CN112426203B - Minimally invasive surgery instrument opening and closing device driven by software - Google Patents
Minimally invasive surgery instrument opening and closing device driven by software Download PDFInfo
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- CN112426203B CN112426203B CN202011236285.0A CN202011236285A CN112426203B CN 112426203 B CN112426203 B CN 112426203B CN 202011236285 A CN202011236285 A CN 202011236285A CN 112426203 B CN112426203 B CN 112426203B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00589—Coagulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
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Abstract
The invention discloses a minimally invasive surgical instrument opening and closing device driven by a soft body, which comprises: the end clamp comprises a tail end clamp body, a soft driving assembly, a connecting mechanism, a transmission structure, an electric assembly and a fluid control module; the tail end clamp body is connected with the output end of the soft driver through a connecting piece; a software driver component comprising a software driver; the transmission structure is a long-distance device for packaging gas/liquid pipelines, the interior of the transmission structure is hollow, and pipelines and electric through holes are reserved in the front and the back of the transmission structure; the electrical assembly comprises two connecting wires, the fluid control module is connected with a hose and is a gas/liquid source, and fluid control is simultaneously implemented; the fluid control module comprises 1-4 control components with the same structure. The invention can realize the elastic operation when clamping and dissociating human tissues, has adjustable rigidity and improves the safety of the interaction of the instrument and the biological tissues. Compared with a connecting rod and a rope wire mechanism, the fluid transmission does not need a supporting structure, does not have coupling, and has a simple structure.
Description
Technical Field
The invention discloses a software-driven minimally invasive surgical instrument opening and closing device, relates to the field of endoscopic surgery or robot minimally invasive surgical instruments, and particularly relates to a minimally invasive surgical end operation instrument.
Background
Minimally invasive surgery is a surgical method in which an operator performs surgery in a human body cavity by direct operation or by mounting a distal end operation instrument in a robot in combination with an endoscope or other devices. Compared with the traditional open surgery, the minimally invasive surgery has the characteristics of small wound, light pain, less bleeding, less complications and the like, can improve the precision and the flexibility of the surgery, and has been widely applied in various departments of hospitals, including laparoscopic surgery, thoracoscopic surgery, head and neck surgery, gynecology, urology surgery and the like. The end operation instrument is the key in the minimally invasive surgery.
When performing minimally invasive operations on the head and neck, thyroid, abdominal cavity, thoracic cavity and the like, the tail end operation instrument directly acts on human tissues, wherein the grasping forceps, the separating forceps and the like mainly perform the operations of clamping, dissociating and the like on the human tissues and perform the functions of nerve detection, electric coagulation and the like when needed, and the operations are realized by the opening and closing device of the instrument. The instrument opening and closing device can clamp tissues by closing the forceps jaws and release the tissues by opening the forceps jaws, and the prior art mainly utilizes transmission modes such as connecting rods, ropes and the like to pull the forceps bodies to rotate around a shaft to realize opening and closing movement. In the existing minimally invasive surgery or robot surgery, such as the American DaVinci surgical robot, designed nondestructive grasping forceps and separating forceps are mostly driven by connecting rods or wires, a transmission driving mechanism is made of rigid materials, and a driving system and a transmission system are high in rigidity and unadjustable in rigidity. The grabbed object is human soft tissue, so that the elastic modulus is low, and the tissue and organs are easily damaged when the grabbing force of the tail end opening and closing instrument formed by rigid materials is large. Meanwhile, the rigid transmission system is easy to couple in long-distance multi-free transmission, and the transmission structure is complex in design.
In summary, the transmission driving system related to the existing opening and closing instrument is usually made of rigid materials such as steel, iron, aluminum alloy and the like, the Young modulus is high, the Young modulus is 12 Pa of 10 to 9 th power to 10 th power, when the soft tissue of a human body is clamped, the rigidity is high, the hard collision with the human body is easy to occur, and the safety is low. The driving device (a motor or pulled by a human hand) for the opening and closing movement of the instrument is arranged at the far end outside the body. When the existing connecting rod and rope wire mode is used for long-distance multi-degree-of-freedom transmission driving, the degrees of freedom of the far end and the near end are highly coupled, and the transmission supporting structure at a turning part is complex in design and difficult to control. The transmission mechanism made of rigid materials has poor flexibility, so that the surgical action is limited.
Disclosure of Invention
Aiming at the problems, particularly aiming at the requirements of grabbing, clamping and dissociating operation of soft tissues such as muscles, fat, livers, thyroid glands and the like with Young modulus of 10 of 4 th power to 10 th power Pascal, in order to improve collision safety and contact flexibility of operation, improve drive transmission integration level, reduce transmission coupling and realize variable-rigidity clamping operation, the invention provides and designs a minimally invasive operation instrument opening and closing device driven by software, particularly a novel tail end opening and closing operation instrument based on software materials and fluid drive, and realize flexible opening and closing and adjustable clamping rigidity, so that the problems of high rigidity, low safety, invariable rigidity, complex transmission and the like when the minimally invasive operation tail end operation device is interacted with human tissues in the prior art are solved. A soft body-driven minimally invasive surgical instrument opening and closing device, comprising: the end clamp comprises a tail end clamp body, a soft driving assembly, a connecting mechanism, a transmission structure, an electric assembly and a fluid control module;
the tail end clamp body is used as a part which is directly contacted with a human body in the operation process and comprises a first clamp body and a second clamp body which are respectively connected with the output end of the soft driver through a connecting piece;
the soft driving component comprises 2 soft drivers which are symmetrically distributed and respectively drive the first clamp body and the second clamp body to coaxially move around the rotating supporting shaft of the first clamp body and the second clamp body so as to realize the double-knife bidirectional opening and closing action;
the connecting mechanism fixes the soft driving component to the tail end of the transmission structure;
the transmission structure is a long-distance device for packaging gas/liquid pipelines, the interior of the transmission structure is hollow, and pipelines and electric through holes are reserved in the front and the back of the transmission structure;
the electric assembly is two connecting wires, each wire is respectively connected with the tail end clamp body and the detecting instrument or the electrocoagulator, can be used as an electric signal to detect the state of the nerve when being connected to the nerve detecting instrument, and can be used for electrocoagulation when being connected to the electrocoagulator;
the fluid control module is connected with a hose, is a gas/liquid source and simultaneously implements fluid control; the fluid control module comprises 1-4 control components with the same structure; each control assembly comprises a button piston, a fluid sealing shell and a return spring; the fluid control module can be manually controlled or automatically controlled.
The other form of the soft body driving component comprises 1 soft body driver, the soft body driver drives the first clamp body to coaxially move around a rotating support shaft, and the second clamp body is fixedly connected to the rotating support shaft through a connecting piece and a rigid piece, so that the single-knife bidirectional opening and closing action is realized.
The soft driver comprises an output end, an end cover, a rotary supporting shaft, a bearing, a first soft module, a second soft module and a hose;
the inner part of the output end is cylindrical and hollow, the inner peripheral ring of the output end, the output end baffle, the end cover and the rotary support shaft baffle of the rotary support shaft form a front hollow cavity and a rear hollow cavity, and 1 software module is arranged in each cavity;
one end of the soft module is fixedly connected with the rotary supporting shaft baffle, and the other end of the soft module is fixedly connected with the output end baffle or is not fixedly connected with the output end baffle but keeps contact with the output end baffle through inflation;
the hose passes through the gap of the baffle of the rotary supporting shaft and is inserted into the gap from the bottom end of the soft module to supply air/liquid or suck air/liquid for the soft module.
The soft module is a closed structure made of flexible materials, a hollow cavity is arranged in the soft module, and the whole soft module expands or contracts by inflating/liquid or inhaling/liquid in the hollow cavity to push other outer structural members adjacent to or connected with the soft module to move.
The manufacturing method of the software module comprises the following steps:
designing a fan-shaped cylinder according to the hollow shape of the cylinder in the output end, wherein the top of the fan-shaped cylinder is open, a thin-wall mold is formed by digging a hole in the fan-shaped cylinder, and the lower half part of the soft module is cast;
pouring liquid silica gel, wherein the common materials comprise platinum-catalyzed silica gel and polydimethylsiloxane, and pouring the two components into a mold after uniformly mixing and stirring; in order to form a hollow cavity in the soft module, a solid piece with the same size as the hollow cavity is placed in the liquid silica gel of the mold without touching the bottom surface of the mold, and the solid piece is level with or higher than the liquid silica gel and is suspended;
placing the whole mould and silica gel at normal temperature, standing for more than 24-72 hours, or placing the mould and silica gel in a vacuum chamber, heating at constant temperature for 30-120 ℃ for curing and removing internal bubbles; after solidification, taking out the solid piece to form the lower half part of a soft module with a hollow cavity inside;
inserting a hose into the hollow chamber of the lower half part of the soft body module from one end;
then a mould with the same cross section shape is manufactured, the height of the mould is small, liquid silica gel is led into the mould, and a fan-shaped thin-wall silica gel sheet is formed after solidification, wherein the shape and the area of the thin-wall silica gel sheet are the same as the lower half part of the molded soft module;
after liquid silica gel is coated on the lower half part of the software module and the middle of the thin-wall silica gel sheet, the two are adhered together and solidified to form 1 software module.
The transmission structure is as follows: the long-distance rigid transmission structure is a rigid structural member made of metal, carbon fiber and plastic and used for abdominal cavity and nasal cavity operations; or a long-distance flexible transmission structure, and the typical material is a flexible material piece made of rubber, silica gel or nickel-titanium alloy and used for the operation of the alimentary canal or the throat.
A rigidity adjusting method of a minimally invasive surgery instrument opening and closing device driven by a soft body comprises the following steps: the soft driver is symmetrically driven by two soft modules, one soft module is used as a rigidity adjusting module, the other soft module is used as an active driving module, acting force is formed between the two soft modules, and resultant force is used as the output of the soft driver; the soft body module on one side of the rigidity adjusting module is filled with gas, and the gas is restrained in a certain space, so that the external acting force and the deformation amount form an equivalent spring relation, the preset pressure and the gas volume are adjusted, and the rigidity coefficient of the equivalent spring can be changed; the soft body module on the other side of the inflation is used as an active driving module to control the flow of the inflation gas, the resultant force of the two modules is used as the output of the soft body driver, and the integral equivalent stiffness of the output can be adjusted.
An operation method of a minimally invasive surgical instrument opening and closing device driven by software comprises the steps of double-knife bidirectional independent opening and closing control of a tail end clamp body, double-knife bidirectional coupling symmetrical opening and closing control and single-knife bidirectional opening and closing control.
When the double-blade bidirectional independent opening and closing control is carried out, the software driving component comprises 2 software drivers and 4 software modules; driving control is carried out by using 4 control components; the first control component is communicated with a first software module of the first software driver through 1 hose; the second control component is communicated with the second software module of the first software driver through another 1 hose to realize the bidirectional independent opening and closing control of the first clamp body; the third control component is communicated with the first software module of the second software driver through 1 hose; the fourth control assembly is communicated with a second software module of the second software driver through another 1 hose to realize bidirectional independent opening and closing control of the second clamp body, so that bidirectional independent opening and closing control of the two clamp bodies is realized; wherein the first and third control assemblies can be used as driving assemblies for rigidity adjustment, and the second and fourth control assemblies can be used as active driving sources for opening and closing actions, and vice versa.
When the double-blade bidirectional coupling symmetric opening and closing control is carried out, the software driving component comprises 2 software drivers and 4 software modules; 2 control components are used for driving control; a control component is respectively communicated with the first soft modules of the two soft drivers through 1 communicated hose; the other control component is respectively communicated with the second software modules of the two software drivers through another 1 communicating hose; one control component controls the first software module at the same time, and the other control component controls the second software module at the same time, and the two clamp bodies can be symmetrically opened or closed; one control assembly is used as a driving assembly for rigidity adjustment, and the other control assembly is used as an active driving source for opening and closing actions.
When the single-blade bidirectional opening and closing control of the end instrument is used, the software driving component only has 1 software driver which comprises 2 software modules, and the 2 control components are used for driving control; a control component is communicated with a first software module of the software driver through 1 hose; the other control component is communicated with a second software module of the software driver through another 1 hose to realize the bidirectional opening and closing control of a single clamp body; one control assembly is used as a driving assembly for rigidity adjustment, and the other control assembly is used as an active driving source for opening and closing actions.
The invention relates to a minimally invasive surgical instrument opening and closing device driven by a soft body, which has the advantages and the effects that: the invention can realize the elastic operation when clamping and dissociating human tissues, has adjustable rigidity and improves the safety of the interaction of the instrument and the biological tissues. The instrument opening and closing device can be arranged in a rigid transmission structure to go deep into a human body, such as an abdominal cavity, a thoracic cavity and the like, to implement minimally invasive surgery, and can also be arranged in a flexible transmission structure to go deep into the human body, such as a digestive tract, an upper respiratory tract of a mouth, a nose and a throat, a lower respiratory tract of a lung organ, the digestive tract, a gynecological cavity and a rectum, to implement minimally invasive surgery through a natural cavity. When the rigid transmission and flexible transmission structure has turning and multi-degree-of-freedom rotary joints, compared with a connecting rod and a rope wire mechanism, the fluid transmission does not need a supporting structure, does not have coupling, and has a simple structure.
Drawings
FIG. 1 is a view of the whole assembly of the soft body-driven minimally invasive surgical instrument opening and closing device of the invention.
Fig. 2 is a composition diagram of a soft body-driven minimally invasive surgical instrument opening and closing device (double-knife and double-direction) according to an embodiment of the invention.
FIG. 3 is a schematic view of a soft body-driven minimally invasive surgical instrument opening and closing device (single-knife, two-way).
FIG. 4 is a diagram of software driver components.
Figures 5a and 5b show exploded views of the soft drive.
FIG. 6 shows the software module composition and installation method.
FIG. 7 is a schematic diagram of a software module manufacturing method.
Fig. 8 shows a long-range rigid transmission structure.
Fig. 9 shows a long-distance flexible transmission structure.
FIG. 10 illustrates the components of the control components within the fluid control module.
Fig. 11 is a connection diagram of the double-blade bidirectional independent opening and closing control of the end instrument.
FIG. 12 is a view of the double-blade bi-directional coupling symmetrical open/close control connection of the distal instrument.
Fig. 13 is a connection diagram of single-blade two-way single-action opening and closing control.
Fig. 14 shows an automatic control diagram of the control unit.
Fig. 15 is a view showing a configuration of a manual control of the distal instrument.
The numbers in the figures are as follows:
1. end clamp body 2, soft driving component 3 and connecting mechanism
4. Transmission structure 5, electric assembly 6 and fluid control module
11. A first clamp body 12, a second clamp body 13 and a first connecting piece
14. Second connecting member 15, rigid member
21. A first software driver 22 and a second software driver
211. Output end 212, end cap 213, first rotating support shaft
214. Bearing 215, 225, first software module 216, 226, second software module
217. Hose 218, bolts 219, 220, chamber
2111. Output end baffle 2131, rotary support shaft baffle 2151 and hollow cavity
223. Second rotary supporting shaft 41, rigid transmission structure 42 and flexible transmission structure
61. 62, 63, 64, control assembly 611, push button piston
612. Fluid seal housing 613, return spring
71. Extension button 72, linear motion motor 73, and operation handle
Detailed Description
The technical solution of the present invention is further described with reference to the accompanying drawings and specific embodiments.
A soft body-driven minimally invasive surgical instrument opening and closing device, comprising: the end clamp comprises an end clamp body 1, a soft driving component 2, a connecting mechanism 3, a transmission structure 4, an electrical component 5 and a fluid control module 6, and is shown in figure 1.
As shown in fig. 2, the distal forceps body 1, as a part directly contacting with a human body in an operation process, is composed of a first forceps body 11 (left) and a second forceps body 12 (right), which are respectively connected with an output end of a soft body driver through a first connecting piece 13 (left) and a second connecting piece 14 (right), wherein the connecting pieces are insulators (typically made of engineering plastics) or metal pieces.
The tail end clamp body 1 can be replaced by different instruments according to the requirements of surgical type, in one embodiment, the instruments are non-destructive grasping clamps, and in one embodiment, the instruments are separating clamps.
The soft driving component 2, an example (fig. 2) includes 2 soft drivers, specifically, two driving devices of a first soft driver 21 and a second soft driver 22, which are symmetrically distributed, and drive the first forceps body 11 and the second forceps body 12 to coaxially move around the first rotating support shaft 213 and the second rotating support shaft 223, respectively, so as to implement a two-way opening and closing operation of the two blades. In another embodiment of the present invention (fig. 3), the soft driving component is provided with only 1 first soft driver 21, the first connecting member 13 drives the first pincer 11, and the other end pincer (the second pincer 12) is fixedly connected to the rotating support shaft 223 through the second connecting member 14 and the rigid member 15 without the soft driver 22, so as to realize the single-blade two-way opening and closing action.
The soft body driver comprises an output end 211, an end cover 212, a rotary supporting shaft 213, a bearing 214, a first soft body module 215, a second soft body module 216, a hose 217 and a bolt 218, as shown in fig. 4. The exploded view of the soft drive is shown in FIG. 5, with FIG. 5a being a left side view and FIG. 5b being a right side view.
The output end 211 is internally cylindrical and hollowed, an inner ring of the output end 211, the output end baffle 2111, the end cover 212 and the rotating support shaft baffle 2131 of the rotating support shaft 213 form a front hollow chamber 219 and a rear hollow chamber 220, and each chamber is internally provided with 1 software module. In fig. 4, the software modules 215 and 216 are removed, i.e., chambers 219 and 220 are visible.
One end of the soft module is connected and fixed with the rotating support shaft baffle 2131, and the other end is connected with the output end baffle 2111 either fixedly or not fixedly and keeps contact through inflation, as shown in fig. 6.
The soft module is a closed structure made of flexible materials such as silica gel and the like. Inside it is a hollow chamber 2151 (fig. 6), which is inflated or deflated by inflating or inhaling air (liquid) to make the whole soft body module expand or contract, and push the other outer structural members adjacent to or connected with it to move.
The manufacturing method of the software module comprises the following steps: (1) according to the hollow shape of the cylinder inside the output end 211, the fan-shaped cylinder is designed, the top is open, the inside is dug to form a thin-wall mold, and the lower half part of the soft body module is cast and molded, as shown in part (a) in fig. 7. When pouring the liquid silica gel, the release agent can be sprayed. The poured liquid silica gel material is usually formed by mixing the components A and B, can be cured into a solid state at normal temperature or under heating, and commonly used materials comprise platinum-catalyzed silica gel and PDMS (polydimethylsiloxane), and have good tensile strength and extensibility of not less than 1: 3. And mixing the component A and the component B according to the molding proportion required by the material, uniformly stirring, and pouring into a mold. To form the hollow chamber 2151 in the soft body module, a solid member having the same size as the hollow chamber 2151 is put into the liquid silicone rubber of the mold without touching the bottom surface of the mold, and the solid member is suspended to be flush with or higher than the top of the liquid silicone rubber, as shown in fig. 7 (b). The whole mould and the silica gel are placed in a normal temperature place and are stood for more than 24-72 hours, or the whole mould and the silica gel are placed in a vacuum chamber to be heated at constant temperature (more than 30 ℃ and less than 120 ℃), so that the rapid solidification is facilitated and internal bubbles are removed. After curing, the solid piece is removed to form the lower half of the software module with the hollow chamber 2151 inside, as shown in fig. 7 (c). A hose 217 is inserted into the hollow chamber of the lower half of the soft body module from one end, as shown in fig. 7 (d). Then, a mold with the same cross section shape is manufactured, the height of the mold is small, liquid silica gel is introduced into the mold, and after solidification, a fan-shaped thin-wall silica gel sheet (about 1-3mm) is formed, as shown in fig. 7 (e), the shape and the area of the thin-wall silica gel sheet are the same as those of the lower half part of the molded software module, and after the liquid silica gel mixed with A and B is coated between the lower half part of the software module and the thin-wall silica gel sheet, the lower half part and the thin-wall silica gel sheet are attached together, and 1 software module is formed after solidification, as shown in fig. 7 (f).
The hose 217 penetrates through the gap of the rotating support shaft baffle 2131, and is inserted into the inner hollow chamber from the bottom end of the soft module to supply air (liquid) or suck air (liquid) for the soft module.
In the first soft body driver 21, when the gas (liquid) pressure of the first soft body module 215 is greater than the gas (liquid) pressure of the second soft body module 216, the output end baffle 2111 is pushed to rotate around the shaft, the correspondingly connected first pincer body 11 rotates around the rotation support shaft 213, and the first pincer body 11 rotates towards the opening direction; on the contrary, when the gas (hydraulic) pressure of the first soft body module 215 is smaller than the gas (hydraulic) pressure of the second soft body module 216, the correspondingly connected first pincer body 11 rotates reversely around the rotating support shaft, and the first pincer body 11 rotates towards the closing direction; the gas (hydraulic) pressure of the first software module 215 is equal to the gas (hydraulic) pressure of the second software module 216, and the balance is kept. The operation of the jaw opening and closing is the same for the soft body driver 22.
The stiffness adjustment is important when the distal clamp is used to clamp the tissue or to open and expand the tissue chamber, the first soft module 215 is used as a stiffness adjustment module (air spring), and the second soft module 216 is used as an active driving module to control the clamp (i.e. one side is used to control the variation of the stiffness K and the other side is used to control the angle, thereby generating the variable stiffness control). A method for controlling the rigidity adjustment of a soft driver comprises pre-charging a first soft module 215 with gas to a volume V0The stiffness coefficient of the first soft body module 215 can be approximately equivalently calculated as K1 ═ (p)0×(V0/V)m-pa)×(dA/dx)-A×m×p0×((V0 m/Vm+1) (dV/Dx) where paThe absolute gas pressure p of the gas in the soft module in static balance0Standard atmospheric pressure, V0The volume of gas in the soft module at the static balance position, V is the volume of gas in the current soft module, m is an index, the value is generally 1-1.4, the typical value is 1.33, A is the cross section area, and x is the deformation of the soft module, so that the rigidity K of the soft module can be changed by changing the gas pressure, the volume and the like of the gas in the soft module during the static balance; the relationship between the first software module 215 and the rotation angle a of the end clamp body is approximately T1 ═ K1 × r × a × r, where r is the rotation radius; thus, when the output torque of the second software module 216 is T2, the output T of the software driver is T2-T1-T2-K1 × r × a × r. To realize changeThe rigidity control is that firstly, the air pressure and the volume of the first software module 215 during static balance are controlled in advance, then the real-time control of the pressure is combined, the first software module 215 can be used as an equivalent air spring with adjustable rigidity K1, then the air volume or the pressure of the second software module 216 on the other side is adjusted, the opening and closing of a terminal instrument under different rigidities can be realized, namely, after the balance, air is filled into the second software module 216, the pincer body is driven to rotate by the second software module 216, otherwise, the air is sucked out, and the pincer body is driven to rotate reversely under the preset pressure of the first software module 215. In addition, by filling with gas or particulate fillers of different densities (e.g. coffee powder, foam), the stiffness K1 can also be varied due to the different densities. The soft body driving module adopts silica gel sealing fluid, simplifies the transmission mode, and simultaneously can keep safe elastic contact with human soft tissues in the operation due to large elasticity of the fluid, and has better safety compared with a rigid instrument.
The connecting mechanism 3 fixes the soft driving component 2 to the end of the transmission structure 4.
The transmission structure 4 is a long-distance device for packaging gas (liquid) pipelines, the interior of the long-distance device is hollow, and pipelines and electric through holes are reserved in the front and the back of the long-distance device. One example is a long-distance rigid transmission structure 41, as shown in fig. 8, a rigid structure made of metal, carbon fiber or plastic, which can be used for abdominal and nasal cavity operations; one example is a long-range flexible drive structure 42, as shown in fig. 9, typically made of a flexible material such as rubber, silicone, nitinol, etc., which may be used for digestive tract or laryngeal surgery. Because the soft driver is driven by fluid and the transmission mode is a flexible pipeline, the flexible driver can turn in the flexible transmission structure 42, thereby facilitating transmission, and the transmission coupling phenomenon does not exist at the rotating and turning positions like steel wires and connecting rod pieces.
The electric component 5 is two connecting wires, one end of one wire (anode) is connected to the rear edge transmission structure 4 of the tail end clamp body 1 and led out of the body, the other end of the wire is connected to a detecting instrument (the positive electrode of the nerve detecting instrument or the positive electrode of the electrocoagulator), one end of the other wire (cathode) is connected to the rear edge transmission structure 4 of the tail end clamp body 1 and led out of the body, the other end of the wire is connected to the detecting instrument (the negative electrode of the nerve detecting instrument or the negative electrode of the electrocoagulator), the wire can be used as an electric signal to detect the state of the nerve when being connected to the nerve detecting instrument, and the wire can be used for electrocoagulation when being connected to the electrocoagulator.
The fluid control module 6 is connected with each hose, is a gas (liquid) source and simultaneously implements fluid control; the fluid control module comprises 1-4 control assemblies 61, 62, 63, 64 (the number of the control assemblies is the same as that of the software modules), the control assemblies are the same, and each control assembly comprises a button piston 611, a fluid sealing shell 612 and a return spring 613, as shown in fig. 10. The volume and pressure of the gas (liquid) in the control assembly can be adjusted by controlling the stroke of the button piston 611, and the volume and pressure of the fluid in the soft module in the end instrument can be controlled through fluid transmission. The return spring 613 accelerates the return of the control assembly stroke when the button piston 611 is released. The control method comprises the steps of double-knife bidirectional independent opening and closing control, double-knife bidirectional coupling symmetrical opening and closing control and single-knife bidirectional opening and closing control of the tail end instrument.
When the double-blade bidirectional independent opening and closing control of the terminal instrument is used, the terminal instrument is provided with 2 soft drivers 21 and 22 which comprise 4 soft modules; the drive control was performed using 4 control components as shown in fig. 11. A control component 61 is communicated with the first software module 215 of the first software driver 21 through 1 hose; the second control component 62 is communicated with the second software module 216 of the first software driver 21 through another 1 hose, so as to realize the bidirectional independent opening and closing control of the first caliper body 11; the third control component 63 is communicated with the first software module 225 of the second software driver 22 through 1 hose; the fourth control component 64 is communicated with the second software module 226 of the second software driver 22 through another 1 hose to realize the two-way independent opening and closing control of the second pincer body 12, thereby realizing the two-way independent opening and closing control of the two pincer bodies. The control assemblies 61, 63 may act as stiffness adjusting drive assemblies while the control assemblies 62 and 64 act as opening and closing motion active drive sources, and vice versa.
When the double-blade bidirectional coupling symmetrical opening and closing control of the terminal instrument is used, the terminal instrument is provided with 2 soft drivers 21 and 22 which comprise 4 soft modules; the drive control was performed using 2 control components as shown in fig. 12. A control component 61 is communicated with the first software modules 215 and 225 of the two software drivers 21 and 22 through 1 communicated hose; the other control component 62 is communicated with the second software modules 216 and 226 of the two software drivers 21 and 22 through another 1 communicating hose. The control component 61 controls the software modules 215 and 225 at the same time, and the control component controls the software modules 216 and 226 at the same time, so that the forceps bodies 11 and 12 can be symmetrically opened or closed. The control assembly 61 may act as a stiffness adjustment drive assembly and the control assembly 62 as an opening and closing motion active drive source, or vice versa.
When using the single-blade two-way opening and closing control of the distal end instrument, the distal end instrument has only 1 software driver 21, including 2 software modules, and uses 2 control components for driving control, as shown in fig. 13. A control component 61 is communicated with the first software module 215 of the first software driver 21 through 1 hose; the other control component 62 is communicated with the second software module 216 of the first software driver 21 through another 1 hose to realize the bidirectional opening and closing control of the single forceps body 11. The control assembly 61 may act as a stiffness adjustment drive assembly and the control assembly 62 as an opening and closing motion active drive source, or vice versa.
The fluid control module is controlled manually in one example and automatically in another example.
When the fluid control module 6 is automatically controlled, the placement can be adjusted on site, the fluid pipeline and the electric wire can be lengthened and shortened, the button pistons 611 of the control assemblies 61 are respectively controlled by the linear motion motors 72 connected with the button pistons, and each control assembly is controlled by 1 linear motion motor, as shown in fig. 14.
During manual control, an operating handle 73 is arranged at the starting end of the transmission structure, so that an operator can conveniently hold the transmission structure. The fluid drive module 6 is mounted within the handle 73 and the extension button 71 is connected to the button piston 611 of the control assembly as shown in figure 15. The number and the placing layout of the extension buttons are arranged according to the number and the placing layout of the internal control assemblies, and the extension buttons extend out of the operating handle to allow an operator to press and loosen the extension buttons, so that the opening and closing operation control of the tail end instrument is realized.
Claims (11)
1. A minimally invasive surgical instrument opening and closing device driven by a soft body is characterized in that: this device that opens and shuts includes: the end clamp comprises a tail end clamp body, a soft driving assembly, a connecting mechanism, a transmission structure, an electric assembly and a fluid control module;
the tail end clamp body is used as a part which is directly contacted with a human body in the operation process and comprises a first clamp body and a second clamp body which are respectively connected with the output end of the soft driver through a connecting piece;
the soft driving component comprises 2 soft drivers which are symmetrically distributed and respectively drive the first clamp body and the second clamp body to coaxially move around the rotating supporting shaft of the first clamp body and the second clamp body so as to realize the double-knife bidirectional opening and closing action; the soft driver comprises an output end, an end cover, a rotary supporting shaft, a bearing, a first soft module, a second soft module and a hose; the inner part of the output end is cylindrical and hollow, the inner peripheral ring of the output end, the output end baffle, the end cover and the rotary support shaft baffle of the rotary support shaft form a front hollow cavity and a rear hollow cavity, and 1 software module is arranged in each cavity; one end of the soft module is fixedly connected with the rotary supporting shaft baffle, and the other end of the soft module is fixedly connected with the output end baffle or is not fixedly connected with the output end baffle but keeps contact with the output end baffle through inflation; the hose penetrates through the gap of the baffle of the rotary supporting shaft and is inserted into the gap from the bottom end of the soft module to supply air/liquid or suck air/liquid for the soft module;
the connecting mechanism fixes the soft driving component to the tail end of the transmission structure;
the transmission structure is a long-distance device for packaging gas/liquid pipelines, the interior of the transmission structure is hollow, and pipelines and electric through holes are reserved in the front and the back of the transmission structure;
the electric assembly is two connecting wires, each wire is respectively connected with the tail end clamp body and the detecting instrument or the electrocoagulator, can be used as an electric signal to detect the state of the nerve when being connected to the nerve detecting instrument, and can be used for electrocoagulation when being connected to the electrocoagulator;
the fluid control module is connected with a hose, is a gas/liquid source and simultaneously implements fluid control; the fluid control module comprises 1-4 control components with the same structure; each control assembly comprises a button piston, a fluid sealing shell and a return spring; and the fluid control module is manually controlled or automatically controlled.
2. A minimally invasive surgical instrument opening and closing device driven by a soft body is characterized in that: this device that opens and shuts includes: the end clamp comprises a tail end clamp body, a soft driving assembly, a connecting mechanism, a transmission structure, an electric assembly and a fluid control module;
the tail end clamp body is used as a part which is directly contacted with a human body in the operation process and comprises a first clamp body and a second clamp body which are respectively connected with the output end of the soft driver through a connecting piece;
the soft driving component comprises 1 soft driver, the soft driver drives the first clamp body to coaxially move around the rotating support shaft, and the second clamp body is fixedly connected to the rotating support shaft through a connecting piece and a rigid piece, so that the single-blade bidirectional opening and closing action is realized; the soft driver comprises an output end, an end cover, a rotary supporting shaft, a bearing, a first soft module, a second soft module and a hose; the inner part of the output end is cylindrical and hollow, the inner peripheral ring of the output end, the output end baffle, the end cover and the rotary support shaft baffle of the rotary support shaft form a front hollow cavity and a rear hollow cavity, and 1 software module is arranged in each cavity; one end of the soft module is fixedly connected with the rotary supporting shaft baffle, and the other end of the soft module is fixedly connected with the output end baffle or is not fixedly connected with the output end baffle but keeps contact with the output end baffle through inflation; the hose passes through the gap of the baffle of the rotary supporting shaft and is inserted into the gap from the bottom end of the soft module to supply air/liquid or suck air/liquid for the soft module.
3. The soft body driven minimally invasive surgical instrument opening and closing device according to claim 1 or 2, wherein: the soft body module is a closed structure made of flexible materials, a hollow cavity is arranged in the soft body module, and the whole soft body module is expanded or contracted by inflating/liquid or inhaling/liquid in the hollow cavity.
4. The soft-body driven minimally invasive surgical instrument opening and closing device according to claim 3, wherein: the manufacturing method of the software module comprises the following steps:
designing a fan-shaped cylinder according to the hollow shape of the cylinder in the output end, wherein the top of the fan-shaped cylinder is open, a thin-wall mold is formed by digging a hole in the fan-shaped cylinder, and the lower half part of the soft module is cast;
pouring liquid silica gel, wherein the common materials comprise platinum-catalyzed silica gel and polydimethylsiloxane, and pouring the two components into a mold after uniformly mixing and stirring; in order to form a hollow cavity in the soft module, a solid piece with the same size as the hollow cavity is placed in the liquid silica gel of the mold without touching the bottom surface of the mold, and the solid piece is level with or higher than the liquid silica gel and is suspended;
placing the whole mould and silica gel at normal temperature, standing for 24-72 hours, or placing the mould and silica gel in a vacuum chamber, heating at constant temperature for 30-120 ℃ for curing, and removing internal bubbles; after solidification, taking out the solid piece to form the lower half part of a soft module with a hollow cavity inside;
inserting a hose into the hollow chamber of the lower half part of the soft body module from one end;
then a mould with the same cross section shape is manufactured, the height of the mould is small, liquid silica gel is led into the mould, and a fan-shaped thin-wall silica gel sheet is formed after solidification, wherein the shape and the area of the thin-wall silica gel sheet are the same as the lower half part of the soft body module;
after liquid silica gel is coated on the lower half part of the software module and the middle of the thin-wall silica gel sheet, the two are adhered together and solidified to form 1 software module.
5. The soft body driven minimally invasive surgical instrument opening and closing device according to claim 1 or 2, wherein the transmission structure comprises: the long-distance rigid transmission structure is a rigid structural member made of metal, carbon fiber and plastic and used for abdominal cavity and nasal cavity operations; or a long-distance flexible transmission structure, and the typical material is a flexible material piece made of rubber, silica gel or nickel-titanium alloy and used for the operation of the alimentary canal or the throat.
6. A rigidity adjusting method of a minimally invasive surgery instrument opening and closing device driven by a soft body comprises the following steps: the soft driver is symmetrically driven by two soft modules, one soft module is used as a rigidity adjusting module, the other soft module is used as an active driving module, acting force is formed between the two soft modules, and resultant force is used as the output of the soft driver; the soft body module on one side of the rigidity adjusting module is filled with gas, and the gas is restrained in a certain space, so that the external acting force and the deformation amount form an equivalent spring relation, the preset pressure and the gas volume are adjusted, and the rigidity coefficient of the equivalent spring can be changed; the soft body module on the other side of the inflation is used as an active driving module to control the flow of the inflation gas, the resultant force of the two modules is used as the output of the soft body driver, and the integral equivalent stiffness of the output can be adjusted.
7. The method for operating the soft body-driven minimally invasive surgical instrument opening and closing device according to claim 1, wherein the method comprises the following steps: comprises a double-blade bidirectional independent opening and closing control and a double-blade bidirectional coupling symmetrical opening and closing control of a tail end clamp body.
8. The operating method of the soft body driven minimally invasive surgical instrument opening and closing device according to claim 7, characterized in that: when the double-blade bidirectional independent opening and closing control is carried out, the software driving component comprises 2 software drivers and 4 software modules; driving control is carried out by using 4 control components; the first control component is communicated with a first software module of the first software driver through 1 hose; the second control component is communicated with the second software module of the first software driver through another 1 hose to realize the bidirectional independent opening and closing control of the first clamp body; the third control component is communicated with the first software module of the second software driver through 1 hose; the fourth control assembly is communicated with a second software module of the second software driver through another 1 hose to realize bidirectional independent opening and closing control of the second clamp body, so that bidirectional independent opening and closing control of the two clamp bodies is realized; wherein the first and third control assemblies can be used as driving assemblies for rigidity adjustment, and the second and fourth control assemblies can be used as active driving sources for opening and closing actions, and vice versa.
9. The operating method of the soft body driven minimally invasive surgical instrument opening and closing device according to claim 7, characterized in that: when the double-blade bidirectional coupling symmetric opening and closing control is carried out, the software driving component comprises 2 software drivers and 4 software modules; 2 control components are used for driving control; a control component is respectively communicated with the first soft modules of the two soft drivers through 1 communicated hose; the other control component is respectively communicated with the second software modules of the two software drivers through another 1 communicating hose; one control component controls the first software module at the same time, and the other control component controls the second software module at the same time, and the two clamp bodies can be symmetrically opened or closed; one control assembly is used as a driving assembly for rigidity adjustment, and the other control assembly is used as an active driving source for opening and closing actions.
10. A method of operating the soft body-driven minimally invasive surgical instrument opening and closing device according to claim 2, wherein: the control is single-knife bidirectional opening and closing.
11. The operating method of the soft body driven minimally invasive surgical instrument opening and closing device according to claim 10, wherein: when the single-blade bidirectional opening and closing control is carried out, the software driving component only has 1 software driver which comprises 2 software modules, and 2 control components are used for carrying out driving control; a control component is communicated with a first software module of the software driver through 1 hose; the other control component is communicated with a second software module of the software driver through another 1 hose to realize the bidirectional opening and closing control of a single clamp body; one control assembly is used as a driving assembly for rigidity adjustment, and the other control assembly is used as an active driving source for opening and closing actions.
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| DE102013110216A1 (en) * | 2013-09-17 | 2015-03-19 | gomtec GmbH | End effector for a surgical instrument and surgical instrument with an end effector |
| CN105619450A (en) * | 2016-03-17 | 2016-06-01 | 上海交通大学 | Flexible mechanical arm and control method thereof |
| CN108927791B (en) * | 2018-08-16 | 2021-12-03 | 大连海事大学 | Variable-rigidity soft mechanical arm controlled by electrorheological fluid |
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| CN105856264A (en) * | 2015-01-22 | 2016-08-17 | 南京理工大学 | Software-driven radial opening and closing type pneumatic clamping device |
| CN108742848A (en) * | 2018-06-19 | 2018-11-06 | 深圳铭锐医疗自动化有限公司 | A kind of micro-wound operation robot device |
| CN110116422A (en) * | 2019-04-29 | 2019-08-13 | 天津大学 | A kind of double drive multimode software end attachment device |
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