Cutting instruments, forceps, end effectors, medical tools, medical systems, robots, surgical medical robots, grasping and cutting methods, and portable surgical instruments

Abstract

To provide a cutter, forceps, an end effector, a medical tool, a medical system, a robot, a surgical medical robot, a gripping / cutting method, and a portable surgical instrument which are capable of gripping a target part and cutting the target part without changing or replacing devices.SOLUTION: Forceps 1 are provided with a gripping mechanism 17 that has an upper jaw part 14 and a lower jaw part 116 assembled openably / closably and a wire 16a for the upper jaw rotating the upper jaw part 14 toward the lower jaw part 116; and a cutting mechanism 10 which has a cutting cutter 15 provided at the upper jaw part 14 and a wire 16b for the cutter rotating the cutting cutter 15 in the same direction as rotation of the upper jaw part 14. In the state that a biological tissue is gripped by the gripping mechanism 17, the cutting cutter 15 is rotated by the cutting mechanism 10 to cut the biological tissue by being bonded to the lower jaw part 116.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a cutting instrument that contacts a target site and cuts it, and in particular to forceps, end effectors, medical tools, medical systems, robots, surgical medical robots, grasping and cutting methods, and portable surgical instruments that are capable of grasping, incising, dissecting, coagulating (hemostasis), and cutting surgical operations. [Background technology]

[0002] The basic operation of the extraction surgery is the repetition of the operation of dissection, coagulation (hemostasis), and cutting. During this time, the operation of grasping the target area is also required. In surgery, it is desirable to perform each operation consecutively, and ideally, it would be possible to continue the operation without changing the device.

[0003] However, the Ligasure, which is famous for its high-frequency energy, has a two-stage structure in which a wide blade like a waterfowl's beak is used to grasp the biological tissue (target area), high-frequency energy is passed through it to coagulate it, and then the coagulated part with a cutting edge is cut with a scalpel or scissors-like tool, making it a two-stage operation. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2017-060846 A Summary of the Invention [Problem to be solved by the invention]

[0005] No instrument has been developed that can abut and cut tissue without changing or replacing the device, and so a multi-function device is needed to ensure smooth, continuous surgical procedures and to reduce the time required for instrument replacement, which is particularly important in laparoscopic and robotic surgeries where the surgeon's hands cannot reach. There is a demand for a device that can cut and grasp tissue while maintaining coagulation and hemostatic functions.

[0006] An object of the present invention is to provide a cutting instrument capable of grasping a target portion and cutting the target portion without changing or replacing the device, and further to provide a forceps, an end effector, a medical tool, a medical system, a robot, a surgical medical robot, a grasping and cutting method, and a portable surgical instrument capable of contacting and cutting tissue without changing or replacing the device. [Means for solving the problem]

[0007] The cutting device of the present invention for solving the above problems is provided with a gripping mechanism having a first gripping portion and a second gripping portion assembled to be able to be opened and closed, and a gripping portion rotation means for rotating the first gripping portion toward the second gripping portion, and a cutting mechanism having a cutting portion attached to the first gripping portion and a cutting portion rotation means for rotating the cutting portion in the same direction as the rotation of the first gripping portion, and is characterized in that when a target portion is gripped by the gripping mechanism, the cutting mechanism rotates the cutting portion and joins it to the second gripping portion, thereby cutting the target portion.

[0008] The medical tool of the present invention for solving the above problems comprises an end effector having a gripping mechanism and a cutting mechanism, and a drive unit for driving the end effector, wherein the gripping mechanism has a first gripping portion and a second gripping portion assembled so as to be able to be opened and closed, and a gripping portion rotation means for rotating the first gripping portion toward the second gripping portion, the cutting mechanism has a cutting portion provided adjacent to the first gripping portion, and a cutting portion rotation means for rotating the cutting portion in the same direction as the rotation of the first gripping portion, and the drive unit selectively provides at least one of a drilling function, a gripping function, a coagulation function, a cutting function, and an opening and exhausting function by driving the first gripping portion, the second gripping portion, and the cutting portion in combination.

[0009] The medical system of the present invention for solving the above problem is characterized in that it comprises a gripping mechanism having a first gripping portion and a second gripping portion assembled to be able to be opened and closed, and a gripping portion rotation means for rotating the first gripping portion toward the second gripping portion, a cutting mechanism having a cutting portion attached to the first gripping portion and a cutting portion rotation means for rotating the cutting portion in the same direction as the rotation of the first gripping portion, a rotation axis for rotatably supporting the first gripping portion and the cutting portion is provided for the second gripping portion, a drive unit for independently driving the gripping portion rotation means and the cutting portion rotation means, and a medical robot configured to coagulate and cut the target portion while gripping the target portion by applying a drive signal to the drive unit.

[0010] The cutting device, robot, or portable surgical instrument of the present invention for solving the above-mentioned problems is provided with a cutting mechanism having a first gripping section and a second gripping section assembled so as to be openable and closable, and a gripping section rotation means for rotating the first gripping section towards the second gripping section, a cutting section provided alongside the first gripping section, and a cutting section rotation means for rotating the cutting section in the same direction as the rotation of the first gripping section, and a rotation shaft for rotatably supporting the first gripping section and the cutting section with respect to the second gripping section is provided, and the gripping section rotation means moves a portion of the first gripping section supported by the rotation shaft at a predetermined distance from the rotation shaft. The cutting unit moving means is composed of a gripping unit moving means which moves a portion of the cutting unit supported by the pivot shaft at a predetermined distance from the pivot shaft, and the gripping unit moving means and the cutting unit moving means are composed of elongated members and moved along the longitudinal direction of the elongated member, and in a state in which the first gripping unit is rotated by the longitudinal movement of the gripping unit moving means to grip the target portion with the gripping mechanism, the gripping unit moving means rotates the cutting unit by moving in the longitudinal direction and joins it to the second gripping unit to cut the target portion.

[0011] According to the above-mentioned configuration, the first gripping unit and the cutting unit are moved by the gripping unit moving means and the cutting unit moving means, respectively, so that the target site can be gripped by the gripping mechanism and the target site can be cut by the cutting mechanism. The long member may be a flexible long member having flexibility.

[0012] In addition, the gripping portion moving means made of the flexible long member may include a first gripping portion moving means connected to one of two predetermined locations on the first gripping portion that are spaced a predetermined distance from the pivot axis and moving the first gripping portion in the pulling direction in the longitudinal direction, and a second gripping portion moving means connected to the other predetermined location and moving the first gripping portion in the pulling direction in the longitudinal direction, and the cutting portion moving means made of the flexible long member may include a first gripping portion moving means connected to one of two predetermined locations on the cutting portion that are spaced a predetermined distance from the pivot axis and moving the first gripping portion in the pulling direction in the longitudinal direction, and a second gripping portion moving means connected to the other predetermined location and moving the first gripping portion in the pulling direction in the longitudinal direction.

[0013] According to this configuration, the first gripping section moving means and the first gripping section moving means can rotate the first gripping section and the cutting section in the pulling direction relative to the second gripping section by moving a predetermined location in the pulling direction in the longitudinal direction, and the second gripping section moving means and the second gripping section moving means can rotate in the pulling direction by moving a predetermined location in the pulling direction in the longitudinal direction. Therefore, for example, when the first gripping section (cutting section) is rotated in the gripping direction (cutting direction) relative to the second gripping section by moving the first gripping section moving means (the first cutting section moving means) in the pulling direction, the first gripping section (cutting section) can be opened by moving the second gripping section moving means (the second cutting section moving means) in the pulling direction. In other words, the rotation of the first gripping section (cutting section) in the gripping direction (cutting direction) and the rotation in the opening direction relative to the second gripping section can be operated by moving the moving means.

[0014] In addition, the gripping portion moving means and the cutting portion moving means, which are made of the flexible long member, may be provided with a gripping biasing portion that moves a predetermined location in a pulling direction in the longitudinal direction and biases the first gripping portion in a direction in which the predetermined location moves in a pushing direction in the longitudinal direction, and a cutting biasing portion that biases the second cutting portion in a direction in which the predetermined location moves in the pushing direction. The gripping unit moving means and the cutting unit moving means may move predetermined locations in a pushing direction and a pulling direction in the longitudinal direction.

[0015] According to this configuration, by moving the first gripping portion with the gripping portion moving means, the first gripping portion rotates relative to the second gripping portion to grip the target portion, and by moving the cutting portion with the cutting portion moving means, the cutting portion rotates relative to the second gripping portion to cut the target portion.

[0016] Also, The long member is a rod-shaped slide plate that slides in the longitudinal direction relative to a reference frame to rotate the first gripping part or the cutting part, and the slide plate slides in the longitudinal direction relative to the reference frame on which the first gripping part or the cutting part rotates, The first gripping portion relative to the second gripping portion or A notification unit that notifies the outside of at least one of the rotations of the cutting unit may be provided, and a notification amount adjustment means that adjusts the amount of notification from the notification unit may be provided. The notification unit may be, for example, a notification by a sound such as a click sound, a notification by a sensation such as a click feeling, or a notification as an electrical or electric signal such as ON / OFF of electricity. Therefore, the notification amount adjustment means is a means for adjusting the loudness of the click sound, the loudness of the click feeling, the amount of electricity, etc. According to this configuration, at least one of the rotation of the first gripping part relative to the second gripping part and the rotation of the cutting part can be notified to the outside.

[0017] Electrodes for irradiating electromagnetic waves may be provided at least one of a gripping portion for gripping the target portion in the first gripping portion and a vicinity of the cutting blade in the cutting portion, and a gripping portion for gripping the target portion in the second gripping portion, the electrodes being coaxial electrodes having a center electrode and an outer electrode surrounding the center electrode via an insulator, and a coaxial cable connecting an irradiation device for irradiating the electromagnetic waves to the electrodes may be branched into a plurality of parallel branches, and each of the coaxial electrodes may be electrically connected to a center conductor and an outer conductor of the coaxial cable. Furthermore, the coaxial electrodes may be connected in reverse polarity to the coaxial cable.

[0018] The medical system of the present invention for solving the above-mentioned problem may include the above-mentioned cutting device, a drive unit that independently drives the gripper moving means and the cutting unit moving means, and a medical robot connected to apply a drive signal to the drive unit.

[0019] The robot of the present invention for solving the above-mentioned problems comprises an input / output unit connected to the above-mentioned cutting device via a wired and / or wireless connection, an input unit for receiving operation signals in real time, an arithmetic unit for executing a predetermined operation program based on the operation signals, and an output unit for generating a gripping drive signal for gripping the target part with the first gripping part and the second gripping part by moving the gripping part moving means in the longitudinal direction, and / or a cutting drive signal for cutting the target part with the cutting part by moving the cutting part moving means in the longitudinal direction, based on the output from the arithmetic unit.Furthermore, in the surgical medical robot of the present invention for solving the above-mentioned problems, in addition to the robot, the output unit may provide a drive signal to an external drive unit that mechanically drives the cutting device.

[0020] In order to solve the above problem, the end effector of the present invention may include the above-mentioned cutting device, an attachment portion for attaching at least the second gripping portion of the cutting device to the tip of a robot arm, the gripping portion side connection portion for connecting to a drive mechanism for driving the gripping portion moving means on the robot arm side, and a cutting portion side connection portion for connecting to a drive mechanism for driving the cutting portion moving means on the robot arm side.

[0021] The forceps of the present invention for solving the above problem includes the above-mentioned cutter, the target site is biological tissue, and includes a gripping operation unit that drives and operates the cutting unit moving means and a cutting operation unit that drives and operates the cutting unit moving means, the gripping operation unit is operated to grip the biological tissue with a first gripping unit and a second gripping unit, and the cutting operation unit is operated to cut the biological tissue with the cutting unit. Alternatively, the forceps may include the above-mentioned cutter, the target site is biological tissue, and includes a gripping operation unit that drives and operates the gripping unit moving means and a cutting operation unit that drives and operates the cutting unit moving means, the gripping operation unit is operated to grip the biological tissue with the first gripping unit and the second gripping unit, electromagnetic waves are irradiated from the electrodes to coagulate at least a part of the biological tissue, and the cutting operation unit is operated to cut the biological tissue with the cutting unit.

[0022] The gripping and cutting method of the present invention for solving the above-mentioned problems comprises the steps of using the above-mentioned cutting device, operating the gripping part moving means to rotate the first gripping part toward the second gripping part and gripping the target part with the first gripping part and the second gripping part, and operating the cutting part moving means to move the cutting part attached to the first gripping part along the first gripping part and join it with the second gripping part, thereby cutting the gripped target part. Alternatively, the method may use the above-mentioned cutting device, and the target portion is biological tissue, and include the steps of: operating the gripping portion moving means to rotate the first gripping portion toward the second gripping portion and gripping the target portion with the first gripping portion and the second gripping portion; irradiating electromagnetic waves from the electrode to coagulate at least a portion of the biological tissue; and operating the cutting portion moving means to move the cutting portion attached to the first gripping portion along the first gripping portion and join it with the second gripping portion, thereby cutting the gripped and coagulated target portion. Effect of the Invention

[0023] According to the present invention, it is possible to provide a cutting instrument, forceps, end effector, medical tool, medical system, robot, surgical medical robot, grasping and cutting method, and portable surgical instrument that can grasp a target part and cut the target part without changing or replacing the device. [Brief description of the drawings]

[0024] [Figure 1] FIG. 2 is a front view of the forceps in the open state according to the first embodiment. [Diagram 2] 2(a) is a rear view of the forceps in an open state according to the first embodiment, FIG. 2(b) is a plan view of the forceps, and FIG. 2(c) is a bottom view of the forceps in FIG. [Diagram 3] Schematic diagram of the forceps in Fig. 1. Fig. 3(a) is a side cross-sectional view taken along the line AA in Fig. 1(a), Fig. 3(b) is a partial longitudinal cross-sectional view of the forceps, and Fig. 3(c) is an enlarged view of the electrode part taken along the line BB in Fig. 3(b). [Figure 4]FIG. 4(a) is a front view of the forceps in the gripping state with the gripping mechanism closed, and FIG. 4(b) is a rear view of the forceps in the same state. [Diagram 5] An explanatory diagram of the cutting state of the forceps in Figure 1. Figure 5(a) is a front view of the forceps in a cutting state with the cutting cutter of the cutting mechanism closed, and Figure 5(b) is a rear view of the forceps in the same state. [Figure 6] Fig. 6(a) is a cross-sectional view taken along the line AA in Fig. 1 before gripping by the gripping mechanism, Fig. 6(b) is a cross-sectional view taken along the line CC in Fig. 4(b) after the target part has been gripped by the gripping mechanism, Fig. 6(c) is a cross-sectional view taken along the line DD in Fig. 5(b) after the target part has been cut by the cutting cutter, and Fig. 6(d) is a schematic right side view of the cutting mechanism of another embodiment in a gripping state. [Figure 7] FIG. 13 is a front view of the forceps in the open state according to the second embodiment. [Figure 8] FIG. 13 is a bottom view of the forceps in the open state of the second embodiment. [Figure 9] 9(a) is a front view of the forceps in the gripping state with the gripping mechanism closed, and FIG. 9(b) is a rear view of the forceps in the same state. [Figure 10] 10 is an explanatory diagram of the cutting state of the forceps in Fig. 7. Fig. 10(a) is a front view of the cutting state in which the cutting cutter of the cutting mechanism in the forceps is closed, and Fig. 10(b) is a rear view of the forceps in the same state. [Figure 11] 11(a) is a front view of the forceps of the third embodiment in an open state, and FIG 11(b) is a plan view of the forceps. [Figure 12] FIG. 13 is a rear view of the forceps in the open state according to the third embodiment. [Figure 13] Fig. 13 is an explanatory diagram of the forceps in Fig. 11. Fig. 13(a) is a front view of the forceps in a gripping state with a gripping mechanism closed, and Fig. 13(b) is a front view of the forceps in a cutting state with a cutting cutter of a cutting mechanism closed. [Figure 14] 14(a) is a rear view of the forceps in an open state having a cutting mechanism according to a fourth embodiment, FIG. 14(b) is a partial longitudinal sectional view of the forceps, and FIG. 14(c) is a side sectional view taken along the line EE in FIG. [Figure 15]15(a) and 15(b) are explanatory views of forceps in an open state having a cutting mechanism according to a fifth embodiment, in which Fig. 15(a) is a rear view of the forceps and Fig. 15(b) is a partial longitudinal sectional view of the forceps. [Figure 16] FIG. 13 is a schematic front view of an end effector according to a sixth embodiment. [Figure 17] Fig. 17 is a schematic explanatory diagram of the end effector in Fig. 16. Fig. 17(a) is a side cross-sectional view taken along the line FF in Fig. 16, Fig. 17(b) is a partial vertical cross-sectional view of the end effector, Fig. 17(c) is an enlarged plan view taken along the line GG in Fig. 16, and Fig. 17(c) is an enlarged view of Fig. 17(b). [Figure 18] 18A is a schematic front view of the end effector in a normal state, FIG. 18B is a schematic front view of the end effector in a gripping state, and FIG. 18C is a schematic front view of the end effector in a cutting state according to a sixth embodiment. [Figure 19] Fig. 19 is a schematic explanatory diagram of an end effector which is a modification of the end effector of Fig. 17. Fig. 19(a) is a side sectional view taken along the line FF in Fig. 16, Fig. 19(b) is a partial vertical sectional view of the end effector, and Fig. 19(c) is an enlarged plan view taken along the line GG in Fig. 16. [Figure 20] FIG. 11 is a schematic diagram of a medical device according to another embodiment. [Figure 21] 13 is a schematic diagram of a telesurgery system according to another embodiment. [Figure 22] FIG. 1 is a schematic diagram illustrating a surgical device in a remote surgical system. [Figure 23] FIG. 1 is an explanatory diagram of a remote surgery system. [Figure 24] 13 is a schematic diagram of a forceps according to another embodiment. [Diagram 25] FIG. 13 is a schematic diagram showing the functional configuration of forceps according to another embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0025] The following embodiment describes the cutting device of the present invention as an example of a medical device, and the embodiment will be described below as a pair of forceps. However, the present invention provides a cutting device that is not limited to medical devices.

[0026] For example, FIG. 1 shows a front view of forceps 1 of a first embodiment in an open state. Fig. 2 shows an explanatory diagram of the forceps 1 in an open state of the first embodiment. In detail, Fig. 2(a) shows a rear view of the forceps 1, Fig. 2(b) shows a plan view of the forceps 1, and Fig. 2(c) shows a bottom view of the forceps 1 in Fig. 2(b).

[0027] Fig. 3 shows a schematic diagram of the forceps 1 in Fig. 1. In detail, Fig. 3(a) shows a side cross-sectional view taken along the line AA in Fig. 1(a), Fig. 3(b) shows a partial vertical cross-sectional view of the forceps 1, and Fig. 3(c) shows an enlarged view of the electrode portion taken along the line BB in Fig. 3(b).

[0028] Fig. 4 shows an explanatory diagram of the gripping state of the forceps 1 in Fig. 1. In detail, Fig. 4(a) shows a front view of the forceps 1 in the gripping state with the gripping mechanism 17 closed, and Fig. 4(b) shows a rear view of the forceps 1 in the same state.

[0029] Fig. 5 shows an explanatory diagram of the cutting state of the forceps 1 in Fig. 1. In detail, Fig. 5(a) shows a front view of the forceps 1 in a cutting state with the cutting cutter 15 of the cutting mechanism 10 in a closed state, and Fig. 5(b) shows a rear view of the forceps 1 in the same state.

[0030] Fig. 6 shows explanatory views of the gripping state of the gripping mechanism 17 of the forceps 1 and the cutting state of the cutting mechanism 10. In detail, Fig. 6(a) shows a side cross-sectional view taken along the line AA in Fig. 1 before gripping by the gripping mechanism 17, and Fig. 6(b) shows a side cross-sectional view taken along the line CC in Fig. 4(b) in a state in which the target site is gripped by the gripping mechanism 17. Fig. 6(c) shows a side cross-sectional view taken along the line DD in Fig. 5(b) in a state in which the target site has been cut by the cutting cutter 15, and Fig. 6(d) shows a right schematic side view of the cutting mechanism 10 in a state in which it is gripped by the gripping mechanism 17 of another embodiment.

[0031] 1 to 6, the forceps 1 includes a main body frame 11, a pinion gear 12, a trigger handle 13 (13a, 13b), an upper jaw portion 14, a cutting cutter 15, and an opening / closing wire 16. As shown in FIG. The direction along the longitudinal direction of the main body frame 11 of the forceps 1 is defined as the longitudinal direction L, the side of the main body frame 11 on which the upper jaw portion 14 and the cutting cutter 15 are arranged is defined as the tip side F, and the side on which the trigger handle 13 is arranged is defined as the base side R.

[0032] The main body frame 11 is roughly composed of two sides intersecting at an obtuse angle, one of which is a fixed handle frame 111 that functions as an operating section together with the trigger handle 13, and the other is a reference frame 112. The main body frame 11 thus configured is made of metal such as stainless steel.

[0033] The end of the fixed handle frame 111 is provided with a ring portion 113 into which the finger of the user who operates the forceps 1 is inserted. Further, a support shaft 114 for supporting a trigger handle 13 (described later) is provided near the base of the reference frame 112, and a gear support portion 115 for supporting a pinion gear 12 (described later) is provided above the support shaft 114.

[0034] Furthermore, a lower jaw 116 is provided at the end of the tip side F of the reference frame 112 to constitute a gripping mechanism 17 that cooperates with the gripping trigger handle 13a of the trigger handle 13 to grip a target site such as a blood vessel B (see FIG. 6) to be treated. The lower jaw 116 is configured to have a tapered shape toward the tip side F when viewed from the front. The lower jaw 116 is also called a jaw. Further, a tip support portion 117 that axially supports the upper jaw portion 14 and the cutting cutter 15 is provided on the base end side R of the lower jaw portion 116 of the reference frame 112 .

[0035] The pinion gear 12, which functions as a gripping unit rotating (moving) means and a cutting unit rotating (moving) means in cooperation with the opening and closing wire 16 described later, is journaled on the above-mentioned gear support part 115 and converts the operation of the trigger handle 13 into the movement of the opening and closing wire 16. Specifically, there is an upper jaw gear 12a that converts the operation of the gripping trigger handle 13a into the movement of the upper jaw wire 16a, and a cutter gear 12b that converts the operation of the cutting trigger handle 13b into the movement of the cutter wire 16b, with the upper jaw gear 12a being disposed on the front side and the cutter gear 12b being disposed on the back side.

[0036] The upper jaw gear 12a and the cutter gear 12b have the same configuration, and the outer peripheral surface of the grasping trigger handle 13a has gear teeth 121 that mesh with the rack gear 134 of the trigger handle 13 described later, and is provided with a wire attachment portion 122 to which the base end of the opening / closing wire 16 described later is attached.

[0037] 1, there is a near-side mounting part 152a disposed at the axial center 115a of the gear support part 115 and to which the tip of the near-side wire 161 is attached, and an open-side mounting part 152b disposed above the axial center 115a and to which the tip of the open-side wire 162 is attached. The wire mounting part 122 is disposed at a predetermined distance in the radial direction from the axial center 115a of the gear support part 115.

[0038] 2, there is a proximal side mounting part 152a disposed at the axial center 115a of the gear support part 115 to which a tip of a proximal side wire 161 of the wire for cutter 16b is attached, and an open side mounting part 152b disposed above the axial center 115a to which a tip of an open side wire 162 of the wire for cutter 16b is attached. The wire mounting part 152 is disposed at a predetermined distance in the radial direction from the axial center 115a of the gear support part 115.

[0039] The trigger handle 13 is an operating part for operating the opening and closing wire 16 described later to rotate the upper jaw portion 14 and the cutting cutter 15, and includes a grasping trigger handle 13a for rotating the upper jaw portion 14 and a cutting trigger handle 13b for rotating the cutting cutter 15.

[0040] The trigger handle 13 has a ring portion 132 into which the user's finger is inserted at the lower end of a handle body 131 extending downward, and a pivot portion 133 near the upper end of the handle body 131 that is pivotally supported on the support shaft 114 of the main body frame 11. Further, a rack gear 134 arranged in the shape of an upwardly protruding circular hole is formed at the upper end of the handle body 131. The rack gear 134 is configured to mesh with the gear teeth 121 of the pinion gear 12.

[0041] The grasping trigger handle 13a and the cutting trigger handle 13b have the same configuration as described above, with the only difference being the length of the handle body 131. Specifically, the handle body 131a of the grasping trigger handle 13a is formed longer than the handle body 131b of the cutting trigger handle 13b so that the finger ring portion 132 of the cutting trigger handle 13b is positioned above the finger ring portion 132 of the grasping trigger handle 13a.

[0042] The upper jaw portion 14 has a base end side R pivotally supported by a tip support portion 117 of the main body frame 11, and constitutes a gripping mechanism 17 together with a lower jaw portion 116 of the main body frame 11. The upper jaw portion 14 is also called a jaw. A shaft receiving portion 141 that is axially supported by the tip support portion 117 of the main body frame 11 is provided at the base end portion (left side in FIG. 1) of the upper jaw portion 14.

[0043] The axially-receiving portion 141 is provided with a wire attachment portion 142 to which the tip of the opening / closing wire 16 described later is attached. Specifically, there is a proximal-side attachment portion 142a disposed below the axially-receiving portion 141 to which the tip of the proximal-side wire 161 of the upper jaw wire 16a is attached, and an open-side attachment portion 142b disposed above the axially-receiving portion 141 to which the tip of the open-side wire 162 of the upper jaw wire 16a is attached. The wire attachment portion 142 is disposed at a predetermined distance in the radial direction from the axial center 117a of the tip support portion 117 pivotally supported by the axially-receiving portion 141.

[0044] As shown in FIGS. 1 and 2, the cutting cutter 15 is disposed on the rear side of the upper jaw portion 14 and includes a shaft receiving portion 151 that is axially supported by the tip support portion 117 of the main body frame 11. As shown in FIG.

[0045] The shank 151 is provided with a wire attachment portion 152 to which a tip of an opening / closing wire 16, which will be described later, is attached. Specifically, there is a proximal side attachment portion 152a disposed below the shank 151 to which a tip of a proximal side wire 161 of the cutter wire 16b is attached, and an open side attachment portion 152b disposed above the shank 151 to which a tip of an open side wire 162 of the cutter wire 16b is attached. The wire attachment portion 152 is disposed at a predetermined distance in the radial direction from the shaft center 117a of the tip support portion 117, which is journaled by the shank 151.

[0046] The cutter 15 thus configured has a cutting blade 153 formed along the lower end. The cutter 15 is plate-shaped and configured to rotate along the side surface of the upper jaw 14 with the shaft receiving portion 151 as an axis.

[0047] The opening / closing wire 16, which functions as a gripping part rotating (moving) means and a cutting part rotating (moving) means in cooperation with the above-mentioned pinion gear 12, is linear and has a certain strength to which a pulling force can act, and is flexible, and includes an upper jaw wire 16a that rotates the upper jaw part 14, and a cutter wire 16b that rotates the cutter 15. As shown in Fig. 2(b), the upper jaw wire 16a that rotates the upper jaw part 14 is disposed on the front side, and the cutter wire 16b that rotates the cutter 15 is disposed on the back side. The opening / closing wire 16 does not have to be linear, but may be in the form of a plate or a strip, so long as it has a certain strength that allows a pulling force to act on it and is flexible.

[0048] The opening / closing wires 16 (16a, 16b) each include a proximal side wire 161 which rotates in a proximal direction to grip or cut the upper jaw 14 or the cutter 15, and an opening side wire 162 which rotates in an opening direction. That is, the opening / closing wires 16 include the proximal side wire 161 and the opening side wire 162 as the upper jaw wire 16a, and the proximal side wire 161 and the opening side wire 162 as the cutter wire 16b, for a total of four opening / closing wires. The opening / closing wires 16 are hung between the upper jaw 14 or the cutter 15 and the pinion gear 12 under tension.

[0049] Specifically, the proximal side wire 161 of the upper jaw wire 16a is arranged between the wire attachment portion 122a of the pinion gear 12 and the proximal side attachment portion 142a of the upper jaw portion 14 so as to be inclined downward toward the tip side F, and the open side wire 162 of the upper jaw wire 16a is arranged between the wire attachment portion 122b of the pinion gear 12 and the open side attachment portion 142b of the upper jaw portion 14 so as to be inclined upward toward the tip side F. Therefore, when viewed from the front side, the proximal side wire 161 and the open side wire 162 of the upper jaw wire 16a intersect near the center of the longitudinal direction L of the reference frame 112.

[0050] In addition, the proximal side wire 161 of the cutter wire 16b is also wired between the wire attachment portion 122a of the pinion gear 12 and the proximal side attachment portion 152a of the cutting cutter 15 so as to incline downward toward the tip side F, and the open side wire 162 of the cutter wire 16b is also wired between the wire attachment portion 122b of the pinion gear 12 and the open side attachment portion 152b of the cutting cutter 15 so as to incline upward toward the tip side F. Therefore, when viewed from the front side, the proximal side wire 161 and the open side wire 162 of the cutter wire 16b intersect near the center of the reference frame 112 in the longitudinal direction L.

[0051] In the forceps 1 configured in this manner, a lower jaw 116 provided at the end of the tip side F of the main body frame 11 and an upper jaw 14 whose base is pivotally supported on the main body frame 11 by a tip support portion 117 constitute a gripping mechanism 17 for gripping the target area. Further, the cutter 15 which rotates along the side surface of the upper jaw portion 14 to cut the target site gripped by the gripping mechanism 17 constitutes the cutting mechanism 10 together with the lower jaw portion 116 .

[0052] The forceps 1 is provided with irradiation electrodes 24 (24a, 24b, 24c), and a coaxial cable 40 that connects the irradiation electrodes 24 to a microwave generator 30 that oscillates microwaves is connected thereto. Specifically, the upper jaw 14 is provided with an irradiation electrode 24a, the lower jaw 116 is provided with an irradiation electrode 24b, and the inside of the cutter 15 is provided with an irradiation electrode 24c, and they are connected to a coaxial cable 40. Although not shown, the irradiation electrodes 24 (24a, 24b, 24c) arranged on the upper jaw 14, the cutter 15, and the lower jaw 116 have an insulating layer arranged on the outside, and are insulated from the upper jaw 14, the cutter 15, and the lower jaw 116.

[0053] As shown in the enlarged cross-sectional view of Figure 3(b), the coaxial cable 40 is composed of a central conductor 41, an insulator 42, an outer conductor 43, and an insulating coating 44 sandwiched between the central conductor 41, and is arranged in this order from the center toward the radially outer side. Central conductor 41 is a linear conductor disposed at the center of coaxial cable 40, and may be a single conductor of an appropriate diameter, or may be composed of multiple core wires.

[0054] The insulator 42 is made of resin, surrounds the outside of the central conductor 41, and insulates the central conductors 41 and 43 from each other, and is cylindrical with a predetermined thickness. The outer conductor 43 is made of a braided wire provided along the outer peripheral surface of the insulator 42 .

[0055] The insulating coating 44 is an insulating coating that surrounds the outside of the outer conductor 43 . Thus, the coaxial cable 40 in which the central conductor 41, the insulator 42, the outer conductor 43 and the insulating coating 44 are arranged in this order from the center side has appropriate flexibility.

[0056] As shown in Fig. 3, the irradiation electrodes 24a and 24c are connected to a central conductor 41 of a coaxial cable 40, and the irradiation electrode 24b is connected to an outer conductor 43, so that electromagnetic waves (microwaves) are irradiated from the irradiation electrodes 24a and 24c to the irradiation electrode 24b. The electrode structure may be a coaxial structure as shown in Fig. 17, and the connection polarity may be a same-polarity connection structure or a different-polarity connection structure.

[0057] One of the first electrode portions of the irradiation electrodes 24a, 24c of the upper jaw portion 14 and the cutter 15, and the second electrode portion of the irradiation electrode 24b provided on the lower jaw portion 116 is connected to the central conductor 41 of the coaxial cable 40, and the other is connected to the outer conductor 43. In this manner, the forceps 1 provided with the irradiation electrodes 24a, 24c can irradiate microwaves from one of the first electrode portions of the irradiation electrodes 24a, 24c and the second electrode portion of the irradiation electrode 24b to the other.

[0058] This allows for coagulation by irradiating microwaves to the target site grasped by the grasping mechanism 17 composed of the lower jaw 116 and the upper jaw 14. If necessary, the irradiating electrode 24c may be electrically connected to the irradiating electrode 24b, and microwaves may be irradiated between the upper jaw 14 and the cutting cutter 15 to coagulate the biological tissue.

[0059] The operation of the forceps 1 configured as above will be described below. A user inserts his or her fingers into the finger ring portion 113 of the main frame 11 and the finger ring portion 132 of the gripping trigger handle 13a, and rotates the gripping trigger handle 13a around the pivot portion 133 supported on the support shaft 114 in a direction that brings the gripping trigger handle 13a closer to the fixed handle frame 111 (in a direction in which the lower part of the gripping trigger handle 13a moves to the left in Figure 1).

[0060] 1. When the gripping trigger handle 13a rotates about the pivot 133 in a direction approaching the fixed handle frame 111, the upper jaw gear 12a, whose gear teeth 121 mesh with a rack gear 134 protruding upward from the pivot 133, rotates counterclockwise in Fig. 1. When the upper jaw gear 12a rotates counterclockwise, the proximal side wire 161 of the upper jaw wire 16a, whose proximal end is attached to the wire attachment part 122a, is pulled toward the proximal side R and moves.

[0061] When the proximal side wire 161 of the upper jaw wire 16a moves toward the base end side R, the tip of the proximal side wire 161 is fixed to the proximal side mounting portion 142a, and the upper jaw 14 supported by the tip support portion 117 pivots with the axis center 117a as the rotation center in the direction in which the tip side F approaches the lower jaw 116 (see Figure 4). At this time, the cutting cutter 15 does not rotate and remains in the initial position as shown in FIG.

[0062] As a result, in the initial state (open state) as shown in Figure 6(a), blood vessel B, which is the target site in the biological tissue, is placed between the upper jaw portion 14 and the lower jaw portion 116, and as shown in Figure 6(b), blood vessel B can be clamped between the upper surface of the lower jaw portion 116 and the bottom surface of the upper jaw portion 14, thereby allowing blood vessel B to be grasped by the grasping mechanism 17 formed by the lower jaw portion 116 and the upper jaw portion 14.

[0063] As described above, the state shown in Figures 4 and 6(b) in which the grasping trigger handle 13a is operated to bring the upper jaw portion 14 close to the lower jaw portion 116 is referred to as the grasping state in which the target area, such as blood vessel B, is grasped by the grasping mechanism 17. When the cutting trigger handle 13b is further operated from this gripping state in a direction approaching the fixed handle frame 111, the cutting trigger handle 13b rotates about the pivot part 133 in a direction approaching the fixed handle frame 111, rotating the cutter gear 12b, whose gear teeth 121 mesh with the rack gear 134 protruding upward from the pivot part 133, clockwise in Fig. 2. When the cutter gear 12b rotates clockwise, the proximal side wire 161 of the cutter wire 16b, whose proximal end is attached to the wire attachment part 122a, is pulled and moves toward the proximal end side R.

[0064] When the proximal side wire 161 of the cutter wire 16b moves toward the base end side R, the tip of the proximal side wire 161 is fixed to the proximal side mounting portion 152a, and the cutting cutter 15 axially supported by the tip support portion 117 pivots with the axis center 117a as the center of rotation, so that the tip side F pivots in a direction approaching the lower jaw portion 116, and the cutting blade 153 pivots over the upper surface of the lower jaw portion 116. 6(c), the cutter 15 moves along the side surface of the upper jaw portion 14, and the blood vessel B gripped by the gripping mechanism 17 can be cut by the cutting blade 153 of the cutter 15.

[0065] As described above, the state in which the cutter 15 is rotated by further operating the cutting trigger handle 13b so that the cutting blade 153 passes over the upper surface of the lower jaw 116 as shown in FIG. 5(b) is referred to as the cutting state.

[0066] As described above, the forceps 1 can grasp a target site such as a blood vessel B with the upper jaw portion 14 and the lower jaw portion 116 constituting the grasping mechanism 17, and cut the target site with the cutting cutter 15, by operating the grasping trigger handle 13a and the cutting trigger handle 13b. During the grasping and cutting of the target site by operating the grasping trigger handle 13a and the cutting trigger handle 13b, microwaves can be irradiated from the irradiation electrode 24 to the target site to cause coagulation.

[0067] When the cutting trigger handle 13b is operated in a direction away from the fixed handle frame 111 from the above-mentioned cut state, the cutting trigger handle 13b rotates about the pivot part 133 in a direction away from the fixed handle frame 111, rotating the cutter gear 12b, whose gear teeth 121 mesh with the rack gear 134 protruding upward from the pivot part 133, counterclockwise in Fig. 2. When the cutter gear 12b rotates counterclockwise, the open side wire 162 of the cutter wire 16b, whose base end is attached to the wire attachment part 122b, is pulled and moves toward the base end side R.

[0068] When the open side wire 162 of the cutter wire 16b moves toward the base end side R, the tip of the open side wire 162 is fixed to the open side mounting portion 152b, and the cutting cutter 15 supported by the tip support portion 117 pivots in the direction in which the tip side F moves away (opens) from the lower jaw portion 116, with the axis center 117a as the rotation center. This allows the cutting cutter 15 to return to the initial position shown in FIG.

[0069] Furthermore, when the grasping trigger handle 13a is operated in a direction away from the fixed handle frame 111 from the above-mentioned grasping state, the grasping trigger handle 13a rotates about the pivot part 133 in a direction away from the fixed handle frame 111, causing the upper jaw gear 12a, whose gear teeth 121 mesh with the rack gear 134 protruding upward from the pivot part 133, to rotate clockwise in Fig. 1. When the upper jaw gear 12a rotates clockwise, the open-side wire 162 of the upper jaw wire 16a, whose base end is attached to the wire attachment part 122b, is pulled and moves toward the base end side R.

[0070] When the open side wire 162 of the upper jaw wire 16a moves toward the base end side R, the tip of the open side wire 162 is fixed to the open side mounting portion 142b, and the upper jaw portion 14 supported by the tip support portion 117 pivots with the axis center 117a as the rotation center in the direction in which the tip side F moves away from the lower jaw portion 116. This allows the upper jaw 14 to return to the initial position shown in FIG.

[0071] As described above, the forceps 1 can grasp the target area with the grasping mechanism 17 and cut the target area with the cutting mechanism 10 by moving the upper jaw portion 14 and the cutting cutter 15 using the upper jaw wire 16a and the cutter wire 16b, respectively.

[0072] In addition, the upper jaw wire 16a, which is made of a flexible, long member, has a proximal side wire 161 that is connected to a proximal side mounting portion 142a that is spaced a predetermined distance from the center of the rotation axis in the upper jaw portion 14 and moves in the pulling direction in the longitudinal direction L, and an open side wire 162 that is connected to the open side mounting portion 142b and moves in the pulling direction in the longitudinal direction L.

[0073] The cutter wire 16b, which is made of a flexible, long member, is connected to a proximal side mounting portion 152a located a predetermined distance from the center of the rotation axis of the cutting cutter 15, and has a proximal side wire 161 that moves in the pulling direction in the longitudinal direction L, and an open side wire 162 that is connected to the open side mounting portion 152b and moves in the pulling direction in the longitudinal direction L.

[0074] Therefore, by moving a predetermined portion of the proximal side wire 161 in the pulling direction in the longitudinal direction L, the upper jaw 14 and the cutter 15 can be rotated in the pulling direction relative to the lower jaw 116, and by moving a predetermined portion of the opening side wire 162 in the pulling direction in the longitudinal direction L, the opening side wire 162 can be rotated in the pulling direction. Therefore, for example, when the upper jaw 14 (cutter 15) is rotated in the gripping direction (cutting direction) relative to the lower jaw 116 by moving the proximal side wire 161 in the pulling direction, the upper jaw 14 (cutter 15) can be opened by moving the opening side wire 162 in the pulling direction. In other words, the upper jaw 14 (cutter 15) can be rotated in the gripping direction (cutting direction) and the opening direction relative to the lower jaw 116 by moving the opening / closing wire 16.

[0075] Next, forceps 1X according to a second embodiment is shown in FIGS. FIG. 7 shows a front view of the forceps 1X of the second embodiment in an open state, and FIG. 8 shows a bottom view of the forceps 1X of the second embodiment in an open state.

[0076] Fig. 9 shows an explanatory diagram of the gripping state of the forceps 1X in Fig. 7. Specifically, Fig. 9(a) shows a front view of the forceps 1X in the gripping state with the gripping mechanism 17 closed, and Fig. 9(b) shows a rear view of the forceps 1X in the same state.

[0077] Fig. 10 shows an explanatory diagram of the cutting state of the forceps 1X in Fig. 7. Specifically, Fig. 10(a) shows a front view of the forceps 1X in a cutting state with the cutting cutter of the cutting mechanism 10 in the forceps 1X closed, and Fig. 10(b) shows a rear view of the forceps 1X in the same state. In the following description of the forceps 1X, the same components as those of the forceps 1 are given the same reference numerals and detailed description thereof will be omitted.

[0078] The forceps 1 of the above-mentioned embodiment 1 is configured such that the proximal side wire 161 and the opening side wire 162 of the opening / closing wire 16 are pulled toward the base end side R by operating the trigger handle 13 (13a, 13b), and the upper jaw portion 14 and the cutting cutter 15 are rotated so as to approach the lower jaw portion 116, thereby grasping or cutting, or are separated from the lower jaw portion 116 to open. In contrast, the forceps 1X of the embodiment 2 does not include the opening side wire 162, and the opening / closing wire 16 is made up of only the proximal side wire 161, and the trigger handle 13 (13a, 13b) is operated to pull the proximal side wire 161 of the opening / closing wire 16 toward the base end side R, and the upper jaw portion 14 and the cutting cutter 15 are rotated so as to approach the lower jaw portion 116. The upper jaw portion 14 and the cutting cutter 15 are rotated in the direction of separation by the biasing force of the spring 19 to open them.

[0079] Specifically, springs 19 (19a, 19b) are provided on the width direction and outside of upper jaw 14 and cutter 15. Spring 19 is made up of a coil portion 191 fitted onto the axis of tip support portion 117, a first arm 192 extending from one end of coil portion 191 and fixed to reference frame 112, and a second arm 193 fixed to upper jaw 14 or cutter 15.

[0080] The operation of the forceps 1X configured as described above will be described below. The action of bringing the upper jaw 14 and the cutting cutter 15 close to the lower jaw 116 for gripping or cutting is the same as that of the forceps 1. However, in order to operate the trigger handle 13 to bring the upper jaw 14 and the cutting cutter 15 close to the lower jaw 116 for gripping or cutting, the upper jaw 14 and the cutting cutter 15 must be rotated against the biasing force of the spring 19b.

[0081] To release the above-mentioned cutting state or gripping state, the gripping trigger handle 13a and the cutting trigger handle 13b can be automatically rotated in the open direction by the biasing force of the spring 19 by releasing the operating force of the gripping trigger handle 13a and the cutting trigger handle 13b, which have been operated in a direction approaching the fixed handle frame 111.

[0082] Specifically, by loosening the operating force on the side that brings the grasping trigger handle 13a closer to the fixed handle frame 111 against the biasing force of the spring 19a, the upper jaw 14 in the grasping state is rotated in a direction away from the lower jaw 116 by the biasing force of the spring 19, and is released.

[0083] In addition, by loosening the operating force on the side that brings the cutting trigger handle 13b closer to the fixed handle frame 111 against the biasing force of the spring 19a, the cutting cutter 15 in the gripped state is rotated in a direction away from the lower jaw 116 by the biasing force of the spring 19, and is released.

[0084] In this way, the forceps 1X of Example 2 has the same effect as the forceps 1 described above, and can rotate the upper jaw portion 14 in the gripping state and the cutting cutter 15 in the cutting state in the opening direction without operating the trigger handle 13 in a direction away from the fixed handle frame 111.

[0085] Specifically, the upper jaw wire 16a and the cutter wire 16b, which are made of flexible long members, are provided with a spring 19a that urges the upper jaw portion 14 in a direction in which a specific portion moves in the pushing direction in the longitudinal direction L by moving a specific portion in the pulling direction in the longitudinal direction L, and a spring 19b that urges the cutting cutter 15 in a direction in which a specific portion moves in the pushing direction. Therefore, by moving a specific portion of the upper jaw wire 16a and the cutter wire 16b in the pulling direction in the longitudinal direction L, the upper jaw portion 14 and the cutting cutter 15 can be rotated in the pulling direction relative to the lower jaw portion 116, and can be rotated in the pushing direction by the biasing force of the springs 19a and 19b. Therefore, for example, when the upper jaw portion 14 (cutting cutter 15) is rotated in the gripping direction (cutting direction) relative to the lower jaw portion 116 by movement in the pulling direction, the upper jaw portion 14 (cutting cutter 15) can be opened by the biasing force of spring 19a (spring 19b).

[0086] In the above description of the forceps 1X, only the proximal wire 161 is provided, and the upper jaw 14 and the cutting cutter 15 are rotated in a direction approaching the lower jaw 116 by operating the trigger handle 13, and the upper jaw 14 in the gripping state and the cutting cutter 15 in the cutting state are rotated in the opening direction by the biasing force of the spring 19.

[0087] In response to this, the spring 19 may be configured in such a way that it biases the tip sides of the upper jaw 14 and the cutting cutter 15 in a direction toward the side closest to the lower jaw 116, and by operating the trigger handle 13 toward the side closest to the fixed handle frame 111, the upper jaw 14 and the cutting cutter 15 are rotated in a direction away from the lower jaw 116, and the biasing force of the spring 19 biases the tip sides of the upper jaw 14 and the cutting cutter 15 toward the side closest to the lower jaw 116, thereby performing grasping or cutting.

[0088] Furthermore, only one of the springs 19a and 19b may be provided, and the other may be provided with both the proximal side wire 161 and the releasing side wire 162. In this case, one of the cutting mechanism 10 and the gripping mechanism 17 is automatically returned by the spring 19, but the other is configured to be returned by the operation of the trigger handle 13.

[0089] Next, forceps 1Y according to a third embodiment is shown in FIGS. Fig. 11 is an explanatory diagram of the forceps 1Y in an open state according to the third embodiment. In detail, Fig. 11(a) shows a front view of the forceps 1Y according to the third embodiment, and Fig. 11(b) shows a plan view of the forceps 1Y.

[0090] Fig. 12 shows a rear view of the forceps 1Y of the third embodiment in an open state, and Fig. 13 shows an explanatory diagram of the forceps 1Y of Fig. 11. In detail, Fig. 13(a) shows a front view of the forceps 1Y in a gripping state with a gripping mechanism closed, and Fig. 13(b) shows a front view of the forceps 1Y in a cutting state with a cutting cutter of a cutting mechanism closed. 11B and the enlarged views in FIG. 13 show cross-sectional views of the vicinity of the center in the height direction of the regulation frame 124.

[0091] In the following description of the forceps 1Y, the same components as those of the forceps 1 and 1X will be given the same reference numerals and detailed description thereof will be omitted. Unlike the forceps 1 in which the operation of the trigger handle 13 is transmitted through an opening / closing wire 16 to rotate the upper jaw portion 14 and the cutting cutter 15, the forceps 1Y is configured so that the operation of the trigger handle 13Y is transmitted through a rod-shaped slide plate 12Y (12Ya, 12Yb) to rotate the upper jaw portion 14 and the cutting cutter 15.

[0092] Specifically, the forceps 1Y includes a main body frame 11Y, a slide plate 12Y (12Ya, 12Yb), a trigger handle 13Y (13Ya, 13Yb), an upper jaw portion 14Y, and a cutter 15Y.

[0093] The forceps 1Y is configured such that a first slide plate 12Ya slides in the longitudinal direction L relative to a reference frame 112Y to rotate the upper jaw 14, and a second slide plate 12Yb slides in the longitudinal direction L relative to the reference frame 112Y to rotate the cutting cutter 15 to perform cutting.

[0094] More specifically, like the main body frame 11 which is composed of a fixed handle frame 111 and a reference frame 112, the main body frame 11Y is composed of a fixed handle frame 111 and a reference frame 112Y which intersect at an obtuse angle.

[0095] The first slide plate 12Ya and the second slide plate 12Yb are configured to slide along the upper surface of the reference frame 112Y. The reference frame 112Y includes a restriction frame 124 that restricts the first slide plate 12Ya and the second slide plate 12Yb, which slide along the upper surface, so that they can slide.

[0096] The first slide plate 12Ya and the second slide plate 12Yb are formed in a plate shape, stacked in the thickness direction, and regulated by a regulating frame 124 so as to be independently slidable along the upper surface of the reference frame 112Y.

[0097] An upper support shaft 121Ya that supports a drive shaft 181Ya of an arm 18Ya (to be described later) is provided at the middle portion of the first slide plate 12Ya, the tip of which is connected to the upper jaw portion 14. An upper support shaft 121Yb that supports a drive shaft 181Yb of an arm 18Yb (to be described later) is provided in the middle portion of the second slide plate 12Yb, the tip of which is connected to the cutting cutter 15.

[0098] The trigger handle 13Y includes a gripping trigger handle 13Ya for sliding the first slide plate 12Ya to rotate the upper jaw 14, and a cutting trigger handle 13Yb for sliding the second slide plate 12Yb to rotate the cutting cutter 15.

[0099] The trigger handle 13Y (13Ya, 13Yb) has an upper pivot portion 134Y (134Ya, 134Yb) provided above a pivot portion 133 journaled on the reference frame 112Y in a manner protruding upward from the first slide plate 12Ya and the second slide plate 12Yb.

[0100] An arm 18Y (18Ya, 18Yb) inclined downward on the tip side F is connected to the upper pivot portion 134Y (134Ya, 134Yb), and the above-mentioned drive shaft 181Y (181Ya, 181Yb) is provided at the tip of the arm 18Y (18Ya, 18Yb).

[0101] The forceps 1Y also includes a click mechanism 50. For example, as shown in the enlarged view of FIG. 11, the click mechanism 50 includes a ratchet hook 51 on the inner surface of the side wall of the regulating frame 124, and a ratchet recess 52 on the side surface of the slide plate 12Y disposed inside the regulating frame 124.

[0102] The ratchet hook 51 has an arm 511 extending in the longitudinal direction L and a locking protrusion 512 at the tip thereof, and the locking protrusion 512 is pressed against the slide plate 12Y by the biasing force of the arm 511. Also, an adjustment screw 53 is provided for adjusting the amount of pressing of the locking protrusion 512 by the arm 511.

[0103] When both the cutting mechanism 10 and the gripping mechanism 17 are in the open state, the locking protrusion 512 of the ratchet hook 51 is not engaged with the ratchet recess 52, and as the slide plate 12Y moves to the tip side F, the ratchet recess 52 moves to the tip side F, and the clicking sound and clicking sensation produced when the locking protrusion 512 engages with the ratchet recess 52 that has moved to the tip side F can notify the movement of the slide plate 12Y, i.e., gripping by the gripping mechanism 17 or cutting by the cutting mechanism 10.

[0104] By screwing the adjustment screw 53 in and out, the force of the arm 511 pressing the locking protrusion 512 against the slide plate 12Y can be adjusted, and by adjusting the force of the arm 511, it is possible to adjust the increase or decrease in the clicking sound and clicking feeling when the locking protrusion 512 locks into the ratchet recess 52.

[0105] The click mechanism 50 may be provided with a ratchet hook 51 on the side surface of the slide plate 12Y, and a ratchet recess 52 on the inner surface of the regulating frame 124. In addition, a ratchet hook 51 and a ratchet recess 52 may be provided on the inner surface of the upper plate of the regulating frame 124 and the upper surface of the slide plate 12Y, or the ratchet hook 51 and the ratchet recess 52 may be provided on the bottom surface of the slide plate 12Y and the upper surface of the reference frame 112.

[0106] Furthermore, the click mechanism 50 shown in FIG. 11 has ratchet hooks 51 on both side surfaces of the regulating frame 124 and ratchet recesses 52 on the side surfaces of both the first slide plate 12Ya and the second slide plate 12Yb, but may be provided only on one of the side surfaces of the regulating frame 124 and the side surface of the slide plate 12Y corresponding to that side surface.

[0107] In the forceps 1Y configured in this manner, when the grasping trigger handle 13Ya is operated in a direction approaching the fixed handle frame 111, the upper pivot portion 134Ya moves to the tip side F with the pivot portion 133 as a rotation axis.

[0108] When the upper pivot portion 134Ya moves toward the tip side F, the arm 18Ya connected to the upper pivot portion 134Ya also moves toward the tip side F while changing its inclination angle. When the arm 18Ya moves toward the tip side F while changing its inclination angle, the first slide plate 12Ya that supports the drive shaft 181Ya of the arm 18Ya by the upper support shaft 121Yab slides toward the tip side F relative to the reference frame 112Y.

[0109] When the first slide plate 12Ya moves to the tip side F, the upper jaw 14, whose lower shaft receiving portion 141 is pivotally supported by the tip support portion 117 of the main body frame 11Y and whose upper rotary bearing portion 143 is pivotally supported by the tip upper support shaft 122Ya, moves the tip upper support shaft 122Ya to the tip side F. As a result, the tip side F pivots around the tip support portion 117 in a direction approaching the lower jaw 116, and the gripping mechanism 17 composed of the lower jaw 116 and the upper jaw 14 enters a gripping state in which it can grip a target site such as a blood vessel B (see FIG. 17).

[0110] At this time, as shown in the enlarged view of Fig. 13(a), the locking protrusion 512 of the ratchet hook 51 provided on the side wall of the regulating frame 124 locks into the ratchet recess 52 formed on the side surface of the moved first slide plate 12Ya. The clicking sound and clicking feeling produced when the locking protrusion 512 of the ratchet hook 51 locks into the ratchet recess 52 formed on the side surface of the first slide plate 12Ya notifies the user that the gripping state has been achieved.

[0111] In the forceps 1Y in the gripped state, when the cutting trigger handle 13Yb is operated in a direction approaching the fixed handle frame 111, the upper pivot portion 134Yb moves to the tip side F with the pivot portion 133 as a rotation axis.

[0112] When the upper pivot portion 134Yb moves toward the tip side F, the arm 18Yb connected to the upper pivot portion 134Yb also moves toward the tip side F while changing its inclination angle. When the arm 18Yb moves toward the tip side F while changing its inclination angle, the second slide plate 12Yb that supports the drive shaft 181Yb of the arm 18Yb by the upper support shaft 121Yb slides toward the tip side F relative to the reference frame 112Y.

[0113] When the second slide plate 12Yb moves to the tip side F, the cutter 15, whose lower shaft receiving portion 151 is journaled to the tip support portion 117 of the main frame 11Y and whose upper rotary bearing portion 154 is journaled to the tip upper support shaft 122Yb, moves the tip upper support shaft 122Yb to the tip side F. As a result, the tip side F pivots about the tip support portion 117 in a direction approaching the lower jaw 116, and the cutting mechanism 10 composed of the lower jaw 116 and the cutter 15 enters a cutting state in which the target site such as a blood vessel B can be cut (see FIG. 17).

[0114] At this time, as shown in the enlarged view of Fig. 13(b), the locking protrusion 512 of the ratchet hook 51 provided on the side wall of the regulating frame 124 locks into the ratchet recess 52 formed on the side surface of the moved second slide plate 12Yb. The clicking sound and clicking sensation produced when the locking protrusion 512 of the ratchet hook 51 locks into the ratchet recess 52 formed on the side surface of the second slide plate 12Yb notifies the user that the disconnected state has been achieved.

[0115] When the cutting trigger handle 13Yb is operated in a direction away from the fixed handle frame 111 in the cutting state, the upper pivot portion 134Yb moves to the base end side R with the pivot portion 133 as a rotation axis. When the upper pivot portion 134Yb moves to the base end side R, the arm 18Yb connected to the upper pivot portion 134Yb also moves to the base end side R while changing its inclination angle. When the arm 18Yb moves to the base end side R while changing its inclination angle, the second slide plate 12Yb that supports the drive shaft 181Yb of the arm 18Yb by the upper support shaft 121Yb slides and moves to the base end side R relative to the reference frame 112Y.

[0116] When the second slide plate 12Yb moves to the base end side R, the cutting cutter 15, whose lower shaft receiving portion 151 is journaled to the tip support portion 117 of the main frame 11Y and whose upper rotary bearing portion 154 is journaled to the tip upper support shaft 122Yb, moves the tip upper support shaft 122Yb to the base end side R. As a result, the base end side R pivots about the tip support portion 117 in a direction away from the lower jaw 116, and the cutting mechanism 10 composed of the lower jaw 116 and the cutting cutter 15 can be opened.

[0117] Furthermore, when the gripping trigger handle 13Ya is operated in a direction away from the fixed handle frame 111 in the gripped state, the upper pivot portion 134Ya moves to the base end side R with the pivot portion 133 as a rotation axis. When the upper pivot portion 134Ya moves to the base end side R, the arm 18Ya connected to the upper pivot portion 134Ya also moves to the base end side R while changing its inclination angle. When the arm 18Ya moves to the base end side R while changing its inclination angle, the first slide plate 12Ya that supports the drive shaft 181Ya of the arm 18Ya by the upper support shaft 121Ya slides to the base end side R relative to the reference frame 112Y.

[0118] When the first slide plate 12Ya moves to the base end side R, the upper jaw 14, whose lower shaft receiving portion 141 is journaled to the tip support portion 117 of the main frame 11Y and whose upper rotary bearing portion 143 is journaled to the tip upper support shaft 122Ya, moves the tip upper support shaft 122Ya to the base end side R. As a result, the base end side R pivots about the tip support portion 117 in a direction away from the lower jaw 116, and the gripping mechanism 17 composed of the lower jaw 116 and the upper jaw 14 can be opened.

[0119] As described above, in the forceps 1Y, like the forceps 1 and 1X, the upper jaw 14 and lower jaw 116 constituting the gripping mechanism 17 can grip a target site such as a blood vessel B with the gripping cutter 15, by operating the trigger handle 13 (13a, 13b). During gripping and cutting of the target site by operating the trigger handle 13 (13a, 13b), microwaves can be irradiated from the irradiation electrode 24 to the target site to cause coagulation.

[0120] Next, a forceps 1A having a cutting mechanism 10 will be described as a fourth embodiment with reference to FIG. Fig. 14 shows an explanatory diagram of forceps 1A in an open state equipped with a cutting mechanism 10 of the fourth embodiment. In detail, Fig. 14(a) shows a rear view of forceps 1A, Fig. 14(b) shows a partial vertical cross-sectional view of forceps 1A, and Fig. 14(c) shows a side cross-sectional view taken along the arrow EE in Fig. 14(a).

[0121] In the following description of the forceps 1A, the same components as those of the forceps 1, 1X, and 1Y are given the same reference numerals and detailed description thereof will be omitted. In the above-mentioned forceps 1, 1X, a lower jaw 116 is formed at the tip of the tip side F of the reference frame 112 in the main body frame 11, and a trigger handle 13 (13a, 13b) is provided which cooperates with the fixed handle frame 111 to rotate the upper jaw 14 and the cutting cutter 15. However, although the forceps 1A is equipped with a cutting mechanism 10 and a gripping mechanism 17, the base of the main body frame 11A on which the lower jaw 116 is provided is configured to be attached to an attachment 60 provided at the tip of the tube T.

[0122] Specifically, the lower half of the main body frame 11A has a downwardly convex semicircular cross-sectional shape, and the base end side R is provided with an upwardly convex inverse arc-shaped roof 119. Therefore, the base end side R of the main body frame 11A is formed into a circular cross-sectional shape by the lower half part having a downwardly convex semicircular cross-sectional shape and the upwardly convex inverse arc-shaped roof 119, and a fastening portion to be fastened to the mounting fixture 60 is formed at the end of the base end side R. The tube T to which the forceps 1A is connected via the attachment 60 is a flexible hollow tube.

[0123] In addition, in the forceps 1A, four opening and closing wires 16 whose tips are attached to the upper jaw portion 14 and the cutting cutter 15 pass through the inside of the roof 119 and are inserted into the inside of the tube T to the opposite end and connected to an operating part (not shown) provided on the opposite side of the tube T.

[0124] The upper jaw wire 16a and the cutter wire 16b move a predetermined location to the tip side F or base side R in the longitudinal direction L, so that the upper jaw 14 and the cutting cutter 15 can be rotated in the approaching direction or the opening direction relative to the lower jaw 116.

[0125] Therefore, for example, when the upper jaw 14 (cutting cutter 15) is rotated from a gripping state (cutting state) to an opening direction relative to the lower jaw 116 by moving the opening side wire 162 in the pulling direction, the upper jaw 14 (cutting cutter 15) can be rotated in the gripping direction (cutting direction) by moving the proximal side wire 161 in the pulling direction.

[0126] A coaxial cable 24x for supplying electricity to the irradiation electrode 24 provided on the forceps 1A is also inserted into the inside of the tube T and connected to a microwave generator 30 provided on the opposite side of the tube T.

[0127] The forceps 1A configured in this manner is used, for example, in endoscopic surgery while inserted into the channel of an endoscope, and by operating an operating unit (not shown) provided on the opposite side of the tube T (the base side of the endoscope), the proximal side wire 161 and the opening side wire 162 of the opening / closing wire 16 can be pulled to rotate the upper jaw portion 14 of the grasping mechanism 17 and the cutting cutter 15 of the cutting mechanism 10, respectively, to grasp, cut, or open the target site, which is biological tissue. In this way, the above-described forceps 1A can achieve the same effects as the forceps 1, 1X, and 1Y equipped with the gripping mechanism 17 and the cutting mechanism 10.

[0128] Next, a forceps 1B having a cutting mechanism 10 will be described as a fifth embodiment with reference to FIG. Fig. 15 shows an explanatory diagram of forceps 1B in an open state having a cutting mechanism 10 of the fifth embodiment. In detail, Fig. 15(a) shows a rear view of the forceps 1B, and Fig. 15(b) shows a partial vertical cross-sectional view of the forceps 1B.

[0129] In the following description of the forceps 1B, the same components as those of the forceps 1, 1X, 1Y and forceps 1A will be given the same reference numerals and detailed description thereof will be omitted. In the above-described forceps 1A, the base of the main body frame 11 is attached to the mounting fixture 60 provided at the tip of the tube T. However, the forceps 1B does not use the tube T and mounting fixture 60, and the main body frame 11B and roof 119, which form a circular cross section, are formed to the same length as the tube T in the forceps 1A.

[0130] Although main body frame 11B and roof 119, which form a circular cross section, have a certain degree of flexibility, the portion that forms lower jaw 116 has a rigid structure. In the forceps 1B, the four opening and closing wires 16, whose tips are attached to the upper jaw portion 14 and the cutting cutter 15, pass through the inside of the roof 119, pass through the inside of the tube T to the opposite end, and are connected to an operating part (not shown) provided on the opposite side of the tube T.

[0131] Further, a coaxial cable (not shown) for supplying electricity to the irradiation electrode 24 provided on the forceps 1B is inserted into the inside of the tube T and connected to a microwave generator 30 provided on the opposite side of the tube T.

[0132] Like the forceps 1A, the forceps 1B configured in this manner is used in a state where it is inserted into a channel of an endoscope in a endoscopic surgery, and by operating an operation unit (not shown) provided on the opposite side of the tube T (the base side of the endoscope), the proximal side wire 161 and the opening side wire 162 of the opening / closing wire 16 can be pulled to rotate the upper jaw portion 14 of the gripping mechanism 17 and the cutting cutter 15 of the cutting mechanism 10, respectively, to grip, cut, or open a target site which is biological tissue. Furthermore, the irradiation electrode 24 can coagulate the target site which is biological tissue. In this way, the above-described forceps 1B can achieve the same effects as the forceps 1, 1X, and 1Y that include the gripping mechanism 17 and the cutting mechanism 10, similarly to the forceps 1A.

[0133] An opening / closing wire 16 having a thickness large enough to slide in the internal space may be inserted between the main body frame 11A and the roof 119. In this case, the opening / closing wire 16 having a thickness large enough to slide in the internal space can move not only in the pulling direction toward the base end side R but also in the pushing direction toward the tip end side F, allowing the upper jaw 14 and the cutting cutter 15 to rotate in either direction.

[0134] Next, an end effector 10c for irradiating biological tissue with microwaves will be described as a sixth embodiment with reference to FIGS. FIG. 16 shows a schematic front view of an end effector 10c according to the sixth embodiment.

[0135] Figure 17 shows a schematic diagram of the end effector 10c in Figure 16. In detail, Figure 17(a) shows a side cross-sectional view taken along the line FF in Figure 16, Figure 17(b) shows a partial vertical cross-sectional view of the end effector 10c, Figure 17(c) shows an enlarged plan view taken along the line GG in Figure 16, and Figure 17(c) shows an enlarged view of Figure 17(b).

[0136] Fig. 18 shows a schematic explanatory diagram of the end effector 10c of the sixth embodiment. In detail, Fig. 18(a) shows a schematic front view of the end effector 10c in a normal state, Fig. 18(b) shows a schematic front view of the end effector 10c in a gripping state, and Fig. 18(c) shows a schematic front view of the end effector 10c in a cutting state.

[0137] The end effector 10c is used in a multi-function surgical instrument and corresponds to the cutting mechanism 10 in the above-described forceps 1. Therefore, the same reference numerals are used for configurations similar to those in the above-described forceps 1. Also, the end effector in this embodiment can constitute the above-described cutter, cutting mechanism, and forceps, and includes other similar configurations.

[0138] 16 and 17, a part of the tip side F of the end effector 10c is shown. The end effector 10c includes a reference axis 11a (corresponding to the reference frame 112 in the cutting mechanism 10) that passes through a bellows-shaped flexible portion 101 provided at the tip of a tubular support tool 100 that is attached to a multi-function surgical instrument, an upper jaw portion 14, a cutting cutter 15, and an opening / closing wire 16.

[0139] In addition, in the reference shaft 11a, a portion corresponding to the inside of the flexible portion 101 having flexibility is configured to have flexibility that allows it to deform following the movable flexible portion 101, but a wire may be used for driving.

[0140] The operation of the upper jaw 14 and cutting cutter 15 in the end effector 10c configured in this manner is similar to that of the upper jaw 14 and cutting cutter 15 of the cutting mechanism 10 in the forceps 1 described above, and by moving the opening and closing wire 16 in the longitudinal direction L, the target area can be grasped by the grasping mechanism 17 consisting of the upper jaw 14 and the lower jaw 116 provided at the end of the tip side F of the reference shaft 11a, and can be cut by the cutting cutter 15.

[0141] In the end effector 10c thus configured, a coaxial electrode 20 is provided along the longitudinal direction L on the upper surface of the lower jaw 116 and the bottom surface of the upper jaw 14. Further, the end effector 10c is connected to a coaxial cable 40 that connects a microwave transmitter 30 that irradiates microwaves with the coaxial electrode 20. The microwave transmitter 30 may be provided inside the end effector 10c.

[0142] As shown in the enlarged cross-sectional view of Figure 17, the coaxial cable 40 is composed of a central conductor 41, an insulator 42, an outer conductor 43, and an insulating coating 44 sandwiched between the central conductor 41, which are arranged in this order from the center to the radially outward, and has appropriate flexibility.

[0143] The coaxial electrode 20 provided on the bottom surface of the upper jaw 14 and the top surface of the lower jaw 116 is composed of a central conductor 21, a semicircular insulator 22 with a semicircular cross-section, and a semicircular tube conductor 23 arranged outside the semicircular insulator 22, as shown in the enlarged view in Figure 17(c).

[0144] 17(c), the coaxial electrode 20 configured in this manner is semi-cylindrical and of a predetermined length, and is disposed along the longitudinal direction so that the flat surfaces face each other on the bottom surface of the upper jaw 14 and the top surface of the lower jaw 116. Although not shown, the coaxial electrodes 20 disposed on the upper jaw 14 and the lower jaw 116 have an insulating layer disposed on the outside, and are insulated from the upper jaw 14 and the lower jaw 116.

[0145] 17(b), the central conductor 21 of each of the coaxial electrodes 20 provided on the upper jaw 14 and the lower jaw 116 is connected to the central conductor 41 of the coaxial cable 40, and the semicircular tube conductor 23 of the coaxial electrode 20 is connected to the outer conductor 43 of the coaxial cable 40, forming a homopolar connection. If necessary, one of the electrodes may be connected to the opposite polarity.

[0146] In this way, the coaxial electrode 20 connected to the microwave transmitter 30 via the coaxial cable 40 can irradiate microwaves between the central conductor 21 and the semicircular tube conductor 23 of the coaxial electrode 20 via the coaxial cable 40 when the microwave transmitter 30 is operating.

[0147] When microwaves are irradiated from the coaxial electrode 20 while the target site, blood vessel B, is gripped by the gripping mechanism 17, the blood vessel B gripped by the gripping mechanism 17 is coagulated by the microwaves. The portion of the blood vessel B that has coagulated due to the microwaves irradiated from the coaxial electrode 20 can then be cut by the cutting cutter 15. As a modification of this embodiment, FIG. 16 shows an embodiment in which an electronic module 31 is built into the end effector 10c.

[0148] Although the microwave transmitter 30 described above is built into the end effector 10c, it may be an electronic module that incorporates a microwave irradiation module 222 shown in Fig. 20 or an electronic circuit of a surgical device 221 shown in Fig. 22(b) as appropriate. By providing the electronic module 31 in the end effector 10c, it is possible to miniaturize the medical equipment, improving the convenience of surgery.

[0149] Furthermore, the end effector 10c may be configured such that the coaxial electrodes 20 provided on the opposing surfaces of the lower jaw portion 116a and the upper jaw portion 14 are connected to have opposite polarities. Furthermore, although not shown, in the end effector 10c, the coaxial electrode 20 may be provided on the side surface of the cutter 15 in addition to the opposing surfaces of the lower jaw 116a and the upper jaw 14, or the coaxial electrode 20 may not be provided on the upper jaw 14 but may be provided on the upper surface of the lower jaw 116a and the side surface of the cutter 15. Furthermore, the coaxial electrode 20 may be provided only on one of the opposing surfaces of the upper jaw 14 and the lower jaw 116a.

[0150] 19, the above-mentioned irradiation electrodes 24a, 24b may be provided instead of the coaxial electrode 20 provided on the upper jaw 14 and the lower jaw 116a of the end effector 10c. Furthermore, an irradiation electrode 24c may be provided on the side surface of the cutter 15. Note that FIG. 19(a) shows a vertical cross-sectional view of the end effector 10c provided with the irradiation electrodes 24 (24a, 24b, 24c), and FIG. 19(b) shows a partially enlarged vertical cross-sectional view of the end effector 10c provided with the irradiation electrode 24.

[0151] Furthermore, at least one of the upper jaw portion 14, the cutting cutter 15 and the lower jaw portion 116 of the above-mentioned forceps 1, 1X and 1Y may be provided with a coaxial electrode 20 connected to the microwave transmitter 30 by a coaxial cable 40.

[0152] Furthermore, even if a coaxial electrode 20 is provided on both the lower jaw 116a and the upper jaw 14 of the end effector 10c, or if a coaxial electrode 20 is provided on the lower jaw 116a and the cutting cutter 15, or even if a coaxial electrode 20 is provided on all of the lower jaw 116a, the upper jaw 14 and the cutting cutter 15, the cutting mechanism of the end effector 10c can cut, for example, a coagulated portion of a blood vessel B.

[0153] Surgical instruments such as the end effector 10c that emits microwaves emit little smoke or mist, have a strong hemostatic function, and are ideal for surgical support in closed spaces such as laparoscopic surgery and robotic surgery. However, the hemostatic power in a blood pool in the case of heavy bleeding and in liquids is weakened, just like other energy devices.

[0154] Figure 20 shows a medical instrument 220 according to another embodiment of the present invention. In Figure 20(a), the medical instrument 220 includes a surgical device 221 that drives an end effector 10c of a multifunctional surgical instrument (medical processing tool) as described in conjunction with Figures 16 to 19.

[0155] The surgical device 221 includes a microwave irradiation module 222 including a microwave control circuit such as an irradiator and an amplifier, and a drive unit 224 of a mechanical mechanism that drives the end effector 10c by manually operating a lever 223. Specifically, the trigger handle 13 of the forceps shown in Figures 1 to 13 may be used as the lever 223, and the mechanical mechanism from the trigger handle 13 to the end effector 10c may be incorporated into the surgical device 221.

[0156] A microwave irradiation module 222 having an irradiator is provided inside the surgical device 221, but if necessary, it can be provided inside the shaft portion 225, or in a bending portion 226 having a wrist function (such as the flexible portion 101 in Figure 16), or in the end effector 10c (Figures 1 and 2, or the electronic module 31 in Figure 16(a)), making it possible to make the medical device 220 ultra-compact.

[0157] When an operator manually grips and operates a lever 223 of a grip portion of the surgical device 221, a drive unit 224 operates the end effector 10c of FIG.

[0158] The surgical device 221 is supplied with power from an adapter 227. The microwave irradiation module 222 included in the surgical device 221 may be configured to be directly or indirectly connected to an irradiator installed in the robot body, in addition to the conventional stationary type, shoulder type, or built-in type.

[0159] In the above embodiment, microwave irradiation does not cause coagulation when gripping with the lower jaw 116 and upper jaw 14 of the end effector 10c, but rather coagulates the target tissue when the upper jaw 14 rotates relative to the lower jaw 116, thereby enabling coagulation, hemostasis, and cutting of the tissue. Furthermore, microwaves may be irradiated when the tissue is gripped by the gripping mechanism 17a in the end effector 10c and cut by the cutting cutter 15.

[0160] With such forceps, the grasping function can be used to open and remove tissue, grasp and remove obstacles, and prepare the surgical field, and it is also possible to grasp the part to be coagulated and cut with the forceps and then perform the coagulation and cutting. The coagulation and cutting operations do not require multiple re-grasping of tissue or re-clamping, but the operation is completed by grasping what has already been clamped. Therefore, surgical operations such as grasping, coagulation, and cutting can be performed with a single device. All of the procedures involved in general resection surgery can be completed using a single instrument, eliminating the need to switch to other instruments.

[0161] As a modified example of this embodiment, the microwave irradiation module 222 may be provided with an execution program memory, and the drive unit 224 may be configured as an electric mechanical mechanism controlled by the execution program. In operation, when the lever 223 is gripped, the execution program moves the drive unit 224 based on the position data of the lever 223, and by configuring the end effector 10c in Fig. 16, the upper jaw wire 16a and the cutter wire 16b are moved, thereby rotating the upper jaw portion 14 in the direction of the lower jaw portion 116, and the program sends a microwave signal to the irradiation electrode 24, and the living tissue can be coagulated by irradiating microwaves.

[0162] Furthermore, when lever 223 is grasped, the proximal wire 161 of the upper jaw wire 16a moves in the pulling direction according to the position data by the program as described above, and the living tissue can be grasped by upper jaw portion 14a and lower jaw portion 116a.

[0163] Furthermore, when the lever 223 is gripped, the proximal wire 161 of the cutter wire 16b moves in the pulling direction according to the lever position data by the program, thereby rotating only the cutting cutter 15, thereby cutting the coagulated biological tissue. After cutting, the medical device 220 is configured to return to the initial state (open state) based on the lever position data by releasing the lever 223.

[0164] In addition, the rotational position of the upper jaw 14 and the cutting cutter 15 relative to the lower jaw 116, the rotation of the pinion gear 12, and the position of the trigger handle 13 (13a, 13b) relative to the fixed handle frame 111 may be detected, and a detection signal based on the detection results may be received to detect the state of the cutting mechanism 10 and the gripping mechanism 17.

[0165] FIG. 20(b) is a schematic diagram of a surgical system equipped with multiple medical devices 220 as shown in FIG. 20(a). The internal configuration of each is similar to that of FIG. 20(a), but each microwave irradiation module 222 of the medical device 220 further includes a unit for synchronizing the microwave wavelengths of each other, and the synchronization is performed via an adapter 227 or wirelessly.

[0166] Therefore, when two medical devices 220 are operated inside a patient by one or two operators, the wavelengths of the microwaves of both devices are synchronized, thereby preventing the occurrence of sparks and the like between the two medical devices 220, thereby increasing safety.

[0167] 21 shows a remote surgery system 200 according to an embodiment of the present invention. The remote surgery system 200 includes a surgeon console 201 serving as a station for each of two operators D (D1, D2), a master control unit 202 operated by the operator D, a viewing angle / core cart 240, and a patient side cart 210, which is a patient side cart.

[0168] The surgeon console 201 includes a viewer 201a in which an image of the surgical site is displayed to an operator D. When using the surgeon console 201, operators D1 and / or D2 typically sit in a chair at the surgeon console, position their eyes in front of the viewer 201a, and hold the master control unit 202 in one hand.

[0169] The remote surgery system 200 can be operated by two operators simultaneously, but can also be operated by a single operator. When two operators operate simultaneously, they can cooperate with each other, which has the advantage of shortening the total surgery time for the patient. The system may be provided with three or more surgeon consoles 201 and master control units 202, if necessary.

[0170] The robot on the Patient Side Cart 210 is placed adjacent to the patient. During use, the Patient Side Cart 210 is placed near the patient requiring surgery. The robot on the Patient Side Cart 210 is stationary during the surgical procedure but has casters on the base 211 to allow for mobility. The Surgeon Console 201 is used in the same operating room as the Patient Side Cart, but may be located remotely from the Patient Side Cart 210.

[0171] The patient side cart 210 includes four robot arm assemblies 212, but the number of the robot arm assemblies 212 is arbitrary. Each robot arm assembly 212 is connected to and driven and controlled by a drive unit 213 that enables three-dimensional movement.

[0172] A display 214 displays image data related to the surgery. The drive unit 213 is controlled by a master control unit 202 on the surgeon console 201. The movement of the manipulator portion of the robotic arm assembly 212 is controlled by operation of the master control unit 202.

[0173] An image capture device 215, such as an endoscope, is disposed on one of the four robotic arm assemblies 212, robotic arm assembly 212a. The remote end of image capture device 215 includes a viewing camera 216. Image capture device 215 is an elongated shaft that allows for insertion of viewing camera 216 through a surgical entry port in a patient (not shown). The image capture device 215 is operatively connected to the viewer 201 a of the surgeon console 201 for displaying images captured by its viewing camera 216 .

[0174] Each of the other robotic arm assemblies 212 is a linkage that supports and includes a respective detachable surgical instrument, tool 217. The tools 217 of the robotic arm assemblies 212 each include an end effector 10c.

[0175] The tool 217 has an elongated shaft to allow for insertion of the end effector 10c through a surgical entry port of the patient. Movement of the end effector 10c is controlled by the master control unit 202 of the surgeon console 201.

[0176] When the end effector 10c includes the microwave irradiation electrodes (20, 24) and the microwave irradiation unit as the tool 217, the wavelengths of the microwaves irradiated from the end effector 10c are synchronized.

[0177] For example, when one or two operators D operate multiple tools 217 inside a patient, the wavelengths of the irradiated microwaves are synchronized to prevent sparks and the like from occurring between the multiple tools 217 or the multiple end effectors 10c, thereby improving safety. Operating multiple end effectors 10c simultaneously not only enables advanced surgery but also shortens the surgery time.

[0178] Figure 22 shows a configuration of a tool 217 that can be loaded onto the robot arm assembly 212 of the telesurgery system 200 of Figure 21 as a representative example of a surgical device. The tools 217 attached to other robot arm assemblies 212 may have a similar configuration, or may be surgical devices of other configurations.

[0179] 22(a) shows a plan view of a tool 217. The tool 217 has an end effector 10c of a multifunctional surgical instrument, a bending portion 226, a shaft portion 225, a surgical device 221 that drives, controls, and monitors the tool 217, and a connector 228 that connects to a robot. The bending portion 226 increases the degree of freedom of the operation angle of the effector, improving the accuracy of robot control.

[0180] Fig. 22(b) shows the internal configuration of the tool 217 in Fig. 22(a). A medical system is shown that is configured with a surgical device 221 that drives the end effector 10c directly connected to the slide shaft in Fig. 16 via a shaft portion 225, and a robot of a patient side cart 210 that controls the surgical device 221.

[0181] The end effector 10c is equipped with a cutter having a rotatable upper jaw 14 and lower jaw 116 held so as to be able to open and close, and a movable cutting cutter 15 provided adjacent to the upper jaw 14 and lower jaw 116. A surgical device 221 connected to the end effector 10c has an alignment unit 231 with the tool 217, a reflected wave monitor 232, a control circuit 233 for controlling signals within the surgical device, an irradiation / driving unit 234 having an amplifier and a microwave generating irradiator for mechanically driving the cutter of the tool 217 via a shaft 225 of the tool 217, and a signal interface 235 with the robot of the patient side cart 210.

[0182] 23, the robot of the patient side cart 210 is connected to the surgical device 221 by wire and / or wirelessly via a signal interface 235 and a connector 228, and the robot of the patient side cart 210 is provided with an input unit 210a that receives operation signals from the master control unit 202, a computing unit CPU that executes a predetermined operation program based on the operation signals, and an output unit 210a that generates a drive signal to drive the upper jaw portion 14 and the cutting cutter 15 of the end effector 10c via the surgical device 221 based on the output from the computing unit. The input unit and the output unit are composed of an input / output unit 210a (I / O). FIG. 23 is an explanatory diagram of a remote surgery system 200, in which FIG. 23(a) is a block diagram showing the connection relationships between the units, and FIG. 23(b) is an operational flow diagram of the remote surgery system 200.

[0183] The vision core cart 240 has a function related to the image capture device. When the remote surgery system 200 is started for surgery, the surgeon operates the master control unit 202 of the surgeon console 201, and in the case of two surgeons, the surgeon also operates the master control unit 202 of the surgeon console 201 (step S1), and the command generated by the operation is sent to the vision core cart 240 (step S2). The vision core cart 240 then interprets the signals and moves the desired robotic arm assembly 212 to the patient's surgical area (step S3).

[0184] Next, the tool 217 attached to the selected robot arm assembly 212 is inserted into the patient through the long and thin pipe (step S4), and the end effector 10c of the above embodiment is caused to grasp, coagulate and cut the tissue (step S5), thereby completing the surgery on the living tissue.

[0185] The action of grasping, coagulating and cutting the biological tissue in step S5 is the action of the end effector 10c, and there are three action patterns: a first action pattern in which the biological tissue is coagulated, grasped and cut while irradiating microwaves from the electrode, a second action pattern in which the biological tissue is grasped, coagulated by irradiating microwaves from the electrode and cut while irradiating microwaves from the electrode, and a third action pattern in which the biological tissue is grasped and coagulated while irradiating microwaves from the electrode, but the irradiation of microwaves from the electrode is stopped and the tissue is cut. These three action patterns are configured to be selectively taken depending on the contents of the surgery. In addition, a pattern in which the tool 217 grasps or coagulates the tissue and another tool 217 cuts the tissue may be shared by multiple tools in FIG. 21.

[0186] In this embodiment, the operations of coagulating, grasping, and cutting tissue can be performed by the end effector 10c based on a control signal from the robot 210, instead of the controlled operation of the end effector 10c based on the position data of the lever 223 described as a modified example of the embodiment in Figure 20, so that a similar controlled operation flow can be obtained.

[0187] That is, a medical system can be provided that includes a medical robot configured to: provide a gripping mechanism having a first gripping portion and a second gripping portion assembled so as to be able to be opened and closed, and a gripping portion rotation means for rotating the first gripping portion toward the second gripping portion; a cutting mechanism having a cutting portion attached to the first gripping portion, and a cutting portion rotation means for rotating the cutting portion in the same direction as the rotation of the first gripping portion; a rotation axis for rotatably supporting the first gripping portion and the cutting portion is provided for the second gripping portion; a drive unit for independently driving the gripping portion rotation means and the cutting portion rotation means; and a medical robot configured to coagulate and cut a target portion while gripping the target portion by applying a drive signal to the drive unit.

[0188] As another embodiment, a configuration diagram of forceps 1D is shown in Fig. 24. Fig. 24(a) shows a rear view of forceps 1D, Fig. 24(b) shows a front view of end effector unit 10D at the tip of forceps 1D, Fig. 24(c) shows a plan view of end effector unit 10D shown in Fig. 24(a), Fig. 24(d) shows a partial cross-sectional external view of forceps 1D, and Fig. 24(e) shows a cross-sectional view of tube T connecting forceps 1D and drive unit 32.

[0189] It is equipped with a drive unit 32 that drives and controls the forceps 1D, and the forceps 1D and the drive unit 32 are connected by a drive wire 16Da that rotates the upper jaw 14, a drive wire 16Db that rotates the cutting cutter 15, and a coaxial cable 24D that is connected to the electrode 24a of the upper jaw 14 and the electrode 24b of the lower jaw 116, which are inserted into a flexible tube T.

[0190] The end effector unit 10D is composed of a fixed lower jaw unit 116, an upper jaw unit 14, and a cutting cutter 15, and the base 11A of the main body frame 11 on which the lower jaw unit 116 is provided is configured to be attached to an attachment fixture 60 provided at the tip of the tube T.

[0191] The tip of the drive wire 16Da rotatably engages with the base of the upper jaw 14 on an engagement shaft 143 that is pivotally supported by the rotation shaft 141 and spaced apart above the rotation shaft 141. When the drive wire 16Da moves to the tip side F, the engagement shaft 143 moves to the tip side F, and the upper jaw 14 that is pivotally supported by the rotation shaft 141 rotates in a direction approaching the lower jaw 116. Then, the upper jaw 14 and the lower jaw 116 grasp an object such as a biological tissue. Conversely, when the drive wire 16Da is moved to the base side R, the upper jaw 14 moves away from the lower jaw 116 and the grasp is released.

[0192] In Figures 24(a) and 24(c), the cutting cutter 15 is arranged adjacent to the upper jaw portion 14 so as to be able to rotate independently, and the base of the cutting cutter 15 is supported by a rotating shaft 151 provided on the lower jaw portion 116, and the tip of the drive wire 16Db is rotatably engaged with the base of the cutting cutter 15 to an engagement shaft 154 spaced above the rotating shaft 151.

[0193] When the drive wire 16Db moves to the tip side F, the engagement shaft 154 moves to the tip side F, and the cutter 15 journaled on the rotating shaft 151 rotates in a direction approaching the lower jaw 116 and joins with it, thereby cutting the target object such as biological tissue. Conversely, when the drive wire 16Db moves to the base side R, the cutter 15 moves away from the lower jaw 116 and the cutting state is canceled.

[0194] The central conductor of the coaxial cable 24D is connected to the electrode 24a, and the outer conductor is connected to the electrode 24b, but the connection structure with both electrodes is not limited to this embodiment and may be the electrode connection structure of the above-mentioned embodiment. As shown in Figure 24 (d), the coaxial cable 24D is inserted into the hollow part of the tube T, and is led out of the forceps 1D together with the driving wires 16Da, Db, and connected to the driving unit 32.

[0195] The drive unit 32 includes a circuit for supplying electromagnetic waves, microwaves, high frequency waves, and electric current to the electrodes 24a, 24b, and includes a control unit that can individually control the rotation of the upper jaw 14 and the cutter 15 by selectively or simultaneously pushing the drive wires 16Da, Db toward the forceps 1D or pulling them away from the forceps 1D based on an internal or external signal. A micromotor M is built into the drive unit 32, and the upper jaw 14 and the cutter 15 can be individually driven to rotate by an electric signal.

[0196] According to this embodiment, the end effector unit 10D has a simple structure that does not require differential mechanisms such as springs and gears, and therefore can prevent malfunction due to biological tissue entering the end effector unit 10D, and is particularly suitable for ultra-thin forceps with an aperture of a few millimeters. The drive wires 16Da, Db are forced to move in the direction of travel by running along the inner wall of the tube T as shown in Fig. 24(e), making the end effector unit 10Da, Db suitable for endoscopic forceps. Both the tube T and the drive wire 16D are flexible, but the wire may be a long thin plate member, or may be made of a rigid material if necessary.

[0197] By incorporating the functions of the drive unit 32 into the drive unit 224 of the medical device in Figure 20, or into the irradiation / drive unit 2 of the surgical device in Figure 22, it is possible to easily provide multiple functions such as a portable medical device and a robotic drilling function, grasping function, coagulation function, cutting function, and opening and removal function.

[0198] For example, in step S5 in the flow chart of FIG. 23, if the end effector unit 10D of this embodiment is applied to the end effector 10c of the tool 217 of FIG. 22, the upper jaw unit 14 and the cutting cutter 15 can be easily driven independently, so that, as shown in FIG. 25, (1) The upper jaw, lower jaw, and cutting cutter are all closed to provide the drilling function. (2) Providing a grasping function by manipulating the upper and lower jaws together; (3) In the second gripping function state, the coagulation button is operated to provide the coagulation function; (4) Cutting function is provided by operating a cutter; (5) The opening and closing function of the upper and lower jaws is provided. This allows a multi-function forceps function to be provided at the surgical site with a single forceps tool 217 without the need for replacement.

[0199] That is, a medical tool is provided that includes an end effector having a gripping mechanism and a cutting mechanism, and a drive unit that drives the end effector, the gripping mechanism includes a first gripping part and a second gripping part that are assembled so as to be openable and closable, and a gripping part rotation means that rotates the first gripping part toward the second gripping part, the cutting mechanism includes a cutting part provided in the first gripping part and a cutting part rotation means that rotates the cutting part in the same direction as the rotation of the first gripping part, and the drive unit drives the first gripping part, the second gripping part, and the cutting part in combination, thereby selectively providing at least one of a perforation function, a gripping function, a coagulation function, a cutting function, and an opening and exhausting function. The medical tool may be used alone, or may be used in a medical robot that is driven by a control signal from a robot. In addition, when the gripping and cutting parts are all closed and integrated, they can be used for window cutting, and when one of the cutting and gripping parts opens together from this state, they can be used for opening and removing.All surgical operations can be recorded and saved in the robot, making it possible to perform surgery using artificial intelligence (AI) functions.

[0200] The above-mentioned examples and embodiments have been described using medical examples such as forceps and medical instruments, but the present invention is not limited to the above description, and the target site may be not only a part of an object but also a member, and includes a general-purpose cutting device that can grasp / contact and cut the target member. In addition, the energy wave irradiated from the electrodes of the forceps is not limited to microwaves, and may include other electromagnetic waves and currents.

[0201] For example, as described above, in the cutting mechanism 10 and end effector 10c of the forceps 1, 1X, 1Y, etc., the gripping mechanism 17 is configured to be made up of the lower jaw portion 116 and the upper jaw portion 14, and the target portion such as the blood vessel B gripped by the gripping mechanism 17 is cut by the cutting cutter 15. However, as shown in FIG. 6(d), the gripping mechanism 17 made up of the lower jaw portion 116 and the upper jaw portion 14 may be provided on both sides of the cutting cutter 15, and the target portion gripped by the two sets of gripping mechanisms 17 may be cut by the cutting cutter 15.

[0202] In addition, the horizontal movement of the forceps or end effector of the present invention is not limited to axial movement, and may be structured to be connected by a wire in order to increase the degree of freedom of the position and angle of the end effector. The spring mechanism for moving the upper jaw and the cutting cutter for grasping, coagulating, and cutting biological tissue may be provided at any position other than that of the embodiment.

[0203] In addition, parts other than the electrodes and cutting edges may be appropriately insulated to prevent corrosion and sparks. In the above embodiment, the tissue between the upper jaw 14 or the cutter 15 and the lower jaw 116 can be coagulated from both sides. The split part of the coaxial cable that supplies microwaves to the end effector allows for a structure that transmits energy beyond multiple robot joints with a flexible cable without restricting the movement of the multiple joints.

[0204] In addition, by using a metal blade, the rigidity and shape can be freely designed. The forceps and medical devices with end effectors of the present invention can be used under MR image guidance, and microwave energy can be introduced not only under endoscopy and with robotic hands, but also in endovascular surgery and fetal surgery.

[0205] In the above embodiment, the tissue between the upper jaw 14 or the cutter 15 and the lower jaw 116 can be coagulated from both sides. The split portion of the coaxial cable supplying microwaves to the end effector allows energy to be sent across multiple robot joints using a flexible cable without restricting the movement of the multiple joints.

[0206] In addition, by using a metal blade, the rigidity and shape can be freely designed. The forceps and medical devices having the end effector of the present invention can be used under MR image guidance, and microwave energy can be introduced not only under endoscopy and with robotic hands, but also in endovascular surgery and fetal surgery.

[0207] The embodiments of the present invention are illustrative in all respects, and the scope of the present invention includes all modifications within the meaning and scope of the claims. [Explanation of symbols]

[0208] 1,1A,1B,1X,1Y…forceps 10,10X…cutting mechanism 10c…End effector 11, 11X, 11Y…Main frame 11a...Reference axis 13a…Grip trigger handle 13b…Cutting trigger handle 14…Upper jaw 15…Cutting cutter 19…Spring 17...Gripping mechanism 18Y…Arm 20…Coaxial electrode 21...Central conductor 22...Semicircular insulator 23...Semicircular tube conductor 24a, 24b, 24c…(irradiation) electrode 30...Microwave transmitter 40…Coaxial cable 41…Central conductor 42...Insulator 43…Outer conductor 44…Insulating coating 51…Ratchet hook 111…Fixed handle frame 112…Reference frame 113…Ring section 115...Support shaft 116...lower jaw part 117…Tip support part 121,121Ya,121Yb…Top support shaft 122,122Xa,122Yb…Tip top support shaft 200...Remote surgery system 212, 212a...Robot arm assembly 220…Medical equipment 221...Surgical equipment B...Vessel

Claims

1. a gripping mechanism including a first gripping portion and a second gripping portion assembled so as to be openable and closable, and a gripping portion rotating means for rotating the first gripping portion toward the second gripping portion; a cutting mechanism including a cutting unit provided next to the first gripping unit and a cutting unit rotating means for rotating the cutting unit in the same direction as the rotation of the first gripping unit; In a state where the target portion is gripped by the gripping mechanism, the cutting mechanism rotates the cutting unit and joins the cutting unit to the second gripping unit, thereby cutting the target portion. cutting device.

2. a gripping mechanism including a first gripping portion and a second gripping portion assembled so as to be openable and closable, and a gripping portion rotating means for rotating the first gripping portion toward the second gripping portion; a cutting mechanism including a cutting unit provided next to the first gripping unit and a cutting unit rotating means for rotating the cutting unit in the same direction as the rotation of the first gripping unit; A rotation shaft that rotatably supports the first gripping portion and the cutting portion is provided for the second gripping portion, the gripping part rotating means is constituted by a gripping part moving means for moving a portion of the first gripping part pivotally supported by the pivot shaft at a predetermined distance from the pivot shaft, the cutting unit rotating means is composed of a cutting unit moving means for moving a portion of the cutting unit journaled by the rotating shaft at a predetermined distance from the rotating shaft, The gripping unit moving means and the cutting unit moving means are made of elongated members and are moved along the longitudinal direction of the elongated members; In a state where the first gripping part is rotated by the movement of the gripping part moving means in the longitudinal direction and the target part is gripped by the gripping mechanism, the cutting part is rotated by the movement of the cutting part moving means in the longitudinal direction and joined to the second gripping part, thereby cutting the target part. cutting device.

3. The elongated member is a flexible elongated member having flexibility. The cutter of claim 2.

4. The gripper moving means, which is made of the flexible long member, includes a first gripper moving means that is connected to one of two predetermined locations on the first gripper that are spaced a predetermined distance from the rotation shaft and moves the first gripper in a pulling direction in the longitudinal direction, and a second gripper moving means that is connected to the other predetermined location and moves the first gripper in the pulling direction in the longitudinal direction, The cutting section moving means, which is made of the flexible long member, includes a first gripping section moving means that is connected to one of two predetermined locations at a predetermined distance from the rotation shaft in the cutting section and moves the cutting section in the pulling direction in the longitudinal direction, and a second gripping section moving means that is connected to the other predetermined location and moves the cutting section in the pulling direction in the longitudinal direction. The cutter of claim 3.

5. The gripping unit moving means and the cutting unit moving means, which are made of the flexible elongated member, move a predetermined portion in a pulling direction in the longitudinal direction, The gripping biasing portion biases the first gripping portion in a direction in which the predetermined portion moves in the push-in direction in the longitudinal direction, and the cutting biasing portion biases the cutting portion in a direction in which the predetermined portion moves in the push-in direction. The cutter of claim 3.

6. The gripping unit moving means and the cutting unit moving means move the predetermined portion in the pushing direction and the pulling direction in the longitudinal direction. The cutter of claim 3.

7. The long member is a rod-shaped slide plate that slides in the longitudinal direction relative to a reference frame to rotate the first gripping portion or the cutting portion, A notification unit is provided that notifies an outside party of at least one of the rotation of the first gripping unit or the cutting unit relative to the second gripping unit by sliding the slide plate in the longitudinal direction relative to the reference frame on which the first gripping unit or the cutting unit rotates. A cutter according to any one of claims 2 to 6.

8. A notification amount adjustment means for adjusting the amount of notification by the notification unit is provided. The cutter of claim 7.

9. Electrodes for irradiating electromagnetic waves are provided at least one of a gripping portion for gripping the target site in the first gripping portion and a vicinity of a cutting blade in the cutting portion, and at a gripping portion for gripping the target site in the second gripping portion. A cutter according to any one of claims 2 to 8.

10. The electrode is A coaxial electrode includes a center electrode and an outer electrode surrounding the center electrode via an insulator, A coaxial cable connecting an irradiation device for irradiating the electromagnetic wave and the electrode is branched into a plurality of parallel branches, and the coaxial electrodes are electrically connected to the central conductor and the outer conductor of the coaxial cable, respectively.

10. The cutter of claim 9.

11. The coaxial electrodes are connected in opposite polarity to the coaxial cable. The cutter of claim 10.

12. A cutter according to any one of claims 2 to 11, a drive unit that drives the gripping unit moving means and the cutting unit moving means independently of each other; a medical robot connected to apply a drive signal to the drive unit. Healthcare system.

13. an input / output unit connected by wire and / or wirelessly to the cutting device according to any one of claims 2 to 11; an input unit for receiving an operation signal in real time; a computing unit that executes a predetermined operation program based on the operation signal; and an output unit for generating a gripping drive signal for gripping the target site with the first gripping unit and the second gripping unit by moving the gripping unit moving means in the longitudinal direction based on an output from the arithmetic unit, and / or a cutting drive signal for cutting the target site with the cutting unit by moving the cutting unit moving means in the longitudinal direction. robot.

14. The robot according to claim 13, The output unit provides a drive signal to an external drive unit that mechanically drives the cutter. Surgical medical robot.

15. A cutter according to any one of claims 2 to 11, a mounting portion for mounting at least the second gripping portion of the cutting device to a tip end of a robot arm; a gripper side connection part that is connected to a drive mechanism that drives the gripper moving means on the robot arm side; A cutting unit side connection part is provided on the robot arm side to connect with a drive mechanism that drives the cutting unit moving means. End effector.

16. A cutting device according to any one of claims 2 to 8, The target site is a biological tissue, A gripping operation unit that drives and operates the gripping unit moving means; a cutting operation unit that drives and operates the cutting unit moving means, The gripping operation unit is operated to grip the biological tissue with a first gripping unit and a second gripping unit, and the cutting operation unit is operated to cut the biological tissue with a cutting unit. forceps.

17. A cutting device according to any one of claims 9 to 11, The target site is a biological tissue, A gripping operation unit that drives and operates the gripping unit moving means; a cutting operation unit that drives and operates the cutting unit moving means, The gripping operation unit is operated to grip the biological tissue with a first gripping unit and a second gripping unit, irradiating electromagnetic waves from the electrodes to coagulate at least a portion of the biological tissue; The cutting operation unit is operated to cut the biological tissue with the cutting unit. forceps.

18. a gripping mechanism including a first gripping portion and a second gripping portion assembled so as to be openable and closable, and a gripping portion rotating means for rotating the first gripping portion toward the second gripping portion; a cutting mechanism including a cutting unit provided next to the first gripping unit and a cutting unit rotating means for rotating the cutting unit in the same direction as the rotation of the first gripping unit; A rotation shaft that rotatably supports the first gripping portion and the cutting portion is provided for the second gripping portion, the gripping part rotating means is constituted by a gripping part moving means for moving a portion of the first gripping part pivotally supported by the pivot shaft at a predetermined distance from the pivot shaft, the cutting unit rotating means is composed of a cutting unit moving means for moving a portion of the cutting unit journaled by the rotating shaft at a predetermined distance from the rotating shaft, The gripping unit moving means and the cutting unit moving means are made of elongated members and are moved along the longitudinal direction of the elongated members; A gripping side drive unit that drives the gripping unit moving means and a cutting side drive unit that drives the cutting unit moving means are provided, In a state in which the first gripping part is rotated by the gripping part moving means driven by the gripping side drive part and the target site is gripped by the gripping mechanism, The cutting unit is rotated by the cutting unit moving means driven by the cutting side drive unit, and the target site is cut by joining the cutting unit to the second gripping unit. robot.

19. a gripping mechanism including a first gripping portion and a second gripping portion assembled so as to be openable and closable, and a gripping portion rotating means for rotating the first gripping portion toward the second gripping portion; a cutting mechanism including a cutting unit provided next to the first gripping unit and a cutting unit rotating means for rotating the cutting unit in the same direction as the rotation of the first gripping unit; A rotation shaft that rotatably supports the first gripping portion and the cutting portion is provided for the second gripping portion, the gripping part rotating means is constituted by a gripping part moving means for moving a portion of the first gripping part pivotally supported by the pivot shaft at a predetermined distance from the pivot shaft, the cutting unit rotating means is composed of a cutting unit moving means for moving a portion of the cutting unit journaled by the rotating shaft at a predetermined distance from the rotating shaft, The gripping unit moving means and the cutting unit moving means are made of elongated members and are moved along the longitudinal direction of the elongated members; A gripping side drive unit that drives the gripping unit moving means and a cutting side drive unit that drives the cutting unit moving means are provided, In a state in which the first gripping part is rotated by the gripping part moving means driven by the gripping side drive part and the living tissue to be cut is gripped by the gripping mechanism, The cutting unit is rotated by the cutting unit moving means driven by the cutting side drive unit, and the living tissue is cut by joining the cutting unit to the second gripping unit. Portable surgical equipment.

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