CN103584829B - Endoscope surgical instrument outer sheath with variable rigidity - Google Patents

Endoscope surgical instrument outer sheath with variable rigidity Download PDF

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CN103584829B
CN103584829B CN 201310511754 CN201310511754A CN103584829B CN 103584829 B CN103584829 B CN 103584829B CN 201310511754 CN201310511754 CN 201310511754 CN 201310511754 A CN201310511754 A CN 201310511754A CN 103584829 B CN103584829 B CN 103584829B
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flexible
airbag
rigid
surgical instrument
variable stiffness
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CN 201310511754
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CN103584829A (en )
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罗云
赵儒镇
赵爽
李祥
张文光
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上海交通大学
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Abstract

一种微创手术器械技术领域的可变刚度的内镜手术器械外护套,其由若干可变刚度柔性单元串联组成,每个单元包括:器械通道、柔性高伸缩率气囊、刚性连接件、刚性丝及圆盘,在每个柔性单元中,刚性丝穿过若干刚性连接件并与其刚性连接,刚性连接件上的圆孔套在气囊的最小直径位置将三个柔性高伸缩率气囊连接在一起,三个柔性高伸缩率气囊的两端均分别与第一圆盘、第二圆盘相连接。 Endoscopic surgical instrument of the outer sheath variable stiffness BACKGROUND A minimally invasive surgical instrument, consisting of a plurality of variable stiffness of flexible units in series, each unit comprising: an instrument channel, flexible balloon high expansion ratio, a rigid connecting member, wire and rigid disk, flexible in each cell, a plurality of rigid wire passing through a rigid connection and rigidly connected thereto, the circular rigid connection sleeve in the minimum diameter position of the bladder three flexible high expansion rate in the balloon connector together, three ends of the flexible airbag high expansion ratio are respectively, a second disc connected to the first disk. 通过控制气囊内部气压,可实现空间弯曲及变刚度的目的。 By controlling the gas pressure inside the airbag, and can achieve spatial variation bending rigidity purposes. 本发明作为内镜手术器械进入体内的外护套,能够顺应人体腔道的生理弯曲,避免对内壁组织的压迫,在到达病患位置后通过变刚度,为手术器械提供力学支撑,可在保证微创内镜手术安全性的前提下,更有效的开展手术。 The present invention as an endoscopic surgical instrument into the outer sheath body can adapt to the physiological curvature body cavity, to avoid pressure on the inner wall of the tissue, to provide mechanical support in the patient after reaching a position of the surgical instrument through the variable stiffness, can be guaranteed under the premise of safety of minimally invasive endoscopic surgery, more effectively carry out surgery.

Description

可变刚度的内镜手术器械外护套 Endoscopic surgical instrument variable stiffness outer sheath

技术领域 FIELD

[0001] 本发明涉及的是一种微创医疗器械领域的手术器械外护套,尤其是一种为内镜手术器械提供进出人体的通道,提高微创内镜手术器械灵活性及手术安全性的可变刚度的内镜手术器械外护套。 [0001] The present invention relates to the field of medical devices is a minimally invasive surgical instruments of the outer sheath, in particular an endoscopic surgical instrument to provide a passage out of the body, improving flexibility of minimally invasive endoscopic surgical instruments and surgical safety variable stiffness of the outer sheath endoscopic surgical instrument.

背景技术 Background technique

[0002] 经自然腔道内镜手术是以软式内镜为治疗工具,不经皮肤切口,而通过口、阴道、结直肠等自然腔道对腹腔疾病进行治疗的微创外科治疗方法,与腹膜和腹腔脏器接触较少,可以降低传统开腹外科和腹腔镜手术造成的创伤,减轻术后疼痛,并避免创口感染、切口疝及肠梗阻等并发症。 [0002] natural orifice endoscopic surgery is a tool for the treatment of flexible endoscopes, without a skin incision, and minimally invasive surgical treatment of treatment of celiac disease by the oral, vaginal, colorectal and other natural orifice, and peritoneum and abdominal viscera less contact can be reduced traditional open surgery and laparoscopic trauma caused by surgery, reduce postoperative pain, wound infection and to avoid, complications such as ileus and incisional hernia. 目前,由于手术器械的功能限制,利用现有手术器械在临床上只能实施经口或经阴道等对器械性能要求不高的手术,同时为避免在手术过程中造成不必要的组织损伤等问题,需要对外科医生进行较长时间的培训来降低手术风险。 Currently, due to the functional limitations of the surgical instrument, surgical instrument existing only in clinical performance requirements embodiment of a surgical instrument orally or vagina, as well as to avoid unnecessary problems caused by tissue damage during surgery , the need for training a long time for surgeons to reduce the risk of surgery. 在经自然腔道内镜手术过程中,从器械操作上可分为两个阶段:首先将较长尺度(一般大于30cm)的内镜导管通过人体自然腔道插入体内深部,其次在器械末端到达患部后进行各类外科诊断与手术治疗。 In natural orifice endoscopic surgical procedure, from the instrumentation can be divided into two stages: First, the longer dimension (typically greater than 30cm) of the endoscope inserted into the body of the catheter through the body's natural deep cavity, followed by arriving at the instrument tip for various surgical diagnosis and surgical treatment of the affected area. 在第一阶段中,由于人体的自然腔道形状与解剖结构复杂(如结肠),周围血管神经密布,组织极易受损,要求手术器械具有较高的径向柔性和轴向刚度,并能在三维空间内灵活顺应腔道形状的特性才能保证手术的安全性;而在第二阶段中手术器械要在靠近手术区域的内镜器械末端进行手术操作,这就要求器械整体在该阶段具备较高的刚度才能为末端提供力学支撑,同时通过保持其本身的形状以避免形成对腔道及周围组织的牵扯而造成损伤,达到安全、准确手术操作的目的。 In the first stage, due to the complex shape of the natural orifice of the human anatomy (e.g., colon), dense perivascular nerves, easily damaged tissue, it requires surgical instrument having a high radial flexibility and axial stiffness, and can flexible and conform in three dimensions the shape of the cavity characteristics to ensure safety of operation; surgical instrument to the surgical procedure in the second stage in the area close to the surgical endoscopic instrument tip, which requires more overall instrument comprising the stage high stiffness can provide mechanical support for the terminal, while maintaining its shape by itself to avoid the formation of the cavity involved and surrounding tissues and cause damage, for secure, accurate surgical procedures. 由于目前临床上使用的软式内镜不能同时满足这两个要求,对新型器械技术的迫切需求已成为医疗工作者的共识。 Due to the current flexible endoscopes used clinically can not meet both requirements at the same time, the urgent need for new equipment technology has become the consensus of the medical workers. 研发具有高灵活性且刚度可变的内镜辅助器械成为经自然腔道内镜手术器械革新的技术重点和难点。 Assisted endoscopic device R & D is highly flexible and variable stiffness of a technology focus and difficult natural orifice transluminal endoscopic surgical instrument innovation.

[0003] 经对现有技术文献的检索发现,在文献“Yagi, Akihiko, et al."Rigid-flexibleouter sheath model using slider linkage locking mechanism and air pressurefor endoscopic surgery."Medical Image Computing and Computer-AssistedIntervent1n - MICCAI 2006.Springer Berlin Heidelberg, 2006.503-510.,,中提出一种内窥镜外护套装置,可实现在柔性和刚性两种状态的转换。它包括:鞘单元、弹簧、连杆、通气管及单侧具有齿条机构并可啮合的滑块和制动块。工作原理为:起初滑块与制动块分离,滑块的上下移动实现机构的弯曲,当向通气管内施加气压后,制动块被向上顶起与滑块啮合锁定外护套形状。但该装置结构复杂,且只能实现二维弯曲,对腔道环境适应性差,锁定装置只能起到锁定形状的作用而无法实现自由变刚度。 ". Yagi, Akihiko, et al". [0003] of the prior art documents retrieved discovery, Rigid-flexibleouter sheath model using slider linkage locking mechanism and air pressurefor endoscopic surgery in the document "Medical Image Computing and Computer-AssistedIntervent1n - MICCAI . 2006.Springer Berlin Heidelberg, 2006.503-510 ,, proposes an outer sheath of the endoscope apparatus can be achieved in flexible and rigid converted two states comprising: sheath means, springs, connecting rods, and snorkel one side having a slider and a brake shoe and a rack meshing mechanism works as follows: initially the slider and separated from the brake shoe, the vertical movement of the slider to achieve bending mechanism, when air pressure is applied into the vent tube, the brake block is pushed upward from the locking engagement with the slider outer jacket shape but the complexity of the apparatus structure and can realize a two-dimensional curved, poor adaptability to the channel environment chamber, the locking means can only play a role in the shape-locking can not be realized freely variable stiffness.

发明内容 SUMMARY

[0004] 本发明针对上述现有技术的不足,提供一种基于柔性连续体的形状与刚度控制一体化的内镜器械外护套,为内镜手术器械提供进出体内的通道,提高器械的灵活性及手术的安全性。 [0004] The present invention addresses deficiencies in the prior art, there is provided a method of controlling an integrated endoscopic instrument outer sheath stiffness based on the shape of the flexible continuous member, and out of the body to provide endoscopic surgical instrument channels, and improve the flexibility of the instrument and safety procedures.

[0005] 本发明是通过以下技术方案来实现的,本发明包括若干可变刚度柔性单元串联组成,每个柔性单元包括:第一柔性高伸缩率气囊、第二柔性高伸缩率气囊、第三柔性高伸缩率气囊、刚性连接件、刚性丝、第一圆盘、第二圆盘、器械通道、进气口和导气管通道;在每个柔性单元中,刚性丝穿过若干刚性连接件并与其刚性连接,刚性连接件上的圆孔套在气囊的最小直径位置将三个柔性高伸缩率气囊连接在一起,三个柔性高伸缩率气囊的两端均分别与第一圆盘、第二圆盘相连接,器械通道位于刚性连接件的中心处,进气口和导气管通道均布置在第二圆盘上;多节可变刚度柔性单元均通过第一圆盘和第二圆盘串接在一起。 [0005] The present invention is achieved by the following technical solutions, the present invention includes a plurality of flexible variable stiffness units in series, each of the flexible cells comprising: a first flexible high expansion ratio of the balloon, the second balloon flexible high expansion ratio, a third flexible airbag high expansion ratio, a rigid connecting member, the rigidity of the wire, a first disk, a second disk, the instrument channel, and the air inlet airway passage; flexible in each cell, a plurality of rigid wire passing through the rigid connection and rigidly connected thereto, the circular rigid connection sleeve in the minimum diameter position of the bladder three flexible connecting together a high expansion ratio of the balloon, a flexible and highly stretchable three ends of the airbag are respectively the first disc, a second a disk connected to an instrument channel located at the center of the rigid connection, the intake port and airway passages are arranged on the second disc; multi-section through the variable stiffness of the flexible units are first and second disc disc string together.

[0006] 进一步地,在本发明中,刚性丝为不可伸缩刚性丝,三个柔性高伸缩率气囊纵截面均为S型弯曲形状。 [0006] Further, in the present invention, the rigid non-stretchable yarn as rigid wire, three flexible balloon high expansion ratio are vertical cross-sectional shape S-bend.

[0007] 更进一步地,在本发明中,第一柔性高伸缩率气囊、第二柔性高伸缩率气囊、第三柔性高伸缩率气囊沿刚性丝呈圆周对称排列。 [0007] Furthermore, in the present invention, the first flexible bladder high expansion ratio, a high expansion ratio of the second flexible airbag, the airbag of the third flexible and highly stretchable circumferentially symmetrically arranged in a rigid wire.

[0008] 更进一步地,在本发明中,第一柔性高伸缩率气囊、第二柔性高伸缩率气囊、第三柔性高伸缩率气囊均通过气动方式驱动。 [0008] Furthermore, in the present invention, the first flexible bladder high expansion ratio, a high expansion ratio of the second flexible airbag, the airbag third flexible high expansion ratio are pneumatically driven.

[0009] 在本发明的工作过程中,柔性高伸缩率气囊在气动驱动下具有较大的伸缩率,充当连续体机构弯曲及变刚度的驱动单元,三个气囊圆周排列可实现机构各个方位的弯曲;不可伸缩的刚性丝与刚性连接件为刚性连接,刚性连接件上的圆孔套在气囊的最小直径位置将三个柔性气囊连接在一起;两端的圆盘起到为气囊提供定位、密封的作用,多节柔性变刚度单元通过圆盘相串联。 [0009] During operation of the present invention, a flexible balloon having a high expansion ratio in the expansion ratio greater pneumatic drive, the drive unit and the bending mechanism acts as a continuum of variable rigidity, three balloons may be implemented in all directions circumferentially arranged means curved; non-stretchable wire and the rigid member rigidly connected to a rigid connection, the circular rigid connection sleeve in the minimum diameter position of the balloon connecting together three flexible bladder; disk functions to provide both ends of the positioning balloon, sealing the role of the variable stiffness of flexible multi-section through the disk units connected in series. 在向气囊内冲入气压后,一个气囊伸长产生的力学作用通过刚性连接件及刚性丝传递到其他两个气囊,刚性连接件起到杠杆力臂的作用,刚性丝起到杠杆支点的作用,进而实现机构的弯曲。 After the gas pressure into the airbag, an airbag elongated mechanical action is transferred to the other two air bag through a rigid connecting member and a rigid wire, the rigid connecting member acts as a lever arm, rigid wire leverage fulcrum effect , and further to achieve the bending mechanism. 多个单独控制的变刚度单元串联后可实现空间的复杂弯曲以更好的顺应腔道的生理弯曲。 It can be achieved after the spatial variable stiffness control of a plurality of individual cells connected in series of complex physiological bent better compliance curved cavity. 通过对气囊中气压的控制,可实现不同弯曲角度下机构的刚度控制。 By controlling the air pressure in the air bag, the stiffness can be achieved at different bending angle control mechanism.

[0010] 与现有技术相比,本发明有如下优点: [0010] Compared with the prior art, the present invention has the following advantages:

[0011] 第一,本发明采用气动方式对每个气囊的伸缩进行单独控制,可实现对弯曲方位及弯曲角度的主动控制; [0011] First, the present invention is pneumatically controlled individually for each of the telescoping balloon, may be active control of the orientation of the bending and bending angle;

[0012] 第二,本发明采用特殊结构的伸缩气囊,具有较大的伸缩率,使得机构可实现较大的弯曲角度,将其嵌入内镜器械可提高对人体腔道环境的适应性,提高手术安全性; [0012] Second, the present invention is an airbag special telescopic structure, has a large expansion ratio, so that the mechanism can achieve a large bending angle, which is fitted to the endoscope instrument can improve the adaptability of the body cavity environment, improved surgical safety;

[0013] 第三,本发明采用气动控制方式,可实现对弯曲刚度的实时快速控制,使得结构在保持形状的前提下能承受较大的力学作用。 [0013] Third, the present invention employs a pneumatic control mode, can achieve real-time fast control of the bending stiffness, so that the structure while maintaining the shape can withstand a greater mechanical action.

附图说明 BRIEF DESCRIPTION

[0014] 图1是本发明的结构示意图; [0014] FIG. 1 is a structural diagram of the present invention;

[0015] 图2是本发明中可变刚度柔性单元的结构示意图; [0015] FIG. 2 is a structural diagram of the present invention, a variable stiffness of the flexible unit;

[0016] 图3是柔性高伸缩率气囊与刚性连接件的局部视图; [0016] FIG. 3 is a partial view of a flexible high expansion ratio of the bladder and the rigid connecting member;

[0017] 图4是刚性连接件及刚性丝的结构示意图; [0017] FIG. 4 is a schematic view of a rigid connecting member and the rigid filaments;

[0018] 图5是柔性高伸缩率气囊的纵截面图; [0018] FIG. 5 is a longitudinal cross-sectional view of a flexible high expansion ratio of the bladder;

[0019] 图6是第二圆盘的结构示意图; [0019] FIG. 6 is a schematic view of a second disk;

[0020] 其中:1、第一柔性高伸缩率气囊,2、第二柔性高伸缩率气囊,3、第三柔性高伸缩率气囊,4、刚性连接件,5、刚性丝,6、第一圆盘,7、第二圆盘,8、器械通道,9、进气口,10、导气管通道。 [0020] wherein: a first flexible high expansion ratio of the airbag 2, the airbag second flexible high expansion ratio, 3, the third flexible high expansion ratio airbag 4, the rigid connecting member 5, the rigid wire 6, a first disc 7, the second disc 8, the instrument channel 9, the intake port 10, airway passage.

具体实施方式 detailed description

[0021] 下面结合附图对本发明的实施例作详细说明,本实施例以本发明技术方案为前提,给出了详细的实施方式和具体的操作过程,但本发明的保护范围不限于下述的实施例。 [0021] The following embodiments in conjunction with the accompanying drawings of embodiments of the present invention will be described in detail, the present embodiments are premised aspect of the invention, it is given and the specific operation of the embodiment in detail, but the scope of the present invention is not limited to the following embodiment.

[0022] 实施例 [0022] Example

[0023] 如图1至图5所示,本发明由若干可变刚度柔性单元串联组成,每个柔性单元包括:第一柔性高伸缩率气囊1、第二柔性高伸缩率气囊2、第三柔性高伸缩率气囊3、刚性连接件4、刚性丝5、第一圆盘6、第二圆盘7、器械通道8、进气口9和导气管通道10 ;在每个柔性单元中,刚性丝5穿过若干刚性连接件4并与其刚性连接,刚性连接件4上的圆孔套在气囊的最小直径位置将三个柔性高伸缩率气囊连接在一起,三个柔性高伸缩率气囊的两端均分别与第一圆盘6、第二圆盘7相连接,器械通道8位于刚性连接件4的中心处,进气口9和导气管通道10均布置在第二圆盘7上;多节可变刚度柔性单元均通过第一圆盘6和第二圆盘7串接在一起;刚性丝5为不可伸缩刚性丝,三个柔性高伸缩率气囊纵截面均为S型弯曲形状,第一柔性高伸缩率气囊1、第二柔性高伸缩率气囊2、第三柔性高 [0023] As shown in FIG. 1 to FIG. 5, the present invention is a variable stiffness in series a plurality of flexible units, each of the flexible cells comprising: a first flexible high expansion ratio of the airbag 1, a second flexible high expansion ratio of the airbag 2, the third the flexible high expansion ratio of the balloon 3, the rigid connecting member 4, the rigid wires 5, 6 a first disc, a second disc 7, the instrument channel 8, the intake port 9 and the airway passage 10; in each unit of the flexible, rigid a plurality of wire 5 through the rigid connection 4 and rigidly connected thereto, on the circular sleeve member 4 rigidly connected to the balloon in position of the minimum diameter of the flexible connecting together three high expansion ratio of the airbag, the airbag three flexible high expansion ratio of the two with the first end of each disk 6, the disc 7 is connected to a second instrument channel 8 located at the center of the rigid connecting member 4, the intake port 9 and the airway passage 10 are arranged on the second disc 7; multiple The variable stiffness of the flexible section of each unit by a first disk and second disk 7 6 strung together; rigid rigid non-stretchable filament yarn is 5, three flexible balloon high expansion ratio are vertical cross-sectional shape S-bend, the first a flexible high expansion ratio of the airbag 1, a second flexible high expansion ratio of the airbag 2, the third flexible high 伸缩率气囊3沿刚性丝5呈圆周对称排列,第一柔性高伸缩率气囊1、第二柔性高伸缩率气囊2、第三柔性高伸缩率气囊3均通过气动方式驱动。 3 in the expansion ratio of the balloon circumferentially rigid wire 5 are arranged symmetrically, the first flexible high expansion ratio of the airbag 1, a second flexible high expansion ratio of the airbag 2, the airbag third flexible high expansion ratio 3 are pneumatically driven.

[0024] 本发明的操作过程如下:将内镜手术器械插入外护套的器械通道8内,在进入人体腔道的过程中,控制柔性气囊内的气压使结构弯曲,通过传感等手段获得腔道及外护套的形状信息,调节气囊内部气压使外护套适应腔道形状避免对腔道内壁造成压迫。 [0024] During operation of the present invention is as follows: the endoscopic surgical instrument is inserted into the instrument channel of the outer sheath 8, the process enters the body cavity, the control air pressure within the bladder so that the flexible structure bends and the like obtained by the sensor means cavity and the outer sheath of the shape information, adjusting the internal pressure of the airbag jacket adapted to the outer shape of the cavity to avoid pressure on the cavity inner wall. 在外护套末端到达病灶位置后,调节气囊内部气压,在保持外护套形状不变的前提下增大弯曲刚度,为内部器械对组织施加力的过程中提供力学支撑。 After the end of the outer sheath reaches the lesion location, adjusting the internal pressure of the airbag, increasing the bending stiffness in the shape of the outer jacket maintaining the same premise, the process of applying a force to the internal organization of the instrument provides mechanical support. 在外护套从体内拉出的过程中,通过调节气囊内气压,使得外护套获得顺应腔道形状的弯曲,在对腔道内壁无压迫的前提下拉出体外,完成手术。 The outer sheath is pulled out from the process in vivo, by adjusting the gas pressure inside the balloon, such that the outer sheath lumen conform to the curved shape is obtained, and is pulled out in vitro in the absence of oppression premise cavity inner wall, to complete the operation.

Claims (4)

  1. 1.一种可变刚度的内镜手术器械外护套,其特征在于,它是由若干可变刚度柔性单元串联组成,每个柔性单元包括:第一柔性高伸缩率气囊(I)、第二柔性高伸缩率气囊(2)、第三柔性高伸缩率气囊(3 )、刚性连接件(4)、刚性丝(5 )、第一圆盘(6 )、第二圆盘(7 )、器械通道(8 )、进气口( 9 )和导气管通道(10 );在每个柔性单元中,刚性丝(5 )穿过若干刚性连接件(4)并与其刚性连接,刚性连接件(4)上的圆孔套在气囊的最小直径位置将三个柔性高伸缩率气囊连接在一起,三个柔性高伸缩率气囊的两端均分别与第一圆盘(6)、第二圆盘(7)相连接,器械通道(8)位于刚性连接件(4)的中心处,进气口(9)和导气管通道(10)均布置在第二圆盘(7)上;多节可变刚度柔性单元均通过第一圆盘(6)和第二圆盘(7)串接在一起。 An endoscopic surgical instrument of the outer sheath variable stiffness, characterized in that it is composed of a number of variable stiffness of flexible units in series, each of the flexible cells comprising: a first flexible high stretching ratio of the airbag (the I), of two high-elasticity of the flexible airbag (2), the third high-elasticity of the flexible balloon (3), a rigid connecting member (4), the rigid wire (5), the first disc (6), the second disc (7), instrument channel (8), the intake port (9) and the airway passage (10); each flexible element, the rigid wire (5) through a plurality of rigid links (4) and rigidly connected thereto, the rigid connector ( circular hole 4) is set in the minimum diameter position of the airbag to connect three high expansion ratio of the airbag with a flexible, three ends of a flexible and highly stretchable airbag are respectively the first disc (6), the second disc (7) is connected to the instrument channel (8) in the center of the rigid connecting member (4), the air inlet (9) and the airway passages (10) are arranged on the second disc (7); multi-section can variable stiffness units are strung together by a first disk (6) and the second disc (7).
  2. 2.根据权利要求1所述的可变刚度的内镜手术器械外护套,其特征在于,所述刚性丝(5)为不可伸缩刚性丝,所述三个柔性高伸缩率气囊纵截面均为S型弯曲形状。 The endoscopic surgical instrument of the outer jacket of variable stiffness claimed in claim 1, wherein the rigid wire (5) is a rigid non-stretchable yarn, a high expansion ratio of the three flexible airbag are longitudinal sectional S-shaped bent shape.
  3. 3.根据权利要求2所述的可变刚度的内镜手术器械外护套,其特征在于,所述第一柔性高伸缩率气囊(I)、第二柔性高伸缩率气囊(2)、第三柔性高伸缩率气囊(3)沿刚性丝(5)呈圆周对称排列。 The endoscopic surgical instrument of the outer jacket of variable stiffness claimed in claim 2, wherein the first flexible high-rate stretching the airbag (the I), a second flexible high stretching ratio of the airbag (2), three telescopic flexible high rate airbag (3) in rigid wire (5) circumferentially arranged symmetrically.
  4. 4.根据权利要求3所述的可变刚度的内镜手术器械外护套,其特征在于,所述第一柔性高伸缩率气囊(I)、第二柔性高伸缩率气囊(2)、第三柔性高伸缩率气囊(3)均通过气动方式驱动。 The endoscopic surgical instrument of the outer jacket of variable stiffness claimed in claim 3, wherein the first flexible high-rate stretching the airbag (the I), a second flexible high stretching ratio of the airbag (2), three telescopic flexible high rate airbag (3) are driven pneumatically.
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