US20100262162A1 - Medical manipulator and medical robot system - Google Patents

Abstract

The present invention relates to a medical manipulator and a medical robot system. The manipulator has a connecting block, a joint shaft, and a distal-end working unit. The distal-end working unit has a gripper, a pitch axis, and a yaw axis which serve as distal-end joints for changing the orientation of the gripper. The gripper, the pitch axis, and the yaw axis are operated by rotors around which wires are wound. The joint shaft has a first intermediate joint and a second intermediate joint which are bendable by the wires which are moved back and forth. Since the manipulator can be bent at the first intermediate joint and the second intermediate joint, the joint shaft can appropriately be placed, and the gripper can be adjusted to an appropriate orientation with respect to an organ by being turned around the pitch axis and the yaw axis.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• This application is a continuation-in-part and claims the benefit of priority from U.S. application Ser. No. 12/327,189 filed Dec. 3, 2008, the entire contents of which are hereby incorporated by reference. U.S. application Ser. No. 12/327,189, claims the benefit of Priority to Japanese Patent Application No. 2007-339211, filed on Dec. 28, 2007.
BACKGROUND OF THE INVENTION
• 1. Field of the Invention
• The present invention relates to a medical manipulator having a distal-end joint operable by flexible members that are actuated by actuators, and a medical robot system for actuating such a medical manipulator with a robot arm.
• 2. Description of the Related Art
• According to a laparoscopic surgical operation process, small holes are opened in the abdominal region, for example, of a patient, and an endoscope and manipulators or forceps are inserted into such holes. The surgeon performs a surgical operation on the patient with the manipulators or forceps, while watching an image captured by the endoscope and displayed on a display monitor. Since the laparoscopic surgical operation process does not require a laparotomy to be performed, the operation is less burdensome on the patient and greatly reduces the number of days required for the patient to spend in the hospital before recovering from the operation and being released from the hospital. Therefore, the range of surgical operations in which the endoscopic surgical operation process may be applied is expected to increase.
• As disclosed in Japanese Laid-open Patent Publication No. 2002-102248 and Japanese Laid-open Patent Publication No. 2003-061969, a manipulator system comprises a manipulator and a controller for controlling the manipulator. The manipulator comprises an operating unit, which is manually operated, and a working unit replaceably mounted on the operating unit.
• The working unit comprises a long joint shaft and a distal-end working unit (referred to as an “end effector”) mounted on the distal end of the joint shaft. The operating unit has motors for actuating the working unit through wires. The wires have proximal end portions wound around respective pulleys. The controller energizes the motors of the operating unit to cause the pulleys to move the wires circulatively.
• There has also been proposed a medical robot system for actuating medical manipulators with robot arms (see, for example, U.S. Pat. No. 6,331,181). The medical robot system can be remotely controlled by a master arm, and can be moved in various ways under a programmed control.
• The medical robot system has the robot arms, which can selectively be used depending on the surgical technique required. One of the robot arms incorporates an endoscope therein for capturing an image representing the inside of a body cavity, which is capable of being visually confirmed on a display monitor.
• According to the laparoscopic surgical operation process, it is desirable to provide a wider operative field in the body cavity being operated on of the patient because the wider operative field allows the manipulators to operate with greater freedom in the body cavity.
• The body cavity may contain various organs in addition to the organ as the affected region, which make it difficult to provide a wide operative field in the body cavity. The manipulator on one of the robot arms of medical robot systems may be used as a retractor for retracting an organ or organs other than the affected region to a position out of interference with the surgical operation.
• However, when the organ or organs are retracted by the retractor, the retractor itself may be positioned across the body cavity, and present itself as an obstacle in the operative field.
SUMMARY OF THE INVENTION
• It is an object of the present invention to provide a medical manipulator which is capable of keeping a wide operative field in a body cavity and a medical robot system incorporating such a medical manipulator.
• A medical manipulator according to an aspect of the present invention includes a rod-shaped member housing therein a first flexible member actuatable by a first actuator and a second flexible member actuatable by a second actuator, the rod-shaped member being flexible at least partly, at least one distal-end joint disposed on a distal end of the rod-shaped member, the distal-end joint being angularly movable by a rotor around which the first flexible member is wound, and at least one intermediate joint disposed on the rod-shaped member more closely to a proximal end thereof than the distal-end joint, the intermediate joint being bendable in response to back-and-forth movement of the second flexible member.
• The medical manipulator allows the distal-end joint to perform an appropriate surgical procedure, and also allows the rod-shaped member to be appropriately placed because it can be bent at the intermediate joint, particularly for avoiding physical interference with other medical manipulators. The medical manipulator thus provides a wide operative field in a body cavity.
• The rod-shaped member may include at least one guide plate having a hole defined therein through which the first flexible member extends. The guide plate allows the first flexible member to be placed in an appropriate position even when the intermediate joint is bent.
• The medical manipulator may be connected to a robot arm, and the robot arm is controlled to insert the rod-shaped member through a trocar into a body cavity and to move back and forth and tilt the rod-shaped member with respect to the trocar. The medical manipulator can thus be appropriately moved with respect to the trocar.
• The intermediate joint may include a first intermediate joint and a second intermediate joint which are successively arranged from the distal end of the rod-shaped member. The first intermediate joint may be disposed in a position within a range from 3 cm to 5 cm from the distal end of the rod-shaped member, and the second intermediate joint may be disposed in a position within a range from 7 cm to 12 cm from the distal end of the rod-shaped member. The rod-shaped member can thus be placed appropriately in the body cavity.
• A medical robot system according to another aspect of the present invention includes a plurality of first robot arms supporting respective manipulators thereon, a second robot arm supporting an endoscope thereon, and a controller for controlling the first robot arms and the second robot arm, each of the manipulators including a rod-shaped member for insertion through a trocar into a body cavity, and a distal-end working unit mounted on a distal end of the rod-shaped member and having at least one joint, wherein at least one of the manipulators comprises a retractor and has at least one intermediate joint disposed in the rod-shaped member for bending the rod-shaped member.
• The medical robot system allows the retractor to retract an organ or the like in a body cavity to a given region for thereby providing a wide operative field in the body cavity. As the rod-shaped member is bendable at the intermediate joint, the rod-shaped member can appropriately be positioned in the body cavity for providing a wider operative field in the body cavity. The rod-shaped member can thus avoid physical interference with other manipulators for performing a surgical procedure with ease.
• The retractor may coact with one of the first robot arms connected thereto in a predetermined operation mode for moving the distal-end working unit back and forth while keeping a posture of the distal-end working unit constant, in a coordinate system based on the posture of the distal-end working unit. The retractor can thus easily be operated to retract the organ or the like in the body cavity.
• The retractor may coact with one of the first robot arms connected thereto in a predetermined operation mode for bending the intermediate joint while keeping a position and a posture of the distal-end working unit constant. The intermediate joint can thus be bent appropriately with ease.
• The medical robot system may further include rotary input means for moving the intermediate joint on a hypothetical sphere or a hypothetical arc around a predetermined reference point on the rod-shaped member, depending on the angular amount by which and the direction in which the rotary input means is angularly moved. The rotary input means allows the user to bend the intermediate joint appropriately with ease and intuitively.
• The rotary input means may comprise a trackball for easy operation.
• The medical robot system may further include a switch for selectively enabling and disabling the rotary input means. The switch prevents the intermediate joint from being operated carelessly.
• A medical robot system according to another aspect of the present invention includes a plurality of first robot arms supporting respective manipulators thereon, a second robot arm supporting an endoscope thereon, and a controller for controlling the first robot arms and the second robot arm, the manipulators and the endoscope being inserted into a body cavity through a common trocar supporting member, wherein each of the manipulators includes a rod-shaped member for insertion through the trocar supporting member into the body cavity, a distal-end working unit mounted on a distal end of the rod-shaped member and having at least one joint, and at least one intermediate joint disposed in the rod-shaped member for bending the rod-shaped member.
• With the above structure, when a surgical procedure is performed by single port access, the distal-end working units having the end effectors can be moved closer to each other by bending the rod-shaped members of the two manipulators which intersect with each other at the trocar supporting member, by means of the intermediate joints. Accordingly, for example, an operator can grip an affected region to be treated, with a gripper provided as an end effector at one distal-end working unit, while the operator can perform a procedure (incision etc.) on a portion around the region gripped by the gripper, with scissors provided as an end effector at another distal-end working unit. Additionally, the robot arms do not interfere with each other outside the body of the patient. Thus, a surgical procedure by single port access can be performed suitably.
• At least one of the manipulators may serve as a retractor, and the rod-shaped member of the at least one manipulator serving as the retractor may include a plurality of the intermediate joints.
• With the above structure, the manipulator serving as a retractor performs an operation (e.g., gripping) on an affected region with the end effector provided at the distal end thereof, while the manipulator pushes aside (retracts) the organ (obstacle to the operative field) with the rod-shaped member having a plurality of intermediate joints. In this manner, one manipulator doubles as a forceps and a retractor. As a result, a surgical procedure can be performed using a smaller number of manipulators. Also, the trocar for a retractor can be omitted, and thus a much less-invasive surgery can be achieved.
• The medical robot system may further comprise a monitor for displaying an image captured with the endoscope, first input means which is operated by the left hand of an operator, and second input means which is operated by the right hand of the operator, wherein, when the rod-shaped members of two of the manipulators intersect with each other at the trocar supporting member, the manipulator that is located on the left side on a screen of the monitor is operated based on input operation by the first input means, and the manipulator that is located on the right side on the screen of the monitor is operated based on input operation by the second input means.
• With the above structure, even if the manipulators are inserted into the body cavity with the rod-shaped members thereof intersecting with each other, the operator can operate the manipulators intuitively in a manner to fit the feeling of the operator, because operation by the left hand of the operator is reflected on the movement of the manipulator that is located on the left side on the screen, and operation by the right hand of the operator is reflected on the movement of the manipulator that is located on the right side on the screen.
• The above and other objects, features, and advantages of the present invention will become more apparent from the following description when taken in conjunction with the accompanying drawings in which preferred embodiments of the present invention are shown by way of illustrative example.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a perspective view of a medical robot system according to a first embodiment of the present invention;
• FIG. 2 is a side elevational view, partly in cross section, of a manipulator according to the first embodiment of the present invention;
• FIG. 3 is a plan view of a pulley and an arm;
• FIG. 4 is an exploded perspective view of a first intermediate joint;
• FIG. 5 is an exploded perspective view of a second intermediate joint;
• FIG. 6 is a perspective view of a distal-end working unit;
• FIG. 7 is a perspective view of a console;
• FIG. 8 is a view illustrative of a tool coordinate operation mode;
• FIG. 9 is a perspective view of a master arm;
• FIG. 10 is a view illustrative of a bending motion of the first intermediate joint in an intermediate joint operation mode;
• FIG. 11 is a view illustrative of a hypothetical hemisphere used as a reference for bending the first intermediate joint in the intermediate joint operation mode;
• FIG. 12 is a view illustrative of a bending motion of the second intermediate joint according to a first control process in the intermediate joint operation mode;
• FIG. 13 is a view illustrative of a bending motion of the second intermediate joint according to a second control process in the intermediate joint operation mode;
• FIG. 14 is a perspective view showing the manner in which a gripper of the manipulator grips a large intestine;
• FIG. 15 is a perspective view showing the manner in which the gripper of the manipulator retracts the large intestine;
• FIG. 16 is a perspective view showing the manner in which the first intermediate joint is bent;
• FIG. 17 is a perspective view showing the manner in which the second intermediate joint is bent;
• FIG. 18 is a perspective view of a distal-end action unit having a fan-like mechanism;
• FIG. 19 is a schematic view illustrative of a medical robot system according to a second embodiment of the present invention;
• FIG. 20 is a schematic view illustrative of a medical robot system according to a third embodiment of the present invention; and
• FIG. 21 is a schematic perspective view of a console of the medical robot system according to the third embodiment.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
• Like or corresponding parts shall be denoted by like or corresponding reference characters throughout the views.
• A medical manipulator and a medical robot system according to embodiments of the present invention will be described below with reference toFIGS. 1 through 21.
• As shown inFIG. 1, amedical manipulator10cand amedical robot system12 according to a first embodiment of the present invention are particularly suitable for performing a laparoscopic surgical operation on apatient14.
• Themedical robot system12 comprises astation16 disposed near asurgical bed15, fourrobot arms18a,18b,18c,18dmounted on thestation16, and a console (controller)20 for controlling themedical robot system12 in its entirety. Therobot arm18cwill also be referred to as a first robot arm, and therobot arm18das a second robot arm. Therobot arms18athrough18dand theconsole20 may be connected to each other by a communication means comprising a wired link, a wireless link, a network, or a combination thereof. Theconsole20 is not required to control themedical robot system12 in its entirety, but therobot arms18athrough18dmay be feedback-controlled by internal controllers combined with themedical robot system12. Therobot arms18athrough18cmay be actuated under the control of theconsole20 for being operated according to automatic programmed operations or may be manually actuated byrespective joysticks80a,80b,80con theconsole20. Therobot arms18athrough18dalso may be actuated through a combination of automatic programmed operations and manually controlled operations.
• Therobot arms18athrough18chavemanipulators10a,10b,10cdisposed respectively on distal ends thereof. Therobot arm18dhas anendoscope24 on the distal end thereof. Themanipulators10athrough10cand theendoscope24 are inserted into abody cavity27 of the patient14 throughrespective trocars25. Thestation16 may comprise a plurality of stations supporting therespective robot arms18athrough18d. Themanipulators10athrough10cand theendoscope24 are removably mounted onto therespective robot arms18athrough18d.
• Each of therobot arms18athrough18dhas an articulated mechanism, e.g., a mechanism with six independent axes. Therobot arms18athrough18dare controlled by theconsole20, so as to set themanipulators10athrough10cand theendoscope24 at arbitrary postures and at arbitrary positions, within the operating ranges of therobot arms18athrough18d. Therobot arms18athrough18chave respective joint mechanisms includingrotary mechanisms22 for rotating themanipulators10athrough10cabout respective joints shafts (rod-shaped members)44.
• Therobot arms18athrough18dhaverespective slide mechanisms26 for moving themanipulators10athrough10cand theendoscope24 back and forth along the axes defined by the distal ends thereof, and respective lifting and loweringmechanisms28, which are movable vertically along thestation16. Therobot arms18athrough18dmay be structurally identical to each other, or may have different structures depending on the types ofmanipulators10athrough10cand theendoscope24 that are utilized.
• Themanipulators10a,10bmounted respectively on therobot arms18a,18bserve to perform direct surgical techniques on an affected region of thepatient14. A gripper, scissors, an electrosurgical knife, for example, are mounted onto distal-end working units of themanipulators10a,10b. Themanipulator10cmounted on therobot arm18ccomprises a retractor for retracting an organ in abody cavity27 or the like to a given place to allow the surgeon to have a wider operative field.
• Further structural details of themanipulator10cand a joint between themanipulator10cand therobot arm18cwill be described below. As shown inFIGS. 2 through 6, it is assumed that directions established with respect to themanipulator10cinclude X directions representing horizontal transverse directions of themanipulator10c, Y directions representing vertical transverse directions of themanipulator10c, and Z directions representing longitudinal directions of themanipulator10c, i.e., a joint shaft (rod-shaped member)44 thereof. The X directions include an X1 direction representing a rightward direction as viewed from the front of themanipulator10cand an X2 direction representing a leftward direction as viewed from the front of themanipulator10c. The Y directions include a Y1 direction representing an upward direction and a Y2 direction representing a downward direction. The Z directions include a Z1 direction representing a forward direction and a Z2 direction representing a rearward direction.
• As shown inFIG. 2, themanipulator10cis removably mounted on aslider40, which is disposed on the distal end of therobot arm18c. Theslider40 is slidable by theslide mechanism26. Theslider40 supports sevenmotors30a,30b,30c,30d,30e,30f,30gmounted therein in an array along the Z directions. Themotors30athrough30c(first actuator) serve to actuate a distal-end working unit46, and themotors30dthrough30g(second actuator) serve to actuate a first intermediate joint58 and a second intermediate joint60.
• Themanipulator10ccomprises a connectingblock42 for connection to theslider40, a hollowjoint shaft44 extending from the connectingblock42 in the Z1 direction, and a distal-end working unit46 mounted on the distal end of thejoint shaft44.
• The connectingblock42 is removably and replaceably mounted on theslider40 by a removable mounting mechanism. The connectingblock42 supports pulleys48a,48b,48c,48d,48e,48f,48gmounted thereon in an array along the Z directions and held in engagement with therespective motors30athrough38g. Themotors30athrough30gor thepulleys48athrough48ghave noncircular teeth, while thepulleys48athrough48gor themotors30athrough30ghave noncircular recesses. The noncircular teeth engage with the respective noncircular recesses for transmitting rotation of themotors30athrough30gto thepulleys48athrough48g.
• Wires50a,50b,50c,50d,50e,50f,50gare wound respectively around thepulleys48athrough48g. Thewires50athrough50c(first flexible member) are annular in shape, wherein portions thereof are fixed to thepulleys48athrough48cfor preventing slippage on thepulleys48athrough48c. Thewires50athrough50care wound in 1.5 turns around thepulleys48athrough48c, and extend in the Z1 direction inside thejoint shaft44. When thepulleys48athrough48care rotated about their own axes by themotors30athrough30c, one of the two left and right turns of each of thewires50athrough50cis wound around the pulley, and the other turn is paid out from the pulley. Thewires50athrough50care spaced from each other in the Y directions so as to be held out of interference with each other.
• Thepulleys48e,48ghave respective windingmembers52 around which thewires50e,50g(second flexible member) are wound. The connectingblock42 houses therein pairs ofidlers54a,54bfor guiding thewires50e,50gfrom the windingmembers52 to thejoint shaft44. Theidlers54a,54bin the pairs are disposed in obliquely upward and downward positions that are spaced from the windingmembers52 of thepulleys48e,48gin directions between the Z1 and Y1 directions and between the Z1 and Y2 directions, for guiding thewires50e,50gto upper and lower positions above and below the central axis of thejoint shaft44.
• When thepulleys48e,48gare rotated about their own axes by themotors30e,30g, one of the two upper and lower turns of each of thewires50e,50gis wound around the pulley, and the other turn is paid out from the pulley.
• As shown inFIG. 3, thepulley48dhas anarm56 extending in the X directions, and thewire50dhas opposite ends connected to the respective ends of thearm56. When thepulley48dis rotated about its own axis by themotor30d, one of the two left and right turns of thewire50dis wound in, and the other turn is wound off. Although not shown, thepulley48fand thewire50fare of a structure identical to thepulley48dand thewire50d. As thewires50d,50f(second flexible member) are not wound around thepulleys48d,48f, thepulleys48d,48fdo not operate as pulleys, but are referred to as pulleys for the sake of convenience.
• As shown inFIG. 2, thejoint shaft44 extends from the connectingblock42 in the Z1 direction, and the distal-end working unit46 is mounted on the distal end of thejoint shaft44. Thejoint shaft44 has a first intermediate joint58 and a second intermediate joint60 which are successively spaced from the distal end thereof. The first intermediate joint58 and the second intermediate joint60 are bent when thewires50dthrough50gare displaced back and forth in thejoint shaft44. The first intermediate joint58 may be located in any position (distance L1 inFIG. 2) within a range from 3 cm to 5 cm from the distal end of thejoint shaft44 including the distal-end working unit46. The second intermediate joint60 may be located in any position (distance L2 inFIG. 2) within a range from 7 cm to 12 cm from the distal end of thejoint shaft44 including the distal-end working unit46. With the first intermediate joint58 and the second intermediate joint60 being thus positioned, themanipulator10csuitably operates as a retractor in surgical techniques (seeFIGS. 14 through 17) inside thebody cavity27.
• As shown inFIG. 4, the first intermediate joint58 comprises a stacked array ofjoint rings62 that are angularly movable with respect to each other. InFIG. 4, the first intermediate joint58 is shown as comprising threejoint rings62. However, the number ofjoint rings62 is not limited to three, and the first intermediate joint58 may comprise a suitable number ofjoint rings62, e.g., 4 through 30 joint rings62.
• Each of the joint rings62 has a pair of V-shapedgrooves64 defined in one surface thereof in diametrically opposite relation to each other across the center of thejoint ring62, and also has a pair ofsemicylindrical ridges66 disposed on the other surface thereof in diametrically opposite relation to each other across the center of thejoint ring62. Thegrooves64 and theridges66 are angularly spaced 90° from each other. Adjacent two of the joint rings62 are arranged such that their pairs ofgrooves64 are angularly spaced 90° from each other, and are also joined to each other such that theridges66 of one of the joint rings62 are inserted in therespective grooves64 of the otherjoint ring62.
• Each of the joint rings62 has four throughholes67 defined therein at positions of thegrooves64 and theridges66. Thewires50d,50eextend respectively through the throughholes67 in the joint rings62 and have respective tip ends coupled to thejoint ring62 at the distal end side of the first intermediate joint58 in the Z1 direction. The joint rings62 are joined together into a substantially integral assembly.
• With theridges66 being inserted in therespective grooves64, gaps are left between the adjacent ones of the joint rings62, allowing theridges66 to being angularly moved in therespective grooves64. Therefore, the adjacent ones of the joint rings62 can be angularly moved with respect to each other. Although the joint rings62 of each adjacent pair are angularly movable through a small angle with respect to each other, the sum of the angles through which the joint rings62 of all adjacent pairs are angularly movable is large enough to allow the first intermediate joint58 to be bent through a desired angle, for example, in the range from about 60° to 120°. Accordingly, the distal-end working unit46 can be bent into an orientation not parallel to the longitudinal axis of thejoint shaft44.
• When thepulleys48d,48eare rotated a given angle about their own axes under the control of theconsole20, thewires50d,50eare displaced back and forth by the corresponding distance for thereby bending the first intermediate joint58 through a desired angle vertically and horizontally in a plane transverse to thejoint shaft44. In other words, the first intermediate joint58 is bent or curved actively by being pulled by thewires50d,50e. The first intermediate joint58 may be bent in desired directions and with a desired degree of freedom. Although not shown, the outer circumferential surface of each of the joint rings62 may be covered with a layer made of an elastic or flexible material.
• Each of the joint rings62 has acentral guide plate70 having sixguide holes68 defined therein, through which thewires50a,50b,50cextend. The sixguide holes68 are arranged in three pairs spaced apart in the Y directions, and are arrayed in two vertical rows spaced apart in the X directions. The sixguide holes68 are clustered near the central axis of theguide plate70. When the first intermediate joint58 is not bent, thewires50a,50b,50cextending through the guide holes68 are not bent, but extend straight. Although the joint rings62 are shown as having therespective guide plates70, at least one of the joint rings62 may have acentral guide plate70.
• When the first intermediate joint58 is bent, thewires50athough50care guided through the guide holes68 against being unduly displaced or bent, and are held out of contact with each other and remain in respective appropriate positions.
• As shown inFIG. 5, the second intermediate joint60 is essentially identical in structure to the first intermediate joint58, and comprises a stacked array ofjoint rings62 each having four additional throughholes72 defined respectively adjacent to the four throughholes67. Thewires50f,50gextend respectively through the throughholes67 in the joint rings62, and act in the same manner as thewires50d,50ein the first intermediate joint58, for actively bending or curving the second intermediate joint60. Thewires50d,50eextend respectively through the throughholes72 and further extend toward the first intermediate joint58 in the Z1 direction.
• The first intermediate joint58 and the second intermediate joint60 are covered with respective bellows-like or flexible and bendable sheaths. The other portion of thejoint shaft44 than the first intermediate joint58 and the second intermediate joint60 is made of a hard material.
• As shown inFIG. 6, the distal-end working unit46 is mounted on the distal end of thejoint shaft44, and comprises at least a pulley (rotor) around which thewire50ais wound, a pulley around which thewire50bis wound, and a pulley around which thewire50cis wound. When thewires50a,50b,50care moved back and forth upon rotation of thepulleys48a,48b,48cin the connectingblock42, the pulleys in the distal-end working unit46 are driven to rotate, causing the distal-end working unit46 to move about three axes. The motions of the distal-end working unit46 include angular motions about a pitch axis (distal-end joint)74 and a yaw axis (distal-end joint)75 and opening and closing motions of agripper78, for example. Thegripper78 comprises a pair of gripper arms, one or both of which are openable. The distal-end working unit46 may be of the same mechanism as the distal-end working unit of the medical manipulator disclosed in Japanese Laid-Open Patent Publication No. 2003-061969, for example.
• Since the first intermediate joint58, the second intermediate joint60, thepitch axis74, the yaw axis75, and thegripper78 can possibly cause a mutual interference, theconsole20 calculates an amount of interference and controls thewires50athrough50gto move back and forth to compensate for an interfering movement. In other words, theconsole20 controls thewires50athrough50gsuch that when it moves one of the movable members, it prevents the other from unnecessarily moving due to such an interfering movement.
• Themanipulators10a,10bmay be of a structure which is free from the first intermediate joint58, the second intermediate joint60, themotors30dthrough30f, thewires50dthrough50f, and thepulleys48dthrough48fof themanipulator10c, and which is otherwise the same as themanipulator10c. Alternatively, themanipulators10a,10bmay be structurally identical to themanipulator10c.
• As shown inFIG. 7, theconsole20 has threejoysticks80a,80b,80cas manual control units, a display monitor82 (seeFIG. 1), two trackballs (rotary input means)84a,84b, enableswitches86a,86bfor enabling or disabling input actions of thetrackballs84a,84b, and returnswitches88a,88b. The display monitor82 displays information about an endoscopic image captured by theendoscope24 and other information. Thetrackballs84a,84bare spaced from each other at a central area on the upper surface of the control table of theconsole20. The return switches88a,88bare disposed behind therespective trackballs84a,84b. The enable switches86a,86bcomprise arcuately-shaped momentary switches disposed around respectively partly circumferential surfaces of thetrackballs84a,84b.
• The operator can operate thejoysticks80a,80b,80cto move therobot arms18a,18b,18cindividually. Therobot arm18dcan be operated by another input means, not shown. Thejoysticks80a,80bare positioned at respective left and right positions where they can easily be operated by the operator. Thejoystick80cis positioned in a central position behind thejoysticks80a,80b.
• Thejoysticks80a,80b,80care vertically movable, twistable, and tiltable in all directions for moving therobot arms18a,18b,18caccording to the joystick motions. When thejoysticks80a,80b,80care released from the hands of the operator, they automatically return to their upright reference orientations shown inFIG. 7 with therobot arms18a,18b,18cbeing kept in their displaced positions. Thejoysticks80a,80b,80care basically identical in structure to each other, and have ahandle grip100 which is gripped by a human hand, atrigger lever102 which is pushed and pulled mainly by an index finger and a middle finger, and acomposite input pad104 which is gripped mainly by a thumb. When thetrigger lever102 is operated, thegripper78 is opened and closed. Thecomposite input pad104 includes horizontal and vertical see-saw switches104a,104bdisposed centrally thereof in a crisscross pattern. When the horizontal see-saw switch104ais operated, the distal-end working unit46 is tilted about the yaw axis75, and when the vertical see-saw switch104bis operated, the distal-end working unit46 is tilted about thepitch axis74.
• Therobot arms18a,18b,18ccan be operated in an absolute coordinate (world coordinate) operation mode and a tool coordinate operation mode, for example.
• In the absolute coordinate operation mode, themanipulator10ccoacts with therobot arm18c(including the slide mechanism26) connected thereto based on an input action of thejoystick80c. At this time, the position of the distal-end working unit46 is set based on absolute coordinates depending on the movement of thehandle grip100, and the orientation of the distal-end working unit46 is set based on input actions of the see-saw switches104a,104b.
• In the tool coordinate operation mode, themanipulator10ccoacts with therobot arm18c(including the slide mechanism26) connected thereto based on an input action of thejoystick80c, for moving the distal-end working unit46 back and forth in a constant posture based on a tool coordinate system according to the posture of the distal-end working unit46.
• For example, as shown inFIG. 8, according to the posture of the distal-end working unit46 at the time, a tool coordinate system having orthogonal axes Zt₀, Xt₀, Yt₀(the axis Yt₀is omitted from illustration) is established, and the distal-end working unit46 is operated based on the established tool coordinate system. The distal-end working unit46 is moved from an imaginary-line position to a solid-line position while thegripper78 is extending along the coordinate axis Zt₀. At this time, the position of a hypothetical reference point P1 at the trocar25 (pivot point) and the posture of the distal-end working unit46 are kept constant.
• Thejoysticks80a,80b,80cmay be replaced with amaster arm200 shown inFIG. 9.
• As shown inFIG. 9, themaster arm200 comprises apivot shaft202, a firstU-shaped member204, a secondU-shaped member206, and a pair oftongue members208. The firstU-shaped member204 is open upwardly and rotatably mounted on the upper end of thepivot shaft202 for rotation in a horizontal plane. The angle through which the firstU-shaped member204 is rotated with respect to thepivot shaft202 is detected by arotation sensor210 and reflected in the motion of the distal-end working unit46 about the yaw axis75.
• The secondU-shaped member206 is smaller in size than the firstU-shaped member204, and is disposed in the firstU-shaped member204. The firstU-shaped member204 and the secondU-shaped member206 have their ends rotatably connected to each other. The secondU-shaped member206 is rotatable in a vertical plane with respect to the firstU-shaped member204. The angle through which the secondU-shaped member206 is rotated with respect to the firstU-shaped member204 is detected by arotation sensor212 and reflected in the motion of the distal-end working unit46 about thepitch axis74.
• Thetongue members208 are rotatably mounted on an intermediate portion of the secondU-shaped member206 by ashaft214. The angle through which theshaft214 is rotated with respect to the secondU-shaped member206 is detected by arotation sensor216 and reflected in the operation of the rotary mechanisms22 (seeFIG. 1).
• Thetongue members208 are openable and closable with respect to, i.e., movable toward and away from, each other about theshaft214. The angle through which thetongue members208 are opened or closed with respect to each other is detected by aninternal sensor218 and reflected in the opening and closing motion of thegripper78.
• Themaster arm200 is displaceable as a whole in the X, Y, and Z directions shown inFIG. 9. The positions of themaster arm200 in the X, Y, and Z directions with respect to theconsole20 can be detected by a sensor, not shown. Themaster arm200 may be tilted in the X and Y directions with respect to theconsole20 by tilting mechanisms. The detected position of themaster arm200 in the X, Y, and Z directions with respect to theconsole20 are reflected in the absolute coordinates of the distal-end working unit46. Themaster arm200 is thus capable of indicating six parameters with respect to the position and orientation of the distal-end working unit46, and also of instructing thegripper78 to be opened and closed.
• When themaster arm200 is released from the operator's hands, themaster arm200 may be returned to its home position shown inFIG. 9 under the bias of resilient members, not shown, with therobot arms18a,18b,18cbeing kept in their displaced positions.
• In the tool coordinate operation mode, the distal-end working unit46 may be moved along another coordinate axis Zt or in directions along the coordinate axis Zt or in a combination of those directions. In the tool coordinate operation mode, when themaster arm200 is operated, the directions in which the distal-end working unit46 moves laterally, i.e., the X directions inFIG. 9, correspond to a coordinate axis Xt, the directions in which the distal-end working unit46 moves back and forth, i.e., the Y directions inFIG. 9, correspond to a coordinate axis Yt, and the directions in which the distal-end working unit46 moves vertically, i.e., in the Z directions inFIG. 9, correspond to a coordinate axis Zt.
• In the tool coordinate operation mode, the posture of therobot arm18cmay be determined by setting the position and posture of the distal-end working unit46, defining the position of the hypothetical reference point P1, and performing known matrix transform calculations. The distal-end working unit46 may also be operated in the tool coordinate operation mode with thejoystick80cor themaster arm200.
• In the tool coordinate operation mode, the distal-end working unit46 can easily be operated to retract an organ in thebody cavity27.
• Thetrackball84aserves as an input means for operating the first intermediate joint58 of themanipulator10c.
• Based on an input action of thetrackball84ain an intermediate joint operation mode, themanipulator10ccoacts with therobot arm18c(including the slide mechanism26) connected thereto to bend the first intermediate joint58 with the distal-end working unit46 being kept in constant position and posture.
• For example, as shown inFIG. 10, there is assumed a sphere (hypothetical spherical surface)110 defined around the position P2 of the distal-end joint (thepitch axis74 and the yaw axis75) of the distal-end working unit46 at the time, thesphere110 having a radius equal to the distance r1 from the position P2 to the first intermediate joint58, and the first intermediate joint58 (indicated by a point P3 inFIGS. 10 and 11) is moved along the surface of thesphere110 from an imaginary-line position to a solid-line position. At this time, the position of the hypothetical reference point P1 at thetrocar25 and the position and posture of the distal-end working unit46 are kept constant.
• If the first intermediate joint58 can be bent either vertically or laterally only, then the first intermediate joint58 may be moved along a given hypothetical arc instead of thesphere110.
• In the intermediate joint operation mode, as shown inFIG. 11, orthogonal coordinate axes Xp, Yp extending across the first intermediate joint58 along thesphere110 are established based on the orientation of the distal-end working unit46 or the orientation of theoverall manipulator10cat the time. At this time, when thetrackball84ais operated, the directions in which it is angularly moved laterally correspond to the coordinate axis Xp, and the directions in which it is angularly moved back and forth correspond to the coordinate axis Yp. The first intermediate joint58 is also bendable in all directions other than the coordinate axes Xp, Yp. When thetrackball84ais angularly moved in a given direction, the first intermediate joint58 is bent depending on the direction in which thetrackball84ais angularly moved and the angular amount by which thetrackball84ais angularly moved. When thetrackball84ais stopped, the first intermediate joint58 stops being bent. When the first intermediate joint58 reaches a limit of its bending range in a given direction, a bending command for bending the first intermediate joint58 further in that direction is disabled.
• In the intermediate joint operation mode, another rotary input means may be employed rather than thetrackball84a. For example, thejoystick80cmay be employed such that the directions in which it is tilted laterally correspond to the coordinate axis Xp and the directions in which it is tilted back and forth correspond to the coordinate axis Yp.
• In the intermediate joint operation mode, the posture of therobot arm18cmay be determined by setting the position and posture of the distal-end working unit46, defining the positions of the hypothetical reference point P1 and the first intermediate joint58, and performing known matrix transform calculations.
• For operating the first intermediate joint58, the enable switch86ais pressed to enable thetrackball84a. If the enable switch86ais not pressed, then thetrackball84aremains disabled, and the first intermediate joint58 is prevented from being moved when thetrackball84ais operated carelessly.
• When the return switch88ais pressed, the first intermediate joint58 automatically returns to a zero-bend-angle state (seeFIG. 2) at a predetermined speed. With the first intermediate joint58 in the zero-bend-angle state, thejoint shaft44 can easily be pulled out of thetrocar25. The return switch88ais a momentary switch which is enabled only when it is pressed. When the return switch88ais released, the returning motion of the first intermediate joint58 is interrupted, allowing the operator to confirm the state of the first intermediate joint58.
• In the intermediate joint operation mode, the second intermediate joint60 can also be bent by thetrackball84b, the enableswitch86b, and thereturn switch88b. Thetrackball84b, the enableswitch86b, and thereturn switch88boperate in the same manner as thetrackball84a, the enable switch86a, and the return switch88a.
• The second intermediate joint60 can be controlled according to a plurality of control processes, which can be selected. According to a first control process, as shown inFIG. 12, there is assumed asphere112 around the first intermediate joint58, thesphere112 having a radius equal to the distance r2 from the first intermediate joint58 to the second intermediate joint60, and the second intermediate joint60 is moved along the surface of thesphere112 from an imaginary-line position to a solid-line position. At this time, the position of the hypothetical reference point P1 at thetrocar25, the position and posture of the distal-end working unit46, and the position and posture of alink114 extending from the point P2 to the first intermediate joint58 are kept constant. According to the first control process, the first intermediate joint58 is also bent in coaction with the second intermediate joint60 as it is bent.
• According to a second control process, as shown in FIG.13, there is assumed asphere116 defined around the position P2 of the distal-end joint (thepitch axis74 and the yaw axis75) of the distal-end working unit46 at the time, thesphere116 having a radius equal to the distance r3 from the position P2 to the second intermediate joint60, and the second intermediate joint60 is moved along the surface of thesphere116 from an imaginary-line position to a solid-line position. At this time, the position of the hypothetical reference point P1 at thetrocar25 and the position and posture of the distal-end working unit46 are kept constant. According to the second control process, the first intermediate joint58 remains bent.
• The first intermediate joint58 and the second intermediate joint60 may automatically be moved according to a program or a teaching process, rather than being controlled based on the operation of thetrackballs84a,84b.
• Operation of themanipulator10cand themedical robot system12 thus constructed will be described below.
• First, a gas is introduced around the affected region of the patient to form thebody cavity27, and the distal-end working units46 and thejoint shaft44 of themanipulator10care inserted through thetrocar25. The state in thebody cavity27 is confirmed based on an endoscopic image captured by theendoscope24 that has been inserted into thebody cavity27.
• Prior to a surgical technique to be performed on anaffected region118, other organs that exist around theaffected region118 are retracted to given regions to provide a wide operative field in thebody cavity27.
• For example, as shown inFIG. 14, for retracting alarge intestine120, the distal-end working unit46 is bent around thepitch axis74 and the yaw axis75 into an orientation substantially perpendicularly to an appropriate portion of thelarge intestine120. Thereafter, thegripper78 grips thelarge intestine120 lightly.
• Then, as shown inFIG. 15, the distal-end working unit46 is moved forward to retract thelarge intestine120 to a deeper region. At this time, in order to keep the distal-end working unit46 and the gripped portion of thelarge intestine120 oriented relatively to each other, the distal-end working unit46 may be pushed in the direction of a coordinate axis Zt1 in the tool coordinate operation mode (seeFIG. 8).
• By thus retracting thelarge intestine120, thelarge intestine120 is sufficiently spaced from the affectedregion118, allowing the surgeon to perform a surgical operation on theaffected region118. Themanipulator10cthus acts as a retractor. In some instances, even when thelarge intestine120 is retracted away from the affectedregion118 by themanipulator10c, themanipulator10cmay be positioned across thebody cavity27, failing to provide a wide operative field in thebody cavity27.
• To avoid the above difficulty, at least one of the first intermediate joint58 and the second intermediate joint60 of themanipulator10cis bent.
• For example, as shown inFIG. 16, in the intermediate joint operation mode, the first intermediate joint58 is bent to make thelink114 substantially parallel to thelarge intestine120. Thus, thejoint shaft44 is spaced from the affectedregion118, providing a wideoperative field122 around theaffected region118. The surgeon finds it easy to perform a surgical procedure on theaffected region118 with theother manipulators10a,10b. As a result, the time required to perform the surgical operation may be shortened.
• Although the wideoperative field122 is provided simply by bending the first intermediate joint58, the second intermediate joint60 may instead be bent to provide a wideroperative field124, as shown inFIG. 17. For bending the second intermediate joint60, one or both of the first control process (seeFIG. 12) and the second control process (seeFIG. 13) may be carried out.
• In this case, it is assumed that the distal-end working unit46 has an axis S1, thelink114 has an axis S2, and alink129 extending from the first intermediate joint58 to the second intermediate joint60 has an axis S3. The second intermediate joint60 may be bent such that the axes S2, S3 are held in alignment with each other.
• For retracting thelarge intestine120, it may not be gripped by thegripper78, but may be engaged and pushed by a distal-end action unit130 (seeFIG. 18) having a folding-fan-like mechanism. The distal-end action unit130 may comprise a membrane extending between two openable gripper arms. Since the distal-end action unit130 does not grip thelarge intestine120, it is less detrimental to thelarge intestine120. When the distal-end action unit130 is folded by closing the openable gripper arms, it can easily be inserted through thetrocar25.
• With themanipulator10caccording to the present embodiment, thegripper78 can be adjusted in orientation about thepitch axis74 and the yaw axis75 of the distal-end joint for performing an appropriate surgical procedure on the affected region. If themanipulator10cis used as a retractor, then thegripper78 can appropriately be oriented to an organ such as thelarge intestine120. Furthermore, since thejoint shaft44 of themanipulator10ccan be bent at the first intermediate joint58 and the second intermediate joint60, thejoint shaft44 can be appropriately placed around the affected region to provide a wide operative field in thebody cavity27. Particularly, the bendablejoint shaft44 is preferable to avoid physical interference with theother manipulators10a,10bin thebody cavity27.
• Themanipulator10cis connected to therobot arm18c, and therobot arm18ccoacts with themanipulator10cto move themanipulator10cback and forth and tilt themanipulator10cwith respect to the reference point P1 at thetrocar25 for achieving appropriate manipulator motions.
• With themedical robot system12 according to the present embodiment, themanipulator10cis used to retract an organ or organs in thebody cavity27 to a given region to provide a wide operative field in thebody cavity27. Inasmuch as thejoint shaft44 is bendable at the first intermediate joint58 and the second intermediate joint60, thejoint shaft44 can appropriately be positioned in thebody cavity27 to provide a wider operative field in thebody cavity27 and also to avoid physical interference with theother manipulators10a,10bfor allowing the surgeon to perform a surgical procedure with ease.
• The first intermediate joint58 and the second intermediate joint60 are movable on a hypothetical sphere or a hypothetical arc around a given reference point depending on the angular amount by which and the direction in which thetrackballs84a,84bare angularly moved. Thetrackballs84a,84ballow the operator to bend the first intermediate joint58 and the second intermediate joint60 appropriately with ease and also intuitively in a manner to fit the feeling of the operator.
• FIG. 19 is a schematic view illustrative of a medical robot system according to a second embodiment of the present invention.FIG. 19 showsmanipulators10d,10eand anendoscope24, which are constituent elements of the medical robot system.
• The medical robot system according to the second embodiment differs from the medical robot system10 according to the first embodiment in that themanipulator10dhaving a different structure from themanipulator10ais provided at the distal end of therobot arm18aand themanipulator10ehaving a different structure from themanipulator10bis provided at the distal end of therobot arm18b.
• A rod-shapedmember44d of themanipulator10dhas an intermediate joint60din an intermediate portion thereof, and a rod-shapedmember44e of themanipulator10ehas an intermediate joint60ein an intermediate portion thereof. Theintermediate joints60d,60ehave the same structure as the first intermediate joint58 shown inFIGS. 2 and 4. More specifically, themanipulators10d,10ehave such a structure that the second intermediate joint60 is eliminated from the manipulator10 shown inFIG. 2. In the structure shown inFIG. 19, an end effector provided at the distal end of themanipulator10dis configured asscissors79, and an end effector provided at the distal end of themanipulator10eis configured as agripper78.
• Themanipulators10d,10ecan be operated using operation input means shown inFIG. 7. More specifically, an operator operates joysticks (first and second input means)80a,80bto move and open/close distal-end working units76d,76eof themanipulators10d,10eand change the posture thereof. Further, the operator can operatetrackballs84a,84bto move theintermediate joints60d,60e. Incidentally, thetrackballs84a,84bmay be omitted. In this case, a switch may be provided to select an object(s) to be operated, and the operator may operate thejoysticks80a,80bto move theintermediate joints60d,60e.
• As shown inFIG. 19, themanipulators10d,10eand theendoscope24 are inserted into abody cavity27 of a patient14 through a commontrocar supporting member125. The operator captures images of an affected region and its peripheral portions with theendoscope24, while performs a given surgical procedure on the affected region with the end effectors (gripper78 and scissors79) provided at the distal end of themanipulators10d,10e. That is, the medical robot system according to the second embodiment enables the operator to perform a surgical procedure by single port access.
• More specifically, thetrocar supporting member125 has a plurality of holes (three holes in the present embodiment), into which thetrocars25ato25care hermetically inserted, respectively. Thetrocars25a,25bare adapted for themanipulators10d,10e, whereas thetrocar25cis adapted for theendoscope24. If the outer diameter of the rod-shapedmembers44d,44eof themanipulators10d,10ehas the same size as the inner diameter of theendoscope24, thetrocars25a,25band thetrocar25cmay have the same structure.
• A laparoscopic surgical operation process is performed using the medical robot system according to the second embodiment by single port access in the following manner.
• First, thetrocar supporting member125 is inserted into thepatient14. Next, thetrocars25a,25bfor themanipulators10d,10eand thetrocar25cfor theendoscope24 are inserted into thetrocar supporting member125. Then, the twomanipulators10d,10eand theendoscope24 are inserted into thebody cavity27 of the patient14 through thetrocars25a,25b,25c, respectively. In this case, as shown inFIG. 19, the rod-shapedmembers44d,44eof themanipulators10d,10eare straightened, and then they are inserted such that the rod-shapedmembers44d,44eintersect with each other.
• After the rod-shapedmembers44d,44eare inserted to a certain extent, theintermediate joints60d,60eare bent in such a direction that the end effectors (gripper78 and scissors79) approach each other. Next, an observing point of theendoscope24 is secured in order that images of a portion to be treated and the distal-end working units76d,76ecan be captured with theendoscope24. Then, the operator performs a given surgical procedure on the portion to be treated, with the end effectors. In a surgical example shown inFIG. 19, atissue121 within thebody cavity27 is gripped with thegripper78, while amembranous tissue140 near thetissue121 is cut out with thescissors79.
• With the medical robot system according to the second embodiment, when a surgical procedure is performed by single port access, the distal-end working units76 having the end effectors can be moved closer to each other by bending the rod-shapedmembers44d,44eof the twomanipulators10d,10ewhich intersect with each other at thetrocar supporting member125, by means of theintermediate joints60d,60e. Thus, a surgical procedure by single port access can be performed suitably.
• As shown inFIG. 19, when the rod-shapedmembers44d,44eof themanipulators10d,10eintersect with each other, the proximal end portion of themanipulator10dis located on the left side, while the proximal end portion of themanipulator10eis located on the right side. Accordingly, the positional relation of the proximal end portions is opposite to the positional relation of the distal-end working units76d,76e. For easier understanding, the field of view of the endoscope24 (image captured with the endoscope24), i.e., the area that is displayed on the screen of the monitor82 (seeFIG. 1), is represented by reference character A. As described above, the proximal end of themanipulator10dis located on the left side whereas the distal-end working unit76dof themanipulator10dis located on the right side on the screen of themonitor82. Similarly, the proximal end of themanipulator10eis located on the right side whereas the distal-end working unit76eof themanipulator10eis located on the left side on the screen of themonitor82.
• If theleft joystick80ainFIG. 7 always serves to operate theleft manipulator10dand theright joystick80balways serves to operate theright manipulator10e, an operator has to operate thejoysticks80a,80bwhile imagining a positional relation that is left-and-right reverse to the positional relation of the distal-end working units76d,76eon the screen. Accordingly, the operator can not operate the manipulators intuitively.
• Thus, when themanipulators10d,10eare inserted into thebody cavity27 such that the rod-shapedmembers44d,44eintersect with each other, the console20 (seeFIG. 1) may control operation of themanipulators10d,10ein a left-and-right reverse operation mode to be described below. In the left-and-right reverse operation mode, theconsole20 operates themanipulator10ewhose distal-end working unit76eis located on the left side on the screen of themonitor82, based on input operation of theleft joystick80a, while theconsole20 operates themanipulator10dwhose distal-end working unit76dis located on the right side on the screen of themonitor82, based on input operation of theright joystick80b.
• By setting the left-and-right reverse operation mode, even if themanipulators10d,10eare inserted into thebody cavity27 with the rod-shapedmembers44d,44eintersecting with each other, the operator can operate the manipulators intuitively in a manner to fit the feeling of the operator, because operation by the left hand of the operator is reflected on the movement of themanipulator10ewhose distal-end working unit76eis located on the left side on the screen, and operation by the right hand of the operator is reflected on the movement of themanipulator10dwhose distal-end working unit76dis located on the right side on the screen.
• In this case, a switch may be provided onto theconsole20, for enabling/disabling the left-and-right reverse operation mode, and the operator may manually operate the switch to cause the console to control operation of the manipulators in the left-and-right reverse operation mode.
• Alternatively, theconsole20 may determine whether the rod-shapedmembers44d,44eintersect with each other or not, based on the positional coordinates of themanipulators10d,10e, and when theconsole20 determines that the rod-shapedmembers44d,44eintersect with each other, theconsole20 may automatically set the left-and-right reverse operation mode. In this case, the operator does not need to determine by oneself whether the rod-shapedmembers44d,44eintersect with each other or not, and burden on the operator is thus reduced.
• FIG. 20 is a schematic view illustrative of a medical robot system according to a third embodiment of the present invention.FIG. 20 showsmanipulators10c,10dand anendoscope24, which are constituent elements of the medical robot system.
• The medical robot system according to the third embodiment is a medical robot system in which themanipulator10c(seeFIG. 2) of the medical robot according to the first embodiment, instead of themanipulator10e, is applied to the medical robot system according to the second embodiment. Themanipulator10dthat is provided at the distal end of therobot arm18ahas the same structure as themanipulator10daccording to the second embodiment.
• As described above, themanipulator10chas the first intermediate joint58 and the second intermediate joint60, and accordingly the rod-shapedmember44 can be bent at two points. Thus, themanipulator10chas greater flexibility to its possible shape, compared to themanipulator10e(seeFIG. 19). Thetrocar supporting member125 and thetrocars25ato25chave the same structures as thetrocar supporting member125 and thetrocars25ato25cshown inFIG. 19, respectively.
• Themanipulators10c,10dcan be operated by means of operation input means21 of aconsole20ashown inFIG. 21. Theconsole20ahaving the operation input means21 differs from theconsole20 shown inFIG. 7 in that theconsole20afurther comprises twotrackballs84c,84dand two enableswitches86c,86d. More specifically, an operator can operate thejoysticks80a,80bto move and open/close distal-end working units76,76dof themanipulators10c,10dand change the posture thereof, and also operate thetrackballs84ato84dto actuate the intermediate joint60d, the first intermediate joint58 and the second intermediate joint60.
• Theconsole20acan execute the left-and-right reverse operation mode, as with theconsole20 according to the second embodiment. Accordingly, when themanipulators10c,10dintersect with each other, themanipulator10cwhose distal-end working unit76 is located on the left side is operated based on input operation by theleft joystick80a, and themanipulator10dwhose distal-end working unit76dis located on the right side is operated based on input operation by theright joystick80b. In this case, one (e.g., trackball84aat the back) of the twoleft trackballs84a,84cserves to operate the first intermediate joint58, while the other trackball (e.g.,trackball84cat the front) serves to operate the second intermediate joint60. Further, one of the tworight trackballs84b,84dserves to operate the intermediate joint60d.
• When themanipulators10c,10ddo not intersect with each other, themanipulator10dis operated based on input operation by theleft joystick80a, while themanipulator10cis operated based on input operation by theright joystick80b. In this case, one of the twoleft trackballs84a,84cserves to operate the intermediate joint60d. Also, one (e.g.,trackball84bat the back) of the tworight trackballs84b,84dserves to operate the first intermediate joint58, and the other trackball (e.g.,trackball84dat the front) serves to operate the second intermediate joint60.
• Incidentally, as with the operation input means of theconsole20 shown inFIG. 7, thetrackballs84a,84bmay be provided on the left side and on the right side, respectively. In this case, a switch may be provided to select an object to be operated based on input operation by each of thetrackballs84a,84b. For example, the switch may be configured such that the operator can switch between one mode where operation by thetrackball84a(or thetrackball84b) is reflected on the movement of the intermediate joint60dand anther mode where operations by thetrackballs84a,84bare reflected on the movements of the first and secondintermediate joints58,60, respectively.
• A laparoscopic surgical operation process is performed using the medical robot system according to the third embodiment by single port access in the following manner. First, thetrocar supporting member125 is inserted into thepatient14. Next, thetrocars25a,25bfor themanipulators10c,10dand thetrocar25cfor theendoscope24 are inserted into thetrocar supporting member125. Then, the twomanipulators10c,10dand theendoscope24 are inserted into thebody cavity27 of the patient14 through thetrocars25a,25b,25c, respectively. In this case, as shown inFIG. 20, the rod-shapedmembers44,44dof themanipulators10c,10dare straightened, and then they are inserted such that the rod-shapedmembers44,44dintersect with each other.
• After the rod-shapedmembers44,44dare inserted to a certain extent, the first and secondintermediate joints58,60 of themanipulator10care bent, so that an organ142 (obstacle to an operative field) is pushed aside (retracted) with the rod-shaped member44 (link114 inFIG. 20) for a wider operative field. After the wider operative field has been thus secured, the intermediate joint60dof the rod-shapedmember44dare bent and the first and secondintermediate joints58,60 are further bent so as to move the end effectors closer to each other.
• Next, an observing point of theendoscope24 is secured in order that images of a portion to be treated and the distal-end working units76,76dcan be captured with theendoscope24. Then, the operator performs a given surgical procedure on the portion to be treated, with the end effectors. In a surgical example shown inFIG. 20, atissue121 within thebody cavity27 is gripped with thegripper78, while amembranous tissue140 near thetissue121 is cut out with thescissors79.
• With the medical robot system according to the third embodiment, the distal-end working units76,76dhaving the end effectors can be moved closer to each other by operation of the intermediate joint60dand the first and secondintermediate joints58,60. Thus, in the third embodiment, a surgical procedure can be performed suitably by single port access, as in the second embodiment.
• Also, with the third embodiment, themanipulator10cserving as a retractor performs an operation (e.g., gripping) on an affected region with the end effector provided at the distal end thereof, while themanipulator10cpushes aside the organ142 (obstacle to the operative field) with the rod-shapedmember44 having a plurality of intermediate joints. In this manner, onemanipulator10cdoubles as a forceps and a retractor. As a result, a surgical procedure can be performed using a smaller number of manipulators. Also, the trocar for a retractor can be omitted, and thus a much less-invasive surgery can be achieved.
• Although certain preferred embodiments of the present invention have been shown and described in detail, it should be understood that various changes and modifications may be made therein without departing from the scope of the appended claims.

Claims (13)

1. A medical manipulator comprising:

a rod-shaped member housing therein a first flexible member actuatable by a first actuator and a second flexible member actuatable by a second actuator, said rod-shaped member being flexible at least partly;

at least one distal-end joint disposed on a distal end of said rod-shaped member, said distal-end joint being angularly movable by a rotor around which said first flexible member is wound; and

at least one intermediate joint disposed on said rod-shaped member more closely to a proximal end thereof than said distal-end joint, said intermediate joint being bendable in response to back-and-forth movement of said second flexible member.

2. A medical manipulator according toclaim 1, wherein said rod-shaped member includes at least one guide plate having a hole defined therein through which said first flexible member extends.

3. A medical manipulator according toclaim 1, which is connected to a robot arm, wherein said robot arm is controlled to insert said rod-shaped member through a trocar into a body cavity and to move back and forth and tilt said rod-shaped member with respect to said trocar.

4. A medical manipulator according toclaim 1, wherein said intermediate joint includes a first intermediate joint and a second intermediate joint which are successively arranged from the distal end of said rod-shaped member;

said first intermediate joint is disposed in a position within a range from 3 cm to 5 cm from the distal end of said rod-shaped member; and

said second intermediate joint is disposed in a position within a range from 7 cm to 15 cm from the distal end of said rod-shaped member.

5. A medical robot system comprising:

a plurality of first robot arms supporting respective manipulators thereon;

a second robot arm supporting an endoscope thereon; and

a controller for controlling said first robot arms and said second robot arm;

each of said manipulators including a rod-shaped member for insertion through a trocar into a body cavity, and a distal-end working unit mounted on a distal end of said rod-shaped member and having at least one joint;

wherein at least one of said manipulators comprises a retractor and has at least one intermediate joint disposed in said rod-shaped member for bending said rod-shaped member.

6. A medical robot system according toclaim 5, wherein said retractor coacts with one of said first robot arms connected thereto in a predetermined operation mode for moving said distal-end working unit back and forth while keeping a posture of the distal-end working unit constant, in a coordinate system based on the posture of said distal-end working unit.

7. A medical robot system according toclaim 5, wherein said retractor coacts with one of said first robot arms connected thereto in a predetermined operation mode for bending said intermediate joint while keeping a position and a posture of said distal-end working unit constant.

8. A medical robot system according toclaim 7, further comprising:

rotary input means for moving said intermediate joint on a hypothetical sphere or a hypothetical arc around a predetermined reference point on said rod-shaped member, depending on an angular amount by which and a direction in which said rotary input means is angularly moved.

9. A medical robot system according toclaim 8, wherein said rotary input means comprises a trackball.

10. A medical robot system according toclaim 8, further comprising:

a switch for selectively enabling and disabling said rotary input means.

11. A medical robot system comprising:

a plurality of first robot arms supporting respective manipulators thereon;

a second robot arm supporting an endoscope thereon; and

a controller for controlling said first robot arms and said second robot arm;

said manipulators and said endoscope being inserted into a body cavity through a common trocar supporting member,

wherein each of said manipulators includes a rod-shaped member for insertion through said trocar supporting member into said body cavity, a distal-end working unit mounted on a distal end of said rod-shaped member and having at least one joint, and at least one intermediate joint disposed in said rod-shaped member for bending said rod-shaped member.

12. A medical robot system according toclaim 11, wherein at least one of said manipulators serves as a retractor, and said rod-shaped member of said at least one manipulator serving as the retractor includes a plurality of said intermediate joints.

13. A medical robot system according toclaim 11, further comprising:

a monitor for displaying an image captured with said endoscope;

first input means which is operated by the left hand of an operator; and

second input means which is operated by the right hand of said operator,

wherein, when said rod-shaped members of two of said manipulators intersect with each other at said trocar supporting member, said manipulator that is located on the left side on a screen of said monitor is operated based on input operation by said first input means, and said manipulator that is located on the right side on said screen of said monitor is operated based on input operation by said second input means.

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