Surgical assist devices

Abstract

The invention comprises: a plurality of connecting arms; a bracket supported by the connecting arms; and a fixed base connected to the connecting arms, wherein the fixed base comprises: a base body, inside which predetermined parts are arranged; and a clamp, at least a part of which protrudes from the base body, and the clamp can be fixed to the operating table and the position of the clamp in the vertical direction relative to the base body can be changed. Thus, in any state of the fixed base being fixed to the operating table or fixed to the stage, the position of the clamp in the vertical direction relative to the base body can be changed.

Description

Technical Field

[0001] The present invention relates to the technical field of a surgical assisting device having a fixed base that can be fixed to an operating table. Background Art

[0002] In recent years, surgical operations using surgical assisting devices have become popular. Such surgical assisting devices have a plurality of connecting arms that are sequentially connected in a rotatable or rotating manner, and the connecting arms are operated by a driving force such as a driver, and a bracket for holding surgical instruments is connected to the connecting arm at one end of the connecting direction. Depending on the type and condition of the operation, an endoscope, forceps, etc. are used as surgical instruments.

[0003] In the surgery assisting device, when a plurality of connecting arms are rotated or pivoted in predetermined directions, the position and posture of the surgical instrument change along with the movement of the connecting arms, and a surgical operation is performed using the surgical instrument held by the holder.

[0004] The surgical operation using the above-mentioned surgical assisting device is generally performed by the operator (physician) remotely controlling the surgical assisting device installed in the operating room in a master-slave mode. When performing such a surgical operation, a pivot point is set as a reference point for the position and posture of the surgical instrument.

[0005] The pivot point is located at a position that is substantially consistent with the incision formed in the patient's body cavity for inserting the surgical instrument, and is substantially consistent with the position of the trocar when a trocar is used. Therefore, when the surgical instrument is inserted into the patient's body cavity, the position and posture of the surgical instrument are controlled in such a way that a part of the surgical instrument always passes through the pivot point, so that a part of the surgical instrument passes through the pivot point, thereby preventing a load from being generated on the tissue near the patient's body surface, thereby ensuring safety.

[0006] Among the surgical assisting devices described above, there are surgical assisting devices that are used in a state where they are fixed to an operating table with a clamp during surgery (for example, see Patent Documents 1 and 2). In addition, there are also cases where such surgical assisting devices can be used in a state where they are fixed to a stage (trolley) with a clamp and the stage is set around the operating table.

[0007] Prior art literature

[0008] Patent Literature

[0009] Patent Document 1: Japanese Patent Application Publication No. 2021-78781

[0010] Patent Document 2: Japanese Patent Application Publication No. 2002-191545 Summary of the invention

[0011] Problems to be solved by the invention

[0012] However, during surgery, there is a desired height of the surgical assisting device to be used depending on the patient's body shape, surgical method, etc., and using the surgical assisting device at such a desired height can improve ease of use and enable surgery to be performed appropriately and quickly.

[0013] In addition, when the base body is used with being fixed to the stage, it is also desired that the parts of the surgical assisting device do not interfere with the operating table and that the stage be used as close to the operating table as possible, thereby improving ease of use.

[0014] Therefore, an object of the surgical assisting device of the present invention is to improve the usability in any state of the surgical assisting device being fixed to the operating table or being fixed to the stage.

[0015] Solutions for solving problems

[0016] The surgical assisting device according to the present invention comprises: a plurality of connecting arms; a bracket supported by the connecting arms; and a fixed base connected to the connecting arms, wherein the fixed base comprises: a base body, wherein predetermined parts are arranged inside the base body; and a clamp, at least a part of which protrudes from the base body, and the clamp can be fixed to an operating table and its position in the up-down direction relative to the base body can be changed.

[0017] Thus, in any state of the state where the clamp is fixed to the operating table or the state where the clamp is fixed to the stage, the position of the clamp in the vertical direction relative to the base body can be changed.

[0018] Effects of the Invention

[0019] According to the present invention, the position of the clamp in the up-down direction relative to the base body can be changed in any state of the fixed base being fixed to the operating table and being fixed to the stage. Therefore, the surgical auxiliary device can be set to the most suitable height in the state of being fixed to the operating table, and the clamp can be removed without interfering with the operating table in the state of being fixed to the stage, thereby improving ease of use in either state. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 and Figures 2 to 9 The following is an embodiment of the surgical assisting device of the present invention. Figure 1 This is a schematic perspective view showing a usage state of the surgical assisting device.

[0021] Figure 2 It is a schematic three-dimensional diagram of a surgical assisting device.

[0022] Figure 3It is a perspective view showing a state where the surgical assisting device is installed on a stage.

[0023] Figure 4 It is a cross-sectional view showing a state before the clamp is fixed to the base body.

[0024] Figure 5 It is a three-dimensional diagram of the clamp.

[0025] Figure 6 So from Figure 5 A perspective view of the clamp showing states of being viewed from different directions.

[0026] Figure 7 It is a cross-sectional view showing a state in which the clamp is being fixed to the base body.

[0027] Figure 8 It is a cross-sectional view showing a state where the clamp is fixed to the base body.

[0028] Fig. 9 It is an exploded perspective view showing a separator and an adapter equipped with a surgical instrument. DETAILED DESCRIPTION

[0029] Hereinafter, a mode for implementing the surgical assisting device of the present invention will be described with reference to the drawings.

[0030] In addition, the front, back, up, down, left, and right directions shown below are only for convenience of description, and the implementation of the present invention is not limited to these directions.

[0031] <General Structure of Surgery Assisting Devices, Etc.>

[0032] First, the schematic structure of the surgical assisting device 1 and the like will be described (see Figure 1 as well as Figure 2 ).

[0033] An operating table 100 is provided in an operating room, and a patient 200 lies flat on the operating table 100, for example, in a supine position. A fixing rail 100a is provided on the side of the operating table 100. An incision 202 is formed in a body cavity 201 of the patient 200, for example, an abdominal wall 201a. When performing a surgical operation, a part of a surgical instrument described later is inserted into the incision 202. The incision 202 is a small hole through which a part of the surgical instrument is inserted.

[0034] The surgical assisting device 1 includes a device body 2 and a support 3. Inside the device body 2, for example, one electric motor (not shown) and a plurality of pneumatic actuators (not shown) are arranged.

[0035] The device body 2 includes a fixed base 4 that can be fixed to the operating table 100 , and an arm 5 that is connected to the fixed base 4 .

[0036] The fixed base 4 includes: a substantially rectangular parallelepiped base body 6, in which predetermined mechanisms and the like are provided; a base 7 rotatably supported by the base body 6; and a clamp 8, except for a part of the clamp 8, which protrudes from the base body 6. In the fixed base 4, the base 7 is rotatably supported by the base body 6 with an axis S1 extending in the vertical direction as a fulcrum. The base 7 rotates relative to the fixed base 4 by the driving force of a motor, for example.

[0037] The arm body 5 has a first connection arm 9, a second connection arm 10, and a third connection arm 11. The number of connection arms in the arm body 5 is not limited to three, and any number may be two or more, or may be four or more.

[0038] One end of the long direction of the first connecting arm 9 is set as the first connecting portion 9a, and the other end of the long direction is set as the second connecting portion 9b. The first connecting portion 9a of the first connecting arm 9 is connected to the base 7, and the first connecting arm 9 can rotate relative to the base 7 with the axis S2 extending in the horizontal direction as a fulcrum. For example, the first connecting arm 9 is rotated relative to the base 7 by a pneumatic actuator, and the pneumatic actuator is operated by compressed air supplied from a compressor.

[0039] One end of the second connecting arm 10 in the long direction is provided as a first connecting portion 10a, and the other end in the long direction is provided as a second connecting portion 10b. The first connecting portion 10a of the second connecting arm 10 is connected to the second connecting portion 9b of the first connecting arm 9, and the second connecting arm 10 can rotate relative to the first connecting arm 9 with the axis S3 extending in the horizontal direction as a fulcrum. For example, the second connecting arm 10 is rotated relative to the first connecting arm 9 by a pneumatic actuator that is operated by compressed air supplied from a compressor.

[0040] One end of the third connecting arm 11 in the long direction is set as a first connecting part 11a, and the other end of the long direction is set as a second connecting part 11b. The second connecting part 11b is composed of, for example, two wrists. The first connecting part 11a of the third connecting arm 11 is connected to the second connecting part 10b of the second connecting arm 10, and the third connecting arm 11 can rotate relative to the second connecting arm 10 with the axis S4 as a fulcrum, and the axis S4 extends in a direction orthogonal to the axis S3. The third connecting arm 11 is, for example, a part that performs the following free rotation action: it does not rotate by an external driving force such as a driving force of a motor or a pneumatic driver, but rotates according to its own weight or other actions of the first connecting arm 9, the second connecting arm 10, etc.

[0041] The bracket 3 is rotatably supported (connected) to the second connection portion 11b of the third connection arm 11. The bracket 3 can rotate relative to the third connection arm 11 with the axis S5 as a fulcrum, and the axis S5 extends in a direction perpendicular to the axis S4. The bracket 3 is a portion that performs the following free rotational movement: it does not rotate by an external driving force such as a driving force of a motor or a pneumatic actuator, but rotates according to its own weight or other movements of the first connection arm 9, the second connection arm 10, the third connection arm 11, etc.

[0042] A part of the bracket 3 is rotatable, and the bracket 3 includes: a base cylinder 12 that does not rotate; a rotating portion 13 that is rotatably supported by the base cylinder 12; and a connecting cylinder 14 that is mounted on the base cylinder 12 (see Figure 3 ).

[0043] A portion of the rotating portion 13 is located inside the base cylinder 12 and the connecting cylinder 14, and the rear end of the rotating portion 13 is located on the rear side of the base cylinder 12. The rotating portion 13 can rotate relative to the base cylinder 12 and the connecting cylinder 14 in a direction of rotation around an axis S6, and the axis S6 is orthogonal to the axis S5. For example, the rotating portion 13 can be rotated by a pneumatic actuator that is operated by compressed air supplied from a compressor, and can also be rotated manually.

[0044] A locking mechanism (not shown) is disposed inside the bracket 3. An unlocking button 14a is disposed on the connecting tube 14. A switching button 13a is disposed on the rear end of the rotating part 13. The switching button 13a has a function of switching the driving force for rotating the rotating part 13.

[0045] In the stand 3, when the switch button 13a is operated, the rotating part 13 can be rotated manually. On the other hand, when the switch button 13a is not operated, the rotating part 13 can be rotated by the driving force of the pneumatic actuator.

[0046] As described above, in the surgical assisting device 1, each part is configured to be able to rotate or turn at six axes from the axis S1 to the axis S6, so the direction and position (posture) of the surgical instrument held by the support 3 have a high degree of freedom, and the surgery can be performed quickly with high precision. In particular, since the axis S4 and the axis S5 are freely rotated or turned and the axis S4 is orthogonal to the axis S5, when the direction or position of the surgical instrument inserted into the incision 202 changes, when the direction or position of the incision 202 changes due to the patient 200's respiratory state, etc., the load on the tissue near the body surface of the patient 200 can be reduced.

[0047] In addition, in the surgical assisting device 1, the rotation of the arm body 5 at the axis S1 which is the farthest distance from the surgical instrument is performed by the driving force of the motor, while the rotation or rotation of the arm body 5 at the axis S2, axis S3, and axis S6 which are closer to the surgical instrument than the axis S1 is performed by the driving force of the pneumatic driver.

[0048] Therefore, at a position close to the surgical instrument, the arm 5 is moved by the driving force of the pneumatic actuator which has a smaller load on the patient 200 than the driving force of the electric motor, thereby further reducing the load on the tissue near the body surface of the patient 200.

[0049] Furthermore, the arm 5 can be rotated or turned at more locations by the driving force of the pneumatic actuator than by the driving force of the electric motor, thereby reducing the load on the tissue near the body surface of the patient 200 .

[0050] In addition, an ultrasonic motor such as a piezoelectric motor capable of high-precision positioning may be used in place of an electric motor or a pneumatic actuator in the surgical assisting device 1. By using an ultrasonic motor, power saving and miniaturization of the surgical assisting device 1 can be achieved.

[0051] <Specific structure of the fixed base, etc.>

[0052] Next, the specific structure of the fixed base 4 will be described (see Figures 2 to 8 ).

[0053] As described above, the fixed base 4 includes a base body 6, a base 7, and a clamp 8 (see Figure 2 and Figure 3 ).

[0054] The base body 6 includes a housing 15 formed in a substantially rectangular parallelepiped shape, predetermined mechanisms arranged inside the housing 15, and the housing 15 is composed of a front surface portion 16, an upper surface portion 17, a pair of side surfaces 18, a lower surface portion not shown, and a rear surface portion not shown (see Figure 3 and Figure 4 ).

[0055] A plurality of positioning holes 16a are formed in the front surface portion 16. For example, three positioning holes 16a are formed separately in the upper and lower parts. A plurality of configuration holes 16b are formed in the front surface portion 16. The configuration holes 16b are formed slightly below the outer side of the positioning holes 16a in the left-right direction. Thus, three configuration holes 16b are formed on the left and right sides of the positioning holes 16a, respectively.

[0056] In addition, in the base body 6, the number of the positioning holes 16a can be any number as long as there are plural positioning holes 16a, and one arrangement hole 16b is formed on the left and right of each positioning hole 16a.

[0057] The base body 6 is provided with fixing protrusions 19 that protrude outward from the pair of side surface portions 18 . The fixing protrusions 19 are provided at positions close to the upper ends of the side surface portions 18 .

[0058] The base body 6 is provided with a locking member 20, and a portion of the locking member 20 is inserted into the arrangement hole 16b and arranged (see Figure 4 ). The locking member 20 is formed into a cylindrical shape extending axially in the front-to-back direction, and is in a state where the front end is inserted into the configuration hole 16b. The space inside the locking member 20 is formed as an insertion hole 21. An inclined surface whose diameter increases toward the rear is formed in the middle part of the inner peripheral surface of the locking member 20 in the axial direction, and the inclined surface is provided as a locking engagement portion 20a. The insertion hole 21 is formed as a displacement limiting portion 21a in which the portion closer to the front side is smaller in diameter than the portion closer to the rear side compared to the locking engagement portion 20a.

[0059] An air intake pipe (not shown) protrudes from the rear surface of the base body 6. The air intake pipe is connected to the compressor via an intake pipe. Thus, compressed air is supplied from the compressor to the interior of the fixed base 4. The compressed air supplied to the interior of the fixed base 4 flows through the interior of the fixed base 4 toward the interior of the arm body 5 and is used as a driving force to rotate or turn the first connecting arm 9, the second connecting arm 10, and the bracket 3.

[0060] The clamp 8 includes a clamp base 22, a lower clamp portion 23, a clamp rod 24, and a pair of locked members 25 (see Figures 4 to 6 ).

[0061] The clamping base 22 has: a roughly rectangular frame portion 26 that passes through from front to back; an upper clamping portion 27 that protrudes forward from the upper end of the frame portion 26; a pair of support plate portions 28 that protrude forward from the left and right side portions of the frame portion 26, respectively; and a pair of mounting protrusions 29 that protrude outward in the left and right directions from the portion extending from the rear end of the frame portion 26 to the rear end of the support plate portion 28.

[0062] A screw hole (not shown) penetrating vertically is formed in the upper clamping portion 27. An upper insertion recess 27a opening downward and laterally is formed near the front end of the upper clamping portion 27.

[0063] The front end of the support plate portion 28 is located rearward of the front end of the upper clamp portion 27. The support plate portion 28 is provided with a stopper shaft 28a that protrudes inward in the left-right direction.

[0064] The mounting protrusion 29 is formed with a shaft insertion hole 30 that penetrates the front and rear sides. The shaft insertion hole 30 is formed by a large diameter portion 31 located on the front side and a small diameter portion 32 located on the rear side (see Figure 4A forward-facing annular stepped surface 33 is formed at a boundary portion between the large diameter portion 31 and the small diameter portion 32 of the mounting protrusion 29 .

[0065] The clamp 8 is provided with a positioning pin 34 (see Figure 6 ).

[0066] On the lower side of the upper clamping portion 27, the lower clamping portion 23 is supported by a pair of support plate portions 28 in a rotatable manner. The lower clamping portion 23 has: a main body portion 35, which is located between the pair of support plate portions 28; and a pair of supported shaft portions 36, which protrude from the main body portion 35 to the outside in the left and right directions. The main body portion 35 is formed in a flat shape, and has a lower insertion recess 35a opened upward and laterally at the front end portion. The rear end portion of the main body portion 35 is provided with a pressed portion 35b. The supported shaft portion 36 is supported by the pair of support plate portions 28, whereby the lower clamping portion 23 can rotate relative to the clamping base 22 with the supported shaft portion 36 as a fulcrum.

[0067] The supported shaft portion 36 protrudes from the portion between the lower insertion recess 35a and the pressed portion 35b. The supported shaft portion 36 supports the coil portion 37a of the torsion coil spring 37. The arm portion 37b of one side of the torsion coil spring 37 is engaged with the support plate portion 28, and the arm portion 37c of the other side is engaged with the main body portion 35. Therefore, the lower clamping portion 23 is urged in the direction in which the pressed portion 35b approaches the upper clamping portion 27 by the force of the torsion coil spring 37. The main body portion 35 contacts the stopper shaft 28a of the support plate portion 28, thereby limiting the rotation of the lower clamping portion 23 in the direction in which the torsion coil spring 37 urges the lower clamping portion 23.

[0068] The clamp rod 24 is composed of a rotation operation portion 24a and a threaded shaft portion 24b. The threaded shaft portion 24b protrudes downward from the rotation operation portion 24a. A thread groove is formed on the outer peripheral surface of the threaded shaft portion 24b.

[0069] The threaded shaft portion 24b of the clamping rod 24 is screwed into the threaded hole while the upper clamping portion 27 is passed through, and the clamping rod 24 is in a state where the lower end of the threaded shaft portion 24b contacts the pressed portion 35b of the main body portion 35 from above. The pressed portion 35b of the main body portion 35 is pushed to the lower end of the threaded shaft portion 24b by the force of the torsion coil spring 37. Therefore, when the rotation operation portion 24a of the clamping rod 24 is manually rotated, the thread groove screwed into the threaded hole is conveyed in the axial direction of the threaded shaft portion 24b, and the threaded shaft portion 24b moves up and down according to the rotation direction of the rotation operation portion 24a, so that the lower clamping portion 23 rotates relative to the clamping base 22 with the supported shaft portion 36 as a fulcrum.

[0070] The locked member 25 is formed in a shaft shape extending in the front-rear direction (see Figure 6 ). The first insertion portion 38 is provided as approximately half of the front side of the locked member 25 except the front end, and the second insertion portion 39 is provided as approximately half of the rear side. The diameter of the first insertion portion 38 is larger than the diameter of the second insertion portion 39, and is one circle smaller than the diameter of the large diameter portion 31 of the shaft insertion hole 30 formed in the mounting protrusion 29. The diameter of the second insertion portion 39 is one circle smaller than the diameter of the small diameter portion 32 of the shaft insertion hole 30 formed in the mounting protrusion 29, and is approximately the same as the diameter of the displacement limiting portion 21a of the locking member 20.

[0071] The plurality of locking balls 40 are separated in the circumferential direction and supported by the rear end portion of the second insertion portion 39 in a displaceable state (see Figure 4 The locking ball 40 can be displaced in the radial direction of the second insertion portion 39 and can be displaced between a protruding position which is a position most protruding from the second insertion portion 39 and an introduction position which is a position most introduced into the interior of the second insertion portion 39. The locking ball 40 is biased in a direction from the introduction position toward the protruding position by a biasing spring (not shown) disposed inside the second insertion portion 39.

[0072] In the fixed base 4 configured as described above, the clamp 8 is mounted on the base body 6 (see Figure 4 , Figure 7 as well as Figure 8 ).

[0073] First, the positioning pin 34 of the clamp 8 is inserted into the positioning hole 16a of the base body 6, so that the clamp 8 is positioned on the base body 6. At this time, the positioning pin 34 is inserted into any positioning hole 16a formed separately up and down, so the clamp 8 can be installed at a desired height in the base body 6.

[0074] When the clamp 8 is positioned on the base body 6, the shaft insertion hole 30 formed in the mounting protrusion 29 and the insertion hole 21 of the locking member 20 are aligned in front and back (see Figure 4 ).

[0075] Then, the pair of locked members 25 are sequentially inserted into the shaft insertion hole 30 formed in the mounting protrusion 29 and the insertion hole 21 of the locking member 20. When the locked member 25 is inserted into the insertion hole 21 from the shaft insertion hole 30 and the second insertion portion 39 is located at the displacement limiting portion 21a of the insertion hole 21, the locking ball 40 located at the protruding position is restricted from displacement toward the protruding position by the displacement limiting portion 21a, and is displaced toward the introduction position against the urging force of the urging spring (see Figure 7When the locked member 25 is further inserted into the inner side of the shaft insertion hole 30, the rear surface of the first insertion portion 38 approaches or contacts the stepped surface 33 of the shaft insertion hole 30, and the locking ball 40 is located at the rear side of the displacement limiting portion 21a, and the displacement restriction is released, so that the locking ball 40 is displaced toward the protruding position due to the force of the biasing spring, and is engaged with the locking engaging portion 20a (refer to Figure 8 ). Thus, the clamp 8 is locked to the base body 6 by the locking member 20 .

[0076] When the locking ball 40 is located at the rear side of the displacement limiting portion 21a and is engaged with the locking engaging portion 20a, the displacement of the locking ball 40 is transmitted to the operator's finger, so that the operator can recognize that the clamp 8 has been locked to the base body 6 by the locking member 20. In addition, it can also be configured so that when the locking ball 40 is engaged with the locking engaging portion 20a, a sound is generated along with the displacement of the locking ball 40. In this case, the operator can recognize that the clamp 8 has been locked to the base body 6 by the locking member 20 by listening to the sound.

[0077] As described above, in the surgical assisting device 1 , the clamp 8 is provided with two locked members 25 , and the base body 6 is provided with two locking members 20 . The locked members 25 are respectively engaged with the two locking members 20 , and the two locking members 20 lock the clamp 8 to the base body 6 .

[0078] Therefore, even when one locked member 25 is disengaged from the locking member 20, the other locked member 25 is engaged with the locking member 20, and the clamp 8 is retained by the base body 6, thereby preventing the clamp 8 from accidentally falling off the base body 6.

[0079] The locking member 20 is formed in a cylindrical shape, and the locked member 25 is formed in a shaft shape. The locked member 25 is inserted into the locking member 20 to a predetermined position, whereby the clamp 8 is locked to the base body 6 .

[0080] Therefore, since the locked member 25 is inserted into the locking member 20 and the clamp 8 is locked to the base body 6 , the clamp 8 can be locked to the base body 6 easily and reliably.

[0081] Meanwhile, the locked member 25 is pulled out from the insertion hole 21 and the shaft insertion hole 30 to release the engagement of the lock ball 40 with the lock engagement portion 20 a and the positioning pin 34 is pulled out from the positioning hole 16 a , whereby the clamp 8 can be removed from the base body 6 .

[0082] In addition, it can also be configured such that threaded groove portions that are screwed together are formed on a portion of the inner circumferential surface of the locking member 20 and a portion of the outer circumferential surface of the locked member 25, and the locked member 25 is rotated relative to the locking member 20 while the threaded groove portions of the two are screwed together, thereby causing the locked member 25 to move axially relative to the locking member 20.

[0083] <Structure of separator, etc.>

[0084] Next, the structure of the partition member 41 attached to the bracket 3 will be described (see Figure 1 , Figure 2 as well as Fig. 9 ).

[0085] The partition 41 is detachably mounted on the bracket 3. The partition 41 includes: a substantially disk-shaped mounting portion 42; an insertion portion 43 protruding from one surface of the mounting portion 42 in the thickness direction; and a pair of engaging portions 44 protruding from the other surface of the mounting portion 42 in the thickness direction. The partition 41 is mounted on the bracket 3 in a state where the insertion portion 43 is inserted into the front end portion of the bracket 3 and locked to the bracket 3 by the locking mechanism. The lock button 14a of the bracket 3 is operated, thereby releasing the lock of the bracket 3 by the partition 41.

[0086] The adapter 45 is detachably mounted on the partition 41 . The adapter 45 is formed by vertically coupling a first member 46 and a second member 47 , for example. The rear end of the adapter 45 is provided as a mounted portion 48 , which is engaged and mounted on the partition 41 .

[0087] The surgical instrument 80 is mounted on the adapter 45. The surgical instrument 80 is provided as a mirror component of an endoscope, for example, and includes a shaft 81 in which a plurality of lenses are arranged, a head 82 coupled to one end of the shaft 81, and a light guide 83 coupled to a middle portion of the shaft 81. An imaging element (not shown) is arranged in the head 82.

[0088] A signal line and a power line, that is, a cable (not shown) is connected to the head 82 , and a light guide cable (not shown) for guiding light is connected to the light guide 83 .

[0089] The head 82 of the surgical instrument 80 is clamped from above and below by the first member 46 and the second member 47, whereby the surgical instrument 80 is held by the adapter 45. In the adapter 45 holding the surgical instrument 80, the mounted portion 48 is inserted between the pair of engaging portions 44 to engage with the mounting portion 42 and the engaging portion 44, whereby the adapter 45 is mounted to the partition 41. Thus, the surgical instrument 80 is held by the bracket 3 via the adapter 45 and the partition 41.

[0090] At least the front end of the shaft 81 of the surgical instrument 80 is inserted into the body cavity 201 from the incision 202 formed in the patient 200. When the front end of the shaft 81 is inserted into the body cavity 201, illumination light is irradiated from the front end of the shaft 81, and the internal state of the body cavity 201 is photographed by the imaging element.

[0091] <Stage Structure, etc.>

[0092] Next, the structure of the stage 50 to which the fixed base 4 is fixed, etc. will be described (see Figure 3 ).

[0093] In the surgical assisting device 1 , for example, the fixed base 4 is provided on a stage 50 which can also be used as a carriage, and after being transported to a sterilization room by the stage 50 and sterilized, the device is transported to an operating room for surgery.

[0094] The stage 50 includes a platform 52 supporting a plurality of wheels 51, a connection base 53 connected to the platform 52, and a device fixing portion 54 connected to the connection base 53. The connection base 53 and the device fixing portion 54 are located on the upper side of the platform 52, and the position of the device fixing portion 54 can be adjusted in the vertical direction relative to the connection base 53. Therefore, in the stage 50, the height of the surgical assisting device 1 can be changed by adjusting the height of the device fixing portion 54.

[0095] The upper portion of the device fixing portion 54 is bent backward relative to the lower portion, and the bent backward portion serves as a handle portion 54a held by the user (carrier). A pair of fixing arms 54b protruding forward below the handle portion 54a are provided on the device fixing portion 54 in a left-right separated manner.

[0096] For example, the fixing members 55 are attached to each of the pair of fixing protrusions 19 that protrude outward from the side surface portion 18 , and the fixing members 55 are fastened to the fixing arm portions 54 b by the fasteners 56 , thereby fixing the fixing base 4 to the stage 50 .

[0097] In a state where the fixed base 4 is fixed to the stage 50 and the surgical assisting device 1 is placed on the stage 50 , the clamp 8 is located on the opposite side of the handle portion 54 a with the base body 6 clamped therebetween.

[0098] <Usage status of surgical assisting devices, etc.>

[0099] Next, the usage state of the surgical assisting device 1 and the like will be described (see Figure 1 as well as Figure 3 ).

[0100] During surgery, the surgical assisting device 1 (see FIG. 1 ) can be used while the fixed base 4 is fixed to the fixing rail 100 a of the operating table 100 by the clamp 8 . Figure 1 ).

[0101] As described above, the positioning holes 16a and the insertion holes 21 have different heights, so the positioning pin 34 and the locked member 25 of the clamp 8 can be inserted into any positioning hole 16a and the insertion hole 21 respectively, so that the clamp 8 can be installed relative to the base body 6 and locked at a desired height.

[0102] When the fixing rail 100a is inserted between the upper clamping part 27 and the lower clamping part 23, the clamping rod 24 is rotated in one direction, thereby fixing the fixing rail 100a by the clamp 8. When the clamping rod 24 is rotated, the lower clamping part 23 rotates relative to the clamping base 22 in a direction in which the lower insertion recess 35a approaches the upper clamping part 27 with the pair of supported shaft parts 36 as a fulcrum. Therefore, the fixing rail 100a is inserted between the upper insertion recess 27a of the upper clamping part 27 and the lower insertion recess 35a of the lower clamping part 23, and the fixing rail 100a is clamped by the upper clamping part 27 and the lower clamping part 23, thereby fixing the fixing base 4 to the fixing rail 100a by the clamp 8.

[0103] On the other hand, by rotating the clamp lever 24 in the direction opposite to the above direction and pivoting the lower clamp portion 23 , the clamp 8 is removed from the fixing rail 100 a , and the fixing state of the fixing base 4 to the fixing rail 100 a can be released.

[0104] In addition, as described above, during surgery, the surgical assisting device 1 can also be used in a state where the fixed base 4 is fixed to the stage 50 (see Figure 3 When the surgical assisting device 1 is used in a state where the fixed base 4 is fixed to the stage 50 , it is desirable to use the surgical assisting device 1 in a state where the surgical assisting device 1 is as close to the operating table 100 as possible.

[0105] In the surgical assisting device 1, the clamp 8 is detachably mounted on the base body 6. When the surgical assisting device 1 is used in a state where the fixed base 4 is fixed to the stage 50, the clamp 8 is not required. Therefore, in this case, the surgical assisting device 1 can be used by removing the clamp 8 from the base body 6. Therefore, by removing the clamp 8 protruding from the base body 6, the surgical assisting device 1 and the stage 50 can be brought closer to the operating table 100 accordingly.

[0106] In addition, during surgery, when the fixed base 4 is fixed to the stage 50, the clamp 8 can be installed at a position that does not interfere with the operating table 100, for example, the clamp 8 can be installed at the lowest height to use the surgical assisting device 1, or the clamp 8 can be removed to use the surgical assisting device 1.

[0107] <Conclusion>

[0108] As described above, in the surgical assisting device 1, the fixed base 4 comprises: a base body 6, inside which predetermined parts can be arranged; and a clamp 8, at least a portion of which protrudes from the base body 6, and the clamp 8 is fixed to the operating table 100, and the position of the clamp 8 in the up-and-down direction relative to the base body 6 can be changed.

[0109] Therefore, in any state of the fixed base 4 being fixed to the operating table 100 and the fixed base 50, the position of the clamp 8 in the vertical direction relative to the base body 6 can be changed. Thus, the surgical assisting device 1 can be set to the most suitable height when the fixed base 4 is fixed to the operating table 100, and the clamp 8 can be removed so as not to interfere with the operating table 100 when the fixed base 4 is fixed to the stage 50, thereby improving the usability of the surgical assisting device 1 in either state.

[0110] In addition, the example in which the clamp 8 is locked to the base body 6 by the locking member 20 or the like is shown above, but the clamp 8 may be moved in the vertical direction relative to the base body 6 by, for example, driving a motor or the like. In addition, for example, a rotation operation unit having a ball screw or the like may be used, and the clamp 8 may be moved in the vertical direction relative to the base body 6 by manually rotating the rotation operation unit.

[0111] In addition, the clamp 8 is installed on the base body 6 in a detachable manner. Therefore, when the base body 6 is fixed to the stage 50 with the clamp 8 removed from the base body 6 and the surgical assisting device 1 is used during surgery, the clamp 8 will not interfere with the operating table 100. Therefore, the surgical assisting device 1 can be brought close to the operating table 100 to use the surgical assisting device 1, thereby further improving the ease of use of the surgical assisting device 1.

[0112] In addition, when the base body 6 is fixed to the stage 50 with the clamp 8 removed from the base body 6 and the surgical assisting device 1 is used during surgery, the height of the surgical assisting device 1 can be changed according to the body shape of the patient 200, the surgical method, etc. by the height adjustment mechanism of the stage 50. In addition, when the clamp 8 is fixed to the fixing rail 100a of the operating table 100 with the clamp 8 attached to the base body 6 and the surgical assisting device 1 is used during surgery, the attachment position of the clamp 8 relative to the base body 6 is adjusted, thereby making it possible to change the height of the surgical assisting device 1 according to the body shape of the patient 200, the surgical method, etc.

[0113] Description of Reference Numerals

[0114] 100: operating table; 1: surgical assisting device; 3: support; 4: fixed base; 6: base body; 8: clamp; 9: first connecting arm; 10: second connecting arm; 11: third connecting arm; 20: locking member; 20a: locking engaging portion; 25: locked member.

Claims

1. A surgical assisting device comprising: a plurality of connecting arms; a support supported by the connecting arms; and a fixed base connected to the connecting arms. The fixed base comprises: a base body, in which predetermined parts are arranged; and a clamp, at least a part of which protrudes from the base body, and the clamp can be fixed to the operating table. The position of the clamp relative to the base body in the vertical direction can be changed. The clamp is detachably mounted on the base body. The clamp is provided with two locked members. The base body is provided with two locking members, the locked members are respectively engaged with the two locking members, and the two locking members lock the clamp to the base body. The locking member is formed into a cylindrical shape, The locked member is formed into a shaft shape, The locked member is inserted into a predetermined position of the locking member, whereby the clamp is locked to the base body. The clamp is provided with a positioning pin, and a positioning hole is formed on the base body. The positioning pin is inserted into the positioning hole. When the clamp is positioned relative to the base body, the clamp is locked on the base body.

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