JP6709928B1 - Minimally invasive surgical equipment - Google Patents

Abstract

An operation handle (2) operated by a user in a body cavity, a treatment section (3) for holding a predetermined surgical instrument which is inserted into the body cavity and operated by the operation section so as to be replaceable, and the operation. A connecting part (4) is provided between the handle part and the treatment part for arranging the surgical instrument held by the treatment part at a desired position in a body cavity in a desired posture, and the connection part is , At least two or more connecting parts (7a) that are connected in series in the major axis direction of the connecting part and constitute joints (7, 8) that enable rotation about the major axis or about an axis orthogonal to the major axis. , 7b, 8a, 8b) and the two or more connecting portions are moved toward or away from each other to open the angle about the major axis of the joint and/or the angle about the axis orthogonal to the major axis. Alternatively, it has a connecting portion control mechanism that restrains the treatment portion and thereby arranges the treatment portion at a desired position and posture in the body cavity. [Selection diagram]

Description

TECHNICAL FIELD The present invention relates to a surgical instrument used in a surgery for treating a lesion in a body cavity with minimal invasion to a human body.

In recent years, the use of minimally invasive surgery represented by laparoscopic surgery and thoracoscopic surgery has been expanding.

According to these minimally invasive surgery, there is an advantage that the skin incision is small and the burden on the human body is small as compared with the conventional surgery in which a large incision is made on the human body and a surgical procedure is performed under direct vision. Minimally invasive surgery is advancing day by day due to improvements in the performance of endoscopes and surgical instruments and improvements in surgical techniques themselves.

Here, a surgical instrument used in general minimally invasive surgery includes a small-diameter insertion portion to be inserted into a body cavity and a handle portion for operating the insertion portion at hand. When using this surgical instrument, first, a small skin incision is made in a patient's chest or abdomen, and a surgical instrument insertion port (port) is inserted into this incision. Then, the insertion portion of the surgical instrument is inserted into the body cavity through this port. A scissors, scissors, a blade of an electric knife, etc. for performing a surgical procedure are attached to the tip of the body cavity insertion section, and a desired operation is performed by controlling the blade with the handle section.

However, it is difficult to use the conventional minimally invasive surgical equipment in the following cases, and in that case, it is necessary to select a highly invasive surgery.

(1) When there is an unavoidable working space, it is unavoidable that devices that are held by both hands, or devices and devices such as endoscopes, or important organs are in contact with each other.

(2) When there is an important organ or an obstacle such as adhesion that is present between the hand and the target site, especially when the mobility of the important organ is poor, or when the adhesion is wide.

(3) When the hand and the object cannot be placed on the same plane. For example, when you have an important organ that cannot be moved, and your hand and the target area are sitting opposite to each other.

(4) When the vector of the treatment performed on the object is not on the same plane as the hand and the object structure. For example, for an artery running parallel to the line connecting the two surgical instrument insertion ports (ports), make an incision not in the arterial wall on the proximal side but in the arterial wall that is rotated 90 degrees clockwise around the centerline of the artery. It may be added.

For the above problems, conventionally, to expand the working space, open the wound on the body surface, add another port, move a movable organ in the body cavity, or move to thoracotomy/laparotomy. , Etc. are investigated, but those methods are generally treatments for increasing invasiveness to the human body.

On the other hand, robot surgery has been developed to solve the above-mentioned problems by introducing a surgical robot capable of extremely highly flexible motion in a body cavity (see, for example, Patent Document 1).

On the other hand, in order to deal with the above problems by developing conventional surgical instruments, by providing joints on the distal end portion and the shaft, a surgical instrument having a higher degree of freedom of the surgical treatment portion provided at the distal end of the instrument is proposed. Development is underway (see, for example, Patent Document 2).

However, the conventional surgical robot described in Patent Document 1 has the advantage of enabling extremely highly flexible motions and fine motions, while it has become popular, but its mechanism is generally extremely complicated and large. It can be expensive. Therefore, it is not easy to introduce from the viewpoint of equipment and financial aspect. In addition, it is said that it is difficult to obtain biofeedback centering on tactile sensation from the surgical treatment section provided in the robot with the current technology, and the material cost for one operation is high.

Further, in the surgical instrument as described in Patent Document 2, the shaft can be bent or curved, and the surgical operation part can reach the target object by the rolling operation of the entire part far from the shaft. is there. However, with the mechanism of Document 2, it is difficult to perform three-dimensional deformation of the shaft and highly bend more than 90 degrees with respect to the handle central axis. This is because it is important for conventional surgical equipment to be a small-diameter shaft that can be operated with one hand. Under these conditions, it is possible to freely deform the shaft in three axial directions and perform high bending to maintain the rigidity of the shaft. This is partly due to the fact that it is not possible and the structure becomes extremely complicated.

JP2012-143589A JP, 2017-189571, A

The present invention has been made in consideration of the above-mentioned problems, and is capable of bending and rotating in multiple directions while maintaining the rigidity of the shaft and without complicating the structure. Alternatively, it is an object of the present invention to provide a surgical instrument capable of imparting a high degree of freedom to a distal end working unit having a surgical treatment unit by maintaining a three-dimensional complicated shape.

In order to solve the above problems, according to a first aspect of the present invention, the following inventions are provided. (1) A minimally invasive surgical device,
Provided between the operation handle portion and the treatment portion, which is operated by the user outside the body cavity, a treatment portion which holds a predetermined surgical instrument inserted into the body cavity and operated by the operation portion in a replaceable manner. And a connecting portion for arranging the surgical instrument held by the treatment portion at a desired position in a body cavity in a desired posture,
The connecting portion is
At least two connecting portions that are connected in series in the long axis direction of the connecting portion and that constitute a joint that enables rotation about the long axis or about an axis orthogonal to the long axis;
By moving the two or more connecting portions in a direction in which they approach or separate from each other, the angle about the major axis of the joint and/or the angle about the axis orthogonal to the major axis is opened or restrained, whereby the treatment section. A minimally invasive surgical instrument, comprising: a connecting portion control mechanism for arranging the subject at a desired position and posture in a body cavity.
(2) In the minimally invasive surgical device according to (1) above,
The connecting portion control mechanism,
A connecting portion control slider that is slidable along the longitudinal direction on the operation handle portion and can lock its movement at a predetermined position;
The flexible shaft member is inserted through the entire length of the connecting portion, one end is fixed to the treatment portion side, and the other end is fixed to the connecting portion operation slider side.
A minimally invasive surgical instrument characterized in that the angle between the joints is opened or restrained by slidingly moving the connecting portion control slider along the longitudinal direction of the operation handle portion.
(3) In the minimally invasive surgical device according to (1) above,
The connecting portion has one or both of a first joint that allows rotation about the major axis and a second joint that allows rotation about the axis orthogonal to the major axis. Minimally invasive surgical equipment.
(4) In the minimally invasive surgical device according to (3) above,
The connection portion has a concave portion and a convex portion that can be engaged with each other, and the angle control portion releases the engagement between the concave portion and the convex portion when released and engages the concave portion and the convex portion when restrained. The minimally invasive surgical equipment is characterized in that the angle is fixed by doing so.
(5) In the minimally invasive surgical device according to (3) above,
The minimally invasive surgical instrument characterized in that the connecting portion has a stopper mechanism that regulates a rotation angle around an axis orthogonal to the long axis.
(6) In the minimally invasive surgical device according to (5) above,
The minimally invasive surgical instrument, wherein the regulated rotation angle is +-30 degrees.
(7) In the minimally invasive surgical device according to (6) above,
The minimally invasive surgical instrument characterized in that the connecting portion has a number of joints capable of maintaining a curved shape of 90 degrees to 180 degrees by a plurality of joint portions.
(8) In the minimally invasive surgical device according to (1) above,
The minimally invasive surgical instrument, wherein the connecting portion control slider is attached to a slide guide provided on the operation handle portion.
(9) In the minimally invasive surgical device according to (8) above,
The shaft member is a tension transmission rod or wire,
The minimally invasive surgical instrument, wherein the connecting portion control slider is a tension slider for adjusting the tension of the tension transmission rod.
(10) In the minimally invasive surgical device according to (9) above,
A minimally invasive surgical instrument characterized in that the tension of the tension transmission rod or the wire is adjusted by operating the connecting portion control slider in parallel with the longitudinal axis of the handle.
(11) In the minimally invasive surgical device according to (1) above,
further,
A flexible shaft member for surgical treatment part control, one end of which is connected to the surgical treatment part, and the other end side of which extends through the inside of the connection part toward the handle part side,
A surgical operation part drive slider attached to the handle part in a state of being connected to the other end of the flexible shaft member for controlling a surgical operation part, a minimally invasive surgical instrument.
(12) In the minimally invasive surgical device according to (11) above,
The minimally invasive surgical instrument, wherein the surgical treatment section drive slider is attached to the coupling section control slider and is provided so as to be movable with respect to the coupling section control slider.

Features of the present invention other than the above will be clarified in the description of the embodiments of the present invention described below.

FIG. 1 is a schematic configuration diagram showing a minimally invasive surgical instrument according to an embodiment of the present invention.

FIG. 2 is a schematic configuration diagram similarly showing the operation.

Similarly, FIG. 3 is a schematic configuration diagram showing a joint member.

Similarly, FIG. 4 is a schematic configuration diagram showing a first joint member.

Similarly, FIG. 5 is a schematic configuration diagram showing a second joint member.

Similarly, FIG. 6 is a schematic view showing the operation of the joint member.

FIG. 7 is a schematic configuration diagram similarly showing the movement of the first and second joint portions.

Similarly, FIG. 8 is a schematic configuration diagram showing a slide guide.

Similarly, FIG. 9 is a schematic configuration diagram showing the configuration of the slider.

FIG. 10 is a schematic configuration diagram similarly showing the operation handle portion.

FIG. 11 is a schematic view for explaining the operation of the slide operation handle and the ring.

An embodiment of the present invention will be described below with reference to the drawings.

(overall structure)
FIG. 1 is an overall schematic diagram showing a minimally invasive surgical instrument 1 of this embodiment.

The surgical instrument 1 is roughly divided into an operating handle portion 2 for the user to operate the surgical instrument outside the body cavity, and an operating handle portion 2 inserted into the body cavity of a subject (not shown) and operated by the operating handle portion 2. A treatment section 3 for holding a predetermined surgical instrument 5, the operation handle section 2 and the treatment section 3 are coupled, and the surgical instrument 5 held by the treatment section 3 is arranged at a predetermined position in a body cavity. And part 4.

1 and 2 show a state in which the connecting portion 4 is displaced and the position and direction of the treatment portion 3 (surgical instrument 5) are displaced three-dimensionally, that is, in the XYZ direction and the axis rotation θ direction. It is a thing.

(Structure of connecting part)
The feature of the present invention lies in the configuration of the connecting portion 4 which realizes such three-dimensional displacement/positioning of the surgical instrument 5, and will be described in detail below.

As shown in FIG. 1, the connecting portion 4 has two kinds of joint members 7, 8 arranged in series in the longitudinal direction of the connecting portion 4 like 7, 8, 7, 8, 7, 7, 8. Are connected to each other alternately and form joints between them.

FIG. 3 is an enlarged view showing a connection relationship between the above-mentioned two kinds of joint members (first joint member 7 and second joint member 8), and FIGS. 4A to 4D show the first joint. The front view, the plan view, the side view, and FIGS. 5A to 5D showing the member 7 are the front view, the plan view, and the side view showing the second joint member 8.

First, the first joint member 7 and the second joint member 8 are, as shown in the connection relationship in FIG. 3, respectively, the insertion portions 7a and 8a inserted into one joint member and the insertion portion of the other. It has outer insertion portions 7b and 8b for receiving the insertion of the portions 7a and 8a. The inner insertion portions 7a and 8a and the outer insertion portions 7b and 8b respectively form the connection portion of the present invention, and when they are connected, they form the joint of the connection portion 4.

As shown in FIG. 4, the outer insertion portion 7b of the first joint member 7 has a cylindrical shape and a holding hole 7c for holding the first connecting pin 9 in the diametrical direction. On the other hand, the inner insertion portion 8a of the second joint member 8 inserted into the outer insertion portion 7b of the first joint member 7 has an outer insertion portion of the first joint member 7 as shown in FIG. It has a pillar shape that fits the inner diameter of 7b, and has an engagement hole 8c that engages with the first connecting pin 9 mounted on the outer insertion portion 7b of the first joint member 7. The engagement hole 8c is composed of a recessed portion 8d that is provided in pairs in the diametrical direction at intervals of 30 degrees in the circumferential direction, and a connection passage 8e that connects adjacent recessed portions 8d. The recess 8d is configured to mesh with the first connecting pin 9 when the first and second joint members 7 and 8 are driven in a direction in which they approach each other (direction shown by an arrow in FIG. 3). ing. The connecting passage 8e is provided with the first connecting pin 9 and the recess 8d when the first and second joint members 7 and 8 are driven in a direction in which they are separated from each other (a direction opposite to the arrow in FIG. 3). Is disengaged to allow the connecting pin 9 to move between the recesses 8d.

On the other hand, as shown in FIG. 5, the second joint member 8 has a pair of opposing arms 8f, 8f extending in the axial direction as the outer insertion portion 8b. The tip portions of the pair of arms 8f are composed of a sharpened portion 8g that engages with a guide surface 7d and a stepped portion 7e, which will be described later, of the first joint member 7, and a sliding surface 8h that slides with the guide surface 7d. Composed. Further, the arm 8f is provided with the engaging hole 8c for holding the second connecting pin 10 suspended in a direction orthogonal to the central axis of the second joint member 8.

Then, as shown in FIG. 4, the first joint member 7 comes into contact with the arm 8f of the second joint member 8 and slides on the sliding surface 8h of the arm 8f to move the arm 8f. A guide surface 7d that guides around the second connecting pin 10 (in the direction of arrow B) and first and second step portions 7e that engage with the tip 8g of the arm 8f to fix the rotation angle. 7e' is provided.

Further, the inner insertion portion 7a of the first joint member 7 is provided with a center guide portion 7f that is inserted between a pair of arms 8f that are the outer insertion portions 8b of the second joint member 8, and this center portion 7f is provided. The guide portion 7f is provided with a holding hole 7g for holding the second connecting pin 10 suspended between the pair of arms 8f.

The holding hole portion 7g includes a second connecting pin 10 attached to the second joint member 8 at a position where the sharpened portion 8g engages with the first step portion 7e, and a second step portion. It has first and second recesses 7h and 7h' which are respectively held at positions where they engage with 7e'.

(Operation of connecting part)
6(a) and 6(b) are schematic diagrams showing an assembling mode of the first and second joint members 7 and 8 and a displacement operation in the front-rear direction.

As described above, the first and second joint members 7 and 8 insert one inner insertion portion 7a and 8a into the other outer insertion portion 7b and 8b with their central axes aligned. In this way, they are combined with each other, and are connected to each other by the first and second connecting pins 9 and 10 so as not to fall off. As a result, the connecting portion 4 having a plurality of joints is configured.

On the other hand, a slide guide 12 and a slider 13 which can slide and position in the axial direction along the slide guide 12 are attached to the operation handle portion 2. One end of a first drive wire 14 shown in the figure is fixed to the slider 13. The other end of the first drive wire 14 is fixed to the rear end of the treatment section 3 through the first and second joint members 7 and 8 connected to each other as shown by an arrow in the figure. There is.

In this embodiment, the tip portion 12a of the slide guide 12 is formed in the same shape as the outer insertion portion 8b of the second joint member 8, and the rear end of the coupling portion 4 is formed by the second coupling pin 10. And a portion (interpolated portion 7a of the first joint member 7).

Further, the rear end portion 3a of the treatment portion 3 is formed in the same shape as the inner insertion portion 8a of the second joint member 8, and is connected to the tip end portion of the connecting portion 4 by the first connecting pin 9. Has been done.

The length of extension of the first drive wire 14 from the slider 13 is adjusted by adjusting the connecting position of the slider 13 and the first drive wire 14. FIG. 6A shows a state in which the slider 13 is moved to the frontmost side, and FIG. 6B shows a state in which the slider 13 is moved to the rearmost side.

Here, in the state of FIG. 6( a ), the pay-out length of the first drive wire 14 is as shown in the figure between the first and second joint members 7 and 8 (between the connecting portions of the present invention). The gaps 16 and 17 are secured, and in the state of FIG. 6B, the gaps 16 and 17 are adjusted to be eliminated between the first and second joint members 7 and 8.

That is, as shown in FIG. 3, the second joint member 8 has a collar portion 8i formed between the inner insertion portion 8a and the outer insertion portion 8b, as shown in FIG. 6(a). In the state, the flange portion 8i of the second joint member 8 and the end surface 7i of the outer insertion portion 7b of the first joint member 7 are separated from each other to form the first gap 16. In this state, the second joint member 8 is rotatable about the central axis as shown by A in FIGS.

Then, by moving the slider 13 rearward to the state shown in FIG. 6B, the flange portion 8i of the second joint member 8 is attached to the end surface 7i of the outer insertion portion 7b of the first joint member 7. Are abutted to eliminate the first gap 16 to restrict further movement of the joint members 7 and 8 in the axial direction, and the first connecting pin 9 to the second joint. By engaging with the recess 8d of the member 8, the rotation around the central axis is also restricted.

Further, the second gap 17 shown in FIG. 6A is a gap between the step portion 7e formed in the first joint member 7 and the sharpened portion 8g of the second joint member 8, When the second gap 17 is present, the first and second joint members 7 and 8 are rotatable with respect to each other in the arrow B direction shown in FIG.

Then, by moving the slider 13 in the backward direction to the state shown in FIG. 6B, the second step portion 7e formed on the first joint member 7 and the second joint member 8 are separated from each other. The sharpened portion 8g is brought into contact with each other so that there is no gap. As a result, the first and second joint members are locked to each other and their rotations are restricted.

Hereinafter, the movement between the first and second joint members 7 and 8 will be described in more detail with reference to FIG.

In FIG. 7, portions where the first joint members 7 and 7 are attached to the front and rear of one second joint member 8 will be described.

7A and 7B show a state in which the slider 13 is positioned on the tip side (a state shown in FIG. 6A), and FIG. 7C shows the slider 13 at the rear end. It shows a state of being moved to the side (state shown in FIG. 6B).

In the state shown in FIG. 7A, the first joint member 7 attached to the front side of the second joint member 8 can be rotated about the axis orthogonal to the central axis as indicated by arrow B. Further, the first joint member 7 attached to the rear side of the second joint member 8 can be rotated around the central axis as indicated by arrow A.

In this state, FIG. 6B shows a state in which the sliders 13 are simply moved backward to eliminate the gaps 16 and 17, as described above.

On the other hand, in FIG. 7B, the first joint member 7 on the rear side is rotated by 30 degrees about the central axis, and the first joint member 7 on the front side is rotated by 30 degrees about the axis orthogonal to the central axis. This is a state in which they are made to move.

That is, the first joint member 7 on the front side is positioned at two angles (0 degree and 30 degrees) (directions indicated by arrow B) in accordance with the positions of the first and second step portions 7e and 7e'. It can be rotated as much as possible. The first joint member 7 on the rear side can be rotated clockwise by 0°, −30°, +30° (direction indicated by arrow A) in accordance with the position of the recess 8d. It is a thing.

FIG. 7C shows a state in which the slider 13 is moved rearward from the state shown in FIG. 7B. According to the configuration of this embodiment, as the slider 13 is moved, the postures of the first and second joint members 7 and 8 are adjusted in a self-aligning manner and fixed at a predetermined angle. There is. That is, between the first joint member 7 on the front side and the second joint member 8 in the central portion, the sliding surface 8h of the arm 8f of the second joint member 8 and the guide surface of the first joint member 7 are formed. 7d slides, and the sharpened portion 8g is guided and engaged with the stepped portion 7e to be positioned. As a result, even when the angle between the first joint member 7 and the second joint member 8 is initially deviated from 30 degrees or 0 degrees (no inclination), the sliding surface 8h and the guide portion 7d are formed. In the state where the second gap 17 is eliminated by being guided by, the position is fixed at 30 degrees or 0 degrees.

At this time, the upper end edge portion 7j of the first joint member 7 and the upper end edge portion 8j of the second joint member 8 are brought into contact with each other, and the second connecting pin 10 serves as the holding hole 7g. It is adapted to mesh with the recess 7h. As a result, the first joint member 7 and the second joint member 8 are eventually positioned and held at three points, and the posture is maintained in a highly rigid state even in a tilted state.

On the other hand, also with respect to the first joint member 7 and the second joint member 8 on the rear side, as the slider 13 moves rearward, the first connecting pin 9 is placed in one of the recesses 8d. Guided, meshed and positioned. As a result, when the gaps 16 and 17 are eliminated, the first and second joint members 7 and 8 are fixed at angles of 30°, 0°, and −30° with respect to each other. ..

According to such a configuration, in the state where the slider 13 is positioned on the front side as shown in FIG. 6A, the first and second joint members 7 and 8 are arranged around the central axis A and the central axis. Each of them is rotatable about an axis line B that is orthogonal to each other, and as a result, as shown in FIGS. 1 and 2, the connecting portion 4 can be freely deformed in the three-dimensional XYZ directions and the θ direction around the central axis line. ..

That is, in the state shown in FIG. 6( a ), the postures of the first and second joint members 7 and 8 can be freely displaced, but the first and second joint pins 9.10 can be used to move them from each other. The displacement is regulated so as not to fall off.

Then, when the slider 13 is moved rearward from the state shown in FIG. 6A to the state shown in FIG. 6B, the gap between the first and second joint members 7 and 8 is reduced. As they disappear, their postures are fixed at a predetermined angle in a self-aligning manner, and the shape of the freely deformed connecting portion 4 is fixed.

In addition, since the plurality of first and second joint members 7 and 8 constituting the connecting portion 4 can be moved along the first drive wire 14, in the process of moving the slider 13, , The first and second joint members 7 and 8 are fixed in rotation angles, and the desired three-dimensional shape is realized while adjusting the rotation angles of the other first and second joint members 7 and 8. You can Therefore, it is possible to determine an approximate shape before moving the slider 13 and then determine the final posture while moving the slide 13.

(Slider configuration)
Next, a more detailed structure and operation of the slider 13 will be described.

FIG. 8 is a schematic configuration diagram showing the slide guide 12, and FIGS. 9A and 9B are schematic diagrams showing the configuration of the slider 13 attached to the slide guide 12.

The slide guide 12 has a through passage 12b provided along the central axis, slits 12c provided on the through passage 12b and opening on the surface of the slide guide 12, and along the slit 12c at predetermined intervals in the axial direction. It has a plurality of notches 12d formed.

On the other hand, as shown in FIG. 9A, the slider 13 is inserted into the through passage 12b of the slide guide 12 (not shown in FIG. 9A) and is movable along the slide guide 12. 13a and an operation handle portion 13b that is externally inserted into the slide guide 12 and fixed to the main body 13a.

FIG. 9(b) shows only the main body 13a. As shown in this figure, the first drive wire 14 for controlling the posture of the connecting portion 4 is fixed to the front end portion of the main body 13a with a screw 15. Further, another second drive wire 18 for controlling the surgical instrument 5 is inserted into the main body 13a, and the second drive wire 18 is attached to the main body 13a so as to be slidable back and forth. It is attached to the instrument control slider 19. In addition, a main body projection 20 is provided at the rear end of the main body 13a so as to project outward in the axial direction.

When assembling the slider 13, first, the main body 13a is inserted from one end of the slide guide 12 into the through passage 12b, and then the operation handle portion 13b is externally inserted into the slide guide 12 and combined with the main body 13a.

FIG. 10 is a perspective view showing the operation handle portion 13b. When assembling, the slider front end 21 is removed and one end side of the slit 22 is opened, and the slider 19 is assembled so that the slider 19 enters the slit 22. A cylindrical gap 23 and a protrusion 24 protruding inward in the axial direction are provided inside the operation handle portion 13b. The protrusion 20 of the slider body 13a is accommodated in the gap 23 inside the handle, and the operation handle 13b can be rotated around the central axis of the slide guide 12. Further, as the operation handle portion 13b rotates, the handle inside projection 24 also rotates, and the projection portion 24 engages with the cutout portion 12d of the slide guide to fix the handle portion 13 so as not to move in the longitudinal direction. ..

Next, ring-shaped members indicated by reference numeral 13c in FIG. 9A are attached to both ends 19a and 19b of the surgical instrument control slider 19. The ring 13c is a handle for operating the surgical instrument control slider 19.

After the combination of the main body 13a, the operation handle portion 13b and the ring 13c is completed in this way, the slider front end 21 is fixed and one end of the slit 22 is closed.

The operation handle portion 13b engages with the main body projection 20 in the handle inner gap 23, and the operation handle portion 13b is moved in the axial direction, whereby the main body 13a can be moved in the same direction. .. On the other hand, although the operation handle 13b can be rotated about the central axis, the main body projection 20 remains in the slit 12c of the slide guide, so that the rotation of the main body 13a about the central axis is suppressed.

(Slider operation)
Next, a method of operating this handle will be described with reference to FIG.

As shown in FIG. 11A, as described above, the slider 13 is pulled backward along the slide guide 12 while the rotation angles of the other first and second joint members 7 and 8 are adjusted as desired. The process for determining the shape of the connecting portion 4 so as to realize the three-dimensional shape is shown.

Then, once the shape of the connecting portion 4 can be set to a desired shape, the operation handle portion 13b of the slider 13 is rotated about the axis by a predetermined angle in FIG. 11(b). As a result, the protrusion 24 (not shown) inside the operation handle can be engaged with the notch 12d and the slider 13 can be fixed so as not to move.

Next, FIGS. 11C and 11D show an operation of operating the surgical instrument 5 by operating the ring 13c to move the ring 13c relatively to the slider 13. It is a thing. In this embodiment, the surgical instrument 5 is “scissors” (shown in FIG. 1), and by moving FIG. 11(c) forward, the second drive wire 18 is driven forward to remove the scissors. It can be opened. Further, as shown in FIG. 11D, by moving the ring 13c in the rear direction, the scissors can be closed by the second drive wire 18.

According to the configuration as described above, it is possible to obtain a surgical instrument in which the connecting portion 4 can be three-dimensionally deformed, and in particular, a high degree of bending of 90 degrees or more with respect to the central axis of the operation handle portion 2 is possible. it can.

It should be noted that the present invention is not limited to the above-described one embodiment, and can be variously modified without changing the gist of the invention.

For example, in the above-described embodiment, the number of joints formed by the first and second joint members 7 and 8 is about 10, but this number is the required degree of deformation in the three-dimensional direction and the amount of deformation. It can be freely set according to.

Further, "two or more connecting portions" in the claims refers to "an interposing portion of one joint portion" and "an outer inserting portion of the other joint portion", and a pair of interpolating portions. Also, one joint that relatively rotates is configured by the outer insertion portion. For example, in the example of FIG. 6A, even if the distal end portion 12a of the slide guide 12 is directly connected to the rear end portion 3a of the treatment portion 3 except for the joint members 7 and 8, the slide is performed. The guide 12 and the treatment portion 3 are rotatably and positionably connected to each other around the connecting pin by "two or more connecting portions" to form one joint. In the sense that at least one joint is sufficient, the present invention can be realized even without the joint members 7 and 8 as in the above embodiment.

Further, in the above-described embodiment, the rotation angle about the major axis and the rotation angle about the axis in the direction orthogonal to the major axis of each joint are plus or minus 30 degrees, but the invention is not limited to this. Instead, it is also possible to set, for example, plus or minus 40 degrees.

In this way, by setting the number of joint members and joints and the rotatable angle, it is possible to change the range of motion of the joint according to the practitioner's preference or the contents of surgery.

For example, when the rotation angle around the major axis of the joint formed by the joints 7b and 8a is plus or minus 30 degrees, the moving range becomes plus or minus 60 degrees when two joints are used, and six joints are used. It becomes plus or minus 180 degrees. It should be noted that, when no one is used, that is, when only the joint constituted by the joints 7a and 8b is used, the rotation around the long axis becomes impossible, but such setting may of course be made.

On the other hand, when the rotation angle around the axis orthogonal to the long axis of the joint formed by the joints 7a and 8b is plus or minus 30 degrees, the use range of the two joints gives a movable range of plus or minus 60 degrees. It becomes plus or minus 180 degrees by using 6 pieces. It should be noted that when no one is used, that is, when only the joint formed by the joints 7b and 8a is used, the rotation around the axis orthogonal to the long axis becomes impossible, but such a setting may of course be made. ..

Further, in the above-described one embodiment, a surgical treatment section capable of joint movement like scissors has been described as an example of the surgical instrument, but the surgical instrument is not limited to this. For example, the surgical instrument can be replaced with a treatment section that does not require joint movement, such as a scalpel or a spatula. In this case, the second drive wire 18 connected to the treatment section 3 and the handle for driving the second drive wire 18 are unnecessary. In this case, the ring 13c can be removed or replaced with an operating handle that originally does not have this.

DESCRIPTION OF SYMBOLS 1... Minimally invasive surgical equipment 2... Operation handle part 3... Treatment part 3a... Rear end part 4... Connection part 5... Surgical instrument 7... 1st joint member 7a... Internal insertion part (connection part of this invention)
7b... Extrapolation part (connection part of this invention)
7c... Retaining hole 7d... Guide surface 7e... 1st step part 7e'... 2nd step part 7f... Center guide part 7g... Retaining hole 7h... Recess 7i... End surface 7j... Upper edge 8... 2nd joint member 8a... Interpolation part (connection part of this invention)
8b... Extrapolation part (connection part of this invention)
8c... Engaging hole 8d... Recessed portion 8e... Connection passage 8f... Arm 8g... Sharpened portion 8h... Sliding surface 8i... Collar portion 8j... Upper edge 9... First connecting pin 10... Second connecting pin 12 ...Slide guide 12a...Tip 12b...Through passage 12c...Slit 12d...Notch 13...Slider 13a...Main body 13b...Operation handle 13c...Ring 14...First drive wire 15...Screw 16...First gap 17 Second gap 18 Second drive wire 19 Surgical instrument control slider 19a One end 19b One end 20 Main body protrusion 21 Slider front end 22 Slit 23 Handle inner gap 24 Handle inner protrusion

Claims (12)

A minimally invasive surgical instrument (1) for performing a predetermined surgical operation, which is inserted into a body cavity through a skin incision part of a patient,
An operation handle part (2) operated by a user outside the body cavity, and a treatment part (3) which holds a predetermined surgical instrument (5) inserted into the body cavity and operated by the operation handle part (3) in a replaceable manner. For arranging a surgical instrument (5) provided between the operation handle portion (2) and the treatment portion (3) and held by the treatment portion (3) at a desired position in a body cavity in a desired posture Having a connecting portion (4),
The connecting part (4) is
Two or more connections that are connected in series in the long axis direction of the connecting portion (4) and are movably held in a direction along the central axis of the connecting section (4) so as to approach or separate from each other in the direction along the central axis. Has parts (7, 8),
The two or more connecting portions (7, 8) constitute a joint that enables rotation about the central axis or an axis orthogonal to the central axis by combining the two or more connecting portions (7, 8). Is what
Around the central axis of the joint by driving the two or more connecting portions (7, 8) in a direction in which they approach each other from positions separated from each other and engaging the connecting portions (7, 8) with each other. And/or an angle about an axis orthogonal to the central axis, thereby connecting the treatment section (3) at a desired position and posture in the body cavity with a connecting section control mechanism (13, 14). Then
The desired position and posture of the treatment section are such that an angle about the central axis of the joint and/or an axis orthogonal to the central axis of the joint in a state where the two or more connecting sections (7, 8) are separated from each other. The angle is defined by being held by the user to be displaced and defined, and the connecting part control mechanism (13, 14) moves the connecting parts (7, 8) in a direction approaching from a position separated from each other, A minimally invasive surgical instrument for fixing the position and posture of the treatment section (3) defined above. The minimally invasive surgical instrument according to claim 1,
The connecting portion control mechanism,
A connecting portion control slider that is slidable along the longitudinal direction on the operation handle portion and that can lock its movement at a predetermined position;
A flexible shaft member that is inserted through the inside of the connecting portion along the central axis thereof over the entire length, one end is fixed to the treatment portion side, and the other end is fixed to the connecting portion operation slider side;
A minimally invasive surgical instrument characterized in that the angle between the joints is opened or restrained by slidingly moving the connecting portion control slider along the longitudinal direction of the operation handle portion. The minimally invasive surgical instrument according to claim 1,
The connecting portion has one or both of a first joint that allows rotation about the major axis and a second joint that allows rotation about the axis orthogonal to the major axis. Minimally invasive surgical equipment. The minimally invasive surgical device according to claim 3,
The connection portion has a concave portion and a convex portion that can be engaged with each other, and the angle control portion releases the engagement between the concave portion and the convex portion when released and engages the concave portion and the convex portion when restrained. The minimally invasive surgical equipment is characterized in that the angle is fixed by doing so. The minimally invasive surgical device according to claim 3,
The minimally invasive surgical instrument characterized in that the connecting portion has a stopper mechanism that regulates a rotation angle around an axis orthogonal to the long axis. The minimally invasive surgical device according to claim 5,
The minimally invasive surgical instrument, wherein the regulated rotation angle is +-30 degrees. The minimally invasive surgical device according to claim 6,
The minimally invasive surgical instrument characterized in that the connecting part has a number of joints capable of maintaining a curved shape of 90 to 180 degrees by a plurality of joint parts. The minimally invasive surgical instrument according to claim 1,
The minimally invasive surgical instrument, wherein the connecting portion control slider is attached to a slide guide provided on the operation handle portion. The minimally invasive surgical instrument according to claim 8,
The shaft member is a tension transmission rod or wire,
The minimally invasive surgical instrument characterized in that the connecting portion control slider is a tension slider for adjusting the tension of the tension transmission rod. The minimally invasive surgical device according to claim 9,
A minimally invasive surgical instrument characterized in that the tension of the tension transmission rod or the wire is adjusted by operating the connecting portion control slider in parallel with the longitudinal axis of the handle. The minimally invasive surgical instrument according to claim 1,
further,
A flexible shaft member for controlling a surgical treatment portion, one end of which is connected to the surgical treatment portion, and the other end side of which is extended to the handle portion side through the inside of the connection portion,
A surgical operation part drive slider attached to a handle part in a state of being connected to the other end of the flexible shaft member for controlling a surgical operation part, which is a minimally invasive surgical instrument. The minimally invasive surgical device according to claim 11,
The minimally invasive surgical instrument, wherein the surgical treatment section drive slider is attached to the coupling section control slider and is provided so as to be movable with respect to the coupling section control slider.

Images