WO2021255908A1 - Surgical instrument holding mechanism - Google Patents
Surgical instrument holding mechanism Download PDFInfo
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- WO2021255908A1 WO2021255908A1 PCT/JP2020/024021 JP2020024021W WO2021255908A1 WO 2021255908 A1 WO2021255908 A1 WO 2021255908A1 JP 2020024021 W JP2020024021 W JP 2020024021W WO 2021255908 A1 WO2021255908 A1 WO 2021255908A1
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- surgical instrument
- axis
- holding mechanism
- guide
- surgical tool
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
Definitions
- the present invention relates to a technique for holding a surgical tool such as forceps or an endoscope in a predetermined position or posture.
- Patent Document 1 includes a base mounted on a floor, a support tower installed on the base, and a plurality of arms supported at one end by the support tower, and surgical operations are performed on the tips of the plurality of arms.
- a slave-side robot provided with a manipulator for holding and moving a tool is disclosed.
- the remote center of motion (RCM: Remote Center) of the robot is used so that the body surface of the patient undergoing surgery and the surgical tool inserted from the insertion port formed on the body surface do not interfere with each other. It is necessary to work to set it so that it matches with Motion).
- the robot mentioned above has a large degree of freedom in the movement of the arm and manipulator, the device is large and the mechanism is complicated.
- this robot requires a control unit that sets the insertion port to the robot's RCM and performs calculations and controls to move the surgical tool around the RCM, and further, the position of each part. It is also necessary to have a configuration for grasping with high accuracy.
- the present invention has been made in view of such a situation, and one of its exemplary purposes is to provide a new technique for holding a surgical instrument in a predetermined position and posture with a simple configuration.
- the surgical instrument holding mechanism has a predetermined remote motion center through which the axis of the held surgical instrument passes, and the posture and position of the surgical instrument are within a range of at least 4 degrees of freedom. Can be changed and held with.
- This surgical instrument holding mechanism has a first rotating joint that rotates the surgical instrument in the roll direction with the first axis passing through the center of remote movement as a rotation axis, and a second axis that intersects the first axis and passes through the center of remote movement.
- a second rotating joint that rotates the surgical instrument in the pitch direction with the axis of It includes a third rotary joint that rotates in the yaw direction and a linear motion joint that linearly moves the surgical instrument along the third axis.
- the surgical instrument holding mechanism so that the insertion port for inserting the surgical instrument into the body of the patient coincides with a predetermined remote movement center of the surgical instrument holding mechanism, the skin or abdominal wall of the patient is provided.
- the posture and position of the surgical instrument can be changed and held within a range of at least 4 degrees of freedom without applying an excessive load to the surgical instrument.
- a holding portion for holding the surgical tool may be further provided.
- the first rotary joint may have an arcuate first guide that guides the holding portion as it rotates in the pitch direction.
- the second rotary joint may have an arcuate second guide that guides the holding portion as it rotates in the roll direction.
- the radius of the arc of the first guide is larger than the radius of the arc of the second guide.
- the annular mounting portion can be easily installed on the patient so that the insertion port is at the center.
- the center of remote movement and the insertion slot can be aligned with each other.
- a driving force for rotating the surgical tool in the yaw direction and a driving force for directly moving the surgical tool along the third axis may be further provided.
- the drive unit may be connected to the holding unit.
- the surgical instrument can be held in a predetermined position and posture with a simple configuration.
- FIG. 2A is a diagram for explaining the sizes of the two guides of the surgical instrument holding mechanism seen from the direction A of FIG. 1
- FIG. 2B is a surgical tool viewed from the direction B of FIG. It is a figure for demonstrating the size of two guides of a holding mechanism.
- FIG. 2A is a diagram for explaining the sizes of the two guides of the surgical instrument holding mechanism seen from the direction A of FIG. 1
- FIG. 2B is a surgical tool viewed from the direction B of FIG.
- It is a figure for demonstrating the size of two guides of a holding mechanism.
- the present invention will be described with reference to the drawings based on the embodiments.
- the same or equivalent components, members, and processes shown in the drawings shall be designated by the same reference numerals, and duplicate description thereof will be omitted as appropriate.
- the embodiment is not limited to the invention but is an example, and all the features and combinations thereof described in the embodiment are not necessarily essential to the invention.
- the present invention can be applied to, for example, a slave-side surgical holder robot that is placed on the abdominal wall of a patient while holding a forceps or an endoscope as surgical tools.
- the surgical holder robot on the slave side can be remotely controlled based on the command of the master robot operated by a surgeon such as a doctor.
- FIG. 1 is a perspective view showing a schematic configuration of a surgical instrument holding mechanism according to the present embodiment.
- FIG. 2A is a diagram for explaining the sizes of the two guides of the surgical instrument holding mechanism seen from the direction A of FIG. 1
- FIG. 2B is a surgical tool viewed from the direction B of FIG. It is a figure for demonstrating the size of two guides of a holding mechanism.
- the surgical instrument holding mechanism 10 shown in FIG. 1 has a predetermined remote movement center Rc through which the axis Ax of the rod-shaped surgical instrument 12 such as a held forceps or an endoscope passes, and the posture and position of the surgical instrument 12 can be freely changed by at least four. It can be changed and held within a range of degrees.
- the surgical instrument holding mechanism 10 has a first rotating joint 14 that rotates the surgical instrument 12 in the roll direction Rx with the first axis X passing through the remote movement center Rc as a rotation axis, and a first axis X.
- the surgical instrument holding mechanism 10 is installed at a predetermined position so that the insertion port for inserting the surgical instrument 12 into the patient's body coincides with the predetermined remote movement center Rc of the surgical instrument holding mechanism 10.
- the posture and position of the surgical instrument 12 can be changed and held within a range of at least 4 degrees of freedom without applying an excessive load to the skin or the abdominal wall.
- the remote movement center Rc is not limited to a mathematically exact position, and may be defined within a region set so that the surgical instrument does not interfere with the patient during surgery. ..
- the surgical tool holding mechanism 10 further includes a holding portion 22 for holding the surgical tool 12.
- the first rotary joint 14 has an arc-shaped first guide 24 that guides the holding portion 22 when it rotates in the pitch direction Ry.
- the second rotary joint 16 has an arc-shaped second guide 26 that guides the holding portion 22 when it rotates in the roll direction Rx.
- the holding portion 22 according to the present embodiment has a first guide groove 22a that engages with the first guide 24 and a second guide groove 22b that engages with the second guide 26.
- the posture of the surgical tool 12 can be tilted in the roll direction Rx with the remote movement center Rc as a fixed point only by controlling the rotation of the actuator 28 that drives the first guide 24. Further, the posture of the surgical tool 12 can be tilted in the pitch direction Ry with the remote movement center Rc as a fixed point only by controlling the rotation of the actuator 30 that drives the second guide 26.
- the radius r1 of the arc of the first guide 24 is larger than the radius r2 of the arc of the second guide 26.
- the first guide 24 and the second guide 26 can move independently without interfering with each other.
- the surgical instrument holding mechanism 10 includes an annular mounting portion 32 to which both end portions 24a and 24b of the first guide 24 and both end portions 26a and 26b of the second guide 26 are fixed.
- the attachment portion 32 may be attached at a predetermined position (on a stage installed on or near the abdomen or chest) so as to surround the insertion port into which the surgical instrument 12 is inserted into the patient's body.
- the shape of the mounting portion is not limited to an annular shape, but may be an elliptical shape or a polygonal shape having an opening formed in the central portion.
- the annular mounting portion includes not only a completely connected shape but also a C-shape or a U-shape in which a part is cut out.
- the annular mounting portion 32 is installed on the patient so that the insertion port is at the center. Therefore, the remote movement center Rc and the insertion slot can be easily matched.
- an adhesive tape is used.
- the adhesive tape a polyurethane film which is a medical tape is preferable.
- the surgical tool holding mechanism 10 includes a driving force 34 that generates a driving force for rotating the surgical tool 12 in the yaw direction Rz and a driving force for directly moving the surgical tool 12 along the third axis Z. Further prepared.
- the drive unit 34 has a first omni wheel 36 that generates a driving force that rotates in the yaw direction Rz, and a second omni wheel 38 that generates a driving force that directly moves the surgical tool 12 along the third axis Z. And have.
- the drive unit 34 is connected to the holding unit 22.
- the surgical tool 12 can be arranged at a predetermined position with respect to the driving portion 34.
- the mechanism for generating the driving force may be provided inside the driving unit, or may be transmitted from the outside to the driving unit via a gear or a link.
- FIG. 3 is a schematic view showing a state in which two surgical instrument holding mechanisms according to the present embodiment are installed on the abdominal wall.
- the number of surgical tools is not limited to one, and for example, an endoscope and a pair of forceps are used in combination. Therefore, it is necessary to use a plurality of surgical instrument holding mechanisms.
- the surgical instrument holding mechanism 10 has a simple structure as a whole, and can be installed in a space-saving manner as compared with a parallel link mechanism having an RCM. Therefore, it is also possible to install a plurality of surgical instrument holding mechanisms 10 on the abdominal wall 40 of the patient. Further, since the surgical instrument holding mechanism 10 is installed by fixing the attachment portion 32 on the abdominal wall 40 of the patient with an adhesive tape, it is possible to shorten the time required for preparation before the operation.
- the four-degree-of-freedom surgical instrument holding mechanism 10 employs the RCM mechanism, and the forceps manipulator, which is the surgical instrument 12, pivots around the insertion point 42 of the patient's abdominal wall 40. It is configured to do.
- the surgical instrument holding mechanism 10 makes it relatively easy to match a predetermined RCM with the insertion point 42, and can save labor in preparation before surgery.
- the present invention has been described above with reference to the above-described embodiment, the present invention is not limited to the above-described embodiment, and the present invention is not limited to the above-described embodiment, and the present invention may be a combination or a replacement of the configurations of the embodiments as appropriate. It is included in the present invention. Further, it is also possible to appropriately rearrange the combinations and the order of processing in the embodiment based on the knowledge of those skilled in the art, and to add modifications such as various design changes to the embodiments, and such modifications are added. The embodiments described above may also be included in the scope of the present invention.
- the present invention can be used in a technique for holding a surgical tool such as forceps or an endoscope in a predetermined position or posture.
- r1, r2 ... radius, 10 ... surgical instrument holding mechanism, 12 ... surgical instrument, 14 ... first rotary joint, 16 ... second rotary joint, 18 ... third rotary joint, 20 ... linear motion joint, 22 ... Holding part, 22a ... 1st guide groove, 22b ... 2nd guide groove, 24 ... 1st guide, 26 ... 2nd guide, 28, 30 ... actuator, 32 ... mounting part, 34 ... drive part, 36 ... 1st omni wheel, 38 ... 2nd omni wheel, 40 ... abdominal wall, 42 ... insertion point.
Abstract
This surgical instrument holding mechanism 10 has a prescribed remote center of motion Rc through which the axis of a surgical instrument 12 being held passes, and is capable of changing and holding the attitude and the position of the surgical instrument 12 within a range of at least four degrees of freedom. This surgical instrument holding mechanism 10 comprises: a first rotary joint 14 that rotates the surgical instrument in the roll direction Rx, having a first axis X that passes through the remote center of motion Rc as the rotational axis; a second rotary joint 16 that rotates the surgical instrument 12 in the pitch direction Ry, having a second axis Y that intersects the first axis X and passes through the remote center of motion Rc as the rotational axis; a third rotary joint 18 that rotates the surgical instrument 12 in the yaw direction Rz, using a third axis Z that intersects the first axis X and the second axis Y and passes through the remote center of motion Rc as the rotational axis; and a prismatic joint 20 that moves the surgical instrument 12 linearly along the third axis Z.
Description
本発明は、鉗子や内視鏡といった術具を所定の位置や姿勢で保持する技術に関する。
The present invention relates to a technique for holding a surgical tool such as forceps or an endoscope in a predetermined position or posture.
近年、術者の負担軽減や、医療施設の省人化を図るためにロボット（マニピュレータ）を利用した医療処置の提案がされている。外科分野では、術者が遠隔操作可能な手術用マニピュレータを操作して患者の処置を行う、手術用マニピュレータシステムに関する提案が行われている。
In recent years, medical procedures using robots (manipulators) have been proposed in order to reduce the burden on the surgeon and save labor in medical facilities. In the field of surgery, there are proposals for a surgical manipulator system in which a surgeon operates a remote-controlled surgical manipulator to treat a patient.
例えば、特許文献１には、床に載る土台と、土台に設置される支持塔と、支持塔に一端が支持されている複数のアームとを備え、複数のアームの先端部には、外科手術道具を保持して移動させためのマニピュレータがそれぞれ設けられているスレーブ側ロボットが開示されている。このロボットでは、手術中の患者の体表面と、体表面に形成された挿入口から挿入された外科手術道具とが干渉しないように、例えば、挿入口とロボットの遠隔運動中心（ＲＣＭ：Remote Center of Motion）とが一致するように設定するための作業が必要である。
For example, Patent Document 1 includes a base mounted on a floor, a support tower installed on the base, and a plurality of arms supported at one end by the support tower, and surgical operations are performed on the tips of the plurality of arms. A slave-side robot provided with a manipulator for holding and moving a tool is disclosed. In this robot, for example, the remote center of motion (RCM: Remote Center) of the robot is used so that the body surface of the patient undergoing surgery and the surgical tool inserted from the insertion port formed on the body surface do not interfere with each other. It is necessary to work to set it so that it matches with Motion).
しかしながら、前述のロボットは、アームやマニピュレータの動作の自由度が多いものの、装置が大型であり機構も複雑である。また、このロボットは、挿入口をロボットのＲＣＭに設定し、かつそのＲＣＭを中心として外科手術道具が動くようにするための演算や制御を行う制御部が必要であり、更には各部位の位置を高い精度で把握するための構成も必要である。
However, although the robot mentioned above has a large degree of freedom in the movement of the arm and manipulator, the device is large and the mechanism is complicated. In addition, this robot requires a control unit that sets the insertion port to the robot's RCM and performs calculations and controls to move the surgical tool around the RCM, and further, the position of each part. It is also necessary to have a configuration for grasping with high accuracy.
本発明はこうした状況に鑑みてなされたものであり、その例示的な目的の一つは、簡易な構成で術具を所定の位置や姿勢で保持する新たな技術を提供することにある。
The present invention has been made in view of such a situation, and one of its exemplary purposes is to provide a new technique for holding a surgical instrument in a predetermined position and posture with a simple configuration.
上記課題を解決するために、本発明のある態様の術具保持機構は、保持した術具の軸が通る所定の遠隔運動中心を有し、術具の姿勢及び位置を少なくとも４自由度の範囲で変化させ保持することができる。この術具保持機構は、遠隔運動中心を通る第１の軸を回転軸として術具をロール方向に回転させる第１の回転関節と、第１の軸と交差し、遠隔運動中心を通る第２の軸を回転軸として術具をピッチ方向に回転させる第２の回転関節と、第１の軸及び第２の軸と交差し、遠隔運動中心を通る第３の軸を回転軸として術具をヨー方向に回転させる第３の回転関節と、第３の軸に沿って術具を直動させる直動関節と、を備える。
In order to solve the above problems, the surgical instrument holding mechanism according to an aspect of the present invention has a predetermined remote motion center through which the axis of the held surgical instrument passes, and the posture and position of the surgical instrument are within a range of at least 4 degrees of freedom. Can be changed and held with. This surgical instrument holding mechanism has a first rotating joint that rotates the surgical instrument in the roll direction with the first axis passing through the center of remote movement as a rotation axis, and a second axis that intersects the first axis and passes through the center of remote movement. A second rotating joint that rotates the surgical instrument in the pitch direction with the axis of It includes a third rotary joint that rotates in the yaw direction and a linear motion joint that linearly moves the surgical instrument along the third axis.
この態様によると、例えば、患者の体内に術具を挿入する挿入口が、術具保持機構の所定の遠隔運動中心と一致するように術具保持機構を設置することで、患者の皮膚や腹壁に過大な負荷をかけずに、術具の姿勢及び位置を少なくとも４自由度の範囲で変化させ保持することができる。
According to this aspect, for example, by installing the surgical instrument holding mechanism so that the insertion port for inserting the surgical instrument into the body of the patient coincides with a predetermined remote movement center of the surgical instrument holding mechanism, the skin or abdominal wall of the patient is provided. The posture and position of the surgical instrument can be changed and held within a range of at least 4 degrees of freedom without applying an excessive load to the surgical instrument.
術具を保持する保持部を更に備えてもよい。第１の回転関節は、保持部がピッチ方向に回転する際にガイドする円弧状の第１のガイドを有してもよい。第２の回転関節は、保持部がロール方向に回転する際にガイドする円弧状の第２のガイドを有してもよい。これにより、保持部の移動が所定の範囲に規制されるため、保持部に保持された術具を所定の位置や姿勢に変化させるための制御を簡素化できる。
A holding portion for holding the surgical tool may be further provided. The first rotary joint may have an arcuate first guide that guides the holding portion as it rotates in the pitch direction. The second rotary joint may have an arcuate second guide that guides the holding portion as it rotates in the roll direction. As a result, the movement of the holding portion is restricted to a predetermined range, so that the control for changing the surgical instrument held by the holding portion to a predetermined position or posture can be simplified.
第１のガイドの円弧の半径は、第２のガイドの円弧の半径よりも大きい。これにより、第１のガイドと第２のガイドが干渉せずに独立して動くことができる。
The radius of the arc of the first guide is larger than the radius of the arc of the second guide. As a result, the first guide and the second guide can move independently without interfering with each other.
第１のガイドの両端部と、第２のガイドの両端部とが固定される取付部であって、患者の体内に術具を挿入する挿入口を囲むように所定の位置に取り付けられる取付部を更に備えてもよい。これにより、例えば、環状の取付部の中央部が術具保持機構の所定の遠隔運動中心である場合、挿入口が中心にくるように環状の取付部を患者の上に設置することで、簡便に遠隔運動中心と挿入口とを一致させることができる。
An attachment part to which both ends of the first guide and both ends of the second guide are fixed, and the attachment part is attached at a predetermined position so as to surround the insertion slot for inserting the surgical instrument into the patient's body. May be further provided. Thereby, for example, when the central portion of the annular mounting portion is the predetermined remote movement center of the surgical instrument holding mechanism, the annular mounting portion can be easily installed on the patient so that the insertion port is at the center. The center of remote movement and the insertion slot can be aligned with each other.
術具をヨー方向に回転させる駆動力、及び、術具を第３の軸に沿って直動させる駆動力を発生させる駆動部を更に備えてもよい。駆動部は、保持部に連結していてもよい。これにより、保持部と駆動部とが別々に設けられている場合と比較して、術具保持機構を簡易な構成にできる。また、保持部に術具を保持させることで、駆動部に対して所定の位置に術具を配置することが可能となる。
A driving force for rotating the surgical tool in the yaw direction and a driving force for directly moving the surgical tool along the third axis may be further provided. The drive unit may be connected to the holding unit. As a result, the surgical instrument holding mechanism can be simplified as compared with the case where the holding portion and the driving portion are separately provided. Further, by holding the surgical tool on the holding portion, it is possible to arrange the surgical tool at a predetermined position with respect to the driving portion.
なお、以上の構成要素の任意の組合せ、本発明の表現を方法、装置、システム、などの間で変換したものもまた、本発明の態様として有効である。
It should be noted that any combination of the above components and the conversion of the expression of the present invention between methods, devices, systems, etc. are also effective as aspects of the present invention.
本発明によれば、簡易な構成で術具を所定の位置や姿勢で保持することができる。
According to the present invention, the surgical instrument can be held in a predetermined position and posture with a simple configuration.
以下、本発明を実施の形態をもとに図面を参照しながら説明する。各図面に示される同一又は同等の構成要素、部材、処理には、同一の符号を付するものとし、適宜重複した説明は省略する。また、実施の形態は、発明を限定するものではなく例示であって、実施の形態に記述される全ての特徴やその組合せは、必ずしも発明の本質的なものであるとは限らない。本発明は、例えば、術具である鉗子や内視鏡を保持しながら患者の腹壁の上に載置されて使用されるスレーブ側の手術用ホルダロボットに適用できる。スレーブ側の手術用ホルダロボットは、医者等の術者が操作するマスタ側ロボットの指令に基づいて遠隔操作が可能である。
Hereinafter, the present invention will be described with reference to the drawings based on the embodiments. The same or equivalent components, members, and processes shown in the drawings shall be designated by the same reference numerals, and duplicate description thereof will be omitted as appropriate. Further, the embodiment is not limited to the invention but is an example, and all the features and combinations thereof described in the embodiment are not necessarily essential to the invention. The present invention can be applied to, for example, a slave-side surgical holder robot that is placed on the abdominal wall of a patient while holding a forceps or an endoscope as surgical tools. The surgical holder robot on the slave side can be remotely controlled based on the command of the master robot operated by a surgeon such as a doctor.
図１は、本実施の形態に係る術具保持機構の概略構成を示す斜視図である。図２（ａ）は、図１のＡ方向から見た術具保持機構の２つのガイドの大きさを説明するための図、図２（ｂ）は、図１のＢ方向から見た術具保持機構の２つのガイドの大きさを説明するための図である。
FIG. 1 is a perspective view showing a schematic configuration of a surgical instrument holding mechanism according to the present embodiment. FIG. 2A is a diagram for explaining the sizes of the two guides of the surgical instrument holding mechanism seen from the direction A of FIG. 1, and FIG. 2B is a surgical tool viewed from the direction B of FIG. It is a figure for demonstrating the size of two guides of a holding mechanism.
図１に示す術具保持機構１０は、保持した鉗子や内視鏡といった棒状の術具１２の軸Ａｘが通る所定の遠隔運動中心Ｒｃを有し、術具１２の姿勢及び位置を少なくとも４自由度の範囲で変化させ保持することができる。具体的には、術具保持機構１０は、遠隔運動中心Ｒｃを通る第１の軸Ｘを回転軸として術具１２をロール方向Ｒｘに回転させる第１の回転関節１４と、第１の軸Ｘと交差し、遠隔運動中心Ｒｃを通る第２の軸Ｙを回転軸として術具１２をピッチ方向Ｒｙに回転させる第２の回転関節１６と、第１の軸Ｘ及び第２の軸Ｙと交差し、遠隔運動中心Ｒｃを通る第３の軸Ｚを回転軸として術具１２をヨー方向Ｒｚに回転させる第３の回転関節１８と、第３の軸Ｚに沿って術具を直動させる直動関節２０と、を備える。
The surgical instrument holding mechanism 10 shown in FIG. 1 has a predetermined remote movement center Rc through which the axis Ax of the rod-shaped surgical instrument 12 such as a held forceps or an endoscope passes, and the posture and position of the surgical instrument 12 can be freely changed by at least four. It can be changed and held within a range of degrees. Specifically, the surgical instrument holding mechanism 10 has a first rotating joint 14 that rotates the surgical instrument 12 in the roll direction Rx with the first axis X passing through the remote movement center Rc as a rotation axis, and a first axis X. Crosses the second rotary joint 16 that rotates the surgical instrument 12 in the pitch direction Ry with the second axis Y passing through the remote movement center Rc as the rotation axis, and intersects the first axis X and the second axis Y. Then, the third rotary joint 18 that rotates the surgical instrument 12 in the yaw direction Rz with the third axis Z passing through the remote movement center Rc as the rotation axis, and the direct movement of the surgical instrument along the third axis Z. The moving joint 20 is provided.
これにより、患者の体内に術具１２を挿入する挿入口が、術具保持機構１０の所定の遠隔運動中心Ｒｃと一致するように術具保持機構１０を所定位置に設置することで、患者の皮膚や腹壁に過大な負荷をかけずに、術具１２の姿勢及び位置を少なくとも４自由度の範囲で変化させ保持することができる。なお、遠隔運動中心Ｒｃは、数学的に厳密な位置に限定されるわけではなく、あくまで手術の際に術具が患者に干渉しないように設定される領域内に定義されたものであればよい。
As a result, the surgical instrument holding mechanism 10 is installed at a predetermined position so that the insertion port for inserting the surgical instrument 12 into the patient's body coincides with the predetermined remote movement center Rc of the surgical instrument holding mechanism 10. The posture and position of the surgical instrument 12 can be changed and held within a range of at least 4 degrees of freedom without applying an excessive load to the skin or the abdominal wall. It should be noted that the remote movement center Rc is not limited to a mathematically exact position, and may be defined within a region set so that the surgical instrument does not interfere with the patient during surgery. ..
術具保持機構１０は、術具１２を保持する保持部２２を更に備えている。そして、第１の回転関節１４は、保持部２２がピッチ方向Ｒｙに回転する際にガイドする円弧状の第１のガイド２４を有している。また、第２の回転関節１６は、保持部２２がロール方向Ｒｘに回転する際にガイドする円弧状の第２のガイド２６を有している。本実施の形態に係る保持部２２は、第１のガイド２４と係合する第１のガイド溝２２ａと、第２のガイド２６と係合する第２のガイド溝２２ｂと、を有する。これにより、保持部２２の移動が２つの円弧状のガイドが交差する半球状の表面の範囲に規制されるため、保持部２２に保持された術具１２を所定の位置や姿勢に変化させるための制御を簡素化できる。
The surgical tool holding mechanism 10 further includes a holding portion 22 for holding the surgical tool 12. The first rotary joint 14 has an arc-shaped first guide 24 that guides the holding portion 22 when it rotates in the pitch direction Ry. Further, the second rotary joint 16 has an arc-shaped second guide 26 that guides the holding portion 22 when it rotates in the roll direction Rx. The holding portion 22 according to the present embodiment has a first guide groove 22a that engages with the first guide 24 and a second guide groove 22b that engages with the second guide 26. As a result, the movement of the holding portion 22 is restricted to the range of the hemispherical surface where the two arc-shaped guides intersect, so that the surgical tool 12 held by the holding portion 22 is changed to a predetermined position and posture. Control can be simplified.
つまり、第１のガイド２４を駆動するアクチュエータ２８の回転を制御するだけで、遠隔運動中心Ｒｃを不動点として、術具１２の姿勢をロール方向Ｒｘに傾けることができる。また、第２のガイド２６を駆動するアクチュエータ３０の回転を制御するだけで、遠隔運動中心Ｒｃを不動点として、術具１２の姿勢をピッチ方向Ｒｙに傾けることができる。
That is, the posture of the surgical tool 12 can be tilted in the roll direction Rx with the remote movement center Rc as a fixed point only by controlling the rotation of the actuator 28 that drives the first guide 24. Further, the posture of the surgical tool 12 can be tilted in the pitch direction Ry with the remote movement center Rc as a fixed point only by controlling the rotation of the actuator 30 that drives the second guide 26.
また、図２（ａ）、図２（ｂ）に示すように、第１のガイド２４の円弧の半径ｒ１は、第２のガイド２６の円弧の半径ｒ２よりも大きい。これにより、第１のガイド２４と第２のガイド２６が干渉せずに独立して動くことができる。
Further, as shown in FIGS. 2A and 2B, the radius r1 of the arc of the first guide 24 is larger than the radius r2 of the arc of the second guide 26. As a result, the first guide 24 and the second guide 26 can move independently without interfering with each other.
本実施の形態に係る術具保持機構１０は、第１のガイド２４の両端部２４ａ，２４ｂと、第２のガイド２６の両端部２６ａ，２６ｂとが固定される環状の取付部３２を備える。なお、図１では、第１のガイド２４の両端部２４ａ，２４ｂと、第２のガイド２６の両端部２６ａ，２６ｂとの図示を省略している。取付部３２は、患者の体内に術具１２を挿入する挿入口を囲むように所定の位置（腹部や胸部の上、またはその近傍に設置されたステージ上）に取り付けられるものであればよい。また、取付部の形状は円環状のものだけでなく、楕円形状や多角形状の中央部に開口が形成されているものであってもよい。また、環状の取付部とは、完全に繋がった形状のものだけではなく、一部が切り欠かれたＣ字形状やコの字形状も含まれる。
The surgical instrument holding mechanism 10 according to the present embodiment includes an annular mounting portion 32 to which both end portions 24a and 24b of the first guide 24 and both end portions 26a and 26b of the second guide 26 are fixed. In FIG. 1, both end portions 24a and 24b of the first guide 24 and both end portions 26a and 26b of the second guide 26 are not shown. The attachment portion 32 may be attached at a predetermined position (on a stage installed on or near the abdomen or chest) so as to surround the insertion port into which the surgical instrument 12 is inserted into the patient's body. Further, the shape of the mounting portion is not limited to an annular shape, but may be an elliptical shape or a polygonal shape having an opening formed in the central portion. Further, the annular mounting portion includes not only a completely connected shape but also a C-shape or a U-shape in which a part is cut out.
これにより、例えば、環状の取付部３２の中央部が術具保持機構１０の所定の遠隔運動中心Ｒｃである場合、挿入口が中心にくるように環状の取付部３２を患者の上に設置することで、簡便に遠隔運動中心Ｒｃと挿入口とを一致させることができる。なお、取付部３２を患者に取り付ける場合は、例えば、粘着テープが用いられる。粘着テープとしては、医療用テープであるポリウレタンフィルムが好ましい。
Thereby, for example, when the central portion of the annular mounting portion 32 is the predetermined remote movement center Rc of the surgical instrument holding mechanism 10, the annular mounting portion 32 is installed on the patient so that the insertion port is at the center. Therefore, the remote movement center Rc and the insertion slot can be easily matched. When the attachment portion 32 is attached to the patient, for example, an adhesive tape is used. As the adhesive tape, a polyurethane film which is a medical tape is preferable.
また、本実施の形態に係る術具保持機構１０は、ヨー方向Ｒｚに回転させる駆動力、及び、術具１２を第３の軸Ｚに沿って直動させる駆動力を発生させる駆動部３４を更に備えている。駆動部３４は、ヨー方向Ｒｚに回転させる駆動力を発生させる第１のオムニホイール３６と、術具１２を第３の軸Ｚに沿って直動させる駆動力を発生させる第２のオムニホイール３８とを有する。駆動部３４は、保持部２２に連結している。これにより、保持部２２と駆動部３４とが別々に設けられている場合と比較して、術具保持機構１０を簡易な構成にできる。また、保持部２２に術具１２を保持させることで、駆動部３４に対して所定の位置に術具１２を配置することが可能となる。なお、駆動力を発生させる機構は、駆動部の内部に設けてもよく、又は外部からギヤやリンクを介して駆動部に伝達してもよい。
Further, the surgical tool holding mechanism 10 according to the present embodiment includes a driving force 34 that generates a driving force for rotating the surgical tool 12 in the yaw direction Rz and a driving force for directly moving the surgical tool 12 along the third axis Z. Further prepared. The drive unit 34 has a first omni wheel 36 that generates a driving force that rotates in the yaw direction Rz, and a second omni wheel 38 that generates a driving force that directly moves the surgical tool 12 along the third axis Z. And have. The drive unit 34 is connected to the holding unit 22. As a result, the surgical instrument holding mechanism 10 can be configured in a simple manner as compared with the case where the holding portion 22 and the driving portion 34 are separately provided. Further, by holding the surgical tool 12 on the holding portion 22, the surgical tool 12 can be arranged at a predetermined position with respect to the driving portion 34. The mechanism for generating the driving force may be provided inside the driving unit, or may be transmitted from the outside to the driving unit via a gear or a link.
次に、本実施の形態に係る術具保持機構を複数用いて手術する場合について説明する。図３は、本実施の形態に係る術具保持機構を腹壁の上に２つ設置した状態を示す模式図である。通常の手術では、術具が一つだけと言うことはなく、例えば、内視鏡と一対の鉗子とを組み合わせて用いられる。そのため、複数の術具保持機構を用いる必要がある。
Next, a case where surgery is performed using a plurality of surgical instrument holding mechanisms according to the present embodiment will be described. FIG. 3 is a schematic view showing a state in which two surgical instrument holding mechanisms according to the present embodiment are installed on the abdominal wall. In normal surgery, the number of surgical tools is not limited to one, and for example, an endoscope and a pair of forceps are used in combination. Therefore, it is necessary to use a plurality of surgical instrument holding mechanisms.
図３に示すように、本実施の形態に係る術具保持機構１０は、全体が簡易な構成であり、ＲＣＭを有する平行リンク機構と比較して省スペースでの設置が可能である。そのため、患者の腹壁４０の上に複数の術具保持機構１０を設置することも可能である。また、術具保持機構１０は、患者の腹壁４０の上に粘着テープで取付部３２を固定することで設置が完了するため、手術前の準備にかかる時間の短縮が可能である。
As shown in FIG. 3, the surgical instrument holding mechanism 10 according to the present embodiment has a simple structure as a whole, and can be installed in a space-saving manner as compared with a parallel link mechanism having an RCM. Therefore, it is also possible to install a plurality of surgical instrument holding mechanisms 10 on the abdominal wall 40 of the patient. Further, since the surgical instrument holding mechanism 10 is installed by fixing the attachment portion 32 on the abdominal wall 40 of the patient with an adhesive tape, it is possible to shorten the time required for preparation before the operation.
このように、本実施の形態に係る４自由度の術具保持機構１０は、ＲＣＭ機構を採用しており、患者の腹壁４０の挿入点４２を中心に術具１２である鉗子マニピュレータがピボット運動するように構成されている。換言すると、術具保持機構１０は、所定のＲＣＭを挿入点４２と一致させることが比較的容易であり、手術前の準備を省力化できる。
As described above, the four-degree-of-freedom surgical instrument holding mechanism 10 according to the present embodiment employs the RCM mechanism, and the forceps manipulator, which is the surgical instrument 12, pivots around the insertion point 42 of the patient's abdominal wall 40. It is configured to do. In other words, the surgical instrument holding mechanism 10 makes it relatively easy to match a predetermined RCM with the insertion point 42, and can save labor in preparation before surgery.
以上、本発明を上述の実施の形態を参照して説明したが、本発明は上述の実施の形態に限定されるものではなく、実施の形態の構成を適宜組み合わせたものや置換したものについても本発明に含まれるものである。また、当業者の知識に基づいて実施の形態における組合せや処理の順番を適宜組み替えることや各種の設計変更等の変形を実施の形態に対して加えることも可能であり、そのような変形が加えられた実施の形態も本発明の範囲に含まれうる。
Although the present invention has been described above with reference to the above-described embodiment, the present invention is not limited to the above-described embodiment, and the present invention is not limited to the above-described embodiment, and the present invention may be a combination or a replacement of the configurations of the embodiments as appropriate. It is included in the present invention. Further, it is also possible to appropriately rearrange the combinations and the order of processing in the embodiment based on the knowledge of those skilled in the art, and to add modifications such as various design changes to the embodiments, and such modifications are added. The embodiments described above may also be included in the scope of the present invention.
本発明は、鉗子や内視鏡といった術具を所定の位置や姿勢で保持する技術に利用できる。
The present invention can be used in a technique for holding a surgical tool such as forceps or an endoscope in a predetermined position or posture.
ｒ１，ｒ２…半径、 １０…術具保持機構、 １２…術具、 １４…第１の回転関節、 １６…第２の回転関節、 １８…第３の回転関節、 ２０…直動関節、 ２２…保持部、 ２２ａ…第１のガイド溝、 ２２ｂ…第２のガイド溝、 ２４…第１のガイド、 ２６…第２のガイド、 ２８，３０…アクチュエータ、 ３２…取付部、 ３４…駆動部、 ３６…第１のオムニホイール、 ３８…第２のオムニホイール、 ４０…腹壁、 ４２…挿入点。
r1, r2 ... radius, 10 ... surgical instrument holding mechanism, 12 ... surgical instrument, 14 ... first rotary joint, 16 ... second rotary joint, 18 ... third rotary joint, 20 ... linear motion joint, 22 ... Holding part, 22a ... 1st guide groove, 22b ... 2nd guide groove, 24 ... 1st guide, 26 ... 2nd guide, 28, 30 ... actuator, 32 ... mounting part, 34 ... drive part, 36 ... 1st omni wheel, 38 ... 2nd omni wheel, 40 ... abdominal wall, 42 ... insertion point.
Claims (5)
- 保持した術具の軸が通る所定の遠隔運動中心を有し、前記術具の姿勢及び位置を少なくとも４自由度の範囲で変化させ保持することができる術具保持機構であって、
前記遠隔運動中心を通る第１の軸を回転軸として前記術具をロール方向に回転させる第１の回転関節と、
前記第１の軸と交差し、前記遠隔運動中心を通る第２の軸を回転軸として前記術具をピッチ方向に回転させる第２の回転関節と、
前記第１の軸及び前記第２の軸と交差し、前記遠隔運動中心を通る第３の軸を回転軸として前記術具をヨー方向に回転させる第３の回転関節と、
前記第３の軸に沿って前記術具を直動させる直動関節と、
を備えることを特徴とする術具保持機構。 A surgical tool holding mechanism that has a predetermined remote movement center through which the axis of the held surgical tool passes, and can change and hold the posture and position of the surgical tool within a range of at least 4 degrees of freedom.
A first rotary joint that rotates the surgical instrument in the roll direction with the first axis passing through the center of remote movement as a rotation axis, and
A second rotary joint that rotates the surgical instrument in the pitch direction with the second axis that intersects the first axis and passes through the center of remote motion as a rotation axis.
A third rotary joint that intersects the first axis and the second axis and rotates the surgical instrument in the yaw direction with the third axis passing through the center of remote motion as a rotation axis.
A linear joint that moves the surgical instrument linearly along the third axis,
A surgical tool holding mechanism characterized by being provided with. - 前記術具を保持する保持部を更に備え、
前記第１の回転関節は、前記保持部がピッチ方向に回転する際にガイドする円弧状の第１のガイドを有し、
前記第２の回転関節は、前記保持部がロール方向に回転する際にガイドする円弧状の第２のガイドを有することを特徴とする請求項１に記載の術具保持機構。 Further provided with a holding portion for holding the surgical instrument,
The first rotary joint has an arcuate first guide that guides the holding portion as it rotates in the pitch direction.
The surgical tool holding mechanism according to claim 1, wherein the second rotary joint has an arc-shaped second guide that guides the holding portion when it rotates in the roll direction. - 前記第１のガイドの円弧の半径は、前記第２のガイドの円弧の半径よりも大きいことを特徴とする請求項２に記載の術具保持機構。 The surgical tool holding mechanism according to claim 2, wherein the radius of the arc of the first guide is larger than the radius of the arc of the second guide.
- 前記第１のガイドの両端部と、前記第２のガイドの両端部とが固定される取付部であって、患者の体内に前記術具を挿入する挿入口を囲むように所定の位置に取り付けられる取付部を更に備えることを特徴とする請求項２または３に記載の術具保持機構。 It is an attachment part to which both ends of the first guide and both ends of the second guide are fixed, and is attached at a predetermined position so as to surround an insertion port into which the surgical instrument is inserted into the patient's body. The surgical tool holding mechanism according to claim 2 or 3, further comprising a mounting portion to be provided.
- 前記術具をヨー方向に回転させる駆動力、及び、前記術具を前記第３の軸に沿って直動させる駆動力を発生させる駆動部を更に備え、
前記駆動部は、前記保持部に連結していることを特徴とする請求項２乃至４のいずれか１項に記載の術具保持機構。 Further provided with a driving force for generating a driving force for rotating the surgical tool in the yaw direction and a driving force for directly moving the surgical tool along the third axis.
The surgical instrument holding mechanism according to any one of claims 2 to 4, wherein the driving portion is connected to the holding portion.
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Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0630896A (en) * | 1992-05-27 | 1994-02-08 | Internatl Business Mach Corp <Ibm> | Surgical treatment method and apparatus |
| US20030229338A1 (en) * | 2000-11-03 | 2003-12-11 | Irion Klaus M. | Device for holding and positioning an endoscopic instrument |
| JP2004129956A (en) * | 2002-10-11 | 2004-04-30 | Aska Corp | Endoscope holder |
| WO2009015548A1 (en) * | 2007-07-31 | 2009-02-05 | Tianming Lv | Simple structured stereotaxic apparatus |
| US20130282022A1 (en) * | 2012-04-18 | 2013-10-24 | Basem Fayez Yousef | Manipulator For Surgical Tools |
| CN104146772A (en) * | 2014-07-29 | 2014-11-19 | 北京理工大学 | Robot for accurate diagnosis and treatment of maxillofacial diseases |
| JP2015502814A (en) * | 2011-12-05 | 2015-01-29 | コーニンクレッカ フィリップス エヌ ヴェ | Surgical tool positioning and orientation during patient-specific port placement |
| CN108245244A (en) * | 2016-12-28 | 2018-07-06 | 中国科学院深圳先进技术研究院 | A kind of method and device of RF ablation |
-
2020
- 2020-06-18 WO PCT/JP2020/024021 patent/WO2021255908A1/en active Application Filing
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0630896A (en) * | 1992-05-27 | 1994-02-08 | Internatl Business Mach Corp <Ibm> | Surgical treatment method and apparatus |
| US20030229338A1 (en) * | 2000-11-03 | 2003-12-11 | Irion Klaus M. | Device for holding and positioning an endoscopic instrument |
| JP2004129956A (en) * | 2002-10-11 | 2004-04-30 | Aska Corp | Endoscope holder |
| WO2009015548A1 (en) * | 2007-07-31 | 2009-02-05 | Tianming Lv | Simple structured stereotaxic apparatus |
| JP2015502814A (en) * | 2011-12-05 | 2015-01-29 | コーニンクレッカ フィリップス エヌ ヴェ | Surgical tool positioning and orientation during patient-specific port placement |
| US20130282022A1 (en) * | 2012-04-18 | 2013-10-24 | Basem Fayez Yousef | Manipulator For Surgical Tools |
| CN104146772A (en) * | 2014-07-29 | 2014-11-19 | 北京理工大学 | Robot for accurate diagnosis and treatment of maxillofacial diseases |
| CN108245244A (en) * | 2016-12-28 | 2018-07-06 | 中国科学院深圳先进技术研究院 | A kind of method and device of RF ablation |
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