JP2018153444A - Instrument for surgical operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an instrument for surgical operation that can further reduce operational mistakes and enable further intuitive operation.SOLUTION: An instrument 1 for surgical operation includes: a treatment instrument 4; a support shaft 3 allowing the treatment instrument 4 to displace in a first direction D1 and a second direction D2; a first operation member 61 for causing the treatment instrument 4 to displace in the first direction D1 by receiving force in a first operation direction D10 along the first direction D1; and a second operation member 71 for causing the treatment instrument 4 to displace in the second direction D2 by receiving force in a second operation direction D20 along the second direction D2.SELECTED DRAWING: Figure 1

Description

  The present invention relates to surgical instruments.

  In surgical operations such as open surgery, laparoscopic surgery, and thoracoscopic surgery, surgical instruments such as forceps are used (see, for example, Non-Patent Document 1). The forceps described in Non-Patent Document 1 includes a forceps body, a first shaft extending from the forceps body, a second shaft connected to the tip of the first shaft, a clamp portion attached to the tip of the second shaft, have. The first axis is rotatable with the central axis of the first axis as the first rotation axis. Further, the second shaft is configured to be swingable with respect to the first shaft around a second rotation shaft extending in a direction orthogonal to the direction in which the first rotation shaft extends. Furthermore, the second axis can rotate with the central axis of the second axis as the third rotation axis.

Steerable Laparoscopic Instruments -especially beneficial in single incision endoscopic surgery-, (Taiwan), CoreBio Technologies Co., Ltd., CoreBio Mas -laparoscopic instrument-

  In the forceps described in Non-Patent Document 1, the rotation operation around the first to third axes is performed by an operator operating three dials. These three dials are arranged in series and on the same rotation axis, and the surgeon performs a rotation operation around the same rotation axis regardless of which dial is operated. For this reason, it is difficult for the surgeon to distinguish which of the three dials is the desired dial, and the surgeon may operate a dial other than the dial that the surgeon wants to operate by mistake.

  Furthermore, the rotation direction of the second axis around the second rotation axis does not match the rotation operation direction of the corresponding dial, and the dial rotation direction corresponding to the rotation direction of the second axis around the third rotation axis. The rotation operation direction does not necessarily match. As a result, it is difficult for the surgeon to perform an intuitive operation using the three dials.

  An object of the present invention is to provide a surgical instrument that can reduce operation errors and can be operated more intuitively in view of the above problems.

  (1) A surgical instrument according to the present invention for achieving the above object includes a treatment tool for performing a treatment on a treatment target, a distal end portion that supports the treatment instrument, and a group that is paired with the distal end portion. A support shaft having an end portion, the support shaft displaceable in a predetermined first direction and a second direction with respect to the base end portion, and a first operation direction along the first direction; A first operating member for receiving a force to displace the tip in the first direction, and a force in a second operation direction along the second direction to displace the tip in the second direction. A second operating member.

  According to this configuration, the surgeon can displace the treatment tool in the first direction by operating the first operation member while applying a force in the first operation direction along the first direction. Similarly, the surgeon can displace the treatment tool in the second direction by operating the second operation member while applying a force in the second operation direction along the second direction. In this way, the surgeon only needs to apply a force along the direction in which the treatment tool is to be displaced to the corresponding operation member. With this configuration, the surgeon can operate each operation member more intuitively. Thereby, the erroneous operation of operating the operation member different from the operation member that the surgeon wants to operate can be more reliably suppressed. As described above, it is possible to realize a surgical instrument that can reduce an operation error by an operator and can be operated more intuitively.

  (2) The first operation direction and the second operation direction may be set in directions orthogonal to each other.

  According to this configuration, the range in which the treatment tool can be moved by each operation of the first operation member and the second operation member can be further widened.

  (3) The first operating member and the second operating member may each include a rotary dial member that rotates about a predetermined rotation axis.

  According to this configuration, the operator can displace the treatment instrument in the first direction and the second direction with a simple operation of rotating the rotary dial member. Moreover, if it is a rotary dial member, the surgeon can operate a rotary dial member, without moving a finger | toe largely. Therefore, the surgeon can more easily operate the surgical instrument.

  (4) The surgical instrument may further include a position holding mechanism for restricting displacement of the first operation member and displacement of the second operation member.

  According to this configuration, the position holding mechanism can keep the position of the treatment instrument in each of the first direction and the second direction constant. Thereby, it is possible to prevent the operator from constantly operating each operation member during the surgical operation.

  (5) The first operation member is configured to be rotatable about a predetermined first rotation axis, the second operation member is configured to be rotatable about a predetermined second rotation axis, and the position holding mechanism is A first position holding portion for restricting rotation of the first rotating shaft by engaging with the first rotating shaft; and rotation of the second rotating shaft by engaging with the second rotating shaft. And a second position holding unit for regulating.

  According to this configuration, each position holding portion engages with the corresponding rotation shaft, so that the rotational displacement of the corresponding operation member can be more reliably regulated with a simple configuration.

  (6) Each said position holding part may have a wedge-shaped part comprised so that a corresponding rotating shaft could be pinched | interposed.

  According to this configuration, the rotational displacement of the corresponding operation member can be strongly regulated by sandwiching the rotation shaft corresponding to the wedge-shaped portion.

  (7) The surgical instrument further includes a release mechanism for releasing the rotation restriction of each rotation shaft by the position holding mechanism, and the release mechanism corresponds to each wedge-shaped portion of the position holding mechanism. There is a case where the engagement with the rotating shaft is released.

  According to this configuration, the engagement between each wedge-shaped portion and the corresponding rotating shaft can be released by operating the release mechanism. By providing the release mechanism, the operator does not have to perform a troublesome work to release the engagement between each wedge-shaped portion and the corresponding rotary shaft, such as pulling each operation member with a strong force.

  According to the present invention, it is possible to realize a surgical instrument that can reduce operation errors and can be operated more intuitively.

1 is a perspective view of a surgical instrument according to an embodiment of the present invention. It is a typical partial cross section side view of a surgical instrument, and a part of support shaft is omitted and shown. It is a typical perspective view for demonstrating the structure of the principal part of a joint part. It is a side view which expands and shows the structure of the front-end | tip part of a spindle and an opening / closing operation mechanism, and has shown one part by the cross section. (A) is a perspective view which shows the structure of the principal part of a 1st operation mechanism, (B) is a perspective view which shows the structure of the principal part of a 2nd operation mechanism. FIG. 6 is a plan view of the rear part of the surgical instrument. It is the partial cross section side view which expanded the rear part of the main body of a surgical instrument, and the periphery of a joint part. (A) is a figure for demonstrating closing operation of a treatment tool, (B) is a figure for demonstrating opening operation of a treatment tool. (A) is a figure for demonstrating the operation | movement which displaces a treatment tool to the one (upward) of a 1st direction, (B) demonstrates the operation | movement which displaces a treatment tool to the other (downward) of a 1st direction. FIG. (A) is a figure for demonstrating the operation | movement which displaces a treatment tool to one side (right) of a 2nd direction, (B) is the operation | movement which displaces a treatment tool to the other (left side) of a 2nd direction. It is a figure for demonstrating. It is a typical partial exploded perspective view which shows the principal part of a modification.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.

  FIG. 1 is a perspective view of a surgical instrument 1 according to an embodiment of the present invention. FIG. 2 is a schematic partial cross-sectional side view of the surgical instrument 1, with a part of the support shaft 3 omitted. With reference to FIG. 1 and FIG. 2, the surgical instrument 1 is operated by an operator's hand in a surgical operation such as a laparoscopic operation and a thoracoscopic operation on a patient as a treatment target, An operation for grasping the affected area, an operation for cutting the affected area, and the like are configured. In this embodiment, the surgical instrument 1 is formed in a pistol shape (L-shape in side view) as a whole, and has a shape that can be easily grasped by an operator's hand.

  In the present embodiment, the direction along the longitudinal direction of the surgical instrument 1 is referred to as the front-rear direction FB, and the direction orthogonal to the front-rear direction FB in the side view of the surgical instrument 1 is referred to as the up-down direction UD. A direction orthogonal to both the directions UD is referred to as a left-right direction LR.

  The surgical instrument 1 includes a main body 2, a support shaft 3 attached to the main body 2, a treatment tool 4 supported by the support shaft 3, and a treatment tool operation mechanism 5 for operating the treatment tool 4. Have.

  In the present embodiment, the main body 2 is formed in an L shape in a side view. The main body 2 is formed in a hollow shape using a synthetic resin or a metal material, and a part of the treatment instrument operating mechanism 5 is accommodated in the main body 2.

  The main body 2 has a grip portion 6 and a barrel portion 7.

  The grip portion 6 is a portion that is gripped by an operator's hand. The grip part 6 is formed in a column shape. The rear part of the grip part 6 is formed in a recessed shape and is configured to receive the operator's palm. Moreover, the front part of the grip part 6 is formed in the linear shape extended in the up-down direction UD, for example, and is comprised so that an operator's fingertip may be received. At the lower end portion of the grip portion 6, a lower end opening 45 is formed through which a release button 91 described later of the treatment instrument operation mechanism 5 is exposed. The lower end opening 45 is disposed at a position where the operator can touch the operator with his / her finger when the operator grips the grip 6. The upper end portion of the grip portion 6 is continuous with the barrel portion 7.

  The barrel portion 7 is a shaft-like portion that is elongated in the front-rear direction FB. The rear portion of the barrel portion 7 is continuous with the rear portion of the upper end portion of the grip portion 6 and is arranged so that it can be touched by the surgeon's thumb. The front part of the barrel part 7 projects forward of the grip part 6. A support shaft 3 is attached in front of the barrel portion 7.

  The support shaft 3 is a shaft member for supporting the treatment instrument 4. The support shaft 3 is elongated in the front-rear direction FB, and is formed in a round shaft shape in the present embodiment. The diameter of the support shaft 3 is made as small as possible so that the amount of incision on the patient's body surface during surgery can be made as small as possible. In the support shaft 3, a base end portion 3 a and a distal end portion 3 b that supports the treatment instrument 4 are paired in the front-rear direction.

  The support shaft 3 includes a base shaft 11 fixed to the front end portion of the barrel portion 7 of the main body 2, a movable shaft 12 that can be displaced with respect to the base shaft 11, and a joint that connects the base shaft 11 and the movable shaft 12 to each other. Part 13.

  The base shaft 11 is a hollow shaft member that extends straight in the front-rear direction FB. The base end portion of the base shaft 11 is fixed to the front end portion of the barrel portion 7 and is continuous with the space in the barrel portion 7. A movable shaft 12 is disposed on the front end side of the base shaft 11.

  The movable shaft 12 is connected to the base shaft 11 via a joint portion 13. In the present embodiment, the outer diameter of the movable shaft 12 is set to be the same as the outer diameter of the base shaft 11. Further, the movable shaft 12 is configured so that the distal end portion of the movable shaft 12 can be displaced in a predetermined first direction D1 with respect to the base shaft 11 and the main body 2, and in a predetermined second direction. D2 is configured to be displaceable.

  In the present embodiment, the first direction D1 is the up-down direction UD, and the second direction D2 is the left-right direction LR. In the present embodiment, when the movable shaft 12 is displaced with respect to the base shaft 11 with the joint portion 13 as a fulcrum, the distal end portion of the movable shaft 12 is displaced in the first direction D1 and the second direction D2. That is, the distal end portion 3b of the support shaft 3 (the distal end portion of the movable shaft 12) is displaced in the first direction D1 and the second direction D2 with respect to the base end portion 3a of the support shaft 3 (the base end portion of the base shaft 11). Is possible. In the present embodiment, the first direction D1 and the second direction D2 are directions orthogonal to each other.

  The movable shaft 12 is a hollow shaft member that extends linearly. A base end portion of the base shaft 11 is connected to the joint portion 13. The movable shaft 12 is arranged so as to be aligned with the base shaft 11. The front end portion of the movable shaft 12 supports the treatment instrument 4.

  FIG. 3 is a schematic perspective view for explaining the configuration of the main part of the joint part 13. With reference to FIGS. 2 and 3, the joint portion 13 is configured such that the front end portion of the base shaft 11 and the rear end portion of the movable shaft 12 are relative to each other in one degree of freedom or multiple degrees of freedom (in this embodiment, two degrees of freedom). It is provided to displaceably connect. The joint portion 13 is disposed near the distal end portion 3b of the support shaft 3, and the displacement amount of the distal end portion 3b of the movable shaft 12 when the movable shaft 12 swings with respect to the base shaft 11 does not become excessive. It is configured as follows.

  The joint portion 13 has a plurality of node rings 16 covered with a cover portion 15.

  The cover portion 15 is a member for preventing a liquid such as a body fluid from entering the support shaft 3, and is formed of a material having elasticity such as rubber.

  The plurality of node rings 16 are members provided to connect the base shaft 11 and the movable shaft 12 in cooperation with a first displacement operation wire 62 and a second displacement operation wire 72 described later. A plurality (four in this embodiment) of node rings 16 are provided. In the present embodiment, the node ring 161 is fixed to the inner peripheral surface of the front end portion of the base shaft 11. The node rings 162 and 163 are disposed between the base shaft 11 and the movable shaft 12 and are not fixed to any of these shafts 11 and 12. The node ring 164 is fixed to the inner peripheral surface of the rear end portion of the movable shaft 12. The plurality of node rings 161 to 164 are connected to each other by the first displacement operation wire 62 and the second displacement operation wire 72. Each node ring 16 is formed using, for example, a synthetic resin or a metal.

  Each node ring 16 includes a peripheral wall portion 16a, first and second walls 16b and 16c formed on the inner peripheral portion of the peripheral wall portion 16a, first displacement operation wire through-hole portions 16d and 16e, and a second displacement. It has the through-hole parts 16f and 16g for operation wires, the ball | bowl formation part 16h, and the bearing formation part 16i.

  The peripheral wall 16a is formed in a cylindrical shape such as a cylindrical shape. The outer diameter of the peripheral wall portion 16a is set to be substantially the same as the inner diameter of the shafts 11 and 12. The peripheral wall portions 16 a of the node rings 161 and 164 are fixed to the inner peripheral surfaces of the corresponding base shaft 11 and movable shaft 12, respectively. The first wall 16b is formed in a thin flat plate shape, and is disposed so as to connect portions (upper end portion and lower end portion) separated by 180 degrees in the peripheral wall portion 16a. Similarly, the 2nd wall 16c is formed in the shape of a thin flat plate, and is arrange | positioned so that the location (left end part and right end part) 180 degree apart may be connected among the surrounding wall parts 16a. In the present embodiment, the positions of the first wall 16b and the second wall 16c in the circumferential direction of the peripheral wall portion 16a are shifted by 90 degrees.

  First displacement operation wire through-hole portions 16d and 16e are formed at both ends of the first wall 16b. Similarly, second displacement operation wire through holes 16f and 16g are formed at both ends of the second wall 16c. Each through-hole portion 16 d to 16 g extends so as to penetrate the node ring 16 along the axial direction of the node ring 16. The inner diameters of the through-hole portions 16d to 16g are the same as the outer diameters of the corresponding wires 62 and 72, or about several percent larger than the outer diameters. A sphere forming portion 16h and a bearing forming portion 16i extend from the vicinity of the intersection between the first wall 16b and the second wall 16c.

  The ball forming portion 16h is formed in a shaft shape protruding forward from the node ring 16, and a spherical portion is formed at the tip of the shaft-shaped portion. The bearing forming portion 16i is formed in a shaft shape protruding rearward from the node ring 16, and a concave bearing portion is formed at the rear end of the shaft-shaped portion. The radius of curvature of the bearing is set to be greater than the radius of curvature of the spherical portion. The spherical part of the ball forming part 16h and the bearing part of the bearing forming part 16i in the two node rings 16 adjacent to each other in front and back are in contact with each other, thereby forming a spherical joint. With this configuration, adjacent node rings 16 are configured to be relatively displaced by spherical joints. The distal end portion 3 b of the support shaft 3 having the above configuration supports the treatment instrument 4.

  FIG. 4 is an enlarged side view showing the configuration of the tip 3b of the support shaft 3 and the opening / closing operation mechanism 30, and a part thereof is shown in cross section. With reference to FIG. 2 and FIG. 4, the treatment tool 4 is used to perform treatment on a patient. In this embodiment, the treatment tool 4 is a grasping forceps and is mainly used for grasping a patient's body tissue. The treatment tool 4 may have a configuration for performing other functions such as scissors for cutting the patient's body tissue and a hook for hooking the patient's body tissue.

  The treatment instrument 4 includes a pair of jaws 18a and 18b and an opening / closing mechanism 19 for opening and closing the pair of jaws 18a and 18b.

  The jaws 18a and 18b are each formed in an elongated plate shape and face each other. The base ends of the jaws 18 a and 18 b are connected to the opening / closing mechanism 19. The opening / closing mechanism 19 is attached to the distal end portion 3 b of the movable shaft 12.

  The opening / closing mechanism 19 includes a linear motion shaft 22 and a motion conversion mechanism 23.

  The linear motion shaft 22 is a shaft member that is accommodated in the distal end portion 3 b of the movable shaft 12 and extends parallel to the movable shaft 12. A first rack tooth 24 a and a second rack tooth 24 b which are rack teeth are formed on the outer peripheral surface of the linear motion shaft 22. The first rack teeth 24 a and the second rack teeth 24 b extend in parallel to the axial direction of the movable shaft 12. The linear motion shaft 22 is connected to the motion conversion mechanism 23.

  The motion conversion mechanism 23 is housed in the distal end portion 3b of the movable shaft 12, and converts the linear motion of the linear motion shaft 22 into an opening / closing motion of the pair of jaws 18a and 18b. As the motion conversion mechanism, various configurations such as a link mechanism and a cam mechanism can be exemplified. For example, when the linear motion shaft 22 is displaced toward the motion conversion mechanism 23, the pair of jaws 18a and 18b can be closed to grasp the patient's body tissue. On the other hand, when the linear motion shaft 22 is displaced in a direction away from the motion conversion mechanism 23, the pair of jaws 18a and 18b can be opened to release the body tissue. The treatment instrument 4 having the above configuration is operated by the treatment instrument operation mechanism 5.

  The treatment instrument operating mechanism 5 is disposed across the main body 2 and the support shaft 3, and is operated by an operator to dispose the treatment instrument 4 disposed at the distal end portion 3b of the movable shaft 12 in the first direction D1. Further, the pair of jaws 18a and 18b are opened and closed by being displaced in the second direction D2.

  The treatment instrument operation mechanism 5 includes an opening / closing operation mechanism 30 and a displacement operation mechanism 50.

  The opening / closing operation mechanism 30 is provided to open and close the pair of jaws 18a and 18b of the treatment instrument 4 in response to an instruction from the operator. The opening / closing operation mechanism 30 is disposed from the barrel portion 7 of the main body 2 to the distal end portion 3 b of the movable shaft 12.

  The opening / closing operation mechanism 30 includes a trigger 31, a biasing member 32 for biasing the trigger 31, a sector gear 33 provided on the trigger 31, a proximal-side rotating member 34 that meshes with the sector gear 33, and a proximal-side rotation. The opening / closing operation wire 35 attached to the member 34, the first distal end side rotating member 36 that receives the force from the one end side portion 35a of the opening / closing operation wire 35 and meshes with the first rack teeth 24a, and the other end of the opening / closing operation wire 35 A second distal end side rotation member 37 that receives force from the side portion 35b and meshes with the second rack teeth 24b.

  The trigger 31 is a member operated by an operator to open and close the jaws 18a and 18b. The trigger 31 is a member formed in an arc shape, and extends obliquely downward from the front portion of the barrel portion 7 of the main body 2. The base end portion of the trigger 31 is swingably supported by the barrel portion 7 via a connecting shaft 31a extending in the left-right direction. The connecting shaft 31 a is disposed in the barrel portion 7. With the above configuration, the trigger 31 can be swung by the operator's finger holding the grip portion 6.

  The trigger 31 is configured to stop at a stop position shown in FIG. 2 by an urging member 32 such as a coil spring. The tip of the trigger 31 is biased in a direction away from the grip portion 6. Thereby, when the trigger 31 is pulled (the tip of the trigger 31 is displaced toward the grip portion 6), the trigger 31 is displaced against the elastic repulsive force of the urging member 32. A sector gear 33 is formed at the base end portion of the trigger 31, and when the sector gear 33 rotates around the connecting shaft 31a, the base end side rotation member 34 rotates.

  The proximal end side rotation member 34 is disposed in the barrel portion 7 and is rotatably supported by the barrel portion 7 via a connecting shaft 34a. The proximal end side rotation member 34 has an external tooth portion 34b that meshes with the sector gear 33, and a body portion 34c that rotates integrally with the external tooth portion 34b.

  The trunk | drum 34c is formed in the column shape. An opening / closing operation wire 35 is wound around, for example, about a half circumference of the body portion 34 c and is in frictional contact with the opening / closing operation wire 35. With this configuration, a portion of the opening / closing operation wire 35 that is frictionally engaged with the trunk portion 34c rotates integrally with the trunk portion 34c around the connecting shaft 34a. With this configuration, when the base end side rotation member 34 (body portion 34c) rotates to one side around the connecting shaft 34a, one end side portion 35a of the opening / closing operation wire 35 is wound around the body portion 34c, and the opening / closing operation wire 35 The other end side part 35b is drawn out from the trunk | drum 34c. Similarly, when the proximal end side rotation member 34 (body portion 34c) rotates to the other side around the connecting shaft 34a, the other end side portion 35b of the opening / closing operation wire 35 is wound around the body portion 34c, and the opening / closing operation wire 35 The one end side part 35a is drawn out from the trunk | drum 34c.

  The opening / closing operation wire 35 passes through the barrel portion 7, the base shaft 11 of the support shaft 3, each node ring 16, and the movable shaft 12, and the corresponding first tip side rotation member 36 and second tip side. The rotary member 37 is connected.

  The first front end side rotation member 36 and the second front end side rotation member 37 are respectively disposed in the movable shaft 12 and are rotatably supported by the movable shaft 12 via corresponding connecting shafts 36a and 37a. . The first distal end rotation member 36 includes an external tooth portion 36b that meshes with the first rack teeth 24a of the linear movement shaft 22 of the treatment instrument 4, and a body portion 36c that rotates integrally with the external tooth portion 36b. . Similarly, the two distal end side rotation member 37 includes an external tooth portion 37b that meshes with the second rack tooth 24b of the linear movement shaft 22 of the treatment instrument 4, and a body portion 37c that rotates integrally with the external tooth portion 37b. ing.

  The trunk portions 36c and 37c are each formed in a columnar shape. One end portion of the opening / closing operation wire 35 is fixed to the body portion 36c, and one end side portion 35a of the opening / closing operation wire 35 is wound thereon. The other end portion of the opening / closing operation wire 35 is fixed to the body portion 37c, and the other end side portion 35b of the opening / closing operation wire 35 is wound thereon.

  The above is the configuration of the opening / closing operation mechanism 30. Next, the displacement operation mechanism 50 will be described.

  The displacement operation mechanism 50 is provided for displacing the treatment instrument 4 and the movable shaft 12 in the first direction D1 and the second direction D2 by the operation of the operator. The displacement operation mechanism 50 is disposed from the rear end portion of the main body 2 to the joint portion 13, and transmits an operation force applied from an operator's finger holding the grip portion 6 to the joint portion 13.

  The displacement operation mechanism 50 includes a first operation mechanism 51, a second operation mechanism 52, a position holding mechanism 53, and a release mechanism 54.

  FIG. 5A is a perspective view illustrating a configuration of a main part of the first operation mechanism 51. FIG. 5B is a perspective view illustrating a configuration of a main part of the second operation mechanism 52. FIG. 6 is a plan view of the rear part of the surgical instrument 1. FIG. 7 is a partially sectional side view in which the rear part of the main body 2 of the surgical instrument 1 and the periphery of the joint part 13 are enlarged.

  Referring to FIGS. 2, 5A, 6 and 7, the first operating mechanism 51 is a mechanism for displacing the treatment instrument 4 and the distal end portion 3b of the support shaft 3 along the first direction D1. It is.

  The first operation mechanism 51 receives a force in the first operation direction D10 along the first direction D1, and displaces the treatment instrument 4 and the distal end portion 3b of the support shaft 3 in the first direction D1. A first displacement operation wire 62 for transmitting the force applied to the first operation member 61 to the joint portion 13 and a coil spring for applying a biasing force to the first operation member 61 toward the unlocking position D1a. And the like.

  The first operation member 61 is a member that is given a force along the first operation direction D10 by being operated by an operator. The first operation direction D10 and the first direction D1 are parallel to each other, and in the present embodiment, are the up-down direction UD. The first operation member 61 is disposed in the operation region 40 formed in the rear portion of the barrel portion 7 of the main body 2. The operation area 40 has an outer surface inclined rearward and obliquely, and is disposed at a place where, for example, the thumb of the operator holding the grip portion 6 touches naturally. A part of the first operation member 61 is exposed to the outside of the main body 2 through a first opening 41 formed in the operation region 40 and elongated in the front-rear direction FB. In the present embodiment, the first operation member 61 is a rotary dial member and is an integrally molded product.

  The first operating member 61 has a first rotating shaft 61a, and a body portion 61b and a first dial portion 61c fixed to the first rotating shaft 61a.

  The first rotation shaft 61a is a shaft member that extends along the left-right direction LR. Both ends of the first rotating shaft 61a are supported at both ends by a pair of first elongated holes 42 formed in the operation region 40 of the main body 2, and are around the central axis of the first rotating shaft 61a with respect to the main body 2. Can be rotated. In the present embodiment, each first long hole portion 42 is elongated in a direction different from the first direction D1, and in the present embodiment, extends in the left-right direction LR that intersects the first direction D1. With this configuration, the first operating member 61 can rotate around the first rotation shaft 61a and can move linearly in the front-rear direction FB. A body portion 61b and a first dial portion 61c are disposed in the middle portion of the first rotation shaft 61a.

  The trunk portion 61b is a portion around which the first displacement operation wire 62 is wound, and is formed in a cylindrical shape in the present embodiment. The body 61b is accommodated in the operation area 40. An annular groove with which the first displacement operation wire 62 is engaged is formed in the body portion 61b. By forming this annular groove, the first displacement operation wire 62 is prevented from being detached from the body portion 61b.

  A first displacement operation wire 62 is wound around the body portion 61 b over, for example, about a half circumference of the body portion 61 b and is in frictional contact with the first displacement operation wire 62. With this configuration, the portion of the first displacement operation wire 62 that is frictionally engaged with the body portion 61b rotates integrally with the body portion 61b around the first rotation shaft 61a.

  The first displacement operation wire 62 is a flexible wire provided to transmit the force applied to the first operation member 61 to the joint portion 13 as a tensile load. 3 and 7, one end side portion 62a of the first displacement operation wire 62 passes through one first displacement operation wire through-hole portion 16d of each joint ring 16 of the joint portion 13. One end of the first displacement operation wire 62 is fixed to a node ring 164 fixed to the movable shaft 12. The one end may be directly fixed to the movable shaft 12. The other end side portion 62b of the first displacement operation wire 62 penetrates the other first displacement operation wire through-hole portion 16e of each joint ring 16 of the joint portion 13. The other end of the first displacement operation wire 62 is fixed to a node ring 164 fixed to the movable shaft 12. This other end may be directly fixed to the movable shaft 12. The one end side portion 62 a and the other end side portion 62 b are received by pulleys 64 a and 64 b that are rotatably supported by the main body 2. The first displacement operation wire 62 is displaced together with the rotational displacement of the first dial portion 61c.

  The 1st dial part 61c is a part which touches an operator's finger | toe. The first dial portion 61 c is formed in a disc shape, and a part thereof is exposed from the first opening 41 of the main body 2. The diameter of the 1st dial part 61c is set larger than the diameter of the trunk | drum 61b. The larger the ratio of the diameter of the first dial part 61c to the diameter of the body part 61b, the smaller the rotation angle of the body part 61b with respect to the unit displacement amount of the outer peripheral surface of the first dial part 61c around the first rotation shaft 61a. Thereby, the operation amount of the first dial portion 61c by the operator is transmitted to the trunk portion 61b so as to be decelerated. As a result, the displacement amount of the treatment instrument 4 in the first direction D1 with respect to the operation amount of the first dial portion 61c becomes relatively small, and the position of the treatment instrument 4 can be adjusted more finely. In addition, the indicator which shows the displacement amount of the treatment tool 4 in the 1st direction D1 may be displayed on the outer surface of the 1st dial part 61c.

  With reference to FIGS. 2, 5B, 6, and 7, the second operation mechanism 52 displaces the treatment instrument 4 and the distal end portion 3b of the support shaft 3 along the second direction D2. Mechanism.

  The second operation mechanism 52 receives a force in the second operation direction D20 along the second direction D2, and displaces the treatment instrument 4 and the distal end portion 3b of the support shaft 3 in the second direction D2. A second displacement operation wire 72 that transmits the force applied to the second operation member 71 to the joint portion 13, and a coil spring for applying a biasing force to the second operation member 71 toward the unlocking position P2a. Etc., and a second urging member 73.

  The second operation member 71 is a member that is given a force along the second operation direction D20 by being operated by an operator. The second operation direction D20 and the second direction D2 are parallel to each other, and are the left-right direction LR in the present embodiment. Thus, in this embodiment, the 1st operation direction D10 (up-down direction UD) and the 2nd operation direction D20 are set to the direction orthogonal to each other. The second operation member 71 is disposed in the operation area 40 of the main body 2. A part of the second operation member 71 is exposed to the outside of the main body 2 through a second opening 43 formed in the operation region 40 and elongated in the left-right direction LR. In the present embodiment, the second operation member 71 is a rotary dial member and is an integrally molded product.

  The second operating member 71 includes a second rotating shaft 71a, and a body portion 71b and a second dial portion 71c fixed to the second rotating shaft 71a.

  The 2nd rotating shaft 71a is a shaft member extended along the front-back direction FB. Both ends of the second rotating shaft 71a are supported at both ends by a pair of second elongated holes 44 formed in the operation region 40 of the main body 2, and are around the central axis of the second rotating shaft 71a with respect to the main body 2. Can be rotated. In the present embodiment, each of the second long hole portions 44 is elongated in a direction different from the second direction D2, and in the present embodiment, extends in the left-right direction LR that intersects the second direction D2. With this configuration, the second operation member 71 can rotate around the second rotation shaft 71a and can move linearly in the left-right direction LR. A body portion 71b and a second dial portion 71c are disposed in the middle portion of the second rotation shaft 71a.

  The trunk | drum 71b is a part around which the 2nd displacement operation wire 72 is wound, and is formed in the column shape in this embodiment. The body 71b is accommodated in the operation area 40. An annular groove with which the second displacement operation wire 72 is engaged is formed in the body portion 71b. By forming this annular groove, the second displacement operation wire 72 is prevented from being detached from the body portion 71b.

  A second displacement operation wire 72 is wound around the body 71b, for example, around the half circumference of the body 71b, and is in frictional contact with the second displacement operation wire 72. With this configuration, the portion of the second displacement operation wire 72 that is frictionally engaged with the body 71b rotates integrally with the body 71b around the second point axis 71a.

  Moreover, the 2nd displacement operation wire 72 is extended in the left-right direction LR around the trunk | drum 71b. Therefore, the pulley 74a for changing the direction of the one end side portion 72a of the second displacement operation wire 72 between the left and right direction LR and the front and rear direction FB, and the direction of the other end side portion 72b are changed to the left and right direction LR and the front and rear direction. And a pulley 74b for changing between the FB and the FB. These pulleys 74a and 74b are disposed in the barrel portion 7 of the main body 2 and supported by the main body 2, and can rotate around a rotation axis extending in the vertical direction UD.

  The second displacement operation wire 72 is a flexible wire provided to transmit the force applied to the second operation member 71 to the joint portion 13 as a tensile load. Referring to FIGS. 3 and 7, one end side portion 72 a of the second displacement operation wire 72 passes through one second displacement operation wire through-hole portion 16 f of each node ring 16 of the joint portion 13. One end of the second displacement operation wire 72 is fixed to a node ring 164 fixed to the movable shaft 12. The one end may be directly fixed to the movable shaft 12. The other end portion 72 b of the second displacement operation wire 72 passes through the other second displacement operation wire through-hole portion 16 g of each joint ring 16 of the joint portion 13. The other end of the second displacement operation wire 72 is fixed to a node ring 164 fixed to the movable shaft 12. This other end may be directly fixed to the movable shaft 12. The second displacement operation wire 72 is displaced together with the rotational displacement of the second dial portion 71c.

  Referring to FIGS. 1, 3, and 7, second dial portion 71c is a portion that touches the operator's finger. The second dial portion 71 c is formed in a disc shape, and a part thereof is exposed from the second opening 43 of the main body 2. The diameter of the 2nd dial part 71c is set larger than the diameter of the trunk | drum 71b. The larger the ratio of the diameter of the second dial part 71c to the diameter of the body part 71b, the smaller the rotation angle of the body part 71b with respect to the unit displacement amount of the outer peripheral surface of the second dial part 71c around the second rotation shaft 71a. Thereby, the operation amount of the second dial portion 71c by the surgeon is transmitted to the trunk portion 71b so as to be decelerated. As a result, the amount of displacement of the treatment instrument 4 in the second direction D2 with respect to the operation amount of the second dial portion 71c becomes relatively small, and the position of the treatment instrument 4 can be adjusted more finely. In addition, the indicator which shows the displacement amount of the treatment tool 4 in the 2nd direction D2 may be displayed on the outer surface of the 2nd dial part 71c.

  The second dial portion 71c and the first dial portion 61c are disposed adjacent to each other so that the operator can easily touch both the dial portions 61c and 71c while holding the grip portion 6. Has been placed. In the present embodiment, the dial portions 61c and 71c are arranged in a T shape in plan view as a whole. The layout of the first operation member 61 and the second operation member 71 may be any place that can be touched with the thumb of the operator who holds the grip portion 6, and the specific position is not limited.

  In the present embodiment, the shape of the first operation member 61 and the shape of the second operation member 71 are the same. In the present embodiment, when the operation amount of the first dial portion 61c and the operation amount of the second dial portion 71c are the same, the displacement amount of the treatment tool 4 in the first direction D1 and the treatment tool 4 in the second direction D2. The displacement amount is the same.

  With reference to FIG. 2, FIG. 5A, FIG. 5B, and FIG. 7, the position holding mechanism 53 regulates the rotational displacement of the first operating member 61 and the rotational displacement of the second operating member 71. It is provided for. In the present embodiment, the position holding mechanism 53 can regulate the rotational displacement of the first operating member 61 and the rotational displacement of the second operating member 71 independently of each other. The position holding mechanism 53 is disposed in the barrel portion 7 of the main body 2.

  The position holding mechanism 53 includes a first position holding unit 81 and a second position holding unit 82.

  The first position holding part 81 has a first position holding part 81 for restricting the rotation of the first rotating shaft 61 a by engaging with the first rotating shaft 61 a of the first operating member 61.

  The first position holding portion 81 has a pair of wedge-shaped portions 83 fixed to the grip portion 6 of the main body 2.

  The pair of wedge-shaped portions 83 is disposed adjacent to the lock position P1b of the pair of first long hole portions 42. The lock position P1b is a position of the first rotation shaft 61a when the rotation of the first rotation shaft 61a is restricted, and is defined at one end of the first long hole portion. The other end of each first long hole portion 42 is defined as a lock release position P1a. When the first rotation shaft 61a (first operation member 61) is at the unlock position P1a, the first operation member 61 is not engaged with the wedge-shaped portion 83 and is rotatable. On the other hand, when the first rotating shaft 61a (first operating member 61) reaches the lock position P1b against the urging force of the first urging member 63, the rotation is restricted by engaging with the wedge-shaped portion 83. .

  Each wedge-shaped portion 83 is formed in a V shape and has a shape that opens toward the first rotation shaft 61a, and can sandwich a corresponding end portion of the first rotation shaft 61a. The gap inside each wedge-shaped portion 83 is narrowed as the first rotating shaft 61a advances in the direction from the unlock position P1a toward the lock position P1b. Anti-slip processing such as knurling may be performed on the inner surface of each wedge-shaped portion 83.

  The second position holding portion 82 has a second position holding portion 82 for restricting the rotation of the second rotating shaft 71 a by engaging with the second rotating shaft 71 a of the second operating member 71.

  The second position holding portion 82 has a pair of wedge-shaped portions 84 fixed to the grip portion 6 of the main body 2.

  The pair of wedge-shaped portions 84 are disposed adjacent to the lock position P <b> 2 b of the pair of second long hole portions 44. The lock position P2b is a position of the second rotation shaft 71a when the rotation of the second rotation shaft 71a is restricted, and is defined at one end of the second long hole portion 44. The other end of each second long hole portion 44 is defined as a lock release position P2a. When the second rotating shaft 71a (second operating member 71) is in the unlock position P2a, the second operating member 71 is not engaged with the wedge-shaped portion 84 and is rotatable. On the other hand, when the second rotating shaft 71a (second operating member 71) reaches the lock position P2b against the urging force of the second urging member 73, the rotation is restricted by engaging with the wedge-shaped portion 84. .

  Each wedge-shaped portion 84 is formed in a V shape and has a shape that opens toward the second rotation shaft 71a, and can sandwich a corresponding end portion of the second rotation shaft 71a. The clearance inside each wedge-shaped portion 84 is narrowed as the second rotating shaft 71a advances in the direction from the unlock position P2a toward the lock position P2b. Anti-slip processing such as knurling processing may be applied to the inner surface of each wedge-shaped portion 84.

  A release mechanism 54 is provided in association with the position holding mechanism 53 having the above configuration. The release mechanism 54 is provided to collectively release the rotation restriction of the rotation shafts 61 a and 71 a of the operation members 61 and 71 by the position holding mechanism 53. The release mechanism 54 is accommodated in the main body 2 and is arranged from the grip portion 6 to the barrel portion 7 of the main body 2 in the present embodiment.

  The release mechanism 54 includes a release button 91 disposed at the lower end of the main body 2, an urging member 92 attached to the release button 91, and a first transmission unit 93 and a second transmission unit 94 that transmit displacement of the release button 91. And have.

  The release button 91 is a button member operated by the operator. The release button 91 is disposed at the lower front portion of the grip portion 6 of the main body 2 and faces obliquely downward in the front, and is exposed from the lower end opening 45 formed at the lower end portion of the grip portion 6. The release button 91 is disposed so that it can be touched with, for example, a little finger of an operator holding the grip portion 6. The release button 91 is configured not to come off from the main body 2 because the outer peripheral edge of the release button 91 is received by the edge of the lower end opening 45. The release button 91 is elastically urged toward the edge of the lower end opening 45 by an urging member 92 such as a coil spring. The release button 91 is displaced to the upper side of the main body 2 when pressed by the operator. The displacement of the release button 91 is transmitted to the first transmission unit 93 and the second transmission unit 94.

  The first transmission unit 93 is provided to convert the displacement of the release button 91 into a linear displacement of the first operation member 61. The first transmission portion 93 is disposed from the grip portion 6 to the barrel portion 7 in the main body 2. The first transmission unit 93 includes a motion transmission mechanism such as a link mechanism or a cam mechanism. When the first transmission portion 93 is displaced upward by the pressing operation of the release button 91, the first transmission shaft 93 pushes, for example, the first dial portion 61 c of the first operation member 61 in conjunction with the displacement, thereby 61a is displaced from the lock position P1b of the first long hole portion 42 toward the lock release position P1a. Further, when the release button 91 is displaced downward by the urging force of the urging member 92, the distal end portion of the first transmission portion 93 is directed from the lock release position P1b side of the first long hole portion 42 to the lock position P1a side. It is displaced to.

  By such an operation, the first transmission portion 93 pushes the first rotation shaft 61a (first operation member 61) from the lock position P1b to the lock release position P1a, so that the first rotation shaft 61a and the wedge-shaped portion 83 are pushed. Release the engagement.

  The second transmission unit 94 is provided to convert the displacement of the release button 91 into the linear displacement of the second operation member 71. The second transmission portion 94 is disposed from the grip portion 6 to the barrel portion 7 in the main body 2. The second transmission unit 94 includes a motion transmission mechanism such as a link mechanism or a cam mechanism. When the second transmission part 94 is displaced upward by the pressing operation of the release button 91, the second transmission part 94 pushes, for example, the second dial part 71c of the second operation member 71 in conjunction with this displacement, thereby 71a is displaced from the lock position P2b of the second long hole portion 44 toward the lock release position P2a. Further, when the release button 91 is displaced downward by the urging force of the urging member 92, the distal end portion of the second transmission portion 94 is directed from the lock release position P2a side of the second long hole portion 44 to the lock position P2b side. It is displaced to.

  By such an operation, the second transmission portion 94 pushes the second rotation shaft 71a (second operation member 71) from the lock position P2b to the lock release position P2a, so that the second rotation shaft 71a and the wedge-shaped portion 84 are pushed. Release the engagement.

  The above is the schematic configuration of the surgical instrument 1. Next, an example of the operation of the surgical instrument 1 will be described.

<Closing action of treatment tool>
FIG. 8A is a view for explaining the closing operation of the treatment instrument 4. With reference to FIG. 8A, when the trigger 31 is pulled, the proximal end side rotation member 34 rotates around the connecting shaft 34a as indicated by an arrow A11. As a result, the one end side portion 35 a of the opening / closing operation wire 35 is attracted to the proximal end side rotation member 34. Then, the one end side portion 35a of the opening / closing operation wire 35 is fed out from the first distal end side rotating member 36 as indicated by an arrow A12, and the first distal end side rotating member 36 rotates one around the connecting shaft 36a. As a result, the external tooth portion 36b of the first distal end side rotation member 36 displaces the linear movement shaft 22 including the first rack teeth 24a rearward as indicated by an arrow A13. As a result, the pair of jaws 18a and 18b are closed. It is done.

  Thus, when the pair of jaws 18a and 18b is closed, the other end side portion 35b of the opening / closing operation wire 35 is fed out from the proximal end side rotation member 34. Further, the second distal end side rotating member 37 rotates with the displacement of the linear motion shaft 22, and as a result, the second distal end side rotating member 37 winds up the other end side portion 35 b of the opening / closing operation wire 35.

<Opening action of treatment tool>
FIG. 8B is a view for explaining the opening operation of the treatment instrument 4. Referring to FIG. 8B, when the trigger 31 is returned (the trigger base end is displaced rearward), the base end side rotation member 34 is rotated around the connecting shaft 34a as indicated by an arrow A21. Is wound around the other end side portion 35b of the opening / closing operation wire 35. Then, the other end side part 35b of the opening / closing operation wire 35 is drawn out from the second distal end side rotating member 37 as indicated by an arrow A22. Thereby, the 2nd tip side rotation member 37 rotates the circumference of connecting shaft 37a. As a result, the external tooth portion 37b of the second distal end side rotation member 37 displaces the linear movement shaft 22 including the second rack teeth 24b forward as indicated by the arrow A23, and as a result, the pair of jaws 18a and 18b are opened. It is.

  When the pair of jaws 18a and 18b is thus opened, the one end side portion 35a of the opening / closing operation wire 35 is fed out from the proximal end side rotation member 34. Further, the first distal end side rotation member 36 rotates with the displacement of the linear motion shaft 22, and as a result, the first distal end side rotation member 35 winds up the one end side portion 35 a of the opening / closing operation wire 35.

<Operation for displacing the treatment instrument in the first direction>
FIG. 9A is a view for explaining an operation of displacing the treatment instrument 4 in one direction (upward) in the first direction D1. Referring to FIG. 9 (A), the surgeon moves in the first direction of operation D10 as indicated by an arrow A31 in the first dial portion 61c of the first operating member 61 where the operator touches the operator's finger. It is displaced along one side (for example, upward direction). Thereby, one end side part 62a of the 1st displacement operation wire 62 is pulled by the 1st operation member 61 side by rotation of the 1st operation member 61, as shown by arrow A32. Thereby, the space | interval of the part connected by the one end side part 62a of the 1st displacement operation wire 62 among the some node rings 16 of the joint part 13 becomes short. With this displacement, the ball forming portion 16h and the bearing forming portion 16i of the adjacent node rings 16 that are in contact with each other function as a spherical joint. As a result, the movable shaft 12 and the treatment instrument 4 connected to the joint portion 13 are displaced in one direction (upward) in the first direction D1. At this time, the other end side portion 62b of the first displacement operation wire 62 is sent out from the first operation member 61 as indicated by an arrow A33. And the space | interval of the part connected by the other end side part 62b of the 1st displacement operation wire 62 among the some node rings 16 of the joint part 13 becomes long.

  FIG. 9B is a diagram for explaining an operation of displacing the treatment instrument 4 in the other direction (downward) in the first direction D1. With reference to FIG. 9 (B), the other part of the first operation direction D10 (as indicated by an arrow A41) in the first dial portion 61c of the first operation member 61 where the operator touches the operator's finger. For example, it is displaced along the downward direction. Thereby, by the rotation of the first operation member 61, the other end side portion 62b of the first displacement operation wire 62 is pulled toward the first operation member 61 as indicated by an arrow A42. Thereby, the space | interval of the part connected with the other end side part 62b of the 1st displacement operation wire 62 among the some node rings 16 of the joint part 13 becomes short. With this displacement, the ball forming portion 16h and the bearing forming portion 16i of the adjacent node rings 16 that are in contact with each other function as a spherical joint. As a result, the movable shaft 12 and the treatment instrument 4 connected to the joint portion 13 are displaced in the other direction (downward) in the first direction D1. At this time, the one end side part 62a of the 1st displacement operation wire 62 is sent out from the 1st operation member 61, as shown by arrow A43. And the space | interval of the part connected by the one end side part 62a of the 1st displacement operation wire 62 among the some node rings 16 of the joint part 13 becomes long.

<Operation for displacing the treatment instrument in the second direction>
FIG. 10A is a diagram for explaining an operation of displacing the treatment instrument 4 in one direction (rightward) in the second direction D2. Referring to FIGS. 7 and 10A, the operator operates in the second operation direction as indicated by arrow A51 in the second dial portion 71c of the second operation member 71 where the finger touches the operator's finger. Displacement along one side of D20 (for example, to the right). Thereby, by rotation of the 2nd operation member 71, the one end side part 72a of the 2nd displacement operation wire 72 is pulled to the 2nd operation member 71 side, as shown by arrow A52. Thereby, the space | interval of the part connected with the one end side part 72a of the 2nd displacement operation wire 72 among the some node rings 16 of the joint part 13 becomes short. With this displacement, the ball forming portion 16h and the bearing forming portion 16i of the adjacent node rings 16 that are in contact with each other function as a spherical joint. As a result, the movable shaft 12 (treatment instrument 4) connected to the joint portion 13 is displaced in one direction (rightward) in the second direction D2. At this time, the other end side portion 72b of the second displacement operation wire 72 is sent out from the second operation member 71 as indicated by an arrow A53. And the space | interval of the part connected by the other end side part 72b of the 2nd displacement operation wire 72 among the some node rings 16 of the joint part 13 becomes long.

  FIG. 10B is a diagram for explaining an operation for displacing the treatment instrument 4 to the other side (left side) in the second direction D2. Referring to FIGS. 7 and 10B, the operator operates in the second operation direction as indicated by arrow A61 in the second dial portion 71c of the second operation member 71 where the finger touches the operator's finger. Displacement to the other side of D20 (for example, to the left). Thereby, by rotation of the 2nd operation member 71, the other end side part 72b of the 2nd displacement operation wire 72 is pulled to the 2nd operation member 71 side, as shown by arrow A62. Thereby, the space | interval of the part connected by the other end side part 72b of the 2nd displacement operation wire 72 among the some node rings 16 of the joint part 13 becomes short. With this displacement, the ball forming portion 16h and the bearing forming portion 16i of the adjacent node rings 16 that are in contact with each other function as a spherical joint. As a result, the movable shaft 12 (the treatment instrument 4) connected to the joint portion 13 is displaced to the other (left side) in the second direction D2. At this time, the one end side part 72a of the 2nd displacement operation wire 72 is sent out from the 2nd operation member 71, as shown by arrow A63. And the space | interval of the part connected with the other end side part 72b of the 2nd displacement operation wire 72 among the some node rings 16 of the joint part 13 becomes long.

  As described above, according to the surgical instrument 1, the surgeon operates the first operation member 61 by applying a force in the first operation direction D10 along the first direction D1, so that the first treatment tool 4 is operated. It can be displaced in one direction D1. Similarly, the surgeon can displace the treatment instrument 4 in the second direction D2 by operating the second operation member 71 while applying a force in the second operation direction D20 along the second direction D2. In this way, the surgeon only needs to apply a force along the direction in which the treatment instrument 4 is desired to be displaced to the corresponding operation members 61 and 71. With this configuration, the surgeon can operate the operation members 61 and 71 more intuitively. Thereby, the erroneous operation of operating the operation members 61 and 71 other than the operation members 61 and 71 that the operator wants to operate can be more reliably suppressed. As described above, it is possible to realize the surgical instrument 1 that can reduce operation errors by the operator and can be operated more intuitively.

  Moreover, according to the surgical instrument 1, the first operation direction D10 and the second operation direction D20 are set in directions orthogonal to each other. According to this configuration, the range in which the treatment instrument 4 can be moved by the operations of the first operation member 61 and the second operation member 71 can be further widened.

  Further, according to the surgical instrument 1, the operator moves the treatment instrument 4 in the first direction D1 by a simple operation of rotating the rotary dial portions 61c and 71c of the first operation member 61 and the second operation member 71, respectively. And can be displaced in the second direction D2. Further, with the rotary dial portions 61c and 71c, the surgeon can operate the rotary dial portions 61c and 71c without moving the finger greatly. Therefore, the surgeon can more easily operate the surgical instrument 1.

  Moreover, according to the surgical instrument 1, the position holding mechanism 53 can maintain the position of the treatment instrument 4 in each of the first direction D1 and the second direction D2 constant. Thereby, it is possible to prevent the operator from constantly operating the operation members 61 and 71 during the surgical operation.

  Further, according to the surgical instrument 1, the position holding portions 81 and 82 are engaged with the corresponding rotation shafts 61 a and 71 a, so that the rotational displacement of the corresponding operation members 61 and 71 can be more reliably performed with a simple configuration. Can be regulated.

  Further, according to the surgical instrument 1, the rotational displacements of the corresponding operation members 61 and 71 can be strongly regulated by sandwiching the rotation shafts 61 a and 71 a corresponding to the wedge-shaped portions 83 and 84.

  Further, according to the surgical instrument 1, by operating the release mechanism 54, the engagement between the wedge-shaped portions 83 and 84 and the corresponding rotating shafts 61a and 71a of the operation members 61 and 71 can be released. Since the release mechanism 54 is provided, the operator has trouble in releasing the engagement between the wedge-shaped portions 83 and 84 and the corresponding rotary shafts 61a and 71a, such as pulling the operation members 61 and 71 with a strong force. You don't have to do this work.

  The embodiment of the present invention has been described above. However, the present invention is not limited to the above-described embodiments, and various modifications are possible as long as they are described in the claims.

  (1) For example, in the above-described embodiment, the first direction D1 (first operation direction D10) and the second direction D2 (second operation direction D20) are described as an example in which the directions are orthogonal to each other. However, this need not be the case. The first direction D1 (first operation direction D10) and the second direction D2 (second operation direction D20) may be different from each other.

  (2) Moreover, in the above-mentioned embodiment, the 1st operation member 61 and the 2nd operation member 71 demonstrated as an example the form which is a separate member. However, this need not be the case. FIG. 11 is a schematic partially exploded perspective view showing a main part of a modified example. In the following, different configurations from the above-described embodiment will be mainly described, and the same configurations are denoted by the same reference numerals in the drawings, and detailed description thereof will be omitted.

  In the modification shown in FIG. 11, the displacement operation mechanism 50 </ b> A includes a first displacement operation wire 62, a second displacement operation wire 72, a spherical operation member 100, and a bearing portion 101.

  The operation member 100 is an example of the “first operation member” in the present invention, and receives a force from the operator in the first operation direction D10 along the first direction D1, and the tip 3b of the support shaft 3 is moved in the first direction. It is configured to be displaced to D1. The operation member 100 is an example of the “second operation member” in the present invention, and receives a force from the operator in the second operation direction D20 along the second direction D2, and the distal end portion 3b in the second direction D2. It is configured to be displaced. The surgeon can displace the treatment instrument 4 (not shown in FIG. 11) in the first direction D1 and the second direction D2 by operating the one operation member 100. Part of the operation member 100 is accommodated in the operation region 40 of the barrel portion 7 of the main body 2, and the remaining part (part of the spherical portion) is exposed from the opening 102 formed in the operation region 40. ing.

  The operation member 100 is provided with a pair of first displacement operation wire fixing portions 103 and a pair of second displacement operation wire fixing portions 104.

  A pair of 1st displacement operation wire fixing | fixed part 103 is formed in the axial shape which protrudes from the spherical part of the operation member 100 along the 1st operation direction D10. One end side portion 62 a of the first displacement operation wire 62 is attached to one (lower) first displacement operation wire fixing portion 103, and the first displacement operation is fixed to the other (upper) first displacement operation wire fixing portion 103. The other end side part 62b of the wire 62 is attached.

  A pair of 2nd displacement operation wire fixing | fixed part 104 is formed in the axial shape which protrudes from the spherical part of the operation member 100 along the 2nd operation direction D20. One end side 72a of the second displacement operation wire 72 is attached to one (left) second displacement operation wire fixing portion 104, and the second displacement operation wire fixing portion 104 is attached to the other (right) second displacement operation wire fixing portion 104. The other end side 72b of 72 is attached.

  The operation member 100 is received in a hemispherical recess portion of the bearing portion 101 fixed in the main body 2 and is slidable with respect to the bearing portion 101.

  With the above configuration, when the operator touches the operator's finger in the spherical portion of the operation member 100 in any one of the first directions D1, the first displacement operation wire is rotated by the rotation of the operation member 100. Either one end side portion 62a or the other end side portion 62b of 62 is pulled backward, and the other is directed forward. As a result, the first displacement operation wire 62 displaces the treatment instrument 4 in either one of the first directions D1 by the same operation as that described in the above embodiment.

  Similarly, when the operator touches the operator's finger in the spherical portion of the operation member 100 in any one of the second directions D2, the rotation of the operation member 100 causes the second displacement operation wire 72 to move. One of the one end side portion 72a and the other end side portion 72b is pulled backward, and the other is directed forward. As a result, the second displacement operation wire 72 displaces the treatment instrument 4 in either one of the second directions D2 by the same operation as that described in the above embodiment.

  Also in this case, the surgeon can displace the treatment instrument 4 in the first direction D1 and the second direction D2 by an intuitive operation.

  (3) In the above-described embodiment and modification, the treatment instrument 4 is displaced upward by applying an upward force to the first operation member 61 or the operation member 100, and the first operation member 61 or the operation member 100 is moved. An example in which the treatment tool 4 is displaced downward by applying a downward force has been described. However, this need not be the case. For example, the treatment tool 4 is displaced upward by applying a downward force to the first operation member 61 or the operation member 100, and the treatment tool 4 is moved downward by applying an upward force to the first operation member 61 or the operation member 100. A configuration of displacing may be adopted. Similarly, the treatment tool 4 is displaced leftward by applying a rightward force to the second operation member 71 or the operation member 100, and the treatment tool 4 is applied by applying a leftward force to the second operation member 71 or the operation member 100. A configuration may be adopted in which is displaced to the right.

  The present invention can be widely applied as a surgical instrument.

DESCRIPTION OF SYMBOLS 1 Surgical instrument 3 Support shaft 3a Base end portion of support shaft 3b Tip end portion of support shaft 4 Treatment tool 53 Position holding mechanism 54 Release mechanism 61 First operation member (rotating dial member)
61a First rotating shaft 71 Second operation member (rotating dial member)
71a Second point axis 81 First position holding portion 82 Second position holding portion 83 Wedge shape portion of first position holding portion 84 Wedge shape portion of second position holding portion D1 First direction D2 Second direction D10 First Operation direction D20 Second operation direction

Claims (7)

A treatment tool for performing treatment on the treatment object;
A support shaft having a distal end portion that supports the treatment instrument and a proximal end portion that is paired with the distal end portion, and the distal end portion is displaceable in predetermined first and second directions with respect to the proximal end portion. A pivot,
A first operating member for displacing the tip in the first direction by receiving a force in a first operating direction along the first direction;
A surgical instrument, comprising: a second operation member that receives a force in a second operation direction along the second direction to displace the tip portion in the second direction. The surgical instrument according to claim 1, comprising:
The surgical instrument, wherein the first operation direction and the second operation direction are set in directions orthogonal to each other. A surgical instrument according to claim 1 or claim 2, wherein
The surgical instrument, wherein each of the first operating member and the second operating member includes a rotary dial member that rotates about a predetermined rotation axis. The surgical instrument according to any one of claims 1 to 3,
A surgical instrument further comprising a position holding mechanism for restricting displacement of the first operation member and displacement of the second operation member. The surgical instrument according to claim 4, wherein
The first operation member is configured to be rotatable around a predetermined first rotation axis,
The second operation member is configured to be rotatable around a predetermined second rotation axis,
The position holding mechanism engages with the first rotating shaft to engage the first rotating shaft and the second rotating shaft to engage the second position holding portion for restricting the rotation of the first rotating shaft. And a second position holding part for restricting rotation of the rotation shaft. The surgical instrument according to claim 5, wherein
Each said position holding part has a wedge shape part comprised so that a corresponding rotating shaft could be pinched | interposed, The surgical instrument characterized by the above-mentioned. A surgical instrument according to claim 6, comprising:
A release mechanism for releasing the rotation restriction of each rotary shaft by the position holding mechanism;
The surgical instrument, wherein the release mechanism is configured to release the engagement between each wedge-shaped portion of the position holding mechanism and the corresponding rotation shaft.

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