Abstract:
A surgical operation apparatus according to the present invention comprises an insert section, a first jaw that has a first grip section, and that turns about a first pivot provided at the insert section, a second jaw that has a second grip section, and that turns about a second pivot provided at the first jaw, the second grip section forming a contacted/spaced face to be contacted or spaced relevant to a grip object in collaboration with the first grip section, a first driving rod connected to a first jaw, a second driving rod connected to a second jaw, and a driving mechanism, the driving mechanism being adopted to drive the first and second driving rods to be advanced or retracted.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is based upon and claims the benefit of priority from the prior Japanese Patent Applications No. 11-331623, filed Nov. 22, 1999; and No. 11-331624, filed Nov. 22, 1999, the entire contents of which are incorporated herein by reference. 
     BACKGROUND OF THE INVENTION 
     The present invention relates to a surgical operation apparatus for remotely transmitting an operation of a master manipulator that a surgeon operates to a sub-manipulator, thereby performing surgical operation. 
     In a master/slave system, an operation of a master manipulator that the surgeon operates while observing an endoscopic image of a diseased site is recognized by means of a computer for computing a position of the master manipulator. This recognized signal is transmitted to a slave manipulator via an optical fiber cable and a slave manipulator control computer so as to perform a surgical operation. 
     This master/slave system is disclosed in the specifications of U.S. Pat. Nos. 5,792,135, 5,797,900, and 5,807,377. These specifications show a slave manipulator, wherein a support member is turnably provided at a tip end of an insert section to be inserted into a cavity via a pivot section, and a grip member for gripping a tissue or a treatment instrument is turnably provided at this support member. 
     A driving section is provided at a proximal end of the insert section, and a plurality of motors are incorporated in this driving section. These motors are hung on the support member at the tip end of the insert section and a pulley of the grip member via a wire hung on the pulley. In addition, the rotational force of the motor is transmitted via a plurality of wires hung on the pulley so as to turn the support member at the tip end of the insert section and to openably drive the grip member. 
     However, the aforementioned conventional manipulator transmits the rotational force of the motor incorporated in the driving section via a plurality of wires hung on the pulley so as to drive the support member and grip member at the tip end. 
     That is, a plurality of wires are inserted into the insert section, and these wires are pushed or pulled by means of the rotational force of the motor. Therefore, there is a problem that a space is required for retractably inserting wires into the insert section, and the diameter of the insert section increases. In addition, since wires are expanded when a tensile stress is applied, even if the motor is driven to rotate, the support member and grip member may not work well. Further, it is difficult to cause the support member and grip member to reliably approach a target site, and to actuate them finely. 
     BRIEF SUMMARY OF THE INVENTION 
     It is an object of the present invention to provide a surgical operation apparatus capable of improving approach properties for a treatment site in a cavity, and improving the degree of freedom for treatment. 
     The above object of the present invention is achieved by the following surgical operation apparatus. That is, a surgical operation apparatus according to the present invention comprises: an insert section to be inserted into a body; a first jaw having a first grip section, the first jaw being turned about a first bearing provided at a tip end of the insert section; a second jaw having a second grip section, the second jaw being turned about a second bearing provided at the first jaw, the second grip section forming a contacted/spaced face to be contacted or spaced relevant to a grip object in collaboration with the first grip section; a first driving rod connected to the first jaw, the first driving rod advancing or retracting the jaw along the insert section, thereby turning the first jaw; a second driving rod connected to the second jaw, the second driving rod advancing or retracting along the insert section, thereby turning the second jaw by; driving means provided at a proximal end of the insert section, the driving means being adopted to drive the first and second driving rods to be advanced or retracted. 
     Additional objects and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out hereinafter. 
    
    
     BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING 
     The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate presently preferred embodiments of the invention, and together with the general description given above and the detailed description of the preferred embodiments given below, serve to explain the principles of the invention. 
     FIG. 1 is a schematic view showing a configuration of a master/slave system; 
     FIG. 2 is a side view showing essential portions of a surgical operation apparatus as a slave manipulator according to a second embodiment of the present invention; 
     FIG. 3 is a perspective view showing essential portions of the slave manipulator shown in FIG. 2; 
     FIG.  4 A and FIG. 4B are views showing a state in which the slave manipulator shown in FIG. 2 is used; 
     FIG. 5A is a vertical side view having a partial cross section of a tip end of the slave manipulator according to the second embodiment of the present invention; 
     FIG. 5B is a cross section taken along the line  5 B— 5 B shown in FIG. 5A; 
     FIG. 5C is a cross section taken along the line  5 C— 5 C shown in FIG. 5A; 
     FIG. 5D is a cross section taken along the line  5 D— 5 D shown in FIG. 5A; 
     FIG. 5E is a cross section taken along the line  5 E— 5 E shown in FIG. 5A; 
     FIG. 6A is a side view having a partial cross section showing a state in which a treatment section of the slave manipulator shown in FIG. 5A is set straight; 
     FIG. 6B is a side view having a partial cross section of a state in which the treatment section of the slave manipulator shown in FIG. 5A is turned downward at a right angle; 
     FIG. 7 is a plan view showing a state in which the treatment section of the slave manipulator shown in FIG. 5A is turned in the counterclockwise direction; 
     FIG. 8 is a side view having a partial cross section of essential portion of a slave manipulator according to a third embodiment of the present invention; 
     FIG. 9 is a view seen from the direction indicated by the arrow  9  shown in FIG. 8; and 
     FIG. 10 is a view seen from the direction indicated by the arrow  9  shown in FIG.  8 . 
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     Hereinafter, one embodiment of the present invention will be described with reference to the accompanying drawings. FIG. 1 to FIG.  4 A and FIG. 4B show a first embodiment of the present invention. By referring now to a master/slave system shown in FIG. 1, reference numeral  1  denotes a pair of left and right manipulators, and reference numeral  2  denotes a monitor on which an endoscopic image is acquired. A pair of master manipulators  1  is designed so that a surgeon can operate the manipulators with both hands while observing the monitor  2 . When this master manipulator  1  is moved in the XY and Z directions, its position data is inputted to a position detector  3 . A master manipulator control foot switch  4  is connected to this position detector  3 . 
     The position detector  3  is connected to a master manipulator position computing computer  6  via a signal cable  5 , and the master manipulator position computing computer  6  is connected to a slave manipulator control computer  8  installed remotely from the master manipulator  1  via an optical fiber cable  7 . Further, the slave manipulator control computer  8  is connected to a motor unit  10  via a signal cable  9 . 
     14 servo units  11  are provided inside of the motor unit  10  in the present embodiment. Reference numeral  12  denotes a pair of slave manipulators that are a surgical operation apparatus corresponding to the master manipulators  1 . The pair of slave manipulators  12  have the same structure as that of master manipulator. Each manipulator consists of: an insert section  13 ; a treatment section  14  provided at the tip end of this insert section  13 ; and a slave driving section  15  provided at the proximal end of the insert section  13 , the slave driving section  15  for driving the treatment section  14 , wherein seven servo motors  16  are provided at each slave driving section  15 . 
     The insert section  13  of the pair of slave manipulators  12  is inserted into a patent&#39;s cavity together with an endoscope (not shown), and a surgeon operates the master manipulator  1  with both hands while observing the endoscopic image on the monitor  2 , whereby the slave manipulators  12  are actuated according to the operation so that a surgical operation can be performed. 
     Now, slave manipulators  12  will be described with reference to FIG.  2  and FIG.  3 . The insert section  13  is composed of an elongated metallic pipe of short diameter. A first driving rod  21  and a second driving rod  22  that are made of metallic rods of short diameter are inserted into this pipe in parallel to each other. These first and second driving rods  21  and  22  are disposed symmetrically at both sides while a axial center of the insert section  13  is sandwiched therebetween, and are retractable independently in an axial direction. 
     A treatment section support tube  23  is connected to the tip end of the insert section  13 . At this treatment section support tube  23 , there is integrally provided a pair of support sections  24  having their rigidity, the support sections protruding forward. Both ends of a first pivot pin  25  are fixed between tip ends of the pair of support section  24 , and a proximal end of a first jaw  26  is turnably pivoted at the intermediate part of this first pivot pin  25 . A bent section  26   a  is provided at the proximal end of the first jaw  26 , and a tip end of the first driving rod  21  is connected to a bend section  26   a  of the first jaw  26  by means of a first connecting pin  27 . 
     A second jaw  29  is turnably connected at the intermediate part of the first jaw  26  by means of a second pivot pin  28 , and the first jaw  26  and the second jaw  29  are turnable with the second pivot pin  28  being a fulcrum. One end of the connecting member  31  is turnably connected at the proximal end of the second jaw  29  via the second connecting pin  30 , and the other end of the connecting member  31  is turnably connected at the tip end of the second driving rod  22  via a third connecting pin  32 . 
     At the tip ends of the first and second jaws  26  and  29 , contacted/spaced faces configuring first and second grip sections  33  and  34  for gripping a tissue or a treatment instrument are provided in opposite to each other. Fine irregularities or teeth are formed on these contacted/spaced faces. 
     According to the thus configured slave manipulator  12 , when the first driving rod  21  is advanced, the first jaw  26  is pushed forward via the first connecting pin  27 . Thus, the first jaw  26  is turned in the direction indicated by the arrow ‘a’ with the first pivot pin  25  being a fulcrum. Conversely, when the second driving rod  22  is retracted, the proximal end of the second jaw  29  is pulled backward via a connecting member  31 . Thus, the second jaw  29  turns in the direction indicated by the arrow ‘b’ with the second pivot pin  28  being a fulcrum. Therefore, the first and second jaws  26  and  29  protrudes in an extension direction of the insert section  13  as indicated by solid line shown in FIG. 2, and the first and second grip sections  33  and  34  close. 
     In addition, from this state, when the second driving rod  22  is advanced while the first driving rod  21  remains, the proximal end of the second jaw  29  is pushed forward via the connecting member  31 . Thus, the second jaw  29  turns in the direction indicated by the arrow ‘c’ with the second pivot pin  28  being a fulcrum, and the first and second grip sections  33  and  34  open. Therefore, the first and second driving rods  21  and  22  are advanced and retracted, whereby the first and second jaws  26  and  29  can be opened or closed. 
     Next, when the first driving rod  21  is retracted, the first driving rod  21  pulls a bent section  26   a  of the first jaw  26 . Thus, the first jaw  26  turns in the direction indicated by the arrow ‘d’ with the first pivot pin  25  being a fulcrum, and turns at a substantial right angle relevant to an axle of the insert section  13 . In addition, when the second driving rod  22  is advanced in this state, the proximal end of the second jaw  29  is pushed via the connecting member  31 . Thus, the second jaw  29  turns in the direction indicated by the arrow ‘e’ shown in FIG. 3 with the pivot pin  28  being a fulcrum, and the first and second grip sections  33  and  34  open. 
     Further, conversely, when the second driving rod  22  is retracted, the proximal end of the second jaw  29  is pulled via the connecting member  31 . Thus, the second jaw  29  turns in the direction indicated by the arrow ‘f’ shown in FIG. 3 with the second pivot pin  28  being a fulcrum, and the first and second grip sections  33  and  34  close. 
     Therefore, even if the first and second jaws  26  and  29  are forced to be turnably displaced at a substantial right angle relevant to the axle of the insert section  13 , the first and second jaws  26  and  29  are turned, whereby the first and second grip sections  33  and  34  can be opened or closed. 
     Although the advancement or retraction of the first and second driving rods  21  and  22  is driven by converting a rotational movement of the servo motor  16  incorporated in the slave driving section  15  into a linear movement by means of a wire provided inside of the slave driving section  15  and a pulley having the wire hung thereon (not shown), advancement and retraction driving means of the first and second driving rods  21  and  22  is not limited. 
     Now, a method of suturing a dissection site of a tissue using a master/slave system will be described here. FIG. 4A shows a state in which a first driving rod  21  is retracted, and first and second jaws  26  and  29  are turned at a substantial right angle relevant to an axle of the insert section  13  and a state in which a threaded suture needle  35  is gripped by the first and second gripped sections  33  and  34 . In this state, when the suture needle  35  is positioned in the vicinity of a dissection site  37  of a tissue  36 , whereby the tip end of the insert section  13  is pushed up in the direction of the tissue  36 , the suture needle  35  is punctured at the tissue  36 . 
     Next, when the first driving rod  21  is advanced, the proximal end of the first jaw  26  is pushed. Thus, the first jaw  26  turns forward with the first pivot pin  26  being a fulcrum. As shown in FIG. 4B, the suture needle  35  is punctured at the tissue  36  having the dissection site  37 , and the tip end of the suture needle  35  protrudes from a top layer of the tissue  36 . In this way, the first and second jaws  26  and  29  can be turned in the axial direction of the suture needle  35 , and the suture needle  35  can be easily punctured. 
     In addition, as described previously, in a state in which the first and second jaws  26  and  29  are oriented in the axial direction of the insert section  13  or are turnably displaced at a substantial right angle relevant to the axle, the first and second jaws  26  and  29  are turned, whereby the first and second grip sections  33  and  34  can be opened or closed, or can approach a target site reliably. The tissue  36  can be easily not only sutured but also can be easily gripped or released. 
     FIG. 5A to FIG. 7 each show a second embodiment of the present invention. As illustrated, as in the first embodiment, the slave manipulator according to the present embodiment is also actuated by means of the master manipulator  1 . In addition to the fact that the first and second jaws according to the first embodiment are opened or closed and are turned in a vertical direction, the first and second jaws can be turned in a transverse direction. 
     As shown in FIG. 5A to FIG. 7, an insert section  40  is composed of an elongated metallic pipe of short diameter. A first driving rod  41  and a second driving rod  42  that are made of metallic rods of short diameter are inserted into this pipe in parallel to each other. The first driving rod  41  is disposed eccentrically more upward than the axial center of the insert section  40 . The second and third driving rods  42  and  43  are disposed symmetrically more downward than the axial center of the insert section  13 , and is retractable independently in an axial direction. 
     A support section  44  having its rigidity that protrudes forward is integrally provided at the tip end of the insert section  40 . A slitting  44   a  is provided at the tip end of the support section  44 . To this slitting  44   a , there is connected a turn plate  44   a  that turns in a traverse direction about a pivot  44   b  orthogonal to the axial direction of the insert section  40 . To the turn plate  44   c , a first pivot pin  45  is fixed in the direction orthogonal to the pivot  44   b . To this first pivot pin  45 , the proximal end of the first jaw  46  is turnably pivoted about this first pivot pin  45 . A bent section  46   a  is provided at the proximal end of the first jaw  46  so that the second and third driving rods  42  and  43  are connected to this bent section  46   a  by means that will be described later. 
     A second jaw  49  is turnably connected at the intermediate part of the first jaw  46  by means of a second pivot pin  48 , and the first jaw  46  and the second jaw  49  are turnable with the second pivot pin  48  being a fulcrum. The proximal end of the second jaw  49  is turnably connected to one end of the first connecting member  51  via the first connecting pin  50 , and the other end of the first connecting member  51  is connected to the second connecting member  52  via a pivot pin  51   a  in the traverse direction. The other end of the second connecting member  52  is turnably connected at the tip end of the first driving rod  41  via a connecting pin  52   a.    
     In addition, a third connecting member  56  is connected to a bent section  46   a  of the first jaw  46  via a third connecting pin  55 . The proximal end of this third connecting member  56  is wide in the transverse direction. At this proximal end, the fourth connecting pin  57  and the fifth connecting pin  58  are provided to be spaced in the transverse direction. The fourth connecting pin  57  is connected to the second driving rod  42 , and the fifth connecting pin  58  is connected to the third driving rod  43 . 
     According to the thus configured slave manipulator, when the first driving rod  41  is advanced, the proximal end of the second jaw  49  is pushed forward via the first and second connecting members  51  and  52 . Thus, the second jaw  49  turns with the second pivot pin  48  being a fulcrum, and the first and second jaws  46  and  419  open. Conversely, when the first driving rod  1  is retracted, the proximal end of the second jaw  49  is pulled backward via the first and second connecting members  51  and  52 . Thus, the second jaw  49  turns with the second pivot pin  48  being a fulcrum, and the first and second jaws  46  and  49  close. 
     In addition, when the second and third driving rods  42  and  43  are retracted simultaneously, and the first driving rod is advanced, the proximal end of the first jaw  46  is pulled backward via the third connecting member  56 . Thus, the first jaw  46  turns with the first pivot pin  45  being a fulcrum, and the second jaw  49  turns in the same direction with the first connecting pin  50  being a fulcrum, whereby the first and second jaws  46  and  49  can be turned at a substantial right angle relevant to the axle of the insert section  40 . 
     In addition, from this state, when the first driving rod  41  is advanced, the proximal end of the second jaw  49  is pushed forward via the first and second connecting members  51  and  52 . Thus, the second jaw  49  turns with the second pivot pin  48  being a fulcrum, and the first and second jaws  46  and  49  open. 
     Next, when the second driving rod  42  is retracted, and the third driving rod  43  is advanced, a turn plate  4   c  turns in the counterclockwise direction with the pivot  44   b  being a fulcrum. Thus, as shown in alternate dot and dashed line in FIG. 7, the first and second jaws  46  and  49  turn in the counterclockwise direction with the pivot  44   b  being a fulcrum. Conversely, when the second driving rod  42  is advanced, and the third driving rod  43  is retracted, the turn plate  44   c  turns in the clockwise direction with the pivot  44   b  being a fulcrum. Thus, the first and second jaws  46  and  49  turns in the clockwise direction with the pivot  44   b  being a fulcrum. 
     According to the present embodiment, the first and second jaws  46  and  49  that are openable can be turned in the vertical and transverse directions, and the first and second jaws  46  and  49  can approach a target site easily, whereby the degree of freedom for treatment can be improved. 
     FIG. 8 to FIG. 10 show a third embodiment of the present invention. As illustrated, in a slave manipulator  12  of the present embodiment, the insert section  13  is composed of an elongated metallic pipe of short diameter. A first driving rod  121  and a second driving rod  122  that are made of metallic rods of short diameter are inserted into this pipe in parallel to each other. These first and second driving rods  121  and  122  are disposed symmetrically at both sides at an eccentric position more downward than the axial center part of the insert section  13 , and is retractable independently in the axial direction. 
     At the tip end of the insert section  13 , there is provided a protrusion  123  having its rigidity, the protrusion protruding forward at the upper side of the insert section  13  by cutting its lower side. A support section  124  is provided integrally at the tip end of this protrusion  123 . A first pivot pin  125  that penetrate in the vertical direction is fixed to the support section  124 . The proximal end of a first connecting member  126  is turnably pivoted at both ends of this first pivot pin  125 . That is, a slitting  126   a  is provided at the proximal end of the first connecting member  126 . The support section  124  is connected at this slitting  126   a  by means of the first connecting member  126  with the support section being sandwiched in the vertical direction. 
     The first connecting member  126  is short in a longitudinal direction. A protrusion  126   b  is provided integrally at the intermediate part in the transverse direction at its tip end, and the intermediate part of the second pivot pin  127  that penetrates in the transverse direction is provided at this protrusion  126   b . In this manner, a second pivot pin  127  is provided at the tip end rather than the first pivot pin  125  and in the vicinity of the first pivot pin  125 . At this second pivot pin  127 , the proximal end of a tip end acting member  128  is turnably pivoted in the vertical direction. The tip end acting member  128  is a metallic rod-like member. A slitting  128   a  is provided at the proximal end of this member. At this slitting  128   a , the protrusion  126   b  is connected while the protrusion  126   b  is sandwiched between the tip end acting members  128  in the transverse direction. Therefore, the tip end acting member  128  is turnable in the transverse direction with the first pivot pin  125  being a fulcrum, and is turnable in the vertical direction with the second pivot pin  127  being a fulcrum. 
     Further, one end of a second connecting member  130  is connected at the substantial intermediate part in the longitudinal direction of the tip end acting member  128  via a first connecting pin  129 . That is, a slitting  128   b  is also provided at the intermediate part of the tip end acting member  128 . The tip end of the second connecting member  130  is connected to this slitting  128   b  by means of a first connecting pin  129  while the tip end is inserted. 
     A wide section  130   a  that extends in the transverse direction is provided at the proximal end of the second connecting member  130 . A second connecting pin  131  and a third connecting pin  132  are provided at both ends at the right and left of this wide section  130   a . The first driving rod  121  is connected to the second connecting pin  131 , and a second driving rod  122  is connected to a third connecting pin  132 . 
     According to the thus configured slave manipulator  12 , the first driving rod  121  is retracted, and the second driving rod  122  is advanced, whereby the tip end acting member  128  turns in the counterclockwise direction (in the direction indicated by the arrow ‘a’) with the pivot pin  125  being a fulcrum. The first driving rod  121  is advanced, and the second driving rod  122  is retracted, whereby the tip end acting member  128  turns in the clockwise direction (the direction indicated by the arrow ‘b’) with the first pivot pin  125  being a fulcrum. Further, the first and second driving rods  121  and  122  are advanced or retracted simultaneously, the tip end acting member  128  turns in the vertical direction (the direction indicated by the arrow ‘c’) with the second pivot pin  127  being a fulcrum. 
     Therefore, the tip end acting member  128  can approach a target site easily. In addition, the tip end acting member  128  is turned in the transverse direction or turned in the vertical direction, whereby a tissue can be released or pushed. In addition, a high frequency current is supplied to the tip end acting member  128 , thereby making it possible to employ the member as a high frequency knife for coagulating or dissecting the tissue. Further, a pair of the tip end acting members  128  is made openable, whereby treatment can be performed such that a tissue is gripped or a suture needle is griped, thereby suturing a dissected site. 
     Although the advancement or retraction of the first and second driving rods  121  and  122  is driven by converting a rotational movement of the servo motor  16  incorporated in the slave driving section  15  into a linear movement by means of a wire provided inside of the slave driving section  15  and a pulley having the wire hung thereon (not shown), means for advancing and retracting the first and second driving rods  121  and  122  is not limited. 
     As has been described above, according to the present invention, the first and second driving rods are operated to be advanced or retracted, whereby the first and second jaws (tip end acting members) can be directionally changed in the axial direction of the insert section and relevant to the axle. Moreover, in any state as well, the first and second jaws can be opened or closed. Therefore, approach properties for a target site are improved, and the degree of freedom for treatment can be improved. 
     Further, the first and second jaws (tip end acting members) are driven by operating the first and second driving rods to be advanced or retracted, whereby a force twice as much as usual can be obtained, and an operational failure due to wire expansion or the like does not occur. There is an advantageous effect that, even if external force is applied to the first and second jaws (tip end acting members), these jaws do not move, and reliable treatment can be performed. 
     Additional advantages and modifications will readily occur to those skilled in the art. Therefore, the invention in its broader aspects is not limited to the specific details and representative embodiments shown and described herein. Accordingly, various modifications may be made without departing from the spirit or scope of the general inventive concept as defined by the appended claims and their equivalents.