WO2012040981A1 - Micro-invasive surgical instrument with articulated linkage - Google Patents

Micro-invasive surgical instrument with articulated linkage Download PDF

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Publication number
WO2012040981A1
WO2012040981A1 PCT/CN2010/079761 CN2010079761W WO2012040981A1 WO 2012040981 A1 WO2012040981 A1 WO 2012040981A1 CN 2010079761 W CN2010079761 W CN 2010079761W WO 2012040981 A1 WO2012040981 A1 WO 2012040981A1
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WO
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Patent type
Prior art keywords
chain
stage
link plates
joint
link
Prior art date
Application number
PCT/CN2010/079761
Other languages
French (fr)
Chinese (zh)
Inventor
张祖仁
张奕奕
徐维华
Original Assignee
上海创亿医疗器械技术有限公司
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005Flexible endoscopes
    • A61B1/0051Flexible endoscopes with controlled bending of insertion part
    • A61B1/0055Constructional details of insertion parts, e.g. vertebral elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00305Constructional details of the flexible means
    • A61B2017/00314Separate linked members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00318Steering mechanisms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • A61B2017/00318Steering mechanisms
    • A61B2017/00323Cables or rods
    • A61B2017/00327Cables or rods with actuating members moving in opposite directions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2908Multiple segments connected by articulations

Abstract

A micro-invasive surgical instrument with an articulated linkage includes a tool head (2), the articulated linkage (3), an extending tube (4), an instrument body (5) and an operation mechanism (6).The operation mechanism (6) is provided at the instrument body (5) to control the articulated linkage (3) to bend toward two sides, thereby leading the tool head (2) to swing toward two sides. The tool head (2), the articulated linkage (3), the extending tube (4), and the instrument body (5) are connected in sequence. Gear teeth are provided on two ends of link plates of the articulated linkage (3), and the gear teeth of the adjacent link plates in the same row are engaged with each other.

Description

BACKGROUND Minimally invasive surgical instrument with a chain joint

The present invention relates to a dial-in minimally invasive surgical procedures, the isolated, jaw, cut, cut, puncture, needle suture, staple or clip the body's tissues and organs snare and micro implant with a chain joint invasive surgical instruments, and more particularly to a dial-in endoscopic surgery, hysteroscopic surgery and endoscopic surgery, isolated, jaw, cut, cut, puncture, needle suture, staple or clip body snare tissues and organs minimally invasive surgical instrument having the articulation of the chain, and more particularly relates to the separation and toggle hernia surgery in human tissues and organs minimally invasive surgical instrument with a chain or a joint hernia repair material, and more particularly relates to to the minimally invasive surgical instrument with a chain toggle joint tissue within the vertebral body in the molding percutaneous vertebroplasty procedures, and still more particularly to tissues and organs in transurethral or electrosurgical coagulation of the human body with a chain joint minimally invasive surgical instruments. Background technique

Toggle required often in a variety of minimally invasive surgery, isolated, jaw, cut, cut, puncture, needle suture, staple or clip snare human tissue or organ implant.

For example, in minimally invasive surgical endoscopic surgery, hysteroscopic surgery and endoscopic surgery and the like, in order to release or expose the surgical area formed tissues and organs, or the placement of the implant at the implantation site, require surgical site 2-3 specifically left puncture device to toggle isolated, jaw, cut, puncture, needle suture, staple or clip snare human tissue or organ implant. Puncture is minimally invasive surgery in the diameter of 5mm 10mm, so that, into the puncture device separator, forceps or retractors may be very small operating range, often need to insert a separator in two puncture respectively, forceps or retractors operate together. After formation of the surgical area, it requires the use of various instruments perform cut, puncture, bleeding, the suture needle, surgical staples or clips trap operation tissues and organs of the human body.

As another example, in minimally invasive hernia surgery is transabdominal preperitoneal repair method (of TAPP) or intraperitoneal laying repair method (IPOM), it is necessary two puncture diameter of 5mm, a pure separation expose or release tissue and organ formation region surgery, hernia repair material laid toggle hernia repair site. In minimally invasive surgical hernia repair method intraperitoneally outer completely (TEP), the diameter of 5mm by the puncture, the use of balloons for most of the front gap separating the peritoneum, and then separated by inserting the puncture device 2 5mm a gap formed to complete a full jaw separation zone surgery, hernia repair material laid toggle hernia repair site. Since minimally invasive hernia surgery, the separator or separator clamp needs to be inserted deeply, so that the working range can be separated into the separate clamp or puncture is small, therefore, the toggle hernia repair material laid hernia repair site 2 5mm diameter of the puncture, a minimally invasive hernia surgery is the most difficult and time consuming operation required.

As another example, in a vertebroplasty procedure, usually by needle puncture diameter of 3.5mm to 4mm, using crushed vertebral body balloon. Since the balloon is formed of a cavity within the vertebral body was olive, wherein the bone cement filled into the obstructed trabecular olive-shaped cavity and the surrounding cancellous bone, it is difficult to penetrate into the cavity around the olive region, so that wherein the cured bone cement filled into the olive also showed. Thus, after vertebroplasty procedure, adjacent healthy vertebrae easily broken at an extrusion olive hard bone cement, requires vertebral surgery. If the charge pressure increase bone cement, the bone cement will crack generated from the vertebral body after the flattening balloon is extruded to form a puncture in the cement near the vertebral body fracture, damage to surrounding tissues and organs .

As another example, in the electric coagulation electrosurgery often hook tissue dissection, coagulation can also be cut tissue, bleeding, or coagulation using shovel loose tissue separation and burning of the surgical wound, or electric coagulation coagulation rod hemostasis. These high-frequency knife into monopolar and bipolar electrosurgical high-frequency knife, a diameter of 5mm by the puncture device into the surgical area. Therefore, the puncture device into the working range of the high-frequency knife is small, you may need to perform electrosurgery unit via a plurality of puncture.

In the minimally invasive surgical instrument described in U.S. Patent No. 20100076260, the two string cables into the hole in the joint on both sides of the joint sheet irregularities, so that irregularities in series joint piece joint, the joint by pulling the control wire bent to both sides , so as to drive a toggle having various, separate, jaw, cut, cut, puncture, or high-frequency knife functions to both sides of the tool head pivot. In the minimally invasive surgical instrument described in U.S. Patent No. 20090312773, the joints in the two metal sheets string into the hole on both sides of the uneven joint sheet, a joint sheet so that unevenness in series joint, the joint control of both push-pull by bending a metal sheet, so as to drive the tool head having a needle swinging stitching function to both sides. These two designs are unsatisfactory at a minimally invasive surgical instrument is a cable or a metal sheet while bending to both sides of the joint can be driven, but after the bending on both sides of the joint, the joint sheet consisting of a series of irregularities in the joint is difficult to any bending position have sufficient rigidity, resulting in a minimally invasive surgical instrument is easy to shift the tool head, the positioning accuracy is poor. Thus, minimally invasive surgical instruments need to improve the structure of the joints.

It is apparent from the above, have now devised a different style of minimally invasive surgical instruments, and the new structure of the joint development work continues minimally invasive surgical instruments, for further minimally invasive surgical instruments used in a large number of the world each year improvements, such minimally invasive surgical instruments at any bending position of the joint have sufficient rigidity, more accurate positioning of the tool head, the operating range may be greater. SUMMARY

Object of the present invention is to provide a minimally invasive surgical instrument having a chain joint, realized by the chain articulation joint composed of both ends of the chain link plate joint with teeth, with the teeth row adjacent link plates engaged with each other techniques embodiment, to both sides of the chain joints may be large-scale, large-curvature curved, precise positioning, at any location has a sufficient bending rigidity technical effect. Suitable for minimally invasive surgery in a variety of toggle, the isolated, jaw, cut, puncture, needle suture, staple or clip snare body organ or tissue implants, tissue dissection, coagulation or electric knife cutting tissue, may also be positioned after the bending use as retractors. Thereby reducing the number of minimally invasive surgical instrument and a surgical puncture in use, the tool head more accurate positioning, greater operative range, facilitate the surgical procedure, saving operation time.

Currently, well-known minimally invasive surgical instruments, its components comprising: a tool head, the joint, the extension tube, the body and the operating mechanism. An operating mechanism located living, controlled flexion to both sides, so as to drive the tool head swung to the side. Tool head, joints, extension tube connected to the body sequential order. Extension tube may be a rigid tube may be a flexible tube. The tool head can be hooked, spade-shaped head, angular head, head-shaped bend separator, a needle head, intestinal clamp, right angle clamp, the anvil grasping forceps, pliers lung, grasping forceps, curved forceps separation, peeling curved knife, spherical hemostasis tool, the separation hook, hook sharp, curved scissors, cut the greater curvature, a blunt dissector, needle holder, clip applying the staple cartridge, snare, high-frequency knife or various other means may be used for minimally invasive surgery head.

Object of the invention is achieved by the following technical scheme: a joint with minimally invasive surgical instrument for articulation of the chain of the chain joint. Chain link plate and pin of articulation components. Link plates are connected by a staggered arrangement of the two pivot pins. Proximal end of the extension tube nearest the pivot end of the link plate is connected by a joint operation of the chain driving mechanism, a distal end with teeth. The distal end of the tool head and the distal-most end of the pivot joints of the chain link plates connecting the proximal end with teeth. The distal end of the extension tube with teeth. Teeth and tooth distal end of the proximal end of the extension tube of the last articulation of the chain link plate end engaged with each other. The proximal end of the tool head with teeth. Teeth and tooth proximal the distal end of the tool head of the chain articulation next most distal link plate meshing with each other. Other ends of the chain link plate joint with teeth. Column with teeth adjacent link plates engaged with each other. Teeth of the link plates may be fixed to the gear teeth of the link plates, the chain may be fixed fork plate, thread, or other types of teeth having a similar function in. Each of the gear teeth of the link plates may have the same pitch diameter, it may also have different pitch circle diameters. That of the gear teeth of the link plates of each may be the same, may not be the same. Chain articulation to the tool head drive curved sides, positioning accuracy, at any location has a sufficient bending rigidity.

Operating the chain drive mechanism most end of the proximal end of articulation link plates of the first stage, the first stage of the chain articulation pin link plate rotates, the first stage around the corner; the end of the last stage of the second link plate of the link plates in the first stage driven pin and the dual role of gear teeth engaging gear teeth of the second gear stage link plate extending at the distal end of the tube, the angle of the link plate of the first stage to a second stage of transmitting superposed strand corner panels, the corner of the first stage to the second stage is superimposed angle; third stage drive pin link plates at a second stage gear of the first link plate and the link plate teeth stage and third stage link plate dual role of teeth engaging the drive gear, then the second corner plate superimposed-chain tertiary transmitted to the link plate corners, the corner of the second stage to the third stage is superimposed angle; and a fourth plate-chain in the third stage driven pin link plates and the dual role of gear teeth engaging gear teeth and the fourth gear stage of the second link plate stage link plates, link plates of the third stage and then corner to corner superimposed transmission link plates fourth stage, the third stage to the fourth stage rotation angle superimposition ; Fifth stage drive pin link plates at the fourth stage and the link plates of the dual role of engaged transmission gear teeth of the gear teeth of the link plates of the third stage and fifth stage of the link plate, and then corner fourth stage transmission link plates superposed to the fifth stage rotation angle of the link plates, the corner of the fourth stage to the fifth stage is superimposed angle; and so on, until the pin tool head driven by the N-th stage and the second link plate dual role (N-1) engaging the drive gear teeth of gear teeth and the head of the tool-chain plate angle further stage N is transmitted to the link plate superimposed angle of the tool head, the first level N superimposed into the corner of the (N + 1) stage corner; Thus, when the operating mechanism controlling the operation of a chain joint, operating the drive mechanism at the distal end of the extension tube, is transmitted to the nearest end of the articulation angle of the chain link plates of the first stage, by gear teeth of the same row of adjacent intermeshing link plates, after (N + 1) is transmitted to the superimposition stage angle of the tool head.

In the same number of teeth of the gear teeth of the link plates of each condition, the tool head 2 can be obtained corresponds to the angle of articulation of the chain nearest end of the first stage doubler link plate corners (N + 1). More more of the chain articulation link plate number N, is superimposed is transmitted to the rotation angle of the tool head (N +. 1) multiple; fewer chain articulation link plate number N, is superimposed is transmitted to the rotation angle of the tool head (N + 1) fewer multiples. In the number of teeth of the teeth of each chain plate are not the same conditions, the corner joints of the chain nearest end of the first stage is transmitted to the link plate superimposed angle of the tool head having a different multiple.

There may be pin holes on both ends of the link plates of the chain with a minimally invasive surgical instrument of the present invention joint. Pins are inserted into pin holes of the respective link plates of the link plates are connected by a pivot pin arranged in two staggered.

One end of the link plates may have a pin hole, the other end of the fixed pin. Each of the link plates fixed pin inserted into the pin hole of the other link plate, so that the pivot link plates connected by pins arranged in two staggered. There may also be a portion of a pin hole on both ends of the link plates, pin fixed to both end portions of the other link plate. Each pin link plates with pins inserted into the pin holes of the respective link plates having a pin hole, and a link plate connected by a pivot pin arranged in two staggered.

The outer periphery of the chain articulation minimally invasive surgical instrument of the present invention with a chain joint may be sheathed with the sleeve. The sleeve may be prevented and the link plates of the chain articulation pin detached from each other, can be prevented within the space between the teeth of the chain link plates of tissue around the joint is sandwiched between a chain or a joint intermeshing link plates. The sleeve may be either a bellows, a flexible tube may be.

Minimally invasive surgical instrument operation mechanism of the present invention with a chain joint can be articulated cable. The cable may be a single wire cable, the cable may be a plurality of twisted wire cables. Proximal and distal end of the chain articulation cable joint nearest end of the link plate is connected. Joint operating mechanism pulls the cable, the cable joint nearest the proximal end of the chain pulls the articulation link plates, link plates driven end of the chain nearest joint rotation, the tool head swung to the side.

The operating mechanism may have a rack of gear teeth or gear teeth at the distal end of the extension tube. Most end of the proximal end of the link plate of the chain joints have gear teeth. The operating mechanism engaged with each other in the gear tooth proximal most end of the tooth or teeth of a rack gear at the distal end of the extension tube and the joint link plates of the chain. The operating mechanism through the gear tooth proximal most end of the link plate teeth articulation drive chain or gear rack teeth, the driven end of the chain link plate nearest joint rotation, the tool head swung to the side.

It said chain bending articulation toggle mechanism is particularly suitable for minimally invasive surgery in a variety of isolated, jaw, cut, puncture, needle suture, staple or clip snare body organ or tissue implant, after further bending positioning can be used as a retractor, thereby reducing the number of surgical instruments used in minimally invasive surgery and the puncture device, and facilitate the surgical procedure, saving operation time; also particularly useful in minimally invasive hernia surgery revealed the formation of tissues and organs or release the surgical area, the hernia repair material laid toggle hernia repair site; also particularly suitable for vertebroplasty procedure, a balloon cavity formed within the vertebral body olive toggle trimmed into a flat cavity, preventing vertebroplasty after surgery healthy vertebral bodies adjacent the bone cement is pressed broken side; and particularly suitable for performing electrosurgical tissue dissection surgery, coagulation or cutting operations of various tissues.

The chain joint with minimally invasive surgical instrument according to the present invention a chain joint can extend from the distal end to the proximal end of the channel. Operation means by the operation of the chain articulation channel is transmitted to the tool head. The link plates of the chain can extend from the proximal to the distal end of the joint groove, the joint groove form a chain link plates extends from the proximal end to the distal end of the channel.

A cable operating mechanism is driven. A drive cable to the tool head and the passage through the extension tube extending from the proximal end of the chain articulation to the distal end. The operating mechanism pulls the drive cable, the cable pulls the driving tool bit to perform various surgical procedures. Of the cable drive mechanism is particularly suitable for performing a variety of minimally invasive surgery toggle separated, jaw, cut, puncture, suture needle, snare or nail clip various operations tissues and organs of the human body or implant . Are also particularly suitable for minimally invasive hernia surgery revealed the formation of tissues and organs or release the surgical area, the hernia repair material laid toggle hernia repair site; also suitable for vertebroplasty procedure, a balloon within the vertebral body olive toggle trimmed cavity formed into a flat cavity which prevents the healthy vertebral vertebroplasty procedure adjacent the bone cement is pressed broken side effects.

Transmission wire within the channel may be under operator control means, the high-frequency current through the electric knife extends host pipe and extends to a distal end from the proximal end of the chain articulation to the tool head, the tool head perform electrosurgery tissue dissection, coagulation or cutting tissue electric knife various operations. BRIEF DESCRIPTION

FIG. 1 is an external perspective view of a minimally invasive surgical instrument of articulation of the chain with a chain joint embodiment of the present invention does not rotate;

FIG 2 shows a sleeve joint of the first embodiment of the chain of FIG. 1 after being removed, the chain articulation partial enlarged head and the tool joint when the chain is not rotating external perspective view;

FIG 3 is a partial back surface of the chain articulation in FIG. 2 and its annexes enlarged external perspective view;

FIG 4 is a partial enlarged attachment and articulation of the chain external perspective view of the chain of FIG. 2 is rotated counterclockwise joint; FIG. 5 is a partial back surface of the chain articulation in FIG. 4 and Annex enlarged external perspective view;

FIG 6 is a partial chain the chain articulation joint of FIG. 2 is rotated clockwise and its annexes enlarged external perspective view; FIG. 7 is a proximal end of the most distal end of the chain link plates and the joints of the cable of FIG. 2 connected an enlarged external perspective view;

FIG 8 is an enlarged perspective view showing the appearance of the link plates of the chain with a single articulation pin holes in FIG. 2 and the single pin; FIG. 9 is an enlarged external perspective view of the sleeve of Figure 1;

FIG 10 is a partial enlarged articulation of the chain when the chain articulation to the second embodiment of FIG. 1 is not rotating an external perspective view; FIG. 11 is a partial back surface of the chain joint of FIG. 10 and an enlarged external perspective view of the attachment;

FIG 12 is a partial enlarged attachment and articulation of the chain external perspective view of the chain of FIG 10 is rotated counterclockwise joint; FIG. 13 is a partial back surface of the chain articulation 12 and its annexes FIG enlarged external perspective view;

FIG 14 is an enlarged perspective view showing the appearance of the link plates of the chain double pin bore of joints;

FIG 15 is an enlarged external perspective view of the pin of the chain joints;

FIG 16 is an enlarged perspective view showing the appearance of the link plate with the chain double pin joint. DETAILED DESCRIPTION Method

By way of example below, Chen Shu a preferred embodiment of the present invention are shown minimally invasive surgical instrument with a chain joint binding. The scope of the invention will be pointed out in the claims. It should be appreciated that some or all of the drawings is a schematic view for explaining a preferred embodiment of the present invention and are not depicted true size of the portion of FIG. Described in detail with reference to preferred embodiments, it will be more clearly understood achieve the foregoing and other objects and advantages of practical embodiment of the present invention.

In order to illustrate its pattern of the chain articulation and projection of the tool head, the tool head and the joints other than the addition to the chain and related parts in the drawings will not be detailed description of the other components.

In the drawings and the following description, the term "proximal" refers to the end of the chain joint with minimally invasive surgical instrument closer to the operator, while the term "distal" refers to a minimally invasive surgical instrument away from the operator with a chain joint One end of persons. "End" can be either the end face, the end portions may be. Other directional terms can be understood from the following description and accompanying drawings.

All parts of minimally invasive surgical instrument with a chain joint below in conjunction with FIGS. 1 to 16 of the embodiment of the present invention will be described, illustrate specific embodiments of the respective components.

1, a minimally invasive surgical instrument 1 part of a chain with a joint comprising: a tool head 2, the chain articulation 3, the extension tube 4, the body 5 and the operating mechanism 6. The operating mechanism 6 is located in the body 5, the control of the chain articulation to the pivot 3 on both sides, so as to drive the tool head 2 is swung to the side. The tool head 2, the chain articulation 3, the extension tube 4, the body 5 successively connected sequentially.

2 to FIG. 8, one end of the plate 3 form a chain articulated chain 7 is fixed to the pin 8, the other end of the pin hole 9. Each of the link plates fixed pin 8 is inserted into the other pin hole 9 of the link plates, link plates 7 so that the pin 8 and the pin hole 9 arranged in a staggered pivotally connected to two 10 and 11.

3 nearest the distal end of the chain articulation of the link plates 12 have gear teeth 14, the left proximal end of the operating mechanism 6, and the right joint 28 is connected to the cable 29. 3 nearest the proximal end of articulation of the chain link plates 12 of the extension tube 4 and the pivot connection. 3 the last articulation of the chain end link plate 16 has a proximal end with teeth of gear teeth of the distal end of the extension tube 4 gears 15 meshing with each other 17, the distal end 18 has gear teeth. Chain plate 19 has a proximal end and a distal end of the link plate 12 of the gear teeth 14 intermeshing gear teeth 20, gear teeth 21 have distal end. 3 chain most distal articulation link plate 22 has a proximal end and a distal end 16 of the link plates intermeshing gear teeth 18 of the gear teeth 23, the distal end of the proximal end of the head with gear teeth of the gear 24 of the tool 2 the gear teeth 25 meshing with each other. 3 chain most distal articulation link plate 26 has a gear tooth proximal end 27, a distal end of the tool head 2 is pivotally connected.

The operating mechanism 6 to pull the cable joint 28 when the left side, the left side of the proximal end of the cable 28 pulls the chain articulation joint 3 nearest the end plate 12 of the chain, the chain articulation 3 latest drive end plate 12 counterclockwise about the link pin 30 rotates, the first a counterclockwise corner. Dual role engaging drive gear teeth 16 of the teeth 17 of the link plate 15 and the last end of the link plate 16 is driven by the pin link plates 12 and the extension tube 31 at the distal end of the gear 4, a chain corner panel 12 is superimposed is transmitted to the link plate 16 in a counterclockwise angle of the first stage to the second stage is superimposed angle corner, the second stage is a first stage the corner angle twice. Link plate 19 driven by the pin 32 of the link plate 16 of the dual role of gear teeth engaging gear teeth 12 of the gear and the link plates 14 and 19 of the link plate 20, then the angle of the link plate 16 is superimposed transmitted to the link plate 19 counterclockwise angle, in the second stage to the third stage is superimposed angle corner angle is three times the third level stage of the first corner. The next most distal link plates 22 driven dual action pin 33 of the link plate 19 of the gear teeth and the gear teeth of the link plates 16 and 18 times the most distal link plates 22 engages a gear 23 lower, then the angle of the link plate 19 is superimposed into a secondary transfer counter-clockwise rotation angle of the distal-most end of the link plate 22, the third stage to the fourth stage corner angle is superimposed, the fourth stage is a first stage the corner angle four times. Driven pin link plates 34, 22 of the next most distal link plate 26 under the action of the dual gear teeth and the gear teeth of the link plates 19 and 21 of the link plate 26 engages gear 27, and then chain corner panel 22 is superimposed is transmitted to the link plate 26 in a counterclockwise angle, so that the fourth stage to the fifth stage is superimposed angle corner, the fifth stage of the first stage the corner angle is five times. The tool head 2 is driven by the pin link plates 35, 26 of the dual role of gear teeth engaging drive gear teeth and the next most distal link plates 22 and 25 of the tool 24 of the head 2, further chain corner panel 26 is superimposed is transmitted to the tool head 2 counterclockwise angle, so that the fifth stage to a sixth stage corner angle is superimposed, the sixth stage is a first stage the corner angle six times. Teeth so that, when the 6 controls the operating means of the chain articulation 3 is operated, the operating mechanism 6 in the transmission of the extension tube 4 at the distal end, is transmitted angle of rotation of the chain articulation 3 nearest end of the link plate 12 of the adjacent through same column link plate intermeshing gear, superimposed through 6 transmitted to the tool head 2, the tool head 2 can be obtained corresponds to 6 times the angle of the corner of the link plate 12. The more the number of link plates 3 of the chain joint, is superimposed is transmitted to the tool head corners 2 multiples the more; the fewer number of link plates 3 of the chain joint, is superimposed is transmitted to the tool head corners 2 multiples fewer. So as to achieve both sides of the chain joints may be wide, a large bending curvature, positioning accuracy, at any location has a sufficient bending rigidity technical effect. The above is the same as that of the gear teeth of the link plates of each condition, the corner joints of the chain link plates 12 3 superimposed is transmitted to the tool head rotation angle of a multiple of 2. While in that of the gear teeth of the link plates of each of the different conditions, the corner joints of the chain link plates 12 3 superimposed is transmitted to the rotation angle of the tool head 2 is different multiples.

When the operating mechanism 6 to pull the cable joint 29 when the right to drive the chain articulation 3 is rotated clockwise-most end 12 of the link plate, the tool head 2 is swung to the other side. The operation of the drive mechanism at the distal end of the extension tube 4 through the nearest corner end 3 of the chain articulation link plates 12 stepwise superposed transmitted to the tool head 2 and the process similar to the above described.

From the proximal end of the chain has a joint to the distal end 3 extending grooves 36 on the link plate 7, the grooves 7 composed of the chain link plates 36 extending from the proximal end 3 articulated to the distal end of the channel 37.

The above-described structure is particularly suitable for minimally invasive surgical instrument 1 with a chain joint puncture hole 3. 5mm to 5mm into the body for minimally invasive surgery by performing caliber. For example, under operator control means 6, the high-frequency current through the electric knife master channel extension tube 4 and the chain joints 3 extending from the proximal end to the distal end 37 of the transmission line 38 to the tool head 2, is applicable to performing dissected tissue electrosurgery, coagulation or cutting operations of various tissues. As another example, under operator control means 6, the drive cable 38 extends from the proximal end to the distal end of the extension tube 4 through the passage and articulation of the chain 337 driving the tool head 2, is suitable for endoscopic surgery, the thoracoscopic surgery minimally invasive surgery and the like hysteroscopic surgery toggle isolated, jaw, cut, puncture, needle suture, staple or clip snare body organ or tissue implant, or a minimally invasive hernia surgery or exposed tissue organogenesis release the surgical area and the toggle hernia repair material placement portion in hernia repair, vertebroplasty or balloon surgery will form a cavity within the vertebral body olive toggle trimmed flat cavity.

As shown in FIG. 1 and FIG. 9, the outer periphery of the chain articulation sleeve 3 bellows 39. Bellows 39 may be prevented from the joints of the chain link plates 3 7 and pin 8 from each other, can also prevent the gear tooth tissue surrounding articulation of the chain 3 or fall into the chain joint interposed intermeshing link plates 3 7 or within the space between link plates 7.

As shown in FIGS. 10 to 13, the operation mechanism of the second embodiment of the rack 41. The rack teeth 41 intermesh with the gear teeth 42 at the distal end. 44 gear teeth nearest the proximal joint end 43 of the chain link plate teeth 45 of gear 42 mesh with each other. Operating drive chain mechanism driven gear teeth 42 of the gear teeth 43 of the joint 44 of the proximal most end of the link plate 45 by the teeth of the rack 41, the chain drive 43 rotates the nearest end of articulation link plate 44.

When the operation of the control mechanism of the tool head joint motion, with adjacent columns via a transmission link plate teeth meshing with each other, the operation of the drive mechanism at the distal end of the extension tube articulation angle via the chain strand 43 nearest the end plate 44 progressively superimposed similar process is transmitted to the tool head of FIG. 2 to FIG. 8 described.

In the operation mechanism, the chain may be most end articulation 44 of the proximal end of link plates 43 directly from the rack teeth 41 of the operating mechanism of the gear teeth 45 engage with each other, a drive chain joints 44 nearest the proximal end 43 of the link plate the gear teeth 45 to drive the chain articulation link plate 43 nearest end 44 is rotated.

Each link plate has a proximal end 46 of the chain 43 extending from the joint to the distal end of the groove 47. A chain composed of the articulation groove 47 on the link plate 43 extends from the proximal end to the distal end 46 of the channel 48.

Operating mechanism 49 with a driving cable. By a chain drive cable 49 extends from the proximal end to the distal end of the articulation passage 48 is connected to the tool head 43. The operating mechanism pulls the drive cable 49, the cable 49 pulls the driving tool head. The above-described structure is particularly suitable for minimally invasive surgical instrument 1 with a chain joint puncture hole 5mm to 10mm diameter to enter the body through, in endoscopic surgery, endoscopic surgery, hysteroscopic surgery, minimally invasive hernia surgery or vertebroplasty various minimally invasive surgical procedures and the like, to perform various surgical procedures.

17 and 18, another embodiment of the two ends of the link plate 50 has a pin hole 51 embodiment. The pins 52 are inserted into the respective pin holes 50 of the inner link plates 51, 50 so that the pivot link plates connected to two staggered arrangement. The above-described link plate or link plates 7 different 46, the proximal end to the distal end 3 extending grooves 36 or groove 47 from the joint 50 is not a chain link plate.

19, still another embodiment of the two ends of the link plate 53 is fixed to pin 54. Plate 53 fixed on the chain pins 54 are respectively inserted into the pin hole 51 of the link plate 50, so that two link plates 53 are connected in a staggered and 50 pivot link plates.

Seen from the foregoing detailed description, minimally invasive surgical instrument having articulation of the chain of the present invention has the following technical effects: In various minimally invasive surgery often requires the use of tools toggle head, isolated, jaws, cutting, shearing, puncture, suture needle, nail clip or snare or implant tissues and organs of the human body. The tool head can be hooked, spade-shaped head, angular head, head-shaped bend separator, a needle head, intestinal clamp, right angle clamp, the anvil grasping forceps, pliers lung, grasping forceps, curved forceps separation, peeling curved knife, spherical hemostasis tool, the separation hook, hook sharp, curved scissors, cut the greater curvature, a blunt dissector, needle holder, clip applying the staple cartridge, snare, high-frequency knife or various other means may be used for minimally invasive surgery head.

For example, in minimally invasive surgical endoscopic surgery, hysteroscopic surgery and endoscopic surgery and the like, in order to release or expose the surgical area formed tissues and organs, or the placement of the implant at the implantation site, require surgical site 2-3 specifically left puncture device to toggle isolated, jaw, cut, puncture, needle suture, staple or clip snare human tissue or organ implant. Puncture is minimally invasive surgery in the diameter of 5mm 10mm, so that, into the puncture device separator, forceps or retractors may be very small operating range, often need to insert a separator in two puncture respectively, forceps or retractors operate together. After formation of the surgical area, it requires the use of various instruments perform cut, puncture, bleeding, the suture needle, surgical staples or clips trap operation tissues and organs of the human body.

As another example, in minimally invasive hernia surgery is transabdominal preperitoneal repair method (of TAPP) or intraperitoneal laying repair method (IPOM), it is necessary two puncture diameter of 5mm, a pure separation expose or release tissue and organ formation region surgery, hernia repair material laid toggle hernia repair site. In minimally invasive surgical hernia repair method intraperitoneally outer completely (TEP), the diameter of 5mm by the puncture, the use of balloons for most of the front gap separating the peritoneum, and then separated by inserting the puncture device 2 5mm a gap formed to complete a full jaw separation zone surgery, hernia repair material laid toggle hernia repair site. Since minimally invasive hernia surgery, the separator or separator clamp needs to be inserted deeply, so that the working range can be separated into the separate clamp or puncture is small, therefore, the toggle hernia repair material laid hernia repair site 2 5mm diameter of the puncture, a minimally invasive hernia surgery is the most difficult and time consuming operation required.

As another example, in a vertebroplasty procedure, usually by needle puncture diameter of 3.5mm to 4mm, using crushed vertebral body balloon. Since the balloon is formed of a cavity within the vertebral body was olive, wherein the bone cement filled into the obstructed trabecular olive-shaped cavity and the surrounding cancellous bone, it is difficult to penetrate into the cavity around the olive region, so that wherein the cured bone cement filled into the olive also showed. Thus, after vertebroplasty procedure, adjacent healthy vertebrae easily broken at an extrusion olive hard bone cement, requires vertebral surgery. If the charge pressure increase bone cement, the bone cement will crack generated from the vertebral body after the flattening balloon is extruded to form a puncture in the cement near the vertebral body fracture, damage to surrounding tissues and organs .

As another example, in the electric coagulation electrosurgery often hook tissue dissection, coagulation can also be cut tissue, bleeding, or coagulation using shovel loose tissue separation and burning of the surgical wound, or electric coagulation coagulation rod hemostasis. These high-frequency knife into monopolar and bipolar electrosurgical high-frequency knife, a diameter of 5mm by the puncture device into the surgical area. Therefore, the puncture device into the working range of the high-frequency knife is small, you may need to perform electrosurgery unit via a plurality of puncture.

Conventional minimally invasive surgical instruments, in a joint two cables or two metal sheets both sides of the string into the hole of the joint sheet irregularities, so that irregularities in series joint piece joint, by pulling the control cable or sliding metal sheet to both sides of the joint is bent, so as to drive a toggle having various, separate, jaw, cut, cut, puncture, or high-frequency knife functions to both sides of the tool head pivot. These two designs are unsatisfactory at a minimally invasive surgical instrument is a cable or a metal sheet while bending to both sides of the joint can be driven, but after the bending on both sides of the joint, the joint sheet consisting of a series of irregularities in the joint is difficult to any bending position have sufficient rigidity, resulting in a minimally invasive surgical instrument is easy to shift the tool head, the positioning accuracy is poor. Thus, minimally invasive surgical instruments need to improve the structure of the joints.

Aspect of minimally invasive surgical instruments of the present invention with a chain joint are: a chain drive mechanism operation proximal most end of articulation link plates of the first stage, the first stage of articulation of the chain link plate to rotate about the pin, generating a first stage angle; dual role of gear teeth engaging gear teeth of the end of the last stage of the second link plates driven by a first stage the pin link plates, and the extension tube at the distal end of the gear stage and the second link plate at the corner of the first stage is transmitted to a link plate superimposed angle of the link plate of the second stage, the first stage to a second stage superposed corner angle; driven pin link plates at the third level stage of the second link plate and the dual role of the drive teeth engaging the gear teeth of the first gear stage to the third stage of the link plates of the link plates, and then the angle of the second stage is superimposed is transmitted to the link plate corners tertiary link plates, superimposing the second stage to the third stage angle corner; the fourth stage driven pin link plates in the link plates of the third stage and the fourth gear teeth and the chain to the second stage gear plate link plate wheel dual role meshing gear teeth, then the angle of the third link plate superimposed transmission stage The fourth stage to the corner link plates, the third stage to the fourth stage superimposed angle corner; tooth fifth stage drive pin link plates at the fourth stage and the third stage of the link plates of the link plate with the gear dual role engaging the drive teeth of the fifth stage of the gear link plates, link plates and then the fourth stage corner superimposed angle into the fifth stage transmission link plates, so that the fourth stage to the fifth stage is superimposed angle corner; and so on, until the tool head and the lower drive pin at the stage N of link plates (N-1) of the dual role of the drive teeth meshing gear teeth of the gear head and the tool-chain plate further the angle stage N is transmitted to the link plate superimposed angle of the tool head, the first angle superposition into a first-class N (N + 1) stage corner; Thus, when the operating mechanism controlling the operation of a chain joint, the distal end of the extension tube operation mechanism at transmission, it is transmitted to the nearest end of the articulation angle of the chain link plates of the first stage, transmission through the teeth of the same row of adjacent link plates engaged with each other through the (N + 1) is transmitted to the superimposition stage angle of the tool head.

In the same number of teeth of the gear teeth of the link plates of each condition, the tool head 2 can be obtained corresponds to the angle of articulation of the chain nearest end of the first stage doubler link plate corners (N + 1). More more of the chain articulation link plate number N, is superimposed is transmitted to the rotation angle of the tool head (N +. 1) multiple; fewer chain articulation link plate number N, is superimposed is transmitted to the rotation angle of the tool head (N + 1) fewer multiples. In the number of teeth of the teeth of each chain plate are not the same conditions, the corner joints of the chain nearest end of the first stage is transmitted to the link plate superimposed angle of the tool head having a different multiple. So as to achieve both sides of the chain joints may be wide, a large bending curvature, positioning accuracy, at any location has a sufficient bending rigidity technical effect. Another aspect of minimally invasive surgical instruments of the present invention with a chain joints are: the link plates of the chain can extend from the proximal end to the distal end of the joint groove, the joint groove form a chain extending from a proximal end of the link plates to the distal end of the channel. Operation means by the operation of the chain articulation channel is transmitted to the tool head.

A cable operating mechanism is driven. A drive cable to the tool head and the passage through the extension tube extending from the proximal end of the chain articulation to the distal end. The operating mechanism pulls the drive cable, the cable pulls the driving tool bit to perform various surgical procedures. Of the cable drive mechanism is particularly suitable for performing a variety of minimally invasive surgical toggle endoscopic surgery, hysteroscopic surgery and endoscopic surgery and the like, separated, jaw, cut, puncture, suture needle, clips or staples of various tissues and organs or implant operations of the trap body, thus reducing the number of surgical instruments and minimally invasive surgical puncture device used, facilitate the surgical procedure, saving operation time; more particularly suitable for minimally invasive hernia surgery or exposed tissues and organs release the surgical area is formed, a dial-laid material hernia repair hernia repair site; more particularly suitable for vertebroplasty procedure, a balloon cavity formed within the vertebral body olive toggle trimmed into a flat cavity which prevents the vertebroplasty procedure adjacent healthy vertebral fracture bone cement is pressed side effects.

Transmission wire within the channel may be under operator control means, the high-frequency current through the electric knife extends host pipe and extends to a distal end from the proximal end of the chain articulation to the tool head, the tool head perform electrosurgery dissecting tissue, tissue coagulation or cutting various operations.

Compared with the conventional variety of minimally invasive surgical instruments, minimally invasive surgical instrument with a chain articulation joint of the present invention is achieved by a chain composed of articulation, both ends of the link plates of the chain joint with teeth, with the adjacent link plate column aspect of the mutually engaging teeth, to be bent to the side for the chain articulation range, a large curvature, positioning accuracy, at any location has a sufficient bending rigidity technical effect. It applies both to toggle various minimally invasive surgical endoscopic surgery, hysteroscopic surgery and endoscopic surgery and the like, separated, jaw, cut, puncture, needle suture, staple or clip the body snare organ or tissue implant, the positioning after the bending may also be used as a retractor, thereby reducing the number of surgical instruments and minimally invasive surgical puncture device used, facilitate the surgical procedure, saving operation time; but also for minimally invasive hernia surgery organ or tissue revealed that the peeled area is formed surgery, hernia repair material laid toggle hernia repair site; also applies to vertebroplasty procedure, a balloon cavity formed within the vertebral body olive trimmed to dial a flat cavity which prevents the vertebroplasty procedure is adjacent healthy vertebral fracture bone cement extruded side effects; also suitable for dissecting tissue in electrosurgery, electrosurgical coagulation or cut tissue.

Thus it can be seen, the above stated objectives, including those from the foregoing description of the target displayed is effectively achieved. Herein are merely exemplary of the preferred embodiment of the application of the present invention, the above-described configuration may be some variations not departing from the spirit and scope of the invention. Or limiting, the present invention is not limited to the specific details set forth herein, but should retain any improvements or modifications of ordinary skill in the art medium is obvious.

Claims

Claims
1, a minimally invasive surgical instrument having a chain joint, its components comprising: a tool head, a chain joint, the extension tube, the body and the operating mechanism;
The operating mechanism is in the living unit, to control the operation of the chain articulation mechanism is bent to both sides, so as to drive the tool head pivot to both sides;
The tool head, a chain joint, the extension tube, the body in turn is connected sequence;
Chain link plate and pin by a joint composed of the link plates by a pivot pin connecting the two staggered arrangement, with the proximal end of extension tube end nearest the pivot of articulation of the link plate of the chain drive is connected by an operating mechanism , distal gear teeth, the distal end of the most distal joints of the chain link plates pivotally connected to the tool head, with a gear tooth proximal end, the distal end of the tube extending gear teeth, the chain articulation the gear teeth of the distal end of the proximal end of the last gear teeth of the link plates and the end of the extension pipe mutual engagement, the proximal end of the tool head gear teeth, the chain articulation next most distal link plate gear teeth of the gear teeth of the gear teeth of the proximal end of the distal end of the tool head with intermeshing, the other ends of the link plates of the chain joints have gear teeth, with the adjacent link plates of the column intermeshing.
2. The minimally invasive surgical instrument with a chain joint according to claim 1, characterized in that the operating mechanism articulated cable, the cable joint and the distal end of the chain nearest end of the joint link plates the proximal connector; joint operating mechanism pulls the cable, pulling the cable joint nearest proximal end of articulation link plate of the chain, driven by the chain link plate end nearest the joint rotation of the pivot to the side of the tool head.
3, a minimally invasive surgical instrument according to claim articulation with a chain according to claim 1, characterized in that said operating mechanism has gear teeth at the distal end of the extension pipe, the joint end of the chain nearest chain the proximal end of the plate has gear teeth, said operating mechanism engaged with each other at the proximal end of gear teeth of the gear teeth nearest the end at the distal end of the extension tube and the joint link plates of the chain; by the operating mechanism gear teeth of the chain drive gear tooth proximal most end of the joint link plates, the chain drive chain joints nearest end plate is rotated, causing the end effector to pivot on both sides.
4. The minimally invasive surgical instrument as claimed in claim articulation with a chain according to claim 1, characterized in that, with a channel extending from the proximal end to the distal end of the articulation of the chain, the chain channel through the articulation mechanism of the operation the operation is transmitted to the tool head.
5. The minimally invasive surgical instrument with a chain joint according to claim 4, characterized in that the link plates of the chain extending from the proximal end to the distal end of the joint slot, the link plates form a chain joint grooves extending from the proximal end to the distal end of the channel.
6. The minimally invasive surgical instrument with a chain joint according to claim 4, characterized in that said operating mechanism has a cable drive, the drive cable extending from the proximal end of said tube and extending through the articulation of the chain to the distal end of the channel is connected to said tool head; operating mechanism pulls the driving cable, the cable pulls the driving tool bit to perform various surgical procedures.
7, a minimally invasive surgical instrument in accordance with a chain joint according to claim 4, characterized in that, under control of said operating means, the high frequency current through the electric knife master and the extension pipe joint of the chain from the wire proximal end extends into the distal end of the channel to transmit to the tool head.
8. A minimally invasive surgical instrument with a chain joint according to claim 1, characterized in that, on both ends of the pin hole of the link plate, the pin is inserted into each of the pin holes of the respective link plates, that the pivot link plates connected by pins arranged in two staggered.
9. The minimally invasive surgical instrument with a chain joint according to claim 1, characterized in that one end of the chain pin hole plate, the other end is fixed to the pin, each of said link plates fixed pin inserted into the pin hole of the other link plate, so that the pivot pin link plates connected by two staggered arrangement.
10. The minimally invasive surgical instrument with a chain joint according to claim 1, characterized in that, on both ends of the pin hole portion of the link plate, is fixed to another portion of the pin at both ends of the link plate , the pin link plates each having a pin inserted into the respective pin holes of the link plates having a pin hole, so that the pivot pin link plates connected by two staggered arrangement.
11. The minimally invasive surgical instrument with a chain joint according to claim 1, characterized in that the outer periphery of the chain joint bellows sleeve, in the binding effect of the bellows, to prevent the chain link plate joints and pin each other out.
12. A minimally invasive surgical instrument with a chain joint according to claim 1, characterized in that the proximal-most end of the chain articulation mechanism drives the first stage of the operation of the link plate, the chain link plates about the articulation of the first stage pin rotates, a first stage the corner; the end of the last stage of the second drive pin link plates at the first stage and the link plates of the gear teeth of the gear stage at the distal end of the second link plate of the extension tube dual role of teeth meshing transmission, the rotation angle of the first stage is transmitted to a link plate superimposed angle of the link plate of the second stage, the first stage to a second stage superposed corner angle; third level stage of the second link plate the driven pin link plates and the dual role of the drive teeth engaging gear teeth of the first gear stage to the third stage of the link plates of the link plates, link plates of the second stage and then the angle superposition transfer into the corner link plates third stage, the second stage to the third stage is superimposed angle corner; the fourth stage gear of the second stage and the link plates of the link plate teeth and the second drive pin at the third level of the link plates dual role engaging the drive gear teeth of the link plates of the four, then the third stage Superimposing transfer plate angle corner into the fourth stage of the link plates, the third stage to the fourth stage superimposed angle corner; the fifth stage drive pin link plates at the fourth stage and the third stage of the link plates of the link plates dual role of teeth engaging the drive gear with the gear teeth of the link plates of the fifth stage, the fourth stage and then the corner link plates into angle superimposing the fifth stage transmission link plates, superimposed into the corner of the fourth stage fifth stage corner; and so on, until the tool head is driven by the pin link plates of the N-th stage and the (N-1) engaging the drive gear teeth of the gear teeth of the tool head of the plate-chain dual role, further corner N th link plates superimposed transfer into the corner of the tool head, the first N-level corner superimposed into a first (N + 1) stage corner; Thus, when the operating mechanism control the chain joint motion, the operating mechanism in the drive at the distal end of the extension tube, is transmitted to the nearest end of the articulation angle of the chain link plates of the first stage, transmission through the same row of adjacent link plate teeth engaged with each other through the (N + 1) is transmitted to the tool superposition stage the head of the corner.
PCT/CN2010/079761 2010-09-30 2010-12-14 Micro-invasive surgical instrument with articulated linkage WO2012040981A1 (en)

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CN 201010299407 CN102440820B (en) 2010-09-30 2010-09-30 Minimally invasive surgical apparatus provided with chain joints

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US9539021B2 (en) 2013-01-03 2017-01-10 Just Right Surgical, Llc Medical device and method of use
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