Patent Application
20150127019
1. Field of the Invention
The present invention relates to a medical manipulator. More particularly, the present invention relates to a medical manipulator in which a part inserted into the body of a patient can be bent.
2. Description of Related Art
In the related art, a medical manipulator in which a part to be inserted into the body of a patient or the like who undergoes a procedure is bendable is known (for example, refer to Japanese Unexamined Patent Application, First Publication No. 2008-289556). In such a medical manipulator, a desired procedure is performed by manipulating a treatment part provided on a distal end part of the medical manipulator with a proximal manipulation part while observing a region where the procedure is performed with observation means, such as an endoscope.
The medical manipulator of Japanese Unexamined Patent Application, First Publication No. 2008-289556 includes a switching tube part in which a number of switching tubes that function as joints are arranged in a part to be inserted into the body. The manipulation part is provided with a dial, and can be switched between a rigid state where a bent state of the switching tube part is held (locked), and a flexible state where the switching tubes move freely by manipulating the dial.
Accordingly, insertion is easy and patient discomfort is minimized by switching the medical manipulator into the flexible state when the medical manipulator is being inserted into the body, and a stable state while a procedure is being formed can be obtained by switching the medical manipulator into the rigid state.
According to a first aspect of the invention, a medical manipulator includes an insertion part which includes an external cylindrical tube that has a bendingly manipulable bending part and that has flexibility; a manipulation part which performs a manipulation input for manipulating the insertion part; an arm part which is provided on a distal end part of the insertion part and has a bendingly manipulable arm and a treatment part that performs a procedure; a mode-input part which is provided on the manipulation part and is capable of inputting a mode that is selected among a plurality of modes that are combinations of states of the bending part and the arm part; and a control part that selectively controls the bending part and the arm part such that the bending part and the arm part are controlled to enter one of two states consisting of a locked state in which the bending part and the arm part are locked in a predetermined state in which the manipulation input is not accepted, and a non-locked state, on the basis of the manipulation input and a mode input to the mode-input part.
According to a second aspect of the present invention, in the medical manipulator according to the first aspect, at least one of the locked states of the arm part may be a retracted state in which the arm part is arranged within a width of the external cylindrical tube.
According to a third aspect of the present invention, in the medical manipulator according to the second aspect, at least one of the non-locked states may be a manipulable state in which the bending part or the arm part is operated according to the manipulation input.
According to a fourth aspect of the present invention, in the medical manipulator according to the third aspect, at least one of the plurality of modes may be an insertion mode suitable for inserting the insertion part into a body, and in the insertion mode, the bending part may be brought into the manipulable state and the arm part may be brought into the retracted state.
According to a fifth aspect of the present invention, in the medical manipulator according to the fourth aspect, in this case, a rigid length of the insertion part on a distal end side in the retracted state may be smaller than a maximum value of a rigid length in a procedure.
According to a sixth aspect of the present invention, in the medical manipulator according to the fourth aspect, at least one of the plurality of modes may be a treatment mode suitable for performing a procedure using the treatment part, and in the treatment mode, the bending part may be brought into the locked state and the arm part may be brought into the manipulable state.
According to a seventh aspect of the present invention, in the medical manipulator according to the fourth aspect, at least one of the plurality of modes may be a treatment mode suitable for performing a procedure using the treatment part, and in the treatment mode, the bending part and the arm part may be brought into the manipulable state.
According to an eighth aspect of the present invention, in the medical manipulator according to any one of the fourth aspect to the seventh aspect, at least one of the plurality of modes may be an urgent extraction mode suitable for rapidly extracting the insertion part out of the body, and in the urgent extraction mode, the bending part and the arm part may be brought into a free state which is one of the non-locked states and in which an operation in response to the manipulation input is not performed and deformation by an external force is allowed.
According to a ninth aspect of the present invention, in the medical manipulator according to the sixth aspect or the seventh aspect, the arm part may have the arm fixed to the distal end part of the external cylindrical tube, and a treatment tool having the treatment part on a distal end part of the treatment part and being inserted through the external cylindrical tube and the arm, and a protruding amount of the treatment part from the arm in the insertion mode may be smaller than a protruding amount of the treatment part from the arm in the treatment mode.
A first embodiment of the invention will be described with reference to
As shown in
An insertion part 50 to be inserted into the body of the patient P is attached to a distal end part of the slave arm 31.
The external cylindrical tube 51 is attached so as to be rotatable around its own axis with respect to the slave arm 31. A manipulating member for rotating the external cylindrical tube 51 and the manipulating member (not shown) for manipulating the bending part 52 are pulled out from a proximal end side of the external cylindrical tube 51 and are fixed to pulleys (not shown), respectively, and a shaft of each pulley is coupled to a drive shaft (not shown) that is provided on the slave arm 31. Each drive shaft is provided with a driving mechanism (not shown) that has the same configuration as the above-described power part, and the bending manipulation and rotation manipulation of the external cylindrical tube 51 can be performed by rotating the drive shafts with the driving mechanisms. Hereinafter, the drive shafts and the driving mechanisms may be generically referred to as an “external cylindrical tube drive part”.
The two arms 61 are attached to the distal end of the external cylindrical tube 51. Each arm 61 has the same bending structure as the bending part 52, and can be bent in biaxial directions orthogonal to an axis of each arm 61. Additionally, each arm 61 is formed in a tubular shape having an inner cavity, and the inner cavity communicates with an inner cavity of a treatment tool channel (not shown) provided in the external cylindrical tube 51.
An arm manipulating member for bendingly manipulating each arm 61 is coupled to a drive shaft for an arm provided on the slave arm, in the same manner as the manipulating member of the external cylindrical tube, and each arm 61 can be bent with the driving mechanism for an arm. Hereinafter, the drive shafts and the driving mechanisms may be generically referred to as an “arm drive part”.
A treatment tool 71 for performing a treatment is inserted through each arm 61. The treatment tool 71 includes an elongated sheath part 72 (refer to
A treatment tool manipulating member (not shown), such as a wire, is attached to each forceps member 74, and the treatment part 73 can be driven by advancing and retracting the treatment tool manipulating member with respect to the treatment part 73. The treatment tool manipulating member is coupled to a drive shaft for a treatment tool provided on the slave arm 31 in the same aspect as the manipulating member of the external cylindrical tube and the arm manipulating member, and the treatment part 73 is driven by the driving mechanism for a treatment tool. Additionally, the treatment tool 71 is advanceable/retractable and rotatable with respect to the external cylindrical tube 51 and the arm 61. The protruding length of the treatment part 73 from the distal end opening of the arm 61 can be adjusted by advancing and retracting the treatment tool 71, and the opening/closing direction of the treatment part 73 can be adjusted in a suitable state with respect to a procedure by rotating the treatment tool 71. A manipulating member for advancing/retracting and rotating the treatment tool 71 is also connected to a drive shaft and a driving mechanism that are respectively provided on the slave arm 31, similar to the above-described respective manipulating members. Hereinafter, respective drive shafts and respective driving mechanisms for driving respective parts of the treatment tool 71 may be generically referred to as a “treatment tool drive part”.
An arm part 65 for performing a procedure on a target region is configured by the two arms 61, and the treatment tool 71 that has the treatment part 73 and is inserted through each arm 61. By means of the above-described configuration, in the arm part 65, the bending of each arm 61 in the biaxial directions orthogonal to the axis of the arm and the advance/retraction and rotation of the treatment tool 71 are allowed. The surgeon Op can appropriately perform these manipulations via a master input part 2, thereby bringing the position and posture of the treatment part 73 into a desired state.
As shown in
The master input part 2, as shown in
The configuration of the mode-input part is not limited to the foot switch and may be, for example, buttons provided on the gripping part 21A, a touch panel displayed on the display part 22, or the like, and there is no particular limitation to a specific configuration. Additionally, multiple configurations may be appropriately combined.
In addition, the modes of the insertion part 50 will be described below in detail.
The computation part 92 generates signals for operating respective parts of the slave manipulator 3 on the basis of the manipulation inputs from the master arms 21 and the signal received from the mode management part 91, sends the signals to the manipulator control part 82, and controls the operation of respective parts of the insertion part 50.
The manipulator control part 82 is connected to the external cylindrical tube drive part 95 that drives the external cylindrical tube 51, the arm drive part 96 that drives the respective arms 61, the treatment tool drive part 97 that drives the respective treatment tools 71, and the observation means drive part 98 that drives the observation means. Detection means, such as encoders, which detects the amounts of displacement of the manipulating members of the coupled respective parts, is attached to the drive shafts of the respective drive parts 95, 96, 97, and 98, signals indicating the amounts of displacement are sent from the respective drive parts to the manipulator control part 82, and various manipulation amounts, such as the bending amounts or protruding amounts of the respective parts, are recognized. The manipulator control part 82 generates driving signals on the basis of these manipulation amounts and the signals received from the computation part 92, and sends the driving signals to the respective drive parts. Accordingly, the insertion part 50 and the respective parts inserted through the insertion part 50 are operated.
The observation means 75 is connected to the image controller 76, an image of a surgical field acquired by the observation means 75 is sent to the display part 22 via the image controller 76, and the image is displayed on the display part 22.
The operation when the master slave system 1 is configured as mentioned above will be described.
The surgeon Op first inserts the insertion part 50 into the body from a natural opening of the Patient P. Although
Next, the surgeon Op selects a treatment tool in accordance with a procedure to be performed, mounts the selected treatment tool on the slave arm 31 to insert the mounting tool into the forceps port 51a of the insertion part 50, and makes the treatment part 73 protrude from an arm 61. The protruding amount in this case is a predetermined initial protruding amount, and may be, for example, a maximum protruding amount such that an engaging part provided on the treatment tool 71 is engaged with an engaged part provided on the arm and the treatment part 73 cannot protrude any more.
Thereafter, the surgeon Op manipulates the two arm parts 65 while viewing the image of the observation means 75, and performs a desired procedure on a target region. If necessary, the treatment tool may be replaced, or the distal end part of the insertion part 50 may be moved to other target regions so as to perform a procedure.
If all procedures are finished, the insertion part 50 is extracted from the patient P, and the surgeon Op ends a series of operations.
Although the above is the outline of the operation when the master slave system 1 of the present embodiment is used, a plurality of modes configured by the combination of the states of the respective parts of the insertion part 50 are set in the master slave system 1. Thus, the above-described respective operations can be suitably performed by selecting appropriate modes depending on the situation.
Operation states, such as the bending of the bending part 52 of the external cylindrical tube 51, the bending of the respective arms 61, the protruding amount and opening/closing of the treatment part 73 in the treatment tool 71, and the protruding amount and the bending part 75a of the observation means 75 are set in the respective modes. Respective portions are set to any one of three types roughly including a “locked state” where a predetermined state (shape) is held (locked) and a manipulation input from the master arm 21 is not received, a “manipulable state” where an operation is made according to the manipulation from the master arm 21, and a “free state” where the manipulation input of the master arm is not received and deformation is made due to an external force according to its own degree of freedom.
Methods for realizing the locked state are not particularly limited, and various well-known methods can be used. For example, a manipulating member may be held at a predetermined position by the servo control of a driving mechanism, or the manipulating member may be held by a brake or the like installed at the driving mechanism. Additionally, the insertion part 50 may be held at a predetermined position by the servo control of the driving mechanism (each drive part), or may be held by the brake or the like installed at the driving mechanism. Additionally, when the insertion part 50 is driven by a wire, the wire may be fixed so as not to be moved.
The respective modes of the master slave system 1 and a transition diagram thereof are shown in
Next, an example of the correspondence of the modes in respective processes of the operation in the above-described use and the specific setting contents of the respective modes will be described with reference to
In Step S10 of
In Step S20 where the insertion part 50 is inserted into the body of a patient from a natural opening and is introduced to a target region, the insertion/extraction mode is applied. As shown in
An example of a shape in the retracted state of the arms 61 and the treatment tools 71 is shown in
In the retracted state, the observation means 75 is retracted and locked to a position where the distal end thereof does not protrude from the external cylindrical tube 51.
In Step S30 that executes a procedure on the target region, the treatment mode is applied. In the treatment mode, as shown in
In Step S40 where the insertion part 50 is extracted to the outside of the body of the patient P after the end of the procedure, the insertion/extraction mode is applied. Thereafter, in Step S50 where preparation of the next procedure and post-processing after use are performed, the standby mode is applied.
When the insertion part 50 is within the body of the patient P and it is necessary to rapidly move the insertion part 50 to the outside of the body due to the patient's condition having changed suddenly or the like (Step S60 shown in
In a medical manipulator including a bendable arm, the arm is bent in various directions during a procedure. As a result, as shown in
By lengthening the length of the arm in the medical manipulator, a range where treatment is allowed can be increased, whereas the dimension of the arm in an axis direction becomes long. If the dimension of the arm in the axis direction becomes long, the bending radius of the insertion part on the distal end side increases. As a result, there is a problem in that it is difficult for the insertion part to pass through a region, such as the large intestine, which is strong against flexure.
According to the master slave system 1 of the present embodiment, in the plurality of modes provided by combining the states of the respective parts of the insertion part 50, the computation part 92 selectively controls the bending part 52 and the arm part 65 to the locked state where the manipulation input is not received and the shape is held, and a non-locked state, respectively, on the basis of a mode when an input is made via the foot switch 23.
In the insertion/extraction mode that is one of the modes, the arm part 65 including the bendable arms 61 and the treatment tools 71 having the treatment parts 73 is locked to the retracted state. As a result, the arm part 65 falls within the range of the width of the external cylindrical tube 51 regardless of the specific configuration of the treatment parts 73, and the insertion and extraction of the insertion part can be smoothly performed.
Additionally, since the rigid length L1 in the retracted state becomes shorter than the maximum value L2 of the rigid length when a procedure is performed using the treatment parts 73, further suppression of a catch during insertion or extraction can be expected.
Additionally, in the treatment mode that is one of the modes, since the bending part 52 of the external cylindrical tube 51 is set to the locked state, the surgeon does not need to perform a manipulation for holding the shape of the external cylindrical tube, and can proceed with a procedure while concentrating on the manipulation of the arm part or the like. As a result, a user-friendly medical manipulator can be provided.
Moreover, since the arm part 65 is constituted of the arms 61 that are fixed to the external cylindrical tube 51, and the treatment tools 71 that are inserted through the external cylindrical tube 51 and the arms 61 and have the treatment parts 73, the rigid length in the retracted state can be set to be shorter by changing the protruding length of the treatment parts from the arms.
Subsequently, a second embodiment of the invention will be described with reference to
A treatment tool 271 having a knife part 175, which applies a high-frequency current, at the treatment part 73 is shown as an example of the treatment tool in
The observation means 75 is fixed to a distal end part of the arm 161, and is not advanced and retracted with respect to the arm 161.
While the respective embodiments of the invention have been described above, the technical scope of the invention is not limited to the above embodiments. Combinations of constituent elements can be changed, various alternations can be added to the respective constituent elements, or omissions can be made, without departing from the concept of the invention.
For example, in the medical manipulator of the invention, the observation means is not necessarily provided on the insertion part. That is, the observation means may be attached to another slave arm for the observation means and introduced into the vicinity of a target region, or a port may be provided in an abdominal wall and parenterally introduced, using a laparoscope as the observation means. In this case, it is needless to say that that it is not necessary to set the state of the observation means in the respective modes.
Additionally, the number of arm parts is also not particularly limited, and may be one or may be three or more.
Moreover, the specific shape in the retracted state is also not particularly limited if the shape is a form that falls within the range of the width of the external cylindrical tube. Here, if the form in the retracted state is set so that the distal ends of the plurality of arm parts 65 are gathered at the same point as in the above-described embodiments, the maximum dimensions of the insertion part 50 in the width direction in the retracted state become smaller approaching the distal ends. Therefore, insertion or extraction can be more suitably performed, which is preferable.
Moreover, in the medical manipulator of the invention, the configuration of the arm part is not limited to the above-described example, and can be variously changed. The shape in the retracted state can also be variously set according to respective configurations.
For example, in an insertion part 50A of a modification example shown in
In addition, a treatment tool having a joint on a distal end side thereof may be inserted through an arm fixed to the external cylindrical tube.
Moreover, other modes may be further set in addition to the above-described modes.
Additionally, the medical manipulator of the invention is not limited to a configuration in which the insertion part as described above is remotely controlled by the manipulation part, and may have a configuration in which the manipulation part and the insertion part are integrally provided.
While preferred embodiments of the invention have been described and illustrated above, it should be understood that these are exemplary of the invention and are not to be considered as limiting. Additions, omissions, substitutions, and other modifications can be made without departing from the scope of the present invention. Accordingly, the invention is not to be considered as being limited by the foregoing description, and is only limited by the scope of the appended claims.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2012-169667 | Jul 2012 | JP | national |
This application is a continuation application based on a PCT International Application No. PCT/JP2013/070349, filed on Jul. 26, 2013, whose priority is claimed on Japanese Patent Application No. 2012-169667, filed Jul. 31, 2012, the contents of the PCT Application and the Japanese Patent Application are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/JP2013/070349 | Jul 2013 | US |
| Child | 14594511 | US |
