JPH08164141A - Treating tool - Google Patents
Treating toolInfo
- Publication number
- JPH08164141A JPH08164141A JP6308827A JP30882794A JPH08164141A JP H08164141 A JPH08164141 A JP H08164141A JP 6308827 A JP6308827 A JP 6308827A JP 30882794 A JP30882794 A JP 30882794A JP H08164141 A JPH08164141 A JP H08164141A
- Authority
- JP
- Japan
- Prior art keywords
- bending
- forceps
- treatment instrument
- treatment
- outer casing
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Abstract
PURPOSE: To provide a treating tool provided with highly rigid and free curva ture and capable of surely transmitting the operational feeling of an operating part. CONSTITUTION: This tool comprises a forceps 5, an insertion part 4 provided with a curvature part 2 to insert the forceps 5 into a body cavity, and the operating part 3 which drives the forceps 5, and a connection member which connects the operating part 3 to the forceps 5 is constituted of a flexible outer easing 17 and an inner cable 18 movable in an axial direction in the inside of the outer casing 17.
Description
【０００１】[0001]
【産業上の利用分野】この発明は、内視鏡下外科手術に
用いられる処置具に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment instrument used for endoscopic surgery.
【０００２】[0002]
【従来の技術】近年、胆のう摘出、虫垂切除、大腸切除
等の手術が内視鏡を用いることにより低侵襲に行われる
ようになった。この術式は一般に内視鏡下外科手術と呼
ばれ、トラカールと呼ばれる案内管を腹腔等の体腔内に
刺入し、このトラカールをガイドとして光学視管や処置
具を体腔内に挿入し、処置を行うものである。2. Description of the Related Art In recent years, operations such as excision of the gallbladder, excision of the appendix, and excision of the large intestine have been performed minimally by using an endoscope. This surgical procedure is generally called endoscopic surgery, in which a guide tube called a trocar is inserted into a body cavity such as the abdominal cavity, and an optical tube or a treatment tool is inserted into the body cavity using the trocar as a guide to perform treatment. Is to do.
【０００３】前記処置具は、挿入部の先端側に処置部を
有し、手元側に操作部を有した構造であるが、挿入部の
先端部の湾曲を可変させることができるものとして、例
えばＵＳＰ５２５４１３０が知られている。これはあら
かじめ湾曲形状を記憶させた超弾性チューブを固定され
た外筒管に出入りさせることで、湾曲を可変する方法で
ある。また、前記ＵＳＰ５２５４１３０には、超弾性チ
ューブの外側に回転用のチューブを設けることで、処置
具の先端部を回転する方法が開示されている。さらに、
ＥＰＯ５５７８０６Ａ２には関節構造をリンク構造を用
いて湾曲させる方法が開示されている。The treatment instrument has a treatment portion on the distal end side of the insertion portion and an operation portion on the proximal side, but as a device capable of changing the curvature of the distal end portion of the insertion portion, for example, USP 5254130 is known. This is a method in which the bending can be changed by moving a superelastic tube in which the curved shape is stored in advance into and out of a fixed outer tube. Further, USP 5254130 discloses a method of rotating a distal end portion of a treatment instrument by providing a rotating tube outside a superelastic tube. further,
EPO557806A2 discloses a method of bending a joint structure using a link structure.
【０００４】また、処置具マニピュレータを遠隔的に操
作して手術する手術装置が、ＵＳＰ５２１７００３、特
願平５−２８５２０６に開示されている。この手術装置
の構成は、手術処置機能を持った処置用マニピュレータ
と、この処置用マニピュレータを遠隔位置から操作する
ための情報入力手段、あるいは遠隔操作手段から構成さ
れている。A surgical device for operating a treatment instrument manipulator remotely is disclosed in US Pat. No. 5,217,003 and Japanese Patent Application No. 5-285206. The configuration of this surgical apparatus includes a treatment manipulator having a surgical treatment function, and information input means or remote control means for operating the treatment manipulator from a remote position.
【０００５】処置具の先端部を湾曲および回転させ、体
腔内での処置性を向上させる方法が前記ＵＳＰ５２５４
１３０に開示されている。また、体腔外に第２の湾曲部
を用いて体腔外の操作性を向上させる方法が文献「Ｉｎ
ｓｔｒｍｅｎｔｓ ｆｏｒＥｎｄｏｓｃｏｐｉｃ Ｓｕ
ｒｇｅｒｙ」に示されている。また、体腔内に複数の湾
曲手段を設け、処置性を向上させる方法が、特願平３−
３３９５９１に開示されている。A method of curving and rotating the distal end portion of a treatment tool to improve the procedural property in a body cavity is described in USP 5254.
130. In addition, a method for improving the operability outside the body cavity by using the second bending portion outside the body cavity is disclosed in "In.
struments for Endoscopic Su
rgery ”. Further, a method of providing a plurality of bending means in the body cavity to improve the procedural property is disclosed in Japanese Patent Application No.
339591.
【０００６】さらに、従来、内視鏡などの体腔内医療器
具の湾曲手段として、複数の節輪を連結した湾曲管構造
が用いられており、これは特願平５−２９４５２に開示
されている。この特願平５−２９４５２には超弾性合金
に切り欠きを多数設けることにより、一体の部材で製造
可能な湾曲構造が開示されている。Further, conventionally, a bending tube structure in which a plurality of node rings are connected has been used as a bending means for a medical device in a body cavity such as an endoscope, which is disclosed in Japanese Patent Application No. 5-29452. . This Japanese Patent Application No. 5-29452 discloses a curved structure that can be manufactured as an integral member by providing a notch in a superelastic alloy.
【０００７】また、内視鏡下外科手術を遠隔的に操作す
るための遠隔操作手段として、複数関節の握り装置から
なる医療用のマスターマニピュレータが、特願平６−１
２８６４８に開示されている。さらに、ワイヤを用いた
３次元的な位置の入力装置がＵＳＰ５３０５４２９に開
示されている。As a remote control means for remotely controlling endoscopic surgery, a medical master manipulator comprising a gripping device with a plurality of joints is disclosed in Japanese Patent Application No. 6-1.
28648. Further, US Pat. No. 5,305,429 discloses a three-dimensional position input device using a wire.
【０００８】[0008]
【発明が解決しようとする課題】しかしながら、前述し
た従来技術は次のような問題がある。まず、ＵＳＰ５２
５４１３０は、処置具の先端部の湾曲を可変させるため
に、あらかじめ湾曲形状を記憶させた超弾性チューブを
固定された外筒管に出入りさせているため、超弾性チユ
ーブと外筒管の摩擦のために、処置具操作中に湾曲を自
在に可変させることは困難である。また、操作に必要な
剛性を超弾性チューブに持たせるためには、外筒管によ
る抑制によって発生する応力が大きくなり超弾性チュー
ブの寿命は著しく短くなってしまい長期使用が困難であ
る。However, the above-mentioned prior art has the following problems. First, USP52
In 54130, in order to change the curvature of the distal end portion of the treatment tool, a superelastic tube in which the curved shape is stored in advance is put in and out of the fixed outer tube, so that there is no friction between the superelastic tube and the outer tube. Therefore, it is difficult to freely change the curve during operation of the treatment tool. Further, in order to provide the superelastic tube with the rigidity required for operation, the stress generated by the restraint by the outer tube becomes large and the life of the superelastic tube becomes remarkably shortened, which makes long-term use difficult.
【０００９】それに対して湾曲に関節構造を用いたＥＰ
０５５７８０６Ａ２の例では、高剛性を保ちながら自在
に湾曲させることが可能であるが、先端処置具を駆動す
るためのワイヤの経路が不確定であり、そのため処置具
を開く力によって剥離を行おうとしても、ワイヤが座屈
し、力が伝達されない。処置具を閉じる場合にも、ワイ
ヤのたるみにより直接的な操作感が伝達されない。On the other hand, EP using a joint structure for bending
In the example of 0557806A2, it is possible to freely bend while maintaining high rigidity, but the route of the wire for driving the distal treatment tool is uncertain, and therefore the force of opening the treatment tool is used for peeling. However, the wire buckles and the force is not transmitted. Even when the treatment tool is closed, the slack of the wire does not transmit a direct operation feeling.
【００１０】また、前記ＵＳＰ５２５４１３０では、超
弾性チューブの外側に回転部材を設けることにより、先
端処置具の回転を行っている。しかし、独立した回転部
材のために、処置具の外径が大きくなってしまう。In USP 5254130, the distal treatment instrument is rotated by providing a rotating member outside the superelastic tube. However, because of the independent rotating member, the outer diameter of the treatment tool becomes large.
【００１１】特願平５−２８５２０６に開示されている
処置用マニピュレータは、先端部の湾曲および処置具の
開閉を動力によって実現している。このような動力処置
具では、駆動部の駆動量と処置部の開閉量の関係が一意
的である。すなわちガタやゆるみの無い伝達構造が必要
となる。しかし、駆動部と処置部の間に可動の湾曲部を
有する伝達構造では、ガタやゆるみの無い構造を実現す
ることが困難であった。The treatment manipulator disclosed in Japanese Patent Application No. 5-285206 realizes the bending of the distal end portion and the opening / closing of the treatment tool by power. In such a power treatment instrument, the relationship between the drive amount of the drive unit and the opening / closing amount of the treatment unit is unique. That is, a transmission structure without looseness or looseness is required. However, with the transmission structure having the movable curved portion between the drive portion and the treatment portion, it is difficult to realize a structure without play or looseness.
【００１２】前記ＵＳＰ５２５４１３０に示されるよう
な湾曲処置具を用いることによって、先端部が湾曲して
いない場合に比較して体腔内で対象へのアプローチの自
由度が高くなる。しかし、体腔外では直線状であるた
め、他の処置具や、観察用硬性鏡などと干渉する可能性
がある。そこで文献「Ｉｎｓｔｒｍｅｎｔｓ ｆｏｒＥ
ｎｄｏｓｃｏｐｉｃ Ｓｕｒｇｅｒｙ」に体外に第２の
湾曲部を設ける技術が示されているが、本文献のような
ボールジョイントによる湾曲構造では処置具の開閉や先
端部の回転を行うための伝達構造を実現することが困難
である。By using the bending treatment tool as shown in USP 5254130, the degree of freedom in approaching the object in the body cavity is increased as compared with the case where the distal end portion is not curved. However, since it is linear outside the body cavity, it may interfere with other treatment tools, observation rigid endoscopes, and the like. Therefore, the document “Instruments for E”
A technique of providing a second bending portion outside the body is shown in "Ndoscopic Surgery", but the bending structure using a ball joint as in this document realizes a transmission structure for opening and closing the treatment tool and rotating the distal end portion. Is difficult.
【００１３】さらに、特願平５−２９４５２に開示され
ている、複数の節輪を連結した湾曲管構造では、湾曲管
内部の内蔵物の形状や硬さ、湾曲管と内蔵物との摩擦力
などによって湾曲形状が一定しないため、先端部の微妙
な位置決めが難しく、湾曲操作性が悪いという不具合が
生じている。Further, in the curved tube structure disclosed in Japanese Patent Application No. 5-29452, in which a plurality of node rings are connected, the shape and hardness of the internal body inside the curved tube and the frictional force between the curved tube and the internal body. Since the curved shape is not constant due to such factors, it is difficult to delicately position the tip end, and bending operability is poor.
【００１４】また特願平５−２９４５２に示されてい
る、超弾性合金に切り欠きを多数設けることにより、一
体の部材で製造可能な湾曲構造では、安価に製作できる
利点がある。しかし、切り欠き部に応力集中が発生する
ため、寿命が短く、また２箇所の繋ぎ目のみで力を受け
るため湾曲部の剛性が低いという欠点がある。Further, the curved structure which can be manufactured as an integral member by providing a large number of notches in the superelastic alloy, which is disclosed in Japanese Patent Application No. 5-29452, has an advantage that it can be manufactured at low cost. However, stress concentration occurs in the cutout portion, resulting in a short service life, and since the force is applied only at the two joints, the rigidity of the curved portion is low.
【００１５】特願平６−１２８６４８に開示されてい
る、内視鏡下外科手術を遠隔的に操作するための医療用
のマスターマニピュレータは、複数の関節から成り立っ
ているために、術者の身体と干渉し、自由な操作を妨げ
たり、関節を構成する部材の重量のために機敏な操作を
入力することが困難である。また、力を操作者にフィー
ドバックするためには、関節に駆動源を設ける必要があ
り、全体の構造が大きく、複雑になる。The medical master manipulator for remotely operating endoscopic surgery disclosed in Japanese Patent Application No. 6-128648 is composed of a plurality of joints, so that the body of the operator is not affected. It interferes with free operation and it is difficult to input agile operation due to the weight of the members constituting the joint. Further, in order to feed back the force to the operator, it is necessary to provide a drive source at the joint, and the overall structure is large and complicated.
【００１６】それに対し、ＵＳＰ５３０５４２９に開示
されている３次元的な位置の入力装置では、糸によって
３次元的な位置検出を行っているため、重量が軽く、機
敏な操作に追従する。また、力覚を提示する場合にも、
全体の構造が大きく、複雑になることがない。しかしな
がら、内視鏡下外科手術においては操作者は術者であ
り、従来の手術機器と同様の操作性であることが重要で
ある。On the other hand, in the three-dimensional position input device disclosed in US Pat. No. 5,305,429, since the three-dimensional position is detected by the thread, it is light in weight and follows agile operation. Also, when presenting force sense,
The overall structure is large and does not become complicated. However, in endoscopic surgery, the operator is the operator, and it is important that the operator has the same operability as conventional surgical instruments.
【００１７】この発明は、前述した諸々の事情に着目し
てなされたもので、その目的とするところは、高剛性と
自在な湾曲を実現しながら、処置具開閉の駆動力を確実
に伝達し、先端処置具からの直接的な操作感を伝達する
ことができ、操作性に優れた処置具を提供することにあ
る。The present invention has been made by paying attention to the above-mentioned various circumstances, and its purpose is to reliably transmit the driving force for opening and closing the treatment tool while realizing high rigidity and free bending. Another object of the present invention is to provide a treatment instrument which can transmit a direct operation feeling from the distal treatment instrument and has excellent operability.
【００１８】[0018]
【課題を解決するための手段】この発明は、前記目的を
達成するために、先端処置具と、この先端処置具を体腔
内に挿入するための湾曲部を有する挿入部と、前記先端
処置具を駆動させる操作部と、この操作部と前記先端処
置具とを連結する連結部材とを有する処置具において、
前記連結部材は、フレキシブルな外部材と、この外部材
の内部で軸方向に移動可能な内部材とで構成されたこと
を特徴とする。In order to achieve the above object, the present invention provides a distal treatment instrument, an insertion section having a curved portion for inserting the distal treatment instrument into a body cavity, and the distal treatment instrument. In a treatment tool having an operation part for driving the operation part and a connecting member for connecting the operation part and the distal treatment tool,
The connecting member may include a flexible outer member and an inner member that is axially movable inside the outer member.
【００１９】[0019]
【作用】操作部を操作することにより、湾曲ワイヤが軸
方向に移動して湾曲手段としての湾曲管が湾曲して湾曲
部が湾曲する。また、操作部の回転操作リングを回転す
ると、その回転力は外部材としてのアウターケーシング
を介して伝達されて先端処置具としての鉗子の全体が回
転する。さらに、操作部の操作握り及び操作ハンドルを
開閉することにより、内部材としてのインナーケーブル
がアウターケーシングに対して進退し、鉗子が開閉す
る。When the operating portion is operated, the bending wire is moved in the axial direction, the bending tube serving as the bending means is bent, and the bending portion is bent. Further, when the rotary operation ring of the operating portion is rotated, the rotational force is transmitted through the outer casing as an outer member, and the forceps as the distal treatment instrument is entirely rotated. Further, by opening and closing the operation grip and the operation handle of the operation unit, the inner cable as an inner member moves forward and backward with respect to the outer casing, and the forceps is opened and closed.
【００２０】[0020]
【実施例】以下、この発明の各実施例を図面に基づいて
説明する。図１〜図４は第１の実施例を示し、図１は処
置具の斜視図、図２は処置具の縦断側面図、図３はアウ
ターケーシングとインナーケーブルの構成図、図４は処
置具の作用説明図である。処置具は、先端に設けられた
先端処置具１、この処置具１を位置決めする湾曲部２、
先端処置具１と湾曲部２を操作する操作部３および操作
部３と湾曲部２を接続する挿入部４とから構成されてい
る。Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 show a first embodiment, FIG. 1 is a perspective view of a treatment instrument, FIG. 2 is a longitudinal side view of the treatment instrument, FIG. 3 is a configuration diagram of an outer casing and an inner cable, and FIG. 4 is a treatment instrument. FIG. The treatment tool includes a distal treatment tool 1 provided at a distal end, a bending portion 2 for positioning the treatment tool 1,
The distal treatment tool 1 and the operation section 3 for operating the bending section 2 and the insertion section 4 connecting the operation section 3 and the bending section 2 are configured.
【００２１】前記処置具１は枢支ピン５ａを支点として
回動自在な一対の鉗子片５ｂによって鉗子５が構成され
ており、一対の鉗子片５ｂの基端部は連結ピン６ａを介
してリンク６に連結されている。鉗子５およびリンク６
は鉗子回転シャフト７に開閉自在に支持されており、こ
の鉗子回転シャフト７の中央には鉗子回転シャフト７に
対して進退自在で、リンク６を進退させて鉗子５を開閉
する開閉ロッド８が設けられている。In the treatment instrument 1, the forceps 5 is composed of a pair of forceps pieces 5b rotatable about a pivot pin 5a as a fulcrum, and the base ends of the pair of forceps pieces 5b are linked via a connecting pin 6a. It is connected to 6. Forceps 5 and link 6
Is supported by a forceps rotating shaft 7 so as to be openable and closable. An opening and closing rod 8 is provided at the center of the forceps rotating shaft 7 so as to move forward and backward with respect to the forceps rotating shaft 7 and to move the link 6 forward and backward to open and close the forceps 5. Has been.
【００２２】前記湾曲部２は、多数の湾曲駒９が関節状
に接続された湾曲管１０と、前記鉗子回転シャフト７を
湾曲管１０に回転自在に固定する鉗子支持部１１とから
構成されている。湾曲管１０の内側には湾曲ワイヤ１
２、１３が挿通されており、この一端は湾曲管１０の端
部に固定され、他端は挿入パイプ１４の内部を挿通し、
この挿入パイプ１４に対して回転可能に固定された湾曲
操作ノブ１５に固定されている。湾曲管１０の操作部３
側端部は、挿入パイプ１４に固定されており、挿入パイ
プ１４は操作握り１６に固定されている。The bending portion 2 is composed of a bending tube 10 to which a large number of bending pieces 9 are jointly connected, and a forceps support portion 11 for rotatably fixing the forceps rotating shaft 7 to the bending tube 10. There is. The bending wire 1 is provided inside the bending tube 10.
2 and 13 are inserted, one end of which is fixed to the end of the bending tube 10 and the other end of which is inserted through the inside of the insertion pipe 14,
It is fixed to a bending operation knob 15 that is rotatably fixed to the insertion pipe 14. Operation part 3 of bending tube 10
The side end portion is fixed to the insertion pipe 14, and the insertion pipe 14 is fixed to the operation grip 16.
【００２３】前記湾曲部２の内腔には、管状のフレキシ
ブルな外装部材であるアウターケーシング１７が設けら
れ、更にその内部にはフレキシブルな棒状の内装部材で
あるインナーケーブル１８が設けられている。アウター
ケーシング１７は、湾曲管１０およびインナーケーブル
１８に対して回転自在であり、インナーケーブル１８は
アウターケーシング１７に対して進退自在である。アウ
ターケーシング１７の先端処置具１側端部は、鉗子回転
シャフト７に固定されており、操作部３側端部は中空の
回転伝達軸１９に固定されている。An outer casing 17 which is a tubular flexible exterior member is provided in the inner cavity of the curved portion 2, and an inner cable 18 which is a flexible rod-shaped interior member is provided inside the outer casing 17. The outer casing 17 is rotatable with respect to the bending tube 10 and the inner cable 18, and the inner cable 18 is movable back and forth with respect to the outer casing 17. An end portion of the outer casing 17 on the distal treatment instrument 1 side is fixed to the forceps rotation shaft 7, and an end portion on the operation portion 3 side is fixed to a hollow rotation transmission shaft 19.
【００２４】前記回転伝達軸１９は挿入パイプ１４に対
して回転自在な回転操作リング２０に固定されている。
インナーケーブル１８の先端処置具１側端部は開閉ロッ
ド８に固定され、操作部３側端部には挿入パイプ１４に
挿通された直動ロッド２１に固定されている。直動ロッ
ド２１は、操作握り１６に対して支点を中心に回動可能
な操作ハンドル２２に固定されている。The rotation transmission shaft 19 is fixed to a rotary operation ring 20 which is rotatable with respect to the insertion pipe 14.
An end of the inner cable 18 on the distal treatment instrument 1 side is fixed to the opening / closing rod 8, and an end of the inner cable 18 on the operating portion 3 side is fixed to a direct acting rod 21 inserted through the insertion pipe 14. The linear motion rod 21 is fixed to an operation handle 22 which is rotatable around a fulcrum with respect to the operation grip 16.
【００２５】前記アウターケーシング１７とインナーケ
ーブル１８について説明を加えると、図３に示すように
構成されている。すなわち、アウターケーシング１７
は、ステンレス製の平角スプリング２３およびこの平角
スプリング２３の外側に設けられたステンレス製のブレ
ード２４と、それらの外側に施されたフッ素樹脂による
樹脂コーティング２５より構成されている。インナーケ
ーブル１８は、ステンレス製の芯線２６と、その周囲に
よられた芯線２６よりも細いステンレス製の側線２７と
から構成されている。The outer casing 17 and the inner cable 18 will be described below with reference to FIG. That is, the outer casing 17
Is composed of a flat spring 23 made of stainless steel, a blade 24 made of stainless steel provided on the outside of the flat spring 23, and a resin coating 25 made of a fluororesin on the outside thereof. The inner cable 18 is composed of a stainless steel core wire 26 and a stainless steel side wire 27 that is thinner than the core wire 26 around the core wire 26.
【００２６】インナーケーブル１８は、芯線２６と側線
２７によるより線構造を取ることで、フレキシブルに湾
曲することが可能である。前記鉗子５を閉じようとした
場合に発生するインナーケーブル１８を伸長する力に関
しては、より線が密に寄り合うことで伸長を防止し、鉗
子５を開こうとする場合に発生する、インナーケーブル
１８を圧縮する力に関しては、中心の太い芯線２６によ
って座屈を防止する。The inner cable 18 can be flexibly bent by adopting a stranded wire structure composed of the core wire 26 and the side wire 27. Regarding the force for extending the inner cable 18 generated when the forceps 5 is closed, the inner cables are generated when the forceps 5 are opened by preventing the extension by tightly twisting the twisted wires. Regarding the force of compressing 18, the buckling is prevented by the thick core wire 26 at the center.
【００２７】アウターケーシング１７は平角スプリング
２３、ブレード２４、樹脂コーティング２５によるフレ
キシブルな構造により湾曲が可能である。鉗子５を閉じ
ようとした場合に発生するアウターケーシング１７を圧
縮する力に関しては、平角スプリング２３が密着するこ
とで座屈を防止する。鉗子５を開こうとする場合に発生
する、アウターケーシング１７を伸長する力に関して
は、平角スプリング２３の収縮力とブレード２４および
樹脂コーティング２５によって伸びを抑制する。また、
回転力は、主としてブレード２４と樹脂コーティング２
５により左右両回転とも伝達される。The outer casing 17 can be bent by a flexible structure including the flat spring 23, the blade 24, and the resin coating 25. Regarding the force that compresses the outer casing 17 when the forceps 5 is closed, the flat springs 23 are in close contact with each other to prevent buckling. Regarding the force for expanding the outer casing 17 generated when the forceps 5 is opened, the contraction force of the flat spring 23 and the blade 24 and the resin coating 25 suppress the expansion. Also,
The rotational force is mainly due to the blade 24 and the resin coating 2
Both left and right rotations are transmitted by 5.
【００２８】次に、前述のように構成された処置具の作
用について説明する。操作部３の湾曲操作ノブ１５を操
作することにより、湾曲ワイヤ１２、１３が軸方向に差
動的に動作して湾曲管１０が湾曲し、湾曲部２が湾曲す
る。また、回転操作リング２０を回転すると、その回転
力は回転伝達軸１９、アウターケーシング１７、鉗子回
転シャフト７と伝達されて鉗子５の全体が回転する。さ
らに、操作握り１６及び操作ハンドル２２を開閉するこ
とにより、直動ロッド２１が回転伝達軸１９に対して進
退し、インナーケーブル１８がアウターケーシング１７
に対して進退し、開閉ロッド８が鉗子回転シャフト７に
対して進退して鉗子５が開閉する。Next, the operation of the treatment tool constructed as described above will be described. By operating the bending operation knob 15 of the operation section 3, the bending wires 12 and 13 are differentially operated in the axial direction to bend the bending tube 10 and bend the bending section 2. Further, when the rotary operation ring 20 is rotated, its rotational force is transmitted to the rotation transmission shaft 19, the outer casing 17, and the forceps rotation shaft 7, and the forceps 5 as a whole rotate. Further, by opening and closing the operation grip 16 and the operation handle 22, the direct-acting rod 21 moves back and forth with respect to the rotation transmission shaft 19, and the inner cable 18 moves the outer casing 17.
The open / close rod 8 moves back and forth with respect to the forceps rotation shaft 7, and the forceps 5 opens and closes.
【００２９】したがって、図４に示すように湾曲部２の
湾曲時に鉗子５を生体組織Ａの剥離のために開こうとし
た場合、図４（ａ）に示すように直動ロッド２１を先端
側へ押そうとする力によって、インナーケーブル１８に
撓もうとする力が働くが、図４（ｂ）に示すように、イ
ンナーケーブル１８がアウターケーシング１７により拘
束されているために、鉗子５を開く力が先端に確実に伝
達される。Therefore, when the forceps 5 is opened to detach the living tissue A when the bending portion 2 is bent as shown in FIG. 4, the linear motion rod 21 is moved to the distal end side as shown in FIG. 4 (a). A force that tends to bend the inner cable 18 is exerted by the force that pushes it in, but since the inner cable 18 is constrained by the outer casing 17 as shown in FIG. 4B, the forceps 5 is opened. The force is reliably transmitted to the tip.
【００３０】また、インナーケーブル１８が、アウター
ケーシング１７により拘束されているために湾曲部２の
湾曲による経路の長さ変化がなく、湾曲している場合と
しない場合で同じ操作感で鉗子５の開閉操作を行うこと
ができる。Further, since the inner cable 18 is restrained by the outer casing 17, there is no change in the length of the path due to the bending of the bending portion 2, and the forceps 5 of the forceps 5 can be operated with and without the bending. It can be opened and closed.
【００３１】また、湾曲部２による湾曲とアウターケー
シング１７による回転を同時に行えるため、鉗子５に縫
合針を保持して行う縫合などの複雑な操作を行うことが
容易になる。さらに、湾曲部２を関節を有する構造によ
っているため、操作力が小さく、繰り返しの使用に対し
て耐久性が高い。Further, since the bending by the bending portion 2 and the rotation by the outer casing 17 can be performed at the same time, it becomes easy to perform a complicated operation such as suturing performed while holding the suture needle on the forceps 5. Furthermore, since the bending portion 2 has a structure having joints, the operating force is small and the durability is high against repeated use.
【００３２】図５は第２の実施例を示し、アウターケー
シング１７およびインナーケーブル１８の他の実施例で
ある。図５（ａ）〜（ｃ）はアウターケーシング１７の
構成で、図５（ｄ）（ｅ）はインナーケーブル１８の構
成である。FIG. 5 shows a second embodiment, which is another embodiment of the outer casing 17 and the inner cable 18. 5A to 5C show the structure of the outer casing 17, and FIGS. 5D and 5E show the structure of the inner cable 18.
【００３３】（ａ）に示すアウターケーシング１７は、
平角スプリング２８とその外側に施されたフッ素樹脂に
よる樹脂コーティング２９により構成されている。そし
て、圧縮力は平角スプリング２８で受け、伸長力は樹脂
コーティング２９で受けるようになっている。The outer casing 17 shown in FIG.
It is composed of a flat spring 28 and a resin coating 29 made of fluorine resin on the outside thereof. The compression force is received by the flat spring 28, and the extension force is received by the resin coating 29.
【００３４】（ｂ）に示すアウターケーシング１７は、
一層多条巻きのスプリング３０で構成されている。そし
て、圧縮力および引張り力に対しては、スプリング３０
自身の剛性で受ける。回転力はスプリング３０が締まる
方向に対して伝達されるが、緩む方向の回転伝達力は比
較的小さい。The outer casing 17 shown in (b) is
It is composed of a spring 30 with more windings. Then, for the compressive force and the tensile force, the spring 30
You receive it with your own rigidity. The rotational force is transmitted in the direction in which the spring 30 is tightened, but the rotational force in the loosening direction is relatively small.
【００３５】（ｃ）に示すアウターケーシング１７は、
多層多条巻きのスプリング３１で構成されている。スプ
リング３１の巻き方向を層ごとに変えることにより、左
右両方向の力の伝達を可能にしている。The outer casing 17 shown in (c) is
It is composed of a multi-layer multi-winding spring 31. By changing the winding direction of the spring 31 for each layer, the force can be transmitted in both the left and right directions.
【００３６】（ｄ）に示すインナーケーブル１８は、芯
線３２と側線３３よりなる、より線で構成されている。
この構成によれば、座屈への耐力が小さいが湾曲性が良
いという特徴がある。The inner cable 18 shown in (d) is composed of a stranded wire consisting of a core wire 32 and a side wire 33.
According to this configuration, the proof stress against buckling is small, but the bendability is good.
【００３７】（ｅ）に示すインナーケーブル１８は、芯
線３４及び巻き線３５で構成されている。座屈力に対し
ては、巻き線３４が受けるという構造になっている。図
６および図７は第３の実施例を示し、湾曲部２に構造と
して湾曲管１０の代わりに３節のリンク湾曲部４０によ
り構成したものであり、第１の実施例と同一構成部分は
同一番号を付して説明を省略する。The inner cable 18 shown in (e) is composed of a core wire 34 and a winding wire 35. The winding 34 receives the buckling force. 6 and 7 show a third embodiment, in which the bending portion 2 is structured by a link bending portion 40 of three sections instead of the bending tube 10, and the same components as those of the first embodiment are provided. The same numbers are assigned and the description is omitted.
【００３８】図６は処置具の斜視図、図７はリンク湾曲
部４０の構造を示す。このリンク湾曲部４０は、第１リ
ンク４１と第２リンク４２とは左右対称的に配置され円
環状をなしている。第１リンク４１の端部と第２リンク
４２の中心は、リンク湾曲部４０の両端に固定されてい
る。第１リンク４１と第２リンク４２にはそれぞれ湾曲
ワイヤ４３、４４が連結されており、湾曲ワイヤ４３、
４４の移動量に対して線形な湾曲形状が得られる。FIG. 6 is a perspective view of the treatment tool, and FIG. 7 shows the structure of the link bending portion 40. In the link curved portion 40, the first link 41 and the second link 42 are arranged symmetrically in the left-right direction and have an annular shape. The ends of the first link 41 and the center of the second link 42 are fixed to both ends of the link curved portion 40. Bending wires 43 and 44 are connected to the first link 41 and the second link 42, respectively.
A linear curved shape is obtained with respect to the movement amount of 44.
【００３９】図８は第４の実施例を示し、第３の実施例
の第１リンク４１と第２リンク４２の内側に、円環状に
配置した第３リンク４５および第４リンク４６を用いて
も同様に構成できる。FIG. 8 shows a fourth embodiment, in which a third link 45 and a fourth link 46 arranged in an annular shape are used inside the first link 41 and the second link 42 of the third embodiment. Can be similarly configured.
【００４０】第３および第４の実施例によれば、第１の
実施例の効果に加えて、湾曲形状が外力や湾曲部２の内
蔵物の影響を受けず湾曲ワイヤ４３、４４の移動量によ
って一意的に定まるという効果がある。また、本構造
は、処置具の湾曲部のみならず、内視鏡などの体腔内で
用いる医療機器に広く用いることができることは自明で
ある。According to the third and fourth embodiments, in addition to the effect of the first embodiment, the amount of movement of the bending wires 43, 44 is not influenced by the external force or the internal components of the bending portion 2 in the bending shape. Has the effect of being uniquely determined by. Further, it is obvious that the present structure can be widely used not only for the curved portion of the treatment instrument but also for medical devices used in a body cavity such as an endoscope.
【００４１】図９は第５実施例を示す。第１の実施例に
おける湾曲管１０の代わりに、薄肉円筒体５０の周壁を
部分的に欠如した、伸縮可能な伸縮部４７および可倒可
能な可倒部４８によって湾曲コマ４９を連接した多段湾
曲管５０ａを構成したものである。可倒部４８は、その
両端部に２つの弧状の切り欠きを設けた２つの脆弱部５
１により構成されている。FIG. 9 shows a fifth embodiment. Instead of the bending tube 10 in the first embodiment, a multi-layer bending in which a bending piece 49 is connected by an extendable and retractable portion 47 and a collapsible and collapsible portion 48 in which a peripheral wall of a thin-walled cylindrical body 50 is partially omitted. The tube 50a is configured. The collapsible portion 48 has two fragile portions 5 provided with two arc-shaped notches at both ends thereof.
It is composed of 1.
【００４２】それぞれの湾曲コマ４９は、可倒部４８を
支点として可倒する。可倒による変形は脆弱部５１に集
中するが、脆弱部５１は弧状の切り欠き形状であるた
め、応力集中による破壊を防いでいる。また、可倒部４
８を２つの脆弱部５１から実現しているために、一つの
脆弱部５１当たりの変形量が小さい。伸縮部４７は、そ
の両端部に４つの弧状の切り欠きを設けた４つの脆弱部
５１よりなっている。伸縮部４７は、可倒部４８と同様
の脆弱部５１を関節とするリンク構造を形成しているた
め、軸方向に伸縮可能な構造となっている。Each of the bending pieces 49 is foldable with the foldable portion 48 as a fulcrum. Deformation due to folding is concentrated on the fragile portion 51, but since the fragile portion 51 has an arcuate notch shape, it is prevented from being broken due to stress concentration. Also, the collapsible section 4
Since 8 is realized by the two fragile portions 51, the deformation amount per one fragile portion 51 is small. The expansion / contraction part 47 is composed of four fragile parts 51 having four arc-shaped cutouts at both ends thereof. The expansion / contraction part 47 has a structure similar to that of the inclinable part 48, and has a link structure with the fragile part 51 as a joint.
【００４３】また、脆弱部５１は弾性を有するため、リ
ンク構造全体として伸縮方向に対しばね性を持ってお
り、外力が加わらないときは、多段湾曲管５０ａが元の
形状に戻るという性質を持っている。可倒部４８と伸縮
部４７はそれぞれ対向しており、それぞれの段ごとに可
倒部４８と伸縮部４７の配置を入れ換えることによっ
て、上下左右２自由度に湾曲することが可能になる。Further, since the fragile portion 51 has elasticity, the link structure as a whole has a spring property in the direction of expansion and contraction, and when the external force is not applied, the multistage bending tube 50a has a property of returning to its original shape. ing. The collapsible portion 48 and the stretchable portion 47 are opposed to each other, and by changing the arrangement of the collapsible portion 48 and the stretchable portion 47 for each step, it is possible to bend in two degrees of freedom in the vertical and horizontal directions.
【００４４】本実施例によれば、第１の実施例の効果に
加えて、湾曲構造を一体成型や、一体加工により製造す
ることができ、従来に比して低いコストで製造できると
いう効果を持つ。また、湾曲コマ４９の接続部を可倒部
４８と伸縮部４７の４箇所で結合しているため、湾曲構
造全体の剛性が高い。また、切り欠き部を設けることで
湾曲を実現しているにも拘らず、応力集中しにくい構造
を取ることで、高寿命を実現している。また、本構造
は、処置具の湾曲部のみならず、内視鏡などの体腔内で
用いる医療機器に広く用いることができることは自明で
ある。According to the present embodiment, in addition to the effects of the first embodiment, the curved structure can be manufactured by integral molding or integral processing, and the cost can be reduced compared to the conventional case. To have. Further, since the connecting portion of the bending piece 49 is connected at four points of the inclinable portion 48 and the stretchable portion 47, the rigidity of the entire bending structure is high. In addition, despite the fact that the cutout portion is provided to achieve bending, a structure in which stress is less likely to concentrate is used to achieve long life. Further, it is obvious that the present structure can be widely used not only for the curved portion of the treatment instrument but also for medical devices used in a body cavity such as an endoscope.
【００４５】図１０および図１１は第６の実施例を示
し、第１の実施例と同一構成部分は同一番号を付して説
明を省略する。本実施例の処置具は、第１の実施例の構
成に加え、挿入部４の操作部３側に更にもう一つの第２
の湾曲部５２を設けている。第２の湾曲部５２は、通常
は形状を保つが外力によって湾曲形状が変更可能な中空
のベローズ５３と、このベローズ５３の内側に第１の実
施例と同様のアウターケーシング５４とインナーケーブ
ル５５が設けられている。10 and 11 show a sixth embodiment. The same components as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted. In addition to the configuration of the first embodiment, the treatment tool of the present embodiment has a second member, which is provided on the side of the operation unit 3 of the insertion unit 4.
The curved portion 52 is provided. The second curved portion 52 usually has a hollow bellows 53 that retains its shape, but the curved shape can be changed by an external force, and an outer casing 54 and an inner cable 55 similar to those of the first embodiment are provided inside the bellows 53. It is provided.
【００４６】アウターケーシング５４は、回転操作リン
グ２０に固定された第１の回転伝達軸５６と、第１の湾
曲部２のアウターケーシング１７に固定されている第２
の回転伝達軸５７とを接続している。インナーケーブル
５５は、操作ハンドル２２に固定された第１の直動ロッ
ド５８と、第１の湾曲部２のインナーケーブル１８に固
定されている第２の直動ロッド５９とを接続している。The outer casing 54 has a first rotation transmission shaft 56 fixed to the rotary operation ring 20, and a second rotation transmission shaft 56 fixed to the outer casing 17 of the first bending portion 2.
Is connected to the rotation transmission shaft 57. The inner cable 55 connects the first linear motion rod 58 fixed to the operation handle 22 and the second linear motion rod 59 fixed to the inner cable 18 of the first bending portion 2.
【００４７】本実施例では、第２の湾曲部５２として半
固定のものを用いているが、第１の実施例と同様の可動
の湾曲部を用いることも可能である。したがって、回転
操作リング２０を回転させると、その回転力が第１の回
転伝達軸５６、アウターケーシング５４、第２の回転伝
達軸５７によって伝達され、鉗子５を回転させることが
できる。操作ハンドル２２を開閉すると、第１の直動ロ
ッド５８、インナーケーブル５５、第２の直動ロッド５
９によって伝達される鉗子５を開閉させることができ
る。In the present embodiment, the semi-fixed one is used as the second bending portion 52, but it is also possible to use the same movable bending portion as in the first embodiment. Therefore, when the rotary operation ring 20 is rotated, the rotational force is transmitted by the first rotation transmission shaft 56, the outer casing 54, and the second rotation transmission shaft 57, and the forceps 5 can be rotated. When the operation handle 22 is opened and closed, the first direct acting rod 58, the inner cable 55, and the second direct acting rod 5
The forceps 5 transmitted by 9 can be opened and closed.
【００４８】本実施例によれば、第１の実施例に示され
た効果に加え、内視鏡外科手術では、図１１に示される
ように、皮膚６０に筒状のトラカール６１を挿入し、ト
ラカール６１をガイドとして処置具としての鉗子６２を
挿入する。手術時には、複数の鉗子６３や観察用の内視
鏡６４が複数のトラカール６１から挿入される。このよ
うな状況で体外に第２の湾曲部５２を持つことにより、
術者の操作が行いやすくなり、また鉗子６２の方向を変
えるために体表に新たに操作用の孔を開ける必要が減少
すると考えられる。According to this embodiment, in addition to the effects shown in the first embodiment, in endoscopic surgery, a tubular trocar 61 is inserted into the skin 60 as shown in FIG. The forceps 62 as a treatment tool is inserted using the trocar 61 as a guide. At the time of surgery, a plurality of forceps 63 and an endoscope 64 for observation are inserted from a plurality of trocars 61. By having the second curved portion 52 outside the body in such a situation,
It is considered that the operation of the operator is facilitated, and the need to newly open a hole for operation on the body surface in order to change the direction of the forceps 62 is considered to be reduced.
【００４９】図１２〜図１４は第７の実施例を示す。本
実施例は、図１２に示すように、術者が操作する操作入
力装置６５、モータコントロールユニット６６および処
置用マニピュレータ６７を備えている。操作入力装置６
５は術者の手６８の位置、姿勢、把持の情報を読取り、
この情報に基づきモータコントロールユニット６６は、
位置、姿勢情報に基づき、処置用マニピュレータ６７を
制御させることができる。処置用マニピュレータ６７の
先端部は手術台６９上に固定された患者７０の体内に挿
入されたトラカール７１を挿通されており、患部の処置
を行うことができる。処置用マニピュレータ６７は、円
筒座標系に基づいて動作する３自由度のロボットアーム
７２および上下および回転の２自由度を持つ自在関節７
３と、先端部を動作させる挿入部７４および挿入部７４
を回転させるホルダ７５とから構成されている。12 to 14 show a seventh embodiment. As shown in FIG. 12, this embodiment includes an operation input device 65 operated by an operator, a motor control unit 66, and a treatment manipulator 67. Operation input device 6
5 reads information on the position, posture, and grip of the operator's hand 68,
Based on this information, the motor control unit 66
The treatment manipulator 67 can be controlled based on the position and orientation information. The trocar 71 inserted into the body of the patient 70 fixed on the operating table 69 is inserted into the distal end portion of the treatment manipulator 67, so that the affected portion can be treated. The treatment manipulator 67 includes a robot arm 72 having three degrees of freedom that operates based on a cylindrical coordinate system, and a universal joint 7 having two degrees of freedom of up and down and rotation.
3, and the insertion portion 74 and the insertion portion 74 for operating the tip end portion
And a holder 75 for rotating.
【００５０】前記操作入力装置６５は、図１３に示すよ
うに、立方体形状の枠体７６の角部頂点の部分に、それ
ぞれプーリ７７が配置され、それぞれのプーリ７７には
ワイヤ７８が掛けられている。６本のワイヤ７８は対角
面を形成する３本ずつのグループ７９、８０に分けら
れ、それぞれのグループ７９，８０は棒状の操作部８１
の２ヶ所の近傍のフランジ部８２、８３に取り付けられ
ている。操作部８１の終端には把持用のハンドル８４が
取り付けられている。それぞれのワイヤ７８の終端には
モータ８５とエンコーダ８６が取り付けられ、ワイヤ７
８の引き込み量を計測すると同時に、ワイヤ７８に自由
に張力を与えられるようになっている。In the operation input device 65, as shown in FIG. 13, pulleys 77 are arranged at the corners of the corners of a cubic frame 76, and wires 78 are wound around the pulleys 77. There is. The six wires 78 are divided into three groups 79 and 80 each forming a diagonal surface, and each group 79 and 80 has a rod-shaped operating portion 81.
Are attached to the flange portions 82 and 83 in the vicinity of the two positions. A handle 84 for gripping is attached to the end of the operation portion 81. A motor 85 and an encoder 86 are attached to the end of each wire 78,
At the same time as measuring the pulling amount of No. 8, the wire 78 can be tensioned freely.
【００５１】前記ハンドル８４には把持力を測定する力
センサ８７が設けられている。エンコーダ８６の出力よ
り求められるそれぞれのワイヤ７８の長さから操作部８
１の３次元位置と姿勢が求まる。それぞれのワイヤ７８
の張力を可変することで操作部８１には反力が伝達され
る。モータ８５の代わりにばねを用いても、位置・姿勢
入力装置として用いることができる。力センサ８７の代
わりに把持用ハンドル８４の開閉角度を検出するエンコ
ーダを設けても、操作入力とすることができる。The handle 84 is provided with a force sensor 87 for measuring the gripping force. From the length of each wire 78 obtained from the output of the encoder 86, the operation unit 8
The three-dimensional position and posture of 1 are obtained. Each wire 78
The reaction force is transmitted to the operation portion 81 by changing the tension of the. Even if a spring is used instead of the motor 85, it can be used as a position / orientation input device. It is also possible to provide an operation input by providing an encoder that detects the opening / closing angle of the grip handle 84 instead of the force sensor 87.
【００５２】図１４は処置具の構成を示す。挿入部９０
は、鉗子を有する先端部９１と湾曲部９２および駆動部
９３とから構成されている。湾曲部９２は、上下・左右
２自由度に湾曲する湾曲管９４とこの湾曲管９４を操作
する上下用、左右用それぞれ対向する２本ずつ２組の操
作ワイヤ９５、９６および第１の実施例と同様のアウタ
ーケーシング９７およびインナーケーブル９８とから構
成されている。FIG. 14 shows the structure of the treatment tool. Insertion part 90
Is composed of a tip portion 91 having forceps, a bending portion 92, and a driving portion 93. The bending portion 92 includes a bending tube 94 that bends in two degrees of freedom in the vertical and horizontal directions, two sets of operation wires 95 and 96 that oppose each of the upper and lower sides and the left and right sides that operate the bending tube 94, and the first embodiment. The outer casing 97 and the inner cable 98, which are similar to the above, are included.
【００５３】アウターケーシング９７は鉗子支持部９９
および駆動部９３の挿入パイプ１００に固定され、イン
ナーケーブル９８は、鉗子開閉ロッド１０１および駆動
部９３の直動ロッド１０２に固定されている。操作ワイ
ヤ９５、９６は、モータ１０３、エンコーダ１０４およ
びボールネジ１０５とプーリ１０６により構成される直
動アクチュエータ１０７のボールネジナット１０８に接
続固定されている。直動ロッド１０２も、同様のモータ
１０３、エンコーダ１０４およびボールネジ１０５によ
り構成される直動アクチュエータ１０７のボールネジナ
ット１０８に接続固定されている。The outer casing 97 is a forceps supporting portion 99.
Also, the inner cable 98 is fixed to the insertion pipe 100 of the drive unit 93, and the inner cable 98 is fixed to the forceps opening / closing rod 101 and the linear motion rod 102 of the drive unit 93. The operation wires 95 and 96 are connected and fixed to a ball screw nut 108 of a linear actuator 107 composed of a motor 103, an encoder 104, a ball screw 105 and a pulley 106. The direct-acting rod 102 is also connected and fixed to a ball screw nut 108 of a direct-acting actuator 107 composed of the same motor 103, encoder 104 and ball screw 105.
【００５４】したがって、術者は、操作入力装置６５を
操作し、処置用マニピュレータ６７を動作させて患者７
０の処置を行う。操作入力装置６５により得られた術者
の手６８の位置・姿勢・把持状態の情報は、コントロー
ルユニット６６に入力され、ロボットアーム７２の操作
量、ホルダ７３の挿入部７４の回転量、挿入部７４の湾
曲部９２の湾曲量および鉗子１０９の開閉角度に変換さ
れる。駆動部９３では、モータ１０３の回転によりボー
ルネジナット１０８が進退し、その進退に応じて操作ワ
イヤ９５、９６が差動的に駆動され、湾曲部９２が上下
左右に湾曲する。また、同様に直動ロッド１０２もモー
タ１０３の回転により進退し、鉗子開閉ロッド１０１を
介して鉗子１０９が開閉する。Therefore, the operator operates the operation input device 65 to operate the treatment manipulator 67 to operate the patient 7
Perform 0 treatment. Information on the position / posture / grip state of the operator's hand 68 obtained by the operation input device 65 is input to the control unit 66, and the operation amount of the robot arm 72, the rotation amount of the insertion portion 74 of the holder 73, the insertion portion. The bending amount of the bending portion 92 of 74 and the opening / closing angle of the forceps 109 are converted. In the drive unit 93, the ball screw nut 108 advances and retracts due to the rotation of the motor 103, the operation wires 95 and 96 are differentially driven according to the advance and retreat, and the bending portion 92 bends vertically and horizontally. Similarly, the direct-acting rod 102 also advances and retreats by the rotation of the motor 103, and the forceps 109 opens and closes via the forceps opening / closing rod 101.
【００５５】本実施例では、湾曲部９２の前後における
直動ロッド１０２と鉗子開閉ロッド１０１の動作を、ア
ウターケーシング９７とインナーケーブル９８を用いる
ことにより一致させ、モータ１０３とエンコーダ１０４
により高精度の鉗子１０９の開閉の制御を可能とし、そ
の結果、高度なマスタースレーブ制御による鉗子１０９
の遠隔操作を可能にしている。In this embodiment, the operations of the linear motion rod 102 and the forceps opening / closing rod 101 before and after the bending portion 92 are made to coincide by using the outer casing 97 and the inner cable 98, and the motor 103 and the encoder 104.
This makes it possible to control the opening and closing of the forceps 109 with high accuracy, and as a result, the forceps 109 can be controlled by advanced master-slave control.
It enables remote control of.
【００５６】前述した実施態様によれば、次の構成が得
られる。 （付記１）先端処置具と、この先端処置具を体腔内に挿
入するための湾曲部を有する挿入部と、前記先端処置具
を駆動させる操作部と、この操作部と前記先端処置具と
を連結する連結部材とを有する処置具において、前記連
結部材は、フレキシブルな外装部材と、この外装部材の
内部で軸方向に移動可能な内装部材とで構成されたこと
を特徴とする処置具。 （付記２）先端処置具と、この先端処置具を体腔内に挿
入するための湾曲部を有する挿入部と、前記先端処置具
を駆動させる操作部と、この操作部と前記先端処置具と
を連結する連結部材とを有する処置具において、独立し
た湾曲可能な複数の湾曲手段を有する前記湾曲部と、フ
レキシブルな外装部材とこの外装部材の内部で軸方向に
移動可能な内装部材とで構成された前記連結部材しを具
備したことを特徴とする処置具。 （付記３）前記外装部材が、湾曲部に対して回転するこ
とにより前記先端処置具を回転させ、かつ内装部材が軸
方向に進退運動することにより前記先端処置具を開閉す
ることを特徴とする付記１または２記載の処置具。 （付記４）前記内装部材が、湾曲部に対して回転または
軸方向に進退運動することにより前記先端処置具を回転
または開閉することを特徴とする付記１または２記載の
処置具。 （付記５）前記外装部材は、円筒状の弾性金属バネで形
成されていることを特徴とする付記１記載の処置具。 （付記６）前記外装部材は、円筒状の弾性金属バネおよ
び樹脂層とで形成されていることを特徴とする付記１記
載の処置具。 （付記７）前記外装部材は、円筒状の弾性金属バネ、金
属ブレートおよび樹脂層で形成されていることを特徴と
する付記１記載の処置具。 （付記８）前記外装部材は、多条巻き金属コイルバネを
有することを特徴とする付記１記載の処置具。 （付記９）前記内装部材は、より線ワイヤを有すること
を特徴とする付記１記載の処置具。 （付記１０）前記内装部材は、芯材とより線とからな
り、芯材の径がより線の径より太いことを特徴とする付
記１記載の処置具。 （付記１１）前記湾曲手段の湾曲量がワイヤの張力によ
り可変されることを特徴とする付記１記載の処置具。 （付記１２）前記湾曲手段がモータによって駆動される
ことを特徴とする付記１記載の処置具。 （付記１３）先端処置具がモータによって駆動されるこ
とを特徴とする付記１記載の処置具。 （付記１４）先端処置具と、この先端処置具を体腔内に
挿入するための湾曲部を有する挿入部と、前記先端処置
具を駆動させる操作部と、この操作部と前記先端処置具
とを連結する連結部材とを有する処置具において、前記
湾曲部は、複数の円筒状コマからなり、隣り合うコマが
２箇所以上の支持部と、少なくとも１つの伸縮部を具備
することを特徴とする処置具。 （付記１５）先端処置具と、この先端処置具を体腔内に
挿入するための挿入部と、前記先端処置具を駆動させる
操作部と、この操作部の操作と離れた場所で制御を行う
操作制御手段とを有する操作制御入力装置において、前
記操作制御手段は、６本以上のワイヤと、各々の前記ワ
イヤに接続されたワイヤ牽引手段と、ワイヤの移動量を
検出するワイヤ移動量検出手段とから構成されているこ
とを特徴とする操作制御入力装置。 （付記１６）独立して可動な複数の湾曲構造を有し、そ
の湾曲構造の少なくとも一つが、湾曲手段と、その内側
にフレキシブルな外装部材と、この外装部材に対して進
退するフレキシブルな内装部材とからなり、この内装部
材の進退に応じて先端処置具を駆動する駆動部とから構
成したことを特徴とする処置具。 （付記１７）前記外装部材は、湾曲手段に対して回転自
在であり、前記外装部材の回転により先端処置具を回転
させることを特徴とする付記１４記載の処置具。 （付記１８）前記湾曲部は、複数の湾曲コマからなり、
少なくとも３節を有するリンクを湾曲コマの中に含むこ
とを特徴とする付記１４記載の処置具。 （付記１９）前記湾曲部は、少なくとも３節を有するリ
ンクを構成する湾曲コマが円環状をなす付記１４記載の
処置具。 （付記２０）前記湾曲部は、複数の湾曲コマからなり、
それぞれの湾曲コマが湾曲コマと一体の部材からなる２
つ以上の脆弱部からなる関節部と、３つ以上の脆弱部か
らなる伸縮部によって接続されていることを特徴とする
付記１４記載の処置具。 （付記２１）前記湾曲部は、脆弱部の両端部に弧状の切
り込みを有することを特徴とする付記２０記載の処置
具。According to the above-mentioned embodiment, the following constitution can be obtained. (Supplementary Note 1) A distal treatment instrument, an insertion section having a curved portion for inserting the distal treatment instrument into a body cavity, an operation unit for driving the distal treatment instrument, the operation unit and the distal treatment instrument. A treatment instrument having a coupling member for coupling, wherein the coupling member includes a flexible exterior member and an interior member movable in the axial direction inside the exterior member. (Supplementary Note 2) A distal treatment instrument, an insertion section having a curved portion for inserting the distal treatment instrument into a body cavity, an operation unit for driving the distal treatment instrument, the operation unit and the distal treatment instrument. In a treatment tool having a connecting member for connecting, the bending portion having a plurality of independently bendable bending means, a flexible exterior member, and an interior member axially movable inside the exterior member. A treatment tool comprising the connecting member. (Supplementary Note 3) The distal member is rotated by the exterior member rotating with respect to the curved portion, and the distal member is opened and closed by the axial movement of the inner member. The treatment tool according to appendix 1 or 2. (Supplementary note 4) The treatment instrument according to supplementary note 1 or 2, wherein the distal end treatment instrument is rotated or opened / closed by the interior member rotating or moving back and forth in the axial direction with respect to the curved portion. (Supplementary Note 5) The treatment instrument according to Supplementary Note 1, wherein the exterior member is formed of a cylindrical elastic metal spring. (Supplementary Note 6) The treatment instrument according to Supplementary Note 1, wherein the exterior member is formed of a cylindrical elastic metal spring and a resin layer. (Supplementary Note 7) The treatment instrument according to Supplementary Note 1, wherein the exterior member is formed of a cylindrical elastic metal spring, a metal plate, and a resin layer. (Supplementary Note 8) The treatment instrument according to Supplementary Note 1, wherein the exterior member includes a multi-winding metal coil spring. (Supplementary Note 9) The treatment instrument according to Supplementary Note 1, wherein the interior member includes a stranded wire. (Supplementary Note 10) The treatment instrument according to Supplementary Note 1, wherein the interior member includes a core material and a stranded wire, and the diameter of the core material is larger than the diameter of the stranded wire. (Supplementary Note 11) The treatment tool according to Supplementary Note 1, wherein the bending amount of the bending means is changed by the tension of the wire. (Supplementary Note 12) The treatment tool according to Supplementary Note 1, wherein the bending means is driven by a motor. (Supplementary Note 13) The treatment instrument according to Supplementary Note 1, wherein the distal treatment instrument is driven by a motor. (Supplementary Note 14) A distal treatment instrument, an insertion section having a curved portion for inserting the distal treatment instrument into a body cavity, an operation unit for driving the distal treatment instrument, the operation unit and the distal treatment instrument. In the treatment tool having a connecting member to be connected, the curving portion includes a plurality of cylindrical pieces, and adjacent pieces have a support portion at two or more locations and at least one expansion / contraction portion. Ingredient (Supplementary Note 15) A distal treatment tool, an insertion section for inserting the distal treatment tool into a body cavity, an operation section for driving the distal treatment tool, and an operation for performing control at a location apart from the operation of the operation section. In the operation control input device having control means, the operation control means includes six or more wires, wire pulling means connected to each of the wires, and wire movement amount detection means for detecting the movement amount of the wires. An operation control input device comprising: (Supplementary Note 16) A plurality of independently movable bending structures, at least one of the bending structures, a bending means, a flexible exterior member inside thereof, and a flexible interior member that moves back and forth with respect to the exterior member. And a drive section that drives the distal treatment instrument according to the advance / retreat of the interior member. (Supplementary note 17) The treatment instrument according to supplementary note 14, wherein the exterior member is rotatable with respect to the bending means, and the distal treatment instrument is rotated by the rotation of the exterior member. (Supplementary Note 18) The bending portion includes a plurality of bending pieces,
15. The treatment tool according to appendix 14, wherein a link having at least three joints is included in the curved top. (Supplementary note 19) The treatment tool according to supplementary note 14, wherein the curved portion has a ring-shaped curved piece that forms a link having at least three joints. (Supplementary Note 20) The bending portion includes a plurality of bending pieces,
Each curved piece consists of a member integrated with the curved piece 2
15. The treatment tool according to appendix 14, which is connected to a joint part composed of three or more fragile parts and an elastic part composed of three or more fragile parts. (Supplementary note 21) The treatment instrument according to Supplementary note 20, wherein the curved portion has arcuate cuts at both ends of the fragile portion.
【００５７】前述した付記１、３〜１１によれば、先端
部に、高剛性で自在な湾曲を有し、また手元操作部の操
作感覚を処置具に確実に伝達し、また先端処置具の回転
を実現することで、内視鏡下外科手術用処置具の操作性
を向上させることができる。According to the above-mentioned Supplementary Notes 1, 3 to 11, the distal end portion has a high-rigidity and free curve, and the operation feeling of the hand operation portion is surely transmitted to the treatment instrument, and the distal treatment instrument By realizing the rotation, it is possible to improve the operability of the treatment instrument for endoscopic surgery.
【００５８】付記１２，１３によれば、処置部に駆動力
を伝達することで、動力を用いた精密な処置を実現す
る。付記２によれば、第２の湾曲部を持つ処置具を実現
することで、内視鏡下外科手術用処置具の操作性を向上
させることができる。According to Supplementary Notes 12 and 13, by transmitting the driving force to the treatment portion, a precise treatment using power is realized. According to Supplementary Note 2, by implementing the treatment tool having the second curved portion, the operability of the treatment tool for endoscopic surgery can be improved.
【００５９】付記１４〜１６によれば、外力や内蔵物の
摩擦によって影響を受けない、操作量に対して線形な湾
曲形状を得ることで、処置具先端の位置決めを精密に行
える。付記１７〜２１によれば、剛性が高くて、寿命の
長い湾曲構造を安価に製造できる。According to Supplementary Notes 14 to 16, it is possible to precisely position the distal end of the treatment instrument by obtaining a curved shape which is not affected by external force or friction of the built-in body and is linear with respect to the operation amount. According to Supplementary Notes 17 to 21, the curved structure having high rigidity and long life can be manufactured at low cost.
【００６０】[0060]
【発明の効果】以上説明したように、この発明によれ
ば、高剛性で自在な湾曲を有し、また操作部の操作感覚
を処置具に確実に伝達し、また先端処置具の回転を実現
することで、内視鏡下外科手術用処置具の操作性を向上
させることができるという効果がある。As described above, according to the present invention, it has a high-rigidity and flexible curvature, reliably transmits the operation feeling of the operating portion to the treatment instrument, and realizes the rotation of the distal treatment instrument. By doing so, there is an effect that the operability of the treatment instrument for endoscopic surgery can be improved.
【図１】この発明の第１の実施例を示す処置具の斜視
図。FIG. 1 is a perspective view of a treatment tool showing a first embodiment of the present invention.
【図２】同実施例の処置具の縦断側面図。FIG. 2 is a vertical sectional side view of the treatment tool according to the embodiment.
【図３】同実施例のアウターケーシングとインナーケー
ブルの構成図。FIG. 3 is a configuration diagram of an outer casing and an inner cable of the same embodiment.
【図４】同実施例の作用説明図。FIG. 4 is an operation explanatory view of the same embodiment.
【図５】この発明の第２の実施例のアウターケーシング
とインナーケーブルの構成図。FIG. 5 is a configuration diagram of an outer casing and an inner cable of a second embodiment of the present invention.
【図６】この発明の第３の実施例を示す処置具の斜視
図。FIG. 6 is a perspective view of a treatment tool showing a third embodiment of the present invention.
【図７】同実施例の湾曲部の構成図。FIG. 7 is a configuration diagram of a bending portion of the embodiment.
【図８】この発明の第４の実施例の湾曲部の構成図。FIG. 8 is a configuration diagram of a bending portion according to a fourth embodiment of the present invention.
【図９】この発明の第５の実施例の湾曲部の構成図。FIG. 9 is a configuration diagram of a bending portion according to a fifth embodiment of the present invention.
【図１０】この発明の第６の実施例の処置具の斜視図お
よび第２の湾曲部の内部構成を示す構成図。FIG. 10 is a perspective view of a treatment tool according to a sixth embodiment of the present invention and a configuration diagram showing an internal configuration of a second bending portion.
【図１１】同実施例の作用説明図。FIG. 11 is an operation explanatory view of the same embodiment.
【図１２】この発明の第７の実施例の操作制御入力装置
の構成図。FIG. 12 is a configuration diagram of an operation control input device according to a seventh embodiment of the present invention.
【図１３】同実施例の操作入力装置の構成図。FIG. 13 is a configuration diagram of the operation input device according to the embodiment.
【図１４】同実施例の処置具の内部構造を示す斜視図。FIG. 14 is a perspective view showing the internal structure of the treatment tool of the embodiment.
１…処置部、２…湾曲部、３…操作部、４…挿入部、５
…鉗子、１７…アウターケーシング（外装部材）、１８
…インナーケーブル（内装部材）。DESCRIPTION OF SYMBOLS 1 ... Treatment part, 2 ... Curved part, 3 ... Operation part, 4 ... Insertion part, 5
... forceps, 17 ... outer casing (exterior member), 18
… Inner cable (interior member).
Claims (1)
に挿入するための湾曲部を有する挿入部と、前記先端処
置具を駆動させる操作部と、この操作部と前記先端処置
具とを連結する連結部材とを有する処置具において、前
記連結部材は、フレキシブルな外装部材と、この外装部
材の内部で軸方向に移動可能な内装部材とで構成された
ことを特徴とする処置具。1. A distal treatment instrument, an insertion section having a curved portion for inserting the distal treatment instrument into a body cavity, an operation unit for driving the distal treatment instrument, the operation unit and the distal treatment instrument. In the treatment instrument having a coupling member for coupling, the coupling member includes a flexible exterior member and an interior member movable in the axial direction inside the exterior member.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP6308827A JPH08164141A (en) | 1994-12-13 | 1994-12-13 | Treating tool |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP6308827A JPH08164141A (en) | 1994-12-13 | 1994-12-13 | Treating tool |
Related Child Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2005106537A Division JP4145309B2 (en) | 2005-04-01 | 2005-04-01 | Treatment tool |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JPH08164141A true JPH08164141A (en) | 1996-06-25 |
Family
ID=17985787
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP6308827A Pending JPH08164141A (en) | 1994-12-13 | 1994-12-13 | Treating tool |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPH08164141A (en) |
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