Abstract:
Provided is a surgical tools having multiple functions exhibited by end effector parts, which is small-sized and inexpensive, and which can eliminate the necessity of replacement of surgical tools. The surgical tools incorporating: a tip end portion having a plurality of end effector parts, and a tool sleeve through which a transmission mechanism of driving force for applying driving force to the tip end portion is led. The plurality of end effector parts comprise a pair of a first end effector part and a second end effector part so as to have a first tool function, and a third end effector part mated with one or both of the first end effector part and the second end effector part so as to have a second tool function. The transmission mechanism of driving force comprises a first transmission mechanism of driving force for applying a driving force to the first end effector part and the second end effector part, and a second transmission mechanism of driving force for applying a driving force to the third end effector part, independent from the first transmission mechanism of driving force.

Description:
BACKGROUND OF THE INVENTION 
       [0001]    (1) Field of the Invention 
         [0002]    The present invention relates to a surgical tools and an operating system, in particular to a surgical tools which has a plurality of surgical, functions with the use of end effector parts and which is used in an endoscopic surgical operation, and which is preferably used in an operating system. 
         [0003]    (2) Description of related art 
         [0004]    There have been used various kinds of surgical tools manipulated by surgeons. The surgeons properly use various kinds of surgical tools, depending upon a case of a disease or a situation so as to carry out medical treatments. In an endoscopic surgical operation which has been carried out as Minimally invasive surgery that exerts a least load upon the patient, there has been carried out the surgical operation that a surgical tools is inserted through an outer sheath which is the so-called trocar, and which is fitted in a small hole formed in the body surface. Should the number of kinds of surgical tools be large, the operation that a surgical tools is withdrawn through the trocar, and then a different surgical tool replaced therewith is inserted through the trocar would be inevitably repeated at several times, thereby, larger time and labor are required. Further, it requires the preparation of several kinds of surgical tools, resulting in increasing of the costs. 
         [0005]    Even in a surgical operation with the use of robots, there have caused the problems of requiring man-powers for replacements of robot surgical tool, increasing the sizes of devices for the replacement thereof or the like. 
         [0006]    Further, these years, the technique that a surgical operation is made within an MRI system in order to carry out both diagnosis and treatment at the same time, has been noticeable. However, the image pick-up zone in the MRI system is very narrow, that is, a space through which surgical tools should be introduced into and out, is confined. Thus, it is required not only to bring the patient out from the MRI system in order to exchange surgical tool but also to exchange surgical tool with a very cramped posture within the MRI system, resulting in the requirement of much more time and manpower. 
         [0007]    Thus, for example, JP-A-10-174689 (Patent Document 1) discloses a surgical tool which has optional functions such as electrocauterization, suctioning and injection, in addition to a basic function as a grasper-forceps. 
         [0008]    Further, JP-A-05-184535 (Patent Document 2) also discloses the treatment technique that a plurality of surgical tools is inserted into a main catheter, being operable, independent from one another. 
         [0009]    The surgical tools disclosed in Patent Document 1 is the one which can have a grasping function exhibited by end effector parts, and also has a plurality of additional functions such as electrocauterization, suctioning and injection, but not the one which have multiple functions by end effector parts. Thus, in the case of a treatment using various kinds of operating functions with the use of end effector parts, it is required to exchange surgical tools, and as a result, there has been the problem that the time of surgical operation correspondingly becomes longer. 
         [0010]    Further, as to the treatment technique disclosed in Japanese Patent Document 2 using a plurality of surgical tools inserted in a single catheter, the narrower the catheter, the lager the size of a single surgical tools, relative to the catheter into which it is inserted, the surgical tools is too small to readily manipulate the surgical tools with respect to a size of an affected area, and alternatively, if a surgical tools having a size which is appropriate for an affected area were used, the catheter for receiving the surgical tools would have a larger diameter so as to require making an excessively larger hole in the surface of the human body, resulting in the problem of high infestation into the human body. 
       BRIEF SUMMARY OF THE INVENTION 
       [0011]    The present invention is devised in view of the above-mentioned problems inherent to the prior art, and accordingly, one object of the present invention is to provide a surgical tools which is small-sized and which is capable of carrying out a plurality of treatment functions with the use of end effector parts without the necessity of exchange of surgical tools, thereby it is possible to aim at shortening the time of surgical operation and is also to provide an operating system using the surgical tools for minimally invasive surgery. 
         [0012]    To the end, according to an aspect of the present invention, there is provided a surgical tools including a tip end portion having a plurality of end effector parts, and a tool sleeve through which a transmission mechanism of driving force is led for applying a driving force to the tip end portion, wherein the plurality of end effector parts comprising a pair of first and second end effector part having a first treatment function, a third end effector part adapted to be mated with one or both of the first and second end effector part so as to have a second treatment function, and the transmission mechanism of driving force incorporates a first transmission mechanism of driving force for applying a driving force to the first and second end effector part, and a second transmission mechanism of driving force for applying a driving force to the third end effector part, independent from the first transmission means. 
         [0013]    In the specific embodiments of the first aspect of the present invention, there may be used the following configurations: 
         [0000]    (1) The above-mentioned tip end portion comprises a housing, a first bevel gear integrally formed with the first end effector part and rotatably supported to the housing, a second bevel gear integrally formed with the second end effector part, and rotatably supported to the housing in the condition that it is laid in parallel with and opposed to the first bevel gear, a third bevel gear meshed with both first and second bevel gears and rotatably supported to the housing, a first input gear integrally formed with the third bevel gear, and a second input gear integrally formed with the third end effector part and rotatably supported to the housing in the condition that it is arranged in a direction crossing the first bevel gear, wherein the first input gear is coupled to the first transmission mechanism of driving force on the tool sleeve side, and the second input gear is coupled to the second transmission mechanism of driving force on the tool sleeve side;
 
(2) In the configuration (1), the first and second end effector part carry out opening and closing operations in response to rotation of the third bevel gear, the first bevel gear and the second bevel gear in association with the rotation of the first input gear, and the third end effector part carries out opening and closing operations together with one or both of the first second end effector part in association with the rotation of the second input gear;
 
(3) In the configuration (2), the first end effector part and the second end effector part exhibit a forceps function for scissoring an affected area in cooperation, and the first end effector part and the third end effector part carry out a forceps function for clamping the affected area in cooperation;
 
(4) In the configuration (3), there is provided a function for changing the distance between the first end effector part and the second end effector part to a size corresponding to a curvature of a bending needle for suture, and the first end effector part, the second end effector part and the third end effector part exhibit a function of a needle-driver for gripping the bending needle for suture;
 
(5) The tip end portion is flexibly supported to the tool sleeve through the intermediary of a bending joint;
 
(6) In the configuration (1), the tip end portion is flexibly supported to the tool sleeve through the intermediary of a bending joint, and the bending joint incorporates a plate for bending having a one side end part rotatably supported to the housing, and the other side end part rotatably supported to the tool sleeve so as to couple the housing and the tool sleeve to each other, an immovable gear fixed to the tool sleeve, and a guide gear fixed to the housing and adapted to be meshed with the immovable gear, the plate for bending being coupled to a third transmission mechanism of driving force of the driving force transmission power, and the immovable gear and the guide gear being configured so as to have an equal pitch circle;
 
(7) In the configuration (6), the bending joint incorporates a first bending joint gear meshed with the first input gear which is integrally formed with the third bevel gear, and rotatably supported to the housing, a second joint gear meshed with the first bending joint gear and rotatably supported to the tool sleeve, a third bending joint gear meshed with the second input gear and rotatably supported to the housing, and a fourth bending joint gear meshed with the third bending joint gear and rotatably supported to the tool sleeve, the first bending joint gear and the third bending joint gear have pitch circles equal to that of the guide gear, and the second bending joint gear and the fourth bending joint gear have pitch circles equal to that of the immovable gear.
 
         [0014]    Further, according to the second aspect of the present invention, there is provided an operating system comprising a surgical tools for treating an affected area, and a tool interface for driving the surgical tools, the surgical tools having a tip end portion including a plurality of end effector parts, and a tool sleeve through which a drive transmission means for applying a driving force to the tip end portion is led, the tool interface incorporating a drive means for applying the driving force to the transmission mechanism of driving force, wherein the plurality of end effector parts comprises a first end effector part and a second end effector part in a pair for exhibiting a first tool function, and a third end effector part mated with one or both of the first end effector part and the second end effector part, for exhibiting a second tool function, the transmission mechanism of driving force incorporates a first transmission mechanism of driving force for applying a drive force to the first end effector part and the second end effector part, and a second transmission mechanism of driving force for applying a driving force to the third end effector part, independent from the first transmission mechanism of driving force, and the drive means incorporates a first drive means for applying a driving force to the first transmission mechanism of driving force and a second drive means for applying a driving force to the second transmission mechanism of driving force. 
         [0015]    In view of the surgical tools and the operating system as stated above, there can be provided several tool functions by the end effector parts which are small-sized and inexpensive and which can eliminate the necessity of exchange of surgical tools, thereby it is possible to aim at shortening the time of minimally invasive surgery. 
         [0016]    Further aspects, objects and advantages of the present invention will be apparent in the following description of the preferred embodiments which will be explained hereinbelow with reference to the accompanying drawings, in which: 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING 
         [0017]      FIG. 1  is a perspective view illustrating an operating system in an embodiment of the present invention; 
           [0018]      FIG. 2  is a front view illustrating a tip end portion shown in  FIG. 1  in a condition in which all end effector parts are closed; 
           [0019]      FIG. 3  is a front view illustrating the tip end portion shown in  FIG. 2  in a condition all end effector parts are opened; 
           [0020]      FIG. 4  is a front view illustrating the tip end portion shown in  FIG. 1  in a first example in a condition in which all end effector parts are closed; 
           [0021]      FIG. 5  is a front view illustrating the tip end part shown in  FIG. 4 , in a condition in which a first end effector part and a second end effector part are closed; 
           [0022]      FIG. 6  is a front view illustrating the tip end portion in which all end effector parts are closed; 
           [0023]      FIG. 7  is a front view illustrating the tip end portion in a condition in which the first end effector part and the second end effector part are opened, and the first end effector part and a third end effector part are opened; 
           [0024]      FIG. 8  is a schematic view illustrating the tip end portion shown in  FIG. 1  in a second example, in a condition in which a bending needle for suture is gripped by end effector parts; 
           [0025]      FIG. 9  is a schematic view showing a condition in which a different bending needle for suture is gripped by the end effector parts shown in  FIG. 2 ; 
           [0026]      FIG. 10  is a detailed perspective view illustrating a surgical tools shown in  FIG. 1 ; 
           [0027]      FIG. 11  is an enlarged perspective view illustrating a bending joint part in the surgical tools shown in  FIG. 1 ; 
           [0028]      FIG. 12  is a perspective view illustrating a removal portion and a tool interface part of the surgical tools; 
           [0029]      FIG. 13  is a perspective view illustrating the surgical tools in a condition in which it has been removed from the tool interface shown in  FIG. 12 , and 
           [0030]      FIG. 14  is an enlarged exploded view illustrating a part shown in  FIG. 2 . 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0031]    Next, explanation will be made of the present invention in the form of preferable embodiments with reference to the accompanying drawings. 
         [0032]    At first, explanation will be herein below made of an operating system in its entirety in an embodiment of the present invention with reference to  FIG. 1  which is a perspective e view illustrating an operating system in an embodiment of the present invention. It is noted that the operating system as shown is an example of a manual operating system. 
         [0033]    The operating system comprises a surgical tools  45  for treating an affected area, and a tool interface  50 . 
         [0034]    The surgical tools  45  incorporates a tip end portion  5  having a plurality of end effector part  1 ,  2 ,  3 , a tool sleeve  40  in which a transmission mechanism of driving force for applying a driving force to the tip end portion  5  is led, a bending joint  10  for flexibly supporting the tip end portion  5  to the tool sleeve  40 , and a mounting portion  35  for removably mounting the tool sleeve  40  to the tool interface  50 . An end effector part  1  and an end effector part  2  for carrying out opening and closing operations are provided at the tip end of the surgical tools  45 , and an end effector part  3  adapted to be operated in a plane orthogonal to the direction of movement of the end effector part  1 ,  2  is also provided. The tip end portion including the end effector part  1 ,  2 ,  3  can bend, relative to the tool sleeve  40  due to the provision of the bending joint  10 . The surgical tools  45  is connected to the tool interface  50  through the intermediary of the mounting part  35 . 
         [0035]    The tool interface  50  incorporates a drive means for applying a driving force to the transmission mechanism of driving force for the surgical tools  45 . Further, the tool interface  50  has a grip  20  to be gripped by the surgeon, a trigger  15 , a dial  25  and an opening and closing flipper  30  which are to be manipulated by the surgeon. The surgeon grips the grip  20  with the palm of his hand, and manipulates the trigger  15 , the dial  25  and the opening and closing flipper  30  in order to operate the bending joint  10  of the surgical tools  45  or the end effector part  1 ,  2 ,  3 . 
         [0036]    Next, detailed explanation will be made of the tip end portion  5  with reference to  FIGS. 2 and 3 .  FIG. 2  is a front view illustrating the tip end portion shown in  FIG. 1 , in a condition in which all end effector parts are closed, and  FIG. 3  is a front view illustrating the tip end portion shown in  FIG. 2 , in a condition that all end effector parts are closed. 
         [0037]    The end effector part  1 ,  2 ,  3  consist of a pair of a end effector parts (first end effector part)  1  and a end effector parts (second end effector part)  2 , which exhibit a first tool function, and a end effector part  3  (third end effector part) which is mated with one or both of the end effector part  1 ,  2  so as to exhibit a second tool function. 
         [0038]    The tip end portion  5  incorporates a housing  80 , end effector part  1 ,  2 ,  3 , a bevel gear  51  (first bevel gear) integrally formed with the end effector part  1  and rotatably supported to the housing, a bevel gear  52  (second bevel gear) integrally formed with the end effector part  2  and rotatably supported to the housing  80 , being in parallel with and opposed to the bevel gear  51 , a bevel gear  55  (third bevel gear) rotatably supported to the housing  80 , being meshed with the bevel gears  51 , 52 , an input gear  53  (second input gear) integrally formed with the end effector part  3  and rotatably supported to the housing  80 , being arranged in a direction crossing the bevel gear  51  or the bevel gear  52 . 
         [0039]    In other words, the end effector part  1  integrally formed with the bevel gear  51 , is rotatably supported to the housing  80  by means of a pin  71  together with a collar  61 . The end effector part  2  integrally formed with the bevel gear  52  is rotatably supported to the housing  80  by means of a pin  72  together with a collar  62 . The end effector part  3  integrally formed with the input gear  53  is rotatably supported to the housing by means of a pin  73  together with a collar  63 . An input gear  54  (first input gear) integrally formed with the bevel gear  55  is rotatably supported to the housing  80  by means of a pin  74  together with a collar  64 . 
         [0040]    The bevel gear  55  is meshed with the bevel gears  51 ,  52 , and is rotated in response to the rotation of the input gear  54 , and accordingly, the bevel gears  51 ,  52  are rotated in association with rotation of the bevel gear  55 . Thus, the rotation of the input gear  54  in the direction indicated by the arrow  84  shown in  FIG. 2 , causes the end effector part  1 ,  2  integrally formed respectively with the bevel gears  51 ,  52  are moved respectively in the directions indicated by the arrows  81 ,  82  shown in  FIG. 2 , resulting in postures of the end effector part  1 ,  2  shown in  FIG. 3 . Meanwhile, the end effector part  3  shown in  FIG. 2  is moved as shown in  FIG. 3  in association with the input gear  53  which is moved in the direction indicated by the arrow  83 . On the contrary, the movements of the input gears  53 ,  54  as indicted by the arrows  83 ,  84  shown in  FIG. 3  cause the end effector part  1 ,  2 ,  3  shown in  FIG. 3  to be moved in a condition as shown in  FIG. 2 . 
         [0041]    That is, the end effector part  1 ,  2  are moved at the same time in association with the motion of the input gear  54  so as to carry out opening and closing operations, but the end effector part  3  is operated by the motion of the input gear  53 , independent from the motions of the end effector part  1 ,  2 . As understood from the above-mentioned operations, the end effector part  3  is operated on a plane orthogonal to planes on which the end effector part  1 ,  2  are operated. 
         [0042]    The parts of the end effector parts which define the surfaces  93 ,  90  and  91 ,  92  where the end effector parts are made into contact with each other are configured so as to have any of various shapes in order to materialize surgical tools in any of various combinations such as an scissoring forceps and a grasper-forceps, a needle-driver and a grasper-forceps or the like, that is, there can be presented a single surgical tools  45  having two tool functions, thereby it is possible to reduce the number of exchanges of the surgical tools  45  during an surgical operation with the use of an endoscope. The present invention will be hereinbelow detailed in the form of a first example shown in  FIGS. 4 to 7 , and in the form of a second example shown in  FIGS. 8 and 9 . 
         [0043]    The first example shown in  FIGS. 4 to 7 , the end effector part  1 ,  2  serve as scissoring end effector part  101 ,  102  while the end effector part  3  serves as a grasper-forceps end effector part  103 . Referring to  FIG. 4 , the end effector part  101 ,  102 ,  103  are all opened. The scissoring end effector part  101 ,  102  are closed from the condition shown in  FIG. 4  into a condition shown in  FIG. 5 . The end effector part  101 ,  102  can serve as a scissoring tool for scissoring an object, irrespective of the grasper-forceps end effector part  103 . Meanwhile, the grasper-forceps end effector part  103  serves as a one side-opened grasper-forceps in cooperation with a side surface of the scissoring end effector part  101 , for clamping the object. 
         [0044]    Further, in the example 2 shown in  FIGS. 8 and 9 , the end effector part  1 ,  2 ,  3  are all used so as to serve as a needle-driver. A bending needle for suture  95  shown in  FIG. 8  and a bending needle for suture  96  shown in  FIG. 9  have different sizes, respectively. In this case, the end effector part  1 ,  2  are opened by a degree which is adjusted to curvatures and sizes of the bending needle for sutures  95 ,  96  so as to firmly clamp the bending needle for sutures between the end effector part  1 ,  2  and the end effector part  3 , thereby it is possible to clamp the bending needle for sutures  95 ,  96  having different sizes. Since the opening degree between the end effector part  1 ,  2  can be easily changed, the surgical operation using the bending needle for sutures  95 ,  96  can be carried out, irrespective of the sizes and thicknesses of the bending needle for sutures. 
         [0045]    Next, detailed explanation will be made of the surgical tools  45  with reference to  FIG. 10  which is a perspective view illustrating the details of the surgical tools shown in  FIG. 1 . 
         [0046]    Referring to  FIG. 10  in which a cover  380  is removed in order to show the interior of the surgical tools, the cover  380  is normally fixed to a tool base  260  by means of screws which are not shown. A gear retainer  370  is integrally formed with a shaft  375 , and is arranged so as to be vertically movable relative to the cover  380 . When the shaft  375  is displaced downward, gears  280 ,  285  and  355  are made into contact with the gear retainer  370  so as to be locked immovably. When the shaft  375  is displaced upward, the gears  280 ,  285 ,  355  are unlocked so as to be movable freely. 
         [0047]    At first, explanation will be made of a mechanism for driving the input gear  54  which moves the end effector part  1 ,  2  or  101 ,  102 . 
         [0048]    The tool base  260  is mounted thereon with the gear  280  by means of pins  270 ,  350  so as to be rotatable. The gear  280  is integrally formed with a pinion  275  which is meshed with a rack  265 . The rack  265  which extends through the tool base  260  and the tool sleeve  40 , is meshed with a pinion  250  which is rotatably supported to the end of the tool sleeve  40 . The pinion  250  is integrally formed with a gear  240  which is meshed with a bending joint gear  225  (second bending joint gear) that is in turn meshed with a bending joint gear  205  (first bending joint gear). The bending joint gear  205  is meshed with the input gear  54 . It is noted that the mechanism from the gear  280  to the bending joint gear  205  constitutes a first transmission mechanics of driving force for applying a driving force to the end effector part  1 ,  2 . 
         [0049]    With this configuration, when the gear  280  is rotated together with the pinion  275 , the rack  265  meshed with the pinion  275  is rectilinearly moved in the axial direction of the tool sleeve  40 . The rack  265  rotates the pinion  250  in the end of the tool sleeve  40 , and accordingly, the gear  240  integrally formed with the pinion  250  is rotated. The rotation of the gear  240  causes the bending joint gear  225  meshed with the gear  240  to rotate, and accordingly, the bending joint gear  205  meshed with the bending joint gear  225  is rotated. The rotation of the bending joint gear  205  causes the input gear  54  meshed with the bending joint gear  205  to rotate, and as a result, the end effector part  1 ,  2  or  101  or  102  are operated as stated above. 
         [0050]    Next, explanation will be made of the mechanism for driving the input gear  53  which moves the end effector part  3  or  103  as stated above. 
         [0051]    A gear  355  is mounted to the tool base  260  by means of pins  270 ,  350  so as to be rotatable. The gear  355  is integrally formed with a pinion  360  which is meshed with a rack  345  that extends through the tool base  260  and the tool sleeve  40 , and is then meshed with a pinion  335  rotatably supported to the end of the tool sleeve  40 . The pinion  335  is integrally formed with a gear  340  which is in turn meshed with a bending joint gear  330  (fourth bending joint gear) that is meshed with a bending joint gear  310  (third bending joint gear). The bending joint gear  310  is meshed with the input gear  53 . It is noted that the mechanism from the gear  355  to the bending joint gear  310  constitute a second transmission mechanism of driving force for applying a driving force to the end effector part  3 . 
         [0052]    With the above-mentioned configuration, when the gear  355  is rotated together with the pinion  360 , the rack  345  meshed with the pinion  360  is rectilinearly moved in the axial direction of the tool sleeve  40 . The rack  345  rotates the pinion  335  in the end of the tool sleeve  40 , and accordingly, the gear  340  which is moved integral with the pinion  335  is rotated. The rotation of the gear  340  causes the bending joint gear  310  meshed with the bending joint gear  330  to rotate. The rotation of the bending joint gear  310  causes the input gear  53  meshed with the bending joint gear  310  to rotate, and as a result, the end effector part  3  or  103  is operated as stated above. 
         [0053]    It is noted that the pinion  250  and the gear  240  moved integral with the pinion  250 , and the pinion  335  and the gear  340  moved integral with the pinion  335  are rotatably supported to the end of the tool sleeve  40  by means of pins  245 ,  337 . The bending joint gear  225  and the bending joint gear  330  are rotatably supported to the end of the tool sleeve  40  by means of pins  220 ,  325 . 
         [0054]    Next, explanation will be made of the bending motion of the surgical tools  45  with reference to  FIGS. 10 and 11  which is an enlarged perspective view illustrating the bending joint portion of the surgical tools shown in  FIG. 1 . The surgical tools  45  is configured so as to enable the tip end portion  5  to bend, relative to the tool sleeve  40 . 
         [0055]    In the tip end part of the surgical tools  40 , the immovable gear  315  is secured by pins  325 ,  220  and pins  245  and  340 . The immovable gear  315  is adapted to be meshed with a guide gear  305  fixed to the housing  80 . 
         [0056]    It is noted that the bending joint gear  225 , the immovable gear  315  and the bending joint gear  330  have gear pitch circles which are equal to one another, and further, the bending joint gear  205 , the guide gear  305  and the bending joint gear  310  have gear pitch circles which are equal to one another. Further, the bending joint gear  205  and the bending joint gear  310  are rotatably supported to the housing  80  by means of pins  200 ,  300 . 
         [0057]    The tool sleeve  40  bend to the housing  80  and are arranged so as to maintain the space therebetween by a predetermined distance by means of the immovable gear  315  and the guide gear part  305  which are meshed with each other, and are connected to each other through the intermediary of distance holding plates  210 ,  320  which are rotatable with respect to the pin  220  and the pin  325 , and the pin  200  and the pin  300 . 
         [0058]    The gear  285  is connected to a plate for bending  215  through the intermediary of a link  225  which is rotatably supported by a pin  365 . Further, the plate for bending  215  is rotatably connected to the link  255  by means of a pin  230 . The plate for bending  215 , the links  255 , the gear  355 , the tool sleeve  40  and the tool base  260  are configured, having a parallel link relationship. When the gear  285  is swung around the pins  270 ,  350  as an axis, the plate for bending  215  is swung around the pins  220 ,  325  as an axis. Since the plate for bending  215  is connected to the housing  80  through the intermediary of the pins  200 ,  300 , the plate for bending  215  which is moved around the pins  220 ,  324  as a center, a force for moving the housing is transmitted. At this time, since the guide gear  305  of the hosing  80  is meshed with the immovable gear  310 , the housing  80  is rotated by this force in its entirely around the immovable gear  315 . At this time, since the bending joint gear  310  and the bending joint gear  330 , and the bending joint gear  205  and the bending joint gear  225  are moved with a relationship therebetween similar to that between the guide gear  305  and the immovable gear  315 , the flexible gear  310  and the flexible gear  205  are not moved relative to the housing  80 . Thus, irrespective of the motion of the bending joint gear  10 , the end effector parts can be operated, independent from one another. It is noted that the mechanism of the gear  285  and the link  225  constitutes a third transmission mechanism of driving force for applying a driving force to the plate for bending  215 . 
         [0059]    As understood from the configuration as stated above, the surgical tools  45  in this embodiment can be operated without using any wire. Since the end effector parts can be operated with no use of a wire, the maintainability of the surgical tools  45  can be enhanced, and further, the control ability thereof can be enhanced without occurrence of a problem of loosening of a wire, a problem of cooperative control or the like. 
         [0060]    However, it is noted that the surgical tools having the multiple functions can be materialized by using wires so as to operate the gear  240  or the gear  340  and the plate for bending  215  without using the rack  265 , the rack  345  and the link  255 . 
         [0061]    Next, referring to  FIGS. 12 to 14 , detailed explanation will be made of the tool mounting portion  35  and the tool interface  50 .  FIG. 12  is a perspective view illustrating the removal portion and the tool interface of the surgical tools shown in  FIG. 1 ,  FIG. 13  is a perspective view illustrating the tool interface  50  from which the surgical tools  45  shown in  FIG. 12  is removed, and  FIG. 14  is an exploded enlarged view illustrating a part shown in  FIG. 12 . 
         [0062]    The removal portion  35  of the surgical tools  45  is attached to the tool interface  50  along a guide part of a tool guide  425  of the tool interface  50  as shown in  FIG. 12 , and is locked thereto by a tool mounting lever  420 . The tool mounting lever  420  is rotatably mounted to a guide base  410  by means of a pin  415  serving as a shaft, and accordingly, by manipulating the tool mounting lever  420 , the surgical tools  45  can be removed from and attached to the tool interface  50 . 
         [0063]    The guide base  410  is mounted thereon with racks  430 ,  435 ,  440  which can be therefore rectilinearly moved as shown in  FIG. 13 . These racks  430 ,  435 ,  440  are adapted to be meshed, respectively with the gears  280 ,  285 ,  355  shown in  FIG. 10  after the surgical tools  45  is attached, and accordingly, by moving the racks  430 ,  435 ,  440 , the end effector part  1 ,  2 ,  3  at the tip end of the tool can be operated. 
         [0064]    The mechanism for moving the racks  430 ,  435 ,  440  is shown in  FIG. 14  in which a guide cover  405 , a flipper  30  and the like are disassembled for the brevity of explanation. 
         [0065]    The rack  430  is meshed with a dial  25  and a pinion  500  which is moved integral with a shaft  505  which is rotatably mounted to the guide cover  405 . In the case that the surgeon grips the grip  20  with his right hand, by turning the dial  25  with his thumb, the rack  430  is rectilinearly moved, and accordingly, the end effector part  3  at the tip end of the surgical tools is operated through the intermediary of a gear train. 
         [0066]    Further, the rack  435  is coupled with the trigger  15 , and accordingly, it can be rectilinearly moved, relative to the guide base  410 . In the case that the surgeon grips the grip  20  with his right hand, he inserts his forefinger or middle finger in a hole in the trigger  15  in order to push and pull the trigger  15 , and accordingly, the rack  435  is rectilinearly moved so that the tip end portion  5  bends around the bending joint  10 . 
         [0067]    Further, the rack  440  is meshed with the shaft  400  integrally formed with the pinion. The shaft  400  is secured to the flipper  30 , and is rotatably attached to the guide cover  405  and the guide base  410 . In the case that the surgeon grips the grip with his right hand, by pushing the flipper  30  with his forefinger, the pinion of the shaft  400  integrally formed with the flipper  30  rectilinearly moves the rack  440  so as to cause the end effector part  1 ,  2  at the tip end of the surgical tools to carry out closing operation. When the flipper  30  is opened by a spring which is not shown, the end effector part  1 ,  2  are also opened. 
         [0068]    As understood from the explanation mentioned above, the operating directions of the end effector part  1 ,  2 ,  3  at the tip end of the surgical tools, and the moving directions of the tool interface  50  manipulated by the surgeon fall in one and the same plane. Since the moving directions of the flipper  30  and the operating directions of the end effector part  1 ,  2 , the rotating direction of the dial and the operating direction of the end effector part  3 , and the plane in which the trigger  15  is moved and the plane in which the bending joint  10  is moved, are the same, thereby it is possible to provide a surgical tools which is intuitive and which can be easily manipulated. 
         [0069]    Further, by changing the operating direction of the tool interface  50  into any of its respective directions, intuitive and easy manipulation can be made even though multiple functions are effected at the tip end of the surgical tools. 
         [0070]    It is noted that the surgical tools  45  and the tool interface  50  can be easily disconnected from each other, and accordingly, even though several kinds of surgical tools each having two kinds of functions are prepared by a number required for a specific surgical operation, no more than one tool interface  50  is required, and accordingly, its can offer an advantage of cost reduction. The present invention is of course applicable even though the surgical tools and the tool interface are not disconnectable from each other. 
         [0071]    Further, it is noted that the surgical tools  45  can be used being coupled not only to the tool interface  50  but also to a manipulator. 
         [0072]    According to the present invention, the motions of the end effector part  1 ,  2 ,  3  capable of carrying out two kinds of surgical operating functions, are orthogonal to one another, and accordingly, they do not interfere with one another. Further, the object can be accessed with the surgical tools  45  with any of different operating functions only by turning the shaft of the surgical tools without changing the position thereof, and accordingly the time of surgical operation can be saved. Further, since the single surgical tools  45  can have multiple operating functions, the number of surgical tools to be prepared can be reduced, resulting in cost reduction. 
         [0073]    In the surgical tools apparatus according to the present embodiment, the tip end part of the surgical tools can be bended, independent from the end effector part  1 ,  2 ,  3  provided at the tip end part of the surgical tools. It can be provided as a manual surgical operating unit without using electronic control with an actuator or the like, and the manual control portion thereof can control the motions of the end effector parts at the tip end of the surgical tools, thereby it is possible to intuitively manipulate the surgical tools. 
         [0074]    Further, this surgical tools  45  can be disconnected from the manual control input portion, and accordingly, the same surgical tools can be attached to a manipulator. Thereby it is possible to operate the surgical tools by means of the manipulator. 
         [0075]    Further, this surgical tools  45  having the three end effector part  1 ,  2 ,  3  at the tip end thereof can have two operating functions with the end effector parts which have sizes equal to that of those of conventional surgical tools, or can grips any of bending needle for sutures, irrespective of sizes of the needles. Further, since the operating planes of the end effector parts are coincident with the input operating planes at the manipulating interface, the manipulation thereof can be simplified, thereby it is possible to carry out intuitive manipulation with less occurrence of erroneous operation. Thus, the time required for exchanging surgical tools through the trocar can be saved, and thereby it is possible to exhibit several advantages that the time of a surgical operation is shortened, the surgical operation is hygienic and safe, the number of surgical tools required for the surgical operation can be reduced to a half of the number of conventionally used surgical tools, and the costs can be reduced. Further, this surgical tools can be driven without using any wire, and accordingly, the control ability and the maintainability can be enhanced with no possibility of occurrence of problems of loosening and breakage of a wire. Further, the bending joints can be operated, independent from one another, thereby it is possible to enhance the controllability and the safety. 
         [0076]    It should be further understood by those skilled in the art that although the foregoing description has been made on embodiments of the invention, the invention is not limited thereto and various changes and modifications may be made without departing from the spirit of the invention and the scope of the appended claims.