Surgical instrument

Abstract

To provide a surgical instrument capable of suppressing electrical connection of the surgical instrument including a wrist joint part with respect to a plurality of electrodes provided in an end effector from becoming unstable.SOLUTION: A surgical instrument 40a for a robot surgery system 100 includes: an end effector 43 including a first jaw 431 having a first electrode 81 and a second electrode 82 and a second jaw 432 having a third electrode 83; a wrist joint 45 having a connection part 45c having conductivity; a shaft 42 connected to the wrist joint 45; a rod 47 moving in a longitudinal direction of the shaft 422 to cause the first jaw 431 and the second jaw 432 to relatively move between an open position and a close position so as to be conductive to the first electrode 81; a first conductor 85 connected to an inner surface of the connection part 45c of the wrist joint 45 and connected to the third electrode 83; and a second conductor 84 connected to the second electrode 82.SELECTED DRAWING: Figure 12

Description

[Technical Field]

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

[0002] Conventionally, surgical instruments attached to robotic arms have been known. For example, Patent Document 1 describes a surgical instrument equipped with an end effector having a cutting electrode that applies a current to cut tissue at a surgical site, a sealing electrode that applies a current to seal tissue at the surgical site, and a return electrode that serves as a ground for the cutting electrode and the sealing electrode. Furthermore, the surgical instrument of Patent Document 1 has a wrist that rotates the end effector equipped with the electrode and is provided between the end effector and the shaft. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Publication No. 2022-027783 Summary of the Invention [Problem to be solved by the invention]

[0004] The surgical instrument of Patent Document 1 has a wrist (wrist joint) that rotates an end effector equipped with electrodes, and is located between the end effector and the shaft. Therefore, it is necessary to pass electricity to each electrode of the end effector from the shaft side via the wrist. In this case, since the rotating wrist (wrist joint) is in the path of electricity, the connection between the shaft side and each electrode becomes unstable due to the rotation of the wrist. Therefore, it is desirable to prevent the electrical connection between the multiple electrodes equipped on the end effector of a surgical instrument equipped with a wrist joint from becoming unstable.

[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 is capable of suppressing instability in the electrical connection to multiple electrodes provided on the end effector of the surgical instrument having a wrist joint portion. [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 including a first jaw member and a second jaw member movable relative to each other between an open position and a closed position, the first jaw member having a first electrode and a second electrode different from the first electrode, and the second jaw member having a third electrode; a wrist joint portion including a conductive connecting portion and connected to a proximal end of the end effector via the connecting portion; a shaft connected to the proximal end of the wrist joint portion; an elongated member connected to at least one of the first jaw member and the second jaw member and configured to move the first jaw member and the second jaw member relative to each other by moving in the longitudinal direction of the shaft, the elongated member being configured to be electrically connected to one of the first electrode and the third electrode; a first lead wire connected to an inner surface of the connecting portion of the wrist joint portion and configured to be electrically connected to the other of the first electrode and the third electrode via the connecting portion; and a second lead wire connected to the second electrode.

[0007] In a surgical instrument according to one aspect of the present invention, as described above, a conductive connection portion is provided in the wrist joint portion. This allows the electrodes to be electrically connected to the shaft side via the conductive connection portion of the wrist joint portion. This allows electricity to pass through the connection portion of the wrist joint portion even when the wrist joint portion rotates, thereby stabilizing the electrical connection to the electrodes. As a result, it is possible to prevent the electrical connection to the multiple electrodes provided in the end effector of the surgical instrument having a wrist joint portion from becoming unstable. [Effects of the Invention]

[0008] According to the present invention, it is possible to prevent the electrical connection to a plurality of electrodes provided on an end effector of a surgical instrument having a wrist joint portion from becoming unstable. [Brief explanation of the drawings]

[0009] [Figure 1] FIG. 1 is a diagram illustrating the configuration of a robotic surgery system according to one embodiment. [Figure 2] FIG. 1 is a block diagram showing the control configuration of a robotic surgery system according to one embodiment. [Figure 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. [Figure 5] FIG. 1 is a perspective view of a surgical instrument according to one embodiment, viewed from below. [Figure 6] FIG. 1 is a plan view of a surgical instrument according to one embodiment. [Figure 7] FIG. 1 is a perspective view of a surgical instrument according to one embodiment with a cover removed. [Figure 8] FIG. 1 is a plan view showing a state in which a lid portion of a surgical instrument according to one embodiment is removed. [Figure 9] FIG. 1 is a cross-sectional view showing a state in which a cover portion of a surgical instrument according to one embodiment is removed. [Figure 10] FIG. 12 is a side view of an end effector, wrist joint, and shaft according to one embodiment. [Figure 11] FIG. 10 is a cross-sectional view of an end effector, wrist joint, and shaft according to one embodiment. [Figure 12] FIG. 1 is a first diagram illustrating connections between a first electrode, a second electrode, and a third electrode according to an embodiment. [Figure 13] FIG. 2 is a second diagram illustrating connections between the first electrode, the second electrode, and the third electrode according to one embodiment. [Figure 14]FIG. 10 is a side view illustrating 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 arrows C1-C1 in FIG. 10. FIG. [Figure 16] FIG. 1 is an exploded perspective view of an end effector and rod according to one embodiment. [Figure 17] FIG. 1 is a side view of a rod according to one embodiment. [Figure 18] FIG. 1 is a cross-sectional view of a rod according to one embodiment. [Figure 19] FIG. 12 is a perspective view of a guide portion within a wrist joint of a surgical instrument according to one embodiment. [Figure 20] FIG. 10 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] FIG. 2 is a cross-sectional view illustrating a memory substrate and a fixing portion according to an embodiment. [Figure 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. [Figure 25] 10 is a cross-sectional view showing first and fourth jaws of a wrist joint of a surgical instrument according to one embodiment. FIG. [Figure 26] 10 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. 10 is an enlarged view showing the first and fourth jaws of the wrist joint of a surgical instrument according to one embodiment. [Figure 28] FIG. 10 is an enlarged view showing 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. [Figure 30]FIG. 10 is a diagram showing the wrist joint of the surgical instrument according to one embodiment in a state where it has been rotated by an angle θ1. [Figure 31] FIG. 10 is a diagram showing the wrist joint of the surgical instrument according to one embodiment in a state where it has been rotated by an angle θ2. [Figure 32] FIG. 10 is a diagram showing the wrist joint of the surgical instrument according to one embodiment in a state where it has been rotated by an angle θ3. DETAILED DESCRIPTION OF THE INVENTION

[0010] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, 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, a 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 (surgeon), the remote control device 10 transmits the operation mode command to the patient-side device 20 via a controller 24. Then, 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 a patient P. The patient-side device 20 is placed beside an operating table 30 on which the patient P lies. The patient-side device 20 has multiple 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. Each robot arm 21a, 21b is supported in common by an arm base 22. The multiple robot arms 21a, 21b have multiple 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 so that drive signals given via a controller 24 control the medical instruments attached to the robot arms 21a, 21b to 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 move the position of the arm base 22 three-dimensionally. 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 detachably attached to the distal end 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 can 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 then positioned near the surgical site.

[0016] An endoscope 40b serving as a medical instrument is detachably attached to the distal end 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 positioned near the surgical site.

[0017] The remote control device 10 constitutes an interface with the operator. The remote control device 10 is a device that allows the operator to operate the medical instruments attached to the robot arms 21a, 21b. That is, the remote control device 10 is configured to be able to transmit 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 via the controller 24. 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 performed 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, if the surgical instrument 40a is a vessel sealer, the operation modes to be performed by the surgical instrument 40a are the pitch rotation operation and yaw rotation operation of the wrist of the end effector 43, the operation of opening and closing the jaws, the operation of coagulating tissue by supplying a coagulation current to the end effector 43, and the operation of incising tissue by supplying a cutting current to the end effector 43.

[0019] The operation mode to be performed 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 unit 12, a display unit 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 operating area. That is, the operating handle 11 is configured so as to be movable in the up-down direction, left-right direction, front-rear direction, and rotational direction.

[0023] The remote control device 10 and the patient-side device 20 constitute a master-slave system in controlling the movements of the robot arms 21a and 21b. That is, the operation handle 11 constitutes the master-side operation unit in the master-slave system, and the robot arms 21a and 21b to which medical instruments are attached constitute the slave-side operation unit. When the operator operates the operation handle 11, the movement 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 in accordance with the movement of the operation handle 11.

[0024] Furthermore, the patient-side device 20 is configured to control the operation of the robot arm 21a according to a 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 of the movement distance of the operating handle 11. This allows for precise surgery to be performed with precision.

[0025] The operation pedal unit 12 includes a plurality of pedals for performing 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 operator's feet.

[0026] The coagulation pedal can be operated to coagulate the surgical site using the surgical instrument 40a. Specifically, when the coagulation pedal is operated, a coagulation current is supplied to the surgical instrument 40a, causing coagulation of the surgical site. The cutting pedal can be operated to cut the surgical site using the surgical instrument 40a. Specifically, when the cutting pedal is operated, a cutting current is supplied to the surgical instrument 40a, causing cutting of the surgical site.

[0027] The camera pedal is used to control the position and posture of the endoscope 40b that captures images inside a body cavity. Specifically, the camera pedal enables operation by the operating handle 11 of the endoscope 40b. In other words, while the camera pedal is pressed, the position and posture of the endoscope 40b can be controlled by the operating handle 11. For example, the endoscope 40b is operated by using both the left and right operating handles 11. Specifically, the endoscope 40b is rotated by rotating the left and right operating handles 11 around the midpoint between the left and right operating handles 11. Furthermore, by pushing both the left and right operating handles 11 in together, the endoscope 40b moves further in. Furthermore, by pulling both the left and right operating handles 11 in together, the endoscope 40b moves forward and backward. Furthermore, by moving both the left and right operating handles 11 in up, down, left, and right directions, the endoscope 40b moves 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 and stop the operation of the surgical instrument 40a. Specifically, while the clutch pedal is operated, the robot arm 21a of the patient-side device 20 will not move even if the operating handle 11 is operated. For example, when the operating handle 11 is moved near the end of its movable range, the clutch pedal can be 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 operation of the operating handle 11 can be resumed near the center.

[0029] The display unit 13 is capable of displaying images captured by the endoscope 40b. The display unit 13 is composed of a scope-type display unit or a non-scope-type display unit (a scope-type display unit is shown in FIG. 1). A scope-type display unit is, for example, a display unit that you peer into. A non-scope-type display unit is a concept that includes an open-type display unit with a flat screen that is not a type that you peer into like a normal personal computer display.

[0030] When a scope-type display unit is attached, a 3D image captured by the 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 the endoscope 40b provided in the patient-side device 20 is also displayed. Note that when a non-scope-type display unit is attached, a 2D image captured by the endoscope 40b provided in the patient-side device 20 may also 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 ROM and RAM, and an image control unit 143. The control device 14 may be configured as a single control device for centralized control, or as a plurality of control devices for distributed control in cooperation with each other. The control unit 141 determines whether the operation mode command input via 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. If the control unit 141 determines that the operation mode command input via 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. This causes the controller 24 to drive the robot arm 21a, which in turn controls the operation of the surgical instrument 40a attached to the robot arm 21a.

[0032] Furthermore, when the control unit 141 determines that the operation mode command input to the operating 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 drives the robot arm 21b, and this drive controls the operation of the endoscope 40b attached to the robot arm 21b.

[0033] The memory unit 142 stores, for example, control programs 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 operation commands of the operating handle 11 and / or operating pedal unit 12 of the remote control device 10 can be made to operate in accordance with 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 processes and corrects the image as necessary.

[0035] (Surgical instruments, adapters, drapes and robotic arm configuration) 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 direction toward the tip of the surgical instrument 40a (toward the end effector 43) within 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 is the Z direction, the Z direction toward the surgical instrument 40a within the Z direction is the Z1 direction, and the opposite side of the Z1 direction is the Z2 direction. Furthermore, the direction perpendicular to the Y direction and the Z direction is the X direction, and 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 robot arm 21a and the adapter 60.

[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 used in a clean area and is therefore covered with a drape 70. In the operating room, a clean operation is performed to prevent the surgical incision and medical equipment from becoming contaminated with pathogens or foreign objects. In this clean operation, a clean area and a contaminated area other than the clean area are defined. The surgical site is placed in the clean area. During surgery, members of the surgical team, including the operator, ensure that only sterilized objects are placed in the clean area, and when an object located in the contaminated area is moved to the clean area, the object is sterilized. Similarly, when an assistant on the surgical team, including the operator, places their hands in the contaminated area, they sterilize their hands before directly touching an object located in the clean area. Instruments used in the clean area are sterilized or are 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 portion 72 that is sandwiched between the robot arm 21a and the adapter 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 adapter 60 can engage with each other. The attachment portion 72 is provided in the opening of the main body 71. The attachment portion 72 is made of a resin molded member. The resin molded member is made of a resin material such as polyethylene terephthalate. The attachment portion 72 is formed to be harder (less flexible) than the main body 71. The attachment portion 72 has an opening so that the robot arm 21a and the adapter 60 can engage with each other. The opening of the attachment portion 72 may be provided to correspond to the portion where the robot arm 21a and the adapter 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] 5 and 7, the surgical instrument 40a has multiple (four) drive shafts 44a, 44b, 44c, and 44d. The multiple drive shafts 44a to 44d are provided inside the housing 41 and are rotatable about rotation axes extending in the Z direction. The multiple drive shafts 44a to 44d are rotationally driven by driving force from a motor of a drive unit 213 provided in the robot arm 21a. The multiple drive shafts 44a to 44d are provided to operate (drive) the shaft 42, the end effector 43, and a wrist joint 45, which will be 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 driving 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 shaft 44a to 44d on the Z2 direction side toward the adapter 60 (Z2 direction side). The protrusions 441 are arranged linearly. 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 driving 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 rotatable about a rotation axis extending in the Z direction.

[0044] The multiple drive transmission members 61 include engaging recesses 611 that engage with protrusions 441 of the multiple drive shafts 44a to 44d of the surgical instrument 40a. The engaging recesses 611 are provided on the surgical instrument 40a side (Z1 direction side) of the drive transmission members 61, and are recessed from the Z1 direction side surface of the drive transmission members 61 toward the opposite side from the surgical instrument 40a side (Z2 direction side). The multiple drive transmission members 61 include engaging recesses on their Z2 direction side surfaces that engage with engaging 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 mounting portion 212. The instrument mounting portion 212 includes a drive unit 213 and multiple drive members 214a-214d. Multiple (four) drive units 213 are provided to correspond to the multiple drive shafts 44a-44d of the surgical instrument 40a and the multiple drive transmission members 61 of the adapter 60. The drive unit 213 includes an absolute encoder and a servo motor and is configured to rotate the corresponding drive members about a rotation axis extending in the Z direction. Each of the multiple drive members 214a-214d corresponds to the multiple drive shafts 44a-44d and has an engaging protrusion that engages with an engaging recess on the surface of the drive transmission member 61 on the Z2 direction side. The engaging protrusion protrudes from the surface on the Z1 direction side of the robot arm 21a toward the Z1 direction (toward the adapter 60). The drive unit 213 is configured to drive the drive transmission member 61 of the adapter 60 engaged with the plurality of drive 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 drive member 214d is an example of a "first drive member" in the claims. The drive members 214b and 214c are examples of a "second drive 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 multiple 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 unit 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" 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 detachably attached to the base 411.

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

[0051] As shown in Figure 11, the shaft 42 includes a hollow metal shaft 42a and a heat-shrinkable 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-shrinkable 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-shrinkable tube 42b) can be prevented from peeling off due to friction. This effect is particularly effective in surgical robots that do not have a mechanism for gripping the cannula (trocar) on the robot arm 21a, as in this embodiment. The heat-shrinkable tube 42b covers the surface of the metal shaft 42a by shrinking when heated.

[0052] The heat-shrinkable tube 42b covers 90% to 100% of the metal shaft 42a in the longitudinal direction (Y direction) of the metal shaft 42a. This effectively prevents the material covering the shaft 42 (heat-shrinkable tube 42b) from peeling off when a wide range of the metal shaft 42a is covered with the heat-shrinkable tube 42b. Preferably, the heat-shrinkable 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-shrinkable tube 42b has a length L2 in the Y direction. 0.90L1≦L2≦L1. Preferably, 0.95L1≦L2≦0.99L1. If there is a portion of the metal shaft 42a that is not covered by the heat-shrinkable tube 42b, the portion of the metal shaft 42a that is not covered by the heat-shrinkable tube 42b is located on the distal end side of the metal shaft 42a.

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

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

[0056] The heat-shrinkable tube 42b has a single layer structure, which simplifies the structure of the heat-shrinkable tube 42b compared to a case where a heat-shrinkable tube 42b having a two-layer structure is used.

[0057] The heat-shrinkable tube 42b is black, which can suppress reflection of illumination light from 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 move relative to each other between an open position and a closed position. The first jaw 431 and the second jaw 432 are each electrically conductive. 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 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," respectively, in the claims.

[0059] As shown in FIGS. 10, 11, and 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 also 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 electrical interaction between the first jaw 431 and the second jaw 432 via 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 that does not face the second jaw 432 is coated with an electrically insulating material. Furthermore, the outer surface of the portion of the second jaw 432 that does not face the first jaw 431 is coated with an electrically insulating material. Furthermore, the outer surface of the wrist joint 45 is coated with an electrically insulating material. This prevents the outer surfaces of the non-facing portions of the first jaw 431 and the second jaw 432 from being exposed to the outside, thereby preventing discharge through the outer surfaces of the non-facing portions of the first jaw 431 and the second jaw 432. Furthermore, since the outer surface of the wrist joint 45 is prevented from being exposed to the outside, discharge through the outer surface of the wrist joint 45 can be prevented.

[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 the wrist joint 45 around a first direction (X direction in Figure 7) perpendicular to the Y direction and yaw 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 roll 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 pitch or yaw 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 FIGS. 7, 10, and 11, the wrist joint 45 is connected to the distal end (Y1 direction side) of the shaft 42 and is configured to be capable of articulation. The wrist joint 45 is electrically conductive. For example, the wrist joint 45 is made of stainless steel, which is a conductor. Specifically, the wrist joint 45 has a first joint component 451, a second joint component 452, and a third joint component 453. The first joint component 451 is connected to the distal end (Y1 direction side) of the shaft 42. The second joint component 452 is disposed on the distal end (Y1 direction side) of the first joint component 451 and meshes with the first joint component 451 to enable yaw articulation. The third joint component 453 is disposed on the distal end of the second joint component 452 and meshes with the second joint component 452 to enable pitch articulation. Details of the meshing of the wrist joint 45 will be described later. The first joint part 451 is an example of a "third member" in the claims. The second joint part 452 is an example of a "second member" in the claims. The 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, thereby enabling the end effector to move more freely. Specifically, the wrist joint 45 includes a first joint 45a between the second joint component 452 and a third joint component 453 including a connecting portion 45c (described later) including a conductor, and a second joint 45b between the second joint component 452 and the first joint component 451. This allows articulation at each of the two joints, the first joint 45a and the second joint 45b, allowing the end effector 43 to move more freely than if only one joint were provided. The first joint 45a is configured to articulate with a degree of freedom in the pitch direction. Furthermore, 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 the degree of freedom in a direction perpendicular to the longitudinal axis (Y-axis) of the shaft 42, and the degree of freedom in the yaw direction is the degree of freedom in a direction perpendicular to the longitudinal axis and pitch direction. This allows the first joint 45a and the second joint 45b to move with degrees of freedom in the pitch direction and yaw direction that are perpendicular to each other, so the end effector 43 can move more freely than when two joints move with degrees of freedom in the same direction.

[0066] As shown in FIG. 14 , diameter D1 of end effector 43 at the portion where the rotation axis (support axis 431a described later) of first jaw 431 and second jaw 432 is provided is smaller than diameter D2 of the central portion of wrist joint 45 in the longitudinal direction (Y direction) and diameter D3 of the central portion of shaft 42. This allows diameter D1 of end effector 43 from wrist joint 45 onward to be reduced while maintaining diameter D3 of the central portion of shaft 42 at a diameter that allows strength to be maintained. Therefore, unlike when the end effector 43, wrist joint 45, and shaft 42 all have the same small diameter, end effector 43 can be reduced in diameter while maintaining strength. Furthermore, even for surgical instrument 40a for a robotic surgical system that has a wrist joint 45, which has a more complex structure than a surgical instrument for laparoscopic surgery that does not have a wrist joint 45, end effector 43 can be reduced in diameter while maintaining strength. Diameter D2 is approximately the same as diameter D3. Furthermore, the diameter D1 is the diameter when the first jaw 431 and the second jaw 432 are closed.

[0067] The diameter D1 is larger than 1 / 2 (4 / 8) of the diameters D2 and D3, but smaller than 3 / 4 (6 / 8). 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. Furthermore, 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 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, diameter D1 is 4 mm or more and 6 mm or less. Furthermore, diameters D2 and D3 are 7 mm or more and 9 mm or less. This allows the end effector 43, wrist joint 45, and shaft 42 to have appropriate diameters. Diameter D1 is not particularly limited, but is, for example, 5 mm. Furthermore, diameters D2 and D3 are not particularly limited, but are, for example, 8 mm.

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

[0070] The connection portion 45c of the wrist joint 45 has a diameter D4 at its distal end and a diameter D2 at its proximal end. This allows the diameter at the connection portion 45c of the wrist joint 45 to be narrowed from diameter D2 to diameter D4, making it easy to narrow the diameter of the end effector 43 while maintaining strength. The connection portion 45c of the wrist joint 45 has a shape that gradually tapers from the proximal end having diameter D2 to the distal end having diameter D4. This allows the connection portion 45c of the wrist joint 45 to smoothly narrow from diameter D2 to diameter D4, unlike when the connection portion 45c of the wrist joint 45 has a step where the diameter changes from D2 to D4. Furthermore, the diameter D4 of the connection portion 45c is approximately the same as the diameter D1. This allows the diameter D4 of the connection portion 45c to be approximately the same as the diameter D1 of the end effector 43, making it easier to connect the end effector 43 and the wrist joint 45.

[0071] 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 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 wires 46a and 46b is pulled in the proximal direction (Y2 direction), and the other of wires 46a and 46b is loosened and pulled out in the distal direction (Y1 direction). When the second drive shaft 44b rotates in the opposite direction, the other of wires 46a and 46b is pulled in the proximal direction (Y2 direction), and one of wires 46a and 46b is loosened and pulled out in the distal direction (Y1 direction).

[0073] The distal ends of the wires 46c and 46d are connected to the wrist joint 45, and the proximal ends are 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 pulled 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 pulled 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 wires 46a and 46b by the second drive shaft 44b and by driving wires 46c and 46d by the third drive shaft 44c. The wrist joint 45 rotates the second joint 45b about the rotation axis A1 (yaw joint movement) and the first joint 45a 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] Furthermore, 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. Furthermore, 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 component 453. FIG. 15 is a cross-sectional view of the third joint component 453 as seen from the arrow C1-C1 direction in FIG. 10. As shown in FIG. 15, the cross section of the third joint component 453 is divided into four regions, a first region D1 to a fourth region D4, 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 have their respective ends 46e fixed near the proximal end of the third joint component 453. Specifically, wire 46a passes through a position offset from planes B1 and B2 in first region D1, wire 46b passes through a position offset from planes B1 and B2 in second region D2, wire 46c passes through a position offset from planes B1 and B2 in third region D3, and wire 46d passes through a position offset from planes B1 and B2 in fourth region D4. In Figure 12, first region D1 is located in the first quadrant, second region D2 is located in the third quadrant, third region D3 is located in the second quadrant, and fourth region D4 is located 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, thereby moving the first jaw 431 and the second jaw 432 relatively 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. The rod 47 also 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 when the rod 47 moves in the Y direction. This allows the first jaw 431 to rotate about the axis of the support shaft 431a when the rod 47 moves in the Y direction, opening and closing the first jaw 431 relative to the second jaw 432. The end effector 43 is a one-way swing 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 hole portions 432a provided in the second jaw 432 and rotatably supported. The connection portion 431b has an elongated hole portion 431c. A pair of elongated hole portions 431c are provided. Tips on one side and the other side 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 elongated hole portions 431c and supported so as to be slidable along the elongated hole portions 431c. When the rod 47 is moved in the Y1 direction, the pin portion 47a slides along the elongated hole portions 431c, thereby applying a force in a direction that opens the first jaw 431. As a result, the first jaw 431 rotates in the 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 slides along the elongated hole portion 431c, applying a force in the 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] 12, a rod 47 is connected to the first electrode 81. 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 into 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 into 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 while being insulated using the rod 47, the first conductive wire 85, and the second conductive wire 84. The electrodes can also be electrically connected to the shaft 42 via the connection portion 45c of the wrist joint 45, which includes a conductor. This allows electricity to flow through the connection portion 45c of the wrist joint 45 even when the wrist joint 45 rotates, thereby stabilizing the electrical connection to the electrodes. As a result, it is possible to prevent the electrical connection to the multiple electrodes provided on the end effector 43 of the surgical instrument 40a equipped with 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 for an easy and stable electrical connection between the second jaw 432 and the connection portion 45c.

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

[0085] 11, 17, and 18, the rod 47 includes a conductive first rod 47b connected to the first jaw 431, a conductive wire 47c connected to the proximal end of the first rod 47b, and a conductive second rod 47d connected to the proximal end of the wire 47c. The wire 47c is flexible and 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. Furthermore, unlike when the entire rod 47 is formed of the wire 47c, the strength of the rod 47 can be maintained by providing the first rod 47b and the second rod 47d.

[0086] The first rod 47b has a pin 47a at its tip, and moves the first jaw 431 by forces 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 approximately the same diameter as 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] Furthermore, the wire 47c is a torque coil. This prevents 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 prevent the movement distance of the rod 47 required to open and close the first jaw 431 and the second jaw 432 from varying depending on the degree of tightening of the wire 47c. Furthermore, because the wire 47c is a torque coil, it can exhibit high torque transmission even in a bent state. The torque coil can be one in which unidirectional twisting is made difficult to unravel by forming or the like, or one in which S twisting and Z twisting 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 formed to pass through the longitudinal centerline of the resin guide 90 (a centerline extending in the Y direction) and to guide the rod 47. This allows the rod 47 to be guided through the passage 91 of the resin guide 90, facilitating movement of the rod 47 for opening and closing the first jaw 431 and the second jaw 432. Furthermore, the resin guide 90 can be bent in response to articulation of the wrist joint 45, so that even when the wrist joint 45 articulates, movement of the rod 47 for opening and closing the first jaw 431 and the second jaw 432 can be easily performed. Furthermore, the resin guide 90 includes passages 92 and 93 formed offset from the longitudinal centerline of the resin guide 90. The passage 92 guides the first conducting wire 85. The passage 93 guides the second conducting wire 84. The passage 91 is an example of a "third passage" in the claims. The passage 92 is an example of a "first passage" in the claims. The passage 93 is an example of the "second passage" in the claims.

[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] 11, a positioning member 421 is provided on the distal end side (Y1 direction side) of the shaft 42, which positions the resin guide 90 in the longitudinal direction (Y direction) of the resin guide 90 between the positioning member 421 and the wrist joint 45. This allows the resin guide 90 to be positioned in the longitudinal direction by the positioning member 421, thereby preventing the resin guide 90 from being displaced due to movement of the rod 47. The positioning member 421 has a stepped portion 421a, and positions the resin guide 90 in the longitudinal direction of the resin guide 90 by sandwiching a protrusion 94 of the resin guide 90 between the stepped portion 421a and the first joint part 451. The protrusion 94 protrudes in a direction perpendicular to the longitudinal direction of the resin guide 90, and is sandwiched in the longitudinal direction of the resin guide 90 between the stepped portion 421a and the first joint part 451.

[0093] As shown in FIGS. 7 to 9 , the lever 48 has an arm 481 including a rotatably supported shaft portion 481a 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, moving the rod 47 in the Y direction. Since the shaft portion 481a of the lever 48 itself, which moves the rod 47 in the Y direction, serves as the rotation axis of the lever 48, there is no need to use a drive shaft as the rotation axis. As a result, only one drive shaft (the fourth drive shaft 44d) can be used to move the rod 47 in the Y direction of the shaft 42 and actuate the end effector 43. As a result, the four drive shafts 44a to 44d can rotate the shaft 42 in the roll direction, articulate the end effector 43 in the pitch and yaw directions, and move the rod 47 for actuating the end effector 43 in the Y direction of the shaft 42.

[0094] Furthermore, a pair of arms 481 are provided facing each other in the Z direction. One engaging portion 482 of the pair of arms 481 engages with the rod 47 from one side (the Z1 direction side). The other engaging portion 482 of the pair of arms 481 engages with the rod 47 from the other side (the Z2 direction side). This allows the engaging 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 spaced apart from each other in the Z direction and connected to each other by a connecting portion 483 extending in the Z direction. Each of the pair of arms 481 is provided to extend in the X direction from the connecting portion 483 to the position of the rod 47. Each of the pair of arms 481 has a shaft portion 481a between the end on the connecting portion 483 side and the end on the rod 47 side. Specifically, each of the pair of arms 481 has the shaft portion 481a closer to the connecting portion 483 than the center between the end on the connecting portion 483 side and the end on the rod 47 side. In addition, an engagement portion 482 is provided at the end 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] Further, one shaft portion 481a of the pair of arms 481 protrudes in the Z1 direction. One shaft portion 481a of the pair of arms 481 is rotatably supported by a frame member 52 provided inside the housing 41. Specifically, one shaft portion 481a of the pair of arms 481 is inserted into and rotatably supported by a supported portion 521 including a hole provided in the frame member 52. Further, the other shaft portion 481a of the pair of arms 481 protrudes in the Z2 direction. The other shaft portion 481a of the pair of arms 481 is rotatably supported by the base 411. Specifically, the other shaft portion 481a of the pair of arms 481 is inserted into and rotatably supported by a supported portion 411a including a recess provided in the base 411.

[0098] Furthermore, the axis of shaft portion 481a is disposed between engaging portion 482 and fourth drive shaft 44d in the X direction, which is perpendicular to the Y direction. This allows the axis of shaft portion 481a to be disposed between engaging portion 482 and fourth drive shaft 44d in the X direction, which is perpendicular to the Y direction. This allows lever 48 to be made more compact than when the axis of shaft portion 481a is disposed further outward than fourth drive shaft 44d. The axis of shaft portion 481a is disposed closer to fourth drive shaft 44d than the center between engaging portion 482 and 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, it is possible to easily secure a space for installing the lever 48.

[0100] Furthermore, 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 via the gear train 491. This allows the driving force to be reliably transmitted from the fourth drive shaft 44d to the lever 48 via the gear train 491, which transmits the driving force through 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 the decelerated rotation to the lever 48. This allows the lever 48 to be driven with torque that increases in inverse proportion 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 the ability to drive the lever 48 with torque that increases in inverse proportion to the deceleration of the rotation of the fourth drive shaft 44d is effective when a 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 on a common rotation shaft 491c and rotate integrally 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 engaging portion 482 engages with the rod 47 via the holding member 50, and when the engaging portion 482 pushes the holding member 50 toward the proximal end side in the Y direction (Y2 direction side), the reaction force of the spring member 51 applies a gripping force to the end effector 43. 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. Furthermore, unlike when the gripping force of the end effector 43 is applied using a wire, as in the wrist joint 45, the gripping force is less affected by slight stretching of the wire. This eliminates the need to precisely set the 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 as a circumferentially formed recess. A portion of the engaged portion 501 on the Z1 direction side is recessed toward the Z2 direction side, and one engaging portion 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 engaging portion 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 extended 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 driven to rotate, 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 Y1-side side of the engaging portion 482 of the lever 48 abuts against the Y2-side side of the engaged portion 501 of the holding member 50, pushing and moving the holding member 50 in the Y1 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 Y1 direction. In this case, the first jaw 431 moves in the opening direction. Furthermore, when the rod 47 is moved in the Y2 direction, the Y2-side surface of the engaging portion 482 of the lever 48 abuts against the Y1-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. As a result, the rod 47, whose held portion 47g is held by the rod holding portion 503 of the holding member 50, is moved 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 the fixing mechanism 55 for the circuit board 54 will be described with reference to FIGS. 8, 21 and 22. FIG.

[0108] As shown in Figures 8, 21, and 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 mounted on the base 411. The circuit board 54 is a memory board. Information about the surgical instrument 40a, such as the type of surgical instrument 40a and the number of times the surgical instrument 40a has been used, is stored on the circuit board 54. The fixing mechanism 55 fixes the circuit board 54 to the base 411. The fixing mechanism 55 is a snap-fit ​​fixing mechanism having multiple (four) snap-fit ​​portions 551. Two of the snap-fit ​​portions 551 are provided on each of the Y1 and Y2 sides of the circuit board 54, and press the outer periphery of the circuit board 54 from the Z1 direction. When the circuit board 54 is attached to the fixing mechanism 55 from the Z1 direction to the Z2 direction, the snap-fit ​​portions 551 are pressed by the circuit board 54 and elastically deformed. By providing a snap-fit ​​fixing mechanism as fixing mechanism 55, circuit board 54 can be fixed 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 FIGS. 23 and 24 , the wrist joint 45 includes a first joint component 451 and a second joint component 452 that is adjacent to the first joint component 451 on the distal side (Y1 direction side) and rotates relative to the first joint component 451. The wrist joint 45 also includes a third joint component 453 that is adjacent to the second joint component 452 on the distal side (Y1 direction side) and rotates relative to the second joint component 452. As shown in FIGS. 10 and 23 , the second joint component 452 is rotatable about a rotation axis A1 relative to the first joint component 451. The rotation axis A1 extends in a direction perpendicular to the longitudinal direction (Y direction) of the shaft 42. The third joint component 453 is rotatable about a rotation axis A2 that is perpendicular to the rotation axis A1 relative to the second joint component 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. 23, the wrist joint 45 includes a second joint 45b that rotates around the rotation axis A1 and a first joint 45a that rotates around the rotation axis A2.

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

[0112] The second joint component 452 has a third meshing portion 456 that meshes with the first meshing portion 454, a fourth meshing portion 457 that is disposed radially opposite the third meshing portion 456 (direction A1) and meshes with the second meshing portion 455, a third abutting portion 473 that abuts with the first abutting portion 471, and a fourth abutting portion 474 that abuts with the second abutting portion 472. The third meshing portion 456, the fourth meshing portion 457, the third abutting portion 473, and the fourth abutting portion 474 are provided at an end portion on the proximal side (direction Y2) of the second joint component 452. The abutment between the first abutting portion 471 and the third abutting portion 473 reduces the load between the first meshing portion 454 and the third meshing portion 456. The contact between the second contact portion 472 and the fourth contact portion 474 reduces the load between the second meshing portion 455 and the fourth meshing portion 457.

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

[0114] The third joint component 453 has a seventh meshing portion 460 that meshes with the fifth meshing portion 458, an eighth meshing portion 461 that is disposed radially opposite the seventh meshing portion 460 (direction A2) and meshes with the sixth meshing portion 459, a seventh abutting portion 477 that abuts the fifth abutting portion 475, and an eighth abutting portion 478 that abuts the sixth abutting portion 476. The seventh meshing portion 460, the eighth meshing portion 461, the seventh abutting portion 477, and the eighth abutting portion 478 are provided at the end of the proximal side (direction Y2) of the third joint component 453. The abutment between the fifth abutting portion 475 and the seventh abutting portion 477 reduces the load between the fifth meshing portion 458 and the seventh meshing portion 460. The contact between the sixth contact portion 476 and the eighth contact portion 478 reduces the load between the sixth meshing portion 459 and the eighth meshing portion 461.

[0115] 24 , in this embodiment, the first and second interlocking portions 454 and 455 have different shapes. Furthermore, the third and fourth interlocking portions 456 and 457 have different shapes. This makes it difficult for the first interlocking portion 454 of the first joint component 451 to interlock with the fourth interlocking portion 457 of the second joint component 452, and also makes it difficult for the second interlocking portion 455 of the first joint component 451 to interlock with the third interlocking portion 456 of the second joint component 452. This allows the first and third interlocking portions 454 and 456 to interlock properly, and the second and fourth interlocking portions 455 and 457 to interlock properly when assembling the first and second joint components 451 and 452. As a result, the joint can be assembled easily and accurately, and even if a malfunction occurs, the cause can be easily identified, allowing for appropriate quality control of the surgical instrument.

[0116] Furthermore, the fifth meshing portion 458 and the sixth meshing portion 459 have mutually different shapes. Furthermore, the seventh meshing portion 460 and the eighth meshing portion 461 have mutually different shapes. This also allows the joint to be assembled accurately, and allows for appropriate quality control of the surgical instrument.

[0117] Furthermore, in this embodiment, the first meshing portion 454 and the fourth meshing portion 457 have the same shape. Furthermore, 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 the same as 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 balanced manner by the two meshing structures in the first joint component 451 and the second joint component 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 balanced manner by the two meshing structures in the second joint part 452 and the third joint part 453.

[0119] Furthermore, the first meshing portion 454, the fourth meshing portion 457, the fifth meshing portion 458, and the eighth meshing portion 461 have the same shapes. Furthermore, the second meshing portion 455, the third meshing portion 456, the sixth meshing portion 459, and the seventh meshing portion 460 have the same shapes. 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. Furthermore, 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 engagement portion 454 includes a pair of first protrusions 454a arranged along the rotation direction of the second joint part 452, and a first recess 454b arranged between the pair of first protrusions 454a. Similarly, the fourth engagement portion 457 includes a pair of fourth protrusions 457a arranged along the rotation direction of the second joint part 452, and a fourth recess 457b arranged between the pair of fourth protrusions 457a.

[0121] 26, the second engagement 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 engagement 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 prevents 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 prevents the second meshing portion 455 having the second protrusion 455b from easily meshing with the third meshing portion 456 having the third protrusion 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] 27 and 28 , first interlocking portion 454, second interlocking portion 455, third interlocking portion 456, and fourth interlocking portion 457 have a shape in which arcs are connected together or a shape in which arcs and straight lines are connected together when viewed in the rotation axis direction (direction A1) of second joint component 452. This facilitates the design of first interlocking portion 454, second interlocking portion 455, third interlocking portion 456, and fourth interlocking portion 457. Furthermore, since the shapes of first interlocking portion 454, second interlocking portion 455, third interlocking portion 456, and fourth interlocking portion 457 can be easily inspected, the shapes of first interlocking portion 454, second interlocking portion 455, third interlocking portion 456, and fourth interlocking portion 457 can be more appropriately managed.

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

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

[0126] 29 to 32, the wrist joint 45 performs articulation movement by driving the wire 46 to rotate the second joint part 452 relative to the first joint part 451. As shown in FIG. 10, the end part 46e of the wire 46 is fixed to the third joint part 453 on the end effector side (Y1 direction side) of the wrist joint 45.

[0127] 24, the first meshing portion 454 has a first portion 454c and a second portion 454d that are separated in the radial direction (direction A1) by a gap that allows the wire 46 to pass through. 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, like the first meshing portion 454, has a third portion 457c and a fourth portion 457d that are separated in the radial direction (direction A1) by a gap that allows the wire 46 to pass through. 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 articulation is performed to rotate the second joint part 452 largely 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 also has portions 455d and 455e that are separated in the radial direction (A1 direction) by a gap that allows the wire 46 to pass through. A second protrusion 455b is formed in the fifth portion 455c. A second recess 455a is formed in each of the portions 455d and 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 also has a portion 456d and a portion 456e that are separated and arranged in the radial direction (A1 direction) at an interval that allows the wire 46 to pass through. A third protrusion 456b is formed in the sixth portion 456c. A third recess 456a is formed in each of the portion 456d and the portion 456e.

[0130] 25, the first joint part 451 is disposed at a position spaced apart 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 spaced apart 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 spaced apart 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 spaced apart 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 spaced apart from the meshing part, thereby preventing the meshing part from interfering with the wire 46.

[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 FIGS. 29 to 32, the first meshing portion 454 of the first joint part 451 meshes with the third meshing portion 456 of the second joint part 452, but the second meshing portion 455 of the first joint part 451 meshes with the fourth meshing portion 457 of the second joint part 452 in a similar manner, with the protrusions and recesses interchanged. In addition, 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 part 456b of the third meshing part 456 of the second joint part 452 fits into the first concave part 454b of the first meshing part 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 contacting the first concave portion 454b of the first meshing portion 454 of the first joint part 451, and 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 coming into 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 relative to the first joint part 451, where angle θ2 is greater than angle θ1.

[0135] 32, due to the movement of the wire 46, the third convex portion 456b of the third meshing portion 456 of the second joint part 452 further rotates while coming into 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 relative to the first joint part 451, where angle θ3 is greater than 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 defined by the claims rather than the above description of the embodiments, and further includes all modifications (variations) within the meaning and scope of the claims.

[0137] For example, while the above embodiment illustrates a single-opening configuration in which the first jaw member of the end effector opens and closes relative to the second jaw member, the present invention is not limited to this. The present invention may also include a double-opening configuration in which the first and second jaw members of the end effector open and close independently. The end effector may also have a mechanism that moves the second jaw member relative to the fixed first jaw member to open and close it. In this case, the distal end of the rod of the elongated element may be connected to the proximal 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. Furthermore, 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 greater than 1 / 2 and less 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 less than 1 / 2 of the diameters D2 and D3, or may be greater than or equal to 3 / 4 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 addition, in the above embodiment, an example was shown in which 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-shrinkable 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-shrinkable 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-shrinkable tube is a polyethylene-based heat-shrinkable tube or a fluororesin-based heat-shrinkable tube, but the present invention is not limited to this. In the present invention, the heat-shrinkable tube may be a tube other than a polyethylene-based heat-shrinkable tube or a fluororesin-based heat-shrinkable tube.

[0144] In the above embodiment, the heat-shrinkable tube is a heat-shrinkable tube having a single layer structure, but the present invention is not limited to this. In the present invention, the heat-shrinkable tube may be a heat-shrinkable 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] [Aspect] 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 including a first jaw member and a second jaw member movable relative to one another between an open position and a closed position, the first jaw member having a first electrode and a second electrode different from the first electrode, and the second jaw member having a third electrode; a wrist joint unit including a conductive connecting portion and connected to a proximal end of the end effector via the connecting portion; a shaft connected to a proximal end of the wrist joint; an elongated member connected to at least one of the first jaw member and the second jaw member, configured to move in the longitudinal direction of the shaft to cause the relative movement of the first jaw member and the second jaw member, and configured to be electrically connected to one of the first electrode and the third electrode; a first conducting wire connected to an inner surface of the connection portion of the wrist joint portion and configured to be electrically connected to the other of the first electrode and the third electrode via the connection portion; a second lead connected to the second electrode.

[0150] (Item 2) Item 1. The surgical instrument according to item 1, wherein the wrist joint portion includes a first joint between a first member including the connecting portion and a second member, and a second joint between the second member and a third member.

[0151] (Item 3) the elongated member comprises a conductive first rod connected to at least one of the first jaw member and the second jaw member, a conductive wire connected to a proximal end of the first rod, and a conductive second rod connected to a proximal end of the wire; 3. The surgical instrument according to item 1 or 2, wherein the wire is flexible and is disposed inside the wrist joint.

[0152] (Item 4) Item 4. The surgical instrument of item 3, wherein the wire is a torque coil.

[0153] (Item 5) A flexible resin guide is provided inside the wrist joint, the resin guide includes a first passage formed offset from a longitudinal center line of the resin guide, a second passage formed offset from the longitudinal center line, and a third passage formed to pass through the longitudinal center line, 5. The surgical instrument of claim 3 or 4, wherein the first passageway conducts the first conductor, the second passageway conducts the second conductor, and the third passageway conducts the wire.

[0154] (Item 6) Item 6. The surgical instrument according to item 5, wherein the third passage of the resin guide has an inner surface that guides the wire and is made of a fluororesin.

[0155] (Item 7) 7. The surgical instrument according to item 5 or 6, wherein the shaft includes a positioning member that positions the resin guide.

[0156] (Item 8) the first joint is configured to articulate about a first axis of rotation that intersects a longitudinal direction of the shaft; Item 3. The surgical instrument of item 2, 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.

[0157] (Item 9) 9. The surgical instrument according to any one of items 1 to 8, wherein an outer surface of a portion of the first jaw member that does not face the second jaw member is coated with an electrically insulating material, an outer surface of a portion of the second jaw member that does not face the first jaw member is coated with an electrically insulating material, and an outer surface of the wrist joint portion is coated with an electrically insulating material.

[0158] (Item 10) 10. The surgical instrument according to any one of items 1 to 9, wherein the first electrode is a coagulation electrode, the second electrode is a cutting electrode, and the third electrode is a ground electrode for the first electrode and the second electrode.

[0159] (Item 11) 11. The surgical instrument according to any one of items 1 to 10, wherein the first jaw member is configured to move between an open position and a closed position relative to the fixedly disposed second jaw member, and a proximal end of the second jaw member is electrically connected to the connection portion of the wrist joint portion.

[0160] (Item 12) 12. The surgical instrument according to any one of items 1 to 11, wherein the second jaw member is configured to move between an open position and a closed position relative to the first jaw member that is fixedly disposed, and a proximal end of the first jaw member is electrically connected to the connection portion of the wrist joint portion.

[0161] (Item 13) the first electrode of the first jaw member is conductively connected to the elongated member; the second electrode of the first jaw member is electrically connected to the second conductive wire; 13. The surgical instrument according to any one of items 1 to 12, wherein the third electrode of the second jaw member is electrically connected to the first conductive wire via the connection portion.

[0162] (Item 14) 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; 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 from the second driving member; 14. The surgical instrument according to any one of items 1 to 13, wherein the elongated member moves forward and backward in response to a driving force received by the first receiving member. [Explanation of symbols]

[0163] 21a: robot arm, 40a: surgical instrument, 41: housing (interface), 42: shaft, 43: end effector, 44b, 44c: drive shaft, 44d: drive shaft, 45: wrist joint (wrist joint), 45a: first joint, 45b: second joint, 45c: connection part, 47: rod (elongated member), 47b: first rod, 47c: wire, 47d: second rod, 81: first electrode, 82: second electrode, 83: third electrode, 84: second conducting wire, 85: first conducting wire, 90: resin guide , 91: passage (third passage), 92: passage (first passage), 93: passage (second passage), 100: robotic surgery system, 212: instrument mounting portion, 214b, 214c: driving member (second driving member), 214d: driving member (first driving member), 421: positioning member, 431: first jaw (first jaw member), 432: second jaw (second jaw member), 451: first joint part (third member), 452: second joint part (second member), 453: third joint part (first member)

Claims

1. 1. A surgical instrument for a robotic surgical system, comprising: an end effector including first and second jaw members movable relative to one another between an open position and a closed position, the first jaw member having a first electrode and a second electrode different from the first electrode, and the second jaw member having a third electrode; a wrist joint unit including a conductive connecting portion and connected to a proximal end of the end effector via the connecting portion; a shaft connected to a proximal end of the wrist joint; an elongated member connected to at least one of the first jaw member and the second jaw member, configured to move in the longitudinal direction of the shaft to cause the relative movement of the first jaw member and the second jaw member, and configured to be electrically connected to one of the first electrode and the third electrode; a first conducting wire connected to an inner surface of the connection portion of the wrist joint portion and configured to be electrically connected to the other of the first electrode and the third electrode via the connection portion; a second lead connected to the second electrode.

2. The surgical instrument according to claim 1 , wherein the wrist joint portion includes a first joint between a first member including the connecting portion and a second member, and a second joint between the second member and a third member.

3. the elongated member comprises: a first conductive rod connected to at least one of the first jaw member and the second jaw member; a conductive wire connected to a proximal end of the first rod; and a second conductive rod connected to a proximal end of the wire; The surgical instrument according to claim 1 , wherein the wire is flexible and is disposed inside the wrist joint.

4. The surgical instrument of claim 3 , wherein the wire is a torque coil.

5. A flexible resin guide is provided inside the wrist joint, the resin guide includes a first passage formed offset from a longitudinal center line of the resin guide, a second passage formed offset from the longitudinal center line, and a third passage formed to pass through the longitudinal center line, The surgical instrument of claim 3 , wherein the first passageway conducts the first conductor, the second passageway conducts the second conductor, and the third passageway conducts the wire.

6. The surgical instrument according to claim 5 , wherein the inner surface of the third passage of the resin guide is formed from a fluororesin.

7. The surgical instrument according to claim 5 , wherein the shaft includes a positioning member that positions the resin guide.

8. the first joint is configured to articulate about a first axis of rotation that intersects a longitudinal direction of the shaft; The surgical instrument of claim 2 , 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.

9. The surgical instrument of claim 1 , wherein the outer surface of the wrist joint is coated with an electrically insulating material.

10. The surgical instrument of claim 1 , wherein the first electrode is a coagulation electrode, the second electrode is a cutting electrode, and the third electrode is a ground electrode relative to the first and second electrodes.

11. 2. The surgical instrument of claim 1, wherein the first jaw member is configured to move between open and closed positions relative to the fixedly disposed second jaw member, a proximal end of the second jaw member being conductively connected to the connection portion of the wrist joint.

12. 2. The surgical instrument of claim 1, wherein the second jaw member is configured to move between an open position and a closed position relative to the fixedly disposed first jaw member, and a proximal end of the first jaw member is conductively connected to the connection portion of the wrist joint.

13. the first electrode of the first jaw member is conductively connected to the elongated member; the second electrode of the first jaw member is electrically connected to the second conductive wire; The surgical instrument of claim 1 , wherein the third electrode of the second jaw member is conductively connected to the first lead through the connection portion.

14. 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; 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 from the second driving member; The surgical instrument according to claim 1 , wherein the elongated member advances and retracts in response to a driving force received by the first receiving member.

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