JP4970844B2 - Medical device and torsional force release method - Google Patents

Description

  The present invention relates to a medical device having a medical device that supports various medical devices such as an endoscope, and torsional force that releases a twisted state of the rotating shaft when the medical device is twisted around the rotating shaft. It relates to the release method.

  Patent Document 1 discloses a structure for attaching an endoscope to a holding portion of a holding device. The insertion portion of the endoscope is fixed by being pressed by a spring biasing force of a compression spring from the side with respect to the axial direction of the insertion portion via a slide ring. Note that the slide ring can be released from the pressed state by pressing the push button, and the pressed state cannot be released without pressing the push button.

Patent Document 2 discloses a holding unit that rotatably holds an endoscope. The holding portion can easily rotate the insertion portion when a twisting force is applied to the insertion portion. Further, when the motor unit is attached, the motor unit is fixed to the holding portion.
JP-A-7-227398 JP 2002-2224016 A

  The structure for attaching an endoscope disclosed in Patent Document 1 cannot release the pressing state from the side of the insertion portion of the endoscope unless the pressing button is pressed. For this reason, when a force is applied in the twisting direction (around the axis of the insertion portion), the pressing state must be released by pressing the push button in order to rotate the insertion portion. That is, when the endoscope is fixed to the holding portion, even if a slight twist is applied to the insertion portion of the endoscope to rotate the endoscope, the endoscope cannot be rotated. And since one side becomes a fixed end, when the insertion part is made soft, the force due to torsion accumulates on the fixed end side and is not released, and a loop due to torsion may occur in the insertion part. Since the reaction force is generated so as to cancel the loop (release the force), the operability may be deteriorated, for example, other operations must be performed while maintaining the reaction force. That is, in the structure disclosed in Patent Document 1, there is only an option to switch between a state in which the endoscope is rotated and a state in which the endoscope is fixed, and the grip portion is rotated or fixed in accordance with the torsion of the insertion portion. It is not something that can be done. Moreover, even if it is formed in a structure that can rotate according to torsion, it is difficult to set the amount of torque to start rotating, and in order to correspond to all endoscopes, the amount of torque is set individually. There is a need. Even when the same type of endoscope is used, if the portion to which the torsion is applied is different, there are cases where the rotation is possible and cases where the rotation is not possible.

  On the other hand, when the endoscope is held in the rotatable holding portion disclosed in Patent Document 2, the insertion portion of the endoscope can be moved by applying a little twisting force to the insertion portion of the endoscope. It will rotate with respect to the holding part. That is, each time the insertion portion is twisted, the insertion portion of the endoscope is easily rotated. For this reason, when it is going to return an insertion part to the original state (releasing the force of a twist direction), reaction force does not arise depending on the amount of twist, and operativity may worsen.

  The present invention has been made to solve such a problem, and the object of the present invention is to rotate a medical instrument such as a distal end of an insertion portion of an endoscope into a patient or the like. The torsion (torque) generated when moved is appropriately released to provide a medical device with high operability, and the twisted state of the rotating shaft is released when the medical instrument is twisted around the rotating shaft. It is to provide a method for releasing torsional force.

In order to solve the above-described problem, a medical device according to the present invention includes a support mechanism that rotatably supports a holding unit that holds a medical instrument having a rotation shaft in an appropriate position around the rotation axis of the medical instrument, An operating mechanism that is provided in the holding unit and rotates the holding unit in the same direction as the rotation direction of the medical instrument, the holding unit including a first ring on which the medical instrument is disposed; A second wheel having a central axis common to the first wheel and rotatable or rotatable with respect to the first wheel about the central axis; and the first wheel and the second wheel. disposed between, and having a resistance generating mechanism which inhibits the rotation or pivoting between the first wheel and the second wheel.

The medical device further includes a control unit that is connected to the operation mechanism and controls the operation mechanism, and an instruction unit that is connected to the control unit and instructs the operation mechanism through the control unit. Is preferred.
By operating the operating means from the indicating means through the control means so as to release the torsion applied to the rotating shaft of the medical instrument, that is, for example by manual operation from the indicating means, the torsional force applied to the rotating shaft Can be released.

The medical instrument includes a base portion held by the holding portion, an elongated insertion portion extending from the base portion in the direction of the rotation axis and having a bending portion in the vicinity of a distal end portion, and an operation portion for bending the bending portion. It is preferable that the instruction unit is disposed in the operation unit.
For this reason, the reaction force that the operator must hold when the distal end portion of the insertion portion of the endoscope is rotated around its axis can be reduced.

In addition, the medical device is connected to the operation mechanism and controls the operation mechanism, and is connected to the control unit, detects rotation of the medical instrument around the rotation axis, and displays the rotation detection result. It is preferable to further include a detection mechanism that operates the operation mechanism through the control unit.
Based on the rotation detection result of the rotating shaft by the detection mechanism, the operation mechanism can be operated to a desired state through the control means. Therefore, the operator can automatically rotate the holding portion in the same direction as the rotation axis when the rotation axis is twisted one by one when the rotation axis is twisted or when a twist amount greater than a predetermined twist amount is applied to the rotation axis. The reaction force of the torsional force applied to the rotating shaft that must be maintained can be reduced.

The operation mechanism preferably includes a speed variable mechanism that varies the operation speed.
For this reason, the holding part can be rotated at a desired speed.

Further, the medical device includes a detection mechanism that detects rotation applied around the rotation axis of the medical instrument, an instruction unit that can manually or automatically set the operation of the operation mechanism, the detection mechanism, the operation mechanism, and the And a control unit connected to the instruction unit and configured to manually or automatically control the operation mechanism based on a setting of the instruction unit based on a rotation detection result of the medical instrument detected by the detection mechanism. Is preferred.
If the instruction means manually sets the torsion force applied to the rotating shaft by operating the operating means from the indicating means through the control means so as to release the torsion applied to the rotating shaft of the medical instrument. Can be released. Further, if the setting is automatically made by the instruction means, the operation mechanism can be operated to a desired state through the control means based on the rotation detection result of the rotation shaft by the detection mechanism. Therefore, the operator can automatically rotate the holding portion in the same direction as the rotation axis when the rotation axis is twisted one by one when the rotation axis is twisted or when a twist amount greater than a predetermined twist amount is applied to the rotation axis. The reaction force of the torsional force applied to the rotating shaft that must be maintained can be reduced.

In addition, the medical instrument has a base portion held by the holding portion, a long and narrow portion extending from the base portion in the direction of the rotation axis, having a curved portion in the vicinity of the distal end portion, and the rotation of which is detected by the detection mechanism. It is preferable that the endoscope includes an insertion portion and an operation portion that bends the bending portion.
For this reason, the reaction force that the operator must hold when the distal end portion of the insertion portion of the endoscope is rotated around its axis can be reduced.

In addition, in order to solve the above-described problem, a torsional force releasing method for releasing a torsional force when a medical instrument is twisted around the rotation axis is a method in which the rotation axis is moved while the medical instrument is held by a holding unit. Rotating about the rotation axis, rotating the holding portion in the same direction as the rotation direction of the rotation shaft so as to release a torsional force applied to the medical instrument with rotation around the rotation axis; It is characterized by comprising.
For this reason, the torsional force applied to the rotating shaft can be released by rotating the holding portion in the same direction as the rotating shaft.

In addition, the step of rotating the holding portion in the same direction as the rotation direction of the rotation shaft so as to release the torsional force applied to the medical instrument with the rotation around the rotation shaft is manually performed according to an operator's instruction. It is preferred to do so.
For this reason, it is possible to manually rotate the holding portion to a desired state to release the torsion applied to the rotating shaft.

In addition, in order to solve the above-described problem, a torsional force releasing method for releasing a torsional force when a medical instrument is twisted around the rotation axis is a method in which the rotation axis is moved while the medical instrument is held by a holding unit. Rotating about the rotation axis; detecting the rotation of the rotation axis; and detecting rotation of the rotation axis and rotating the rotation axis to release a torsional force applied to the medical device. A step of automatically rotating the holding portion in the same direction as the direction.
For this reason, since the twist applied to the rotating shaft can be automatically released, the force that the operator has to hold the rotating shaft can be reduced.

  According to the present invention, it is possible to appropriately release torque generated when a medical instrument such as a distal end portion of an insertion portion of an endoscope is rotated to be inserted into a patient or the like, and has high operability. A medical device and a method for releasing the twisting force when the medical instrument is twisted about its axis of rotation can be provided.

  The best mode for carrying out the present invention (hereinafter referred to as an embodiment) will be described below with reference to the drawings.

A first embodiment will be described with reference to FIGS.
As shown in FIGS. 1 and 2, a medical device 10 according to this embodiment includes a support device (support mechanism) 12, an electric bending endoscope (medical instrument) 14, a light source device 16, and a video processor 18. A control box (control means) 20, an operation unit 22, and a detection mechanism 24. The support device 12 is appropriately disposed on the right side or the left side of the bed 26. On the support device 12, an electric bending endoscope 14 is movably supported within a predetermined range, and a light source device 16, a video processor 18, and a control box 20 are placed.

  The electric bending endoscope 14 has an observation function and a treatment function in the body cavity. The light source device 16 supplies an illumination light beam emitted from the front surface of the distal end portion of the insertion portion 34 described later of the endoscope 14. The video processor 18 receives a video signal from the imaging unit 42 described later and performs predetermined signal processing. The control box 20 includes a first system and a second system. The first system is for operating an electromagnetic valve unit for air supply and water supply when the endoscope 14 is used for observation and treatment. The second system is not for controlling the endoscope 14 but for operating an operation mechanism 250 (see FIG. 10) provided separately. The second system will be described later.

  The solenoid valve unit of the first system of the control box 20 controls air supply / water supply and suction operations via an air supply / water supply conduit 52 and a suction conduit 54, which will be described later, provided inside the insertion portion 34. The system controller of the control box 20 is electrically connected to the light source device 16 and the video processor 18.

  As shown in FIG. 1, a fluid control cassette 28 is detachably attached to the electromagnetic valve unit of the control box 20. The fluid control cassette 28 includes a flow rate adjusting mechanism having a valve body related to air supply, water supply, and suction. The solenoid valve unit drives the flow rate adjusting mechanism of the fluid control cassette 28.

  As shown in FIGS. 1 and 2, the endoscope 14 includes, for example, a substantially cylindrical or substantially columnar base portion 32, an elongated insertion portion 34 extending from one side surface of the base portion 32, and a base portion 32. An elongated universal cable 36 extending from the other side surface is integrally provided.

  As shown in FIG. 3, a pair of slide slides 190 (see FIGS. 7 and 8) for locking an endoscope holding unit 100 (see FIG. 1) to be described later are fitted on the outer periphery of the base 32. A fitting groove 32a is formed.

  The insertion portion 34 and the universal cable 36 are disposed on the same axis with respect to the base portion 32. Both the insertion portion 34 and the universal cable 36 are appropriately flexible. As shown in FIGS. 1 and 2, the end of the universal cable 36 is optically connected to the light source device 16 and electrically connected to the video processor 18. The endoscope 14 further includes an operation unit 22 for bending a bending portion 34b described later, and for supplying air and water and sucking. The operation unit 22 is electrically connected to the control box 20.

  The insertion portion 34 is connected to the distal end hard portion 34a formed on the foremost side thereof, the bending portion 34b connected to the proximal end side of the distal end hard portion 34a, and the proximal end side of the bending portion 34b. And a flexible tube portion 34c formed in an elongated shape. The distal end hard portion 34a incorporates an imaging unit 42 including an imaging optical system (not shown), an imaging element such as a CCD, and the like. The bending portion 34b is configured to bend up and down and right and left by drive control of a bending drive mechanism 44, which will be described later, which is controlled in accordance with a bending operation instruction from the operation unit 22.

  The base portion 32 incorporates a bending drive mechanism 44 for bending the bending portion 34b. The insertion portion 34 extending from the base portion 32 has flexibility for insertion into a conduit in a body cavity. The light source device 16 is optically connected to the end of the universal cable 36 extended from the other side of the base 32, and the video processor 18 is electrically connected.

  Further, an angle wire 48 that is driven by receiving a driving force from the driving mechanism 44 is inserted into the insertion portion 34. Although not shown, the angle wire 48 is connected to the distal end side of the bending portion 34b. For this reason, when the angle wire 48 is driven by receiving the driving force from the bending drive mechanism 44 of the base portion 32, the bending portion 34b is bent in the vertical and horizontal directions.

  An air / water supply conduit 52 and a suction conduit 54 are inserted through the insertion portion 34. An air / water supply port is opened at the tip of the air / water supply conduit 52, and a suction port is opened at the tip of the suction conduit 54. At the base end of the air / water supply conduit 52, the air / water supply port is opened at the base portion 32, and at the base end of the suction conduit 54, the suction port is opened at the base portion 32. One end of a tube 82 to be described later is connected to the air / water supply port at the proximal end of the air / water supply conduit 52 and the suction port at the proximal end of the suction conduit 54. That is, one end of the tube 82 is connected to the base portion 32. Further, a forceps conduit 56 through which a treatment tool such as forceps is inserted is inserted into the insertion portion 34. A forceps port is opened at the front side of the distal end of the forceps conduit 56. The proximal end of the forceps conduit 56 is a proximal end portion of the insertion portion 34 and communicates with a forceps insertion port 56 a formed in the vicinity of the base portion 32. For this reason, a treatment instrument such as a forceps inserted from the forceps insertion opening 56 a can be inserted through the forceps conduit 56 and protrude from the front surface on the distal end side of the insertion portion 34.

The bending drive mechanism 44 is a bending drive means configured by the electric motor 62 and various members formed to transmit and disconnect the power generated from the electric motor 62. The bending drive mechanism 44 includes an electric motor 62, a motor control unit 64, an encoder 66, and a reduction gear 68.
The electric motor 62 generates a driving force by rotation. The motor control unit 64 performs overall control of the bending drive mechanism 44 including the electric motor 62. The encoder 66 converts the operation state such as the rotation speed and rotation amount of the drive shaft of the electric motor 62 into data. The reduction gear 68 reduces the rotational power of the drive shaft of the electric motor 62.

  A light guide 72 is connected to the light source device 16. The light guide 72 extends through the universal cable 36, the base portion 32, and the insertion portion 34 to the tip of the insertion portion 34. For this reason, the illumination light beam supplied from the light source device 16 is emitted from the distal end of the insertion portion 34 via the light guide 72.

  A signal cable 76 that transmits a video signal from the imaging unit 42 is connected to the video processor 18. The signal cable 76 extends from the imaging unit 42 at the distal end of the insertion portion 34, passes through the insertion portion 34, the base portion 32, and the universal cable 36 and is connected to a predetermined terminal of the video processor 18. Yes. In addition, a control panel (monitor) 80 is electrically connected to the video processor 18. A video signal output from the video processor 18 is transmitted to the control panel 80. In response to this signal, the control panel 80 displays a predetermined endoscopic image on its display unit. In addition to the display unit, the control panel 80 is provided with an operation unit such as a touch panel on the display surface of the display unit. Therefore, the surgeon can input various operation instructions from the operation unit of the control panel 80.

  The fluid control cassette 28 of the control box 20 is connected to a pair of tubes 82 communicating with the air / water supply conduit 52 and the suction conduit 54 of the insertion portion 34. That is, the electromagnetic valve unit is communicated with the distal end of the insertion portion 34 via the fluid control cassette 28, the tube 82, the air / water supply conduit 52, and the suction conduit 54. For this reason, when the solenoid valve unit is driven and the air supply / water supply operation is performed from the fluid control cassette 28, the air supply / air supply operation is performed from the distal end surface of the insertion portion 34 through the air supply / water supply conduit 52 of the tube 82, the base portion 32 and the insertion portion 34. Water can be sent. In addition, when the electromagnetic valve unit is driven to perform a suction operation, suction can be performed from the distal end surface of the insertion portion 34 through the suction portion 54 and the tube 82 of the insertion portion 34 and the base portion 32. In addition, the tube 82 is formed of a hollow flexible resin material, whereas the universal cable 36 is provided with a light guide 72 and a signal cable 76 so that it is more flexible than the tube 82. hard. That is, the tube 82 is formed with a low torque transmission rate with respect to the universal cable 36.

  The support device 12 includes a support device base 92, an arm 94, first and second support portions 96 and 98, and an endoscope holding unit 100. The support device base 92 is a cart configured with, for example, casters. The support device base 92 houses the light source device 16, the video processor 18, and the control box 20, and is movable on the floor in a state where these are placed. One end of the arm 94 is supported by the support device base 92. In addition, an endoscope holding unit 100 is disposed at the other end of the arm 94. Therefore, the arm 94 supports the endoscope 14 and moves the endoscope 14 within a predetermined range. The first and second support portions 96 and 98 are disposed on the arm 94, for example.

  Each of the first and second support portions 96 and 98 includes a bundle retainer 102. For example, a universal cable 36 and a tube 82 are disposed on one bundle retainer 102 of the first and second support portions 96 and 98. For example, a universal cable 36 and a tube 82 are disposed in the other bundle retainer 102. These bundle retainers 102 allow movement of the universal cable 36 and the tube 82 along the axial direction, respectively, and also allow rotation / rotation around the axis.

  Since the arm 94 may hold the insertion portion 34 of the endoscope 14 in an inclined state, the arm 94 can be inclined by one or a plurality of joints. In addition, since a large force may be applied to the joint, it is preferable that a fixing mechanism for fixing the joint in a desired state, such as an electromagnetic brake, is provided. For this reason, the endoscope 14 can be fixed at a desired angle within a predetermined range. Further, the base portion 32 of the endoscope 14 is supported by the endoscope holding portion 100 so as to be rotatable about the axis of the insertion portion 34 and the universal cable 36.

  As shown in FIG. 4, the operation unit 22 is provided with an operation stick 112 for instructing a bending operation and first to fourth operation buttons (instruction means) 114a, 114b, 114c, 114d. . The operation stick 112 is biased in the center direction, and can be tilted from the center in an appropriate direction such as four directions orthogonal to each other. By this operation, the bending portion 34b of the insertion portion 34 of the endoscope 14 is bent. In addition, an activation switch of the medical device 10 is assigned to the first operation button 114a.

The second operation button 114b is a mode switch. The third and fourth operation buttons 114c and 114d can be used as mode switching switches at the time of setting, and can be used as operation switches at the time of use such as surgery.
For example, the second operation button 114b includes a manual operation (manual) mode (described later) in which the base portion 32 of the endoscope 14 is manually rotated, and an automatic operation (auto) mode (electric operation mode) in which the endoscope 14 is automatically rotated. ) Mode selector switch is assigned. In the manual operation mode, the third and fourth buttons 114c and 114d are assigned operation switches such as a forward / reverse switch for the drive shaft of the motor 252. In addition, a setting switch for selecting a follow-up rotation mode and a constant angle rotation mode, which will be described later, is assigned to the third and fourth buttons 114c and 114d in the automatic operation mode. The third and fourth buttons 114c and 114d are assigned forcible stop switches that forcibly stop the rotation of the drive shaft of the motor 252 during surgery performed after various settings.

In addition, although not shown, the operation unit 22 is preferably provided with various operation buttons for generating a bending operation instruction, air / water supply, and a suction operation instruction signal.
The operation unit 22 is electrically connected to the control box 20 by an electric cable 22a (see FIG. 2). For this reason, an operation instruction signal generated by operating each operation member of the operation unit 22 is transmitted to the first system and the second system of the control box 20 via the electric cable 22a. The electric cable 22a is electrically connected to the system controller.

  As shown in FIG. 5, the second system of the control box 20 includes a control circuit 122, a switch input circuit 124, a rotation drive circuit 126, and a drive stop circuit 128. The switch input circuit 124, the rotation drive circuit 126, and the drive stop circuit 128 are electrically connected to the control circuit 122, respectively. Further, the switch input circuit 124 is electrically connected to the operation unit 22 outside the control box 20. The control circuit 122 is electrically connected to a phototransistor 136e described later of the detection mechanism 24. The rotation drive circuit 126 and the drive stop circuit 128 are electrically connected to the operation mechanism 250.

  Therefore, when the control box 20 receives various instruction signals from the operation unit 22, the control box 20 appropriately transmits control signals for performing control corresponding to the instruction signals to the devices of the first system and the second system. To do. In addition, the control box 20 receives various operation instruction signals from the operation unit of the control panel 80, and appropriately transmits control signals for performing control corresponding to the instruction signals to each device.

  As shown in FIG. 6, the detection mechanism 24 includes a housing 132, a pair of bearings 134, and a sensor 136. The housing 132 is formed with a through hole 132a through which the insertion portion 34 of the endoscope 14 is inserted. A bearing 134 that rotatably supports the insertion portion 34 of the endoscope 14 is disposed in the through hole 132a. A sensor 136 is disposed in the housing 132. The sensor 136 of the detection mechanism 24 is electrically connected to the control box 20 by an electric cable 24a. For this reason, the output of the sensor 136 is input to the control box 20. The operation of the sensor 136 can be controlled by the control box 20. The casing 132 is disposed so as to be prevented from rotating with respect to the bed 26, for example, the lower side in FIG. 1 is formed to be heavier than the upper side. A gravity sensor (not shown) is provided in the housing 132. By this gravity sensor, the casing 132 can be controlled so as to always keep a predetermined direction on the lower side.

The sensor 136 includes a light emitting diode (light emitting element) 136a, a lens 136b, a slit disk 136c, a fixed slit 136d, and a phototransistor (light receiving element) 136e.
A light emitting diode 136 a is fixed to the housing 132. The light emitting diode 136 a emits light along the axial direction of the through hole 132 a of the housing 132, that is, along the axial direction of the insertion portion 34 of the endoscope 14. A lens 136b is disposed on the optical path of the light emitting diode 136a. The lens 136b focuses light at a predetermined focal length. A slit disk 136c is disposed on the optical path through the lens 136b. The slit disk 136 c is disposed on the outer periphery of the insertion portion 34 of the endoscope 14. In the slit disk 136c, slits are formed radially from the center. A fixed slit 136d is disposed behind the slit disk 136c. A phototransistor 136e is disposed behind the fixed slit 136d. The phototransistor 136e detects the light passing through the fixed slit 136d, and detects the rotation direction and the rotation amount of the insertion portion 34 of the endoscope 14 with respect to the initial position.

As shown in FIGS. 7 and 8, the endoscope holding unit 100 includes first and second support mechanisms 142 and 144 and a brake mechanism (resistance force generating mechanism) 146.
The first support mechanism 142 is mounted in a state where the cylindrical inner ring (rotating unit) 152 in which the base portion 32 of the endoscope 14 is disposed and the base portion 32 of the endoscope 14 is disposed in the inner ring 152. And a stopper 154. The second support mechanism 144 includes a cylindrical cover (connecting portion) 162 connected to the arm 94 of the support device 12 and a cylindrical outer ring (supporting portion) 164 disposed inside the cover 162. I have.

  On the outer periphery of the cover 162, an arm mounting shaft 162a to be mounted on the arm 94 (see FIGS. 1 and 2) is formed. For this reason, a cover 162 is attached to the tip of the arm 94 by an arm mounting shaft 162a. An outer ring 164 is fixed inside the cover 162.

  An inner ring 152 is disposed inside the outer ring 164. A bearing 172 is fixed to the inner peripheral surface of the outer ring 164. That is, a bearing 172 is disposed between the inner peripheral surface of the outer ring 164 and the outer peripheral surface of the inner ring 152. Each of the bearings 172 is disposed in a recess 164 a formed on the inner peripheral surface of the outer ring 164 via an adjustment shim 166 that prevents rattling of the bearing 172. Further, a male screw portion 152 a is formed on the outer peripheral surface of the lower end portion of the inner ring 152. A ring-shaped stopper screw 176 can be screwed into the male screw portion 152a. For this reason, the cylindrical collar 178 is disposed so as to support the bearing 172 via the adjustment shim 179 while preventing rattling, and the collar 178 is fixed by the stopper screw 176 to fix the bearing 172. . Therefore, the inner ring 152 can be rotated or rotated with respect to the outer ring 164 with the central axis as a support shaft. That is, the central axes of the inner ring 152 and the outer ring 164 are common.

  A flange portion 180 is formed at the upper end of the inner ring 152 so as to protrude radially outward with respect to the central axis of the inner ring 152. The flange portion 180 is formed with a pair of first and second recesses 180a and 180b in which a lower end portion of a stopper pin 196, which will be described later, can be disposed. The first recess 180a is formed closer to the center of the inner ring 152 than the second recess 180b. The first recess 180 a is formed to a depth up to the point of passing through the flange portion 180. The second recess 180b is formed shallower than the first recess 180a.

  As shown in FIG. 8, the flange portion 180 is formed with a protruding portion 182 that protrudes outward in the radial direction symmetrically with respect to the central axis. Edge portions 184 bent toward the upper side in FIG. 8 are formed at the outer end portions of the projecting portions 182.

  A stopper 154 is disposed on the flange portion 180. The stopper 154 includes a top plate 188, a slide plate 190, a tube 192, a compression spring 194, a stopper pin 196, and a knob 198.

  The top plate 188 is fixed to the flange portion 180 in a state where it is placed on the edge portion 184 of the flange portion 180. A slide plate 190 is disposed between the lower surface of the top plate 188 and the upper surface of the flange portion 180. These slide plates 190 can slide between the lower surface of the top plate 188 and the upper surface of the flange portion 180.

  The top plate 188 is formed with a substantially rectangular through hole 188a. The longitudinal directions of these through holes 188 a are radial directions with respect to the central axis of the inner ring 152.

  A through hole 190 a is formed in the slide plate 190. The lower end portion of the tube 192 is disposed in the through hole 190a. The slide plate 190 is fixed to the tube 192 by the pins 192a. A collar 193 is disposed between the slide plate 190 and the tube 192. That is, the tube 192 is erected from the slide plate 190 through the through hole 188 a of the top plate 188. Therefore, the tube 192 can slide in the through hole 188 a of the top plate 188. Then, when the tube 192 is moved along the through hole 188a, the slide plate 190 is slid with respect to the top plate 188 within a predetermined range.

  A compression spring 194 is disposed inside the tube 192. Further, a stopper pin 196 is disposed inside the compression spring 194 in a state of being biased toward the lower end portion of the tube 192. A knob 198 is fixed to the upper end portion of the stopper pin 196 by a set screw 199 in a state of protruding upward from the upper end portion of the tube 192.

As shown in FIG. 9A, the brake mechanism 146 is provided so as to inhibit the rotation between the inner ring 152 and the outer ring 164.
As shown in FIG. 9B, a click plate (engagement portion) 212 is integrally fixed to the upper end surface of the outer ring 164. The click plate 212 is formed with a plurality of V-shaped portions 212 a having a substantially V-shaped cross section and a plurality of chevron portions 212 b having a cross-sectional shape adjacent to each other. The V-shaped portion 212 a and the chevron portion 212 b are formed over the entire circumference of the upper surface of the click plate 212. That is, the upper surface of the outer ring 164 is formed in a so-called jagged shape.

  A recess 220 is formed in the flange portion 180 of the inner ring 152. A through hole 222 is formed in the recess 220. A leaf spring (biasing portion) 224 is fixed to the recess 220 of the flange portion 180 of the inner ring 152 with a screw 225 so as to cover the through hole 222 from above. The leaf spring 224 presses the click ball 226 against the click plate 212 of the outer ring 164 via a support member 228 described later. The urging force (pressing force) of the support member 228 by the plate spring 224 is appropriately set depending on the material, the plate thickness, the distance from the screw 225, and the like.

  A click ball (contact portion) 226 is placed on one of the V-shaped portions 212 a of the click plate 212. A part of the click ball 226 is accommodated in the through hole 222 of the recess 220 of the flange portion 180 of the inner ring 152. A support member 228 is disposed between the click ball 226 and the leaf spring 224. The click ball 226 always moves along the axial direction of the through hole 222 in a state where a part of the click ball 226 is accommodated in the through hole 222 of the recess 220 of the inner ring 152.

When the inner ring 152 rotates with respect to the outer ring 164, the click ball 226 is gradually moved upward by the chevron 212 b of the click plate 212 and presses the support member 228 against the leaf spring 224. For this reason, the click ball 226 can be accommodated in the adjacent V-shaped portion 212 a over the one chevron 212 b by the rotation of the inner ring 152.
In order to prevent dust and the like from entering the recess 220 of the inner ring 152, it is preferable that a blindfold plate 230 is fixed to the recess 220 with a screw 231.

  As shown in FIG. 10, an operating mechanism 250 that operates the inner ring 152 relative to the outer ring 164 is disposed between the inner ring 152 and the outer ring 164. The operation mechanism 250 includes a motor 252 disposed on a motor base 165 formed integrally with the outer ring 164, a coupling 254, a first gear (variable speed mechanism) 256, and a collar 178 of the inner ring 152. And a second gear (variable speed mechanism) 258 provided on the outer periphery. The motor 252 is arranged to have its axis in a direction parallel to the axial direction of the insertion portion 34 of the endoscope 14. Both the first gear 256 and the second gear 258 are, for example, spur gears. The first gear 256 and the second gear 258 can rotate with respect to each other by an appropriate gear ratio (variable speed mechanism). That is, the inner ring 152 can rotate with respect to the outer ring 164.

  The motor 252 is electrically connected to a rotation drive circuit 126 and a drive stop circuit 128 described later of the control box 20. For this reason, the rotation direction and the number of rotations of the motor 252 are controlled by the control box 20.

  A micro switch 262 is attached to the outer ring 164. The micro switch 262 is electrically connected to the control box 20. On the outer periphery of the collar 178, protrusions 178a are formed at a predetermined interval. These protrusions 178 a are brought into contact with the microswitch 262 as the inner ring 152 and the collar 178 rotate. For this reason, rotation of the motor 252 is controlled by the contact position and the number of times of contact of the protrusions 178a.

  The operation mechanism 250 formed in this manner covers the motor 252, the outer ring 164, the first gear 256, and the like, and is covered by a cover 162 (not shown in FIG. 8) connected to the arm 94 of the support device 12. It has been broken.

Next, the operation of the medical device 10 according to this embodiment will be described.
First, the base 32 of the endoscope 14 is attached to the endoscope holding unit 100 of the support device 12. Here, it is assumed that the slide plate 190 of the endoscope holding unit 100 is in the state shown in FIGS. In this state, the slide plate 190 is disposed closer to the central axis than the inner peripheral surface of the inner ring 152, so that the base 32 of the endoscope 14 cannot be inserted inside the inner ring 152.

  Therefore, the knob 198 of the stopper 154 is gripped and the stopper pin 196 is moved upward in FIG. 8 against the urging force of the compression spring 194. For this reason, the engagement between the lower end of the stopper pin 196 and the second recess 180b is released. In this state, the tube 192 is moved radially outward along the longitudinal direction of the through hole 188a of the top plate 188. That is, the tube 192 of the stopper 154 is moved from the inner side end of the through hole 188a to the outer side end. Then, the slide plate 190 is drawn into the inner peripheral surface of the inner ring 152 and is slid to the lower side of the top plate 188. Release knob 198 in this state. Then, the lower end of the stopper pin 196 is engaged with the first recess 180a by the urging force of the compression spring 194. That is, the base 32 of the endoscope 14 can be disposed inside the inner ring 152.

Then, the base 32 is inserted into the inner ring 152 from the upper side or the lower side of the endoscope holding unit 100. At this time, the slide plate 190 is fitted into the pair of fitting grooves 32 a of the base 32. In this case, the knob 198 is gripped and the stopper pin 196 is moved upward in FIG. 5 against the urging force of the compression spring 194. For this reason, the engagement between the lower end of the stopper pin 196 and the second recess 180b is released. In this state, the tube 192 is moved radially inward along the longitudinal direction of the through hole 188a of the top plate 188. That is, the tube 192 of the stopper 154 is moved from the outer side end portion of the through hole 188 a to the inner side end portion, and the slide plate 190 is protruded to the inner peripheral surface side of the inner ring 152. The slide plate 190 is inserted into the pair of fitting grooves 32 a of the base 32 of the endoscope 14. Release knob 198 in this state. Then, the lower end of the stopper pin 196 is engaged with the first recess 180a by the urging force of the compression spring 194. That is, the base 32 of the endoscope 14 is attached to the inner side of the inner ring 152. At this time, since the first recess 180a is formed sufficiently deeper than the second recess 180b, the stopper pin 196 is difficult to come off. For this reason, even when a large force is applied to the endoscope holding portion 100 via the base portion 32 of the endoscope 14, the state in which the slide plate 190 is inserted into the fitting groove portion 32a of the base portion 32 is maintained. Is done.
The endoscope 14 is used in such a state that it is held by the endoscope holding unit 100 in this way.

  Then, after the main switch of the medical device 10 is activated, the first operation button (activation switch) 114a of the operation unit 22 is pressed. Then, in the medical device 10, the electric operation of the bending portion 34 b of the insertion portion 34 of the endoscope 14 can be performed, and the operation mechanism 250 of the endoscope holding portion 100 of the support device 12 can be operated. The surgeon operates the second operation button 114b of the operation unit 22 to select the manual operation mode and the automatic operation mode.

  Here, when the automatic operation mode is selected, a follow-up rotation that releases the torque applied to the insertion portion 34 by rotating the base portion 32 following the turning operation of the distal end portion of the insertion portion 34 of the endoscope 14 one by one. A mode can also be selected, and torque is applied when the rotation angle of the base 32 detected by the endoscope holding unit 100 and the rotation angle of the insertion unit 34 detected by the detection mechanism 24 reach an appropriate angle difference. It is also possible to select a constant angle rotation mode that operates so as to release. In preparation for the case of selecting a constant angle rotation mode to be operated when the rotation angle of the insertion portion 34 becomes an appropriate angle difference, an angle difference for operating the operation mechanism 250 is set.

  Here, the detection mechanism 24 is disposed so as to prevent rotation with respect to the bed 26. That is, the casing 132 itself of the detection mechanism 24 is prevented from rotating as the insertion portion 34 of the endoscope 14 rotates. At this position, an initial position in the rotational direction of the insertion portion 34 of the endoscope 14 with respect to the detection mechanism 24 is set. This initial position is a state in which no rotational force is applied to the insertion portion 34 of the endoscope 14. That is, a predetermined position of the base 32 of the endoscope 14 with respect to the endoscope holding unit 100 is set as an initial position. It is also preferable to automatically set the state at the time when the first operation button 114a of the operation unit 22 is pressed as the initial position. Further, when the initial position is set again, it is also preferable that the initial position is set by pressing the first operation button 114a of the operation unit 22 briefly.

  The detection mechanism 24 keeps the light emitting diode 136a to emit light immediately after the first operation button 114a of the operation unit 22 is pressed. Light emitted from the light emitting diode 136a enters the phototransistor 136e through the lens 136b and the slit disk 136c and the fixed slit 136d. The phototransistor 136e transmits the detection data to the control circuit 122 through the electric cable 24a at appropriate time intervals. The detection data transmission time interval can be set as appropriate, for example, several times to several tens of times or several tens of times per second. Note that a predetermined position in the rotational direction of the insertion portion 34 of the endoscope 14 is set as the initial position of the detection mechanism 24 by the setting of the initial position described above.

  The control panel 80 displays data (angle) for detecting the position of the base 32 of the endoscope 14 with respect to the initial position set by the endoscope holding unit 100, and data (angle) detected by the detection mechanism 24. ) Is displayed. In addition, the display unit of the control panel 80 displays how much the insertion unit 34 of the endoscope 14 is rotated with respect to the base 32 of the endoscope 14.

  The distal end portion of the insertion portion 34 of the endoscope 14 shown in FIGS. 1 and 2 is introduced to a desired position such as a conduit in the body cavity. At this time, in addition to operating the operation stick 112 of the operation unit 22 to bend the bending portion 34b, as one technique for facilitating insertion, the operator grasps the insertion portion 34 and moves it around the axis of the insertion portion 34. Sometimes inserted while rotating or rotating. When the insertion portion 34 is thus rotated, the turning force is transmitted from the insertion portion 34 to the base portion 32. That is, the rotational force is transmitted to the base portion 32 held by the endoscope holding portion 100 as the insertion portion 34 rotates. For this reason, the rotational force is transmitted from the base 32 to the inner ring 152 through the slide plate 190.

  The inner ring 152 tends to rotate with respect to the outer ring 164 held by a cover 162 fixed to the arm 94. In this case, the click ball 226 that has been pressed against both slopes of the V-shaped portion 212 a by the leaf spring 224 via the support member 228 is pressed against one slope of the V-shaped portion 212 a by the through hole 222 of the inner ring 152. The The click ball 226 tries to climb the slope of the V-shaped portion 212a, that is, the slope of the mountain-shaped portion 212b. Then, the click ball 226 presses the leaf spring 224 upward via the support member 228.

When a force equal to or greater than a predetermined force is applied to the inner ring 152, the click ball 226 elastically deforms the leaf spring 224 against the urging force and gets over the chevron 212b. That is, the click ball 226 is accommodated in the adjacent V-shaped portion 212a. When a state where a force equal to or greater than a predetermined force is applied to the inner ring 152 is maintained, the click ball 226 further repeats the action of getting over the adjacent chevron 212b and being accommodated in the adjacent V-shaped portion 212a. The inner ring 152 rotates with respect to the outer ring 164 while a force exceeding a predetermined force is continuously applied.
When the inner ring 152 rotates with respect to the outer ring 164, the sound and vibration when the leaf spring 224 is brought into contact with the recess 220 of the inner ring 152 due to its elastic force, the click ball 226 has a V-shaped portion 212a. Sounds and vibrations are generated when being housed. That is, a click feeling can be obtained.

  On the other hand, even if a force equal to or less than a predetermined force is applied to the inner ring 152, the click ball 226 pressed downward by the leaf spring 224 via the support member 228 cannot get over the chevron 212b. Therefore, even if a force equal to or less than a predetermined force is applied to the inner ring 152, the rotation with respect to the outer ring 164 is prevented.

  Here, the end of the universal cable 36 is connected to the light source device 16 and the video processor 18. Further, the end of the tube 82 is connected to the control box 20 in a state in which the rotation is prevented. For this reason, there is a limit to the amount of rotation of the universal cable 36 and the tube 82. That is, there is a limit to the amount of rotation of the base portion 32 and the insertion portion 34. Therefore, when the surgeon grasps the insertion portion 34 and rotates the insertion portion 34, a reaction force is exerted to return the rotation. On the other hand, the surgeon continues to exert a turning force against the reaction force so as to keep the inserted portion 34 rotated.

  Here, when the insertion portion 34 is rotated from the pivoted state to the original pivoted state, the click ball 226 accommodated in the V-shaped portion 212 a of the brake mechanism 146 is a plate through the support member 228. The action of getting over the chevron 212b is repeated while the spring 224 is elastically deformed against the biasing force. Thus, when the inner ring 152 is rotated with respect to the outer ring 164, the click ball 226 must overcome the chevron 212b against the urging force of the leaf spring 224. Difficult braking action occurs. Then, each time the click ball 226 passes over the chevron 212b, the reaction energy for the rotation is consumed. Therefore, the rotation for returning the rotation of the insertion portion 34 to the original rotation state is energy. It becomes moderate with consumption.

  When the insertion portion 34 is rotated about its axis, a force is transmitted to the base portion 32 and rotated. However, even if the universal cable 36 is rotated about its axis and the force is transmitted to the base portion 32, the base portion 32 is rotated. It may not move. This is generally caused by the fact that the universal cable 36 is softer than the insertion portion 34 and thus it is difficult to transmit force. For this reason, when a torque sufficient to rotate the base 32 is applied to the base of the universal cable 36, the base 32 is rotated and the insertion portion 34 is also rotated.

  For this reason, the endoscope holding unit 100 according to this embodiment rotates the base 32 when the insertion unit 34 is rotated about its axis, but even if the universal cable 36 is rotated about its axis. The base 32 does not rotate, but the base 32 rotates when a force greater than or equal to a predetermined force is applied, and the rotation of the base 32 is stopped even when a force less than the predetermined force is applied.

It is necessary to release the surgeon from such a reaction force from the insertion portion 34. Hereinafter, an operation when the manual operation mode and the automatic operation mode are selected by the second operation button 114b of the operation unit 22 to release the burden on the operator will be described.
Here, first, an operation when the operating portion 22 is manually released to release the amount of torque generated when the insertion portion 34 of the endoscope 14 is rotated will be described.

  The manual operation mode is selected by pressing the second operation button 114b of the operation unit 22. This signal is input to the switch input circuit 124 in the control box 20 via the electric cable 22a. The display unit of the control panel 80 displays that the manual operation mode has been selected.

  In this state, the operator rotates the insertion portion 34 of the endoscope 14. Then, the detection mechanism 24 detects the rotation angle and transmits the data to the control circuit 122. At this time, the control circuit 122 calculates and compares the angle of the base 32 with respect to the rotation angle of the insertion portion 34 of the endoscope 14 at appropriate time intervals. This data is displayed on the display unit of the control panel 80.

  Here, the operator of the operation unit 22 operates the third operation button 114c and the fourth operation button 114d to operate the operation mechanism 250 of the endoscope holding unit 100. A signal from the operation unit 22 is input to the control circuit 122 through the switch input circuit 124. Then, the control circuit 122 transmits a signal to the rotation drive circuit 126. A signal is sent from the rotation drive circuit 126 to the motor 252 of the operation mechanism 250 to rotate the drive shaft of the motor 252.

  When the drive shaft of the motor 252 rotates, the first gear 256 rotates via the coupling 254. As the first gear 256 rotates, the second gear 258 rotates. That is, the inner ring 152 rotates with respect to the outer ring 164. The amount of rotation of the inner ring 152 at this time is obtained by the relationship between the micro switch 262 and the protrusion 178a. The micro switch 262 transmits the data signal of the direction and the number of times the protrusion 178a touches to the drive stop circuit 128.

  The operator stops the operation of the third operation button 114c and the fourth operation button 114d when the rotational torque amount of the insertion portion 34 reaches a desired state.

  At this time, the universal cable 36 is disposed in the bundle retainer 102 and is formed long. For this reason, the rotation of the universal cable 36 and the movement in the axial direction are allowed.

  Next, an operation for automatically releasing the torque amount generated when the insertion portion 34 of the endoscope 14 is rotated will be described.

  The second operation button 114b of the operation unit 22 is pressed to select the automatic operation mode. This signal is input to the switch input circuit 124 in the control box 20 via the electric cable 22a. The control panel 80 displays that the automatic operation mode has been selected. Further, here, first, a constant angle rotation mode in which torque is released when an appropriate angle is reached is selected.

  The operator rotates the insertion portion 34 of the endoscope 14. Then, the detection mechanism 24 detects the rotation angle and transmits the data to the control circuit 122. At this time, the control circuit 122 calculates and compares the angle of the base 32 with respect to the rotation angle of the insertion portion 34 of the endoscope 14 at appropriate time intervals. When the angle difference exceeds a predetermined angle set in advance after pressing the first operation button 114a, the operation mechanism 250 is operated.

  That is, the control circuit 122 transmits a signal to the rotation drive circuit 126. A signal is sent from the rotation drive circuit 126 to the motor 252 of the operation mechanism 250 to rotate the drive shaft of the motor 252. When the drive shaft of the motor 252 rotates, the first gear 256 rotates via the coupling 254. As the first gear 256 rotates, the second gear 258 rotates. That is, the inner ring 152 rotates with respect to the outer ring 164. The amount of rotation of the inner ring 152 at this time is obtained by the relationship between the micro switch 262 and the protrusion 178a. The micro switch 262 transmits the data signal of the direction and the number of times the protrusion 178a touches to the drive stop circuit 128. The control circuit 122 transmits a signal as to whether or not to stop the rotation of the drive shaft of the motor 252 through the rotation drive circuit 126.

  Even when the automatic operation mode is set, if it is desired to stop the rotation of the drive shaft of the motor 252, either the third operation button 114 c or the fourth operation button 114 d is pressed and the motor 252 is pressed. The rotation of the drive shaft is forcibly stopped.

  When the automatic operation mode is selected and the follow-up rotation mode in which the base portion 32 is rotated according to the rotation operation of the insertion portion 34 is selected, the operation mechanism 250 is rotated one by one with respect to the angle detected by the detection mechanism 24. Let For this reason, even if the surgeon tries to rotate the distal end portion of the insertion portion 34, the operation can be performed only with a small change in torque from the initial state.

  Further, the operator can appropriately change from the manual mode to the automatic mode or from the automatic mode to the manual mode during the operation. In this case, switching is performed by pressing the second operation button 114b. Note that when the manual section is switched to the automatic mode when the insertion section 34 is held in a state where torque is applied, the base section 32 of the endoscope 14 automatically rotates so as to release the torque.

As described above, according to this embodiment, the following can be said.
The torque generated when the distal end portion of the insertion portion 34 of the endoscope 14 is rotated around its axis can be released manually or automatically. For this reason, when the operator must maintain the rotation state against the torque generated at the distal end portion of the insertion portion 34 of the endoscope 14 during surgery or the like, the amount of torque is appropriately reduced. Can do. Therefore, the burden on the operator that the operator must hold the distal end portion of the insertion portion 34 against the torque of the insertion portion 34 can be greatly reduced.

  In this embodiment, it has been described that the setting state of the operation unit 22 is displayed on the control panel 80. For example, a display unit (not shown) is provided on the operation unit 22 to appropriately set items set by the operation unit 22. Can also be displayed.

  Further, in the present embodiment, the detection mechanism 24 has been described as the configuration illustrated in FIG. 6, but is not limited thereto, and for example, the configuration illustrated in FIG. 11 is also preferable.

  As shown in FIG. 11, the sensor 136 of the detection mechanism 24 includes a light emitting element 136a, a lens 136b, and an image sensor 136e. The light emitting element 136a is, for example, a light emitting diode. The light emitting element 136 a emits light toward the insertion portion 34 of the endoscope 14. The lens 136b focuses the light reflected from the outer periphery of the insertion portion 34 of the endoscope 14. The image sensor 136e receives the light focused by the lens 136b. In this case, when light is emitted from the light emitting element 136a to the insertion portion 34, it is also preferable to irradiate the insertion portion 34 via the lens 136b.

  It is also preferable to determine the rotation amount of the insertion portion 34 by reading the rotation amount of the bearing 172 shown in FIG.

  Further, in the above-described embodiment, an operation has been described in which the distal end portion of the insertion portion 34 of the endoscope 14 is rotated and then the base portion 32 is rotated by the operation mechanism 250 to reduce the torque amount one by one. . In addition, since the detection mechanism 24 can quickly detect the rotation direction when the operator tries to rotate the distal end portion of the insertion portion 34 of the endoscope 14, the base portion 32 is actively activated. It is also possible to rotate the distal end portion of the insertion portion 34 while rotating. That is, it is possible to perform power assist that makes it easy to rotate in accordance with the rotation operation direction of the insertion portion 34. In this case, when the surgeon stops trying to rotate the distal end portion of the insertion portion 34, the detection mechanism 24 immediately detects and stops the operation of the operation mechanism 250.

  Next, a second embodiment will be described with reference to FIG. This embodiment is a modification of the first embodiment, and members described in the first embodiment are denoted by the same reference numerals and detailed description thereof is omitted.

  A motor holding portion 165 is formed on the outer ring 164. The motor holding portion 165 is provided with the shaft of the motor 252 in a direction orthogonal to the insertion portion 34 of the endoscope 14 and in a direction orthogonal to the radial direction extending from the center of the outer ring 164 and the inner ring 152. ing. A worm (variable speed mechanism) 256 is fixed to the motor 252. On the other hand, a worm wheel (variable speed mechanism) 258 meshed with the worm 256 is formed on the outer peripheral surface of the collar 178 of the inner ring 152.

  Although not shown here, a micro switch 262 is attached to the outer ring 164, and protrusions 178 a are formed on the outer periphery of the collar 178 at a predetermined interval.

  Since the operation and effect of this embodiment are the same as the operation and effect described in the first embodiment, description thereof will be omitted.

  Next, a third embodiment will be described with reference to FIG. This embodiment is a modification of the second embodiment, and members described in the second embodiment are denoted by the same reference numerals and detailed description thereof is omitted.

  A non-contact type magnet wheel (variable speed mechanism) 256 is fixed to the motor 252 instead of the worm 256 described in the second embodiment. On the other hand, on the outer peripheral surface of the collar 178 of the inner ring 152, there is disposed a magnet wheel (speed variable mechanism) 258 that rotates when the magnet wheel 256 is magnetically affected.

  Although not shown here, a micro switch 262 is attached to the outer ring 164, and protrusions 178 a are formed on the outer periphery of the collar 178 at a predetermined interval.

  Since the magnet wheel 256 disposed on the drive shaft of the motor 252 is not in contact with the magnet wheel 258 disposed on the outer ring 164, the first gear 256 and the worm 256 described in the first and second embodiments. The second gear 258 and the worm wheel 258 can be prevented from being worn. Further, the inner ring 152 need not be provided.

  Although several embodiments have been specifically described so far with reference to the drawings, the present invention is not limited to the above-described embodiments, and all the embodiments performed without departing from the scope of the invention are described. Including implementation.

  According to the above description, the following matters can be obtained. Combinations of the terms are also possible.

[Appendix]
(Additional Item 1) A medical instrument having a rotation axis;
A support mechanism that rotatably supports a holding portion that holds the medical device in an appropriate position around a rotation axis of the medical device;
A medical device, comprising: an operating mechanism that is provided in the holding unit and rotates the holding unit in the same direction as the rotation direction of the medical instrument.

(Additional Item 2) Control means connected to the operation mechanism and controlling the operation mechanism;
A detection mechanism that is connected to the control means, detects rotation of the medical instrument around the rotation axis, and operates the operation mechanism through the control means based on the rotation detection result; and
The operating mechanism includes a speed variable mechanism that varies the operating speed,
The variable speed mechanism includes a motor, a first rotating member disposed on a drive shaft of the motor, and a second rotating member disposed on the holding unit and rotating in accordance with the rotation of the first rotating member. The medical device according to Additional Item 1, further comprising a rotating member.

(Additional Item 3)
An outer ring fixed to the support mechanism;
The medical device according to claim 1, further comprising an inner ring disposed inside the outer ring and holding the medical instrument.

    (Additional Item 4) The medical device according to Additional Item 3, wherein the operation mechanism includes a rotation amount detection mechanism that detects an amount of rotation of the inner ring with respect to the outer ring.

1 is a schematic perspective view showing a medical device according to a first embodiment of the present invention. 1 is a schematic block diagram showing a medical device according to a first embodiment of the present invention. The schematic perspective view which shows the base part of the endoscope of the medical device which concerns on the 1st Embodiment of this invention, the insertion part extended from this base part, and a universal cable. The schematic front view which shows the operation part of the endoscope of the medical device which concerns on the 1st Embodiment of this invention. The schematic block diagram which shows the relationship between the control box of the medical device which concerns on the 1st Embodiment of this invention, an operation part, a detection mechanism, and an operation mechanism. The schematic perspective view which shows the detection mechanism which detects the rotation state of the insertion part of the endoscope of the medical device which concerns on the 1st Embodiment of this invention. 1 is a schematic top view showing a configuration of an endoscope holding unit of a support device for a medical device according to a first embodiment of the present invention. The schematic sectional drawing which follows the VIII-VIII line in FIG. 7 of the endoscope holding part of the support apparatus of the medical device which concerns on the 1st Embodiment of this invention. (A) is schematic sectional drawing which follows the IX-IX line in FIG. 7 of the endoscope holding | maintenance part used for the medical device which concerns on 1st Embodiment, (B) is 1st Embodiment. The schematic perspective view which shows the plate for a click formed in the upper end of the outer ring | wheel of the endoscope holding part used for the medical device which concerns. The schematic longitudinal cross-sectional view which shows the operation | movement mechanism of the endoscope holding part of the support apparatus of the medical device which concerns on the 1st Embodiment of this invention. The schematic perspective view which shows the modification of the detection mechanism which detects the rotation state of the insertion part of the endoscope of the medical device which concerns on the 1st Embodiment of this invention. The schematic longitudinal cross-sectional view which shows the operation | movement mechanism of the endoscope holding part of the support apparatus of the medical device which concerns on the 2nd Embodiment of this invention. The schematic longitudinal cross-sectional view which shows the operation | movement mechanism of the endoscope holding part of the support apparatus of the medical device which concerns on the 3rd Embodiment of this invention.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 100 ... Endoscope holding part, 152 ... Inner ring, 152a ... Male thread part, 164 ... Outer ring, 165 ... Motor base, 172 ... Bearing, 176 ... Stopper screw, 178 ... Collar, 178a ... Projection, 192 ... Tube, 250 ... Operation Mechanism, 252 ... Motor, 254 ... Coupling, 256 ... First gear, 258 ... Second gear, 262 ... Micro switch

Claims (9)

A support mechanism for rotatably supporting a holding part for holding a medical instrument having a rotation axis at an appropriate position around the rotation axis of the medical instrument;
An operating mechanism that is provided in the holding unit and rotates the holding unit in the same direction as the rotation direction of the medical instrument;
The holding part is
A first ring on which the medical device is disposed;
A second wheel having a central axis common to the first wheel, and capable of rotating or rotating with respect to the first wheel about the central shaft as a support shaft;
A resistance force generating mechanism that is disposed between the first wheel and the second wheel and inhibits rotation or rotation between the first wheel and the second wheel. A medical device characterized. The first ring is a cylindrical inner ring;
The second ring is an outer ring disposed outside the inner ring;
The medical device according to claim 1. The resistance generation mechanism is
An engagement portion provided on the second ring and having a V-shaped portion and a chevron portion;
The medical device according to claim 1, further comprising: an abutting portion that is provided on the first ring and abuts in a state of being urged toward the engaging portion. Control means connected to the operating mechanism for controlling the operating mechanism;
The medical device according to any one of claims 1 to 3, further comprising: an instruction unit connected to the control unit and instructing the operation mechanism to operate through the control unit. The medical instrument includes a base portion held by the holding portion, an elongated insertion portion extending from the base portion in the rotation axis direction and having a bending portion in the vicinity of a distal end portion, and an operation portion for bending the bending portion. An endoscope equipped with,
The medical apparatus according to claim 4, wherein the instruction unit is disposed in the operation unit. Control means connected to the operating mechanism for controlling the operating mechanism;
A detection mechanism connected to the control means for detecting rotation of the medical instrument around the rotation axis and operating the operation mechanism through the control means based on the rotation detection result. The medical device according to any one of claims 1 to 3.   The medical device according to claim 6, wherein the operation mechanism includes a speed variable mechanism that varies an operation speed thereof. A detection mechanism for detecting rotation applied around the rotation axis of the medical instrument;
Instruction means capable of manually or automatically setting the operation of the operation mechanism;
The operation mechanism is connected to the detection mechanism, the operation mechanism, and the instruction means, and the operation mechanism is controlled manually or automatically based on the setting of the instruction means based on the rotation detection result of the medical instrument detected by the detection mechanism. The medical device according to any one of claims 1 to 3, further comprising a control unit.   The medical instrument has a base portion held by the holding portion, and an elongated insertion portion extending from the base portion in the direction of the rotation axis, having a curved portion in the vicinity of the distal end portion, and detecting the rotation by the detection mechanism. The medical device according to any one of claims 6 to 8, wherein the medical device includes an operation unit configured to bend the bending unit.

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