Surgical instrument

Abstract

To provide a surgical instrument for a robot surgery system which can maintain its strength and can reduce a diameter of an end effector.SOLUTION: A surgical instrument 40a for a robot surgery system 100 comprises: an end effector 43 which has first and second jaws 431, 432, the jaws being arranged around a rotary axis in a rotatable manner, and rotatable around the rotary axis so as to relatively move mutually between open and closed positions; a wrist joint 45 which is connected to a proximal end of the end effector 43; and a shaft 42 which is connected to a proximal end of the wrist joint 45. A diameter D1 of the end effector 43 of a part where the rotary axis is provided, is smaller than a diameter D2 of a center part in a longer direction of the wrist joint 45, and a diameter D3 on a center part in the longer direction of the shaft 42.SELECTED DRAWING: Figure 14

Description

[Technical field]

[0001] The present invention relates to surgical instruments. [Background technology]

[0002] Conventionally, surgical instruments for robotic surgery systems are known. For example, Patent Document 1 discloses a surgical instrument for robotic laparoscopic surgery. The surgical instrument is attached to a robot arm and includes an end effector, a joint connected to the end effector, and a shaft connected to the joint. Patent Document 1 discloses that the diameter of the shaft is 5 mm or less. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Special Publication No. 2019-505260 Summary of the Invention [Problem to be solved by the invention]

[0004] Although not specified in the above Patent Document 1, surgical instruments with a diameter of 5 mm are mainstream in laparoscopic surgery that does not use a robot, and surgical instruments with a diameter of 5 mm are also desired in robotic laparoscopic surgery. However, in the case of surgical instruments for robotic laparoscopic surgery, compared to surgical instruments for laparoscopic surgery that are manually operated by a doctor, a large force may be applied between the trocar (a member for introducing a surgical instrument into the patient's body) and the shaft of the surgical instrument, and a large strength is required for the shaft. In addition, surgical instruments for robotic laparoscopic surgery have a wrist joint, and are more complex in structure than surgical instruments for laparoscopic surgery that do not have a wrist joint, and it is difficult to reduce the diameter while maintaining strength.

[0005] The present invention has been made to solve the above-mentioned problems, and one object of the present invention is to provide a surgical instrument that enables the diameter of an end effector to be reduced while maintaining strength. [Means for solving the problem]

[0006] In order to achieve the above-mentioned object, a surgical instrument according to one aspect of the present invention is a surgical instrument for a robotic surgical system, comprising: an end effector having first and second jaw members that move relative to each other between an open position and a closed position; a wrist joint portion connected to the end effector; and a shaft connected to the wrist joint portion, wherein a diameter D1 of the end effector at a portion where the rotation axes of the first and second jaw members are provided is smaller than a diameter D2 of a central portion in the longitudinal direction of the wrist joint portion and a diameter D3 of a central portion of the shaft.

[0007] In the surgical instrument according to one aspect of the present invention, as described above, the diameter D1 of the end effector at the portion where the rotation shafts of the first and second jaw members are provided is smaller than the diameter D2 of the central portion in the longitudinal direction of the wrist joint and the diameter D3 of the central portion of the shaft. This allows the diameter D1 of the end effector after the wrist joint to be thinned while the diameter D2 of the central portion in the longitudinal direction of the wrist joint and the diameter D3 of the central portion of the shaft are set to diameters that can maintain strength, so that the end effector can be thinned while maintaining strength, unlike a case in which the end effector, the wrist joint, and the shaft have the same thin diameter. Furthermore, even in a surgical instrument for a robotic surgical system having a wrist joint that has a complex structure compared to a surgical instrument for laparoscopic surgery without a wrist joint, the end effector can be thinned while maintaining strength. Effect of the Invention

[0008] According to the present invention, the diameter of the end effector can be reduced while maintaining its strength. [Brief description of the drawings]

[0009] [Figure 1]FIG. 1 is a diagram showing the configuration of a robotic surgery system according to one embodiment. [Diagram 2] FIG. 2 is a block diagram showing a control configuration of a robotic surgery system according to one embodiment. [Diagram 3] FIG. 1 is a perspective view showing a state in which a surgical instrument is attached to a robot arm via an adapter according to one embodiment. [Figure 4] FIG. 1 is an exploded perspective view showing a state in which a surgical instrument is attached to a robot arm via an adapter according to one embodiment. [Diagram 5] FIG. 1 is a bottom perspective view of a surgical instrument according to one embodiment. [Figure 6] FIG. 1 is a top view of a surgical instrument according to one embodiment. [Figure 7] FIG. 2 is a perspective view of a surgical instrument according to one embodiment with a lid portion removed. [Figure 8] FIG. 2 is a plan view of a surgical instrument according to one embodiment with a lid portion removed. [Figure 9] FIG. 2 is a cross-sectional view showing a state in which a lid portion of a surgical instrument according to one embodiment is removed. [Figure 10] FIG. 13 is a side view illustrating an end effector, wrist joint and shaft in accordance with one embodiment. [Figure 11] FIG. 13 is a cross-sectional view of an end effector, wrist joint, and shaft in accordance with one embodiment. [Figure 12] FIG. 1 is a first diagram for explaining connections between a first electrode, a second electrode and a third electrode according to one embodiment. [Figure 13] FIG. 2 is a second diagram for explaining connections between the first electrode, the second electrode and the third electrode according to one embodiment. [Figure 14] FIG. 13 is a side view of an end effector in a closed position according to one embodiment. [Figure 15] 11 is a cross-sectional view of the third joint part taken along the line C1-C1 of FIG. 10. FIG. [Figure 16] FIG. 13 is an exploded perspective view of an end effector and rod according to one embodiment. [Figure 17] FIG. 2 is a side view of a rod according to one embodiment. [Figure 18] FIG. 2 is a cross-sectional view of a rod according to one embodiment. [Figure 19] FIG. 13 is a perspective view of a guide portion within a wrist joint of a surgical instrument according to one embodiment. [Figure 20] FIG. 13 is a cross-sectional view of a guide portion within a wrist joint of a surgical instrument according to one embodiment. [Figure 21] FIG. 2 is a perspective view illustrating a memory substrate and a fixing portion according to an embodiment. [Figure 22] 1 is a cross-sectional view illustrating a memory substrate and a fixing portion according to an embodiment. [Diagram 23] FIG. 1 is a perspective view of a wrist joint of a surgical instrument according to one embodiment. [Figure 24] FIG. 1 is an exploded perspective view of a wrist joint of a surgical instrument according to one embodiment. [Diagram 25] FIG. 13 is a cross-sectional view showing first and fourth jaws of a wrist joint of a surgical instrument according to one embodiment. [Figure 26] 13 is a cross-sectional view showing second and third jaws of a wrist joint of a surgical instrument according to one embodiment. FIG. [Figure 27] FIG. 13 is an enlarged view of the first and fourth jaws of a wrist joint of a surgical instrument according to one embodiment. [Figure 28] FIG. 13 is an enlarged view of the second and third jaws of the wrist joint of a surgical instrument according to one embodiment. [Figure 29] FIG. 1 illustrates a wrist joint of a surgical instrument in an unrotated state in accordance with one embodiment. [Diagram 30] FIG. 13 illustrates a wrist joint of a surgical instrument rotated by an angle θ1 according to one embodiment. [Diagram 31] FIG. 13 illustrates a wrist joint of a surgical instrument rotated by an angle θ2 according to one embodiment. [Diagram 32] FIG. 13 illustrates a wrist joint of a surgical instrument rotated by an angle θ3 according to one embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, preferred embodiments of the present invention will be described with reference to the accompanying drawings.

[0011] (Configuration of Robotic Surgery System) The configuration of a robotic surgery system 100 according to one embodiment will be described with reference to FIGS.

[0012] As shown in FIG. 1, the robotic surgery system 100 includes a remote control device 10 and a patient-side device 20. The remote control device 10 is provided to remotely control medical equipment provided in the patient-side device 20. When an operation mode command to be executed by the patient-side device 20 is input to the remote control device 10 by an operator, a surgeon, the remote control device 10 transmits the operation mode command to the patient-side device 20 via a controller 24. In response to the operation mode command transmitted from the remote control device 10, the patient-side device 20 operates medical instruments such as a surgical instrument 40 attached to a robot arm 21a and an endoscope 40b attached to a robot arm 21b. In this way, minimally invasive surgery is performed.

[0013] The patient-side device 20 constitutes an interface for performing surgery on the patient P. The patient-side device 20 is placed beside the operating table 30 on which the patient P lies. The patient-side device 20 has a plurality of robot arms 21a, 21b, of which an endoscope 40b is attached to one robot arm 21b, and a surgical instrument 40a is attached to the other robot arm 21a. The robot arms 21a, 21b are commonly supported by an arm base 22. The robot arms 21a, 21b have a plurality of joints, and each joint is provided with a drive unit including a servo motor and a position detector such as an encoder. The robot arms 21a, 21b are configured to be controlled by a drive signal given via a controller 24 so that the medical instruments attached to the robot arms 21a, 21b perform desired operations.

[0014] The arm base 22 is supported by a positioner 23 placed on the floor of the operating room. The positioner 23 includes a vertical articulated robot. The positioner 23 is configured to three-dimensionally move the position of the arm base 22. The controller 24 is a control circuit having a computing unit such as a CPU and memories such as a ROM and a RAM.

[0015] A surgical instrument 40a serving as a medical instrument is removably attached to the tip of the robot arm 21a. The surgical instrument 40a includes a housing 41 (see FIG. 3), a shaft 42 (see FIG. 3), and an end effector 43 (see FIG. 3). The end effector 43 may be, for example, forceps, but is not limited to this, and various treatment tools may be used. In surgery using the patient-side device 20, the robot arm 21a introduces the surgical instrument 40a into the body of the patient P via a cannula (trocar) placed on the body surface of the patient P. The end effector 43 of the surgical instrument 40a is placed in the vicinity of the surgical site.

[0016] An endoscope 40b serving as a medical instrument is removably attached to the tip of the robot arm 21b. The endoscope 40b photographs the inside of the body cavity of the patient P, and the photographed images are output to the remote control device 10. A 3D endoscope or a 2D endoscope capable of photographing three-dimensional images is used as the endoscope 40b. In surgery using the patient-side device 20, the robot arm 21b introduces the endoscope 40b into the body of the patient P via a trocar placed on the body surface of the patient P. Then, the endoscope 40b is placed in the vicinity of the surgical site.

[0017] The remote control device 10 constitutes an interface with an operator. The remote control device 10 is a device that allows the operator to operate the medical instruments attached to the robot arms 21a and 21b. That is, the remote control device 10 is configured to be able to transmit, via the controller 24, operation mode commands to be executed by the surgical instruments 40a and the endoscope 40b input by the operator to the patient-side device 20. The remote control device 10 is installed, for example, beside the operating table 30 so that the state of the patient P can be clearly seen while operating the master. The remote control device 10 can also be installed in a room separate from the operating room in which the operating table 30 is installed.

[0018] The operation modes to be executed by the surgical instrument 40a are the operation (series of positions and postures) of the surgical instrument 40a and the operation modes realized by the individual functions of the surgical instrument 40a. For example, when the surgical instrument 40a is a vessel sealer, the operation modes to be executed by the surgical instrument 40a are pitch rotation operation and yaw rotation operation of the wrist of the end effector 43, an operation of opening and closing the jaws, an operation of coagulating tissue by supplying a coagulation current to the end effector 43, and an operation of incising tissue by supplying a cutting current to the end effector 43.

[0019] The operation mode to be executed by the endoscope 40b is, for example, the position and attitude of the tip of the endoscope 40b, or the setting of the zoom magnification.

[0020] As shown in FIGS. 1 and 2, the remote control device 10 includes an operating handle 11, an operating pedal section 12, a display section 13, and a control device 14.

[0021] The operating handle 11 is provided to remotely operate the medical instruments attached to the robot arm 21a. Specifically, the operating handle 11 receives operations by an operator to operate the medical instruments (surgical instrument 40a, endoscope 40b). Two operating handles 11 are provided along the horizontal direction. That is, one of the two operating handles 11 is operated by the operator's right hand, and the other of the two operating handles 11 is operated by the operator's left hand.

[0022] The operating handle 11 is disposed so as to extend from the rear side to the front side of the remote control device 10. The operating handle 11 is configured so as to be movable within a predetermined three-dimensional operation area. That is, the operating handle 11 is configured so as to be movable in the up-down direction, the left-right direction, the front-rear direction, and by rotation.

[0023] The remote control device 10 and the patient-side device 20 constitute a master-slave type system in controlling the movements of the robot arms 21a and 21b. That is, the operation handle 11 constitutes a master-side operation unit in the master-slave type system, and the robot arms 21a and 21b to which medical instruments are attached constitute a slave-side operation unit. When an operator operates the operation handle 11, the operation of the robot arm 21a or the robot arm 21b is controlled so that the tip of the robot arm 21a (the end effector 43 of the surgical instrument 40a) or the tip of the robot arm 21b (the endoscope 40b) moves while tracing the movement of the operation handle 11.

[0024] In addition, the patient-side device 20 is configured to control the operation of the robot arm 21a according to the set operation magnification. For example, when the operation magnification is set to 1 / 2, the end effector 43 of the surgical instrument 40a is controlled to move a distance that is 1 / 2 the movement distance of the operating handle 11. This allows delicate surgery to be performed accurately.

[0025] The operation pedal unit 12 includes a plurality of pedals for executing functions related to the medical instrument, including a coagulation pedal, a cutting pedal, a camera pedal, and a clutch pedal, and is operated by the feet of an operator.

[0026] The coagulation pedal can be used to perform an operation to coagulate the surgical site using the surgical instrument 40a. Specifically, when the coagulation pedal is operated, a current for coagulation is supplied to the surgical instrument 40a, and the surgical site is coagulated. The cutting pedal can be used to perform an operation to cut the surgical site using the surgical instrument 40a. Specifically, when the cutting pedal is operated, a current for cutting is supplied to the surgical instrument 40a, and the surgical site is cut.

[0027] The camera pedal is used to control the position and attitude of the endoscope 40b that captures images inside the body cavity. Specifically, the camera pedal enables the operation of the endoscope 40b by the operation handle 11. In other words, while the camera pedal is being pressed, the position and attitude of the endoscope 40b can be controlled by the operation handle 11. For example, the endoscope 40b is operated by using both the left and right operation handles 11. Specifically, the endoscope 40b is rotated by rotating the left and right operation handles 11 around the midpoint of the left and right operation handles 11. In addition, the endoscope 40b moves backward by pushing in both the left and right operation handles 11. In addition, the endoscope 40b moves forward by pulling both the left and right operation handles 11. In addition, the endoscope 40b moves up, down, left and right by moving both the left and right operation handles 11 up, down, left and right.

[0028] The clutch pedal is used to temporarily disconnect the operational connection between the robot arm 21a and the operating handle 11 to stop the operation of the surgical instrument 40a. Specifically, while the clutch pedal is being operated, the robot arm 21a of the patient-side device 20 does not move even if the operating handle 11 is operated. For example, when the operating handle 11 is brought near the end of the movable range by operation, the clutch pedal is operated to temporarily disconnect the operational connection and return the operating handle 11 to near the center position. Then, when the operation of the clutch pedal is stopped, the robot arm 21a and the operating handle 11 are reconnected, and the operation of the operating handle 11 can be resumed near the center.

[0029] The display unit 13 is capable of displaying an image captured by the endoscope 40b. The display unit 13 is composed of a scope-type display unit or a non-scope-type display unit (FIG. 1 shows a scope-type display unit). The scope-type display unit is, for example, a display unit that is peered into. The non-scope-type display unit is a concept that includes an open-type display unit having a flat screen that is not peered into like a typical personal computer display.

[0030] When a scope-type display unit is attached, a 3D image captured by an endoscope 40b attached to the robot arm 21b of the patient-side device 20 is displayed. When a non-scope-type display unit is attached, a 3D image captured by an endoscope 40b provided in the patient-side device 20 is also displayed. When a non-scope-type display unit is attached, a 2D image captured by an endoscope 40b provided in the patient-side device 20 may be displayed.

[0031] As shown in FIG. 2, the control device 14 includes, for example, a control unit 141 having a computing unit such as a CPU, a storage unit 142 having memories such as a ROM and a RAM, and an image control unit 143. The control device 14 may be configured by a single control device that performs centralized control, or may be configured by a plurality of control devices that perform distributed control in cooperation with each other. The control unit 141 determines whether the operation mode command inputted through the operation handle 11 is an operation mode command to be executed by the robot arm 21a or an operation mode command to be executed by the endoscope 40b, depending on the switching state of the operation pedal unit 12. Then, when the control unit 141 determines that the operation mode command inputted through the operation handle 11 is an operation mode command to be executed by the surgical instrument 40a, it transmits the operation mode command to the robot arm 21a via the controller 24. As a result, the robot arm 21a is driven by the controller 24, and the operation of the surgical instrument 40a attached to the robot arm 21a is controlled by this drive.

[0032] Furthermore, when the control unit 141 determines that the operation mode command input to the operation handle 11 is an operation mode command to be executed by the endoscope 40b, it transmits the operation mode command to the robot arm 21b via the controller 24. This causes the robot arm 21b to be driven, and this drive controls the operation of the endoscope 40b attached to the robot arm 21b.

[0033] The memory unit 142 stores, for example, a control program corresponding to the type of surgical instrument 40a, and the control unit 141 reads out these control programs according to the type of attached surgical instrument 40a, so that the operating commands of the operating handle 11 and / or operating pedal unit 12 of the remote control device 10 can perform operations suitable for the individual surgical instrument 40a.

[0034] The image control unit 143 transmits the image acquired by the endoscope 40b to the display unit 13. The image control unit 143 performs processing and correction of the image as necessary.

[0035] (Construction of surgical instruments, adapters, drapes and robotic arms) Next, the configurations of the surgical instrument 40a, the adapter 60, the drape 70, and the robot arm 21a will be described with reference to FIGS.

[0036] Here, the longitudinal direction of the surgical instrument 40a (the longitudinal direction of the shaft 42) is the Y direction, the distal end side of the surgical instrument 40a (toward the end effector 43) in the Y direction is the Y1 direction, and the opposite side of the Y1 direction is the Y2 direction. The direction in which the surgical instrument 40a and the adapter 60 are adjacent to each other is the Z direction, the Z direction toward the surgical instrument 40a in the Z direction is the Z1 direction, and the opposite side of the Z1 direction is the Z2 direction. The direction perpendicular to the Y direction and the Z direction is the X direction, one side of the X direction is the X1 direction, and the other side of the X direction is the X2 direction.

[0037] 3 and 4, the surgical instrument 40a is removably attached to the robot arm 21a of the robotic surgery system 100. Specifically, the surgical instrument 40a is removably attached to the robot arm 21a via an adapter 60. The adapter 60 is a drape adapter for sandwiching a sterilized drape 70 for covering the robot arm 21a between the adapter 60 and the robot arm 21a.

[0038] The surgical instrument 40a is attached to the Z1 direction side of the adapter 60. The adapter 60 is attached to the Z1 direction side of the robot arm 21a.

[0039] The robot arm 21a is covered with a drape 70 since it is used in the clean area. Here, in the operating room, a clean operation is performed to prevent the incised part and medical equipment from being contaminated by pathogens or foreign objects. In this clean operation, a clean area and a contaminated area other than the clean area are set. The surgical site is placed in the clean area. The members of the operating team, including the operator, take care that only sterilized objects are placed in the clean area during the operation, and when an object located in the contaminated area is moved to the clean area, the object is sterilized. Similarly, when an assistant of the operating team, including the operator, places his / her hands in the contaminated area, the hand is sterilized before directly contacting the object located in the clean area. The instruments used in the clean area are sterilized or covered with a sterilized drape 70.

[0040] As shown in FIG. 4, the drape 70 includes a main body 71 that covers the robot arm 21a, and an attachment 72 that is sandwiched between the robot arm 21a and the adaptor 60. The main body 71 is made of a flexible film member formed into a film shape. The flexible film member is made of a resin material such as thermoplastic polyurethane or polyethylene. The main body 71 has an opening so that the robot arm 21a and the adaptor 60 can engage with each other. The attachment 72 is provided at the opening of the main body 71. The attachment 72 is made of a resin molded member. The resin molded member is made of a resin material such as polyethylene terephthalate. The attachment 72 is formed to be harder (less flexible) than the main body 71. The attachment 72 has an opening so that the robot arm 21a and the adaptor 60 can engage with each other. The opening of the attachment 72 may be provided to correspond to the portion where the robot arm 21a and the adaptor 60 engage with each other. Furthermore, the attachment portion 72 may have a plurality of openings provided to correspond to a plurality of engaging portions between the robot arm 21a and the adapter 60.

[0041] As shown in Figures 5 and 7, the surgical instrument 40a includes a plurality of (four) drive shafts 44a, 44b, 44c, and 44d. The drive shafts 44a to 44d are provided in the housing 41 and are rotatable about a rotation axis extending in the Z direction. The drive shafts 44a to 44d are rotationally driven by a driving force from a motor of a drive unit 213 provided in the robot arm 21a. The drive shafts 44a to 44d are provided to operate (drive) the shaft 42, the end effector 43, and a wrist joint 45 described later.

[0042] Each of the drive shafts 44a to 44d includes a receiving member 442 that engages with the drive transmission member 61 of the adapter 60 to transmit the drive force from the robot arm 21a to the shaft 42, the end effector 43, and the wrist joint 45. The receiving member 442 is provided with a protrusion 441 that engages with a recess formed in the drive transmission member 61, and the protrusion 441 protrudes from the surface of the drive shafts 44a to 44d on the Z2 direction side toward the adapter 60 side (Z2 direction side). The protrusions 441 are arranged in a straight line. The receiving member 442 of the drive shaft 44d is an example of a "first receiving member" in the claims. The receiving members 442 of the drive shafts 44b and 44c are an example of a "second receiving member" in the claims.

[0043] 4, the adapter 60 includes a drive transmission member 61. The drive transmission member 61 is configured to transmit the drive force from the robot arm 21a to the multiple drive shafts 44a to 44d of the surgical instrument 40a. In other words, a plurality of drive transmission members 61 are provided corresponding to the multiple drive shafts 44a to 44d of the surgical instrument 40a. The drive transmission member 61 is provided rotatably about a rotation axis extending in the Z direction.

[0044] The multiple drive transmission members 61 include engagement recesses 611 that engage with protrusions 441 of the multiple drive shafts 44a to 44d of the surgical instrument 40a. The engagement recesses 611 are provided on the surgical instrument 40a side (Z1 direction side) of the drive transmission member 61, and are recessed from the Z1 direction side surface of the drive transmission member 61 toward the opposite side to the surgical instrument 40a side (Z2 direction side). The multiple drive transmission members 61 include engagement recesses on the Z2 direction side surface that engage with engagement protrusions of drive members 214a to 214d (described later) of the robot arm 21a.

[0045] The robot arm 21a includes a frame 211 and an instrument attachment section 212. The instrument attachment section 212 includes a drive section 213 and a plurality of drive members 214a to 214d. A plurality (four) of the drive sections 213 are provided to correspond to the plurality of drive shafts 44a to 44d of the surgical instrument 40a and the plurality of drive transmission members 61 of the adapter 60. The drive section 213 includes an absolute encoder and a servo motor, and is configured to rotate and drive the corresponding drive members about a rotation axis extending in the Z direction. Each of the plurality of drive members 214a to 214d corresponds to the plurality of drive shafts 44a to 44d, and has an engagement protrusion that engages with an engagement recess on the surface of the drive transmission member 61 on the Z2 direction side. The engagement protrusion protrudes from the surface on the Z1 direction side of the robot arm 21a toward the Z1 direction side (the adapter 60 side). The driving unit 213 is configured to drive the drive transmission member 61 of the adapter 60 engaged with the multiple driving members 214a-214d to rotate about a rotation axis extending in the Z direction, and to drive the drive shafts 44a-44d of the surgical instrument 40a engaged with the drive transmission member 61 to rotate about a rotation axis extending in the Z direction. The driving member 214d is an example of a "first driving member" in the claims. The driving members 214b and 214c are examples of a "second driving member" in the claims.

[0046] The drive shaft 44d receives a drive force for driving the end effector 43 from the drive member 214d. In addition, the drive shafts 44b and 44c receive a drive force for driving the wrist joint 45 from the drive members 214b and 214c. This makes it possible to easily drive the end effector 43 and the wrist joint 45. In addition, the drive shaft 44a receives a drive force for driving the shaft 42 from the drive member 214a.

[0047] (Detailed configuration of surgical instruments) Next, the detailed configuration of the surgical instrument 40a will be described with reference to FIGS.

[0048] As shown in Figs. 6 to 32, the surgical instrument 40a includes a housing 41, a shaft 42, an end effector 43, and a plurality of drive shafts 44a to 44d. The surgical instrument 40a also includes a wrist joint 45, a wire 46, a rod 47, a lever 48, a drive force transmission section 49, a holding member 50, and a spring member 51. The housing 41 is an example of an "interface" in the claims. The wrist joint 45 is an example of a "wrist joint section" in the claims. The rod 47 is an example of an "elongated member" in the claims.

[0049] As shown in FIG. 6, the housing 41 is disposed on the proximal end side (Y2 direction side) of the shaft 42. The housing 41 is attached to the instrument attachment portion 212 of the robot arm 21a. As shown in FIG. 7, the housing 41 has a base 411 and a lid portion 412 (see FIG. 4). The base 411 is attached to the robot arm 21a (see FIG. 4) via an adapter 60. The base 411 is provided with a plurality of drive shafts 44a to 44d. The lid portion 412 covers the base 411. Specifically, the lid portion 412 covers the base 411 from the side opposite to the attachment surface of the base 411 to the robot arm 21a (Z1 direction side). The lid portion 412 is attached to the base 411 in a detachable manner.

[0050] The shaft 42 is provided to extend in the Y direction. A proximal end (an end on the Y2 direction side) of the shaft 42 is connected to the base 411. A distal end (an end on the Y1 direction side) of the shaft 42 is connected to the wrist joint 45. The shaft 42 is connected to a proximal end of the wrist joint 45.

[0051] As shown in Fig. 11, the shaft 42 includes a hollow metal shaft 42a and a heat shrink tube 42b that covers the surface of the metal shaft 42a. This allows the surface of the metal shaft 42a to be covered with the low-friction heat shrink tube 42b, so that even if the cannula (trocar) and the shaft 42 rub against each other, the material covering the shaft 42 (the heat shrink tube 42b) can be prevented from peeling off due to friction. This effect is particularly effective in the case of a surgical robot that does not have a mechanism for gripping the cannula (trocar) in the robot arm 21a as in this embodiment. The heat shrink tube 42b covers the surface of the metal shaft 42a by shrinking when heated.

[0052] The heat shrink tube 42b covers 90% to 100% of the metal shaft 42a in the longitudinal direction (Y direction) of the metal shaft 42a. This makes it possible to effectively prevent the material covering the shaft 42 (the heat shrink tube 42b) from peeling off when a wide range of the metal shaft 42a is covered with the heat shrink tube 42b. Preferably, the heat shrink tube 42b covers 95% to 99% of the metal shaft 42a in the longitudinal direction of the metal shaft 42a.

[0053] 6, the metal shaft 42a has a length L1 in the Y direction. The heat shrink tube 42b has a length L2 in the Y direction. 0.90L1≦L2≦L1. Preferably, 0.95L1≦L2≦0.99L1. When there is a portion of the metal shaft 42a that is not covered by the heat shrink tube 42b, the portion of the metal shaft 42a that is not covered by the heat shrink tube 42b is provided on the distal end side of the metal shaft 42a.

[0054] In addition, the heat shrink tube 42b has insulating properties. This allows the surface of the metal shaft 42a to be covered with an insulating coating (heat shrink tube 42b). This effect is particularly effective when the surgical instrument 40a is an electrosurgical instrument as in this embodiment, since the metal shaft 42a is required to have insulating properties.

[0055] Moreover, the metal shaft 42a is a stainless steel pipe. The heat shrink tube 42b is a polyethylene-based heat shrink tube or a fluororesin-based heat shrink tube. As a result, since the metal shaft 42a is a high-strength stainless steel pipe, high strength can be ensured for the shaft 42. Furthermore, since the heat shrink tube 42b is a low-friction polyethylene-based heat shrink tube or a fluororesin-based heat shrink tube, peeling of the material covering the shaft 42 (the heat shrink tube 42b) due to rubbing between the cannula (trocar) and the shaft 42 can be suppressed.

[0056] In addition, the heat shrink tube 42b has a single-layer structure, which allows the structure of the heat shrink tube 42b to be simpler than when a heat shrink tube 42b having a two-layer structure is used.

[0057] The heat shrink tube 42b is black in color, which can suppress reflection of the illumination light of the endoscope 40b on the shaft 42, thereby suppressing the occurrence of halation.

[0058] As shown in FIG. 7, the end effector 43 is connected to the distal end of the wrist joint 45. The end effector 43 has a first jaw 431 and a second jaw 432 that are rotatable about a rotation axis (a support axis 431a described later) and can move relative to each other between an open position and a closed position. Each of the first jaw 431 and the second jaw 432 includes a conductor. For example, the first jaw 431 and the second jaw 432 are made of stainless steel, which is a conductor. The first jaw 431 and the second jaw 432 are insulated from each other so as not to be electrically connected to each other. The first jaw 431 and the second jaw 432 are examples of a "first jaw member" and a "second jaw member" in the claims, respectively.

[0059] As shown in FIG. 10, FIG. 11, and FIG. 16, the first jaw 431 includes a first electrode 81 and a second electrode 82 insulated from the first electrode 81. The second jaw 432 includes a third electrode 83. For example, the third electrode 83 functions as a ground electrode for the first electrode 81 and the second electrode 82. This allows an electrical action to be performed between the first jaw 431 and the second jaw 432 by the first electrode 81 and the third electrode 83, or the second electrode 82 and the third electrode 83. For example, the first electrode 81 is a coagulation electrode, and the second electrode 82 is a cutting electrode. This allows the first electrode 81 and the third electrode 83 to coagulate the surgical site of the patient P, and the second electrode 82 and the third electrode 83 to cut the surgical site of the patient P.

[0060] The first electrodes 81 are provided on both sides of the second electrode 82 in the width direction so as to sandwich the second electrode 82 therebetween.

[0061] The outer surface of the portion of the first jaw 431 not facing the second jaw 432 is coated with an electrically insulating material. Also, the outer surface of the portion of the second jaw 432 not facing the first jaw 431 is coated with an electrically insulating material. Also, the outer surface of the wrist joint 45 is coated with an electrically insulating material. This makes it possible to prevent the outer surfaces of the non-facing portions of the first jaw 431 and the second jaw 432 from being exposed to the outside, and therefore it is possible to prevent discharge through the outer surfaces of the non-facing portions of the first jaw 431 and the second jaw 432. Also, it is possible to prevent the outer surface of the wrist joint 45 from being exposed to the outside, and therefore it is possible to prevent discharge through the outer surface of the wrist joint 45.

[0062] As shown in Figures 7 to 9, the multiple drive shafts 44a to 44d include a first drive shaft 44a that rolls the shaft 42 around an axis in the Y direction, a second drive shaft 44b and a third drive shaft 44c that pitch jointly move the wrist joint 45 around a first direction (X direction in Figure 7) perpendicular to the Y direction and yaw jointly move the wrist joint 45 around a second direction (Z direction in Figure 7) perpendicular to the Y direction and the first direction, and a fourth drive shaft 44d that moves the rod 47 in the Y direction.

[0063] The first drive shaft 44a is connected to a gear 422 that is connected to the proximal end of the shaft 42. When the first drive shaft 44a is driven to rotate, the shaft 42 is rotated in a roll direction via the gear 422. The second drive shaft 44b and the third drive shaft 44c are connected to a wire 46 that is connected to the wrist joint 45. When the second drive shaft 44b and the third drive shaft 44c are driven to rotate, the wrist joint 45 is caused to perform a pitch or yaw joint movement via the wire 46. The movement of the rod 47 in the Y direction by the fourth drive shaft 44d will be described later.

[0064] As shown in FIG. 7, FIG. 10, and FIG. 11, the wrist joint 45 is connected to the proximal end of the end effector 43 and to the distal end side (Y1 direction side) of the shaft 42, and is configured to be capable of articulation. The wrist joint 45 also includes a conductor. For example, the wrist joint 45 is formed of stainless steel, which is a conductor. Specifically, the wrist joint 45 has a first joint part 451, a second joint part 452, and a third joint part 453. The first joint part 451 is connected to the distal end side (Y1 direction side) of the shaft 42. The second joint part 452 is disposed on the distal end side (Y1 direction side) of the first joint part 451, and meshes with the first joint part 451 so as to be capable of yaw articulation. The third joint part 453 is disposed on the distal end side of the second joint part 452, and meshes with the second joint part 452 so as to be capable of pitch articulation. Details of the meshing of wrist joint 45 will be described later. Note that first joint part 451 is an example of a "third member" in the claims. Also, second joint part 452 is an example of a "second member" in the claims. Also, third joint part 453 is an example of a "first member" in the claims.

[0065] The wrist joint 45 is configured to articulate with multiple degrees of freedom. This allows the wrist joint 45 to articulate with multiple degrees of freedom, so that the end effector can be moved more freely. Specifically, the wrist joint 45 includes a first joint 45a between a third joint part 453 including a connecting part 45c (described later) including a conductor and a second joint part 452, and includes a second joint 45b between the second joint part 452 and the first joint part 451. This allows articulation at each of the two joints, the first joint 45a and the second joint 45b, so that the end effector 43 can be moved more freely than when only one joint is provided. The first joint 45a is configured to articulate around a rotation axis A2 that intersects with the longitudinal direction (Y direction) of the shaft 42. The first joint 45a is configured to articulate with a degree of freedom in the pitch direction. The second joint 45b is configured to articulate around a rotation axis A1 that intersects with both the longitudinal direction (Y direction) of the shaft 42 and the rotation axis A2. The second joint 45b is configured to articulate with a degree of freedom in the yaw direction. The degree of freedom in the pitch direction is a degree of freedom in a direction perpendicular to the longitudinal axis (Y direction axis) of the shaft 42, and the degree of freedom in the yaw direction is a degree of freedom in a direction perpendicular to the longitudinal axis and the pitch direction. This allows the first joint 45a and the second joint 45b to articulate with degrees of freedom in the pitch direction and yaw direction that are perpendicular to each other, so that the end effector 43 can be moved more freely than when the two joints articulate with degrees of freedom in the same direction. The rotation axes A1 and A2 are examples of the "second rotation axis" and the "first rotation axis" in the claims, respectively.

[0066] As shown in FIG. 14, the diameter D1 of the end effector 43 at the portion where the rotation axis (support axis 431a described later) of the first jaw 431 and the second jaw 432 is provided is smaller than the diameter D2 of the central portion in the longitudinal direction (Y direction) of the wrist joint 45 and the diameter D3 of the central portion in the longitudinal direction (Y direction) of the shaft 42. This allows the diameter D1 of the end effector 43 after the wrist joint 45 to be thinned while the diameter D3 of the central portion of the shaft 42 is set to a diameter that can maintain strength, so that the end effector 43 can be thinned while maintaining strength, unlike the case where the end effector 43, the wrist joint 45, and the shaft 42 have the same thin diameter. Also, even in the case of a surgical instrument 40a for a robotic surgical system having a wrist joint 45 having a complex structure compared to a surgical instrument for laparoscopic surgery without a wrist joint 45, the end effector 43 can be thinned while maintaining strength. The diameter D2 is approximately the same as the diameter D3. Moreover, the diameter D1 is the diameter when the first jaw 431 and the second jaw 432 are in a closed state.

[0067] The diameter D1 is larger than 1 / 2 (4 / 8) and smaller than 3 / 4 (6 / 8) of the diameters D2 and D3. As a result, since the diameter D1 is larger than 1 / 2 of the diameters D2 and D3, it is possible to prevent the diameter D1 from becoming excessively small. Also, since the diameter D1 is smaller than 3 / 4 of the diameters D2 and D3, it is possible to prevent the diameter D1 from becoming excessively large. As a result, the end effector 43 can be made to have an appropriate diameter. The diameter D1 is not particularly limited, but is, for example, 5 / 8 of the diameters D2 and D3.

[0068] Furthermore, the diameter D1 is 4 mm or more and 6 mm or less. Furthermore, the diameters D2 and D3 are 7 mm or more and 9 mm or less. This allows the end effector 43, the wrist joint 45, and the shaft 42 to have appropriate diameters. The diameter D1 is not particularly limited, but is, for example, 5 mm. Furthermore, the diameters D2 and D3 are not particularly limited, but are, for example, 8 mm.

[0069] Furthermore, the wrist joint 45 includes a connection portion 45c for connecting to the end effector 43, and a diameter D4 of a distal end of the connection portion 45c is smaller than the diameters D2 and D3. This allows the diameter D4 of the distal end of the connection portion 45c of the wrist joint 45 with the end effector 43 to be matched with the diameter D1 of the end effector 43, making it possible to easily connect the end effector 43 to the wrist joint 45. The connection portion 45c is provided in the third joint component 453.

[0070] The connecting portion 45c of the wrist joint 45 has a distal end with a diameter D4 and a proximal end with a diameter D2. This allows the diameter of the connecting portion 45c of the wrist joint 45 to be reduced from the diameter D2 to the diameter D4, so that the end effector 43 can be easily reduced in diameter while maintaining its strength. The connecting portion 45c of the wrist joint 45 has a shape that gradually tapers from the proximal end with a diameter D2 to the distal end with a diameter D4. This allows the connecting portion 45c of the wrist joint 45 to be smoothly reduced in diameter from the diameter D2 to the diameter D4, unlike the case where a step is provided at the connecting portion 45c of the wrist joint 45 where the diameter changes from the diameter D2 to the diameter D4. In addition, the diameter D4 of the connecting portion 45c is approximately the same as the diameter D1. This allows the diameter D4 of the connecting portion 45c to be approximately the same as the diameter D1 of the end effector 43, so that the end effector 43 and the wrist joint 45 can be more easily connected to each other.

[0071] The wires 46 are provided to drive the wrist joint 45. The wires 46 cause the wrist joint 45 to perform pitch and yaw joint movements. Four wires 46 are provided inside the shaft 42 and extend in the Y direction. Two of the four wires 46 connect the wrist joint 45 to the second drive shaft 44b, and the other two connect the wrist joint 45 to the third drive shaft 44c.

[0072] For example, as shown in FIG. 15, the four wires 46 include wires 46a, 46b, 46c, and 46d. The distal ends of the wires 46a and 46b are connected to the wrist joint 45, and the proximal ends are connected to the second drive shaft 44b. The wires 46a and 46b are wound around the second drive shaft 44b in opposite directions. That is, when the second drive shaft 44b rotates in one direction, one of the wires 46a and 46b is pulled in the proximal direction (Y2 direction), and the other of the wires 46a and 46b is loosened and drawn out in the distal direction (Y1 direction). When the second drive shaft 44b rotates in the other direction opposite to the one direction, the other of the wires 46a and 46b is pulled in the proximal direction (Y2 direction), and one of the wires 46a and 46b is loosened and drawn out in the distal direction (Y1 direction).

[0073] The wires 46c and 46d have distal ends connected to the wrist joint 45 and proximal ends connected to the third drive shaft 44c. The wires 46c and 46d are wound around the third drive shaft 44c in opposite directions. That is, when the third drive shaft 44c rotates in one direction, one of the wires 46c and 46d is pulled in the proximal direction (Y2 direction), and the other of the wires 46c and 46d is loosened and drawn out in the distal direction (Y1 direction). When the third drive shaft 44c rotates in the other direction opposite to the one direction, the other of the wires 46c and 46d is pulled in the proximal direction (Y2 direction), and one of the wires 46c and 46d is loosened and drawn out in the distal direction (Y1 direction).

[0074] 10, the wrist joint 45 includes a second joint 45b that rotates about a rotation axis A1 and a first joint 45a that rotates about a rotation axis A2. The wires 46 cause the wrist joint 45 to perform pitch joint movement and yaw joint movement by driving the wires 46a and 46b by the second drive shaft 44b and by driving the wires 46c and 46d by the third drive shaft 44c. In the wrist joint 45, the second joint 45b rotates about the rotation axis A1 (yaw joint movement) and the first joint 45a rotates about the rotation axis A2 (pitch joint movement) by the second drive shaft 44b and the third drive shaft 44c. 15, the second joint 45b rotates in the A1b direction about the rotation axis A1 as the second drive shaft 44b pulls the wire 46a and loosens the wire 46b, and the third drive shaft 44c pulls the wire 46d and loosens the wire 46c. Also, the second joint 45b rotates in the A1a direction about the rotation axis A1 as the second drive shaft 44b pulls the wire 46b and loosens the wire 46a, and the third drive shaft 44c pulls the wire 46c and loosens the wire 46d.

[0075] Moreover, the first joint 45a rotates in the A2a direction about the rotation axis A2 as the second drive shaft 44b pulls the wire 46a and loosens the wire 46b, and the third drive shaft 44c pulls the wire 46c and loosens the wire 46d. Moreover, the first joint 45a rotates in the A2b direction about the rotation axis A2 as the second drive shaft 44b pulls the wire 46b and loosens the wire 46a, and the third drive shaft 44c pulls the wire 46d and loosens the wire 46c.

[0076] Further, the four wires 46a to 46d have their respective ends 46e (see FIG. 10) fixed near the proximal end of the third joint part 453. FIG. 15 is a cross-sectional view of the third joint part 453 as viewed from the arrow C1-C1 of FIG. 10. As shown in FIG. 15, the cross section of the third joint part 453 is divided into four regions, a first region R1 to a fourth region R4, by a plane B1 parallel to both the longitudinal direction (Y direction) of the shaft 42 and the rotation axis A1, and a plane B2 parallel to both the longitudinal direction (Y direction) of the shaft 42 and the rotation axis A2. The four wires 46a to 46d pass through the first region D1 to the fourth region D4, respectively, and their respective ends 46e are fixed near the proximal end of the third joint part 453. Specifically, the wire 46a passes through a position offset from the planes B1 and B2 in the first region D1, the wire 46b passes through a position offset from the planes B1 and B2 in the second region D2, the wire 46c passes through a position offset from the planes B1 and B2 in the third region D3, and the wire 46d passes through a position offset from the planes B1 and B2 in the fourth region D4. In Fig. 12, the first region D1 is disposed in the first quadrant, the second region D2 is disposed in the third quadrant, the third region D3 is disposed in the second quadrant, and the fourth region D4 is disposed in the fourth quadrant.

[0077] 7 to 9 and 11, the rod 47 is provided to drive the end effector 43. The rod 47 is provided inside the wrist joint 45 and the shaft 42 so as to extend in the Y direction. The distal end of the rod 47 is connected to the end effector 43. Specifically, the distal end of the rod 47 is connected to the first jaw 431.

[0078] The rod 47 is configured to move inside the wrist joint 45 and the shaft 42 in the longitudinal direction (Y direction) of the shaft 42 to relatively move the first jaw 431 and the second jaw 432 between the open position and the closed position. This makes it possible to easily move the first jaw 431 and the second jaw 432 relative to each other between the open position and the closed position by using the rod 47 that moves inside the wrist joint 45 and the shaft 42 in the longitudinal direction of the shaft 42. Also, the rod 47 includes a conductor.

[0079] 11 and 16, the first jaw 431 has a support shaft 431a rotatably supported by the second jaw 432 and a connection portion 431b connected to the distal end of the rod 47, and rotates about the axis of the support shaft 431a by movement of the rod 47 in the Y direction. This allows the first jaw 431 to be rotated about the axis of the support shaft 431a by movement of the rod 47 in the Y direction, and the first jaw 431 can be opened and closed relative to the second jaw 432. The end effector 43 is a single-opening type in which the first jaw 431 opens and closes relative to the second jaw 432.

[0080] A pair of support shafts 431a are provided on both sides of the first jaw 431. The pair of support shafts 431a are inserted into a pair of holes 432a provided in the second jaw 432 and rotatably supported. The connection portion 431b has a long hole portion 431c. A pair of long hole portions 431c are provided. One and the other ends of a pin portion 47a provided at the distal end of the rod 47 so as to extend in a direction perpendicular to the Y direction are inserted into the pair of long hole portions 431c and supported so as to be slidable along the long hole portions 431c. When the rod 47 is moved in the Y1 direction, the pin portion 47a is slidably moved along the long hole portions 431c, and a force in a direction in which the first jaw 431 opens is applied. Therefore, the first jaw 431 rotates in an opening direction around the axis of the support shaft 431a. Furthermore, when the rod 47 is moved in the Y2 direction, the pin portion 47a is slid along the long hole portion 431c, thereby applying a force in a closing direction to the first jaw 431. As a result, the first jaw 431 rotates in the closing direction around the axis of the support shaft 431a.

[0081] In the example shown in FIG. 12, the first electrode 81 is connected to the rod 47. The second electrode 82 is connected to a second conducting wire 84. The second conducting wire 84 is provided so as to pass through the inside of the shaft 42 and extend to the inside of the housing 41. The third electrode 83 is connected to a first conducting wire 85 via a housing of the second jaw 432 made of a conductor and a third joint part 453. The first conducting wire 85 is connected to the inner surface of the connecting portion 45c of the wrist joint 45. The first conducting wire 85 is provided so as to pass through the inside of the shaft 42 and extend to the inside of the housing 41.

[0082] That is, the first electrode 81 of the first jaw 431 is electrically connected to the rod 47. The second electrode 82 of the first jaw 431 is electrically connected to the second conductive wire 84. The third electrode 83 of the second jaw 432 is electrically connected to the first conductive wire 85 via the connection portion 45c. This allows the first electrode 81, the second electrode 82, and the third electrode 83 to be electrically connected to the shaft 42 side in an insulated state using the rod 47, the first conductive wire 85, and the second conductive wire 84. Also, the electrodes can be electrically connected to the shaft 42 side via the connection portion 45c of the wrist joint 45 including a conductor. This allows electricity to pass through the connection portion 45c of the wrist joint 45 even when the wrist joint 45 rotates, so that the electrical connection to the electrodes can be stabilized. As a result, it is possible to suppress the electrical connection to the multiple electrodes provided on the end effector 43 of the surgical instrument 40a including the wrist joint 45 from becoming unstable.

[0083] 12, the first jaw 431 is configured to move between an open position and a closed position relative to the fixedly disposed second jaw 432. The proximal end of the second jaw 432 is electrically connected to the connection portion 45c of the wrist joint 45. This allows the second jaw 432 and the connection portion 45c to be easily and stably connected electrically.

[0084] 13, the second jaw 432 may be configured to move between an open position and a closed position relative to the fixedly disposed first jaw 431. In this case, the first electrode 81 of the first jaw 431 is electrically connected to the first conductive wire 85 via the connection portion 45c. The second electrode 82 of the first jaw 431 is electrically connected to the second conductive wire 84. The third electrode 83 of the second jaw 432 is electrically connected to the rod 47. That is, the proximal end of the first jaw 431 is electrically connected to the connection portion 45c of the wrist joint 45.

[0085] As shown in FIG. 11, FIG. 17, and FIG. 18, the rod 47 has a first rod 47b connected to the first jaw 431, a flexible wire 47c connected to the base end of the first rod 47b, and a second rod 47d connected to the base end of the wire 47c. The wire 47c is disposed inside the wrist joint 45. This allows the wire 47c to bend in response to articulation of the wrist joint 45, so that even when the wrist joint 45 articulates, the first jaw 431 and the second jaw 432 can be easily moved between the open position and the closed position by the rod 47. In addition, unlike the case where the entire rod 47 is constituted by the wire 47c, the first rod 47b and the second rod 47d are provided, so that the strength of the rod 47 can be maintained. The first rod 47b, the wire 47c, and the second rod 47d are conductive. The wire 47c is an example of a "flexible wire" in the claims.

[0086] The first rod 47b has a pin portion 47a at its tip, and moves the first jaw 431 by the force transmitted from the wire 47c and the second rod 47d. The wire 47c transmits the force transmitted from the second rod 47d to the first rod 47b. The second rod 47d transmits the force transmitted from the drive shaft 44d to the wire 47c.

[0087] The wire 47c is disposed inside a flexible resin tube 47e. The resin tube 47e is a fluororesin-based tube. The resin tube 47e has a diameter substantially the same as that of the first rod 47b, eliminating a step at the connection between the first rod 47b and the wire 47c. An insulating coating 47f is provided on the outer surface of the second rod 47d.

[0088] Moreover, the wire 47c is a torque coil. This makes it possible to suppress the wire 47c from tightening or loosening depending on the direction of rotation of the shaft 42 when the shaft 42 rotates. As a result, it is possible to suppress the movement distance of the rod 47 required for opening and closing the first jaw 431 and the second jaw 432 from differing depending on the degree of tightening of the wire 47c. Furthermore, since the wire 47c is a torque coil, it is possible to exhibit high torque transmission even in a bent state. As the torque coil, it is possible to use one in which unidirectional twist is made difficult to unravel by forming or the like, or one in which S twist and Z twist are combined to provide equal torque transmission in both directions of rotation.

[0089] 11, a flexible resin guide 90 is provided inside the wrist joint 45. The resin guide 90 is made of polyamide or silicone.

[0090] As shown in FIG. 19, the resin guide 90 includes a passage 91 that is formed to pass through the longitudinal center line (the center line extending in the Y direction) of the resin guide 90 and guides the rod 47. As a result, the rod 47 can be guided by the passage 91 of the resin guide 90, so that the movement of the rod 47 for opening and closing the first jaw 431 and the second jaw 432 can be easily performed. In addition, since the resin guide 90 can be bent in response to the articulation of the wrist joint 45, even when the wrist joint 45 articulates, the movement of the rod 47 for opening and closing the first jaw 431 and the second jaw 432 can be easily performed. In addition, the resin guide 90 includes passages 92 and 93 that are formed offset from the longitudinal center line of the resin guide 90. The passage 92 guides the first conducting wire 85. The passage 93 guides the second conducting wire 84.

[0091] As shown in FIG. 20, the inner surface of the passage 91 of the resin guide 90, which guides the wire 47c, is made of fluororesin 91a.

[0092] As shown in FIG. 11, the shaft 42 includes a positioning member 421 that positions the resin guide 90. This allows the resin guide 90 to be positioned by the positioning member 421, so that it is possible to prevent the position of the resin guide 90 from being shifted due to the movement of the rod 47. The positioning member 421 has a step portion 421a, and positions the resin guide 90 in the longitudinal direction of the resin guide 90 by sandwiching a protrusion portion 94 of the resin guide 90 between the step portion 421a and the first joint part 451. The protrusion portion 94 protrudes in a direction perpendicular to the longitudinal direction of the resin guide 90, and is sandwiched between the step portion 421a and the first joint part 451 in the longitudinal direction of the resin guide 90.

[0093] As shown in FIG. 7 to FIG. 9, the lever 48 has an arm 481 including a shaft portion 481a supported rotatably, and an engagement portion 482 that protrudes from the arm 481 and engages with the rod 47. The lever 48 rotates around the axis of the shaft portion 481a by the driving force from the fourth drive shaft 44d, and moves the rod 47 in the Y direction. As a result, the shaft portion 481a of the lever 48 itself that moves the rod 47 in the Y direction is used as the rotation axis of the lever 48, so there is no need to use a drive shaft as the rotation axis. As a result, the rod 47 can be moved in the Y direction of the shaft 42 using only one drive shaft (the fourth drive shaft 44d) to operate the end effector 43. As a result, the four drive shafts 44a to 44d can rotate the shaft 42 in roll, the end effector 43 can perform pitch and yaw joint movements, and the rod 47 for operating the end effector 43 can be moved in the Y direction of the shaft 42.

[0094] Further, a pair of arms 481 are provided facing each other in the Z direction. One engagement portion 482 of the pair of arms 481 engages with the rod 47 from one side (Z1 direction side). The other engagement portion 482 of the pair of arms 481 engages with the rod 47 from the other side (Z2 direction side). This allows the engagement portion 482 to engage with the rod 47 from one side and the other side of the rod 47, so that the driving force of the fourth drive shaft 44d can be reliably transmitted to the rod 47 via the lever 48.

[0095] The pair of arms 481 are provided to be spaced apart from each other in the Z direction, and are connected to each other by a connection portion 483 extending in the Z direction. Each of the pair of arms 481 is provided to extend in the X direction from the connection portion 483 to the position of the rod 47. Each of the pair of arms 481 has a shaft portion 481a between an end portion on the connection portion 483 side and an end portion on the rod 47 side. Specifically, each of the pair of arms 481 has the shaft portion 481a on the connection portion 483 side rather than the center between the end portion on the connection portion 483 side and the end portion on the rod 47 side. In addition, an engagement portion 482 is provided at an end portion on the rod 47 side of each of the pair of arms 481.

[0096] Moreover, one engaging portion 482 of the pair of arms 481 protrudes in the Z2 direction and engages with an engaged portion 501 (described later) of the holding member 50 from the Z1 direction side. The other engaging portion 482 of the pair of arms 481 protrudes in the Z1 direction and engages with the engaged portion 501 from the Z2 direction side.

[0097] Moreover, one of the shaft portions 481a of the pair of arms 481 protrudes in the Z1 direction. One of the shaft portions 481a of the pair of arms 481 is rotatably supported by a frame member 52 provided inside the housing 41. Specifically, one of the shaft portions 481a of the pair of arms 481 is inserted into a supported portion 521 including a hole provided in the frame member 52 and rotatably supported. Moreover, the other of the shaft portions 481a of the pair of arms 481 protrudes in the Z2 direction. The other of the shaft portions 481a of the pair of arms 481 is rotatably supported by the base 411. Specifically, the other of the shaft portions 481a of the pair of arms 481 is inserted into a supported portion 411a including a recess provided in the base 411 and rotatably supported.

[0098] In addition, the axis of the shaft portion 481a is disposed between the engaging portion 482 and the fourth drive shaft 44d in the X direction perpendicular to the Y direction. This allows the axis of the shaft portion 481a to be disposed between the engaging portion 482 and the fourth drive shaft 44d in the X direction perpendicular to the Y direction, so that the lever 48 can be made more compact than when the axis of the shaft portion 481a is disposed outside the fourth drive shaft 44d. The axis of the shaft portion 481a is disposed closer to the fourth drive shaft 44d than the center between the engaging portion 482 and the fourth drive shaft 44d in the X direction.

[0099] Furthermore, the driving force transmission unit 49 is provided between the fourth drive shaft 44d and the lever 48, and transmits the driving force from the fourth drive shaft 44d to the lever 48. This allows the driving force to be transmitted from the fourth drive shaft 44d to the lever 48 by the driving force transmission unit 49, so that the lever 48 can be disposed away from the fourth drive shaft 44d. As a result, even when it is difficult to secure a space for installing the lever 48 near the fourth drive shaft 44d, the space for installing the lever 48 can be easily secured.

[0100] Further, the driving force transmission unit 49 has a gear train 491 including a spur gear 491a and a sector gear 491b, and transmits the driving force from the fourth drive shaft 44d to the lever 48 by the gear train 491. This allows the driving force to be reliably transmitted from the fourth drive shaft 44d to the lever 48 by the gear train 491, which transmits the driving force by meshing. Furthermore, because the gear train 491 includes the sector gear 491b, the gear train 491 can be made more compact than when a spur gear is provided instead of the sector gear 491b.

[0101] Furthermore, the driving force transmission unit 49 decelerates the rotation of the fourth drive shaft 44d and transmits it to the lever 48. This allows the lever 48 to be driven with a torque that increases inversely proportional to the deceleration of the rotation of the fourth drive shaft 44d, so that the rod 47 can be easily moved in the Y direction by driving the lever 48. Note that being able to drive the lever 48 with a torque that increases inversely proportional to the deceleration of the rotation of the fourth drive shaft 44d is effective when the spring member 51 is provided as in this embodiment.

[0102] The sector gear 491b meshes with a spur gear 44d1 provided on the fourth drive shaft 44d. The sector gear 491b has a number of teeth that reduces the rotation speed of the fourth drive shaft 44d. The spur gear 491a meshes with a sector gear 483a provided on a connection portion 483 of the lever 48. The spur gear 491a and the sector gear 491b are supported by a common rotation shaft 491c and rotate integrally with each other by the rotation shaft 491c.

[0103] The holding member 50 holds the rod 47. The spring member 51 biases the holding member 50 toward the distal end side in the Y direction (Y1 direction side). The engagement portion 482 engages with the rod 47 via the holding member 50, and applies the gripping force of the end effector 43 by the reaction force of the spring member 51 when the holding member 50 is pushed toward the proximal end side in the Y direction (Y2 direction side) by the engagement portion 482. This allows the gripping force of the end effector 43 to be determined by the spring constant of the spring member 51, so that the gripping force of the end effector 43 can be applied stably. Also, unlike the case where the gripping force of the end effector 43 is applied using a wire like the wrist joint 45, the gripping force is not easily affected by slight stretching of the wire. This eliminates the need to set a precise tightening angle of the motor of the drive unit 213.

[0104] The holding member 50 has an engaged portion 501, a spring accommodating portion 502, and a rod holding portion 503. The engaged portion 501 engages with the engaging portion 482 of the lever 48. The engaged portion 501 is configured with a recess formed in a circumferential shape. A portion of the engaged portion 501 on the Z1 direction side is recessed toward the Z2 direction side, and one of the engaging portions 482 of the pair of arms 481 engages with the engaged portion 501. A portion of the engaged portion 501 on the Z2 direction side is recessed toward the Z1 direction side, and the other of the engaging portions 482 of the pair of arms 481 engages with the engaged portion 501. The spring accommodating portion 502 accommodates the spring member 51. The spring accommodating portion 502 includes a recess recessed toward the Y1 direction side. The spring accommodating portion 502 holds the spring member 51 between itself and a plate-shaped washer 53 provided on the Y2 direction side of the spring accommodating portion 502. The rod holding portion 503 holds a held portion 47g provided on the rod 47. The rod holding portion 503 includes a hole portion extending along the Y direction.

[0105] The spring member 51 is a compression coil spring having a predetermined spring constant. When the holding member 50 is moved in the Y2 direction by the lever 48, the spring member 51 is compressed between the spring accommodating portion 502 and the washer 53. When the holding member 50 is moved in the Y1 direction by the lever 48, the spring member 51 is expanded between the spring accommodating portion 502 and the washer 53.

[0106] The operation of moving the rod 47 in the Y direction by the lever 48 will be described. When the fourth drive shaft 44d is rotationally driven, the driving force from the fourth drive shaft 44d is transmitted to the lever 48 via the gear train 491 of the driving force transmission unit 49. This causes the lever 48 to rotate around the axis of the shaft portion 481a. When the rod 47 is moved in the Y1 direction, the side surface of the engaging portion 482 of the lever 48 on the Y1 direction side comes into contact with the side surface of the engaged portion 501 of the holding member 50 on the Y2 direction side, and the holding member 50 is pushed and moved in the Y1 direction. This causes the rod 47, the held portion 47g of which is held by the rod holding portion 503 of the holding member 50, to move in the Y1 direction. In this case, the first jaw 431 is moved in the opening direction. Furthermore, when the rod 47 is moved in the Y2 direction, the Y2-side side surface of the engaging portion 482 of the lever 48 abuts against the Y1-side side surface of the engaged portion 501 of the holding member 50, and the holding member 50 is pushed and moved in the Y2 direction. This causes the rod 47, whose held portion 47g is held by the rod holding portion 503 of the holding member 50, to move in the Y2 direction. In this case, the first jaw 431 is moved in the closing direction.

[0107] (Configuration of memory board fixing mechanism) Next, the configuration of fixing mechanism 55 for circuit board 54 will be described with reference to FIGS. 8, 21 and 22. FIG.

[0108] As shown in FIG. 8, FIG. 21, and FIG. 22, the surgical instrument 40a includes a circuit board 54 and a fixing mechanism 55 for the circuit board 54. The circuit board 54 is provided on the base 411. The circuit board 54 is a memory board. The circuit board 54 stores information about the surgical instrument 40a, such as the type of the surgical instrument 40a and the number of times the surgical instrument 40a has been used. The fixing mechanism 55 fixes the circuit board 54 to the base 411. The fixing mechanism 55 is a snap-fit ​​fixing mechanism having a plurality (four pieces) of snap-fit ​​portions 551. The snap-fit ​​portions 551 are provided two each on the Y1 direction side and the Y2 direction side of the circuit board 54, and press the outer periphery of the circuit board 54 from the Z1 direction side. In addition, the snap-fit ​​portions 551 are pressed by the circuit board 54 and elastically deformed when the circuit board 54 is attached to the fixing mechanism 55 from the Z1 direction side toward the Z2 direction side. By providing a snap-fit ​​fixing mechanism as fixing mechanism 55, it is possible to fix circuit board 54 to base 411 with a simple structure.

[0109] (Wrist Joint Configuration) Next, the configuration of wrist joint 45 will be described with reference to FIGS.

[0110] As shown in FIG. 23 and FIG. 24, the wrist joint 45 includes a first joint part 451 and a second joint part 452 adjacent to the first joint part 451 on the distal side (Y1 direction side) and rotatable relative to the first joint part 451. The wrist joint 45 also includes a third joint part 453 adjacent to the second joint part 452 on the distal side (Y1 direction side) and rotatable relative to the second joint part 452. As shown in FIG. 10 and FIG. 23, the second joint part 452 is rotatable about a rotation axis A1 relative to the first joint part 451. The rotation axis A1 extends in a direction perpendicular to the longitudinal direction (Y direction) of the shaft 42. The third joint part 453 is rotatable about a rotation axis A2 perpendicular to the rotation axis A1 relative to the second joint part 452. The rotation axis A2 extends in a direction perpendicular to the rotation axis A1 when viewed in the longitudinal direction (Y direction) of the shaft 42. As shown in Fig. 24, the wrist joint 45 includes a first joint 45a that rotates around the rotation axis A1 and a second joint 45b that rotates around the rotation axis A2.

[0111] The first joint part 451 has a first meshing portion 454, a second meshing portion 455 arranged to face the first meshing portion 454 in a radial direction (A1 direction) perpendicular to the longitudinal direction of the shaft, a first abutment portion 471 adjacent to the radial outside of the first meshing portion 454, and a second abutment portion 472 adjacent to the radial outside of the second meshing portion 455. The first meshing portion 454, the second meshing portion 455, the first abutment portion 471 and the second abutment portion 472 are provided at an end of the first joint part 451 on the distal side (Y1 direction side).

[0112] The second joint part 452 has a third meshing part 456 meshing with the first meshing part 454, a fourth meshing part 457 arranged to face the third meshing part 456 in the radial direction (A1 direction) and meshing with the second meshing part 455, a third abutment part 473 abutting with the first abutment part 471, and a fourth abutment part 474 abutting with the second abutment part 472. The third meshing part 456, the fourth meshing part 457, the third abutment part 473, and the fourth abutment part 474 are provided at an end part on the proximal side (Y2 direction side) of the second joint part 452. The abutment between the first abutment part 471 and the third abutment part 473 reduces the load between the first meshing part 454 and the third meshing part 456. Due to the contact between the second contact portion 472 and the fourth contact portion 474, the load between the second meshing portion 455 and the fourth meshing portion 457 is reduced.

[0113] The second joint part 452 has a fifth meshing portion 458, a sixth meshing portion 459 disposed so as to face the fifth meshing portion 458 in the radial direction (A2 direction), a fifth abutment portion 475 adjacent to the radial outside of the fifth meshing portion 458, and a sixth abutment portion 476 adjacent to the radial outside of the sixth meshing portion 459. The fifth meshing portion 458, the sixth meshing portion 459, the fifth abutment portion 475 and the sixth abutment portion 476 are provided at an end portion on the distal side (Y1 direction side) of the second joint part 452.

[0114] The third joint part 453 has a seventh meshing part 460 meshing with the fifth meshing part 458, an eighth meshing part 461 arranged to face the seventh meshing part 460 in the radial direction (A2 direction) and meshing with the sixth meshing part 459, a seventh abutment part 477 abutting with the fifth abutment part 475, and an eighth abutment part 478 abutting with the sixth abutment part 476. The seventh meshing part 460, the eighth meshing part 461, the seventh abutment part 477, and the eighth abutment part 478 are provided at the end part on the proximal side (Y2 direction side) of the third joint part 453. The abutment between the fifth abutment part 475 and the seventh abutment part 477 reduces the load between the fifth meshing part 458 and the seventh meshing part 460. Due to the contact between the sixth contact portion 476 and the eighth contact portion 478, the load between the sixth meshing portion 459 and the eighth meshing portion 461 is reduced.

[0115] Here, in this embodiment, as shown in FIG. 24, the first meshing portion 454 and the second meshing portion 455 have different shapes. In addition, the third meshing portion 456 and the fourth meshing portion 457 have different shapes. This makes it difficult for the first meshing portion 454 of the first joint part 451 to mesh with the fourth meshing portion 457 of the second joint part 452, and makes it difficult for the second meshing portion 455 of the first joint part 451 to mesh with the third meshing portion 456 of the second joint part 452. This makes it possible to correctly mesh the first meshing portion 454 and the third meshing portion 456, and to correctly mesh the second meshing portion 455 and the fourth meshing portion 457, when assembling the first joint part 451 and the second joint part 452. As a result, the joint can be easily and accurately assembled, and even if a malfunction occurs, the cause can be easily identified, allowing for appropriate quality control of the surgical instrument.

[0116] Moreover, the fifth meshing portion 458 and the sixth meshing portion 459 have shapes different from each other. Moreover, the seventh meshing portion 460 and the eighth meshing portion 461 have shapes different from each other. This also enables accurate assembly of the joint and appropriate quality control of the surgical instrument.

[0117] In this embodiment, the first meshing portion 454 and the fourth meshing portion 457 have the same shape. The second meshing portion 455 and the third meshing portion 456 have the same shape. This allows the meshing structure of the first meshing portion 454 and the third meshing portion 456 to be similar to the meshing structure of the second meshing portion 455 and the fourth meshing portion 457, so that the articulation of the wrist joint 45 can be supported in a well-balanced manner by the two meshing structures in the first joint part 451 and the second joint part 452.

[0118] The fifth meshing portion 458 and the eighth meshing portion 461 have the same shape. In addition, the sixth meshing portion 459 and the seventh meshing portion 460 have the same shape. This also allows the articulation movement of the wrist joint 45 to be supported in a well-balanced manner by the two meshing structures in the second joint part 452 and the third joint part 453.

[0119] Moreover, the first meshing portion 454, the fourth meshing portion 457, the fifth meshing portion 458, and the eighth meshing portion 461 have the same shape. Moreover, the second meshing portion 455, the third meshing portion 456, the sixth meshing portion 459, and the seventh meshing portion 460 have the same shape. That is, the first meshing portion 454 and the fifth meshing portion 458 have the same configuration, and the second meshing portion 455 and the sixth meshing portion 459 have the same configuration. Moreover, the third meshing portion 456 and the seventh meshing portion 460 have the same configuration, and the fourth meshing portion 457 and the eighth meshing portion 461 have the same configuration. Therefore, the description of the fifth meshing portion 458, the sixth meshing portion 459, the seventh meshing portion 460, and the eighth meshing portion 461 will be omitted as appropriate.

[0120] 25, the first meshing portion 454 includes a pair of first convex portions 454a arranged along the rotation direction of the second joint part 452, and a first concave portion 454b arranged between the pair of first convex portions 454a. Similarly, the fourth meshing portion 457 includes a pair of fourth convex portions 457a arranged along the rotation direction of the second joint part 452, and a fourth concave portion 457b arranged between the pair of fourth convex portions 457a.

[0121] 26, the second meshing portion 455 includes a pair of second recesses 455a arranged along the rotation direction of the second joint part 452, and a second protrusion 455b arranged between the pair of second recesses 455a. Similarly, the third meshing portion 456 includes a pair of third recesses 456a arranged along the rotation direction of the second joint part 452, and a third protrusion 456b arranged between the pair of third recesses 456a.

[0122] This makes it possible to prevent the first meshing portion 454 having the first recess 454b from easily meshing with the fourth meshing portion 457 having the fourth recess 457b, and also prevents the second meshing portion 455 having the second convex portion 455b from easily meshing with the third meshing portion 456 having the third convex portion 456b. As a result, it is possible to effectively prevent the first joint part 451 and the second joint part 452 from being assembled in the wrong direction.

[0123] As shown in Fig. 27 and Fig. 28, the first meshing portion 454, the second meshing portion 455, the third meshing portion 456, and the fourth meshing portion 457 have a shape in which arcs are connected, or a shape in which arcs and straight lines are connected, as viewed in the rotation axis direction (A1 direction) of the second joint part 452. This makes it easy to design the first meshing portion 454, the second meshing portion 455, the third meshing portion 456, and the fourth meshing portion 457. In addition, since the shapes of the first meshing portion 454, the second meshing portion 455, the third meshing portion 456, and the fourth meshing portion 457 can be easily inspected, the shapes of the first meshing portion 454, the second meshing portion 455, the third meshing portion 456, and the fourth meshing portion 457 can be more appropriately managed.

[0124] Specifically, the first meshing portion 454 and the fourth meshing portion 457 have a shape in which arcs are connected as shown in Fig. 27. The first meshing portion 454 and the fourth meshing portion 457 have an outer shape in which lines including an arc 4541 having a radius R1, an arc 4542 having a radius R2 connected to the arc 4541, an arc 4543 having a radius R3 connected to the arc 4542, an arc 4544 having a radius R4 connected to the arc 4543, an arc 4545 having a radius R3 connected to the arc 4544, an arc 4546 having a radius R2 connected to the arc 4545, and an arc 4547 having a radius R1 connected to the arc 4546 are connected to the arc 4546. Moreover, the first meshing portion 454 and the fourth meshing portion 457 have an axisymmetric shape when viewed in the rotation axis direction (A1 direction) of the second joint part 452.

[0125] 28, the second meshing portion 455 and the third meshing portion 456 have a shape in which a circular arc and a straight line are connected. The second meshing portion 455 and the third meshing portion 456 have an outer shape in which lines including a line segment 4551, a circular arc 4552 connected to the line segment 4551 and having a radius R5, a line segment 4553 connected to the circular arc 4552, a circular arc 4554 connected to the line segment 4553 and having a radius R6, a line segment 4555 connected to the circular arc 4554, a circular arc 4556 connected to the line segment 4555 and having a radius R5, and a line segment 4557 connected to the circular arc 4556 are connected. The second meshing portion 455 and the third meshing portion 456 have an axisymmetric shape when viewed in the rotation axis direction (A1 direction) of the second joint part 452.

[0126] 29 to 32, the wrist joint 45 performs articulation movement to rotate the second joint part 452 relative to the first joint part 451 by driving the wire 46. An end part 46e of the wire 46 is fixed to a third joint part 453 on the end effector side (Y1 direction side) of the wrist joint 45 as shown in FIG.

[0127] 24, the first meshing portion 454 has a first portion 454c and a second portion 454d that are divided and arranged at an interval through which the wire 46 can pass in the radial direction (A1 direction). A first convex portion 454a and a first concave portion 454b are formed in each of the first portion 454c and the second portion 454d. The fourth meshing portion 457 has a third portion 457c and a fourth portion 457d that are divided and arranged at an interval through which the wire 46 can pass in the radial direction (A1 direction) like the first meshing portion 454. A fourth convex portion 457a and a fourth concave portion 457b are formed in each of the third portion 457c and the fourth portion 457d. This prevents the wire 46 from interfering with the first portion 454c and the second portion 454d when a joint movement is performed in which the second joint part 452 is rotated significantly relative to the first joint part 451 as shown in FIG. 32.

[0128] 24, the second meshing portion 455 has a fifth portion 455c formed continuously in the radial direction (A1 direction). The second meshing portion 455 has a portion 455d and a portion 455e which are divided and arranged at an interval allowing the wire 46 to pass in the radial direction (A1 direction). A second protrusion 455b is formed in the fifth portion 455c. A second recess 455a is formed in each of the portion 455d and the portion 454e.

[0129] Similarly to the second meshing portion 455, the third meshing portion 456 has a sixth portion 456c formed continuously in the radial direction (A1 direction). The third meshing portion 456 has a portion 456d and a portion 456e which are separated and arranged at an interval allowing the wire 46 to pass in the radial direction (A1 direction). A third convex portion 456b is formed in the sixth portion 456c. A third concave portion 456a is formed in each of the portion 456d and the portion 456e.

[0130] As shown in FIG. 25, the first joint part 451 is disposed at a position separated from the first meshing part 454 and has a first through hole 451a through which the wire 46 passes. As shown in FIG. 26, the first joint part 451 is disposed at a position separated from the second meshing part 455 and has a second through hole 451b through which the wire 46 passes. As shown in FIG. 26, the second joint part 452 is disposed at a position separated from the third meshing part 456 and has a third through hole 452a through which the wire 46 passes. As shown in FIG. 25, the second joint part 452 is disposed at a position separated from the fourth meshing part 457 and has a fourth through hole 452b through which the wire 46 passes. This allows the through hole through which the wire 46 passes to be disposed at a position separated from the meshing part, so that interference between the meshing part and the wire 46 can be suppressed.

[0131] 29 to 32, the rotation of the second joint part 452 relative to the first joint part 451 will be described. Note that in the example of Fig. 29 to 32, the first meshing part 454 of the first joint part 451 meshes with the third meshing part 456 of the second joint part 452, but the second meshing part 455 of the first joint part 451 meshes with the fourth meshing part 457 of the second joint part 452 in a similar manner with the projections and recesses interchanged. The rotation of the third joint part 453 relative to the second joint part 452 also performs a similar operation.

[0132] As shown in FIG. 29 , when the second joint part 452 is not rotated relative to the first joint part 451, the third convex portion 456b of the third meshing portion 456 of the second joint part 452 fits into the first concave portion 454b of the first meshing portion 454 of the first joint part 451.

[0133] As shown in FIG. 30 , by the operation of the wire 46, the third convex portion 456b of the third meshing portion 456 of the second joint part 452 rotates while coming into contact with the first concave portion 454b of the first meshing portion 454 of the first joint part 451, so that the second joint part 452 rotates by an angle θ1 relative to the first joint part 451.

[0134] 31, by the operation of the wire 46, the third convex portion 456b of the third meshing portion 456 of the second joint part 452 rotates while being in contact with the first convex portion 454a of the first meshing portion 454 of the first joint part 451, and the second joint part 452 rotates by an angle θ2 with respect to the first joint part 451, where the angle θ2 is greater than the angle θ1.

[0135] 32, by the operation of the wire 46, the third convex portion 456b of the third meshing portion 456 of the second joint part 452 further rotates while being in contact with the first convex portion 454a of the first meshing portion 454 of the first joint part 451, and the second joint part 452 rotates by an angle θ3 with respect to the first joint part 451, where the angle θ3 is greater than the angle θ2.

[0136] [Variations] The embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present invention is indicated by the claims, not by the description of the embodiments above, and further includes all modifications (variations) within the meaning and scope of the claims.

[0137] For example, in the above embodiment, a single-opening configuration in which the first jaw member of the end effector opens and closes relative to the second jaw member has been shown, but the present invention is not limited to this. In the present invention, a double-opening configuration in which the first jaw member and the second jaw member of the end effector open and close may also be used. The end effector may be a mechanism that moves the second jaw member relative to the fixed first jaw member to open and close. In this case, the tip of the rod of the elongated element may be connected to the base end of the second jaw member, and the second jaw member may be moved and opened / closed by moving the elongated element in the longitudinal direction of the shaft. Also, a cutting electrode and a coagulation electrode may be provided on the fixed jaw member, and a ground electrode may be provided on the movable jaw member.

[0138] In the above embodiment, the diameter D1 is larger than 1 / 2 and smaller than 3 / 4 of the diameters D2 and D3, but the present invention is not limited to this. In the present invention, the diameter D1 may be 1 / 2 or less of the diameters D2 and D3, or may be 3 / 4 or more of the diameters D2 and D3.

[0139] In the above embodiment, the diameter D1 is 4 mm or more and 6 mm or less, and the diameters D2 and D3 are 7 mm or more and 9 mm or less, but the present invention is not limited to this. In the present invention, the diameter D1 may be smaller than 4 mm or larger than 6 mm. Furthermore, the diameters D2 and D3 may be smaller than 7 mm or larger than 9 mm.

[0140] In the above embodiment, the diameter D4 is approximately the same as the diameter D1, but the present invention is not limited to this. In the present invention, the diameter D4 may be different from the diameter D1.

[0141] In the above embodiment, the heat shrink tube covers 90% to 100% of the metal shaft in the longitudinal direction of the metal shaft, but the present invention is not limited to this. In the present invention, the heat shrink tube may cover less than 90% of the metal shaft in the longitudinal direction of the metal shaft.

[0142] In the above embodiment, the metal shaft is a stainless steel pipe, but the present invention is not limited to this. In the present invention, the metal shaft may be a metal pipe other than stainless steel.

[0143] In the above embodiment, the heat shrink tube is a polyethylene-based heat shrink tube or a fluororesin-based heat shrink tube, but the present invention is not limited to this. In the present invention, the heat shrink tube may be a tube other than a polyethylene-based heat shrink tube or a fluororesin-based heat shrink tube.

[0144] In the above embodiment, the heat shrink tube is a heat shrink tube having a single layer structure, but the present invention is not limited to this. In the present invention, the heat shrink tube may be a heat shrink tube having a two-layer structure.

[0145] In the above embodiment, the heat shrink tube is colored, but the present invention is not limited to this. In the present invention, the heat shrink tube may be colorless.

[0146] In the above embodiment, the wrist joint (wrist joint) is configured to articulate with multiple degrees of freedom, but the present invention is not limited to this. In the present invention, the wrist joint may be configured to articulate with one degree of freedom.

[0147] In the above embodiment, the first and second meshing portions have different shapes, and the third and fourth meshing portions have different shapes, but the present invention is not limited to this. In the present invention, the first and second meshing portions may have the same shape, and the third and fourth meshing portions may have the same shape.

[0148] [Aspects] It will be appreciated by those skilled in the art that the exemplary embodiments described above are examples of the following aspects.

[0149] (Item 1) 1. A surgical instrument for a robotic surgical system, comprising: an end effector rotatably mounted about an axis of rotation, the end effector including first and second jaw members rotatable about the axis of rotation for relative movement relative to one another between an open position and a closed position; A wrist joint portion connected to a proximal end of the end effector; a shaft connected to a proximal end of the wrist joint, A surgical instrument, wherein a diameter D1 of the end effector at the portion where the rotation axis is provided is smaller than a diameter D2 of a central portion in the longitudinal direction of the wrist joint portion and a diameter D3 of a central portion in the longitudinal direction of the shaft.

[0150] (Item 2) 2. The surgical instrument of item 1, wherein the diameter D1 is greater than ½ and less than ¾ of the diameters D2 and D3.

[0151] (Item 3) 3. The surgical instrument according to item 1 or 2, wherein the diameter D1 is equal to or greater than 4 mm and equal to or less than 6 mm, and the diameter D2 and the diameter D3 are equal to or greater than 7 mm and equal to or less than 9 mm.

[0152] (Item 4) 4. The surgical instrument according to any one of items 1 to 3, wherein the wrist joint portion includes a connection portion for connecting to the end effector, and a diameter D4 of a distal end of the connection portion is smaller than the diameters D2 and D3.

[0153] (Item 5) 5. The surgical instrument of item 4, wherein the connection portion of the wrist joint has the diameter D4 at a distal end and the diameter D2 at a proximal end.

[0154] (Item 6) 6. The surgical instrument according to item 5, wherein the connection portion of the wrist joint portion has a shape that gradually tapers from the proximal end having the diameter D2 to the distal end having the diameter D4.

[0155] (Item 7) 7. The surgical instrument according to any one of items 4 to 6, wherein the diameter D4 of the connection portion is substantially the same as the diameter D1.

[0156] (Item 8) The surgical instrument according to any one of items 4 to 7, wherein the wrist joint portion includes a first joint between a first member including the connecting portion and a second member, and includes a second joint between the second member and a third member.

[0157] (Item 9) the first joint is configured to articulate about a first axis of rotation that intersects a longitudinal direction of the shaft; Item 9. The surgical instrument of item 8, wherein the second joint is configured to articulate about a second axis of rotation that intersects both the longitudinal direction of the shaft and the first axis of rotation.

[0158] (Item 10) the first jaw member includes a first electrode and a second electrode insulated from the first electrode; 10. The surgical instrument according to any one of items 1 to 9, wherein the second jaw member includes a third electrode that functions as a ground electrode relative to the first and second electrodes.

[0159] (Item 11) the first electrode is a coagulation electrode; Item 11. The surgical instrument of item 10, wherein the second electrode is a cutting electrode.

[0160] (Item 12) Item 12. The surgical instrument of any one of items 1 to 11, comprising an elongate member configured to move in a longitudinal direction of the shaft to cause the relative movement of the first and second jaw members.

[0161] (Item 13) the elongate member comprises a first rod connected to the first and / or second jaw member, a flexible wire connected to a proximal end of the first rod, and a second rod connected to a proximal end of the flexible wire; Item 13. The surgical instrument of item 12, wherein the flexible wire is disposed inside the wrist joint.

[0162] (Item 14) Item 14. The surgical instrument of item 13, wherein the flexible wire is a torque coil.

[0163] (Item 15) A flexible resin guide is provided inside the wrist joint, 15. The surgical instrument according to any one of items 12 to 14, wherein the resin guide includes a passage formed to pass through a longitudinal center line of the resin guide and for guiding the elongated member.

[0164] (Item 16) Item 16. The surgical instrument according to item 15, wherein the shaft includes a positioning member that positions the resin guide.

[0165] (Item 17) an interface disposed on a proximal end side of the shaft and adapted to be attached to an instrument attachment portion of a robot arm of the robotic surgical system; The tool mount includes a first drive member and a second drive member; 17. The surgical instrument according to any one of items 1 to 16, wherein the interface includes a first receiving member that receives a driving force for driving the end effector from the first driving member and a second receiving member that receives a driving force for driving the wrist joint portion from the second driving member. [Explanation of symbols]

[0166] 21a: robot arm, 40a: surgical instrument, 41: housing (interface), 42: shaft, 43: end effector, 45: wrist joint (wrist joint), 45a: first joint, 45b: second joint, 45c: connection part, 47: rod (elongated member), 47b: first rod, 47c: wire (flexible wire), 47d: second rod, 81: first electrode, 82: second electrode, 83: third electrode, 90: resin guide, 91: passage, 100: robotic surgery system, 212: instrument attachment portion, 214b, 214c: driving member (second driving member), 214d: driving member (first driving member), 421: positioning member, 431a: support shaft (rotation shaft), 442: receiving member (first receiving member, second receiving member), 451: first joint part (third member), 452: second joint part (second member), 453: third joint part (first member), D1, D2, D3, D4: diameter

Claims

1. Surgical instruments for robotic surgical systems, An end effector comprising a first jaw member rotatably mounted around a rotation axis and moving between an open position and a closed position, and a second jaw member fixedly positioned, A wrist joint comprising a first member including a connecting portion connected to the proximal end of the end effector, a second member connected to the first member via a first joint, and a third member connected to the second member via a second joint, The third member comprises a shaft connected to the proximal end, The portion of the end effector on which the rotating shaft is provided has a diameter D1, the central portion in the longitudinal direction of the shaft has a diameter D3, and the connecting portion has a shape that gradually tapers from the proximal end with a diameter D2 to the distal end with a diameter D4. A surgical instrument in which diameters D1 and D4 are greater than half and less than three-quarters of diameters D2 and D3.

2. The surgical instrument according to claim 1, wherein the diameter D1 is 4 mm or more and 6 mm or less, and the diameters D2 and D3 are 7 mm or more and 9 mm or less.

3. The surgical instrument according to claim 1, wherein the proximal end of the end effector has the diameter D1.

4. The surgical instrument according to claim 1, wherein the diameter D2 of the proximal end of the connecting portion is substantially the same as the diameter D3 of the shaft.

5. The first joint is configured to move jointly around a first axis of rotation that intersects the longitudinal direction of the shaft, The surgical instrument according to claim 1, wherein the second joint is configured to articulate around a second axis of rotation that intersects both the longitudinal direction of the shaft and the first axis of rotation.

6. The surgical instrument according to claim 1, further comprising an elongated member configured to move in the longitudinal direction of the shaft, opening the first jaw member relative to the second jaw member by moving toward the distal end of the shaft, and closing the first jaw member relative to the second jaw member by moving toward the proximal end of the shaft.

7. The elongated member comprises a first rod connected to the first jaw member, a flexible wire connected to the base end of the first rod, and a second rod connected to the base end of the flexible wire. The surgical instrument according to claim 6, wherein the flexible wire is disposed inside the wrist joint.

8. A flexible resin guide is provided inside the wrist joint. The surgical instrument according to claim 7, wherein the resin guide is formed to pass through the longitudinal centerline of the resin guide and includes a passage for guiding the flexible wire.

9. The surgical instrument according to claim 8, wherein the shaft includes a positioning member for positioning the resin guide.

10. It is provided with an interface located on the proximal end side of the shaft and attached to the instrument mounting portion of the robotic arm of the robotic surgical system, The aforementioned device mounting section comprises a first drive member, a second drive member, and a third drive member. The surgical instrument according to claim 1, wherein the interface comprises a first receiving member that receives a driving force from the first driving member to drive the first jaw member, a second receiving member that receives a driving force from the second driving member to drive the wrist joint, and a third receiving member that receives a driving force from the third driving member to drive the wrist joint.

11. The surgical instrument according to claim 10, comprising first to fourth wires, each distal end of which is fixed to the first member, for driving the wrist member.

12. The interface comprises a first drive shaft connected to the first receiving member, a second drive shaft connected to the second receiving member, and a third drive shaft connected to the third receiving member, The proximal ends of the first wire and the second wire are wound around the second drive shaft in opposite directions. The proximal ends of the third wire and the fourth wire are wound around the third drive shaft in opposite directions. When the first wire is wound up by the rotation of the second drive shaft and the third wire is wound up by the rotation of the third drive shaft, and when the second wire is wound up by the rotation of the second drive shaft and the fourth wire is wound up by the rotation of the third drive shaft, the first joint performs articulation. The surgical instrument according to claim 11, wherein the second joint performs articular movement when the first wire is wound up by the rotation of the second drive shaft and the fourth wire is wound up by the rotation of the third drive shaft, and when the second wire is wound up by the rotation of the second drive shaft and the third wire is wound up by the rotation of the third drive shaft.

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