JP2021186229A - Surgical instrument - Google Patents

Abstract

To provide a surgical instrument that can reliably prevent a washing tube from being detached.SOLUTION: A surgical instrument 4 comprises a shaft 4a, and a housing 4c including a lid part 44. A washing tube 45 for supplying washing liquid into the shaft 4a is attached to the lid part 44 so as to communicate with a washing liquid supply hole 441. An outer peripheral surface 45b of the washing tube 45 is provided with a movement regulation part 46 for regulating movement of the washing tube 45 in a direction opposite to a supply direction of the washing liquid in the washing tube 45.SELECTED DRAWING: Figure 5

Description

The present invention relates to surgical instruments, and in particular to surgical instruments including a cleaning tube for supplying a cleaning solution to the inside of a shaft.

Conventionally, a surgical instrument including a cleaning tube for supplying a cleaning liquid to the inside of a shaft is known (see, for example, Patent Document 1).

Patent Document 1 discloses a surgical instrument including a housing including a tool base and a tool base cover, and a flash tube (cleaning tube) arranged inside the housing and for supplying a cleaning liquid to the inside of the shaft. There is. Surgical instruments also include end effectors that are operated by cables that run through the shaft.

U.S. Pat. No. 8,398,634

In a surgical instrument as disclosed in Patent Document 1, the arrangement of the flash tube may be changed, for example, in order to make the housing compact. Here, the inventor of the present application causes the shaft to be supplied from the flash tube to the inside of the shaft depending on how the flash tube is arranged, and is caused by the pressure of the cleaning liquid that folds back and flows from the tip end portion to the base end portion of the shaft. I faced the problem that the flash tube (cleaning tube) came off (jumped out of the housing) during cleaning. Further, in the surgical instrument of Patent Document 1, when the end effector is operated by the cable passed through the shaft, the cable rubs against the flash tube as the cable moves, so that the flash tube (during the operation of the end effector) There is also a risk that the cleaning tube) will come off.

The present invention is to ensure that the cleaning tube of the surgical instrument is prevented from coming off.

The surgical instrument according to one aspect of the present invention includes a shaft, an end effector provided on one end side of the shaft, a base arranged on the other end side of the shaft and having a mounting surface for a robot arm, and a lid covering the base. A housing including a portion is provided, and the lid portion is provided with a cleaning liquid supply hole for supplying the cleaning liquid, and a cleaning tube for supplying the cleaning liquid to the inside of the shaft communicates with the cleaning liquid supply hole. The outer peripheral surface of the cleaning tube is provided with a movement restricting portion that regulates the movement of the cleaning tube in the direction opposite to the supply direction of the cleaning liquid in the cleaning tube.

In the surgical instrument according to one aspect of the present invention, as described above, a movement restricting portion for restricting the movement of the cleaning tube in the direction opposite to the supply direction of the cleaning liquid in the cleaning tube is provided on the outer peripheral surface of the cleaning tube. As a result, regardless of how the cleaning tube is arranged, movement is restricted in the direction opposite to the supply direction of the cleaning liquid in the cleaning tube due to the pressure of the cleaning liquid supplied from the cleaning tube to the inside of the shaft. It can be regulated by the department. In addition, when operating the end effector with the wire passed through the shaft, even if the wire rubs against the cleaning tube due to the movement of the wire, it moves in the direction opposite to the supply direction of the cleaning liquid in the cleaning tube. It can be regulated by the movement control department. As a result, it is possible to reliably prevent the cleaning tube from coming off.

According to the present invention, it is possible to surely prevent the cleaning tube from coming off.

It is a figure which showed the outline of the robot operation system by one Embodiment. It is a block diagram which showed the control structure of the robot operation system by one Embodiment. It is a perspective view which showed the state which the surgical instrument was attached to the robot arm by one Embodiment via an adapter. It is a perspective view which showed the state which the 1st lid part and the 2nd lid part were removed from the base by one Embodiment. FIG. 3 is a cross-sectional view taken along the line 101-101 of FIG. It is a perspective view which showed the washing tube in the state which the heat shrink tube of the surgical instrument by one Embodiment was fixed. It is sectional drawing which showed the tip part of the cleaning tube inserted into the shaft of the surgical instrument by one Embodiment. It is a perspective view which showed the vicinity of the heat shrink tube of the surgical instrument by one Embodiment. FIG. 5 is a cross-sectional view taken along the line 102-102 of FIG. It is an enlarged view of the P part of FIG. It is a flowchart which showed the assembly method of the surgical instrument by one Embodiment. It is a perspective view which showed the state which the cleaning tube was inserted into the 1st cleaning liquid supply hole of the 2nd lid part of the surgical instrument by one Embodiment. It is a perspective view which showed the state which inserted the heat shrink tube into the cleaning tube of the surgical instrument by one Embodiment. It is a perspective view which showed the state which heated and contracted the heat shrink tube of the surgical instrument by one Embodiment.

Hereinafter, embodiments will be described with reference to the drawings.

(Structure of robotic surgery system)
A configuration of a robotic surgery system 100 including a surgical instrument 4 according to an embodiment of the present invention will be described with reference to FIGS. 1 and 2.

As shown in FIG. 1, the robotic surgery system 100 includes a remote control device 1 and a patient-side device 2. The remote control device 1 is provided for remotely controlling a medical device provided in the patient side device 2. When the operation mode command to be executed by the patient-side device 2 is input to the remote control device 1 by an operator who is a surgeon, the remote control device 1 issues the operation mode command to the patient-side device via the controller. Send to 2. Then, the patient-side device 2 responds to the operation mode command transmitted from the remote control device 1, a medical instrument such as an endoscope 3 attached to the robot arm 5b, and an operation attached to the robot arm 5a. The instrument (surgical instrument) 4 is operated. This results in minimally invasive surgery.

The patient-side device 2 constitutes an interface for performing surgery on a patient. The patient-side device 2 is placed beside the operating table on which the patient lies. The patient-side device 2 has a plurality of robot arms 5, of which an endoscope 3 is attached to one robot arm 5b, and a surgical instrument 4 is attached to the other robot arm 5a. The plurality of robot arms 5 are commonly supported by the platform 6. The plurality of robot arms 5 have a plurality of joints, and each joint is provided with a drive unit including a servomotor and a position detector such as an encoder. The plurality of robot arms 5 are configured so that medical instruments attached to the plurality of robot arms 5 are controlled to perform desired operations by a drive signal given via a controller.

The platform 6 is supported by a positioner 7 resting on the floor of the operating room. The positioner 7 is connected to a base 7c provided with wheels and a movable floor surface via a pillar portion 7b having a vertically adjustable elevating shaft 7a.

A surgical instrument 4 as a medical instrument is detachably attached to the tip of the robot arm 5a. As shown in FIG. 3, the surgical instrument 4 is removably connected to the robot arm 5a of the robotic surgery system 100 via the adapter 8. The surgical instrument 4 includes an end effector 4b and an elongated shaft 4a having an end effector 4b arranged at one end thereof. Various treatment tools can be applied as the end effector 4b. In the operation using the patient-side device 2, the robot arm 5a introduces the surgical instrument 4 into the patient's body via a cannula (trocca) placed on the patient's body surface. Then, the end effector 4b of the surgical instrument 4 is arranged in the vicinity of the surgical site.

As shown in FIG. 1, an endoscope 3 as a medical device is detachably attached to the tip of the robot arm 5b. The endoscope 3 photographs the inside of the body cavity of the patient, and the captured image is output to the remote control device 1. As the endoscope 3, a 3D endoscope or a 2D endoscope capable of taking a three-dimensional image is used. In the operation using the patient-side device 2, the robot arm 5b introduces the endoscope 3 into the patient's body via the trocca placed on the body surface of the patient. Then, the endoscope 3 is arranged in the vicinity of the surgical site.

The remote control device 1 constitutes an interface with the operator. The remote control device 1 is a device for an operator to operate a medical device attached to a plurality of robot arms 5. That is, the remote control device 1 is configured to be able to transmit an operation mode command to be executed by the surgical instrument 4 and the endoscope 3 input by the operator to the patient side device 2 via the controller. The remote control device 1 is installed near the operating table so that the patient can be clearly seen while operating the master, for example. The remote control device 1 can be installed in a room separate from the operating room in which the operating table is installed, for example, by wirelessly transmitting an operation mode command.

The motion mode to be performed by the surgical instrument 4 is a motion mode (a series of positions and postures) of the surgical instrument 4 and a motion mode realized by the individual functions of the surgical instrument 4. For example, when the surgical instrument 4 is a grasping forceps, the operation modes to be performed by the surgical instrument 4 are the roll rotation position and the pitch rotation position of the wrist of the end effector 4b, and the operation of opening and closing the jaw. .. Further, when the surgical instrument 4 is a snare wire, the operation mode to be performed by the surgical instrument 4 may be a binding operation and a releasing operation of the bound state.

The operation mode to be performed by the endoscope 3 is, for example, the position and orientation of the tip of the endoscope 3 or the setting of the zoom magnification.

As shown in FIGS. 1 and 2, the remote control device 1 includes an operation handle 1a, an operation pedal unit 1b, a display unit 1c, and a control device 1d.

The operation handle 1a is provided for remotely operating a medical device attached to a plurality of robot arms 5. Specifically, the operation handle 1a accepts an operation by an operator for operating a medical instrument (surgical instrument 4, endoscope 3). Two operation handles 1a are provided along the horizontal direction. That is, one of the two operation handles 1a, the operation handle 1a, is operated by the right hand of the operator, and the other operation handle 1a of the two operation handles 1a is operated by the left hand of the operator.

Further, the operation handle 1a is arranged so as to extend from the rear side of the remote control device 1 toward the front side. The operation handle 1a is configured to be movable within a predetermined three-dimensional operation area. That is, the operation handle 1a is configured to be movable in the vertical direction, the horizontal direction, and the front-rear direction.

The remote control device 1 and the patient side device 2 form a master-slave type system in controlling the operation of the robot arm 5a and the robot arm 5b. That is, the operation handle 1a constitutes an operation unit on the master side in the master-slave type system, and the robot arm 5a and the robot arm 5b to which the medical device is attached constitute an operation unit on the slave side. Then, when the operator operates the operation handle 1a, the tip of the robot arm 5a (end effector 4b of the surgical instrument 4) or the tip of the robot arm 5b (endoscope 3) traces the movement of the operation handle 1a. The operation of the robot arm 5a or the robot arm 5b is controlled so as to move.

Further, the patient-side device 2 is configured to control the operation of the robot arm 5a and the robot arm 5b according to the set operation magnification. For example, when the operation magnification is set to 1/2 times, the end effector 4b of the surgical instrument 4 is controlled to move a movement distance of 1/2 of the movement distance of the operation handle 1a. As a result, fine surgery can be performed accurately.

The operation pedal unit 1b includes a plurality of pedals for performing functions related to medical devices. The plurality of pedals include a coagulation pedal, a disconnect pedal, a camera pedal, and a clutch pedal. Further, the plurality of pedals are operated by the feet of the operator.

The camera pedal is used to control the position and posture of the endoscope 3 that images the inside of the body cavity. Specifically, the camera pedal enables the operation by the operation handle 1a of the endoscope 3. That is, while the camera pedal is pressed, the position and posture of the endoscope 3 can be operated by the operation handle 1a. For example, the endoscope 3 is operated by using both the left and right operation handles 1a. Specifically, the endoscope 3 is rotated by rotating the left and right operation handles 1a around the midpoint of the left and right operation handles 1a. Further, by pushing the left and right operation handles 1a together, the endoscope 3 advances to the back. Further, by pulling the left and right operation handles 1a together, the endoscope 3 returns to the front. Further, by moving the left and right operation handles 1a both up, down, left and right, the endoscope 3 moves up, down, left and right.

The clutch pedal is used when the operation connection between the robot arm 5a and the operation handle 1a is temporarily disconnected to stop the operation of the surgical instrument 4. Specifically, while the clutch pedal is being operated, even if the operation handle 1a is operated, the robot arm 5a of the patient-side device 2 does not operate. For example, when the operation handle 1a comes near the end of the movable range by operation, the clutch pedal is operated to temporarily disconnect the operation connection and return the operation handle 1a to the vicinity of the center position. can. Then, when the operation of the clutch pedal is stopped, the robot arm 5a and the operation handle 1a are reconnected, and the operation of the operation handle 1a can be resumed near the center.

The display unit 1c can display an image captured by the endoscope 3. The display unit 1c includes a scope type display unit or a non-scope type display unit. The scope type display unit is, for example, a viewing type display unit 1c. Further, the non-scope type display unit is a concept including an open type display unit 1c having a flat screen which is not a type of looking into the display of a normal personal computer.

When the scope type display unit is attached, the 3D image captured by the endoscope 3 attached to the robot arm 5b of the patient side device 2 is displayed. Even when the non-scope type display unit is attached, the 3D image captured by the endoscope 3 provided in the patient-side device 2 is displayed. When the non-scope type display unit is attached, the 2D image captured by the endoscope 3 provided in the patient-side device 2 may be displayed.

As shown in FIG. 2, the control device 1d includes, for example, a control unit 1e having an arithmetic unit such as a CPU, a storage unit 1f having a memory such as a ROM and a RAM, and an image control unit 1g. The control device 1d may be configured by a single control device 1d for centralized control, or may be configured by a plurality of control devices 1d that cooperate with each other to perform distributed control. The control unit 1e is an operation mode command to be executed by the robot arm 5a according to the switching state of the operation pedal unit 1b, or the operation mode command input by the operation handle 1a, or by the endoscope 3. Determine if it is an operation mode command to be executed. Then, when the control unit 1e determines that the operation mode command input to the operation handle 1a is the operation mode command to be executed by the surgical instrument 4, the control unit 1e transmits the operation mode command to the robot arm 5a. As a result, the robot arm 5a is driven, and the operation of the surgical instrument 4 attached to the robot arm 5a is controlled by this drive.

Further, when the control unit 1e determines that the operation mode command input to the operation handle 1a is an operation mode command to be executed by the endoscope 3, the control unit 1e transmits the operation mode command to the robot arm 5b. As a result, the robot arm 5b is driven, and the operation of the endoscope 3 attached to the robot arm 5b is controlled by this drive.

For example, a control program corresponding to the type of the surgical instrument 4 is stored in the storage unit 1f, and the control unit 1e reads out these control programs according to the type of the attached surgical instrument 4, so that the remote control device 1 The operation command of the operation handle 1a and / or the operation pedal unit 1b of the above can be made to operate in accordance with the individual surgical instrument 4.

The image control unit 1g transmits the image acquired by the endoscope 3 to the display unit 1c. The image control unit 1g performs image processing correction processing as necessary.

The configuration of the surgical instrument 4 according to the embodiment of the present invention will be described with reference to FIGS. 3 to 10.

As shown in FIG. 3, the surgical instrument 4 is a surgical instrument 4 attached to the robot arm 5a of the robotic surgery system 100. The robot arm 5a is covered by the drape 9 because it is used in a clean area. Here, in the operating room, a clean operation is performed in order to prevent the incised portion and the medical device from being contaminated by pathogens, foreign substances, and the like. In this cleanup operation, a clean area and a contaminated area that is an area other than the clean area are set. The surgical site is located in a clean area. Members of the surgical team, including the operator, should take care to ensure that only sterilized objects are located in the clean area during surgery, and when moving objects located in the contaminated area to the clean area, this object. Is sterilized. Similarly, when members of the surgical team, including the operator, place their hands in a contaminated area, the hands are sterilized prior to direct contact with objects located in the clean area. Instruments used in clean areas are sterilized or covered with sterilized drapes 9.

The drape 9 is arranged between the robot arm 5a and the surgical instrument 4. Specifically, the drape 9 is arranged between the adapter 8 and the robot arm 5a. The adapter 8 is attached to the robot arm 5a so as to sandwich the drape 9. That is, the adapter 8 is a drape adapter for sandwiching the drape 9 with the robot arm 5a. Thereby, the drape 9 can be attached by using the adapter 8. Further, the surgical instrument 4 is attached to the adapter 8 attached to the robot arm 5a via the drape 9. The robot arm 5a transmits power to the surgical instrument 4 via the adapter 8 in order to drive the end effector 4b of the surgical instrument 4.

Here, the direction in which the surgical instrument 4 and the adapter 8 are lined up is the Z direction, the surgical instrument 4 side is the Z1 direction, and the adapter 8 side is the Z2 direction. Further, the extending direction of the shaft 4a is the X direction, the tip end side of the shaft 4a is the X1 direction, and the opposite direction of the X1 direction is the X2 direction. Further, the direction orthogonal to the Z direction and the X direction is the Y direction, one side of the Y direction is the Y1 direction, and the other side of the Y direction is the Y2 direction.

As shown in FIG. 4, the surgical instrument 4 includes the shaft 4a, the end effector 4b (see FIG. 3), and the housing 4c.

(housing)
As shown in FIG. 4, the housing 4c constitutes a housing portion for accommodating the drive mechanism of the surgical instrument 4 inside. Specifically, the housing 4c has a base 41, a holding member 42, a plurality of (four) driven members 43, a lid portion 44, a cleaning tube 45, and a movement restricting portion 46. ..

The base 41 has an adapter mounting surface 47 on the Z2 direction side. The adapter mounting surface 47 is a mounting surface of the surgical instrument 4 to the robot arm 5a via the adapter 8. Further, the other end of the shaft 4a is arranged on the base 41. The holding member 42 rotatably holds a plurality of driven members 43. The adapter mounting surface 47 is an example of a “mounting surface” within the scope of the claims.

The plurality of driven members 43 are rotationally driven around the rotation axis C1 by a drive unit provided on the robot arm 5a. The plurality of driven members 43 are configured to move the wire 140 (slender element 14) in the X1 direction or the X2 direction by being rotationally driven around the rotation axis C1. Further, the plurality of driven members 43 drive the end effector 4b (see FIG. 3) by moving the wire 140 in the X1 direction or the X2 direction. Specifically, the end effector 4b is arranged on the X1 direction side of the shaft 4a. Here, the end effector 4b is connected to the shaft 4a via a support member. The base 41 of the housing 4c is connected to the X2 direction side of the shaft 4a. The driven member 43 and the end effector 4b are connected by a wire 140 passed through the shaft 4a.

As described above, the surgical instrument 4 is inserted inside the shaft 4a and includes an elongated element 14 which is a wire 140 for operating the end effector 4b.

As a result, the end effector 4b can be operated by moving the elongated element 14 which is the wire 140, so that the structure for operating the end effector 4b can be made a simple structure.

The shaft 4a is rotated by the rotation of one of the four driven members 43. Further, the end effector 4b is driven by the rotation of the other three driven members 43. Two of the four driven members 43 are arranged in the X direction and two are arranged in the Y direction. The plurality of driven members 43 are provided inside the housing 4c.

The lid portion 44 covers the base 41 from the Z1 direction side. The lid portion 44 has a first lid portion 44a and a second lid portion 44b. The first lid portion 44a is detachably attached to the base 41. The first lid portion 44a has a notch portion 144 for arranging the second lid portion 44b. The cutout portion 144 is formed in a portion of the first lid portion 44a on the X2 direction side. The second lid portion 44b is detachably attached to the base 41. The second lid portion 44b is removably fitted in the notch portion 144 of the first lid portion 44a. The second lid portion 44b has a first cleaning liquid supply hole 441 and a second cleaning liquid supply hole 442. The first cleaning liquid supply hole 441 is an example of the "cleaning liquid supply hole" in the claims.

As shown in FIGS. 4 and 5, the first cleaning liquid supply hole 441 and the second cleaning liquid supply hole 442 are provided for supplying cleaning liquid (water or the like). The first cleaning liquid supply hole 441 and the second cleaning liquid supply hole 442 are through holes that penetrate the second lid portion 44b in the X direction. The first cleaning liquid supply hole 441 and the second cleaning liquid supply hole 442 are arranged side by side in the Z direction. The first cleaning liquid supply hole 441 on the Z1 direction side is provided to supply the cleaning liquid to the inside of the shaft 4a. The second cleaning liquid supply hole 442 on the Z2 direction side is provided to supply the cleaning liquid to the inside of the housing 4c. The first cleaning liquid supply hole 441 has a large diameter portion 441a for inserting (connecting) the tip end portion of a cleaning instrument 444 such as a syringe or a flushing tube for supplying the cleaning liquid, and the large diameter portion 441a on the X1 direction side (described later). It is provided on the F1 direction side) and has a small diameter portion 441b smaller than the large diameter portion 441a. The small diameter portion 441b is formed by the inner peripheral surface of the convex portion 443 protruding from the inner peripheral surface of the large diameter portion 441a toward the center of the first cleaning liquid supply hole 441. The convex portion 443 is provided at the end of the first cleaning liquid supply hole 441 on the X1 direction side.

In this way, the lid portion 44 is attached to the first lid portion 44a and the first lid portion 44a, and is arranged on the side opposite to the shaft 4a side (X2 direction side) in the X direction (axial direction of the shaft 4a). It has a second lid portion 44b in which the first cleaning liquid supply hole 441 is formed. The second lid portion 44b is formed with a first cleaning liquid supply hole 441 attached so that the cleaning tube 45 communicates with the second lid portion 44b.

According to this configuration, by attaching the cleaning tube 45 so as to communicate with the first cleaning liquid supply hole 441 of the second lid portion 44b, the cleaning tube 45 is inserted into the shaft 4a and the second lid portion 44b is first. Since it can be attached to the lid portion 44a, the surgical instrument 4 can be efficiently assembled.

As shown in FIGS. 5 and 6, the cleaning tube 45 is configured to allow the cleaning liquid supplied to the first cleaning liquid supply hole 441 to flow to the tip end portion of the shaft 4a.

Specifically, the cleaning tube 45 is provided so as to extend linearly along the X direction (axial direction of the shaft 4a).

As a result, since the cleaning tube 45 extends linearly along the X direction (axial direction of the shaft 4a), the cleaning liquid flowing in the cleaning tube 45 is compared with the case where the cleaning tube 45 is bent in the middle. Can keep the momentum of. Further, since the cleaning tube 45 extends linearly along the X direction (axial direction of the shaft 4a), the cleaning tube 45 is maintained in a bent posture unlike the case where the cleaning tube 45 is bent in the middle. Since it is not necessary to provide a holding member for the operation, the surgical instrument 4 can be made compact.

The cleaning tube 45 has a cylindrical shape. The cleaning tube 45 is a resin tube extending along the X direction. Specifically, the cleaning tube 45 is made of a fluororesin material. The portion of the cleaning tube 45 on the X2 direction side is inserted into the first cleaning liquid supply hole 441. The portion of the cleaning tube 45 on the X1 direction side is inserted inside the shaft 4a.

The cleaning tube 45 has a flange portion 45a. The flange portion 45a has a function of preventing the cleaning tube 45 from coming off from the first cleaning liquid supply hole 441 in the X1 direction. The flange portion 45a protrudes from the outer peripheral surface 45b of the cleaning tube 45 in the radial direction of the cleaning tube 45 (hereinafter referred to as the D direction). The flange portion 45a is provided at the end portion of the cleaning tube 45 on the X2 direction side.

As shown in FIG. 7, the end portion of the cleaning tube 45 on the X1 direction side is inserted to the vicinity of the tip end portion of the shaft 4a on the X1 direction side. The cleaning liquid supplied from the first cleaning liquid supply hole 441 flows in the cleaning tube 45 and flows out from the tip end portion of the cleaning tube 45. The cleaning liquid flowing out from the tip of the cleaning tube 45 flows into the shaft 4a and flows from the end of the shaft 4a on the X1 direction side toward the end of the shaft 4a on the X2 direction side. Then, the cleaning liquid flows out into the housing 4c from the end portion of the shaft 4a on the X2 direction side, and flows out of the housing 4c using a gap existing in the housing 4c as a discharge hole (not shown). In this way, the inside of the shaft 4a is cleaned.

(Movement Control Department)
As shown in FIGS. 8 and 9, in the surgical instrument 4 of the present embodiment, the cleaning tube is caused by the pressure of the cleaning liquid flowing from the end of the shaft 4a on the X1 direction side toward the end of the shaft 4a on the X2 direction side. A movement control unit 46 is provided to regulate the movement of the 45 in the X2 direction. That is, the movement restricting unit 46 has a function as a retaining member. Specifically, the movement restricting portion 46 is configured to restrict the movement of the cleaning tube 45 in the X2 direction by abutting on the second lid portion 44b.

As described above, the surgical instrument 4 is arranged on the shaft 4a, the end effector 4b provided on one end side of the shaft 4a, and the other end side of the shaft 4a, and has a base 41 having an adapter mounting surface 47 to the robot arm 5a. And a housing 4c including a lid 44 that covers the base 41. The lid portion 44 (specifically, the second lid portion 44b) is provided with a first cleaning liquid supply hole 441 for supplying the cleaning liquid. A cleaning tube 45 for supplying the cleaning liquid to the inside of the shaft 4a is attached so as to communicate with the first cleaning liquid supply hole 441. On the outer peripheral surface 45b of the cleaning tube 45, the cleaning tube 45 moves in a direction opposite to the flow direction of the cleaning liquid in the cleaning tube 45 (hereinafter referred to as the F1 direction and also referred to as the supply direction) (hereinafter referred to as the F2 direction). A movement control unit 46 is provided to regulate the movement. Here, the F1 direction and the F2 direction are directions parallel to the X direction.

According to this configuration, regardless of the arrangement of the cleaning tube 45, the cleaning tube 45 is directed to the F2 direction (opposite to the cleaning liquid supply direction) due to the pressure of the cleaning liquid supplied from the cleaning tube 45 to the inside of the shaft 4a. Movement can be regulated by the movement control unit 46. Further, when the end effector 4b is operated by the wire 140 passed through the shaft 4a, the wire 140 is rubbed against the cleaning tube 45 as the wire 140 moves, and the cleaning tube 45 is in the F2 direction (opposite to the cleaning liquid supply direction). Even when a force in the direction) is applied, the movement of the cleaning tube 45 in the F2 direction can be restricted by the movement restricting unit 46. As a result, it is possible to reliably prevent the cleaning tube 45 from coming off the housing 4c.

Specifically, as shown in FIGS. 9 and 10, the movement restricting unit 46 is provided on the downstream side of the first cleaning liquid supply hole 441 of the second lid portion 44b in the F1 direction (cleaning liquid supply direction). It is in contact with the peripheral edge portion 441d of the opening portion 441c.

According to this configuration, the movement restricting portion 46 is in contact with the peripheral edge portion 441d of the opening 441c provided on the downstream side of the first cleaning liquid supply hole 441 of the second lid portion 44b, so that the cleaning tube 45 is in the F2 direction. Since the movement in the direction (opposite to the supply direction of the cleaning liquid) can be reliably restricted, it is possible to reliably prevent the cleaning tube 45 from coming off the housing 4c.

Here, the opening 441c provided on the downstream side of the first cleaning liquid supply hole 441 is an opening on the F1 direction side of the small diameter portion 441b reduced in diameter by the convex portion 443 of the first cleaning liquid supply hole 441. .. Further, the peripheral edge portion 441d of the opening portion 441c is a portion of the surface 443b on the F1 direction side of the convex portion 443 near the opening portion 441c.

Further, the cleaning tube 45 is restricted from moving not only in the F2 direction but also in the F1 direction. That is, the surgical instrument 4 has a retaining structure for preventing the cleaning tube 45 from coming out from the first cleaning liquid supply hole 441 to the outside of the housing 4c and from the first cleaning liquid supply hole 441 to the inside of the housing 4c. ..

Specifically, the first cleaning liquid supply hole 441 has a large diameter portion 441a for inserting the tip portion of the cleaning instrument 444 for supplying the cleaning liquid, and the large diameter portion 441a on the F1 direction (supply direction) side of the cleaning liquid. It has a small diameter portion 441b smaller than the large diameter portion 441a. The lid portion 44 (specifically, the second lid portion 44b) projects from the inner peripheral surface of the large diameter portion 441a toward the center of the first cleaning liquid supply hole 441, and the convex portion 443 forming the small diameter portion 441b. have. The cleaning tube 45 has a flange portion 45a protruding outward in the D direction (diameter direction of the cleaning tube 45). The movement restricting portion 46 and the flange portion 45a are arranged so as to sandwich the convex portion 443 in the F1 direction (cleaning liquid supply direction).

With this configuration, the movement of the cleaning tube 45 in the F1 direction (cleaning liquid supply direction) and the F2 direction (opposite to the cleaning liquid supply direction) is restricted only by sandwiching the convex portion 443 between the movement restricting portion 46 and the flange portion 45a. Therefore, it is possible to suppress the complexity of the structure that regulates the movement of the cleaning tube 45 in the F1 direction (cleaning liquid supply direction) and the F2 direction (opposite direction to the cleaning liquid supply direction).

As described above, the cleaning tube 45 is restricted from moving to the downstream side by the contact between the flange portion 45a and the upstream surface 443a of the convex portion 443 in the F1 direction (cleaning liquid supply direction). The cleaning tube 45 is restricted from moving to the upstream side by abutting the movement restricting portion 46 and the downstream surface 443b of the convex portion 443 in the F1 direction (cleaning liquid supply direction).

With this configuration, the movement of the cleaning tube 45 in both the F1 direction (cleaning liquid supply direction) and the F2 direction (opposite to the cleaning liquid supply direction) is restricted, so that the cleaning tube 45 is restricted in the F1 direction (cleaning liquid supply direction). It is possible to prevent the cleaning tube 45 from slipping out into the housing 4c due to the movement in the F2 direction (direction), and the cleaning tube 45 moves in the F2 direction (direction opposite to the cleaning liquid supply direction). As a result, it is possible to prevent the cleaning tube 45 from coming out of the housing 4c.

The movement restricting portion 46 is a mounting member (heat shrinkable tube 146 described later) attached to the outer peripheral surface 45b of the cleaning tube 45.

With this configuration, unlike the case where the cleaning tube 45 is integrally provided with a convex portion protruding in the D direction (diameter direction of the cleaning tube 45), the cleaning tube 45 can be moved without changing the shape of the cleaning tube 45. Since it can be regulated, the existing (general-purpose) cleaning tube 45 can be used as it is.

The mounting member has a tubular shape fixed so as to surround (cover) the cleaning tube 45 in the circumferential direction (direction A (see FIG. 8)) of the cleaning tube 45.

With this configuration, the mounting member can be fixed over the entire circumference of the outer peripheral surface 45b of the cleaning tube 45, so that the mounting member can be firmly fixed to the cleaning tube 45.

The mounting member is a heat shrink tube 146.

With this configuration, the heat-shrinkable tube 146 shrinks when heated, so that it can be fixed to the cleaning tube 45 without using an adhesive or the like. Therefore, it is not necessary to perform the inspection (validation) required for fixing with an adhesive. As a result, by not inspecting the fixing of the heat-shrinkable tube 146 to the cleaning tube 45, it is possible to suppress the complicated work of assembling the surgical instrument 4.

The heat shrink tube 146 is a resin tube extending along the X direction. Specifically, the heat-shrinkable tube 146 is formed of a fluororesin material different from that of the cleaning tube 45. The heat-shrinkable tube 146 is a material that becomes harder than the cleaning tube 45 when heated. The heat-shrinkable tube 146 may be made of any other material as long as it is made of a material that undergoes heat-shrinking.

The heat shrink tube 146 has a thickness Tc in the D direction. The thickness Tc of the heat-shrinkable tube 146 in the cured state is smaller than the thickness Tf of the flange portion 45a in the D direction. Further, the thickness Tc of the heat-shrinkable tube 146 in the cured state is larger than the thickness Tw of the cleaning tube 45 in the D direction.

The heat-shrinkable tube 146 is in close contact with the outer peripheral surface 45b of the cleaning tube 45 in the D direction. That is, the heat-shrinkable tube 146 and the cleaning tube 45 are in contact with each other in the D direction. Further, in the heat-shrinkable tube 146, the area obtained by multiplying the circumference around the axis along the F1 direction by the length of the heat-shrinkable tube 146 in the F1 direction is the contact area for tightening the cleaning tube 45.

The heat-shrinkable tube 146 tightens the cleaning tube 45 in a state where it is harder than the cleaning tube 45 due to heat-shrinking.

With this configuration, the bending of the heat-shrinkable tube 146 due to the force applied from the outside can be suppressed as compared with the case where the heat-shrinkable tube 146 has a hardness of 45 or less, so that the force applied from the outside can be suppressed. The heat shrinkable tube 146 can be prevented from coming off from the cleaning tube 45 due to the above.

The heat-shrinkable tube 146 is heated to reduce its diameter to tighten the cleaning tube 45. As a result, the heat shrink tube 146 is fixed at a predetermined position of the cleaning tube 45. Here, the tightening force of the heat-shrinkable tube 146 is set by the inner diameter N1 of the heat-shrinkable tube 146 after curing and the length L of the heat-shrinkable tube 146 in the F1 direction.

The inner diameter N1 of the heat-shrinkable tube 146 in the cured state is such that the inner diameter N2 of the portion of the cleaning tube 45 where the heat-shrinkable tube 146 is arranged is not excessively smaller than the inner diameter of the other portion. That is, in the D direction, the inner diameter N1 of the heat-shrinkable tube 146 in the cured state is slightly smaller than the outer diameter M of the cleaning tube 45 before being tightened by the heat-shrinkable tube 146. According to this configuration, the heat-shrinkable tube 146 can be reliably fixed to the cleaning tube 45 without obstructing the flow of the cleaning liquid through the portion of the cleaning tube 45 where the heat-shrinkable tube 146 is arranged.

The length L in the F1 direction (cleaning liquid supply direction) of the heat-shrinkable tube 146 is equal to or larger than the outer diameter M in the D direction (diametrical direction of the cleaning tube 45) of the cleaning tube 45.

According to this configuration, since the contact area between the heat-shrinkable tube 146 and the cleaning tube 45 can be sufficiently secured, the heat-shrinkable tube 146 can be firmly fixed to the cleaning tube 45.

The length L of the heat-shrinkable tube 146 in the F1 direction is such that the heat-shrinkable tube 146 does not interfere with the wire 140 inserted into the shaft 4a from the driven member 43. Specifically, the length L in the F1 direction of the heat-shrinkable tube 146 is the rotation axis C1 of the two driven members 43 located on the X2 direction side from the end portion of the first cleaning liquid supply hole 441 on the X1 direction side. It is smaller than the distance R to the line 43a connecting the above.

As described above, in the F1 direction, the end portion of the heat-shrinkable tube 146 on the first cleaning liquid supply hole 441 side is arranged at the end portion of the first cleaning liquid supply hole 441 on the X1 direction side. Further, in the F1 direction, the end portion of the heat-shrinkable tube 146 on the shaft 4a side is arranged in the vicinity of the line 43a connecting the rotation axes C1 of the two driven members 43 located on the X2 direction side.

Further, the cleaning tube 45 is press-fitted and attached to the first cleaning liquid supply hole 441.

With this configuration, the movement of the cleaning tube 45 in the F2 direction can be restricted not only by the movement restricting portion 46 but also by being press-fitted and attached to the first cleaning liquid supply hole 441, so that the shaft 4a is being cleaned. It is possible to prevent the cleaning tube 45 from coming off more reliably.

Specifically, the cleaning tube 45 is tightened from the outside in the D direction by the convex portion 443 of the second lid portion 44b.

(How to assemble surgical instruments)
Hereinafter, a method of assembling the surgical instrument 4 by an operator will be described with reference to FIGS. 11 to 14. The method of assembling the surgical instrument 4 includes the work of attaching the heat-shrinkable tube 146 to the cleaning tube 45.

In step S1, the operator inserts the cleaning tube 45 into the first cleaning liquid supply hole 441 (see FIG. 12). Here, the operator inserts the cleaning tube 45 into the first cleaning liquid supply hole 441 until the flange portion 45a of the cleaning tube 45 abuts on the upstream surface 443a (see FIG. 10) of the convex portion 443. In step S2, the operator inserts the heat shrink tubing 146 into the cleaning tube 45 (see FIG. 13). That is, the operator inserts the heat-shrinkable tube 146 into the cleaning tube 45 from the end portion of the cleaning tube 45 opposite to the flange portion 45a side. At this time, the operator inserts the heat-shrinkable tube 146 into the cleaning tube 45 until the heat-shrinkable tube 146 comes into contact with the downstream surface 443b of the convex portion 443 of the second lid portion 44b.

In step S3, the operator heats and shrinks the heat shrink tubing 146 (see FIG. 14). As a result, the heat-shrinkable tube 146 is fixed to the cleaning tube 45 in a state of being in contact with the second lid portion 44b.

In step S4, the operator assembles the other members of the surgical instrument 4. Then, in step S5, the operator assembles the second lid portion 44b while inserting the cleaning tube 45 into the shaft 4a. This completes the assembly work of the surgical instrument 4.

[Modification example]
It should be noted that the embodiments disclosed this time are exemplary in all respects and are not considered to be restrictive. The scope of the present invention is shown by the scope of claims rather than the description of the above-described embodiment, and further includes all modifications (modifications) within the meaning and scope equivalent to the scope of claims.

For example, in the above embodiment, the surgical instrument 4 shows the configuration of the surgical instrument 4 which is not electric, but the present invention is not limited to this. In the present invention, the surgical instrument may be an electric surgical instrument.

Further, in the above embodiment, the cleaning tube 45 is provided so as to extend along the X direction (axial direction of the shaft 4a), but the present invention is not limited to this. In the present invention, the cleaning tube may be bent in a direction other than the axial direction of the shaft.

Further, in the above embodiment, the movement restricting unit 46 is provided separately from the cleaning tube 45, and an example is shown in which the attachment member is attached to the outer peripheral surface 45b of the cleaning tube 45. Not limited. In the present invention, the movement control unit may be provided integrally with the cleaning tube.

Further, in the above embodiment, the mounting member has an example of having a tubular shape fixed so as to surround the cleaning tube 45 in the circumferential direction of the cleaning tube 45, but the present invention is not limited to this. In the present invention, the mounting member may be, for example, a member having a C-shaped cross section.

Further, in the above embodiment, the movement restricting unit 46 shows an example of the heat shrink tube 146, but the present invention is not limited to this. In the present invention, the tubular member may be a tubular member fixed to the cleaning tube with an adhesive.

Further, in the above embodiment, an example is shown in which the heat-shrinkable tube 146 is tightened in a state where the heat-shrinkable tube 146 is harder than the cleaning tube 45 by being heat-shrinked, but the present invention is limited to this. I can't. In the present invention, the heat shrink tubing may be as hard as the wash tubing or softer than the wash tubing.

Further, in the above embodiment, the length L of the heat-shrinkable tube 146 in the F1 direction (the direction of supplying the cleaning liquid in the cleaning tube 45) is orthogonal to the direction D of the cleaning tube 45 (the direction of supplying the cleaning liquid in the cleaning tube 45). Although an example in which the outer diameter is M or more in the direction) is shown, the present invention is not limited to this. In the present invention, the length of the cleaning liquid in the cleaning tube in the heat-shrinkable tube in the flow direction may be less than the outer diameter in the direction orthogonal to the flow direction of the cleaning liquid in the cleaning tube in the cleaning tube.

Further, in the above embodiment, the cleaning tube 45 is attached by being press-fitted into the first cleaning liquid supply hole 441 (cleaning liquid supply hole), but the present invention is not limited to this. In the present invention, the cleaning tube may not be press-fitted into the cleaning liquid supply hole and attached.

Further, in the above embodiment, the movement restricting unit 46 is an opening 441c provided on the downstream side of the first cleaning liquid supply hole 441 (cleaning liquid supply hole) in the F1 direction (cleaning liquid supply direction in the cleaning tube 45). Although an example in which the peripheral portion 441d is in contact with the peripheral portion 441d is shown, the present invention is not limited to this. In the present invention, the movement restricting portion may be arranged at a position away from the peripheral edge portion of the opening provided on the downstream side in the cleaning liquid supply hole.

Further, in the above embodiment, the lid portion 44 has shown an example having the first lid portion 44a and the second lid portion 44b, but the present invention is not limited to this. In the present invention, the lid portion may not be divided into a first lid portion and a second lid portion.

Further, in the above embodiment, an example is shown in which the first cleaning liquid supply hole 441 (cleaning liquid supply hole) to which the cleaning tube 45 communicates is formed in the second lid portion 44b. Is not limited to this. In the present invention, the cleaning liquid supply hole may be formed in the first lid portion.

Further, in the above embodiment, the F1 direction (the direction in which the cleaning liquid in the cleaning tube is supplied) and the F2 direction (the direction opposite to the direction in which the cleaning liquid in the cleaning tube is supplied) are parallel to the X direction (the axial direction of the shaft). However, the present invention is not limited to this. In the present invention, the direction in which the cleaning liquid flows in the cleaning tube and the direction opposite to the direction in which the cleaning liquid flows in the cleaning tube do not have to be parallel to the axial direction of the shaft.

Further, in the above embodiment, an example is shown in which the elongated element 14 for driving the end effector 4b is a wire 140, but the present invention is not limited to this. In the present invention, a cable or a rod may be adopted as an elongated element.

4: Surgical instrument, 4a: Shaft, 4b: End effector, 4c: Housing, 14: Elongated element, 41: Base, 44: Lid, 44a: First lid, 44b: Second lid, 45: Cleaning tube , 45a: Flange part, 45b: Outer peripheral surface (of cleaning tube), 46: Movement control part, 47: Adapter mounting surface (mounting surface), 140: Wire, 146: Heat shrink tube (mounting member), 441: 1st Cleaning liquid supply hole (cleaning liquid supply hole), 441a: Large diameter portion, 441b: Small diameter portion, 441c: Opening, 441d: Peripheral portion, 443: Convex portion, 443a: Surface (on the upstream side of the convex portion), 443b :( Surface (on the downstream side of the protrusion) 444: Cleaning instrument, L: Length (in the flow direction of the cleaning liquid in the cleaning tube in the heat-shrinkable tube), M: (Orthogonal to the flow direction of the cleaning liquid in the cleaning tube in the cleaning tube) Outer diameter (in the direction of)

Claims (13)

With the shaft
The end effector provided on one end side of the shaft and
A housing disposed on the other end of the shaft and having a mounting surface for a robot arm and a housing including a lid covering the base.
The lid portion is provided with a cleaning liquid supply hole for supplying the cleaning liquid, and a cleaning tube for supplying the cleaning liquid to the inside of the shaft is attached so as to communicate with the cleaning liquid supply hole.
A surgical instrument provided on the outer peripheral surface of the cleaning tube with a movement restricting portion that regulates the movement of the cleaning tube in a direction opposite to the supply direction of the cleaning liquid in the cleaning tube. The surgical instrument according to claim 1, wherein the cleaning tube is provided so as to extend along the axial direction of the shaft. The surgical instrument according to claim 1 or 2, wherein the movement restricting portion is a mounting member attached to the outer peripheral surface of the cleaning tube. The surgical instrument according to claim 3, wherein the mounting member has a tubular shape that covers the cleaning tube in the circumferential direction of the cleaning tube. The surgical instrument according to claim 4, wherein the mounting member is a heat-shrinkable tube. The surgical instrument according to claim 5, wherein the heat-shrinkable tube is tightened in a state where the heat-shrinkable tube is harder than the washing tube due to heat shrinkage. The surgical instrument according to claim 5 or 6, wherein the length of the heat-shrinkable tube in the supply direction of the cleaning solution is equal to or larger than the outer diameter of the cleaning tube. The surgical instrument according to any one of claims 1 to 7, wherein the cleaning tube is press-fitted into the cleaning liquid supply hole and attached. The surgical instrument according to any one of claims 1 to 8, wherein the movement restricting portion is in contact with a peripheral edge portion of an opening provided on the downstream side of the cleaning liquid supply hole. The cleaning liquid supply hole is
A large-diameter portion for inserting the tip of a cleaning instrument for supplying the cleaning liquid, and a large-diameter portion.
The large diameter portion is provided on the supply direction side of the cleaning liquid, and has a small diameter portion smaller than the large diameter portion.
The lid portion has a convex portion that protrudes from the inner peripheral surface of the large diameter portion toward the central portion of the cleaning liquid supply hole and forms the small diameter portion.
The cleaning tube has a flange portion protruding outward in the radial direction of the cleaning tube.
The surgical instrument according to any one of claims 1 to 9, wherein the movement restricting portion and the flange portion are arranged so as to sandwich the convex portion in the supply direction of the cleaning liquid. In the cleaning tube, movement to the downstream side is restricted by contact between the flange portion and the upstream surface of the convex portion in the supply direction of the cleaning liquid, and the movement restricting portion and the convex portion are restricted. The surgical instrument according to claim 10, wherein the movement to the upstream side is restricted by the contact with the surface on the downstream side of the portion. The lid is
The first lid and
One of claims 1 to 11, which is attached to the first lid portion, is arranged on the side opposite to the shaft side in the axial direction of the shaft, and has a second lid portion on which the cleaning liquid supply hole is formed. The surgical instrument according to item 1. The surgical instrument according to any one of claims 1 to 12, further comprising an elongated element that is inserted inside the shaft and is a wire or cable for operating the end effector.

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