JP2005177337A - Medical appliance retainer - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To promote miniaturization and lightweight in a simple constitution and to improve handling operability. <P>SOLUTION: The subject medical appliance retainer is provided with; a parallelogrammic link turning air brake 28 changing the drag shape of an arm whole body by locking/unlocking the turning of a parallelogrammic link mechanism around an axis O5; air brakes 3, 10, 11, 13 and 25 locking/unlocking a joint part; an air brake control part 30 for supplying high pressure nitrogen gas; an output hose 36 for supplying the high pressure nitrogen gas being used in common and branched right before the parallelogrammic link turning air brake 28; and a valve element 81 cutting off the supply of the high pressure nitrogen gas provided between the branch part and the parallelogrammic link turning air brake 28. This simple structure can independently controls the air brakes 3, 10, 11, 13 and 25 from the parallelogrammic link turning air brake 28 without enlarging the device whole body. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a medical instrument holding device used for arranging various medical instruments such as endoscopes and medical treatment tools used in, for example, a surgical operation in neurosurgery in an operation part.

  Generally, in neurosurgery, a method of magnifying and observing a fine surgical site using a surgical microscope has been adopted. More recently, an endoscope is used as a means of observing a blind spot observation site of a surgical microscope. By using this, a less invasive treatment is performed. Such an endoscope is arranged so that it can be fixed / released at a desired position by using a medical instrument holding device having a well-known parallelogram link structure that is coupled to a plurality of arms and a joint part so as to be movable and adjustable. Is done.

  As such a medical instrument holding device, for example, it is constituted by a parallelogram link mechanism in which a plurality of arms are linked and connected via joints, and an endoscope is attached to the tip thereof. In this parallelogram link mechanism, a ball pair is arranged at the joint portion, and a counter balance equivalent to the endoscope is arranged on the opposite side of the support portion to which the endoscope is attached (for example, a patent) Reference 1). As a result, the endoscope held at the tip of the parallelogram link mechanism is moved and operated in a so-called weightless manner via the parallelogram link mechanism, and is placed opposite to the surgical site to be observed, and its moving position. In, desired observation becomes possible.

  By the way, in such a medical instrument holding apparatus, for example, when other medical instruments such as a surgical microscope are arranged in the vicinity of the operating field, interference with them is avoided, and a wider surgical work space is provided. In order to ensure the above, it is necessary to change the drawing shape of the entire arm in accordance with the surgical site and the surgical procedure. Since the movement of the parallelogram link mechanism is the movement of the entire arm, it is an unnecessary movement for the movement of the medical instrument in the normal intraoperative operation, and conversely, it moves freely. Then, since the movement trajectory of the arm in the vicinity of the surgical site becomes large, there is a risk of hitting other surgical instruments and a surgical microscope used at the same time.

  Therefore, in the medical instrument holding device, the parallelogram link mechanism is arranged with a degree of freedom to allow the entire arm of the parallelogram link mechanism to rotate with respect to the support portion, and without changing the installation position. Some are configured so as to be able to respond to different surgical sites and procedures simply by changing the scooping form of the arm (see, for example, Patent Document 2). This medical instrument holding device is provided with an electromagnetic brake using an electromagnet provided with a coil at an arm joint part constituting the parallelogram link arm, and uses a spring force as a brake of the joint part for changing the drawing shape of the entire arm. A so-called mechanical brake is employed, and the electromagnetic brake and the mechanical brake are independently driven and controlled to be fixed / released.

  However, in the above-described therapeutic instrument holding device, since the electromagnetic brake is arranged at the arm joint portion, the arm joint portion is increased in size and weight, which increases the counter balance and requires the arm rigidity to be increased. In addition, there is a problem that an increase in weight is caused with an increase in size of the arm itself.

  Also, according to this, since the mechanical brake of the joint part that changes the routing shape of the entire arm needs to hold the weight of the entire arm, a large amount of fixing force is required, and as a spring member that generates the fixing force It is necessary to adopt a spring having a very large spring constant. For this reason, there exists a problem that the operativity is inferior because the operating force amount of the switch operated when releasing the mechanical brake becomes considerably heavy.

Therefore, as a means for improving operability, a so-called air brake using a fluid such as air as a medium is disposed independently at both the arm joint part and the joint part for controlling the operation of the entire arm, and There has been proposed a configuration in which a parallelogram link mechanism can be operated by an operation (see, for example, Patent Document 3).
JP 7-241300 A JP 2001-258903 A JP 2002-345831 A

  However, the therapeutic instrument holding device includes a switching valve for supplying / blocking air in the brake, for example, an electromagnetic valve, and a brake control unit including a power supply unit and a control circuit for controlling the operation of the electromagnetic valve. In addition, since it must be provided in both the arm joint part and the joint part that controls the movement of the entire arm, there is a problem that the increase in the number of components causes an increase in size and weight. In particular, although such a brake control unit can improve operability, since the air supply hose that is housed in the arm and supplies air to the brake unit requires two systems, the arm itself can be downsized. There are constraints on the promotion of

  In particular, medical instruments such as endoscopes are used in the vicinity of the surgical site, and there are various medical instruments such as a surgical microscope in the vicinity of the surgical site. This is one of the important issues from the viewpoint of surgical efficiency.

  The present invention has been made in view of the above circumstances, and provides a therapeutic instrument holding device that can be simplified in configuration, promoted to be smaller and lighter, and improved in handling operability. For the purpose.

  According to the present invention, a tilting mechanism that supports a holding unit that holds a medical instrument in a tiltable manner and a plurality of arms that three-dimensionally move the holding unit that is supported by the tilting mechanism are linked to each other via a joint. A multi-joint arm that is connected to a mechanism; an installation unit that supports the multi-joint arm and arranges the tilting mechanism and the moving mechanism so as to be tiltable and movable adjustable; and the joint of the tilting mechanism and the moving mechanism A first braking means for fixing / releasing the rotation mechanism, a second braking means for fixing / releasing rotation of the tilting mechanism around the central axis of the holding portion with respect to the holding portion, and the first and second braking means. A first control unit that selectively controls the second control unit, and a second control unit that controls a second braking unit that fixes / releases rotation of the tilting mechanism around the central axis of the tilting mechanism with respect to the holding unit. The medical instrument holding device was configured.

  According to the above configuration, the first and second braking means for selectively fixing / releasing the tilt mechanism and the moving mechanism and the second braking means for fixing / releasing the tilt mechanism are provided. The multi-joint arm can be operated with high accuracy by a simple operation by simply operating the two braking means. Accordingly, it is possible to easily perform highly accurate movement adjustment of the holding portion in accordance with the surgical part and the surgical method. In addition, according to this, it is possible to easily share the components of the first and second braking means, and it is also possible to promote reduction in size and weight.

  According to the present invention, it is possible to provide a treatment instrument holding device that can be simplified in configuration, promoted in size and weight reduction, and improved in handling operability.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

(First embodiment)
FIG. 1 shows a treatment instrument holding apparatus according to a first embodiment of the present invention. A support arm 2 constitutes a first braking means in a gantry 1 which is an installation means for supporting the whole. The air brake 3 is installed upright. A parallelogram link mechanism 4, which is a moving mechanism that constitutes a multi-joint arm in which a plurality of arms to be described later are linked and connected via joint portions, is supported by the support arm 2 via the arm support portion 5. . The arm support portion 5 is rotatable around an axis O2 (second rotation axis) with respect to the support arm 2 in the vicinity of the approximate center position of the arm 6 (first arm) of the parallelogram link mechanism 4. In addition to being coupled, the rotation around the axis O2 relative to the support arm 2 is fixed (locked) / released via the air brake 10 constituting the first braking means.

  The parallelogram link mechanism 4 includes an arm 8 (second arm) and an arm 9 that are connected in parallel to each other at both ends of an arm 7 arranged in parallel to the arm 8, and The end is linked and configured. Of these, on the axis O3 to which the arm 8 and the arm 6 are connected, the rotation of the arm 8 around the axis O3 relative to the arm 6, that is, the deformation of the parallelogram link mechanism 4 is fixed (locked) / released. An air brake 11 constituting the braking means is provided.

  In addition, a medical instrument holding arm 12 is connected to one end of the arm 7 of the parallelogram link mechanism 4 via an air brake 13 so as to be rotatable around an axis O4 so as to be locked / released. A medical instrument holding portion 14 is attached to the other end of the medical instrument holding arm 12 via a ball joint 15 that is a tilting mechanism. Thereby, the medical instrument holding portion 14 can be tilted in the arrows A and B with respect to the medical instrument holding arm 12 by the ball joint 15. The ball joint 15 is provided with an air brake 25 constituting the first braking means for fixing (locking) / releasing the inclination in the directions of arrows A and B.

  An endoscope 17, which is a medical instrument, is attached to the medical instrument holder 14 via a fixing screw 19. The endoscope 17 is optically connected to a TV camera 18 that captures an observation image at the eyepiece. The TV camera 18 is electrically connected to a TV camera controller (not shown) via a TV camera cable 20. An LG post 21 is connected to the illumination optical system of the endoscope 17, and a light guide cable 22 that is optically connected to a light source device (not shown) is connected to the LG post 21.

  A counterweight 24 is attached to the other end of the arm 9 constituting the parallelogram link mechanism 4 via a shaft 23. The counterweight 24 is set to a weight that cancels out a moment caused by a heavy object such as the endoscope 17 generated around the axis O2.

  The medical instrument holder 14 is provided with a first input switch 26. The first input switch 26 operates the air brakes 3, 10, 11, 13, 25 in conjunction with the operation. The arm support 5 is provided with a second input switch 27 that can be operated. The second input switch 27 is an arm shape that constitutes a second braking means, which will be described later, that locks / releases the rotation of the parallelogram link mechanism 4 around the axis O5 in conjunction with the operation. The air brake 28 for rotating the parallelogram link for changing is selectively operated.

  The gantry 1 includes an air brake control unit 30 (see FIG. 2) corresponding to the first control unit. The air brake control unit 30 is provided with an electromagnetic valve 31 which is a known flow path switching means. The electromagnetic valve 31 has three air ports, an input port 32, an output port 33, and an exhaust port 34. The input port 32, the output port 33, and the exhaust port 34 include an input hose 35, an output hose 36, and the like. One end of the exhaust hose 37 is connected.

  Among these, the other end of the input hose 35 is connected to a compressed fluid source (not shown) provided on the wall surface of the medical facility, for example. The other end of the output hose 36 is connected to the air brakes 3, 10, 11, 13, 25, and the air brake 28 for rotating the parallelogram link. The other end of the exhaust hose 37 is open to the atmosphere.

  The solenoid valve 31 incorporates a solenoid 39 composed of a coil 391 and a shaft 38. The coil 391 of the solenoid 39 is electrically connected to the first input switch 26 via the control circuit 40, and is driven and controlled via the control circuit 40 in response to the operation of the first input switch 26. Is done.

  Further, a valve body 41 is integrally attached to the tip of the shaft 38, and an elastic force is applied in the direction of arrow H in FIG. The valve body 41 is moved to a position indicated by a solid line in FIG. 2 and a position indicated by a broken line in FIG. 2 by a solenoid 39 whose operation is controlled by a drive signal from the control circuit 40 and an elastic member 42. That is, when the valve body 41 is in the position of the solid line in FIG. 2, the output port 33 and the exhaust port 34 are in communication with each other, and when the valve body 41 is in the position of the broken line in FIG. The communication state is established and the flow path is switched.

  Next, the configuration of the air brake 3 will be described with reference to FIG. The air brake 3 is configured in substantially the same manner as the air brakes 10, 11, and 13, for example, and the housing 48 is attached to the gantry 1. A pressing member 45 is movably mounted in the housing 48.

  The pressing member 45 is provided with a contact portion 46 at one end and an air port 47 to which the output hose 31q6 is connected at the other end. A fixing member 49 is attached to the housing 48 via a bearing 50 so as to be rotatable around the axis O1 with respect to the housing 48. The fixing member 49 is integrally attached to the support arm 2.

  In addition, a protrusion 51 is provided inside the housing 48, and an elastic member 52 such as a coil spring is engaged with the gap between the protrusion 51 and the abutting portion 46 of the pressing member 45. Accordingly, the pressing member 45 is disposed such that the contact portion 46 is pressed against the fixing member 49 by the elastic force of the elastic member 52.

  An air space 531 into which compressed air from the exhaust hose 37 flows is provided in the housing 48. Then, O-rings 54 and 55 are interposed between the housing 48 and the pressing member 45 so that the inside of the housing 48 is set in an airtight state.

  The output hose 36 is connected to the air brakes 10, 11, 13, 25 by air branch ports 36a, 36b, 36c, 36d. An air control valve 56 corresponding to a second control unit is connected to the air branch port 36e of the output hose 36, and an output hose 57 from the air control valve 56 is built in the arm support unit 5. The parallelogram link turning air brake 28 is connected.

  Next, the structure of the air brake 25 which consists of the ball | bowl pair which connects the said medical instrument holding | maintenance part 14 and the medical instrument holding arm 12 is demonstrated with reference to FIG.

  That is, the air brake 25 includes a pressing member 60 inside the housing 63. The pressing member 60 is provided with an abutting portion 61 corresponding to the radius R of the ball joint 15 at one end and an air port 62 to which the output hose 36 is connected at the other end.

  The housing 63 is attached to the medical instrument holding arm 12, and a contact portion 64 corresponding to the radius R of the ball joint 15 is provided on the surface with which the ball joint 15 is contacted, similarly to the contact portion 61. Is provided.

  In addition, a protrusion 65 is provided inside the housing 63, and an elastic member 66 such as a coil spring is engaged in a gap between the protrusion 65 and the pressing member 60 on the contact portion 61 side. As a result, the abutting portion 61 of the pressing member 60 is pressed against the ball joint 15 by the elastic force of the elastic member 66, and the ball joint 15 is sandwiched between the abutting portions 64 and fixed.

  An air space 67 into which compressed air from the output hose 37 flows is provided in the housing 63. Then, O-rings 68 and 69 are interposed between the housing 63 and the pressing member 60, and the inside of the housing 63 is set in an airtight state.

  Next, the parallelogram link rotating air brake 28 corresponding to the third braking means disposed in the arm support portion 5 and locking / releasing the rotation of the parallelogram link mechanism 4 around the axis O5 is provided. The configuration will be described with reference to FIG.

  That is, in the parallelogram link turning air brake 28, the pressing member 70 is accommodated in the housing 73 constituting the arm support portion 5. The pressing member 70 has a contact portion 71 at one end and an air port 72 to which the output hose 53 is connected at the other end.

  The arm 73 constituting the parallelogram link mechanism 4 is attached to the housing 73 so as to be rotatable around the axis O5, and the output hose 53 is forced by the rotation of the arm 6 around the axis O5. The air control valve 56 and the pressing member 70 are installed with sufficient slack so as not to be hung.

  In addition, a protrusion 75 is provided inside the housing 73, and an elastic member 76 such as a coil spring is engaged with the gap between the protrusion 75 and the pressing member 70 on the contact portion 71 side. Thereby, the pressing member 70 is pressed against the flange 77 of the arm 6 by the elastic force of the elastic member 76.

  An air space 78 into which compressed air from the output hose 53 flows is provided in the housing 73. Then, O-rings 79 and 80 are interposed between the housing 73 and the pressing member 70 to set the inside of the housing 73 in an airtight state.

  Here, the configuration of the air control valve 56 corresponding to the second control unit will be described. That is, the valve body 81 is disposed inside the air control valve 56 so as to be rotatable in the direction of arrow C around the axis O6 (clockwise in FIG. 5). An elastic member 84 is engaged with the other end of the valve body 81, and is pressed against the stopper portion 82 via the elastic member 84.

  A known push-pull solenoid 85 is disposed in the housing 73 so as to face one end of the valve body 81. The push-pull solenoid 85 is electrically connected to the second input switch 27 via the control circuit 40, and in the on state, the push-pull solenoid 85 moves the valve element 81 in the arrow C direction against the elastic force of the elastic member 84. Rotating force is applied.

  An airtight packing 86 is provided in the air control valve 56 at a predetermined position corresponding to the valve body 81. As a result, when the valve body 81 is rotated by the push-pull solenoid 85 against the elastic force of the elastic member 84 to the position indicated by the broken line in FIG. 81 is pressed against the packing 86 to form an air space 88 having airtightness.

  Further, the air control valve 56 is provided with an exhaust port 87, the exhaust port 87 is turned off, and the push-pull solenoid 85 is turned off. It is communicated with the output hose 36 while being moved to the position and pressed by the stopper portion 82. When the valve element 81 is returned to the position indicated by the broken line in FIG. 5 against the elastic force of the elastic member 84 by the push-pull solenoid 85, the air control valve 56 and the output hose Are switched so as to communicate with each other.

  In the above configuration, the input hose 35 is connected to, for example, a compressed fluid source of a medical facility, and when a fluid such as high-pressure nitrogen gas is supplied from the compressed fluid source, the valve body 41 is positioned at the solid line shown in FIG. In some situations, the fluid is shielded. At this time, since the output port 33 and the exhaust port 34 of the electromagnetic valve 31 are in communication with each other, the inside of the air brake provided at each joint of the arms constituting the parallelogram link mechanism 4 is maintained at the same pressure as the atmosphere. As a result, each air brake is inoperative (fixed state).

  Next, when changing the observation position by the endoscope 17, the operator operates the first input switch 26 provided in the medical instrument holding unit 13. Then, this operation signal is input to the control circuit 40 in the air brake control unit 30. The control circuit 40 generates a drive signal in response to the operation signal, supplies a current to the coil 391 constituting the solenoid 39 of the electromagnetic valve 31 to generate a magnetic field, and resists the shaft 38 against the elastic force of the elastic member 42. Then, it is moved to the position of the broken line in FIG. Here, the input port 32 and the output port 33 in the electromagnetic valve 31 are in communication with each other, and the valve body 41 shields the exhaust port 34. Then, the high-pressure nitrogen gas filled in the input hose 35 flows into the output hose 36 (see FIG. 3), and the high-pressure nitrogen gas is filled in the air space 531 of the air brake 3.

  Here, when the air space 531 is in a high pressure state, the pressing member 45 is moved in the direction of arrow D in FIG. 3 against the elastic force of the elastic member 52, and the contact portion 46 of the pressing member 45 is moved. The pressing force to the fixing member 49 due to is reduced. Accordingly, the fixing member 49 can rotate with respect to the housing 48 of the air brake 3 via the bearing 50, and the fixing of the air brake 3 is released.

  Similarly, the other air brakes 10, 11 and 13 are released from being fixed.

  Further, the air brake 25 constituted by the ball joint 15 is similarly filled with high-pressure nitrogen gas from the output hose 36 into the air space 67, and the pressing member 60 resists the elastic force of the elastic member 66. 4 is biased so as to be pulled in the direction of arrow E, and the pressing force of the contact portion 61 against the ball joint 15 decreases. Then, the ball joint 15 can freely rotate between the contact portions 61 and 64, and the fixation of the medical instrument holding portion 14 is released here.

  Thus, by releasing the fixing of the air brakes 3, 10, 11, 13 and 25, the arms constituting the parallelogram link mechanism 4 rotate about the axes O1, O2, O3 and O4. Further, the ball joint 15 can freely rotate in the directions of arrows A and B in FIG.

  In this case, the surgeon can arrange the parallelogram linkage mechanism 4 with a counterweight 24 equivalent to the endoscope 17 with respect to the arm 9, so that the endoscope 17 can be moved to a desired position with a light force. It becomes possible to move freely.

  Then, after the endoscope 17 is moved to a place where it is desired to observe, the hand is released from the first input switch 26 and the switch is turned off. Then, the input signal to the control circuit 40 in the air brake control unit 30 is cut off, and the drive signal from the control circuit 40 to the electromagnetic valve 31 is cut off. As a result, the operation of the solenoid 39 is stopped, and the valve body 41 is returned to the position indicated by the solid line in FIG.

  Here, the input port 32 is shut off, and the output port 33 and the exhaust port 34 are in communication with each other, filling the output hose 36 and the air spaces 531 and 67 of the air brakes 3, 10, 11, 13 and 25. The high-pressure nitrogen gas that has been discharged is exhausted to the atmosphere through an exhaust hose 37 connected to the exhaust port 34. As a result, in the air brakes 3, 10, 11, 13, and 25, the contact portions 46 and 61 of the pressing members 45 and 60 are pressed against the fixing member 49 and the ball joint 15 by the elastic members 52 and 66, respectively. The endoscope 17 is fixed (locked), and the endoscope 17 is positioned and fixed.

  In this state, illumination light from a light source device (not shown) is guided to the surgical site via the light guide 22 and the illumination optical system in the endoscope 17. Then, the light emitted from the surgical part is taken into the observation optical system (not shown) of the endoscope 17 and picked up on the TV camera 18, and the optical image is converted into an electric signal. Are input to a TV camera controller (not shown), displayed as an observation image on a TV monitor (not shown), and observed by an operator.

  Next, as shown in FIG. 6, when a problem occurs in which a part of the arm constituting the parallelogram link mechanism 4 interferes with the operation microscope 95, the operator indicates the entire arm with a broken line in the figure. Change to a routing shape like this.

  First, the surgeon operates the first input switch 26 as described above. Then, the high-pressure nitrogen gas is guided to the air spaces 531 and 67 of the air brakes 3, 10, 11, 13, and 25, and the fixing of the air brakes 3, 10, 11, 13, and 25 is released. In this state, the second input switch 27 is operated. Then, the operation signal of the second input switch 27 is input to the control circuit 40, and the push-pull solenoid 85 is activated by the drive signal from the control circuit 40. Then, the valve body 81 is moved around the axis O <b> 6 to the position indicated by the broken line shown in FIG. 5, the output hose 36 and the output hose 53 are in communication with each other, and high-pressure nitrogen gas is introduced into the air space 78.

  Here, due to the pressure of the high-pressure nitrogen gas, the pressing member 70 is biased so as to be pulled in the direction of arrow F in FIG. The pressing force against the flange 77 is reduced, and the arm 6 can be rotated around the axis O <b> 5 via the bearing 74. Then, it becomes possible to rotate around the axis O5 of the parallelogram link mechanism 4 itself, and the surgeon changes the drawing shape of the entire arm to the position of the broken line shown in FIG.

  When the hand is released from the second input switch 27 in this state, the drive signal from the control circuit 40 to the push-pull solenoid 85 is stopped, and the valve body 81 is hit by the elastic force of the elastic member 84. (Position indicated by a solid line in FIG. 5) is moved. Then, the output hose 53 is shielded from the output hose 36 and communicates with the exhaust port 87, and the high-pressure nitrogen gas filled in the air space 78 is exhausted to the atmosphere.

  As a result, the pressing member 70 is again pressed against the flange 77 of the arm 6 by the elastic force of the elastic member 76, and the parallelogram link mechanism 4 is fixed in rotation around its axis O5. Is done. As a result, as shown by the broken line in FIG. 6, the surgeon places the endoscope 17 in a state where the entire arm is disposed at a position that does not interfere with other medical instruments such as the surgical microscope 95 in the vicinity of the surgical site. It is possible to perform the treatment work while arranging the desired position and performing magnified observation of the surgical site.

  In this way, the medical instrument holding device locks / releases the rotation of the parallelogram link mechanism 4 around the axis O5 to change the drawing shape of the entire arm, and the parallelogram link rotation air brake 28, And air brakes 3, 10, 11, 13, and 25 for locking / releasing the joints, an air brake control unit 30 for supplying the high-pressure nitrogen gas, and an output hose 36 for supplying the high-pressure nitrogen gas And a valve body 81 that branches immediately before the parallelogram link rotating air brake 28 and shields the supply of high-pressure nitrogen gas between the branch portion and the parallelogram link rotating air brake 28. The air brakes 3, 10, 11, 13 and 25 and the parallelogram link turning air blur are not required to increase the size of the entire device by a simple structure. And configured to control the key 28 independently. According to this, it is possible to arrange the arm according to the surgical site and the surgical procedure, and it is possible to suppress interference with other medical instruments used in the vicinity of the surgical field to the utmost limit. It is possible to easily realize the improvement.

(Second Embodiment)
7 and 8 show a medical instrument holding device according to a second embodiment of the present invention. However, in FIG. 7 and FIG. 8, the same parts as those in FIG. 1 to FIG.

  In the second embodiment, the solenoid valve 31 and the first input switch 26 are connected to the control circuit 99 of the air brake control unit 100 as shown in FIG. The air brake control unit 100 is housed in the gantry 1 as in the first embodiment, for example.

  The arm support 5 that supports the arm 6 of the parallelogram link mechanism 4 is provided with a parallelogram link rotating air brake 101 for changing the arm shape as shown in FIG. In the parallelogram link turning air brake 101, an air control valve 102 corresponding to a second control unit is housed in the housing 73. For example, the valve body 103 is accommodated in the air control valve 102 so as to be movable on a straight line in a state where an elastic force is applied in the direction of arrow G via the elastic member 84.

  A shaft 104 is projected from the valve body 103. This shaft 104 is movably inserted through an insertion hole 106 provided in the housing 73 through an O-ring 105 while being kept airtight, and the second input switch 27 is attached to the tip of the shaft 104.

  As a result, when the valve body 103 is in the position of the solid line in FIG. 8, the air control valve 102 is in communication with the output hose 53 and the exhaust port 87, and the valve body 81 is in the position of the broken line in FIG. In some cases, the output hose 36 and the output hose 53 communicate with each other and the flow path is switched.

  In the above configuration, when changing the observation position by the endoscope 17, the operator first operates the first input switch 26 as in the case of the first embodiment described above. Then, the air brakes 3, 10, 11, and 13 are released from the joints of the arms, and the endoscope 17 can be moved to a desired position, and moved and adjusted to the desired position.

  Next, as described above, when the entire arm including the parallelogram link mechanism 4 is changed in its routing shape as shown in FIG. 6, the operator operates the first input switch 26. In this state, the second input switch 27 is operated in the arrow G direction. Then, as the second input switch 27 moves in the direction of arrow G, the valve element 103 of the air control valve 102 moves in the same direction to the position indicated by the broken line in FIG. 8 against the elastic force of the elastic member 84. Is done.

  Here, the output hose 36 and the output hose 53 are in communication with each other, and high-pressure nitrogen gas is introduced into the air space 78. Then, as in the first embodiment, the pressing force of the pressing member 70 on the flange 77 integrally attached to the arm 6 is reduced, and the parallelogram link mechanism 4 itself moves around the axis O5. It can be turned. As a result, the surgeon can deform the entire arm to the position of the broken line shown in FIG.

  When the hand is released from the second input switch 27 in this state, the valve element 103 of the air control valve 102 is returned to the position indicated by the solid line in FIG. 8 by the elastic force of the elastic member 84. As a result, the output hose 53 is shielded from the output hose 36 and communicates with the exhaust port 87, and the high-pressure nitrogen gas filled in the air space 78 in the housing 73 is exhausted to the atmosphere. .

  Here, the pressing member 70 is pressed again by the flange 77, and the rotation around the axis O5 of the parallelogram link mechanism 4 is fixed and positioned and fixed. As a result, as shown by the broken line in FIG. 6, the operator places the endoscope 17 in a desired state in a state where the entire arm is disposed at a position that does not interfere with other medical tools such as the surgical microscope 95 in the vicinity of the surgical site. It is possible to move to the position and perform the treatment work while performing magnified observation of the surgical site.

  As described above, in the second embodiment, the operation of the parallelogram link rotating air brake 101 that locks / releases the rotation of the parallelogram link mechanism 4 around the axis O5, which changes the drawing shape of the entire arm. Since the air control valve 102 that controls the air has a mechanical structure, an electric wiring system for controlling the air control valve 102 is not necessary, and further miniaturization can be promoted.

  In each of the above embodiments, a so-called air brake using air such as high-pressure nitrogen gas is used as a brake means for locking / releasing the arm joint, but it is configured using other fluid such as oil. Is also possible.

  In each of the above embodiments, the case where the endoscope 17 is configured as a therapeutic instrument has been described. However, the present invention is not limited to this, and the present invention can be applied to various therapeutic instruments including other treatment instruments. Is possible.

  Further, in each of the above-described embodiments, the case where the present invention is applied to a three-joint arm structure has been described. However, the present invention is not limited to this number, and can be applied to various arm structures, and substantially the same effect can be expected. it can.

  Therefore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the invention at the stage of implementation. Further, the above embodiments include inventions at various stages, and various inventions can be extracted by appropriately combining a plurality of disclosed constituent elements.

  For example, even if some constituent requirements are deleted from all the constituent requirements shown in the embodiment, the problem described in the column of the problem to be solved by the invention can be solved, and the effect described in the effect of the invention can be obtained. In such a case, a configuration in which this configuration requirement is deleted can be extracted as an invention.

  In addition, according to each of the above embodiments, the present invention can also obtain the following configuration.

(Appendix 1)
A medical instrument comprising a multi-joint arm provided with a holding part that holds a medical instrument, an inclination mechanism that supports the holding part in a tiltable manner, and a moving mechanism that supports the holding part so as to move vertically and horizontally. In the holding device,
The moving mechanism includes an installation unit that fixes the entire apparatus with respect to a floor, a support arm that is supported to be rotatable about a first rotation axis with respect to the installation unit, and A support part supported to be rotatable about a second rotation axis that is perpendicular to one rotation axis, and rotatable about a third rotation axis that is perpendicular to the second rotation axis with respect to the support part. A first arm, and a second arm rotatable about a fourth rotation axis perpendicular to the third rotation axis with respect to the first arm,
First to fourth braking means for fixing / releasing rotation about the first to fourth rotation axes;
A common first control unit for controlling the operation of the first to fourth braking means;
A second control unit that independently controls only the operation of the third braking means;
A medical instrument holding device characterized by comprising:

(Appendix 2)
A multi-joint arm comprising a holding part for holding a medical instrument, an inclination mechanism for supporting the holding part so as to be inclined, and a moving mechanism for supporting the holding part so as to be movable vertically and horizontally, and the movement mechanism In a medical instrument holding apparatus comprising: an arm support part that supports the arm support part; and an installation part that is attached to the arm support part and supports the entire articulated arm with respect to the floor,
A plurality of braking means for fixing / releasing each joint of the tilt mechanism and the moving mechanism;
Braking means for fixing / releasing rotation around the central axis of the support portion with respect to the support portion of the tilt mechanism;
A common first control section for controlling the operation of each of the braking means;
A second control unit that independently controls only the operation of the braking means for fixing / releasing rotation of the tilting mechanism around the central axis of the support unit with respect to the support unit;
A medical instrument holding device characterized by comprising:

(Appendix 3)
The medical instrument holding apparatus according to appendix 1 or 2, wherein the moving mechanism is formed by a parallelogram link mechanism.

(Appendix 4)
The medical instrument holding apparatus according to appendix 1 or 3, wherein the first to fourth braking means are fluid brakes using fluid pressure.

(Appendix 5)
4. The medical instrument holding apparatus according to appendix 2 or 3, wherein the braking means is a fluid brake using fluid pressure.

(Appendix 6)
The medical device holding apparatus according to appendix 4 or 5, wherein the fluid brake is an air brake using air pressure.

(Appendix 7)
The medical instrument holding apparatus according to any one of appendices 1 to 6, wherein the second control unit is electrically connected to the first control unit.

(Appendix 8)
The medical instrument holding device according to any one of appendices 1 to 7, wherein the second control unit is completely independent of the first control unit.

(Appendix 9)
9. The medical instrument holding device according to any one of appendices 1 to 8, wherein the second control unit includes a mechanical flow path switching valve.

BRIEF DESCRIPTION OF THE DRAWINGS It is the block diagram which showed the whole structure of the medical device holding | maintenance apparatus which concerns on 1st Embodiment of this invention. It is the figure which showed the control system of the air brake of FIG. It is the figure which showed the detail of the air brake of FIG. It is a figure which shows the structure of the air brake which consists of a ball | bowl pair provided between the medical instrument holding | maintenance part and medical instrument holding arm of FIG. It is the figure which showed XX of FIG. 1 in cross section. It is a figure which shows the extending state of the whole arm changed by the effect | action of the said arm support part. It is the figure which showed the structure of the air brake control part of the treatment instrument holding | maintenance apparatus which concerns on 2nd Embodiment of this invention. It is the figure which showed the structure of the 2nd air brake control part of the treatment instrument holding | maintenance apparatus which concerns on 2nd Embodiment of this invention.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Mount part, 2 ... Support arm, 3 ... Air brake, 4 ... Parallelogram link mechanism, 5 ... Arm support part, 6, 7, 8, 9 ... Arm, 11 ... Air brake, 12 ... Medical instrument holding Arm, 13 ... Air brake, 14 ... Medical instrument holder, 15 ... Ball joint, 16 ... Control box, 17 ... Endoscope, 18 ... TV camera, 19 ... Fixing screw, 20 ... TV camera cable, 21 ... LG Post, 22 ... Light guide cable, 23 ... Shaft, 24 ... Counterweight, 25 ... Air brake, 26 ... First input switch, 27 ... Second input switch, 28 ... Air brake, 30 ... Air brake control unit, 31 ... Solenoid valve, 32 ... Input port, 33 ... Output port, 34 ... Exhaust port, 35 ... Input hose, 36 ... Output hose, 36a, 36b, 36c, 36d, 36e Air branch port, 37 ... exhaust hose, 38 ... shaft, 39 ... solenoid, 391 ... coil, 40 ... control circuit, 41 ... valve body, 42 ... elastic member, 45 ... pressing member, 46 ... contact part, 47 ... air port , 48 ... Housing, 49 ... Fixed member, 50 ... Bearing, 51 ... Projection, 52 ... Elastic member, 531 ... Air space, 53 ... Output hose, 54, 55 ... O-ring, 56 ... Air control valve, 57 ... Output Hose, 60 ... Pressing member, 62 ... Airport, 63 ... Housing, 64 ... Abutting part, 65 ... Protruding part, 66 ... Elastic member, 67 ... Air space, 68,69 ... O-ring, 70 ... Pressing member, 71 ... Contact part 72 ... Air port 73 ... Housing 75 ... Projection part 76 ... Elastic member 77 ... Flange 78 ... Air space 79,80 ... O-ring 81 ... Valve element 82 ... Stopper part 8 DESCRIPTION OF SYMBOLS ... Elastic member, 85 ... Push pull solenoid, 86 ... Packing, 87 ... Exhaust port, 95 ... Surgical microscope, 99 ... Control circuit, 100 ... Air brake control part, 101 ... Air brake, 102 ... Air control valve, 103 ... Valve body, 104 ... shaft.

Claims (1)

A tilting mechanism that supports the holding unit that holds the medical instrument in a tiltable manner and a moving mechanism in which a plurality of arms that three-dimensionally move the holding unit supported by the tilting mechanism are linked via joints are linked. An articulated arm,
Installation means for supporting the articulated arm and arranging the tilt mechanism and the moving mechanism so that the tilt and the movement can be adjusted;
First braking means for fixing / releasing the joint of the tilt mechanism and the moving mechanism;
A second braking means for fixing / releasing rotation of the tilting mechanism around the central axis of the holding mechanism with respect to the holding part;
A first controller that selectively controls the first and second braking means;
A second control unit for controlling second braking means for fixing / releasing rotation of the tilting mechanism around the central axis of the tilting mechanism with respect to the holding unit;
A medical instrument holding device comprising:

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