JP2003144448A - Active forceps for endoscopic operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide active forceps for endoscopic operation of excellent operability allowing minute treatment from an optional direction in a body cavity. SOLUTION: The active forceps for the endoscopic operation comprises an operation implement part 2 with a treating implement 4 and a joint part 5, and a grip 3. The treating implement 4 can be opened/closed by a treatment operation input part 4a and bent and rotated by an attitude operation input part 5a and an attitude operation input part 4b. A connecting mechanism is provided between the treating implement 4 and the joint part 5, or between the operation input part 5a and the grip 3, or at both parts to allow easy replacement with plural kinds of operation implements with different functions or shape at the connection part.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an active forceps for endoscopic surgery for treating tissue in a living body under an endoscope.

[0002]

2. Description of the Related Art Endoscopic surgery typified by laparoscopic surgery such as cholecystectomy is performed by making a plurality of small holes on the body surface and observing an endoscope and long forceps through a trocar attached thereto. It is a minimally invasive surgery that does not require laparotomy by inserting a surgical tool such as the above and performing observation and treatment, and can reduce the burden on the patient.

[0003]

The operations such as grasping, peeling, excision, suturing, and ligation of the in-vivo tissue performed in the above-mentioned endoscopic surgery require very detailed movements.
However, the surgical instruments used in the past have a linear shape, and are limited to a linear movement centered on the trocar and a rotational movement in the axial direction, so it is extremely difficult to perform fine treatment due to poor operability. Is.

To solve such a problem, Japanese Patent Laid-Open No. 2000-
Japanese Patent No. 350735 discloses a medical manipulator in which the posture of a treatment section can be changed to two degrees of freedom or more. However, while a plurality of different surgical tools are used in actual surgery, the medical manipulator has not been examined for attachment and detachment and replacement of surgical tools. Further, in the case where an attempt is made to provide a connecting mechanism for the surgical instrument, the medical manipulator drives most of the operation and posture changes of the surgical instrument by a motor or the like, and a power transmission mechanism is provided for all drive systems at the connecting portion. Since it is necessary to provide the connection mechanism, it is very difficult to provide the connection mechanism. Therefore, when used in an actual surgery, it is desirable that the surgical instrument can be easily attached and detached. In addition, it is very effective to be able to attach and detach the surgical instrument even when performing maintenance of those instruments after the surgery.

In consideration of the above points, the present invention provides an active forceps in which the posture of the treatment portion can be changed to have two degrees of freedom or more, between the treatment portion and the grip portion, for example, between the treatment portion and the joint portion, or An active forceps for endoscopic surgery, which has a connection mechanism between the operation input section and the grip section, or both, and can be easily replaced with a plurality of types of surgical tools having different functions or shapes in the connection section. Is provided.

[0006]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings.

[0007]

1 is a schematic view showing a first embodiment of the present invention. The active forceps 1 for endoscopic surgery according to the present embodiment includes a surgical instrument portion 2.
And the grip 3 and can be detached at the connecting portion 6. For removal, the surgical instrument part 2 can be connected by sliding the surgical instrument part 2 from the rear side to the front side of the grip 3, and conversely, it can be separated by sliding from the front side to the rear side. The surgical instrument section 2 includes a treatment instrument 4, a joint section 5, and a posture operation input section 5a for performing a bending operation of the joint section 5. The grip 3 includes a treatment operation input unit 4a for opening and closing the treatment instrument 4 and a posture operation input unit 4b for rotating the treatment instrument 4. By bending and rotating the treatment instrument 4, it is possible to perform treatment from any direction within the body cavity.

An operating member 55 for inputting a posture operation of the treatment instrument 4 shown in FIG. 2 is supported by a spherical central shaft 56 which can freely change its posture, and is exposed to the outside of the operating member 55. The side that is fixed is fixed to the treatment section 2 by a flexible and deformable rubber ring 57, and constitutes the posture operation input section 5a. Operation member 55 for inputting posture operation
The central axis 56 side of the has a cross shape or a circular shape, and is connected to the surgical instrument bending drive wire 57 in the azimuth of 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock, for example, to operate the posture operation member 55. Is a mechanism for transmitting an action corresponding to the wire to the wire.
This wire is fixed to the final joint of the joint section 5 on the treatment instrument 4 side via a pulley and a joint unit (not shown). Therefore, if you pull the wire with the posture operation input unit 5a,
The joint part 5 can be bent in any direction so as to adjust the path length of the wire.

Further, the posture of the surgical instrument is manually driven by using the above-mentioned mechanism, and this mechanism is provided in the surgical instrument portion 2, so that the connecting portion 6 only opens and closes and rotates the surgical instrument. Since it is sufficient to have a power transmission mechanism, the connecting portion 6
The structure of is very simple, and it is possible to easily replace the surgical tool.

Next, a drive mechanism for rotating and opening / closing the treatment instrument 4 will be described with reference to FIG. The rotation operation of the treatment instrument 4 is performed by the posture operation input unit 4b included in the grip 3, and is driven by the motor 31 included in the grip 3. The rotational force of the motor 31 is transmitted from the grip 3 to the surgical instrument portion 2 in the connection mechanism 60 via the gears 32 and 33. Further, it is transmitted to the gear 24 provided at the rear end of the rod 25 connected to the treatment instrument 4 via the gears 21, 22, and 23 in the surgical instrument unit 2.

The opening / closing operation of the treatment instrument 4 is performed by operating the treatment operation input section 4a provided on the grip 3. Treatment operation input unit 4
By pulling a, the surgical tool opening / closing lever 35 can be operated via the link member 34, and the movable rod 25 can be retracted. After the treatment operation input unit 4a is unloaded, the movable rod 25 is pushed back to its original position by the spring mechanism 26 installed behind it. Since the gear 24 has a certain length with respect to the back-and-forth movement of the movable rod 25 described above,
The transmission of the rotational force from the gear 23 is maintained.

An embodiment of the connection mechanism 60 will be described. When the surgical instrument portion 2 is slid with respect to the grip 3 in FIG. 3, the connecting portion 60 meshes with the connecting member 60a provided on the surgical instrument portion 2 side shown in FIG. 4 and the connecting member 60b provided on the grip 3 side. It has such a shape, and it is possible to transmit the rotational force from the grip 3 to the surgical instrument portion 2.

The opening / closing operation and the rotating operation of the treatment instrument 4 will be described with reference to FIG. The treatment tools 4c and 4d are provided with movable rods 25 via link members 27 and 28, respectively.
When the movable rod 25 is pulled, the treatment tool 4 is closed, and when the movable rod 25 is pushed, the treatment tool 4 is connected.
Opens. Further, a bearing 29 is provided between the treatment instrument 4 and the joint 5.
When the movable rod 25 is rotated, the surgical instrument itself can be rotated by providing the mechanism using the. The rotational movement of the surgical instrument is operated by the posture operation input unit 4b,
It can be applied to procedures that require rotation such as suturing.

According to the embodiment of the present embodiment, in the connecting portion 6 provided between the surgical instrument portion 2 and the grip 3 shown in FIG.
It is possible to easily attach and detach a plurality of types of surgical instrument parts 2 having different surgical instrument functions or shapes for different treatment purposes to the grip 3.

Next, a second embodiment of the present invention will be described. This embodiment is an embodiment in which a connection mechanism is provided between the treatment instrument 4 and the joint portion 5 of FIG. 5 (b) is shown in FIG.
It is a sectional view of the tip side AA 'surface of bearing 29 shown in (a), and is constituted by rod 25 and treatment tool outer cylinder part 43. In order to perform attachment / detachment on the AA ′ surface as in the present embodiment, a connection mechanism may be provided for each of the rod 25 and the treatment tool outer cylinder portion 43. FIG. 6 shows a rod 25
And the connection mechanism of the treatment instrument outer cylinder part 43, respectively. The rod 25 that transmits the opening / closing operation and the rotating operation of the treatment instrument 4 is composed of rods 25a and 25b, and as shown in FIG. 6A, the rods 25a and 25b.
After combining, the connection pin 25c can be attached / detached to be attached / detached. Further, the treatment tool outer cylinder portion 43 through which the rod 25 is passed is composed of outer cylinder portions 43a and 43b, and as shown in FIG. 6B, the outer cylinder portions 43a and 43b.
After combining, the connection clip 43c can be attached / detached for attachment / detachment.

According to the mode of the present embodiment, in the connection mechanism provided between the treatment instrument 4 and the joint portion 5 shown in FIG. 1, a plurality of types of treatment instruments 4 having different surgical instrument functions or shapes for different therapeutic purposes are provided. It is possible to easily attach and detach the main body.

[0017]

According to the present invention, between the treatment part and the joint part,
In addition, since a connection mechanism is provided between the operation input unit and the grip unit, or both of them, and the connection unit can be easily replaced with a plurality of types of surgical instruments having different surgical instrument functions or shapes. Can be quickly replaced with multiple surgical tools and the operating time can be shortened. Moreover, since a plurality of surgical instruments can be used with one grip, it is very effective in terms of cost, and it is possible to provide an active forceps for endoscopic surgery which is excellent in maintainability. in addition,
The operation method of the active forceps for endoscopic surgery of the present invention is based on the operation method of forceps used in the current general endoscopic surgery, and the operation can be performed by the established conventional operation method. Therefore, it is safe and does not require any special training for the surgeon, and accurate surgery can be performed, which greatly contributes to reducing the stress on the patient and the surgeon.

[Brief description of drawings]

FIG. 1 is a front view showing an outline of active forceps for endoscopic surgery according to an embodiment of the present invention.

FIG. 2 is a perspective view showing an outline of a bending posture operation input portion of a joint portion 5.

FIG. 3 is a perspective view schematically showing a drive mechanism for opening / closing and rotating the treatment instrument 4 and a surgical instrument connection mechanism.

FIG. 4 is a perspective view showing an example of the shape of a connection mechanism 60.

FIG. 5 is a cross-sectional view showing a treatment tool 4.

FIG. 6 is a view showing a connection mechanism between a treatment tool 4 and a joint section 5. (A) The figure which showed the connection mechanism of the rod 25. (B) The figure which showed the connection mechanism of the outer cylinder part.

[Explanation of symbols]

1 Active forceps for endoscopic surgery 2 surgical tools 3 grip 4 treatment tools 4a Treatment operation input section 4b Posture operation input section 5 joints 5b Posture operation input section 6 connection 21, 22, 23, 24 gears 25 rod 25c connection pin 26 Spring mechanism 27, 28 links 29 bearings 30 battery 31 motor 32, 33 gears 34 links 35 Surgical tool open / close lever 43 Treatment tool outer cylinder 43c connection clip 55 central axis 56 rubber ring 57 Drive wire for bending surgical tools 60 connection mechanism

Claims (3)

[Claims] 1. An active forceps having a treatment section for performing a treatment, a joint section for changing the posture of the treatment section, and an operation input section for performing a posture operation and a treatment operation of the treatment section. An active forceps for endoscopic surgery, characterized in that it can be exchanged with a plurality of types of surgical instruments having a detachable connection mechanism between them and having different surgical instrument functions or shapes. 2. A plurality of types of surgical tools having a detachable connection mechanism between the operation input section and the grip section and having different surgical tool functions or shapes can be exchanged. The active forceps for endoscopic surgery according to 1. 3. A plurality of types of surgical instruments having a detachable connection mechanism between the treatment section and the joint section and having different surgical instrument functions or shapes can be exchanged. Active forceps for endoscopic surgery as described in.