JP2019084310A

JP2019084310A - Retractor

Info

Publication number: JP2019084310A
Application number: JP2017217400A
Authority: JP
Inventors: 一博本郷; Kazuhiro Hongo; 哲吉堀内; Tetsukichi Horiuchi; 清志伊東; Kiyoshi Ito; 圭治堤; keiji Tsutsumi; 笠原　賢一; Kenichi Kasahara; 賢一笠原; 淳土屋; Atsushi Tsuchiya
Original assignee: Shinshu University NUC; Takashima Sangyo KK
Current assignee: Shinshu University NUC; Takashima Sangyo KK
Priority date: 2017-11-10
Filing date: 2017-11-10
Publication date: 2019-06-06
Anticipated expiration: 2037-11-10
Also published as: JP7019143B2

Abstract

To provide a retractor which holds an incision in an extended state into an intended shape, and which is relatively easily inserted into the incision.SOLUTION: A retractor 1 comprises two rod-shaped insertion members 3 formed of a shape memory alloy having an insertion part 3a inserted into an incision 2, both end parts of the two insertion members 3 are connected by connection members 4, 5. Temperature of a transformation point of the insertion member 3 is lower than normal temperature. In the retractor 1, the two insertion members 3 are in an open state in which an interval between the two insertion parts 3 are extended in an ordinary temperature environment and, before the two insertion parts 3a are inserted into the incision 2, elastically deformed into a closed state in which the interval between the two insertion parts 3 becomes narrow and the two insertion parts 3a come close to each other in the ordinary temperature environment.SELECTED DRAWING: Figure 2

Description

本発明は、手術中に切開された切開創を広げた状態で保持するための開創器に関する。 TECHNICAL FIELD The present invention relates to a retractor for holding an incision which has been opened during surgery in an open state.

従来、切開手術を行う際に切開創を広げた状態で保持するための開創器が知られている（たとえば、特許文献１参照）。特許文献１に記載の開創器は、薄肉の板状体によって構成されている。また、この開創器は、長方形の弾性板に曲げ加工を施すことで形成されており、大径の円筒状に形成されている。この開創器を切開創に装着する際には、手術を行う者や手術を補助する者が、板状体の弾性力に抗して開創器を小径の円筒状に丸め込むとともに丸め込んだ開創器を手で持って切開創に挿入する。切開創に挿入された開創器から手を離すと、板状体の弾性力で開創器が拡径して、切開創の広がった状態が保持される。 BACKGROUND ART A retractor for holding an open wound in a spread state when performing open surgery is conventionally known (see, for example, Patent Document 1). The retractor described in Patent Document 1 is configured of a thin plate-like body. In addition, this retractor is formed by bending a rectangular elastic plate, and is formed in a large diameter cylindrical shape. When attaching this retractor to an incisional wound, the person who performs the surgery or the person who assists in surgery rolls the retractor into a small diameter cylindrical shape against the elastic force of the plate-like body and retracts the retractor. Hold by hand and insert in the incision wound. When the hand is released from the retractor inserted into the incision, the elastic force of the plate-like body expands the diameter of the retractor, and the spread state of the incision is maintained.

特開２００７−８２６７４号公報Japanese Patent Application Publication No. 2007-82674

切開手術を効率的かつ適切に行うためには、手術が行われる患部や手術内容等に応じて、切開創を意図した形に広げた状態で保持することが好ましい。特許文献１に記載の開創器では、切開創を円形状に広げた状態で保持することは可能であるが、切開創をその他の形状に広げた状態で保持することはできない。すなわち、特許文献１に記載の開創器では、必ずしも切開創を意図した形に広げた状態で保持することはできない。また、特許文献１に記載の開創器では、開創器を円筒状に丸め込んだ状態で切開創に挿入するため、切開創に開創器を挿入する際に切開創をある程度広げないと、切開創に開創器を挿入することができない。そのため、特許文献１の開創器の場合、切開創へ開創器を挿入しにくい。 In order to perform the open surgery efficiently and appropriately, it is preferable to hold the open wound in an intended form according to the affected area where the surgery is to be performed, the contents of the operation, and the like. In the retractor described in Patent Document 1, although it is possible to hold the incision in a circularly expanded state, it is not possible to hold the incision in another state. That is, the retractor described in Patent Document 1 can not always hold the incision in the intended form. In addition, in the retractor described in Patent Document 1, since the retractor is rolled into a cylindrical shape and inserted into the incision, when the retractor is inserted into the incision, the incision is not expanded to a certain extent. You can not insert a retractor. Therefore, in the case of the retractor of Patent Document 1, it is difficult to insert the retractor into the incision wound.

そこで、本発明の課題は、切開創を意図した形に広げた状態で保持することが可能であって、かつ、切開創への挿入を比較的容易に行うことが可能な開創器を提供することにある。 Therefore, an object of the present invention is to provide a retractor which can hold an incision in an intended form and can be relatively easily inserted into the incision. It is.

上記の課題を解決するため、本発明の開創器は、手術中に切開された切開創を広げた状態で保持するための開創器であって、切開創に挿入される挿入部を有し形状記憶合金で形成されるとともに棒状または管状に形成される２本の挿入部材と、２本の挿入部材と別体で形成され２本の挿入部材の一端部を連結する第１連結部材と、２本の挿入部材と別体で形成され２本の挿入部材の他端部を連結する第２連結部材とを備え、挿入部材の変態点は、常温よりも低い温度となっており、２本の挿入部材は、常温環境下において、２個の挿入部の間の少なくとも一部の間隔が広がっている開状態となっているとともに、２個の挿入部が切開創に挿入される前に、常温環境下で、２個の挿入部の間隔が狭まって２個の挿入部が互いに近づいた状態となる閉状態に弾性変形させられることを特徴とする。 In order to solve the above-mentioned problems, a retractor according to the present invention is a retractor for holding an incision which has been incised during an operation in a spread state, and has an insertion portion to be inserted into the incision. Two insertion members formed of a memory alloy and formed in a rod shape or a tubular shape, a first connection member formed separately from the two insertion members and connecting one end of the two insertion members, 2 A second connecting member formed separately from the first inserting member and connecting the other ends of the two inserting members, the transformation point of the inserting member being lower than normal temperature; The insertion member is in an open state in which at least a part of the space between the two insertion parts is widening in a normal temperature environment, and the room temperature before the two insertion parts are inserted into the incisional wound. In an environment, the distance between the two insertion parts is narrowed, and the two insertion parts are in a state of approaching each other. Characterized in that it is elastically deformed in the closed state.

本発明の開創器では、形状記憶合金で形成されるとともに棒状または管状に形成される２本の挿入部材が、切開創に挿入される挿入部を備えている。また、本発明では、挿入部材の変態点は、常温よりも低い温度となっており、２本の挿入部材は、常温環境下において、２個の挿入部の間の少なくとも一部の間隔が広がっている開状態となっている。そのため、本発明では、切開創に挿入される２個の挿入部によって切開創を広げた状態で保持することが可能になる。また、本発明では、変態点が常温よりも低い形状記憶合金によって棒状または管状の挿入部材が形成されているため、常温環境下で２本の挿入部材が開状態となっているときの２個の挿入部の形状を、患部や手術内容等に応じて様々な形状にすることが可能になる。したがって、本発明では、切開創に挿入される２個の挿入部によって切開創を意図した形に広げた状態で保持することが可能になる。 In the retractor according to the present invention, the two insertion members formed of shape memory alloy and formed in a rod shape or a tube shape have insertion portions inserted into the incision. Further, in the present invention, the transformation point of the insertion member is a temperature lower than the normal temperature, and the two insertion members expand at least a part of the distance between the two insertion portions under the normal temperature environment. Is in the open state. Therefore, in the present invention, it is possible to hold the incision in a spread state by the two insertion portions inserted into the incision. Further, in the present invention, since the rod-like or tubular insertion member is formed of a shape memory alloy whose transformation point is lower than normal temperature, two pieces when the two insertion members are open in the normal temperature environment According to the present invention, it is possible to make various shapes of the insertion portion according to the affected part, the contents of the operation and the like. Therefore, in the present invention, the two insertion portions inserted into the incision can hold the incision in an intended spread state.

また、本発明では、２個の挿入部が切開創に挿入される前に、２本の挿入部材は、２個の挿入部の間隔が狭まって２個の挿入部が互いに近づいた状態となる閉状態に弾性変形させられているが、本発明では、棒状または管状に形成される２本の挿入部材の一端部が挿入部材と別体で形成された第１連結部材に固定されるとともに、２本の挿入部材の他端部が挿入部材と別体で形成された第２連結部材に固定されているため、２本の挿入部材が閉状態になっているときの２個の挿入部の幅（２個の挿入部が隣接する方向の幅）を狭めることが可能になる。したがって、本発明では、２個の挿入部が隣接する方向において幅が狭くなっている２個の挿入部を切開創に挿入することが可能になる。そのため、本発明では、２個の挿入部を切開創に挿入する際に切開創をそれほど広げなくても、２個の挿入部を切開創に挿入することが可能になる。その結果、本発明では、２個の挿入部の切開創への挿入を比較的容易に行うことが可能になる。 Further, in the present invention, before the two insertion parts are inserted into the incision wound, in the two insertion members, the space between the two insertion parts is narrowed and the two insertion parts are in a state in which the two insertion parts approach each other. In the present invention, one end portion of the two insertion members formed in a rod-like shape or a tubular shape is fixed to the first connecting member formed separately from the insertion member, although it is elastically deformed in the closed state. Because the other end of the two insertion members is fixed to the second connecting member formed separately from the insertion members, when the two insertion members are in the closed state, It becomes possible to narrow the width (the width in the direction in which the two insertion parts are adjacent). Therefore, according to the present invention, it is possible to insert two insertion portions, which are narrowed in the direction in which the two insertion portions are adjacent, into the incisional wound. Therefore, in the present invention, it is possible to insert the two insertion parts into the incision without inserting the two insertion parts into the incision, without widening the incision. As a result, in the present invention, it is possible to relatively easily insert the two insertion portions into the incisional wound.

また、本発明では、棒状または管状に形成される２本の挿入部材の一端部が挿入部材と別体で形成された第１連結部材に固定されるとともに、２本の挿入部材の他端部が挿入部材と別体で形成された第２連結部材に固定されているため、２個の挿入部が切開創に挿入されている開状態の２本の挿入部材を比較的容易に閉状態とすることが可能になる。したがって、本発明では、２個の挿入部を切開創から容易に抜き去ることが可能になる。 Further, in the present invention, one end portion of the two insertion members formed in a rod shape or a tubular shape is fixed to the first connection member formed separately from the insertion member, and the other end portion of the two insertion members Is fixed to the second connection member separately formed from the insertion member, so that the two insertion members in the open state in which the two insertion portions are inserted into the incision are relatively easily closed. It will be possible to Therefore, in the present invention, it is possible to easily remove the two insertion parts from the incision.

本発明において、挿入部材は、棒状に形成されていることが好ましい。棒状の挿入部材の挿入部によって切開創を広げた状態で保持する保持力と、管状の挿入部材の挿入部によって切開創を広げた状態で保持する保持力とを同じにする場合には、棒状の挿入部材の外径よりも管状の挿入部材の外径を大きくする必要がある。そのため、挿入部材が棒状に形成されていると、挿入部材の外径を小さくしつつ、挿入部によって切開創を広げた状態で保持する保持力を確保することが可能になる。 In the present invention, the insertion member is preferably formed in a rod shape. When the holding power for holding the incision in a spread state by the insertion portion of the rod-shaped insertion member is the same as the holding power for holding the incision in a spread state by the insertion portion of the tubular insertion member the same. It is necessary to make the outside diameter of the tubular insertion member larger than the outside diameter of the insertion member. Therefore, when the insertion member is formed in a rod-like shape, it is possible to reduce the outer diameter of the insertion member and to secure a holding force for holding the incision wound in a spread state by the insertion portion.

本発明において、挿入部材は、第１連結部材に固定される直線状の第１被固定部と、第２連結部材に固定される直線状の第２被固定部とを備え、第１被固定部は、挿入部に対して９０°に折れ曲がった状態で挿入部の一端に繋がり、第２被固定部は、挿入部に対して第１被固定部と同方向に９０°に折れ曲がった状態で挿入部の他端に繋がっていることが好ましい。このように構成すると、２個の挿入部を切開創に挿入する際に、第１連結部材および第２連結部材を切開創から遠ざけることが可能になる。したがって、２本の挿入部材が第１連結部材および第２連結部材によって連結されていても、２個の挿入部の切開創への挿入を容易に行うことが可能になる。 In the present invention, the insertion member includes a linear first fixed portion fixed to the first connection member and a linear second fixed portion fixed to the second connection member, and the first fixed portion The part is connected to one end of the insertion part in a state bent at 90 ° with respect to the insertion part, and the second fixed part is bent at a 90 ° in the same direction as the first fixed part with respect to the insertion part It is preferable to be connected to the other end of the insertion part. With this configuration, when the two insertion portions are inserted into the incision, it is possible to move the first connection member and the second connection member away from the incision. Therefore, even if the two insertion members are connected by the first connection member and the second connection member, it is possible to easily insert the two insertion portions into the incisional wound.

本発明において、開創器は、開状態の２本の挿入部材を閉状態とするための摘み部を備え、摘み部は、２本の挿入部材のうちの一方の挿入部材の挿入部に固定される第１摘み部材と、他方の挿入部材の挿入部に固定される第２摘み部材とを備えることが好ましい。このように構成すると、たとえば、開状態の２本の挿入部材を閉状態に弾性変形させる治具を使用しなくても、摘み部を用いて、開状態の２本の挿入部材を閉状態に弾性変形させることが可能になる。したがって、開状態の２本の挿入部材を閉状態に容易に弾性変形させることが可能になる。 In the present invention, the retractor includes a knob for closing the two insertion members in the open state, and the knob is fixed to the insertion portion of one of the two insertion members. It is preferable to provide a first picking member and a second picking member fixed to the insertion portion of the other insertion member. With such a configuration, for example, even if a jig for elastically deforming the two open insertion members into the closed state is not used, the open two insertion members are closed using the knob. It is possible to elastically deform. Therefore, it becomes possible to easily elastically deform the two insertion members in the open state to the closed state.

以上のように、本発明の開創器では、切開創を意図した形に広げた状態で保持することが可能になるとともに、開創器の挿入部の、切開創への挿入を比較的容易に行うことが可能になる。 As described above, in the retractor according to the present invention, it becomes possible to hold the incision in a state of being spread in the intended shape, and the insertion portion of the retractor is relatively easily inserted into the incision. It becomes possible.

本発明の実施の形態にかかる開創器の斜視図である。It is a perspective view of a retractor according to an embodiment of the present invention. 図１に示す開創器を切開創に装着する手順を説明するための図である。It is a figure for demonstrating the procedure which mounts the retractor shown in FIG. 1 to an incisional wound. 本発明の他の実施の形態にかかる開創器の斜視図である。It is a perspective view of a retractor according to another embodiment of the present invention.

以下、図面を参照しながら、本発明の実施の形態を説明する。 Hereinafter, embodiments of the present invention will be described with reference to the drawings.

（開創器の構成）
図１は、本発明の実施の形態にかかる開創器１の斜視図である。図２は、図１示す開創器１を切開創２に装着する手順を説明するための図である。 (Structure of retractor)
FIG. 1 is a perspective view of a retractor 1 according to an embodiment of the present invention. FIG. 2 is a view for explaining the procedure for attaching the retractor 1 shown in FIG. 1 to the incisional wound 2.

本形態の開創器１は、手術中に切開された患者の切開創２を広げた状態で保持するための器具である。開創器１は、切開創２に挿入される挿入部３ａを有する棒状の２本の挿入部材３と、２本の挿入部材３と別体で形成され２本の挿入部材３の一端部を連結する第１連結部材としての連結部材４と、２本の挿入部材３と別体で形成され２本の挿入部材３の他端部を連結する第２連結部材としての連結部材５とを備えている。連結部材４と連結部材５とは、生体毒性の少ない（または生体毒性のない）金属材料で形成されるとともに同形状に形成されている。連結部材４、５は、直方体状に形成されている。また、連結部材４、５は、たとえば、ステンレス鋼で形成されている。なお、連結部材４、５は、チタン合金で形成されていても良いし、タングステンカーバイトで形成されていても良い。 The retractor 1 of the present embodiment is an instrument for holding the incisional wound 2 of the patient incised during surgery in a spread state. The retractor 1 is formed separately from the two rod-like insertion members 3 having the insertion portions 3a inserted into the incisional wound 2 and the two insertion members 3, and connects one end portions of the two insertion members 3 A connecting member 4 as a first connecting member, and a connecting member 5 as a second connecting member formed separately from the two insertion members 3 and connecting the other ends of the two insertion members 3 There is. The connecting member 4 and the connecting member 5 are formed of a metal material with low biotoxicity (or non-biotoxic) and formed in the same shape. The connection members 4 and 5 are formed in a rectangular parallelepiped shape. The connecting members 4 and 5 are made of, for example, stainless steel. The connecting members 4 and 5 may be formed of a titanium alloy, or may be formed of tungsten carbide.

挿入部材３は、ニッケルチタン合金等の形状記憶合金で形成されている。また、挿入部材３は、断面形状が円形状となる細長い円柱状の棒材が所定形状に曲げられることで形成されている。挿入部材３の外径は、たとえば、２．５（ｍｍ）〜３（ｍｍ）程度となっている。挿入部材３は、挿入部３ａに加えて、連結部材４に固定される第１被固定部としての被固定部３ｂと、連結部材５に固定される第２被固定部としての被固定部３ｃとを備えている。被固定部３ｂと被固定部３ｃとは、同形状の直線状に形成されている。本形態の挿入部材３は、挿入部３ａと被固定部３ｂ、３ｃとから構成されている。被固定部３ｂは、挿入部３ａに対して９０°に折れ曲がった状態で挿入部３ａの一端に繋がっている。被固定部３ｃは、挿入部３ａに対して被固定部３ｂと同方向に９０°に折れ曲がった状態で挿入部３ａの他端に繋がっている。 The insertion member 3 is formed of a shape memory alloy such as a nickel-titanium alloy. Further, the insertion member 3 is formed by bending an elongated cylindrical bar having a circular cross-sectional shape into a predetermined shape. The outer diameter of the insertion member 3 is, for example, about 2.5 (mm) to 3 (mm). The insertion member 3 is, in addition to the insertion portion 3 a, a fixed portion 3 b as a first fixed portion fixed to the connecting member 4 and a fixed portion 3 c as a second fixed portion fixed to the connecting member 5. And have. The to-be-fixed part 3b and the to-be-fixed part 3c are formed in the linear shape of the same shape. The insertion member 3 of this embodiment is composed of an insertion portion 3a and fixed portions 3b and 3c. The fixed portion 3b is connected to one end of the insertion portion 3a in a state of being bent at 90 ° with respect to the insertion portion 3a. The fixed portion 3c is connected to the other end of the insertion portion 3a in a state of being bent at 90 ° in the same direction as the fixed portion 3b with respect to the insertion portion 3a.

被固定部３ｂは、連結部材４に形成される貫通穴に挿入された状態で複数のネジ６によって連結部材４に固定されている。同様に被固定部３ｃは、連結部材５に形成される貫通穴に挿入された状態で複数のネジ６によって連結部材５に固定されている。また、２個の被固定部３ｂは、一定の間隔をあけた状態で連結部材４に固定され、２個の被固定部３ｃは、２個の被固定部３ｂと同じ方向において同じ間隔をあけた状態で連結部材５に固定されている。なお、被固定部３ｂ、３ｃは、溶接またはろう付けによって連結部材４、５に固定されていても良い。 The fixed portion 3 b is fixed to the connecting member 4 by a plurality of screws 6 in a state of being inserted into the through hole formed in the connecting member 4. Similarly, the fixed portion 3 c is fixed to the connecting member 5 by a plurality of screws 6 in a state of being inserted into a through hole formed in the connecting member 5. Further, the two fixed parts 3b are fixed to the connecting member 4 in a state of leaving a fixed space, and the two fixed parts 3c are same space in the same direction as the two fixed parts 3b. It is being fixed to the connection member 5 in the state. The parts to be fixed 3b and 3c may be fixed to the connecting members 4 and 5 by welding or brazing.

形状記憶合金で形成される挿入部材３の変態点は、常温よりも低い温度となっている。すなわち、挿入部材３は、超弾性合金で形成されている。２本の挿入部材３は、挿入部材３の変態点を超える温度環境下において、２個の挿入部３ａの間の少なくとも一部の間隔が広がっている開状態となっている（図１（Ａ）参照）。すなわち、２本の挿入部材３は、常温環境下において、開状態となっている。また、常温環境下において、挿入部３ａは、たとえば、図１（Ａ）に示すように、全体的に円弧状に湾曲しており、２本の挿入部材３が開状態となっているときには、２個の挿入部３ａのほぼ全体によって楕円形が形成されている。または、常温環境下において、挿入部３ａの一部が円弧状に湾曲しており、２本の挿入部材３が開状態となっているときには、２個の挿入部３ａの一部によって楕円形が形成されている。 The transformation point of the insertion member 3 formed of a shape memory alloy is a temperature lower than normal temperature. That is, the insertion member 3 is formed of a superelastic alloy. The two insertion members 3 are in the open state in which at least a part of the distance between the two insertion portions 3a is expanded under a temperature environment exceeding the transformation point of the insertion members 3 (FIG. 1 (A )reference). That is, the two insertion members 3 are in the open state under the normal temperature environment. In the normal temperature environment, for example, as shown in FIG. 1A, the insertion portion 3a is curved in a circular arc as a whole, and when the two insertion members 3 are in the open state, An elliptical shape is formed by almost all of the two insertion portions 3a. Alternatively, in a normal temperature environment, when a portion of the insertion portion 3a is curved in a circular arc shape and the two insertion members 3 are in the open state, an elliptical shape is produced by the portions of the two insertion portions 3a. It is formed.

あるいは、２本の挿入部材３が開状態となっているときには、たとえば、２個の挿入部３ａのほぼ全体によって円形が形成されたり、２個の挿入部３ａの一部によって円形が形成されたりする。または、２本の挿入部材３が開状態となっているときには、たとえば、２個の挿入部３ａのほぼ全体によって正方形等の四角形や四角形以外の多角形が形成されたり、２個の挿入部３ａの一部によって正方形等の四角形や四角形以外の多角形が形成されたりする。 Alternatively, when the two insertion members 3 are in the open state, for example, a circle may be formed by almost all of the two insertion portions 3a, or a circle may be formed by a part of the two insertion portions 3a. Do. Alternatively, when the two insertion members 3 are in the open state, for example, a quadrangle such as a square or a polygon other than a quadrilateral may be formed by substantially the entire two insertion portions 3a, or two insertion portions 3a A part of the square may form a square such as a square or a polygon other than a square.

２本の挿入部材３は、２個の挿入部３ａが切開創２に挿入される前に、常温環境下で、２個の挿入部３ａの間隔が狭まって２個の挿入部３ａが互いに近づいた状態となる閉状態に弾性変形させられる（図１（Ｂ）参照）。本形態では、図１（Ｂ）に示すように、挿入部３ａが略直線状となって閉状態の２本の挿入部材３が互いに略平行になるように、所定の治具（図示省略）を使用して手作業で、開状態の２本の挿入部材３を閉状態に弾性変形させる。 In the two insertion members 3, before the two insertion parts 3 a are inserted into the incisional wound 2, the space between the two insertion parts 3 a is narrowed in the normal temperature environment and the two insertion parts 3 a approach each other. It is elastically deformed to the closed state which will be in the closed state (see FIG. 1B). In this embodiment, as shown in FIG. 1B, a predetermined jig (not shown) is provided so that the insertion portion 3a is substantially linear and the two insertion members 3 in the closed state are substantially parallel to each other. The two insertion members 3 in the open state are elastically deformed to the closed state manually by using.

切開創２には、治具によって弾性変形させられて２本の挿入部材３が閉状態となっているときの、２個の挿入部３ａが挿入される（図２（Ａ）、（Ｂ）参照）。閉状態の２本の挿入部材３の挿入部３ａが切開創２に挿入されると、治具が取り外される。挿入部材３の変態点が常温よりも低い温度となっているため、２個の挿入部３ａが切開創２に挿入された後に治具が取り外されると、２本の挿入部材３は開状態となり、図２（Ｃ）に示すように、２個の挿入部３ａが切開創２を広げた状態で保持する。 Two insertion parts 3a are inserted into the incisional wound 2 when the two insertion members 3 are in a closed state after being elastically deformed by a jig (FIGS. 2A and 2B) reference). When the insertion portions 3a of the two insertion members 3 in the closed state are inserted into the incisional wound 2, the jig is removed. Since the transformation point of the insertion member 3 is lower than normal temperature, when the jig is removed after the two insertion parts 3a are inserted into the incisional wound 2, the two insertion members 3 are opened. As shown in FIG. 2 (C), the two insertion parts 3a hold the incisional wound 2 in a spread state.

なお、本形態では、挿入部材３に加工される前の、形状記憶合金製の直線状の棒材の変態点は、常温よりも低い温度となっている。開創器１を製造する際には、まず、この棒材を常温環境下で容易かつ任意の形状に曲げられるように（すなわち、棒材の変態点が常温を超える温度となるように）、この棒材に対して熱処理を行う。熱処理後、被固定部３ｂ、３ｃが形成されるように２本の棒材を曲げるとともに２本の棒材を連結部材４、５に固定する。その後、２個の挿入部３ａによって切開創２を意図した形に広げた状態で保持することが可能となる挿入部３ａの最適な形状が形成されるように所定の治具を用いて２本の棒材を曲げるとともに曲げられた２本の棒材を治具に固定し、その状態で、棒材の変態点が常温よりも低い温度となるように、棒材に対して再度、熱処理を行う。この熱処理が完了すると、２本の挿入部材３が常温環境下で開状態となって、開創器１が完成する。 In the present embodiment, the transformation point of the shape memory alloy linear bar before being processed into the insertion member 3 is a temperature lower than the normal temperature. When manufacturing the retractor 1, first, the bar is easily and easily bent into an arbitrary shape in a normal temperature environment (that is, the transformation point of the bar is a temperature exceeding the normal temperature). Heat treat the bar. After the heat treatment, the two bars are bent so that the fixed portions 3b and 3c are formed, and the two bars are fixed to the connecting members 4 and 5, respectively. Thereafter, two jigs are used so that an optimum shape of the insertion portion 3a can be formed so that the incisional wound 2 can be held in the intended shape by the two insertion portions 3a. The rod is bent and the two bent rods are fixed to a jig, and in that state, heat treatment is performed again on the rods so that the transformation point of the rods becomes lower than normal temperature. Do. When this heat treatment is completed, the two insertion members 3 are opened in a normal temperature environment, and the retractor 1 is completed.

（本形態の主な効果）
以上説明したように、本形態では、形状記憶合金で形成される挿入部材３の変態点は、常温よりも低い温度となっており、棒状に形成される２本の挿入部材３は、常温環境下において２個の挿入部３ａの間の少なくとも一部の間隔が広がっている開状態となっている。そのため、本形態では、常温環境下で２本の挿入部材３が開状態となっているときの２個の挿入部３ａの形状を、患部や手術内容等に応じて様々な形状にすることが可能になる。たとえば、上述のように、２本の挿入部材３が開状態となっているときの２個の挿入部３ａのほぼ全体または一部によって楕円形、円形または多角形を形成することが可能になる。また、本形態では、閉状態の２本の挿入部材３の挿入部３ａが切開創２に挿入されると、２本の挿入部材３が開状態となって、２個の挿入部３ａが切開創２を広げた状態で保持する。そのため、本形態では、切開創２に挿入される２個の挿入部３ａによって切開創２を意図した形に広げた状態で保持することが可能になる。 (Main effects of this form)
As described above, in the present embodiment, the transformation point of the insertion member 3 formed of the shape memory alloy is a temperature lower than the normal temperature, and the two insertion members 3 formed in the bar shape have the normal temperature environment. In the lower state, at least a part of the space between the two insertion parts 3a is in an open state. Therefore, in the present embodiment, the shape of the two insertion portions 3a when the two insertion members 3 are in the open state under a normal temperature environment may be various shapes according to the affected part, the contents of the operation, etc. It will be possible. For example, as described above, it is possible to form an oval, a circle or a polygon by almost all or part of the two insertion parts 3a when the two insertion members 3 are in the open state. . Further, in this embodiment, when the insertion portions 3a of the two insertion members 3 in the closed state are inserted into the incisional wound 2, the two insertion members 3 are opened, and the two insertion portions 3a are cut off. Hold wound 2 open. Therefore, in the present embodiment, the two insertion parts 3a inserted into the incisional wound 2 make it possible to hold the incisional wound 2 in a state of being spread in an intended form.

本形態では、２個の挿入部３ａが切開創に挿入される前に、２本の挿入部材３は、２個の挿入部３ａの間隔が狭まって２個の挿入部３ａが互いに近づいた状態となる閉状態に弾性変形させられているが、本形態では、棒状に形成される２本の挿入部材３の一端部が挿入部材３と別体で形成された連結部材４に固定されるとともに、２本の挿入部材４の他端部が挿入部材３と別体で形成された連結部材５に固定されているため、２本の挿入部材３が閉状態になっているときの２個の挿入部３ａの幅（２個の挿入部３ａが隣接する方向の幅、図２（Ｂ）の上下方向の幅）を狭めることが可能になる。したがって、本形態では、２個の挿入部３ａが隣接する方向において幅が狭くなっている２個の挿入部３ａを切開創２に挿入することが可能になる。そのため、本形態では、２個の挿入部３ａを切開創２に挿入する際に切開創２をそれほど広げなくても、２個の挿入部３ａを切開創２に挿入することが可能になる。その結果、本形態では、２個の挿入部３ａの切開創２への挿入を比較的容易に行うことが可能になる。 In this embodiment, before the two insertion parts 3a are inserted into the incision wound, the two insertion members 3 are in a state in which the space between the two insertion parts 3a is narrowed and the two insertion parts 3a are close to each other. In the present embodiment, one end of two rod-shaped insertion members 3 formed in a rod shape is fixed to a connecting member 4 formed separately from the insertion members 3 in this embodiment. Since the other ends of the two insertion members 4 are fixed to the connecting member 5 formed separately from the insertion member 3, the two insertion members 3 are in the closed state. It becomes possible to narrow the width (the width in the direction in which the two insertion portions 3a are adjacent, the width in the vertical direction of FIG. 2B) of the insertion portion 3a. Therefore, in the present embodiment, it is possible to insert the two insertion portions 3 a whose width is narrowed in the direction in which the two insertion portions 3 a are adjacent to each other in the incisional wound 2. Therefore, in this embodiment, when inserting the two insertion parts 3a into the incisional wound 2, it is possible to insert the two insertion parts 3a into the incisional wound 2 without expanding the incisional wound 2 so much. As a result, in this embodiment, it is possible to relatively easily insert the two insertion portions 3a into the incisional wound 2.

また、本形態では、棒状に形成される２本の挿入部材３の一端部が挿入部材３と別体で形成された連結部材４に固定されるとともに、２本の挿入部材４の他端部が挿入部材３と別体で形成された連結部材５に固定されているため、２個の挿入部３ａが切開創２に挿入されている開状態の２本の挿入部材３を、治具を用いて比較的容易に閉状態とすることが可能になる。したがって、本形態では、２個の挿入部３ａを切開創２から容易に抜き去ることが可能になる。 Further, in the present embodiment, one end portion of the two insertion members 3 formed in a rod shape is fixed to the connecting member 4 formed separately from the insertion member 3 and the other end portion of the two insertion members 4 Is fixed to the connecting member 5 separately formed from the inserting member 3, the two inserting members 3 in the open state in which the two inserting portions 3a are inserted into the incisional wound 2 are used as jigs. It can be used relatively easily to be closed. Therefore, in the present embodiment, it is possible to easily remove the two insertion portions 3a from the incisional wound 2.

本形態では、挿入部３ａに対して９０°に折れ曲がった状態で挿入部３ａの一端に繋がる被固定部３ｂが連結部材４に固定され、挿入部３ａに対して被固定部３ｂと同方向に９０°に折れ曲がった状態で挿入部３ａの他端に繋がる被固定部３ｃが連結部材５に固定されている。そのため、本形態では、２個の挿入部３ａを切開創２に挿入する際に、連結部材４、５を切開創２から遠ざけることが可能になる。したがって、本形態では、２本の挿入部材３が連結部材４、５によって連結されていても、２個の挿入部３ａの切開創２への挿入を容易に行うことが可能になる。 In this embodiment, the fixed portion 3b connected to one end of the insertion portion 3a in a state of being bent at 90 ° with respect to the insertion portion 3a is fixed to the connecting member 4, and the insertion portion 3a is in the same direction as the fixed portion 3b. A fixed portion 3 c connected to the other end of the insertion portion 3 a in a state of being bent at 90 ° is fixed to the connecting member 5. Therefore, in the present embodiment, when the two insertion portions 3 a are inserted into the incisional wound 2, it is possible to move the connecting members 4 and 5 away from the incisional wound 2. Therefore, in this embodiment, even if the two insertion members 3 are connected by the connecting members 4 and 5, the insertion of the two insertion portions 3a into the incisional wound 2 can be easily performed.

（他の実施の形態）
上述した形態において、挿入部材３は、断面形状が多角形状となる細長い角柱状の棒材が所定形状に曲げられることで形成されていても良い。また、挿入部材３は、円管状等の管状に形成されていても良い。ただし、棒状の挿入部材３の挿入部３ａによって切開創２を広げた状態で保持する保持力と、管状の挿入部材３の挿入部３ａによって切開創２を広げた状態で保持する保持力とを同じにする場合には、棒状の挿入部材３の外径よりも管状の挿入部材３の外径を大きくする必要がある。そのため、上述した形態では、挿入部材３の外径を小さくしつつ、挿入部３ａによって切開創２を広げた状態で保持する保持力を確保することが可能になる。 (Other embodiments)
In the embodiment described above, the insertion member 3 may be formed by bending an elongated prismatic rod having a polygonal cross-sectional shape into a predetermined shape. Moreover, the insertion member 3 may be formed in a tubular shape such as a circular tubular shape. However, the holding force for holding the incision 2 in a spread state by the insertion portion 3a of the rod-shaped insertion member 3 and the holding force for holding the incision 2 in a spread state by the insertion portion 3a of the tubular insertion member 3 In the case of making the same, it is necessary to make the outer diameter of the tubular insertion member 3 larger than the outer diameter of the rod-like insertion member 3. Therefore, in the embodiment described above, it is possible to secure the holding force for holding the incisional wound 2 in the expanded state by the insertion portion 3a while reducing the outer diameter of the insertion member 3.

上述した形態において、開創器１は、図３に示すように、開状態の２本の挿入部材３を閉状態とするための摘み部７を備えていても良い。摘み部７は、２本の挿入部材３のうちの一方の挿入部材３の挿入部３ａに固定される第１摘み部材としての摘み部材８と、他方の挿入部材３の挿入部３ａに固定される第２摘み部材としての摘み部材９とを備えている。摘み部材８、９は、長方形の平板状に形成されるとともに同形状に形成されている。摘み部材８と摘み部材９とは、互い平行になるように配置されている。摘み部材８には、摘み部材８と摘み部材９とが近づく方向および摘み部材８と摘み部材９とが離れる方向へ摘み部材８、９を案内するための２本のガイド軸１０が固定され、摘み部材９には、２本のガイド軸１０が挿通される貫通穴９ａが形成されている。 In the embodiment described above, as shown in FIG. 3, the retractor 1 may be provided with a knob 7 for bringing the two insertion members 3 in the open state into the closed state. The knob portion 7 is fixed to the knob member 8 as a first knob member fixed to the insertion portion 3 a of one of the two insertion members 3 and to the insertion portion 3 a of the other insertion member 3. And a pick member 9 as a second pick member. The knob members 8 and 9 are formed in a rectangular flat plate shape and in the same shape. The knob member 8 and the knob member 9 are disposed parallel to each other. The two guide shafts 10 for guiding the pinching members 8 and 9 in a direction in which the pinching members 8 and 9 come close to each other and a direction in which the pinching members 8 and 9 separate from each other are fixed to the pinching member 8 The knob member 9 is formed with a through hole 9 a through which the two guide shafts 10 are inserted.

この場合には、摘み部材８と摘み部材９とが近づくように摘み部７を摘むことで、常温環境下で、開状態の２本の挿入部材３を閉状態に変形させることが可能になる。すなわち、開状態の２本の挿入部材３を閉状態に変形させる治具を使用しなくても、摘み部７を用いて開状態の２本の挿入部材３を閉状態に変形させることが可能になる。したがって、２個の挿入部３ａが切開創２に挿入される前に、開状態の２本の挿入部材３を閉状態に容易に弾性変形させることが可能になる。また、２個の挿入部３ａが切開創２に挿入されている開状態の２本の挿入部材３を容易に閉状態とすることが可能になる。 In this case, it is possible to deform the two inserted members 3 in the open state to the closed state in a normal temperature environment by picking the picker 7 so that the pick members 8 and 9 get close to each other. . That is, it is possible to use the knob 7 to deform the two open insertion members 3 into the closed state without using a jig for deforming the two open insertion members 3 into the closed state. become. Therefore, before the two insertion parts 3a are inserted into the incisional wound 2, it is possible to easily elastically deform the two insertion members 3 in the open state to the closed state. In addition, the two insertion members 3 in the open state in which the two insertion parts 3a are inserted into the incisional wound 2 can be easily closed.

上述した形態において、２本の挿入部材３が閉状態となっているときに、挿入部３ａが湾曲していても良い。すなわち、２本の挿入部材３が閉状態となっているときに、閉状態の２本の挿入部材３が互いに略平行になっていなくても良い。また、上述した形態において、挿入部材３は、被固定部３ｂ、３ｃを備えていなくても良い。この場合には、挿入部材３は、挿入部３ａによって構成されており、挿入部３ａの一端部が連結部材４に固定されるとともに、挿入部３ａの他端部が連結部材５に固定されている。 In the embodiment described above, when the two insertion members 3 are in the closed state, the insertion portion 3a may be curved. That is, when the two insertion members 3 are in the closed state, the two insertion members 3 in the closed state may not be substantially parallel to each other. Moreover, in the embodiment described above, the insertion member 3 may not include the fixed portions 3 b and 3 c. In this case, the insertion member 3 is constituted by the insertion portion 3a, one end of the insertion portion 3a is fixed to the connection member 4, and the other end of the insertion portion 3a is fixed to the connection member 5 There is.

１開創器
２切開創
３挿入部材
３ａ挿入部
３ｂ被固定部（第１被固定部）
３ｃ被固定部（第２被固定部）
４連結部材（第１連結部材）
５連結部材（第２連結部材）
７摘み部
８摘み部材（第１摘み部材）
９摘み部材（第２摘み部材） Reference Signs List 1 retractor 2 incision wound 3 insertion member 3a insertion portion 3b fixed portion (first fixed portion)
3c Fixed part (second fixed part)
4 Connection member (1st connection member)
5 Connection member (second connection member)
7 knob 8 knob (first knob)
9 Picking member (2nd picking member)

Claims

A retractor for holding an opened incision which has been opened during surgery in an open state,
Two of the two insertion members formed of shape memory alloy and having an insertion portion to be inserted into the incision and formed of a rod or a tube, and two of the two insertion members separately from the two insertion members A first connection member connecting one end of the insertion member, and a second connection member formed separately from the two insertion members and connecting the other ends of the two insertion members;
The transformation point of the insertion member is a temperature lower than normal temperature,
The two insertion members are in an open state in which at least a part of the distance between the two insertion portions is wide under the normal temperature environment, and the two insertion portions A retractor characterized in that, before being inserted, the space between the two insertion parts is narrowed in a normal temperature environment to be elastically deformed in a closed state in which the two insertion parts come close to each other.

The retractor according to claim 1, wherein the insertion member is formed in a rod shape.

The insertion member includes a linear first fixed portion fixed to the first connection member and a linear second fixed portion fixed to the second connection member,
The first fixed portion is connected to one end of the insertion portion in a state of being bent at 90 ° with respect to the insertion portion,
The second fixed part is connected to the other end of the insertion part in a state of being bent at 90 ° in the same direction as the first fixed part with respect to the insertion part. The retractor according to 2).

A knob for bringing the two insertion members in the open state into the closed state;
The knob portion is a first knob member fixed to the insertion portion of one of the two insertion members, and a second knob member fixed to the insertion portion of the other insertion member. The retractor according to any one of claims 1 to 3, further comprising: