CN116407215A

CN116407215A - Wearable multi-degree-of-freedom bendable surgical instrument

Info

Publication number: CN116407215A
Application number: CN202310360609.9A
Authority: CN
Inventors: 金浩然; 王云江; 胡鑫奔; 朱永坚; 杨克己
Original assignee: Zhejiang University ZJU
Current assignee: Zhejiang University ZJU
Priority date: 2023-04-03
Filing date: 2023-04-03
Publication date: 2023-07-11

Abstract

The invention discloses a wearable multi-degree-of-freedom bendable surgical instrument which comprises an execution end, a wearable handle, an extension section and a control end. According to the surgical instrument, the wearable structure is designed, so that the whole hand of an operator (doctor) stretches through the annular structure to enter the hand operation area when in use, on one hand, a hillock can be erected in the operation area of a patient to support the surgical instrument, and then the surgical instrument can be kept stable through the support of the annular structure of the surgical instrument by the hand ring of the operator, the operator does not need to hold the surgical instrument by the hand, and the whole hand is completely released to perform other operations. The multi-degree-of-freedom bendable surgical instrument fully plays the role of controlling the hands of a doctor, so that the control of 4 degrees of freedom can be completed by one hand, and a smart and convenient minimally invasive surgical instrument is provided for the doctor.

Description

Wearable multi-degree-of-freedom bendable surgical instrument

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to a wearable multi-degree-of-freedom bendable surgical instrument.

Background

Laparoscopic and like endoscopic procedures are typical representations of minimally invasive surgery, and with the advancement of endoscopic instruments and surgeon surgical techniques, many open procedures have been gradually replaced by laparoscopic and like minimally invasive procedures.

In the laparoscopic surgery process, a passage for entering the abdominal cavity is manufactured by utilizing an abdomen poking hole, at present, a commonly used surgical instrument for the laparoscopic surgery is designed into an elongated rigid straight tube, and is limited by the poking hole position, so that the instrument in the deep part, the narrow or shielding area of the abdominal cavity is difficult to approach or difficult to finely operate and develop, the operation efficiency is low, and the occurrence risk of complications is improved to a certain extent. Most importantly, this limits the surgical indications and severely hampers the further development of endoscopic techniques such as endoscopy. Minimally invasive surgical surgery is expected to move toward more degrees of freedom and flexibility.

For example, the invention application with publication number CN109907797a discloses a bendable laparoscopic surgical forceps, which comprises a fixed handle, wherein an outer protecting tube is arranged on the fixed handle, one end of the outer protecting tube is connected with the fixed handle, a binding clip is arranged on the other end of the outer protecting tube, the binding clip is connected with a movable handle on the fixed handle, the other end of the outer protecting tube is connected with the binding clip through the movable head, the movable head is hinged on the other end of the outer protecting tube, an elbow pull rod is arranged between the movable head and the outer protecting tube, one end of the elbow pull rod is hinged on the movable head, the hinge part of the elbow pull rod connected with the movable head is far away from the hinge part of the movable head connected with the outer protecting tube, the other end of the elbow pull rod is connected with a bending control assembly arranged on the fixed handle through a bending control tube arranged in the outer protecting tube, and a spring shaft is further arranged between the movable head and the outer protecting tube.

For another example, the application of the invention with publication number CN105125241a discloses a novel multi-section bending-adjustable surgical instrument, which comprises a functional instrument assembly, an instrument shaft and a control handle, wherein the instrument shaft comprises an outer tube, a functional instrument control piece, a bending control wire and a bending angle adjusting unit, the control handle further comprises a bending angle adjusting operation piece, the proximal end of the bending angle adjusting unit or the proximal end of the outer tube is fixedly connected with the bending angle adjusting operation piece, the bending angle adjusting unit is provided with one or more fixed bending angle sections, the adjacent part of the fixed bending angle sections is a straight line section, the outer tube is provided with one or more bendable sections, the adjacent part of the bendable sections is a rigid straight line section, the bending angle adjusting operation piece is operated, the outer tube and the bending angle adjusting unit are relatively displaced, when the fixed bending angle sections enter the bendable sections, the bending angle of the outer tube is driven to change, and when the fixed bending angle sections enter the rigid straight line sections, the bending sections are driven to be straightened.

However, the above prior art has the problems: 1. the execution end is still not flexible enough; 2. the operation mapping is not visual, and the control of single degree of freedom can be finished at the same time, so that the operation capability of doctors can not be fully exerted, the operation efficiency is reduced, and the non-visual control mapping can additionally increase the learning cost and promote the technical threshold.

Disclosure of Invention

The invention provides a wearable multi-freedom-degree bendable surgical instrument aiming at the defects in the prior art.

A wearable multi-degree of freedom bendable surgical instrument comprising:

the executing end comprises an executing arm and a clamp mounting seat arranged at the end part of the executing arm, a surgical clamp is arranged on the clamp mounting seat, and the executing arm comprises a plurality of sections of first universal joints connected in series;

the wearing handle is provided with a base, one end of the base is provided with a mounting base, two opposite sides of the other end extend upwards and are folded to form an annular structure for a hand to extend through during operation, and the base, the mounting base and the annular structure are encircled to form a hand operation area;

an extension section, two ends of which are respectively connected with an execution arm of the execution end and a mounting base of the wearing handle;

the steering sleeve sequentially penetrates through the execution arm, the extension section and the mounting base, the distal end of the steering sleeve is connected with the clamp mounting seat, and the steering sleeve drives the clamp mounting seat to rotate when rotating so as to adjust the orientation of the surgical clamp;

the stay rope is arranged in the steering sleeve and used for controlling the surgical clamp to clamp when stretching;

the control end is arranged in the hand operation area and comprises a control arm with one end fixed on the mounting base, the control arm comprises at least one section of second universal joint, and a transmission cable used for transmitting the bending action of the second universal joint to the first universal joint is arranged between the second universal joint and one first universal joint of the execution arm close to the extension section; the proximal end of the steering sleeve passes through the control arm, a rotating cap for controlling the steering sleeve to rotate is arranged at one end of the control arm facing the annular structure, the proximal end of the steering sleeve passes through the rotating cap, and a pressing device which can stretch the inhaul cable when being pressed is arranged at the passing-out part; the screw cap and the pressing device are designed in a split mode or integrated into a whole.

The proximal end in this application refers to the end that is close to the operator (doctor) operation, i.e. the end where the handle is worn, and the distal end refers to the end that is far from the operator operation, i.e. the execution end.

The wearable multi-degree-of-freedom bendable surgical instrument is used when an operator performs minimally invasive surgery, the execution end is used for extending into a patient body to perform operation, and the wearable handle and the control end are left outside, so that minimally invasive requirements are met. The steering sleeve needs to have a certain rigidity in order to be able to transmit the torsion operation to which the proximal end is subjected to the distal end.

Preferably, one end of the clamp mounting seat is provided with the surgical clamp, the other end of the clamp mounting seat is rotationally connected with the distal end of the execution arm and is fixed with the distal end of the steering sleeve, the clamp mounting seat is provided with a U-shaped mounting opening, a sliding sheet capable of being pulled by a guy cable to move along the axial direction is arranged in the U-shaped mounting opening, the sliding sheet is provided with a pair of linear toothed rails oppositely arranged along the axial direction, the surgical clamp comprises two clamp arms which are arranged in pairs, and one end of each clamp arm is rotationally connected with the U-shaped mounting opening and is provided with a gear part matched with one of the linear toothed rails. Two arms of the U-shaped mounting opening are provided with sliding grooves extending along the axial direction, and sliding blocks matched with the sliding grooves are arranged on the sliding sheets. The middle part of the sliding vane is provided with a waist-shaped hole extending along the axial direction, and a pair of linear toothed rails on the sliding vane are arranged on two long edges of the waist-shaped hole. The gear part arranged on the forceps arms of the surgical forceps is a gear arranged on the end face of the fan-shaped structure, and the angle of the fan-shaped structure is set according to the opening angle of the two forceps arms. When the inhaul cable is pulled to the proximal end, the sliding sheet slides to the proximal end, so that the linear toothed rail drives the clamp arm to rotate around a shaft rotationally connected with the U-shaped mounting opening, and the clamping action of the surgical clamp is completed.

Preferably, the pressing device comprises a V-shaped pressing piece and a V-shaped stretching piece, wherein two arms of the stretching piece are hinged with two arms of the pressing piece respectively to form a quadrangle, the proximal end of the inhaul cable is connected with the connecting position of the two arms of the stretching piece, and when the inhaul cable is used, the pressing piece is pressed and deformed to drive the stretching piece to deform so as to stretch the inhaul cable. The stay cable can adopt a high-elasticity alloy wire, so that the stay cable can transmit thrust, and the surgical clamp can be opened. Of course, a reset spring can be arranged between the bottom of the opening of the U-shaped mounting opening and the sliding sheet to reset the sliding sheet, so that the surgical clamp can be opened.

Preferably, the top of the annular structure is provided with a backrest part which is formed by extending to one side of the hand operation area and is used for supporting the back of the hand during operation. When the palm of an operator is compressed towards the palm, the operator can pass the hand through the annular structure, and after the palm is opened, the wearing handle can be tensioned, so that the whole surgical instrument can be lifted or rotated. The arrangement of the backrest part can ensure that the whole surgical instrument does not need to be lifted or rotated only by the action of the bracelet part on the annular structure during operation, but can be propped against the backrest part by means of the backrest, thereby increasing the convenience of use.

Preferably, the actuating arm comprises 2-5 joints of first universal joints connected in series; the control arm comprises 1-3 sections of second universal joints. The superposition of the first universal joint in the actuator arm can prolong the axial length of the actuator arm, so that the actuator arm can realize larger bending degree. Likewise, the superposition of the second universal joint in the steering arm can extend the axial length of the steering arm, so that the steering arm can achieve a greater degree of bending. The length of the execution arm or the control arm is mainly used for meeting the operation requirement, and the reasonable setting is carried out.

More preferably, the first universal joints of the actuating arm have the same size, and the circumferential outer diameter of the first universal joints is 5-15 mm; the circumferential outer diameter of the second universal joint is 15-30 mm. The circumferential outer diameter of the first universal joint is limited by the size of the surgical opening during minimally invasive surgery. The second universal joint may suitably have a circumferential outer diameter that is somewhat larger than the circumferential outer diameter of the first universal joint, so as to be suitable for hand operation.

Preferably, the first universal joint and the second universal joint each comprise two moving platforms and at least three groups of rotating assemblies arranged between the two moving platforms in parallel,

the two moving platforms are a first moving platform and a second moving platform respectively, the first moving platform and the second moving platform are both provided with a rotation center,

each group of rotating components comprises a first rotating piece, a second rotating piece and a third rotating piece, wherein one end of the first rotating piece is hinged with the first moving platform, one end of the second rotating piece is hinged with the second moving platform, the other ends of the third rotating piece are respectively hinged with the first rotating piece and the other end of the second rotating piece, and the axes of hinge shafts of the first rotating piece and the third rotating piece are respectively hinged with the first moving platform and the third rotating piece through the rotating center of the first moving platform; the axis of the hinge shaft of the second rotating piece, which is hinged with the second moving platform and the third rotating piece respectively, passes through the rotation center of the second moving platform,

when the adjacent first universal joints or second universal joints are connected in series, the rotating assemblies are in one-to-one correspondence and are in transmission connection with each other; the first universal joints of the actuating arms positioned at the proximal ends and the second universal joints of the control arms positioned at the distal ends are in one-to-one correspondence and are in transmission connection through the transmission cables.

More preferably, the first rotating member and the second rotating member of the first universal joint and the second universal joint are both processed into external gears, the rotation axis of the external gear of the first rotating member is the hinge shaft of the first rotating member and the first motion platform, the rotation axis of the external gear of the second rotating member is the hinge shaft of the second rotating member and the second motion platform,

when adjacent first universal joints or second universal joints are connected in series, the rotating assemblies are transmitted through meshing between corresponding external gears, and the transmission ratio of the meshed first rotating piece to the meshed second rotating piece is 1:1, the first and second rotating members are symmetrical with respect to the plane of coupling.

Further preferably, the first universal joint and the second universal joint are respectively provided with three groups of rotating components, and the three groups have the same structure and are uniformly distributed along the circumference; the first moving platform and the second moving platform have the same structure; the first rotating piece and the second rotating piece have the same structure; the third rotating member is symmetrical in structure with the first rotating member and the second rotating member. That is, the first rotating member and the second rotating member of each rotating assembly always maintain symmetry, so that the action condition of the other end after the action is transferred can be predicted by controlling the action of one end.

Further preferably, when the second universal joint of the control arm at the far end and the first universal joint of the actuating arm at the near end are driven, the external gear at one side of the control arm is meshed with a steering gear, and then the steering gear is connected with the driving cable. Due to the limitation of the transmission mode between the universal joints (including the first universal joint and the second universal joint), when the motion of the previous universal joint is transmitted to the next universal joint, the rotation directions of the external gears meshed with each other are opposite, and the rotation directions of the two external gears on the two moving platforms on the same universal joint are opposite, so that after the two reversals, the bending direction of the next universal joint and the bending direction of the previous universal joint are kept the same. However, when the second universal joint of the control arm positioned at the far end and the first universal joint of the actuating arm positioned at the near end are driven, the driving rope drives the two external gears to rotate in the same direction, so that when the second universal joint bends towards one direction, the first universal joint bends towards the opposite direction, and the hand action is opposite to the bending direction of the actuating end during operation, which is not convenient for an operator. Therefore, the steering gear is arranged to reverse the rotating direction once, so that the first universal joint and the second universal joint can bend towards one direction, the operation is simple and visual, and the operation by an operator is facilitated. The steering gear is preferably mounted on one side of the second gimbal because the actuator arm of the first gimbal needs to extend into the surgical field of the patient, and is relatively small in size and inconvenient to install. The steering gear is preferably mounted on the mounting base.

The beneficial effects are that:

according to the wearable multi-degree-of-freedom bendable surgical instrument, the wearable structure is designed, when an operator (doctor) uses the surgical instrument, the whole hand stretches through the annular structure to enter the hand operation area, on one hand, a hillock is erected in an operation area of a patient to support the surgical instrument, and then the surgical instrument can be kept stable through the support of the annular structure of the surgical instrument by the hand ring of the operator, the operator does not need to hold the surgical instrument by hand, and the whole hand is completely released to perform other operations.

When the rotary cap and the pressing device are designed in a split mode, an operator holds the rotary cap of the control end by an index finger and a thumb to move left and right and up and down to realize 2-degree-of-freedom deflection control of the execution end, and the rotary motion of the clamp for the operation of the execution end is realized by driving the steering sleeve to rotate by the twisting rotary cap of the index finger; the left three-directional palm center is pressed and held to stretch the inhaul cable by the pressing device so as to realize the opening and closing of the operation clamp; simultaneously, the operator holds the control end cap through forefinger and thumb, will rotate the cap and regard as the operation handle of control arm to push and pull the second universal joint to different directions, and the bending motion of second universal joint drives first universal joint through the driving cable and crookes to make the execution arm crooked to different directions, drive operation clamp action. When the screw cap and the presser are designed integrally, the screw cap and the presser can be designed to be relatively thin in the axial direction, the screw cap part is still held by the index finger and the thumb, and the presser part is held by the remaining three-directional palm centers; it is also possible to design the screw cap and the presser to be thicker and shorter in the axial direction, and then press the presser part using the index finger and the thumb while controlling rotation directly with the pressing position as the action point.

The multi-degree-of-freedom bendable surgical instrument fully plays the role of controlling the hands of a doctor, so that the control of the total 4 degrees of freedom including the bending of the freedom degree of the actuating arm 2 and the rotation and opening and closing movements of the surgical clamp can be completed by one hand, and a smart and convenient minimally invasive surgical instrument is provided for the doctor.

Drawings

Fig. 1 is a schematic structural view of a wearable multi-degree-of-freedom bendable surgical instrument of the present invention.

Fig. 2 is a schematic view of the structure of the wearing handle and the control end.

Fig. 3 is a schematic view of an assembled structure of an end-effector surgical clamp, wherein the left view is an assembled schematic view, and the middle and right views are exploded views.

Fig. 4 is a schematic structural view of the actuator arm.

Fig. 5 is an exploded view of a single first universal joint.

Fig. 6 is a schematic structural diagram of the manipulation terminal.

Fig. 7 is an exploded view of the manipulation end.

Fig. 8 is a schematic diagram of the working structure of the driving cable.

Fig. 9 is a schematic view of the use of the wearable multi-degree of freedom bendable surgical instrument of the present invention.

Fig. 10 is a schematic structural diagram of the manipulation end of embodiment 2.

Fig. 11 is an exploded view of the control end of embodiment 2.

Reference numerals:

a wearing handle 1, a base 11, a mounting base 12, an annular structure 13, a backrest 14;

the control end 2, the control arm 21, the second universal joint 22, the driving cable 23, the screw cap 24, the pressing device 25, the steering gear 26, the sealing cap 27, the rotary inner core 28 and the bearing 29;

screw cap 24', sealing cap 27', rotating inner core 28', bearing 29';

an extension 3;

the surgical clamp comprises an execution end 4, an execution arm 41, a clamp mounting seat 42, a surgical clamp 43, a U-shaped mounting opening 432, a sliding sheet 433, a linear toothed rail 434, a clamp arm 435, a gear part 436, a sliding chute 437, a pin shaft 438, a first universal joint 44, a first moving platform 441, a second moving platform 442, a first rotating member 443, a second rotating member 444, a third rotating member 445, an external gear 446 and a bearing 45;

a steering sleeve 5;

and a pull rope 6.

Detailed Description

Example 1

As shown in fig. 1 to 9, a wearable multi-degree-of-freedom bendable surgical instrument comprises a wearable handle 1, a control end 2, an extension section 3 and an execution end 4. The wearable multi-degree-of-freedom bendable surgical instrument is used when an operator performs minimally invasive surgery, the execution end 4 is used for extending into a patient body to perform operation, and the wearable handle 1 and the control end 2 are left outside, so that minimally invasive requirements are met. The proximal end in this application refers to the end that is closer to the operator (doctor) operation, i.e. the end where the handle 1 is worn, and the distal end refers to the end that is farther from the operator operation, i.e. the execution end 4.

As shown in fig. 2, the wearing handle 1 has a base 11, one end of the base 11 is provided with a mounting base 12, two opposite sides of the other end extend upwards and are folded to form an annular structure 13 through which a hand extends during operation, and the base 11, the mounting base 12 and the annular structure 13 are surrounded to form a hand operation area. The control end 2 is arranged in the hand operation area. The top of the ring-shaped structure 13 is provided with a backrest 14 which is formed to extend to the side of the hand operation area and is used for the back of the hand to be abutted when in operation. When the palm of an operator is compressed towards the palm center, the operator can pass the hand through the annular structure 13, and after the palm is opened, the wearing handle 1 can be tensioned, so that the whole surgical instrument can be lifted or rotated. The arrangement of the backrest portion 14 allows for increased ease of use by not having to merely lift or rotate the entire surgical instrument by virtue of the action of the bracelet portion on the loop structure during operation, but rather by the backrest portion being held against the backrest portion 14.

As shown in fig. 3 and 4, the actuating end 4 includes an actuating arm 41 and a clamp mounting seat 42 provided at a distal end of the actuating arm 41, and a surgical clamp 43 is provided on the clamp mounting seat 42. The surgical clamp 43 can realize clamping action, and the clamp mounting seat 42 can rotate along the vertical axial direction relative to the actuating arm 41, so that the surgical clamp 43 is driven to rotate, and the surgical clamp 43 can be removed from different directions.

The actuator arm 41 is used to allow the actuator end 4 to bend. The actuator arm 41 includes a first gimbal 44 having a plurality of joints connected in series.

The extension section 3 is rod-shaped and is used for connecting the execution end 4 and the control end 2, and two ends of the extension section 3 are respectively connected with the execution arm 41 of the execution end 4 and the mounting base 12 of the wearing handle 1. The extension 3 brings the actuating end 4 and the manipulation end 2 away from each other, so that an operator can control the actuating end 4 in the surgical site to perform a surgical operation by manipulating the manipulation end 2 at a distance from the surgical site.

The clamp mount 42 rotates the surgical clamp 43 in a vertical axial direction relative to the actuator arm 41 by virtue of the steering sleeve 5. The steering sleeve 5 sequentially penetrates through the actuating arm 41, the extension section 3 and the mounting base 12, the distal end of the steering sleeve 5 is connected with the clamp mounting seat 42, and the steering sleeve 5 drives the clamp mounting seat 42 to rotate when rotating so as to adjust the orientation of the surgical clamp 43. The steering sleeve 5 needs to have a certain rigidity in order to be able to transmit the torsion operation to which the proximal end is subjected to the distal end.

The operation of the surgical clamp 43 to effect the clamping action is accomplished by means of the cable 6. A pull cable 6 is provided within the steering sleeve 5 for controlling the clamping of the surgical clamp 43 when stretched.

The control end 2 comprises a control arm 21 with one end fixed on the mounting base 12, the control arm 21 comprises at least one section of second universal joint 22, and a driving cable 23 for transmitting the bending motion of the second universal joint 22 to the first universal joint 44 is arranged between the second universal joint 22 and one first universal joint 44 of the actuator arm 41 close to the extension section 3.

In the embodiment shown in fig. 1 to 9, the screw cap 24 and the presser 25 are of a separate design. The proximal end of the steering sleeve 5 passes through the handling arm 21, the end of the handling arm 21 facing the annular structure 13 is provided with a screw cap 24 for controlling the rotation of the steering sleeve 5, the proximal end of the steering sleeve 5 passes out of the screw cap 24 and the passing-out part is provided with a presser 25 which stretches the cable 6 when pressed. The presser 25 comprises a V-shaped pressing piece and a V-shaped stretching piece, wherein two arms of the stretching piece are respectively hinged with two arms of the pressing piece to form a quadrangle, the proximal end of the inhaul cable 6 is connected with the connecting part of the two arms of the stretching piece, and when the inhaul cable 6 is used, the pressing piece is pressed to deform to drive the stretching piece to deform so as to stretch the inhaul cable 6.

As shown in fig. 6 and 7, a sealing cap 27 is provided on the control arm 21 at the proximal end face of the second universal joint 22, and if the control arm 21 includes a plurality of sections of the second universal joint 22, a sealing cap 27 is provided only at the proximal end face of the second universal joint 22 at the proximal end, and the sealing cap 27 is fixed to the second universal joint 22 by bolts. A rotary inner core 28 is further arranged between the sealing cap 27 and the second universal joint 22, the rotary inner core 28 is sleeved outside the steering sleeve 5 and fixed with the steering sleeve 5, and one end of the rotary inner core 28 penetrates through the sealing cap 27 for installing the rotary cap 24. In order to make the rotary cap 24 smoother when rotating, a bearing 29 is arranged between the rotary inner core 28 and the sealing cap 27, the inner ring of the bearing 29 is fixed with the rotary inner core 28, and the outer ring is fixed with the sealing cap 27.

One end of the clamp mounting seat 42 is provided with a surgical clamp 43, the other end of the clamp mounting seat is rotatably connected with the distal end of the actuating arm 41 and is fixed with the distal end of the steering sleeve 5, the distal end of the actuating arm 41 is provided with a bearing 45 for mounting, the outer ring of the bearing 45 is fixed with the actuating arm 41, and the clamp mounting seat 42 is fixed with the inner ring of the bearing 45. The forceps mounting seat 42 has a U-shaped mounting opening 432, a sliding piece 433 which can be pulled by the guy cable 6 to move in the axial direction is arranged in the U-shaped mounting opening 432, the sliding piece 433 is provided with a pair of straight toothed rails 434 which are oppositely arranged in the axial direction, the surgical forceps 43 comprises two forceps arms 435 which are arranged in pairs, one end of each forceps arm 435 is rotatably connected with the U-shaped mounting opening 432, and a gear part 436 which is matched with one of the straight toothed rails 434 is arranged. Two arms of the U-shaped mounting opening 432 are provided with sliding grooves 437 extending along the axial direction, and sliding pieces 433 are provided with sliding pieces matched with the sliding grooves 437. The slider is shown as a pin 438 passing through the slider 433 and having two ends snapped into side runners 437. The middle part of the sliding sheet 433 is provided with a waist-shaped hole extending along the axial direction, and a pair of linear toothed rails 434 on the sliding sheet 433 are arranged on two long sides of the waist-shaped hole. The gear part 436 provided on the forceps arm 435 of the surgical forceps 43 is a gear provided on the end face of a fan-shaped structure, and the angle of the fan-shaped structure is set according to the opening angle of the two forceps arms 435. When the pull cable 6 is pulled proximally, the sliding piece 433 slides proximally, so that the linear toothed rail 434 drives the clamp arm 435 to rotate around the shaft rotatably connected with the U-shaped mounting opening 432, thereby completing the clamping action of the surgical clamp 43.

The cable 6 may be a high-elasticity alloy wire, so that the cable 6 may transmit a pushing force to open the surgical clamp 43. Of course, a return spring may be provided between the bottom of the opening of the U-shaped mounting opening 432 and the sliding piece 433 to return the sliding piece 433 to open the surgical clamp 43.

In one embodiment, the actuator arm 41 includes 2-5 joints in series of first universal joints 44; the steering arm 21 includes 1 to 3 second universal joints 22. The superposition of the first universal joint 44 in the actuator arm 41 may extend the axial length of the actuator arm 41, allowing a greater degree of bending of the actuator arm 41. Likewise, the superposition of the second universal joint 22 in the actuating arm 21 can extend the axial length of the actuating arm 21, so that a greater degree of bending of the actuating arm 21 can be achieved. The length of the actuator arm 41 or the control arm 21 is mainly required to meet the operation requirement, and the reasonable arrangement is performed. In the embodiment shown in the figures, the actuator arm 41 comprises a first gimbal 44 of 3 joints in series; the steering arm 21 includes 1 second universal joint 22.

In a preferred embodiment, the first universal joints 44 of the actuator arm 41 are the same in size, and the first universal joints 44 have a circumferential outer diameter of 5 to 15mm; the second universal joint 22 has a circumferential outer diameter of 15 to 30mm. The circumferential outer diameter of the first gimbal 44 is limited by the size of the surgical opening at the time of minimally invasive surgery. The second gimbal 22 may suitably have a circumferential outer diameter that is somewhat larger than the circumferential outer diameter of the first gimbal 44, so as to accommodate hand operation.

The first and

second gimbals

44, 22 are different in size but identical in structure, each comprising two motion stages and at least three sets of rotating assemblies arranged in parallel between the two motion stages.

A first gimbal 44 is shown in fig. 5. The two motion platforms are a first motion platform 441 and a second motion platform 442, respectively, the first motion platform 441 and the second motion platform 442 are provided with a rotation center,

each group of rotation components comprises a first rotation piece 443 with one end hinged with the first motion platform 441, a second rotation piece 444 with one end hinged with the second motion platform 442, and a third rotation piece 445 with two ends respectively hinged with the first rotation piece 443 and the other end of the second rotation piece 444, wherein the axis of a hinge shaft of the first rotation piece 443 respectively hinged with the first motion platform 441 and the third rotation piece 445 passes through the rotation center of the first motion platform 441; the hinge axis of the second rotating member 444, which is hinged to the second moving platform 442 and the third rotating member 445, respectively, passes through the rotation center of the second moving platform 442.

When the adjacent first universal joints 44 or second universal joints 22 are connected in series, the rotating assemblies are in one-to-one correspondence and are in transmission connection with each other; the actuating arm 41 is also in one-to-one correspondence and is in driving connection by means of a driving cable 23 between a first universal joint 44 at the proximal end and a second universal joint 22 at the distal end of the actuating arm 21.

In a preferred embodiment, the first and second rotational members of the first and second

universal joints

44 and 22 are each machined as an external gear 446, the rotational axis of the external gear of the first rotational member being the hinge axis of the first rotational member with the first motion platform, and the rotational axis of the external gear of the second rotational member being the hinge axis of the second rotational member with the second motion platform. When the adjacent first universal joints 44 or second universal joints 22 are connected in series, the rotation components are transmitted through the meshing of the corresponding external gears 446. And the transmission ratio of the meshed first rotating member to the meshed second rotating member is 1: and 1, the first rotating piece and the second rotating piece are symmetrical relative to the connecting plane, so that the action between the two connected universal joints can be kept consistent, and the equal-proportion transmission can be realized.

In a preferred embodiment, the first universal joint 44 and the second universal joint 22 are three groups of rotating components, and the three groups are identical in structure and uniformly distributed along the circumference, and the driving cables 23 respectively comprise three groups, and each group of driving cables 23 corresponds to one rotating component. The first moving platform 441 and the second moving platform 442 have the same structure; the first rotating member 443 is identical in structure to the second rotating member 444; the third rotation member 445 is configured to be symmetrical to the half adjacent to the first rotation member 443 and the half adjacent to the second rotation member 444. That is, the first rotating member 443 and the second rotating member 444 of each rotating assembly always maintain symmetry, so that the behavior of one end after the motion is transmitted can be predicted by controlling the behavior of the other end.

As shown in fig. 6 to 8, when the second universal joint 22 of the steering arm 21 at the distal end and the first universal joint 44 of the actuator arm 41 at the proximal end are driven, the external gear 446 on one side is meshed with one steering gear 26, and is connected with the driving cable 23 by the steering gear 26. Due to the limitation of the transmission mode between the universal joints (including the first universal joint and the second universal joint), when the motion of the previous universal joint is transmitted to the next universal joint, the rotation directions of the external gears meshed with each other are opposite, and the rotation directions of the two external gears on the two moving platforms on the same universal joint are opposite, so that after the two reversals, the bending direction of the next universal joint and the bending direction of the previous universal joint are kept the same. However, when the second universal joint 22 of the control arm 21 at the distal end and the first universal joint 44 of the actuator arm 41 at the proximal end are driven by the driving cable 23, the driving cable 23 can only drive the two external gears 446 to rotate in the same direction, so that when the second universal joint 22 bends in one direction, the first universal joint 44 bends in the opposite direction, and the hand motion is opposite to the bending direction of the actuator end 4 during operation, which is not convenient for the operator. Therefore, by providing one steering gear 26 to reverse the direction of one rotation, bending between the first and second

universal joints

44 and 22 in one direction can be achieved, making the operation relatively simple and intuitive, and facilitating the operation by the operator. As shown in the figures, the steering gear 26 is preferably mounted on the side of the second universal joint 22 because the actuator arm 41 on which the first universal joint 44 is located needs to extend into the patient's operating field, which is small in size and inconvenient to install. Steering gear 26 is preferably mounted on mounting base 12. The steering gear 26 also includes 3, each of which cooperates with a set of drive cables 23.

As shown in fig. 9, when the wearable multi-degree-of-freedom bendable surgical instrument is used, an operator (doctor) stretches the whole hand through the annular structure to enter the hand operation area, on one hand, a hillock is erected in the operation area of a patient to support the surgical instrument, the surgical instrument can be kept stable through the support of the annular structure of the surgical instrument by the hand ring of the operator, the operator does not need to hold the surgical instrument by hand, and the whole hand is completely released to perform other operations. During operation, an operator holds the control end cap 24 with an index finger and a thumb to move left and right to realize 2-degree-of-freedom deflection control of the tail end, the steering sleeve 5 is driven to rotate by the twisting cap 24 with the index finger to realize the rotation of the operation clamp 43 of the execution end 4, and the remaining three-directional palm center is used for compressing the holding presser 25 to stretch the inhaul cable 6 to realize the opening and closing of the operation clamp 43; simultaneously, an operator holds the rotary cap 24 of the control end 2 by an index finger and a thumb, and pushes and pulls the second universal joint 22 in different directions by taking the rotary cap 24 as an operation handle of the control arm 21, and the bending action of the second universal joint 22 drives the first universal joint 44 to bend by the driving cable 23, so that the actuating arm 41 bends in different directions to drive the operation clamp 43 to act. The multi-degree-of-freedom bendable surgical instrument fully plays the role of controlling the hands of a doctor, so that the control of 4 degrees of freedom can be completed by one hand, and a smart and convenient minimally invasive surgical instrument is provided for the doctor.

Example 2

The rest of the structure is the same as in embodiment 1, and only the structure of the screw cap and the presser is the same as in embodiment 1. As shown in fig. 10 and 11, the screw cap and the presser are integrally designed and named as screw cap 24'. The cap 27', the rotary core 28' and the bearing 29 'correspond to the cap 27, the rotary core 28 and the bearing 29 in embodiment 1, and the assembly structure is also the same, and a portion of one end of the rotary core 28' passing through the cap 27 'is used for mounting the rotary cap 24'. The cap 24 'includes a V-shaped pressing member and a V-shaped stretching member, wherein two arm connecting ends of the stretching member are used for being fixedly mounted with the rotary inner core 28', two arms of the stretching member are respectively hinged with two arms of the pressing member to form a quadrilateral, and pressing areas which are convenient for the thumb and the index finger to press can be arranged on the outer sides of free ends of the two arms of the stretching member. The proximal end of the inhaul cable is connected with the joint of the two arms of the stretching piece.

When the surgical clamp is used, the thumb and the index finger deform the V-shaped pressing piece through pressing, so that the V-shaped stretching piece is driven to deform, and after the quadrangle is flattened, two opposite endpoints are close to each other, and the other two opposite endpoints are far away from each other, so that the inhaul cable is stretched, and the surgical clamp is controlled to clamp; on the other hand, the thumb and index finger may rotate the cap 24' again for the purpose of twisting the steering cannula to control the rotational movement of the surgical clamp.

Claims

1. A wearable multi-degree of freedom bendable surgical instrument, comprising:

2. The wearable multi-degree-of-freedom bendable surgical instrument according to claim 1, wherein the clamp mount has one end provided with the surgical clamp and the other end rotatably connected to the distal end of the actuator arm and fixed to the distal end of the steering sleeve, the clamp mount has a U-shaped mount port in which a slide sheet that is axially movable by a cable is provided, the slide sheet has a pair of linear racks oppositely arranged in the axial direction, the surgical clamp includes two clamp arms arranged in pairs, one end of each clamp arm is rotatably connected to the U-shaped mount port and has a gear portion that mates with one of the linear racks.

3. The wearable multi-degree-of-freedom bendable surgical instrument according to claim 1, wherein the pressing device comprises a V-shaped pressing piece and a V-shaped stretching piece, two arms of the stretching piece are hinged with two arms of the pressing piece respectively to form a quadrangle, the proximal end of the guy cable is connected with the connecting position of the two arms of the stretching piece, and when the pressing piece is used, the pressing piece is pressed to deform to drive the stretching piece to deform so as to stretch the guy cable.

4. The wearable multi-degree of freedom bendable surgical instrument according to claim 1, wherein the top of the ring structure has a backrest portion extending to one side of the hand operating area for the back of the hand to rest when operated.

5. The wearable multi-degree of freedom bendable surgical instrument according to claim 1, wherein the actuator arm comprises 2-5 tandem first universal joints; the control arm comprises 1-3 sections of second universal joints.

6. The surgical instrument of claim 5, wherein the first universal joints of the actuator arm are the same in size and have a circumferential outer diameter of 5-15 mm; the circumferential outer diameter of the second universal joint is 15-30 mm.

7. The wearable multi-degree of freedom bendable surgical instrument according to claim 1, wherein the first and second gimbals each comprise two motion platforms and at least three sets of rotating assemblies arranged in parallel between the two motion platforms,

8. The surgical instrument of claim 7, wherein the first and second rotational members of the first and second universal joints are each formed as an external gear, the external gear of the first rotational member has a rotational axis that is the hinge axis of the first rotational member and the first motion platform, the external gear of the second rotational member has a rotational axis that is the hinge axis of the second rotational member and the second motion platform,

when the adjacent first universal joints or second universal joints are connected in series, the rotating assemblies are driven by the meshing of the corresponding external gears.

9. The wearable multi-degree of freedom bendable surgical instrument according to claim 8, wherein the first and second universal joints are three sets of rotation assemblies, and the three sets are identical in structure and uniformly distributed along the circumference; the first moving platform and the second moving platform have the same structure; the first rotating piece and the second rotating piece have the same structure; the third rotating member is symmetrical in structure with the first rotating member and the second rotating member.

10. The wearable multi-degree of freedom bendable surgical instrument according to claim 8, wherein the outer gear on one side is meshed with a steering gear and then connected with the driving cable by the steering gear when the second universal joint of the control arm at the distal end and the first universal joint of the actuating arm at the proximal end are driven.