JP4145309B2 - Treatment tool - Google Patents

Description

  The present invention relates to a treatment tool used for endoscopic surgery.

  In recent years, operations such as gallbladder extraction, appendectomy, and large intestine resection have been performed minimally invasively by using an endoscope. This technique is generally called endoscopic surgery. A guide tube called a trocar is inserted into a body cavity such as the abdominal cavity, and an optical endoscope or treatment tool is inserted into the body cavity using this trocar as a guide. Is to do.

  The treatment instrument has a structure having a treatment portion on the distal end side of the insertion portion and an operation portion on the proximal side. For example, Patent Document 1 discloses that the bending of the distal end portion of the insertion portion can be varied. It has been known. This is a method of changing the curvature by moving a superelastic tube having a curved shape stored in advance into and out of a fixed outer tube. Patent Document 1 discloses a method of rotating a distal end portion of a treatment instrument by providing a tube for rotation outside a superelastic tube. Further, EPO557806A2 discloses a method of bending a joint structure using a link structure.

  In addition, Patent Literature 3 and Patent Literature 4 disclose surgical devices that operate by operating a treatment instrument manipulator remotely. The configuration of this surgical apparatus includes a treatment manipulator having a surgical treatment function and information input means for operating the treatment manipulator from a remote position, or remote operation means.

  Patent Document 1 discloses a method for improving the treatment performance in a body cavity by bending and rotating the distal end portion of the treatment tool. Further, a method for improving operability outside the body cavity by using the second curved portion outside the body cavity is shown in a document “Instruments for Endoscopic Surgical”. Further, Patent Document 5 discloses a method of providing a plurality of bending means in a body cavity to improve treatment performance.

  Further, conventionally, a bending tube structure in which a plurality of node rings are connected is used as a bending means of an intracorporeal medical device such as an endoscope, which is disclosed in Patent Document 6. Patent Document 6 discloses a curved structure that can be manufactured by an integral member by providing a number of notches in a superelastic alloy.

Further, Patent Document 7 discloses a medical master manipulator including a multi-joint gripping device as a remote operation means for remotely operating an endoscopic surgical operation. Furthermore, Patent Document 8 discloses a three-dimensional position input device using a wire.
USP5254130 specification EPO557806A2 specification USP 5217033 specification JP-A-7-136173 Japanese Patent Laid-Open No. 5-076482 Japanese Patent Publication No. 5-29452 JP-A-7-328014 USP 5305429 Specification

However, the above-described technique has the following problems.
First, in Patent Document 1, a superelastic tube having a curved shape stored in advance is made to go in and out of a fixed outer tube in order to vary the bending of the distal end portion of the treatment instrument. Due to the friction of the tube, it is difficult to freely change the curvature during the operation of the treatment instrument. In addition, in order to give the superelastic tube the rigidity necessary for the operation, the stress generated by the suppression by the outer tube increases, and the life of the superelastic tube is remarkably shortened, making long-term use difficult.

  On the other hand, in the example of Patent Document 2 using a joint structure for bending, it is possible to freely bend while maintaining high rigidity, but the path of the wire for driving the distal treatment instrument is indeterminate, For this reason, even if the peeling is performed by the force of opening the treatment tool, the wire is buckled and the force is not transmitted. Even when the treatment tool is closed, the direct operational feeling is not transmitted due to the slack of the wire.

  Moreover, in the said patent document 1, the front-end | tip treatment instrument is rotated by providing a rotation member in the outer side of a superelastic tube. However, because of the independent rotating member, the outer diameter of the treatment instrument is increased.

  The treatment manipulator disclosed in Patent Document 4 realizes bending of the distal end portion and opening / closing of the treatment instrument by power. In such a power treatment instrument, the relationship between the drive amount of the drive unit and the opening / closing amount of the treatment unit is unique. That is, a transmission structure free from looseness and looseness is required. However, in a transmission structure having a movable curved portion between the driving unit and the treatment unit, it has been difficult to realize a structure without backlash or looseness.

  By using the bending treatment tool as shown in Patent Document 1, the degree of freedom in approaching the subject in the body cavity is higher than when the distal end portion is not curved. However, since it is linear outside the body cavity, it may interfere with other treatment instruments, observation rigid endoscopes, and the like. Therefore, a technique for providing a second bending portion outside the body is described in the document “Instruments for Endoscopic Surgical”. However, in a bending structure using a ball joint as in this document, transmission for opening and closing the treatment instrument and rotating the distal end portion is described. It is difficult to realize the structure.

  Furthermore, in the curved tube structure in which a plurality of node rings are connected, which is disclosed in Patent Document 6, the curved shape is constant depending on the shape and hardness of the built-in object inside the bent tube and the frictional force between the bent tube and the built-in object. Therefore, there is a problem that it is difficult to position the tip portion delicately and bending operability is poor.

  Further, by providing a large number of notches in the superelastic alloy shown in Patent Document 6, the curved structure that can be manufactured with an integral member has an advantage that it can be manufactured at low cost. However, since stress concentration occurs in the notch portion, there is a disadvantage that the life is short and the rigidity of the curved portion is low because the force is received only at two joints.

  The medical master manipulator disclosed in Patent Document 7 for remotely manipulating endoscopic surgery is composed of a plurality of joints, and thus interferes with the operator's body and is free. It is difficult to input an agile operation because the operation is hindered or because of the weight of the members constituting the joint. Further, in order to feed back force to the operator, it is necessary to provide a drive source at the joint, and the overall structure is large and complicated.

  On the other hand, since the three-dimensional position input device disclosed in Patent Document 8 performs three-dimensional position detection with a thread, it is light in weight and follows an agile operation. Also, when presenting a force sense, the overall structure is large and does not become complicated. However, in an endoscopic surgical operation, an operator is an operator, and it is important that the operability is the same as that of a conventional surgical instrument.

  The present invention has been made by paying attention to the various circumstances described above, and its object is to reliably transmit the driving force for opening and closing the treatment instrument while realizing high rigidity and flexible bending, An object of the present invention is to provide a treatment instrument that can transmit a direct operational feeling from the instrument and is excellent in operability.

In order to achieve the above object, a treatment instrument according to the present invention includes a distal treatment instrument, an insertion portion having a bending portion that changes a bending state for inserting the distal treatment instrument into a body cavity, and the distal treatment. An operating section for driving the instrument, and a connecting member for connecting the operating section and the distal treatment instrument, the connecting member being movable in the axial direction within the flexible exterior member and the exterior member and a interior member, the outer member, Ri Do a plurality of layers having at least a spring, the spring is a flat spring, the outer member, said flat spring, it is disposed outside the flat spring resin and a coating, wherein the flat spring and the resin coating are integrated, the exterior member of the connecting member is subjected to compressive forces in the flat spring, before the stretching force Characterized by being adapted to receive a resin coating.
In order to achieve the above object, the treatment tool according to the present invention includes a distal treatment instrument, an insertion portion having a bending portion for changing the bending state for inserting the distal treatment instrument into a body cavity, An operation unit that drives the distal treatment instrument, and a connection member that couples the operation part and the distal treatment instrument are provided. The connection member moves in the axial direction inside the flexible exterior member and the exterior member. The exterior member is composed of a plurality of layers having at least a spring, the spring is a flat spring, and the exterior member is disposed outside the flat spring and the flat spring. A blade and a resin coating disposed outside the blade, wherein the flat spring, the blade, and the resin coating are integrated, and the exterior Regarding the force to compress the material, buckling is prevented by the flat springs coming into close contact, and with respect to the force to extend the exterior member, the expansion force is suppressed by the contraction force of the flat springs, the blade and the resin coating. The force for rotating the exterior member is transmitted by both the left and right rotations by at least the blade and the resin coating.

In order to achieve the above-described invention, a treatment instrument according to the present invention includes a distal treatment instrument, an insertion portion having a bendable bending portion for inserting the distal treatment instrument into a body cavity, and the distal treatment. An operation section for driving the instrument and bending the bending section; and a connecting member for connecting the operation section and the distal treatment instrument. The connecting member includes a flexible exterior member and the exterior An interior member that is movable in the axial direction inside the member, wherein the curved portion is composed of a plurality of cylindrical pieces, the adjacent pieces are provided with two or more support portions, and at least one extendable portion. , the outer member, Ri Do a plurality of layers having at least a spring, the spring is a flat spring, said the flat spring and the resin coating are integrated, the exterior member of the connecting member, the compression force Received by the flat spring, characterized in that the stretching force and to receive in the resin coating.
In order to achieve the above-described invention, a treatment instrument according to the present invention includes a distal treatment instrument, an insertion portion having a bendable bending portion for inserting the distal treatment instrument into a body cavity, and the distal treatment. An operation section for driving the instrument and bending the bending section; and a connecting member for connecting the operation section and the distal treatment instrument. The connecting member includes a flexible exterior member and the exterior An interior member that is movable in the axial direction inside the member, wherein the curved portion is composed of a plurality of cylindrical pieces, the adjacent pieces are provided with two or more support portions, and at least one extendable portion. The exterior member comprises at least a plurality of layers having springs, the spring comprises a flat spring, and the exterior member comprises the flat spring and a blade disposed outside the flat spring. The flat spring, the blade, and the resin coating are integrated with each other, and with respect to the force for compressing the exterior member, the flat spring is brought into close contact with the seat. With respect to the force for preventing bending and extending the exterior member, the contraction force of the flat spring and the blade and the resin coating suppress the elongation, and the force for rotating the exterior member is at least the blade and the resin. Both the left and right rotations are transmitted by the coating.

  According to these, despite having a bending portion capable of freely changing the bending state, it is possible to reliably transmit the driving force for opening and closing the treatment instrument due to the high rigidity. It is possible to provide a treatment tool with excellent operability, capable of transmitting the driving force for opening and closing the treatment instrument with certainty, and transmitting a direct operational feeling from the distal treatment instrument. it can.

  According to the present invention, it is possible to reliably transmit the driving force for opening and closing the treatment instrument while realizing high rigidity and flexible bending, and to transmit a direct operational feeling from the distal treatment instrument, which is excellent in operability. A treatment tool can be provided.

Embodiments of the present invention will be described below with reference to the drawings.
1 to 4 show a first embodiment, FIG. 1 is a perspective view of a treatment instrument, FIG. 2 is a longitudinal side view of the treatment instrument, FIG. 3 is a configuration diagram of an outer casing and an inner cable, and FIG. FIG. The treatment instrument connects the distal treatment instrument 1 provided at the distal end, the bending portion 2 for positioning the treatment instrument 1, the operation portion 3 for operating the distal treatment instrument 1 and the bending portion 2, and the operation portion 3 and the bending portion 2. It is comprised from the insertion part 4. FIG.

  In the treatment instrument 1, a forceps 5 is constituted by a pair of forceps pieces 5b that are rotatable with a pivot pin 5a as a fulcrum, and a proximal end portion of the pair of forceps pieces 5b is a link 6 via a connecting pin 6a. It is connected to. The forceps 5 and the link 6 are supported by a forceps rotating shaft 7 so as to be opened and closed. The forceps rotating shaft 7 can be moved forward and backward with respect to the forceps rotating shaft 7, and the link 6 is moved forward and backward to open and close the forceps 5. An open / close rod 8 is provided.

  The bending portion 2 includes a bending tube 10 in which a large number of bending pieces 9 are connected in an articulated manner, and a forceps support portion 11 that rotatably fixes the forceps rotating shaft 7 to the bending tube 10. The bending wires 12 and 13 are inserted inside the bending tube 10, one end of which is fixed to the end of the bending tube 10, and the other end is inserted through the insertion pipe 14. It is fixed to a bending operation knob 15 fixed so as to be rotatable. The operation tube 3 side end of the bending tube 10 is fixed to the insertion pipe 14, and the insertion pipe 14 is fixed to the operation grip 16.

  An outer casing 17 that is a tubular flexible exterior member is provided in the lumen of the bending portion 2, and an inner cable 18 that is a flexible rod-shaped interior member is provided therein. The outer casing 17 is rotatable with respect to the bending tube 10 and the inner cable 18, and the inner cable 18 is movable back and forth with respect to the outer casing 17. An end of the outer casing 17 on the distal treatment instrument 1 side is fixed to the forceps rotation shaft 7, and an end on the operation unit 3 side is fixed to a hollow rotation transmission shaft 19.

  The rotation transmission shaft 19 is fixed to a rotation operation ring 20 that is rotatable with respect to the insertion pipe 14. An end portion of the inner cable 18 on the distal treatment instrument 1 side is fixed to the open / close rod 8, and an end portion on the operation portion 3 side is fixed to a linear motion rod 21 inserted through the insertion pipe 14. The linear motion rod 21 is fixed to an operation handle 22 that is rotatable about a fulcrum with respect to the operation grip 16.

  When the outer casing 17 and the inner cable 18 are described further, they are configured as shown in FIG. That is, the outer casing 17 includes a flat spring 23 made of stainless steel, a stainless steel blade 24 provided outside the flat spring 23, and a resin coating 25 made of fluororesin provided on the outside thereof. The inner cable 18 is composed of a stainless steel core wire 26 and a stainless steel side wire 27 that is thinner than the core wire 26 around the inner cable 18.

  The inner cable 18 can be bent flexibly by adopting a twisted wire structure composed of the core wire 26 and the side wire 27. Regarding the force for extending the inner cable 18 that is generated when the forceps 5 is to be closed, the inner cable is generated when the forceps 5 is to be opened by preventing the extension by tightly contacting the stranded wires. With respect to the force for compressing 18, buckling is prevented by the thick core wire 26 at the center.

  The outer casing 17 can be bent by a flexible structure including a flat spring 23, a blade 24, and a resin coating 25. Regarding the force that compresses the outer casing 17 that occurs when the forceps 5 are to be closed, buckling is prevented by the close contact of the flat spring 23. Regarding the force for extending the outer casing 17 that occurs when the forceps 5 are to be opened, the expansion is suppressed by the contraction force of the flat spring 23 and the blade 24 and the resin coating 25. Further, the rotational force is transmitted by both the left and right rotations mainly by the blade 24 and the resin coating 25.

  Next, the operation of the treatment instrument configured as described above will be described. By operating the bending operation knob 15 of the operation unit 3, the bending wires 12 and 13 are differentially operated in the axial direction, the bending tube 10 is bent, and the bending unit 2 is bent. When the rotary operation ring 20 is rotated, the rotational force is transmitted to the rotation transmission shaft 19, the outer casing 17, and the forceps rotation shaft 7, and the entire forceps 5 is rotated. Further, by opening and closing the operation grip 16 and the operation handle 22, the linear motion rod 21 advances and retracts with respect to the rotation transmission shaft 19, the inner cable 18 advances and retracts with respect to the outer casing 17, and the opening and closing rod 8 moves with the forceps rotation shaft. The forceps 5 opens and closes with respect to 7.

  Therefore, when the forceps 5 is to be opened for peeling the living tissue A when the bending portion 2 is bent as shown in FIG. 4, the linear motion rod 21 is pushed toward the distal end side as shown in FIG. The force to bend is exerted on the inner cable 18 by the force to be, but as shown in FIG. 4B, the inner cable 18 is restrained by the outer casing 17, so that the force to open the forceps 5 is the tip. Is transmitted reliably.

  Further, since the inner cable 18 is restrained by the outer casing 17, there is no change in the length of the path due to the bending of the bending portion 2, and the opening / closing operation of the forceps 5 can be performed with the same operational feeling when the bending is not performed. It can be carried out.

  Further, since the bending by the bending portion 2 and the rotation by the outer casing 17 can be performed at the same time, it is easy to perform a complicated operation such as suturing performed by holding the suture needle on the forceps 5. Furthermore, since the bending portion 2 has a structure having a joint, the operation force is small and the durability is high with respect to repeated use.

  FIG. 5 shows a second embodiment, which is another embodiment of the outer casing 17 and the inner cable 18. 5A to 5C show the configuration of the outer casing 17, and FIGS. 5D and 5E show the configuration of the inner cable 18.

  The outer casing 17 shown in FIG. 5A is composed of a flat spring 28 and a resin coating 29 made of a fluororesin on the outside thereof. The compression force is received by the flat spring 28 and the extension force is received by the resin coating 29.

  The outer casing 17 shown in FIG. 5B is composed of a spring 30 with a multi-layer winding. The compression force and the tensile force are received by the rigidity of the spring 30 itself. The rotational force is transmitted in the direction in which the spring 30 is tightened, but the rotational transmission force in the loosening direction is relatively small.

  The outer casing 17 shown in FIG. 5C is configured by a multi-layered multi-winding spring 31. By changing the winding direction of the spring 31 for each layer, it is possible to transmit force in both the left and right directions.

  The inner cable 18 shown in FIG. 5D is constituted by a stranded wire composed of a core wire 32 and a side wire 33. According to this configuration, the buckling strength is small but the curvature is good.

  The inner cable 18 shown in FIG. 5E is composed of a core wire 34 and a winding 35. The winding 34 receives the buckling force.

  FIGS. 6 and 7 show a third embodiment, in which the bending portion 2 is configured by a three-section link bending portion 40 instead of the bending tube 10, and the same components as the first embodiment are as follows. The same numbers are assigned and explanations are omitted.

  FIG. 6 is a perspective view of the treatment instrument, and FIG. 7 shows the structure of the link bending portion 40. In the link bending portion 40, the first link 41 and the second link 42 are arranged symmetrically and have an annular shape. The ends of the first link 41 and the center of the second link 42 are fixed to both ends of the link bending portion 40. Bending wires 43 and 44 are connected to the first link 41 and the second link 42, respectively, and a linear bending shape with respect to the movement amount of the bending wires 43 and 44 is obtained.

  FIG. 8 shows the fourth embodiment. The same applies to the third link 45 and the fourth link 46 arranged in an annular shape inside the first link 41 and the second link 42 of the third embodiment. Can be configured.

  According to the third and fourth embodiments, in addition to the effects of the first embodiment, the curved shape is not influenced by external force or the built-in material of the bending portion 2, and is uniquely determined by the amount of movement of the bending wires 43 and 44. There is an effect that it is determined. Further, it is obvious that this structure can be widely used not only for the bending portion of the treatment instrument but also for medical devices used in a body cavity such as an endoscope.

  FIG. 9 shows a fifth embodiment. Instead of the bending tube 10 in the first embodiment, a multi-stage bending in which a bending piece 49 is connected by an extendable telescopic part 47 and a retractable collapsible part 48 partially lacking the peripheral wall of the thin cylindrical body 50. The tube 50a is configured. The retractable part 48 is composed of two fragile parts 51 provided with two arc-shaped notches at both ends thereof.

  Each bending piece 49 is tilted with the tiltable portion 48 as a fulcrum. Although the deformation due to the tilting is concentrated on the fragile portion 51, the fragile portion 51 has an arc-shaped cutout shape, and therefore prevents destruction due to stress concentration. Further, since the retractable part 48 is realized by the two weak parts 51, the deformation amount per one weak part 51 is small. The stretchable part 47 is composed of four weak parts 51 provided with four arc-shaped cutouts at both ends. The expansion / contraction part 47 forms a link structure with the fragile part 51 similar to the collapsible part 48 as a joint, and thus has a structure that can expand and contract in the axial direction.

  Moreover, since the weak part 51 has elasticity, it has a spring property with respect to the expansion / contraction direction as a whole of the link structure, and when the external force is not applied, it has the property that the multistage bending tube 50a returns to its original shape. The retractable portion 48 and the extendable portion 47 are opposed to each other, and can be bent in two degrees of freedom in the vertical and horizontal directions by changing the arrangement of the retractable portion 48 and the expandable portion 47 for each step.

  According to the present embodiment, in addition to the effects of the first embodiment, the curved structure can be manufactured by integral molding or integrated processing, and it can be manufactured at a lower cost than the conventional one. Further, since the connecting portion of the bending piece 49 is coupled at the four positions of the retractable portion 48 and the extendable portion 47, the rigidity of the entire bending structure is high. In addition, a long life is realized by adopting a structure in which stress is not easily concentrated even though the notch is provided to provide the curvature. Further, it is obvious that this structure can be widely used not only for the bending portion of the treatment instrument but also for medical devices used in a body cavity such as an endoscope.

  10 and 11 show a sixth embodiment, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In addition to the configuration of the first embodiment, the treatment tool of this embodiment further includes another second bending portion 52 on the operation portion 3 side of the insertion portion 4. The second bending portion 52 normally has a hollow bellows 53 whose shape can be changed by an external force, and an outer casing 54 and an inner cable 55 similar to those of the first embodiment are provided inside the bellows 53. Is provided.

  The outer casing 54 connects a first rotation transmission shaft 56 fixed to the rotation operation ring 20 and a second rotation transmission shaft 57 fixed to the outer casing 17 of the first bending portion 2. . The inner cable 55 connects a first linear motion rod 58 fixed to the operation handle 22 and a second linear motion rod 59 fixed to the inner cable 18 of the first bending portion 2.

  In the present embodiment, a semi-fixed one is used as the second bending portion 52, but it is also possible to use a movable bending portion similar to the first embodiment. Therefore, when the rotary operation ring 20 is rotated, the rotational force is transmitted by the first rotation transmission shaft 56, the outer casing 54, and the second rotation transmission shaft 57, and the forceps 5 can be rotated. When the operation handle 22 is opened and closed, the forceps 5 transmitted by the first linear rod 58, the inner cable 55, and the second linear rod 59 can be opened and closed.

  According to this embodiment, in addition to the effects shown in the first embodiment, in endoscopic surgery, as shown in FIG. 11, a cylindrical trocar 61 is inserted into the skin 60, and the trocar 61 is A forceps 62 as a treatment tool is inserted as a guide. At the time of surgery, a plurality of forceps 63 and an observation endoscope 64 are inserted from a plurality of trocars 61. By having the second curved portion 52 outside the body in such a situation, it becomes easier for the operator to perform the operation, and the need for opening a new operation hole in the body surface in order to change the direction of the forceps 62 is reduced. I think that.

  12 to 14 show a seventh embodiment. As shown in FIG. 12, the present embodiment includes an operation input device 65 operated by an operator, a motor control unit 66, and a treatment manipulator 67. The operation input device 65 reads information on the position, posture and grip of the operator's hand 68, and based on this information, the motor control unit 66 can control the treatment manipulator 67 based on the position and posture information. The distal end portion of the treatment manipulator 67 is inserted through a trocar 71 inserted into the body of the patient 70 fixed on the operating table 69, so that the affected area can be treated. The treatment manipulator 67 rotates a robot arm 72 having three degrees of freedom operating based on a cylindrical coordinate system, a universal joint 73 having two degrees of freedom of up and down and rotation, and an insertion portion 74 and an insertion portion 74 for operating the distal end portion. It is comprised from the holder 75 to be made.

  As shown in FIG. 13, the operation input device 65 has pulleys 77 arranged at the corner apexes of a cubic frame 76, and a wire 78 is hung on each pulley 77. The six wires 78 are divided into three groups 79 and 80 each forming a diagonal surface, and each group 79 and 80 is attached to the flange portions 82 and 83 in the vicinity of two places of the rod-shaped operation portion 81. ing. A grip handle 84 is attached to the end of the operation unit 81. A motor 85 and an encoder 86 are attached to the end of each wire 78 so that the wire 78 can be freely tensioned at the same time as the drawing amount of the wire 78 is measured.

  The handle 84 is provided with a force sensor 87 for measuring a gripping force. The three-dimensional position and orientation of the operation unit 81 are obtained from the lengths of the respective wires 78 obtained from the output of the encoder 86. A reaction force is transmitted to the operation unit 81 by varying the tension of each wire 78. Even if a spring is used instead of the motor 85, it can be used as a position / posture input device. Even if an encoder for detecting the opening / closing angle of the grip handle 84 is provided instead of the force sensor 87, an operation input can be performed.

  FIG. 14 shows the configuration of the treatment instrument. The insertion portion 90 includes a distal end portion 91 having forceps, a bending portion 92, and a driving portion 93. The bending portion 92 includes a bending tube 94 that bends in two degrees of freedom in the vertical and horizontal directions, two sets of operation wires 95 and 96 that oppose the vertical and left and right sides for operating the bending tube 94, and the first embodiment. The outer casing 97 and the inner cable 98 are the same.

  The outer casing 97 is fixed to the forceps support portion 99 and the insertion pipe 100 of the drive portion 93, and the inner cable 98 is fixed to the forceps opening / closing rod 101 and the linear motion rod 102 of the drive portion 93. The operation wires 95 and 96 are connected and fixed to a ball screw nut 108 of a linear actuator 107 constituted by a motor 103, an encoder 104, a ball screw 105 and a pulley 106. The linear motion rod 102 is also connected and fixed to a ball screw nut 108 of a linear motion actuator 107 constituted by the same motor 103, encoder 104 and ball screw 105.

  Therefore, the surgeon operates the operation input device 65 and operates the treatment manipulator 67 to treat the patient 70. Information on the position / posture / gripping state of the operator's hand 68 obtained by the operation input device 65 is input to the control unit 66, and the operation amount of the robot arm 72, the rotation amount of the insertion portion 74 of the holder 75, and the insertion portion. 74 is converted into the bending amount of the bending portion 92 and the opening / closing angle of the forceps 109. In the drive unit 93, the ball screw nut 108 advances and retreats by the rotation of the motor 103, and the operation wires 95 and 96 are differentially driven according to the advance and retreat, and the bending portion 92 bends up and down and right and left. Similarly, the linear motion rod 102 advances and retreats by the rotation of the motor 103, and the forceps 109 opens and closes via the forceps opening / closing rod 101.

  In this embodiment, the operations of the linear motion rod 102 and the forceps opening / closing rod 101 before and after the bending portion 92 are made to coincide with each other by using the outer casing 97 and the inner cable 98, and the high-precision forceps 109 of the motor 103 and the encoder 104 are used. As a result, the forceps 109 can be remotely controlled by advanced master-slave control.

According to the embodiment described above, the following configuration is obtained.
(Supplementary Note 1) A distal treatment instrument, an insertion section having a bending portion for inserting the distal treatment instrument into a body cavity, an operation section for driving the distal treatment instrument, and the operation section and the distal treatment instrument. A treatment instrument having a coupling member to be coupled, wherein the coupling member is composed of a flexible exterior member and an interior member movable in the axial direction inside the exterior member.

    (Supplementary Note 2) A distal treatment instrument, an insertion section having a bending portion for inserting the distal treatment instrument into a body cavity, an operation section for driving the distal treatment instrument, and the operation section and the distal treatment instrument. In a treatment instrument having a connecting member to be connected, the bending portion includes a plurality of independent bendable bending means, a flexible exterior member, and an interior member that is movable in the axial direction inside the exterior member. A treatment instrument comprising the connecting member.

    (Additional remark 3) The said exterior member rotates the said front treatment tool by rotating with respect to a curved part, and opens and closes the said front treatment tool by an interior member moving forward / backward in an axial direction, It is characterized by the above-mentioned. The treatment tool according to appendix 1 or 2.

    (Supplementary note 4) The treatment instrument according to supplementary note 1 or 2, wherein the interior member rotates or opens and closes the distal treatment instrument by rotating or axially moving back and forth with respect to the bending portion.

    (Additional remark 5) The said exterior member is formed with the cylindrical elastic metal spring, The treatment tool of Additional remark 1 characterized by the above-mentioned.

    (Additional remark 6) The said exterior member is formed with the cylindrical elastic metal spring and the resin layer, The treatment tool of Additional remark 1 characterized by the above-mentioned.

    (Additional remark 7) The said exterior member is formed with the cylindrical elastic metal spring, the metal brate, and the resin layer, The treatment tool of Additional remark 1 characterized by the above-mentioned.

    (Supplementary note 8) The treatment instrument according to supplementary note 1, wherein the exterior member has a multi-strand metal coil spring.

    (Supplementary note 9) The treatment instrument according to supplementary note 1, wherein the interior member includes a stranded wire.

    (Additional remark 10) The said interior member consists of a core material and a strand, and the diameter of a core material is thicker than the diameter of a strand, The treatment tool of the appendix 1 characterized by the above-mentioned.

    (Supplementary note 11) The treatment instrument according to supplementary note 1, wherein the bending amount of the bending means is varied by the tension of the wire.

    (Supplementary note 12) The treatment instrument according to supplementary note 1, wherein the bending means is driven by a motor.

    (Supplementary note 13) The treatment instrument according to supplementary note 1, wherein the distal treatment instrument is driven by a motor.

    (Supplementary Note 14) A distal treatment instrument, an insertion section having a bending portion for inserting the distal treatment instrument into a body cavity, an operation section for driving the distal treatment instrument, and the operation section and the distal treatment instrument. In the treatment instrument having a connecting member to be connected, the bending portion includes a plurality of cylindrical pieces, and the adjacent pieces include two or more support portions and at least one stretchable portion. Ingredients.

    (Supplementary Note 15) A distal treatment instrument, an insertion section for inserting the distal treatment instrument into a body cavity, an operation section for driving the distal treatment instrument, and an operation for performing control at a location away from the operation of the operation section In the operation control input device having the control means, the operation control means includes six or more wires, wire pulling means connected to each of the wires, and wire movement amount detection means for detecting the movement amount of the wire. An operation control input device comprising:

    (Supplementary Note 16) Having a plurality of independently movable bending structures, at least one of the bending structures is a bending means, a flexible exterior member inside thereof, and a flexible interior member that advances and retreats with respect to the exterior member A treatment instrument comprising: a drive unit that drives the distal treatment instrument in accordance with advancement and retreat of the interior member.

    (Supplementary note 17) The treatment instrument according to supplementary note 14, wherein the exterior member is rotatable with respect to the bending means, and the distal treatment instrument is rotated by the rotation of the exterior member.

    (Supplementary note 18) The treatment instrument according to supplementary note 14, wherein the bending portion includes a plurality of bending pieces and includes a link having at least three nodes in the bending piece.

    (Supplementary note 19) The treatment tool according to supplementary note 14, wherein the bending portion has a circular shape with a bending piece constituting a link having at least three nodes.

    (Supplementary Note 20) The bending portion includes a plurality of bending pieces, and each bending piece includes a joint portion including two or more fragile portions formed of a member integrated with the bending piece, and expansion and contraction including three or more fragile portions. The treatment tool according to appendix 14, wherein the treatment tool is connected by a portion.

    (Supplementary note 21) The treatment instrument according to supplementary note 20, wherein the curved portion has arc-shaped cuts at both ends of the fragile portion.

  According to Supplementary notes 1 and 3 to 11 described above, the distal end portion has a highly rigid and flexible curve, and the operation feeling of the hand operating portion is reliably transmitted to the treatment instrument, and the distal treatment instrument is rotated. As a result, the operability of the surgical instrument for endoscopic surgery can be improved.

  According to Supplementary Notes 12 and 13, a precise treatment using power is realized by transmitting a driving force to the treatment section.

  According to Supplementary Note 2, the operability of the treatment tool for endoscopic surgery can be improved by realizing the treatment tool having the second curved portion.

  According to the supplementary notes 14 to 16, the distal end of the treatment instrument can be accurately positioned by obtaining a linear curved shape with respect to the operation amount that is not affected by external force or friction of built-in objects.

  According to Supplementary Notes 17 to 21, a curved structure having high rigidity and a long life can be manufactured at low cost.

The perspective view of the treatment tool which shows 1st Example of this invention. The vertical side view of the treatment tool of the Example. The block diagram of the outer casing and inner cable of the Example. Action | operation explanatory drawing of the Example. The block diagram of the outer casing and inner cable of 2nd Example of this invention. The perspective view of the treatment tool which shows the 3rd Example of this invention. The block diagram of the curved part of the Example. The block diagram of the curved part of 4th Example of this invention. The block diagram of the curved part of 5th Example of this invention. The perspective view of the treatment tool of 6th Example of this invention, and a block diagram which shows the internal structure of a 2nd bending part. Action | operation explanatory drawing of the Example. The block diagram of the operation control input device of 7th Example of this invention. The block diagram of the operation input apparatus of the Example. The perspective view which shows the internal structure of the treatment tool of the Example.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Treatment part, 2 ... Bending part, 3 ... Operation part, 4 ... Insertion part, 5 ... Forceps, 17 ... Outer casing (exterior member), 18 ... Inner cable (interior member)

Claims (4)

A tip treatment tool,
An insertion portion having a bending portion for changing the bending state for inserting the distal treatment instrument into a body cavity;
An operation unit for driving the distal treatment instrument;
A connecting member for connecting the operation section and the distal treatment instrument;
The connecting member is
A flexible exterior member;
An interior member movable in the axial direction inside the exterior member,
The outer member, Ri Do a plurality of layers having at least a spring,
The spring is a flat spring;
The exterior member includes the flat spring and a resin coating disposed outside the flat spring ,
The flat spring and the resin coating are integral,
The treatment tool characterized in that the exterior member of the connecting member receives a compressive force with the flat spring and receives an extension force with the resin coating . A tip treatment tool,
An insertion portion having a bending portion for changing the bending state for inserting the distal treatment instrument into a body cavity;
An operation unit for driving the distal treatment instrument;
A connecting member for connecting the operating portion and the distal treatment instrument;
Comprising
The connecting member is
A flexible exterior member;
An interior member movable in the axial direction inside the exterior member;
With
The exterior member is composed of at least a plurality of layers having springs,
The spring is a flat spring;
The exterior member includes the flat spring, a blade disposed outside the flat spring, and a resin coating disposed outside the blade .
The flat spring, the blade and the resin coating are integral,
Regarding the force for compressing the exterior member, the flat spring is in close contact to prevent buckling,
With respect to the force for extending the exterior member, the flat spring has a contracting force and the blade and the resin coating to suppress the elongation,
The treatment tool characterized in that both the left and right rotations are transmitted by at least the blade and the resin coating as to the force for rotating the exterior member . A tip treatment tool,
An insertion portion having a bendable bending portion for inserting the distal treatment instrument into a body cavity;
An operation unit for driving the distal treatment instrument and bending the bending unit;
A connecting member for connecting the operation section and the distal treatment instrument;
The connecting member is
A flexible exterior member;
An interior member movable in the axial direction inside the exterior member,
The curved portion is composed of a plurality of cylindrical pieces, and the adjacent pieces include two or more support portions and at least one stretchable portion,
The outer member, Ri Do a plurality of layers having at least a spring,
The exterior member includes the spring and a resin coating disposed outside the spring ,
The spring is a flat spring;
The flat spring and the resin coating are integral,
The treatment tool characterized in that the exterior member of the connecting member receives a compressive force with the flat spring and receives an extension force with the resin coating . A tip treatment tool,
An insertion portion having a bendable bending portion for inserting the distal treatment instrument into a body cavity;
An operation unit for driving the distal treatment instrument and bending the bending unit;
A connecting member for connecting the operating portion and the distal treatment instrument;
Comprising
The connecting member is
A flexible exterior member;
An interior member movable in the axial direction inside the exterior member;
Comprising
The curved portion is composed of a plurality of cylindrical pieces, and the adjacent pieces include two or more support portions and at least one stretchable portion,
The exterior member is composed of at least a plurality of layers having springs,
The spring is a flat spring,
The exterior member includes the flat spring, a blade disposed outside the flat spring, and a resin coating disposed outside the blade.
The flat spring, the blade and the resin coating are integral,
Regarding the force for compressing the exterior member, the flat spring is in close contact to prevent buckling,
With respect to the force for extending the exterior member, the flat spring has a contracting force and the blade and the resin coating to suppress the elongation,
The treatment tool characterized in that both the left and right rotations are transmitted by at least the blade and the resin coating as to the force for rotating the exterior member .

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