Patent Publication Number: US-2017367564-A1

Title: Overtube and medical manipulator system

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This is a continuation of International Application PCT/JP 2016/053156, with an international filing date of Feb. 3, 2016, which is hereby incorporated by reference herein in its entirety. This application claims the benefit of Japanese Patent Application No. 2015-037405, filed on Feb. 26, 2015, the content of which is incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     The present invention relates to an overtube and a medical manipulator system. 
     BACKGROUND ART 
     In the related art, there is a known surgical system in which a manipulator for performing treatment on a diseased part inside a body is provided with a storage means for storing information about the manipulator, and when the manipulator is connected to a control circuit, the manipulator information is passed to the control circuit (for example, see Patent Literature 1). 
     CITATION LIST 
     Patent Literature 
     {PTL 1} 
     Japanese Unexamined Patent Application, Publication No. 2014-57854 
     SUMMARY OF INVENTION 
     Technical Problem 
     An object of the present invention is to provide an overtube and a medical manipulator system that allow easy confirmation that an appropriate overtube has been selected, when using a manipulator via a channel in an overtube. 
     An aspect of the present invention provides an overtube comprising: a distal-end tubular portion in which a manipulator channel through which a manipulator is passed and an endoscope channel through which an endoscope is passed are provided; a proximal-end tubular portion that is connected at an end of the distal-end tubular portion and that has an extension channel to which the manipulator channel is communicated; and a storage unit that stores information of the distal-end tubular portion and the proximal-end tubular portion in a readable manner from outside, wherein the distal-end tubular portion and the proximal-end tubular portion are provided in a detachable manner; wherein the storage unit is provided with a distal-end storage unit that is provided in the distal-end tubular portion and that stores information of the manipulator channel, and a proximal-end storage unit that is provided in the proximal-end tubular portion and that stores information of the extension channel; and wherein the distal-end storage unit and the proximal-end storage unit are formed of electrical circuits that are connected when the distal-end tubular portion and the proximal-end tubular portion are connected; and a connection terminal for an external apparatus to read out the information when the proximal-end tubular portion is connected to the external apparatus is provided in the proximal-end section of the proximal-end tubular portion. 
     In the above-described aspect, the storage unit may store usage count information in a readable and writable manner. 
     In the above-described aspect, a plurality of the manipulator channels may be provided. 
     In the above-described aspect, the distal-end tubular portion may be provided with a plurality of the manipulator channels; the proximal-end tubular portion may be provided with, in the same number as the number of manipulator channels, a plurality of the extension channels that can extend the manipulator channels, in arbitrary combinations; the distal-end storage unit may be provided in each of the manipulator channels; and the proximal-end storage unit may be provided in each of the extension channels. 
     Another aspect of the present invention is a medical manipulator system comprising: any one of the above-described overtubes; the manipulator, which is inserted into the manipulator channel in the overtube; an operating portion that is operated by an operator; a control portion that controls the driving portion on the basis of an operation input that is input via the operation portion; and a readout unit that reads out information stored in the storage unit. 
     Another aspect of the present invention provides a medical manipulator system comprising: the above-described overtube; the manipulator, which is inserted into the manipulator channel in the overtube; an operating portion that is operated by an operator; a control portion that controls the driving portion on the basis of an operation input that is input via the operating portion; a readout unit that reads out information stored in the storage unit; a writing unit that writes a usage count of the overtube into the storage unit; and a notifying unit that, when the usage count read out from the storage unit by the readout unit exceeds a prescribed count, issues a notification to that effect. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         FIG. 1  is a diagram showing the overall configuration of a medical manipulator system according to an embodiment of the present invention. 
         FIG. 2  is a perspective view showing the medical manipulator system in  FIG. 1 . 
         FIG. 3  is a partial perspective view showing an endoscope, manipulators and the distal end of an overtube in the medical manipulator system in  FIG. 2 . 
         FIG. 4A  is a longitudinal sectional view showing the overtube according to an embodiment of the present invention, provided in the medical manipulator system in  FIG. 1 . 
         FIG. 4B  is a distal-end front elevational view showing the overtube according to the embodiment of the present invention, provided in the medical manipulator system in  FIG. 1 . 
         FIG. 4C  is a proximal-end front elevational view showing the overtube according to the embodiment of the present invention, provided in the medical manipulator system in  FIG. 1 . 
         FIG. 4D  is a distal-end front elevational view showing the overtube according to the embodiment of the present invention, provided in the medical manipulator system in  FIG. 1 , and is a distal-end front elevational view of a different pattern from that in  FIG. 4B . 
         FIG. 5A  is a longitudinal sectional view showing a state before the overtube in  FIG. 4A  is connected to a driving portion body. 
         FIG. 5B  is a longitudinal sectional view showing a state after the overtube in  FIG. 4A  is connected to the driving portion body. 
         FIG. 6  is a block diagram for explaining the flow of information stored in the storage unit in the overtube in the medical manipulator system in  FIG. 1 . 
         FIG. 7A  is a partial longitudinal sectional view showing a state before connection to a driving portion body, showing a first modification of the overtube in  FIG. 4A . 
         FIG. 78  is a partial longitudinal sectional view showing a state after connection to a driving portion body, showing the first modification of the overtube in  FIG. 4A . 
         FIG. 8  is a longitudinal sectional view showing a state before connection of a distal-end tubular portion and a proximal-end tubular portion, showing a second modification of the overtube in  FIG. 4A . 
         FIG. 9  is a longitudinal sectional view showing state in which the distal-end tubular portion and the proximal-end tubular portion in the overtube in  FIG. 8  are connected and attached to the driving portion body. 
         FIG. 10  is a longitudinal sectional view showing a third modification of the overtube in  FIG. 4A . 
         FIG. 11  is a longitudinal sectional view showing a fourth modification of the overtube in  FIG. 4A . 
         FIG. 12  is a longitudinal sectional view showing a fifth modification of the overtube in  FIG. 4A . 
         FIG. 13  is a longitudinal sectional view showing a sixth modification of the overtube in  FIG. 4A . 
         FIG. 14  is a longitudinal sectional view showing a seventh modification of the overtube in  FIG. 4A . 
         FIG. 15  is a longitudinal sectional view showing an eighth modification of the overtube in  FIG. 4A . 
         FIG. 16  is a longitudinal sectional view showing a ninth modification of the overtube in  FIG. 4A . 
         FIG. 17A  is a partial perspective view for explaining a parallel connection form of connection sections of the distal-end tubular portion and the proximal-end tubular portion, showing a tenth modification of the overtube in  FIG. 4A  and  FIG. 4B . 
         FIG. 17B  is a partial perspective view for explaining a connection form in which the connection sections of the distal-end tubular portion and the proximal-end tubular portion cross over, showing the teeth modification of the overtube in  FIG. 4A  and  FIG. 4B . 
         FIG. 18  is a longitudinal sectional view showing an eleventh modification of the overtube in  FIG. 4A . 
     
    
    
     DESCRIPTION OF EMBODIMENTS 
     An overtube  4  and a medical manipulator system  1  according to an embodiment of the present invention will be described below with reference to the drawings. 
     As shown in  FIG. 1  and  FIG. 2 , the medical manipulator system  1  according to this embodiment is provided with: an endoscope  2  and two manipulators  3  that are inserted into the body of a patient P; the overtube  4  according to an embodiment of the present invention, which accommodates the endoscope  2  and the manipulators  3 ; an operating portion  5  that is operated by an operator A; a control portion  6  that controls each of the manipulators  3  on the basis of the operation of the operation portion  5 ; and a monitor  7 . 
     As shown in  FIG. 2  and  FIG. 3 , the manipulators  3  are each provided with: an insertion portion  8  that is inserted in the body of the patient P via a channel  13  in the overtube  4 , described later; a movable portion  9  that is provided at the distal end of the insertion portion  8 ; and a driving portion  10  that is disposed at the proximal-end of the insertion portion  8  and that drives the movable portion  9  by means of a motive-force transmitting member such as a wire or the like (not illustrated). 
     The movable portion  9  includes: a treatment portion  11  that is disposed at the extreme distal end and that acts on a diseased part in the body to perform treatment thereon; and a plurality of joints  12  that change the position and orientation of the distal end of the treatment portion  11 . 
     As shown in  FIG. 4A , the overtube  4  according to this embodiment, which is a tube formed of a material having flexibility, includes: a distal-end tubular portion  15  having two manipulator channels  13  through which the manipulators  3  are passed and a single endoscope channel  14  through which an endoscope  2  is passed; and a proximal-end tubular portion  16  having extension channels  13   a  that extend the two manipulator channels  13  from the proximal-end of the distal-end tubular portion  15  towards the proximal-end side. A first housing  17  is fixed at the distal end of the distal-end tubular portion  15 , a second housing  18  is fixed at the proximal-end of the distal-end tubular portion  15 , and a third housing  19  is fixed at the proximal-end of the proximal-end tubular portion  16 . 
     As shown in  FIG. 4B , the first housing  17  is provided with distal-end openings  20  and  21  from which the distal ends of the two manipulators  3  inserted in the two manipulator channels  13  and the distal end of the endoscope  2  inserted in the endoscope channel  14  protrude, respectively. 
     The second housing  18  is provided with a proximal-end opening  22  into which the endoscope  2  is inserted. 
     As shown in  FIG. 4C , the third housing  19  is provided with two proximal-end openings  23  into which the two manipulators  3  are inserted. 
     As shown in  FIG. 4D , the two distal-end openings  20  from which the two manipulators  3  protrude may be provided so as to flank the distal end opening  21  of the endoscope channel  14 , between the distal-end openings  20 . Thus, the positional relationship of the distal-end openings  20  and  21  from which the manipulators  3  and the endoscope  2  protrude is different from the case in  FIG. 4B , and accordingly, the protruding directions and orientations of the manipulators  3  in an image captured by the endoscope  2  change; however, by transferring information thereon to the control portion  6  from a memory circuit  24  according to this embodiment and changing the control parameters, improved operation become possible. 
     As shown in  FIG. 4A , the third housing  19  is provided with a the memory circuit (storage unit)  24 , which stores identification information and a usage count of the overtube  4  in a readable/writable manner, and a connection terminal  25  for reading out the identification information and usage count stored in the memory circuit  24  to the outside, or for writing a usage count from the outside, which are connected by wiring  26 . 
     As shown in  FIG. 2 , the driving portion  10  of the manipulators  3  includes: a driving portion body  27  that includes motors; and manipulator-side driving portions  28  that are detachably provided on the driving portion body  27  and that, by being attached to the driving portion body  27 , transfer the driving forces of the motors to the motive-force transmitting members in the insertion portions  8 . 
     As shown in  FIG. 5A  and  FIG. 5B , it is possible to detachably attach the third housing  19  of the overtube  4  to the driving portion body  27 . The driving portion body  27  is provided with: a connection terminal  29  that contacts the connection terminal  25  provided in the third housing  19  when the third housing  19  is attached, thus being electrically connected thereto; and an input/output unit (external apparatus)  30  that reads and writes information in the memory circuit  24  via the connection terminal  25 . 
     When the connection terminal  25  in the third housing  19  is connected to the connection terminal  29  in the driving portion body  27 , electrical power is supplied to the memory circuit  24  via these connection terminals  25  and  29 , so that the information in the memory circuit  24  can be read out via the connection terminals  25  and  29  and a reading unit (readout unit)  31  in the driving portion body  27 . 
     As shown in  FIG. 6 , the input/output unit  30  is provided with the reading unit  31 , which reads out the information in the memory circuit  24 , and a writing unit  32  for writing usage count information in the memory circuit  24 .  FIG. 6  is a block diagram for explaining the flow of information stored in the memory circuit  24 . 
     The identification information read out from the memory circuit  24  by the reading unit  31  is sent from the control portion  6  to the monitor  7 , where the information is displayed, whereby the operator A can determine if the overtube  4  is appropriate. 
     A notifying unit  33  is connected to the control portion  6 . The notifying unit  33  may be configured as any type of unit, for example, a monitor, a light-emitting part, a speaker or the like, and in the case where the overtube  4  exceeds a prescribed usage count, the operator A can be notified to that effect. 
     The usage count read out from the memory circuit  24  by the reading unit  31  is compared with a prescribed threshold in the control portion  6 , and if, as a result of the comparison, the usage count exceeds the prescribed threshold, a notification to that effect is issued by the notifying unit  33 . 
     At a certain timing, such as at system power up, the control portion  6  increments the usage count of the overtube  4 , and can write it in the memory circuit  24  via the writing unit  32  in the input/output unit  30  and the connection terminals  25  and  29 . 
     The operation of the overtube  4  and the medical manipulator system  1  according to this embodiment, configured in this way, will be described below. 
     To treat a diseased part in the body using the medical manipulator system  1  according to this embodiment, in the state in which the distal ends of the two manipulators inserted in the extension channels  13   a  from the proximal-end openings  23  in the third housing  19  are disposed close to the distal-end openings  20  in the first housing  17  in the distal-end tubular portion  15  via the manipulator channels  13 , and in which the distal end of the endoscope  2  inserted in the endoscope channel  14  from the proximal-end opening  22  provided in the second housing  18  is disposed close to the distal-end opening  21  in the first housing  17 , the overtube  4  is inserted into the body of the patient P. 
     Then, in the state in which the distal end of the overtube  1  is disposed in contact with the diseased part in the body, the operator A causes the distal end of the endoscope  2  to protrude from the distal-end opening  21  in the endoscope channel  14  and causes the two movable portions  9  to protrude from the respective distal-end openings  20  in the manipulator channels  13 . In this state, the third housing  19  of the proximal-end tubular portion  16  is fixed to the driving portion body  27 , and the manipulator-side driving portion  28  is attached to the driving portion body  27 . 
     As shown in  FIG. 5B , when the third housing  19  is fixed to the driving portion body  27 , the connection terminal  29  provided in the driving portion body  27  comes into contact with the connection terminal  25  provided in the third housing  19  to be electrically connected therewith, and when the power supply of the medical manipulator system  1  is turned on, power is supplied to the memory circuit  24 . Accordingly, the identification information and usage count information of the overtube  4 , which are stored in the memory circuit  24 , are read by the reading unit  31 . The read identification information and usage count information are sent to the control portion  6 , the identification information is sent by the control portion  6  to the monitor  7  for display, and it is determined whether or not the usage count information exceeds the prescribed threshold. 
     By displaying the identification information on the monitor  7 , the operator A can confirm whether or not the manipulator channel  13  in the overtube  4  is one that is suitable for the manipulator  3  to be used, without removing the overtube  4 , which is inserted in the body, from the body. 
     If the length of the manipulator channel  13 , the position of the distal-end opening  20 , or the like are appropriate for the manipulator  3  to be used, it can be determined that manipulator channel  13  is a suitable one, whereas if the length of the manipulator channel  13  is large, if the length is extremely short, or if the position of the distal-end opening  20  differs from a desired position, etc., it can be determined that manipulator channel is not suitable for the manipulator  3 . Therefore, in accordance with the displayed identification information, the operator A can change the manipulator  3  or can change the overtube  4 , so as to perform appropriate treatment. 
     If, as a result of the determination in the control portion  6 , the usage count exceeds the prescribed threshold, a notification to that effect is given by the notifying unit  33 . If the usage count is less than or equal to the prescribed threshold, the usage count is incremented and is written in the memory circuit  24  via the writing unit  32  in the input/output unit  30  and the connection terminals  25  and  29 . 
     Thus, with the overtube  4  and the manipulators  3  according to this embodiment, identification information of the manipulator channel  13  in the memory circuit  24  provided in the overtube  4  can be read out externally, and therefore, when the manipulator  3  is inserted into the manipulator channel  13  in the overtube  4  in the state in which the overtube  4  is inserted in the body, the appropriateness thereof can be determined without removing the overtube  4 . 
     By configuring the memory circuit  24  so as to be readable and writable and by writing the usage count of the overtube  4  in the memory circuit  24 , an advantage is afforded in that, during use, it is possible to issue a notification as to whether the usage count of the overtube  4  exceeds the prescribed threshold, it is possible to avoid the drawback wherein the overtube  4  is used in excess of a prescribed number of uses, and it is possible to appropriately manage re-use of the overtube  4 . 
     The connection terminal  25  in the third housing  19  is connected to the connection terminal  29  in the driving portion body  27  so that the identification information and the usage count information are initially read out, and therefore, by displaying the identification information on the monitor  7 , an advantage is afforded in that it is possible to confirm that the connection between the overtube  4  and the driving portion body  27  has been performed correctly. 
     In this embodiment, it has been described that the memory circuit  24  and the connection terminal  25  are provided in the overtube  4 , that power is supplied by electrically connecting them to the connection terminal  29  provided in the driving portion body  27 , and that the identification information etc. is read out from the memory circuit  24 . Instead of this, as shown in  FIG. 7A  and  FIG. 7B , a transmission/reception unit (wireless transmission unit)  35  that wirelessly transmits the information in the memory circuit  24  to an external wireless transmission/reception unit (external apparatus, readout unit)  34  and that receives information wirelessly transmitted from the external wireless transmission/reception unit  34  and writes it in the memory circuit  24  may be provided. 
     This transmission/reception unit  35  may be configured as a circuit that does not operate in the state in which it is disconnected from the driving portion body  27 , as shown in  FIG. 7A , and is capable of transmission and reception in conjunction with a circuit provided on the driving portion body  27  side, when the third housing  19  is connected to the driving portion body  27 , as shown in  FIG. 7B . 
     In this embodiment, the overtube  4  in which the distal-end tubular portion  15  and the proximal-end tubular portion  16  are formed as a single unit has been illustrated as an example; instead of this, however, as shown in  FIG. 8 , the distal-end tubular portion  15  and the proximal-end tubular portion  16  may be attached together in a detachable manner. Since the second housing  18  having the proximal-end opening  22  through with the endoscope  2  is inserted is disposed outside the body of the patient P, the proximal-end tubular portion  16 , which is deposed closer to the proximal-end, is a part that is not inserted into the body of the patient P. 
     By separating the distal-end tubular portion  15 , into which the endoscope  2  is inserted, and the proximal-end tubular portion  16 , into which the endoscope  2  is not inserted, it is possible to facilitate the task of inserting the endoscope  2 . In other words, in the case where the endoscope  2  is inserted into the body, in the state in which the endoscope  2  is made to pass through the endoscope channel  14  in the distal-end tubular portion  15 , and the endoscope  2  is made to protrude by an adequate length from the distal-end opening  21  in the endoscope channel  14 , only the endoscope  2  is inserted further into the body cavity. 
     In this state, the endoscope  2  is operated, and while checking the image acquired by the endoscope  2  on the monitor  7 , the endoscope  2  is inserted farther into the body cavity of the patient P. 
     Once the distal end face of the endoscope  2  has advanced by a certain amount into the body, so that a prescribed site appears in the image, the distal-end tubular portion  15  disposed on the proximal-end side of the endoscope  2  is made to advance relative to the endoscope  2 , so as to move along the endoscope  2 , using the endoscope  2  as a guide. By repeating these operations, the endoscope  2  is inserted farther into the body cavity. 
     At this time, since the proximal-end tubular portion  16  is not connected to the proximal-end of the distal-end tubular portion  15 , the proximal-end tubular portion  16  does not obstruct the task of inserting the distal-end tubular portion  15 , and thus the ease of insertion can be improved. Thereafter, in the state in which the distal-end tubular portion  15  is inserted until the distal end of the distal-end tubular portion  15  is disposed close to the distal end of the endoscope  2 , preparations are completed by fitting the proximal-end of the tubular portion  16  into a hole  36  in the second housing  18 , inserting the manipulator  3  via the proximal-end opening  23  the third housing  19 , and fixing the third housing  19  to the driving portion body  27 , as well as by fixing the manipulator-side driving portion  28  to the driving portion body  27 . 
     Thus, in the case where the distal-end tubular portion  15  and the proximal-end tubular portion  16  are detachably separated, it is necessary to individually manage the distal-end tubular portion  15  and the proximal-end tubular portion  16 . To do so, as shown in  FIG. 8 , this overture  4  is provided with a distal-end storage unit (storage unit)  37  and a proximal-end storage unit (storage unit)  38  that store identification information and information about usage counts etc. for the distal-end tubular portion  15  and the proximal-end tubular portion  16 , respectively, and when the distal-end tubular portion  15  and the proximal-end tubular portion  16  are connected, the connection terminals  39  and  40  and the wires  26  that connect the two storage units  37  and  38  are provided in the distal-end tubular portion  15  an the proximal-end tubular portion  16 , respectively. 
     In other words, the second housing  18  is provided with the distal-end storage unit  37 , which stores the identification information and the usage count for the distal-end tubular portion  15 , and is provided with the connection terminal  39 , which is connected to the distal-end storage unit  37  and which is exposed, in the hole  36 , at the inner circumferential surface that contacts the proximal-end tubular portion  16 . On the other hand, the third housing  19  is provided with the proximal-end storage unit  38 , which stores the identification information and usage count for the proximal-end tubular portion  16 , the wire  26  connected to the proximal-end storage unit  38  extends along the longitudinal direction of the proximal-end tubular portion  16 , and the connection terminal  40 , which is connected to the connection terminal  39  when connected to the second housing  18 , is provided so as to be exposed at the outer circumferential surface. 
     By doing so, as shown in  FIG. 9 , the distal-end of the proximal-end tubular portion  16  is fitted into the hole  36  in the second housing  18  of the distal-end tubular portion  15  so that the manipulator channel  13  and the extension channel  13   a  are connected, and the connection terminals  39  and  40  are connected with each other; and also, by attaching the third housing  19  to the driving portion body  27  and turning on the power supply, the information stored in the distal-end storage unit  37  is read out by the input/output unit  30  via the proximal-end storage unit  38 . In addition, the information stored in the proximal-end storage unit  38  is read out directly. Furthermore, the usage count information from the control portion  6  is written into the distal-end storage unit  37  via the proximal-end storage unit  38 , or is directly written into the proximal-end storage unit  38 . 
     Accordingly, the operator can determine whether either one of the distal-end tubular portion  15  and the proximal-end tubular portion  16  is appropriate for the manipulator  3  to be used. In addition, in the case where the usage count of either one of the distal-end tubular portion  15  and the proximal-end tubular portion  16  exceeds a usage count that set therefor, a notification to that effect is given by the notifying unit  33 , and therefore, it is possible to prevent a situation where the distal-end tubular portion  15  or the proximal-end tubular portion  16  exceeding the usage count is used. 
     In this case also, as shown in  FIG. 10 , the read-out of information from the storage units  37  and  38  or the writing of information into the storage units  37  and  38  may be performed wirelessly. In this case, the proximal-end storage unit  38  and the transmission/reception unit  35  in the proximal-end tubular portion  16  should be disposed close to the distal end of the proximal-end tubular portion  16 , and the connection terminals  39  and  40  that are connected when the distal end of the proximal-end tubular portion  16  is fitted into the hole  36  in the second housing  18  should be provided in the proximal-end tubular portion  16  and the hole  36 , respectively. Accordingly, the information for the proximal-end storage unit  38  is transmitted and received by the transmission/reception unit  35  directly, and the information for the distal-end storage unit  37  is transmitted and received by the transmission/reception unit  35  via the proximal-end storage unit  38 . 
     As shown in  FIG. 11 , the information for the distal-end storage unit  37  may be transmitted and received by a transmission/reception unit (wireless transmission unit)  41  provided in the distal-end tubular portion  15 , and the information for the proximal-end storage unit  38  may be transmitted and received by the transmission/reception unit  35  provided in the proximal-end tubular portion  16 . At this time, it is preferable that transmission and reception from the two transmission/reception units  35  and  41  be enabled by connecting together the connection terminals  39  and  40  that are connected to the storage units  37  and  38 , respectively. 
     As shown in  FIG. 12 , conversely to the case in  FIG. 10 , the transmission/reception unit  41  may be provided only in the distal-end tubular portion  15 . Accordingly, the information for the proximal-end storage unit  38  is transmitted and received by the transmission/reception unit  41  via the distal-end storage unit  37 , and the information for the distal-end storage unit  37  is transmitted and received by the transmission/reception unit  41  directly. 
     Even in the case where the distal-end tubular portion  15  and the proximal-end tubular portion  16  are detachably separated, when either one of them can be used only when paired with the other, as shown in  FIG. 13 , the storage unit  38  may be provided only in the proximal-end tubular portion  16 , or alternatively, as shown in  FIG. 14 , the storage unit  37  may be provided only in the distal-end tubular portion  15 . In addition, as shown in  FIG. 15 , the proximal-end section of the distal-end tubular portion  15  may be electrically connected by a wire with the control portion  6  via detachable connectors L 1  and L 2  so that information is transmitted and received, and in this case also, the transmission and reception may be performed wirelessly, as shown in  FIG. 7  or  FIG. 16 . 
     As shown in  FIG. 17A  and  FIG. 17B , in the case where, for example, there are two manipulator channels  13 , and there are separate ends of the proximal-end tubular portions  16  that connect to the distal-end tubular portion  15  for each manipulator channel  13 , so that it is possible to connect them to either of the manipulator channels  13 , the configurations in  FIGS. 8 to 12  may be provided in each manipulator channel  13 . Accordingly, it is also possible to easily confirm the connection states of the distal-end tubular portion  15  and the proximal-end tubular portions  16 . 
     As shown in  FIG. 18 , a form in which the storage unit  37  is provided in the distal-end tubular portion  15  and performs transmission and reception wirelessly, a separate storage unit  38  is provided in the proximal-end tubular portion  16 , and the storage unit  38  and the input/output unit  30  are electrically connected via the connection terminals  25  and  29  so as to transmit and receive information is also possible. 
     In this embodiment, the case where two manipulators  3  are provided has been illustrated as an example; however, the number of manipulator channels  13  may be 1 or may be 3 or more. 
     In the case where the medical manipulator system  1  is provided with a sterilization apparatus, the number of times that sterilization treatment has been performed on the overtube  4  by the sterilization apparatus may also be stored in the storage units  37  and  38 . 
     Although the memory circuit  24  formed of an electrical circuit has been illustrated as an example of the storage units  37  and  38 , instead of this, the storage units  37  and  38  may be configured of bar codes, and the reading unit  31  may be configured of a bar code reader. The storage units  37  and  38  may also be configured of RFIDs. 
     As a result, the following aspect is read by the above described embodiment of the present invention. 
     An aspect of the present invention provides an overtube comprising: a distal-end tubular portion in which a manipulator channel through which a manipulator is passed and an endoscope channel through which an endoscope is passed are provided; a proximal-end tubular portion that is connected at an end of the distal-end tubular portion and that has an extension channel to which the manipulator channel is communicated; and a storage unit that stores information of the distal-end tubular portion and the proximal-end tubular portion in a readable manner from outside, wherein the distal-end tubular portion and the proximal-end tubular portion are provided in a detachable manner; wherein the storage unit is provided with a distal-end storage unit that is provided in the distal-end tubular portion and that stores information of the manipulator channel, and a proximal-end storage unit that is provided in the proximal-end tubular portion and that stores information of the extension channel; and wherein the distal-end storage unit and the proximal-end storage unit are formed of electrical circuits that are connected when the distal-end tubular portion and the proximal-end tubular portion are connected; and a connection terminal for an external apparatus to read out the information when the proximal-end tubular portion is connected to the external apparatus is provided in the proximal-end section of the proximal-end tubular portion. 
     With this aspect, the manipulator is made to pass through the manipulator channel in the overtube whose distal end is disposed inside the body, the movable portion is made to protrude from the distal end of the overtube, and the movable portion is driven by the driving portion disposed at the proximal-end of the overtube, whereby it is possible to treat a diseased part inside the body. 
     In this case, by reading, from the outside, the identification information of the manipulator channel, which is stored in the storage unit provided in the overtube, it is possible to determine whether the manipulator to be used in the treatment is suitable for the manipulator channel in the overtube inserted in the body, without having to take out the overtube from the body to check it. 
     By reading out the identification information of the manipulator channel, the type of endoscope that is passed through the endoscope channel in the overtube can also be confirmed. 
     The endoscope is passed through the endoscope channel in the distal-end tubular portion, the distal-end tubular portion and the proximal-end tubular portion are connected, the manipulator is passed through the manipulator channel in the distal-end tubular portion from the extension channel in the proximal-end tubular portion, and the endoscope and the movable portion are made to protrude from the distal end of the distal-end tubular portion. Accordingly, it is possible to perform treatment of the diseased part while observing the movable portion with the endoscope. By removing the proximal-end tubular portion from the distal-end tubular portion, it is possible to easily insert the endoscope into the distal-end tubular portion. 
     In this case, by reading, from the outside, the identification information of the manipulator channel, which is stored in the storage unit provided in at least one of the distal-end tubular portion and the proximal-end tubular portion, it is possible to determine whether the manipulator to be used in the treatment is suitable for the manipulator channel in the overtube inserted in the body, without having to take out the overtube from the body to check it. 
     When the distal-end tubular portion and the proximal-end tubular portion are connected, the external apparatus can electrically read out the identification information stored in the storage unit via the connection terminal provided at the proximal-end side of the proximal-end tubular portion. 
     When the distal-end tubular portion and the proximal-end tubular portion are connected, the external apparatus can easily read out, in a wireless manner, the identification information stored in the storage unit by using the wireless transmission unit, which is capable of readout. 
     When the distal-end tubular portion and the proximal-end tubular portion are connected, the identification information of the manipulator channel, stored in the distal-end storage unit, and the identification information of the extension channel, stored in the proximal-end storage unit, can be read out to the external apparatus. Accordingly, it is possible to determine whether each of the distal-end tubular portion and the proximal-end tubular portion, which are detachable, is suitable for the manipulator to be used. 
     When the distal-end tubular portion and the proximal-end tubular portion are connected, the external apparatus can electrically read out the identification information of the manipulator channel, stored in the distal-end storage unit, and the identification information of the extension channel, stored in the proximal-end storage unit, via the connection terminal provided at the proximal-end side of the proximal-end tubular portion. 
     When the distal-end tubular portion and the proximal-end tubular portion are connected, the external apparatus can easily read out, in a wireless manner, the identification information of the manipulator channel, stored in the distal-end storage unit, and the identification information of the extension channel, stored in the proximal-end storage unit, by using the wireless transmission unit, which capable of readout. 
     In the above-described aspect, the storage unit may store usage count information in a readable and writable manner. 
     By doing so, when reusing the overtube, the usage count thereof can be managed. 
     In the above-described aspect, a plurality of the manipulator channels may be provided. 
     By doing so, the types of the overtubes, in which the position of each manipulator channel that opens at the distal end face differs, can also be confirmed without having to remove the overtube, which is inserted into the body, from the body and check it. 
     In the above-described aspect, the distal-end tubular portion may be provided with a plurality of the manipulator channels; the proximal-end tubular portion may be provided with, in the same number as the number of manipulator channels, a plurality of the extension channels that can extend the manipulator channels, in arbitrary combinations; the distal-end storage unit may be provided in each of the manipulator channels; and the proximal-end storage unit may be provided in each of the extension channels. 
     By doing so, when connecting the distal-end tubular portion and the proximal-end tubular portion, once the manipulators channels and extension channels are connected in arbitrary combinations, the external apparatus can read out the identification information in the distal-end storage unit and the proximal-end storage unit, which are connected to each other. Accordingly, it can also be confirmed whether the combination of the manipulator channels and the extension channels is suitable for the manipulator to be used. 
     Another aspect of the present invention is a medical manipulator system comprising: any one of the above-described overtures; the manipulator, which is inserted into the manipulator channel in the overtube; an operating portion that is operated by an operator; a control portion that controls the driving portion on the basis of an operation input that is input via the operation portion; and a readout unit that reads out information stored in the storage unit. 
     According to this aspect, since the information stored in the storage unit provided in the overtube is read out by the readout unit, the operator can confirm whether the manipulator to be used is suitable for the overtube without taking the overtube out of the body. In the case where it is confirmed that the manipulator is suitable, the manipulator is passed through the manipulator channel in the overtube, and by operating the operating portion, the driving portion is driven by the control portion, the movable portion disposed inside the body is operated, and thus it is possible to perform treatment on the diseased part. 
     Another aspect of the present invention provides a medical manipulator system comprising: the above-described overtube; the manipulator, which is inserted into the manipulator channel in the overtube; an operating portion that is operated by an operator; a control portion that controls the driving portion on the basis of an operation input that is input via the operating portion; a readout unit that reads out information stored in the storage unit; a writing unit that writes a usage count of the overtube into the storage unit; and a notifying unit that, when the usage count read out from the storage unit by the readout unit exceeds a prescribed count, issues a notification to that effect. 
     According to this embodiment, when the overtube is used, the usage count is written into the storage unit provided in the overtube by the writing unit, and in the next usage, the information stored in the storage unit is read out with the readout unit. When the usage count read out by the readout unit exceeds the number of treatments, a notification to that effect is given by the notifying unit; therefore, the operator can avoid using an overtube that has exceeded a prescribed usage count. Accordingly, the usage count can be managed to reuse the overtube. 
     REFERENCE SIGNS LIST 
     
         
           1  medical manipulator system 
           3  manipulator 
           4  overtube 
           5  operating portion 
           6  control portion 
           9  movable portion 
           10  driving portion 
           13  manipulator channel 
           13   a  extension channel 
           14  endoscope channel 
           15  distal-end tubular portion 
           16  proximal-end tubular portion 
           24  memory circuit (storage unit) 
           25 ,  29 ,  39 ,  40  connection terminal 
           30  input/output unit (external apparatus) 
           31  reading unit (readout unit) 
           32  writing unit 
           33  notifying unit 
           34  wireless transmission/reception unit (external apparatus, readout unit) 
           35 ,  41  transmission/reception unit (wireless transmission unit) 
           37  distal-end storage unit (storage unit) 
           38  proximal-end storage unit (storage unit) 
         A operator