CN103068333B - Surgical operating instrument - Google Patents

Surgical operating instrument Download PDF

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Publication number
CN103068333B
CN103068333B CN201180038902.9A CN201180038902A CN103068333B CN 103068333 B CN103068333 B CN 103068333B CN 201180038902 A CN201180038902 A CN 201180038902A CN 103068333 B CN103068333 B CN 103068333B
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CN
China
Prior art keywords
wire rod
jut
theater instruments
operating theater
bending apparatus
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201180038902.9A
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Chinese (zh)
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CN103068333A (en
Inventor
崔胜旭
闵东明
李济善
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Eaton Corp
Original Assignee
Eaton Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from KR1020100083252A external-priority patent/KR101733401B1/en
Priority claimed from KR1020100090109A external-priority patent/KR101146945B1/en
Priority claimed from KR1020100113983A external-priority patent/KR101684863B1/en
Priority claimed from KR1020110083013A external-priority patent/KR101643188B1/en
Application filed by Eaton Corp filed Critical Eaton Corp
Priority to CN201510446612.8A priority Critical patent/CN105078524A/en
Priority claimed from PCT/KR2011/006175 external-priority patent/WO2012026720A2/en
Publication of CN103068333A publication Critical patent/CN103068333A/en
Application granted granted Critical
Publication of CN103068333B publication Critical patent/CN103068333B/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A61B2017/00323—Cables or rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/282—Jaws
    • A61B2017/2825—Inserts of different material in jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2908—Multiple segments connected by articulations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2938—Independently actuatable jaw members, e.g. two actuating rods

Abstract

The invention provides a kind of end effector portion can be made in operating theater instruments freely to bend operating theater instruments bending apparatus, there is the apparatus of multi-functional surgery device, the actuator structure of apparatus.

Description

Surgical operating instrument
Technical field
The present invention relates to the bending apparatus of surgical operating instrument, multifunction structure and actuator structure.
Background technology
Operation medically refers to use medical apparatus and instruments to cut skin, mucosa or other tissue, cut or operate and cure focus.Particularly, cutting operation area skin and its internal etc. is treated, the laparotomy ventrotomy etc. of shaping or excision, owing to there is the problems such as hemorrhage, side effect, patient suffering, cicatrix, recently as an alternative, the laparoscopic surgery of robot (robot) is used to enjoy great popularity.
This operating robot comprises main (master) robot and from (slave) robot, this main robot is operated by doctor and generates desired signal and transmit, directly operation action required is carried out to patient after being somebody's turn to do from robot from main robot Received signal strength, main robot and can overall forming from robot, or formed with independent device respectively, and performed the operation under the state being configured in operating room.
Operating robot possesses apparatus (instrument), and this apparatus carries out the surgical operations such as incised tissue to be arranged on to be inserted in human body skin mucosa or skin under the state the robotic arm of robot.
The current application of this apparatus the free operant in order to realize end effector (end effector), i.e. end effector portion and possesses the apparatus of bending apparatus therebetween.
First, the bending apparatus of apparatus is watched with reference to prior art.Fig. 1 to Fig. 7 is the accompanying drawing disclosed in United States Patent (USP) 7320700.At this, directly addition of the accompanying drawing disclosed in U.S. Patent bulletin, and Reference numerals etc. do not change, and be described centered by major part.
Fig. 1 is the schematic diagram representing the apparatus (instrument) possessing bending apparatus, and usually, this apparatus is arranged on from the enterprising line operate of the robotic arm of robot, or the operating portion being connected to manually (hand-held) operating theater instruments carries out surgical operation.
In FIG, Reference numeral 10 represents the toggle (wrist) as the main composition portion of bending apparatus, and Reference numeral 12 represents end effector portion, and Reference numeral 14 represents the body shaft be connected with operating portion.
Fig. 2 is the details drawing of the bending apparatus part illustrated centered by described toggle 10, toggle portion 10 is configured to, the cable 24 be connected with hypotube 26 is provided with inside the coiling (wrap) 34 with helical spring structure, and outside possesses the structure of collapsible tube 36, hypotube 26 is played by coiling during push-and-pull 34 and collapsible tube 36 effect making cable 24 keep respective fixed range.
But, bending apparatus as shown in Figure 2, utilize the case of bending that coiling 34 and collapsible tube 36 keep based on hypotube 26 and cable 24, therefore, because the retractility of collapsible tube 36 causes providing the problem of enough case of bending supporting forces while there is complicated integral structure.Described bending apparatus keeps case of bending by coiling 34 and collapsible tube 36, but when end effector portion is applied in power, is difficult to the more powerful supporting force guaranteed for keeping case of bending by means of only coiling 34 and collapsible tube 36.Therefore, there is the problem of the reliability decrease of apparatus.
On the other hand, another technology of the above-mentioned United States Patent (USP) be disclosed by Fig. 3 to Fig. 5 is the structure being inserted with two disks 224 between helical spring 222, now as shown in Figure 4 and Figure 5, tongue piece 226 is formed with, to be inserted between helical spring 222 the both sides of disk 224 inside are outstanding.Now, the tongue piece of two disks is inserted between helical spring 222 from diverse location with 90 ° of angles.
In addition, Fig. 6 and Fig. 7 is the outer arrangement that representative ring is arranged around described helical spring.
And, another technology of United States Patent (USP) as above is also complicated integral structure, particularly, is configured to only between helical spring 222, insert two disks 224, therefore the tongue piece 226 of different disk is not easy to play a role on accurate location, is difficult to guarantee powerful and even supporting force thus.
Finally, as above-described United States Patent (USP) and spring of the prior art or be arranged in outer arrangement with its similar structures thing, after regulating the case of bending in end effector portion, returned to previous status, however simplify all component and realize more effective machinery form there is limitation.Particularly, be difficult to the case of bending firmly keeping toggle, therefore there is the problem of the reliability decrease of operating theater instruments.
In addition, Figure 25 is the accompanying drawing disclosed in U.S. Patent Publication No. 5797900, represents and is arranged on the apparatus (instrument) 10 being inserted into from the robotic arm of robot and carrying out incised tissue etc. in human body skin mucosa or skin.
Apparatus 10 shown in Figure 25, a side end of pipe component 12 possess for carrying out a pair surgical component 14 of performing the operation, although not shown, with the pipe component 12 of surgical component 14 opposition side on possess and the apparatus housings of the adapter combination of robotic arm (not shown).
Operation cable C1, C2 of being connected by the inside of pipe component 12 is connected with between surgical component 14 and apparatus 10 shell.Operation cable C1, C2 form a pair by two cables, and are connected on surgical component 14a, 14b, carry out action to enable each surgical component 14a, 14b.That is, a pair operation cable C1 can make the first surgical component 14a move, and another can make the second surgical component 14b move to operation cable C2.
For this reason, first and second surgical component 14a, 14b along with being connected with two rotations to rotation body 15a, 15b of operation cable C1, C2, are rotatably connected to the front part of toggle (wrist) body 17 respectively centered by connecting axle 16.
Toggle body 17 is rotatably connected on above-mentioned pipe component 12, and the axle for connecting this toggle body 17 and pipe component 12 has idle pulley 19, and this idle pulley 19 is for guiding and supporting two to the movement operating cable C1, C2.
The apparatus 10 of formation like this, to be connected under the state the robotic arm of (slave) robot, the drive division that main (master) robot starts apparatus 10 is operated by doctor, and by described in drive division push-and-pull two to operation cable C1, C2, therefore a pair surgical component 14a, 14b can by being adjacent to or separating the operation of carrying out cutting bodily tissue etc. each other.
But, comprise the existing apparatus of the apparatus 10 disclosed in United States Patent (USP) described above, performed the operation in pairs by two surgical component, the limitation that a kind of operation tools such as therefore existence can only be used as cutting, clamp is used utilize.
Generally, need to have respectively the medical instrument of difference in functionality when doing once operation, operating robot also needs to use the various apparatuses 10 respectively with difference in functionality.But, if use the various apparatuses respectively with standalone feature to perform the operation, the apparatus meeting function is operated respectively under then needing various apparatus to be inserted into simultaneously the state in human body, or change as required after there is the apparatus of required function and be inserted in human body again and perform the operation, therefore there is the longer and problem that operation process is also complicated of required operating time.
On the other hand, for manual (hand-held) operating theater instruments, end effector be manually carried out by the hands etc. of doctor and not robot carry out, only have on this aspect and there are differences, almost with previously described similar, therefore there is Similar Problems in the structure of above-mentioned apparatus itself and operating principle.
In addition, the existing surgery instrument for laparoscopic surgery, the tip of the axis that its length direction extends is combined with the executors (effector) such as cutter (cutter), clamper (gripper), electrosurgical probe (probe), stiching instrument (stapler).Use when the apparatus of clamper is installed, rotate or mobile apparatus under being difficult to the state clamping (gripping) tissue or internal organs in patient body in the past, therefore need the tissue clamped by relieving or internal organs and again clamp this tissue or internal organs after mobile apparatus.As shown in figure 48, with when rotating apparatus 3 under the state of existing apparatus 3 grasping tissue or internal organs, the accident that tissue clamped by element or internal organs (" T " with reference to Figure 48) are torn or damaged may be there is.
Summary of the invention
Technical problem
The present invention proposes to solve the problem, object is, there is provided a kind of can transmit the bending operation power in end effector portion smoothly with simple structure while, more powerful supporting force can be guaranteed in the bent state thus improve the operating theater instruments bending apparatus of apparatus reliability.
In addition, the object of the invention is, provides one to change operation tool and to utilize a pair surgical component just can carry out various surgical operation, thus can improve the convenience of surgical operation and the apparatus with multi-functional surgical operation device of efficiency.
In addition, object is, provides a kind of and under clamp position, also can rotate freely apparatus and between rotatable clamping and fixed clamp, carry out the actuator structure of the surgery instrument selected as required.
The method of dealing with problems
For the operating theater instruments bending apparatus that the present invention solving described problem relates to, comprise the toggle portion for making end effector portion carry out flexure operation freely, described toggle portion comprises: wire rod portion, and form helical structure, two ends are connected on connector; Multiple jut, outstanding to screw pitch direction between the wire rod forming described wire rod portion, when described wire rod portion being bent when the push pull maneuver by operation cable, induce described wire rod portion to be out of shape or keep deformation state.
Described toggle portion can be arranged between body shaft and described end effector portion, or on the more than one mid portion of described body shaft.
Between body shaft and end effector portion, possessing the toggle portion by operating cable bend, it is characterized in that, described toggle portion comprises: wire rod portion, and form helical structure, its both ends are connected in described body shaft and end effector portion; Multiple jut, gives prominence to along screw pitch direction between the wire rod forming described wire rod portion, when the push pull maneuver by described operation cable makes wire rod portion bend, and the distortion of induction wire rod portion or maintenance deformation state.
Length direction preferably along toggle portion in described wire rod portion is formed with multiple cable hole continuously, passes through for described operation cable.
Preferred described wire rod portion comprises: spire, has helical structure; Both sides fixed part, is formed as circular ring structure, and is connected on the both ends of described spire, and is individually fixed in described body shaft and end effector portion.
Described wire rod portion can be configured to, and makes described spire have compression or stretch modulus.
Preferred described jut makes mutually to retrain along the direction of rotation in wire rod portion between the wire rod in the described wire rod portion of formation.
Preferred described jut, outstanding to pitch direction under the state that side terminal part is fixed on the wire rod of side, and supported under the state that this outstanding opposite side terminal part is separated with another adjacent wire rod.
Now, preferred described jut and the wire segment contacted with this jut are formed with corresponding shape, thus can be intimate contact with one another.
For this reason, the terminal part of preferred described jut is formed as dome-type structure, and the wire segment contacted with this jut forms recessed dome-type structure.
Preferred described jut is circumferentially formed across predetermined angular along spiral respectively described wire rod portion.
That is, circumferentially in the angular range of 180 ° ~ 360 °, described jut can be formed every predetermined angular along spiral in described wire rod portion.
More preferably, circumferentially described jut can be formed along spiral every 240 ° of angles in described wire rod portion.
On the other hand, the opposite side wire rod corresponding with described jut also can be formed with support, this support is outstanding can support described jut to jut direction.
In addition, described jut also can be configured to make both ends all be fixed on the wire rod of both sides, and in contrast, described jut also can be configured to all be separated with both sides wire rod.When being all separated, on the wire rod of both sides, be preferably formed with the insertion section of groove structure, insert to enable the both ends of jut.
In addition, the apparatus of what another embodiment of the present invention related to have multi-functional surgery device, is characterized in that, comprising: main body; A pair surgical component, is located at the end of described main body, carries out surgical operation with human contact; Joint portion, is connected between described main body and a pair surgical component, with make described a pair surgical component have multiple collaborative party to, thus multiple different surgical operation can be implemented; Driving force transmission member, is connected at least side in described a pair surgical component and joint portion, makes described a pair surgical component to implement surgical operation.
According to one embodiment of the invention, described joint portion comprises: a pair rotary body, and connecting into can be rotated by centered by the first axle of described body abutment relatively; A pair second axles, for connecting described each rotary body with described each surgical component carrying out relative rotation.
Now, preferably described first axle and a pair second axles configure with mutually orthogonal direction.
According to another embodiment of the present invention, described a pair surgical component is made up of the fixing operation component of not movement and the movable surgical component to multiple directions movement centered by this fixing operation component, described joint portion comprises: be fixedly connected with portion, for connecting described fixing operation component and main body; Can rotation connection, for connecting described movable surgical component and described fixing operation component or main body.
Now, preferably describedly can rotation connection to comprise: rotary body, rotates centered by the first axle of be fixed surgical component or body abutment; Second axle, can connect described rotary body and movable surgical component with the relative rotation.
Unlike this, describedly can rotation connection also can be made up of globe joint or free bend joint.
According to another embodiment of the present invention, described joint portion can be made up of the multiple globe joints be connected between described main body and each surgical component, or is made up of the multiple free bend joints be connected between described main body and each surgical component.
On the other hand, described driving force transmission member can be made up of operation cable, and this operation cable is connected at least side in described joint portion or a pair surgical component.
Unlike this, described driving force transmission member also can be made up of bar or steel wire, and this bar or steel wire are connected at least side in described joint portion or a pair surgical component.
In addition, described driving force transmission member can be made up of multiple bar, but at least one rod becomes tubular structure, thus transmission of drive force under the state can inserted at other bar.
According to embodiments of the invention, described a pair surgical component can be configured to, in the first collaborative party to execution tweezers function, in the second collaborative party to execution shears function.
In addition, the operating theater instruments that another embodiment of the present invention relates to, carrying out executor (effector) structure of holding action, comprising: the first jaw (jaw) as being combined in its terminal part; Second jaw, to contact with the clamping face of the first jaw along with its clamping face thus carries out holding action; First rotating disk, can be rotatably set on the first jaw; Second rotating disk, can be rotatably set on the second jaw, and opposite with the first rotating disk.
First rotating disk is arranged on the first jaw in the mode that its surface is in the same plane with the clamping face of the first jaw, and the second rotating disk is arranged on the second jaw in the mode that its surface is in the same plane with the clamping face of the second jaw.
First rotating disk projectingly can there is projection, and be recessed at the second rotating disk and be formed with groove, to accommodate projection.In addition, the first rotating disk projectingly can there is the first projection, and correspondingly projectingly with the first projection on the second rotating disk have the second projection.
First rotating disk can be supported on the first jaw by elastomer, its surface is given prominence to from the clamping face of the first jaw, now, when operating the first jaw and/or the second jaw and carry out holding action with the strength being greater than elastomer elastic force, first rotating disk can be forced on the first jaw, thus its rotation is tied.For this reason, projection or groove can be formed on the surface relative with the first jaw of the first rotating disk, and on the first jaw, form the groove corresponding with the projection of the first rotating disk or groove or projection.
In addition, second rotating disk can be supported on the first jaw by elastomer, its surface is given prominence to from the clamping face of the second jaw, now, when operating the first jaw and/or the second jaw and carry out holding action with the strength being greater than elastomer elastic force, second rotating disk can be forced on the second jaw, thus its rotation is tied.For this reason, the first projection or the first groove can be formed on the surface relative with the second jaw of the second rotating disk, and the second groove formed on the second jaw for accommodating the first projection or the second projection be housed in the first groove.
The surface of rotating disk can be formed by the material identical with clamping face and pattern forming, or is formed by materials such as having elastic rubber, silica gel, polyurethane.
Subject matter solution of the present invention as above, can can be clear and definite more in detail by the illustration of ' detailed description of the invention ' described below or ' accompanying drawing ' etc., now, except subject matter solution as above, increase the various problem-solving approaches proposing the present invention relates to and be described.Invention effect
The bending apparatus of the operating theater instruments that the present invention relates to, jut is formed with to screw pitch direction between the wire rod portion with helical structure, therefore, it is possible to transmit the bending operation power in end effector portion smoothly with the structure of overall simple, particularly, under the state that toggle portion is bent, more powerful supporting force can be guaranteed, so have the effect that can improve the equipment dependability comprising the operation of end effector portion.
In addition, the operating theater instruments bending apparatus that the present invention relates to, when jut is configured to retrain wire rod in a rotational direction, when body shaft provides the operating physical force of direction of rotation, can prevent screw type wire rod portion from twisting together, thus when body shaft is rotated, end effector portion also can rotate smoothly.
In addition, the apparatus with multi-functional surgery device that the present invention relates to, can utilize multiple operation tool, therefore need not change apparatus and also can perform the operation simple, convenient and rapidly on an apparatus.Namely, an apparatus with a pair surgical component can use as various operation tool by the present invention, therefore multi-functional apparatus is achieved, thus the operating times such as apparatus replacing construction can be shortened and reduce the number of instruments etc. be inserted in body, simplify operation process, simultaneously, the situation of operating robot also can simplify the necessary structure of whole robot, concerning patient, carry out rapidly performing the operation thus can surgery cost etc. being reduced, significantly improve simplicity and the efficiency of surgical operation.
In addition, according to the apparatus structure that the present invention relates to, by setting up rotating disk on the clamper of operating theater instruments, can apparatus be made rotatable under the state using rotating disk grasping tissue or internal organs.And, make the surface of rotating disk identical with clamping face, or rotating disk is elastically supported on jaw, thus rotatable clamping or fixed clamp can be selected as required to perform the operation.
Accompanying drawing explanation
Fig. 1 to Fig. 7 represents the accompanying drawing disclosed in U.S. Patent number 7320700.
Fig. 8 to Figure 17 is the schematic diagram of the embodiment representing the operating theater instruments bending apparatus that the present invention relates to, wherein,
Fig. 8 a and Fig. 8 b is the axonometric chart of the mode of operation of the embodiment representing the operating theater instruments bending apparatus that the present invention relates to,
Fig. 9 is the axonometric chart of the embodiment representing the operating theater instruments bending apparatus that the present invention relates to,
Figure 10 is the axonometric chart representing illustrative toggle portion in Fig. 9,
Figure 11 is the front view in illustrative toggle portion in Fig. 9,
Figure 12 is the top view in illustrative toggle portion in Fig. 9,
Figure 13 is the reference diagram of the configuration structure of jut in the present invention,
Figure 14 is the detailed section view of the state that arranges of jut in the present invention,
Figure 15 to Figure 17 is the schematic diagram of the different operating state of the operating theater instruments bending apparatus that the present invention relates to.
Figure 18 to Figure 19 is the schematic diagram of another embodiment of the operating theater instruments bending apparatus that the present invention relates to.
Figure 20 is the top view of the different embodiment of the setting position of jut in the operating theater instruments bending apparatus that the present invention relates to.
Figure 21 and Figure 22 is the schematic diagram of another embodiment of the operating theater instruments bending apparatus that the present invention relates to, and Figure 21 is overall perspective view, and Figure 22 is the detailed section view of Figure 21 " A " part.
Figure 23 with Figure 24 is the schematic diagram of the different distortion embodiment corresponding with Figure 22 of the present invention, and Figure 23 is the sectional view of the state that the both sides of jut are all fixed, and Figure 24 is the sectional view of all separated state in the both sides of jut.
Figure 25 is the axonometric chart representing existing apparatus.
Figure 26 to Figure 32 is the schematic diagram of the apparatus that the different embodiments that the present invention relates to are shown, wherein,
Figure 26 is axonometric chart,
Figure 27 is exploded perspective view,
Figure 28 is the skeleton diagram of operation cable connection status,
Figure 29 and Figure 30 is tweezers using state figure,
Figure 31 and Figure 32 is shears using state figure.
Figure 33 a to Figure 35 is the schematic diagram of the apparatus that another embodiment that the present invention relates to is shown, wherein,
Figure 33 a, Figure 33 b are side views, represent the schematic diagram of tweezers using state,
Figure 34 a, Figure 34 b are top views, represent the schematic diagram of shears using state,
Figure 35 is rearview.
Figure 36 a to Figure 38 is the schematic diagram of the apparatus that another embodiment that the present invention relates to is shown, wherein,
Figure 36 a, Figure 36 b are side views, represent the schematic diagram of tweezers using state,
Figure 37 a, Figure 37 b are top views, represent the schematic diagram of shears using state,
Figure 38 is rearview.
Figure 39 is the side view of the apparatus of another embodiment that the present invention relates to.
Figure 40 to Figure 43 is the schematic diagram of the apparatus of another embodiment that the present invention relates to,
Figure 40 and Figure 41 is the side view of tweezers using state,
Figure 42 and Figure 43 is the top view of shears using state.
Figure 44 to Figure 47 is the schematic diagram of the apparatus of another embodiment that the present invention relates to, wherein,
Figure 44 and Figure 45 is the side view representing tweezers using state,
Figure 46 and Figure 47 is the top view representing shears using state.
Figure 48 is the schematic diagram of the using state of the operating theater instruments that prior art relates to.
Figure 49 is the concept map of the actuator structure of the operating theater instruments that another embodiment of the present invention relates to.
Figure 50 is the schematic diagram of the using state of the operating theater instruments that another embodiment of the present invention relates to.
Figure 51 is the concept map of the rotating disk of the operating theater instruments that another embodiment of the present invention relates to.
Figure 52 is the schematic diagram of the actuator structure of the operating theater instruments that another embodiment of the present invention relates to.
Detailed description of the invention
Illustrate that the preferred embodiments of the present invention are as follows with reference to accompanying drawing.
First, when the embodiment of Fig. 8 a to Figure 24 of the present invention is described, in accompanying drawing, same item imparts same reference numerals like structure division, omits repeat specification.
First, with reference to Fig. 8 a to Figure 17, one embodiment of the invention are described.
Fig. 8 a is the approximate three-dimensional map of the terminal part representing surgical unit apparatus, and Reference numeral 110 represents the body shaft be connected from the operating portion of the operating portion of robot or manual operating theater instruments etc.
Body shaft 110 is formed as the tubular structure of hollow usually, can be used in the cable 115(that operates aftermentioned toggle portion 130 with reference to Fig. 9) and for the cable of operational tip operating portion 120 or steel wire inner by it.In addition, the cable for carrying out rotation process to end effector portion 120 can also be had in the inside of body shaft 110.
Reference numeral 120 represents end effector (end effector), i.e. end effector portion, in the accompanying drawing of the present embodiment, be illustrated scissor surgical component 125, but be not limited thereto, the known various surgical component using and form end effector portion 120 can be connected.Such as, except shears, tweezers, cutter, awl, video camera etc. can also be enumerated.
Reference numeral 130 represents toggle portion, and this toggle portion 130, for connecting between body shaft 110 and end effector portion 120, can carry out flexure operation freely to make end effector portion 120.
Toggle portion 130 can be fixedly connected on connector 121 that the rear side terminal part in the connector 111 and end effector portion 120 that the terminal part of body shaft 110 has has respectively.Certainly, toggle portion 130 also can connect into relative rotation with the coupling part in body shaft 110 or end effector portion 120.
As shown in Figure 8 a, this toggle portion 130 is configured to, and end effector portion 120 can be made centered by body shaft 110 to carry out surgical operation freely to all directions comprising direction are all around bending.
Fig. 8 a shows the structure not being coated with overcoat in toggle portion 130, but according to implementation condition, also can cover the overcoat that do not affect toggle portion 130 flexure operation, enough thin soft material is formed.
In addition, as mentioned above, toggle portion 130 can be fixed between the connector 111 of body shaft 110 and the connector 121 in end effector portion 120, but is not limited thereto, and as shown in Figure 8 b, toggle portion 130 also can be fastened on the centre of body shaft 110.That is, toggle portion 130 also can in conjunction with between two connectors 111,112 being fixed on body shaft 110.In addition, although not shown, between toggle portion 130 connector 111 that can be arranged on body shaft 110 as shown in Figure 8 a and the connector 124 in end effector portion 120, simultaneously between two connectors 111,112 that also can be arranged on body shaft 110 as shown in Figure 8 b, according to circumstances, toggle portion 130 also can be separately positioned on the two or more part between two connectors of body shaft 110.Therefore, end effector portion 120 can more be bent freely centered by body shaft 110 by more than one toggle portion 130 on all directions comprising direction all around, thus can carry out surgical operation smoothly.
Below, the structure being combined with the surgery instrument in toggle portion 130 as shown in Figure 8 a and action are described, but first illustrate, in structure as shown in Figure 8 b or possess in the structure in toggle portion 130 in multiple part, toggle portion 130 also can carry out similar action.
Below, centered by described toggle portion 130, main composition part of the present invention is described with reference to Fig. 9 to Figure 17 in detail.
As shown in Figure 9, toggle portion 130 is configured to, bending freely by the operation cable 115 be connected to inside body shaft 110.
At this, preferred operations cable 115 to be connected with operating portion and the steel wire that can carry out push pull maneuver is formed by as above.This operation cable is formed with hook 117 at its terminal part, thus can be arranged on the connector 121(in end effector portion 120 with reference to Fig. 8) on, or can hang or be fixedly installed on the fixed part 136 in aftermentioned toggle portion 130.
Described toggle portion 130 is roughly divided into the wire rod portion 131 with helical structure and the jut 140 be arranged between this wire rod portion 131.
First, described wire rod portion 131 can comprise: spire 133, has helical structure, structure namely as helical spring; With fixed part 135,136, be connected to the both ends of this spire 133, and be connected with described body shaft 110 and end effector portion 120 respectively.
Preferred spire 133 is connected with spiral (or coil shape) structure continuously by single line material, and internal diameter and external diameter are identically formed generally.Now, spire 133 can have elasticity of compression power or tensile elasticity power.
Fixed part 135,136 is the parts in the both-side ends portion being connected to spire 133 with circular ring structure, as mentioned above, is to be connected to the part on the connector 111,121 in body shaft 110 and end effector portion 120.
With reference to Figure 10 and Figure 11, this wire rod portion 131 is formed with continuously multiple cable hole 137 that described operation cable 115 is passed through to the length direction in toggle portion 130.At the present embodiment shown in the drawings of the structure (with reference to Figure 12) being formed with six cable hole 137 when overlooking, but according to implementation condition, between the position of three juts 140, the configuration of three cable hole 137 is formed when also can overlook, or according to implementation condition, more different structures can be formed.But the quantity and spacing setting of cable hole 137 suitably sets according to the quantity of described jut 140 and disposition interval, can implement the even flexure operation in toggle portion 130, preferred entirety is with uniform distance or configure symmetrically.
Secondly, described jut 140 is forming the outstanding formation in pitch direction to spiral between spire 133 and the wire rod of fixed part 135,136, play and transmit along with the action (push away or draw) of described operation cable 115 while the flexure operation power that produces of operation cable 115, play supporting wire rod portion 131 and prevent by the effect compressed, thus make wire rod portion 131 be bent distortion after can keep its deformation state.Therefore, when end effector portion 120(is with reference to Fig. 8) tissue is cut, cut, hold, when the operation such as to burn, while can accurately regulating the direction in end effector portion, under the state of complete its deformation state of maintenance, when not rocking when making end effector portion 120 and guarantee reliable supporting force, surgical operation can be carried out after toggle portion 130 is deformed.
In addition, with reference to Fig. 8 etc., described jut 140 also plays autonomous agent axle 110 when transmitting revolving force via toggle portion 130 terminad operating portion 120, and adjacent wire rod is constrained one another in a rotational direction with the effect of transmitting torque.Namely, if there is no jut 140, when body shaft 110 rotates, spire 133 is twisted together in centre, thus be difficult to moment of torsion to pass to end effector portion 120, but, jut 140 retrains the wire rod forming spire 133 in a rotational direction, therefore, also plays the effect rotary motion of body shaft 110 being passed to smoothly end effector portion 120.Thus, when carrying out surgical operation, while described toggle portion 130 can make apparatus bend freely, the operation in direction of rotation is also implemented freely as integrative-structure.
Preferably these juts 140 are formed along the spiral in wire rod portion 131 every predetermined angular is outstanding, preferably along the circumferencial direction of wire rod in the angle of 180 ° ~ 360 ° every predetermined angular all to direction, side (to body shaft direction or direction, end effector portion) outstanding formation.As shown in figure 13, more preferably can along the circumferencial direction of wire rod every the outstanding formation of 240 ° of angles.Now, under the state that jut 140 evenly configures every hexagonal angle degree in plane plan structure, play and prevent wire rod portion 131 by the effect of supported flexure state while compressing.
What the following describes jut 140 arranges structure.
With reference to Figure 14, supported to screw pitch direction by the opposite side 133L of adjacent wire rod under the state that preferred jut 140 is fixed on wire rod side part 133U.That is, the side end of jut 140 adheres to or is fixed on the side part 133U of wire rod in one-body molded mode etc., and contacts under the state that opposite side end leaves the opposite side part 133L of adjacent wire rod and supported.
Now, the terminal part 140a of the jut 140 preferably contacted and the wire segment 133a contacted with this terminal part is formed (integration) with the structure corresponded to each other to realize contacting gently.That is, as shown in the figure, the terminal part 140a of jut 140 can be formed so that hemispherical dome structure is outstanding, and the wire segment 133a contacted with this jut 140 is formed so that hemispherical dome structure is recessed.
The distortion of spire 133 and jut 140 and contact condition when representing that spire 133 is compressed to direction, side by the part shown in dotted line in Figure 14, illustrate than actual exaggerating for the ease of understanding in the accompanying drawings.
Figure 15 to Figure 17 represents the toggle portion 130 that the present invention relates to the as above approximate three-dimensional map to different directions case of bending, represents to bend state freely according to the push pull maneuver of operation cable 115.
As a reference, Figure 15 to Figure 17 eliminates operation cable 115 and to attach most importance to the schematic diagram illustrated with the mobile status in toggle portion 130.
On the other hand, as in Figure 15 with shown in dotted line, also can on the outline in toggle portion 130 as above aforesaid overcoat 150 avoid toggle portion 130 to expose.
Figure 18 to Figure 19 is the schematic diagram of another embodiment representing the operating theater instruments bending apparatus that the present invention relates to, and Figure 18 is the front view in toggle portion 130, and Figure 19 is the approximate three-dimensional map of the toggle portion operating state shown in Figure 18.
In an embodiment of the invention described above, exemplify the situation that wire rod portion 131 is formed with circular cross-section structure, and exemplify the situation that wire rod portion 131 has rectangular cross section structure in another embodiment.In addition, other parts structure can with the structure same item of an above-mentioned embodiment seemingly, therefore impart same reference numerals, omit repeat specification.
Different from the configuration structure of the illustrative jut of Figure 13 140, Figure 20 shows the planar structure configuring jut 140 to the hand of spiral with 270 ° of intervals successively.That is, the circumferencial direction of jut 140 in wire rod portion 131 is formed along spiral successively with 270 ° of intervals, when therefore overlooking, demonstrates and be interposed between the structure being configured with jut everywhere between 90 °.Now, each configuration one between four spaces being configured with jut of preferred cable hole 137 is total to everywhere.
On the other hand, Figure 21 and Figure 22 is the schematic diagram of the structure representing another embodiment of the present invention, represent spire 133 with pitch direction wire rod respect to one another between, side wire rod is given prominence to and is formed with described jut 140, and give prominence to the structure of the support 142 be formed with for supporting described jut 140 on opposite side wire rod.The part that preferred described jut 140 and support 142 contact, as shown in figure 22, projected curved surface 140a and recessed curved surface 142a touches each other.
Jut 140 and support 142 can with wire rod integrally molding manufacture, but, also can adopt the method be fixedly assembled in pin 145,146 on wire rod as shown in the figure.
In different embodiments of the invention as above, be fixed on certain side of wire rod by jut 140 and be illustrated centered by structure that opposite side is separated, but according to implementation condition, as shown in figure 23, the both ends of jut 140 also can all be fixed on the wire rod of the spire 133 being positioned at both sides.In addition, as shown in figure 24, the both ends of jut 140 also can all be separated with the wire rod of the spire 133 being positioned at both sides.Now, on the wire rod of both sides, be preferably formed with insertion section 134a, 134b of groove structure respectively, both ends 141a, 141b for jut insert to prevent jut 140 from departing from.
Below, when the embodiment of Figure 26 to Figure 47 of the present invention is described, same item imparts same reference numerals like structure division in the accompanying drawings, omits repeat specification.
Figure 26 to Figure 32 is skeleton diagram (Figure 28), tweezers using state figure (Figure 29 and Figure 30), the shears using state figure (Figure 31 and Figure 32) of the axonometric chart (Figure 26) of the apparatus that another embodiment of the present invention is shown, major part exploded perspective view (Figure 27), operation cable connection status.
Reference numeral 21 represents main body in fig. 26.
Main body 21 to support the part of a pair surgical component 30 and joint portion 40, can be to extend from the drive division of apparatus the axle (shaft) or pipe (tube) parts that connect.In addition, main body 21 can be assembled in the structure in the toggle body (wrist member) that is connected with described axle or duct member.
Preferred main body 21 is formed with the tubular structure of hollow, the driving force transmission member such as operation cable C1, C2, C3, C4 for operation a pair surgical component 30 can be made inner by main body 21.
Main body 21 can be configured to, the structure that two-side supporting portion 23 is outstanding to front side (to surgical component direction), so that can rotationally supported joint portion 40.Two-side supporting portion 23 structure that side is outstanding is forward to prevent a pair surgical component 30 from disturbing when different directions moves, as long as this support does not disturb a pair surgical component 30 move and can support the structure of joint portion 40, its shape and structure can carry out various distortion to implement.
As long as main body 21 is also to support the structure of a pair surgical component 30 and joint portion 40, suitably can be out of shape according to apparatus structure.
As mentioned above, possess a pair surgical component 30 carrying out surgical operation with human contact at the end (or front side) of main body 21, possess between this pair surgical component 30 and main body 21 make a pair surgical component 30 have multiple collaborative party to thus realize the joint portion 40 of various surgical operation.In addition, operation cable C1, C2, C3, C4 of being connected to a pair surgical component 30 and joint portion 40 for operating a pair surgical component 30 is possessed.
Describe these each structure divisions in detail as follows.
First, a pair surgical component 30 is formed with string configuration respectively, and terminal part touches each other or contacts, thus can perform particular procedure function.
Illustrative a pair surgical component 30 in the accompanying drawings, be illustrated the structure that can perform tweezers function and shears function, with reference to Figure 27, ' A ' respect to one another face in the first surgical component 31 and the second surgical component 32, tweezers function is performed by contacting with each other, and ' B ' respect to one another in side face, shears function is performed by contacting with each other.
Namely, a pair surgical component 30 is configured to, when first surgical component 31 and the second surgical component 32 are mobile to the first collaborative party to (in fig. 26 D, U direction) centered by described joint portion 40, tweezers function can be performed, and the first surgical component 31 and the second surgical component 32 during movement, can perform shears function to the second collaborative party to (in fig. 26 R, L direction).
Shape and the structure modify that contacts with each other, according to the peculiar function realizing surgical operation, can be various ways by this pair surgical component 30.Exemplify the structure that more terminad portion is more bending to direction respect to one another from the mid portion of each surgical component in the accompanying drawings, contact smoothly to make a pair surgical component 30.
Secondly, illustrate that connection a pair surgical component 30 makes it can implement the joint portion 40 of surgical operation to multiple collaborative party to moving.
Main with reference to Figure 27, joint portion 40 can comprise: a pair rotary body 41,42, can connect with the relative rotation centered by the first axle X supported by main body 21; A pair second axles Y1, Y2, can connect each rotary body 41,42 and each surgical component 31,32 with the relative rotation.
As shown in the figure, a pair rotary body 41,42 can rotate relative to one another under configuration status side by side centered by the first axle X, and be provided with the part of second axle Y1, the Y2 be connected with each surgical component 31,32, in order to the second axle can be formed smoothly, there is relatively wide area.
A pair rotary body 41,42 like this, relatively can rotate as above, and the first axle X is supported by two-side supporting portion 23 between the two-side supporting portion 23 of main body 21, thus can support a pair rotary body 41,42 and can relatively rotate.
First axle X is not limited in and is made up of single-shaft configuration, also can be the structure that a pair rotary body 41,42 can be made under the state being fixed on two-side supporting portion 23 to carry out rotatably supporting, also can be outstanding and rotatably by structure that two-side supporting portion 23 supports from each rotary body 41,42.
A pair surgical component 30 is rotatably assembled on a pair rotary body 41,42 respectively by second axle Y1, Y2, as long as but second axle Y1, Y2 is also the structure that each surgical component 31,32 can be made to rotate relative to each rotary body 41,42, be fixed on which side also harmless, and, also can be do not fix and insert the structure formed with single-shaft configuration.
On the other hand, the structure that first axle X shown in the drawings and a pair second axles Y1, Y2 configure with mutually orthogonal directions, this is that the first axle X and a pair second axles Y1, Y2 are overall with decussate texture configuration thus total is compact and carry out the structure of action smoothly.But be not limited thereto, a pair second axles Y1, Y2 also can be configured on different axis, and need not be positioned on same axis.
Secondly, the driving force transmission member for operating a pair surgical component 30 and joint portion 40 formed as mentioned above is described.
As long as the link that driving force transmission member can make surgical component 30 and joint portion 40 rotate, the known operation connecting elements such as steel wire, cable, bar shaped bar can be utilized to form.
In the accompanying drawings in another embodiment illustrative, represent the structure utilizing cable.
With reference to Figure 27 and Figure 28, driving force transmission member is configured to as follows, each surgical component 31,32 and each rotary body 41,42 possess cable link 31a, 32a, 41a, 42a respectively, and on this cable link 31a, 32a, 41a, 42a, is connected to operation cable C1, C2, C3, C4.
Now, each cable link 31a, 32a, 41a, 42a can not be fixed on each surgical component 31,32 and each rotary body 41,42 with the relative rotation, and preferred setting position lays respectively on the first axle x-ray with on second axle Y1, Y2 line.
The fixed structure of cable link 31a, 32a, 41a, 42a can be formed to form single structure with each surgical component 31,32 or each rotary body 41,42 or to assemble fixing mode after making separately.
Each operation cable C1, C2, C3, C4 can be inner and via each cable link 31a, 32a, 41a, 42a by previously described main body 21, by each cable link 31a, 32a, 41a, 42a, each surgical component 31,32 or each rotary body 41,42 rotated according to the action of push-pull cable.
In accompanying drawing, Reference numeral 35 represents and is used for the idler roller of pressing operation cable C3, C4, idler roller 35 are a pair surgical component 31,32 by open time operation cable C3, C4 also can be made to stablize the state be connected on cable link 41a, 42a under the auxiliary body that carries out operating.
Idler roller 35 not only can be configured to the structure of pressing operation cable C3, C4, also can be configured to the structure supported in the downside (towards surgical component side centered by cable) of each operation cable.Now, even if a pair surgical component 31,32 moves to either direction, operation cable C3, C4 is through a pair idler roller 35 setting up and down and is connected with cable link 41a, 42a, thus can with more stable connection status transmission operating physical force.
In addition, also can be formed there is pore structure guide to replace idler roller 35.That is, operation cable C3, C4 can be made through circular ring structure or tubular guide device, under stablizing to make operation cable C3, C4 the state be connected on cable link 41a, 42a, transmit operating physical force.Now, guide can be arranged on the position identical with the position being provided with described idler roller 35.
The structure of operation operation as above each cable C1, C2, C3, C4, by the patent of invention of the applicant and known in first technology, therefore omits detailed description thereof.
The using state of the apparatus of another embodiment of the present invention as above is described with reference to Figure 29 to Figure 32.
Figure 29 and Figure 30 is as state diagram during tweezers, by operating the first cable C1 and the second cable C2, a pair rotary body 41,42 is rotated centered by the first axle X, thus make a pair surgical component 30 as shown in figure 29 separately, or a pair surgical component 30 is made to contact and utilize as tweezers as shown in figure 30.
Figure 31 and Figure 32 is as state diagram during shears, by operating the 3rd cable C3 and the 4th cable C4, a pair surgical component 30 is rotated respectively centered by second axle Y1, Y2, thus make a pair surgical component 30 as shown in figure 31 separately, or a pair surgical component 30 is made to overlap each other and utilize as shears as shown in figure 32.
Another embodiment > of <
Figure 33 a to Figure 35 is side view (Figure 33 a, Figure 33 b), top view (Figure 34 a, Figure 34 b), the rearview (Figure 35) of the apparatus that another embodiment of the present invention is shown.
Another embodiment of the present invention, except the structure of driving force transmission member, remaining structure division is identical with the structure of another embodiment (Figure 26 to Figure 32) previously described.
Different by operating another embodiment (Figure 26 to Figure 32) above-mentioned that cable C1, C2, C3, C4 form from driving force transmission member, the driving force transmission member of another embodiment is made up of the bar 51,51 ', 52,52 ' of radial type anatomical connectivity.Now, preferred bar 51,51 ', 52,52 ' by have can transmit rectilinear movement the fineness degree of operating physical force and the bar shaped of intensity form.
In the accompanying drawings illustrative bar 51,51 ', 52,52 ' by the first bar 51 be connected on a pair rotary body 41,42,51 ' and the second bar 52,52 ' be connected on a pair surgical component 31,32 form.
First bar to be connected to a pair rotary body 41,42 (with reference to Figure 33 a) from two poles 51 ' of mobile jib 51 branch, equally, the second bar is also to be connected to a pair surgical component 31,32 (with reference to Figure 34 a) from two poles 52 ' of mobile jib 52 branch.
Now, preferably respective mobile jib 51,52 is connected in knuckle joint 51c, 52c mode that can relatively rotate with pole 51 ', 52 ', and pole 51 ', 52 ' and each rotary body 41,42 and surgical component 31,32 are connected in globe joint 51a, 51b, 52a, 52b mode that can be rotatable.The blank area be connected with rotary body 41,42 also can replace globe joint 51a, 51b with knuckle joint and connect.
And, the position that the pole 51 ' of the first bar is connected to each rotary body 41,42 with globe joint 51a, 51b is, in upper and lower (to scheme for the benchmark) position at a distance of predetermined distance centered by the first axle X, the pole 52 ' of the second bar is connected to the position of surgical component 31,32 with globe joint 52a, 52b, the position (with reference to Figure 35) in left and right at a distance of predetermined distance centered by second axle Y1, Y2.
Figure 35 is the rearview of the setting position representing globe joint 51a, 51b, 52a, 52b, a pair surgical component 30 can form the extension outstanding to direction opposite each other to connect pole 52 ' respectively, thus can provide enough moments of torsion by the second bar 52,52 '.
By the push pull maneuver of each bar 51,51 ', 52,52 ' so connected, while a pair rotary body 41,42 is rotated relatively, a pair surgical component 31,32 is rotated relatively.
Namely, as shown in Figure 33 a, pull the first bar 51,51 ', then a pair rotary body 41,42 rotates to the direction making a pair surgical component 30 separate centered by the first axle X, as shown in Figure 33 b, promote the first bar 51,51 ', then a pair rotary body 41,42 rotates to the direction making a pair surgical component 30 close up centered by the first axle X.
In addition, as shown in Figure 34 a, pull the second bar 52,52 ', then a pair surgical component 31,32 rotates to the direction separated centered by second axle Y1, Y2, as shown in Figure 34 b, when promotion second bar 52,52 ', a pair surgical component 31,32 rotates to the direction closed up centered by second axle Y1, Y2.
Be illustrated with the structure connected from a Ge Gan branch above, but unlike this, also can form four bars be connected on each rotary body 41,42 and each surgical component 31,32.
In addition, when being made up of bar, the part be connected with bar and each rotary body 41,42 and each surgical component 31,32, also can connect with the articulated structure that can relatively rotate as previously described, but be not limited thereto, also can on each rotary body 41,42 and each surgical component 31,32 formative gear structure (pinion), the gear structure (tooth bar) of this gear and bar combines, thus can each rotary body of rotary actuation 41,42 and each surgical component 31,32.
On the other hand, in another embodiment of the invention, describe the embodiment that driving force transmission member is made up of bar, but also can be made up of the steel wire with enough rigidity.
Another embodiment > of <
Figure 36 a to Figure 38 is side view (Figure 36 a, Figure 36 b), top view (Figure 37 a, Figure 37 b), the rearview (Figure 38) of the apparatus that another embodiment of the present invention is shown.
The similar of another embodiment of the present invention and previously described embodiment (Figure 33 a to Figure 35), it is the embodiment that mobile jib 51,52 is together formed on coaxially.In addition, the structure difference of another embodiment of the present invention and embodiment (Figure 33 a to Figure 35) is, during catch bar, a pair surgical component 31,32 points is opened, and closes up when pulling bar.
First, illustrate that mobile jib 51,52 is configured in the structure on an axis.
For the first bar be connected on a pair rotary body 41,42, mobile jib 51 can be identical or similar with embodiment (Figure 33 a to Figure 35), and for the second bar be connected on a pair surgical component 31,32, mobile jib 52 forms tubular structure.
That is, can insert to move linearly under the state in the mobile jib 52 of the second bar of tubular structure formation with the mobile jib 51 of the first bar of club shaped structure formation, thus a pair rotary body 41,42 is moved.And the mobile jib 52 with the second bar of tubular structure also can carry out moving linearly and make a pair surgical component 31,32 move.
Same with embodiment (Figure 33 a to Figure 35), each mobile jib 51,52 and pole 51 ', 52 ' are connected in knuckle joint 51c, 52c mode thus can relatively rotate, and what pole 51 ', 52 ' and each rotary body 41,42 and surgical component 31,32 can be rotatable is connected in globe joint 51a, 51b, 52a, 52b mode.
The link position of each globe joint 51a, 51b, 52a, 52b can to configure as shown in figure 38.
Globe joint 51a, 51b of being connected to each rotary body 41,42 can be configured in the side of each rotary body.Knuckle joint now also can be utilized to replace globe joint 51a, 51b be connected with rotary body 41,42.
Be connected globe joint 52a, the 52b on surgical component 31,32, can be arranged on and extend to the extension 45 of the first axle X from each surgical component 31,32.Figure 38 illustrates the embodiment that globe joint 52a, 52b are positioned at the formation on the first axle x-ray.
On the other hand, the setting position of each globe joint 51a, 51b, 52a, 52b in another embodiment of the present invention is positioned at the setting position opposition side with embodiment (Figure 33 a to Figure 35) centered by the first axle X or second axle Y1, Y2.This point can be known by comparing Figure 35 and Figure 38.
Like this, the setting position of each globe joint 51a, 51b, 52a, 52b is set to the situation contrary with embodiment (Figure 33 a to Figure 35), when promoting or pull bar, carries out the action contrary with embodiment (Figure 33 a to Figure 35).
Namely, as shown in Figure 36 a, promote the first bar 51,51 ', then a pair rotary body 41,42 rotates to the direction making a pair surgical component 30 separate centered by the first axle X, as shown in Figure 36 b, when pulling first bar 51,51 ', a pair rotary body 41,42 rotates to the direction making a pair surgical component 30 close up centered by the first axle X.
In addition, as shown in Figure 37 a, promote second bar 52,52 ' with tubular structure, then a pair surgical component 31,32 rotates to separating direction centered by second axle Y1, Y2, as shown in Figure 37 b, pull the second bar 52,52 ', then a pair surgical component 31,32 rotates to the direction closed up each other centered by second axle Y1, Y2.
On the other hand, disclosed mobile jib 51 structure that the mobile jib 52 of the second bar is formed with tubular structure with club shaped structure formation of the first bar, but, in contrast, also can be the first bar mobile jib 51 with tubular structure formed and the mobile jib 52 of the second bar with club shaped structure formed thus be inserted in the mobile jib 51 of the first bar.
In addition, two mobile jibs 51,52 also can all be formed with tubular structure, thus are configured in coaxially with double pipe structure.Also the mobile jib of more than three can be configured in coaxially with triple above tubular construction in this way, now, the most inboard mobile jib also can be formed with single bar or steel wire form.
In addition, be inserted into the bar in the mobile jib of tubular structure formation, be not limited to the rod-like structure of hard (unbending material), also can be made up of the steel wire of soft (relatively easy bending material).
In addition, also can insert in the mobile jib formed with tubular structure and multiple there is bar that is shaft-like or structure of steel wire, and transmit operating physical forces by the mobile jib of tubular structure and the multiple bars be inserted within it.
In addition component part can be identical with the structure of above-described embodiment or similar, and description will be omitted.
Another embodiment > of <
In another embodiment of the invention, a pair surgical component 30 is divided into: motionless fixing operation component 32 ' and centered by this fixing operation component 32 ' to multiple directions motion movable surgical component 31 '.
Namely, as shown in figure 39, possess fixing operation component 32 ' in downside, this fixing operation component 32 ' is fixed in main body 21, possess movable surgical component 31 ' in upside, this movable surgical component 31 ' is centered by fixing operation component 32 ' and rotate centered by the first axle X or the second axle Y1.
Now, joint portion 40 is by the portion that is fixedly connected with 33 for being connected and fixed surgical component 32 ' and main body 21 with for being connected can rotation connection 41, Y1 forming of movable surgical component 31 ' and fixing operation component 32 ' or main body 21.
Being fixedly connected with portion 33 is the structure that main body 21 is connected with fixing operation component 32 ' one or the structure division assembled with being fixed to one another.
Can rotation connection be made up of with the second axle Y1 making movable surgical component 31 ' rotate relative to this rotary body 41 rotary body 41 rotated centered by the first axle X.
At this, as shown in the figure, described first axle X can be supported by the support 23 of main body 21, and the surgical component 32 ' that also can be fixed supports.
In addition structure is identical with the structure of above-described embodiment (Figure 26 to Figure 32), and description will be omitted.Just, the driving force transmission member be made up of cable C1, C3, steel wire, bar etc. is not connected with fixing operation component 32 ', and is only connected with rotary body 41 and movable surgical component 31 '.
Another embodiment of the present invention as above, when basic structure and the similar formation of embodiment (Figure 26 to Figure 32), by operating the first cable C1, rotary body 41 is rotated centered by the first axle X, then movable surgical component 31 ' moves up and down thus realize tweezers function together with fixing operation component 32 ', by operating the 3rd cable C3, movable surgical component 31 ' is rotated centered by the second axle Y1, then movable surgical component 31 ' side-to-side movement thus realize shears function together with fixing operation component 32 '.
On the other hand, although attached not shown, describedly rotation connection also can not utilize rotary body 41, first axle X, the second axle Y1 etc., and the spherical joint connection structure (another embodiment) described in utilizing embodiment below or free bend joint connecting structure (the 6th embodiment) make movable surgical component 31 ' move to multiple directions.
Another embodiment > of <
The structure of another embodiment of the present invention described below joint portion 40 compared with above-described embodiment is different.This is illustrated successively.
Figure 40 and Figure 41 is the side view for representing tweezers operating state, Figure 42 and Figure 43 is the top view for representing scissor action state.
Another embodiment of the present invention is, is made up of a pair globe joint 61,62 for the joint portion 40 connecting main body 21 and a pair surgical component 30.
That is, main body 21 is connected respectively by globe joint 61,62 with each surgical component 31,32, and utilizes operation cable C1, C2, C3, C4 that a pair surgical component 30 is rotated, thus can realize tweezers (Figure 40 and Figure 41) or shears (Figure 42 and Figure 43) function.
Globe joint 61,62 is usual known technology, and each surgical component 31,32 be connected on ball is rotatable centered by the spherical shell being fixed on main body 21.
Reference numeral 65 in accompanying drawing represents the cable guide for guiding each operation cable C1, C2, C3, C4 movement.
On the other hand, described in embodiment (Figure 39), also can in a pair surgical component 30 be directly fixed in main body 21 as fixing operation component, and do not form globe joint, another surgical component, component of can having an operation are connected by globe joint, and realize various function with fixing operation component synergism.
Figure 44 and Figure 45 is the side view for representing tweezers operating state, Figure 46 and Figure 47 is the top view for representing scissor action state.
Another embodiment of the present invention is, is made up of a pair free bend joint 71,72 for the joint portion 40 connecting main body 21 and a pair surgical component 30.
Namely, main body 21 is connected respectively by free bend joint 71,72 with each surgical component 31,32, can as uses such as shears (Figure 42 and Figure 43) time when enabling a pair surgical component 30 to the first collaborative party to rotation as tweezers (Figure 40 and Figure 41) or to the second collaborative party to rotation.
Free bend joint 71,72 can utilize known toggle (wrist) Structure composing using multiple loop coupling structure, coil form steel wire, telescoping tube etc. that end component (surgical component) is operated to different directions, open by U.S. Patent number US07618066, US06053907, US07547311, US07323700, U.S. Patent Publication No. US2310/0087711, US2310/0190735 etc., therefore the accompanying drawing illustration omitted it and detailed description.
In addition, driving force transmission member is also by the Structure composing running through free bend joint 71,72 or be connected with surgical component 31,32 respectively by its inside, the syndeton of this driving force transmission member is also disclosed in first technology etc. by listed above, therefore detailed.
On the other hand, as the basic structure of the present embodiment, described in embodiment (Figure 39), also can in a pair surgical component 30 be directly fixed in main body 21 as fixing operation component, and do not form free bend joint, another surgical component, component of can having an operation are connected by free bend joint, thus realize various function.
Except several embodiments of the invention described above, also can apply technological thought of the present invention and form various embodiment.Other different embodiment described below, illustrates even without accompanying drawing, and general technical staff of the technical field of the invention also by the accompanying drawing of described several embodiment or can describe easily enforcement in detail, therefore omits accompanying drawing, the concise and to the point structure describing each embodiment.
Previously described several embodiments of the present invention exemplify and utilize two, the i.e. structure of a pair surgical component 30, but also can combine three or its above surgical component.
In addition, the structure used together with shears with tweezers in the embodiment of the invention described above is illustrated for main, but this is only an example, as long as the collaborative each other and function that can utilize of a pair surgical component 30, other difference in functionality such as torch, awl also can be configured to.
In addition, even if a pair surgical component 30 is same surgical component, also can the slightly different formation such as size or function.For example, referring to Figure 27, ' A ' respect to one another part can utilize the tweezers that relative area is larger, and ' B ' side is made the face structure of the such sharpened configuration of non-shears and utilizes as the tweezers that relative area is less.
Another embodiment > of <
Below when the embodiment of Figure 49 to Figure 52 of the present invention is described, in the accompanying drawings like component part, same reference numerals is imparted to same item, omit repeat specification.
Figure 49 is the concept map of the actuator structure that the operating theater instruments that another embodiment of the present invention relates to is shown, Figure 50 is the schematic diagram of the using state that the operating theater instruments that another embodiment of the present invention relates to is shown.With reference to Figure 49 and Figure 50, show executor 1, first jaw 10, clamping face 12,22, first rotating disk 14, second jaw 20, second rotating disk 24.
The feature of the present embodiment is, can set up rotating disk by the clamper end in operating theater instruments, with rotating disk clamping (grip) tissue or internal organs in operation process, and with when not damaged tissue or internal organs, apparatus is rotated in clamp position.
The operating theater instruments that the present embodiment relates to is executor 1 structure being combined with clamper at its terminal part, consists essentially of a pair jaw, namely carries out the first jaw 10 and the second jaw 20 of holding action.Executor 1 structure that the present embodiment relates to, is characterized in that, a pair jaw 10,20 is respectively arranged with rotatable rotating disk 14,24.
When the face that first jaw 10 and the second jaw 20 carry out adjoining one another in the process of holding action is called clamping face 12,22, each rotating disk, be namely arranged on the first rotating disk 14 on the first jaw 10 and be arranged on the second rotating disk 24 on the second jaw 20 toward each other, and the surface of rotating disk 14,24 and clamping face 12,22 adjoin one another equally in clamping process.
The situation that the clamper each jaw 10,20 being provided with rotating disk 14,24 comes grasping tissue or internal organs is used in like this, the situation that can be divided into the surface clamping using rotating disk 14,24 and the situation using clamping face 12,22 to clamp in operation process.
When using rotating disk 14,24 to come grasping tissue or internal organs, can in this clamped condition, jaw rotates, therefore, it is possible to make apparatus (centered by rotating disk) rotate under clamp position relative to rotating disk 14,24.This apparatus that can make is called ' rotatable clamping ' with the situation of the state rotated clamping and is described.
On the other hand, when using clamping face 12,22 grasping tissue or internal organs, same with existing clamper, be in the state being difficult to apparatus is rotated, this situation be called ' fixed clamp ' below and be described.
The apparatus that the present embodiment relates to, is characterized in that, can carry out rotatable clamping, also can be fixed clamping as required.
In order to select to realize rotatable clamping and fixed clamp, as shown in figure 49, the surface of rotating disk 14,24 and clamping face 12,22 in the same plane can be made.That is, make a part for jaw 10,20 cave in and be equivalent to the thickness of rotating disk 14,24, and fall into part within it rotating disk 14,24 is set, thus make the surface of rotating disk 14,24 and clamping face 12,22 consistent.This structure can make that the part (disc surfaces) on jaw 10,20 surface is used in rotatable clamping and another part (clamping face) is used in fixed clamp.
At this, the surface of rotating disk 14,24 and clamping face 12,22 are in the same plane that ' same plane ' not only refers in mathematical meaning, this same plane represents when using gripper tissue or internal organs, method of clamping be not projecting height according to clamping face and according to the position of clamping face the different meanings.
As the present embodiment, if set up rotating disk 14,24 on the jaw 10,20 of clamper, then except can rotate the advantage of apparatus under clamp position except, also there is the advantage easily can taking out the pin or clip etc. that drop in abdominal cavity of patients in operation process.
For pin, utilizing apparatus to take out in the process of the pin dropped in abdominal cavity of patients in the past, there is the scratching of pin sleeve and the problem such as again to drop, but, the situation of the clamper using the present embodiment to relate to, as shown in (a) of Figure 50, rotating disk 14,24 is utilized to clamp in the process dropping and take out at Intraabdominal pin (needle), when pin sleeve (trocar) tangles, by its counteracting force, rotating disk 14,24 natural rotation, therefore, as shown in (b) of Figure 50, easily can not take out pin by the interference of sleeve pipe.
Figure 51 is the concept map of the rotating disk that the operating theater instruments that another embodiment of the present invention relates to is shown.With reference to Figure 51, show the first jaw 10, clamping face 12,22, first rotating disk 14, projection 16,28, second jaw 20, second rotating disk 24, groove 26.
In the present embodiment, be formed with projection 16 and groove 26 at rotating disk 14,24, therefore more easily clamp clip (clip) or pin (needle).
Namely, as shown in (a) of Figure 51, projecting projection 16(or groove on the first rotating disk 14), projection 16 is made to be inserted into structure in groove 26 to be formed in clamping process, and cave on the second rotating disk 24 formation groove 26(or projection) time, even if clip or pin etc. also can not be suspended in projection 16 with the surface contact of rotating disk 14,24, thus easily can clamp clip etc.
In (a) of Figure 51, exemplify the situation being formed with a projection-groove structure, but also can form multiple projection and multiple grooves corresponding thereto as required.
On the other hand, as shown in (b) of Figure 51, also can on the first rotating disk 14 and the second rotating disk 24 all projecting projection 16,28, thus in clamping process, make projection be engaged each other, now, clip etc. are clamped between projection 16 and projection 28, therefore, even if clip etc. not with the surface contact of rotating disk 14,24, also easily can clamp clip etc.
In (b) of Figure 51, exemplify the situation being formed with a projection-raised structures, but also can be formed with multiple raised structures corresponded to each other as required.
Figure 52 is the schematic diagram of the actuator structure that the operating theater instruments that another embodiment of the present invention relates to is shown.With reference to Figure 52, show the first jaw 10, clamping face 12,22, first rotating disk 14, projection 32,34, second jaw 20, second rotating disk 24, groove 33,35, elastomer 30.
The rotating disk 14,24 that the present embodiment relates to, under normal conditions, rotatable clamping is carried out than under the state that clamping face 12,22 is given prominence to slightly, and when with specify above strength hold with a firm grip a pair jaw 10,20 time, rotating disk 14,24 is fixed on parent (jaw) and above can not rotates, thus can be fixed clamping.
That is, when the first rotating disk 14 related to by the present embodiment is arranged on the first jaw 10, rotating disk 14 can be bearing on jaw 10 by the elastomers such as spring 30, and the surface of rotating disk 14 is slightly more outstanding than clamping face 12.
When rotating disk 14 is so set, under normal conditions, rotating disk 14 can be used to carry out rotatable clamping.In addition, during with force operations a pair jaw 10,20 being greater than elastomer 30 elastic force to carry out holding action, first rotating disk 14 is pressed to the first jaw 10, therefore due to the friction between rotating disk 14 and jaw 10, rotating disk 14 is in the state that can not freely rotate, that is, the affined state of rotation is in.Under the affined state of rotation of rotating disk 14, when using rotating disk 14 to carry out holding action, can only clamping be fixed, and can not rotatable clamping be carried out.
In a word, when rotating disk 14 is resiliently supported on jaw 10, under normal conditions, rotating disk 14 can be used to carry out rotatable clamping, but with the strength being greater than elastomer 30 elastic force to make jaw 10 be engaged time, rotary body 14 can not rotate, thus be fixed clamping, therefore, use rotating disk 14 to carry out holding action even if same, the strength that can be engaged by adjusting jaw 10 is selected to carry out rotatable clamping and fixed clamp.
On the other hand, more effective in order to make rotating disk 14 be pressed the effect that frictional constraint rotates to jaw 10, projection 32(or groove can be formed on the surface of the rotating disk 14 opposed with jaw), and on jaw 10, form groove 33(or projection) with the projection 32(that rotating disk 14 is formed or groove) mate.
Like this, form the situation of the projection-groove structure matched between rotating disk 14 and jaw 10, when rotating disk 14 is exerted pressure by jaw 10, projection 32 and groove 33 are engaged each other, thus can the rotation of more addition of constraints rotating disk 14.
Select the structure of constraint turntable rotation according to chucking power, only can be used in any one in the rotating disk 14,24 that a pair jaw 10,20 is arranged, also can be used on two in a pair rotating disk 14,24.
That is, same with the first rotating disk 14, when being arranged on the second jaw 20 by the second rotating disk 24, rotating disk 24 is supported on jaw 20 by the elastomers such as spring 30, and the surface of rotating disk 24 is slightly more outstanding than clamping face 22.
Like this, when a pair rotating disk 14,24 is respectively by a pair jaw 10,20 elastic bearing, under normal conditions, rotating disk 14,24 can be used to carry out rotatable clamping, and when with the strength being greater than elastomer 30 elastic force to make jaw 10,20 be engaged time, rotary body 14,24 can not rotate, thus can be fixed clamping.
In addition, affined function is rotated because rubbing with jaw 20 in order to make the second rotating disk 24 more reliably have, projection 34(or groove can be formed) on the surface of the rotating disk 24 opposed with jaw 20, and on jaw 20, form groove 35(or projection), with the projection 34(that rotating disk 24 is formed or groove) mate.
On the other hand, the surface of the rotating disk that the present embodiment relates to can be formed with the clamping face same material or pattern forming of jaw, to avoid object landing in clamping process thus can accurately clamp.Or, even if the surface of rotating disk is made up of the material different from clamping face, also by forming by having the material such as elastic material, such as rubber, silica gel, polyurethane, thus can not firmly can clamp on landing ground.
As above, the technological thought described in embodiments of the invention can independently be implemented, and also can combine enforcement.And, the present invention by accompanying drawing and in the content of invention the embodiment recorded be illustrated, but this is only illustrate, and general technical staff of the technical field of the invention can make various distortion and other impartial embodiment thus.Therefore, technical protection scope of the present invention should be as the criterion with the record of claims.

Claims (15)

1. an operating theater instruments bending apparatus, is characterized in that, comprises the toggle portion for making end effector portion carry out flexure operation freely, and described toggle portion comprises:
Wire rod portion, form helical structure, two ends are connected on connector; And
Multiple jut, outstanding to screw pitch direction between the wire rod forming described wire rod portion, when described wire rod portion being bent when the push pull maneuver by operation cable, induce described wire rod portion to be out of shape or keep deformation state.
2. operating theater instruments bending apparatus according to claim 1, is characterized in that,
Described wire rod portion is formed along the length direction in toggle portion multiple cable hole continuously that pass through for described operation cable.
3. operating theater instruments bending apparatus according to claim 1 and 2, is characterized in that, described wire rod portion comprises:
Spire, has helical structure;
Both sides fixed part, is formed as circular ring structure, and is connected on the both ends of described spire, and is individually fixed in body shaft and end effector portion.
4. operating theater instruments bending apparatus according to claim 3, is characterized in that,
Described wire rod portion is configured to make described spire have compression or stretch modulus.
5. operating theater instruments bending apparatus according to claim 1, is characterized in that,
Described jut is configured to, and the wire rod in the described wire rod portion of formation is retrained mutually along the direction of rotation in wire rod portion.
6. the operating theater instruments bending apparatus according to any one of claim 1,2,5, is characterized in that,
The state that described jut is fixed on the wire rod of side with side terminal part is outstanding to pitch direction, and this outstanding opposite side terminal part is to be supported under the state be separated with another adjacent wire rod.
7. the operating theater instruments bending apparatus according to any one of claim 1,2,5, is characterized in that,
Circumferentially described jut is formed along spiral every predetermined angular in described wire rod portion.
8. operating theater instruments bending apparatus according to claim 7, is characterized in that,
In described wire rod portion circumferentially, in the angle of spiral between 180 ° ~ 360 °, described jut is formed every predetermined angular.
9. operating theater instruments bending apparatus according to claim 7, is characterized in that,
Described wire rod portion circumferentially along spiral every 240 ° formed described juts.
10. operating theater instruments bending apparatus according to claim 6, is characterized in that,
Described jut and the wire segment contacted with this jut are formed as corresponding shape, thus intimate contact with one another.
11. operating theater instruments bending apparatus according to claim 10, is characterized in that,
The terminal part of described jut is formed as dome-type structure, and the wire segment contacted with this jut forms recessed dome-type structure.
12. operating theater instruments bending apparatus according to claim 6, is characterized in that,
Another wire rod described is formed with support, and this support is outstanding can support described jut to jut direction.
13. operating theater instruments bending apparatus according to any one of claim 1,2,5, is characterized in that,
The both ends of described jut are all fixed on the wire rod of both sides.
14. operating theater instruments bending apparatus according to any one of claim 1,2,5, is characterized in that,
Described jut is all separated with both sides wire rod, and both sides wire rod is formed the insertion section of groove structure, inserts to make the both ends of jut.
15. operating theater instruments bending apparatus according to claim 1, is characterized in that,
Described toggle portion is arranged between body shaft and described end effector portion, or on the more than one mid portion of body shaft.
CN201180038902.9A 2010-08-27 2011-08-22 Surgical operating instrument Active CN103068333B (en)

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Applications Claiming Priority (11)

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KR10-2010-0083252 2010-08-27
KR1020100083252A KR101733401B1 (en) 2010-08-27 2010-08-27 Effector structure of surgical instrument
KR10-2010-0090109 2010-09-14
KR1020100090109A KR101146945B1 (en) 2010-09-14 2010-09-14 Wrist device for surgical tool
KR10-2010-0090775 2010-09-15
KR20100090775 2010-09-15
KR10-2010-0113983 2010-11-16
KR1020100113983A KR101684863B1 (en) 2010-11-16 2010-11-16 Instrument of surgical apparatus having multi-function
KR1020110083013A KR101643188B1 (en) 2010-09-15 2011-08-19 Wrist device for surgical tool
KR10-2011-0083013 2011-08-19
PCT/KR2011/006175 WO2012026720A2 (en) 2010-08-27 2011-08-22 Instrument for surgical operation

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