JPH08164141A - 処置具 - Google Patents

処置具

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Publication number
JPH08164141A
JPH08164141A JP6308827A JP30882794A JPH08164141A JP H08164141 A JPH08164141 A JP H08164141A JP 6308827 A JP6308827 A JP 6308827A JP 30882794 A JP30882794 A JP 30882794A JP H08164141 A JPH08164141 A JP H08164141A
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JP
Japan
Prior art keywords
bending
forceps
treatment instrument
treatment
outer casing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP6308827A
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English (en)
Inventor
Akihiro Horii
章弘 堀井
Hitoshi Mizuno
均 水野
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Olympus Corp
Original Assignee
Olympus Optical Co Ltd
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Filing date
Publication date
Application filed by Olympus Optical Co Ltd filed Critical Olympus Optical Co Ltd
Priority to JP6308827A priority Critical patent/JPH08164141A/ja
Publication of JPH08164141A publication Critical patent/JPH08164141A/ja
Pending legal-status Critical Current

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Abstract

(57)【要約】 【目的】高剛性で自在な湾曲を有し、また操作部の操作
感覚を処置具に確実に伝達することができる処置具を提
供することにある。 【構成】鉗子５と、この鉗子５を体腔内に挿入するため
の湾曲部２を有する挿入部４と、前記鉗子５を駆動させ
る操作部３とからなり、この操作部３と前記鉗子５とを
連結する連結部材を、フレキシブルなアウターケーシン
グ１７と、このアウターケーシング１７の内部で軸方向
に移動可能なインナーケーブル１８とから構成したこと
を特徴とする

Description

【発明の詳細な説明】
【０００１】
【産業上の利用分野】この発明は、内視鏡下外科手術に
用いられる処置具に関する。
【０００２】
【従来の技術】近年、胆のう摘出、虫垂切除、大腸切除
等の手術が内視鏡を用いることにより低侵襲に行われる
ようになった。この術式は一般に内視鏡下外科手術と呼
ばれ、トラカールと呼ばれる案内管を腹腔等の体腔内に
刺入し、このトラカールをガイドとして光学視管や処置
具を体腔内に挿入し、処置を行うものである。
【０００３】前記処置具は、挿入部の先端側に処置部を
有し、手元側に操作部を有した構造であるが、挿入部の
先端部の湾曲を可変させることができるものとして、例
えばＵＳＰ５２５４１３０が知られている。これはあら
かじめ湾曲形状を記憶させた超弾性チューブを固定され
た外筒管に出入りさせることで、湾曲を可変する方法で
ある。また、前記ＵＳＰ５２５４１３０には、超弾性チ
ューブの外側に回転用のチューブを設けることで、処置
具の先端部を回転する方法が開示されている。さらに、
ＥＰＯ５５７８０６Ａ２には関節構造をリンク構造を用
いて湾曲させる方法が開示されている。
【０００４】また、処置具マニピュレータを遠隔的に操
作して手術する手術装置が、ＵＳＰ５２１７００３、特
願平５−２８５２０６に開示されている。この手術装置
の構成は、手術処置機能を持った処置用マニピュレータ
と、この処置用マニピュレータを遠隔位置から操作する
ための情報入力手段、あるいは遠隔操作手段から構成さ
れている。
【０００５】処置具の先端部を湾曲および回転させ、体
腔内での処置性を向上させる方法が前記ＵＳＰ５２５４
１３０に開示されている。また、体腔外に第２の湾曲部
を用いて体腔外の操作性を向上させる方法が文献「Ｉｎ
ｓｔｒｍｅｎｔｓ ｆｏｒＥｎｄｏｓｃｏｐｉｃ Ｓｕ
ｒｇｅｒｙ」に示されている。また、体腔内に複数の湾
曲手段を設け、処置性を向上させる方法が、特願平３−
３３９５９１に開示されている。
【０００６】さらに、従来、内視鏡などの体腔内医療器
具の湾曲手段として、複数の節輪を連結した湾曲管構造
が用いられており、これは特願平５−２９４５２に開示
されている。この特願平５−２９４５２には超弾性合金
に切り欠きを多数設けることにより、一体の部材で製造
可能な湾曲構造が開示されている。
【０００７】また、内視鏡下外科手術を遠隔的に操作す
るための遠隔操作手段として、複数関節の握り装置から
なる医療用のマスターマニピュレータが、特願平６−１
２８６４８に開示されている。さらに、ワイヤを用いた
３次元的な位置の入力装置がＵＳＰ５３０５４２９に開
示されている。
【０００８】
【発明が解決しようとする課題】しかしながら、前述し
た従来技術は次のような問題がある。まず、ＵＳＰ５２
５４１３０は、処置具の先端部の湾曲を可変させるため
に、あらかじめ湾曲形状を記憶させた超弾性チューブを
固定された外筒管に出入りさせているため、超弾性チユ
ーブと外筒管の摩擦のために、処置具操作中に湾曲を自
在に可変させることは困難である。また、操作に必要な
剛性を超弾性チューブに持たせるためには、外筒管によ
る抑制によって発生する応力が大きくなり超弾性チュー
ブの寿命は著しく短くなってしまい長期使用が困難であ
る。
【０００９】それに対して湾曲に関節構造を用いたＥＰ
０５５７８０６Ａ２の例では、高剛性を保ちながら自在
に湾曲させることが可能であるが、先端処置具を駆動す
るためのワイヤの経路が不確定であり、そのため処置具
を開く力によって剥離を行おうとしても、ワイヤが座屈
し、力が伝達されない。処置具を閉じる場合にも、ワイ
ヤのたるみにより直接的な操作感が伝達されない。
【００１０】また、前記ＵＳＰ５２５４１３０では、超
弾性チューブの外側に回転部材を設けることにより、先
端処置具の回転を行っている。しかし、独立した回転部
材のために、処置具の外径が大きくなってしまう。
【００１１】特願平５−２８５２０６に開示されている
処置用マニピュレータは、先端部の湾曲および処置具の
開閉を動力によって実現している。このような動力処置
具では、駆動部の駆動量と処置部の開閉量の関係が一意
的である。すなわちガタやゆるみの無い伝達構造が必要
となる。しかし、駆動部と処置部の間に可動の湾曲部を
有する伝達構造では、ガタやゆるみの無い構造を実現す
ることが困難であった。
【００１２】前記ＵＳＰ５２５４１３０に示されるよう
な湾曲処置具を用いることによって、先端部が湾曲して
いない場合に比較して体腔内で対象へのアプローチの自
由度が高くなる。しかし、体腔外では直線状であるた
め、他の処置具や、観察用硬性鏡などと干渉する可能性
がある。そこで文献「Ｉｎｓｔｒｍｅｎｔｓ ｆｏｒＥ
ｎｄｏｓｃｏｐｉｃ Ｓｕｒｇｅｒｙ」に体外に第２の
湾曲部を設ける技術が示されているが、本文献のような
ボールジョイントによる湾曲構造では処置具の開閉や先
端部の回転を行うための伝達構造を実現することが困難
である。
【００１３】さらに、特願平５−２９４５２に開示され
ている、複数の節輪を連結した湾曲管構造では、湾曲管
内部の内蔵物の形状や硬さ、湾曲管と内蔵物との摩擦力
などによって湾曲形状が一定しないため、先端部の微妙
な位置決めが難しく、湾曲操作性が悪いという不具合が
生じている。
【００１４】また特願平５−２９４５２に示されてい
る、超弾性合金に切り欠きを多数設けることにより、一
体の部材で製造可能な湾曲構造では、安価に製作できる
利点がある。しかし、切り欠き部に応力集中が発生する
ため、寿命が短く、また２箇所の繋ぎ目のみで力を受け
るため湾曲部の剛性が低いという欠点がある。
【００１５】特願平６−１２８６４８に開示されてい
る、内視鏡下外科手術を遠隔的に操作するための医療用
のマスターマニピュレータは、複数の関節から成り立っ
ているために、術者の身体と干渉し、自由な操作を妨げ
たり、関節を構成する部材の重量のために機敏な操作を
入力することが困難である。また、力を操作者にフィー
ドバックするためには、関節に駆動源を設ける必要があ
り、全体の構造が大きく、複雑になる。
【００１６】それに対し、ＵＳＰ５３０５４２９に開示
されている３次元的な位置の入力装置では、糸によって
３次元的な位置検出を行っているため、重量が軽く、機
敏な操作に追従する。また、力覚を提示する場合にも、
全体の構造が大きく、複雑になることがない。しかしな
がら、内視鏡下外科手術においては操作者は術者であ
り、従来の手術機器と同様の操作性であることが重要で
ある。
【００１７】この発明は、前述した諸々の事情に着目し
てなされたもので、その目的とするところは、高剛性と
自在な湾曲を実現しながら、処置具開閉の駆動力を確実
に伝達し、先端処置具からの直接的な操作感を伝達する
ことができ、操作性に優れた処置具を提供することにあ
る。
【００１８】
【課題を解決するための手段】この発明は、前記目的を
達成するために、先端処置具と、この先端処置具を体腔
内に挿入するための湾曲部を有する挿入部と、前記先端
処置具を駆動させる操作部と、この操作部と前記先端処
置具とを連結する連結部材とを有する処置具において、
前記連結部材は、フレキシブルな外部材と、この外部材
の内部で軸方向に移動可能な内部材とで構成されたこと
を特徴とする。
【００１９】
【作用】操作部を操作することにより、湾曲ワイヤが軸
方向に移動して湾曲手段としての湾曲管が湾曲して湾曲
部が湾曲する。また、操作部の回転操作リングを回転す
ると、その回転力は外部材としてのアウターケーシング
を介して伝達されて先端処置具としての鉗子の全体が回
転する。さらに、操作部の操作握り及び操作ハンドルを
開閉することにより、内部材としてのインナーケーブル
がアウターケーシングに対して進退し、鉗子が開閉す
る。
【００２０】
【実施例】以下、この発明の各実施例を図面に基づいて
説明する。図１〜図４は第１の実施例を示し、図１は処
置具の斜視図、図２は処置具の縦断側面図、図３はアウ
ターケーシングとインナーケーブルの構成図、図４は処
置具の作用説明図である。処置具は、先端に設けられた
先端処置具１、この処置具１を位置決めする湾曲部２、
先端処置具１と湾曲部２を操作する操作部３および操作
部３と湾曲部２を接続する挿入部４とから構成されてい
る。
【００２１】前記処置具１は枢支ピン５ａを支点として
回動自在な一対の鉗子片５ｂによって鉗子５が構成され
ており、一対の鉗子片５ｂの基端部は連結ピン６ａを介
してリンク６に連結されている。鉗子５およびリンク６
は鉗子回転シャフト７に開閉自在に支持されており、こ
の鉗子回転シャフト７の中央には鉗子回転シャフト７に
対して進退自在で、リンク６を進退させて鉗子５を開閉
する開閉ロッド８が設けられている。
【００２２】前記湾曲部２は、多数の湾曲駒９が関節状
に接続された湾曲管１０と、前記鉗子回転シャフト７を
湾曲管１０に回転自在に固定する鉗子支持部１１とから
構成されている。湾曲管１０の内側には湾曲ワイヤ１
２、１３が挿通されており、この一端は湾曲管１０の端
部に固定され、他端は挿入パイプ１４の内部を挿通し、
この挿入パイプ１４に対して回転可能に固定された湾曲
操作ノブ１５に固定されている。湾曲管１０の操作部３
側端部は、挿入パイプ１４に固定されており、挿入パイ
プ１４は操作握り１６に固定されている。
【００２３】前記湾曲部２の内腔には、管状のフレキシ
ブルな外装部材であるアウターケーシング１７が設けら
れ、更にその内部にはフレキシブルな棒状の内装部材で
あるインナーケーブル１８が設けられている。アウター
ケーシング１７は、湾曲管１０およびインナーケーブル
１８に対して回転自在であり、インナーケーブル１８は
アウターケーシング１７に対して進退自在である。アウ
ターケーシング１７の先端処置具１側端部は、鉗子回転
シャフト７に固定されており、操作部３側端部は中空の
回転伝達軸１９に固定されている。
【００２４】前記回転伝達軸１９は挿入パイプ１４に対
して回転自在な回転操作リング２０に固定されている。
インナーケーブル１８の先端処置具１側端部は開閉ロッ
ド８に固定され、操作部３側端部には挿入パイプ１４に
挿通された直動ロッド２１に固定されている。直動ロッ
ド２１は、操作握り１６に対して支点を中心に回動可能
な操作ハンドル２２に固定されている。
【００２５】前記アウターケーシング１７とインナーケ
ーブル１８について説明を加えると、図３に示すように
構成されている。すなわち、アウターケーシング１７
は、ステンレス製の平角スプリング２３およびこの平角
スプリング２３の外側に設けられたステンレス製のブレ
ード２４と、それらの外側に施されたフッ素樹脂による
樹脂コーティング２５より構成されている。インナーケ
ーブル１８は、ステンレス製の芯線２６と、その周囲に
よられた芯線２６よりも細いステンレス製の側線２７と
から構成されている。
【００２６】インナーケーブル１８は、芯線２６と側線
２７によるより線構造を取ることで、フレキシブルに湾
曲することが可能である。前記鉗子５を閉じようとした
場合に発生するインナーケーブル１８を伸長する力に関
しては、より線が密に寄り合うことで伸長を防止し、鉗
子５を開こうとする場合に発生する、インナーケーブル
１８を圧縮する力に関しては、中心の太い芯線２６によ
って座屈を防止する。
【００２７】アウターケーシング１７は平角スプリング
２３、ブレード２４、樹脂コーティング２５によるフレ
キシブルな構造により湾曲が可能である。鉗子５を閉じ
ようとした場合に発生するアウターケーシング１７を圧
縮する力に関しては、平角スプリング２３が密着するこ
とで座屈を防止する。鉗子５を開こうとする場合に発生
する、アウターケーシング１７を伸長する力に関して
は、平角スプリング２３の収縮力とブレード２４および
樹脂コーティング２５によって伸びを抑制する。また、
回転力は、主としてブレード２４と樹脂コーティング２
５により左右両回転とも伝達される。
【００２８】次に、前述のように構成された処置具の作
用について説明する。操作部３の湾曲操作ノブ１５を操
作することにより、湾曲ワイヤ１２、１３が軸方向に差
動的に動作して湾曲管１０が湾曲し、湾曲部２が湾曲す
る。また、回転操作リング２０を回転すると、その回転
力は回転伝達軸１９、アウターケーシング１７、鉗子回
転シャフト７と伝達されて鉗子５の全体が回転する。さ
らに、操作握り１６及び操作ハンドル２２を開閉するこ
とにより、直動ロッド２１が回転伝達軸１９に対して進
退し、インナーケーブル１８がアウターケーシング１７
に対して進退し、開閉ロッド８が鉗子回転シャフト７に
対して進退して鉗子５が開閉する。
【００２９】したがって、図４に示すように湾曲部２の
湾曲時に鉗子５を生体組織Ａの剥離のために開こうとし
た場合、図４（ａ）に示すように直動ロッド２１を先端
側へ押そうとする力によって、インナーケーブル１８に
撓もうとする力が働くが、図４（ｂ）に示すように、イ
ンナーケーブル１８がアウターケーシング１７により拘
束されているために、鉗子５を開く力が先端に確実に伝
達される。
【００３０】また、インナーケーブル１８が、アウター
ケーシング１７により拘束されているために湾曲部２の
湾曲による経路の長さ変化がなく、湾曲している場合と
しない場合で同じ操作感で鉗子５の開閉操作を行うこと
ができる。
【００３１】また、湾曲部２による湾曲とアウターケー
シング１７による回転を同時に行えるため、鉗子５に縫
合針を保持して行う縫合などの複雑な操作を行うことが
容易になる。さらに、湾曲部２を関節を有する構造によ
っているため、操作力が小さく、繰り返しの使用に対し
て耐久性が高い。
【００３２】図５は第２の実施例を示し、アウターケー
シング１７およびインナーケーブル１８の他の実施例で
ある。図５（ａ）〜（ｃ）はアウターケーシング１７の
構成で、図５（ｄ）（ｅ）はインナーケーブル１８の構
成である。
【００３３】（ａ）に示すアウターケーシング１７は、
平角スプリング２８とその外側に施されたフッ素樹脂に
よる樹脂コーティング２９により構成されている。そし
て、圧縮力は平角スプリング２８で受け、伸長力は樹脂
コーティング２９で受けるようになっている。
【００３４】（ｂ）に示すアウターケーシング１７は、
一層多条巻きのスプリング３０で構成されている。そし
て、圧縮力および引張り力に対しては、スプリング３０
自身の剛性で受ける。回転力はスプリング３０が締まる
方向に対して伝達されるが、緩む方向の回転伝達力は比
較的小さい。
【００３５】（ｃ）に示すアウターケーシング１７は、
多層多条巻きのスプリング３１で構成されている。スプ
リング３１の巻き方向を層ごとに変えることにより、左
右両方向の力の伝達を可能にしている。
【００３６】（ｄ）に示すインナーケーブル１８は、芯
線３２と側線３３よりなる、より線で構成されている。
この構成によれば、座屈への耐力が小さいが湾曲性が良
いという特徴がある。
【００３７】（ｅ）に示すインナーケーブル１８は、芯
線３４及び巻き線３５で構成されている。座屈力に対し
ては、巻き線３４が受けるという構造になっている。図
６および図７は第３の実施例を示し、湾曲部２に構造と
して湾曲管１０の代わりに３節のリンク湾曲部４０によ
り構成したものであり、第１の実施例と同一構成部分は
同一番号を付して説明を省略する。
【００３８】図６は処置具の斜視図、図７はリンク湾曲
部４０の構造を示す。このリンク湾曲部４０は、第１リ
ンク４１と第２リンク４２とは左右対称的に配置され円
環状をなしている。第１リンク４１の端部と第２リンク
４２の中心は、リンク湾曲部４０の両端に固定されてい
る。第１リンク４１と第２リンク４２にはそれぞれ湾曲
ワイヤ４３、４４が連結されており、湾曲ワイヤ４３、
４４の移動量に対して線形な湾曲形状が得られる。
【００３９】図８は第４の実施例を示し、第３の実施例
の第１リンク４１と第２リンク４２の内側に、円環状に
配置した第３リンク４５および第４リンク４６を用いて
も同様に構成できる。
【００４０】第３および第４の実施例によれば、第１の
実施例の効果に加えて、湾曲形状が外力や湾曲部２の内
蔵物の影響を受けず湾曲ワイヤ４３、４４の移動量によ
って一意的に定まるという効果がある。また、本構造
は、処置具の湾曲部のみならず、内視鏡などの体腔内で
用いる医療機器に広く用いることができることは自明で
ある。
【００４１】図９は第５実施例を示す。第１の実施例に
おける湾曲管１０の代わりに、薄肉円筒体５０の周壁を
部分的に欠如した、伸縮可能な伸縮部４７および可倒可
能な可倒部４８によって湾曲コマ４９を連接した多段湾
曲管５０ａを構成したものである。可倒部４８は、その
両端部に２つの弧状の切り欠きを設けた２つの脆弱部５
１により構成されている。
【００４２】それぞれの湾曲コマ４９は、可倒部４８を
支点として可倒する。可倒による変形は脆弱部５１に集
中するが、脆弱部５１は弧状の切り欠き形状であるた
め、応力集中による破壊を防いでいる。また、可倒部４
８を２つの脆弱部５１から実現しているために、一つの
脆弱部５１当たりの変形量が小さい。伸縮部４７は、そ
の両端部に４つの弧状の切り欠きを設けた４つの脆弱部
５１よりなっている。伸縮部４７は、可倒部４８と同様
の脆弱部５１を関節とするリンク構造を形成しているた
め、軸方向に伸縮可能な構造となっている。
【００４３】また、脆弱部５１は弾性を有するため、リ
ンク構造全体として伸縮方向に対しばね性を持ってお
り、外力が加わらないときは、多段湾曲管５０ａが元の
形状に戻るという性質を持っている。可倒部４８と伸縮
部４７はそれぞれ対向しており、それぞれの段ごとに可
倒部４８と伸縮部４７の配置を入れ換えることによっ
て、上下左右２自由度に湾曲することが可能になる。
【００４４】本実施例によれば、第１の実施例の効果に
加えて、湾曲構造を一体成型や、一体加工により製造す
ることができ、従来に比して低いコストで製造できると
いう効果を持つ。また、湾曲コマ４９の接続部を可倒部
４８と伸縮部４７の４箇所で結合しているため、湾曲構
造全体の剛性が高い。また、切り欠き部を設けることで
湾曲を実現しているにも拘らず、応力集中しにくい構造
を取ることで、高寿命を実現している。また、本構造
は、処置具の湾曲部のみならず、内視鏡などの体腔内で
用いる医療機器に広く用いることができることは自明で
ある。
【００４５】図１０および図１１は第６の実施例を示
し、第１の実施例と同一構成部分は同一番号を付して説
明を省略する。本実施例の処置具は、第１の実施例の構
成に加え、挿入部４の操作部３側に更にもう一つの第２
の湾曲部５２を設けている。第２の湾曲部５２は、通常
は形状を保つが外力によって湾曲形状が変更可能な中空
のベローズ５３と、このベローズ５３の内側に第１の実
施例と同様のアウターケーシング５４とインナーケーブ
ル５５が設けられている。
【００４６】アウターケーシング５４は、回転操作リン
グ２０に固定された第１の回転伝達軸５６と、第１の湾
曲部２のアウターケーシング１７に固定されている第２
の回転伝達軸５７とを接続している。インナーケーブル
５５は、操作ハンドル２２に固定された第１の直動ロッ
ド５８と、第１の湾曲部２のインナーケーブル１８に固
定されている第２の直動ロッド５９とを接続している。
【００４７】本実施例では、第２の湾曲部５２として半
固定のものを用いているが、第１の実施例と同様の可動
の湾曲部を用いることも可能である。したがって、回転
操作リング２０を回転させると、その回転力が第１の回
転伝達軸５６、アウターケーシング５４、第２の回転伝
達軸５７によって伝達され、鉗子５を回転させることが
できる。操作ハンドル２２を開閉すると、第１の直動ロ
ッド５８、インナーケーブル５５、第２の直動ロッド５
９によって伝達される鉗子５を開閉させることができ
る。
【００４８】本実施例によれば、第１の実施例に示され
た効果に加え、内視鏡外科手術では、図１１に示される
ように、皮膚６０に筒状のトラカール６１を挿入し、ト
ラカール６１をガイドとして処置具としての鉗子６２を
挿入する。手術時には、複数の鉗子６３や観察用の内視
鏡６４が複数のトラカール６１から挿入される。このよ
うな状況で体外に第２の湾曲部５２を持つことにより、
術者の操作が行いやすくなり、また鉗子６２の方向を変
えるために体表に新たに操作用の孔を開ける必要が減少
すると考えられる。
【００４９】図１２〜図１４は第７の実施例を示す。本
実施例は、図１２に示すように、術者が操作する操作入
力装置６５、モータコントロールユニット６６および処
置用マニピュレータ６７を備えている。操作入力装置６
５は術者の手６８の位置、姿勢、把持の情報を読取り、
この情報に基づきモータコントロールユニット６６は、
位置、姿勢情報に基づき、処置用マニピュレータ６７を
制御させることができる。処置用マニピュレータ６７の
先端部は手術台６９上に固定された患者７０の体内に挿
入されたトラカール７１を挿通されており、患部の処置
を行うことができる。処置用マニピュレータ６７は、円
筒座標系に基づいて動作する３自由度のロボットアーム
７２および上下および回転の２自由度を持つ自在関節７
３と、先端部を動作させる挿入部７４および挿入部７４
を回転させるホルダ７５とから構成されている。
【００５０】前記操作入力装置６５は、図１３に示すよ
うに、立方体形状の枠体７６の角部頂点の部分に、それ
ぞれプーリ７７が配置され、それぞれのプーリ７７には
ワイヤ７８が掛けられている。６本のワイヤ７８は対角
面を形成する３本ずつのグループ７９、８０に分けら
れ、それぞれのグループ７９，８０は棒状の操作部８１
の２ヶ所の近傍のフランジ部８２、８３に取り付けられ
ている。操作部８１の終端には把持用のハンドル８４が
取り付けられている。それぞれのワイヤ７８の終端には
モータ８５とエンコーダ８６が取り付けられ、ワイヤ７
８の引き込み量を計測すると同時に、ワイヤ７８に自由
に張力を与えられるようになっている。
【００５１】前記ハンドル８４には把持力を測定する力
センサ８７が設けられている。エンコーダ８６の出力よ
り求められるそれぞれのワイヤ７８の長さから操作部８
１の３次元位置と姿勢が求まる。それぞれのワイヤ７８
の張力を可変することで操作部８１には反力が伝達され
る。モータ８５の代わりにばねを用いても、位置・姿勢
入力装置として用いることができる。力センサ８７の代
わりに把持用ハンドル８４の開閉角度を検出するエンコ
ーダを設けても、操作入力とすることができる。
【００５２】図１４は処置具の構成を示す。挿入部９０
は、鉗子を有する先端部９１と湾曲部９２および駆動部
９３とから構成されている。湾曲部９２は、上下・左右
２自由度に湾曲する湾曲管９４とこの湾曲管９４を操作
する上下用、左右用それぞれ対向する２本ずつ２組の操
作ワイヤ９５、９６および第１の実施例と同様のアウタ
ーケーシング９７およびインナーケーブル９８とから構
成されている。
【００５３】アウターケーシング９７は鉗子支持部９９
および駆動部９３の挿入パイプ１００に固定され、イン
ナーケーブル９８は、鉗子開閉ロッド１０１および駆動
部９３の直動ロッド１０２に固定されている。操作ワイ
ヤ９５、９６は、モータ１０３、エンコーダ１０４およ
びボールネジ１０５とプーリ１０６により構成される直
動アクチュエータ１０７のボールネジナット１０８に接
続固定されている。直動ロッド１０２も、同様のモータ
１０３、エンコーダ１０４およびボールネジ１０５によ
り構成される直動アクチュエータ１０７のボールネジナ
ット１０８に接続固定されている。
【００５４】したがって、術者は、操作入力装置６５を
操作し、処置用マニピュレータ６７を動作させて患者７
０の処置を行う。操作入力装置６５により得られた術者
の手６８の位置・姿勢・把持状態の情報は、コントロー
ルユニット６６に入力され、ロボットアーム７２の操作
量、ホルダ７３の挿入部７４の回転量、挿入部７４の湾
曲部９２の湾曲量および鉗子１０９の開閉角度に変換さ
れる。駆動部９３では、モータ１０３の回転によりボー
ルネジナット１０８が進退し、その進退に応じて操作ワ
イヤ９５、９６が差動的に駆動され、湾曲部９２が上下
左右に湾曲する。また、同様に直動ロッド１０２もモー
タ１０３の回転により進退し、鉗子開閉ロッド１０１を
介して鉗子１０９が開閉する。
【００５５】本実施例では、湾曲部９２の前後における
直動ロッド１０２と鉗子開閉ロッド１０１の動作を、ア
ウターケーシング９７とインナーケーブル９８を用いる
ことにより一致させ、モータ１０３とエンコーダ１０４
により高精度の鉗子１０９の開閉の制御を可能とし、そ
の結果、高度なマスタースレーブ制御による鉗子１０９
の遠隔操作を可能にしている。
【００５６】前述した実施態様によれば、次の構成が得
られる。 （付記１）先端処置具と、この先端処置具を体腔内に挿
入するための湾曲部を有する挿入部と、前記先端処置具
を駆動させる操作部と、この操作部と前記先端処置具と
を連結する連結部材とを有する処置具において、前記連
結部材は、フレキシブルな外装部材と、この外装部材の
内部で軸方向に移動可能な内装部材とで構成されたこと
を特徴とする処置具。 （付記２）先端処置具と、この先端処置具を体腔内に挿
入するための湾曲部を有する挿入部と、前記先端処置具
を駆動させる操作部と、この操作部と前記先端処置具と
を連結する連結部材とを有する処置具において、独立し
た湾曲可能な複数の湾曲手段を有する前記湾曲部と、フ
レキシブルな外装部材とこの外装部材の内部で軸方向に
移動可能な内装部材とで構成された前記連結部材しを具
備したことを特徴とする処置具。 （付記３）前記外装部材が、湾曲部に対して回転するこ
とにより前記先端処置具を回転させ、かつ内装部材が軸
方向に進退運動することにより前記先端処置具を開閉す
ることを特徴とする付記１または２記載の処置具。 （付記４）前記内装部材が、湾曲部に対して回転または
軸方向に進退運動することにより前記先端処置具を回転
または開閉することを特徴とする付記１または２記載の
処置具。 （付記５）前記外装部材は、円筒状の弾性金属バネで形
成されていることを特徴とする付記１記載の処置具。 （付記６）前記外装部材は、円筒状の弾性金属バネおよ
び樹脂層とで形成されていることを特徴とする付記１記
載の処置具。 （付記７）前記外装部材は、円筒状の弾性金属バネ、金
属ブレートおよび樹脂層で形成されていることを特徴と
する付記１記載の処置具。 （付記８）前記外装部材は、多条巻き金属コイルバネを
有することを特徴とする付記１記載の処置具。 （付記９）前記内装部材は、より線ワイヤを有すること
を特徴とする付記１記載の処置具。 （付記１０）前記内装部材は、芯材とより線とからな
り、芯材の径がより線の径より太いことを特徴とする付
記１記載の処置具。 （付記１１）前記湾曲手段の湾曲量がワイヤの張力によ
り可変されることを特徴とする付記１記載の処置具。 （付記１２）前記湾曲手段がモータによって駆動される
ことを特徴とする付記１記載の処置具。 （付記１３）先端処置具がモータによって駆動されるこ
とを特徴とする付記１記載の処置具。 （付記１４）先端処置具と、この先端処置具を体腔内に
挿入するための湾曲部を有する挿入部と、前記先端処置
具を駆動させる操作部と、この操作部と前記先端処置具
とを連結する連結部材とを有する処置具において、前記
湾曲部は、複数の円筒状コマからなり、隣り合うコマが
２箇所以上の支持部と、少なくとも１つの伸縮部を具備
することを特徴とする処置具。 （付記１５）先端処置具と、この先端処置具を体腔内に
挿入するための挿入部と、前記先端処置具を駆動させる
操作部と、この操作部の操作と離れた場所で制御を行う
操作制御手段とを有する操作制御入力装置において、前
記操作制御手段は、６本以上のワイヤと、各々の前記ワ
イヤに接続されたワイヤ牽引手段と、ワイヤの移動量を
検出するワイヤ移動量検出手段とから構成されているこ
とを特徴とする操作制御入力装置。 （付記１６）独立して可動な複数の湾曲構造を有し、そ
の湾曲構造の少なくとも一つが、湾曲手段と、その内側
にフレキシブルな外装部材と、この外装部材に対して進
退するフレキシブルな内装部材とからなり、この内装部
材の進退に応じて先端処置具を駆動する駆動部とから構
成したことを特徴とする処置具。 （付記１７）前記外装部材は、湾曲手段に対して回転自
在であり、前記外装部材の回転により先端処置具を回転
させることを特徴とする付記１４記載の処置具。 （付記１８）前記湾曲部は、複数の湾曲コマからなり、
少なくとも３節を有するリンクを湾曲コマの中に含むこ
とを特徴とする付記１４記載の処置具。 （付記１９）前記湾曲部は、少なくとも３節を有するリ
ンクを構成する湾曲コマが円環状をなす付記１４記載の
処置具。 （付記２０）前記湾曲部は、複数の湾曲コマからなり、
それぞれの湾曲コマが湾曲コマと一体の部材からなる２
つ以上の脆弱部からなる関節部と、３つ以上の脆弱部か
らなる伸縮部によって接続されていることを特徴とする
付記１４記載の処置具。 （付記２１）前記湾曲部は、脆弱部の両端部に弧状の切
り込みを有することを特徴とする付記２０記載の処置
具。
【００５７】前述した付記１、３〜１１によれば、先端
部に、高剛性で自在な湾曲を有し、また手元操作部の操
作感覚を処置具に確実に伝達し、また先端処置具の回転
を実現することで、内視鏡下外科手術用処置具の操作性
を向上させることができる。
【００５８】付記１２，１３によれば、処置部に駆動力
を伝達することで、動力を用いた精密な処置を実現す
る。付記２によれば、第２の湾曲部を持つ処置具を実現
することで、内視鏡下外科手術用処置具の操作性を向上
させることができる。
【００５９】付記１４〜１６によれば、外力や内蔵物の
摩擦によって影響を受けない、操作量に対して線形な湾
曲形状を得ることで、処置具先端の位置決めを精密に行
える。付記１７〜２１によれば、剛性が高くて、寿命の
長い湾曲構造を安価に製造できる。
【００６０】
【発明の効果】以上説明したように、この発明によれ
ば、高剛性で自在な湾曲を有し、また操作部の操作感覚
を処置具に確実に伝達し、また先端処置具の回転を実現
することで、内視鏡下外科手術用処置具の操作性を向上
させることができるという効果がある。
【図面の簡単な説明】
【図１】この発明の第１の実施例を示す処置具の斜視
図。
【図２】同実施例の処置具の縦断側面図。
【図３】同実施例のアウターケーシングとインナーケー
ブルの構成図。
【図４】同実施例の作用説明図。
【図５】この発明の第２の実施例のアウターケーシング
とインナーケーブルの構成図。
【図６】この発明の第３の実施例を示す処置具の斜視
図。
【図７】同実施例の湾曲部の構成図。
【図８】この発明の第４の実施例の湾曲部の構成図。
【図９】この発明の第５の実施例の湾曲部の構成図。
【図１０】この発明の第６の実施例の処置具の斜視図お
よび第２の湾曲部の内部構成を示す構成図。
【図１１】同実施例の作用説明図。
【図１２】この発明の第７の実施例の操作制御入力装置
の構成図。
【図１３】同実施例の操作入力装置の構成図。
【図１４】同実施例の処置具の内部構造を示す斜視図。
【符号の説明】
１…処置部、２…湾曲部、３…操作部、４…挿入部、５
…鉗子、１７…アウターケーシング（外装部材）、１８
…インナーケーブル（内装部材）。

Claims (1)

    【特許請求の範囲】
  1. 【請求項１】 先端処置具と、この先端処置具を体腔内
    に挿入するための湾曲部を有する挿入部と、前記先端処
    置具を駆動させる操作部と、この操作部と前記先端処置
    具とを連結する連結部材とを有する処置具において、前
    記連結部材は、フレキシブルな外装部材と、この外装部
    材の内部で軸方向に移動可能な内装部材とで構成された
    ことを特徴とする処置具。
JP6308827A 1994-12-13 1994-12-13 処置具 Pending JPH08164141A (ja)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP6308827A JPH08164141A (ja) 1994-12-13 1994-12-13 処置具

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP6308827A JPH08164141A (ja) 1994-12-13 1994-12-13 処置具

Related Child Applications (1)

Application Number Title Priority Date Filing Date
JP2005106537A Division JP4145309B2 (ja) 2005-04-01 2005-04-01 処置具

Publications (1)

Publication Number Publication Date
JPH08164141A true JPH08164141A (ja) 1996-06-25

Family

ID=17985787

Family Applications (1)

Application Number Title Priority Date Filing Date
JP6308827A Pending JPH08164141A (ja) 1994-12-13 1994-12-13 処置具

Country Status (1)

Country Link
JP (1) JPH08164141A (ja)

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