JP2005253987A - Holding device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a holding device of a medical instrument having a wide application range, applicable to various operations different in puncture position of a trocar or the like punctured to be inserted in the body cavity and movable range of a required operation instrument. <P>SOLUTION: A link mechanism part 4 including a strut 3 is covered with a transparent sterilized cover 19. A first tip arm part 21 or a second tip arm 22 different in length from the first tip arm part 21 is selectively removably mounted on the end part of a rod 13 extended from a fixed bearing 11 to the opposite side to a second horizontal rod 12 to clamp a mouth ring 20 of the sterilized cover 19. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a medical instrument holding apparatus that holds an endoscope or a surgical instrument when performing surgery, for example.

  In recent years, with the increasing complexity of endoscopic surgery, the number of devices and instruments that can be operated during surgery has increased. Therefore, a holding device that attaches an endoscope or a surgical instrument that is always used for surgery to an operating table has come to be used. It was.

  For example, Patent Document 1 connects a holding part of a surgical instrument to an extension part on one end side of an upper rod in a link mechanism part composed of a parallelogram link formed by a swivel arm, a lower rod, an upper rod and a connecting rod. In addition, two counterweights that are balanced with respect to the holding portion on which the surgical instrument is mounted are arranged in the link mechanism portion.

  In this example, in order to move the surgical instrument, there is no need to fix or release the joint or holding part, and the amount of moving force is light, so the surgeon can operate with one hand. Since the length of the rod is fixed, the movable range (operation range) of the surgical instrument is limited.

Further, the holding device disclosed in Patent Document 2 is attached to an opening ring 18 supported at a fixed horizontal position, and a flexible member 60 is extended from a standing support rod 50, and the flexible member is provided. A holding means for the endoscope 10 is provided at the end of 60. Further, the support rod 50 is movable along the opening ring 18.
Japanese Patent Application No. 5-325365 U.S. Pat. No. 4,573,452 Japanese Utility Model Publication No. 1-130304

  However, since the surgical instrument holding device of Patent Document 1 has a structure in which the holding part on which the surgical instrument is mounted is balanced by the counterweight, when the surgical instrument is moved, the joint part and the holding part are fixed and released. The operation is not necessary, and the amount of movement is light. Therefore, when the surgical instrument is moved, it is moved to a desired position with one hand, and if it is released as it is, it is fixed at that position. In this respect, the operability is superior to other apparatuses such as the endoscope holding apparatus disclosed in Patent Document 3.

  However, the surgical instrument holding device of Patent Document 1 cannot change the position where the surgical instrument is held or the movable range because the length of the pivoting rod is constant. However, in actual laparoscopic surgery and thoracoscopic surgery, the puncture position of the trocar that is punctured to insert an endoscope or treatment instrument into the body cavity and the required movable range vary depending on the type of operation to be performed.

  Therefore, it is difficult to use this surgical instrument holding device for various types of surgery. If this surgical instrument holding device is intended to be used for various types of surgery, there is no choice but to change the locking position of the surgical instrument holding device to the operating table according to the trocar puncture position of the surgery. If the locking position of the holding device is changed unnecessarily, other surgical instruments and the holding device interfere with each other, and the progress of the operation becomes extremely difficult.

  Moreover, since the holding apparatus of the said patent document 2 can move the support rod 50 from which the flexible member 60 holding the endoscope 10 was extended along the opening ring 18, it differs in the endoscope which changes with surgery. Although it is possible to correspond to the insertion position of the mirror 10 and the required movable range of the endoscope 10, in order to move the support rod 50 along the opening ring 18, After releasing the fixing and moving to a desired position, it is necessary to fix the fixing portion to the opening ring 18 again, and the operability is poor. Of course, one-handed operation by the surgeon is impossible. Further, since the opening ring 18 is positioned on the patient's surgical site, there is a problem that it interferes with the operation of other treatment tools necessary for the operation.

  The present invention has been made paying attention to the above circumstances, and the object of the present invention is various puncture positions such as a trocar to be punctured for insertion into a body cavity and different movable ranges of surgical instruments required. It is an object of the present invention to provide a holding device for a medical instrument with a wide range of application applicable to various operations.

  In order to achieve the above object, the present invention provides a holding device for holding a medical instrument, a link having a movable part supported by an installation part and movably supporting an adapter for holding the medical instrument. It has a mechanism part, a rod extending from the link mechanism part having an attaching / detaching member at the end part, an adapter attaching / detaching part that allows the adapter to be attached / detached at one end side, and an attachment / detachment part to the attaching / detaching member at the other end side It has a tip arm part having a free grip part, a base that can be attached to the outer peripheral surface of the end part of the rod, and a cover that covers the rod and the link mechanism part. .

  Furthermore, in order to achieve the above object, the present invention provides a holding device for holding a medical instrument, wherein the movable part is supported by an installation part and movably supports an adapter for holding the medical instrument. A link mechanism having a rod extending from the link mechanism having an attaching / detaching member at an end, an adapter attaching / detaching portion capable of attaching / detaching the adapter on one end side, and the attachment / detaching member on the other end side. A distal end arm portion having a detachable grip portion, and a base that can be attached to the outer peripheral surface of the end portion of the rod while being sandwiched between the grip portion, and the rod and the link mechanism portion. And a cover for covering.

  In the present invention, since the cover base is fitted into the attachment / detachment portion between the tip arm portion and the rod of the device main body, all or most of the device main body except the tip arm portion side is covered with the cover. Sterilization / disinfection is required only on the tip arm side. Therefore, it is not necessary to sterilize and disinfect the main body side which is large and heavy, and handling becomes very easy. In addition, since the cover is attached with the tip arm part attached / detached, the sterilized state can be maintained without exposing the non-sterile area when the tip arm part is replaced with the tip arm part having a different length. Until it can be replaced.

  According to the present invention, while maintaining high operability, it can be applied to various operations with different puncture positions of trocars and required movable ranges of surgical instruments, for example, for puncturing to insert a medical instrument into a body cavity, The application range can be greatly improved.

Embodiments of the present invention will be described below with reference to the drawings. 1 to 6 show a first embodiment, and FIG. 1 shows the overall configuration of a medical device holding apparatus. Reference numeral 1 denotes, for example, an installation portion that is detachably attached to the guide rail of the operating table by operating the attachment knob 2. A support column 3 is erected along the vertical direction to the installation portion 1 and is connected to be rotatable about a vertical first rotation axis O ₁ .

Further, a fixed bearing 5 of a link mechanism portion 4 composed of a parallelogram link is connected to the upper end portion of the support column 3. On one side surface of the fixed bearing 5, a first vertical rod 6 as a swiveling rod is vertically extended around a _second rotation axis O ₂ orthogonal to the _first rotation axis O ₁ of the column 3. A bearing 7 and a movable bearing 9 in which a first horizontal rod 8 as a swiveling rod is extended in the lateral direction are rotatably connected.

A movable bearing 10 is provided at the upper end of the first vertical rod 6, and this movable bearing 10 is provided on one side of the fixed bearing 11 around a _third rotation axis O ₃ parallel to the _second rotation axis O _2. It is connected to be rotatable. The fixed bearing 11 includes a second horizontal rod 12 as a swiveling rod that extends in the lateral direction in parallel with the first horizontal rod 8, and a rod 13 that extends opposite to the second horizontal rod 12. Are coupled, and a movable bearing 14 is provided at the other end of the second horizontal rod 12.

The movable bearing 14 is coupled to the fixed bearing 15 so as to be rotatable about a _fourth rotation axis O ₄ parallel to the _third rotation axis O ₃ . A second vertical rod 16 as a swiveling rod extends in a vertical direction from the fixed bearing 15 in parallel with the first vertical rod 6, and a movable bearing 17 is provided at the other end of the second vertical rod 16. Yes.

The movable bearing 17 is connected to a fixed bearing 18 provided at the end of the first horizontal rod 8 so as to be rotatable around a _fifth rotation axis O5 parallel to the _second rotation axis O2. In this way, the link mechanism section 4 composed of parallelogram links that can be deformed by the first vertical rod 6, the first horizontal rod 8, the second horizontal rod 12, and the second vertical rod 16 is configured. Yes.

  Further, the link mechanism portion 4 including the support column 3 is covered with a transparent sterilization cover 19. Further, the first tip arm portion 21 or the first tip portion of the sterilization cover 19 is sandwiched between the end portions of the rod 13 extending from the fixed bearing 11 to the opposite side of the second horizontal rod 12. One of the distal end arms 21 and the second distal arm 22 having a different length can be selectively detachably mounted.

  That is, the sterilization cover 19 is disposed so as to cover substantially the holding device of the medical instrument except for the first tip arm portion 21, and a slit 23 is provided at the end of the sterilization cover 19 so as not to hinder the movement of the holding device. It is.

  An adapter attaching / detaching portion 24 is provided at the end of the first tip arm portion 21, and an adapter 26 as a holding portion to which the endoscope 25 is attached is detachably attached. A TV camera 27 and a light guide cable 28 are attached to the endoscope 25, and the cable 29 and the light guide cable 28 of the TV camera 27 can be attached to and detached from the first tip arm portion 21 and the first vertical rod 6. The hooks 30 and 31 are connected to a TV camera control device and a light source device (not shown). (At this time, the cable 31 and the light guide cable 28 are hooked and stopped on the stopper 31 through the sterilization cover 19.) Two counterweights 32a and 32b are arranged in a state of being balanced with respect to the first tip arm portion 21 to which the endoscope 25 is attached (that is, in a state where the weight is balanced), thereby constituting a balance mechanism 33. ing. One first counterweight 32a is attached so as to be movable along a shaft 34 that extends from the fixed bearing 18 to the opposite side of the first horizontal rod 8. The other counterweight 32b is attached to the movable bearing 7 so as to be movable along a shaft 35 extending on the opposite side of the first vertical rod 6.

  FIG. 2 is a detailed view of the first tip arm portion 21 and the attaching / detaching portion of the rod 13. A grip portion 36 is provided at the end of the distal arm portion 21, and a detachable member 38 is coupled to the grip portion 36 in such a manner that a rotary screw 37 is rotatably sandwiched. A guide pin 39 is attached to the end surface of the detachable member 38. Is fixed. An arm rod 40 of the first tip arm portion 21 is inserted into the grip portion 36, and a flange portion 41 of the arm rod 40 is sandwiched by a presser member 43 coupled to the grip portion 36 via a washer 42, With this configuration, the arm rod 40 is coupled to the grip 36 so as to be rotatable about the axial direction.

  The detachable portion of the first tip arm portion 21 configured as described above includes a protrusion 44 and a guide pin 39 provided at the end of the detachable member 38, a guide hole 45 provided at the end of the rod 13, In a state of being engaged with 46, the rotary screw 37 is attached to the rod 13 by screwing into the screw portion 47 at the end of the rod 13.

  Further, when the first tip arm portion 21 is attached to the rod 13, the outer periphery of the screw portion 47 of the rod 13 is fitted into the base 20 of the sterilization cover 19 so that the sterilization cover 19 is attached to the first tip arm portion. It is mounted so as to cover and cover almost all the holding devices of medical instruments except 21.

  The mounting of the second tip arm portion 22 and the rod 13 is the same as in the case of the first tip arm portion 21. FIG. 3 is a detailed view of the counterweight 32a portion.

  The counterweight 32 a is screwed into a screw portion 48 provided at an end portion of the shaft 34, and a stopper plug 49 is coupled to the end portion of the shaft 34. With this configuration, the counterweight 32a can be moved along the shaft 34 by rotating. The counterweight 32b and the shaft 35 have the same configuration.

  FIG. 4 is a detailed view of the adapter 26 and the adapter attaching / detaching portion 24 provided at the ends of the first tip arm portion 21 and the adapter 26. 5 shows the A-A ′ cross section of FIG. 4, and FIG. 6 shows the B-B ′ cross section of FIG. 4.

  The adapter 26 includes an adapter main body 50 and a push screw 51 screwed into the adapter main body 50, and the internal screw inserted into the adapter 26 by rotating the push screw 51 and crushing an elastic body 52 such as rubber. The mirror 25 can be fixed. Since the elastic body 52 is crushed and the insertion portion 53 of the endoscope 25 is gripped and fixed, an endoscope or an surgical instrument having an insertion portion with a somewhat different outer diameter can be detachably fixed with a simple configuration.

  The adapter body 50 is mounted on the plate member so as to be rotatable about the rotation axis O6 by a pressing member 55 fixed to the end of the adapter body 50 so as to sandwich the bent plate member 54. Here, at least the adapter main body 50 and the push screw 51 are made of an insulating material, and electrically insulate the endoscope 25 from the medical device holding device.

  A removable member 56 is coupled to the other end of the plate member 54. That is, the adapter attaching / detaching portion 24 is attached to the attaching / detaching portion main body 57 coupled to the end of the arm rod 40 and the groove 58 provided in the attaching / detaching portion main body 57 so as to be rotatable around the two pins 59 and 60. It is constituted by two locking members 61 and 62.

  Buttons 63 and 64 are coupled to the locking members 61 and 62 so as to face each other, and a spring 65 is disposed with both ends of the buttons 63 and 64 as guides. The spring 65 applies a biasing force so that the other end portions of the locking members 61 and 62 are closed with the pins 59 and 60 as fulcrums. In addition, a pin 66 is provided at the other end portion of the detachable portion main body 57 to keep a gap between the grooves 58. Are combined.

  When the adapter 26 is attached to the adapter attaching / detaching portion 24, when the attaching / detaching member 56 of the adapter 26 is inserted into the attaching / detaching portion main body 57 using the guide pin 67 as a guide, the tapered portion 68 at the tip of the attaching / detaching member 56 becomes the locking members 61, 62. Is pushed against the urging force of the spring 65. Thereafter, the locking members 61 and 62 engage with a V groove 69 provided on the outer periphery of the intermediate portion of the attaching / detaching member 56, and the adapter 26 is attached to the adapter attaching / detaching portion 24 so as to be rotatable about the axis of the guide pin 67.

  When the adapter 26 is removed, by pressing the buttons 63 and 64, the locking members 61 and 62 are opened with the pins 59 and 60 as fulcrums and detached from the V groove 69 of the detachable member 56. At this time, since the detachable member 56 is set at a substantially center of gravity of the system including the endoscope 25, the adapter 26, and the TV camera 27, the detachable member can be used even if the adapter 26 is rotated around the guide pin 67. The position can be maintained by the frictional force between 56 and the locking members 61 and 62.

  The adapter attaching / detaching portion (see FIG. 1) of the second tip arm portion 22 has the same configuration, and the adapter 26 to which the endoscope 25 is attached can be detachably attached. Next, the operation of the medical device holding apparatus configured as described above will be described. Since the endoscope 25 which is a surgical instrument mounted on the first distal arm portion 21 is held in a balanced state (balanced state) by the link mechanism portion 4 and the counterweights 32a and 32b, Even if the endoscope 25 is moved to any position by deforming the link mechanism 4, the endoscope 25 stops at that position. Therefore, the operator simply moves the endoscope 25 to a desired position, and the endoscope 25 can maintain the position, and no operation for fixation is required.

  In addition, the first tip arm portion 21 can be replaced with the second tip arm portion 22 having a different length, and even in this case, a balance is achieved by supporting the positions of the counterweights 32a and 32b. Therefore, the above operability is not impaired.

  In laparoscopic surgery, the puncture position of the trocar for inserting an endoscope or surgical instrument into the abdominal cavity differs depending on the type of operation to be performed, and the required movable range of the endoscope or surgical instrument is also different. .

  In the surgical instrument holding apparatus of the present embodiment, the first and second tip arm portions 21 and 22 having different lengths can be replaced as necessary, and the movable range of the endoscope 25 is changed according to the operation. And the applicability of this device can be greatly expanded. Moreover, by adjusting the positions of the counterweights 32a and 32b, the balance can be maintained even when the first and second tip arm portions 21 and 22 are replaced with different lengths, so that the operability is impaired. There is nothing.

  Further, in this embodiment, the first tip end is fitted by fitting the base 20 of the sterilization cover 19 into the attachment / detachment portion between the first tip arm portion 21 (or the second tip arm portion 22) and the rod 13 of the apparatus main body. Since all or most of the apparatus main body excluding the arm part 21 side is covered with the sterilization cover 19, the sterilization / disinfection is performed on the first tip arm 21 (or second tip arm part 22) side. It only needs to be large and heavy, and there is no need to sterilize and disinfect the main body, making handling very easy. Moreover, since the sterilization cover 19 is attached with the attachment / detachment portion of the distal arm portion 21 (or the second distal arm portion 22) as a boundary, the distal arm portion 21 (or the second distal arm portion 22) has a length. When the tip arm portion 22 (or the first tip arm portion 21) is different, it can be replaced while the sterilized state is maintained without exposing the non-sterile region.

  In this embodiment, the tip arm portion can replace two types of tip arm portions 21 and 22 having different lengths. Of course, a plurality of tip arm portions having different lengths can be selectively attached. May be. In that case, the counterweight adjustment range may be set so as to be balanced in accordance with various tip arm portions.

  FIG. 7 shows a second embodiment. In this embodiment, instead of the counterweights 32a and 32b of the first embodiment, the balance (balance) of the endoscope attached to the distal arm portion by the distal arm portion is maintained by the compression springs 71 and 72.

  The compression spring 71 is connected between the first vertical rod 74 and the second vertical rod 75 of the link mechanism 73 formed of a parallelogram link. The connecting portion of the compression spring 71 to the first vertical rod 74 is moved along the axis of the first vertical rod 74 by the adjusting mechanism 76 so that the force of the compression spring 71 can be adjusted.

  The compression spring 72 is connected to a fixed bearing 77 of the link mechanism 73 between a rod 79 extending in the direction opposite to the first horizontal rod 78 and an adjustment mechanism 81 fixed to the support 80. By moving the position of the connecting portion between the compression spring 72 and the adjustment mechanism 81, the amount of force of the compression spring 72 can be adjusted.

  Other configurations are the same as those of the first embodiment. The operation of the second embodiment is the same as that of the first embodiment. However, in this embodiment, when the tip arm portion is replaced with one having a different length, the compression spring 71 is adjusted by the adjusting mechanisms 76 and 81. And 72 are adjusted to maintain the balance (balance).

  Therefore, the same effect as the first embodiment can be obtained. In this embodiment, since there is no counterweight, the weight of the medical device holding device main body becomes light and the handling becomes easy. In addition, during the operation, the operator, an assistant who performs treatment in cooperation with the operator, or an assistant who operates other devices often passes in the vicinity of the operating table, but in this embodiment, there is no counterweight. The amount of protrusion of the holding device to the outside of the operating table can be reduced.

  Similarly to the first embodiment, this embodiment may be configured so that a large number of tip arm portions having different lengths can be selectively attached. Further, as in the first embodiment, a sterilization cover may be mounted between the tip arm portion and the holding device main body so as to cover the main body side.

  FIG. 8 shows a third embodiment. The mounting portion 82 is detachably locked by a mounting knob 83 to a side rail such as an operating table. A column 84 is erected along the vertical direction to the mounting portion 82 and is coupled to be rotatable about the vertical direction.

  A fixed bearing 85 is connected to the upper end portion of the column 84, and a movable bearing 86 is rotatably connected to one side surface of the fixed bearing 85. A first swivel rod 87 is coupled to the movable bearing 86, and a rod 88 extends in the direction opposite to the first swivel rod 87.

  A second fixed bearing 89 is fixed to the other end of the first swivel rod 87. A second movable bearing 91 having a second swivel rod 90 connected thereto is rotatably connected to one side surface of the second fixed bearing 89.

  A first tip arm 92 is detachably connected to the other end of the second swivel rod 90, and an endoscope 93, which is a medical instrument, is detachably attached to the other end of the tip arm 92. The adapter 94 attached to the detachable is attached detachably and rotatably. In addition, a TV camera 95 and a light guide cable 96 are connected to the endoscope 93. The first tip arm portion 92 can be replaced with a second tip arm portion 97 having a different length as needed. The configurations of the distal arm portions 92 and 97 and the adapter 94 are the same as those in the first embodiment.

  The second swivel rod 90 is provided with a connecting member 98, and the compression spring 100 is connected to both ends of the connecting member 98 and the adjusting mechanism 99 provided on the first swivel rod 87 by ball joints. ing. The adjustment mechanism 99 is movable along the axial direction of the first swivel rod 87, and thereby the force of the compression spring 100 can be adjusted. The compression spring 100 counterbalances the second swivel arm 90 including the distal end arm portion 92 to which the endoscope 93 is attached to the first swivel arm 87 against the swivel motion due to their own weight. It is fixed in the state.

  A connecting member 101 is provided at the end of the rod 88, and a second compression spring 103 is connected by a ball joint between the connecting member 101 and the adjusting mechanism 102 disposed on the support column 84. The adjusting mechanism 102 can move along the axial direction of the support 84, thereby adjusting the force of the compression spring 103. The compression spring 103 applies a reaction force to the swiveling motion due to its own weight in all systems from the distal arm portion 92 to which the endoscope 93 is attached to the first swiveling rod 90 to the first swiveling rod 87. Given and fixed in a balanced state.

  With the configuration as described above, in this embodiment as well, as in the first embodiment, the swivel arms 90 and 87 are swung to move the endoscope 93 to any position and fixed at that position. can do.

  The basic operation is the same as that of the first embodiment. However, in this embodiment, when the tip arm portion is replaced with one having a different length, the force of the compression springs 100 and 103 is adjusted by the adjusting mechanisms 99 and 102. It can be adjusted to keep balance.

  Although the basic effect is the same as that of the second embodiment, this embodiment does not have a parallelogram link as in the second embodiment, and the structure is simplified and the weight can be reduced.

  Further, the compression spring 103 may be disposed so as to connect the support column 84 and the first swivel rod 87. In that case, the rod 88 is not necessary, and the amount of protrusion to the outside of the operating table can be further reduced. In addition, as in the first embodiment, a large number of tip arm portions having different lengths may be selectively attached, or a sterilization cover may be attached.

  FIG. 9 shows a fourth embodiment. In this embodiment, air cylinders 104 and 105 are provided in place of the compression springs 100 and 103 of the third embodiment. The air cylinder 104 is connected to the pressurizing device 110 by a tube 109 extending from the mounting base 108 via a pipe line (not shown) provided inside the first swivel rod 106 and the support column 107.

  The air cylinder 105 is also connected to the pressure device 110 through a tube 111 extending from the mounting base 108 via a second pipe (not shown) provided inside the support column 107. Therefore, the pressure of the fluid such as air in the air cylinders 104 and 105 can be adjusted independently by controlling the pressurizing device 110.

  This embodiment is basically the same as the third embodiment, but when the tip arm portion is replaced with one having a different length, the inside of the air cylinders 104 and 105 is controlled by controlling the pressurizing device 110. The pressure of fluid such as air can be adjusted to keep the balance.

  Therefore, the effect is the same as in the third embodiment, but in this embodiment, the pressure values of the air cylinders 104 and 105 suitable for the tip arm portions of various lengths are input to the pressurizing device 110 in advance. In this case, when the tip arm is replaced, the pressure of the air cylinders 104 and 105 can be instantaneously set in a balanced state with one touch.

  As in the third embodiment, the air cylinder 105 may be disposed between the support column 107 and the first swivel rod 106 in this embodiment. Further, the pressurizing device 110 may be incorporated in the mounting base 108. In this case, the tubes 109 and 111 are not necessary, and the whole can be simplified.

  Further, similarly to the first embodiment, a large number of tip arm portions having different lengths or a sterilization cover may be attached. FIG. 10 shows a fifth embodiment. In this embodiment, air cylinders 112 and 113 are used instead of the compression springs 71 and 72 of the second embodiment, and other basic configurations are the same as those of the second embodiment.

  The air cylinders 112 and 113 are connected to a pressurizing device 114 by two pipe lines (not shown), and by controlling the pressurizing device 114, the pressure of fluid such as air in the air cylinders 112 and 113 is controlled. Can be adjusted independently. Therefore, the same effect as the fourth embodiment can be obtained.

  FIG. 11 shows a sixth embodiment. In this embodiment, there is an adapter 123 in which an arm base 117 having a distal arm 115 detachably connected to a rod 116, a plurality of connecting members 118, 119, 120, 121, and an endoscope 122 are detachably installed. The arm end portion 124 is detachably and rotatably locked.

  Other configurations are the same as those of the first embodiment. However, in this embodiment, no sterilization cover is attached. Since the connecting members 118, 119, 120, and 121 all have the same connecting means such as screws and snap-ins at both ends, the required number of connecting members so that the distal end arm portion 115 has a required length. 118-121 can be connected.

  According to the present embodiment, the number of connecting members 118 to 121 that connect the distal arm portion 115 to a required length is determined. After setting the tip arm portion 115 to a required length, the counterweight position can be adjusted in the same manner as in the first embodiment to achieve a balance.

  The basic effect of the present embodiment is the same as that of the first embodiment. In this embodiment, it is not necessary to align the entire tip arm portion of various lengths as in the first embodiment, and the connecting member can be used. Since only a necessary number of connections are required, the entire system can be made inexpensive.

  12 and 13 show a seventh embodiment. FIG. 12 is an overall view of a holding device for a medical instrument, and a distal arm 126 that is detachably connected to a rod 125 of the holding device is configured to be extendable and contractable. Other basic configurations are the same as those in the first embodiment.

  FIG. 13 shows a detailed view of the tip arm portion 126. A mounting member 128 is connected and fixed to one end portion of the first arm rod 127 of the distal end arm portion 126 by a pin 129. A rotating screw 130 is disposed on the outer periphery of the mounting member 128 so as to be rotatable and slidable so as to be sandwiched between the flange portion 131 of the mounting member 128 and the end surface of the arm rod 127.

  A second arm rod 132 is inserted into the first arm rod 127 and is slidable by a pin 134 engaged with a key groove 133 provided in the second arm rod 132. It is connected to. Reference numeral 135 denotes a fixing screw for fixing the second arm rod 132 at an arbitrary position. An adapter 137 to which an endoscope 136 is detachably attached is detachably and rotatably locked to the end of the second arm rod 132.

  The distal end arm portion 126 configured in this way is provided with the end of the mounting member 128 at the end of the rod 125 of the holding device body of the medical device and is inserted into the guide hole 138, and the rotating screw 130 abuts against the end surface of the rod 125. By being screwed in, the rod 125 is rotatably connected.

  Further, when the distal arm portion 126 is connected to the rod 125, the base 140 of the sterilization cover 139 is attached to the outer periphery of the end portion of the rod 125, and the distal arm portion 126 side is removed by the sterilization cover 139. Covers the whole.

  The basic operation of this embodiment is the same as that of the first embodiment. In this embodiment, the fixing arm 135 is loosened and the second arm rod 132 is slid to adjust the tip arm 126 to the required length. Thereafter, the fixing screw 135 is fastened and fixed.

  The basic effect of the present embodiment is the same as that of the first embodiment. However, in this embodiment, the length can be adjusted as necessary with one tip arm portion. There is no need to replace it, and the operation becomes easy.

  In this embodiment, the length is adjusted by sliding the two arm rods 127 and 132, but the length is adjusted by sliding three or more arm rods like antennas. It may be.

  In the case of the present embodiment, the tip arm portion may be fixed to the holding device body. (However, in that case, the sterilization cover cannot be mounted.) FIG. 14 shows an eighth embodiment. In the present embodiment, a self-supporting flexible tube 143 is disposed at an intermediate portion of the distal arm portion 142 that is detachably attached to the rod 141 of the medical device holding device. Other configurations are the same as those of the first embodiment. However, the sterilization cover is not attached in this embodiment.

  In the case of the present embodiment, the self-supporting flexible tube 143 is bent into a necessary shape to adjust the distance from the link mechanism to the endoscope, and then the position of the counterweight is the same as in the first embodiment. Adjust to balance.

  Although the basic effect is the same as that of the seventh embodiment, in the case of this embodiment, since the tip arm portion is composed of a self-supporting flexible tube, not only the axial direction of the tip arm portion, Since the position of the endoscope can be adjusted in any direction, the degree of freedom of the position and movable range of the endoscope is increased.

  In the case of this embodiment, the tip arm portion may be fixed to the holding device instead of being detachable. Next, the features of the present invention are listed as follows.

  (Characteristic 1) A balance mechanism having an adjusting means is provided to balance each swivel rod in accordance with the length of the tip arm portion when the length is changed. The medical device holding device as described.

  (Characteristic 2) The swivel rod includes a first vertical rod extending in a vertical direction supported rotatably about a second rotation axis orthogonal to the first rotation axis of the support, and the first A first horizontal rod that is supported so as to be pivotable about two rotation axes and extends in the lateral direction; and the first horizontal rod that is disposed in parallel to the first horizontal rod and is A second horizontal rod supported rotatably about a third rotation axis parallel to the second rotation axis, and the first horizontal rod and the second horizontal rod arranged in parallel to the first vertical rod. From the parallelogram link formed by the second vertical rod supported so as to be rotatable about the fourth and fifth rotation shafts parallel to the second and third rotation shafts, respectively, with respect to the horizontal rod The medical device holding device according to claim 1.

  (Feature 3) The medical instrument holding device according to Feature 1, wherein the balance mechanism is configured by a counterweight provided on the parallelogram link in a state of being balanced with respect to the distal arm portion on which the medical device is held.

  (Feature 4) The medical device holding device according to Feature 1, wherein the balance mechanism is configured by a compression spring provided on the parallelogram link in a state of being balanced with respect to a distal end arm portion on which the medical device is held.

  (Feature 5) The medical device holding device according to Feature 1, wherein the balance mechanism is configured by an air cylinder provided in a parallelogram link in a state of being balanced with respect to a distal end arm portion on which the medical device is held.

  (Feature 6) The medical instrument holding apparatus according to claim 1, wherein the distal arm portion can selectively mount a plurality of distal arm portions having different lengths.

(Feature 7) The medical device holding apparatus according to claim 1, wherein the distal arm portion is formed by connecting a plurality of connecting members having connecting means at both ends.

  (Feature 8) The medical device holding apparatus according to claim 1, wherein the distal arm portion is configured to be extendable and contractable in an axial direction.

(Feature 9) The medical device holding apparatus according to claim 1, wherein the distal arm portion is formed of a flexible tube having self-supporting properties.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an overall perspective view of a medical device holding apparatus according to a first embodiment of the present invention. The side view which sectioned a part of attachment-and-detachment part of the tip arm part and rod of the Example. The vertical side view of the counterweight of the Example. The vertical side view of the adapter attachment / detachment part of the Example. Sectional drawing which follows the AA 'line of FIG. Sectional drawing which follows the BB 'line of FIG. The perspective view of the whole holding | maintenance apparatus of the medical device which shows 2nd Example of this invention. The perspective view of the whole holding | maintenance apparatus of the medical device which shows the 3rd Example of this invention. The perspective view of the whole holding | maintenance apparatus of the medical device which shows the 4th Example of this invention. The perspective view of the whole holding | maintenance apparatus of the medical device which shows the 5th Example of this invention. The perspective view of the whole holding | maintenance apparatus of the medical device which shows the 6th Example of this invention. The perspective view of the whole holding | maintenance apparatus of the medical device which shows the 7th Example of this invention. The side view which sectioned a part of tip arm part of the example. The perspective view of the whole holding | maintenance apparatus of the medical device which shows the 8th Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Installation part, 3 ... Support | pillar, 4 ... Link mechanism part, 5, 11, 14, 15, 18 ... Fixed bearing, 6, 8, 12, 13, 16 ... Rod, 7, 9, 10, 17 ... Movable bearing , 19 ... Sterilization cover, 20 ... base, 21 ... tip arm part, 24 ... adapter attaching / detaching part, 25 ... endoscope (medical instrument), 26 ... adapter, 33 ... balance mechanism, 36 ... grip part, 38 ... attaching / detaching member .

Claims (2)

In a holding device for holding a medical instrument,
A link mechanism unit supported by an installation unit and having a movable unit for movably supporting an adapter for holding the medical instrument;
A rod extending from the link mechanism having an detachable member at the end;
A distal end arm portion having an adapter detachable portion detachably attached to the adapter on one end side, and a grip portion detachable on the detachable member on the other end side;
A cover that can be attached to the outer peripheral surface of the end of the rod, and covers the rod and the link mechanism;
A holding device comprising: In a holding device for holding a medical instrument,
A link mechanism unit supported by an installation unit and having a movable unit for movably supporting an adapter for holding the medical instrument;
A rod extending from the link mechanism having an detachable member at the end;
A distal end arm portion having an adapter detachable portion detachably attached to the adapter on one end side, and a grip portion detachable on the detachable member on the other end side;
A cover that can be attached to the outer peripheral surface of the end portion of the rod in a state of being sandwiched between the grip portion and a cover that covers the rod and the link mechanism portion;
A holding device comprising:

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