CN111714162B

CN111714162B - Surgical device and surgical instrument

Info

Publication number: CN111714162B
Application number: CN201910389682.2A
Authority: CN
Inventors: 李涛; 何超; 孙峰
Original assignee: Shanghai Microport Medbot Group Co Ltd
Current assignee: Shanghai Microport Medbot Group Co Ltd
Priority date: 2019-05-10
Filing date: 2019-05-10
Publication date: 2023-03-28
Anticipated expiration: 2039-05-10
Also published as: CN111714162A

Abstract

The invention provides a surgical device and a surgical instrument, wherein the surgical instrument comprises a handheld end, a connecting structure, an end effector and a transmission device; the near end of the connecting structure is arranged at the handheld end, and the far end of the connecting structure is connected with the end effector; and the connecting structure comprises a first flexible structure and a second flexible structure; the transmission comprises a first flexible transmission structure connecting the first flexible structure and the second flexible structure, and the first flexible transmission structure is configured to rotate the first flexible structure and the second flexible structure in opposite directions; the configuration realizes the purpose that more than two surgical instruments are simultaneously inserted into a human body for surgical operation, interference does not occur in the operation process, and the surgical instruments can be preferably selected to be close to the same target tissue simultaneously, so that the surgical difficulty is reduced.

Description

Surgical device and surgical instrument

Technical Field

The invention relates to the technical field of medical instruments, in particular to a surgical device and a surgical instrument.

Background

To reduce the number of surgical wounds and improve surgical aesthetics, single port laparoscopic surgery is becoming increasingly favored. However, due to the chopstick effect, after the common medical apparatus (mostly rigid straight rod) is inserted into the body, the cross operation is needed, it is difficult to approach a single target area in the treated tissue by two or more tools simultaneously, which increases the difficulty of the operation, and the common medical apparatus can generate cross friction during the simultaneous operation, which not only affects the normal use, but also may cause secondary injury to the patient sometimes.

Chinese patent application CN105266856A discloses a glove-type single port laparoscopic puncture device, which adopts a flexible glove-type structure, and does not solve the problem of interference between surgical instruments in the abdominal cavity although the operating space of the doctor holding end is increased. In addition, chinese patent No. CN104352264B discloses a multi-degree-of-freedom laparoscopic surgical instrument, which is provided with a handle, wherein a knob is disposed at the handle, and a proximal end of a push rod passes through the center of the knob, so that the bending of a bending unit is controlled by the rotation of the knob, and the purpose that the front end can be bent in any direction is achieved.

Disclosure of Invention

In order to solve the above technical problems, an object of the present invention is to provide a surgical device and a surgical instrument, which can prevent interference when more than two surgical instruments are inserted into a human body for operation, reduce secondary damage to a patient, and reduce surgical difficulty because the surgical instruments can approach the same target tissue at the same time.

Further, to achieve the above object, the present invention provides a surgical instrument comprising:

a handheld end;

an end effector;

a connection structure having a proximal end mounted to the hand-held end and a distal end connected to the end effector, the connection structure including a first flexible structure and a second flexible structure; and

an actuator comprising a first flexible actuator structure connecting the first and second flexible structures, and configured to rotate the first and second flexible structures in opposite directions.

Optionally, the first flexible structure has rotational freedom to rotate about a first axis, and the second flexible structure has rotational freedom to rotate about a third axis, the third axis being parallel to the first axis.

Optionally, the first flexible structure further has a rotational degree of freedom to rotate about a second axis, and the second flexible structure further has a rotational degree of freedom to rotate about a fourth axis, the fourth axis being parallel to the second axis, and the first axis being perpendicular to the second axis.

Optionally, the first flexible drive structure comprises a first drive wire set and a second drive wire set;

when the first flexible structure is driven to rotate around the first axis, the first transmission wire group and the second transmission wire group are used for driving the second flexible structure to rotate around the third axis in a direction opposite to the rotation direction of the first flexible structure;

when the first flexible structure is driven to rotate around the second axis, the first transmission wire group and the second transmission wire group are used for driving the second flexible structure to be driven to rotate around the fourth axis in a direction opposite to the rotating direction of the first flexible structure.

Optionally, the first drive wire set comprises a first drive wire and a second drive wire;

when the first flexible structure is driven to rotate around the first axis, the first transmission wire and the second transmission wire are used for driving the second flexible structure to rotate around the third axis in a direction opposite to the rotating direction of the first flexible structure;

the second transmission screw group comprises a third transmission screw and a fourth transmission screw;

when the first flexible structure is driven to rotate around the second axis, the third transmission wire and the fourth transmission wire are used for driving the second flexible structure to rotate around the fourth axis in a direction opposite to the rotating direction of the first flexible structure.

Optionally, the fixed position of the proximal end of the first drive wire on the first flexible structure is in an opposite configuration to the fixed position of the distal end of the first drive wire on the second flexible structure; a fixed position of a proximal end of the second drive wire on the first flexible structure in an opposite configuration to the fixed position of the distal end of the second drive wire on the second flexible structure;

a fixed position of a proximal end of the third drive wire on the first flexible structure in an opposite configuration to the fixed position of the distal end of the third drive wire on the second flexible structure; the attachment location of the proximal end of the fourth drive wire to the first flexible structure is in an opposite configuration to the attachment location of the distal end of the fourth drive wire to the second flexible structure.

Optionally, the connecting structure further comprises an outer tube, the outer tube further comprises a first proximal portion, a first middle portion and a first distal portion, and the first proximal portion, the first flexible structure, the first middle portion, the second flexible structure and the first distal portion are sequentially arranged from near to far; the connecting structure further comprises a third flexible structure positioned at the far end, the third flexible structure has at least one degree of freedom of rotation and is connected with the end effector so as to drive the end effector to rotate;

the surgical instrument has an initial state and an open state;

when the surgical instrument is in the initial state, the first intermediate portion, second flexible structure, first distal portion, third flexible structure are co-linear with an axis of an end effector, and the first proximal portion is offset from the axis of the first intermediate portion by the first flexible structure;

when the surgical instrument is in the open state, the first proximal end portion is offset from the axis of the first intermediate portion by the first flexible structure, the first distal end portion is offset from the axis of the first intermediate portion by the second flexible structure, and the end effector is proximate to the axis of the first intermediate portion by the third flexible structure.

Optionally, the first transmission wire set and/or the second transmission wire set further include a first elastic structure to prevent a backlash of the first transmission wire set and/or the second transmission wire set.

Optionally, the first flexible transmission structure comprises a first transmission wire, a second transmission wire, a third transmission wire and a fourth transmission wire;

when the first flexible structure is driven to rotate around the first axis, the first transmission wire and the second transmission wire are used for driving the second flexible structure to rotate around a third axis in a direction opposite to the rotating direction of the first flexible structure, and the third axis is parallel to the first axis;

when the first flexible structure is driven to rotate around a second axis, the third transmission wire and the fourth transmission wire are used for driving the second flexible structure to rotate around a fourth axis in a direction opposite to the rotating direction of the first flexible structure, and the second axis is parallel to the fourth axis and is perpendicular to the first axis;

the first transmission wire and the second transmission wire are not equal in length, and/or the third transmission wire and the fourth transmission wire are not equal in length.

Optionally, the connection structure further includes a third flexible structure at the distal end, the third flexible structure is connected to the end effector, and the third flexible structure has at least one rotational degree of freedom to rotate the end effector; the handheld end comprises an operation device, a wrist structure and an arc body which are sequentially connected, the near end of the connecting structure is installed on the arc body, and the wrist structure has at least one rotational degree of freedom;

wherein the transmission further comprises a second flexible transmission structure connecting the wrist structure and a third flexible structure, the second flexible transmission structure being configured to rotate the third flexible structure in the same direction as the wrist structure.

Optionally, the wrist structure has rotational freedom to rotate about a fifth axis and rotational freedom to rotate about a sixth axis, the third flexible structure has rotational freedom to rotate about a seventh axis and rotational freedom to rotate about an eighth axis, the fifth axis is perpendicular to the sixth axis, the seventh axis is perpendicular to the eighth axis, and the fifth axis is parallel to the seventh axis.

Optionally, the second flexible drive structure comprises a third drive wire set and a fourth drive wire set;

when the wrist structure is driven to rotate around a fifth axis, the third transmission screw group and the fourth transmission screw group are used for driving the third flexible structure to rotate around a seventh axis in the same direction as the rotation direction of the wrist structure;

when the wrist structure is driven to rotate around the sixth axis, the third transmission wire set and the fourth transmission wire set are used for driving the third flexible structure to rotate around the eighth axis in the same direction as the rotation direction of the wrist structure.

Optionally, the third transmission wire set and/or the fourth transmission wire set further include a second elastic structure for compensating a bending amount of the third transmission wire set and/or the fourth transmission wire set so as to maintain the posture of the end effector unchanged when the first flexible structure and the second flexible structure are adjusted.

Optionally, the handheld end includes an operating device, a wrist structure and an arc body, which are connected in sequence, the proximal end of the connecting structure is mounted to the arc body, the operating device has a rotation degree of freedom rotating around a ninth axis, and the operating device is rotatably disposed on the wrist structure;

the end effector has a rotational degree of freedom to rotate about a tenth axis;

the transmission further includes a third flexible transmission structure connecting the manipulation device and the end effector, the third flexible transmission structure being configured to cause the end effector to spin in an opposite direction from the manipulation device.

Optionally, the handheld end includes an opening and closing control mechanism, an operating device, a wrist structure and an arc body, which are connected in sequence, the proximal end of the connecting structure is mounted to the arc body, and the opening and closing control mechanism can perform opening and closing movements relative to the operating device;

the end effector comprises a tool flap and a proximal effector mount, the tool flap being capable of opening and closing movement relative to the proximal effector mount;

the transmission device further comprises a fourth flexible transmission structure, a first conversion device and a second conversion device; the near end of the fourth flexible transmission structure is connected with the first conversion device, and the far end of the fourth flexible transmission structure is connected with the second conversion device; the first conversion device is movably connected with the opening and closing control mechanism and used for converting the opening and closing movement of the opening and closing control mechanism into the axial movement of a fourth flexible transmission structure, and the second conversion device is movably connected with the tool valve and used for converting the axial movement of the fourth flexible transmission structure into the opening and closing movement of the tool valve; and the fourth flexible transmission structure, the first conversion device and the second conversion device are configured to enable the opening and closing control mechanism to move in the same way as the tool valve.

Optionally, the end effector has a telescopic degree of freedom for movement in an axial direction of the connection structure.

Optionally, the connecting structure includes an inner tube and an outer tube movably sleeved on the inner tube, an axial length of the inner tube is greater than an axial length of the outer tube, and the inner tube is capable of moving relative to the outer tube;

the proximal end of the inner tube is mounted to the hand-held end, and the distal end is connected with the end effector; the first flexible structure is located at a proximal end of the outer tube and the second flexible structure is located at a distal end of the outer tube.

Optionally, a third flexible structure is disposed at the distal end of the inner tube, and the third flexible structure has at least one rotational degree of freedom and is connected to the end effector to rotate the end effector.

Optionally, the outer tube further comprises a first proximal end portion, a first middle portion and a first distal end portion, the first proximal end portion, the first flexible structure, the first middle portion, the second flexible structure and the first distal end portion are sequentially arranged from the proximal to the distal, and the first proximal end portion, the first middle portion and the first distal end portion are all rigid members; the inner tube comprises a second proximal end part, a second middle part and a second distal end part which are sequentially arranged from near to far, wherein the second proximal end part and the second distal end part are both rigid parts, and the second middle part is a flexible part;

wherein: the second intermediate portion of the inner tube corresponds to the first, first and second flexible structures of the outer tube, and has an axial length greater than the total axial length of the first, first and second flexible structures.

Optionally, the second proximal end portion of the inner tube comprises a first inner sub-tube and a second inner sub-tube arranged in sequence from far to near; the outer diameter of the first inner sub-tube is no greater than the inner diameter of the first proximal portion of the outer tube such that the first inner sub-tube is disposed within the first proximal portion of the outer tube; the outer diameter of the second inner sub-tube is larger than the inner diameter of the first proximal end part of the outer tube, so that the second inner sub-tube is arranged outside the first proximal end part of the outer tube to form a proximal limit;

the second distal end part comprises a third sub-inner tube and a fourth sub-inner tube which are arranged from near to far in sequence; the outer diameter of the third sub-inner tube is no greater than the inner diameter of the first distal end portion of the outer tube such that the third sub-inner tube is disposed within the first distal end portion of the outer tube; the outer diameter of the fourth sub-inner tube is greater than the inner diameter of the first distal end portion of the outer tube such that the fourth sub-inner tube is disposed outside the first distal end portion of the outer tube to form a distal stop;

the first, second and third inner sub-tubes have a total axial length greater than the axial length of the outer tube.

Optionally, the connecting structure further comprises an outer tube, a proximal end of the outer tube being mounted to the handheld end, and the outer tube comprising a first flexible structure at the proximal end and a second flexible structure at the distal end;

the handheld end comprises a connecting shaft, the connecting shaft is movably arranged in the outer tube in a penetrating mode, the far end of the connecting shaft extends out of the outer tube and is connected with the end effector, and the far end of the outer tube is movably connected with the end effector to drive the end effector to rotate.

Optionally, the outer tube further comprises a first proximal portion, a first intermediate portion, a first distal portion, and a third flexible structure; the first proximal part, the first flexible structure, the first middle part, the second flexible structure, the first distal part and the third flexible structure are arranged in sequence from near to far, and the first proximal part, the first middle part and the first distal part are all rigid parts; the first proximal portion is mounted to the handle end and the third flexible structure has at least one degree of rotational freedom and is movably coupled to the end effector to rotate the end effector.

Optionally, the handheld end includes controlling device, wrist structure and the arc body that connects gradually, the near-end of outer tube is installed to the arc body, controlling device movably sets up on the wrist structure, controlling device with the near-end of connecting axle is connected.

Optionally, the connecting shaft includes a proximal section, a middle section and a distal section, which are sequentially arranged from the proximal end to the distal end; wherein the proximal section and the distal section are both rigid members, and the intermediate section is a flexible member; the manipulation device is connected with the proximal section and is movably connected with the wrist structure through the proximal section; the distal section extends from the distal end of the third flexible structure and is coupled to an end effector.

Optionally, the handheld end includes an operation device, a wrist structure and an arc body, which are connected in sequence; the proximal end of the outer tube is mounted to the arcuate body; the wrist structure is provided with a rigid sleeve on a surface opposite to the control device, the control device is movably arranged on the rigid sleeve, and the control device is connected with the near end of the connecting shaft.

Optionally, the connecting shaft includes a proximal section, a middle section and a distal section, which are sequentially arranged from the proximal end to the distal end; wherein the proximal and distal sections are both rigid members and the intermediate section is a flexible member; the steering device is coupled to the proximal section and movably coupled to the rigid cannula through the proximal section, and the distal section is coupled to the end effector after extending from the distal end of the third flexible structure.

Optionally, the connecting shaft includes a proximal section, a middle section and a distal section, which are sequentially arranged from the proximal end to the distal end; wherein the proximal section and the distal section are both rigid members, and the intermediate section is a flexible member; the manipulation device is connected with the proximal end section, and the distal end section extends out of the end of the third flexible structure and then is connected with the end effector;

the connecting shaft is configured to:

when the manipulation device is moved to a proximal end of the surgical instrument to a proximal-most position, the distal section maintains a mating relationship with the distal end of the third flexible structure to form a distal stop;

the manipulation device maintains a mating relationship with the wrist structure to form a proximal stop when the distal section moves proximally of the surgical instrument to a proximal-most position.

Optionally, the connecting shaft is configured to:

when the proximal end section moves to the proximal end of the surgical instrument to the nearest position, the distal end section keeps a matching relation with the tail end of the third flexible structure to form a distal limit;

when the distal section moves proximally of the surgical instrument to a proximal-most position, the proximal section maintains a mating relationship with the wrist structure to form a proximal stop.

Optionally, the end effector comprises a proximal end effector mount, the proximal end mount comprising a first sub-effector mount and a second sub-effector mount located at a distal end, the outer diameter of the first sub-effector mount being no greater than the inner diameter of the third flexible structure, the outer diameter of the second sub-effector mount being greater than the inner diameter of the third flexible structure.

Optionally, the end effector comprises a proximal effector mount having an outer diameter greater than an inner diameter of the third flexible structure.

In order to achieve the above object, the present invention further provides a surgical device, which comprises the surgical instrument, an endoscope and a poking card; the surgical instrument and the endoscope are both detachably secured to the poke card.

Optionally, an instrument channel is disposed on the stab card, the connection structure of the surgical instrument being positioned within the instrument channel and removably secured therewith.

Optionally, the surgical device has a tool axis, a symmetry plane, and a working plane, the surgical device is symmetric about the symmetry plane, the number of the surgical instruments is at least two, the stab card is provided with at least two instrument channels, the working plane is perpendicular to the symmetry plane, the working plane passes through the axes of the at least two instrument channels, the intersection line of the symmetry plane and the working plane forms the tool axis, and each surgical instrument is positioned in a corresponding one of the instrument channels;

the connecting structures of both of the surgical instruments further comprise an outer tube further comprising a first proximal portion, a first intermediate portion, and a first distal portion; the first proximal end part, the first flexible structure, the first middle part, the second flexible structure and the first distal end part are arranged from the near to the far in sequence, and the axis of the first middle part is parallel to the axis of the tool; the connecting structures of the two surgical instruments further comprise third flexible structures positioned at the far ends, the third flexible structures have at least one rotational degree of freedom and are connected with the end effectors so as to drive the end effectors to rotate;

wherein each surgical instrument has an initial state and an open state:

when the two surgical instruments are in the initial state, the first proximal end parts of the two surgical instruments are deviated from the axis of the first middle part through the first flexible structure, the first middle part, the second flexible structure, the first distal end part and the third flexible structure are collinear with the axis of the end effector, and the axes of the first proximal end parts, the first flexible structure, the first middle part, the second flexible structure, the first distal end part, the third flexible structure and the end effector are all positioned on the working surface;

when the two surgical instruments are in the open state, the first proximal end portions of the two surgical instruments are offset from the axis of the first middle portion by the first flexible structure, the first distal end portions are offset from the axis of the first middle portion by the second flexible structure, the end effector is close to the axis of the first middle portion by the third flexible structure, and the axes of the first proximal end portions, the first flexible structure, the first middle portion, the second flexible structure, the first distal end portions, the third flexible structure and the end effector are all located on the working surface.

Optionally, a first positioning portion is arranged on the connecting structure, and a second positioning portion is arranged on the instrument channel; the first positioning part is used for being matched with the second positioning part so as to limit the axis of the part of the connecting structure where the first positioning part is located to be parallel to the axis of the tool.

In summary, in the surgical device and the surgical instrument provided by the invention, through linkage (i.e. mirror motion) of the first flexible structure and the second flexible structure, more than two surgical instruments can be simultaneously inserted into a human body for operation without interference during operation, so that secondary injury to a patient is reduced, and the surgical instruments can be simultaneously close to the same target tissue for operation, thereby increasing the operation space of the surgical instruments and reducing the operation difficulty.

In particular, the surgical device of the present invention has an initial state and an open state. Through first flexible construction of transmission adjustment and second flexible construction, can make all surgical instruments when initial condition stick the card downside the part and draw together, and stick the part of card upside and keep away from each other, a plurality of surgical instruments of being convenient for insert the human body simultaneously like this, also be convenient for remove a plurality of surgical instruments after accomplishing the operation, reduced the degree of difficulty of installation and dismantlement a plurality of surgical instruments like this. And then the first flexible structure and the second flexible structure are adjusted through the transmission device, so that each surgical instrument can be opened in vivo without mutual interference, the operable space of the handheld end and the end effector is enlarged, more than two surgical instruments can be used for performing surgical operation at the same time, and the surgical instruments cannot interfere with each other. Furthermore, in the surgical device and the surgical instrument provided by the invention, the third flexible structure is adjusted through the transmission device, so that more than two surgical instruments can approach the same target tissue in vivo, and the surgical difficulty is further reduced.

Drawings

The features, nature, and advantages of embodiments of the invention will be more fully described in connection with the following drawings in which:

FIG. 1 is a schematic view of a surgical device according to a first embodiment of the present invention with two surgical instruments in an initial state;

FIG. 2 is a schematic view of a surgical device according to a first embodiment of the present invention with both surgical instruments in an open position;

FIG. 3 is a schematic view of a surgical device according to a first embodiment of the present invention operating on a human body;

FIG. 4 is a schematic view of the connection structure of the first embodiment of the present invention, in which the outer tube and the inner tube connected to the handle end are not assembled;

FIG. 5 is a partial schematic view of the outer tube and the inner tube assembled together in the connection structure according to the first embodiment of the present invention;

FIG. 6a is a schematic view of a first positioning portion disposed on an outer wall of a first middle portion of an outer tube according to a first embodiment of the present invention;

FIG. 6b is a schematic view of a second positioning portion disposed in an instrument channel of a stamp card according to a first embodiment of the present invention;

FIG. 7 is a schematic view of the freedom of movement of a surgical instrument according to a first embodiment of the present invention;

FIG. 8 is a schematic view of a flexible structure according to a first embodiment of the present invention, wherein the flexible structure is a serpentine joint;

FIG. 9 is a schematic view of a first flexible structure and a second flexible structure connected by a first transmission wire set and a second transmission wire set according to a first embodiment of the present invention;

FIG. 10 is a schematic view of a wrist structure according to a first embodiment of the present invention, wherein the wrist structure is a hook joint structure;

fig. 11a and 11b are schematic diagrams illustrating a motion relationship between a manipulation device and an end effector according to a first embodiment of the present invention;

FIG. 12 is a schematic view of a wrist structure and a third flexible structure connected by a third transmission wire set and a fourth transmission wire set according to a first embodiment of the present invention;

FIG. 13 is a schematic view of a drive wire controlled surgical instrument in an initial state according to a first embodiment of the present invention;

fig. 14 is a schematic view of the opening and closing control mechanism and the end effector connected by a third flexible transmission structure and a fourth flexible transmission structure according to the first embodiment of the present invention;

FIG. 15 is a schematic view of a handheld terminal according to a first embodiment of the present invention, wherein a finger stall structure is disposed on the opening/closing control mechanism;

FIG. 16 is a schematic view of the second embodiment of the present invention showing the freedom of movement of the surgical instrument;

FIG. 17 is an exploded view of a second surgical instrument according to a second embodiment of the present invention;

fig. 18 is an assembled view of the surgical instrument according to the second embodiment of the present invention, in which the structure of the distal end of the surgical instrument is also partially enlarged.

In the figure:

100-surgical device: 1-surgical instruments; 2, endoscope; 3-poking a card;

31-a second location portion; 32-an instrument channel; 4-a handheld end; 41. 41' -a manipulation device; 42. 42' -wrist structure; 421-outer frame; 422-inner frame; 42A-ninth fixation point; 42B-tenth fixation point; 42C-eleventh fixation point; 42D-twelfth fixation point; 43-an arcuate body; 5-a linking structure; 51. 51' -an outer tube; 511. 511' -a first proximal portion; 512. 512' -a first intermediate portion; 5121-a first positioning portion; 513. 513' -a first distal portion; 514. 514' -a first flexible structure; 514A-first fixed point; 514B-a second fixation point; 514C-a third fixation point; 514D-a fourth fixation point; 515. 515' -a second flexible structure; 515A-fifth fixation point; 515B-sixth fixation point; 515C-seventh fixation point; 515D-eighth fixation point; 71A-a first drive wire; 71B-a second drive wire; 72A-a third drive wire; 72B-a fourth drive wire; 52-an inner tube; 521-a second proximal end portion; 5211-first sub-inner tube; 5212-second sub-inner tube; 522-a second intermediate portion; 523-a second distal end portion; 5231-third sub-inner tube; 5232-fourth sub-inner tube; 524. 516' -a third flexible structure; 524A-thirteenth fixation point; 524B-a fourteenth fixation point; 524C-fifteenth fixation point; 524D-sixteenth fixation point; 6-end effector; 75-a third flexible transmission structure; 76-a fourth flexible transmission structure; 11-a first snap flap; 12-a second snap flap; 13-finger stall; 75' -a connecting shaft; 751' -a proximal section; 752' -middle section; 753' -a distal section; 421' -rigid sleeve; a guide wheel 5145.

Detailed Description

The present invention will now be described in more detail with reference to the accompanying schematic drawings, in which preferred embodiments of the invention are shown, it being understood that one skilled in the art may modify the invention herein described while still achieving the advantageous effects of the invention. Accordingly, the following description should be construed as broadly as possible to those skilled in the art and not as limiting the invention.

In the interest of clarity, not all features of an actual implementation are described. In the following description, well-known functions or constructions are not described in detail since they would obscure the invention in unnecessary detail. It will of course be appreciated that in the development of any such actual embodiment, numerous implementation-specific details must be set forth in order to achieve the developer's specific goals, such as compliance with system-related and business-related constraints, which will vary from one implementation to another. Moreover, it will be appreciated that such a development effort might be complex and time-consuming, but would nevertheless be a routine undertaking for those of ordinary skill in the art.

The invention is described in more detail in the following paragraphs by way of example with reference to the accompanying drawings. Advantages and features of the present invention will become apparent from the following description and from the claims. It is to be noted that the drawings are in a very simplified form and are not to precise scale, which is provided for the purpose of facilitating and clearly illustrating embodiments of the present invention.

The following preferred embodiments are given to clearly illustrate the contents of the present invention, and it should be understood that the contents of the present invention are not limited to the following embodiments, and other modifications by conventional means of skill in the art are also within the scope of the idea of the present invention.

A core idea of the invention is to provide a surgical instrument comprising:

a handheld end;

an end effector;

Through the application of the surgical instrument, the problem that the operation is difficult to be simultaneously performed by two or more surgical instruments at present can be solved, so that the operation difficulty is reduced.

Furthermore, the connection structure of the invention further comprises a third flexible structure positioned at the far end, the third flexible structure is connected with the end effector, and the third flexible structure has at least one rotational degree of freedom to drive the end effector to rotate; the handheld end comprises an operation device, a wrist structure and an arc body which are sequentially connected, the near end of the connecting structure is installed on the arc body, and the wrist structure has at least one rotational degree of freedom; wherein the transmission further comprises a second flexible transmission structure connecting the wrist structure and a third flexible structure, the second flexible transmission structure being configured to rotate the third flexible structure in the same direction as the wrist structure, and thereby the end effector and the manipulation device in the same direction. By doing so, can realize that a plurality of surgical instruments are close to same target tissue simultaneously to still can realize the syntropy operation of handheld end and end effector to further reduce the operation degree of difficulty, reduce the operation risk.

The surgical instrument and the surgical device according to the embodiments of the present invention will be further described with reference to the accompanying drawings and specific embodiments.

< example one >

Fig. 1 is a schematic view of a surgical apparatus according to a first embodiment of the present invention, in which two surgical instruments are in an initial state, and fig. 2 is a schematic view of a surgical apparatus according to a first embodiment of the present invention, in which two surgical instruments are in an open state. As shown in fig. 1 and 2, a surgical device 100 according to an embodiment of the present invention includes a surgical instrument 1, an endoscope 2, and a poking card 3, and the endoscope 2 and the surgical instrument 1 are detachably fixed to the poking card 3. Further, the stab card 3 is provided with a number of instrument channels 32 (see fig. 6 b) for detachable fixation with the endoscope 2 and the surgical instrument 1.

Further, the surgical device 100 further comprises a tool axis, a symmetry plane and a working plane, the surgical device 100 is symmetrical with respect to the symmetry plane, the working plane is perpendicular to the symmetry plane of the surgical device 100, and the working plane passes through at least two axes of the instrument channel 32 detachably connected to the surgical instrument 1, and an intersection line of the symmetry plane and the working plane forms the tool axis. As shown in FIG. 3, in actual operation, the stab card 3 is placed on a wound site on the surface of a human body, and the surgical instrument 1 and the endoscope 2 are respectively passed through the instrument channel 32 of the stab card 3 into the interior of the human body. The surgical instrument 1 may be one, or two or more, and may be configured by the surgeon according to the actual surgical needs.

The following description illustrates two surgical instruments 1 as an example of the surgical device 100, which facilitates the simultaneous approach of a plurality of surgical instruments 1 to the same target tissue for surgical operation without interference between the plurality of surgical instruments 1, but the present invention should not be limited thereto.

As shown in fig. 1 and 2, the two surgical instruments 1 are provided, and the two surgical instruments 1 respectively pass through different instrument channels 32 on the stab card 3 to enter the human body for performing the surgical operation. The two surgical instruments 1 may have the same configuration, but it will be appreciated that the two surgical instruments 1 may also differ in some respects, for example with different end effectors. Furthermore, the present invention is not particularly limited as to the type of end effector on the surgical instrument 1, and may be selected by the surgeon according to the surgical needs. For example, the end effector may be scissors, graspers, clamps, tweezers, or other clamp-like actuators, or may be an electro-dynamic end effector such as a resistance heater, a motor drive element, or may be an arc-shaped actuator such as a hook. Of course the end effector may take other forms.

As shown in fig. 1, after the stab card 3 is secured in place at the wound site of the patient, two surgical instruments 1 in an initial state are inserted into the stab card 3. In the initial state, the two surgical instruments 1 are in a Y shape, that is, the external structures of the two surgical instruments 1 on the upper side of the stab card 3 (i.e., the surgical instrument structures outside the patient) are opened away from each other, while the internal structures of the two surgical instruments 1 on the lower side of the stab card 3 (i.e., the surgical instrument structures inside the patient) are closed close to each other and are in the working plane. In particular, the first flexible structure of the surgical instrument 1 in the initial state is deflected by an angle relative to the tool axis, while the second flexible structure, the third flexible structure and even the end effector are set to the initial state, i.e. the second flexible structure, the third flexible structure and the end effector, if having a freedom of deflection, are not deflected relative to the tool axis. As such, the first flexible structure to the handle end of the surgical instrument 1 is offset from the tool axis, and the second flexible structure to the end effector are all substantially in a line parallel to the tool axis, i.e., the axes of the second flexible structure, the third flexible structure, and the end effector are collinear. Upon insertion of the stab card 3, the first and second flexible structures of the surgical instrument 1 are arranged outside and inside the body, respectively. Under this state (initial state promptly), not only be convenient for two surgical instruments 1 insert simultaneously internal, also be convenient for remove these surgical instruments 1 after accomplishing the operation, reduced the degree of difficulty of two surgical instruments 1 of dismouting like this, also make things convenient for simultaneously near same target tissue after two follow-up surgical instruments 1 are opened in a controlled way moreover, avoided the interference between two surgical instruments.

After the surgical instrument 1 is inserted into the body, referring to fig. 2, the surgical instrument 1 is further opened, and the surgical instrument is in an opened state, that is, the external structures of the two surgical instruments 1 on the upper side of the stab card 3 are further away from each other, and simultaneously, the internal structures of the two surgical instruments 1 on the lower side of the stab card 3 are C-shaped and are in the working plane. The C-shape herein is not narrowly construed as a circular arc but is broadly construed as an inner structure having different bending directions, i.e., the inner structure is first bent in a direction away from the axis of the card 3 and then bent in a direction close to the axis of the card 3. By doing so, two or more end effectors can be used to approach the same target tissue at the same time, and cross-friction does not occur during simultaneous operation between the surgical instruments 1, so that normal use can be ensured, and secondary damage to patients is not caused.

Further illustration is provided in the context of a surgical instrument of the same construction. As shown in fig. 1 and 2, the surgical instrument 1 specifically includes a handpiece 4, a connecting structure 5, an end effector 6, and a transmission. Wherein, the handheld end 4 comprises an operation device 41, a wrist structure 42 and an arc-shaped body 43 which are connected in sequence; the manipulation device 41 is arranged on the wrist structure 42 and is used for driving the wrist structure 42 to move; wrist structure 42 is rotatably coupled to the proximal end of arcuate body 43 such that wrist structure 42 is rotatable relative to arcuate body 43. The present invention has no special requirements for the specific curve shape of the arc-shaped body 43, and can be designed according to human engineering, optionally, the near end of the arc-shaped body 43 is provided with a near end mounting base, the far end is provided with a far end mounting base, and the near end mounting base is rotatably connected with the wrist structure 42.

As shown in fig. 4 and 5, in the embodiment of the present invention, the connection structure 5 includes an inner pipe 52 and an outer pipe 51 sleeved outside the inner pipe 52. The proximal end of inner tube 52 is connected to the distal end of arcuate body 43 (e.g., to a distal mount), while the distal end of inner tube 52 is connected to end effector 6. In practice, the inner tube 52 is axially movable relative to the outer tube 51, and both the proximal end and the distal end of the inner tube 52 extend out of the outer tube 51, i.e. the axial length of the inner tube 52 is greater than the axial length of the outer tube 51. Further, the outer tube 51 comprises a first flexible structure 514 at the proximal end and a second flexible structure 515 at the distal end. Inner tube 52 preferably includes a third flexible structure 524 at the distal end, the third flexible structure 524 having at least one degree of rotational freedom and being coupled to end-effector 6 to rotate end-effector 6.

The actuators are connected to the first and second

flexible structures

514 and 515, respectively, to effect linkage (i.e., rotation in opposite directions) of the first and second

flexible structures

514 and 515. Preferably, the transmission is also connected to the wrist structure 42 and the third flexible structure 524, respectively, to enable linkage (i.e., rotation in the same direction) of the wrist structure 42 and the third flexible structure 524. Specifically, to ensure that multiple surgical instruments 1 do not interfere in the body, the first and second

flexible structures

514 and 515 are moved in mirror image relative to the card 3. Further, in order to realize the operation of the manipulation device 41 and the end effector 6 in the same direction, the axis of the manipulation device 41 and the axis of the end effector 6 are always parallel (parallel including coinciding), and the wrist structure 42 and the third flexible structure 524 are linked and rotate in the same direction through the transmission device, and finally, the manipulation device 41 and the end effector 6 are linked and rotate in the same direction.

More specifically, as shown in fig. 7, the first flexible structure 514 has rotational freedom to rotate about a first axis R1 'and rotational freedom to rotate about a second axis R2', the first axis R1 'intersecting the second axis R2'. Preferably, the first axis R1 'is perpendicular to the second axis R2'. Preferably, the second axis R2' is perpendicular to the working surface. The second flexible structure 515 has freedom to rotate about a third axis R3 'and freedom to rotate about a fourth axis R4', the third axis R3 'intersecting the fourth axis R4'. Preferably, the third axis R3 'is perpendicular to the fourth axis R4'. More preferably, the third axis R3' is parallel to the first axis R1', while the fourth axis R4' is parallel to the second axis R2', i.e. the fourth axis R4' is also perpendicular to the working surface. The transmission is used to drive the second flexible structure 515 to rotate in opposite directions about the third and fourth axes R3', R4' as the first flexible structure 514 rotates about the first and second axes R1', R2'. Preferably, surgical instrument 1 also has a telescopic degree of freedom R3, i.e., advancement and retraction of end effector 6 to approach or move away from the target tissue is accomplished by axial movement of inner tube 52 within outer tube 51 relative to outer tube 51.

In addition, wrist structure 42 has a degree of freedom of rotation about a fifth axis R5 and a degree of freedom of rotation about a sixth axis R6, fifth axis R5 intersecting sixth axis R6. Preferably, the fifth axis R5 is perpendicular to the sixth axis R6. Preferably, the fifth axis R5 is perpendicular to the working surface. The steering device 41 is further adapted to drive rotation of the wrist structure 42 about a fifth axis R5 and a sixth axis R6, respectively. The third flexible structure 524 has a degree of freedom to rotate about a seventh axis R7 and a degree of freedom to rotate about an eighth axis R8, the seventh axis R7 intersecting the eighth axis R8. Preferably, the seventh axis R7 is perpendicular to the eighth axis R8. Preferably, the fifth axis R5 is parallel to the seventh axis R7, i.e. said seventh axis R7 is perpendicular to said working surface, and the sixth axis R6 is parallel to the eighth axis R8. The manipulation device 41 is further configured to drive the wrist structure 42 to rotate and simultaneously drive the third flexible structure 524 to rotate around the seventh axis R7 and the eighth axis R8 in the same direction through the transmission device. Here, a co-directional co-operation of the wrist structure 42 and the third flexible structure 524, and thus of the manipulator 41 and the end-effector 6, is achieved by means of the transmission.

To achieve the opened state shown in fig. 2, after the surgical instrument 1 is in the initial state, the two surgical instruments 1 are further opened, so that the handle end 4 and the first flexible structure 514 rotate around the second axis R2' in the direction away from the axis of the card 3, and the distal end of the outer tube 51 is driven by the first flexible structure 514 and the second flexible structure 515 to rotate in the working plane in the direction away from the axis of the card 3 under the driving of the second flexible structure 515 due to the cooperation of the first flexible structure 514 and the second flexible structure 515. At this time, in cooperation with the operation of the manipulating device 41, the end effector 6 is rotated around the seventh axis R7 by the third flexible structure 524 to bend back toward the axial direction of the poking card 3, so that the portion of the surgical instrument entering the human body is C-shaped in the working plane. By doing so, the two surgical instruments 1 can be opened in vivo without interfering with each other and can be further close to the same target tissue, thereby improving the operation space of the end effector and also reducing the operation difficulty.

As shown in FIG. 4, in an embodiment of the present invention, outer tube 51 further includes a first proximal portion 511, a first intermediate portion 512, and a first distal portion 513. The first proximal portion 511, the first flexible structure 514, the first intermediate portion 512, the second flexible structure 515, and the first distal portion 513 are disposed in that order from the proximal side to the distal side. First proximal portion 511, first intermediate portion 512, and first distal portion 513 are each rigid members, such as being made of a highly rigid stainless steel material. In the present embodiment, the term "rigid" means that the partial components do not bend or distort themselves during the use (operation). In the initial state, the first intermediate portion 512, the second flexible structure 515, the first distal portion 513, and the third flexible structure 524 are collinear with the axis of the end effector 6, and the first proximal portion 511 is offset from the axis of the first intermediate portion 512 by the first flexible structure 514; in the open state, the first proximal portion 511 is offset from the axis of the first intermediate portion 512 by the first flexible structure 514, the first distal portion 513 is offset from the axis of the first intermediate portion 512 by the second flexible structure 515, and the end effector 6 is adjacent to the axis of the first intermediate portion 512 by the third flexible structure 524. Further, in the initial state and the open state, the first proximal portion 511, the first intermediate portion 512 and the first distal portion 513 are all located within the working plane; in the initial state, first intermediate section 512 and first distal section 513 are collinear. By the arrangement, the hand plane operated by the doctor can be parallel to the working plane, so that the hand plane is more suitable for the doctor to operate, and the operation fatigue of the doctor is reduced.

Further, inner tube 52 also includes a second proximal end portion 521, a second intermediate portion 522, and a second distal end portion 523. The second proximal portion 521, the second middle portion 522, the second distal portion 523 and the third flexible structure 524 are disposed in a proximal-to-distal manner, and the second proximal portion 521 and the second distal portion 522 are rigid members, for example, made of a rigid stainless steel material. While the second intermediate portion 522 is a flexible member, for example constituted by a spring or a bellows. Accordingly, "flexible" in this embodiment means that the assembly is capable of or susceptible to bending or distortion during use (a surgical procedure). And the second proximal portion 521 is connected to the distal mounting seat of the arcuate body 43.

The second middle portion 522 is disposed through the first flexible structure 514, the first middle portion 512 and the second flexible structure 515 of the outer tube 51, and in order to enable the inner tube 52 to move in the outer tube 51 smoothly, the axial length of the second middle portion 522 is greater than the total axial length of the first flexible structure 514, the first middle portion 512 and the second flexible structure 515. Therefore, through the propulsion and the withdrawal of control handheld end 4, can control inner tube 52 translation in outer tube 51 to drive end effector 6 at internal translation, conveniently be close and keep away from the target tissue like this, and can avoid among the operation process because the repeated business turn over human of surgical instruments leads to stabbing secondary injury such as card drop and subcutaneous edema. Further, the inner tube 52 is preferably hollow to facilitate housing of the transmission.

Further, as shown in fig. 4, the second proximal end portion 521 is preferably a rigid tube having a stepped shape, and specifically includes a first sub-inner tube 5211 and a second sub-inner tube 5212, wherein the first sub-inner tube 5211 and the second sub-inner tube 5212 are arranged in the order from the far side to the near side. The outer diameter of the first sub-inner tube 5211 is not greater than the inner diameter of the first proximal end portion 511 of the outer tube 51, such that the first sub-inner tube 5211 is directly received within the first proximal end portion 511 of the outer tube 51, while the outer diameter of the second sub-inner tube 5212 is greater than the inner diameter of the first proximal end portion 511 of the outer tube 51, such that when the outer tube 51 is stationary and the inner tube 52 is advanced distally, the second sub-inner tube 5212 can abut against the first proximal end portion 511, thereby limiting the inner tube 52 from continuing to move distally.

Similarly, the second distal end portion 523 is preferably a stepped rigid tube including a third sub-inner tube 5231 and a fourth sub-inner tube 5232, the third sub-inner tube 5231 and the fourth sub-inner tube 5232 being disposed sequentially proximally and distally, and the outer diameter of the third sub-inner tube 5231 being no greater than the inner diameter of the first distal end portion 513 of the outer tube 51, such that the third sub-inner tube 5231 is directly received within the first distal end portion 513 of the outer tube 51, and the outer diameter of the fourth sub-inner tube 5232 being greater than the inner diameter of the first distal end portion 513, such that when the outer tube 51 is immobilized and the inner tube 52 is retracted proximally, the fourth sub-inner tube 5232 can abut against the first distal end portion 513, thereby limiting the inner tube 52 from continuing to move proximally. Also, in order that the inner pipe 52 is movable in the outer pipe 51, the total axial length of the first sub inner pipe 5211, the second intermediate portion 522, and the third sub inner pipe 5231 is greater than the axial length of the outer pipe 51. The travel of the inner tube 52 moving in the outer tube 51 is:

s＝L1-L2

s < l1, and s < l2

Wherein: s is the travel of the inner tube moving in the outer tube, and L1 is the total axial length of the first sub-inner tube, the second intermediate portion, and the third sub-inner tube; l2 is the axial length of the outer tube; l1 is the axial length of the first sub-inner tube; l2 is the axial length of the third sub-inner tube.

Thus, with the above-described structure, the second proximal end portion 521 and the second distal end portion 523 define the extension range of the surgical instrument 1, and the inner tube 52 is prevented from being withdrawn from the outer tube 51 while avoiding the tissue from being accidentally injured due to the excessive extension range, wherein the schematic view of the hand-held end 4 being operated to extend the surgical instrument 1 toward the inside of the human body is shown in fig. 5.

Furthermore, in the actual assembly, the first intermediate portion 512 of the outer tube 51 is intended to be removably fixed with the instrument channel 32 of the stab card 3, and defines, by means of the outer tube 51, the telescopic direction of the end-effector 6. Wherein, when the surgical instrument 1 is in the initial state, the axis of the first intermediate portion 512 is configured to be parallel to the tool axis of the surgical device 100, and the first distal end portion 513 of the outer tube 51 is configured to be collinear with the axis of the first intermediate portion 512, i.e. to extend in the direction of the tool axis. At this point, first intermediate portion 512, second flexible structure 515, first distal portion 513, and third flexible structure 524 all extend in the same line parallel to the tool axis of surgical device 100, thereby facilitating the removal and installation of multiple surgical instruments. In addition, in the initial state, the first flexible structure 514 is bent relative to the first middle portion 512 to deflect the first proximal portion 511 of the outer tube 51 from the axis of the first middle portion 512, preferably, the axis of the manipulation device 41 is collinear with or parallel to the axis of the first proximal portion 511, and the manipulation device 41 is preferably directed toward the first proximal portion 511.

Further opening of the surgical instrument 1 by manipulating the handle 4 causes both the first and second

flexible structures

514 and 515 of the outer tube 51 to bend relative to the first intermediate portion 512 in the same direction, thereby bringing both the first proximal and

distal end portions

511 and 513 of the outer tube 51 away from the axis of the first intermediate portion 512, and the first proximal and

distal end portions

511 and 513 into mirror image orientations relative to the card 3, and pulling the manipulation device 41 in a direction closer to the tool axis causes the third flexible structure 524 to also bend in a direction closer to the tool axis, thereby causing the end-effector 6 to bend in a direction toward the tool axis, so that the end-effectors of both surgical instruments can approach the same target tissue.

The present invention does not require any particular configuration for the first flexible structure 514, the second flexible structure 515 and the third flexible structure 524, as long as two directions of oscillation (preferably two perpendicular directions) can be achieved, and in a preferred embodiment, any one of the flexible structures is a serpentine joint having two degrees of freedom of oscillation S1, S2, as shown in fig. 8 in particular.

Further, referring to fig. 6a and 6b, the outer wall of the first middle portion 512 of the outer tube 51 is provided with a first positioning portion 5121, and the first positioning portion 5121 is used for cooperating with the second positioning portion 31 in the instrument channel 32 of the poking card 3, so as to prevent the outer tube 51 from moving in the axial direction and rotating in the circumferential direction relative to the poking card 3, and to limit the axis of the first middle portion 512 of the outer tube 51 to be parallel to the tool axis. Optionally, the first positioning portion 5121 is a groove, and the second positioning portion 31 is an elastic protrusion, or the first positioning portion 5121 may also be an elastic protrusion, and the second positioning portion 31 is a groove. Preferably, the first positioning portion 5121 is disposed at the middle position of the first middle portion 512, and the second positioning portion 31 is disposed on the inner wall of the instrument channel 32. The number of the first positioning portions 5121 is the same as the number of the first positioning portions 31, and more preferably, the second positioning portions 31 are arranged in pairs, and the line of each pair passes through the central axis of the instrument channel 32. Of course, the first positioning portion and the second positioning portion may have other structures with the same function, and the invention is not limited to this. In addition, through the first positioning portion and the second positioning portion, the embodiment can also limit that the two surgical instruments 1 into which the poking card 3 is initially inserted are both located in the working surface, that is, all the surgical instruments perform surgical operation based on the same working reference, thereby reducing the operation difficulty.

Next, referring to fig. 9 to 13, the specific structure of the transmission will be further described.

In an embodiment of the present invention, the transmission device includes a first flexible transmission structure, which is connected to the first flexible structure 514 and the second flexible structure 515, respectively, so that the second flexible structure 515 is driven by the first flexible transmission structure to rotate in the opposite direction (i.e. mirror image motion) to the first flexible structure 514, for example, when the first flexible structure 514 is driven to rotate counterclockwise around the first axis, the second flexible structure 515 is driven to rotate clockwise around the third axis by the first flexible transmission structure. Optionally, the first flexible transmission structure includes a first transmission wire set and a second transmission wire set. The first and second drive wire sets are configured to: as the first flexible structure 514 is driven to rotate about the first axis R1', the first drive wire set and the second drive wire set drive the second flexible structure 515 to rotate about the third axis R3' in a direction opposite to the direction of rotation of the first flexible structure 514; and the first flexible structure 514 is driven to rotate about the second axis R2', the first drive wire set and the second drive wire set drive the second flexible structure 515 to rotate about the fourth axis R4' in a direction opposite to the direction of rotation of the first flexible structure 514; finally, the first flexible structure 514 and the second flexible structure 515 are linked through the first transmission wire set and the second transmission wire set, and the first flexible structure 514 and the second flexible structure 515 do mirror image movement relative to the stamp card 3.

Specifically, the first and second transmission wires control the second flexible structure 515 to swing with the back and forth swing of the first flexible structure 514, and to swing with the left and right swing of the first flexible structure 514. By providing the length of the drive wire, the surgical device 1 is constrained to an initial state, i.e. when the first flexible structure 514 is offset from the tool axis, the second flexible structure 515 is not offset and parallel to the tool axis, which facilitates the installation or removal of the surgical device 1, i.e. the lower part of the stab (in vivo) can be straightened out, while the upper part of the stab (in vitro) is opened out without interference, i.e. the first flexible structure 514 has an initial angle relative to the tool axis, which initial angle is used to avoid interference between the devices, and when the first flexible structure 514 is opened at the initial angle, the second flexible structure 515 can be parallel to the tool axis due to the length of the drive wire. In an exemplary embodiment, as shown in fig. 13, two drive wires L1, L2 are connected to the second flexible structure 515, extend through the guide wheel 5145, and are connected to the first flexible structure 514 in a reversed manner, and have unequal lengths. For example, the length of the left side drive wire L1 is smaller than the length of the right side drive wire L2. So configured, the first and second

flexible structures

514 and 515, respectively, are angled away from the tool axis. When the surgical device 1 is in the initial state, the first flexible structure 514 is controlled to be at an initial angle, when the second flexible structure 515 is parallel to the tool axis. In addition, the two transmission wires form a crossed closed motion loop, which can realize that the first flexible structure 514 and the second flexible structure 515 rotate in opposite directions. In the embodiment of the invention, the lengths of the two transmission wires in the first transmission wire group are not equal, and/or the lengths of the two transmission wires in the second transmission wire group are not equal. The details are described below.

Further, the proximal end of the first set of drive wires is fixed to the first flexible structure 514 in an opposite configuration to the position where the distal end of the first set of drive wires is fixed to the second flexible structure 515; the proximal end of the second drive wire set is fixed in position to the first flexible structure 514 in an opposite configuration to the position in which the distal end of the second drive wire set is fixed to the second flexible structure 515; so that the first and second

flexible structures

514, 515 make a mirrored movement with respect to the stamp card 3 when the handheld end 4 is operated. The reverse configuration here means that it is configured as follows: for example, when the proximal end of the first drive wire set is above the fixed position of the first flexible structure 514, the distal end of the first drive wire set is below the fixed position of the second flexible structure 515; when the proximal end of the first drive wire set is at a left side of the fixed position with the first flexible structure 514, the distal end of the first drive wire set is at a right side of the fixed position with the second flexible structure 515. Similarly, the second transmission screw set is configured in the opposite way.

As shown in FIG. 9, a first attachment point 514A, a second attachment point 514B, a third attachment point 514C and a fourth attachment point 514D are provided on the first flexible structure 514, and as viewed from the distal end to the proximal end, each of the attachment points is 514A,514C,514B and 514D in the counterclockwise direction. The proximal end of the first set of drive wires is connected to a first fixation point 514A and a second fixation point 514B; the proximal end of the second drive wire set is connected to the third attachment point 514C and the fourth attachment point 514D. Preferably, a line connecting the first fixed point 514A and the second fixed point 514B is arranged to be collinear with the second axis R2', and a line connecting the third fixed point 514C and the fourth fixed point 514D is arranged to be collinear with the first axis R1'. Alternatively, the connection line between the first fixed point 514A and the third fixed point 514C, and the connection line between the second fixed point 514B and the fourth fixed point 514D are respectively parallel to the first axis R1'; the line connecting the first fixed point 514A and the fourth fixed point 514D, and the line connecting the second fixed point 514B and the third fixed point 514C are parallel to the second axis R2', respectively. Still alternatively, a connecting line between the first fixed point 514A and the third fixed point 514C, and a connecting line between the second fixed point 514B and the fourth fixed point 514D are respectively parallel to the second axis R2'; the line connecting the first fixed point 514A and the fourth fixed point 514D, and the line connecting the second fixed point 514B and the third fixed point 514C are parallel to the first axis R1'.

The second flexible structure 515 is provided with a fifth fixed point 515A, a sixth fixed point 515B, a seventh fixed point 515C, and an eighth fixed point 515D, which are 515a,515d,515b, and 515C in the order from the proximal end to the distal end in the counterclockwise direction. The distal end of the first set of drive wires is connected to the fifth fixing point 515A and the sixth fixing point 515B; the distal end of the second drive wire set is connected to the seventh fixing point 515C and the eighth fixing point 515D. Preferably, the line connecting the fifth fixing point 515A and the sixth fixing point 515B is arranged collinear with the fourth axis R4', and the line connecting the seventh fixing point 515C and the eighth fixing point 515D is arranged collinear with said third axis R3'. Alternatively, a line connecting fifth fixed point 515A and seventh fixed point 515C and a line connecting sixth fixed point 515B and eighth fixed point 515D are arranged parallel to fourth axis R4', and a line connecting fifth fixed point 515A and eighth fixed point 515D and a line connecting sixth fixed point 515B and seventh fixed point 515C are arranged parallel to third axis R3'. Still alternatively, a line connecting fifth fixed point 515A and seventh fixed point 515C and a line connecting sixth fixed point 515B and eighth fixed point 515D are arranged parallel to third axis R3', and a line connecting fifth fixed point 515A and eighth fixed point 515D and a line connecting sixth fixed point 515B and seventh fixed point 515C are arranged parallel to fourth axis R4'.

Further, the first transmission wire set includes a first transmission wire 71A and a second transmission wire 71B. When the first flexible structure 514 is driven to rotate about the first axis, the first and

second drive wires

71A and 71B are used to drive the second flexible structure 515 to rotate about the third axis in a direction opposite to the direction of rotation of the first flexible structure 514. The second drive wire set includes a third drive wire 72A and a fourth drive wire 72B. The third and

fourth drive wires

72A, 72B are used to drive the second flexible structure 515 about the fourth axis in a direction opposite to the direction of rotation of the first flexible structure 514 when the first flexible structure 514 is driven to rotate about the second axis. With this arrangement, it is avoided that the first flexible structure 514 and the second flexible structure 515 rotate around one axis and rotate around the other axis at the same time, and therefore the problem of motion compensation needs to be considered.

At this point, the proximal end of the first drive wire 71A is first connected to the first fixation point 514A on the first flexible structure 514, and then after the body of the first drive wire 71A is reversed, the distal end of the first drive wire 71A is connected to the sixth fixation point 515B on the second flexible structure 515 such that the proximal and distal ends of the first drive wire 71A are in an inverted mating relationship.

Similarly, the proximal end of the second driving wire 71B is coupled to the second attachment point 514B on the first flexible structure 514, and then after the body of the second driving wire 71B is reversed, the distal end of the second driving wire 71B is coupled to the fifth attachment point 515A on the second flexible structure 515 such that the proximal and distal ends of the second driving wire 71B are in an inverted mating relationship.

The proximal end of the third driving wire 72A is first coupled to the third attachment point 514C on the first flexible structure 514, and then after the body of the third driving wire 72A is reversed, the distal end of the third driving wire 72A is coupled to the eighth attachment point 515D on the second flexible structure 515 such that the proximal and distal ends of the third driving wire 72A are in an inverted mating relationship.

The proximal end of the fourth driving wire 72B is first coupled to the fourth attachment point 514D on the first flexible structure 514, and then after the body of the fourth driving wire 72B is reversed, the distal end of the fourth driving wire 72B is coupled to the seventh attachment point 515C on the second flexible structure 515 such that the proximal and distal ends of the fourth driving wire 72B are in an inverted mating relationship.

At this time, a line connecting the first fixed point 514A and the second fixed point 514B is arranged to be collinear with the second axis, and a line connecting the third fixed point 514C and the fourth fixed point 514D is arranged to be collinear with the first axis. A line connecting fifth fixed point 515A and sixth fixed point 515B is arranged to be collinear with the fourth axis, and a line connecting seventh fixed point 515C and eighth fixed point 515D is arranged to be collinear with the third axis.

With the above configuration, the bending directions of the first flexible structure 514 and the second flexible structure 515 extending outward from both ends of the first intermediate portion 512 are the same, that is, the movements of the first flexible structure 514 and the second flexible structure 515 are mirrored with respect to the stamp card 3. Through the connection of the above structures, the surgical instrument 1 is switched between the initial state (as shown in fig. 1) and the open state (as shown in fig. 2), and during the operation, by operating the handheld end 4, the angle of the first distal end part 513 from the tool axis can be adjusted, the distance between the end effectors of a plurality of surgical instruments 1 can be controlled, and the surgical instruments 1 can be controlled to approach or move away from the tissue region. It will be understood by those skilled in the art that the number of the fixing points of any one flexible structure is not limited to 4, but may be 6, 8, etc., and that the more precise control of the flexible structure can be realized by increasing the number of the fixing points.

Further, the first drive wire set further comprises at least one first guide wheel for reversing the body of the first drive wire 71A and the second drive wire 71B.

Further, the second transmission wire set further includes at least one second guide wheel for reversing the body of the third transmission wire 72A and the fourth transmission wire 72B.

In other embodiments, in order to reverse the bodies of the first transmission wire 71A and the second transmission wire 71B, the bodies of the first transmission wire 71A and the second transmission wire 71B may be interlaced and then connected to the corresponding fixing points on the second flexible structure 515, that is, the steering by the guide wheels is not required.

Likewise, in other embodiments, to effect reversal of the bodies of the third and

fourth drive wires

72A, 72B, it may be configured such that: the bodies of the third drive wire 72A and the fourth drive wire 72B are interlaced and then connected to a fixed point on the second flexible structure 515.

Further preferably, the first drive wire set and/or the second drive wire set further comprises a first resilient structure, such as a spring. The first transmission wire group and/or the second transmission wire group, such as steel wires, are generally kept longer than the actual required length in the installation process, and a small spring is added in the middle, so that the steel wires can be pre-tensioned, and the return difference is prevented. More specifically, a spring is connected to at least a portion of the drive wire of the first drive wire set and/or the drive wire of the second drive wire set.

In this embodiment, the first and second drive wire sets are disposed in a channel between the outer tube 51 and the inner tube 52. Preferably, all of the first drive wire set and the second drive wire set are made of a flexible material capable of transmitting torque, such as a nickel titanium wire, a tungsten wire, and the like. In addition, the swinging motion of the first flexible structure and the second flexible structure can be locked by a locking structure, and the locking mode can be locking a transmission thread set or locking the flexible structures.

Further, the transmission device further includes a second flexible transmission structure, which is respectively connected to the wrist structure 42 and the third flexible structure 524, so that the third flexible structure 524 rotates in the same direction with the wrist structure 42 through the second flexible transmission structure, and the end effector 6 also rotates in the same direction with the control device 41.

Still further, the second flexible drive structure includes a third drive wire set and a fourth drive wire set. The third and fourth drive wire sets are configured to: when wrist structure 42 is driven to rotate about fifth axis R5, the third and fourth drive wire sets drive third flexible structure 524 to rotate about seventh axis R7 in the same direction as the direction of rotation of wrist structure 42; when the wrist structure 42 is driven to rotate about the sixth axis R6, the third and fourth drive wire sets drive the third flexible structure 524 to rotate about the eighth axis R8 in the same direction as the rotation of the wrist structure 42. Finally, the linkage of the wrist structure 42 and the third flexible structure 524 is realized through the third transmission screw set and the fourth transmission screw set, and the rotation directions are the same.

Furthermore, the position where the proximal end of the third transmission wire set is fixed to the wrist structure 42 is also configured to correspond to the position where the distal end of the third transmission wire set is fixed to the third flexible structure 524 in the opposite direction, and the position where the proximal end of the fourth transmission wire set is fixed to the wrist structure 42 is also configured to correspond to the position where the distal end of the fourth transmission wire set is fixed to the third flexible structure 524 in the opposite direction, so that the control device 41 and the end effector 6 have the same rotation direction in the same direction.

Similarly, if the angles of the first flexible structure 514 and the second flexible structure 515 are adjusted during the operation, the states of the transmission wires in the third and fourth transmission wire sets may be changed at the same time, so as to change the posture of the end effector, which is not desirable. Therefore, the third and/or fourth transmission wire sets further include a second elastic structure for compensating the bending amount of the third and/or fourth transmission wire sets, so as to ensure that the posture of the end effector 6 is not changed when the first and second

flexible structures

514 and 515 are adjusted. More specifically, at least a portion of the drive wires of the third drive wire set and/or the drive wires of the fourth drive wire set are connected with springs to compensate for the amount of bending of the drive wires.

The present embodiment does not require any particular configuration for wrist structure 42, as long as it has at least two rotational degrees of freedom that enable two-directional oscillation about fifth axis R5 and sixth axis R6. Alternatively, wrist structure 42 is a hook hinge structure, a ball hinge structure, or a serpentine hinge structure. The hooke joint structure is used as an example to illustrate that the wrist structure 42 can be linked with the third flexible structure 524 and rotate in the same direction.

As shown in fig. 10, the hooke's hinge structure includes an outer frame 421 and an inner frame 422 received in the outer frame 421, the outer frame 421 is rotatably connected to the proximal mounting seat of the arc-shaped body 43, and the outer frame 421 rotates about a fifth axis R5, the inner frame 422 is rotatably connected to the outer frame 421, and the inner frame 422 rotates about a sixth axis R6.

As shown in fig. 12, the operating device 41 has a mounting portion which is received in the inner frame 422, i.e. the inner frame 422 rotates with the mounting portion. The mounting portion has a proximal end surface provided with a ninth fixing point 42A, a tenth fixing point 42B, an eleventh fixing point 42C, and a twelfth fixing point 42D, and the ninth fixing point 42A, the eleventh fixing point 42C, the tenth fixing point 42B, and the twelfth fixing point 42D are arranged in this order counterclockwise as viewed from the proximal end toward the distal end. Preferably, a line connecting the ninth fixing point 42A and the tenth fixing point 42B is collinear with the fifth axis R5, and a line connecting the eleventh fixing point 42C and the twelfth fixing point 42D is collinear with the sixth axis R6. Alternatively, a line connecting the ninth fixing point 42A and the eleventh fixing point 42C, and a line connecting the tenth fixing point 42B and the twelfth fixing point 42D are parallel to the fifth axis R5, respectively; the line connecting the ninth fixing point 42A and the twelfth fixing point 42D, and the line connecting the eleventh fixing point 42C and the tenth fixing point 42B are parallel to the sixth axis R6, respectively. Alternatively, a line connecting the ninth fixing point 42A and the eleventh fixing point 42C, and a line connecting the tenth fixing point 42B and the twelfth fixing point 42D are parallel to the sixth axis R6, respectively; the line connecting the ninth fastening point 42A and the twelfth fastening point 42D and the line connecting the eleventh fastening point 42C and the tenth fastening point 42B are parallel to the fifth axis R5, respectively.

Correspondingly, a thirteenth fixing point 524A, a fourteenth fixing point 524B, a fifteenth fixing point 524C and a sixteenth fixing point 524D are arranged on the third flexible structure 524, and the thirteenth fixing point 524A, the fifteenth fixing point 524C, the fourteenth fixing point 524B and the sixteenth fixing point 524D are arranged in the counterclockwise direction from the proximal end to the distal end. Preferably, a line connecting the thirteenth fixing point 524A and the fourteenth fixing point 524B is collinear with the seventh axis R7, and a line connecting the fifteenth fixing point 524C and the sixteenth fixing point 524D is collinear with the eighth axis R8. Alternatively, a line connecting the thirteenth fixed point 524A and the fifteenth fixed point 524C, and a line connecting the fourteenth fixed point 524B and the sixteenth fixed point 524D are parallel to the seventh axis R7, respectively; the line connecting the thirteenth fastening point 524A and the sixteenth fastening point 524D, and the line connecting the fifteenth fastening point 524C and the fourteenth fastening point 524B are parallel to said eighth axis R8, respectively. Alternatively, a line connecting the thirteenth fixed point 524A and the fifteenth fixed point 524C, and a line connecting the fourteenth fixed point 524B and the sixteenth fixed point 524D are parallel to the eighth axis R8, respectively; a line connecting the thirteenth fixing point 524A and the sixteenth fixing point 524D, and a line connecting the fifteenth fixing point 524C and the fourteenth fixing point 524B are parallel to the seventh axis R7, respectively.

The third drive wire set includes a fifth drive wire 73A and a sixth drive wire 73B. Fifth drive wire 73A and sixth drive wire 73B are used to drive third flexible construct 524 in the same direction of rotation about seventh axis R7 when wrist construct 42 is driven in rotation about fifth axis R5. The fourth drive wire set includes a seventh drive wire 74A and an eighth drive wire 74B. The seventh drive wire 74A and the eighth drive wire 74B are configured to drive the third flexible construct 524 in the same direction about the eighth axis R8 when the wrist construct 42 is driven to rotate about the sixth axis R6. Specifically, when the manipulation device 41 drives the wrist structure 42 to rotate around the fifth axis R5, the wrist structure 42 drives the third flexible structure 524 to rotate around the seventh axis R7 through the fifth transmission wire 73A and the sixth transmission wire 73B; similarly, when the manipulating device 41 drives the wrist structure 42 to rotate around the sixth axis R6, the wrist structure 42 drives the third flexible structure 524 to rotate around the eighth axis R8 through the seventh driving wire 74A and the eighth driving wire 74B. More specifically, the fifth and

sixth drive wires

73A, 73B control the wrist structure 42 to pitch with the third flexible structure 524, and the seventh and

eighth drive wires

74A, 74B control the wrist structure 42 to yaw with the third flexible structure 524.

At this time, the proximal end of the fifth driving wire 73A is connected to the ninth fixing point 42A of the mounting portion of the operation device, and then the distal end of the fifth driving wire 73A is connected to the fourteenth fixing point 524B of the third flexible structure 524 after the body of the fifth driving wire 73A is reversed, so that the proximal end and the distal end of the fifth driving wire 73A form an inverse pair.

Similarly, the proximal end of the sixth driving wire 73B is first connected to the tenth fixing point 42B of the mounting portion, and then the distal end of the sixth driving wire 73B is connected to the thirteenth fixing point 524A of the third flexible structure 524 after the body of the sixth driving wire 73B is reversed, so that the proximal end and the distal end of the sixth driving wire 73B form an inverse-paired relationship.

The proximal end of the seventh drive wire 74A is first connected to the eleventh attachment point 42C on the mounting portion, and then after the body of the seventh drive wire 74A is reversed, the distal end of the seventh drive wire 74A is connected to the sixteenth attachment point 524D on the third flexible structure 524, such that the proximal and distal ends of the seventh drive wire 74A form an inverted pair.

The proximal end of the eighth drive wire 74B is first connected to the twelfth attachment point 42D on the mounting portion, and then the body of the eighth drive wire 74B is reversed such that the distal end of the eighth drive wire 74B is connected to the fifteenth attachment point 524C, thus forming an inverted mating relationship between the proximal and distal ends of the eighth drive wire 74B.

At this time, the ninth fixing point 42A, the tenth fixing point 42B, the eleventh fixing point 42C, and the twelfth fixing point 42D are arranged such that a line connecting the ninth fixing point 42A and the tenth fixing point 42B is on the fifth axis R5, and a line connecting the eleventh fixing point 42C and the twelfth fixing point 42D is on the sixth axis R6. The thirteenth fixing point 524A, the fourteenth fixing point 524B, the fifteenth fixing point 524C, and the sixteenth fixing point 524D are arranged such that a line connecting the thirteenth fixing point 524A and the fourteenth fixing point 524B is on the seventh axis R7, and a line connecting the fifteenth fixing point 524C and the sixteenth fixing point 524D is on the eighth axis R8.

Further, the third transmission wire set further includes at least one third guide wheel for reversing the bodies of the fifth transmission wire 73A and the sixth transmission wire 73B. Further, the fourth driving wire set further includes at least one fourth guide wheel for reversing the body of the seventh driving wire 74A and the eighth driving wire 74B.

In other embodiments, in order to reverse the bodies of the fifth driving wire 73A and the sixth driving wire 73B, the bodies of the fifth driving wire 73A and the sixth driving wire 73B may be interlaced and then connected to the third flexible structure 524.

Similarly, in other embodiments, in order to reverse the bodies of the seventh and

eighth drive wires

74A, 74B, the bodies of the seventh and

eighth drive wires

74A, 74B may be interlaced and then connected to the third flexible structure 524.

With the above-described configuration, as shown in fig. 11a and 11B, when the manipulation device 41 in fig. 11a switches between the respective states a, B, C, and D, the end effector 6 in fig. 11B also switches between the corresponding states a ', B', C ', and D' by rotating the end effector 6 and the manipulation device 41 in the same direction and in the same posture under the control of the manipulation device 41, and the end effector 6 and the manipulation device 6 operate in the same configuration.

Further, through the connection of the above structures, the third flexible structure 524 can realize the operation with two degrees of freedom, and can drive the end effector 6 to accurately approach or leave the tissue region, thereby completing the surgical operation. It should be understood by those skilled in the art that the number of the fixing points on the third flexible structure 524 and the manipulating device 41 is not limited to 4, but may be 6, 8, etc., and the increase of the number of the fixing points can achieve more precise control of the third flexible structure 524 and the wrist structure 42.

In this embodiment, the third and fourth drive wire sets are disposed in the passage between the inner tube 52 and the outer tube 51. Preferably, all of the third drive wire sets and all of the fourth drive wire sets are made of a flexible material capable of transmitting torque, such as a nickel titanium wire, a tungsten wire, and the like. In addition, the swinging motion of the control device and the third flexible structure can be preferably locked by a locking structure, and the locking mode can be locking a transmission wire set, or locking the control device and the flexible structure.

With continued reference to fig. 7, the actuation device 41 preferably also has a rotational degree of freedom, i.e. the actuation device 41 is capable of a rotational movement about a ninth axis R9, in which case the actuation device 41 is rotatably arranged on the wrist structure 42. Further, the end effector 6 has a rotation degree of freedom for rotation about the tenth axis R10. Preferably, the ninth axis is parallel to (parallel to including coincident with) the tenth axis. Further, the manipulation device 41 drives the end effector 6 to rotate through a transmission device, that is, the manipulation device 41 drives the end effector 6 to rotate along with the rotation of the manipulation device 41 through the transmission device, and the rotation direction of the manipulation device 41 is opposite to the rotation direction of the end effector 6 when viewed from the far side and the near side.

As shown in fig. 14, the transmission device further includes a third flexible transmission structure 75, one end of the third flexible transmission structure 75 is connected to the manipulation device 41 through the wrist structure 42, and the other end is connected to the end effector 6 through the inner tube 52, so that the third flexible transmission structure 75 transmits the rotation motion of the manipulation device 41 to the end effector 6, and the end effector 6 rotates around its axis. The third flexible transmission structure 75 is specifically a transmission wire capable of transmitting torque, such as a nickel-titanium wire, a tungsten wire, or other materials. Preferably, the transmission device further comprises a plurality of steering wheels arranged along the extending direction of the third flexible transmission structure 75 for changing the extending direction of the third flexible transmission structure 75. More preferably, the transmission device further comprises a locking structure for locking the rotation movement of the operation device 41, for example, by locking the rotation of the third flexible transmission structure 75.

Further, the end effector 6 includes a tool flap and a proximal effector mount. The end effector 6 also has open and close degrees of freedom, for example the end effector 6 may be scissors, graspers, clamps, forceps, and other tool petals that can rotate relative to its proximal effector mount. The control device 41 drives the end effector 6 to make opening and closing movement through the transmission device. Specifically, as shown in fig. 14, the handheld end 4 further includes an opening and closing control mechanism, the opening and closing control mechanism is rotatably connected to the control device 41 to realize an opening and closing movement for controlling the opening and closing of the end effector 6, and a movement manner (movement configuration) of the opening and closing control mechanism is configured to be the same as a movement manner of the tool flap of the end effector 6, that is, the opening and closing control mechanism is opened, the tool flap of the end effector 6 is also opened, and if the opening and closing control mechanism is closed, the tool flap of the end effector 6 is also closed.

The operation device 41 includes an operation rod, for example, in an embodiment, the opening and closing control mechanism includes a first opening and closing flap 11 and a second opening and closing flap 12, one end of each opening and closing flap is rotatably connected to the operation rod of the operation device 41, and the other end extends outwards from the operation rod, so as to realize opening and closing movement. In another embodiment, the opening and closing control mechanism may only include one opening and closing flap, and may also control the opening and closing of the end effector 6.

Preferably, the transmission further comprises a fourth flexible transmission structure 76, a first conversion device and a second conversion device. The proximal end of the fourth flexible transmission structure 76 is connected to said first conversion means and the distal end is connected to said second conversion means. The first conversion device is movably connected with the opening and closing control mechanism and is used for converting the opening and closing movement of the opening and closing control mechanism into the axial movement of the fourth flexible transmission structure 76. The second conversion device is movably connected with the tool flap and is used for converting the axial movement of the fourth flexible transmission structure 76 into the opening and closing movement of the tool flap. The opening and closing movement of the opening and closing control mechanism is converted into the axial movement of the fourth flexible transmission structure 76 through the first conversion device, and then the axial movement of the fourth flexible transmission structure 76 is transmitted to the second conversion device, and the second conversion device converts the axial movement of the fourth flexible transmission structure 76 into the opening and closing movement of the tool flap of the end effector 6. The fourth flexible transmission structure 76 is specifically a transmission wire capable of transmitting torque, such as a nickel-titanium wire, a tungsten wire, and the like. Preferably, the locking structure of the surgical instrument 1 may also realize open-close locking, for example, by locking the open-close movement of the open-close control mechanism, the axial movement of the fourth flexible transmission structure 76, the open-close movement of the end effector 6, and the like. In a preferred embodiment, as shown in fig. 15, a finger guard structure 13 is disposed on the first opening/closing flap 11 and/or the second engaging flap 12, and the finger guard structure 13 has a cavity for receiving a finger of a person, so that a doctor can operate the opening/closing control mechanism more comfortably.

< example two >

The structure of the surgical device of this embodiment is basically the same as that of the first embodiment, and only different points will be described below.

As shown in fig. 16, the end effector 6 of the present embodiment has a pitch degree of freedom, a roll degree of freedom, a telescopic degree of freedom, a rotation degree of freedom, and an opening and closing degree of freedom, that is, substantially the same as those shown in fig. 7. Wherein the telescopic movement of the end effector 6 is controlled by a telescopic movement of the manipulation device 41 'relative to the wrist structure 42', i.e. the manipulation device 41 'is movably arranged on the wrist structure 42'.

As shown in fig. 17, compared to the first embodiment, the connection structure 5 of the present embodiment only includes an outer tube 51', a proximal end of the outer tube 51' is connected to the distal end mounting seat of the arc-shaped body, and a distal end of the outer tube 51' is a free end. Specifically, the outer tube 51 'includes a first proximal portion 511', a first flexible structure 514', a first intermediate portion 512', a second flexible structure 515', a first distal portion 513', and a third flexible structure 516 'disposed in a proximal-to-distal manner, and the first proximal portion 511', the first intermediate portion 512', and the first distal portion 513' are substantially rigid members, such as made of stainless steel. Similar to the above embodiments, the term "rigid" in this embodiment means that the partial components do not bend or distort themselves during use (surgical procedure). The first proximal portion 511' is connected to the distal mounting seat of the curved body 43', and the distal end of the third flexible structure 516' is a free end.

At the same time, the manipulation means 41 'of the handheld end 4 is movably connected to said wrist structure 42'. The hand-held end 4 further comprises a connecting shaft 75', the manipulation device 41' is connected to a proximal end of the connecting shaft 75', and a distal end of the connecting shaft 75' is connected to the end effector 6. In practice, the connecting shaft 75 'is movably inserted into the outer tube 51', and the distal end of the connecting shaft 75 'extends out of the outer tube 51' to be connected with the end effector 6. Further, by operating the manipulating device 41', the end effector 6 can be advanced and retracted along the direction of the restraint of the outer tube 51' by the connecting shaft 75 '.

Further, the connecting shaft 75 'specifically includes a proximal section 751', a middle section 752 'and a distal section 753' arranged in sequence from the proximal end to the distal end. The proximal section 751' is a substantially rigid member, and the proximal section 751' is fixedly attached to the steering device 41 '. And the intermediate section 752' is essentially a flexible member that passes through the arcuate body to the end of the third flexible structure 516' of the outer tube 51' (e.g., a mount for the distal end of the serpentine structure); the distal section 753 is also a substantially rigid member that extends from the end of the third flexible structure 516' and is coupled to the end effector 6. Similar to the above embodiments, "flexible" in this embodiment means that the partial components may be bent and deformed during the use (operation). The connecting shaft 75' is configured such that when the manipulation device 41' is moved proximally of the surgical instrument 1 to a proximal-most position (e.g., the manipulation device 41' is moved in a direction closer to the operator until the position at which it abuts the wrist structure 42' is the proximal-most position of the manipulation device 41 '), the distal section 753' remains engaged with the distal end of the third flexible structure 516' (i.e., does not separate, e.g., at least a portion of the distal section 753' is received in the third flexible structure 516 '), but does not completely separate (as shown in fig. 18), thereby forming a distal stop; the connecting shaft 75' is further configured such that when the distal section 753' is moved proximally of the surgical instrument to a proximal-most position (e.g., the position at which the end effector 6 abuts the third flexible structure 516' is the proximal-most position of the distal section 453', i.e., the distal-most position of the manipulation device 41 '), the manipulation device 41' remains engaged (i.e., detachably connected) with the wrist structure 42' without separation, thereby forming a proximal stop. Therefore, the limit of the two ends of the connecting shaft 75' limits the extension range of the surgical instrument 1, which can ensure the safety of the surgical operation and reduce the surgical risk.

Preferably, the intermediate section 752 'has sufficient torsional stiffness to be able to transmit torque, and the intermediate section 752' may be a polymer tube, a helical tube, or the like. In this way, by rotating the manipulation device 41 'to make the rotation motion around the ninth axis R9, the rotation motion can be transmitted to the end effector 6 through the connecting shaft 75', so that the end effector 6 makes the rotation motion around the tenth axis R10, thereby realizing the rotation of the end effector 6.

In an alternative embodiment, since the manipulation device 41' is movably arranged at the wrist structure 42' by means of the connection shaft 75', the end effector 6 is movably connected with the third flexible structure 516' by means of the connection shaft 75 '. At this point, the connecting shaft 75 'is configured such that, when the proximal section 751' is moved to the proximal-most position (e.g., a position in which the manipulation device 41 'is moved in a direction closer to the operator until abutting the wrist structure 42'), the distal section 753 'remains engaged with the end of the third flexible structure 516' (i.e., not separated, e.g., the distal section 753 'is at least partially received in the third flexible structure 516'), not completely separated (as shown in fig. 18), thereby forming a distal stop; connecting shaft 75 'is also configured such that when distal section 753' is moved to the proximal-most position (e.g., the position at which end effector 6 abuts third flexible structure 516 'is the proximal-most position of distal section 453'), proximal section 751 'remains engaged (i.e., detachably connected) with wrist structure 42' and is not separated, thereby forming a proximal stop. Therefore, the limit of the two ends of the connecting shaft 75' limits the extension range of the surgical instrument 1, which can ensure the safety of the surgical operation and reduce the surgical risk. Therefore, by operating the telescopic movement of the manipulation device 41 'with respect to the arc-shaped body 43, the extension or retraction of the end of the connection shaft 75' with respect to the third flexible structure 516 'can be controlled, so that the end effector 6 has a telescopic degree of freedom in addition to the degree of freedom that the third flexible structure 516' can have in rotation. In contrast to the first embodiment, the direction of the telescoping movement of the manipulator 41' is opposite to the direction of the telescoping of the end effector 6.

In some preferred embodiments, wrist structure 42 'is provided with a rigid sleeve 421' on a surface opposite to manipulation device 41', and proximal end section 751' of connecting shaft 75 'is at least partially received in rigid sleeve 421' and is movably connected to rigid sleeve 421', i.e., can move telescopically along rigid sleeve 421', thereby enabling telescopic movement of manipulation device 41 'relative to wrist structure 42'. Simultaneously, the pitch and yaw motions of the manipulator 41' both drive the wrist structure 42' via the proximal section 751', and the motions of the wrist structure 42' are transmitted to the third flexible structure 516' via the third and fourth sets of drive wires, thereby controlling the pitch and yaw motions of the end effector 6. Further, the rigid sleeve 421' can abut against the manipulation device 41' to define the telescopic range of the manipulation device 41 '.

In some alternative embodiments, manipulation device 41 'is movably coupled to rigid sleeve 421', i.e., manipulation device 41 'is at least partially received within rigid sleeve 421' and is movable relative to rigid sleeve 421', and manipulation device 41' may drive a wrist structure 42 'in a swinging or pitching motion via rigid sleeve 421' to effect end effector pitch or deflection.

In a preferred embodiment, the outer diameter of the proximal effector mount of the end effector 6 is greater than the inner diameter of the third flexible structure 516', thereby defining the reach of the end effector 6. At this point, the distal section 753 'is movably connected with the third flexible structure 516'. In an alternative embodiment, the end effector 6 is movably connected with the third flexible structure 516'. Specifically, the proximal end effector mount of the end effector 6 includes a first sub-effector mount at the proximal end and a second sub-effector mount at the distal end, the outer diameter of the first sub-effector mount is not larger than the inner diameter of the third flexible structure 516', and the outer diameter of the second sub-effector mount is larger than the inner diameter of the third flexible structure 516'. At this point, when the proximal section 751 'or the steering device 41' is moved to the proximal-most position, the first sub-actuator mount remains engaged with the end of the third flexible structure 516 '(i.e., without separation, e.g., at least a portion of the first sub-actuator mount is received within the third flexible structure 516')

In this embodiment, the implementation form of the opening/closing degree of freedom of the surgical instrument 1 is the same as that of the first embodiment, and will not be described in detail here. Thus, the end effector 6 of the present embodiment can have the degrees of freedom of pitch, tilt, expansion and contraction, opening and closing, and rotation.

In summary, in the surgical device and the surgical instrument provided in the embodiments of the present invention, through the linkage of the first flexible structure 514 and the second flexible structure 515, it is achieved that more than two surgical instruments 1 can be inserted into a human body simultaneously for operation without interference during operation, so that secondary injury to a patient is reduced, and the surgical instruments 1 can also approach the same target tissue simultaneously for operation, thereby increasing the operation space of the surgical instruments and reducing the operation difficulty. In addition, the configuration of the two-handle surgical instrument in the initial state is not particularly limited, and the two-handle surgical instrument may have a Y-shaped symmetrical structure or an asymmetrical structure.

The above description is only for the purpose of describing the preferred embodiments of the present invention, and is not intended to limit the scope of the present invention, and any variations and modifications made by those skilled in the art based on the above disclosure are within the scope of the appended claims.

Claims

1. A surgical instrument, comprising:

a handheld end;

an end effector;

the connecting structure comprises an outer tube, a first flexible structure, a second flexible structure and a third flexible structure, wherein the outer tube comprises a first proximal part, a first middle part and a first distal part, the first proximal part, the first flexible structure, the first middle part, the second flexible structure, the first distal part and the third flexible structure are sequentially arranged from near to far, the first proximal part, the first middle part and the first distal part are rigid pieces, and the third flexible structure has at least one degree of freedom of rotation and is connected with the end effector to drive the end effector to rotate; and

an actuator comprising a first flexible actuator structure connecting the first and second flexible structures and configured to rotate the first and second flexible structures in opposite directions; the first flexible structure having rotational freedom to rotate about a second axis, the second flexible structure having rotational freedom to rotate about a fourth axis, the fourth axis being parallel to the second axis;

wherein the surgical instrument has an initial state and an open state;

2. A surgical instrument as recited in claim 1, wherein the first flexible structure has rotational freedom to rotate about a first axis, wherein the second flexible structure has rotational freedom to rotate about a third axis, wherein the third axis is parallel to the first axis, and wherein the first axis and the second axis are perpendicular.

3. A surgical instrument as recited in claim 2, wherein the first flexible drive structure includes a first drive wire set and a second drive wire set;

when the first flexible structure is driven to rotate around the second axis, the first transmission wire group and the second transmission wire group are used for driving the second flexible structure to rotate around the fourth axis in a direction opposite to the rotating direction of the first flexible structure.

4. A surgical instrument according to claim 3,

the first transmission wire group comprises a first transmission wire and a second transmission wire;

the second transmission wire group comprises a third transmission wire and a fourth transmission wire;

5. A surgical instrument as recited in claim 4, wherein a fixed position of the proximal end of the first drive wire on the first flexible structure is in an opposite configuration to a fixed position of the distal end of the first drive wire on the second flexible structure; a fixed position of a proximal end of the second drive wire on the first flexible structure in an opposite configuration from a fixed position of a distal end of the second drive wire on the second flexible structure;

a securing position of a proximal end of the third drive wire on the first flexible structure in an opposite configuration to the securing position of the distal end of the third drive wire on the second flexible structure; the attachment location of the proximal end of the fourth drive wire to the first flexible structure is in an opposite configuration from the attachment location of the distal end of the fourth drive wire to the second flexible structure.

6. The surgical instrument of claim 1, wherein the first flexible transmission structure comprises a first transmission wire set and a second transmission wire set;

when the first flexible structure is driven to rotate around the second axis, the first transmission wire group and the second transmission wire group are used for driving the second flexible structure to rotate around the fourth axis in the direction opposite to the rotation direction of the first flexible structure;

the first transmission wire group and/or the second transmission wire group further comprise a first elastic structure for preventing the first transmission wire group and/or the second transmission wire group from generating return difference.

7. The surgical instrument of claim 6, wherein the first flexible drive structure includes a first drive wire, a second drive wire, a third drive wire, and a fourth drive wire;

when the first flexible structure is driven to rotate around the first axis, the first transmission wire and the second transmission wire are used for driving the second flexible structure to rotate around the third axis in a direction opposite to the rotation direction of the first flexible structure;

when the first flexible structure is driven to rotate around the second axis, the third transmission wire and the fourth transmission wire are used for driving the second flexible structure to rotate around the fourth axis in a direction opposite to the rotating direction of the first flexible structure;

wherein the lengths of the first drive wire and the second drive wire are not equal, and/or the lengths of the third drive wire and the fourth drive wire are not equal.

8. A surgical instrument as recited in claim 1, wherein the hand-held end includes a manipulation device, a wrist structure, and an arcuate body connected in series, a proximal end of the connection structure being mounted to the arcuate body, the wrist structure having at least one rotational degree of freedom;

9. A surgical instrument as recited in claim 8, wherein the wrist structure has rotational freedom to rotate about a fifth axis and a sixth axis, the third flexible structure has rotational freedom to rotate about a seventh axis and a rotational freedom to rotate about an eighth axis, the fifth axis is perpendicular to the sixth axis, the seventh axis is perpendicular to the eighth axis, and the fifth axis is parallel to the seventh axis.

10. The surgical instrument of claim 9, wherein the second flexible drive structure includes a third drive wire set and a fourth drive wire set;

11. The surgical instrument of claim 10, wherein the third and/or fourth drive wire sets further comprise a second resilient structure to compensate for an amount of bending of the third and/or fourth drive wire sets to maintain the attitude of the end effector while the first and second flexible structures are adjusted.

12. A surgical instrument as recited in claim 1, wherein the hand-held end includes a manipulation device, a wrist structure, and an arc-shaped body connected in series, a proximal end of the connection structure being mounted to the arc-shaped body, the manipulation device having a rotational degree of freedom about a ninth axis, and the manipulation device being rotatably disposed on the wrist structure;

13. The surgical instrument according to claim 1, wherein the hand-held end comprises an opening and closing control mechanism, an operating device, a wrist structure and an arc-shaped body which are connected in sequence, the proximal end of the connecting structure is mounted to the arc-shaped body, and the opening and closing control mechanism can perform opening and closing movements relative to the operating device;

the transmission device further comprises a fourth flexible transmission structure, a first conversion device and a second conversion device; the near end of the fourth flexible transmission structure is connected with the first conversion device, and the far end of the fourth flexible transmission structure is connected with the second conversion device; the first conversion device is movably connected with the opening and closing control mechanism and used for converting the opening and closing movement of the opening and closing control mechanism into the axial movement of a fourth flexible transmission structure, and the second conversion device is movably connected with the tool flap and used for converting the axial movement of the fourth flexible transmission structure into the opening and closing movement of the tool flap; and the fourth flexible transmission structure, the first conversion device and the second conversion device are configured to enable the opening and closing control mechanism to move in the same way as the tool valve.

14. A surgical instrument as recited in claim 1, wherein the end effector has a telescopic degree of freedom for movement in an axial direction of the connecting structure.

15. A surgical instrument as recited in claim 1, wherein the connecting structure further includes an inner tube, the outer tube movably received over the inner tube, the inner tube having an axial length greater than an axial length of the outer tube, the inner tube being movable relative to the outer tube;

16. A surgical instrument as recited in claim 15, wherein the distal end of the inner tube is provided with the third flexible structure.

17. The surgical instrument of claim 15, wherein the inner tube comprises a second proximal portion, a second intermediate portion, and a second distal portion arranged in a proximal-to-distal order, wherein the second proximal portion and the second distal portion are both rigid members, and the second intermediate portion is a flexible member;

wherein: the second middle part of the inner pipe penetrates through the first flexible structure, the first middle part and the second flexible structure of the outer pipe, and the axial length of the second middle part is larger than the axial total length of the first flexible structure, the first middle part and the second flexible structure.

18. The surgical instrument of claim 17, wherein the second proximal portion of the inner tube comprises a first sub-inner tube and a second sub-inner tube arranged in a distal-to-proximal order; the first sub inner tube having an outer diameter no greater than an inner diameter of the first proximal end portion of the outer tube such that the first sub inner tube is disposed within the first proximal end portion of the outer tube; the outer diameter of the second inner sub-tube is larger than the inner diameter of the first proximal end part of the outer tube, so that the second inner sub-tube is arranged outside the first proximal end part of the outer tube to form a proximal limit;

the second distal end part comprises a third sub-inner tube and a fourth sub-inner tube which are arranged from the near to the far in sequence; the outer diameter of the third sub-inner tube is no greater than the inner diameter of the first distal end portion of the outer tube such that the third sub-inner tube is disposed within the first distal end portion of the outer tube; the outer diameter of the fourth sub-inner tube is greater than the inner diameter of the first distal end portion of the outer tube such that the fourth sub-inner tube is disposed outside the first distal end portion of the outer tube to form a distal stop;

19. A surgical instrument as recited in claim 1, wherein a proximal end of the outer tube is mounted to the hand-held end, and the outer tube includes a first flexible structure at the proximal end and a second flexible structure at the distal end;

the handheld end comprises a connecting shaft, the connecting shaft is movably arranged in the outer tube in a penetrating mode, the far end of the connecting shaft extends out of the outer tube and is connected with the end effector, and the far end of the outer tube is movably connected with the end effector.

20. A surgical instrument as recited in claim 19, wherein the outer tube further includes the third flexible structure, the first proximal end portion being mounted to the hand-held end.

21. A surgical instrument as recited in claim 20, wherein the hand-held end includes a manipulation device, a wrist structure, and an arc-shaped body connected in series, the proximal end of the outer tube being mounted to the arc-shaped body, the manipulation device being movably disposed on the wrist structure, the manipulation device being connected to the proximal end of the connection shaft.

22. A surgical instrument as recited in claim 21, wherein the connecting shaft includes a proximal section, an intermediate section, and a distal section disposed in that order from a proximal end to a distal end; wherein the proximal and distal sections are both rigid members and the intermediate section is a flexible member; the manipulation device is connected with the proximal section and movably connected with the wrist structure through the proximal section; the distal section extends from the end of the third flexible structure and is coupled to the end effector.

23. A surgical instrument as recited in claim 20, wherein the hand-held end includes a manipulator, a wrist structure, and an arcuate body connected in series; the proximal end of the outer tube is mounted to the arcuate body; the wrist structure is provided with a rigid sleeve on a surface opposite to the control device, the control device is movably arranged on the rigid sleeve, and the control device is connected with the near end of the connecting shaft.

24. A surgical instrument as recited in claim 23, wherein the connecting shaft includes a proximal section, an intermediate section, and a distal section disposed in order from a proximal end to a distal end; wherein the proximal and distal sections are both rigid members and the intermediate section is a flexible member; the steering device is coupled to the proximal section and movably coupled to the rigid cannula through the proximal section, and the distal section is coupled to the end effector after extending from the distal end of the third flexible structure.

25. A surgical instrument as recited in claim 21, wherein the connecting shaft includes a proximal section, an intermediate section, and a distal section disposed in that order from a proximal end to a distal end; wherein the proximal and distal sections are both rigid members and the intermediate section is a flexible member; the manipulation device is connected with the proximal section, and the distal section extends from the end of the third flexible structure and is connected with the end effector;

the connecting shaft is configured to:

when the manipulation device moves towards the proximal end of the surgical instrument to the nearest position, the distal section and the tail end of the third flexible structure are kept in a matching relation to form a distal limit;

26. A surgical instrument as recited in claim 22, wherein the connecting shaft is configured to:

27. A surgical instrument as recited in claim 25 or 26, wherein the end effector includes a proximal effector mount, the proximal effector mount including a first sub-effector mount and a second sub-effector mount at a distal end, the first sub-effector mount having an outer diameter that is no greater than the inner diameter of the third flexible structure, the second sub-effector mount having an outer diameter that is greater than the inner diameter of the third flexible structure.

28. The surgical instrument of claim 20, wherein the end effector includes a proximal effector mount having an outer diameter greater than an inner diameter of the third flexible structure.

29. A surgical device comprising the surgical instrument of claim 1, an endoscope, and a badge; the surgical instrument and the endoscope are both detachably secured to the poke card.

30. A surgical device according to claim 29 wherein said stab card is provided with an instrument channel, said attachment formation of said surgical instrument being positioned within said instrument channel and removably secured thereto.

31. The surgical device of claim 29, wherein the surgical device has a tool axis, a plane of symmetry about which the surgical device is symmetrical, at least two surgical instruments, at least two instrument channels are disposed on the poke card, the working surface is perpendicular to the plane of symmetry and passes through the axes of the at least two instrument channels, the intersection of the plane of symmetry and working surface forming the tool axis, each surgical instrument being positioned within a corresponding one of the instrument channels; the axis of the first intermediate portion is parallel to the tool axis;

when both of the surgical instruments are in the initial state, the axes of the first proximal portion, first flexible structure, first intermediate portion, second flexible structure, first distal portion, third flexible structure, and end effector all lie on the working surface;

when both of the surgical instruments are in the open state, the axes of the first proximal portion, first flexible structure, first intermediate portion, second flexible structure, first distal portion, third flexible structure, and end effector all lie on the working surface.

32. The surgical device of claim 31, wherein the connecting structure is provided with a first detent and the instrument channel is provided with a second detent; the first positioning part is used for being matched with the second positioning part so as to limit the axis of the part of the connecting structure where the first positioning part is located to be parallel to the axis of the tool.