Distal steerable medical instrument and robotic surgical system

Abstract

The utility model provides a far-end controllable medical instrument and a robot operation system using the instrument, wherein the far-end bending capability, the execution capability of an end effector and the motion response capability are taken into account in the far-end controllable medical instrument. According to the actuator actuating wire, the flexural rigidity of the small part of the far end is smaller than the flexural rigidity of the large part of the near end in the length direction, the body part of the large part of the near end bears force transmission, and the first bending part of the small part of the far end can receive large-amplitude passive bending; according to the actuator actuating wire, the axial movement performance (pushability) and the bending performance (flexibility) are both considered, and in other words, on the premise that the bending effect of the controllable arm is met, the end actuator can obtain enough force for corresponding examination and treatment operation and good movement response capacity.

Description

Technical Field

[0001] The utility model relates to a remotely manipulable medical device and a robotic surgery system. Background Art

[0002] A distally steerable medical device has a manipulator at its proximal end, allowing the distal end to be manipulated and bent. It has an actuator wire, and pushing and pulling the actuator wire directly controls the position and posture of the end effector. It's easy to understand that changes in the distal end position of the medical device also cause changes in the end effector position, with the actuator wire passively bending.

[0003] A specific example is a medical device used with a gastroscope. The diameter of a gastroscope's instrument channel is typically around 3 mm, requiring the portion of the medical device that passes through the channel to be no larger than the diameter of the channel. A diameter of 3 mm or less reduces the deflection torque required to manipulate the distal end of the medical device, making distal manipulation of such devices more difficult. One factor influencing the bending performance of medical devices is the bending stiffness of the actuator wire. When the bending stiffness of the actuator wire is too high, it is less likely to bend passively, which can affect the manipulation of the distal end of the medical device.

[0004] At the same time, due to the slender structure of this medical device, maintaining the end effector's actuating force (especially the force required to achieve operations such as pulling, grasping, and grabbing) and response speed requires maintaining the effective diameter of the actuator wire. Simply reducing the overall diameter of the actuator wire can easily cause the actuator wire to bend when push and pull forces are applied to the actuator wire. This can lead to a decrease in the actuating ability of the end effector at its distal end and a delay in the end effector's movement (a decrease in response speed). Utility Model Content

[0005] The utility model provides a distally manipulable medical device which takes into account distal bending capability, end effector execution capability and motion response capability, and a robotic surgery system using the device.

[0006] A distally steerable medical device, comprising:

[0007] A maneuverable arm, wherein the maneuverable arm can be manipulated to bend, and the maneuverable arm is configured to have a first inner cavity running through the length direction of the maneuverable arm;

[0008] an end effector carried by the maneuverable arm, the end effector being operably controlled by an effector actuation wire;

[0009] The actuator wire has a main body portion and a first bend portion along its own length, the first bend portion extends within the first inner cavity of the manipulator arm and is connected to the end effector, the actuator wire is allowed to advance and retract axially, and the first bend portion is passively bent when the manipulator arm bends, and the first bend portion has a bending stiffness smaller than that of the main body portion.

[0010] Preferably, a cross-sectional area of ​​the first curved portion is smaller than a cross-sectional area of ​​the main body portion.

[0011] Preferably, the main body and the first bent portion are integrally formed by welding, or the first bent portion is obtained by partial grinding of the main body.

[0012] Preferably, the first curved portion includes a transition section.

[0013] Preferably, the first curved portion has a first starting point located at the end of the main body portion, and the first starting point is located outside the first inner cavity covered by the maneuverable arm.

[0014] Preferably, the end effector is connected to the first bend through a first connecting member, the first connecting member is constructed with a sleeve structure, the outer diameter of the distal end of the first bend matches the inner diameter of the sleeve structure, and the distal end of the first bend is inserted into the sleeve structure and fixed.

[0015] Preferably, the steerable arm is configured to be actuated to bend by at least one bending actuation wire.

[0016] Preferably, the maneuverable arm is formed by a plurality of curved segments connected in series.

[0017] Preferably, the maneuverable arm is formed by making at least one cut in a metal tube.

[0018] Preferably, the medical device further comprises a sheath, wherein the sheath defines a travel path of the actuator actuating wire.

[0019] Preferably, the sheath is made of a lubricating material.

[0020] Preferably, the sheath is configured as a wire spiral tube.

[0021] A distally steerable medical device, which is delivered to a treatment site through an instrument channel of an endoscope, comprising:

[0022] A maneuverable arm, wherein the maneuverable arm can be manipulated to bend, and the maneuverable arm is configured to have a first inner cavity running through the length direction of the maneuverable arm;

[0023] an end effector carried by the maneuverable arm, the end effector being operably controlled by an effector actuation wire;

[0024] The actuator wire has a main body portion and a first bend portion along its own length, the first bend portion extends within the first inner cavity of the manipulator arm and is connected to the end effector, the actuator wire is allowed to advance and retract axially, and the first bend portion is passively bent when the manipulator arm bends, and the first bend portion has a bending stiffness smaller than that of the main body portion.

[0025] Preferably, a cross-sectional area of ​​the first curved portion is smaller than a cross-sectional area of ​​the main body portion.

[0026] Preferably, the main body and the first bent portion are integrally formed by welding, or the first bent portion is obtained by partial grinding of the main body.

[0027] Preferably, the first curved portion includes a transition section.

[0028] Preferably, the medical instrument passes through the instrument channel, and an instrument channel outlet at the distal end of the instrument channel provides an anchor point to support the bending of the maneuverable arm extending out of the instrument channel.

[0029] Preferably, the first curved portion has a first starting point located at the end of the main body portion, and during use of the medical device, the first starting point does not exceed the anchor point.

[0030] Preferably, the first curved portion has a first starting point located at the end of the main body portion, and the first starting point is located outside the first inner cavity covered by the maneuverable arm.

[0031] Preferably, the end effector is connected to the first bend through a first connecting member, the first connecting member is constructed with a sleeve structure, the outer diameter of the distal end of the first bend matches the inner diameter of the sleeve structure, and the distal end of the first bend is inserted into the sleeve structure and fixed.

[0032] Preferably, the medical device is provided with a torque decoupling member to decouple the torque applied to the maneuverable arm from the torque applied to the actuator wire.

[0033] Preferably, the torque separation member is configured in a circular ring shape, and the torque separation member is defined between an inner circumferential surface of the maneuverable arm and an outer circumferential surface of the first connecting member.

[0034] Preferably, the torque decoupling member is configured as a bearing, comprising an outer ring and an inner ring, wherein the outer ring and the inner ring are connected to the maneuverable arm and the first connecting member respectively.

[0035] Preferably, the steerable arm is configured to be actuated to bend by at least one bending actuation wire.

[0036] Preferably, the steerable arm is configured as a flexible tube.

[0037] Preferably, the maneuverable arm is formed by a plurality of curved segments connected in series.

[0038] Preferably, the maneuverable arm is formed by making at least one cut in a metal tube.

[0039] Preferably, the steerable arm is configured as a wire coil.

[0040] Preferably, the medical device further comprises a sheath, wherein the sheath defines a travel path of the actuator actuating wire.

[0041] Preferably, the sheath is made of a lubricating material.

[0042] Preferably, the sheath is configured as a wire spiral tube.

[0043] A distally steerable medical device, attached to the exterior of the distal end of an endoscope via a parallel connection, and delivered to a treatment site along with the endoscope, comprising:

[0044] A maneuverable arm, wherein the maneuverable arm can be manipulated to bend, and the maneuverable arm is configured to have a first inner cavity running through the length direction of the maneuverable arm;

[0045] an end effector carried by the maneuverable arm, the end effector being operably controlled by an effector actuation wire;

[0046] The actuator wire has a main body portion and a first bend portion along its own length, the first bend portion extends within the first inner cavity of the manipulator arm and is connected to the end effector, the actuator wire is allowed to advance and retract axially, and the first bend portion is passively bent when the manipulator arm bends, and the first bend portion has a bending stiffness smaller than that of the main body portion.

[0047] Preferably, a cross-sectional area of ​​the first curved portion is smaller than a cross-sectional area of ​​the main body portion.

[0048] Preferably, the main body and the first bent portion are integrally formed by welding, or the first bent portion is obtained by partial grinding of the main body.

[0049] Preferably, the first curved portion includes a transition section.

[0050] Preferably, the medical device extends out through the parallel connector, and the second end portion at the distal end of the parallel connector provides an anchor point to support the bending of the steerable arm that is separated from the parallel connector.

[0051] Preferably, the first curved portion has a first starting point located at the end of the main body portion, and during use of the medical device, the first starting point does not exceed the anchor point.

[0052] Preferably, the first curved portion has a first starting point located at the end of the main body portion, and the first starting point is located outside the first inner cavity covered by the maneuverable arm.

[0053] Preferably, the end effector is connected to the first bend through a first connecting member, the first connecting member is constructed with a sleeve structure, the outer diameter of the distal end of the first bend matches the inner diameter of the sleeve structure, and the distal end of the first bend is inserted into the sleeve structure and fixed.

[0054] Preferably, the medical device is provided with a torque decoupling member to decouple the torque applied to the maneuverable arm from the torque applied to the actuator wire.

[0055] Preferably, the torque separation member is configured in a circular ring shape, and the torque separation member is defined between an inner circumferential surface of the maneuverable arm and an outer circumferential surface of the first connecting member.

[0056] Preferably, the torque decoupling member is configured as a bearing, comprising an outer ring and an inner ring, wherein the outer ring and the inner ring are connected to the maneuverable arm and the first connecting member respectively.

[0057] Preferably, the steerable arm is configured to be actuated to bend by at least one bending actuation wire.

[0058] Preferably, the steerable arm is configured as a flexible tube.

[0059] Preferably, the maneuverable arm is formed by a plurality of curved segments connected in series.

[0060] Preferably, the maneuverable arm is formed by making at least one cut in a metal tube.

[0061] Preferably, the steerable arm is configured as a wire coil.

[0062] Preferably, the medical device further comprises a sheath, wherein the sheath defines a travel path of the actuator actuating wire.

[0063] Preferably, the sheath is made of a lubricating material.

[0064] Preferably, the sheath is configured as a wire spiral tube.

[0065] A robotic surgical system using the above-mentioned medical instrument includes an instrument controller, and the medical instrument includes a manipulator, wherein the manipulator is configured with an interface coupled to the instrument controller. When the manipulator is coupled to the instrument controller, the manipulator can be controlled to manipulate the bending of the manipulatable arm, and the manipulator can advance or retract the actuator wire; when the manipulator is decoupled and separated from the instrument controller, the two no longer operate together.

[0066] Preferably, the manipulator is equipped with a torque transmission member fixed to the proximal end of the actuator wire. When the manipulator is coupled to the instrument controller, the manipulator can be controlled to rotate the actuator wire around its own axis.

[0067] The medical device of the present invention arranges the actuator actuating wire in the length direction so that the bending stiffness of the distal small part is smaller than the bending stiffness of the proximal large part. The main body of the proximal large part is responsible for the transmission of force, and the first bending part of the distal small part can accept a relatively large range of passive bending. The actuator actuating wire is able to take into account both axial movement performance (pushability) and bending performance (flexibility). That is, under the premise of satisfying the bending effect of the manipulator arm, the end effector can obtain sufficient force and good movement response capability to perform corresponding inspection and treatment operations. BRIEF DESCRIPTION OF THE DRAWINGS

[0068] Figure 1 A schematic diagram of the connection structure between the actuator wire and the end effector provided in one embodiment of the utility model;

[0069] Figure 2 A schematic diagram of the connection structure of a manipulable arm and an end effector provided in one embodiment of the present invention (the bending actuator wire is not shown);

[0070] Figure 3 for Figure 2 An exploded view of the distal end of a medical device in an embodiment (the bending actuation wire is not shown);

[0071] Figure 4 for Figure 2 A schematic structural diagram of the end effector in the embodiment;

[0072] Figure 5 for Figure 2 A schematic structural diagram of a fork-shaped connector in an embodiment;

[0073] Figure 6 for Figure 2 A schematic structural diagram of the first connecting member in the embodiment;

[0074] Figure 7 and Figure 8A schematic diagram of the partial structure of a manipulable arm provided by one embodiment of the present invention (the actuator actuating wire and the bending actuating wire are not shown);

[0075] Figure 9 This is a schematic diagram of the structure of a traditional gastroenteroscopy;

[0076] Figure 10 A schematic structural diagram of a medical device provided in one embodiment of the present utility model;

[0077] Figure 11 、 Figure 12 、 Figure 13 Schematic diagrams of the connection structures of the manipulable arms and the bending actuating wires in several embodiments of the present invention;

[0078] Figure 14 A schematic diagram of the connection structure of a manipulable arm, a sheath, and an actuator actuating wire according to one embodiment of the present invention (the bending actuating wire is not shown);

[0079] Figure 15 A schematic diagram of the connection structure between a medical device provided by another embodiment of the present invention and a traditional gastroenteroscope;

[0080] Figure 16 for Figure 15 Schematic diagram of the connection structure of the maneuverable arm and the bending actuator wire in the embodiment;

[0081] Figure 17 and Figure 18 A schematic diagram of the internal structure of a manipulator provided by one embodiment of the present utility model;

[0082] Figure 19 for Figure 17 A schematic structural diagram of the first slider in the embodiment;

[0083] Figure 20 for Figure 17 Schematic diagram of the structure of the second sliding block in the embodiment.

[0084] The reference numerals involved are as follows:

[0085] Operation portion 110, insertion portion 120, second bending portion 130, instrument channel entrance 140, distal hard portion 150, instrument channel exit 160, parallel connector 170, auxiliary channel exit 171, manipulator 200, first slider 210, first guide hole 211, second guide hole 212, third guide hole 213, boss 214, second slider 220, third slider 230, base 250, guide rod 261, sheath 300, manipulator arm 400, first inner cavity 401, second inner cavity 402, extension hole 403, curved segment 4 04, sheath 405, inner layer 406, outer layer 407, bending actuator wire 410, torque separator 420, end actuator 500, first link 501, second link 502, first pivot pin 505, third link 503, fourth link 504, second pivot pin 506, first connecting member 507, sleeve structure 508, second connecting member 509, actuator actuator wire 510, main body 511, first bend 512, transition section 513, first starting point 514, fork-shaped connecting member 521, tube 522, arm 523. DETAILED DESCRIPTION

[0086] It should be noted that, in the absence of conflict, the embodiments and features of the embodiments of the present invention can be combined with each other. The present invention will be described in detail below with reference to the accompanying drawings and in combination with the embodiments.

[0087] In the description of this utility model, the terms "proximal end" and "distal end" will be used to describe the axially opposite ends of the device and the axial ends of various component features. The term "proximal end" is used in its conventional sense to refer to the end of the device (or component) that is closest to the medical professional during use of the assembly. The term "distal end" is used in its conventional sense to refer to the end of the device (or component) that is initially inserted into the patient's body or is closest to the patient during use.

[0088] It should also be noted that, in the description of this utility model, unless otherwise expressly specified or limited, the terms "connected" and "connection" should be understood in a broad sense. For example, it can mean a fixed connection, a detachable connection, or an integral connection; it can mean a direct connection, an indirect connection through an intermediate medium, or internal communication between two components. For those skilled in the art, the specific meanings of the above terms in this utility model can be understood according to the specific circumstances.

[0089] The medical device of the present invention is suitable for entering the body through natural cavities or micro-incisions for examination and treatment. The device can be used alone or attached to another device and transported together with the device to the treatment site for examination and treatment. The examination and treatment procedures described herein may include traction, grasping, grasping, suturing, electrocoagulation, and cutting.

[0090] The medical device of the embodiment of the present utility model includes a manipulator 200, a manipulatable arm 400 and an end effector 500. The manipulator 200 is used to manipulate the bending of the manipulatable arm 400 and to manipulate the end effector 500 for inspection and treatment. The manipulator 200 can be manual or electric. The manual manipulator 200 is respectively connected to the bending actuator wire 410 and the actuator actuator wire 510 and provides an operation interface. The operation interface is constructed as a slide groove and a slide handle provided on the handle, or a wrench, or a knob. By operating the operation interface, the operator can pull and release the bending actuator wire 410, thereby controlling the bending of the manipulatable arm 400; the operator can also push and pull the actuator actuator wire 510, thereby controlling the end effector 500 for inspection and treatment.

[0091] Figure 10 The manipulator 200 in the illustrated embodiment is suitable for a robotic surgery system, and embodiments suitable for a robotic surgery system will be further described below.

[0092] In the embodiment of the manual manipulator 200, the proximal end of the manipulator arm 400 is connected to the sheath 300. The sheath 300 is constructed as a rigid or semi-rigid tubular structure to provide the necessary support and stability. The sheath 300 serves as a channel for transmitting actuation wires or other functional connectors, and its proximal and distal ends are connected to the manipulator 200 and the manipulator arm 400, respectively.

[0093] The manipulator arm 400 is configured to be positioned according to actuation of the manipulator 200 . In some embodiments, the manipulator arm 400 may include one or more curved segments, which may be a continuous structure driven by a wire.

[0094] The maneuverable arm 400 carries an end effector 500, which is operably controlled by an actuator wire 510. The maneuverable arm is configured to have a first lumen 401 extending through its length to accommodate the actuator wire 510. Figure 2 、 Figure 7 In the embodiment shown, the first lumen 401 is located at the longitudinal center axis of the maneuverable arm 400. Although not shown in the figure, it is understood that Figure 2 、 Figures 11 to 13 In the illustrated embodiment, the actuator wire 510 extends from the end effector 500 through the first lumen 401 of the steerable arm 400 and the lumen of the sheath 300 to the proximal manipulator 200 .

[0095] The end effector 510 can be smooth jaws, serrated jaws, a clamp, scissors, an electric scalpel, a stapler, a needle holder, a stapler, or the like.

[0096] Figure 4In the embodiment shown, the end effector 510 is a serrated jaw. When the actuator wire 510 is advanced and retracted, the distal clamp will open and close, thereby achieving traction / holding / grasping of human tissue. Figure 4 The end effector shown includes a four-bar linkage mechanism, in which the first link 501 and the second link 502 are connected by a first pivot pin 505, and the third link 503 and the fourth link 504 are connected by a second pivot pin 506. The distal end of the actuator actuating wire 510 is connected to the second pivot pin 506, and the first link 501 and the second link 502 are extended respectively to form a clamp.

[0097] like Figure 3 As shown, a fork-shaped connector 521 serves as an intermediary to connect the end effector 500 and the maneuverable arm 400. The fork-shaped connector 521 comprises a tube 522 and an arm 523. The tube 522 is sleeved onto the distal end of the maneuverable arm 400 and secured by welding. The distal end of the actuator wire 510 passes through the tube 522 and connects to the second pivot pin 506. The ends of the first pivot pin 505 are respectively connected to the arm 523. When the actuator wire 510 is advanced or retracted, the position of the first pivot pin 505 remains relatively fixed, while the second pivot pin 506 moves closer to or further from the first pivot pin 505, resulting in the distal clamp opening or closing.

[0098] In another optional configuration, the end effector 500 includes a pair of jaws pivotally connected to each other, wherein an actuator wire 510 is operably connected to at least one jaw of the pair of jaws, and wherein actuation of the actuator wire 510 is configured to cause the pair of jaws to pivot relative to each other.

[0099] The actuator wire 510 includes a main body portion 511 and a first curved portion 512 along its length. The first curved portion 512 extends within the first lumen 401 of the manipulable arm 400 and is connected to the end effector 500. It should be noted that this connection can be direct or indirect via an intermediary. The actuator wire 510 is allowed to advance and retract axially, and the first curved portion 512 passively bends when the manipulable arm 400 bends. The first curved portion 512 has a lower bending stiffness than the main body portion 511.

[0100] Here, we need the actuator wire 510 to be able to effectively transmit force to the distal end when subjected to axial force, thereby actuating the distal end effector 500, while not providing additional resistance when the manipulable arm 400 bends. For a slender actuator wire, high bending stiffness means that it can maintain its original straight state when subjected to external force and is not easily bent or deformed. Therefore, the first curved portion 512 has a lower bending stiffness than the main portion 511. The main portion 511 constitutes the majority of the actuator wire 510's length and is able to effectively transmit axial force. The first curved portion 512 constitutes a smaller portion of the actuator wire 510's length and is more susceptible to passive bending. Since it occupies a small proportion of the actuator wire 510's length, its impact on axial force transmission is also minimal.

[0101] The actuator wire 510 is typically made of metal. For example, the actuator wire 510 can be a steel wire or a nickel-titanium wire. To achieve a first curved portion 512 with a lower bending stiffness than the main portion 511, the main portion 511 and the first curved portion 512 can be made of different materials. The bending stiffness of the first curved portion 512 is only required to be lower than that of the main portion 511.

[0102] In certain embodiments, the cross-sectional area of ​​the first curved portion 512 is smaller than that of the main body 511. This smaller cross-sectional area can provide the first curved portion 512 with a lower bending stiffness. The ratio of the cross-sectional area of ​​the main body 511 to the cross-sectional area of ​​the first curved portion 512 can be between three-quarters and one-third. For example, the diameter of the main body can be 0.5 mm, and the diameter of the first curved portion can be 0.3 mm.

[0103] The main body 511 and the first curved portion 512 can be integrally formed by welding. More specifically, the main body 511 and the first curved portion 512 can be resistance welded together by butting the ends of two slender metal wires together. Other welding methods that can be used include pressure welding, friction welding, ultrasonic welding, magnetic welding, laser welding, hot pressure welding, plasma welding, cladding welding, etc.

[0104] In some specific embodiments, the first curved portion 512 is obtained by partially rotating and grinding the main body portion 511. Figure 1In the illustrated embodiment, after localized rotational grinding, a transition section 513 with a gradually changing cross-sectional area may be formed between the two sections with different cross-sectional areas. Compared to the bending stiffness of the main body 511, the transition section 513 has already begun to have a lower bending stiffness. Therefore, the transition section 513 is considered to be part of the first curved portion 512. For the same reason, the distal end of the main body 511 is designated as the first starting point 514, which is also the starting point of the first curved portion 512.

[0105] It should be noted that the so-called "point" of the first starting point 514 is a basic element without size, shape and dimension, used to represent a position. Figure 1 and Figure 2 As shown, the first starting point 514 may be an area included in the cross section that meets the above conditions.

[0106] To achieve the desired effect of the present invention and minimize the effect of the actuator wire 510 on the flexible bending of the maneuverable arm 400, the first starting point 514 is preferably located outside the first inner cavity 401 covered by the maneuverable arm 400. Furthermore, even when the actuator wire 510 is advanced to the limit of its preset travel, the first starting point 514 remains outside the first inner cavity 401 covered by the maneuverable arm 400.

[0107] When the main body 511 and the first bend 512 are welded together, the diameter change (cross-sectional area change) is relatively abrupt, possibly with a step-like connection. Of course, the distal end of the main body 511 is still referred to as the first starting point 514, which is also the starting point of the first bend 512.

[0108] In certain specific embodiments, such as Figure 3 As shown, the end effector 500 is connected to the first bending portion 512 via the first connecting member 507. Figure 6 As shown, one end of the first connecting member 507 is configured with a sleeve structure 508, and a small section of the distal end of the first curved portion 512 is inserted into the sleeve structure 508 and fixed, such as by welding. The other end of the first connecting member 507 is provided with a through hole for the second pivot pin 506 to pass through.

[0109] In some specific embodiments, the medical device of the present invention can be attached to another main body device and transported together with the main body device to a treatment site for inspection and treatment. A typical embodiment of the main body device is a medical endoscope.

[0110] A medical endoscope is a device that enters the body through natural cavities or tiny incisions for visual inspection and treatment. Endoscopes can be either soft or rigid.

[0111] The main components of a medical endoscope include an outer cannula and an imaging system. The outer cannula is constructed as a slender insertion tube with an instrument channel for advancing / retracting other medical instruments.

[0112] Taking soft endoscope as an example, Figure 9 The illustrated gastroenteroscope comprises, from proximal to distal, an operating section 110, an insertion section 120, a second bending section 130, and a distal rigid section 150. The operating section 110 is the primary area where the physician controls the endoscope to perform various operations. It is equipped with multiple control elements and interfaces for adjusting the endoscope's posture, executing specific functions, and connecting to external devices. The operating section 110 is provided with an instrument channel entrance 140 for inserting various surgical instruments, such as biopsy forceps and injection needles, for further examination or treatment under endoscopic guidance. The insertion section 120 is the main portion of the endoscope that enters the human body. The second bending section 130 is the distal end of the endoscope that can be flexed according to user manipulation. Specifically, the second bending section 130 is composed of multiple movable annular parts or joints that can move relative to each other in a predetermined manner. This design allows the user to control the bending direction and angle of the second bending section 130 via the joystick or angle knob on the operating section 110. The front hard portion 150 is a relatively hard portion used to protect the optical components (such as the lens group) at the front end. The light guide window and the instrument channel outlet are also located here.

[0113] In certain specific embodiments, the medical device of the present invention can be delivered to the treatment site through the instrument channel of an endoscope for inspection and treatment operations. The inspection and treatment operations mentioned here can include pulling, grasping, grasping, suturing, electrocoagulation, cutting, etc.

[0114] Because it needs to pass through the instrument channel, the proximal end of the maneuverable arm 400 is connected to a flexible sheath 300 to accommodate the bending operation of the soft endoscope. The distal end of the maneuverable arm 400 extends from the instrument channel outlet 160 at the distal end of the instrument channel. The mouth of the instrument channel outlet 160 provides an anchor point to support the bending of the maneuverable arm 400 extending from the instrument channel, thereby enabling the maneuverable arm 400 and the end effector 500 to achieve a specific position and posture.

[0115] To achieve the desired effect of the present invention and minimize the effect of the actuator wire 510 on the flexible bending of the manipulable arm 400 , at least one of the following two conditions may be met:

[0116] The first condition is that, as previously described, the first curved portion 512 has a first starting point 514 located at the end of the main body 511. During use of the medical device, the first starting point 514 does not cross the anchor point (i.e., the end of the instrument channel outlet 160). Furthermore, even when the actuator wire 510 is advanced to the limit of the preset stroke, the first starting point 514 does not cross the anchor point.

[0117] The second condition is that the first curved portion 512 has a first starting point 514 located at the end of the main body 511. The first starting point 514 is located outside the first inner cavity 401 covered by the manipulator arm 400. In other words, the first starting point 514 does not fall within the range surrounded by the manipulator arm 400. Most of the length of the first curved portion 512 falls within the range surrounded by the manipulator arm 400. For example, Figure 2 In the illustrated embodiment, the L region shows the range encompassed by the maneuverable arm 400 , and the first starting point 514 is located outside the L region; Figure 11 and Figure 12 In the illustrated embodiment, the portion extending distally from the extension hole 403 is regarded as the maneuverable arm 400, and the first starting point 514 does not fall within the range surrounded by the maneuverable arm 400; Figure 13 In the illustrated embodiment, the portion extending distally from the proximal end of the cutout on the metal tube is considered the manipulable arm 400, and the first starting point 514 does not fall within the range encompassed by the manipulable arm 400. Furthermore, even when the actuator wire 510 is advanced to the limit of the preset stroke, the first starting point 514 is still outside the first inner cavity 401 covered by the manipulable arm 400.

[0118] In some embodiments, the manipulator arm 400 is configured to bend by at least one bending actuation wire 410. The bending actuation wire 410 may be disposed within the first lumen 401 (e.g., Figure 13 The embodiment shown in FIG. 4 may also be arranged on the periphery of the manipulable arm 400 (eg Figure 11 、 Figure 12 、 Figure 16 In the embodiment shown in FIG. 4 , a second inner cavity 402 (such as FIG. 402 ) for arranging the bending actuator wire 410 can also be constructed in the body of the manipulator arm 400. Figure 8 It should be noted that the above embodiment does not limit the arrangement of the bending actuator wire 410, but rather illustrates a variety of possible arrangements of the bending actuator wire 410. Those skilled in the art can flexibly configure the arrangement as needed based on the inspiration of the present invention.

[0119] If the maneuverable arm 400 is required to achieve more bending directions, the number of bending actuating wires 410 can be increased, such as using two, three, four, six, eight, or even more strands. In this case, the multiple strands of bending actuating wires 410 can be evenly distributed or offset appropriately based on the expected bending motion of the maneuverable arm 400.

[0120] In some specific embodiments, the manipulator arm 400 is constructed as a flexible tubing. As mentioned above, since the medical device of the embodiment of the utility model passes through the instrument channel, the proximal end of the manipulator arm 400 is connected to a flexible sheath 300 to accommodate the bending operation of the soft endoscope. Here, the manipulator arm 400 and the sheath 300 can be an integral structure. The flexible tubing needs to bend during use, and the actuating wire or other functional connectors need to pass through the lumen. This requires that the tubing should be able to provide the necessary support to maintain the stability of the lumen and facilitate the introduction and operation of the actuating wire or other functional connectors. Therefore, the flexible tubing needs to have anti-bending ability. In addition, the flexible tubing also needs to have anti-deformation ability and biocompatibility. To this end, the material of the flexible tubing can be selected from polyurethane (TPU), polytetrafluoroethylene (PTFE), etc.

[0121] The flexible tube can also be a multi-layer braided tube. For example, the inside of the cavity is made of polytetrafluoroethylene (PTFE) material to reduce the friction of the cavity on the actuating wire; the middle layer is woven with stainless steel material to provide sufficient support function to ensure that the sheath will not be squeezed and deformed when passing through the instrument channel of the endoscope, affecting the traction effect of the actuating rope; the outermost layer is polyether block amide (PEBAX) material to provide support and anti-torsion performance.

[0122] In certain embodiments where the maneuverable arm 400 is configured as a flexible tube, at least one anchoring ring (not shown) is embedded within the arm 400, while a bending actuation wire 410 is disposed within the sidewall of the tube and extends axially along the tube. The ends of the bending actuation wire 410 are connected to the manipulator 200 and the anchoring ring, respectively. By operating the manipulator 200, the bending actuation wire 410 can be pulled, thereby causing the distal end of the tube (maneuverable arm 400) to bend.

[0123] In other embodiments where the maneuverable arm 400 is configured as a flexible tube, Figure 11 As shown, the distal end of the sheath tube 300 is provided with an extension hole 403 , and the bending actuator wire 410 originally extending in the lumen of the sheath tube 300 passes through the extension hole 403 and finally its distal end is connected to the distal end of the maneuverable arm 400 .

[0124] In some specific embodiments, the manipulator arm 400 is formed by connecting a plurality of curved segments 404 in series. The curved segments 404 can have a variety of different structural forms. The curved segments 404 can be ring-shaped or block-shaped (e.g., Figure 2The curved segments 404 may be hinged or slidably connected between projections and grooves (the curved segments 404 are adjacent to each other and can move relative to each other at an angle).

[0125] In such Figure 7 and Figure 8 In the embodiment shown, the manipulable arm 400 is constructed with a first lumen 401 and a second lumen 402, which respectively provide paths for the actuator actuating wire 510 and the bending actuating wire 410 to pass through. Figure 8 In the illustrated embodiment, a total of six second lumens 402 are provided. For simplicity, only three of the second lumens 402 are shown in dashed lines. It is understood that the through hole provided on each curved segment 404 may form a first lumen 401 and a second lumen 402 for transmitting the actuating wire. Figure 7 and Figure 8 In the illustrated embodiment, only four bending segments 404 are shown. The bending segments 404 have inclined surfaces, thereby forming a maneuverable arm 400 that can be bent within a certain range.

[0126] In some specific embodiments, the manipulator arm 400 is formed by cutting a metal tube at least once. The cutting method can be horizontal cutting, oblique cutting or spiral cutting, and the material of the metal tube can be a memory alloy. Figure 12 In the embodiment shown, the distal end of the sheath 300 is provided with an extension hole 403, and the bending actuator wire 410 originally extending in the lumen of the sheath 300 passes through the extension hole 403 and finally its distal end is connected to the distal end of the maneuverable arm 400. Figure 13 In the illustrated embodiment, a bend actuation wire 410 that originally extends within the lumen of the sheath 300 is connected to the distal end of the steerable arm 400 .

[0127] It should be noted that the above embodiment does not constitute a limitation on the connection method of the manipulator arm 400 and the bending actuator wire 410, but rather shows a variety of possible connection methods of the manipulator arm 400 and the bending actuator wire 410. Technicians in the relevant field can make flexible choices according to their needs under the guidance of the present invention.

[0128] In some specific embodiments, the medical device of the present invention further includes a sheath 405 , which defines a travel path for the actuator actuating wire 510 .

[0129] In some embodiments, the sheath 405 is made of a lubricating material, preferably a low-friction resin such as polytetrafluoroethylene (PTFE), polychlorotrifluoroethylene (PCTFE), polyvinylidene fluoride (PVDF), ethylene-tetrafluoroethylene copolymer (ETFE), ethylene-chlorotrifluoroethylene copolymer (ECTFE), polyvinyl fluoride (PVF), etc. Such a sheath 405 can facilitate smoother travel of the actuator wire 510.

[0130] In other embodiments, the sheath 405 is configured as a wire spiral tube. The wire spiral tube is formed by tightly winding a wire in the form of a spiral line, forming a hollow tube inside. This structure has a certain degree of elasticity and toughness. In order to make the actuator actuating wire 510 pass through more smoothly, the wire spiral tube can also be dipped in a lubricating resin. Similarly, resins with a low friction coefficient can be selected, such as polytetrafluoroethylene (PTFE), polychlorotrifluoroethylene (PCTFE), polyvinylidene fluoride (PVDF), ethylene-tetrafluoroethylene copolymer (ETFE), ethylene-chlorotrifluoroethylene copolymer (ECTFE), polyvinyl fluoride (PVF), etc.

[0131] Figure 14 In the illustrated embodiment, the sheath 405 is constructed as a composite structure, comprising an inner layer 406 made of a lubricating material and an outer layer 407 constructed as a metal wire spiral tube. This structure allows the actuator wire 510 to pass through more smoothly while also providing the manipulable arm 400 with a certain degree of elasticity and toughness.

[0132] In certain specific embodiments, such as Figure 3 As shown, the end effector 500 is connected to the first bending portion 512 via the first connecting member 507. Figure 6 As shown, one end of the first connecting member 507 is constructed with a sleeve structure 508, and a small section of the distal end of the first curved portion 512 is inserted into the sleeve structure 508 and fixed, and the fixing method can be welding.

[0133] In some specific embodiments, the medical device of the present invention is further configured with a torque separation member 420 to separate the torque applied to the manipulable arm 400 from the torque applied to the actuator actuating wire 510 .

[0134] In some embodiments, the torque separator 420 is configured as a circular ring, and the torque separator 420 is defined between the inner circumference of the manipulable arm 400 and the outer circumference of the first connecting member 507. Figure 3 As shown, the torque separation member 420 is confined between the inner circumference of the second connecting member 509 and the outer circumference of the sleeve structure 508 of the first connecting member 507. At this time, the outer wall and the inner wall of the ring of the torque separation member 420 can be slidingly connected to the inner circumference of the second connecting member 509 and the outer circumference of the sleeve structure 508 respectively.

[0135] In other embodiments, the torque separator 420 is configured as a bearing, and the bearing includes an outer ring and an inner ring, wherein the outer ring and the inner ring are connected to the maneuverable arm 400 and the first connecting member 507 respectively.

[0136] In certain embodiments, the medical device of the present invention is attached to the exterior of the distal end of an endoscope (e.g., the hard portion 150 of a flexible endoscope) and is delivered to the treatment site along with the distal end of the endoscope. To facilitate attachment of the medical device to the exterior of the distal end of the endoscope, a parallel connector 170 is required. Figure 15 and Figure 16 In the illustrated embodiment, one side of the parallel connector 170 is sleeved on the distal end hard portion 150 of the flexible endoscope, while the other side has an auxiliary channel for the maneuverable arm 400 to pass through and extend.

[0137] It should be noted that the structure of the parallel connection member 170 is not limited to Figure 15 In the embodiment shown, as long as the medical device of the present invention can be bound to the distal end of the endoscope in a suitable manner to form a stable connection relationship, the manipulable arm 400 and the end effector 500 of the medical device can pass through the auxiliary channel provided by the parallel connector 170 and can be manipulated to perform certain inspection and treatment operations. Such a structure is a suitable structure of the parallel connector 170.

[0138] Figure 16 for Figure 15 A schematic diagram of the connection structure between the maneuverable arm and the bending actuator wire in an embodiment. The illustrated structure is another embodiment of a maneuverable arm 400, which is configured as a wire spiral. A wire spiral is formed by tightly winding a wire in a spiral, forming a hollow tube inside. A wire spiral is typically made of a metal material with excellent biocompatibility, corrosion resistance, and mechanical strength, such as stainless steel or titanium alloy.

[0139] In some embodiments, as Figure 16 As shown, the proximal and distal ends of a sheath 300 are connected to a manipulator 200 (not shown) and a parallel connector 170, respectively. A manipulator arm 400 configured as a wire spiral tube extends within the sheath 300, and a bending actuator wire 410 is disposed outside the manipulator arm 400. Here, the sheath 300 may be configured as a multi-lumen tube, with the manipulator arm 400 and the bending actuator wire 410 respectively passing through different lumens of the multi-lumen tube and extending distally from different lumens of the multi-lumen tube. The distal end of the bending actuator wire 410 is ultimately connected to the distal end of the manipulator arm 400 or the end effector 500.

[0140] The distal end of the manipulable arm 400 extends from the auxiliary channel outlet 171 at the distal end of the parallel connector 170. The mouth of the auxiliary channel outlet 171 provides an anchor point to support the bending of the manipulable arm 400 extending out of the auxiliary channel (detached from the parallel connector 170), so that the manipulable arm 400 and the end effector 500 can obtain a certain position and posture. It should be noted that in order to avoid unnecessary damage to human tissue caused by the end effector 500 during the process of being inserted into the human body, the parallel connector 170 has a structure with a space for accommodating the end effector 500. Therefore, the auxiliary channel outlet 171 may be lower than the farthest end of the parallel connector 170 (such as Figure 16 shown).

[0141] To achieve the desired effect of the present invention and minimize the impact of the actuator wire 510 on the flexible bending of the manipulable arm 400, at least one condition must be met: as previously described, the first curved portion 512 has a first starting point 514 located at the end of the main body 511. During use of the medical device, the first starting point 514 does not extend beyond the anchor point (i.e., the end of the auxiliary channel outlet 171). Furthermore, even when the actuator wire 510 is advanced to the limit of its predetermined travel, the first starting point 514 does not extend beyond the anchor point.

[0142] It should be noted that Figure 2 、 Figure 11 、 Figure 12 and Figure 13 The illustrated embodiment of the maneuverable arm 400 may still be adapted to be attached to the exterior of the distal end of an endoscope (eg, the distal hard portion 150 of a flexible endoscope) via a parallel connection 170 and transported along with the distal end of the endoscope to a treatment site.

[0143] As another aspect, the present invention also provides a robotic surgery system, which, in addition to the aforementioned remotely manipulable medical instrument, also includes an instrument controller, a user input device, and a control module.

[0144] One or more instrument controllers configured to move and position a medical instrument having an end effector. Each instrument controller includes one or more motors.

[0145] The user input device (eg, one or more hand control devices, one or more foot pedals, one or more buttons on one or more input control devices) is connected to the control module to provide control signals.

[0146] The control module receives control signals from the user input device and switches between multiple operation modes according to these signals, and / or sends control commands to operate one or more instrument controllers.

[0147] The manipulator 200 of the medical device is configured with an interface coupled to the device controller, and the manipulator 200 is controllably connected to the proximal end of the bending actuation wire 410 and the proximal end of the actuator actuation wire 510 .

[0148] When the manipulator 200 is coupled to the interface of the instrument controller, the manipulator 200 can be controlled to manipulate the bending of the manipulatable arm 400 through the bending actuator wire 410, and / or manipulate the end actuator 500 to perform medical operations through the actuator actuator wire 510; when the manipulator 200 is decoupled and separated from the instrument controller, the two no longer operate together.

[0149] Figure 17 and Figure 18 The internal structure of the manipulator 200 provided by one embodiment of the present invention (the housing is not shown), wherein the advancement or retreat of the first slider 210 ultimately results in the advancement or retreat of the manipulator arm 400. Figure 2 In the case of the first slider 210 is connected to the proximal end of the sheath tube 300; when the embodiment is Figure 15 In the case of the above-mentioned situation, the maneuverable arm 400 is configured as a wire spiral tube. In this case, the first slider 210 is connected to the proximal end of the maneuverable arm 400, while the proximal end of the sheath tube 300 is connected to the housing of the manipulator 200. The first slider 210 is provided with a first guide hole 211 for the proximal end of the sheath tube 300 or the proximal end of the maneuverable arm 400 in the above-mentioned different situations to pass through and be secured with a fastener.

[0150] The advancement or retraction of the second slider 220 ultimately results in the advancement or retraction of the actuator wire 510. In other words, the second slider 220 is connected to the proximal end of the actuator wire 510. The second slider 220 is provided with a second guide hole 212 for the proximal end of the actuator wire 510 to pass through and be secured thereto by a fastener.

[0151] The third slider 230 is connected to the proximal end of the bending actuating wire 410. The advancement or retraction of the third slider 230 ultimately results in the bending of the manipulable arm 400. The third slider 230 can be replaced by a reel, that is, a winding method replaces the movement of the slider. The reel includes a capstan and a mandrel, and the mandrel is constrained on the base 250. The capstan on the mandrel can be a simple cylindrical capstan with a circular cross-section, around which the bending actuating wire 410 is wound.

[0152] In order to control the position and posture of the manipulator arm 400 and the end effector 500, the trajectory of the slider movement must be determined. To this end, a track must be provided on the base 250 of the manipulator 200 to define the trajectory of the slider movement. The track can have various structural forms. In some specific embodiments, such as Figure 17As shown, the track includes three groups of guide rods 261 and guide grooves for guiding the first slider 210 , the second slider 220 , and the third slider 230 respectively. The first slider 210 and the second slider 220 share one group of guide rods 261 and guide grooves.

[0153] The first slider 210, the second slider 220, and the third slider 230 are each provided with a third guide hole 213 that mates with the guide rod 261, and a boss 214 that mates with the guide groove. The boss 214 extends through the guide groove toward the bottom of the base 250. The bottom of the boss 214 (the interface of the manipulator 200) is provided with a matching coupling structure with the interface of the instrument controller. The coupling structure can be a groove, a protrusion, a hole, a shaft, etc. It will be understood that when the interface of the manipulator 200 is coupled to the interface of the instrument controller, the motor of the instrument controller is able to drive the manipulator 200.

[0154] It should be noted that the above embodiment does not constitute a limitation on the internal structure of the manipulator 200. Under the guidance of the present invention, technicians in the relevant field can make local changes to the structure, position and size of the slider or reel as needed to achieve control of the bending actuator wire 410 and / or the actuator actuator wire 510.

[0155] In a specific embodiment in which a torque separation member 420 is provided, the manipulator 200 is further provided with a torque transmission member (not shown), which is fixed to the proximal end of the actuator actuating wire 510. The torque transmission member can be constructed as a gear transmission mechanism, and the instrument controller is provided with a motor that drives the gear transmission mechanism. When the manipulator 200 is coupled to the instrument controller, the manipulator 200 can be controlled to manipulate the actuator actuating wire 510 to rotate around its own axis.

[0156] In some embodiments, the robotic surgical system further includes an outer cannula controller configured to move and position the outer cannula (e.g., the outer cannula may be an elongated insertion tube having one or more instrument channels therein for advancing / retracting medical instruments therein), the one or more medical instruments being extendable through the instrument channels of the outer cannula such that the end effector extends from the distal end of the outer cannula.

[0157] For a soft endoscope, the position and posture of the distal end of the endoscope can be controlled manually, that is, by a knob on the operating unit 110; it can also be controlled by a robotic surgical system, for example, by a combination of a hand control device and a foot pedal, or a combination of a hand control device and buttons on the hand control device.

[0158] At this time, the control module can be configured to move the end effector by controlling one or more instrument controllers according to the control signal; the control module can also be configured to move the outer sleeve by controlling the outer sleeve controller according to the control signal, while moving the camera and end effector mounted thereon.

[0159] The medical device of the present invention arranges the actuator actuating wire in the length direction so that the bending stiffness of the distal small part is smaller than the bending stiffness of the proximal large part. The main body of the proximal large part is responsible for the transmission of force, and the first bending part of the distal small part can accept a relatively large range of passive bending. The actuator actuating wire is able to take into account both axial movement performance (pushability) and bending performance (flexibility). That is, under the premise of satisfying the bending effect of the manipulator arm, the end effector can obtain sufficient force and good movement response capability to perform corresponding inspection and treatment operations.

[0160] In scenarios where the end effector is required to rotate around its own axis, if the wire itself is prone to bending and deformation during its rotation, this deformation will absorb or disperse a portion of the rotational energy, causing the end effector's rotational response to slow down, i.e., generating rotational hysteresis. A wire with high bending stiffness can better maintain its linearity and stability, reduce bending deformation during rotation, and thus transfer rotational energy to the end effector faster, reducing rotational hysteresis. Therefore, the actuator wire provided by the present invention can also achieve better torque transmission performance (torsionability), which provides a better solution for improving the control accuracy and response speed of the end effector carried by the manipulable arm to perform multi-degree-of-freedom motion.

Claims

1. A distally manipulable medical device, characterized in that: The medical devices include: A maneuverable arm, wherein the maneuverable arm can be manipulated to bend, and the maneuverable arm is configured to have a first inner cavity running through the length direction of the maneuverable arm; an end effector carried by the maneuverable arm, the end effector being operably controlled by an effector actuation wire; The actuator wire has a main body portion and a first bend portion along its own length, the first bend portion extends within the first inner cavity of the manipulator arm and is connected to the end effector, the actuator wire is allowed to advance and retract axially, and the first bend portion is passively bent when the manipulator arm bends, and the first bend portion has a bending stiffness smaller than that of the main body portion.

2. The medical device according to claim 1, wherein The cross-sectional area of ​​the first bent portion is smaller than the cross-sectional area of ​​the main body portion.

3. The medical device according to claim 2, characterized in that The main body and the first bent portion are integrally formed by welding, or the first bent portion is obtained by partially grinding the main body.

4. The medical device according to claim 3, characterized in that The first curved portion includes a transition section.

5. The medical device according to claim 2, 3 or 4, characterized in that: The first curved portion has a first starting point located at the end of the main body portion, and the first starting point is located outside the first inner cavity covered by the maneuverable arm.

6. The medical device according to claim 1, 2, 3 or 4, characterized in that: The end effector is connected to the first curved portion via a first connecting member. The first connecting member is configured with a sleeve structure, and the distal end of the first curved portion is inserted into and fixed in the sleeve structure.

7. The medical device according to claim 1 or 2, characterized in that: The steerable arm is configured to be actuated to bend by at least one bending actuation wire.

8. The medical device according to claim 7, characterized in that The maneuverable arm is formed by a plurality of curved segments connected in series.

9. The medical device according to claim 7, characterized in that The maneuverable arm is formed by making at least one cut in a metal tube.

10. The medical device according to claim 1 or 2, characterized in that: The medical device also includes a sheath defining a travel path for the actuator wire.

11. The medical device according to claim 10, characterized in that The sheath is made of a lubricating material.

12. The medical device according to claim 10, characterized in that The sheath is configured as a wire spiral tube.

13. A distally steerable medical device, characterized in that The medical device is delivered to the treatment site through the device channel of the endoscope, and the medical device includes: A maneuverable arm, wherein the maneuverable arm can be manipulated to bend, and the maneuverable arm is configured to have a first inner cavity running through the length direction of the maneuverable arm; an end effector carried by the maneuverable arm, the end effector being operably controlled by an effector actuation wire; The actuator wire has a main body portion and a first bend portion along its own length, the first bend portion extends within the first inner cavity of the manipulator arm and is connected to the end effector, the actuator wire is allowed to advance and retract axially, and the first bend portion is passively bent when the manipulator arm bends, and the first bend portion has a bending stiffness smaller than that of the main body portion.

14. The medical device according to claim 13, characterized in that The cross-sectional area of ​​the first bent portion is smaller than the cross-sectional area of ​​the main body portion.

15. The medical device according to claim 14, characterized in that The main body and the first bent portion are integrally formed by welding, or the first bent portion is obtained by partially grinding the main body.

16. The medical device according to claim 15, characterized in that The first curved portion includes a transition section.

17. The medical device according to claim 14, characterized in that The medical instrument passes through the instrument channel, and an instrument channel outlet at the distal end of the instrument channel provides an anchor point to support the bending of the maneuverable arm extending out of the instrument channel.

18. The medical device according to claim 17, characterized in that The first curved portion has a first starting point located at the end of the main body portion. During use of the medical device, the first starting point does not exceed the anchor point.

19. The medical device according to claim 14 or 15 or 16 or 17 or 18, characterized in that: The first curved portion has a first starting point located at the end of the main body portion, and the first starting point is located outside the first inner cavity covered by the maneuverable arm.

20. The medical device according to claim 13 or 14 or 15 or 16 or 17 or 18, characterized in that: The end effector is connected to the first curved portion via a first connecting member. The first connecting member is configured with a sleeve structure, and the distal end of the first curved portion is inserted into and fixed in the sleeve structure.

21. The medical device according to claim 20, characterized in that The medical device is equipped with a torque separation element to separate the torque applied to the manipulable arm from the torque applied to the actuator wire.

22. The medical device according to claim 21, wherein The torque separation member is configured in a circular ring shape and is defined between an inner circumferential surface of the maneuverable arm and an outer circumferential surface of the first connecting member.

23. The medical device according to claim 21, characterized in that The torque separation member is configured as a bearing. The bearing includes an outer ring and an inner ring. The outer ring and the inner ring are connected to the maneuverable arm and the first connecting member respectively.

24. The medical device according to claim 13 or 14, characterized in that The steerable arm is configured to be actuated to bend by at least one bending actuation wire.

25. The medical device according to claim 24, characterized in that The steerable arm is configured as a flexible tube.

26. The medical device according to claim 24, characterized in that The maneuverable arm is formed by a plurality of curved segments connected in series.

27. The medical device according to claim 24, characterized in that The maneuverable arm is formed by making at least one cut in a metal tube.

28. The medical device according to claim 24, characterized in that The steerable arm is configured as a wire coil.

29. The medical device according to claim 13 or 14, characterized in that The medical device also includes a sheath defining a travel path for the actuator wire.

30. The medical device according to claim 29, characterized in that The sheath is made of a lubricating material.

31. The medical device according to claim 29, wherein The sheath is configured as a wire spiral tube.

32. A distally steerable medical device, characterized in that The medical device is attached to the exterior of the distal end of the endoscope via a parallel connection piece and is delivered to the treatment site along with the endoscope. The medical device comprises: A maneuverable arm, wherein the maneuverable arm can be manipulated to bend, and the maneuverable arm is configured to have a first inner cavity running through the length direction of the maneuverable arm; an end effector carried by the maneuverable arm, the end effector being operably controlled by an effector actuation wire; The actuator wire has a main body portion and a first bend portion along its own length, the first bend portion extends within the first inner cavity of the manipulator arm and is connected to the end effector, the actuator wire is allowed to advance and retract axially, and the first bend portion is passively bent when the manipulator arm bends, and the first bend portion has a bending stiffness smaller than that of the main body portion.

33. The medical device according to claim 32, characterized in that The cross-sectional area of ​​the first bent portion is smaller than the cross-sectional area of ​​the main body portion.

34. The medical device according to claim 33, characterized in that The main body and the first bent portion are integrally formed by welding, or the first bent portion is obtained by partially grinding the main body.

35. The medical device according to claim 34, characterized in that The first curved portion includes a transition section.

36. The medical device according to claim 33, characterized in that The medical device extends through the parallel connector, and the second end portion at the distal end of the parallel connector provides an anchor point to support the bending of the steerable arm that is separated from the parallel connector.

37. The medical device according to claim 36, characterized in that The first curved portion has a first starting point located at the end of the main body portion. During use of the medical device, the first starting point does not exceed the anchor point.

38. The medical device according to claim 33, 34, 35, 36 or 37, wherein: The first curved portion has a first starting point located at the end of the main body portion, and the first starting point is located outside the first inner cavity covered by the maneuverable arm.

39. The medical device according to claim 32, 33, 34, 35, 36 or 37, wherein: The end effector is connected to the first curved portion via a first connecting member. The first connecting member is configured with a sleeve structure, and the distal end of the first curved portion is inserted into and fixed in the sleeve structure.

40. The medical device according to claim 39, wherein The medical device is equipped with a torque separation element to separate the torque applied to the manipulable arm from the torque applied to the actuator wire.

41. The medical device according to claim 40, characterized in that The torque separation member is configured in a circular ring shape and is defined between an inner circumferential surface of the maneuverable arm and an outer circumferential surface of the first connecting member.

42. The medical device according to claim 40, characterized in that The torque separation member is configured as a bearing. The bearing includes an outer ring and an inner ring. The outer ring and the inner ring are connected to the maneuverable arm and the first connecting member respectively.

43. The medical device according to claim 32 or 33, characterized in that The steerable arm is configured to be actuated to bend by at least one bending actuation wire.

44. The medical device according to claim 43, characterized in that The steerable arm is configured as a flexible tube.

45. The medical device according to claim 43, wherein The maneuverable arm is formed by a plurality of curved segments connected in series.

46. ​​The medical device according to claim 43, wherein The maneuverable arm is formed by making at least one cut in a metal tube.

47. The medical device according to claim 43, characterized in that The steerable arm is configured as a wire coil.

48. The medical device according to claim 32 or 33, characterized in that The medical device also includes a sheath defining a travel path for the actuator wire.

49. The medical device according to claim 48, characterized in that The sheath is made of a lubricating material.

50. The medical device according to claim 48, wherein The sheath is configured as a wire spiral tube.

51. A robotic surgery system, characterized in that: The medical device according to any one of claims 13 to 50 is used, wherein the robotic surgical system includes an instrument controller, the medical device includes a manipulator, the manipulator is configured with an interface coupled to the instrument controller, and when the manipulator is coupled to the instrument controller, the manipulator can be controlled to manipulate the bending of the manipulator arm, and the manipulator can advance or retract the actuator wire; When the manipulator is decoupled and separated from the instrument controller, the two no longer operate together.

52. The robotic surgery system according to claim 51, wherein: The manipulator is equipped with a torque transmission member fixed to the proximal end of the actuator wire. When the manipulator is coupled to the instrument controller, the manipulator can be controlled to rotate the actuator wire around its own axis.

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