WO2020017605A1 - Joint of medical instrument and medical instrument - Google Patents

Abstract

Provided is a joint disposed between a rod-like portion and a surgical tool in a medical instrument. The joint includes: a cylindrical outer shell portion having a space therein; a cylindrical core tube disposed in an inner space of the outer shell portion and having higher compression rigidity than that of the outer shell portion; and a cylindrical resin tube which is disposed in an inner space of the core tube, into which a cable used for the manipulation of the surgical tool is inserted, and which is made of a material having a smaller friction coefficient against the cable than that of the core tube.

Description

Medical device joints and medical devices Cross-reference of related applications

This international application is filed with Japanese Patent Application No. 2018-135096 filed with the Japan Patent Office on July 18, 2018, and with a Japanese patent application filed with the Japan Patent Office on March 26, 2019. No. 2019-58401, the entire content of which is incorporated herein by reference.

The present disclosure relates to a joint of a medical device and a medical device.

In recent years, endoscopic surgery using a surgery support robot has become widespread. The forceps of the surgery support robot are provided with flexible joints having a total of three degrees of freedom of roll, pitch, and yaw. This joint allows the tip of the forceps to rotate in the roll direction, the pitch direction, and the yaw direction, and can reproduce the movement of the wrist joint of the operator (for example, see Patent Document 1).

Japanese Patent No. 5339472

構造 In the structure disclosed in Patent Document 1 described above, the joint is bent by driving the wire. Then, forceps (hereinafter also referred to as “end effector”) perform operations such as grasping. In such a structure, for example, when a large tension is applied to the drive wire, there is a problem that it is difficult to perform operations such as bending and gripping as intended by the operator. This problem occurs when the joint has insufficient rigidity in the compression direction. Specifically, this occurs because the joint part having insufficient rigidity contracts and collapses due to the tension of the drive wire.

技術 In order to solve this problem, a technique has been proposed in which a member such as a close contact coil spring having compression rigidity and bending flexibility is used as a core material of a joint. However, in this technique, since the close contact coil spring does not contract, there is a problem that the operation of the end effector interferes with the bending operation of the joint.

Specifically, when the joint is bent by applying tension to the drive wire, the inside of the bent portion of the joint extends outward without shrinking. On the other hand, the wire that drives the end effector is located in the joint. As described above, when the joint is bent in such a manner that the inside extends without expanding, the path length of the wire that drives the end effector disposed inside becomes longer than before the bending.

That is, when the joint is bent, tension for operating the end effector is applied without operating the wire that drives the end effector. As described above, it is difficult to make the operation of the end effector independent of the bending operation of the joint, and there is a problem that the end effector and the joint interfere with each other.

技術 Instead of the core material, a technique of providing compression rigidity and bending flexibility (linear elasticity) by an outer shell portion arranged on the outer periphery of the core material has also been proposed. In this technique, a tube (hereinafter also referred to as “NiTi tube”) formed of a nickel titanium alloy having a slit (cut) on a side surface is used.

However, when compressive rigidity and bending flexibility are ensured by the outer shell, the outer shell has a larger radius than the core material, and therefore has a larger bending radius. When the bending radius is large, there is a problem that the operability at the time of surgery in the surgery support robot having the joint is deteriorated as compared with the case where the bending radius is small.

On the other hand, if the cut amount of the slit provided in the outer shell portion is increased to reduce the bending radius, it is difficult to ensure durability against bending of the outer shell portion, and there is a problem that the possibility of breakage increases.

In addition, when the wire for driving the end effector is disposed inside the joint as described above, when the joint is bent, the inner surface of the joint contacts the wire. When the wire is operated in the contact state, friction occurs between the inner surface of the joint and the operation of the wire is hindered.

According to one aspect of the present disclosure, it is desirable to provide a joint part and a medical device of a medical device that can easily ensure the operability of the joint part and the surgical instrument.

The joint of the medical device according to the first aspect of the present disclosure is a joint arranged between the rod-shaped portion and the surgical tool of the medical device, and is formed in a cylindrical shape having a space therein. A shell portion, a core tube formed in a cylindrical shape having a higher compression rigidity than the outer shell portion, and a resin tube, which is disposed in the inner space of the outer shell portion; And a resin tube formed into a tubular shape from a material having a smaller coefficient of friction with respect to the cable than the core tube while a cable used for operating the surgical tool is inserted into the resin tube. ing.

A medical device according to a second aspect of the present disclosure includes a joint according to the first aspect of the present disclosure, a rod-shaped portion disposed at one end of the joint, and the other end of the joint. And a surgical tool arranged in the part.

According to the joint portion of the medical device according to the first embodiment of the present disclosure, and the medical device according to the second embodiment, the joint portion and the joint portion are formed by combining the outer shell portion, the core tube, and the resin tube. It becomes easy to secure the operability of the surgical tool.

Specifically, the combination of the outer shell and the core tube makes it easier for the joint as a whole to bend into an arc shape, and it is easy to ensure the operability of the joint. In addition, it is possible to suppress insufficient compression stiffness at the joint portion, and it is easy to ensure operability of the surgical instrument.

In addition, by combining the resin tube, it becomes easy to arrange the cable used for operating the surgical instrument near the center axis of the joint. Thereby, it becomes easy to suppress the change in the path length of the cable when the joint is bent, and it is easy to secure the operability of the surgical instrument. Further, since the coefficient of friction with respect to the cable is small, the cable can be easily operated, and the operability of the surgical instrument can be easily secured.

In the above disclosure, a plurality of slits extending in a circumferential direction may be provided on a side surface of the core tube, and the plurality of slits may be arranged at regular intervals in a longitudinal direction of the core tube.

By providing a plurality of slits arranged at equal intervals in the longitudinal direction, it becomes easier to make the flexibility in the longitudinal direction of the joint more uniform than in the case where the intervals of the plurality of slits are uneven, and the operability of the joint is improved. Is easy to secure.

In the above disclosure, on the side surface of the core tube, a plurality of slits extending in a circumferential direction are provided, and the plurality of slits are arranged along the longitudinal direction of the core tube, and a plurality of slits are formed. The arrangement interval may be shorter from the rod portion in the longitudinal direction toward the surgical instrument.

By shortening the interval between the plurality of slits toward the surgical tool, the flexibility of the surgical tool side at the joint becomes higher than when the interval between the multiple slits is uniform. Bends easily.

In the above disclosure, the outer shell may be a flexible body having a helical structure.

By forming the outer shell portion by spirally winding the outer shell plate formed in a belt shape, for example, compared with a case where the outer shell plates formed in a disk shape are arranged in the longitudinal direction, the joint portion is formed. It is easy to shorten the dimension in the longitudinal direction.

In the above disclosure, the outer shell may include a plurality of disk-shaped outer shell plates having a through-hole at the center, which are arranged side by side in the longitudinal direction.

By using a plurality of disc-shaped outer shell plates arranged in the longitudinal direction as an outer shell portion, compared to a case where the outer shell plate formed in a belt shape is spirally wound to form an outer shell portion. In addition, the torsional rigidity at the joint can be easily increased.

In the above disclosure, the core tube may be formed of a metal material containing at least nickel and titanium as components.

By forming the core tube from a metal material containing at least nickel and titanium as components, the compression stiffness and bending flexibility of the core tube are ensured as compared with the case where the core tube is formed from other metal materials. It will be easier.

In the above disclosure, a gap between the core tube and the resin tube may be smaller than a gap between the outer shell member and the core tube.

By making the gap between the core tube and the resin tube smaller than the gap between the outer shell member and the core tube, it becomes easier to bend the joint as compared with the case where it is enlarged, and the operation of the joint is made. Easy to secure.

In the above disclosure, a gap between the resin tube and the cable may be smaller than a gap between the outer shell member and the core tube.

By making the gap between the resin tube and the cable smaller than the gap between the outer shell member and the core tube, the path length of the cable changes when the joint is bent as compared with the case where it is enlarged. And it is easy to secure the operability of the surgical tool.

In the above disclosure, the outer shell and the cable are formed of a conductive material, and are electrically connected to the surgical tool, and the resin tube is disposed between the outer shell and the cable. It may be formed from an insulating material that enables insulation.

The outer shell and the cable are made electrically conductive, and each is electrically contacted with the surgical tool. Two energization paths can be secured. In other words, the surgical tool can be used as a bipolar device.

In addition, since an energization path including the outer shell and an energization path including a cable arranged inside the outer shell are used, the joints are smaller than when the two energization paths pass inside the outer shell. It is easy to reduce the diameter of the part. For example, when the cross-sectional areas of the current-carrying paths passing through the inside of the outer shell are equalized, the current-carrying path including the outer shell and the outer shell are compared with when the two current paths pass through the inside of the outer shell. When an energization path passing through the inside is used, it is easy to reduce the diameter of the joint.

When the outer diameters of the joints are equal, the cross-sectional area of the energized path passing through the inside of the outer shell and the path including the outer shell are smaller than when the two energized paths pass through the inside of the outer shell. Easy to increase. Therefore, it is easy to increase the maximum voltage that can be applied to the surgical instrument. In addition, the current supply path is not easily disconnected due to bending of the joint, in other words, it is difficult to disconnect.

In the above disclosure, a first power cable is provided at an end of the outer shell portion on the side of the surgical instrument so as to enable conduction between the outer shell portion and the surgical tool. A second power cable may be provided at the end opposite to the tool for connecting the outside and the outer shell so as to enable conduction.

(4) By providing the first power cable, the degree of freedom in setting the energization path is increased as compared with the case where the first power cable is not provided, so that conduction between the outer shell and the surgical instrument can be easily ensured. In addition, by providing the second power cable, the degree of freedom in setting the energizing path is increased as compared with a case where the second power cable is not provided, so that conduction between the outside and the outer shell can be easily secured. .

In the above disclosure, at least one of an end of the resin tube on the side of the surgical instrument and an end of the resin tube on the opposite side may protrude from the outer shell in a direction in which the cable extends.

(4) By making the end of the resin tube protrude in the direction in which the cable extends beyond the end of the outer shell, a short circuit between the outer shell and the cable is less likely to occur as compared with a case where it does not protrude. Specifically, as compared with the case where the end of the resin tube is not protruded, the creeping distance, which is the distance from the region of the cable not covered by the resin tube to the outer shell, is likely to be longer, so that a short circuit occurs. It becomes difficult.

In the above disclosure, a cover formed of a material having an insulating property and covering at least a periphery of the outer shell may be provided.

設 け る By providing a cover that covers at least the periphery of the outer shell, it is easier to suppress the flow of current between the outer shell and the treatment target. The cover is disposed between the outer shell and the treatment target or the like. For this reason, a leakage path through which a current flows between the outer shell portion and the treatment target is less likely to occur.

ADVANTAGE OF THE INVENTION According to the joint part of the medical device of this indication, and a medical device, there exists an effect that it becomes easy to ensure the operability of a joint part and a surgical instrument by combining an outer shell part, a core material tube, and a resin tube. .

It is a perspective view explaining the whole medical instrument composition concerning a 1st embodiment. FIG. 2 is a cross-sectional view illustrating the configuration of the joint of FIG. 1. FIG. 2 is a partial cross-sectional view illustrating a configuration of a joint of FIG. 1. FIG. 4 is a perspective view illustrating a configuration of a core tube of FIG. 3. FIG. 4 is a front view illustrating a configuration of a core tube of FIG. 3. FIG. 3 is a schematic cross-sectional view illustrating a relationship between a plurality of gaps in a joint. It is sectional drawing explaining the structure of the joint part in the medical device which concerns on 2nd Embodiment. It is a perspective view explaining the structure of the core tube of FIG. It is sectional drawing explaining the structure of the joint part in the medical device which concerns on 3rd Embodiment. It is a perspective view explaining the structure of the core tube of FIG. It is a partial perspective view explaining composition of an outer shell part in a joint part of a medical instrument concerning a 4th embodiment. FIG. 12 is another partial perspective view illustrating the configuration of the outer shell part in FIG. 11. It is a partial perspective view explaining composition of a medical instrument concerning a 5th embodiment of this indication. FIG. 14 is a cross-sectional view illustrating the configuration of the joint of FIG. 13.

1, 101, 201, 301, 401: medical instrument, # 10: rod-shaped part, # 20: surgical tool, 21: cable (cable) for surgical tool, # 30, 130, 230, 330, 430: joint part, # 31, 331 , 431: outer shell (outer shell member), # 41, 141, 241: core tube, # 42, 242: slit, # 51, 451: resin tube, # 335: outer shell plate, 460: cover, #first power cable 471 , {2nd power cable 472, DA, DB, DC ... gap, D, D1, Dn ... interval

[First Embodiment]
Hereinafter, the medical device 1 according to the first embodiment of the present disclosure will be described with reference to FIGS. 1 to 6. The medical instrument 1 according to the present embodiment is an endoscopic surgical instrument used for an endoscopic surgical operation or the like, and may be used for a surgical assistance robot.

As shown in FIG. 1, the medical instrument 1 includes a rod-shaped portion 10 disposed on the side of the surgery support robot, a surgical tool 20 used for endoscopic surgery, and the like, between the rod-shaped portion 10 and the surgical tool 20. And a joint 30 arranged at the center of the vehicle.

The rod-shaped portion 10 is a column-shaped member attached to the surgery support robot. The rod-shaped part 10 is formed in a cylindrical shape having an internal space (not shown) through which a later-described surgical instrument cable (cable) 21 and a joint part cable 61 are inserted. For ease of explanation, the direction in which the central axis CL corresponding to the rod-shaped portion 10 extends is described as an X direction, a direction orthogonal to the X direction is defined as a Y direction, and a direction orthogonal to the X direction and the Y direction is defined as a Z direction. I do.

The surgical tool 20 is arranged at the tip of the joint 30, in other words, at the end on the positive side in the X direction. In addition, the relative position and the relative posture of the surgical tool 20 with respect to the rod 10 are controlled by bending the joint 30. The surgical tool 20 is a forceps that is opened and closed by a surgical tool cable 21. The surgical instrument 20 may be other instruments used for endoscopic surgery or the like, other than forceps, and the specific type is not limited.

The joint 30 is a cylindrical or columnar member provided at the tip of the rod 10 attached to the surgery support robot, in other words, at the end on the positive side in the X direction. By operating a joint cable 61 to be described later, the joint 30 is bent in an arc shape in the Y direction, in an arc shape in the Z direction, and in a direction combining the Y direction and the Z direction. Is configured to be capable of bending in an arc shape.

As shown in FIG. 2, the joint 30 includes an outer shell (outer shell member) 31, a core tube 41, a resin tube 51, and a joint cable 61.

The outer shell 31 is a member constituting the outer shape of the joint 30 and is formed in a cylindrical shape. The outer shell 31 is attached to the rod 10 and the surgical tool 20. The outer shell portion 31 is configured to be capable of arcuate bending in the Y direction, arcuate bending in the Z direction, and arcuate bending in a direction combining the Y direction and the Z direction. Thus, it is configured to be able to expand and contract in the X direction. The material forming the outer shell 31 may be a metal material or a resin material.

As shown in FIGS. 2 and 3, the outer shell 31 has a rod-side end 32 (hereinafter referred to as an end 32) to which the rod 10 is attached, and a surgical-tool-side end 33 to which the surgical tool 20 is attached. (Hereinafter referred to as an end portion 33). The end 32 is a negative end of the outer shell 31 in the X direction, and the end 33 is a positive end of the outer shell 31 in the X direction. The end portion 32 and the end portion 33 are provided with a step portion 34 used for attaching the rod portion 10 and the surgical instrument 20, respectively.

領域 A region between the end portion 32 and the end portion 33 in the outer shell portion 31 is a region that can be bent in an arc shape. In the present embodiment, the plate-like member 35 extending substantially along the YZ plane is a rod-shaped member that rotates around the longitudinal direction of the outer shell 31 (in other words, a portion corresponding to the outer shell 31 on the center axis CL). The part 10 and the surgical tool 20 are arranged so as to move from one side to the other (in other words, spirally). Note that the region may be any shape as long as it can be bent in an arc shape, and the specific shape is not limited.

As shown in FIGS. 2 and 3, the outer shell 31 extends in the longitudinal direction of the outer shell 31 (in other words, in the X direction when the outer shell 31 extends linearly). A first through-hole (space) 36 and a second through-hole 37 penetrating the outer shell 31 are provided.

The first through-hole 36 is a through-hole extending along a portion corresponding to the outer shell 31 on the center axis CL. In the first through hole 36, the core tube 41, the resin tube 51, and the surgical instrument cable 21 can be arranged. The inner peripheral surface of the first through hole 36 supports the core tube 41 from the periphery.

The second through-hole 37 is a through-hole provided on a circumference centered on the center axis line CL and spaced at equal intervals. Specifically, the second through hole 37 is located at a position away from the first through hole 36 in the positive direction in the Y direction, at a position away from the first through hole 36 in the negative direction, and at a position away from the first through hole 36 in the positive direction in the Z direction. , Through holes provided at a total of four locations separated in the negative direction. In each of the four second through holes 37, a cable 61 for a joint can be arranged.

径 At the end of the second through hole 37 on the side of the surgical instrument 20 (positive side in the X direction), an enlarged portion 38 having a larger diameter than other portions is formed (see FIG. 3). A locking end 62 provided on the joint cable 61 is disposed in the enlarged diameter portion 38 (see FIG. 2).

In the present embodiment, the second through-holes 37 are provided at four positions. However, the number of the second through-holes 37 is not limited as long as the outer shell 31 can be bent in an arbitrary direction.

As shown in FIGS. 3 to 5, the core tube 41 is a cylindrical member having an outer diameter smaller than that of the outer shell 31 and is provided inside the first through hole 36 of the outer shell 31. It is a member to be arranged. The core tube 41, like the outer shell 31, has an arc-shaped bend in the Y-direction, an arc-shaped bend in the Z-direction, and an arc-shaped bend in a direction combining the Y-direction and the Z-direction. Has a possible configuration.

(4) The core tube 41 has a higher compression rigidity than the outer shell portion 31 and has less expansion and contraction due to a compressive force and a tensile force in the X direction. For example, by forming the core tube 41 from a metal material containing at least nickel and titanium as components, more preferably a nickel-titanium alloy, the compression rigidity of the core tube 41 is increased.

The core tube 41 is provided with a plurality of slits 42 extending in the circumferential direction on a side surface (circumferential surface) thereof. On the side surface of the core tube 41, two slits 42 extending substantially halfway around the side surface are arranged at the same position (same height) in the center axis CL, that is, in the X direction. Between the two slits 42, a column 43 that forms a part of the side surface of the core tube 41 is formed.

The two slits 42 are arranged side by side at an interval D along a central axis CL that is a longitudinal direction of the core tube 41. The interval D has the same value from the end of the core tube 41 on the side of the rod 10 (the end on the negative side in the X direction) to the end on the side of the surgical instrument 20 (the end on the positive side in the X direction). ing.

In other words, the plurality of slits 42 are arranged at equal intervals in the longitudinal direction of the core tube 41. The plurality of slits 42 include a set in which two slits 42 are arranged in the Y direction and a set in which two slits 42 are arranged in the Z axis. The sets arranged side by side in the Y direction and the sets arranged side by side in the Z axis are arranged alternately.

The resin tube 51 is a member formed in a cylindrical shape as shown in FIGS. 2 and 3, and is a member arranged inside the core tube 41. The surgical instrument cable 21 is inserted into the resin tube 51.

The resin tube 51 is formed of a material having a smaller coefficient of friction with respect to the surgical instrument cable 21 than the material forming the core tube 41. As a material for forming the resin tube 51, a material having a small friction coefficient and high heat resistance, for example, PTFE (polytetrafluoroethylene) can be exemplified.

In addition, the resin tube 51 is arranged such that the surgical instrument cable 21 arranged inside is arranged coaxially with or near the center axis CL of the joint 30 (hereinafter also referred to as “near the center axis CL”). , Guide the surgical instrument cable 21. For example, when the joint portion 30 is in a posture extending coaxially with the rod-shaped portion 10 (a posture extending linearly), the surgical instrument cable 21 is arranged near the center axis CL extending in the X direction. Guide the component cable 21. When the joint 30 is bent, the surgical instrument cable 21 is guided so that the surgical instrument cable 21 is disposed near the center axis CL of the bent joint 30.

6, the gap DA between the core tube 41 and the resin tube 51 is smaller than the gap DC between the outer shell 31 and the core tube 41 (gap DA <gap DC). ). The gap DB between the resin tube 51 and the surgical instrument cable 21 is smaller than the gap DC between the outer shell 31 and the core tube 41 (gap DB <gap DC).

Next, the operation of the medical device 1 having the above configuration will be described. Specifically, the bending operation of the joint 30 and the operation of the surgical tool 20 will be described with reference to FIGS. 1 and 2. For example, when the joint 30 is bent in an arc shape in the positive direction of the Y direction, At least one of the two joint cables 61 (joint cables 61 shown in a cross section in FIG. 2) arranged in the Y direction among the four joint cables 61 is operated.

Specifically, an operation is performed in which the joint cable 61 arranged on the positive side in the Y direction is pulled toward the rod 10 (negative side in the X direction). The joint portion cable 61 disposed on the negative side in the Y direction may be positively sent out toward the surgical instrument 20 (the positive side in the X direction), or may be sent out with the bending of the joint portion 30. It may be. Furthermore, in order to control the bending state of the joint part 30, a tension may be applied to pull the joint part cable 61 toward the rod-shaped part 10 while sending the joint part cable 61 toward the surgical instrument 20 (the positive side in the X direction).

The joint 30 is bent in an arc shape by operating the joint cable 61. At this time, the compression stiffness of the core tube 41 suppresses the joint 30 from shrinking in the X direction due to the pulling operation of the joint cable 61. In addition, since the core tube 41 having an outer diameter smaller than that of the outer shell portion 31 is disposed inside the first through hole 36 of the outer shell portion 31, the center axis CL of the joint portion 30 due to bending is formed. The change in the length along the portion is suppressed.

When returning the bent joint 30 to the posture extended in the X direction, the operation of pulling the joint cable 61 disposed on the negative side in the Y direction toward the rod 10 (the negative side in the X direction). Is performed.

When the joint 30 is bent in an arc shape in the Z direction, at least one of the two joint cables 61 arranged in the Z direction among the four joint cables 61 is operated. When bending in an arc shape in a direction combining the Y direction and the Z direction, at least two of the four joint cables 61 are operated.

術 The operation of the surgical instrument 20 of the medical instrument 1 is performed by operating the surgical instrument cable 21. For example, the operation of the surgical tool 20 is performed by an operation of pulling the surgical tool cable 21 toward the rod portion 10 (negative side in the X direction). The operation method of the operation tool cable 21 can be appropriately changed according to the type of the operation tool 20, and is not limited to the above operation method.

According to the above configuration, the operability of the joint 30 and the surgical instrument 20 can be easily secured by combining the outer shell 31, the core tube 41, and the resin tube 51.

Specifically, the combination of the outer shell 31 and the core tube 41 makes it easier for the joint 30 to bend into an arcuate shape as a whole, and to ensure the operability of the joint 30. In addition, shortage of compression stiffness in the joint 30 can be suppressed, and operability of the surgical instrument 20 can be easily secured.

In addition, by combining the resin tube 51, the surgical instrument cable 21 used for operating the surgical instrument 20 can be easily arranged near the center axis CL of the joint section 30. This makes it easy to suppress a change in the path length of the surgical instrument cable 21 when the joint portion 30 is bent, and it is easy to secure the operability of the surgical instrument 20. Furthermore, since the resin tube 51 has a small coefficient of friction with respect to the surgical instrument cable 21, the operation of the surgical instrument cable 21 is facilitated, and the operability of the surgical instrument 20 is easily ensured.

By providing a plurality of slits 42 arranged at equal intervals along the central axis line CL which is the longitudinal direction of the core tube 41, compared with the case where the intervals of the slits 42 are non-uniform, It becomes easy to make the flexibility uniform, and it becomes easy to secure the operability of the joint 30.

By forming the outer shell portion 31 by spirally winding an outer shell plate formed in a belt shape, for example, as compared with a case where the outer shell plates formed in a disk shape are arranged in the longitudinal direction, It is easy to shorten the dimension of the outer shell 31 in the direction of the central axis CL which is the longitudinal direction of the joint 30.

By forming the core tube 41 from a metal material containing at least nickel and titanium as components, the compression stiffness and bending flexibility of the core tube 41 are compared with the case where the core tube 41 is formed from other metal materials. Is easy to secure.

By making the gap DA between the core tube 41 and the resin tube 51 smaller than the gap DC between the outer shell portion 31 and the core tube 41, the joint portion is larger than the case where the gap DA is larger than the gap DC. The joint 30 is easily bent, and the operability of the joint 30 is easily ensured.

By making the gap DB between the resin tube 51 and the surgical instrument cable 21 smaller than the gap DC between the outer shell portion 31 and the core tube 41, compared with the case where the gap DB is made larger than the gap DC, When the joint portion 30 is bent, a change in the path length of the surgical instrument cable 21 is easily suppressed, and the operability of the surgical instrument 20 is easily ensured.

[Second embodiment]
Next, a second embodiment of the present disclosure will be described with reference to FIGS. 7 and 8. The basic configuration of the medical device of the second embodiment is the same as that of the first embodiment, but is different from the first embodiment in the configuration of the core tube. In the second embodiment, the configuration of the core tube will be described with reference to FIGS. 7 and 8, and description of other configurations will be omitted.

The core tube 141 of the joint 130 in the medical device 101 of the second embodiment is a cylindrical member having an outer diameter smaller than that of the outer shell 31 as shown in FIGS. 7 and 8. It is a member arranged inside the first through hole 36 of the outer shell 31.

The core material tube 141 has a configuration capable of bending in an arc shape in the Y direction, bending in an arc shape in the Z direction, and bending in an arc shape combining the Y direction and the Z direction. The material for forming the core tube 141 is the same as the material for forming the core tube 41 of the first embodiment, and a description thereof will be omitted.

The core tube 141 is provided with a plurality of slits 42 which are cuts extending in the circumferential direction on the side surface. At the same position (same height) in the X direction, at least two slits 42 and column portions 43 extending substantially halfway around the side surface are formed on the side surface of the core tube 141.

The above-mentioned two slits 42 are arranged side by side at an interval. The interval is from the interval D1 at the end of the core tube 141 on the rod-shaped portion 10 side (the end on the negative side in the X direction) to the interval at the end on the surgical instrument 20 side (the end on the positive side in the X direction). Dn (n is a natural number and a value determined by the number of slits 42) is set so that the value becomes smaller (the interval becomes shorter).

The operation (bending operation of the joint 30 and operation of the surgical instrument 20) in the medical device 101 having the above-described configuration is the same as the operation in the medical device 1 of the first embodiment, and a description thereof will be omitted. .

According to the above configuration, by shortening the arrangement interval of the plurality of slits 42 toward the surgical instrument 20, compared with the case where the interval of the plurality of slits 42 is uniform, Flexibility is increased. Therefore, the joint 130 can be easily bent in an arc shape.

[Third embodiment]
Next, a third embodiment of the present disclosure will be described with reference to FIGS. 9 and 10. The basic configuration of the medical device of the third embodiment is the same as that of the first embodiment, but is different from the first embodiment in the configuration of the core tube. Therefore, in the third embodiment, the configuration of the core tube will be described with reference to FIGS. 9 and 10, and the description of the other configurations will be omitted.

The core tube 241 of the joint 230 in the medical device 201 of the third embodiment is a cylindrical member having an outer diameter smaller than that of the outer shell 31 as shown in FIGS. 9 and 10. It is a member arranged inside the first through hole 36 of the outer shell 31.

The core tube 241 has a configuration capable of bending in an arc shape in the Y direction, bending in an arc shape in the Z direction, and bending in an arc shape combining the Y direction and the Z direction. The material for forming the core tube 241 is the same as the material for forming the core tube 41 of the first embodiment, and a description thereof will be omitted.

ス リ ッ ト The core tube 241 is provided with a slit 242 which is a cut in the side surface. The slit 242 is a cut formed in a spiral shape that extends so as to rotate about the central axis CL and extends from the rod-shaped portion 10 toward the surgical instrument 20 along the central axis CL.

The pitch P1 at the end of the core tube 241 on the rod-shaped portion 10 side (the end on the negative side in the X direction) is greater than the pitch P2 at the end on the surgical instrument 20 side (the end on the positive side in the X direction). Becomes larger. Further, the value of the pitch of the slit 242 continuously changes. Here, the pitch is an amount by which the slit 242 moves along the central axis CL during one rotation around the central axis CL.

The operation (bending operation of the joint 30 and operation of the surgical instrument 20) in the medical device 201 having the above-described configuration is the same as the operation in the medical device 1 of the first embodiment, and thus the description thereof is omitted. .

According to the above configuration, by shortening the pitch of the slit 42 toward the surgical tool, the flexibility of the joint section 230 on the surgical tool 20 side is increased as compared with the case where the pitch of the slit 42 is uniform. . Therefore, the joint 230 can be easily bent in an arc shape.

[Fourth embodiment]
Next, a fourth embodiment of the present disclosure will be described with reference to FIGS. The basic configuration of the medical device of the fourth embodiment is the same as that of the first embodiment, but is different from the first embodiment in the configuration of the outer shell. Therefore, in the fourth embodiment, the configuration of the outer shell will be described with reference to FIGS. 11 and 12, and the description of other configurations will be omitted.

The outer shell 331 of the joint 330 in the medical device 301 of the fourth embodiment constitutes the outer shape of the joint 330 as shown in FIGS. 11 and 12, and includes the rod-shaped portion 10 and the surgical instrument. 20. The material forming the outer shell 331 may be a metal material or a resin material.

The outer shell portion 331 is configured by stacking a plurality of disk-shaped or columnar outer shell plates 335 in the direction of the center axis CL (X direction). The end surface of the outer shell plate 335 on the side of the surgical instrument 20 (the positive side in the X direction) is formed with a concave surface 336 having a V-shaped cross section and extending. On the end surface on the side of the rod-shaped portion 10 (negative side in the X direction), a convex surface 337 whose cross section protrudes and extends in a V-shape is formed.

方向 The direction in which the concave surface 336 extends in the same outer shell plate 335 and the direction in which the convex surface 337 extends intersect. More preferably, they are orthogonal. Further, the V-shaped angle of the concave surface 336 is larger than the V-shaped angle of the convex surface 337.

When the outer shell plate 335 and the other outer shell plate 335 are overlapped, the convex surface 337 of the other outer shell plate 335 is overlapped with the concave surface 336 of the one outer shell plate 335. At this time, the V-shaped ridge line of the concave surface 336 and the V-shaped ridge line of the convex surface 337 are overlapped.

The space between one outer shell plate 335 and the other outer shell plate 335 is in contact at the above-mentioned ridge line, and a space is formed in the other region. Due to this space, one outer shell plate 335 and the other outer shell plate 335 can relatively rotate about the ridge line as an axis.

In other words, the outer shell portion 331 has a configuration capable of bending in an arc shape in the Y direction, bending in an arc shape in the Z direction, and bending in an arc shape combining the Y direction and the Z direction. .

The operation (bending operation of the joint 30 and operation of the surgical instrument 20) in the medical device 301 having the above-described configuration is the same as the operation in the medical device 1 of the first embodiment, and a description thereof will be omitted. .

According to the above configuration, a plurality of disk-shaped outer shell plates 335 are arranged in the longitudinal direction, in other words, in the direction of the center axis CL to form the outer shell portion 331, so that the belt-shaped outer shell plate 331 is formed. The torsional rigidity of the joint 330, for example, the torsional rigidity about the center axis CL is easily increased as compared with the case where the outer shell is formed by spirally winding.

The end surface of the outer shell plate 335 on the side of the surgical instrument 20 (positive side in the X direction) may be formed as a concave surface 336, and the end surface on the rod-shaped portion 10 side (negative side in the X direction) may be formed as a convex surface 337. Alternatively, the end surface on the side of the surgical instrument 20 may be formed as a convex surface 337, and the end surface on the side of the rod-shaped portion 10 may be formed as a concave surface 336.

[Fifth Embodiment]
Next, a fifth embodiment of the present disclosure will be described with reference to FIGS. The basic configuration of the medical device of the fifth embodiment is the same as that of the first embodiment, but differs from the first embodiment mainly in the configuration of the outer shell. Therefore, in the fifth embodiment, the configuration of the outer shell and the like will be described with reference to FIGS. 13 and 14, and the description of the other configurations will be omitted.

As shown in FIG. 13, the medical device 401 of the fifth embodiment has a rod-shaped portion 10, a surgical tool 20 used for endoscopic surgery or the like, and between the rod-shaped portion 10 and the surgical tool 20. A joint 430 to be arranged and a cover 460 covering at least the periphery of the joint 430 are provided.

The joint 430 is a cylindrical or columnar member provided at the tip of the rod 10 attached to the surgery support robot, in other words, at the positive end in the X direction. By operating the joint cable 61, the joint 430 can be bent in an arc shape in the Y direction, an arc shape in the Z direction, and a circle in a direction combining the Y direction and the Z direction. It is configured such that arc-shaped bending is possible.

As shown in FIGS. 13 and 14, the joint 430 is provided with an outer shell (outer shell member) 431, a core tube 41, a resin tube 451, and a joint cable 61. .

The outer shell 431 is a member that is formed in a cylindrical shape and constitutes the outer shape of the joint 430, and is a member that is attached to the rod 10 and the surgical instrument 20. The outer shell portion 431 has a configuration capable of bending in an arc shape in the Y direction, bending in an arc shape in the Z direction, and bending in an arc shape combining the Y direction and the Z direction. It is configured to be able to expand and contract in the direction. Examples of the material forming the outer shell portion 431 include a conductive material, for example, a metal material such as SUS304 (a JIS standard symbol for stainless steel that is a steel containing chromium and nickel).

Similarly to the outer shell 31 of the first embodiment, the outer shell 431 includes an end 32, an end 33, a step 34, a first through hole 36, and a second through hole 37. Is provided. The region between the end portion 32 and the end portion 33 in the outer shell portion 431 is configured in the same manner as in the first embodiment.

Further, a first power cable 471 for enabling connection between the outer shell portion 431 and the surgical instrument 20 and an electrical connection between the outside and the outer shell portion 431 are connected to the outer shell portion 431. A second power cable 472 is provided.

The first power cable 471 is a conductive cable that extends from the end face of the end 33 toward the surgical instrument 20. Among the ends of the first power cable 471, the end on the end 33 side is conductively connected to the end 33, and the end on the surgical instrument 20 side is conductively connected to the surgical tool 20. .

The second power cable 472 is a conductive cable extending along the rod 10 from the end face of the end 32. Of the ends of the second power cable 472, the end on the end 32 side is conductively connected to the end 32, and the opposite end is conductive on a power source disposed outside the rod 10. It is connected to the.

As the first power cable 471 and the second power cable 472, cables having conductivity can be used, and specific configurations and types thereof are not limited.

The resin tube 451 is a member formed in a cylindrical shape, and is a member arranged inside the core tube 41. The surgical instrument cable 21 is inserted into the inside of the resin tube 451.

The resin tube 451 is formed of the same material as the resin tube 51 of the first embodiment. Further, it also guides such that the surgical instrument cable 21 arranged inside is arranged near the center axis CL of the joint 430.

端 The end of the resin tube 451 on the side of the surgical instrument 20 is arranged so as to protrude from the end surface of the end 33, and the end of the resin tube 451 on the side of the rod-shaped portion 10 is arranged so as to protrude from the end surface of the end 32.

The amount by which the end of the resin tube 451 protrudes from the end surface of the end portion 33 and the amount by which it protrudes from the end surface of the end portion 32 can ensure at least insulation between the outer shell portion 431 and the surgical instrument cable 21. The amount is preferred.

In other words, the protrusion between the end surface of the end portion 33 and the surface of the surgical instrument cable 21 exposed from the resin tube 451 is preferably such that insulation can be ensured. It is preferable that the protrusion between the end surface of the end portion 32 and the surface of the surgical instrument cable 21 that is exposed from the resin tube 451 can ensure insulation.

The degree of insulation is a value determined based on the voltage applied from the power supply to the surgical instrument 20, and also determined based on rules that regulate the safety required of the medical device 401.

The cover 460 is a cylindrical member formed from a material having an insulating property as shown in FIG. The cover 460 has a length that covers at least the periphery of the outer shell 431. Specifically, it has a length that covers the periphery of the outer shell 431 and the end of the rod 10.

径 Around the end of the cover 460 on the side of the surgical instrument 20, there is formed an enlarged area in which the diameter of the cover 460 increases toward the rod 10. Further, the area of the cover 460 facing the rod 10 is smaller in diameter than the area facing the outer shell 431, and is in contact with the outer peripheral surface of the rod 10.

材料 The material for forming the cover 460 is preferably a material having higher insulating properties than the outer shell 431. For example, a flexible material such as silicone rubber that can be used in endoscopic surgery or the like is preferable.

The operation (bending operation of the joint 430 and operation of the surgical instrument 20) in the medical device 401 having the above-described configuration is the same as the operation in the medical device 1 of the first embodiment, and thus the description thereof is omitted. .

According to the medical device 401 having the above-described configuration, the outer shell portion 431 and the operating tool cable 21 are made conductive, and each of them is electrically contacted with the operating tool 20. Since the two are insulated by the resin tube 451 disposed between the cables 21, two current paths can be secured for the surgical instrument 20. In other words, the surgical tool 20 can be used as a bipolar device.

In addition, since an energizing path including the outer shell 431 and an energizing path including the surgical instrument cable 21 disposed inside the outer shell 431 are used, two energizing paths pass through the inside of the outer shell 431. In comparison with the case, the diameter of the joint 430 can be easily reduced. For example, when the cross-sectional areas of the energization paths passing through the inside of the outer shell portion 431 are equalized, the energization path including the outer shell portion 431 and the outer When an energization path passing through the inside of the shell 431 is used, the diameter of the joint 430 can be easily reduced.

When the outer diameters of the joints 430 are equalized, compared to the case where the two energization paths pass through the inside of the outer shell, the energization path passing through the inside of the outer shell 431 and the path including the outer shell 431 are compared. Easy to increase cross-sectional area. Therefore, the maximum voltage that can be applied to the surgical instrument 20 can be easily increased. In addition, it is possible to make it difficult for the current supply path to be disconnected due to the bending of the joint 430 or the like, in other words, to make it difficult for disconnection.

(4) By providing the first power cable 471, the degree of freedom in setting the energization path is increased as compared with the case where the first power cable 471 is not provided. Therefore, conduction between the outer shell 431 and the surgical instrument 20 can be easily secured. Further, by providing the second power cable 472, the degree of freedom in setting the energization path is increased as compared with the case where the second power cable 472 is not provided. Therefore, conduction between the outside and the outer shell portion 431 is easily ensured.

さ せ る By making the end of the resin tube 451 protrude from the end of the outer shell 431, a short circuit between the outer shell 431 and the surgical instrument cable 21 is less likely to occur than in a case where the resin tube 451 does not protrude. Specifically, as compared with the case where the end of the resin tube 451 is not protruded, the creepage distance which is the distance from the region of the surgical instrument cable 21 not covered by the resin tube 451 to the outer shell portion 431 is increased. Therefore, a short circuit is less likely to occur.

By providing the cover 460 that covers at least the periphery of the outer shell portion 431, it becomes easier to suppress the flow of current between the outer shell portion 431 and the target to be treated by the surgical instrument 20 or the like. The cover 460 is disposed between the outer shell 431 and the treatment target or the like. Therefore, it is difficult to form a leakage path, which is a path through which current flows between the outer shell 431 and the treatment target or the like.
The technical scope of the present disclosure is not limited to the above embodiment, and various changes can be made without departing from the spirit of the present disclosure. For example, the present disclosure is not limited to the one applied to the above embodiment, and may be applied to an embodiment in which these embodiments are appropriately combined, and is not particularly limited.

Claims (13)

1. A joint portion disposed between the rod portion and the surgical tool in the medical device,
   An outer shell formed into a cylindrical shape having a space inside,
   A core material tube arranged in the inner space of the outer shell portion and formed in a cylindrical shape having a higher compression rigidity than the outer shell portion;
   A resin tube which is disposed in the inner space of the core tube, into which a cable used for operating the surgical tool is inserted, and which is formed in a tubular shape from a material having a smaller coefficient of friction with respect to the cable than the core tube. When,
   A joint of a medical device, comprising:
2. A plurality of slits extending in the circumferential direction are provided on a side surface of the core tube,
   The joint of the medical device according to claim 1, wherein the plurality of slits are arranged at regular intervals in a longitudinal direction of the core tube.
3. A plurality of slits extending in the circumferential direction are provided on a side surface of the core tube,
   The plurality of slits are arranged side by side in the longitudinal direction of the core tube, and the arrangement interval of the plurality of slits decreases from the rod-shaped portion in the longitudinal direction toward the surgical tool.
   The joint of the medical device according to claim 1.
4. 4. The joint of the medical device according to claim 1, wherein the outer shell is a flexible body having a helical structure. 5.
5. 4. The outer shell portion according to claim 1, wherein outer shell plates, which are a plurality of disk-shaped members provided with through holes in the center, are arranged in the longitudinal direction. 5. Joints of medical instruments.
6. The joint part of the medical device according to any one of claims 1 to 5, wherein the core material tube is formed of a metal material containing at least nickel and titanium as components.
7. The joint section of the medical device according to any one of claims 1 to 6, wherein a gap between the core tube and the resin tube is smaller than a gap between the outer shell member and the core tube. .
8. The joint part of the medical device according to any one of claims 1 to 7, wherein a gap between the resin tube and the cable is smaller than a gap between the outer shell member and the core tube.
9. The outer shell and the cable are formed of a conductive material, and are electrically connected to the surgical tool,
   The joint of a medical device according to claim 1, wherein the resin tube is formed of an insulating material that enables insulation between the outer shell and the cable.
10. At the end of the outer shell portion on the side of the surgical instrument, a first power cable that connects the outer shell portion and the surgical instrument so as to allow conduction is provided,
    10. The medical device according to claim 9, wherein a second power cable is provided at an end of the outer shell opposite to the surgical instrument, the second power cable connecting the outer shell and the outer shell so as to enable conduction. The joints of the instrument.
11. 11. The end according to claim 9, wherein at least one of an end of the resin tube on the side of the surgical tool and an end of the resin tube opposite to the surgical tool protrudes from the outer shell in a direction in which the cable extends. A joint of the medical device as described.
12. The joint part of the medical device according to any one of claims 9 to 11, wherein a cover made of a material having an insulating property and covering at least a periphery of the outer shell part is provided.
13. A joint part according to any one of claims 1 to 12,
    A rod-shaped portion disposed at one end of the joint,
    A surgical tool arranged at the other end of the joint,
    Is provided, medical equipment.

Images