JP5547971B2 - Surgical instruments - Google Patents

Description

  The present invention relates to a surgical instrument. For example, the present invention relates to a surgical instrument that can be operated remotely.

2. Description of the Related Art Conventionally, in surgical operations, for example, surgical instruments in which the operation of a treatment instrument such as forceps is remotely controlled and the position and posture of the treatment instrument can be remotely controlled are known. Such a surgical instrument has a large number of moving parts, and even if a part of it is broken or damaged, it will not function. Therefore, it is strongly recommended that the user can easily replace it for repair. It has been demanded.
For example, as an example of such a surgical instrument, Patent Document 1 discloses an operation command unit having a posture operation unit and a treatment operation unit, a connection unit having one end connected to the operation command unit, and other than the connection unit. A working unit connected to the end side and having a treatment unit (treatment instrument unit) and a support unit that supports the treatment unit in a posture changeable in two or more degrees of freedom, and an operation command from the posture operation unit to the support unit In order to change the posture of the treatment unit by sending the operation command from the treatment operation unit to the treatment unit to operate the treatment unit and to remove the treatment unit from the support unit There is described a medical manipulator characterized by comprising a detachable part.
According to the medical manipulator of Patent Literature 1, the operation of the treatment unit and the posture with other degrees of freedom can be operated via the gear. Moreover, since the treatment part is detachably provided by the attachment / detachment part, the treatment part can be replaced when the treatment part fails.

JP 2001-277157 A

However, the conventional surgical instruments as described above have the following problems.
In the technique described in Patent Document 1, when only the treatment part fails, it can be easily maintained by replacing the treatment part. However, the treatment part is supported so that the posture can be changed with two or more degrees of freedom. Since the supporting part to be performed has a more complicated movable part, not only the treatment part but also the supporting part may be damaged. For example, there is a possibility that a rod-like tube or a wire constituting the drive mechanism of the support portion may be damaged.
Failures at the time of driving often occur in a driving system with a large driving load. However, with the technique described in Patent Document 1, for example, when a rod-like tube or wire of a specific driving system is damaged, Since it cannot be easily replaced, the entire support portion must be replaced, and there is a problem that a device portion of a normal drive system is wasted. Therefore, the repair cost is expensive.

  The present invention has been made in view of the above problems, and in a surgical instrument remotely operated by a drive system, it can be easily assembled and replaced in units of drive systems, and is efficiently repaired. It is an object to provide a surgical instrument that can.

In order to solve the above-mentioned problem, in the invention according to claim 1, a surgical instrument having a driven part and a driving part for remotely controlling the operation of the driven part, wherein the driven part includes: A plurality of driven units each having a driven body and a holding member that holds the driven body so as to be relatively movable are detachably connected, and the driving unit is connected to the driven body of the driven unit. A distal end side is connected to each of the driven bodies from the proximal end side, and a driving force transmitting portion that independently transmits the driving force, and a proximal end side of the driving force transmitting portion is connected to each of the driven force transmitting portions. A driving force supply unit that supplies the positioning unit, and each of the driven units is detachably connected to at least one of the driven body and the holding member with respect to another driven unit. With a connecting part In addition, the at least one driven unit is provided with an attaching / detaching opening which is an opening through which the other driven unit can be inserted together with the driving force transmitting portion when the other driven unit is attached / detached. The configuration is as follows.

  According to a second aspect of the present invention, in the surgical instrument according to the first aspect, three or more driven units are detachably connected.

  According to a third aspect of the present invention, in the surgical instrument according to the first or second aspect, one of the driven units is a treatment instrument that treats the treatment target as one driven body of the driven unit. And a unit that changes at least one of the position and orientation of the holding member of another driven unit to which another driven body of the driven unit is connected in addition to the driven unit. And

  According to a fourth aspect of the present invention, in the surgical instrument according to the third aspect, each other driven body of the driven unit is rotatably supported by each other holding member of the driven unit. The configuration is as follows.

  According to a fifth aspect of the present invention, in the surgical instrument according to the fourth aspect, each of the other driving force transmitting portions of the driven unit is fixed to another driven body of the driven unit, A driving body and a pulley that is rotatably supported by another holding member of the driven unit, and a flexible linear member that is wound around the pulley.

  According to a sixth aspect of the present invention, in the surgical instrument according to the fifth aspect, the linear member is inserted through a flexible tubular member.

  According to a seventh aspect of the present invention, in the surgical instrument according to the sixth aspect, the tubular member is a coil pipe obtained by winding a metal wire in a coil shape.

  The invention according to claim 8 is the surgical instrument according to claim 6, wherein the tubular member is a pipe member made of a superelastic alloy.

  The invention according to claim 9 is the surgical instrument according to claim 6, wherein the tubular member is a tube member having flexibility.

  According to a tenth aspect of the present invention, in the surgical instrument according to the fourth aspect, each of the other driving force transmitting portions of the driven unit is configured to rotate relative to a rotation fulcrum of the other driven body of the driven unit. And a link mechanism for advancing and retracting the eccentricly provided link member.

  According to an eleventh aspect of the present invention, in the surgical instrument according to any one of the first to tenth aspects, the attachment / detachment opening provided in the driven unit is externally fitted to an outer peripheral portion of the driven unit to be attached / detached. And it consists of the hole part penetrated inside, and the said positioning connection part is set as the structure provided inside the said hole part.

  According to a twelfth aspect of the present invention, in the surgical instrument according to any one of the first to tenth aspects, the attachment / detachment opening provided in the driven unit is formed on a side of the driven body and the holding member. It is made up of a slit provided so that the driven unit to be attached / detached can be inserted / removed from the side together with the driving force transmission portion.

  According to a thirteenth aspect of the present invention, in the surgical instrument according to any one of the first to tenth aspects, the positioning connecting portion is provided as a recess in one of the driven units to be connected to each other and connected to each other. The other of the driven units is provided as a convex part that fits into the concave part.

  The invention according to claim 14 is the surgical instrument according to claim 13, wherein the convex portion is made of an elastic member and is provided so as to be movable forward and backward in the protruding direction.

In the invention described in claim 15, A surgical instrument according to any of claims 1 to 10, wherein the positioning coupling portion, said to one of the one and the other of the drive unit coupled to each other physician, mounting The position is fixed by the fastening member provided.

  According to a sixteenth aspect of the present invention, in the surgical instrument according to any one of the first to tenth aspects, a driving force supply source that generates the driving force supplied from the driving force supply unit is provided.

  According to the surgical instrument of the present invention, the driving force transmission unit and the driving force supply unit are connected to the driven unit to form a driving system, and the driven unit includes the positioning connecting portion and the detachable opening. In a surgical instrument that is remotely operated by the system, it is possible to easily assemble and replace each drive system, and it is possible to efficiently repair the surgical instrument.

It is a typical perspective view which shows the structure of the principal part of the surgical instrument which concerns on embodiment of this invention. It is a typical exploded perspective view of the principal part of the surgical instrument concerning the embodiment of the present invention. It is AA sectional drawing in FIG. 2 which shows a mode at the time of closing and opening of the treatment instrument part of the surgical instrument which concerns on embodiment of this invention. FIG. 3 is a BB cross-sectional view, a DD cross-sectional view, and an EE cross-sectional view in FIG. 2 showing the configuration of the first joint portion of the surgical instrument according to the embodiment of the present invention. It is a typical sectional view showing an example of composition of a driving force supply part of a surgical instrument concerning an embodiment of the present invention, and its F side view. It is typical sectional drawing which shows the structure of the 2nd joint part of the surgical instrument which concerns on embodiment of this invention, and its GG sectional drawing. It is the fragmentary sectional view of the front view which shows an example of a structure of the driving force supply source of the surgical instrument which concerns on embodiment of this invention, and its HH sectional drawing. It is a typical disassembled perspective view which shows the attachment form to the base part of the main part of the surgical instrument which concerns on embodiment of this invention. It is typical sectional drawing which shows the assembly state of the to-be-driven part of the surgical instrument which concerns on embodiment of this invention. Schematic perspective view showing a schematic configuration of a treatment instrument part and a first joint part used in the surgical instrument of the first modified example of the embodiment of the present invention, its JJ sectional view, K in this JJ sectional view It is -K sectional drawing, MM sectional drawing, and operation | movement explanatory drawing. It is a fragmentary sectional view which shows the driving force transmission part used for the surgical instrument of the 1st modification of embodiment of this invention, and a driving force supply part. It is a typical perspective view showing the composition of the modification (second modification) of the driven unit of the surgical instrument concerning the embodiment of the present invention, its NN sectional view, and PP sectional view. The typical perspective view which shows the structure of the modification (3rd modification) of the driven unit of the surgical instrument which concerns on embodiment of this invention, its QQ sectional drawing, RR sectional drawing, and the side of S view FIG.

  Embodiments of the present invention will be described below with reference to the accompanying drawings. In all the drawings, even if the embodiments are different, the same or corresponding members are denoted by the same reference numerals, and common description is omitted.

A surgical instrument according to an embodiment of the present invention will be described.
FIG. 1 is a schematic perspective view showing a configuration of a main part of a surgical instrument according to an embodiment of the present invention. FIG. 2 is a schematic exploded perspective view of a main part of the surgical instrument according to the embodiment of the present invention. FIGS. 3A and 3B are cross-sectional views taken along line AA in FIG. 2, respectively, showing a state when the treatment instrument portion of the surgical instrument according to the embodiment of the present invention is closed and opened. Fig.4 (a) is BB sectional drawing in FIG. 2 which shows the structure of the 1st joint part of the surgical instrument which concerns on embodiment of this invention. 4B and 4C are a DD sectional view and an EE sectional view in FIG. 4A, respectively. Fig.5 (a) is typical sectional drawing which shows an example of a structure of the driving force supply part of the surgical instrument which concerns on embodiment of this invention. FIG.5 (b) is a side view of the F view in Fig.5 (a). Fig.6 (a) is typical sectional drawing which shows the structure of the 2nd joint part of the surgical instrument which concerns on embodiment of this invention. FIG. 6B is a cross-sectional view taken along the line GG in FIG. Fig.7 (a) is a fragmentary sectional view of the front view which shows an example of a structure of the driving force supply source of the surgical instrument which concerns on embodiment of this invention. FIG.7 (b) is HH sectional drawing in Fig.7 (a). FIG. 8 is a schematic exploded perspective view showing an attachment form of the main part of the surgical instrument according to the embodiment of the present invention to the base part.
Each figure is a schematic diagram, and the size and shape of each member are exaggerated for ease of viewing (the same applies to the following drawings).

As shown in FIG. 1, the surgical instrument 1 of the present embodiment has a treatment instrument part 2A (driven unit), a first joint part 3A (driven unit), and a second joint part 4A (driven unit) on the distal end side. ) Are coupled to each other as a whole, and a driving force supply unit 2C, 3C, 4C and a driving unit 40 (driving force supply source) are provided on the base end side.
As shown in FIG. 2, the treatment instrument part 2A and the driving force supply part 2C, the first joint part 3A and the driving force supply part 3C, the second joint part 4A and the driving force supply part 4C are respectively connected to the driving force transmission part 2B, It is connected by 3B and 4B. The driving force transmission units 2B, 3B, and 4B, the driving force supply units 2C, 3C, and 4C, and the driving unit 40 constitute a driving unit that remotely controls the operation of the driven unit 5.
As described above, the surgical instrument 1 of the present embodiment includes the first drive system 2 including the treatment instrument unit 2A, the driving force transmission unit 2B, and the driving force supply unit 2C, the first joint unit 3A, the driving force transmission unit 3B, And a second driving system 3 including a driving force supply unit 3C and three driving systems including a second joint unit 4A, a driving force transmission unit 4B, and a third driving system 4 including a driving force supply unit 4C. ing.
In addition, as shown in FIG. 1, the driving force supply units 2C, 3C, and 4C are detachably fixed on the flat base 6 and fixed on the drive unit 40 via the base 6. Yes.

First, the configuration of the first drive system 2, the second drive system 3, and the third drive system 4 will be described.
As shown in FIG. 3A, the treatment instrument portion 2A includes a forceps 10 (driven body), a forceps holding portion 12 (holding member), and an elastic member 13 (positioning connecting portion).
The forceps 10 includes two bent rod-shaped members that intersect each other in the vicinity of the bending position, and are rotatably connected by the rotation support shaft 11 at the intersecting position. Grippers 10A and 10B for gripping and releasing gripping are formed, and arms 10a and 10b for rotating the grippers 10A and 10B, respectively, are formed on the other end side.
The ends of the arms 10a and 10b are rotatably connected to one ends of the link members 15a and 15b by pins 16a and 16b, respectively. The other ends of the link members 15a and 15b are rotatably connected to the tip end portion 14a of the substantially cylindrical rod 14 by a pin 14c. For this reason, the forceps 10 and the link members 15a and 15b constitute a parallel link. The link does not necessarily have to be a parallel link.

The forceps holding portion 12 holds the forceps 10 and the link members 15a and 15b between them, and holds a pair of support plates 12a that support both ends of the rotation support shaft 11, and a base end portion of these support plates 12a. In addition, a rod-shaped rod 14 and an annular holding portion main body 12b for holding an end portion of a coil pipe 17 described later are provided.
The holding portion main body 12b is penetrated by a slide hole 12c that slidably holds the rod 14 along its central axis. Moreover, in order to hold | maintain the edge part of the coil pipe 17 in the edge part on the opposite side to the forceps 10 of the holding | maintenance part main body 12b, it is a coil pipe larger diameter than the slide hole 12c between an end surface and the intermediate part of an axial direction. A mounting hole 12e is provided. The outer peripheral surface of the holding body 12b is formed in a step shape in which the outer peripheral surface 12f closer to the forceps 10 has a larger diameter than the outer peripheral surface 12g closer to the coil pipe mounting hole 12e.
And the elastic member attachment part 12d which is a recessed hole part for attaching the elastic member 13 to the outer peripheral surface 12f side is provided in the boundary part with the outer peripheral surfaces 12f and 12g of the holding | maintenance part main body 12b.

  With such a configuration, in the treatment instrument section 2A, the grippers 10A and 10B of the forceps 10 are rotated around the rotation support shaft 11 by moving the rod 14 in the slide hole 12c in the axial direction, and the forceps holding section It is possible to move relative to 12. Therefore, the treatment instrument section 2A constitutes one driven unit having a driven body and a holding member that holds the driven body so as to be relatively movable.

The elastic member 13 of the present embodiment is an elastically expandable member such as rubber or elastomer, and is formed into a shape that fits into the elastic member attachment portion 12d, for example, a rectangular parallelepiped shape. The size of the elastic member 13 has a size that protrudes radially outward from the outer peripheral surface 12f in a natural state, and constitutes a convex portion that protrudes radially from the outer peripheral surface 12f. And it can compress to the outer peripheral surface 12f by applying external force from the radial direction outer side in the state fixed to the elastic member attaching part 12d.
As a method for fixing the elastic member 13 to the elastic member mounting portion 12d, for example, a fixing method such as adhesion can be employed.

  In the forceps holding portion 12, when the forceps 10 are closed and the elastic member 13 is compressed to the outer peripheral surface 12f, each component member is a range of a cylindrical space obtained by extending the outer shape of the outer peripheral surface 12f in the axial direction. It is contained in.

As shown in FIG. 3A, the driving force transmission unit 2B includes a wire 18 that is a flexible linear member and a coil pipe 17 that is a tubular member through which the wire 18 is slidably inserted. . The length of the driving force transmission unit 2B is longer than the length of the driven unit 5.
The wire 18 is a member that transmits and receives the driving force supplied from the driving force supply unit 2C to the treatment instrument unit 2A by moving the rod 14 forward and backward in the slide hole 12c, and opens and closes the forceps 10. One end side of the wire 18 is connected to the rear end portion 14b of the rod 14, and the other end side is connected to the driving force supply unit 2C.
The coil pipe 17 is formed in a tubular member having a substantially the same inner diameter as the outer diameter of the wire 18 by densely winding a metal wire. For this reason, the coil pipe 17 can be curved without changing the inner diameter, and the wire 18 can be slidably inserted along the curved shape in the curved state. At that time, since the coil pipe 17 is tightly wound, even if it receives a compressive force from the wire 18 in the axial direction, the total length does not change.
One end of the coil pipe 17 is fixed to the coil pipe mounting hole 12e of the forceps holding section 12 by, for example, adhesion or soldering. The other end of the coil pipe 17 is fixed in the same manner to a driving force transmission portion holding member 9 of a driving force supply portion 2C described later.

The driving force supply unit 2C is connected to the base end side of the driving force transmission unit 2B and supplies the driving force to the driving force transmission unit 2B. As shown in FIGS. A rectangular support plate 23, a fixing member 24, a pinion gear 21, and a driving member 20 are included.
The fixing member 24 is a member that fixes the driving force transmission unit holding member 9 to which the other end of the coil pipe 17 of the driving force transmission unit 2B is fixed to the support plate 23, and the driving force transmission unit holding member 9 is disposed on the outer peripheral side. In this state, the support plate 23 is fastened to the support plate 23 by screws or the like (not shown).

As shown in FIG. 3A, the driving force transmission portion holding member 9 includes a coil pipe mounting hole 9a for inserting the other end portion of the coil pipe 17 therein and fixing it by, for example, bonding or soldering. The cylindrical member includes a drive rod guide hole 9b having an inner diameter smaller than the inner diameter of the coil pipe mounting hole 9a and penetrating in the axial direction from the bottom of the coil pipe mounting hole 9a.
The driving force transmission part holding member 9 of the present embodiment is inserted and fixed to the fixing member 24 at the outer peripheral surface of the portion where the coil pipe mounting hole 9a is formed.

The pinion gear 21 supplies a driving force to the driving force transmission unit 2B, and is rotatably supported by a rotation support shaft 22 provided on an extension line in the axial direction of the driving force transmission unit holding member 9.
The rotation support shaft 22 is disposed so as to penetrate in the thickness direction of the support plate 23 of the driving force supply unit 2C, as in the driving force supply units 3C and 4C described later (see FIGS. 5A and 5B). The shaft member is rotatably supported by a bearing portion 23 a provided on the support plate 23, and is attached to the tip end portion (lower end portion) of the shaft that penetrates the support plate 23 toward the side opposite to the pinion gear 21. Is formed with a plate-like engagement protrusion 22a extending toward the tip of the shaft along the diameter in one direction.
In addition, on the side of the support plate 23 where the tip of the rotation support shaft 22 is located, together with the rotation support shaft 22, a positioning projection 23b for positioning the support plate 23 on the base portion 6 is a driving force supply section 3C described later. 4C (see FIGS. 5A and 5B).

The drive member 20 converts the rotational motion of the pinion gear 21 into a linear motion and transmits the linear motion to the wire 18. The tip of the drive member 20 is connected to the other end of the wire 18 and inserted into the drive rod guide hole 9 b. The driving rod 19 includes a driving block 20a having an L shape in plan view connected to the rear end of the driving rod 19. The outer diameter of the drive rod 19 is slightly smaller than the inner diameter of the drive rod guide hole 9b so that it can advance and retreat in the axial direction inside the drive rod guide hole 9b.
In addition, a rack 20b that meshes with the pinion gear 21 and converts the rotational motion of the pinion gear 21 into a linear motion is provided at a portion of the drive block 20a that extends in parallel with the drive rod 19.

As shown in FIGS. 2, 4A, 4B, and 4C, the first joint portion 3A includes an annular driven body 26 (driven body), an annular support member 25 (holding member), and an elastic member. A member 13 is provided.
The annular driven body 26 is a substantially annular member including a through-hole 26a having a circular cross-section into which the outer peripheral surface 12f of the forceps holding portion 12 is fitted, and an outer peripheral surface 26b having a cylindrical surface coaxial with the through-hole 26a. . One end face in the axial direction of the annular driven body 26 is connected to the annular support member 25 so as to be rotatable, so that the projecting piece portions 26c are opposed to each other in the radial direction and extended in parallel along the axial direction. 26d is provided at a position slightly inside the outer shape of the outer peripheral surface 26b.
At the intermediate portion in the axial direction of the through hole 26a, the elastic member 13 is protruded radially outward from the forceps holding portion 12 on the inner surface on the protruding piece portion 26c side in the direction in which the protruding pieces 26c and 26d face each other. A concave hole portion 26e (positioning connecting portion) which is a concave portion to be joined is provided.

The annular support member 25 includes a through hole 25a having an inner diameter through which the forceps holding portion 12 can be inserted in a state where the elastic member 13 of the forceps holding portion 12 is compressed, and an annular driven body 26 formed of a cylindrical surface coaxial with the through hole 25a. It is a substantially annular member provided with the outer peripheral surface 25b which has the same outer diameter as the outer peripheral surface 26b. One end face of the annular support member 25 in the axial direction is rotatably connected to a pair of projecting pieces 26c and 26d of the annular driven body 26, so that they face each other in the radial direction and extend along the axial direction. The projecting piece portions 25c and 25d extended in parallel are provided at positions substantially along the outer shape of the outer peripheral surface 25b.
On the outer periphery of the other end portion of the annular support member 25 in the axial direction, an elastic member is attached for attaching the elastic member 13 to the annular support member 25 on the projecting piece portion 25c side in the direction in which the projecting piece portions 25c and 25d face each other. A portion 12d is provided.
The elastic member 13 is fixed to the elastic member attaching portion 12 d of the annular support member 25 in the same manner as the elastic member 13 of the forceps holding portion 12. For this reason, the elastic member 13 forms a convex portion that protrudes radially outward from the outer peripheral surface 25b in a natural state, and can be compressed to the outer peripheral surface 25b by applying an external force from the radially outer side.

The protruding pieces 26c and 26d of the annular driven body 26 are inserted between the pair of protruding pieces 25c and 25d of the annular support member 25, respectively, and are one of the annular support member 25 and the annular driven body 26. The pins 27 and 28 aligned in the radial direction are rotatably connected.
Here, the pin 27 may be fixed to any one of the projecting pieces 25c and 26c, or may be only fixed and not fixed. However, the pin 28 is fixed to the projecting piece portion 26d in a state of slightly projecting from the projecting piece portion 26d toward the projecting piece portion 26c, and at the same time, a driven pulley 29 (pulley) that transmits a driving force to the annular driven body 26. ) Is fixed so as to be coaxial with the pin 28. Alternatively, the driven pulley 29 may be formed integrally with the annular driven body 26 so as to be coaxial with the pin 28, and the pin 28 may be fixed to the protruding piece portion 26d.
Further, a groove portion 25e extending along the axial direction is provided on the inner peripheral surface of the through hole 25a in the vicinity of the position where the protruding piece portion 25d is protruded, to the end portion on the opposite side to the protruding piece portion 25d.
The groove 25e allows the wire 31 to be wound around the driven pulley 29 and the pair of tubular members 30 for guiding the wire 31 to be arranged on the radially outer side than the through hole 25a.

  With such a configuration, when the annular support member 25 and the annular driven body 26 are arranged in a coaxial positional relationship (hereinafter referred to as a straight state of the first joint portion 3A), the through holes 25a and 26a and the outer periphery The surfaces 25b and 26b are aligned coaxially to form a substantially cylindrical shape as a whole. Inside the substantially cylindrical shape, a substantially columnar insertion space is formed through which the forceps holding portion 12 can be inserted in a state where the elastic member 13 provided in the forceps holding portion 12 is compressed.

  Further, with such a configuration, in the first joint portion 3A, the annular driven body 26 rotates around the pins 27 and 28 by rotating the driven pulley 29 around the pin 28 with respect to the protruding piece portion 25d. Thus, it can move relative to the annular support member 25. Therefore, the first joint portion 3A constitutes one driven unit having a driven body and a holding member that holds the driven body so as to be relatively movable.

  As shown in FIG. 5A, the driving force transmission unit 3 </ b> B includes a wire 31, two tubular members 30, and a cladding tube 70 that covers both the two tubular members 30.

The wire 31 of the driving force transmission part 3B is formed in an endless annular shape having flexibility, and is hung between a driven pulley 29 of the first joint part 3A and a driving pulley 32 of a driving force supply part 3C described later. It has been turned. Alternatively, one point or a part of the wire 31 may be fixed to the driven pulley 29 with solder or the like. The material of the wire 31 may be metal, resin, or a composite thereof. Further, it may be a single wire or a stranded wire.
The tubular member 30 is a tubular member having an inner diameter that is substantially the same as the outer diameter of the wire 31. The tubular member 30 is slidably held through the wire 31, and the length in the axial direction changes as the wire 31 advances and retreats. It has flexibility without any problems. For this reason, the distribution shape of the wire 31 inserted inside can be changed by curving the tubular member 30. The tubular member 30 is provided so that the facing portions of the wire 31 wound around the driven pulley 29 and the driving pulley 32 are parallel to each other between the vicinity of the driven pulley 29 and the driving force supply unit 3C. ing.
As shown in FIG. 4C, the end of each tubular member 30 on the first joint portion 3A side is fixed to the annular support member 25 in a groove 25e in the vicinity of the projecting piece 25d. As a fixing method of the tubular member 30, for example, a fixing method such as adhesion or soldering can be adopted depending on the material.
An intermediate portion of each tubular member 30 is covered with a covering tube 70 made of a soft tube such as synthetic resin or rubber fixed to the end portion of the annular support member 25 on the opposite side to the projecting piece portion 25d, and the driving force supply portion 3C. (See FIGS. 2 and 5A).
Further, the end of each tubular member 30 on the driving force supply unit 3C side is fixed inside the driving force supply unit 3C.
As the material of the tubular member 30, for example, a coil pipe in which a metal wire is tightly wound, a pipe made of a superelastic alloy, a tube member made of a synthetic resin, and the like are suitable. Good.

The driving force supply unit 3C is connected to the base end side of the driving force transmission unit 3B and supplies driving force to the driving force transmission unit 3B. As shown in FIGS. 2 and 5A, the support plate 23, a fixing member 71, a tubular member fixing member 39, and a driving pulley 32 are arranged in this order from the driving force transmitting portion 3B side.
The fixing member 71 is a member that fixes the cladding tube 70 of the driving force transmitting portion 3B to the support plate 23 and guides the tubular member fixing member 39 through the two tubular members 30 in the cladding tube 70. In a state where the tube 70 is held from the outer peripheral side, the tube 70 is fastened to the support plate 23 by screws (not shown) or the like.

The tubular member fixing member 39 is a block-like member arranged to face the fixing member 71. As shown in FIG. 2, the ends of the two tubular members 30 branched from the fixing member 71 into two branches. And has two fixing portions 39a each having a stepped through hole through which a wire 31 having a diameter smaller than that of the tubular member 30 inserted into each tubular member 30 is passed to the drive pulley 32 side. Yes.
The central axes of the fixed portions 39a are parallel to each other and parallel to the plate surface of the support plate 23. The distance between the fixed portions 39a is equal to the pulley diameter of the drive pulley 32. Thereby, the opposing portions of the wires 31 that are close to each other in the driving force transmitting portion 3B pass between the fixing member 71 and the tubular member fixing member 39 through the inside of the tubular member 30, respectively. Are guided in an oblique direction in which the opposing distance increases, and after passing through each fixing portion 39a, they are extended in directions parallel to each other and parallel to the plate surface of the support plate 23.

The driving pulley 32 supplies a driving force to the driving force transmitting portion 3B, and the height of the pulley groove from the plate surface of the support plate 23 is set at a fixed distance from the tubular member fixing member 39. It is rotatably supported by the rotation support shaft 22 so as to have the same height as the wire 31 extending in parallel from 39a.
As shown in FIGS. 5A and 5B, the rotation support shaft 22 penetrates in the thickness direction of the support plate 23 of the driving force supply unit 3 </ b> C, and is rotated by a bearing portion 23 a provided on the support plate 23. A shaft member that is movably supported, and extends to the tip end side of the shaft along the diameter at the tip end portion (lower end portion) of the shaft penetrating the support plate 23 toward the side opposite to the drive pulley 32. An engagement protrusion 22a is formed.
In addition, on the side of the support plate 23 where the tip of the rotation support shaft 22 is located, together with the rotation support shaft 22, a positioning projection 23b for positioning the support plate 23 on the base portion 6 has a cylindrical projection shape, for example. It is provided in the shape.
The distance between the tubular member fixing member 39 and the rotation support shaft 22 is such that an appropriate tension is generated in the wire 31 in a state where the wire 31 extended from each fixing portion 39a is wound around the driving pulley 32. Is set. The tension of the wire 31 can be adjusted by, for example, the fixing position of the tubular member fixing member 39 when the tubular member fixing member 39 is fixed to the support plate 23.

As shown in FIGS. 2, 6A, and 6B, the second joint portion 4A includes an annular driven body 34 (driven body) and a cylindrical support member 33 (holding member).
The annular driven body 34 is a substantially annular member that includes a through hole 34a having a circular cross section into which the outer peripheral surface 25b of the first joint portion 3A is fitted, and an outer peripheral surface 34b having a cylindrical surface coaxial with the through hole 34a. is there. One end face in the axial direction of the annular driven body 34 is rotatably connected to the cylindrical support member 33, and thus is opposed to each other in the radial direction and is extended in parallel along the axial direction. , 34d are provided at positions slightly inside the outer shape of the outer peripheral surface 34b.
An elastic member that protrudes radially outward from the first joint portion 3A at a position rotated by 90 ° in the circumferential direction with respect to a direction in which the projecting piece portions 34c and 34d face each other at an intermediate portion in the axial direction of the through hole 34a. A recessed hole portion 34e (positioning connecting portion) that is a recessed portion that engages with 13 is provided.

The cylindrical support member 33 includes a through hole 33a having an inner diameter through which the first joint portion 3A that is straight can be inserted in a state where the elastic member 13 provided on the annular support member 25 is compressed to the outer peripheral surface 25b. It is a substantially cylindrical member that is longer than the annular driven body 34 and includes an outer circumferential surface 33 b that has a cylindrical surface coaxial with the through-hole 33 a and has the same outer diameter as the outer circumferential surface 34 b of the annular driven body 34. One end face in the axial direction of the cylindrical support member 33 is rotatably connected to the pair of projecting pieces 34c and 34d of the annular driven body 34, so that they face each other in the radial direction and extend along the axial direction. The projecting piece portions 33c and 33d extended in parallel with each other are provided at positions substantially along the outer shape of the outer peripheral surface 33b.
To fix the fixing screw 38 (see FIG. 5A) to the other end portion in the axial direction of the cylindrical support member 33 at a position rotated by 90 ° from the direction in which the projecting piece portions 33c and 33d face each other. A female screw portion 33e is provided that penetrates from the outer peripheral surface 33b toward the inner peripheral surface of the through hole 33a.
A positioning projection 33f for positioning the cylindrical support member 33 around the central axis is provided in the shape of, for example, a cylindrical projection on the outer peripheral surface 33b at a position facing the female screw portion 33e in the radial direction. ing.

The projecting pieces 34c and 34d of the annular driven body 34 are rotatably connected by pins 37 and 35 while being inserted between the pair of projecting pieces 33c and 33d of the cylindrical support member 33, respectively. Yes.
Here, the pin 37 may be fixed to any of the projecting piece portions 33d and 34d, or may be only fixed and not fixed. However, the pin 35 is fixed to the projecting piece 34c in a state of slightly projecting from the projecting piece 34c to the projecting piece 34d side, and transmits a driving force to the annular driven body 34 (pulley). ) Is fixed so as to be coaxial with the pin 35. Alternatively, the driven pulley 36 may be formed integrally with the annular driven body 34 so as to be coaxial with the pin 35, and the pin 35 may be fixed to the protruding piece portion 34c.
Further, on the inner peripheral surface of the through hole 33a in the vicinity of the position where the projecting piece portion 33c is projected, a wire 31 to be hung around the driven pulley 36 and a pair of tubular members 30 for guiding the wire 31 are respectively formed in the through hole 33a. Further, the groove 33g is provided along the axial direction to the end opposite to the projecting piece 33c in order to be disposed on the radially outer side.
With such a configuration, when the cylindrical support member 33 and the annular driven body 34 are arranged in a coaxial positional relationship (hereinafter referred to as a straight state of the second joint portion 4A), the through holes 33a, 34a, and The outer peripheral surfaces 33b and 34b are aligned coaxially, and a substantially cylindrical shape is formed as a whole. Inside the substantially cylindrical shape, a substantially columnar insertion space is formed through which the straight first joint portion 3A can be inserted in a state where the elastic member 13 provided on the annular support member 25 is compressed. The

  Further, with such a configuration, in the second joint portion 4A, the driven pulley 36 is rotated around the pin 35 with respect to the projecting piece portion 33c, so that the annular driven body 34 is rotated around the pins 35 and 37. Thus, it can move relative to the cylindrical support member 33. Therefore, the second joint portion 4A constitutes one driven unit having a driven body and a holding member that holds the driven body so as to be relatively movable.

  As shown in FIG. 5A and FIGS. 6A and 6B, the driving force transmission unit 4B is similar to the driving force transmission unit 3B in that the wire 31, the two tubular members 30, and the two It consists of a cladding tube 70 that covers the tubular member 30 together.

The wire 31 of the driving force transmission unit 4B is the same member as the wire 31 of the driving force transmission unit 3B. However, the wire 31 of the driving force transmission part 4B is hung between the driven pulley 36 of the second joint part 4A and the driving pulley 32 of the driving force supply part 4C described later. Different from 3B wire 31.
The tubular member 30 of the driving force transmission unit 4B is the same member as the tubular member 30 of the driving force transmission unit 3B. However, the tubular member 30 of the driving force transmitting portion 4B is configured so that the facing portion of the wire 31 wound around the driven pulley 36 of the second joint portion 4A and the driving pulley 32 of the driving force supply portion 4C is from the vicinity of the driven pulley 36. It differs from the tubular member 30 of the driving force transmission unit 3B in that the driving force supply unit 4C is provided so as to be close to each other and parallel to each other.
Further, as shown in FIGS. 6A and 6B, the end of each tubular member 30 of the driving force transmission portion 4B on the second joint portion 4A side is within the groove portion 33g in the vicinity of the projecting piece portion 33c. It is fixed to the annular support member 33. As a fixing method of the tubular member 30, for example, a fixing method such as adhesion or soldering can be adopted depending on the material.
An intermediate portion of each tubular member 30 is covered with a covering tube 70 similar to the driving force transmission portion 3B fixed to the end portion of the cylindrical support member 33 on the opposite side to the protruding piece portion 33c, up to the driving force supply portion 4C. (See FIGS. 2 and 5 (a)).
Further, the end of each tubular member 30 on the driving force supply part 4C side is fixed inside the driving force supply part 4C.

  The driving force supply unit 4C is connected to the base end side of the driving force transmission unit 4B and supplies driving force to the driving force transmission unit 4B. As shown in FIGS. 2 and 5A, the support plate 23, a fixing member 71, a tubular member fixing member 39, and a driving pulley 32 are arranged in this order from the driving force transmitting portion 4B side. Since these configurations are exactly the same as those of the driving force transmission unit 3B, description thereof is omitted.

Next, the configuration of the drive unit 40 will be described.
In addition, although the arrangement | positioning attitude | position of the drive unit 40 is not specifically limited, as shown in FIG. 7 (a), (b) below, the base 41 of the drive unit 40 is arrange | positioned horizontally for simplicity of description, The relative positional relationship will be described using an example in which the driving force supply units 2C, 3C, and 4C are arranged on the upper side of the driving unit 40.
The drive unit 40 includes a ball screw 42 whose both ends are rotatable by two bearing portions 43 provided on the base 41 and supported at the same height from the upper surface of the base 41, and a ball screw 42 connected to one end of the ball screw 42. A guide rail support member 72 provided in parallel with the ball screw 42 on the base 41, and a side of the guide rail support member 72 on the side facing the ball screw 42 in parallel with the ball screw 42. A guide rail 73, a slider 74 that moves in the direction in which the ball screw 42 extends along the guide rail 73, a nut portion 45 that is screwed into the ball screw 42 and has a side connected to the slider 74, A mounting plate 46 having a rectangular shape in plan view and fixed in a posture parallel to the base 41 is provided on the upper portion of the nut portion 45. Hereinafter, the direction in which the ball screw 42 and the guide rail 73 extend is referred to as a linear movement direction L of the drive unit 40.

The mounting plate 46 has one side in a rectangular shape in plan view that extends along the linear motion direction L, and is arranged in plane symmetry with a vertical plane including the central axis of the ball screw 42 as a symmetry plane. The upper surface of the nut portion 45 is connected.
On the one end side in the linear motion direction L, the mounting plate 46 is provided with a square hole-shaped slit 46 b penetrating in the plate thickness direction in the vicinity of the nut portion 45. On the lower surface of the mounting plate 46 on the side where the slit 46b is provided, the motor 50 having the rotary shaft 50a arranged in parallel to the linear movement direction L is in a state where the tip of the rotary shaft 50a faces the nut portion 45 side. It is fixed. A driving gear 51 is fixed to the tip of the rotating shaft 50a of the motor 50 with the gear tip entering the slit 46b.

Further, the mounting plate 46 is provided on the other end side in the linear motion direction L, as shown in FIG. 7B, at three positions spaced in the direction orthogonal to the linear motion direction L, respectively. A through hole 46a having an inner diameter slightly larger than the outer diameter of the rotation support shaft 22 of 2C, 3C, and 4C and penetrating in the plate thickness direction is provided.
A drive shaft 49 is inserted into each of the three through holes 46a from the lower surface side.
The drive shaft 49 is provided with a slit-like engaging groove 49a extending in the radial direction that engages with the engaging protrusion 22a of the rotating support shaft 22 at the upper end portion inserted into the through hole 46a. A bevel gear 49 b is provided at a lower end portion extending below the mounting plate 46.
Each drive shaft 49 is fixed to the mounting plate 46 so as to be rotatable about the vertical axis by a bearing 52 fixed to the lower surface side of the mounting plate 46.

On the lower surface of the mounting plate 46, between the nut portion 45 and each driving shaft 49, a motor 47 (driving force supply source) in which a rotating shaft 47a is disposed in parallel to the linear motion direction L is provided at the tip of the rotating shaft 47a. Is fixed in a state in which is directed to the drive shaft 49 side. A bevel gear 47 b that engages with the bevel gear 49 b is provided at the tip of the rotation shaft 47 a of each motor 47.
The bevel gears 47 b and 49 b constitute a gear transmission mechanism 48 that transmits the rotational driving force of the motor 47 to the drive shaft 49. Depending on the arrangement position of the motor 47, the gear transmission mechanism 48 may employ a gear transmission mechanism other than the bevel gear. Further, instead of the gear transmission mechanism 48, another transmission mechanism such as a belt transmission mechanism may be employed.

  The motors 44, 50, and 47 are electrically connected to a motor control unit 53 (see FIG. 1) that independently controls the rotation angle, the rotation amount, the rotation speed, and the like by wiring (not shown). .

The driving force supply units 2C, 3C, and 4C are attached to the driving unit 40 via the base unit 6 as shown in FIGS.
The base portion 6 of the present embodiment is a substantially rectangular flat plate that is smaller than the mounting plate 46, the longitudinal direction of the rectangle is aligned with the linear motion direction L, and one end portion in the longitudinal direction is the slit 46 b of the mounting plate 46. It is fixed to the upper surface of the mounting plate 46 with screws (not shown) while being arranged in the vicinity of the edge in the longitudinal direction.
As shown in FIGS. 5A and 8, a bearing portion 7 that holds the gear 8 rotatably is erected on one end portion of the base portion 6.

The gear 8 has an outer diameter that is larger than the outer diameter of the gear portion 8b and the gear portion 8b that meshes with the drive gear 51 of the drive unit 40 from one end side in the axial direction and the outer peripheral surface 33b of the cylindrical support member 33. A shaft portion 8a having a diameter is provided, and a fitting portion 8c which is a circular hole into which the outer peripheral surface 33b of the cylindrical support member 33 is fitted is passed through the center of the gear portion 8b and the shaft portion 8a.
In the vicinity of the end portion on the other end side in the axial direction of the gear 8, a screw hole 8 d that is a through hole through which the fixing screw 38 is inserted in the radial direction is provided. Further, a positioning groove 8e formed by cutting out the end surface of the gear portion 8b and the inner peripheral surface of the fitting portion 8c of the gear 8 is provided at a position facing the screw hole 8d in the radial direction. The positioning groove 8e is a rectangular groove having a width substantially the same as the outer diameter of the positioning projection 33f of the cylindrical support member 33, and is extended in the axial direction of the gear 8. Thereby, the positioning projection 33f is moved from the outside in the axial direction. It can be inserted and locked in the circumferential direction.

  The bearing portion 7 holds the shaft portion 8a of the gear 8 between the screw hole 8d and the gear portion 8b. When the base portion 6 is fixed to the mounting plate 46, the rotation center axis of the gear 8 is Further, it is provided in a shape and an attachment position that coincide with the linear motion direction L of the drive unit 40 and that can maintain an inter-axis distance at which the engagement of the gear 8 with the drive gear 51 is appropriate.

Further, as shown in FIGS. 7B and 8, the other end of the base portion 6 has three through holes 6a having the same inner diameter as the through holes 46a of the mounting plate 46 and penetrating in the plate thickness direction. Is provided. These through-holes 6 a are provided in a positional relationship that aligns coaxially with the respective through-holes 46 a of the mounting plate 46 when the base portion 6 is fixed to the mounting plate 46.
Further, on the upper surface of the base portion 6 between each through hole 6a and the bearing portion 7, there are provided positioning recesses 6b that are externally fitted to positioning protrusions 23b protruding from the lower surface of the support plate 23 for positioning. ing. The positioning recess 6b of the present embodiment is a hole deeper than the height of the positioning protrusion 23b.

Next, a method for assembling and disassembling the surgical instrument 1 having such a configuration will be described.
FIG. 9 is a schematic cross-sectional view showing an assembled state of the driven portion of the surgical instrument according to the embodiment of the present invention.

In the surgical instrument 1 of the present embodiment, the first drive system 2, the second drive system 3, the third drive system 4, and the drive unit 40 are replacement units when the user replaces parts. These are assumed to be assembled in advance.
The first drive system 2, the second drive system 3, and the third drive system 4 are respectively a treatment instrument section 2A and a driving force supply section 2C, a first joint section 3A and a driving force supply section 3C, and a second joint section 4A. Since the driving force supply unit 4C is connected by the flexible driving force transmission units 2B, 3B, and 4B, the treatment instrument unit 2A, the first joint unit 3A, and the second joint unit 4A are respectively driven. The position and posture can be freely changed to some extent with respect to the force supply units 2C, 3C, and 4C.

First, as shown in FIG. 4A, with respect to the through hole 25a of the first joint portion 3A in a straight state, the treatment instrument portion 2A is placed with the forceps 10 in a state where the grippers 10A and 10B are closed at the head. Then, it inserts from the annular support member 25 side. Since the forceps 10 and the support plate 12a have a smaller diameter than the through holes 25a and 26a, the treatment instrument 2A is smoothly inserted into the insertion space of the first joint 3A.
When the holding portion main body 12b is inserted into the through hole 25a, the treatment instrument portion 2A is inserted while being positioned in the substantially radial direction. At this time, the circumferential position of the holding portion main body 12b is adjusted, and the elastic member 13 provided in the holding portion main body 12b and the recessed hole portion 26e of the through hole 26a are positioned on the same straight line in the axial direction. Insert like so.
When the elastic member 13 of the treatment instrument portion 2A reaches the position of the end surface of the annular support member 25 and then is further inserted, the elastic member 13 receives an external force from the annular support member 25 and is compressed to the outer peripheral surface 12f. Because it retracts, it can continue to be inserted.

Furthermore, when the holding part main body 12b of the forceps holding part 12 moves to the through hole 26a of the annular driven body 26 and the elastic member 13 reaches the position of the recessed hole part 26e, the compression of the elastic member 13 is released together with the insertion. The elastic member 13 is protruded and fitted into the recessed hole portion 26e, and the forceps holding portion 12 is positioned and connected to the annular driven body 26 in the axial direction and the circumferential direction as shown in FIG. Thereby, the connection body 5A of the treatment instrument part 2A and the first joint part 3A is formed.
Conversely, when the treatment instrument part 2A is pulled out from this connected state in the direction opposite to the insertion direction at the time of connection, the elastic member 13 is compressed by the annular driven body 26, the connection is released, and the treatment instrument part 2A. Is pulled out from the first joint portion 3A through the through holes 26a, 25a.

Next, the connecting body 5A connected in this manner is cylindrically supported with the forceps 10 in a state in which the grippers 10A and 10B are closed in the through hole 33a of the second joint portion 4A in a straight state. Insert from the member 33 side. Since the treatment instrument part 2A has a smaller diameter than the through holes 33a and 34a, the treatment instrument part 2A is smoothly inserted into the insertion space of the second joint part 4A. When the annular driven body 26 of the coupling body 5A is inserted into the through hole 33a, the coupling body 5A is inserted in a state of being positioned in a substantially radial direction. At this time, the position of the connecting body 5A in the circumferential direction is adjusted so that the elastic member 13 provided in the annular support member 25 and the recessed hole portion 34e of the through hole 34a of the annular driven body 34 have the same axial direction. Insert it so that it is on a straight line.
Similarly to the case where the treatment instrument part 2A is connected to the first joint part 3A, the elastic member 13 provided on the annular support member 25 reaches the position of the end face of the cylindrical support member 33 and then further inserted. Then, since the elastic member 13 is compressed by receiving an external force from the cylindrical support member 33 and retracts to the outer peripheral surface 25b, the insertion can be continued as it is.

  Further, the annular support member 25 of the connecting body 5 </ b> A moves to the through hole 34 a of the annular driven body 34, and the elastic member 13 provided in the annular support member 25 is a recessed hole portion 34 e provided in the annular driven body 34. , The compression of the elastic member 13 is released together with the insertion, and the elastic member 13 protrudes and fits into the recessed hole portion 34e. As shown in FIG. 9, the connecting body 5A is an annular driven body. 34 and positioned in the axial and circumferential directions.

By such an operation, the connecting body 5A is connected to the second joint part 4A, and the driven part 5 is formed. For this reason, the driven unit 5 is configured such that the treatment instrument unit 2A, the first joint unit 3A, and the second joint unit 4A, which are three driven units, are detachably connected.
The driving force transmitting units 2B, 3B, and 4B connected to the treatment instrument unit 2A, the first joint unit 3A, and the second joint unit 4A all pass through the insertion space of the second joint unit 4A and are outside the cylindrical support member 33. It has been extended.
Further, in the driven portion 5, when the connecting body 5A is pulled out in the direction opposite to the insertion direction at the time of connection, the elastic member 13 is compressed by the annular driven body 34, and the connection is released. It is pulled out from the second joint portion 4A through 34a and 33a.

  In such a driven portion 5, the rotational axis of the annular driven body 34 is determined from the positional relationship between the recessed hole 34 e provided in the annular driven body 34 and the elastic member 13 provided in the annular driven body 26. The axial direction connecting the pins 35 and 37 and the axial direction connecting the pins 27 and 28 which are the rotation shafts of the annular driven body 26 with respect to the annular support member 25 are orthogonal to each other. The drive body 34 is connected in a positional relationship orthogonal to the central axis direction of the drive body 34. For this reason, the treatment instrument 2A connected to the annular driven body 26 has two axes around the axis perpendicular to the paper surface (around the pins 35 and 37) and the axis parallel to the paper surface (around the pins 27 and 28) in FIG. Can be rotated.

In the present embodiment, the through hole 25a of the first joint portion 3A is a hole portion that is fitted onto the outer peripheral portion of the treatment instrument portion 2A that is the attachment / detachment partner and allows the treatment instrument portion 2A to be inserted therein. Therefore, the through-hole 25a is an opening through which the treatment instrument part 2A can be inserted together with the driving force transmission part 2B when the treatment instrument part 2A, which is another driven unit, is attached to and detached from the first joint part 3A. A detachable opening is formed.
Further, in the present embodiment, the through hole 33a of the second joint portion 4A is a hole portion that is fitted on the outer peripheral portion of the first joint portion 3A that is the attachment / detachment partner and allows the first joint portion 3A to be inserted therein. For this reason, the through-hole 33a is an opening through which the first joint portion 3A can be inserted together with the driving force transmission portion 3B when the first joint portion 3A, which is another driven unit, is attached to and detached from the second joint portion 4A. The detachable opening is configured.
Further, the concave hole portion 34e of the first joint portion 3A and the elastic member 13 of the treatment instrument portion 2A are a concave portion provided in the through hole 26a that is a hole portion, and a convex portion that fits into the concave portion. The forceps holding portion 12 is positioned on the annular driven body 26 to constitute a positioning connection portion that is detachably connected.
Further, the recessed hole portion 26e of the annular driven body 34 and the elastic member 13 of the annular support member 25 are a recessed portion provided in the through hole 34a that is a hole portion, and a protruding portion that fits into the recessed portion. In addition, a positioning connecting portion for positioning the annular support member 25 to the annular driven member 34 and detachably connecting the annular driven member 34 is configured.

In this embodiment, since the positioning connecting portion using the concave portion and the convex portion made of the elastic member is provided as described above, and the detachable opening portion is configured by the hole portion, the detachable opening portion of the driven unit is provided with the concave portion and the detachable opening portion. Two driven units can be easily connected by inserting other driven units in a positional relationship in which the circumferential positions of the convex portions coincide with each other. It is also easy to disassemble by the reverse operation.
For example, the driving force transmitting portion can be easily attached and detached without being twisted as in the case where the driven units are screwed together.

Next, the driven unit 5 and the driving force supply units 2C, 3C, 4C are fixed to the driving unit 40.
First, as shown in FIG. 8, the driven part 5 in the straight state has a shaft part on the fitting part 8 c of the gear 8 held on the bearing part 7 on the base part 6 with the treatment instrument part 2 </ b> A at the top. Insert from the 8a side. Since the treatment instrument portion 2A and the first joint portion 3A are within a smaller diameter range than the fitting portion 8c, the treatment instrument portion 2A and the first joint portion 3A are smoothly inserted into the insertion space of the treatment instrument portion 2A and the first joint portion 3A, and are annularly driven. When the body 34 and the cylindrical support member 33 are inserted, the driven portion 5 is inserted while being positioned in the radial direction of the fitting portion 8c. Then, the positioning protrusion 33f of the cylindrical support member 33 is inserted to the end of the cylindrical support member 33 so as to be fitted into the positioning groove 8e from the outside in the axial direction. As a result, the cylindrical support member 33 is positioned relative to the gear 8 in the circumferential direction. In this state, the fixing screw 38 is inserted into the screw hole 8d and screwed into the female screw portion 33e of the cylindrical support member 33. Then, the cylindrical support member 33 and the gear portion 8b are fixed (see FIG. 5A).

Driving force supply units 2C, 3C, and 4C are connected to the end portions of the driving force transmission units 2B, 3B, and 4B extending from the through-hole 33a, respectively, but the driving force transmission units 2B, 3B, and 4B are connected to each other. Since it has flexibility, the driving force supply units 2C, 3C, and 4C can change the position and orientation freely to some extent.
Therefore, for example, as shown in FIG. 5A, a positioning projection 23b and a rotation support shaft 22 that protrude downward from the support plate 23 of the driving force supply unit 3C are respectively positioned into a positioning recess 6b of the base unit 6, Each is inserted into the through hole 6a. As a result, the driving force supply unit 3C is positioned on the base unit 6, and thus the support plate 23 is fixed to the base unit 6 with screws (not shown).
Similarly, the driving force supply units 2 </ b> C and 4 </ b> C are fixed to the base unit 6.
In this way, as shown in FIG. 1, the driven portion 5 and the driving force supply portions 2 </ b> C, 3 </ b> C, and 4 </ b> C are fixed to the base portion 6.

Next, the base portion 6 is inserted into the three through holes 46a on the mounting plate 46 of the drive unit 40, and the gear portion 8b is inserted into the three rotation support shafts 22 protruding from the base portion 6. The base portion 6 is arranged in a positional relationship that engages with the drive gear 51.
At this time, as necessary, the engagement protrusions 22a of the rotation support shaft 22 inserted into the through holes 46a are engaged with the engagement grooves 49a of the drive shaft 49 provided in the through holes 46a. Then, the position of the engagement protrusion 22a is adjusted by turning the drive pulley 32 and the pinion gear 21.
After all the engaging protrusions 22a are engaged with the engaging concave grooves 49a, the base portion 6 is fixed to the mounting plate 46 using, for example, screws.
This completes the assembly of the surgical instrument 1.

Next, operation | movement of the surgical instrument 1 of this embodiment is demonstrated.
The surgical instrument 1 uses the base 41 of the drive unit 40 fixed to an installation table (not shown). The installation table may include a moving mechanism that can appropriately control the overall posture of the surgical instrument 1.
The surgical instrument 1 fixed to the installation base can be remotely operated by operating the motor control unit 53 as appropriate to remotely move the driven unit 5 provided at the distal end of the surgical instrument 1 with respect to the base 41.
For example, by rotating the motor 44, the nut portion 45 and the attachment plate 46 fixed to the nut portion 45 can be advanced and retracted along the linear motion direction L. Thereby, the forceps 10 can be moved back and forth in the linear movement direction L.
Further, by rotating the motor 50, the gear 8 can be driven to rotate in two directions via the drive gear 51. Thereby, since the cylindrical support member 33 is rotated around the central axis of the bearing portion 7, the linear movement is performed in the direction in which the grippers 10 </ b> A and 10 </ b> B of the forceps 10 are opened and closed, i. The direction L can be changed in the range of 0 ° to 360 °. At this time, the driving force supply units 2C, 3C, 4C fixed on the base unit 6 and the cylindrical support member 33 are connected via the flexible driving force transmission units 2B, 3B, 4B. Therefore, the cylindrical support member 33 can be smoothly rotated by providing a certain margin in the lengths of the driving force transmission portions 2B, 3B, and 4B.

Further, by rotating the motor 47 that drives the drive shaft 49 engaged with the rotation support shaft 22 of the driving force supply unit 2C, the forceps 10 of the treatment instrument unit 2A can be opened and closed.
As shown in FIG. 3A, when the rotation support shaft 22 to which the pinion gear 21 is connected is rotated counterclockwise in the drawing, the rack of the driving member 20 moves to the right side in the drawing, and the driving rod 19 of the driving member 20 moves. The wire 18 is pulled into the driving force supply unit 2C.
As a result, the rod 14 connected to the other end of the wire 18 is drawn into the slide hole 12c, and the grippers 10A and 10B are closed by the action of the parallel link.
Further, as shown in FIG. 3B, when the rotation support shaft 22 is rotated clockwise in the figure, the rack of the drive member 20 moves to the left side in the figure, and the drive rod 19 of the drive member 20 drives the wire 18. Pushing toward the outside of the force supply unit 2C.
Thereby, the rod 14 connected to the other end of the wire 18 is pushed out of the slide hole 12c, and the grippers 10A and 10B are opened by the action of the parallel link.
The wire 18 has substantially the same inner diameter as the outer diameter of the wire 18 and is slidably inserted into the coil pipe 17 that is tightly wound and is not compressed in the axial direction. When moving forward and backward, the coil pipe 17 is bent along the curved shape, and the insertion length in the coil pipe 17 does not change.
For this reason, the advance / retreat amount of the drive rod 19 is accurately transmitted to the rod 14, and the opening / closing operation of the forceps 10 can be remotely controlled.

Further, by rotating the motor 47 that drives the drive shaft 49 engaged with the rotation support shaft 22 of the drive force supply unit 3C, the bending operation of the first joint portion 3A by rotation can be performed.
When the rotating support shaft 22 to which the driving pulley 32 of the driving force supply unit 3C is connected is rotated, the driven pulley 29 of the first joint portion 3A is rotated by the wire 31. At this time, since the wire 31 is slidably inserted into the tubular member 30 having the same inner diameter as the outer diameter of the wire 31, when the wire 31 advances and retracts in the tubular member 30, It is moved along the curved shape. Therefore, it is accurately transmitted to the driven pulley 29 according to the rotation amount of the drive pulley 32 and the ratio of the pulley diameter, and the bending operation of the first joint portion 3A can be remotely controlled.
As a result, the annular driven body 26 having the treatment instrument portion 2 </ b> A connected to the distal end is rotated with respect to the annular support member 25 around the pins 27 and 28. When the driving pulley 32 is rotated in the reverse direction, the annular driven body 26 is rotated in the reverse direction.

Similarly, by rotating the motor 47 that drives the drive shaft 49 engaged with the rotation support shaft 22 of the drive force supply unit 4C, the bending operation of the second joint portion 4A by rotation can be performed. .
When the rotating support shaft 22 to which the driving pulley 32 of the driving force supply unit 4C is coupled is rotated, the driven pulley 36 of the second joint portion 4A is rotated by the wire 31. As a result, the annular driven body 34 having the first joint 3 </ b> A connected to the tip is rotated around the pins 35 and 37 with respect to the cylindrical support member 33. Further, when the driving pulley 32 is rotated in the reverse direction, the annular driven body 34 is rotated in the reverse direction.
As described above, the first joint portion 3A and the second joint portion 4A constitute a driven unit that can rotate and bend in two axial directions perpendicular to the central axis of the cylindrical support member 33. By connecting the treatment instrument 2A to these tips, the treatment instrument 2A can be rotated in two axial directions perpendicular to the central axis of the cylindrical support member 33 by remote control of the driving force supply units 3C and 4C. It can be moved.

As described above, according to the surgical instrument 1 of the present embodiment, the motor control unit 53 rotates the motors 50, 44, and 47 so that the treatment instrument unit 2A moves forward and backward along the linear direction L, and the linear direction. Rotation around L and rotation around two axes orthogonal to the linear motion direction L to change the position, posture and opening / closing direction of the forceps 10 of the treatment instrument part 2A attached to the distal end side, and the gripper 10A, The opening / closing operation of 10B can be remotely controlled.
If the movable parts of the first drive system 2, the second drive system 3, and the third drive system 4 break down or are damaged, the driven body 5 has the connecting body 5 </ b> A in the axial direction. By pulling out, the connecting body 5A can be detached from the second joint portion 4A together with the driving force transmitting portions 2B and 3B. In addition, in the removed connection body 5A, the treatment instrument part 2A can be removed from the first joint part 3A by pulling out the treatment instrument part 2A together with the driving force transmission part 2B in the axial direction. As described above, the first drive system 2, the second drive system 3, and the third drive system 4 can be easily detached from the surgical instrument 1 only by simple operations. Further, the first drive system 2, the second drive system 3, and the third drive system 4 that have failed or damaged are connected again in place of a new replacement unit that has been assembled in advance, and assembly is performed. By doing so, the surgical instrument 1 can be easily repaired.

  In this way, the first drive system 2, the second drive system 3, and the third drive system 4 are used as exchange units, thereby disconnecting the connections between the driven units, the driving force transmission unit, and the driving force supply unit. Can be exchanged without For this reason, for example, the tension of the wire 18 and the wire 31 is adjusted, the rotation amount of each pinion gear 21 of each driving force supply unit, each driving pulley 32 and the treatment instrument part 2A, the first joint part 3A, the second joint part. Since the operation of adjusting the relationship with the driven amount with respect to 4A can be exchanged without any operation, even an operator who does not have a skilled repair technique can easily and quickly perform the repair.

Next, the surgical instrument of the 1st modification of this embodiment is demonstrated.
Fig.10 (a) is a typical perspective view which shows schematic structure of the treatment instrument part used for the surgical instrument of the 1st modification of embodiment of this invention, and a 1st joint part. FIG.10 (b) is JJ sectional drawing in Fig.10 (a). FIGS. 10C and 10D are a KK sectional view and a MM sectional view in FIG. FIG.10 (e) is operation | movement explanatory drawing of the 1st joint part of the 1st modification of embodiment of this invention. FIG. 11 is a partial cross-sectional view showing a driving force transmission unit and a driving force supply unit used in the surgical instrument of the first modified example of the embodiment of the present invention.

As shown in FIGS. 10A and 11, the surgical instrument of this modification is replaced with the treatment instrument part 2A, the driving force transmission part 3B, the driving force supply part 3C, and the second joint part 4A of the above embodiment. The treatment instrument unit 120A (driven unit), the first joint unit 130A (driven unit), the driving force transmission unit 130B, and the driving force supply unit 130C are provided. Hereinafter, a description will be given focusing on differences from the above embodiment.
The treatment instrument part 120A, the first joint part 130A, and the second joint part 4A of this modification form three driven units, and although not particularly illustrated, the treatment instrument part 2A of the above embodiment, The driven portion is configured by being connected to the same positional relationship as the first joint portion 3A and the second joint portion 4A.
In the present modification, the treatment instrument unit 120A, the driving force transmission unit 2B, and the driving force supply unit 2C are exchange units as in the first driving system 2 and the second driving system 3 of the above embodiment. The first drive system is configured, and the first joint portion 130A, the drive force transmission unit 130B, and the drive force supply unit 130C form a second drive system that is an exchange unit.

  The treatment instrument part 120A is replaced with the forceps holding part 12 of the treatment instrument part 2A of the above-described embodiment, and a forceps holding part 12A having a holding part body 120b in which the outer peripheral surface 12f of the holding part main body 12b has the same diameter as the outer peripheral surface 12g. (The holding member) is provided, and the only difference is that a concave hole portion 12h (positioning connection portion) for fixing with a fixing screw 75 (positioning connection portion) described later is provided on the side surface of the holding portion main body 120b. As the shape of the recessed hole portion 12h, for example, a circular hole having an inner diameter slightly larger than the outer diameter of the fixing screw 75, a mortar-shaped hole having a V-shaped cross section having an opening larger than the outer diameter of the fixing screw 75, etc. can do.

The first joint portion 130A includes a C-shaped annular driven body 55 (driven body) and a C-shaped annular support member 54 (holding member) instead of the annular driven body 26 and the annular support member 25 of the above-described embodiment. .
The C-shaped annular driven body 55 has an outer peripheral surface 55b having the same outer diameter as the annular driven body 26 of the above-described embodiment, and a through-hole having a larger inner diameter than the maximum outer diameter of the treatment instrument portion 120A coaxially with the outer peripheral surface 55b. A C-shaped annular member having a C-shaped cross section in which a side slit portion 55d penetrating in a radial direction is provided in a part of the annular body including the hole 55a in the circumferential direction. The side slit portion 55d has a width that allows the outer peripheral surfaces 12f and 12g of the forceps holding portion 12A and the driving force transmission portion 2B to be taken in and out simultaneously from the side.
One end face in the axial direction of the C-shaped annular driven body 55 is connected to the C-shaped annular support member 54 so as to be rotatable, and is opposed to each other in the radial direction and extended in parallel along the axial direction. The pair of projecting piece portions 55c is provided at a position slightly inside the outer shape of the outer peripheral surface 55b.
A female screw 55e for screwing a fixing screw 75 for fixing the treatment instrument portion 120A inside penetrates in a thickness direction from the outer peripheral surface 55b toward the through hole 55a on the side surface provided with one protruding piece portion 55c. Is provided.

The C-shaped annular support member 54 includes a through-hole 54a and an outer peripheral surface 54b having the same outer diameter, inner diameter, and width as the outer peripheral surface 55b, the through-hole 55a, and the side slit portion 55d of the C-shaped annular driven body 55. And a C-shaped annular member including a side slit portion 54d.
One end face in the axial direction of the C-shaped annular support member 54 is pivotally connected to a pair of projecting piece portions 55c of the C-shaped annular driven body 55, so that they are opposed to each other in the radial direction. A pair of projecting piece portions 54c extended in parallel along the outer periphery surface 54b is provided at a position substantially along the outer shape of the outer peripheral surface 54b.
On the outer periphery of the other end of the C-shaped annular support member 54 in the axial direction, an elastic member for attaching the elastic member 13 to the C-shaped annular support member 54 is provided on one side in the direction in which the projecting piece portions 55c face each other. A portion 12d is provided.
The elastic member 13 is fixed to the elastic member mounting portion 12 d of the C-shaped annular support member 54 in the same manner as the annular support member 25. And it can compress to the outer peripheral surface 54b by applying external force from the radial direction outer side in the state fixed to this elastic member attaching part 12d.

The pair of protruding pieces 54c of the C-shaped annular support member 54 are inserted between the pair of protruding pieces 55c of the C-shaped annular driven body 55, respectively, and the C-shaped annular support member 54 and the C-shaped annular support member 54 are inserted. The driven body 55 is rotatably connected by a pair of pins 56 aligned in one radial direction.
Here, the pin 56 may be fixed to any one of the projecting piece portions 54c and 55c, or may be only fixed and not fixed.
Further, the C-shaped annular driven body 55 and the C-shaped annular support member 54 are arranged so that the radial position between the female screw 55e of the C-shaped annular driven body 55 and the elastic member mounting portion 12d of the C-shaped annular support member 54 is the center. They are connected so as to be in positions opposite to each other across the shaft.

As shown in FIGS. 10B and 10C, on the inner peripheral surface of the through hole 54a of the C-shaped annular support member 54, the axial end portion on the side opposite to the side where the protruding piece portion 54c is provided, A guide portion 54e protruding radially inward is provided at a position facing the slit portion 54d in the radial direction.
The guide portion 54e is provided with a guide hole 54f through which a rod member 57 of a driving force transmission portion 130B described later is inserted inside along the axial direction of the through hole 54a.

  With such a configuration, when the C-shaped annular support member 54 and the C-shaped annular driven body 55 are arranged in a coaxial positional relationship (hereinafter referred to as a straight state of the first joint portion 130A), the through holes 54a, 55a, outer peripheral surfaces 54b and 55b, and side slit portions 54d and 55d are aligned coaxially to form a C-shaped annular member having a C-shaped cross section as a whole.

The driving force transmission unit 130B includes a rod member 57, a link member 58, and a coil pipe 17, as shown in FIGS.
The rod member 57 is a flexible elongated rod-shaped member made of, for example, a superelastic alloy or a synthetic resin, has an outer shape substantially equal to the inner diameter of the coil pipe 17, and can slide inside the coil pipe 17. Can be inserted. The rod member 57 and the link member 58 may have a circular or polygonal cross-sectional shape, but the rod member 57 and the link member 58 of the present embodiment employ square bars having a rectangular cross section.
The tip of the rod member 57 is connected to the end of a rod-like link member 58 that extends in the axial direction and is fixed to the end of the through-hole 55a of the C-shaped annular driven body 55 where the projecting piece 55c is provided. The pin 58a is rotatably connected.
The coil pipe 17 of the drive transmission portion 130B is joined to the end face of the guide portion 54e of the C-shaped annular support member 54 by, for example, adhesion or soldering, and the base end portion is the same as the drive force supply portion 2C. It is fixed to the driving force supply unit 130C. The rod member 57 is inserted into the coil pipe 17 and guided into the driving force supply unit 130C.

The driving force supply unit 130C is connected to the base end side of the driving force transmission unit 130B and supplies driving force to the driving force transmission unit 130B. As shown in FIG. 11, the driving force supply unit 130C is similar to the driving force supply unit 2C. The support plate 23 has a rectangular shape in plan view, a fixing member 24, a pinion gear 21, and a drive member 20.
The fixing member 24 is a member that fixes the driving force transmission portion holding member 9 to which the other end portion of the coil pipe 17 of the driving force transmission portion 130B is fixed to the support plate 23 in the same manner as the driving force supply portion 2C.

The pinion gear 21 of the driving force supply unit 130C supplies driving force to the driving force transmission unit 130B, and can be rotated by a rotation support shaft 22 provided on an extension line in the axial direction of the driving force transmission unit holding member 9. It is supported.
The drive member 20 of the drive force supply unit 130C converts the rotational motion of the pinion gear 21 into a linear motion and transmits the linear motion to the rod member 57. Like the drive member 20 of the drive force supply unit 2C, the drive member 19 and the drive member 20 are driven. The drive rod 19 is connected to the proximal end of the rod member 57 and inserted into the drive rod guide hole 9b. The rack 20b of the drive block 20a is connected to the pinion gear 21 of the drive force supply unit 130C. Is engaged.

Next, a method for assembling and disassembling the driven part according to this modification will be described.
First, as shown in FIG. 10 (a), the forceps holding part 12A and the driving force transmitting part 2B of the treatment instrument part 120A are laterally passed through the side slit parts 55d and 54d of the first joint part 130A in a straight state. To the first joint part 130A. At this time, the treatment instrument portion 120A is inserted so that the recessed hole portion 12h substantially overlaps the female screw 55e of the C-shaped annular driven body 55.
Next, the fixing screw 75 is screwed into the female screw 55e, the tip of the fixing screw 75 is engaged with the concave hole portion 12h of the treatment instrument portion 120A, and the side surface opposite to the concave hole portion 12h of the forceps holding portion 12A is The fixing screw 75 is screwed in until the inner circumferential surface of the through hole 55a of the C-shaped annular driven body 55 is pressed. Thereby, the treatment instrument part 120A is aligned and connected to the C-shaped annular driven body 55, and the connection body 5B including the treatment instrument part 120A and the first joint part 130A is formed.
Conversely, by loosening the fixing screw 75 from this connected state, the fixation of the treatment instrument part 120A is released, and the forceps holding part 12A and the drive of the treatment instrument part 120A are driven from the side slit parts 54d and 55d. The force transmission part 2B can be removed to the side.

  Next, the grippers 10A and 10B are closed with respect to the through-hole 33a of the second joint portion 4A in the straight state, with the connection body 5B connected in this way, similarly to the connection body 5A of the above-described embodiment. With the forceps 10 in the state of the head being inserted from the cylindrical support member 33 side, the elastic member 13 provided in the first joint portion 130A is fitted into the recessed hole portion 34e in the annular driven body 34, The C-shaped annular support member 54 is connected to the annular driven body 34 in a positioned state.

By such an operation, the connecting body 5B is connected to the second joint part 4A, and a driven part including the treatment instrument part 120A, the first joint part 130A, and the second joint part 4A is formed.
The driving force transmission units 2B, 130B, and 4B connected to the treatment instrument unit 120A, the first joint unit 130A, and the second joint unit 4A all pass through the insertion space of the second joint unit 4A to the outside of the cylindrical support member 33. It has been extended.
Further, in this driven portion, when the connecting body 5B is pulled out in the direction opposite to the insertion direction at the time of connection, the elastic member 13 is compressed by the annular driven body 34, and the connection is released. It is pulled out from the second joint portion 4A through 34a and 33a.

In this modification, the side slit portions 54d and 55d of the first joint portion 130A are attached to the other driven unit (the treatment instrument portion 120A), which is an attachment / detachment partner, respectively. It is a detachable opening that is an opening that can be inserted together with the driving force transmitting portion (driving force transmitting portion 2B).
That is, in this modification, the attachment / detachment opening is provided on the side of the driven body and the holding member, and includes a slit that allows the driven unit to be attached / detached to be inserted / removed from the side together with the driving force transmission portion. It is an example of the case. According to such a detachable opening, even if the driving force transmitting portion is highly flexible and it is difficult to insert the driven unit in the axial direction, it can be easily connected.

Further, the fixing screw 75 and the recessed hole portion 12h constitute a positioning connection portion of the treatment instrument portion 120A and the first joint portion 130A.
According to such a positioning connection part, since it does not need to be pushed in and pulled out in the axial direction, connection and connection release are performed without applying a load to the connection part between the treatment instrument part 120A and the driving force transmission part 2B. be able to.

Next, the surgical instrument of the 2nd modification of this embodiment is demonstrated.
Fig.12 (a) is a typical perspective view which shows the structure of the modification (2nd modification) of the driven unit of the surgical instrument which concerns on embodiment of this invention. 12B and 12C are an NN sectional view and a PP sectional view in FIG. 12A, respectively.

As shown in FIGS. 12A, 12 </ b> B, and 12 </ b> C, the rotating unit 60 of this modification is replaced with the treatment instrument unit 2 </ b> A, the first joint unit 3 </ b> A, and the second joint unit 4 </ b> A of the above embodiment. It is a modified example of a driven unit that can be used in addition to these or can be used in addition to these.
The schematic configuration of the rotating unit 60 includes an annular driven body 62 (driven body), an annular support member 61 (holding member), and an elastic member 13.
Further, as the driving force transmitting portion of the rotating portion 60, a configuration including the wire 31, a pair of tubular members 65, and a flexible tube 66 can be employed.

The annular driven body 62 is a cylindrical member in which a through hole 62a and an outer peripheral surface 62b are provided coaxially.
The inner peripheral surface of the through-hole 62a can have an appropriate shape depending on the application. For example, when connecting the treatment instrument part 2A, it is only necessary to have an inner diameter that fits outside the holding part main body 12b and to provide a not-shown recessed hole part 26e. Further, the through hole 62a may be simply a cylindrical hole, for example, a cylindrical member such as an optical fiber or a lens unit may be fitted therein and fixed by adhesion or the like.

The annular support member 61 is a substantially cylindrical member that includes an inner peripheral surface 61 a that is slidably fitted to the outer peripheral surface 62 b of the annular driven body 62.
On one end side in the axial direction of the annular support member 61, a pair of pulley accommodating portions 61 c each including a concave portion directed radially outward with respect to the inner peripheral surface 61 a is provided at a position facing the radial direction.
Rotating support shafts 64a and 64b are erected along the radial direction of the annular support member 61 inside each pulley accommodating portion 61c.
Driven pulleys 63a and 63b (pulleys) having the same pulley diameter are rotatably supported on the rotation support shafts 64a and 64b, respectively. The installation positions of the driven pulleys 63a and 63b along the axial direction of the annular support member 61 are such that the outer peripheral portions of the driven pulleys 63a and 63b protrude outward in the axial direction from the end portion of the pulley accommodating portion 61c. It is set to be slightly shifted from each other. In this modification, the rotation support shaft 64b slightly protrudes outward in the axial direction than the rotation support shaft 64a.
As shown in FIG. 12B, the end of the annular driven member 62 is fitted inside one end of the annular support member 61 in the axial direction. After the wire 31 inserted along the axial direction is wound around the driven pulley 63a and bent approximately 90 °, the wire 31 is wound around the outer peripheral surface 62b of the annular driven body 62 by about one and a half rounds. It is wound around the driven pulley 63b and bent by approximately 90 °, and is arranged in a positional relationship parallel to the wire 31 before being wound around the driven pulley 63a. For this reason, the position of the annular driven body 62 in the axial direction is fixed by friction with the wound wire 31.

Further, as shown in FIG. 12B, an elastic member mounting portion 12d is provided on the outer peripheral cylindrical portion 61b side on the other end side in the axial direction of the annular support member 61, and the elastic member 13 is fixed. . The circumferential position of the elastic member attaching portion 12d can be set as appropriate, but in this modification, it is set to a positional relationship orthogonal to the central axes of the rotation support shafts 64a and 64b.
In addition, a tubular member mounting portion 61d protrudes radially inward on the inner peripheral surface 61a on the other end side in the axial direction of the annular support member 61, and a pair of tubular members 65 is formed at the tip of the tubular member mounting portion 61d. The end is fixed.
In addition, an annular flexible tube mounting portion 61e through which each tubular member 65 is inserted is provided on the end surface of the annular support member 61 on the other end side in the axial direction. Each tubular member 65 is fixed to the tubular member mounting portion 61d.
Each tubular member 65 allows the wire 31 hung on the driven pulleys 63a and 63b to be inserted along the axial direction of the annular support member 61, and is a flexible tube whose end is fixed to the flexible tube mounting portion 61e. 66, and is led from an annular support member 61 to a driving force supply unit (not shown) that remotely operates the rotating unit 60.
The configurations of the tubular members 65 and the flexible tubes 66 may be the same as the configurations of the tubular member 30 and the cladding tube 70 of the above embodiment.
Further, the driving force supply unit that supplies the driving force to the rotating unit 60 can adopt the same configuration as the driving force supply unit 3C of the above-described embodiment.

  According to this modification, by driving the wire 31 by a driving force supply unit (not shown) similar to the driving force supply unit 3C of the above embodiment, the annular driven body 62 around which the wire 31 is wound is provided. The annular support member 61 can be rotated around the central axis.

Next, the surgical instrument of the 3rd modification of this embodiment is demonstrated.
FIG. 13A is a schematic perspective view showing a configuration of a modified example (third modified example) of the driven unit of the surgical instrument according to the embodiment of the present invention. FIGS. 13B and 13C are a Q-Q cross-sectional view and an RR cross-sectional view in FIG. 13A, respectively. FIG.13 (d) is a side view of the S view in Fig.13 (a).

As shown in FIGS. 13 (a), (b), (c), and (d), the linear motion part 80 of the present modification includes the treatment instrument part 2A, the first joint part 3A, and the second part of the above embodiment. This is a modified example of the driven unit that can be used in place of the joint portion 4A or can be used in addition to these.
The schematic configuration of the linear motion unit 80 includes an annular driven body 81 (driven body), an annular support member 82 (holding member), and an elastic member 13.
Moreover, as the driving force transmission part of the linear motion part 80, the structure which consists of the wire 31, the pair of tubular members 30, and the cladding tube 70 similar to the driving force transmission part 4B, for example can be employ | adopted.

The annular driven body 81 is a cylindrical member in which a through hole 81a and an outer peripheral surface 81b are provided coaxially.
The inner peripheral surface of the through hole 81a can have an appropriate shape depending on the application. For example, when connecting the treatment instrument part 2A, it is only necessary to have an inner diameter that fits outside the holding part main body 12b and to provide a not-shown recessed hole part 26e. Further, the through-hole 81a may be simply a cylindrical hole, for example, a cylindrical member such as an optical fiber or a lens unit may be fitted therein and fixed by adhesion or the like.
A part of a side surface of the annular driven body 81 is provided with a rectangular hole 81c having a substantially rectangular shape that is long in the axial direction of the annular driven body 81 in the thickness direction. The square hole portion 81c has a width in the short side direction that allows a pinion gear 83b of a transmission member 83 to be described later to be inserted, and a rack portion 81d that engages with the pinion gear 83b is formed on an inner peripheral portion that constitutes one side in the longitudinal direction. .
A pin portion 81e protruding outward in the radial direction is provided on the outer peripheral surface 81b side of the side surface facing the square hole portion 81c.

The annular support member 82 is a substantially cylindrical member that includes an inner peripheral surface 82 a that is slidably fitted to the outer peripheral surface 81 b of the annular driven body 81.
On one end side of the annular support member 82 in the axial direction, a transmission member accommodating portion 82c is provided which is a concave portion that extends radially outward with respect to the inner peripheral surface 82a.
A rotation support shaft 84 is erected along the radial direction of the annular support member 82 inside the transmission member accommodating portion 82c.
A transmission member 83 in which a driven pulley 83a and a pinion gear 83b are coaxially integrated is rotatably supported on the rotation support shaft 84. The driven pulley 83a is disposed on the inner peripheral surface side of the transmission member accommodating portion 82c, and the pinion gear 83b is provided at a position where it can engage with the rack portion 81d of the annular driven member 81 inserted into the annular support member 82. Yes.
A linear guide that guides the pin portion 81e along the axial direction of the annular support member 82 by internally fitting the pin portion 81e of the annular driven member 81 on the side surface of the annular support member 82 that faces the rotation support shaft 84. A slit 82d is provided.

  Further, an elastic member attaching portion 12d is provided on the outer peripheral cylindrical portion 82b side on the other end side in the axial direction of the annular support member 82, and the elastic member 13 is fixed. The circumferential position of the elastic member mounting portion 12d can be set as appropriate, but in this modification, it is set to a positional relationship orthogonal to the central axis of the rotation support shaft 84.

Such a linear motion portion 80 is inserted into the annular support member 82 with the pin portion 81 e fitted into the linear motion guide slit 82 d of the annular support member 82 and the annular driven member 81. The wire 31 is hung around the driven pulley 83a, the pinion gear 83b is engaged with the rack portion 81d of the annular driven body 81, and the transmission member 83 is attached to the rotary support shaft 84.
As shown in FIG. 13B, the wire 31 wound around the driven pulley 83 a is inserted into the tubular member 30, and each tubular member 30 is in the groove 82 e formed on the inner peripheral surface 82 a of the annular support member 82. The other end side of the annular support member 82 in the axial direction is fixed to the inner peripheral surface 82a together with the cladding tube 70 covering each tubular member 30 in the same manner as the driving force transmission portion 4B. .

  According to this modification, the driving force supply unit (not shown) similar to the driving force supply unit 4C of the above embodiment drives the wire 31, thereby rotating the transmission member 83 and rotating the pinion gear 83b in the rack. The annular driven body 81 can be linearly moved along the direction of the central axis of the linear motion guide slit 82d aligned in the axial direction of the annular support member 82.

In the above description, the example in which three driven units are connected is described, but the driven unit is not limited to three connections.
For example, as an example of a configuration in which four or more driven units are connected, a plurality of driven units in which joint portions having the same configuration as the first joint portion 3A can be attached to and detached from each other are connected. The example of the structure which formed the bending mechanism which has a joint, and connected 2 A of treatment instrument parts to this bending mechanism can be given.

In the above description, one example of a driven unit is a treatment instrument unit that treats a body to be treated. However, all the driven units do not perform processing on the body to be treated. The structure which only moves a to-be-driven body relative to a holding member may be sufficient.
For example, a configuration in which an optical fiber, a lens system, or the like is provided on the driven body of the driven unit at the tip to illuminate or observe the treated body may be used.

Further, in the above description, the positioning connecting portion has been described as an example where the concave portion and the convex portion are formed and the convex portion is formed of an elastic member. However, the elastic member is, for example, a member such as rubber that can be elastically compressed. It is not limited. For example, an elastic member that can be flexibly deformed, such as a leaf spring, may be used.
Moreover, it is good also as a structure which a convex part consists of a combination of the rigid body fitted to a recessed part, and the elastic member which presses this rigid body toward a recessed part, for example, elastic members, such as a leaf | plate spring and a coil spring.

  In the above description, the example in which the detachable opening is provided in two driven units among the three driven units has been described, but only one driven unit has the other two driven units. It is good also as a structure provided with two attachment / detachment openings for attaching / detaching a unit.

  In the description of the first embodiment, the example in the case where each of the through hole 25a and the through hole 33a constitutes a detachable opening is described.

  In the above description, the driving force supply units 2C, 3C, and 4C have been described as examples in the case of being connected to the three motors 47 that are the driving force supply sources that generate the driving force. It is not necessary to provide a power supply source. For example, the rotation support shaft 22 is manually rotated by connecting a member such as an appropriate transmission mechanism or a rotation knob to the rotation support shaft 22 of the drive force supply units 2C, 3C, and 4C to generate a drive force. It is good.

  In the description of the second modified example, the outer peripheral surface 62b of the annular driven body 62 is described as a cylindrical surface. However, a spiral groove for winding the wire 31 may be provided.

  In the above description, the driven body of the driven unit and the through hole of the holding member have been described as substantially cylindrical. However, the cross-sectional shape of the through hole is deformed depending on the cross-sectional shape of the holding part of another driven unit to be combined. Can be made.

In addition, all the constituent elements described in the above embodiments and the respective modifications can be implemented in appropriate combination within the scope of the technical idea of the present invention.
For example, it is good also as a structure which provided the recessed hole part 26e in 2 A of treatment instrument parts of the said embodiment, and the through-hole 55a of the 1st joint part 130A of the 1st modification of the said embodiment. In this case, the driving force transmitting portion 2B connected to the treatment instrument portion 2A is inserted into the first joint portion 130A from the side slit portions 55d and 54d, and the treatment instrument portion 2A is inserted into the through hole 55a in a C shape. The treatment instrument portion 2A and the C-shaped annular driven body 55 provided with the recessed hole portion 26e can be connected by being inserted in the axial direction from the annular driven body 55 side. In this case, the through hole 55a and the side slit portions 55d and 54d together form a detachable opening when the treatment instrument portion 2A is connected.

DESCRIPTION OF SYMBOLS 1 Surgical instrument 2 1st drive system 2A, 120A Treatment instrument part (driven unit)
2B, 3B, 4B, 120B, 130B Driving force transmission unit 2C, 3C, 4C, 130C Driving force supply unit 3 Second driving system 3A, 130A First joint unit (driven unit)
4 Second drive system 4A Second joint (driven unit)
5 Driven portion 5A, 5B Connecting body 8 Gear L Linear motion direction 10 Forceps (driven body)
11 Rotating spindle 12, 12A Forceps holding part (holding member)
12h Recessed hole (positioning connecting part, recessed part)
13 Elastic member (positioning connecting part, convex part)
17 Coil pipe (tubular member)
18, 31 Wire (Linear member having flexibility)
25, 61 Annular support member (holding member)
25a, 33a Through hole (detachable opening, hole)
26, 34, 62 Annular driven body (driven body)
26e, 34e Recessed hole (positioning connecting part, recessed part)
29, 36, 63a, 63b Driven pulley (pulley)
30, 65 Tubular member 33 Tubular support member (holding member)
40 Drive unit 44, 50 Motor 47 Motor (drive power supply source)
53 Motor controller 54 C-shaped annular support member (holding member)
54d, 55d Side slit (detachable opening, slit)
55 C-shaped annular driven body (driven body)
57 Rod member 58 Link member 60 Rotating part (driven unit)
61a Inner peripheral surface (detachable opening, hole)
66 Flexible tube 70 Coated tube 75 Fixing screw (positioning connection part, convex part, fastening member)

Claims (16)

A surgical instrument having a driven part and a driving part for remotely controlling the operation of the driven part,
The driven part is
A plurality of driven units each having a driven body and a holding member that holds the driven body so as to be relatively movable are detachably connected,
The drive unit is
A driving force transmission portion that is connected to the driven body of the driven unit, and that transmits a driving force independently from the base end side to each of the driven bodies;
A driving force supply unit connected to the base end side of the driving force transmission unit and independently supplying a driving force;
The driven unit is:
Each of the driven body and the holding member has a positioning connecting portion that is positioned so as to be detachably connected to another driven unit, and
At least one of the driven units includes
A surgical instrument, wherein an attachment / detachment opening, which is an opening through which the other driven unit can be inserted together with the driving force transmission part when the other driven unit is attached / detached, is provided.   The surgical instrument according to claim 1, wherein three or more of the driven units are detachably connected. One of the driven units is
As one driven body of the driven unit, a treatment instrument unit for treating the treated body is provided,
Other than the driven unit,
3. The device according to claim 1, wherein at least one of a position and a posture of the holding member of another driven unit to which another driven body of the driven unit is connected is changed. Surgical instruments. Each other driven body of the driven unit is:
The surgical instrument according to claim 3, wherein the surgical instrument is rotatably supported by each other holding member of the driven unit. Each other driving force transmission part of the driven unit is:
A pulley fixed to the other driven body of the driven unit, and a pulley supported by the other holding member of the driven unit together with the driven body;
The surgical instrument according to claim 4, comprising a flexible linear member wound around the pulley.   The surgical instrument according to claim 5, wherein the linear member is inserted into a flexible tubular member.   The surgical instrument according to claim 6, wherein the tubular member is a coil pipe in which a metal wire is wound in a coil shape.   The surgical instrument according to claim 6, wherein the tubular member is a pipe member made of a superelastic alloy.   The surgical instrument according to claim 6, wherein the tubular member is a flexible tube member. Each other driving force transmission part of the driven unit is:
The surgical instrument according to claim 4, comprising a link mechanism that advances and retracts a link member that is eccentric with respect to a rotation fulcrum of another driven body of the driven unit. The removable opening provided in the driven unit is:
It consists of a hole that is externally fitted to the outer periphery of the driven unit to be attached and detached, and inserted into the inside.
The positioning connecting portion is
The surgical instrument according to any one of claims 1 to 10, wherein the surgical instrument is provided inside the hole. The removable opening provided in the driven unit is:
11. A slit which is provided on a side of the driven body and the holding member and which allows the driven unit to be attached / detached to be inserted / removed from the side together with the driving force transmission portion. The surgical instrument according to any one of the above. The positioning connecting portion is
One of the driven units connected to each other is provided as a recess,
The surgical instrument according to any one of claims 1 to 10, wherein the other of the driven units connected to each other is provided as a convex portion that fits into the concave portion.   The surgical instrument according to claim 13, wherein the convex portion is made of an elastic member and is provided so as to be able to advance and retreat in a protruding direction side. The positioning connecting portion is
The one and the other one of said driven unit connected to each other physician of claims 1 to 10, characterized in that to fix the position by the attached fastening member according to any surgical instrument .   The surgical instrument according to claim 1, further comprising a driving force supply source that generates the driving force supplied from the driving force supply unit.

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