【０００１】[0001]
【発明の属する技術分野】本発明は内視鏡下において生
体内組織の処置を行う内視鏡手術用能動鉗子に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an active forceps for endoscopic surgery for treating tissue in a living body under an endoscope.
【０００２】[0002]
【従来の技術】胆のう摘出術などの腹腔鏡下手術に代表
される内視鏡手術は、体表に複数個小さな穴を開け、そ
れに取りつけられたトラカールを介して観察用内視鏡お
よび長鉗子等の術具を挿入し、観察および処置を行うこ
とで開腹を必要とせず、患者に与える負担を軽減できる
低侵襲な手術である。2. Description of the Related Art Endoscopic surgery typified by laparoscopic surgery such as cholecystectomy is performed by making a plurality of small holes on the body surface and observing an endoscope and long forceps through a trocar attached thereto. It is a minimally invasive surgery that does not require laparotomy by inserting a surgical tool such as the above and performing observation and treatment, and can reduce the burden on the patient.
【０００３】[0003]
【発明が解決しようとする課題】前述した内視鏡手術に
おいて実施される生体内組織の把持、剥離、切除、縫
合、結紮などの処置は非常に細かな動作が要求される。
しかし、従来使用されている術具は直線形状であり、ト
ラカールを中心とする直線動作とその軸方向への回転動
作に限定されるため、操作性に乏しく微細な処置を行う
ことは非常に困難である。The operations such as grasping, peeling, excision, suturing, and ligation of the in-vivo tissue performed in the above-mentioned endoscopic surgery require very detailed movements.
However, the surgical instruments used in the past have a linear shape, and are limited to a linear movement centered on the trocar and a rotational movement in the axial direction, so it is extremely difficult to perform fine treatment due to poor operability. Is.
【０００４】このような課題に対して、特開２０００−
３５０７３５号に開示されている医療用マニピュレータ
などが提案されている。しかし、前記医療用マニピュレ
ータはそれ自体を保持するためのグリップが先端術具の
処置操作および姿勢操作の入力装置であるため、マニピ
ュレータ自体の姿勢変更と術具の処置操作および姿勢操
作が互いに影響を受け易く、それぞれの操作の区別が難
しい。To solve such a problem, Japanese Patent Laid-Open No. 2000-
A medical manipulator and the like disclosed in No. 350735 have been proposed. However, since the grip for holding the medical manipulator is an input device for the treatment operation and the posture operation of the distal surgical instrument, the posture change of the manipulator itself and the treatment operation and the posture operation of the surgical instrument influence each other. It is easy to receive and it is difficult to distinguish each operation.
【０００５】そして、前記医療用マニピュレータなど
は、術具動作のほとんどをモータにより駆動しているた
め術具の脱着機構を具備することが難しく、外部より電
力を供給する必要があるため電源コードを具備したもの
になってしまう。さらに、手術では複数の術具を必要と
し、また、細かな処置が要求されるため電源コード類は
術者の動作を妨げる恐れがある。Since most of the operation of the surgical instrument such as the medical manipulator is driven by a motor, it is difficult to provide a mechanism for attaching and detaching the surgical instrument, and it is necessary to supply electric power from the outside. It will be equipped. In addition, the surgical operation requires a plurality of surgical tools, and since detailed procedures are required, the power cords may hinder the operation of the operator.
【０００６】本発明は以上の点を考慮し、鉗子自体の姿
勢変更と処置部の処置操作および姿勢操作が互いに影響
を与えにくいような処置操作部と姿勢操作部の機構およ
び配置を有し、バッテリ駆動により電源コードを具備し
ない内視鏡手術用能動鉗子を提供するものである。In consideration of the above points, the present invention has a mechanism and an arrangement of a treatment operation portion and a posture operation portion in which the posture change of the forceps itself and the treatment operation and the posture operation of the treatment portion are less likely to affect each other. The present invention provides an active forceps for endoscopic surgery that is battery-powered and does not include a power cord.
【０００７】[0007]
【発明の実施の形態】以下、図面を参照して本発明の実
施の形態について説明する。BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings.
【０００８】[0008]
【実施例】図１は本発明の第１の実施例を示す概略図で
ある。本実施例の内視鏡手術用能動鉗子１は、術具部２
とグリップ３から成り、接続部６において取り外しが可
能である。取り外しは術具部２をその軸方向にグリップ
３の後方から前方にスライドすることで接続が行え、逆
に前方から後方にスライドすると分離可能である。術具
部２は処置具４と関節部５と関節部５の屈曲操作を行う
姿勢操作入力部５ａを具備している。グリップ３は処置
具４の開閉操作を行う処置操作入力部４ａと処置具４の
回転操作を行う姿勢操作入力部４ｂを具備する。処置具
４の屈曲動作および回転動作により、体腔内において任
意の方向から処置を行うことが可能である。1 is a schematic view showing a first embodiment of the present invention. The active forceps 1 for endoscopic surgery according to the present embodiment includes a surgical instrument portion 2.
And the grip 3 and can be detached at the connecting portion 6. For removal, the surgical instrument part 2 can be connected by sliding the surgical instrument part 2 from the rear side to the front side of the grip 3, and conversely, it can be separated by sliding from the front side to the rear side. The surgical instrument section 2 includes a treatment instrument 4, a joint section 5, and a posture operation input section 5a for performing a bending operation of the joint section 5. The grip 3 includes a treatment operation input unit 4a for opening and closing the treatment instrument 4 and a posture operation input unit 4b for rotating the treatment instrument 4. By bending and rotating the treatment instrument 4, it is possible to perform treatment from any direction within the body cavity.
【０００９】本実施例の形態によれば、前述する本発明
の内視鏡手術用能動鉗子１を使用する場合にはグリップ
３を握り姿勢を維持したまま、処置具４の開閉操作を処
置操作入力部４ａにおいて人差し指で、また、処置具４
の姿勢変更について姿勢操作入力部４ｂおよび５ａを親
指で操作することが可能となる。したがって、独立した
指の操作で本能動鉗子の姿勢変更と前記処置部の処置操
作および姿勢操作が互いに影響を与えにくいことを特徴
としている。According to the embodiment of the present invention, when the above-mentioned active forceps 1 for endoscopic surgery of the present invention is used, the opening / closing operation of the treatment tool 4 is performed while the grip 3 is held and the posture is maintained. With the index finger at the input section 4a, the treatment tool 4
It is possible to operate the posture operation input units 4b and 5a with the thumb for changing the posture. Therefore, it is characterized in that the posture change of the active forceps and the treatment operation and the posture operation of the treatment section are unlikely to affect each other by independent finger operations.
【００１０】まず、関節部５の屈曲動作および屈曲操作
を行う機構について図２および図３を参照して説明す
る。関節部５は複数個の関節ユニット５０からなり、関
節５０は処置具４の開閉動作および回転動作を伝達する
ためのフレキシブルロッドを通す穴５１と、術具の姿勢
を屈曲するための駆動ワイヤを通す穴５２を有する。関
節ユニット５０は突起した軸部５３と軸受け部５４を有
し、図２に示すように軸まわりに９０度回転させた状態
で複数個組み合わせることで、２方向への屈曲が可能で
ある。First, a bending operation of the joint portion 5 and a mechanism for performing the bending operation will be described with reference to FIGS. 2 and 3. The joint portion 5 is composed of a plurality of joint units 50. The joint 50 has a hole 51 through which a flexible rod for transmitting the opening / closing operation and the rotating operation of the treatment instrument 4 is inserted, and a drive wire for bending the posture of the surgical instrument. It has a through hole 52. The joint unit 50 has a protruding shaft portion 53 and a bearing portion 54, and can be bent in two directions by combining a plurality of them in a state of being rotated 90 degrees about the axis as shown in FIG.
【００１１】図３に示す姿勢操作を入力するための操作
部材５５は、自由に姿勢変形できるような球状の中心軸
５６で支持されており、前記操作部材５５の外部に露出
している側は柔軟性を備え変形可能なゴムリング５７で
処置部２に固定され、姿勢操作入力部５ａを構成してい
る。姿勢操作を入力するための操作部材５５の中心軸５
６側は十字形または円形をしており、例えば面して１２
時、３時、６時、９時の方位において術具屈曲用駆動ワ
イヤ５７と接続され、姿勢操作部材５５の操作に対応す
る動作をワイヤに伝えるような機構である。このワイヤ
は図示しないプーリおよび関節ユニット５０の駆動ワイ
ヤを通す穴５２を経て、関節部５の処置具４側の最終関
節と固定されている。このため、姿勢操作入力部５ａで
ワイヤを引くと、関節部５はワイヤの経路長を調節する
ように任意の方向に屈曲することが可能である。An operating member 55 for inputting a posture operation shown in FIG. 3 is supported by a spherical center shaft 56 which allows the posture to be freely changed, and the side exposed outside the operating member 55. It is fixed to the treatment section 2 by a flexible and deformable rubber ring 57, and constitutes a posture operation input section 5a. The central axis 5 of the operation member 55 for inputting a posture operation
6 side is cruciform or circular, for example, facing 12
It is a mechanism that is connected to the surgical instrument bending drive wire 57 in the azimuth directions of 3 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock, and transmits a motion corresponding to the operation of the posture operation member 55 to the wire. This wire is fixed to the final joint on the treatment instrument 4 side of the joint section 5 through a pulley 52 (not shown) and a hole 52 through which the drive wire of the joint unit 50 passes. Therefore, when the posture operation input unit 5a pulls the wire, the joint unit 5 can be bent in any direction so as to adjust the path length of the wire.
【００１２】次に、処置具４の回転および開閉の駆動機
構について図４ａを参照して説明する。処置具４の回転
動作はグリップ３に具備する姿勢操作入力部４ｂにより
行い、グリップ３内に具備するモータ３１により駆動さ
れる。モータ３１の回転力はギヤ３２、３３を経て、接
続部６０においてグリップ３から術具部２に伝達され
る。さらに、術具部２内のギヤ２１、２２、２３を経
て、処置具４と接続されているロッド２５の後端に具備
するギヤ２４に伝達される。処置具４の開閉動作はグリ
ップ３に具備する処置操作入力部４ａの操作で行う。処
置操作入力部４ａを引くことにより、リンク部材３４を
介して術具開閉レバー３５を動作させ、可動ロッド２５
を後退させることができる。処置操作入力部４ａの除加
重後、可動ロッド２５はその後方に設置されたバネ機構
２６により元の位置まで押し戻される。前述する可動ロ
ッド２５の前後動作に対して、ギヤ２４がある長さを有
しているため、ギヤ２３からの回転力の伝達は保たれ
る。Next, a drive mechanism for rotating and opening / closing the treatment instrument 4 will be described with reference to FIG. 4a. The rotation operation of the treatment instrument 4 is performed by the posture operation input unit 4b included in the grip 3, and is driven by the motor 31 included in the grip 3. The rotational force of the motor 31 is transmitted from the grip 3 to the surgical instrument portion 2 at the connecting portion 60 via the gears 32 and 33. Further, it is transmitted to the gear 24 provided at the rear end of the rod 25 connected to the treatment instrument 4 via the gears 21, 22, and 23 in the surgical instrument unit 2. The opening / closing operation of the treatment instrument 4 is performed by operating the treatment operation input unit 4a provided on the grip 3. By pulling the treatment operation input portion 4a, the surgical instrument opening / closing lever 35 is operated via the link member 34, and the movable rod 25
Can be retracted. After the treatment operation input unit 4a is unloaded, the movable rod 25 is pushed back to its original position by the spring mechanism 26 installed behind it. Since the gear 24 has a certain length with respect to the back-and-forth movement of the movable rod 25, the transmission of the rotational force from the gear 23 is maintained.
【００１３】また、原理の一例として図４ｂに示すよう
に、ギヤ３３を術具部２あるいはグリップ３の筐体表面
より露出するような機構を設けることで、電気的な故障
により上記回転駆動が不可能になった場合、この露出し
たギヤを手で操作し、手動で処置具４の回転動作を行う
ことが可能である。以上のように、本発明では処置部の
回転動作のみ電動で駆動し術具の姿勢は手動で行うこと
でモータの個数を減らし、その電源としてバッテリ３０
を採用することで電源コードを排除することが可能であ
り、不慮の電気的な故障の場合においても手動で操作が
行えるような構成となっていることから、術者は本内視
鏡手術用能動鉗子を用いて安全な手術を行うことが可能
である。Further, as an example of the principle, as shown in FIG. 4b, by providing a mechanism for exposing the gear 33 from the surface of the casing of the surgical instrument portion 2 or the grip 3, the above rotational drive can be performed due to an electrical failure. When it becomes impossible, the exposed gear can be manually operated to manually rotate the treatment instrument 4. As described above, in the present invention, only the rotational movement of the treatment section is electrically driven and the posture of the surgical instrument is manually performed to reduce the number of motors.
Since the power cord can be eliminated by adopting the configuration, the operator can operate it manually even in the case of an unexpected electrical failure. It is possible to perform safe surgery using active forceps.
【００１４】処置具４の開閉動作および回転動作につい
て図５を参照して説明する。処置具４１、４２はそれぞ
れリンク部材２７、２８を介して可動ロッド２５に接続
されており、可動ロッド２５が引かれると処置具４が閉
じ、反対に可動ロッド２５を押されると処置具４が開
く。また、処置具４と関節５の間にベアリング２９を用
いた機構を設けることで、可動ロッド２５が回転される
と、術具自体を回転することが可能である。この術具の
回転動作は、姿勢操作入力部４ｂにより操作され、縫合
などの回転を必要とする処置に応用できる。The opening / closing operation and the rotating operation of the treatment instrument 4 will be described with reference to FIG. The treatment tools 41 and 42 are connected to the movable rod 25 via link members 27 and 28, respectively. When the movable rod 25 is pulled, the treatment tool 4 is closed, and when the movable rod 25 is pushed, the treatment tool 4 is moved. open. Further, by providing a mechanism using the bearing 29 between the treatment instrument 4 and the joint 5, it is possible to rotate the surgical instrument itself when the movable rod 25 is rotated. The rotation operation of the surgical instrument is operated by the posture operation input unit 4b, and can be applied to a procedure requiring rotation such as suturing.
【００１５】[0015]
【発明の効果】以上説明したように、本発明によれば、
体腔内において任意の方向から処置を行うことが可能で
あることから、従来の内視鏡手術で困難であった処置が
容易に行え、本能動鉗子の姿勢変更と前記処置部の処置
操作および姿勢操作が互いに影響を与えにくいような機
構および配置を有しているため、非常に操作性に優れた
内視鏡手術用能動鉗子を提供することが可能である。ま
た、本発明によれば、現在の一般的な内視鏡手術におい
て使用されている鉗子類の操作と大きく違わず、確立さ
れた従来の術式で手術が行えるため、安全であると同時
に術者に対しても特別なトレーニングを必要としないな
ど多くの特徴を有するものである。As described above, according to the present invention,
Since it is possible to perform treatment from any direction inside the body cavity, it is possible to easily perform the treatment that was difficult in the conventional endoscopic surgery, and change the posture of the active forceps and the treatment operation and posture of the treatment section. Since the mechanism and the arrangement are such that the operations are less likely to affect each other, it is possible to provide the active forceps for endoscopic surgery which is extremely excellent in operability. Further, according to the present invention, the operation is similar to the operation of the forceps used in the current general endoscopic surgery, and the operation can be performed by the established conventional operation method. It has many characteristics such as no special training is required for persons.
【図１】本発明の第１の実施の形態による内視鏡手術用
能動鉗子を示す概略を示した正面図FIG. 1 is a schematic front view showing an active forceps for endoscopic surgery according to a first embodiment of the present invention.
【図２】図１の関節部分を示した斜視図FIG. 2 is a perspective view showing a joint portion of FIG.
【図３】図１の術具の屈曲姿勢操作入力部分の概略を示
した透視図FIG. 3 is a perspective view showing an outline of a bending posture operation input portion of the surgical instrument of FIG.
【図４ａ】図１の術具の開閉および回転の駆動機構と術
具接続機構の概略を示した透視図FIG. 4a is a perspective view schematically showing a driving mechanism for opening / closing and rotating the surgical instrument and a surgical instrument connecting mechanism of FIG.
【図４ｂ】図４の上面図4b is a top view of FIG.
【図５】図１の術具部分を示した断面図5 is a cross-sectional view showing the surgical instrument portion of FIG.
１ 内視鏡手術用能動鉗子２ 術具部３ グリップ４ 処置具４ａ 処置操作入力部４ｂ 姿勢操作入力部５ 関節部５ａ 姿勢操作入力部６ 接続部２１、２２、２３、２４ ギヤ２５ 可動ロッド２６ バネ機構２７、２８ リンク部材２９ ベアリング３０ バッテリ３１ モータ３２、３３ ギヤ３４ リンク部材３５ 術具開閉レバー４１、４２ 処置具５０ 関節５１ フレキシブルロッド用の穴５２ 駆動ワイヤ用の穴５３ 軸部５４ 軸受け部５５ 操作部材５６ 中心軸５７ ゴムリング５７ 術具屈曲用駆動ワイヤ６０ 術具接続機構1 Active forceps for endoscopic surgery2 surgical tools3 grip4 treatment tools4a Treatment operation input section4b Posture operation input section5 joints5a Posture operation input section6 connection21, 22, 23, 24 gears25 Movable rod26 Spring mechanism27, 28 Link member29 bearings30 battery31 motor32, 33 gears34 Link member35 Surgical tool open / close lever41, 42 treatment tools50 joints51 Hole for flexible rod52 Hole for drive wire53 Shaft54 Bearing55 Operation member56 central axis57 rubber ring57 Drive wire for bending surgical tools60 surgical tool connection mechanism
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2001373420AJP2003135473A (en) | 2001-11-01 | 2001-11-01 | Active forceps for endoscopic surgery |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2001373420AJP2003135473A (en) | 2001-11-01 | 2001-11-01 | Active forceps for endoscopic surgery |
| Publication Number | Publication Date |
|---|---|
| JP2003135473Atrue JP2003135473A (en) | 2003-05-13 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2001373420APendingJP2003135473A (en) | 2001-11-01 | 2001-11-01 | Active forceps for endoscopic surgery |
| Country | Link |
|---|---|
| JP (1) | JP2003135473A (en) |
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