JP2020065662A - Exchange device for soft instrument for surgical operation and soft instrument for surgical operation - Google Patents

Abstract

To provide a soft instrument exchange device which can facilitate exchange of an instrument and easily manage a sanitary state of the exchanged instrument, and a soft instrument which is suitable for the soft instrument exchange device.SOLUTION: A soft instrument exchange device 1 of the present invention comprises: a soft instrument which can be inserted into and removed from a living body and which can be bent in a living body; housings 100 for storing a plurality of soft instruments according to applications; a storage part 20 for storing a plurality of housings which are arranged and stacked in multi stages in a vertical direction; an exchange part 30 comprising a lifting mechanism 33 for lowering or lifting up the storage part so that positions of housings sequentially match a position of a transport plane in the vertical direction; a feeding part 40 for moving the housing whose vertical position matches a position of the transport plane in a direction of the living body out of the housings; and an instrument operation part 50 storing the moved housing. The housing is exchanged according to an application.SELECTED DRAWING: Figure 1

Description

  BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical soft surgical instrument changing device and a surgical soft surgical instrument, and more specifically to a surgical soft surgical instrument exchanging device suitable for endoscopic surgery and the surgical soft surgical instrument. Regarding

  In recent years, with the miniaturization of endoscopes or laparoscopes, minimally invasive endoscopic surgery or laparoscopic surgery, which is laparoscopic surgery, has been widely deployed. As such a surgical instrument, a master-slave operation system including a master manipulator operated by an operator and a slave manipulator that operates based on a signal emitted from the master manipulator is known, and is operated remotely. A surgical instrument having a treatment section for performing treatment on a treatment target site is attached (see Patent Document 1).

  While arthroscopic surgery has the major advantage of being minimally invasive to patients, it has a limitation on the shape and operability of surgical instruments, so there is less damage to patients and it is necessary to reduce the burden during surgery. Various techniques have been disclosed. For example, in order to facilitate maintenance such as cleaning and sterilization, a technique related to surgical instrument replacement in which the surgical instrument can be attached and detached with a simple configuration (see Patent Documents 1 and 2). Furthermore, in order to bypass organs and the like when the surgical instrument reaches the corresponding site when the affected part exists deep inside the body, a technique relating to a flexible surgical instrument applying a mechanism that bends from a conventional linear shape and a flexible conductor is disclosed. (See Patent Documents 3 and 4).

  Further, in a treatment instrument storage device for storing an endoscopic treatment having an elongated flexible sheath, a case main body, a treatment instrument insertion port opening on one side surface of the case main body, and the insertion An operation section storage section communicating with the mouth, a loop-shaped sheath storage section communicating with the operation section storage section, and a treatment instrument fixing means for detachably fixing the treatment instrument in the stored state. There is disclosed a technique in which the case main body has a flat plate shape and the sheath housing portion is a tube (see Patent Document 5).

Japanese Patent No. 6010027 Japanese Patent No. 6202430 JP, 2005-80556, A JP, 2008-68708, A JP, 57-164051, A

  In the technologies described in Patent Documents 1 and 2, the surgical instrument is easily replaced by providing a removable surgical instrument portion, but the cleaning / sterilization state of the removable (surgical instrument connection) portion is sufficiently confirmed. Had to do. In the technique described in Patent Document 3, since a complicated opening / closing mechanism is provided to achieve tilting and rolling of the surgical instrument, the number of parts is large and the number of operating parts is large. Therefore, it is difficult to improve the productivity of the sterilization work and the subsequent assembling work.

  In the technique described in Patent Document 4, the forceps can be opened and closed with a simple structure, but there is a problem that it takes time to replace the surgical instrument. The technique described in Patent Document 5 simply stores and takes out forceps having an elongated sheath, and an operator takes out (pulls out) forceps from a living body when exchanging a surgical tool during surgery. There was a need.

  The present invention has been made in view of these circumstances in the background described above, and facilitates the replacement of the surgical instrument, and can easily manage the hygienic state of the exchanged surgical instrument. It is an object of the present invention to provide a soft surgical instrument suitable for the soft surgical instrument changing device.

  The present invention is a replacement device for a soft surgical tool used in arthroscopic surgery. A soft surgical instrument exchange device according to one aspect of the present invention includes a soft surgical instrument which can be inserted into and removed from a living body and which can be bent in the living body, and a housing which stores a plurality of the soft surgical instruments according to applications. A storage unit in which a plurality of the casings arranged in a multi-tiered manner in the vertical direction are stored, and the storage unit such that the respective positions of the plurality of the casings in the vertical direction are sequentially aligned with the position of the transport surface. An exchanging unit having an elevating mechanism for lowering or raising the unit, and a sending unit for moving the casing, of which the vertical position corresponds to the position of the transport surface, of the plurality of casings toward the living body. And a surgical instrument operating section in which the moved casing is housed. Then, the case is configured to be replaced according to the purpose.

  According to the above configuration, a plurality of housings each storing a flexible surgical tool corresponding to the intended use are provided, and the housings are exchanged according to the intended use, thereby facilitating the replacement of the surgical instrument. Further, by providing a surgical instrument corresponding to the surgery for each housing, the hygiene state of the replaced surgical instrument can be easily managed. That is, by storing the soft surgical instrument in the case and storing the flexible surgical instrument in the so-called cassette format in which the functional parts / devices are built, the storage / management becomes easy. By standardizing the size and shape, it is possible to standardize the flexible surgical instrument as an exchange device. Furthermore, by providing the exchanging unit and the sending unit, it becomes easy to prevent medical malpractice due to artificial selection mistake of the soft surgical instrument.

  In the above aspect, the soft surgical instrument includes a flexible cord-shaped insertion portion having a treatment tool that opens and closes at a distal end mounted thereon, and an operation portion that operates opening and closing movements of the treatment instrument. A storage drum that includes a wire whose one end is connected to the treatment tool, and an exterior tube that covers the wire, and in which the operation portion winds the insertion portion and rotates the insertion portion to insert or remove the insertion portion. Also, the other end of the wire is fixed and includes an opening / closing mechanism that rotates in cooperation with the storage drum and is movable in a direction different from the winding direction, and the opening / closing mechanism is a direction different from the winding direction. An operation of opening and closing the treatment instrument by moving the storage drum in the axial direction, rotating the storage drum in the casing, and operating the movement of the storage drum in the axial direction from the outside of the casing. Connection It is possible to construct a flexible surgical instrument changer as provided.

  The above configuration is a technique of the inventor described in Patent Document 4, and is a master that can independently perform two different operations of the opening / closing device and the opening / closing of the opening / closing device itself in the operation unit. -It is applied to the flexible surgical instrument changing device as a cassette in which the slave operation system is built in the housing.

  Specifically, the flexible tube is inserted into and removed from the living body by sending out and retracting the extrapolation tube by rotating the storage drum. And, different from the winding direction of the extrapolation tube of the storage drum, for example, by moving a part of the storage drum in the axial direction, the wire feeding / pulling operation of the wire attached to this part is performed by It is performed independently of the movement. By connecting the opening / closing device to the wire, feeding / pulling-in of the wire can be converted into opening / closing operation.

  Therefore, according to this configuration, even if the flexible surgical instrument according to the application is stored, the surgical instrument can be easily operated (opened / closed, delivered, retracted, etc.). In addition, since a complicated mechanism is not included in the surgical instrument portion on the distal end side that is inserted into and removed from the living body, sanitary management such as cleaning and sterilization is facilitated. Further, since there is no rotation, power transmission mechanism, connection mechanism, etc., and the number of parts is smaller than that of the prior art, it is advantageous in terms of cost and productivity is improved.

  In the above aspect, the surgical instrument operating portion includes an operating mechanism connected to the operating connecting portion, and rotation of the operating mechanism rotates the storage drum via the operating connecting portion, and The push / pull of the operating mechanism may be configured to move the opening / closing device in the axial direction.

  According to the above configuration, since the surgical instrument operating unit includes the operating mechanism without requiring a complicated mechanism, the master side can easily operate the opening / closing mechanism on the slave side. Then, by exposing the side surface of the storage drum of the cassette, a hole or a key-shaped projection can be provided on this surface, and the hole or projection can be operated from the outside. In this way, the master side can operate the opening / closing operation of the opening / closing device and the feeding / retracting of the opening / closing device itself. Then, it is possible to operate the opening / closing mechanism according to the practitioner's intention.

  In the soft surgical instrument provided in the soft surgical instrument exchange device according to the aspect, in the outer tube, a plurality of the wires, one end of which is connected to the treatment instrument, are housed, and the other end of each of the wires is stored. However, the flexible surgical instrument can be configured so as to independently move in the axial direction of the storage drum.

  In the above configuration, a plurality of mechanisms for independently pulling the wire by moving the storage drum in the axial direction are independently provided, and for example, one wire is pulled in and the other wire is opened by an operation such as maintaining the same state. By realizing the state and then retracting the other wire, the one wire can be returned to the original state and returned to the closed state. In Patent Document 4, the operation is limited to one-way operation of opening or closing, and for example, another mechanism is required to return the opening / closing mechanism to the closed state after pulling the wire into the open state. However, according to this configuration, by opening the plurality of wires independently, the opening operation and the closing operation can be performed independently, and the gripping force of the wire opening / closing device can be adjusted by adjusting the drawing force. It is suitable for grasping organs or affected areas in different states.

  In the soft surgical instrument provided in the soft surgical instrument exchanging device according to the aspect, the treatment instrument has a common rotating shaft, and a first rotating portion that rotates in different directions to open and close the first rotating portion. Two rotating parts, and the first rotating part and the second rotating part have an arc shape having a first center eccentric to the opening side of the rotating surface with respect to the rotating shaft. A first groove and an arc-shaped second groove having a second center that is eccentric to the closing operation side of the rotating surface are formed, and the first groove and the second groove of the first rotating portion are formed. One wire is connected to the first groove of the rotating portion, and a first pin movable on the rotating surface is inserted, and the second groove and the second groove of the first rotating portion are inserted. The flexible surgical tool can be configured such that the other wire is connected to the second groove of the rotating portion, and the second pin movable on the rotating surface is inserted.

  According to the above configuration, when the wire connected to the first pin is pulled in while the opening / closing mechanism is closed, the first pin is pulled. Since the first rotating portion and the second rotating portion have a common rotation center, the first pin and the second groove of the first rotating portion are separated from the rotation center. The first rotation part and the second rotation part are rotated by slidingly moving in the first groove of the. When the first pin reaches the end of the first groove, the rotations of the first rotating portion and the second rotating portion are stopped, and the opening / closing mechanism is opened.

  Then, when the wire connected to the second pin is pulled in, the second pin is pulled. Since the first rotating portion and the second rotating portion have a common rotation center, the second pin and the second groove of the first rotating portion are separated from the rotation center. The second rotating portion is slidably moved to rotate the first rotating portion and the second rotating portion. When the second pin reaches the end of the second groove, the rotations of the first rotating portion and the second rotating portion are stopped, and the opening / closing mechanism is closed.

  According to this configuration, by independently pulling the plurality of wires, the opening operation and the closing operation can be performed independently, and by adjusting the pulling force, it is possible to adjust the gripping force of the wire opening / closing device.

  In the soft surgical instrument included in the soft surgical exchanging device according to the aspect, the insertion portion is rotatably inserted into the cylindrical exterior portion and the exterior portion to regulate rotation of the treatment instrument. A rotating portion externally fitted to the treatment instrument, and a drive bevel gear that rotates by a movement of the wire in the axial direction of the storage drum, having a rotating shaft in a direction orthogonal to the inserting / removing direction in the living body. The soft surgical instrument can be configured to include a driven bevel gear that is provided in the rotating portion and that meshes with the drive bevel gear.

  According to the above configuration, by rotating the drive bevel gear by pushing and pulling the wire, it is possible to rotate the driven bevel gear that meshes with the drive bevel gear and rotate the treatment instrument. With such a configuration, the opening / closing device can be rotated to an appropriate position for gripping the affected area.

  In the soft surgical instrument provided in the soft surgical instrument exchange device of the aspect, a flexible shaft having one end connected to the treatment instrument is housed in the outer tube, and the other end of the flexible shaft is rotated. Then, the soft surgical instrument can be configured to rotate the treatment instrument.

  The flexible shaft is a long shaft component having flexibility, and can transmit rotational power to a distant place. According to the above configuration, the flexible shaft is arranged coaxially with the wire, and the surgical tool can be rotated by rotating the flexible shaft. It is preferable that the flexible shaft be extended to a portion as close to the axis as possible so that resistance (friction, wear) when rotating the surgical instrument by rotation of the shaft is small.

  Although the bevel gear rotates the surgical instrument by pushing and pulling the wire and the flexible shaft directly rotates the surgical instrument, these configurations can be appropriately selected depending on the storage space and the bending state.

  The present invention provides a soft surgical instrument exchange device that facilitates the exchange of surgical instruments and can easily manage the hygiene state of the exchanged surgical instruments, and a soft surgical instrument suitable for the soft surgical instrument exchange device. can do.

It is explanatory drawing of the soft surgical instrument exchange device which concerns on 1st Embodiment of this invention. It is a perspective view of the storage part of the soft surgical instrument exchange device concerning a 1st embodiment of the present invention. FIG. 3 is a perspective view of a soft surgical instrument unit applied to the soft surgical instrument changing device according to the first embodiment of the present invention. It is explanatory drawing which shows the cross section of the soft surgical instrument unit applied to the soft surgical instrument exchange device which concerns on 1st Embodiment of this invention. It is a perspective view of the 1st scanning connection part of the operation tool operation part of the flexible operation tool exchange device concerning a 1st embodiment of the present invention. It is a perspective view of the 2nd scan connection part of the operation tool operation part of the flexible operation tool exchange device concerning a 1st embodiment of the present invention. It is a perspective view showing the state where the 1st scanning connection part of the operation tool operation part of the flexible operation tool exchange device concerning a 1st embodiment of the present invention was connected to the flexible operation tool unit. FIG. 4 is a perspective view of the soft surgical instrument unit applied to the soft surgical instrument exchanging device according to the first embodiment of the present invention, viewed from the back side of FIG. 3. It is sectional drawing which shows the state which the 1st scanning connection part of the operation tool operating part of the flexible surgery tool exchange device which concerns on 1st Embodiment of this invention was connected to the flexible surgery tool unit. It is sectional drawing which shows the structure of the storage drum of the soft surgical instrument exchange device which concerns on 1st Embodiment of this invention. It is a perspective view showing a state where a sending part of a soft surgical implement exchange device concerning a 1st embodiment of the present invention connects with a soft surgical implement unit. It is explanatory drawing which shows operation | movement of one Example of the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. It is sectional drawing which shows the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. It is a perspective view of an opening / closing guide of an opening / closing device of the soft surgical instrument exchange device according to the second embodiment of the present invention. It is a perspective view which shows the operation part of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. It is explanatory drawing which shows the opening / closing operation | movement of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. It is explanatory drawing which shows operation | movement of the other Example of the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. It is a perspective view of the rotation part of the opening / closing device of the soft surgical instrument exchange device which concerns on 3rd Embodiment of this invention. It is isometric view sectional drawing which shows the internal structure of the rotation part of the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 3rd Embodiment of this invention. It is explanatory drawing which shows operation | movement of the rotating part of the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 4th Embodiment of this invention. It is a perspective view of a rotation part of an opening-and-closing device of a soft surgery implement exchange device concerning a 5th embodiment of the present invention.

  Hereinafter, preferred embodiments of a soft surgical instrument exchange device and a soft surgical instrument exchange device of the present invention will be described with reference to the drawings. In the following description, the same reference numerals are used in the different drawings, and the description thereof may be omitted.

  One aspect according to the present invention is a flexible surgical instrument that can be inserted into and removed from a living body and can be bent in the living body, a housing that stores a plurality of the flexible surgical tools according to the application, and a multi-stage in the vertical direction. The storage unit in which the plurality of casings arranged in a stack are stored, and the storage unit is lowered or raised so that the respective positions of the plurality of casings in the vertical direction are sequentially aligned with the position of the transport surface. An exchanging unit having an elevating mechanism, a sending unit that moves the housing, of which the vertical position corresponds to the position of the transport surface, of the plurality of housings toward the living body, and the housing that has been moved. Any specific mode may be adopted as long as it is a flexible surgical instrument exchanging device comprising: a surgical instrument operating part for accommodating a body, and the casing being exchanged according to the application. I do not care.

(First embodiment)
First, the soft surgical instrument changing device according to the first embodiment of the present invention will be described with reference to FIGS. 1 to 11. FIG. 1 is an explanatory diagram of a soft surgical instrument exchange device according to the first embodiment of the present invention. FIG. 2 is a perspective view showing the storage section of FIG. FIG. 3 is a perspective view of a soft surgical instrument unit applied to the soft surgical instrument changing device. FIG. 4 is an explanatory diagram showing a cross section of the soft surgical instrument unit. FIG. 5 is a perspective view of the first scan connecting portion of the surgical instrument operating portion. FIG. 6 is a perspective view of the second scanning connection portion of the operation tool operating portion. FIG. 7 is a perspective view showing a state in which the first scanning connecting portion is connected to the soft surgical instrument unit. FIG. 8 is a perspective view from the back surface of FIG. 3 of the soft surgical instrument unit applied to the soft surgical instrument changing device according to the present embodiment. FIG. 9 is a cross-sectional view showing a state in which the first scan connecting portion of the surgical instrument operating portion of the flexible surgical instrument changing device according to the present embodiment is connected to the flexible surgical instrument unit. FIG. 10 is a sectional view showing the structure of the storage drum. FIG. 11 is a perspective view showing a state in which the delivery section of the flexible surgical instrument changing device is connected to the flexible surgical instrument unit.

<Overall description of flexible surgical instrument changing device>
Referring to FIG. 1 (A), the soft surgical instrument exchange device 1 is installed so that the living body is located on the left side of the figure. In addition, in FIG. 1, the vertical direction of the drawing is the vertical direction when the soft surgical instrument exchange device 1 is arranged, and may be simply referred to as the vertical direction in the following description. In addition, the living body to be treated is located in the left direction of FIG.

  The soft surgery exchange device 1 is a surgical instrument unit 100 that is a plurality of housings each storing a plurality of soft surgical tools that are insertable into and removable from the living body and that can be bent in the living body, and that store a plurality of soft surgical tools according to the application. And a storage portion 20 in which a plurality of surgical tool units 100 arranged in a multi-tiered manner in the vertical direction are stored, and the respective positions of the surgical tool units 100 in the vertical direction sequentially match the positions of the transport surface 45. The exchanging unit 30 including the elevating / conveying unit 33 that lowers or raises the storage unit 20 and the surgical instrument unit 100 in which the vertical position of the surgical instrument units 100 coincides with the position of the transport surface 45. It is provided with a delivery section 40 that moves toward the living body, and a surgical instrument operating section 50 that houses the moved surgical instrument unit 100. Hereinafter, the individual configurations included in the present embodiment will be described, and then the replacement operation in the soft surgical instrument replacement device 1 will be described.

<Explanation of storage section>
Referring to FIG. 2, the storage unit 20 includes a storage box 21 having a plurality of mounting shelves 22 formed therein. The storage box 21 is, for example, a hollow hexahedron, and has a box-like shape with an opening 25 on one side facing the surgical instrument operating portion 50, and the outside of the side surface of the opening 25 is attached to the belt 35 of the elevating and conveying portion 33. Has been done.

  The belt 35 is engaged by two rollers 34 at an upper side and a lower side. By rotating either one or both of the rollers 34, the belt 35 is rotated and the storage box 21 attached to the belt 35 is rotated. Go up and down.

  The mounting shelf 22 can be formed as a convex step facing the same height in the left-right direction of the opening 25 having a surface for mounting the surgical instrument unit 100. The mounting shelf 22 may have a configuration in which the surgical instrument unit 100 is mounted as a convex step as shown in the figure, or may have a box shape in which the surgical instrument unit 100 can be stored. Further, the number of stages of the mounting shelf 22 is at least two or more, and the number of stages according to the operation is provided.

<Description of the surgical instrument unit 100>
Referring to FIGS. 3 and 4, the surgical instrument unit 100 is a housing for storing a flexible surgical instrument, and the flexible surgical instrument has a flexible cord-like shape to which an opening / closing device 200, which is a treatment instrument that opens and closes, is attached. The flexible operating material 122 that serves as an insertion portion, the operating portion 116 that operates the opening / closing operation of the opening / closing device 200, and the storage drum 110 that winds the flexible operating material 122 are provided.

  The storage drum 110 is housed in the surgical instrument unit 100 so as to be rotatable in the winding direction of the flexible operation material 122. The operation portion 116 is housed in an operation portion housing portion 111 that is a bottomed hole formed in the storage drum 110 so as to be movable in the rotation axis direction of the storage drum 100. The operation portion 116 is engaged with the storage drum 110 by a rotation stop key 118 fitted in the key groove 119 so as to rotate in cooperation with the storage drum 110 and move in the rotation axis direction. Furthermore, in order to regulate the movement of the operation unit 116 in the direction of the rotation axis of the storage drum 110 and to stabilize the posture and position, the operation unit storage unit 111 is biased by a biasing device 114 such as a spring from the bottom.

  The flexible operating material 122 includes an operating wire 124 having one end connected to the opening / closing device 200, and an outer tube 126 covering the operating wire 124, and is wound around a flexible operating material storage groove 113 formed in the storage drum 110. . Then, by rotating the storage drum 110, the soft operating material 122 is sent out and retracted, so that the opening / closing device 200 can be inserted into / extracted from the living body. The other end of the actuation wire 124 is connected to the operation unit 116.

  Referring also to FIG. 5 and FIG. 7, the first operation connecting portion 141 having the rod 142 whose leading end portion is a thin cylinder is disposed so that the tip of the rod 142 is in contact with the operating portion 116. There is.

  Referring also to FIGS. 6 and 8, the surgical instrument unit 100 and the lower surface of the storage drum 110 are flush with each other. A plurality of bottomed engagement holes 117 are formed on the lower surface of the storage drum 110. The engagement holes 117 are formed so as to engage with the engagement pins 144 formed on the second operation connection portion 143. An operation connection portion 143 is provided. The engaging hole 117 may have a hole shape such as a square hole or a spur gear, and the engaging pin 144 of the second operation connecting portion 143, which is the counterpart, may be the square hole or the spur gear. In such a configuration, the number of engaging holes 117 may be one instead of plural.

  A mounting ridge 160 for mounting the surgical instrument unit 100 on the mounting shelf 22 is formed on a side surface parallel to the direction in which the opening / closing device 200 of the surgical instrument unit 100 expands and contracts due to the winding of the flexible operating material 122. As shown in FIG. 2, the mounting ridge 160 is mounted on the mounting shelf 22 so that the surgical instrument unit 100 is stored in the storage box 21.

  Next, with reference to FIGS. 9 and 10 as well, a feeding operation and an opening / closing operation of the opening / closing device 200 serving as the opening / closing mechanism of the present embodiment will be described. As shown in FIG. 10 (A), the soft operating material 122 including the actuating wire 124 and the outer tube 126 as the outer skin thereof is wound around the soft operating material storage groove 113 of the storage drum 110. The operation portion 116, to which the other end of the operation wire 124 is connected, is engaged with the storage drum 110 by the rotation stop key 118 so as to rotate in cooperation with the storage drum 110.

  Next, referring to FIG. 10B, since the operating portion 116 rotates in cooperation with the storage drum 110, the actuating wire 124 and the flexible operating material 122 operate the opening / closing device 200 while maintaining their positional relationship. Send out. Thus, the opening / closing device 200 can be inserted into and removed from the living body while maintaining the state. Regarding the rotation of the storage drum 110, a handle or the like may be provided to rotate the storage drum 110 manually, or the storage drum 110 may be connected to a motor and rotated.

  FIG. 9 illustrates the opening / closing operation of the opening / closing device 200, and the outer tube 126 serving as the outer skin of the operating wire 124 is not shown. Referring to FIG. 9 (A), the operation unit 116 is not biased from the first operation connection unit 141, and the biasing device 114 regulates the vertical movement and stabilizes the posture and position of the operation unit 116. It is accommodated on the upper side of the part accommodating portion 111.

  One end of the operation wire 124 is connected to the switchgear 200, and the other end is connected to a wire locking portion 125 provided on the cylindrical side surface of the operation portion 116. The relative position of the actuation wire 124 and the outer tube 126 does not change even when the outer tube 126 (not shown in FIG. 9) is delivered to the left in the figure or is drawn to the right. Therefore, as shown in FIG. 9A, the opening / closing device 200 maintains the closed state. In FIGS. 10A and 10B, the relative position between the actuation wire 124 and the flexible operating material 122 does not change even when the flexible operating material 122 is delivered, and the opening / closing device 200 maintains the open state. Is shown.

  With reference to FIG. 9B, the first operation connecting portion 141 moves downward, and the operation portion 116 is also moved downward by being pushed by the first operation connecting portion 141. Since the operation portion 116 is biased upward by the biasing device 114, the downward movement amount of the first operation connection portion 141 is the downward movement amount of the operation portion 116.

  When the operating portion 116 moves downward, the actuation wire 124 connected to the wire locking portion 125 is pulled in relative to the flexible operating member 122 (not shown) in the right direction, which is the T direction. The opening / closing device 200 can be opened by utilizing this retracting operation. In the case of a scissors-like forceps having two blades having a hinge, for example, the mechanism for opening and closing can be opened by attaching the actuation wire 124 to one blade and moving only that blade to the right. However, it is not particularly limited.

  Referring to FIGS. 8 and 11, the surgical instrument unit 100 has a notch 150 formed in the thickness direction from the upper surface to the lower surface. The shape of the notch 150 coincides with the outer shape of the engaging portion 42 formed at the end of the delivery rod 41 provided in the delivery portion 40, and the operation tool unit 100 moves up and down by the elevating and transporting portion 33, thereby The joint portion 42 is accommodated in the notch 150.

<Explanation about flexible surgical tool replacement>
The soft surgery exchange will be described with reference to FIG. 1 again. In FIG. 1 (A), the flexible surgery exchange device 1 shows a state in which a plurality of surgical instrument units 100, which are vertically stacked and arranged in multiple stages, are stored in a storage portion 20. In the surgical instrument operating unit 50, a surgical instrument positioning tool 51 having a predetermined interval in the vertical direction is provided on the left side of the living body. The surgical instrument positioning tool 51 is, for example, a rod-shaped member extending in the depth direction of the drawing, and a roller or the like can be applied. The predetermined interval is set so as to regulate the vertical movement of the surgical instrument unit 100 in accordance with the dimension of the surgical instrument unit 100 in the thickness direction. The transport surface 45 represents a horizontal movement surface of the surgical instrument unit 100.

  When the surgical instrument unit 100 to be used is selected, a command is sent to the exchange section 30 and the sending section 40. The exchanging unit 30 drives the roller 34 of the elevating / conveying unit 33 to move the selected surgical instrument unit 100 to the position of the conveying surface 45. At this time, the engaging portion 42 of the delivery rod 41 of the delivery portion 40 is arranged at the position of the transport surface 45 so as to engage with the notch 150 of the surgical instrument unit 100, and is engaged by the movement of the surgical instrument unit 100. The portion 42 and the notch 150 are engaged with each other.

  Referring to FIG. 1B, the surgical instrument unit 100 in which the delivery rod 41 is engaged with the notch 150 is pushed leftward along the transport surface 45. At this time, the surgical instrument unit 100 is arranged so as to be sandwiched between the surgical instrument positioning tools 51, and the engaging pin 144 of the second operation connecting portion 143 and the engaging hole 117 are engaged with each other. The tool unit 100 is stably disposed in the surgical tool operating unit 50. Then, the first operation connecting portion 141 descends, and the rod 142 connects to the operating portion 116. Here, the positioning tool 51 is used as a roller that is rotated by using the power of a motor or the like, and the surgical instrument unit 100 is conveyed leftward by this roller, whereby the replacement work can be performed more smoothly.

  When the surgical instrument unit 100 is replaced, the operation of the opening / closing device 200 can be operated by the first operation connection part 141, and the delivery and retraction of the flexible operation material 122 can be operated by the second operation connection part 143.

(Second embodiment)
Next, a second embodiment of the present invention will be described. The second embodiment of the present invention is an embodiment relating to the mechanism of the switchgear, and since the other configurations are the same as the first embodiment, in the following description, the configurations overlapping with the first embodiment will be described. The description is omitted. In addition, the switchgear according to the present embodiment will be described below, and then a mechanism for operating the switchgear will be described. FIG. 12: is explanatory drawing which shows operation | movement of one Example of the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. FIG. 13 is a cross-sectional view showing an opening / closing device of the soft surgical instrument exchange device according to the second embodiment of the present invention. FIG. 14 is a perspective view of an opening / closing guide of the opening / closing device of the soft surgical instrument changing device according to the second embodiment of the present invention. FIG. 15: is a perspective view which shows the operation part of the soft surgical instrument exchange device which concerns on 2nd Embodiment of this invention. FIG. 16 is an explanatory diagram showing an opening / closing operation of the soft surgical instrument exchange device according to the second embodiment of the present invention. FIG. 17 is an explanatory diagram showing an operation of another example of the opening / closing device of the soft surgical instrument exchange device according to the second embodiment of the present invention.

<Explanation of switchgear>
Referring to FIG. 12, the opening / closing device 201 according to the present exemplary embodiment has a common rotation center 230 and has a first rotation unit 210 and a second rotation unit 220 that rotate in different directions to open and close. It consists of and. In FIG. 12, the first rotating portion 210 and the second rotating portion 220 are line-symmetrical with respect to the center line passing through the rotation center 230 when the opening / closing device 201 is closed, but are limited to this shape. Instead, it may be in any form as long as it has a relationship between the groove and the pin described below.

  The first turning portion 210 has an arc-shaped first groove 242 having a first center 241 that is eccentric to the opening center of the turning surface with respect to the turning center 230 and a closing operation side of the turning surface. An arc-shaped second groove 252 having an eccentric second center 251 is formed. Also in the second rotating portion 220, an arc-shaped first groove 243 having a center that is axisymmetric to the first center 241 that is eccentric to the opening center of the rotating surface with respect to the rotation center 230, and a rotation. A second center 251 that is eccentric to the closing side of the moving surface and an arc-shaped second groove 253 having a center at a line symmetrical position are formed. It should be noted that the eccentric centers of the second rotating portions 220 are omitted because the drawing becomes complicated.

  In the first groove 242 of the first rotating portion 210 and the first groove 243 of the second rotating portion 220, the first pin 240 that is movable on the rotating surface is inserted. Referring also to FIG. 13, a first wire 271 is connected to the first pin 240 as an operating wire. Similarly, in the second groove 252 of the first rotating portion 210 and the second groove 253 of the second rotating portion 220, the second pin 250 that is movable on the rotating surface is inserted. A second wire 272 is connected to the second pin 250 as an operating wire.

  Referring to FIGS. 13 and 14, the opening / closing device 201 including the first rotating portion 210 and the second rotating portion 220 is housed in the opening / closing guide 260 having a U-shaped cross section. The opening / closing guide 260 is formed with a rotating shaft 231 that serves as a rotating shaft of the rotation center 230 of the first rotating portion 210 and the second rotating portion 220. Oval guide grooves 261 and 262 penetrating the upper surface and the lower surface are formed on the flat plate that constitutes the upper surface and the lower surface of the opening / closing guide 260. The first pin 240 and the second pin 250 are inserted into the guide grooves 261 and 262 and are movable in the length direction of the ellipse.

  As described above, the first wire 271 is connected to the first pin 240 as an actuation wire, and the second wire 272 is connected to the second pin 250 as an actuation wire. The wire can be pulled.

  Referring to FIGS. 12A and 12B together, FIG. 12A shows a state in which the first wire 271 and the second wire 272, which are operating wires, are not tensioned, and the opening / closing device 201 is closed. It is in a state of The distance between the first pin 240 and the second pin 250 at this time is LP.

  When the opening / closing mechanism 201 is in the closed state and the first wire 271 connected to the first pin 240 is pulled in, the first pin 240 is pulled to the right in the drawing. Since the first rotation part 210 and the second rotation part 220 have the common rotation center 230, the first pin 240 is separated from the rotation center 230 by the first groove of the first rotation part 210. 242 and the first groove 243 of the second rotating portion 220 are slidably moved to rotate the first rotating portion 210 and the second rotating portion 220. When the first pin 240 reaches the ends of the first grooves 242 and 243, the rotations of the first rotating portion 210 and the second rotating portion 220 stop, and the opening / closing mechanism 201 enters the open state shown in (B). As shown in FIG. 12B, in the open state, the distance LP between the first pin 240 and the second pin 250 is shorter than that in (A).

  Next, when the second wire 272 connected to the second pin 250 is pulled in, the second pin 250 is pulled to the right side of the drawing. Since the first rotation part 210 and the second rotation part 220 have the common rotation center 230, the second pin 250 is separated from the rotation center 230 by the second groove of the first rotation part 210. 252 and the second groove 253 of the second rotating portion 220 are slidably moved to rotate the first rotating portion 210 and the second rotating portion 220. When the second pin 250 reaches the ends of the second grooves 252, 253, the rotations of the first rotating portion 210 and the second rotating portion 220 stop, and the opening / closing mechanism 201 enters the closed state shown in (A).

<Explanation of the mechanism for operating the opening / closing device>
FIG. 16 is for explaining the opening / closing operation of the opening / closing device 201, and the exterior tube 126 serving as the outer skin of the first wire 271 and the second wire 272 is not shown. Referring to FIG. 16 (C), the operation unit 216 is not biased from the first operation connection unit 141, and the biasing device 114 regulates the vertical movement and stabilizes the posture and position to operate the operation unit 216. It is accommodated on the upper side of the part accommodating portion 281. Note that in FIG. 16B, the first operation connection portion 141 is in the most urged state, and in FIG. 16A, it is in the state in which the first operation connection portion 141 is positioned in the middle between (B) and (C). Thus, the urging forces of (A), (B), and (C) can be regulated as the amount of downward movement. That is, the movement amount of the biasing device 114 and the rod 142 becomes the movement amount of the operation portion 216, and the tension of the actuation wire can be controlled by this movement amount.

  Referring also to FIG. 15, the operating portion 216 according to the present embodiment divides a cylinder into halves in the axial direction and provides slits 218 between the respective halves, and these halves have a long vertical cross section. The shape is such that the wire guide portion 217 formed into a column is connected.

  One ends of the first wire 271 and the second wire 272 are connected to the tensioner 219 through a guide hole 221 that communicates with the upper surface of the operation portion housing portion 281 of the housing drum 280 from the side surface thereof. The first wire 271 led out to the guide hole 221 passes through the lower portion of the wire guide portion 217 in the slit 218, and the second wire 272 passes through the upper portion of the wire guide portion 217 in the slit 218. It is engaged with the first pin 240 and the second pin 250 shown in FIG.

  The tensioner 219 is provided to constantly apply tension to the first wire 271 and the second wire 272 to eliminate looseness. This is because if there is slack, the opening / closing operation of the opening / closing device 201 cannot be controlled and an unintended opening / closing operation may occur.

  Referring to FIGS. 16A, 16B, and 16C, in FIG. 16A, the first wire 271 and the second wire 272 are equally tensioned, and in FIG. 16B, the first wire 271 is the second wire. A large tension is applied as compared with 272, and in (C), the second wire 272 is applied with a larger tension than the first wire 271. In any of the states shown in FIGS. 16A, 16B, and 16C, since the wire is connected to the tensioner 219, the wire does not loosen even if the wire has a low tension.

  Specifically, when the states of FIGS. 16A, 16B, and 16C are applied to the operating state of the opening / closing device 201, FIG. 16B shows the open state and FIG. 16C shows the closed state. As described above, in this embodiment, the opening / closing device 201 can be surely opened / closed.

  FIG. 17 shows an opening / closing device 300 as a modified example. Referring to FIG. 17, the opening / closing device 300 has a common rotation center 330 and includes a first rotation unit 310 and a second rotation unit 320 that rotate in different directions to open and close. There is.

  The first rotating portion 310 has an arc-shaped first groove 342 having a center (not shown) eccentric to the opening center of the rotation surface with respect to the rotation center 330, and a closing operation side of the rotation surface. And an arc-shaped second groove 352 having an eccentric center (not shown). Also in the second rotating portion 320, an arc-shaped first groove 343 having a center (not shown) that is axisymmetric to the center of the rotating surface eccentric to the opening side with respect to the rotation center 330, An arcuate second groove 353 having an eccentric center (not shown) and a center at an axisymmetric position is formed on the closing side of the rotating surface.

  In the first groove 342 of the first rotating portion 310 and the first groove 343 of the second rotating portion 320, a first pin 340 that is movable on its rotating surface is inserted. One operating wire (not shown) is connected to the first pin 340. Similarly, in the second groove 352 of the first rotating portion 310 and the second groove 353 of the second rotating portion 320, the second pin 350 whose movable surface is movable is inserted. To the second pin 350, one operating wire and another operating wire (not shown) are connected.

  With reference to FIGS. 17A and 17B, FIG. 17A shows a state in which the tension of one actuation wire and the other actuation wire are not applied, and the switchgear 300 is in a closed state. .

  When the one operation wire connected to the first pin 340 is pulled in while the opening / closing mechanism 300 is in the closed state, the first pin 340 is pulled to the right side in the drawing. Since the first rotation portion 310 and the second rotation portion 320 have the common rotation center 330, the first pin 340 is separated from the rotation center 330 in the first groove of the first rotation portion 310. 342 and the first groove 343 of the second rotating portion 320 are slidably moved to rotate the first rotating portion 310 and the second rotating portion 320. When the first pin 340 reaches the ends of the first grooves 342 and 343, the rotations of the first rotating portion 310 and the second rotating portion 320 stop, and the opening / closing mechanism 300 enters the open state shown in (B).

  Then, when another actuating wire connected to the second pin 350 is pulled in, the second pin 350 is pulled to the right side of the drawing. Since the first rotation part 310 and the second rotation part 320 have the common rotation center 330, the second pin 350 is separated from the rotation center 330 by the second groove of the first rotation part 310. 352 and the second groove 353 of the second rotating portion 320 are slidably moved to rotate the first rotating portion 310 and the second rotating portion 320. When the second pin 350 reaches the end of the second grooves 352, 353, the rotations of the first rotating portion 310 and the second rotating portion 320 stop, and the opening / closing mechanism 300 enters the closed state shown in (A).

  As described above, even with the opening / closing mechanism 300 of the modified example, the same operation as that of the opening / closing mechanism 201 described in FIG. 12 and the like can be realized, and the same operation can be performed.

(Third Embodiment)
Next, a third embodiment of the present invention will be described. The third embodiment of the present invention is an embodiment of the rotating unit 400 related to the rotating mechanism of the opening / closing device, and the other configurations are the same as those of the first embodiment or the second embodiment. Therefore, in the following description, The description of the configuration overlapping with the first embodiment or the second embodiment will be omitted. FIG. 18 is a perspective view of a rotating portion of the opening / closing device of the soft surgical instrument changing device according to the third embodiment of the present invention. FIG. 19 is a perspective sectional view showing the internal structure of the rotating portion of the opening / closing device of the soft surgical instrument changing device according to the third embodiment of the present invention.

  When gripping an organ in a living body, the opening / closing device 200 having a rotating surface needs to rotate the opening / closing rotation surface to match the grip position of the organ. The flexible operating member 122 coupled to the opening / closing device 200 is inserted into the elliptic cylindrical adapter 411. Then, the opening / closing device 200 is inserted into the adapter fitting portion 450 so that the adapter 411 having an oval in cross section restricts the rotation of the rotary cylinder 410 so that the adapter 411 rotates in cooperation with the cylindrical rotary cylinder 410. . Further, the rotary cylinder 410 is rotatably inserted in the exterior 420. With the rotation unit 400 having such a configuration, the rotation cylinder 410 is rotated in the exterior 420, and the rotation surface of the opening / closing device 200 is opened / closed, that is, the rotation axis in the direction orthogonal to the insertion / extraction direction into / from the living body. The device 200 can be rotated.

  Next, refer to FIG. FIG. 19 shows a partial cross section (cross section along the XY axis of FIG. 18) on the surgical instrument operating portion 50 side of the soft surgical instrument exchange device 1 which is the right depth side of FIG. 18. A driven bevel gear 440 having radial teeth is formed around the cylindrical portion of the rotary cylinder 410. The driven bevel gear 440 may be integrated with the rotating barrel 410 or may be a separate body, but the rotating barrel 410 is also rotated by the rotation of the driven bevel gear 440.

  A drive bevel gear 430 that rotates with a rotating shaft in a direction orthogonal to the insertion / removal direction in the living body is provided so as to mesh with the driven bevel gear 440. The drive bevel gear rotation shaft 431, which is the rotation shaft of the drive bevel gear 430, is rotatably provided on the exterior 420 so as not to be affected by the rotation of the rotary cylinder 410.

  For example, the first wire 271 shown in FIG. 16 is wound around the drive bevel gear rotation shaft 431, and the first wire 271 is pulled in by the movement of the operation unit 216 in the axial direction, so that the first wire 271 can be inserted into and removed from the living body. It rotates by the rotation axis in the orthogonal direction. The drive bevel gear 430 is rotated by the rotation of the drive bevel gear rotation shaft 431, and the rotation is transmitted to the driven bevel gear 440.

  According to this configuration, by rotating the drive bevel gear by pushing and pulling the wire, it is possible to rotate the driven bevel gear that meshes with the drive bevel gear and rotate the opening / closing device that is the treatment tool. The rotating part 400 having such a configuration can rotate the opening / closing device to a position where the affected part is gripped. The rotating mechanism shown in FIG. 19 is preferably arranged near the tip of the outer casing 420.

(Fourth Embodiment)
Next, a fourth embodiment of the present invention will be described. 4th Embodiment of this invention is an embodiment which concerns on the mechanism which inserts several opening / closing apparatus in a living body and selects a rotating device according to a treatment, and is the same as 1st-3rd embodiment about another structure. Therefore, in the following description, the description of the configurations overlapping with those of the first to third embodiments will be omitted. FIG. 20: is explanatory drawing which shows operation | movement of the rotating part of the opening / closing apparatus of the soft surgical instrument exchange device which concerns on 4th Embodiment of this invention.

  Referring to FIG. 20 (A), a rotary unit and a switchgear having the same configuration as the third embodiment shown in FIG. 19 are arranged in parallel. First, looking at the right side of (A), the rotation exchange section 500 has a drive bevel gear rotation shaft 531 that is a rotation shaft in a direction orthogonal to the insertion / removal direction in the living body, and a drive bevel gear 530 that rotates, A driven bevel gear 540 that meshes with the drive bevel gear 530 is provided. As shown in FIG. 20 (B), the rotation of the driving bevel gear 530 is transmitted to the driven bevel gear 540, and the opening / closing device 200 and the soft operating member 122 rotate.

  When the whole of FIG. 20 (A) is viewed again, the transmission mechanism by the same bevel gear as on the left side is provided on the right side as well. Further, in (A), the left and right driving bevel gears 530 and 530 are not meshed with the left and right driven bevel gears 540 and 550 corresponding thereto. Next, looking at (B), the transmission mechanism by the bevel gear on the right side moves in the direction of arrow Z1. The movement can be realized by retracting the soft operating material 122 by the storage drums 110, 280 and the like. The driven bevel gear 540 and the drive bevel gear 530 mesh with each other by the movement of the transmission mechanism by the right bevel gear in the arrow Z1 direction, and the opening / closing device 200 and the soft operating member 122 can be rotated. The rotation operation is the same as in the third embodiment. In (C), the same operation as in (B) is established by moving the transmission mechanism by the left bevel gear in the direction of arrow Z2 to establish the transmission mechanism by the left bevel gear, and the opening / closing device 200 and the flexible operating member 122 are rotated. .

  According to this configuration, even when a plurality of opening / closing devices are inserted in the living body, by rotating the driving bevel gear by pushing and pulling the wire, the driven bevel gear that meshes with the driving bevel gear is rotated, The opening / closing device, which is a treatment tool, can be rotated. With such a configuration, the opening / closing device can be rotated to a position where the affected area is gripped.

(Fifth Embodiment)
Next, a fifth embodiment of the present invention will be described. The fifth embodiment of the present invention is an embodiment relating to a mechanism for inserting a plurality of opening / closing devices into a living body and selecting a rotating device in accordance with an operation, and other configurations are the same as the first to fourth embodiments. Therefore, in the following description, the description of the configurations overlapping with those of the first to fourth embodiments will be omitted. FIG. 21 is a perspective view of a rotating portion of the opening / closing device of the soft surgical instrument changing device according to the fifth embodiment of the present invention.

  Referring to FIG. 21, a flexible shaft 600 according to a fifth exemplary embodiment of the present invention transmits rotational power to a remote place in an outer tube 320 that covers the first wire 271 and the second wire 272 of the second exemplary embodiment. Is interpolated. The flexible shaft 600 is a long shaft component having flexibility, and when one end is rotated, loss such as twisting is reduced and the rotation can be transmitted to the other end.

  In this embodiment, one end of the flexible shaft 600 can be projected from the operation portion 216 of FIG. 16, and the other end can be connected to the rotary cylinder 410. With this configuration, by rotating the flexible shaft 600 with the operation unit 216, the flexible operation member 122 and the opening / closing device 200 shown in FIG. 18 can be rotated via the rotating cylinder 410.

  That is, according to this configuration, by inserting the first wire 271 and the second wire 272 into the flexible shaft 600, they can be arranged coaxially. By rotating only the flexible shaft 600, the opening / closing device 200 serving as a surgical tool can be rotated. In addition, it is preferable that the flexible shaft 600 extends in a portion as close to the axis as possible, and has a configuration in which resistance (friction, wear) when rotating the surgical instrument which is the opening / closing device 200 by rotation of the flexible shaft 600 is small. Becomes

  The rotating mechanism by the bevel gear described in the third and fourth embodiments rotates the surgical instrument by pushing and pulling the operating wire, and the rotating mechanism by the flexible shaft of the present embodiment directly rotates the surgical instrument. Can be appropriately selected depending on the storage space and the bending condition.

  INDUSTRIAL APPLICABILITY As described above, the present invention is suitable for a soft surgical instrument exchange device and a soft surgical instrument exchange device which can facilitate the exchange of surgical instruments and can easily manage the hygienic state of the exchanged surgical instruments. A flexible surgical instrument can be provided.

DESCRIPTION OF SYMBOLS 1 ... Soft surgical instrument exchange device 20 ... Storage part 21 ... Storage box 22 ... Loading shelf 25 ... Opening 30 ... Exchange part 33 ... Elevating / conveying part 34 ... Roller 35 ... Belt 40 ... Delivery section 41 ... Delivery rod 42 ... Engagement section 45 ... Conveying surface 50 ... Operation tool operating section 51 ... Operation tool positioning tool 100 ... -Surgery tool unit 110, 280 ... Storage drum 111, 281 ... Operation portion storage portion 113 ... Flexible operation material collection groove 114 ... Biasing device 116, 216 ... Operation portion 117 ... Engagement hole 118 ... Anti-rotation key 119 ... Key groove 122 ... Flexible operating material 124 ... Actuating wire 125 ... Wire locking part 126, 320 ... Exterior tube 141 ... No. 1 operation connection part 142 ... Rod 143 ... 2nd operation connection part 144 ... Engagement pin 150 ... Notch 160 ... Mounting ridge 200, 201, 300 ... Opening / closing device 210, 310 ... 1st rotation part 217 ... -Wire guide part 218 ... Slit 219 ... Tensioner 220,320 ... 2nd rotation part 221 ... Guide hole 230 ... Rotation center 231 ... Rotation shaft 240, 340 ... 1st pin 241 ... 1st center 242, 243, 342, 343 ... 1st groove 250, 350 ... 2nd pin 251 ... 2nd center 252, 253, 352, 353 ... 2-groove 260 ... Opening / closing guide 261, 262 ... Guide groove 271 ... First wire 272 ... Second wire 400 ... Rotating part 410 ... Rotating cylinder 411 ... Adapter 420 ...・ Exterior 43 , 530 ... drive bevel gear 431,531 ... drive bevel gear rotation shaft 440, 540 ... driven bevel gear 450 ... adapter fitting portion 500 ... rotary exchanger section 600 ... flexible shaft

Claims (7)

A flexible surgical tool that can be inserted into and removed from a living body and can be bent in the living body.
A housing that stores each of the plurality of flexible surgical tools according to the purpose,
An accommodating portion accommodating a plurality of the casings arranged in a multi-tiered manner in the vertical direction,
An exchange unit including an elevating mechanism that lowers or raises the storage unit so that the respective positions of the plurality of housings in the vertical direction sequentially match the positions of the transport surface,
Of the plurality of housings, a delivery unit that moves the housings whose vertical positions match the positions of the transport surface toward the living body,
And a surgical instrument operating section in which the moved casing is stored,
A flexible surgical instrument exchange device, wherein the casing is exchanged according to the application. The flexible surgical instrument includes a flexible cord-shaped insertion portion on which a treatment tool that opens and closes at the distal end is mounted, and an operation unit that operates the opening and closing movement of the treatment instrument,
The insertion portion includes a wire whose one end is connected to the treatment tool, and an outer tube covering the wire,
The operation section winds the insertion section and rotates the storage section to rotate and rotate the insertion section to insert and remove the insertion section, and the other end of the wire is fixed and rotates in cooperation with the storage drum and winding. Including an opening and closing mechanism that can move in a direction different from the direction,
The opening and closing mechanism opens and closes the treatment tool by moving in the axial direction of the storage drum, which is a direction different from the winding direction,
The operation connection part for rotating the storage drum and operating the movement of the storage drum in the axial direction from the outside of the case is provided on the housing. Soft surgical tool changing device. The operation tool operation unit is provided with an operation mechanism connected to the operation connection unit,
The softness according to claim 2, wherein rotation of the operation mechanism rotates the storage drum via the operation connection portion, and push / pull of the operation mechanism moves the opening / closing device in an axial direction. Surgical tool changer. The soft surgical instrument provided in the soft surgical instrument exchange device according to claim 2 or 3,
The exterior tube contains a plurality of the wires, one end of which is connected to the treatment tool,
The soft surgical instrument characterized in that the other end of each of the wires independently moves in the axial direction of the storage drum. The treatment instrument has a common rotation shaft, and includes a first rotation portion and a second rotation portion that rotate in different directions to perform the opening and closing movements,
The first rotating portion and the second rotating portion include an arc-shaped first groove having a first center eccentric to the opening side of the rotating surface with respect to the rotating shaft, and the rotating portion. An arc-shaped second groove having an eccentric second center is formed on the side of the closing motion of the surface,
One of the wires is connected to the first groove of the first rotating portion and the first groove of the second rotating portion, and a first pin movable on the rotating surface is inserted.
Another wire is connected to the second groove of the first rotating portion and the second groove of the second rotating portion, and a second pin movable on the rotating surface is inserted. The flexible surgical tool according to claim 4, wherein: The insertion portion is
A cylindrical exterior part,
A rotating portion that is rotatably inserted into the exterior portion and that is externally fitted to the treatment tool so as to restrict rotation of the treatment tool;
By the movement of the wire in the axial direction of the storage drum, a drive bevel gear that rotates with a rotation axis in a direction orthogonal to the insertion / removal direction in the living body,
The soft surgical instrument according to claim 4 or 5, further comprising: a driven bevel gear that is provided in the rotating portion and that meshes with the drive bevel gear. A flexible shaft, one end of which is connected to the treatment tool, is housed in the outer tube,
The soft surgical instrument according to claim 4, wherein the treatment instrument is rotated by rotating the other end of the flexible shaft.