。上部消化管への内視鏡の挿入時などは、患者の顔付近で軸ローラ９０全体が回転することになるため、患者へ圧迫感や恐怖感を与えてしまうため、この点の改善も望まれる。 According to the shaft roller 90 of Patent Document 1, the tubular portion 64 of the endoscope can be held so as to be able to advance and retreat in the axial direction, and the tubular portion of the endoscope can be controlled by controlling the rotation of the sheaves 92A and 92B. It is possible to control the feed amount of 64 in the axial direction.
However, in the configuration of the shaft roller 90 of Patent Document 1, only the tubular portion 64 of the endoscope cannot be rotated around its axis. In use, the endoscope may require a "twisting motion" or rotation of the tubular portion of the endoscope about its axis. On the other hand, in the shaft roller 90 of Patent Document 1, since the tubular portion 64 of the endoscope is held by the sheaves 92A and 92B so as not to slip, it is possible to give a twisting action only to the tubular portion 64 of the endoscope. I can't. In order to give a twisting motion to the tubular portion 64 of the endoscope, it is necessary to rotate the shaft roller 90 itself that sandwiches the tubular portion 64 of the endoscope. That is, a rotating mechanism for rotating the shaft roller 90 itself is required. Since it is desired that the rotating mechanism rotates the shaft roller 90 about the shaft of the tubular portion 64 of the endoscope, the orbit for rotating the shaft roller 90 is unavoidably large. Such a rotating mechanism causes an increase in size and cost of the device.
Further, when the "twisting motion" is to be electrified, power for driving the endoscope to rotate about the major axis of the tubular portion and power for driving the entire shaft roller 90 to rotate are required. Two motors are required, and a control mechanism that moves the two motors in coordination is also required. Moreover, if the rotations of the two motors do not cooperate for some reason, a strong twist is applied to the tubular portion, which may damage the endoscope.
In addition, it is desirable that the axial roller 90 is disposed near the patient to prevent the tubular portion of the endoscope from meandering outside the patient's body, but the rotational trajectory of the axial roller 90 is large near the patient. If this happens, there is a risk of contact with the patient. When the endoscope is inserted into the upper digestive tract, the entire shaft roller 90 rotates near the patient's face, which gives the patient a feeling of pressure and fear. Therefore, improvement of this point is also desired. Be done.
　本発明は、上記の点に鑑み、軟性内視鏡などの医療用器具の管状部を進退可能に保持する保持装置であって、保持装置そのものを回転させることなく、医療用器具の管状部のひねり動作を許容することが可能な保持装置を提供することを目的とする。 In view of the above points, the present invention is a holding device that holds a tubular portion of a medical instrument such as a flexible endoscope so that the tubular portion can be moved back and forth, without rotating the holding device itself, of the tubular portion of the medical instrument. An object of the present invention is to provide a holding device capable of allowing a twisting motion.
（構成１）
　管状部を有する医療用器具を保持するための保持装置であって、前記管状部を、その長手方向に前記保持装置に対して相対的に進退させつつ、長手方向を軸とした回転方向に対しては回動自在に保持する保持部材を備える、保持装置。 (Structure 1)
A holding device for holding a medical device having a tubular portion, wherein the tubular portion is moved forward and backward relative to the holding device in a longitudinal direction thereof, with respect to a rotational direction about the longitudinal direction. A holding device that includes a holding member that holds a rotatable member.
（構成２）
　前記保持部材が、第１の保持部材と第２の保持部材によって前記管状部を挟むように保持し、前記第１の保持部材が、前記長手方向と略直交する方向を回転軸とするホイール部材であって、その外周上に、当該外周の接線と略平行な軸を回転軸とする小回転体を複数有しているホイール部材を備えている、構成１に記載の保持装置。 (Structure 2)
A wheel member in which the holding member holds the tubular portion so as to be sandwiched by a first holding member and a second holding member, and the first holding member has a rotation axis in a direction substantially orthogonal to the longitudinal direction. The holding device according to configuration 1, further comprising a wheel member having a plurality of small rotating bodies having, as a rotation axis, an axis substantially parallel to a tangent line of the outer circumference on the outer circumference thereof.
（構成３）
　前記第２の保持部材が、前記長手方向と略直交する方向を回転軸とするホイール部材であって、その外周上に、当該外周の接線と略平行な軸を回転軸とする小回転体を複数有しているホイール部材を備えている、構成２に記載の保持装置。 (Structure 3)
The second holding member is a wheel member having a rotation axis in a direction substantially orthogonal to the longitudinal direction, and a small rotating body having an axis substantially parallel to a tangent line of the outer circumference as a rotation axis on its outer circumference. The holding device according to configuration 2, comprising a plurality of wheel members.
（構成４）
　前記第１の保持部材と第２の保持部材によって前記管状部を挟むように保持する際において、前記第１の保持部材が備えるホイール部材の小回転体と、前記第２の保持部材が備えるホイール部材の小回転体とのうち、少なくとも１つの小回転体が必ず前記管状部と接するように構成されている、構成３に記載の保持装置。 (Structure 4)
A small rotating body of a wheel member included in the first holding member and a wheel included in the second holding member when holding the tubular portion so as to be sandwiched by the first holding member and the second holding member. The holding device according to configuration 3, wherein at least one of the small rotating bodies of the member is configured to be in contact with the tubular portion without fail.
（構成５）
　前記第１の保持部材又は前記第２の保持部材の少なくとも一方が複数の前記ホイール部材を備えている、構成３又は４に記載の保持装置。 (Structure 5)
The holding device according to configuration 3 or 4, wherein at least one of the first holding member and the second holding member includes a plurality of the wheel members.
（構成６）
　前記第１の保持部材又は前記第２の保持部材の少なくとも一方が、同一回転軸上に平行に配置された複数の前記ホイール部材を備えている、構成３又は４に記載の保持装置。 (Structure 6)
The holding device according to configuration 3 or 4, wherein at least one of the first holding member and the second holding member includes a plurality of the wheel members arranged in parallel on the same rotation axis.
（構成７）
　前記第１の保持部材又は前記第２の保持部材の少なくとも一方に備えられる、前記複数のホイール部材の直径が略同一である、構成５又は６に記載の保持装置。 (Structure 7)
7. The holding device according to configuration 5 or 6, wherein the plurality of wheel members provided in at least one of the first holding member and the second holding member have substantially the same diameter.
（構成８）
　前記第１の保持部材に備えられる前記ホイール部材と、前記第２の保持部材に備えられる前記ホイール部材の直径が全て略同一である、構成３から７の何れかに記載の保持装置。 (Structure 8)
8. The holding device according to any one of configurations 3 to 7, wherein the wheel member included in the first holding member and the wheel member included in the second holding member have substantially the same diameter.
（構成９）
　前記第１の保持部材のホイール部材の回転軸と、前記第２の保持部材のホイール部材の回転軸が、略平行である構成３から８の何れかに記載の保持装置。 (Configuration 9)
The holding device according to any one of configurations 3 to 8, wherein a rotation axis of the wheel member of the first holding member and a rotation axis of the wheel member of the second holding member are substantially parallel to each other.
（構成１０）
　前記第１の保持部材及び前記第２の保持部材がそれぞれ少なくとも２つの前記ホイール部材を備え、前記第１の保持部材と第２の保持部材によって前記管状部を挟むように保持する際において、前記第１の保持部材が備える複数のホイール部材の小回転体と、前記第２の保持部材が備える複数のホイール部材の小回転体のうち、少なくとも３つの小回転体が必ず前記管状部と接するように構成されている、構成３から９の何れかに記載の保持装置。 (Configuration 10)
The first holding member and the second holding member each include at least two wheel members, and when the tubular portion is held by the first holding member and the second holding member, Among the small rotating bodies of the plurality of wheel members included in the first holding member and the small rotating bodies of the plurality of wheel members included in the second holding member, at least three small rotating bodies are always in contact with the tubular portion. 10. The holding device according to any one of configurations 3 to 9, which is configured to.
（構成１１）
　前記第１の保持部材及び前記第２の保持部材が備える前記ホイール部材がそれぞれ２つである、構成３から１０の何れかに記載の保持装置。 (Configuration 11)
The holding device according to any one of configurations 3 to 10, wherein the first holding member and the second holding member each include two wheel members.
（構成１２）
　前記第１の保持部材のホイール部材の回転と、前記第２の保持部材のホイール部材の回転を、相互に逆回転となるように且つ回転を同期させる回転リンク機構を備えている、構成３から１１の何れかに記載の保持装置。 (Configuration 12)
From the configuration 3, a rotation link mechanism is provided which synchronizes the rotation of the wheel member of the first holding member and the rotation of the wheel member of the second holding member with each other so as to be mutually reverse rotations. 11. The holding device according to any one of 11.
（構成１３）
　前記第１の保持部材と前記第２の保持部材の間隔を広げることができるように構成されており、且つ、所定の間隔にて固定させる間隔保持機構を備えている、構成２から１２の何れかに記載の保持装置。 (Configuration 13)
Any of the configurations 2 to 12, which is configured so that the distance between the first holding member and the second holding member can be widened, and further includes a distance holding mechanism for fixing the first holding member and the second holding member at a predetermined distance. The holding device according to claim 1.
（構成１４）
　前記ホイール部材が着脱可能に構成されている構成２から１３の何れかに記載の保持装置。 (Configuration 14)
14. The holding device according to any one of configurations 2 to 13, wherein the wheel member is configured to be removable.
（構成１５）
　前記第２の保持部材が、前記管状部を摺動可能に保持する摺動部材を備えている、構成２に記載の保持装置。 (Configuration 15)
The holding device according to configuration 2, wherein the second holding member includes a sliding member that slidably holds the tubular portion.
（構成１６）
　前記第１の保持部材が、複数の前記ホイール部材を備えている、構成１５に記載の保持装置。 (Configuration 16)
16. The holding device according to configuration 15, wherein the first holding member includes a plurality of the wheel members.
（構成１７）
　前記第１の保持部材が、２つの前記ホイール部材を備えている、構成１５に記載の保持装置。 (Configuration 17)
16. The holding device according to configuration 15, wherein the first holding member comprises two wheel members.
（構成１８）
　前記第１の保持部材が、同一回転軸上に平行に配置された２つの前記ホイール部材を備えている、構成１５に記載の保持装置。 (Structure 18)
16. The holding device according to configuration 15, wherein the first holding member includes two wheel members that are arranged in parallel on the same rotation axis.
（構成１９）
　前記第１の保持部材に備えられる、前記２つのホイール部材の直径が略同一である、構成１７又は１８に記載の保持装置。 (Structure 19)
19. The holding device according to configuration 17 or 18, wherein the two wheel members included in the first holding member have substantially the same diameter.
（構成２０）
　前記小回転体の形状が、紡錘形状若しくは樽状である、構成２から１９の何れかに記載の保持装置。 (Configuration 20)
20. The holding device according to any one of configurations 2 to 19, wherein the small rotating body has a spindle shape or a barrel shape.
（構成２１）
　前記小回転体を備えたホイール部材の外周の形状が略円形である、構成２から２０の何れかに記載の保持装置。 (Configuration 21)
21. The holding device according to any one of Configurations 2 to 20, wherein the wheel member including the small rotating body has a substantially circular outer peripheral shape.
（構成２２）
　前記保持部材が、前記管状部の長手方向に複数配置されている構成１から２１の何れかに記載の保持装置。 (Configuration 22)
The holding device according to any one of configurations 1 to 21, wherein a plurality of the holding members are arranged in a longitudinal direction of the tubular portion.
（構成２３）
　前記管状部の表面をふき取るためのふき取り部を備える、構成１から２２の何れかに記載の保持装置。 (Structure 23)
The holding device according to any one of configurations 1 to 22, comprising a wiping portion for wiping a surface of the tubular portion.
（構成２４）
　構成１から２３の何れかに記載の保持装置を備える、軟性内視鏡の駆動システム。 (Configuration 24)
A drive system for a flexible endoscope, comprising the holding device according to any one of configurations 1 to 23.
　本発明の保持装置によれば、医療用器具の管状部をその長手方向に保持装置に対して相対的に進退させつつ、長手方向を軸とした回転方向に対しては回動自在に保持する保持部材を備えることにより、保持装置そのものを回転させることなく医療用器具の管状部にひねり動作を許容することができる。 According to the holding device of the present invention, the tubular portion of the medical instrument is held in the longitudinal direction relative to the holding device so as to be rotatable in the rotational direction about the longitudinal direction. By providing the holding member, the twisting operation can be allowed in the tubular portion of the medical device without rotating the holding device itself.
本発明に係る実施形態の軟性内視鏡の駆動システムを示す概略図1 is a schematic diagram showing a drive system for a flexible endoscope according to an embodiment of the present invention. 本発明に係る実施形態の保持装置を示す斜視図A perspective view showing a holding device of an embodiment concerning the present invention. 保持装置の内部機構を示す斜視図Perspective view showing the internal mechanism of the holding device 保持装置の内部機構を示す正面図Front view showing the internal mechanism of the holding device 保持装置の内部機構を示す底面図Bottom view showing the internal mechanism of the holding device 保持装置に備えられる保持部材を示す図The figure which shows the holding member with which a holding device is equipped. 保持部材に備えられるホイール部材を示す図The figure which shows the wheel member with which a holding member is equipped. ディスク部材を示す平面図Plan view showing the disk member ディスク部材を示す斜視図Perspective view showing the disc member 内視鏡の管状部を把持した状態の保持部材部分を示す図The figure which shows the holding member part in the state which hold|gripped the tubular part of an endoscope. 内視鏡の管状部を把持した状態を説明する説明図Explanatory drawing explaining the state which hold|gripped the tubular part of the endoscope. 保持装置の他の例の保持部材の構成を示す図The figure which shows the structure of the holding member of the other example of a holding device. 保持装置の他の例の保持部材の構成を示す図The figure which shows the structure of the holding member of the other example of a holding device. 保持装置の他の例の保持部材の構成を示す図The figure which shows the structure of the holding member of the other example of a holding device. 保持装置の他の例の保持部材の構成を示す図The figure which shows the structure of the holding member of the other example of a holding device. 保持装置に、内視鏡の管状部をふき取るためのふき取り部を設けた例を示す図The figure which shows the example which provided the holding device with the wiping part for wiping the tubular part of an endoscope.
　以下、本発明の実施形態について、図面を参照しながら具体的に説明する。なお、以下の実施形態は、本発明を具体化する際の一形態であって、本発明をその範囲内に限定するものではない。 Embodiments of the present invention will be specifically described below with reference to the drawings. The following embodiment is one mode for embodying the present invention, and does not limit the present invention within the scope thereof.
　図１は、本発明に係る実施形態の軟性内視鏡の駆動システムを示す概略図である。
　図１に示されるように、軟性内視鏡の駆動システム１００は、その大まかな構成として、本体部１０１と、操作部１０２と、アーム部１０３と、内視鏡取り付け部１０４と、屈曲アーム１０５と、保持装置１と、を備える。
　軟性内視鏡の駆動システム１００は、管状部を持つ医療器具である軟性内視鏡２を用いた検査や処置の操作をサポートするためのシステムであり、内視鏡取り付け部１０４内に内視鏡２が取り付けられて使用される。
　内視鏡取り付け部１０４は、内視鏡２の操作部や内視鏡２に備えられる送気・送水・吸引ボタンや操作ダイヤル等（特に図示せず）と嵌合して、当該ボタン類や操作ダイヤル等を駆動する駆動部を有する。また、内視鏡取り付け部１０４は、内視鏡２を回転（図１の矢印）させるように駆動するための駆動部も有し、これにより、内視鏡２の管状部２１を、その長手方向を軸とした軸回りに回転させることができる。
　操作部１０２は、内視鏡２に対する操作を行うためのユーザインターフェースである。
　本体部１０１は、操作部１０２に対する操作に基づく信号に対応させて、内視鏡取り付け部１０４と保持装置１の駆動部を駆動させるための制御処理を行う制御部を有する。本体部１０１の下部にはキャスターが設けられており、装置全体を移動可能に構成されている。
　アーム部１０３は、本体部１０１に対して回動可能であり、また、アームがその長手方向に伸縮可能に構成されている（特に図示せず）。これにより、内視鏡２や保持装置１の配置位置を適宜調節することができるものである。
　屈曲アーム１０５は、保持装置１が取り付けられるアームであり、アームの中程に屈曲部を有する。保持装置１の使用位置は、例えば患者が横たわっているベッド上であり、患者の口や肛門の近くである。 FIG. 1 is a schematic diagram showing a drive system for a flexible endoscope according to an embodiment of the present invention.
As shown in FIG. 1, the drive system 100 for a flexible endoscope has, as its rough structure, a main body 101, an operating portion 102, an arm portion 103, an endoscope mounting portion 104, and a bending arm 105. And a holding device 1.
The drive system 100 for a flexible endoscope is a system for supporting an operation of an inspection or a treatment using the flexible endoscope 2 which is a medical instrument having a tubular portion, and an endoscope is installed inside the endoscope mounting portion 104. The mirror 2 is attached and used.
The endoscope attachment portion 104 is fitted with an operation portion of the endoscope 2 or an air supply/water supply/suction button, an operation dial, or the like (not particularly shown) provided in the endoscope 2, and the buttons and the like. It has a drive unit that drives an operation dial and the like. The endoscope mounting portion 104 also has a drive portion for driving the endoscope 2 so as to rotate (arrow in FIG. 1), whereby the tubular portion 21 of the endoscope 2 is lengthened. It can be rotated around an axis with the direction as the axis.
The operation unit 102 is a user interface for operating the endoscope 2.
The main body 101 has a control unit that performs control processing for driving the endoscope mounting unit 104 and the drive unit of the holding device 1 in response to a signal based on an operation on the operation unit 102. A caster is provided below the main body 101 so that the entire apparatus can be moved.
The arm portion 103 is rotatable with respect to the main body portion 101, and the arm is configured to be extendable/contractible in its longitudinal direction (not particularly shown). Thereby, the arrangement positions of the endoscope 2 and the holding device 1 can be adjusted appropriately.
The bending arm 105 is an arm to which the holding device 1 is attached, and has a bending portion in the middle of the arm. The holding device 1 is used, for example, on the bed on which the patient is lying and near the mouth and anus of the patient.
　図２は保持装置１をアーム基端側から見た斜視図である。保持装置１は、内視鏡２の管状部２１を、その長手方向に対しては送り出し量を制御可能なように保持して相対的に進退させつつ、長手方向を軸とした回転方向に対しては回動自在に保持する装置である。
　保持装置１は、ホイール部材を備えた保持部材１１Ａ、１１Ｂの間に内視鏡２の管状部２１を挟むように保持しつつ保持部材が回転することで管状部２１を進退させ、同時に、長手方向を軸とした回転方向に対しては回動自在に保持する。
　保持部材１１Ａ、１１Ｂは回転する部材であり、内視鏡検査や処置において当該回転部に例えば術着の端などの物が巻き込まれることを低減するためのホイール部カバー１６によってカバーされている。また、全体的に本体ケース１１によってカバーされている。 FIG. 2 is a perspective view of the holding device 1 viewed from the base end side of the arm. The holding device 1 holds the tubular portion 21 of the endoscope 2 relative to the longitudinal direction so as to control the delivery amount and advances and retracts the tubular portion 21 relative to the longitudinal direction with respect to the rotational direction about the longitudinal direction. Is a device that holds it rotatably.
The holding device 1 advances and retracts the tubular portion 21 by rotating the holding member while holding the tubular portion 21 of the endoscope 2 between the holding members 11A and 11B equipped with wheel members, and at the same time, the longitudinal portion It is rotatably held in the direction of rotation about the direction.
The holding members 11A and 11B are rotating members, and are covered by a wheel portion cover 16 for reducing the inclusion of an object such as an end of surgical operation in the rotating portion during endoscopic examination or treatment. Further, it is entirely covered by the main body case 11.
　図３～５は、本体ケース１１等を省いて保持装置１の内部機構を示した図であり、図３がアーム基端側から見た斜視図、図４は正面図、図５が底面図である。
　図４、５に示されるように、保持装置１は、固定ブロック１Ａとスライドブロック１Ｂを備えている。スライドブロック１Ｂは、固定ブロック１Ａに対してスライド可能に構成され、保持部材１１Ａと保持部材１１Ｂの間隔を、ロック位置と解放位置に狭めたり広げたりすることができる。 3 to 5 are views showing the internal mechanism of the holding device 1 without the main body case 11 and the like. FIG. 3 is a perspective view seen from the arm proximal end side, FIG. 4 is a front view, and FIG. 5 is a bottom view. Is.
As shown in FIGS. 4 and 5, the holding device 1 includes a fixed block 1A and a slide block 1B. The slide block 1B is configured to be slidable with respect to the fixed block 1A, and the gap between the holding member 11A and the holding member 11B can be narrowed or widened between the lock position and the release position.
　固定ブロック１Ａは、フレーム１２Ａに対して各構成要素が取り付けられており、保持部材１１Ａ及び１１Ｂを駆動するためのモータＭ、保持部材１１Ａ、モータＭから保持部材１１Ａへの動力伝達機構である各ギヤＧ１～Ｇ５、回転シャフト１５、間隔を保持しつつスライドをロックするスライドロック機構１８Ａ、スライドロック機構１８Ａのロックを解除するロック解除レバー１４等が備えられている。本実施例ではモータＭを制御するための駆動回路は配線を介してアーム部１０３に備えられるが，駆動回路の場所は配置しやすい場所でよい。 Each component of the fixed block 1A is attached to the frame 12A, and is a motor M for driving the holding members 11A and 11B, a holding member 11A, and a power transmission mechanism from the motor M to the holding member 11A. Gears G1 to G5, a rotary shaft 15, a slide lock mechanism 18A that locks the slide while maintaining a gap, a lock release lever 14 that unlocks the slide lock mechanism 18A, and the like are provided. In this embodiment, the drive circuit for controlling the motor M is provided in the arm portion 103 via the wiring, but the drive circuit may be located easily.
　スライドブロック１Ｂは、フレーム１２Ｂに対して各構成要素が取り付けられており、保持部材１１Ｂ、モータＭから保持部材１１Ｂへの動力伝達機構である各ギヤＧ６、Ｇ７、スライドロック機構１８Ｂ、スライドブロック１Ｂをスライドさせるための持ち手となる把手１３等が備えられている。 Each component of the slide block 1B is attached to the frame 12B, and the holding member 11B, the gears G6 and G7 that are power transmission mechanisms from the motor M to the holding member 11B, the slide lock mechanism 18B, and the slide block 1B. A handle 13 or the like, which serves as a handle for sliding, is provided.
　図５に示されるように、モータＭの回転軸に設けられたギヤＧ１は、減速ギヤＧ２と噛み合う。減速ギヤＧ２は、かさ歯車であるギヤＧ３と共に回転シャフト１５に対して回動不能に取り付けられている。
　保持部材１１Ａの回転軸２０Ａは軸ホルダー１９Ａに対して着脱可能、回動不能に取り付けられる。軸ホルダー１９Ａの下端にはかさ歯車であるギヤＧ４が回動不能に取り付けられており、ギヤＧ４がギヤＧ３と噛み合うことで、モータＭの回転が保持部材１１Ａに伝達される。
　また、回転シャフト１５の先端側（スライドブロック１Ｂ側）には、かさ歯車であるギヤＧ６と、ギヤＧ６に対してスライド可能且つ回動不能に噛み合うギヤＧ５が形成されている。ギヤＧ５は回転シャフト１５の長手方向に、固定ブロック１Ａに対するスライドブロック１Ｂのスライド量と同じかそれ以上の長さを有して形成される。ギヤＧ６の中心部には、ギヤＧ５と噛み合う孔が形成され、これにより、ギヤＧ５とＧ６がスライド可能且つ回動不能に噛み合うものである。保持部材１１Ｂは軸ホルダー１９Ｂに対して着脱可能、回動不能に取り付けられる。軸ホルダー１９Ｂの下端には、かさ歯車であるギヤＧ７が回動不能に取り付けられており、ギヤＧ６とギヤＧ７が噛み合うことで、モータＭの回が保持部材１１Ｂに伝達される。
　図５に示されるように、回転シャフト１５上に対向するように取り付けられたかさ歯車であるギヤＧ３、Ｇ６がかさ歯車であるギヤＧ４とギヤＧ７にそれぞれ噛み合うことにより保持部材１１Ａの回転軸２０Ａと、保持部材１１Ｂの回転軸２０Ｂは、回転方向が逆になる。
　上記により、保持部材１１Ａと保持部材１１Ｂの間隔を可変としつつ、保持部材１１Ａの回転と、保持部材１１Ｂの回転を、相互に逆回転となるように且つ回転を同期させる回転リンク機構が構成される。 As shown in FIG. 5, the gear G1 provided on the rotation shaft of the motor M meshes with the reduction gear G2. The reduction gear G2 is non-rotatably attached to the rotary shaft 15 together with the bevel gear G3.
The rotating shaft 20A of the holding member 11A is detachably attached to the shaft holder 19A and is non-rotatably attached. A gear G4, which is a bevel gear, is non-rotatably attached to the lower end of the shaft holder 19A, and the rotation of the motor M is transmitted to the holding member 11A by meshing the gear G4 with the gear G3.
A gear G6, which is a bevel gear, and a gear G5, which meshes with the gear G6 slidably and non-rotatably, are formed on the distal end side (slide block 1B side) of the rotary shaft 15. The gear G5 is formed in the longitudinal direction of the rotary shaft 15 so as to have a length equal to or longer than the sliding amount of the slide block 1B with respect to the fixed block 1A. A hole that meshes with the gear G5 is formed in the center of the gear G6, so that the gears G5 and G6 mesh slidably and non-rotatably. The holding member 11B is detachably attached to the shaft holder 19B and is non-rotatably attached. A gear G7, which is a bevel gear, is non-rotatably attached to the lower end of the shaft holder 19B, and the rotation of the motor M is transmitted to the holding member 11B when the gears G6 and G7 mesh with each other.
As shown in FIG. 5, the gears G3 and G6, which are bevel gears mounted so as to face each other on the rotary shaft 15, mesh with the gears G4 and G7, which are bevel gears, respectively. Then, the rotating shaft 20B of the holding member 11B is rotated in the opposite direction.
As described above, the rotation link mechanism is configured such that the rotation of the holding member 11A and the rotation of the holding member 11B are opposite to each other and the rotations are synchronized while the distance between the holding members 11A and 11B is variable. It
　図４に示されるように、固定ブロック１Ａに備えられるスライドロック機構１８Ａは、先端側（スライドブロック１Ｂ側）に、スライドロック機構１８Ｂと係合するフックを有する。スライドロック機構１８Ａはフレーム１２Ａに対して基端側が回動可能に取り付けられており、先端側が保持装置１の底面方向に回動する。
　一方、スライドブロック１Ｂに備えられるスライドロック機構１８Ｂは、先端側（固定ブロック１Ａ側）に、スライドロック機構１８Ａと係合するフックを有し、保持装置１の上面方向へ回動する機構を有する。
　スライドブロック１Ｂを固定ブロック１Ａに対して近づけるようにスライドさせると、スライドロック機構１８Ａのフックと、スライドロック機構１８Ｂのフックが係合する。より具体的には、スライドロック機構１８Ａの先端とスライドロック機構１８Ｂの先端が接触した際に、両者の接触箇所に傾斜面が形成されていることにより、スライドロック機構１８Ａのフックが底面側に下がるような回転トルクがスライドロック機構１８Ａに生じ、スライドロック機構１８Ｂのフックが上面側に上がるような回転トルクがスライドロック機構１８Ｂに生じる。これにより、スライドロック機構１８Ａのフックは下がりながら、スライドロック機構１８Ａのフックは上がりながら、スライドブロック１Ｂは固定ブロックＡに近づく。スライドロック機構１８Ａのフックとスライドロック機構１８Ｂのフックが噛み合う位置まで来ると、各スライドロックの回転軸内に配置されたねじりコイルばねにより両フックが元の位置に戻ろうとしフック同士が係合し、ロックされるものである。これにより、保持部材１１Ａと保持部材１１Ｂの間隔が所定間隔にて固定される。
　スライドロック機構１８Ａは、ロック解除レバー１４をスライドブロック１Ｂから離れる方向にスライドさせることで、スライドロック機構１８Ａのフックとスライドロック機構１８Ｂのフックの係合が解除される位置まで、スライドロック機構１８Ａのフックが保持装置１の底面側に下がるように構成されている。よって、ロック解除レバー１４の操作により、ロックを解除することができる。ロックが解除されると、スライドブロック１Ｂと底面フレーム１２Ｃの間に設置された圧縮バネの作用によりスライドブロック１Ｂはスライドブロック１Ｂが固定ブロック１Ａから離れるようにスライドし、保持部材１１Ａと保持部材１１Ｂの間隔を広げることができる。 As shown in FIG. 4, the slide lock mechanism 18A provided in the fixed block 1A has a hook that engages with the slide lock mechanism 18B on the tip side (slide block 1B side). The base end side of the slide lock mechanism 18A is rotatably attached to the frame 12A, and the front end side of the slide lock mechanism 18A rotates in the direction of the bottom surface of the holding device 1.
On the other hand, the slide lock mechanism 18B provided in the slide block 1B has a hook that engages with the slide lock mechanism 18A on the tip side (fixed block 1A side), and has a mechanism that rotates in the upper surface direction of the holding device 1. ..
When the slide block 1B is slid so as to approach the fixed block 1A, the hook of the slide lock mechanism 18A and the hook of the slide lock mechanism 18B are engaged. More specifically, when the tip of the slide lock mechanism 18A and the tip of the slide lock mechanism 18B come into contact with each other, an inclined surface is formed at the contact point between the two, so that the hook of the slide lock mechanism 18A moves to the bottom surface side. Rotational torque that decreases is generated in the slide lock mechanism 18A, and rotation torque that causes the hook of the slide lock mechanism 18B to rise to the upper surface side is generated in the slide lock mechanism 18B. As a result, the hook of the slide lock mechanism 18A is lowered, the hook of the slide lock mechanism 18A is raised, and the slide block 1B approaches the fixed block A. When the hooks of the slide lock mechanism 18A and the hooks of the slide lock mechanism 18B come to the position where they mesh with each other, the two hooks are engaged with each other by the torsion coil springs arranged in the rotation shaft of each slide lock so that both hooks return to their original positions. And is locked. Thereby, the distance between the holding member 11A and the holding member 11B is fixed at a predetermined distance.
The slide lock mechanism 18A slides the lock release lever 14 in a direction away from the slide block 1B to reach a position where the hooks of the slide lock mechanism 18A and the slide lock mechanism 18B are disengaged from each other. The hooks are arranged to hang down on the bottom surface side of the holding device 1. Therefore, the lock can be released by operating the lock release lever 14. When the lock is released, the slide block 1B slides away from the fixed block 1A by the action of the compression spring installed between the slide block 1B and the bottom frame 12C, and the holding member 11A and the holding member 11B. The intervals can be widened.
　図６に示されるように、保持部材１１Ａは、保持装置１を水平面に置いた状態において鉛直方向となる回転軸２０Ａを有しており、当該回転軸２０Ａに上下に配置されたホイール部材１０を２つ備えている。即ち、保持部材１１Ａは、同一回転軸上に平行に配置された２つのホイール部材１０を備えている。なお、個々のホイール部材１０は同一構造である。
　２つのホイール部材１０は回転軸２０Ａに対して回動不能に取り付けられる。上下２段のホイール部材１０の間には、その間隔を保持するためのスペーサー３０Ａが設けられている。小回転体１０Ｒと医療用器具のサイズの関係上、スペーサー３０Ａが不要な場合は設けなくても良い。
　保持部材１１Ａの上記構成は、保持部材１１Ｂにおいても同様である。 As shown in FIG. 6, the holding member 11A has a rotary shaft 20A that is in the vertical direction when the holding device 1 is placed on a horizontal plane, and the wheel member 10 arranged above and below the rotary shaft 20A. I have two. That is, the holding member 11A includes two wheel members 10 arranged in parallel on the same rotation axis. The individual wheel members 10 have the same structure.
The two wheel members 10 are non-rotatably attached to the rotary shaft 20A. A spacer 30</b>A is provided between the upper and lower two-stage wheel members 10 to maintain the space therebetween. Due to the size relationship between the small rotating body 10R and the medical device, the spacer 30A may be omitted if it is unnecessary.
The above-described configuration of the holding member 11A is the same for the holding member 11B.
　図７は、ホイール部材１０を示す斜視図である。
　図７に示されるように、ホイール部材１０は、ディスク部材１０Ｄの外周上に、当該外周の接線と略平行な軸を回転軸とする樽状、若しくは紡錘形状の小回転体１０Ｒを複数有しており、ここでは小回転体１０Ｒが５つのものを例としている。ホイール部材１０を複数枚積層したものは、一般的に“オムニホイール”と呼ばれ、多方向への移動を可能にする車輪として利用されている。
　小回転体１０Ｒの外周形状は、ホイール部材１０の外周に接する円の弧と略同一であることにより、ホイール部材１０をディスク部材の面に対して垂直な方向から見ると、ホイール部材１０としての外周の形状は略円形である。小回転体１０Ｒは、樽状、若しくは紡錘形状、の長軸の中心に貫通孔を有しており、当該貫通孔に回転軸となるシャフトが挿通され、当該回転軸回りに回転自在に構成されている。なお、小回転体と小回転体の回転軸が一体形成若しくは両者が固定されており、回転軸を回転可能に受ける軸受がディスク部材に形成されているものであってもよい。
　ディスク部材や小回転体の回転軸は、ステンレス鋼、真鍮、チタンなどの金属部材で形成されることが好ましく、この中ではステンレス鋼が好ましい。
　小回転体の材料としては、ポリエチレン、ポリプロピレン、ＡＢＳ、塩化ビニール、ナイロンなどの合成樹脂や、シリコーン系ゴム、ウレタン系ゴムなどの合成ゴム、ステンレス鋼などの金属が考えられる。繰り返し使用する場合は蒸気滅菌に耐え得るものであることが好ましい。小回転体の材料は、小回転体と管状部の間の長軸方向の滑りを押さえるために、滑りにくい素材であることが好ましく、シリコーンが好適である。また小回転体の表面に滑り止めとなる凹凸様の形状、エンボス加工やサンドブラスト加工などを施しても良い。
　図８はディスク部材１０Ｄを示す平面図であり、図９は斜視図である。
　ディスク部材１０Ｄは、五角形の頂点となる箇所において、小回転体１０Ｒの回転軸であるシャフトを固定するための接合部１０Ｄ１を有している。また、五角形の各辺となる箇所は、小回転体１０Ｒを受け入れ可能な形状に形成される。ここでは、小回転体１０Ｒの外周に沿った形状としたものを例としている。
　接合部１０Ｄ１には、シャフトを受け入れる凹部が形成され、当該凹部にシャフトがはめ込まれて溶接等によって固定される。即ち、隣り合う接合部１０Ｄ１において、小回転体１０Ｒの回転軸であるシャフトの両端部が固定され、これにより、ディスク部材１０Ｄに対して小回転体１０Ｒが回転自在に取り付けられる。なお、ここではシャフトがディスク部材１０Ｄに対して溶接などによって固定されるものを例としたが、脱着可能に構成されるものであってもよい。 FIG. 7 is a perspective view showing the wheel member 10.
As shown in FIG. 7, the wheel member 10 has a plurality of barrel-shaped or spindle-shaped small rotating bodies 10R on the outer circumference of the disk member 10D, the axis of rotation of which is substantially parallel to the tangent line of the outer circumference. In this case, five small rotating bodies 10R are used as an example. A stack of a plurality of wheel members 10 is generally called an "omni wheel" and is used as a wheel that enables movement in multiple directions.
Since the outer peripheral shape of the small rotating body 10R is substantially the same as the arc of a circle contacting the outer periphery of the wheel member 10, when the wheel member 10 is viewed from the direction perpendicular to the surface of the disc member, The shape of the outer circumference is substantially circular. The small rotating body 10R has a barrel-shaped or spindle-shaped through-hole at the center of its long axis, and a shaft serving as a rotation axis is inserted through the through-hole and is configured to be rotatable around the rotation axis. ing. The small rotating body and the rotating shaft of the small rotating body may be integrally formed or fixed to each other, and a bearing that rotatably receives the rotating shaft may be formed on the disk member.
The disk member and the rotary shaft of the small rotating body are preferably formed of a metal member such as stainless steel, brass, or titanium, and of these, stainless steel is preferable.
As the material of the small rotating body, synthetic resin such as polyethylene, polypropylene, ABS, vinyl chloride, nylon, synthetic rubber such as silicone rubber and urethane rubber, and metal such as stainless steel can be considered. When repeatedly used, it is preferably one that can withstand steam sterilization. The material of the small rotating body is preferably a non-slip material in order to suppress slippage in the long axis direction between the small rotating body and the tubular portion, and silicone is preferable. Further, the surface of the small rotating body may be provided with a non-slip shape such as non-slip, embossing or sandblasting.
8 is a plan view showing the disk member 10D, and FIG. 9 is a perspective view.
The disk member 10D has a joint portion 10D1 for fixing the shaft that is the rotation axis of the small rotating body 10R at the position that is the apex of the pentagon. Further, each side of the pentagon is formed in a shape capable of receiving the small rotating body 10R. Here, an example is given in which the shape is along the outer circumference of the small rotating body 10R.
A recess for receiving the shaft is formed in the joint portion 10D1, and the shaft is fitted into the recess and fixed by welding or the like. That is, at the joint portions 10D1 adjacent to each other, both ends of the shaft, which is the rotation axis of the small rotating body 10R, are fixed, whereby the small rotating body 10R is rotatably attached to the disc member 10D. Although the shaft is fixed to the disk member 10D by welding or the like as an example here, the shaft may be detachable.
　図１０は、内視鏡２の管状部２１を把持した状態の保持部材１１Ａ、１１Ｂ部分を示す概略図である。
　上述のごとく、本実施形態の保持装置１においては、スライドブロック１Ｂが固定ブロック１Ａに対してスライド可能に構成されており、スライドブロック１Ｂを、保持部材１１Ａと保持部材１１Ｂの間を開くようにスライドさせた状態において、内視鏡２の管状部２１の脱着を行う。
　保持部材１１Ａと保持部材１１Ｂの間を広げた状態において、両者の間に内視鏡２の管状部２１を配置し、スライドブロック１Ｂを閉じるようにスライドさせて上述のロックをさせることにより、保持部材１１Ａと保持部材１１Ｂによって内視鏡２の管状部２１を挟むように保持した状態（図１０）となる。
　図１０に示されるように、保持部材１１Ａと保持部材１１Ｂは、管状部２１の長手方向と略直交する方向を回転軸とするホイール部材１０をそれぞれ２つ備え、合計４つのホイール部材１０によって、管状部２１を囲むように保持する。 FIG. 10 is a schematic view showing the holding members 11A and 11B in a state where the tubular portion 21 of the endoscope 2 is held.
As described above, in the holding device 1 of the present embodiment, the slide block 1B is configured to be slidable with respect to the fixed block 1A, and the slide block 1B is opened between the holding member 11A and the holding member 11B. In the slid state, the tubular portion 21 of the endoscope 2 is attached and detached.
In a state where the holding member 11A and the holding member 11B are widened, the tubular portion 21 of the endoscope 2 is arranged between them, and the slide block 1B is slid so as to be closed to hold the above-mentioned lock. The tubular portion 21 of the endoscope 2 is held so as to be sandwiched by the member 11A and the holding member 11B (FIG. 10).
As shown in FIG. 10, the holding member 11A and the holding member 11B each include two wheel members 10 each having a rotation axis in a direction substantially orthogonal to the longitudinal direction of the tubular portion 21, and a total of four wheel members 10. The tubular portion 21 is held so as to surround it.
　図１１は、内視鏡２の管状部２１を保持した状態を説明するための概略断面図である。
　保持部材１１Ａは、上下に配置されるホイール部材１０を２つ備えており、上段のホイール部材１０と下段のホイール部材１０は位相をずらした配置となっている。具体的には、一方のホイール部材１０の小回転体１０Ｒと他方のホイール部材１０の接合部１０Ｄ１が対向するような配置となっている。これにより、保持部材１１Ａが備える小回転体のうちの少なくとも１つが管状部２１と接する構成となっている。この構成は保持部材１１Ｂにおいても同様である。
　また、保持部材１１Ａのホイール部材１０の接合部１０Ｄ１が、保持部材１１Ｂのホイール部材１０の小回転体１０Ｒと対向するように配置されており、且つ、保持部材１１Ｂのホイール部材１０の接合部１０Ｄ１が、保持部材１１Ａのホイール部材１０の小回転体１０Ｒと対向するように配置されている。
　本実施形態の保持装置１は、保持部材１１Ａ及び保持部材１１Ｂの回転位置に関わらず、保持部材１１Ａが備える２つのホイール部材１０の小回転体１０Ｒと、保持部材１１Ｂが備える２つのホイール部材１０の小回転体１０Ｒのうち、少なくとも３つの小回転体１０Ｒが必ず管状部２１と接するように構成されている。
　このように、常に少なくとも３つの小回転体１０Ｒが管状部２１に接触するための条件を下記に述べる。 FIG. 11 is a schematic cross-sectional view for explaining a state in which the tubular portion 21 of the endoscope 2 is held.
The holding member 11A includes two wheel members 10 arranged vertically, and the wheel member 10 in the upper stage and the wheel member 10 in the lower stage are arranged so as to be out of phase with each other. Specifically, the small rotating body 10R of one wheel member 10 and the joint portion 10D1 of the other wheel member 10 are arranged to face each other. Thereby, at least one of the small rotating bodies included in the holding member 11A is in contact with the tubular portion 21. This structure is the same for the holding member 11B.
Further, the joint portion 10D1 of the wheel member 10 of the holding member 11A is arranged so as to face the small rotating body 10R of the wheel member 10 of the holding member 11B, and the joint portion 10D1 of the wheel member 10 of the holding member 11B. Are arranged so as to face the small rotating body 10R of the wheel member 10 of the holding member 11A.
In the holding device 1 of the present embodiment, regardless of the rotational positions of the holding member 11A and the holding member 11B, the small rotating body 10R of the two wheel members 10 included in the holding member 11A and the two wheel members 10 included in the holding member 11B. Of the small rotating bodies 10R, at least three small rotating bodies 10R are configured to be in contact with the tubular portion 21 without fail.
The conditions under which at least three small rotating bodies 10R always contact the tubular portion 21 in this manner will be described below.
ホイール部材直径Ｄ［ｍｍ］
小回転体の数　Ｎｒ
小回転体角度　α［ｄｅｇ］
接合部角度　β［ｄｅｇ］
接合部長さｌ　＞５［ｍｍ］
　図８に示されるように、小回転体角度αは一つの小回転体がホイール部材の外周に占める角度（中心角）であり、接合部角度βは小回転体間に存在する一つの接合部１０Ｄ１がホイール部材の外周に占める角度（中心角）である。図８の一点鎖線の円Ｃは、ホイール部材の外周に接する円であり小回転体１０Ｒの外周が接する線でもある。ホイール部材の直径Ｄとは、円Ｃの直径であり、接合部長さｌは、中心角βによって形成される円Ｃ上の弧の長さである。
　一つのホイール部材の外周に配置される小回転体の数をＮｒとすると、α、β、Ｎｒは数１で表される。 Wheel member diameter D [mm]
Number of small rotating bodies Nr
Small rotating body angle α [deg]
Joint angle β [deg]
Joint length l >5 [mm]
As shown in FIG. 8, the small rotating body angle α is the angle (center angle) that one small rotating body occupies on the outer periphery of the wheel member, and the joint angle β is one joint existing between the small rotating bodies. The angle 10D1 occupies the outer circumference of the wheel member (center angle). A circle C indicated by an alternate long and short dash line in FIG. 8 is a circle in contact with the outer periphery of the wheel member, and is also a line in contact with the outer periphery of the small rotating body 10R. The diameter D of the wheel member is the diameter of the circle C, and the joint length 1 is the length of the arc on the circle C formed by the central angle β.
When the number of small rotating bodies arranged on the outer periphery of one wheel member is Nr, α, β, and Nr are expressed by the equation 1.
Figure JPOXMLDOC01-appb-M000001
Figure JPOXMLDOC01-appb-M000001
　管状部２１の長軸方向のある点をホイール部材４つで保持する際、保持する点における各ホイール部材の角度はそれぞれ（α＋β）／４［ｄｅｇ］ずつずらして配置すると、保持する点において複数の接合部が存在する確率が最も低くなる。この時、常に３つの小回転体で保持するためには、α≧３βの条件を満たす必要がある。これを数１に代入すると数２となる。 When holding a certain point in the long axis direction of the tubular portion 21 with four wheel members, if the angle of each wheel member at the holding point is shifted by (α+β)/4 [deg], it is possible to hold multiple points at the holding point. The probability of the existence of the joint is lowest. At this time, the condition of α≧3β must be satisfied in order to always hold the three small rotating bodies. Substituting this into equation 1 yields equation 2.
Figure JPOXMLDOC01-appb-M000002
Figure JPOXMLDOC01-appb-M000002
　接合部１つがホイール部材の外周上に占める長さｌは接合部角度βとホイール部材の直径Ｄにより数３で表される。 The length 1 that one joint occupies on the outer circumference of the wheel member is expressed by Equation 3 by the joint angle β and the diameter D of the wheel member.
Figure JPOXMLDOC01-appb-M000003
Figure JPOXMLDOC01-appb-M000003
　接合部は小回転体の回転軸であるシャフトの溶接など、具体的な製造手段を考慮すると、ホイール部材外周上の距離にして１箇所あたり５［ｍｍ］程度は最低必要であることから、接合部長さｌに５［ｍｍ］を代入すると、βは数４で表される。 Considering concrete manufacturing means such as welding of the shaft which is the rotating shaft of the small rotating body, the minimum distance required for the outer periphery of the wheel member is about 5 [mm] per joint. Substituting 5 [mm] for the part length l, β is expressed by Equation 4.
Figure JPOXMLDOC01-appb-M000004
Figure JPOXMLDOC01-appb-M000004
　患者近くに配置される保持部材は小さいことが望ましく、ホイール部材の直径Ｄを例えばＤ＝３８ｍｍで構成する場合、数４からβ≧１５．０８［ｄｅｇ］となる。これを数２に代入すると、小回転体の個数Ｎｒは、
Ｎｒ≦５．９６［ｐｃｓ］
となる。即ち、接合部が縮められない場合（５［ｍｍ］以上の場合）、常に３つの小回転体が管状部２１を支えるための小回転体の個数条件は５個以下となる。
　上記のごとくホイール部材の直径Ｄは小さいことが望ましく、大きくても６０mm程度であることが好ましい。この場合、小回転体の個数条件を数４、数２から同様に算出すると、β≧９．５４［ｄｅｇ］、Ｎｒ≦９．４２［ｐｃｓ］となる。ホイール部材の直径Ｄは、５０mm以下であるとさらに好ましく、この場合、β≧１１．４５［ｄｅｇ］、Ｎｒ≦７．８５［ｐｃｓ］となる。
　従って、小回転体の個数Ｎｒは３～９個であることが好ましく、より好ましくは３～７個であり、最も好適には３～５個である。なお、当該個数条件を満足する上で、小回転体の個数は多い方が、医療用器具が長軸周りに回転しやすくより好適である。 It is desirable that the holding member arranged near the patient is small, and when the diameter D of the wheel member is set to D=38 mm, for example, β≧15.08 [deg] from Equation 4. Substituting this into Equation 2, the number Nr of small rotating bodies is
Nr≦5.96 [pcs]
Becomes That is, when the joining portion is not contracted (when it is 5 [mm] or more), the number condition of the small rotating bodies for the three small rotating bodies to always support the tubular portion 21 is 5 or less.
As described above, the diameter D of the wheel member is preferably small, and at most about 60 mm. In this case, when the number condition of the small rotating bodies is similarly calculated from the equations 4 and 2, β≧9.54 [deg] and Nr≦9.42 [pcs]. The diameter D of the wheel member is more preferably 50 mm or less, and in this case, β≧11.45 [deg] and Nr≦7.85 [pcs].
Therefore, the number Nr of the small rotating bodies is preferably 3 to 9, more preferably 3 to 7, and most preferably 3 to 5. In addition, in order to satisfy the number condition, it is more preferable that the number of the small rotating bodies is large, since the medical device can easily rotate around the long axis.
　以上のごとく、本実施形態の保持装置１は、２つのホイール部材１０を有する２つの保持部材１１Ａ、保持部材１１Ｂによって、内視鏡２の管状部２１を挟むように保持する。保持部材１１Ａと保持部材１１Ｂの回転が連動し、これによって４つのホイール部材１０が連動して回転することで管状部２１を長軸方向に前後させる。即ち、管状部２１の長手方向に対しては送り出し量を制御可能に保持される。一方で、ホイール部材１０の外周に配置された小回転体１０Ｒは受動的に回転可能であるため、管状部２１に軸周りの回転力が加わった際には、小回転体１０Ｒが回転し、管状部２１はその軸周りに回転自在となっている。従って、内視鏡取り付け部１０４による内視鏡２の回転（図１参照）により管状部２１に長手方向の軸周りの回転力が加わると、小回転体１０Ｒが受動的に回転し、管状部２１に対するひねり駆動を許容する。即ち、管状部２１等の細長い胴部を持つ医療用器具を、長軸周りに回転自由に保持する際、保持部全体を回転させる必要がなくなり、駆動部の小型化とこれに伴う患者の安全性向上が期待できる。
　本実施形態では、軟性内視鏡の駆動システム１００に備えられる保持装置として説明し、“ひねり動作”が軟性内視鏡の駆動システム１００によって駆動されるものを例としているが、ひねり動作が術者によって行われる場合にも勿論使用できる。特に下部軟性内視鏡検査においては、内視鏡を長い腸管に挿入しても腸管の運動や内圧により押し戻されることが多く、管状部が押し戻されると術者は再度挿入を行う必要があった。管状部が押し戻されないためには、術者が常に、管状部を患者体内に挿入する方向に力を加えている必要があった。しかし保持装置１によれば管状部の進退動作は保持部材によって電動で送り量を調節し所望の位置で固定することが可能で、挿入・処置に必要な捻り動作は術者が医療用器具を回転させる力を加えるだけで医療用器具を保持したまま回転させることができる。
　また、本実施形態の保持装置１によれば、医療用器具を保持する部分において、少なくとも３つの小回転体１０Ｒが管状部２１に常に接触するように保持部材１１Ａ、１１Ｂの各ホイール部材１０を構成することにより、管状部２１の軸回転を拘束せずに前後動作で滑りを生じることなく安定して管状部２１を保持することができる。 As described above, the holding device 1 of the present embodiment holds the tubular portion 21 of the endoscope 2 so as to sandwich the tubular portion 21 with the two holding members 11A and 11B having the two wheel members 10. The rotation of the holding member 11A and the holding member 11B are interlocked with each other, whereby the four wheel members 10 are interlocked with each other to rotate and thereby move the tubular portion 21 back and forth in the longitudinal direction. That is, the delivery amount is controllably held in the longitudinal direction of the tubular portion 21. On the other hand, since the small rotating body 10R arranged on the outer periphery of the wheel member 10 can passively rotate, when the rotational force around the axis is applied to the tubular portion 21, the small rotating body 10R rotates, The tubular portion 21 is rotatable about its axis. Therefore, when a rotational force about the longitudinal axis is applied to the tubular portion 21 by the rotation of the endoscope 2 by the endoscope mounting portion 104 (see FIG. 1), the small rotating body 10R passively rotates and the tubular portion is rotated. Allows twisting drive for 21. That is, when a medical device having an elongated body such as the tubular portion 21 is rotatably held around the long axis, it is not necessary to rotate the entire holding portion, and the drive unit is downsized and patient safety is accordingly reduced. It can be expected to improve the sex.
In the present embodiment, the holding device provided in the drive system 100 for the flexible endoscope is described, and the "twisting motion" is driven by the drive system 100 for the flexible endoscope as an example. Of course, it can also be used when performed by a person. Especially in lower flexible endoscopy, even if an endoscope is inserted into a long intestinal tract, it is often pushed back by the movement and internal pressure of the intestinal tract, and when the tubular part is pushed back, the operator had to reinsert it. .. In order to prevent the tubular portion from being pushed back, it was necessary for the operator to constantly apply force in the direction of inserting the tubular portion into the patient's body. However, according to the holding device 1, the forward/backward movement of the tubular portion can be electrically controlled by the holding member to adjust the feed amount and be fixed at a desired position, and the twisting movement necessary for insertion/treatment is performed by the operator in the medical device. The medical device can be rotated while being held by simply applying a rotating force.
Further, according to the holding device 1 of the present embodiment, the wheel members 10 of the holding members 11A and 11B are arranged so that at least three small rotating bodies 10R are always in contact with the tubular portion 21 in the portion holding the medical device. With this configuration, the tubular portion 21 can be stably held without restraining the axial rotation of the tubular portion 21 and causing no slippage in the back-and-forth movement.
　なお、保持部材に対してホイール部材を着脱可能に構成してもよい。ホイール部材を着脱可能とすることにより、内視鏡の管状部と接触する部分（即ち、患者体液が付着し得る部分）のみを簡単に洗浄、滅菌することができる。また、異なる直径のホイール部材と交換することや、上下２段のホイール部材の間隔を保持するためのスペーサーを高さが違うものに交換すること等によって、直径が異なる管状部への対応も可能となる。同様の目的で保持部材を保持装置に対して着脱可能に構成してもよい。 The wheel member may be detachably attached to the holding member. By making the wheel member detachable, it is possible to easily wash and sterilize only the portion of the endoscope that comes into contact with the tubular portion (that is, the portion to which the patient's body fluid can adhere). Also, it is possible to handle tubular parts with different diameters by exchanging with wheel members of different diameters or exchanging spacers for holding the gap between the upper and lower two-stage wheel members with different heights. Becomes For the same purpose, the holding member may be configured to be detachable from the holding device.
　本実施形態では、保持部材として、保持部材１１Ａと保持部材１１Ｂを備えているものを例としているが、さらに保持部材を増加させてもよい。図１２には、保持部材が、管状部の長手方向に複数配置されているものの一例を示した。このように、長手方向に複数保持部材を配することにより内視鏡の管状部に接触する小回転体の数が多くなるため前後動作時の保持力を上げることができる。また、内視鏡の管状部の長軸方向に離れた複数の箇所に支持点があるため、口や肛門など患者の自然開口部への内視鏡管状部の挿入角度を規定し易くなる。 In the present embodiment, the holding member includes the holding member 11A and the holding member 11B as an example, but the number of holding members may be increased. FIG. 12 shows an example in which a plurality of holding members are arranged in the longitudinal direction of the tubular portion. In this way, by disposing a plurality of holding members in the longitudinal direction, the number of small rotating bodies that come into contact with the tubular portion of the endoscope is increased, so that the holding force at the time of forward/backward movement can be increased. In addition, since there are support points at a plurality of locations apart from each other in the longitudinal direction of the tubular portion of the endoscope, it becomes easy to define the insertion angle of the tubular portion of the endoscope into the natural opening of the patient such as the mouth and anus.
　また、本実施形態では、保持部材としての保持部材１１Ａと保持部材１１Ｂが回転駆動されるものを例としているが、本発明をこれに限るものではない。
　図１３（ａ）、図１３（ｂ）には、一方の保持部材が、内視鏡など医療用器具の管状部を摺動可能に保持する摺動部材として構成されているものの例を示した。
　図１３（ａ）、図１３（ｂ）における保持部材１１Ａ－３は、基本的に本実施形態における保持部材１１Ａと同様の構成である。一方、保持部材１１Ｂ－３は、保持部材１１Ａ－３に対向して設けられ、保持部材１１Ａ－３との間で内視鏡の管状部を挟んで保持する壁状の部材である。保持部材１１Ｂ－３の保持部材１１Ａ－３に対向する側には、管状部の表面との関係において摩擦が低い部材で形成され、管状部を保持するための凹部を有する摺動保持部材Ｓが設けられている。摺動保持部材Ｓの材料としては、例えば、テフロン（登録商標）などのフッ素樹脂、ポリエチレン、ポリプロピレン、ＡＢＳなどの合成樹脂、滑りを良くするための表面処理を施したSUS部材などの金属等が挙げられ、この中では、特に摺動が良いテフロン（登録商標）などのフッ素樹脂が好ましい。
　このような構成とすることにより、小回転体表面と医療用器具の管状部表面の摩擦力が十分な場合、ホイール部材を備える保持部材を一つにできるので、保持装置全体をより小さくすることができる。また、摺動保持部材Ｓの凹部を内視鏡の管状部に合わせて長軸方向に長めにとることにより、管状部先端が屈曲動作をした際の管状部の姿勢や、患者の自然開口部への管状部の挿入角度を安定させることができる。
　当該構成においても、先に説明したごとく、保持部材が管状部の長手方向に複数配置されるようにしてもよい。図１４には、図１３（ａ）、図１３（ｂ）の例において、保持部材が管状部の長手方向に複数配置されているものの一例を示した。このような構成とすることにより、管状部に接触する小回転体の数が多いため前後動作時の保持力を上げることができる。また、管状部の長軸方向に離れた複数の支持点があるため、患者の自然開口部への内視鏡の挿入角度を規定し易くなる。 Further, in the present embodiment, the holding member 11A and the holding member 11B serving as holding members are rotationally driven by way of example, but the present invention is not limited to this.
FIGS. 13(a) and 13(b) show an example in which one holding member is configured as a sliding member that slidably holds a tubular portion of a medical device such as an endoscope. ..
The holding member 11A-3 in FIGS. 13A and 13B has basically the same configuration as the holding member 11A in the present embodiment. On the other hand, the holding member 11B-3 is a wall-shaped member that is provided so as to face the holding member 11A-3 and that holds the tubular portion of the endoscope with the holding member 11A-3. On the side of the holding member 11B-3 facing the holding member 11A-3, there is provided a sliding holding member S formed of a member having a low friction in relation to the surface of the tubular portion and having a concave portion for holding the tubular portion. It is provided. Examples of the material of the slide holding member S include fluororesins such as Teflon (registered trademark), synthetic resins such as polyethylene, polypropylene and ABS, and metals such as SUS members that have been surface-treated to improve sliding. Among them, a fluororesin such as Teflon (registered trademark) having particularly good sliding property is preferable.
With such a configuration, when the frictional force between the surface of the small rotating body and the surface of the tubular portion of the medical device is sufficient, the holding member including the wheel member can be integrated into one, so that the entire holding device can be made smaller. You can Further, by taking the recess of the slide holding member S to be longer in the long axis direction in accordance with the tubular portion of the endoscope, the posture of the tubular portion when the distal end of the tubular portion bends and the natural opening of the patient. It is possible to stabilize the insertion angle of the tubular portion into the.
Also in this configuration, as described above, a plurality of holding members may be arranged in the longitudinal direction of the tubular portion. FIG. 14 shows an example in which a plurality of holding members are arranged in the longitudinal direction of the tubular portion in the examples of FIGS. 13(a) and 13(b). With such a configuration, since the number of small rotating bodies that come into contact with the tubular portion is large, it is possible to increase the holding force during the forward and backward movements. Further, since there are a plurality of support points that are separated from each other in the long axis direction of the tubular portion, it becomes easy to define the insertion angle of the endoscope into the natural opening of the patient.
　内視鏡の管状部を患者の自然開口部に挿入する際は、体内での摩擦を軽減するために潤滑ジェルが塗布されることがある。このように潤滑ジェルが塗布された場合、管状部の前後動作に対して、管状部表面と保持部材の間に滑りを生じさせるおそれがある。これを防止するために、潤滑ジェルをふき取ることができる構成としてもよい。
　図１５には、管状部の表面の潤滑ジェルをふき取るためのふき取り部を備えさえた保持装置の一例を示した。
　ふき取り部１７は、保持部材１１Ａ、１１Ｂよりも患者側、又は保持部材１１Ａ、１１Ｂの患者側と手元側両方に設けられる。ふき取り部１７には、医療用器具表面からジェル又は水分を除去するための例えばスポンジやゴム部材から成る部材Ｗが設置されることが好ましい。この部材Ｗは患者体液が付着するため、取り替え可能であるとより好適である。
　このように、管状部の表面の潤滑ジェルや水分を除去することで、保持力の低下による管状部の長軸方向の動きに対する意図しない滑りを低減することができる。 When inserting the tubular portion of the endoscope into the natural opening of the patient, a lubricating gel may be applied to reduce friction in the body. When the lubricating gel is applied in this manner, slippage may occur between the surface of the tubular portion and the holding member with respect to the back-and-forth movement of the tubular portion. In order to prevent this, the lubricating gel may be wiped off.
FIG. 15 shows an example of a holding device having a wiping portion for wiping the lubricating gel on the surface of the tubular portion.
The wiping portion 17 is provided on the patient side of the holding members 11A and 11B, or on both the patient side and the hand side of the holding members 11A and 11B. It is preferable that the wiping portion 17 is provided with a member W made of, for example, a sponge or a rubber member for removing gel or water from the surface of the medical device. Since the patient's body fluid adheres to this member W, it is more preferable that it can be replaced.
In this way, by removing the lubricating gel and the water on the surface of the tubular portion, it is possible to reduce unintended slippage due to the movement of the tubular portion in the long axis direction due to the reduction in the holding force.
　本実施形態では、保持部材１１Ａ、１１Ｂが、同軸上に上下２段に平行に設置されるホイール部材を備えているものを例としているが、本発明をこれに限るものではない。
　例えば、図１３（ａ）、図１３（ｂ）で例示したものにおいて、摺動保持部材Ｓの凹部によって管状部２１が上下方向に外れないよう保持できる場合には、保持部材１１Ａ－３のホイール部材を１段とすることも許容され得る。逆に、管状部２１の保持をより確実なものとするために、保持部材にホイール部材を３段以上設けるものであってもよい。
　何れにせよ、内視鏡に代表される医療用器具の管状部を、その長手方向には保持して進退させ、長手方向の軸周りには自由に回転させることができるものであれば、保持部材に設けられるホイール部材は、同軸上に設けられる必要はなく、平行に設ける必要もない。
　また、ホイール部材の直径が異なるものを混合して使用するようなものであっても構わない。また、以下で例示する構成の異なるホイール部材を混合して使用しても構わない。
　なお、保持部材１１Ａに設けられるホイール部材の直径と、保持部材１１Ｂに設けられるホイール部材の直径が異なるような構成とした場合においても、保持部材１１Ａ、１１Ｂのそれぞれに回転力を伝えるギアのギア比を適切に設定することによって、保持部材１１Ａの回転と保持部材１１Ｂの回転を、相互に逆回転となるように且つホイール部材外周における周速度が等しくなるよう同期させることができる。 In the present embodiment, the holding members 11A and 11B are provided with wheel members that are coaxially installed in parallel in two steps, but the present invention is not limited to this.
For example, in the example illustrated in FIGS. 13A and 13B, when the tubular portion 21 can be held by the recess of the slide holding member S so as not to come off in the vertical direction, the wheel of the holding member 11A-3 It is also acceptable to have a single stage member. On the contrary, in order to make the holding of the tubular portion 21 more reliable, the holding member may be provided with three or more stages of wheel members.
In any case, as long as the tubular portion of the medical device typified by an endoscope can be held in the longitudinal direction thereof to advance and retreat and can be freely rotated about the longitudinal axis, it is retained. The wheel members provided on the members need not be provided coaxially or in parallel.
Further, the wheel members having different diameters may be mixed and used. Further, wheel members having different configurations exemplified below may be mixed and used.
Even when the diameter of the wheel member provided on the holding member 11A is different from the diameter of the wheel member provided on the holding member 11B, the gear of the gear that transmits the rotational force to each of the holding members 11A and 11B. By appropriately setting the ratio, the rotation of the holding member 11A and the rotation of the holding member 11B can be synchronized with each other so that they rotate in opposite directions and the peripheral velocities on the outer circumference of the wheel member become equal.
　また、本実施形態では、各小回転体の大きさが同一であり、小回転体がホイールの外周上に均等に設けられるものを例としているが、小回転体の大きさが異なるものがホイールの外周上に配されるものであっても構わない。 Further, in the present embodiment, the small rotating bodies have the same size, and the small rotating bodies are evenly provided on the outer periphery of the wheel, but the small rotating bodies have different sizes. It may be arranged on the outer periphery of.
　本実施形態では、内視鏡の管状部を保持する場合には、スライドブロック１Ｂと固定ブロック１Ａの位置関係（即ち、保持部材１１Ａ、１１Ｂの間隔）がロックされるものを例としたが、本発明をこれに限るものではない。例えば、対向する保持部材を接近させるように付勢させる付勢機構を設け、内視鏡の管状部を保持する際に、常時、保持部材の間隔を狭めるような付勢力を生じさせるようにしてもよい。 In the present embodiment, when the tubular portion of the endoscope is held, the positional relationship between the slide block 1B and the fixed block 1A (that is, the distance between the holding members 11A and 11B) is locked, but this is an example. The present invention is not limited to this. For example, a biasing mechanism that biases the opposing holding members toward each other is provided, and when holding the tubular portion of the endoscope, a biasing force that constantly narrows the interval between the holding members is generated. Good.
　１．．．保持装置
　　１０．．．ホイール部材
　　　１０Ｒ．．．小回転体
　　１１Ａ、１１Ｂ．．．保持部材
　　１７．．．ふき取り部
　　１８．．．スライドロック機構（間隔保持機構）
　２．．．内視鏡（医療用器具）
　　２１．．．管状部
　Ｓ．．．摺動保持部材
　１００．．．軟性内視鏡の駆動システム 1. ． ． Holding device 10. ． ． Wheel member 10R. ． ． Small rotating body 11A, 11B. ． ． Holding member 17. ． ． Wiping part 18. ． ． Slide lock mechanism (spacing mechanism)
2. ． ． Endoscope (medical device)
21. ． ． Tubular part S. ． ． Sliding holding member 100. ． ． Drive system for flexible endoscope

Claims (24)

  1. 　管状部を有する医療用器具を保持するための保持装置であって、
    　前記管状部を、その長手方向に前記保持装置に対して相対的に進退させつつ、長手方向を軸とした回転方向に対しては回動自在に保持する保持部材を備える、保持装置。     A holding device for holding a medical device having a tubular portion,
    A holding device, comprising: a holding member that holds the tubular portion in a longitudinal direction relative to the holding device and is rotatable in a rotation direction about the longitudinal direction.
  2. 　前記保持部材が、第１の保持部材と第２の保持部材によって前記管状部を挟むように保持し、
    　前記第１の保持部材が、前記長手方向と略直交する方向を回転軸とするホイール部材であって、その外周上に、当該外周の接線と略平行な軸を回転軸とする小回転体を複数有しているホイール部材を備えている、請求項１に記載の保持装置。     The holding member holds the tubular portion so as to be sandwiched between the first holding member and the second holding member,
    The first holding member is a wheel member having a rotation axis in a direction substantially orthogonal to the longitudinal direction, and a small rotating body having an axis substantially parallel to a tangent line of the outer circumference as a rotation axis on its outer circumference. The holding device according to claim 1, comprising a plurality of wheel members.
  3. 　前記第２の保持部材が、前記長手方向と略直交する方向を回転軸とするホイール部材であって、その外周上に、当該外周の接線と略平行な軸を回転軸とする小回転体を複数有しているホイール部材を備えている、請求項２に記載の保持装置。 The second holding member is a wheel member having a rotation axis in a direction substantially orthogonal to the longitudinal direction, and a small rotating body having an axis substantially parallel to a tangent line of the outer circumference as a rotation axis on the outer circumference thereof. The holding device according to claim 2, further comprising a plurality of wheel members.
  4. 　前記第１の保持部材と第２の保持部材によって前記管状部を挟むように保持する際において、
    　前記第１の保持部材が備えるホイール部材の小回転体と、前記第２の保持部材が備えるホイール部材の小回転体とのうち、少なくとも１つの小回転体が必ず前記管状部と接するように構成されている、請求項３に記載の保持装置。     When the tubular portion is held so as to be sandwiched by the first holding member and the second holding member,
    At least one small rotating body of the small rotating body of the wheel member included in the first holding member and the small rotating body of the wheel member included in the second holding member is configured to be in contact with the tubular portion without fail. The holding device according to claim 3, which is provided.
  5. 　前記第１の保持部材又は前記第２の保持部材の少なくとも一方が複数の前記ホイール部材を備えている、請求項３に記載の保持装置。 The holding device according to claim 3, wherein at least one of the first holding member and the second holding member includes a plurality of the wheel members.
  6. 　前記第１の保持部材又は前記第２の保持部材の少なくとも一方が、同一回転軸上に平行に配置された複数の前記ホイール部材を備えている、請求項３に記載の保持装置。 The holding device according to claim 3, wherein at least one of the first holding member and the second holding member includes a plurality of the wheel members arranged in parallel on the same rotation axis.
  7. 　前記第１の保持部材又は前記第２の保持部材の少なくとも一方に備えられる、前記複数のホイール部材の直径が略同一である、請求項５に記載の保持装置。 The holding device according to claim 5, wherein the plurality of wheel members provided in at least one of the first holding member and the second holding member have substantially the same diameter.
  8. 　前記第１の保持部材に備えられる前記ホイール部材と、前記第２の保持部材に備えられる前記ホイール部材の直径が全て略同一である、請求項３に記載の保持装置。 The holding device according to claim 3, wherein all the diameters of the wheel member included in the first holding member and the wheel member included in the second holding member are substantially the same.
  9. 　前記第１の保持部材のホイール部材の回転軸と、前記第２の保持部材のホイール部材の回転軸が、略平行である請求項３に記載の保持装置。 The holding device according to claim 3, wherein a rotation axis of the wheel member of the first holding member and a rotation axis of the wheel member of the second holding member are substantially parallel to each other.
  10. 　前記第１の保持部材及び前記第２の保持部材がそれぞれ少なくとも２つの前記ホイール部材を備え、
    　前記第１の保持部材と第２の保持部材によって前記管状部を挟むように保持する際において、
    　前記第１の保持部材が備える複数のホイール部材の小回転体と、前記第２の保持部材が備える複数のホイール部材の小回転体のうち、少なくとも３つの小回転体が必ず前記管状部と接するように構成されている、請求項３に記載の保持装置。     Each of the first holding member and the second holding member includes at least two wheel members,
    When the tubular portion is held so as to be sandwiched by the first holding member and the second holding member,
    At least three small rotating bodies among the small rotating bodies of the plurality of wheel members included in the first holding member and the small rotating bodies of the plurality of wheel members included in the second holding member are always in contact with the tubular portion. The holding device according to claim 3, which is configured as follows.
  11. 　前記第１の保持部材及び前記第２の保持部材が備える前記ホイール部材がそれぞれ２つである、請求項３に記載の保持装置。 The holding device according to claim 3, wherein each of the first holding member and the second holding member includes two wheel members.
  12. 　前記第１の保持部材のホイール部材の回転と、前記第２の保持部材のホイール部材の回転を、相互に逆回転となるように且つ回転を同期させる回転リンク機構を備えている、請求項３に記載の保持装置。 4. A rotation link mechanism for synchronizing the rotation of the wheel member of the first holding member and the rotation of the wheel member of the second holding member so that they are opposite to each other and are synchronized with each other. The holding device according to 1.
  13. 　前記第１の保持部材と前記第２の保持部材の間隔を広げることができるように構成されており、且つ、所定の間隔にて固定させる間隔保持機構を備えている、請求項２に記載の保持装置。 3. The distance holding mechanism according to claim 2, which is configured so that a distance between the first holding member and the second holding member can be widened, and includes a distance holding mechanism for fixing the first holding member and the second holding member at a predetermined distance. Holding device.
  14. 　前記ホイール部材が着脱可能に構成されている請求項２に記載の保持装置。 The holding device according to claim 2, wherein the wheel member is configured to be removable.
  15. 　前記第２の保持部材が、前記管状部を摺動可能に保持する摺動部材を備えている、請求項２に記載の保持装置。 The holding device according to claim 2, wherein the second holding member includes a sliding member that slidably holds the tubular portion.
  16. 　前記第１の保持部材が、複数の前記ホイール部材を備えている、請求項１５に記載の保持装置。 The holding device according to claim 15, wherein the first holding member includes a plurality of the wheel members.
  17. 　前記第１の保持部材が、２つの前記ホイール部材を備えている、請求項１５に記載の保持装置。 The holding device according to claim 15, wherein the first holding member includes two of the wheel members.
  18. 　前記第１の保持部材が、同一回転軸上に平行に配置された２つの前記ホイール部材を備えている、請求項１５に記載の保持装置。 The holding device according to claim 15, wherein the first holding member includes two wheel members arranged in parallel on the same rotation axis.
  19. 　前記第１の保持部材に備えられる、前記２つのホイール部材の直径が略同一である、請求項１７に記載の保持装置。 The holding device according to claim 17, wherein the two wheel members provided in the first holding member have substantially the same diameter.
  20. 　前記小回転体の形状が、紡錘形状若しくは樽状である、請求項２に記載の保持装置。 The holding device according to claim 2, wherein the shape of the small rotating body is a spindle shape or a barrel shape.
  21. 　前記小回転体を備えたホイール部材の外周の形状が略円形である、請求項２に記載の保持装置。 The holding device according to claim 2, wherein the wheel member including the small rotating body has a substantially circular outer peripheral shape.
  22. 　前記保持部材が、前記管状部の長手方向に複数配置されている請求項１に記載の保持装置。 The holding device according to claim 1, wherein a plurality of the holding members are arranged in the longitudinal direction of the tubular portion.
  23. 　前記管状部の表面をふき取るためのふき取り部を備える、請求項１に記載の保持装置。 The holding device according to claim 1, further comprising a wiping portion for wiping the surface of the tubular portion.
  24. 　請求項１に記載の保持装置を備える、軟性内視鏡の駆動システム。 A drive system for a flexible endoscope, comprising the holding device according to claim 1.
PCT/JP2019/045430 2018-12-12 2019-11-20 Holding device, and driving system for flexible endoscope WO2020121763A1 (en)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0397431A (en) * 1989-09-08 1991-04-23 Olympus Optical Co Ltd Endoscope device
US20130137927A1 (en) * 2011-11-30 2013-05-30 Fujifilm Corporation Propulsion assembly for endoscope and driving method

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0397431A (en) * 1989-09-08 1991-04-23 Olympus Optical Co Ltd Endoscope device
US20130137927A1 (en) * 2011-11-30 2013-05-30 Fujifilm Corporation Propulsion assembly for endoscope and driving method

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