WO2018225788A1 - Robotic operating table and medical system - Google Patents

Robotic operating table and medical system Download PDF

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Publication number
WO2018225788A1
WO2018225788A1 PCT/JP2018/021707 JP2018021707W WO2018225788A1 WO 2018225788 A1 WO2018225788 A1 WO 2018225788A1 JP 2018021707 W JP2018021707 W JP 2018021707W WO 2018225788 A1 WO2018225788 A1 WO 2018225788A1
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WO
WIPO (PCT)
Prior art keywords
holder
robot arm
movable element
robot
operating table
Prior art date
Application number
PCT/JP2018/021707
Other languages
French (fr)
Japanese (ja)
Inventor
平塚充一
田村悦之
中西徹弥
北野幸彦
矢野佑太郎
Original Assignee
株式会社メディカロイド
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Application filed by 株式会社メディカロイド filed Critical 株式会社メディカロイド
Priority to JP2018561280A priority Critical patent/JP6770097B2/en
Publication of WO2018225788A1 publication Critical patent/WO2018225788A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves 
    • A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves  involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B90/57—Accessory clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/02—Adjustable operating tables; Controls therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/02—Adjustable operating tables; Controls therefor
    • A61G13/08—Adjustable operating tables; Controls therefor the table being divided into different adjustable sections
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25J—MANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J9/00—Programme-controlled manipulators
    • B25J9/06—Programme-controlled manipulators characterised by multi-articulated arms

Definitions

  • the present invention provides a robot operating table and a medical system that can efficiently and safely perform a movement and / or posture change of a table on which a treatment target is placed.
  • the purpose is to do.
  • the robot operating table 1 is disposed in the medical room 3.
  • an anesthesia machine 4 as a medical fluid injection device is held by a holder 15.
  • the anesthesia machine 4 is an example of a medical device used when the patient K is operated, and is a medical device that cannot be disconnected from the patient K during the operation when the patient K moves.
  • the medical device holder unit 11 has a holder 15 configured to support the anesthesia machine 4 which is a medical fluid injection device, and is mounted on the table unit 100.
  • the other end of the second movable element 1052 and one end of the third movable element 1053 are connected by a third joint 1063 that is a horizontal rotary joint, and is rotated by a second axis and is a third axis parallel to the second axis.
  • the third movable element 1053 can rotate around (vertical direction).
  • the fourth to sixth joints 1064 to 1066 between the third movable element 1053 and the fourth movable element 1054 are rotary joints around the fourth to sixth axes, respectively.
  • the fourth axis is a direction in which the third movable element 1053 extends
  • the fifth axis is a direction orthogonal to the fourth axis rotated by the fourth joint 1064
  • the sixth axis is rotated by the fifth joint 1065.
  • the direction is perpendicular to the fifth axis.
  • the rotating direction of the rotating member is shown in the vicinity of the member.
  • the “one end portion” of a movable element extending in a specific direction means one of two regions on both sides when the movable element is divided into three equal parts in a specific direction (longitudinal direction).
  • the “other end portion” of the element means an end portion on the opposite side to one end portion of the two regions on both sides when the movable element is divided into three equal parts in a specific direction (longitudinal direction).
  • end part it means either one end part or the other end part.
  • the part between both ends is called “central part”.
  • the first movable element 1051 moves up and down while maintaining a state parallel to the horizontal plane, and the second movable element 1052 and the third movable element 1053 rotate while maintaining a state parallel to the first movable element 1051. Yes.
  • the width of the table 10 is preferably larger than the width of the movable elements 1051 to 1054 of the robot arm 103.
  • the width of the table 10 is preferably larger than the width of the movable elements 1051 to 1054 of the robot arm 103.
  • the fourth movable element 1054 is located at the tip of the robot arm 103.
  • the tip of the robot arm 103 is fixed to the lower surface of the central portion of the table 10 extending in a specific direction.
  • the table 10 can be supported with high support strength, and the movable element and the base of the robot arm 103 can be easily stored under the table 10.
  • the length of the third movable element 1053 may be shortened and the support position of the table 10 may be one end, and even in this case, the effect of securing space and downsizing can be obtained. There is no.
  • the robot arm 103 includes a plurality of actuators (in this configuration example, the first to sixth actuators 1071 that move or rotate the first to fourth movable elements 1051 to 1054 corresponding to the first to sixth joints 1061 to 1066. 1076), a plurality of position detectors (first to sixth position detectors 1081 to 1086 in the present configuration example) incorporated in each joint and detecting the position of each movable element, and driving of each actuator.
  • a control device 109 for controlling is included.
  • the control device 109 is located in the base 104, but may be an external independent device, for example.
  • the first to sixth actuators 1071 to 1076 are, for example, servo motors.
  • an encoder may be used, or a resolver or a potentiometer may be used.
  • the robot arm 103 preferably includes first to sixth electromagnetic brakes 1101 to 1106 corresponding to the first to sixth joints 1061 to 1066, respectively. If the electromagnetic brake is not provided, the posture of the robot arm 103 is kept constant by driving the plurality of actuators 1071 to 1076. However, if the electromagnetic brake is included, the driving of the actuator of a certain part is turned off. Also, by turning on the electromagnetic brake function, the posture of the robot arm 103 can be kept constant.
  • each of the first to sixth actuators 1071 to 1076 is provided with a power transmission speed reduction mechanism and a coupling.
  • the robot arm 103 shown in FIG. Note that the degree of freedom of the robot arm of the present invention is not necessarily 6 and may be 5 or less or 7 or more.
  • the base 16 is fixed to the lower surface of the table 10 at, for example, a front portion of the table 10 (near the portion where the head of the patient K is disposed).
  • the base 16 is connected to one end of the first movable element 17a via the first joint 18a. Accordingly, the first movable element 17a can rotate around the first axis (vertical direction).
  • One end portion of the first movable element 17a is connected to the other end portion of the second movable element 17b by a second joint 18b which is a horizontal rotary joint, and the second movable element 17b around the second axis (vertical direction).
  • the first axis and the second axis are axes that extend in a direction parallel to the direction in which the second movable element 17b extends.
  • the height position of the other end (upper end) of the second movable element 17b is set higher than the height position of the upper surface of the table 10.
  • the other end side of the second movable element 17b supports the holder 15.
  • the robot operating table according to this configuration example is used for intraoperative MRI as a hybrid operation, and the operation of moving the table among a plurality of positions is performed using the robot operating table 1 with 6 degrees of freedom shown in FIGS. The case where it is used will be described with reference to FIGS.
  • FIG. 4 shows a state in which the table 10 is positioned at the mounting position when the patient K is moved from the mounting position (first position) to the imaging position (second position) by a certain MRI apparatus. Yes.
  • the placement position may be a position for preparing for surgery for introducing anesthesia to a patient, connecting a drip agent, and the like.
  • FIG. 5 shows that the second movable element 1052 and the third movable element 1053 move as indicated by arrows under the control of the control device 109, and the table 10 rotates around the sixth axis and moves as indicated by arrows (in some cases, the first The first movable element 1051 is also moved in the vertical direction to adjust the height, and the table 10 is rotated about the longitudinal direction and / or the width direction by the rotation about the fourth axis and / or the fifth axis, so that the inclination is finely adjusted.
  • a state in which the head of the patient moves obliquely with respect to the MRI apparatus 414 as a medical image diagnostic apparatus (modality) is shown.
  • FIG. 6 shows a state where the table 10 is inserted into the MRI apparatus 414 and the patient has reached the imaging position (second position).
  • the position (first position) of the table 10 in FIG. 4 may also be an operation position, and the table 10 is each from the imaging position (second position) in FIG. 6 to the operation position (first position) in FIG.
  • the movable element moves in the reverse direction and returns to the original position, and immediately after the image is taken, the operator 412 can perform an operation while confirming the contents of the medical image.
  • the patient's head may be on the opposite side in the longitudinal direction of the table 10, in which case the table 10 moves to the MRI apparatus 414 while rotating in the direction opposite to the table moving direction shown in FIG. become.
  • the base 104 when the base 104 is stored under the table 10, the patient may be oriented in any direction. If the position of the table 10 in FIG. However, an operation can be performed, and the table 10 including the assistant can be surrounded by the operation. Since the base 104 does not get in the way, the operator 412 can perform the operation while sitting.
  • FIG. 7 shows an open type MRI apparatus 414 used as the medical image diagnostic apparatus.
  • the open type MRI apparatus 414 is an open type that opens forward and laterally. Specifically, it includes a substantially T-shaped upper inspection portion (upper magnet) 415 and lower inspection portion (lower magnet) 416 with the center portion protruding forward, and between these inspection portions 415 and 416. A space for inserting a table on which a patient is placed is formed. Both ends of the upper inspection unit 415 and the lower inspection unit 416 are connected by a pair of support columns 417.
  • the MRI apparatus 414 may be a donut type, but when applied to a case where the patient can be easily inserted into the MRI apparatus obliquely (as shown in FIG. 5), a table is placed in front of the cavity inside the donut. Since it is inserted into the cavity after being positioned, the movement of the robot arm may be a little cramped.
  • the part formed by the space between the upper inspection part (upper magnet) 415 and the lower inspection part (lower magnet) 416 is the imaging space.
  • the table 10 is at the MRI imaging position. Since the position of the table 10 in the imaging space varies depending on the imaging region of the patient and the height and size of the patient, it is not always constant. However, a specific position in the imaging space can be stored in a storage device in the control device 109. In the hybrid operation, since the operation position and the imaging position are usually reciprocated a plurality of times, the imaging position and / or the operation position may be stored for each operation.
  • the above-described surgical position as the first position is a position where the table 10 is not close to the imaging space, that is, a position away from the imaging space by a certain distance or more.
  • a surgical instrument table 413 for placing a surgical instrument used by the operator 412 is installed in the vicinity of the surgical position, and these surgical instruments are arranged near the MRI apparatus 414. Therefore, the surgical position should be kept far away from the MRI apparatus and more than the 5 gauss line L. It is desirable to be separated.
  • the base 104 of the robot arm 103 is also arranged outside the 5 Gauss line L.
  • the base 104 of the robot arm 103 is provided with a large motor, and the motor includes a magnet. Therefore, if the motor is located near the MRI apparatus 414, a magnetic field formed in the imaging space of the MRI apparatus 414 is generated. This is because it is distorted and leads to deterioration of the captured image.
  • the robot operating table 1 constituted by the robot arm 103 and the table 10 preferably sets the operation position as the first position to a position where the shortest distance S from the MRI apparatus is a predetermined distance or more. In view of the characteristics, it is preferable to set the shortest distance S to 5 gauss lines L.
  • the shortest distance between the MRI apparatus 414 and the robot operating table 1 at the first position is preferably set to at least 1 m. It is expected that the shortest distance S can be set a little shorter depending on the development situation of the low magnetic field MRI apparatus.
  • the shortest distance S When using an MRI apparatus with a larger magnetic field or when trying to ensure higher safety, it is preferable to set the shortest distance S to, for example, 1.5 m or more.
  • the table is set at the imaging position as the second position.
  • a large robot arm 103 that can withstand a large load capacity is required.
  • the operation position which is the first position (so, when an operator or assistant surrounds the table 10 and performs an operation).
  • the shortest distance S between the robot operating table 1 in the first position and the MRI apparatus can be increased. The bigger the better, the better.
  • the setting position of the first position of the robot operating table 1 should be close to the MRI apparatus 414.
  • the 5 Gauss line will be about 2.8 m of the gantry (MRI system) at the shortest point (“Travel 3T MRI adsorption accident”, Toshio Dobashi, Monthly Inner Vision September 2012 Therefore, in consideration of the rigidity of the 5 Gauss line and the robot arm 103 (stability of the table 10) and the miniaturized structure, the upper limit of the shortest distance S between the MRI apparatus 414 and the robot operating table 1 at the first position is For example, it is preferably set to 3 m or less. If the static magnetic field strength is 0.3 Tesla and the 5 Gauss line is about 1 m, considering that the person holding the surgical instrument stands on the MRI apparatus side, if the upper limit of the shortest distance S is about 2 m, Good.
  • the 5 Gauss line is formed in an elliptical shape around the MRI apparatus, and the MRI of 1.5 Tesla In this case, the shortest point is 2.8 m from the MRI apparatus, but the longest is 5 m.
  • intraoperative MRI uses a rotating-lifting-top-sliding operating table, but if the operating table is limited to these three, the table can be moved to the imaging position. The position of the operating table is limited, and it may be difficult to place the operating table near the shortest part of the 5 Gauss line. Has a merit that the degree of freedom of the installation location is also high.
  • the table 10 can be accurately and quickly moved to a target position such as an imaging position or a surgical position. Efficiency can be significantly improved. For example, the table 10 can be smoothly moved without giving a large vibration to the patient K as compared with the case where the patient as a placement target is moved by a table with casters.
  • the robot operating table includes the holder unit 11 that holds the medical infusion device, a device that cannot be removed during an operation, such as the anesthesia machine 4, can be moved together with the table 10. . Therefore, it is not necessary to take the tubes 4f and 4g connected to the patient K long in consideration of the operation range of the table 10.
  • the risk of the tubes 4f and 4g connected to the patient K becoming tangled by the movement of the table 10 can be reduced.
  • the space which installs an anesthesia machine immovably can be reduced, and it is advantageous to introduce into the operating room which can ensure only a limited space.
  • the medical device that must be connected to the patient K during the operation is not limited to the anesthesia machine 4.
  • the patient K loses body fluid due to bleeding during the operation, it is also common to administer an instillation controlled by an infusion pump to replenish water. Therefore, in this modification, in addition to the holder for holding the anesthesia machine 4, a holder for holding the infusion pump is provided, and these are both fixed to the table 10.
  • FIG. 8 is a side view of a medical system according to a first modification of the first configuration example.
  • an infusion pump holder unit 13 is provided in addition to the anesthesia machine holder unit 11 having the configuration of the first configuration example.
  • the medical device holder unit 13 has an arm 26 and a holder portion 27.
  • the arm 26 has a specific degree of freedom (one degree of freedom or more, and the arm 26 has two degrees of freedom), and supports the holder portion 27 on which the infusion pump 6 is held at the tip thereof. Moreover, the arm 26 has a fishing support 6b that hangs a drip agent (medicine or nutrient) 6a. In the present configuration example, the arm 26 as a support device is moved manually.
  • the arm 26 includes a base 28, a plurality of movable elements (first to second movable elements 29a to 29b in the present configuration example), and a plurality of joints (first to second joints 30a to 30b in the present configuration example). And including.
  • the base 28 is fixed to the lower surface of the table 10 at, for example, a rearward portion of the table 10 (near the side opposite to the side where the head of the patient K is disposed).
  • the base 28 is connected to one end of the first movable element 29a via the first joint 30a.
  • the first movable element 29a can rotate around the first axis (vertical direction).
  • One end portion (lower end portion) of the second movable element 29b is connected to the other end portion of the first movable element 29a by a second joint 30b which is a horizontal rotary joint, and the second movable element 29b is arranged around the second axis (vertical direction). 2
  • the movable element 29b can rotate.
  • the first axis to the second axis are axes that extend in a direction parallel to the direction in which the second movable element 29b extends.
  • the first movable element 29a has a rod shape extending in a specific direction in a direction parallel to the upper surface of the table 10, and the length is appropriately designed according to the necessary movable range of the arm 26.
  • the second movable element 29b has a rod shape extending in a direction orthogonal to the first movable element 29a and in a direction orthogonal to the upper surface of the table 10, and the length thereof is such that the instillation 6a is located above the patient K. Selected.
  • the base 28 is arranged so as to be fixed under the table 10. With this configuration, one end of the first movable element 29a can be arranged so as to be hidden under the table 10 when viewed from the upper side in the vertical direction.
  • a plurality of medical fluid injection devices and holders for holding the medical fluid injection devices are provided, and these sets are fixed to the table 10 respectively.
  • the anesthesia machine 4 and the infusion pump 6 as a plurality of medical fluid injection devices are held by holders 15 and 27 connected to the table 10, and the table 10 is as shown in FIGS. Even when moving, it moves together. Accordingly, a plurality of devices such as the anesthesia machine 4 and the infusion pump 6 that cannot be removed during the operation can be moved together with the table 10 together.
  • many tubes are connected to the patient K in the operation. However, it is not necessary to take these tubes for a long time in consideration of the operation range of the table 10, and the tubes connected to the patient. Can be reduced by the operation of the table 10.
  • the table 10 may be configured such that only the medical device holder unit 13 on which the infusion pump 6 is mounted is connected. (Second modification of the first configuration example)
  • the medical fluid injection device holder unit 240 includes a holder robot arm 241 and a holder 242, and is supported by the table 10.
  • the holder robot arm 241 has multiple degrees of freedom, and supports the anesthesia machine 4 as a medical fluid injection device at its tip.
  • the holder robot arm 241 includes a base 243, a plurality of movable elements (first to fourth movable elements 2441 to 2444 in the present configuration example), and a plurality of joints (first to sixth joints 2451 in the present configuration example). 2456).
  • the base 243 is fixed to the lower surface of the table 10 at the end of the table 10.
  • the base 243 is disposed so as to be hidden by the table 10 when viewed from above.
  • One end of the base 243 and the first movable element 2441 is connected by a first joint 2451 which is a horizontal rectilinear joint, and the first movable element 2441 can move in the first axial direction (linear direction).
  • the other end portion of the first movable element 2441 and one end portion of the second movable element 2442 are connected by a second joint 2452 which is a vertical rotary joint, and the second movable element 2442 is a second axis orthogonal to the first axis ( (Horizontal direction) can rotate around.
  • the other end of the second movable element 2442 and one end of the third movable element 2443 are connected by a third joint 2453 that is a vertical rotary joint, and the third movable element 2443 is around a third axis parallel to the second axis. Can be rotated.
  • the other end (upper end) of the third movable element 2443 and one end (lower end) of the fourth movable element 2444 are a fourth joint 2454 that is a horizontal rotary joint, a fifth joint 2455 that is a vertical rotary joint, and They are connected by a sixth joint 2456 which is a horizontal rotation joint.
  • the fourth movable element 2444 has a fourth axis parallel to the direction in which the third movable element 2443 extends, a fifth axis orthogonal to the fourth axis, and a sixth axis orthogonal to the fifth axis. , Can rotate around each axis.
  • the first to fourth movable elements 2441 to 2444 are rod-shaped extending in a specific direction, and the lengths of these movable elements are appropriately designed according to the necessary movable range of the robot arm 241.
  • the first movable element 2441 extends in parallel with the upper surface of the table 10.
  • the robot arm 241 for holder corresponds to the first to sixth joints 2451 to 2456, and includes a plurality of actuators that move or rotate the first to fourth movable elements 2441 to 2444 (in this modification, the first to sixth joints). Actuators 2461 to 2466), a plurality of position detectors (first to sixth position detectors 2471 to 2476 in this modification) incorporated in the respective joints to detect the positions of the respective movable elements, A control device 249 for controlling driving is included.
  • the first to sixth actuators 2461 to 2466 are, for example, servo motors.
  • an encoder may be used, or a resolver or a potentiometer may be used.
  • the holder robot arm 241 preferably includes first to sixth electromagnetic brakes 2481 to 2486 corresponding to the first to sixth joints 2451 to 2456, respectively. If the electromagnetic brake is not provided, the posture of the robot arm 241 is kept constant by driving the plurality of actuators 2461 to 2466. However, if the electromagnetic brake is included, the driving of the actuator of a certain part is turned off. Also, by turning on the electromagnetic brake function, the posture of the robot arm 241 can be kept constant.
  • the holder 242 is supported on the fourth movable element 2444 that is the tip of the robot arm 241.
  • the holder 242 is provided as a part for holding the anesthesia machine 4.
  • the holder part 242 is formed in a flat plate shape, for example.
  • One edge portion of the holder portion 242 is detachably fixed to the fourth movable element 2444 using a fixing member such as a screw member, for example.
  • the configuration in which the holder unit 242 holds the anesthesia machine 4 is the same as that of the holder unit 15 in the first configuration example, and thus detailed description thereof is omitted.
  • the control device 249 can control the operations of the second, third, and fifth joints 2452, 2453, and 2455 (robot arm 241).
  • control device 109 of the table robot arm 103 and the control device 209 of the holder robot arm 241 are linked, and the control device 109 of the table robot arm 103 changes the posture information of the robot arm 103 to the holder robot arm 241.
  • the control device 209 of the holder robot arm 241 receives the posture information of the robot arm 103 so that the posture of the holder robot arm 241 becomes constant, and the holder portion 242 becomes constant in relation to the horizontal plane. To control.
  • the holder 242 is capable of horizontal rotation movement, horizontal rotation movement, and parallel movement with respect to the table 10. Therefore, the parallel state of the anesthesia machine 4 and the infusion pump 6 held by the holder 242 can be maintained.
  • the holder robot arm 241 can be operated using an operation member that can be remotely operated.
  • an operation member 71 shown in FIG. 10A can be exemplified.
  • the operation member 71 is a joystick, and has a stick 711 for an operator (operator, anesthesiologist, assistant, nurse, etc.) to grasp by hand.
  • the tip of the holder robot arm 241 is displaced in the tilted direction.
  • the stick 711 may be provided with an up / down button 712 for displacing the tip of the holder robot arm 241 up and down.
  • the tip of the holder robot arm 241 is displaced in a direction corresponding to the operation.
  • an operation member 72 shown in FIG. 10B may be used as the operation member.
  • the operation member 72 is a button device, and has a plurality of buttons for a treatment person to push and operate by hand.
  • a front / rear left / right button 721 for displacing the tip of the holder robot arm 241 on a specific plane is provided.
  • An up / down button 722 for displacing the tip of the holder robot arm 241 in a direction perpendicular to the plane may be provided.
  • the electromagnetic brake of each joint is configured to lock the joints 18a and 18b.
  • the operation of the joint is prevented by pressing the corresponding link on the rotating shaft to be in a locked state.
  • the electromagnetic brake is energized, a magnetic force is generated in the coil of the electromagnet, and the brake being pressed is released to release the joint lock state.
  • the shape of the actuator is not limited to a button, and may be a lever switch or a slide switch.
  • the attachment device 400 includes an attachment base 401 fixed to the side surface of the table 10, a slider 402 that can be attached to the attachment base 401 so that the position of the table 10 in the front-rear direction can be changed, and a position sensor attached to the slider 402. 403.
  • the attachment base 401 extends along the front-rear direction of the table 10 and forms, for example, a protruding rail.
  • the slider 402 is formed in a shape having a groove fitted to the rail of the attachment base 401, and can slide on the attachment base 401 in the longitudinal direction of the table 10.
  • a fixing member 404 such as a fixing screw is screwed to the slider 402. When the fixing member 404 is rotated in the tightening direction, the slider 402 and the fixing member 404 firmly sandwich the attachment base 401. Thereby, the slider 402 is fixed.
  • the base 213 of the medical fluid injection device holder unit 201 is fixed to the slider 402, and the base 213 of the medical fluid injection device holder unit 201 is displaced in the longitudinal direction of the table 10 together with the slider 402.
  • the position sensor 403 is, for example, a sensor such as an infrared sensor or a rotary encoder, and is configured to be able to measure the distance from the front end of the table 10 to the slider 402.
  • the position detection result of the position sensor 403 is output to the control device 219 (corresponding to 249 in FIG. 9) of the medical fluid injection device holder unit 201.
  • the control device 219 of the medical fluid injection device holder unit 201 acquires and stores the mounting position information of the base 213 with respect to the table 10 detected by the position sensor 403. And the control apparatus 219 controls the drive of the robot arm 201 for medical device holders using this attachment position information. As an example, the control device 219 calculates the mounting position by measuring the distance between one corner of the table 10 and the mounting position of the slider 402.
  • a slider 412 that clamps a U-shaped rail 411 fixed to the table 10 by cooperation with a screw 414 with a handle may be used instead of the slider 402. .
  • FIG. 12 shows that the table 10 is moved from the placement position at the first position to the anesthesia introduction position at the third position when the placement position of the patient is different from the anesthetic introduction position and is the same as the operation position. It shows how to do.
  • the second, third, and sixth joints 1062, 1063, 1066 are rotated (in some cases, the table height by the first joint 1061). And the inclination of the table 10 in the longitudinal direction and / or the width direction is adjusted by the fourth and / or fifth joints 1064 and 1065).
  • the table 10 moves as indicated by the arrow in FIG. It faces in the opposite direction to the MRI apparatus 414 and moves to a position sufficiently away from the 5 Gauss line.
  • the anesthesia position third position shown in FIG. 12 when the table 10 is looked down from the upper side in the vertical direction, the end of the base 10 and the movable element 10 opposite to the end directly connected to the base 104.
  • the part is not hidden under the table 10.
  • the maximum dimension of the robot arm 103 that is not hidden under the table 10 is 1 ⁇ 4 or more of the dimension in the longitudinal direction of the table. If the placement position is the same as the anesthesia introduction position, this moving step is omitted.
  • each movable element is operated by the control of the control device 10 to move the table 10 in the direction opposite to the arrow shown in FIG. 12 and move to the surgical position which is the first position.
  • the operator 412 performs an operation on the patient based on the image information imaged by the MRI apparatus before the operation, and, for example, when the brain tumor is extracted, the table 10 is set to the imaging position which is the second position as described above. And the MRI image of the affected area (for example, the brain) is taken, and the table 10 is returned to the operation position at the first position again. For example, when a residual tumor is observed, the operation by the operator 412 is continued. Will continue.
  • the anesthesia introduction position which is the third position, should be installed on the opposite side of the MRI apparatus in the table width direction (direction perpendicular to the longitudinal direction) when the table 10 is in the surgical position, which is the first position. Is preferred. This is because the anesthesiologist 415, who is treated as unclean, can introduce anesthesia at a surgical position that is a clean area and at a position far from the imaging position, so when performing surgery on the upper body side of the patient, such as brain tumor removal surgery. This is because it is advantageous.
  • the above-described medical fluid injection device holder unit 11 preferably forms a tube path 3111 connecting the patient and the medical fluid injection device.
  • the movable element 17b is cylindrical
  • a part of the curved surface portion is formed on a removable cover that can be removed, and the removable cover can be removed so that the tube can be put inside the cylindrical movable element 17b.
  • the table 10 is also provided with a fixture 3121 for fixing the tubes 4f and 4g.
  • a robot arm can be adopted as the support device 14 of the holder 15 and a trigger button for releasing the brake of each joint can be provided.
  • a motor actuator
  • the motor also moves according to the manual movement, and at the same time with the position detector The position will be stored. When it is moved electrically, it moves to a position according to the instruction signal based on the stored position information.
  • a plurality of medical fluid injection device holder units may be provided, or both the holder support device dedicated to manual operation and the one driven by a robot arm may be used.
  • An anesthetic introduction position may be provided.
  • the device that the holder 15 holds is a medical fluid injection device. Regardless, it covers a wide range of medical devices such as medical monitors and generators. (Second configuration example)
  • FIG. 13 shows a side view of the robot operating table according to the second configuration example.
  • the robot arm 2901 used in the robot operating table according to this configuration example has multiple degrees of freedom (3 degrees of freedom or more), and supports the table 2908 on which the placement target is placed at the tip.
  • the table 2908 and the robot arm 2901 constitute a robot operating table.
  • the third axis is a direction in which the second movable element 2923 extends
  • the fourth axis is a direction orthogonal to the third axis rotated by the third joint 2933
  • the fifth axis is rotated by the fourth joint 2934.
  • the first movable element 2922 and the second movable element 2923 are rod-shaped extending in a specific direction, and the length is appropriately designed according to the necessary movable range of the robot arm 2901.
  • the first movable element 2922 is moved up and down while maintaining a state parallel to the horizontal plane, and the second movable element 2923 is rotated around the second axis while maintaining a state parallel to the first movable element 2922. ing.
  • This is an advantageous configuration for reducing the size of the robot arm 2901, and is advantageous for introduction to a medical site where only a limited space can be secured or for securing more space for treatment or surgery.
  • the robot arm 2901 corresponds to the first to fifth joints 2931 to 2935 and the slide mechanism 2909, and includes a plurality of actuators (in this configuration example) that move or rotate the first to third movable elements 2922 to 2924 and the slide mechanism 2909. , First to fifth actuators 2941 to 2945 and slide mechanism actuator 2949) and a plurality of position detectors (first to fifth positions in the present configuration example) for detecting the positions of the respective movable elements. Detectors 2951 to 2955 and a slide mechanism position detector 2959), and a control device 2907 for controlling the driving of each actuator.
  • the control device 2907 is located in the base 2921, but may be an external independent device, for example.
  • the first to fifth actuators 2941 to 2945 and the slide mechanism actuator 2949 are, for example, servo motors.
  • As the position detector, an encoder, a resolver, and a potentiometer can be used as in the first to fourth configuration examples.
  • the robot arm 2901 also preferably includes first to fifth electromagnetic brakes 2961 to 2965 and a slide mechanism electromagnetic brake 2969 corresponding to the first to fifth joints 2931 to 2935 and the slide mechanism 2909, respectively.
  • the electromagnetic brake is not provided, the posture of the robot arm 2901 is kept constant by driving the plurality of actuators 2941 to 2945 and the slide mechanism actuator 2949. Even if the drive of is turned off, by turning on the electromagnetic brake function, the posture of the robot arm 2901 can be kept constant.
  • the first to fifth electromagnetic brakes 2961 to 2965 are turned on when the drive current is not supplied to the actuators 2941 to 2945, and when the drive current is supplied to the actuators 2941 to 2945, respectively. It is configured to turn off the brake function.
  • the slide mechanism 2909 is configured to move the table 10 while maintaining the table 10 parallel to the horizontal plane.
  • the slide mechanism 2909 has a table base 1156 supported by any one of the robot arms 2901 and a slide member 1159.
  • the table base 1156 is supported by a robot arm 2901 and controlled by a control device 2907, and a pair of pinions that are rotationally driven by the pair of actuators 1161 and 1162. 1163 and 1164.
  • Each actuator 1161, 1162 is, for example, a servo motor.
  • the slide member 1159 has a configuration in which a pair of racks 1165 and 1166 are formed on a pair of left and right side surfaces of a recess formed in the lower surface of the flat plate-like portion.
  • a pair of pinions 1163 and 1164 are engaged with the pair of racks 1165 and 1166.
  • a table 2908 is fixed to the upper surface of the slide member 1159. In this configuration, the slide member 1159 and the table 2908 slide by the meshing operation of the racks 1165 and 1166 and the pinions 1163 and 1164.
  • the provision of the slide mechanism has the advantage that the size of the robot arm can be reduced.
  • the tip of the robot arm supports the end of the table, but a manual slide mechanism may be employed in a configuration in which the tip of the robot arm supports the center of the table.
  • the length of the groove 2983 of the table 2908 into which the actuator-driven slide mechanism 2909 is fitted may be limited to only the central portion. In this case, the slide width is shortened, but compared to the case where the slide width is large, The table 2908 is less likely to be bent.
  • slide mechanism may adopt other configurations such as a ball screw instead of the rack and pinion.
  • FIG. 15 is a perspective view showing the movement of the robot operating table when this configuration example is applied to intraoperative MRI.
  • FIG. 15 shows that the table 2908 is in the patient placement position and the operation position, which is the first position, the second movable element 2923 rotates horizontally around the second axis, and the table 2908 rotates around the fifth axis at the same time.
  • the height of the table 2908 is adjusted by the first joint 2931 and the inclination in the longitudinal direction and / or the width direction is adjusted by the third and / or fourth joints 2933 and 2934
  • FIG. To the MRI imaging preparation position shown in FIG. Then, the table 2908 slides to a position where it overlaps with the imaging space of the MRI apparatus by driving the actuator, and the table 2908 moves to the MRI imaging position which is the second position (FIG. 17).
  • the MRI imaging preparation position shown in FIG. 16 is the position where the table 2908 does not overlap the imaging space and is close to the imaging position (for example, the distance from the imaging space is 10 cm to 40 cm).
  • the specific direction (longitudinal direction) is a position facing the direction toward the opening of the MRI apparatus 414, and is a position parallel to the specific direction (longitudinal direction) of the table at the imaging position.
  • the direction facing the opening is almost uniquely determined.
  • the movement is temporarily stopped at this imaging preparation position, for example, an assistant prepares for MRI imaging (confirms that there is no metal object and corrects the position / posture of the patient), and then transports the table 2908 to the MRI apparatus. May be.
  • the MRI imaging preparation position is merely a via position, and the table 2908 may be smoothly moved to the MRI imaging position without stopping at this position. (Third configuration example)
  • FIG. 18 shows a side view of the robot operating table according to the third configuration example.
  • a robot arm 2001 used for a robot operating table has multiple degrees of freedom (three degrees of freedom or more), and supports a table 2208 on which a placement target is placed at the tip thereof.
  • the table 2208 and the robot arm 2001 constitute a robot operating table.
  • the robot arm 2001 includes a base 2021, a plurality of movable elements (first to fourth movable elements 2022 to 2026 in the present configuration example), and a plurality of joints (first configuration in the present configuration example). To sixth joints 2031 to 2036).
  • first joint 2031 which is a horizontal rotary joint
  • first movable element 2022 can rotate around a first axis (vertical direction).
  • the other end of the first movable element 2022 is open at least on the other end side in the specific direction, and the second movable element 2023 is fitted into the opening from one end.
  • the 1st movable element 2022 and the 2nd movable element 2023 are connected by the rectilinear joint. Therefore, the second movable element 2023 can move in the second axial direction (horizontal direction).
  • the other end of the second movable element 2023 and one end of the third movable element 2024 are connected by a vertical rotary joint, and the third movable element 2024 has a longitudinal direction (a direction in which the third movable element 2024 extends) and a vertical direction. It can rotate around a third axis that is orthogonal to both.
  • the third movable element 2024 is configured by a parallel link, and links having the same length provided on the upper side and the lower side in the vertical direction are provided in pairs. Therefore, the rotation axis of the second movable element 2023 and the third movable element 2024 is two on the upper side and the lower side in the vertical direction.
  • the fourth movable element 2025 is connected to the third movable element.
  • the four movable elements 2025 move up and down in the vertical direction while maintaining the state parallel to the horizontal plane, and operate in conjunction with each other so as to rotate 15 degrees counterclockwise around the two rotation axes.
  • the fourth to sixth joints 2034 to 2036 between the fourth movable element 2025 and the fifth movable element 2026 are rotary joints around the fourth to sixth axes, respectively.
  • the first movable element 2022 to the fourth movable element 2026 are rod-shaped extending in a specific direction, and the length of these movable elements depends on the necessary movable range of the robot arm 2001 and the range in which the table 2208 is moved in the vertical direction. Are appropriately designed.
  • the vertical movement of the table 2208 is performed by the parallel link 2024 (third vertical rotation joint 2033), the height of the base 2021 as in the first and second configuration examples. There is no need to secure. That is, the vertical movement width of the table 2208 can be adjusted not by the vertical height of the base 2021 but by the length of the third movable element 2024.
  • the two movable elements (2023 and 2025) connected by the parallel link 2024 for moving the table 2208 in the height direction are in a specific posture, for example, the robot arm 2001 is the most in the vertical movable range of the table 2208.
  • the table 2208 is overlapped on the same horizontal plane, so that the height of the table 2208 can be further reduced, and it is possible to secure a low treatment position and to place a placement object at a low position.
  • the base 2021 is configured to be hidden under the table 2208, which is advantageous for introduction to a medical site where only a limited space can be secured, and for securing more space for treatment and surgery. . Since the height of the table 2208 is determined by the length H of the third movable element, the dimension of H is determined in consideration of the operating range in the height direction.
  • the two movable elements connected by the vertical rotary joint do not necessarily have a configuration in which the end portions are connected as shown in FIG. 18.
  • the side surfaces of the movable element are connected by the vertical rotary joint.
  • Such a configuration may be used.
  • the configuration in which the movable elements connected by the vertical rotary joint overlap in the same horizontal plane does not necessarily need to be used together with the linear motion joint.
  • it is used instead of the vertical linear joint. This is an independent feature for realizing a robot operating table for space saving, which is not limited to the case of this configuration example.
  • the robot operating table according to the present configuration example can move the table 2208 up and down (in the vertical direction) while keeping the table 2208 in a horizontal state in parallel with the horizontal plane.
  • the robot arm 2001 is configured not to contact the robot arm 2001 even if it is rotated (for example, rotated 360 degrees). Therefore, in this configuration example, no matter what posture the robot arm takes, as long as the table 2208 is maintained parallel to the horizontal plane, no matter how the table 2208 is rotated, the table There is no contact between the robot arm and the robot arm.
  • the robot arm 2001 includes a plurality of actuators that move or rotate the first to fifth movable elements 2022 to 2026 corresponding to the first to sixth joints 2031 to 2036 (in the present configuration example, the first to sixth actuators 2041).
  • a plurality of position detectors first to sixth position detectors 2051 to 2056 in the present configuration example
  • the control apparatus 2007 (refer FIG. 18) to control is included.
  • the control device 2007 is located in the base 2021 in this configuration example, but may be an external independent device, for example.
  • the first to sixth actuators 2041 to 2046 are, for example, servo motors.
  • an encoder may be used, or a resolver or a potentiometer may be used.
  • the robot arm 2001 preferably includes first to sixth electromagnetic brakes 2061 to 2066 corresponding to the first to sixth joints 2031 to 2036, respectively.
  • the electromagnetic brake is not provided, the posture of the robot arm 2001 is kept constant by driving the plurality of actuators 2041 to 2046. However, if the electromagnetic brake is included, the driving of the actuator of a certain part is turned off. Also, by turning on the electromagnetic brake function, the posture of the robot arm 2001 can be kept constant.
  • each of the first to sixth electromagnetic brakes 2061 to 2066 turns on the brake function when the drive current is not supplied to the actuator, and turns off the brake function when the drive current is supplied to the actuator. Is configured to do.
  • each of the first to sixth actuators 2041 to 2046 is provided with a power transmission speed reduction mechanism and a coupling.
  • an actuator In the parallel link 2024, an actuator, a position detector, and a brake may be provided at any one of the four rotating shafts.
  • FIG. 20 shows a biplane angio device that combines a ceiling traveling type and a floor fixed type as a medical image diagnostic apparatus, and a slide mechanism mounted on this configuration example (shown in FIG. 18) as a robot operating table. Is used to show how the table is moved from the surgical position (first position) to the imaging position (second position).
  • 20 (A), (C), and (E) are perspective views
  • FIGS. 20 (B), (D), and (F) are plan views when the operating room is looked down from above in the vertical direction.
  • the first position setting method is similar to the case where an MRI apparatus is used even when an angiography apparatus is used as a medical image diagnostic apparatus, and the robot operating table and the angio apparatus are located at the operation position as the first position. It is determined by the shortest distance S.
  • the shortest distance S from the angio apparatus is a predetermined distance or more so that the operator and assistant can surround the table when the table is in the operation position (first position).
  • the medical diagnostic imaging apparatus is a ceiling-running or floor-fixed angio apparatus
  • imaging is performed by moving along the rail during surgery or by rotating the main body (part C) with respect to the support section. It is also possible to reciprocate between the position and the retracted position.
  • the maximum allowable dimension that the robot arm protrudes from the table in a space-saving posture. Is about 60 cm.
  • the dimension in the longitudinal direction of the table illustrated in FIG. 21A is 230 cm, and the dimension of the robot arm that is not hidden by the table is 55 cm, which is less than 1 ⁇ 4 of the dimension in the longitudinal direction of the table.
  • the driving force (motor) can be reduced, so that the amount of the robot arm protruding from the table can be slightly reduced.
  • the anesthesia machine 4 is held by the holder 15 above the table, but may be held below the table as long as it moves integrally with the table.
  • each configuration example the structure of a different table robot arm is shown, and a combination with one of medical image diagnostic apparatuses such as an MRI apparatus, an angio apparatus, and a CT apparatus is shown. Needless to say, the combination is not limited to these, and any combination may be used.
  • medical image diagnostic apparatuses such as an MRI apparatus, an angio apparatus, and a CT apparatus.
  • the present invention can be applied as an operating table used for hybrid surgery.

Abstract

A robotic operating table is equipped with a table (10) on which a treatment subject (K) is placed, a robotic arm (103) for supporting the table (10) so that the table (10) can be moved between a first position and a second position, tubes (4f, 4g) having one end attached to the treatment subject (K), and a holder (15) holding a medial fluid injection-specific medical device (4) to which the other ends of tubes (4f, 4g) are connected, a support device (14) for supporting the holder (15) being secured to the table (10).

Description

ロボット手術台、及び医療システムRobotic operating table and medical system
　本発明は、効率的な手術を実現するために用いられるロボット手術台、及び医療システムに関する。 The present invention relates to a robot operating table used for realizing efficient surgery and a medical system.
　一般的に、患者に手術等の治療を施す際には、患者を移動させず安静な状態とすることが好ましい。しかしながら、医用画像装置による撮影と手術を同一治療室で行うようなハイブリッド手術室においては、患者側を動かす方が効率的に治療を行うことができる場合がある。例えば脳腫瘍摘出手術でＭＲＩ検査と手術を交互に行うケース（いわゆる術中ＭＲＩ）においては、患者側を動かすケースが多い。特許文献１においては、昇降スライド式のテーブルを用いて、患者をＭＲＩ装置に対して搬入及び搬出するものが開示されている。 Generally, when a patient is treated, such as surgery, it is preferable that the patient be in a resting state without moving. However, in a hybrid operating room where imaging by a medical imaging apparatus and surgery are performed in the same treatment room, it may be possible to perform treatment more efficiently by moving the patient side. For example, in a case where an MRI examination and an operation are alternately performed in a brain tumor extraction operation (so-called intraoperative MRI), there are many cases in which the patient is moved. Japanese Patent Laid-Open No. 2004-228561 discloses a technique for carrying a patient in and out of an MRI apparatus using an elevating slide table.
特開２０１０－９４２９１号公報JP 2010-94291 A
　通常、手術室におけるテーブルの周囲には、麻酔器、輸液ポンプ、ジェネレーター、ディスプレイ（生体モニタや内視鏡ディスプレイ）など種々の医療機器が配置される。そしてテーブルの周囲には、これらの医療機器と接続されるチューブやケーブルが存在することになる。 Usually, various medical devices such as an anesthesia machine, an infusion pump, a generator, and a display (biological monitor and endoscope display) are arranged around the table in the operating room. Around the table, there are tubes and cables connected to these medical devices.
　このような手術室において、患者側を移動させる治療を行う場合、現実的な対策としてはチューブやケーブルとして長いものを使用し、これらのチューブやケーブルが患者から分離できない場合でも延長できるようにすることが考えられる。 In such operating rooms, when performing treatment to move the patient side, as a practical measure, use long tubes and cables so that these tubes and cables can be extended even if they cannot be separated from the patient. It is possible.
　例えば、患者に麻酔器からのチューブが取り付けられている場合、撮影位置と手術位置との間を移動させる場合でも麻酔器は取り外すことができない装置であるため、麻酔器より伸びるチューブが患者に取り付けられたままテーブルを移動させることとなる。このときテーブルの移動範囲に対応できるようにチューブの長さを確保するが、チューブの絡まりや周囲の人・物との引っかかりなどの可能性があり、安全性の面で課題がある。 For example, when a tube from the anesthesia machine is attached to the patient, the anesthesia machine cannot be removed even if it is moved between the imaging position and the operation position, so a tube extending from the anesthesia machine is attached to the patient. The table will be moved as it is. At this time, the length of the tube is secured so as to correspond to the moving range of the table. However, there is a possibility of tangling of the tube or catching with a surrounding person or object, which causes a problem in terms of safety.
　本発明は、上記実情に鑑みることにより、処置対象を載置したテーブルの移動及び／又は姿勢変化が生じる場合でも、これらを効率的かつ安全に行うことができるロボット手術台、及び医療システムを提供することを目的とする。 In view of the above circumstances, the present invention provides a robot operating table and a medical system that can efficiently and safely perform a movement and / or posture change of a table on which a treatment target is placed. The purpose is to do.
　（１）上記目的を達成するためのある局面に係るロボット手術台は、処置対象を載置するテーブルと、前記テーブルを第１の位置と第２の位置との間を移動可能なように、前記テーブルを支持するロボットアームと、一端が処置対象に取り付けられるチューブと、前記チューブの他端が接続される医療用流体注入機器を保持するホルダーとを備え、前記ホルダーを支持する支持装置が前記テーブルに固定されている構成を有している。 (1) A robot operating table according to an aspect for achieving the above object includes a table on which a treatment target is placed, and the table can be moved between a first position and a second position. A robot arm for supporting the table; a tube having one end attached to a treatment target; and a holder for holding a medical fluid injection device to which the other end of the tube is connected. It has the structure currently fixed to the table.
　本発明によると、手術中に処置対象を載置したテーブルの移動及び／又は姿勢変化が伴う場合であっても、効率的かつ安全に手術工程を実施することができる。 According to the present invention, even when the table on which the treatment target is placed is moved and / or the posture is changed during the operation, the operation process can be performed efficiently and safely.
本発明の第１構成例に係るロボット手術台の模式的な斜視図である。It is a typical perspective view of the robot operating table which concerns on the 1st structural example of this invention. 本発明の第１構成例に係るロボット手術台の側面図である。It is a side view of the robot operating table which concerns on the 1st structural example of this invention. アクチュエータ、位置決め装置、ブレーキ機構を１ユニットした場合の概念図である。It is a conceptual diagram at the time of uniting an actuator, a positioning device, and a brake mechanism. 第１構成例に係るロボット手術台が配置された手術室の平面図であり、テーブルが第１の位置にある状態を示す。It is a top view of the operating room where the robot operating table which concerns on a 1st structural example is arrange | positioned, and shows the state which has a table in a 1st position. 第１構成例に係るロボット手術台が配置された手術室の平面図であり、テーブルが第１の位置から第２の位置に移る途中の状態を示す。It is a top view of the operating room where the robot operating table concerning the 1st example of composition is arranged, and shows the state in the middle of a table moving from the 1st position to the 2nd position. 第１構成例に係るロボット手術台が配置された手術室の平面図であり、テーブルが第２の位置にある状態を示す。It is a top view of the operating room where the robot operating table which concerns on a 1st structural example is arrange | positioned, and shows the state which has a table in a 2nd position. ＭＲＩ装置の斜視図である。It is a perspective view of an MRI apparatus. 第１構成例の第１変形例に係るロボット手術台の構成を示す側面図である。It is a side view which shows the structure of the robot operating table which concerns on the 1st modification of a 1st structural example. 第１構成例の第２変形例に係るロボット手術台の構成を示す側面図である。It is a side view which shows the structure of the robot operating table which concerns on the 2nd modification of a 1st structural example. （Ａ）～（Ｃ）は、ホルダー用ロボットアームの操作部材を示す斜視図であり、（Ｄ）は、操作部材とホルダー用ロボットアームとの電気的な接続構成を模式的に示すブロック図である。(A) to (C) are perspective views showing an operation member of the holder robot arm, and (D) is a block diagram schematically showing an electrical connection configuration between the operation member and the holder robot arm. is there. （Ａ）は第１構成例の第４変形例を示す斜視図であり、（Ｂ）は第１構成例の第４変形例の別の例を示す側面図である。(A) is a perspective view which shows the 4th modification of a 1st structural example, (B) is a side view which shows another example of the 4th modification of a 1st structural example. 第１構成例に係るロボット手術台が配置された手術室の平面図であり、テーブルが第３の位置にある状態を示す。It is a top view of the operating room where the robot operating table which concerns on a 1st structural example is arrange | positioned, and shows the state which has a table in a 3rd position. 第２構成例に係るロボット手術台の側面図である。It is a side view of the robot operating table which concerns on a 2nd structural example. （Ａ）は、第２構成例に係るロボット手術台の主要部を側方から見た状態を示す断面図であり、（Ｂ）は、第２構成例に係るロボット手術台の主要部を鉛直方向上側から見た状態を示す図である。(A) is sectional drawing which shows the state which looked at the principal part of the robot operating table which concerns on a 2nd structural example from the side, (B) is a main part of the robotic operating table which concerns on a 2nd structural example perpendicularly | vertically. It is a figure which shows the state seen from the direction upper side. 第２構成例に係るロボット手術台が術中ＭＲＩに適用された場合の斜視図であり、テーブルが手術位置にある状態を示す。It is a perspective view at the time of the robot operation table which concerns on a 2nd structural example being applied to intraoperative MRI, and shows the state which has a table in an operation position. 第２構成例に係るロボット手術台が術中ＭＲＩに適用された場合の斜視図であり、テーブルが撮影準備位置にある状態を示す。It is a perspective view at the time of the robot operating table which concerns on a 2nd structural example being applied to intraoperative MRI, and shows the state which has a table in an imaging | photography preparation position. 第２構成例に係るロボット手術台が術中ＭＲＩに適用された場合の斜視図であり、テーブルが撮影位置にある状態を示す。It is a perspective view at the time of the robot operating table which concerns on a 2nd structural example being applied to intraoperative MRI, and shows the state which has a table in an imaging | photography position. 第３構成例に係るロボット手術台の側面図である。It is a side view of the robot operating table which concerns on a 3rd structural example. 第３構成例に係るロボット手術台を上下に移動させた場合の遷移状態を示す側面図である。It is a side view which shows the transition state at the time of moving the robot operating table which concerns on a 3rd structural example up and down. スライド機構が搭載された第３の構成例に係るロボット手術台が第１の位置から第２の位置へ移動する様子を示した斜視図と対応する平面図である。It is a top view corresponding to the perspective view which showed a mode that the robot operating table based on the 3rd structural example by which a slide mechanism was mounted moved from a 1st position to a 2nd position. テーブルその他のロボット手術台の設計を説明するための図である。It is a figure for demonstrating the design of a table and other robot operating tables.
　以下、本発明を実施するための形態について図面を参照しつつ説明する。 Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.
［ロボット手術台の構成］
（第１構成例）
　図１は、本発明の第１構成例に係るロボット手術台１の模式的な斜視図である。図２は、ロボット手術台１の側面図である。図３は、アクチュエータ、位置決め装置、ブレーキ機構を１ユニットとした部品の概念図である。 [Configuration of robot operating table]
(First configuration example)
FIG. 1 is a schematic perspective view of a robot operating table 1 according to a first configuration example of the present invention. FIG. 2 is a side view of the robot operating table 1. FIG. 3 is a conceptual diagram of parts in which an actuator, a positioning device, and a brake mechanism are one unit.
　第１構成例では、手動式の医療用注入機器ホルダーユニットが装着されたロボット手術台１を説明する。 In the first configuration example, a robot operating table 1 equipped with a manual medical injection device holder unit will be described.
　図１及び図２を参照して、本明細書のロボット手術台は、処置対象（載置対象ともいう）に検査、測定、及び、手術などの治療を含む工程を施すために用いられる。処置対象として、人間と、犬及び猫などの動物と、を含む生体を例示することができる。本明細書では、処置対象が人間（患者）である場合を例に説明する。 Referring to FIGS. 1 and 2, the robot operating table of the present specification is used for performing a process including examination, measurement, and treatment such as surgery on a treatment target (also referred to as a placement target). Examples of treatment targets include living bodies including humans and animals such as dogs and cats. In this specification, a case where the treatment target is a human (patient) will be described as an example.
　また、第１構成例では、患者Ｋに術者Ｔが手術を行う場合を例に説明する。図１では、術者Ｋがドレープ２に覆われた状態を示している。また、図２以降の図については、説明の便宜上、想像線である２点鎖線で示している箇所がある。 In the first configuration example, a case where the operator T performs an operation on the patient K will be described as an example. In FIG. 1, the operator K is shown covered with the drape 2. Further, in the drawings after FIG. 2, there are places indicated by two-dot chain lines that are imaginary lines for convenience of explanation.
　ロボット手術台１は、医療室３に配置されている。また、ロボット手術台１は、医療用流体注入機器としての麻酔器４がホルダー１５により保持されている。麻酔器４は、患者Ｋの手術時に用いられる医療機器の一例であり、患者Ｋの移動時に手術中の患者Ｋとの接続を解除できない医療機器である。 The robot operating table 1 is disposed in the medical room 3. In the robot operating table 1, an anesthesia machine 4 as a medical fluid injection device is held by a holder 15. The anesthesia machine 4 is an example of a medical device used when the patient K is operated, and is a medical device that cannot be disconnected from the patient K during the operation when the patient K moves.
　麻酔器４は、患者Ｋに対して麻酔を導入し、麻酔薬を連続的に投与することによって麻酔状態を維持するために設けられている。麻酔器４は、ガス供給部４ａと、呼吸回路部４ｂとを有している。 The anesthesia machine 4 is provided in order to maintain anesthesia by introducing anesthesia to the patient K and continuously administering an anesthetic. The anesthesia machine 4 includes a gas supply unit 4a and a breathing circuit unit 4b.
　ガス供給部４ａは、酸素、笑気ガス（亜酸化窒素）を混合することで麻酔用のガスを作り出すように構成されている。ガス供給部４ａは、酸素、笑気ガス（亜酸化窒素）及び空気の流量を計測する流量計４ｄと、流量計４ｄを通過した酸素、笑気ガス（亜酸化窒素）及び空気によって構成された麻酔用ガスを気化させる気化器４ｅと、を有している。ガス供給部４ａに隣接して、呼吸回路部４ｂが設けられている。呼吸回路部４ｂは、呼気弁、吸気弁、呼吸バッグ及び二酸化炭素を吸収するカニスタを内蔵した構成を有している。 The gas supply unit 4a is configured to produce anesthetic gas by mixing oxygen and laughing gas (nitrous oxide). The gas supply unit 4a is composed of a flow meter 4d that measures the flow rates of oxygen, laughing gas (nitrous oxide), and air, and oxygen, laughing gas (nitrous oxide), and air that have passed through the flow meter 4d. A vaporizer 4e for vaporizing the anesthetic gas. A breathing circuit unit 4b is provided adjacent to the gas supply unit 4a. The breathing circuit unit 4b has a configuration in which an exhalation valve, an inhalation valve, a breathing bag, and a canister that absorbs carbon dioxide are incorporated.
　呼吸回路部４ｂには、可撓性の吸気チューブ４ｆ及び呼気チューブ４ｇが接続されている。吸気チューブ４ｆの一端は、上記の吸気弁に接続されている。呼気チューブ４ｇの他端は、患者Ｋの口に当てられるマスクに接続されている。また、呼気チューブ４ｇの一端は、上記の呼気弁に接続されている。呼気チューブ４ｇの他端は、上記マスクに接続されている。上記の構成により、麻酔用のガスは、吸気チューブ４ｆを介して患者Ｋに供給される。また、患者Ｋからの呼気は、呼気チューブ４ｇを介して呼吸回路部４ｂに送られる。 A flexible inspiratory tube 4f and an expiratory tube 4g are connected to the breathing circuit unit 4b. One end of the intake tube 4f is connected to the intake valve. The other end of the exhalation tube 4g is connected to a mask applied to the mouth of the patient K. One end of the exhalation tube 4g is connected to the exhalation valve. The other end of the exhalation tube 4g is connected to the mask. With the above configuration, the anesthetic gas is supplied to the patient K through the inspiratory tube 4f. In addition, exhaled breath from the patient K is sent to the breathing circuit unit 4b through the exhalation tube 4g.
　ロボット手術台１は、テーブルユニット１００と、医療機器ホルダーユニット１１と、を備えている。 The robot operating table 1 includes a table unit 100 and a medical device holder unit 11.
　テーブルユニット１００は、患者Ｋを載置するテーブル１０と、テーブル１０を支持するロボットアーム１０３と、を有している。 The table unit 100 includes a table 10 on which the patient K is placed and a robot arm 103 that supports the table 10.
　医療機器ホルダーユニット１１は、医療用流体注入機器である麻酔器４を支持可能に構成されたホルダー１５を有し、テーブルユニット１００に装着されている。 The medical device holder unit 11 has a holder 15 configured to support the anesthesia machine 4 which is a medical fluid injection device, and is mounted on the table unit 100.
　患者Ｋを載置するテーブル１０を支持するロボットアーム１０３は、多自由度（３自由度以上）を有している。 The robot arm 103 that supports the table 10 on which the patient K is placed has multiple degrees of freedom (more than 3 degrees of freedom).
　テーブル１０は、患者Ｋが載せられる板状部材である。テーブル１０は、特定の方向を長手方向（前後方向）として延びる、矩形の板状部材である。 The table 10 is a plate-like member on which the patient K is placed. The table 10 is a rectangular plate-like member extending with a specific direction as a longitudinal direction (front-rear direction).
　ロボットアーム１０３は、ベース１０４と、複数の可動要素（本構成例では、第１～第４可動要素１０５１～１０５４）と、複数のジョイント（本構成例では、第１～第６ジョイント１０６１～１０６６）と、を含む。 The robot arm 103 includes a base 104, a plurality of movable elements (first to fourth movable elements 1051 to 1054 in the present configuration example), and a plurality of joints (first to sixth joints 1061 to 1066 in the present configuration example). ) And.
　ベース１０４と第１可動要素１０５１の一端部は、鉛直直進ジョイントである第１ジョイント１０６１によって連結されており、第１可動要素１０５１は第１軸方向（鉛直方向）に移動することができる。第１可動要素１０５１の他端部と第２可動要素１０５２の一端部は水平回転ジョイントである第２ジョイント１０６２で連結されており、第２可動要素１０５２は第２軸（鉛直方向）まわりに回転することができる。第２可動要素１０５２の他端部と第３可動要素１０５３の一端部は水平回転ジョイントである第３ジョイント１０６３で連結されており、第２軸によって回転され、第２軸と平行な第３軸（鉛直方向）まわりに第３可動要素１０５３が回転することができる。第３可動要素１０５３と第４可動要素１０５４の間の第４～第６ジョイント１０６４～１０６６は、それぞれ、第４～第６軸回りの回転ジョイントである。第４軸は第３可動要素１０５３の延びる方向であり、第５軸は第４ジョイント１０６４によって回転される、第４軸と直交する方向であり、第６軸は、第５ジョイント１０６５によって回転される、第５軸と直交する方向である。なお、図では、回転部材の回転方向を当該部材の付近に示している。 The one end of the base 104 and the first movable element 1051 is connected by a first joint 1061 that is a vertical rectilinear joint, and the first movable element 1051 can move in the first axial direction (vertical direction). The other end of the first movable element 1051 and one end of the second movable element 1052 are connected by a second joint 1062 that is a horizontal rotary joint, and the second movable element 1052 rotates about the second axis (vertical direction). can do. The other end of the second movable element 1052 and one end of the third movable element 1053 are connected by a third joint 1063 that is a horizontal rotary joint, and is rotated by a second axis and is a third axis parallel to the second axis. The third movable element 1053 can rotate around (vertical direction). The fourth to sixth joints 1064 to 1066 between the third movable element 1053 and the fourth movable element 1054 are rotary joints around the fourth to sixth axes, respectively. The fourth axis is a direction in which the third movable element 1053 extends, the fifth axis is a direction orthogonal to the fourth axis rotated by the fourth joint 1064, and the sixth axis is rotated by the fifth joint 1065. The direction is perpendicular to the fifth axis. In the figure, the rotating direction of the rotating member is shown in the vicinity of the member.
　第２可動要素１０５２と第３可動要素１０５３は特定方向に延びる棒状となっており、これらの可動要素の長さはロボットアーム１０３の必要な可動範囲に応じて適宜設計される。 The second movable element 1052 and the third movable element 1053 have a rod shape extending in a specific direction, and the lengths of these movable elements are appropriately designed according to the necessary movable range of the robot arm 103.
　本明細書において、特定方向に延びる可動要素の「一端部」とは、可動要素を特定方向（長手方向）に三等分したときの両側２つの領域のどちらかをいい、特定方向に延びる可動要素の「他端部」とは、可動要素を特定方向（長手方向）に三等分したときの両側２つの領域の一端部とは反対側の端部をいう。単に「端部」という場合には、一端部又は他端部のどちらかをいう。両端部の間にある部分は「中央部」という。 In this specification, the “one end portion” of a movable element extending in a specific direction means one of two regions on both sides when the movable element is divided into three equal parts in a specific direction (longitudinal direction). The “other end portion” of the element means an end portion on the opposite side to one end portion of the two regions on both sides when the movable element is divided into three equal parts in a specific direction (longitudinal direction). When it is simply referred to as “end part”, it means either one end part or the other end part. The part between both ends is called “central part”.
　第１可動要素１０５１は水平面に平行な状態を維持して上下移動し、第２可動要素１０５２及び第３可動要素１０５３は第１可動要素１０５１と平行な状態を維持して回転する構成となっている。このような構成であれば、第２及び第３アクチュエータ１０７２，１０７３において鉛直方向の重力補償を行う必要がないためモータを小さくすることができる。これは、ロボットアーム１０３の小型化に有利な構成であり、限られたスペースしか確保できない医療現場に導入する場合や、治療や手術でより多くのスペースを確保するのに有利である。 The first movable element 1051 moves up and down while maintaining a state parallel to the horizontal plane, and the second movable element 1052 and the third movable element 1053 rotate while maintaining a state parallel to the first movable element 1051. Yes. With such a configuration, it is not necessary to perform gravity compensation in the vertical direction in the second and third actuators 1072 and 1073, so that the motor can be made small. This is an advantageous configuration for reducing the size of the robot arm 103, and is advantageous for introduction to a medical site where only a limited space can be secured or for securing more space for treatment or surgery.
　テーブル１０の幅はロボットアーム１０３の各可動要素１０５１～１０５４の幅よりも大きい方が好ましい。例えば、鉛直方向上側から見下ろした場合に端部同士が水平回転ジョイントで連結された第２可動要素１０５２と第３可動要素１０５３の特定方向を平行となる状態において、鉛直方向上側から見下ろした場合に全ての可動要素がテーブル１０に隠れることが可能であることが望ましい。さらに、本構成例においては、テーブル１０の長さもロボットアーム１０３の各可動要素の長さよりも大きい方が好ましい。例えば、鉛直方向上側から見下ろした場合に端部同士が水平回転ジョイントで連結された第２可動要素１０５２と第３可動要素１０５３を特定方向が平行で第２可動要素１０５２と第３可動要素１０５３の中央部が被る状態において、鉛直方向上側から見下ろした場合にベース１０４がテーブル１０に隠れることが望ましい。 The width of the table 10 is preferably larger than the width of the movable elements 1051 to 1054 of the robot arm 103. For example, when looking down from the upper side in the vertical direction in a state where the specific directions of the second movable element 1052 and the third movable element 1053 whose ends are connected by a horizontal rotary joint are parallel when looking down from the upper side in the vertical direction It is desirable that all movable elements can be hidden by the table 10. Further, in the present configuration example, it is preferable that the length of the table 10 is larger than the length of each movable element of the robot arm 103. For example, when looking down from the upper side in the vertical direction, the second movable element 1052 and the third movable element 1053 whose ends are connected by a horizontal rotation joint are parallel to each other in the specific direction and the second movable element 1052 and the third movable element 1053 are parallel to each other. In a state where the central portion is covered, it is desirable that the base 104 is hidden by the table 10 when looking down from the upper side in the vertical direction.
　本構成例では互いの端部同士が水平回転ジョイントで接続された２つの可動要素（第２可動要素１０５２と第３可動要素１０５３）のひとつ（第２可動要素１０５２）がベース１０４に間接的に（第１可動要素１０５１を介して）連結されている。しかしながら、この通りでなくてもよい。例えば第２可動要素１０５２を直接鉛直直進ジョイントである第１ジョイント１０６１に連結されるようにしてもよい。また、第２可動要素１０５２は、さらなる水平回転ジョイントや垂直回転ジョイントを介してさらに間接的にベースに連結されていてもよい。この場合でも上述した位置関係が担保されている限り、スペース確保及びコンパクトという効果を得ることができる。 In this configuration example, one of the two movable elements (the second movable element 1052 and the third movable element 1053) whose end portions are connected by a horizontal rotary joint (second movable element 1052) is indirectly connected to the base 104. It is connected (via the first movable element 1051). However, this need not be the case. For example, the second movable element 1052 may be directly connected to the first joint 1061 that is a vertical rectilinear joint. Further, the second movable element 1052 may be further indirectly connected to the base via a further horizontal rotary joint or a vertical rotary joint. Even in this case, as long as the above-described positional relationship is secured, it is possible to obtain the effects of space securing and compactness.
　第４可動要素１０５４は、ロボットアーム１０３の先端に位置している。本構成例では、ロボットアーム１０３の先端が、特定方向に延びるテーブル１０の中央部の下面に固定されている。このような構成であれば、大きな支持強度でテーブル１０を支持することができ、また、テーブル１０の下にロボットアーム１０３の可動要素及びベースを収納しやすくなる。ただし、例えば第３可動要素１０５３の長さを短くし、テーブル１０の支持位置を一端部とするようにしてもよく、この場合であってもスペース確保及びコンパクト化という効果を得られることに違いはない。 The fourth movable element 1054 is located at the tip of the robot arm 103. In this configuration example, the tip of the robot arm 103 is fixed to the lower surface of the central portion of the table 10 extending in a specific direction. With such a configuration, the table 10 can be supported with high support strength, and the movable element and the base of the robot arm 103 can be easily stored under the table 10. However, for example, the length of the third movable element 1053 may be shortened and the support position of the table 10 may be one end, and even in this case, the effect of securing space and downsizing can be obtained. There is no.
　ロボットアーム１０３は、第１～第６ジョイント１０６１～１０６６に対応して、第１～第４可動要素１０５１～１０５４を移動又は回転させる複数のアクチュエータ（本構成例では、第１～第６アクチュエータ１０７１～１０７６）と、それぞれのジョイントに組み込まれそれぞれの可動要素の位置を検出する複数の位置検出器（本構成例では第１～第６位置検出器１０８１～１０８６）と、それぞれのアクチュエータの駆動を制御する制御装置１０９を含む。制御装置１０９はベース１０４内に位置しているが、例えば外部の独立した装置としてもよい。 The robot arm 103 includes a plurality of actuators (in this configuration example, the first to sixth actuators 1071 that move or rotate the first to fourth movable elements 1051 to 1054 corresponding to the first to sixth joints 1061 to 1066. 1076), a plurality of position detectors (first to sixth position detectors 1081 to 1086 in the present configuration example) incorporated in each joint and detecting the position of each movable element, and driving of each actuator. A control device 109 for controlling is included. The control device 109 is located in the base 104, but may be an external independent device, for example.
　第１～第６アクチュエータ１０７１～１０７６は、例えばサーボモータである。位置検出器としては、エンコーダを用いてもよいしレゾルバやポテンショメータを用いても構わない。 The first to sixth actuators 1071 to 1076 are, for example, servo motors. As the position detector, an encoder may be used, or a resolver or a potentiometer may be used.
　ロボットアーム１０３は、また、第１～第６ジョイント１０６１～１０６６に対応して、それぞれ、第１～第６電磁ブレーキ１１０１～１１０６を含むことが望ましい。電磁ブレーキを備えていない場合は、複数のアクチュエータ１０７１～１０７６の駆動によりロボットアーム１０３の姿勢を一定に保つことになるが、電磁ブレーキを含んでいると、ある部分のアクチュエータの駆動をオフにしても電磁ブレーキ機能をオンとすることにより、ロボットアーム１０３の姿勢を一定に保つことができる。 The robot arm 103 preferably includes first to sixth electromagnetic brakes 1101 to 1106 corresponding to the first to sixth joints 1061 to 1066, respectively. If the electromagnetic brake is not provided, the posture of the robot arm 103 is kept constant by driving the plurality of actuators 1071 to 1076. However, if the electromagnetic brake is included, the driving of the actuator of a certain part is turned off. Also, by turning on the electromagnetic brake function, the posture of the robot arm 103 can be kept constant.
　電磁ブレーキが設けられる場合の第１～第６電磁ブレーキ１１０１～１１０６それぞれは、アクチュエータへ駆動電流が供給されないときにブレーキ機能をオンにし、アクチュエータへ駆動電流が供給されたときにブレーキ機能をオフにするように構成されている。 When the electromagnetic brake is provided, each of the first to sixth electromagnetic brakes 1101 to 1106 turns on the brake function when the drive current is not supplied to the actuator, and turns off the brake function when the drive current is supplied to the actuator. Is configured to do.
　アクチュエータとしてのモータ、位置検出器としてのエンコーダ、及びブレーキは、図３に示すように一体化した部品として構成されることが多い。さらに、第１～第６アクチュエータ１０７１～１０７６のそれぞれには、動力伝達用の減速機構及びカップリングなどが設けられる。 The motor as the actuator, the encoder as the position detector, and the brake are often configured as integrated parts as shown in FIG. Further, each of the first to sixth actuators 1071 to 1076 is provided with a power transmission speed reduction mechanism and a coupling.
　以上、図１に示したロボットアーム１０３は、自由度が６である。なお、本発明のロボットアームの自由度は、必ずしも６である必要はなく、５以下であってもよいし７以上であってもよい。 As described above, the robot arm 103 shown in FIG. Note that the degree of freedom of the robot arm of the present invention is not necessarily 6 and may be 5 or less or 7 or more.
　次に、医療用流体注入機器ホルダーユニット１１について説明する。 Next, the medical fluid injection device holder unit 11 will be described.
　医療用流体注入機器ホルダーユニット１１は、支持装置１４と、ホルダー１５と、を有している。 The medical fluid injection device holder unit 11 includes a support device 14 and a holder 15.
　支持装置１４は、特定の自由度（１自由度以上、本構成例では２自由度）を有するアームで構成されており、その先端で麻酔器４が保持されるホルダー１５を支持する。アーム１４は、本構成例では、人手で動かされる。 The support device 14 is configured by an arm having a specific degree of freedom (one degree of freedom or more, two degrees of freedom in this configuration example), and supports the holder 15 that holds the anesthesia machine 4 at the tip thereof. In this configuration example, the arm 14 is moved manually.
　支持装置１４は、ベース１６と、複数の可動要素（本構成例では、第１～第２可動要素１７ａ～１７ｂ）と、複数のジョイント（本構成例では、第１～第２ジョイント１８ａ～１８ｂ）と、を含む。 The support device 14 includes a base 16, a plurality of movable elements (first to second movable elements 17a to 17b in the present configuration example), and a plurality of joints (first to second joints 18a to 18b in the present configuration example). ) And.
　ベース１６は、テーブル１０の例えば前寄り部分（患者Ｋの頭部が配置される部分の付近）において、テーブル１０の下面に固定されている。ベース１６は、第１ジョイント１８ａを介して、第１可動要素１７ａの一端部と連結されている。これにより、第１可動要素１７ａは、第１軸（鉛直方向）まわりに回転することができる。第１可動要素１７ａの一端部は、第２可動要素１７ｂの他端部と、水平回転ジョイントである第２ジョイント１８ｂによって連結されており、第２軸（鉛直方向）まわりに第２可動要素１７ｂが回転することができる。上記の第１軸と第２軸は、第２可動要素１７ｂが延びる方向と平行な方向に延びる軸である。 The base 16 is fixed to the lower surface of the table 10 at, for example, a front portion of the table 10 (near the portion where the head of the patient K is disposed). The base 16 is connected to one end of the first movable element 17a via the first joint 18a. Accordingly, the first movable element 17a can rotate around the first axis (vertical direction). One end portion of the first movable element 17a is connected to the other end portion of the second movable element 17b by a second joint 18b which is a horizontal rotary joint, and the second movable element 17b around the second axis (vertical direction). Can rotate. The first axis and the second axis are axes that extend in a direction parallel to the direction in which the second movable element 17b extends.
　第１可動要素１７ａは、テーブル１０の上面と平行な方向で且つ特定方向に延びる棒状となっており、長さはアーム１４の必要な可動範囲に応じて適宜選択される。第２可動要素１７ｂは、第１可動要素１７ａと直交する方向で且つテーブル１０の上面と直交する方向に延びる棒状となっており、長さは、各手術工程において邪魔にならないよう長すぎない寸法で設計される。 The first movable element 17a has a bar shape extending in a specific direction in a direction parallel to the upper surface of the table 10, and the length is appropriately selected according to the required movable range of the arm 14. The second movable element 17b has a rod shape extending in a direction orthogonal to the first movable element 17a and in a direction orthogonal to the upper surface of the table 10, and the length is a dimension that is not too long so as not to interfere with each surgical process. Designed with.
　第１可動要素１７ａの高さ位置は、テーブル１０の高さ位置よりも低く設定されている。また、第１可動要素１７ａの一端部は、テーブル１０における長手方向の一端部（本構成例では、テーブル１０に載せられた患者Ｋの頭部側）に配置されたベース１６と接続されている。また、第１可動要素１７ａの一端部は、鉛直方向上側から見下ろしたときに、テーブル１０の下方に隠れるように配置することができる。 The height position of the first movable element 17a is set lower than the height position of the table 10. In addition, one end of the first movable element 17a is connected to a base 16 disposed at one end in the longitudinal direction of the table 10 (in this configuration example, the head side of the patient K placed on the table 10). . Moreover, the one end part of the 1st movable element 17a can be arrange | positioned so that it may hide under the table 10 when it looks down from the perpendicular direction upper side.
　第２可動要素１７ｂの他端部（上端部）の高さ位置は、テーブル１０の上面の高さ位置よりも高く設定されている。そして、第２可動要素１７ｂの他端側は、ホルダー１５を支持している。 The height position of the other end (upper end) of the second movable element 17b is set higher than the height position of the upper surface of the table 10. The other end side of the second movable element 17b supports the holder 15.
　ホルダー１５は、麻酔器４を保持する部分として設けられている。ホルダー１５は、例えば、鉛直方向に立てられた平板状に形成されている。ホルダー１５の一縁部は、例えば、ねじ部材などの固定部材を用いて、第２可動要素１７ｂに着脱可能に固定されている。ホルダー１５は、麻酔器４の枠部をホルダーの受け部に引っ掛けることなどによって当該麻酔器４を保持するように構成されており、ホルダー１５の片側面に、麻酔器４が保持されている。なお、ホルダー１５に麻酔器４を保持することができればよく、ホルダー１５に麻酔器４を保持するための構成の具体例は、限定されない。 The holder 15 is provided as a part for holding the anesthesia machine 4. The holder 15 is formed, for example, in a flat plate shape standing in the vertical direction. One edge of the holder 15 is detachably fixed to the second movable element 17b using a fixing member such as a screw member, for example. The holder 15 is configured to hold the anesthesia machine 4 by, for example, hooking a frame part of the anesthesia machine 4 to a receiving part of the holder, and the anesthesia machine 4 is held on one side of the holder 15. In addition, the anesthesia machine 4 should just be hold | maintained at the holder 15, and the specific example of the structure for hold | maintaining the anesthesia machine 4 in the holder 15 is not limited.
　本構成例に係るロボット手術台がハイブリッド手術としての術中ＭＲＩに用いられて、テーブルが複数の位置の間で移動する動作を、図１及び図２に示した６自由度のロボット手術台１を用いた場合を例にして、図４～図６を参照して説明する。 The robot operating table according to this configuration example is used for intraoperative MRI as a hybrid operation, and the operation of moving the table among a plurality of positions is performed using the robot operating table 1 with 6 degrees of freedom shown in FIGS. The case where it is used will be described with reference to FIGS.
　図４は、患者Ｋを載置位置（第１の位置）からあるＭＲＩ装置による撮影位置（第２の位置）へ移動させる場合に、テーブル１０が載置位置に位置している様子を示している。載置位置は患者への麻酔導入や点滴剤の接続などを行う手術準備を行う位置であってもよい。図５は、制御装置１０９による制御によって第２可動要素１０５２及び第３可動要素１０５３が矢印の如く動き、またテーブル１０が第６軸まわりに回転して矢印の如く動いて（場合によっては、第１可動要素１０５１も鉛直方向に動いて高さが調節され、また第４軸又は／及び第５軸まわりの回転によりテーブル１０が長手方向又は／及び幅方向まわりに回転して傾きが微調整され）患者の頭部が医用画像診断装置（モダリティ）としてのＭＲＩ装置４１４に対して斜めから移動してゆく様子を示している。図６はテーブル１０がＭＲＩ装置４１４の内部に挿入され、患者が撮影位置（第２の位置）に到達した様子を示している。なお、図４におけるテーブル１０の位置（第１の位置）は手術位置でもあり得、テーブル１０が図６の撮影位置（第２の位置）から図４の手術位置（第１の位置）まで各可動要素が逆方向に動いて元の位置に戻り、撮影直後に術者４１２が医用画像の内容を確認しながら手術を行うことができる。 FIG. 4 shows a state in which the table 10 is positioned at the mounting position when the patient K is moved from the mounting position (first position) to the imaging position (second position) by a certain MRI apparatus. Yes. The placement position may be a position for preparing for surgery for introducing anesthesia to a patient, connecting a drip agent, and the like. FIG. 5 shows that the second movable element 1052 and the third movable element 1053 move as indicated by arrows under the control of the control device 109, and the table 10 rotates around the sixth axis and moves as indicated by arrows (in some cases, the first The first movable element 1051 is also moved in the vertical direction to adjust the height, and the table 10 is rotated about the longitudinal direction and / or the width direction by the rotation about the fourth axis and / or the fifth axis, so that the inclination is finely adjusted. ) A state in which the head of the patient moves obliquely with respect to the MRI apparatus 414 as a medical image diagnostic apparatus (modality) is shown. FIG. 6 shows a state where the table 10 is inserted into the MRI apparatus 414 and the patient has reached the imaging position (second position). Note that the position (first position) of the table 10 in FIG. 4 may also be an operation position, and the table 10 is each from the imaging position (second position) in FIG. 6 to the operation position (first position) in FIG. The movable element moves in the reverse direction and returns to the original position, and immediately after the image is taken, the operator 412 can perform an operation while confirming the contents of the medical image.
　なお、患者の頭の向きはテーブル１０の長手方向において反対側でもよく、その場合はテーブル１０の回転方向が図５に示したテーブルの移動方向とは逆に回りながらＭＲＩ装置４１４に移動することになる。このように、ベース１０４がテーブル１０の下に収納されると、患者の向きがどちらであってもよく、図４のテーブル１０の位置が手術位置だとすると、術者４１２はテーブル１０のどちら側からでも手術を行うことができ、助手も含めてテーブル１０を取り囲んで手術にあたることができる。ベース１０４が邪魔となることもないので、術者４１２は座った状態で手術を行うことができる。 The patient's head may be on the opposite side in the longitudinal direction of the table 10, in which case the table 10 moves to the MRI apparatus 414 while rotating in the direction opposite to the table moving direction shown in FIG. become. Thus, when the base 104 is stored under the table 10, the patient may be oriented in any direction. If the position of the table 10 in FIG. However, an operation can be performed, and the table 10 including the assistant can be surrounded by the operation. Since the base 104 does not get in the way, the operator 412 can perform the operation while sitting.
　上記医用画像診断装置として用いられるオープン型のＭＲＩ装置４１４を図７に示す。当該オープン型ＭＲＩ装置４１４は、前方及び側方に開口するオープン型である。具体的には、中央部が前方に張り出すような略Ｔ字状の上側検査部（上部磁石）４１５及び下側検査部（下部磁石）４１６を含み、これらの検査部４１５、４１６の間に患者が載置されたテーブルが挿入される空間が形成されている。上側検査部４１５及び下側検査部４１６の両端部同士は、一対の支柱４１７によって連結されている。ＭＲＩ装置４１４はドーナツ型であってもよいが、患者を斜めからＭＲＩ装置に挿入しやすいようなケース（図５のような場合）に適用する場合には、ドーナツ内側の空洞の正面にテーブルを位置させてから空洞内部へ挿入することとなるため、ロボットアームの動きが少し窮屈になる場合がある。 FIG. 7 shows an open type MRI apparatus 414 used as the medical image diagnostic apparatus. The open type MRI apparatus 414 is an open type that opens forward and laterally. Specifically, it includes a substantially T-shaped upper inspection portion (upper magnet) 415 and lower inspection portion (lower magnet) 416 with the center portion protruding forward, and between these inspection portions 415 and 416. A space for inserting a table on which a patient is placed is formed. Both ends of the upper inspection unit 415 and the lower inspection unit 416 are connected by a pair of support columns 417. The MRI apparatus 414 may be a donut type, but when applied to a case where the patient can be easily inserted into the MRI apparatus obliquely (as shown in FIG. 5), a table is placed in front of the cavity inside the donut. Since it is inserted into the cavity after being positioned, the movement of the robot arm may be a little cramped.
　上側検査部（上部磁石）４１５及び下側検査部（下部磁石）４１６で挟まれる空間で形成される部分が撮影空間である。テーブル１０の少なくとも一部が当該撮影空間とオーバーラップする場合において、テーブル１０がＭＲＩ撮影位置にあるということができる。撮影空間内でのテーブル１０の位置は、患者の撮影部位や患者の身長・大きさによって異なるため、常に一定であるとは限らない。しかし、撮影空間内の特定位置を制御装置１０９内の記憶装置に記憶させておくことはできる。ハイブリッド手術では手術位置と撮影位置を複数回往復することが普通なので、手術ごとに撮影位置及び／又は手術位置を記憶させてもよい。 The part formed by the space between the upper inspection part (upper magnet) 415 and the lower inspection part (lower magnet) 416 is the imaging space. When at least a part of the table 10 overlaps the imaging space, it can be said that the table 10 is at the MRI imaging position. Since the position of the table 10 in the imaging space varies depending on the imaging region of the patient and the height and size of the patient, it is not always constant. However, a specific position in the imaging space can be stored in a storage device in the control device 109. In the hybrid operation, since the operation position and the imaging position are usually reciprocated a plurality of times, the imaging position and / or the operation position may be stored for each operation.
　上述した第１の位置としての手術位置とは、テーブル１０が撮影空間に近接しない、すなわち撮影空間と一定距離以上離れた位置である。そして、上記の例において、手術位置の近傍には、術者４１２が使用する手術器具を置くための手術器具台４１３が設置されており、これら手術器具がＭＲＩ装置４１４の近くに配置されていると、ＭＲＩ装置４１４の永久磁石の影響を受けて（例えば浮揚して）患者や取り扱う者を傷つける恐れがあるため、手術位置はＭＲＩ装置より十分離れた位置に確保し、５ガウスラインＬよりも離れていることが望ましい。 The above-described surgical position as the first position is a position where the table 10 is not close to the imaging space, that is, a position away from the imaging space by a certain distance or more. In the above example, a surgical instrument table 413 for placing a surgical instrument used by the operator 412 is installed in the vicinity of the surgical position, and these surgical instruments are arranged near the MRI apparatus 414. Therefore, the surgical position should be kept far away from the MRI apparatus and more than the 5 gauss line L. It is desirable to be separated.
　さらに、ロボットアーム１０３のベース１０４も、５ガウスラインＬの外側に配置されていることが好ましい。ロボットアーム１０３のベース１０４には大きなモータが設けられており、モータは磁石を含んでいるため、これがＭＲＩ装置４１４の近くに位置していると、ＭＲＩ装置４１４の撮影空間に形成された磁界が歪められ、撮影画像の劣化に繋がるためである。 Furthermore, it is preferable that the base 104 of the robot arm 103 is also arranged outside the 5 Gauss line L. The base 104 of the robot arm 103 is provided with a large motor, and the motor includes a magnet. Therefore, if the motor is located near the MRI apparatus 414, a magnetic field formed in the imaging space of the MRI apparatus 414 is generated. This is because it is distorted and leads to deterioration of the captured image.
　よって、ロボットアーム１０３とテーブル１０により構成されるロボット手術台１は、第１の位置である手術位置を、ＭＲＩ装置との最短距離Ｓが一定距離以上離れた位置に設定することが好ましく、安全性を考慮すると、当該最短距離Ｓを５ガウスラインＬに設定するのが好ましい。 Therefore, the robot operating table 1 constituted by the robot arm 103 and the table 10 preferably sets the operation position as the first position to a position where the shortest distance S from the MRI apparatus is a predetermined distance or more. In view of the characteristics, it is preferable to set the shortest distance S to 5 gauss lines L.
　５ガウスラインについては、低磁場のＭＲＩ装置が開発されており、例えば、静磁場強度が0.3テスラで５ガウスラインをガントリー辺縁より約１ｍとすることが可能になっている（「インテリジェントオペ室・ＭＲＩ誘導手術対応システム」、MEDIX, 39 : 11-16, 2001参照）。従って、ＭＲＩ装置４１４と第１の位置にあるロボット手術台１との最短距離は少なくとも１ｍに設定するのが好ましい。低磁場のＭＲＩ装置の開発状況によっては、上記最短距離Ｓをもう少し短く設定可能となることが期待される。 For the 5 Gauss line, an MRI apparatus with a low magnetic field has been developed. For example, the static magnetic field strength is 0.3 Tesla and the 5 Gauss line can be set to about 1 m from the gantry edge (“Intelligent Operation Room”). "MRI guided surgery compatible system", MEDIX, 39: 11-16, 2001). Therefore, the shortest distance between the MRI apparatus 414 and the robot operating table 1 at the first position is preferably set to at least 1 m. It is expected that the shortest distance S can be set a little shorter depending on the development situation of the low magnetic field MRI apparatus.
　他の磁場が大きめのＭＲＩ装置を使用する場合や、より高い安全性を確保しようとする場合には、上記最短距離Ｓを例えば１．５ｍ以上に設定することが好ましい。 When using an MRI apparatus with a larger magnetic field or when trying to ensure higher safety, it is preferable to set the shortest distance S to, for example, 1.5 m or more.
　ただし、ロボットアーム１０３がテーブル１０を支持することができる耐荷重なども考慮すると、第１の位置である治療位置をＭＲＩ装置４１４より遠くに設置した場合、第２の位置である撮影位置にテーブル１０を移動させるには、大きな耐荷重に耐えうる大型のロボットアーム１０３が必要となる。そして、大型のロボットアーム１０３では第１の位置である手術位置においてテーブル下にロボットアーム１０３の大部分を収納させることが困難となり（よって、術者や助手がテーブル１０を取り囲んで手術する際に邪魔となり）、またロボット手術台１をＭＲＩ装置４１４より遠くに設置する分の大きめの手術室が必要となるため、第１の位置にあるロボット手術台１とＭＲＩ装置との最短距離Ｓが大きければ大きいほどよいという訳ではない。 However, in consideration of the load resistance capable of supporting the table 10 by the robot arm 103, when the treatment position as the first position is installed farther than the MRI apparatus 414, the table is set at the imaging position as the second position. In order to move 10, a large robot arm 103 that can withstand a large load capacity is required. In the large-sized robot arm 103, it becomes difficult to store most of the robot arm 103 under the table at the operation position, which is the first position (so, when an operator or assistant surrounds the table 10 and performs an operation). In addition, since a larger operating room is required for installing the robot operating table 1 farther than the MRI apparatus 414, the shortest distance S between the robot operating table 1 in the first position and the MRI apparatus can be increased. The bigger the better, the better.
　従って、ＭＲＩ装置４１４との関係で十分な安全性を確保することができる限りにおいてはロボット手術台１の第１の位置の設定場所はＭＲＩ装置４１４に近い方がよい。例えば1.5テスラのＭＲＩだと、５ガウスラインは最短の箇所でガントリー（ＭＲＩ装置）の２．８ｍくらいになる（「３Ｔ　ＭＲＩの吸着事故を防ごう」、土橋俊男、月間インナービジョン２０１２年９月号）ため、５ガウスラインとロボットアーム１０３の剛性（テーブル１０の安定性）や小型化構造を考慮すると、ＭＲＩ装置４１４と第１の位置にあるロボット手術台１との最短距離Ｓの上限は、例えば３ｍ以下に設定することが好ましい。静磁場強度が0.3テスラで５ガウスラインが１ｍ程度である場合は、手術器具を把持した人がＭＲＩ装置側に立てることも考慮して、上記最短距離Ｓの上限として２ｍ程度を見ておけばよい。 Therefore, as long as sufficient safety can be ensured in relation to the MRI apparatus 414, the setting position of the first position of the robot operating table 1 should be close to the MRI apparatus 414. For example, with an MRI of 1.5 Tesla, the 5 Gauss line will be about 2.8 m of the gantry (MRI system) at the shortest point (“Travel 3T MRI adsorption accident”, Toshio Dobashi, Monthly Inner Vision September 2012 Therefore, in consideration of the rigidity of the 5 Gauss line and the robot arm 103 (stability of the table 10) and the miniaturized structure, the upper limit of the shortest distance S between the MRI apparatus 414 and the robot operating table 1 at the first position is For example, it is preferably set to 3 m or less. If the static magnetic field strength is 0.3 Tesla and the 5 Gauss line is about 1 m, considering that the person holding the surgical instrument stands on the MRI apparatus side, if the upper limit of the shortest distance S is about 2 m, Good.
　なお、上記文献（「３Ｔ　ＭＲＩの吸着事故を防ごう」、月間インナービジョン２０１２年９月号）にも記載している通り５ガウスラインはＭＲＩ装置まわりに楕円状に形成され、1.5テスラのＭＲＩの場合、最短の箇所でＭＲＩ装置より２．８ｍであるが、最長の場合は５ｍである。現在ではほとんどの場合、術中ＭＲＩでは回転－昇降－天板スライド式の手術台が用いられているが、手術台の動作がこの３つに限定されているとテーブルの撮影位置への移動が可能な位置が制限され、手術台の設置場所を５ガウスラインの最短部分付近に設置することが困難な場合があるが、ロボット手術台であればこれまで示したようにテーブルの移動方向の自由度が高いので、設置場所の自由度も高いというメリットがある。 In addition, as described in the above-mentioned document (“Let's prevent 3T MRI adsorption accident”, Monthly Inner Vision September 2012 issue), the 5 Gauss line is formed in an elliptical shape around the MRI apparatus, and the MRI of 1.5 Tesla In this case, the shortest point is 2.8 m from the MRI apparatus, but the longest is 5 m. Currently, in most cases, intraoperative MRI uses a rotating-lifting-top-sliding operating table, but if the operating table is limited to these three, the table can be moved to the imaging position. The position of the operating table is limited, and it may be difficult to place the operating table near the shortest part of the 5 Gauss line. Has a merit that the degree of freedom of the installation location is also high.
　以上のように構成されたロボット手術台を用いれば、テーブル上に患者を載置した後、テーブル１０を撮影位置や手術位置といった目的とする位置に正確かつ迅速に移動させることができ、手術工程の効率を格段に向上させることができる。例えば、キャスター付きのテーブルにより載置対象としての患者を移動させるのと比較して、患者Ｋに大きな振動を与えることなくテーブル１０をスムーズに移動させることができる。また、上記ロボット手術台は医療用注入機器を保持するホルダーユニット１１を備えているため、麻酔器４のような手術中に取り外しができないような機器もテーブル１０と一体的に移動させることができる。従って、患者Ｋに接続されているチューブ４ｆ，４ｇを、テーブル１０の動作範囲を考慮して長くとる必要がなくなる。また、患者Ｋに接続されているチューブ４ｆ，４ｇがテーブル１０が動くことによって絡まる危険性を低減することができる。そして、麻酔器を不動に設置しておくスペースが削減でき、限られたスペースしか確保できない手術室に導入するのに有利である。 By using the robot operating table configured as described above, after placing the patient on the table, the table 10 can be accurately and quickly moved to a target position such as an imaging position or a surgical position. Efficiency can be significantly improved. For example, the table 10 can be smoothly moved without giving a large vibration to the patient K as compared with the case where the patient as a placement target is moved by a table with casters. In addition, since the robot operating table includes the holder unit 11 that holds the medical infusion device, a device that cannot be removed during an operation, such as the anesthesia machine 4, can be moved together with the table 10. . Therefore, it is not necessary to take the tubes 4f and 4g connected to the patient K long in consideration of the operation range of the table 10. Further, the risk of the tubes 4f and 4g connected to the patient K becoming tangled by the movement of the table 10 can be reduced. And the space which installs an anesthesia machine immovably can be reduced, and it is advantageous to introduce into the operating room which can ensure only a limited space.
（第１構成例の第１変形例）
　手術中に患者Ｋと接続しておかなければならない医療機器は、麻酔器４に限定されない。例えば、手術中には患者Ｋが出血によって体液を失うため、水分を補充するために輸液ポンプにより制御して点滴剤を投与することも一般的である。従って、本変形例では、麻酔器４を保持するホルダーに加えて、輸液ポンプを保持するホルダーを設け、これらを共にテーブル１０に固定する。 (First Modification of First Configuration Example)
The medical device that must be connected to the patient K during the operation is not limited to the anesthesia machine 4. For example, since the patient K loses body fluid due to bleeding during the operation, it is also common to administer an instillation controlled by an infusion pump to replenish water. Therefore, in this modification, in addition to the holder for holding the anesthesia machine 4, a holder for holding the infusion pump is provided, and these are both fixed to the table 10.
　なお、以下では、先に説明された構成と同一の構成については、図に同一の符号を付し、詳細な説明は省略する場合がある。 In the following, the same components as those described above are denoted by the same reference numerals, and detailed description may be omitted.
　図８は、第１構成例の第１変形例に係る医療システムの側面図である。 FIG. 8 is a side view of a medical system according to a first modification of the first configuration example.
　図８を参照して、第１構成例の第１変形例では、第１構成例の構成の麻酔器用ホルダーユニット１１に加えて、輸液ポンプ用ホルダーユニット１３が設けられている。 Referring to FIG. 8, in the first modification of the first configuration example, an infusion pump holder unit 13 is provided in addition to the anesthesia machine holder unit 11 having the configuration of the first configuration example.
　医療機器ホルダーユニット１３は、アーム２６と、ホルダー部２７と、を有している。 The medical device holder unit 13 has an arm 26 and a holder portion 27.
　アーム２６は、特定の自由度（１自由度以上、アーム２６では２自由度）を有し、その先端で輸液ポンプ６が保持されるホルダー部２７を支持する。また、アーム２６は、点滴剤（薬剤や栄養分）６ａを吊るす釣支部６ｂを有する。支持装置としてのアーム２６は、本構成例では、人手で動かされる。 The arm 26 has a specific degree of freedom (one degree of freedom or more, and the arm 26 has two degrees of freedom), and supports the holder portion 27 on which the infusion pump 6 is held at the tip thereof. Moreover, the arm 26 has a fishing support 6b that hangs a drip agent (medicine or nutrient) 6a. In the present configuration example, the arm 26 as a support device is moved manually.
　アーム２６は、ベース２８と、複数の可動要素（本構成例では、第１～第２可動要素２９ａ～２９ｂ）と、複数のジョイント（本構成例では、第１～第２ジョイント３０ａ～３０ｂ）と、を含む。 The arm 26 includes a base 28, a plurality of movable elements (first to second movable elements 29a to 29b in the present configuration example), and a plurality of joints (first to second joints 30a to 30b in the present configuration example). And including.
　ベース２８は、テーブル１０の例えば後ろ寄り部分（患者Ｋの頭部が配置される側と反対側の付近）において、テーブル１０の下面に固定されている。ベース２８は、第１ジョイント３０ａを介して、第１可動要素２９ａの一端部と連結されている。これにより、第１可動要素２９ａは、第１軸（鉛直方向）まわりに回転することができる。第２可動要素２９ｂの一端部（下端部）は、第１可動要素２９ａの他端部と、水平回転ジョイントである第２ジョイント３０ｂによって連結されており、第２軸（鉛直方向）まわりに第２可動要素２９ｂが回転することができる。上記の第１軸～第２軸は、第２可動要素２９ｂが延びる方向と平行な方向に延びる軸である。 The base 28 is fixed to the lower surface of the table 10 at, for example, a rearward portion of the table 10 (near the side opposite to the side where the head of the patient K is disposed). The base 28 is connected to one end of the first movable element 29a via the first joint 30a. Thereby, the first movable element 29a can rotate around the first axis (vertical direction). One end portion (lower end portion) of the second movable element 29b is connected to the other end portion of the first movable element 29a by a second joint 30b which is a horizontal rotary joint, and the second movable element 29b is arranged around the second axis (vertical direction). 2 The movable element 29b can rotate. The first axis to the second axis are axes that extend in a direction parallel to the direction in which the second movable element 29b extends.
　第１可動要素２９ａは、テーブル１０の上面と平行な方向で且つ特定方向に延びる棒状でとなっており、長さはアーム２６の必要な可動範囲に応じて適宜設計される。第２可動要素２９ｂは、第１可動要素２９ａと直交する方向で且つテーブル１０の上面と直交する方向に延びる棒状となっており、長さは、点滴剤６ａが患者Ｋより上方に位置するように選択される。 The first movable element 29a has a rod shape extending in a specific direction in a direction parallel to the upper surface of the table 10, and the length is appropriately designed according to the necessary movable range of the arm 26. The second movable element 29b has a rod shape extending in a direction orthogonal to the first movable element 29a and in a direction orthogonal to the upper surface of the table 10, and the length thereof is such that the instillation 6a is located above the patient K. Selected.
　ベース２８はテーブル１０の下に固定されるように配置されている。この構成により、第１可動要素２９ａの一端部は、鉛直方向上側から見下ろしたときに、テーブル１０の下方に隠れるように配置することができる。 The base 28 is arranged so as to be fixed under the table 10. With this configuration, one end of the first movable element 29a can be arranged so as to be hidden under the table 10 when viewed from the upper side in the vertical direction.
　以上のように、本変形例では医療用流体注入機器及びこれを保持するホルダーを複数設け、これらの組をそれぞれテーブル１０に固定するようにした。具体的には、複数の医療用流体注入機器として麻酔器４及び輸液ポンプ６を、テーブル１０に連結されるホルダー１５、２７に保持させるようにし、テーブル１０が図４～図６に示すような動作をした場合でも、一体的に移動するようにした。従って、麻酔器４や輸液ポンプ６のような手術中に取り外しができないような複数の機器もまとめてテーブル１０と一体的に移動することができる。このように手術においては患者Ｋに多くのチューブ類が接続されるが、これらのチューブ類を、テーブル１０の動作範囲を考慮して長くとる必要がなくなり、また、患者に接続されているチューブ類がテーブル１０の動作によって絡まる危険性を低減することができる。 As described above, in this modification, a plurality of medical fluid injection devices and holders for holding the medical fluid injection devices are provided, and these sets are fixed to the table 10 respectively. Specifically, the anesthesia machine 4 and the infusion pump 6 as a plurality of medical fluid injection devices are held by holders 15 and 27 connected to the table 10, and the table 10 is as shown in FIGS. Even when moving, it moves together. Accordingly, a plurality of devices such as the anesthesia machine 4 and the infusion pump 6 that cannot be removed during the operation can be moved together with the table 10 together. As described above, many tubes are connected to the patient K in the operation. However, it is not necessary to take these tubes for a long time in consideration of the operation range of the table 10, and the tubes connected to the patient. Can be reduced by the operation of the table 10.
　なお、点滴剤は患者Ｋより高い位置に保っておく必要があるため、テーブル１０の医用画像診断装置内（撮影位置）への移送の際に邪魔となるためテーブル長手方向において端部に設けておくことが好ましい。 In addition, since it is necessary to keep the instillation at a position higher than the patient K, it is obstructed when the table 10 is transferred into the medical image diagnostic apparatus (imaging position). It is preferable to keep it.
　また、テーブル１０には輸液ポンプ６を搭載する医療機器ホルダーユニット１３のみが連結される構成であってもよい。
（第１構成例の第２変形例） Further, the table 10 may be configured such that only the medical device holder unit 13 on which the infusion pump 6 is mounted is connected.
(Second modification of the first configuration example)
　図９を参照して、本変形例に係る医療用流体注入機器ホルダーユニット２４０は、ホルダー用ロボットアーム２４１と、ホルダー２４２と、を有しており、テーブル１０に支持されている。 Referring to FIG. 9, the medical fluid injection device holder unit 240 according to this modification includes a holder robot arm 241 and a holder 242, and is supported by the table 10.
　ホルダー用ロボットアーム２４１は、多自由度を有し、その先端で医療用流体注入機器としての麻酔器４を支持する。 The holder robot arm 241 has multiple degrees of freedom, and supports the anesthesia machine 4 as a medical fluid injection device at its tip.
　ホルダー用ロボットアーム２４１は、ベース２４３と、複数の可動要素（本構成例では、第１～第４可動要素２４４１～２４４４）と、複数のジョイント（本構成例では、第１～第６ジョイント２４５１～２４５６）と、を含む。 The holder robot arm 241 includes a base 243, a plurality of movable elements (first to fourth movable elements 2441 to 2444 in the present configuration example), and a plurality of joints (first to sixth joints 2451 in the present configuration example). 2456).
　ベース２４３は、テーブル１０の端部において、テーブル１０の下面に固定されている。ベース２４３は、鉛直上方からみてテーブル１０に隠れるように配置されている。ベース２４３と第１可動要素２４４１の一端部は、水平直進ジョイントである第１ジョイント２４５１によって連結されており、第１可動要素２４４１は第１軸方向（直線方向）に移動することができる。第１可動要素２４４１の他端部と第２可動要素２４４２の一端部は鉛直回転ジョイントである第２ジョイント２４５２で連結されており、第２可動要素２４４２は第１軸と直交する第２軸（水平方向）まわりに回転することができる。第２可動要素２４４２の他端部と第３可動要素２４４３の一端部は鉛直回転ジョイントである第３ジョイント２４５３で連結されており、第３可動要素２４４３は第２軸と平行な第３軸まわりに回転することができる。 The base 243 is fixed to the lower surface of the table 10 at the end of the table 10. The base 243 is disposed so as to be hidden by the table 10 when viewed from above. One end of the base 243 and the first movable element 2441 is connected by a first joint 2451 which is a horizontal rectilinear joint, and the first movable element 2441 can move in the first axial direction (linear direction). The other end portion of the first movable element 2441 and one end portion of the second movable element 2442 are connected by a second joint 2452 which is a vertical rotary joint, and the second movable element 2442 is a second axis orthogonal to the first axis ( (Horizontal direction) can rotate around. The other end of the second movable element 2442 and one end of the third movable element 2443 are connected by a third joint 2453 that is a vertical rotary joint, and the third movable element 2443 is around a third axis parallel to the second axis. Can be rotated.
　第３可動要素２４４３の他端部（上端部）と第４可動要素２４４４の一端部（下端部）は、水平回転ジョイントである第４ジョイント２４５４、鉛直回転ジョイントである第５ジョイント２４５５、及び、水平回転ジョイントである第６ジョイント２４５６で連結されている。これにより、第４可動要素２４４４は、第３可動要素２４４３が延びる方向と平行な第４軸まわりと、第４軸に直交する第５軸回りと、第５軸に直交する第６軸回りと、のそれぞれの軸まわりに回転することができる。 The other end (upper end) of the third movable element 2443 and one end (lower end) of the fourth movable element 2444 are a fourth joint 2454 that is a horizontal rotary joint, a fifth joint 2455 that is a vertical rotary joint, and They are connected by a sixth joint 2456 which is a horizontal rotation joint. As a result, the fourth movable element 2444 has a fourth axis parallel to the direction in which the third movable element 2443 extends, a fifth axis orthogonal to the fourth axis, and a sixth axis orthogonal to the fifth axis. , Can rotate around each axis.
　第１～第４可動要素２４４１～２４４４は特定方向に延びる棒状となっており、これらの可動要素の長さはロボットアーム２４１の必要な可動範囲に応じて適宜設計される。第１可動要素２４４１は、テーブル１０の上面と平行に延びている。 The first to fourth movable elements 2441 to 2444 are rod-shaped extending in a specific direction, and the lengths of these movable elements are appropriately designed according to the necessary movable range of the robot arm 241. The first movable element 2441 extends in parallel with the upper surface of the table 10.
　ホルダー用ロボットアーム２４１は、第１～第６ジョイント２４５１～２４５６に対応して、第１～第４可動要素２４４１～２４４４を移動又は回転させる複数のアクチュエータ（本変形例では、第１～第６アクチュエータ２４６１～２４６６）と、それぞれのジョイントに組み込まれそれぞれの可動要素の位置を検出する複数の位置検出器（本変形例では第１～第６位置検出器２４７１～２４７６）と、それぞれのアクチュエータの駆動を制御する制御装置２４９を含む。 The robot arm 241 for holder corresponds to the first to sixth joints 2451 to 2456, and includes a plurality of actuators that move or rotate the first to fourth movable elements 2441 to 2444 (in this modification, the first to sixth joints). Actuators 2461 to 2466), a plurality of position detectors (first to sixth position detectors 2471 to 2476 in this modification) incorporated in the respective joints to detect the positions of the respective movable elements, A control device 249 for controlling driving is included.
　第１～第６アクチュエータ２４６１～２４６６は、例えばサーボモータである。位置検出器としては、エンコーダを用いてもよいしレゾルバやポテンショメータを用いても構わない。 The first to sixth actuators 2461 to 2466 are, for example, servo motors. As the position detector, an encoder may be used, or a resolver or a potentiometer may be used.
　ホルダー用ロボットアーム２４１は、また、第１～第６ジョイント２４５１～２４５６に対応して、それぞれ、第１～第６電磁ブレーキ２４８１～２４８６を含むことが望ましい。電磁ブレーキを備えていない場合は、複数のアクチュエータ２４６１～２４６６の駆動によりロボットアーム２４１の姿勢を一定に保つことになるが、電磁ブレーキを含んでいると、ある部分のアクチュエータの駆動をオフにしても電磁ブレーキ機能をオンとすることにより、ロボットアーム２４１の姿勢を一定に保つことができる。 The holder robot arm 241 preferably includes first to sixth electromagnetic brakes 2481 to 2486 corresponding to the first to sixth joints 2451 to 2456, respectively. If the electromagnetic brake is not provided, the posture of the robot arm 241 is kept constant by driving the plurality of actuators 2461 to 2466. However, if the electromagnetic brake is included, the driving of the actuator of a certain part is turned off. Also, by turning on the electromagnetic brake function, the posture of the robot arm 241 can be kept constant.
　上記のロボットアーム２４１の先端である第４可動要素２４４４に、ホルダー２４２が支持されている。ホルダー２４２は、麻酔器４を保持する部分として設けられている。ホルダー部２４２は、例えば、平板状に形成されている。ホルダー部２４２の一縁部は、例えば、ねじ部材などの固定部材を用いて、第４可動要素２４４４に着脱可能に固定されている。ホルダー部２４２が麻酔器４を保持する構成は、第１構成例のホルダー部１５と同様であるので、詳細な説明は省略する。 The holder 242 is supported on the fourth movable element 2444 that is the tip of the robot arm 241. The holder 242 is provided as a part for holding the anesthesia machine 4. The holder part 242 is formed in a flat plate shape, for example. One edge portion of the holder portion 242 is detachably fixed to the fourth movable element 2444 using a fixing member such as a screw member, for example. The configuration in which the holder unit 242 holds the anesthesia machine 4 is the same as that of the holder unit 15 in the first configuration example, and thus detailed description thereof is omitted.
　図９示すように、本変形例に係るロボットアーム１０３の動作によってテーブル１０が水平面に対して傾斜したとき、テーブル１０の姿勢にかかわらず、水平面に対するホルダー部２４２及び麻酔器４の傾斜角度がゼロとなるように、制御装置２４９が例えば第２、第３、第５ジョイント２４５２，２４５３，２４５５（ロボットアーム２４１）の動作を制御することができる。 As shown in FIG. 9, when the table 10 is tilted with respect to the horizontal plane by the operation of the robot arm 103 according to this modification, the tilt angle of the holder unit 242 and the anesthesia machine 4 with respect to the horizontal plane is zero regardless of the posture of the table 10. For example, the control device 249 can control the operations of the second, third, and fifth joints 2452, 2453, and 2455 (robot arm 241).
　具体的には、テーブル用ロボットアーム１０３の制御装置１０９とホルダー用ロボットアーム２４１の制御装置２０９を連携させ、テーブル用ロボットアーム１０３の制御装置１０９によりロボットアーム１０３の姿勢情報がホルダー用ロボットアーム２４１の制御装置２０９に伝えられ、ホルダー用ロボットアーム２４１の制御装置２０９が上記ロボットアーム１０３の姿勢情報を受けてホルダー用ロボットアーム２４１の姿勢を、ホルダー部２４２が水平面との関係で一定となるように、制御する。 Specifically, the control device 109 of the table robot arm 103 and the control device 209 of the holder robot arm 241 are linked, and the control device 109 of the table robot arm 103 changes the posture information of the robot arm 103 to the holder robot arm 241. The control device 209 of the holder robot arm 241 receives the posture information of the robot arm 103 so that the posture of the holder robot arm 241 becomes constant, and the holder portion 242 becomes constant in relation to the horizontal plane. To control.
　この構成によると、ホルダー２４２は、テーブル１０に対する水平回転移動、水平回転移動、及び、平行移動が可能である。よって、ホルダー２４２に保持される麻酔器４や輸液ポンプ６の平行状態も保つことができる。 According to this configuration, the holder 242 is capable of horizontal rotation movement, horizontal rotation movement, and parallel movement with respect to the table 10. Therefore, the parallel state of the anesthesia machine 4 and the infusion pump 6 held by the holder 242 can be maintained.
　また、上記のようなロボティックホルダーを導入する場合、ホルダー用ロボットアーム２４１を遠隔操作可能な操作部材を用いて操作できるようにしておくことが望ましい。 In addition, when the robotic holder as described above is introduced, it is desirable that the holder robot arm 241 can be operated using an operation member that can be remotely operated.
　このような操作部材として、図１０（Ａ）に示す操作部材７１を例示することができる。操作部材７１は、ジョイスティックであり、操作者（術者、麻酔医、助手、看護師等）が手で把持するためのスティック７１１を有している。スティック７１１を操作者が傾けることで、傾けた方向にホルダー用ロボットアーム２４１の先端が変位する。また、スティック７１１には、ホルダー用ロボットアーム２４１の先端を上下に変位させるための上昇・降下ボタン７１２が備えられていてもよい。操作者が操作部材７１を操作することで、ホルダー用ロボットアーム２４１の先端は、当該操作に応じた方向に変位する。 As such an operation member, an operation member 71 shown in FIG. 10A can be exemplified. The operation member 71 is a joystick, and has a stick 711 for an operator (operator, anesthesiologist, assistant, nurse, etc.) to grasp by hand. When the operator tilts the stick 711, the tip of the holder robot arm 241 is displaced in the tilted direction. Further, the stick 711 may be provided with an up / down button 712 for displacing the tip of the holder robot arm 241 up and down. When the operator operates the operation member 71, the tip of the holder robot arm 241 is displaced in a direction corresponding to the operation.
　また、操作部材として、図１０（Ｂ）に示す操作部材７２が用いられてもよい。操作部材７２は、ボタン装置であり、処置者が手で押し操作するための複数のボタンを有している。このボタンとして、例えば、ホルダー用ロボットアーム２４１の先端を特定の平面上で変位させるための前後左右ボタン７２１が備えられている。なお、ホルダー用ロボットアーム２４１の先端を上記の平面に対して鉛直な方向に変位させるための上昇・降下ボタン７２２が設けられてもよい。 Further, an operation member 72 shown in FIG. 10B may be used as the operation member. The operation member 72 is a button device, and has a plurality of buttons for a treatment person to push and operate by hand. As this button, for example, a front / rear left / right button 721 for displacing the tip of the holder robot arm 241 on a specific plane is provided. An up / down button 722 for displacing the tip of the holder robot arm 241 in a direction perpendicular to the plane may be provided.
　また、操作部材として、図１０（Ｃ）に示す操作部材７３が用いられてもよい。操作部材７３は、フットペダル装置であり、操作者が足で操作するための複数のペダルを有している。このペダルとして、例えば、ホルダー用ロボットアーム２４１の先端を特定の平面上で変位させるための前後左右ペダル７３１が備えられている。なお、ホルダー用ロボットアーム２４１の先端を上記の平面に対して鉛直な方向に変位させるための上昇・降下ペダル７３２が設けられてもよい。 Further, an operation member 73 shown in FIG. 10C may be used as the operation member. The operation member 73 is a foot pedal device, and has a plurality of pedals for an operator to operate with his / her foot. As this pedal, for example, a front / rear left / right pedal 731 for displacing the tip of the holder robot arm 241 on a specific plane is provided. An ascending / descending pedal 732 for displacing the tip of the holder robot arm 241 in a direction perpendicular to the plane may be provided.
　上記の操作部材７１～７３の何れかは、図４１（Ｄ）に示すように、ホルダー用ロボットアーム２４１の制御装置２４９に、有線又は無線によって接続される。なお、操作部材７１～７３は、２種類又は３種類が組み合わせて用いられてもよい。
（第１構成例の第３変形例） Any one of the operation members 71 to 73 is connected to the control device 249 of the holder robot arm 241 by wire or wirelessly as shown in FIG. The operation members 71 to 73 may be used in combination of two types or three types.
(Third Modification of First Configuration Example)
　図２を参照して、本変形例においては、医療用流体注入機器ホルダーユニット１１は各関節（上記例の場合は１８ａ及び１８ｂ）に電磁ブレーキを備え、また電磁ブレーキをＯＮ及びＯＦＦに切り替えるための作動子として、手動操作トリガーボタン３１０１を備える。 With reference to FIG. 2, in this modification, the medical fluid injection device holder unit 11 is provided with an electromagnetic brake at each joint (in the above example, 18a and 18b), and for switching the electromagnetic brake to ON and OFF. As an actuator, a manual operation trigger button 3101 is provided.
　各ジョイントの電磁ブレーキは、ジョイント１８ａ及び１８ｂをそれぞれロック状態にするように構成されている。電磁ブレーキは、通電されていない場合に、回転軸において対応するリンクを押圧することでジョイントの動作を妨げロック状態とする。また、電磁ブレーキは、通電されている場合に、電磁石のコイルに磁力が生じ上記押圧しているブレーキを引き離して関節のロック状態を解除する。 The electromagnetic brake of each joint is configured to lock the joints 18a and 18b. When the electromagnetic brake is not energized, the operation of the joint is prevented by pressing the corresponding link on the rotating shaft to be in a locked state. Further, when the electromagnetic brake is energized, a magnetic force is generated in the coil of the electromagnet, and the brake being pressed is released to release the joint lock state.
　トリガーボタン３１０１は、押下されることにより、対応する電磁ブレーキに通電されて、ロック状態が解除される。これにより、操作者がトリガーボタン３１０１を押下している間は、関節が自由になり、ホルダー１５の位置を操作者の所望の位置に動かすことができる。 When the trigger button 3101 is pressed, the corresponding electromagnetic brake is energized and the locked state is released. As a result, while the operator presses the trigger button 3101, the joint becomes free and the position of the holder 15 can be moved to a position desired by the operator.
　なお、上記作動子の形状はボタンに限定されず、レバースイッチやスライドスイッチなどであってもよい。 The shape of the actuator is not limited to a button, and may be a lever switch or a slide switch.
（第１構成例の第４変形例）
　上記では、医療用流体注入機器ホルダーユニット１１、１３のベースがテーブル１０に固定される形態を主に説明した。しかしながら、この通りでなくてもよい。テーブル１０に取り付けられる医療用流体注入機器ホルダーユニット１１、１３のベースは、図１１に示すように、テーブル１０とは別体に形成され、テーブル１０に対する取付位置が変更可能に構成されていてもよい。 (Fourth modification of the first configuration example)
In the above description, the configuration in which the bases of the medical fluid injection device holder units 11 and 13 are fixed to the table 10 has been mainly described. However, this need not be the case. As shown in FIG. 11, the bases of the medical fluid injection device holder units 11 and 13 attached to the table 10 are formed separately from the table 10, and the attachment position with respect to the table 10 can be changed. Good.
　図１１（Ａ）は、本変形例の主要部の構成を示す斜視図である。一例として図１１（Ａ）に示す医療用流体注入機器ホルダーユニット２０１（上記例では１１又は１３）は、アタッチメント装置４００を用いてテーブル１０の長手方向一端部に取り付けられている。 FIG. 11A is a perspective view showing the configuration of the main part of this modification. As an example, a medical fluid injection device holder unit 201 (11 or 13 in the above example) shown in FIG. 11A is attached to one end in the longitudinal direction of the table 10 using the attachment device 400.
　アタッチメント装置４００は、テーブル１０の側面に固定されたアタッチメントベース４０１と、このアタッチメントベース４０１に対してテーブル１０の前後方向の位置を変更可能に取り付けられるスライダ４０２と、スライダ４０２に取り付けられた位置センサ４０３と、を有している。 The attachment device 400 includes an attachment base 401 fixed to the side surface of the table 10, a slider 402 that can be attached to the attachment base 401 so that the position of the table 10 in the front-rear direction can be changed, and a position sensor attached to the slider 402. 403.
　アタッチメントベース４０１は、テーブル１０の前後方向に沿って延びており、例えば、突起状のレールを形成している。スライダ４０２は、このアタッチメントベース４０１のレールに嵌合される溝部を有する形状に形成されており、アタッチメントベース４０１上をテーブル１０の長手方向にスライド可能である。また、スライダ４０２には、固定ネジなどの固定部材４０４がねじ結合している。そして、固定部材４０４が締められる方向に回転されると、スライダ４０２と固定部材４０４とがアタッチメントベース４０１を強固に挟む。これにより、スライダ４０２が固定される。スライダ４０２には、医療用流体注入機器ホルダーユニット２０１のベース２１３が固定されており、このスライダ４０２とともに、医療用流体注入機器ホルダーユニット２０１のベース２１３がテーブル１０の長手方向に変位する。位置センサ４０３は、例えば、赤外線センサ、ロータリーエンコーダなどのセンサであり、テーブル１０の前端からスライダ４０２までの距離を測定することが可能に構成されている。位置センサ４０３の位置検出結果は、医療用流体注入機器ホルダーユニット２０１の制御装置２１９（図９の２４９に相当）に出力される。 The attachment base 401 extends along the front-rear direction of the table 10 and forms, for example, a protruding rail. The slider 402 is formed in a shape having a groove fitted to the rail of the attachment base 401, and can slide on the attachment base 401 in the longitudinal direction of the table 10. A fixing member 404 such as a fixing screw is screwed to the slider 402. When the fixing member 404 is rotated in the tightening direction, the slider 402 and the fixing member 404 firmly sandwich the attachment base 401. Thereby, the slider 402 is fixed. The base 213 of the medical fluid injection device holder unit 201 is fixed to the slider 402, and the base 213 of the medical fluid injection device holder unit 201 is displaced in the longitudinal direction of the table 10 together with the slider 402. The position sensor 403 is, for example, a sensor such as an infrared sensor or a rotary encoder, and is configured to be able to measure the distance from the front end of the table 10 to the slider 402. The position detection result of the position sensor 403 is output to the control device 219 (corresponding to 249 in FIG. 9) of the medical fluid injection device holder unit 201.
　医療用流体注入機器ホルダーユニット２０１の制御装置２１９は、位置センサ４０３が検出した、テーブル１０に対するベース２１３の取付位置情報を取得するとともに記憶する。そして、制御装置２１９は、この取付位置情報を用いて医療機器ホルダー用ロボットアーム２０１の駆動を制御する。一例として、制御装置２１９は、テーブル１０の１つの隅部と、スライダ４０２の取付位置のとの距離を計測することにより、上記の取付位置を算出する。 The control device 219 of the medical fluid injection device holder unit 201 acquires and stores the mounting position information of the base 213 with respect to the table 10 detected by the position sensor 403. And the control apparatus 219 controls the drive of the robot arm 201 for medical device holders using this attachment position information. As an example, the control device 219 calculates the mounting position by measuring the distance between one corner of the table 10 and the mounting position of the slider 402.
　なお、図１１（Ｂ）に示すように、テーブル１０に固定されたＵ字状のレール４１１を取っ手付きねじ４１４との協働によってクランプするスライダ４１２が、スライダ４０２に代えて用いられてもよい。
（第１構成例の第５変形例） As shown in FIG. 11B, a slider 412 that clamps a U-shaped rail 411 fixed to the table 10 by cooperation with a screw 414 with a handle may be used instead of the slider 402. .
(Fifth modification of the first configuration example)
　図１２は、患者の載置位置が麻酔導入位置とは異なり、手術位置と同じである場合において、テーブル１０を第１の位置にある載置位置から第３の位置にある麻酔導入位置に移動する様子を示している。 FIG. 12 shows that the table 10 is moved from the placement position at the first position to the anesthesia introduction position at the third position when the placement position of the patient is different from the anesthetic introduction position and is the same as the operation position. It shows how to do.
　第１の位置においてテーブル１０上に患者が載置された後、第２、第３、及び第６ジョイント１０６２、１０６３、１０６６が回動して（場合によっては、第１ジョイント１０６１によってテーブル高さが調節され、また第４及び／又は第５ジョイント１０６４、１０６５によってテーブル１０の長手方向及／又は幅方向まわりの傾きが調節され）テーブル１０は図１２の矢印の如く動いて患者の頭部がＭＲＩ装置４１４と反対方向を向き、５ガウスラインより十分離れた位置まで移動する。図１２に示す麻酔位置（第３の位置）においては、テーブル１０を鉛直方向上側から見下ろした場合に、ベース１０及び可動要素１０のうちベース１０４に直接連結される端部とは反対側の端部がテーブル１０の下に隠れていない。そして、テーブル１０の下に隠れないロボットアーム１０３の最大寸法は、テーブルの長手方向の寸法の１／４以上となっている。なお、載置位置が麻酔導入位置と同じである場合、この移動工程は省略される。 After the patient is placed on the table 10 in the first position, the second, third, and sixth joints 1062, 1063, 1066 are rotated (in some cases, the table height by the first joint 1061). And the inclination of the table 10 in the longitudinal direction and / or the width direction is adjusted by the fourth and / or fifth joints 1064 and 1065). The table 10 moves as indicated by the arrow in FIG. It faces in the opposite direction to the MRI apparatus 414 and moves to a position sufficiently away from the 5 Gauss line. In the anesthesia position (third position) shown in FIG. 12, when the table 10 is looked down from the upper side in the vertical direction, the end of the base 10 and the movable element 10 opposite to the end directly connected to the base 104. The part is not hidden under the table 10. The maximum dimension of the robot arm 103 that is not hidden under the table 10 is ¼ or more of the dimension in the longitudinal direction of the table. If the placement position is the same as the anesthesia introduction position, this moving step is omitted.
　そして、麻酔医４１５は患者に対して麻酔処置を行う。麻酔処置が完了すると、制御装置１０の制御により各可動要素が動作してテーブル１０を図１２に示される矢印とは逆方向に動かし、第１の位置である手術位置へと移動する。そして、術者４１２は術前にＭＲＩ装置によって撮影した画像情報を元に患者に対して手術を施し、例えば脳腫瘍を摘出した時点で、上述したようにテーブル１０を第２の位置である撮影位置へと移動させ、患部（例えば脳）のＭＲＩ撮影を行い、再びテーブル１０を第１の位置にある手術位置に戻して、例えば残存腫瘍が認められた場合には、引き続き術者４１２による手術が継続される。 And the anesthesiologist 415 performs anesthesia treatment for the patient. When the anesthesia treatment is completed, each movable element is operated by the control of the control device 10 to move the table 10 in the direction opposite to the arrow shown in FIG. 12 and move to the surgical position which is the first position. Then, the operator 412 performs an operation on the patient based on the image information imaged by the MRI apparatus before the operation, and, for example, when the brain tumor is extracted, the table 10 is set to the imaging position which is the second position as described above. And the MRI image of the affected area (for example, the brain) is taken, and the table 10 is returned to the operation position at the first position again. For example, when a residual tumor is observed, the operation by the operator 412 is continued. Will continue.
　第３の位置である麻酔導入位置は、テーブル１０が第１の位置である手術位置にある場合において、テーブル幅方向（長手方向に直交する方向）に関して、ＭＲＩ装置とは反対側に設置することが好ましい。これは、不潔扱いとなる麻酔医４１５が清潔エリアである手術位置及び撮影位置から遠い別の位置で麻酔導入を行うことができるので、脳腫瘍摘出手術など患者の上半身側の手術を行う場合には有利であるためである。 The anesthesia introduction position, which is the third position, should be installed on the opposite side of the MRI apparatus in the table width direction (direction perpendicular to the longitudinal direction) when the table 10 is in the surgical position, which is the first position. Is preferred. This is because the anesthesiologist 415, who is treated as unclean, can introduce anesthesia at a surgical position that is a clean area and at a position far from the imaging position, so when performing surgery on the upper body side of the patient, such as brain tumor removal surgery. This is because it is advantageous.
　上記変形例の手術工程においても、医療用流体注入機器ホルダーユニット１１はテーブル１０に固定されたままであるので、患者Ｋに接続されているチューブを、テーブル１０の動作範囲を考慮して長くとる必要がなく、また、患者Ｋに接続されているチューブ４ｆ，４ｇがテーブル１０が動くことによってロボットアーム１０３などに絡まる危険性を低減することができる。
（第１構成例の第６変形例） Even in the surgical process of the above modification, the medical fluid injection device holder unit 11 remains fixed to the table 10, so that the tube connected to the patient K needs to be long considering the operating range of the table 10. In addition, the risk of the tubes 4f and 4g connected to the patient K becoming entangled with the robot arm 103 and the like when the table 10 moves can be reduced.
(Sixth Modification of First Configuration Example)
　図１を参照して、上記説明した医療用流体注入機器ホルダーユニット１１（及び１３）は、患者と医療用流体注入機器とを繋いでいるチューブの経路３１１１を形成していることが好ましい。例えば、可動要素１７ｂが円筒形である場合に、曲面部分の一部が取り外し可能な着脱カバーに形成され、この着脱カバーを取り外してチューブを円筒形の可動要素１７ｂ内を這わせることができる。 Referring to FIG. 1, the above-described medical fluid injection device holder unit 11 (and 13) preferably forms a tube path 3111 connecting the patient and the medical fluid injection device. For example, when the movable element 17b is cylindrical, a part of the curved surface portion is formed on a removable cover that can be removed, and the removable cover can be removed so that the tube can be put inside the cylindrical movable element 17b.
　さらに、テーブル１０にも、上記チューブ４ｆ，４ｇを固定する固定具３１２１を設けておくことが好ましい。 Furthermore, it is preferable that the table 10 is also provided with a fixture 3121 for fixing the tubes 4f and 4g.
　これらにより、手術工程においてテーブル１０がどのように移動したとしても、チューブ４ｆ，４ｇの絡まりを最小限にすることができる。 Thus, no matter how the table 10 moves in the surgical process, the entanglement of the tubes 4f and 4g can be minimized.
　上記説明した変形例は、任意に選択及び組み合わせをして各構成例に付加することができることに留意すべきである。 It should be noted that the modifications described above can be arbitrarily selected and combined and added to each configuration example.
　例えば、ホルダー１５の支持装置１４にロボットアームを採用して、各関節のブレーキを解除するトリガーボタンを設けることができる。ロボットアームのように、各関節にモーター（アクチュエータ）が設けられている場合でも手動によりアームを動かすことが可能であり、この場合は手動での動きに合わせてモーターも動き、同時に位置検出器で位置が記憶されることになる。電動で動かす場合には、記憶された位置情報を基に、指示信号に従った位置に移動することになる。 For example, a robot arm can be adopted as the support device 14 of the holder 15 and a trigger button for releasing the brake of each joint can be provided. Even if a motor (actuator) is provided for each joint, such as a robot arm, it is possible to manually move the arm. In this case, the motor also moves according to the manual movement, and at the same time with the position detector The position will be stored. When it is moved electrically, it moves to a position according to the instruction signal based on the stored position information.
　また、何れの変形例においても、医療用流体注入機器ホルダーユニットを複数設けてもよいし、ホルダーの支持装置を手動操作専用のものとロボットアームにより駆動するものの両方を用いてもよし、手術工程において麻酔導入位置を設けていてもよい。 Further, in any of the modifications, a plurality of medical fluid injection device holder units may be provided, or both the holder support device dedicated to manual operation and the one driven by a robot arm may be used. An anesthetic introduction position may be provided.
　さらに、変形例で示した特徴が単独で新規性を有する場合には、各構成例との組み合わせによらず、単独で発明が成立することにも留意すべきである。 Furthermore, it should be noted that when the features shown in the modification examples are novel independently, the invention is established independently regardless of the combination with each configuration example.
　例えば、ホルダー１５を支持する支持装置１４の関節に電磁ブレーキを備え、各関節のロック状態をトリガーボタンで解除して手動操作できる構成について、ホルダー１５が保持する機器としては、医療用流体注入機器に関わらず、医療用モニタやジェネレータなど広範な医療機器が対象となる。
（第２構成例） For example, regarding a configuration in which the joint of the support device 14 that supports the holder 15 is provided with an electromagnetic brake, and the lock state of each joint can be released manually with a trigger button, the device that the holder 15 holds is a medical fluid injection device. Regardless, it covers a wide range of medical devices such as medical monitors and generators.
(Second configuration example)
　図１３に第２構成例に係るロボット手術台の側面図を示す。本構成例に係るロボット手術台に用いられるロボットアーム２９０１は、多自由度（３自由度以上）を有し、その先端で載置対象物が載置されるテーブル２９０８を支持する。テーブル２９０８及びロボットアーム２９０１は、ロボット手術台を構成する。 FIG. 13 shows a side view of the robot operating table according to the second configuration example. The robot arm 2901 used in the robot operating table according to this configuration example has multiple degrees of freedom (3 degrees of freedom or more), and supports the table 2908 on which the placement target is placed at the tip. The table 2908 and the robot arm 2901 constitute a robot operating table.
　ロボットアーム２９０１は、ベース２９２１と、複数の可動要素（本構成例では、第１～第３可動要素２９２２～２９２４）と、複数のジョイント（本構成例では、第１～第５ジョイント２９３１～２９３５）を含む。 The robot arm 2901 includes a base 2921, a plurality of movable elements (first to third movable elements 2922 to 2924 in the present configuration example), and a plurality of joints (first to fifth joints 2931 to 2935 in the present configuration example). )including.
　ベース２９２１と第１可動要素２９２２の一端部は鉛直直進ジョイントである第１ジョイント２９３１によって連結されており、第１可動要素２９２２は第１軸方向（鉛直方向）に移動することができる。第１可動要素２９２２の他端部と第２可動要素２９２３の一端部は水平回転ジョイントで連結されており、第２軸（鉛直方向）まわりに第２可動要素２９２３が回転することができる。第２可動要素２９２３と第３可動要素２９２４の間の第３～第５ジョイント２９３３～２９３５は、それぞれ、第３～第５軸回りの回転ジョイントである。第３軸は第２可動要素２９２３の延びる方向であり、第４軸は第３ジョイント２９３３によって回転される、第３軸と直交する方向であり、第５軸は、第４ジョイント２９３４によって回転される、第４軸と直交する方向である。 One end of the base 2921 and the first movable element 2922 are connected by a first joint 2931 that is a vertical rectilinear joint, and the first movable element 2922 can move in the first axial direction (vertical direction). The other end of the first movable element 2922 and one end of the second movable element 2923 are connected by a horizontal rotary joint, and the second movable element 2923 can rotate around the second axis (vertical direction). Third to fifth joints 2933 to 2935 between the second movable element 2923 and the third movable element 2924 are rotary joints around the third to fifth axes, respectively. The third axis is a direction in which the second movable element 2923 extends, the fourth axis is a direction orthogonal to the third axis rotated by the third joint 2933, and the fifth axis is rotated by the fourth joint 2934. The direction perpendicular to the fourth axis.
　第１可動要素２９２２と第２可動要素２９２３は特定方向に延びる棒状となっており、長さはロボットアーム２９０１の必要な可動範囲に応じて適宜設計される。そして、第１可動要素２９２２は水平面に平行な状態を維持して上下移動し、第２可動要素２９２３は第１可動要素２９２２と平行な状態を維持して第２軸まわりに回転する構成となっている。このような構成であれば、第２アクチュエータ２９４２において鉛直方向の重力補償を行う必要がないためモータを小さくすることができる。これは、ロボットアーム２９０１の小型化に有利な構成であり、限られたスペースしか確保できない医療現場に導入する場合や、治療や手術でより多くのスペースを確保するのに有利である。 The first movable element 2922 and the second movable element 2923 are rod-shaped extending in a specific direction, and the length is appropriately designed according to the necessary movable range of the robot arm 2901. The first movable element 2922 is moved up and down while maintaining a state parallel to the horizontal plane, and the second movable element 2923 is rotated around the second axis while maintaining a state parallel to the first movable element 2922. ing. With such a configuration, it is not necessary to perform gravity compensation in the vertical direction in the second actuator 2942, and the motor can be made small. This is an advantageous configuration for reducing the size of the robot arm 2901, and is advantageous for introduction to a medical site where only a limited space can be secured or for securing more space for treatment or surgery.
　第３可動要素２９２４は、ロボットアーム２９０１の先端に位置している。本構成例では、ロボットアーム２９０１の先端が、テーブル２９０８のスライド機構２９０９に連結されている。 The third movable element 2924 is located at the tip of the robot arm 2901. In this configuration example, the tip of the robot arm 2901 is connected to the slide mechanism 2909 of the table 2908.
　ロボットアーム２９０１は、第１～第５ジョイント２９３１～２９３５及びスライド機構２９０９に対応して、第１～第３可動要素２９２２～２９２４及びスライド機構２９０９を移動又は回転させる複数のアクチュエータ（本構成例では、第１～第５アクチュエータ２９４１～２９４５及びスライド機構用アクチュエータ２９４９）と、それぞれのジョイントに組み込まれそれぞれの可動要素の位置を検出する複数の位置検出器（本構成例では第１～第５位置検出器２９５１～２９５５及びスライド機構用位置検出器２９５９）と、それぞれのアクチュエータの駆動を制御する制御装置２９０７を含む。制御装置２９０７はベース２９２１内に位置しているが、例えば外部の独立した装置としてもよい。 The robot arm 2901 corresponds to the first to fifth joints 2931 to 2935 and the slide mechanism 2909, and includes a plurality of actuators (in this configuration example) that move or rotate the first to third movable elements 2922 to 2924 and the slide mechanism 2909. , First to fifth actuators 2941 to 2945 and slide mechanism actuator 2949) and a plurality of position detectors (first to fifth positions in the present configuration example) for detecting the positions of the respective movable elements. Detectors 2951 to 2955 and a slide mechanism position detector 2959), and a control device 2907 for controlling the driving of each actuator. The control device 2907 is located in the base 2921, but may be an external independent device, for example.
　第１～第５アクチュエータ２９４１～２９４５及びスライド機構用アクチュエータ２９４９は、例えばサーボモータである。位置検出器としては第１～第４の構成例と同様、エンコーダやレゾルバ、ポテンショメータを用いることができる。 The first to fifth actuators 2941 to 2945 and the slide mechanism actuator 2949 are, for example, servo motors. As the position detector, an encoder, a resolver, and a potentiometer can be used as in the first to fourth configuration examples.
　ロボットアーム２９０１はまた、第１～第５ジョイント２９３１～２９３５及びスライド機構２９０９に対応して、それぞれ、第１～第５電磁ブレーキ２９６１～２９６５及びスライド機構用電磁ブレーキ２９６９を含むことが望ましい。電磁ブレーキを備えていない場合は、複数のアクチュエータ２９４１～２９４５及びスライド機構用アクチュエータ２９４９の駆動によりロボットアーム２９０１の姿勢を一定に保つことになるが、電磁ブレーキを含んでいると、ある部分のアクチュエータの駆動をオフにしても電磁ブレーキ機能をオンとすることにより、ロボットアーム２９０１の姿勢を一定に保つことができる。 The robot arm 2901 also preferably includes first to fifth electromagnetic brakes 2961 to 2965 and a slide mechanism electromagnetic brake 2969 corresponding to the first to fifth joints 2931 to 2935 and the slide mechanism 2909, respectively. When the electromagnetic brake is not provided, the posture of the robot arm 2901 is kept constant by driving the plurality of actuators 2941 to 2945 and the slide mechanism actuator 2949. Even if the drive of is turned off, by turning on the electromagnetic brake function, the posture of the robot arm 2901 can be kept constant.
　電磁ブレーキが設けられる場合の第１～第５電磁ブレーキ２９６１～２９６５それぞれは、アクチュエータ２９４１～２９４５へ駆動電流が供給されないときにブレーキ機能をオンにし、アクチュエータ２９４１～２９４５へ駆動電流が供給されたときにブレーキ機能をオフにするように構成されている。 When the electromagnetic brake is provided, the first to fifth electromagnetic brakes 2961 to 2965 are turned on when the drive current is not supplied to the actuators 2941 to 2945, and when the drive current is supplied to the actuators 2941 to 2945, respectively. It is configured to turn off the brake function.
　図１４（Ａ）に示すように、スライド機構２９０９は、テーブル１０を水平面に平行な状態を維持してテーブル１０を移動させるように構成されている。スライド機構２９０９は、ロボットアーム２９０１の何れかに支持されるテーブルベース１１５６と、スライド部材１１５９と、を有している。 As shown in FIG. 14A, the slide mechanism 2909 is configured to move the table 10 while maintaining the table 10 parallel to the horizontal plane. The slide mechanism 2909 has a table base 1156 supported by any one of the robot arms 2901 and a slide member 1159.
　図１４（Ｂ）に示すように、テーブルベース１１５６は、ロボットアーム２９０１に支持され、制御装置２９０７によって制御される一対のアクチュエータ１１６１，１１６２と、一対のアクチュエータ１１６１，１１６２によって回転駆動する一対のピニオン１１６３，１１６４と、を有している。各アクチュエータ１１６１，１１６２は、例えば、サーボモータである。スライド部材１１５９は、平板状部分の下面に形成された窪みの左右一対の側面に一対のラック１１６５，１１６６が形成された構成を有している。 As shown in FIG. 14B, the table base 1156 is supported by a robot arm 2901 and controlled by a control device 2907, and a pair of pinions that are rotationally driven by the pair of actuators 1161 and 1162. 1163 and 1164. Each actuator 1161, 1162 is, for example, a servo motor. The slide member 1159 has a configuration in which a pair of racks 1165 and 1166 are formed on a pair of left and right side surfaces of a recess formed in the lower surface of the flat plate-like portion.
　一対のラック１１６５，１１６６に一対のピニオン１１６３，１１６４が噛み合っている。スライド部材１１５９の上面にテーブル２９０８が固定されている。この構成では、ラック１１６５，１１６６とピニオン１１６３，１１６４との噛み合い動作により、スライド部材１１５９及びテーブル２９０８がスライドする。 A pair of pinions 1163 and 1164 are engaged with the pair of racks 1165 and 1166. A table 2908 is fixed to the upper surface of the slide member 1159. In this configuration, the slide member 1159 and the table 2908 slide by the meshing operation of the racks 1165 and 1166 and the pinions 1163 and 1164.
　以上のように、スライド機構を設けると、ロボットアームのサイズを小型化できるというメリットがある。 As described above, the provision of the slide mechanism has the advantage that the size of the robot arm can be reduced.
　なお、ここで紹介した例ではロボットアームの先端がテーブルの端部を支持しているが、ロボットアームの先端がテーブルの中央部を支持している構成において手動スライド機構を採用してもよい。また、アクチュエータ駆動のスライド機構２９０９が嵌まり込むテーブル２９０８の溝２９８３の長さを中央部分だけに制限してもよく、この場合はスライド幅が短くなるが、スライド幅が大きい場合と比べて、テーブル２９０８の撓みは発生しにくくなる。 In the example introduced here, the tip of the robot arm supports the end of the table, but a manual slide mechanism may be employed in a configuration in which the tip of the robot arm supports the center of the table. Further, the length of the groove 2983 of the table 2908 into which the actuator-driven slide mechanism 2909 is fitted may be limited to only the central portion. In this case, the slide width is shortened, but compared to the case where the slide width is large, The table 2908 is less likely to be bent.
　また、上記スライド機構はラックアンドピニオンではなく、ボールネジなど他の構成を採用してもよい。 In addition, the slide mechanism may adopt other configurations such as a ball screw instead of the rack and pinion.
　図１５に、本構成例を術中ＭＲＩに適用した場合のロボット手術台の動きを斜視図を用いて示す。図１５はテーブル２９０８が第１の位置である患者の載置位置及び手術位置にあり、第２の可動要素２９２３が第２軸まわりに水平回転し、同時にテーブル２９０８が第５軸まわりに軸回転して（場合によっては第１ジョイント２９３１によってテーブル２９０８の高さが調節され、また第３及び／又は第４ジョイント２９３３，２９３４により長手方向及び／又は幅方向まわりの傾きが調整され）、図１６に示すＭＲＩ撮影準備位置に移動する。そして、テーブル２９０８がアクチュエータ駆動によりＭＲＩ装置の撮影空間とオーバーラップする位置までスライドし、テーブル２９０８が第２の位置であるＭＲＩ撮影位置へと移動する（図１７）。 FIG. 15 is a perspective view showing the movement of the robot operating table when this configuration example is applied to intraoperative MRI. FIG. 15 shows that the table 2908 is in the patient placement position and the operation position, which is the first position, the second movable element 2923 rotates horizontally around the second axis, and the table 2908 rotates around the fifth axis at the same time. (In some cases, the height of the table 2908 is adjusted by the first joint 2931 and the inclination in the longitudinal direction and / or the width direction is adjusted by the third and / or fourth joints 2933 and 2934), and FIG. To the MRI imaging preparation position shown in FIG. Then, the table 2908 slides to a position where it overlaps with the imaging space of the MRI apparatus by driving the actuator, and the table 2908 moves to the MRI imaging position which is the second position (FIG. 17).
　本構成例に係るロボット手術台を用いた場合、スライド機構が設けられているので、テーブルの可動範囲を大きくとるために第１可動要素や第２可動要素を長くする必要がなくなるのでロボットアームのサイズを小型化できるというメリットがある。 When the robot operating table according to this configuration example is used, since the slide mechanism is provided, it is not necessary to lengthen the first movable element and the second movable element in order to increase the movable range of the table. There is an advantage that the size can be reduced.
　なお、図１６で示したＭＲＩ撮影準備位置とは、テーブル２９０８が撮影空間とオーバーラップしておらず、撮影位置に近接する位置（例えば、撮影空間との距離が１０ｃｍ～４０ｃｍ）でテーブル２９０８の特定方向（長手方向）がＭＲＩ装置４１４の開口部への方向を向く位置であり、撮影位置におけるテーブルの特定方向（長手方向）と平行である位置である。オープン型のＭＲＩだと開口は広いので開口部の方向は複数あるが、ドーナツ型のＭＲＩ装置であると、開口部を向く方向はほぼ一意に決まる。この撮影準備位置において一旦移動を止め、例えば助手がＭＲＩ撮影のための準備（金属物がないことの確認や患者の位置・姿勢の修正）をし、その後ＭＲＩ装置にテーブル２９０８を搬送するようにしてもよい。もちろん、ＭＲＩ撮影準備位置は単なる経由位置で、テーブル２９０８をこの位置で一旦止めることなくスムーズにＭＲＩ撮影位置に移動させるようにしてもよい。
（第３構成例） Note that the MRI imaging preparation position shown in FIG. 16 is the position where the table 2908 does not overlap the imaging space and is close to the imaging position (for example, the distance from the imaging space is 10 cm to 40 cm). The specific direction (longitudinal direction) is a position facing the direction toward the opening of the MRI apparatus 414, and is a position parallel to the specific direction (longitudinal direction) of the table at the imaging position. In the case of an open type MRI, since the opening is wide, there are a plurality of directions of the opening, but in the case of a donut type MRI apparatus, the direction facing the opening is almost uniquely determined. The movement is temporarily stopped at this imaging preparation position, for example, an assistant prepares for MRI imaging (confirms that there is no metal object and corrects the position / posture of the patient), and then transports the table 2908 to the MRI apparatus. May be. Of course, the MRI imaging preparation position is merely a via position, and the table 2908 may be smoothly moved to the MRI imaging position without stopping at this position.
(Third configuration example)
　次に、第３の構成例に係るロボット手術台の側面図を図１８に示す。ロボット手術台に用いられるロボットアーム２００１は、多自由度（３自由度以上）を有し、その先端で載置対象物が載置されるテーブル２２０８を支持する。テーブル２２０８及びロボットアーム２００１は、ロボット手術台を構成する。 Next, FIG. 18 shows a side view of the robot operating table according to the third configuration example. A robot arm 2001 used for a robot operating table has multiple degrees of freedom (three degrees of freedom or more), and supports a table 2208 on which a placement target is placed at the tip thereof. The table 2208 and the robot arm 2001 constitute a robot operating table.
　図１８に示すように、ロボットアーム２００１は、ベース２０２１と、複数の可動要素（本構成例では、第１～第４可動要素２０２２～２０２６）と、複数のジョイント（本構成例では、第１～第６ジョイント２０３１～２０３６）を含む。 As shown in FIG. 18, the robot arm 2001 includes a base 2021, a plurality of movable elements (first to fourth movable elements 2022 to 2026 in the present configuration example), and a plurality of joints (first configuration in the present configuration example). To sixth joints 2031 to 2036).
　ベース２０２１と第１可動要素２０２２の一端部は水平回転ジョイントである第１ジョイント２０３１によって連結されており、第１可動要素２０２２は第１軸（鉛直方向）まわりに回転することができる。第１可動要素２０２２の他端部は少なくとも特定方向の他端部側において開口しており、該開口に第２可動要素２０２３が一端部から嵌り込んでいる。これにより、第１可動要素２０２２と第２可動要素２０２３は直進ジョイントで連結されている。よって、第２可動要素２０２３は第２軸方向（水平方向）に移動することができる。第２可動要素２０２３の他端部と第３可動要素２０２４の一端部は垂直回転ジョイントで連結されており、第３可動要素２０２４は長手方向（第３可動要素２０２４の延びる方向）と鉛直方向の両方に直交する第３軸まわりに回転することができる。なお、本構成例において、第３可動要素２０２４はパラレルリンクで構成されており、鉛直方向上側と下側に設けられた同一長さのリンクが対になって設けられている。従って、第２可動要素２０２３と第３可動要素２０２４との回転軸は鉛直方向上側と下側の２つとなる。第３可動要素２０２４の他端部と第４の可動要素２０２５の一端部は垂直回転する回転軸で連結されており、第４可動要素２０２５は長手方向（第４可動要素２０２５の延びる方向）と鉛直方向の両方に直交し第３軸と平行な第４軸まわりに回転することができる。第３可動要素２０２４がパラレルリンクで構成されているため、第３可動要素２０２４と第４可動要素２０２５との回転軸も鉛直方向上側と下側の２つとなる。第３可動要素２０２４の４つの回転軸は互いに連動して動き、例えば第３可動要素２０２４を第３軸の時計まわりに１５度回転させると、第４可動要素２０２５は第３可動要素と接続する２つの回転軸で反時計回りに１５度回転するように機構的に連動して動作し、第４可動要素２０２５全体が水平面と平行な状態を維持したまま鉛直方向に上下移動する。第４可動要素２０２５と第５可動要素２０２６の間の第４～第６ジョイント２０３４～２０３６は、それぞれ、第４～第６軸回りの回転ジョイントである。第４軸は第５可動要素２０２６の延びる方向であり、第５軸は第４ジョイント２０３４によって回転される、第４軸と直交する方向であり、第６軸は、第５ジョイント２０３５によって回転される、第５軸と直交する方向である。 One end of the base 2021 and the first movable element 2022 is connected by a first joint 2031 which is a horizontal rotary joint, and the first movable element 2022 can rotate around a first axis (vertical direction). The other end of the first movable element 2022 is open at least on the other end side in the specific direction, and the second movable element 2023 is fitted into the opening from one end. Thereby, the 1st movable element 2022 and the 2nd movable element 2023 are connected by the rectilinear joint. Therefore, the second movable element 2023 can move in the second axial direction (horizontal direction). The other end of the second movable element 2023 and one end of the third movable element 2024 are connected by a vertical rotary joint, and the third movable element 2024 has a longitudinal direction (a direction in which the third movable element 2024 extends) and a vertical direction. It can rotate around a third axis that is orthogonal to both. In this configuration example, the third movable element 2024 is configured by a parallel link, and links having the same length provided on the upper side and the lower side in the vertical direction are provided in pairs. Therefore, the rotation axis of the second movable element 2023 and the third movable element 2024 is two on the upper side and the lower side in the vertical direction. The other end of the third movable element 2024 and one end of the fourth movable element 2025 are connected by a rotating shaft that rotates vertically, and the fourth movable element 2025 is in the longitudinal direction (the direction in which the fourth movable element 2025 extends). It can rotate around a fourth axis that is perpendicular to both of the vertical directions and parallel to the third axis. Since the third movable element 2024 is configured by a parallel link, the rotation axes of the third movable element 2024 and the fourth movable element 2025 are also two on the upper side and the lower side in the vertical direction. The four rotation axes of the third movable element 2024 move in conjunction with each other. For example, when the third movable element 2024 is rotated 15 degrees clockwise around the third axis, the fourth movable element 2025 is connected to the third movable element. The four movable elements 2025 move up and down in the vertical direction while maintaining the state parallel to the horizontal plane, and operate in conjunction with each other so as to rotate 15 degrees counterclockwise around the two rotation axes. The fourth to sixth joints 2034 to 2036 between the fourth movable element 2025 and the fifth movable element 2026 are rotary joints around the fourth to sixth axes, respectively. The fourth axis is a direction in which the fifth movable element 2026 extends, the fifth axis is a direction orthogonal to the fourth axis rotated by the fourth joint 2034, and the sixth axis is rotated by the fifth joint 2035. The direction is perpendicular to the fifth axis.
　第１可動要素２０２２～第４可動要素２０２６は特定方向に延びる棒状となっており、これらの可動要素の長さはロボットアーム２００１の必要な可動範囲及びテーブル２２０８を鉛直方向に移動させる範囲に応じて適宜設計される。そして、本構成例においては、テーブル２２０８の鉛直方向上下の移動を、パラレルリンク２０２４（第３の垂直回転ジョイント２０３３）で行うため、第１及び第２の構成例のようにベース２０２１の高さを確保する必要がない。すなわち、テーブル２２０８の鉛直方向の移動幅は、ベース２０２１の鉛直方向高さではなく、第３可動要素２０２４の長さで調整することができる。このように、テーブル２２０８を高さ方向に移動させるためのパラレルリンク２０２４により連結される２つの可動要素（２０２３及び２０２５）が特定姿勢、例えばロボットアーム２００１がテーブル２２０８を鉛直方向の可動範囲において最も低くする姿勢をとった場合に、同一水平面において重なる構成をとるため、テーブル２２０８の高さをさらに低くすることができ、低い治療ポジションの確保や低い位置での載置対象の載置も可能となる。また、ベース２０２１をテーブル２２０８の下に隠れるような構成とすることにより、限られたスペースしか確保できない医療現場に導入する場合や、治療や手術でより多くのスペースを確保するのに有利である。なお、テーブル２２０８の高さの調整は、第３可動要素の長さＨで決定されるため、高さ方向の動作範囲を考慮してＨの寸法を決定する。 The first movable element 2022 to the fourth movable element 2026 are rod-shaped extending in a specific direction, and the length of these movable elements depends on the necessary movable range of the robot arm 2001 and the range in which the table 2208 is moved in the vertical direction. Are appropriately designed. In this configuration example, since the vertical movement of the table 2208 is performed by the parallel link 2024 (third vertical rotation joint 2033), the height of the base 2021 as in the first and second configuration examples. There is no need to secure. That is, the vertical movement width of the table 2208 can be adjusted not by the vertical height of the base 2021 but by the length of the third movable element 2024. As described above, the two movable elements (2023 and 2025) connected by the parallel link 2024 for moving the table 2208 in the height direction are in a specific posture, for example, the robot arm 2001 is the most in the vertical movable range of the table 2208. When the posture to be lowered is taken, the table 2208 is overlapped on the same horizontal plane, so that the height of the table 2208 can be further reduced, and it is possible to secure a low treatment position and to place a placement object at a low position. Become. In addition, the base 2021 is configured to be hidden under the table 2208, which is advantageous for introduction to a medical site where only a limited space can be secured, and for securing more space for treatment and surgery. . Since the height of the table 2208 is determined by the length H of the third movable element, the dimension of H is determined in consideration of the operating range in the height direction.
　なお、垂直回転ジョイントにより連結される２つの可動要素は、必ずしも図１８に示されるような端部同士が連結される構成をとる必要はなく、例えば可動要素の側面同士が垂直回転ジョイントにより連結されるような構成であってもよい。また、垂直回転ジョイントにより連結される可動要素を同一水平面において重なる構成は必ずしも直動ジョイントとともに用いられる必要はなく、例えば第１の構成例や第２の構成例において垂直直進ジョイントの代わりに用いてもよく、本構成例の場合に限定されない、省スペース用のロボット手術台を実現するための独立した特徴である。 Note that the two movable elements connected by the vertical rotary joint do not necessarily have a configuration in which the end portions are connected as shown in FIG. 18. For example, the side surfaces of the movable element are connected by the vertical rotary joint. Such a configuration may be used. In addition, the configuration in which the movable elements connected by the vertical rotary joint overlap in the same horizontal plane does not necessarily need to be used together with the linear motion joint. For example, in the first configuration example and the second configuration example, it is used instead of the vertical linear joint. This is an independent feature for realizing a robot operating table for space saving, which is not limited to the case of this configuration example.
　また、第１及び第２の構成例においては、ロボットアームが可動要素の端部同士が水平回転ジョイントで接続された構成であったため、鉛直方向では可動要素の重なりが生じていたが、本構成例においては、ロボットアームに水平直進ジョイントを採用しているため、この重なりを解消しており、テーブル２２０８を低い位置にするのにさらに有利な構成となっている。 Further, in the first and second configuration examples, since the robot arm has a configuration in which the end portions of the movable elements are connected to each other by the horizontal rotation joint, the movable elements overlap in the vertical direction. In the example, since the horizontal straight joint is employed for the robot arm, this overlap is eliminated, and the table 2208 is further advantageous for lowering the position.
　そして、本構成例に係るロボット手術台は、テーブル２２０８が水平な状態を保ったテーブル２２０８が水平面に平行な状態を保ったまま上下に（鉛直方向に）移動させても、またテーブル２２０８をどのように回転させても（例えば、３６０度回転させても）ロボットアーム２００１に接触しないように構成されている。よって、本構成例においては、ロボットアームがどのような任意の姿勢をとっても、テーブル２２０８が水平面に平行な状態にあることが維持されていれば、テーブル２２０８をどのように回転させても、テーブルとロボットアームとが接触することはない。 The robot operating table according to the present configuration example can move the table 2208 up and down (in the vertical direction) while keeping the table 2208 in a horizontal state in parallel with the horizontal plane. Thus, the robot arm 2001 is configured not to contact the robot arm 2001 even if it is rotated (for example, rotated 360 degrees). Therefore, in this configuration example, no matter what posture the robot arm takes, as long as the table 2208 is maintained parallel to the horizontal plane, no matter how the table 2208 is rotated, the table There is no contact between the robot arm and the robot arm.
　そして、テーブル２２０８の幅はロボットアーム２００１の各可動要素及びベースの幅よりも大きく、鉛直方向上側から見下ろした場合にベース２０２１を含むロボットアーム２００１の全体がテーブル２２０８の下に隠れることが好ましい。例えば、鉛直方向上側から見下ろした場合にテーブル２２０８の長手方向と第１及び第２可動要素２０２２・２０２３の特定方向が平行となる状態において、テーブル２２０８を鉛直方向上側から見下ろした場合に全ての可動要素及びベース２０２１がテーブル２２０８に隠れることが可能であることが望ましい。 The width of the table 2208 is larger than the width of each movable element and base of the robot arm 2001, and it is preferable that the entire robot arm 2001 including the base 2021 is hidden under the table 2208 when looking down from the upper side in the vertical direction. For example, in a state where the longitudinal direction of the table 2208 is parallel to the specific direction of the first and second movable elements 2022 and 2023 when looking down from the upper side in the vertical direction, all movements are possible when the table 2208 is looked down from the upper side in the vertical direction. It is desirable that the element and base 2021 can be hidden in the table 2208.
　なお、上記説明における「一端部」「他端部」「端部」「中央部」の定義については、第１及び第２の構成例と同様である。 The definitions of “one end”, “other end”, “end”, and “center” in the above description are the same as in the first and second configuration examples.
　ロボットアーム２００１は、第１～第６ジョイント２０３１～２０３６に対応して、第１～第５可動要素２０２２～２０２６を移動又は回転させる複数のアクチュエータ（本構成例では、第１～第６アクチュエータ２０４１～２０４６）と、それぞれのジョイントに組み込まれそれぞれの可動要素の位置を検出する複数の位置検出器（本構成例では第１～第６位置検出器２０５１～２０５６）と、それぞれのアクチュエータの駆動を制御する制御装置２００７（図１８参照）を含む。制御装置２００７は本構成例においてベース２０２１内に位置しているが、例えば外部の独立した装置としてもよい。 The robot arm 2001 includes a plurality of actuators that move or rotate the first to fifth movable elements 2022 to 2026 corresponding to the first to sixth joints 2031 to 2036 (in the present configuration example, the first to sixth actuators 2041). To 2046), a plurality of position detectors (first to sixth position detectors 2051 to 2056 in the present configuration example) incorporated in each joint and detecting the position of each movable element, and driving of each actuator. The control apparatus 2007 (refer FIG. 18) to control is included. The control device 2007 is located in the base 2021 in this configuration example, but may be an external independent device, for example.
　第１～第６アクチュエータ２０４１～２０４６は、例えばサーボモータである。位置検出器としては第１及び第２の構成例と同様、エンコーダを用いてもよいしレゾルバやポテンショメータを用いても構わない。 The first to sixth actuators 2041 to 2046 are, for example, servo motors. As the position detector, as in the first and second configuration examples, an encoder may be used, or a resolver or a potentiometer may be used.
　ロボットアーム２００１はまた、第１～第６ジョイント２０３１～２０３６に対応して、それぞれ、第１～第６電磁ブレーキ２０６１～２０６６を含むことが望ましい。電磁ブレーキを備えていない場合は、複数のアクチュエータ２０４１～２０４６の駆動によりロボットアーム２００１の姿勢を一定に保つことになるが、電磁ブレーキを含んでいると、ある部分のアクチュエータの駆動をオフにしても電磁ブレーキ機能をオンとすることにより、ロボットアーム２００１の姿勢を一定に保つことができる。 The robot arm 2001 preferably includes first to sixth electromagnetic brakes 2061 to 2066 corresponding to the first to sixth joints 2031 to 2036, respectively. When the electromagnetic brake is not provided, the posture of the robot arm 2001 is kept constant by driving the plurality of actuators 2041 to 2046. However, if the electromagnetic brake is included, the driving of the actuator of a certain part is turned off. Also, by turning on the electromagnetic brake function, the posture of the robot arm 2001 can be kept constant.
　電磁ブレーキが設けられる場合の第１～第６電磁ブレーキ２０６１～２０６６それぞれは、アクチュエータへ駆動電流が供給されないときにブレーキ機能をオンにし、アクチュエータへ駆動電流が供給されたときにブレーキ機能をオフにするように構成されている。 When the electromagnetic brake is provided, each of the first to sixth electromagnetic brakes 2061 to 2066 turns on the brake function when the drive current is not supplied to the actuator, and turns off the brake function when the drive current is supplied to the actuator. Is configured to do.
　第１及び第２の構成例と同様、アクチュエータとしてのモータ、位置検出器としてのエンコーダ、及びブレーキは、図３に示すように一体化したユニットとして構成されることが多い。さらに、第１～第６アクチュエータ２０４１～２０４６のそれぞれには、動力伝達用の減速機構及びカップリングなどが設けられる。 As in the first and second configuration examples, the motor as the actuator, the encoder as the position detector, and the brake are often configured as an integrated unit as shown in FIG. Further, each of the first to sixth actuators 2041 to 2046 is provided with a power transmission speed reduction mechanism and a coupling.
　なお、パラレルリンク２０２４においては、４つの回転軸のうち何れか１か所にアクチュエータ、位置検出器、及びブレーキを設けておけばよい。 In the parallel link 2024, an actuator, a position detector, and a brake may be provided at any one of the four rotating shafts.
　また、上記構成では、第２可動要素２０２３と第４可動要素２０２５との連結にパラレルリンクを用いたが、単一のリンクにより構成された可動要素を採用し、第２可動要素２０２３及び第４可動要素２０２５のそれぞれと、独立して制御可能なように連結してもよい。 In the above configuration, the parallel link is used to connect the second movable element 2023 and the fourth movable element 2025. However, a movable element constituted by a single link is adopted, and the second movable element 2023 and the fourth movable element 2023 are connected to each other. Each of the movable elements 2025 may be connected so as to be independently controllable.
　図１９は、本構成例でテーブル２２０８を上下に移動させた場合の側面図を示している。 FIG. 19 shows a side view when the table 2208 is moved up and down in this configuration example.
　このように、本構成例ではパラレルリンク機構を採用したので、テーブル２２０８を鉛直方向に上下動させる際に、テーブル２２０８に載置された載置対象の重量を受ける点がパラレルリンクの第２可動要素２０２３側ではなく第４可動要素２０２５側の回動軸になるので、テーブル２２０８を鉛直方向に上下動させるためのトルクを小さくすることができる。従って、パラレルリンクを駆動するためのアクチュエータを小型化することができ、ロボットアーム２００１を小型化することができる。これは、ロボットアーム２００１全体をテーブル２２０８下の空間に収納される構成とするのに有利である。 As described above, since the parallel link mechanism is employed in this configuration example, when the table 2208 is moved up and down in the vertical direction, the point of receiving the weight of the placement target placed on the table 2208 is the second movable of the parallel link. Since the rotation axis is not the element 2023 side but the fourth movable element 2025 side, the torque for moving the table 2208 up and down in the vertical direction can be reduced. Therefore, the actuator for driving the parallel link can be reduced in size, and the robot arm 2001 can be reduced in size. This is advantageous in that the entire robot arm 2001 is stored in the space under the table 2208.
　以上のように構成されたロボット手術台を用いれば、テーブル上に患者を載置した後、テーブル２２０８を撮影位置や手術位置といった目的とする位置に正確かつ迅速に移動させることができ、手術工程の効率を格段に向上させることができる。 By using the robot operating table configured as described above, after placing the patient on the table, the table 2208 can be accurately and quickly moved to a target position such as an imaging position or a surgical position. Efficiency can be significantly improved.
　図２０に、医用画像診断装置として天井走行式と床固定式を組み合わせたバイプレーンのアンギオ装置を用い、ロボット手術台として本構成例（図１８に示したもの）にスライド機構が搭載されたものを用いて、手術位置（第１の位置）から撮影位置（第２の位置）にテーブルを移動させる様子を示す。図２０（Ａ）、（Ｃ）、（Ｅ）は斜視図であり、図２０（Ｂ）、（Ｄ）、（Ｆ）は手術室を鉛直方向上方から見下ろした場合の平面図である。 FIG. 20 shows a biplane angio device that combines a ceiling traveling type and a floor fixed type as a medical image diagnostic apparatus, and a slide mechanism mounted on this configuration example (shown in FIG. 18) as a robot operating table. Is used to show how the table is moved from the surgical position (first position) to the imaging position (second position). 20 (A), (C), and (E) are perspective views, and FIGS. 20 (B), (D), and (F) are plan views when the operating room is looked down from above in the vertical direction.
　図２０（Ａ）、（Ｂ）では、テーブルの下にロボットアーム全体が隠れる第１の位置としての手術位置にテーブルが位置している。図２０（Ｃ）、（Ｄ）では、第１及び第６ジョイントが回転し、第２ジョイントが伸縮して第６ジョイントのベースからの距離が調整され（場合によっては、第３ジョイントの回動によりテーブル高さが調整され、また、第４又は／及び第５ジョイントによってテーブルの長手方向又は／及び幅方向まわりの傾きが調整され）テーブルが撮影準備位置に到達している。図２０（Ｅ）、（Ｆ）では、スライド機構の駆動によりテーブルが撮影位置（第２の位置）に到達している。 20A and 20B, the table is located at the surgical position as the first position where the entire robot arm is hidden under the table. In FIGS. 20C and 20D, the first and sixth joints rotate, the second joint expands and contracts, and the distance from the base of the sixth joint is adjusted (in some cases, the third joint rotates). The table height is adjusted by (4) and the inclination of the table in the longitudinal direction or / and the width direction is adjusted by the fourth or / and fifth joint), and the table has reached the photographing preparation position. In FIGS. 20E and 20F, the table has reached the photographing position (second position) by driving the slide mechanism.
　第１の位置の設定方法は、医用画像診断装置としてアンギオ装置を用いる場合でも、ＭＲＩ装置を用いる場合と類似しており、第１の位置としての手術位置にあるロボット手術台とアンギオ装置との最短距離Ｓで決定される。医用画像診断装置としてアンギオ装置を用いる場合、磁性の影響を考える必要はないため、５ガウスラインは考慮しなくてよい。しかし、テーブルが手術位置（第１の位置）にある場合に術者や助手がテーブルまわりを取り囲めるようにアンギオ装置との最短距離Ｓは一定距離以上離すことが好ましい。また、医用画像診断装置としてアンギオ装置を用いる場合のハイブリッド手術においても、手術時に手術用顕微鏡（マイクロスコープ）などの医療機器をテーブルまわりに配置することから、これらを配置可能とするためにも最短距離Ｓを一定距離以上とすることが好ましい。この最短距離Ｓは、例えば手術用顕微鏡のベース部分の直径寸法を考慮して、ロボット手術台とアンギオ装置との間に手術用顕微鏡を配置可能なように８０ｃｍ以上とすることができる。 The first position setting method is similar to the case where an MRI apparatus is used even when an angiography apparatus is used as a medical image diagnostic apparatus, and the robot operating table and the angio apparatus are located at the operation position as the first position. It is determined by the shortest distance S. When an angiography apparatus is used as a medical image diagnostic apparatus, it is not necessary to consider the influence of magnetism, so the 5 Gauss line need not be considered. However, it is preferable that the shortest distance S from the angio apparatus is a predetermined distance or more so that the operator and assistant can surround the table when the table is in the operation position (first position). Further, even in a hybrid operation in which an angiography apparatus is used as a medical image diagnostic apparatus, medical devices such as a surgical microscope (microscope) are arranged around the table at the time of the operation. It is preferable to set the distance S to a certain distance or more. This shortest distance S can be set to 80 cm or more so that the surgical microscope can be disposed between the robot operating table and the angio device, for example, considering the diameter dimension of the base portion of the surgical microscope.
　また、医用画像診断装置としてＭＲＩ装置を用いる場合と同様に、ロボットアームがテーブルを支持することができる耐荷重と、手術位置（第１の位置）におけるロボットアームのテーブル下の収納可能性（ロボット構造の小型化）及びロボットアームの剛性（テーブルの安定性）を考慮すると、第１の位置にあるロボット手術台とアンギオ装置との最短距離Ｓが大きければ大きいほどよいという訳ではない。従って、アンギオ装置と第１の位置にあるロボット手術台との最短距離Ｓは、例えば手術用顕微鏡（マイクロスコープ）の設置が可能な８０ｃｍに加えて、さらに人が通過可能な程度を考慮して２ｍ以下に設定することが好ましい。 Further, as in the case of using an MRI apparatus as a medical image diagnostic apparatus, the load capacity that the robot arm can support the table and the possibility of storage under the table of the robot arm at the operation position (first position) (robot Considering the miniaturization of the structure and the rigidity of the robot arm (table stability), it is not necessarily better that the shortest distance S between the robot operating table at the first position and the angio device is larger. Accordingly, the shortest distance S between the angio device and the robot operating table at the first position is, for example, in addition to 80 cm where a surgical microscope (microscope) can be installed, and further considering the extent to which a person can pass. It is preferable to set it to 2 m or less.
　次に、医用画像診断装置が天井走行式や床固定式のアンギオ装置である場合は、手術中でもレールに沿って動かすことにより、又は本体（Ｃの部分）を支持部に関して回転させることにより、撮影位置と退避位置とを往復させることも可能である。
（ロボット手術台と医療システムの設計についての補足） Next, when the medical diagnostic imaging apparatus is a ceiling-running or floor-fixed angio apparatus, imaging is performed by moving along the rail during surgery or by rotating the main body (part C) with respect to the support section. It is also possible to reciprocate between the position and the retracted position.
(Supplementary information on robot operating table and medical system design)
　上記各構成例のハイブリッド手術において説明した、図４及び図２０の第１の位置は、テーブルを鉛直方向上側から見下ろした場合に、テーブル用ロボットアームの全てが前記テーブルの下に隠れる様子を示しているが、術者や助手がテーブルを取り囲むのに差支えの無い場合はロボットアームがテーブルに隠れない部分（はみ出し）が生じてもよい。このようなはみ出しは、例えばテーブルの幅方向の一端側のみで生じ、テーブルに隠れないロボットアームの最大寸法はテーブル長手方向の寸法の１／４未満であればよい。そして、テーブルからのロボットアームのはみ出し量がテーブルの幅方向の１／３以上である場合は、「ロボットアームのうち一定量がテーブルの下に隠れていない（テーブルからはみ出す）」ということができる。 The first position in FIGS. 4 and 20 described in the hybrid surgery of each configuration example above shows that when the table is looked down from the upper side in the vertical direction, all of the table robot arms are hidden under the table. However, if the surgeon or assistant has no trouble surrounding the table, a portion where the robot arm does not hide from the table (protrusion) may occur. Such protrusions occur only at one end in the width direction of the table, for example, and the maximum dimension of the robot arm that is not hidden by the table may be less than ¼ of the dimension in the table longitudinal direction. If the amount of protrusion of the robot arm from the table is 1/3 or more of the width direction of the table, it can be said that “a certain amount of the robot arm is not hidden under the table (out of the table)”. .
　また、上記ハイブリッド手術に用いられるロボット手術台は、医用画像診断装置による画像撮影のみに用いられる場合とは違い、手術位置において術式に応じた適当な手術を行うことが要求されるため、床面を基準としたテーブルの高さ位置は、下方が７０ｃｍ以下、望ましくは５０ｃｍまで下がり、上方は１００ｃｍ以上、望ましくは１２０ｃｍまで上がるように、ロボットアームを設計するようにすることが好ましい。例えば、図１９に示すように、テーブルを水平面に平行な状態を保ったまま鉛直方向に動作させる場合において、テーブルが最も低くなる場合の床面からテーブル上面までの距離Ｈ１が５０ｃｍ以上７０ｃｍ以下であり、テーブルが最も高くなる場合の床面からテーブル上面までの距離Ｈ２が１００ｃｍ以上１２０ｃｍ以下である。 The robot operating table used for the hybrid operation is different from the case where it is used only for image capturing by the medical image diagnostic apparatus, and is required to perform an appropriate operation according to the surgical method at the operation position. It is preferable to design the robot arm such that the height of the table relative to the surface is 70 cm or less below the surface, desirably 50 cm, and above 100 cm, preferably 120 cm above. For example, as shown in FIG. 19, when the table is operated in the vertical direction while maintaining a state parallel to the horizontal plane, the distance H1 from the floor surface to the table upper surface when the table is the lowest is 50 cm or more and 70 cm or less. Yes, the distance H2 from the floor surface to the upper surface of the table when the table is the highest is 100 cm or more and 120 cm or less.
　また、上記ハイブリッド手術においては、医用画像診断装置（モダリティ）がひとつのみ用いられ、ロボット手術台と組み合わせる例を示したが、複数の医用画像診断装置と組み合わせてもよい。ただし、その場合は上記の配置方法の考え方を利用することはできるが、医用画像診断装置どうしの配置関係や麻酔器の配置位置など考慮して医療システムを再設計することが好ましい。 In the hybrid surgery, only one medical image diagnostic apparatus (modality) is used and combined with the robot operating table. However, it may be combined with a plurality of medical image diagnostic apparatuses. However, in this case, it is possible to use the concept of the arrangement method described above, but it is preferable to redesign the medical system in consideration of the arrangement relationship between the medical image diagnostic apparatuses and the arrangement position of the anesthesia machine.
　上記で説明した通り、各構成例で示したロボット手術台は昇降－回転－スライド式の手術台と同程度かそれ以上に省スペースで用いることができる構成となっており、ハイブリッド手術にも好適に用いることができる。それでいて、昇降－回転－天板スライド式手術台と比較するとテーブルの動作範囲が広く、また動作範囲にある限りはテーブルを３次元空間で自由に移動させることができるという柔軟さも有する。さらに、テーブルの平面的な動作はスライド及び回転に限定されないため、医用画像診断装置との関係におけるロボット手術台の配置場所も柔軟に選択することができる。 As described above, the robot operating table shown in each configuration example can be used in a space-saving manner that is equivalent to or higher than a lifting-rotating-sliding operating table, and is also suitable for hybrid surgery. Can be used. Nevertheless, the table has a wider range of motion than the lift-rotation-top slide type operating table, and has the flexibility that the table can be freely moved in a three-dimensional space as long as it is within the range of motion. Furthermore, since the planar operation of the table is not limited to sliding and rotation, the placement location of the robot operating table in relation to the medical image diagnostic apparatus can be flexibly selected.
　以上のとおり、第１～第３構成例を手術室に適用する例を示したけれども、本発明の趣旨を逸脱しない範囲で種々の変形が可能である。 As described above, although the example in which the first to third configuration examples are applied to the operating room has been shown, various modifications can be made without departing from the gist of the present invention.
　例えば、図４、図２０（Ｂ）など載置位置や手術位置において、テーブルを支持するロボットアームは完全にテーブル下に収まる態様としているが、載置や手術において邪魔にならないならば多少のはみ出しを許容するような構成としてもよい。各構成例におけるテーブルは手術室の大きさや術式などの事情に応じて適宜設計可能であるが、テーブルトップとしての機能を考慮すると、載置対象として例えば長身の患者を載置可能なように２１０ｃｍ以上は確保すべきであるということができる。 For example, in the placement position or the operation position such as in FIG. 4 or FIG. 20B, the robot arm that supports the table is completely placed under the table. It is good also as a structure which accept | permits. The table in each configuration example can be appropriately designed according to circumstances such as the size of the operating room and the surgical procedure, but considering the function as a table top, for example, a tall patient can be placed as a placement target It can be said that 210 cm or more should be secured.
　図２１（Ａ）に示すように、ロボット手術台が手術室において最も省スペースとなる姿勢においてロボットアームがテーブルよりはみ出ることを許容する構成を取る場合は、はみ出たロボットアームも考慮したロボット手術台全体のサイズを検討することが望ましい。ロボットアームのはみ出しがテーブルの長手方向である場合、省スペース姿勢におけるロボット手術台の全長は少なくとも３００ｃｍ未満には抑えることが望ましいため、テーブルの長手方向の寸法は２４０ｃｍ未満とすべきである。すなわち、はみ出し量はテーブルの長手方向の寸法の１／４以下には抑えることが好ましいことから、テーブルの長手方向の寸法が約２４０ｃｍの場合、省スペース姿勢においてロボットアームがテーブルよりはみ出す許容最大寸法は約６０ｃｍとなる。図２１（Ａ）に例示したテーブルの長手方向の寸法は２３０ｃｍであり、テーブルに隠れないロボットアームの寸法を、テーブル長手方向の寸法２３０ｃｍの１／４未満の５５ｃｍとしている。このようにテーブル長手方向の寸法が小さければ駆動力（モーター）も小さくできるためロボットアームがテーブルよりはみ出す量も若干小さくできる。 As shown in FIG. 21 (A), when the robot operating table is configured to allow the robot arm to protrude from the table in a posture where the robot operating table is the most space-saving, the robot operating table also takes into account the protruding robot arm. It is desirable to consider the overall size. When the protrusion of the robot arm is in the longitudinal direction of the table, the length of the table in the longitudinal direction should be less than 240 cm because it is desirable to keep the total length of the robot operating table in a space-saving posture at least less than 300 cm. In other words, it is preferable to keep the amount of protrusion to ¼ or less of the dimension in the longitudinal direction of the table. Therefore, when the dimension in the longitudinal direction of the table is about 240 cm, the maximum allowable dimension that the robot arm protrudes from the table in a space-saving posture. Is about 60 cm. The dimension in the longitudinal direction of the table illustrated in FIG. 21A is 230 cm, and the dimension of the robot arm that is not hidden by the table is 55 cm, which is less than ¼ of the dimension in the longitudinal direction of the table. Thus, if the dimension in the longitudinal direction of the table is small, the driving force (motor) can be reduced, so that the amount of the robot arm protruding from the table can be slightly reduced.
　一方、ロボット手術台が省スペースとなる姿勢において、図２１（Ｂ）のようにロボットアームがテーブルの下に完全に隠れる構成を取る場合は、例えば２００ｋｇ程度の耐荷重ロボットアームはそれなりに大きくなることから、ロボットアームをテーブル下に収めるためにはテーブルを大きめに形成することが要求される場合が多い。従って、テーブルの長手方向の寸法としては、例えばテーブルからのロボットアームのはみ出しを許容する構成よりも長い２４０ｃｍ以上とすることが好ましい。また、省スペース姿勢におけるロボット手術台の全長は少なくとも３００ｃｍ未満には抑えることが望ましいため、ロボットアームがテーブルの下に完全に隠れる場合のテーブルの長手方向の寸法も３００未満とすることが好ましい。図２１（Ｂ）に例示したテーブルの長手方向の寸法は２６０ｃｍである。上記は２４０ｃｍを基準としてロボットアームが完全に隠れる場合とはみ出る場合を切り分けたが、必ずしもある値で切り分ける必要はなく、それぞれのテーブル長さの寸法でオーバーラップする範囲が生じることを排除するものではない。 On the other hand, in a posture where the robot operating table is space-saving, when the robot arm is configured to be completely hidden under the table as shown in FIG. 21B, for example, a load-bearing robot arm of about 200 kg is increased accordingly. Therefore, in order to fit the robot arm under the table, it is often required to make the table larger. Therefore, it is preferable that the length of the table in the longitudinal direction is 240 cm or longer, for example, longer than the configuration that allows the robot arm to protrude from the table. In addition, since it is desirable to keep the total length of the robot operating table in a space-saving posture at least less than 300 cm, it is preferable that the longitudinal dimension of the table when the robot arm is completely hidden under the table is also less than 300. The dimension in the longitudinal direction of the table illustrated in FIG. 21B is 260 cm. In the above, the case where the robot arm is completely hidden and the case where it protrudes is divided on the basis of 240 cm, but it is not always necessary to separate the robot arm at a certain value, and it does not exclude the occurrence of overlapping ranges with the respective table length dimensions. Absent.
　テーブルの幅方向の寸法については、小さすぎると例えば載置対象である患者が落下する危険が大きく、大きすぎると省スペースの妨げになることから、顧客要求に応じて適宜設計することが好ましい。だいたい４５ｃｍ以上は確保し、一般的なシングルベッドほどには大きくない９０ｃｍ未満とすることが好ましい。図２１（Ａ）の例では６０ｃｍとしている。図２１（Ａ）の例においては、Ｔ字型テーブルを採用しており、一端側（狭い方）が５０ｃｍ、他端側（広い方）を７０ｃｍとしている。なお、本明細書において単に幅の寸法と記載する場合は、特に明示しない限りテーブルの最大幅を意味する。なお、鉛直方向上側から見下ろした場合のテーブルの形状が図２１（Ａ）のような長方形である場合や、図２１（Ｂ）のようなＴ字型である場合は、ストレッチャーをぴったりとテーブル側部に隣接させて例えば載置対象である患者をテーブルに移動させやすくさせやすいというメリットがある。 If the dimension in the width direction of the table is too small, for example, there is a high risk that the patient to be placed will fall, and if it is too large, space saving will be hindered. It is preferable to secure 45 cm or more, and to be less than 90 cm which is not as large as a general single bed. In the example of FIG. In the example of FIG. 21A, a T-shaped table is adopted, and one end side (narrower side) is 50 cm and the other end side (wider side) is 70 cm. In the present specification, the simple description of the width means the maximum width of the table unless otherwise specified. In addition, when the shape of the table when looking down from the upper side in the vertical direction is a rectangle as shown in FIG. 21A, or when it is a T-shape as shown in FIG. For example, there is an advantage that it is easy to easily move a patient to be placed on the table adjacent to the side portion.
　その他、上記説明では麻酔器４はテーブルより上側でホルダー１５により保持される態様をしめしたが、テーブルと一体的に移動する構成であれば、テーブルより下側で保持するようにしてもよい。 In the above description, the anesthesia machine 4 is held by the holder 15 above the table, but may be held below the table as long as it moves integrally with the table.
　また、医療機器ホルダーユニットに保持される医療用流体注入機器は、麻酔器４と輸液ポンプ６を例示したが、輸血器などであってもよい。 Moreover, although the medical fluid injection device held by the medical device holder unit is exemplified by the anesthesia machine 4 and the infusion pump 6, it may be a blood transfusion device or the like.
　さらに、テーブルに連結される医療機器ホルダーユニットに手術器具のジェネレーターやモニターなどを保持させるように変形させもよい。 Furthermore, the medical device holder unit connected to the table may be deformed so as to hold the generator or monitor of the surgical instrument.
　さらにまた、手術工程のみならず、検査など他の医療工程において、医療機器ホルダーユニットを備えたロボティックベッドを用いるように適用させてもよい。 Furthermore, it may be applied to use a robotic bed equipped with a medical device holder unit not only in a surgical process but also in other medical processes such as examination.
　なお、各構成例では異なるテーブル用ロボットアームの構造を示し、ＭＲＩ装置、アンギオ装置、およびＣＴ装置などの医用画像診断機器のうち１つとの組み合わせを示したが、ロボット手術台と医用画像診断機器との組み合わせがこれらに限定されず、どのような組み合わせでもよいことは言うまでもない。 In each configuration example, the structure of a different table robot arm is shown, and a combination with one of medical image diagnostic apparatuses such as an MRI apparatus, an angio apparatus, and a CT apparatus is shown. Needless to say, the combination is not limited to these, and any combination may be used.
　本発明は、ハイブリッド手術に用いられる手術台として適用することができる。 The present invention can be applied as an operating table used for hybrid surgery.
　１　ロボット手術台
　４　麻酔器
　４ｅ　気化器
　６　輸液ポンプ
　１０　テーブル
　１１、１３　医療用流体注入機器ホルダーユニット
　１５、２７　ホルダー
　１００　テーブルユニット
　１０３、２００１、２９０１　ロボットアーム
　３１１１　経路
　Ｋ　処置対象
　Ｔ，４１５　術者 DESCRIPTION OF SYMBOLS 1 Robot operating table 4 Anesthesia machine 4e Vaporizer 6 Infusion pump 10 Table 11, 13 Medical fluid injection equipment holder unit 15, 27 Holder 100 Table unit 103, 2001, 2901 Robot arm 3111 Path | route K Treatment object T, 415 operator

Claims (13)

  1. 　処置対象を載置するテーブルと、
    　前記テーブルを第１の位置と第２の位置との間を移動可能なように、前記テーブルを支持するロボットアームと、
    　一端が前記処置対象に取り付けられるチューブと、
    　前記チューブの他端が接続される医療用流体注入機器を保持するホルダーと、を備え、
    　前記ホルダーを支持する支持装置が前記テーブルに固定されている、ロボット手術台。     A table on which a treatment target is placed;
    A robot arm that supports the table so that the table can be moved between a first position and a second position;
    A tube having one end attached to the treatment target;
    A holder for holding a medical fluid injection device to which the other end of the tube is connected,
    A robot operating table, wherein a support device for supporting the holder is fixed to the table.
  2. 　前記第１の位置は、鉛直方向上側から前記テーブルを見下ろした場合に前記テーブルに隠れない前記ロボットアームの最大寸法が前記テーブルの長手方向の寸法の１／４未満である位置であり、
    　前記第２の位置は、鉛直方向上側から前記テーブルを見下ろした場合に前記テーブルに隠れない前記ロボットアームの最大寸法が前記テーブルの長手方向の寸法の１／４以上である位置である、請求項１に記載のロボット手術台。     The first position is a position where the maximum dimension of the robot arm that is not hidden by the table when looking down from the upper side in the vertical direction is less than ¼ of the dimension in the longitudinal direction of the table;
    The second position is a position where a maximum dimension of the robot arm that is not hidden by the table when looking down from the upper side in the vertical direction is equal to or more than 1/4 of a dimension in the longitudinal direction of the table. The robot operating table according to 1.
  3. 　前記ホルダーを支持する支持装置はロボットアームにより構成される、請求項１又は２に記載のロボット手術台。 The robot operating table according to claim 1 or 2, wherein the support device for supporting the holder is constituted by a robot arm.
  4. 　前記医療用流体注入機器は、麻酔器又は輸液ポンプである、請求項１～３の何れかに記載のロボット手術台。 The robotic operating table according to any one of claims 1 to 3, wherein the medical fluid injection device is an anesthesia machine or an infusion pump.
  5. 　前記医療用流体注入機器及び前記ホルダーを複数有し、前記複数の医療用流体注入機器は麻酔器及び輸液ポンプを含む、請求項１～３の何れかに記載のロボット手術台。 The robot operating table according to any one of claims 1 to 3, comprising a plurality of the medical fluid injection device and the holder, wherein the plurality of medical fluid injection devices include an anesthesia machine and an infusion pump.
  6. 　前記麻酔器は、気化器を含み、
    　前記ホルダーは、前記気化器を保持可能に構成されている、請求項４又は５に記載のロボット手術台。     The anesthesia machine includes a vaporizer,
    The robot operating table according to claim 4 or 5, wherein the holder is configured to hold the vaporizer.
  7. 　前記テーブルは、水平面に平行な状態を維持して移動させるように構成されたスライド機構を備えている、請求項１～６の何れかに記載のロボット手術台。 The robot operating table according to any one of claims 1 to 6, wherein the table includes a slide mechanism configured to move while maintaining a state parallel to a horizontal plane.
  8. 　前記ホルダーを支持するロボットアームを遠隔操作するための操作部材をさらに備えている、請求項３に従属する請求項４～７に記載のロボット手術台。 The robot operating table according to any one of claims 4 to 7, further comprising an operation member for remotely operating a robot arm that supports the holder.
  9. 　前記ホルダーの支持装置は、前記テーブルとは別体に形成されており、前記テーブルに対する取付位置を変更可能に構成されている、請求項１～８の何れかに記載のロボット手術台。 The robot operating table according to any one of claims 1 to 8, wherein the support device for the holder is formed separately from the table, and is configured to be capable of changing a mounting position with respect to the table.
  10. 　前記ホルダーを支持する支持装置の動作を制御するための制御装置をさらに備え、
    　前記制御装置は、前記テーブルの姿勢にかかわらず、水平面に対する前記医療用流体注入機器の傾斜角度がゼロとなるように、前記支持装置を制御するように構成されている、請求項１～９の何れかに記載のロボット手術台。     A control device for controlling the operation of the support device for supporting the holder;
    10. The control device according to claim 1, wherein the control device is configured to control the support device so that an inclination angle of the medical fluid injection device with respect to a horizontal plane becomes zero regardless of an attitude of the table. The robot operating table according to any one of the above.
  11. 　前記ホルダーの支持装置内には、前記チューブが通過する経路が設けられている、請求項１～１０の何れかに記載のロボット手術台。 The robot operating table according to any one of claims 1 to 10, wherein a path through which the tube passes is provided in a support device of the holder.
  12. 　請求項１～１１の何れかに記載のロボット手術台と、医用画像診断装置を備え、
    　前記第１の位置は、前記医用画像診断装置による撮影位置又は撮影準備位置、及び手術位置のうちの一方であり、
    　前記第２の位置は、前記撮影位置又は撮影準備位置、及び前記手術位置のうちの他方である、医療システム。     A robot operating table according to any one of claims 1 to 11, and a medical image diagnostic apparatus,
    The first position is one of a photographing position or a photographing preparation position by the medical image diagnostic apparatus, and a surgical position.
    The second position is a medical system which is the other of the imaging position or the imaging preparation position and the surgical position.
  13. 　前記医用画像診断装置は、ＭＲＩ撮影装置、アンギオ装置、又はＣＴ装置である、請求項１２に記載の医療システム。 The medical system according to claim 12, wherein the medical image diagnostic apparatus is an MRI imaging apparatus, an angio apparatus, or a CT apparatus.
PCT/JP2018/021707 2017-06-09 2018-06-06 Robotic operating table and medical system WO2018225788A1 (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110141430A (en) * 2019-06-24 2019-08-20 开封市中心医院 Transfer device is used in a kind of nursing of emergency department
JP2021175501A (en) * 2020-04-28 2021-11-04 川崎重工業株式会社 Surgery support robot
CN115337171A (en) * 2022-09-13 2022-11-15 山东威高医用工程有限公司 Emergency control circuit for operating table and operating table

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2000139947A (en) * 1998-09-01 2000-05-23 Olympus Optical Co Ltd Medical system
JP2005087419A (en) * 2003-09-17 2005-04-07 Kuroda Precision Ind Ltd Operation table equipped with fluid pressure massage device
JP2005160857A (en) * 2003-12-04 2005-06-23 Nemoto Kyorindo:Kk Needle falling detector
JP2008539963A (en) * 2005-05-13 2008-11-20 アキュレイ・インコーポレーテッド Robotic arm for patient positioning assembly
JP2009131718A (en) * 2004-04-06 2009-06-18 Accuray Inc Patient-positioning assembly
JP2010094291A (en) * 2008-10-16 2010-04-30 Mizuho Co Ltd Device of positioning operating table
JP2013540045A (en) * 2010-10-20 2013-10-31 メドトロニック ナビゲーション，インコーポレイテッド Gated image acquisition and patient model structure
JP2014508546A (en) * 2010-11-23 2014-04-10 アシスト・メディカル・システムズ，インコーポレイテッド Clamp for couch horizontal plate

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS60153125U (en) * 1984-03-19 1985-10-12 日本電気株式会社 treatment bed
JP2535989Y2 (en) * 1990-09-26 1997-05-14 日本電気三栄株式会社 Movable bed equipment
DE29720449U1 (en) * 1997-11-18 1998-04-23 Kreuzer Gmbh & Co Ohg Surgical facility
JP2002035006A (en) * 2000-07-27 2002-02-05 Olympus Optical Co Ltd Medical device arrangement control system
US6971617B2 (en) * 2001-05-04 2005-12-06 Texas Children's Hospital Apparatus for supporting medical fluids

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2000139947A (en) * 1998-09-01 2000-05-23 Olympus Optical Co Ltd Medical system
JP2005087419A (en) * 2003-09-17 2005-04-07 Kuroda Precision Ind Ltd Operation table equipped with fluid pressure massage device
JP2005160857A (en) * 2003-12-04 2005-06-23 Nemoto Kyorindo:Kk Needle falling detector
JP2009131718A (en) * 2004-04-06 2009-06-18 Accuray Inc Patient-positioning assembly
JP2008539963A (en) * 2005-05-13 2008-11-20 アキュレイ・インコーポレーテッド Robotic arm for patient positioning assembly
JP2010094291A (en) * 2008-10-16 2010-04-30 Mizuho Co Ltd Device of positioning operating table
JP2013540045A (en) * 2010-10-20 2013-10-31 メドトロニック ナビゲーション，インコーポレイテッド Gated image acquisition and patient model structure
JP2014508546A (en) * 2010-11-23 2014-04-10 アシスト・メディカル・システムズ，インコーポレイテッド Clamp for couch horizontal plate

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110141430A (en) * 2019-06-24 2019-08-20 开封市中心医院 Transfer device is used in a kind of nursing of emergency department
JP2021175501A (en) * 2020-04-28 2021-11-04 川崎重工業株式会社 Surgery support robot
JP7344927B2 (en) 2020-04-28 2023-09-14 川崎重工業株式会社 surgical support robot
CN115337171A (en) * 2022-09-13 2022-11-15 山东威高医用工程有限公司 Emergency control circuit for operating table and operating table
CN115337171B (en) * 2022-09-13 2024-02-23 山东威高医用工程有限公司 Emergency control circuit for operating table and operating table

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