JP2003010195A - Surgical manipulating handle structure - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical manipulating handle structure capable of reducing the number of part items and simplifying the constitution so as to reduce the manufacturing cost. SOLUTION: The lower end part of a trigger 123 is brought closely to and away from a grip part 124a, thereby reciprocating a push bar 126 in a grip case 124. The push bar 126 is provided with ratchet teeth 126b formed along the moving direction, and a ratchet member 128 is disposed in the grip case 124. The central part of the head of the ratchet member 128 is journaled to the grip case 124, the tip of the head is shaped like a mountain, and ratchet teeth meshing with the ratchet teeth of the push bar 126 are formed on both slant faces of the mountain-like part, respectively. The ratchet member 128 is provided with a plate spring part 128d formed extending from the head part thereof toward the counter-tip. The grip case 124 is provided with a gate 124d for regulating the turning range of the plate spring part 128d of the ratchet member 128.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical operation handle structure used by a surgical instrument used in surgical treatment and operated by an operator.

[0002]

2. Description of the Related Art For example, in endoscopic surgery, a small incision is made in the abdomen, and a medical instrument such as an elongated tube or a cannula for guiding the inside and outside the body is inserted into the incision, and a surgical instrument is inserted through them. The surgical instrument is inserted, and for example, a clip is attached to the trachea, blood vessels, ducts, and other body tissues in the body, or cutting and suturing are performed.

For example, as a surgical instrument for applying a clip, the one described in Japanese Patent Application Laid-Open No. 10-118083 is known, and in the surgical clip applying apparatus described in this publication, the handle structure is fixed. A movable handle is swingably attached to a housing portion having a handle portion, and an upper end portion of the movable handle is engaged with a pushing plate disposed movably in a predetermined direction inside the housing portion and protrudes from the housing portion. When the lower end of the movable handle approaches or separates from the fixed handle, the pushing plate moves and operates.
A rack having ratchet teeth is provided on the pushing plate, and a pawl that meshes with the ratchet teeth is pivotally attached to the housing portion. The spring constantly urges the pawl so as to mesh with the ratchet teeth of the rack. The ratchet teeth of the rack are shaped so as to have a substantially vertical portion and a substantially inclined portion, so that the backward movement of the pushing plate can be prevented.

[0004]

However, the above-mentioned conventional structure has a problem that a spring is required, the number of parts is increased, and the manufacturing cost is increased.

Further, the ratchet teeth of the rack have a shape having a substantially vertical portion and a substantially inclined portion,
As a result, although the backward movement of the push-in plate can be prevented during the forward movement, the forward movement cannot be reliably prevented during the backward movement of the push-in plate.

The present invention has been made in view of such conventional problems, and an object thereof is to provide a surgical operating handle structure capable of reducing the number of parts, simplifying the structure, and reducing the manufacturing cost. To that end.

[0007]

In order to achieve the above-mentioned object, the invention according to claim 1 is such that a trigger is swingably attached to a grip case having a grip portion, and an upper end portion of the trigger is the grip case. The lower end of the trigger, which is engaged with a push bar disposed so as to reciprocate in a predetermined direction inside the grip case, protrudes from the grip case and moves toward and away from the grip portion, whereby the push bar reciprocates. In the surgical operating handle structure adapted to operate in accordance with the above, ratchet teeth are formed on the push bar along the moving direction thereof, and the ratchet member is disposed in the grip case. The central part of the head is pivotally attached to the grip case, the tip of the head of the ratchet member has a chevron shape, and the ratchets of the push bars are provided on both slopes of the ratchet member. Ratchet teeth that mesh with the teeth are formed, and the ratchet member is further formed with a leaf spring portion extending in the direction opposite to the tip direction from the head portion of the ratchet member. It is characterized in that a regulating portion for regulating the rotation range of the leaf spring portion is formed.

When the trigger is swung so as to approach the grip, the push bar engaged with the trigger moves in a certain direction. When the ratchet teeth of the push bar move as the push bar moves, the head of the ratchet teeth of the ratchet member rotates about the pivot point, and the tip of the head tilts in the moving direction of the push bar. The ratchet teeth formed on one of the two slopes at the tip of the head mesh with the ratchet teeth of the push bar. At this time, since the rotation range of the leaf spring portion is regulated by the regulation portion, the leaf spring portion is bent, and the ratchet teeth at the tip of the head are biased by the leaf spring portion in the direction in which they mesh with the ratchet teeth of the push bar. To be done. In this state, even if the force applied to the trigger is released, the head of the ratchet member cannot escape so as to allow movement in a direction opposite to the direction in which the push bar is moving, and thus such a push bar Movement in the opposite direction is prohibited. Thus, the push bar moves only in the direction it is moving until its ratchet teeth have completely passed the ratchet teeth of the ratchet member.

Next, when the push bar moves in the direction opposite to the moving direction, the head of the ratchet member rotates in the opposite direction to the tip, and the tip of the head tilts in the moving direction of the push bar, and the head moves. The ratchet teeth formed on the other of the two slopes at the tip end mesh with the ratchet teeth of the push bar. This causes the head of the ratchet member to move in the opposite direction because the head of the ratchet member cannot escape to allow movement in the direction opposite to the direction in which the push bar is moving, by the same action as above. Is prohibited. Thus, the push bar moves only in the direction it is moving until its ratchet teeth have completely passed the ratchet teeth of the ratchet member. In this way, the moving direction of the push bar can be regulated only by the ratchet member without using a spring, the number of parts can be reduced, and the manufacturing cost can be reduced.

According to a second aspect of the present invention, the ratchet teeth formed on the push bar have a contour of an isosceles right triangle, and the ratchet teeth are formed on both slopes of the tip of the head of the ratchet member. Is also characterized by forming an isosceles right triangle.

In this way, the ratchet member can act in the same manner with respect to the movement of the push bar in the reciprocating motion in any direction, and even when the push bar is moving in any direction, the ratchet member has the same function. It is possible to reliably prevent the push bar from moving in the direction opposite to the moving direction.

[0012]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. The following embodiments do not limit the present invention.

FIG. 1 is an overall perspective view of a clip applying apparatus as a surgical instrument using a surgical operation handle structure according to the present invention. This surgical clip applying device 10
As a whole, it has a handle portion 12, a shaft portion 14 extending from the handle portion 12 to the tip side, and a jaw 18 arranged near the tip portion of the shaft portion 14. A plurality of clips are accommodated in the shaft portion 14, and further, a push rod that is movable in the axial direction according to the operation of the handle portion 12 and a push rod that is connected to the push rod to connect the jaw element of the jaw 18 to each other. A jaw closure member for moving to the proximal position and a clip supply mechanism for sequentially supplying clips one by one between the jaw elements of the jaws 18 are housed.

As shown in FIG. 1, the handle portion 12 is
A grip right case 121 and a grip left case 122 are provided, and the grip right case 121 and the grip left case 122 constitute a grip case 124, and a case internal space is defined therein. . The grip case 124 includes a grip portion 1 suitable for being gripped by an operator.
24a is formed. As shown in FIG. 2, the trigger 123 is axially mounted in the space inside the case.
The pin 124b protruding from the inside of the case of the grip case 124 passes through the third pin through hole 123a.
The lower end portion of the trigger 123 projects from the grip case 124 and swings so as to be able to move toward and away from the grip portion 124a. The operator holding the grip portion 124a can set a clip on the jaw 18 by pulling the trigger 123, tighten the clip, and perform a series of operations for applying the clip to a desired portion of the body tissue.

As shown in FIG. 2, the upper end portion of the trigger 123 is engaged with a protrusion 126a formed on a push bar 126 arranged on the same line as the shaft portion 14. In the space inside the case, the push bar 126 is
It is arranged so as to be reciprocally movable in the axial direction of the shaft portion 14, and the swinging motion of the trigger 123 is converted into movement of the push bar 126 in the axial direction of the shaft portion 14. As shown in FIG. 3, a downward bulging portion is formed at the rear end portion of the push bar 126, and ratchet teeth 126b are formed on the lower surface of the bulging portion. Each tooth of the ratchet tooth 126b has a contour of an isosceles right triangle. The front side and the rear side of the bulging portion where the ratchet teeth 126b are formed are relief portions 126c and 126d. A shaft portion 126e extends at the tip end portion of the push bar 126, and a receiving portion 126f that is connected to the rear end of the push rod so as to be relatively rotatable is formed at the tip end of the shaft portion 126e.

Further, a ratchet member 128 is axially mounted in the space inside the case. That is, the ratchet member 1
The pin 28 has a pin through hole 128a formed at the center of its head.
A pin 124c protruding from the inner space of the case 24 passes through the case. As shown in FIG. 4, the tip of the head of the ratchet member 128 is formed in a mountain shape, and ratchet teeth 128b, 12 are formed on both slopes of the mountain shape, respectively.
8c is formed. These ratchet teeth 128
b and 128c have an isosceles right triangle contour so that they can mesh with the ratchet teeth 126b of the push bar 126. From the head of the ratchet member 128, a thin plate-shaped leaf spring portion 12 having flexibility in the direction opposite to the front end is provided.
8d is formed. The leaf spring portion 128d of the ratchet member 128 passes through a gate (regulating portion) 124d formed in the case internal space of the grip case 124, and within a range where the leaf spring portion 128d exists in the gate 124d, the ratchet portion 128d is provided. The member 128 is rotatable around the pin 124c. The gate 124d is
The ratchet member 128 is formed symmetrically with respect to the ratchet member 128 so that the leaf spring portion 128d passes through the intermediate position when the ratchet member 128 is in the neutral position in which the ratchet member 128 is perpendicular to the push bar 126 (see FIG. 2). It looks asymmetric because it is a slightly oblique view).

A rotating piece 130 is rotatably arranged at the tip end of the grip case 124. Rotating piece 130
As shown in FIG. 5, has a base portion 130a arranged in the case internal space.

A return spring 132 is wound around the outer periphery of the shaft portion 126e of the push bar 126, and the tip end of the return spring 132 is a step portion 130d formed inside the rotary piece 130 (see FIG. b))
Is in contact with. The rear end of the return spring 132 is in contact with the step portion 126g of the push bar 126, and the push bar 126 is
Is always urged in the direction to move backward. Also,
The receiving portion 126f and the shaft portion 126 of the push bar 126.
When the push bar 126 is moved forward against the urging force of the return spring 132, the tip of e moves to the rotating top 1
The handle portion 12 can be inserted and penetrated from the handle portion 12.

A screw portion 130c is formed on the tip end side of the base portion 130a of the rotating piece 130.

The shaft portion 14 comprises a rotary knob 142 and a guide pipe 144. The threaded portion 142b formed on the inner peripheral surface of the rotation knob 142 is screwed into the threaded portion 130c of the rotating piece 130. In addition, the guide pipe 144
A collar portion 144 a formed at the rear end of the step portion 1 formed on the front end surface of the rotating piece 130 and the inner peripheral surface of the rotation knob 142.
It is sandwiched between 42a. Now the rotary knob 142,
The guide pipe 144 and the rotating piece 130 are integrally connected, and when the operator rotates the rotating knob 142, the guide pipe 144 and the rotating piece 130 are integrally rotated, and the components arranged in the guide pipe 144 are arranged. Also rotates together. Therefore, when the operator wants to rotate the direction in which the clip is applied, it can be adjusted as appropriate by rotating the rotation knob 142.

The receiving portion 126f of the push bar 126 is connected to a push rod extending inside the shaft portion 14.
A locking member, which is a part of the clip supply mechanism, is connected to the push rod, and the locking member is locked to a clip carrier that pushes a clip between the jaw elements of the jaws 18. A jaw closing member for closing the jaw elements of the jaws 18 is connected to the front end of the push rod. When the push rod advances, the clip feeding mechanism starts to operate with the advance of the push rod, the clip is pushed between the pair of jaw elements of the jaw 18, and the advance of the push rod locks the clip applying operation. The member is disengaged from the clip carrier and the clip carrier is retracted, while the jaw closure member is advanced to move the pair of jaw elements to the approximated position so that the clip is tightened and the desired clip is reached. Given to the body tissue of
When the push rod retracts, the locking member retracts with the push rod and locks again on the clip carrier.
It is performed in the flow.

The operation of the handle portion 12 constructed as above will be described. The operator holds the grip portion 124a,
When the trigger 123 is pulled to approach the grip 124a,
The upper end of the trigger 123 is the protrusion 126 of the push bar 126.
Since it is engaged with a, the push bar 126 moves forward, that is, moves toward the shaft portion 14. As a result, the tip end head portion of the ratchet member 128 hits the ratchet teeth 126b of the push bar 126, and as shown in FIG. 6, the tip end head portion is centered on the pin 124c so as to be pushed down to the front side, that is, the shaft portion 14 side. To rotate as. Then, the ratchet teeth 128b are attached to the push bar 12.
6 ratchet teeth 126b. At the same time, the leaf spring portion 128d is bent so as to be convex to the right in FIG. 6 while hitting the pillar at the right end of the gate 124d in FIG. Due to the spring force of the leaf spring portion 128d, the ratchet member 1
The tip end portion of 28 is pressed toward the ratchet teeth 126b of the push bar 126, and particularly toward the upper right of FIG. If you continue to push the push bar 126 forward,
The head portion of the ratchet member 128 swings between the upper right portion and the lower left portion in FIG. 6, and the ratchet teeth 128b move relative to the ratchet tooth 126b while appropriately escaping from the ratchet tooth 126b. When the swinging movement of the trigger 123 is stopped and the forward movement of the push bar 126 is stopped, the tip end head portion of the ratchet member 128 is pressed upward rightward toward the ratchet teeth 126b, and the ratchet teeth 128b and the ratchet teeth 128b. Engagement with the teeth 126b is secured, and the stop of the push bar 126 is held.
At this time, the push bar 126 is acted on by the biasing force of the return spring 132 so as to move the push bar 126 backward.
And the ratchet teeth 126b are in mesh with each other, and the ratchet teeth 128b cannot escape in the direction in which the push bar 126 can be retracted.
The retreat of 6 is prohibited.

When the push bar 126 is further advanced by further pulling the trigger 123, as shown in FIG. 7, the ratchet teeth 128b of the ratchet member 128 and the ratchet teeth 126b of the push bar 126 are disengaged, and the ratchet member 128 is disengaged. The tip of the head is the escape portion 126.
Enter d. In this way, the push bar 126 is released from the ratchet member 128. Ratchet member 12
8 returns to a straight line.

When the force on the trigger 123 is released, the push bar 1 is urged by the urging force of the return spring 132.
26 moves back. At this time, the tip head portion of the ratchet member 128 has the ratchet teeth 126 b of the push bar 126.
As shown in FIG. 8, the pin 124 is pushed so that its tip head portion is pushed down to the rear side, that is, the side opposite to the shaft 14.
Rotate around c. And ratchet teeth 128
c meshes with the ratchet teeth 126b of the push bar 126. At the same time, the leaf spring portion 128d is bent so as to be convex to the left in FIG. 8 while hitting the pillar at the left end of the gate 124d in FIG. Due to the spring force of the plate spring portion 128d, the tip end head portion of the ratchet member 128 is pressed toward the ratchet teeth 126b of the push bar 126, and particularly toward the upper left of FIG. Push bar 12
As the ratchet member 128 continues to move backward, the tip end head of the ratchet member 128 swings between the upper left side and the lower right side of FIG. 8, and the ratchet tooth 128c appropriately escapes from the ratchet tooth 126b, and comes to the ratchet tooth 126b. Move relative to.
If the trigger 123 is pulled again to move the push bar 126 forward in the midway state as shown in FIG. 8, the ratchet teeth 128c and the ratchet teeth 126b are meshed with each other, and the ratchet teeth 128c are the same as the push bar 12.
The forward movement of the push bar 126 is prohibited because it cannot escape in the direction in which the forward movement of 6 is permitted.

When the push bar 126 is further retracted, the state shown in FIG. 2 is restored, and the ratchet teeth 128c of the ratchet member 128 and the ratchet teeth 126b of the push bar 126 are disengaged from each other, and the ratchet member 12 is released.
The tip end head of 8 enters the escape portion 126c. In this way, the push bar 126 is released from the ratchet member 128.

By the action of the push bar 126 and the ratchet member 128 described above, the one-cycle operation including the complete pulling operation and the complete releasing operation of the trigger 123 is surely performed, and the halfway operation is prevented. However, it is ensured that a series of clips are added and the next clip is prepared.

In the handle portion 12, since the ratchet member 128 itself is provided with the plate spring portion 128d, a separate spring member can be omitted and the number of parts can be reduced.

The handle portion 12 of this embodiment is made of plastic except for the return spring 132, and after use, the return spring 132 can be removed for separate disposal.

Although the clip applying device has been described as an example in the above embodiments, the present invention is not limited to this, and the clip applying device can also be used for an automatic suturing device or a specific forceps, for example.

[0030]

As described above, according to the present invention, the moving direction of the push bar can be regulated only by the ratchet member without requiring a spring, so that the number of parts can be reduced and the manufacturing cost can be reduced. Can be reduced.

[Brief description of drawings]

FIG. 1 is an overall perspective view of a clip applying device as a surgical instrument using a surgical operation handle structure of the present invention.

FIG. 2 is a diagram showing an internal configuration of the handle portion when the grip left case is removed.

FIG. 3 is a side view of a push bar of a handle portion.

FIG. 4 is a side view of a ratchet member of a handle portion.

FIG. 5A is a perspective view of a rotating top of the handle portion;
(B) is a semi-longitudinal sectional view.

FIG. 6A is a diagram showing an internal configuration in the middle of pulling the trigger as seen when the grip left case of the handle portion is removed, and FIG. 6B is a diagram showing the ratchet teeth of the push bar and the ratchet member of the ratchet member. FIG.

FIG. 7 is a diagram showing an internal configuration showing a state in which the grip left case of the handle portion is removed and the trigger is completely pulled.

FIG. 8A is a view showing an internal configuration in the middle of returning the trigger as seen after removing the grip left case of the handle portion, and FIG. 8B is an enlarged view of the ratchet teeth of the push bar and the ratchet teeth of the ratchet member. Is.

FIG. 9 is a vertical cross-sectional view of a rotating top and a shaft portion.

[Explanation of symbols]

12 Handle 14 Shaft 123 Trigger 124 grip case 124a grip 124d Gate (Regulatory Department) 126 push bar 126b ratchet teeth 128 ratchet member 128b, 128c ratchet teeth 128d leaf spring part

Claims (2)

[Claims] 1. A grip is attached to a grip case having a grip portion so as to be swingable, and an upper end portion of the trigger is engaged with a push bar arranged so as to be reciprocally movable in a predetermined direction in the grip case. In the surgical operating handle structure in which the lower end of the trigger protruding from the case moves toward and away from the grip to operate the push bar by reciprocating in the predetermined direction. Has ratchet teeth formed along the moving direction thereof, a ratchet member is disposed in the grip case, and a central portion of the head of the ratchet member is pivotally attached to the grip case. The tip of the head has a chevron shape, and ratchet teeth that mesh with the ratchet teeth of the push bar are formed on both slopes. The member is further formed with a leaf spring portion extending from the head portion in the direction opposite to the tip end, and the grip case limits the rotation range of the leaf spring portion of the ratchet member around the shaft attachment portion. A surgical operation handle structure characterized by being formed. 2. The ratchet teeth formed on the push bar have a contour of an isosceles right triangle, and the ratchet teeth formed on both slopes at the tip of the head of the ratchet member also have an isosceles right triangle. The surgical operating handle structure of claim 1, wherein the operating handle structure is contoured.