JP3540702B2 - Medical forceps - Google Patents

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a medical forceps for performing a treatment such as grasping or cutting off a tissue in a body cavity.
[0002]
[Prior art]
FIG. 19 shows an entire conventional medical grasping forceps. FIG. 20 is a longitudinal sectional view of a tip forceps portion of the grasping forceps, and FIG. 21 is a sectional view taken along a line GG in FIG. In this conventional medical grasping forceps 100, a hand operation section 102 is formed at a hand end of an insertion section sheath 101, and the forceps section 103 provided at the distal end of the insertion section sheath 101 is remotely operated by the hand operation section 102. Opening and closing operations are performed to treat various tissues in the body cavity.
[0003]
The hand operation unit 102 includes a fixed handle 104 and a movable handle 105. The movable handle 105 is connected to an operation shaft 106 inserted in the sheath 101. Then, by rotating the movable handle 105 in the direction of the arrow in FIG. 19, the operation shaft 106 is slid in the front-rear direction, and the forceps unit 103 is opened and closed.
[0004]
As shown in FIG. 20, the pair of opening / closing arm members 107 of the forceps section 103 are collectively and pivotally attached to one pivot pin 109 supported on the distal end tip 108 of the sheath 101 so as to be freely opened and closed. . The proximal ends of the opening / closing arm members 107 are connected to the distal ends of a pair of links 110 by pivot pins 111, respectively, and the rear ends of the links 110 are collectively connected to the operation shaft 106 by one pivot pin 112. It was done.
[0005]
In addition, as shown in FIG. 21, the pivotal connecting portion of the pair of opening / closing arm members 107 in the forceps portion 103 is fitted into a slit between the support arm portions 113 of the distal end tip 108, and the opening / closing arm member A pivot pin 109 penetrates the intersection of 107 and the support arm 113. Each end of the pivot pin 109 is fixed to the support arm 113 by being caulked to the support arm 113, and the end of the pivot pin 109 is flush with the outer peripheral surface of the support arm 113. I have.
[0006]
In addition, depending on the type of medical forceps, that is, the forceps for an endoscope, a stopper 115 is provided on the movable handle 105 of the hand operation unit 102 so as to protrude toward the fixed handle 104 side. Of the movable handle 105 can be positioned in a stepwise manner by hooking on a claw provided on the fixed handle 104 side.
[0007]
[Problems to be solved by the invention]
By the way, when performing a treatment using such forceps, if an excessive amount of force is applied to the operation handle, the force is directly transmitted to the operation shaft 106, which may adversely affect the operation of the operation shaft.
[0008]
The present invention has been made in view of the above problems, and an object of the present invention is to provide a medical forceps capable of reducing an excessive amount of force applied to an operation handle.
[0009]
[Means for Solving the Problems]
According to the first aspect of the present invention, a forceps portion that opens and closes, an operation shaft that moves in the front-rear direction to open and close the forceps portion, and is pivotally supported by a pivot shaft to move the operation shaft. A movable handle, a spring that transmits the amount of rotation of the movable handle to the operation shaft, and a force that is in contact with the spring and directly acts on the operation shaft, wherein the force of the movable handle transmitted by the spring A connecting member that transmits the operation shaft and is supported by the pivot shaft;
A medical forceps comprising:
[0010]
According to a second aspect of the present invention, a forceps portion that opens and closes, an operation shaft that moves in the front-rear direction to open and close the forceps portion, and is pivotally supported by a pivot shaft to move the operation shaft. A movable handle, a spring that transmits the amount of rotation of the movable handle to the operation shaft, and a force that is in contact with the spring and directly acts on the operation shaft, wherein the force of the movable handle transmitted by the spring And a connecting member that transmits the operating shaft to the operating shaft and is supported by the pivot shaft, and an adjusting screw that adjusts a relative positional relationship between the connecting member and the movable handle. Medical forceps.
[0012]
According to the first aspect of the present invention, the amount of force of the movable handle is transmitted to the operating shaft by a spring and a connecting member pivotally supported by the pivot shaft.
[0013]
In the invention according to claim 2, the amount of force of the movable handle is transmitted to the operation shaft by a spring and a connecting member pivotally supported by the pivot shaft. The relative positional relationship between the connecting member and the movable handle can be adjusted with an adjusting screw.
[0015]
【Example】
First Embodiment A medical grasping forceps according to a first embodiment of the present invention will be described with reference to FIGS. As shown in FIG. 2, the grasping forceps 1 for an endoscope here has a hand operation section 3 at a hand end of an insertion section sheath 2, and the hand operation section 3 is provided for the insertion section sheath 2. The forceps unit 4 provided at the distal end is remotely opened and closed to perform treatment on various tissues in the body cavity. The hand operation unit 3 includes a fixed handle 5 and a movable handle 6. The movable handle 6 slides an operation shaft 7 inserted into the sheath 2 in the front-rear direction to open and close the forceps unit 4.
[0016]
As shown in FIG. 1, the forceps unit 4 has a pair of opening / closing arm members 8. The pair of opening / closing arm members 8 intersect each other, and a single pivot pin 10 supported by the distal end tip 9 of the sheath 2 penetrates the intersection. Thus, the forceps part 4 is configured to be freely openable and closable by pivotally supporting the pair of openable and closable arm members 8. The distal end of a link 11 is connected to the base end of each opening / closing arm member 8 by a pivot pin 12, and the rear end of each link 11 is collectively connected to the distal end of the operation shaft 7 to form one pivot pin 13. They are connected by pivoting through them.
[0017]
That is, the pair of opening / closing arm members 8 of the forceps unit 4 are opened / closed by the push / pull operation of the operation shaft 7 via the link mechanism 14.
[0018]
1A, a continuous triangular sawtooth 15 is formed as seen from the side, as shown in FIG. 1A, and a cross-section as shown in FIG. It has a shape provided with a vertical groove 16 having a planar shape.
[0019]
As shown in FIG. 3, the pivotal portion of the forceps section 4 where the pair of opening / closing arm members 8 intersect is positioned by being fitted into a slit between the support arm sections 17 of the distal end tip 9. The pivot pin 10 penetrates the intersection of the opening and closing arm member 8 and the support arm 17. Each end of the pivot pin 10 is fixed to the support arm 17 by being caulked to the support arm 17, and the end of the pivot pin 10 is flush with the outer peripheral surface of the support arm 17. I have. Further, the outer peripheral surface of the support arm 17 near the end of the pivot pin 10 is formed as a plane 18 perpendicular to the axis L of the pivot pin 10.
[0020]
According to the above configuration, since the corner 19 at the end of the pivot pin 10 does not protrude greatly from the outer peripheral surface of the support portion, as compared with the conventional pivot structure shown in FIG. Even if the pin 10 rotates, the pivotal pin 10 does not damage the inner wall of the body cavity. There is no need to provide means for locking the pivot pin 10.
[0021]
On the other hand, the movable handle 6 of the hand operation unit 3 is pivotally supported on a root portion of the fixed handle 5 using a set screw 21. That is, the movable handle 6 is attached and fixed to one end of a torsion spring 22 which is supported by winding an intermediate portion around a set screw 21. The other end of the torsion spring 22 is connected to the rear end of the operation shaft 7 inserted into the insertion portion sheath 2.
[0022]
As shown in FIG. 6A, one end of the torsion spring 22 is bent in a U-shape, and this U-shaped portion is locked to the end of the operating shaft 7. The other end of 22 is inserted and connected to the movable handle 6.
[0023]
Although the torsion spring 22 shown in FIG. 6A is of a one-point support type, the torsion spring 22 may be of a double torsion type and of a two-point support type as shown in FIG. 6B. With this two-point support system, it is possible to prevent the movable handle 6 and the torsion spring 22 from being offset, and to smoothly perform the opening and closing operations.
[0024]
Further, the movable handle 6 of the hand operation unit 3 is provided with a stopper 24 having a saw-like tooth 23 formed on the upper surface thereof so as to protrude toward the fixed handle 5. As shown in FIG. 5, the stopper 24 penetrates a hole 25 opened in the middle of the fixed handle 5, and a claw portion 26 for engaging with the teeth 23 of the stopper 24 is formed on the upper edge of the hole 25. Have been. When the movable handle 6 is rotated toward the fixed handle 5, the saw-like teeth 23 of the stopper 24 are sequentially locked by the claw portions 26, and the movable handle 6 is fixed at each position where the rotation operation is stopped. That is, the turning position of the movable handle 6 to be turned can be determined stepwise.
[0025]
In this embodiment, the teeth 23 of the stopper 24 in the present embodiment are not provided near the movable handle 6 than the conventional one, and are reduced near the fixed handle 5. Since the teeth 23 of the stopper 24 are not in the middle, even if the movable handle 6 is further gripped in the closing direction from the position F shown in FIG. 4, the positioning and fixing by the stopper 24 become impossible.
[0026]
On the other hand, the features of the forceps unit 4 and the link mechanism 14 described above are as follows. That is, in FIG. 1, the length (“r” in FIG. 1) of the base end arm portion of the opening / closing arm member 8 that rotates around the pivot pin 10 is changed to the length of the link 11 (“l” in FIG. 1). ), That is, an unequal length relationship of r: l = 2: 1.
[0027]
The grasping forceps 1 in this embodiment is intended to grasp the intestine under a laparoscopic method using a trocar. Therefore, the length of the grasping arm portion on the distal end side of the opening / closing arm member 8 (see FIG. m ") is about three times that of a normal grasping forceps.
[0028]
When the length r of the proximal arm portion of the opening / closing arm member 8 in the forceps portion 4 is twice the length "l" of the link 11, that is, in FIG. 1, when r: l = 2: 1, Immediately before the opening / closing arm member 8 of the forceps section 4 is completely closed, the amount of force transmitted to the tip of the opening / closing arm member 8 is about 1 in comparison with the case of r: 1 = 1: 1 (conventional example). .6 times.
[0029]
Further, in order to open and close the opening / closing arm member 8 of the forceps section 4, as shown in FIG. 2, the movable handle 6 may be rotated as shown by an arrow to move the operation shaft 7 in the front-back direction. When the movable handle 6 is rotated, the torsion spring 22 and the movable handle 6 can operate as if they were integral with the set screw 21 as a fulcrum. Here, the position D shown in FIG. 4 indicates a position where the forceps unit 4 at the tip is open, and the position E indicates a position where the forceps unit 4 grips the intestine and the like and closes to the end. However, even if the force is further applied to the movable handle 6 from the position E in the direction in which the forceps unit 4 closes, only the torsion spring 22 is deformed, and the position of the operation shaft 7 does not move in the front-rear direction. Since the forceps section 4 is already closed, it is not closed any more. Then, only the movable handle 6 moves in the closing direction along with the deformation of the torsion spring 22 (position F).
[0030]
Since the gripping forceps 1 have a length (“m” in FIG. 1) of the gripping portion of the forceps portion 4 which is about three times that of a normal gripping forceps, the length of the link is equal to the base arm portion of the forceps portion 4. Although it was inevitable that the amount of force transmitted to the distal end of the forceps section 4 was reduced in the structure of the above, according to the configuration of this embodiment, the length of the proximal end arm section of the forceps section 4 was Since the length is twice as long, the force transmitted to the distal end of the forceps unit 4 can be reduced without changing the structure of the hand operation unit 3 or increasing the amount of force operated by the operator. It is about 1.6 times, which can correspond to it.
[0031]
In addition, by making the shape of the gripping portion of the forceps portion 4 as shown in FIG. 1, a gripping target such as the intestine can be gripped as much as possible without scratching and slipping, which is more suitable for gripping. . Further, even if an excessive amount of force is applied when the intestine or the like is gripped by the forceps unit 4, the excessive amount of force is not transmitted to the operation shaft 7 and the forceps unit 4 due to the deformation of the torsion spring 22 as described above. .
[0032]
In addition, the user grasps the movable handle 6 and loses the teeth 23 of the stopper 24 halfway, so that the user notices that the displacement amount of the movable handle 6 is already sufficiently large, and can prevent excessive grip.
In this embodiment, r: l = 2: 1, but the ratio of r to l is not limited to 2: 1.
[0033]
FIG. 7 shows an example of a biopsy forceps according to the second embodiment of the present invention. In this biopsy forceps, the length of the proximal arm portion (“r” in FIG. 7) of the opening / closing arm member 8 of the forceps portion 4 is 倍 times the length of the link 11 (“l” in FIG. 7). (That is, r: 1 = 1: 2). In this biopsy forceps, it is desired that the biopsy amount is large, that is, the opening angle of the forceps part 4 that opens and closes is as large as possible. Therefore, by setting r: l = 1: 2, the operating shaft 7 does not come into contact with the arm of the forceps unit 4 and the forceps unit 4 can be opened by 180 °.
[0034]
FIG. 8 shows an example of scissors forceps according to the third embodiment of the present invention. Since the scissors forceps have a large sliding area of the opening / closing section, a large amount of operation force is usually required, and the amount of force transmitted to the forceps section 4 is preferably as large as possible. In this embodiment, by setting the length of the base arm of the opening / closing arm member 8 in the forceps unit 4 to twice the length of the link 11, the amount of force transmitted to the distal end working site of the forceps unit 4 is reduced. It was about 1.6 times the structure.
[0035]
FIG. 9 shows an example of a peeling forceps according to a fourth embodiment of the present invention. In this embodiment, a peeling forceps is used instead of the grasping forceps shown in the first embodiment. This exfoliating forceps is used for exfoliating work such as peeling off tissue in a body cavity. In particular, since a fine operation is performed, the length of the exfoliating portion of the forceps unit 4 (“m” shown in FIG. 9) is usually used. The forceps are about twice as large as the peeling forceps, and it is inevitable that the amount of force transmitted to the distal end of the forceps portion 4 becomes small. Therefore, the length of the proximal arm portion of the forceps section 4 is set to be twice the length of the link 11, and the amount of force transmitted to the action section of the forceps section 4 is increased.
[0036]
FIG. 10 shows an example of a grasping forceps according to a fifth embodiment of the present invention. Although the forceps section 4 in the first embodiment described above has a structure that is opened on both sides by a pair of opening and closing arm members 8, this embodiment is different in that the forceps section 4 is configured to open to only one side. With this grasping forceps, only one opening / closing arm member 8 is opened, and the other opening / closing arm member 8 is fixed and does not move, so that it may be easy to grasp by an object to be grasped. The point that the length of the base arm portion of the forceps portion 4 is twice the length of the link 11 is the same as in the first embodiment.
[0037]
FIG. 11 shows an example of a grasping forceps according to the sixth embodiment of the present invention. This is such that only one open / close arm member 8 of the forceps portion 4 in the biopsy forceps of the second embodiment described above is opened. The other opening / closing arm member 8 is fixedly provided. Since only one opening / closing arm member 8 is opened, the biopsy section is fixed and does not move, so that it is easy to perform a biopsy depending on a biopsy target. Further, the point that the length of the base arm portion of the forceps portion 4 is 倍 the length of the link 11 is the same as in the first embodiment.
[0038]
12 and 13 show an example of a grasping forceps according to a seventh embodiment of the present invention. Although the operating shaft 7 and the torsion spring 22 in the first embodiment described above are directly connected, in this embodiment, a connecting member 31 for connecting the operating shaft 7 is attached to a corresponding end of the torsion spring 22. The operating shaft 7 and the torsion spring 22 are indirectly connected via the connecting member 31. Since the connection is made via the connection member 31 in this manner, the connection with the operation shaft 7 can be performed with high accuracy, and the bending of the torsion spring 22 which is usually complicated can be further simplified.
[0039]
Further, the connecting member 31 is configured such that its lower portion is extended so that this extended portion 32 abuts on the movable handle 6 as shown in FIG. Further, an adjusting screw 33 protruding toward the peripheral surface of the movable handle 6 is attached to a lower portion of the extension portion 32. The tip of the adjusting screw 33 can also be brought into contact with the peripheral surface of the movable handle 6.
[0040]
When the torsion spring 22 as shown by the solid line in FIG. 13 in the free state is assembled to the movable handle 6, the torsion spring 22 is elastically deformed to the position indicated by the dotted line. For this reason, it is possible to bias the connecting member 31 to that position with respect to the movable handle 6. Further, the relative positional relationship between the movable handle 6 and the connecting member 31 can be adjusted by the adjusting screw 33, and the magnitude of the urging force can be adjusted.
[0041]
By biasing the connecting member 31 toward the movable handle 6 in advance by the torsion spring 22, the connecting member 31 and the movable handle 6 operate as one unit until a certain amount of force is applied to the movable handle 6. . The value of the force at that time can be adjusted by the adjusting screw 33.
[0042]
FIG. 14 shows an eighth embodiment of the present invention. In this embodiment, the movable handle 6 provided simply at the end of the torsion spring 22 in the above-described seventh embodiment is supported by a set screw 21 coaxially with the torsion spring 22. In this case, the end of the torsion spring 22 is bent at a right angle, and the tip is hooked on the movable handle 6 to urge the movable handle 6 against the connecting portion 31. The mounting strength and the mounting accuracy of the movable handle 6 to the fixed handle 5 can be increased as compared with those of the embodiments described above.
[0043]
FIG. 15 shows a ninth embodiment of the present invention. In this embodiment, the connecting member 31 provided at the end of the torsion spring 22 is pivotally supported by the set screw 21 coaxially with the torsion spring 22 in the seventh embodiment. At this time, the end of the torsion spring 22 is bent at a right angle, and the movable handle 6 is urged against the connecting member 31 by hooking its tip to the connecting member 31. The attachment strength and the attachment accuracy of the connecting member 31 to the movable handle 6 can be increased as compared with those of the previous embodiments.
[0044]
16 and 17 show a tenth embodiment of the present invention. In this embodiment, the connecting member 31 and the movable handle 6 provided at the end of the torsion spring 22 in the above-described eighth embodiment are supported by a set screw 21 coaxially with the torsion spring 22. Further, the position of the movable handle 6 with respect to the connecting member 31 is conventionally determined by the extension portion 32 of the connecting member 31, whereas the positioning is performed by the groove 41 of the connecting member 31 and the upper portion 42 of the movable handle 6. ing. An adjustment screw 43 is provided on the upper portion 42 of the movable handle 6 so that the relative position between the connecting member 31 and the movable handle 6 can be adjusted.
[0045]
Since both the movable handle 6 and the connecting member 31 are pivotally supported by the set screw 21, the mounting strength and the mounting accuracy are further increased. Further, the shape of the connecting member 31 is simpler than those of the tenth and eleventh embodiments.
[0046]
According to the embodiment, since the exchange of the torsion spring 22 is relatively easy, several kinds of strength of the torsion spring 22 are prepared, and the strength can be selected and used depending on the target organ and the operator's preference. Further, when the torsion spring 22 loses the initial force due to repeated use, the torsion spring 22 can be easily replaced, which is economical.
[0047]
FIG. 18 shows an eleventh embodiment of the present invention. FIG. 18 shows the hand-held operation unit 3 of the forceps. In this embodiment, the movable handle 6 is fixed and the fixed handle 5 moves in reverse. In this embodiment, an adjusting screw 43 is provided on the connecting member 31.
[0048]
【The invention's effect】
As described above, according to the present invention, even when an excessive force is applied to the operation handle, the excessive force is not directly transmitted to the operation shaft.
[Brief description of the drawings]
FIG. 1A is a cross-sectional view of a forceps portion of a grasping forceps according to a first embodiment of the present invention, and FIG. 1B is a cross-sectional view taken along line AA in FIG.
FIG. 2 is a side view of the grasping forceps according to the first embodiment of the present invention.
FIG. 3 is a sectional view taken along line BB in FIG.
FIG. 4 is a side view of a hand operation unit of the grasping forceps according to the first embodiment of the present invention.
FIG. 5 is a partially sectional side view of a hand operation unit of the grasping forceps according to the first embodiment of the present invention.
FIG. 6 is a rear view of the hand operation unit as viewed from the hand side.
FIG. 7 is a cross-sectional view of a forceps part in a biopsy forceps according to a second embodiment of the present invention.
FIG. 8 is a cross-sectional view of a forceps portion of the scissors forceps according to the third embodiment of the present invention.
FIG. 9 is a cross-sectional view of a forceps portion in a peeling forceps according to a fourth embodiment of the present invention.
FIG. 10 is a cross-sectional view of a forceps portion of a grasping forceps according to a fifth embodiment of the present invention.
FIG. 11 is a cross-sectional view of a forceps section of a grasping forceps according to a sixth embodiment of the present invention.
FIG. 12 is a sectional view of a hand operation unit of the grasping forceps according to the seventh embodiment of the present invention.
FIG. 13 is a side view of a torsion spring of the grasping forceps according to the seventh embodiment of the present invention.
FIG. 14 is a side view of a hand operation unit of the grasping forceps according to the eighth embodiment of the present invention.
FIG. 15 is a side view of a hand operation unit of the grasping forceps according to the ninth embodiment of the present invention.
FIG. 16 is a side view of a hand operation unit of the grasping forceps according to the tenth embodiment of the present invention.
FIG. 17 is an exploded perspective view of a hand operation unit of the grasping forceps according to the tenth embodiment of the present invention.
FIG. 18 is a side view of a hand operation unit of the grasping forceps according to the eleventh embodiment of the present invention.
FIG. 19 is a side view of a conventional grasping forceps.
FIG. 20 is a sectional view of a forceps part of the grasping forceps.
FIG. 21 is a sectional view of a portion along the line GG in FIG. 20;
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... grasping forceps, 2 ... sheath, 3 ... hand operation part, 4 ... forceps part, 5 ... fixed handle, 6 ... movable handle, 7 ... operation shaft, 8 ... opening / closing arm member, 21 ... set screw, 22 ... screw Respring, 31 ... connecting member.

Claims (2)

A forceps part that opens and closes,
An operation shaft that moves in the front-rear direction to open and close the forceps unit,
A movable handle pivotally supported by a pivot shaft to move the operation shaft,
A spring for transmitting the amount of rotation of the movable handle to the operation shaft;
A contact member that comes into contact with the spring and directly acts on the operation shaft, and that transmits a force of the movable handle transmitted by the spring to the operation shaft and is supported by the pivot shaft; ,
A medical forceps comprising: A forceps part that opens and closes,
An operation shaft that moves in the front-rear direction to open and close the forceps unit,
A movable handle pivotally supported by a pivot shaft to move the operation shaft,
A spring for transmitting the amount of rotation of the movable handle to the operation shaft;
A contact member that comes into contact with the spring and directly acts on the operation shaft, and that transmits a force of the movable handle transmitted by the spring to the operation shaft and is supported by the pivot shaft; ,
An adjusting screw for adjusting a relative positional relationship between the connecting member and the movable handle,
A medical forceps comprising:

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