Surgical assistive device

Abstract

To provide a surgical auxiliary instrument capable of easily performing buzzing by using an electric knife and a robot hand functioning as the electric knife.SOLUTION: A surgical auxiliary instrument (10) includes: a main shaft (11) whose one end (113) is inserted into a patient's body from outside the body through an opening of the patient's body, where at least part of the main shaft (11) is made of a flexible material; a conductive tip (12) provided at the one end (113); a connecting member (112) for connecting the tip (12) to the one end (113); and a grip part (13) provided on the connecting member (112) so as to protrude to a lateral side of the main shaft (11), the grip part (13) being gripped by a surgical instrument and being partially or entirely formed of a conductor conducting to the tip (12).SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a surgical aid for use in endoscopic surgery. [Background technology]

[0002] In surgeries such as cholecystectomy, colectomy, ovarian abscess removal, and total hysterectomy, a technique called laparoscopic surgery (or laparoscopic surgery) is widely used, which is performed by inserting a laparoscope, which is a type of endoscope, into the abdominal cavity. In laparoscopic surgery, an operator (e.g., a surgeon) inserts a laparoscope and surgical instruments for observing the abdominal cavity through artificial openings, which are small holes made in several places in the patient's abdomen, and performs surgery by operating the surgical instruments from outside the patient's body while viewing images of the abdominal cavity obtained by the laparoscope.

[0003] Examples of surgical instruments used in laparoscopic surgery as described above include electric scalpels (see Non-Patent Documents 1-3) and forceps. The electric scalpel can incise or stop bleeding of a patient's biological tissue depending on the magnitude of high-frequency current supplied to a conductive tip provided at the tip. In addition, the electric scalpel can perform buzzing, which is to connect the electric scalpel and other surgical instruments by contacting the conductive tip with another surgical instrument and supplying high-frequency current. In the following, buzzing is also used to refer to the process of connecting a surgical instrument that generates high-frequency current to a surgical instrument such as forceps made of a conductor, thereby connecting the surgical instrument that generates high-frequency current to the surgical instrument such as forceps. These surgical instruments are characterized in that they are operated from outside the patient's body, and are provided with a shaft that connects a handle portion operated by the surgeon outside the patient's body and a tip portion that is inserted into the patient's body. The main shaft provided in one embodiment of the present invention corresponds to the shaft.

[0004] Also, a robot that assists in laparoscopic surgery is known (see Non-Patent Document 4). This robot has multiple arms. A robot hand that functions as an electric scalpel, forceps, or the like is attached to the tip of each arm. The arm to which the robot hand that functions as an electric scalpel is attached is configured to be capable of supplying high-frequency current. By attaching the robot hand that functions as an electric scalpel to the arm that can supply high-frequency current, incision and hemostasis can be performed.

[0005] The robot hand described above is inserted into the abdominal cavity of a patient, and the surgeon operates the robot to perform surgery. Hereinafter, laparoscopic surgery using such a robot will also be referred to as robotic surgery.

[0006] The above-mentioned surgical instruments and robots can be applied to thoracoscopic surgery in addition to laparoscopic surgery. In thoracoscopic surgery, a thoracoscope, which is one type of endoscope, is inserted into the thoracic cavity to perform surgery. The above-mentioned surgical instruments and robots can also be applied to endoscopic surgical procedures other than laparoscopic surgery and thoracoscopic surgery. However, the following will be described with reference to laparoscopic surgery. [Prior art documents] [Non-patent literature]

[0007] [Non-Patent Document 1] [online], Medtronic, [Retrieved August 9, 2022], Internet <URL: https: / / www.medtronic.com / covidien / en-us / products / electrosurgical-instruments / laparoscopic-instruments.html> [Non-Patent Document 2] [online], Ethicon endo Surgery, [Retrieved August 9, 2022], Internet〈URL:https: / / www.ethicon.jp / products / energy / probeplusII.html〉 [Non-Patent Document 3] [online], CONMED, [Retrieved August 9, 2022], Internet <URL: https: / / www.conmed.com / en-DE / Products / Surgical-and-Medical-Instruments / Suction-Irrigation-and-Tubing / suctionirrigation / universal-plus-handpieces-and-reusable-electrodes> [Non-Patent Document 4] [online], Intuitive Surgical, [Retrieved August 9, 2022], Internet <URL: https: / / www.intuitive.com / en-us / products-and-services / da-vinci> Summary of the Invention [Problem to be solved by the invention]

[0008] However, electric scalpels and robot hands that function as electric scalpels are designed primarily for the purpose of cutting biological tissue, and therefore are not suitable for buzzing. In other words, it is difficult to perform buzzing using electric scalpels and robot hands that function as electric scalpels.

[0009] A surgical assist instrument according to one aspect of the present invention has been made in consideration of the above-mentioned problems, and its purpose is to provide a surgical assist instrument that can easily perform buzzing using an electric scalpel and a robot hand that functions as an electric scalpel. [Means for solving the problem]

[0010] The surgical assistant instrument according to the first aspect of the present invention is a surgical assistant instrument used in endoscopic surgery. In order to solve the above problems, the surgical assistant instrument includes a main shaft, one end of which is inserted from outside the patient's body into the patient's body through an opening in the patient's body, at least a part of which is made of a flexible material, a conductive tip provided at the one end, a connecting member connecting the tip to the one end, and a gripping part provided at the connecting part so as to protrude to the side of the main shaft, which is gripped by a surgical instrument, and the gripping part is partially or entirely made of a conductor electrically connected to the tip.

[0011] According to the above configuration, by grasping the portion made of a conductor in the gripping portion using a surgical instrument capable of supplying high-frequency current (e.g., an electric scalpel, a robot hand functioning as an electric scalpel, etc.), buzzing can be easily performed using a conductive tip that is conductive to the gripping portion.

[0012] In addition, in this surgical auxiliary tool, at least a part of the main shaft is made of a flexible material, which has the secondary effect of making interference between the main shaft and the arm less likely to occur compared to when the main shaft is made of a rigid shaft.

[0013] In addition, when the surgical support instrument is not used for buzzing, it can be placed anywhere in the abdominal cavity. As described above, since at least a part of the main shaft of the surgical support instrument is made of a flexible material, it has the secondary effect of increasing the degree of freedom when placed in the abdominal cavity.

[0014] In addition, in the surgical support instrument according to the second aspect of the present invention, in addition to the configuration of the surgical support instrument according to the first aspect described above, the tip has a shape of a rotating body.

[0015] According to the above-mentioned configuration, the tip of the surgical auxiliary instrument can increase the area of ​​contact with the affected area or tissue near the affected area in the abdominal cavity. The tip configured in this way is suitable for buzzing.

[0016] Furthermore, in a surgical auxiliary instrument according to a third aspect of the present invention, in addition to the configuration of the surgical auxiliary instrument according to the first or second aspect described above, a configuration is adopted in which the surgical auxiliary instrument further comprises a cylindrical guide whose length is shorter than the main shaft and whose inner surface slides along the outer surface of the main shaft, the guide being made of a material that is less flexible than a flexible material that constitutes at least a portion of the main shaft.

[0017] According to the above configuration, the flexibility of the spindle can be temporarily reduced by sliding the guide toward one end of the spindle, so that the surgeon or assistant surgeon located near the patient can easily move one end of the spindle to a desired position.

[0018] Furthermore, in a surgical auxiliary instrument according to a fourth aspect of the present invention, in addition to the configuration of the surgical auxiliary instrument according to any one of the first to third aspects described above, a configuration is adopted in which the main shaft is provided with a through hole that connects from the one end to the other end, the other end being connected to an exhaust pipe.

[0019] According to the above configuration, by connecting an exhaust mechanism to the other end of the through hole, gas and mist present in the abdominal cavity can be exhausted from one end of the main shaft. That is, when the affected area is treated using this surgical auxiliary tool, an exhaust port can be provided in the immediate vicinity of the affected area. Therefore, gas and mist that may occur in the affected area during buzzing can be efficiently exhausted, and the abdominal cavity can be prevented from being filled with these gases and mist, so that the laparoscope can capture a clearer image of the abdominal cavity. In addition, gas and mist can also occur in the abdominal cavity when the affected area is incised. Since this surgical auxiliary tool can be placed near the affected area even when it is not used for buzzing, gas and mist that may occur during incision can also be suppressed.

[0020] An example of the exhaust mechanism is an exhaust line installed in an operating room. If an exhaust line is not installed in an operating room, a pump such as a vacuum pump can be used as the exhaust mechanism.

[0021] Furthermore, in the surgical support instrument according to the fifth aspect of the present invention, in addition to the configuration of the surgical support instrument according to any one of the first to fourth aspects described above, a configuration is adopted which further includes an opening and closing mechanism for controlling exhaust from the exhaust pipe.

[0022] According to the above configuration, the exhaust through the exhaust pipe can be controlled by the opening and closing mechanism. Therefore, the surgeon who is located near the patient can adjust the timing of the exhaust by himself / herself without asking the assistant for help. Therefore, this surgical assistant tool is suitable for endoscopic surgery that is not a robotic surgery.

[0023] Furthermore, in the surgical support instrument according to the sixth aspect of the present invention, in addition to the configuration of the surgical support instrument according to any one of the first to fifth aspects described above, a configuration is adopted in which, at the other end, a cleaning fluid pipe for supplying cleaning fluid and a suction pipe for sucking liquid are connected to the through hole, together with the exhaust pipe.

[0024] According to the above configuration, the surgical auxiliary instrument can be provided with a cleaning function and a suction function, and therefore the number of surgical instruments to be inserted into the abdominal cavity, the number of arms, or the frequency of arm replacement can be reduced.

[0025] Furthermore, in the surgical support instrument according to the seventh aspect of the present invention, in addition to the configuration of the surgical support instrument according to any one of the first to sixth aspects described above, a configuration is adopted in which a section including the one end of the main shaft is made of a material having higher flexibility than other sections of the main shaft, and a bending adjustment mechanism is further provided for arbitrarily adjusting the bending of the section.

[0026] According to the above configuration, the surgeon can use the bending adjustment mechanism to bend a section including one end of the main shaft as desired. Therefore, the surgical auxiliary tool can further increase the accuracy when moving one end of the main shaft to a desired position. Effect of the Invention

[0027] A surgical assistant instrument according to one aspect of the present invention can easily perform buzzing using an electric scalpel and a robot hand that functions as an electric scalpel. [Brief description of the drawings]

[0028] [Figure 1] FIG. 1A is a perspective view of a surgical assistant instrument according to one embodiment of the present invention, and FIG. 1B is a cross-sectional view of a main shaft of the surgical assistant instrument shown in FIG. [Diagram 2] FIG. 2 is a perspective view of a tip and a gripping portion provided on the surgical auxiliary instrument shown in FIG. [Diagram 3] FIG. 2 is a perspective view of a modified example of a grip provided in the surgical auxiliary instrument shown in FIG. [Figure 4] FIG. 1(a) is a schematic diagram of laparoscopic surgery using the surgical auxiliary instrument shown in FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0029] [Overview of surgical support equipment] In a surgical procedure (hereinafter also referred to as "endoscopic surgery") in which an endoscope and surgical instruments are inserted from outside the patient's body into the patient's body through an opening in the patient's body, the surgeon (e.g., a surgeon) performs surgery using multiple surgical instruments while viewing an image of the inside of the body (e.g., an affected area) obtained by the endoscope. The opening in the patient's body is preferably an artificial opening provided on the surface of the patient's body for the endoscopic surgery. The opening in the patient's body may also be a natural opening such as the mouth, anus, urethra, nose, or ear. The surgical auxiliary instrument 10 is a surgical instrument suitable for use in combination with an endoscope in such an endoscopic surgery. Specific examples of endoscopes include a laparoscope, a thoracoscope, a hysteroscope, a ureteroscope, a thyroid endoscope, a breast endoscope, and an arthroscope. Specific examples of endoscopes inserted into the body through a natural opening include an upper gastrointestinal endoscope, a lower gastrointestinal endoscope, a pharyngoscope, an otoscope, and a nasal mirror. An upper gastrointestinal endoscope is also called a gastroscope, and a lower gastrointestinal endoscope is also called a colonoscope or a colonoscope. However, the endoscope used in combination with the surgical assist instrument 10 is not limited to the exemplified endoscope, and can be selected as appropriate. In this embodiment, the surgical assist instrument 10 will be described taking laparoscopic surgery, which is one aspect of an endoscope, as an example. However, in one aspect of the present invention, the surgical assist instrument 10 can be used in all cases except when used in combination with a laparoscope and when used in combination with a thoracoscope. That is, in one aspect of the present invention, the surgical assist instrument 10 can be used in all cases except when used in laparoscopic surgery and when used in thoracoscope.

[0030] In this embodiment, the surgical auxiliary instrument 10 has a smoke exhaust function, a cleaning function, and a suction function. The smoke exhaust function is a function for exhausting at least one of gas and mist in the abdominal cavity. The cleaning function is a function for cleaning the abdominal cavity by ejecting a cleaning liquid. The suction function is a function for sucking liquid present in the abdominal cavity.

[0031] [Configuration of surgical support equipment] The configuration of a surgical assistant tool 10 according to one embodiment of the present invention will be described with reference to Figs. 1(a), 1(b), 2, and 3. Fig. 1(a) is a perspective view of the surgical assistant tool 10. Fig. 1(b) is a cross-sectional view of a main shaft 11 provided in the surgical assistant tool 10. Fig. 1(b) is a cross-sectional view that is a cross-section perpendicular to the central axis of the main shaft 11, and passes through the line A-A' shown in Fig. 1(a). Fig. 2 is a perspective view of a tip 12 and a gripping portion 13 provided in the surgical assistant tool 10.

[0032] As shown in FIG. 1( a ), a surgical auxiliary instrument 10 includes a main shaft 11 , a tip 12 , a holding portion 13 , a guide 14 , a connector 15 , a grip 16 , an exhaust pipe 17 , a cleaning pipe 18 , and a suction pipe 19 .

[0033] <Main shaft> As shown in FIG. 1( a ), the main shaft 11 includes a main tube 111 and a connecting member 112 .

[0034] (Main Tube) The main tube 111 constituting the main part of the main shaft 11 is a cylindrical and flexible tube. The material constituting the main tube 111 may be any flexible material, and is preferably a resin material. A specific example of a resin material is polyvinyl chloride. However, the material constituting the main tube 111 is not limited to resin, and can be appropriately selected from among flexible materials.

[0035] In this embodiment, a tube configured to be entirely flexible is adopted as the main tube 111. However, in one aspect of the present invention, it is sufficient that at least a part of the main tube 111 is flexible. When a part of the main tube 111 is configured from a flexible material and the remaining part of the main tube 111 is configured from a rigid material, it is preferable that a part including an end portion 113 described later is configured from a flexible material. In this case, the length of the part can be appropriately determined, but is preferably, for example, less than half the length of the main tube 111 (for example, 700 mm as described later). By configuring the main tube 111 in this way, it is possible to provide flexibility to the main tube 111 inserted into the abdominal cavity, while providing rigidity to most of the main tube 111 located outside the body. By providing flexibility to the entire main tube 111 or at least a part of the main tube 111, it is possible to bend the flexible part of the main tube 111. Therefore, the surgical auxiliary tool 10 can prevent the main tube 111 from being included in the angle of view of the laparoscope when the surgeon places the tip 12 in the abdominal cavity. When a portion of the main tube 111 including the end portion 113 is made flexible, the position of the tip 12 in the abdominal cavity can be easily adjusted from outside the abdominal cavity (i.e., outside the patient's body) compared to when the entire section of the main tube 111 is made flexible.

[0036] When a section including the end 113 is made of a flexible material, the surgical auxiliary instrument 10 preferably includes a bending adjustment mechanism for adjusting the bending degree of the main tube 111 in that section. One example of this bending adjustment mechanism includes a wire and a winding mechanism for adjusting the tension of the wire. In this bending adjustment mechanism, the distal end of the wire is fixed near the end 113, and the middle section of the wire is wound in the internal space of the main tube 111 (hereinafter, referred to as the through hole T). HThe wire is routed along a line extending from the end of the wire to the end of the grip 16. The proximal end of the wire is fixed to a winding mechanism, which is fixed to a grip 16, which will be described later. The winding mechanism may be a manual type that uses a lever to wind the wire, or an automatic type that uses a motor to wind the wire.

[0037] When the winding mechanism is not winding the wire, the main tube 111 remains straight. On the other hand, as the winding mechanism winds the wire, the vicinity of the end 113 to which the distal end of the wire is fixed is pulled toward the grip 16. As a result, a portion of the main tube 111 made of a flexible material bends according to the length of the wire wound by the winding mechanism.

[0038] Such a bending adjustment mechanism can bend a partial section of the main tube 111 in one direction. Therefore, by providing a plurality of such bending adjustment mechanisms for the surgical auxiliary instrument 10, the partial section of the main tube 111 can be bent in a plurality of directions.

[0039] The outer diameter of the main tube 111 may be appropriately determined according to the inner diameter of a trocar used when inserting the tip 12 of the surgical support instrument 10 into the abdominal cavity in laparoscopic surgery. The trocar is an instrument inserted into an artificial opening provided in the patient's body, and is an instrument that connects the outside and inside of the patient's body. The surgical support instrument 10 inserts the tip 12 into the abdominal cavity from the outside of the body through the trocar. For example, when the surgical support instrument 10 is inserted into the abdominal cavity using a trocar with an inner diameter of 5 mm, the outer diameter of the main tube 111 is preferably about 4 mm. This is because, in the case of the surgical support instrument 10, a guide 14, which will be described later, is further provided on the outside of the main tube 111, and the outer diameter of the guide 14 is required to be less than the inner diameter of the trocar (for example, 5 mm). When the guide 14 is omitted, the outer diameter of the main tube 111 can be appropriately determined within a range of less than 5 mm. When a trocar is not used in laparoscopic surgery, the tip 12 may be directly inserted into the artificial opening or natural opening. In this case, the outer diameter of the main tube 111 can be arbitrarily determined according to the size of the artificial opening or natural opening.

[0040] The length of the main tube 111 is not limited and can be determined appropriately. In this embodiment, the length of the main tube 111 is 700 mm. When the surgical auxiliary instrument 10 is used in laparoscopic surgery on adults, the length of the main tube 111 is preferably 600 mm or more and 1000 mm or less.

[0041] In addition, one end of the main tube 111, which is an end adjacent to the tip 12 described later, is referred to as end 113. In FIG. 1(a), the end 113 is covered by a connecting member 112 described later and cannot be seen. Therefore, in FIG. 1(a), the lead line of the reference numeral 113 is illustrated by a dashed line. In addition, in the main tube 111, the other end is located inside a grip body 161 of a grip 16 described later via a connector 15 described later. In the following, a portion near the other end and inserted into the connector 15 is referred to as a connection portion 114.

[0042] The other end of the main tube 111 is connected to an exhaust pipe 17, a cleaning pipe 18, and a suction pipe 19 via a three-way connector inside the grip body 161. The exhaust pipe 17 is an example of an exhaust pipe.

[0043] The connection member 112 has a cylindrical shape and is made of a conductor. The connection member 112 is fixed in a state of being placed over the main tube 111 so as to cover the end portion 113. In this embodiment, the connection member 112 is made of copper. In this embodiment, the connection member 112 is fixed to the main tube 111 by crimping. However, the conductor constituting the connection member 112, the length of the connection member 112, and the method of fixing the connection member 112 to the main tube 111 are not limited and can be appropriately determined. Note that the conductor constituting the connection member 112 is preferably a metal with high conductivity, and examples of such metals include aluminum and stainless steel in addition to the above-mentioned copper.

[0044] The tip 12 is provided at the end 113 of the main tube 111 .

[0045] (Internal structure of the spindle) As shown in FIG. 1(b), the main shaft 11 has a through hole T penetrating from the end 113 to the other end. H is provided. (Modification of the spindle) As described above, the main shaft 11 has a through hole T H However, at least a part of the main shaft 11 is made of a flexible material, and the through hole T H For example, the main shaft 11 may be a columnar member having flexibility and provided with a through hole for exhaust, a through hole for suction, and a through hole for cleaning. H The sub-tube may be configured to accommodate an exhaust sub-tube, a suction sub-tube, and a cleaning sub-tube.

[0046] <Tip> 2, the tip 12 is provided at an end 113 of the main tube 111, the end 113 being covered by a connecting member 112. The tip 12 is fixed to the connecting member 112.

[0047] The tip 12 has a shape of a rotating body. In this embodiment, the tip 12 has a bullet shape as shown in Fig. 2 as an example of the rotating body, but the shape of the tip 12 is not limited to this. A specific example of the rotating body is a sphere.

[0048] The diameter of the tip 12 is appropriately determined according to the inner diameter of the trocar. Here, the diameter of the tip 12 means the diameter of the transverse section (cross section perpendicular to the axis of rotation of the tip 12) of the tip 12, which is a rotating body. For example, when a trocar with an inner diameter of 8 mm is used, the diameter of the tip 12 may be less than 8 mm. In this embodiment, the diameter of the tip 12 is 7 mm. When a trocar is not used, the diameter of the tip 12 can be arbitrarily determined according to the size of the artificial opening.

[0049] In this embodiment, aluminum is used as the material of the tip 12. That is, in this embodiment, the tip 12 is a bullet-shaped conductive tip. The conductor constituting the tip 12 is not limited to aluminum, and can be appropriately selected from among conductors.

[0050] The chip 12 is provided with one cleaning / suction port 121 and multiple exhaust ports 122 (see FIG. 2).

[0051] (Irrigation and suction port) The cleaning and suction port 121 is a through hole provided so as to pass through the center of the bullet-shaped tip 12 and penetrate the tip 12. The cleaning and suction port 121 communicates the internal space of the main tube 111 with the external space of the main tube 111. The opening 121a of the pair of openings of the cleaning and suction port 121, which is farther from the connection member 112, is located at the tip of the tip 12. The opening of the pair of openings of the cleaning and suction port 121, which is closer to the connection member 112, is connected to the end 113 of the main tube 111 inside the connection member 112. This opening is not shown in FIG. 2, so the reference numeral is omitted. The tip 12 is fixed to the end 113 so that the through hole constituting the cleaning and suction port 121 is parallel to the central axis of the main tube 111.

[0052] The irrigation and suction port 121 can eject irrigation liquid supplied using the irrigation pipe 18 and the main tube 111 in a direction along the central axis of the main tube 111, and can also suck up liquid present in the abdominal cavity using the main tube 111 and the suction pipe 19.

[0053] (Exhaust port) The exhaust port 122 is composed of a plurality of through holes arranged isotropically so as to surround the cleaning and suction port 121. The through holes of the exhaust port 122, like the through holes of the cleaning and suction port 121, communicate the internal space of the main tube 111 with the external space of the main tube 111.

[0054] Of the pair of openings of each through hole constituting the exhaust port 122, the opening 122a on the side farther from the connecting member 112 is provided around the opening 121a of the cleaning suction port 121. Of the pair of openings of each through hole constituting the exhaust port 122, the opening on the side closer to the connecting member 112 is connected to the end 113 of the main tube 111.

[0055] The openings 122a of the exhaust port 122 are provided so that the normal line of each opening 122a intersects with the rotation axis of the tip 12, that is, the normal line of each opening 122a is radial. With this configuration, even if some of the multiple openings 122a are blocked due to contact with the affected area, the remaining openings 122a remain open. Therefore, by using the tip 12 configured in this manner, it is possible to prevent a situation in which all openings 122a are blocked and exhaust is not possible.

[0056] The exhaust port 122 can exhaust at least one of gas and mist that may be generated in the abdominal cavity during surgery near the location where the gas and / or mist is generated. Therefore, the surgical auxiliary instrument 10 can exhaust at least one of gas and mist more efficiently than conventional methods.

[0057] <Gripping part> 2, grip portion 13 is a tubular member fixed to a part of the side surface of cylindrical connection member 112. In this embodiment, the cross-sectional shape of grip portion 13 is elliptical. However, the cross-sectional shape of grip portion 13 is not limited to elliptical and can be determined appropriately.

[0058] 1(a), end 113 is fixed to the side of connecting member 112 so that its axial direction (the normal direction to the bottom surface of end 113) is approximately parallel to the direction of the central axis of connecting member 112 (i.e., the direction of the central axis of main tube 111). Therefore, in a state in which connecting member 112 is fixed to main tube 111 so that connecting member 112 covers end 113, gripping portion 13 is provided on connecting member 112 so as to protrude to the side of main shaft 11. Furthermore, gripping portion 13 is cylindrical in shape and contacts the upper portion of connecting member 112.

[0059] Moreover, gripping portion 13 is made of a conductor. In this embodiment, gripping portion 13 is made of copper like connecting member 112, and is integrally molded with connecting member 112. Therefore, gripping portion 13 is electrically connected to connecting member 112, and is also electrically connected to chip 12.

[0060] <Guide> As shown in Fig. 1(a), the guide 14 is a cylindrical pipe whose length is shorter than the main shaft 11. In this embodiment, the length of the guide 14 is 400 mm. When the surgical auxiliary instrument 10 is used in laparoscopic surgery on adults, the length of the guide 14 is preferably 300 mm or more and 500 mm or less.

[0061] The guide 14 is configured so that its inner diameter is slightly larger than the outer diameter of the main tube 111. Also, the guide 14 is configured so that its outer diameter is smaller than the inner diameter of the trocar (for example, 5 mm).

[0062] The guide 14 is made of a material that is less flexible than the flexible material that constitutes the main shaft 11 (main tube 111 in this embodiment). In this embodiment, polycarbonate with a thickness of 2.0 mm is used as the material of the guide 14. However, the material of the guide 14 is not limited to this, and any material that is less flexible than the main tube 111 may be used. Specific examples of the material of the guide 14 include silicone, ethylene propylene rubber, and stainless steel in addition to the above-mentioned polycarbonate.

[0063] The guide 14 has lower flexibility than the main tube 111. Therefore, when a force acting in a direction that bends the main tube 111 acts, which may occur when moving the tip of the tip 12 during surgery, the degree to which the guide 14 bends is less than the degree to which the main tube 111 bends.

[0064] The guide 14 is disposed such that its inner surface surrounds the outer surface of the main tube 111. That is, the main tube 111 penetrates the internal space of the guide 14. Therefore, the guide 14 is configured such that its inner surface can slide along the outer surface of the main tube 111 in the direction of the arrow B shown in FIG. 1(a) (the direction of the central axis of the main tube 111).

[0065] In this embodiment, a pipe of a certain length is used as the guide 14. However, in one aspect of the present invention, the guide 14 may be an expandable pipe, and the end of the guide 14 close to the connector 15 may be fixed to the main tube 111. By moving the end of the guide 14 farther from the connector 15 in a direction approaching the tip 12, the exposed portion of the main tube 111 can be reduced, and the unflexible portion of the main tube 111 can be increased.

[0066] Furthermore, if the guide 14 is designed so that the length of the guide 14 when fully extended is approximately the same as the length of the main tube 111, it is possible to cover almost the entire main tube 111 with the guide 14. In this state, the surgeon or surgical assistant positioned near the patient can move one end 113 of the main shaft 11 to a desired position with greater precision.

[0067] From the viewpoint of hygiene, it is preferable that the main shaft 11, tip 12, gripping portion 13, guide 14, and connector 15 among the components constituting the surgical auxiliary instrument 10 are disposable items that are disposed of after each surgery. It is also preferable that the main shaft 11, tip 12, gripping portion 13, guide 14, and connector 15 are preassembled products that are assembled in a factory.

[0068] <Grip> As shown in FIG. 1( a ), the grip 16 includes a grip body 161 , a cleaning button 162 , and a suction button 163 .

[0069] In this embodiment, the grip body 161 has a cylindrical shape, but is not limited to this. In this embodiment, a resin material is used as the material constituting the grip body 161, but is not limited to this. The material constituting the grip body 161 may be, for example, a metal material. The grip body 161 is held by the surgeon or the surgical assistant when operating the surgical assistant instrument 10.

[0070] In addition, an exhaust pipe 17, a cleaning pipe 18 and a suction pipe 19 are inserted into the internal space of the grip body 161.

[0071] When using the surgical auxiliary instrument 10, (1) the exhaust pipe 17 is connected to an exhaust port (e.g., an exhaust port of an insufflation device) provided in the operating room, (2) the cleaning pipe 18 is connected to a cleaning liquid supply port provided in the operating room, and (3) the suction pipe 19 is connected to a liquid suction port provided in the operating room.

[0072] A cleaning button 162 and a suction button 163 are provided in a straight line on the outer surface of the grip body 161. In this embodiment, the cleaning button 162 is disposed closer to the spindle 11 than the suction button 163, but the positional relationship between the cleaning button 162 and the suction button 163 is not limited to this.

[0073] The cleaning button 162 is related to the cleaning function of the surgical auxiliary instrument 10. When the cleaning button 162 is pressed, the cleaning pipe 18 and the through hole T H The washing liquid is discharged from the washing and suction port 121 of the tip 12 via the nozzle.

[0074] The suction button 163 is related to the suction function of the surgical auxiliary instrument 10. When the suction button 163 is pressed, the suction pipe 19 and the through hole T H Through this, liquid present in the abdominal cavity can be aspirated from the irrigation and suction port 121 of the chip 12.

[0075] The grip body 161 may also be provided with an opening / closing mechanism for controlling the exhaust from the exhaust pipe 17, and a button or dial for controlling this opening / closing mechanism.

[0076] In this embodiment, the above-mentioned opening and closing mechanism is preferably a valve that completely opens or completely closes the inner cavity of the exhaust pipe 17. However, the present invention is not limited to this, and the above-mentioned opening and closing mechanism may be, for example, a valve.

[0077] (Modified grip) A grip 16A, which is a modified example of the grip 16, will be described with reference to Fig. 3. Fig. 3 is a perspective view of the grip 16A. As shown in Fig. 3, the grip 16A includes a grip body 161A, a cleaning button 162A, and a suction button 163A. The grip 16A is shaped like a pistol, and the cleaning button 162A and the suction button 163A are arranged side by side at the bent portion of the grip body 161A. The functions of the grip body 161A, the cleaning button 162A, and the suction button 163A correspond to the functions of the grip body 161, the cleaning button 162, and the suction button 163 of the grip 16, respectively. The grip 16A is connected to the spindle 11 by a connector 15.

[0078] <Connector> The connector 15 is a member for connecting the spindle 11 to the grip 16. In this embodiment, the connector 15 includes a spindle holder 151 and a rotation knob 152, as shown in FIG.

[0079] The shape of the spindle holding part 151 is cylindrical. In this embodiment, a resin material is used as the material constituting the spindle holding part 151, but the material is not limited to this. The material constituting the spindle holding part 151 may be, for example, a metal material.

[0080] The connecting portion 114 of the main tube 111 is inserted into the through hole of the main shaft holding portion 151 and fixed therein.

[0081] In connector 15, spindle holding portion 151 is fitted into grip 16, thereby connecting spindle 11 and grip 16.

[0082] The rotation knob 152 is a tubular member that is attached to the spindle holder 151 in a state that it can rotate about its axis. By rotating the rotation knob 152, the direction of the spindle 11 can be adjusted.

[0083] In addition, in the surgical auxiliary instrument 10, in addition to the assembly of the main shaft 11, the tip 12, the gripping portion 13, the guide 14, and the connector 15, an assembly of a conventional straight shaft main shaft and the connector 15 can be connected to the grip 16 for use. In this case, it is preferable that the assembly of the conventional straight shaft main shaft and the connector 15 is also disposable. The assembly of the main shaft 11, the tip 12, the gripping portion 13, the guide 14, and the connector 15 may be sold as a package product including the assembly of the conventional straight shaft main shaft and the connector 15 and the grip 16, or may be sold as a refill product in which both assemblies are set, or may be sold as a single refill product.

[0084] (Modification of the function of surgical support instruments) In one embodiment of the surgical assistant instrument 10, at least one of the exhaust function, cleaning function, and suction function may be omitted. In one embodiment of the surgical assistant instrument 10, when at least one of the exhaust function, cleaning function, and suction function is omitted, the pipe corresponding to the omitted function among the above-mentioned exhaust pipe 17, cleaning pipe 18, and suction pipe 19 may be omitted. This allows the surgical assistant instrument 10 to be made smaller and lighter.

[0085] [Examples of use of surgical support equipment]

[0086] (Example of gripping part usage) The gripping portion 13 as described above is gripped by various surgical instruments used in laparoscopic surgery, and is configured to be able to supply high-frequency current to the tip. For example, in laparoscopic surgery, when a robot that supports laparoscopic surgery is used, the arm of the robot and the robot hand R shown in FIG. H In this embodiment, the robot hand R H The robot hand R is equipped with a pair of claws Cr at the tip of the hand. H The pair of claws Cr is inserted into the internal space of the gripping portion 13, and the robot is operated to open the pair of claws Cr to form the robot hand R. H The operator can thus hold the tip 12 via the gripping portion 13 fixed to the pair of claws Cr, and the robot hand R H In this embodiment, a robot hand R having a pair of claws Cr is used as a surgical instrument for gripping the gripping portion 13. H is taken as an example, but the present invention is not limited thereto. Any surgical instrument capable of opening and closing the tip like a pair of claws Cr may be used, and the gripping portion 13 may be gripped by an electric scalpel, a surgical manipulator, forceps, or the like. Even when a surgical manipulator or forceps is used, the gripping portion 13 is held in the same manner by opening the tip (e.g., a claw or scissors) inserted into the internal space of the gripping portion 13.

[0087] The gripping portion 13 can perform buzzing by supplying a high-frequency current to the tip of a surgical instrument holding the gripping portion 13. For example, if the surgical instrument holding the gripping portion 13 is a robot hand R having a pair of claws Cr at its tip, H A robot hand R capable of supplying high frequency current HIn this case, the operator of the robot can perform buzzing by holding the gripping portion 13 with the claws Cr and supplying a high-frequency current to the claws Cr, as described above. In the case where the surgical instrument holding the gripping portion 13 is an electric scalpel, the operator can perform buzzing by supplying a high-frequency current from the electric scalpel.

[0088] (Example of use for tip position control) In addition to the above-mentioned example of using the gripping portion 13 to control the position of the tip 12, there is also an example of using the guide 14. In the example of using the guide 14, the surgeon or surgical assistant positioned near the patient moves the guide 14 in a direction approaching the tip 12 to temporarily reduce the flexibility of the main tube 111. Then, the grip 16 can be operated to move the tip 12 to a desired position. Furthermore, when the main tube 111 is equipped with the bending mechanism described above, the bending mechanism may be used in addition to the position control using at least one of the gripping portion 13 and the guide 14. For example, at least one of the gripping portion 13 and the guide 14 may be used to move the tip 12 to the vicinity of a desired position, and then the bending mechanism may be used to perform more precise position control of the tip 12. (Example of the use of surgical support instruments in laparoscopic surgery) An example of how the surgical assistant tool 10 is used in laparoscopic surgery will be described with reference to Fig. 4. Fig. 4 is a schematic diagram of laparoscopic surgery in which the surgical assistant tool 10 is used in conjunction with a laparoscope L.

[0089] As shown in FIG. 4, in such laparoscopic surgery, an imaging element provided at the tip of a laparoscope L captures images of the abdominal cavity C of a patient P through a trocar Tr1 inserted into an opening A. A The image sensor captures the abdominal cavity C. A The moving image of the inside of the abdominal cavity C is displayed on a monitor M placed in the operating room. The surgeon or the assistant surgeon can see the abdominal cavity C displayed on the monitor M. A Laparoscopic surgery is performed while referring to moving images of the inside of the body.

[0090] When performing laparoscopic surgery, the surgeon or assistant surgeon inserts the surgical assistant instrument 10 and the forceps F together with the laparoscope L into the abdominal cavity C. A Specifically, the tip 12 provided at the end 113 of the main tube 111 of the surgical auxiliary instrument 10 is inserted into the abdominal cavity C through the trocar Tr2 inserted into the opening A. A The forceps F are inserted into the abdominal cavity C through the trocar Tr3 inserted into the opening A. A Insert it inside.

[0091] Here, the surgeon or the surgical assistant slides the guide 14 toward the end 113 of the main tube 111 so that the portion of the main tube 111 covered by the guide 14, i.e., the vicinity of the end 113 of the main tube 111, does not bend. In this state, the surgeon or the surgical assistant moves the tip 12 to a desired position.

[0092] After moving the tip 12 to the desired position, the surgeon or surgical assistant slides the guide 14 toward the connection part 114 of the main tube 111 (see FIG. 1(a)). This allows the surgeon or surgical assistant to bend the part of the main tube 111 that is not covered by the guide 14. In this state, the surgeon or surgical assistant bends the part of the main tube 111 that is not covered by the guide 14 as appropriate, and moves it within the abdominal cavity CA. While watching the moving image of the inside of the abdominal cavity CA displayed on the monitor M, the surgeon or surgical assistant moves the part of the main tube 111 that is not covered by the guide 14, and adjusts it so that the main tube 111 is not included in the angle of view of the laparoscope L.

[0093] As described above, in the surgical assistant instrument 10, the guide 14 can be slid toward the end 113 of the main tube 111 to prevent the portion of the main tube 111 covered by the guide 14, i.e., the vicinity of the end 113 of the main tube 111, from bending. This makes the main tube 111 behave as if it were a rigid shaft with no flexibility, allowing the surgeon or surgical assistant to easily move the tip 12 to a desired position.

[0094] In addition, in the surgical auxiliary instrument 10, by sliding the guide 14 toward the connecting portion 114 of the main tube 111, the portion of the main tube 111 that is not covered by the guide 14 can be made bendable. This allows the portion of the main tube 111 that is not covered by the guide 14 to be bent, and the abdominal cavity C A Therefore, the main tube 111 can be prevented from being included in the angle of view of the laparoscope L.

[0095] Here, the trocar Tr3 is connected to the insufflation device D via the air supply pipe PL1. P The insufflation port P1 of the trocar Tr1 is connected to the insufflation device D via the suction pipe PL2. P The suction port P2 of the suction port P1 is connected to the suction port P2 of the suction port

[0096] By inserting a Y-shaped connector in the middle of the suction pipe PL2, B The branch point P B The exhaust pipe 17 of the surgical auxiliary instrument 10 is connected to the insufflation device D. P Using the suction port P2, not only exhaust from the trocar Tr1 but also exhaust from the washing and suction port 121 of the tip 12 is performed.

[0097] In addition, insufflation device D P C AThe amount of air sent and the amount of suction are adjusted so that the pressure inside the trocar Tr1 becomes a preset pressure. Therefore, in this example of use, even when exhaust is performed from the irrigation and suction port 121 of the tip 12 in addition to exhaust from the trocar Tr1, the abdominal cavity C A The internal pressure can be maintained at a preset pressure.

[0098] [Additional Notes] The present invention is not limited to the above-described embodiments, and various modifications are possible within the scope of the claims. Embodiments obtained by appropriately combining the technical means disclosed in different embodiments are also included in the technical scope of the present invention. [Explanation of symbols]

[0099] 10 Surgical aids 11 Spindle 111 Main Tube 112 Connection member 113 End (one end) 114 Connection (between the main shaft 11 and the connector 15) T H Through hole 12 Chips 13 Grip part 14 Guide 15 Connector 151 Spindle holding part 152 Rotation knob 16 Grip 161 Grip body 162 Cleaning button 163 Suction button 17 Exhaust pipe 18 Cleaning Pipe 19 Suction pipe

Claims

1. A surgical assistant instrument for use in endoscopic surgery, comprising: A main shaft, one end of which is inserted from outside the patient's body into the patient's body through an opening in the patient's body, and at least a portion of which is made of a flexible material; a conductive tip provided at one end; a connecting member for connecting the tip to the one end; a cylindrical gripping portion provided on a part of a side surface of the connecting member so as to protrude in any direction to the side of the main shaft, the gripping portion being gripped by a surgical instrument; The gripping portion is partially or entirely composed of a conductor electrically connected to the tip. A surgical auxiliary instrument comprising:

2. The shape of the tip is a body of revolution. A surgical assistant instrument according to claim 1 .

3. Further, the guide is a cylindrical guide having a length shorter than that of the main shaft, and the inner surface of the guide slides along the outer surface of the main shaft, The guide is made of a material having a lower flexibility than a flexible material constituting at least a part of the main shaft.

3. A surgical assistant instrument according to claim 1 or 2.

4. The main shaft is provided with a through hole that connects from the one end to the other end, and the other end is connected to an exhaust pipe.

3. A surgical assistant instrument according to claim 1 or 2.

5. Further comprising an opening / closing mechanism for controlling exhaust from the exhaust pipe.

5. A surgical assistant instrument according to claim 4.

6. At the other end of the through hole, a cleaning liquid pipe for supplying a cleaning liquid and a suction pipe for sucking a liquid are connected to the exhaust pipe, 5. A surgical assistant instrument according to claim 4.

7. a section including the one end of the main shaft is made of a material having a higher flexibility than other sections of the main shaft; Further provided with a bending adjustment mechanism for arbitrarily adjusting the bending of the partial section.

3. A surgical assistant instrument according to claim 1 or 2.

8. A surgical assistant instrument for use in endoscopic surgery, comprising: A main shaft, one end of which is inserted from outside the patient's body into the patient's body through an opening in the patient's body, and at least a portion of which is made of a flexible material; a conductive tip provided at one end; a connecting member for connecting the tip to the one end; a gripping portion provided on a part of a side surface of the connecting member so as to protrude in any direction to the side of the main shaft, the gripping portion being gripped by a surgical instrument; The gripping portion is partially or entirely formed of a conductor electrically connected to the tip, Further, the guide is a cylindrical guide having a length shorter than that of the main shaft, and the inner surface of the guide slides along the outer surface of the main shaft, The guide is made of a material having a lower flexibility than a flexible material constituting at least a part of the main shaft. A surgical auxiliary instrument comprising:

9. A surgical assistant instrument for use in endoscopic surgery, comprising: A main shaft, one end of which is inserted from outside the patient's body into the patient's body through an opening in the patient's body, and at least a portion of which is made of a flexible material; a conductive tip provided at one end; a connecting member for connecting the tip to the one end; a gripping portion provided on a part of a side surface of the connecting member so as to protrude in any direction to the side of the main shaft, the gripping portion being gripped by a surgical instrument; The gripping portion is partially or entirely formed of a conductor electrically connected to the tip, The main shaft is provided with a through hole that connects from the one end to the other end, and the other end is connected to an exhaust pipe. A surgical auxiliary instrument comprising:

10. A surgical assistant instrument for use in endoscopic surgery, comprising: A main shaft, one end of which is inserted from outside the patient's body into the patient's body through an opening in the patient's body, and at least a portion of which is made of a flexible material; a conductive tip provided at one end; a connecting member for connecting the tip to the one end; a gripping portion provided on a part of a side surface of the connecting member so as to protrude in any direction to the side of the main shaft, the gripping portion being gripped by a surgical instrument; The gripping portion is partially or entirely formed of a conductor electrically connected to the tip, a section including the one end of the main shaft is made of a material having a higher flexibility than other sections of the main shaft; Further provided with a bending adjustment mechanism for arbitrarily adjusting the bending of the partial section. A surgical auxiliary instrument comprising:

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