CN112617728B

CN112617728B - Bronchoscope sheath and operating device thereof

Info

Publication number: CN112617728B
Application number: CN202011626840.0A
Authority: CN
Inventors: 孙加源; 郑筱轩; 严笠骏; 刘帅洋
Original assignee: Shanghai Chest Hospital
Current assignee: Shanghai Chest Hospital
Priority date: 2020-12-30
Filing date: 2020-12-30
Publication date: 2024-01-23
Anticipated expiration: 2040-12-30
Also published as: CN112617728A

Abstract

The invention discloses a bronchoscope sheath and an operating device thereof, wherein the bronchoscope sheath comprises a deflector rod, a base body, a hard sheath tube, a control cable and a controllable bending part, wherein the base body, the hard sheath tube and the controllable bending part are sequentially connected from a near end to a far end, and communicated cavities are formed in the base body, the hard sheath tube and the controllable bending part to form a scope sheath channel for inserting or extracting an air supply scope; the deflector rod is arranged on the base body, a bronchoscope interface is arranged at the proximal end of the base body and communicated with the scope sheath channel, and an opening from which the far-end mirror surface of the air supply tube mirror extends is arranged at the far-end port of the controllable bending part; the proximal end of the control cable is connected with the deflector rod, the distal end of the control cable passes through the hard sheath tube and is connected with the distal end of the controllable bending component, and the deflector rod controls the bending direction and the bending degree of the controllable bending component through the control cable. Avoiding iatrogenic injury and bringing convenience to clinical operation.

Description

Bronchoscope sheath and operating device thereof

Technical Field

The invention relates to the technical field of medical equipment, in particular to a bronchoscope sheath and an operating device thereof.

Background

At present, as the application of some complicated airway interventional treatments is mature, the hard bronchoscopes are widely used and are indispensable. However, due to the overall metallic texture of the hard bronchoscope sheath used at present, the hard bronchoscope sheath is very hard, the entry into the glottis under general anesthesia is still a technical difficulty, and mechanical damage is easily caused to the oral cavity, teeth, throat and glottis of a patient. In a similar invention, the patent number 201520501193.9 discloses a bronchoscope sheath, but the bronchoscope sheath is a hard sheath tube, and the end part of the bronchoscope sheath cannot bend into the left main bronchus and the right main bronchus. The patent application number 201720674653.7 discloses a bendable hard bronchoscope which is a bronchoscope, and the bronchoscope is basically eliminated by using an electronic bronchoscope clinically at present. The patent application number 201020509955.7 discloses a soft and hard combined bendable steering endoscope, mainly comprising a rotatable oviduct lens and a ureteroscope, which is not suitable for rotating the bronchoscope. Therefore, it is necessary to provide a bronchoscope sheath and an operating device thereof, which are suitable for diagnosis or treatment of left and right main bronchi after the bronchoscope enters the body.

Disclosure of Invention

The technical problem to be solved by the invention is to provide the bronchoscope sheath and the operating device thereof, wherein the distal end of the bronchoscope sheath can be controlled in a bending way, so that the bronchoscope sheath is suitable for diagnosing or treating left and right main bronchi after the bronchoscope enters a body, and iatrogenic injury can be avoided.

The technical scheme adopted by the invention for solving the technical problems is to provide a bronchoscope sheath, which comprises a deflector rod, a base body, a hard sheath tube, a control cable and a controllable bending part, wherein the base body, the hard sheath tube and the controllable bending part are sequentially connected from a near end to a far end, and communicated cavities are formed in the base body, the hard sheath tube and the controllable bending part to form a scope sheath channel for inserting or extracting an air supply scope; the deflector rod is arranged on the base body, a bronchoscope interface is arranged at the proximal end of the base body and communicated with the scope sheath channel, and an opening from which the far-end mirror surface of the air supply tube mirror extends is arranged at the far-end port of the controllable bending part; the proximal end of the control cable is connected with the deflector rod, the distal end of the control cable passes through the hard sheath tube and is connected with the distal end of the controllable bending component, and the deflector rod controls the bending direction and the bending degree of the controllable bending component through the control cable.

Preferably, the number of the control cables is 2, namely a first control cable and a second control cable; the two ends of the deflector rod are fixedly connected with the first wire wheel and the second wire wheel respectively, the proximal end of the first control cable is wound on the first wire wheel, the proximal end of the second control cable is wound on the second wire wheel, and the winding directions of the first control cable and the second cable are opposite.

Preferably, the distal ends of the first control cable and the second control cable are fixed to the distal end of the controllable bending member, respectively, and the two fixed positions are axially symmetrically distributed.

Preferably, the controllable bending part comprises a movable part and an end part, the proximal end of the movable part is connected with the hard sheath tube, the distal end of the movable part is connected with the end part, the movable part is composed of a plurality of annular hollow parts, and the adjacent hollow parts can be driven to swing along the mutually contacted end surfaces by the pulling force applied on the control cable.

Preferably, a first through hole and a second through hole are formed in the annular wall of the hollow part in a penetrating manner in the axial direction, the first control cable penetrates through the first through hole and the second control cable penetrates through the second through hole to connect a plurality of hollow parts in series, and the first through hole and the second through hole are uniformly distributed in the circumferential direction.

Preferably, the end face of the hollow part is formed with a first concave arc and a second concave arc which are symmetrical along the circumferential direction, the first through hole is positioned at the middle of the first concave arc, and the second through hole is positioned at the middle of the second concave arc.

Preferably, the distal ends of the first control cable and the second control cable are fixed at the distal end of the movable member.

Preferably, a locking knob is arranged outside the deflector rod, the locking knob is in threaded connection with the second wire wheel, and the deflector rod and the base body can be pressed tightly by rotating the locking knob, so that the deflector rod is locked.

Preferably, the base body is provided with a respirator interface, and the respirator interface is communicated with the cavity in the base body and is used for ventilation of the respirator in operation.

Preferably, the respirator interface comprises a first interface and a second interface which are coaxially arranged outside the basal body, the second interface is also communicated with an operation instrument interface, and the operation instrument interface passes through the second interface and is communicated with a cavity in the basal body; or the breathing machine interface is one, and the breathing machine interface and the instrument interface are arranged on two sides of the substrate.

Preferably, the base body comprises a main body section and a first closing-in section, wherein the cross-sectional area of the main body section is larger than that of the hard sheath, and the outer diameter of the first closing-in section gradually decreases from the proximal end to the distal end until the outer diameter of the first closing-in section is the same as that of the hard sheath.

Preferably, the outer diameter of the hard sheath tube is 8mm-14mm, the length of the hard sheath tube in the axial direction is 300mm-600mm, the length of the movable part in the axial direction is 30mm-60mm, and the end part is provided with a bevel which is provided with the opening.

The invention aims to solve the technical problems, and also provides an operating device of a bronchoscope sheath, which comprises a bending driving box, a rotating driving box and a bracket; the bending driving box is matched with the bronchoscope sheath, a space for embedding a matrix of the bronchoscope sheath is formed in the bending driving box, a first driving part is arranged in the bending driving box and used for controlling rotation of the deflector rod, and a third through hole is formed in the bending driving box in an axial direction; the rotary driving box is connected with the bending driving box, a second driving part is arranged in the rotary driving box, the second driving part is connected with the bending driving box and used for controlling the bending driving box to perform rotary motion, the rotary driving box is provided with a fourth through hole which is communicated in the axial direction, and the fourth through hole is communicated with the third through hole; the rotary driving box is connected with the bracket.

Preferably, the bending drive box comprises a first base and a first shell, the first shell is detachably connected with the first base, the first base comprises a bottom side, a first side, a second side, a third side and a fourth side, a space formed by surrounding the bottom side, the first side, the second side, the third side, the fourth side and the first shell can accommodate a matrix of the bronchoscope sheath, the first side of the first base is provided with a first groove, the second side of the first base is provided with a second groove, and the third side of the first base is provided with a third groove; the side wall of the fourth side of the first base is fixed with a first fixing piece, the first driving part is a first motor, the first motor is fixed on the first fixing piece, the proximal end of the fourth side is provided with a second rotating shaft, the center of the second rotating shaft is provided with a third through hole, and the third through hole axially penetrates through the fourth side of the first base.

Preferably, the bending drive box further comprises a first bevel gear and a second bevel gear, the first fixing piece comprises a first fixing portion, a second fixing portion and a third fixing portion, the first fixing portion and the second fixing portion are in an L-shaped arrangement, the first fixing portion is arranged on the proximal side of the second fixing portion, the third fixing portion is arranged on the distal side of the second fixing portion, the first fixing portion is fixed on the side wall of the fourth side, the output end of the first motor passes through the second fixing portion and then is connected with the first bevel gear, the third fixing portion is provided with a first rotating shaft, one end of the first rotating shaft is fixedly provided with the second bevel gear, the second bevel gear is meshed with the first bevel gear, the other end of the first rotating shaft passes through and stretches out of the third fixing portion and then is provided with a shifting piece, and the shifting piece is provided with a fourth groove capable of being nested.

Preferably, the second driving component is a second motor, the rotary driving box comprises a coupler, a first opening is formed in the distal end face of the rotary driving box, the second motor is arranged in the rotary driving box, the proximal end of the coupler is connected with the output end of the second motor, the distal end of the coupler is connected with the second rotating shaft penetrating through the first opening and extending into the rotary driving box, the motor shaft of the second motor is a hollow shaft, and a fourth through hole is formed in a cavity in the hollow shaft.

Preferably, a second fixing part is arranged in the rotary driving box and comprises a fourth fixing part and a fifth fixing part, the fourth fixing part and the fifth fixing part are in L-shaped arrangement, the fourth fixing part is fixedly connected with the rotary driving box shell, a second opening is formed in the fifth fixing part, and the output end of the second motor passes through the second opening and then is connected with the proximal end of the coupler.

Preferably, the support comprises a telescopic support which is connected with the bottom of the rotary drive box and can control the rotary drive box to move along the axial direction.

Preferably, the telescopic bracket comprises a fourth shell, a sliding rail, a sliding block, a driving block, a third motor and a screw rod, wherein the sliding rail is axially arranged on the fourth shell, the sliding block is connected to the sliding rail in a sliding manner, the sliding block is connected with the rotary driving box, the third motor is arranged inside the fourth shell, the screw rod is connected with one end of the driving block, the output end of the third motor is connected with one end of the screw rod, the driving block is in threaded connection with the screw rod, a sliding groove is axially formed in the fourth shell, and the sliding block and the driving block penetrate through the sliding groove to be connected.

Preferably, the sliding block is connected with the rotary driving box through a screw, and the sliding rail is fixed on the fourth shell through a screw.

Preferably, a third fixing piece and a fourth fixing piece are arranged in the fourth shell, and two ends of the screw are respectively connected with the third fixing piece and the fourth fixing piece.

Preferably, the support still includes the runing rest, the bottom of telescopic bracket with the end connection of runing rest, the runing rest includes rotor plate, first adaptor, second adaptor, fourth motor and support main part, the rotor plate has roof, first curb plate and second curb plate, first curb plate with the second curb plate sets up relatively, and all with the roof sets up perpendicularly, be provided with first adaptor on the first curb plate, be provided with the second adaptor on the second curb plate, the fourth motor wears to establish the tip of support main part, the output of fourth motor with first adaptor circumference is connected, the other end of fourth motor with second adaptor circumference is connected, the second adaptor with press between the fourth motor tip and be equipped with first bearing.

Preferably, the device further comprises a trolley, wherein a supporting plate is arranged at the end part of the trolley, a connecting base is arranged at the bottom of the rotating bracket, and the connecting base is connected with the supporting plate.

Preferably, the trolley comprises at least two sections of telescopic rods, a second base is arranged at the bottom end of each telescopic rod, and a plurality of moving wheels are arranged at the bottom of each second base.

Preferably, the bending drive box further comprises an operation handle, and the operation handle is in communication connection with the bending drive box, the rotation drive box and/or the bracket.

Preferably, the display screen is arranged on the operating handle, or the display screen and the operating handle are separately and independently arranged.

Compared with the prior art, the invention has the following beneficial effects: the bronchoscope sheath provided by the invention is provided with the hard sheath tube and the controllable bending part, the bending direction and the bending degree of the controllable bending part are controlled by the control deflector rod and the control cable, and the bronchoscope sheath can enter the left main bronchus and the right main bronchus for diagnosis or treatment. Because the controllable bending part at the far end is arranged into an inclined plane, the glottis can be easily accessed, the iatrogenic injury is avoided, and the clinical operation is convenient. Particularly, the distal end of the sheath can be locked by locking the deflector rod during manual operation, the bending shape of the distal end of the sheath can be maintained, the sheath channel can be ensured, and the device can be used for shoveling focus of left and right bronchi. The operating device provided by the invention can control the movement and rotation of the bronchoscope sheath, realize the automatic operation of the bronchoscope and the bronchoscope sheath, control the rotation of the deflector rod through the bending driving box so as to control the bending direction and the bending degree of the controllable bending part, realize the degree of freedom of the overall rotation direction of the bronchoscope sheath through the rotation driving box, control the depth of the bronchoscope extending into the body and the back and forth plug-in and plug-out of the bronchoscope through the telescopic bracket, control the overall inclination of the bronchoscope sheath in the pitching direction through the rotation bracket, and realize the remote control of the bending driving box, the rotation driving box, the telescopic bracket and the rotation bracket through the operating handle, thereby ensuring the safety in the operation process, reducing the damage of doctors by X-ray radiation, having stronger professionals and practical values.

Drawings

FIG. 1a is a schematic view of the overall structure of a bronchoscope sheath according to an embodiment of the present invention, and FIG. 1b is a schematic view of the overall structure of a bronchoscope sheath according to another embodiment of the present invention;

FIG. 2a is a schematic perspective view of a bronchoscope sheath according to an embodiment of the present invention, and FIG. 2b is a perspective view of a bronchoscope sheath according to another embodiment of the present invention;

FIG. 3 is a schematic view of a control cable and a controllable bending member and an operating handle according to an embodiment of the present invention;

FIG. 4a is an enlarged view of a bronchoscope sheath after rigid sheath truncation according to one embodiment of the present invention, and FIG. 4b is an enlarged view of a bronchoscope sheath after rigid sheath truncation according to another embodiment of the present invention;

FIG. 5 is an enlarged schematic view of the control cable after being cut off and the controllable bending member and the operating handle according to an embodiment of the present invention;

FIG. 6a is a schematic view of the overall structure of the hollow part, FIG. 6b is a side view of the hollow part of FIG. 6a, FIG. 6c is a side view of the distal hollow part, and FIG. 6d is a top view of the hollow part of FIG. 6 a;

FIG. 7 is a schematic illustration of the bending of a cable in series with adjacent hollow members after being subjected to a force;

FIG. 8a is a schematic illustration of a manual insertion of a bronchoscope into a bronchoscope sheath according to an embodiment of the present invention, and FIG. 8b is a schematic illustration taken along line A of FIG. 8 a;

FIG. 9 is a schematic flow chart of a bronchoscope sheath according to an embodiment of the present invention;

fig. 10a is a schematic structural view of an operation device for a bronchoscope sheath according to an embodiment of the present invention, fig. 10b is a schematic structural view of the operation device in fig. 10a after the bronchoscope sheath is assembled, and fig. 10c is a schematic structural view of the operation device in fig. 10b after the bronchoscope sheath is assembled;

fig. 11a is a schematic overall structure of the bending drive box, fig. 11b is a schematic partial structure of the bending drive box in fig. 11a after the first housing is removed, fig. 11c is a perspective view of fig. 11b, and fig. 11d is a schematic partial structure of the first fixing plate;

fig. 12a is a schematic view of the entire structure of the rotary driving case, fig. 12b is a perspective view of fig. 12a, fig. 12c is a schematic view of fig. 12a with the second housing removed, and fig. 12d is a perspective view of fig. 12 c;

fig. 13a is a schematic view showing the overall structure of the bending drive cassette and the rotation drive cassette after being assembled, fig. 13b is a perspective view of fig. 13a, fig. 13c is a schematic view showing the structure of fig. 13a after the first housing is removed and the bronchoscope sheath is assembled, fig. 13d is a sectional view of fig. 13c, and fig. 13e is a partial sectional view of fig. 13 a;

fig. 14a is a schematic view of the overall structure of the telescopic bracket, and fig. 14b is a sectional view of fig. 14 a;

FIG. 15a is a schematic view of the overall structure of the rotary bracket, and FIG. 15b is a partial cross-sectional view of the fourth motor of FIG. 15 a;

FIG. 16 is a schematic view of the overall structure of the carriage;

FIG. 17a is a schematic view of the whole structure of an operation handle, and FIG. 17b is a schematic view of the structure of another operation handle;

FIG. 18 is a schematic illustration of an operator manually manipulating a bronchoscope and its sheath using a bronchoscope sheath;

fig. 19a is a front view of an operator controlling a bronchoscope sheath using an operating device, fig. 19b is a perspective view of an operator controlling a bronchoscope sheath using an operating device, and fig. 19c is a schematic view of an operator controlling a bronchoscope and its sheath using an operating device.

Fig. 20a and 20b are schematic diagrams of an operator remotely controlling a bronchoscope and its sheath using a separate display screen.

In the figure:

1-base, 2-lever, 3-hard sheath, 4-controllable bending part, 5, control cable, 11-bronchoscope interface, 12-ventilator interface, 121-first interface, 122-second interface, 13-instrument interface, 14-first closing-in section, 15-main section, 16-second closing-in section, 21-locking knob, 41-movable part, 42-end part, 43-opening, 411-hollow part, 51-first control cable, 52-second control cable, 61-first wire wheel, 62-second wire wheel, 412-first through hole, 413-second through hole, 414-first concave arc, 415-second concave arc, 10-sheath, 20-bronchoscope, 30-bending drive box, 40-rotary drive box, 50-telescopic bracket, 60-rotary bracket, 70-trolley, 201-guide tube, 31-bottom side, 32-first side, 33-second side, 34-third side, 35-fourth side, 36-space, 37-first fixing piece, 38-first motor, 39-first rotation shaft, 301-first base, 302-first housing, 321-first groove, 331-second groove, 341-third groove, 351-second rotation shaft, 352-third through hole, 381-first bevel gear, 391-second bevel gear, 392-dial, 393-first bearing, 394-fourth groove, 401-second housing, 402-third housing, 403-coupling, 44-fourth through hole, 45-first opening, 46-second motor, 47-second fixing piece, 421-first connecting hole, 461-output end of fourth motor, 471-fourth fixing part, 472-fifth fixing part, 473-second opening, 48-motor wire, 501-fourth shell, 502-slide rail, 53-slide block, 54-connecting plate, 55-driving block, 56-third motor, 57-screw, 521-screw, 531-second connecting hole, 532-slide groove, 58-third fixing piece, 59-fourth fixing piece, 601-rotating plate, 602-second bearing, 603-top plate, 604-first side plate, 605-second side plate, 63-bracket main body, 64-connecting base, 65-fourth motor, 66-output shaft, 67-first adapter, 68-second adapter, 71-support plate, 72-telescopic link, 73-second base, 74-moving wheel, 80, 90-operating handle, 81, 91, 92, 93-operating key, 82, 94-display screen, 100-operating device, 103-patient bed operator, 102-patient.

Detailed Description

The invention is further described below with reference to the drawings and examples.

It should be noted that the terms "inner", "outer", "upper", "lower" and the like are used for the purpose of illustration only and do not represent the only embodiments. The invention uses "distal", "proximal", "axial", wherein "distal" is the side distal from the bronchoscope operator; the "proximal" is the side proximal to the bronchoscope operator and the "axial" is the direction in which the axis of the rigid sheath of the bronchoscope sheath is located or parallel.

Referring to fig. 1a and fig. 2a, the bronchoscope sheath provided by the invention comprises a deflector rod 2, a base body 1, a hard sheath tube 3, a control cable 5 and a controllable bending part 4, wherein the base body 1, the hard sheath tube 3 and the controllable bending part 4 are sequentially connected from a proximal end to a distal end, and a communicating cavity is formed in the base body 1, the hard sheath tube 3 and the controllable bending part 4 to form a sheath channel for inserting or extracting an air supply tube scope. The hard sheath 3 is a metal tube, the material is hard and inflexible, the material can be stainless steel, titanium alloy, tantalum alloy, etc., the controllable bending part 4 comprises a movable part 41 formed by hinging a plurality of annular hollow parts 411, the controllable bending part 4 is also made of metal, and the material can be stainless steel, titanium alloy, tantalum alloy, etc.

The deflector rod 2 is arranged on the base body 1, a bronchoscope interface 11 is arranged at the proximal end of the base body 1, the bronchoscope interface 11 is communicated with the sheath channel, and an opening 43 for extending out of a distal mirror surface of the gas supply tube is arranged at the distal end port of the controllable bending part 4. The proximal end of the control cable 5 is connected with the deflector rod 2, the distal end of the control cable 5 passes through the hard sheath tube 3 to be connected with the distal end of the controllable bending part 4, and the deflector rod 2 controls the bending direction and the bending degree of the controllable bending part 4 through the control cable 5. Therefore, the distal end of the bronchoscope sheath provided by the invention can be bent to reach the left and right main bronchi.

Referring to fig. 3, in a preferred embodiment, the number of control cables 5 is 2, namely a first control cable 51 and a second control cable 52; the first wire wheel 61 and the second wire wheel 62 are connected with the base body 1 through a hinge or a sliding bearing, so that the first wire wheel and the second wire wheel can relatively rotate with the base body 1. The driving lever 2 is fixedly connected with the first wire wheel 61 and the second wire wheel 62 through screw fixation, tight fit, glue joint, welding and the like, so that the driving lever 2 drives the first wire wheel 61 and the second wire wheel 62 to rotate when rotating. The proximal end of the first control cable 51 is wound on the first wire wheel 61, the proximal end of the second control cable 52 is wound on the second wire wheel 62, and the first control cable 51 is opposite to the winding direction of the second cable 52, that is, when the shift lever 2 rotates, one control cable is loosened and the other control cable is wound tightly. The distal ends of the first control cable 51 and the second control cable 52 are fixed to the distal end of the controllable bending member 4, respectively, and the fixed positions are axially symmetrical, i.e. the two fixed positions are symmetrically arranged about the central axis of the controllable bending member 4. The bending direction and the bending degree of the controllable bending member 4 can be controlled by the combined action of the distal ends of the first control cable 51 and the second control cable 52.

Referring to fig. 2a, 4a and 5, in a specific embodiment, the controllable bending member 4 includes a movable member 41 and an end member 42, a proximal end of the movable member 41 is connected to the rigid sheath 3, a distal end of the movable member 41 is connected to the end member 42, and the movable member 41 is formed by hinging a plurality of annular hollow parts 411. The distal ends of the first control cable 51 and the second control cable 52 are fixed to the distal end of the movable member 41. The movable part 41 is composed of a plurality of annular hollow parts 411, and the adjacent hollow parts 411 can be driven to swing along the mutually contacted end surfaces thereof by the pulling force applied on the control cable 5, so that the controllable bending part 4 can be bent in different directions. When the shift lever 2 rotates in the direction shown in fig. 5, the first control cable 61 is tightened, the second control cable 62 is loosened, the controllable bending part 4 rotates upwards, and vice versa, the second control cable 62 is tightened, the first control cable 61 is loosened, the controllable bending part 4 rotates downwards, and in actual operation, the direction of the rotating base body 1 can be matched at the same time, so that the controllable bending part 4 bends in any direction required by a patient. In a specific embodiment, referring to fig. 6a and 6d, a first through hole 412 and a second through hole 413 are axially formed through the annular wall of the hollow part 411, and the first through hole 412 and the second through hole 413 are uniformly distributed along the circumferential direction, that is, the first through hole 412 and the second through hole 413 are located on the same diameter in the top view shown in fig. 6 d. The end surfaces of the hollow parts 411 are circumferentially provided with a first concave arc 414 and a second concave arc 415 which are symmetrical about an AA line, the first through hole 412 is positioned in the middle of the first concave arc 414, the second through hole 413 is positioned in the middle of the second concave arc 415, thus a space swinging along the end surfaces is formed between two adjacent hollow parts 411, and the most distal hollow part 411 is fixedly connected with the end part, preferably in a side view shape shown in fig. 6c, namely, the distal end surface is a plane, so that the most distal hollow part 411 is conveniently fixedly connected with the end part 42; the other hollow part 411 has a side view as shown in fig. 6b, i.e. the end faces of both ends are formed with a first concave arc 414 and a second concave arc 415. Referring to fig. 7, the first control cable 51 passes through the first through hole 412 and the second control cable 52 passes through the second through hole 413 to connect the hollow parts 411 in series, and simultaneously movably connect the proximal end of the movable member 41 with the distal end of the rigid sheath 2, and the pulling force applied to the control cable 5 can drive the adjacent hollow parts 411 to swing along the end surfaces where they contact each other, so as to control the curvature and the bending direction of the movable member 41. Further, the distal end of the movable member 41 is connected to the proximal end of the end member 42 by gluing, welding, tight fitting, or the like.

With continued reference to fig. 4a and fig. 5, further, a locking knob 21 is disposed outside the lever 2, the locking knob 21 is in threaded connection with the second wire wheel 62, and rotating the locking knob 21 can compress the lever 2 with the base 1, so as to lock the lever 2. After the deflector rod 2 is locked, the controllable bending part 4 at the distal end of the sheath can also be locked to maintain the bending shape of the distal end of the sheath, thereby being beneficial to ensuring the sheath channel and being used for removing the focus of left and right bronchi.

With continued reference to fig. 2a, 2b, 4a and 4b, the base 1 is provided with a ventilator interface 12, the ventilator interface 12 is in communication with the cavity in the base 1, and in operation, a ventilator is in communication with the sheath channel via the ventilator interface 12, so as to ventilate a patient. Specifically, in one embodiment, as shown in fig. 2a and 4a, the ventilator interface 12 includes a first interface 121 and a second interface 122 coaxially disposed outside of the base. The second interface 122 is further communicated with an instrument interface 13, the instrument interface 13 passes through the second interface 122 and is communicated with the cavity in the base body 1, an operation instrument can enter the sheath channel to operate through the instrument interface 13, and the instrument interface 13 can also be used as a water injection hole or a working channel of a suction tube. In the manual operation mode, the positions and shapes of the ventilator interface 12 and the instrument interface 13 are not particularly limited as long as the operation is possible. In another embodiment, as shown in fig. 1b, 2b and 4b, in order to match the matching relationship with the automatic operation device, the positions of the ventilator interface 12, the instrument interface 13 and the deflector rod 2 are adjusted, the ventilator interface 12 and the instrument interface 13 are disposed on two sides of the base 1, and are directly communicated with the sheath channel, and the deflector rod 2 is disposed at the proximal end of the base 2.

With continued reference to fig. 2a and 2b, the base 1 includes a main body section 15 and a first closing-in section 14, wherein the cross-sectional area of the main body section 15 is larger than the cross-sectional area of the hard sheath 3, and the outer diameter of the first closing-in section 14 gradually decreases from the proximal end to the distal end until the outer diameter of the first closing-in section 14 is the same as the outer diameter of the hard sheath 3. The section shape of the second closing-in section of the cavity wall in the matrix 1 is gradually reduced from the proximal end to the distal end, which is beneficial to the insertion of the instrument and the bronchoscope. The end piece 42 has a bevel to facilitate passage through the glottis and airway constriction, while also facilitating removal of tumors from the airway wall. The inclined surface is provided with the opening 43, preferably, the outer diameter of the hard sheath tube 3 is 8mm-14mm, the length of the hard sheath tube 3 is 300mm-600mm, and the length of the movable part 41 in the axial direction is 30mm-60mm. In use, referring to fig. 8a and 8b, fig. 8b is an internally expanded view of fig. 8a, with the catheter 201 of the bronchoscope 20 entering the sheath channel and the distal end of the catheter 201 extending from the opening 43 for in vivo detection or surgery.

Referring to fig. 9, the bronchoscope sheath provided by the invention comprises the following steps:

A1, inserting the bronchoscope sheath provided by the invention into the mouth of a patient;

a2, operating the deflector rod to control the remote controllable bending part to bend through the glottis and enter the bronchus to reach the target position.

A3, screwing the locking knob to lock the shape of the controllable bending part;

a4, using a bronchoscope to enter a sheath channel through the bronchoscope interface for insertion or extraction, and performing related diagnosis or treatment operation.

The bronchoscope sheath provided by the invention is provided with the hard sheath tube and the controllable bending part, and the bending direction and the bending degree of the controllable bending part are controlled by the control deflector rod and the control cable, so that the bronchoscope sheath can enter the left and right main bronchus for diagnosis or treatment. Because the controllable bending part at the far end is arranged into an inclined plane, the glottis can be easily accessed, the iatrogenic injury is avoided, and the clinical operation is convenient. Particularly, the distal end of the sheath can be locked by locking the deflector rod, the bending shape of the distal end of the sheath can be maintained, the sheath channel can be ensured, and the sheath can be used for removing focuses of left and right bronchi.

The bronchoscope sheath 10 provided by the invention can be manually operated according to the above manner, and in order to facilitate the operation, a medical staff can conveniently and automatically operate the bronchoscope 20 and the bronchoscope sheath 10 thereof in a remote manner, referring to fig. 10a and 10b, the embodiment also provides an operation device 100 of the bronchoscope sheath, which comprises a bending driving box 30, a rotating driving box 40, a telescopic bracket 50, a rotating bracket 60, a trolley 70 and an operation handle 80 or 90. The bending drive box 30 is matched with the bronchoscope sheath 10, the base body 1 of the bronchoscope sheath 10 is embedded into the bending drive box 30, a first drive component is arranged in the bending drive box 30, and the first drive component is used for controlling the rotation of the deflector rod 2; the rotation driving box 40 is connected with the bending driving box 30, a second driving component is arranged in the rotation driving box 40, and the second driving component is connected with the bending driving box 30 to control the bending driving box 30 to perform rotation motion; the rotary driving box 40 is connected with the telescopic bracket 50, the rotary driving box 40 is controlled to move along the axial direction, the telescopic bracket 50 is connected with the rotary bracket 60, the inclination between the telescopic bracket 50 and the horizontal plane is controlled, and the rotary bracket 60 is connected with the top end of the trolley 70. The bending drive box 30 is provided with a third through hole 352 which is penetrated in the axial direction, the rotating drive box 40 is provided with a fourth through hole 44 which is penetrated in the axial direction, the fourth through hole 44 is communicated with the third through hole 352 and then communicated with the sheath channel, and the conduit 201 of the air supply tube mirror 20 respectively penetrates through the fourth through hole 44 and the third through hole 352 and enters into the sheath channel.

In an embodiment, referring to fig. 11a, the bending drive box 30 includes a first base 301 and a first housing 302, the first housing 302 is detachably connected to the first base 301, the first base 301 includes a bottom side 31, a first side 32, a second side 33, a third side 34, and a fourth side 35, a space 36 defined by the bottom side 31, the first side 32, the second side 33, the third side 34, the fourth side 35, and the first housing 302 can accommodate the base 1 of the bronchoscope sheath 10, the first side 32 of the first base 301 has a first groove 321, the second side 33 of the first base 301 has a second groove 331, and the third side 34 of the first base 301 has a third groove 341; referring to fig. 11b and 11c, a first fixing member 37 is disposed on a side wall of the fourth side 35 of the first base 301, the first driving member is a first motor 38, the first motor 38 is fixed on the first fixing member 37, a second rotating shaft 351 is disposed at a proximal end of the fourth side 35 in a protruding manner, a third through hole 352 is disposed in a center of the second rotating shaft 351, and the third through hole 352 penetrates through the fourth side 35 of the first base 301. Specifically, the first fixing member 37 includes a first fixing portion 371, a second fixing portion 372, and a third fixing portion 373, the first fixing portion 371 and the second fixing portion 372 are L-shaped, the first fixing portion 371 is disposed on a proximal side of the second fixing portion 372, the third fixing portion 373 is disposed on a distal side of the second fixing portion 372, the first fixing portion 371 is fixed on a side wall of the fourth side 35, an output end of the first motor 38 passes through the second fixing portion 372 and then is connected with the first bevel gear 381, the third fixing portion 373 is provided with a first rotary shaft 39, one end of the first rotary shaft 39 is fixedly provided with a second bevel gear 391, the second bevel gear 391 is meshed with the first bevel gear 381, see fig. 11d, a first bearing 393 is disposed between the first rotary shaft 39 and the third fixing portion 373, another end of the first rotary shaft 39 passes through and stretches out of the third fixing portion and then is provided with a pulling plate 392, the pulling plate 392 has a fourth groove, and the pulling plate 392 is rotatably driven by the first bevel gear 381, and the pulling plate is driven by the first bevel gear 381 to rotate by the first motor 394, and the pulling plate 392 is driven by the first bevel gear 381, and the pulling plate 381 is driven by the first bevel gear 381 to rotate by the first rotary shaft 381, and the first bevel gear 381, thereby driving the first bevel gear 381 and the first bevel gear 381 to rotate by the first rotary shaft 394.

Referring to fig. 13c, when the bronchoscope sheath 10 and the bending drive box 30 are assembled, the base 1 is placed in the space 36 formed by the side walls of the first base 301, at this time, the first closing-in section 14 of the bronchoscope sheath 10 is placed in the first groove 321, the instrument interface 13 is placed in the second groove 331, the ventilator interface 12 is placed in the third groove 341, the deflector rod 2 is embedded in the fourth groove 394 of the deflector plate 392, the size of the first groove 321 is smaller than that of the base 1, the first groove 321 and the fourth side 35 limit the bronchoscope sheath 10 in the axial direction, and after the first housing 302 is covered, the base 1 of the bronchoscope sheath 10 is completely limited in the space 36 of the bending drive box 30.

Referring to fig. 12a, 12b, 12c and 12d, the rotary driving box 40 includes a rotary driving box housing, preferably, the rotary driving box housing includes a second housing 401 and a third housing 402, the second driving part is a second motor 46, the rotary driving box 40 includes a coupler 403, a first opening 45 is disposed on a distal end surface of the rotary driving box 40, the second motor 46 is disposed in the rotary driving box 40, a proximal end of the coupler 403 is connected to an output end 461 of the second motor 46, a distal end of the coupler 403 is connected to a second rotating shaft 351 of the curved driving box 30 penetrating through the first opening 45 and extending into the rotary driving box 40, and a motor shaft of the second motor 46 is a hollow shaft, and a cavity in the hollow shaft forms a fourth opening 44.

The second fixing member 47 is disposed in the rotary driving box 40, specifically, the second fixing member 47 includes a fourth fixing portion 471 and a fifth fixing portion 472, the fourth fixing portion 471 and the fifth fixing portion 472 are disposed in an L-shape, the fourth fixing portion 471 is fixedly connected with an inner wall of the third housing 402, the fifth fixing portion 472 is provided with a second opening 473, a proximal end of the second motor 46 is connected to an inner side of a proximal end face of the third housing 402, and an output end 461 of the second motor 46 passes through the second opening 473 and is connected to a proximal end of the coupling 403.

Referring to fig. 13a, 13b, 13c and 13d, the proximal end of the bending driving box 30 and the distal end of the rotating driving box 40 are close together, a second rotating shaft 351 on the proximal end surface of the bending driving box 30 passes through the first opening 45 and then enters the rotating driving box 40 to be connected with the coupling 403, the fourth through hole 44 is communicated with the third through hole 352, and under the control of the second motor 46, the coupling 403 drives the second rotating shaft 351 to rotate, so as to drive the bending driving box 30 to perform a rotating motion in the circumferential direction, thereby controlling the distal controllable bending part 4 to bend at any position in the circumferential direction.

The stand comprises a telescopic stand 50 and a rotary stand 60, please refer to fig. 14a, the telescopic stand 50 is connected with the bottom of the rotary driving box 40 and can control the rotary driving box 40 to move along the axial direction, the bottom of the telescopic stand 50 is connected with the end of the rotary stand 60, the rotary stand 60 controls the telescopic stand 50 to rotate along the pitching direction, the inclination of the telescopic stand 50 is adjusted, and finally the inclination angle of the bronchoscope sheath 10 relative to the horizontal plane is controlled.

Referring to fig. 14a and 14b, the telescopic bracket 50 includes a fourth housing 501, a sliding rail 502, a sliding block 53, a driving block 55, a third motor 56 and a screw 57, where the sliding rail 502 is disposed on the surface of the fourth housing 501 along the axial direction, the sliding block 53 is slidingly connected to the sliding rail 502, the sliding block 53 is fixedly connected to the rotary driving box 40, the third motor 56, the screw 57 and the driving block 55 are disposed inside the fourth housing 501, the screw 57 extends along the axial direction, an output end of the third motor 56 is connected with one end of the screw 57, the driving block 55 is in threaded connection with the screw 57, and the fourth housing 501 is axially provided with a sliding groove 532, and the sliding block 53 and the driving block 55 penetrate through the sliding groove 532 to be connected. Preferably, the top surface of the slider 53 has a second connection hole 531, the bottom surface of the third housing 402 of the rotary driving box 40 has a first connection hole 421, a screw passes through the first connection hole 421 and the second connection hole 531 to fixedly connect the bottom surface of the rotary driving box 40 and the top surface of the slider 53, and the slide rail 502 is fixed on the fourth housing 501 by the screw 521, and the connection manner between these components is not particularly limited as long as the connection is possible. Further, a third fixing member 58 and a fourth fixing member 59 are disposed in the fourth housing 501, and two ends of the screw 57 are respectively connected to the third fixing member 58 and the fourth fixing member 59. When the bronchoscope is in operation, the third motor 56 drives the screw 57 to rotate, the screw 57 drives the driving block 55 to move along the axial direction when rotating, the driving block 55 drives the sliding block 53 to move along the axial direction, and the sliding block 53 drives the rotary driving box 40 to move along the axial direction, so that the depth of the distal end of the catheter 201 of the bronchoscope 20 entering the body and the back and forth insertion and extraction are controlled.

Referring to fig. 15a and 15b, in a specific embodiment, the rotating bracket 60 includes a rotating plate 601, a first adapter 67, a second adapter 68, a fourth motor 65, a bracket main body 63 and a connection base 64, the rotating plate 601 has a top plate 603, a first side plate 604 and a second side plate 605, the first side plate 604 and the second side plate 605 are opposite to each other and are perpendicular to the top plate 603, a connecting plate 54 is disposed at the bottom of the telescopic bracket 50, the connecting plate 54 is connected with the top plate 603, a first adapter 67 is disposed on the first side plate 604, a second adapter 68 is disposed on the second side plate 605, the fourth motor 65 is disposed at an end of the bracket main body 63 in a penetrating manner, an output shaft 66 of the fourth motor 65 is connected with the first adapter 67, the other end of the fourth motor 65 is connected with the second adapter 68, a second bearing 602 is disposed between the second adapter 68 and the end of the fourth motor 65 in a pressing manner, and when in operation, the fourth motor 65 drives the fourth motor 65 to rotate along the bottom of the telescopic bracket 54, the second adapter 68 is connected with the top plate 603, the second adapter 68 is disposed on the side of the support body, and the fourth motor 65 is disposed on the side of the support body, and the support body.

Referring to fig. 16, the trolley 70 includes a support plate 71, a telescopic rod 72 and a second base 73, the end of the trolley 70 is provided with the support plate 71, the bottom of the rotating bracket 60 is provided with the connection base 64, the connection base 64 is connected with the support plate 71, meanwhile, the support plate 71 can be provided with an operating handle 80 or 90, preferably, the trolley 70 includes at least two telescopic rods 72, the bottom ends of the telescopic rods 72 are connected with the second base 73, the height of the operating device 100 can be adjusted, the specific structure of the telescopic rods 72 is not particularly limited, so long as the telescopic rods can realize up-down telescopic operation, the height can be adjusted, the bottom of the second base 73 is provided with a plurality of moving wheels 74, the moving wheels 74 are preferably universal wheels, and the moving wheels 74 are locked when the brake button is in a pressed state, and the operating safety is ensured.

Referring to fig. 17a and 17b, the operating handle provided in this embodiment may have two structures, one is the operating handle 80 shown in fig. 17a, and the operating handle 80 is provided with a display 82 and an operating key 81. One is an operation handle 90 as shown in fig. 17b, the operation handle 90 and a display 94 are separately and independently provided, and the operation handle 90 is provided with operation keys 91, 92 or 93 as shown in fig. 20a and 20 b. The operation keys 81, 91, 92, 93 may be set according to specific needs, and this embodiment is not particularly limited. The operation handle 80 or 90 is communicatively connected to the bending driving box 30, the rotation driving box 40, the telescopic bracket 50 and/or the rotation bracket 60, and the first motor 38, the second motor 46, the third motor 56 and the fourth motor 65 can be remotely controlled by the operation handle 80 or 90 to control the direction and the position of the bronchoscope 20 and the sheath 10 thereof in each degree of freedom so as to meet the diagnosis and treatment requirements.

Referring to fig. 18, if the operating device 100 is not used, the operator 101 may use a manual operation mode, and after the patient 102 is lying on the patient bed 103, the operator 101 operates the bronchoscope 20 and the sheath 10 thereof, specifically, the direction, the position and the curvature of the distal end of the bronchoscope sheath 10 in the body may be controlled by rotating the sheath 10 in the circumferential direction and rotating the shift lever 2.

Referring to fig. 19a, 19b and 19c, the operation device 100 is used to control the bronchoscope 20 and the sheath 10 thereof, so that automatic operation and remote control can be realized, after the patient 102 is lying on the hospital bed 103, the operator 101 remotely controls the bending driving box 30 to control the rotation of the deflector rod 2 through the operation handle 80 or 90, controls the rotation of the sheath 10 in the circumferential direction through the rotation driving box 40, controls the depth of the sheath 10 entering the body and back and forth insertion and extraction through the telescopic bracket 50, and controls the inclination of the sheath 10 relative to the horizontal plane through the rotation bracket 60. Thereby enabling diagnosis or treatment of the left and right bronchi after the distal end of the bronchoscope 20 and the scope sheath 10 have been introduced into the body of the patient 102.

Therefore, the operating device provided by the invention can control the movement and rotation of the bronchoscope sheath, realize the automatic operation of the bronchoscope, control the rotation of the deflector rod through the bending driving box so as to control the bending direction and the bending degree of the controllable bending part, realize the degree of freedom of the overall rotation direction of the bronchoscope sheath through the rotation driving box, control the depth of the bronchoscope extending into the body and the back and forth plug-in and plug-out of the bronchoscope through the telescopic bracket, control the overall inclination of the bronchoscope sheath in the pitching direction through the rotation bracket, and the bending driving box, the rotation driving box, the telescopic bracket and the rotation bracket can be remotely operated through the operating handle, thereby ensuring the safety in the operation process, reducing the damage of doctors by X-ray radiation, having stronger specialization and practical value.

While the invention has been described with reference to the preferred embodiments, it is not intended to limit the invention thereto, and it is to be understood that other modifications and improvements may be made by those skilled in the art without departing from the spirit and scope of the invention, which is therefore defined by the appended claims.

Claims

1. The bronchoscope sheath is characterized by comprising a deflector rod, a base body, a hard sheath tube, a control cable and a controllable bending part, wherein the base body, the hard sheath tube and the controllable bending part are sequentially connected from a proximal end to a distal end, and communicated cavities are formed in the base body, the hard sheath tube and the controllable bending part to form a sheath channel for inserting or extracting an air supply tube scope;

the deflector rod is arranged on the base body, a bronchoscope interface is arranged at the proximal end of the base body and communicated with the scope sheath channel, and an opening from which the far-end mirror surface of the air supply tube mirror extends is arranged at the far-end port of the controllable bending part;

the proximal end of the control cable is connected with the deflector rod, the distal end of the control cable passes through the hard sheath tube and is connected with the distal end of the controllable bending component, and the deflector rod controls the bending direction and the bending degree of the controllable bending component through the control cable.

2. The bronchoscope sheath of claim 1, wherein the number of control cables is 2, a first control cable and a second control cable, respectively; the two ends of the deflector rod are fixedly connected with the first wire wheel and the second wire wheel respectively, the proximal end of the first control cable is wound on the first wire wheel, the proximal end of the second control cable is wound on the second wire wheel, and the winding directions of the first control cable and the second control cable are opposite.

3. The bronchoscope sheath according to claim 2, wherein the distal ends of said first control cable and said second control cable are each fixed to the distal end of said controllable curved member with the two fixed positions being axially symmetrically distributed.

4. A bronchoscope sheath according to claim 3, wherein said controllably bending member comprises a movable member and an end member, a proximal end of said movable member being connected to said rigid sheath, a distal end of said movable member being connected to said end member, said movable member being comprised of a plurality of hollow members having a loop shape, said movable member being adapted to oscillate along their mutually contacting end surfaces upon application of tension to said control cable.

5. The bronchoscope sheath according to claim 4, wherein a first through hole and a second through hole are formed in the annular wall of the hollow part in a penetrating manner in the axial direction, the first control cable penetrates through the first through hole and the second control cable penetrates through the second through hole to connect the hollow parts in series, and the first through hole and the second through hole are uniformly distributed in the circumferential direction.

6. The bronchoscope sheath according to claim 5, wherein the end face of the hollow part is formed with a first concave arc and a second concave arc which are symmetrical along the circumferential direction, the first through hole is positioned at the middle of the first concave arc, and the second through hole is positioned at the middle of the second concave arc.

7. The bronchoscope sheath according to claim 4, wherein distal ends of said first control cable and said second control cable are secured to distal ends of said movable member.

8. The bronchoscope sheath according to claim 2, wherein a locking knob is arranged outside the deflector rod, the locking knob is in threaded connection with the second wire wheel, and the deflector rod and the basal body can be pressed tightly by rotating the locking knob, so that the deflector rod is locked.

9. The bronchoscope sheath according to claim 1, wherein a ventilator interface is provided on said base, said ventilator interface being in communication with a cavity in said base for ventilation of a ventilator during surgery.

10. The bronchoscope sheath of claim 9, wherein the ventilator interface comprises a first interface and a second interface coaxially disposed outside of the base, the second interface further communicating with an operating instrument interface disposed through the second interface and communicating with a cavity within the base; or the breathing machine interface is one, and the breathing machine interface and the instrument interface are arranged on two sides of the substrate.

11. The bronchoscope sheath of claim 10, wherein the base comprises a main body section and a first necked-in section, the main body section having a cross-sectional area greater than a cross-sectional area of the rigid sheath, the first necked-in section having an outer diameter that tapers from a proximal end to a distal end until the first necked-in section has an outer diameter that is the same as the outer diameter of the rigid sheath.

12. The bronchoscope sheath according to claim 4, wherein said rigid sheath has an outer diameter of 8mm to 14mm, said rigid sheath has an axial length of 300mm to 600mm, said movable member has an axial length of 30mm to 60mm, said end member has a bevel with said opening.

13. An operating device for a bronchoscope sheath according to any one of claims 1 to 12, comprising a bending drive box, a rotation drive box and a bracket;

the bending driving box is matched with the bronchoscope sheath, a space for embedding a matrix of the bronchoscope sheath is formed in the bending driving box, a first driving part is arranged in the bending driving box and used for controlling rotation of the deflector rod, and a third through hole is formed in the bending driving box in an axial direction;

the rotary driving box is connected with the bending driving box, a second driving part is arranged in the rotary driving box, the second driving part is connected with the bending driving box and used for controlling the bending driving box to perform rotary motion, the rotary driving box is provided with a fourth through hole which is communicated in the axial direction, and the fourth through hole is communicated with the third through hole;

the rotary driving box is connected with the bracket.

14. The manipulating device according to claim 13, wherein the bending drive box comprises a first base and a first housing, the first housing being detachably connected to the first base, the first base comprising a bottom side, a first side, a second side, a third side, and a fourth side, the bottom side, the first side, the second side, the third side, the fourth side, and the first housing enclosing a space configured to receive the base of the bronchoscope sheath, the first side of the first base having a first recess, the second side of the first base having a second recess, the third side of the first base having a third recess; the side wall of the fourth side of the first base is fixed with a first fixing piece, the first driving part is a first motor, the first motor is fixed on the first fixing piece, the proximal end of the fourth side is provided with a second rotating shaft, the center of the second rotating shaft is provided with a third through hole, and the third through hole axially penetrates through the fourth side of the first base.

15. The operating device according to claim 14, wherein the bending drive box further comprises a first bevel gear and a second bevel gear, the first fixing member comprises a first fixing portion, a second fixing portion and a third fixing portion, the first fixing portion and the second fixing portion are arranged in an L-shaped manner, the first fixing portion is arranged on a proximal side of the second fixing portion, the third fixing portion is arranged on a distal side of the second fixing portion, the first fixing portion is fixed on a side wall of the fourth side, an output end of the first motor passes through the second fixing portion and then is connected with the first bevel gear, the third fixing portion is provided with a first rotating shaft, one end of the first rotating shaft is fixedly provided with the second bevel gear, the second bevel gear is in meshed connection with the first bevel gear, the other end of the first rotating shaft penetrates through and extends out of the third fixing portion and then is provided with a pulling piece, and the pulling piece is provided with a fourth groove capable of nesting the pulling lever.

16. The operation device according to claim 14, wherein the second driving member is a second motor, the rotary driving case includes a coupling, a first opening is provided on a distal end face of the rotary driving case, the second motor is provided in the rotary driving case, a proximal end of the coupling is connected to an output end of the second motor, a distal end of the coupling is connected to the second rotation shaft extending into the rotary driving case through the first opening, a motor shaft of the second motor is a hollow shaft, and a cavity in the hollow shaft forms a fourth through hole.

17. The operation device according to claim 16, wherein a second fixing member is disposed in the rotary driving box, the second fixing member includes a fourth fixing portion and a fifth fixing portion, the fourth fixing portion and the fifth fixing portion are disposed in an L-shape, the fourth fixing portion is fixedly connected with the rotary driving box housing, a second opening is formed in the fifth fixing portion, and an output end of the second motor passes through the second opening and is connected with a proximal end of the coupling.

18. The operating device of claim 13, wherein the bracket comprises a telescoping bracket coupled to the bottom of the rotary drive box and operable to move the rotary drive box in an axial direction.

19. The operating device according to claim 18, wherein the telescopic bracket comprises a fourth housing, a sliding rail, a sliding block, a driving block, a third motor and a screw rod, wherein the sliding rail is axially arranged on the fourth housing, the sliding block is slidingly connected on the sliding rail and is connected with the rotary driving box, the third motor, the screw rod and the driving block are arranged inside the fourth housing, the output end of the third motor is connected with one end of the screw rod, the driving block is in threaded connection with the screw rod, a sliding groove is axially formed in the fourth housing, and the sliding block and the driving block are connected through the sliding groove.

20. The operating device of claim 19, wherein the slider is screwed to the rotary drive box and the slide rail is screwed to the fourth housing.

21. The operating device of claim 19, wherein a third fixing member and a fourth fixing member are provided in the fourth housing, and both ends of the screw are connected to the third fixing member and the fourth fixing member, respectively.

22. The operating device of claim 18, wherein the bracket further comprises a swivel bracket, the bottom of the telescoping bracket being connected to an end of the swivel bracket; the rotary support comprises a rotary plate, a first adapter, a second adapter, a fourth motor and a support main body, wherein the rotary plate is provided with a top plate, a first side plate and a second side plate, the first side plate and the second side plate are oppositely arranged and are perpendicular to the top plate, the first side plate is provided with the first adapter, the second side plate is provided with the second adapter, the fourth motor penetrates through the end part of the support main body, the output end of the fourth motor is connected with the first adapter in the circumferential direction, the other end of the fourth motor is connected with the second adapter in the circumferential direction, and a first bearing is arranged between the second adapter and the end part of the fourth motor in a pressing mode.

23. The manipulating device according to claim 18, further comprising a trolley, wherein a support plate is provided at an end of the trolley, and wherein a connection base is provided at a bottom of the rotating bracket, and wherein the connection base is connected to the support plate.

24. The handling device of claim 23, wherein the trolley comprises at least two telescoping rods, a second base is provided at a bottom end of the telescoping rods, and a plurality of moving wheels are provided at a bottom of the second base.

25. The operating device of claim 13, further comprising an operating handle communicatively coupled to the bend drive box, the rotation drive box, and/or the bracket.

26. The operating device of claim 25, further comprising a display screen disposed on the operating handle or the display screen and the operating handle are disposed separately and independently.