JP2020006093A - Medical instrument - Google Patents

Abstract

To provide a medical instrument that can smoothly perform medical treatment.SOLUTION: A medical instrument includes a first blade (1), a second blade (2) and a connection member (4). The first blade (1) and the second blade (2) have an arc-shaped cross section along a width direction that crosses with an extension direction that is oriented from a proximal end toward a distal end. The connection member (4) connects proximal ends of the first blade (1) and the second blade (2) so as to be rotatable. A recess part (6) is formed in a first side edge (12) of the first blade (1), while a recess part (7) is formed in a third side edge (22) of the second blade (2).SELECTED DRAWING: Figure 1

Description

  The present invention relates to a medical device inserted into a hole of a human or an animal.

  2. Description of the Related Art Conventionally, as a medical device inserted into a hole of a person, a medical device including a pair of blades rotatably connected is known. For example, a vaginal speculum, which is an example of the above-mentioned medical instrument, is used for performing examination, surgery, and other medical measures on the vagina and uterus.

  Medical procedures may be performed with the speculum inserted into the vaginal cavity. At this time, the medical procedure may not be able to proceed smoothly because the space between the opposing side edges of the blades is narrow.

  The above-mentioned problems may also occur when performing medical treatment on a site other than the vagina, for example, the anus. In addition, medical treatment for animals other than humans as well as medical treatment for humans can occur in the same manner.

JP 2001-509706A

  An object of the present invention is to provide a medical device capable of smoothly performing medical treatment on a hole of a human or an animal.

  The medical device according to the present invention includes a first blade and a second blade. The first blade has a first proximal end, a first distal end, a first side edge between the first distal end and the first proximal end, and a second side opposite the first side edge. It has an edge, and a cross section along a first width direction that intersects a first extension direction from the first base end portion to the first tip end portion is arc-shaped. The second blade has a second proximal end, a second distal end, a third side edge facing the first side edge, and a fourth side edge facing the second side edge. A cross section along a second width direction intersecting with a second extending direction from the base end toward the second front end is arc-shaped. At least one of the first side edge, the second side edge, the third side edge, and the fourth side edge has a recess.

  According to the invention having the above configuration, it is possible to smoothly perform medical treatment for the hole of a human or an animal.

FIG. 2 is a schematic perspective view of the speculum according to the first embodiment. FIG. 3 is a schematic side view of the colposcope. Sectional drawing along the 1st width direction of the upper blade and the 2nd width direction of the lower blade with which the said colposcope is provided. FIG. 3 is a plan view of the speculum. FIG. 9 is a schematic perspective view of a speculum according to a second embodiment. FIG. 11 is a schematic side view of a speculum according to a third embodiment.

  Hereinafter, some embodiments will be described with reference to the drawings. In each embodiment, a speculum to be inserted into a human vagina is disclosed as an example of a medical device.

[First Embodiment]
FIG. 1 is a schematic perspective view of a speculum 100 according to the first embodiment. The colposcope 100 includes an upper blade 1, a lower blade 2, a handle 3, and a connecting member 4. Each of these elements is formed of a metal such as stainless steel. However, these elements may be at least partially formed of a material other than metal such as a resin material. In the present embodiment, the upper blade 1 is an example of a first blade, and the lower blade 2 is an example of a second blade.

  The upper blade 1 has a proximal end portion 10, a distal end portion 11 opposite to the proximal end portion 10, a first side edge 12 between the proximal end portion 10 and the distal end portion 11, and an opposite side of the first side edge. And a second side edge 13. The upper blade 1 has a spatula shape that is elongated in a first extending direction from the base end portion 10 to the tip end portion 11. That is, the cross section of the blade 1 along the first width direction orthogonal to the first extension direction is arc-shaped.

  The lower blade 2 has a base end portion 20, a front end portion 21 opposite to the base end portion 20, a third side edge 22 facing the first side edge 12, and a fourth side facing the second side edge 13. Edge 23. Like the upper blade 1, the lower blade 2 has a spatula shape that is long in the second extending direction from the base end portion 20 to the distal end portion 21. That is, the cross section of the lower blade 2 along the second width direction orthogonal to the second extending direction is arc-shaped.

  The handle 3 extends downward from the base end 20 of the lower blade 2 in the figure. The handle 3 has a through hole 30. The handle 3 is integral with the lower blade 2 in the illustrated example, but may be a different component from the lower blade 2.

  The connecting member 4 includes a semi-circular holding portion 40 connected to the base end portion 10 of the upper blade 1, a handle 41 extending downward from the holding portion 40 in the drawing, and a through-hole provided on the handle 41. And a hole 42. Both ends in the second width direction of the base end portion 20 of the lower blade 2 are rotatably connected to the holding portion 40 by pins 43, respectively.

  The colposcope 100 further includes a bolt 5. The bolt 5 has a knob 50 having a female screw and a male screw 51 passed through the female screw of the knob 50. One end of the male screw 51 is passed through the through hole 30 and is rotatably connected to the handle 3. The other end of the male screw 51 is passed through the through hole 42. The knob 50 is passed between the other end of the male screw 51 and the handle 41. When the knob 50 is rotated in a predetermined direction, the knob 50 moves in a direction approaching one end of the male screw 51 connected to the handle 3. Accordingly, the handle 41 moves in a direction approaching the handle 3. That is, the movable range of the handle 41 with respect to the handle 3 can be adjusted by the knob 50. Here, the upper blade 1 is connected to the connecting member 4 including the handle 41. Further, the lower blade 2 is connected to the handle 3 and further rotatably connected to a holding portion 40 of the connecting member 4 by a pin 43. Therefore, the turning range of the upper blade 1 with respect to the lower blade 2 can be adjusted by the knob 50.

  As described above, the upper blade 1 is rotatably connected to the lower blade 2 by the connecting mechanism including the handle 3, the connecting member 4, the bolt 5, and the like. However, the mechanism for rotatably connecting the upper blade 1 and the lower blade 2 is not limited to the illustrated example.

  The first side edge 12 of the upper blade 1 has a recess 6. In the recess 6, the upper blade 1 is cut out along a direction intersecting the first extending direction and the first width direction of the upper blade 1. The third side edge 22 of the lower blade 2 has the concave portion 7. In the concave portion 7, the lower blade 2 is cut out along a direction intersecting the second extending direction and the second width direction of the lower blade 2. The recesses 6 and 7 are formed in the first and third side edges 12 and 22 by, for example, grinding the upper blade 1 and the lower blade 2. As described above, when the concave portions 6 and 7 are included between the first side edge 12 and the third side edge 22 in the colposcope 100, the first side edge 12 and the third side The space between the rim 22 is widened.

  For example, a uterine manipulator capable of adjusting the position of the uterus may be used in a laparoscopic operation to secure a surgical field of view. For example, a uterine manipulator includes a shaft, a movable member attached to one end of the shaft, and a handle for moving the movable member, and the movable member can be moved by operating the handle. For example, such a uterine manipulator is inserted into the vaginal cavity from between the side edge of the upper blade and the side edge of the lower blade, with the vaginal cavity opened by the vaginal speculum.

  In the colposcope 100 according to the present embodiment, the space between the first side edge 12 and the third side edge 22 is wider due to the concave portions 6 and 7. Therefore, it is easy to insert the uterine manipulator from between the first side edge 12 and the third side edge 22 with the vaginal cavity opened by the colposcope 100. Further, when removing the vaginal speculum 100 from the vagina after inserting the uterine manipulator, the space between the first side edge 12 and the third side edge 22 is wide, so that the vaginal speculum 100 is less likely to be caught by the uterine manipulator.

  In addition, for example, in an operation performed by inserting the colposcope 100 into the vagina, when the affected part is excised with an electric scalpel or a laser scalpel, smoke is generated by a suction tube because smoke is generated. When the suction tube is inserted through the opening OP, the suction tube itself or an assistant having the suction tube may obstruct the doctor's operation. Further, even if an attempt is made to insert the suction tube from between the second side edge 13 having no concave portion and the fourth side edge 23, there is a possibility that there is not enough space. On the other hand, since a large space is formed between the first side edge 12 and the third side edge 22 by the concave portions 6 and 7, the suction tube can be easily inserted. Further, when the suction tube is inserted without passing through the opening OP in this way, it is difficult to hinder the operation by a doctor, and the suction tube can be stably held. As a result, the operation can proceed smoothly.

  FIG. 2 is a schematic side view of the colposcope 100. Here, the speculum 100 is shown in a closed state. In the colposcope 100, the first side edge 12 of the upper blade 1 has the concave portion 6, and the third side edge 22 of the lower blade 2 has the concave portion 7. Thus, when the opposing first and third side edges 12 and 22 have the concave portions 6 and 7, both the concave portions 6 and 7 are located between the first side edge 12 and the third side edge 22. It is included. Thereby, a wider space between the first side edge 12 and the third side edge 22 is ensured as compared with the case where only the opposing first side edge 12 or the third side edge 22 has a concave portion. it can.

  The concave portion 6 has a depth D along a direction perpendicular to the first extending direction and the first width direction of the upper blade 1. In FIG. 2, the first side edge 12 is bent in an arc shape near the end portions 60 and 61 of the concave portion 6, whereby the concave portion 6 is tapered. On the other hand, excluding the vicinity of the ends 60 and 61, the depth D decreases substantially linearly from the base end 10 toward the tip end 11. That is, the depth D includes a portion that decreases from the base end portion 10 to the distal end portion 11.

  When the speculum 100 does not have the concave portions 6 and 7, when the speculum 100 is opened as shown in FIG. 1, the distance between the first side edge 12 and the third side edge 22 is increased. It becomes smaller from 11 toward the base end 10. On the other hand, as in the present embodiment, the first side edge 12 has the concave portion 6 and the concave portion 6 includes a portion where the depth D increases from the distal end portion 11 side toward the base end portion 10 side. Also on the end 10 side, a wide space between the first side edge 12 and the third side edge 22 can be ensured.

  From the viewpoint of obtaining the above-described effects with respect to the insertion of the uterine manipulator and the suction tube, the depth D is preferably, for example, 6 mm or more, more preferably 7 mm or more, and still more preferably 8 mm or more at the position where the depth is maximum. In addition, from the same viewpoint, the depth D is preferably 2 mm or more, more preferably 3 mm or more, and still more preferably 4 mm or more at the position where the taper starts near the end 61. On the other hand, if the depth D is too large, the strength of the upper blade 1 and the lower blade 2 may be reduced, and when the vaginal speculum 100 is inserted into the vaginal cavity, the first side edge 12 and the third side edge 22 may not move. The vaginal wall may penetrate between them and hinder the procedure. Therefore, the depth D is preferably, for example, 14 mm or less at the maximum position, more preferably 12 mm or less, and still more preferably 10 mm or less. From a similar viewpoint, the depth D is preferably, for example, 9 mm or less, more preferably 8 mm or less, and even more preferably 7 mm or less, at the position where the taper starts near the end 61. Here, the description has been made using the concave portion 6, but the same applies to the concave portion 7.

  FIG. 2 shows a state in which the colposcope 100 is closed, that is, portions other than the concave portions 6 and 7 of the first and third side edges 12 and 22 are close to each other, and the second and fourth side edges 13 and 23 are close to each other. It is in the state that it is. In this state, the end portion 60 of the concave portion 6 on the base end portion 10 coincides with the end portion 70 of the concave portion 7 on the base end portion 20 side, and the end portion 61 of the concave portion 6 on the tip end portion 11 side It matches the end 71 of the recess 7. Thereby, the opening formed between the concave portion 6 and the concave portion 7 can be formed in a smooth shape.

  FIG. 3 is a cross-sectional view of the speculum 100 taken along the line III-III of FIG. The height H1 in the figure is the height at which the height from the upper blade 1 to the lower blade 2 is maximum in the cross section, and the height H2 is the height from the concave portion 6 to the concave portion 7 in the cross section. As an example, the height H2 is preferably at least １ ／ of the height H1, and more preferably at least の of the height H1. Such a relationship between the heights H1 and H2 may be established at all positions except for a portion where the concave portion 6 tapers in the vicinity of the end portions 60 and 61 in FIG.

  FIG. 4 is a schematic plan view of the colposcope 100. The width Wmin in the figure is the minimum value of the width of the upper blade 1 along the first width direction in the concave portion 6. The region A points between the concave portion 6 and the tip portion 11, and the width WA is a length of the upper blade 1 in the region A along the first width direction. The upper blade 1 has a shape in which the vicinity of the tip portion 11 tapers in an arc shape. The width WA in the area A excluding the vicinity of the tip 11 is larger than the width Wmin. The width WA is maximum at the end 61, for example. Here, the description has been made using the concave portion 6, but the same applies to the concave portion 7.

  With such a configuration, when the speculum 100 is inserted into the vagina, the contact area between the vaginal wall and the upper blade 1 and the lower blade 2 in the region A increases. Therefore, the vaginal cavity can be easily opened by the colposcope 100. As an example, the difference between the maximum value of the width WA and the width Wmin can be expected if the difference is 3 mm or more, and the difference is preferably 4 mm or more, more preferably 5 mm or more.

  L in FIG. 4 is the length in the first extending direction from the pin 43 shown in FIG. 1 to the end 61 of the recess 6. In the present embodiment, the length L is equal to or more than の of the length in the first extending direction from the pin 43 to the distal end portion 11. In the present embodiment, the length between the ends 60 and 61 in the first extension direction is also １ ／ or more of the length from the pin 43 to the tip 11 in the first extension direction. That is, the recess 6 is also formed on the tip 11 side from the midpoint between the pin 43 and the tip 11. Thereby, a wide space can be secured between the first side edge 12 and the third side edge 22 also on the tip end 11 side.

  According to the vaginal speculum 100 according to the above-described first embodiment, the first and third side edges 12, 22 have the concave portions 6, 7, so that the medical procedure using the uterine manipulator or the suction tube described above can be smoothly performed. It is possible to do.

  Further, in the colposcope 100 according to the first embodiment, the second and fourth side edges 13 and 23 do not have a concave portion. Thereby, the strength of the upper blade 1 and the lower blade 2 can be increased as compared with the case where the concave portions are also provided in the second and fourth side edges 13 and 23.

  In addition, when the concave portion is provided, the vaginal wall easily enters between the upper blade 1 and the lower blade 2 when the speculum 100 is inserted into the vaginal cavity, and the field of view of the practitioner is narrowed. If the first and third side edges 12 and 22 are provided with the concave portions 6 and 7 as in the first embodiment, compared to the case where the second and fourth side edges 13 and 23 are also provided with the concave portions, The amount of the vaginal wall entering between the upper blade 1 and the lower blade 2 can be reduced, and the field of view can be widened.

  In the above-described first embodiment, the end portions 60 and 61 of the concave portion 6 and the end portions 70 and 71 of the concave portion 7 coincide with each other in a state where the speculum 100 is closed, but may not coincide with each other. For example, the end 60 may coincide with the end 70 and the end 61 may not coincide with the end 71. Further, for example, the end 60 does not need to match the end 70, and the end 61 does not need to match the end 71. In addition, the length between the ends 60 and 61 in the first extending direction and the length between the ends 70 and 71 in the second extending direction may be the same or different.

  In the above-described first embodiment, the above-described effects can be obtained even if the first side edge 12 is replaced with the second side edge 13 and the third side edge 22 is replaced with the fourth side edge 23. That is, in the first embodiment described above, the second side edge 13 has the concave portion 6 and the fourth side edge 23 has the concave portion 7, and the first and third side edges 12, 22 do not have the concave portion. The above-described effects can also be obtained.

  In the above-described first embodiment, an example in which the concave portions 6 and 7 are provided in both the first side edge 12 and the third side edge 22 has been disclosed. As another example, only one of the concave portions 6 and 7 may be provided. Further, the recesses may be provided on both or one of the second side edge 13 and the third side edge 23 without providing the recesses 6 and 7 on the first side edge 12 and the third side edge 22.

[Second embodiment]
FIG. 5 is a schematic perspective view of a speculum 200 according to the second embodiment. The colposcope 200 is different from the colposcope described above in that the second and fourth side edges 13 and 23 have recesses 8 and 9 in addition to the recesses 6 and 7 of the first and third side edges 12 and 22. Different from 100. The same elements as those of the speculum 100 are denoted by the same reference numerals, and description thereof will be omitted.

  For example, the recesses 8 and 9 have the same shape as the recesses 6 and 7. However, the shapes of the recesses 8 and 9 and the shapes of the recesses 6 and 7 may be different.

  In the present embodiment, the recesses 6 and 7 are included between the first side edge 12 and the third side edge 22, and the recesses 8 and 9 are located between the second side edge 13 and the fourth side edge 23. It is included. Thus, for example, in a state where the colposcope 200 is inserted, the uterus can be moved from either between the first side edge 12 and the third side edge 22 or between the second side edge 13 and the fourth side edge 23. Instruments such as manipulators and suction tubes can be easily inserted.

In a conventional vaginal speculum having no concave portion, the vaginal wall may be sandwiched between the side edge of the upper blade and the side edge of the lower blade, particularly when performing treatment on a patient having a narrow vaginal cavity. By providing concave portions in both the first side edge 12 and the third side edge 22 and the second side edge 13 and the fourth side edge 23 as in the present embodiment, it is possible to prevent the vaginal speculum 200 from sandwiching the vaginal wall. Can be suppressed. That is, since the first to fourth side edges 12, 13, 22, and 23 of the colposcope 200 have the concave portions 6, 7, 8, and 9, the medical procedure can smoothly proceed.
Even with the configuration of the present embodiment, the same effects as those of the first embodiment can be obtained.

  In the above-described second embodiment, an example in which the first to fourth side edges 12, 13, 22, and 23 have recesses 6 to 9 respectively has been described. As another example, a recess may be provided in one of the first and second side edges 12 and 13 and one of the third and fourth side edges 22 and 23, respectively.

[Third embodiment]
FIG. 6 is a schematic plan view of a speculum 300 according to the third embodiment. The colposcope 300 has concave portions 6 and 7 on the first and third side edges similarly to the colposcope 100 described above, but the length between the end portions 60 and 61 of the concave portion 60 and the end portion 70 of the concave portion 7 are provided. , 71 are different from the speculum 100 described above. The same elements as those of the speculum 100 are denoted by the same reference numerals, and description thereof will be omitted.

  In the colposcope 300, the position of the end 60 is the same as the position of the end 60 in the colposcope 100 shown in FIG. 2, but the position of the end 61 is the position of the end 61 in the colposcope 100 shown in FIG. It is located closer to the base end 10 than the position. That is, the length between the ends 60 and 61 of the concave portion 6 in the colposcope 300 is smaller than that of the colposcope 100 shown in FIG.

  Specifically, in the example of FIG. 4, the length L in the first extending direction from the pin 43 (see FIG. 1) to the end 61 is the length in the first extending direction from the pin 43 to the tip 11. Less than 1/2 of the length. The length between the end portions 60 and 61 in the first extending direction is preferably 以下 or less, more preferably １ ／ or less, of the length from the pin 43 to the distal end portion 11 in the first extending direction. Is more preferred. That is, in the present embodiment, the concave portion 6 is not formed on the distal end portion 11 side from the midpoint of the length from the pin 43 to the distal end portion 11. Thereby, the length of the region A becomes larger than the colposcopy 100 in the first embodiment. Therefore, the penetration of the vaginal wall into the concave portions 6 and 7 when the vaginal cavity is opened by the vaginal speculum 300 can be further suppressed as compared with the case of the vaginal speculum 100, and the practitioner's field of view can be secured well. Here, the description has been made using the concave portion 6, but the same applies to the concave portion 7.

  In the third embodiment described above, even when the second side edge 13 has the concave portion 6, the fourth side edge 23 has the concave portion 7, and the first and third side edges 12, 22 have no concave portion. Thus, the effects described above can be obtained.

  In addition, even with the configuration of the present embodiment, the same effects as those of the first embodiment can be obtained.

  The structures disclosed in the above first to third embodiments can be appropriately combined. For example, in the colposcope 300, the second and fourth side edges 13, 23 may have the concave portions 8, 9 as in the example of FIG.

  In each embodiment, the concave portions 6, 7, 8, and 9 are exemplified by the same shape, but each concave portion may have a different shape.

  In each embodiment, the colposcopes 100, 200, and 300 having the coupling mechanism capable of rotating the upper blade 1 with respect to the lower blade 2 have been exemplified. However, the configuration relating to the recesses 6, 7, 8, 9 can also be applied to other types of speculum. For example, in a vaginal speculum in which the upper blade can move up and down and rotate with respect to the lower blade, a concave portion may be provided on at least one of the side edges of the upper blade and the lower blade.

  In each embodiment, a speculum to be inserted into a human vagina has been disclosed as an example of a medical device. However, the configuration relating to the recesses 6, 7 and the like can also be applied to other kinds of medical instruments having two blades (first blade and second blade), for example, an anoscope. Further, the use target of the medical device is not limited to a human, and may be an animal other than a human.

  For example, in some anoscopes, one opposing side edges of a first blade and a second blade are rotatably connected to each other, and the other opposing side edges are opened and closed by a handle operation or the like. By providing a concave portion on the side edge on the side on which the anoscope is opened / closed, it is possible to widen the field of view when observing the anus with the anoscope inserted, and to smoothly perform medical treatment.

  The embodiments described above do not limit the scope of the invention to the configurations disclosed in these embodiments. The present invention can be implemented in various other forms. The configurations and modifications disclosed in each embodiment are included in the invention described in the claims and the equivalents thereof.

100, 200, 300: vaginal speculum, 1: upper blade, 12: first side edge, 13: second side edge,
2 lower blade, 22 third side edge, 23 fourth side edge, 3 handle, 4 connecting member,
6, 7, 8, 9 ... recessed portion.

Claims (6)

A medical device inserted into a hole of a human or animal,
A first proximal end, a first distal end, one side edge between the first distal end and the first proximal end, and a second side edge opposite to the first side edge; A first blade having an arc-shaped cross section along a first width direction intersecting a first extension direction from one base end toward the first tip;
A second base end portion, a second front end portion, a third side edge facing the first side edge, and a fourth side edge facing the second side edge; A second blade having an arc-shaped cross section along a second width direction intersecting with a second extension direction toward the second tip portion;
A medical device wherein at least one of the first side edge, the second side edge, the third side edge, and the fourth side edge has a recess. The recess is formed on both the first side edge and the third side edge, or on both the second side edge and the fourth side edge.
The medical device according to claim 1. The first side edge and the third side edge have the concave portion,
The second side edge and the fourth side edge do not have the recess.
The medical device according to claim 1. The concave portion of the first blade has a shape in which a depth along a direction intersecting the first extending direction and the first width direction decreases from the first base end side toward the first distal end side. Including
The concave portion of the second blade has a shape in which a depth along a direction intersecting with the second extending direction and the second width direction decreases from the second base end side toward the second distal end side. including,
The medical device according to claim 2. The first blade has a first width between the concave portion and the first tip portion of the first blade that is smaller than the width of the first blade along the first width direction in the concave portion where the width of the first blade is minimum. A portion having a large width of the first blade along a direction,
The second blade has a second width between the concave portion and the second tip portion of the second blade that is smaller than a portion of the concave portion where the width of the second blade along the second width direction is minimum. A portion having a large width of the second blade along a direction,
The medical device according to any one of claims 2 to 4. In a state where the first blade and the second blade are closed, an end of the recess of the first blade coincides with an end of the recess of the second blade.
The medical device according to any one of claims 2 to 5.

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