Patent Application
20150150634
1. Field of the Invention
The present invention relates to a medical system and an operation method.
This application is a continuation application based on a PCT International Application No. PCT/JP2013/073274, filed on Aug. 30, 2013, whose priority is claimed on Japanese Patent Application No. 2012-189881, filed Aug. 30, 2012, the contents of the PCT Application and the Japanese Patent Application are incorporated herein by reference.
2. Description of Related Art
Conventionally, a treatment tool used together with an endoscope has been known as a treatment tool for performing treatment in the inside of a body. For example, Japanese Patent No. 4271088 discloses an endoscope treatment system including an endoscope provided with an insertion part inserted into the inside of the body and a treatment tool mounted in the insertion part of the endoscope.
In the endoscope treatment system disclosed in Japanese Patent No. 4271088, the treatment tool mounted in the endoscope is detachable from the endoscope and can be received in a receiving part mounted in the endoscope. Furthermore, in Japanese Patent No. 4271088, forceps are provided as an example of the treatment tool.
According to a first aspect of the present invention, a medical system includes an insertion part inserted into an inside of a body, an arm part provided on the insertion part and capable of moving with respect to the insertion part, a device disposed in the inside of the body, a holding part provided on the arm part and holding the device, and a part to be held provided on the device and held by the holding part.
According to a second aspect of the present invention, in the medical system according to the first aspect, at least one of the holding part and the part to be held may have a restriction part that restricts movement of the device.
According to a third aspect of the present invention, in the medical system according to the first aspect or the second aspect, the holding part may have a grip part that grips the part to be held, and the part to be held may have a part to be gripped capable of engaging with the grip part.
According to a fourth aspect of the present invention, in the medical system according to any one of the first aspect to the third aspect, the holding part and the part to be held may have concave-convex shapes engaging with each other.
According to a fifth aspect of the present invention, in the medical system according to any one of the first aspect to the fourth aspect, the holding part and the part to be held may engage with each other through frictional force.
According to a sixth aspect of the present invention, in the medical system according to any one of the first aspect to the fifth aspect, a rod-shaped part may be provided on one of the holding part and the part to be held, and a hole to which the rod-shaped part is fitted may be formed in a remaining one of the holding part and the part to be held.
According to a seventh aspect of the present invention, in the medical system according to any one of the first aspect to the sixth aspect, the part to be held may have a plurality of projection-stripe portions, and the plurality of projection-stripe portions may extend in parallel to one another in a longitudinal axial direction of the device.
According to an eighth aspect of the present invention, in the medical system according to any one of the first aspect to the seventh aspect, the part to be held may have a plurality of conical-shaped portions having apexes capable of coming in contact with the holding part.
According to a ninth aspect of the present invention, in the medical system according to any one of the first aspect to the eighth aspect, the insertion part may have an external tube and a device channel formed in the external tube, and the device may have a flexible tube part insertable into the device channel.
According to a tenth aspect of the present invention, in an operation method of a device disposed in an inside of a body, a part of the device is held using a holding part provided on an arm part that is the body provided separately from the device and has at least one degree of freedom, and the arm part is moved, so that the device held by the holding part is moved together with the arm part.
A medical system of one embodiment of the present invention will be described below.
As shown in
The master manipulator 2 includes master arms 3, a display part 4, and a control part 5. The master arms 3 are operated by the operator Op. The display part 4 displays video or the like captured using the endoscope device 10 for treatment. The control part 5 generates an operation command for operating the slave manipulator 6 on the basis of the operation of the master arms 3.
In the present embodiment, the master arms 3 are operation parts provided in order to operate holding tools 20 (which will be described later) mounted in the endoscope device 10 for treatment. Although not shown in detail, the master manipulator 2 has the master arms 3 corresponding to the right hand and the left hand of the operator Op. Each of the master arms 3 has a multiple joint structure used to operate a joint part 22 of the holding tool 20 having at least one degree of freedom, which will be described later. A grip part (not shown) for operating a grip part 26 of the holding tool 20, which will be described later, is provided at an end portion of each of the master arms 3 positioned at the operator Op side.
The display part 4 is a device on which the video of a site to be treated, which is captured by an observation device 15 (which will be described later) mounted in the endoscope device 10 for treatment, is displayed. On the display part 4, the video of the holding tool 20 and the video of a treatment tool 30, which will be described later, are also displayed together with the video of the site to be treated.
The slave manipulator 6 has a placement table 7 on which a patient is placed, a multiple-joint robot 8 disposed in the vicinity of the placement table 7, the endoscope device 10 for treatment mounted in the multiple-joint robot 8, the holding tool 20 (an arm part), and the treatment tool 30. The treatment tool 30 is an example of a device disposed inside of a body. The multiple-joint robot 8 operates according to the operation command sent from the master manipulator 2.
As shown in
The external tube 11 of the endoscope device 10 for treatment is a long member that is inserted into the inside of a patient's body. The external tube 11 may be curved by a well-known curved mechanism 11A and can direct the holding tool 20 in a desired direction in the inside of the body. Furthermore, the external tube 11 is provided with a treatment tool channel 16 into which the treatment tool 30 is inserted.
Furthermore, the observation device 15 having an imaging mechanism 13 and an illumination mechanism 14 is inserted into the endoscope channel 12 provided in the external tube 11.
The endoscope channel 12 is provided in the external tube 11 so as to be opened at the distal end of the external tube 11.
The observation device 15 is a device for observing a site to be treated using the imaging mechanism 13 and the illumination mechanism 14. The observation device 15 may also have a curved mechanism (not shown) for directing the imaging mechanism 13 and the illumination mechanism 14 in a desired direction. Furthermore, as the observation device 15, an endoscope having a well-known structure may also be appropriately selected and employed.
The holding tool 20 has the joint part 22 that is curved by the operation of the master arm 3, and the grip part 26 (a holding part) mounted in the joint part 22. In the holding tool 20, a curvable structure is not limited to the joint structure based on a combination of long tubular parts as shown in
The grip part 26 is a member for holding grooves 36a of a ring part 36, which will be described later, with the grooves 36a interposed therebetween, and has a pair of grip members 27 entering the grooves 36a of the ring part 36. In the grip part 26, the pair of grip members 27 are opened and closed by the operation of the aforementioned operation part. Furthermore, the grip part 26 is further provided with a two-axis joint for bending the grip part 26 at the distal end of the joint part 22.
The flexible tube part 31 is a tubular member flexibly formed of a resin and is a long member inserted into the treatment tool channel 16.
The treatment part 32 has a hook-shaped electrode 33, the ring part 36 (a part to be held, a part to be gripped, a restriction part) provided at the distal end of the flexible tube part 31, and is provided in order to perform treatment for a site to be treated. In the present embodiment, the treatment part 32 can incise a biological tissue.
The hook-shaped electrode 33 is a fine line-shaped electrode having a shaft portion 34 extending concentrically with the conducting wire 37, and a hook portion 35 with a protruding end having a shape bent with respect to the shaft portion 34 at 90°.
The ring part 36 is provided at an outer peripheral side of the shaft portion 34 in the hook-shaped electrode 33, and has a pair of grooves 36a. The grooves 36a formed in the ring part 36 are configured to be fitted to the grip members 27. The ring part 36 is made of a material with high biocompatibility. For example, as a metallic ring part 36, stainless steel, a nickel-titanium alloy, a cobalt-chrome-based alloy, pure titanium, a titanium alloy, and a magnesium alloy may be employed. Furthermore, as a bioabsorbable resin ring part 36, PGA, PLA, PDS, TMC, poly ε-caprolacton, and a copolymer thereof may be employed. Furthermore, as the ring part 36 made of a nonbioabsorbable resin, nylon, polyester, polypropylene, polybutester, a fluorine resin or the like may be employed. The ring part 36 has sufficient strength or flexibility so as not to be easily broken such that fragments generated when the ring part 36 is cut or divided by the gripping of the grip members 27 are prevented from remaining in the inside of a body. The ring part 36 is made of a material with high biocompatibility, such that painful of a patient is restricted to a minimum level even though the fragments of the ring part 36 remain inside of the body.
The conducting wire 37 is also used as a wire for advancing, retracting, and rotating the hook-shaped electrode 33, in addition to the energizing of a high frequency current. When the conducting wire 37 is advanced and retracted along its own central axial line, it is possible to adjust the protruding length of the hook-shaped electrode 33 from the flexible tube part 31. When the conducting wire 37 is rotated around its own central axial line, the hook-shaped electrode 33 is rotated around the central axial line of the flexible tube part 31, so that it is possible to change the direction of the hook-shaped electrode 33.
The treatment tool 30 of the present embodiment is a medical device capable of incising a biological tissue by connecting a high frequency power supply apparatus to the treatment tool 30 and applying a high frequency current to the biological tissue through the hook-shaped electrode 33.
The structure of the treatment tool 30 is not limited to the medical device using a high frequency current, and a treatment tool having a well-known structure may be appropriately selected and employed as long as it has dimensions by which it is insertable into the treatment tool channel 16. For example, as the treatment tool 30, a snare, a basket, grip forceps, a needle holder, a suture instrument, a test probe or the like for an endoscope may be employed.
Next, the operation and effect of the medical system 1 when used will be described.
At the time of use of the medical system 1, the external tube 11 of the endoscope device 10 for treatment is inserted into the inside of a body, and the observation device 15 is further inserted into the endoscope channel 12, so that the imaging mechanism 13 is guided up to the vicinity of a site to be treated. The bending operation of the external tube 11, for example, is performed by the master arm 3 by switching a mode of the master arm 3 to a mode of operating the external tube 11 through a foot switch provided on the master manipulator 2.
Furthermore, when it is necessary to treat the site to be treated, the treatment tool 30 is inserted into the treatment tool channel 16 of the external tube 11. Then, the treatment part 32 of the treatment tool 30 is gripped using the grip part 26 provided on the holding tool 20 by operating the grip part provided on the master arm 3. In the present embodiment, any of the two holding tools 20 can grip the treatment part 32.
When the grip member 27 provided on the grip part 26 of the holding tool 20 is opened, fitted to the grooves 36a of the ring part 36, and closed, the treatment part 32 can be held by the grip member 27. At this time, the advance and retraction movement of the ring part 36 to/from the grip member 27 is restricted. Thus, for example, an assistant (not shown) in the vicinity of a patient rotates the conducting wire 37 around the central axial line of the conducting wire 37, so that it is possible to freely change the direction of the hook-shaped electrode 33.
Furthermore, in the case of using the treatment part 32 outside of a movable range of one of the holding tools 20, the treatment part 32 is gripped by the other one of the holding tools 20, so that the treatment part 32 can be used. In the case of switching the treatment part 32 between the two holding tools 20, for example, in the state in which the ring part 36 is gripped in the one of the holding tools 20, a part of the treatment part 32 other than the ring part 36 or the flexible tube part 31 is gripped using the grip part 26 of the other one of the holding tools 20. Thereafter, the one of the holding tools 20 is detached from the ring part 36, and is shifted to a part of the treatment part 32 other than the ring part 36 or the flexible tube part 31. Moreover, the ring part 36 is surrounded by the other one of the holding tools 20. Consequently, the switching of the treatment part 32 and orientation change for a target part of the treatment tool 30 are possible without dropping the treatment part 32.
Furthermore, at the time of the use of the medical system 1, between the two holding tools 20, a holding tool 20 not gripping the treatment part 32 can be used in order to support a tissue X in the vicinity of the site to be treated.
As described above, according to the medical system 1 of the present embodiment, it is possible to simply change the direction, position, orientation or the like of the treatment tool 30 while maintaining the direction of the external tube 11.
Furthermore, in the state in which the movement of the advance and retraction direction of the treatment tool 30 is restricted by the holding tool 20, it is possible to rotate the treatment part 32 by employing the central axial line of the flexible tube part 31 as a rotation center. Consequently, it is possible to adjust the direction of the hook portion 35 to be preferably directed to an object to be treated, and to treat a tissue.
(Modification 1)
Next, a modification 1 of the aforementioned embodiment will be described.
As shown in
Even in such a structure, the same effects as those of the aforementioned embodiment are achieved.
(Modification 2)
Next, a modification 2 of the aforementioned embodiment will be described.
As shown in
In the present modification, while the electromagnet is being energized, the body 38 to be absorbed can be absorbed by the absorbing body 39. In this case, as compared to the case in which the aforementioned grip part 26 is employed, it is not necessary for an operator to continuously apply force for closing the grip member 27, and it is possible to hold the treatment part 32 through the on-off control of power for the electromagnet.
(Modification 3)
Next, a modification 3 of the aforementioned embodiment will be described.
As shown in
The absorbing pad 41 is provided with a suction pipeline 42 and decompresses the inside while abutting the body 40 to be absorbed, so that the body 40 to be absorbed is absorbed by a sucker.
Even in such a structure, the same effects as those of the aforementioned embodiment are achieved.
(Modification 4)
Next, a modification 4 of the aforementioned embodiment will be described.
The present modification is different from the aforementioned embodiment in that a part 43 to be inserted (a part to be held) and a rod-shaped part 44 (a holding part) inserted into the part 43 to be inserted are provided as shown in
In addition, instead of the ring part 36 and the grip part 26 described in the aforementioned embodiment, the rod-shaped part may be provided in a part to be held, and the holes, into which the rod-shaped part is inserted, may be provided in a holding part.
Even in such a structure, the same effects as those of the aforementioned embodiment are achieved.
(Modification 5)
Next, a modification 5 of the aforementioned embodiment will be described.
As shown in
Even in the structure of the present modification, the same effects as those of the aforementioned embodiment are achieved.
(Modification 6)
Next, a modification 6 of the aforementioned embodiment will be described.
As shown in
The concave-convex shape 46 formed in the grip part 26 is provided on each grip member 27, and has a plurality of projection-stripe portions 46a extending in parallel to one another.
The concave-convex shape 47 formed in the part 36A to be gripped has a plurality of projection-stripe portions 47a extending in parallel to one another on the outer surface of the part 36A to be gripped. The projection-stripe portions 47a extend in the longitudinal axial direction of the flexible tube part 31 (the treatment tool 30).
In addition, in the present modification, as shown in
Furthermore, in the present modification, a straight needle-shaped electrode 48 provided at the distal end of the flexible tube part 31 is provided as the treatment part 32.
Even in the structure of the present modification, the same effects as those of the aforementioned embodiment are achieved.
(Modification 7)
Next, a modification 7 of the aforementioned embodiment will be described.
As shown in
Furthermore, in the present modification, as the treatment part 32, a rod-shaped electrode 50 provided with a conical-shaped distal end portion 50a having a diameter that gradually decreases toward the distal end side is provided on the distal end of the flexible tube part 31.
Even in such a structure, the same effects as those of the aforementioned embodiment are achieved.
In addition, it is preferable that the grip surface of the grip part 26 be provided with a plurality of conical-shaped portions that engage with the plurality of conical-shaped portions 49.
(Modification 8)
Next, a modification 8 of the aforementioned embodiment will be described.
As shown in
Furthermore, in the present modification, as the treatment part 32, a rod-shaped electrode 52 with a snare loop 52a provided on a distal end thereof is provided on the distal end of the flexible tube part 31.
Even in such a structure, the same effects as those of the aforementioned embodiment are achieved.
(Modification 9)
As shown in
Furthermore, holes 55 and 56, into which at least parts of the protrusions 53 and 54 are inserted, respectively, are formed in the grip members 27 of the grip part 26. In this case, the length of the flexible tube part 31 including the protrusions 53 and 54 in the diameter direction is smaller than the inner diameter of the treatment tool channel 16.
In the present modification, in the state in which the protrusions 53 and 54 are inserted into the holes 55 and 56 formed in the grip members 27, the treatment part 32 can be rotated with respect to the grip part 26 by employing the central axial lines of the protrusions 53 and 54 as rotating centers as shown in
So far, the embodiment of the present invention has been described in detail with reference to the accompanying drawings. However, detailed configurations are not limited to the embodiment. For example, a design change and the like within the range without departing from the scope of the present invention are also included.
For example, in the present embodiment, the structure in which the part to be held is held by the holding part by fitting, friction, magnetic force, or absorption has been described; however, the part to be held may be a marking for simply indicating a position at which the treatment part can be preferably held. Such a marking may be configured to inform an operator of desired angle and position at which the treatment part, in which the direction of the hook-shaped electrode when used has been decided, is held.
Furthermore, in the present embodiment, as the operation part, the master arm 3 in the master manipulator 2 of the master-slave type system has been described as an example; however, the present invention is not limited thereto. Even in a structure in which the operation part is directly provided at the distal end of the endoscope device 10 for treatment, the same effects of the present invention are achieved.
Furthermore, in the present embodiment, the structure in which the holding tool is mounted at the distal end of the external tube 11 has been described as an example; however, the holding tool is not limited thereto. For example, a structure in which the holding tool is inserted into a channel formed in the external tube 11 may also be employed. In this case, a portion exposed by the distal end of the external tube 11 is an arm part.
Furthermore, as the treatment tool, a treatment tool that is entirely introduced into the inside of a body and used may also be employed. For example, a knife, a retractor or the like disposed in the inside of the body is employed as the treatment tool, and can be held by the holding tool for use. In this case, the part to be held is provided on the treatment tool itself by performing processing such as shaving of a part other than the treatment part of the treatment tool. As described above, the part to be held is not limited to the part to be held provided on the flexible tube part as in the aforementioned embodiment and each modification.
Furthermore, instead of the treatment tool, a device not for diagnosis or medical cure of the human body can be introduced into the inside of the body, and can be used similarly to the aforementioned embodiment and each modification.
Furthermore, the elements in the aforementioned embodiment and each modification can be appropriately combined with one another.
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 |
|---|---|---|---|
| 2012-189881 | Aug 2012 | JP | national |
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/JP2013/073274 | Aug 2013 | US |
| Child | 14615550 | US |
