WO2012040981A1

WO2012040981A1 - Micro-invasive surgical instrument with articulated linkage

Info

Publication number: WO2012040981A1
Application number: PCT/CN2010/079761
Authority: WO
Inventors: 张祖仁; 张奕奕; 徐维华
Original assignee: 上海创亿医疗器械技术有限公司
Priority date: 2010-09-30
Filing date: 2010-12-14
Publication date: 2012-04-05
Also published as: CN102440820B; CN102440820A

Abstract

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

Description

Minimally invasive surgical instrument with chain joints

The present invention relates to a microstrip with a chain joint for use in a minimally invasive surgery for snagging, separating, clamping, cutting, shearing, piercing, needle stitching, nail clipping or snare body tissue and implants Invasive surgical instruments, especially for use in laparoscopic surgery, endoscopic surgery, and hysteroscopic surgery for swaying, separating, clamping, cutting, cutting, piercing, needle stitching, nail clips or snares Minimally invasive surgical instruments with chain joints for tissue organs, and more particularly to minimally invasive surgical instruments with chain joints that move and separate human tissue or tendon repair materials during hernia surgery, and more particularly Minimally invasive surgical instruments with chain joints that move the tissues of the vertebral body during percutaneous vertebroplasty, and more particularly to the chain joints of tissues and organs that are electrocuted or electrocoagulated during electrosurgery Minimally invasive surgical instruments. Background technique

Tissue, organs or implants of the human body are often required to be moved, dissected, clamped, cut, sheared, threaded, needle-stitched, stapled or trapped in various minimally invasive surgical procedures.

For example, in minimally invasive surgery such as endoscopic surgery, endoscopic surgery, and hysteroscopic surgery, in order to expose or peel the tissue to form the surgical field, or to place the implant at the implantation site, it is necessary to Specially reserved for 2 to 3 piercing devices for dialing, separating, clamping, cutting, piercing, needle stitching, nail clips or snares of human tissue or implants. In the minimally invasive surgery, the diameter of the piercing device is 5mm 10mm, so that the separator, the clamp or the hook that enters the piercing device can work in a small range, and it is often necessary to insert the separator into the two piercing devices, Pliers or hooks work together. After the surgical field is formed, a variety of instruments are required to perform the surgical operations of cutting, piercing, hemostasis, needle stitching, nail clipping or trapping of the tissues and organs of the human body.

For example, in the transperitoneal preperitoneal repair (TAPP) or intraperitoneal network repair (IPOM) of minimally invasive fistula surgery, two penetrating devices with a diameter of 5 mm are required, which are exposed or stripped with a pure separator. Organs and organs are formed in the operation area, and the repair material is placed on the repair site. In the complete extraperitoneal repair (TEP) of minimally invasive hernia surgery, the majority of the preperitoneal space was separated by a balloon through a 5 mm perforator, and then inserted through two 5 mm perforators. The forceps complete all the gap separation to form the operation area, and the sputum repair material is plucked and laid on the sputum repairing part. Due to the minimally invasive surgery, the separator or the separation forceps need to be inserted so deeply that the separator or the separation forceps that can enter the piercing device have a small working range. Therefore, the repair material is placed on the repair site. Two piercings with a diameter of 5 mm are required, which is the most difficult and time-consuming operation in minimally invasive surgery.

For example, in a percutaneous vertebroplasty operation, the vertebral body which is flattened by a balloon is often used by a perforating needle having a caliber of 3.5 mm to 4 mm. Since the cavity formed by the expansion of the balloon in the vertebral body is olive-shaped, the bone cement filled therein is blocked by the trabecular bone and the cancellous bone around the olive-shaped cavity, and it is difficult to penetrate into the area around the olive-shaped cavity, so that The bone cement filled therein is also olive-shaped after curing. Therefore, after percutaneous vertebroplasty, the adjacent healthy vertebral body is easily broken under the compression of the hard olive cement, and the vertebral body surgery is required again. If you increase the pressure of filling the bone cement, then the bone The cement will be squeezed out from the cracks produced by the collapsed vertebral body after being expanded by the balloon, forming a cement sputum in the body near the vertebral body crack, and damaging the surrounding tissues and organs.

For example, in electrosurgery, electrocoagulation hooks are commonly used to dissect tissue, either by electrocoagulation to stop bleeding or to cut tissue, or by electrocoagulation to separate loose tissue and cauterization of wounds, or electrocoagulation with electrocoagulation rods. Stop bleeding. These high-frequency electric knives are divided into single-pole high-frequency electrosurgical knives and bipolar high-frequency electrosurgical knives, which enter the operating area through a 5 mm-diameter piercing device. Therefore, the high-frequency electrosurgical blade that enters the piercing device has a small working range, and it may be necessary to perform electrosurgery through a plurality of piercing devices.

In the minimally invasive surgical instrument described in U.S. Patent No. 2,100,076,260, the two cables are inserted into the holes on both sides of the concave and convex joint piece in the joint, so that the concave and convex joint pieces are connected in series to form a joint, and the joint is bent to the sides by pulling the cable. , thus driving a variety of tool heads with the functions of dialing, separating, clamping, cutting, shearing, threading or high-frequency electric knife to swing to both sides. In the minimally invasive surgical instrument described in U.S. Patent No. 2,090,312,773, two pieces of metal pieces are inserted into the holes on both sides of the concave and convex joint piece in the joint, so that the concave and convex joint pieces are connected in series to form a joint, and the joint is bent to the sides by pushing and pulling the metal piece. Thereby, the tool head with the needle thread stitching function is swung to both sides. The unsatisfactory of these two types of minimally invasive surgical instruments is that although the cable or the metal piece can drive the joint to bend to both sides, but the joint of the concave and convex joints is difficult to be in any joint after the joint is bent to the sides. The bending position is sufficiently rigid, resulting in easy displacement of the tool head of the minimally invasive surgical instrument and poor positioning accuracy. Therefore, the joint structure of minimally invasive surgical instruments needs to be improved.

It is apparent from the above that different types of minimally invasive surgical instruments have been designed, and the development of joint structures for new minimally invasive surgical instruments is continuing to further develop the world's most widely used minimally invasive surgical instruments each year. The improvement makes the joints of the minimally invasive surgical instruments rigid enough in any bending position, and the tool head is positioned more accurately and has a larger working range. Summary of the invention

The object of the present invention is to provide a minimally invasive surgical instrument with a chain joint, which realizes that the joint is composed of a chain joint, the two ends of the chain plate of the chain joint have teeth, and the teeth of the adjacent chain plates of the same row mesh with each other. The solution achieves the technical effect that the chain joint can be bent to a large extent and a large curvature to both sides, and the positioning is accurate and has sufficient rigidity at any bending position. Suitable for use in all kinds of minimally invasive surgery, such as dislocation, separation, clamping, shearing, piercing, needle suture, nail clip or snare body tissue or implant, dissection of tissue, electrocoagulation or electrocautery The tissue can be cut and used as a hook after bending. Thereby reducing the number of surgical instruments and piercing devices used in minimally invasive surgery, the positioning of the tool head is more accurate, the working range is larger, the operation is convenient, and the operation time is saved.

Currently, well-known minimally invasive surgical instruments, the components of which include: tool heads, joints, extension tubes, bodies and operating mechanisms. The operating mechanism is located at the body, and the control joint is bent to both sides, thereby driving the tool head to swing to both sides. The tool head, the joint, the extension tube, and the body are sequentially connected in sequence. The extension tube can be either a rigid tube or a flexible tube. The tool head can be a hook shape, a shovel head, a horn head, a curved split head, a needle head, a bow clamp, a right angle pliers, an anvil holding pliers, a lobes, a grasping forceps, a bending splitting pliers, a curved peeling knife, Spherical hemostats, separation hooks, sharp hooks, curved shears, large curved shears, blunt-head separators, needle holders, staple clamps, snares, high-frequency electrosurgical or other tools for minimally invasive surgery head.

The task of the present invention is achieved by the following technical solutions: A joint of a minimally invasive surgical instrument with a chain joint is a chain joint. The chain joint consists of a chain plate and a pin. The link plates are pivotally connected by pins to two staggered rows. The proximal end of the proximal end of the chain joint is pivotally coupled to the extension tube and is driven by the operating mechanism with teeth at the distal end. The distal end of the most distal chain plate of the chain joint is pivotally connected to the tool head and has teeth at the proximal end. The distal end of the extension tube has teeth. The proximal teeth of the proximal most proximal link of the chain joint engage the teeth of the distal end of the extension tube. The proximal end of the tool head has teeth. The teeth of the distal end of the second most distal chain plate of the chain joint intermesh with the teeth of the proximal end of the tool head. The other chain plates of the chain joint have teeth at both ends. The teeth of the adjacent chain plates of the same row are in mesh with each other. The teeth on the link plate may be gear teeth of a gear fixed to the link plate, or may be a fork, a thread or other various teeth having a similar function fixed to the link plate. The gear teeth of the gear plates on each link plate may have the same pitch circle diameter or may have different pitch circle diameters. The number of teeth of the gear teeth of each of the link plates may be the same or different. The chain joints drive the tool head to the sides for bending, precise positioning and sufficient rigidity in any bending position.

The operating mechanism drives the proximal end of the first-stage chain plate at the proximal end of the chain joint, so that the first-stage chain plate of the chain joint rotates around the pin shaft to generate the first-stage corner; the second-stage chain plate of the second-most proximal end is in the first-stage chain plate Under the action of the pin shaft and the meshing gear of the gear teeth of the gear at the distal end of the extension pipe and the gear teeth of the gear of the second-stage chain plate, the rotation of the first-stage chain plate is superimposed and transmitted into the second-stage chain. The corner of the board is such that the first stage corner is superimposed into the second stage corner; the third stage chain board is driven by the pin of the second stage chain plate and the gear teeth of the first stage chain plate and the third stage chain board Under the dual action of the gear teeth of the gear teeth, the corners of the second-stage chain plates are superimposed and transmitted into the corners of the third-stage chain plates, so that the second-stage corners are superimposed into the third-stage corners; the fourth-stage chain plate Under the driving action of the pin of the third-stage chain plate and the meshing transmission of the gear teeth of the gear of the second-stage chain plate and the gear teeth of the gear of the fourth-stage chain plate, the third-stage chain plate is further The corner superposition is transmitted into the corner of the fourth-stage chain plate, so that the third-level corner is superimposed into the fourth The fifth-stage link plate is driven by the pin of the fourth-stage link plate and the meshing drive of the gear teeth of the gear of the third-stage link plate and the gear teeth of the gear of the fifth-stage link plate, Then, the corner of the fourth-stage chain plate is superimposed and transmitted into the corner of the fifth-level chain plate, so that the fourth-stage corner is superimposed into the fifth-level corner; and so on, until the tool head is driven by the pin of the N-th chain plate. And the double action of the gear teeth of the gears of the (N-1)th grade chain plate and the gear teeth of the gear head of the tool head, further transmitting the rotation angle of the Nth stage chain plate to the rotation angle of the tool head, so that The N-level corners are superimposed into the (N+1)-th order corners; thus, when the operating mechanism controls the chain joint motion, the transmission of the operating mechanism at the distal end of the extension tube is transmitted as the corner of the first-stage link plate at the proximal end of the chain joint. , through the transmission of the teeth of the adjacent chain plates in the same row, through the (N+1) level superposition and transmitted into the corner of the tool head.

Under the condition that the number of teeth of the gear teeth of the respective link plates is the same, the tool head 2 can obtain (N+1) times the rotation angle of the rotation angle of the first-stage link plate at the proximal end of the chain joint. The more the number of chain plates N of the chain joint, the more (N+1) multiples of the corners that are superimposed and transmitted to the tool head; the fewer the number of chain plates N of the chain joint, the superimposed transmission to the corner of the tool head (N+ 1) The smaller the multiple. Under the condition that the number of teeth of the gear teeth of each chain plate is different, the corners of the first-order chain plate at the proximal end of the chain joint are superimposed and transmitted to the corner of the tool head with different multiples.

The chain plate of the minimally invasive surgical instrument with chain joint of the present invention may have pin holes at both ends. The pins are respectively inserted into the pin holes of the respective link plates, so that the link plates are pivotally connected by the pin shafts into two rows arranged in a staggered manner.

The chain plate may also have a pin hole at one end and a pin shaft at the other end. The pin pins fixed on the respective link plates are inserted into the pin holes of the other link plates, so that the link plates are pivotally connected by the pin shafts into two rows arranged in a staggered manner. It is also possible to have pin holes on both ends of one of the link plates, and pins on both ends of the other link plates. Pins on each of the pinned link plates are inserted into pin holes on each of the chain plates with pin holes, so that the link plates are pivotally connected by pins to two staggered rows.

The outer circumference of the chain joint of the minimally invasive surgical instrument with chain joint of the present invention may be sheathed. The sleeve prevents the chain plates and pins of the chain joint from disengaging from each other, and prevents the tissue around the chain joint from being caught in the teeth of the interlocking link plates in the chain joint or in the gap between the link plates. The sleeve can be either a bellows or a flexible tube.

The operating mechanism of the minimally invasive surgical instrument with chain joint of the present invention may have a joint cable. The cable can be a single cable or a multiple cable twisted cable. The distal end of the joint cable is connected to the proximal end of the proximalmost chain plate of the chain joint. The operating mechanism pulls the joint cable, and the joint cable pulls the proximal end of the proximal end of the chain joint to drive the proximal end of the chain joint to rotate, so that the tool head swings to both sides.

The operating mechanism can also have gear teeth or gear teeth at the distal end of the extension tube. The proximal end of the chain plate of the proximal end of the chain joint has gear teeth. The gear teeth of the rack or the gear teeth of the rack at the distal end of the extension tube intermesh with the teeth of the proximal end of the chain plate of the proximal end of the chain joint. The operating mechanism drives the gear teeth of the proximal end of the link plate of the proximal end of the chain joint through the teeth of the rack teeth or the gear teeth of the gear to drive the chain plate of the proximal end of the chain joint to rotate, so that the tool head swings to both sides.

The above-mentioned chain joint bending mechanism is particularly suitable for the movement, separation, clamping, shearing, piercing, needle stitching, nail clip or snare body tissue or implant in various minimally invasive surgical operations, after bending and positioning It can be used as a hook to reduce the number of surgical instruments and piercing devices used in minimally invasive surgery, to facilitate surgical operation and save operation time. It is also particularly suitable for revealing or peeling tissue-forming surgical areas in minimally invasive surgery. The sputum repairing material is placed on the sacral repairing site; it is also particularly suitable for dilating the balloon into the vertebral body to form an olive-shaped cavity in the vertebral body shaping operation, and trimming into a flat cavity to prevent vertebral body formation. The side effects of adjacent healthy vertebral bodies being crushed by bone cement after surgery; and particularly suitable for performing various operations of anatomically separating tissue, electrocoagulation, or cutting tissue during electrosurgery.

The chain joint of the minimally invasive surgical instrument with chain joint of the present invention may have a passage extending from the proximal end to the distal end. The operating mechanism transmits the operation to the tool head through the passage of the chain joint. The chain plate may have grooves extending from the proximal end to the distal end of the chain joint, the grooves on the chain plate forming a passage from the proximal end to the distal end of the chain joint.

The operating mechanism can have a drive cable. The drive cable is connected to the tool head through a channel extending from the proximal end to the distal end of the extension tube and the chain joint. The operating mechanism pulls the drive cable to cause the drive cable to pull the tool head to perform various surgical operations. The above cable drive mechanism is particularly suitable for performing various operations such as swaying, separating, clamping, shearing, threading, needle stitching, nail clipping or trapping of a human tissue or implant in various minimally invasive surgical procedures. . It is also especially suitable for exposing or peeling the tissue-forming operation area in minimally invasive fistula surgery, and laying the tendon repair material on the repair site; it is also suitable for dilating the balloon in the vertebral body during vertebroplasty surgery. The formation of an olive-shaped cavity is trimmed into a flat cavity to prevent side effects of adjacent healthy vertebral bodies being crushed by bone cement after vertebral body formation surgery.

It is also possible to transmit the high-frequency current of the electrosurgical main unit through the extension tube and the wire in the channel extending from the proximal end to the distal end of the chain joint under the control of the operating mechanism to the tool head, so that the tool head is executed in the electrosurgery Dissecting the various operations of separating tissue, electrocoagulation, or electrocautery cutting tissue. DRAWINGS

1 is a perspective view showing the appearance of a chain joint of a minimally invasive surgical instrument with a chain joint according to an embodiment of the present invention when it is not rotated;

Figure 2 is a partially enlarged perspective view showing the chain joint and the tool head when the chain joint is not rotated after the sleeve on the chain joint of the first embodiment of Figure 1 is removed;

Figure 3 is a partially enlarged perspective view showing the back side of the chain joint of Figure 2 and its accessories;

Figure 4 is a partially enlarged perspective view showing the chain joint and its attachment when the chain joint of Figure 2 is rotated counterclockwise; Figure 5 is a partially enlarged perspective view showing the back side of the chain joint of Figure 4 and its attachment;

Figure 6 is a partially enlarged perspective view showing the chain joint and its attachment when the chain joint of Figure 2 is rotated clockwise; Figure 7 is a view showing the distal end of the joint cable of Figure 2 connected to the proximal end of the chain plate of the proximal end of the chain joint; Enlarge the appearance of the perspective view;

Figure 8 is a perspective view showing an enlarged appearance of a chain plate with a single pin hole and a single pin shaft in the chain joint of Figure 2; Figure 9 is an enlarged perspective view showing the sleeve of Figure 1;

Figure 10 is a partially enlarged perspective view showing the chain joint when the chain joint of the second embodiment of Figure 1 is not rotated; Figure 11 is a partially enlarged perspective view showing the back side of the chain joint of Figure 10 and its attachment;

Figure 12 is a partially enlarged perspective view showing the chain joint and its attachment when the chain joint of Figure 10 is rotated counterclockwise; Figure 13 is a partially enlarged perspective view showing the back side of the chain joint of Figure 12 and its attachment;

Figure 14 is an enlarged perspective view showing the chain plate with double pin holes in the chain joint;

Figure 15 is a perspective view showing an enlarged appearance of a pin shaft in a chain joint;

Fig. 16 is an enlarged perspective view showing a chain plate with a double pin in a chain joint. Specific implementation method

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a preferred embodiment of a minimally invasive surgical instrument with a chain joint of the present invention will be described by way of example with reference to the accompanying drawings. The scope of the invention is pointed out in the claims. It will be appreciated that some or all of the drawings are illustrative of the preferred embodiment of the invention and are not intended to depict the true dimensions of the illustrated. The practical manner of achieving the above and other objects and advantages of the present invention will become more apparent from the detailed description of the preferred embodiments.

In order to highlight the graphics of the chain joints and the tool head and their description, other components are not described in detail in the drawings except for the chain joints and the tool heads and their related parts.

In the drawings and the following description, the term "proximal" refers to the end of a minimally invasive surgical instrument with a chain joint that is close to the operator, and the term "distal" refers to a minimally invasive surgical instrument with a chain joint that is remote from the operation. One end of the person. "One end" can be either an end face or an end. Other directional terms can be understood from the drawings and the following description.

Hereinafter, each component of the minimally invasive surgical instrument with a chain joint according to an embodiment of the present invention will be described with reference to Figs. 1 to 16, and a specific embodiment of each component will be described.

As shown in Figure 1, the components of the minimally invasive surgical instrument 1 with a chain joint include: a tool head 2, a chain joint 3, The tube 4, the body 5 and the operating mechanism 6 are extended. The operating mechanism 6 is located at the body 5, and the control chain joint 3 is swung to both sides, thereby causing the tool head 2 to swing to both sides. The tool head 2, the chain joint 3, the extension tube 4, and the body 5 are sequentially connected in sequence.

As shown in Figs. 2 to 8, the chain plate 7 constituting the chain joint 3 has a pin 8 fixed at one end and a pin hole 9 at the other end. The pin 8 fixed to each of the link plates is inserted into the pin hole 9 of the other link plate, and the link plate 7 is pivotally connected by the pin 8 and the pin hole 9 into two rows 10 and 11 which are staggered.

The proximal end of the chain link 3 has gear teeth 14 at the distal end and a proximal end connected to the left and right joint cables 28 and 29 of the operating mechanism 6. The proximal end of the proximal end link 12 of the chain joint 3 is pivotally connected to the extension tube 4. Chain Joints The proximal end of the chain plate 16 has the gear teeth 17 of the gears that mesh with the teeth 15 of the gears at the distal end of the extension tube 4, and the gear teeth 18 of the distal end. The teeth 14 of the gears at the proximal end of the link plate 19 and the distal end of the link plate 12 mesh with the gear teeth 20 of the gears and the gear teeth 21 of the distal end. The chain distal end of the chain joint 3 has the teeth 23 of the gears at the proximal end of the distal end of the chain plate 16 and the gear teeth 24 of the gear with the proximal end of the tool head 2 Gear teeth 25 of intermeshing gears. Chain joint 3 The most distal chain plate 26 has gear teeth 27 at the proximal end, and the distal end is pivotally connected to the tool head 2.

When the operating mechanism 6 pulls the left joint cable 28, the left joint cable 28 pulls the proximal end of the proximal end of the chain joint 3, and the chain plate 12 at the proximal end of the chain joint 3 rotates counterclockwise around the pin 30, resulting in the first One level counterclockwise corner. The next-most proximal chain plate 16 is driven by the pin 31 of the link plate 12 and the meshing drive of the gear teeth 15 of the gear at the distal end of the extension pipe 4 and the gear teeth 17 of the gear plate of the link plate 16 The corners of the plate 12 are superimposed and transmitted into the counterclockwise angle of the link plate 16, so that the first stage corners are superimposed into the second stage corners, and the second stage corners are twice the first stage corners. The chain plate 19 is driven by the pin 32 of the link plate 16 and the meshing drive of the gear teeth 14 of the gears of the link plate 12 and the gear teeth 20 of the gears of the link plate 19, and then superimposes the corners of the link plate 16 The counterclockwise angle transmitted to the chain plate 19 is such that the second stage corner is superimposed into the third stage corner, and the third stage corner is three times the first stage angle. The second most distal chain plate 22 is driven by the pin 33 of the link plate 19 and the meshing action of the gear teeth 18 of the gears of the link plate 16 and the gear teeth 23 of the gears of the second most distal chain plate 22 Next, the corners of the chain plate 19 are superimposed and transmitted to the counterclockwise angle of the second most distal chain plate 22, so that the third stage corner is superimposed into the fourth stage corner, and the fourth stage corner is four times the first stage angle. The chain plate 26 is driven by the pin 34 of the second most distal chain plate 22 and the meshing drive of the gear teeth 21 of the gear plate 19 and the gear teeth 27 of the chain plate 26, and then the chain The corners of the plate 22 are superimposed and transmitted as counterclockwise angles of the link plates 26, so that the fourth stage corners are superimposed into the fifth stage corners, and the fifth stage corners are five times the first stage corners. The tool head 2 is further driven by the pin 35 of the link plate 26 and the meshing drive of the gear teeth 25 of the gear of the second most distal link 22 and the gear teeth 24 of the gear of the tool head 2 The corners of the plate 26 are superimposed and transmitted to the counterclockwise angle of the tool head 2, so that the fifth stage corner is superimposed into the sixth stage corner, and the sixth stage corner is six times the first stage angle. Thus, when the operating mechanism 6 controls the movement of the chain joint 3, the transmission of the operating mechanism 6 at the distal end of the extension tube 4 is transmitted as the corner of the chain plate 12 at the proximal end of the chain joint 3, through the teeth of the adjacent chain plates of the same column. The intermeshing transmission is transmitted to the tool head 2 through a 6-stage superposition, and the tool head 2 can obtain a rotation angle equivalent to 6 times the rotation angle of the chain plate 12. The more the number of links of the chain joint 3, the more the multiple of the corners transmitted to the tool head 2 is superimposed; the smaller the number of links of the chain joint 3, the smaller the multiple of the corners that are superimposed and transmitted to the tool head 2. Therefore, the chain joint can be bent to a large extent and a large curvature to both sides, and the positioning is accurate, in any bending position. The set has a sufficiently rigid technical effect. The above is a multiple of the rotation angle of the chain plate 12 of the chain joint 3 superimposed and transmitted to the tool head 2 under the condition that the number of teeth of the gear teeth of the respective chain plates is the same. On the other hand, under the condition that the number of teeth of the gear teeth of the chain plates is different, the corners of the chain plates 12 of the chain joints 3 are superimposed and transmitted to the corners of the tool head 2 with different multiples.

When the operating mechanism 6 pulls the right joint cable 29, the chain plate 12 that drives the proximal end of the chain joint 3 rotates clockwise, and the tool head 2 swings to the other side. The process of transferring the actuator at the distal end of the extension tube 4 through the corners of the proximal end link 12 of the chain joint 3 to the tool head 2 is superimposed similarly to that described above.

The link plate 7 has a groove 36 extending from the proximal end to the distal end of the chain joint 3, and the groove 36 on the link plate 7 constitutes a passage 37 extending from the proximal end to the distal end of the chain joint 3.

The above structure is particularly suitable for minimally invasive surgical instruments with chain joints. 1 The minimally invasive surgery is performed by a perforation hole having a diameter of 3. 5 mm to 5 mm. For example, under the control of the operating mechanism 6, the high-frequency current of the electrosurgical main unit is transmitted to the tool head 2 through the extension tube 4 and the wire 38 in the channel 37 extending from the proximal end to the distal end of the chain joint 3, which is suitable for Various operations of dissecting tissue, electrocoagulation, or cutting tissue are performed during electrosurgery. For another example, under the control of the operating mechanism 6, the drive cable 38 drives the tool head 2 through the extension tube 4 and the channel 37 extending from the proximal end to the distal end of the chain joint 3, which is suitable for use in endoscopic surgery, Traction, separation, clamping, shearing, piercing, needle suture, nail clip or snare body tissue or implant in minimally invasive surgery such as mirror surgery and hysteroscopic surgery, or in minimally invasive surgery During surgery, the surgical area is exposed or exfoliated and the sacral repair material is placed in the sacral repair site, or the balloon is expanded in the vertebral body to form an olive-shaped cavity. The cavity.

As shown in Figs. 1 and 9, the outer periphery of the chain joint 3 is provided with a bellows 39. The bellows 39 can prevent the chain plate 7 and the pin 8 of the chain joint 3 from being separated from each other, and can prevent the tissue around the chain joint 3 from falling or being caught by the gear teeth of the interlocking link plates 7 of the chain joint 3. Within the gap between the inner or chain plates 7.

As shown in Figs. 10 to 13, the operating mechanism of the second embodiment has a rack 41. The teeth of the rack 41 mesh with the teeth of the gear 42 at the distal end. The teeth of the gear 42 mesh with the teeth 45 of the gears at the proximal end of the link plate 44 at the proximal end of the chain joint 43. The operating mechanism drives the gear teeth of the gear 42 through the teeth of the rack 41 to drive the gear teeth 45 of the proximal end of the chain link 44 of the chain link 43 to drive the chain plate 44 at the proximal end of the chain joint 43 to rotate.

When the operating mechanism controls the joint movement of the tool head, the transmission of the operating mechanism at the distal end of the extension tube is superimposed by the rotation angle of the chain plate 44 at the proximal end of the chain joint 43 by the transmission of the teeth of the adjacent chain plates. The process of passing to the tool head is similar to that described in Figures 2-8.

In the above operation mechanism, the teeth of the rack 41 of the operating mechanism may directly mesh with the gear teeth 45 of the gear at the proximal end of the link plate 44 at the proximal end of the chain joint 43, and drive the proximal end of the link plate 44 at the proximal end of the chain joint 43. The gear teeth 45 of the gear rotate to drive the chain plate 44 at the proximal end of the chain joint 43.

Each link plate 46 has a slot 47 extending from the proximal end to the distal end of the chain joint 43. The slot 47 in the link plate 46 constitutes a channel 48 on the chain joint 43 extending from the proximal end to the distal end.

The operating mechanism has a drive cable 49. The drive cable 49 passes through the passage 48 of the chain joint 43 extending from the proximal end to the distal end Connect to the tool head. The operating mechanism pulls the drive cable 49 to cause the drive cable 49 to pull the tool head. The above structure is particularly suitable for a minimally invasive surgical instrument with a chain joint to enter the human body through a perforation having a diameter of 5 mm to 10 mm, in endoscopic surgery, endoscopic surgery, hysteroscopic surgery, minimally invasive surgery In various minimally invasive surgery, such as vertebroplasty, various surgical procedures are performed.

As shown in Figs. 17 and 18, the chain plate 50 of another embodiment has pin holes 51 at both ends. The pins 52 are inserted into the pin holes 51 of the respective link plates 50, respectively, so that the link plates 50 are pivotally connected in two rows arranged in a staggered manner. Unlike the link plate 7 or the link plate 46 described above, the link plate 50 has no groove 36 or groove 47 extending from the proximal end to the distal end of the chain joint 3.

As shown in Fig. 19, a pin shaft 54 is fixed to both ends of the link plate 53 of still another embodiment. Pins 54 fixed to the link plate 53 are inserted into the pin holes 51 of the link plate 50, respectively, so that the link plate 53 and the link plate 50 are pivotally connected in two rows arranged in a staggered manner.

According to the above detailed description, the minimally invasive surgical instrument with chain joint of the present invention has the following technical effects: In various minimally invasive surgical operations, various tool heads are often required to be used for plucking, separating, clamping, cutting, cutting, and Wear tissue, organelles or implants of the human body by sputum, needle stitching, nail clips or snares. The tool head can be a hook shape, a shovel head, a horn head, a curved split head, a needle head, a bow clamp, a right angle pliers, an anvil holding pliers, a lobes, a grasping forceps, a bending splitting pliers, a curved peeling knife, Spherical hemostats, separation hooks, sharp hooks, curved shears, large curved shears, blunt-head separators, needle holders, staple clamps, snares, high-frequency electrosurgical or other tools for minimally invasive surgery head.

In the existing minimally invasive surgical instruments, two cables or two pieces of metal pieces are inserted into the holes on both sides of the concave and convex joint piece in the joint, so that the uneven joint pieces are connected in series to form a joint, and the cable is controlled by pulling the cable or pushing and pulling the metal piece. The joint is bent to both sides, thereby driving various tool heads with the functions of dialing, separating, clamping, cutting, shearing, threading or high-frequency electric knife to swing to both sides. The unsatisfactory of these two types of minimally invasive surgical instruments is that although the cable or the metal piece can drive the joint to bend to both sides, but the joint of the concave and convex joints is difficult to be in any joint after the joint is bent to the sides. The bending position is sufficiently rigid, resulting in easy displacement of the tool head of the minimally invasive surgical instrument and poor positioning accuracy. Therefore, the joint structure of minimally invasive surgical instruments needs to be improved.

The technical solution of the minimally invasive surgical instrument with chain joint of the present invention is: the operating mechanism drives the proximal end of the first-stage chain plate at the proximal end of the chain joint, so that the first-stage chain plate of the chain joint rotates around the pin shaft to generate the first stage. The second-stage chain plate of the second nearest end is driven by the pin of the first-stage chain plate and the meshing transmission of the gear teeth of the gear at the distal end of the extension pipe and the gear teeth of the gear of the second-stage chain plate. Next, the corner of the first-stage chain plate is superimposed and transmitted into the corner of the second-stage chain plate, so that the first-stage corner is superimposed into the second-stage corner; the third-stage chain plate is driven by the pin of the second-stage chain plate. And the double action of the gear teeth of the gears of the first-stage chain plate and the gear teeth of the gears of the third-stage chain plate, and then the corners of the second-stage chain plate are superimposed and transmitted into the corners of the third-stage chain plate. The second stage corner is superimposed into the third stage corner; the fourth stage chain plate is driven by the pin of the third stage chain plate and the gear teeth of the second stage chain plate and the gear wheel of the fourth stage chain plate Under the dual action of the meshing transmission of the teeth, the corners of the third-stage chain plate are stacked Passing into the corner of the fourth-stage chain plate, so that the third-stage corner is superimposed into the fourth-stage corner; the fifth-stage chain plate is driven by the pin of the fourth-stage chain plate and the gear teeth of the third-stage chain plate Under the dual action of the meshing transmission of the gear teeth of the gear of the fifth-stage chain plate, the rotation angle of the fourth-stage chain plate is superimposed and transmitted into the rotation angle of the fifth-stage chain plate, so that the fourth-stage rotation angle is superimposed into the fifth-level rotation angle. And so on, until the tool head is driven by the pin of the Nth chain plate and the gear teeth of the gear of the (N-1)th chain plate and the gear teeth of the gear of the tool head, Further, the corner of the Nth-level chain plate is superimposed and transferred to the corner of the tool head, so that the N-th corner is superimposed into the (N+1)-th order corner; thus, when the operating mechanism controls the chain joint movement, the operating mechanism is extended in the tube The drive at the end is transmitted as the corner of the first-stage link at the proximal end of the chain joint, and is transmitted through the (N+1)-stage superimposition to the corner of the tool head through the transmission of the teeth of the adjacent chain plates.

Under the condition that the number of teeth of the gear teeth of the respective link plates is the same, the tool head 2 can obtain (N+1) times the rotation angle of the rotation angle of the first-stage link plate which is the closest end of the chain joint. The more the number of chain plates N of the chain joint, the more (N+1) multiples of the corners that are superimposed and transmitted to the tool head; the fewer the number of chain plates N of the chain joint, the superimposed transmission to the corner of the tool head (N+ 1) The smaller the multiple. Under the condition that the number of teeth of the gear teeth of each chain plate is different, the corners of the first-stage chain plates at the proximal end of the chain joint are superimposed and transmitted to the corners of the tool head with different multiples. Thereby reaching the chain joint can be two The side has a wide range, large curvature, precise positioning, and sufficient rigidity in any bending position. Another technical solution of the minimally invasive surgical instrument with chain joint of the present invention is as follows: The chain plate may have a groove extending from the proximal end to the distal end of the chain joint, and the groove on the chain plate constitutes a chain joint extending from the proximal end To the far end channel. The operating mechanism transmits the operation to the tool head through the passage of the chain joint.

The operating mechanism can have a drive cable. The drive cable is connected to the tool head through a channel extending from the proximal end to the distal end of the extension tube and the chain joint. The operating mechanism pulls the drive cable to cause the drive cable to pull the tool head to perform various surgical operations. The cable drive mechanism described above is particularly suitable for performing swaying, separating, clamping, shearing, threading, needle stitching, etc. in various minimally invasive surgical procedures such as endoscopic surgery, endoscopic surgery, and hysteroscopic surgery. Nail clips or snares of various operations of the tissues or implants of the human body, thereby reducing the number of surgical instruments and piercing devices used in minimally invasive surgery, facilitating surgical operations and saving operation time; more particularly suitable for use in minimally invasive procedures In the surgical operation, the surgical organ is exposed or exfoliated, and the sacral repair material is placed on the sacral repair site. It is also more suitable for dilating the balloon into the vertebral body to form an olive-shaped cavity during vertebral body surgery. Trimming into a flat cavity prevents side effects of adjacent healthy vertebral bodies being crushed by bone cement after vertebral body shaping surgery.

It is also possible to transmit the high-frequency current of the electrosurgical main unit through the extension tube and the wire in the channel extending from the proximal end to the distal end of the chain joint under the control of the operating mechanism to the tool head, so that the tool head is executed in the electrosurgery Analyze the various operations of separating tissue, electrocoagulation, or cutting tissue.

Compared with the existing minimally invasive surgical instruments, the minimally invasive surgical instrument with chain joint of the present invention realizes that the joint is composed of chain joints, the chain plates of the chain joint have teeth at both ends, and the adjacent chain plates are in the same column. The technical solution of the intermeshing of the teeth is to achieve the technical effect that the chain joint can be bent to a large extent and a large curvature to both sides, and the positioning is accurate and has sufficient rigidity at any bending position. Suitable for use in all kinds of minimally invasive surgery such as endoscopic surgery, endoscopic surgery and hysteroscopic surgery. Tapping, separating, clamping, cutting, piercing, needle stitching, nail clips or snares Tissue organs or implants can also be used as a hook after bending positioning, thereby reducing the number of surgical instruments and piercing devices used in minimally invasive surgery, facilitating surgical operations and saving operation time; and being suitable for minimally invasive surgery The surgical area is exposed or exfoliated, and the sputum repair material is placed on the sacral repair site; it is also suitable for dilating the balloon into the vertebral body to form an olive-shaped cavity in the vertebral body formation surgery. The flat cavity prevents side effects of adjacent healthy vertebral bodies from being crushed by bone cement after vertebral body shaping surgery; it is also suitable for dissecting tissue, electrocoagulation, or electrosurgical cutting tissue during electrosurgery.

Thus, it can be seen that the above stated objectives, including those shown by the foregoing description, are effectively achieved. The present invention is to be considered as a preferred embodiment of the present invention, and it is possible to make some changes to the above-described structure without departing from the spirit and scope of the invention. The invention is not limited or limited to the specific details set forth herein, and any modifications or variations that are obvious to those skilled in the art are

Claims

Claim

1. A minimally invasive surgical instrument with a chain joint, the components comprising: a tool head, a chain joint, an extension tube, a body and an operating mechanism;

The operating mechanism is located at the body, and the operating mechanism controls the chain joint to bend to both sides, thereby driving the tool head to swing to both sides;

The tool head, the chain joint, the extension tube, and the body are sequentially connected;

The chain joint is composed of a chain plate and a pin shaft, and the chain plate is pivotally connected by the pin shafts into two rows arranged in a staggered manner. The proximal end of the proximal end chain plate of the chain joint is pivotally connected with the extension tube and driven by the operating mechanism. a gear tooth at the distal end, a distal end of the most distal chain plate of the chain joint pivotally connected with the tool head, a tooth with a gear at the proximal end, a tooth with a gear at the distal end of the extension tube, and a joint of the chain The teeth of the proximal gear of the nearest proximal chain mesh with the teeth of the gear of the distal end of the extension tube, the gear teeth of the proximal end of the tool head, and the second most distal chain of the chain joint The teeth of the distal gear are in mesh with the teeth of the gear of the proximal end of the tool head, the teeth of the gears of the other chain plates of the chain joint have gear teeth, and the gear teeth of the adjacent chain plates of the same column Engage each other.

2. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the operating mechanism has a joint cable, a distal end of the joint cable and a proximal end of the chain joint The proximal end is connected; the operating mechanism pulls the joint cable, and the joint cable pulls the proximal end of the proximal end of the chain joint to drive the proximal end of the chain joint to rotate, so that the tool head swings to both sides.

3. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the operating mechanism has gear teeth at a distal end of the extension tube, and a proximal chain of the chain joint a proximal end of the plate having gear teeth, the operating mechanism of the gear at the distal end of the extension tube meshing with the teeth of the proximal end of the chain link of the chain joint; the operating mechanism passes The gear teeth of the gear drive the teeth of the gear of the proximal end of the proximal end of the chain joint, and the chain plate of the proximal end of the chain joint is rotated to swing the execution head to both sides.

4. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the chain joint has a passage extending from a proximal end to a distal end, and the operating mechanism passes through the passage of the chain joint. Pass the operation to the tool head.

5. The minimally invasive surgical instrument with a chain joint according to claim 4, wherein said chain plate has a groove extending from a proximal end to a distal end of said chain joint, said chain plate The troughs form a channel that extends from the proximal end to the distal end of the chain joint.

6. The minimally invasive surgical instrument with a chain joint according to claim 4, wherein said operating mechanism has a drive cable, said drive cable extending from said proximal end through said extension tube and chain joint A distal end channel is coupled to the tool head; the operating mechanism pulls the drive cable to cause the drive cable to pull the tool head to perform various surgical operations.

7. The minimally invasive surgical instrument with a chain joint according to claim 4, wherein a high frequency current of the electrosurgical main body is passed through the extension tube and the chain joint under the control of the operating mechanism A wire extending proximally to the distal end channel is transmitted to the tool head.

8. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the two ends of the link plate have pin holes, and the pin shafts are respectively inserted into the pin holes of each of the link plates. The chain plates are pivotally connected by pins to two staggered rows.

9. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the chain plate has a pin hole at one end and the pin shaft fixed at the other end, and each of the chain plates is fixed. The pin is inserted into the pin hole of the other link plate so that the link plates are pivotally connected by the pin into two rows arranged in a staggered manner.

10. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein a pin hole is formed at both ends of the one of the chain plates, and the pin is fixed to both ends of the other chain plate. The pin shafts on each of the pinned link plates are inserted into the pin holes of each of the pin hole-attached link plates, so that the link plates are pivotally connected by the pin shafts into two rows arranged in a staggered manner.

The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the outer circumference of the chain joint is provided with a bellows, and under the constraint of the bellows, the chain plate of the chain joint is prevented. And the pin is separated from each other.

12. The minimally invasive surgical instrument with a chain joint according to claim 1, wherein the operating mechanism drives the proximal end of the first-stage chain plate at the proximal end of the chain joint, so that the first-order chain plate of the chain joint is wound. The pin shaft rotates to generate a first stage rotation angle; the second nearest stage second stage chain plate is driven by the pin of the first stage chain plate and the gear teeth of the gear at the distal end of the extension tube and the gear of the second stage chain plate Under the dual action of the gear meshing transmission, the corners of the first stage chain plate are superimposed and transmitted into the corners of the second stage chain plate, so that the first stage corners are superimposed into the second stage corners; the third stage chain plates are in the second stage. Under the driving action of the pin shaft of the chain plate and the meshing gear of the gear teeth of the gear of the first-stage chain plate and the gear teeth of the gear of the third-stage chain plate, the rotation angle of the second-stage chain plate is superimposed and transmitted into The corner of the third-stage chain plate, so that the second-stage corner is superimposed into the third-stage corner; the fourth-stage chain plate is driven by the pin of the third-stage chain plate and the gear teeth of the second-stage chain plate Under the dual action of the gear teeth of the gears of the four-stage chain plate, The corner of the three-stage chain plate is superimposed and transmitted into the corner of the fourth-stage chain plate, so that the third-stage corner is superimposed into the fourth-stage corner; the fifth-stage chain plate is driven by the pin of the fourth-stage chain plate and the third-stage Under the dual action of the gear teeth of the gears of the chain plate and the gear teeth of the gears of the gears of the fifth-stage chain plate, the rotation angle of the fourth-stage chain plate is superimposed and transmitted into the rotation angle of the fifth-stage chain plate, so that the fourth stage The corners are superimposed into a fifth-order corner; and so on, until the tool head is driven by the pin of the N-th chain plate and the gear teeth of the (N-1)-stage chain plate and the gear teeth of the tool head Under the dual action of the meshing transmission, the corners of the Nth-stage chain plate are further superimposed into the corners of the tool head, so that the N-th rotation angle is superimposed into the (N+1)-th order rotation angle; thus, when the operating mechanism controls the chain joint movement The transmission of the operating mechanism at the distal end of the extension tube is transmitted as the rotation angle of the first-stage link plate at the proximal end of the chain joint, and is transmitted through the (N+1) level by the transmission of the teeth of the adjacent adjacent chain plates. Passed into the corner of the tool head.