Endoscopic surgical instrument and proximal delivery device and distal operating device therefor

Abstract

Disclosed are an endoscopic surgical instrument, a proximal conveying device and a distal operating device. The distal operating device of the endoscopic surgical instrument comprises a driving wire, a driving wire sleeve and an operating component connected at the distal ends of the two. The proximal end of the driving wire and the driving wire sleeve is respectively provided with a driving wire terminal and a driving wire sleeve terminal. The proximal conveying device of the endoscopic surgical instrument comprises a control wire, a control wire sleeve and a handle connected at the proximal ends of the two. The distal end of the control wire and the control wire sleeve is respectively provided with a control wire terminal and a control wire sleeve terminal. The driving wire sleeve and the control wire sleeve are detachably connected through the driving wire sleeve terminal and the control wire sleeve terminal. The driving wire and the control wire are detachably connected through the driving wire terminal and the control wire terminal. According to the embodiment of the present application, the distal operating device and the proximal conveying device are designed to be separable, the repeated loading of the distal operating device is realized, and the proximal conveying device can be repeatedly used for multiple times, thereby reducing material waste.

Description

TECHNICAL FIELD

[0001] Embodiments of the present application relate to the technical field of medical instruments, and more particularly to an endoscopic surgical instrument, a proximal delivery device for the endoscopic surgical instrument, and a distal operating device for the endoscopic surgical instrument. BACKGROUND

[0002] A tissue clipping device is a minimally invasive surgical instrument, which is often used for hemostasis of a wound in a patient, such as hemostasis of a wound in a digestive tract. The tissue clipping device belongs to physical hemostasis, and the tissue clipping device clamps and fixes the tissue and blood vessels around the wound by the closing force between the clamping pieces, so as to achieve the effect of hemostasis. The closing force between the clamping pieces blocks the blood supply of the clamped tissue, so that the mucosal tissue is necrotic and falls off.

[0003] At present, the tissue clipping device is mostly disposable. After being taken out of the package, the tissue clipping device is used for hemostasis and suture of a wound, etc. After being used, the tissue clipping device is discarded. After clamping the tissue (wound), most hemostatic clips separate the clamping part from the delivery device. The clamping part is retained in the human body due to clamping the wound, and then the delivery device is removed out of the body. Because the distal end of the delivery device contacts the human body, the delivery device is discarded after being removed out of the body. If the discarded delivery device is not properly treated, it is easy to cause environmental pollution or cause secondary infection to other patients. In addition, the treated delivery device also causes waste of materials, which is not conducive to sustainable development.

[0004] Therefore, there is a need for improved endoscopic surgical instruments to solve the above technical problems. SUMMARY

[0005] The purpose of the present application is to at least alleviate or solve the above problems by providing an endoscopic surgical instrument, a proximal delivery device for the endoscopic surgical instrument, and a distal operating device for the endoscopic surgical instrument.

[0006] According to a first aspect of the present application, there is provided an endoscopic surgical instrument comprising: a proximal delivery device and a distal operating device. The distal operating device comprises a drive wire, a drive wire sleeve disposed externally of the drive wire, and an operating component connected at a distal end of both the drive wire and the drive wire sleeve, a proximal end of the drive wire being provided with a drive wire termination, a proximal end of the drive wire sleeve being provided with a drive wire sleeve termination. The proximal delivery device comprises a control wire, a control wire sleeve disposed externally of the control wire, and a handle connected at a proximal end of both the control wire and the control wire sleeve, a distal end of the control wire being provided with a control wire termination, a distal end of the control wire sleeve being provided with a control wire sleeve termination. The drive wire sleeve and the control wire sleeve are configured to be detachably connected by the drive wire termination and the control wire termination to form a delivery tube, and the drive wire and the control wire are configured to be detachably connected by the drive wire termination and the control wire termination such that the handle can control movement of the control wire and the drive wire relative to the delivery tube, thereby controlling operation of the operating component.

[0007] In one or more embodiments, when the drive wire termination and the drive wire sleeve termination are connected with the control wire termination and the control wire sleeve termination respectively, the drive wire termination and the control wire termination are connected at a position within the control wire sleeve.

[0008] In one or more embodiments, the handle can control movement of the control wire relative to the control wire sleeve such that the control wire termination can move between a retracted position within the control wire sleeve and an extended position extending out of the control wire sleeve.

[0009] In one or more embodiments, the distal operating device is configured such that the drive wire termination remains extended from the proximal end of the drive wire sleeve.

[0010] In one or more embodiments, when the drive wire termination and the control wire termination form detachable connection, the drive wire termination and the control wire termination do not move relative to each other in the axial and circumferential directions of the control wire.

[0011] In one or more embodiments, the inner diameter of the delivery tube is configured such that the drive wire termination and the control wire termination connected to each other cannot be separated in the radial and axial directions within the delivery tube.

[0012] In one or more embodiments, the drive wire termination and the control wire termination comprise axial limit portions that can cooperate with each other to limit axial relative movement between the drive wire termination and the control wire termination.

[0013] In one or more embodiments, the axial limiting portion of the drive wire termination portion is provided with a first protrusion and a first recess in the same radial direction, and the axial limiting portion of the control wire termination portion is provided with a second recess and a second protrusion in the same radial direction, for respectively mating with the first protrusion and the first recess of the drive wire termination portion in the radial direction to form the detachable connection.

[0014] In one or more embodiments, the axial limiting portion of the drive wire termination portion has a first mating surface facing the radial direction, the axial limiting portion of the control wire termination portion has a second mating surface facing the radial direction, one of the first mating surface and the second mating surface is formed with a recess, and the other is formed with a protrusion, the first mating surface and the second mating surface are fitted together in the radial direction, so that the protrusion is fitted in the recess to form the detachable connection.

[0015] In one or more embodiments, the drive wire sleeve termination portion and the control wire sleeve termination portion are connected to each other by threads.

[0016] In one or more embodiments, one of the drive wire sleeve termination portion and the control wire sleeve termination portion is a deformation termination portion including an elastically deformable portion, and the other is a compression termination portion including a compression portion, the deformation termination portion and the compression termination portion are formed into and out of detachable connection by elastic deformation of the elastically deformable portion under the action of the compression portion.

[0017] In one or more embodiments, the deformation termination portion and the compression termination portion are formed into and out of detachable connection by elastic deformation of the elastically deformable portion in the radial direction.

[0018] In one or more embodiments, the elastically deformable portion is at least one elastic tab arranged in the circumferential direction of the deformation termination portion, the elastic tab is biased radially inwardly or outwardly, and the compression termination portion is formed with a tab receiving portion. When the deformation termination portion and the compression termination portion are crimped to each other in the axial direction, the elastic tab is first elastically deformed radially outwardly or inwardly under the compression of the compression portion, then enters the tab receiving portion and at least partially restores the elastic deformation, so that the connection between the deformation termination portion and the compression termination portion is formed. When the deformation termination portion and the compression termination portion are away from each other in the axial direction, the elastic tab is first elastically deformed radially outwardly or inwardly under the compression of the compression portion, then is separated from the tab receiving portion, so that the connection between the deformation termination portion and the compression termination portion is disconnected.

[0019] In one or more embodiments, the tab receiving portion is at least one surface recess or cutout arranged in the circumferential direction of the compression termination portion.

[0020] In one or more embodiments, the extrusion portion is formed at the end of the extrusion end portion and has a circular ring shape.

[0021] In one or more embodiments, the elastic tab has a first abutting surface and a second abutting surface for abutting against the extrusion portion in different axial directions, respectively, to guide the elastic tab to elastically deform in the radial direction when abutting against the extrusion portion.

[0022] In one or more embodiments, the elastic tab is formed as a cantilever extending in the axial direction.

[0023] In one or more embodiments, the deformed end portion and the extrusion end portion are formed and detached from the detachable connection through the elastic deformation of the elastic deformation portion in the circumferential direction.

[0024] In one or more embodiments, the extrusion portion is at least one protrusion arranged in the circumferential direction of the extrusion end portion and extending in the radial direction. The deformed end portion has a cylindrical body on which a guide groove open to the end of the deformed end portion and a limiting opening in communication with the guide groove are formed, and axially extending slits are formed on both sides of the guide groove, so that the elastic deformation portion is formed between the guide groove and the slit, which can be elastically deformed in the circumferential direction to expand the guide groove, thereby allowing the extrusion portion to enter the limiting opening along the guide groove and exit the deformed end portion from the limiting opening along the guide groove.

[0025] In one or more embodiments, one of the drive line sleeve end portion and the control line sleeve end portion is a plug end portion, and the other is a socket end portion. The plug end portion includes an outer protrusion arranged in the circumferential direction and protruding radially outward. The socket end portion includes an inner protrusion arranged in the circumferential direction and protruding radially inward, a notch portion arranged in the circumferential direction alternately with the inner protrusion, and an inner flange arranged in the axial direction and spaced from the inner protrusion and the notch portion. The outer protrusion is configured to enter the socket end portion via the notch portion, and when the outer protrusion is rotated by a preset angle in the circumferential direction relative to the inner protrusion, the inner protrusion is configured to limit the outer protrusion in the axial direction between the inner protrusion and the inner flange.

[0026] In one or more embodiments, the socket end portion further includes an elastic element and a support portion arranged between the inner protrusion and the inner flange. The elastic element is arranged between the support portion and the inner flange for applying an axial outward thrust to the outer protrusion entering the socket end portion via the support portion.

[0027] In one or more embodiments, the operation component forms a detachable connection with the distal ends of both the drive line and the drive line sleeve.

[0028] In one or more embodiments, the operating component is a tissue clamping component.

[0029] According to a second aspect of the present application, there is provided a proximal delivery device for an endoscopic surgical instrument, comprising a control wire, a control wire sleeve arranged outside the control wire, and a handle connected to the proximal end of both the control wire and the control wire sleeve, wherein the distal end of the control wire is provided with a control wire termination, the distal end of the control wire sleeve is provided with a control wire sleeve termination, and the control wire termination and the control wire sleeve termination are configured to form a detachable connection with the proximal end of a distal operating device delivered by the proximal delivery device.

[0030] In one or more embodiments, the handle is capable of controlling the movement of the control wire relative to the control wire sleeve, so that the control wire termination is capable of moving between a retracted position located within the control wire sleeve and an extended position extending out of the control wire sleeve.

[0031] According to a third aspect of the present application, there is provided a distal operating device for an endoscopic surgical instrument, comprising a drive wire, a drive wire sleeve arranged outside the drive wire, and an operating component connected to the distal end of both the drive wire and the drive wire sleeve, wherein the proximal end of the drive wire is provided with a drive wire termination, the proximal end of the drive wire sleeve is provided with a drive wire sleeve termination, and the drive wire termination and the drive wire sleeve termination are configured to form a detachable connection with the distal end of a proximal delivery device for delivering the distal operating device.

[0032] In one or more embodiments, the distal operating device is configured such that the drive wire termination remains extended from the proximal end of the drive wire sleeve.

[0033] According to a fourth aspect of the present application, there is provided a proximal delivery device for the endoscopic surgical instrument described above.

[0034] According to a fifth aspect of the present application, there is provided a distal operating device for the endoscopic surgical instrument described above.

[0035] By means of the above technical solutions of the present application, at least the following beneficial technical effects can be achieved:

[0036] The hemostatic clip of the reloadable release device according to the embodiments of the present application solves the problem that the distal operating device cannot be reloaded in the prior art by means of the separable design of the distal operating device and the proximal delivery device, and at the same time, the proximal delivery device can be used repeatedly for multiple times, thereby reducing the waste of materials. BRIEF DESCRIPTION OF DRAWINGS

[0037] Other features, objects, and advantages of the present application will become more apparent from the following detailed description of non-limiting embodiments thereof as made in conjunction with the accompanying drawings:

[0038] Figure 1 is a structural view of an endoscope surgical instrument according to an embodiment of the present application;

[0039] Figure 2 is a structural view of an endoscope surgical instrument according to an embodiment of the present application;

[0040] Figure 3 is a structural view of a detachable connection between a drive wire end fitting and a control wire end fitting according to an embodiment of the present application;

[0041] Figure 4 is a perspective structural view of a drive wire, a drive wire end fitting, a control wire end fitting, and a control wire according to an embodiment of the present application;

[0042] Figure 5 is an axial cross-sectional structural view of a drive wire, a drive wire end fitting, a control wire end fitting, and a control wire according to an embodiment of the present application;

[0043] Figure 6 is a perspective structural view of a drive wire, a drive wire end fitting, a control wire end fitting, and a control wire according to an embodiment of the present application;

[0044] Figure 7 is a perspective structural view of a drive wire, a drive wire end fitting, a control wire end fitting, and a control wire according to an embodiment of the present application;

[0045] Figure 8 is a structural view of a delivery tube according to an embodiment of the present application;

[0046] Figure 9 is a perspective structural view of a deformation end fitting and a compression end fitting of a drive wire sleeve end fitting and a control wire sleeve end fitting according to an embodiment of the present application;

[0047] Figure 10 is an axial cross-sectional structural view of a deformation end fitting and a compression end fitting of a drive wire sleeve end fitting and a control wire sleeve end fitting according to an embodiment of the present application;

[0048] Figure 11 is a perspective structural view of a drive wire sleeve, a drive wire sleeve end fitting, a control wire sleeve end fitting, and a control wire sleeve according to an embodiment of the present application;

[0049] Figure 12 is a perspective structural view of a drive wire sleeve, a drive wire sleeve end fitting, a control wire sleeve end fitting, and a control wire sleeve according to an embodiment of the present application;

[0050] Figure 13 is a perspective view of a variant termination and extruded termination of a drive line sleeve termination and a control line sleeve termination according to an embodiment of the present application;

[0051] Figure 14 is a perspective view of a drive line sleeve termination and a control line sleeve termination according to an embodiment of the present application;

[0052] Figure 15 is a perspective view of a drive line sleeve, a drive line sleeve termination, a control line sleeve termination and a control line sleeve according to an embodiment of the present application;

[0053] Figure 16 is a perspective view of a drive line sleeve, a drive line sleeve termination, a control line sleeve termination and a control line sleeve according to an embodiment of the present application;

[0054] Figure 17 is a perspective view of a socket termination according to an embodiment of the present application;

[0055] Figure 18 is a perspective view of a socket termination according to an embodiment of the present application;

[0056] Figure 19 is a schematic view of a known endoscopic surgical instrument entering a human environment; and

[0057] Figure 20 is a schematic view of an endoscopic surgical instrument entering a human environment according to an embodiment of the present application DETAILED DESCRIPTION

[0058] The present application will be further described with reference to the drawings and embodiments. It is to be understood that the specific embodiments described herein are merely illustrative of the present application and are not intended to limit the present application. It is also to be understood that, for the purpose of clarity, only those parts of the drawings that are necessary for the description of the present application are shown.

[0059] In the description of the embodiments of the present application, the terms "upper", "lower", "inner", "outer", "central", "longitudinal", "transverse" and the like indicate the orientation or positional relationship based on the orientation or positional relationship shown in the drawings. These terms are mainly used to better describe the present application and its embodiments, and are not intended to limit the indicated devices, components or components to have a specific orientation, or to be constructed and operated in a specific orientation.

[0060] In the description of the embodiments of the present application, the terms "horizontal", "vertical" and the like do not mean that the components must be absolutely horizontal or vertical, but can be slightly inclined. For example, "horizontal" only means that its direction is more horizontal relative to "vertical", and does not mean that the structure must be completely horizontal, but can be slightly inclined.

[0061] Unless otherwise clearly indicated or implied to the contrary by context, the word "set" or "sets" as used herein is to be interpreted broadly to encompass both "connected" and "coupled" arrangements. For example, a connection can be a fixed connection, a releasable connection, or an integral connection; can be a mechanical connection, an electrical connection, or a combination thereof; and can be a direct connection, or an indirect connection via an intervening medium, or an internal connection between two elements. The specific meaning of the word "set" or "sets" in the present application will be apparent to those of ordinary skill in the art, in light of the specific context in which such word is used.

[0062] In the embodiments of the present application, the proximal end refers to the end of the endoscopic surgical instrument that is closer to the operator, and the distal end refers to the end opposite the proximal end, for example, the end closer to the object to be operated on, such as tissue, located in the body. In addition, the axial direction refers to the longitudinal axis extension direction of the control wire of the endoscopic surgical instrument, the radial direction refers to the direction perpendicular to the axial direction, and the circumferential direction refers to the circumferential direction around the axial direction. Unless otherwise specified, the distal end of a component refers to the end of the component closer to the inside of the body, and the proximal end refers to the end of the component closer to the outside of the body.

[0063] Embodiments of the present application will be described in detail below with reference to the accompanying drawings. In the case of no conflict, each of the embodiments described below and each of the features in the embodiments can be combined with each other.

[0064] Figure 1 And Figure 2 is a structural diagram of an endoscopic surgical instrument 1 according to an embodiment of the present application. Figure 1 And Figure 2 The difference is that Figure 1 shows the detachable connection between the drive wire end 215 of the drive wire 210 and the control wire end 115 of the control wire 110, while Figure 2 shows the detachable connection between the drive wire sleeve end 225 of the drive wire sleeve 220 and the control wire sleeve end 125 of the control wire sleeve 120.

[0065] In combination with Figure 1 And Figure 2 , an endoscopic surgical instrument 1 provided by an embodiment of the present application is described. The endoscopic surgical instrument 1 as a whole includes a proximal end delivery device 10 and a distal end operating device 20.

[0066] The distal end operating device 20 includes a drive wire 210, a drive wire sleeve 220 sleeved outside the drive wire 210, and an operating component 230 connected at the distal end of both the drive wire 210 and the drive wire sleeve 220, the proximal end of the drive wire 210 is provided with a drive wire end 215, and the proximal end of the drive wire sleeve 220 is provided with a drive wire sleeve end 225.

[0067] The proximal delivery device 10 includes a control wire 110, a control wire sleeve 120 disposed externally to the control wire 110, and a handle 130 connected proximally to both the control wire 110 and the control wire sleeve 120, the distal end of the control wire 110 being provided with a control wire termination 115, and the distal end of the control wire sleeve 120 being provided with a control wire sleeve termination 125.

[0068] The drive wire 210 and the control wire 110 are configured to be detachably connected by the drive wire termination 215 and the control wire termination 115, such that the handle 130 can control the movement of the control wire 110 and the drive wire 210 relative to the delivery tube 30 (see Figure 8 ) to thereby control the operation of the operation member 230.

[0069] In an exemplary embodiment, when the drive wire termination 215 and the drive wire sleeve termination 225 are connected to the control wire termination 115 and the control wire sleeve termination 125, respectively, the connection position of the drive wire termination 215 to the control wire termination 115 can be located within the control wire sleeve 120.

[0070] In an exemplary embodiment, the handle 130 can control the movement of the control wire 110 relative to the control wire sleeve 120, such that the control wire termination 115 can be moved between a retracted position located within the control wire sleeve 120 and an extended position extending out of the control wire sleeve 120.

[0071] In an exemplary embodiment, the distal operation device 20 can be configured such that the drive wire termination 215 remains extended from the proximal end of the drive wire sleeve 220.

[0072] In an exemplary embodiment, when the drive wire termination 215 and the control wire termination 115 form a detachable connection, the drive wire termination 215 and the control wire termination 115 do not move relative to each other in the axial and circumferential directions of the control wire 110.

[0073] In an exemplary embodiment, the inner diameter of the delivery tube 30 can be configured such that the drive wire termination 215 and the control wire termination 115 connected to each other cannot be separated in the radial and axial directions within the delivery tube 30.

[0074] Figure 3 is a structural diagram of the detachable connection between the drive wire termination 215 and the control wire termination 115 according to an embodiment of the present application.

[0075] The detachable connection between the drive wire termination 215 and the control wire termination 115 is described in conjunction with Figure 3 In an exemplary embodiment, the drive wire termination 215 and the control wire termination 115 can include axial limit portions 40 that can cooperate with each other to limit the axial relative movement between the drive wire termination 215 and the control wire termination 115.

[0076] Figure 4 is a perspective view of the drive line 210, the drive line termination 215, the control line termination 115 and the control line 110 according to an embodiment of the present application, and Figure 5 is a cross-sectional view along the axial direction of the drive line 210, the drive line termination 215, the control line termination 115 and the control line 110 according to an embodiment of the present application.

[0077] In conjunction with Figure 4 and Figure 5 a scenario of detachable connection between the drive line termination 215 and the control line termination 115 according to an embodiment of the present application is described. In this exemplary embodiment, the axial stop 40 of the drive line termination 215 and the control line termination 115 employs a cooperating protrusion and recess.

[0078] In the exemplary embodiment, the axial stop 40 of the drive line termination 215 can be provided with a first protrusion 410 and a first recess 411 in the same radial direction, and the axial stop 40 of the control line termination 115 can be provided with a second recess 421 and a second protrusion 420 in the same radial direction for cooperating with the first protrusion 410 and the first recess 411 of the drive line termination 215 respectively in the radial direction to form the detachable connection.

[0079] Figure 6 and Figure 7 is a perspective view of the drive line 210, the drive line termination 215, the control line termination 115 and the control line 110 according to an embodiment of the present application. Figure 6 and Figure 7 The difference is that, Figure 7 the view of Figure 6 is rotated by 90 degrees in the circumferential direction relative to the view of

[0080] In conjunction with Figure 6 and Figure 7 another scenario of detachable connection between the drive line termination 215 and the control line termination 115 is described, i.e. the axial stop 40 employs a cooperating surface provided with a protrusion and a surface provided with a recess.

[0081] A cross-sectional structural view of the drive wire 210, the drive wire end 215, the control wire end 115, and the control wire 110 along the axial direction. In an exemplary embodiment, the axial stop portion 40 of the drive wire end 215 can have a first mating surface 413 facing the radial direction, the axial stop portion 40 of the control wire end 115 can have a second mating surface 423 facing the radial direction, a recess 40R can be formed on one of the first mating surface 413 and the second mating surface 423, and a protrusion 40P can be formed on the other, the first mating surface 413 and the second mating surface 423 can be fitted together along the radial direction, such that the protrusion 40P is fitted in the recess 40R to form a detachable connection.

[0082] Figure 8 is a structural view of a delivery tube according to an embodiment of the present application.

[0083] In combination Figure 8 A detachable connection between the drive wire sleeve end 225 and the control wire sleeve end 125 of the delivery tube 30 is described. The drive wire sleeve 220 and the control wire sleeve 120 are configured to be detachably connected by the drive wire sleeve end 225 and the control wire sleeve end 125 to form the delivery tube 30.

[0084] Figure 9 is a perspective structural view of the deformable end 51 and the extruded end 52 of the drive wire sleeve end 225 and the control wire sleeve end 125 according to an embodiment of the present application, and Figure 10 is a cross-sectional structural view of the deformable end 51 and the extruded end 52 of the drive wire sleeve end 225 and the control wire sleeve end 125 according to an embodiment of the present application along the axial direction.

[0085] In combination Figure 9 and Figure 10 A first scenario of the deformable end 51 and the extruded end 52 is described.

[0086] In an exemplary embodiment, one of the drive wire sleeve end 225 and the control wire sleeve end 125 can be a deformable end 51 including an elastically deformable portion 510, and the other can be an extruded end 52 including an extruded portion 520, the deformable end 51 and the extruded end 52 can be formed and detached from the detachable connection by the elastically deformable portion 510 elastically deforming under the action of the extruded portion 520.

[0087] In an exemplary embodiment, the deformable end 51 and the extruded end 52 can be formed and detached from the detachable connection by the elastically deformable portion 510 elastically deforming in the radial direction.

[0088] In an example embodiment, the elastic deformation portion 510 can be at least one elastic tab 511 arranged along the circumference of the deformation end portion 51, the elastic tab 511 can be biased radially inward or outward, and the extrusion end portion 52 can be formed with a tab receiving portion 521. When the deformation end portion 51 and the extrusion end portion 52 are pressed against each other in the axial direction, the elastic tab 511 can first elastically deform radially outward or inward under the extrusion of the extrusion portion 520, and then enter the tab receiving portion 521 and at least partially restore the elastic deformation, so as to form a connection between the deformation end portion 51 and the extrusion end portion 52. When the deformation end portion 51 and the extrusion end portion 52 are moved away from each other in the axial direction, the elastic tab 511 can first elastically deform radially outward or inward under the extrusion of the extrusion portion 520, and then disengage from the tab receiving portion 521, so as to disengage the connection between the deformation end portion 51 and the extrusion end portion 52.

[0089] In an example embodiment, the tab receiving portion 521 can be at least one surface recess or cutout arranged along the circumference of the extrusion end portion 52.

[0090] In an example embodiment, the extrusion portion 520 can be formed at the end of the extrusion end portion 52 and can have a circular ring shape.

[0091] In an example embodiment, the elastic tab 511 can have a first abutting surface 511F and a second abutting surface 511B, respectively used to abut against the extrusion portion 520 in different directions in the axial direction, so as to guide the elastic tab 511 to elastically deform in the radial direction when abutting against the extrusion portion 520.

[0092] In an example embodiment, the elastic tab 511 can be formed as a cantilever extending in the axial direction.

[0093] In an example embodiment, the deformation end portion 51 and the extrusion end portion 52 can form and disengage the detachable connection through the elastic deformation of the elastic deformation portion 510 in the circumferential direction.

[0094] Figure 11 and Figure 12 are perspective structural views of the drive wire ferrule 220, the drive wire ferrule end portion 225, the control wire ferrule end portion 125, and the control wire ferrule 120 according to an embodiment of the present application. Figure 11 and Figure 12 The difference is that, Figure 12 the view of Figure 11 is rotated 90 degrees in the circumferential direction relative to the view of

[0095] The cooperation between the drive wire ferrule end portion 225 and the control wire ferrule end portion 125 and the cooperation between the drive wire 210 and the control wire 110 are described in combination with Figure 11 and Figure 12 .

[0096] In Figure 11 and Figure 12 , the driving wire sleeve termination 225 is taken as the deformed termination 51, and the control wire sleeve termination 125 is taken as the extruded termination 52. However, in other exemplary embodiments, the driving wire sleeve termination 225 can be the extruded termination 52, and the control wire sleeve termination 125 can be the deformed termination 51.

[0097] Figure 13 is a perspective structural view of the deformed termination 51 and the extruded termination 52 of the driving wire sleeve termination 225 and the control wire sleeve termination 125 according to an embodiment of the present application.

[0098] In combination with Figure 13 a second scenario of the deformed termination 51 and the extruded termination 52 is described.

[0099] In exemplary embodiments, the extruded portion 520 can be at least one protrusion 52X arranged along the circumference of the extruded termination 52 and extending in the radial direction. The deformed termination 51 can have a cylindrical body 51B, on which a guide groove 51G open to the end of the deformed termination 51 and a limiting opening 51H in communication with the guide groove 51G can be formed, and on both sides of the guide groove 51G, axially extending slits 51S can be formed, so as to form an elastically deformed portion 510 between the guide groove 51G and the slits 51S. The elastically deformed portion 510 is capable of elastically deforming in the circumferential direction to expand the guide groove 51G, thereby allowing the extruded portion 520 to enter the limiting opening 51H along the guide groove 51G and exit the deformed termination 51 from the limiting opening 51H along the guide groove 51G.

[0100] In the foregoing, a detachable connection manner between the driving wire sleeve termination 225 and the control wire sleeve termination 125 according to an embodiment of the present application is described. Figure 9 to Figure 13 In the exemplary embodiments described above, the connection between the driving wire sleeve termination 225 and the control wire sleeve termination 125 is formed by the deformed termination 51 and the extruded termination 52.

[0101] Figure 14 is a perspective structural view of the driving wire sleeve termination 225 and the control wire sleeve termination 125 according to an embodiment of the present application.

[0102] In combination with Figure 14 another detachable connection manner between the driving wire sleeve termination 225 and the control wire sleeve termination 125 is described. In the present exemplary embodiments, the connection between the driving wire sleeve termination 225 and the control wire sleeve termination 125 is formed by a threaded connection.

[0103] In the example embodiment, the drive wire sleeve termination 225 and the control wire sleeve termination 125 can be connected to each other by a screw thread.

[0104] Figure 15 and Figure 16 is a perspective structural view of the drive wire sleeve 220, the drive wire sleeve termination 225, the control wire sleeve termination 125, and the control wire sleeve 120 according to an embodiment of the present application. Figure 15 and Figure 16 The difference is that Figure 15 is a view from the proximal side of the endoscope surgical instrument 1, while Figure 16 is a view from the distal side of the endoscope surgical instrument 1.

[0105] Figure 17 and Figure 18 is a perspective structural view of the socket termination 62 according to an embodiment of the present application. Figure 17 (A), (B) of FIG. 6 show the inner protrusion 62A, the notch 62B, and the inner flange 62C of the socket termination 62, and are views from the distal side and the proximal side of the endoscope surgical instrument 1, respectively. Figure 17 (C) of FIG. 6 also shows the support 62E of the socket termination 62. Figure 18 (A), (B), (C) of FIG. 6 show the elastic element 62D and the support 62E of the socket termination 62, where (A) is an exploded view of the elastic element 62D and the support 62E, (B) and (C) are assembled state views of the elastic element 62D and the support 62E and are views from the distal side and the proximal side of the endoscope surgical instrument 1, respectively.

[0106] In combination with Figure 15 , Figure 16 , Figure 17 and Figure 18 another detachable connection between the drive wire sleeve termination 225 and the control wire sleeve termination 125 is described. In the present example embodiment, the connection between the drive wire sleeve termination 225 and the control wire sleeve termination 125 is formed by the plug termination 61 and the socket termination 62.

[0107] In combination with Figure 15 , Figure 16 , Figure 17 and Figure 18 a scenario of the plug termination 61 and the socket termination 62 is described.

[0108] In the example embodiment, one of the drive wire sleeve termination 225 and the control wire sleeve termination 125 can be the plug termination 61 and the other can be the socket termination 62. As Figure 15 and Figure 16As shown, the plug end 61 can include an outer protrusion 61X arranged circumferentially and protruding radially outward. The socket end 62 can include an inner protrusion 62A arranged circumferentially and protruding radially inward, a gap 62B arranged circumferentially alternately with the inner protrusion 62A, and an inner flange 62C arranged axially spaced from the inner protrusion 62A and the gap 62B, see Figure 17 The outer protrusion 61X can be configured to enter the socket end 62 via the gap 62B. When the outer protrusion 61X is rotated circumferentially relative to the inner protrusion 62A by a preset angle, the inner protrusion 62A can be configured to restrict the outer protrusion 61X axially between the inner protrusion 62A and the inner flange 62C.

[0109] In exemplary embodiments, the socket end 62 can further include a resilient element 62D arranged between the inner protrusion 62A and the inner flange 62C, and a support 62E, the resilient element 62D can be arranged between the support 62E and the inner flange 62C, for applying an axially outward pushing force to the outer protrusion 61X entering the socket end 62 via the support 62E.

[0110] In exemplary embodiments, the operation component 230 can form a detachable connection with the distal end of both the drive wire 210 and the drive wire sleeve 220. The operation component 230 can be a tissue clamping component, such as a hemostatic clip.

[0111] With the operation component 230 being a tissue clamping component such as a hemostatic clip, the use and operation of the endoscopic surgical instrument 1 according to embodiments of the present application are described. As described above, the endoscopic surgical instrument 1 includes the distal operation device 20 and the proximal delivery device 10, the distal operation device 20 including the drive wire 210, the drive wire sleeve 220, and the operation component 230 (i.e., the hemostatic clip). The proximal delivery device 10 includes the control wire 110, the control wire sleeve 120, and the handle 130. In addition, the operation component 230 (i.e., the hemostatic clip) can include a clip, a clip seat, and a pin shaft.

[0112] Before the endoscopic surgical instrument 1 is taken out of the packaging bag, the distal operation device 20 and the proximal delivery device 10 are packaged separately. The distal operation device 20 and the proximal delivery device 10 are taken out of the packaging bag respectively. The handle 130 in the proximal delivery device 10 is pushed distally, so that the control wire 110 in the proximal delivery device 10 distally exposes the control wire sleeve 120. Then the control wire 110 distally and the drive wire 210 proximally are cooperatively docked, and the handle 130 is pulled proximally, so that the control wire sleeve 120 distally and the drive wire sleeve 220 proximally are close to each other (i.e., the control wire sleeve end 125 and the drive wire sleeve end 225 are close to each other), and are cooperatively docked, thus completing the connection of the distal operation device 20 and the proximal delivery device 10, and the assembly of the endoscopic surgical instrument 1 is completed.

[0113] According to the general operation method of the hemostatic clip, the clip is opened and closed by moving the handle 130. When the clip is moved to the target position, the clip is opened to the maximum, and then the target object to be clamped is aligned, the clip is closed, and the handle 130 is pulled proximally to separate the operating component 230 from the drive wire sleeve 220, thereby completing the entire hemostatic action.

[0114] After the hemostatic action is completed, the hemostatic clip is removed from the endoscope, the drive wire sleeve 220 proximal end and the proximal delivery device 10 distal end are disassembled, and then the drive wire 210 proximal end and the control wire 110 distal end are disassembled, thereby realizing the disassembly of the distal operating device 20 (which does not contain the operating component 230 at this time) and the proximal delivery device 10. At this time, the distal operating device 20 can be discarded as waste, and the proximal delivery device 10 can be used again with another new distal operating device 20.

[0115] In the endoscopic surgical instrument 1 described in combination with the above embodiments, the connection of the distal operating device 20 and the proximal delivery device 10 includes the connection between the distal end of the external control wire sleeve 120 and the drive wire sleeve 220, and the connection between the control wire 110 and the drive wire 210. The two connections are separable connections and can be separated and connected multiple times. The operating component 230 such as the tissue clamping part includes at least two openable and closable clips and a clip seat. The clip seat is mainly used to accommodate the clips and realize the opening and closing of the clips. After release, the tissue clamping part will remain in the human body. The drive wire sleeve 220 is used to connect the operating component 230 such as the tissue clamping part and the proximal delivery device 10, and the drive wire sleeve 220 and the tissue clamping part form the distal operating device 20, which is disposable and separable from the proximal delivery device 10. The distal end of the drive wire 210 is connected to the proximal end of the clip, and the proximal end of the drive wire 210 is connected to the distal end of the control wire 110, and the connection is a separable connection.

[0116] The proximal delivery device 10 can be repeatedly used. The delivery tube 30 is divided into a proximal end and a distal end, the control wire sleeve end connection part 125 at the proximal end of the delivery tube 30 is connected to the handle 130 through the control wire sleeve 120, and the drive wire sleeve end connection part 225 at the distal end of the delivery tube 30 is connected to the drive wire sleeve 220. The control wire 110 is used to connect the drive wire 210 and control the opening and closing of the clip through the drive wire 210. The control wire 110 has a torque transmission function to realize 360-degree rotational positioning of the clip. The handle 130 is used to connect the control wire 110 and apply force to the control wire 110 to realize the opening and closing of the clip.

[0117] According to the embodiment of the present application, the distal operating device 20 and the proximal delivery device 10 are detachably connected. The distal operating device 20 is disposable, and the proximal delivery device 10 is reusable. In addition, the distal operating device 20 and the proximal delivery device 10 are simple, reliable and easy to detach.

[0118] The embodiment of the present application also provides a proximal delivery device 10 for an endoscopic surgical instrument 1, comprising a control wire 110, a control wire sleeve 120 sleeved outside the control wire 110, and a handle 130 connected to the proximal ends of the control wire 110 and the control wire sleeve 120. The distal end of the control wire 110 is provided with a control wire terminal 115, and the distal end of the control wire sleeve 120 is provided with a control wire sleeve terminal 125. The control wire terminal 115 and the control wire sleeve terminal 125 are configured to form a detachable connection with the proximal end of the distal operating device 20 delivered by the proximal delivery device 10.

[0119] In the exemplary embodiment, the handle 130 can control the movement of the control wire 110 relative to the control wire sleeve 120, so that the control wire terminal 115 can move between a retracted position located in the control wire sleeve 120 and an extended position extending out of the control wire sleeve 120.

[0120] The embodiment of the present application also provides a distal operating device 20 for an endoscopic surgical instrument 1, comprising a drive wire 210, a drive wire sleeve 220 sleeved outside the drive wire 210, and an operating component 230 connected to the distal ends of the drive wire 210 and the drive wire sleeve 220. The proximal end of the drive wire 210 is provided with a drive wire terminal 215, and the proximal end of the drive wire sleeve 220 is provided with a drive wire sleeve terminal 225. The drive wire terminal 215 and the drive wire sleeve terminal 225 are configured to form a detachable connection with the distal end of the proximal delivery device 10 used to deliver the distal operating device 20.

[0121] In the exemplary embodiment, the distal operating device 20 can be configured such that the drive wire terminal 215 remains extended from the proximal end of the drive wire sleeve 220.

[0122] The embodiment of the present application also provides a proximal delivery device 10 for an endoscopic surgical instrument 1 described in the above exemplary embodiments.

[0123] The embodiment of the present application also provides a distal operating device 20 for an endoscopic surgical instrument 1 described in the above exemplary embodiments.

[0124] Figure 19 is a schematic view of an endoscopic surgical instrument 1' known to enter a human body environment, and Figure 20 is a schematic view of an endoscopic surgical instrument 1 according to the embodiment of the present application entering a human body environment.

[0125] As shown in Figure 19 , the endoscopic surgical instrument 1' comprises a distal operating device 20' and a proximal delivery device 10'. In use, the distal end of the endoscopic surgical instrument 1' enters a human body environment through an endoscope forceps channel 1N'. The region 1F' of the endoscopic surgical instrument 1' that actually extends out of the endoscope, for example, includes the operating components of the distal operating device 20' and part of the drive wire sleeve, particularly the distal end portion of the drive wire sleeve. After the tissue clipping device is used for operations such as hemostatic suturing of a wound surface, the tissue clipping device is discarded. The tissue clipping component is separated from the proximal delivery device 10'. The tissue clipping component is retained in the human body due to the clamping of the wound surface, and then the proximal delivery device 10' is removed out of the body. Because the proximal delivery device 10' and the distal operating device 20' are fixedly connected to each other, and the distal end of the distal operating device 20' is in contact with the human body. Therefore, when the distal operating device 20' (at this time not including the tissue clipping component) and the proximal delivery device 10' are removed out of the body, they are discarded. The discarded distal operating device 20' and the proximal delivery device 10' are prone to cause environmental pollution or secondary infection to other patients if not properly disposed of. In addition, the disposal of the proximal delivery device 10' also causes waste of materials, which is not conducive to sustainable development.

[0126] As shown in Figure 20 and described in the above embodiments in conjunction with Figure 1 to Figure 18 , the endoscopic surgical instrument 1 comprises a distal operating device 20 and a proximal delivery device 10. According to embodiments of the present application, the distal operating device 20 and the proximal delivery device 10 are detachably connected. In use, the distal end of the endoscopic surgical instrument 1 enters a human body environment through an endoscope forceps channel 1N. The region 1F of the endoscopic surgical instrument 1 that actually extends out of the endoscope, for example, includes the operating components 230 of the distal operating device 20 and part of the drive wire sleeve 220, particularly the distal end portion of the drive wire sleeve 220 (see Figure 2 ).

[0127] As described above, the endoscopic surgical instrument 1 according to the embodiment of the present application, the distal end operating device 20 and the proximal end conveying device 10 are detachably connected. The tissue clamping component and the distal end (the part contacting the human body) of the proximal end conveying device 10 are arranged in one independent module (for example, which can be called a release unit), the module exists independently, and is detachably connected with the proximal end (the part not contacting the human body) of the proximal end conveying device 10, and is repeatedly loadable. That is, the proximal end of the proximal end conveying device 10 can be sequentially connected with multiple release units. When the tissue clamping component in the release unit is released, the original proximal end of the proximal end conveying device 10 can still be used, and another release unit is reloaded and released. In this way, the proximal end of the proximal end conveying device 10 can be repeatedly used for multiple times. Because the proximal end of the proximal end conveying device 10 does not directly contact the human body in actual use, it does not carry the pollution source, so multiple repeated uses will not cause harm to the human body and the environment. At the same time, the cost of materials is saved, and the economic pressure of the patient is also alleviated.

[0128] The above description is merely preferred embodiments of the present application and a description of the principles of the technology used. It should be understood by those skilled in the art that the scope of the application involved in the present application is not limited to the technical solutions formed by the specific combinations of the above technical features, and should also cover other technical solutions formed by any combination of the above technical features or equivalent features without departing from the inventive concept. For example, the above features are replaced with the technical features disclosed in the present application (but not limited to) having similar functions to form technical solutions.

Claims

1. An endoscopic surgical instrument for use in accessing a human body environment through an endoscope channel to perform an operation, comprising: A proximal delivery device and a distal operating device, wherein the distal operating device comprises a drive wire, a drive wire sleeve sheathed outside the drive wire, and an operating component connected at the distal end of both the drive wire and the drive wire sleeve, the proximal end of the drive wire is provided with a drive wire terminal, and the proximal end of the drive wire sleeve is provided with a drive wire sleeve terminal; the proximal delivery device comprises a control wire, a control wire sleeve sheathed outside the control wire, and a handle connected at the proximal end of both the control wire and the control wire sleeve, the distal end of the control wire is provided with a control wire terminal, and the distal end of the control wire sleeve is provided with a control wire sleeve terminal; the drive wire sleeve and the control wire sleeve are configured to be detachably connected through the drive wire terminal and the control wire terminal to form a delivery tube, and the drive wire and the control wire are configured to be detachably connected through the drive wire terminal and the control wire terminal, so that the handle can control the movement of the control wire and the drive wire relative to the delivery tube, thereby controlling the operation of the operating component; and the distal operating device and the proximal delivery device are further configured such that, during use, part of the drive wire sleeve protrudes out of the endoscope, and the drive wire terminal and the control wire terminal are located inside the endoscope forceps channel.

2. The endoscopic surgical instrument of claim 1, wherein, When the drive wire terminal and the drive wire sleeve terminal are connected with the control wire terminal and the control wire sleeve terminal respectively, the connection position of the drive wire terminal and the control wire terminal is located inside the control wire sleeve.

3. The endoscopic surgical instrument of claim 2, wherein, The handle can control the movement of the control wire relative to the control wire sleeve, so that the control wire terminal can move between a retracted position located inside the control wire sleeve and an extended position protruding out of the control wire sleeve.

4. The endoscopic surgical instrument of claim 3, wherein, The distal operating device is configured such that the drive wire terminal remains protruding out of the proximal end of the drive wire sleeve.

5. The endoscopic surgical instrument of claim 4, wherein, When the drive wire terminal and the control wire terminal form a detachable connection, the drive wire terminal and the control wire terminal do not move relative to each other in the axial and circumferential directions of the control wire.

6. The endoscopic surgical instrument of claim 1, wherein, The inner diameter of the delivery tube is configured such that the drive wire terminal and the control wire terminal connected with each other cannot be separated in the radial and axial directions inside the delivery tube.

7. The endoscopic surgical instrument of claim 1 or 6, wherein, The drive wire terminal and the control wire terminal comprise axial limiting portions that can cooperate with each other to limit the axial relative movement between the drive wire terminal and the control wire terminal.

8. The endoscopic surgical instrument of claim 7, wherein, The axial limiting portion of the drive wire terminal is provided with a first protrusion and a first groove in the same radial direction, and the axial limiting portion of the control wire terminal is provided with a second groove and a second protrusion in the same radial direction, for cooperating with the first protrusion and the first groove of the drive wire terminal respectively in the radial direction to form a detachable connection.

9. The endoscopic surgical instrument of claim 7, wherein, The axial limiting portion of the drive wire end termination has a first mating surface facing the radial direction, the axial limiting portion of the control wire end termination has a second mating surface facing the radial direction, one of the first mating surface and the second mating surface is formed with a recess, and the other is formed with a protrusion, the first mating surface and the second mating surface are fitted together along the radial direction, so that the protrusion is fitted in the recess to form a detachable connection.

10. The endoscopic surgical instrument of claim 1, wherein, The drive wire sleeve end termination and the control wire sleeve end termination are connected to each other by threads.

11. The endoscopic surgical instrument of claim 1, wherein, One of the drive wire sleeve end termination and the control wire sleeve end termination is a deformation end termination including an elastically deformed portion, and the other is a pressing end termination including a pressing portion, the deformation end termination and the pressing end termination are formed and detached from the detachable connection by elastic deformation of the elastically deformed portion under the action of the pressing portion.

12. The endoscopic surgical instrument of claim 11, wherein, The deformation end termination and the pressing end termination are formed and detached from the detachable connection by elastic deformation of the elastically deformed portion in the radial direction.

13. The endoscopic surgical instrument of claim 12, wherein, The elastically deformed portion is at least one elastic tab arranged along the circumference of the deformation end termination, the elastic tab is biased radially inward or outward, and the pressing end termination is formed with a tab receiving portion, wherein When the deformation end termination and the pressing end termination are pressed against each other in the axial direction, the elastic tab is first elastically deformed radially outward or inward under the pressing of the pressing portion, then enters the tab receiving portion and at least partially restores the elastic deformation, so that the connection between the deformation end termination and the pressing end termination is formed; and When the deformation end termination and the pressing end termination are moved away from each other in the axial direction, the elastic tab is first elastically deformed radially outward or inward under the pressing of the pressing portion, then is detached from the tab receiving portion, so that the connection between the deformation end termination and the pressing end termination is disconnected.

14. The endoscopic surgical instrument of claim 13, wherein, The tab receiving portion is at least one surface recess or cutout arranged circumferentially on the pressing end termination.

15. The endoscopic surgical implement according to claim 14, wherein, The pressing portion is formed at the end of the pressing end termination and has a circular ring shape.

16. The endoscopic surgical instrument of claim 13, wherein, The elastic tab has a first abutting surface and a second abutting surface for abutting against the pressing portion in different directions in the axial direction, respectively, to guide the elastic tab to elastically deform in the radial direction when abutting against the pressing portion.

17. The endoscopic surgical instrument of claim 16, wherein, The elastic tab is formed as a cantilever extending in the axial direction.

18. The endoscopic surgical instrument of claim 11, wherein, The deformation end termination and the pressing end termination are formed and detached from the detachable connection by elastic deformation of the elastically deformed portion in the circumferential direction.

19. The endoscopic surgical implement of claim 18, wherein, The pressing portion is at least one protrusion arranged circumferentially on the pressing end termination and extending in the radial direction, and The deformed end portion has a cylindrical body, a guide groove open to a distal end of the deformed end portion is formed on the cylindrical body, a limiting opening in communication with the guide groove is formed on the cylindrical body, and slits extending axially are formed on both sides of the guide groove, so that the elastic deformation portion is formed between the guide groove and the slits, the elastic deformation portion can be elastically deformed in a circumferential direction to expand the guide groove, thereby allowing the extrusion portion to enter the limiting opening along the guide groove and exit the deformed end portion from the limiting opening along the guide groove.

20. The endoscopic surgical instrument of claim 1, wherein, One of the drive wire sleeve end portion and the control wire sleeve end portion is a plug end portion, and the other is a socket end portion, the plug end portion includes an outer protrusion arranged circumferentially and protruding radially outward, the socket end portion includes an inner protrusion arranged circumferentially and protruding radially inward, a notch portion arranged circumferentially alternately with the inner protrusion, and an inner flange arranged axially and spaced apart from the inner protrusion and the notch portion, and The outer protrusion is configured to be able to enter the socket end portion via the notch portion, and when the outer protrusion is rotated by a preset angle relative to the inner protrusion in the circumferential direction, the inner protrusion is configured to limit the outer protrusion axially between the inner protrusion and the inner flange.

21. The endoscopic surgical instrument of claim 20, wherein, The socket end portion further includes an elastic element and a support portion arranged between the inner protrusion and the inner flange, the elastic element is arranged between the support portion and the inner flange, and is configured to apply an axial outward thrust to the outer protrusion entering the socket end portion via the support portion.

22. The endoscopic surgical instrument of claim 1, wherein, The operation member forms a detachable connection with the distal ends of both the drive wire and the drive wire sleeve.

23. The endoscopic surgical instrument of claim 22, wherein, The operation member is a tissue clamping member.

24. A proximal delivery device for an endoscopic surgical instrument for use in accessing a human environment through an endoscopic channel to perform an operation, the proximal delivery device comprising: A control wire, a control wire sleeve sleeved outside the control wire, and a handle connected to the proximal ends of both the control wire and the control wire sleeve, wherein A distal end of the control wire is provided with a control wire end portion, a distal end of the control wire sleeve is provided with a control wire sleeve end portion, the control wire end portion and the control wire sleeve end portion are configured to form a detachable connection with a proximal end of a distal end operation device delivered by the proximal end delivery device; and The proximal end delivery device is configured such that, during use, the control wire sleeve end portion is located inside an endoscope channel.

25. The proximal delivery device for endoscopic surgical instruments according to claim 24, wherein, The handle can control the movement of the control wire relative to the control wire sleeve, so that the control wire end portion can move between a retracted position located inside the control wire sleeve and an extended position extending out of the control wire sleeve.

26. A remote operation device for an endoscopic surgical instrument for performing an operation through an endoscopic fenestrated channel access to a human environment, the remote operation device comprising: A drive wire, a drive wire sleeve sleeved outside the drive wire, and an operation member connected to the distal ends of both the drive wire and the drive wire sleeve, wherein A proximal end of the drive wire is provided with a drive wire end portion, a proximal end of the drive wire sleeve is provided with a drive wire sleeve end portion, the drive wire end portion and the drive wire sleeve end portion are configured to form a detachable connection with a distal end of a proximal end delivery device for delivering the distal end operation device; and The distal operating device is configured such that, in use, part of the drive wire sleeve protrudes out of the endoscope and the drive wire sleeve termination is located inside the endoscope channel.

27. The distal operation device for endoscopic surgical instruments according to claim 26, wherein, The distal operating device is configured such that the drive wire termination remains protruding from the proximal end of the drive wire sleeve.

28. A proximal delivery device for an endoscopic surgical instrument according to any of claims 1-23.

29. A distal operating device for an endoscopic surgical instrument according to any of claims 1-23.

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