Patent Publication Number: US-2022226060-A1

Title: Surgical instrument

Description:
The present disclosure claims a priority of a Chinese patent application NO. CN 201910338326.8 filed on Apr. 25, 2019 in China. All disclosures of the Chinese patent application may be quoted by the present disclosure. 
     FIELD 
     The subject matter herein generally relates to surgical systems, in particular to a surgical instrument. 
     BACKGROUND 
     Minimally invasive surgery refers to a surgical method of performing a procedure in a human body cavity using modern medical instruments such as laparoscopes, thoracoscopes, and so on. Compared with traditional surgery modes, minimally invasive surgery has advantages of being small in trauma, light in pain, fast in recovery, and the like. 
     With advances in science and technology, minimally invasive surgical technologies are increasingly mature and widely used. At present, surgical instruments usually have an adjusting member for adjusting positions and/or poses of the instruments, such that an end effector for the surgery can work in a desired position and/or poses. However, as the adjusting member is frequently moved for at least one freedom, a more accurate control for driving the adjusting member and as well as the end effector is needed. 
     SUMMARY 
     In view of the above problems, the present disclosure provides a surgical instrument with better driving performance. 
     In one embodiment, a surgical instrument includes: an end effector; a connecting assembly including a plurality of connecting units connected in sequence and connected to the end effector; and a tip driving unit including a flexible rod and a driving wire. The driving wire extends through the flexible rod and is connected to the end effector, the flexible rod extends in the connecting assembly, and at least one end of the flexible rod is a free end. 
     In another embodiment, a surgical instrument includes: an end effector; a connecting assembly including a plurality of connecting units connected in sequence and connected to the end effector; and a tip driving unit including a flexible rod and a driving wire, the driving wire extending through the flexible rod and connected to the end effector, the flexible rod extending in the connecting assembly, and at least one end of the flexible rod being a free end. A space is maintained between two adjacent connecting units to allow bending of the two adjacent connecting units, the flexible rod covers at least a part of the space; and the flexible rod includes a plurality of openings for facilitating bending of the flexible rod. 
     In further another embodiment, a surgical instrument includes: an end effector, a connecting assembly including a plurality of connecting units connected in sequence and connected to the end effector; and a tip driving unit including a flexible rod and a driving wire, the driving wire extending through the flexible rod and connected to the end effector, the flexible rod extending in the connecting assembly, and at least one end of the flexible rod being a free end. A space is maintained between two adjacent connecting units to allow bending of the two adjacent connecting units, the flexible rod covers at least part of the space; and the tip driving unit further includes a driving assembly and a positioning member, the driving wire includes a driving connecting portion, the driving connecting portion is connected to the driving assembly, at least at part of the driving wire extending out of the connecting assembly is oriented by the positioning member, and the driving wire is driven by the driving assembly along a straight line. 
     With the above embodiments of the surgical instruments, the driving wire extends through the flexible rod to be connected to the end effector, thus a friction of the driving wire in a driving state can be reduced, and thereby a life of the driving wire can be prolonged, and as well as an accurate movement of the driving wire can be maintained. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a structural schematic view of an embodiment of a surgical robot according to the present disclosure. 
         FIG. 2  is a partial schematic view of an embodiment of a surgical robot. 
         FIG. 3  is a partial schematic view of another embodiment of a surgical robot. 
         FIG. 4  is a schematic view of an embodiment of a surgical instrument. 
         FIGS. 5-32  and  FIG. 34  are partial schematic views of embodiments of the surgical instrument according to the present disclosure. 
         FIG. 33  is an enlarged view of the surgical instrument of  FIG. 32 . 
     
    
    
     DETAILED DESCRIPTION 
     For ease of understanding of the present application, the present application will be described more fully hereinafter with reference to the associated drawings. Preferred embodiments of the present application are set forth in the accompanying drawings. This application may, however, be embodied in many different forms and is not limited to the embodiments described herein. Rather, these embodiments are provided for the purpose of providing a more thorough and thorough understanding of the disclosure of the present application. 
     It should be noted that when an element is referred to as being “disposed on” another element, it may be directly on the other element or intervening elements may also be present. When an element is considered to be “connected” to another element, it may be directly connected to another element or intervening elements may be present at the same time. When an element is considered to be “coupled” to another element, it may be directly coupled to another element or intervening elements may be present at the same time. As used herein, the terms “vertical”, “horizontal”, “left”, “right” and the like are intended for purposes of illustration only and are not intended to be limiting. As used herein, the terms “distal end” and “proximal end” are common terms in the art of interventional medical devices, where “distal end” refers to the end far away from the operator during the surgical procedure, and the “proximal end” refers to the end close to the operator during the surgical procedure. 
     Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term “and/or” includes all combinations of one or more of the associated listed items. 
     Referring to  FIG. 1 , a surgical robot in accordance with an embodiment of the present application includes a master console  1  and a slave operating device  2 . The master console  1  is used for sending control commands to the slave operating device  2  according to the operation of a surgeon to control the slave operating device  2 . The master console  1  is also used for displaying images acquired from the slave operating device  2 . The slave operating device  2  is used for responding to the control commands sent by the master console  1  and performing corresponding operations, and the slave operating device  2  is also used for acquiring images in human body. 
     Specifically, the slave operating device  2  includes a mechanical arm  21 , a power mechanism  22  disposed on the mechanical arm  21 , a surgical instrument  23  disposed on the power mechanism  22 , and a sleeve  24  sleeving the surgical instrument  23 . The mechanical arm  21  is used for adjusting the position of the surgical instrument  23 . The power mechanism  22  is used for driving the surgical instrument  23  to perform a corresponding surgical operation. The surgical instrument  23  is used for extending into the human body and performing a surgical operation by an end effector located at a tip end thereof, and/or acquiring images within the human body. In one embodiment, as shown in  FIG. 2  and  FIG. 3 , the surgical instrument  23  is sleeved in the sleeve  24 , and an end effector  100  extends out of the sleeve  24  and is driven by the power mechanism  22  to perform the surgical operation. In  FIG. 2 , the part of the surgical instrument  23  sleeved in the sleeve  24  is a rigid part. In  FIG. 3 , the part of the surgical instrument  23  sleeved in the sleeve  24  is a flexible part, and the sleeve  24  is bent with the flexible part. In another embodiment, the sleeve  24  may also be omitted. 
     Referring to  FIGS. 4 and 5 , the surgical instrument  23  includes the end effector  100 , a connecting assembly  200 , a connecting rod  300 , a driving housing  400 , and a tip driving unit  500 . The end effector  100 , the connecting assembly  200 , the connecting rod  300 , and the tip driving unit  500  are sequentially connected. The tip driving unit  500  is located in the driving housing  400 , and is connected to the end effector  100 , for driving the end effector  100  to perform a surgical operation, for example, when the end effector  100  is a clamping device, driving the end effector  100  to open or close. In other embodiments, the connecting rod  300  and/or the driving housing  400  can be omitted. 
     The connecting assembly  200  includes a number of connecting units  210  connected in sequence. In particular, the connecting units  210  can be connected directly, for example, the connecting unit  210  has a connecting shaft, and two adjacent connecting units  210  are connected by the connecting shaft. In other embodiments, the connecting units  210  can be connected by another element, for example, the connecting units  210  can be connected by a driving wire, and the driving wire can drive the connecting assembly  200  to move. In particular, a size and a structure of the connecting units  210  can be the same or different. In other embodiments, the connecting assembly  200  can be other structures. 
     The tip driving unit  500  includes a flexible rod  510  and a driving wire  520  received in and extending out of the flexible rod  510 , the driving wire  520  is connected to the end effector  100 , and is configured for driving the end effector  100 , and the flexible rod  510  can orient the movement of the driving wire  520 . In particular, a rigidity of the driving wire  520  is greater than that of the flexible rod  510 , but the driving wire  520  can be flexible with the connecting assembly  200 , and can drive the end effector  100  to open or close. For example, a rigidity of the driving wire  520  can be 50-70 N/mm. When the driving wire  520  drives the end effector  100  to move towards a distal end from a proximal end, the flexible rod  510  can obstruct the driving wire being bent, such that the end effector  100  can move more accurately. A friction coefficient between the driving wire  520  and the flexible rod  510  is less than that of between the driving wire  520  and the connecting assembly  200 , in this way, the flexible rod  510  can decrease the friction of the driving wire  520  in a movement state contrast to that the driving wire  520  being directly received in the connecting assembly, a life of the driving wire  520  can be prolonged, and thus the accuracy of its movement can be maintained. 
     In one embodiment, the flexible rod  510  is oriented to extend along a central axis of the connecting assembly  200 . That is, the flexible rod is disposed at a center area of the connecting assembly and extends along the connecting assembly  200 . In particular, the flexible rod  510  maintains a space from the connecting assembly  200 , thereby the flexible rod  510  has a little freedom relative to the connecting assembly  200 , and thus a friction between the flexible rod  510  and the connecting assembly  200  can be reduced. For example, the space can be 0.1-3 mm, or can be 0.2 mm. In another embodiment, the flexible rod  510  is not in a central area of the connecting assembly  200 , but at a periphery of the connecting assembly, and extends along with the connecting assembly. In other embodiments, the connecting units  210  can have a number of receiving holes, and the flexible rod  510  can be received in one of the receiving holes according to need. 
     Referring to  FIG. 6 , the flexible rod  510  defines a wire hole  511 , the driving wire  520  is received in the wire hole  511 . In one embodiment, the wire hole  511  is defined at a central area of the flexible rod  510 , and extends along with the flexible rod  510 . In another embodiment, the wire hole  511  can be defined at other areas, for example, the wire hole  511  is near a central axis of the flexible rod  510 , and extends along with the flexible rod  510 , i.e., the driving wire  520  deviates a little from the central area of the flexible rod  510 . In further another embodiment, a number of the wire holes  511  are defined, and each one of the wire holes  511  maintains a space from the other ones, and the driving wire  520  can be received in one of the wire holes  511 . In particular, a space is maintained between the driving wire  520  and an inner wall of the wire hole  511 , for example, the space can be 0.05-0.5 mm, or can be 0.2 mm. 
     In one embodiment, the flexible rod  510  extends along the connecting assembly  200 , and at least one end of the flexible rod  510  is a free end, with a direction of which can be changed by a force applied thereon. In this way, a deformation of the flexible rod  510  can be reduced, and thus the position of the driving wire  520  in the flexible rod  510  can be more accurate and the movement of the end effector  100  can also be accurate. As shown in  FIGS. 6 and 7 , a free end of the flexible rod  510  is an end of the flexible rod  510  which is not fixed, and a retaining portion  220  is formed on the connecting assembly  200  to retain the free end of the flexible rod  510 . In one embodiment, the free end of the flexible rod  510  is located on an end of the flexible rod  510  by a universal structure, thereby a direction of the free end of the flexible rod  510  can be changed when a force is applied thereon, and a stretching deformation of the flexible rod  510  can be reduced. In other embodiments, the free end of the flexible rod  510  can be retained by other structures facilitating reducing a deformation of the flexible rod  510 . In another other embodiments, an end of the flexible rod  510  can be fixed, that is the flexible rod  510  does not have a free end. 
     When the flexible rod  510  includes more than one ends, the flexible rod  510  can have one free end, or can have two free ends (see  FIGS. 1 and 19-22 ). When the flexible rod  510  has only one free end, the other end of the flexible rod  510  is fixed, for example, a distal end of the flexible rod  510  is a free end, a proximal end of the flexible rod  510  is fixed to the connecting assembly  200 , the connecting rod  300 , and the driving housing  400  removably or unremovably. When the flexible rod  510  has two free ends, the two free ends are retained by some structures, for example, the two free ends are retained by the retaining portions  220 . In other embodiments, one of the two free ends is retained by the retaining portion  220 , and the other one of the two free ends is retained by a universal structure. In further other embodiments, the flexible rod  510  has two free ends. 
     Referring to  FIGS. 6 and 7 , the free end of the flexible rod  510  is retained by the retaining portion  220 , the connecting unit  210  has a receiving hole  211 , and the flexible rod  510  is received in the receiving hole  211 . In particular, at least one of the connecting units  210  has the retaining portion  220 , and the retaining portion  220  covers a part of the receiving hole  211 , thus retains the free end of the flexible rod  510 , thereby limiting the movement of the free end of the flexible rod  510 . In the present embodiment, the retaining portion  220  only covers a part of the receiving hole  211 , and the driving wire  520  can extend out of the receiving hole  211  to be connected to the end effector  100 . The retaining portion  220  and the receiving hole  211  form a receiving space for receiving the free end of the flexible rod  510 . In particular, when the connecting assembly  200  has two connecting units  210  with each of which has a retaining portion  220 , and the retaining portions  220  and the connecting units  210  therebetween forms a receiving space for receiving the flexible rod  510 . A size and a structure of the above receiving hole  211  can be the same or can be different. 
     The retaining portion  220  can have different structures. For example, as shown in  FIGS. 6 and 7 , the retaining portion  220  is a continuous piece, and gives only a passage for the driving wire  520  passing through. In other embodiments, as shown in  FIG. 8 , the retaining portion  220  is porous, and thus has a plurality of holes, the driving wire  520  extends through one of the holes of the porous retaining portion  220 . As shown in  FIG. 9 , the retaining portion  220  has a curved surface, and correspondingly the flexible rod  510  also has a curved surface. The retaining portion  220  can be integrally formed with the connecting units  210 , or can be detachably connected to the connecting units  210 . 
     A fixed end of the flexible rod  510  can have different structures, as shown in  FIG. 10 , the fixed end of the flexible rod  510  has a flange  512 , and the flange  512  is configured for engaging with the connecting assembly  200 . In particular, the connecting unit  210  has the retaining portion  220 , the flange  512  is engaged with the retaining portion  220 , and the connecting unit  210  has a cover  230  in a configuration that the flange  512  is received between the retaining portion  220  and the cover  230 , thereby the end of the flexible rod  510  is fixed. In other embodiments, the retaining portion  220  can be omitted, in this situation, the flange  512  is engaged with an end of the connecting unit  210 . In further other embodiments, the cover  230  can also be omitted, and the flange  512  is engaged with an adjacent structure of the connecting unit. In another embodiment, the flexible rod  510  can be fixed by other methods, such as being stuck. 
     In one embodiment, the flexible rod  510  can be retained at a middle portion thereof, thereby orienting the flexible rod  510  and the driving wire  520 . As shown in  FIG. 11 , the receiving hole  211  has a first receiving hole  211 A and a second receiving hole  211 B, a diameter of the second receiving hole  211 B is less than that of the first receiving hole  211 A, such that a space between the flexible rod  510  and an inner wall of the first receiving hole  211 A is greater than a space between the flexible rod  510  and an inner wall of the second receiving hole  211 B. In particular, the flexible rod  510  can move in the second receiving hole  211 B, that is, the space therebetween can allow the flexible rod  510  to move therein. In other embodiments, the flexible rod  510  can be almost fixed in the second receiving hole  211 B, that is, the space therebetween is very little, alternatively, the flexible rod  511  is fixed relative to the connecting assembly  200 . When the flexible rod is almost fixed in the second receiving hole  211 B, the connecting unit  210  having the second receiving hole  211 B can be a detachable structure, such that facilitating assembly of the flexible rod  510  into the second receiving hole  211 B. The second receiving hole  211 B can reduce the movement of the flexible rod  510 , thereby a control of the end effector can be more accurate. 
     When the connecting assembly  200  have a number of the second receiving holes  211 B, the plurality of the second receiving holes  211 B are spaced, i.e., in two adjacent connecting units  210 , only one of the connecting units  210  has the second receiving hole  211 B, in this way, deformation of the flexible rod in a bending state can be reduced. The second receiving holes  211 B can surround a central area of the flexible rod  510 , or surround a proximal end or distal end of the flexible rod  510 . 
     In particular, sections of the flexible rod  510  can have different size, such that different sections of the flexible rod  510  can have different spaces with the second receiving holes  211 B, thereby retaining the flexible rod  510  in the second receiving holes  211 B. Alternatively, adjusting both of the size of the flexible rod  510  and the second receiving hole  211 B, i.e., adjusting an outer diameter of the flexible rod  510  and an inner diameter of the second receiving hole  211 B, thereby a space therebetween can be adjusted. In other embodiments, the connecting assembly  200  does not obstruct the movement of the central area of the flexible rod  510 , and the connecting units  210  can be bent with the free end of the flexible rod  510 , thereby reducing the deformation of the flexible rod  510  when the flexible rod  510  is in a bending state. 
     In embodiments shown as in  FIGS. 4-16 , two adjacent connecting units  210  of the connecting assembly  200  has a space  240 , in this way, the connecting units  210  can move towards each other. The flexible rod  510  covers at least a part of the space  240 , in this way, the flexible rod  510  can obstruct bending of the driving wire  520  in the space  240 , thereby reducing bending of the driving wire  520 , and thus the movement of the driving wire  520  can be more accurate. 
     The flexible rod  510  can cover the entire space  240  of the connecting assembly, alternatively, cover a part of the space  240  of the connecting assembly  200 . When the space  240  of the connecting units  210  is partially covered, each space  240  between each of adjacent connecting units  210  is partially covered, and the covered portions of the space  240  are equally spaced. Preferably, when the movement between the two adjacent connecting units  210  is greater than others, then most of the space  240  or the entire of the space  240  is covered by the flexible rod  510 , thereby bending of the driving wire  520  can be reduced. In one embodiment, the covered portion of the space  240  and the uncovered portion of the space  240  are equally spaced. In detail, two adjacent covered spaces  240  can have one or more uncovered space  240  therebetween. In addition, the connecting units  210  can have different structures, for example, two adjacent connecting units  210  may not have the space  240 . 
     The above covered portion of the space  240  can be entirely covered, or can be partially covered by the flexible rod  510 . When the space  240  is partially covered by the flexible rod  510 , the bending of the driving wire  520  can be obstructed. In one embodiment, an uncovered portion of the space  240  has 1-4 mm in height. 
     Referring to  FIG. 12 , the flexible rod  510  is located in the space  240 , but is not received in the receiving hole  211 , to obstruct the driving wire  520  being bent at the space  240 . In this situation, an inner diameter of the receiving hole  211  can be a little greater than an outer dimeter of the driving wire  520 , to obstruct the driving wire  520  being bent. In other embodiments, an inner diameter of the receiving hole  211  can give a greater space for the movement of the driving wire  520 , thereby reducing the friction therebetween. In this situation, more than one of the flexible rods  510  can be positioned at the corresponding connecting units  210  to cover the corresponding space  240 . 
     The flexible rod  510  can extend part of the connecting units  210 . As shown in  FIG. 13 , at least one end of the flexible rod  510  is received in the connecting units  210 , that is, an end of the flexible rod  510  is not in the space  240 . For example, two ends of the flexible rod  510  can be received in the receiving hole  211  of the connecting units  210 . In other embodiments, the flexible rod  510  is received in all of the connecting units  210 , for example, the flexible rod  510  extends out of three adjacent connecting units  210 , alternatively, the flexible rod  510  extends out of one connecting unit  210 , and is partially received in another connecting unit  210 . In other embodiments, an end of the flexible rod  510  can be received in the space  240 , for example, a free end of the flexible rod  510  can be received in the space  240 . 
     Referring to  FIG. 14 , there are more than one, or a plurality of the flexible rods  510  arranged along an extending axis of the connecting assembly  200 , and the driving wire  520  extends out the flexible rods  510 . In particular, the flexible rods  510  are spaced with each other, that is, ends of the flexible rods  510  do not contact with each other, and when the connecting units  210  rotate, the ends of the flexible rods  510  do not interfere with each other. When the connecting units  210  are in a bending state, the more than one, or the plurality of the flexible rods  510  can reduce deformation thereof, thereby making the control of the driving wire  520  more accurate. 
     In the present embodiments, two adjacent ends of the flexible rods  510  are received in the connecting units  210 . In other embodiments, ends of the flexible rods  510  can be received in the space  240 , in a same space  240  or in different spaces  240 . 
     In one embodiment, lengths of the flexible rods  510  are the same. In other embodiments, at least two flexible rods  510  have different lengths, or all of the flexible rods  510  have different lengths. In further other embodiments, the flexible rod  510  in frequently bent connecting units  210  can have a shorter length, and in rarely bent connecting units  210  can have a longer length. Alternatively, a length of a flexible rod  510  at a distal end is less than that of the flexible rod  510  at a proximal end. 
     In one embodiment, a space between the flexible rod  510  and the receiving hole  211  can be predetermined according to need. For example, at least two flexible rods  510  have different spaces with the receiving hole  211 . Alternatively, all the flexible rods  510  have the same space with the receiving hole  211 , but different sections of the flexible rods  510  can have different spaces with the receiving hole  211 . 
     In one embodiment, a cross section of each of the flexible rods  510  is the same, in this situation, the flexible rods  510  can be in a columnar shape, and different sections of the flexible rods  510  are the same. In detail, the specs including shapes and sizes, and the cross section of the flexible rods  510  can be in a round, ellipse, triangle, or polygon shape. In other embodiments, at least two flexible rods  510  have different cross section sizes, such that a space between a distal end of the flexible rod  510  and an inner wall of the receiving hole  211  is greater than a space between a proximal end of the flexible rod  510  and the inner wall of the receiving hole  211 . Alternatively, a size of the flexible rod  510  in frequently bent connecting units  210  is less than a size of the flexible rod  510  in rarely bent connecting units  210 , such that the space between the frequently bent flexible rod  510  and the inner wall of the receiving hole  211  can be greater than the space between the rarely bent flexible rod  510  and the inner wall of the receiving hole  211 . Alternatively, sections of the flexible rod  510  have two different sizes, and the sections of different sizes are spaced arranged. 
     Alternatively, cross sections of a same flexible rod  510  can have different sizes, for example, a cross section size of a proximal end of the flexible rod  510  is less than a cross section size of a distal end of the flexible rod  510 . Alternatively, cross sections of the flexible rod  510  can have different shapes. 
     When the specs of the cross sections of the flexible rod  510  are different, the space between the flexible rod  510  and the inner wall of the receiving hole  211  are different, the greater space, the more flexible of the flexible rod  510  with the connecting units  210  when in a bending state; and the less space, the less movement of the flexible rod  510  in the receiving hole  211 , resulting that a position of the driving wire  520  can be better controlled. 
     The rigidity of the flexible rods  510  can be selected according to need, for example, the rigidity of the flexible rods  510  can be the same, alternatively, at least two flexible rods  510  have different rigidity. Alternatively, the rigidity of frequently bent sections of the flexible rod  510  is less than that of rarely bent sections of the flexible rod  510 . 
     In other embodiments, the flexible rods  510  are received in the connecting units  210 , uncover the space  240 , or partially cover the space  240 . The arrangement, structures, and connection with other elements can be combined with the embodiments illustrated above. 
     In one embodiment, the flexible rod  510  has one or more openings  513 , with this configuration, the flexible rod  510  can be bent more easily, and thereby the deformation of the flexible rod  510  in a bending state can be reduced. The openings  513  can have different arrangements. As shown in  FIG. 15 , there are a plurality of the openings  513 , and the openings  513  are arranged at a same side of the flexible rod  510 . As shown in  FIG. 16 , the plurality of the openings  513  are arranged at two opposite sides of the flexible rod  510 . In the present embodiment, the openings  513  in a first side  11  are spaced with the openings  513  in a second side  12 , each of the openings  513  in the first side  11  is arranged between two openings  513  in the second side  12 , and each of the openings  513  in the first side  11  can be adjacent to, or not adjacent to one of the openings  513  in the second side  12 . For example, three openings  513  in the first side  11  are arranged between two openings  513  in the second side  12 , and the three openings  513  in the first side  11  are arranged in sequence. In other embodiments, the openings  513  in the first side  11  and the second side  12  can be arranged in a regular pattern, or in an irregular pattern. As shown in  FIG. 17 , the flexible rod  510  has a plurality of the openings  513 , and the plurality of the openings  513  are arranged in a periphery of the flexible rod  510  along an extending axis thereof. As shown in  FIG. 18 , the plurality of the openings  513  are in a step shape and arranged along an extending axis of the flexible rod  510 . 
     In particular, the openings  513  can be located in the space between the connecting assembly  200 , alternatively, can be received in the connecting units of the connecting assembly  200 , and in some embodiments, some openings  513  are located in the space between the connecting units  210 , and other openings  513  are received in the connecting units  210 . 
     The openings  513  can be in different shapes, for example, the openings  513  are in a strip shape. Alternatively, the openings  513  are in a line shape, that is the opening  513  are cut in the flexible rod  510 , or in a wave shape. 
     Referring  FIGS. 19 to 22 , an inner wall of the receiving hole  211  and/or the flexible rod  510  has an abutting portion, thereby the flexible rod  510  and the receiving hole  211  can be abutted at each other. That is, when the flexible rod  510  and the connecting units  210  extend along an axis, and the flexible rod  510  is located in the connecting units  210  at a side thereof, the flexible rod  510  and the receiving hole  211  can be abutted at each other at the abutting portion, without the entire side of the connecting units  210  abutting the flexible rod  510 . In this way, a contact area between the flexible rod  510  and the connecting units  210  can be reduced, thus the friction therebetween can be reduced. 
     The abutting portion can have different structures, for example, the abutting portion can be a curved surface, or a flat surface and so on. As shown in  FIG. 19 , the receiving hole  211  is in a cone shape, and the abutting portion can be the smaller end of the cone-shaped receiving hole  211 . In particular, the connecting units  210  having a cone-shaped hole can also retain the free end of the flexible rod  510 , that is, when an opening thereof is smaller, the flexible rod  510  cannot extend out of, a position of the free end of the flexible rod  510  can be determined. As shown in  FIG. 20 , an inner wall of the receiving hole  211  has a protrusion, the abutting portion can be located on the protrusion. In detail, the abutting portion can be one or more, more than one abutting portions can be arranged along a periphery of the connecting units  210 , i.e., along a periphery of an inner wall of the receiving hole  211 . As shown in  FIG. 21 , the receiving hole  211  is in a sandglass shape, a protrusion in an inner wall thereof is the abutting portion. In more detail, the receiving hole  211  are two communicated cone-shaped holes, the protrusion is defined between the two communicated cone-shaped holes, the cone-shaped holes can have the same specs, or different specs, i.e., the protrusion can be at a middle portion of the connecting unit  210 , or at an end portion thereof. As shown in  FIG. 22 , the abutting portion is defined on the flexible rod  510 , in detail, the flexible rod  510  has the protrusion to abut at an inner wall of the receiving hole  211 . 
     In one embodiment, the abutting portions of the connecting units  210  are the same. In other embodiments, at least two connecting units  210  has different abutting portions. 
     Referring to  FIG. 23 , the end effector  100  has two rotatable clamping portions  110 . In particular, the clamping portions  110  has two clamps  111 , an insulating member  112 , two rotatable members  113 , the clamp  111  forms electrodes, and is insulated with the rotatable member  113  by the insulating member  112 , the rotatable members  113  are rotatably connected to allow the clamps  111  to open or close. The insulating member  112  makes the clamps  111 , the rotatable members  113 , and the connecting assembly  200  being insulated with each other, thus improving the stabilization of the end effector  100 . In the present embodiments, the clamps  111  and the rotatable members  113  are made by metallic materials, for ensuring a rigidity thereof. In other embodiments, the rotatable members  113  can be made by insulated materials, in this situation, the rotatable members  113  can be connected to the clamps  111  by the insulating member  112 , or alternatively, the insulating member  112  can be omitted. 
     In particular, the end effector  100  can have other structures, for example, the insulating member  112  is positioned between the two rotatable members  113 , to make the rotatable members  113  being insulated with each other. Alternatively, the clamps  111  are rotatably connected to the rotatable members  113 , the insulating member  112  is on a main body and also makes the clamps  111  being insulated with the rotatable members  113 , meanwhile makes the rotatable members  113  being insulated with each other. In this situation, the rotatable members  113  are positioned on the main body, and can be rotatable relative to the main body, the connecting units  210  are also connected to the main body. In other embodiments, the clamping portions  110  can work without the insulating member  112 . 
     Referring again to  FIG. 23 , the insulating member  112  protrudes outwards from the clamps  111 . Referring to  FIG. 24 , the insulating member  112  does not protrude outwards from the clamps  111 , but the clamps  111  are positioned in the insulating member  112 , and each of the clamps  111  has a clamping surface  101 . The clamping surfaces  101  face each other. In this situation, the clamping surfaces  101  protrude from the insulating member  112 . In embodiments, the clamping surfaces  101  of the clamps  11   l  can be flat with the insulating member  112  or positioned in the insulating member  112 . For example, one clamping surface  101  protrudes from the insulating member  112 , and the other clamping surface  101  is positioned in the insulating member  112 . Alternatively, the clamping surfaces  101  are flat with the insulating member  112 . In a situation of the clamping surface  101  being positioned in the insulating member  112 , the insulating member  112  does not influence the electrode work when the clamps  111  are in a state of clamping a muscle tissue. 
     In one embodiment, one of the clamps  111  has an electrode. As shown in  FIG. 25 , each of the clamps  111  has more than one electrode  102 , and the electrodes  102  face each other for facilitating forming a conductive loop when the clamps  111  are in the state of clamping muscle tissue. In the present embodiment, the clamp  111  has a conductive strip, the conductive strip acts as an electrode, when the clamp  111  has only one electrode, the conductive strip can be only one. Alternatively, the entire clamp  111  can be an electrode. 
     Referring to  FIGS. 23 and 24 , the insulating member  112  at least covers two surfaces of the clamps  111  and/or the rotatable members  113 , to be securely connected to the clamps  111  and/or the rotatable members  113 . Alternatively, the insulating member  112  can be connected to the clamps  111  and/or the rotatable members  113  by other structures, such as by a connecting assembly; alternatively, the insulating member  112  is integrally formed with the clamps  111  and/or the rotatable members  113 ; and alternatively, the insulating member  112  can be riveted to the clamps  111  and/or the rotatable members  113 . In other embodiments, the insulating member  112  can be connected to only one surface of the clamps  111  and/or the rotatable members  113 . 
     Referring to  FIGS. 23 to 26 , the end effector  100  further includes a body  120 , the rotatable members  113  are positioned on the body  120 , and are rotatable relative to the body  120  surrounding a rotation axis, and the rotation axis is not changed when the rotatable members  113  are rotated. In the present embodiment, the end effector  100  further includes push rods  130  connected to the respective rotatable members  113 , the push rods  130  and the rotatable members  113  form a four-bar structure, thereby driving the clamps  111  to open or close. In detail, the driving wire  520  of the tip driving unit  500  is connected to the push rods  130 , thereby driving the clamps  111  by the push rods  130 . 
     In other embodiments, the clamping portion  110  can be driven by other structures, alternatively, the push rods  130  can be omitted. In this situation, the driving wire  520  of the tip driving unit  500  can be directly connected to the rotatable members  113 , thereby driving the rotatable members  113  to rotate. 
     Referring to  FIGS. 27 to 29 , the surgical instrument  23  further includes an electrocoagulation assembly. In detail, the electrocoagulation assembly includes a conductive wire  610 , a distal end of the conductive wire  610  is connected to the clamps  111 , thereby the clamps III forms an electrode. Part of the conductive wire  610  in the connecting assembly  200  is in a loose state, and the conductive wire  610  has a fixing portion  611  fixed to a body and/or the end effector  100 , thereby the distal end of the conductive wire  610  can be disposed adjacent to the end effector  100 . In detail, the body includes one of connecting assembly, connecting rod, driving housing, for example, the body may include the connecting assembly and the connecting rod, alternatively, the body may include the connecting assembly and the driving housing. When the fixing portion  611  of the conductive wire  610  is in the connecting unit, at least part of the conductive wire  610  in the connecting assembly is in a loose state. The loose state of the conductive wire  610  is when the connecting units are in an extend state, a length of the conductive wire  610  in the connecting assembly is greater than a length of the connecting assembly; or alternatively, when the conductive assembly is in a bending state, at least part of the conductive wire  610  has the length greater than that of the part when the connecting assembly is in an extend state, in a condition that a tension of the conductive wire  610  remains unchanged. In one embodiment, the length of the conductive wire  610  in the connecting rod, is greater than a length of the connecting rod, in this way, when the connecting assembly is in a bending state, the conductive wire  610  in the connecting rod is disposed in the connecting assembly, to meet the bending of the connecting rod. Alternatively, the conductive wire  610  can be collected in a collecting portion, when the connecting assembly is in a bent state, the conductive wire  610  is released to make the conductive wire  610  in the connecting unit longer. In particular, the end effector  100  can also be hook electrode, which is connected to the conductive wire  610  to activate the electrode. 
     As the above-mentioned connecting units are in a loose state, when the connecting assembly is bent, the conductive wire  610  is not in a tightening state, thereby an accurate operation of the surgical instrument  23  can be achieved, thus extending a life of the conductive wire  610 . The above-mentioned fixing portion  611  can limit the conductive wire  610  at the end effector  100  to be too loose. 
     The fixing portion  611  can be designed according to need. As shown in  FIG. 28 , the fixing portion  611  is defined at an area adjacent to the rotatable members  113 , and the area can be on the rotatable members  113 , the main body  120 , a rotation shaft and so on areas. In the present embodiment, the fixing portion  611  is defined on the main body  120  adjacent to the rotation shaft, in this way, when the clamping portions  110  open or close, a first distance defined between the fixing portion  611  of the main body  120  and a distal end of the clamps  111  remains unchanged. Furthermore, in the present embodiment, a second defined between the fixing portion  611  and a distal end of the conductive wire  610  is almost equal to the above-mentioned first distance, in this way, the conductive wire  610  is adapted to the clamping portion  110 , thus avoid the conductive wire  610  to be too loose to influence the work of the end effector  100 . In this situation, as the first distance remains unchanged, the conductive wire  610  will not be dragged. 
     In other embodiments, the fixing portion  611  of the conductive wire  610  can be defined on the rotatable members  113 , for example, on a rotation axis area of the rotatable members  113 , or alternatively, the fixing portion  611  can be defined on a rotation shaft of the rotatable members  113 . As shown in  FIG. 28 , the fixing portion  611  is not at the rotation axis area of the rotatable members  113 , as well as not at the rotation shaft of the rotatable members  113 , in this situation, the above-mentioned second distance is greater than the first distance, thereby the clamping portion  110  has space to open or close, and at the same time the conductive wire  610  is avoided to be too tight. 
     In other embodiments, the above-mentioned second distance can be a little greater than the first distance, for example, the second distance can be 1-3 mm greater than the first distance. In this situation, the conductive wire  610  extends along the clamping portion  110 , and is in a loose state. 
     The fixing portion  611  can also be defined on a main body of the surgical instrument  23 . In one embodiment, the fixing portion  611  is defined at a proximal end of the main body, and is nearer than a proximal end of the connecting assembly  200 . As shown in  FIG. 29 , the fixing portion  611  is defined at the connecting rod  300 , or alternatively, the fixing portion  611  can be defined on the driving housing  400 . In one embodiment, the fixing portion  611  is defined on a connecting unit  210  at a proximal end of the connecting assembly  200 . In these ways, the conductive wire  610  is not too tight when the connecting assembly  200  are in a bending state, as well as not too loose to be free. 
     In one embodiment, the fixing portion  611  can be defined in the connecting assembly  200 , and the fixing portion  611  divides the conductive wire  610  in the connecting assembly  200  into at least two sections, in more detail, at least one section is in a loose state, or alternatively, all sections are in loose state. The fixing portion  611  defined in the connecting assembly  200  can reduce the movement of the conductive wire  610  in the connecting assembly  200 . 
     The fixing portion  611  of the conductive wire  610  can be one or more, and the more than one fixing portions  611  can be arranged on any of the above-mentioned positions. For example, one fixing portion  611  is defined on an area around the rotatable members  113 , another fixing portion  611  is defined on the connecting rod  300  or in the driving housing  400 . Alternatively, one fixing portion  611  is defined in the connecting rod  300 , the other fixing portions  611  are defined in the connecting assembly  200 . 
     In one embodiment, the clamping portion  110  has a guiding member, the conductive wire  610  is arranged on the clamping portion  110  and extends along the guiding member, thus the conductive wire  610  being arranged adjacent to the clamping portion  110 . As shown in  FIG. 30 , a guiding member  114  has a guiding hole  103  and an opening  104  communicated with the guiding hole  103 , thus the conductive wire  610  is received in the guiding hole  103  via the opening  104 . In other embodiments, the opening  104  can be avoided, in this situation, the conductive wire  610  extends through the guiding hole  103 , thus received in the guiding hole  103 . Alternatively, the guiding member  114  can directly be a guiding groove in the clamping portion  110 , the conductive wire  610  is received in the guiding groove. In the present embodiment, the guiding groove is on a surface of the clamping portion  110 , for example, on a side surface of the clamping portion  110 , in more detail, the side surface is the surface adjacent to the opposite surfaces of the clamping portion  110  facing to each other. In other embodiments, the guiding member  114  may include a guiding groove formed in the clamping portion  110 , and a guiding element, the conductive wire  610  is received in the guiding groove, and the guiding element helps guiding the conductive wire  610  in the guiding groove. For example, the guiding element can be a bar, and an extending axis of the bar is not parallel with an extending axis of the guiding groove. 
     In one embodiment, the conductive wire  610  extends through the connecting assembly, and the conductive wire  610  is positioned at a central axis of the connecting assembly. Alternatively, the conductive wire  610  is adjacent to the central axis of the connecting assembly. Two conductive wires  610  can extend through the connecting assembly via a hole, or extend through the connecting assembly via two holes. 
     In one embodiment, the surgical instrument  23  further includes a wire receiving rod extending through the connecting assembly. The wire receiving rod has a wire receiving hole, the conductive wire  610  is received in the wire receiving hole, and is spaced with an inner wall of the wire receiving hole. In particular, the wire receiving rod can be in similar structure with the flexible rod  510  described above, to protect and orient the conductive wire  610 . 
     Referring to  FIGS. 31 to 34 , the tip driving unit  500  of the surgical instrument  23  has the driving wire  520 , a driving assembly  530 , and a positioning member  540 . The driving wire  520  extends through the connecting assembly  200  to be connected with the end effector  100 , and can be bent with the connecting assembly  200 . The driving wire  520  has a driving connecting portion  521  connected to the driving assembly  530 , at least part of the driving wire  520  extending out of the connecting assembly  200  is oriented by the positioning member  540 , thereby the driving wire  520  is driven by the driving assembly  530  to move along a straight line, and in this way, the end effector  100  is driven. In particular, the rigidity of the at least part of the driving wire  520  is greater than that of the part of the driving wire  520  received in and bent with the connecting assembly  200 , and the above-mentioned driving wire  520  driven along a straight line is referred to at least the driving connecting portion  521  of the driving wire  520  is driven to move along the straight line. The end effector  100  can have the clamps  111 , and the driving wire  520  drives the clamps  111  to open or close. Alternatively, the driving wire  520  drives the end effector  100  to rotate, in this situation, the end effector  100  can be worm structures connected to be a distal end of the driving wire  520 . 
     In a working state of the above configured end effector  100 , when the driving wire  520  drives the end effector  100  to move forward, the positioning member  540  can help orienting the driving wire  520 , thereby a moving error of the driving wire  520  can be reduced, and thus an operation of the end effector  100  can be more accurate. 
     In one embodiment, in an original state of the connecting assembly  200 , a moving direction of the driving connecting portion  521  of the driving wire  520  is the same with an extending direction of the connecting assembly  200 , i.e., in the original state, the connecting assembly  200  extends along a straight line, and the driving wire  520  is also in a straight line, to be the same with the moving direction of the driving connecting portion  521  of the driving wire  520 . In other embodiments, in an original state of the connecting assembly  200 , a moving direction of the driving connecting portion  521  of the driving wire  520  forms an angle with an extending direction of the connecting assembly  200 , for example, the angle be an obtuse angle. In this situation, the part of the driving wire  520  within the connecting assembly  200  can be movably retained by inner structures of the connecting assembly  200 , for example, can be movably retained by the receiving hole  211  of the connecting assembly  200 . Preferably, in one embodiment, the driving wire  520  moves along a central axis of the connecting assembly  200 , that is, the driving wire  520  is oriented at a central area of the connecting assembly  200 , thereby further improving an accurate of the operation. 
     The above defined positioning member  540  can have various structures, for example, as shown in  FIG. 31 , the tip driving unit  500  has the flexible rod  510  extending through the connecting assembly  200 , the driving wire  520  extends through the flexible rod  510 , and the part of the flexible rod  510  which extends through the connecting assembly  200  forms the positioning member  540  to orient the driving wire  520 , thereby obstructing bending of the driving wire  520 . In embodiments illustrated in  FIGS. 32 and 33 , the positioning member  540  has a groove, and the driving wire  520  is received in and moves along the groove, thereby obstructing bending of this part of the driving wire  520 . As shown in  FIG. 34 , the positioning member  540  surrounds the driving connecting portion  521  of the driving wire  520 , in this way, obstructing bending of this part of the driving wire  520 , and in this situation, the positioning member  540  can be positioned at the driving assembly  530 , and can be moved along with the driving wire  520 , and the driving connecting portion  521  can be directly positioned at the driving assembly  530 , and alternatively positioned at the driving assembly  530  via the positioning member  540 . In one embodiment, the positioning member  540  can be in a strip shape, for example, a length of the positioning member  540  can be in a range of 5-10 mm. In other embodiments, there are a plurality of the positioning members  540 , and the positioning members  540  can be spaced with each other in a line. 
     It can be understood that, the positioning member  540  can also be a combination of the above-mentioned structures, for example, the positioning member  540  may include a part of the flexible rod  510  and a groove, and the flexible rod  510  is received in the groove, and the groove cooperates with the part of the flexible rod  510  to orient the driving wire  520 . 
     In one embodiment, the positioning member  540  is arranged near the driving connecting portion  521  of the driving wire  520  for reducing a distance between the positioning member  540  and the driving connecting portion  521  of the driving wire  520 . Referring to  FIG. 31 , a part of the flexible rod  510  is arranged near the driving connecting portion  521  of the driving wire  520 , and the part of the flexible rod  510  does not obstruct the working of the driving assembly  530 . For example, when the driving connecting portion  521  is at a farthest position, the connecting portion  521  is at a proximal end of the flexible rod  510 , that is, when the driving assembly  530  drives the driving connecting portion  521  moves to the farthest position, the proximal end of the flexible rod  510  and a periphery of the driving connecting portion  521  are located at a same surface. Alternatively, when the driving connecting portion  521  moves to the farthest position, the proximal end of the flexible rod  510  is almost at a distal end of the driving connecting portion  521 , and a distance can be maintained therebetween in a range of 3-10 mm. In embodiments illustrated in  FIGS. 32 and 33 , a surface of the groove surrounds the driving connecting portion  521  when the driving connecting portion  521  is in a movement state, and an opposite surface of the groove is at a farthest position where the driving connecting portion  521  moves to. 
     In one embodiment, the driving assembly  530  may be a transmission assembly including two wheels, and a conveyer belt transmitted by the two wheels. The driving connecting portion  521  of the driving wire  520  is connected to the conveyer belt, and is driven along a straight line by the conveyer belt. In detail, the two wheels roll at a same direction and at a same rate with the conveyer belt. In a further embodiment, the conveyer belt can be driven by the wheels by the friction therebetween. In other embodiments, the driving assembly  530  can be other structures, for example, the driving assembly  530  can be a gear, and the driving wire  520  can be oriented by the gear. 
     In one embodiment, the driving wire  520  is welded on the driving assembly  530 , for example, the driving connecting portion  521  of the driving wire  520  is welded with the conveyer belt of the driving assembly  530 . When the welded portions are in a strip shape, the welded portions can be understood as the positioning member  540  surrounding the driving connecting portion  521  of the driving wire  520 . In another embodiment, the driving wire  520  can be connected to the driving assembly  530  by a connecting element, for example, the connecting element is welded with the driving wire  520 , alternatively, the driving wire  520  is engaged with the connecting element, and the connecting element is located on the conveyer belt. In detail, the driving wire can have an engaging protrusion for engaging with the connecting element. In particular, the connecting element can have an engaging groove, and the engaging groove is engaged in the engaging protrusion. In this situation, it can also be understood that the connecting element is a part of the positioning member  540 . 
     In one embodiment, a distal end of the driving wire  520  is the driving connecting portion  521 , in this situation, at least part of the driving assembly  530  is located within the driving housing  400 . In another embodiment, a proximal end of the driving wire  520  can also be the driving connecting portion  521 , that is, at least part of the driving assembly  530  is arranged near the end effector  100 . Alternatively, the driving connecting portion  521  can also be a middle portion of the driving wire  520 . 
     It is noted that, the endoscope of the present disclosure may be applied to the operating arm of the surgical robot or other devices where the endoscope is desired. 
     The various technical features of the above-described embodiments may be combined in any combination, so that the description is concise, and all possible combinations of the various technical features in the above-described embodiments are described. However, as long as the combination of these technical features does not conflict, it is to be understood that the scope of the present specification is not to be taken in a limiting sense. 
     The above-described embodiments have only expressed several embodiments of the present application, which are described in more detail and detail, but are not therefore to be construed as limiting the scope of the present application. It should be noted that variations and modifications may be made to one of ordinary skill in the art without departing from the spirit of the present application, all of which fall within the scope of the present application. Therefore, the scope of the appended claims should be accorded the broadest interpretation so as to encompass all such modifications and similar arrangements.