JP2003127076A - Medical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical instrument capable of moving a scope to follow the movement of a treatment tool so that person holding the scope is not required. SOLUTION: The scope 281 is attached to the arm of a vertical multi-joint robot 285 with 6 degrees of freedom, and the treatment tool 282 is approached to a treatment object from a position different from the scope 281. The position and attitude of the tool 282 to the scope 281 and the top edge position of the tool 282 are calculated and the robot 285 is controlled so that the top edge of the tool 282 passes in the axial center of the scope 281.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical instrument, such as a robotic endosurgery, which is attached to a robot for diagnosis and treatment.

[0002]

2. Description of the Related Art Recently, in order to improve the operability of surgery and expand its function, it is possible to attach a medical instrument to a robot such as a robotic endosurgery to diagnose and treat a patient. Has been.

[0003]

With this type of device, a tactile sensor is provided at the insertion portion of the main body of the medical instrument to be inserted into the body cavity, for example, the grasping portion for grasping the tissue at the tip of the treatment tool, and when grasping the tissue. It is designed to prevent tissue damage.
However, there is a possibility that safety cannot be ensured in the case where the sensor itself of the tactile sensor or the wiring of the tactile sensor is broken.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a medical device capable of ensuring safety even if a sensor has a single failure.

[0005]

According to a first aspect of the present invention, there is provided a scope attached to an arm of a robot, a treatment instrument which is brought closer to a treatment target from a position different from the scope, and a treatment instrument for the scope. A medical instrument comprising: a control unit that controls the robot so as to determine the position and orientation and the position of the distal end of the treatment instrument so that the distal end of the treatment instrument passes on the axis of the scope. Is.

According to the first aspect of the present invention, the robot is controlled so that the position and orientation of the treatment tool with respect to the scope attached to the robot and the position of the tip of the treatment tool are obtained, and the tip of the treatment tool passes along the axis of the scope. By doing so, the scope is moved in accordance with the movement of the treatment tool.

According to a second aspect of the present invention, the treatment tool is
A movable coil for posture detection is attached, and a fixed transmitter serving as a reference for position / posture detection of the treatment instrument is provided at a place where a relative positional relationship with the robot is determined, and the control unit controls the robot. A rotation angle calculation unit for each axis, scope detection means for detecting the position and orientation of the scope from the angle of each joint of the robot, the position / orientation detection device for the treatment instrument, and the tip of the treatment instrument. By controlling the rotation angle of each axis of the robot so that the tip of the treatment instrument passes on a straight line on the extension of the axial center of the scope, the tip position calculating section calculates the position of the treatment section. The medical instrument according to claim 1, further comprising: a scope image adjusting unit that always captures a distal end of the treatment tool in the center of the scope image.

According to the second aspect of the present invention, the position / orientation of the treatment tool is obtained by determining the relative position and attitude of the movable coil with respect to the fixed oscillator arranged at the position where the relative positional relationship with the robot is determined. To detect. Furthermore, a rotation angle calculation unit for each axis of the robot, a scope detection unit that detects the position and orientation of the scope from the angle of each joint of the robot, a position / orientation detection device for the treatment instrument, and a treatment for the distal end of the treatment instrument. The rotation angle of each axis of the robot is adjusted so that the tip of the treatment instrument passes along a straight line on the extension of the axis of the scope from the output signals from the tip position calculator that calculates the position of the part. The tip of the treatment tool is always caught in the center of the scope image by controlling.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION FIGS. 1A to 3 show an example of a medical device. FIG. 2 shows a schematic configuration of the entire system of a medical instrument for endoscopic surgery. In FIG. 2, reference numeral 1 is a main body of the external device. A light source device 3, a camera control unit (CCU) 4, a tactile sense detection control unit 5, a drive control unit 6, and a suction / pneumoperitoneum 7 are provided on a support base 2 of the external device body 1. Here, the drive control unit 6 includes a plurality of external operation units 8a, 8b, 8
c is connected. Further, a TV monitor 9 is connected to the CCU 4.

Further, 10 is a bed 11 in the operating room, for example.
It is a medical equipment mounting base to be attached to. This mount 1
Reference numeral 0 indicates an endoscope 12, a first treatment tool 13, and a second treatment tool 1.
Terminal part 1 to which various medical instruments such as 4 are detachably mounted
5a, 15b, 15c are provided.

Further, the endoscope 12 is provided with an insertion portion 16 to be inserted into the body and an extracorporeal arrangement portion 17 connected to the base end portion and arranged outside the body. Furthermore, the external placement unit 1
One end of a cable 18 is connected to 7. The other end of the cable 18 is attached to the mount 1 via the connector 19.
It is detachably connected to the 0 connector receiver.

Further, the first treatment tool 13 is provided with an insertion portion 20 to be inserted into the body and an extracorporeal arrangement portion 21 connected to the base end portion and arranged outside the body.
One end of a cable 22 is connected to the cable 2
The other end of 2 is detachably connected to a connector receiver of the mount 10 via a connector 23.

Further, similarly to the first treatment tool 13, the second treatment tool 14 is also provided with an insertion portion 24 to be inserted into the body and an extracorporeal arrangement portion 25 arranged outside the body.
One end of the cable 26 is connected to the cable 2
The other end of 6 is detachably connected to a connector receiver of the mount 10 via a connector 27.

Further, external terminals 28 and 29 are provided at the end of the mount 10. These external connections 2
8 and 29 are connection cables 30 and 3 on the external device main body 1 side.
1 is detachably connected via connectors 30a and 31a, respectively.

Then, the endoscope 12, the first treatment tool 13,
The second treatment tool 14 is connected to the external device main body 1 side via the internal wiring of the mounting base 10 and the connection cables 30 and 31, and the operation of the endoscope 12 is controlled by, for example, the external operation unit 8a. The operation section 8b controls the operation of the first treatment tool 13, and the external operation section 8c controls the operation of the second treatment tool 14. Further, the observation image taken by the endoscope 12 is displayed on the TV monitor 9.

Further, FIG. 1 (A) shows the distal end portion of the insertion portion 20 of the first treatment tool 13. The insertion portion 20 is provided with a sheath 32 and a gripping tool 33 that is housed so as to be able to project to the outside from the distal end opening portion of the sheath 32. A pair of gripping members 34a and 34b that can be opened and closed are provided at the tip of the gripping tool 33.

Here, at least one gripping member 34a
A tactile sensor 35 having robustness is attached to the inner surface of the. The tactile sensor 35 is formed by a distributed sensor unit 36 which is a sensor array shown in FIG. In this sensor unit 36, a plurality of sensors 37 are arranged side by side in the vertical and horizontal directions in a substantially matrix shape.

Further, as shown in FIG. 3, a signal processing circuit 39 which independently detects an odd row and an even row of each sensor 37 by an independent detection circuit 38 and outputs one sensor output from the detected value. It is provided. In addition, in FIG.
Reference numeral 40 is a comparison circuit, and 41 is an arithmetic circuit.

Here, the signals of the respective sensors 37 are output in a time series as shown in FIG. 1C by sequentially switching and reading the respective sensors 37 in a matrix.

Then, in the signal processing circuit 39, for example, when two adjacent sensors 37, for example, C ₁₁ and C ₂₁ have substantially the same value, they are added and the average is calculated. Also,
When one of them is disconnected and the output is out of the proper value, the other output is used as the sensor output. These judgments are made by the comparison circuit 40 and the arithmetic circuit 41.

Next, the operation of the above configuration will be described.
First, during endoscopic surgery, the first treatment tool 13 and the second treatment tool 14 are operated while visually observing an observation image from the endoscope 12 displayed on the TV monitor 9. And the first
The distal end portion of the insertion portion 20 of the treatment instrument 13 and the distal end portion of the insertion portion 24 of the second treatment instrument 14 are guided to the vicinity of the target site such as the affected area in the body cavity of the patient. Here, the first treatment tool 13
The second treatment tool 14 and the second treatment tool 14 are independently operated, and an appropriate treatment is performed on the affected area.

When the first treatment tool 13 is used, the gripping tool 33 is projected to the outside from the distal end opening of the sheath 32 by the operation of the external operating portion 8b, and the gripping member 34a at the tip part of the gripping tool 33, 34b is opened and closed.

Furthermore, when a target tissue such as an affected area is grasped during the closing operation of the grasping members 34a and 34b, the tactile sensor 35 on the inner surface of the grasping member 34a immediately detects the touch. When the tactile sensor 35 operates, the signal processing circuit 39 outputs one sensor output. That is, the odd-numbered row and the even-numbered row of each sensor 37 in the sensor unit 36 of the tactile sensor 35 are independent detection circuits 3 respectively.
8 is independently detected, and one sensor output is output from the detected value.

Therefore, in the above-described structure, a plurality of sensors 37 are arranged in a matrix in the sensor unit 36 of the tactile sensor 35 in the vertical and horizontal directions, and the sensor wiring and the detection circuit 38 are respectively provided. Since they are provided independently of each other, even if one of the plurality of sensors 37 in the sensor unit 36 has a failure such as a disconnection or a sensor breakage, the sensor output can be reliably obtained.

Although the sensor output is obtained from the two sensor cells in the sensor unit 36 of the tactile sensor 35 in the above example, one sensor output may be obtained from more cells.

FIGS. 4 and 5 show a first modification of the medical device shown in FIGS. 1 (A) to 3. As shown in FIG. 4, the sensor unit 36 is provided with a plurality of sensor blocks 51, which are integrated into one sensor block 36, and the outputs of the sensors 37 serving as cells in each sensor block 51 are added. In this configuration, one output is output.

FIG. 5 shows the signal processing circuit 52. Here, 53 is an adder circuit that adds the outputs of the respective sensors 37 in the respective sensor blocks 51 and outputs one output,
Reference numeral 54 is a detection circuit for detecting the output signal from the addition circuit 53.

Therefore, in the above configuration, if the number of the sensors 37 in each sensor block 51 is large, even if one sensor 37 is broken, the influence on the output is minimized.

FIG. 6 shows a second modification of the medical device of FIGS. 1 (A) to 3. This is
(A) thru | or the distributed type tactile sensor 61,6 which has three robustness on the outer surface of the sheath 32 of the 1st treatment tool 13 in the system of the medical device for endoscopic surgery.
2, 63 are provided.

Here, the first tactile sensor 61 is arranged in the range projected on the TV monitor 9. Further, the second tactile sensor 62 is arranged on the tip side of the terminal portion 15b, and the third tactile sensor 62 is arranged on the base side of the terminal portion 15b.

Therefore, in the case of the above structure, when the second tactile sensor 62 hits and an output is produced, the TV is set.
Since it is detected that the portion not projected on the monitor 9, that is, the tissue that cannot be observed, or the treatment tool hits the outer surface of the sheath 32 of the first treatment tool 13,
The surgical operation is discontinued.

Further, when the output is output to the third tactile sensor 62, it is considered that the portion of the outer surface of the sheath 32 of the first treatment instrument 13 on the base side of the terminal portion 15b is hit with a contaminant. Because it is thought that it was touched or touched by another operator, the operation was also stopped.

Further, in FIG. 6, the second treatment tool 14 is provided with a bending portion 64 for lifting the living tissue on the distal end side of the insertion portion 24. A fourth tactile sensor 65 is provided on the tip side of the curved portion 64, and a fifth tactile sensor 6 is provided on the middle side.
6, and a sixth tactile sensor 67 is provided on the root side.

The fourth to sixth tactile sensors 65 to 65 are provided.
The state of lifting the living tissue is determined based on the output state from 67. Here, the fourth to the sixth, which are the criteria for judgment
Table 1 below shows the combined states of the outputs from the tactile sensors 65 to 67.

[0035]

[Table 1]

In the case of (1), it is judged that the living tissue to be lifted by the bending portion 64 is large and is not lifted. Further, in the case of (2), it is determined that the distal end of the insertion portion 24 of the second treatment tool 14 cannot project to the opposite side of the living tissue to be lifted. In the case of (3), it is determined that the pushing of the distal end of the insertion portion 24 of the second treatment tool 14 is insufficient. In the case of (4), it is determined that the living tissue has been successfully lifted. Then, the operation of the first treatment tool 13 is controlled based on this determination result.

Although this shows an example in which the living tissue is lifted by the bending portion 64 of the insertion portion 24 of the second treatment tool 14, it is provided in the end GIA or the like to judge whether or not the clip can be reliably clipped. May be used for.

FIG. 7 shows a schematic structure of the entire surgical system. This surgical system is provided with an intraoperative three-dimensional bio-image simulation system and an instrument input system by screen display, and these are linked to operate in the same system.

Here, the intraoperative three-dimensional biomedical image simulation system accumulates three-dimensional preoperative biometric image information and displays it on the monitor 71, an intraoperative endoscopic image,
Based on the means for accumulating ultrasonic images and the preoperative three-dimensional information, the intraoperative image information is taken in, and the elastic coefficient of the living body is calculated while obtaining the information of the site obtained by the intraoperative image information. And means for accumulating and displaying the information of the part which is not recorded and the three-dimensional information before the operation.

Further, the instrument input system by the screen display is a forceps which grasps or excludes an organ on either one of the images on the endoscopic image or the intraoperative three-dimensional image of the living body image, When an instruction is given to another position on the image of the monitor 72, the manipulator that supports the forceps operates so as to automatically move to that position within the upper limit of the force that does not damage the organ.

Therefore, in the case of the above-mentioned configuration, the preoperative biological image information (CT, NMR, US tomographic image) is accumulated by the intraoperative three-dimensional biological image simulation system,
The image from the intraoperative object and the endoscopic image are combined to form a three-dimensional simulation image, which is monitored 71
Can be displayed on.

Therefore, the target organ is relatively immovable like the brain as in the prior art which is used for intraoperative puncture or the like by obtaining preoperative CT, NMR or ultrasonic diagnostic information. It is effective if there is any, but there is no possibility of becoming unsuitable for those that move due to intra-operative operations such as abdominal organs, and good treatment can be performed for those that move due to intra-operative operations.

When it is desired to exclude an organ from one position to another position with forceps or the like on an endoscopic image or a simulation image, if the organ position after the exclusion is indicated on the image, the organ is automatically excluded. You can Therefore, when it becomes necessary to confirm the position of the instrument or the position of an organ in the body cavity during the operation of a part of the body cavity, endoscopy is performed as in the current endoscopic surgery. It is not necessary to change the position of the mirror to change the field of view, and it is possible to improve the efficiency of surgery under the endoscope.

Further, FIG. 8A shows a multi-joint manipulator 81 which is a manipulator for intracavity surgery for performing intracorporeal surgery by remote control. The multi-joint manipulator 81 has a first bending portion 83 arranged on the front end side at the tip of an insertion portion 82 inserted into the body, and a first bending portion 83 connected to the rear end of the first bending portion 83. Two curved portions 84 are provided.

Further, the base end portion 85 of the insertion portion 82 has a first
A drive device 86 for the bending portion 83 and the second bending portion 84 is provided. Since the drive devices 86 for the first bending portion 83 and the second bending portion 84 have substantially the same configuration, only the drive device 86 for the second bending portion 84 is shown in FIG. 8A.

The drive device 86 is provided with a drive motor 90 for a pulling mechanism 89 for pulling and operating the pair of angle wires 87, 88 of the second bending portion 84. Further, compliance setting sections 91 are provided in the middle of the angle wires 87 and 88, respectively.

FIG. 8B shows a schematic configuration of the compliance setting section 91. The compliance setting section 91 is provided with a cylinder 92 and a piston 93 arranged in the cylinder 92. The piston rod 94 of the piston 93 is interposed between the angle wires 87 and 88.

Further, the coil spring 9 is provided in the cylinder 92.
5 are provided. Further, one end of a connecting pipe 97 is connected to a pipe connecting portion 96 provided on the outer peripheral surface of the cylinder 92 on the one end side. The other end of the connecting pipe 97 is connected to the pump 98.

By changing the hydraulic pressure in the cylinder 92 of the compliance setting section 91 by the pump 98, the compliance at the time of pulling the wires 87, 88 can be controlled.

For example, when it is not desired to apply an excessive force when pulling the wires 87 and 88, as in the case where the distal end portion of the insertion portion 82 contacts the body cavity wall during the bending operation of the second bending portion 84, The pressure in the cylinder 92 is reduced, and the spring elasticity of the coil spring 95 releases the tension of the wires 87 and 88.

On the contrary, when it is desired to apply a force when pulling the wires 87 and 88, the pressure in the cylinder 92 is increased. Although the coil spring 95 is disposed only on the left side of the piston 93 in FIG. 8B, it may be disposed on both sides.

Therefore, in the above configuration, the cylinder 9 of the compliance setting section 91 is driven by the pump 98.
Since the compliance when the wires 87, 88 are pulled can be controlled by changing the hydraulic pressure in the valve 2, it is possible to improve the safety to the living body without providing the manipulator 81 with a tactile sensor.

Further, FIGS. 9A and 9B show an example in which the wire driving type driving device 86 is applied to the bending type manipulator 101. Here, when approaching the bendable manipulator 101 to the affected tissue H, FIG.
Angle wires 87, 8 for each joint as shown in FIG.
Make 8 flexible and flexible. When the affected tissue H is being treated, as shown in FIG. 9B, the elasticity of the joint portion 101a on the proximal side of the bending manipulator 101 is lowered to increase the hardness, and the tip working joint 101b is increased in elasticity. I have to.

Further, FIG. 10 shows a compliance setting unit 102 having a configuration different from that of FIG. 8 (B).
The compliance setting unit 102 is provided with an energization control unit 104 that controls the spring elasticity according to the temperature change of the SMA coil 103 interposed between the angle wires 87 and 88.

Further, FIG. 11 shows a compliance setting section 111 having a configuration different from that of FIG. This is because the large-diameter pulley 1 is inserted in the middle of each angle wire 87, 88.
12 and two small-diameter pulleys 113 and 114 are provided,
Large-diameter pulley 1 arranged between small-diameter pulleys 113 and 114
One end of the SMA coil 115 is connected to the support shaft portion of 12, and the other end of the SMA coil 115 is fixed to an appropriate fixing portion. Also in this case, the energization control unit 116 that controls the spring elasticity by the temperature change of the SMA coil 115.
Is provided.

FIG. 12 shows a modification of the compliance setting section 111 shown in FIG. This is
The SMA coil 115 of No. 1 is formed by the coil spring 121, and the electromagnetic chuck 122 for adsorbing the large-diameter pulley 112 so that it can be contacted and separated is provided.

When the electromagnetic chuck 122 is turned off, the elasticity of the spring 121 connected to the pulley 112 loosens the tension of the angle wires 87 and 88. Further, when the electromagnetic chuck 122 is turned on, the pulley 112 is attracted and fixed, and the tension of the angle wires 87 and 88 is directly applied.

14 and 15 show a treatment robot 131 with a safety mechanism. The treatment robot 131 is provided with an articulated manipulator 132. A plurality of arm portions 133 are rotatably connected to the manipulator 132 via joint portions 134, respectively.

In this case, the joint portion 134 of the arm portion 133
A joint rotation motor 135 is arranged inside the.
Further, the motor 135 of each arm 133 is connected to the cable 1
It is connected to the controller 137 via 36.

Further, a treatment tool support member 138 is arranged at the tip of the most advanced arm 133. The treatment tool support member 138 is removably adsorbed by an electromagnet 139 fixed to the tip of the arm 133. This electromagnet 139 is connected to the controller 1 via a cable 140.
Connected to 37.

Further, the treatment instrument 141 is detachably attached to the treatment instrument support member 138 by a screw member. The drive device 142 of the treatment instrument 141 is the cable 14
3 to the controller 137.

The treatment instrument 141 is inserted into the body through the trocar 144. A substantially box-shaped treatment tool receiving member 145 is fixed to the base end of the trocar 144 as shown in FIG. An insertion hole for the treatment instrument 141 communicating with the trocar 144 is formed in the axial center of the treatment instrument receiving member 145.

Further, an inner box 146 is mounted inside the treatment instrument receiving member 145 so as to be vertically slidable in FIG. In this case, a spring member 147 for urging the inner box 146 to press the inner box 146 upward in FIG. 15 is provided on the inner bottom portion of the treatment instrument receiving member 145. In addition, inner box 1
An insertion hole for the treatment instrument 141 is formed in the axial center portion of 46.

Next, the operation of the above configuration will be described.
First, during operation of each arm 133 of the manipulator 132, the treatment instrument support member 138 and the treatment instrument 141 operate in conjunction with the movement of the arm 133. At this time,
A current having a value preset in the controller 137 is applied to the electromagnet 139, and the treatment tool support member 138 is attracted to the electromagnet 139 of the arm 133 with a predetermined attraction force.

When the treatment instrument 141 is deeply inserted into the body, the inner box 146 inside the treatment instrument receiving member 145 is inserted into the spring member 1 as the treatment instrument 141 is inserted.
It is pushed against the inner bottom side of the treatment instrument receiving member 145 against the spring force of 47.

Here, when the treatment instrument 141 comes into contact with the living tissue H, the reaction force received from the tissue H by the treatment instrument 141 exceeds the threshold value, and the sliding force of the treatment instrument support member 138 with respect to the arm portion 133 is as described above. When the electromagnetic force of the electromagnet 139 is exceeded, the treatment tool support member 138 and the arm 133 are separated. At this time, the inner box 146 inside the treatment instrument receiving member 145 is pushed upward by the restoring force of the spring member 147 contracted by inserting the treatment instrument 141 into the body. Therefore, since the treatment tool 141 is also pushed upward,
It is possible to prevent an excessive force from being applied to the living tissue H.

Therefore, in the above-mentioned structure, when the pressure value acting between the living tissue H and the treatment instrument 141 becomes abnormally high, the treatment instrument support member 138 and the arm portion 133 are separated from each other. Due to the restoring force of the spring member 147, the inner box 146 inside the treatment instrument receiving member 145 is pushed upward,
Since the treatment tool 141 is also pushed upward and separated from the living tissue, there is no risk of the operator accidentally applying a strong force to the living tissue H from the treatment tool 141, and the safety of the treatment can be improved.

After use, the treatment tool 141 can be easily separated from the treatment tool support member 138 by removing the screw member, so that only the treatment tool 141 is disinfected.
It is possible to sterilize, and it becomes easy to disinfect and sterilize the treatment tool 141.

FIG. 16 shows a modification of the treatment robot shown in FIG. This is the treatment tool support member 138.
And the arm portion 133 are fixedly connected to each other, and the treatment tool receiving member 14 in the treatment tool supporting member 138 is connected.
The pressure sensor 15 is provided on the lower surface and the side surface which are in contact with the inner box 146 of
1, the sensor output line of the pressure sensor 151 passes through the inside of the arm portion 133, is connected to the constant current circuit 152, and the sensor output thereof is input to the controller 137.

Therefore, in the above-described structure, the treatment instrument 141 is inserted deeply into the living body by the operation of the manipulator 132 while the treatment instrument support member 138 is being inserted.
The pressure sensors 151 on the lower surface and the side surface of the treatment tool receiving member 14
The sensor output is sent to the controller 137 by coming into contact with the inner box 146 inside 5.

Here, in advance, the controller 137
By setting an upper limit value of the sensor output in the controller 1, when a strong pressure such that the sensor output value exceeds the upper limit is applied from the treatment tool 141 to the living body, the controller 1
The power of the drive device 142 is turned off by 37, and the movement of the arm 133 is stopped, so that the compressed spring member 14
The force to restore the natural length of 7 acts on the inner box 146, and by pushing the inner box 146 upward, the treatment tool 141 is also pushed upward, and it is possible to prevent excessive pressure on the living tissue H. .

In addition, the treatment tool support member 13 is in a state in which an excessive horizontal pressure is applied to the living tissue H from the treatment tool 141.
It is detected by the pressure sensor 151 on the eight side surfaces. Therefore, also in this case, when the pressure sensor 151 detects a state in which an excessive horizontal pressure is applied, the power supply of the drive device 142 is turned off and the movement of the arm 133 is stopped. It is possible to prevent the living tissue H from being excessively pressed because it is extruded upward. Therefore, it is possible to avoid the risk of crushing and perforating the living tissue H caused by applying excessive pressure in the horizontal direction.

FIG. 17 (A) shows a schematic structure of the entire surgical operating apparatus 161 with a tension detecting mechanism, which has means for controlling the manipulator so as to prevent damage to the living tissue by detecting the tension of the thread. It is shown.

The surgical apparatus 161 is provided with an articulated manipulator 162. This manipulator 1
62 includes a plurality of arm portions 163. Each arm 163 is provided with a joint and a rotation mechanism for the joint.

Further, the base end portions of a pair of treatment tools 164 are connected to the tip end portion of the most distal arm portion 163. An openable / closable grip portion 165 for gripping a living tissue or a medical instrument is provided at the tip of each treatment tool 164. In this case, a treatment tool rotating mechanism (not shown) is provided at the tip of the arm portion 163, and a gripper opening / closing mechanism (not shown) is provided at the tip of each treatment tool 164. Further, the manipulator 162 includes a robot drive control device 16 for controlling the movement of each arm portion 163 and the treatment tool 164.
6 is connected.

A thread insertion port 165a is formed on the inner surface of the one grip portion 165 on the tip end side.
The thread insertion passage 16 communicated with the thread insertion port 165a
5b is extended toward the connection part side with the treatment tool 164. Inside the treatment tool 164, as shown in FIG. 17B, a thread insertion cavity 167 extending along the axial direction.
a is provided. A spool storage chamber 167b is formed at the base end of the cavity 167a.

Further, with the grasping portion 165 of the treatment instrument 164 grasping the suture needle 176, the suture needle 176 is guided from the suture needle 176 into the cavity 167a of the treatment instrument 164 through the thread insertion port 165a of the grasping portion 165. The thread 177 to be broken is stored. In addition, the yarn 1 is stored in the spool storage chamber 167b.
A bobbin 168 for winding 77 is provided.

The spool 168 is composed of a central rod 169 and a cylinder 170 around the rod. Further, the bobbin winding storage chamber 167b is provided at the tip of the arm portion 163.
A recessed portion 171 communicating with the inside is formed.

A hook 173 is attached to the outer surface of the partition 172 at the inner bottom of the recess 171. The hook 173 and the bar 169 at the center of the spool 168 are connected by a tension thread 174.

Further, a strain gauge 175 is adhered to the inner surface of the partition wall 172. The gauge output line from the gauge 175 passes through the inside of the arm portion 163 and the constant current circuit 1
It is connected to 79. A bobbin lock switch 178 is connected to the circuit 179, and the switch 178 is connected to a bobbin lock mechanism 180 attached to a center rod 169 of the bobbin 168.

Next, the operation of the above configuration will be described.
First, when the grasping portion 165 of the treatment tool 164 grasps the needle 176 and starts suturing, the spool lock switch 178 is turned off.
It is F. Therefore, the thread winding 168 rotates and the thread 177 extends until it reaches the sutured site in the tissue.

When the stitches are tightened to tie the threads and the sewing operation is finished, the thread winding lock switch 178 is turned on and tension is applied to the thread 177 to complete the sewing.

Here, when the thread 177 is entangled in a tissue other than the target during the suturing operation, when the thread 177 is tensioned, an abnormal tension is applied to the thread 177. At this time, the rod 169 at the center of the spool 168
Is pulled by the thread 177, so that the hook 173 is pulled by the tension thread 174 connected to the rod 169. Therefore, since the partition wall 172 is bent, the constant current circuit 17 is deformed due to the deformation of the strain gauge 175 bonded thereto.
The gauge output is taken out by 9.

Here, if the upper limit value of the gauge output is set to the karajimeji thread winding lock switch 178, an abnormally strong tension exceeding the upper limit value is applied to the yarn 177, and the living tissue is damaged. When there is a risk of giving it, this switch 178 turns off and the spool 168
Is rotated, the thread 177 returns to the free state.

Therefore, in the case of the above construction, the treatment tool 164 having the cavity 167a for accommodating the thread 177 therein.
Since the thread 177 is provided, the thread 177 is less entangled. Further, the tension of the thread 177 is detected by the strain gauge 175, and the manipulator 16 is detected from the detected value.
Since the movement of No. 2 is controlled, it is possible to prevent the risk of the occurrence of damage to the biological tissue due to the tension of the thread 177.

FIG. 18A shows a modification of the surgical operating apparatus shown in FIG. 17A. Here, FIG.
As shown in (B), the second opening 181 is formed in the inner surface of the one gripping portion 165 on the proximal end side, and the treatment tool 16
The tip of the cavity 167a formed inside
Is communicated with the opening 181. Further, a blade 182 is projectingly provided on the inner surface of the other grip portion 165 at a position corresponding to the second opening 181.

Next, the operation of the above configuration will be described.
When ligating a blood vessel or the like, a thread 17 locked by a thread winding 168 inside one treatment tool 164 as shown in FIG. 18 (A).
7 is grasped by the grasping portion 165 of the other treatment tool 164,
The ligation operation is performed while applying tension to the thread 177.

Finally, when the ligation is finished, the thread 177 is
Since it is necessary to cut the strain gauge output value in advance in the robot drive control device 166 and apply a strong tension exceeding the value to the thread 177, the robot drive control device 166 causes the grip portion 165 to move. Acting to close, the blade 182 moves down with the grip 165. At this time, the thread 177 is located on the upper surface of the second opening 181 because the thread 177 is strongly tensioned. Therefore, the blade 182 contacts the thread 177 through the second opening 181 with the grip 165 fully closed, so that the thread 17
7 is cut.

When the thread 177 is entangled with an unintended tissue and the tension of the thread 177 becomes abnormally high,
As in the case of FIG. 17A, take out the gauge output,
If the upper limit value is set in the robot drive control device 166, the thread 177 is cut by the above mechanism and damage to the tissue can be prevented.

Therefore, in the above configuration,
With the gripping portion 165 fully closed, the thread 1 is cut by the blade 182.
Since 77 can be cut, re-sewing can be easily performed when the thread 177 is entangled.

FIG. 19 shows a surgical apparatus 191 with a body position change detecting means having a mechanism for preventing a danger to living tissue by detecting a body position change of a patient.
The surgical apparatus 191 is provided with a manipulator 192 having a plurality of joints. This manipulator 19
2 has a plurality of arm portions 193. The arm portion 193 is provided with a joint and a motor 194 for rotating or opening / closing the treatment tool gripping portion inside the joint.

The base end of the treatment tool 195 is attached to the tip of the most advanced arm 193. The treatment instrument 195 is inserted into a trocar 196 that is fitted with a hole in the patient's skin. This trocar 19
A piezoelectric film 197 is wound around and bonded to the outer peripheral wall surface of 6.

The film 197 is connected to the control circuit 199 of the surgical apparatus 191 via the amplifier circuit 198. The motor 194 and the drive device 200 are connected to the control circuit 199.

Next, the operation of the above configuration will be described.
First, during surgery, when the surgeon changes the patient's position,
At the first moment, the pressure from the skin of the living body is applied to the trocar 196. At this time, when the above-mentioned pressure is detected by the piezoelectric film 197 on the portion of the outer wall surface of the trocar 196 that comes into contact with the skin, a pulse voltage as shown in FIG. 20 is generated.

This pulse voltage is transmitted to the control circuit 199 while being amplified by the amplifier circuit 198. When this pulse voltage is input, the control circuit 199 causes the motor 194 to
Is sent to the motor 194, and the joint of the arm 193 is switched to the free state.

As a result, the joints of the arm portion 193 are held in a free state during movement of the patient's body position, and move in conjunction with the movement of the trocar 196, so there is no damage to the living body.

When the patient is changed to a desired posture and the posture changing operation is completed, pressure from the skin of the patient is applied to the trocar 196 again. Therefore, the output pulse from the piezoelectric film 197 at this time is as described above. Similarly, when transmitted to the control circuit 199, a signal for turning on the power source of the motor 194 is sent to the motor 194. Therefore, the arm portion 193 that has once become free can be fixed again, and the operator can perform surgery again at a desired position.

Therefore, in the above structure, the state of the manipulator 192 can be controlled by utilizing the output detected by the piezoelectric film 197 provided on the trocar 196 inserted into the patient's body. The operation performed while changing the position of the patient can be performed speedily, and damage to the living tissue can be prevented. Therefore, even if the posture of the patient is changed, it is possible to prevent damage to the living body due to the pressure of the trocar.

FIG. 21 shows a modification of the surgical operating apparatus 191 shown in FIG. This is a piezoelectric film 19 wound around and bonded to the outer peripheral wall surface of the trocar 196.
7, a buzzer 200 is connected via an amplifier circuit 198 and a buzzer switch 201.

In this case, while the surgeon is performing surgery at a fixed position without changing the posture of the patient,
In the unlikely event that the patient's body slightly moves, the operator accidentally touches the patient's body, or the arm portion 193 of the manipulator 192 malfunctions, the piezoelectric film 197 receives a slight pressure from the patient's skin. Works, so this film 1
The voltage output pulse of 97 is amplified by the amplification circuit 198,
When it is sent to the buzzer switch 201, it is turned on only during the pulse generation time, the buzzer 202 sounds, and the operator can be warned. The volume of the buzzer 202 also rises and falls depending on the magnitude of the pulse.

Therefore, in the case of the above structure, the operator can immediately recognize that the position of the patient has changed even by listening to the sound generated by the buzzer 202.
In addition, it is possible to determine whether or not the change is abrupt by the loudness of the sound, which is one measure for preventing damage to the living tissue.

FIG. 22 shows a surgical manipulator 211 capable of easily releasing a contact state with a living tissue when a failure occurs. The manipulator 211 for surgery is provided with an arm 212 having multiple joints.

A treatment instrument drive unit 213 is attached to the tip of the arm 212. An insertion portion 214 to be inserted into the body is connected to the treatment instrument drive unit 213. The bending portion 21 is provided at the tip of the insertion portion 214.
The treatment portion 216 is connected via the connector 5. The treatment section 216 includes, for example, a needle holder, a biopsy forceps for collecting living tissue, or a grasping forceps for grasping living tissue.

In addition, the drive unit 213 includes a treatment section 21.
6 and an actuator for operating the bending portion 215 are built in. The movement of this actuator is transmitted to the treatment portion 216 and the bending portion 215 by a mechanical transmission element 218 such as a wire or a rod.
When 17 is loosened, as shown in FIG.
The mechanical transmission element 218 is also separated together therewith. The arm 212 and the treatment section 216 are driven by an actuator built in the arm 212,
The position and speed are controlled by the computer.

Therefore, in the case of the above structure, the insertion portion 216 and the arm 212 are added to the surgical manipulator 211.
Since the fixing screw 217 that mechanically separates the treatment tool drive unit 213 on the side is provided, when the manipulator 211 does not operate during surgery due to a computer or actuator failure or a power failure, the fixing screw 217 is provided. By loosening 217, the insertion part 214 is separated,
As shown in FIG. 23B, the insertion portion 214 can be taken out of the body.

At this time, since the treatment portion 216 and the bending portion 215 are separated from the actuator, they are in a mechanically free state and can be formed in a straight line shape which is convenient for taking out.

Further, FIG. 24A shows a modification of the manipulator 211 for surgery of FIG. this is,
A drive unit mounting portion 221 is provided at the tip of the arm 212 of the manipulator 211, and a treatment instrument drive unit 213 is detachably connected to the drive unit mounting portion 221.

In this case, the connecting portion 222 of the drive unit 213 in the drive unit mounting portion 221 is provided with a connector portion 223 for connecting an electric signal of the actuator, a pair of screw insertion holes 224, and a pair of positioning pins 225. Has been.

Further, a connector portion 227 removably connected to a connector portion 223 on the arm 212 side and a positioning pin 225 on the arm 212 side are inserted into a joint portion 213a of the treatment instrument drive unit 213 with the arm 212. A pair of pin insertion holes 226 and a pair of screw holes 228
And are provided.

When the connecting portion 213a of the treatment instrument drive unit 213 and the connecting portion 222 on the arm 212 side are connected, the connector portion 223 on the arm 212 side and the connector portion 227 on the drive unit 213 side are connected. In addition, with the positioning pin 225 inserted in the pin insertion hole 226, the fixing screw 229 is screwed into the screw hole 228 via the screw insertion hole 224.

Further, the drive unit 213 has a fixing screw 22.
When 9 is removed, it is separated from the arm 212 side. Therefore, when the manipulator 211 does not operate due to a failure or the like, the insertion unit 214 can be taken out of the body by separating the drive unit 213 from the arm 212 side. Is.

Further, FIGS. 25A to 25D and FIG.
(A) and (B) are arms 212 of the manipulator 211.
At least two types of treatment units 231 and 232 are exchangeably connected to the distal end portion of the.

Here, there are some treatment units having different shapes such as the needle holder 231 shown in FIG. 25 (B) and the grasping forceps 232 shown in FIG. 25 (C) according to the purpose of treatment, but the connecting portion 213a. However, the arm 212 can be replaced. The grasping forceps 232 has an insertion portion 23.
A grip portion 234 that can be opened and closed is provided at the tip of the No. 3.

Further, the connector portions 223 and 227 have connection line terminals 2 of the drive control circuit 243 of the motor 242.
44 and 245, and a terminal 246 of the discrimination line of the type of the treatment units 231 and 232.

Here, the discrimination terminal 246 on the side of the treatment units 231 and 232 is short-circuited to VCC and one of AD1 to AD, and the combination that short-circuits is treated.
It is assigned for each type of 1 and 232. In addition, the control unit 241 of the manipulator 211 is provided with a detection circuit 248 including a photocoupler 247 that detects a short-circuited discrimination line.

Therefore, the treatment unit 231 or 23
When the second connector unit 227 is connected to the connector unit 223 on the manipulator 211 side, the type of the treatment unit 231 or 232 can be recognized.

Therefore, in the above-described structure, the types of the treatment units 231 and 232 can be recognized, and therefore the number of joints, length, joint stroke, maximum speed, drive mechanism of each treatment unit 231 and 232 can be recognized. It is possible to select information required for control such as the speed ratio of the above from data stored in advance in the manipulator control device 241. Therefore, when the surgery is performed by one manipulator 211, the treatment units 231 and 232 at the tip of the manipulator 211 can be appropriately exchanged according to the content of the treatment, so that a plurality of treatments can be performed by one.

FIG. 27 shows a medical robot manipulator 251. This manipulator 25
1, an electric drive element is built in, and an end effector 252 for performing observation and treatment in a body cavity of a patient is detachably attached. The end effector 252 is provided with an insertion portion 254 to be inserted into the body cavity of a patient, and a curved portion 255 is provided at the tip of the insertion portion 254. A servo motor 253 as a drive element shown in FIG. 29 is built in the end effector 252. By driving the servo motor 253, a curved portion 255 at the tip end as shown by a dotted line in FIG. Is curved.

Further, the manipulator 251 is provided with an arm 256 for spatially positioning the end effector 252 at a desired position. This arm 25
As shown in FIG. 28, the end effector 2 is attached to the tip of the end effector 6.
A mount 256a for 52 is provided. Then, the end effector 25 is attached to the mount 256a of the arm 256.
2 is removably attached.

The arm 256 has a built-in driving servo motor (not shown) for each joint. These servomotors are connected to a control device 257 for controlling the end effector 252 and the drive motor of the arm 256. Then, the control device 257 can perform the desired operation of the arm 256 and the desired operation of the end effector 252.

Further, reference numeral 258 denotes an input means, which transmits the input information of the operator to the control device 257, whereby the tip end effector 252 and the arm 256 can be operated by the operator as desired. Note that this input device may be, for example, a joystick or a teaching pendant used in an industrial robot.

FIG. 29 shows a drive power supply section between the end effector 252 and the arm 256. In this case, the driving power supply coil 259 is arranged on the end effector mount 256a of the arm 256, and the coil 260 connected to the servo motor 253 is arranged on the end effector 252 at a position corresponding to the coil 259. .

The electric power for driving the servo motor 253 output from the controller 257 can be supplied from the arm 256 to the end effector 252 by electromagnetic coupling.

By the way, since the end effector 252 is inserted into the body cavity after the inside of the body cavity is observed and treated by using the medical robot, it may be necessary to perform sterilization / disinfection. Therefore, with the above configuration, the tip end effector 252 can be removed, so that the portion can be sterilized.

Moreover, since the energy is supplied to the servomotor 253 in the tip end effector 252 by electromagnetic coupling by the coils 259 and 260 and is driven, the lead wire and the energy supply means for removing the servomotor 253 are provided. A connector or the like for connecting it is unnecessary, and it is not necessary to take protective measures against sterilization of the connection part.

Further, since the energy supply method is based on electromagnetic coupling, it has the same function as the insulating transformer, and therefore there is no fear of electric shock due to patient leakage current. As a result, sterilization measures and electric shock measures can be taken, and a medical robot that is both hygienic and electrically safe can be realized.

FIG. 30 shows a modification of the driving power supply section between the end effector 252 and the arm 256. This is because the pair of electrodes 261 and 262 are arranged inside the end effector mounting base 256a of the arm 256, and the pair of electrodes 263 and 264 arranged inside the end effector 252 so as to face the electrodes 261 and 262, respectively. Is provided.

As a result, electric capacitive coupling is realized in that portion, and it is possible to supply electric power to the servo motor 253 inside the end effector 252 by causing an alternating current to flow in that portion.

Therefore, even in the case of the above-mentioned structure, it is unnecessary to take a sterilization protection measure for the connecting portion between the end effector 252 and the arm 256 and to cut the electric power of the direct current component which easily flows into the human body. Therefore, the risk of electric shock is reduced. As a result, sterilization countermeasures and electric shock countermeasures are possible, and a medical robot that is both hygienic and electrically safe can be realized.

Further, FIG. 31 shows a system of the medical robot manipulator 256 which enables the diagnostic treatment to be continued even if a power failure occurs during the operation. this is,
The battery unit 272 is built in the control device 257, and when the control device 257 is operated by the power supplied from a normal power outlet (hereinafter referred to as the main power supply) 271, it does not function, but once the main power supply 271 is supplied. The battery section 272 is made to function when it is no longer operated.

FIG. 32 shows a connection circuit between the main power source 271 and the battery section 272. Where 2
Reference numeral 73 denotes a power supply detection means including a potential difference detection circuit, which is for detecting whether or not power is supplied from the main power supply 271. Further, 274 is the power source detection means 2
It is a control circuit for determining whether to control the manipulator 256 by the power source from the battery unit 272, which is charged in advance, based on the detection information from 73. Furthermore, 2
75 is a main power source 271 according to a command from the control circuit 274.
And a battery unit 272.

In the above structure, the main power source 27 is operated during the operation.
When the power from the power supply unit 1 is no longer supplied due to a power failure, the power supply detecting means 273 in the battery unit 272 controls the control circuit 27.
4 outputs an electric signal indicating that there is a power failure, which causes the control circuit 274 to send a switching signal to the switching means 275, whereby the manipulator controller 2
Power is supplied from the battery unit 272 to 57.

When the main power supply 271 recovers from a power failure, the power supply detecting means 273 in the battery section 272 outputs a recovery signal to the control circuit 274, and the control circuit 274.
From the power supply switching means 275 to the main power supply 271.

As a result, when the power failure is restored, the driving of the battery unit 272 can be stopped immediately and the energy of the battery unit 272 can be used without waste. Therefore, it becomes possible to supply electric power even if a power failure occurs during the operation, and it is possible to continuously perform the operation.

Further, FIGS. 33A and 33B show the first embodiment of the present invention. FIG. 33 (A) shows a treatment instrument follow-up type scope 281 capable of automatically providing a visual field important for an operator and saving labor of holding the scope. Here, 282 is a treatment tool, and 283 is a treatment section at the tip of this treatment tool 282. Further, a movable coil 284 for position / orientation detection is attached to the treatment instrument 282.

Reference numeral 285 is a vertical multi-joint type 6-DOF robot. This vertical articulated 6-DOF robot 285
At the tip of the arm of the
Is attached.

Further, the vertical articulated 6-DOF robot 2
The 85 arm is provided with six joints 286-291. The position and orientation of the scope 292 are obtained from the angles of the joints 286 to 291 of the robot 285. A fixed transmitter 294, which serves as a reference for detecting the position / orientation of the treatment instrument 282, is provided at a position where the relative positional relationship with the robot 285 is determined.

FIG. 33B shows the processing circuit of the treatment instrument follow-up type scope 281. Where 295
Is a position / orientation detecting device for the treatment instrument 282, and 296 is a distal end position calculation unit for calculating the position of the distal treatment unit 283.
Reference numeral 97 is a rotation angle calculation unit for each axis of the robot, and 298 is a monitor driver. In this case, the position / orientation detection device 29
A movable coil 284 and a fixed oscillator 294 are connected to the switch 5.

Next, the operation of the above configuration will be described.
A method of determining the relative position and orientation of the movable coil 284 with respect to the fixed oscillator 294 using electromagnetic induction using the movable coil 284 including three coils and the fixed oscillator 294 also including three coils is described below. , Japanese Patent Application No. 3-2
It is known as disclosed in 35019. Using this method, the moving coil 2 with respect to the fixed oscillator 294
The relative positional relationship of 84 can be obtained.

Further, since the mounting position / direction of the movable coil 284 to the treatment instrument 282 is known, the movable coil 2
Length L from 84 to the treatment portion 283 at the tip of the treatment instrument 282
Is used, the position of the distal end portion of the treatment instrument 282 can be obtained.

Further, the robot 285 and the fixed oscillator 2
Since the relationship of 94 is also known, the position of the tip of the treatment instrument 282 with respect to the robot 285 and the direction of the treatment instrument 282 are obtained.

Therefore, by controlling the rotation angle of each axis of the robot 285 so that the distal end of the treatment instrument 282 passes on a straight line extending from the axis of the scope 292, the treatment instrument is always positioned at the center of the image of the scope 292. The tip of 282 can be captured.

Therefore, in the case of the above configuration, when the rotation angle of each axis of the robot 285 is determined by adding a constraint condition that the distance between the distal end of the treatment instrument 282 and the distal end of the scope 292 is fixed, the magnification is increased. However, a constant image is always obtained. Further, by adding a constraint condition such that the axis of the scope 292 always passes through one point in the designated space,
When using the trocar in endoscopic surgery, it is possible to prevent the trocar site from moving too much.

The present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention.

[0145]

According to the present invention, a distributed sensor unit having a plurality of sensors is provided in the insertion portion of the medical instrument main body to be inserted into the body cavity, and based on the plurality of sensor outputs output from the sensor unit. Since the control means for controlling the main body of the medical device is provided, the safety can be secured even if the sensor has a single failure.

[Brief description of drawings]

FIG. 1A is a perspective view showing a grip portion of a treatment instrument,
(B) is a plan view showing the sensor unit of the tactile sensor,
FIG. 6C is a diagram showing a signal output from the sensor unit.

FIG. 2 is a schematic configuration diagram of the entire system of a medical instrument for endoscopic surgery.

FIG. 3 is a block diagram showing a signal processing circuit.

FIG. 4 is a plan view of a sensor unit of a tactile sensor showing a main configuration of a first modification of the medical device of FIGS. 1 (A) to 3;

FIG. 5 is a block diagram showing a signal processing circuit.

FIG. 6 is a schematic configuration diagram of the entire system of a second modified example of the medical device of FIGS.

FIG. 7 is a schematic configuration diagram showing an intraoperative three-dimensional biological image simulation system.

FIG. 8A is a schematic configuration diagram of a manipulator for intracorporeal surgery, and FIG. 8B is a vertical cross-sectional view showing a compliance setting unit of an articulated manipulator.

FIG. 9 shows a bending type manipulator, (A)
Is a side view showing a state in which a bending manipulator is approached to the affected tissue, and (B) is a side view showing a treatment operation state of the affected tissue.

FIG. 10 is a schematic configuration diagram showing a modified example of the compliance setting unit.

FIG. 11 is a schematic configuration diagram showing a second modification of the compliance setting unit.

FIG. 12 is a schematic configuration diagram showing a third modification of the compliance setting unit.

FIG. 13 is a schematic configuration diagram showing an electromagnetic chuck of a compliance setting unit.

FIG. 14 is a perspective view showing an overall schematic configuration of a treatment robot with a safety mechanism.

FIG. 15 is a schematic configuration diagram showing an upper structure of a trocar.

16 is a schematic configuration diagram showing a modified example of the treatment robot of FIG.

FIG. 17A is a schematic configuration diagram of an entire surgical apparatus with a tension detection mechanism, and FIG. 17B is a schematic configuration diagram of a treatment tool.

18A is a schematic configuration diagram showing a modified example of the surgical operating apparatus of FIG. 17A, and FIG. 18B is a schematic configuration diagram of a treatment tool.

FIG. 19 is a schematic configuration diagram showing a surgical apparatus with a body posture change detection means.

FIG. 20 is a characteristic diagram showing a pulse voltage generated when pressure is detected by the piezoelectric film.

21 is a schematic configuration diagram showing a modified example of the surgical operating apparatus in FIG.

FIG. 22 is a schematic configuration diagram showing a surgical manipulator.

FIG. 23 (A) is a perspective view showing a state in which the mechanical transmission element is separated together with the insertion portion, and FIG. 23 (B) is a view in which the treatment portion 216 and the bending portion 215 separated from the actuator are extended in a straight line shape. FIG.

24A is a schematic configuration diagram showing a modified example of the surgical manipulator of FIG. 23, and FIG. 24B is a plan view showing a coupling portion on the drive unit side.

25A is a perspective view showing an arm of a surgical manipulator, FIG. 25B is a perspective view showing a treatment unit including a needle holder, and FIG. 25C is a perspective view showing a treatment unit including grasping forceps. FIG. 6D is a plan view showing the coupling portion on the treatment unit side.

FIG. 26A is a schematic configuration diagram of the entire manipulator for surgery, and FIG. 26B is a schematic configuration diagram of a control unit of the manipulator.

FIG. 27 is a schematic configuration diagram of the entire medical robot manipulator.

FIG. 28 is a schematic configuration diagram showing a connecting portion between an end effector and an arm.

FIG. 29 is a schematic configuration diagram showing a driving power supply section between the end effector and the arm.

FIG. 30 is a schematic configuration diagram showing a modified example of the drive power supply section between the end effector and the arm.

FIG. 31 is a schematic configuration diagram of the entire medical robot manipulator.

FIG. 32 is a schematic configuration diagram showing a power supply detection circuit.

FIG. 33 shows a first embodiment of the present invention,
(A) is a schematic configuration diagram of the entire treatment instrument following type scope,
FIG. 3B is a schematic configuration diagram showing a processing circuit.

[Explanation of symbols]

281 Scope on the arm 282 treatment tool 285 Vertical articulated 6-DOF robot

─────────────────────────────────────────────────── ───

[Procedure amendment]

[Submission date] July 17, 2002 (2002.7.1)
7)

[Procedure Amendment 1]

[Document name to be amended] Statement

[Name of item to be corrected] 0002

[Correction method] Change

[Correction content]

[0002]

2. Description of the Related Art Recently, in order to improve the operability of surgery and expand its function, it is possible to attach a medical instrument to a robot such as a robotic endosurgery to diagnose and treat a patient. Has been. In addition, the endoscope
Abdominal wall of a patient as one of the surgical techniques using
With a plurality of holes in the section, one endoscope and one or
Multiple treatment tools are inserted into the body through different holes
Is done. Then, within the field of view of the endoscope
Display the tissue to be treated and the tip of the treatment tool together
By doing so, the treatment state of the target tissue to be treated by the treatment instrument
It is possible to perform safe treatment while visually checking with an endoscopic image.
It has been made.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Name of item to be corrected] 0003

[Correction method] Change

[Correction content]

[0003]

With this type of device, a tactile sensor is provided at the insertion portion of the main body of the medical instrument to be inserted into the body cavity, for example, the grasping portion for grasping the tissue at the tip of the treatment tool, and when grasping the tissue. It is designed to prevent tissue damage.
By the way, during the surgical procedure, the treatment performed during insertion into the patient's abdominal wall
The placement tool and endoscope should be moved as appropriate according to the progress of the surgical operation.
Be done. However, in the conventional device, the endoscope and the treatment tool
Since they move independently of each other, treatment instruments and endoscope
The movement may cause the treatment tool to move out of the field of view of the endoscope.
It has Therefore, move the endoscope following the treatment tool.
Hold the endoscope such as an assistant who operates the movement of the endoscope
There is a problem that the person needs.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0004

[Correction method] Change

[Correction content]

The present invention has been made in view of the above circumstances, and its purpose is to move the scope following the treatment tool.
Bets can be, in the scope holder to provide unnecessary and Do that medical device.

[Procedure amendment 4]

[Document name to be amended] Statement

[Correction target item name] 0143

[Correction method] Change

[Correction content]

[0143]

EFFECTS OF THE INVENTION According to the present invention, a squat follows a treatment tool.
The doctor who can move the scope and does not need a scope holder
A medical treatment instrument can be provided .

[Procedure Amendment 5]

[Document name to be amended] Statement

[Correction target item name] Explanation of code

[Correction method] Change

[Correction content]

[Explanation of reference numerals] 281 Treatment instrument following type scope 282 Treatment instrument 285 Vertical multi-joint type 6-DOF robot

─────────────────────────────────────────────────── ─── Continuation of front page (51) Int.Cl. ⁷ Identification code FI theme code (reference) B25J 13/00 B25J 13/00 Z G05D 3/12 G05D 3/12 E K (72) Inventor Akio Nakata Tokyo 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Inventor Naoki Uchiyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Tatsuya Kubota Tokyo 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Tatsuya Yamaguchi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Yasuhiro Ueda Tokyo 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Toshimasa Kawai 2 Hatagaya, Shibuya-ku, Tokyo Eye 43-2 Olympus Optical Co., Ltd. (72) Inventor Masahiro Kudo 2-4-2 Hatagaya, Shibuya-ku, Tokyo Inside 43 Olympus Optical Co., Ltd. (72) Yutaka Fujisawa 2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. 43-72 (72) Inventor Sakae Takehata 2-43-2 Hatagaya, Shibuya-ku, Tokyo F-Term of Olympus Optical Co., Ltd. (reference) 3C007 AS35 BS12 KS03 KS04 KS17 KS20 KS36 KT01 KT05 KT15 KV08 KV09 KW06 KX19 LT00 LV04 LV05 MS27 4C060 GG22 GG28 GG40 4C061 HH51 HH60 NN10 YY20 5H303 AA10 CC10 GG07 GG14 QQ06 QQ08 QQ09

Claims (2)

[Claims] 1. A scope attached to an arm of a robot, a treatment tool that approaches a treatment target from a position different from the scope, a position and orientation of the treatment tool with respect to the scope, and a tip portion of the treatment tool. A medical device comprising: a control unit that controls the robot so that a distal end portion of the treatment instrument passes through the axial center of the scope by determining a position. 2. A fixed oscillator to which a movable coil for position / posture detection is attached, and which serves as a reference for position / posture detection of the treatment tool at a location where a relative positional relationship with the robot is determined. Is provided, the control unit, a rotation angle calculation unit of each axis of the robot, a scope detection means for detecting the position and orientation of the scope from the angle of each joint of the robot, the position of the treatment instrument A posture detection device, a distal end position calculation unit that calculates the position of the treatment unit at the distal end of the treatment instrument, and the robot so that the distal end of the treatment instrument passes on a straight line extending from the axis of the scope. The medical instrument according to claim 1, further comprising: a scope image adjusting unit that always captures the tip of the treatment tool at the center of the image of the scope by controlling the rotation angle of each axis.