JP4331490B2 - Surgical instrument - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
According to the present invention, a surgeon performs a surgical operation, particularly an endoscopic surgical operation by operating a treatment member provided at a distal end portion by operating an operation portion provided at a proximal end portion of an insertion portion by a hand. The present invention relates to a surgical treatment instrument.
[0002]
[Prior art]
2. Description of the Related Art Conventionally, endoscopes that can perform observations and various treatments on a treatment site while observing a subject image obtained by inserting an endoscope having an elongated insertion portion into a body cavity or the like have been widely used. Yes. Also, in recent years, a trocar that guides an endoscope for observation into a body cavity and a trocar that guides a surgical treatment tool to a treatment site without laparotomy in order to reduce the invasion to a patient is inserted into the endoscope. Thus, laparoscopic surgery and the like for performing treatment and treatment while observing a surgical treatment tool and a treatment site are performed.
[0003]
The surgical treatment instrument used in the laparoscopic surgery or the like is elongated and is operated by operating an operation unit provided on the proximal side with a treatment member arranged at the distal end of the insertion unit. . In US application (hereinafter abbreviated as USP) 5,549,637, there is shown a surgical treatment instrument in which a treatment member arranged at the distal end of an insertion portion is rotatable.
[0004]
Specifically, the surgical instrument of USP 5,549,637 can open and close a treatment tool provided at the distal end portion, and the distal end portion can be rotated in a direction deviating from the main axis of the treatment instrument. . And it is the structure which operates the said treatment tool with the proximal side rod which has rigidity, the link which substantially passes a rotation joint part, and the front end side rod.
[0005]
[Patent Document 1]
USP 5,549,637 (FIGS. 1 to 4)
[0006]
[Problems to be solved by the invention]
However, the actual configuration of the treatment tool is not specifically shown in the surgical treatment tool of USP 5,549,637. There is no suggestion about the effective length of the link itself. Naturally, in an actual surgical treatment instrument, a treatment tool is disposed on the distal end side, and the treatment tool is required to operate reliably. In order to ensure the operation of each treatment tool, the effective length of the link is important.
[0007]
That is, when the treatment tool has an opening / closing mechanism such as a forceps, the opening / closing angle of the pair of treatment pieces, in particular, the fully opened state is important, and the opening / closing angle varies depending on the turning operation of the distal end portion. In addition, workability during peeling, gripping, incision, etc. may be impaired.
[0008]
On the other hand, when the treatment tool is a stapler, a clip applier, or the like, the operation stroke is important. If the operation stroke fluctuates due to the turning operation of the tip as described above, the clip treatment or the stapler fire is performed. There is a risk that the certainty of this will be impaired.
[0009]
The present invention has been made in view of the above circumstances, and is a surgical procedure that can reliably perform a desired operation by a treatment unit by reliably operating the treatment unit within its movable range regardless of the rotation state of the treatment unit. The purpose is to provide ingredients.
[0010]
[Means for Solving the Problems]
    The surgical treatment tool of the present invention comprises:
  An elongated tubular insertion portion forming tube member constituting the insertion portion;
  A region forming member that is disposed in the insertion portion forming tube member and divides the inner hole of the insertion portion forming tube member into a plurality of regions;
  In the first through hole formed by arranging the region forming memberIt is arranged to move forward and backwardRu fineA first shaft formed in a length;
  In the second through hole formed by arranging the region forming memberIt is arranged to move forward and backwardRu fineA second shaft formed in a length;
  A surgical treatment section configured to freely open and close a pair of treatment pieces;
A base member to which one treatment piece of the surgical treatment section is rotatably connected and the second shaft is rotatably connected;
  In order to pivotably connect the surgical treatment section to the distal end of the insertion section, the base member is pivotally coupled to the insertion section, and is disposed perpendicular to the axial direction of the insertion section. A rotation pin constituting a posture rotation joint,
  A first connecting member that is pivotally connected to the other treatment piece of the surgical treatment section, and that advances and retracts inside the base member when the pair of treatment pieces are opened and closed by the advance and retreat movement of the first shaft; ,
  A distal end portion and the first connecting member are rotatably connected by a second connecting pin constituting a treatment portion side joint portion having a central axis that is coaxial with the central axis of the rotating pin. The end portion and the first shaft are rotatably connected by a third connecting pin that forms a shaft-side joint portion having a central axis that is coaxial with the central axis of the rotating pin, When opening and closing the pair of treatment pieces by moving the first shaft forward and backward to connect the first shaft and the first connecting member, a central axis of the second connecting pin and a central axis of the rotating pin A second connecting member that moves between a position where the shaft is coaxial and a position where the center axis of the third connecting pin and the center axis of the rotating pin are coaxial;
  A first operating portion provided at a proximal end of the first shaft, and opening and closing the surgical treatment portion by moving the first shaft forward and backward;
  A second operating portion that is provided at a base end of the second shaft and moves the second shaft forward and backward to operate an angle of the posture rotation joint;
It has.
[0011]
  According to this configuration, when the first shaft is advanced or retracted, the axis of the treatment unit side joint or the shaft side joint coincides with the axis of the posture rotation joint regardless of the rotation state of the treatment unit base member. Move to position and surgical treatment partThe pair of treatment pieces constitutingState orOpenChange to state.
[0012]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
(First embodiment)
FIGS. 1 to 20 relate to a first embodiment of the present invention, FIGS. 1 to 10 are views for explaining the configuration of a surgical treatment instrument, FIG. 1 is a perspective view of the surgical treatment instrument, and FIG. FIG. 3 is a diagram illustrating the configuration of the treatment section, FIG. 4 is a cross-sectional view illustrating the configuration of the treatment section, and FIG. 5 is a diagram illustrating the rotating state of the treatment section. 6 is a view for explaining the open / close state of the treatment piece when the treatment portion is not rotated, FIG. 7 is a view for explaining the open / close state of the treatment piece when the treatment portion is in the maximum rotation state, and FIG. FIG. 9 is a cross-sectional view illustrating the configuration of the insertion unit and the gripping operation unit, and FIG. 10 is an enlarged view of the insertion unit unit base end side shown in FIG. 3A is a perspective view of the treatment portion, FIG. 3B is a perspective view of the treatment portion with the treatment portion base removed, and FIG. 4A is a line BB in FIG. 3A. Sectional drawing and FIG.4 (b) are CC sectional view taken on the line of Fig.4 (a).
[0013]
FIGS. 11 to 19 are views for explaining the operation of the surgical treatment tool, FIG. 11 is a view for explaining the operation when the turning handle of the treatment section operation unit is operated, and FIG. 12 is a view of the turning handle. FIG. 13 is a view for explaining the movement of the treatment section operation rod that operates in response to the operation. FIG. 13 shows the movement of the flat tip of the treatment section operation rod with the treatment section base removed and the opening and closing of the treatment pieces constituting the treatment section. FIG. 14 is a diagram for explaining the relationship of the operation, FIG. 14 is a diagram for explaining the action when the rotary knob is operated, and FIG. 15 is the movement of the rotary base and the treatment unit base operating bar that operate in response to the operation of the rotary knob FIG. 16 is a view for explaining the relationship between the movement of the distal end arrangement portion of the treatment portion base operation rod and the turning motion of the treatment portion with the treatment portion base removed, and FIG. Explains the action when operating the rotating handle of the treatment unit operation unit in the state FIG. 18 is a diagram for explaining the movement of the rotation base and the treatment section base operation rod that operate in response to the operation of the rotation knob and the movement of the treatment section operation rod that operates in response to the operation of the rotation handle. FIG. 19 is a diagram for explaining the opening / closing operation of the treatment piece constituting the treatment portion when the treatment portion is in the rotating state.
FIG. 20 is a diagram for explaining the relationship between the pin-to-pin distance, the rotation angle θ1 and the opening / closing angle θ2.
[0014]
As shown in FIG. 1, the surgical treatment instrument 1 according to the present embodiment is a surgical instrument that is, for example, a peeling forceps in which a first treatment piece 21 and a second treatment piece 22 that are a pair of rigid treatment pieces can be opened and closed. An insertion portion 3 whose exterior is constituted by a treatment portion (hereinafter abbreviated as a treatment portion) 2, an insertion portion formation tube member (hereinafter abbreviated as an insertion tube) 31 which is an elongated insertion portion formation tube member, The gripping operation unit 4 includes a treatment unit operation unit 40 that is one operation unit.
[0015]
As shown in FIG. 2, the surgical treatment instrument 1 has a configuration that can be divided into a treatment unit 5, an insertion unit 6, and a gripping operation unit 7.
The treatment unit 5 includes the treatment pieces 21 and 22, a treatment portion base 23 connected to the proximal end portions of the treatment pieces 21 and 22, a distal end cover 24 disposed on the insertion tube 31, It is mainly composed of a treatment portion operation rod 51 formed to a predetermined length with a rigid member as a shaft and a treatment portion base operation rod 52 formed into a predetermined length with a rigid member as a second shaft.
[0016]
The treatment portion operation rod 51 and the treatment portion base operation rod 52 are inserted and arranged in parallel in the insertion tube 31. A connecting rod 53 having a ball portion 53 a is integrally disposed at the proximal end portion of the treatment portion operation rod 51.
[0017]
The insertion unit 6 includes the insertion tube 31, a rotation base 61 disposed at the proximal end of the insertion tube 31, a rotation knob 62 as a second operation unit, and a rotation knob 63 as a third operation unit. It is mainly composed of. A removal button 70 is provided between the rotating knob 62 and the rotating knob 63 to be used when removing the insertion unit 6 from the gripping operation unit 7.
When assembling the treatment section unit 5 to the insertion section unit 6, the small diameter section 24 a of the distal end cover 24 is engaged with the distal end opening 31 a of the insertion tube 31. At this time, the treatment portion operation rod 51 and the connecting rod 53 are projected from the proximal end surface of the insertion tube 31. The proximal end portion of the treatment portion base operation rod 52 is configured to be integrally fixed to the rotation base 61 by a connecting screw (reference numeral 67 in FIG. 10) described later.
[0018]
The grip operation unit 7 is mainly composed of a fixed handle 41 and a rotation handle 42 that constitute the treatment section operation unit 40. The fixed handle 41 and the rotating handle 42 are pivotally supported via a handle pin 43 so as to be rotatable. The rotating handle 42 rotates in the direction of the arrow a and the arrow b in the figure. A connecting rod receiver 44 in which the ball portion 53a of the connecting rod 53 is detachably disposed is formed at a predetermined portion on the tip side of the rotating handle 42. On the other hand, an attaching / detaching portion 45 is provided at a predetermined portion on the distal end side of the fixed handle 41 so as to be detachably attached to the insertion unit 6.
[0019]
When assembling the treatment unit 5 and the insertion unit 6 integrally assembled to the gripping operation unit 7, the base end of the insertion unit 6 is attached to the attachment / detachment unit 45 of the gripping operation unit 7. The ball portion 53a of the connecting rod 53 integral with the treatment portion operation rod 51 constituting the treatment portion unit 5 is engaged with and arranged in the connecting rod receiver 44. As a result, the surgical treatment instrument 1 shown in FIG. 1 is constructed.
[0020]
The configuration of the surgical treatment instrument 1 will be specifically described with reference to FIGS.
First, the treatment unit 5 will be described with reference to FIGS. 3 (a) to 4 (b).
[0021]
An opening / closing link mechanism for opening / closing the first treatment piece 21 and the second treatment piece 22 constituting the treatment portion 2 and a position of the treatment portion 2 in the axial direction of the insertion portion 3 are disposed in the treatment portion unit 5. A rotating link mechanism to be changed is provided.
[0022]
The opening / closing link mechanism and the rotation link mechanism include the first treatment piece 21 and the second treatment piece 22, a treatment portion base 23, a distal end cover 24, a first connection member 25, a second connection member 26, and various pins 8a and 8b. , 9a, 9b, 10a, 10b, 10c, the treatment unit operation rod 51 and the treatment unit base operation rod 52 are appropriately combined. The tip cover 24, the first connecting member 25, the second connecting member 26, and the various pins 8a, 8b, 9a, 9b, 10a, 10b, 10c constitute a joint part.
[0023]
The treatment portion base 23 and the distal end cover 24 are formed of substantially tubular members having rigidity and flexibility. On the proximal end side of the distal end cover 24, there is provided a small diameter portion 24a that is engaged with and disposed in the distal end side opening 31a of the insertion tube 31 constituting the insertion portion 3. On the other hand, in the treatment portion base 23, a pair of sections 23a and 23b are formed on the distal end side and the proximal end side.
[0024]
The first connecting member 25 is formed of a plate-like rigid member. The second connecting member 26 is formed of a rigid member having recesses at both ends and having a substantially H-shaped cross section (see FIG. 4A). A flat plate-like distal end portion 51a formed on the distal end side of the treatment portion operation rod 51 is disposed in the concave portion on the proximal end side of the second coupling member 26, and the first coupling member 25 is disposed in the concave portion on the distal end side. A proximal end is arranged.
[0025]
Between the pair of cover sections 24b formed on the distal end cover 24, a pair of proximal end section sections 23a formed on the proximal end side of the treatment section base 23 and the second connecting member 26 are disposed. Is done.
[0026]
The configuration of the rotation link mechanism will be described.
The cover section 24b of the distal end cover 24 and the proximal end section section 23a of the treatment section base 23 are freely rotatable by a pair of first rotation pins 8a arranged orthogonal to the axial direction of the insertion section 3. It is connected as a simple posture rotation joint. In addition, a distal end arrangement portion 52a of the treatment portion base operation rod 52 is rotated at a proximal end portion of the treatment portion base 23 by a second rotation pin 8b disposed in parallel with the first rotation pin 8a. Connected freely.
[0027]
The treatment portion base operation rod 52 is disposed in a notch groove 24 c formed at a predetermined position of the distal end cover 24. Further, the position of the second rotation pin 8b that pivotally supports the treatment portion base operation rod 52 shown in FIG. 4B is described as a rotation zero end, and the treatment portion base operation rod 52 shown in FIG. The position of the supporting second rotation pin 8b is described as the maximum rotation end.
[0028]
As shown in FIG. 5, by moving the distal end portion of the treatment portion base operation rod 52 from the rotation zero end indicated by the alternate long and short dash line to the maximum rotation end indicated by the solid line which is a predetermined position by a linear distance by L1. The treatment portion base 23 rotates about the pair of first rotation pins 8a and reaches a position indicated by a solid line. As a result, the position of the treatment section 2 constituted by the first treatment piece 21 and the second treatment piece 22 changes to a rotational state inclined by a predetermined angle θ1 from the horizontal position indicated by the alternate long and short dash line. In other words, the position of the treatment section 2 is set to a desired position within the range of the angle θ1 by appropriately arranging the position of the distal end portion of the treatment section base operation rod 52 from the rotation zero end to the maximum rotation end. Is done.
[0029]
The configuration of the opening / closing link mechanism will be described.
A first opening / closing pin 9 a parallel to the first rotation pin 8 a is fixed to the distal end side section 23 b of the treatment portion base 23. The middle part of the second treatment piece 22 is rotatably connected to the first opening / closing pin 9a. Accordingly, the second treatment piece 22 rotates with respect to the treatment portion base 23 around the first opening / closing pin 9a.
[0030]
A second opening / closing pin 9 b is provided at the proximal end portion of the second treatment piece 22. The middle part of the first treatment piece 21 is rotatably connected to the second opening / closing pin 9b. As a result, the first treatment piece 21 and the second treatment piece 22 rotate with respect to each other about the second opening / closing pin 9b. Then, when the first treatment piece 21 and the second treatment piece 22 perform a rotating operation, the first treatment piece 21 and the second treatment piece 22 change to a closed state or an open state.
[0031]
The proximal end portion of the first treatment piece 21 is rotatably connected to the distal end portion of the first connecting member 25 by a first connecting pin 10a. The side surfaces 25 a and 25 b of the first connecting member 25 are in contact with the contact surfaces 23 c and 23 d of the treatment portion base 23. As a result, the first connecting member 25 always moves forward and backward in the treatment portion base 23 in parallel.
[0032]
The other end of the first connecting member 25 is disposed in a recess on the tip side of the second connecting member 26. In this state, the first connecting member 25 and the second connecting member 26 are connected by the second connecting pin 10b. It is connected as a rotatable treatment unit side joint. Further, a flat distal end portion 51a of the treatment portion operation rod 51 is disposed in the other end portion of the second connecting member 26 and a recess on the proximal end side of the second connecting member 26. The treatment portion operation rod 51 and the second connecting member 26 are connected as a rotatable shaft side joint by the connecting pin 10c. That is, the treatment portion operation rod 51 and the treatment portion 2 are connected via the second connection member 26 and the first connection member 25.
[0033]
In addition, the 1st treatment piece 21 and the 2nd treatment piece 22 which comprise the said treatment part 2 are the one terminal states in the position of the 3rd connection pin 10c which pivotally supports the treatment part operation stick 51 shown in FIG.4 (b). The first treatment piece 21 and the second treatment piece 21 constituting the treatment portion 2 are described as the first end to be closed, and the position of the third connecting pin 10c that pivotally supports the treatment portion operation rod 51 shown in FIGS. The treatment piece 22 is described as a second end that is in a predetermined maximum open state that is another end state. The distance between the pins, which is the interval between the through holes in which the second connecting pin 10b and the third connecting pin 10c of the second connecting member 26 are arranged, is set to a predetermined dimension, and the treatment section 2 is shown in FIG. , (B), the central axis of the second connecting pin 10b and the central axis of the first rotating pin 8a are located on the same axis, as shown in FIGS. When the treatment portion 2 is in the predetermined maximum open state, the central axis of the third connecting pin 10c and the central axis of the first rotating pin 8a are coaxially positioned.
[0034]
As a result, when the first treatment piece 21 and the second treatment piece 22 constituting the treatment portion 2 are in the closed state, the treatment portion 2 rotates when the second connection pin 10b is centered. Therefore, the closed state of the first treatment piece 21 and the second treatment piece is maintained. On the other hand, when the first treatment piece 21 and the second treatment piece 22 are in the open state, when the treatment portion 2 is turned, the first treatment piece 21 is turned around the third connecting pin 10c. And the open state by the said 2nd treatment piece 22 is maintained.
[0035]
Accordingly, as shown in FIGS. 6 and 7, the distal end portion of the treatment portion operation rod 51 is moved by a linear distance L2 from the first end indicated by the alternate long and short dash line to the second end indicated by the solid line which is a predetermined position. As a result, the first connecting member 25 moves in parallel in the treatment portion base 23, and the first treatment piece 21 and the second treatment piece 22 rotate about the second opening / closing pin 9b and the first opening / closing pin 9a. By doing so, the treatment section 2 changes from the closed state indicated by the alternate long and short dash line to the maximum opened state that is opened at the predetermined angle θ2. That is, the treatment portion 2 opened by the first treatment piece 21 and the second treatment piece 22 is disposed by appropriately arranging the position of the distal end portion of the treatment portion operation rod 51 from the first end to the second end. The state angle is set to a desired angle within the range of the angle θ2.
[0036]
The first treatment piece 21 and the second treatment piece 22 are provided with opposing gripping surfaces 21a and 22a. In the present embodiment, predetermined unevenness processing is performed. Further, the treatment pieces 21 and 22 are not limited to the illustrated shape and uneven processing, and the treatment portion 2 may be, for example, an acupuncture forceps, a grasping forceps, a stapler, or the like. Further, instead of a configuration in which the side surface of the first connection member 25 is in contact with the contact surfaces 23c and 23d of the treatment portion base 23, for example, a guide groove is formed in the treatment portion base 23, and the first connection member 25 is formed. A similar function may be obtained by providing a guide pin engaging with the guide groove.
[0037]
Next, the insertion unit 6 will be described with reference to FIGS.
The insertion part 3 constituting the insertion part unit 6 inserts and arranges the treatment part operation rod 51 constituting the opening / closing link mechanism and the treatment part base operation rod 52 constituting the rotation link mechanism in parallel so as to advance and retreat. As shown in FIG. 8, an insertion tube 31 that constitutes an exterior, and an area forming tube member that is an elongated second tube member having a predetermined cross-sectional shape that divides the inner hole of the insertion tube 31 into a plurality of pieces. Hereinafter, the region forming tube 32 is abbreviated as “region forming tube”. The insertion tube 31 and the region forming tube 32 are made of a rigid member such as a stainless steel member.
[0038]
The region forming tube 32 of the present embodiment is a treatment portion base operating rod having a rectangular cross section between the outer peripheral curved surface portion 32a disposed in close contact with the inner peripheral surface of the insertion tube 31 and the inner peripheral surface of the insertion tube 31. And a straight portion 32b that forms a through hole for inserting and arranging 52. Then, the region forming tube 32 is arranged in a predetermined state on the inner peripheral surface of the insertion tube 31, and a first through hole 33 through which the treatment portion operation rod 51 is inserted into the insertion portion 3, and the treatment portion base A second through hole 34 through which the operation rod 52 is inserted is formed.
[0039]
In the second through hole 34 of the present embodiment, the opening dimension on the side corresponding to the thickness dimension of the treatment portion base operating rod 52 is set to be approximately the same as the thickness dimension for the purpose of preventing buckling. . Thus, buckling is prevented when an axial force is transmitted by advancing and retracting a member having a relatively thin thickness, such as the treatment portion base operation rod 52, and a longitudinally elongated member, and in the axial direction. It is possible to reliably transmit the power.
[0040]
As shown in FIGS. 9 and 10, the rotation knob 62 and the rotation knob 63 are close to the proximal end portion of the insertion portion 3 so as to be operated by a finger gripping the treatment portion operation portion 40. It is arranged in the vicinity of the treatment unit operation unit 40.
[0041]
The insertion tube 31 and the region forming tube 32 constituting the insertion portion 3 are set to a predetermined length, and a tubular first base tube 64 is formed at the base end of the insertion tube 31 and the region forming tube 32. It is fixed. A tubular second base tube 65 is integrally fixed to the base end portion of the first base tube 64 via a first fixing member 91.
[0042]
The rotating base 61 is disposed on the outer peripheral surface of the first base tube 64 so as to be able to advance and retract. The turning knob 62 is rotatably arranged with respect to a tube portion formed by the first base tube 64 and the second base tube 65. The turning knob 62 and the turning base 61 are integrated in a screwed state. The rotary knob 63 is integrally fixed to the second base tube 65. The rotation knob 62 is held by a flange 66a provided on the rotation knob 63 so as not to move with respect to the pipe portion. The rotation base 61 and the rotation knob 63 are formed of a resin member.
[0043]
A specific configuration will be described with reference to the drawings.
The treatment portion operating rod 51 is inserted and disposed in the first base tube 64, and the base end portions of the insertion tube 31 and the region forming tube 32 are respectively disposed in stepped holes formed on the inner peripheral surface. Has been. A long hole 64 a communicating with the second through hole 34 through which the treatment portion base operation rod 52 is inserted is formed at a predetermined position on the side surface portion of the first base tube 64. Thus, the base end portion of the treatment portion base operation rod 52 inserted through the second through hole 34 can be accessed from the outer peripheral surface side of the first base tube 64 through the long hole 64a. . In addition, a screw arrangement hole 61a communicating with the long hole 64a is formed at a predetermined position on a side surface portion of the rotation base 61 which is arranged on the outer peripheral surface of the first base tube 64 so as to be able to advance and retreat.
[0044]
Accordingly, the connecting screw 67 is inserted and arranged with the screw arrangement hole 61a aligned with the elongated hole 64a, and the connecting screw 67 is formed on the proximal end portion of the treatment portion base operation rod 52. The treatment portion base operation rod 52 is integrally connected and fixed to the rotation base 61 by being screwed into the screw portion 52b. As a result, the connecting base 67 is integrated with the rotating base 61 by the connecting screw 67 by moving the connecting screw 67 in the elongated hole 64 a by moving the rotating base 61 forward and backward with respect to the first base tube 64. The treatment portion base operation rod 52 advances and retreats, and the position of the distal end arrangement portion 52a changes within the range shown in FIG.
[0045]
For example, an O-ring 93 is provided at a predetermined position on the inner peripheral surface of the rotation base 61 as an airtight means for preventing the abdominal cavity and the outside from communicating with each other via the elongated hole 64a and the second through hole 34. Is arranged.
[0046]
On the other hand, a flange member 66 having a flange 66 a that holds the rotating knob 62 is disposed at the tip of the rotating knob 63 that is integrally fixed to the second base tube 65. The flange 66a of the flange member 66 is disposed in a small-diameter hole 62a having a stepped hole formed with a predetermined depth and diameter on the rotary knob 63 side, which is the base end face side of the rotary knob 62. It is like that.
[0047]
An annular regulating ring 68 for holding the flange 66a is arranged in the large-diameter hole 62b of the stepped hole. The restriction ring 68 is integrally fixed to the rotating knob 62 by a fixing screw 94. Accordingly, the rotation knob 62 is disposed so as to be rotatable with respect to the flange 66a in a state where movement of the insertion portion 3 in the axial direction is restricted.
[0048]
A female screw part 62 c is formed in the through hole of the turning knob 62. Further, a male screw portion 61 b is formed at the base end portion of the rotation base 61. Then, the male screw part 61b and the female screw part 62c are screwed together so that the rotary knob 62 and the rotary base 61 are integrated. Therefore, the rotation base 61 can be moved forward and backward with respect to the first base tube 64 by rotating the rotation knob 62 in a desired direction. As a result, as described above, the treatment portion base operation rod 52 integral with the rotation base 61 is advanced and retracted by the connecting screw 67, and the position of the distal end arrangement portion 52a changes within the range shown in FIG.
When the rotation base 61 is at the position shown in FIG. 9, the distal end portion of the treatment portion base operation rod 52 is located at the rotation zero end shown in FIGS.
[0049]
Further, the depth dimension of the small diameter hole 62a is set to be larger than the thickness dimension of the flange 66a by a predetermined dimension, and a step portion is provided at the bottom of the small diameter hole 62a of the turning knob 62 so as to be narrower than the flange 66a. The contact area with the bottom surface of the diameter hole 62a is set to the minimum necessary to reduce the amount of friction, and the turning knob 62 can be easily rotated with fingers holding the surgical treatment instrument 1 to advance and retract the turning base 61. It can be moved.
[0050]
Further, the axis of the treatment section operation rod 51 is made substantially coincident with the axis of the rotary knob 63 so that the insertion section 3 can be rotated around the center of the rotary knob axis.
[0051]
The detaching button 70 is located between the rotating knob 62 and the rotating knob 63, and includes a first engaging member 71 having an engaging claw 71a on the rotating knob 63, an engaging pin 72, and an elastic material. The release mechanism is configured by arranging the formed button portion 73 and is configured to be detachable from the grip operation portion 4 indicated by a two-dot chain line.
[0052]
Next, the grip operation unit 7 will be described with reference to FIG.
The fixed handle 41 and the rotating handle 42 constituting the treatment unit operation unit 40 are formed of a resin member. Ring members 41a and 42a are attached to the fixed handle 41 and the rotating handle 42 to reduce the burden on the operator's fingers during operation.
[0053]
A connecting rod receiver 44 in which the ball portion 53 a of the connecting rod 53 is disposed is formed on the distal end side of the rotating handle 42. On the other hand, an attaching / detaching portion 45 having a through hole through which the treatment portion operation rod 51 with which the connecting rod 53 is integrated is inserted at the distal end side of the fixed handle 41. An engagement portion 45 a is provided at the distal end portion of the detachable portion 45 to which the locking claw 71 a of the first engagement member 71 is engaged. The fixed handle 41 is formed with a through hole through which the connecting rod 53 integral with the treatment portion operation rod 51 is inserted.
[0054]
In the through hole of the detachable portion 45, a treatment portion operation rod receiver 46 is disposed so as to be rotatable around an axis. The treatment portion operation rod receiver 46 has a guide portion 46a on the distal end side, and receives a rotation guide pin 65a provided at the distal end portion of the second base tube 65 by the guide portion 46a. Further, the smooth side surface 53 b of the connecting rod 53 integrated with the proximal end side of the treatment portion operation rod 51 is joined to the treatment portion operation rod receiver 46.
[0055]
Accordingly, when the treatment section operation rod receiver 46 rotates together with the second base tube 65 constituting the insertion section unit 6 when the rotation knob 63 is rotated, the treatment section operation rod 51 also follows this rotation. Rotate. That is, the position of the treatment section 2 with respect to the treatment section operation section 40 can be changed by appropriately rotating the rotation knob 63.
[0056]
The fixed handle 41 is provided with an airtight cap 47 that prevents the intra-abdominal pressure from decreasing via the first through hole 33. The fixed handle 41 is provided with a high frequency input pin 48. The first through-hole 33 is formed with an outer diameter dimension capable of covering and disposing an insulating tube (not shown) on the outer peripheral side, and is treated by a high frequency input from the high frequency input pin 48 by taking a configuration covering the insulating tube. Is possible.
[0057]
The operation of the surgical treatment tool 1 configured as described above will be described.
First, the turning operation of the turning handle 42 will be described.
3 (a), 3 (b) and 4 (a), 4 (b), the treatment section 2 is in a non-rotating state in a straight line with respect to the insertion section 3, and the treatment section 2 is When the first treatment piece 21 and the second treatment piece 22 are in the closed state, as shown in FIGS. 11 and 12, when the turning handle 42 is turned about the handle pin 43 in the direction of arrow a, For example, the rotation handle 42 located on the one-dot chain line moves to a position indicated by a solid line.
[0058]
As a result, the position of the ball portion 53a of the connecting rod 53 arranged on the treatment portion operation rod receiver 46 is changed, and the treatment portion operation rod 51 integrated with the connection rod 53 is moved to the arrow e along the insertion axis. Move forward as shown. Then, as shown in FIG. 6, the flat tip 51 a of the treatment portion operation rod 51 moves forward, and the second connection member 26 and the first connection member 25 move inside the treatment portion base 23. As shown in FIGS. 6, 11, and 13, the first treatment piece 21 and the second treatment piece 22 constituting the treatment portion 2 are changed to an open state.
[0059]
Then, as shown in FIG. 12, the rotation handle 42 is rotated to move the ball portion 53a along the insertion axis by a linear distance L2, thereby causing the third connecting pin as shown in FIG. The center position of 10c moves by the linear distance L2, and the first treatment piece 21 and the second treatment piece 22 are in the maximum open state opened at an angle θ2.
[0060]
On the other hand, by operating the rotation handle 42 in the direction of the arrow b which is the opposite direction to the above, the center position of the ball portion 53a and the third connection pin 10c moves rearward along the insertion axis, The treatment section 2 that has been in an open state gradually changes to a closed state.
That is, when the surgeon appropriately rotates the rotation handle 42, the flat-plate-shaped distal end portion 51a moves forward and backward as shown by the arrow in FIG. 13, and the first treatment piece 21 and the second treatment piece. 22 is changed to a desired state.
[0061]
Next, the turning operation of the turning knob 62 will be described.
3 (a), 3 (b) and 4 (a), 4 (b), the treatment section 2 is in a non-rotating state in a straight line with respect to the insertion section 3, and the treatment section 2 is When the first treatment piece 21 and the second treatment piece 22 that are configured are in the closed state, as shown in FIG. 14, when the rotation knob 62 is rotated around the insertion axis, for example, in the arrow d direction (c direction may be used). The rotation base 61 that is screwed to the rotation knob 62 moves to the front side along the insertion shaft corresponding to the rotation amount of the rotation knob 62. Then, as shown in FIG. 15, with the movement of the rotation base 61 to the front side, the treatment portion base operation rod 52 integrally fixed by the connecting screw 67 moves to the front side. At this time, the position of the connecting screw 67 with respect to the long hole 64a changes.
[0062]
As the treatment portion base operation rod 52 moves forward, the distal end placement portion 52a moves forward as shown in FIG. 16, and the second rotation pin 8b also moves. As a result, the treatment portion base 23 in which the first treatment piece 21 and the second treatment piece 22 are arranged is turned around the first turning pin 8a as an axis, and the turning angle is increased. It will change gradually. Then, as shown in FIG. 15, the turning knob 62 is turned to move the turning base 61 along the insertion axis by the linear distance L1, thereby performing the second operation as shown in FIG. The central position of the moving pin 8b is moved by the linear distance L1, and the treatment section 2 is rotated from the horizontal position indicated by the alternate long and short dash line to the position where the treatment section 2 is inclined at the maximum rotation angle of the angle θ1.
[0063]
At this time, since the center of the second connecting pin 10b coincides with the center of the first rotation pin 8a that is the rotation center of the treatment portion base 23, when the treatment portion base 23 rotates, The closed state of the first treatment piece 21 and the second treatment piece 22 is maintained.
[0064]
Next, a rotation operation combining the rotation knob 62 and the rotation handle 42 will be described.
For example, as shown in FIGS. 17 and 18, as shown in FIGS. 17 and 18, the rotating knob 62 is rotated to rotate the treatment section 2 as shown in FIG. When the turning handle 42 is turned in the direction of arrow a, as shown in FIG. 7, the flat tip 51a of the treatment portion operation bar 51 moves from the position indicated by the alternate long and short dash line to the position indicated by the solid line, As shown in FIG.17 and FIG.19, the 1st treatment piece 21 and the 2nd treatment piece 22 which comprise the treatment part 2 will be in an open state.
[0065]
At this time, since the center of the third connecting pin 10c coincides with the center of the first rotation pin 8a that is the rotation center of the treatment portion base 23, even when the treatment portion base 23 rotates, The open state of the first treatment piece 21 and the second treatment piece 22 is maintained constant. That is, the opening / closing operation of the first treatment piece 21 and the second treatment piece 22 by operating the turning handle 42 in a state where the turning base 61 is moved by an arbitrary amount and the treatment section 2 is turned. Can be done. In addition, the rotation operation of the treatment part 2 at this time, and the opening / closing operation of the 1st treatment piece 21 and the 2nd treatment piece 22 which comprise this treatment part 2 can be performed by arbitrary combinations.
[0066]
Here, the relationship between the pin-to-pin distance, the rotation angle θ1 and the opening / closing angle θ2 will be described with reference to FIG.
[0067]
The solid line in the figure represents the change in the opening / closing angle θ2 when the distance between the second connecting pin 10b and the third connecting pin 10c is the linear distance L2, and the alternate long and short dash line is when the distance between the pins is smaller than L2. Represents the change in the opening / closing angle θ2, and the broken line represents the change in the opening / closing angle θ2 when the distance between the pins is larger than L2.
[0068]
First, when the distance between the pins is smaller than L2, the open / close angle formed by the first treatment piece 21 and the second treatment piece 22 is indicated by the alternate long and short dash line as the rotation angle of the treatment portion 2 increases from the straight extension state. Close. On the other hand, when the distance between the pins is larger than L2, the open / close angle formed by the first treatment piece 21 and the second treatment piece 22 is indicated by the broken line as the rotation angle of the treatment portion 2 increases from the straight extension state. Open up. That is, in either case, the opening / closing angle changes with the change of the rotation angle.
[0069]
On the other hand, in the present embodiment, the first treatment piece 21 and the second treatment piece 22 are configured to have the maximum open state when the flat tip 51a of the treatment part operation rod 51 moves the distance L2. is there. Since the distance between the pins is set to L2, when the first treatment piece 21 and the second treatment piece 22 are in the closed state, the center of the second connection pin 10b and the center of the first rotation pin 8a And the center of the third connecting pin 10c and the center of the first rotation pin 8a match when the first treatment piece 21 and the second treatment piece 22 are in the open state. In this case, the opening and closing angle between the first treatment piece 21 and the second treatment piece 22 is kept constant as shown by the solid line in any rotation state of the treatment section 2 within a range of 0 to 60 degrees, for example. Can be maintained.
[0070]
Finally, the operation of the rotary knob 63 will be described.
When the rotary knob 63 is rotated around the insertion axis, the integrated second base tube 65, first base tube 64, first through hole 33, and second through hole 34 rotate around the insertion axis and simultaneously rotate. The treatment portion operation rod receiver 46 including the guide portion 46a received by the guide pin 65a is integrated with the connecting rod 53 by the smooth side surface 53b to rotate the treatment portion operation rod 51 about the insertion axis. That is, the opening / closing direction of the first treatment piece 21 and the second treatment piece 22 can be arbitrarily changed by rotating the entire insertion portion 3 around the insertion axis.
[0071]
The insertion unit 6 and the gripping operation unit 7 are integrated by engaging the engaging claw 71a of the first engaging member 71 constituting the detaching button 70 with the engaging part 45a of the attaching / detaching part 45. It has a typical structure. Therefore, by pressing the button portion 73 of the detaching button 70 and moving the first engagement member 71 toward the center of the insertion axis, the engagement between the locking claw 71a and the engagement portion 45a is achieved. The state is released. In this state, the pivot handle 42 is pivoted about the handle pin 43 and, at the same time, the treatment portion operation rod 51 is moved to remove the ball portion 53 a of the connecting rod 53 from the treatment portion operation rod receiver 46. With this, the insertion unit 6 and the gripping operation unit 7 are disassembled.
[0072]
Further, by loosening the connecting screw 67 arranged on the rotation base 61, the treatment portion base operation rod 52 becomes removable from the rotation base 61, and in this state, the treatment portion operation rod 51 and the treatment portion. The base operation rod 52 is removed from the first through hole 33 and the second through hole 34. As a result, the insertion unit 6 and the treatment unit 5 are disassembled.
[0073]
Thus, a treatment having a turning knob for turning the treatment portion on the surgical treatment instrument and a turning handle for operating the treatment portion connected to the distal end of the treatment portion operation rod via the link mechanism having the joint portion. When the treatment part operation part is provided, the movement distance of the treatment part operation rod moved forward and backward by the rotation handle, and the pin of the second connection pin constituting the treatment part side joint part and the third connection pin constituting the shaft side joint part When the treatment section operating rod is moved from the first end to the second end by setting the distance to a predetermined value, the center axis of the treatment section side joint section, the center axis of the posture rotation joint section, and the shaft side joint Since the central axis of the treatment part and the central axis of the posture turning joint part are made to coincide with each other, the treatment part always performs the work intended by the operator accurately regardless of the turning state of the treatment part. be able to.
[0074]
(Second Embodiment)
FIG. 21 to FIG. 24 are related to a second embodiment of the present invention. FIG. 21 is a diagram for explaining the treatment portion in a straight extension state with respect to the insertion portion, which is characteristic of the constitution of the treatment portion base, and FIG. FIG. 23 is a view when the treatment section is turned from the straight extension state to the rotation state, and FIG. 24 is a view when the treatment section in the rotation state is opened with the treatment section base removed. FIG.
[0075]
In the treatment section 2A of the present embodiment, the rotational direction of the treatment section 2A and the opening / closing direction of the first treatment piece 21 and the second treatment piece 22 constituting the treatment section 2A are orthogonal to each other.
[0076]
Therefore, in the treatment section 2A and the treatment section 2 of this embodiment, the configuration of the treatment section base 23A and the configuration of the treatment section base 23 are different as shown in FIGS. Specifically, the direction of the distal end section 23b of the treatment portion base 23 and the direction of the distal end section 23e of the treatment portion base 23A are different from each other, and are in a mutually orthogonal positional relationship. Then, along with the change of the distal end side section 23e, the first connection pin 10a and the second connection are connected in order to connect the proximal end of the second treatment piece 22 and the opening of the distal end side recess of the second connection member 26. 25 A of 1st connection members are formed so that it may become a positional relationship orthogonal to the pin 10b. Other configurations are the same as those of the first embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.
[0077]
Thus, the first treatment piece 21 and the second treatment piece 21 constituting the treatment portion 2A as shown in FIG. 22 are moved by moving the flat tip portion 51a of the treatment portion operation rod 51 in the state shown in FIG. The treatment piece 22 performs the opening / closing operation indicated by the solid line arrow orthogonal to the opening / closing operation indicated by the broken line arrow shown in FIG.
[0078]
Further, by moving the distal end arrangement portion 52a of the treatment portion base operation rod 52 in the state shown in FIG. 21, the treatment portion 2A can be changed from the straight extension state to the rotation state as shown in FIG. Further, by moving the flat tip 51a of the treatment portion operation rod 51 in this turning state, the first treatment piece 21 and the second treatment piece 22 constituting the treatment portion 2A as shown in FIG. The opening / closing operation indicated by the solid line arrows orthogonal to the opening / closing operation indicated by the broken line arrows shown in FIG. 19 is performed.
[0079]
Thus, by making the opening / closing direction of the pair of treatment pieces constituting the treatment part orthogonal to the rotation direction of the treatment part, the movable reachable range of the tip tool is widened and the operability and practicality are further improved. Can be achieved.
[0080]
It should be noted that the present invention is not limited to the embodiments described above, and various modifications can be made without departing from the spirit of the invention.
[0081]
[Appendix]
According to the embodiment of the present invention as described above in detail, the following configuration can be obtained.
[0082]
(1) An elongated and tubular insertion portion forming tube member constituting the insertion portion;
A surgical treatment section is provided in the inner hole of the insertion section forming tube member so as to freely advance and retract, and a surgical treatment section is provided at the distal end portion via a joint section. A first shaft formed into an elongated shape,
A treatment portion base member that is disposed in an inner hole of the insertion portion forming tube member so as to freely advance and retract, has a surgical treatment portion at a distal end portion thereof, and is rotated around a posture rotation joint portion as a central axis is connected to the base portion. An elongated second shaft provided with a second operation portion for rotating the treatment portion base member at an end portion thereof to move the arrangement position of the surgical treatment portion provided in the treatment portion base member; ,
A link mechanism connecting the surgical treatment section and the first shaft, and having a treatment section side joint section and a shaft side joint section;
In a surgical treatment instrument comprising:
The posture rotation joint portion and the treatment portion are arranged in a single terminal state in the movable range of the surgical treatment portion with respect to the arrangement positional relationship between the posture rotation joint portion, the treatment portion side joint portion, and the shaft side joint portion. Surgical treatment instrument set such that the axis of the side joint part coincides and the axes of the posture rotation joint part and the shaft side joint part coincide in the other terminal state in the movable range of the surgical treatment part .
[0083]
(2) When the surgical treatment section has an opening / closing mechanism for performing an opening / closing operation,
The surgical treatment tool according to appendix 1, wherein the opening / closing mechanism is in a closed state when the surgical treatment section is in one terminal state, and the opening / closing mechanism is in a maximum open state in another terminal state.
[0084]
The purpose of this supplementary statement is to clarify the operating state of the opening / closing mechanism of the surgical treatment section, and the opening / closing mechanism is in a closed state when it is in one terminal state, and is in a fully open state when in another terminal state.
[0085]
(3) When changing the surgical treatment section to one terminal state or another terminal state,
The surgical treatment according to claim 1, wherein the treatment portion side joint portion configuring the link mechanism moves forward and backward along the axis of the surgical treatment portion, and the shaft side joint portion moves forward and backward along the axis of the first shaft. Ingredients.
[0086]
The purpose of this supplementary note is to ensure that the surgical treatment section is in one terminal state and the other terminal state when the operation section is operated at hand, and the forward and backward movement of the treatment section side joint section and the shaft side joint section moves linearly. Therefore, the axes of the posture rotation joint portion and the shaft side joint portion and the axes of the posture rotation joint portion and the treatment portion side joint portion surely coincide with each other.
[0087]
(4) The surgical treatment instrument according to appendix 1 or appendix 3, wherein the first shaft and the second shaft are rigid members.
[0088]
The purpose of this supplementary note is to ensure that the surgical treatment section and the treatment section base member are operated when the operation section is operated by hand, and that the shaft is prevented from being deformed when the operation section is operated by hand. Moves forward and backward with high accuracy corresponding to the amount of operation of the operation unit.
[0089]
(5) The surgical treatment tool according to appendix 1, wherein a region forming member that divides an inner hole of the insertion portion forming tube member into a plurality of regions is disposed in the insertion portion forming tube member.
[0090]
The purpose of this supplementary note is to reliably move the plurality of shafts arranged in the inner hole of the insertion portion forming tube member forward and backward. The inner hole of the insertion portion forming tube member is divided into a plurality of regions by the region forming member. By arranging the shafts according to the purpose of use in the respective areas, interference between the shafts is prevented and a reliable forward / backward movement is performed.
[0091]
【The invention's effect】
As described above, according to the present invention, it is possible to provide a surgical treatment instrument that can reliably perform a desired operation by a treatment unit by reliably operating the treatment unit within the movable range regardless of the rotation state of the treatment unit. can do.
[Brief description of the drawings]
1 to 20 relate to an embodiment of the present invention, and FIG. 1 is a perspective view of a surgical treatment instrument.
FIG. 2 is a perspective view illustrating the configuration of a surgical treatment instrument.
FIG. 3 is a diagram illustrating the configuration of a treatment unit
FIG. 4 is a cross-sectional view illustrating the configuration of a treatment unit
FIG. 5 is a diagram for explaining a turning state of a treatment unit.
FIG. 6 is a view for explaining an open / close state of a treatment piece in a state where the treatment section is not rotating.
FIG. 7 is a view for explaining the open / close state of the treatment piece when the treatment section is in the maximum rotation state;
8 is a cross-sectional view taken along line AA in FIG.
FIG. 9 is a cross-sectional view illustrating configurations of an insertion unit and a gripping operation unit
10 is an enlarged view of the base end side of the insertion unit shown in FIG. 9;
FIG. 11 is a diagram for explaining the operation when the rotary handle of the treatment section operation section is operated.
FIG. 12 is a diagram for explaining the movement of the treatment section operation bar that operates in response to the operation of the rotation handle;
FIG. 13 is a view for explaining the relationship between the movement of the flat tip of the treatment portion operation rod and the opening / closing operation of the treatment piece constituting the treatment portion with the treatment portion base removed.
FIG. 14 is a diagram for explaining the operation when the rotary knob is operated.
FIG. 15 is a view for explaining the movement of the rotation base and the treatment unit base operation bar that operate in response to the operation of the rotation knob;
FIG. 16 is a diagram for explaining the relationship between the movement of the distal end arrangement portion of the treatment portion base operation rod and the rotation operation of the treatment portion with the treatment portion base removed
FIG. 17 is a diagram for explaining the operation when operating the rotation handle of the treatment unit operation unit with the rotation knob operated;
FIG. 18 is a view for explaining the movement of the rotation base and the treatment section base operation bar that operate in response to the operation of the rotation knob and the movement of the treatment section operation bar that operates in response to the operation of the rotation handle;
FIG. 19 is a view for explaining an opening / closing operation of a treatment piece constituting the treatment portion when the treatment portion is in a rotating state;
FIG. 20 is a diagram for explaining the relationship between the distance between pins and the rotation angle θ1 and the opening / closing angle θ2.
FIG. 21 to FIG. 24 are related to a second embodiment of the present invention, and FIG. 21 is a view for explaining a treatment portion in a straight extension state with respect to an insertion portion, which is characteristic of the constitution of the treatment portion base.
FIG. 22 is a diagram when the treatment section is opened.
FIG. 23 is a view when the treatment section is turned from the straight extension state to the rotation state.
FIG. 24 is a diagram when the rotating treatment section is opened with the treatment section base removed.
[Explanation of symbols]
1 ... Surgical instrument
2 ... treatment section
3 ... Insertion section
8a ... 1st rotation pin
9a ... First opening / closing pin
9b ... Second opening / closing pin
10b ... Second connecting pin
10c ... Third connecting pin
21. First treatment piece
22 ... Second treatment piece
23 ... Treatment unit base
24 ... Tip cover
25. First connecting member
26: Second connecting member
31 ... Insertion tube
51 ... Treatment unit operation stick

Claims (3)

An elongated tubular insertion portion forming tube member constituting the insertion portion;
A region forming member that is disposed in the insertion portion forming tube member and divides the inner hole of the insertion portion forming tube member into a plurality of regions;
A first shaft formed on elongated and that will be movably disposed in the first through-hole formed by arranging the region forming member,
A second shaft formed on elongated and that will be movably disposed in the second through-hole formed by arranging the region forming member,
A surgical treatment section configured to freely open and close a pair of treatment pieces;
A base member to which one treatment piece of the surgical treatment section is rotatably connected and the second shaft is rotatably connected;
In order to pivotably connect the surgical treatment section to the distal end of the insertion section, the base member is pivotally coupled to the insertion section, and is disposed perpendicular to the axial direction of the insertion section. A rotation pin constituting a posture rotation joint,
A first connecting member that is pivotally connected to the other treatment piece of the surgical treatment section, and that advances and retracts inside the base member when the pair of treatment pieces are opened and closed by the advance and retreat movement of the first shaft; ,
A distal end portion and the first connecting member are rotatably connected by a second connecting pin constituting a treatment portion side joint portion having a central axis that is coaxial with the central axis of the rotating pin. The end portion and the first shaft are rotatably connected by a third connecting pin that forms a shaft-side joint portion having a central axis that is coaxial with the central axis of the rotating pin, When opening and closing the pair of treatment pieces by moving the first shaft forward and backward to connect the first shaft and the first connecting member, a central axis of the second connecting pin and a central axis of the rotating pin A second connecting member that moves between a position where the shaft is coaxial and a position where the center axis of the third connecting pin and the center axis of the rotating pin are coaxial;
A first operating portion provided at a proximal end of the first shaft, and opening and closing the surgical treatment portion by moving the first shaft forward and backward;
A second operating portion that is provided at a base end of the second shaft and moves the second shaft forward and backward to operate an angle of the posture rotation joint;
A surgical treatment instrument comprising: When changing a pair of treatment pieces of the surgical treatment section to a closed state or an open state,
  The said treatment part side joint part moves forward / backward along the axis | shaft of the said surgical treatment part, The said shaft side joint part moves forward / backward along the axis | shaft of the said 1st shaft, It is characterized by the above-mentioned. Surgical treatment tool. The surgical treatment instrument according to claim 1 or 2, wherein the first shaft and the second shaft are members having rigidity.

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