CN219166552U - Bionic surgical instrument - Google Patents

Abstract

The application provides a bionic surgical instrument includes the handle, connects the handle and can flex for the extension piece of handle, locates the functional piece of the tip of extension piece, wherein, when the operator grips on the handle, the extension piece is located the palm below of operator for the center of flexibility of handle, and the handle can be forced and flex for the extension piece to adjust the operating position of functional piece. Accordingly, the bionic surgical instrument can provide intuitive control and better operation hand feeling, and the accuracy of instrument operation can be improved.

Description

Bionic surgical instrument

Technical Field

The embodiment of the application relates to the technical field of medical instruments, in particular to a handle control instrument.

Background

Minimally invasive surgery refers to cutting or repairing organ focuses in abdominal cavities, thoracic cavities, pelvic cavities or joint cavities and the like by puncturing the body surfaces of human bodies to form a plurality of operation channels; or enter the body cavity through natural cavity such as oral cavity, urethra, rectum, vagina, etc. by the above-mentioned route with endoscope and operation instrument, under the monitoring of endoscope by operator, through the operation instrument of operator outside patient's body, extend into patient's body cavity with the help of instrument working end, and carry out operations such as excision or repair, suture to the focus in the cavity, and take out endoscope and instrument after the operation, suture the aperture or natural cavity of body surface and says incision and can accomplish whole operation.

In view of the above, a primary object of the present application is to provide a surgical instrument for assisting in performing minimally invasive surgery.

Disclosure of Invention

In view of the above, the present application provides a bionic surgical instrument to overcome or at least partially solve the above-mentioned problems.

The embodiment of the application provides a bionic surgical instrument, which comprises: a handle; an extension member coupled to the handle and being deflectable relative to the handle; a functional member provided at an end of the extension member; wherein, when the operator holds the handle, the extending piece is positioned below the palm of the operator relative to the flexible center of the handle; the handle is deflectable relative to the extension member to adjust the operating position of the functional element.

Optionally, the extension member is no more than 10cm from the centre of deflection of the handle to the centre of the operator's palm.

Optionally, the extension piece includes: a first link connected to the handle and extending vertically downward from an end of the handle; a second link connected to the first link and extending laterally from an end of the first link; the handle can flex relative to the first connecting rod so as to adjust the positioning axial direction of the functional piece through the second connecting rod; an included angle of not more than 90 degrees is formed between the handle axis of the handle and the second axis of the second connecting rod.

Optionally, the second axis of the second link is along a first axis perpendicular to the first link such that a right angle is formed between the first link and the second link.

Optionally, the apparatus further comprises: a head end bendable structure connecting the second link and the functional element; a tail end bendable structure connecting the first link and the handle; the tail end bendable structure can be stressed to bend along different directions and drive the head end bendable structure to act in a linkage mode along different directions so as to adjust the operation position of the functional piece.

Optionally, the handle and the first link position a first end and a second end of the trailing bendable structure, respectively; the handle is controlled to rotate in different directions relative to the first connecting rod, so that the positioning position of the second end relative to the first end is adjusted, and the tail end bendable structure bends in different directions.

Optionally, the first link includes an adjustment socket that can position the second end, and the handle includes a positioning socket that can position the first end; the adjusting sleeve joint part and the positioning sleeve joint part are movably sleeved with each other to form an accommodating space for accommodating the tail end bendable structure; the adjusting sleeve joint part can flex relative to the positioning sleeve joint part so as to adjust the positioning position of the second end relative to the first end.

Optionally, the instrument further comprises an operating member provided on the handle, connected to the extending member via a drive shaft and reciprocally movable relative to the handle between an active position and a non-active position to drive the extending member to reciprocally move in an axial direction thereof; the operating piece is axially fixed relative to the driving shaft and circumferentially rotates, and when the operating piece reciprocates between an active position and an inactive position relative to the handle, the driving shaft can be driven to axially move, so that the extending piece is driven to axially reciprocate along the extending piece, and the functional piece is switched between an active state and an inactive state.

Optionally, when the operator holds the handle, the operator's thumb may be inserted into the operating member to drive the operating member to reciprocate between the active position and the inactive position.

Optionally, the instrument further comprises a lock; wherein when the operator holds the handle, the operator's index finger and/or middle finger can be inserted into the locking member to drive the locking member to switch between a locking position and an unlocking position relative to the handle, thereby allowing or limiting the movement of the operating member relative to the handle.

Optionally, the apparatus further comprises a rotation member provided on the handle, connected to the extension member and rotatable circumferentially with respect to the handle, to drive the function member to perform a rotation motion via the extension member.

Optionally, the rotating member is located within an operable range of the thumb of the operator when the operator holds on the handle.

Optionally, the apparatus further comprises: a drive shaft connected to the rotating member; a first gear provided at an end of the drive shaft near the first link; a second gear provided at an end of the first link near the handle and engaged with the first gear; a third gear provided at an end of the first link near the second link; a fourth gear which is provided at an end portion of the second link near the first link and is engaged with the third gear;

optionally, when the autorotation member rotates circumferentially relative to the handle, the first connecting rod can be driven to rotate circumferentially, and the second connecting rod can be driven to rotate circumferentially via the first connecting rod, so that the functional member can execute the rotating motion.

Optionally, the functional element comprises one of forceps and scissors.

To sum up, the bionic surgical instrument of the present application, when the handle is operated, the flexible center of the handle is located below the palm of the operator, and the structural design accords with the ergonomics, so that the operation feeling of the operator can be improved.

Furthermore, the bionic surgical instrument can also provide an intuitive control mode, has simple control and effect logic, can be operated by hands without special training, can reduce the surgical barriers and enlarge the range of indications.

In addition, the bionic surgical instrument has the advantages that the size of the handle is small, the mutual collision among different surgical instruments in the surgical process can be avoided, the smoothness of the surgery is improved, and the surgery time is shortened.

In addition, the bionic surgical instrument can conveniently realize the autorotation of the functional piece when the functional piece is positioned at different operation positions by increasing the autorotation control of the functional piece, so that the operation flexibility and the application range of the instrument are enlarged, and better performance can be provided in the shearing and stitching operation of the visual field side view blind area.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the following description will briefly introduce the drawings that are required to be used in the embodiments or the description of the prior art, and it is obvious that the drawings in the following description are only some embodiments described in the embodiments of the present application, and other drawings may also be obtained according to these drawings for a person having ordinary skill in the art.

Fig. 1 is a schematic overall structure of an embodiment of a bionic surgical instrument according to the present application.

Fig. 2 is a schematic cross-sectional view of the structure of fig. 1.

Fig. 3 is a schematic diagram of the principle of actuation of the bionic surgical instrument of the present application.

Fig. 4 is a schematic view of an embodiment of a holding posture of the bionic surgical instrument according to the present application.

Fig. 5 is a schematic view of a partial structure of fig. 1.

Element labels

1: bionic surgical instruments;

10: a handle;

12: positioning the sleeving part;

20: an extension member;

22: a first link;

222: adjusting the sleeving part;

24: a second link;

30: a functional member;

42: a head end bendable structure;

44: a tail end bendable structure;

442: a first end;

444: a second end;

52: an operating member;

524: a finger ring;

54: a locking member;

56: a rotating member;

562: a thumb wheel;

60: a drive shaft;

62: a first gear;

64: a second gear;

66: a third gear;

68: and a fourth gear.

Detailed Description

In order to better understand the technical solutions in the embodiments of the present application, the following descriptions will clearly and completely describe the technical solutions in the embodiments of the present application with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only some embodiments of the present application, but not all embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the embodiments of the present application shall fall within the scope of protection of the embodiments of the present application.

Minimally invasive surgery refers to cutting or repairing organ focuses in abdominal cavities, thoracic cavities, pelvic cavities or joint cavities and the like by puncturing the body surfaces of human bodies to form a plurality of operation channels; or enter the body cavity through natural cavity such as oral cavity, urethra, rectum, vagina, etc. by the above-mentioned route with endoscope and operation instrument, under the monitoring of endoscope by operator, operate the instrument outside the patient's body through the hand, stretch into the patient's body cavity with the help of instrument working end and carry on operations such as excision or repair, suture to the organ of intracavity, etc. after the operation, take out endoscope and instrument, suture the aperture or natural cavity of the body surface and cut, can finish the whole operation.

Compared with the traditional surgery, the minimally invasive surgery has the advantages of small surgical wound, less postoperative complications, reduced postoperative pain, short hospitalization time and the like, and is now the first choice treatment scheme for a plurality of common diseases in surgery. The operation type incision is usually about 3-5 incisions with the length of 5-20 mm as an operation channel, and a doctor needs to conduct operation by means of an elongated special laparoscopic surgical instrument.

The laparoscopic surgical instruments most commonly used worldwide are generally elongated straight surgical instruments, which have the following drawbacks over traditional open surgery: 1. the operation angle of the straight instrument is severely limited, and only lever type movement taking the body surface incision as a movement fulcrum can be performed in a human body; 2. for operations requiring complicated operations such as fine separation, suturing, knotting and the like, the straight instrument is difficult to achieve, and a doctor is usually required to master the operation through a large amount of model training or animal experiment training; 3. for single incision operation of thoracic cavity and abdominal cavity or minimally invasive operation of natural cavity channel of human body, the common long straight instrument is difficult to adapt to the operation requirement of narrow space, and presents great challenges for the training level of operating doctors, and although the operation mode is very favored by patients, the number of operators capable of completing the operation mode is very rare. The reason for this is mainly the lack of a multi-degree-of-freedom surgical instrument with flexible motion control capability, which can be controlled by simple logic and intuitionally.

With the progress of science and technology, intelligent surgical instrument systems represented by da vinci surgical robots are gradually popularized and used in various countries around the world, and the complex operations of suturing and knotting become very simple due to the light intuitive control mode, the comfortable doctor remote control mode and the wrist-imitating instrument movement mode; however, the surgical instruments used by the technology are consumable products, the average consumable cost of each operation is between 3-5 ten thousand RMB, the number of robot-assisted minimally invasive operations finished in China is less than 10 ten thousand (the number of robot-assisted machines in China is less than 200 by 2022 in 1 month), and compared with the requirement of chest and laparoscope minimally invasive operations in thousands of cases in each year, the requirements of people on the high and new technology can not be met.

In recent years, a novel manual bendable surgical instrument is internationally appeared, a joint capable of controlling bending is added on the basis of a traditional straight laparoscopic instrument, and besides lever type prying, the joint movement of an arm and a wrist can be used for controlling the head end of the instrument to bend and rotate in multiple degrees of freedom. For example: the form of the instrument provided in CN101909526a and CN102525659a patents. However, clinical application for many years proves that as the movement center of the force application part of the instrument is positioned at the front side of the palm, the ergonomics during operation are not ideal, the control of the instrument needs the wrist movement and the large-amplitude movement of the hand forearm, even the large arm and the shoulder to control the instrument, so that a surgeon is very confused, and both products are withdrawn from the market until now.

In patent US20170095922A1 (FlexDex Surgical inc.) a design using the center point of the wrist of the human body as the bendable control center point appears, and the rotating center of the whole force application member is just located at the center point of the section of the wrist by wearing a bracelet on the hand of the doctor and then engaging the bracelet with the force application member of the instrument, so that the intuitive movement habit of grasping an object by the human hand and swinging the object by rotating the wrist is consistent, thereby realizing simpler control and effect logic, improving the control efficacy, avoiding long-time adaptive training and reducing the using operation threshold. However, doctors find that the grasping form of the instrument force application member can not enable the doctor to complete the grasping and separating actions of the instrument by one hand after clinical application, and when an emergency such as bleeding occurs in the operation, the doctor of the main knife is difficult to quickly release the instrument force application member, so that possible risks are caused. In addition, as the surgical operation of different target organs or the same organ, the selection of different surgical access ways can lead to the changeable angle of the surgical instrument inserted into the human body, so that the changeable requirement on the included angle between the arm and the instrument main body is met, the angle and the direction of the force application part of the instrument held by the hand of a doctor are not fixed, but the holding mode of the force application part of the instrument is single and cannot adapt to the change of various holding modes, so that the wrist or the arm of the doctor can be easily damaged due to the fact that the flexible holding mode and angle cannot be selected during the surgical operation, and the use experience is poor; finally, another major drawback of the above-mentioned instruments is that the connecting bridge of the force application member accommodated by the plurality of traction linkage wires for motion control is too large in volume, so that the collision interference between the instruments or between the instruments and the surgical endoscope often occurs, which brings great influence to the efficiency of the surgical operation.

In US20180110577A1, US20200237466A1 and US10363055B2, a multi-joint multi-degree-of-freedom surgical instrument is provided, wherein the instrument head end consists of two orthogonally arranged motion pivots, which can simulate the motion form of a human hand, and a corresponding orthogonal axis is arranged on a force application member for intuitively controlling the motion form of the instrument head end, so that the instrument (such as the surgical instrument provided in US5792135a, US6312435B1 and US6746443B 1) similar to the da vinci surgical robot (INTUITIVE SURGICAL OPERATIONS, INC.) can realize multi-degree-of-freedom control through a mechanical transmission force application member, the bionic control of the human hand motion form is better realized by the instrument, the control logic is simpler, a doctor can adapt quickly without long-time adaptive training, and the using operation threshold is reduced. The device is characterized in that the movement center of the force application part is positioned right above the wrist, when the device is used, the palm wraps the columnar force application part, and the index finger and the thumb are inserted into the operation ring and used for controlling the opening and closing and the left-right movement of the device head, when the hand grasps the pitching movement of the force application part, the pitching movement control of the device head end can be realized, and the rotation of the device head end along the device rod can be realized by requiring the wrist of a doctor to hold the device force application part to rotate by an angle of 1:1. The main disadvantage of the instrument is that the holding mode of the force application part is strictly limited, and the instrument cannot adapt to the diversified requirements of various target organs or surgical access options on the holding mode of the instrument, so that the wrist and the arm of a doctor are easy to be damaged; secondly, the head end of the instrument cannot independently control rotation, so that a doctor needs to rotate and control by continuously rotating the wrist or the forearm during suturing or knotting operation, the burden of the wrist and the arm is increased, when the head end of the instrument is in an offset state, the wrist is in left, right or up and down bending, and the rotation of the wrist and the forearm is difficult to be overlapped, so that the movement of overlapping bending and rotation can not be realized, and the applicability of the instrument in operation is limited; again, the force application members of the solutions described in the above-mentioned patents are relatively bulky, and collisions between the force application members or between the instrument force application member and the endoscope force application member easily occur, thereby affecting the progress of the operation.

In view of the above, the present application provides a handle control instrument that at least partially solves the above-described problems of the prior art.

Embodiments of the present application will be described in detail below with reference to the accompanying drawings.

Referring to fig. 1 to 3, a bionic surgical instrument 1 of the present application includes a handle 10, an extension member 20, and a functional member 30.

The extension member 20 is connected to the handle 10 and is flexible relative to the handle 10.

In this embodiment, the extension member 20 includes a first link 22 and a second link 24.

The first link 22 is connected to the handle 10 and extends vertically downward from an end of the handle 10, and the second link 24 is connected to the first link 22 and extends laterally from an end of the first link 22.

Alternatively, the second link 24 may extend along a second axis perpendicular to the first axis of the first link 22 such that a right angle is formed between the first link 22 and the second link 24.

Alternatively, the handle axis of the handle 10 may form an angle with the second axis of the second link 24 of no more than 90 degrees.

The functional element 30 is provided at the end of the extension element 20.

In the present embodiment, the functional member 30 is connected to an end of the second link 24.

Alternatively, the functional element 30 may comprise one of forceps and scissors.

Wherein, when the operator holds the handle 10, the extension member 20 is located below the palm of the operator with respect to the center of deflection of the handle 10 (refer to fig. 4).

In this embodiment, the distance between the center of deflection of the extension member 20 relative to the handle 10 and the palm of the operator is not more than 10cm.

In this embodiment, the handle 10 can be forced to flex relative to the extension member 20 to adjust the operating position of the function member 30 (see fig. 1 and 2).

Specifically, the handle 10 is flexible relative to the first link 22 to adjust the operating position of the function 30 via the second link 24.

In this embodiment, the bionic surgical instrument 1 further comprises a cephalad bendable structure 42 and a caudal bendable structure 44.

In this embodiment, the cephalad-end bendable structure 42 and the caudal bendable structure 44 may comprise a snake bone structure.

The head end bendable structure 42 connects the second link 24 with the function element 30 for adjusting the axial direction of the function element 30 to position the function element 30 in different operating positions.

The tail end bendable structure 44 connects the first link 22 with the handle 10 to form a pivot center between the extension member 20 and the handle 10.

Wherein the tail end bendable structure 44 is forced to bend in different directions and drives the head end bendable structure 42 to act in conjunction in different directions to adjust the operating position of the functional element 30.

Alternatively, the handle 10 and the first link 22 position the first end 442 and the second end 444 (see fig. 2) of the tail end bendable structure 44, respectively, to adjust the positioning position of the second end 444 relative to the first end 442 by controlling the handle 10 to rotate in different directions relative to the first link 22 so that the tail end bendable structure 44 bends in different directions.

Specifically, the first link 22 may include an adjustment socket 222 that may position the second end 444, and the handle 10 may include a positioning socket 12 for positioning the first end 442.

Wherein, the adjusting socket 222 and the positioning socket 12 are movably sleeved with each other to form a receiving space a (refer to fig. 2) for receiving the tail end bendable structure 44.

In this embodiment, the adjusting socket portion 222 and the positioning socket portion 12 each include a hemispherical receiving cavity to form a spherical receiving space a.

Wherein, the adjusting socket 222 can flex (i.e. rotate 360 degrees) relative to the positioning socket 12 to adjust the positioning position of the second end 444 relative to the first end 442, so that the tail end bendable structure 44 bends in different directions according to the positioning position of the second end 444 relative to the first end 442.

Alternatively, the first link 22 may comprise a bellows.

Optionally, the bionic surgical instrument 1 further comprises an operating member 52 provided on the handle 10, which is connected to the extension member 20 via a drive shaft 60 and is reciprocally movable relative to the handle 10 between an active position and an inactive position for driving the extension member 20 to reciprocally move in its axial direction.

Referring to fig. 5, the operating member 52 is axially fixed and circumferentially rotatable relative to the drive shaft 60, and as the operating member 52 reciprocates relative to the handle 10 between the active and inactive positions, the drive shaft 60 is driven to move axially and the extension member 20 is driven to reciprocate axially therealong, so that the functional member 30 is switched between the active and inactive states.

For example, when the functional element 30 is a forceps, the operating element 52 can be used to control the switching between the clamping state (i.e. active state) and the opening state (i.e. inactive state).

In this embodiment, when the operating member 52 reciprocates between the active position and the inactive position relative to the handle 10, the first link 22 is driven to axially reciprocate, and the second link 24 is driven to axially reciprocate, so as to control the functional member 30 to switch between the active state and the inactive state.

Alternatively, the operating member 52 can include a finger ring 524 wherein an operator's thumb can be threaded into the operating member 52 to drive the operating member 52 to reciprocate between the active and inactive positions.

Optionally, the bionic surgical instrument 1 may further comprise a locking 54.

Wherein, when the operator grasps the handle 10, the operator's index finger and/or middle finger may be disposed through the locking member 54 to drive the locking member 54 to switch between the locked position and the unlocked position relative to the handle 10, thereby allowing or limiting the movement of the operating member 52 relative to the handle 10 between the active position and the inactive position.

In this embodiment, the locking member 54 can position the operating member 52 in any one of the active and inactive positions for the functional member 30 (e.g., forceps) to be adapted to perform related operations with respect to target tissues of different thicknesses.

Optionally, the bionic surgical instrument 1 further comprises a rotation member 56 provided on the handle 10, which is connected to the extension member 20 and is rotatable circumferentially with respect to the handle 10 to drive the functional member 30 via the extension member 20 to perform a rotation motion.

Optionally, autorotation 56 comprises thumb wheel 562.

Wherein, when the operator holds the handle 10, the thumb wheel 562 is located within the operable range of the operator's thumb to drive the thumb wheel 562 to rotate circumferentially relative to the handle 10 in a clockwise direction or a counterclockwise direction.

Optionally, the bionic surgical instrument 1 further comprises a drive shaft 60, a first gear 62, a second gear 64, a third gear 66, a fourth gear 68.

Referring to fig. 5, the driving shaft 60 is connected to the rotation member 56, the first gear 62 is provided at an end of the driving shaft 60 near the first link 22, the second gear 64 is provided at an end of the first link 22 near the handle 10 and engaged with the first gear 62, the third gear 66 is provided at an end of the first link 22 near the second link 24, and the fourth gear 68 is provided at an end of the second link 24 near the first link 22 and engaged with the third gear 66.

Wherein thumb wheel 562 and first gear 62 are circumferentially fixed and axially movable relative to drive shaft 60, and operating member 52 is axially fixed and circumferentially rotatable relative to drive shaft 60. Therefore, when the driving shaft 60 is controlled to move linearly in the axial direction thereof by the operating member 52, the thumb wheel 562 and the first gear 62 do not generate an axial movement linkage with the axial movement of the driving shaft 60; similarly, when the driving shaft 60 is controlled to rotate circumferentially by the thumb wheel 562, the operating member 52 does not generate a circumferential rotational linkage with the circumferential rotation of the driving shaft 60.

In this embodiment, when the rotation member 56 rotates circumferentially relative to the handle 10, the first link 22 is driven to rotate circumferentially, and the second link 24 is driven to rotate circumferentially via the first link 22, so that the functional member 30 performs the rotation.

In summary, the bionic surgical instrument provided in the embodiments of the present application may provide an open handle holding manner, so as to meet the requirement of different surgical approaches on the diversity of the holding angles of the instrument, and by using the design mechanism that the extension piece is located below the palm of the operator relative to the flexible center of the handle, the operation hand feeling of the operator may be improved.

Furthermore, the bionic surgical instrument can provide an intuitive control mode, can be operated by hands without special training, can reduce a surgical barrier, and improves the control accuracy of the surgical instrument.

In addition, the bionic surgical instrument has the advantage of small volume, and can avoid collision between instrument bodies or instrument handles of different surgical instruments (such as the bionic surgical instrument and an endoscope) in the surgical process, so that the smoothness of the surgery is improved, and the surgical time is shortened.

In addition, the bionic surgical instrument can flexibly adjust the positioning axial direction of the functional piece through increasing the rotation control of the functional piece so that the functional piece is positioned at different operation positions, conveniently realize the rotation of the functional piece, enlarge the operation flexibility and the application range of the instrument, and provide better performance in shearing and stitching operation of visual field side view blind areas.

Finally, it should be noted that: the above embodiments are only for illustrating the technical solutions of the embodiments of the present application, and are not limited thereto; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit and scope of the corresponding technical solutions.

Claims (14)

1. A bionic surgical instrument comprising:

a handle;

an extension member coupled to the handle and being deflectable relative to the handle;

a functional member provided at an end of the extension member; wherein, the liquid crystal display device comprises a liquid crystal display device,

when the operator holds the handle, the extension piece is positioned below the palm of the operator relative to the flexible center of the handle;

the handle is deflectable relative to the extension member to adjust the operating position of the functional element.

2. The apparatus of claim 1, wherein the extension is no more than 10cm from the center of deflection of the handle relative to the center of palm of the operator.

3. The instrument of claim 1, wherein the extension comprises:

a first link connected to the handle and extending vertically downward from an end of the handle;

a second link connected to the first link and extending laterally from an end of the first link;

the handle can flex relative to the first connecting rod so as to adjust the positioning axial direction of the functional piece through the second connecting rod;

an included angle of not more than 90 degrees is formed between the handle axis of the handle and the second axis of the second connecting rod.

4. The instrument of claim 3, wherein the second axis of the second link is along a first axis perpendicular to the first link such that a right angle is formed between the first link and the second link.

5. The instrument of claim 3, further comprising:

a head end bendable structure connecting the second link and the functional element;

a tail end bendable structure connecting the first link and the handle;

the tail end bendable structure can be stressed to bend along different directions and drive the head end bendable structure to act in a linkage mode along different directions so as to adjust the operation position of the functional piece.

6. The instrument of claim 5, wherein the handle and the first link position the first and second ends of the tail end bendable structure, respectively;

the handle is controlled to rotate in different directions relative to the first connecting rod, so that the positioning position of the second end relative to the first end is adjusted, and the tail end bendable structure bends in different directions.

7. The instrument of claim 6, wherein the first link includes an adjustment socket that can position the second end, and the handle includes a positioning socket that can position the first end;

the adjusting sleeve joint part and the positioning sleeve joint part are movably sleeved with each other to form an accommodating space for accommodating the tail end bendable structure;

the adjusting sleeve joint part can flex relative to the positioning sleeve joint part so as to adjust the positioning position of the second end relative to the first end.

8. An instrument according to claim 1 or 3, further comprising an operating member provided on the handle, connected to the extension member via a drive shaft and reciprocally movable relative to the handle between an active position and a non-active position;

the operating piece is axially fixed relative to the driving shaft and circumferentially rotates, and when the operating piece reciprocates between an acting position and a non-acting position relative to the handle, the operating piece can drive the driving shaft to axially move and drive the extending piece to axially reciprocate along the operating piece, so that the functional piece is switched between an acting state and a non-acting state.

9. The apparatus of claim 8, wherein the operator's thumb is insertable into the operating member to drive the operating member to reciprocate between the active and inactive positions when the operator is held on the handle.

10. The instrument of claim 8, further comprising a lock;

wherein when the operator holds the handle, the operator's index finger and/or middle finger can be inserted into the locking member to drive the locking member to switch between a locking position and an unlocking position relative to the handle, thereby allowing or limiting the movement of the operating member relative to the handle.

11. The instrument of claim 3, further comprising a rotatable member disposed on the handle, coupled to the extension member and rotatable circumferentially relative to the handle to actuate the functional member via the extension member to perform the rotational motion.

12. The apparatus of claim 11, wherein the pivoting member is located within an operable range of a thumb or middle finger of the operator when the operator is holding on the handle.

13. The instrument of claim 11, further comprising:

a drive shaft connected to the rotating member;

a first gear provided at an end of the drive shaft near the first link;

a second gear provided at an end of the first link near the handle and engaged with the first gear;

a third gear provided at an end of the first link near the second link;

a fourth gear which is provided at an end portion of the second link near the first link and is engaged with the third gear;

the self-rotating piece and the first gear are circumferentially fixed relative to the driving shaft and axially move, when the self-rotating piece circumferentially rotates relative to the handle, the first connecting rod can be driven to circumferentially rotate, and the second connecting rod is driven to circumferentially rotate through the first connecting rod, so that the functional piece can execute rotating motion.

14. The instrument of claim 1, wherein the functional element comprises one of a surgical clamp and a surgical scissors.

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