JP3174074B2 - Surgical equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical apparatus for performing a surgical operation by operating a treatment tool.

[0002]

2. Description of the Related Art Generally, when performing an operation using an endoscope or a stereotaxic apparatus, the treatment tool is often moved by hand. For example, the surgeon holds the hand of the treatment instrument introduced into the body cavity through the channel of the endoscope with his / her own hand, and performs operations such as push and pull under the observation of the endoscope to push the distal end of the treatment instrument for treatment purposes. Guide to the affected area.

[0003]

However, in the operation in the conventional method, it takes time and effort to move the treatment tool back and forth, and the position cannot be determined accurately. When a subtle movement is performed, for example, a device using a screw feeder is not conceivable, but the feeder is complicated, large, and large. In addition, there is a problem that the operation is extremely troublesome.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and has as its object to provide a surgical apparatus which has a simple structure and which can automatically and easily move a treatment tool. Is to do.

[0005]

SUMMARY OF THE INVENTION In order to solve the above-mentioned problems, the present invention provides a lumen provided in an insertion member to be inserted into a body and having a distal end opening exposed at a distal end of the insertion member, A movable body having a surgical instrument disposed at an end facing the distal end opening of the lumen, while being movably inserted into the inner periphery of the lumen, and having a substantially entire outer peripheral surface in frictional contact with the inner peripheral surface of the lumen. And a piezoelectric element having one end in the axial direction that expands and contracts with the moving body, an inertial body attached to the other end in the axial direction of the piezoelectric element, and a drive voltage applied to the piezoelectric element. Using the frictional force generated between the moving body and the treatment tool simultaneously with the inertial force of the inertial body when the piezoelectric element expands and contracts in the axial direction and the deformation restoring force from the elastic body received by the moving body. Control means for traveling operation for moving the treatment tool. A surgical apparatus characterized.

Further, another object of the present invention is to provide a moving body which is supported at a fixed portion via an elastic body and moves the treatment tool by a frictional force in contact with the treatment tool, and an axial end which expands and contracts with the moving body. Are connected, the inertial body attached to the other end of the piezoelectric element in the axial direction, and the drive voltage applied to the piezoelectric element is controlled to control the drive voltage applied to the piezoelectric element when the piezoelectric element expands and contracts in the axial direction. A traveling operation control means for moving the treatment tool using a frictional force generated between the moving body and the treatment tool at the same time as the inertia force of the inertial body and the deformation restoring force of the moving body from the elastic body received, A surgical apparatus comprising:

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described with reference to FIGS. In FIG. 1, reference numeral 1 denotes an endoscope, and a movement actuator 3 for a treatment tool of a surgical apparatus is inserted into a channel 2 of the endoscope 1. This moving actuator 3
Is constituted by a cylindrical moving body M holding an treatment instrument, an inertial body m, and a laminated piezoelectric element (PZT) P concentrically connecting the moving body M and the inertial body m. A knife 4 as a treatment tool to be used is attached to the moving body M. The knife 4 moves together with the moving body M. When the knife 4 is used, as shown in FIG. 1, the tip of the knife 4 protrudes into the body cavity 6 from the distal end opening 5 of the channel 2.

[0008] The movable body M is formed so that its peripheral surface can slide in close contact with the inner surface of the channel 2. Normally, the moving body M is held at that position by a frictional force between the peripheral surface and the inner surface of the channel 2. The inertial body m and the multilayer piezoelectric element P are formed in a shape and size that do not touch the inner surface of the channel 2. Generally, the moving body M is formed so as to have a larger mass than the inertial body m.

A lead wire 7 is connected to an electrode of the multilayer piezoelectric element P, and the lead wire 7 is connected to the piezoelectric element P.
Is connected to an applied voltage control unit 8 for applying a moving voltage to the power supply. When a driving voltage having a waveform as shown in FIG. 4 is applied to the piezoelectric element P, the moving body M holding the knife 4 moves forward or backward according to a moving principle described later. Next, the basic operation principle of the moving actuator 3 will be described with reference to FIG.

First, the operation when the moving body M moves to the left operates in the order shown in the left diagram of FIG. Before the start, the moving body M is placed on the base B and held by the static frictional force, and the piezoelectric element P is in a contracted state. For this reason,
The inertia body m is attracted by the moving body M ahead and is on standby.

In this state, when a high drive voltage is instantaneously applied to the piezoelectric element P to rapidly expand the piezoelectric element P, the moving body M and the inertial body m rapidly move simultaneously in opposite directions.
At this time, the moving body M is moved to the left by a distance Δ while receiving the dynamic friction force.
m ₁ to move.

Next, the voltage applied to the piezoelectric element P is reduced and the piezoelectric element P is contracted within a range where the moving body M is held by the frictional force with the base B and stopped, and the inertial body m is slowly moved at a constant speed or a small acceleration. To the moving body M side.

When the current is suddenly stopped when the piezoelectric element P is sufficiently contracted and the contraction of the piezoelectric element P is suddenly stopped, the inertial body m
Has the effect of colliding with the moving body M. As a result, the entire moving actuator 3 moves to overcome the static friction force, moves to the left until the kinetic energy is lost by the dynamic friction force of the moving body M, and stops. This operation moves the distance Δm ₂ to the left.

In this one-cycle operation, (Δm ₁ + Δ
m ₂ ). By repeating this fine movement, a large movement can be achieved. In addition,
If the energy generated at the time of rapid deformation is taken into account at the time of the next rapid deformation by raising the voltage immediately after the voltage is lowered, a greater momentum can be obtained.

On the other hand, in the case of moving to the right, the reverse operation of the above-mentioned operation pattern is performed, and this operation is performed as shown in the right side of FIG. That is, before the start, the moving body M is placed on the base B, stopped by the static friction force, and the piezoelectric element P is in an extended state. For this reason, the inertia body m is waiting away from the moving body M ahead.

When the application of the high voltage to the piezoelectric element P is instantaneously erased from the stationary state and the piezoelectric element P is rapidly contracted, the moving body M moves to the right in response to the inertial force of the inertial body m. That is, the repulsive force becomes relatively large compared to the frictional force that the moving body M receives from the base B, and the moving body M and the inertial body m
Move simultaneously in opposite directions. Then, the moving body M moves rightward by a distance Δm ₁ .

Next, the voltage applied to the piezoelectric element P is gradually increased to extend the piezoelectric element P, and the inertial body m is moved at a constant speed or a small acceleration from the moving body M side.
At this time, the moving body M is stopped by being held by the static friction force with the base B.

When the expansion of the piezoelectric element P suddenly stops when the piezoelectric element P is sufficiently expanded, a large inertia force is generated in the inertial body m, and the entire moving actuator 3 starts to move rightward overcoming the frictional force. The moving actuator 3 moves to the right and stops until the kinetic energy of the entire moving actuator 3 is lost by the kinetic frictional force of the moving body M. This operation moves the distance Δm ₂ backward.

In this one-cycle operation, the right (Δ
(m ₁ + Δm ₂ ). By repeating this fine movement retreat, it can be made to retreat largely. On the basis of such a principle, the entire movement actuator 3 performs an operation of moving forward or backward.

Therefore, when introducing the endoscope 1 into the body cavity of the patient, the moving actuator 3 is caused to perform a retreat operation, and the knife 4 is drawn into the channel 2 and stored. The moving actuator 3 is held by a frictional force between the moving body M and the inner surface (base) of the channel 2.

The distal end of the endoscope 1 is positioned close to an affected part 9 such as a polyp in a body cavity by predicting the direction of a knife 4 protruding from a distal end opening 5 of a channel 2. Therefore, a voltage of a pattern that causes the moving actuator 3 to perform an operation of moving forward is applied to the piezoelectric element P, and the moving actuator 3 moves forward in the channel 2. Then, the knife 4 protrudes from the distal end opening 5 of the channel 2 as shown in FIG. 1, and furthermore, the distal blade 4a of the knife 4 is applied to the incision site of the affected part 9 as shown in FIG.

Then, a voltage is again applied to the piezoelectric element P of the moving actuator 3 to rapidly expand the piezoelectric element P. As a result, the moving body M advances rapidly while receiving the inertial force of the inertial body m, and the knife 4 also advances to cut the affected part 9 accordingly. On the contrary, the voltage applied to the piezoelectric element P is rapidly erased. Then, the piezoelectric element P rapidly contracts, whereby the knife 4 is quickly retracted together with the moving body M, and the affected part 9 is incised. The sharpness of the knife 4 is improved by repeating the rapid advance and retreat of the knife 4 in this manner.

According to the configuration of this embodiment, the simple operation of pressing a switch for controlling the voltage applied to the piezoelectric element P and the automatic insertion and removal of the knife 4 without using an operator's hand are performed. Can be done. In addition, the movement of the knife 4 can be reliably performed by fine movement.

FIG. 5 shows a second embodiment of the present invention. In this embodiment, a manipulator 11 for abdominal surgery is used.
This is an example. This forms a manipulator 11 by sequentially connecting a plurality of arms 12 with a ball joint 13.
Further, an inertial body m is attached to the tip of each moving arm 12 via a piezoelectric element P, and the moving arm 12 functions as a moving body, thereby constituting a moving actuator 14. The operation principle of each moving actuator 14 is as described above.

A treatment guide tube 15 is held at the tip of the manipulator 11. The treatment guide tube 15 introduces a treatment tool 16 such as treatment scissors into a surgical site of a patient 17,
A suction tube 18 is connected to this to perform a suction treatment. Each manipulator 11 is attached to each of the left and right portions of the operating table 19.

However, when performing surgery, the treatment guide tube 1
In order to change the position, inclination, etc. of the position 5, the moving actuator 14 is operated. When the moving element 14 rapidly deforms the piezoelectric element P, it receives the inertial force of the inertial body m and rotates the arm 12 about the ball joint 13 to the side opposite to the position where the inertial body m is located. Usually, each arm 12 is held by the static friction force of the ball joint 13. As described above, all or a part of each of the moving actuators 14 is driven, and furthermore, by adjusting the moving amount, the position and the inclination of the arm 12 of the manipulator 11 are changed, and the position and the inclination of the treatment guide tube 15 are changed. Can be.

FIGS. 6 to 8 show a third embodiment of the present invention. This embodiment is an example in which a mobile actuator based on the same principle as described above is applied to the stereotactic apparatus 20. As shown in FIG.
A surgical ring 23 is attached to the device 1 via a support 22. The surgical ring 23 securely holds the head of the patient 24. The stereotaxic apparatus 20 has a horizontal guide arm 25 and a vertical guide arm 26 that intersect each other. The proximal end portion of the horizontal guide arm 25 is attached to the operating ring 23 via a positioning device 27.
The positioning device 27 is adapted to rotatably support the base end of the horizontal guide arm 25 so that the rotation angle α can be adjusted. The proximal end portion of the vertical guide arm 26 is held by a holder 28 and supported so as to be slidable while receiving a frictional force in the longitudinal direction β. further,
The holder 28 itself is provided so as to rotate while receiving a frictional force in a γ direction in a horizontal plane with respect to a support table 29 attached to the operating ring 23.

At the intersection of the horizontal guide arm 25 and the vertical guide arm 26, a fixed frame 31 for holding the moving actuator is attached. A horizontal drive moving actuator 32 and a vertical drive moving actuator 33 are attached to the fixed frame 31. The horizontal drive moving actuator 32 has an inertia body 35 attached to the fixed frame 31 via a laminated piezoelectric element 34 extending in the horizontal direction, so that the fixed frame 31 side functions as a moving body. I have. The vertical drive moving actuator 33 is fixed frame 3
An inertial body 37 is attached to the device 1 via a laminated piezoelectric element 36 extending in the vertical direction, so that the fixed frame 31 side functions as a moving body. That is, the frictional force received when the moving body of the horizontal drive moving actuator 32 moves mainly occurs on the guide sliding contact surface of the horizontal guide arm 25. Further, the frictional force received when the moving body of the vertical drive moving actuator 33 moves is generated mainly on the surface where the base end side portion of the vertical guide arm 26 is held by the holder 28 and in sliding contact therewith. .

The fixed frame 31 has a rigid endoscope 40 as a treatment tool.
Is slidably mounted by a guide rail 39. The mounting table 38 is held by a treatment tool 41 such as a rigid endoscope 40 or an ultrasonic device using a rubber ring or the like. Further, a movement actuator 42 is also mounted on the mounting table 38. The moving actuator 42 has an inertia body 44 attached thereto via a laminated piezoelectric element 43 arranged along the moving direction of the mounting table 38, and the mounting table 38 side functions as the moving body. That is, the movement actuator 42
The mounting table 38 is moved by operating. The frictional force at this time is received from the guide rail 39. Numeral 45 is a power supply for an ultrasonic device incorporating a suction device.

Each of the moving actuators 32, 33, 4
2 can move the fixed frame 31 or the mounting base 38 forward and backward by applying a drive voltage in the same manner as described above. When the moving actuators 32 and 33 are driven, the fixed frame 31 can be moved in both the vertical and horizontal directions X and Y.
When moving on the horizontal guide arm 25, the holder 2
Vertical guide arm 2 while rotating around the center of rotation 8
6 moves up and down while being held by the holder 28, and the fixed frame 31 slides along the horizontal guide arm 25 following the movement. Thus, the position of the fixed frame 31 can be selectively adjusted.

FIGS. 9 and 10 show a fourth embodiment of the present invention. This embodiment is an example in which a feed device 54 incorporating a movement actuator 53 is attached to a channel entrance mouthpiece 52 of an endoscope 51.

The feeding device 54 has a cylindrical mounting frame 55 as shown in FIG. 9, and a connection port 56 for engaging with the channel inlet base 52 of the endoscope 51 is formed at the tip of the mounting frame 55. I have. Note that a method such as fitting or screwing is used as the engagement means.

The moving actuator 53 includes a moving body M
, A ring-shaped inertial body m, and a hollow laminated piezoelectric element P concentrically connecting the holding ring member 57 and the inertial body m. The holding ring member 57 is formed with an inner diameter that is in close contact with the peripheral surface of the treatment tool 58 to be used, and generates a frictional force with the treatment tool 58 to hold the treatment tool 58. The inertial body m and the multilayer piezoelectric element P are provided with the treatment tool 58.
Is formed with an inner diameter that does not touch the peripheral surface. In general,
The holding ring member 57 is formed so as to have a larger mass than the inertial body m.

A holding ring member 57 as a moving body
Is supported by a fixed portion of the endoscope 51 via an elastic body 59. That is, the peripheral surface of the holding ring member 57 is elastically supported by the inner surface of the mounting frame 55 via the elastic body 59. As the elastic body 59, for example, a spring material, elastic rubber, a balloon containing a fluid, or the like can be considered. A lead wire 61 is connected to an electrode of the multilayer piezoelectric element P, and the lead wire 61 is connected to an applied voltage control unit 62 for applying a moving voltage to the piezoelectric element P.

Thus, when the piezoelectric element P is rapidly deformed, only the holding ring member 57 as a moving body moves. The treatment tool 58 remains stopped, and the elastic body 59 is deformed. However, since the holding ring member 57 is supported by the deformable elastic body 59, when the holding ring member 57 is thereafter returned to the original position by the elastic restoring force of the elastic body 59, the treatment tool 58 is moved between the original positions. Hold and move with frictional force. Further, the inertial body m is slowly pulled back. By repeating this, the treatment tool 58 can be automatically inserted or retracted. The holding ring member 57 does not move, and only the long treatment tool 58 can be largely moved. Further, the moving direction can be selected by changing the waveform applied to the piezoelectric element P as described above. It should be noted that the present invention is not limited to the above-described embodiments, and various modifications are conceivable.

[0036]

As described above, according to the present invention, the piezoelectric element which can be expanded and contracted in the axial direction, the treatment tool driving moving body provided at one end in the axial direction, and the piezoelectric element which is provided at the other end in the axial direction of the piezoelectric element. Since the configuration is constituted by the provided inertial body, the configuration of the traveling mechanism can be simplified, and the movement of the treatment tool can be accurately controlled. Further, the operation of moving the treatment tool can be automatically and easily performed.

[Brief description of the drawings]

FIG. 1 is a sectional view showing a first embodiment of the present invention.

FIG. 2 is a perspective view showing a treatment state of the first embodiment.

FIG. 3 is an explanatory view showing a principle traveling operation of the first embodiment.

FIG. 4 is a waveform diagram of a drive voltage applied to the piezoelectric element of the first embodiment.

FIG. 5 is an explanatory diagram of a treatment state according to a second embodiment of the present invention.

FIG. 6 is an explanatory diagram of a treatment state according to a third embodiment of the present invention.

FIG. 7 is a perspective view showing a main part of the third embodiment.

FIG. 8 is a sectional view showing a main part of the third embodiment.

FIG. 9 is a sectional view of a main part of a fourth embodiment of the present invention.

FIG. 10 is a side view of an endoscope to which the fourth embodiment is applied.

[Explanation of symbols]

M: moving body, m: inertial body, P: piezoelectric element, B: base,
DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Channel, 3 ... Moving actuator, 4 ... Knife, 11 ... Manipulator, 14 ... Moving actuator, 20 ... Stereotaxic apparatus, 32, 33 ... Moving actuator, 36 ... Piezoelectric element, 37 ... Inertial Body, 4
2. Moving actuator, 51 Endoscope, 54 Feeding device, 57 Holding ring member, 58 Treatment device.

Continuation of the front page (72) Inventor Yorio Matsui 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Industrial Co., Ltd. (72) Inventor Koichi Tatsumi 2-43-2 Hatagaya, Shibuya-ku, Tokyo e Within Linmp Optical Co., Ltd. (72) Eiichi Fuse, Inventor 2-43-2, Hatagaya, Shibuya-ku, Tokyo O Inside Olympus Optical Co., Ltd. (72) Katsuya Suzuki 2-43-2, Hatagaya, Shibuya-ku, Tokyo O (56) References JP-A-2-180578 (JP, A) JP-A-63-299785 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 19/00 A61B 1/00 A61B 17/00-18/28 G02B 23/24

Claims (2)

(57) [Claims] 1. An insertion member to be inserted into a body,
A lumen having a distal end opening exposed at the distal end of the insertion member, movably inserted into the lumen, substantially the entire outer peripheral surface of the lumen comes into frictional contact with the inner peripheral surface of the lumen, and A moving body having a surgical treatment tool disposed at an end facing the distal end opening of the cavity; a piezoelectric element having one end in the axial direction extending and contracting to the moving body; and a piezoelectric element attached to the other end in the axial direction of the piezoelectric element. And an inertial force of the inertial body when the piezoelectric element expands and contracts in the axial direction by controlling a drive voltage applied to the piezoelectric element, and a deformation restoring force of the elastic body received by the moving body. A surgical operation device for moving the treatment tool by using a frictional force generated between the moving body and the treatment tool. 2. A moving element which is supported by a fixed portion via an elastic body and moves the treatment tool by a frictional force in contact with the treatment tool, and a piezoelectric element having one end in the axial direction extending and contracting to the moving body. An inertial body attached to the other end of the piezoelectric element in the axial direction, and an inertial force of the inertial body when the piezoelectric element expands and contracts in the axial direction by controlling a drive voltage applied to the piezoelectric element. Running means for moving the treatment tool by using a frictional force generated between the moving body and the treatment tool at the same time as the deformation restoring force received by the moving body from the elastic body, And surgical equipment.