Surgical support system and pivot position setting method

Abstract

To provide a surgery support system capable of setting a pivot position at an appropriate position.SOLUTION: A medical manipulator 1 includes an arm 60 at the tip of which medical equipment 4 is attached, a pivot button 85 for teaching a pivot position PP that serves as a fulcrum for the movement of the medical equipment 4 attached to the arm 60, a storage part 32, and a control part 31. The control part 31 sets a provisional pivot position PP1 on the basis of the teaching by the pivot button 85, and stores, in the storage part 32, the position adjusted by a predetermined length L1 from the provisional pivot position PP1 as the pivot position PP.SELECTED DRAWING: Figure 14

Description

Technical Field

[0005] , , ,

[0001] This disclosure relates to a surgical support system and a pivot positioning method.

Background Art

[0002] Conventionally, a surgical support robot in which a medical instrument attached to an arm is moved with a pivot position as a fulcrum is known. Patent Document 1 discloses a robotic surgical system including a robot, an end effector, a surgical instrument held by the end effector, and a robot controller. In this robotic surgical system, the surgical instrument is inserted into the patient's body through a small opening formed in the patient. Then, the robot is controlled by the robot controller to rotate the surgical instrument about a predetermined fulcrum.

[0003] Also, in Patent Document 1, a potentiometer is attached to the end effector of the robot. After the potentiometer is attached to the end effector of the robot, the cable of the potentiometer is extended along the surgical instrument. Also, the cable is extended to the opening of the patient into which the surgical instrument is inserted. Then, the distance between the end effector and the opening of the patient is detected by the potentiometer. The robot controller sets the fulcrum of the rotation of the surgical instrument based on the detected distance.

Prior Art Documents

[0006] This disclosure is made to solve the problems described above, and one of its purposes is to provide a surgical support system and a pivot position setting method that can set the pivot position to an appropriate position. [Means for solving the problem]

[0007] To achieve the above objective, the surgical assistance system according to the first aspect of this disclosure comprises an arm to which a medical instrument is attached at its tip, a pivot position teaching unit for teaching the pivot position which serves as the fulcrum for the movement of the medical instrument attached to the arm, a memory unit, and a control unit. Input section, The control unit is equipped with a pivot position teaching unit located on the arm, and when the tip of the medical instrument attached to the end of the arm is moved to an arbitrary position corresponding to the insertion position of the trocar inserted into the patient's body surface, the pivot position teaching unit is operated to set the position corresponding to the tip of the medical instrument as a temporary pivot position, and from the temporary pivot position , pre-entered via the input section and whose length can be changed The position adjusted by a predetermined length is stored in the memory unit as the pivot position.

[0008] In the surgical support system according to the first aspect of this disclosure, as described above, the control unit is a pivot position teaching unit The position corresponding to the tip of the medical instrument is changed by the manipulation of this mechanism. Temporary pivot position asThe system sets the pivot position and stores it in the memory unit after adjusting it by a predetermined length from the temporary pivot position. This allows the pivot position to be set at a location adjusted by a predetermined length from the temporary pivot position set on the patient's body surface. For example, the pivot position can be set towards the center of the abdominal wall rather than the patient's body surface. Therefore, the pivot position can be set appropriately.

[0009] The surgical assistance system according to the second aspect of this disclosure comprises an arm to which a medical instrument is attached at its tip, a pivot position teaching unit for teaching a pivot position that serves as the fulcrum for the movement of the medical instrument attached to the arm, a memory unit, and a control unit, wherein the pivot position teaching unit is located on the arm, and the control unit sets a first provisional pivot position by operating the pivot position teaching unit when the tip of the medical instrument attached to the end of the arm is moved to a position corresponding to the insertion position of a trocar inserted into the patient's body surface, sets a second provisional pivot position by operating the pivot position teaching unit when the tip of the medical instrument is moved to a position corresponding to the tip of a trocar located inside the patient's body, and stores the position adjusted based on the first provisional pivot position and the second provisional pivot position as the pivot position in the memory unit. The pivot position setting method according to the third aspect of this disclosure includes the steps of: receiving operation of a pivot position teaching unit to teach a pivot position that will serve as the fulcrum for the movement of the medical device attached to the arm, with the tip of the medical device attached to the end of the arm moved to an arbitrary position corresponding to the insertion position of a trocar inserted into the patient's body surface; setting the position corresponding to the tip of the medical device as a temporary pivot position by operating the pivot position teaching unit; and moving from the set temporary pivot position. , pre-entered via the input section and whose length can be changed The pivot position teaching unit is located on the arm and includes the step of storing the position adjusted by a predetermined length as the pivot position in the memory unit.

[0010] This disclosure 3The pivot position setting method, as described above, comprises the steps of: operating the pivot position teaching unit to set a position corresponding to the tip of the medical instrument as a temporary pivot position; and storing a position adjusted by a predetermined length from the set temporary pivot position as the pivot position in the memory unit, with the pivot position teaching unit located on the arm. This makes it possible to set a position adjusted by a predetermined length from the temporary pivot position set on the patient's body surface as the pivot position. For example, the pivot position can be set on the side of the abdominal wall that is closer to the center than the patient's body surface. Therefore, it is possible to provide a pivot position setting method that makes it possible to set the pivot position to an appropriate position. A pivot position setting method according to the fourth aspect of this disclosure comprises the steps of: receiving operation of a pivot position teaching unit for teaching a pivot position that will serve as the fulcrum for the movement of a medical device attached to an arm, with the tip of a medical device attached to the end of an arm moved to a position corresponding to the insertion position of a trocar inserted into the patient's body surface; setting a position corresponding to the tip of the medical device as a first provisional pivot position by operating the pivot position teaching unit with the tip of the medical device moved to a position corresponding to the tip of a trocar located inside the patient's body, and setting a second provisional pivot position by operating the pivot position teaching unit; and storing the position adjusted based on the first provisional pivot position and the second provisional pivot position as a pivot position in a memory unit, wherein the pivot position teaching unit is located on an arm. [Effects of the Invention]

[0011] According to this disclosure, the pivot position can be set to an appropriate position as described above. [Brief explanation of the drawing]

[0012] [Figure 1] This is a diagram showing the configuration of a surgical system according to the first embodiment. [Figure 2] This figure shows the configuration of a medical manipulator according to the first embodiment. [Figure 3] This figure shows the configuration of the arm of a medical manipulator according to the first embodiment. [Figure 4] This is a perspective view showing the configuration of the operating section of a medical manipulator according to the first embodiment. [Figure 5] This is a side view showing the configuration of the operating section of a medical manipulator according to the first embodiment. [Figure 6] This figure shows the state in which an operator is gripping the operating part of the medical manipulator according to the first embodiment. [Figure 7] This is a diagram showing an endoscope. [Figure 8] This is a diagram showing a pivot position teaching device. [Figure 9]It is a diagram showing a state where the tip of the endoscope is moved to a position where the outer surface of the trocar and the body surface are in contact. [Figure 10] It is a diagram showing the display screen of the display unit. [Figure 11] It is a diagram for explaining the translational movement of the arm. [Figure 12] It is a diagram for explaining the rotational movement of the arm. [Figure 13] It is a block diagram showing the configuration of the control unit of the medical manipulator. [Figure 14] It is a diagram for explaining the adjustment of the pivot position according to the first embodiment. [Figure 15] It is a diagram showing a touch panel for inputting the adjustment amount of the pivot position. [Figure 16] It is a diagram showing an inquiry screen for the adjustment amount of the pivot position. [Figure 17] It is a diagram for explaining the change of the pivot position. [Figure 18] It is a flowchart for explaining the pivot position setting method according to the first embodiment. [Figure 19] It is a flowchart for explaining the pivot position setting method according to the second embodiment. [Figure 20] It is a diagram for explaining the setting of the first provisional pivot position according to the second embodiment. [Figure 21] It is a diagram for explaining the adjustment of the pivot position according to the second embodiment. [Figure 22] It is a diagram showing a graduated trocar. [Mode for Carrying Out the Invention]

[0013] Hereinafter, an embodiment of the present disclosure that embodies the present disclosure will be described based on the drawings.

[0014] [First Embodiment] Referring to Figures 1 to 18, the configuration of the surgical system 100 according to the first embodiment will be described. The surgical system 100 comprises a medical manipulator 1, which is a patient P-side device, and a remote control device 2, which is an operator-side device for operating the medical manipulator 1. The medical manipulator 1 is equipped with a medical trolley 3 and is configured to be movable. The remote control device 2 is positioned at a distance from the medical manipulator 1, and the medical manipulator 1 is configured to be remotely controlled by the remote control device 2. The surgeon inputs commands to the remote control device 2 to cause the medical manipulator 1 to perform desired actions. The remote control device 2 transmits the input commands to the medical manipulator 1. The medical manipulator 1 operates based on the received commands. The medical manipulator 1 is also positioned in the operating room, which is a sterile field. Note that the medical manipulator 1 is an example of a surgical support system.

[0015] The remote control device 2 is located, for example, inside or outside the operating room. The remote control device 2 includes an operating manipulator arm 21, an operating pedal 22, a touch panel 23, a monitor 24, a support arm 25, and a support bar 26. The operating manipulator arm 21 constitutes an operating handle for the surgeon to input commands. The monitor 24 is a scope-type display device that displays images taken by the endoscope 6. The support arm 25 supports the monitor 24 so that its height is at the height of the surgeon's face. The touch panel 23 is located on the support bar 26. The medical manipulator 1 becomes controllable by the remote control device 2 when the surgeon's head is detected by a sensor located near the monitor 24. The surgeon operates the operating manipulator arm 21 and the operating pedal 22 while viewing the affected area on the monitor 24. This inputs commands to the remote control device 2. The commands input to the remote control device 2 are transmitted to the medical manipulator 1. The operating manipulator arm 21 is an example of an operating handle. The touch panel 23 is an example of an input and reception unit.

[0016] The medical trolley 3 is equipped with a control unit 31 that controls the operation of the medical manipulator 1, and a storage unit 32 that stores programs for controlling the operation of the medical manipulator 1. Based on commands input to the remote control device 2, the control unit 31 of the medical trolley 3 controls the operation of the medical manipulator 1.

[0017] Furthermore, the medical trolley 3 is equipped with an input device 33. The input device 33 is configured to accept commands to move or change the posture of the positioner 40, arm base 50, and multiple arms 60, primarily for preparing for surgery before the procedure.

[0018] The medical manipulator 1 shown in Figures 1 and 2 is positioned in an operating room. The medical manipulator 1 comprises a medical trolley 3, a positioner 40, an arm base 50, and multiple arms 60. The arm base 50 is attached to the tip of the positioner 40. The arm base 50 has a relatively long rod shape. The base of each of the multiple arms 60 is attached to the arm base 50. The multiple arms 60 are configured to be folded and stored. The arm base 50 and the multiple arms 60 are used covered with a sterile drape.

[0019] The positioner 40 is composed of, for example, a 7-axis articulated robot. The positioner 40 is also positioned on a medical trolley 3. The positioner 40 moves the arm base 50. Specifically, the positioner 40 is configured to move the position of the arm base 50 in three dimensions.

[0020] The positioner 40 also includes a base portion 41 and a plurality of link portions 42 connected to the base portion 41. The plurality of link portions 42 are connected to each other by joint portions 43.

[0021] As shown in Figure 1, a medical instrument 4 is attached to the tip of each of the multiple arms 60. The medical instrument 4 includes, for example, replaceable instruments, an endoscope 6 as shown in Figure 7, and so on.

[0022] As shown in Figure 3, the instrument, which is a medical device 4, is equipped with a driven unit 4a that is driven by a servo motor M2 located on a holder 71 of the arm 60. An end effector 4b is also provided at the tip of the instrument. The end effector 4b includes jointed instruments such as forceps, scissors, grabbers, needle holders, microdissectors, stable applicators, tackers, suction and cleaning tools, snare wires, and clip applicators. The end effector 4b also includes non-jointed instruments such as cutting blades, cauterization probes, washers, catheters, and suction orifices. The medical device 4 also includes a shaft 4c that connects the driven unit 4a and the end effector 4b. The driven unit 4a, the shaft 4c, and the end effector 4b are arranged along the Z direction.

[0023] Next, the configuration of the arm 60 will be described in detail. As shown in Figure 3, the arm 60 includes an arm portion 61 and a translational movement mechanism portion 70 provided at the tip of the arm portion 61. The arm 60 includes a base portion 62, a link portion 63, and a joint portion 64. The arm 60 is configured to move its tip portion in three dimensions relative to the arm base 50 at the root end of the arm 60. Note that multiple arms 60 have similar configurations to each other.

[0024] The translational movement mechanism 70 is located at the tip of the arm 61 and to which the medical instrument 4 is attached. The translational movement mechanism 70 translates the medical instrument 4 in the direction of insertion into the patient P. The translational movement mechanism 70 is configured to translate the medical instrument 4 relative to the arm 61. Specifically, the translational movement mechanism 70 is provided with a holder 71 for holding the medical instrument 4. The holder 71 houses the servo motor M2 shown in Figure 13. The servo motor M2 is configured to rotate a rotating body provided on the driven unit 4a of the medical instrument 4. The rotation of the rotating body of the driven unit 4a causes the end effector 4b to operate.

[0025] The arm 60 is configured to be detachable from the arm base 50. The arm portion 61 and the translational movement mechanism portion 70 do not have any mechanisms or devices for holding the trocar T. As a result, the space near the body surface S of the patient P on which multiple trocar T are placed is widened, making it possible to work easily near the body surface S of the patient P on which multiple trocar T are placed.

[0026] The arm section 61 is composed of a 7-axis articulated robot arm. The arm section 61 also includes a base section 62 for attaching the arm section 61 to the arm base 50, and a plurality of link sections 63 connected to the base section 62. The plurality of link sections 63 are connected to each other by joint sections 64.

[0027] The translational movement mechanism 70 is configured to translate the medical instrument 4 attached to the holder 71 along the Z-direction, which is the direction in which the shaft 4c extends, by translating the holder 71 along the Z-direction. Specifically, the translational movement mechanism 70 includes a base-side link portion 72 connected to the tip of the arm portion 61, a tip-side link portion 73, and a connecting link portion 74 provided between the base-side link portion 72 and the tip-side link portion 73. The holder 71 is provided on the tip-side link portion 73.

[0028] Furthermore, the connecting link portion 74 of the translational movement mechanism 70 is configured as a double-speed mechanism that moves the tip-side link portion 73 relative to the base-side link portion 72 along the Z direction. In addition, the relative movement of the tip-side link portion 73 with respect to the base-side link portion 72 along the Z direction causes the medical instrument 4 provided on the holder 71 to move translationally along the Z direction. The tip of the arm portion 61 is connected to the base-side link portion 72 so as to rotate the base-side link portion 72 around the Y direction, which is perpendicular to the Z direction.

[0029] As shown in Figure 4, the medical manipulator 1 is attached to the arm 60 and includes an operating unit 80 for operating the arm 60. The operating unit 80 includes an enable switch 81, a joystick 82, and a switch unit 83. The enable switch 81 allows or disallows the movement of the arm 60 by the joystick 82 and the switch unit 83. The enable switch 81 is also activated when an operator, such as a nurse or assistant, grasps and presses the operating unit 80, thereby allowing the arm 60 to move the medical device 4.

[0030] Specifically, the enable switch 81 is a push-button switch that is pressed by the operator's finger. When the enable switch 81 is pressed, it becomes possible to control the servo motors M1 to M3 by supplying power to them. In other words, when the enable switch 81 is pressed, it becomes possible to control the servo motors M1 to M3 to be driven. That is, it becomes possible to control the movement of the arm 60 only while the enable switch 81 is pressed.

[0031] As shown in Figure 6, the joystick 82 is configured to be operated by tilting it with the operator's finger. The direction and speed of movement of the arm 60 are controlled to change according to the direction and angle in which the joystick 82 is tilted. The operator controls the joystick 82 by placing their finger against its tip 82a and moving their finger. The signal input from the operation of the joystick 82 is accepted only while the enable switch 81 is pressed. In other words, when the enable switch 81 is not pressed, the arm 60 will not move even if the joystick 82 is operated.

[0032] Furthermore, the enable switch 81 is provided on the outer circumferential surface 80a of the operating section 80, and is configured so that when the operator grasps the outer circumferential surface 80a of the operating section 80 and presses the enable switch 81, it allows the arm 60 to move the medical device 4. Also, as shown in Figure 5, a pair of enable switches 81 are provided on both sides of the outer circumferential surface 80a of the operating section 80. The enable switches 81 are provided on both sides of the outer circumferential surface 80a of the operating section 80 on which the switch section 83 is provided. Specifically, the cross-section of the operating section 80 has a substantially rectangular shape, and the enable switch 81 and the switch section 83 are provided on mutually opposing surfaces 80b of the operating section 80. In detail, the operating section 80 has a substantially rectangular prism shape, and the enable switch 81 and the switch section 83 are provided on the surface 80b along the longitudinal direction of the substantially rectangular prism-shaped operating section 80. Then, when the operator grasps the outer circumferential surface 80a of the operating unit 80 and presses at least one of the enable switches 81 provided on both sides of the outer circumferential surface 80a of the operating unit 80, the movement of the arm 60 is permitted.

[0033] Furthermore, the operating unit 80 is configured such that pressing only one of the enable switches 81 located on both sides of the outer circumferential surface 80a of the operating unit 80 allows the movement of the arm 60 to be permitted. This reduces the burden on the operator and improves operator convenience, as it eliminates the need to press both enable switches 81 located on both sides of the outer circumferential surface 80a of the operating unit 80.

[0034] Furthermore, as shown in Figure 4, the joystick 82 is provided on the end face 80c that intersects with the outer circumferential surface 80a of the operating unit 80. The joystick 82 is configured to be operable by the operator's fingers while the operator grips the outer circumferential surface 80a of the operating unit 80 and presses the enable switch 81 to allow the movement of the arm 60. For example, as shown in Figure 6, while the operator presses the pair of enable switches 81 provided on the outer circumferential surface 80a of the operating unit 80 with their thumb and middle finger, they operate the joystick 82 provided on the end face 80c of the operating unit 80 with their index finger. This makes it easy to maintain a nearly constant distance between the operator's thumb and middle finger gripping the operating unit 80 and the index finger operating the joystick 82. Note that the fingers used to operate the enable switch 81 and the joystick 82 are not limited to the above example.

[0035] Furthermore, the joystick 82 is configured to control the movement of the medical instrument 4 by the arm 60 so that the tip 4d of the medical instrument 4 shown in Figure 3 moves along a predetermined plane. The operating unit 80 also includes a switch unit 83 for controlling the movement of the medical instrument 4 by the arm 60 so that the tip 4d of the medical instrument 4 moves along the longitudinal direction of the medical instrument 4 which is perpendicular to the predetermined plane. The predetermined plane on which the tip 4d of the medical instrument 4 moves is the XY plane shown in Figure 11, which is parallel to the end face 80c of the operating unit 80. The longitudinal direction of the medical instrument 4 which is perpendicular to the predetermined plane is the Z direction which is perpendicular to the XY plane in Figure 11. The coordinates represented by the X, Y, and Z axes in Figure 11 are called the tool coordinate system or base coordinate system. Furthermore, when the switch unit 83 is pressed while the enable switch 81 is pressed, allowing the movement of the medical instrument 4 by the arm 60, the tip 4d of the medical instrument 4 moves along the longitudinal direction of the medical instrument 4.

[0036] Furthermore, the switch section 83 includes a switch section 83a that moves the tip 4d of the medical instrument 4 toward the direction in which the medical instrument 4 is inserted into the patient P, along the longitudinal direction of the medical instrument 4, and a switch section 83b that moves the tip 4d of the medical instrument 4 toward the opposite direction from the direction in which the medical instrument 4 is inserted into the patient P. Both the switch section 83a and the switch section 83b are composed of push-button switches.

[0037] Furthermore, as shown in Figure 5, the switch sections 83 are provided on both sides of the outer circumferential surface 80a of the operating section 80. Specifically, the switch sections 83 are provided on the surfaces 80b that run along the longitudinal direction of the roughly rectangular prism-shaped operating section 80. In other words, both the switch sections 83a and 83b are provided in pairs on both sides of the operating section 80.

[0038] Furthermore, when the switch unit 83 is operated, the arm unit 61 is moved, causing the tip 4d of the medical instrument 4 to be translated until the tip 4d of the medical instrument 4 moves to the vicinity of the pivot position PP shown in Figure 12. After the tip 4d of the medical instrument 4 moves to the vicinity of the pivot position PP, the translational movement mechanism unit 70 is moved, causing the tip 4d of the medical instrument 4 to be translated. Specifically, when the switch unit 83 is operated, the arm unit 61 is moved, causing the tip 4d of the medical instrument 4 to be translated until the tip 4d of the medical instrument 4 moves a certain distance from the pivot position PP. After the tip 4d of the medical instrument 4 moves a certain distance from the pivot position PP, the translational movement mechanism unit 70 is moved, causing the tip 4d of the medical instrument 4 to be translated. In other words, after the tip 4d of the medical instrument 4 moves a certain distance from the pivot position PP, the arm unit 61 is not moved, and only the translational movement mechanism unit 70 is moved. The pivot position PP will be explained later.

[0039] Furthermore, in the first embodiment, as shown in Figure 4, the operating unit 80 includes a pivot button 85 that teaches the pivot position PP, which serves as the pivot point for the movement of the medical device 4 attached to the arm 60 shown in Figure 12. The pivot button 85 is also provided on the surface 80b of the operating unit 80, adjacent to the enable switch 81.

[0040] As shown in Figure 7, the endoscope 6 attached to the tip of the arm 60 when storing the pivot position PP is the actual endoscope 6 used during surgery. On the other hand, as shown in Figure 8, the pivot position teaching device 7 attached to the tip of the arm 60 when storing the pivot position PP is a dummy that mimics a medical instrument 4 such as forceps that is actually used during surgery. The pivot position teaching device 7 includes a part 7a that mimics the driven unit 4a and a part 7b that mimics the shaft 4c. Furthermore, the tip of part 7b of the pivot position teaching device 7 does not have a pointed shape.

[0041] Furthermore, in the first embodiment, as shown in Figure 9, when the pivot button 85 is pressed while the tip of the endoscope 6 or pivot position teaching device 7 attached to the end of the arm 60 is moved to a position where the outer surface TS of the trocar T inserted into the patient P's body surface S is in contact with the body surface S, a temporary pivot position PP1 is stored in the storage unit 32. That is, when the pivot button 85 is pressed while the endoscope 6 or pivot position teaching device 7 is not inserted into the trocar T, but the tip of the endoscope 6 or pivot position teaching device 7 is positioned to the side of the outer surface TS of the trocar T and in the vicinity of the body surface S, a temporary pivot position PP1 is stored in the storage unit 32. Also, the vicinity of the body surface S is a concept that includes the body surface S itself and the area around the body surface S. The setting of the pivot position PP based on the temporary pivot position PP1 will be explained later.

[0042] Furthermore, the joystick 82 is operated so that the tip of the endoscope 6 or pivot position teaching device 7 attached to the end of the arm 60 is moved to a position corresponding to the insertion position of the trocar T inserted into the patient P's body surface S. Specifically, with the enable switch 81 pressed, the tip of the endoscope 6 or pivot position teaching device 7 is moved by operating the joystick 82 and the switch unit 83.

[0043] Furthermore, as shown in Figure 1, an endoscope 6 is attached to one of the multiple arms 60, for example, arm 60c, and other medical instruments 4 are attached to the remaining arms 60, for example, arms 60a, 60b, and 60d. Specifically, in surgery, an endoscope 6 is attached to one of the four arms 60, and other medical instruments 4, such as forceps, are attached to the other three arms 60. For the arm 60 to which the endoscope 6 is attached, the pivot position PP is stored in the memory unit 32 with the endoscope 6 attached. Similarly, for the arms 60 to which other medical instruments 4 are attached, the pivot position PP is stored in the memory unit 32 with the pivot position teaching device 7 attached. The endoscope 6 is attached to either of the two central arms 60b and 60c, among the four arms 60 that are arranged adjacent to each other.

[0044] Furthermore, as shown in Figure 5, the pivot buttons 85 are provided on both sides of the outer circumferential surface 80a of the operating section 80. Specifically, the cross-section of the operating section 80 has a substantially rectangular shape, and the pivot buttons 85 are provided on the mutually opposing surfaces 80b of the operating section 80.

[0045] Furthermore, as shown in Figure 10, a display unit 33a is provided to indicate that the pivot positions PP of multiple arms 60 have been stored. The display unit 33a is provided on the input device 33 of the medical trolley 3. The display unit 33a is composed of, for example, a liquid crystal panel. The display unit 33a displays numbers 1, 2, 3, and 4 corresponding to the multiple arms 60a, 60b, 60c, and 60d, respectively. The display unit 33a also displays the type of medical instrument 4 attached to each of the multiple arms 60, such as an endoscope 6 and forceps. When the pivot position PP is stored, a check mark CM is displayed for each of the multiple arms 60.

[0046] Furthermore, as shown in Figure 4, an adjustment button 86 for optimizing the position of the arm 60 is provided on the surface 80b of the operating unit 80. After the pivot position PP for the arm 60 to which the endoscope 6 is attached is stored, pressing the adjustment button 86 optimizes the positions of the other arms 60 and the arm base 50.

[0047] Furthermore, as shown in Figure 4, the operating unit 80 includes a mode switching button 84 that switches between a mode for translating the medical instrument 4 attached to the arm 60, as shown in Figure 11, and a mode for rotating it, as shown in Figure 12. In the operating unit 80, the mode switching button 84 is located near the joystick 82. Specifically, on the end face 80c of the operating unit 80, the mode switching button 84 is provided adjacent to the joystick 82. The mode switching button 84 is a push-button switch. A mode indicator 84a is also provided near the mode switching button 84. The mode indicator 84a displays the switched mode. Specifically, when the mode indicator 84a is lit, it represents the rotational movement mode, and when it is off, it represents the translational movement mode.

[0048] Furthermore, the mode indicator 84a also functions as a pivot position indicator, showing that the pivot position PP has been memorized. Specifically, when the pivot position PP is memorized, the mode indicator 84a remains lit and does not turn off even when the mode switching button 84 is pressed. This indicates that the medical device 4 attached to the arm 60 is only capable of rotational movement mode and that this position has been memorized. To reset the pivot position PP, remove the medical device 4 attached to the arm 60 that you want to reset and press and hold the pivot button 85.

[0049] As shown in Figure 11, in the mode in which the arm 60 is translated, the arm 60 is moved so that the tip 4d of the medical instrument 4 moves on the XY plane. Also, as shown in Figure 12, in the mode in which the arm 60 is rotated, if the pivot position PP is not stored, the arm 60 rotates around the end effector 4b, and if the pivot position PP is stored, the arm 60 is moved so that the medical instrument 4 rotates with the pivot position PP as the fulcrum. Note that the medical instrument 4 is rotated while its shaft 4c is inserted into the trocar T.

[0050] Furthermore, as shown in Figure 3, the operating unit 80 is provided on the translational movement mechanism 70. The operating unit 80 is attached to the translational movement mechanism 70 so as to be adjacent to the medical device 4 which is attached to the translational movement mechanism 70. Specifically, the operating unit 80 is attached to the tip-side link portion 73 of the translational movement mechanism 70. The operating unit 80 is also positioned so as to be adjacent to the driven unit 4a of the medical device 4.

[0051] Furthermore, as shown in Figure 13, the arm 60 is equipped with multiple servo motors M1, encoders E1, and a reduction gear, corresponding to the multiple joints 64 of the arm portion 61. The encoders E1 are configured to detect the rotation angle of the servo motors M1. The reduction gear is configured to reduce the rotation of the servo motors M1 and increase the torque.

[0052] Furthermore, as shown in Figure 13, the translational movement mechanism 70 is equipped with a plurality of servo motors M2 for rotating a rotating body provided on the driven unit 4a of the medical instrument 4, a servo motor M3 for translating the medical instrument 4, a plurality of encoders E2 and E3, and a plurality of speed reducers. Encoders E2 and E3 are configured to detect the rotation angles of servo motors M2 and M3, respectively. The speed reducers are configured to reduce the rotation of servo motors M2 and M3 and increase the torque.

[0053] Furthermore, the positioner 40 is equipped with multiple servo motors M4, encoders E4, and a reduction gear to correspond to the multiple joints 43 of the positioner 40. The encoders E4 are configured to detect the rotation angle of the servo motors M4. The reduction gear is configured to reduce the rotation of the servo motors M4 and increase the torque.

[0054] Furthermore, the medical trolley 3 is equipped with a servo motor M5, an encoder E5, and a reduction gear, each of which drives one of the multiple front wheels of the medical trolley 3. The encoder E5 is configured to detect the rotation angle of the servo motor M5. The reduction gear is configured to reduce the rotation of the servo motor M5 and increase the torque.

[0055] The control unit 31 of the medical trolley 3 includes an arm control unit 31a that controls the movement of a plurality of arms 60 based on a command, and a positioner control unit 31b that controls the movement of the positioner 40 and the driving of the front wheels of the medical trolley 3 based on a command. The arm control unit 31a is electrically connected to a servo control unit C1 for controlling a servo motor M1 for driving the arms 60. The servo control unit C1 is also electrically connected to an encoder E1 for detecting the rotation angle of the servo motor M1.

[0056] Furthermore, a servo control unit C2 for controlling a servo motor M2 for driving the medical device 4 is electrically connected to the arm control unit 31a. An encoder E2 for detecting the rotation angle of the servo motor M2 is electrically connected to the servo control unit C2. Furthermore, a servo control unit C3 for controlling a servo motor M3 for translating the translational movement mechanism 70 is electrically connected to the arm control unit 31a. An encoder E3 for detecting the rotation angle of the servo motor M3 is electrically connected to the servo control unit C3.

[0057] The operation command input to the remote control device 2 is then input to the arm control unit 31a. The arm control unit 31a generates a position command based on the input operation command and the rotation angle detected by the encoders E1, E2, or E3, and outputs the position command to the servo control units C1, C2, or C3. The servo control units C1, C2, or C3 generate a current command based on the position command input from the arm control unit 31a and the rotation angle detected by the encoders E1, E2, or E3, and output the current command to the servo motors M1, M2, or M3. As a result, the arm 60 is moved in accordance with the operation command input to the remote control device 2.

[0058] Furthermore, the arm control unit 31a of the control unit 31 is configured to operate the arm 60 based on the input signal from the joystick 82 of the operation unit 80. Specifically, the arm control unit 31a generates a position command based on the input signal received from the joystick 82 and the rotation angle detected by the encoder E1, and outputs the position command to the servo control unit C1. The servo control unit C1 generates a current command based on the position command received from the arm control unit 31a and the rotation angle detected by the encoder E1, and outputs the current command to the servo motor M1. As a result, the arm 60 is moved in accordance with the operation command input to the joystick 82.

[0059] The arm control unit 31a is configured to operate the arm 60 based on input signals from the switch unit 83 of the operation unit 80. Specifically, the arm control unit 31a generates a position command based on the input signal received from the switch unit 83 and the rotation angle detected by the encoder E1 or E3, and outputs the position command to the servo control unit C1 or C3. The servo control unit C1 or C3 generates a current command based on the position command received from the arm control unit 31a and the rotation angle detected by the encoder E1 or E3, and outputs the current command to the servo motor M1 or M3. As a result, the arm 60 is moved in accordance with the operation command input to the switch unit 83.

[0060] Furthermore, the arm control unit 31a of the control unit 31 is configured to reduce changes in the movement speed of the arm 60 by performing at least one of the following: setting an upper limit on the input signal from the joystick 82, and smoothing the input signal from the joystick 82. Specifically, the control unit 31 sets an upper limit on the input signal from the joystick 82, and when an input signal exceeding the upper limit is input, it uses the upper limit as the input signal to control the movement of the arm 60. In addition, the control unit 31 smooths the input signal from the joystick 82, for example, by using an LPF (Low-pass filter). In the first embodiment, the control unit 31 performs both setting an upper limit on the input signal from the joystick 82 and smoothing the input signal from the joystick 82.

[0061] Furthermore, as shown in Figure 13, a servo control unit C4 for controlling the servo motor M4 that moves the positioner 40 is electrically connected to the positioner control unit 31b. An encoder E4 for detecting the rotation angle of the servo motor M4 is also electrically connected to the servo control unit C4. In addition, a servo control unit C5 for controlling the servo motor M5 that drives the front wheels of the medical trolley 3 is electrically connected to the positioner control unit 31b. An encoder E5 for detecting the rotation angle of the servo motor M5 is also electrically connected to the servo control unit C5.

[0062] Furthermore, operation commands related to setting the preparation position are input from the input device 33 to the positioner control unit 31b. The positioner control unit 31b generates a position command based on the operation command input from the input device 33 and the rotation angle detected by the encoder E4, and outputs the position command to the servo control unit C4. The servo control unit C4 generates a current command based on the position command input from the positioner control unit 31b and the rotation angle detected by the encoder E4, and outputs the current command to the servo motor M4. As a result, the positioner 40 is moved in accordance with the operation command input to the input device 33. Similarly, based on the operation command from the input device 33, the positioner control unit 31b moves the medical trolley 3.

[0063] Next, we will explain how to set the pivot position PP.

[0064] In the first embodiment, as shown in Figure 14, the control unit 31 sets a temporary pivot position PP1 based on the information provided by the pivot button 85 and stores it in the storage unit 32. The storage unit 32 then stores the position adjusted by a predetermined length L1 from the temporary pivot position PP1 as the pivot position PP. The pivot button 85 is an example of a pivot position teaching unit.

[0065] Specifically, as shown in Figure 9, the tip of the endoscope 6 shown in Figure 7 or the pivot position teaching device 7 shown in Figure 8, which is a medical device 4 attached to the tip of the arm 60, is moved by the operating unit 80 to a position corresponding to the insertion position of the trocar T inserted into the patient P's body surface S. Then, the pivot button 85 is pressed. This sets a temporary pivot position PP1. Then, a position adjusted by a predetermined length L1 from the temporary pivot position PP1 is stored in the storage unit 32 as the pivot position PP. Note that the pivot position PP is set as a single point, and setting the pivot position PP does not set the direction of the medical device 4.

[0066] Furthermore, in the first embodiment, as shown in Figure 14, the control unit 31 stores in the storage unit 32 a pivot position PP which is adjusted by a predetermined length L1 along the direction in which the medical instrument 4 extends, relative to the temporary pivot position PP1. The direction in which the medical instrument 4 extends is the Z direction. The pivot position PP is a point which is moved by a predetermined length L1 in the Z1 direction, which is the tip side of the medical instrument 4, or in the Z2 direction, which is the base end side of the medical instrument 4, relative to the temporary pivot position PP1.

[0067] Furthermore, in the first embodiment, as shown in Figure 15, the medical manipulator 1 is equipped with a touch panel 23 for pre-inputting a predetermined length L1. The control unit 31 then stores the position adjusted by the pre-input predetermined length L1 relative to the temporary pivot position PP1 as the pivot position PP in the storage unit 32. Note that "pre-input" means before the pivot position PP is set.

[0068] Specifically, in the first embodiment, the touch panel 23 is located on the remote control device 2. The touch panel 23 includes a selection unit 23a for selecting the number of arm 60. One of the following can be selected as the number of arm 60: 1, 2, 3, or 4. The numbers 1 to 4 of arm 60 correspond to arms 60a to 60d, respectively. The touch panel 23 also includes an adjustment amount input unit 23b for inputting the adjustment amount. The adjustment amount refers to a predetermined length L1. The adjustment amount input unit 23b allows input of a length up to a predetermined limit. The predetermined limit is, for example, -10 mm or more and +30 mm or less. The touch panel 23 also includes a registration button 23c. When the operator has selected the number of arm 60 and entered the adjustment amount, the operator presses the registration button 23c.

[0069] Then, as shown in Figure 16, when the registration button 23c is pressed, the inquiry screen 23d is displayed on the touch panel 23 of the remote control device 2. The inquiry screen 23d is a screen for asking the operator whether or not to allow the change of the pivot position PP. The inquiry screen 23d displays the number of the arm 60 whose pivot position PP will be changed, and the adjustment amount. The adjustment amount is also displayed for each arm 60. The inquiry screen 23d also displays buttons for "Yes," "No," and "Apply to all arms." If the "Yes" button is pressed, the adjustment amount is stored in the storage unit 32. If the "No" button is pressed, the adjustment amount is not stored in the storage unit 32. If the "Apply to all arms" button is pressed, the adjustment amount at the time the registration button 23c was pressed is stored in the storage unit 32 as the adjustment amount for all arms 60.

[0070] Thus, in the first embodiment, the control unit 31 stores in the storage unit 32 a pivot position PP for each of the arms 60a to 60d, which is adjusted by a predetermined length L1 from the temporary pivot position PP1.

[0071] Furthermore, as shown in Figure 14, it is preferable that the pivot position PP be set to the center of the patient P's abdominal wall F in the thickness direction. The patient P's abdominal wall F is, for example, the abdominal wall. The operator then inputs an adjustment amount so that the pivot position PP is set to the center of the patient P's abdominal wall F in the thickness direction. For example, for a patient P with a small abdominal wall F thickness, the operator sets a relatively small adjustment amount. For a patient P with a large abdominal wall F thickness, the operator sets a relatively large adjustment amount. As a result, the control unit 31 adjusts the temporary pivot position PP1 so that the pivot position PP is located in the center of the patient P's abdominal wall F in the thickness direction. The adjusted pivot position PP is then stored in the storage unit 32. The term "center" includes the center itself and the vicinity of the center.

[0072] Furthermore, in the first embodiment, as shown in Figure 14, the touch panel 23 accepts a change in the pivot position PP. The control unit 31 then stores the pivot position PP in the storage unit 32, and when a change in the pivot position PP is accepted by the touch panel 23, it stores the accepted changed pivot position PP in the storage unit 32. Specifically, the touch panel 23 accepts the amount of change from the current pivot position PP. The control unit 31 then stores the position moved by the amount of the change along the Z direction in which the medical device 4 extends as the changed pivot position PP in the storage unit 32.

[0073] Specifically, after the pivot position PP is initially set, the pivot position PP may be changed during surgery or other operations. The touch panel 23 displays the selection section 23a, the adjustment amount input section 23b, and the registration button 23c, just as before the pivot position PP was set. The operator selects the number of the arm 60 whose pivot position PP is to be changed using the selection section 23a. The operator also inputs the amount of change to the pivot position PP using the adjustment amount input section 23b. Then, the operator presses the registration button 23c. Upon pressing the registration button 23c, the inquiry screen 23d shown in Figure 16 is displayed on the touch panel 23 of the remote control device 2.

[0074] For example, as shown in Figure 17, when changing the pivot position PP in the XY direction (see Figure 11), the operator moves the joystick 82 in the direction they want to move the pivot position PP. At this time, the pivot position PP is set to a point moved +20 mm towards the tip of the medical instrument 4 from the temporary pivot position PP1. Subsequently, the touch panel 23 accepts a change to set the pivot position PP to 0 mm. This changes the pivot position PP to a point moved -20 mm towards the base of the medical instrument 4. The pivot position PP is also moved along the direction in which the shaft 4c extends in the current orientation of the medical instrument 4. After that, the operator changes the orientation of the medical instrument 4 so that its longitudinal direction is parallel to the desired pivot position PP. Furthermore, the touch panel 23 accepts a change to set the pivot position PP to +10 mm. This changes the pivot position PP to a point moved in the XY direction and +10 mm towards the tip of the medical instrument 4.

[0075] Note that changes to the pivot position PP are not accepted when the operator is looking at the monitor 24, but are accepted when the operator's head is away from the monitor 24. Whether or not the operator is looking at the monitor 24 is detected by the sensor 241 shown in Figure 1. Furthermore, the change in the pivot position PP may be displayed on the monitor 24.

[0076] Furthermore, if the operator looks at the monitor 24 after pressing the "Yes" button on the inquiry screen 23d, and the control unit 31 has finished changing the pivot position PP, the pivot position PP may be changed. Conversely, if the operator looks at the monitor 24 after pressing the "Yes" button on the inquiry screen 23d, and the control unit 31 has not finished changing the pivot position PP, the pivot position PP does not need to be changed.

[0077] Furthermore, if the operator operates the manipulator arm 21 after the "Yes" button on the inquiry screen 23d is pressed, the pivot position PP may be changed if the control unit 31 has finished changing the pivot position PP. Also, if the operator operates the manipulator arm 21 after the "Yes" button on the inquiry screen 23d is pressed, the pivot position PP does not need to be changed if the control unit 31 has not finished changing the pivot position PP.

[0078] Next, the method for setting the pivot position using the medical manipulator 1 will be described. One of the four arms 60 is fitted with an endoscope 6, and the other arms 60 are fitted with pivot position teaching devices 7. A trocar T is inserted into the body surface S of the patient P.

[0079] First, as shown in Figure 18, in step S1, the touch panel 23 receives input for the adjustment amount for each arm 60.

[0080] Next, in step S2, as shown in Figure 9, the operating unit 80 moves the tip of the endoscope 6 attached to the end of the arm 60 to a position corresponding to the insertion position of the trocar T inserted into the body surface S of the patient P. Specifically, the tip of the endoscope 6 is moved to a position where the outer surface TS of the trocar T inserted into the body surface S of the patient P comes into contact with the body surface S.

[0081] Next, in step S3, with the tip of the endoscope 6 moved to a position corresponding to the insertion position of the trocar T, the pivot button 85 is pressed. As a result, the control unit 31 receives confirmation of the operation of the pivot button 85.

[0082] Next, in step S4, as shown in Figure 14 of the first embodiment, the control unit 31 sets a temporary pivot position PP1 based on what was taught by the pivot button 85 and stores it in the storage unit 32.

[0083] Next, in step S5, in the first embodiment, the control unit 31 stores in the storage unit 32 a position adjusted by a predetermined length L1 from the set temporary pivot position PP1 as the pivot position PP.

[0084] Next, in step S6, the display unit 33a indicates that the pivot position PP of the arm 60 has been stored. Specifically, a check mark CM is displayed below the number corresponding to the arm 60 to which the endoscope 6 is attached.

[0085] Next, in step S7, the mode indicator 84a of the control unit 80 indicates that the pivot position PP has been stored. Specifically, the mode indicator 84a of the control unit 80, which is attached to the arm 60 to which the endoscope 6 is attached, lights up.

[0086] Thus, first, the pivot position PP is set for one arm 60 to which the endoscope 6 is attached. Then, by repeating steps S2 to S7 described above, the pivot position PP is set for the remaining arms 60 to which the pivot position teaching device 7 is attached.

[0087] Next, the procedure for using the medical manipulator 1 will be described. In a procedure using the medical manipulator 1, first, the medical trolley 3 is moved to a predetermined position in the operating room by the operator. Next, the operator moves the arm base 50 by operating the positioner 40 so that the arm base 50 and the operating table 5 or patient P are in a desired positional relationship by operating the touch panel included in the input device 33. The arm 60 is also moved so that the trocar T and medical instrument 4, which are placed on the surface of the patient P's body, are in a predetermined positional relationship. The trocar T serves as a working channel for inserting surgical instruments, etc., into the body cavity. Furthermore, the operator moves the multiple arms 60 to desired positions by operating the joystick 82 and switch unit 83. Then, the pivot position PP is set as described above. With the positioner 40 stationary, the multiple arms 60 and medical instrument 4 are operated based on commands from the remote control device 2. This completes the procedure using the medical manipulator 1.

[0088] [Effects of the First Embodiment] In the first embodiment, the following effects can be obtained.

[0089] In the first embodiment, as described above, the control unit 31 sets a temporary pivot position PP1 based on the information provided by the pivot button 85, and stores the position adjusted by a predetermined length L1 from the temporary pivot position PP1 as the pivot position PP in the storage unit 32. This makes it possible to set the pivot position PP to a position adjusted by a predetermined length L1 from the temporary pivot position PP1 set on the body surface S of the patient P. For example, the pivot position PP can be set to the center of the abdominal wall F rather than the body surface S of the patient P. Therefore, the pivot position PP can be set to an appropriate position.

[0090] Furthermore, in the first embodiment, as described above, the control unit 31 stores in the storage unit 32 a position adjusted by a predetermined length L1 along the direction in which the medical instrument 4 extends relative to the temporary pivot position PP1 as the pivot position PP. This makes it easy to set the pivot position PP on the side of the abdominal wall F that is closer to the center than the body surface S of the patient P by adjusting by a predetermined length L1 along the direction in which the medical instrument 4 extends relative to the temporary pivot position PP1.

[0091] Furthermore, in the first embodiment, as described above, the control unit 31 stores in the storage unit 32 a position adjusted by a predetermined length L1 relative to the temporary pivot position PP1 as the pivot position PP. This allows the operator to set the temporary pivot position PP1 and store the pivot position PP with only one operation of the pivot button 85. Therefore, the complexity of the pivot position PP setting process can be suppressed, thereby reducing the burden on the operator.

[0092] Furthermore, in the first embodiment, as described above, the touch panel 23 is located on the remote control device 2. This places the touch panel 23 near the doctor or other operator who is operating the remote control device 2. Therefore, the doctor or other operator can easily input a predetermined length L1 in advance.

[0093] Furthermore, in the first embodiment, as described above, the control unit 31 stores in the storage unit 32 a pivot position PP for each of the multiple arms 60, which is a position adjusted by a predetermined length L1 from the temporary pivot position PP1. This makes it possible to appropriately set the pivot position PP for each of the multiple arms 60.

[0094] Furthermore, in the first embodiment, as described above, after the control unit 31 stores the pivot position PP in the storage unit 32, if a change in the pivot position PP is received via the touch panel 23, the control unit 31 stores the received changed pivot position PP in the storage unit 32. This allows an operator, such as a doctor, to change the pivot position PP even after it has been set. Therefore, even if the patient P moves after the pivot position PP has been set, an appropriate pivot position PP can be set.

[0095] Furthermore, in the first embodiment, as described above, the touch panel 23 receives the amount of change from the pivot position PP, and the control unit 31 stores the position moved by the amount of change along the direction in which the medical device 4 extends as the changed pivot position PP in the storage unit 32. As a result, the pivot position PP can be changed simply by moving the pivot position PP by the amount of change received. Therefore, the control burden on the control unit 31 can be reduced.

[0096] Furthermore, in the first embodiment, as described above, the control unit 31 sets the central part of the patient P's abdominal wall F in the thickness direction as the pivot position PP. This effectively reduces the impact on the patient P's abdominal wall F caused by the medical device 4 rotating around the pivot position PP as a fulcrum.

[0097] [Second Embodiment] The pivot position setting method of the second embodiment will be described.

[0098] In the second embodiment, as shown in Figure 19, step S1 of the first embodiment is not performed. Also, the operations of steps S2 and S3 are the same as in the first embodiment.

[0099] In the second embodiment, in step S4a, as shown in Figure 20, the control unit 31 sets a first temporary pivot position PP11 when the pivot button 85 is operated while the tip of the medical instrument 4 attached to the tip of the arm 60 has been moved to a position corresponding to the insertion position of the trocar T inserted into the body surface S of the patient P.

[0100] Next, in step S4b, as shown in Figure 21, with the tip of the medical instrument 4 moved to a position corresponding to the tip of the trocar T located inside the patient P's body, the pivot button 85 is operated, causing the control unit 31 to set a second temporary pivot position PP12. Note that the endoscope 6 has already been inserted from the surface S of the patient P's body. The operator confirms from the image captured by the endoscope 6 that the tip of the medical instrument 4 has moved to a position corresponding to the tip of the trocar T.

[0101] Next, in step S5a, the control unit 31 stores the position adjusted based on the first temporary pivot position PP11 and the second temporary pivot position PP12 as the pivot position PP in the storage unit 32. Specifically, the control unit 31 calculates a difference value L13 by subtracting the amount L12 of the protrusion of the tip of the trocar T from the abdominal wall F of the patient P into the body from the distance L11 between the first temporary pivot position PP11 and the second temporary pivot position PP12. Then, the control unit 31 stores the position moved inward from the first temporary pivot position PP11 by half of the difference value L13 as the pivot position PP in the storage unit 32. The protrusion amount L12 of the trocar T is a predetermined value. Also, as shown in Figure 22, the trocar T is marked with a scale. The operator adjusts the insertion amount of the trocar T by referring to the scale of the trocar T so that the protrusion amount L12 becomes the predetermined value from the image acquired by the endoscope 6. Note that the difference value L13 is an example of a predetermined length.

[0102] The operations in steps S6 and S7 are the same as in the first embodiment described above.

[0103] [Effects of the second embodiment] In the second embodiment, the following effects can be obtained.

[0104] In the second embodiment, as described above, the control unit 31 stores the position adjusted based on the first temporary pivot position PP11 and the second temporary pivot position PP12 as the pivot position PP in the storage unit 32. This makes it possible to set the pivot position PP appropriately according to the thickness of the patient's abdominal wall F, even when the thickness of the patient's abdominal wall F is unknown, based on the first temporary pivot position PP11 and the second temporary pivot position PP12.

[0105] Furthermore, in the second embodiment, as described above, the control unit 31 stores in the storage unit 32 the position moved inward from the first temporary pivot position PP11 by half of the difference value L13 as the pivot position PP. Here, the position moved inward from the first temporary pivot position PP11 by half of the difference value L13 corresponds to the center in the thickness direction of the patient P's abdominal wall F. Therefore, the pivot position PP can be set to the center in the thickness direction of the patient P's abdominal wall F.

[0106] [Differentiation] It should be noted that the embodiments disclosed herein are illustrative and not restrictive in all respects. The scope of this disclosure is defined by the claims rather than the description of the embodiments above, and further includes all modifications (modifications) within the meaning and scope equivalent to the claims.

[0107] For example, in the first and second embodiments described above, the pivot position PP is shown to be a position adjusted by a predetermined length L1 along the direction in which the medical device 4 extends, relative to the temporary pivot position PP1, but the disclosure is not limited thereto. For example, the direction in which the adjustment by the predetermined length L1 is made may be set to the vertical direction or the like.

[0108] Furthermore, while the first and second embodiments described above show examples in which the pivot position PP is set by the control unit 31 of the medical trolley 3, this disclosure is not limited thereto. For example, the pivot position PP may be set by a control device other than the control unit 31 of the medical trolley 3.

[0109] Furthermore, although the first embodiment described above shows an example in which the touch panel 23 is located on the remote control device 2, this disclosure is not limited to this. For example, the touch panel 23 may be located on a part other than the remote control device 2.

[0110] Furthermore, while the first embodiment described above shows an example in which the pivot position PP is stored by pressing the pivot button 85, the disclosure is not limited to this. For example, the pivot position PP may be stored by an operation other than pressing the button.

[0111] Furthermore, while the first embodiment described above shows an example in which the operator inputs a predetermined length L1 into the touch panel 23 in advance, this disclosure is not limited to this. For example, the control unit 31 calculates the thickness of the patient P's abdominal wall F based on a three-dimensional model created from images of the patient P taken in advance. The control unit 31 may then store in the storage unit 32 a pivot position PP that has been adjusted by half the thickness relative to the temporary pivot position PP1. Specifically, the control unit 31 acquires a three-dimensional model generated from images of the patient P taken by a CT scanner or the like. Then, it calculates the thickness of the patient P's abdominal wall F based on the three-dimensional model. By setting the pivot position PP based on the three-dimensional model in this way, even if there are individual differences in the thickness of the patient P's abdominal wall F, the pivot position PP can be appropriately set according to the thickness of each patient P's abdominal wall F.

[0112] Furthermore, in the second embodiment described above, an example was shown in which the pivot position PP is set to a position moved from the first temporary pivot position PP11 by half of the difference value L13 obtained by subtracting the amount of protrusion L12 of the tip of the trocar T from the distance L11 between the first temporary pivot position PP11 and the second temporary pivot position PP12. However, the disclosure is not limited to this. For example, the pivot position PP may be set to a position moved from the first temporary pivot position PP11 by an amount different from half of the difference value L13.

[0113] Furthermore, while the first embodiment described above shows an example in which the touch panel 23 accepts both a predetermined length L1 and the amount of change in the pivot position PP, the disclosure is not limited thereto. For example, a separate receiving unit for accepting changes in the pivot position PP may be provided, separate from the touch panel 23 for pre-inputting the predetermined length L1.

[0114] Furthermore, while the first and second embodiments described above show examples where the pivot position PP is set in the center of the thickness direction of the patient P's abdominal wall F, this disclosure is not limited thereto. For example, the pivot position PP may be set closer to the body surface S than the center of the thickness direction of the patient P's abdominal wall F, or further from the body surface S than the center of the thickness direction of the patient P's abdominal wall F.

[0115] Furthermore, while the first and second embodiments described above show examples in which the pivot position PP is set with the pivot position teaching device 7 attached to the arm 60, this disclosure is not limited thereto. In this disclosure, the pivot position PP may be set with the forceps or the like that to be actually used attached to the arm 60.

[0116] Furthermore, while the first and second embodiments described above show examples in which four arms 60 are provided, the disclosure is not limited thereto. In this disclosure, the number of arms 60 may be any other number, as long as at least one or more are provided.

[0117] Furthermore, while the first and second embodiments described above show examples in which the arm portion 61 and positioner 40 are composed of a 7-axis articulated robot, this disclosure is not limited thereto. For example, the arm portion 61 and positioner 40 may be composed of an articulated robot with an axis configuration other than a 7-axis articulated robot. An axis configuration other than a 7-axis articulated robot could be, for example, 6 axes or 8 axes.

[0118] Furthermore, while the first and second embodiments described above show examples in which the medical manipulator 1 includes a medical trolley 3, a positioner 40, and an arm base 50, this disclosure is not limited to these examples. For instance, the medical trolley 3, the positioner 40, and the arm base 50 are not necessarily required, and the medical manipulator 1 may consist only of an arm 60.

[0119] The functions of the elements disclosed herein can be performed using circuits or processing circuits, including general-purpose processors, dedicated processors, integrated circuits, ASICs (Application Specific Integrated Circuits), 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 circuits. In this disclosure, a circuit, unit, or means is hardware that performs the enumerated functions, or hardware programmed to perform the enumerated functions. The hardware may be hardware disclosed herein, or other known hardware that is programmed or configured to perform the enumerated functions. If the hardware is a processor, which is considered a type of circuit, then the circuit, means, or unit is a combination of hardware and software, and the software is used to configure the hardware and / or the processor. [Explanation of Symbols]

[0120] 1. Medical manipulator (surgical support system) 2 Remote control device 4 Medical devices 21. Manipulator arm (operating handle) 23. Touch panel (input section, reception section) 31 Control Unit 32 Storage section 60 Arm 85. Pivot Button (Pivot Position Teaching Unit) F abdominal wall L1 predetermined length L11 Distance between the first and second temporary pivot positions L12 Overhang amount L13 Difference value (of a given length) P patient PP Pivot Position PP1 Temporary pivot position PP11 First provisional pivot position PP12 Second temporary pivot position S body surface T Trocar

Claims

1. An arm to which medical instruments can be attached, A pivot position teaching unit for teaching the pivot position that serves as the fulcrum for the movement of the medical device attached to the arm, Memory unit and, Control unit and It includes an input section, The pivot position teaching unit is located on the arm, The control unit, With the tip of the medical device attached to the end of the arm moved to an arbitrary position corresponding to the insertion position of the trocar inserted into the patient's body surface, the pivot position teaching unit is operated to set the position corresponding to the tip of the medical device as a temporary pivot position. A surgical support system that stores in the memory unit the position adjusted by a predetermined length, which is pre-inputted by the input unit and whose length can be changed, from the provisional pivot position.

2. The surgical support system according to claim 1, wherein the control unit stores in the storage unit a position adjusted by a predetermined length along the direction in which the medical instrument extends, relative to the temporary pivot position, as the pivot position.

3. The device further includes a remote control device that includes an operating handle for operating the aforementioned medical device, The surgical support system according to claim 1, wherein the input unit is located in the remote control device.

4. An arm to which medical instruments can be attached, A pivot position teaching unit for teaching the pivot position that serves as the fulcrum for the movement of the medical device attached to the arm, Memory unit and, It comprises a control unit and, The pivot position teaching unit is located on the arm, The control unit, With the tip of the medical instrument attached to the end of the arm moved to a position corresponding to the insertion position of the trocar inserted into the patient's body surface, the pivot position teaching unit is operated to set a first provisional pivot position. With the tip of the medical device moved to a position corresponding to the tip of the trocar located inside the patient's body, the pivot position teaching unit is operated to set a second provisional pivot position. A surgical support system that stores a position adjusted based on the first and second temporary pivot positions as the pivot position in the memory unit.

5. The control unit, The difference is calculated by subtracting the amount the tip of the trocar protrudes from the patient's abdominal wall toward the inside of the body from the distance between the first provisional pivot position and the second provisional pivot position. The surgical support system according to claim 4, wherein the position moved inward from the first provisional pivot position by half of the difference value is stored in the memory unit as the pivot position.

6. The aforementioned arms are provided in multiple quantities. The surgical support system according to any one of claims 1 to 3, wherein the control unit stores in the storage unit a position adjusted by a predetermined length from the temporary pivot position for each of the multiple arms as the pivot position.

7. The system further includes a receiving unit that accepts changes to the pivot position, The surgical support system according to any one of claims 1 to 6, wherein the control unit stores the pivot position in the storage unit, and if a change in the pivot position is received by the reception unit, the control unit stores the received changed pivot position in the storage unit.

8. The receiving unit receives the amount of change from the pivot position, The surgical support system according to claim 7, wherein the control unit stores in the storage unit the position moved by the amount of the change along the direction in which the medical instrument extends as the changed pivot position.

9. The surgical support system according to any one of claims 1 to 3, wherein the control unit stores in the storage unit a position adjusted by a predetermined length relative to the temporary pivot position as the pivot position, such that the pivot position is located in the center of the thickness direction of the patient's abdominal wall.

10. The surgical support system according to claim 1, wherein the control unit is configured to store the pivot position in the storage unit based on the position corresponding to the tip of the medical instrument after it has been moved, by operating the pivot position teaching unit on the medical instrument that has been moved with the temporary pivot position set.

11. The surgical support system according to claim 10, wherein the position corresponding to the tip of the medical instrument after movement is the position corresponding to the tip of the medical instrument that was inserted into and moved in the trocar placed on the patient.

12. The process involves receiving an operation from a pivot position teaching unit for teaching a pivot position that serves as the fulcrum for the movement of a medical device attached to the end of an arm, while the tip of the medical device attached to the end of the arm has been moved to an arbitrary position corresponding to the insertion position of a trocar inserted into the patient's body surface; The pivot position teaching unit is operated to set a position corresponding to the tip of the medical instrument as a temporary pivot position, The process includes the step of storing in the storage unit a position adjusted by a predetermined length, which is pre-inputted by the input unit and whose length can be changed, from the set temporary pivot position, as the pivot position. The pivot position teaching unit is a pivot position setting method arranged on the arm.

13. The process involves receiving an operation from a pivot position teaching unit to teach the pivot position that serves as the fulcrum for the movement of the medical instrument attached to the arm, while the tip of the medical instrument attached to the arm has been moved to a position corresponding to the insertion position of the trocar inserted into the patient's body surface. The pivot position teaching unit is operated to set the position corresponding to the tip of the medical instrument as the first temporary pivot position, The steps include setting a second provisional pivot position by operating the pivot position teaching unit while the tip of the medical device is moved to a position corresponding to the tip of the trocar located inside the patient's body, The process includes the step of storing in the storage unit the position adjusted based on the first temporary pivot position and the second temporary pivot position as the pivot position, The pivot position teaching unit is a pivot position setting method arranged on the arm.

Images