CN110279451B - Distal end integrated form multi freedom supersound sword - Google Patents
Distal end integrated form multi freedom supersound sword Download PDFInfo
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- CN110279451B CN110279451B CN201910498678.XA CN201910498678A CN110279451B CN 110279451 B CN110279451 B CN 110279451B CN 201910498678 A CN201910498678 A CN 201910498678A CN 110279451 B CN110279451 B CN 110279451B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
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- 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
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2936—Pins in guiding slots
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320098—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with transverse or torsional motion
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Abstract
The invention discloses a far-end integrated multi-degree-of-freedom ultrasonic scalpel which comprises a far-end ultrasonic scalpel, a snake-shaped joint, a hollow long straight rod and an instrument box which are sequentially connected. The far-end ultrasonic knife comprises an ultrasonic knife shell with a reducing sliding channel inside, clamping pincers connected with the left outer wall and the right outer wall of the front end of the ultrasonic knife shell through connecting pin shafts, and an ultrasonic knife arranged in the ultrasonic knife shell through flanges, and the reducing sliding channel further comprises a T-shaped push rod, a spring and a wire drawing which are sequentially connected and used for realizing the opening and closing actions of the clamping pincers. The ultrasonic cutter has four degrees of freedom of deflection motion in two mutually perpendicular directions, rotary motion around the axis of the hollow long straight rod and opening and closing motion of the clamping forceps, and has the advantages of higher operation flexibility, larger treatment space in a patient body, easy control and adjustment of the direction and angle of the cutter head part at the tail end of the ultrasonic cutter contacting tissues, convenient processing and manufacturing and wider application range.
Description
Technical Field
The invention relates to the technical field of surgical instruments, in particular to a distal end integrated multi-degree-of-freedom ultrasonic scalpel.
Background
The ultrasonic scalpel is an accurate and efficient energy surgical instrument, has the advantages of less bleeding during operation, less postoperative complications, difficulty in adhesion with tissues, less smoke generation and the like, and is widely applied to traditional minimally invasive surgery and robot-assisted minimally invasive surgery at present. One important advantage of the robot-assisted minimally invasive surgery is that a doctor can flexibly operate a surgical instrument with multiple kinematic joints to complete complex surgical actions through a surgical robot, and the robot-assisted minimally invasive surgery has the advantages of high surgical precision, convenience in operation and the like. However, due to the limitation of mechanical vibration propagation characteristics, longitudinal vibration ultrasonic energy cannot be transmitted in a bending way, so that the ultrasonic scalpel currently used in the traditional minimally invasive surgery and the robot-assisted minimally invasive surgery adopts a rigid long straight knife bar structure and only has two degrees of freedom of rotation around the axis of the knife bar and opening and closing of the end jaw, so that the flexibility of the ultrasonic scalpel in the surgical operation and the treatment space in the body of a patient are severely limited, and the ultrasonic scalpel is not attractive in some complex internal surgeries, particularly in the robot-assisted minimally invasive surgery.
Compared with other multi-degree-of-freedom surgical instruments applied to robot-assisted minimally invasive surgery, the existing ultrasonic scalpel used in the robot-assisted minimally invasive surgery is limited in the direction and angle of contacting with organs or tissues in the surgery due to the fact that a tail end wrist joint is absent, and the safety of the surgery is greatly affected by the fact that the direction and angle of the ultrasonic scalpel head acting on the tissues cannot be correctly controlled, wherein the risk of mistakenly damaging or accidentally bleeding tissues around a focus point is increased.
Some ultrasonic knives aiming at the above problems have been proposed, such as the ultrasonic knife with multiple degrees of freedom at the distal end disclosed in patent CN106175879A, which realizes the operation with multiple degrees of freedom by adjusting the rotation angle of the distal tip and the two piezoelectric ceramic drivers through the rotary driving assembly, although the above problems can be solved, the silicon crystal tip used in the ultrasonic knife with multiple degrees of freedom has the disadvantages of being fragile and easy to crack under high stress, and has certain risk of operation safety, and the connection mode of filling conductive adhesive between the silicon crystal tip and the piezoelectric ceramic drivers has the disadvantages of poor electromechanical coupling and energy transmission effect, and high energy loss at the connection part of the tip and the piezoelectric ceramic drivers.
Disclosure of Invention
The invention aims to overcome the defects of the prior art and provide a multi-degree-of-freedom ultrasonic knife for robot-assisted minimally invasive surgery, which has higher operation flexibility and larger treatment space.
The invention is realized by the following technical scheme:
the far-end integrated multi-degree-of-freedom ultrasonic knife comprises a far-end ultrasonic knife, wherein the far-end ultrasonic knife comprises an ultrasonic knife shell, the ultrasonic knife shell comprises a left ultrasonic knife shell and a right ultrasonic knife shell which are bilaterally symmetrical about a middle vertical plane, and the front ends of the left ultrasonic knife shell and the right ultrasonic knife shell are fixedly butted through a fixed pin shaft;
an ultrasonic knife is arranged in the ultrasonic knife shell, the ultrasonic knife comprises a front end cover, a screw rod is connected in the middle of the rear end face of the front end cover, one end of the screw rod penetrates through middle holes of a plurality of pieces of thickness polarization piezoelectric ceramics and is in threaded connection with a middle threaded hole of the rear end cover, all the parts are connected together through the screw rod and apply pre-pressure to the piezoelectric ceramics, and a fixed pin shaft is arranged in a direction perpendicular to the axis of the screw rod;
an electrode plate is respectively arranged between two adjacent pieces of thickness polarization piezoelectric ceramics and between the intersection parts of the rear end cover, the front end cover and the thickness polarization piezoelectric ceramics, and the electrode plates are alternately arranged as a negative electrode and a positive electrode from the rear end cover to the front end cover;
the electrode plates serving as the negative electrodes at the thickness polarization piezoelectric ceramics are connected with a first electrode of an ultrasonic main machine alternating current circuit together through a first circuit line, and the electrode plates serving as the positive electrodes at the thickness polarization piezoelectric ceramics are connected with a second electrode of the ultrasonic main machine alternating current circuit together through a second circuit line;
the front end cover is coaxially and fixedly connected with a thick-end cylindrical part, a first arc transition section, a second arc transition section and a thin-end cylindrical tool bit with the diameter smaller than that of the thick-end cylindrical part from back to front in sequence, the screw rod is coaxially and fixedly connected with the thick-end cylindrical part, the contour line of the first arc transition section is tangent to the contour line of the thick-end cylindrical part, the contour line of the second arc transition section is tangent to the contour line of the thin-end cylindrical tool bit, and the contour lines of the first arc transition section and the second arc transition section are tangent at an intersection point;
an annular groove is formed in the inner wall of the front end of the ultrasonic knife shell, a vibration displacement nodal surface of the ultrasonic knife is arranged at the interface of the thick-end cylindrical part and the first arc transition section, a flange is arranged at the vibration displacement nodal surface in a surrounding mode, the flange on the front end cover is clamped and fixed in the annular groove of the ultrasonic knife shell, and a thin-end cylindrical knife head of the front end cover extends out of an opening hole in the front wall of the ultrasonic knife shell;
the upper parts of the left outer wall and the right outer wall at the front ends of the left ultrasonic knife shell and the right ultrasonic knife shell are respectively fixed with a connecting pin shaft, the connecting pin shafts are arranged in parallel with the fixed pin shafts, and the middle parts of the left connecting rod and the right connecting rod at the rear ends of the clamping pincers are respectively connected with the connecting pin shafts at the left side and the right side in a rotating way; a diameter-variable sliding channel is arranged in the middle of the bottom of the ultrasonic knife shell along the axial direction of the ultrasonic knife shell, the diameter-variable sliding channel comprises a front sliding channel positioned at the front part, a middle sliding channel communicated with the rear end of the front sliding channel and a rear sliding channel communicated with the rear end of the middle sliding channel, the diameter of the middle sliding channel is respectively larger than that of the front sliding channel and that of the rear sliding channel, a T-shaped push rod comprises a cross rod at the front end and a longitudinal rod fixedly connected with the cross rod, a limiting table with the diameter larger than that of the longitudinal rod is fixed at the rear end of the longitudinal rod, the rear part of the longitudinal rod of the T-shaped push rod is inserted in the middle sliding channel and can slide back and forth in the middle sliding channel, the front part of the longitudinal rod of the T-shaped push rod is inserted in the front sliding channel and can slide back and forth in the front sliding channel, the cross rod of the T-shaped push rod is arranged outside the diameter-variable sliding channel, the left end and the right end of the cross rod respectively penetrate through a shell sliding groove on the shell and connecting rod sliding grooves on connecting rods on the left side and the right side of the rear end of the clamping pincers, the shell sliding grooves are arranged along the axial direction of the shell of the ultrasonic scalpel, and the connecting rod sliding grooves are arranged along the length direction of the connecting rods on the left side and the right side of the clamping pincers; the cross rod of the T-shaped push rod is connected with the shell sliding groove in a sliding mode in a front-back mode and connected with the connecting rod sliding groove in a sliding mode along the length direction of the connecting rod, the head portion of each clamping forceps and the thin-end cylindrical tool bit of the front end cover form a shear type clamping structure, the limiting table is used for being connected with one end of a wire drawing for achieving opening and closing actions of the clamping forceps, one end of a spring is fixed on the limiting table, and the other end of the spring is fixedly connected with the rear wall of the middle sliding channel.
Compared with the prior art, the invention has the following beneficial effects:
1. the invention can realize four-freedom-degree operation of deflection motion of the ultrasonic knife in two mutually vertical directions, rotary motion around the axis of the hollow long straight rod and opening and closing motion of the clamping forceps by miniaturizing and prepositioning the traditional ultrasonic knife with the long straight knife rod and adding a section of snake-shaped joint at the tail end of an instrument to be connected with the ultrasonic knife. Compared with the ultrasonic knife with a rigid long straight knife bar used in the traditional minimally invasive surgery and the robot-assisted minimally invasive surgery at present, the ultrasonic knife increases two deflection motion degrees of freedom, so the ultrasonic knife has higher operation flexibility and larger treatment space in a patient body, and doctors can control the ultrasonic knife to complete more complex surgical operations through the surgical robot.
2. The distal end integrated multi-degree-of-freedom ultrasonic cutter has the function of terminal deflection motion, so that the distal end integrated multi-degree-of-freedom ultrasonic cutter has higher operation flexibility, and the direction and the angle of the cutter head part at the terminal of the ultrasonic cutter contacting tissues are easier to control and adjust in minimally invasive surgery, thereby reducing the risk of mistaken injury or accidental bleeding of tissues around a focus point, and having better operation safety.
3. The invention greatly reduces the volume and the weight of the ultrasonic knife and can reduce the production cost of the ultrasonic knife and the treatment expense of patients by miniaturizing and prepositioning the traditional ultrasonic knife with the long straight knife rod.
4. Compared with the traditional ultrasonic knife with a rigid long straight knife rod, the ultrasonic knife has the advantages of simpler processing technology and easier production and manufacture.
Drawings
FIG. 1 is a schematic view of the overall structure of a distal integrated multi-degree-of-freedom ultrasonic scalpel according to the present invention;
FIG. 2a is a schematic view of the external structure of the distal ultrasonic blade shown in FIG. 1;
FIG. 2b is a schematic view of the internal structure of the distal ultrasonic blade shown in FIG. 1;
FIG. 2c is a schematic structural view of the left ultrasonic blade housing shown in FIG. 2 b;
FIG. 2d is a schematic structural view of the T-shaped push rod shown in FIG. 2 b;
FIG. 2e is a schematic structural view of the ultrasonic blade shown in FIG. 2 b;
FIG. 2f is a schematic structural view of the front end cap with a double circular arc transition section shown in FIG. 2 e;
FIG. 3a is a schematic view of the mounting connection of the serpentine joint shown in FIG. 1;
FIG. 3b is a schematic view of the overall structure of the serpentine joint shown in FIG. 3 a;
FIG. 3c is a schematic view of the installation and connection of the hollow long straight rod shown in FIG. 1;
FIG. 4 is a schematic view of the internal gearing of the instrument pod of FIG. 1;
FIG. 5a is a schematic view of a first positive yaw motion of the present invention;
FIG. 5b is a schematic view of a first counter-deflection motion of the present invention;
fig. 6 is an operational schematic diagram of the distal end integrated multi-degree-of-freedom ultrasonic knife of the present invention closing a blood vessel under an abdominal cavity.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention will be described in further detail with reference to the following embodiments and accompanying drawings. The exemplary embodiments and descriptions of the present invention are provided to explain the present invention, but not to limit the present invention.
The invention discloses a far-end integrated multi-degree-of-freedom ultrasonic knife which comprises a far-end ultrasonic knife 1, and the far-end integrated multi-degree-of-freedom ultrasonic knife 1 is combined with figures 2a, 2b, 2c, 2d, 2e, 2f, 3a and 3b, wherein the far-end ultrasonic knife 1 comprises an ultrasonic knife shell, the ultrasonic knife shell comprises a left ultrasonic knife shell 101-1 and a right ultrasonic knife shell 101-2 which are bilaterally symmetrical about a middle vertical plane, the front ends of the left ultrasonic knife shell 101-1 and the right ultrasonic knife shell 101-2 are butted and fixed through a fixed pin shaft 102, and when the ultrasonic knife is used, the rear ends of the ultrasonic knife shells are butted and then form a shaft hole matched and fixed with a joint sleeve 201 at the far end of a snake-shaped joint 2.
An ultrasonic knife is arranged in the ultrasonic knife shell, the ultrasonic knife comprises a front end cover 114, a screw rod is connected in the middle of the rear end face of the front end cover 114, one end of the screw rod penetrates through middle holes of the multiple pieces of thickness polarization piezoelectric ceramics 113 and is in threaded connection with a middle threaded hole of the rear end cover 111, and all the parts are connected together through the screw rod and apply pre-pressure to the piezoelectric ceramics. The fixed pin 102 is arranged along the direction perpendicular to the axis of the screw.
One electrode sheet 112 is provided between two adjacent pieces of thickness-polarized piezoelectric ceramics 113 and between the intersecting portions of the rear end cap 111, the front end cap 114, and the thickness-polarized piezoelectric ceramics 113, respectively. The electrode tabs 112 are alternately provided with a negative electrode and a positive electrode from the rear end cap 111 toward the front end cap 114.
Specifically, the electrode tabs 112 are respectively mounted between the rear end cap 111 and the leftmost one of the thickness-polarized piezoelectric ceramics 113, between the adjacent two of the thickness-polarized piezoelectric ceramics 113, and between the rightmost one of the thickness-polarized piezoelectric ceramics 113 and the front end cap 114.
Each adjacent thickness-polarized piezoelectric ceramics 113 is stacked and connected in a manner that the polarization directions are opposite, so that two faces of the adjacent two thickness-polarized piezoelectric ceramics 113 connected with the same electrode sheet 112 have the same polarity. The electrode plates 112 as the negative electrodes at the thickness polarization piezoelectric ceramics 113 are connected with the first electrode of the alternating current circuit of the ultrasonic main unit 501 through a first circuit line 502, and the electrode plates 112 as the positive electrodes at the thickness polarization piezoelectric ceramics 113 are connected with the second electrode of the alternating current circuit of the ultrasonic main unit 501 through a second circuit line 503.
In one embodiment of the present invention, the thickness-polarized piezoelectric ceramic 113 may have a conventional structure, i.e., a circular ring structure. The outer diameter of the thickness polarization piezoelectric ceramic ring can be 8mm, the inner diameter is 4mm, the thickness is 2mm, and the number is 4 pieces. The electrode pads 112 may each have a thickness of 0.2 mm. The frequency of the electrical signal in the ac circuit of the ultrasound mainframe 501 may be 55.5 kHz.
Preferably, the thickness polarization piezoelectric ceramic 113 can also adopt a smaller outer diameter of 6-8mm and a smaller inner diameter of 3-4mm, so that the ultrasonic scalpel has a more compact structure and a smaller appearance, and the operation in a narrow space is more convenient.
The rear end cover 111 is made of metal materials with large acoustic impedance, such as stainless steel, alloy steel, chrome steel and the like, so that more ultrasonic vibration energy is transmitted to the front end cover 114.
The front end cover 114 adopts the medical titanium alloy TC4ELI, and has the advantages that the TC4ELI has biocompatibility and has excellent anti-fatigue property.
Preferably, epoxy resin adhesive is filled between the rear end cover 111 and the leftmost first electrode sheet 112, and between the front end cover 114 and the rightmost first electrode sheet 112, so that air gaps on the connecting surface can be eliminated, better energy transmission is ensured, and the problem of heat generation is reduced.
The double-circular-arc transition section structure of the front end cover 114 has a better amplitude amplification effect and smaller stress concentration, so that the fatigue stress generated by the cutter head when the same cutting amplitude is generated is smaller, and the service life of the ultrasonic cutter can be prolonged. Of course, the front end cap 114 may also be a conventional composite structure with a conical transition section, an exponential transition section, or a catenary transition section.
As shown in fig. 2b, an annular groove is formed on the inner wall of the front end of the ultrasonic blade housing, a vibration displacement nodal plane (i.e., a cross-sectional position where the ultrasonic vibration displacement is 0) of the ultrasonic blade 100 is disposed at an interface between the thick-end cylindrical portion 114-1 and the first arc transition section 114-2 (the setting method of the position can be referred to the principle and design of an ultrasonic transducer, the method disclosed in 2004, linshuyu, and the flange is circumferentially disposed at the vibration displacement nodal plane, the flange on the front end cap 114 is clamped and fixed in the annular groove of the ultrasonic blade housing, and the thickness of the flange can be 1 mm. The thin end cylindrical blade of the front end cap 114 extends out of the opening in the front wall of the ultrasonic blade housing.
The upper parts of the left and right outer walls at the front ends of the left ultrasonic knife shell 101-1 and the right ultrasonic knife shell 101-2 are respectively fixed with a connecting pin shaft 105, the connecting pin shafts are arranged in parallel with the fixed pin shaft 102, and the middle parts of the left and right connecting rods at the rear end of the clamping forceps 103 are respectively connected with the connecting pin shafts 105 at the left and right sides in a rotating way. The head part of the clamping forceps 103 can be of an existing structure, for example, the head part of the clamping forceps in the Chinese patent 'a novel ultrasonic knife' with publication number CN107789036 can be arranged.
A diameter-variable sliding channel is arranged in the middle of the bottom of the ultrasonic knife shell along the axial direction of the ultrasonic knife shell, the diameter-variable sliding channel comprises a front sliding channel positioned at the front part, a middle sliding channel communicated with the rear end of the front sliding channel and a rear sliding channel communicated with the rear end of the middle sliding channel, the diameter of the middle sliding channel is respectively larger than that of the front sliding channel and that of the rear sliding channel, a T-shaped push rod 104 comprises a cross rod at the front end and a longitudinal rod fixedly connected with the cross rod, a limiting table with the diameter larger than that of the longitudinal rod is fixed at the rear end of the longitudinal rod, the rear part of the longitudinal rod of the T-shaped push rod 104 is inserted in the middle sliding channel and can slide back and forth in the middle sliding channel, the front part of the longitudinal rod of the T-shaped push rod 104 is inserted in the front sliding channel and can slide back and forth in the front sliding channel, the cross bar of the T-shaped push rod 104 is arranged outside the diameter-variable sliding channel, the left end and the right end of the cross bar respectively penetrate through a shell sliding groove on the shell and a connecting rod sliding groove on connecting rods on the left side and the right side of the rear end of the clamping pliers 103, the shell sliding groove is arranged along the axial direction of the shell of the ultrasonic knife, and the connecting rod sliding groove is arranged along the length direction of the connecting rods on the left side and the right side of the clamping pliers. The cross bar of the T-shaped push rod 104 is connected with the sliding groove of the shell in a sliding manner back and forth and is connected with the sliding groove of the connecting rod in a sliding manner along the length direction of the connecting rod, and the head part of the clamping forceps 103 and the thin-end cylindrical tool bit of the front end cover 114 form a shear type clamping structure. The limiting table is used for being connected with one end of a wire drawing for realizing the opening and closing actions of the clamping pincers 103, one end of a spring 106 is fixed on the limiting table, and the other end of the spring is fixedly connected with the rear wall of the middle sliding channel.
The outer edge part of the thin-end cylindrical cutter head close to the front end is used for cutting and stopping bleeding of tissues, and the diameter of the thin-end cylindrical cutter head can be 2 mm.
The far-end integrated multi-degree-of-freedom ultrasonic scalpel is connected with an existing driving device when in use.
Referring to fig. 1, 3a, 3b and 3c, the conventional driving device comprises a serpentine joint 2, wherein a distal joint sleeve 201 of the serpentine joint 2 is fixedly connected with the distal ultrasonic blade 1 through a mounting screw 202, and a proximal joint sleeve 204 is connected with a hollow long straight rod 3. The rear end of the distal joint sleeve 201 is connected with the front end of the proximal joint sleeve 204 through a plurality of intermediate joints 203 which are connected in sequence. The invention has no specific limitation on the structure of the snake-shaped joint, and can realize the deflection motion in two mutually perpendicular directions. For example, the serpentine joint 2 may be a serpentine joint structure in chinese patent publication CN106073897A, "a serpentine joint for a single-hole minimally invasive robot and its mechanism".
In this embodiment, the number of the intermediate joints 203 is 7, the outer diameter of each intermediate joint and each joint socket is 10mm, and the oblique section inclination angle of each intermediate joint and each joint socket is 10 degrees.
Preferably, in order to ensure a proper operation space range of the ultrasonic cutter of the present invention, the number of the middle joints 203 may be 5-10, and the inclined section inclination angle of each middle joint and each joint sleeve may be 8-15 degrees.
An instrument box 4 comprises a bottom shell 408 with an opening, a shell cover 409 is fixedly connected to the opening of the bottom shell 408, a transmission system is arranged in the bottom shell 408, a cylindrical seat structure with a through hole in the middle and a groove in the side wall is fixed in the middle of the rear wall of the shell cover 409, a bearing 410 is arranged in the through hole, and the near end of the hollow long straight rod 3 is fixed in an inner ring of the bearing 410.
A first deflection transmission device 400-1 and a second deflection transmission device 400-2 are respectively arranged at two lower corners of the shell cover 409, a rotary transmission device 400-3 and an opening and closing transmission device 400-4 are respectively arranged at two upper corners of the shell cover 409, and one end of a transmission shaft of the two deflection transmission devices, the rotary transmission device 400-3 and the opening and closing transmission device 400-4 is rotatably connected with the shell cover 409. The two deflection transmission devices, the rotation transmission device 400-3 and the opening and closing transmission device 400-4 in the instrument box 4 shown in fig. 4 are respectively arranged by adopting the structures of the deflection transmission device, the rotation transmission device and the opening and closing transmission device in the Chinese patent 'minimally invasive surgical instrument with tail end rotation function' with the publication number of 105286999.
One end of each of the first strand 401 and the second strand 402 is fixed on a wire wheel of the first deflection transmission device 400-1, the other end of each of the first strand 401 and the second strand 402 is guided by a guide wheel 411, then passes through the middle channel of the hollow long straight rod 3 and the wire passing channel of each joint on the serpentine joint 2 and is fixed inside the joint sleeve 201 at the far end through a limiting block 205 (a total of four limiting blocks, each strand is connected with one limiting block), and the winding directions of the first strand 401 and the second strand 402 on the first deflection transmission device 400-1 are opposite.
Specifically, one end of the first strand 401 is wound on the wire wheel of the first deflection transmission device 400-1 along the counterclockwise direction in the top view, and the other end is fixed by a limit block 205; one end of the second strand 402 is wound on the wire wheel of the first deflection actuator 400-1 in a clockwise direction in plan view and the other end is also fixed by a stop block 205.
One ends of the third strand 403 and the fourth strand 404 are both fixed on the wire wheel of the second deflection transmission device 400-2, and the other ends of the third strand 403 and the fourth strand 404 are both guided by the guide wheel 411, then pass through the middle channel of the hollow long straight rod 3 and the wire moving channels of the joints on the serpentine joint 2 and are fixed inside the joint sleeve 201 through the limiting blocks 205 fixedly connected with the strands, and the winding directions of the third strand 403 and the fourth strand 404 on the second deflection transmission device 400-2 are opposite.
Specifically, one end of the third strand of filament 403 is wound on the filament wheel of the second deflection transmission device 400-2 along the counterclockwise direction in the top view, and the other end is fixed by a limit block 205; one end of the fourth strand of wire 404 is wound on the wire wheel of the second deflection actuator 400-2 in a clockwise direction in a top view and the other end is also fixed by a stopper 205.
One ends of the fifth strand of wire 405 and the sixth strand of wire 406 are both fixed on the wire wheel of the rotary transmission device 400-3, the other ends of the fifth strand of wire 405 and the sixth strand of wire 406 are both fixed on the outer wall of the hollow long straight rod 3, and the winding directions of the fifth strand of wire 405 and the sixth strand of wire 406 on the rotary transmission device 400-3 and the hollow long straight rod 3 are opposite.
Specifically, one end of the fifth strand of wire 405 is wound on the wire wheel of the rotary transmission device 400-3 in a clockwise direction in a top view, and the other end of the fifth strand of wire is wound on the hollow long straight rod 3 in a counterclockwise direction in the top view; one end of the sixth wire 406 is wound on the wire wheel of the rotary transmission device 400-3 in the counterclockwise direction in the top view, and the other end is wound on the hollow long straight rod 3 in the clockwise direction in the top view.
One end of the seventh strand of wire 407 is fixed on the wire wheel of the opening and closing transmission device 400-4, and the other end of the seventh strand of wire 407 is guided by the guide wheel 411, passes through the middle channel of the hollow long straight rod 3 and the serpentine joint 2, extends into the rear sliding channel, and is fixedly connected with the limiting table at the rear end of the T-shaped push rod 104, and the seventh strand of wire 407 is wound on the wire wheel of the opening and closing transmission device 400-4 along the counterclockwise direction.
The yaw driving method according to the present invention will be described with reference to fig. 3a, 3b, 4, 5a, and 5 b. When the first deflection transmission device 400-1 is rotated in the clockwise direction in the top view, the first strand 401 is wound on the wire wheel of the first deflection transmission device 400-1 for increasing the number of turns and is in a tensioned state, and the second strand 402 is wound on the wire wheel of the first deflection transmission device 400-1 for decreasing the number of turns and is in a relaxed state, as shown in fig. 5a, the first strand 401 pulls each intermediate joint 203 and the distal joint sleeve 201 on the serpentine joint 2 to deflect to the side where the first strand 401 is located, so as to realize the first forward deflection motion.
When the first deflection transmission device 400-1 is rotated in the counterclockwise direction in the top view, the second strand 402 is wound on the wire wheel of the first deflection transmission device 400-1 for increasing the number of turns and is in a tensioned state, the first strand 401 is wound on the wire wheel of the first deflection transmission device 400-1 for decreasing the number of turns and is in a relaxed state, as shown in fig. 5b, the second strand 402 pulls each intermediate joint 203 and the distal joint sleeve 201 on the serpentine joint 2 to deflect to the side where the second strand 402 is located, and the first reverse deflection action is realized.
Similarly, when the second deflection transmission device 400-2 is rotated in the clockwise direction in the top view, the third strand 403 is wound on the wire wheel of the second deflection transmission device 400-2 for an increased number of turns and is in a tensioned state, the fourth strand 404 is wound on the wire wheel of the second deflection transmission device 400-2 for a decreased number of turns and is in a relaxed state, and the third strand 403 pulls each of the middle joint 203 and the distal joint sleeve 201 of the serpentine joint 2 to deflect to the side where the third strand 403 is located, so that the second positive deflection action is realized.
When the second deflection transmission device 400-2 is rotated in the counterclockwise direction in the top view as a whole, the fourth strand 404 is wound on the wire wheel of the second deflection transmission device 400-2 for a number of times and is in a tensioned state, the third strand 403 is wound on the wire wheel of the second deflection transmission device 400-2 for a number of times and is in a relaxed state, and the fourth strand 404 pulls each intermediate joint 203 and joint sleeve 201 on the serpentine joint 2 to deflect to the side where the fourth strand 404 is located, so that the second reverse deflection action is realized.
The slewing drive principle of the present invention will be explained below. As shown in fig. 4, when the entire rotary transmission device 400-3 rotates clockwise in a top view, the sixth wire 406 is wound on the wire wheel of the rotary transmission device 400-3 for a number of turns and is in a tensioned state, the fifth wire 405 is wound on the wire wheel of the rotary transmission device 400-3 for a number of turns and is in a relaxed state, and the sixth wire 406 pulls the hollow long straight rod 3 to rotate clockwise in a top view.
When the whole rotary transmission device 400-3 rotates along the counterclockwise direction in the top view, the fifth strand 405 is wound on the wire wheel of the rotary transmission device 400-3 for a number of times and is in a tensioned state, the sixth strand 406 is wound on the wire wheel of the rotary transmission device 400-3 for a number of times and is in a relaxed state, and the fifth strand 405 pulls the long straight rod 3 to rotate along the counterclockwise direction in the top view.
The opening and closing driving method of the present invention will be described with reference to fig. 2b and 4. When the opening and closing transmission device 400-4 integrally rotates in the clockwise direction in the top view, the number of turns of the seventh wire 407 wound on the wire wheel of the opening and closing transmission device 400-4 is increased and is in a tensioned state, the seventh wire 407 pulls the push rod 104 to move backwards along the circular hole channel in the middle of the lower parts of the left ultrasonic knife shell 101-1 and the right ultrasonic knife shell 101-2, the T-shaped push rod 104 pulls the jaw part at the front end of the clamping jaw 103 to rotate around the pin shaft 105 towards one side of the thin-end cylindrical tool bit close to the front end cover 114, the closing action of the clamping jaw 103 is realized, and the spring 106 is compressed.
When the opening and closing transmission device 400-4 integrally rotates along the counterclockwise direction in the top view, the number of turns of the seventh wire 407 wound on the wire wheel of the opening and closing transmission device 400-4 is reduced and the seventh wire is in a loose state, the compressed spring 106 pushes the T-shaped push rod 104 to move forward along the circular hole channel in the middle of the lower parts of the left ultrasonic knife housing 101-1 and the right ultrasonic knife housing 101-2, the T-shaped push rod 104 pushes the jaw part at the front end of the clamping jaw 103 to rotate around the pin shaft 105 to the side of the thin-end cylindrical tool bit far away from the front end cover 114, the opening action of the clamping jaw 103 is realized, and the spring 106 recovers to deform.
Fig. 6 is a schematic view of a doctor operating the distal integrated multi-degree-of-freedom ultrasonic scalpel installed on a surgical robot to close a blood vessel. The device enters the body of a patient through an orifice on the abdominal wall 601, firstly, the position of the ultrasonic knife is quickly adjusted to deflect towards one side of the blood vessel 602 and gradually approaches the blood vessel 602, then the blood vessel 602 is clamped between the thin-end cylindrical knife head 114-4 of the ultrasonic knife and the head part of the clamping forceps 103, the axial direction of the thin-end cylindrical knife head 114-4 is perpendicular to the blood vessel 602 through adjustment, and finally, an alternating current circuit on the ultrasonic host 501 is conducted, at the moment, the ultrasonic knife of the invention is activated and starts to work, and the closing operation of the blood vessel 602 is completed.
It should be noted that the above preferred embodiments are only used to illustrate the technical solutions and advantages of the present invention, and do not limit the application scope. The present invention and its embodiments have been described above schematically, without limitation, and what is shown in the drawings is only one of the embodiments of the present invention, and the actual structure is not limited thereto. Therefore, if those skilled in the art should understand that they can make various changes and modifications without departing from the spirit and scope of the present invention, they should not be construed as inventive and similar structural embodiments and embodiments, but rather should be construed to cover all modifications, equivalents, and equivalents of the claims.
Claims (5)
1. A far-end integrated multi-degree-of-freedom ultrasonic knife is characterized in that: the ultrasonic scalpel comprises a far-end ultrasonic scalpel, wherein the far-end ultrasonic scalpel comprises an ultrasonic scalpel shell, the ultrasonic scalpel shell comprises a left ultrasonic scalpel shell (101-1) and a right ultrasonic scalpel shell (101-2) which are bilaterally symmetrical about a middle vertical plane, and the front ends of the left ultrasonic scalpel shell and the right ultrasonic scalpel shell are fixedly butted through a fixed pin shaft (102);
an ultrasonic knife is arranged in the ultrasonic knife shell, the ultrasonic knife comprises a front end cover (114), a screw rod is connected in the middle of the rear end face of the front end cover, one end of the screw rod penetrates through middle holes of a plurality of pieces of thickness polarization piezoelectric ceramics (113) and is in threaded connection with a middle threaded hole of a rear end cover (111), all the parts are connected together through the screw rod and apply pre-pressure to the piezoelectric ceramics, and a fixed pin shaft (102) is arranged in the direction perpendicular to the axis of the screw rod;
electrode plates (112) are respectively arranged between two adjacent thickness polarization piezoelectric ceramics (113) and between the intersection parts of the rear end cover (111), the front end cover (114) and the thickness polarization piezoelectric ceramics (113), and the electrode plates are alternately arranged as a negative electrode and a positive electrode from the rear end cover (111) to the front end cover (114);
the electrode plates as the negative electrodes at the thickness polarization piezoelectric ceramics (113) are connected with the first electrode of the alternating current circuit of the ultrasonic main machine (501) through a first circuit line (502) together, and the electrode plates as the positive electrodes at the thickness polarization piezoelectric ceramics are connected with the second electrode of the alternating current circuit of the ultrasonic main machine (501) through a second circuit line (503) together;
the front end cover (114) is coaxially and fixedly connected with a thick-end cylindrical part (114-1), a first arc transition section (114-2), a second arc transition section (114-3) and a thin-end cylindrical tool bit (114-4) with the diameter smaller than that of the thick-end cylindrical part in sequence from back to front, the screw is coaxially and fixedly connected with the thick-end cylindrical part (114-1), the contour line of the first arc transition section is tangent to the contour line of the thick-end cylindrical part, the contour line of the second arc transition section is tangent to the contour line of the thin-end cylindrical tool bit, and the contour lines of the first arc transition section and the second arc transition section are tangent at an intersection point;
an annular groove is formed in the inner wall of the front end of the ultrasonic knife shell, a vibration displacement nodal plane of the ultrasonic knife (100) is arranged at the interface of the thick-end cylindrical part (114-1) and the first arc transition section (114-2), a flange is arranged at the vibration displacement nodal plane in a surrounding mode, the flange on the front end cover (114) is clamped and fixed in the annular groove of the ultrasonic knife shell, and a thin-end cylindrical knife head of the front end cover (114) extends out of an opening hole in the front wall of the ultrasonic knife shell;
the upper parts of the left outer wall and the right outer wall at the front end of the left ultrasonic knife shell (101-1) and the right ultrasonic knife shell (101-2) are respectively fixed with a connecting pin shaft (105), the connecting pin shafts are arranged in parallel with the fixed pin shaft (102), and the middle parts of the left connecting rod and the right connecting rod at the rear end of the clamping pliers (103) are respectively connected with the connecting pin shafts (105) at the left side and the right side in a rotating way; a diameter-variable sliding channel is arranged in the middle of the bottom of the ultrasonic knife shell along the axial direction of the ultrasonic knife shell, the diameter-variable sliding channel comprises a front sliding channel positioned at the front part, a middle sliding channel communicated with the rear end of the front sliding channel and a rear sliding channel communicated with the rear end of the middle sliding channel, the diameter of the middle sliding channel is respectively larger than that of the front sliding channel and that of the rear sliding channel, a T-shaped push rod (104) comprises a cross rod at the front end and a longitudinal rod fixedly connected with the cross rod, a limiting table with the diameter larger than that of the longitudinal rod is fixed at the rear end of the longitudinal rod, the rear part of the longitudinal rod of the T-shaped push rod is inserted in the middle sliding channel and can slide back and forth in the middle sliding channel, the front part of the longitudinal rod of the T-shaped push rod is inserted in the front sliding channel and can slide back and forth in the front sliding channel, the cross rod of the T-shaped push rod is arranged outside the diameter-variable sliding channel, the left end and the right end of the cross rod respectively penetrate through a shell sliding groove on the shell and connecting rod sliding grooves on connecting rods on the left side and the right side of the rear end of the clamping pincers, the shell sliding grooves are arranged along the axial direction of the shell of the ultrasonic scalpel, and the connecting rod sliding grooves are arranged along the length direction of the connecting rods on the left side and the right side of the clamping pincers; the cross rod of the T-shaped push rod (104) is connected with the shell sliding groove in a sliding mode in a front-back sliding mode and is connected with the connecting rod sliding groove in a sliding mode along the length direction of the connecting rod, the head portion of each clamping forceps and the thin-end cylindrical tool bit of the front end cover form a shear type clamping structure, the limiting table is used for being connected with one end of a wire drawing device for achieving opening and closing actions of the clamping forceps (103), one end of a spring (106) is fixed on the limiting table, and the other end of the spring is fixedly connected with the rear wall of the middle sliding channel.
2. The distal end integrated multi-degree of freedom ultrasonic blade of claim 1, wherein: the ratio of the arc radiuses of the contour lines of the first arc transition section and the second arc transition section is R1 to R2, and the ratio of the arc radiuses of the contour lines of the first arc transition section and the second arc transition section is 0.4-0.8.
3. The distal end integrated multi-degree-of-freedom ultrasonic blade according to claim 1 or 2, wherein: epoxy resin adhesive is filled between the rear end cover and the first electrode plate on the leftmost side and between the front end cover and the first electrode plate on the rightmost side respectively.
4. The distal end integrated multi-degree of freedom ultrasonic blade of claim 3, wherein: the front end cover adopts medical titanium alloy TC4 ELI.
5. The distal end integrated multi-degree of freedom ultrasonic blade of claim 3, wherein: the rear end cover is made of stainless steel.
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| CN111000599B (en) * | 2019-12-13 | 2021-07-27 | 山东大学 | Variable-rigidity snake-shaped surgical robot based on nickel-titanium alloy framework |
| CN112170149A (en) * | 2020-10-27 | 2021-01-05 | 李宏亮 | Dual-mode ultrasonic vibrator for drawing metal wire |
| CN112244944B (en) * | 2020-11-18 | 2024-06-11 | 福建医科大学附属协和医院 | Visual ultrasonic knife |
| CN112690873B (en) * | 2020-12-25 | 2021-10-26 | 中南大学湘雅医院 | Bendable ultrasonic knife |
| CN112617937B (en) * | 2020-12-29 | 2022-05-17 | 美科特医疗科技(苏州)有限公司 | Anastomat sleeve pipe assembly |
| CN114052838A (en) * | 2021-11-01 | 2022-02-18 | 无锡贝恩外科器械有限公司 | Cutter arbor structure and supersound sword |
| CN113907849B (en) * | 2021-11-11 | 2024-05-28 | 以诺康医疗科技（苏州）有限公司 | Sleeve assembly and ultrasonic blade |
| CN114209370A (en) * | 2021-12-10 | 2022-03-22 | 美科特医疗科技(苏州)有限公司 | Flexible connecting piece and end effector assembly |
| CN114305591A (en) * | 2021-12-20 | 2022-04-12 | 江苏集萃微纳自动化系统与装备技术研究所有限公司 | Pincers end effector assembly and pincers surgical operation instrument |
| CN117883152A (en) * | 2024-03-13 | 2024-04-16 | 苏州康多机器人有限公司 | End effector and ultrasonic cutting hemostasis system |
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