Surgical instrument holding device and surgical assisting device

Abstract

Provided are an adapter to which a surgical instrument is detachably attached, a partition to which the adapter is detachably attached, a holding body to which the partition is detachably attached, and a driving body that rotatably supports the holding body and applies a driving force to the holding body. The partition is provided with a receiving portion. The adapter is provided with an engaging portion that elastically deforms when the adapter is attached to the partition and a pushing portion that is pushed against the receiving portion. The pushing portion is pushed against the receiving portion, and the engaging portion engages the receiving portion in an elastically returned state, whereby the adapter is attached to the partition.

Description

Technical Field

[0001] This invention relates to the technical field of surgical instrument holding devices for holding surgical instruments and surgical aids equipped with surgical instrument holding devices. Background Technology

[0002] In recent years, surgical procedures using surgical aids have become increasingly common. Such surgical aids consist of multiple movable bodies connected in a rotatable manner. These movable bodies are rotated by a drive force, and the movable body at one end in the connection direction is configured as a retainer. These movable bodies are configured as arms or joints, and surgical instruments are held in the retainer, with a portion (the proximal end) of the instrument inserted into the patient's body cavity. Depending on the type and condition of the surgery, endoscopes, forceps, etc., are used as surgical instruments.

[0003] In surgical aids, when multiple movable bodies rotate in predetermined directions, the position and posture of the surgical instruments change along with the rotation of the movable bodies, allowing the front end of the surgical instruments to be inserted into the patient's body cavity to perform surgery.

[0004] Surgical procedures using such surgical aids are generally performed remotely by the surgeon (physician) through a master-slave operation, controlling the surgical aids located in the operating room. During such surgeries, a pivot point is established as a reference point for the position and orientation of the surgical instruments.

[0005] The pivot point is located approximately at the same point as the incision made within the patient's body cavity for inserting surgical instruments. When using a cannula, the pivot point roughly coincides with the cannula's position. Therefore, with the surgical instrument inserted into the patient's body cavity, its position and orientation are always controlled via the pivot point. This pivot point prevents stress on the patient's surrounding tissues, ensuring safety.

[0006] The surgical aid device described above is provided with a surgical instrument holding device for holding surgical instruments. Various types of surgical instrument holding devices exist (for example, see Patent Document 1, Patent Document 2, and Patent Document 3). In such a surgical instrument holding device, the aforementioned holding body is provided, and a portion or all of the holding body is configured as a holding part for holding surgical instruments.

[0007] As described above, surgical instrument holding devices exist in various types. These devices include adapters that correspond the size and shape of the holding body to the surgical instrument, which is then mounted and held in the holding body via the adapter (see, for example, Patent Document 3). Additionally, surgical aids also exist in which a cover for separating clean and non-clean areas is mounted on a separator, and the separator is mounted on the holding body. In such surgical aids, an adapter is mounted on the separator, and the surgical instrument is held in the holding body via the separator and the adapter.

[0008] Existing technical documents

[0009] Patent documents

[0010] Patent Document 1: Japanese Patent Application Publication No. 2015-228922

[0011] Patent Document 2: Japanese Patent Application Publication No. 2003-284726

[0012] Patent Document 3: Japanese Patent Application Publication No. 6-63003 Summary of the Invention

[0013] The problem that the invention aims to solve

[0014] However, surgical instruments are used by inserting the tip of the instrument into the patient's body cavity. For example, an endoscope embedded in the surgical instrument is used to observe the condition inside the body cavity, or forceps attached to the tip of the surgical instrument are used to remove lesions.

[0015] Therefore, when surgical instruments are unstable in their holding position relative to the retainer, it is impossible to accurately observe the condition inside the body cavity with an endoscope, or to accurately remove the lesion with forceps, which may reduce the accuracy and safety of the surgery.

[0016] Therefore, the purpose of the surgical instrument holding device and surgical aid device of the present invention is to prevent the surgical instrument from shifting relative to the holding body in order to ensure the accuracy and safety of the surgery.

[0017] Solution for solving the problem

[0018] First, the surgical instrument holding device of the present invention comprises: an adapter to which the surgical instrument is detachably mounted; a separator to which the adapter is detachably mounted; a holding body to which the separator is detachably mounted; and a driving body that supports the holding body in a rotatable manner and applies a driving force to the holding body. A receiving portion is provided on the separator, and the adapter is provided with a locking portion that elastically deforms when the adapter is installed on the separator, and a pushing portion that is pressed against the receiving portion. The pushing portion is pressed against the receiving portion, and the locking portion engages with the receiving portion in an elastically reset state, thereby mounting the adapter to the separator.

[0019] Therefore, the following state is set: when the adapter is installed on the separator, the pushing part of the adapter is pushed against the receiving part of the separator and the engaging part is engaged with the receiving part in an elastically reset state, and each part of the adapter can press the receiving part with two different parts.

[0020] Second, in the surgical instrument holding device of the present invention described above, it is desirable that the engaging portion is formed in a shape protruding from the pushing portion, and the engaging portion is provided with: a base end portion that is continuous with the pushing portion and extends in a protruding direction from the pushing portion; a folded-back portion that is continuous with the base end portion and is formed in a folded-back shape; an outer portion that is continuous with the folded-back portion and at least a portion of which faces the base end portion and is located on the outer periphery of the pushing portion; and an engaging claw portion that is continuous with the outer portion and bends toward the pushing portion relative to the outer portion, the engaging claw portion engaging with the receiving portion.

[0021] Therefore, the pushing part is pushed against the receiving part and the second engaging part engages with the receiving part in a resiliently reset state, thereby the adapter is installed on the separator.

[0022] Third, in the surgical instrument holding device of the present invention described above, it is desirable to provide a locking receiving portion in the receiving portion, wherein the locking claw portion clamps the receiving portion and engages with the locking receiving portion from the opposite side of the pushing portion.

[0023] Thus, the receiving part is held from opposite sides by the pushing part and the engaging claw part, thereby the adapter is installed on the separator.

[0024] Fourth, in the surgical instrument holding device of the present invention, it is desirable that the continuous direction of each part of the engaging portion is set as the length direction, and the direction orthogonal to the length direction and connecting the inner peripheral surface and the outer peripheral surface is set as the thickness direction, and the thickness of the base end portion is thinner than the thickness of the engaging claw portion.

[0025] Therefore, when a force in the thickness direction is applied to the base end via the outer portion, the base end is easy to bend, while when a force in the thickness direction is applied to the engaging claw portion, the engaging claw portion is not easy to bend.

[0026] Fifth, in the surgical instrument holding device of the present invention described above, it is desirable that the thickness of the outer portion is greater than the thickness of the base end portion.

[0027] Therefore, when a force in the thickness direction is applied to the base end, the base end is easy to bend, while when a force in the thickness direction is applied to the engaging claw of the engaging part, the outer part is not easy to bend.

[0028] Sixth, in the surgical instrument holding device of the present invention, it is desirable that the engaging portion and the engaging receiving portion are respectively configured as a second engaging portion and a second engaging receiving portion, a first engaging receiving portion is provided in the holding body, a first engaging portion is provided in the separator, and when the separator is installed in the holding body, the first engaging portion elastically deforms and engages with the first engaging receiving portion, and the first engaging portion engages with the first engaging receiving portion in an elastically reset state, thereby the separator is installed in the holding body.

[0029] Thus, the first engaging part, which is elastically deformed, engages with the first engaging receiving part in the elastically reset state, and the second engaging part, which is elastically deformed, engages with the second engaging receiving part in the elastically reset state, thereby holding the surgical instrument in the retainer by means of the separator and the adapter.

[0030] Seventh, the surgical aid device of the present invention includes a surgical instrument holding device for holding surgical instruments. In the surgical aid device, the surgical instrument holding device includes: an adapter to which the surgical instrument is detachably mounted; a separator to which the adapter is detachably mounted; a holding body to which the separator is detachably mounted; and a drive body that supports the holding body in a rotatable manner and applies a driving force to the holding body. A receiving portion is provided on the separator, and the adapter is provided with a locking portion that elastically deforms when the adapter is installed on the separator and a pushing portion that is pressed against the receiving portion. The pushing portion is pressed against the receiving portion, and the locking portion engages with the receiving portion in an elastically reset state, thereby installing the adapter on the separator.

[0031] Therefore, the following state is established: in the surgical instrument holding device, with the adapter installed on the separator, the pushing part of the adapter is pushed against the receiving part of the separator and the engaging part is engaged with the receiving part in an elastically reset state, and each part of the adapter can press the receiving part with two different parts.

[0032] The effects of the invention

[0033] According to the present invention, the adapter is configured such that, when the adapter is installed on the separator, the pushing part of the adapter is pushed against the receiving part of the separator and the engaging part is engaged with the receiving part in an elastically reset state. Each part of the adapter can press against the receiving part with two different parts. Therefore, the adapter can be installed on the separator in a stable state, which can prevent the surgical instrument from shifting relative to the retainer, thereby ensuring the accuracy and safety of the surgery. Attached Figure Description

[0034] Figure 1 and Figures 2 to 44 Embodiments of the surgical instrument holding device and surgical aid device of the present invention are also shown. Figure 1 It is a schematic perspective view showing surgical aids and the like.

[0035] Figure 2 This is a schematic diagram of surgical aids, etc.

[0036] Figure 3 It is a schematic three-dimensional diagram of a surgical aid device with multiple main components.

[0037] Figure 4 It is a three-dimensional diagram of a surgical instrument holding device and surgical instruments.

[0038] Figure 5 It is an exploded perspective view of the surgical instrument holding device and the surgical instrument.

[0039] Figure 6 This is a side view showing the surgical instrument holding device and the surgical instrument in a state of connection with the fourth movable body.

[0040] Figure 7 It is a side view showing the internal structure of the drive unit, etc.

[0041] Figure 8 This is a front view of the driving body and the retaining body.

[0042] Figure 9 This is a rear view of the testing facility and the retainer.

[0043] Figure 10 It is a sectional view of the retaining body.

[0044] Figure 11 It is a three-dimensional diagram that maintains the volume of the object.

[0045] Figure 12 This is a bottom view showing the separation of the separator and adapter.

[0046] Figure 13 It is a three-dimensional view of the separator.

[0047] Figure 14 This is the front view of the divider.

[0048] Figure 15 It is along Figure 14 A cross-sectional view of the XV-XV line.

[0049] Figure 16 This is an exploded 3D view of the adapter.

[0050] Figure 17 This is the front view of the adapter.

[0051] Figure 18 It is along Figure 17 A cross-sectional view of the XVIII-XVIII line.

[0052] Figure 19 This is a top view showing the second engaging part, etc.

[0053] Figure 20 This is a cross-sectional view showing the state before the surgical instruments are mounted on the adapter by the mounting components.

[0054] Figure 21 This is a cross-sectional view showing the state in which the surgical instrument is mounted on the adapter by the mounting components.

[0055] Figure 22 It is a cross-sectional view showing the first engaging portion of the separator being inserted into the retainer and the first engaging portion elastically deforming.

[0056] Figure 23 It is a cross-sectional view showing the state in which the first engaging portion is elastically reset and engaged with the first engaging receiving portion, thereby the separator is installed in the retainer.

[0057] Figure 24 This is a side view showing the state in which the separator is installed in the retainer, as detected by the first detection unit.

[0058] Figure 25 It is a cross-sectional view showing the separator installed in the retainer.

[0059] Figure 26 This is a perspective view showing the state of a surgical instrument installed on the adapter before the separator is inserted, with the separator in place of the retainer.

[0060] Figure 27 This is a perspective view showing the state in which a surgical instrument installed on the adapter is inserted into the separator while the separator is installed in the retainer.

[0061] Figure 28 This is a side view showing the state in which the cylindrical part of the adapter is inserted into the insertion part of the separator, and the sliding surface of the engaging claw is in contact with the receiving part of the separator.

[0062] Figure 29This is a side view showing the state in which the cylindrical part of the adapter is inserted into the insertion part of the separator and the second engaging part is elastically deformed.

[0063] Figure 30 This is a side view showing the state in which the adapter is installed on the separator, with the second engaging portion resiliently reset and the engaging claw portion engaging with the second engaging receiving portion.

[0064] Figure 31 It is a 3D view of the adapter installed in the separator.

[0065] Figure 32 This is a side view showing the state in which the adapter is detected by the second detection unit as being installed on the separator.

[0066] Figure 33 It is a bottom view of a section showing a portion of the adapter being installed on the separator and the surgical instrument being held in a retainer state by means of the separator and the adapter.

[0067] Figure 34 This is a rear view showing the adapter installed on the separator and the surgical instruments held in the retainer by means of the separator and the adapter.

[0068] Figure 35 This is a rear view showing the positional relationship between the detection mechanism and the second engaging part of the adapter.

[0069] Figure 36 This is a schematic diagram showing the state of a surgical instrument inserted into an incision moving relative to the body cavity.

[0070] Figure 37 This is a schematic diagram showing the state of a surgical instrument inserted into an incision, tilted relative to the body cavity.

[0071] Figure 38 This is a schematic diagram showing the state in which an external force is applied to the base end of the second engaging portion via the outer portion.

[0072] Figure 39 This is a schematic diagram showing the state in which an external force is applied to the engaging claw portion of the second engaging portion.

[0073] Figure 40 This is a schematic diagram showing the state in which an external force is applied to the portion of the second engaging part near the outer side of the engaging claw.

[0074] Figure 41 This is a side view showing the state of the drive body in the first rotational position.

[0075] Figure 42 This is a side view showing the state of the drive body in the second rotational position.

[0076] Figure 43This is a rear view showing an example of a detection mechanism that uses detection light for detection.

[0077] Figure 44 This is a top view showing the second engaging part, etc., formed in other shapes. Detailed Implementation

[0078] The following description, with reference to the accompanying drawings, illustrates the manner in which the surgical instrument holding device and surgical aid device are used to implement the present invention.

[0079] The embodiments shown below illustrate an example of the type in which the surgical aid device of the present invention is applied to the floor or the like in an operating room. However, the application scope of the surgical aid device of the present invention is not limited to the type used in the floor or the like in an operating room; the surgical aid device of the present invention can also be applied to the type used in the ceiling or walls of an operating room.

[0080] Furthermore, the directions shown below—front, back, up, down, left, and right—are for ease of explanation, and the implementation of this invention is not limited to these directions.

[0081] In addition, the surgical aid device shown below has a structure for rotating a movable body, but the "rotation" refers to the action of rotating in the direction of rotation about a reference axis (central axis) including any point, that is, it also includes the action of "rotation".

[0082] <Overview of the structure of surgical aids, etc.>

[0083] First, the general structure of the surgical aid device 1, etc., will be explained (see reference). Figures 1 to 3 ).

[0084] An operating table 100 is set up in the operating room, and the patient 200 lies supine on the operating table 100 (see reference). Figure 1 An incision 202 is formed in the body cavity 201 of the patient 200, such as the abdominal wall 201a. During surgery, a portion (the anterior end) of a surgical instrument, described later, is inserted into the incision 202. The incision 202 is a small hole for inserting the axial surgical instrument.

[0085] The surgical aid device 1 includes: a base 2 placed on the floor of the operating room, etc.; a cylindrical column 3 fixed to the base 2; and a main body 4 supported by the column 3. The base 2 is provided on the floor or the like on the side of the operating table 100, and the lower end of the column 3 is fixed to the base 2 in a vertically extending state.

[0086] The main body 4 is supported by the column 3 in a manner that allows it to move along the column 3 in the vertical direction. It is designed with the parts connected in a rotatable state and can be fixed at a desired position in the vertical direction along the column 3.

[0087] The main body 4 has a first connecting arm 5 and a second connecting arm 6 that are rotatably connected to each other.

[0088] The first connecting arm 5 is formed in a shape that extends horizontally, with one end in the long direction being a supported cylindrical portion 5a and the other end in the long direction being a fulcrum portion 5b. The supported cylindrical portion 5a of the first connecting arm 5 is inserted through the column 3, and can be moved up and down relative to the column 3 by manual or electric means, and can be rotated relative to the column 3 in the direction of rotation about an axis with the supported cylindrical portion 5a as the fulcrum.

[0089] The first connecting arm 5 can be fixed along the column 3 to a desired position in the vertical direction and in a desired position in the direction of rotation about the axis.

[0090] The second connecting arm 6 is shaped to extend horizontally, with one end in the longitudinal direction serving as a fulcrum portion 6a and the other end in the longitudinal direction serving as a support shaft portion 6b. The fulcrum portion 6a of the second connecting arm 6 is connected to the fulcrum portion 5b of the first connecting arm 5 in a state where it overlaps vertically with the fulcrum portion 5b of the first connecting arm 5 and can rotate relative to it. The second connecting arm 6 can be rotated relative to the first connecting arm 5 with the fulcrum portion 6a as the fulcrum by manual or electric means.

[0091] The main body 4 has a first movable body 7 that functions as a joint, and the first movable body 7 is rotatably connected to the support shaft 6b of the second connecting arm 6 (see reference). Figure 1 as well as Figure 2 ).

[0092] The end of the first movable body 7 on the side of the second connecting arm 6 is designated as a base-end connecting portion 7a, and the end on the opposite side of the second connecting arm 6 is designated as a front-end connecting portion 7b. The base-end connecting portion 7a of the first movable body 7 is rotatably connected to the support shaft portion 6b of the second connecting arm 6, for example, rotating relative to the second connecting arm 6 in a direction about a reference axis that extends in the vertical direction. Therefore, the first movable body 7 rotates relative to the second connecting arm 6, thereby giving the surgical aid device 1 a degree of freedom in its direction of movement.

[0093] The main body 4 has a second movable body 8 that functions as an arm. The second movable body 8 is rotatably connected to the front end connecting part 7b of the first movable body 7.

[0094] One end of the second movable body 8 in the longitudinal direction is designated as a base-end connecting portion 8a, and the other end in the longitudinal direction is designated as a front-end connecting portion 8b. The base-end connecting portion 8a of the second movable body 8 is rotatably connected to the front-end connecting portion 7b of the first movable body 7, for example, by rotating relative to the first movable body 7 in a direction about a reference axis that extends in a direction orthogonal to the connection direction between the second movable body 8 and the first movable body 7. Therefore, the second movable body 8 rotates relative to the first movable body 7, thereby giving the surgical aid device 1 a degree of freedom in its direction of movement.

[0095] For example, a linkage mechanism is provided in the second movable body 8. The linkage mechanism has two sets of parallel connecting rods 9, 9, ... and connecting pins 10, 10, ... that connect the connecting rods 9, 9, ... . The connecting pins 10, 10 of the second movable body 8 located on the side of the first movable body 7 are rotatably connected to the front end connecting part 7b of the first movable body 7.

[0096] The main body 4 has a third movable body 12 that functions as an arm, and the third movable body 12 is connected to the intermediate connecting member 11. One end of the third movable body 12 in the longitudinal direction is designated as a base-end side connecting portion 12a, and the other end in the longitudinal direction is designated as a front-end side connecting portion 12b. The base-end side connecting portion 12a of the third movable body 12 is connected to the intermediate connecting member 11 and can rotate, for example, relative to the intermediate connecting member 11, in a direction about a reference axis that extends orthogonally to the connection direction between the third movable body 12 and the intermediate connecting member 11. Therefore, the third movable body 12 rotates relative to the intermediate connecting member 11, thereby giving the surgical aid device 1 a degree of freedom in its direction of movement.

[0097] For example, a linkage mechanism is provided in the third movable body 12. The linkage mechanism has two sets of parallel connecting rods 13, 13, ... and connecting pins 14, 14, ... that connect the connecting rods 13, 13, ... The connecting pins 14, 14 of the second movable body 8 located on the side of the intermediate connecting member 11 are rotatably connected to the other end of the intermediate connecting member 11.

[0098] Furthermore, the above example shows an example where the second movable body 8 and the third movable body 12 are connected by an intermediate connecting member 11. However, in the surgical aid device 1, the intermediate connecting member 11 may not be provided, and the second movable body 8 and the third movable body 12 may not be connected by an intermediate connecting member 11.

[0099] The main body 4 has a fourth movable body 15 that functions as a joint. The fourth movable body 15 is rotatably connected to the front end connecting portion 12b of the third movable body 12. The end of the fourth movable body 15 on the side facing the third movable body 12 is designated as a base end connecting portion 15a, and the end on the opposite side of the third movable body 12 is designated as a front end connecting portion 15b. The base end connecting portion 15a of the fourth movable body 15 is rotatably connected to the front end connecting portion 12b of the third movable body 12, for example, by rotating relative to the third movable body 12 in a direction about a reference axis that extends along the connection direction between the fourth movable body 15 and the third movable body 12. Therefore, the fourth movable body 15 rotates relative to the third movable body 12, thereby giving the surgical aid device 1 a degree of freedom in its direction of movement.

[0100] The first movable body 7, the second movable body 8, the third movable body 12, and the fourth movable body 15 described above rotate, for example, due to the driving force of an electric actuator (not shown). Alternatively, the first movable body 7, the second movable body 8, the third movable body 12, and the fourth movable body 15 may rotate due to the driving force of an air pressure actuator.

[0101] The main body 4 has a surgical instrument holding device 16. The surgical instrument holding device 16 is rotatably connected to the front end connecting part 15b of the fourth movable body 15.

[0102] Furthermore, the above example illustrates a surgical aid device 1 having a main body 4 and the main body 4 having multiple movable bodies. However, the number of main bodies 4 provided on the surgical aid device 1 is not limited to one, and can also be multiple (see [reference]). Figure 3 In such a surgical aid device 1, for example, if two main bodies 4, 4 are provided, it can also be structured as follows: two second connecting arms 6, 6 that are rotatable relative to the first connecting arm 5 are provided, and the first movable bodies 7, 7 are connected to the second connecting arms 6, 6 respectively.

[0103] By setting up multiple main bodies 4, not only can multiple surgical instruments be used to perform surgery, thereby shortening the operation time, but also multiple surgical instruments of different types can be used to perform highly complex surgical procedures.

[0104] <Structure of Surgical Instrument Holding Device>

[0105] The structure of the surgical instrument holding device 16 connected to the fourth movable body 15 will be described below (see reference). Figures 4 to 19 ).

[0106] Furthermore, the surgical instrument holding device 16 has the following structure: a sixth movable body is rotatably supported by a fifth movable body. In the following description, for the sake of simplicity, with the sixth movable body supported on the lower side of the fifth movable body, the direction in which the two exist is defined as the up-down direction, and the direction of the central axis, which serves as the rotation reference of the sixth movable body, is defined as the front-back direction. However, the following front-back, up-down, and left-back directions are for ease of explanation and are not limited to these directions in relation to the implementation of the present invention.

[0107] As described above, the surgical instrument holding device 16 is rotatably connected to the front end connecting portion 15b of the fourth movable body 15 (see reference). Figures 4 to 6 The surgical instrument holding device 16 includes: a drive body 17, which is rotatably connected to a fourth movable body 15 and functions as a fifth movable body; a holding body 18, which is rotatably supported by the drive body 17 and functions as a sixth movable body; a separator 19, which is detachably mounted to the holding body 18; and an adapter 20, which is detachably mounted to the separator 19.

[0108] (Structure of the drive unit and detection mechanism)

[0109] The drive unit 17 has a bracket 21, a drive force transmission mechanism 22, and a housing 23. The drive force transmission mechanism 22 is supported by the bracket 21 and is housed inside the housing 23 (see reference). Figures 6 to 8 ).

[0110] The bracket 21 has a first support member 24 extending front-to-back and a second support member 25 extending vertically, the upper end of the second support member 25 being mounted to the front end of the first support member 24. A connecting member 26 is mounted on the upper surface of the front end of the first support member 24. A through hole (not shown) extending front-to-back is formed at the upper end of the front end of the bracket 21.

[0111] The lower end of the second support member 25 is provided as a support portion 25a, which is formed into an upwardly convex arc shape. Guide protrusions 25b, 25b are provided circumferentially on the second support member 25, which protrude downward from the inner circumferential surface of the support portion 25a.

[0112] A connecting member 27 is installed on the connecting member 26, which is connected to the front end connecting portion 15b of the fourth movable body 15. The connecting member 27 is connected to the front end connecting portion 15b, thereby allowing the drive body 17 to rotate, for example, relative to the fourth movable body 15, in a direction about a reference axis that extends orthogonal to the connection direction between the drive body 17 and the fourth movable body 15. Therefore, the drive body 17, which functions as the fifth movable body, rotates relative to the fourth movable body 15, thus giving the surgical aid device 1 a degree of freedom in its direction of movement.

[0113] The drive body 17, which functions as the fifth movable body, rotates due to the driving force of an electric actuator and an air pressure actuator (not shown).

[0114] The lower end of the third support member 28 is installed at the rear end of the first support member 24 (see reference). Figure 7 A through hole (not shown) is formed on the front side of the first support member 24 immediately adjacent to the third support member 28, extending vertically.

[0115] The drive force transmission mechanism 22 has belt pulleys 29 and 30. The belt pulleys 29 and 30 are supported vertically by the front surface of a third support member 28. A drive belt 31 is wound between the belt pulleys 29 and 30 through a belt insertion hole in the first support member 24. An encoder 32 is disposed on the front surface of the third support member 28, which detects the rotation angle of the upper belt pulley 29.

[0116] A drive motor 33 is mounted on the lower surface of the rear end of the first support member 24. The motor shaft of the drive motor 33 is fixed to the center of the lower belt pulley 30. Therefore, when the drive motor 33 rotates, the driving force is transmitted to the upper belt pulley 29 via the lower belt pulley 30 and the transmission belt 31. When the belt pulley 29 rotates, the rotational position of the belt pulley 29 is detected by the encoder 32.

[0117] The driving force transmission mechanism 22 has a pulley 34, a connecting shaft 35, and intermediate pulleys 36, 36.

[0118] The pulley 34 is supported by the front surface of the upper end of the second support member 25 (see reference). Figure 7 as well as Figure 8 Pulley 34 is connected to the lower pulley 30 by a connecting shaft 35, which passes through a shaft insertion hole formed in the bracket 21 and connects to the lower pulley 30. Therefore, the rotational force of the pulley 30 is transmitted to pulley 34 via the connecting shaft 35. The intermediate pulleys 36 are supported by the front surface of the second support member 25 in a left-right separated state and are located below pulley 34.

[0119] Drive ropes 37 and 38 are wound around pulley 34 and intermediate pulleys 36. One drive rope 37, when wound around one intermediate pulley 36, has one end fixed to pulley 34 and the other end fixed to retainer 18; the other drive rope 37, when wound around another intermediate pulley 36, has one end fixed to pulley 34 and the other end fixed to retainer 18. Therefore, when pulley 34 rotates and drive ropes 37 and 38 are conveyed, retainer 18 rotates in a direction corresponding to the conveying direction of drive ropes 37 and 38.

[0120] A detection mechanism 38 is disposed on the rear surface of the second support member 25 (see reference). Figure 7 as well as Figure 9 The detection mechanism 38 consists of a first detection unit 39 and a second detection unit 40. The first detection unit 39 and the second detection unit 40 are arranged on the second support member 25 in a state separated from the rotation direction of the retainer 18.

[0121] The first detection unit 39 has the function of detecting the installation status of the separator 19 with respect to the retainer 18, and the second detection unit 40 has the function of detecting the installation status of the adapter 20 with respect to the separator 19.

[0122] As described above, the first detection unit 39 and the second detection unit 40 are arranged on the bracket 21 in a state of separation in the rotation direction of the holding body 18. Thus, the positions of the first detection unit 39 and the second detection unit 40 are arranged in the same plane as the bracket 21, so the space of the bracket 21 can be effectively utilized to achieve miniaturization of the surgical aid device 1.

[0123] The first detection unit 39 includes: a main body 41 mounted on the second support member 25; a detection pin 42 movable relative to the main body 41; and a detection switch 43 mounted on the second support member 25.

[0124] The detection pin 42 is configured to extend radially along the retainer 18 and move relative to the main body 41 toward the center of the retainer 18 and toward separation. The upper and lower ends of the detection pin 42 protrude upwards and downwards from the main body 41, respectively. The upper end of the detection pin 42 is configured as an operating part 42a, and the lower end is configured as an actuated part 42b. The front end of the actuated part 42b is hemispherical, and its front end face is formed as a spherical surface 42c that convexes toward the front end.

[0125] The detection pin 42 is exerted with force by a spring (not shown) in a direction that moves downward relative to the main body 41, and is located below the lower edge of the support portion 25a of the second support member 25 by the action portion 42b.

[0126] The detection switch 43 is located above the operating part 42a of the detection pin 42. When no upward force is applied to the detection pin 42, the detection pin 42 is at its lower moving end, the operating part 42a is below and separated from the detection switch 43, and the detection switch 43 is in the off state. The actuated part 42b is located below the lower edge of the support part 25a of the second support member 25. When the detection pin 42 moves upward against the force of the spring, the detection switch 43 is operated by the operating part 42a to become on, and a detection signal is sent to a detection circuit (not shown).

[0127] The second detection unit 40 includes: a main body 44 mounted on the second support member 25; a detection pin 45 movable relative to the main body 44; and a detection switch 46 mounted on the second support member 25.

[0128] The detection pin 45 is configured to extend radially along the retainer 18 and move relative to the main body 44 towards and away from the center of the retainer 18. The upper and lower ends of the detection pin 45 protrude upwards and downwards from the main body 44, respectively. The upper end of the detection pin 45 is configured as an operating part 45a, and the lower end is configured as an actuated part 45b. The front end of the actuated part 45b is hemispherical, and its front end face is formed as a spherical surface 45c that convexes towards the front end.

[0129] The detection pin 45 is forced by a spring (not shown) in a direction that moves downward relative to the main body 44, and is located below the lower edge of the support portion 25a of the second support member 25 by the actuating portion 45b. The detection pin 45 of the second detection portion 40 is located slightly behind the detection pin 42 of the first detection portion 39.

[0130] The detection switch 46 is located above the operating portion 45a of the detection pin 45. When no upward force is applied to the detection pin 45, the detection pin 45 is at its lower moving end, the operating portion 45a is below and separated from the detection switch 46, and the detection switch 46 is in the off state. The actuated portion 45b is located below the lower edge of the support portion 25a of the second support member 25. When the detection pin 45 moves upward against the force of the spring, the detection switch 46 is operated by the operating portion 45a to become on, and a detection signal is sent to a detection circuit (not shown).

[0131] The housing 23 is, for example, divided into four parts, formed by a first housing part 23a, a second housing part 23b, a third housing part 23c, and a fourth housing part 23d (see reference). Figures 4 to 6 The housing 23 is formed, for example, of a resin material. The housing 23 is formed of a resin material, thereby enabling the drive body 17 to be lightweight, suppressing the load on the movement of the drive body 17, and enabling the drive body 17 to rotate smoothly relative to the fourth movable body 15.

[0132] The first housing portion 23a is mounted from above on the rear side of the first support member 24 and the connecting member 26, and the pulley 29, the third support member 28, etc. are covered by the first housing portion 23a.

[0133] Manual switches 47, 47 are respectively arranged on both sides of the first housing portion 23a. By manually operating the manual switches 47, 47, the drive body 17 can be rotated relative to the fourth movable body 15, for example. Operating one manual switch 47 causes the drive body 17 to rotate in one direction, and operating the other manual switch 47 causes the drive body 17 to rotate in the other direction. Alternatively, the structure could be such that manually operating the manual switches 47, 47 drives the motor 33 to rotate, and the holding body 18 rotates relative to the drive body 17. The manual switches 47, 47 can be operated, for example, by the surgeon or assistant in the operating room.

[0134] The second housing portion 23b is installed from below on the first support member 24, and the pulley 30, connecting shaft 35, etc. are covered by the second housing portion 23b.

[0135] A third housing portion 23c is mounted from the front on the second support member 25, and pulleys 34, intermediate pulleys 36, 36, etc. are covered by the third housing portion 23c. A component insertion hole (not shown) is formed at the lower end of the third housing portion 23c, which runs vertically through the third housing portion 23c. Drive ropes 37, 37 are led downward from the inside of the third housing portion 23c through the component insertion hole and fixed to the retainer 18.

[0136] The fourth housing portion 23d is mounted from the rear on the second support member 25, and the detection mechanism 38 and the like are covered by the fourth housing portion 23d. A component insertion hole (not shown) is formed at the lower end of the fourth housing portion 23d, which runs vertically through the component insertion hole. The detection pin 42 of the first detection portion 39 and the detection pin 45 of the second detection portion 40 are led downward from the interior of the fourth housing portion 23d through the component insertion hole.

[0137] As described above, the drive body 17 is generally formed into a horizontally inverted L-shape, and the portion extending from front to back is composed of a narrow portion 48 with a small vertical width and a wide portion 49 with a large vertical width compared to the narrow portion 48.

[0138] A connecting shaft 35 is disposed inside the narrow portion 48, and pulleys 29 and 30, a drive motor 33, etc., are disposed inside the wide portion 49. The wide portion 49 is the part used to house the pulleys 29 and 30, the drive motor 33, etc., and is therefore formed with a large vertical width. The lower part of the narrow portion 48 and the wide portion 49 are continuous. A first concave space 50 opening upward is formed on the upper side of the narrow portion 48, and a second concave space 51 opening downward is formed on the lower side of the narrow portion 48.

[0139] (Maintaining the structure of the body)

[0140] The retainer 18 is rotatably supported by the drive body 17 and functions as the sixth movable body. The retainer 18 is rotatably supported by the support portion 25a of the second support member 25 (see reference). Figures 4 to 8 ).

[0141] The retainer 18 is formed in a generally arc shape, and has a guide groove 18a that opens outward and extends circumferentially at its outer periphery. The center of the retainer 18 is formed into a through hole 18b that runs through the front and back.

[0142] The retainer 18 is formed in a generally arc shape in the circumferential direction, for example, at an angle of 270 to 330 degrees, and the space between the two ends in the circumferential direction is formed as a mounting hole 18c. The mounting hole 18c communicates with the insertion hole 18b.

[0143] The inner periphery of the retainer 18 is configured as a retaining portion 52, which holds the surgical instrument by means of a separator 19 and an adapter 20. Insertion portions 53, 53 are formed in the retaining portion 52, opening in opposite directions at positions 180 degrees apart. The insertion portions 53, 53 are formed at a position 90 degrees circumferentially separated from the mounting / removing hole 18c and communicate with the through hole 18b.

[0144] The surfaces of the insertion portions 53, 53 that face each other in the left and right directions are respectively formed as sliding portions 53a, 53a (see reference). Figure 8 as well as Figure 11 Additionally, the surfaces of each of the surfaces forming the insertion portion 53 that are continuous with the sliding portion 53a and face each other in the vertical direction are formed as rotation limiting portions 53b, 53b.

[0145] The front opening edges of the insertion portions 53 and 53 of the retainer 18 are respectively formed as first engaging receiving portions 54 and 54.

[0146] The guide protrusions 25b, 25b of the second support member 25 are inserted into the guide groove 18b, and the retainer 18 is guided by the guide protrusions 25b, 25b and rotates relative to the drive body 17. In addition, although not shown, the guide protrusions 25b, 25b are formed to suspend the retainer 18 and have the function of preventing the retainer 18 from falling off the drive body 17.

[0147] The retainer 18 rotates, for example, relative to the drive body 17, about a reference axis that extends orthogonally to the connection direction between the retainer 18 and the drive body 17. Thus, the retainer 18, which functions as the sixth movable body, rotates relative to the drive body 17, which functions as the fifth movable body, thereby giving the surgical aid device 1 a degree of freedom in its direction of motion.

[0148] As described above, the first movable body 7 rotates relative to the second connecting arm 6, the second movable body 8 rotates relative to the first movable body 7, the third movable body 12 rotates relative to the intermediate connecting member 11, the fourth movable body 15 rotates relative to the third movable body 12, the driving body 17 rotates relative to the fourth movable body 15, and the holding body 18 rotates relative to the driving body 17, thereby the surgical aid device 1 has six degrees of freedom in its direction of motion.

[0149] The retainer 18 rotates due to the driving force of the drive motor 33. Specifically, when the drive motor 33 rotates, the belt pulley 30 fixed to the motor shaft rotates. Along with the rotation of the belt pulley 30, the belt pulley 29 rotates via the transmission belt 31, and the pulley 34 rotates via the connecting shaft 35. Due to the rotation of the pulley 34, the drive ropes 37 are transmitted via the intermediate pulleys 36, and the retainer 18 rotates in the direction corresponding to the transmission direction of the drive ropes 37. At this time, the encoder 32 detects the rotational position of the belt pulley 29 and calculates the rotation angle (rotational position) of the retainer 18 relative to the drive body 17.

[0150] (Structure of the separator)

[0151] A portion of the cover used to separate the clean area from the non-clean area is installed on the separator 19, and the cover separates the clean area where the patient 200 is located from the non-clean area where the surgical aid device 1 is located.

[0152] The separator 19 is formed of resin material and all parts are integrally formed. The separator 19 has: an insertion portion 55 with an axial direction in the front-to-back direction; and a flange-shaped receiving portion 56 extending outward from the rear edge of the insertion portion 55 (see reference). Figures 12 to 15 ).

[0153] The insertion portion 55 is formed in a generally arcuate shape in the circumferential direction, for example, at an angle of 200 to 300 degrees. At the position on the opposite side in the circumferential direction of the front half of the insertion portion 55, there are forming notches 55a, 55a that open forward.

[0154] The separator 19 is provided with rotation-restricted portions 57, 57 protruding from the outer peripheral surface of the insertion portion 55. The rotation-restricted portions 57, 57 are located on opposite sides of the insertion portion 55 in the circumferential direction and protrude outward from the rear half of the insertion portion 55. The rotation-restricted portions 57, 57 are inserted into the insertion portions 53, 53 when the separator 19 is installed on the retainer 18, and are formed in a generally cuboid shape.

[0155] In the separator 19, first engaging portions 58 are provided continuously with the rotation-restricted portions 57, 57 respectively. The first engaging portion 58 is located in the forming notch 55a of the insertion portion 55 and can be elastically deformed in the radial direction of the insertion portion 55 relative to the rotation-restricted portion 57.

[0156] In this way, the rotation-restricted portion 57 and the first engaging portion 58 are arranged to be continuous in the partition 19. Therefore, the rotation-restricted portion 57 and the first engaging portion 58, which protrude from the insertion portion 55, are not provided in a separate position in the partition 19. Thus, when the partition 19 is formed by injection molding, the mold can be made with a simple structure, and the partition 19 can be formed easily.

[0157] The first engaging portion 58 is formed by a deformable portion 59 protruding forward from the front surface of the rotation-restricted portion 57 and a protruding portion 60 protruding outward from the front end of the deformable portion 59. The protruding portion 60 is formed into a generally triangular prism shape that tapers at the front end as it separates outward from the deformable portion 59. The front surface is formed into a sliding inclined surface 60a, and the rear surface is formed into an engaging surface 60b. The sliding inclined surface 60a is formed into an inclined surface that approaches the front end of the deformable portion 59 as it moves forward, and the engaging surface 60b is formed into a rearward-facing surface. The protruding portion 60 of the first engaging portion 58 is located at the front end compared to the front end of the insertion portion 55.

[0158] The bearing portion 56, corresponding to the insertion portion 55, is formed in a generally arcuate shape in the circumferential direction, for example, at an angle of 200 to 300 degrees. An inclined surface 56a is formed on the outer periphery of the bearing portion 56, which shifts inward as it moves forward. The two end edges of the bearing portion 56 in the circumferential direction are formed as limiting portions 56b, 56b.

[0159] Second engaging receiving portions 61, 61 are provided at both ends of the circumferential direction of the receiving portion 56. A recess 56c is formed in a part of the front portion of the receiving portion 56, thereby the second engaging receiving portion 61 is formed such that the recess 56c is thinner than other portions.

[0160] As described above, the insertion portion 55 and the receiving portion 56 of the separator 19 are formed in a generally arc shape in the circumferential direction, for example, at a degree of 200 to 300 degrees, and an opening 19a for assembly and disassembly is formed in the space between the two ends in the circumferential direction.

[0161] (Adapter structure)

[0162] The adapter 20 is structured to correspond to the size and shape of various surgical instruments of different sizes and shapes and is properly installed on the separator 19 so that the surgical instruments are held in the holder 18 by means of the separator 19.

[0163] The adapter 20 consists of a plug-in component 62 and a mounting component 63 (see reference). Figure 12 , Figure 16 , Figure 17 as well as Figure 18 ).

[0164] The insertion member 62 is formed of resin material and all parts are integrally formed. The insertion member 62 has: a cylindrical part 64 with the front-to-back direction in an axial direction; and a flange-shaped pushing part 65 extending outward from the rear edge of the cylindrical part 64.

[0165] The cylindrical portion 64 is generally cylindrical, and has a threaded groove 64a on the outer peripheral surface of the rear half. Slits 64b, 64b, 64b that open forward are formed at equal intervals along the circumference of the cylindrical portion 64, and slits 64b, 64b, 64b are also present in the portion where the threaded groove 64a is formed. Fastening portions 66, 66, 66 are respectively provided between the slits 64b, 64b, 64b of the cylindrical portion 64. The fastening portions 66, 66, 66 are elastically deformable in directions approaching and separating from the center of the cylindrical portion 64.

[0166] The pressing part 65 is formed in a generally circular shape, and an inclined surface 65a is formed on the outer periphery that moves towards the inner periphery as it moves forward.

[0167] An arc-shaped restricted portion 65b is provided on the front surface of the pressing portion 65, and the restricted portion 65b is formed to protrude slightly forward relative to the other parts of the pressing portion 65. Notches 65c, 65c that open outward are formed separately in the circumferential direction of the pressing portion 65.

[0168] The adapter 20 is provided with second engaging portions 67, 67 protruding from the outer periphery of the pressing portion 65. The second engaging portions 67, 67 protrude rearward from a position near the notches 65c, 65c on the rear surface of the pressing portion 65 (see reference). Figure 16 , Figure 17 as well as Figure 19 The circumferential distance between the second engaging portions 67 and 67 is the same as the circumferential distance between the second engaging receiving portions 61 and 61 of the separator 19, and the pushing portion 65 is located at a separation degree of 80 to 120 degrees in the circumferential direction.

[0169] The second engaging portion 67 is composed of a base end portion 68, a folded-back portion 69, an outer portion 70, and an engaging claw portion 71. The base end portion 68 is continuous with the pushing portion 65 and extends in the protruding direction from the pushing portion 65. The folded-back portion 69 is continuous with the base end portion 68 and is formed in a folded-back shape. The outer portion 70 is continuous with the folded-back portion 69 and is partially located in a position facing the base end portion 68. The engaging claw portion 71 is continuous with the outer portion 70 and is bent at a right angle relative to the outer portion 70 towards the pushing portion 65.

[0170] The continuous direction of the base end portion 68, the folded-back portion 69, the outer side portion 70, and the engaging claw portion 71 of the second engaging portion 67 is defined as the length direction, and the direction orthogonal to the length direction and connecting the inner and outer peripheral surfaces of each portion is defined as the thickness direction. Therefore, the width direction of the base end portion 68, the folded-back portion 69, the outer side portion 70, and the engaging claw portion 71 is orthogonal to both the length direction and the thickness direction, and the widths of the base end portion 68, the folded-back portion 69, the outer side portion 70, and the engaging claw portion 71 are the same.

[0171] The thickness T1 of the base end 68 is smaller than its width, and it is formed into a shape that extends in the front-to-back direction (see reference). Figure 19 ).

[0172] The thickness T2 of the folded-back portion 69 is thicker than the thickness T1 of the base portion 68. A rearwardly convex U-shape is formed in the folded-back portion 69, with a portion of one front end face continuous with the rear end face of the base portion 68. Thus, because a portion of one front end face of the folded-back portion 69 is continuous with the rear end face of the base portion 68, a stepped surface 69a is formed at the boundary between the folded-back portion 69 and the base portion 68.

[0173] The thickness T3 of the outer portion 70 is the same as the thickness T2 of the folded-back portion 69, and it is shaped to extend in the front-back direction. Therefore, the thickness T3 of the outer portion 70 is thicker than the thickness T1 of the base end portion 68. The outer portion 70 is located parallel to the base end portion 68 and is shaped to extend in the front-back direction.

[0174] The outer portion 70 is longer than the base portion 18, and is located on the outer periphery of the pressing portion 65, extending from the rear to the front of the pressing portion 65, and a portion of it is located in the notch 65c.

[0175] In adapter 20, since the outer portions 70, 70 are located on the outer periphery of the pressing portion 65, their overall size is likely to be larger. However, notches 65c, 65c are formed in the pressing portion 65, and the outer portions 70, 70 are located in notches 65c, 65c respectively. Therefore, although the structure is that the outer portions 70, 70 are located on the outer periphery of the pressing portion 65, the notches 65c, 65c are formed, which allows for a smaller overall size and miniaturization.

[0176] The engaging claw portion 71 protrudes from the front end of the outer portion 70 toward the cylindrical portion 64, and its thickness T4 is the same as the thickness T3 of the outer portion 70. Therefore, the thickness T4 of the engaging claw portion 71 is thicker than the thickness T1 of the base end portion 68. The engaging claw portion 71 is located on the front side of the pressing portion 65 and is in a state where it is at a fixed distance from the front surface of the pressing portion 65.

[0177] The front end of the engaging claw portion 71 is formed into a shape that becomes thinner as it moves toward the front end, and has: a sliding surface 71a that is inclined in a way that moves rearward as it approaches the front end; and an engaging surface 71b that faces rearward.

[0178] The second engaging portion 67 has the structure described above. Compared with the thickness T2 of the folded-back portion 69, the thickness T3 of the outer portion 70, and the thickness T4 of the engaging claw portion 71, the thickness T1 of the base end portion 68 is thinner. The base end portion 68 can be elastically deformed in the thickness direction.

[0179] The mounting member 63 is formed in a generally cylindrical shape with its axial direction in the front-rear direction, and operating grooves 63a, 63a, ... (see reference) are formed circumferentially on the outer peripheral surface of the front half. Figures 16 to 18 The mounting member 63 has operating grooves 63a, 63a, ..., which makes it easier to rotate the mounting member 63 when it is held and rotated, thereby improving operability.

[0180] A threaded portion 63b is formed on the inner circumferential surface of the rear half of the mounting member 63, and the threaded portion 63b is threaded into the threaded groove 64a of the cylindrical portion 64. When the mounting member 63 is rotated, the threaded position of the threaded portion 63b relative to the threaded groove 64a changes, and the mounting member 63 moves in the back-and-forth direction relative to the cylindrical portion 64, causing the fastening portions 66, 66, 66 to elastically deform. The elastic deformation of the fastening portions 66, 66, 66 causes a change in the diameter of the cylindrical portion 64.

[0181] The front half of the mounting member 63 is configured as a deformation limiting part 63c. When the separator 19 is installed on the retainer 18, the deformation limiting part 63c restricts the deformation of the first engaging parts 58, 58 of the separator 19.

[0182] <Structure of Surgical Instruments>

[0183] The following describes the structure of the surgical instrument 80 held in the holder 18 (see reference). Figures 4 to 6 ).

[0184] The surgical instrument 80 is configured, for example, as an endoscope unit having an endoscope, including: a shaft portion 81 extending in the front and back; a camera 82 coupled to the rear end of the shaft portion 81; and a light guide 83 coupled to the middle portion of the shaft portion 81.

[0185] A plurality of lenses (not shown) are arranged axially inside the shaft portion 81. An imaging element (not shown) is arranged inside the camera 82.

[0186] Cable 84 is connected to camera 82. The camera element and the camera circuit (not shown) send and receive signals via cable 84, and supply current to the camera element via cable 84.

[0187] The light guide 83 has: an annular connecting portion 83a that is connected to the shaft portion 81; a middle portion 83b that protrudes from the connecting portion 83a and is substantially orthogonal to the shaft portion 81; and a light-incident portion 83c that is orthogonal to the middle portion 83b, the light-incident portion 83c being above the shaft portion 81 and in a state substantially parallel to the shaft portion 81.

[0188] The optical fiber cable 85 is connected to the light-incident portion 83c of the optical fiber 83. A light source (not shown) guides light through the optical fiber cable 85 into the interior of the shaft portion 81, and illuminates the front end of the shaft portion 81 with illumination light L (see reference). Figure 6 ).

[0189] The front end of the shaft portion 81 of the surgical instrument 80 is inserted into the body cavity 201 through an incision 202 formed in the patient 200. With the front end of the shaft portion 81 inserted into the body cavity 201, illumination light is shone from the front end of the shaft portion 81, and an imaging element captures an image of the state inside the body cavity 201. The image of the state inside the body cavity 201 captured by the imaging element is transmitted as an imaging signal via a cable 84 to an operating device (control device, not shown) operated by the surgical operator (physician), allowing the surgical operator to remotely observe the state inside the body cavity 201.

[0190] <Installing surgical instruments into the adapter>

[0191] Then, the installation procedure of the surgical instrument 80 with the adapter 20 is explained (see...). Figure 20 as well as Figure 21 ).

[0192] With the mounting member 63 not installed in the cylindrical portion 64 of the insertion member 62, the shaft portion 81 of the surgical instrument 80 is inserted into the insertion member 62 and the mounting member 63 from the rear (see reference). Figure 20 At this point, the mounting member 63 is in the following state: the threaded portion 63b and the threaded groove 64a are not threaded together, or the threaded range of the threaded portion 63b and the threaded groove 64a is small. Therefore, the diameter of the cylindrical portion 64 is large, making it easy to insert the shaft portion 81 into the cylindrical portion 64.

[0193] With the insertion member 62 and the mounting member 63 inserted into the shaft portion 81, manually rotating the mounting member 63 in a predetermined direction increases the engagement range between the threaded portion 63b and the threaded groove 64a, thereby securing the cylindrical portion 64 to the mounting member 63 (see reference). Figure 21 ).

[0194] When the mounting component 63 rotates and the engagement range between the threaded part 63b and the threaded groove 64a increases, the diameter of the cylindrical part 64 decreases, the shaft part 81 is fastened by the fastening parts 66, 66, 66, and the surgical instrument 80 is mounted on the adapter 20.

[0195] Conversely, when the mounting member 63 rotates in the opposite direction and the engagement range between the threaded part 63b and the threaded groove 64a decreases, the diameter of the cylindrical part 64 increases, enabling the surgical instrument 80 to be pulled out and removed from the adapter 20.

[0196] By rotating the mounting member 63 with the insertion member 62 and mounting member 63 inserted in the shaft 81, the surgical instrument 80 can be installed onto the adapter 20. By rotating the mounting member 63 in the opposite direction, the surgical instrument 80 can be removed from the adapter 20.

[0197] Therefore, the surgical instrument 80 is easy to attach and detach from the adapter 20, which improves the operability of the surgical instrument 80 to the adapter 20.

[0198] <Install the separator to the retainer>

[0199] Next, the installation operation of the separator 19 for the retainer 18 will be explained (see reference). Figures 22 to 25 ).

[0200] The insertion portion 55 of the separator 19 is inserted into the insertion hole 18b of the retainer 18 from the rear, and the first engaging portions 58, 58 are respectively inserted into the insertion portions 53, 53 of the retainer 18 from the rear (see reference). Figure 22 At this time, the separator 19 is inserted into the retainer 18 with the installation and removal opening 19a located on the lower side.

[0201] When the separator 19 is inserted into the retainer 18 facing forward, the protruding portions 60 and sliding inclined surfaces 60a and 60a of the first engaging portions 58 slide on the end edges of the sliding portions 53a and 53a of the retainer 18, respectively. The deformable portions 59 and 59 of the first engaging portions 58 elastically deform in a direction that brings them closer to each other, so that the protruding portions 60 and 60 slide on the sliding portions 53a and 53a, respectively.

[0202] As the separator 19 is further inserted forward into the retainer 18, the protrusions 60, 60 of the first engaging portions 58, 58 pass over the sliding portions 53a, 53a (see reference). Figure 23 The protrusions 60, 60 extend beyond the sliding portions 53a, 53a and protrude rearward from the retainer 18, thereby elastically resetting the first engaging portions 58, 58 in the direction of separation. The engaging surfaces 60b, 60b of the protrusions 60, 60 respectively engage with the first engaging receiving portions 54, 54 of the retainer 18.

[0203] Furthermore, the elastically reset state of the first engaging portion 58 when the engaging surface 60b engages with the first engaging receiving portion 54 includes not only its original state before elastic deformation, but also a state where the degree of deformation is small relative to the state where the sliding inclined surface 60a of the protruding portion 60 slides and elastically deforms in the sliding portion 53a of the retainer 18. Therefore, the state of the first engaging portion 58 when the engaging surface 60b engages with the first engaging receiving portion 54 can also be a state where the degree of elastic deformation is small relative to the state where the sliding inclined surface 60a slides and elastically deforms in the sliding portion 53a.

[0204] When the engaging surfaces 60b and 60b of the protrusions 60 and 60 respectively engage with the first engaging receiving portions 54 and 54 of the retainer 18, the receiving portion 56 of the separator 19 is in contact with the rear surface of the retainer 18. The separator 19 is installed on the retainer 18 while the protrusions 60 and 60 and the receiving portion 56 are clamping the retainer 18 in the front-rear direction.

[0205] When the bearing portion 56 comes into contact with the rear surface of the retainer 18, the inclined surface 56a formed on the bearing portion 56 slides on the spherical part 42c of the applied portion 42b, and the detection pin 42 moves upward (see reference). Figure 24 The detection pin 42, which is actuated by the action part 42b, is located on the first detection part 39. When the detection pin 42 moves upward, the detection switch 43 is operated by the operation part 42a to become closed, and a detection signal is sent to the detection circuit to detect that the separator 19 is properly installed on the holder 18.

[0206] As described above, with the separator 19 installed in the retainer 18, the rotation-limiting portions 57, 57 of the separator 19 are respectively inserted into the insertion portions 53, 53 of the retainer 18, and the rotation-limiting portions 57, 57 are in contact with the rotation-limiting portions 53b, 53b, ... of the insertion portions 53, 53 (see reference). Figure 23 as well as Figure 25 Therefore, the rotation limiting parts 53b, 53b, ... limit the rotation of the separator 19 relative to the retainer 18.

[0207] The protrusions 60, 60 protruding rearward from the retainer 18 are displaced in a direction that brings them closer to each other, causing the deformable portions 59, 59 of the first engaging portions 58, 58 to elastically deform, thereby pulling the separator 19 out of the retainer 18 rearward, thereby enabling the separator 19 to be removed from the retainer 18.

[0208] <Install adapter to separator>

[0209] Then, the installation procedure of adapter 20 for separator 19 is explained (refer to...). Figures 26 to 33 ).

[0210] With the surgical instrument 80 installed on the adapter 20 and the separator 19 installed on the retainer 18, the adapter 20 is installed onto the separator 19 (see reference). Figure 26 When installing the adapter 20 into the separator 19, firstly, the portion of the shaft 81 of the surgical instrument 80 that is forward of the portion installed on the adapter 20 is inserted into the interior of the separator 19 from below via the mounting / removal hole 18c of the retainer 18 and the mounting / removal opening 19a of the separator 19 (see reference). Figure 27 ).

[0211] Then, the mounting member 63 and the cylindrical part 64 of the adapter 20 are inserted from the rear into the insertion part 55 of the separator 19 (see reference). Figure 28 When the mounting member 63 and the cylindrical part 64 are inserted into the insertion part 55 facing forward, the sliding surfaces 71a and 71a of the locking claws 71 and 71 of the second locking parts 67 and 67 respectively come into contact with the outer periphery of the rear surface of the receiving part 56 of the separator 19.

[0212] Then, when the mounting member 63 and the cylindrical part 64 are inserted into the insertion part 55 facing forward, the sliding surfaces 71a and 71a of the engaging claws 71 and 71 slide on the outer periphery of the rear surface of the bearing part 56, and the second engaging parts 67 and 67 elastically deform in the direction of separation from each other, and the engaging claws 71 and 71 straddle the outer periphery of the bearing part 56 (see reference). Figure 29 At this time, the thickness of the base end portion 68 of the second engaging portion 67 is thinner than the thickness of other portions, so the base end portion 68 is mainly elastically deformed.

[0213] When the mounting member 63 and the cylindrical part 64 are further inserted forward into the insertion part 55, the sliding surfaces 71a and 71a of the engaging claws 71 and 71 slide on the outer peripheral surface of the receiving part 56 and pass over the receiving part 56 (see reference). Figure 30 The engaging claws 71 and 71 pass over the receiving portion 56, thereby the second engaging portions 67 and 67 elastically return to their original position in the direction where the engaging claws 71 and 71 approach each other, and the engaging surfaces 71b and 71b of the engaging claws 71 and 71 respectively engage with the second engaging receiving portions 61 and 61 of the separator 19 (see reference). Figure 31 ).

[0214] Furthermore, the elastically reset state of the second engaging portion 67 when the engaging surface 71b engages with the second engaging receiving portion 61 includes not only its original state before elastic deformation, but also a state where the degree of deformation is smaller compared to the state where the sliding surface 71a of the engaging claw portion 71 slides and elastically deforms on the outer peripheral surface of the receiving portion 56. Therefore, the state of the second engaging portion 67 when the engaging surface 71b engages with the second engaging receiving portion 61 can also be a state where the degree of elastic deformation is smaller compared to the state where the sliding surface 71a slides and elastically deforms on the outer peripheral surface of the receiving portion 56.

[0215] When the engaging surfaces 71b and 71b of the engaging claws 71 and 71 respectively engage with the second engaging receiving portions 61 and 61 of the separator 19, the pushing portion 65 of the adapter 20 is in contact with the rear surface of the receiving portion 56 of the separator 19. With the engaging claws 71 and 71 and the pushing portion 65 clamping the separator 19 in the front-back direction, the adapter 20 is installed on the separator 19.

[0216] When the pressing part 65 comes into contact with the rear surface of the receiving part 56, the inclined surface 65a formed on the pressing part 65 slides on the spherical part 45c of the applied part 45b, and the detection pin 45 moves upward (see reference). Figure 32 The detection pin 45 of the second detection unit 40 is provided with the action part 45b. When the detection pin 45 moves upward, the detection switch 46 is operated by the operation part 45a to become closed, and the detection signal is sent to the detection circuit to detect that the adapter 20 is properly installed on the separator 19.

[0217] As described above, with the adapter 20 installed on the separator 19, the restricted portion 65b of the adapter 20 is inserted between the restricting portions 56b and 56b of the separator 19, and the two ends of the restricted portion 65b in the circumferential direction are respectively connected to the restricting portions 56b and 56b (see reference). Figure 31 Therefore, the rotation of the adapter 20 relative to the separator 19 is restricted by the limiting parts 56b, 56b.

[0218] As described above, with the adapter 20 installed on the separator 19, the mounting member 63 and the cylindrical portion 64 of the adapter 20 are inserted into the insertion portion 55 of the separator 19, and the deformation limiting portion 63c of the mounting member 63 is in contact with or close to the first engaging portions 58, 58 of the separator 19 (see reference). Figure 33 ).

[0219] Thus, with the deformation limiting part 63c provided in the adapter 20, when the adapter 20 is installed on the separator 19, the deformation limiting part 63c limits the deformation of the first engaging parts 58, 58. When the separator 19 is installed on the retainer 18, the deformation limiting part 63c limits the deformation of the first engaging parts 58, 58 in the direction of releasing the engaging state with the first engaging receiving parts 54, 54.

[0220] Therefore, with the separator 19 installed on the retainer 18 and the adapter 20 installed on the separator 19, the deformation of the first engaging parts 58, 58 is limited by the deformation limiting part 63c. Thus, with the adapter 20 installed on the separator 19, the separator 19 will not unintentionally fall off the retainer 18. A simple structure can ensure a stable installation state of the separator 19 on the retainer 18.

[0221] In addition, the adapter 20 is composed of a plug-in member 62 and a mounting member 63. The plug-in member 62 is for the surgical instrument 80 to be plugged in, and the mounting member 63 rotates relative to the plug-in member 62 to mount the surgical instrument 80 onto the plug-in member 62. A deformation limiting part 63c is provided on the mounting member 63.

[0222] Therefore, since the mounting member 63 for mounting the surgical instrument 80 to the insertion member 62 is provided with a deformation limiting part 63c, it is not necessary to provide other dedicated members with deformation limiting parts on the adapter 20, thus not increasing the number of parts and ensuring a stable mounting state of the separator 19 for the retainer 18.

[0223] By displacing the engaging claws 71, 71 in a direction of separation, the second engaging portions 67, 67 elastically deform and pull the adapter 20 backward from the separator 19, allowing the adapter 20 to be removed from the separator 19. Furthermore, with the adapter 20 pulled backward from the separator 19 and removed, the shaft portion 81 of the surgical instrument 80 is pulled downward from the mounting / removal hole 18c of the holder 18 and the mounting / removal opening 19a of the separator 19, thereby allowing the surgical instrument 80 to be removed from the holder 18 and the separator 19.

[0224] As described above, the retainer 18 and the separator 19 are respectively formed with radially opening mounting holes 18c and mounting openings 19a, and the surgical instrument 80 installed on the adapter 20 is inserted or removed from the mounting holes 18c and mounting openings 19a.

[0225] Therefore, the surgical instrument 80 can be inserted and removed radially in the insertion part 55 without moving the shaft part 81 of the surgical instrument 80 axially in the insertion part 55 to load and unload the surgical instrument 80 onto the separator 19 with the help of the adapter 20. The surgical instrument 80 can be loaded and unloaded onto the separator 19 quickly with the help of the adapter 20.

[0226] As described above, in the surgical instrument holding device 16, the pushing part 65 pushes against the receiving part 56, and the second engaging parts 67, 67 engage with the receiving part 56 in an elastically reset state, thereby the adapter 20 is installed on the separator 19.

[0227] Therefore, the adapter 20 is configured such that the pushing part 65 of the adapter 20 pushes against the receiving part 56 of the separator 19 and the elastically deformed second engaging parts 67, 67 engage in the elastically reset state. Each part of the adapter 20 can press against the receiving part 56 with two different parts. Therefore, the adapter 20 is installed on the separator 19 in a stable state, which can prevent the surgical instrument 80 from displacing relative to the retainer 18, thereby ensuring the accuracy and safety of the surgery.

[0228] Furthermore, the second engaging portion 67 of the separator 19 is formed to protrude from the pressing portion 65. The second engaging portion 67 is provided with: a base end portion 68, which is continuous with the pressing portion 65 and extends in the protruding direction from the pressing portion 65; a folded-back portion 69, which is continuous with the base end portion 68 and is formed to fold back; an outer portion 70, which is continuous with the folded-back portion 69 and at least a portion of which faces the base end portion 68 and is located on the outer periphery of the pressing portion 65; and an engaging claw portion 71, which is continuous with the outer portion 70 and bends toward the pressing portion 65 relative to the outer portion 70. The engaging claw portion 71 engages with the receiving portion 56.

[0229] Therefore, the pushing part 65 pushes against the receiving part 56, and the second engaging part 67 engages with the receiving part 56 in a state of elastic reset, thereby the adapter 20 is installed on the separator 19, so the adapter 20 can be easily installed on the separator 19.

[0230] Furthermore, a second engaging receiving part 61 is provided in the receiving part 56, and the engaging claw part 71 clamps the receiving part 56 and engages with the second engaging receiving part 61 from the opposite side of the pushing part 65.

[0231] Therefore, the adapter 20 is installed on the separator 19 by the pressing part 65 and the engaging claw part 71 clamping the receiving part 56 from the opposite side, thus ensuring a stable installation state of the adapter 20 on the separator 19.

[0232] In the surgical instrument holding device 16, as described above, the drive body 17 is provided with: a drive force transmission mechanism 22, which transmits drive force to the holding body 18; and a bracket 21, which supports the drive force transmission mechanism 22, and the detection mechanism 38 is disposed on the bracket 21.

[0233] Therefore, by configuring the detection mechanism 38 on the bracket 21 of the drive body 17 that supports the retainer 18 in a rotatable manner, the detection mechanism 38 does not rotate with the retainer 18. Since the detection mechanism 38 is configured in the non-operating part that does not move with the retainer 18, the detection accuracy of the detection mechanism 38 related to the position of the separator 19 and the adapter 20 can be improved.

[0234] In addition, the detection mechanism 38 is positioned in a non-operating part that does not move along with the retainer 18, so it is less likely to cause a load on the cable used to connect the detection mechanism 38 to the detection circuit and the power supply circuit, thus suppressing cable deterioration.

[0235] Furthermore, in the surgical instrument holding device 16, both when the separator 19 is installed on the holding body 18 and when the adapter 20 is installed on the separator 19, the detection mechanism 38 performs the detection. The detection mechanism 38 is provided with the main body parts 41 and 44 installed on the bracket 21 and the detection pins 42 and 45 that move relative to the main body parts 41 and 44. The detection is performed because the detection pins 42 and 45 move due to the action of the separator 19 and the adapter 20 on the detection pins 42 and 45.

[0236] Therefore, the installation status of the separator 19 relative to the retainer 18 is detected by the movement of the detection pins 42 and 45 due to the action of the separator 19, and the installation status of the adapter 20 relative to the separator 19 is detected by the movement of the detection pins 42 and 45 due to the action of the adapter 20. Thus, the separator 19 and the adapter 20 can be detected easily and reliably respectively.

[0237] Furthermore, with the insertion part 55 inserted into the retainer 18, the separator 19 is installed on the retainer 18. With the separator 19 installed on the retainer 18 and the cylindrical part 64 inserted into the insertion part 55, the adapter 20 is installed on the separator 19. The installation state of the separator 19 on the retainer 18 is detected based on the action of the receiving part 56 on the detection pins 42 and 45 when the insertion part 55 is inserted into the retainer 18. The installation state of the adapter 20 on the separator 19 is detected based on the action of the pushing part 65 on the detection pins 42 and 45 when the cylindrical part 64 is inserted into the insertion part 55.

[0238] Therefore, the installation status of the separator 19 on the retainer 18 is detected based on the action of the receiving part 56 extending outward from the outer periphery of the insertion part 55 on the detection pins 42 and 45, and the installation status of the adapter 20 on the separator 19 is detected based on the action of the pushing part 65 extending outward from the outer periphery of the cylindrical part 64 on the detection pins 42 and 45. Thus, the length of the detection pins 42 and 45 can be shortened, and the detection mechanism 38 can be miniaturized.

[0239] Furthermore, an inclined surface 56a is formed on the outer periphery of the receiving portion 56, which approaches the insertion portion 55 as it moves toward the insertion direction of the insertion portion 55 toward the retainer 18. An inclined surface 65a is formed on the outer periphery of the pushing portion 65, which approaches the cylindrical portion 64 as it moves toward the insertion direction of the cylindrical portion 64 toward the insertion portion 55. The inclined surfaces 56a and 65a slide at the front ends of the detection pins 42 and 45, respectively, thereby detecting the movement of the detection pins 42 and 45 relative to the main body portions 41 and 44.

[0240] Therefore, when the separator 19 is installed onto the retainer 18, the inclined surface 56a of the bearing portion 56 slides on the detection pin 42, and when the adapter 20 is installed onto the separator 19, the inclined surface 65a of the pressing portion 65 slides on the detection pin 45. Thus, the separator 19 can be smoothly installed onto the retainer 18 and the adapter 20 can be installed onto the separator 19, and the detection pins 42 and 45 can be reliably moved to ensure the proper operating state of the detection mechanism 38.

[0241] Furthermore, the front end faces of the detection pins 42 and 45 are formed as spherical surfaces 42c and 45c that bulge towards the front end. Therefore, when the separator 19 is installed onto the retainer 18, the bearing portion 56 slides on the spherical surface 42c, and when the adapter 20 is installed onto the separator 19, the pushing portion 65 slides on the spherical surface 45c.

[0242] Therefore, the separator 19 can be smoothly installed on the retainer 18 and the adapter 20 can be installed on the separator 19, and the detection pins 42, 45 can be reliably moved to ensure the proper operating state of the detection mechanism 38.

[0243] <Maintenance status of surgical instrument holders>

[0244] As described above, with the separator 19 installed on the retainer 18 and the surgical instrument 80 installed on the adapter 20, the adapter 20 is installed on the separator 19, thereby the surgical instrument 80 is held in the retainer 18 by means of the separator 19 and the adapter 20.

[0245] As described above, with the adapter 20 installed on the separator 19, the first engaging portions 58, 58 of the separator 19 and the second engaging portions 67, 67 of the adapter 20 clamp the retainer 18 in the axial (front-back direction) direction of the cylindrical portion 64 and are located on opposite sides (see reference). Figure 32 as well as Figure 33 ).

[0246] Therefore, the first engaging portions 58 and 58 and the second engaging portions 67 and 67 are located in a separated position in the axial direction of the cylindrical portion 64. Thus, when the second engaging portions 67 and 67 are elastically deformed to remove the adapter 20 from the separator 19, the fingers are less likely to accidentally touch the first engaging portions 58 and 58, which can prevent the separator 19 from accidentally falling off the retainer 18.

[0247] In particular, since the separator 19 is a component used to install part of the cover, if the separator 19 is accidentally detached from the holder 18, the cover may be damaged due to contact with the surgical aid device 1, etc. Therefore, by preventing the separator 19 from accidentally detaching from the holder 18, damage to the cover can also be prevented.

[0248] Furthermore, with the adapter 20 installed on the separator 19, the first engaging portions 58, 58 of the separator 19 and the second engaging portions 67, 67 of the adapter 20 are located at different positions circumferentially on the cylindrical portion 64 (see reference). Figure 34 ).

[0249] Therefore, the first engaging portions 58, 58 and the second engaging portions 67, 67 are located in a separated position in the circumferential direction of the cylindrical portion 64. Thus, when the second engaging portions 67, 67 are elastically deformed to remove the adapter 20 from the separator 19, the fingers are unlikely to come into contact with the first engaging portions 58, 58, which can prevent the separator 19 from accidentally falling off the retainer 18.

[0250] Furthermore, with the adapter 20 installed on the separator 19, two planes passing through both ends of the circumferential detection mechanism 38 of the cylindrical portion 64 and the center Q of the cylindrical portion 64 are designated as plane S1 and plane S2 (see reference). Figure 35 At this time, when the area where the detection mechanism 38 is located in the region divided by plane S1 and plane S2 is designated as the first region 72 and the other regions are designated as the second region 73, the second engaging parts 67, 67 are located in the second region 73.

[0251] Therefore, the multiple second engaging parts 67, 67 respectively engage with the second engaging receiving parts 61, 61, and the detection mechanism 38 is located in different areas with the multiple second engaging parts 67, 67. Thus, it is possible to ensure a stable installation state of the adapter 20 with respect to the separator 19, and also to prevent interference between the second engaging parts 67, 67 and the detection mechanism 38 to ensure the proper operation state of the detection mechanism 38.

[0252] In addition, in the adapter 20, the second engaging portions 67, 67 protrude from the opposite side of the pushing portion 65 in the circumferential direction by 180 degrees, thereby ensuring the most stable installation state of the adapter 20 for the separator 19.

[0253] However, since the second engaging portions 67, 67 protrude from opposite sides of the pushing portion 65 at a circumferential angle of 180 degrees, and considering the close distance between the second engaging portions 67, 67 and the detection mechanism 38, fingers may unintentionally come into contact with the detection mechanism 38 when the adapter 20 is installed on the separator 19. Therefore, in order to prevent such contact between fingers and the detection mechanism 38, it is desirable that the second engaging portions 67, 67 be located at a position lower than the horizontal plane passing through the center Q of the cylindrical portion 64.

[0254] In addition, in the surgical instrument holding device 16, the first engaging parts 58, 58 engage with the first engaging receiving parts 54, 54 in the elastically reset state, thereby the separator 19 is installed on the holding body 18, and the second engaging parts 67, 67 engage with the second engaging receiving parts 61, 61 in the elastically reset state, thereby the adapter 20 is installed on the separator 19.

[0255] Therefore, the elastically deformable first engaging portions 58, 58 engage with the first engaging receiving portions 54, 54 in the elastically reset state, and the elastically deformable second engaging portions 67, 67 engage with the second engaging receiving portions 61, 61 in the elastically reset state. Thus, the surgical instrument 80 is held in the retainer 18 by means of the separator 19 and the adapter 20, so that the surgical instrument 80 can be easily and quickly attached to and detached from the retainer 18.

[0256] Furthermore, the adapter 20 is provided with a cylindrical portion 64 through which the surgical instrument 80 passes, and the separator 19 is provided with a through portion 55 through which the cylindrical portion 64 is inserted. When the cylindrical portion 64 is inserted into the through portion 55, the separator 19 is installed on the retainer 18 and the adapter 20 is installed on the separator 19.

[0257] Therefore, with the cylindrical portion 64, through which the surgical instrument 80 is inserted, inserted into the insertion portion 55, the separator 19 is installed on the retainer 18. Thus, by arranging the separator 19 and the adapter 20 on the retainer 18 in a space-saving manner, the surgical instrument retainer 16 can be miniaturized.

[0258] <Operation of surgical aids>

[0259] Then, the operation of surgical aid 1 will be explained (refer to...). Figures 36 to 42 ).

[0260] When performing surgery, the surgical aid device 1 configured as described above rotates the first movable body 7, the second movable body 8, the third movable body 12, the fourth movable body 15, the drive body 17 which functions as the fifth movable body, and the retainer body 18 which functions as the sixth movable body, so that the position and posture of the surgical instrument 80 held in the retainer body 18 are changed to the desired state.

[0261] When the first movable body 7 rotates, the second movable body 8, the third movable body 12, the fourth movable body 15, the driving body 17, and the holding body 18 move to change the position or orientation of the surgical instrument 80. Similarly, when the second movable body 8 rotates, the third movable body 12, the fourth movable body 15, the driving body 17, and the holding body 18 move to change the position or orientation of the surgical instrument 80. Likewise, when the third movable body 12 rotates, the fourth movable body 15, the driving body 17, and the holding body 18 move to change the position or orientation of the surgical instrument 80. And when the fourth movable body 15 rotates, the driving body 17 and the holding body 18 move to change the position or orientation of the surgical instrument 80. Furthermore, when the drive body 17 rotates, the retainer 18 moves to change the position or orientation of the surgical instrument 80 along with the rotation of the drive body 17. When the retainer 18 rotates, the surgical instrument 80 rotates along with the rotation of the retainer 18.

[0262] For example, a surgeon (physician) remotely operates a surgical aid device 1 located in the operating room to perform surgery using a master-slave configuration. In this master-slave configuration, the master and slave devices share the responsibilities. When multiple devices operate in coordination, the master device controls and operates all devices, while the slave devices operate under the control of the master device. In this surgical procedure, the unillustrated operating device (control device) operated by the surgeon is designated as the master device, and the surgical aid device 1 is designated as the slave device.

[0263] When using the surgical aid device 1 in a surgical procedure, firstly, the position of the main body 4 is set by moving the first connecting arm 5 up and down relative to the column 3 according to the position of the patient 200. Then, the position of the surgical instrument 80 is set by rotating the first connecting arm 5 relative to the column 3 and rotating the second connecting arm 6 relative to the first connecting arm 5 according to the surgical position.

[0264] During surgical procedures, the pivot point P (reference point) is set as the reference point for the movement of the surgical instrument 80. Figure 36 as well as Figure 37 ).

[0265] Pivot point P is located approximately at the same position as the incision 202 where surgical instrument 80 is inserted, and approximately at the same position as cannula 90 when using cannula 90 (see reference). Figure 2 Therefore, with the surgical instrument 80 inserted into the body cavity 201 of the patient 200, if appropriate pivoting movements are performed by controlling the position of a portion of the surgical instrument 80 through pivot point P, even if the position of the surgical instrument 80 is relative to its original position ( Figure 36The position G) changes ( Figure 36 The location (H) can also prevent load on tissues near the patient's body surface at a distance of 200, thus ensuring safety.

[0266] In addition, to facilitate understanding of the surgical instrument 80 that moves axially toward the shaft portion 81, Figure 36 As shown, the surgical instrument 80 before and after the movement are intentionally offset slightly in a direction orthogonal to the axis, and the solid line used to indicate the surgical instrument 80 at position G does not overlap with the dashed line used to indicate the surgical instrument 80 at position H.

[0267] Furthermore, with the surgical instrument 80 inserted into the body cavity 201 of the patient 200, if the surgical instrument 80 is always controlled in a manner that the posture is controlled through the pivot point P to perform appropriate pivotal movements, even if the posture of the surgical instrument 80 is relative to the original posture ( Figure 37 The attitude J) changes ( Figure 37 The posture (K) can also prevent load on the tissues near the patient's body surface at 200 degrees, thus ensuring safety.

[0268] On the other hand, in surgical procedures, there are surgeons, assistants, and multiple surgical instruments in the operating room. Therefore, especially when the operating room is limited in size, people and instruments in the operating room may inadvertently come into contact with various parts of the surgical aid device 1.

[0269] For example, during surgery or in the preparation stage, if a person or instrument in the operating room accidentally comes into contact with the partition 19 and applies a force due to the contact, the applied force may cause the adapter 20 to be unstable in its installation state with respect to the partition 19. On the other hand, in order to improve the workability of the installation operation, it is desirable to be able to easily install the adapter 20 onto the partition 19.

[0270] Therefore, in order to prevent problems caused by such external force and to ensure ease of installation, in the second engaging portion 67 of the adapter 20, the thickness T1 of the base end portion 68 is thinner than the thickness T4 of the engaging claw portion 71 (see reference). Figure 38 as well as Figure 39 ).

[0271] Therefore, a force F1 in the thickness direction is applied to the base end 68 via the outer portion 70 (refer to...). Figure 38 When the base end 68 is easily bent, a force F2 in the thickness direction is applied to the engaging claw 71 (refer to...). Figure 39When force F1 is applied to the base end 68, the engagement between the locking claw 71 and the bearing portion 56 is easily released, allowing the adapter 20 to be easily removed from the separator 19. Furthermore, when force F2 is applied to the locking claw 71, the engagement between the locking claw 71 and the bearing portion 56 is not easily released, thus preventing the adapter 20 from falling off the separator 19.

[0272] Furthermore, in the second engaging portion 67 of the adapter 20, the thickness T3 of the outer portion 70 is thicker than the thickness T1 of the base end portion 68 (see reference). Figure 38 as well as Figure 40 ).

[0273] Therefore, a force F1 in the thickness direction is applied to the base end 68 (refer to...). Figure 38 The base end 68 is prone to bending when a force F2 in the thickness direction is applied to the engaging claw portion 71 (refer to...). Figure 40 The outer portion 70 is not easily bent. Therefore, when a force F1 is applied to the base end 68, the engagement between the locking claw portion 71 and the bearing portion 56 is easily released, thereby making it easy to remove the adapter 20 from the separator 19. And when a force F2 is applied to the locking claw portion 71, the engagement between the locking claw portion 71 and the bearing portion 56 is not easily released, thereby preventing the adapter 20 from falling off the separator 19.

[0274] In addition, as mentioned above, when people or instruments in the operating room accidentally come into contact with the partition 19 or the adapter 20 and apply external force, it may also cause the endoscope to be unable to accurately observe the inside of the body cavity 201.

[0275] Furthermore, since the surgical procedure using the surgical aid device 1 is performed remotely by the surgeon in a master-slave manner, when the positions of the various parts of the surgical instrument 80 change unintentionally relative to the holder 18, the position and orientation of the surgical instrument 80 identified by the surgeon based on the information input to the operating device as the master may differ from the actual position and orientation of the surgical instrument 80, which may reduce the accuracy and safety of the surgery.

[0276] Therefore, in the surgical instrument holding device 16, as described above, a limiting portion 56b, 56b is formed in the separator 19, which engages with the limiting portion 65b to limit the circumferential rotation of the adapter 20 in the cylindrical portion 64.

[0277] Therefore, with the adapter 20 installed on the separator 19 and the separator 19 installed on the retainer 18, the rotation of the adapter 20 with the surgical instrument 80 installed relative to the separator 19 is restricted. This prevents the surgical instrument 80 from rotating unintentionally relative to the retainer 18 and prevents displacement of the surgical instrument 80 relative to the retainer 18, thereby ensuring the accuracy and safety of the surgery.

[0278] In addition, the separator 19 is provided with rotation-restricted portions 57, 57, and the retainer 18 is formed with rotation-restricted portions 53b, 53b, ... The rotation-restricted portions 53b, 53b, ... engage with the rotation-restricted portions 57 to restrict the rotation of the separator 19 in the circumferential direction of the insertion portion 55.

[0279] Therefore, with the adapter 20 installed on the separator 19 and the separator 19 installed on the retainer 18, the rotation of the adapter 20 relative to the separator 19 and the rotation of the separator 19 relative to the retainer 18 are restricted. Thus, the surgical instrument 80 can be prevented from rotating unintentionally relative to the retainer 18, ensuring high positional accuracy of the surgical instrument 80 and thus performing the surgery accurately.

[0280] In the surgical aid device 1, during and before / after surgery, the surgical instrument holding device 16 may rotate relative to the fourth movable body 15. In this case, the drive body 17 in the surgical instrument holding device 16 rotates relative to the fourth movable body 15, and the drive body 17 can rotate relative to the fourth movable body 15 between a first rotation position and a second rotation position (see reference). Figure 41 as well as Figure 42 ).

[0281] The first rotational position is, for example, the position where the shaft 81 of the surgical instrument 80 is held in a generally horizontal state (see reference). Figure 41 The second rotational position is, for example, a position in which the shaft 81 of the surgical instrument 80 is slightly tilted relative to the vertical direction while it is positioned below the camera 82 (see reference). Figure 42 ).

[0282] As described above, the surgical instrument holding device 16 is generally L-shaped, with the front portion of the front part being a narrow portion 48 with a small vertical width, and the rear portion of the front part being a wide portion 49 with a large vertical width compared to the narrow portion 48.

[0283] The portion of the drive body 17 extending forward and backward at the second rotational position is located near the fourth movable body 15. However, the drive body 17 is formed by a narrow portion 48 and a wide portion 49 as described above. Thus, at the second rotational position, the narrow portion 48 is close to the fourth movable body 15, and a portion of the fourth movable body 15 is located in the first concave space 50. The drive body 17 and the fourth movable body 15 are not in contact (see reference). Figure 42 ).

[0284] Therefore, it is possible to prevent the drive body 17 from contacting the fourth movable body 15 to prevent damage to both, and to enable the drive body 17 to rotate smoothly relative to the fourth movable body 15.

[0285] In addition, the drive body 17 is formed into a shape consisting of a narrow portion 48 and a wide portion 49, so that the light guide 83 of the surgical instrument 80 is close to the narrow portion 48, and the light-incident portion 83c is located in the second concave space 51 and is located at a position separated from the wide portion 49.

[0286] Therefore, it is possible to prevent damage to the drive body 17 and the light guide 83, and to enable the surgical instrument 80 to rotate smoothly relative to the drive body 17 in the direction of rotation around the axis 81 without interference with the drive body 17.

[0287] In particular, in the drive body 17, the part close to the connecting part to the fourth movable body 15, namely the connecting member 27, is set as a narrow part 48, and the part separated from the connecting member 27 is set as a wide part 49. As a result, the encoder 32, drive motor 33 and other structures required to rotate the holding body 18 can be arranged in the wide part 49 with a large configuration space, thereby increasing the degree of design freedom.

[0288] In addition, the shaft-shaped connecting shaft 35, which is used to transmit driving force from the drive motor 33 to the holding body 18, is arranged in the narrow part 48, thereby minimizing the shape of the narrow part 48 and easily and efficiently avoiding interference between the drive body 17 and the fourth movable body 15, and interference between the drive body 17 and the light guide 83.

[0289] <Other>

[0290] The above example shows a detection mechanism 38, which includes main bodies 41 and 44 and detection pins 42 and 45 that move relative to the main bodies 41 and 44. However, in the surgical instrument holding device 16, a detection mechanism 38A that performs detection by detection light may be used instead of the detection mechanism 38 (see reference). Figure 43 ).

[0291] When using the detection mechanism 38A, at least the bearing portion 56 in the separator 19 and at least the pushing portion 65 in the adapter 20 are formed of a light-reflective material or have been treated with a light-reflective surface.

[0292] The detection mechanism 38A has a first detection unit 39A and a second detection unit 40A, and a light-emitting unit (not shown) and a light-receiving unit are respectively provided in the first detection unit 39A and the second detection unit 40A. Lasers (detection lights) are emitted from the light-emitting units of the first detection unit 39A and the second detection unit 40A toward the receiving part 56 of the separator 19 and the pushing part 65 of the adapter 20, respectively.

[0293] When the laser emitted from the light-emitting part of the first detection unit 39A is reflected by the receiving part 56 and received by the light-receiving part of the first detection unit 39A, the situation of the laser being received by the light-receiving part is sent to the detection circuit as a detection signal, thereby detecting that the separator 19 is properly installed in the holder 18.

[0294] Furthermore, when the laser emitted from the light-emitting part of the second detection unit 40A is reflected by the pusher 65 and received by the light-receiving part of the second detection unit 40A, the situation where the laser is received by the light-receiving part is sent to the detection circuit as a detection signal, thereby detecting that the detection adapter 20 is properly installed on the separator 19.

[0295] Thus, a detection mechanism 38A is provided in the surgical instrument holding device 16. The detection mechanism 38A has: a light-emitting part that emits detection light toward the separator 19 or the adapter 20; and a light-receiving part that receives the detection light reflected by the separator 19 or the adapter 20. The installation state of the separator 19 relative to the holding body 18 is detected by the detection light reflected by the separator 19, and the installation state of the adapter 20 relative to the separator 19 is detected by the detection light reflected by the adapter 20.

[0296] Therefore, the installation status related to the separator 19 and the adapter 20 can be easily detected with a simple structure.

[0297] Alternatively, the rotation directions of the first movable body 7, the second movable body 8, the third movable body 12, the fourth movable body 15, the driving body 17, and the holding body 18 are not limited to the directions shown above. If the surgical instrument 80 can move in orthogonal triaxial directions and can be set to any posture, it can be set to any direction.

[0298] Furthermore, the surgical aid device 1 with six degrees of freedom was shown as an example above. The surgical aid device 1 can be any structure if it is a structure that can move in orthogonal triaxial directions.

[0299] Additionally, as an example shown above, a second engaging portion 67 is provided in the adapter 20. This second engaging portion 67 has a stepped surface 69a formed at the boundary between the folded-back portion 69 and the base portion 68. However, it is also possible that, for example, the thickness direction surface of the base portion 68 is formed as a curved surface or a plane, and the base portion 68 is continuous with the folded-back portion 69 (see reference). Figure 44 ).

[0300] In this way, the second engaging portion 67 is provided, and the thickness direction surface of the base end portion 68 of the second engaging portion 67 is formed as a curved surface or a plane. The base end portion 68 is continuous with the folded-back portion 69, thereby making it less likely for stress concentration to occur at the boundary between the base end portion 68 and the folded-back portion 69, and thus improving the strength of the second engaging portion 67.

[0301] Explanation of reference numerals in the attached figures

[0302] 1: Surgical aid device; 7: First movable body; 8: Second movable body; 12: Third movable body; 15: Fourth movable body; 16: Surgical instrument holding device; 17: Drive body; 18: Holding body; 19: Separator; 19a: Assembly / disassembly opening; 20: Adapter; 52: First engaging receiving part; 56: Receiving part; 58: First engaging part; 61: Second engaging receiving part; 65: Pushing part; 67: Second engaging part; 68: Base end; 69: Fold-back part; 70: Outer side; 71: Engaging claw part.

Claims

1. A surgical instrument holding device, wherein the surgical instrument holding device comprises: An adapter is provided, and surgical instruments are detachably mounted on the adapter. A separator, wherein the adapter is detachably mounted to the separator; A retainer, wherein the separator is detachably mounted on the retainer; as well as A driving body that supports the retainer in a rotatable manner and applies a driving force to the retainer. A bearing portion is provided in the partition. The adapter is provided with a snap-fit ​​portion that elastically deforms when the adapter is installed into the separator, and a push-fit portion that is pressed against the receiving portion. The pushing part is pressed against the receiving part, and the engaging part, in its elastically reset state, engages with the receiving part from a direction opposite to the pushing direction of the pushing part relative to the receiving part, thereby installing the adapter onto the separator. The engaging portion is formed to protrude from the pushing portion. The engaging portion is provided with: a base end portion, which is continuous with the pushing portion and extends in the protruding direction from the pushing portion; and a fold-back portion, which is continuous with the base end portion and is formed in a fold-back shape; An outer portion, which is continuous with the folded-back portion and at least a portion faces the base end and is located on the outer periphery of the pressing portion; and an engaging claw portion, which is continuous with the outer portion and bends toward the pressing portion relative to the outer portion. The engaging claw engages with the receiving part.

2. The surgical instrument holding device according to claim 1, characterized in that, A locking support part is provided in the support part. The engaging claw clamps the receiving portion and engages with the engaging receiving portion from the opposite side of the pushing portion.

3. The surgical instrument holding device according to claim 1 or claim 2, characterized in that, The continuous direction of each part of the engaging portion is defined as the length direction, and the direction orthogonal to the length direction and connecting the inner and outer peripheral surfaces is defined as the thickness direction. The thickness of the base end is thinner than the thickness of the engaging claw portion.

4. The surgical instrument holding device according to claim 3, characterized in that, The outer portion is thicker than the base portion.

5. The surgical instrument holding device according to claim 2, characterized in that, The engaging portion and the engaging receiving portion are respectively configured as a second engaging portion and a second engaging receiving portion. A first engaging receiving part is provided in the retaining body. A first engaging portion is provided in the separator. When the separator is installed into the retainer, the first engaging portion elastically deforms and engages with the first engaging receiving portion. The first engaging portion engages with the first engaging receiving portion in a resiliently reset state, thereby the separator is installed on the retaining body.

6. A surgical aid device comprising a surgical instrument holding device for holding surgical instruments, wherein in the surgical aid device, The surgical instrument holding device includes: An adapter to which the surgical instrument is detachably mounted; A separator, wherein the adapter is detachably mounted to the separator; A retainer, wherein the separator is detachably mounted on the retainer; as well as A driving body that supports the retainer in a rotatable manner and applies a driving force to the retainer. A bearing portion is provided in the partition. The adapter is provided with a snap-fit ​​portion that elastically deforms when the adapter is installed into the separator, and a push-fit portion that is pressed against the receiving portion. The pushing part is pressed against the receiving part, and the engaging part, in its elastically reset state, engages with the receiving part from a direction opposite to the pushing direction of the pushing part relative to the receiving part, thereby installing the adapter onto the separator. The engaging portion is formed to protrude from the pushing portion. The engaging portion is provided with: a base end portion, which is continuous with the pushing portion and extends in the protruding direction from the pushing portion; and a fold-back portion, which is continuous with the base end portion and is formed in a fold-back shape; An outer portion, which is continuous with the folded-back portion and at least a portion faces the base end and is located on the outer periphery of the pressing portion; and an engaging claw portion, which is continuous with the outer portion and bends toward the pressing portion relative to the outer portion. The engaging claw engages with the receiving part.

Images