Medical system, control apparatus, and control method

Abstract

To accurately detect an external force applied to the distal end of a soft part at the proximal end of the soft part.SOLUTION: The present invention provides a control device for controlling a driving device connected to a proximal end of a flexible medical manipulator, the driving device driving at least one wire for bending a bending portion at a distal end of the medical manipulator, the control device including: A tension of the wire is measured at the proximal end, and the control device includes at least one processor that controls the driving device to pull or loosen the wire within a range in which a bending angle of the bendable section is maintained at a certain angle in order to detect an external force acting on the bendable section based on a change in the tension of the wire in a state in which the bendable section is disposed at the certain angle.SELECTED DRAWING: Figure 7

Description

[Technical Field]

[0001] The present invention relates to a medical system, a control device, and a control method. [Background technology]

[0002] Conventionally, there is known an electric endoscope that bends the tip of the insertion section by driving a wire (see, for example, Patent Document 1). This endoscope uses a tension sensor located at the base end of the flexible section of the endoscope to detect the load on the bending section at the tip, and by driving the wire in a direction that reduces the load, it is possible to prevent excessive load from being applied to biological tissue from the bending section. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Patent No. 6157063 specification Summary of the Invention [Problem to be solved by the invention]

[0004] However, when the bending section is bent in one direction and the wire inside the endoscope is stationary, static friction acts on the wire at each position where the flexible section is bent, making it difficult to detect the external force acting on the tip of the flexible section using a tension sensor at the base end of the flexible section. Therefore, it is desirable to more accurately detect the external force acting on the tip of the flexible section at the base end of the flexible section. [Means for solving the problem]

[0005] One aspect of the present invention is a control device that controls a drive device connected to a base end of a flexible medical manipulator, wherein the drive device drives at least one wire for bending a bending portion at the tip of the medical manipulator, and the tension of the wire is measured at the base end. The control device is equipped with at least one processor, and the processor controls the drive device to pull or relax the wire within a range where the bending angle is maintained at a certain angle, in order to detect an external force acting on the bending portion based on a change in tension of the wire when the bending angle of the bending portion is set at the certain angle.

[0006] Another aspect of the present invention is a medical system comprising: a flexible medical manipulator; a drive unit connected to a base end of the medical manipulator and driving the medical manipulator; and a control unit controlling the drive unit, wherein the medical manipulator comprises at least one wire for bending a bending portion at the tip of the medical manipulator and a sensor for measuring tension of the wire at the base end, and the control unit comprises at least one processor, wherein the processor controls the drive unit to pull or relax the wire within a range where the bending angle is maintained at a certain angle in order to detect an external force acting on the bending portion based on a change in tension of the wire when the bending angle of the bending portion is set at the angle.

[0007] Another aspect of the present invention is a control method for driving at least one wire for bending a bending portion at the tip of a flexible medical manipulator, the control method measuring the tension of the wire at the base end of the medical manipulator, and controlling the wire to be pulled or relaxed within a range in which the bending angle is maintained at a certain angle, in order to detect an external force acting on the bending portion based on a change in the tension of the wire, from a state in which the bending angle of the bending portion is set at the certain angle. [Brief explanation of the drawings]

[0008] [Figure 1]1 is an overall configuration diagram showing the configuration of a medical system according to a first embodiment of the present invention. [Figure 2] FIG. 2 is a diagram showing an insertion portion of an endoscope of the medical system of FIG. 1. [Figure 3] 2 is a cross-sectional view showing an insertion portion of an endoscope of the medical system of FIG. 1. [Figure 4] 2 is a perspective view showing a first detachable part before being attached to the drive device of the medical system of FIG. 1. FIG. [Figure 5A] 2 is a diagram showing a wire attaching / detaching unit and a wire driving unit before being attached to a driving device of the medical system of FIG. 1. FIG. [Figure 5B] 2 is a diagram showing a wire attaching / detaching unit and a wire driving unit attached to a driving device of the medical system of FIG. 1. FIG. [Figure 6] FIG. 2 is a block diagram showing a control device according to the present embodiment. [Figure 7] FIG. 10 is a diagram showing the relationship between the amount of drive of the wire and the tension and bending angle. [Figure 8A] 10 is a schematic diagram showing the configuration of the endoscope in a state where the bending section is bent in one direction by pulling one wire. FIG. [Figure 8B] 8B is a diagram illustrating the tension distribution at each position in the longitudinal direction of one wire in FIG. 8A. FIG. [Figure 9] 7 is a flowchart illustrating a control method executed by the control device of FIG. 6. [Figure 10A] 8B is a schematic diagram showing the configuration of the endoscope in a state in which one wire is relaxed within a range in which the bending angle of the bending section is maintained from the state in FIG. 8A. FIG. [Figure 10B] 10B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 10A. FIG. [Figure 11A] 11C is a schematic diagram showing the configuration of the endoscope, illustrating a state in which an external force acts in a second direction in the tension distribution of the wire in FIG. 11B. FIG. [Figure 11B] 11B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 11A. FIG. [Figure 12A] 10B is a schematic diagram showing the configuration of the endoscope when detecting an external force in a first direction from the state of FIG. 10A. FIG. [Figure 12B] 12B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in the state of FIG. 12A. FIG. [Figure 13A] 12C is a schematic diagram showing the configuration of the endoscope, illustrating a state in which an external force acts in a first direction in the tension distribution of the wire in FIG. 12B. FIG. [Figure 13B] 13B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 13A. FIG. [Figure 14A] 8B is a schematic diagram showing the configuration of the endoscope in a state in which one wire is relaxed from the state in FIG. 8A to a point halfway within the range in which the bending angle of the bending section is maintained. FIG. [Figure 14B] 14B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 14A. FIG. [Figure 15A] 10 is a diagram showing a wire attach / detach unit and a wire driving unit before being attached to a driving device of a medical system according to a second embodiment of the present invention. FIG. [Figure 15B] 15B is a diagram showing the wire attaching / detaching unit and the wire driving unit in a state where they are attached to the driving device of the medical system of FIG. 15A. FIG. [Figure 16A] 8B is a schematic diagram showing the configuration of the endoscope in a state in which the second wire is pulled within a range in which the bending angle of the bending section is maintained, from the state in FIG. 8A in which the first wire is pulled. [Figure 16B] 16B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 16A. FIG. [Figure 17A] 16C is a schematic diagram showing the configuration of the endoscope, illustrating a state in which an external force acts in a second direction in the tension distribution of the wire in FIG. 16B. FIG. [Figure 17B] 17B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 17A. FIG. [Figure 18A] 16B is a schematic diagram showing the configuration of the endoscope when detecting an external force in a first direction from the state of FIG. 16A. FIG. [Figure 18B] 18B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 18A. FIG. [Figure 19A] 18C is a schematic diagram showing the configuration of the endoscope, illustrating a state in which an external force acts in a first direction in the tension distribution of the wire in FIG. 18B. FIG. [Figure 19B] 19B is a diagram illustrating the tension distribution at each position in the longitudinal direction of the wire in FIG. 19A. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0009] A medical system 100, a control device 40, and a control method according to a first embodiment of the present invention will be described with reference to the drawings. As shown in FIG. 1, a medical system 100 according to this embodiment is a system for observing and treating the inside of the body of a patient lying on an operating table T. The medical system 100 includes a medical manipulator 10, a drive unit 30, and a control unit 40. In this embodiment, the drive unit 30 and the control unit 40 are housed in the same cabinet. The medical system 100 also includes an operation unit 50, an image control unit 60, and a display unit 70.

[0010] The medical manipulator 10 is a flexible endoscope (hereinafter referred to as the endoscope 10) that is inserted into a lumen of a patient. An endoscopic image acquired by the endoscope 10 is input to a display device 70 via an image control device 60 and displayed on the display device 70.

[0011] The operation device 50 is connected to the adapter 40a of the control device 40 via an operation cable 51. An operation input input to the operation device 50 is input from the operation device 50 to the control device 40. The control device 40 controls the drive device 30 based on the operation input input to the operation device 50. In this way, the endoscope 10 is operated in accordance with the operation input.

[0012] The endoscope 10 is detachably connected to the drive unit 30. In the following description, the side of the endoscope 10 that is inserted into a lumen of a patient is referred to as the distal end, and the side that is attached to the drive unit 30 is referred to as the proximal end.

[0013] 1, the endoscope 10 includes, in order from the distal end, an insertion section 11, a connecting section 12, an extracorporeal flexible section 13, a first detachable section 14, and a second detachable section 15. The insertion section 11 is a flexible, elongated member, and an internal path 11a is formed inside the insertion section 11, as shown in FIG.

[0014] The internal path 11a of the endoscope 10 extends along the longitudinal direction A of the endoscope 10 from the tip of the insertion section 11 to the base end of the first detachable section 14. As shown in Fig. 3, the internal path 11a accommodates a wire 16, a channel tube 17, a light guide 18, an imaging cable 19, and the like, which will be described later.

[0015] The insertion section 11 has, in order from the distal end side, a distal end section 20, a bending section 21, and an internal flexible section 22. 2, the tip portion 20 includes an opening 20a communicating with the channel tube 17, an illumination portion 20b, and an imaging portion 20c. A treatment portion 81 such as grasping forceps provided at the tip of a treatment tool 80 that passes through a channel in the channel tube 17 appears and disappears in the opening 20a. A light guide 18 is connected to the illumination portion 20b, and an imaging cable 19 is connected to the imaging portion 20c.

[0016] The bending portion 21 has a first bending portion 21a and a second bending portion 21b provided on the proximal end side of the first bending portion 21a. Each of the first bending portion 21a and the second bending portion 21b can be bent upward, downward, left, and right.

[0017] 3, four wires 16 are connected to the first bending portion 21a for bending the first bending portion 21a up, down, left, and right, respectively. Similarly, four other wires 16 are connected to the second bending portion 21b for bending the second bending portion 21b up, down, left, and right, respectively. The first bending portion 21a and the second bending portion 21b can be bent independently in different directions.

[0018] The connecting portion 12 connects the internal flexible portion 22 and the external flexible portion 13 of the insertion portion 11. The connecting portion 12 is also provided with an insertion opening 12a for inserting a treatment tool 80 into the channel tube 17 in the internal path 11a.

[0019] 4, the first detachable unit 14 has four wire attachable / detachable units 23 which are mechanisms for detachably connecting the wires 16 to the driving device 30. Each wire attachable / detachable unit 23 is provided at the base end of two pairs of wires 16, and attaches / detaches the wires 16 to / from the driving device 30. For example, the four wire attachable / detachable units 23 attach / detach the pair of wires 16 for bending the first bending portion 21a up and down, the pair of wires 16 for bending the first bending portion 21a left and right, the pair of wires 16 for bending the second bending portion 21b up and down, and the pair of wires 16 for bending the second bending portion 21b left and right, respectively, to / from the driving device 30.

[0020] The second detachable part 15 is detachably connected to an adapter 60a of the image control device 60. The light guide 18 and the imaging cable 19 are connected to the image control device 60 via the second detachable part 15.

[0021] The drive device 30 is connected to a power source (not shown) and operates on power supplied from the power source. As shown in FIG. 4, the drive device 30 has four wire drive units 31, which are mechanisms for driving the wires 16. By connecting the first detachable unit 14, the four wire drive units 31 are respectively coupled to the four wire detachable units 23 and can drive each of the two pairs of wires 16. For example, the four wire drive units 31 drive a pair of wires 16 for bending the first bending portion 21a up and down, a pair of wires 16 for bending the first bending portion 21a left and right, a pair of wires 16 for bending the second bending portion 21b up and down, and a pair of wires 16 for bending the second bending portion 21b left and right, respectively.

[0022] 5A and 5B show the configurations of wire attaching / detaching unit 23 and wire driving unit 31. Fig. 5A shows wire attaching / detaching unit 23 and wire driving unit 31 in a state where they are separated from each other, and Fig. 5B shows wire attaching / detaching unit 23 and wire driving unit 31 in a state where they are connected to each other.

[0023] 5A and 5B show, for example, a wire attaching / detaching unit 23 including a pair of wires 16 for bending the first bending portion 21a up and down, and a wire driving unit 31. Other wire attaching / detaching units 23 and other wire driving units 31 also have the configurations shown in FIGS. 5A and 5B, so redundant explanations will be omitted.

[0024] Each wire attaching / detaching unit 23 has a rotating drum 24 and a support member 25 that supports the rotating drum 24. The support member 25 is a part that is fixed to the support member 32 of the wire driving unit 31 when the wire attaching / detaching unit 23 is coupled to the wire driving unit 31.

[0025] The rotating drum 24 is supported by a support member 25 so as to be rotatable about a rotation axis B extending in the longitudinal direction A of the insertion portion 11. The rotating drum 24 includes a take-up pulley 24a arranged coaxially with the rotation axis B, and a coupling portion 24b fixed to the take-up pulley 24a. The pair of wires 16 is led to a take-up pulley 24a via one or more pulleys 26 that guide the wires 16, and is wound around the outer circumferential surface of the take-up pulley 24a. The take-up pulley 24a rotates around a rotation axis B to pull or feed the pair of wires 16.

[0026] The coupling portion 24b is a disk member fixed to the base end of the winding pulley 24a and arranged coaxially with the rotation axis B, and is exposed on the base end side of the wire attaching / detaching portion 23. Two mating protrusions 24c are formed on the surface on the base end side of the coupling portion 24b, on both sides of the rotation axis B. Each wire attaching / detaching section 23 is provided with a dog 27 that is provided on the support member 25 and that detects attachment / detachment between the wire attaching / detaching section 23 and the wire driving section 31.

[0027] Dog 27 is a member that protrudes from support member 25 outward from wire attaching / detaching unit 23 and is exposed on the base end side of wire attaching / detaching unit 23, and is, for example, a pin-shaped member that extends parallel to rotation axis B. As shown in FIG. 5B , when wire attaching / detaching unit 23 is connected to wire driving unit 31, dog 27 penetrates support member 32 of wire driving unit 31 and is inserted into wire driving unit 31.

[0028] The wire driving unit 31 has a shaft 33, a motor 34 connected to the shaft 33, and a support member 32 that supports the shaft 33 rotatably. The shaft 33 is supported by the support member 32 so as to be rotatable about a rotation axis C and movable back and forth in the longitudinal direction A. The rotation axis C is the central axis of the shaft 33, and coincides with the rotation axis B of the rotating drum 24 when the first detachable part 14 is connected to the drive device 30.

[0029] The motor 34 is, for example, a DC motor. The motor 34 generates a rotational force as a driving force using electric power supplied from a power source, and rotates the shaft 33 around the rotation axis C. The wire driving unit 31 is provided with an encoder 34a for the motor 34 that detects the rotation speed and rotation angle of the motor 34. The encoder 34a is connected to the base end of the motor 34.

[0030] The wire driving unit 31 also has a coupled portion 33 a that is provided on the shaft 33 and serves as a mechanism for connecting the motor 34 to the rotary drum 24 . The coupled part 33a is a disk member fixed to the tip of the shaft 33 and arranged coaxially with the rotation axis C, and rotates integrally with the shaft 33. The coupled part 33a is exposed on the tip side of the wire driving part 31. Two fitting recesses 33b are formed on the surface on the tip side of the coupled part 33a, on both sides of the rotation axis C.

[0031] 5B, mating convex portion 24c and mating concave portion 33b are mated with each other, thereby coupling coupling portion 24b and coupled portion 33a, and thereby motor 34 is connected to wire 16 via rotating drum 24. In this state, rotating drum 24, coupling portion 24b, coupled portion 33a, and shaft 33 can rotate integrally around rotation axes B and C. Therefore, the rotational force (driving force) generated by motor 34 is transmitted to wire 16 as a force in longitudinal direction A via rotating drum 24.

[0032] When the motor 34 is rotated in one direction around the rotation axis C, the rotating drum 24 is rotated in one direction around the rotation axis B, and as a result, for example, one (first wire) of a pair of wires 16 arranged on both sides in the vertical direction is pulled and the other (second wire) is loosened. Conversely, when the motor 34 is rotationally driven in the other direction, the pulled and loosened wires 16 are swapped. Therefore, by switching the rotational drive direction of the motor 34, the bending portion 21 can be bent in either the vertical direction. The same applies to the left and right direction.

[0033] The medical system 100 further includes a tension sensor (sensor) 35a, a torque sensor 35b, an attachment / detachment sensor 35c, a coupling sensor 35d, and a current sensor (not shown). The tension sensor 35a is provided in each of the four wire attaching / detaching units 23, and the torque sensor 35b, the attachment / detachment sensor 35c, the coupling sensor 35d, and the current sensor are provided in each of the four wire driving units 31. The sensors 35a, 35b, 35c, and 35d are connected to the control device 40, and the outputs of the sensors 35a, 35b, 35c, and 35d are sequentially transmitted to the control device 40.

[0034] The tension sensor 35a is provided for each wire 16 and is configured, for example, by a strain sensor mounted on the support 26a of the pulley 26, and measures the tension of the wire 16 based on the strain of the support 26a. By measuring the tension with the tension sensor 35a for each drive amount of the wire 16, information regarding changes in the tension of the wire 16 can be obtained. The torque sensor 35b is provided for each motor 34 and detects the torque of the motor 34. For example, the torque sensor 35b is attached to the shaft 33 and detects the torque around the rotation axis C as the torque of the motor 34.

[0035] The attachment / detachment sensor 35c detects attachment / detachment of the wire attachment / detachment unit 23 to the wire driving unit 31. When the wire attachment / detachment unit 23 is connected to the wire driving unit 31, the attachment / detachment sensor 35c engages with the dog 27 that has penetrated the support member 32 and inserted into the wire driving unit 31. The attachment / detachment sensor 35c has, for example, an optical sensor that detects contact with or proximity to the dog 27, and detects engagement with the dog 27 by the optical sensor.

[0036] A coupling sensor 35d is provided for each motor 34. The coupling sensor 35d detects the engagement between the coupling portion 24b and the coupled portion 33a based on the displacement of the shaft 33, thereby detecting that the motor 34 is connected to the wire 16.

[0037] 5B, the coupled portion 33a is pressed by the coupling portion 24b and moves toward the base end side A2 together with the shaft 33. The coupling sensor 35d has, for example, an optical sensor that detects the proximity of a dog 33c provided on the shaft 33, and detects the engagement between the coupling portion 24b and the coupled portion 33a based on the proximity of the dog 33c.

[0038] The coupled portion 33a is biased toward the distal end side A1 by an elastic member 36, such as a compression spring, disposed between the coupled portion 33a and the support member 32. As shown in FIG. 5A, when the wire attaching / detaching unit 23 and the wire driving unit 31 are separated, the coupled portion 33a moves toward the distal end side A1 together with the shaft 33 due to the biasing force of the elastic member 36, and the dog 33c is positioned away from the coupling sensor 35d. In this state, the coupling sensor 35d does not detect the engagement between the coupling portion 24b and the coupled portion 33a. A current sensor is provided for each motor 34 and detects the current flowing through the motor 34.

[0039] The operation device 50 is a device through which an operator such as a surgeon inputs operations for driving the endoscope 10. The input operation input is transmitted to the control device 40 via an operation cable 51. As shown in FIG. 1, the operating device 50 includes a main body 52, a first angle knob 53, and a second angle knob .

[0040] The main body 52 is formed in a shape that can be held by an operator such as a surgeon in, for example, the left hand. The first angle knob 53 and the second angle knob 54 are attached to the main body 52 so as to rotate around the same rotation axis 52a. When the operator rotates the first angle knob 53, for example, with the right hand, the wire 16 that bends the bending portion 21 in the up-down direction is driven. Also, when the operator rotates the second angle knob 54, for example, the wire 16 that bends the bending portion 21 in the left-right direction is driven.

[0041] The control device 40 acquires an operation input from the operation device 50 via the adapter 40a. The control device 40 controls the drive device 30 based on the acquired operation input. As shown in FIG. 6, the control device 40 is a programmable computer that includes at least one processor 41, at least one memory 42, a storage unit 43 that can store programs and data, and an input / output control unit (interface) 44.

[0042] The storage unit 43 is a non-transient, non-volatile recording medium, such as a ROM or a hard disk, that stores programs and necessary data. The functions of the control device 40, which will be described later, are realized by loading a control program stored in the storage unit 43 into the memory 42 and executing it with the processor 41. At least some of the functions of the control device 40 may be realized by a dedicated logic circuit.

[0043] The memory 42 stores a model capable of outputting a drive amount of the wire 16 that can be pulled or loosened within a range that maintains the bending angle θ by inputting the drive amount and tension of the wire 16. This model may be capable of outputting a drive amount of the wire 16 that can be pulled or loosened within a range that maintains the bending angle θ by inputting the drive amount of the wire 16 or the tension of the wire 16. Here, the bending angle refers to the angle displaced from the straight state when the bending portion 21 is bent, with the straight state of the bending portion 21 being defined as 0 degrees. Alternatively, the bending angle can be determined from the imaging direction of the tip of the bending portion 21. The imaging direction when the bending portion 21 is straight is defined as 0 degrees, and when the bending portion 21 is bent, the angle is the angle between the imaging direction when the bending portion 21 is straight and the imaging direction after bending. The relationship between the drive amount of the wire 16, the tension of the wire 16, and the bending angle of the bending portion 21 in the model is, for example, as shown in FIG. 7. When the wire 16 is pulled starting from the origin position where the amount of drive of the wire 16 is zero, the tension and bending angle of the wire 16 each increase approximately linearly in proportion to the amount of drive of the wire 16, as indicated by arrow Y1.

[0044] After the bending angle reaches an arbitrary first angle θ1, if an attempt is made to relax the wire 16 to decrease the bending angle, the tension of the wire 16 decreases rapidly, as shown by arrow Y2, without being proportional to the amount of drive of the wire 16, until the amount of drive of the wire 16 decreases to a predetermined point S. Then, when the amount of drive of the wire 16 decreases to a predetermined point S, at that point, as the amount of drive of the wire 16 decreases, the bending angle begins to decrease as shown by arrow Y3, and the tension and bending angle of the wire 16 again begin to decrease approximately linearly in proportion to the amount of drive of the wire 16.

[0045] Therefore, the relationship between the amount of drive of the wire 16 and the tension and the relationship between the amount of drive of the wire 16 and the bending angle draws a hysteresis curve with different paths when the wire 16 is being pulled and when it is being relaxed.

[0046] That is, the operator first rotates the first angle knob 53 or the second angle knob 54 in one direction to increase the amount of drive of one wire 16 and bring the bending angle of the bending portion 21 to the first angle θ1. Then, when the operator rotates the first angle knob 53 or the second angle knob 54 in the other direction to decrease the amount of drive of the wire 16, the bending angle is maintained unchanged while the tension of the wire 16 is greatly reduced. In other words, the wire 16 can be relaxed within a range in which the bending angle of the bending portion is maintained.

[0047] Therefore, by using the model stored in memory 42, the drive amount (dead zone) of wire 16 for relaxing wire 16 within a range in which the bending angle is maintained can be obtained using the drive amount of wire 16 and the tension of wire 16 at each point in time.

[0048] The input / output control unit 44 is connected to the drive device 30, the operation device 50, and the display device 70. Based on the control of the processor 41, the input / output control unit 44 transmits and receives data and control signals to and from connected devices.

[0049] Next, a control method executed by the control device 40 according to this embodiment will be described below. In the control device 40 according to this embodiment, the processor 41 acquires the operation input generated by an operator such as a surgeon operating the first angle knob 53 or the second angle knob 54 of the operating device 50, and controls the drive device 30.

[0050] Specifically, the processor 41 activates any one of the motors 34 of the drive device 30 corresponding to the operation input, thereby pulling and relaxing the wire 16. This allows the bending portion 21 to bend in a desired direction by a desired bending angle.

[0051] The control device 40 enters the external force detection mode when a predetermined trigger is input. For example, the trigger may be a timer (not shown) measuring the passage of a predetermined time from the point when no operation input is made to the operation device 50. Alternatively, the trigger may be a switching operation by the operator using the changeover switch 55 or the sound sensor 56 provided on the operation device 50.

[0052] As an example, a case will be described in which the operator operates the first angle knob 53 of the operation device 50 to increase the tension of one of the wires 16, bending the bending section 21 in the first direction to the first position P1 in Figure 7 at the first angle θ1, and then a trigger is input to the processor 41. In this case, the drive amount of one of the wires 16 is drive amount D1, and the tension is tension T1. An example of the configuration of the endoscope 10 in this state is as shown in Figure 8A, and the tension distribution of the wire 16 along the length of the endoscope 10 is as shown in Figure 8B.

[0053] As shown in Fig. 9, the processor 41 inputs the drive amount D1 and tension T1 of one wire 16 into a model in the memory 42 to obtain a drive amount ΔD of the wire 16 corresponding to the dead zone (step S1). The processor 41 drives the motor 34 in accordance with the obtained drive amount ΔD of the wire 16, thereby relaxing the wire 16 (step S2). This causes the bending section 21 to move to the second position P2 in Fig. 7. This is the state immediately before the bending angle of the bending section 21 begins to change from the first angle θ1. An example of the shape of the endoscope 10 in this state is as shown in Fig. 10A, and the tension distribution of the wire 16 along the length direction of the endoscope 10 is as shown in Fig. 10B.

[0054] Note that the acquired drive amount ΔD may be 0 depending on the input drive amount D1 and tension T1 of the wire 16. For example, this may occur when the bending portion 21 is relaxed by the operator's operation from the first position P1 in FIG. 7 to a drive amount of the wire equal to or less than the second position P2. In such a case, the tension distribution of the wire 16 is already in a favorable state for detecting an external force on the bending portion 21, as shown in FIG. 10B. Therefore, even if a trigger is input to the processor 41, there may be cases where the processor 41 does not need to operate the motor 34 to relax the wire 16.

[0055] When the wire is stationary with the tension distribution shown in Fig. 8B, at each position on the wire 16, the tension in the proximal direction A2 is greater than the tension in the distal direction A1, and a static friction force in the distal direction A1 acts to balance this. In order to transmit an external force applied in the second direction to the distal end of the bending portion 21 to the proximal end of the wire 16, it is necessary to reverse the relationship of tension between the distal and proximal ends of the wire 16. That is, even if an external force in the second direction that reduces the bending angle is applied to the distal end of the bending portion 21 in the state shown in Fig. 8B, the tension distribution at each position on the wire 16 simply reverses gradually from the distal end to the proximal end, and an extremely large external force is required before the external force is detected by the tension sensor 35a at the proximal end of the wire 16.

[0056] 10B, the static friction force in the direction toward the distal end direction A1 disappears at each position on the wire 16. Therefore, in this state, when an external force in the second direction that reduces the bending angle is applied to the distal end of the bending section 21, the external force is immediately transmitted to the tension sensor 35a at the proximal end of the wire 16, allowing the change in tension to be detected with high sensitivity.

[0057] 10B, in which the static friction force acting in the distal direction A1 has disappeared, the wire 16 is relaxed by the drive amount ΔD corresponding to the dead zone, so that the bending angle of the bending section 21 remains at the first angle θ1. Therefore, the bending state of the bending section 21 of the endoscope 10 does not change, and the endoscopic image displayed on the display device 70 does not change.

[0058] When the insertion portion 11 is removed from the body in this state, if the tip of the insertion portion 11 comes into contact with the inner wall of the body cavity, the bending portion 21, which is bent at the first angle θ1, receives an external force in the second direction that reduces the bending angle, as shown in FIG. 11A. In the external force detection mode, as shown in Fig. 10B, the tension distribution of wire 16 is in a state where static friction force in the distal direction A1 disappears at each position on wire 16. Therefore, when an external force is applied in a direction that bends bending portion 21 in the second direction, the tension measured by tension sensor 35a arranged at the proximal end of wire 16 immediately changes, as shown in Fig. 11B.

[0059] After entering the external force detection mode, the processor 41 monitors the amount of change in tension measured by the tension sensor 35a (step S3), and if the amount of change exceeds a predetermined threshold, performs external force reduction control to reduce the external force (step S4). Examples of external force reduction control include a method of cutting off power to the motor 34 to allow the bending portion 21 to move freely, and a method of driving the wire 16 in a direction that actively reduces the bending angle. Examples of a driving method that actively reduces the bending angle include returning the wire 16 to the origin position where the tension of the wire 16 is zero, or driving the drive device 30 so that the tension difference between the pair of wires 16 becomes zero.

[0060] As described above, the medical system 100, the control device 40, and the control method according to this embodiment can detect an external force acting on the distal end of the flexible insertion section 11 more quickly and accurately at the proximal end of the insertion section 11, and can perform external force reduction control before the load on the bending section 21 increases due to the external force. This makes it possible to prevent damage to the bending section 21 or to living tissue that comes into contact with the bending section 21 when, for example, the endoscope 10 is removed.

[0061] In this embodiment, the case of detecting an external force that bends the bending portion 21 in the second direction has been described, but the present invention can also be applied to the case of detecting an external force that further bends the bending portion 21 in the first direction. For example, when the wire 16 is stationary with the tension distribution shown by the solid line in Fig. 10B, the processor 41 inputs the drive amount D2 of the wire 16 and the tension T2 of the wire 16 into a model in the memory 42 to obtain a drive amount ΔD of the wire 16 corresponding to the dead zone (step S1). The processor 41 drives the motor 34 by the obtained drive amount ΔD of the wire 16, thereby pulling the wire 16 (step S2). This moves the bending section 21 to the first position P1 in Fig. 7. An example of the configuration of the endoscope 10 in this state is as shown in Fig. 12A, and the tension distribution of the wire 16 along the length direction of the endoscope 10 is as shown by the solid line in Fig. 12B.

[0062] When wire 16 is stationary with the tension distribution shown by the solid line in Fig. 10B (dashed line in Fig. 12B), static friction force in the direction toward the tip disappears at each position on wire 16. However, even if an external force in the first direction that increases the bending angle is applied to the tip of bending portion 21, when wire 16 is in a relaxed state, the external force in the direction that further relaxes wire 16 is not transmitted to tension sensor 35a at the base end of wire 16, and no change in tension is detected.

[0063] On the other hand, when the wire 16 is stationary with the tension distribution shown by the solid line in Fig. 12B, a static friction force is generated in a direction toward the tip at each position of the wire 16. Therefore, in this state, when an external force in the first direction that increases the bending angle is applied to the tip of the bending portion 21, the external force is immediately transmitted to the tension sensor 35a at the base end of the wire 16, and the change in tension can be detected with high sensitivity.

[0064] 12B, the wire 16 is pulled by an amount ΔD corresponding to the dead zone, and the bending angle of the bending section 21 is maintained at the first angle θ1. Therefore, the bending state of the bending section 21 of the endoscope 10 does not change, and the endoscopic image displayed on the display device 70 does not change.

[0065] Then, when the insertion portion 11 is pushed further into the body in this state, the bending portion 21, which is bent at the first angle θ1, receives an external force in the first direction from the inner wall of the body cavity with which it comes into contact, which increases the bending angle, as shown in FIG. 13A. In the external force detection mode, the tension distribution of wire 16 is such that static friction forces are generated in a direction toward the tip at each position on wire 16, as shown by the dashed lines in Fig. 13B. Therefore, when an external force is applied in a direction that bends bending portion 21 in the first direction, the tension measured by tension sensor 35a disposed at the base end of wire 16 immediately changes, as shown by the solid lines in Fig. 13B.

[0066] After entering the external force detection mode, the processor 41 monitors the amount of change in tension measured by the tension sensor 35a (step S3), and if the amount of change exceeds a predetermined threshold, performs external force reduction control to reduce the external force (step S4). Examples of external force reduction control include cutting off power to the motor 34 to allow the bending portion 21 to move freely, and driving the wire 16 in a direction that actively increases the bending angle.

[0067] As described above, the medical system 100, the control device 40, and the control method according to this embodiment can detect an external force acting on the distal end of the flexible insertion section 11 more quickly and accurately at the proximal end of the insertion section 11, and can perform external force reduction control before the load on the bending section 21 increases due to the external force. This makes it possible to prevent damage to the bending section 21 or living tissue that comes into contact with the bending section 21 during insertion of the endoscope 10, etc.

[0068] Furthermore, in this embodiment, the tension distribution of the wire 16 shown in FIG. 10B was achieved by relaxing the wire 16 until just before the bending angle of the bending portion 21 starts to change from the first angle θ1, as shown in FIG. 8B where the wire 16 was pulled. Similarly, the tension distribution of the wire 16 shown by the dashed line in FIG. 12B where the wire 16 was relaxed was achieved by pulling the wire 16 until just before the bending angle of the bending portion 21 starts to change from the first angle θ1. Alternatively, as shown in FIGS. 14A and 14B , the wire 16 may be relaxed or pulled not just before the bending angle of the bending portion 21 starts to change from the first angle θ1, but just before that, i.e., by an amount smaller than the wire drive amount ΔD corresponding to the dead zone.

[0069] By doing this, the smaller the drive amount, the lower the external force detection performance becomes compared to when the wire 16 is relaxed or pulled by the drive amount ΔD corresponding to the dead zone. However, there is an advantage in that after entering the external force detection mode, the start of movement of the bending portion 21 can be improved when the mode in which the bending portion 21 is operated by an operator such as a doctor is entered again.

[0070] Next, a medical system 100, a control device 40, and a control method according to a second embodiment of the present invention will be described with reference to the drawings. In this embodiment, parts having the same configuration as the first embodiment described above are denoted by the same reference numerals, and the description thereof will be omitted.

[0071] The medical system 100 according to this embodiment differs from the first embodiment in that a wire attaching / detaching section 23' and a wire driving section 31' separately drive, for example, a pair of wires 16a, 16b for bending the first bending section 21a up and down.

[0072] 15A and 15B show the configurations of wire attach-detachment unit 23' and wire driving unit 31'. FIG. 15A shows wire attach-detachment unit 23' and wire driving unit 31' in a state where they are separated from each other, and FIG. 15B shows wire attach-detachment unit 23' and wire driving unit 31' in a state where they are connected to each other. FIGS. 15A and 15B show, for example, wire attach-detachment unit 23' and wire driving unit 31' that include a pair of wires 16a, 16b for bending first bending portion 21a up and down. Other wire attach-detachment units 23' and other wire driving units 31' also have the configurations shown in FIGS. 15A and 15B.

[0073] Each wire attaching / detaching section 23' has a pair of rotary drums 24 and a connecting mechanism 28 that connects the pair of rotary drums 24 to each other. Each rotating drum 24 is supported by a support member 25 so as to be rotatable about a rotation axis B extending in the longitudinal direction A of the insertion portion 11. Each rotating drum 24 has a take-up pulley 24a arranged coaxially with the rotation axis B, and a gear 24d fixed to the take-up pulley 24a and arranged coaxially with the rotation axis B.

[0074] The base end of each wire 16a, 16b is led to a take-up pulley 24a via one or more pulleys 26 and wound around the take-up pulley 24a. The wires 16a, 16b are pulled or fed out as the rotary drum 24 rotates around the rotation axis B. The gear 24d is a spur gear that rotates integrally with the take-up pulley 24a.

[0075] The connecting mechanism 28 is configured to limit the rotation of the pair of rotary drums 24 and prevent the pair of wires 16a, 16b from loosening when the wire attaching / detaching unit 23' is separated from the wire driving unit 31'. The connecting mechanism 28 includes a cylindrical member 28a, a link gear 28b, and an elastic member 28c.

[0076] The cylindrical member 28a is supported by the support member 25 so as to be rotatable about a rotation axis C extending in the longitudinal direction A and so as to be movable back and forth in the longitudinal direction. The rotation axis C is parallel to the rotation axis B of the rotating drum 24. The base end of the cylindrical member 28a penetrates the support member 25, protrudes outside the wire attaching / detaching portion 23′, and is exposed at the base end side A2 of the wire attaching / detaching portion 23′. The ring gear 28b is a spur gear that is fixed to the cylindrical member 28a and is arranged coaxially with the rotation axis C. The elastic member 28c is, for example, a spring, and biases the ring gear 28b and the cylindrical member 28a toward the base end side A2.

[0077] 15A, when the wire attaching / detaching unit 23' is separated from the wire driving unit 31', the link gear 28b and the cylindrical member 28a, biased by the elastic member 28c, are positioned in the separated position. The link gear 28b in the separated position is positioned between the pair of gears 24d and meshes with both of the pair of gears 24d. As a result, the pair of rotating drums 24 rotate in opposite directions in conjunction with each other, and the pair of wires 16a, 16b are pulled or let out in conjunction with each other as if a single looped wire (loop state). In the loop state, when the bending portion 21 is bent up or down by an external force, the pair of wires 16a, 16b do not slacken, and the relationship between the rotation angle of the rotating drum 24 and the bending angle of the bending portion 21 is maintained.

[0078] On the other hand, as shown in FIG. 15B, when the wire attaching / detaching unit 23' is connected to the wire driving unit 31', the cylindrical member 28a is pressed toward the tip side A1 by the engaging member 37a (described below) against the biasing force of the elastic member 28c, and the link gear 28b and the cylindrical member 28a are placed in the connected position. The link gear 28b placed in the connected position does not mesh with the pair of gears 24d. As a result, the pair of rotating drums 24 do not rotate in conjunction with each other, and the pair of wires 16a, 16b are pulled or let out independently of each other (antagonistic state). Reference numeral 29 denotes an antagonistic sensor that detects the cylindrical member 28a when in the antagonistic state.

[0079] The wire driving unit 31' has a pair of shafts 33 and a pair of motors (power generating units) 34 connected to the pair of shafts 33, respectively. Each shaft 33 is supported by the support member 32 so as to be rotatable about a rotation axis C and movable back and forth in the longitudinal direction A. The rotation axis C is the central axis of each shaft 33, and coincides with the rotation axis B of the rotating drum 24 when the detachable unit 14 is connected to the drive device 30.

[0080] Each motor 34 generates a rotational force as a driving force using electric power supplied from a power source, causing the corresponding shaft 33 to rotate around the rotation axis C. The wire driving unit 31' is provided with two encoders 34a for each motor 34, which detect the rotation speed and rotation angle of the motor 34. The encoders 34a are connected to the base ends of the motors 34.

[0081] The support member 32 is provided with an engagement member 37a for releasing the connection between the pair of rotating drums 24 by the connection mechanism 28. The engagement member 37a is a cylindrical member exposed at the tip side of the wire driving unit 31' and is provided at a position corresponding to the cylindrical member 28a. As shown in Fig. 15B, when the wire attach-detach unit 23' is connected to the wire driving unit 31', the engagement member 37a presses the cylindrical member 28a to the connected position. The wire driving unit 31' also has a coupled portion 33a, which is a mechanism provided on each of the pair of shafts 33 and connects the motor 34 to each of the rotary drums 24.

[0082] Next, a control method executed by the control device 40 according to this embodiment will be described below. The control device 40 enters the external force detection mode when a predetermined trigger is input. As an example, we will explain the case where the operator operates the first angle knob 53 of the operating device 50 to increase the tension of the wire (hereinafter referred to as the first wire) 16a on the inside of the bend of the bending portion 21 out of the pair of wires 16a, 16b, and sufficiently relax the tension of the wire (hereinafter referred to as the second wire) 16b on the outside of the bend, thereby bending the bending portion 21 in the first direction to the first angle θ1, and then input a trigger to the processor 41.

[0083] In this case, the drive amount of the first wire 16a is drive amount D1, the tension of the first wire 16a is tension T1, and the bending portion 21 is located at the first position P1 in Fig. 7. In addition, the tension distribution of the first wire 16a along the longitudinal direction of the endoscope 10 in this state is as shown in Fig. 8B, and the tension distribution of the second wire 16b is sufficiently relaxed over the entire length and is approximately zero.

[0084] In this state, when a trigger is input, the processor 41 pulls only the second wire 16b within a range in which the bending angle θ1 of the bending portion 21 is maintained as shown in Fig. 16A, and generates a predetermined tension in the second wire 16b at the distal end position of the bending portion 21 as shown in Fig. 16B. In this case, the drive amount of the second wire 16b may be a preset drive amount. Because a large tension is generated in the first wire 16a, the bending portion 21 does not move and the bending angle θ1 is maintained until the tension in the second wire 16b becomes sufficiently large.

[0085] When second wire 16b is stationary with the tension distribution shown in Fig. 16B, static friction forces are generated at each position of the second wire in a direction toward the tip. Therefore, in this state, when an external force in the second direction that reduces the bending angle is applied to the tip of bending portion 21 as shown in Fig. 17A, the external force is immediately transmitted to tension sensor 35a at the base end of second wire 16b as shown in Fig. 17B, allowing tension changes to be detected with high sensitivity.

[0086] Therefore, it is possible to prevent damage to the bending portion 21 or to living tissue that comes into contact with the bending portion 21 when, for example, the endoscope 10 is removed. In this case, unlike the medical system 100 and control method according to the first embodiment, the external force detection mode can be set without relaxing the tension on the first wire 16a, which has the advantage of improving the start of movement of the bending portion 21 when the mode in which the bending portion 21 is operated by an operator such as a doctor is entered again after the external force detection mode.

[0087] In this embodiment, the case of detecting an external force that bends the bending portion 21 in the second direction has also been described, but the present invention can also be applied to the case of detecting an external force that bends the bending portion 21 in the first direction. For example, when the first wire 16a has the tension distribution shown in Fig. 8B and the second wire 16b is stationary with almost zero tension over its entire length, the processor 41 first pulls the second wire 16b to achieve the tension distribution shown in Fig. 16B without relaxing the first wire 16a in the same manner as described above. Thereafter, the second wire 16b is relaxed as shown by the solid line in Fig. 18B within a range in which the bending angle of the bending portion 21 is maintained as shown in Fig. 18A.

[0088] When second wire 16b is stationary with the tension distribution shown by the solid line in Fig. 18B, a static friction force in the proximal direction A2 is generated at each position of second wire 16b. Therefore, in this state, when an external force in a first direction that increases the bending angle is applied to the tip of bending portion 21 as shown in Fig. 19A, the external force is immediately transmitted to tension sensor 35a at the proximal end of second wire 16b as shown in Fig. 19B, and tension changes can be detected with high sensitivity.

[0089] Therefore, it is possible to prevent damage to the bending portion 21 or to the living tissue that comes into contact with the bending portion 21 when, for example, pushing the endoscope 10 in. Even in this case, the external force detection mode can be set without relaxing the tension on the first wire 16a, which has the advantage of improving the start of movement of the bending portion 21 when the mode in which the endoscope 10 is operated by an operator such as a doctor is entered again after the external force detection mode.

[0090] Furthermore, when the second wire 16b is pulled without loosening the first wire 16a, there is an advantage in that external forces in both directions can be detected by detecting an external force in the second direction with the second wire 16b and detecting an external force in the first direction with the first wire 16a. Furthermore, when the second wire 16b is relaxed within a range in which the bending angle of the bending portion 21 is maintained, the external force in the first direction is detected by the second wire 16b, and the external force in the first direction is also detected by the first wire 16a, thereby enabling doubly detecting the external force and improving robustness.

[0091] In this embodiment, the second wire 16b is pulled without loosening the first wire 16a. Alternatively, the first wire 16a may be loosened and the second wire 16b may be pulled. In this case, the first wire 16a is loosened by an amount smaller than the amount of drive ΔD of the wire 16 corresponding to the dead zone, as shown in FIG. 14B. This prevents the bending portion 21 from being displaced even if the second wire 16b is pulled when the external force detection mode is entered, and the tension distribution of the second wire 16b can be set to the state shown in FIG. 16B. This has the advantage that it is possible to improve the start of movement of the bending portion 21 in the second direction when the mode in which the operation is performed by an operator such as a doctor is entered again after the external force detection mode.

[0092] In this case, the tension distribution of the first wire 16a in the external force detection mode is as shown in Fig. 14B, and the tension distribution of the second wire 16b is as shown in Fig. 16B, so that the external force in the second direction can be detected by both the first wire 16a and the second wire 16b. Therefore, there is an advantage in that the robustness can be improved by doubly detecting the external force in the second direction.

[0093] Furthermore, in this embodiment, the tension sensor 35a that measures the tension of the wire 16 has been exemplified, but the present invention is not limited to this. Instead of the tension sensor 35a, a torque sensor 35b that acquires the drive torque, which is information regarding changes in the tension of the wires 16, 16a, and 16b, or a current sensor that acquires the current value of the motor 34 may be employed, and the acquired drive torque or current value may be converted into the tension of the wires 16, 16a, and 16b.

[0094] Although the endoscope 10 has been exemplified as a medical manipulator, other manipulators may be used instead. For example, a treatment tool robot having an end effector and a bending portion at its tip may be used. Although the external force reduction control is performed when the amount of change in tension of the wires 16, 16b exceeds a predetermined threshold, any value may be used as the threshold. For example, to prevent damage to tissues in the body cavity, it is preferable to set the threshold to 18 N or less. [Explanation of symbols]

[0095] 10 Endoscope (medical manipulator) 16 wires 16, 16a First wire (wire) 16, 16b Second wire (wire) 21 Curved section 30 Drive unit 35a Tension sensor (sensor) 40 Control device 41 processors 42 memory 100 Healthcare Systems

Claims

1. A control device that controls a drive device connected to a base end of a flexible medical manipulator, the driving device drives at least one wire for bending a bending portion at the tip of the medical manipulator; The tension in the wire is measured at the proximal end; at least one processor; The processor: A control device that controls the drive device to pull or relax the wire within a range in which the bending angle of the bending portion is maintained at a certain angle, in order to detect an external force acting on the bending portion based on a change in tension of the wire when the bending angle of the bending portion is set to the certain angle.

2. The control device according to claim 1 , wherein the range in which the bending angle is maintained at the angle is before the bending angle is changed.

3. the processor: The control device according to claim 1, wherein after the wire is pulled or relaxed within a range in which the bending angle is maintained at the angle, if a change in tension in the wire exceeds a predetermined threshold, the control device controls the drive device in a direction opposite to the change in tension in the wire.

4. at least one memory that stores a model representing a relationship between at least one of the driving amount of the wire and the tension of the wire, and the bending angle; The control device according to claim 1 , wherein the processor obtains an amount of drive for the wire that maintains the bend angle at the angle based on the model, the bend angle, and the tension.

5. The state in which the bending angle is set to the angle is a state in which the wire is pulled and bent to the angle, The control device of claim 1 , wherein the processor controls the driver to relax the wire to a degree that maintains the bend angle at the angle.

6. The state in which the bending angle is set to the angle is a state in which the wire is relaxed within a range in which the bending angle is maintained at the angle, The control device according to claim 1 , wherein the processor controls the drive device to pull the wire within a range in which the bending angle is maintained at the angle.

7. the at least one wire is a first wire for bending the bending portion in a first direction and a second wire for bending the bending portion in a second direction different from the first direction, the processor:

2. The control device according to claim 1, wherein, in a state in which the bending angle in the first direction of the bending portion is set to a certain angle by pulling the first wire and relaxing the second wire, the control device controls the drive device to pull the second wire within a range in which the bending angle of the bending portion is maintained at the angle, in order to detect an external force acting on the bending portion in the second direction based on a change in tension of the second wire.

8. the processor: The control device according to claim 7, wherein after the second wire is pulled within a range in which the bending angle is maintained at the angle, if a decrease in tension of the second wire exceeds a predetermined threshold, the control device controls the drive device in a direction opposite to the change in tension of the first wire.

9. The control device according to claim 7 , wherein the range in which the bending angle is maintained at the angle is before the bending angle is changed.

10. the at least one wire is a first wire for bending the bending portion in a first direction and a second wire for bending the bending portion in a second direction different from the first direction, the processor:

2. The control device according to claim 1, wherein, after the bending angle in the first direction of the bending portion is set to a certain angle by pulling the first wire and relaxing the second wire, in a state in which the second wire is pulled within a range in which the bending angle of the bending portion is maintained at that angle, the control device controls the drive device to relax the second wire within a range in which the bending angle is maintained at that angle, in order to detect an external force acting on the bending portion in the first direction based on a change in tension of the second wire.

11. the processor: The control device according to claim 10, wherein after the second wire is relaxed within a range in which the bending angle is maintained at the angle, if an increase in tension of the second wire exceeds a predetermined threshold, the control device controls the drive device in a direction opposite to the change in tension of the second wire.

12. The control device according to claim 10 , wherein the range in which the bending angle is maintained at the angle is before the bending angle is changed.

13. a soft medical manipulator; a driving device connected to a base end of the medical manipulator and driving the medical manipulator; a control device that controls the drive device, the medical manipulator includes at least one wire for bending a bending portion at a distal end of the medical manipulator, and a sensor for measuring tension of the wire at the proximal end; the control device comprises at least one processor; the processor: A medical system that controls the drive device to pull or relax the wire within a range where the bending angle of the bending portion is maintained at a certain angle, in order to detect an external force acting on the bending portion based on a change in tension of the wire when the bending angle of the bending portion is set at the angle.

14. the at least one wire is a first wire for bending the bending portion in a first direction and a second wire for bending the bending portion in a second direction different from the first direction, the processor:

14. The medical system according to claim 13, wherein, in a state where the bending angle in the first direction of the bending portion is set to a certain angle by pulling the first wire and relaxing the second wire, the drive device is controlled to pull the second wire within a range in which the bending angle of the bending portion is maintained at the angle, so that the sensor detects an external force acting in the second direction on the basis of a change in tension of the second wire.

15. the at least one wire is a first wire for bending the bending portion in a first direction and a second wire for bending the bending portion in a second direction different from the first direction, the processor:

14. The medical system according to claim 13, wherein, after the bending angle in the first direction of the bending portion is set to a certain angle by pulling the first wire and relaxing the second wire, the second wire is pulled within a range in which the bending angle of the bending portion is maintained at that angle, and the sensor detects an external force acting in the first direction on the basis of a change in tension of the second wire, so that the drive device is controlled to relax the second wire within a range in which the bending angle is maintained at that angle.

16. A control method for driving at least one wire for bending a bending portion at a tip of a flexible medical manipulator, comprising: measuring the tension of the wire at the proximal end of the medical manipulator; A control method in which, from a state in which the bending angle of the bending portion is set to a certain angle, the wire is controlled to be pulled or relaxed within a range in which the bending angle is maintained at the angle in order to detect an external force acting on the bending portion based on a change in tension of the wire.

17. The control method according to claim 16, wherein the wire is pulled or relaxed within a range in which the bending angle is maintained at the angle, and then, if a change in the tension of the wire exceeds a predetermined threshold, the change in the tension of the wire is controlled to be suppressed.

18. the at least one wire is a first wire for bending the bending portion in a first direction and a second wire for bending the bending portion in a second direction different from the first direction, 17. The control method according to claim 16, wherein the controlling comprises, in a state where the bending angle of the bending portion in the first direction is set to a certain angle by pulling the first wire and relaxing the second wire, controlling to pull the second wire within a range where the bending angle of the bending portion is maintained at the angle, in order to detect an external force acting on the bending portion in the second direction based on a change in tension of the second wire.

19. the at least one wire is a first wire for bending the bending portion in a first direction and a second wire for bending the bending portion in a second direction different from the first direction, 17. The control method according to claim 16, wherein the controlling comprises pulling the first wire and relaxing the second wire to set the bending angle of the bending portion in the first direction to a certain angle, and then, in a state where the second wire is pulled within a range where the bending angle of the bending portion is maintained at that angle, controlling to relax the second wire within a range where the bending angle is maintained at that angle, in order to detect an external force acting on the bending portion in the first direction based on a change in tension of the second wire.

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