The present invention relates to a surgical instrument to be used in a clinical site, and more particular, to a surgical instrument, of which a position and a posture can be operated by a wire drive type joint.
As a related art for a medical manipulator, which includes movable parts of two degrees of freedom at a tip end of a forceps and a forceps operating part at a rear end of the forceps to minutely operate a forceps, JP-A-2001-276091 discloses an arrangement, which comprises at a tip end of a forceps a first rotary joint and a second rotary joint, and in which a motor at an operating part drives to control the respective joints through gears, etc. to perform an operation of determining a posture of a tip end of the forceps, and a lever provided on an operating rod is operated to control an amount of opening and closing of the forceps.
JP-A-2004-154164 discloses a related art of a multiple degree-of-freedom type treatment tool including a treatment tool body comprising a treatment part connected thereto through an joint, a joy stick, which bends the treatment part in a vertical direction and in a lateral direction, a dial, which rotationally operates the treatment part, and a lever, which operates the treatment part to open and close the same, wherein the treatment part is simply set in a desired position and a desired posture.
There is disclosed a related art for a medical manipulator, in which miniaturization and controllability of the manipulator are improved by maintaining drive wires in path length and phase irrespective of an angular change in joints (see, for example, JP-A-2004-122286).
With the related art disclosed in JP-A-2001-276091, however, a complicated control of rotary operations of first and second rotating shafts provided on the joints must be exercised by operation of the joy stick and driving of the motor since the joy stick provided on the operating rod is operated lateral and vertically in a complicated manner to determine a position and a posture of the forceps and determination of the position and the posture is made by driving a motor provided on the operating rod.
With the disclosure of JP-A-2004-154164, any motor is not used but a joy stick for manual operation is used to operate drive wires directly, so that skill is necessary in operation of the joy stick when appropriately setting the treatment part in position and posture. With the construction of joints proposed in JP-A-2004-122286, control of a motor is involved in a method of driving swinging movements and opening and closing movements of the blades in the embodiment disclosed therein.
It is an object of the invention to provide a surgical instrument, a position and a posture of a multiple degree-of-freedom gripper of which can be easily manipulated by movements without strain of a wrist and fingers of an operator at an operating part.
According to an aspect of the invention, there is provided a surgical instrument comprising a tip end joint part having an openable and closeable gripper, an operating part including a hand grip to be grasped by a palm and a plurality of operating dials, and an arm part that accommodates wires for cooperation of actions of the operating part and the tip end joint part, and wherein a first operating dial is arranged above the hand grip and on an upper inclined surface of the operating part and second and third operating dials are arranged above the hand grip and on a front surface of the operating part, and wherein the first operating dial is operated by a thumb and the second operating dial is operated by a forefinger whereby the tip end joint part is operated vertically and laterally to perform a swinging action, and the third operating dial is operated by a forefinger whereby the tip end gripper is operated to open or close.
According to another aspect of the invention, there is provided a surgical instrument comprising a tip end joint part having an openable and closeable gripper, an operating part including a hand grip to be grasped by a palm and a plurality of operating dials, and an arm part that accommodates wires for cooperation of actions of the operating part and the tip end joint part, and wherein the operating part is shaped to be schematically modified-elliptical in cross section, first and second operating dials are arranged on an inclined surface formed on an upper portion of the hand grip on this side of the operating part, and a third operating dial is arranged on the upper portion of the hand grip on an opposite side to this side, and wherein the first and second operating dials are operated by a thumb to move the tip end joint part vertically and laterally to have the tip end joint part swing, and the third operating dial is operated by a forefinger whereby the tip end gripper is operated to open and close.
According to the invention, a position and a posture of a gripper, which functions as a forceps, can be easily and stably operated by an operator movements without strain at an operating part without the use of electronic control such as an actuator, etc.
Since a position and a posture of a gripper can be easily operated mainly by a thumb and a forefinger at an operating part, the surgical instrument is suited to an operation during a long period of time. Also, it is possible to provide a surgical instrument, which is simple in construction and operation.
Other objects, features, and advantages of the invention will be made apparent from the following descriptions with respect to an embodiment of the invention.
A surgical instrument according to the invention will be described with reference to FIGS. 1 to 4.
A surgical instrument for medical care will be exemplarily described for the purpose of a specific illustration (the invention is not specifically limited to a surgical instrument for medical care but provides a construction for general operation tools, a gripper of which is manually operated). A tip end portion (also, referred below to as a tip end joint or an instrument joint) of a surgical instrument (also, referred below to as instrument) comprises a gripper (forceps part) 14 that grips a suture thread, a needle, or the like, a tip end part 15 positioned near a lower portion of the gripper 14 shown in
The gripper 14 comprises a pair of blades 1a, 1b, and blade pulleys 2a, 2b are arranged at roots of the respective blades 1a, 1b. The blade pulleys 2a, 2b are formed with grooves 22a, 22b, around which the drive wires 3a to 3d for operation of the blades are wound (see
The tip end part 15 comprises a tip end base portion 4 in the form of a flat plate interposed between the pair of blades 1a, 1b, and a rolling member 4b being a flat plate substantially perpendicular to the tip end base portion 4 and having a semi-circular gear portion 4a (see
The root part 17 comprises a cylindrical-shaped cylinder portion 13 and a rolling member 13b positioned at a tip end of the cylinder portion 13 and formed with a semi-circular gear portion 13a. A hole is formed centrally of the rolling member 13b (see
The intermediate part 16 is formed between the tip end part 15 and the root part 17 so that the tip end part 15 and the root part 17 can turn about respective axes of the two shafts 8a, 8b. That is, the intermediate part 16 comprises egg-shaped intermediate plates 9b, 12 mounted to the shafts 8a, 8b and formed with two holes, wire-guide pulleys 6e to 6h interposed between the intermediate plates 9b, 12, egg-shaped intermediate plates 11, 9a mounted likewise to the shafts 8a, 8b and formed with two holes, an intermediate plate 10 adjoining the intermediate plate 11 and formed on a side, through which the shaft 8b extends, with a disk-shaped projection 20, and guide pulleys 6a to 6d interposed between the intermediate plates 10, 9a (see
The intermediate plate 10 is formed to be low around the projection 20 and to make a portion around the hole, through which the shaft 8a extends, as high as the projection 20. The plate 10 and the plate 11 thus formed are joined together to form guide paths for the wires 5a, 5b (see
The wires 5a, 5b are fixed to an intersection Pe (see
As shown in
The wire 3a fixed at one point to the blade pulley 2a is led to the pulley 6a, then to the pulley 6c, and fixed at one point to an outer periphery of a rotating shaft 125 of a hand grip 123 on the operating part 102 on a hand side as shown in
The wires 3c, 3d are mounted on a side of the blade 1b in the same manner as on a side of the blade 1a. That is, the wire 3c fixed at one point to the blade pulley 2b is led to the pulley 6b, then to the pulley 6d, and fixed at one point to an outer periphery of a rotating shaft 126 of the hand grip 123 on the operating part 102 on a hand side as shown in
An operation of the tip end portion (a tip end joint or an instrument joint) of the surgical instrument, according to the invention, constructed in the above manner will be described below with reference to FIGS. 1 to 4. The gripper 14 rotates about the shaft 7 relative to the tip end part 15. On this occasion, when the shaft 7 is the same in a direction of rotation as the blades 1a, 1b, the gripper 14 is changed in orientation, and when the blades 1a, 1b rotate in a reverse direction to a direction, in which the shaft 7 rotates, the gripper 14 performs opening and closing actions. Specifically, when a first blade drive source, for example, a dial described later is manually operated to pull the wire 3b, the blade 1a moves in a closing direction. Conversely, when the wire 3a is pulled, the blade 1a moves in an opening direction. When a second blade drive source, for example, a dial described later is manually operated to pull the wire 3c, the blade 1b is closed, and when the wire 3d is pulled, the blade 1b is opened. When the wire 3a and the wire 3c are pulled together, or the wire 3b and the wire 3d are pulled together, the gripper 14 rotates about the shaft 7 to change a gripping direction. This is referred to as a swing action of the gripper joint.
As shown in
In the case where the gear portions 4a, 13a comprise gears having the same size, the tip end part 15 is rotated by θ1 about the shaft 8b and by θ2=θ1 about the shaft 8a when the intermediate plate 10 is rotated by θ1 about the shaft 8b. Thereby, an angle α, over which the tip end part 15 swings relative to the root part 17, becomes twice an angle, over which the intermediate plate 10 is rotated about the shaft 8b. When the operating part on the hand side of the instrument is operated to rotate the vertical swing dial 103 shown in
In the case where a radius of the gear portion 4a is R times a radius of the gear portion 13a, the tip end part 15 is rotated by θ2=θ1/R about the shaft 8a when the intermediate plate 10 is rotated by θ1 about the shaft 8b. Accordingly, the tip end part 15 swings by an angle α=θ1(1+1/R) relative to the root part 17.
Central angles of those portions of the respective pulleys, with which the wires 3a, 3b are in contact, are varied according to a swing angle α. For example, the wire 3a comes into contact with the two pulleys 6a, 6c. The sum of central angles of those portions of the two pulleys 6a, 6c, with which the wire 3a comes into contact, is (d1+d2) in
Here, the phase of the wire corresponds to an angle of opening and closing of the blades 1a, 1b and also corresponds to a position of the wire according to the angle of opening and closing, that is, a quantity, by which the drive pulls the wire. Since the wire is not changed in phase, the blades 1a, 1b do not open or close even when the joint of the tip end part 15 moves. Thereby, even when an angle α of the joint of the tip end part 15 is varied, no influences are produced on path length, phase and tension of those wires, which control the blades 1a, 1b provided further beyond the joint. Consequently, only a force applied on the moving part through the wires can be transmitted as a change in tension to a hand of an operator who operates the instrument joint (a tip end joint).
According to the embodiment, since only the wires 5a, 5b are operated at the time of swinging action to maintain the blades 1a, 1b constant in angle of opening and closing, it is unnecessary to adjust quantities, by which the wires 3a, 3b are pulled. Since the wire is not varied in path length even when a swing angle is changed, it is possible to prevent a situation, in which the wire is pulled to be unable to vary a swing angle. There is not generated a situation, in which the wire becomes loose when a swing angle is varied.
According to the embodiment, an operation of a wire can be correctly represented as an action of the instrument joint (a tip end joint) because of no interference on a wire, and an operation can be always performed with the same feeling of operation since the feeling of operation is not changed by that change in tension, which accompanies an operation. Since a force generated at the instrument joint can be transmitted as a change in tension to an operator, a situation of a therapeutic operation can be felt through an inner force sense and an operation is enabled while an operator feels an inner force sense as if treatment were normally performed directly by an operator's own hand, so that it is possible to grip an object with an appropriate force at a clinical site in the case where blood vessel and tissue is gripped and stitched. Thereby, a delicate treatment is enabled in low invasion.
Since a vertical swing wire (for example, the wire 5a, 5b) and a gripper operating wire (for example, the wires 3a to 3d) can be operated without any interference, an operation is made easy and an action of the instrument joint is made stable. It is possible to correctly perform the opening and closing action of the blades at any swing angle in a movable range and a swing action, which is performed while an object is gripped by the blades, and an operator can perform an operation in an intuitional feeling of operation without the need of any complicated operation. Since the intermediate part 16 having two centers of rotation is provided, it is possible to increase a range, in which the tip end part 15 can swing relative to the root part 17. Therefore, it is possible to treat the affected part, which is hidden behind internal organs.
The construction of the gripper 14, the tip end part 15, the intermediate part 16, and the root part 17 described above presents an example of a fundamental construction adopted in the surgical instrument according to the invention. The fundamental construction shown in FIGS. 1 to 4 is also applied to a first modification of a surgical instrument according to the invention illustrated with reference to FIGS. 5 to 10.
Subsequently, features of the first modification according to the invention will be described in detail with reference to FIGS. 5 to 10.
In FIGS. 5 to 10, the reference numeral 100 denotes an instrument joint, 101 an arm part, 102 an operating part, 103 a vertical swing dial, 104 a lateral swing dial, 105 an opening and closing dial, 106 a lock button, 107 a stability holder, 108, 109 fixing parts, 110 a thumb, 111 a forefinger, 112, 113 fixing parts, 114 to 122 pulleys, 123 a hand grip, 124 a projection, 125, 126 rotating shafts, 127 an inclined mount surface, 128, 129, 131, 132 rotating shafts, 133 to 136 drive wires, 137, 138 dial mount angles, 139 a hand grip horizontal, 140 a hand grip vertical, 141 a hand grip surface, 142 a dial mount surface, 143 an interior angle of the stability holder, 144, 145 sides of the stability holder, 146 a shaft, 148, 149 holding plates, 150 a spring plate, 152 a slide hole, and 154, 155 mount surfaces.
The first modification of the surgical instrument (referred to as instrument) according to the invention comprises, as shown in
The operating part 102 comprises a dial 103 that operates vertical swing of a tip end joint (for example, the tip end joint acts in the B-direction when the dial is operated in the A-direction), a dial 104 that operates lateral swing of a gripper (the blades 1a, 1b) (for example, two blades 1a, 1b swing together in the same D-direction when the dial is operated in a C-direction), and a dial 105 that operates opening and closing of a gripper (blades) (for example, the blades 1a, 1b, respectively, act in an opening direction when the dial is operated in an E-direction, and perform reverse actions to those indicated by arrows in the figure when the dial is operated in a reverse direction). In addition, associated actions of the vertical swing dial 103, the lateral swing dial 104, and the opening and closing dial 105 in the operating part 102, and the instrument joint 100 will be described below in detail with reference to
As shown in FIGS. 6 to 8, the first modification has a feature in a configuration and a construction, in which the hand grip 123 can be grasped by a palm, a middle finger, a ring finger, and a fifth finger. As can be appreciated from
Described with reference to
The both dials are arranged so that when the hand grip 123 is grasped, the lateral swing dial 104 and the opening and closing dial (a dial for opening and closing the blades 1a, 1b of the instrument joint 100) 105 are positioned in a position, in which a forefinger 111 is naturally extended. In
Since a finger skeleton is shaped so that when a forefinger 111 is swung vertically in a state, in which the hand grip 123 is grasped by a middle finger, a ring finger, and a fifth finger, the inner surface of a finger makes an arcuate movement about the root side joint of a finger, the lateral swing dial 104 and the opening and closing dial 105 are mounted as shown in
The vertical swing dial 103 is provided on an inclined mount surface 127, which comprises a surface inclined relative to a hand grip vertical line 140 (see
In
In case of grasp with a right hand, the stability holder 107 is mounted on a right side of the hand grip 123 as shown in
Subsequently,
The lateral swing dial 104 and the opening and closing dial 105 are mounted to the hand grip 123 as shown in
The wires 3a, 3b, 3c, 3d, 5a, 5b are wired from the joints shown in
The wire 3a fixed at one point to the blade pulley 2a is led to the pulley 6a, then to the pulley 6c (see
Described further in detail, the wires 5a, 5b are guided along paths by the pulley 122, wired along the projection 124 of the vertical swing dial 103, and led again as the wire 5b toward the joint. The wires 5a, 5b, respectively, are fixed to the projection 124 and connected to be able to transmit a drive force to the intermediate plate 10 according to rotation of the vertical swing dial 103, that is, the projection 124. The wires 5a, 5b may comprise a length of wire, or two lengths of wire.
The wire 3a is guided along a path by the pulleys 119, 121, led to the rotating shaft 125, wired along a predetermined groove (illustration of which is omitted) provided on the rotating shaft 125, guided as the wire 3b along a path by the pulleys 120, 118, and wired again toward the joint. The predetermined groove provided on the rotating shaft 125 may be simply concave in shape. The wire 3a and the wire 3b, respectively, are fixed to the rotating shaft 125 and connected to be able to transmit a drive force to the joint according to rotation of the rotating shaft 125. The wire 3a and the wire 3b may comprise a length of wire, or two separate lengths of wire.
The wire 3c is guided along a path by the pulleys 115, 117, led to the rotating shaft 126 (a pulley will do), wired along a predetermined groove (illustration of which is omitted) provided on the rotating shaft 126, guided as the wire 3d along a path by the pulleys 116, 114, and wired again toward the joint. The predetermined groove provided on the rotating shaft 126 may be simply concave in shape. The wire 3c and the wire 3d, respectively, are fixed to the rotating shaft 126 and connected to be able to transmit a drive force to the joints according to rotation of the rotating shaft 126. The wire 3c and the wire 3d may comprise a length of wire, or two separate lengths of wire.
The wire 133 is one wired to transmit a drive force between the rotating shaft 125 described above and the rotating shaft 128, and fixed at one point to the rotating shaft 128 and at one point to the rotating shaft 125. The wire 133 is wired as shown in
The wire 135 is one wired to transmit a drive force between the rotating shaft 126 described above and the rotating shaft 132, and fixed at one point to the rotating shaft 132 and at one point to the rotating shaft 126. At this time, the wire 135 is wired along the predetermined grooves of the rotating shafts 132, 126. Further, the wire 136 is one wired to transmit a drive force between the rotating shaft 125 described above and the rotating shaft 132, and fixed at one point to the rotating shaft 131 and at one point to the rotating shaft 125. The wire 136 is wired as shown in
Subsequently, description will be given to actions of the dials (the dials for vertical swing, lateral swing, and opening and closing) and the drive wires. When the vertical swing dial 103 is operated by a thumb 110 in the A-direction, the wire 5b is pulled, and the intermediate plate 10 is swung about a center of rotation of the projection 20 in the B-direction. When the vertical swing dial 103 is operated in a reverse direction to the A-direction, the wire 5a is pulled, and the intermediate plate is swung in a reverse direction to the B-direction. At this time, an operation is made so that a direction, in which the vertical swing dial 103 is operated by a finger, and a direction, in which the joint swings, itself are consistent with each other.
When the lateral swing dial 104 is to be operated, a forefinger 111 pushes the dial 104 to rotate the same (a detailed construction for the pushing rotation will be described with reference to
When the lateral swing dial 104 is operated in the C-direction (see
When the opening and closing dial 105 is to be operated, a forefinger 111 pushes the dial 105 to rotate the same. Applied between the dial 105 and the rotating shafts 131, 132 is a configuration that enables transmission of torque. For example, the configuration enables transmission of torque by frictional forces, or transmission by a gear configuration. When a forefinger 111 is separated from the dial 105, the dial 105 is separated from the rotating shafts 131, 132 to bring about a state, in which torque cannot be transmitted mutually.
When the opening and closing dial 105 is operated in the E-direction (see
Here, when the lateral swing dial 104 is operated in the C-direction, this operation is accompanied by rotation of the rotating shaft 131 through the rotating shaft 125 in the J-direction and rotation of the rotating shaft 132 through the rotating shaft 126 in a reverse direction to the L-direction, but the rotating shafts 131, 132 are put in a state, in which torque is not transmitted between them and the opening and closing dial 105, so that any interference is not caused. Likewise, when the opening and closing dial 105 is operated, any interference with the lateral swing dial 104 is not caused.
As described above, while the joint construction according to the embodiment comprises respective drive wires provided on respective blades and made individually operable in order to realize a multiple degree-of-freedom construction having a high operability, connection of an operating part and joints is made according to the embodiment whereby relatively different operations of two blades, in which the two blades are moved simultaneously in the same direction, or the two blades are moved simultaneously in opposite directions, can be allotted to independent dials, respectively.
Therefore, when the joint construction according to the embodiment is to be operated manually, operation of one dial can realize a swinging action, in which the two blades are operated together in the same direction, an opening and closing action, in which the two blades are operated in different directions, and an operation of the multiple degree-of-freedom joint intuitionally and easily unlike a complicated operating method, in which two wires are allotted to separate operating means and an operator operates the separate operating means by the same amounts simultaneously in the same direction, or operates the means simultaneously in different directions. Operation of the joint is increased in freedom and operability is enhanced whereby a further complicate treatment can be performed further safely. Since an operation can be performed not electrically but directly and manually, an operator's hand can feel a grasping force by the instrument at a tip end, and sense at the time of contact with an organ, and a delicate state of an applied force can be controlled making use of a touch, which cannot be obtained with an electrically controlled equipment.
The dial 104 is formed with the projection 146, which becomes a rotating shaft. Although not shown in
A longitudinal direction of the slide hole 152 on the holding plate 148 corresponds to a direction, in which the dial 104 slides. When the dial 104 is to be operated, the dial 104 is pushed against an end of the slide hole 152 on an opposite side along the slide hole 152 by a force of a forefinger as shown in
While the construction, function and action of the surgical instrument according to the second embodiment of the invention have been described, the following features are specifically provided by the second embodiment. That is, in a fundamental configuration, in which the hand grip is grasped by a palm and the stability holder has a back of the hand in holding the instrument, an operation by a thumb with a thumb obliquely forward or upward enables the shoulder joint (the armpit) to be clamped to the body, so that a stable posture for surgery can be ensured and fatigue is hard to generate. Thereby, it is possible to operate the instrument for a long time.
It is possible to hold the hand grip by a middle finger, a ring finger, a fifth finger, and a palm and to operate the lateral swing dial and the opening and closing dial in a natural posture (without strain) of a forefinger. In a specific example, a relative distance of the both dials is made around 1 cm and a relative angle (an angle formed by the plane 137 and the plane 138 in
The fundamental function and operation of the first modification, to which the construction shown in FIGS. 1 to 4 is applied, widens a range, in which a forceps can swing, and enables ensuring multiple degrees of freedom, so that it is possible to expect an improvement in operability. Since the tip end joint is constructed such that a swinging action of a forceps is not accompanied by forward movements of a forceps, the tip end of the instrument is not shifted much by such swing and a delicate and further exact, medical operation can be realized while a swinging operation is added in a flow of the medical operation. Further, no strain is imposed on a posture during the operation and complicated movements of the tip end of the instrument can be made with ease, so that the operation of the instrument with less fatigue and with constant stability is enabled.
Subsequently, an explanation will be given to a second modification with reference to
In FIGS. 11 to 18, the reference numeral 156 denotes an operating part, 157 a hand grip, 158 a finger rest (a stopper for movement of a middle finger), 159 a vertical swing dial, 160 a lateral swing dial, 161 an opening and closing dial, 162 a lock button, 163 an operating part, 164 an opening and closing dial, 165 an operating part, 167 a wrist, 168 a thumb, 169 a forefinger, 170 a middle finger, 171 a ring finger, 172 a fifth finger, 173 a mount surface, 174 an operating part axis, 175 a dial rotating shaft, 176 a pulley, 177 a pulley, 178 a pulley, 179 a pulley, 180 a pulley, 181 a pulley, 182 a projection, 183 a rotating shaft, 184 a rotating shaft, 185 a rotating shaft, 186 a rotating shaft, 187 a rotating shaft, 188 a rotating shaft, 189 a drive wire, 190 a drive wire, 191 a drive wire, 192 a drive wire, 193 a rotating shaft, and 194 a rotating shaft.
The second modification comprises the instrument joint 100 including a gripper and a swing joint, an operating part 156 including a part, which an operator grasps in order to hold the same, a part, which operates swing of an joint and opening and closing, and an arm part 101 including transmission means that couples the operating part 156 and the instrument joint 100 with each other to transmit an operation made with the operating part 156 to the instrument joint 100.
The reference numeral 157 denotes a hand grip, which an operator grasps, and in which an operating force transmission means coupling a dial operating system and the instrument joint 100 with each other is provided. The reference numeral 158 denotes a finger rest formed convexly on the hand grip 157, the finger rest permitting a finger to be put thereon when the opening and closing dial 161 is operated, and serving to prevent other fingers from touching the dial (details will be described with reference to
The reference numeral 160 denotes a lateral swing dial for operation of lateral swing of the hand grip, and when the dial 160 is operated in the C-direction, the two blades 1a, 1b (see
In
With the construction shown in
When a thumb should be moved to the lateral swing dial 160 from the vertical swing dial 159, a thumb is moved transversely, which movement is made in a direction, in which a thumb can move easily. Since a direction (see the C-direction in
Further, since it is possible to grasp the hand grip 157 and operate the instrument in a natural state, in which a wrist is extended, grasp and operation become easy to enable a decrease in fatigue. Since grasp and operation are enabled in an easy posture, sense of a tip of a finger can be accurately reflected on the operation of the tip end of the instrument with the result that it is possible to realize a delicate operation of the instrument. Since the instrument can be operated delicately, it is possible to improve an operation of medical treatment in safety and accuracy.
By forming the hand grip 157 in the operating part to make the same substantially conical or substantially tapered form cross section of which substantially elliptical, the hand grip 157 can be easily received and carried in a palm. Further, since the hand grip is larger on a side toward a fifth finger in cross sectional area than on a side toward a middle finger, it is possible to increase a force, with which the hand grip is grasped by a ring finger and a fifth finger, thus enabling grasping the hand grip further firmly. Further, since the mount surface 173 for the vertical swing dial 159 and the lateral swing dial 160 is defined by an inclined surface, which is directed inward from the substantially conical configuration of the hand grip 157, a thumb can touch the dials 159, 160 in a posture, in which it can move in a wide range (angle), in a state of grasp as shown in
As shown in
With reference to
The pulleys 176, 177, 178, 179, 180, 181 and the rotating shafts 183, 184, 185, 186, 187, 188 are rotatably provided within the hand grip 157. The projection 182 is provided around the rotating shaft on the vertical swing dial 159. The lateral swing dial 160 and the opening and closing dial 161 have the same structure as those in
When the lateral swing dial 160 is slid to the inner part by a finger, it comes into contact with the rotating shafts 183, 184 at the same time, so that torque can be transmitted mutually. Upon separation of a finger, the lateral swing dial is pushed back by forces of the spring plates 150, 151 in the same manner as that shown in
The drive wire 189 is wired between the rotating shaft 183 and the rotating shaft 185 to enable transmission of torque. The drive wire 190 is wired between the rotating shaft 184 and the rotating shaft 186 to enable transmission of torque. Further, the drive wire 192 is wired between the rotating shaft 187 and the rotating shaft 186 to enable transmission of torque. The drive wire 191 is wired between the rotating shaft 188 and the rotating shaft 185 to enable transmission of torque.
Here, drive wires extending from the instrument joint (tip end joint) 100 comprise the six drive wires 3a, 3b, 3c, 3d, 5a, 5d as shown in
The wire 5a is led to the projection 182, provided on the vertical swing dial 159, by the pulley 176 to be fixed at one point on the projection 182. The wire 5b is led to the projection 182, provided on the vertical swing dial 159, by the pulley 177 to be fixed at one point on the projection 182. The wires 5a, 5b may comprise a length of wire. Rotation of the vertical swing dial 159 gives tension to the wires 5a, 5b to enable transmitting a rotating angle of the vertical swing dial 159 to the projection 20 provided on the intermediate plate 10.
In specific actions, for example, when the vertical swing dial 159 is rotated in the A-direction, the projection 20 rotates in synchronism with the vertical swing dial 159 and the instrument joint 100 rotates in the B-direction. When the lateral swing dial 160 is pushed to bring into a state, in which torque can be transmitted between it and the rotating shafts 183, 184, and when the lateral swing dial 160 is rotated in the C-direction, the rotating shaft 183 is rotated in the F-direction and the rotating shaft 184 is rotated in the G-direction (see
At this time, while rotations of the rotating shafts 185, 186 are also transmitted to the rotating shafts 188, 187, the rotating shafts 188, 187 only idle unless the opening and closing dial 161 is pushed, so that torque is not transmitted to the opening and closing dial 161. Since the rotating shafts 188, 187, respectively, are about to rotate in a sense, in which the opening and closing dial 161 is rotated in a reverse direction, rotations of the rotating shafts 188, 187 interfere with each other to be fixed when the opening and closing dial 161 is pushed. Thereby, movements of the rotating shafts 185, 186 can be fixed simultaneously with the result that it is possible to fix the lateral swing dial 160 in movement to fix the swinging motion.
When the opening and closing dial 161 is rotated in the E-direction in a state, in which the opening and closing dial 161 is pushed to enable transmission of torque between it and the rotating shafts 188, 187, the rotating shaft 187 rotates in the J-direction and the rotating shaft 188 rotates in the K-direction. Further, the rotating shaft 185 is rotated through the drive wire 191 in an opposite direction to the H-direction and the rotating shaft 186 is rotated through the drive wire 192 in the I-direction, whereby the wires 3a, 3d are pulled, so that the blade pulley 2a rotates in the D-direction, and the blade pulley 2b rotates in an opposite direction to the D-direction. Thereby, the blades 1a, 1b are rotated in a direction, in which they open relative to each other. When the opening and closing dial 161 is rotated in an opposite direction to the E-direction, the blades 1a, 1b are rotated in a direction, in which they close relative to each other.
At this time, while rotations of the rotating shafts 185, 186 are also transmitted to the rotating shafts 183, 184, the rotating shafts 183, 184 only idle unless the lateral swing dial 160 is pushed, so that torque is not transmitted to the lateral swing dial 160. At this time, since the rotating shafts 183, 184, respectively, are about to rotate in a sense, in which the lateral swing dial 160 is rotated in opposite directions, rotations of the rotating shafts 183, 184 interfere with each other to be fixed when the lateral swing dial 160 is pushed. Thereby, movements of the rotating shafts 185, 186 can be fixed simultaneously with the result that it is possible to fix the opening and closing dial 161 in movement to fix the opening and closing motion.
In this manner, swinging operations, allotted to the respective dials, in predetermined directions, and opening and closing operations of the gripper can be performed independently by using the vertical swing dial 159, the lateral swing dial 160, and the opening and closing dial 161 and operating the respective dials to perform operations, in which the drive wires connected to the instrument joint 100 are appropriately put in cooperation with one another. Thereby, an operator can easily realize an intended action only through movements of a tip of a finger without any complicated operation.
In this manner, swinging operations, allotted to the respective dials, in predetermined directions, and opening and closing operations of the gripper can be performed independently by using the vertical swing dial 159, the lateral swing dial 160, and the opening and closing dial 161 and operating the respective dials to perform operations, in which the drive wires connected to the instrument joint 100 are appropriately put in cooperation with one another. Thereby, an operator can easily realize an intended action only through movements of a tip of a finger without any complicated operation.
While the fundamental function and operation of the embodiment of the invention and the first, second, and third modifications thereof have been described, the invention can fulfill the following function and operation especially. That is, for the operability of the surgical instrument, the tip end of the instrument (forceps) is movable in a wide range and multiple in degree of freedom, an operation in multiple degrees of freedom can be realized by movements of a thumb and a forefinger without strain, and a forceps can be operated in an easy posture. Since it is possible to bend the tip end in multiple degrees of freedom even in an easy posture of operation to make an approach to the affected part in a desired posture of the tip end, it is unnecessary to use a whole arm to perform an operation. Therefore, fatigue is not generated since an operation can be performed in an easy posture. Further, since an operation can be performed in a posture, in which the armpit is clamped, while holding the instrument in a grasping posture with no burden on a wrist, a delicate operation is enabled to result in an increase in safety.
Since the tip end can be operated in multiple degrees of freedom, it is possible to heighten a posture of the instrument at the tip end, which approaches the affected part, in freedom.
Since the tip end joint can be operated in posture only by movements of a tip of a finger, an operation to a desired posture of the tip end is enabled without interruption of the operation of medical treatment. Since the operation of medical treatment is not interrupted, it is possible to shorten time for medical treatment.
A direction of swing of a forceps and opening and closing actions, respectively, are allotted to one operating dial, operation of the operating dial in cooperation with the drive wires for operation of the joint is made without any complicated operation, and the tip end joint can be operated easily, so that an operation can be made further intuitionally and desirably to achieve an increase in operability and safety.
Further, a forceps can be moved in a large range owing to the construction, in which the joints, respectively, do not interfere in freedom with each other. Further, since a state of large swing does not affect subsequent operability and operating forces in freedom, it is possible to maintain a predetermined operability irrespective of a posture of swing of the joint.
Since large swing of an joint arranged in one location can be made in multiple degrees of freedom, a tip end position is not moved due to curvature of a tip end of an instrument as in the related art (forward movements are not made following swing), it is possible to adequately observe a large range, in which a forceps can be moved, within a range of a constant (narrow) range of visual field, in which observation is made by means of an endoscope, thus enabling a treatment in wide movements of a forceps.
Also, for the joints, there is no change in wire path length even when a forceps swings. Further, freedom at the tip end side is led to freedom on the hand side to achieve transmission of drive forces through the wires. Since no change in path length is caused in spite of swing in freedom on the hand side, no external forces due to swing are applied to those wires, which extend to the tip end side, and other freedom (for example, opening and closing of the blades) is not interfered with.
While the embodiment has been described, the invention is not limited thereto and it is apparent to those skilled in the art that the invention is susceptible to various changes and modifications within the sprit of the invention and the scope of the appended claims.
Number | Date | Country | Kind |
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2004-309613 | Oct 2004 | JP | national |