CN210170102U - Surgical instrument with bendable actuator - Google Patents

Abstract

An effector deflectable surgical instrument includes an effector at a distal end, a controller at a proximal end, and an extension tube between the effector and the controller; the extension tube is movably connected with the distal end of the controller, and the distal end of the extension tube is pivotally connected with the proximal end of the actuator; the extension pipe forms a connecting channel for transmitting the action made by the controller to the actuator; the controller comprises a bending control mechanism which can move towards at least one direction; the extension tube includes a first flexible member that is moved in at least one direction by the bend-controlling mechanism to cause the first flexible member to provide at least one lateral rotation of the actuator relative to the distal end of the extension tube. The bending control mechanism is simple in scheme, few in parts, simple to manufacture, low in cost and capable of achieving flexible bending of the actuator.

Description

Surgical instrument with bendable actuator

Technical Field

The present application relates to medical instruments, and more particularly to surgical instruments having deflectable actuators.

Background

A surgical stapler is a surgical instrument that functions by closing two corresponding actuators (typically including an anvil assembly and a cartridge assembly) to clamp tissue and then pushing metal staples out of the stapler cartridge to form and staple the tissue together. In some staplers, a cutting knife is also provided for severing the stapled tissue.

With the progress of the technology, the traditional operation mode gradually turns to endoscopic surgery. The endoscopic surgery is to make a plurality of small incisions with the diameter of 5-12 mm at different parts of the abdomen or the chest, insert a camera lens and various special surgical instruments through the small incisions, transmit images of various organs in the abdominal cavity shot by a camera inserted into the abdominal cavity to a television screen, and finish the surgery by observing the images and using various surgical instruments to operate in vitro. Among them, the endoscopic stapler plays the most critical role in surgery.

However, laparoscopic surgery also has limitations. Due to the limitation of the space in the abdominal cavity or the thoracic cavity, the traditional linear endoscope anastomat cannot effectively reach the operation part to clamp, cross and anastomose tissues under extreme conditions, so that the endoscope anastomat with the anastomat actuator capable of turning is promoted.

EndoGIAUniversal cutting staplers and staple cartridges, available from TycoHealthcare corporation (hereafter Covidien), are representative products for performing the above-described functions. The product structure of U.S. patent application publication No. US2010/0237131a1 employs a hinge + eccentric rigid link hinge arrangement to effect deflection of the actuator. Limited by the structural design principle, the maximum bending angle of the nail box actuator is only 45 degrees. Under the condition that the operation can be completed only by bending the actuator by a large angle, the focus resection of certain parts cannot be realized by adopting the actuator with a small bending angle. For example, in low-position proctostomy, because the space of the pelvic cavity limits the angle of the instrument entering the pelvic cavity, although the nail box actuator makes a turn, the actuator still can not suture and cut at a vertical angle with the rectum in partial operation, so that partial patients with low tumor positions can not use the instrument for surgical treatment

The inventor previously filed CN 201510672007.2-a surgical instrument with bendable executor, cn201510026576. x-a surgical instrument and a bending control mechanism thereof, which can realize 60-degree bending of a nail box executor, but the nail box executor and the manual bending control mechanism belong to different products, and when a doctor uses the nail box executor and the manual bending control mechanism, the two are required to be loaded together to realize bending control, so that certain requirements are made on the loading accuracy.

Accordingly, it is desirable to design a surgical instrument that does not require loading by the surgeon for manual control of bending.

Disclosure of Invention

In accordance with the present application, there is provided an effector deflectable surgical instrument comprising an effector at a distal end, a controller at a proximal end, and an extension tube between the effector and the controller; the extension tube is movably connected with the distal end of the controller, and the distal end of the extension tube is pivotally connected with the proximal end of the actuator; the extension pipe forms a connecting channel for transmitting the action made by the controller to the actuator; the controller comprises a bending control mechanism which can move towards at least one direction; the extension tube includes a first flexible member that is moved in at least one direction by the bend-controlling mechanism to cause the first flexible member to provide at least one lateral rotation of the actuator relative to the distal end of the extension tube.

Preferably, the distal end of the elongated tube is pivotally connected to the proximal end of the actuator by a hinge, and the first flexible member does not pass through the center of the hinge, such that the first flexible member provides a rotational torque to the actuator about the hinge axis to rotate the actuator at least one side relative to the distal end of the elongated tube.

Further, the actuator rotates on a plane perpendicular to the hinge rotation axis.

According to one aspect, the bending control mechanism comprises an operating part, a bending control gear and a first bending control rack, wherein the operating part is connected with the bending control gear and drives the bending control gear to rotate, the bending control gear is meshed with the first bending control rack, and the rotation of the bending control gear drives the first bending control rack to move forwards or backwards; the first bending control rack is fixedly connected with the near end of the first flexible part.

Further, the extension tube further comprises a second flexible component, and the distal end of the first flexible component and the distal end of the second flexible component are respectively connected to two sides of the actuator along the central shaft; when the bending control mechanism moves towards a first direction, the first flexible part is driven to move towards the proximal end of the first flexible part, the second flexible part moves towards the distal end of the second flexible part, and the actuator is driven to rotate towards a first side relative to the distal end of the extension tube; when the bending control mechanism moves towards the second direction, the first flexible part is driven to move towards the far end of the first flexible part, the second flexible part moves towards the near end of the second flexible part, and the actuator is driven to rotate towards the second side relative to the far end of the extension pipe.

Further, the first flexible component and the second flexible component are segmented flexible components.

Further, the first flexible component and the second flexible component are bent pull tabs or pull ropes.

Furthermore, the bending control mechanism also comprises a second bending control rack, the bending control gear is meshed with the second bending control rack, and the rotation of the bending control gear drives the second bending control rack to move forwards or backwards; and the second bending control rack is fixedly connected with the near end of the second flexible part.

Further, the operating part is a bending control wrench. The operating area of the rotary bend-controlling wrench is located outside the extension pipe.

Further, the extension pipe comprises an outer sleeve, an upper inner pipe and a lower inner pipe, and the upper inner pipe, the lower inner pipe and the outer sleeve are coaxially arranged.

Further, the first flexible part is a left bending pull piece, the second flexible part is a right bending pull piece, the first bending control rack is a left bending control rack, the second bending control rack is a right bending control rack, and the left bending control rack and the right bending control rack are respectively arranged on two sides of the lower inner pipe; the left bending pull tab and the right bending pull tab respectively penetrate through the connecting assembly and are connected to the left side and the right side of the actuator along the central shaft; the upper side of the bending control gear is connected with the bending control wrench, so that the rotation of the bending control wrench drives the rotation of the bending control gear, the left bending control rack and the right bending control rack are further driven to move forwards or backwards, the left bending pull piece is correspondingly driven to move forwards or backwards, and the right bending control rack drives the right bending pull piece to move forwards or backwards.

Further, the near end of extension pipe sets up interconnect's rotatory head upper cover and rotating head lower cover, accuse curved mechanism is located between rotatory head upper cover and the rotating head lower cover, accuse curved spanner rotationally connects through accuse curved spanner round pin on the rotatory head upper cover.

The angle of rotation of the actuator to at least one side relative to the distal end of the elongated tube is any value between 0 ° and 180 °.

The rotation angle α of the bending control wrench can be fed back to the bending angle β of the actuator without loss basically, the transmission efficiency is high, the bending angle β of the actuator can be controlled by adjusting the rotation angle α of the bending control wrench 14, α can be any numerical value from 0 to 180 degrees, such as 0 degree, 30 degrees, 45 degrees, 60 degrees, 90 degrees, 120 degrees, 135 degrees, 180 degrees and the like, β can be any numerical value from 0 to 180 degrees, such as 0 degree, 30 degrees, 45 degrees, 60 degrees, 90 degrees, 120 degrees, 135 degrees, 180 degrees and the like;

in one embodiment, the angular relationship of α and β satisfies the following equation:

β＝0.9α-2.1

further, the bent tab is detachable, for example, by a sectional bent tab, i.e., the left bent tab and the right bent tab are two-stage or multi-stage.

In another embodiment, the bent tab may be placed in two or more overlapping pieces.

Preferably, the surgical instrument is for an endoscopic stapler.

Further, the flexible member is a bendable tab or a wire rope.

The surgical instrument of the application adopts the flexible part to provide the bending of the executor relative to the distal end of the extension tube, so that the executor can be bent to a larger angle, thereby being suitable for medical treatment under more complex clinical conditions, for example, the surgery can be more conveniently carried out at the position with limited space (such as a chest cavity and a pelvic cavity), and the problem which cannot be solved by other surgical instruments is solved. The actuator can be bent to a large angle, and the surgical instrument can complete the functions of nidus excision, tissue cutting, suturing and the like of various difficult and complicated positions, so that more patients can benefit. For example, for patients with rectal cancer, the actuator of the instrument can still rotate to an angle perpendicular to the rectum at the lowest position of the rectum, so that more patients with low rectal cancer can also receive minimally invasive surgery. In addition, the transmission parts are few, the manufacturing cost of the transmission system is low, the tolerance accumulation of the transmission system is small, the assembly and disassembly can be realized by arranging the sectional type bent pull piece, and the use is convenient.

The surgical instruments of the present application may be used not only in surgery, but also in related therapeutic and diagnostic procedures. In addition, the endoscope anastomat can be applied to endoscope anastomats, and can also be applied to products such as closers and electric knives.

Drawings

In order to more clearly illustrate the technical solutions of the present application, the drawings needed for the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present application, and it is obvious for those skilled in the art to obtain other drawings without creative efforts.

FIG. 1 is a schematic design view of a surgical instrument according to the present application;

FIG. 2 is an exploded view of the oval area of FIG. 1;

FIG. 3 is a diagram of an actuator bend state according to the present application;

in the figure: 1: an actuator; 2: a connector assembly; 3: left bending the pull tab; 4. 5: a cutter bar guard plate; 6: connecting sheets; 7: an outer sleeve; 8: an upper inner tube; 9: a tool holder assembly; 10: a center rod assembly; 11: a right curved pull tab; 12: a lower inner tube; 13: bending control spanner pins; 14: controlling a bending wrench; 15: an upper cover of the rotary head; 16: controlling bending of the gear; 17: a right bending control rack; 18: a left bending control rack; 19: rotating the lower cover of the head; 20: an extension tube; 30: a controller; 31: a movable handle; 32: and (5) fixing a handle.

Detailed Description

The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings of the specification, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.

The term "exemplary" is used herein to mean "serving as an example, instance, or illustration. Any implementation described herein as "exemplary" is not necessarily to be construed as preferred or advantageous over other implementations. Also, herein, "proximal", "rear" refers to the end near the operator, and "distal", "front" refers to the end away from the operator.

For simplicity, the instrument of the present application is illustrated by way of example as a stapler. Those skilled in the art will appreciate that the effector-deflectable surgical instruments of the present application are not limited to endoscopic staplers. The techniques of the present application may also be employed in other products, such as closures, electrotomes, and the like.

FIG. 1 is a schematic design view of a surgical instrument according to the present application, preferably a stapler. The stapler includes an actuator 1 at a distal end, a controller 30 at a proximal end, and an extension tube 20 between the actuator 1 and the controller 30. The extension tube 20 is movably connected to the distal end of the controller 30, and the distal end of the extension tube 20 is pivotally connected to the proximal end of the actuator 1, preferably by one or more hinges. The extension tube 20 constitutes a connection passage for effecting transmission of the motion made by the controller 30 to the actuator 1. The actuator 1 is controlled to rotate, preferably by a certain angle in a plane perpendicular to the hinge rotation axis, by operating the controller 30.

The surgical instrument of the present application may be of a unitary design, i.e., extension tube 20 as a unit is connected to the distal end of controller 30 and to the proximal end of effector 1, respectively. The length of the extension tube 20 may vary depending on the indication and the particular condition of the patient.

The surgical instruments of the present application may also be of a split design, which may include a stapler and a staple cartridge. The anastomat and the nail box can be combined into a whole for use through a certain assembling relation. In a split design, the same stapler can be adapted to various types of staple cartridges during surgery.

Referring to fig. 2, the controller 30 includes a bend control mechanism 33. As shown in the figure, the bending control mechanism 33 adopts a gear reversing mechanism for controlling the actuator 1 to bend in two directions. Specifically, the bending control mechanism 33 includes a bending control gear 16, a left bending control rack 18, and a right bending control rack 17 located between the rotary head upper cover 15 and the rotary head lower cover 19, and the rotary head upper cover 15 and the rotary head lower cover 19 are located at the proximal end of the extension tube 20. It is understood that the bending control gear 16, the left bending control rack 18 and the right bending control rack 17 can also be arranged in the extension pipe 20.

Further, the controller 30 may employ handle components, and in particular, the controller 30 includes a bend controlling wrench 14, a fixed handle 32, a movable handle 31 (e.g., firing trigger) relatively movably coupled to the fixed handle, and a set of transmission mechanisms that transmit motion of the movable handle 31 to the implement 1. By pulling the trigger 31, the functions of continuously clamping, suturing, cutting and the like of the executor 1 to the human tissue can be realized. The operation area for rotating the steer key 14, through which the operator rotates the steer key 14 to rotate the actuator, is located outside the rotator head upper cover 15 or the rotator head lower cover 19.

Preferably, the bend controlling wrench 14 is rotated to each specific position, and the actuator 1 is correspondingly rotated by a specific angle. The actuator 1 can be rotated by different angles to adapt to different clinical application situations. The two functions of rotating the steer wrench 14 to rotate the implement 1 and operating the firing trigger to drive the implement into operation are independent of each other. In general, the surgical instrument of the present application operates as follows: firstly, operating the bend control wrench to control the actuator to rotate to a proper angle required clinically, then adjusting the position of the tissue in the jaw of the actuator, and then operating the firing trigger to clamp, suture, cut and the like the tissue.

The endoscopic stapler is described in detail below as an example of an integrated design.

Referring to FIG. 2, an exploded view of a portion of a surgical instrument according to an embodiment of the present application is shown. The proximal end of the actuator 1 is connected to the distal end of the extension tube 20 by an intermediate connection portion comprising a connection assembly 2. In a preferred embodiment, the connection assembly 2 is hinged to both the extension tube 20 and the actuator 1. As an example, the two hinges are spatially parallel to each other, perpendicular to the plane in which the actuator can be bent.

As an example, the extension tube 20 of the endoscopic stapler comprises an outer sleeve 7, an upper inner tube 8, a lower inner tube 12, a left bent pull tab 3, a right bent pull tab 11. In the embodiment shown, the upper inner tube 8, the lower inner tube 12 are arranged coaxially with the outer sleeve 7. The length of the lower inner tube 12 is greater than the length of the upper inner tube 8, preferably the length of the upper inner tube 8 corresponds to the length of the carriage assembly 9. The left bending control rack 18 and the right bending control rack 17 are respectively arranged at two sides of the lower inner tube 12. The left bending-control rack 18 is fixedly connected with the near end of the left bending pulling-on piece 3, and the right bending-control rack 17 is fixedly connected with the near end of the right bending pulling-on piece 11. The left and right bent tabs 3 and 11 are connected to the left and right sides of the actuator 1 along the central axis, respectively, through the connection assembly 2. The bending control gear 16 is arranged between the left bending control rack 18 and the right bending control rack 17 and is meshed with the left bending control rack 18 and the right bending control rack 17. The upper side of the bending control gear 16 is connected with the bending control wrench 14, so that the rotation of the bending control wrench 14 drives the rotation of the bending control gear 16, the rotation of the further bending control gear 16 drives the forward or backward movement (i.e. the movement towards the near end or the far end) of the left bending control rack 18 and the right bending control rack 17 correspondingly drives the left bending pull tab 3 to move forward or backward, and the right bending control rack 17 drives the right bending pull tab 11 to move forward or backward.

Referring to fig. 2, the bending control wrench 14 is rotatably coupled to the rotator head upper cover 15 through the bending control wrench pin 13, and the rotator head upper cover 15 has a through hole through which a portion of the bending control wrench 14 passes and is coupled to the bending control gear 16 between the rotator head upper cover 15 and the rotator head lower cover 19.

The anastomat comprises a driving assembly, wherein the driving assembly comprises a sliding block, a cutting knife, a knife rest assembly 9 and a central rod assembly 10. The cutting knife is used for cutting the tissue between the rows of staple lines after the tissue is sutured by the staples.

According to one example of the application, the carriage assembly 9 of the drive assembly is partially disposed inside the extension tube 20 and passes through the attachment assembly 2. The cutting knife and the sliding block are arranged inside the actuator 1.

Referring to fig. 2, a cutter bar guard plate 4 and a cutter bar guard plate 5 are arranged at the joint of the cutter frame assembly 9 and the connecting assembly 2.

As shown in fig. 1 to 3, according to an embodiment of the present application, in an initial state, the actuator 1 is in a linear state in line with the central axis of the extension tube 20. The distal ends of the left and right bent tabs 3, 11 are each fixedly connected to the actuator 1, for example by rivets. In such a design, the connection positions of the left and right bent tabs 3, 11 to the actuator 1 are offset from the central symmetry plane of the rotation axes of the two hinges, and the left and right bent tabs 3, 11 do not pass through the centers of the hinges. Therefore, the two pull tabs take the hinge as a rotating shaft, a certain rotating torque is provided for the actuator, and the actuator 1 is driven to rotate.

Referring to FIG. 3, a schematic diagram of the actuator turning to the first side and a partial view thereof in a surgical instrument according to an embodiment of the present application is shown, wherein the bending control wrench 14 is rotated counterclockwise (as indicated by arrow A) to rotate the bending control gear 16 counterclockwise, and since the right bending control rack 17 and the left bending control rack 18 are engaged with the bending control gear 16, the right bending control rack 17 is driven to move forward, the right bending tab 11 is released (as indicated by arrow B), and the left bending control rack 18 is driven to move backward to tighten the left bending tab 3 (as indicated by arrow C), and the actuator 1 is driven to rotate counterclockwise by a certain angle relative to the extension tube 2. by the rotation of the bending control wrench 14, the rotation angle of the actuator 1 can be controlled, according to an embodiment of the present application, α can be any value between 0 ° and 180 ° (e.g., 0 °, 30 °, 45 °, 60 °, 90 °, 120 °, 135 °, 180 °, etc.).

As can be seen in FIG. 3, the left curved tab 3 is tightened and the right curved tab 11 is loosened, thereby driving the actuator to turn. In this embodiment, the bending control gear 16 is engaged with the right bending control rack 17 and the left bending control rack 18, so that the right bending control rack 17 is driven to move forward, the right bending pull tab 11 is released, the moving directions of the two racks are opposite, and when the actuator rotates, the displacement generated by the tightening of the left bending pull tab 3 and the release of the right bending pull tab 11 are equal and mutually offset. In the design of the present application, the displacement of the two pull tabs in opposite directions can also be counteracted in other ways.

The principle of the actuator turning to the second side direction is similar to the principle of turning to the first side direction, and the difference is that the right bent pull tab 11 is tightened and the left bent pull tab 3 is loosened. For example, clockwise rotation of the bend control wrench 14 moves the right bending tab 11 and the left bending tab 3 in the opposite direction to that shown in fig. 3, driving the actuator to rotate clockwise.

The tolerance accumulation of the transmission system is small, the rotation angle α of the bending control wrench 14 can be fed back to the actuator bending angle β basically without loss, the transmission efficiency is high, the rotation angle β of the actuator can be controlled by adjusting the rotation angle α of the bending control wrench 14, theoretically, α can be any numerical value of 0-180 degrees, such as 0 degree, 30 degrees, 45 degrees, 60 degrees, 90 degrees, 120 degrees, 135 degrees, 180 degrees and the like, and β can be any numerical value of 0-180 degrees, such as 0 degree, 30 degrees, 45 degrees, 60 degrees, 90 degrees, 120 degrees, 135 degrees, 180 degrees and the like;

in one embodiment, the angular relationship of α and β satisfies the following equation:

β＝0.9α-2.1

in another embodiment, the left and right curved tabs 3, 11 may be two or more sections. The pull piece can be assembled and disassembled after being segmented.

In another embodiment, the bent tab may be placed in two or more overlapping pieces.

In another embodiment, the bend controlling wrench 14 is not rotated continuously, but a plurality of fixed rotation gears are provided, and the gear difference is, for example, 2 °, 5 °, or 10 °.

The surgical instrument of the present application may be used in pulmonary, gastrointestinal (including gastric, intestinal) surgery. Pulmonary surgery is typically achieved by removal of the lesion. In the operation of digestive tract, the lesion is usually cut off, and the cut intestinal canal needs to be butted again.

In general, the actuator of the bendable endoscopic stapler can be bent, the proximal end of the actuator is connected with a bending control mechanism (e.g., a bending control gear 16 in the figure) inside a controller (e.g., a stapler handle), and the actuator can be controlled to bend for a plurality of angles by adjusting the bending control mechanism. In an initial state, the central axes of the actuator and the extension tube are in a linear state, the actuator of the anastomat extends into the thoracic cavity or the abdominal cavity through the puncture outfit, the actuator is controlled to bend a certain angle through a bending control mechanism on an external control handle, and a series of operations such as clamping, transverse cutting, anastomosis and the like are carried out on the operation part. After the operation is finished, the bending control mechanism on the in-vitro control handle controls the actuator to be changed into a linear state again, and the in-vitro control handle is withdrawn from the body.

For example, for digestive tract surgery, in order to completely remove a tumor and prevent the tumor tissue from remaining in the clinic, the position of the transverse cutting line is usually about 5cm away from the tumor boundary. When the rectal cancer tumor is close to the lower position of the anus of a patient, the actuator of the anastomat needs to be capable of being placed into the lower position in the narrow pelvic cavity, the entering position of the anastomat is limited by the hip bone, the actuator of the anastomat with a small turning angle cannot vertically and transversely cut the rectum, and the operation risk of incomplete tumor resection is increased.

Surgical instruments with small effector turn angles do not provide vertical transection of the rectum, while staplers with large effector turn angles do. Moreover, the surgical instrument with the larger turning angle of the actuator can deal with tumors at lower positions. When the rotation angle of the actuator of the surgical instrument is larger, the tumor can be cut at a lower position, and the surgical instrument can be better applied to low-position rectal cancer surgery or other situations with limited space in the body.

The surgical instrument according to the present application, wherein the rotation angle of the actuator can be up to 90 ° or even 180 ° to accommodate extreme application situations.

According to another embodiment of the present application, the left and right bent tabs 3, 11 may alternatively be wire ropes. Such as a flexible member, such as a single strand or a multi-strand wound wire. It should be understood that the bendable tabs, wires, and cords described above are by way of example only and not limitation, and that one skilled in the art could conceive of many other similar flexible components to effect the bending of the actuator. Such implementations should not be read as resulting in a departure from the scope of the present application.

Further, it should also be understood that the various embodiments described above may also be implemented in a surgical instrument such as a laparoscopic stapler of unitary design. Furthermore, various embodiments may also be implemented in other products such as closers, electrotomes, and the like.

The surgical instrument of the application adopts the flexible part to provide the bending of the executor relative to the distal end of the extension tube, so that the executor can be bent to a larger angle, thereby being suitable for medical treatment under more complex clinical conditions, for example, the surgery can be more conveniently carried out at the position with limited space (such as a chest cavity and a pelvic cavity), and the problem which cannot be solved by other surgical instruments is solved. The actuator can be bent to a large angle, and the surgical instrument can complete the functions of nidus excision, tissue cutting, suturing and the like of various difficult and complicated positions, so that more patients can benefit.

The foregoing description and drawings are provided by way of illustrative example only. Any reference to claim elements in the singular, for example, using the articles "a," "an," or "the" is not to be construed as limiting the element to the singular. Skilled artisans may implement the described structure in varying ways for each particular application, but such implementation decisions should not be interpreted as causing a departure from the scope of the present application.

The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the application. Thus, the present application is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the following claims and the principles and novel features disclosed herein.

Claims (16)

1. An effector deflectable surgical instrument comprising a distal effector, a proximal controller, and an extension tube between the effector and the controller; the extension tube is movably connected with the distal end of the controller, and the distal end of the extension tube is pivotally connected with the proximal end of the actuator; the extension pipe forms a connecting channel for transmitting the action made by the controller to the actuator; the controller comprises a bending control mechanism which can move towards at least one direction; the extension tube includes a first flexible member that is moved in at least one direction by the bend-controlling mechanism to cause the first flexible member to provide at least one lateral rotation of the actuator relative to the distal end of the extension tube.

2. The effector deflectable surgical instrument of claim 1, wherein the distal end of said extension tube is pivotably connected to the proximal end of said effector by a hinge, said first flexible member not passing through the center of said hinge, whereby said first flexible member provides rotational torque to said effector about said hinge axis, urging said effector to rotate at least one side relative to the distal end of said extension tube.

3. The effector deflectable surgical instrument of claim 2, wherein said effector rotates in a plane perpendicular to said hinge as an axis of rotation.

4. The effector bendable surgical instrument according to any one of claims 1-3, wherein the bend-controlling mechanism comprises an operating member, a bend-controlling gear, a first bend-controlling rack, the operating member being connected to the bend-controlling gear and driving the bend-controlling gear to rotate, the bend-controlling gear being engaged with the first bend-controlling rack, the rotation of the bend-controlling gear driving the first bend-controlling rack to move forward or backward; the first bending control rack is fixedly connected with the near end of the first flexible part.

5. The effector deflectable surgical instrument of any of claims 1-3, wherein said extension tube further comprises a second flexible member, a distal end of said first flexible member and a distal end of said second flexible member being attached to said effector on opposite sides of said central axis; when the bending control mechanism moves towards a first direction, the first flexible part is driven to move towards the proximal end of the first flexible part, the second flexible part moves towards the distal end of the second flexible part, and the actuator is driven to rotate towards a first side relative to the distal end of the extension tube; when the bending control mechanism moves towards the second direction, the first flexible part is driven to move towards the far end of the first flexible part, the second flexible part moves towards the near end of the second flexible part, and the actuator is driven to rotate towards the second side relative to the far end of the extension pipe.

6. The effector deflectable surgical instrument of claim 4, wherein said extension tube further comprises a second flexible member, a distal end of said first flexible member and a distal end of said second flexible member being connected to said effector on opposite sides of said central axis; when the bending control mechanism moves towards a first direction, the first flexible part is driven to move towards the proximal end of the first flexible part, the second flexible part moves towards the distal end of the second flexible part, and the actuator is driven to rotate towards a first side relative to the distal end of the extension tube; when the bending control mechanism moves towards a second direction, the first flexible part is driven to move towards the far end of the bending control mechanism, the second flexible part moves towards the near end of the bending control mechanism, the actuator is driven to rotate towards a second side relative to the far end of the extension tube, the bending control mechanism further comprises a second bending control rack, the bending control gear is meshed with the second bending control rack, and the second bending control rack is driven to move forwards or backwards through the rotation of the bending control gear; and the second bending control rack is fixedly connected with the near end of the second flexible part.

7. The effector deflectable surgical instrument of claim 5, wherein said first and second flexible members are segmented flexible members.

8. The effector deflectable surgical instrument of claim 6, wherein said first and second flexible members are segmented flexible members.

9. The effector bendable surgical instrument of claim 6 wherein the operating member is a bend control wrench and the operating region of the rotary bend control wrench is located outside of the extension tube.

10. The effector deflectable surgical instrument of claim 9, wherein said extension tube comprises an outer sleeve, an upper inner tube, and a lower inner tube, said upper inner tube, lower inner tube and outer sleeve being coaxially arranged.

11. The effector deflectable surgical instrument of claim 5, wherein said first flexible member, second flexible member is a bendable tab or wire rope.

12. The effector deflectable surgical instrument of claim 6, wherein said first flexible member, second flexible member is a bendable tab or wire rope.

13. The effector bendable surgical instrument of claim 10, wherein the first flexible member is a left bending tab, the second flexible member is a right bending tab, the first bending control rack is a left bending control rack, the second bending control rack is a right bending control rack, and the left bending control rack and the right bending control rack are respectively disposed on both sides of the lower inner tube; the left bent pull piece and the right bent pull piece respectively penetrate through the connecting assembly and are connected to the left side and the right side of the actuator along the central shaft; the upper side of the bending control gear is connected with the bending control wrench, so that the rotation of the bending control wrench drives the rotation of the bending control gear, the left bending control rack and the right bending control rack are further driven to move forwards or backwards, the left bending pull piece is correspondingly driven to move forwards or backwards, and the right bending control rack drives the right bending pull piece to move forwards or backwards.

14. The surgical implement bendable instrument of any one of claims 1-3 wherein the proximal end of the extension tube is provided with an upper rotating head cover and a lower rotating head cover that are connected to each other, the bend control mechanism being located between the upper rotating head cover and the lower rotating head cover, the bend control wrench being pivotally connected to the upper rotating head cover by a bend control wrench pin.

15. The effector deflectable surgical instrument of any of claims 1-3, 6, 9-13, wherein said effector is rotated to at least one side relative to said distal end of said elongated tube by an angle of any value between 0 ° and 180 °.

16. The effector bendable surgical instrument according to any one of claims 1-3, 6, 9-13, wherein the surgical instrument is a stapler for endoscopic use.

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