JP5952953B1 - Bending mechanism for treatment instrument and treatment instrument - Google Patents

Abstract

Provided is a treatment tool that can be reused while realizing a large degree of freedom in a tip portion. A bending unit includes a distal end side shaft member and a proximal end side shaft member. An end surface 41T on the proximal end side of the distal end side shaft member obliquely intersects with the axial direction 41X of the distal end side shaft member. The distal end side end surface 42T of the proximal end side shaft member obliquely intersects the axial direction 42X of the proximal end side shaft member. Further, the proximal end side shaft member includes a projecting cylinder 42 </ b> B protruding from the end face on the distal end side. The protruding cylinder is rotationally symmetric with respect to a vertical axis 42TX extending in the vertical direction from the end face 42T. An accommodation hole 41B is formed in the end surface on the proximal end side of the distal end side shaft member. The accommodation hole is formed to be rotationally symmetric with respect to the vertical axis 41TX extending in the vertical direction from the end face 41T. [Selection] Figure 6

Description

The present invention relates to a bending mechanism for a treatment instrument and a treatment instrument.

  In all surgical fields, minimally invasive surgery (for example, endoscopic surgery) that is less invasive to patients has become common. Since the forceps used in such a minimally invasive surgery are inserted into the patient's body through the incision, they can only approach the affected area from a limited direction. Development of forceps that can be bent so that the tip of the forceps can be rotated in order to easily perform operations such as gripping and ligation under such conditions, and the tip of the tip is directed in a desired direction has been developed. (For example, Patent Document 1).

JP 2014-91027 A

  However, such forceps increase the degree of freedom of the distal end portion, resulting in an increase in the number of component parts or a complicated shape of the component parts. As a result, the manufacturing cost of the forceps increases.

  By the way, from the viewpoint of avoiding infectious diseases, forceps are often disposable. On the other hand, hospitals are demanding reuse of expensive forceps in order to reduce medical costs. However, in order to reuse the forceps, it is necessary to clean and disinfect the forceps after use.

  As described above, with forceps having a number of components and each having a complicated shape, it is very difficult to remove tissue pieces, blood, and mucus that have entered the gaps between the components. As a result, before and after the forceps cleaning and disinfection operations, the burden of disassembly and assembly operations increases. Such a situation is not limited to the forceps, and is common to other treatment instruments such as a needle holder, a retractor, and scissors.

In view of such circumstances, the present invention seeks to provide a treatment instrument that can be reused while realizing a large degree of freedom in the distal end portion, and a treatment instrument bending mechanism for realizing such a treatment instrument. Is.

The bending mechanism for a treatment instrument according to the present invention includes a first axial member extending in the first axial direction, a second axial member extending in the second axial direction, and a first engagement provided on the first axial member. When the rotation of the one side shaft member around the first shaft and the other side engagement portion that is provided on the other side shaft member and can be engaged with the one side engagement portion is performed. , freely switched between the second state to restrict rotation of the other side shaft member in the first state and the second axis around which allows the rotation of the other side shaft member in the second axis around A one-way clutch, a dial fitted to the one-way clutch, a one-side transmission mechanism that connects the dial and the one-side shaft member, and transmits the movement of the dial to the one-side shaft member, and the one-way Connecting the clutch and the other shaft member, With the other side transmission mechanism for transmitting the movement of the latch to the other side shaft member, the one side engaging portion is formed in a vertical direction from one side end surface that intersects obliquely with respect to the first axis direction The other-side engagement portion has a second-side engagement structure formed in a vertical direction from the other-side end face that obliquely intersects the second axial direction. The one-way clutch enters the first state when the dial is rotated in the first rotation direction, and transmits the rotation movement of the dial to the other transmission mechanism, while the dial is The second state is achieved when the second direction of rotation is opposite to the first direction of rotation, and the one-side transmission mechanism and the other side when the one-way clutch is in the first state. And the transmission mechanism, the one-way clutch In the case of two states, the one-side transmission mechanism rotates relative to the other-side transmission mechanism, and the relative positional relationship between the first axial direction and the second axial direction is different. It can be changed .

The other side transmission mechanism is preferably arranged so as to penetrate the other hand one formed on the side engaging structure side insertion hole and the other side engagement structure which is formed on the other side insertion hole. Moreover, it is preferable that the said other side transmission mechanism can be moved in the said 1st axial direction or the said 2nd axial direction . Further, it is preferable that the contour of the one side end surface is a circular shape having a center on the first axis , and the contour of the other side end surface is a circular shape having a center on the second axis .

A one-side identifier provided on the outer peripheral surface of the one-side shaft member and extending in the first axial direction; and a second-side identifier provided on the outer peripheral surface of the other-side shaft member and extending in the second axial direction. It is preferable to provide . Moreover, it is preferable that when the first axial direction and the second axial direction are in a straight line state, the one-side identifier and the other-side identifier are on a straight line .

The one-side engaging portion and the other-side engaging portion have contact surfaces that contact each other, and when the relative positional relationship between the first axial direction and the second axial direction changes, the one-side engaging portion. It is preferable that the joint portion and the other side engaging portion slide through the contact surface .

The one perpendicular line and the perpendicular of the other side end surface of the side end surface is a collinear allows relative movement of the one side engaging structure and the other side engagement structure in a perpendicular around said one side edge surface And a restricting mechanism for restricting relative movement in the perpendicular direction, the restricting mechanism extending in a vertical direction from an end surface of any one of the one side shaft member and the other side shaft member. And an engaging groove formed around the normal of the end surface of the protrusion, and an engaging pin that can be inserted into the engaging groove through a hole provided in the remaining shaft member, It is preferable that the engagement pin is fixed to the shaft member in a state of being inserted into the engagement groove.

Treatment tool of the present invention, the above treatment instrument bending mechanism, the treatment mechanism for performing a predetermined treatment disposed on one side of the treatment instrument bending mechanism, disposed on the other side of the treatment instrument bending mechanism the And an operation mechanism for operating the treatment mechanism.

  According to the present invention, it is possible to provide a treatment tool that can be reused while realizing a large degree of freedom in the distal end portion, and a bending mechanism for realizing such a treatment tool.

(A) is a front view of a forceps with a jaw unit in a closed state, and (B) is a forceps with a jaw unit in an open state. (A) and (B) are both when the jaw unit is in the open state, (A) is when the jaw unit is opened in the vertical direction, and (B) is when the jaw unit is opened in the paper surface direction. belongs to. (A) is a front view of a forceps in which a bending unit is in a straight line state, and (B) is a bending unit in a bent state. It is an enlarged view of a jaw unit and its vicinity. It is an enlarged view of an operation unit and its vicinity. It is an exploded sectional view showing an outline of a bending unit. (A) is a linear state, (B) is sectional drawing which shows the outline | summary of the bending unit of a bending state. It is an exploded view showing an outline of forceps. (A) is a linear state, (B) is sectional drawing which shows the outline | summary of the bending unit (modification) of a bending state. (A) is a front view showing the external shape of a bending unit. (X) is an X-ray end view in (A), and (Y) is a Y-line end view in (A). (A) is a front view showing the external shape of a bending unit. (X) is an X-ray end view in (A), and (Y) is a Y-line end view in (A). (A) is a front view showing the external shape of a bending unit. (X) is an X-ray end view in (A), and (Y) is a Y-line end view in (A).

  As shown in FIG. 1, the forceps 2 are used for minimally invasive surgery or the like, and are connected to the jaw unit 10 that performs a predetermined treatment, the operation unit 20 that operates the jaw unit 10, and the operation unit 20. And a cylindrical bending unit 40 coupled to the jaw unit 10 and the sheath 30. By the predetermined operation by the operation unit 20, the jaw unit 10 can be opened and closed, the jaw unit 10 can be rotated (FIG. 2), and the jaw unit 10 can be bent (FIG. 3).

  As shown in FIG. 4, the jaw unit 10 includes a guide pipe 11 disposed in a hollow portion of the bending unit 40, a movable cylinder 12 that can be advanced and retracted in the hollow portion of the guide pipe 11, and a jaw 13 that can be opened and closed. And a link mechanism 15 that switches the forward / backward movement of the movable cylinder 12 to the opening / closing movement of the jaw 13. Since the movable cylinder 12 is connected to the operation unit 20, the movement cylinder 12 can be moved forward and backward through the operation of the operation unit 20. The jaw 13 can be switched between a closed state (FIG. 1A) and an open state (FIG. 1B) by the forward and backward movement of the movable cylinder 12. The amount of forward / backward movement of the movable cylinder 12 necessary for switching between the closed state (FIG. 1A) and the open state (FIG. 1B) is the amount indicated by reference numeral 23X in FIG.

  As shown in FIG. 5, the operation unit 20 includes a handle 21 for opening / closing the jaw unit 10, a dial 22 for rotating and bending the jaw unit 10, and an operation and dial for the handle 21. And a one-way clutch 25 that couples the transmission shaft 23 and the dial 22 to each other.

  As shown in FIGS. 4 to 5, the transmission shaft 23 is disposed so as to penetrate the inner space of the sheath 30 and the bending unit 40. On the base end side of the transmission shaft 23, a spherical engagement end portion 23T is formed. The engaging portion 23X is inserted into an engaging recess 21MT (FIG. 8) formed in the handle 21. As shown in FIG. 1, the transmission shaft 23 can be moved in the longitudinal direction of the sheath 30, that is, moved forward and backward by operating the handle 21. As a result, the jaw unit 10 can be opened and closed.

  As shown in FIG. 4, the transmission shaft 23 includes a highly rigid high-rigidity member 23H and an elastic member 23E rich in elasticity. Of the transmission shaft 23, the internal space of the bending unit 40, particularly the portion disposed in the refracting portion, is preferably the elastic member 23E, and the other is preferably the high-rigidity member 23H. The proximal end side of the elastic member 23E is inserted into the distal end portion of the cylindrical high-rigidity member 23H and fixed by caulking. Similarly, the distal end side of the elastic member 23E is inserted into the proximal end side of the movable cylinder 12, and is fixed by caulking. In addition, the joining method of the elastic member 23E and another member is not limited to crimping.

  As the high-rigidity member 23H, a member having a larger elastic coefficient than that of the elastic member 23E is preferable, and a forming material includes stainless steel. On the other hand, the elastic member 23E is preferably in the form of a wire, and examples of the forming material include a super elastic memory alloy, a titanium alloy (β titanium, rubber metal (Toyotsu Material Co., Ltd.)), and stainless steel.

  As shown in FIG. 5, the one-way clutch 25 holds the transmission shaft 23. The transmission shaft 23 is movable in the longitudinal direction of the sheath 30 while being held by the one-way clutch 25. The dial 22 is fitted to the one-way clutch 25.

  The one-way clutch 25 can be switched between a transmission state in which a rotational movement caused by operation of the dial 22 is transmitted to the transmission shaft 23 and a retracted state in which the one-way clutch 25 is retracted from the transmission state. For this reason, when the dial 22 is rotated in one direction (FIG. 2), the one-way clutch 25 transmits the rotation of the dial 22 to the transmission shaft 23. On the other hand, when the dial 22 is rotated in the other direction (FIG. 3), the one-way clutch 25 does not transmit the rotation of the dial 22 to the transmission shaft 23. That is, the one-way clutch 25 is a switching mechanism that can be switched between a state in which the rotation of the transmission shaft 23 is allowed and a state in which the rotation of the transmission shaft 23 is restricted when the dial 22 is rotated. Function.

  The forceps 2 further includes an attachment mechanism 70. The attachment mechanism 70 includes a flange 71 formed on the proximal end side of the sheath 30, a cylindrical portion 72 protruding from the distal end surface side of the dial 22, and a cap 73 that can be screwed onto the outer peripheral surface of the cylindrical portion 72. Have. When the cap 73 is screwed onto the cylindrical portion 72 in a state where the flange 71 is pressed against the cylindrical portion 72, the sheath 30 can be rotated together with the dial 22.

  As shown in FIG. 6, the bending unit 40 includes a distal end side shaft member 41 and a proximal end side shaft member 42. The distal end side shaft member 41 and the proximal end side shaft member 42 are each formed in a cylindrical shape. Further, the proximal end portion of the proximal end side shaft member 42 can be screwed to the distal end portion of the sheath 30 (FIG. 4). On the other hand, the distal end portion of the distal end side shaft member 41 can be screwed to the proximal end portion of the guide pipe 11 (FIG. 3).

  An end surface 41 </ b> T on the proximal end side of the distal end side shaft member 41 obliquely intersects with the axial direction 41 </ b> X of the distal end side shaft member 41. Similarly, the end surface 42 </ b> T on the distal end side of the proximal end side shaft member 42 obliquely intersects with the axial direction 42 </ b> X of the proximal end side shaft member 42.

  The proximal end side shaft member 42 includes a projecting cylinder 42B protruding from an end face 42T on the distal end side, and a circumferential groove 42BM formed on the outer peripheral surface of the projecting cylinder 42B. The protruding cylinder 42B has a rotationally symmetric shape with respect to the vertical axis 42TX extending in the vertical direction from the end face 42T. On the other hand, an accommodation hole 41 </ b> B is formed in the end surface 41 </ b> T on the proximal end side of the distal end side shaft member 41. The accommodation hole 41B has a rotationally symmetric shape with respect to the vertical axis 41TX extending in the vertical direction from the end surface 41T. Furthermore, the base end side shaft member 42 has an engagement pin 44 and an engagement pin insertion hole 44X into which the engagement pin 44 can be inserted. The engagement pin insertion hole 44X extends from the outer peripheral surface of the distal end side shaft member 41 to the accommodation hole 41B.

  As shown in FIG. 7, when the projecting cylinder 42B is received in the receiving hole 41B, the vertical shaft 41TX and the vertical shaft 42TX are on the same straight line, and the protruding cylinder 42B is engaged in the radial direction of the receiving hole 41B. It has a shape that can be stopped. For this reason, when the protruding cylinder 42B is accommodated in the accommodation hole 41B, the distal end side shaft member 41 is rotatable around the vertical axis 42TX. Due to the relative movement of the distal end side shaft member 41 and the proximal end side shaft member 42 around the vertical axis 41TX, the axial direction 41X of the distal end side shaft member 41 is in the first direction and the first direction relative to the proximal end side shaft member 42. It becomes possible to change between the second direction different from the direction (FIGS. 7A and 7B). As described above, the projecting cylinder 42B and the circumferential groove 42BM function as a distal end side engaging structure. The accommodation hole 41B functions as a proximal end side engagement structure.

  In addition, when the protrusion cylinder 42B is accommodated in the accommodation hole 41B, it is preferable that the front end surface of the protrusion cylinder 42B is in contact with the bottom surface of the accommodation hole 41B. Since the distal end surface of the projecting cylinder 42B and the bottom surface of the receiving hole 41B are always in contact, the distal end side shaft member 41 is stably supported by the proximal end side shaft member 42 even when an external force is applied to the distal end side shaft member 41. Is done.

  Further, the distal end of the engagement pin 44 inserted into the engagement pin insertion hole 44 </ b> X engages with the circumferential groove 42 </ b> BM of the proximal end side shaft member 42. As a result, the distal end side shaft member 41 is locked to the proximal end side shaft member 42 in the direction of the vertical axis 41TX. The engagement pin 44 is fixed to the distal end side shaft member 41 in a state of being inserted into the engagement pin insertion hole 44X. In this way, the distal end side shaft member 41 can be rotated around the vertical axis 41TX while being engaged with the proximal end side shaft member 42, and the direction of its own axial direction 41X is determined by the amount of rotation around the vertical axis 41TX. Can be changed. Therefore, the engagement pin 44 and the engagement pin insertion hole 44X enable relative movement of the distal end side shaft member 41 and the proximal end side shaft member 42 around a predetermined axis, and the distal end side shaft member in the axial direction. 41 and function as a restricting mechanism for restricting relative movement of the proximal end side shaft member 42. The change amount α of the direction of the distal end side shaft member 41 at this time may be greater than 0 ° and less than 180. The range of the change amount α may be appropriately adjusted according to the application, and may be, for example, “greater than 0 ° and 90 ° or less”.

  The angle of the intersection angle θ41 (FIG. 6) between the end surface 41T and the vertical axis 41TX is preferably less than 90 °, for example. Similarly, the angle of the crossing angle θ42 (FIG. 6) between the end face 42T and the vertical axis 42TX is preferably less than 90 °, for example.

  Further, in the proximal end side shaft member 42, the intersection of the vertical axis 42TX and the axial direction 42X is preferably located within a plane including the end face 42T. Similarly, also in the front end side shaft member 41, it is preferable that the intersection of the vertical axis 41TX and the axial direction 41X is located in a plane including the end face 42T.

  Next, the operation of the forceps 2 will be described. When the handle 21 is in the closed state, the jaw 13 is in the closed state (FIG. 1 (A)). Here, when the movable handle 21M is moved away from the fixed handle 21F, the transmission shaft 23 moves to the distal end side, and as a result, the jaw 13 is opened (FIG. 1B). Next, when the movable handle 21M is moved so as to approach the fixed handle 21F, the transmission shaft 23 moves to the base end side, and as a result, the jaw 13 returns to the closed state (FIG. 1 (A)).

  Next, when the dial 22 is rotated in one direction (FIG. 2), the one-way clutch 25 transmits the rotational movement of the dial 22 to the transmission shaft 23. As a result, the transmission shaft 23 rotates in one direction together with the sheath 30 screwed directly into the dial 22. Since the sheath 30 and the transmission shaft 23 rotate together, the posture of the bending unit 40 is not changed, and the rotational motion is transmitted to the jaw unit 10. As a result, the direction of the jaw 13 can be changed.

  On the other hand, when the dial 22 is rotated in the other direction (FIG. 3), the one-way clutch 25 does not transmit the rotational movement of the dial 22 to the transmission shaft 23. As a result, the rotational movement of the sheath 30 that is directly screwed to the dial 22 is performed, while the rotational movement of the transmission shaft 23 is not performed. Thus, since the sheath 30 performs a relative rotational movement with respect to the transmission shaft 23, in the bending unit 40, the proximal end side shaft member 42 screwed into the sheath 30 is interposed via the guide pipe 11. Thus, a relative rotational movement is performed with respect to the distal end side shaft member 41 connected to the transmission shaft 23. As a result, the axial direction 41X of the distal end side shaft member 41 can be changed between the first direction and a second direction different from the first direction with respect to the axial direction 42X of the proximal end side shaft member 42 (FIG. 7 (B)).

Therefore, the jaw unit 10 connected to the distal end side shaft member 41 has a straight state (FIG. 3A) extending linearly with respect to the sheath 30 and a bent state bent with respect to the sheath 30 (FIG. 3 ( B)). Further, when the dial 22 is continuously rotated in the other direction, the bent state (FIG. 3B) is changed to the linear state (FIG. 3A), and then the bent state (FIG. 3B). That is,
The straight line state (FIG. 3A) and the bent state (FIG. 3B) are alternately switched.

  In this way, the forceps 2 can perform a bending operation and a rotation operation depending on the rotation direction of one dial 22. Further, the bending operation and the rotation operation can be selected according to the rotation direction of the dial 22. Further, the state of the bending unit 40 for realizing the bending operation is switched by sliding between the projecting cylinder 42B and the circumferential groove 42BM and the surface of the accommodation hole 41B. For this reason, regardless of the state of the bending unit 40, even if an external force is applied to the distal end side shaft member 41, the distal end side shaft member 41 is stably supported with respect to the proximal end side shaft member 42.

  The bending unit 40 uses a distal end side shaft member 41 and a proximal end side shaft member 42, that is, cylindrical members having end surfaces that are inclined with respect to their own axes. As described above, since the constituent member of the bending unit 40 is a member having a relatively simple structure, there is a low possibility that a tissue piece, blood, or mucus will enter the gap between the constituent parts. Moreover, disassembly work and assembly work are easy. Accordingly, it is possible to reduce the burden required for cleaning and disinfecting the forceps, and to reduce the burden of disassembling work and assembling work accompanying the cleaning and disinfecting work.

  The forceps 2 used for the treatment is cleaned and sterilized for reuse. For this reason, the forceps 2 used for the treatment can be disassembled as shown in FIG. First, the rotation pin 21P (FIG. 1A) is removed, the movable portion 21M is removed from the fixed portion 21F of the handle 21, and the engagement end of the transmission shaft 23 is engaged from the engagement recess 21MT formed in the movable portion 21M. Remove the part 23T. Thereafter, when the distal end portion of the distal end side shaft member 41 is removed from the proximal end portion of the guide pipe 11 (FIG. 3), the transmission shaft 23 is detached from the sheath 30 while being integrated with the movable cylinder 12 and the jaw unit 10. Further, when the cap 73 is removed from the cylindrical portion 72, the bending unit 40 can be detached from the operation unit 20 while being integrated with the sheath 30.

  In order to determine whether or not the bending unit 40 is in a straight line state (FIG. 3A), an identifier 41N and an identifier 42N may be provided on each of the distal end side shaft member 41 and the proximal end side shaft member 42. Good. For example, the identifier 41 </ b> N extends in the axial direction of the distal end side shaft member 41 on the outer periphery of the distal end side shaft member 41. The identifier 42N extends in the axial direction of the proximal end side shaft member 42 on the outer periphery of the proximal end side shaft member 42. When the bending unit 40 is in a straight line state (FIG. 3A), the identifier 41N and the identifier 42N are on a straight line. By using the identifier 41N and the identifier 42N, it is easy to determine whether the bending unit 40 is in a straight line state (FIG. 3A). As a result, when the forceps 2 is inserted into the body or removed from the body, it is easy to determine whether the bending unit 40 is in the straight state (FIG. 3A). You do n’t have to. Further, when the bending unit 40 is in a straight line state (FIG. 3A), it is possible to mark the identifier 41N and the identifier 42N when the disassembly and assembly operations are easier.

  In the above-described embodiment, the proximal end surface 41T of the distal end side shaft member 41 and the distal end side end surface 42T of the proximal end side shaft member 42 include the axial direction 41X of the distal end side shaft member 41 and the proximal end side shaft member 42. Although it is parallel when it makes the axial direction 42X on the same straight line, this invention is not restricted to this, You may cross | intersect.

  In the above-described embodiment, the cylindrical projecting cylinder 42B is provided as the base end side engagement structure. However, the present invention is not limited to this, and at a position equidistant from the vertical axis 42TX at a predetermined interval around the vertical axis 42TX. It is good also considering the several protrusion member arranged as a base end side engagement structure.

  Although the protruding cylinder 42B as the base end side engaging structure is provided in the base end side shaft member 42 and the accommodation hole 41B as the front end side engaging structure is provided in the front end side shaft member 41, the present invention is not limited to this. An insertion hole as the proximal end engagement structure may be provided in the proximal end side shaft member 42, and a protruding cylinder that can be engaged with the insertion hole as the distal end side engagement structure may be provided in the distal end side shaft member 41.

  In the above embodiment, the distal end side shaft member 41 is locked in the vertical axis 41TX direction with respect to the proximal end side shaft member 42 by inserting the engagement pin 44 into the engagement pin insertion hole 44X. Not limited to. As shown in FIG. 9, the distal end side shaft member 41 is formed using a protrusion 42BT extending radially outward from the distal end portion of the protruding cylinder 42B and an engaging groove 41BM formed in the accommodation hole 41B and engageable with the protrusion 42BT. May be locked in the direction of the vertical axis 41TX with respect to the base end side shaft member 42.

  In the above embodiment, the cylindrical bending unit 40, that is, the cylindrical distal end side shaft member 41 and the cylindrical proximal end side shaft member 42 are used. In such a case, the contours of the end surface 41T on the proximal end side of the distal end side shaft member 41 and the end surface 42T on the distal end side of the proximal end side shaft member 42 become elliptical (FIG. 10), and therefore in a straight line state (FIG. 3). In the switching in (A)) and the bent state (FIG. 3B), part of the end surface 41T and the end surface 42T is exposed to the outside. Therefore, the contour of the end surface 41T is preferably circular with the vertical axis 41TX as the center, and the contour of the end surface 42T is preferably circular with the vertical axis 42TX as the center (FIGS. 11 and 12). . In order to obtain such a shape, the end surface 41T and the end surface 42T are circular (FIG. 11 (Y)) using elliptical cylindrical members (FIG. 11 (X)) as the distal end side shaft member 41 and the proximal end side shaft member 42. ), The outer peripheral portion may be tapered (FIG. 11 (A)), and cylindrical members (FIG. 11 (X)) may be used as the distal end side shaft member 41 and the proximal end side shaft member 42. The outer peripheral portion may be tapered so that the end surface 41T and the end surface 42T are circular (FIG. 11Y) (FIG. 12A).

  In the above embodiment, the forceps 2 has been described as an example of the treatment tool. However, the treatment tool of the present invention is not limited to the forceps, and can be used for other treatment tools such as a needle holder, a retractor, and scissors.

  It should be noted that the present invention is not limited to the above-described embodiment, and it is needless to say that various modifications can be made without departing from the gist of the present invention.

2 Forceps 10 Jaw unit 11 Guide pipe 12 Mover 13 Jaw 15 Link mechanism 20 Operation unit 21 Handle 22 Dial 23 Transmission shaft 23E Elastic member 23H High-rigidity member 25 One-way clutch 30 Sheath 40 Bending mechanism 41 Tip side shaft member 41B Projection cylinder 41BM Circumferential groove 41T End surface 41TX Vertical shaft 41X Axial direction 42 Base end side shaft member 42B Projection cylinder 42BM Circumferential groove 42T End surface 42TX Vertical shaft 42X Axial direction

Claims (9)

One side shaft member extending in the first axial direction ;
The other side shaft member extending in the second axial direction ;
One side engaging portion provided on the one side shaft member;
The other side engaging portion provided on the other side shaft member and engageable with the one side engaging portion;
When the rotation of the one-side shaft member around the first axis is performed, the first state that allows the rotation of the other-side shaft member around the second shaft and the rotation around the second shaft A one-way clutch switchable between a second state that restricts rotation of the other side shaft member ;
A dial fitted to the one-way clutch;
A one-side transmission mechanism that connects the dial and the one-side shaft member, and transmits the movement of the dial to the one-side shaft member;
The one-way clutch and the other-side shaft member are connected, and the other-side transmission mechanism that transmits the movement of the one-way clutch to the other-side shaft member ,
The one side engaging portion has a one side engaging structure formed in a vertical direction from one side end face obliquely intersecting the first axial direction,
The other side engaging portion has the other side engaging structure formed in a vertical direction from the other side end face obliquely intersecting the second axial direction,
The one-way clutch enters the first state when the dial is rotated in the first rotation direction, and transmits the rotation movement of the dial to the other-side transmission mechanism, while the dial is The second state when it is turned in a second turning direction opposite to the turning direction of 1,
When the one-way clutch is in the first state, the one-side transmission mechanism and the other-side transmission mechanism rotate together,
When the one-way clutch is in the second state, the one-side transmission mechanism rotates relative to the other-side transmission mechanism, and the relative positional relationship between the first axial direction and the second axial direction. Can be changed between different states, a bending mechanism for a treatment instrument . The other side transmission mechanism, wherein, characterized in that it is arranged to penetrate the other hand one formed on the side engaging structure side insertion hole and the other side engagement structure which is formed on the other side insertion hole Item 2. A bending mechanism for a treatment instrument according to Item 1 . The bending mechanism for a treatment instrument according to claim 1 or 2 , wherein the other side transmission mechanism is movable in the first axial direction or the second axial direction . The outline of the one end face is a circle having a center on the first axis ,
The bending mechanism for a treatment instrument according to any one of claims 1 to 3, wherein a contour of the other side end surface is a circle having a center on the second axis . A one-side identifier provided on an outer peripheral surface of the one-side shaft member and extending in the first axial direction;
The bending for a treatment instrument according to any one of claims 1 to 4, further comprising: an other-side identifier provided on an outer peripheral surface of the other-side shaft member and extending in the second axial direction. mechanism. The bending for a treatment instrument according to claim 5, wherein when the first axial direction and the second axial direction are in a straight line state, the one-side identifier and the other-side identifier are in a straight line. mechanism. The one side engaging portion and the other side engaging portion have contact surfaces that contact each other;
When the relative positional relationship between the first axial direction and the second axial direction changes, the one side engaging portion and the other side engaging portion slide through the contact surface. The bending mechanism for a treatment instrument according to any one of claims 1 to 6, wherein the bending mechanism is for a treatment instrument. The perpendicular of the one end face and the perpendicular of the other end face are on the same straight line,
Together to permit relative movement of the one side engaging structure and the other side engagement structure in a perpendicular around the one side end face, provided with a restricting mechanism for restricting the relative movement in the perpendicular direction,
The regulation mechanism is
A protrusion extending in a vertical direction from an end surface of any one of the one side shaft member and the other side shaft member;
An engagement groove formed around the normal of the end surface of the protrusion,
An engagement pin that can be inserted into the engagement groove through a hole provided in the remaining shaft member;
The bending mechanism for a treatment instrument according to any one of claims 1 to 7 , wherein the engagement pin is fixed to the shaft member in a state of being inserted into the engagement groove. A bending mechanism for a treatment instrument according to any one of claims 1 to 8 ,
A treatment mechanism arranged on one side of the treatment instrument bending mechanism to perform a predetermined treatment;
An operation mechanism that is disposed on the other side of the treatment instrument bending mechanism and that operates the treatment mechanism.

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