Endoscopic Robot System

Abstract

An endoscope robot system is provided that can easily perform the position adjustment work of a sheath member in the insertion direction relative to a patient. [Solution] This robot system 100 comprises a hand 13 that holds a ureteroscope 800 to be inserted into a patient 900, a robot arm 12 to which the hand 13 is attached, a base unit 11 to which the robot arm 12 is attached, a sheath holding unit 60 that is disposed on the base unit 11 and holds a sheath member 902 that is inserted into the patient 900 to insert the ureteroscope 800, and a horizontal drive unit 72 that moves the sheath holding unit 60 along the insertion direction of the sheath member 902 relative to the patient 900.

Description

[Technical Field]

[0001] The present disclosure relates to an endoscopic robotic system. [Background technology]

[0002] Conventionally, surgical support robots that insert an endoscope into a patient's body have been disclosed. For example, Patent Document 1 discloses a surgical support robot that is a master-slave endoscopic system. This surgical support robot includes an endoscope and an operating unit. The endoscope has a flexible insertion portion that is inserted into the patient's body. The operating unit receives operations to bend the endoscope and to move the endoscope three-dimensionally. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2015-16181 Summary of the Invention [Problem to be solved by the invention]

[0004] Although not described in Patent Document 1, there are cases in which a sheath member serving as a guide for inserting an endoscope into a patient is inserted into the patient in advance, and the endoscope is then inserted into the patient via the sheath member. In such cases, images acquired by the endoscope may become unclear due to the positioning of the sheath member inserted into the patient's body in the insertion direction relative to the patient. For example, when inserting an endoscope into a patient's urinary tract, the patient's ureter may be bent at the tip of the sheath member, making it difficult to confirm the path of the urinary tract in the images acquired by the endoscope. In such cases, a physician can correct the bend in the ureter by manually holding the sheath member and moving it toward the patient in the insertion direction, but this position adjustment is not easy. Therefore, there is a need for an easy method of adjusting the position of the sheath member in the insertion direction relative to the patient.

[0005] The present disclosure has been made to solve the above-mentioned problems, and one object of the present disclosure is to provide an endoscopic robot system that can easily perform the position adjustment work of a sheath member in the insertion direction relative to a patient. [Means for solving the problem]

[0006] In order to achieve the above object, an endoscopic robot system according to one aspect of the present disclosure includes: a hand that holds an endoscope to be inserted into a patient; a robot arm to which the hand is attached; a base unit to which the robot arm is attached; a sheath holding unit that is disposed on the base unit and holds a sheath member that is inserted into the patient to insert the endoscope; and a drive unit that moves the sheath holding unit along the insertion direction of the sheath member relative to the patient.

[0007] As described above, an endoscopic robot system according to one aspect of the present disclosure includes a sheath holding unit that is disposed on a gantry and holds a sheath member to be inserted into a patient for endoscope insertion, and a drive unit that moves the sheath holding unit along the insertion direction of the sheath member relative to the patient. This allows the sheath holding unit that holds the sheath member to be easily moved along the insertion direction by operation of the drive unit, unlike when a physician manually grasps the sheath member to adjust its position in the insertion direction. As a result, the position of the sheath member relative to the patient in the insertion direction can be easily adjusted. [Effects of the Invention]

[0008] As described above, the endoscopic robot system of the present disclosure can easily perform the position adjustment of the sheath member in the insertion direction relative to the patient. [Brief explanation of the drawings]

[0009] [Figure 1] FIG. 1 is a diagram illustrating a robot system according to a first embodiment. [Figure 2] FIG. 2 is a perspective view of a hand of the robot according to the first embodiment. [Figure 3] FIG. 2 is a diagram for explaining the configuration of a sheath holding part according to the first embodiment. [Figure 4] FIG. 10 is a perspective view for explaining the attachment / detachment structure of the sheath holding portion. [Figure 5] 10 is a cross-sectional view illustrating the attachment of the clamp holding portion to the base portion. FIG. [Figure 6] 10 is a cross-sectional view for explaining the attachment of the sheath clamp portion to the clamp holding portion. FIG. [Figure 7] FIG. 10 is a partial enlarged view for explaining a clamp attaching / detaching mechanism. [Figure 8] FIG. 1 is a block diagram of a robot system according to a first embodiment. [Figure 9] FIG. 2 is a block diagram for explaining control by a control unit according to the first embodiment. [Figure 10] FIG. 10 shows the ureteroscope in a bent state. [Figure 11] FIG. 10 is a diagram illustrating a gantry drape and an arm drape. [Figure 12] FIG. 3 is a flowchart illustrating an operation method of the robot system according to the first embodiment. [Figure 13] FIG. 10 is a diagram illustrating a robot system according to a second embodiment. [Figure 14] FIG. 10 is a block diagram for explaining control by a control unit according to a second embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0010] [First embodiment] A first embodiment of the present disclosure will now be described with reference to the drawings.

[0011] As shown in FIG. 1 , the robot system 100 performs a ureteroscopy procedure on a patient 900 using a ureteroscope 800 to break up urinary stones. The robot system 100 inserts the ureteroscope 800 into the urethra 901 of the patient 900 via a sheath member 902 that has been inserted into the urethra 901 of the patient 900 in advance by an operator, and captures images of the inside of the urinary tract, such as the urethra 901 and ureters of the patient 900. The captured images are displayed on the display unit 50. The operator performs the ureteroscopy procedure on the patient 900 by operating the robot 10 using the operating device 20 while checking the real-time image of the patient 900 displayed on the display unit 50. The sheath member 902 is a ureteral access sheath that is inserted into the patient 900 prior to the ureteroscope 800 in order to insert the ureteroscope 800 into the urethra 901 of the patient 900. In this specification, the insertion direction in which the robot system 100 moves the ureteroscope 800 in and out of the patient 900 is referred to as direction A. The direction perpendicular to direction A is referred to as direction B. The direction perpendicular to directions A and B is referred to as direction C. For example, the patient 900 lies on a bed, and directions A and B are horizontal directions along a horizontal plane. Direction C is a vertical direction along gravity. In other words, direction C is an up-down direction perpendicular to the ground, which is the installation surface on which the robot system 100 is installed. The ureteroscope 800 is an example of an endoscope. The robot system 100 is an example of an endoscopic robot system.

[0012] (Robot system configuration) 1, the robot system 100 includes a robot 10, an operating device 20, a control unit 30, a storage unit 40, and a display unit 50. The robot 10 also includes a base unit 11, a robot arm 12, a hand 13, and a sheath holding unit 60. The operating device 20 is an example of an operating unit.

[0013] A robot arm 12 is attached to the pedestal unit 11. Wheel units 11a are arranged on the underside of the pedestal unit 11 for movement, allowing an operator to manually move the pedestal unit 11. Wheel units 11a are arranged at each of the four corners of the bottom surface of the pedestal unit 11. In addition, ground contact units 11b are arranged on the pedestal unit 11 separately from the wheel units 11a. The ground contact units 11b stop the movement of the pedestal unit 11 by contacting the ground. A pair of ground contact units 11b are arranged on the bottom surface of the pedestal unit 11. The pair of ground contact units 11b are arranged one on each side of the bottom surface of the pedestal unit 11 in direction B. When the operator steps on both sides of the pedestal unit 11, the ground contact units 11b move along direction C and are switched between a ground contact state and a state separated from the ground. Further, the mount part 11 is attached with a sheath holding part 60 that supports the sheath member 902 from below.

[0014] The robot arm 12 is a vertically articulated robot arm 12 that is disposed on the upper surface of the base unit 11 and has a hand 13 attached to its tip. The robot arm 12 includes a plurality of joints JT. For example, the robot arm 12 includes six joints JT1, JT2, JT3, JT4, JT5, and JT6. That is, the robot arm 12 is a robot arm 12 having six axes. An arm driver 14 shown in FIG. 8 is disposed at each of the joints JT1 to JT6.

[0015] (Ureteroscope and forceps) As shown in FIG. 2 , the ureteroscope 800 includes a main body 801 and an insertion section 802. The main body 801 is attached to the hand 13. The insertion section 802 is inserted into the urinary tract of a patient 900. The ureteroscope 800 is provided with a hole 803 into which a basket forceps 903 for retrieving urinary stones and a laser fiber 904 for crushing the urinary stones of the patient 900 are inserted. The laser fiber 904 and basket forceps 903 for crushing the urinary stones of the patient 900 are inserted into the urinary tract of the patient 900 through the hole 803. Ureteroscopic surgery involves identifying the location of the stone in the patient 900, crushing the stone by irradiating it with laser light using the laser fiber 904, and retrieving the stone using the basket forceps 903.

[0016] The ureteroscope 800 also includes an endoscope operation unit 804 that accepts operations on the ureteroscope 800. Specifically, the endoscope operation unit 804 accepts operations to bend the ureteroscope 800. The endoscope operation unit 804 is, for example, a lever that rotates in the R direction. The endoscope operation unit 804 is arranged along the C direction on the B1 side surface of the main body unit 801. When the endoscope operation unit 804 is rotated in the R direction, the insertion unit 802 is bent. Note that the endoscope operation unit 804 may also be a lever that translates along the A direction, etc.

[0017] The basket forceps 903 also includes a forceps operation unit 903a that receives operation on the basket forceps 903. The forceps operation unit 903a receives operation to open and close the tip portion of the basket forceps 903 in the urethra 901 of the patient 900. Specifically, the basket forceps 903 includes a cylindrical main body 903b and a thin wire-shaped insertion unit 903c that is inserted into the body of the patient 900 via the insertion unit 802 of the ureteroscope 800. The forceps operation unit 903a is a member that slides in direction A on the outer surface of the basket forceps 903. When the forceps operation unit 903a is moved in direction A, the tip portion of the insertion unit 903c opens and closes inside the body of the patient 900.

[0018] The laser fiber 904 is a fiber core, and the base side of the laser fiber 904 is connected to a stationary laser irradiation device 904b. An attachment 904a including a roller member is attached to the laser fiber 904. Rotation of the roller member of the attachment 904a moves the laser fiber 904 back and forth inside the body of the patient 900.

[0019] The hand 13 holds the ureteroscope 800, the basket forceps 903, and the laser fiber 904. The hand 13 holds the ureteroscope 800 and either the basket forceps 903 or the laser fiber 904. The hand 13 may hold the ureteroscope 800, the basket forceps 903, and the laser fiber 904 on the upper surface of the C1 side of the hand 13, or on the lower surface of the C2 side, the side surface of the B1 side, or the side surface of the B2 side of the hand 13.

[0020] An endoscope moving mechanism 15 and a forceps moving mechanism 16 are also disposed in the hand 13. The endoscope moving mechanism 15 moves the endoscope operation unit 804 based on an operation received by the operation device 20. The endoscope moving mechanism 15 has a drive source such as a servo motor. The endoscope moving mechanism 15 abuts against the endoscope operation unit 804 and rotates the endoscope operation unit 804 in the R direction to bend the ureteroscope 800. The forceps moving mechanism 16 moves the forceps operation unit 903a of the basket forceps 903 based on an operation received by the operation device 20. The forceps moving mechanism 16 has a drive source such as a servo motor. When a laser fiber 904 is held in the hand 13, the laser fiber 904 is moved inside the body of the patient 900 by the drive force of the forceps moving mechanism 16.

[0021] (Sheath holding part) As shown in FIG. 3 , the sheath holding section 60 holds a sheath member 902 that is inserted into the patient 900 to insert the ureteroscope 800 into the patient 900. In the first embodiment, the sheath holding section 60 includes a clamp holding section 61 and a sheath clamp section 62. The clamp holding section 61 is disposed on a side surface of the gantry section 11 and extends along the horizontal direction A. The clamp holding section 61 is an elongated member that extends from the side surface of the gantry section 11 toward the sheath clamp section 62 and holds the sheath clamp section 62. The sheath clamp section 62 clamps and holds the sheath member 902. The sheath clamp section 62 extends upward in the C1 direction from the tip of the clamp holding section 61 in the A1 direction and clamps and holds the sheath member 902 at its upper end 62a. For example, as shown in FIG. 4, the upper end 62a of the sheath clamp portion 62 has a circular ring shape in which the sheath member 902 is disposed, and has a hinge portion 62b that can be opened and closed so as to be split in the C direction.

[0022] As shown in FIG. 3 , the robot system 100 also includes an elevation drive unit 71 and a horizontal drive unit 72 that move the sheath holder 60. The elevation drive unit 71 is disposed on the base 11 and moves the sheath holder 60 in the vertical direction. The elevation drive unit 71 has a slider 71a that slides in the vertical direction C and a motor 71b as a drive source. The elevation drive unit 71 has, for example, a ball screw mechanism and moves the slider 71a in the vertical direction by rotational driving of the motor 71b. The clamp holder 61 of the sheath holder 60 is attached to the slider 71a of the elevation drive unit 71 disposed on the base 11 and moves in the vertical direction in conjunction with the vertical movement of the slider 71a. The horizontal drive unit 72 is an example of a drive unit.

[0023] The horizontal driver 72 moves the sheath holding section 60 along direction A, which is the insertion direction of the sheath member 902 relative to the patient 900. Specifically, the horizontal driver 72 is disposed in the clamp holding section 61. The horizontal driver 72 moves the sheath clamp section 62 along direction A, which is the insertion direction. The horizontal driver 72 extends and contracts the clamp holding section 61, thereby moving the sheath clamp section 62 along the horizontal direction, which is the insertion direction, in which the clamp holding section 61 extends. The horizontal driver 72 has a rod member 72a arranged to extend along the insertion direction, and a motor 72b as a drive source. The horizontal driver 72 has, for example, a ball screw mechanism, and extends and contracts in direction A by moving the rod member 72a in the insertion direction via rotational driving of the motor 72b.

[0024] For example, the clamp holding unit 61 has a base portion 61a and a tip portion 61b. The clamp holding unit 61 has the base portion 61a, horizontal drive unit 72, and tip portion 61b arranged in this order along the horizontal direction from the base end side, which is the A2 direction side. The base portion 61a is attached to a slider 71a of the elevation drive unit 71. The sheath clamp unit 62 is attached to the C1 direction side above the tip portion 61b. The tip portion 61b is attached to a rod member 72a of the horizontal drive unit 72. The rod member 72a moves so as to expand and contract in the insertion direction, thereby moving the tip portion 61b, on which the sheath clamp unit 62 is arranged, in the insertion direction.

[0025] <Sheath holding part attachment / detachment structure> 4, the sheath holding unit 60 is detachably disposed on the gantry unit 11. Specifically, the clamp holding unit 61 is detachably attached to the slider 71a of the elevation drive unit 71 by an attachment member 63 and an attachment member 64. Each of the attachment members 63 and 64 fixes the base unit 61a of the clamp holding unit 61 to the slider 71a of the elevation drive unit 71. Furthermore, the attachment members 63 and 64 can be attached and detached by a simple operation by the operator.

[0026] 5, the mounting member 63 and the mounting member 64 have knobs 63a and 64a, respectively. A fixing member 75 is fixed to the A1 direction side of the slider 71a. An engaging portion 65 disposed on the base portion 61a of the clamp holding portion 61 engages with the fixing member 75. That is, the engaging portion 65 of the base portion 61a engages with the pedestal portion 11. With the engaging portion 65 engaged with the pedestal portion 11, the mounting members 63 and 64 can be switched between a fixed state and a released state from the pedestal portion 11 by an operating force applied by the operator. A mounting base member 73 to which the mounting member 63 is attached and a mounting base member 74 to which the mounting member 64 is attached are disposed on the fixing member 75. With the engaging portion 65 engaged with the slider 71a of the gantry 11, the operator rotates the knob 63a by 90 degrees around the A direction as the axis of rotation, thereby fixing the mounting member 63 to the mounting base 73. This positions the clamp holding portion 61 relative to the gantry 11. With the mounting member 63 fixed, the operator rotates the knob 64a by 90 degrees around the A direction as the axis of rotation, thereby fixing the mounting member 64 to the mounting base 74. In this way, the two different mounting members 63 and 64 arranged side by side in the C direction are fixed in a positioned state on the slider 71a of the lifting drive unit 71 of the gantry 11. The fixed state of the mounting members 63 and 64 is released by rotating the knobs 63a and 64a by 90 degrees in the opposite direction around the A direction as the axis of rotation. For example, when the robot system 100 is stored or moved, the clamp holding part 61 is detached from the pedestal part 11 by releasing the fixed state of the attachment members 63 and 64. In other words, when the robot system 100 is stored or moved, the entire sheath holding part 60 is detached from the pedestal part 11.

[0027] 4, the clamp holding part 61 has a clamp attachment / detachment mechanism 66 at the tip part 61b. The sheath clamp part 62 is switched between a state where it is attached to the tip part 61b and a state where it is detached from the tip part 61b by the clamp attachment / detachment mechanism 66. In other words, the sheath clamp part 62 is arranged to be attachable to and detachable from the clamp holding part 61.

[0028] Specifically, as shown in FIG. 6 , the clamp attachment / detachment mechanism 66 has a pin member 66a, an attachment hole 66b, a lock knob 66c, and an orientation fixing portion 66d. The pin member 66a is disposed at the end of the sheath clamp portion 62 on the C2 side and is a pin-shaped member extending along the C direction. The attachment hole 66b is disposed at the tip portion 61b of the clamp holding portion 61, and the pin member 66a disposed in the sheath clamp portion 62 is inserted into the attachment hole 66b. The lock knob 66c is rotated by the operator around the C direction as the rotation axis. By rotating the lock knob 66c, the pin member 66a inserted into the attachment hole 66b is fixed inside the attachment hole 66b. Furthermore, by rotating the lock knob 66c in the opposite direction, the pin member 66a is released from the state in which it is fixed to the attachment hole 66b. That is, in the first embodiment, the clamp attachment / detachment mechanism 66 is switched between a state in which the sheath clamp portion 62 is inserted into the attachment hole portion 66b and fixed, and a state in which the fixation is released, by the operating force of the operator.

[0029] 7, the orientation fixing portion 66d is disposed integrally with the sheath clamp portion 62 on the C1 direction side, above the pin member 66a. The orientation fixing portion 66d has a linear notch that engages with the upper part of the mounting hole portion 66b. In the example shown in FIG. 7, the linear notch is disposed along the A direction. By fitting the orientation fixing portion 66d into the upper part of the mounting hole portion 66b, the sheath clamp portion 62 inserted into the mounting hole portion 66b is prevented from rotating about the C direction as its rotation axis. In this way, the sheath clamp portion 62 can be attached and detached with a single touch while being prevented from rotating.

[0030] (Configuration of control unit) As shown in FIG. 8 , the control unit 30 controls the operations of the robot arm 12, the hand 13, and the sheath holding unit 60. The control unit 30 includes a main control unit 31, a servo control unit 32, and a drive circuit unit 33. The main control unit 31 and the servo control unit 32 each include, for example, a CPU (Central Processing Unit). The main control unit 31 controls the arm drive unit 14 of the joint JT of the robot 10, the endoscope moving mechanism 15, and the forceps moving mechanism 16. The main control unit 31 also controls the elevation drive unit 71 and horizontal drive unit 72 of the sheath holding unit 60. The servo control unit 32 controls the power supplied to the arm drive unit 14 of the joint JT, the endoscope moving mechanism 15, the forceps moving mechanism 16, the elevation drive unit 71, and the horizontal drive unit 72 based on commands from the main control unit 31. The control unit 30 is a robot controller. The control unit 30 is disposed, for example, on the pedestal unit 11. The storage unit 40 is a memory such as a RAM or a ROM, a hard disk, etc. The storage unit 40 is disposed in the stand unit 11, for example.

[0031] The drive circuit unit 33 supplies drive power to the arm drive unit 14 of the joint JT, the endoscope movement mechanism 15, the forceps movement mechanism 16, the elevation drive unit 71, and the horizontal drive unit 72. The drive circuit unit 33 includes an inverter circuit that supplies AC power as drive power. A drive circuit unit 33 is provided for each joint JT. A drive circuit unit 33 is also provided for each of the endoscope movement mechanism 15, the forceps movement mechanism 16, the elevation drive unit 71, and the horizontal drive unit 72.

[0032] The arm driver 14 serves as a drive source for operating the robot 10. The arm driver 14 includes a servo motor, an encoder, and a reducer. The servo motor rotates when power is supplied. The servo motor rotates a rotation shaft, for example, using three-phase AC power. The encoder detects the rotation angle of the servo motor. The encoder then outputs a detection value indicating the detected rotation angle of the servo motor to the main control unit 31 and the servo control unit 32. The configurations of the drive units in the endoscope moving mechanism 15 and the forceps moving mechanism 16 are similar to those of the arm driver 14. The configurations of the elevation drive unit 71 and the horizontal drive unit 72 are also similar to those of the arm driver 14. That is, a servo motor and an encoder are provided in each of the endoscope moving mechanism 15, the forceps moving mechanism 16, the elevation drive unit 71, and the horizontal drive unit 72. The control unit 30 performs feedback control for each of the arm drive unit 14, endoscope movement mechanism 15, forceps movement mechanism 16, lift drive unit 71, and horizontal drive unit 72, controlling the operation of the servo motor based on signals from the encoder.

[0033] 1, the operation device 20 accepts operations of the robot 10. The operation device 20 includes, for example, a joystick, a cross key, and a plurality of buttons. The operation device 20 accepts operations of the robot arm 12 and the sheath holding portion 60.

[0034] 9, the control unit 30 controls the operation of the robot arm 12 and the operation of the ureteroscope 800, basket forceps 903, or laser fiber 904 held by the hand 13 based on the operation received by the operation device 20. That is, the control unit 30 executes processing to operate the joints JT of the vertically articulated robot arm 12, the endoscope moving mechanism 15 that operates the ureteroscope 800, and the forceps moving mechanism 16 that operates the basket forceps 903 or the laser fiber 904 based on the operation received by the operation device 20. For control purposes, the control unit 30 controls the endoscope moving mechanism 15 as an axis JT7 and the forceps moving mechanism 16 as an axis JT8, together with the axes corresponding to the six joints JT of the robot arm 12.

[0035] 10 , when the operating device 20 is operated, the control unit 30 operates the joint JT of the robot arm 12, causing the ureteroscope 800 to move in the direction A. When the operating device 20 is operated, the control unit 30 operates the joint JT6 of the robot arm 12, causing the ureteroscope 800 to rotate in the direction D. When the operating device 20 is operated, the control unit 30 operates the endoscope moving mechanism 15, causing the insertion section 802 of the ureteroscope 800 to bend in the direction E. When the operating device 20 is operated, the control unit 30 operates the forceps moving mechanism 16, causing the tip of the basket forceps 903 to open and close, or the laser fiber 904 to move in the forward and backward directions. When the operating device 20 is operated, the control unit 30 operates the joint JT of the robot arm 12, causing the robot arm 12 to move the ureteroscope 800 up and down. By moving the ureteroscope 800 in the up and down direction, the height position of the ureteroscope 800 is adjusted to the height position of the sheath member 902 that has been inserted into the urethra 901 of the patient 900 in advance.

[0036] 9, the control unit 30 controls the operation of the sheath holding unit 60 based on an operation received by the operating device 20. That is, the operating device 20 receives an operation of the sheath holding unit 60. The control unit 30 executes a process of operating the elevation drive unit 71 and the horizontal drive unit 72 based on the operation received by the operating device 20. The control unit 30 also executes a process of controlling the elevation drive unit 71 as an axis JT9 and the horizontal drive unit 72 as an axis JT10, together with axes corresponding to the six joints JT of the robot arm 12. For example, when the operating device 20 is operated, the control unit 30 operates the elevation drive unit 71 to move the sheath holding unit 60 in the up-down direction. When the operating device 20 is operated, the control unit 30 also operates the horizontal drive unit 72 to move the sheath holding unit 60 in the insertion direction.

[0037] <Control of movement of sheath holding part> In the first embodiment, the control unit 30 adjusts the position of the ureteroscope 800 by moving the sheath holding unit 60 in the up-down direction using the elevation drive unit 71 based on an operation received by the operation device 20 before the ureteroscope 800 is inserted into the patient 900. The control unit 30 also adjusts the position of the ureteroscope 800 by moving the sheath holding unit 60 in the insertion direction using the horizontal drive unit 72 based on an operation received by the operation device 20 before the ureteroscope 800 is inserted into the patient 900. Specifically, before the start of surgery to insert the ureteroscope 800 into the body of the patient 900, a roll-in operation is performed to place the robot system 100 in a predetermined position. In the roll-in operation, first, the gantry unit 11 is moved to the vicinity of the patient 900 by movement using the wheel unit 11a. Then, with the movement of the gantry unit 11 stopped by the ground contact unit 11b, the operation device 20 is operated to adjust the positions of the robot arm 12 and the sheath holding unit 60. In this position adjustment, the control unit 30 adjusts the position of the sheath holding unit 60 in the up-down direction and the insertion direction by operating the elevation drive unit 71 and the horizontal drive unit 72 based on an operation received by the operation device 20 in accordance with the position, posture, or physique of the patient 900. In the position adjustment operation, the robot arm 12 and the sheath holding unit 60 may be moved in the up-down direction and the insertion direction in conjunction with each other, or the sheath holding unit 60 may be moved in the up-down direction and the insertion direction separately from the robot arm 12. For example, when the robot arm 12 and the sheath holding unit 60 are moved in conjunction with each other, the control unit 30 operates the elevation drive unit 71 and the horizontal drive unit 72 in synchronization with the operation of the robot arm 12, while maintaining a constant relative positional relationship between the hand 13 of the robot arm 12 and the sheath holding unit 60. Note that when the robot arm 12 and the sheath holding unit 60 are moved in conjunction with each other, they may be moved in only the up-down direction or the insertion direction.

[0038] Furthermore, when the ureteroscope 800 is inserted into the body of the patient 900, the control unit 30 adjusts the position of the sheath member 902 by operating the elevation drive unit 71 and the horizontal drive unit 72. For example, if the ureter of the patient 900 is bent at the position of the tip of the sheath member 902, it may be difficult to confirm the path within the urinary tract in the image displayed on the display unit 50. In response to this, the operator operates the operation device 20 to move the sheath member 902 toward the front in the insertion direction. Based on an input operation to the operation device 20, the control unit 30 operates the horizontal drive unit 72 to move the sheath holding unit 60 so as to contract, in order to move the position of the sheath member 902 toward the A2 direction, which is the front in the insertion direction.

[0039] As shown in FIG. 1 , in the first embodiment, a suction device 905 is connected to the sheath member 902 to remove foreign matter from the body of a patient 900. The sheath member 902 has a side port 902a to which a tube 905a of the suction device 905 is connected. The suction device 905 performs a suction operation while connected to the side port 902a of the sheath member 902, thereby creating a negative pressure inside the sheath member 902. For example, to collect dust, which is foreign matter generated when a calculus is crushed, the suction device 905 creates a negative pressure inside the sheath member 902. In this case, for example, an operator operates the operation device 20 to move the sheath member 902 rearward in the insertion direction to aspirate the foreign matter. The control unit 30 operates the horizontal drive unit 72 based on the operation received by the operation device 20, thereby moving the sheath holding unit 60 so as to extend it, in order to move the sheath member 902 toward the A1 direction, which is the rearward side in the insertion direction. In other words, in the first embodiment, the horizontal drive unit 72 moves the sheath holding unit 60, which holds the sheath member 902 to which the suction device 905 is connected, along the insertion direction in order to remove foreign matter from inside the body of the patient 900.

[0040] <Respiration-driven> The control unit 30 moves the sheath holding unit 60 in the up-down direction and the insertion direction by the elevation drive unit 71 in synchronization with the movement of the hand 13 in the up-down direction and the insertion direction by the robot arm 12. In the first embodiment, the control unit 30 moves the robot arm 12 and the sheath holding unit 60 in the up-down direction and the insertion direction in synchronization with the breathing of the patient 900.

[0041] For example, as shown in FIG. 1 , in a surgery using a ureteroscope 800 using the robot system 100, general anesthesia is administered to a patient 900. The robot system 100 acquires timing information indicating the timing of the patient's breathing from an anesthesia machine 906 that administers general anesthesia. When the ureteroscope 800 is inserted into the patient's body, the control unit 30 moves the robot arm 12 and the sheath holding unit 60 in the up-down direction C and the insertion direction A in synchronization with the patient's breathing based on the acquired timing information. For example, when the ureteroscope 800 is inserted into the patient's body, the control unit 30 receives an operation to move the ureteroscope 800 in the insertion direction from the operation device 20, and swings the hand 13 in the up-down direction and the insertion direction in synchronization with the patient's breathing based on the timing information, separately from the operation received by the operation device 20. The amount of movement of the hand 13 in the up-down direction and the insertion direction based on the timing information is, for example, preset and stored. Then, in synchronization with the vertical and insertion direction swing of the hand 13 synchronized with breathing, the control unit 30 moves the sheath holding unit 60 in the vertical direction using the elevation drive unit 71, and moves the sheath holding unit 60 in the insertion direction using the horizontal drive unit 72. The control unit 30 controls the operations of the elevation drive unit 71 and the horizontal drive unit 72 so that the amount of movement of the hand 13 in the vertical direction and insertion direction and the amount of movement of the sheath holding unit 60 in the vertical direction and insertion direction match each other.

[0042] (drape) As shown in FIG. 11 , the robot system 100 includes a gantry drape 81 and an arm drape 82. The gantry drape 81 integrally covers the gantry unit 11 and the sheath holding unit 60. The arm drape 82 covers the robot arm 12. The gantry drape 81 and the arm drape 82 are cloth-like members that are replaced after each surgery. The gantry drape 81 covers the entire gantry unit 11 and the clamp holding unit 61 of the sheath holding unit 60 that is arranged along the horizontal surface. In other words, the sheath clamp unit 62 of the sheath holding unit 60 is exposed from the gantry drape 81. An opening 81a is provided in the gantry drape 81. A hard film member is provided around the periphery of the opening 81a.

[0043] 6, when the sheath clamp section 62 is attached to the clamp holding section 61 by the clamp attaching / detaching mechanism 66, the hard film member at the opening 81a is sandwiched between the clamp holding section 61 and the sheath clamp section 62. The gantry drape 81 is positioned by sandwiching the hard film member at the opening 81a between the clamp holding section 61 and the sheath clamp section 62. The gantry drape 81 may be welded to the sheath holding section 60 at the opening 81a.

[0044] 11 , the arm drape 82 is fixed to a drape fixing portion 13a disposed on the hand 13. In the hand 13, the ureteroscope 800 held by the hand 13, and the basket forceps 903 or the laser fiber 904 are exposed from the arm drape 82. That is, the arm drape 82 has an opening that exposes the upper surface of the hand 13 on the C1 direction side. The gantry drape 81 and the arm drape 82 are bound together at the base end portion of the robot arm 12.

[0045] (Operation method of the robot system) Next, an operation method of the robot system 100 according to the first embodiment will be described with reference to Fig. 12. Note that the control processes from step S1 to step S7 in the operation method of the robot system 100 are executed by the control unit 30.

[0046] First, in step S1, draping is performed. Specifically, the robot system 100, with the sheath holding unit 60 detached from the gantry 11, is manually transported into the operating room. Then, the clamp holding unit 61 of the sheath holding unit 60 is attached to the gantry 11 using the attachment members 63 and 64. Then, with the clamp holding unit 61 attached to the gantry 11, the robot 10 is controlled to assume a draping posture. The draping posture is a posture for attaching the gantry drape 81 and the arm drape 82. In the draping posture, for example, the robot arm 12 is placed on standby with the robot arm 12 extended linearly along the horizontal direction. After the gantry drape 81 and the arm drape 82 are attached to the robot 10 in the draping posture, the sheath clamp unit 62 is attached to the clamp holding unit 61, and the robot 10 is changed to a standby posture and waits until preparations for surgery are complete.

[0047] Next, in step S2, position adjustment is performed. After anesthesia is administered to a patient 900 lying in an operating room using an anesthesia device 906, a sheath member 902 is inserted into the patient 900, thereby preparing for surgery. After preparation for surgery is complete, the robot system 100 is manually moved to a predetermined position for surgery, and then a position adjustment control process is performed to adjust the positions of the robot arm 12 and the sheath holding unit 60. In the position adjustment, with the movement of the wheel unit 11a stopped by the ground contact unit 11b, the arm driving unit 14 is operated based on an operation of the operating device 20 to adjust the position of the robot arm 12, and the elevation driving unit 71 and the horizontal driving unit 72 are operated based on an operation of the operating device 20 to adjust the position of the sheath holding unit 60. After the adjustment is complete, the sheath member 902 is clamped and held by the upper end 62a of the sheath clamp unit 62. After the sheath member 902 is held by the sheath clamp section 62, the position of the robot arm 12 in the insertion direction may be adjusted.

[0048] Next, in step S3, the ureteroscope 800 is held by the hand 13 and inserted into the patient 900 to start the surgery. In the surgery using the ureteroscope 800, the operation of the endoscope moving mechanism 15 and the forceps moving mechanism 16 is controlled by operating the operation device 20, and thereby the operation of the ureteroscope 800, the basket forceps 903, and the laser fiber 904 is controlled.

[0049] Next, in step S4, it is determined whether or not to move the sheath holding unit 60. For example, during surgery using the ureteroscope 800, it is determined whether or not an operation to move the sheath holding unit 60 has been accepted in order to move the sheath member 902 in the insertion direction. If the sheath holding unit 60 is to be moved, the process proceeds to step S5. If the sheath holding unit 60 is not to be moved, the process proceeds to step S6. Note that when the hand 13 and the sheath holding unit 60 are to be moved in the up-down direction and the insertion direction in response to the breathing of the patient 900, even if the operation to move the sheath holding unit 60 has not been accepted, the operations of the arm driver 14, the elevation driver 71, and the horizontal driver 72 are controlled in synchronization with the breathing of the patient 900 based on timing information from the anesthesia machine 906, thereby controlling the operations of the robot arm 12 and the sheath holding unit 60.

[0050] In step S5, the sheath holding section 60 is moved based on the operation received by the operation device 20. For example, the operation of the horizontal drive section 72 is controlled based on the operation received by the operation device 20, thereby moving the sheath clamp section 62 in the insertion direction. Then, the process proceeds to step S6.

[0051] In step S6, it is determined whether the surgery has ended. If it is determined that the surgery using ureteroscope 800 has ended, the process proceeds to step S7. If it is determined that the surgery has not ended, the process returns to step S4. For example, if an operation to instruct the end of the surgery is received by operating operation device 20, the surgery is determined to have ended.

[0052] In step S7, the gantry drape 81 and the arm drape 82 are removed. After the surgery is completed and the ureteroscope 800 is removed from the hand 13 and the sheath clamp unit 62 is removed from the clamp holder 61, the robot system 100 is moved by the operation of the wheel unit 11a to a position away from the patient 900. Then, the robot 10 is controlled to assume a draping posture. In the draping posture, the gantry drape 81 and the arm drape 82 are removed, and then the robot 10 is changed to a storage posture in which the robot arm 12 is folded. Then, the clamp holder 61 is removed from the gantry unit 11, and the control process for the operation method of the robot system 100 is terminated.

[0053] [Effects of the first embodiment] As described above, the robot system 100 serving as an endoscopic robot system is disposed on the gantry 11 and includes the sheath holding unit 60 that holds the sheath member 902 to be inserted into the patient 900 in order to insert the ureteroscope 800 serving as the endoscope, and the horizontal driving unit 72 that serves as a driving unit that moves the sheath holding unit 60 along the insertion direction of the sheath member 902 relative to the patient 900. This allows the sheath holding unit 60 that holds the sheath member 902 to be easily moved along the insertion direction by the operation of the horizontal driving unit 72, unlike when a doctor manually grasps the sheath member 902 to perform position adjustment in the insertion direction. As a result, the position adjustment of the sheath member 902 in the insertion direction relative to the patient 900 can be easily performed.

[0054] The robot system 100, which serves as an endoscopic robot system, includes a control unit 30 that controls the operation of the sheath holding unit 60 and an operating device 20 that serves as an operating unit that accepts operations of the sheath holding unit 60. The control unit 30 moves the sheath holding unit 60 along the insertion direction using a horizontal driving unit 72 that serves as a driving unit based on operations accepted by the operating device 20. Here, X-ray imaging may be performed to confirm the position of a ureteroscope 800 serving as an endoscope within the body of a patient 900. In such cases, it is considered that the ureteroscope 800 is remotely operated from a position separated from the patient 900 to reduce exposure to X-rays. In consideration of this, in the first embodiment, the horizontal driving unit 72 moves the sheath holding unit 60 along the insertion direction based on operations accepted by the operating device 20. As a result, when the ureteroscope 800 is remotely operated, the sheath holding unit 60 can be operated from a position separated from the patient 900 by operating the operating device 20, thereby effectively and easily adjusting the position of the sheath member 902 in the insertion direction.

[0055] The hand 13 holds the ureteroscope 800 to be inserted into the urethra 901 of the patient 900. The horizontal drive unit 72, which serves as a drive unit, moves the sheath holding unit 60, which holds the sheath member 902 to be inserted into the urethra 901 of the patient 900, along the insertion direction. Here, when the ureteroscope 800 is inserted into the urethra 901 of the patient 900, it may be difficult to confirm the path within the urinary tract in an image acquired by the ureteroscope 800 because the ureter of the patient 900 is bent at the position of the tip of the sheath member 902. In contrast, in the first embodiment, the sheath holding unit 60, which holds the sheath member 902 inserted into the urethra 901, is moved along the insertion direction by the horizontal drive unit 72, thereby easily adjusting the position of the sheath member 902 to be inserted into the urethra 901 in the insertion direction relative to the patient 900. Therefore, by adjusting the position of the sheath member 902, it is possible to easily eliminate the bend in the ureter of the patient 900, thereby making it easy to confirm the path within the urinary tract. As a result, it is possible to easily avoid the progress of surgery using the ureteroscope 800 being hindered due to difficulty in checking the path inside the urinary tract.

[0056] The sheath holding unit 60 includes a sheath clamp unit 62 that sandwiches and holds the sheath member 902, and a clamp holding unit 61 that is arranged on the side surface of the gantry unit 11 and holds the sheath clamp unit 62. As a result, the sheath clamp unit 62 is held by the clamp holding unit 61 that is arranged on the side surface of the gantry unit 11 while the sheath member 902 is held by the sheath clamp unit 62, so the sheath member 902 can be held at a position separated from the gantry unit 11. Therefore, by moving the sheath holding unit 60 including the clamp holding unit 61 and the sheath clamp unit 62 in the insertion direction, the sheath holding unit 60 can be moved in the insertion direction while holding the sheath member 902 at a position closer to the patient 900, so the position of the sheath member 902 in the insertion direction can be more appropriately adjusted.

[0057] The horizontal driving unit 72 serving as a driving unit is disposed in the clamp holding unit 61 and moves the sheath clamp unit 62 along the insertion direction. As a result, since the horizontal driving unit 72 is disposed in the clamp holding unit 61, the sheath member 902 held by the sheath clamp unit 62 can be moved along the insertion direction by moving the sheath clamp unit 62 relative to the clamp holding unit 61. Therefore, compared to moving the clamp holding unit 61 and the sheath clamp unit 62 as a whole along the insertion direction, the sheath member 902 can be moved more easily along the insertion direction by moving the sheath clamp unit 62 relative to the clamp holding unit 61.

[0058] The clamp holding unit 61 is disposed on the side surface of the gantry 11 and extends horizontally. A horizontal driving unit 72 serving as a driving unit moves the sheath clamp unit 62 along the horizontal direction, which is the insertion direction. As a result, the clamp holding unit 61 extends horizontally from the side surface of the gantry 11, and the sheath clamp unit 62 is moved by the horizontal driving unit 72 along the horizontal direction, which is the insertion direction. Therefore, the sheath member 902 can be moved in the insertion direction by moving the sheath clamp unit 62 along the extension direction of the clamp holding unit 61. Therefore, the sheath member 902 can be moved in the insertion direction more easily than when the sheath clamp unit 62 is moved in a direction different from the extension direction of the sheath clamp unit 62.

[0059] The horizontal driving unit 72 serving as a driving unit extends and retracts the clamp holding unit 61, thereby moving the sheath clamp unit 62 along the insertion direction. As a result, the clamp holding unit 61 extends and retracts when the sheath clamp unit 62 is moved, and therefore the clamp holding unit 61 can be contracted when the sheath clamp unit 62 is moved toward the front. Therefore, compared to when the sheath clamp unit 62 is slid on the clamp holding unit 61, the clamp holding unit 61 can be made more compact, and physical interference of the clamp holding unit 61 with the patient 900 or members arranged around the patient 900 can be suppressed.

[0060] The horizontal driving unit 72 serving as a driving unit moves the sheath holding unit 60, which holds the sheath member 902 to which the suction device 905 is connected, along the insertion direction in order to remove a foreign body from inside the body of the patient 900. Thus, by moving the sheath holding unit 60 along the insertion direction using the horizontal driving unit 72, the sheath member 902 to which the suction device 905 is connected can be easily moved in the insertion direction inside the body of the patient 900. Therefore, the sheath member 902 can be easily moved to match the position of the foreign body inside the body of the patient 900, and the foreign body from inside the body of the patient 900 can be easily and effectively removed by the sheath member 902.

[0061] The clamp holding unit 61 includes an engaging portion 65 that engages with the gantry 11, and attachment members 63 and 64 that, when the engaging portion 65 is engaged with the gantry 11, are switched between a state in which the clamp holding unit 61 is fixed to the gantry 11 and a state in which the clamp holding unit 61 is released from the gantry 11 by an operating force applied by the operator. This allows the clamp holding unit 61 to be easily attached to and detached from the gantry 11 using the attachment members 63 and 64. Therefore, since the entire sheath holding unit 60 can be easily attached to and detached from the gantry 11, when the robot system 100 serving as an endoscopic robot system is stored or moved, the sheath holding unit 60 can be removed from the gantry 11 to easily prevent the robot system 100 from physically interfering with surrounding objects. Furthermore, since the clamp holding unit 61 can be easily fixed to the gantry 11 using the attachment members 63 and 64, the sheath holding unit 60 can be easily attached to the gantry 11 when performing surgery using the ureteroscope 800 serving as an endoscope.

[0062] The clamp holding part 61 has an attachment hole 66b into which the sheath clamp part 62 is inserted, and a clamp attachment / detachment mechanism 66 that switches between a state in which the sheath clamp part 62 is inserted into and fixed in the attachment hole 66b and a state in which the fixation is released, by an operating force from an operator. This allows the sheath clamp part 62 to be easily attached to and detached from the clamp holding part 61 by the clamp attachment / detachment mechanism 66. Therefore, the sheath clamp part 62 that directly contacts the sheath member 902 can be easily replaced.

[0063] The robot system 100, which serves as an endoscopic robot system, is disposed on the upper surface of a gantry 11 and includes a vertically articulated robot arm 12 having multiple axes. The clamp holder 61 is disposed on the side surface of the gantry 11 and extends horizontally. As a result, the vertically articulated robot arm 12 is disposed on the upper surface of the gantry 11 and the clamp holder 61 extending horizontally is disposed on the side surface of the gantry 11, which prevents the clamp holder 61 from interfering with the operation of the robot arm 12. Therefore, the position adjustment of the sheath member 902 in the insertion direction relative to the patient 900 can be easily performed while preventing the clamp holder 61 from interfering with the operation of the robot arm 12.

[0064] The robot system 100 as an endoscopic robot system includes a gantry drape 81 that integrally covers the gantry 11 and the sheath holding unit 60, and an arm drape 82 that covers the robot arm 12. The gantry drape 81 and the arm drape 82 thus enable the gantry 11, the sheath holding unit 60, and the robot arm 12 to be kept hygienic.

[0065] The gantry unit 11 includes wheel units 11a arranged for movement, and ground contact units 11b arranged separately from the wheel units 11a and stopping the movement of the gantry unit 11 by coming into contact with the ground. This allows the gantry unit 11 to be easily moved by the wheel units 11a, and the ground contact units 11b to easily fix the gantry unit 11 so that it does not move. Therefore, it can be easily moved to the position where surgery is to be performed and stopped at the position where surgery is to be performed.

[0066] The control unit 30 executes processing to operate the axes of the robot arm 12 and the axis JT10 of the horizontal drive unit 72, which serves as a drive unit that moves the sheath holding unit 60. As a result, the control unit 30 can collectively perform processing for the joints JT1 to JT6 of the robot arm 12 and the axis JT10 of the horizontal drive unit 72. Therefore, compared to a case in which a control device that performs processing to operate each axis of the arm drive unit 14 that drives the robot arm 12 and a control device that performs processing to operate the axis JT10 of the horizontal drive unit 72 are separately provided, it is possible to suppress the complexity of the device configuration.

[0067] [Second embodiment] Next, a robot system 200 according to a second embodiment will be described with reference to Figures 13 and 14. Unlike the first embodiment in which the operation of the arm driver 14 of the robot arm 12 and the operations of the lift driver 71 and horizontal driver 72 of the sheath holder 60 are controlled by a common controller 30, the robot system 200 of the second embodiment has controllers 234 and 235 that are separate from the controller 230 that controls the arm driver 14, respectively, that control the operations of the lift driver 71 and horizontal driver 72. Note that the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted.

[0068] As shown in FIG. 13 , in the second embodiment, the robot system 200 includes a control unit 230, a control unit 234, and a control unit 235. The control unit 230 executes a process of operating the axis of the robot arm 12. The control unit 234 is disposed separately from the control unit 230 and executes a process of operating the axis of the elevation drive unit 71 that moves the sheath holding unit 60 based on a signal from the control unit 230. The control unit 235 is disposed separately from the control unit 230 and executes a process of operating the axis of the horizontal drive unit 72 that moves the sheath holding unit 60 based on a signal from the control unit 230. The robot system 200 is an example of an endoscopic robot system. The control unit 230 is an example of a robot control unit. The control unit 235 is an example of a sheath control unit.

[0069] As shown in FIG. 14 , the control unit 230 controls the operation of the arm driver 14 of the robot arm 12, similar to the control unit 30 of the first embodiment. Specifically, the control unit 230 performs feedback control to control the operation of the servo motor of the arm driver 14 based on a signal from the encoder of the arm driver 14. Similarly to the control unit 30 of the first embodiment, the control unit 230 also controls the operation of the endoscope moving mechanism 15 and the forceps moving mechanism 16 of the hand 13. Similarly to the control of the arm driver 14, the control unit 230 controls the operation of the endoscope moving mechanism 15 and the forceps moving mechanism 16 by feedback control of the current supplied to the servo motor based on the signal from the encoder. Similarly to the control of the arm driver 14, the control unit 230 controls the operation of the endoscope moving mechanism 15 and the forceps moving mechanism 16. Similarly to the control unit 30 of the first embodiment, the control unit 230 controls the joints JT1 to JT6 of the robot arm 12, and controls the endoscope moving mechanism 15 as an axis JT7 and the forceps moving mechanism 16 as an axis JT8. The control unit 230 is a robot controller similar to the control unit 30.

[0070] In the second embodiment, the operations of the lifting / lowering drive unit 71 and the horizontal drive unit 72 are controlled by feedback control by control units 234 and 235, which are arranged separately from the control unit 230 serving as a robot controller. For example, the control unit 234, separately from the control unit 230, acquires a signal from the encoder of the lifting / lowering drive unit 71 and controls the drive power supplied to the servo motor of the lifting / lowering drive unit 71 by feedback control. The control unit 235, separately from the control unit 230, acquires a signal from the encoder of the horizontal drive unit 72 and controls the drive power supplied to the servo motor of the horizontal drive unit 72 by feedback control. Each of the control units 234 and 235 includes, for example, a CPU and an inverter circuit that supplies drive power.

[0071] Furthermore, the control units 234 and 235 control the operations of the lift drive unit 71 and the horizontal drive unit 72, respectively, based on operation signals from the control unit 230. For example, when controlling the operations of the lift drive unit 71 and the horizontal drive unit 72 based on an operation received by the operation device 20, the control unit 230 outputs an operation signal based on the operation received by the operation device 20 to the control units 234 and 235. The control units 234 and 235 operate the lift drive unit 71 and the horizontal drive unit 72, respectively, based on the operation signal acquired from the control unit 230, so that the sheath holding unit 60 moves by an amount corresponding to the received operation. Similarly, when the lift drive unit 71 and the horizontal drive unit 72 are automatically operated in response to the respiration of the patient 900, the operation of the lift drive unit 71 is controlled by the control unit 234 and the operation of the horizontal drive unit 72 is controlled by the control unit 235, based on the operation signal from the control unit 230.

[0072] As an example, control unit 230 outputs a 1-bit operation signal to each of control units 234 and 235. Control units 234 and 235 operate lift driver 71 and horizontal driver 72 for the period during which the operation signal is acquired, respectively, and output current position information indicating the amount of movement by lift driver 71 and horizontal driver 72 to control unit 230. The current position information is, for example, 32-bit data. Control unit 230 corrects the operation of lift driver 71 and horizontal driver 72 by outputting a correction operation signal to control units 234 and 235 based on the current position information acquired from control units 234 and 235. Control units 234 and 235 operate lift driver 71 and horizontal driver 72 based on the correction operation signal, thereby moving sheath holder 60. Note that if high operational accuracy of lift driver 71 and horizontal driver 72 is not required, the correction operation based on the current position information may be omitted. Other configurations of the second embodiment are similar to those of the first embodiment.

[0073] [Effects of the second embodiment] The robot system 200, which is an endoscopic robot system, includes a control unit 230 serving as a robot control unit that executes processing to operate the axis of the robot arm 12. The robot system 200 also includes a control unit 235 that is arranged separately from the control unit 230 and serves as a sheath control unit that executes processing to operate the axis of the horizontal drive unit 72 that serves as a drive unit that moves the sheath holding unit 60 based on a signal from the control unit 230. As a result, the control unit 230 that controls the operation of the robot arm 12 and the control unit 235 that controls the movement of the sheath holding unit 60 in the insertion direction are arranged separately, which makes it possible to prevent the processing load on a single control unit from becoming too large.

[0074] [Variations] It should be noted that the embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present disclosure is defined by the claims rather than the description of the above embodiments, and further includes all modifications (variations) within the meaning and scope equivalent to the claims.

[0075] For example, in the first and second embodiments described above, the vertical and insertion direction movements of the robot arm 12 and the sheath holding unit 60 are synchronized in conjunction with the breathing of the patient 900 based on timing information from the anesthesia device 906. However, the present disclosure is not limited to this. In the present disclosure, the movements of the robot arm and the sheath holding unit may be controlled based on information other than signals from the anesthesia device. For example, the robot arm and the sheath holding unit may be moved in accordance with the patient's body movements by detecting the patient's body movements from images captured by an imaging unit that captures the patient's appearance. Alternatively, the sheath holding unit may be moved automatically without being synchronized with the robot arm. Alternatively, when synchronized with the patient's breathing, the robot arm and the sheath holding unit may be moved only in either the vertical or insertion direction.

[0076] In addition, in the above first and second embodiments, an example of an endoscope according to the present disclosure is shown in which the ureteroscope 800 is inserted into the urinary tract of the patient 900, but the present disclosure is not limited to this. For example, the present disclosure may be applied to an endoscope inserted into the respiratory organs such as the lungs and bronchi, or the digestive organs such as the stomach and large intestine.

[0077] In the first and second embodiments, the sheath member 902 held by the sheath holding unit 60 is a ureteral access sheath connected to the suction device 905, but the present disclosure is not limited to this. In the present disclosure, the sheath member may not be connected to a suction device. Furthermore, the sheath member may not be a ureteral access sheath, but may be a sheath member inserted into a site other than the urinary tract.

[0078] Furthermore, in the above first and second embodiments, an example was shown in which the sheath holding unit 60 includes the clamp holding unit 61 extending horizontally from the side surface of the gantry unit 11 and the sheath clamp unit 62 extending upward from the tip of the clamp holding unit 61 and clamping and holding the sheath member 902, but the present disclosure is not limited to this. In the present disclosure, the sheath holding unit may have a portion extending horizontally and a portion extending upward integrally arranged. Furthermore, the sheath holding unit may be arranged to extend from the upper surface of the gantry unit. Furthermore, the sheath clamp unit may have a shape other than a circular ring shape.

[0079] Furthermore, in the above-described first and second embodiments, an example was shown in which the elevation drive unit 71 that moves the sheath holding unit 60 in the up-down direction is disposed on the gantry unit 11, but the present disclosure is not limited to this. In the present disclosure, the drive unit that moves the sheath holding unit in the up-down direction may be disposed on the clamp holding unit. For example, a drive unit that moves the sheath clamp unit in the up-down direction may be disposed on the clamp holding unit. Also, a drive unit that moves the sheath clamp unit in the up-down direction may be disposed on the sheath clamp unit. In this case, the sheath clamp unit itself may be configured to extend and retract, or the portion of the sheath clamp unit that grips the sheath member may be configured to move in the up-down direction.

[0080] Furthermore, in the above-described first and second embodiments, the horizontal driver 72 serving as the driver for moving the sheath holding portion 60 along the insertion direction is disposed in the clamp holding portion 61 and extends and retracts the clamp holding portion 61. However, the present disclosure is not limited to this. In the present disclosure, the driver for moving the sheath holding portion along the insertion direction may be disposed in the pedestal. Furthermore, when the driver for moving the sheath holding portion along the insertion direction is disposed in the clamp holding portion, the sheath clamp portion may be moved in the insertion direction by sliding the sheath clamp portion in the clamp holding portion. For example, the sheath clamp portion may be moved along the insertion direction by disposing an electric slider on the upper surface of the clamp holding portion extending along the horizontal direction.

[0081] In the first and second embodiments, the sheath holding unit 60 includes the base portion 61a, the horizontal drive unit 72, and the tip portion 61b, which are arranged in this order along the horizontal direction. However, the present disclosure is not limited to this. In the present disclosure, the base portion does not necessarily have to be arranged in the sheath holding unit. Furthermore, the positions of the base portion and the horizontal drive unit may be interchanged.

[0082] Furthermore, in the above-described first and second embodiments, an example has been shown in which the clamp holder 61 is detachably fixed to the gantry 11 by being fixed by the attachment members 63 and 64 while the engagement portion 65 is engaged with the gantry 11. However, the present disclosure is not limited to this. In the present disclosure, the clamp holder may be fixed to the gantry by a fastening member or the like. Furthermore, the clamp holder may be fixed to the gantry by a single attachment member. In this case, even with a single attachment member, it is preferable that the sheath holder is prevented from falling and its rotation is restrained. Furthermore, the clamp holder may be attached to a flat surface of the gantry without providing an engagement portion. Furthermore, when two attachment members are provided, they may be arranged horizontally rather than vertically.

[0083] Furthermore, in the first and second embodiments described above, an example was shown in which the sheath clamp portion 62 was attached to the clamp holding portion 61 by the clamp attaching / detaching mechanism 66 having the pin member 66a, the attachment hole portion 66b, the lock knob 66c, and the orientation fixing portion 66d, but the present disclosure is not limited to this. In the present disclosure, the sheath clamp portion may be fixed to the clamp holding portion by a fastening member or the like. Alternatively, a hole may be provided in the sheath clamp portion so that a pin member arranged in the clamp holding portion can be inserted into the sheath clamp portion. Alternatively, the sheath clamp portion may be fixed by inserting it into the attachment hole and then rotating the sheath clamp portion itself.

[0084] Furthermore, in the above first and second embodiments, an example has been shown in which the robot arm 12 is a vertically articulated robot arm 12, but the present disclosure is not limited to this. In the present disclosure, the robot arm may be a robot arm other than a vertically articulated robot arm. For example, the robot arm may be a horizontally articulated robot arm. Furthermore, the robot arm may be a three-axis robot arm that moves in the X, Y, and Z directions.

[0085] Furthermore, in the above first and second embodiments, an example has been shown in which a gantry drape 81 that integrally covers the gantry 11 and the sheath holding unit 60 and an arm drape 82 that covers the robot arm 12 are arranged, but the present disclosure is not limited to this. In the present disclosure, the gantry, the sheath holding unit, and the robot arm may be integrally covered by a single drape. Alternatively, the gantry and the sheath holding unit may be covered by separate drapes.

[0086] Furthermore, in the above-described first and second embodiments, an example was shown in which the gantry unit 11 includes the wheel unit 11a and the ground contact unit 11b that stops the movement of the gantry unit 11 by abutting against the ground, but the present disclosure is not limited to this. In the present disclosure, instead of a ground contact unit that contacts the ground, a brake mechanism that brakes the rotation of the wheel unit may be provided. Furthermore, the number of wheel units may be three or less, or four or more. Similarly, when ground contact units are provided, the number of ground contact units may be other than two. Furthermore, the endoscopic robot system may be a stationary type that is fixed to the floor surface without providing wheel units.

[0087] In the first and second embodiments, the operating device 20 serving as an operating unit that accepts operations of the robot arm 12 and the sheath holding unit 60 includes a joystick, a cross key, and multiple buttons. However, the present disclosure is not limited to this. In the present disclosure, the operating unit may be a touch panel or the like. Furthermore, the operating unit that accepts operations of the robot arm and the operating unit that accepts operations of the sheath holding unit may be arranged separately from each other. For example, when adjusting the position during roll-in, the operation to adjust the position of the sheath holding unit may be accepted by a position adjustment button arranged on the platform.

[0088] Furthermore, in the above first and second embodiments, an example has been described in which the ureteroscope 800 and the basket forceps 903 or the laser fiber 904 are disposed in the hand 13, but the present disclosure is not limited to this. In the present disclosure, only the ureteroscope may be disposed in the hand. In this case, the forceps moving mechanism is not disposed in the hand, and only the endoscope moving mechanism is disposed. Alternatively, the ureteroscope, the basket forceps, and the laser fiber may all be disposed in the hand. In this case, a forceps moving mechanism is disposed separately for each of the basket forceps and the laser fiber.

[0089] Furthermore, in the first and second embodiments described above, an example was shown in which an elevation drive unit 71 that moves the sheath holding unit 60 in the up-down direction and a horizontal drive unit 72 that moves the sheath holding unit 60 in the horizontal insertion direction were provided, but the present disclosure is not limited to this. In the present disclosure, a drive unit that moves the sheath holding unit in the up-down direction may not be provided. Furthermore, a drive unit that moves the sheath holding unit in the left-right direction perpendicular to the insertion direction in a horizontal plane may also be provided. Furthermore, the insertion direction may be a direction other than the horizontal direction. Furthermore, the drive unit may be operated by a driving force such as an air actuator other than an electric actuator. Furthermore, power may be transmitted by a power transmission mechanism other than a ball screw, such as a rack and pinion or a belt and pulley.

[0090] Furthermore, in the first embodiment, an example was described in which the six-axis arm driver 14, the endoscope moving mechanism 15, the forceps moving mechanism 16, the lifting / lowering driver 71, and the horizontal driver 72 serving as a driver were controlled by a common controller 30. In the second embodiment, an example was described in which the controller 230 serving as a robot controller controls the six axes of the arm driver 14 and the two axes of the endoscope moving mechanism 15 and the forceps moving mechanism 16, and the controller 234 and the controller 235 serving as a sheath controller control the lifting / lowering driver 71 and the horizontal driver 72, respectively. However, the present disclosure is not limited to this. In the present disclosure, either the vertical movement or the insertion direction movement of the sheath holder may be controlled by a robot controller serving as a robot controller. Furthermore, when the operation of the sheath holder is commonly controlled by a controller serving as a robot controller, control of any axis of the six-axis robot arm may be used to control the axis of the driver that moves the sheath holder. That is, some of the control axes of the multiple joints of the robot arm may be shared with the control axes of the drive unit of the sheath holding unit. For example, when performing surgery using an endoscope, control of the first axis, which is the joint closest to the base end of the multiple joints, may be stopped, and instead of control of the first axis, control of the drive unit that moves the sheath holding unit may be performed. This makes it possible to prevent an increase in the number of control axes required by the control unit as a robot controller.

[0091] The functions of the elements disclosed herein can be performed using circuits or processing circuits, including general-purpose processors, special-purpose processors, integrated circuits, application-specific integrated circuits (ASICs), conventional circuits, and / or combinations thereof, configured or programmed to perform the disclosed functions. A processor is considered a processing circuit or circuit because it includes transistors and other circuitry. In this disclosure, a circuit, unit, or means is hardware that performs the recited functions or hardware that is programmed to perform the recited functions. The hardware may be hardware disclosed herein or other known hardware that is programmed or configured to perform the recited functions. Where the hardware is a processor, which is considered a type of circuit, the circuit, means, or unit is a combination of hardware and software, and the software is used to configure the hardware and / or processor.

[0092] [Aspect] It will be appreciated by those skilled in the art that the exemplary embodiments described above are examples of the following aspects.

[0093] (Aspect 1) a hand for holding an endoscope to be inserted into a patient; a robot arm to which the hand is attached; a base unit to which the robot arm is attached; a sheath holding portion disposed on the gantry and holding a sheath member to be inserted into the patient for inserting the endoscope; a drive unit that moves the sheath holding unit along an insertion direction of the sheath member relative to the patient.

[0094] (Aspect 2) a control unit that controls the operation of the sheath holding unit; An operation unit that accepts operation of the sheath holding unit, The endoscopic robot system according to aspect 1, wherein the control unit causes the drive unit to move the sheath holding unit along the insertion direction based on an operation received by the operation unit.

[0095] (Aspect 3) the hand holds the endoscope including a ureteroscope to be inserted into the patient's urethra; The endoscopic robot system according to aspect 1 or 2, wherein the drive unit moves the sheath holding unit, which holds the sheath member to be inserted into the patient's urethra, along the insertion direction.

[0096] (Aspect 4) The sheath holding portion is a sheath clamp portion that clamps and holds the sheath member; The endoscopic robot system according to any one of aspects 1 to 3, further comprising: a clamp holding section disposed on a side surface of the gantry section and holding the sheath clamp section.

[0097] (Aspect 5) 5. The endoscopic robot system according to claim 4, wherein the drive unit is disposed in the clamp holding unit and moves the sheath clamp unit along the insertion direction.

[0098] (Aspect 6) the clamp holding portion is disposed on a side surface of the base portion and extends horizontally, The endoscopic robot system according to aspect 5, wherein the drive unit moves the sheath clamp unit along the horizontal direction as the insertion direction.

[0099] (Aspect 7) The endoscopic robot system according to aspect 5 or 6, wherein the drive unit moves the sheath clamp unit along the insertion direction by extending and contracting the clamp holding unit.

[0100] (Aspect 8) The endoscopic robot system according to any one of aspects 1 to 7, wherein the drive unit moves the sheath holding unit, which holds the sheath member to which a suction device is connected, along the insertion direction to remove foreign matter from inside the patient's body.

[0101] (Aspect 9) The clamp holding portion is an engaging portion that engages with the base portion; The endoscopic robot system according to any one of aspects 4 to 7, further comprising: an attachment member that, when the engagement portion is engaged with the base portion, can be switched between a state where it is fixed to the base portion and a state where it is released by an operating force applied by an operator.

[0102] (Aspect 10) The clamp holding portion is an attachment hole into which the sheath clamp portion is inserted; The endoscopic robot system according to any one of aspects 4 to 7, further comprising a clamp detachment mechanism that switches between a state in which the sheath clamp portion is inserted into and fixed in the mounting hole portion and a state in which the sheath clamp portion is released from the fixed state, by the operating force of an operator.

[0103] (Aspect 11) the robot arm is disposed on an upper surface of the base unit and includes a vertical articulated robot arm having a plurality of axes, The endoscopic robot system according to any one of aspects 4 to 7, wherein the clamp holding portion is disposed on a side surface of the pedestal portion and extends horizontally.

[0104] (Aspect 12) a gantry drape that integrally covers the gantry portion and the sheath holding portion; The endoscopic robot system according to any one of aspects 1 to 11, further comprising an arm drape that covers the robot arm.

[0105] (Aspect 13) An endoscopic robot system according to any one of aspects 1 to 12, wherein the base unit includes a wheel unit arranged for movement and a ground contact unit arranged separately from the wheel unit and configured to stop the movement of the base unit by contacting the ground.

[0106] (Aspect 14) The endoscopic robot system according to aspect 2, wherein the control unit executes processing to operate the axis of the robot arm and the axis of the drive unit that moves the sheath holding unit.

[0107] (Aspect 15) The control unit a robot control unit that executes a process for operating the axis of the robot arm; a sheath control unit that is arranged separately from the robot control unit and that executes processing to operate the axis of the drive unit that moves the sheath holding unit based on a signal from the robot control unit. [Explanation of symbols]

[0108] 11 Mounting section 11a Wheel section 11b Grounding part 12 Robotic Arm 13 hands 20 Operation device (operation unit) 30 Control Unit 60 Sheath holding part 61 Clamp holding part 62 Sheath clamp part 63, 64 Mounting members 65 Engagement part 66 Clamp attachment / detachment mechanism 66b Mounting hole 71 Lifting drive unit 72 Horizontal drive unit (drive unit) 81 Trestle Drape 82 Arm Drape 100, 200 Robot System (Robot System for Endoscopy) 230 Control Unit (Robot Control Unit) 235 Control Unit (Sheath Control Unit) 800 Ureteroscope (endoscope) 900 patients 901 Urethra 902 Sheath material 905 Suction device

Claims

1. a hand for holding an endoscope to be inserted into a patient; a robot arm to which the hand is attached; a base unit to which the robot arm is attached; a sheath holding portion disposed on the gantry and holding a sheath member to be inserted into the patient for inserting the endoscope; a drive unit that moves the sheath holding unit along an insertion direction of the sheath member relative to the patient.

2. A control unit that controls the operation of the sheath holding part, An operation unit that accepts operation of the sheath holding unit, The endoscopic robot system according to claim 1 , wherein the control unit causes the drive unit to move the sheath holding unit along the insertion direction based on an operation received by the operation unit.

3. the hand holds the endoscope including a ureteroscope to be inserted into the patient's urethra; The endoscopic robot system according to claim 1 , wherein the driving unit moves the sheath holding unit, which holds the sheath member to be inserted into the patient's urethra, along the insertion direction.

4. The sheath holding portion is A sheath clamp portion that holds the sheath member between its legs, 3. The endoscopic robot system according to claim 1, further comprising: a clamp holder disposed on a side surface of the mount unit and configured to hold the sheath clamp unit.

5. The endoscopic robot system according to claim 4 , wherein the drive unit is disposed in the clamp holding unit and moves the sheath clamp unit along the insertion direction.

6. the clamp holding portion is disposed on a side surface of the base portion and extends horizontally, The robotic system for endoscopes according to claim 5, wherein the drive unit moves the sheath clamp along the horizontal direction as the insertion direction.

7. The endoscopic robot system according to claim 5 , wherein the driving unit moves the sheath clamp unit along the insertion direction by extending and contracting the clamp holding unit.

8. 3. The endoscopic robot system according to claim 1, wherein the drive unit moves the sheath holding unit, which holds the sheath member to which a suction device is connected, along the insertion direction in order to remove foreign matter from inside the patient's body.

9. The clamp holding portion is an engaging portion that engages with the base portion; 5. The endoscopic robot system according to claim 4, further comprising: an attachment member that, when the engagement portion is engaged with the gantry portion, is switched between a state where it is fixed to the gantry portion and a state where it is released from the gantry portion by an operating force applied by an operator.

10. The clamp holding portion is The mounting hole into which the sheath clamp portion is inserted, 5. The endoscopic robot system according to claim 4, further comprising a clamp attachment / detachment mechanism that switches between a state in which the sheath clamp portion is inserted into the attachment hole and fixed, and a state in which the sheath clamp portion is released, by an operating force applied by an operator.

11. The robot arm is positioned on the upper surface of the base and includes a vertical articulated robot arm having multiple axes. The endoscope robot system according to claim 4, wherein the clamp holding portion is arranged on the side of the base portion and extends along the horizontal direction.

12. A frame drape that integrally covers the frame portion and the sheath holding portion, The robotic endoscope system according to claim 1 or 2, further comprising an arm drape covering the robotic arm.

13. 3. The endoscopic robot system according to claim 1, wherein the pedestal unit includes a wheel unit arranged for movement, and a ground contact unit arranged separately from the wheel unit and adapted to stop movement of the pedestal unit by contacting the ground.

14. The endoscopic robot system according to claim 2 , wherein the control unit executes processing for operating a shaft of the robot arm and a shaft of the drive unit that moves the sheath holding unit.

15. The control unit A robot control unit that performs a process to move the axis of the robot arm, a sheath control unit that is arranged separately from the robot control unit and that executes processing to operate the shaft of the drive unit that moves the sheath holding unit based on a signal from the robot control unit.

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