Ligation device

Abstract

To provide a ligation device capable of reducing possibility that a thread remaining in the device due to a cutting operation interferes with a next ligation operation.SOLUTION: A ligation device comprises: a jaw member 3 having a first jaw 3A and a second jaw 3B that moves relative to the first jaw 3A, and holding a ligated body between the first jaw 3A and the second jaw 3B; a repositioning gripping member 4B that moves backward away from the jaw member 3 while gripping a part of a thread that passes through the first jaw 3A and the second jaw 3B; and a separation unit having at least a reel member 73 intersecting a movement trajectory U that passes during movement of the repositioning gripping member 4B, and rotating about a rotation axis parallel to a vertical direction to wind the thread, the separation unit making the thread separate from the movement trajectory U.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention relates to a ligation device for ligating an object to be ligated with a thread. [Background technology]

[0002] A ligation device has been proposed that ligates an object to be ligated with a thread. The ligation device described in Patent Document 1 presses a loop of the thread against the object to be ligated while wrapping the thread around the object. The ligation device then tightens the loop to form a knot, thereby ligating the object to be ligated. The ligation device then cuts the thread with a cutter. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Publication No. 8-252257 Summary of the Invention [Problem to be solved by the invention]

[0004] In a ligation device, a thread that is cut off from the ligated body by a cutting operation after a ligation operation may remain inside the ligation device. In this case, the remaining thread may interfere with the next ligation operation.

[0005] An object of the present invention is to provide a ligation device that can reduce the possibility that a thread remaining in the device after a cutting operation will interfere with the next ligation operation. [Means for solving the problem]

[0006] The ligation device according to the present invention is characterized by comprising: a jaw member having a first jaw and a second jaw that moves relative to the first jaw and holds an object to be ligated between the first jaw and the second jaw; a gripping member that moves in a first direction away from the jaw member while gripping a portion of the thread passing through the first jaw and the second jaw; and a separation unit that has at least a reel member that rotates about a rotation axis that intersects a movement trajectory traversed by the gripping member when it moves and is parallel to a second direction that intersects the first direction and winds up the thread, and that separates the thread from the movement trajectory.

[0007] According to the present invention, when a suture remains in the device due to a cutting operation after a ligating operation, the ligating device moves the remaining suture away from the movement trajectory of the gripping member, thereby reducing the possibility that the remaining suture will interfere with the movement of the gripping member in the next ligating operation. [Brief explanation of the drawings]

[0008] [Figure 1] 2A and 2B are perspective views of the ligation device 1 and a partially enlarged perspective view showing a state in which a cartridge 7 is detached from a mounting portion 28. FIG. [Figure 2] 2 is a cross-sectional view taken along line II-II of FIG. 1, viewed from the direction of the arrow, and a partially enlarged cross-sectional view showing a state of a mounting portion 28 from which a cartridge 7 has been detached. [Figure 3] 3 is a cross-sectional view taken along line III-III in FIG. 1, viewed from the direction of the arrow, and a partially enlarged cross-sectional view showing a state of the mounting portion 28 from which the cartridge 7 has been detached. [Figure 4] 4 is a cross-sectional view taken along line IV-IV in FIG. 1, viewed from the direction of the arrows. [Figure 5] FIG. 10 is a perspective view of a loop forming portion 2B. [Figure 6] FIG. [Figure 7] FIG. 2 is a right side view of the cartridge 7. [Figure 8] FIG. 2 is a front view of the cartridge 7. [Figure 9] FIG. 2 is a bottom view of the cartridge 7. [Figure 10]FIG. 7 is a cross-sectional view taken along line XX in FIG. 6, viewed from the direction of the arrow. [Figure 11] 10 is a cross-sectional view taken along line XI-XI in FIG. 7, seen from the direction of the arrows. [Figure 12] 8 is a cross-sectional view taken along line XII-XII in FIG. 7, seen from the direction of the arrows. [Figure 13] 2 is a perspective view of a gripper 4, a pusher 5, and a drive unit 8. FIG. [Figure 14] FIG. 2 is a rear view of the drive unit 8. [Figure 15] FIG. 2 is a perspective view of a ligature holding member 4A and a first driving mechanism 8A. [Figure 16] FIG. 10 is a perspective view of a rearrangement gripping member 4B and a second driving mechanism 8B. [Figure 17] 10 is a perspective view of a pusher 5 and a third drive mechanism 8C. FIG. [Figure 18] FIG. 2 is a perspective view of first rods 41 and 43. [Figure 19] FIG. 2 is a side view of the first rods 41 and 43. [Figure 20] FIG. 2 is a perspective view of second rods 42 and 44. [Figure 21] FIG. 2 is a side view of the second rods 42 and 44. [Figure 22] 22 is a cross-sectional view taken along line XXII-XXII in FIG. 21, viewed from the direction of the arrows. [Figure 23] 1 is a perspective view of first rods 41, 43 and second rods 42, 44. FIG. [Figure 24] FIG. 10 is a side view of the first rods 41, 43 and the second rods 42, 44 in the released state. [Figure 25] 10 is a side view of first rods 41, 43 and second rods 42, 44 in a semi-gripped state. [Figure 26] FIG. 10 is a side view of the first rods 41, 43 and the second rods 42, 44 in the fully gripped state. [Figure 27] FIG. [Figure 28] FIG. [Figure 29] 2 is a block diagram showing the electrical configuration of the robot R and the ligation device 1. FIG. [Figure 30] 1 is a flowchart showing a ligation process. [Figure 31] 31 is a flowchart showing the ligation process, which is a continuation of FIG. 30. [Figure 32] 10 is a flowchart showing a tightening process. [Figure 33] 10 is a graph showing a current value, a first-order differential value of the current value, and a second-order differential value of the current value obtained from a motor driver Fb1. [Figure 34] FIG. 10 is a diagram showing the initial state of the ligation process. [Figure 35] FIG. 1 shows the first step of the ligation process. [Figure 36] FIG. 10 is a diagram showing the second step of the ligation process. [Figure 37] FIG. 10 is a diagram showing the third step of the ligation process. [Figure 38] FIG. 10 is a diagram showing the fourth step of the ligation process. [Figure 39] FIG. 10 shows the fifth step of the ligation process. [Figure 40] FIG. 10 shows the sixth step of the ligation process. [Figure 41] FIG. 10 shows the seventh step of the ligation process. [Figure 42] FIG. 10 shows the ninth step of the ligation process. [Figure 43] FIG. 10 shows the tenth step of the ligation process. [Figure 44] FIG. 11 shows the 11th step of the ligation process. [Figure 45] FIG. 12 shows the twelfth step of the ligation process. [Figure 46] FIG. 13 shows the thirteenth step of the ligation process. [Figure 47] 1 is a diagram showing a state of a subject S to be ligated around which a suture T is wound. [Figure 48] FIG. 14 shows the 14th step of the ligation process. [Figure 49] 1 is a diagram showing a state of a subject S to be ligated around which a suture T is wound. [Figure 50] FIG. 15 shows the 15th step of the ligation process. [Figure 51]FIG. 16 shows the 16th step of the ligation process. [Figure 52] FIG. 17 shows the 17th step of the ligation process. [Figure 53] 10 is a diagram showing how the line T1 moves along the reel member 73. FIG. [Figure 54] 10 is a diagram showing how the line T1 is wound around the reel member 73. FIG. [Figure 55] FIG. 18 shows the 18th step of the ligation process. [Figure 56] FIG. 19 shows the 19th step of the ligation process. [Figure 57] 10 is a flowchart showing a rearrangement process. [Figure 58] FIG. 10 is a diagram showing a first step of a rearrangement step. [Figure 59] FIG. 10 is a diagram showing a second step of the rearrangement step. [Figure 60] FIG. 10 is a diagram showing a third step of the rearrangement step. [Figure 61] FIG. 10 is a diagram showing a fourth step of the rearrangement step. [Figure 62] FIG. 10 is a diagram showing a fifth step of the rearrangement step. [Figure 63] FIG. 10 is a diagram showing a sixth step of the rearrangement step. [Figure 64] FIG. 10 is a diagram showing a seventh step of the rearrangement step. [Figure 65] FIG. 10 is a diagram showing a first reel member 731. [Figure 66] FIG. 10 is a diagram showing a second reel member 732. [Figure 67] FIG. 10 is a diagram showing a third reel member 733. [Figure 68] FIG. 10 is a diagram showing a fourth reel member 734. [Figure 69] FIG. 10 is a diagram showing a fifth reel member 735. [Figure 70] FIG. 10 is a diagram showing a sixth reel member 736. [Figure 71] FIG. 10 is a diagram showing a seventh reel member 737. DETAILED DESCRIPTION OF THE INVENTION

[0009] An embodiment of a ligation device 1 according to the present invention will be described with reference to the drawings. The referenced drawings are used to explain technical features that can be adopted by the present invention. The configuration of the device described is not intended to be limiting but is merely an illustrative example. The upper, lower, lower left, upper right, lower right, and upper left sides of FIG. 1 correspond to the upper, lower, front, rear, left, and right sides of the ligation device 1, respectively.

[0010] <Summary of Ligation Device 1> The ligation device 1 is a device for ligating a target object S with a thread T. The target object S is, for example, a part of a living body, such as a blood vessel. The ligation device 1 is used while connected to a surgical support robot R for performing surgery using minimally invasive techniques.

[0011] The ligation device 1 includes a main body 2A, a loop forming portion 2B, and a jaw member 3 shown in FIG. 1, a gripping body 4 and a pusher 5 shown in FIG. 13, a guide member 6 shown in FIG. 27, and a drive unit 8 shown in FIG. 13.

[0012] <Main unit 2A> As shown in FIGS. 1 to 3, the main body 2A has a cylindrical shape and extends in the front-to-rear direction. A jaw member 3, which will be described later, is supported at the front end of the main body 2A. The jaw member 3 is rotatable about a first axis C1 that extends in the up-down direction. The following description will be given on the assumption that the main body 2A and the jaw member 3 are arranged in a straight line in the front-to-rear direction.

[0013] 4, a plurality of insertion holes are formed inside the main body 2A. Specifically, a first hole 21, a second hole 22A, a third hole 22B, a fourth hole 23A, a fifth hole 23B, a sixth hole 24A, a seventh hole 24B, an eighth hole 25A, a ninth hole 25B, and a tenth hole 26 are formed inside the main body 2A.

[0014] The first hole 21 is disposed in the center of the main body 2A in the left-right direction. As shown in FIG. 2, the first hole 21 includes an extending portion 21A, a first branch portion 21B, and a second branch portion 21C. The extending portion 21A extends rearward from the front end of the main body 2A. The first branch portion 21B extends rearward from the rear end of the extending portion 21A. The second branch portion 21C extends diagonally rearward and downward from the rear end of the extending portion 21A, then bends rearward and extends rearward again. The first hole 21 branches into the first branch portion 21B and the second branch portion 21C at the rear end of the extending portion 21A. A portion of the ligation grasping member 4A and a portion of the pusher 5 are inserted into the first branch portion 21B. A portion of the rearrangement grasping member 4B is inserted into the second branch portion 21C.

[0015] The second hole 22A, the third hole 22B, the fourth hole 23A, the fifth hole 23B, the sixth hole 24A, the seventh hole 24B, the eighth hole 25A, the ninth hole 25B, and the tenth hole 26 shown in FIG. 4 extend in the front-rear direction.

[0016] The second hole 22A and the third hole 22B are arranged in the center of the main body 2A in the up-down direction. The second hole 22A is arranged to the right of the first hole 21. The third hole 22B is arranged to the left of the first hole 21. A third operating wire (not shown) is inserted through the second hole 22A and the third hole 22B. The fourth hole 23A is arranged to the right of the second branching portion 21C. The fifth hole 23B is arranged to the left of the second branching portion 21C. The loop-shaped rotating belt 230 shown in FIG. 2 is inserted through the fourth hole 23A and the fifth hole 23B.

[0017] Sixth hole 24A is located to the right of second hole 22A. Seventh hole 24B is located to the left of third hole 22B. A second operating wire (not shown) is inserted through sixth hole 24A and seventh hole 24B. In main body 2A, jaw member 3 rotates relative to main body 2A in response to operation of the second operating wire.

[0018] The eighth hole 25A is disposed on the left side of the first branch portion 21B. The ninth hole 25B is disposed on the left side of the second branch portion 21C. The eighth hole 25A and the ninth hole 25B are aligned in the vertical direction. A fourth operating wire (not shown) is inserted through the eighth hole 25A and the ninth hole 25B. The tenth hole 26 is disposed on the right side of the second branch portion 21C and to the left of the fourth hole 23A. A first operating wire (not shown) is inserted through the tenth hole 26.

[0019] <Loop forming portion 2B> 2 and 3, the loop forming unit 2B is disposed inside the main body 2A, behind the jaw members 3. The loop forming unit 2B forms a loop in the yarn T in the extension portion 21A of the first hole 21. The loop forming unit 2B includes a first loop axis 46 and a second loop axis 56.

[0020] 5, the first loop shaft 46 includes a first support base 46A, a first separating base 46B, a second separating base 46C, a first separating wall 461B, a second separating wall 462B, a third separating wall 461C, a fourth separating wall 462C, and a first gear 46D. The second loop shaft 56 includes a second support base 56A, a third separating base 56B, a fourth separating wall 56C, a fifth separating wall 561B, a sixth separating wall 562B, a seventh separating wall 561C, an eighth separating wall 562C, and a second gear 56D.

[0021] The first support base 46A and the second support base 56A are circular plates and are perpendicular to the vertical direction. The first support base 46A and the second support base 56A are aligned in the front-to-rear direction. The first support base 46A is disposed behind the second support base 56A. The first support base 46A is rotatable about a fourth axis C4 that passes through the center and extends in the vertical direction. The second support base 56A is rotatable about a fifth axis C5 that passes through the center and extends in the vertical direction.

[0022] A first groove 463 is formed on the side of the first support base 46A. The third operation wire extends from the rear to the front of the first support base 46A, wraps around the first groove 463, changes direction, and extends rearward. A first gear 46D is provided on the underside of the first support base 46A. A second gear 56D is provided on the underside of the second support base 56A. The first gear 46D and the second gear 56D mesh with each other. In response to operation of the third operation wire, the first support base 46A and the second support base 56A rotate in unison.

[0023] When viewed from above, if the first support base 46A rotates clockwise, the second support base 56A rotates counterclockwise. Hereinafter, this rotation direction will be referred to as the "first rotation direction R1." When the first support base 46A rotates counterclockwise when viewed from above, the second support base 56A rotates clockwise. Hereinafter, this rotation direction will be referred to as the "second rotation direction R2." In the following explanation, unless otherwise specified, the terms "clockwise direction" and "counterclockwise direction" refer to the rotation directions when viewed from above.

[0024] The first and second separating stands 46B and 46C are provided on the upper surface of the first support stand 46A. The first and second separating stands 46B and 46C are spaced apart in the radial direction about the fourth axis C4. A second groove 460A is formed between the first and second separating stands 46B and 46C. The third and fourth separating stands 56B and 56C are provided on the upper surface of the second support stand 56A. The third and fourth separating stands 56B and 56C are spaced apart in the radial direction about the fifth axis C5. A third groove 560A is formed between the third and fourth separating stands 56B and 56C.

[0025] The first partition wall 461B and the second partition wall 462B protrude upward from the first partition base 46B. The first partition wall 461B and the second partition wall 462B are spaced apart in the circumferential direction about the fourth axis C4. A fourth groove 460B is formed between the first partition wall 461B and the second partition wall 462B. The third partition wall 461C and the fourth partition wall 462C protrude upward from the second partition base 46C. The third partition wall 461C and the fourth partition wall 462C are spaced apart in the circumferential direction about the fourth axis C4. A fifth groove 460C is formed between the third partition wall 461C and the fourth partition wall 462C. The upper ends of the first partition wall 461B, the second partition wall 462B, the third partition wall 461C, and the fourth partition wall 462C are inclined upward from the clockwise end to the opposite end.

[0026] The fifth partition wall 561B and the sixth partition wall 562B protrude upward from the third partition base 56B. The fifth partition wall 561B and the sixth partition wall 562B are spaced apart in the circumferential direction about the fifth axis C5. A sixth groove 560B is formed between the fifth partition wall 561B and the sixth partition wall 562B. The seventh partition wall 561C and the eighth partition wall 562C protrude upward from the fourth partition base 56C. The seventh partition wall 561C and the eighth partition wall 562C are spaced apart in the circumferential direction about the fifth axis C5. A seventh groove 560C is formed between the seventh partition wall 561C and the eighth partition wall 562C. The upper ends of the fifth partition 561B, the sixth partition 562B, the seventh partition 561C, and the eighth partition 562C are inclined upward from the end in the counterclockwise direction to the opposite end.

[0027] As shown in FIG. 5, when the first loop shaft 46 rotates and the second separating stand 46C is positioned to the right of the first separating stand 46B, the second loop shaft 56 rotates in conjunction with the first separating stand 46B, and the fourth separating stand 56C is positioned to the left of the third separating stand 56B. Hereinafter, the rotation position shown in FIG. 5 will be referred to as the "first rotation position." The position where the first loop shaft 46 and the second loop shaft 56 are rotated 90 degrees in the first rotation direction R1 from the first rotation position will be referred to as the "second rotation position." The position where the first loop shaft 46 and the second loop shaft 56 are rotated 180 degrees from the first rotation position will be referred to as the "third rotation position."

[0028] When the first loop shaft 46 and the second loop shaft 56 are disposed in the first rotation position or the third rotation position, the second groove 460A and the third groove 560A extend in the front-rear direction, and the fourth groove 460B, the fifth groove 460C, the sixth groove 560B, and the seventh groove 560C extend in the left-right direction. When the first loop shaft 46 and the second loop shaft 56 are disposed in the second rotation position, the second groove 460A and the third groove 560A extend in the left-right direction, and the fourth groove 460B, the fifth groove 460C, the sixth groove 560B, and the seventh groove 560C extend in the front-rear direction.

[0029] The loop forming unit 2B can form a first loop P1 and a second loop P2 shown in FIG. 35 and the like by winding the yarn T around the first loop shaft 46 and the second loop shaft 56. The first loop P1 is formed on the first loop shaft 46, and the second loop P2 is formed on the second loop shaft 56. Furthermore, by rotating the first loop shaft 46 and the second loop shaft 56 with the first loop P1 and the second loop P2 formed, the loop forming unit 2B can remove the first loop P1 and the second loop P2 from the first loop shaft 46 and the second loop shaft 56 while maintaining the state in which the first loop P1 and the second loop P2 are formed on the yarn T.

[0030] <Jaw member 3> 1, the jaw member 3 is provided at the front end of the main body 2A. The jaw member 3 includes a jaw body 20A, a first jaw 3A, and a second jaw 3B.

[0031] The jaw body 20A has a cylindrical shape and extends in the front-to-rear direction. The diameter of the jaw body 20A is the same as the diameter of the main body 2A. The rear end of the jaw body 20A is rotatably supported by the main body 2A. A first jaw 3A and a second jaw 3B are provided at the front end of the jaw body 20A. The first jaw 3A and the second jaw 3B hold the body to be ligated S shown in Figure 35 etc.

[0032] 1, the first jaw 3A extends forward from the front end of the main body 2A. The width of the first jaw 3A in the left-right direction is smaller than the width of the jaw main body 20A in the left-right direction.

[0033] The first jaw 3A and the jaw main body 20A have a mounting portion 28 to which a cartridge 7, described below, is attached. The portion of the mounting portion 28 that is provided on the jaw main body 20A is referred to as the first portion mounting portion 28A. The first portion mounting portion 28A is recessed downward from the upper surface of the jaw main body 20A. The portion of the mounting portion 28 that is provided on the first jaw 3A is referred to as the second portion mounting portion 32A. The second portion mounting portion 32A penetrates between the upper and lower surfaces of the first jaw 3A. The left-right width of the second portion mounting portion 32A is smaller than the left-right width of the first portion mounting portion 28A.

[0034] As shown in Figures 2 and 3, a pulley 27 is provided at the bottom of the first partial mounting portion 28A. The pulley 27 has a plate shape and is perpendicular to the vertical direction. A mounting hole 27A is formed in the center of the pulley 27. The mounting hole 27A has a regular hexagonal cross section and penetrates in the vertical direction. A protrusion 72B of the cartridge 7, which will be described later, is fitted into the mounting hole 27A. A rotating belt 230 is wound around the side of the pulley 27. The pulley 27 rotates in accordance with the rotation of the rotating belt 230. Hereinafter, the pulley 27 and the rotating belt 230 will be referred to as a "transmission mechanism 29."

[0035] 2, a jaw through-hole 33 is formed near the front end of the first jaw 3A. The jaw through-hole 33 passes through the first jaw 3A in the up-down direction. The side of the jaw through-hole 33 is formed by the front surface of the cartridge 7 attached to the attachment portion 28 and the side surface of the second partial attachment portion 32A.

[0036] As shown in Figures 1 and 2, an eleventh hole 32B is formed in the jaw main body 20A and behind the first portion mounting portion 28A. The front end of the eleventh hole 32B communicates with the first portion mounting portion 28A. The eleventh hole 32B extends rearward from the portion communicating with the mounting portion 28A to the rear end of the jaw main body 20A. The rear end of the eleventh hole 32B is located forward of the front end of the extension portion 21A of the first hole 21 provided in the main body 2A.

[0037] The second jaw 3B extends forward from the front end of the main body 2A below the first jaw 3A, then bends diagonally upward and forward, and extends further. The left-right width of the second jaw 3B is smaller than the left-right width of the jaw main body 20A and is the same as that of the first jaw 3A.

[0038] The rear end of second jaw 3B is rotatably supported on the front end of main body 2A. A seventh axis C7 extends along the rotation center of second jaw 3B in the left-right direction. In response to rotation about the seventh axis C7, second jaw 3B moves between a close position (see FIGS. 1 and 2) in contact with the front end of first jaw 3A and a distant position spaced downward from the front end of first jaw 3A. Second jaw 3B moves between the close position and the distant position in response to operation of the fourth operating wire.

[0039] With the second jaw 3B positioned at the close position, a gap is formed between the first jaw 3A except for the portion that contacts the second jaw 3B and the second jaw 3B except for the portion that contacts the first jaw 3A. The object to be ligated S is held by the first jaw 3A and the second jaw 3B while being positioned in this gap. The region where the object to be ligated S held by the first jaw 3A and the second jaw 3B is positioned is referred to as the "holding region Sp."

[0040] 2, a twelfth hole 31A is formed in the second jaw 3B. The twelfth hole 31A extends diagonally downward and rearward from the portion that contacts the first jaw 3A when the jaw is positioned in the close position, bends rearward, and extends rearward to the rear end of the second jaw 3B.

[0041] A thirteenth hole 31B is formed in the jaw body 20A below the pulley 27 of the first portion mounting portion 28A. The thirteenth hole 31B extends rearward from the front end of the jaw body 20A. The front end of the thirteenth hole 31B is located rearward of the rear end of the twelfth hole 31A provided in the second jaw 3B. A guide member 6 shown in FIG. 27, which will be described later, is located in the twelfth hole 31A and the thirteenth hole 31B.

[0042] <Cartridge 7> The cartridge 7 is detachably attached to the mounting portion 28 of the jaw member 3. As shown in Figure 6, the cartridge 7 has a first partial body 7A and a second partial body 7B.

[0043] The first partial body 7A is shaped like a rectangular parallelepiped that is long in the front-to-rear direction. The second partial body 7B is rod-shaped and extends forward from near the upper end of the front surface 700F of the first partial body 7A. The left-to-right width of the second partial body 7B is smaller than the left-to-right width of the first partial body 7A. The up-to-down width of the second partial body 7B is smaller than the up-to-down width of the first partial body 7A. The top surfaces of the first partial body 7A and the second partial body 7B are arranged on the same plane. The first partial body 7A is attached to the first partial attachment portion 28A of the attachment portion 28 shown in FIG. 1. The second partial body 7B is attached to the second partial attachment portion 32A of the attachment portion 28 shown in FIG. 1.

[0044] A protruding portion 700P that protrudes downward is provided on a portion of the underside 700S of the first partial main body 7A near the front end. As shown in FIG. 7, a bobbin B is provided on the protruding portion 700P. A thread T is wound around the bobbin B. As shown in FIG. 2, the bobbin B is disposed rearward of the holding region Sp where the ligation target body S is held by the first jaw 3A and the second jaw 3B. The bobbin B is supported rotatably about a third axis C3 that extends in the left-right direction.

[0045] As shown in Fig. 10, a fourteenth hole 7H is formed in protruding portion 700P below bobbin B. When cartridge 7 is attached to attachment portion 28 of jaw member 3, fourteenth hole 7H is located between twelfth hole 31A of second jaw 3B and thirteenth hole 31B of jaw body 20A shown in Fig. 2. Twelfth hole 31A, thirteenth hole 31B, and fourteenth hole 7H are aligned in a straight line in the front-to-rear direction.

[0046] As shown in Fig. 6, the first partial main body 7A has a storage recess 71 extending downward from the upper surface 700U. The cross-sectional shape of the storage recess 71 is circular. As shown in Figs. 10 and 11, the storage recess 71 has a collection section 71A and a first storage section 71B, each having a different inner diameter.

[0047] The first storage section 71B is located below the collection section 71A. The inner diameter of the first storage section 71B is uniform in the vertical direction. The inner diameter of the first storage section 71B is larger than the inner diameter of the collection section 71A. The side surface 70B of the first storage section 71B extends in the vertical direction. A spiral groove 711 is formed in the side surface 70B. The groove 711 revolves around an axis that passes through the center of the storage recess 71 and extends in the vertical direction. A plurality of protrusions 710 that protrude inward are formed in the area sandwiched between the grooves 711 in the vertical direction. The protrusion direction of the protrusions 710 is perpendicular to the vertical direction.

[0048] A transmission through-hole 71C is formed in the bottom surface 70C of the accommodation recess 71, and communicates with the lower surface 700S of the first partial main body 7A.

[0049] A reel member 73 is housed in the housing recess 71. The reel member 73 extends downward from the upper end of the collection section 71A to the lower end of the first housing section 71B. The reel member 73 is a double spring including a first coil spring 73A and a second coil spring 73B.

[0050] The first coil spring 73A and the second coil spring 73B have the same diameter. The first coil spring 73A and the second coil spring 73B have the same diameter in the vertical direction. The centers of the first coil spring 73A and the second coil spring 73B coincide at the position of the second axis C2. The second axis C2 extends in the vertical direction. The first coil spring 73A and the second coil spring 73B have wires 730. The wires 730 of the first coil spring 73A are arranged at equal intervals in the vertical direction. The wires 730 of the second coil spring 73B are arranged at equal intervals in the vertical direction. The wires 730 of the first coil spring 73A and the second coil spring 73B are arranged alternately in the vertical direction. The intervals between the wires 730 of the first coil spring 73A and the second coil spring 73B in the vertical direction are uniform. The wire 730 is inclined with respect to the direction in which the second axis C2 extends.

[0051] The diameters of the first coil spring 73A and the second coil spring 73B are the same as the inner diameter of the collection section 71A and smaller than the inner diameter of the first storage section 71B. The reel member 73 contacts the inner wall 70A that forms the collection section 71A. The reel member 73 and the side surface 70B of the first storage section 71B are spaced apart in the radial direction about the second axis C2.

[0052] The rotating body 72 is connected to the lower end of the reel member 73. The rotating body 72 has a support plate 72A and a protrusion 72B.

[0053] The support plate 72A is a circular plate that is perpendicular to the up-down direction. The lower surface of the support plate 72A near the peripheral edge contacts the bottom surface 70C of the accommodating recess 71 from above. The lower end of the reel member 73 is connected to the upper surface of the support plate 72A.

[0054] The protrusion 72B protrudes downward from the lower surface of the support plate 72A. As shown in Fig. 9, the shape of the protrusion 72B is a hexagonal prism. The protrusion 72B is inserted into a transmission through-hole 71C provided in the bottom surface 70C of the accommodating recess 71. As shown in Fig. 7, the protrusion 72B protrudes downward from the lower surface 700S of the first partial main body 7A.

[0055] The rotating body 72 is rotatably supported on the bottom surface 70C of the accommodating recess 71. The rotating body 72 rotates about a sixth axis C6 extending in the vertical direction. As shown in Figure 10, the position of the sixth axis C6 coincides with the position of the second axis C2 passing through the center of the reel member 73.

[0056] The protrusion 72B fits into the mounting hole 27A of the pulley 27 shown in Fig. 3 when the cartridge 7 is mounted on the mounting portion 28 of the jaw member 3 shown in Fig. 2. When the pulley 27 rotates in accordance with the rotation of the rotary belt 230, the rotating body 72 rotates about the sixth axis C6. In addition, as the rotating body 72 rotates, the reel member 73 connected to the support plate 72A also rotates about the second axis C2.

[0057] As shown in FIGS. 6 and 8, the first partial main body 7A is provided with a first communication hole 76A, a second communication hole 76B, and a third communication hole 76C.

[0058] As shown in FIG. 6, the first communication hole 76A extends forward from the rear surface 700B of the first partial main body 7A and communicates with the storage recess 71. The first communication hole 76A is a rectangular hole that is long in the up-down direction. A first circular portion 761 with curved sides is provided below the upper end of the first communication hole 76A. The left-right width of the first circular portion 761 is greater than the left-right width of the portion of the first communication hole 76A excluding the first circular portion 761. As shown in FIG. 10, the first circular portion 761 connects to the inner wall 70A of the collection portion 71A of the storage recess 71.

[0059] As shown in FIG. 8, the second communication hole 76B extends rearward from the front surface 700F of the first partial main body 7A and communicates with the storage recess 71. The second communication hole 76B is a rectangular hole that is long in the vertical direction. A second circular portion 762 with curved sides is provided below the upper end of the second communication hole 76B. The left-right width of the second circular portion 762 is greater than the left-right width of the portion of the second communication hole 76B excluding the second circular portion 762. As shown in FIG. 10, the second circular portion 762 connects to the inner wall 70A of the collection portion 71A of the storage recess 71.

[0060] The first communicating hole 76A and the second communicating hole 76B are aligned in the front-rear direction. The first circular portion 761 of the first communicating hole 76A and the second circular portion 762 of the second communicating hole 76B are aligned in a straight line in the front-rear direction. As shown in Fig. 11, the first communicating hole 76A and the second communicating hole 76B are positioned so as to overlap with the second axis C2 and the sixth axis C6 in the front-rear direction.

[0061] As shown in FIG. 6, the third communication hole 76C extends downward from the upper surface 700U of the first partial main body 7A and communicates with the second communication hole 76B.

[0062] As shown in Figures 10 and 12, the winding yarn cutter 77 is provided in front of the reel member 73 and behind the bobbin B. The winding yarn cutter 77 is plate-shaped and perpendicular to the front-rear direction. The winding yarn cutter 77 extends rightward from the left end of the first section main body 7A. The winding yarn cutter 77 overlaps with the reel member 73 in the left-right direction. A blade 77A of the winding yarn cutter 77 protrudes toward the portion of the storage recess 71 that communicates with the second communication hole 76B. The blade 77A extends in the up-down direction. As shown in Figure 11, the blade 77A is positioned leftward of the second axis C2 and the sixth axis C6 in the left-right direction.

[0063] As shown in FIGS. 8 and 9, the second partial main body 7B has an upper plate 78U, a right plate 78R, and a left plate 78L. The upper plate 78U is perpendicular to the up-down direction. The right plate 78R extends downward from the right end of the upper plate 78U. The left plate 78L extends downward from the left end of the upper plate 78U. A portion of an area 780 surrounded by the upper plate 78U, right plate 78R, and left plate 78L overlaps in the front-to-rear direction with the first circular portion 761 of the first communicating hole 76A and the second circular portion 762 of the second communicating hole 76B.

[0064] A gripping thread cutter 79 is provided near the front end of the upper plate 78U of the second partial body 7B. As shown in Fig. 2, when the cartridge 7 is attached to the jaw members 3, the gripping thread cutter 79 is located rearward of the jaw through-hole 33 of the first jaw 3A. As shown in Figs. 9 and 10, a blade 79A of the gripping thread cutter 79 protrudes toward an area 780 surrounded by the upper plate 78U, right plate 78R, and left plate 78L.

[0065] <Gripper 4> At least a portion of the gripping body 4 is disposed within the main body 2A. The gripping body 4 is movable in the front-rear direction relative to the main body 2A. The gripping body 4 grips the suture T and moves rearward, thereby drawing the suture T into the main body 2A. As shown in FIG. 13, the gripping body 4 includes a ligature gripping member 4A and a rearrangement gripping member 4B. The ligature gripping member 4A and the rearrangement gripping member 4B have the same shape. As shown in FIG. 14, the ligature gripping member 4A is disposed above the rearrangement gripping member 4B. The ligature gripping member 4A is disposed inside a pusher 5, which will be described later.

[0066] As shown in FIG. 15, the ligation and grasping member 4A has a first rod 41 and a second rod 42. The first rod 41 has a cylindrical shape and extends in the front-rear direction. The second rod 42 is disposed in a through hole within the first rod 41. The second rod 42 has a rod shape, more specifically, a cylindrical shape, and extends in the front-rear direction. As shown in FIG. 16, the rearrangement grasping member 4B has a first rod 43 and a second rod 44. The first rod 43 and the second rod 44 correspond to the first rod 41 and the second rod 42 of the ligation and grasping member 4A shown in FIG. 15. The first rods 41, 43 and the second rods 42, 44 will be described in detail below.

[0067] The ligation and grasping member 4A is movable in the front-to-rear direction along the extension portion 21A and the first branch portion 21B of the first hole 21 of the main body 2A shown in FIG. 2, the eleventh hole 32B of the jaw main body 20A, and the first circular portion 761 of the first communicating hole 76A of the cartridge 7 shown in FIG. 10, the second circular portion 762 of the second communicating hole 76B, and the recovery portion 71A of the storage recess 71.

[0068] The rearrangement gripping member 4B is movable in the front-rear direction along the extension portion 21A and the second branch portion 21C of the first hole 21 of the main body 2A shown in Fig. 2, the eleventh hole 32B of the jaw main body 20A, and the first circular portion 761 of the first communication hole 76A of the cartridge 7, the second circular portion 762 of the second communication hole 76B, and the recovery portion 71A of the storage recess 71 shown in Fig. 10. Hereinafter, the trajectory that the rearrangement gripping member 4B passes through when it moves as shown in Fig. 2 will be referred to as a "movement trajectory U."

[0069] 10, the movement locus U intersects with the reel member 73 arranged in the accommodating recess 71 of the cartridge 7. The first accommodating portion 71B of the accommodating recess 71 of the cartridge 7 is spaced downward from the movement locus U. The blade 79A of the gripping yarn cutter 79 of the cartridge 7 protrudes toward the movement locus U.

[0070] <First rods 41, 43 and second rods 42, 44> The first rods 41 and 43 have the same configuration. The second rods 42 and 44 have the same configuration. In the following, the first rod 41 and the second rod 42 will be described as an example, and a description of the first rod 43 and the second rod 44 will be omitted.

[0071] 18 and 19, the first rod 41 has a cylindrical body 45. An eighth axis C8 passing through the center of the cylindrical body 45 extends in the front-rear direction.

[0072] A first notch 40 is provided in the front end 45F of the cylindrical body 45. The first notch 40 has a first one-side notch 461 and a first other-side notch 462. The first one-side notch 461 and the first other-side notch 462 are each recessed portions formed in the front end 45F and extend linearly rearward. The first one-side notch 461 and the first other-side notch 462 face each other in a direction perpendicular to the eighth axis C8. The widths of the first one-side notch 461 and the first other-side notch 462 at their connection portions with the front end 45F increase toward the front. As shown in FIG. 18, the thickness of the cylindrical body 45 is denoted as "D1." The thickness D1 is greater than the thickness of the thread T.

[0073] As shown in Figures 20 and 21, the second rod 42 has a cylindrical body 47. A ninth axis C9 passing through the center of the cylindrical body 47 extends in the front-rear direction. The diameter of the cylindrical body 47 is the same as the inner diameter of the cylindrical body 45 of the first rod 41, 43. A second notch 48 is provided in the front end portion 47F of the cylindrical body 47. The second notch 48 has a first partial notch 480 and a second partial notch 481.

[0074] The first partial cutout 480 is a recess formed in the front end portion 47F and extends linearly rearward. The first partial cutout 480 is connected in a direction perpendicular to the ninth axis C9. The width of the first partial cutout 480 at the connection portion with the front end portion 47F increases toward the front. The length of the first partial cutout 480 in the front-rear direction is equal to the length of the first cutout 40 of the first rod 41, 43 in the front-rear direction.

[0075] 21 and 22, the second partial cutout 481 is provided at the rear end of the first partial cutout 480. The second partial cutout 481 has a first notch 481A and an other notch 481B. The first notch 481A and the other notch 481B face each other in a direction perpendicular to the ninth axis C9. The first notch 481A and the other notch 481B each extend clockwise from the rear end of the first partial cutout 480 along the circumferential direction centered on the ninth axis C9 as viewed from the front.

[0076] 23, the second rod 42 is disposed inside the first rod 41. The front end 45F of the first rod 41 and the front end 47F of the second rod 42 are positioned in the front-to-rear direction. The eighth axis C8 of the first rod 41 and the ninth axis C9 of the second rod 42 are positioned in the same direction. The second rod 42 is rotatable around the ninth axis C9 relative to the first rod 41.

[0077] The extending direction of the first notch 40 of the first rod 41 coincides with the extending direction of the first partial notch 480 of the second rod 42. On the other hand, the extending direction of the first notch 40 of the first rod 41 is perpendicular to the extending direction of the second partial notch 481 of the second rod 42.

[0078] 24, 25, and 26 differ in the positional relationship between the first rod 41 and the second rod 42. The state shown in FIG. 24 is called the "released state." The state shown in FIG. 25 is called the "half-gripped state." The state shown in FIG. 26 is called the "fully-gripped state."

[0079] 24, the first notch 40 of the first rod 41 and the first partial notch 480 of the second rod 42 overlap in the radial direction centered on the eighth axis C8 and the ninth axis C9. In the released state, the thread T can be inserted into the first notch 40 and the first partial notch 480, and the thread T can be removed from the first notch 40 and the first partial notch 480.

[0080] The semi-gripped state shown in Fig. 25 indicates a state in which the second rod 42 has rotated approximately 45 degrees counterclockwise as viewed from the front from the released state shown in Fig. 24. In this state, the first notch 40 of the first rod 41 and a portion of the second partial notch 481 of the second rod 42 overlap in the radial direction centered on the eighth axis C8 and the ninth axis C9. The first partial notch 480 of the second rod 42 is covered by the cylindrical body 45 of the first rod 41.

[0081] After the thread T is inserted into the first notch 40 and the first partial notch 480 in the released state, when the state changes from the released state to the semi-held state, the thread T is positioned at the bottom of the first notch 40 of the first rod 41 and the second partial notch 481 of the second rod 42. The thread T is covered from the front by a portion of the second rod 42, and therefore cannot be detached from the first rod 41 and the second rod 42. Note that in the semi-held state, the cross-sectional area of ​​the region formed by the bottom of the first notch 40 of the first rod 41 and the second partial notch 481 of the second rod 42 is larger than the cross-sectional area of ​​the thread T. Therefore, the thread T is movable relative to the first rod 41 and the second rod 42.

[0082] The fully gripped state shown in Fig. 26 indicates a state in which the second rod 42 is rotated approximately 45 degrees counterclockwise as viewed from the front from the semi-gripped state shown in Fig. 25. In this state, the bottom of the first notch 40 of the first rod 41 and a part of the tip of the second partial notch 481 of the second rod 42 overlap in the radial direction centered on the eighth axis C8 and the ninth axis C9. Note that the first partial notch 480 of the second rod 42 and the part of the second partial notch 481 excluding their tip portions are covered by the cylindrical body 45 of the first rod 41.

[0083] When the open state is changed to the fully gripped state after the thread T is inserted into the first notch 40 and the first partial notch 480 in the released state, the thread T is gripped by the tip ends of the first notch 40 and the second partial notch 481. Therefore, the thread T becomes immovable relative to the first rod 41 and the second rod 42.

[0084] <Pusher 5> 17 is at least partially disposed within the main body 2A. The pusher 5 is movable in the front-to-rear direction relative to the main body 2A. By moving forward, the pusher 5 pushes the first loop P1 and the second loop P2 of the yarn T formed in the loop forming section 2B forward from the main body 2A.

[0085] The pusher 5 has a cylindrical shape and extends in the front-rear direction. The ligature grasping member 4A shown in FIG. 15 is disposed inside the pusher 5. A tenth axis C10 passing through the center of the pusher 5 coincides with the eighth axis C8 and the ninth axis C9 passing through the center of the ligature grasping member 4A. The front end 51 of the pusher 5 is inclined with respect to a plane perpendicular to the tenth axis C10.

[0086] The pusher 5 is movable in the front-rear direction along the extension portion 21A and the first branch portion 21B of the first hole 21 of the main body 2A shown in Fig. 2, the eleventh hole 32B of the jaw main body 20A, and the first circular portion 761 of the first communicating hole 76A of the cartridge 7, the second circular portion 762 of the second communicating hole 76B, and the recovery portion 71A of the accommodating recess 71 shown in Fig. 10. In addition, the pusher 5 is movable in the front-rear direction relative to the ligation grasping member 4A arranged therein.

[0087] <Guide member 6> The guide member 6 shown in FIG. 27 passes the yarn T unwound from the bobbin B through the twelfth hole 31A of the second jaw 3B of the jaw member 3 shown in FIG. 2 and guides it toward the jaw through-hole 33 of the first jaw 3A. The movement direction of the guide member 6 at this time is defined as the "first movement direction Y1." The direction opposite to the first movement direction Y1 is referred to as the "second movement direction Y2." In FIG. 27, the upward direction corresponds to the first movement direction Y1, and the downward direction corresponds to the second movement direction Y2. The direction extending along the first movement direction Y1 and the second movement direction Y2 is referred to as the "extension direction Y."

[0088] The guide member 6 has a plate body 60. The shape of the plate body 60 is a rectangle that is elongated in the extension direction Y and perpendicular to the up-down direction. An upstream end 60B, which is the upstream end of the plate body 60 in the first movement direction Y1, extends in the left-right direction. A plurality of round holes 60H are formed in the portion of the plate body 60 between the center in the extension direction and the upstream end 60B. A left end 60L and a right end 60R of the plate body 60 each extend in a direction along the extension direction Y. The left end 60L has a left curved portion 601 at its downstream end in the first movement direction Y1. The right end 60R has a right curved portion 602 at its downstream end in the first movement direction Y1.

[0089] A first inclined portion 61, a second inclined portion 62, a slit 63, and a capture portion 64 are formed at the downstream end of the plate body 60 in the first movement direction Y1.

[0090] The first inclined portion 61 extends linearly from the left curved portion 601 at the left end 60L to the right and upstream in the first movement direction Y1. The right end of the first inclined portion 61 is located to the right of the center position Qc of the plate body 60 in the left-right direction. A virtual line Q1 extending along the first inclined portion 61 is defined. The direction extending along the virtual line Q1 intersects with the extension direction Y.

[0091] A first curved portion 603 is connected to the right end of the first inclined portion 61. The first curved portion 603 curves from the end connected to the first inclined portion 61 to the opposite end, upstream in the first movement direction Y1, and further extends while curving leftward.

[0092] The second inclined portion 62 extends linearly from the right curved portion 602 at the right end 60R to the left and upstream in the first moving direction Y1. The left end of the second inclined portion 62 is located near the center position Qc of the plate body 60. The second inclined portion 62 intersects with the imaginary line Q1. A imaginary line Q2 is defined extending along the second inclined portion 62. The direction extending along the imaginary line Q2 intersects with the drawing direction Y and the imaginary line Q1. A portion of the second inclined portion 62 faces the first curved portion 603 upstream in the first moving direction Y1. The distance between the second inclined portion 62 and the first curved portion 603 is denoted by "D2." The distance D2 is smaller than the thickness of the yarn T.

[0093] The slit 63 connects to the upstream end of the second inclined portion 62 in the first moving direction Y1. The slit 63 extends from the connecting portion with the second inclined portion 62 toward the upstream side in the first moving direction Y1 along the drawing direction Y. The left-right position of the slit 63 coincides with the center position Qc of the plate body 60. The spacing between the slits 63 is denoted as "D3". The spacing D3 is smaller than the thickness of the yarn T. The spacing D3 is smaller than the spacing D2.

[0094] The capturing portion 64 is connected to the end of the first curved portion 603 opposite to the end connected to the first inclined portion 61. The capturing portion 64 is recessed downstream in the first movement direction Y1. The capturing portion 64 is positioned downstream in the first movement direction Y1 with respect to the slit 63. An opening 604 is formed at the upstream end of the capturing portion 64 in the first movement direction Y1. The opening 604 opens upstream in the first movement direction Y1. The width of the opening 604 is referred to as "D4". The width D4 is greater than the spacing D3 of the slit 63.

[0095] The portion of the plate 60 near the downstream end in the first moving direction Y1, where the first inclined portion 61, the second inclined portion 62, the slit 63, and the capture portion 64 are provided, is referred to as the "downstream end portion 60F."

[0096] A first operating wire is connected to a plurality of round holes 60H of the guide member 6. The guide member 6 moves in a first movement direction Y1 or a second movement direction Y2 in response to an operation of the first operating wire. The guide member 6 is movable along the thirteenth hole 31B of the jaw body 20A shown in FIG. 2, the fourteenth hole 7H of the cartridge 7 shown in FIG. 10, and the twelfth hole 31A of the second jaw 3B shown in FIG. 2.

[0097] When the guide member 6 moves in the first movement direction Y1 while the second jaw 3B is in the close position, the plate body 60 bends as shown in Fig. 28. The downstream end 60F of the plate body 60 protrudes from the tip of the second jaw 3B shown in Fig. 2 and moves toward the jaw through-hole 33 of the first jaw 3A. The downstream end 60F of the plate body 60 is inserted into the jaw through-hole 33 of the first jaw 3A.

[0098] When the guide member 6 has moved the furthest in the first movement direction Y1, the downstream end 60F of the plate body 60 faces rearward. As shown in Fig. 28, the portion of the plate body 60 located most forward is referred to as the "upstream end Q3." The upstream end Q3 is located forward of the portion of the plate body 60 located most downstream in the first movement direction Y1, i.e., the downstream end 60F.

[0099] Hereinafter, the position of the guide member 6 that has moved the furthest in the first movement direction Y1 will be referred to as the "protruding position." The position of the guide member 6 that has moved the furthest in the second movement direction Y2 will be referred to as the "retracted position." When the guide member 6 is disposed in the retracted position, the plate body 60 extends linearly in the front-rear direction. In addition, the downstream end 60F of the plate body 60 is located rearward of the fourteenth hole 7H of the cartridge 7.

[0100] <Robot connection part 9> As shown in FIG. 1, the robot connector 9 covers the rear end of the main body 2A. The robot connector 9 has a cylindrical shape. The main body 2A passes rearward past the front end of a side surface 91 of the robot connector 9 and extends to the rear end of the side surface 91. The gripper 4 and the pusher 5 pass through the main body 2A and extend rearward beyond the rear end of the side surface 91.

[0101] The disk Rr of the robot R is connected to the upper end of the robot connection part 9. A plurality of robot motors MR built into the robot R are connected to the disk Rr. The rotation axes of the plurality of robot motors MR extend into the robot connection part 9. The robot R operates the first operation wire, the second operation wire, the third operation wire, the fourth operation wire, and the rotating belt 230 by rotating the plurality of robot motors MR.

[0102] <Drive unit 8> As shown in FIG. 1, the drive unit 8 is connected to the rear end of the side surface 91 of the robot connection part 9. The drive unit 8 has a cylindrical case 804. The case 804 houses the first drive mechanism 8A, the second drive mechanism 8B, and the third drive mechanism 8C shown in FIGS. 13 to 17, as well as the first motor Ma1, the first auxiliary motor Ma2, the second motor Mb1, the second auxiliary motor Mb2, the third motor Mc1, and the third auxiliary motor Mc2 shown in FIG. 29.

[0103] The first drive mechanism 8A shown in Fig. 15 moves the first rod 41 and the second rod 42 of the ligation grasping member 4A in the front-rear direction and rotates the second rod 42. The second drive mechanism 8B shown in Fig. 16 moves the first rod 43 and the second rod 44 of the rearrangement grasping member 4B in the front-rear direction and rotates the second rod 44. The third drive mechanism 8C shown in Fig. 17 moves the pusher 5 in the front-rear direction and rotates it.

[0104] <First driving mechanism 8A> As shown in FIG. 15, the first drive mechanism 8A has a first screw shaft Xa1, a first auxiliary shaft Xa2, a first grip support portion 80A, and a first motor Ma1 and a first auxiliary motor Ma2 shown in FIG.

[0105] The first screw shaft Xa1 has a rod shape with a circular cross section. A male thread is formed on the side surface of the first screw shaft Xa1. The male thread extends spirally in the front-to-rear direction. The first screw shaft Xa1 is disposed diagonally downward to the right of the first auxiliary shaft Xa2 and extends parallel to the first auxiliary shaft Xa2. The first auxiliary shaft Xa2 is a D-cut shaft with a D-shaped cross section. The first screw shaft Xa1 rotates when driven by the first motor Ma1. The first auxiliary shaft Xa2 rotates when driven by the first auxiliary motor Ma2.

[0106] The first gripping support portion 80A supports the first rod 41 and the second rod 42. The first gripping support portion 80A has a support base 81A, a first main gear 81B, and a first follower gear 81C.

[0107] The support base 81A supports the first rod 41, the first main gear 81B, and the first driven gear 81C. The support base 81A has a first through hole 811, a second through hole 812, and a third through hole 813. A female thread is formed on the inner surface of the first through hole 811. The female thread extends spirally in the front-to-rear direction. A first screw shaft Xa1 is inserted into the first through hole 811. The male thread of the first screw shaft Xa1 and the female thread of the first through hole 811 mesh with each other. A first auxiliary shaft Xa2 is inserted into the second through hole 812. The rear end of the first rod 41 is connected to the periphery of the third through hole 813 and to the front surface of the support base 81A.

[0108] The first main gear 81B is a spur gear with teeth provided only on approximately half of its circumferential area. The rotation axis of the first main gear 81B extends in the front-rear direction. A gear through hole 81H with a D-shaped cross section is formed in the center of the first main gear 81B. The second through hole 812 and the gear through hole 81H are aligned in a straight line in the front-rear direction. The first auxiliary shaft Xa2 is inserted through the gear through hole 81H. The first main gear 81B is movable in the front-rear direction relative to the first auxiliary shaft Xa2. The cross section of the first auxiliary shaft Xa2 is also D-shaped. Therefore, the first main gear 81B rotates in response to the rotation of the first auxiliary shaft Xa2.

[0109] The first slave gear 81C is a spur gear. The rotation axis of the first slave gear 81C extends in the front-rear direction. The first slave gear 81C is provided at the rear end of the second rod 42. The second rod 42 extends forward from the first slave gear 81C. The second rod 42 passes through the third through hole 813 and is inserted into the through hole of the first rod 41. The first slave gear 81C meshes with the first main gear 81B. The first slave gear 81C rotates in accordance with the rotation of the first main gear 81B.

[0110] <Explanation of Operation of First Drive Mechanism 8A> When the ligation device 1 moves the first rod 41 and the second rod 42 of the ligation grasping member 4A in the front-rear direction, the first motor Ma1 is driven to rotate the first screw shaft Xa1. The first through-hole 811 receives a forward or rearward force in response to the rotation of the first screw shaft Xa1, and moves in the front-rear direction. In this case, the support base 81A in which the first through-hole 811 is formed moves in the front-rear direction in response to the movement of the first through-hole 811. The first rod 41 and the second rod 42 of the ligation grasping member 4A move in the front-rear direction together.

[0111] Furthermore, when the second rod 42 of the ligation grasping member 4A is rotated relative to the first rod 41, the ligation device 1 drives the first auxiliary motor Ma2 to rotate the first auxiliary shaft Xa2. As the first auxiliary shaft Xa2 rotates, the first main gear 81B and the first driven gear 81C rotate. As the first driven gear 81C rotates, the second rod 42 also rotates. As a result, the second rod 42 rotates relative to the first rod 41 in the ligation grasping member 4A.

[0112] As described above, the first drive mechanism 8A moves the first rod 41 and the second rod 42 of the ligation grasping member 4A together in the front-to-rear direction in response to rotation of the first screw shaft Xa1 by driving the first motor Ma1. Also, the first drive mechanism 8A rotates the second rod 42 relative to the first rod 41 in response to rotation of the first auxiliary shaft Xa2 by driving the first auxiliary motor Ma2.

[0113] <Second driving mechanism 8B> As shown in FIG. 16, the second drive mechanism 8B has a second screw shaft Xb1, a second auxiliary shaft Xb2, a second grip support portion 80B, and a second motor Mb1 and a second auxiliary motor Mb2 shown in FIG.

[0114] The second screw shaft Xb1 has a rod shape with a circular cross section. A male screw is formed on the side surface of the second screw shaft Xb1. The male screw extends spirally in the front-to-rear direction. The second screw shaft Xb1 is disposed to the right of the second auxiliary shaft Xb2 and extends parallel to the second screw shaft Xb1. The second auxiliary shaft Xb2 is a D-cut shaft with a D-shaped cross section. The second screw shaft Xb1 is rotated by being driven by the second motor Mb1. The second auxiliary shaft Xb2 is rotated by being driven by the second auxiliary motor Mb2.

[0115] The second gripping support portion 80B supports the first rod 43 and the second rod 44. The configuration of the second gripping support portion 80B is the same as that of the first gripping support portion 80A shown in FIG.

[0116] The second gripping support part 80B has a support base 82A, a first main gear 82B, and a first driven gear 82C. The support base 82A, the first main gear 82B, and the first driven gear 82C correspond to the support base 81A, the first main gear 81B, and the first driven gear 81C of the first gripping support part 80A shown in Fig. 15. A first through hole 821, a second through hole 822, and a third through hole 823 formed in the support base 82A correspond to the first through hole 811, the second through hole 812, and the third through hole 813 formed in the support base 81A shown in Fig. 15, respectively.

[0117] The second screw shaft Xb1 is inserted through the first through hole 821. The male thread of the second screw shaft Xb1 meshes with the female thread of the first through hole 821. The second auxiliary shaft Xb2 is inserted through the second through hole 822. The rear end of the first rod 43 is connected to the periphery of the third through hole 823 and to the front surface of the support base 82A.

[0118] The second through-hole 822 and the gear through-hole 82H of the first main gear 82B are aligned in a straight line in the front-to-rear direction. The second auxiliary shaft Xb2 is inserted through the gear through-hole 82H. The first main gear 82B is movable in the front-to-rear direction relative to the second auxiliary shaft Xb2. The first main gear 82B rotates in response to the rotation of the second auxiliary shaft Xb2.

[0119] The first slave gear 82C is provided at the rear end of the second rod 44. The second rod 44 extends forward from the first slave gear 82C. The second rod 44 passes through the third through-hole 823 and is inserted into the through-hole of the first rod 43. The first slave gear 82C meshes with the first main gear 82B. The first slave gear 82C rotates in response to the rotation of the first main gear 82B.

[0120] <Description of Operation of Second Drive Mechanism 8B> The operation of the second drive mechanism 8B when moving the first rod 43 and the second rod 44 of the rearrangement gripping member 4B in the front-rear direction is the same as the operation of the first drive mechanism 8A shown in Fig. 15. The second drive mechanism 8B moves the first rod 43 and the second rod 44 of the rearrangement gripping member 4B together in the front-rear direction in response to rotation of the second screw shaft Xb1 by driving of the second motor Mb1. Furthermore, the second drive mechanism 8B rotates the second rod 44 relative to the first rod 43 in response to rotation of the second auxiliary shaft Xb2 by driving of the second auxiliary motor Mb2.

[0121] <Third driving mechanism 8C> As shown in FIG. 17, the third drive mechanism 8C has a third screw shaft Xc1, a third auxiliary shaft Xc2, and a pusher support portion 80C, as well as a third motor Mc1 and a third auxiliary motor Mc2 shown in FIG.

[0122] The third screw shaft Xc1 has a rod shape with a circular cross section. A male thread is formed on the side surface of the third screw shaft Xc1. The male thread extends spirally in the front-to-rear direction. The third screw shaft Xc1 is located diagonally downward and left with respect to the third auxiliary shaft Xc2 and extends parallel to the third screw shaft Xc1. The third auxiliary shaft Xc2 is a D-cut shaft with a D-shaped cross section. The third screw shaft Xc1 is rotated by being driven by the third motor Mc1. The third auxiliary shaft Xc2 is rotated by being driven by the third auxiliary motor Mc2.

[0123] The pusher support portion 80C supports the pusher 5. The configuration of the pusher support portion 80C is common to the first grip support portion 80A shown in FIG. 15 and the second grip support portion 80B shown in FIG.

[0124] The pusher support part 80C has a support base 83A, a second main gear 83B, and a second slave gear 83C. The support base 83A, the second main gear 83B, and the second slave gear 83C correspond to the support base 81A, the first main gear 81B, and the first slave gear 81C of the first grip support part 80A shown in Fig. 15. A first through hole 831, a second through hole 832, and a third through hole 833 formed in the support base 83A correspond to the first through hole 811, the second through hole 812, and the third through hole 813 formed in the support base 81A shown in Fig. 15, respectively.

[0125] The third screw shaft Xc1 is inserted into the first through hole 831. The male thread of the third screw shaft Xc1 is engaged with the female thread of the first through hole 831. The third auxiliary shaft Xc2 is inserted into the second through hole 832.

[0126] The second through-hole 832 and the gear through-hole 83H of the second main gear 83B are aligned in a straight line in the front-to-rear direction. The third auxiliary shaft Xc2 is inserted through the gear through-hole 83H. The second main gear 83B is movable in the front-to-rear direction relative to the third auxiliary shaft Xc2. The second main gear 83B rotates in response to the rotation of the third auxiliary shaft Xc2.

[0127] The second secondary gear 83C is provided at the rear end of the pusher 5. The pusher 5 extends forward from the second secondary gear 83C. The pusher 5 extends forward through the third through-hole 833. The second secondary gear 83C meshes with the second primary gear 83B. The second secondary gear 83C rotates in response to the rotation of the second primary gear 83B.

[0128] <Operation of the third driving mechanism 8C> The operation of the third drive mechanism 8C when moving the pusher 5 in the front-to-rear direction is the same as the operation of the first drive mechanism 8A shown in Fig. 15. The third drive mechanism 8C moves the pusher 5 in the front-to-rear direction in response to the rotation of the third screw shaft Xc1 by the drive of the third motor Mc1. The third drive mechanism 8C also rotates the pusher 5 in response to the rotation of the third auxiliary shaft Xc2 by the drive of the third auxiliary motor Mc2.

[0129] <Positional Relationship Between First Drive Mechanism 8A, Second Drive Mechanism 8B, and Third Drive Mechanism 8C> 14, the positions of the first grip support part 80A and the second grip support part 80B are different from each other in the up-down direction and the left-right direction. Therefore, when the first grip support part 80A and the second grip support part 80B move in the front-rear direction, the first grip support part 80A and the second grip support part 80B do not come into contact with each other. Therefore, the first grip support part 80A can move further forward than the second grip support part 80B, and the second grip support part 80B can move further forward than the first grip support part 80A.

[0130] When viewed from behind, the ligation grasping member 4A and the pusher 5 are arranged coaxially. The eighth axis C8 of the first rod 41, the ninth axis C9 of the second rod 42, and the tenth axis C10 of the pusher 5 are arranged on the same straight line. A portion of the first grasping support portion 80A and the pusher support portion 80C overlap in directions (up-down and left-right directions) perpendicular to the front-rear direction. The pusher support portion 80C is arranged forward of the first grasping support portion 80A. Movement of the first grasping support portion 80A forward of the pusher support portion 80C is restricted by the rear surface of the pusher support portion 80C contacting the front surface of the first grasping support portion 80A.

[0131] On the other hand, the positions of the second grip support portion 80B and the pusher support portion 80C are different from each other in the up-down direction and the left-right direction. Therefore, when the second grip support portion 80B and the pusher support portion 80C move in the front-to-back direction, the second grip support portion 80B and the pusher support portion 80C do not come into contact with each other. Therefore, the second grip support portion 80B can move further forward than the pusher support portion 80C, and the pusher support portion 80C can move further forward than the second grip support portion 80B.

[0132] <Electrical configuration> 29, the robot R includes a controller 96, a memory 97, a motor driver Fr, a plurality of robot motors MR, an encoder Zr, an input unit 98A, and an output unit 98B. The ligation device 1 includes motor drivers Fa1, Fa2, Fb1, Fb2, Fc1, and Fc2, first motors Ma1 and Mb1, first auxiliary motors Ma2 and Mb2, a third motor Mc1, a third auxiliary motor Mc2, and encoders Za1, Za2, Zb1, Zb2, Zc1, and Zc2.

[0133] The controller 96 is a CPU (Central Processing Unit) and controls the ligation device 1 so that the ligation device 1 ligates the object S with the thread T. The controller 96 is electrically connected to the memory 97, the motor drivers Fr, Fa1, Fa2, Fb1, Fb2, Fc1, Fc2, the encoders Zr, Za1, Za2, Zb1, Zb2, Zc1, Zc2, the input unit 98A, and the output unit 98B.

[0134] The memory 97 includes volatile and non-volatile storage devices, and stores a ligation program executed by the controller 96 and various setting information.

[0135] The motor driver Fr is electrically connected to the robot motor MR. The encoder Zr detects the rotation speed of the robot motor MR. The motor driver Fa1 is electrically connected to the first motor Ma1. The encoder Za1 detects the rotation speed of the first motor Ma1. The motor driver Fa2 is electrically connected to the first auxiliary motor Ma2. The encoder Za2 detects the rotation speed of the first auxiliary motor Ma2. The motor driver Fb1 is electrically connected to the second motor Mb1. The encoder Zb1 detects the rotation speed of the second motor Mb1. The motor driver Fb2 is electrically connected to the second auxiliary motor Mb2. The encoder Zb2 detects the rotation speed of the second auxiliary motor Mb2. The motor driver Fc1 is electrically connected to the third motor Mc1. The encoder Zc1 detects the rotation speed of the third motor Mc1. The motor driver Fc2 is electrically connected to the third auxiliary motor Mc2. The encoder Zc2 detects the rotation speed of the third auxiliary motor Mc2.

[0136] The motor driver Fr applies a DC voltage to the robot motor MR in response to a signal received from the controller 96, thereby driving the robot motor MR. The motor driver Fr also acquires the current value of the current flowing through the robot motor MR and the number of rotations of the robot motor MR detected by the encoder Zr, and transmits these to the controller 96.

[0137] The motor driver Fa1 applies a DC voltage to the first motor Ma1 in response to a signal received from the controller 96, thereby driving the first motor Ma1. The motor driver Fa1 also obtains the current value of the current flowing through the first motor Ma1 and the rotation speed of the first motor Ma1 detected by the encoder Za1, and sends these to the controller 96. The motor driver Fa2 applies a DC voltage to the first auxiliary motor Ma2 in response to a signal received from the controller 96, thereby driving the first auxiliary motor Ma2. The motor driver Fa2 also obtains the current value of the current flowing through the first auxiliary motor Ma2 and the rotation speed of the first auxiliary motor Ma2 detected by the encoder Za2, and sends these to the controller 96.

[0138] The motor driver Fb1 applies a DC voltage to the second motor Mb1 in response to a signal received from the controller 96, thereby driving the second motor Mb1. The motor driver Fb1 also obtains the current value of the current flowing through the second motor Mb1 and the rotation speed of the second motor Mb1 detected by the encoder Zb1, and sends these to the controller 96. The motor driver Fb2 applies a DC voltage to the second auxiliary motor Mb2 in response to a signal received from the controller 96, thereby driving the second auxiliary motor Mb2. The motor driver Fb2 also obtains the current value of the current flowing through the second auxiliary motor Mb2 and the rotation speed of the second auxiliary motor Mb2 detected by the encoder Zb2, and sends these to the controller 96.

[0139] The motor driver Fc1 applies a DC voltage to the third motor Mc1 in response to a signal received from the controller 96, thereby driving the third motor Mc1. The motor driver Fc1 also obtains the current value of the current flowing through the third motor Mc1 and the rotation speed of the third motor Mc1 detected by the encoder Zc1, and sends these to the controller 96. The motor driver Fc2 applies a DC voltage to the third auxiliary motor Mc2 in response to a signal received from the controller 96, thereby driving the third auxiliary motor Mc2. The motor driver Fc2 also obtains the current value of the current flowing through the third auxiliary motor Mc2 and the rotation speed of the third auxiliary motor Mc2 detected by the encoder Zc2, and sends these to the controller 96.

[0140] The input unit 98A is a button, a touch panel, a keyboard, etc. for inputting various information to the robot R. The output unit 98B is a display that displays various information.

[0141] <Ligation process> The ligation process will be described below in which the controller 96 of the robot R controls the ligation device 1 to ligate the object S to be ligated with the suture T. In the following description, the act of the controller 96 driving the motor by sending a signal to the driver will be referred to as "the controller 96 driving the motor." As shown in Figure 30, the ligation process is started by the ligation device 1 in an initial state (S11). The initial state is as follows:

[0142] As shown in FIG. 34, the second jaw 3B is positioned at the close position. When the first ligation process is performed after replacing the cartridge 7, the guide member 6 is positioned at the retracted position. The downstream end 60F of the guide member 6 is positioned rearward of the 14th hole 7H of the cartridge 7 and in the 13th hole 31B in the jaw body 20A. At this time, the suture T is not held by the guide member 6. On the other hand, when the second or subsequent ligation process is performed after replacing the cartridge 7, the guide member 6 is positioned at the intermediate position. The intermediate position is the position of the guide member 6 when the downstream end 60F is positioned in the 12th hole 31A of the second jaw 3B. At this time, the suture T is captured by the capturing portion 64 of the guide member 6.

[0143] The ligature grasping member 4A and the pusher 5 are disposed over the extension portion 21A and first branch portion 21B of the first hole 21, as well as the first circular portion 761, the recovery portion 71A, the second circular portion 762, and part of the region 780 of the cartridge 7 shown in FIG. 10. The front ends of the ligature grasping member 4A and the pusher 5 are located near the jaw through-hole 33. The front end of the ligature grasping member 4A protrudes slightly forward beyond the front end of the pusher 5. The ligature grasping member 4A is in a released state. The rearrangement grasping member 4B is disposed in the second branch portion 21C of the first hole 21. The rearrangement grasping member 4B is in a fully grasping state.

[0144] The suture T unwound from the bobbin B passes through the twelfth hole 31A of the second jaw 3B, the first circular portion 761, the recovery portion 71A, and the second circular portion 762 of the cartridge 7, and the extension portion 21A and second branching portion 21C of the first hole 21. The tip of the suture T is gripped by the rearrangement gripping member 4B in the full gripping state. The first loop shaft 46 and the second loop shaft 56 of the loop forming unit 2B are positioned at the third rotation position. A first loop P1 is formed on the first loop shaft 46, and a second loop P2 is formed on the second loop shaft 56. The ligation gripping member 4A and the pusher 5 are inserted through the first loop P1 and the second loop P2. For ease of understanding, FIGS. 34 to 63 show the first loop P1 and the second loop P2 disengaged from the first loop shaft 46 and the second loop shaft 56.

[0145] The main body 2A of the ligation device 1 is positioned posterior to the body S to be ligated inside the body. The controller 96 drives the robot motor MR to operate the fourth operating wire (S13) in order to move the second jaw 3B from the close position to the distant position. As shown in FIG. 35, the second jaw 3B moves from the close position to the distant position (arrow Y11). In this state, the main body 2A moves forward toward the body S to be ligated. The body S to be ligated is positioned between the first jaw 3A and the second jaw 3B.

[0146] Next, the controller 96 drives the robot motor MR to operate the fourth operating wire (S15) to move the second jaw 3B from the distant position to the close position. As shown in FIG. 36, the second jaw 3B moves from the distant position to the close position (arrow Y12). The object to be ligated S is sandwiched between the first jaw 3A and the second jaw 3B and placed in the holding area Sp. The suture T is placed below the object to be ligated S.

[0147] Next, the controller 96 drives the robot motor MR to operate the first operating wire in order to move the guide member 6 to the protruding position in the first movement direction Y1 shown in FIGS. 27 and 28 (S17).

[0148] Here, when the first ligation process is performed after replacing the cartridge 7, the guide member 6 moves from the retracted position to the protruding position. As the guide member 6 moves, the first inclined portion 61 of the guide member 6 shown in FIG. 27 comes into contact with a portion of the thread T that extends between the bobbin B and the object to be ligated S. As shown in FIG. 27, the thread T is guided upstream in the first moving direction Y1 along the first inclined portion 61. The thread T leaves the first inclined portion 61 and then comes into contact with the second inclined portion 62. The thread T is guided upstream in the first moving direction Y1 along the first inclined portion 61. The thread T enters the slit 63 connected to the second inclined portion 62 and is clamped by the slit 63 from both the left and right sides.

[0149] On the other hand, when the second or subsequent ligation step is performed after replacing the cartridge 7, the guide member 6 moves from the intermediate position to the protruding position. At this time, the suture T, which is captured by the capturing portion 64 of the guide member 6, moves upstream in the first movement direction Y1 and enters the slit 63 as the guide member 6 moves. The suture T is clamped on both the left and right sides by the slit 63.

[0150] The guide member 6, with the suture T clamped therein, further moves in the first movement direction Y1 toward the protruding position. As shown in FIG. 37, the downstream end 60F of the guide member 6 is inserted into the jaw through-hole 33 of the first jaw 3A and protrudes upward (arrow Y13). The downstream end 60F of the guide member 6 faces the front of the ligating and grasping member 4A. The guide member 6 lifts the suture T clamped by the slit 63 upward. At this time, the portion of the suture T extending between the guide member 6 and the body to be ligated S enters the first notch 40 and the first partial notch 480 of the ligating and grasping member 4A in the released state shown in FIG. 24.

[0151] Next, the controller 96 drives the first auxiliary motor Ma2 to rotate the second rod 42 of the ligating grasping member 4A to change the state from the released state to the semi-gripped state (S19). As shown in Fig. 38, the second rod 42 of the ligating grasping member 4A rotates relative to the first rod 41 (arrow Y14), and the ligating grasping member 4A enters the semi-gripped state. The portion of the suture T extending between the guide member 6 and the object to be ligated S is movably held by the first rod 41 and second rod 42 of the ligating grasping member 4A in the semi-gripped state.

[0152] Next, the controller 96 drives the robot motor MR to operate the first operating wire in order to move the guide member 6 from the protruding position to the intermediate position (S21). As shown in FIG. 39, the guide member 6 moves in the second movement direction Y2 to the intermediate position (arrow Y15). At this time, the yarn T comes off the slit 63. The yarn T enters the catching portion 64, which is located upstream of the slit 63 in the second movement direction Y2, in other words, downstream of the first movement direction Y1, and is caught by the catching portion 64. Therefore, even if the yarn T comes off the slit 63, it does not come off the guide member 6.

[0153] Next, the controller 96 drives the first motor Ma1 and the third motor Mc1 to move the ligating and grasping member 4A and the pusher 5 rearward (S23). As shown in FIG. 39, the ligating and grasping member 4A and the pusher 5 move rearward (arrow Y16). The front ends of the ligating and grasping member 4A and the pusher 5 are located rearward of the cartridge 7 and forward of the loop forming unit 2B. Note that the ligating and grasping member 4A is in a semi-gripped state, and the suture T is movable relative to the first rod 41 and the second rod 42. Therefore, as the ligating and grasping member 4A moves rearward, the suture T is unwound from the bobbin B. The suture T is wound around the object S to be ligated.

[0154] Next, the controller 96 drives the first auxiliary motor Ma2 to rotate the second rod 42 of the ligating and grasping member 4A to change the state from the partial grasping state to the full grasping state (S25). As shown in Fig. 40, the second rod 42 of the ligating and grasping member 4A rotates relative to the first rod 41 (arrow Y17), and the ligating and grasping member 4A changes to the full grasping state. The portion of the suture T that has been unwound from the bobbin B is held immovably by the first rod 41 and second rod 42 of the ligating and grasping member 4A that is now in the full grasping state.

[0155] Next, the controller 96 drives the robot motor MR to operate the first operating wire in order to move the guide member 6 from the intermediate position to the protruding position (S27). During the movement of the guide member 6, the portion of the suture T extending between the bobbin B and the ligation holding member 4A moves from the capture portion 64 of the guide member 6 toward the slit 63 and is clamped by the slit 63. The guide member 6, with the suture T clamped, moves further toward the protruding position.

[0156] As shown in FIG. 41 , the downstream end 60F of the guide member 6 is inserted into the jaw through-hole 33 of the first jaw 3A and protrudes upward (arrow Y18). The suture T is clamped by the slit 63. The guide member 6 lifts the suture T clamped in the slit 63 upward. At this time, the portion of the suture T extending between the guide member 6 and the ligature gripping member 4A is pressed from below against the blade 79A of the gripping suture cutter 79 of the cartridge 7. Note that the ligature gripping member 4A is in a fully gripping state, and the suture T is immovable relative to the first rod 41 and the second rod 42. Furthermore, the suture T is clamped in the slit 63 of the guide member 6, and the suture T is immovable relative to the guide member 6. Therefore, the portion extending between the guide member 6 and the ligature gripping member 4A is cut by the gripping suture cutter 79 (S27).

[0157] Of the thread T, the thread T1 that has been cut and separated from the bobbin B side is held by the rearrangement holding member 4B at a first end ta on one side. The thread T1 extends forward from the first end ta, wraps around the body S to be ligated, extends rearward, bends at the portion held by the ligation holding member 4A, extends forward, and reaches a second end tb on the other side. The thread T1 is wound around the body S to be ligated.

[0158] Next, the controller 96 drives the first auxiliary motor Ma2 to rotate the second rod 42 of the ligating and grasping member 4A to change the state from the fully grasped state to the semi-gripped state (S29). As shown in Fig. 41, the second rod 42 of the ligating and grasping member 4A rotates relative to the first rod 41 (arrow Y19), and the ligating and grasping member 4A enters the semi-gripped state. The portion of the suture T1 that extends between the second end tb cut in step S27 and the portion wound around the ligation target S is held by the first rod 41 and second rod 42 of the ligating and grasping member 4A, which is now in the semi-gripped state.

[0159] Next, the controller 96 drives the robot motor MR to operate the first operating wire in order to move the guide member 6 from the protruding position to the intermediate position (S31). As shown in Fig. 42, the guide member 6 moves in the second movement direction Y2 to the intermediate position (arrow Y20). The thread T leaves the slit 63 and is captured by the capturing portion 64.

[0160] Next, the controller 96 drives the first motor Ma1 and the third motor Mc1 to move the ligature holding member 4A and the pusher 5 rearward (S33). As shown in FIG. 42, the ligature holding member 4A and the pusher 5 move rearward (arrow Y21). The front ends of the ligature holding member 4A and the pusher 5 move to the rear of the loop forming section 2B. Note that the ligature holding member 4A is in a semi-gripping state, and the suture T1 is movable relative to the first rod 41 and the second rod 42. Therefore, during the process of the ligature holding member 4A and the pusher 5 moving rearward, the second end tb of the suture T1 passes rearward through the first loop P1 and the second loop P2 and moves to a position close to the first rod 41 and the second rod 42 of the ligature holding member 4A.

[0161] Next, the controller 96 drives the first auxiliary motor Ma2 to rotate the second rod 42 of the ligating and grasping member 4A to change from the partial grasping state to the full grasping state (S35). As shown in Fig. 43, the second rod 42 of the ligating and grasping member 4A rotates relative to the first rod 41 (arrow Y22), and the ligating and grasping member 4A changes to the full grasping state. The vicinity of the second end tb of the suture T1 is held by the first rod 41 and the second rod 42 of the ligating and grasping member 4A, which is now in the full grasping state.

[0162] Next, the controller 96 drives the first motor Ma1 and the third motor Mc1 to slightly move the ligation and gripping member 4A and the pusher 5 forward (S37). As shown in FIG. 44, the ligation and gripping member 4A and the pusher 5 move slightly forward (arrow Y23). The front ends of the ligation and gripping member 4A and the pusher 5 approach the loop forming unit 2B from behind. This releases the tension in the suture T1 between the portion wound around the object S and the second end tb.

[0163] Next, the controller 96 drives the robot motor MR to operate the third operating wire in order to drive the loop forming unit 2B (S39). As shown in Fig. 45, the first loop shaft 46 and the second loop shaft 56 rotate 360 ​​degrees in the first rotation direction R1 from the third rotation position. The first loop P1 disengages from the first loop shaft 46, and the second loop P2 disengages from the second loop shaft 56.

[0164] Next, as shown in Fig. 31, the controller 96 drives the first motor Ma1 and the third motor Mc1 to move the ligation grasping member 4A and the pusher 5 forward (S41). As shown in Fig. 46, the ligation grasping member 4A and the pusher 5 move forward (arrow Y24). The front ends of the ligation grasping member 4A and the pusher 5 move to the vicinity of the ligation target body S. At this time, the pusher 5 moves the first loop P1 and the second loop P2 to the vicinity of the ligation target body S. Fig. 47 shows the first loop P1 and the second loop P2 arranged in the vicinity of the ligation target body S.

[0165] The controller 96 also drives the second motor Mb1 to move the rearwardly repositioning and holding member 4B (S43). As shown in Fig. 46, the rearwardly repositioning and holding member 4B moves (arrow Y25). This suppresses slack in the yarn T1 caused by the movement of the first loop P1 and the second loop P2. Next, the controller 96 executes a tightening step to tighten the first loop P1 and the second loop P2 (S45).

[0166] The tightening process will be described with reference to Fig. 32. The controller 96 drives the second motor Mb1 to move the rearwardly rearwardly of the rearrangement gripping member 4B (S101). The controller 96 receives and acquires, from the motor driver Fb1, the value of the current flowing through the second motor Mb1 in response to the driving of the second motor Mb1 by the motor driver Fb1 (S103).

[0167] The controller 96 determines whether the acquired current value is equal to or less than a predetermined threshold value Th0 (S105). If the current value flowing through the second motor Mb1 is greater than the predetermined threshold value Th0 (S105: YES), there is a high possibility that some abnormality has occurred in the ligation device 1. Therefore, if the controller 96 determines that the acquired current value is greater than the predetermined threshold value Th0 (S105: NO), it causes the output unit 98B to display a screen notifying the occurrence of an error (S107). The controller 96 ends the tightening process and the ligation process.

[0168] When the controller 96 determines that the acquired current value is equal to or less than the predetermined threshold value Th0 (S105: YES), the controller 96 drives the second motor Mb1 to continue moving the rearward of the rearrangement grasping member 4B (S109). Note that the vicinity of the second end tb of the suture T1 is held by the first rod 41 and the second rod 42 of the ligation grasping member 4A, which is in the full-holding state. Also, the rearrangement grasping member 4B is in the full-holding state, and the first end ta of the suture T1 is held by the first rod 43 and the second rod 44. Therefore, as the rearward movement of the rearrangement grasping member 4B occurs, the suture T1 is pulled, and the first loop P1 and the second loop P2 are tightened.

[0169] The controller 96 selects a determination condition for whether or not to stop the rearward movement of the rearrangement gripping member 4B started in S109 based on setting information stored in the memory 97 (S111). The setting information is stored in the memory 97 by being input in advance by the user via the input unit 98A of the robot R. The selectable determination condition is any one of the following determination conditions G1 to G8. Details of the determination conditions G1 to G8 are as follows:

[0170] The first graph in FIG. 33 shows the change over time in the value of the current flowing to the second motor Mb1 when the rearrangement gripping member 4B moves backward. As shown, the current value increases as the time passes while the rearrangement gripping member 4B moves. The current value flowing to the second motor Mb1 correlates with the magnitude of the force with which the rearrangement gripping member 4B moves backward and pulls the thread T1. That is, as the movement of the rearrangement gripping member 4B gradually tightens the clamping of the first loop P1 and the second loop P2, the force with which the rearrangement gripping member 4B pulls the thread T1 also gradually increases. Therefore, the vertical axis of the first graph can be replaced with the force with which the rearrangement gripping member 4B pulls the thread T1. In the following explanation, the vertical axis of the first graph will be replaced with force.

[0171] The force change trend includes an initial state H1, an intermediate state H2, and a final state H3. In the initial state H1, the force changes at a constant rate of increase. In the intermediate state H2, the rate of increase of the force increases. In the final state H3, the force changes at a constant rate of increase. Note that the rate of increase of the force in the final state H3 is greater than the rate of increase of the force in the initial state H1.

[0172] The second graph in Figure 33 shows the change over time in the first derivative, which is the value obtained by first differentiating the time change in force in the first graph. The first state H11, second state H12, and third state H13 in the second graph correspond to the initial state H1, intermediate state H2, and final state H3 in the first graph, respectively. The third graph in Figure 33 shows the change over time in the second derivative, which is the value obtained by second-differentiating the time change in force in the first graph. The fourth state H21, fifth state H22, and sixth state H23 in the third graph correspond to the initial state H1, intermediate state H2, and final state H3 in the first graph, respectively.

[0173] In the judgment conditions G1 to G3, the judgment is made based on a first derivative value obtained by differentiating the time change of the force once, while in the judgment conditions G4 to G8, the judgment is made based on a second derivative value obtained by differentiating the time change of the force twice.

[0174] In the judgment condition G1, when the state changes from the first state H11 to the second state H12, it is judged that the rearward movement of the rearward gripping member 4B is to be stopped. More specifically, the controller 96 judges that the state has changed from the first state H11 to the second state H12 when the state changes from a state in which the first differential value fluctuates within a range within a predetermined first ratio W1 (%) with respect to the moving average value of the first differential value to a state in which the first differential value fluctuates within a range greater than the first ratio W1 (%). When the controller 96 determines that the state has changed from the first state H11 to the second state H12, it determines that the rearward movement of the rearward gripping member 4B is to be stopped.

[0175] In the judgment condition G2, if, after a change from the first state H11 to the second state H12, the first differential value becomes larger than a value statistically derived from the first differential value in the first state H11 by a predetermined first threshold value Th1 or more, it is judged that the rearward movement of the rearward gripping member 4B is to be stopped. More specifically, if, after a change to the second state H12, the first differential value becomes larger than the moving average value of the first differential value in the first state H11 by the first threshold value Th1 or more, the controller 96 judges that the rearward movement of the rearward gripping member 4B is to be stopped.

[0176] In the judgment condition G3, when the state changes from the second state H12 to the third state H13, it is judged that the rearward movement of the rearward gripping member 4B is stopped. More specifically, the controller 96 judges that the state has changed from the second state H12 to the third state H13 when, after the state changes to the second state H12, the state changes to one in which the first differential value fluctuates within a range of a first ratio W1 (%) with respect to the moving average value of the first differential value. When it is determined that the state has changed from the second state H12 to the third state H13, the controller 96 determines that the rearward movement of the rearward gripping member 4B is stopped.

[0177] In the judgment condition G4, when the state changes from the fourth state H21 to the fifth state H22, it is judged that the rearward movement of the rearward gripping member 4B is stopped. More specifically, the controller 96 judges that the state has changed from the fourth state H21 to the fifth state H22 when the state changes from a state in which the second derivative value fluctuates within a range within a predetermined second ratio W2 (%) with respect to the moving average value of the second derivative value to a state in which the second derivative value fluctuates within a range greater than the second ratio W2 (%). When the controller 96 determines that the state has changed from the fourth state H21 to the fifth state H22, it determines that the rearward movement of the rearward gripping member 4B is stopped.

[0178] In the judgment condition G5, if, after a change from the fourth state H21 to the fifth state H22, the second differential value becomes larger than a value statistically derived from the second differential value in the fourth state H21 by a predetermined second threshold value Th2 or more, it is judged that the rearward movement of the rearward gripping member 4B is to be stopped. More specifically, if, after a change to the fifth state H22, the second differential value becomes larger than the moving average value of the second differential value in the fourth state H21 by the second threshold value Th2 or more, the controller 96 judges that the rearward movement of the rearward gripping member 4B is to be stopped.

[0179] In the judgment condition G6, if the second differential value becomes a local maximum after the state changes from the fourth state H21 to the fifth state H22, it is judged that the rearward movement of the rearrangement gripping member 4B is to be stopped. More specifically, the controller 96 detects, as a local maximum point, a point at which the value obtained by differentiating the second differential value becomes 0 after the state changes to the fifth state H22. When the controller 96 detects a local maximum point, it judges that the rearward movement of the rearrangement gripping member 4B is to be stopped.

[0180] In the judgment condition G7, if the second differential value becomes smaller than the maximum value of the maximum point by a predetermined third threshold value Th3 or more after the state changes from the fourth state H21 to the fifth state H22, it is judged that the rearward movement of the rearrangement gripping member 4B is to be stopped. More specifically, if the controller 96 detects a maximum point after the state changes to the fifth state H22, it identifies the maximum value of the maximum point. If the second differential value becomes smaller than the identified maximum value by the third threshold value Th3 or more, the controller 96 determines that the rearward movement of the rearrangement gripping member 4B is to be stopped.

[0181] In the judgment condition G8, when the state changes from the fifth state H22 to the sixth state H23, it is judged that the rearward movement of the rearward gripping member 4B is stopped. More specifically, the controller 96 judges that the state has changed from the fifth state H22 to the sixth state H23 when, after the state changes to the fifth state H22, the state changes so that the second differential value fluctuates within a range of the second ratio W2 (%) with respect to the moving average value of the second differential value. When it is determined that the state has changed from the fifth state H22 to the sixth state H23, the controller 96 judges that the rearward movement of the rearward gripping member 4B is stopped.

[0182] As shown in FIG. 32, after selecting one of the judgment conditions G1 to G9 in S111, the controller 96 receives and acquires from the motor driver Fb1 the value of the current flowing through the second motor Mb1 in response to the driving of the second motor Mb1 by the motor driver Fb1 (S113). Based on the acquired current value, the controller 96 determines whether or not to stop the rearward movement of the rearrangement gripping member 4B in accordance with one of the judgment conditions G1 to G9 selected in S111 (S115). If the controller 96 determines not to stop the rearward movement of the rearrangement gripping member 4B (S115: NO), the process returns to S113 and repeats the process. In this case, as shown in FIG. 46, the rearrangement gripping member 4B moves rearward (arrow Y25). This causes the first loop P1 and the second loop P2 to be tightened.

[0183] When the controller 96 determines that the rearward movement of the rearrangement gripping member 4B should be stopped (S115: YES), the controller 96 stops driving the second motor Mb1 in order to stop the movement of the rearrangement gripping member 4B (S117).

[0184] As shown in Fig. 31, the controller 96 then drives the first motor Ma1 to move the ligation grasping member 4A backward (S47). As shown in Fig. 48, the ligation grasping member 4A moves backward (arrow Y26). The controller 96 also drives the second motor Mb1 to move the rearrangement grasping member 4B forward (S47). As shown in Fig. 48, the rearrangement grasping member 4B moves forward (arrow Y27).

[0185] The movement of the ligation holding member 4A and the rearrangement holding member 4B extends the first loop P1 shown in Fig. 47. As shown in Fig. 49, a new first loop P11 is formed in the portion of the thread T1 between the second loop P2 and the first end ta. As a result, a man's knot K is formed, and the body S is ligated with the thread T1.

[0186] Next, the controller 96 drives the first auxiliary motor Ma2 to rotate the second rod 42 of the ligating grasping member 4A to change the fully gripped state to the released state (S49). As shown in Fig. 50, the second rod 42 of the ligating grasping member 4A rotates relative to the first rod 41 (arrow Y28), and the ligating grasping member 4A enters the released state. The vicinity of the second end tb of the suture T1 is released from the first rod 41 and the second rod 42 of the ligating grasping member 4A.

[0187] Next, the controller 96 drives the first motor Ma1 and the third motor Mc1 to move the ligature grasping member 4A and the pusher 5 rearward (S51). As shown in FIG. 51, the ligature grasping member 4A and the pusher 5 move rearward (arrow Y29). The ligature grasping member 4A and the pusher 5 are disposed in the first branch portion 21B of the first hole 21.

[0188] Next, the controller 96 drives the robot motor MR to rotate the rotating belt 230 in order to cut the portion of the suture T1 from the portion wound around the ligation target object S to the first end ta and store the portion in the first storage portion 71B of the cartridge 7 (S53). The pulley 27 of the transmission mechanism 29 provided in the first portion mounting portion 28A of the jaw body 20A rotates in response to the rotation of the rotating belt 230. Accordingly, as shown in FIG. 52, the rotating body 72 of the cartridge 7 mounted in the mounting hole 27A of the pulley 27 also rotates, and the reel member 73 connected to the rotating body 72 also rotates (arrow Y30).

[0189] 53, the thread T1 in contact with the reel member 73 is guided along the wires 730 of the first coil spring 73A and the second coil spring 73B. As a result, the thread T1 moves from the collection section 71A toward the first storage section 71B in the storage recess 71 of the cartridge 7. The thread T1 moves downward away from the movement trajectory U of the rearrangement gripping member 4B.

[0190] As the yarn T1 moves from the collection section 71A toward the first storage section 71B in the storage recess 71, the first end portion ta of the yarn T1 is pulled forward. In response to this, the controller 96 drives the second motor Mb1 to move the rearrangement gripping member 4B forward (S55). As shown in Fig. 52, the rearrangement gripping member 4B, which holds the first end portion ta of the yarn T1, moves forward (arrow Y31).

[0191] The reel member 73 continues to rotate even after the thread T1 has moved to the bottom end of the reel member 73. In this case, as shown in FIG. 54, the thread T1 is wound onto the bottom end of the reel member 73. When the winding of the thread T1 onto the reel member 73 begins, the portion of the thread T1 that extends from the portion wound around the ligation target S toward the reel member 73 moves leftward from the center of the cartridge 7 in the left-right direction. The thread T1 comes into contact with the winding thread cutter 77 of the cartridge 7 and is cut by the blade 77A (S57). The winding thread cutter 77 cuts off the portion of the thread T1 that extends from the knot K toward the first end ta from the knot K. Hereinafter, the portion of the thread T1 that has been cut off from the knot K will be referred to as thread T11.

[0192] After the yarn T1 is cut by the winding yarn cutter 77 of the cartridge 7, the controller 96 drives the second auxiliary motor Mb2 to rotate the second rod 44 of the rearrangement gripping member 4B to change from the fully gripped state to the released state (S59). As shown in FIG. 55, the second rod 44 of the rearrangement gripping member 4B rotates relative to the first rod 43 (arrow Y32), and the rearrangement gripping member 4B enters the released state. The vicinity of the first end ta of the yarn T11 is released from the first rod 43 and the second rod 44 of the rearrangement gripping member 4B.

[0193] The controller 96 continues to rotate the pulley 27 of the jaw body 20A, and continues to rotate the reel member 73 of the cartridge 7 (arrow Y33). As a result, the yarn T11 is completely wound onto the reel member 73 (S61). The wound yarn T11 is accommodated in the first accommodation portion 71B of the accommodation recess 71. The volume of the first accommodation portion 71B is adjusted to be at least twice the total volume of the yarn T11 wound onto the reel member 73 through the above process, and not more than the total volume of the yarn T wound around the bobbin B in an uncompressed state.

[0194] Next, the controller 96 drives the robot motor MR to operate the third operating wire (S63) in order to rotate the first loop shaft 46 and the second loop shaft 56. As shown in Fig. 56, the first loop shaft 46 and the second loop shaft 56 rotate 180 degrees in the second rotation direction R2 from the third rotation position toward the first rotation position.

[0195] Next, the controller 96 drives the robot motor MR to operate the fourth operating wire to move the second jaw 3B from the close position to the distant position (S65). As shown in Fig. 56, the second jaw 3B moves from the close position to the distant position (arrow Y34). The ligated body S, which has been ligated with the thread T1, is removed from the jaw member 3.

[0196] Next, controller 96 drives robot motor MR to operate the fourth operating wire to move second jaw 3B from the distant position to the close position (S67). As shown in Fig. 56, second jaw 3B moves from the distant position to the close position (arrow Y35).

[0197] <Relocation process> After the ligation step in which the object S to be ligated is ligated with the thread T, a rearrangement step in which the ligation device 1 is returned to its initial state will be described.

[0198] As shown in Fig. 57, the controller 96 drives the second motor Mb1 to move the rearrangement gripping member 4B forward (S71). As shown in Fig. 58, the rearrangement gripping member 4B moves forward (arrow Y51). The rearrangement gripping member 4B is disposed over the extension portion 21A and second branch portion 21C of the first hole 21, as well as the first circular portion 761, the collection portion 71A, the second circular portion 762, and part of the region 780 of the cartridge 7 shown in Fig. 10. The front end of the rearrangement gripping member 4B reaches the vicinity of the jaw through-hole 33 of the first jaw 3A.

[0199] Next, the controller 96 drives the robot motor MR to operate the first operating wire in order to move the guide member 6 from the intermediate position to the protruding position (S73). During the process in which the guide member 6 moves in the first movement direction Y1, the yarn T captured by the capturing portion 64 enters the slit 63 and is clamped by the slit 63.

[0200] The guide member 6, while holding the thread T, further moves in the first movement direction Y1 toward the protruding position. As shown in FIG. 59, the downstream end 60F of the guide member 6 is inserted into the jaw through-hole 33 of the first jaw 3A and protrudes upward (arrow Y53). The guide member 6 lifts the thread T held by the slit 63 upward. At this time, the tip of the thread T enters the first notch 40 and the first partial notch 480 of the rearrangement gripping member 4B in the released state. The downstream end 60F of the guide member 6 faces the front of the rearrangement gripping member 4B.

[0201] Next, the controller 96 drives the second auxiliary motor Mb2 to rotate the second rod 44 of the rearrangement gripping member 4B to change from the released state to the full-holding state (S75). As shown in Fig. 59, the second rod 44 of the rearrangement gripping member 4B rotates relative to the first rod 43 (arrow Y54), and the rearrangement gripping member 4B enters the full-holding state. The tip of the yarn T is held immovably by the first rod 43 and the second rod 44 of the rearrangement gripping member 4B, which is now in the full-holding state.

[0202] Next, the controller 96 drives the robot motor MR to operate the first operating wire in order to move the guide member 6 from the protruding position to the intermediate position (S77). As shown in Fig. 60, the guide member 6 moves in the second movement direction Y2 to the intermediate position (arrow Y55). The yarn T leaves the slit 63 and is captured by the capturing portion 64.

[0203] Next, the controller 96 drives the second motor Mb1 to move the rearrangement gripping member 4B rearward (S79). As shown in FIG. 61, the rearrangement gripping member 4B moves rearward (arrow Y56). The front end of the rearrangement gripping member 4B is positioned rearward of the loop forming unit 2B. Note that the rearrangement gripping member 4B is in a full gripping state, and the yarn T is immovable relative to the first rod 43 and the second rod 44. Therefore, the yarn T is unwound from the bobbin B in response to the rearward movement of the rearrangement gripping member 4B.

[0204] Next, the controller 96 drives the robot motor MR to drive the loop former 2B and operate the third operating wire (S81). As shown in Fig. 62, the first loop shaft 46 and the second loop shaft 56 rotate 90 degrees in the first rotation direction R1 from the first rotation position to the second rotation position. As a result, the yarn T arranged along the second groove 460A moves to the fourth groove 460B and the fifth groove 460C, and the yarn T arranged along the third groove 560A moves to the sixth groove 560B and the seventh groove 560C.

[0205] Next, the controller 96 drives the second motor Mb1 to move the rearwardly repositioning gripping member 4B (S83). As shown in Fig. 63, the rearwardly repositioning gripping member 4B moves (arrow Y57). The front end of the rearrangement gripping member 4B reaches the second branch portion 21C of the first hole 21.

[0206] Next, the controller 96 drives the second motor Mb1 to move the rearrangement gripping member 4B forward (S85). The rearrangement gripping member 4B moves slightly forward (arrow Y58). The controller 96 also drives the robot motor MR to drive the loop forming unit 2B and manipulates the third operating wire (S87). As shown in FIG. 63, the first loop shaft 46 and the second loop shaft 56 rotate 270 degrees in the second rotation direction R2 from the second rotation position toward the third rotation position. As a result, as shown in FIG. 64, a first loop P1 is formed on the first loop shaft 46, and a second loop P2 is formed on the second loop shaft 56.

[0207] Next, the controller 96 drives the third motor Mc1 to move the pusher 5 forward (S89). The front end of the pusher 5 protrudes forward beyond the ligature grasping member 4A. Next, the controller 96 drives the first motor Ma1 and the third motor Mc1 to move the ligature grasping member 4A and the pusher 5 forward (S91). As shown in FIG. 64, the ligature grasping member 4A and the pusher 5 pass through the first loop P1 formed on the first loop shaft 46 of the loop forming section 2B and the second loop P2 formed on the second loop shaft 56.

[0208] The controller 96 also drives the third auxiliary motor Mc2 to alternately rotate the pusher 5 each time the front end of the pusher 5 passes through the suture T forming the first loop P1 and the second loop P2 (S93). As shown in FIG. 64, the pusher 5 alternately rotates 180 degrees to one side and the other side about the tenth axis C10 (arrow Y60). This allows the pusher 5 to move forward without getting caught on the first loop P1 and the second loop P2. After passing through the first loop P1 and the second loop P2, the front ends of the ligation gripping member 4A and the pusher 5 reach the vicinity of the front end of the main body 2A. This returns the ligation device 1 to its initial state.

[0209] <Actions and Effects of This Embodiment> In the ligation device 1, after the object S to be ligated is ligated in S45 and S47, the operation of cutting the suture T1 is performed in S57. In this case, the cut suture T11 remains inside the ligation device 1. Here, the ligation device 1 moves the remaining suture T11 downward from the movement trajectory U of the rearrangement gripping member 4B by rotating the reel member 73. In this case, the ligation device 1 can reduce the possibility that the remaining suture T11 will interfere with the movement of the rearrangement gripping member 4B when the next ligation is performed in the ligation device 1.

[0210] The reel member 73 has a first coil spring 73A and a second coil spring 73B. The wire 730 of each of the first coil spring 73A and the second coil spring 73B is inclined with respect to the up-down direction in which the second axis C2 extends. In this case, the ligation device 1 can move the thread T11 downward along the wire 730 by rotating the reel member 73, thereby separating the thread T11 from the movement trajectory U.

[0211] The winding thread cutter 77 is disposed between the holding area Sp, where the ligation target object S is located, and the reel member 73. The winding thread cutter 77 cuts the portion of the thread T1 that extends between the portion ligated to the ligation target object S and the first end ta gripped by the rearrangement gripping member 4B. This allows the ligation device 1 to wind the thread T11, which is on the side opposite the holding area Sp with respect to the reel member 73, onto the reel member 73 and separate it from the movement trajectory U. The winding thread cutter 77 is also disposed at a position that overlaps with the reel member 73 in the left-right direction. Therefore, the winding thread cutter 77 can cut the thread T1, which moves leftward during winding onto the reel member 73, with the blade 77A extending in the vertical direction. Therefore, the winding thread cutter 77 can cut the thread T1 simultaneously with winding the thread T1 onto the reel member 73.

[0212] The reel member 73 is provided in the cartridge 7. The cartridge 7 is attached to the attachment portion 28 of the jaw member 3. That is, the reel member 73 is provided inside the jaw member 3. In this case, the ligation device 1 can wind the suture T11 onto the reel member 73 using the jaw member 3, and move the suture T11 away from the movement trajectory U. The ligation device 1 can wind the suture T11 onto the reel member 73 at a position close to the holding region Sp where the object to be ligated S is held, thereby effectively reducing the possibility that the suture T11 remaining inside the device will interfere with the ligation operation.

[0213] The capacity of the first storage section 71B of the cartridge 7 is adjusted to be at least twice the total volume of the thread T11 wound around the reel member 73 in one ligating operation. Furthermore, the capacity of the first storage section 71B of the cartridge 7 is adjusted to be equal to or less than the total volume of the thread T wound around an unused bobbin B in an uncompressed state. In this case, the ligating device 1 can store, in the first storage section 71B, the thread T11 wound around the reel member 73 when the ligating operation is performed at least two times. Therefore, the ligating device 1 can reduce the frequency with which the user removes the thread T11 stored in the first storage section 71B from the device.

[0214] A groove 711 spirally spiraling about the second axis C2 and the sixth axis C6 is formed on the side surface 70B of the first accommodating portion 71B. The groove 711 enables the ligation device 1 to prevent the suture T accommodated in the first accommodating portion 71B from moving upward toward the movement trajectory U. Therefore, the ligation device 1 can maintain the state in which the suture T is accommodated in the first accommodating portion 71B.

[0215] A plurality of protrusions 710 that protrude toward the second axis C2 and the sixth axis C6 are formed on the side surface 70B of the first accommodating portion 71B. The protrusions 710 enable the ligation device 1 to prevent the suture T accommodated in the first accommodating portion 71B from moving upward toward the movement trajectory U. Therefore, the ligation device 1 can maintain the state in which the suture T is accommodated in the first accommodating portion 71B.

[0216] The reel member 73 is formed integrally with the cartridge 7. Therefore, a user of the ligation device 1 can retrieve the suture T11 wound around the reel member 73 by replacing the cartridge 7.

[0217] The cartridge 7 is provided with a bobbin B that stores the suture T. Therefore, a user of the ligation device 1 can replenish the suture T in the ligation device 1 by replacing the cartridge 7.

[0218] The gripping suture cutter 79 is provided on the cartridge 7 behind the jaw through-hole 33 and ahead of the reel member 73. Therefore, the gripping suture cutter 79 can cut the portion of the suture T unwound from the bobbin B between the portion held by the guide member 6 inserted into the jaw through-hole 33 and the reel member 73. Furthermore, when a user of the ligation device 1 replaces the cartridge 7 to replenish the suture T, the user can also replace the gripping suture cutter 79 at the same time.

[0219] The ligation device 1 rotates the reel member 73 by transmitting power to the cartridge 7 via the transmission mechanism 29. In this case, there is no need to provide a rotation drive source for the reel member 73 in the cartridge 7, so the cartridge 7 can be made smaller.

[0220] The transmission mechanism 29 rotates the pulley 27 by the rotation of the rotary belt 230. Therefore, the transmission mechanism 29 can efficiently transmit the power that rotates the reel member 73 to the reel member 73 via the pulley 27.

[0221] <Modification> The present invention is not limited to the above embodiment and various modifications are possible. Reel member 73 may have a structure other than a spring. Below, first reel member 731, second reel member 732, third reel member 733, fourth reel member 734, fifth reel member 735, sixth reel member 736, and seventh reel member 737, which are modifications of reel member 73, will be described.

[0222] The first reel member 731 shown in Figure 65 has a first extension portion 731A and a second extension portion 731B instead of a first coil spring 73A and a second coil spring 73B. The first extension portion 731A extends in a straight line obliquely upward to the right from near the center of the support plate 72A of the rotating body 72. The second extension portion 731B extends in a straight line obliquely upward to the left from near the center of the support plate 72A of the rotating body 72. The distance between the first extension portion 731A and the second extension portion 731B increases upward.

[0223] The second reel member 732 shown in FIG. 66 has a first extension portion 732A, a second extension portion 732B, a third extension portion 732C, and a fourth extension portion 732D instead of the first coil spring 73A and the second coil spring 73B. The first extension portion 732A extends in a straight line obliquely upward to the right from near the center of the support plate 72A of the rotating body 72. The second extension portion 732B extends in a straight line obliquely upward to the front from near the center of the support plate 72A of the rotating body 72. The third extension portion 732C extends in a straight line obliquely upward to the left from near the center of the support plate 72A of the rotating body 72. The fourth extension portion 732D extends in a straight line obliquely upward to the rear from near the center of the support plate 72A of the rotating body 72. The distance between the first extension portion 732A and the third extension portion 732C increases upward. The distance between the second extending portion 732B and the fourth extending portion 732D increases upward.

[0224] The third reel member 733 shown in FIG. 67 has a first extension portion 733A, a second extension portion 733B, and a third extension portion 733C instead of the first coil spring 73A and the second coil spring 73B. The first extension portion 733A extends in a straight line obliquely upward to the right from near the center of the support plate 72A of the rotating body 72. The second extension portion 733B extends in a straight line obliquely upward to the left from near the center of the support plate 72A of the rotating body 72. The distance between the first extension portion 733A and the second extension portion 733B increases upward. The third extension portion 733C spans between the upper ends of the first extension portion 733A and the second extension portion 733B.

[0225] The first reel member 731 shown in Fig. 65, the second reel member 732 shown in Fig. 66, and the third reel member 733 shown in Fig. 67 all have the same action of guiding the thread T11 downward and winding the thread T11 when the rotor 72 rotates. For example, in the case of the first reel member 731, when the rotor 72 rotates, the thread T11 that comes into contact with the first extending portion 731A and the second extending portion 731B is guided downward along the first extending portion 731A and the second extending portion 731B. As a result, the thread T11 moves from the collection portion 71A toward the first storing portion 71B in the storing recess 71 of the cartridge 7 and moves downward away from the movement trajectory U of the rearrangement gripping member 4B. Furthermore, after the thread T11 moves to the lower ends of the first and second stretching portions 731A and 731B, the thread T11 is wound around the lower ends of the first and second stretching portions 731A and 731B.

[0226] The fourth reel member 734 shown in FIG. 68 has a first extension portion 734A and a second extension portion 734B instead of the first coil spring 73A and the second coil spring 73B. The first extension portion 734A extends in a straight line obliquely upward to the right from a position forward and to the left of the center of the support plate 72A of the rotating body 72. The second extension portion 734B extends in a straight line obliquely upward to the left from a position rearward and to the right of the center of the support plate 72A of the rotating body 72. The first extension portion 734A and the second extension portion 734B are spaced apart in the front-to-rear direction. The distance between the first extension portion 734A and the second extension portion 734B increases upward.

[0227] The fifth reel member 735 shown in Figure 69 has a first extension portion 735A and a second extension portion 735B instead of the first coil spring 73A and the second coil spring 73B. The first extension portion 735A extends in a straight line obliquely upward to the right from a position to the left of the center of the support plate 72A of the rotating body 72. The second extension portion 735B extends in a straight line obliquely upward to the left from a position to the right of the center of the support plate 72A of the rotating body 72. The first extension portion 735A and the second extension portion 735B are connected at a position where they intersect with the second axis C2 and the sixth axis C6.

[0228] The fourth reel member 734 shown in Fig. 68 and the fifth reel member 735 shown in Fig. 69 have the same action of guiding the thread T11 downward and winding the thread T11 when the rotor 72 rotates. For example, in the case of the fourth reel member 734, when the rotor 72 rotates, the thread T11 that comes into contact with the first extension portion 734A and the second extension portion 734B is guided downward along the first extension portion 734A and the second extension portion 734B. As a result, the thread T11 moves toward the position where the first extension portion 734A and the second extension portion 734B intersect when viewed from the front (hereinafter referred to as the "intersection position"), and moves downward away from the movement trajectory U of the rearrangement gripping member 4B. Furthermore, after the thread T11 moves to the intersection position of the first extension portion 734A and the second extension portion 734B, the thread T11 is wound around the intersection position of the first extension portion 734A and the second extension portion 734B.

[0229] The sixth reel member 736 shown in Figure 70 is a truncated cone-shaped member provided on the upper surface of the support plate 72A of the rotor 72. The diameter of the sixth reel member 736 gradually decreases downward. The sixth reel member 736 has a slit 736H penetrating in the front-rear direction. The ligation grasping member 4A, the rearrangement grasping member 4B, and the pusher 5 pass through the slit 736H.

[0230] When the rotating body 72 rotates, the thread T11 that comes into contact with the side surface of the sixth reel member 736 is guided downward along the side surface. As a result, the thread T11 moves from the collection section 71A toward the first storage section 71B of the storage recess 71 of the cartridge 7, and moves downward away from the movement trajectory U of the rearrangement gripping member 4B. After the thread T11 moves to the lower end of the sixth reel member 736, the thread T11 is wound around the lower end of the sixth reel member 736.

[0231] 71 is a columnar member provided on the upper surface of the support plate 72A of the rotating body 72. The seventh reel member 737 has a slit 737H penetrating therethrough in the front-rear direction. The ligation grasping member 4A, the rearrangement grasping member 4B, and the pusher 5 pass through the slit 737H.

[0232] When the rotating body 72 rotates, the thread T11 that comes into contact with the side surface of the seventh reel member 737 is wound around the seventh reel member 737. In this state, for example, the pusher 5 passes through the slit 737H. At this time, the front end 51 of the pusher 5 comes into contact with the thread T11 wound around the seventh reel member 737, moving the thread T11 downward. As a result, the thread T moves downward away from the movement trajectory U of the rearrangement gripping member 4B.

[0233] <Other variations> The jaw members 3 may hold the body to be ligated S by moving the first jaw 3A relative to the second jaw 3B.

[0234] The vertical spacing of the wires 730 of the reel member 73 does not have to be uniform. For example, the vertical spacing of the wires 730 of the reel member 73 may gradually increase or decrease downward. Furthermore, for example, the vertical spacing of the wires 730 of the portion of the reel member 73 that is disposed in the collection section 71A may be different from the vertical spacing of the wires 730 of the portion of the reel member 73 that is disposed in the first storage section 71B. More specifically, the vertical spacing of the wires 730 of the portion of the reel member 73 that is disposed in the first storage section 71B may be smaller than the vertical spacing of the wires 730 of the portion of the reel member 73 that is disposed in the collection section 71A.

[0235] The diameters of the first coil spring 73A and the second coil spring 73B of the reel member 73 do not have to be constant in the vertical direction. For example, the diameters of the first coil spring 73A and the second coil spring 73B may gradually decrease or increase downward.

[0236] The reel member 73 does not have to be provided in the cartridge 7, but may be provided directly in any part of the ligation device 1. In this case, the reel member 73 may be provided directly in the jaw member 3, or may be provided in front of the loop forming portion 2B in the main body 2A. In the ligation device 1, only the bobbin B may be replaceable, and the cartridge 7 may not be used.

[0237] The capacity of the first storage section 71B of the cartridge 7 may be equal to or greater than the total volume of the thread T wound around an unused bobbin B in a compressed state, and may be less than twice the total volume of the thread T11 wound around the reel member 73 in one ligating operation. In this case, for example, the ligation device 1 may reduce the volume by compressing the thread T11 stored in the first storage section 71B.

[0238] The inner diameter of the first accommodating portion 71B does not have to be uniform in the vertical direction. For example, the inner diameter of the first accommodating portion 71B may gradually increase downward.

[0239] The side surface 70B of the first accommodating section 71B may be provided with only a protrusion and may not be provided with a spiral groove. The side surface 70B of the first accommodating section 71B may also be flat. In this case, the side surface 70B of the first accommodating section 71B may be subjected to a surface treatment that increases the frictional force with the accommodated yarn T11.

[0240] The gripping suture cutter 79 does not have to be provided in the cartridge 7, but may be provided directly at any location on the ligation device 1. In this case, the ligation device 1 may cut the suture T by rotating a rotor that holds the gripping suture cutter 79.

[0241] The transmission mechanism 29 may have a configuration other than the rotary belt 230 and the pulley 27. For example, the transmission mechanism 29 may rotate the reel member 73 by rotating a pinion gear provided on the protrusion 72B of the cartridge 7 using a rack gear provided on the ligation device 1.

[0242] The cartridge 7 may have a drive mechanism for rotating the rotating body 72. In this case, the cartridge 7 may move the yarn T away from the movement locus U by rotating the reel member 73 using this drive mechanism.

[0243] <Other> The rearrangement gripping member 4B is an example of a "gripping member" in the present invention. The rearward direction is an example of a "first direction" in the present invention. The downward direction is an example of a "second direction" in the present invention. The second axis C2 and the sixth axis C6 are examples of a "rotation axis" in the present invention. The reel member 73 and the first storage section 71B are examples of a "separation unit" in the present invention. The wire 730 is an example of an "inclined section" in the present invention. The left-right direction is an example of a "third direction" in the present invention. The bobbin B is an example of a "second storage section" in the present invention. The jaw through-hole 33 is an example of a "through-hole" in the present invention. [Explanation of symbols]

[0244] 1: Ligation device 2A: Main unit 2B: Loop forming part 3: Jaw member 3A: 1st jaw 3B: 2nd jaw 4B: Relocation gripping member 7: Cartridge 27: Pulley 28: Mounting part 29: Transmission mechanism 33: Mandibular foramen 73: Reel parts 77: Winding thread cutter 77A:Blade 230: Rotating belt 710:Protrusion 711: Groove 730: Wire B: Bobbin P1: First loop P2: Second loop Y:Stretching direction

Claims

1. a jaw member having a first jaw and a second jaw that moves relative to the first jaw and holds a body to be ligated between the first jaw and the second jaw; a gripping member that moves in a first direction away from the jaw members while gripping a portion of the yarn passing through the first jaw and the second jaw; a separating unit that has at least a reel member that rotates about a rotation axis that intersects a movement locus passed by the gripping member when it moves and is parallel to a second direction that intersects with the first direction and winds up the line, and that separates the line from the movement locus; A ligation device comprising:

2. The reel member is a tilted portion that contacts the thread and is tilted with respect to the rotation axis; 2. The ligation device of claim 1.

3. The jaw member further includes a winding suture cutter configured to cut a portion of the suture extending between the portion ligated to the object and the portion gripped by the gripping member, The winding yarn cutter is the reel member is disposed between a holding region in which the object to be ligated held by the jaw members is located and the reel member, and at a position overlapping the reel member in a third direction intersecting the first direction and the second direction; a blade extending along the second direction; 2. The ligation device of claim 1.

4. 4. The ligating device according to claim 3, wherein said reel member is disposed inside said jaw member.

5. The separation unit is a first storage section that is disposed at a position separated from the movement locus of the gripping member in the second direction and that stores the line wound by the reel member; A portion of the reel member is accommodated in the first accommodation portion, The ligation device according to claim 1, characterized in that the volume of the first storage section is larger than the total volume of the thread wound onto the reel member when the ligation device performs a ligation operation of ligating the object to be ligated with the thread at least twice.

6. The ligation device according to claim 5, characterized in that a protrusion that protrudes in a direction intersecting the second direction is provided on a side surface of the first accommodating portion along the second direction at a position that overlaps with the reel member in the second direction.

7. 6. The ligation device according to claim 5, wherein a spiral groove revolving around an axis extending parallel to the second direction is provided on a side surface of the first accommodating portion along the second direction at a position that overlaps with the reel member in the second direction.

8. a cartridge detachably attached to the jaw member; 2. The ligating device according to claim 1, wherein the reel member is formed integrally with the cartridge.

9. a cartridge detachably attached to the jaw member; The cartridge comprises: a second accommodation portion that accommodates the yarn that is unwound toward the first jaw and the second jaw; 2. The ligation device of claim 1.

10. a guide member that holds the yarn unwound from the second storage section and moves toward a through hole provided in the first jaw to guide the yarn, The gripping member is the first jaw moves in the first direction inside the first jaw while gripping the thread guided by the guide member; The cartridge comprises:

10. The ligation device according to claim 9, further comprising a gripping suture cutter having a blade that protrudes toward the movement trajectory of the gripping member, the gripping suture cutter being located downstream of the through hole and upstream of the reel member in the first direction.

11. a cartridge in which the reel member is provided; a mounting portion provided on the jaw member to which the cartridge is attached and detached; Further provided with 2. The ligating device according to claim 1, wherein the mounting portion has a transmission mechanism that transmits power to rotate the reel member to the reel member.

12. The transmission mechanism includes:

12. The ligating device according to claim 11, further comprising a looped rotating belt attached to a pulley connected to the reel member.

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