CN115068115A - Mechanical arm assembly and endoscopic surgery auxiliary instrument - Google Patents

Mechanical arm assembly and endoscopic surgery auxiliary instrument Download PDF

Info

Publication number
CN115068115A
CN115068115A CN202210829699.7A CN202210829699A CN115068115A CN 115068115 A CN115068115 A CN 115068115A CN 202210829699 A CN202210829699 A CN 202210829699A CN 115068115 A CN115068115 A CN 115068115A
Authority
CN
China
Prior art keywords
actuation
elastic tube
slider
distal
tube
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN202210829699.7A
Other languages
Chinese (zh)
Inventor
皇建
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Shenzhen Robo Medical Technology Co ltd
Original Assignee
Shenzhen Robo Medical Technology Co ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shenzhen Robo Medical Technology Co ltd filed Critical Shenzhen Robo Medical Technology Co ltd
Priority to CN202210829699.7A priority Critical patent/CN115068115A/en
Publication of CN115068115A publication Critical patent/CN115068115A/en
Pending legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/37Master-slave robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00269Type of minimally invasive operation endoscopic mucosal resection EMR
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/0034Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope

Abstract

The elastic tube piece of the mechanical arm assembly comprises a proximal section and a distal section which are different in flexibility, the distal section of the proximal section is difficult to bend, and the proximal section and the distal section are spiral tubes formed by spirally winding metal wires. In order to make the proximal end of the elastic tube member before entering the body lumen and the distal end for performing the surgical operation exhibit different bending characteristics, the flexibility of the proximal end section and the flexibility of the distal end section are changed by the difference in the sectional shape of the metal wire constituting the spiral tube, thereby being easily controlled to reach a desired surgical site when applied to a robot arm assembly of an endoscopic surgical robot.

Description

Mechanical arm assembly and endoscopic surgery auxiliary instrument
Technical Field
The invention relates to a mechanical arm assembly applied to an endoscopic surgery robot and an endoscopic surgery auxiliary instrument.
Background
Endoscopic surgery is a technique for performing examination and treatment intuitively using endoscopes (including soft endoscopes and hard endoscopes) that can be fed into body lumens. The endoscopic surgery through the digestive tract usually adopts a soft endoscope, and the pain of a patient is reduced because an incision does not need to be formed on the skin of the patient.
The morbidity and mortality of malignant tumors of the digestive tract (gastric cancer, esophageal cancer and colon cancer) are in the prostate, early diagnosis and treatment are the core for improving the survival rate, and minimally invasive treatment such as Endoscopic Submucosal Dissection (ESD) and the like is a standard treatment mode of the early tumors of the digestive tract at present, so that more early digestive tract cancers can be completely resected under an endoscope by ESD at one time, and the pain of an open surgery and the resection of organs are avoided.
Although being the mainstream treatment mode of digestive tract superficial lesions, ESD has the advantages of small wound, quick recovery, low cost and the like; it is inherently a complex technique that requires an endoscope to perform. Most of common soft endoscopes are single channels, namely only one surgical instrument channel, and due to lack of corresponding matching in the surgical operation process, a mucous membrane peeling surface cannot be effectively exposed, so that the surgical field is unclear. ESD remains a relatively difficult procedure for most endoscopists, and is prone to serious complications such as bleeding, perforation, etc.
It is well known that good surgical field is key to reducing complications. In contrast, domestic and foreign endoscopists make a lot of attempts and researches on improving the operability and safety of endoscopes: if methods such as titanium clip thin rope traction, external magnetic anchoring and the like appear in the aspect of increasing mucous membrane traction, although the operative field of a mucous membrane stripping surface can be enhanced to a certain extent, a specially designed endoscope is required, and the defects that the traction force and direction cannot be adjusted, the traction force disappears gradually along with the operation and the like exist at the same time.
In the technical scheme disclosed in the chinese patent application No. 202210489369.8, "endoscope adapter and endoscopic surgery auxiliary instrument", the elastic tube of the mechanical arm assembly is a spiral tube with the same shape and material, and during use, because the flexibility of the near end and the far end of the spiral tube is consistent, when the requirement that the far end is easy to bend is met, the part of the near end, which is left outside the body cavity, of the elastic tube is too bent due to the same easy bending, so that the mechanical arm assembly is difficult to control; while the proximal end is inflexible, the distal end is not able to meet the deflection requirements of the robotic arm assembly because it is also inflexible.
Disclosure of Invention
The invention provides a mechanical arm assembly suitable for accurately controlling an endoscopic surgery robot and an endoscopic surgery auxiliary instrument.
A robotic arm assembly, the robotic arm assembly comprising:
an end effector;
an elastic tube member including a proximal section and a distal section having different flexibilities, the proximal section being less bendable than the distal section, the proximal section and the distal section each being a helical tube formed by spirally winding a metal wire;
a first actuation cord extending through the elastic tube and having a distal end connected to the end effector for actuating the end effector to perform a surgical procedure;
at least two second actuation cords, the second actuation cords being positioned outside the elastic tube and distal ends of the second actuation cords being coupled to the distal end of the elastic tube to actuate distal deflection of the elastic tube.
Preferably, the cross-sectional shape of the wire forming the helical tube is different to vary the flexibility of the proximal section and the flexibility of the distal section.
Preferably, the cross-sectional shape of the metal wire of the proximal end section is rectangular, and the cross-sectional shape of the metal wire of the distal end section is circular.
Preferably, the proximal section and the distal section are connected through an intermediate tube.
An endoscopic surgical assist device, comprising:
an endoscope adapter for connection with a distal end of an insertion portion of an endoscope;
a manipulator;
a sheath tube for forming a communication channel between the outer channel of the endoscope adapter and the manipulator; and
the robotic arm assembly as described above, comprising an end effector, an elastic tube, a first actuation cord, and at least two second actuation cords, the elastic tube passing through the communication channel of the sheath, a distal end of the elastic tube extending out of the sheath, and a proximal end of the elastic tube being operably connected to the manipulator; the first actuation cable is threaded through the elastic tube, a distal end of the first actuation cable is connected to the end effector, and a proximal end of the first actuation cable is operably connected to the manipulator; the second actuation cord is threaded through the sheath and out of the elastic tube, a distal end of the second actuation cord is connected to a distal end of the elastic tube, and a proximal end of the second actuation cord is operably connected to the manipulator to actuate deflection of the distal end of the elastic tube toward an axial center of the inner set of the endoscope adapter.
Preferably, the second actuating rope jacket is provided with a polytetrafluoroethylene tube.
Preferably, the communication channel of the sheath includes an elastic tube channel for passing the elastic tube therethrough and a second actuation rope channel for passing the second actuation rope therethrough, the second actuation rope channel being arranged at a distance from the elastic tube channel.
Preferably, a reel or a slider is arranged in the manipulator, the proximal end of the actuating rope is connected with the reel or the slider, the reel or the slider is detachably coupled with a connecting piece at the output end of the driving device, when the endoscopic surgery auxiliary instrument is coupled with the driving device, the driving device drives the endoscopic surgery auxiliary instrument to perform operation, and when the endoscopic surgery auxiliary instrument is decoupled and separated from the driving device, the endoscopic surgery auxiliary instrument and the driving device do not operate together.
Preferably, the manipulator includes a first slider connected to the proximal end of the elastic tube, a second slider connected to the proximal end of the first actuation cord, a third slider connected to the proximal end of the second actuation cord, and a base provided with a track, and the first slider, the second slider, and the third slider are respectively driven to slide along the corresponding track on the base.
Preferably, the manipulator includes a first slider connected to the proximal end of the elastic tube, a second slider connected to the proximal end of the first actuating cord, a reel connected to the proximal end of the second actuating cord, and a base provided with a track, and the first slider and the second slider are respectively driven to slide along the corresponding track on the base; the reel is connected with the base through a mandrel, and the reel can be driven to rotate around the mandrel.
Preferably, the end effector includes a four-bar linkage in which a first link and a second link are connected by a first pivot pin, and a third link and a fourth link are connected by a second pivot pin, a distal end of the first actuation cord is connected to the second pivot pin, a distal end of the elastic tube is connected to the first pivot pin by a forked link, and the first link and the second link extend to form the forceps, respectively.
In order to realize the accurate control of the endoscopic surgical robot, the elastic tube of the mechanical arm assembly comprises a proximal section and a distal section which have different flexibility, the distal section of the proximal section is difficult to bend, and the proximal section and the distal section are spiral tubes formed by spirally winding metal wires. In order to make the proximal end of the elastic tube member before entering the body cavity and the distal end for performing the surgical operation exhibit different bending characteristics, the flexibility of the proximal section and the flexibility of the distal section are changed by the difference in the sectional shape of the metal wire constituting the helical tube. For example, the cross-sectional shape of the metal wire of the proximal section is rectangular, and the cross-sectional shape of the metal wire of the distal section is circular. When the section of the metal wire at the proximal section is rectangular, the contact area of the adjacent metal wires is large, the wound spiral tube is not easy to bend, the proximal end before entering the body cavity is not easy to drop and bend, and the influence on the precise control of the endoscopic surgical robot is small; when the cross-sectional shape of the wire of the distal segment is circular, the contact area of adjacent wires is small, and the coiled coil is easily bent, thereby being easily controlled to reach a desired surgical site when applied to a robot arm assembly of an endoscopic surgical robot.
Drawings
Fig. 1 is a schematic perspective view of an endoscopic surgery assistance apparatus according to an embodiment of the present invention;
FIG. 2 is a schematic view of an endoscopic surgery auxiliary instrument applied to a robotic arm cart according to an embodiment of the present invention;
FIG. 3 is a schematic view of the distal end of an endoscopic surgical assistance instrument in accordance with an embodiment of the present invention;
figures 4-6 are schematic views of an endoscope adapter according to one embodiment of the present invention;
FIG. 7 is a schematic view of the construction of an inner sleeve of an endoscope adapter according to an embodiment of the present invention;
FIG. 8 is a schematic view of the outer sleeve member of the endoscope adapter according to one embodiment of the present invention;
FIG. 9 is a perspective view of an endoscope adapter (without an internal member) and a sheath according to an embodiment of the present invention;
figure 10 is a top view of an endoscopic adapter and sheath in a coupled relationship in accordance with one embodiment of the present invention;
FIG. 11 is a schematic view of the distal end of the robotic arm assembly in accordance with one embodiment of the present invention;
FIG. 12 is a schematic view of the mechanical arm assembly in a sheath connection (distal position) according to one embodiment of the present invention;
FIG. 13 is an illustration of an end effector of one embodiment of the present invention being a clamp;
FIG. 14 is a perspective view of a forked connection member of the end effector of the above-described embodiment of the present invention;
fig. 15 is a schematic view of the internal structure of the manipulator according to an embodiment of the present invention;
fig. 16 is a perspective view of a first slide of the manipulator according to the above embodiment of the present invention;
fig. 17 is a perspective view of a second slide of the manipulator according to the above embodiment of the invention;
fig. 18 is a perspective view of a third slide of the manipulator according to the above embodiment of the invention;
fig. 19 is a schematic view of the actuation principle of the manipulator of the above embodiment of the present invention;
fig. 20 is a schematic view of an actuation principle of a manipulator according to another embodiment of the present invention;
fig. 21 is a schematic structural diagram of an elastic tube according to an embodiment of the present invention.
Reference numerals: 1. an endoscopic surgery auxiliary instrument; 10. an endoscope adapter; 11. an inner sleeve member; 110. an inner channel; 111. an inner sleeve body; 112. an axial limiting block; 113. a circumferential limiting block; 114. a limiting ring; 115. a limiting groove; 12. an outer sleeve member; 120. an outer channel; 121. an outer casing; 1210. a transverse bore; 1211. a smaller head; 1212. a larger head; 1213. a distal end face; 1214. a groove; 122. a separator; 1220. an upper surface; 123. sleeving a hole; 124. accommodating a tank; 20. a mechanical arm assembly; 21. a first actuation cord; 22. an end effector; 220. clamping; 221. a first link; 222. a second link; 223. a third link; 224. a fourth link; 225. a first pivot pin; 226. a second pivot pin; 227. a forked connector; 2271. a tube portion; 2272. an arm portion; 23. an elastic tube member; 231. a proximal segment; 232. a distal segment; 24. a second actuation cord; 30. a manipulator; 31. a first slider; 311. a first through hole; 312. a first protrusion; 313. a first channel; 314. a first fastening hole; 32. a second slider; 321. a second through hole; 322. a second protrusion; 323. a second channel; 324. a second fastening hole; 33. a third slider; 331. a third through hole; 332. a third protrusion; 333. a fixing hole; 34. a base; 340. a track; 341. a guide bar; 342. a guide groove; 343. a connecting pipe; 35. a reel; 40. a sheath tube; 400. a communication channel; 410. an elastic tube passage; 420. a second actuation cord channel; 50. a mechanical arm vehicle; 51. a main manipulator; 52. a driving device.
Detailed Description
It should be noted that the embodiments and features of the embodiments may be combined with each other without conflict. The present invention will be described in detail below with reference to the embodiments with reference to the attached drawings.
In the present invention, unless stated to the contrary, use of the directional terms "upper, lower, left, right" generally refer to the orientation as shown in the drawings, or to the orientation of the component itself as being vertical, perpendicular, or gravitational; likewise, for ease of understanding and description, "inner and outer" refer to the inner and outer relative to the profile of the components themselves, but the above directional words are not intended to limit the invention.
It should also be noted that, in the description of the present invention, unless otherwise explicitly specified or limited, the terms "connected" and "connected" are to be interpreted broadly, e.g., as being either fixedly connected, detachably connected, or integrally connected; the two components can be directly connected or indirectly connected through an intermediate medium, and the two components can be communicated with each other. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.
As shown in fig. 4 to 6, an endoscope adapter 10 according to one embodiment of the present invention includes an inner sheath member 11 and an outer sheath member 12. The inner sleeve member 11 has an inner passage 110 for receiving the distal end of the insertion portion of the endoscope. The outer sleeve member 12 is sleeved outside the inner sleeve member 11 to form an outer channel 120 between the outer sleeve member 12 and the inner sleeve member 11, the outer channel 120 being used for advancing and retracting the robot arm assembly 20 with the end effector 22. In this manner, the endoscope adapter 10 provides a reliable external channel outside of the original working channel of the soft endoscope, allowing the end effector at the distal end of the robotic arm assembly to reach a desired position along with the distal end of the insertion portion of the endoscope to assist in performing a surgical procedure.
As shown in fig. 8, the outer sleeve 12 of the endoscope adapter 10 includes an outer sleeve 121 and a partition 122 extending from the outer sleeve 121 to the inner sleeve 11, the outer channel 120 penetrates the partition 122, and the partition 122 is used for limiting the inner sleeve 11 and the outer channel 120. In other words, the inner space of the outer casing 121 can be divided into two parts fixed in position by the partition 122, namely, the outer passage 120 and the fitting hole 123 for fitting to the inner sleeve 11.
As shown in FIG. 6, which is an example of the outer peripheral cross section of the outer sleeve 121, it is understood that the outer peripheral cross section of the outer sleeve 121 is only required to allow the distal end of the insertion portion of the endoscope and the arm assembly to be parallel at the same time and to obtain a minimum cross section. Therefore, the outer casing 121 may have a cross section of a small circle and a large circle which are tangent or connected to each other. Moreover, the outer circumferential surface of the outer casing 121 is smooth and free of edges and corners, thereby preventing damage during insertion into a body cavity. According to the above design, the outer casing 121 has a smaller head 1211 and a larger head 1212.
The partition 122 forms an outer channel 120 and a nesting hole 123 in the inner cavity of the outer sleeve body 121, as shown in FIG. 10, the outer channel 120 is located at the smaller head 1211 of the outer sleeve body 121, the nesting hole 123 is located at the larger head 1212 of the outer sleeve body 121, the diameter of the nesting hole 123 is larger than that of the outer channel 120, and the inner sleeve matched with the nesting hole 123 has the inner channel 110, so that the inner channel 110 and the outer channel 120 are respectively adapted to the distal end of the insertion part of the endoscope with larger diameter and the sheath tube 40 with smaller diameter.
As an example, the division bodies 122 are integrally connected to the inner wall surface of the outer casing 121, that is, the outer casing 12 is integrally molded. Further, while in the above example of the present invention the outer sleeve 12 includes two separate dividers 122, it is understood that the dividers 122 could be a unitary body with only a gap in the middle of the dividers 122 to provide the outer passage 120.
As shown in fig. 8 and 9, the upper surface 1220 of the spacer 122 is recessed downward from the distal surface 1213 of the outer sheath 121 to form a receiving slot 124 for receiving the end effector 22 at the distal end of the outer sheath 121 to prevent the end effector 22 from being exposed to damage organs of the human body during the surgical operation.
The inner sleeve 11 of the endoscope adapter 10 comprises an inner sleeve 111 having an inner channel. The inner sleeve 11 is made of a flexible material (e.g., soft polyvinyl chloride, polyurethane, silicone), and the inner diameter of the inner sleeve 11 is slightly smaller than the outer diameter of the distal end of the insertion portion of the endoscope, so that the inner sleeve 11 can be tightly fitted on the distal end of the insertion portion of the endoscope. Specifically, the inner diameter of the inner sleeve 111 is smaller than the outer diameter of the distal end of the insertion portion of the endoscope by about 0.2mm, so that a proper tight fit relationship can be obtained. Meanwhile, the inner sleeve 11 has flexibility, so that the service life of the endoscope can be prolonged.
As shown in fig. 7, a pair of axial stoppers 112 extend outward from the outer surface of the inner sheath 111. When the outer sleeve 12 is sleeved on the inner sleeve 111, the axial limiting block 112 limits the upper and lower end faces of the outer sleeve 12. In other words, the two axial stoppers 112 form a stopper groove 115 for the outer casing 121 of the outer casing member 12 to be inserted into on the outer surface of the inner casing 111, and prevent the outer casing member 12 from sliding axially relative to the inner casing member 11.
At least one circumferential limiting block 113 extends outwards from the outer surface of the inner sleeve body 111. The circumferential limiting block 113 may be independently disposed or may be integrally connected to the axial limiting block 112. The circumferential stop 113 of fig. 7 extends from one axial stop 112 to the other axial stop 112. Correspondingly, the outer casing 121 of the outer casing 12 is provided with a groove 1214 matching with the circumferential stopper 113, and when the outer casing 121 is sleeved on the inner casing 111, the circumferential stopper 113 is embedded in the groove 1214 of the outer casing 121 to prevent the outer casing 12 from rotating circumferentially relative to the inner casing 11.
The inner surface of the inner sheath 111 is provided with a raised limiting ring 114, and the limiting ring 114 is used for preventing the distal end of the insertion part of the endoscope from penetrating through the inner sheath 11, so as to ensure that the connection position between the inner sheath and the distal end of the insertion part of the endoscope is stable and reliable.
Referring to fig. 1 and 11, an endoscopic surgical assistance apparatus 1 according to an embodiment of the present invention includes an endoscopic adapter 10, a manipulator assembly 20, a manipulator 30, and a sheath 40. The structure of the endoscope adapter 10 has been described above.
The sheath 40 is used to form a communication channel 400 between the outer channel of the endoscope adapter 10 and the manipulator. As an embodiment, as shown in fig. 4 and 8, the outer casing 121 is provided with a transverse hole 1210 for communicating the outer channel 120 with the outside, and the medical adhesive is filled in the transverse hole 1210 to fix the distal end of the sheath tube 40 in the outer channel 120 of the outer casing member 12. As shown in fig. 15, the base 34 is provided with a connecting tube 343, and the proximal end of the sheath tube 40 is fitted and fixed to the connecting tube 343.
As shown in fig. 3 and 11, the robot arm assembly 20 includes a first actuation cord 21, an end effector 22, an elastic tube 23, and two second actuation cords 24. The elastic tube 23 slidably penetrates the sheath 40, a distal end of the elastic tube 23 can extend out of the sheath 40, and a proximal end of the elastic tube 23 is operatively connected to the manipulator 30, under the control of the manipulator 30, the elastic tube 23 is pushed and pulled along the elastic tube channel 410 to drive the robot arm assembly 20 to integrally advance and retract; the second actuation cord 24 is extended through the sheath 40 and out of the elastic tube 23, the distal end of the second actuation cord 24 is connected to the distal end of the elastic tube 23, and the proximal end of the second actuation cord 24 is operably connected to the manipulator 30, so as to actuate the distal end of the elastic tube 23 to deflect toward the axial center of the inner sleeve 11 of the endoscope adapter 10. In this manner, an operator can manipulate end effector 22 to a desired position via manipulator 30.
The first actuation cable 21 is extended through the elastic tube 23, a distal end of the first actuation cable 21 is connected to the end effector 22, and a proximal end of the first actuation cable 21 is operably connected to the manipulator 30, such that operation of the end effector 22 is controlled under the manipulation of the manipulator 30.
The sheath 40 is a multi-lumen tube, and as shown in fig. 9 and 12, the communication channel 400 of the sheath 40 includes an elastic tube channel 410 and two independent second actuation cord channels 420. The elastic tube 23 penetrates through the elastic tube channel 410, and the two second actuation cords 24 penetrate through the second actuation cord channels 420 of the sheath 40, so that the elastic tube 23 and the two second actuation cords 24 can be actuated separately without mutual interference during use.
As shown in FIG. 10, the second actuation cord channel 420 is located in the area between the axial center of the elastic tube channel 410 of the sheath 40 and the axial center of the inner channel 110 of the inner sheath 11, and when the second actuation cord 24 is pulled, the distal end of the elastic tube 23 will deflect toward the axial center of the inner sheath 11, so that the end effector 22 is biased toward the distal end of the insertion portion of the endoscope, which is sheathed in the inner channel 110, and so that the end effector 22 is always located in the surgical field of the endoscope.
As shown in fig. 9 and 12, the two second actuation cord passages 420 are arranged side by side on the same side of the elastic tube passage 410, i.e., the lower left side and the lower right side of the elastic tube passage 410, so that the bending of the distal end section 232 of the elastic tube 23 is controlled to be right downward, left downward, or right downward by the two second actuation cords 24. It will be appreciated that when only the lower left second actuation cord 24 is pulled tight, the distal end section 232 of the elastic tube member 23 bends downward and to the left as viewed; when only the second actuation cord 24 on the lower right is pulled tight, the distal end section 232 of the elastic tube member 23 bends toward the lower right as viewed in the drawing; and when the two second actuation cords 24 are simultaneously pulled tight, the distal end section 232 of the elastic tube member 23 bends toward the right below as shown. In addition, upon loosening of the two second actuation cords 24, the distal section 232 of the elastic tube member 23 will return to a straightened state.
The polytetrafluoroethylene tube is sleeved outside the second actuating rope, so that the resistance of the second actuating rope in the actuating process is reduced, and the control precision of the far end of the mechanical arm assembly is improved.
End effector 22 may be a surgical tool such as scissors, clamps, or the like. As one example, as shown in fig. 13, the end effector 22 includes a four-link mechanism in which a first link 221 and a second link 222 are connected by a first pivot pin 225, a third link 223 and a fourth link 224 are connected by a second pivot pin 226, and a distal end of the first actuation rope 21 is connected to the second pivot pin 226, a distal end of the elastic tube member 23 is connected to the first pivot pin 225 by a forked link 227, and the first link 221 and the second link 222 are extended to form the clamp 220, respectively. It will be appreciated that advancing and retracting the first actuation cord 21 controls the opening and closing of the jaws 220.
As shown in fig. 14, clevis 227 includes a tube portion 2271 and an arm portion 2272. The tube part 2271 is sleeved with the far end of the elastic tube 23 and is welded and fixed; the distal end of the second actuation cord 24 is directly connected to the arm portion 2272 in the clevis 227, and the two ends of the first pivot pin 225 are respectively connected to the arm portions 2272.
A spool or slider is provided within the manipulator 30 and the proximal end of the actuation cord is attached to the spool or slider. The reel or the slider is detachably coupled with the connecting member at the output end of the driving device 52, when the endoscopic surgery auxiliary instrument 1 is coupled with the driving device 52, the driving device 52 drives the endoscopic surgery auxiliary instrument 1 to perform operation, and when the endoscopic surgery auxiliary instrument 1 is decoupled and separated from the driving device 52, the two are not operated together.
In the case of a reel, the reel comprises a winch and its spindle, which is constrained to the base 34 of the manipulator 30. The capstan on the mandrel may be a simple cylindrical capstan having a circular cross-section about which the actuation cord is wound.
In the case of the slider, the slider slides back and forth under the guide of the linear guide mechanism. The linear guide mechanism includes a guide rail provided on the base 34 of the manipulator 30 and a lead screw provided on the driving device 52.
Specifically, as shown in fig. 15, the manipulator 30 includes a first slider 31 connected to the proximal end of the elastic tube 23, a second slider 32 connected to the proximal end of the first actuation cord 21, a third slider 33 connected to the proximal end of the second actuation cord 24, and a base 34 provided with a track 340, wherein the first slider 31, the second slider 32, and the third slider 33 can be driven to slide along the corresponding track 340 on the base 34 so as to actuate the elastic tube 23, the first actuation cord 21, and the second actuation cord 24, respectively. The housing of the manipulator 30 shown in fig. 1 and 2 is not shown in fig. 15 in order to show the internal structure of the manipulator 30.
The rail 340 of the base 34 includes a guide rod 341 and a guide groove 342 for guiding the first slider 31, the second slider 32, and the third slider 33 to slide, so that the first slider 31, the second slider 32, and the third slider 33 directionally slide along the corresponding guide rod 341 and guide groove 342.
As shown in fig. 16, the first slider 31 is provided with a pair of first through holes 311 matching with the guide rods 341, a first protrusion 312 matching with the guide groove 342, a first passage 313 through which the elastic tube 23 passes, and a first fastening hole 314 communicating with the first passage 313. Thus, the first through hole 311 of the first slider 31 is penetrated by the guide rod 341, and the first protrusion 312 of the first slider 31 can slide in the guide groove 342, so that the first slider 31 can stably slide on the base 34. Meanwhile, the first slider 31 can fix the elastic tube 23 passing through the first passage 313 through the first fastening hole 314 by a bolt, so that the elastic tube 23 can be pushed and pulled by the first slider 31.
As shown in fig. 17, the second slider 32 is provided with a pair of second through holes 321 matching the guide rods 341, a second protrusion 322 matching the guide groove 342, a second passage 323 through which the first actuating cord 21 passes, and a second fastening hole 324 communicating with the second passage 323. Thus, the second through hole 321 of the second slider 32 is provided for the guide rod 341 to pass through, and the second protrusion 322 of the second slider 32 can slide in the guide groove 342, so that the second slider 32 can stably slide on the base 34 in an oriented manner. Meanwhile, the second slider 32 can fix the first actuation string 21 passing through the second passage 323 through the second fastening hole 324 by a bolt, so that the elastic tube member 23 can be pushed and pulled by the second slider 32.
As shown in fig. 18, the third sliding block 33 has a third through hole 331 matching with the guide rod 341, a third protrusion 332 matching with the guide groove 342, and a fixing hole 333 for fixing the second actuation cord 24. Thus, the third through hole 331 of the third sliding block 33 is penetrated by the guide rod 341, and the third protrusion 332 of the third sliding block 33 can slide in the guide groove 342, so that the third sliding block 33 can stably and directionally slide on the base 34. Meanwhile, the third slider 33 can fix the second actuation cord 24 through the fixing hole 333 so that the second actuation cord 24 can be pulled by the third slider 33.
The elastic tube 23 includes a proximal section 231 and a distal section 232 with different flexibility, the proximal section 231 and the distal section 232 are difficult to bend, and the proximal section 231 and the distal section 232 are helical tubes formed by spirally winding metal wires. In order to make the elastic tube member 23 exhibit different bending characteristics at the proximal end before entering the body lumen and at the distal end where the surgical operation is performed, the flexibility of the proximal section and the flexibility of the distal section are changed by the difference in the sectional shape of the metal wire constituting the helical tube. As an example, as shown in fig. 21, the sectional shape of the metal wire of the proximal end section 231 is rectangular, and the sectional shape of the metal wire of the distal end section 232 is circular. When the section of the metal wire of the proximal end section 231 is rectangular, the contact area of the adjacent metal wires is large, the wound spiral tube is not easy to bend, the proximal end before entering the body cavity is not easy to drop and bend, and the influence on the precise control of the endoscopic surgical robot is small; when the cross-sectional shape of the metal wire of the distal section 232 is circular, the contact area of the adjacent metal wires is small, and the wound helical tube is easily bent, thereby easily controlling and more precisely reaching a desired surgical site when applied to a robot arm assembly of an endoscopic surgical robot.
The proximal section 231 and the distal section 232 are connected by an intermediate tube 233. As an example, as shown in fig. 21, both ends of the middle tube member 233 have inner diameters respectively corresponding to the outer diameters of the proximal section 231 and the distal section 232, and the elastic tube member 23 can be manufactured by fitting both ends of the middle tube member 233 to the ends of the proximal section 231 and the distal section 232, respectively, and fixing them by spot welding.
The endoscopic surgery auxiliary instrument 1 provided by the invention is suitable for a surgical robot adopting a master-slave mode control mode. As shown in fig. 2, in use, the manipulator 30 of the endoscopic surgery assistance apparatus 1 is loaded on the robot cart 50, and the main manipulator 51 and the driving device 52 are provided on the robot cart 50. The main manipulator 51 may be in the form of, but not limited to, a tandem isomorphic manipulator, a parallel manipulator, an exoskeleton glove, and the like. The main manipulator 51 in fig. 2 includes an arm having three rotary joints and a wrist having three rotary joints, the wrist (i.e., the handle) at the end is provided with an open/close button, and the three rotary joints of the arm are respectively provided with sensors. The operator operates the handle or the key of the main operating hand 51, and the corresponding information is transmitted to the controller. The controller calculates the received information and transmits the calculated information to the driving device 52 as an operation command.
The driving device 52 includes a driver and a motor respectively controlled by the driver. When the driver receives the action command sent by the controller, the corresponding motor is controlled to run or stop.
The driving device 52 corresponding to the embodiment of fig. 19 includes four linear motors (not shown in the figure) for respectively driving the first slide 31, the second slide 32 and the two third slides 33 to slide. The bottoms of the first slide block 31, the second slide block 32 and the third slide block 33 are respectively provided with a groove, a hole or a shaft connected with the output shaft of the motor so as to obtain drivable connection with the output shaft of the motor.
Figure 20 is an alternative example of figure 19 in which the third sled 33 is replaced by a reel 35, the proximal end of the second actuation cord 24 in the robotic arm assembly 20 is attached to the reel 35, and the reel 35 is attached to the base 34 by a spindle about which the reel 35 can be separately driven to rotate. It will be appreciated that the spool 35 can be brought into drivable connection with the motor output shaft to cause the second actuation cord 24 to be pulled by winding to control deflection of the distal end of the robotic arm assembly.
Reference is now made to the following examples, which together with the above descriptions illustrate the invention in a non limiting manner.
In the case of gastric ESD, the procedure typically includes several steps, such as marking of the diseased tissue, submucosal injection, edge dissection, peeling, and the like. After marking, submucosal injection, and edge incision, the endoscopic surgery assistance apparatus 1 of the present invention is used to perform assisted dissection.
Firstly, the manipulator 30 is embedded in the mounting groove of the manipulator car 50, and since the bottom of the slider (or the scroll) of the manipulator 30 is provided with the groove, the mounting groove of the manipulator car 50 is provided with the boss which is matched with the mounting groove and connected to the motor, so as to ensure that the manipulator 30 is effectively connected with the driving device 52 after the groove is connected with the corresponding boss.
By connecting the endoscope adapter 10 to the distal end of the insertion portion of the endoscope by the inner sheath member 11, the distal end of the endoscopic surgery assistance apparatus 1 can be introduced into the diseased tissue of the stomach along with the distal end of the insertion portion of the endoscope through the mouth of the patient.
In the stripping step, two operators cooperate to respectively operate the endoscope and the main manipulator on the mechanical arm vehicle. The operator holds the handle of the main manipulator 51, and operates the handle of the main manipulator 51 by means of the observation image obtained by the endoscope, whereby the advance and retreat of the elastic tube member 23 and the pull of the second actuation rope 24 can be controlled, so that the end effector 22 reaches a desired position; an operator presses an opening and closing button on the handle to control the opening and closing of the clamp, so that the clamp can grasp the pathological tissue; then the handle of the main manipulator 51 is operated to pull up the mucous membrane, so that the tissue under the mucous membrane is exposed clearly; at the same time, an ESD peel-off operation is performed using an electrosurgical knife through the endoscope working channel.
The auxiliary instrument 1 for endoscopic surgery can provide proper traction direction and tension in the stripping process of ESD so as to ensure that lesion tissues are completely stripped, thereby being beneficial to greatly improving the accuracy and stability of ESD surgical operation, reducing the operation difficulty and shortening the operation time.

Claims (11)

1. A robot arm assembly, characterized in that the robot arm assembly comprises:
an end effector;
an elastic tube member including a proximal section and a distal section having different flexibilities, the proximal section being less bendable than the distal section, the proximal section and the distal section each being a helical tube formed by spirally winding a metal wire;
a first actuation cord extending through the elastic tube and having a distal end connected to the end effector for actuating the end effector to perform a surgical procedure;
at least two second actuation cords, the second actuation cords being positioned outside the elastic tube and distal ends of the second actuation cords being coupled to the distal end of the elastic tube to actuate distal deflection of the elastic tube.
2. The arm assembly of claim 1, wherein the cross-sectional shape of the wire forming the coil varies to vary the flexibility of the proximal section and the flexibility of the distal section.
3. The mechanical arm assembly of claim 2, wherein the cross-sectional shape of the metal wire of the proximal section is rectangular and the cross-sectional shape of the metal wire of the distal section is circular.
4. The robotic arm assembly of any one of claims 1-3, wherein the proximal segment and the distal segment are connected by an intermediate tube.
5. An endoscopic surgery auxiliary instrument, comprising:
an endoscope adapter for connection with a distal end of an insertion portion of an endoscope;
a manipulator;
a sheath tube for forming a communication channel between the outer channel of the endoscope adapter and the manipulator; and
the robot arm assembly of any of claims 1-3, comprising an end effector, a resilient tube, a first actuation cord, and at least two second actuation cords, the resilient tube passing through the communication channel of the sheath, a distal end of the resilient tube protruding out of the sheath, and a proximal end of the resilient tube operably connected to the manipulator; the first actuation cable is threaded through the elastic tube, a distal end of the first actuation cable is connected to the end effector, and a proximal end of the first actuation cable is operably connected to the manipulator; the second actuation cord is threaded through the sheath and out of the elastic tube, a distal end of the second actuation cord is connected to a distal end of the elastic tube, and a proximal end of the second actuation cord is operably connected to the manipulator to actuate deflection of the distal end of the elastic tube toward an axial center of the inner set of the endoscope adapter.
6. An endoscopic surgical assist device according to claim 5, wherein said second actuation cord sheath is provided with a polytetrafluoroethylene tube.
7. An endoscopic surgical assist device according to claim 5, wherein said communicating channel of said sheath tube comprises an elastic tube channel for passing said elastic tube member therethrough and a second actuation cord channel for passing said second actuation cord therethrough, said second actuation cord channel being arranged spaced apart from said elastic tube channel.
8. An endoscopic surgery auxiliary instrument according to claim 5, wherein a reel or a slider is provided in the manipulator, the proximal end of the actuating cord is connected with the reel or the slider, the reel or the slider is detachably coupled with a connecting member of an output end of the driving device, when the endoscopic surgery auxiliary instrument is coupled with the driving device, the driving device drives the endoscopic surgery auxiliary instrument to perform operation, and when the endoscopic surgery auxiliary instrument is decoupled and separated from the driving device, the endoscopic surgery auxiliary instrument and the driving device are not operated together.
9. An endoscopic surgical assist device according to claim 5 or 8, wherein said manipulator comprises a first slider connected to a proximal end of said elastic tube, a second slider connected to a proximal end of said first actuation cord, a third slider connected to a proximal end of said second actuation cord, and a base provided with a track, said first slider, said second slider and said third slider being respectively drivable to slide along said corresponding track on said base.
10. An endoscopic surgical assist device according to claim 5 or 8, wherein said manipulator comprises a first slider connected to a proximal end of said elastic tube, a second slider connected to a proximal end of said first actuation cord, a reel connected to a proximal end of said second actuation cord, and a base provided with a track, said first slider and said second slider being respectively drivable to slide along said corresponding track on said base; the reel is connected to the base by a spindle about which the reel can be driven to rotate.
11. An endoscopic surgical assist instrument as defined in claim 5, wherein the end effector includes a four-bar linkage in which a first link and a second link are connected by a first pivot pin and a third link and a fourth link are connected by a second pivot pin, the distal end of the first actuation rope being connected to the second pivot pin, the distal end of the elastic tube being connected to the first pivot pin by a forked connection, the first link and the second link extending to form a clamp, respectively.
CN202210829699.7A 2022-07-14 2022-07-14 Mechanical arm assembly and endoscopic surgery auxiliary instrument Pending CN115068115A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202210829699.7A CN115068115A (en) 2022-07-14 2022-07-14 Mechanical arm assembly and endoscopic surgery auxiliary instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202210829699.7A CN115068115A (en) 2022-07-14 2022-07-14 Mechanical arm assembly and endoscopic surgery auxiliary instrument

Publications (1)

Publication Number Publication Date
CN115068115A true CN115068115A (en) 2022-09-20

Family

ID=83258939

Family Applications (1)

Application Number Title Priority Date Filing Date
CN202210829699.7A Pending CN115068115A (en) 2022-07-14 2022-07-14 Mechanical arm assembly and endoscopic surgery auxiliary instrument

Country Status (1)

Country Link
CN (1) CN115068115A (en)

Similar Documents

Publication Publication Date Title
JP5197980B2 (en) Multi-joint bending mechanism and medical device with multi-joint bending mechanism
JP5074069B2 (en) Multi-joint bending mechanism and medical device with multi-joint bending mechanism
JP3930911B2 (en) Spring-based multipurpose medical device
EP2123225B1 (en) Endoscope device
US7927327B2 (en) Medical instrument having an articulatable end effector
US8652030B2 (en) Two-part bending endoscope
AU2007202140B2 (en) Medical instrument having a catheter and having a catheter accessory device and method for using
EP2773257B1 (en) An endoscopic instrument having a deflectable distal tool
CN107072721B (en) Guide apparatus for delivery of flexible instruments and methods of use
JP2008264253A (en) Medical treatment tool and endoscope treatment system
KR102252846B1 (en) Flexible endoscopic support system
JP2008237812A (en) Multi-joint bending mechanism and medical instrument with multi-joint bending mechanism
EP1857061A1 (en) Medical instrument having a needle knife
US20100121269A1 (en) Apparatus and method for sensing force on a robotically controlled medical instrument
JP2011525125A (en) Methods and devices for accessing anatomical structures
WO2009117696A1 (en) Steerable tool guide for use with flexible endoscopic medical devices
KR102354214B1 (en) Deflecting endoscope accessory channels
JP2019193764A (en) Device having working channel guide element
JP2010516325A (en) Diagnostic or therapeutic tool for colonoscopy
EP2386255B1 (en) Endoscope treatment instrument
WO2019202699A1 (en) Medical device
CN115068115A (en) Mechanical arm assembly and endoscopic surgery auxiliary instrument
CN217907962U (en) Bending-controlled cutting knife
JP7425163B2 (en) Endoscope adapter and endoscopic surgery auxiliary equipment
CN219814306U (en) Surgical instrument and surgical robot

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication