Treatment instrument

Abstract

This treatment instrument includes: a first gripping member 16; a second gripping member 12 openable and closable with respect to the first gripping member 16 and gripping a treatment object between the first gripping member 16 and itself; a support member 11 having an elongated shape and supporting the second gripping member 12 in a distal end portion to open and close the second gripping member with respect to the first gripping member 16; and a first wire Wi1 having one end connected to the second gripping member 12, to open and close the second gripping member 12 with respect to the first gripping member 16. The support member 11 has an outer surface provided with a groove portion 1141c that is recessed radially inward in the support member 11 and that extends from one end to the other end of the support member 11 along a longitudinal direction in the support member 11. The first wire WI1 is inserted into the groove portion 1141c.

Description

Treatment instrument

[0001] The present invention relates to a treatment instrument.

[0002] Conventionally, a robotic surgery system is known in which a surgeon operates a robotic device from a location away from the patient and performs surgery on the patient (see, for example, Patent Document 1). In the robotic surgery system described in Patent Document 1, a treatment instrument is attached to the robotic device. This treatment instrument is inserted into the subject and applies treatment energy to a site in the living tissue that is the target of treatment (hereinafter referred to as the treatment target) to perform the treatment on the treatment target.

[0003] US Patent Application Publication No. 2024 / 0296608

[0004] As a treatment instrument attached to the above-described robotic device, there is a demand for improving usability, such as reducing the diameter of the portion inserted into the subject.

[0005] The present invention has been made in view of the above, and an object thereof is to provide a treatment instrument that can improve usability.

[0006] In order to solve the above-described problems and achieve the object, the treatment instrument according to the present invention includes a first gripping member, a second gripping member that can be opened and closed with respect to the first gripping member and grips a treatment target between the first gripping member and the second gripping member, a support member having a long shape and supporting the second gripping member so as to be openable and closable with respect to the first gripping member at a tip portion, and a first wire having one end connected to the second gripping member and opening and closing the second gripping member with respect to the first gripping member. A recess is provided on the outer surface of the support member so as to be recessed toward the radially inner side of the support member, and a groove portion extending from one end to the other end of the support member along the longitudinal direction of the support member is provided. The first wire is inserted into the groove portion.

[0007] According to the treatment instrument of the present invention, usability can be improved.

[0008] Figure 1 is a diagram illustrating a robotic surgical system according to Embodiment 1. Figure 2 is a diagram illustrating a robotic device. Figure 3 is a perspective view of a medical device viewed from the distal end. Figure 4 is a diagram illustrating the configuration of the end effector. Figure 5 is a diagram illustrating the configuration of the end effector. Figure 6 is a diagram illustrating the configuration of the end effector. Figure 7 is a diagram illustrating the configuration of the end effector. Figure 8 is a diagram illustrating the configuration of the end effector. Figure 9 is a diagram illustrating the configuration of the end effector. Figure 10 is a diagram illustrating the configuration of the drive unit. Figure 11 is a diagram illustrating the configuration of the drive unit. Figure 12 is a diagram illustrating the configuration of the drive unit. Figure 13 is a diagram illustrating the configuration of the drive unit. Figure 14 is a diagram illustrating the configuration of the drive unit. Figure 15 is a diagram illustrating the configuration of the drive unit. Figure 16 is a diagram illustrating modification 1-1 of Embodiment 1. Figure 17 is a diagram illustrating modification 1-1 of Embodiment 1. Figure 18 is a diagram illustrating modification 1-2 of Embodiment 1. Figure 19 is a diagram illustrating the configuration of an ultrasonic treatment device according to Embodiment 2. Figure 20 is a diagram illustrating a method for manufacturing an ultrasonic treatment device. Figure 21 is a diagram illustrating an example (1) of the method for adjusting the spring constant k and mass m in the first step. Figure 22 is a diagram illustrating an example (2) of the method for adjusting the spring constant k and mass m in the first step. Figure 23 is a diagram illustrating an example (3) of the method for adjusting the spring constant k and mass m in the first step. Figure 24 is a diagram illustrating an example (4) of the method for adjusting the spring constant k and mass m in the first step. Figure 25 is a diagram illustrating an example (5) of the method for adjusting the spring constant k and mass m in the first step. Figure 26 is a diagram illustrating a modification 2-1 of Embodiment 2. Figure 27 is a diagram illustrating a modification 2-2 of Embodiment 2. Figure 28 is a diagram illustrating a modification 2-3 of Embodiment 2. Figure 29 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 30 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 31 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 32 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 33 is a diagram illustrating the configuration of the end effector according to Embodiment 3.Figure 34 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 35 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 36 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 37 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 38 is a diagram illustrating the configuration of the end effector according to Embodiment 3. Figure 39 is a diagram illustrating Modification 3-1 of Embodiment 3. Figure 40 is a diagram illustrating Modification 3-1 of Embodiment 3.

[0009] The embodiments for carrying out the present invention (hereinafter referred to as "embodiments") will be described below with reference to the drawings. However, the present invention is not limited to the embodiments described below. Furthermore, in the drawings, the same parts are denoted by the same reference numerals.

[0010] (Embodiment 1) [Outline Configuration of the Robotic Surgical System] Figure 1 is a diagram of the robotic surgical system 1 according to Embodiment 1. Figure 2 is a diagram of the robotic device 2. As shown in Figure 1, the robotic surgical system 1 is a system in which the surgeon OP 1 operates the robotic device 2 from a distance to perform surgery on the patient PA. In addition, one or more assistants OP 2, anesthesiologists OP 3, and nurses OP 4 can also participate in the surgery in the robotic surgical system 1. As shown in Figures 1 and 2, the robotic surgical system 1 comprises the robotic device 2, an imaging device 3, a processing device 4, an operating device 5, and a medical device 6.

[0011] The robotic device 2 is installed on the floor of the operating room or similar location. As shown in Figures 1 and 2, the robotic device 2 comprises a plurality of robotic arms 21. The robotic arms 21 support an imaging device 3 or a medical device 6 at their distal ends. The robotic arms 21 have multiple joints, allowing them to move the imaging field of view of the supported imaging device 3 or the position of the distal end of the supported medical device 6 with multiple degrees of freedom.

[0012] The imaging device 3 generates an image by imaging the surgical site. The image generated by the imaging device 3 is then output to the processing device 4.

[0013] The processing unit 4 is installed on the floor of the operating room or elsewhere, and performs predetermined image processing on the image captured by the imaging device 3 to generate a video signal for display. The video signal for display generated by the processing unit 4 is then output to the operating device 5.

[0014] The operating device 5 is installed on the floor of the operating room or elsewhere and includes an input control device that receives operations from the surgeon OP1 and operates the robot device 2 and medical device 6 in response to those operations. The operating device 5 is also equipped with a display device that displays captured images based on display video signals output from the processing device 4. In other words, the surgeon OP1 operates the robot device 2 and medical device 6 by operating the input control device while confirming the captured images displayed on the display device.

[0015] The medical device 6 performs treatment on the area of ​​the patient PA that is to be treated (hereinafter referred to as the treatment target) in response to the operation of the control device 5 by the operator OP 1. The configuration of the medical device 6 will be described below.

[0016] [About the configuration of the medical device] Figure 3 is a perspective view of the medical device 6 from the distal end. In the following, one side of the cylindrical sheath 20 along the central axis Ax1 will be referred to as the tip side Ar1, and the other side as the proximal end side Ar2. The axis parallel to the central axis Ax1 will be defined as the Z-axis (the distal end side is the +Z-axis side), the axis perpendicular to the Z-axis and parallel to the opening and closing direction of the jaws 12 relative to the treatment section 1321 will be defined as the X-axis (the side on which the jaws 12 are positioned relative to the treatment section 1321: the +X-axis side), and the axis perpendicular to the X and Z axes will be defined as the Y-axis.

[0017] In the following drawings, including Figure 3, the central axis Ax1 of the sheath 20 and the central axis Ax2 along the longitudinal direction of the support member 11 are assumed to be approximately coincident. In the following explanation, the central axes Ax1 and Ax2 will also be described in a state where they are approximately coincident. Note that, due to the bending operation of the end effector 10, which will be described later, central axis Ax2 intersects central axis Ax1.

[0018] The medical device 6 corresponds to the treatment instrument according to the present invention. This medical device 6 treats a target by applying treatment energy to the target. In this embodiment 1, the treatment energy is ultrasonic energy and high-frequency energy. The treatments that can be performed by the medical device 6 according to this embodiment 1 include coagulation (sealing) of the target, incision of the target, etc. Coagulation and incision may also be performed simultaneously.

[0019] As shown in Figure 3, the medical device 6 comprises an end effector 10, a sheath 20, and a drive unit 30. Here, the sheath 20 is a cylindrical pipe and corresponds to the tubular member according to the present invention. The end effector 10 is connected to the tip end Ar1 of the sheath 20. The drive unit 30 is connected to the base end Ar2 of the sheath 20. The sheath 20 is rotatably connected to the drive unit 30 about a central axis Ax1. The rotation of the sheath 20 about the central axis Ax1 causes the end effector 10 to rotate about the same central axis Ax1. Details of the rotation operation of the sheath 20 will be explained later in "Configuration of the Rotation Mechanism". The configurations of the end effector 10 and the drive unit 30 will be described in order below.

[0020] [About the End Effector Configuration] Figures 4 to 9 illustrate the configuration of the end effector 10. Specifically, Figure 4 is a view of the tip end Ar1 of the end effector 10 from the +Y axis side. Figure 5 is a cross-sectional view of the tip end Ar1 of the end effector 10 cut by the XZ plane containing the central axes Ax1 and Ax2. Figure 6 is a diagram of the ultrasonic treatment device 13. Figure 7 is a perspective view of the proximal end Ar2 of the end effector 10 as seen from the tip end Ar1. Figure 8 is a cross-sectional view of the proximal end Ar2 of the end effector 10 cut by the XZ plane containing the central axes Ax1 and Ax2. Figure 9 is a cross-sectional view of the proximal end Ar2 of the end effector 10 cut by the YZ plane containing the central axes Ax1 and Ax2.

[0021] The end effector 10 is located at the distal end (the end of the tip side Ar1) of the medical device 6 and is the part that treats the target of treatment. As shown in Figures 4 to 9, the end effector 10 comprises a support member 11, a jaw 12, an ultrasonic treatment device 13, and a bendable portion 14.

[0022] The support member 11 is connected to the end of the tip side Ar1 in the bent portion 14 and is a member that supports the jaw 12 and the ultrasonic treatment device 13. This support member 11 is made up of a substantially cylindrical body in which the end of the base side Ar2 is connected to the end of the tip side Ar1 in the bent portion 14. Furthermore, the support member 11 is covered with electrically insulating heat shrink tubing TO (Figures 4 and 5) with both ends exposed to the outside.

[0023] The jaw 12 corresponds to the second gripping member according to the present invention. As shown in Figure 5, the jaw 12 comprises a jaw body 121 and a pad 122. The jaw body 121 is made of a conductive material. As shown in Figures 4 and 5, the jaw body 121 is a member in which a base 1211 and a pair of protrusions 1212 are integrally formed.

[0024] The base body 1211 corresponds to the gripping body according to the present invention. This base body 1211 is composed of a long, roughly plate-like body. The base end Ar2 of the base body 1211 is pivotally supported so as to be rotatable around a rotation axis RAx1 (Figures 4 and 5) which is parallel to the Y-axis with respect to the tip end Ar1 of the support member 11. In other words, the base body 1211 opens and closes relative to the treatment section 1321 by rotating around the rotation axis RAx1.

[0025] The pair of protrusions 1212 correspond to the connecting portion according to the present invention. These pair of protrusions 1212 each protrude from the end of the base end side Ar2 of the base body 1211, facing each other along the Y axis. As shown in Figure 5, one end of the opening / closing wire WI1 is connected to the pair of protrusions 1212, and they receive the driving force transmitted by the opening / closing wire WI1. Specifically, the protruding end side of the pair of protrusions 1212 is provided with a pin-shaped portion 1212a that is stretched between the two protrusions 1212. The pin-shaped portion 1212a is also provided with a cylindrical protrusion 1212b that protrudes toward the base end side Ar2. One end of the opening / closing wire WI1 is inserted through the protrusion 1212b and connected (fixed) to the protrusion 1212b. This opening / closing wire WI1 corresponds to the first wire according to the present invention. The pair of protrusions 1212 receive a driving force, causing the base 1211 to open and close relative to the treatment section 1321. Details of the opening and closing operation of the jaws 12 will be explained later in the section "Configuration of the drive unit".

[0026] Here, as shown in Figure 5, an elastic member RS1 is provided between the base end Ar2 of the pair of protrusions 1212 and the tip end Ar1 of the support member 11. This elastic member RS1 corresponds to the biasing member according to the present invention. The elastic member RS1 has a tubular shape and is positioned between the base end Ar2 of the pair of protrusions 1212 and the tip end Ar1 of the support member 11 with one end of the opening / closing wire WI1 inserted through it.

[0027] The pad 122 is made of a resin material having electrical insulation and biocompatibility, such as polytetrafluoroethylene (PTFE), and has a substantially rectangular parallelepiped shape that extends along the longitudinal direction of the base body 1211. As shown in Figure 5, the pad 122 is attached to the surface of the base body 1211 that faces the treatment portion 1321. As a result, when the base body 1211 is closed against the treatment portion 1321, the pad 122 comes into contact with the treatment portion 1321.

[0028] The ultrasonic treatment device 13 generates ultrasonic vibrations in response to the operation of the operating device 5 by the operator OP 1. The ultrasonic treatment device 13 is inserted into the support member 11, and the treatment portion 1321 is supported by the support member 11 with the treatment portion protruding outward from the tip side Ar1 of the support member 11. As shown in Figure 6, the ultrasonic treatment device 13 comprises an ultrasonic transducer 131 and an ultrasonic blade 132.

[0029] The ultrasonic transducer 131 is the part that generates ultrasonic vibrations. As shown in Figure 6, the ultrasonic transducer 131 comprises a piezoelectric element unit 1311 and a holding part 1312.

[0030] As shown in Figure 6, the piezoelectric element unit 1311 comprises a plurality of piezoelectric elements 1311a, each composed of annular plates, stacked along the central axis Ax2. In response to the supplied driving power, a potential difference is generated in the stacking direction along the central axis Ax2, causing piezoelectric properties to be generated and the plurality of piezoelectric elements 1311a to alternately undergo displacement along the stacking direction. As a result, the piezoelectric element unit 1311 generates ultrasonic vibrations of longitudinal vibration with the stacking direction as the vibration direction.

[0031] The holding portion 1312 extends linearly along the central axis Ax2. At the base end Ar2 of the holding portion 1312, there is a bolt (not shown) that extends linearly toward the base end Ar2 along the central axis Ax2 and is inserted through each of the multiple piezoelectric elements 1311a. A nut NT (Figure 6) is attached to the base end Ar2 of the bolt. In other words, the ultrasonic transducer 131 is composed of a bolt-clamped Langevin-type transducer.

[0032] The ultrasonic blade 132 corresponds to the first gripping member according to the present invention. This ultrasonic blade 132 is connected to the tip end Ar1 of the holding portion 1312 and applies ultrasonic vibrations generated by the ultrasonic transducer 131 to the object to be treated. As shown in Figure 6, this ultrasonic blade 132 extends linearly along the central axis Ax2 and includes a treatment portion 1321 that applies ultrasonic vibrations to the object to be treated. In addition, the base end Ar2 of the ultrasonic blade 132 is provided with a flange portion 1322 that has a larger outer diameter than other parts. Here, the ultrasonic blade 132 is positioned between the base body 1211 and the connection position of the opening / closing wire WI1 to the pair of protrusions 1212.

[0033] The power supply unit (not shown) provided on the robot device 2 then applies treatment energy to the object being treated, which is gripped between the jaws 12 and the treatment unit 1321, via an electrical cable.

[0034] For example, when operator OP1 performs an operation on the operating device 5 to apply ultrasonic energy to the treatment target, the power supply device (not shown) provided on the robot device 2 supplies driving power to the piezoelectric element unit 1311 in the ultrasonic treatment device 13 via an electrical cable (not shown). This electrical cable is routed along the path from the power supply device (not shown) to the drive unit 30, then to the sheath 20, and finally to the piezoelectric element unit 1311. As a result, the piezoelectric element unit 1311 generates longitudinal vibrations (ultrasonic vibrations) that vibrate in a direction along the central axis Ax2 (Figures 4 to 6) of the support member 11. The treatment unit 1321 also vibrates with a desired amplitude due to these longitudinal vibrations. The treatment target, which is gripped between the jaws 12 (base 1211 and pad 122) and the treatment unit 1321, receives ultrasonic vibrations from the treatment unit 1321. In other words, ultrasonic energy is applied to the treatment target from the treatment unit 1321.

[0035] Furthermore, for example, when operator OP1 performs an operation on the operating device 5 to apply high-frequency energy to the object to be treated, the power supply unit (not shown) provided on the robot device 2 supplies high-frequency power between the jaw 12 and the ultrasonic treatment device 13 via an electrical cable. The electrical cable WI4 (Figure 5), which is electrically connected to the jaw 12 (base 1211), is routed along the path from the power supply unit (not shown) to the drive unit 30, through the sheath 20, between the support member 11 and the heat shrink tube TO, and then to the jaw 12 (base 1211). Similarly, the electrical cable (not shown) which is electrically connected to the ultrasonic treatment device 13 is routed along the path from the power supply unit (not shown) to the drive unit 30, through the sheath 20, and then to the ultrasonic treatment device 13. When high-frequency power is supplied between the jaw 12 and the ultrasonic treatment device 13, a high-frequency current is supplied to the object to be treated that is gripped between the jaw 12 (base 1211 and pad 122) and the treatment unit 1321. In other words, high-frequency energy is applied to the target of treatment. Furthermore, if the first switching wire WI1 is equipped with the function of electrically connecting the aforementioned path, it is not necessary to provide the electrical cable WI4.

[0036] As shown in Figures 7 to 9, the bent portion 14 connects the base end Ar2 of the support member 11 to the tip end Ar1 of the sheath 20, and configures the end effector 10 to bend relative to the sheath 20.

[0037] Then, as shown in Figure 8, within the XZ plane including the central axis Ax1, the portion between the two ends of the first bending wire WI2 is positioned at the end of the base end Ar2 of the support member 11, via the bent portion 14. The end effector 10 bends relative to the sheath 20 within the XZ plane including the central axis Ax1 by receiving the driving force transmitted by the first bending wire WI2. In other words, in this embodiment 1, the portions at both ends of the first bending wire WI2 are positioned at locations offset by 180° with respect to the central axis Ax1.

[0038] Furthermore, as shown in Figure 9, within the YZ plane including the central axis Ax1, the portion between the two ends of the second bending wire WI3 is positioned at the base end Ar2 of the support member 11 via the bent portion 14. The end effector 10 then bends relative to the sheath 20 within the YZ plane including the central axis Ax1 by receiving the driving force transmitted by the second bending wire WI3. In other words, in this embodiment 1, the portions at both ends of the second bending wire WI3 are positioned at locations offset by 180° with respect to the central axis Ax1.

[0039] For the sake of clarity, the bending motion of the end effector 10 in the XZ plane (the bending motion of the end effector 10 along the opening and closing direction of the jaw 12) will be referred to as the first bending motion, and the bending motion of the end effector 10 in the YZ plane will be referred to as the second bending motion. Details of the first and second bending motions of the end effector 10 will be explained later in "Configuration of the First Bending Mechanism" and "Configuration of the Second Bending Mechanism," respectively.

[0040] [Regarding the configuration of the drive unit] Figures 10 to 15 are diagrams illustrating the configuration of the drive unit 30. Specifically, Figure 10 is a perspective view of the inside of the drive unit 30 from the front end Ar1 and from the +Y axis side. Figure 11 is a perspective view of the inside of the drive unit 30 from the front end Ar1 and from the -Y axis side. Figure 12 is a perspective view of the inside of the drive unit 30 from the base end Ar2 and from the +Y axis side. Figure 13 is a cross-sectional view of the drive unit 30 cut by the XZ plane including the central axis Ax1. Figure 14 is a cross-sectional view of the drive unit 30 cut by the YZ plane including the central axis Ax1. Figure 15 is a view of the opening and closing mechanism 80 from the base end Ar2.

[0041] As shown in Figure 3, the drive unit 30 is connected to the base end Ar2 of the sheath 20. The drive unit 30 is a unit that causes the end effector 10 to bend, the jaws 12 to open and close, and the sheath 20 to rotate, respectively, in accordance with the driving forces from the four first to fourth motors (not shown) provided on the robot device 2.

[0042] Here, when the operator OP1 performs an operation on the operating device 5 to cause the first motor (not shown) to perform a first bending operation on the end effector 10, the first motor is driven. Also, when the operator OP1 performs an operation on the operating device 5 to cause the second motor (not shown) to perform a second bending operation on the end effector 10, the second motor is driven. Further, when the operator OP1 performs an operation on the operating device 5 to cause the jaw 12 to perform an opening / closing operation, the third motor (not shown) is driven. Also, when the operator OP1 performs an operation on the operating device 5 to cause the sheath 20 to perform a rotational operation, the fourth motor (not shown) is driven.

[0043] As shown in FIGS. 10 to 15, the drive unit 30 includes a storage housing 40, a shaft 50, first and second bending mechanisms 60 and 70, an opening / closing mechanism 80, and a rotation mechanism 90. Hereinafter, each member 40 to 90 will be described in order.

[0044] [Regarding the configuration of the storage housing] As shown in FIG. 3, the storage housing 40 includes a housing main body 41 having a substantially rectangular parallelepiped container shape with an open tip side Ar1, and a base portion 42 formed of a substantially rectangular flat plate that closes the opening of the tip side Ar1 in the housing main body 41. And each member 50 to 90 is stored in the storage housing 40 and supported by the storage housing 40.

[0045] Here, as shown in FIG. 3, support holes 421 and first to fifth driving force receiving holes 422 to 426 that penetrate the front and back surfaces are formed in the base portion 42.

[0046] As shown in FIG. 3, the support hole 421 is a circular hole through which the end of the base end side Ar2 of the sheath 20 is inserted. The first to fifth driving force receiving holes 422 to 426 are circular holes provided on the lower side of the support hole 421 in FIG. 3 in the base portion 42.

[0047] Specifically, when the base portion 42 is viewed from the tip side Ar1, the first driving force receiving hole 422 is provided at the lower right corner portion of the base portion 42 in FIG. 3. This first driving force receiving hole 422 is a hole for transmitting the driving force from the first motor (not shown) to the first bending mechanism 60.

[0048] Further, the second driving force receiving hole 423 is provided at the lower left corner portion in FIG. 3 of the base portion 42 when viewed from the tip side Ar1. This second driving force receiving hole 423 is a hole for transmitting the driving force from a second motor (not shown) to the second bending mechanism 70.

[0049] Further, the third driving force receiving hole 424 is provided in the base portion 42 on the upper side in FIG. 3 and in the substantially central portion in the left-right direction in FIG. 3 with respect to the first and second driving force receiving holes 422 and 423. This third driving force receiving hole 424 is a hole for transmitting the driving force from a third motor (not shown) to the opening / closing mechanism 80.

[0050] Further, the fourth driving force receiving hole 425 is located between the support hole 421 and the third driving force receiving hole 424 in the base portion 42, and is provided on the right side of the central portion in the left-right direction of the base portion 42 in FIG. 3 when viewed from the tip side Ar1. This fourth driving force receiving hole 425 is a hole for transmitting the driving force from a fourth motor (not shown) to the rotation mechanism 90.

[0051] Further, the fifth driving force receiving hole 426 is provided on the left side in FIG. 3 with respect to the fourth driving force receiving hole 425 in the base portion 42 when viewed from the tip side Ar1. In the first embodiment, the fifth driving force receiving hole 426 is not used. Therefore, the fifth driving force receiving hole 426 is blocked by a blocking member 427 (FIG. 3).

[0052] [Regarding the configuration of the shaft] As shown in FIGS. 13 and 14, the shaft 50 is a cylindrical pipe and is arranged coaxially with the central axis Ax1 in the storage housing 40.

[0053] [Regarding the configuration of the first bending mechanism] The first bending mechanism 60 is a mechanism that operates in response to the driving force from a first motor (not shown) and causes the end effector 10 to perform a first bending operation. As shown in FIGS. 10 to 14, this first bending mechanism 60 includes a first bending support shaft portion 61 and two first bending bearing portions 62 and 63.

[0054] The first bending support shaft portion 61 receives a driving force (rotational motion) from the first motor (not shown) and rotates around an axis parallel to the Z-axis. As shown in Figures 10 and 12, this first bending support shaft portion 61 comprises a first shaft body 611 and a first driving force receiving portion 612.

[0055] The first shaft body 611 extends linearly along the Z-axis. The first drive force receiving portion 612 is the part that receives the drive force (rotational motion) from the first motor (not shown) and is provided at the tip end Ar1 of the first shaft body 611. The first bending support shaft portion 61 is positioned such that the first drive force receiving portion 612 is exposed to the outside of the housing 40 through the first drive force receiving hole 422.

[0056] The first bending bearing portion 62 is connected to the first shaft body 611 by a first screw structure SC1 (Figures 10 and 12). The first bending bearing portion 62 then performs linear motion along the Z-axis in response to rotation around an axis parallel to the Z-axis of the first shaft body 611 (driving force (rotational motion) from the first motor (not shown)). As shown in Figures 10, 12 to 14, the first bending bearing portion 62 comprises a first wire connection portion 621 and a first bearing body 622.

[0057] As shown in Figures 13 and 14, the first wire connector 621 has an annular shape through which the shaft 50 is inserted. As shown in Figure 13, one end of the first bending wire WI2 is connected to the first wire connector 621. The first wire connector 621 is positioned such that it is allowed to move along the central axis Ax1 relative to the shaft 50, but rotation about the central axis Ax1 is restricted.

[0058] The first bearing body 622 extends vertically in Figures 10 and 12. One end of the first bearing body 622 is connected to the first shaft body 611 by a first screw structure SC1. The other end of the first bearing body 622 holds the first wire connection part 621. The first bearing body 622 comprises first and second connection parts 6221 and 6222, and an extending part 6223.

[0059] As shown in Figures 10 and 12, the first connecting portion 6221 is the part that connects to the first shaft body 611 by the first screw structure SC1.

[0060] The second connecting portion 6222 is the part that holds the first wire connecting portion 621. This second connecting portion 6222 has a shape in which a part of the annular shape extending in the rotational direction around the central axis Ax1 is cut out. As shown in Figures 13 and 14, the inner circumferential surface of the second connecting portion 6222 is provided with a groove 6222a into which the outer end of the first wire connecting portion 621 fits.

[0061] The extended portion 6223 is the part that extends in the vertical direction in Figures 10 and 12. First and second connecting portions 6221 and 6222 are provided at both ends of the extended portion 6223, respectively. Furthermore, as shown in Figures 10 and 12, a guide shaft portion GI1 that extends along the Z axis is inserted through the extended portion 6223. The first bearing body 622 is then guided by the guide shaft portion GI1, enabling linear motion along the Z axis.

[0062] The first bending bearing portion 63 corresponds to the first bearing portion according to the present invention. This first bending bearing portion 63 includes a first wire connection portion 631 and a first bearing portion body 632 (including first and second connection portions 6321 and 6322 (including groove portion 6322a) and an extended portion 6223) similar to the first wire connection portion 621 and the first bearing portion body 622 (including first and second connection portions 6221 and 6222 (including groove portion 6222a) and an extended portion 6223) of the first bending bearing portion 62.

[0063] Here, as shown in Figures 13 and 14, the first wire connection portion 631 is located at the base end Ar2 of the first wire connection portion 621 when the shaft 50 is inserted through it. The other end of the first bending wire WI2 is connected to the first wire connection portion 631, as shown in Figure 13. The first wire connection portion 631, like the first wire connection portion 621, is allowed to move along the central axis Ax1 relative to the shaft 50, but rotation about the central axis Ax1 is restricted.

[0064] Furthermore, as shown in Figures 10 and 12, the first connecting portion 6321 is connected to the first shaft body 611 by a second screw structure SC2. In addition, the second connecting portion 6322 holds the first wire connecting portion 631 by the outer peripheral end of the first wire connecting portion 631 fitting into the groove portion 6322a. Also, as shown in Figures 10 and 12, a guide shaft portion GI1 extending along the Z axis is inserted through the extended portion 6323. The first bearing body 632 is then guided by the guide shaft portion GI1 and is able to move linearly along the Z axis.

[0065] The first and second screw structures SC1 and SC2 described above are reverse-threaded screw structures with opposite threads to each other.

[0066] The end effector 10 then performs a first bending operation using the first bending wire WI2 and the first bending mechanism 60, as shown below. Specifically, when the first bending mechanism 60 receives a driving force (rotational motion) from the first motor (not shown), the first bending support shaft 61 rotates about an axis parallel to the Z-axis. The two first bending bearings 62 and 63 each perform linear motion along the Z-axis in a direction that moves them closer to each other or in a direction that moves them apart, in response to the rotation of the first bending support shaft 61. The first bending wire WI2, with both ends connected to the two first bending bearings 62 and 63, is pulled towards one end or towards the other end in response to the linear motion of the two first bending bearings 62 and 63. As a result, the first bending wire WI2 causes the end effector 10 to perform a first bending operation due to the frictional force between the portion between its ends and the support member 11. Note that the portion between the ends of the first bending wire WI2 and the support member 11 may be fixed to each other.

[0067] [Regarding the configuration of the second bending mechanism] The second bending mechanism 70 operates in response to the driving force from the second motor (not shown) and causes the end effector 10 to perform a second bending operation. As shown in Figures 11, 13, and 14, this second bending mechanism 70 comprises a second bending support shaft portion 71 and two second bending bearing portions 72 and 73.

[0068] The second bending support shaft portion 71 receives a driving force (rotational motion) from a second motor (not shown) and rotates around an axis parallel to the Z-axis. As shown in Figure 11, this second bending support shaft portion 71 includes a second shaft body 711 and a second driving force receiving portion 712, similar to the first shaft body 611 and the first driving force receiving portion 612 of the first bending support shaft portion 61.

[0069] Here, the second drive force receiving portion 712 is the part that receives the drive force (rotational motion) from the second motor (not shown), and is positioned so as to be exposed to the outside of the housing 40 through the first drive force receiving hole 422.

[0070] The second bending bearing portion 72 includes a second wire connection portion 721 and a second bearing portion body 722 (including the first and second connection portions 7221 and 7222 (including the groove portion 7222a) and an extended portion 7223) similar to the first wire connection portion 621 and the first bearing portion body 622 (including the first and second connection portions 6221 and 6222 (including the groove portion 7222a) and an extended portion 6223) of the first bending bearing portion 62.

[0071] Here, as shown in Figures 13 and 14, the second wire connection portion 721 is located between the first wire connection portions 621 and 631 with the shaft 50 inserted through it. Then, as shown in Figure 14, one end of the second bending wire WI3 is connected to the second wire connection portion 721. The second wire connection portion 721, like the first wire connection portions 621 and 631, is allowed to move along the central axis Ax1 relative to the shaft 50, but rotation about the central axis Ax1 is restricted.

[0072] Furthermore, as shown in Figure 11, the first connecting portion 7221 is connected to the second shaft body 711 by the first screw structure SC3. In addition, the second connecting portion 7222 holds the second wire connecting portion 721 by the outer end of the second wire connecting portion 721 fitting into the groove portion 7222a. Also, as shown in Figure 11, a guide shaft portion GI2 extending along the Z axis is inserted through the extending portion 7223. The second bearing body 722 is then guided by the guide shaft portion GI2 and is able to move linearly along the Z axis.

[0073] The second bending bearing portion 73 includes a second wire connection portion 731 and a second bearing portion body 732 (including the first and second connection portions 7321 and 7322 (including the groove portion 7322a) and an extended portion 7323), similar to the first wire connection portion 621 and the first bearing portion body 622 (including the first and second connection portions 6221 and 6222 (including the groove portion 6222a) and the extended portion 6223) of the first bending bearing portion 62.

[0074] Here, as shown in Figures 13 and 14, the second wire connection portion 731 is located at the base end Ar2 of the first wire connection portion 631 when the shaft 50 is inserted through it. The other end of the second bending wire WI3 is connected to the second wire connection portion 731, as shown in Figure 14. The second wire connection portion 731, like the first wire connection portions 621 and 631, is allowed to move along the central axis Ax1 relative to the shaft 50, but rotation about the central axis Ax1 is restricted.

[0075] Furthermore, as shown in Figure 11, the first connecting portion 7321 is connected to the second shaft body 711 by a second screw structure SC4. In addition, the second connecting portion 7322 holds the second wire connecting portion 731 by the outer peripheral end of the second wire connecting portion 731 fitting into the groove portion 7322a. Also, as shown in Figure 11, a guide shaft portion GI2 extending along the Z axis is inserted through the extended portion 7323. The second bearing body 732 is then guided by the guide shaft portion GI2 and is able to move linearly along the Z axis.

[0076] The first and second screw structures SC3 and SC4 described above are reverse-threaded screw structures, with opposite threads to each other.

[0077] The end effector 10 then performs a second bending operation using the second bending wire WI3 and the second bending mechanism 70, as shown below. Specifically, when the second bending mechanism 70 receives a driving force (rotational motion) from the second motor (not shown), the second bending support shaft 71 rotates about an axis parallel to the Z-axis. The two second bending bearings 72 and 73 move linearly along the Z-axis in directions that move them closer together or further apart, in response to the rotation of the second bending support shaft 71. The second bending wire WI3, with both ends connected to the two second bending bearings 72 and 73, is pulled towards one end or towards the other end in response to the linear motion of the two second bending bearings 72 and 73. As a result, the second bending wire WI3 causes the end effector 10 to perform a second bending action due to the frictional force between the portion between its ends and the support member 11. Note that the portion between the ends of the second bending wire WI3 and the support member 11 may be fixed to each other.

[0078] [Regarding the configuration of the opening and closing mechanism] The opening and closing mechanism 80 operates in response to the driving force from the third motor (not shown) and causes the jaw 12 to open and close. As shown in Figure 12, this opening and closing mechanism 80 comprises an opening and closing support shaft portion 81, an opening and closing bearing portion 82, and first and second support members 83 and 84.

[0079] The opening / closing support shaft portion 81 receives a driving force (rotational motion) from a third motor (not shown) and rotates around an axis parallel to the Z-axis. As shown in Figures 11 and 12, this opening / closing support shaft portion 81 comprises a shaft body 811 and an opening / closing driving force receiving portion 812.

[0080] The shaft body 811 extends linearly along the Z-axis. The opening / closing drive force receiving portion 812 is the part that receives the driving force (rotational motion) from the third motor (not shown) and is provided at the tip end Ar1 of the shaft body 811. The opening / closing support shaft 81 is positioned such that the opening / closing drive force receiving portion 812 is exposed to the outside of the housing 40 through the third drive force receiving hole 424.

[0081] The opening / closing bearing section 82 extends vertically in Figure 12 and is connected to the shaft body 811 at its upper end by a screw structure SC5. The opening / closing bearing section 82 performs linear motion along the Z-axis in response to rotation around an axis parallel to the Z-axis of the shaft body 811 (driving force (rotational motion) from the third motor (not shown)). As shown in Figure 12, a guide shaft section GI3 extending along the Z-axis is inserted through the opening / closing bearing section 82. The opening / closing bearing section 82 is then guided by the guide shaft section GI3, enabling linear motion along the Z-axis.

[0082] Furthermore, as shown in Figure 12, the other end of the opening / closing wire WI1 is connected to the opening / closing bearing section 82. One end of this opening / closing wire WI1 is connected to a pair of protrusions 1212 on the jaw 12, as described above. The opening / closing wire WI1 is then routed through the support member 11, the sheath 20, and the shaft 50, with the other end connected to the opening / closing bearing section 82.

[0083] The first and second support members 83 and 84 are members that guide the opening / closing wire WI1, which is routed from the base end Ar2 of the shaft 50 to the outside of the shaft 50, to the opening / closing bearing 82. As shown in Figure 12, these first and second support members 83 and 84 are each composed of pulleys to facilitate the smooth movement of the opening / closing wire WI1 to one end or the other end.

[0084] The jaw 12 then opens and closes using the opening / closing wire WI1 and the opening / closing mechanism 80, as shown below. Specifically, when the opening / closing mechanism 80 receives a driving force (rotational motion) from a third motor (not shown), the opening / closing support shaft 81 rotates around an axis parallel to the Z-axis. The opening / closing bearing 82 then performs linear motion along the Z-axis towards either the tip side Ar1 or the base side Ar2, respectively, in response to the rotation of the opening / closing support shaft 81. When the opening / closing bearing 82 moves towards the tip side Ar1, the opening / closing wire WI1 is pulled toward the opening / closing bearing 82, compressing the elastic member RS1 between the pair of protrusions 1212 on the jaw 12 and the support member 11, and pulling the pair of protrusions 1212 toward the base side Ar2. As a result, the jaw 12 rotates counterclockwise around the rotation axis RAx1 in Figure 5, closing toward the treatment section 1321. On the other hand, when the opening / closing bearing portion 82 moves toward the base end side Ar2, the biasing force of the compressed elastic member RS1 presses the pair of protrusions 1212 toward the tip side Ar1, causing the jaw 12 to rotate clockwise around the rotation axis RAx1 in Figure 5 and open toward the treatment portion 1321.

[0085] [Regarding the configuration of the rotating mechanism] The rotating mechanism 90 operates in response to the driving force from the fourth motor (not shown) and causes the sheath 20 to rotate. As shown in Figures 10 to 15, the rotating mechanism 90 comprises a rotating support shaft portion 91, first and second gears 92 and 93, and a connecting portion 94.

[0086] The rotating support shaft portion 91 receives a driving force (rotational motion) from a fourth motor (not shown) and rotates around an axis parallel to the Z-axis. This rotating support shaft portion 91 extends linearly along the Z-axis, and its tip end Ar1 is exposed to the outside of the housing 40 through the fourth driving force receiving hole 425.

[0087] The first gear 92 is fixed to the base end Ar2 of the rotational support shaft portion 91 and rotates together with the rotational support shaft portion 91 about an axis parallel to the Z-axis.

[0088] As shown in Figure 15, the second gear 93 is positioned coaxially with the central axis Ax1 and meshes with the first gear 92.

[0089] As shown in Figure 15, the connecting portion 94 has a cylindrical shape and is positioned coaxially with the central axis Ax1, and the second gear 93 is fixed to its outer circumferential surface. Furthermore, the tip end Ar1 of the connecting portion 94 is connected to the base end Ar2 of the sheath 20. In addition, the base end Ar2 of the connecting portion 94 is connected to the tip end Ar1 of the shaft 50.

[0090] The sheath 20 then rotates in accordance with the rotation mechanism 90, as shown below. Specifically, when the rotation mechanism 90 receives a driving force (rotational motion) from the fourth motor (not shown), the rotation support shaft 91 rotates around an axis parallel to the Z-axis. The first and second gears 92 and 93 and the connecting part 94 also rotate in conjunction with the rotation of the rotation support shaft 91. That is, the connecting part 94 rotates around the central axis Ax1. As a result, the sheath 20 connected to the connecting part 94 rotates together with the connecting part 94 around the central axis Ax1. At this time, since the shaft 50 is also connected to the connecting part 94, the shaft 50, the first wire connecting parts 621 and 631, and the second wire connecting parts 721 and 731 also rotate together with the connecting part 94 around the central axis Ax1.

[0091] The above-described embodiment 1 provides the following advantages. The medical device 6 according to embodiment 1 employs a structure that uses one wire each (first and second bending wires WI2 and WI3 and opening / closing wire WI1) to realize the first and second bending movements of the end effector 10 and the opening and closing movements of the jaws 12. Therefore, compared to a structure that uses multiple wires each to realize the first and second bending movements of the end effector 10 and the opening and closing movements of the jaws 12, the diameter of the end effector 10 can be reduced.

[0092] Furthermore, in the medical device 6 according to this embodiment 1, a heat-shrinkable tube TO is provided on the outer surface of the support member 11. Therefore, compared to a configuration in which an outer pipe through which the support member 11 is inserted is provided in the end effector 10, the dimension of the wall thickness of the outer pipe becomes approximately zero, thus enabling a reduction in the diameter of the end effector 10.

[0093] Furthermore, the medical device 6 according to this embodiment 1 employs a structure in which an ultrasonic treatment device 13 is provided on the end effector 10. Therefore, compared to a structure in which an ultrasonic blade 132 is arranged across the end effector 10 and the sheath 20, this structure allows the end effector 10 to bend relative to the sheath 20 without bending the ultrasonic blade 132 itself, thus making it easy to realize this bending structure.

[0094] Based on the above, the medical device 6 according to this embodiment 1 can improve ease of use.

[0095] In the above-described embodiment 1, instead of the heat-shrinkable tube TO, a first outer pipe or a second outer pipe configured as follows may be used. The first outer pipe is constructed by MIM (Metal Injection Molding) using a mold, and the support member 11 is inserted inside. The second outer pipe is constructed by metal lamination without using a mold, and the support member 11 is inserted inside. Here, the heat-shrinkable tube TO may be provided on the outer surface of the first outer pipe or the second outer pipe described above.

[0096] Furthermore, in the embodiment 1 described above, instead of the heat shrink tube TO, a coating layer having heat insulation and electrical insulation properties may be provided on the outer surface of the support member 11. Here, if the first outer pipe or the second outer pipe described above is provided, the coating layer described above may be provided on the outer surface of the first outer pipe or the second outer pipe.

[0097] Furthermore, in the embodiment 1 described above, the following modified examples 1-1 and 1-2 may also be adopted.

[0098] (Modification 1-1) Figures 16 and 17 illustrate Modification 1-1 of Embodiment 1. Specifically, Figure 16 is a cross-sectional view obtained by cutting the end of the tip side Ar1 of the end effector 10 according to Modification 1-1 with respect to the YZ plane including the central axes Ax1 and Ax2. Figure 17 is a perspective view showing the retaining member 112 (113). As shown in Figures 16 and 17, the support member 11 according to Modification 1-1 comprises a support member body 111 and two retaining members 112 and 113.

[0099] The support member body 111 is a cylindrical body that supports the jaw 12 so as to be rotatable about the rotation axis RAx1 by the end of the tip side Ar1, and the end of the base side Ar2 is connected to the bent portion 14. As shown in Figure 16, the support member body 111 is provided with two openings 1111 and 1112 that penetrate the inside and outside, respectively. The inner circumferential surface of the support member body 111 has a stepped shape in which the diameter of the tip side Ar1 decreases relative to the base side Ar2. Hereafter, this stepped surface will be referred to as the stepped surface 1113. The outer circumferential surface of the support member body 111 is formed to taper toward the tip side Ar1, which is closer to the tip than the stepped surface 1113 in contact with the flange portion 1322.

[0100] As shown in Figures 16 and 17, the retaining member 112 comprises a cover portion 1121 and a retaining portion 1122.

[0101] The cover portion 1121 is a part that fits into the opening 1111 in the support member body 111 and closes the opening 1111.

[0102] The pressing portion 1122 is a bulging portion on the back surface of the cover portion 1121 (the inner surface of the support member 11). The pressing portion 1122 presses the flange portion 1322 against the stepped surface 1113, with the annular elastic member RS2 sandwiched between the pressing portion 1122 and the flange portion 1322 of the ultrasonic blade 132. As a result, the ultrasonic treatment device 13 is positioned in a direction along the central axis Ax2 with respect to the support member 11.

[0103] As shown in Figures 16 and 17, the retaining member 113 includes a cover portion 1131 and a retaining portion 1132, similar to the cover portion 1121 and retaining portion 1122 of the retaining member 112.

[0104] Here, the cover portion 1131 fits into the opening 1112 in the support member body 111, closing the opening 1112. The retaining portion 1132 has the same function as the retaining portion 1122.

[0105] Even when adopting the configuration of the modified example 1-1 described above, the same effects as in the embodiment 1 described above are achieved. In particular, the positioning of the ultrasonic treatment device 13 in the direction along the central axis Ax2 with respect to the support member 11 can be achieved by attaching the pressing members 112 and 113 to the support member body 111 from the outside of the support member body 111. As a result, the diameter of the end effector 10 can be reduced.

[0106] (Modification 1-2) Figure 18 is a diagram illustrating modification 1-2 of Embodiment 1. Specifically, Figure 18 shows the state in which the first and second attachments 100 and 200 according to this modification 1-2 are attached to the medical device 6. In this modification 1-2, the medical device 6 can be used as a handpiece by attaching the first and second attachments 100 and 200 as shown in Figure 18.

[0107] As shown in Figure 18, the first attachment 100 is attached to the base end Ar2 of the drive unit 30. This first attachment 100 comprises handle portions 101 and 102 and three switches SW1 to SW3.

[0108] The handle portions 101 and 102 are the parts that the operator grasps.

[0109] The three switches SW1 to SW3 are located on the side of the handle 102. The operator can then operate one of the three switches SW1 to SW3 to set the device to apply only ultrasonic energy, only high-frequency energy, or both ultrasonic and high-frequency energy to the target of treatment.

[0110] As shown in Figure 18, the second attachment 200 is attached to the tip end Ar1 of the drive unit 30. This second attachment 200 has four gripping parts 201.

[0111] The four gripping parts 201 are provided in correspondence with the first and second bending mechanisms 60 and 70, the opening and closing mechanism 80, and the rotating mechanism 90, respectively. These four gripping parts 201 are connected to the first and second drive force receiving parts 612 and 712, the opening and closing drive force receiving part 812, and the rotating support shaft part 91, respectively, when the second attachment 200 is attached to the drive unit 30. The operator then operates the first and second bending mechanisms 60 and 70, the opening and closing mechanism 80, and the rotating mechanism 90 by manipulating any of the four gripping parts 201.

[0112] Even when adopting the configuration of the modified example 1-2 described above, the same effects as those of the embodiment 1 described above are achieved. Furthermore, by attaching the first and second attachments 100 and 200 to the drive unit 30, the medical device 6 can be used as a handpiece. Therefore, if the robotic device 2 malfunctions during surgery, the surgeon can remove the medical device 6 from the robotic device 2, attach the first and second attachments 100 and 200, and use the medical device 6 as a handpiece to continue the surgery.

[0113] In the above-described modified examples 1-2, two first and second attachments 100 and 200 were used as the attachment according to the present invention, but it may also be composed of only one. Furthermore, the configuration of the operating part in the attachment according to the present invention is not limited to the above-described knob 201, but other configurations may also be adopted.

[0114] Embodiment 1 and Modifications 1-1 and 1-2 described above have the following technical features: (1) A medical device to be attached to a robotic device constituting a robotic surgical system, comprising: an end effector for treating a target to be treated; a tubular member disposed on the base end side of the end effector; a drive unit disposed on the base end side of the tubular member; and a first wire (first and second bending wires WI2 and WI3), wherein the drive unit comprises two first bearing parts (first and second bending bearing parts 62, 63, 72, and 73) that perform linear motion in response to rotational motion transmitted from the outside, and the first wire has one end connected to one of the two first bearing parts and the other end connected to the other first bearing part, and the portion between the one end and the other end passes through the end effector, causing the end effector to bend relative to the tubular member in response to the linear motion of the two first bearing parts. (2) The medical device according to (1), wherein the end effector is bendable relative to the tubular member in a first plane (XZ plane) including a central axis extending in the longitudinal direction of the tubular member, and is also bendable relative to the tubular member in a second plane (YZ plane) including the central axis and perpendicular to the first plane, and two sets of the two first bearing portions are provided corresponding to the bending of the end effector relative to the tubular member in the first plane and the second plane, and two first wires are provided corresponding to the bending of the end effector relative to the tubular member in the first plane and the second plane. (3) The medical device according to (1), wherein the end effector comprises a first gripping member and a second gripping member which is openable and closable with respect to the first gripping member and grips the object to be treated between itself and the first gripping member, the drive unit further comprises a second bearing portion (opening / closing bearing portion 82) which performs linear motion in response to rotational motion transmitted from the outside, and the medical device further comprises a second wire (opening / closing wire WI1) which has one end connected to the second bearing portion and the other end connected to the second gripping member and opens and closes the second gripping member with respect to the first gripping member in response to the linear motion of the second bearing portion.(4) The medical device according to (1), wherein the tubular member is configured to be rotatable with respect to the drive unit about a central axis extending in the longitudinal direction of the tubular member, and the drive unit further comprises a rotation mechanism that transmits rotational motion transmitted from the outside to the tubular member and rotates the tubular member with respect to the drive unit about the central axis. (5) The medical device according to (1), wherein the drive unit further comprises a support shaft portion (first and second bending support shaft portions 61, 71) that is connected to one of the two first bearing portions by a first screw structure and to the other first bearing portion by a second screw structure, the support shaft portion rotates in response to rotational motion transmitted from the outside, and the rotation causes the two first bearing portions to move in a linear motion, and the first screw structure and the second screw structure are reverse screw structures which are opposite to each other. (6) The medical device according to (1), wherein the end effector comprises an ultrasonic transducer that generates ultrasonic vibrations and an ultrasonic blade connected to the tip end of the ultrasonic transducer and having a treatment section that applies the ultrasonic vibrations generated by the ultrasonic transducer to the object to be treated.(7) A medical device to be attached to a robotic device constituting a robotic surgical system, comprising: an end effector that treats a target by applying ultrasonic vibrations to the target; a tubular member disposed on the proximal end side of the end effector; and a drive unit disposed on the proximal end side of the tubular member that drives the medical device in accordance with a driving force transmitted from the outside, wherein the end effector comprises an ultrasonic treatment unit having an ultrasonic transducer that generates the ultrasonic vibrations and an ultrasonic blade connected to the tip end of the ultrasonic transducer that applies the ultrasonic vibrations generated by the ultrasonic transducer to the target; and a support member that supports the ultrasonic treatment unit, wherein the ultrasonic treatment unit is provided with a flange portion supported by the support member, and the support member comprises a tubular support member body through which the ultrasonic treatment unit is inserted, and a pressing member connected to the support member body that abuts the flange portion against the support member body along the longitudinal direction of the support member body. (8) The medical device according to (7), wherein the support member is inserted into an electrically insulating heat shrinkable tube and at least a portion of it is covered by the heat shrinkable tube. (9) A medical device to be attached to a robotic device constituting a robotic surgical system, comprising: an end effector for treating a target to be treated; a tubular member disposed on the proximal end side of the end effector; a drive unit disposed on the proximal end side of the tubular member for driving the medical device by a driving force transmitted from the outside; and attachments (first and second attachments 100, 200) that are detachably attached to the drive unit and, when attached, enable the medical device to be used as a handpiece.

[0115] (Embodiment 2) Next, Embodiment 2 will be described. In the following description, components similar to those in Embodiment 1 described above will be denoted by the same reference numerals, and their detailed descriptions will be omitted or simplified. In Embodiment 2, the configuration of the ultrasonic treatment device 13 is changed from that of the embodiment described above. The ultrasonic treatment device 13 and the method for manufacturing the ultrasonic treatment device 13 will be described in order below.

[0116] [Configuration of the ultrasonic treatment device] Figure 19 is a diagram showing the configuration of the ultrasonic treatment device 13. Specifically, Figure 19 is a cross-sectional view obtained by cutting the ultrasonic treatment device 13 in a plane containing the central axis Ax2. As shown in Figure 19, the ultrasonic treatment device 13 comprises an ultrasonic transducer 15 and an ultrasonic blade 16.

[0117] The ultrasonic transducer 15 is the part that generates ultrasonic vibrations. As shown in Figure 19, the ultrasonic transducer 15 comprises a piezoelectric element unit 17 and an element holding part 18.

[0118] As shown in Figure 19, the piezoelectric element unit 17 comprises first and second electrode portions 171 and 172, and a plurality of piezoelectric elements 173 (three in this embodiment 2).

[0119] As shown in Figure 19, the first electrode section 171 comprises a plurality (two in this second embodiment) of first electrode plates 1711, a first bridge 1712 (see Figure 28), and a first electrode terminal (not shown).

[0120] Multiple first electrode plates 1711 are each composed of annular plate bodies and are arranged side by side along the central axis Ax2. The first bridge 1712 is the part that electrically connects the outer edges of adjacent first electrode plates 1711. The first electrode terminal extends from the outer edge of the first electrode plate 1711 located at the base end Ar2 of the multiple first electrode plates 1711 toward the base end Ar2. The first electrode terminal is also electrically connected to a power supply device (not shown) provided in the robot device 2.

[0121] As shown in Figure 19, the second electrode section 172 comprises a plurality (two in this embodiment 2) second electrode plates 1721, a second bridge 1722, and a second electrode terminal 1723.

[0122] Multiple second electrode plates 1721 are each composed of annular plate bodies and are arranged side by side along the central axis Ax2. The second electrode plates 1721 have substantially the same shape as the first electrode plates 1711. The first and second electrode plates 1711 and 1721 are arranged alternately along the central axis Ax2, as shown in Figure 19. The second bridge 1722 is the part that electrically connects the outer edges of adjacent second electrode plates 1721. The second electrode terminal 1723 extends from the outer edge of the second electrode plate 1721 located furthest towards the base end Ar2 among the multiple second electrode plates 1721 toward the base end Ar2. The second electrode terminal 1723 is electrically connected to a power supply device (not shown) provided in the robot device 2. Then, between the first electrode terminal and the second electrode terminal 1723, drive power is supplied from a power supply device (not shown) provided on the robot device 2.

[0123] Each of the multiple piezoelectric elements 173 is composed of annular plates and is arranged between the first and second electrode plates 1711 and 1721, respectively. That is, the multiple piezoelectric elements 173 are stacked along the central axis Ax2. Then, in response to the driving power supplied to the first and second electrode portions 171 and 172, a potential difference is generated in the stacking direction along the central axis Ax2, causing the multiple piezoelectric elements 173 to exhibit piezoelectric properties and to alternately repeat displacement along the stacking direction. As a result, the piezoelectric element unit 17 generates ultrasonic vibrations of longitudinal vibration with the stacking direction as the vibration direction.

[0124] The element holding portion 18 is made of a conductive material in at least part of it, and as shown in Figure 19, it is a component in which the element mounting portion 181 and the blade mounting portion 182 are integrally formed, and it holds the piezoelectric element unit 17.

[0125] The element mounting portion 181 is a bolt that extends linearly along the central axis Ax2 and is inserted through a plurality of first electrode plates 1711, a plurality of second electrode plates 1721, and a plurality of piezoelectric elements 173, respectively. A fastening portion 19, which is a nut, is attached to the base end side Ar2 of the element mounting portion 181, as shown in Figure 19.

[0126] As shown in Figure 19, the blade mounting portion 182 is provided at the end of the tip side Ar1 of the element mounting portion 181 and has a substantially cylindrical shape that extends linearly toward the tip side Ar1 along the central axis Ax2. In addition, a flange portion 1821 with a larger diameter than the element mounting portion 181 is provided at the end of the base side Ar2 of the blade mounting portion 182. As a result, the multiple first electrode plates 1711, multiple second electrode plates 1721, and multiple piezoelectric elements 173 are clamped between the flange portion 1821 and the fastening portion 19 with the element mounting portion 181 passing through along the central axis Ax2, thereby fastening them together in a substantially cylindrical shape. In other words, the ultrasonic transducer 15 is composed of a bolt-clamped Langevin-type transducer.

[0127] Furthermore, as shown in Figure 19, the blade mounting portion 182 is provided with a substantially cylindrical projection 1822 that extends linearly from the flange portion 1821 toward the tip side Ar1. On the outer circumferential surface of the projection 1822, a threaded portion 1823, which is a male thread, is provided at the end of the tip side Ar1.

[0128] The ultrasonic blade 16 applies ultrasonic vibrations generated by the ultrasonic transducer 15 to the object to be treated. As shown in Figure 19, the ultrasonic blade 16 is a component in which a transducer mounting portion 161 and a treatment portion 162 are integrally formed.

[0129] The transducer mounting portion 161 is a substantially cylindrical member that extends linearly along the central axis Ax2. As shown in Figure 19, the transducer mounting portion 161 is provided with an insertion recess 1611. This insertion recess 1611 is a recess that extends linearly from the end face of the base end side Ar2 of the transducer mounting portion 161 toward the tip end side Ar1 along the central axis Ax2. The projection 1822 is inserted into the insertion recess 1611. On the inner circumferential surface of this insertion recess 1611, a threaded portion 1612, which is a female thread, is provided at the end of the tip end side Ar1. The ultrasonic blade 16 is connected to the ultrasonic transducer 15 by screwing the threaded portion 1823 into the threaded portion 1612. Hereafter, the connection portion (threaded portion 1612, 1823) where the ultrasonic transducer 15 and the ultrasonic blade 16 connect to each other will be referred to as the connection portion CN.

[0130] Furthermore, a flange portion 1613, which has a larger diameter than other parts, is provided on the outer circumferential surface of the transducer mounting portion 161. This flange portion 1613 is provided at the nodal position of vibration when vibration occurs at a specific resonant frequency f (when ultrasonic vibration is generated).

[0131] The treatment section 162 extends from the end face of the tip side Ar1 of the transducer mounting section 161 toward the tip side Ar1 along the central axis Ax2.

[0132] The power supply unit (not shown) provided on the robot device 2 then applies treatment energy to the object being treated, which is gripped between the jaws 12 and the treatment unit 162, via an electrical cable (not shown).

[0133] For example, when operator OP1 performs an operation on the operating device 5 to apply ultrasonic energy to the object to be treated, the power supply device (not shown) provided on the robot device 2 supplies driving power between the first electrode terminal and the second electrode terminal 1723 of the piezoelectric element unit 17 via an electrical cable (not shown). As a result, the piezoelectric element unit 17 generates longitudinal vibration (ultrasonic vibration) that vibrates in the direction along the central axis Ax2. The treatment unit 162 also vibrates at the desired vibration due to this longitudinal vibration. Then, ultrasonic vibration is applied from the treatment unit 162 to the object to be treated that is gripped between the jaws 12 and the treatment unit 162. In other words, ultrasonic energy is applied from the treatment unit 162 to the object to be treated.

[0134] Furthermore, for example, when operator OP1 performs an operation on the operating device 5 to apply high-frequency energy to the object to be treated, the power supply device (not shown) provided on the robot device 2 supplies high-frequency power between the jaws 12 and the ultrasonic treatment device 13 via an electrical cable (not shown). When high-frequency power is supplied between the jaws 12 and the ultrasonic treatment device 13, a high-frequency current is supplied to the object to be treated that is gripped between the jaws 12 and the treatment unit 162. In other words, high-frequency energy is applied to the object to be treated.

[0135] [Method for Manufacturing an Ultrasonic Treatment Device] Next, the method for manufacturing the ultrasonic treatment device 13 described above will be explained. Figure 20 is a diagram illustrating the method for manufacturing the ultrasonic treatment device 13. Specifically, Figure 20 is a diagram showing the vibration model MO used when manufacturing the ultrasonic treatment device 13. First, the vibration model MO used when manufacturing the ultrasonic treatment device 13 will be explained with reference to Figure 20. The vibration model MO is a vibration model in which the ultrasonic treatment device 13 vibrates at a specific resonant frequency f (ultrasonic vibration), with the structure from the nodal position P1 to the antinode position P2 adjacent to the nodal position P1 being defined as mass m, and the section from the nodal position P1 to the antinode position P2 being defined as a spring SP with spring constant k.

[0136] Here, using the vibration model MO, the resonant frequency is expressed by the following equation (1).

[0137]

[0138] In other words, the resonant frequency decreases as the spring constant k decreases and the mass m increases.

[0139] Then, using the vibration model MO described above, the ultrasonic treatment device 13 is manufactured as shown below. For the sake of explanation, the method of shortening the length along the central axis Ax2 in the ultrasonic treatment device 13 will be mainly described below.

[0140] First, the resonant frequency is set to a first resonant frequency f1 that is smaller than a specific resonant frequency f by adjusting at least one of the mass m and the spring constant k (first step). In the first step, the resonant frequency is set to the first resonant frequency f1 by (1) increasing the mass m, (2) decreasing the spring constant k, or (3) increasing the mass m and decreasing the spring constant k.

[0141] After the first step, the length from the nodal position P1 to the antinode position P2 is shortened until the resonant frequency becomes a specific resonant frequency f (second step). In the second step, by shortening the length from the nodal position P1 to the antinode position P2, the spring constant k can be increased or the mass m can be decreased, thereby increasing the resonant frequency from the first resonant frequency f1 to the specific resonant frequency f.

[0142] The above first and second steps make it possible to shorten the length along the central axis Ax2 in the ultrasonic treatment device 13.

[0143] The following is an example of how to adjust the spring constant k and mass m in the first step.

[0144] [An Example of Adjustment Method (Part 1)] Figure 21 is a diagram illustrating an example (Part 1) of an adjustment method for the spring constant k and mass m in the first step. Here, Figure 21 schematically shows a region 300 in the ultrasonic treatment device 13 that includes a nodal position P1 and two antinode positions P2 adjacent to the nodal position P1 on both sides. Figure 21(a) shows a reference region 300 having a columnar shape with a constant diameter, where the spring constant k and mass m have not been adjusted. That is, Figure 21(a) shows a region 300 where the spring constant k is the reference spring constant k(ST) and the mass m is the reference mass m(ST), and these reference spring constant k(ST) and reference mass m(ST) result in a specific resonance frequency f. Figures 21(b) and 21(c) show a region 300 in which the spring constant k and mass m have been adjusted from the reference spring constant k(ST) and reference mass m(ST).

[0145] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 21(b), the spring constant k is made smaller than the reference spring constant k(ST) by making the section from one antinode P2 to the nodal position P1 hollow. As a result, the resonant frequency becomes a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode P2, the resonant frequency becomes a specific resonant frequency f. That is, the total length L' of section 300 in Figure 21(b) is shorter than the total length L of section 300 in Figure 21(a).

[0146] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 21(c), a hollow shape is made from one antinode P2 to the nodal position P1, similar to the example of Figure 21(b), and the diameter of the one antinode P2 is made thicker than that of the part 300 in Figure 21(a), making the mass m larger than the reference mass m(ST). As a result, the resonant frequency becomes a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode P2, the resonant frequency becomes a specific resonant frequency f. That is, the total length L' of the part 300 in Figure 21(c) is shorter than the total length L of the part 300 in Figure 21(a).

[0147] If the hollow portion shown in Figure 21(b) and Figure 21(c) is designated as the insertion recess 1611, then the part 300 shown in Figure 21 can be exemplified as the ultrasonic blade 16. However, the part 300 is not limited to the ultrasonic blade 16; any other part of the ultrasonic treatment device 13, such as the ultrasonic transducer 15, may also be used.

[0148] [An Example of Adjustment Method (Part 2)] Figure 22 is a diagram illustrating an example (Part 2) of the adjustment method for the spring constant k and mass m in the first step. Here, Figure 22 schematically shows a region 300 in the ultrasonic treatment device 13 that includes a nodal position P1 and two antral positions P2 adjacent to the nodal position P1 on both sides. Figure 22(a) is a diagram corresponding to Figure 21(a). Figures 22(b) and 22(c) show a region 300 in which the spring constant k and mass m have been adjusted from the reference spring constant k(ST) and reference mass m(ST).

[0149] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 22(b), the spring constant k is made smaller than the reference spring constant k(ST) by making the section 300 shown in Figure 22(a) thinner from the nodal position P1 to both antinode positions P2. Also, in the example of Figure 22(b), the diameter of one antinode position P2 is made thicker than the section 300 in Figure 22(a), making the mass m larger than the reference mass m(ST). As a result, the resonant frequency becomes a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode position P2, the resonant frequency becomes a specific resonant frequency f. That is, the total length L' of section 300 in Figure 22(b) is shorter than the total length L of section 300 in Figure 22(a).

[0150] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 22(c), the section from the nodal position P1 to both antinode positions P2 is made thinner than the section 300 shown in Figure 22(a), similar to the example of Figure 22(b). Also, in the example of Figure 22(c), the diameters of both antinode positions P2 are made thicker than the section 300 in Figure 22(a), and the mass m is made larger than the reference mass m(ST) in each case. As a result, the resonant frequency becomes a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode position P2, the resonant frequency becomes a specific resonant frequency f. That is, the total length L'' of the section 300 in Figure 22(c) is shorter than the total length L of the section 300 in Figure 22(a), and further shorter than the total length L'' of the section 300 in Figure 22(b).

[0151] Examples of the part 300 shown in Figure 22 include an ultrasonic transducer 15 or an ultrasonic blade 16.

[0152] [An Example of Adjustment Method (Part 3)] Figure 23 is a diagram illustrating an example (Part 3) of the adjustment method for the spring constant k and mass m in the first step. Here, Figure 23 schematically shows a region 300 in the ultrasonic treatment device 13 that includes a nodal position P1 and two antral positions P2 adjacent to the nodal position P1 on both sides. Figure 23(a) is a diagram corresponding to Figure 21(a). Figures 23(b) and 23(c) show a region 300 in which the spring constant k and mass m have been adjusted from the reference spring constant k(ST) and reference mass m(ST).

[0153] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 23(b), a hollow shape is created from one antinode P2 to the nodal position P1, similar to the example of Figure 21(b). In addition, in the example of Figure 23(b), a multi-stage shape is created from one antinode P2 to the other antinode P2. Specifically, in the example of Figure 23(b), a multi-stage shape is created in which the diameter dimensions (outer and inner diameter dimensions) decrease in stages from one antinode P2 to the other antinode P2 along the longitudinal direction of the part 300 (left-right direction in Figure 23(b)). That is, the spring constant k is made smaller than the reference spring constant k(ST) by the hollow shape and the multi-stage shape. As a result, the resonant frequency becomes a first resonant frequency f1 which is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode P2, the resonant frequency becomes the specific resonant frequency f. In other words, the total length L' of part 300 in Figure 23(b) is shorter than the total length L of part 300 in Figure 23(a).

[0154] As a method for adjusting the spring constant k and mass m in the first step, the only difference between the example in Figure 23(c) and the example in Figure 23(b) is that a multi-stage shape is adopted in which parts with large diameters (outer diameter and inner diameter) and parts with small diameters alternate. In this case as well, the total length L' of part 300 in Figure 23(c) is shorter than the total length L of part 300 in Figure 23(a).

[0155] If the hollow portion shown in Figure 23(b) and Figure 23(c) is designated as the insertion recess 1611, then the part 300 shown in Figure 23 can be exemplified as the ultrasonic blade 16. However, the part 300 is not limited to the ultrasonic blade 16; any other part of the ultrasonic treatment device 13, such as the ultrasonic transducer 15, may also be used.

[0156] [An Example of Adjustment Method (Part 4)] Figure 24 is a diagram illustrating an example (Part 4) of the adjustment method for the spring constant k and mass m in the first step. Here, Figure 24 schematically shows a region 300 in the ultrasonic treatment device 13 that includes a nodal position P1 and two adjacent antinode positions P2 on both sides of the nodal position P1. Figure 24(a) is a diagram corresponding to Figure 21(a). Figure 24(b) shows a region 300 in which the spring constant k and mass m have been adjusted from the reference spring constant k(ST) and reference mass m(ST).

[0157] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 24(b), the spring constant k is made smaller than the reference spring constant k(ST) by making the area from the nodal position P1 to both antinode positions P2 spring-shaped. Also, in the example of Figure 24(b), the diameters of both antinode positions P2 are made thicker than the part 300 in Figure 24(a), and the mass m is made larger than the reference mass m(ST). As a result, the resonant frequency becomes a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode position P2, the resonant frequency becomes a specific resonant frequency f. That is, the total length L' of part 300 in Figure 24(b) is shorter than the total length L of part 300 in Figure 24(a).

[0158] The part 300 shown in Figure 24 can be exemplified by the ultrasonic transducer 15. However, the part 300 is not limited to the ultrasonic transducer 15; other parts of the ultrasonic treatment device 13, such as the ultrasonic blade 16, may also be used.

[0159] [An Example of Adjustment Method (Part 5)] Figure 25 is a diagram illustrating an example (Part 5) of the adjustment method for the spring constant k and mass m in the first step. Here, Figure 25 schematically shows a region 300 in the ultrasonic treatment device 13 that includes a nodal position P1 and two antral positions P2 adjacent to the nodal position P1 on both sides. Figure 25(a) is a diagram corresponding to Figure 21(a). Figure 25(b) shows a region 300 in which the spring constant k and mass m have been adjusted from the reference spring constant k(ST) and reference mass m(ST).

[0160] As a method for adjusting the spring constant k and mass m in the first step, in the example of Figure 25(b), the spring constant k is made smaller than the reference spring constant k(ST) by creating a bellows shape from the nodal position P1 to both antinode positions P2. Also, in the example of Figure 25(b), the diameters of both antinode positions P2 are made thicker than the part 300 in Figure 25(a), and the mass m is made larger than the reference mass m(ST). As a result, the resonant frequency becomes a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, in the second step, by shortening the length from the nodal position P1 to the antinode position P2, the resonant frequency becomes a specific resonant frequency f. That is, the total length L' of part 300 in Figure 25(b) is shorter than the total length L of part 300 in Figure 25(a).

[0161] The part 300 shown in Figure 25 can be exemplified by the ultrasonic transducer 15. However, the part 300 is not limited to the ultrasonic transducer 15; other parts of the ultrasonic treatment device 13, such as the ultrasonic blade 16, may also be used.

[0162] The second embodiment described above provides the following effects. In the manufacturing method of the ultrasonic treatment device 13 according to this second embodiment, the vibration model MO described above is used, and by adjusting at least one of the mass m and the spring constant k, the resonant frequency is set to a first resonant frequency f1 that is smaller than a specific resonant frequency f. Then, the ultrasonic treatment device 13 is manufactured by shortening the length from the nodal position P1 to the antinode position P2 until the resonant frequency becomes the specific resonant frequency f. Therefore, according to the manufacturing method of the ultrasonic treatment device 13 according to this second embodiment, a miniaturized (shorter overall length) ultrasonic treatment device 13 can be manufactured as an ultrasonic treatment device 13 to be installed at the tip side Ar1 of the bent portion 14.

[0163] Furthermore, as a method for manufacturing the ultrasonic treatment device 13 using the vibration model MO, a different manufacturing method from the one described in Embodiment 2 above may be adopted, as shown below. In the manufacturing method of the ultrasonic treatment device 13 shown below, the vibration model MO is used in the same way as in the manufacturing method described in Embodiment 2 above. For the sake of explanation, the following mainly describes a method for shortening the length along the central axis Ax2 of the ultrasonic treatment device 13.

[0164] First, by shortening the length from the nodal position P1 to the antinode position P2 and increasing the spring constant k, the resonant frequency is set to a second resonant frequency f2 that is greater than the specific resonant frequency f (first step).

[0165] After the first step, the mass m is increased until the resonant frequency reaches a specific resonant frequency f (second step). In the second step, the resonant frequency is increased from the second resonant frequency f2 to the specific resonant frequency f by increasing the mass m (e.g., by increasing the diameter of the antinode P2).

[0166] The above first and second steps make it possible to shorten the length along the central axis Ax2 in the ultrasonic treatment device 13.

[0167] Furthermore, in the above-described embodiment 2, the configurations of the following modified examples 2-1 to 2-3 may also be adopted.

[0168] (Modification 2-1) Figure 26 is a diagram illustrating modification 2-1 of Embodiment 2. Here, Figures 26(a) and 26(b) schematically show a conventional ultrasonic treatment device. Hereafter, the conventional ultrasonic treatment device, ultrasonic transducer, and ultrasonic blade will be referred to as ultrasonic treatment device 13', ultrasonic transducer 15', and ultrasonic blade 16'. Also, in Figures 26(a) and 26(b), the waveform shown by curve C1' shows the vibration of the ultrasonic transducer 15' at a first specific resonance frequency f'1. The waveform shown by curve C2' shows the vibration of the ultrasonic blade 16' at a second specific resonance frequency f'2. Figures 26(c) and 26(d) schematically show the ultrasonic treatment device 13 according to this modification 2-1. Furthermore, in Figures 26(c) and 26(d), the waveform shown by curve C1 represents the vibration of the ultrasonic transducer 15 at a first specific resonant frequency f'1. The waveform shown by curve C2 represents the vibration of the ultrasonic blade 16 at a second specific resonant frequency f'2.

[0169] Here, the first and second specific resonant frequencies f'1 and f'2 are ideally identical to the specific resonant frequency f, but in reality, they are different frequencies that are close to the specific resonant frequency f. For the sake of explanation, the first and second specific resonant frequencies f'1 and f'2 will be described as the specific resonant frequency f below.

[0170] In the conventional ultrasonic treatment device 13', the ultrasonic transducer 15' and ultrasonic blade 16' are configured such that their tip and base ends are at the antinodes P2, and there is only one nodal position P1 between these two antinodes P2, as shown in Figure 26(a). That is, if the wavelength of vibration at a specific resonant frequency f (first and second specific resonant frequencies f'1, f'2) is λ, then the total length of the ultrasonic transducer 15' and ultrasonic blade 16' is λ / 2 each. Furthermore, in the conventional ultrasonic treatment device 13', the ultrasonic transducer 15' and ultrasonic blade 16' are connected to each other with their antinodes P2 approximately coinciding, as shown in Figure 26(b). Therefore, the total length of the conventional ultrasonic treatment device 13' is λ.

[0171] In the ultrasonic treatment device 13 of this modified example 2-1, the ultrasonic transducer 15 and ultrasonic blade 16 are configured similarly to the conventional ultrasonic treatment device 13', as shown in Figure 26(c), with the tip and base ends being antinodes P2, and having only one nodal position P1 between these two antinodes P2. That is, if the wavelength of vibration at a specific resonant frequency f (first and second specific resonant frequencies f'1, f'2) is λ, the total length of the ultrasonic transducer 15 and ultrasonic blade 16 is λ / 2 each. In the ultrasonic treatment device 13 of this modified example 2-1, the ultrasonic blade 16 is connected to the ultrasonic transducer 15 at the connection part CN with the protruding part 1822 inserted into the insertion recess 1611, as shown in Figure 26(d). Therefore, the total length of the ultrasonic treatment device 13 of this modified example 2-1 is smaller than λ. Furthermore, the connection portion CN is located at a position that includes the antinode P2 of the ultrasonic transducer 15, and at a position spaced apart from the antinode P2 of the ultrasonic blade 16 (close to the nodal position P1). Therefore, the amplitude of the ultrasonic vibration at the antinode P2 located at the tip of the ultrasonic blade 16 can be increased.

[0172] (Modification 2-2) Figure 27 is a diagram illustrating modification 2-2 of Embodiment 2. Specifically, Figures 27(a) and 27(b) correspond to Figures 26(c) and 26(d), and schematically show the ultrasonic treatment device 13 according to this modification 2-2.

[0173] In the modified example 2-1 described above, the protrusion 1822 according to the present invention may be provided on the ultrasonic blade 16 and the insertion recess 1611 according to the present invention may be provided on the ultrasonic transducer 15, as shown in the modified example 2-2 in Figures 27(a) and 27(b). In this case as well, similar to the modified example 2-1 described above, the total length of the ultrasonic treatment device 13 in the modified example 2-2 will be smaller than λ, and the amplitude of ultrasonic vibration at the ventral position P2 located at the tip of the ultrasonic blade 16 can be increased.

[0174] (Modification 2-3) Figure 28 is a diagram illustrating modification 2-3 of Embodiment 2. Specifically, Figure 28 is a diagram showing an ultrasonic treatment device 13 according to this modification 2-3. In Embodiment 2 and modifications 2-1 and 2-2 described above, a configuration may be adopted in which the first electrode terminal of the first electrode portion 171 and the second electrode terminal 1723 of the second electrode portion 172 are not provided.

[0175] In this case, the connection positions for the first electrical cable CA1, which supplies power from a power supply device (not shown) provided on the robot device 2 to the first electrode section 171, and the second electrical cable CA2, which supplies power from the power supply device to the second electrode section 172, can be the connection positions shown in Figure 28(a) or Figure 28(b).

[0176] In the example shown in Figure 28(a), the first electrical cable CA1 is electrically connected to the flange portion 1821. Here, the blade mounting portion 182 is electrically connected to the first electrode portion 171. The second electrical cable CA2 is electrically connected to the second bridge 1722.

[0177] In the example shown in Figure 28(b), the first electrical cable CA1 is electrically connected to the first bridge 1712. The second electrical cable CA2 is electrically connected to the second bridge 1722.

[0178] With the above configuration, it is not necessary to provide a first electrode terminal in the first electrode section 171 and a second electrode terminal 1723 in the second electrode section 172, thus shortening the overall length of the ultrasonic treatment device 13.

[0179] The embodiment 2 and modified examples 2-1 to 2-3 described above have the following technical features: (1) A method for manufacturing an ultrasonic treatment device for treating biological tissue by applying generated ultrasonic vibrations to the biological tissue, wherein, in a state in which the ultrasonic treatment device vibrates at a specific resonant frequency, a vibration model is used in which the mass at the antinode is a mass m and the distance from the nodal position to the antinode is a spring with spring constant k, and by adjusting at least one of the mass m and the spring constant k, the resonant frequency is set to a first resonant frequency smaller than the specific resonant frequency, and the length from the nodal position to the antinode is shortened until the resonant frequency becomes the specific resonant frequency, thereby manufacturing the ultrasonic treatment device. (2) The method for manufacturing an ultrasonic treatment device according to (1), wherein the distance from the nodal position to the antinode is made hollow to reduce the spring constant k and set the resonant frequency to the first resonant frequency. (3) A method for manufacturing an ultrasonic treatment device according to (2), wherein the spring constant k is reduced by making the section from the nodal position to the antinode position a multi-stage shape, and the resonant frequency is set to the first resonant frequency. (4) A method for manufacturing an ultrasonic treatment device according to (1), wherein the spring constant k is reduced by making the section from the nodal position to the antinode position thinner, and the resonant frequency is set to the first resonant frequency. (5) A method for manufacturing an ultrasonic treatment device according to (1), wherein the mass m is increased by making the antinode position thicker, and the resonant frequency is set to the first resonant frequency. (6) A method for manufacturing an ultrasonic treatment device according to (1), wherein the spring constant k is reduced by making the section from the nodal position to the antinode position a spring shape, and the resonant frequency is set to the first resonant frequency. (7) A method for manufacturing an ultrasonic treatment device according to (1), wherein the spring constant k is reduced by making the section from the nodal position to the antinode position a bellows shape, and the resonant frequency is set to the first resonant frequency.(8) A method for manufacturing an ultrasonic treatment device for treating biological tissue by applying generated ultrasonic vibrations to the biological tissue, wherein the ultrasonic treatment device is vibrating at a specific resonant frequency, and the configuration from the nodal position to the antinode adjacent to the nodal position is a vibration model in which the mass at the antinode is mass m and the distance from the nodal position to the antinode is a spring with spring constant k, and the length from the nodal position to the antinode is shortened and the spring constant k is increased to make the resonant frequency a second resonant frequency greater than the specific resonant frequency, and then the mass m is increased until the resonant frequency becomes the specific resonant frequency, thereby manufacturing the ultrasonic treatment device. (9) An ultrasonic treatment device comprising an ultrasonic transducer for generating ultrasonic vibrations for treating biological tissue, and an ultrasonic blade connected to the tip end of the ultrasonic transducer and having a treatment portion for applying the ultrasonic vibrations generated by the ultrasonic transducer to the biological tissue, wherein one of the ultrasonic transducer and the ultrasonic blade is provided with a projection that protrudes toward the other of the ultrasonic transducer and the ultrasonic blade, and the other of the ultrasonic transducer and the ultrasonic blade is provided with an insertion recess through which the projection is inserted, and the connection portion connecting the ultrasonic transducer and the ultrasonic blade to each other is provided at a position including the antinode of the vibration of the ultrasonic transducer and at a position spaced apart from the antinode of the vibration of the ultrasonic blade when the ultrasonic transducer vibrates at a first specific resonant frequency and the ultrasonic blade vibrates at a second specific resonant frequency. (10) The ultrasonic treatment device according to (9), wherein the projection is provided on the ultrasonic transducer and the insertion recess is provided on the ultrasonic blade. (11) The ultrasonic treatment device according to (9), wherein the ultrasonic transducer comprises a plurality of piezoelectric elements, a plurality of electrode plates for supplying power to the plurality of piezoelectric elements, and a bridge for electrically connecting the plurality of electrode plates, and the wire for supplying power to the plurality of piezoelectric elements is electrically connected to the bridge.(12) The ultrasonic treatment device according to (9), wherein the ultrasonic transducer is composed of a bolted Langevin transducer, and a wire for supplying power to the ultrasonic transducer is electrically connected to the front mass of the bolted Langevin transducer. (13) A medical system comprising a remotely operated robotic device and a medical device having an ultrasonic treatment device and attached to the robotic device, wherein the ultrasonic treatment device comprises an ultrasonic transducer that generates ultrasonic vibrations for treating biological tissue and an ultrasonic blade connected to the tip end of the ultrasonic transducer and having a treatment portion for applying the ultrasonic vibrations generated by the ultrasonic transducer to the biological tissue, wherein one of the ultrasonic transducer and the ultrasonic blade is provided with a projection that protrudes toward the other of the ultrasonic transducer and the ultrasonic blade, the other of the ultrasonic transducer and the ultrasonic blade is provided with an insertion recess through which the projection is inserted, and the connection portion connecting the ultrasonic transducer and the ultrasonic blade to each other is provided at a position including the antinode of the vibration of the ultrasonic transducer and at a position spaced apart from the antinode of the vibration of the ultrasonic blade when the ultrasonic transducer vibrates at a first specific resonant frequency and the ultrasonic blade vibrates at a second specific resonant frequency.

[0180] (Embodiment 3) Next, Embodiment 3 will be described. In the following description, components similar to those in Embodiments 1 and 2 described above will be denoted by the same reference numerals, and their detailed descriptions will be omitted or simplified. In Embodiment 3, the configuration of the end effector 10 is changed from that of the embodiments described above. The configuration of the end effector 10 will be described below.

[0181] [About the End Effector Configuration] Figures 29 to 38 illustrate the configuration of the end effector 10 according to Embodiment 3. Specifically, Figure 29 is a perspective view of the end effector 10 as seen from the tip side Ar1. Figure 30 is a perspective view showing the end effector 10 shown in Figure 29 with the outer tube TO removed. Figure 31 is a perspective view showing the end effector 10 shown in Figure 30 with the support member 11 removed. Figure 32 is a view of the end effector 10 shown in Figure 30 from the +Y axis side. Figure 33 is a view of the end effector 10 shown in Figure 30 from the +X axis side. Figure 34 is a view of the end effector 10 shown in Figure 30 from the -X axis side. Figure 35 is a cross-sectional view of the end effector 10 shown in Figure 29 cut by the XZ plane including the central axes Ax1 and Ax2. Figure 36 is a cross-sectional view of the end effector 10 shown in Figure 29, cut by the YZ plane containing the central axes Ax1 and Ax2. Figure 37 is a cross-sectional view taken along line A-A in Figure 32. Figure 38 is a cross-sectional view of the end of the base end Ar2 of the end effector 10 shown in Figure 29, cut by the XZ plane containing the central axes Ax1 and Ax2.

[0182] The end effector 10 according to this third embodiment, as shown in Figures 29 to 38, comprises a support member 11, a jaw 12, an ultrasonic treatment device 13, and a bent portion 14, similar to the end effector 10 described in the first embodiment described above. Of these members 11 to 14 in this third embodiment, the ultrasonic treatment device 13 has the same configuration as the ultrasonic treatment device 13 described in the modified example 2-3 shown in Figure 28(b). The treatment portion 162 corresponds to the first portion according to the present invention. In the ultrasonic blade 16, the transducer mounting portion 161, which is another portion other than the treatment portion 162, corresponds to the second portion according to the present invention. In the ultrasonic treatment device 13 according to this third embodiment, the first and second bridges 1712 and 1722 are arranged on the +Y axis side and the -Y axis side, respectively, as shown in Figure 36.

[0183] As shown in Figures 30 and 32 to 36, the support member 11 according to this third embodiment comprises a tubular support portion 114 and a connecting member 115.

[0184] The tubular support portion 114 is made up of a cylindrical body and is the part that supports the jaw 12 and the ultrasonic treatment device 13. As shown in Figures 30, 32 to 34, and 36, the tubular support portion 114 comprises a tubular support portion body 1141 and two pressing members 1142.

[0185] The tubular support body 1141 is made up of a cylindrical body, and the ultrasonic treatment device 13 is inserted through it from the proximal end side Ar2. That is, the ultrasonic transducer 15 is located inside the tubular support body 1141. The tubular support body 1141 supports the ultrasonic treatment device 13 with the treatment portion 162 protruding outward toward the tip side Ar1. That is, the treatment portion 162 corresponds to the second part according to the present invention. Furthermore, in the ultrasonic treatment device 13, the parts other than the treatment portion 162 correspond to the first part according to the present invention.

[0186] Furthermore, the tubular support body 1141 supports the jaw 12 so that it can rotate around the rotation axis RAx1 (Figure 35) by the end of the tip side Ar1. The tubular support body 1141 is provided with two openings 1141a that penetrate both the inside and outside, as shown in Figures 30, 32 to 34, and 36. The inner circumferential surface of the tubular support body 1141 has a stepped shape in which the tip side Ar1 is reduced in diameter relative to the base side Ar2. Hereafter, this stepped surface will be referred to as the stepped surface 1141b (Figures 35 and 36). The outer circumferential surface of the tubular support body 1141 is formed such that it tapers towards the tip side at the base side Ar2, compared to the stepped surface 1141b to which the flange portion 1613 is pressed with the annular elastic member RS3 in between.

[0187] Furthermore, on the outer circumferential surface of the tubular support body 1141, as shown in Figures 30, 33 to 35, and 37, there are first and second grooves 1141c and 1141d on the -X-axis side and the +X-axis side, respectively, which are recessed radially inward on the tubular support body 1141 and extend along the longitudinal direction of the tubular support body 1141 from the tip to the base. The cross-sectional shapes of these first and second grooves 1141c and 1141d are substantially the same. The first groove 1141c corresponds to the groove according to the present invention.

[0188] Furthermore, in the tubular support body 1141, two notches 1141e are provided on the +Y axis side and the -Y axis side, respectively, cut out from the base end toward the tip end Ar1, as shown in Figures 30, 32, and 36. These two notches 1141e are designed to prevent the first and second bridges 1712 and 1722 from mechanically interfering with the tubular support body 1141 when the ultrasonic treatment device 13 is inserted into the tubular support body 1141 from the base end Ar2. In other words, when the ultrasonic treatment device 13 is supported by the tubular support body 1141, the first and second bridges 1712 and 1722 are positioned within the two notches 1141e, respectively. As a result, the inner diameter of the tubular support body 1141 does not increase in accordance with the first and second bridges 1712 and 1722, and the outer diameter of the tubular support body 1141 can also be reduced.

[0189] As described above, the first and second grooves 1141c and 1141d and the two notches 1141e are respectively positioned at 90° rotationally symmetrical positions with respect to the central axis Ax2.

[0190] The two retaining members 1142 each have the same shape as the retaining member 112 described in the above-described modified example 1-1 shown in Figures 16 and 17. Specifically, as shown in Figures 30, 32 to 34, and 36, the retaining member 1142 comprises a cover portion 1142a and a retaining portion 1142b.

[0191] As shown in Figures 30, 32 to 34, and 36, the cover portion 1142a is a part that fits into the opening 1141a of the tubular support body 1141 and closes the opening 1141a.

[0192] As shown in Figure 36, the pressing portion 1142b is a bulge from the back surface of the cover portion 1142a (the inner surface of the tubular support portion 114). By fitting the cover portion 1142a into the opening 1141a, the pressing portion 1142b presses the flange portion 1613 of the ultrasonic blade 132 toward the stepped surface 1141b, with the annular elastic member RS3 sandwiched between the flange portion 1613 and the stepped surface 1141b. As a result, the ultrasonic treatment device 13 is positioned in a direction along the central axis Ax2 with respect to the tubular support portion 114.

[0193] As shown in Figures 30 to 36, the connecting member 115 has a substantially cylindrical shape and is fixed to the tubular support body 1141 by being fitted into the tubular support body 1141 from the base end side Ar2 of the tubular support body 1141. The connecting member 115 is provided with first through holes 1151 that extend from the tip to the base end, through which the electrical cable WI4, the switching wire WI1, and the first and second electrical cables CA1 and CA2 are inserted, respectively.

[0194] Furthermore, the electrical cable WI4 according to this third embodiment has the function of an electrical cable for supplying high-frequency power between the jaw 12 and the ultrasonic treatment device 13, as well as the function of an opening / closing wire that transmits the driving force from the fifth motor (not shown) provided in the drive unit 30 to the jaw 12, and opens and closes the jaw 12 relative to the treatment unit 162. In other words, the electrical cable WI4 corresponds to the second wire according to the present invention. Hereinafter, for the sake of convenience of explanation, the opening / closing wire WI1 will be referred to as the first opening / closing wire WI1, and the electrical cable WI4 will be referred to as the second opening / closing wire WI4.

[0195] The bent portion 14 according to this third embodiment connects the connecting member 115 to the end of the tip side Ar1 of the sheath 20, and configures the end effector 10 to bend relative to the sheath 20. In this bent portion 14, as shown in Figures 35 and 36, a second through hole 141 is provided at each position opposite the four first through holes 1151, extending from the tip to the base, through which the first and second opening / closing wires WI1 and WI4 and the first and second electrical cables CA1 and CA2 are inserted, respectively. The second through holes 141 correspond to the through holes according to the present invention.

[0196] The bent portion 14 and connecting member 115 described above are made of metal material. The tubular support portion 114 is made of an electrically insulating resin material.

[0197] Then, as shown in Figures 29 to 36, one first bending wire WI2 extends from the base end Ar2 to the tip end Ar1 on the +X axis side within the sheath 20, passes through the bending portion 14 and the connecting member 115, and then extends from the +X axis side to the +Y axis side along the outer surface of the connecting member 115 while being locked to the connecting member 115, and folds back toward the base end Ar2. After folding back toward the base end Ar2, one first bending wire WI2 again passes through the connecting member 115 and the bending portion 14, and extends from the tip end Ar1 to the base end Ar2 on the +Y axis side within the sheath 20. In other words, in this embodiment 3, the portions at both ends of one first bending wire WI2 are positioned at positions offset by 90° around the central axis Ax1. Then, the end effector 10 bends relative to the sheath 20 in the +X axis direction and the +Y axis direction, respectively, upon receiving the driving force transmitted by the first bending wire WI2.

[0198] Furthermore, as shown in Figures 29 to 36, one second bending wire WI3 extends from the base end Ar2 to the tip end Ar1 on the -X axis side within the sheath 20, passes through the bending portion 14 and the connecting member 115, and then extends from the -X axis side to the -Y axis side along the outer surface of the connecting member 115 while being locked to the connecting member 115, and folds back toward the base end Ar2. Then, after folding back toward the base end Ar2, one second bending wire WI3 again passes through the connecting member 115 and the bending portion 14, and extends from the tip end Ar1 to the base end Ar2 on the -Y axis side within the sheath 20. In other words, in this embodiment 3, the portions at both ends of one second bending wire WI3 are positioned at positions offset by 90° around the central axis Ax1. Then, the end effector 10 bends relative to the sheath 20 in the -X axis and -Y axis directions, respectively, upon receiving the driving force transmitted by the second bending wire WI3.

[0199] As described above, by arranging the first and second bending wires WI2 and WI3, the end effector 10 can be made thinner while maintaining a simple structure.

[0200] Specifically, four bending wires are typically required to bend the end effector 10. When four bending wires are used in this way, four points need to be created to fix the bending wires to the connecting member 115. However, by using only two bending wires, the first and second bending wires WI2 and WI3, and securing them to the connecting member 115 as described above, the number of points to which the bending wires are fixed to the connecting member 115 can be reduced to two.

[0201] Furthermore, as in Embodiment 1 described above, if the ends of the first and second bending wires WI2 and WI3 are positioned at a 180° offset from the central axis Ax1, the portions of the first and second bending wires WI2 and WI3 that are locked (fixed) to the connecting member 115 (hereinafter referred to as the folded portion) will pass through the connecting member 115 or extend along the outer surface of the connecting member 115 for a 180° arc centered on the central axis Ax1.

[0202] Furthermore, if the folded portions of the first and second bending wires WI2 and WI3 are configured to pass through the connecting member 115, they may mechanically interfere with the first and second opening / closing wires WI1 and WI4 and the first and second electrical cables CA1 and CA2 within the connecting member 115, potentially complicating the arrangement of the folded portions of the first and second bending wires WI2 and WI3 within the connecting member 115. Also, if the folded portions of the first and second bending wires WI2 and WI3 are configured to extend along the outer surface of the connecting member 115 by a 180° arc centered on the central axis Ax1, the folded portions may overlap each other on the outer surface of the connecting member 115. Moreover, if the folded portions are offset in the direction along the central axis of the connecting member 115 to prevent them from overlapping, the length of the connecting member 115 will increase by the amount of the offset.

[0203] The jaw 12 according to this third embodiment differs from the jaw 12 described in the first embodiment above in the configuration of the jaw body 121. The jaw body 121 is made of a conductive material and, as shown in Figures 29 to 31, is a member in which a gripping body 1213, a connecting portion 1214, and a pivot support portion 1215 are integrally formed.

[0204] The gripping body 1213 is constructed of a long, roughly plate-like body, similar to the base body 1211 described in Embodiment 1 above. A pad 122 is attached to the surface of the gripping body 1213 facing the treatment portion 162. As a result, the pad 122 comes into contact with the treatment portion 162 when the gripping body 1213 is closed against the treatment portion 162. In other words, the surface of the pad 122 facing the treatment portion 162 corresponds to the gripping surface 1221 (Figure 35) according to the present invention.

[0205] As shown in Figures 29 to 31, the connecting portion 1214 has a configuration in which the tip portions in the protruding direction of the pair of protruding portions 1212 described in Embodiment 1 above are connected to each other. That is, the connecting portion 1214, together with the gripping portion body 1213, has a ring shape. The treatment portion 162 is inserted through the ring shape formed by the connecting portion 1214 and the gripping portion body 1213. In addition, the connecting portion 1214 is provided with a connecting hole 1214a (Figure 35) that penetrates from the tip side Ar1 to the base side Ar2, and to which the first opening / closing wire WI1 is connected. That is, the treatment portion 162 is positioned between the gripping portion body 1213 and the connection position of the first opening / closing wire WI1 to the connecting portion 1214.

[0206] As shown in Figures 29 to 31, the pivot support portion 1215 is provided on a surface of the gripping body 1213 that is spaced apart from the treatment portion 162, and is pivotally supported on the end of the tip side Ar1 of the tubular support portion 114 so as to be rotatable around the rotation axis RAx1. The treatment portion 162 is positioned between the pivot support portion 1215 and the connection position of the first opening / closing wire WI1 to the connecting portion 1214.

[0207] [Regarding the arrangement of the first and second switching wires and the first and second electrical cables] Next, the arrangement of the first and second switching wires WI1 and WI4 and the first and second electrical cables CA1 and CA2, which extend from the drive unit 30, will be described. The first switching wire WI1 extends from the drive unit 30 along the central axis Ax1 towards the tip side Ar1 within the sheath 20 as shown in Figure 35, and is inserted through the second through hole 141 of the bent portion 14 and the first through hole 1151 of the connecting member 115, and is then inserted into the first groove portion 1141c from the base end side Ar2 towards the tip side Ar1. Specifically, the first opening / closing wire WI1 is routed from the second through hole 141 toward the first groove 1141c at the tip side Ar1 of the bent portion 14, at an angle with respect to the central axis Ax2 (tilting toward the -X axis as it approaches the tip side Ar1). The other end of the first opening / closing wire WI1 is inserted through the connecting hole 1214a from the base side Ar2 toward the tip side Ar1, and then fixed to the connecting portion 1214 by brazing or the like. When the jaw 12 is closed toward the treatment portion 162, the connection position of the first opening / closing wire WI1 to the rotation axis RAx1 and the connecting portion 1214 is located in a plane perpendicular to the central axis Ax2. The portion of the first opening / closing wire WI1 inserted into the first groove 1141c is covered by the outer tube TO.

[0208] Here, the first opening / closing wire WI1 is covered by a first tube TU1 made of an electrically insulating resin material, as shown in Figure 37. This first tube TU1 corresponds to the tube according to the present invention. This first tube TU1 improves the sliding properties of the first opening / closing wire WI1. Also, the depth dimension of the first groove 1141c is larger than the diameter dimension of the first opening / closing wire WI1 including the first tube TU1. Furthermore, as shown in Figure 38, the first opening / closing wire WI1 is inserted into the first coil sheath CS1 in the path from inside the sheath 20 to the second through hole 141 of the bent portion 14 to the first through hole 1151 of the connecting member 115. The first opening / closing wire WI1 moves back and forth inside the first coil sheath CS1 in accordance with the driving force from the drive unit 30. In other words, by arranging the first coil sheath CS1 from the tip side Ar1 to the base side Ar2 of the bent portion 14, the tension of the first opening / closing wire WI1 can be suppressed by the first coil sheath CS1, thereby preventing the end effector 10 from bending due to this tension.

[0209] In the embodiment 1 described above, a first groove 1141c may be provided in the support member 11, and the first opening / closing wire WI1 may be inserted into the first groove 1141c.

[0210] The second opening / closing wire WI4 extends from the drive unit 30 through the sheath 20 along the central axis Ax1 toward the tip side Ar1, as shown in Figure 35. After being inserted through the second through hole 141 of the bent portion 14 and the first through hole 1151 of the connecting member 115, it is inserted into the second groove portion 1141d from the base end side Ar2 toward the tip side Ar1. Specifically, the second opening / closing wire WI4 is routed from the second through hole 141 toward the second groove portion 1141d at the tip side Ar1 of the bent portion 14, inclined with respect to the central axis Ax2 (inclined toward the +X axis as it approaches the tip side Ar1). The other end of the second opening / closing wire WI4 is fixed to the pivot support portion 1215. Furthermore, the portion of the second opening / closing wire WI4 that is inserted into the second groove 1141d is covered by the outer tube TO.

[0211] In this third embodiment, the jaw 12 closes relative to the treatment section 162 when the connecting portion 1214 is pulled toward the base end side Ar2 by the first opening / closing wire WI1. On the other hand, the jaw 12 opens relative to the treatment section 162 when the pivot support portion 1215 is pulled toward the base end side Ar2 by the second opening / closing wire WI4. In other words, in this third embodiment, the elastic member RS1 described in the first embodiment above is not provided.

[0212] Here, the second switching wire WI4 is covered by a second tube TU2 made of an electrically insulating resin material, as shown in Figure 37. This second tube TU2 improves the sliding properties of the second switching wire WI4. Furthermore, the diameter of the second switching wire WI4 including the second tube TU2 is the same as the diameter of the first switching wire WI1 including the first tube TU1. In addition, as shown in Figure 38, the second switching wire WI4 is inserted into the second coil sheath CS2 in the path from inside the sheath 20 to the second through hole 141 of the bent portion 14 to the first through hole 1151 of the connecting member 115. The second switching wire WI4 then moves back and forth within the second coil sheath CS2 in accordance with the driving force from the drive unit 30. In other words, by arranging the second coil sheath CS2 from the tip side Ar1 to the base side Ar2 of the bent portion 14, the tension of the second opening / closing wire WI4 can be suppressed by the second coil sheath CS2, thereby preventing the end effector 10 from bending due to this tension.

[0213] The first electrical cable CA1 extends from the drive unit 30 through the sheath 20 along the central axis Ax1 toward the tip side Ar1, as shown in Figure 36. After being inserted through the second through hole 141 of the bent portion 14 and the first through hole 1151 of the connecting member 115, it is electrically connected to the first bridge 1712. The first bridge 1712 and the first electrical cable CA1, located within the notch 1141e, are covered by the outer tube TO.

[0214] The second electrical cable CA2 extends from the drive unit 30 through the sheath 20 along the central axis Ax1 toward the tip side Ar1, as shown in Figure 36. After being inserted through the second through hole 141 of the bent portion 14 and the first through hole 1151 of the connecting member 115, it is electrically connected to the second bridge 1722. The second bridge 1722 and the second electrical cable CA2, located within the notch 1141e, are covered by the outer tube TO.

[0215] As described above, the first and second opening / closing wires WI1 and WI4 and the first and second electrical cables CA1 and CA2 are respectively positioned at 90° rotationally symmetrical positions with respect to the central axis Ax2. The first opening / closing wire WI1 is positioned radially outward of the ultrasonic blade 16, which corresponds to the first gripping member according to the present invention. Furthermore, one end of the first opening / closing wire WI1 is connected to the connection portion 1214 at a position radially outward of the ultrasonic blade 16. The support member 11 is located between the first opening / closing wire WI1 and the flange portion 1613. Furthermore, the treatment portion 162 is positioned between the first connection position of the first opening / closing wire WI1 to the connection portion 1214 and the second connection position of the second opening / closing wire WI4 to the pivot support portion 1215. Furthermore, the first separation dimension between the gripping surface 1221 and the first connection position is longer than the second separation dimension between the gripping surface 1221 and the second connection position.

[0216] As described above, this embodiment 3 provides the same effects as embodiments 1 and 2 described above, as well as the following effects. As described above, this embodiment 3 provides the following effects. In the medical device 6 according to this embodiment 3, the first and second opening and closing wires WI1 and WI4 are inserted into the first and second grooves 1141c and 1141d provided on the outer circumferential surface of the support member 11, respectively. Therefore, compared to a configuration in which the first and second opening and closing wires WI1 and WI4 are arranged inside the tubular support portion 114 or outside the tubular support portion 114 without the first and second grooves 1141c and 1141d, the diameter of the end effector 10 can be reduced. Accordingly, the medical device 6 according to this embodiment 3 can improve ease of use.

[0217] (Modification 3-1) Figures 39 and 40 illustrate Modification 3-1 of Embodiment 3. Specifically, Figure 39 is an exploded perspective view of the end effector 10 according to Modification 3-1 as seen from the base end side Ar2. Figure 40 is a cross-sectional view of the end effector 10 according to Modification 3-1 cut by the YZ plane including the central axes Ax1 and Ax2. In Modification 3-1, the tubular support body 1141 described in Embodiment 3 above is divided into a tip side Ar1 portion and a base end side Ar2 portion. Hereinafter, the tip side Ar1 portion will be referred to as the tip side support portion 1143 (Figures 39 and 40), and the base end side Ar2 portion will be referred to as the base end support portion 1144 (Figures 39 and 40).

[0218] Two retaining members 1142 are attached to the tip-side support portion 1143, similar to the tip-side Ar1 portion of the tubular support body 1141 described in Embodiment 3 above. At the base end Ar2 of this tip-side support portion 1143, locking holes 1143a that penetrate both the inside and outside are provided on the +Y axis side and the -Y axis side, as shown in Figures 39 and 40.

[0219] The base end support portion 1144 has a connecting member 115 fitted inside, similar to the base end Ar2 portion of the tubular support body 1141 described in Embodiment 3 above. As shown in Figures 39 and 40, the base end support portion 1144 is divided into two parts by an XZ plane including the central axis Ax2. The base end support portion 1144 is provided with two openings 1144a that penetrate both the inside and outside, respectively, and have the same function as the notch portion 1141e described in Embodiment 3 above. That is, when the base end support portion 1144 is assembled to the ultrasonic treatment device 13, the first and second bridges 1712 and 1722 are positioned in the two openings 1144a, respectively. Furthermore, at the tip end Ar1 of the base end support portion 1144, locking projections 1144b are provided on the +Y axis side and the -Y axis side, respectively, protruding toward the tip end Ar1, being inserted into the tip end support portion 1143, and being locked into the locking holes 1143a. By locking the locking projections 1144b into the locking holes 1143a, the base end support portion 1144 is connected to the tip end support portion 1143. In other words, a snap-fit ​​type connection structure is adopted as the connection structure between the tip end support portion 1143 and the base end support portion 1144. Note that this connection structure is not limited to a snap-fit ​​type connection structure; other connection structures may also be adopted.

[0220] As described above, this modified example 3-1 provides the same effects as the above-described embodiment 3, as well as the following effects. However, in the above-described embodiment 3, if the outer diameter of the flange portion 1613 is larger than the outer diameter of the flange portion 1821, the ultrasonic treatment device 13 is inserted into the tubular support portion 114 from the base end side Ar2 of the tubular support portion 114, so the inner diameter of the tubular support portion 114 must be adjusted to match the outer diameter of the flange portion 1613. In contrast, in this modified example 3-1, the tubular support portion body 1141 described in the above-described embodiment 3 is divided into a tip side Ar1 portion (tip side support portion 1143) and a base end side Ar2 portion (base end support portion 1144). Furthermore, the base end support portion 1144 is divided into two parts by an XZ plane including the central axis Ax2. Therefore, in the above-described case, it is not necessary to match the inner diameter of the base end support portion 1144 to the outer diameter of the flange portion 1613, and the diameter of the base end Ar2 portion of the end effector 10 can be reduced.

[0221] 1 Robotic surgical system 2 Robot device 3 Imaging device 4 Processing device 5 Operating device 6 Medical device 10 End effector 11 Support member 12 Jaws 13, 13' Ultrasonic treatment device 14 Bending section 15, 15' Ultrasonic transducer 16, 16' Ultrasonic blade 17 Piezoelectric element unit 18 Element holding section 19 Fastening section 20 Sheath 21 Robot arm 30 Drive unit 40 Housing 41 Housing body 42 Base section 50 Shaft 60 First bending mechanism 61 First bending support shaft section 62, 63 First bending bearing section 70 Second bending mechanism 71 Second bending support shaft section 72, 73 Second bending bearing section 80 Opening / closing mechanism 81 Opening / closing support shaft section 82 Opening / closing bearing section 83 First support member 84 Second support member 90 Rotation mechanism 91 Rotation support shaft 92 First gear 93 Second gear 94 Connection part 100 First attachment 101, 102 Handle part 111 Support member body 112, 113 Pressing member 114 Tubular support part 115 Connection member 121 Jaw body 122 Pad 131 Ultrasonic transducer 132 Ultrasonic blade 141 Second through hole 161 Transducer mounting part 162 Treatment part 171 First electrode part 172 Second electrode part 173 Piezoelectric element 181 Element mounting part 182 Blade mounting part 200 Second attachment 201 Thumb part 300 Part 421 Support hole 422 First driving force receiving hole 423 Second drive force receiving hole 424 Third drive force receiving hole 425 Fourth drive force receiving hole 426 Fifth drive force receiving hole 427 Closing member 611 First shaft body 612 First drive force receiving part 711 Second shaft body 712 Second drive force receiving parts 621, 631 First wire connection part 622, 632 First bearing body 721, 731 Second wire connection part 722, 732 Second bearing body 811 Shaft body 812 Opening / closing drive force receiving part 1111, 1112 Opening 1113 Stepped surface 1121,1131 Cover part 1122, 1132 Pressing part 1141 Tubular support part body 1141a Opening 1141b Stepped surface 1141c First groove part 1141d Second groove part 1141e Notch part 1142 Pressing member 1142a Cover part 1142b Pressing part 1143 Tip side support part 1143a Locking hole 1144 Base end support part 1144a Opening 1144b Locking projection part 1151 First through hole 1211 Base body 1212 Protruding part 1212a Pin-shaped part 1212b Protruding part 1213 Gripping part body 1214 Connecting part 1214a Connecting hole 1215 Axle support part 1221 1311 gripping surface; 1311a piezoelectric element unit; 1312 piezoelectric element; 1312 holding part; 1321 processing part; 1322 flange part; 1611 insertion recess; 1612 threaded part; 1613 flange part; 1711 first electrode plate; 1712 first bridge; 1721 second electrode plate; 1722 second bridge; 1723 second electrode terminal; 1821 flange part; 1822 protruding part; 1823 threaded part; 6221, 6321 first connection part; 6222, 6322 second connection part; 6222a, 6322a groove; 6223, 6323 extended part; 7221, 7321 first connection part; 7222, 7322 second connection part; 7222a, 7322a groove 7223,7323 Extension Ar1 Tip side Ar2 Base side Ax1,Ax2 Central axis C1,C1',C2,C2' Curve CA1 First electrical cable CA2 Second electrical cable CN Connection part CS1 First coil sheath CS2 Second coil sheath GI1-GI3 Guide shaft L,L',L'' Total length MO Vibration model NT Nut OP1 Operator OP2 Assistant OP3 Anesthesiologist OP4 Nurse P1 Node position P2 Ventral position RAx1 Rotation axis RS1-RS3 Elastic member SC1,SC3 First screw structure SC2,SC4 Second threaded structure SC5 Threaded structure SP Spring SW1-SW3 Switch TO Heat shrink tubing TU1 First tubing TU2 Second tubing WI1 Opening / closing wire (first opening / closing wire) WI2 First bending wire WI3 Second bending wire WI4 Electrical cable (second opening / closing wire)

Claims

A first gripping member and A second gripping member is provided that can be opened and closed relative to the first gripping member and grips the object to be treated between itself and the first gripping member, A support member having an elongated shape, which at its tip supports the second gripping member so that it can be opened and closed relative to the first gripping member, It comprises a first wire, one end of which is connected to the second gripping member, and which opens and closes the second gripping member relative to the first gripping member, On the outer surface of the support member, A groove is provided in the support member that is recessed radially inward and extends along the longitudinal direction of the support member from one end to the other. The first wire is, A treatment tool inserted into the groove. 　 The first gripping member is, It has a long shape, The first wire is, The treatment tool according to claim 1, which is disposed at a position radially outward of the first gripping member. 　 One end of the first wire is The treatment tool according to claim 2, which is connected to the second gripping member. 　 The second gripping member is, A gripping body that grips the object to be treated between itself and the first gripping member, It comprises a connecting portion that protrudes from the gripping body and to which the first wire is connected, The first gripping member is, The treatment tool according to claim 1, which is disposed between the gripping body and the connection position of the connecting part and the first wire. 　 Between the connecting portion and the support member, The treatment device according to claim 4, wherein a biasing member is provided that elastically deforms when the second gripping member closes to the first gripping member by being pressed by the connecting portion, and biases the connecting portion in the direction in which the second gripping member opens relative to the first gripping member. 　 The biasing member is The treatment device according to claim 5, having a tubular shape through which the first wire is inserted. 　 The second gripping member is, It comprises a connecting portion to which the first wire is connected, and a pivot portion that is rotatably supported on the support member, and opens and closes relative to the first gripping member by rotating relative to the support member, The first gripping member is, The treatment device according to claim 1, which is disposed between the shaft support and the connection position of the first wire to the connection portion. 　 The aforementioned support member is It has a tubular shape and includes a tubular support portion at its tip that rotatably supports the second gripping member relative to the first gripping member, The aforementioned treatment device is It is further equipped with an ultrasonic transducer that generates ultrasonic vibrations, The ultrasonic transducer is, The treatment tool according to claim 1, which is disposed within the tubular support portion. 　 A tubular member is positioned on the base end side of the end effector, which is a unitized unit comprising the first gripping member, the second gripping member, the support member, and the ultrasonic transducer. The end effector further comprises a bending portion provided at the base end of the end effector, which bends the end effector relative to the tubular member, The aforementioned bent portion includes, A through hole is provided that extends from the tip to the base. The first wire is, The treatment tool according to claim 8, which is inserted into the through hole and the tubular member. 　 The first wire is, The treatment tool according to claim 9, wherein, at the tip side of the bent portion, it is routed in an inclined manner with respect to the central axis along the longitudinal direction of the support member, from the through hole into the groove. 　 The first gripping member is, The treatment tool according to claim 8, which is an ultrasonic blade having a treatment portion connected to the tip end of the ultrasonic transducer and for applying the ultrasonic vibrations generated by the ultrasonic transducer to the object to be treated. 　 The first gripping member is, The first portion is disposed within the support member, It comprises a first portion and a second portion that protrudes outward from the support member toward the tip, The first part above includes, The treatment tool according to claim 1, wherein the flange portion is formed to have a larger outer diameter than other parts of the first portion and is supported by the support member. 　 The aforementioned support member is The treatment tool according to claim 12, which is positioned between the first wire and the flange portion. 　 The treatment device according to claim 1, further comprising a second wire, one end of which is connected to the second gripping member. 　 The first gripping member is, The treatment device according to claim 14, wherein the device is positioned between the first connection position of the first wire to the second gripping member and the second connection position of the second wire to the second gripping member. 　 The second gripping member is, Having a gripping surface for gripping the object to be treated, The first distance between the gripping surface and the first connection position is The treatment tool according to claim 15, wherein the distance between the gripping surface and the second connection position is longer than the second separation dimension. 　 The depth dimension of the groove is, The treatment tool according to claim 1, wherein the diameter dimension is larger than that of the first wire. 　 The first wire is, The treatment device according to claim 1, which is covered by a tube made of an electrically insulating resin material.

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