JPH07227398A - Operational tool supporting apparatus - Google Patents

Abstract

PURPOSE:To improve operability for moving an operational tool supported by a supporting part for the operational tool, to make the amt. of force for movement of the operational tool to avoid spoiling of the operability caused by the dead wt. of the operational tool and to miniaturize the whole apparatus. CONSTITUTION:A supporting part 14 of an operational tool is connected with an extending part of one end side of an upper rod 9 on a link mechanism part 4 consisting of a parallelogram link formed by a revolutional arm 6, a lower rod 7, the upper rod 9 and a connecting rod 13, and counter wt. 24 and 25 being made to be balanced to the supporting part 14 fitted with the operational tool are arranged on the link mechanism part 4 of the parallelogram link.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical instrument holding device for holding a treatment tool or an endoscope inserted in the abdominal cavity of a patient on behalf of the operator.

[0002]

2. Description of the Related Art Generally, surgical procedures using a medical rigid endoscope such as a laparoscope have advanced and become complicated in recent years. For this reason, a main doctor (hereinafter referred to as a main surgeon) who performs a treatment carries out an operation with treatment tools in both hands. At this time, the assistant also carries out the surgery in cooperation with the main surgeon with the treatment tool.

For this reason, the main surgeon and an assistant who jointly treats cannot hold and operate the endoscope for observing the surgical site in the abdominal cavity. It is held by a dedicated assistant (hereinafter referred to as an endoscope holder). Then, when you want to change the observation position of the operative site or the angle of view, according to the instructions from the main surgeon or an assistant who jointly treats,
The endoscope holder manually operates such as changing the direction of the endoscope and moving the endoscope forward and backward.

Therefore, there is a problem in that the endoscope holder must continue to hold the endoscope during operation, which requires a great deal of labor. Furthermore, the operating room is narrow because there are various medical devices necessary for surgery and an assistant who operates them, and the presence of an endoscope holder has a problem of further reducing the space.

Therefore, the endoscope or the treatment instrument inserted into the body cavity of the patient is held by the endoscope holding device or the surgical instrument supporting device, and the main operator can directly operate the endoscope or the treatment instrument. Such a method is, for example, the actual Kaihei 1-130.
No. 304 and JP-A-2-239854.

Here, in the endoscope holding device disclosed in Japanese Utility Model Laid-Open No. 1-130304, the holder is connected to the upper end of the arm whose lower end is fixed to the floor via a plurality of arms. However, the endoscope is attached to the holder. Then, in order to make the endoscope movable, the joint portion of each arm is rotatable about one axis, for example, the weight is provided so as not to rotate naturally due to the weight of the arm and the endoscope. The joint part is provided, and the holder part is slidable with respect to the arm and can be fixed by a fixing screw.

Further, the surgical instrument support device disclosed in Japanese Patent Application Laid-Open No. 2-239854 discloses a hand portion for mounting a surgical instrument and a plurality of bendable and rotatably connected continuously supporting the hand portion. And a mounting portion for mounting the flexible arm portion to the support member. Here, a plurality of piston rods that are continuously provided are slidably fitted in the connecting body of the flexible arm portion. And by operating the fixed lever,
The flexible arm portion and the hand portion are fixed by pressing the piston rod.

[0008]

DISCLOSURE OF THE INVENTION Problems to be Solved by the Invention
In the endoscope holding device disclosed in Japanese Patent Publication No. 304, in order to move the endoscope, it is necessary to rotate the joint by applying force to each of the two arms connected to each joint with the left and right hands. Therefore, there is a problem that only one degree of freedom can be moved at a time.

When the holder is slid with respect to the arm, the fixing screw of the holder is temporarily loosened to move the endoscope, and after the endoscope is positioned, the fixing screw is tightened again. Since a complicated operation of fixing the part to the arm side is required, it is difficult for the main operator to accurately perform these complicated operations during the operation.

Further, at the time of sliding operation of the endoscope, when the fixing screw is loosened, the endoscope is prevented from being inadvertently moved in an arbitrary direction different from the desired direction due to its own weight, which is safe. In order to secure the property, it is necessary for the main operator to surely hold the endoscope in advance and prepare for the movement of the endoscope by its own weight. Therefore, also in this case, an operation using both hands is required similarly to the rotation operation of the joint between the two arms, and therefore, the endoscope holding is performed during the operation in which the main operator operates the treatment tool etc. by himself. When the device is used, it is necessary to remove the treatment tool once and move the endoscope with both hands, which causes a problem that the operation cannot be continued promptly.

In the surgical instrument support device disclosed in Japanese Patent Laid-Open No. 2-239854, the entire flexible arm can be fixed and released at once by operating the fixing lever. It is superior to the endoscope holding device disclosed in Japanese Utility Model Laid-Open No. 1-130304 in that the surgical instrument can be moved in any direction at a time.

However, also in this case, in the same manner as described above, in order to prevent the surgical instrument from being inadvertently moved in an arbitrary direction different from the desired direction by the self-weight of the surgical instrument and ensure safety, the operating lever is provided. Since it is necessary for the main surgeon to securely hold the surgical instrument at the time of the above operation, it is necessary to perform a reliable operation using both hands, which is not suitable for surgery by the main surgeon alone.

During the operation, the main operator, an assistant who cooperates with the main operator, an assistant who operates other equipment, and the like often pass near the operating table. Therefore, as a surgical instrument holding device, it is the actual situation that the amount of protrusion to the outside of the operating table including the connecting portion with the operating table is desired to be as small as possible.

The present invention has been made in view of the above circumstances, and an object thereof is to hold a surgical instrument holding portion for moving a surgical instrument held by a surgical instrument holding portion such as a treatment instrument or an endoscope. There is no need to perform a troublesome operation such as fixing or releasing the fixing portion of the surgical instrument, and the operability can be improved, and the operability of the surgical instrument is light and the operability is not impaired by the weight of the surgical instrument. The object of the present invention is to provide a surgical instrument holding device of a compact size that does not interfere even when connected to an operating table or the like.

[0015]

According to the present invention, there is provided a mounting portion which is removably engaged with a base, and which is erected vertically.
A vertical rod that is rotatably connected to the mounting portion, and a swing arm that is rotatably supported about a second rotation axis that is orthogonal to the rotation axis of the vertical rod and that extends vertically. A lower rod that is rotatably supported about the second rotating shaft and that extends in the lateral direction; and a second rotating shaft that is disposed parallel to the lower rod and that is rotatable with respect to the revolving arm. An upper rod rotatably supported about a parallel third rotation axis, and the second rod and the third rod which are arranged in parallel with the swivel arm and which are provided with respect to the lower rod and the upper rod.
Connecting rods that are rotatably supported about fourth and fifth rotation axes that are respectively parallel to the rotation axes,
A holding portion of the surgical instrument connected to an extension portion of the parallelogram link formed by the lower rod, the upper rod, and the connecting rod on the one end side of the upper rod, and the holding portion on which the surgical instrument is mounted. And a counterweight arranged on the parallelogram link in a counterbalanced state.

[0016]

The surgical instrument attached to the holding portion of the surgical instrument is movable in the vertical and horizontal directions by the rotational movement and deformation operation of the parallelogram link, and the rotational movement and deformation operation of the parallelogram link. Thus, even if the surgical instrument moves in the vertical and horizontal directions, the balance is maintained by the counter weight.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS.
This will be described with reference to (B). FIG. 1 shows a schematic configuration of the entire surgical instrument holding device. Reference numeral 1 denotes a mounting portion that is detachably locked to a base such as an operating table. A vertical rod 2 is erected on the mounting portion 1 along the vertical direction. The vertical rod 2 has a force adjusting portion 3 with respect to the mounting portion 2.
Is rotatably connected via a vertical rotation axis O ₁ . Here, the force amount adjusting portion 3 adjusts the weight of the movement of the vertical rod 2 rotating with respect to the mounting portion 2.

Further, a support member 5 of a link mechanism portion 4 composed of a parallelogram link for holding a surgical instrument is connected to an upper end portion of the vertical rod 2. The support member 5 is rotatably connected about a _second rotation axis O ₂ in the horizontal direction orthogonal to the rotation axis O ₁ of the vertical rod 2.

Further, on the support member 5, the lower end of the pivot arm 6 extending in the vertical direction and the one end of the lower rod 7 extending in the horizontal direction are respectively rotated around the second rotation axis O _2. It is movably supported and has a second rotation axis O ₂
The torque adjustment unit 8 arranged above is connected. The rotational force amount adjusting unit 8 is provided with respect to the supporting member 5 and the revolving arm 6
Is to adjust the weight of the rotating motion.

At the upper end of the swivel arm 6, a middle part of the upper rod 9 arranged in parallel with the lower rod 7 is connected to a third rotating shaft O ₂ via a joint 10 in parallel with the _second rotating shaft O _2. O
_It is rotatably supported around ₃ .

Further, the other end of the lower rod 7 and one end of the upper rod 9 have fourth and fifth rotation axes O ₄ and O ₅ parallel to the _second and _third rotation axes O ₂ and O ₃ , respectively. They are connected in parallel by a connecting rod 13 arranged in parallel with the revolving arm 6 via joint parts 11 and 12 which are rotatable around the center. The swing arm 6, the upper rod 9, the lower rod 7, and the connecting rod 13 constitute the link mechanism unit 4 which is a deformable parallelogram link.

The end of the upper rod 9 opposite to the end on the side of the joint 12 is extended outward through the joint 10, and the holding portion 14 of the surgical instrument is connected to this extension. There is. The holding portion 14 is provided with an L-shaped arm 15 and an L-shaped connecting member 16. Here, one L-shaped component portion 15a of the L-shaped arm 15 is rotated around the rotation axis O ₆ which is the central axis of the upper rod 9 through the rotational force amount adjusting portion 17 at the extending portion of the upper rod 9. Connected as possible. The rotational force amount adjusting unit 17 adjusts the weight of the movement of the holding unit 14 rotating with respect to the upper rod 9.

Further, at the tip of the other L-shaped component 15b of the L-shaped arm 15, the tip of one L-shaped component 16a of the L-shaped connecting member 16 is orthogonal to the rotation axis O _6. It is rotatably connected around O ₇ via a torque adjusting unit 18. The rotational force amount adjusting portion 18 adjusts the weight of the movement of the L-shaped connecting member 16 rotating with respect to the rotation axis O ₇ of the L-shaped forming portion 15b.

The other L-shaped component 16b of the L-shaped connecting member 16 is provided with a surgical instrument receiving portion 19 as shown in FIG. An insertion hole 19a for a surgical instrument is formed in the receiving portion 19. An endoscope 20 as a surgical instrument is inserted into the insertion hole 19a of the receiving portion 19, and the endoscope 20 has an endoscope holding member 21.
Is connected so as to be rotatable about a rotation axis O ₈ which is the insertion direction of the endoscope 20. The endoscope 20 has a T
A TV camera 23 is attached via the V adapter 22. Further, the rotation axis O ₈ is arranged so as to be orthogonal to the rotation axis O ₇ , and the rotation axes O ₆ , O ₇ , and O ₈ intersect at an intersection point C.

Further, the link mechanism section 4 composed of parallelogram links is provided with two sets of counterweights 24 and 25 in a balanced state with respect to the holding section 14 on which the endoscope 20 as a surgical instrument is mounted. It is set up. Here, the first counterweight 24 is the shaft 26 of the lower rod 7.
It is mounted so as to be movable along. Further, the second counterweight 25 is attached to the support member 5 coaxially with the turning arm 6 and movably along a guide arm 27 arranged on the opposite side of the turning arm 6.

FIG. 2 shows the internal structure of the rotational force amount adjusting portion 8 around the rotation axis O _{2 as} viewed from the direction of arrow Q in FIG. Here, at both ends of the support member 5, small-diameter shaft portions 28 and 29 having a diameter reduced by one step are formed.

Further, a through hole 30 coaxial with the rotation axis O ₂ is formed in the axial center portion of the support member 5. A slide shaft 31 is fitted in the through hole 30. A flange 32 is formed at one end of the slide shaft 31, and a male screw portion 34 that is screwed into a screw hole 33a formed in the adjustment dial 33 is formed at the other end.

Further, a long hole 35 which is long in the axial direction of the support member 5 is formed in one small-diameter shaft portion 28 of the support member 5. Further, a key groove 36 is formed on the slide shaft 31 at a position corresponding to the small diameter shaft portion 28. A key 37 is engaged with the key groove 36 through the elongated hole 35 of the small diameter shaft portion 28. The slide shaft 31 is slidably supported on the support member 5 without rotating on the rotation axis O ₂ .

A bearing member 38 of the swivel arm 6 is rotatably connected to the small diameter shaft portion 28 of the support member 5.
The bearing member 38 is provided with a substantially cylindrical bearing body 38a. A ring-shaped convex portion 39 is provided at the center of the inner peripheral surface of the bearing main body 38a. This ring-shaped protrusion 3
Ring-shaped collars 40 and 41 are provided on both sides of the plate 9.

Further, between the adjusting dial 33 screwed with the male screw portion 34 of the slide shaft 31 and the collar 41 arranged in the bearing member 38, O is sequentially provided from the collar 41 side.
A ring 42 and a washer 43 are arranged. Then, the ring-shaped convex portion 39 of the bearing member 38 between the collars 40 and 41 is O due to the screwing operation of the male screw portion 34 of the slide shaft 31 and the screw hole 33a of the adjustment dial 33.
It is assembled to the small-diameter shaft portion 28 of the support member 5 via the ring 42 and the washer 43.

Further, on the outer peripheral surface of the bearing member 38, an arm connecting portion 44 connected to the lower end portion of the revolving arm 6 and an arm connecting portion 45 connected to the upper end portion of the guide arm 27 are provided in a protruding manner.

The bearing member 46 of the lower rod 7 is rotatably connected to the other small-diameter shaft portion 29 of the support member 5. The bearing member 46 has a substantially cylindrical bearing body 46a.
Is provided. A ring-shaped convex portion 47 is projectingly provided at the center of the inner peripheral surface of the bearing body 46a. Ring-shaped collars 48 and 49 are arranged on both sides of the ring-shaped convex portion 47.

The bearing member 46 is used for the turning arm 6
Like the bearing member 38, the ring-shaped convex portion 47 is rotatably connected to the small diameter shaft portion 29 of the support member 5 via the collars 48 and 49 on both sides.

Further, FIG. 3 shows a main structure of the holding portion 14 of the surgical instrument. Here, the endoscope holding member 21 is provided with a grip portion 50 that is formed in a substantially cylindrical shape and has a knurl formed on the outer peripheral surface. This cylindrical grip 5
An endoscope connecting portion 51 connected to the endoscope 20 is provided on one end side of 0.

The endoscope connecting portion 51 is provided with an insertion hole 53 through which the insertion portion 52 of the endoscope 20 is inserted, and a large diameter hole portion 54 having a diameter larger than the insertion hole 53. Further, a screw hole 56 into which the endoscope fixing screw 55 is screwed is formed in the peripheral wall portion of the large diameter hole portion 54.

Then, the endoscope holding member 21 is attached to the endoscope 20.
When the endoscope is mounted, the insertion portion 52 of the endoscope 20 is inserted into the insertion hole 53 of the endoscope coupling portion 51, and the step between the insertion portion 52 of the endoscope 20 and the proximal end 57 is inserted. The attached portion 58 is inserted into the large-diameter hole portion 54 of the endoscope connecting portion 51 to insert the insertion hole 53.
It is screwed and fixed by an endoscope fixing screw 55 in a state where it is abutted against a step portion 59 between the large diameter hole portion 54 and the large diameter hole portion 54.

A small diameter portion 60 having a reduced diameter is formed at the tip of the endoscope connecting portion 51 of the endoscope holding member 21. Further, a fitting recess 61 is formed on the outer peripheral surface of the small diameter portion 60.

An intermediate ring 62 is rotatably connected to the small diameter portion 60 of the endoscope holding member 21. A flange 63 is provided on the inner peripheral surface of the intermediate ring 62 so as to be engaged with the fitting recess 61 of the small-diameter portion 60 and inhibit the movement in the thrust direction. Further, a flange-shaped ring receiver 64 is provided on the outer peripheral surface of the intermediate ring 62 in a protruding manner.

A fixed ring 65 is attached to the ring receiver 64 of the intermediate ring 62. This fixing ring 6
An engaging portion 66 having a smaller diameter than the ring receiver 64 is provided at one end of
Is formed, and a screw hole 67 is formed at the other end. The screw hole portion 67 is the receiving portion 1 of the L-shaped connecting member 16.
It is screwed into a male screw portion 68 formed on the shaft 9.

Next, the balance of the link mechanism section 4 composed of parallelogram links will be described with reference to FIG. Here, it is assumed that each arm constituting the link mechanism unit 4, that is, the revolving arm 6, the upper rod 9, the lower rod 7, and the connecting rod 13 has no weight.

In FIG. 5, r is the radius of gyration of the swivel arm 6, G ₁ is the center of gravity of the portion on the tip side of the L-shaped arm 15, and the weight at that point is M ₁ . Further, if the distance from the rotation axis O ₃ to G ₁ is R ₁ , the center of gravity of the first counterweight 24 is G _W1 , its weight is M _W1 , and the distance from the rotation axis O ₂ to G _W1 is R _W1. ,
The balance of the upper rod 9 around the rotation axis O ₃ is expressed by the following equation (1).
Given in.

M ₁ × R ₁ = M _W1 × R _W1 (1) Then, the center of gravity synthesized by G ₁ and G _{W1 under} these conditions is the straight line H connecting between G ₁ and G _W1 and the swing arm. It becomes the intersection G ₂ with 6. Here, the distance from the rotation axis O ₂ to G ₂ is R ₂ , and the weight applied to G ₂ is M ₂ = M ₁ + M _G1 ,
The center of gravity of the second counterweight 25 is G _W2 and the rotation axis O
_When the distance from ₂ to G _W2 is R _W2 and the weight of the second counterweight 25 is M _W2 , the balance around the rotation axis O ₂ is expressed by the following equation (2).

M ₂ × R ₂ = M _W2 × R _W2 (2) At this time, the center of gravity of the entire link mechanism section 4 composed of parallelogram links is on the rotation axis O ₂ .

Further, the endoscope holding member 21 is provided with an endoscope 20,
The position of the center of gravity when the accessories such as the TV adapter 22 and the TV camera 23 are assembled is arranged on the rotation axis O ₈ . Furthermore, the position of the center of gravity of these when combined L-shaped connecting member 16, i.e., the center of gravity of the part which rotates the rotation shaft O ₇ around is disposed on the rotation axis O _7. Further, the endoscope connecting portion 51 is arranged so that the center of gravity when the L-shaped arm 15 is combined with these, that is, the center of gravity of the portion that rotates around the rotation axis O ₇ is arranged on the rotation axis O _6. The positional relationship between the stepped portion 59 and the stepped portion 58 of the endoscope 20 is defined.

The direction of the rotation axis O ₈ and the rotation axis O ₈ with respect to the intersection point C of the rotation axes O ₆ , O ₇ , and O ₈ are matched with the case where various endoscopes and TV adapters having different center of gravity positions are mounted. The endoscope holding member 21 formed by shifting the position of the step portion 59 of the endoscope connecting portion 51 in the direction orthogonal to O _8.
The position of the center of gravity does not change from that in the above case by connecting.

[0046] For example, heavy upper portion of the endoscope 20, the stepped portion 59 of the rotary shaft O ₇ position of the center of gravity of the part which rotates around the rotation axis O ₇ inner if there from above endoscope connection portion 51 An endoscope holding member 21 formed in a state of being displaced downward in FIG. 3 is connected to the rotation axis O ₇ .

Alternatively, when the same endoscope holding member 21 is used, when the stepped portion 58 of the endoscope 20 is abutted against the stepped portion 59 of the endoscope connecting portion 51, the endoscope 20 , T
The center of gravity of the endoscope 20 when the accessories such as the V adapter 22 and the TV camera 23 are combined is always a constant position with respect to the intersection C of the rotation axes O ₆ , O ₇ , and O ₈ . It is sufficient that the stepped portion 58 is formed. In order to keep the weight constant, it is possible to deal with the endoscope holding member 21 by changing the material of the specific gravity or the thickness of the grip portion 50.

Next, a method for adjusting the balance of the link mechanism section 4 composed of parallelogram links will be described. First, the deformation of the link mechanism portion 4 composed of parallelogram links, that is, the balance adjustment work regarding the rotation of the rotation axis O ₃ of the upper rod 9 will be described.

During this balance adjustment work, the revolving arm 6
The movement of the endoscope 20 is confirmed in a state where it is held by hand so as not to rotate. At this time, when the endoscope 20 moves upward or downward, the first counterweight 24
By rotating a moving ring (not shown) and moving the counterweight 24 along the shaft 26 of the lower rod 7, an optimum position where the endoscope 20 does not move is set.

Next, with the constraint of the swing arm 6 released, the second counterweight 25 is moved to the guide arm 27.
By moving along the upper part, the balance adjustment work around the rotation axis O ₂ is performed. This is the same as the movement of the first counterweight 24 described above, and thus the description thereof is omitted.

In actual use, the amount of rotational force of each movable portion of the link mechanism portion 4 composed of a parallelogram link is optimally adjusted. Here, the adjustment of the amount of force around the rotation axis O ₂ will be described with reference to FIG.

First, when the adjustment dial 33 is rotated,
With the key 37 engaging with the male screw portion 34 of the slide shaft 31 and engaging with the key groove 36 of the slide shaft 31 through the long hole 35 of the small diameter shaft portion 28 of the support member 5, the slide shaft 31 does not rotate. The adjustment dial 33 moves or thrusts to the right in the figure and to the left in the figure.

By this action, the collar 48 is pressed by the flange 32 of the slide shaft 31 at the bearing member 46 portion of the lower rod 7, and the ring-shaped convex portion 47 of the bearing member 46 is sandwiched between the collars 48 and 49. , The amount of torque is adjusted.

Further, the ring-shaped convex portion 39 inside the bearing member 38 of the revolving arm 6 is sandwiched between the collars 40 and 41, and the amount of rotational force is adjusted. In this case, the amount of torque can be gradually adjusted by the elasticity of the O-ring 42 arranged between the adjustment dial 33 and the collar 41.

Next, the operation of the above configuration will be described.
First, the mounting portion 1 of the device is mounted on the operating table. Subsequently, with the insertion portion 52 of the endoscope 20 used during operation inserted in the large-diameter hole portion 54 and the insertion hole 53 of the endoscope holding member 21, the screw hole 56 of the endoscope connection portion 51. The internal endoscope fixing screw 55 is screwed and fixed, and the endoscope 20 is assembled to the endoscope holding member 21.

Then, the endoscope 20 and the TV adapter 2
2. After the work of assembling the TV camera 23 and the like is completed, as shown in FIG. 3, the intermediate ring 62 of the endoscope holding member 21.
The bottom surface of is contacted with the receiving portion 19 of the L-shaped connecting member 16. In this state, the fixing ring 65 is rotationally operated, and the screw hole portion 67 of the fixing ring 65 is screwed into the male screw portion 68, so that the endoscope holding member 21 becomes the L-shaped connecting member 1.
It is fixed to the receiving portion 19 of 6.

At this time, the endoscope holding member 21 and the endoscope 2
0 is the rotation axis O with respect to the receiving portion 19 of the L-shaped connecting member 16.
It is possible to rotate integrally around ₈ . Further, the L-shaped arm 15 rotates about the rotation axis O ₆ to rotate the rotation axis O ₇
Since the L-shaped connecting member 16 rotates about the center, the endoscope 20 can rotate about the intersection C of the two rotation axes O ₆ and O ₇ . Here, since the center of gravity of the portion that moves around each rotation axis ₆ , O ₇ is on each rotation axis ₆ , O ₇ , the endoscope 20 rotates about the rotation axes O ₆ , O ₇ , O _8. Even if it moves, the center of gravity does not shift, and the balance of the entire apparatus does not get lost.

Next, the movement and the balance of the link mechanism section 4 composed of the parallelogram link of this apparatus are shown in FIG.
This will be described with reference to (A) and (B). First, the endoscope 20
6 (A), when horizontally moving in the left-right direction, as shown in the figure, the rotation of the entire parallelogram link mechanism 4 around the rotation axis O ₂ and the parallelogram link mechanism. It is performed by a combination of four deformation operations. Furthermore, FIG.
In (A), the horizontal movement of the endoscope 20 in the direction perpendicular to the paper surface is performed by turning the vertical rod 2 around the rotation axis O ₁ .

Further, when the endoscope 20 is moved in the vertical direction, as shown in FIG.
It is performed by a combination of _two rotations of the link mechanism section 4 of the parallelogram link and a deformation operation of the link mechanism section 4 of the parallelogram link.

Therefore, in the above-mentioned structure, two sets of counterweights 24 are provided in the link mechanism section 4 composed of parallelogram links in a state of being balanced with respect to the holding section 14 on which the endoscope 20 is mounted. Since 25 is provided, the endoscope 2
0 is held in a balanced state at any position and angle. Therefore, there is no concern that the surgical instrument such as the endoscope 20 will fall spontaneously, and the amount of movement of the surgical instrument such as the endoscope 20 can be reduced to improve the operability.

Further, the holding portion 14 on which the endoscope 20 is mounted
Counterweight 2 to keep balance against
Since 4 and 25 are divided and arranged in two, the counterweights 24 and 25 from the operating table mounting portion 1 are deformed when the link mechanism portion 4 of the parallelogram link is deformed by the movement of the endoscope 20.
Does not protrude significantly. Therefore, the entire surgical instrument holding device can be downsized, so that the link mechanism portion 4 of the parallelogram link can be prevented from coming into contact with the operator and the patient during the operation. Furthermore, since the balance adjustment of the two counterweights 24 and 25 can be performed independently, setting is easy.

Further, the adjustment dial 3 of the force amount adjusting portion 8 around the rotation axis O ₂ of the link mechanism portion 4 of the parallelogram link.
When 3 is rotated, the rotational force of the deformation of the link mechanism portion 4 of the parallelogram link and the turning of the entire link mechanism portion 4 of the parallelogram link, that is, the vertical and horizontal movement force of the endoscope 20 is changed at a time. It is adjustable and can be adjusted in a short time. Therefore, the adjustment work of the vertical and horizontal movement force of the endoscope 20 can be easily performed, and the surgical instrument holding portion 1 is provided.
It is possible to improve the operability for moving the endoscope 20 held by No. 4. Moreover, since the number of adjusting handles and the like can be reduced as compared with the conventional one, the overall size of the device can be reduced.

Furthermore, since the L-shaped arm 15 and the L-shaped connecting member 16 can be freely rotated 360 degrees around the rotation axis O ₆ and the rotation axis O ₇ , respectively, the operator can easily operate them during the operation. The L-shaped arm 15 can be freely oriented in the direction, and the usability can be further enhanced.

Further, since the endoscope holding member 21 and the L-shaped connecting member 16 are separable from each other, it is possible to separate these during the work of mounting the endoscope 20 and the disinfection work. Therefore, it is possible to improve workability such as the work of attaching the endoscope 20 and the disinfection work.

In the present embodiment, the vertical rod 2 is straight and coaxial with the rotation axis O _1. However, the vertical rod 2 is not limited to this, and there is no problem even if it is bent. Further, in this embodiment, the counterweights 24 and 25 are set to 2 with respect to the rotation axis O _1.
However, for example, by arranging the combined center of gravity from the link mechanism portion 4 of the parallelogram link to the endoscope 20 at the intersection of the rotation axis O ₁ and the rotation axis O ₂ , The balance around the rotation axis O ₁ will not be lost even if the operating table to which the mounting portion 1 is mounted or the base such as a column installed on the floor is tilted in any direction.

In the present embodiment, as shown in FIG. 3, the members that move around the rotary shafts O ₄ , O ₅ , and O ₆ have the center of gravity on each rotary shaft, but the present invention is not limited to this. If you give an appropriate weight to each force adjustment part, not something
Some imbalance does not affect operability.

FIG. 6C shows a modification of the first embodiment. This is a configuration in which the holding portion 14 of the surgical instrument is balanced by one counterweight of the link mechanism portion 4 formed of a parallelogram link.

That is, here, the rotary shaft O ₉ is arranged between the rotary shaft O ₂ and the rotary shaft O ₃ of the link mechanism portion 4 of the parallelogram link, and the upper end portion of the vertical rod 2 is connected to the rotary shaft O _{9. 9}
It is rotatably connected with.

In order to unify the conditions, the weight of the counterweight 71, the distance from the rotation axis O ₂ to the center of gravity of the counterweight 71, and the radius of gyration of the revolving arm 6 are set to M _W1 , R respectively. _W1 , r and G ₁
Make the conditions of the same.

In this case, in order to establish the balance, G
It is necessary to match the center of gravity that is combined with ₁ and G _W1 on the rotation axis O ₂ . That is, a distance K is required between the rotary shaft O ₂ and the rotary shaft O _{9 to} which the lower rod 7 and the swing arm 6 are connected.

Therefore, the center of gravity of the counterweight 71 moves on an arc having a radius of R _W1 + K at the maximum due to the deformation and turning of the link mechanism portion 4 of the parallelogram link. The protrusion of the counterweight 71 is larger than in the case where the counterweights 24 and 25 are divided into two and arranged as in the above embodiment.

Further, in the above embodiment, the surgical instrument holding portion 1
4 shows a structure in which the endoscope 20 is held as a surgical instrument, the holding section 14 can hold various other surgical instruments. For example, FIG. 7 shows a configuration in which the treatment tool 81 is held by the holding portion 14 of the surgical instrument.

Reference numeral 82 denotes a rotatable treatment tool holding member obtained by deforming the endoscope holding member 21 of the first embodiment. The treatment tool holding member 82 includes an insertion portion 8 for the treatment tool 81.
An insertion hole 84 through which 3 is inserted is provided. further,
A ring-shaped groove 85 is formed in the peripheral wall portion of the insertion hole 84, and a rubber O-ring 86 for sealing is attached thereto.

A small diameter portion 87 having a reduced diameter is formed at the tip of the treatment instrument holding member 82. Further, a fitting recess 88 is formed on the outer peripheral surface of the small diameter portion 87. The treatment tool holding member 82 is fixed to the receiving portion 19 of the L-shaped connecting member 16 by the intermediate ring 62 and the fixing ring 65 similar to those in the first embodiment. In this case as well, like the endoscope 20, it is possible to move while maintaining balance.

Further, FIGS. 8 to 9C show the second embodiment of the present invention.
FIG. In this embodiment, electrical fixing means are arranged on the rotation axis O ₁ of the vertical rod 2 of the first embodiment and the rotation axis O ₂ of the link mechanism section 4 composed of a parallelogram link. Only parts different from the first embodiment will be described.

FIG. 8 shows a schematic configuration of the entire surgical instrument holding device, and 100 is a trocar inserted into the abdominal wall opening S. Further, 101 is the rotation axis O ₁ of the vertical rod 2.
Vertical rod lock for fixing rotation around, 1
Reference numeral 02 denotes a lower rod lock portion for fixing the rotation of the lower rod 7 around the rotation axis O ₂ , and 103 denotes a rotation arm lock portion for fixing the rotation of the rotation arm 6 around the rotation axis O ₂ . The vertical rod lock portion 101, the lower rod lock portion 102, and the swing arm lock portion 103 respectively include a vertical rod fixed electromagnetic brake 104, a lower rod fixed electromagnetic brake 105, and a swing arm fixed electromagnetic brake, which will be described later, shown in FIG. 9A. 106 is built in.

A push button type switch 107 is arranged on the grip portion 50 of the endoscope holding member 21. The switch 107 can be connected to an electric cable (not shown) in the receiving portion 19 of the L-shaped connecting member 16 via an electric contact (not shown).

Further, FIG. 9A is a block diagram for explaining the electric system. Here, the switch 107 controls the vertical rod fixed electromagnetic brake 104,
The lower rod fixed electromagnetic brake 105 and the swing arm fixed electromagnetic brake 106 are connected.

Further, FIG. 9B shows the swing arm lock portion 1
03 shows the internal structure of 03. Here, 109 is a support member disposed above the vertical rod 2. The support member 109 has a permanent magnet 110 coaxially with the rotation axis O _2.
A stator 112 of a swing arm fixed electromagnetic brake 106, which is a permanent magnet type non-excitation actuated brake having a coil 111 built in, is fixed by a fixing screw 113.

Further, 114 is a shaft arranged at the axial center of the brake 106. The shaft 114 is supported by ball bearings 115 and 116 so as to be rotatable about a rotation axis O ₂ . A flange 117 is formed at one end of the shaft 114. The cover 118 of the brake 106 is fixed to the flange 117 with a fixing screw 119.

Reference numeral 120 is a leaf spring arranged between the cover 118 and the armature 121. One end of the leaf spring 120 is fixed to the cover 118 by a fixing screw 122.
, And the other end is connected to the armature 121 by a rivet 123. Then, the swing arm 6 is attached to the cover 118 of the swing arm fixed electromagnetic brake 106.
The lower ends of are connected. Note that the lower rod lock portion 102 has the same configuration as this, and a description thereof will be omitted.

FIG. 9C shows the vertical rod lock portion 1
1 shows the internal structure of 01. The vertical rod lock portion 101 also has substantially the same configuration as the above-described turning arm lock portion 103, and only different portions will be described here.

That is, the vertical rod fixed electromagnetic brake 1
The No. 04 stator 112 is fixed to the mounting portion 1 by a fixing screw 113. Further, the brake 10 is provided on the cover 125 of the vertical rod fixed electromagnetic brake 104.
The vertical rod 2 is screwed and fixed coaxially with the rotation axis O ₁ of the shaft 114 arranged at the axial center of the shaft 4.

Next, the operation of the above configuration will be described.
First, the operation of the swing arm lock unit 103 will be described. When the switch 107 is not pushed by the operator, the armature 121 is brought into close contact with the stator 112 of the brake 106 by the magnetic force of the permanent magnet 110, and the brake is applied. That is, the shaft 114 and the cover 118 are fixedly held, and the revolving arm 6 is locked in a non-rotatable state.

When the operator presses the switch 107 while holding the grip portion 50 of the endoscope holding member 21, the operator only operates while the signal is being input from the switch 107.
The coil 111 is energized by an actuation signal from the control unit 108, and an electromagnetic force acts in a direction opposite to the direction of the magnetic force of the permanent magnet 110. As a result, the armature 121 is separated from the stator 112 by the restoring force of the leaf spring 120 and the brake is released, so that the shaft 114 becomes rotatable.
Therefore, the shaft 114 and the cover 118 are rotatable, and the swing arm 6 is unlocked.

This action is the same for the lower rod lock portion 102 and the vertical rod lock portion 101. Then, when the switch 107 is pressed, the unlocking operation is simultaneously performed on the swing arm lock portion 103, the lower rod lock portion 102, and the vertical rod lock portion 101.

When the switch 107 is not pushed, the vertical rod 2, the swing arm 6 and the lower rod 7 are held in a fixed state, that is, the link mechanism portion 4 of the parallelogram link is held in a fixed state. Endoscope 2
In 0, only the turning motion around the intersection C of the rotation axes O ₆ , O ₇ , and O ₈ shown in FIG. 8 is possible.

Therefore, the endoscope 20 is supported at two points, the intersection C and the abdominal wall opening S in which the trocar 100 is inserted, and the position and the insertion angle are fixed. Then, when the switch 107 is pressed, the endoscope 20 can be freely moved and tilted similarly to the first embodiment.

Therefore, in the case of the above-mentioned configuration, the operator grips the grip portion 50 of the endoscope holding member 21 and the switch 10
Unless you press 7, the electromagnetic brakes 104, 105, 1
06 is not released from the brake, and the vertical rod 2, the lower rod 7, and the swing arm 6 of the link mechanism portion 4 composed of the parallelogram link are securely fixed, so that the operator mistakenly operates the parallelogram link during the operation. Even if an external force is applied to the arm of the link mechanism unit 4, the endoscope 20 does not move, which is safe. Moreover, since the amount of operation force when the electromagnetic brake is released can be reduced, operability can be improved.

Further, the vertical rod fixed electromagnetic brake 10
4, the lower rod fixed electromagnetic brake 105 and the swing arm fixed electromagnetic brake 106 are arranged only in a portion that fixes the movement of the endoscope 20 in the horizontal direction and the vertical direction.
Since it is not placed in the part that fixes the inclination of,
There is no protruding portion or the like on the abdomen of the patient, and the workability of surgery is not impaired.

Further, the switch 107 arranged in the grip portion 50 of the endoscope holding member 21 can be connected to the electric cable in the receiving portion 19 of the L-shaped connecting member 16 via an electric contact. Therefore, the endoscope holding member 21 and the receiving portion 19 of the L-shaped connecting member 16 can be separated. Therefore, as in the first embodiment, the workability of attaching the endoscope 20 and disinfecting work can be improved.

Further, FIGS. 10 to 16 show a third embodiment of the present invention. In this embodiment, the structure of the mounting portion for mounting the endoscope 20 to the L-shaped connecting member 16 in the second embodiment is changed, and an electric drive mechanism is added. Here, the second embodiment will be described. Only parts different from the example will be described.

In FIG. 10, reference numeral 150 is a support member having a swivel arm drive section, which will be described later, 151 is a mounting section that has a vertical rod drive section, which will be described later, and 157 is the endoscope 20 L
It is an endoscope attachment part attached to the character-shaped connecting member 16.

Here, the endoscope mounting portion 157 is shown in FIG.
As shown in (A), the L-shaped connecting portion 16 of the L-shaped connecting portion 16 is formed.
A rotating ring 163 is provided that is rotatably connected to 6b. The rotating ring 163 is provided with a through hole 170 into which the insertion portion 52 of the endoscope 20 is inserted.

Further, a substantially cylindrical fitting portion 167 is provided on the lower surface side of the rotary ring 163 so as to project. This fitting part 1
67 is rotatably fitted into a mounting hole 16c formed in the L-shaped component 16b of the L-shaped connecting member 16. A male screw portion 169 with which a retaining ring 168 is screwed is formed at the tip of the fitting portion 167.

Further, on the upper surface side of the rotating ring 163, a substantially cylindrical holding cylinder portion 171 which has a diameter larger than that of the fitting portion 167 is projected. A slide ring 173 is slidably disposed on the bottom surface 172 inside the holding cylinder 171. The outer diameter of the slide ring 173 is smaller than the inner diameter of the inner peripheral surface of the holding cylinder 171 and is slidable along the inner bottom surface of the holding cylinder 171.

Further, inside the slide ring 173, an endoscope insertion opening 173a through which the insertion portion 52 of the endoscope 20 is inserted is formed. This endoscope insertion port 173a
Is set to have a larger diameter than the insertion portion 52 of the endoscope 20.

A screw hole 171a is formed on the inner peripheral surface of the upper portion of the holding cylinder portion 171. The lid 175 provided on the slide ring 173 is attached to the holding cylinder portion 17
1 is screwed into the screw hole 171 a, and the upper opening of the holding cylinder 171 is sealed by the lid 175. An endoscope insertion opening 175a is formed at the axial center of the lid 175.

Further, the holding cylinder portion 171 of the rotating ring 163.
One end of the guide bar 176 is press-fitted into the peripheral wall surface of the. The other end of the guide bar 176 is provided so as to project inward in the radial direction of the holding cylinder portion 171 and has a slide ring 173.
The slide hole 177 is formed so as to be slidably fitted. Further, a compression coil spring 178 is arranged around the guide bar 176 between the slide ring 173 and the peripheral wall surface of the holding cylinder 171.

Also, the holding cylinder portion 171 of the rotating ring 163.
A fitting hole 179 is formed in a portion of the peripheral wall surface facing the guide bar 176. The shaft 181 of the push button 180 is slidably fitted in the fitting hole 179. A male screw portion 182 is formed at the tip of the shaft 181. This male screw part 182 is a slide ring 173.
Is screwed into a screw hole formed on the outer peripheral surface of the.

An annular index 183 is displayed on the insertion portion 52 of the endoscope 20. Then, when the endoscope 20 is attached to the endoscope attachment portion 157, the index 183 and the upper surface of the lid 175 of the holding cylinder portion 171 of the rotating ring 163 are aligned so as to be aligned with each other, so that rotation can be achieved. The centers of gravity of the members that rotate around the axes O ₆ , O ₇ , and O ₈ are set so as to coincide with each other on their respective rotation axes.

FIG. 11 shows the internal structure of the support member 150. Here, the support member 1 of the second embodiment
The difference from 09 is as follows. First, the support member 1
A rotary seat 155 is supported in the bearing 50 through ball bearings 153 and 154. A worm wheel 156 is fixed to one end of the rotary seat 155 with a fixing screw (not shown).

A swing arm drive motor 158, which is a motor with an electromagnetic brake, is fixed inside the support member 150. Output shaft 159 of this drive motor 158
The worm gear 1 that meshes with the worm wheel 156.
60 is fixed.

The stator 112 of the swing arm fixed electromagnetic brake 106 is fixed to the other end of the rotary seat 155, as in the second embodiment. The other structure is similar to that of the second embodiment. The configuration of the vertical rod drive unit in the mounting portion 151 is also the same, and the description thereof is omitted here.

FIG. 13 shows a joystick 152 which is connected to a drive control unit which will be described later and which can be operated by the operator with his / her foot. This joystick 152 is shown in FIG.
It is connected to the drive control unit 161 shown in. A switch 107 similar to that of the second embodiment is connected to the drive control section 161. The switch 107 is arranged in the L-shaped forming portion 16b of the L-shaped connecting member 16.

Further, in the drive controller 161, control signals are output to the vertical rod fixed electromagnetic brake 104, the swing arm fixed electromagnetic brake 106, and the lower rod fixed electromagnetic brake 105, and the swing arm drive motor 158,
A logic circuit (not shown) that outputs a drive signal to the vertical rod drive motor 162 is provided.

Next, the endoscope 20 is attached to the endoscope mounting portion 157.
The work of mounting the insertion portion 52 of will be described. First,
When the push button 180 is not pushed, the rotating ring 16 is pressed by the spring force of the compression coil spring 178.
The slide ring 173 in the holding cylinder portion 171 of FIG.
This slide ring 1 is pressed to the left in (A).
The fixed portion of the push button 180 in 73 is the holding cylinder portion 17
It is held in a state of being pressed against the inner wall surface of No. 1. At this time,
The endoscope insertion opening 173 a of the slide ring 173 is a lid 17.
5, the endoscope insertion opening 175a and the through hole 170 of the rotary ring 163 are held at positions eccentric to each other.
It is held so that it cannot be inserted inside.

Further, the push button 180 is the rotating ring 16
3 is pushed in until it abuts on the shaft 3, the shaft 181 moves inward through the fitting hole 179 of the rotating ring 163, and the slide ring 173 is guided by the guide bar 176 in the slide hole 177.
It moves to the right in FIG. 12 (A) against the spring force of 78. As a result, the endoscope insertion opening 173a of the slide ring 173 is arranged coaxially with the endoscope insertion opening 175a of the lid 175 and the through hole 170 of the rotation ring 163, so that the insertion portion 52 of the endoscope 20 is rotated. It can be inserted into the through hole 170 of the ring 163.

In this state, after inserting the insertion portion 52 of the endoscope 20 into the through hole 170 of the rotary ring 163 from above, when the push button 180 is released, the spring force of the compression coil spring 178 causes the rotary ring to rotate. 163 holding cylinder part 1
The slide ring 173 in 71 is pressed leftward as shown in FIG. At this time, the insertion portion 52 of the endoscope 20 has the endoscope insertion opening 173 a of the slide ring 173.
12B in FIG. 12B, the through hole 170 of the rotary ring 163 and the endoscope insertion opening 1 of the lid 175.
It is sandwiched and fixed between the end edge portion on the left side in FIG.

The actual fixed position of the insertion portion 52 of the endoscope 20 may be set to an optimum position by a surgical technique, but in the case where the balance state of the apparatus is to be perfectly balanced. Is an index 183 displayed on the endoscope 20.
May be aligned and fixed in a state of being aligned with the upper surface of the lid 175 of the endoscope mounting portion 157. Next, the operation of the drive controller 161 will be described based on the following Table 1.

[0111]

[Table 1]

First, when the switch 107 is pushed in, an operation signal is output to the vertical rod fixed electromagnetic brake 104, the swing arm fixed electromagnetic brake 106, and the lower rod fixed electromagnetic brake 105, and the fixation of all the electromagnetic brakes is released. To be done. In this state, joystick 1
When 52 is operated and the control signal from the joystick 152 is input, the operation signals of the electromagnetic brakes 104, 105 and 106 are output so as to perform the operations shown in Table 1 above, and the motors 156 and 162 are also output. The drive signal is output to.

That is, when a signal in the X direction is input by the joystick 152, the swing arm fixed electromagnetic brake 106 and the vertical rod fixed electromagnetic brake 104 are provided.
No operation signal is output to the lower rod fixing electromagnetic brake 105, and an operation signal is output to the lower rod fixing electromagnetic brake 105 to release the fixation. At this time, a drive signal is output to the swing arm drive motor 158.

When a signal in the Y direction is input by the joystick 152, no operation signal is output to the swing arm fixed electromagnetic brake 106 and the vertical rod fixed electromagnetic brake 104, and the lower rod fixed electromagnetic brake is held in a fixed state. An operation signal is output to the brake 105 and the fixing is released. At this time, the vertical rod drive motor 16
A drive signal is output to 2.

Further, X is set by the joystick 152.
If signals in both the direction and the Y direction are input at the same time, the operation of the electromagnetic brake does not change, and the swing arm drive motor 15
8. The drive signals are simultaneously output to the vertical motor 162 and the vertical motor 162, respectively.

Next, the operations of the swing arm drive unit and the vertical rod drive unit, which are different from those of the second embodiment, will be described. First, the operation of the swing arm drive unit will be described with reference to FIG.
The slewing arm drive motor 158 is rotated by a motor drive signal from the drive control unit 161 based on a signal in the X direction from the joystick 152, and the worm wheel 156 is passed through the worm gear 160 fixed to the output shaft 159.
Rotates.

At this time, the rotary seat 155 and the swing arm fixed electromagnetic brake 106 fixed to the rotary seat 155 rotate integrally with the worm wheel 156. Here, since the swing arm fixed electromagnetic brake 106 is held in a fixed state by the action described in the second embodiment, the rotary seat 1
55 and the swivel arm 6 rotate integrally with the cover 118.

When an operation signal is input from the drive control section 161 based on the signal in the Y direction from the joystick 152 to the swing arm fixed electromagnetic brake 106, the swing arm fixed electromagnetic brake is operated by the action described in the second embodiment. The fixing of the brake 106 is released, and the swing arm 6 is covered by the cover 1.
It becomes integral with 18 and is in a rotatable state. The same applies when the switch 107 is pressed.

When neither the switch 107 nor the joystick 152 is operated, the swing arm fixed electromagnetic brake 106 is held in a fixed state, and the swing arm drive motor 158 is also held in a stopped state. Therefore, due to the meshing between the worm wheel 156 and the worm gear 160, the swing arm fixed electromagnetic brake 106.
The rotary seat 155 is fixed in a non-rotatable state, and the revolving arm 6 is in a fixed state. The operation of the vertical rod drive unit is the same as that of the swivel arm drive unit, and a description thereof will be omitted.

Next, the movement of the endoscope 20 will be described. When the switch 107 and the joystick 152 are not operated, as in the second embodiment, the vertical rod 2 and the link mechanism unit 4 including the parallelogram link are held in a fixed state, and the endoscope 20 sets the intersection C at the intersection C. Only turning motion around the center is possible. Then, when the switch 107 is pressed, the endoscope 2 is operated as in the second embodiment.
0 can be moved freely.

FIG. 15 is a diagram for explaining the movement of the endoscope 20 when the joystick 152 is operated in the X direction. In the figure, the joystick 152
Are arranged so that the longitudinal direction of the upper rod 9 is the X direction.

When the joystick 152 is operated in the X direction, the revolving arm 6 rotates while the rotation of the vertical rod 2 is fixed, and the lower rod 7 is unfixed. That is, since the upper rod 9 can be rotated, the endoscope 20 can be moved by the frictional force with the trocar 100.
Without moving in the insertion direction, the abdominal wall opening S where the trocar 100 is punctured is tilted in the direction of arrow E in FIG. By this action, the observation site by the endoscope 20 can be moved in the direction of arrow e in the figure.

FIG. 16 is a diagram for explaining the movement of the endoscope 20 when the joystick 152 is operated in the Y direction. The joystick 152 is arranged such that the longitudinal direction of the upper rod 7 is the X direction.

Here, when the joystick 152 is operated in the Y direction, the vertical rod 2 is rotated and the lower rod 7 is released from the fixed state while the swing arm 6 is fixed. That is, since the upper rod 9 can be rotated, the endoscope 20 is caused by the frictional force with the trocar 100.
It does not move in the insertion direction, but inclines in the direction of arrow F in FIG. 16 with the abdominal wall opening S where the trocar 100 is punctured as the inclination center point. By this action, the observation site by the endoscope 20 can be moved in the direction of arrow f in the figure.

Therefore, in the structure described above, since the electric drive mechanism is added to the second embodiment, the observation field of view of the endoscope 20 can be moved even if the operator does not use his / her hands during the operation. Therefore, the operation time and the operator's fatigue can be reduced.

Further, the motorized mechanism of the observation field of view of the endoscope 20 is not provided with a drive unit in a portion related to the inclination of the endoscope 20,
Since the revolving arm 6 and the vertical rod 2 are electrically driven, the driving unit can be arranged in the support member 150 and the mounting unit 151. Therefore, as in the second embodiment, there is no obstructive protrusion on the abdomen of the patient during surgery,
Does not impair the workability of surgery. Further, since the endoscope 20 does not move in the insertion direction with respect to the abdominal wall opening S during electric drive, there is no possibility that the distal end portion of the endoscope 20 moves in a direction other than the desired direction, and safety can be improved.

Further, various types of endoscopes can be fixed to the endoscope mounting portion 157 at arbitrary positions in the insertion direction,
Highly versatile for endoscopes of various models with different center of gravity positions and diameters. Furthermore, in this embodiment, the endoscope 2
Instead of 0, the treatment tool can be directly held and inserted.

17 to 20 show a fourth embodiment of the present invention. In the surgical instrument holding apparatus of this embodiment, the rotational force amount adjusting unit 8 of the first embodiment is changed to the configuration shown in FIG. The basic structure of the support structure of the adjustment dial 33 of this embodiment is the same as that of the first embodiment.

In this embodiment, the disc spring 641 is used as the bias means of the adjustment dial 33, and
Instead of the washer 43 of the first embodiment, the bearing 6
42 is used. In FIG. 18, 643
Is a collar pressed against the outer peripheral surface of the bearing member 38, and 644 is a stopper for the bearing 642.

Therefore, in this embodiment, since the disc spring 641 is used as the biasing means of the adjusting dial 33, the biasing means by the pressure contact of the ring-shaped collars 40 and 41 and the O-ring 42 as in the first embodiment is used. In comparison, it is possible to widen the adjustment range of the operating force amount of the parallelogram link mechanism 4.

Further, in this embodiment, a height adjusting mechanism for adjusting the height of the entire apparatus is provided. Here, for example, the fixed arm 234 of the installation portion 232 that is detachably fixed to the side rail of the operating table by the fixing screw 233 is shown in FIG.
As shown in FIG. 9, a through hole 235 penetrating in the vertical direction is formed. The lower shaft portion 236 of the vertical rod 2 is inserted into the through hole 235 so as to be vertically movable. The lower shaft portion 236 of the vertical rod 2 is provided with a plurality of annular grooves 236a at predetermined intervals in the axial direction.

Further, the fixed arm 234 has a through hole 23.
A first screw hole (not shown) is bored in the direction perpendicular to 5. A height fixing pin 239 is screwed into this screw hole. By engaging the tip end portion of the height fixing pin 239 with the annular groove 236a of the lower shaft portion 236 of the vertical rod 2, the vertical position of the vertical rod 2 with respect to the fixing arm 234 can be fixed. . Therefore, the vertical rod 2 can be vertically slid with respect to the fixed arm 234 to be adjusted to an arbitrary height.

FIG. 19 shows a rotational force amount adjusting mechanism for adjusting the weight of the rotation of the lower shaft portion 236 of the vertical rod 2 with respect to the fixed arm 234. In this rotational force amount adjusting mechanism, a second screw hole 237 is formed in the fixed arm 234 in a direction perpendicular to the through hole 235. A large-diameter hole portion 651 is formed at a connecting portion of the screw hole 237 with the through hole 235.

Further, a rotational force amount adjusting dial 238 is arranged on the side surface of the fixed arm 234. The torque adjustment dial 238 is provided with a male screw portion 238b. The screw portion 238b is fixed to the fixed arm 23.
4 is screwed into the screw hole 237.

Further, a small diameter portion 652 is formed at the tip of the screw portion 238b of the rotational force adjustment dial 238. A ring-shaped disc spring 653 and a pressure contact member 654 are inserted into the small diameter portion 652. Further, the small diameter portion 65
A fixing screw 655 is fixed to the front end surface of 2. Then, the fixing screw 655 and the rotational force amount adjusting dial 238
Between the screw portion 238b of the disc spring 653 and the pressure contact member 6
54 is rotatably supported.

Then, the threaded portion 238b of the rotational force adjusting dial 238 is screwed into the threaded hole 237 of the fixed arm 234, and the pressure contact body 654 at the tip of the threaded portion 238b is pressed against the lower shaft portion 236 of the vertical rod 2. At this time, the pressure contact body 6 is adjusted by adjusting the screwing amount of the screw portion 238b in accordance with the rotation operation of the rotating force amount adjusting dial 238.
It is possible to adjust the rotational force of the lower shaft portion 236 of the vertical rod 2 by adjusting the frictional force between 54 and the moving arm 236.

Further, in this embodiment, the structure of the surgical instrument holding portion connected to the upper rod 9 of the parallelogram linkage mechanism 4 is changed. That is, in the surgical instrument holding portion, an adapter attaching / detaching portion 551 fixed to the tip end portion of a connecting arm 331 detachably connected to the upper rod 9, and an endoscope 335 detachably connected to the adapter attaching / detaching portion 551. Holding adapter 552 is provided.

Here, the holding adapter 55 of the endoscope 335.
Between the adapter 2 and the adapter attachment / detachment portion 551, for example, a slide type coupling means is provided. Further, the adapter attachment / detachment portion 551 is provided with an engagement means for releasably engaging with the holding adapter 552 and a release knob 565 for releasing the engagement of the holding adapter 552. Then, when the holding adapter 552 is attached to the adapter attaching / detaching portion 551, the holding adapter 552 is fixed to the adapter attaching / detaching portion 551 side by the engaging means, and the release knob 565 is provided.
The holding adapter 552 is disengaged with the operation of, and the holding adapter 552 can be detached from the adapter attaching / detaching portion 551 side.

FIG. 20 shows the structure of the connecting portion between the base end of the connecting arm 331 and the upper rod 9 of the parallelogram linkage mechanism 4. Here, a coupling mechanism 661 for coupling with the upper rod 9 is provided at the base end portion of the coupling arm 331.

This connecting mechanism 661 has a connecting arm 331.
An arm rotation block 662 fixed to the base end of the arm is provided. A rotating shaft 663 serving as a rotating shaft of the connecting arm 331 is rotatably connected to the arm rotating block 662. The rotating shaft 663 is arranged in parallel with the connecting arm 331.

A rotary screw 347 for connecting with the upper rod 9 is attached to the tip of the rotary shaft 663 so as to be movable back and forth in the axial direction. In addition, the rotating shaft 663
A small diameter portion 664 and a screw portion 665 are formed at the base end portion of the. The small diameter portion 664 is provided with an O-ring 666 as a biasing device sandwiched between a pair of bearings 667 and a collar 668.

Further, the screw portion 665 has a screw hole 6 at the shaft center portion.
A rotary operation force adjusting dial 669 having a portion 69a formed therein is screwed on. Then, a pair of bearings 66 are sandwiched between the adjusting dial 669 and a connecting portion of the rotating shaft 663 with the arm rotating block 662.
7, an O-ring 666 and a collar 668 are supported.

Then, the adjusting dial 669 is screwed into the rotary shaft 663, and the O-ring 666 is press-contacted,
A frictional force between the arm rotation block 662 and the rotation shaft 663 is adjusted to adjust the amount of rotation operation force. It should be noted that the present invention is not limited to the above-mentioned embodiments, and it is needless to say that various modifications can be made without departing from the gist of the present invention.

[0144]

According to the present invention, the holding portion of the surgical instrument is connected to the extension portion on one end side of the upper rod in the parallelogram link formed by the pivot arm, the lower rod, the upper rod and the connecting rod, Since the counterweight, which is balanced with the holding part on which the surgical instrument is mounted, is arranged on the parallelogram link, in order to move the surgical instrument held on the holding part of the surgical instrument such as a treatment instrument or an endoscope. There is no need to perform a troublesome operation such as fixing and releasing the fixing part of the holding part of the surgical instrument, and the operability can be improved, and the operativeness of the surgical instrument is light and the operability is reduced due to the weight of the surgical instrument. It is not damaged, and it can be made into a compact size that does not get in the way even when connected to an operating table or the like.

[Brief description of drawings]

FIG. 1 is a perspective view showing a schematic configuration of an entire surgical instrument holding device according to a first embodiment of the present invention.

FIG. 2 is a side view showing a partial cross-section of the structure of a force amount adjusting portion around a rotation axis O ₂ viewed from the direction of arrow Q in FIG.

FIG. 3 is a vertical cross-sectional view showing a main configuration of an endoscope holding portion.

FIG. 4 is a perspective view showing a state in which the endoscope holding member is removed from the L-shaped connecting member.

FIG. 5 is a schematic configuration diagram for explaining a balanced state of parallelogram links.

6A is a schematic configuration diagram for explaining horizontal movement of the endoscope, FIG. 6B is a schematic configuration diagram for explaining vertical movement of the endoscope, and FIG. 6C is a first embodiment. The schematic block diagram for explaining the modification of an example.

FIG. 7 is a side view showing a state in which a treatment tool is attached to a holding portion of a surgical instrument holding device, with a partial cross section thereof.

FIG. 8 is a perspective view showing a schematic configuration of an entire surgical instrument holding device according to a second embodiment of the present invention.

9A is a block diagram for explaining an electric system, FIG. 9B is a vertical cross-sectional view showing an internal structure of a swing arm lock part, and FIG. 9C is a vertical cross-sectional view showing an internal structure of a vertical rod lock part. Fig.

FIG. 10 is a perspective view showing a schematic configuration of an entire surgical instrument holding device according to a third embodiment of the present invention.

FIG. 11 is a vertical cross-sectional view showing the internal structure of the support member.

FIG. 12 (A) is a vertical cross-sectional view showing a state in which the endoscope is detached from the endoscope mounting portion, and FIG. 12 (B) is a vertical sectional view showing a state in which the endoscope is attached to the endoscope mounting portion. Face view.

FIG. 13 is a perspective view showing a joystick.

FIG. 14 is a block diagram for explaining an electric system.

FIG. 15 is a schematic configuration diagram for explaining the movement of the endoscope when the joystick is operated in the X direction.

FIG. 16 is a schematic configuration diagram for explaining the movement of the endoscope when the joystick is operated in the Y direction.

FIG. 17 is a perspective view showing a schematic configuration of an entire surgical instrument holding device according to a fourth embodiment of the present invention.

FIG. 18 is a vertical cross-sectional view of a main part showing a support structure of an adjustment dial.

FIG. 19 is a vertical cross-sectional view of a main portion showing a rotational force amount adjusting mechanism portion of a lower shaft portion of a vertical rod.

FIG. 20 is a vertical cross-sectional view of a main part showing a structure of a connecting portion between a connecting arm and a parallelogram link mechanism portion.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Attachment part, 2 ... Vertical rod, 4 ... Link mechanism part which consists of parallelogram links, 6 ... Revolving arm, 7 ... Lower rod, 9 ... Upper rod, 13 ... Connecting rod, 14 ... Surgical instrument holding part, 24 ... 1st counterweight, 25 ...
Second counterweight, 71 ... Counterweight.

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[Procedure amendment]

[Submission date] January 24, 1995

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0017

[Correction method] Change

[Correction content]

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS.
This will be described with reference to (B). FIG. 1 shows a schematic configuration of the entire surgical instrument holding device. Reference numeral 1 denotes a mounting portion that is detachably locked to a base such as an operating table. A vertical rod 2 is erected on the mounting portion 1 along the vertical direction. This vertical rod 2 is attached to the mounting portion 1 with a force adjusting portion 3
Is rotatably connected via a vertical rotation axis O ₁ . Here, the force amount adjusting portion 3 adjusts the weight of the movement of the vertical rod 2 rotating with respect to the mounting portion 1 .

[Procedure Amendment 2]

[Document name to be amended] Statement

[Name of item to be corrected] 0136

[Correction method] Change

[Correction content]

Then, the threaded portion 238b of the rotational force adjusting dial 238 is screwed into the threaded hole 237 of the fixed arm 234, and the pressure contact body 654 at the tip of the threaded portion 238b is pressed against the lower shaft portion 236 of the vertical rod 2. At this time, the pressure contact body 6 is adjusted by adjusting the screwing amount of the screw portion 238b in accordance with the rotation operation of the rotating force amount adjusting dial 238.
Of the rotating operation force and acceleration vertical rods 2 a frictional force between the 54 and the lower shaft portion 236 can be adjusted.

[Procedure 3]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 19

[Correction method] Change

[Correction content]

FIG. 19

Claims (1)

[Claims] 1. A mounting portion releasably locked to a base, a vertical rod standing upright along a vertical direction and rotatably connected to the mounting portion, and a rotary shaft of the vertical rod. Is supported rotatably about a second rotation axis orthogonal to
A swivel arm extending in the vertical direction, a lower rod rotatably supported about the second rotation shaft, extending in the horizontal direction, and a lower rod arranged in parallel with the lower rod. An upper rod rotatably supported with respect to an arm about a third rotation axis parallel to the second rotation axis, and an upper rod disposed in parallel to the swivel arm and arranged on the lower rod and the upper rod. On the other hand, a connecting rod rotatably supported about fourth and fifth rotating shafts respectively parallel to the second and third rotating shafts, and the swing arm, the lower rod, the upper rod and the connecting rod. In the parallelogram link to be formed, a holding part of the surgical instrument connected to the extension part on the one end side of the upper rod and the parallel part in a state of being balanced with the holding part on which the surgical instrument is mounted. The power placed on the quadrilateral link Surgical instrument holding apparatus characterized by comprising a centers weight.