JP3868111B2 - Rigid forceps - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a rigid endoscope forceps used for endoscopy and endoscopic surgery.
[0002]
[Prior art]
In recent years, surgical operations under endoscopic observation have been actively performed. In such an operation, various treatments are performed with forceps inserted into a body cavity while viewing an endoscopic image displayed on a monitor. The grasping forceps used at this time is provided with a gripper that can be opened and closed at the distal end of a long insertion portion, a proximal operation portion having a handle is provided at the proximal end of the insertion portion, and the handle and the gripping portion are inserted into the insertion portion. Connected through a long operating shaft. Then, the gripping portion at the tip is opened / closed from outside the body with the handle of the hand operation portion.
[0003]
Since this type of treatment instrument has a considerably long axial length of the insertion portion, the operation force applied to the handle of the hand operation portion does not strictly correspond to the force applied to the body tissue by the grip portion at the tip. For this reason, there is a tendency that an excessive force is applied to the handle. Originally, since endoscopic surgery is intended to reduce the invasion to a patient, the insertion portion and the thickness (outer diameter) of the operation shaft are inevitably limited, and there is a limit in strength. is there.
Furthermore, if a large operating force is applied to such a treatment instrument, the gripping part at the tip may be damaged or deformed. If it is damaged, the damaged part will fall into the body cavity and will be externally viewed under endoscopy. It will be difficult to extract. In addition, if the tip gripping part is deformed, it becomes difficult to remove the treatment tool from the body cavity, and a new treatment such as widening the insertion hole is required.
[0004]
In order to solve these problems, for example, in USP 5,395,375, a plate having at least two parallel flat surfaces in the middle part of the operating shaft connecting the tip operating part (forceps part) and the operating operation means When a large excessive operating force is applied to the operation shaft, the link portion is broken before the tip portion, thereby preventing the tip portion from being damaged in advance. .
[0005]
[Problems to be solved by the invention]
According to USP 5,395,375, the link portion that is easy to break is formed by cutting out a substantially circular hole in a plate-like member. However, with such a shape, it is difficult to accurately set the breaking strength of the portion, and since deformation is likely to occur, it is difficult to obtain a stable breaking strength. Furthermore, because it is a plate-like member, when a force is applied in the direction of the plate surface during handle operation, the portion easily breaks down due to fatigue failure, etc. There was also.
The present invention has been made by paying attention to the above-described problems, and the purpose of the present invention is to prevent the operation shaft transmitting the operation force of the operation portion to the action member at the tip even if the force exceeds a predetermined level and breaks. is to provide an open closing forceps rigid endoscope can be safely removed and enables the operation of the working member.
[0006]
[Means for Solving the Problems]
In order to achieve the above object, the present invention provides a rigid insertion portion having a distal end and a proximal end, an action member provided at the distal end of the insertion portion, and a proximal end of the insertion portion. An operating portion provided, an operating shaft provided in the insertion portion so as to be able to advance and retreat, and an operation shaft that transmits the movement of the operating portion to the action member; A first operating force transmission mechanism that breaks or separates when the operating force is applied, and a second operating force transmission mechanism that is provided on the operation shaft and is connected with play in the advancing and retreating direction of the operation shaft. In the forceps for a rigid endoscope , the operation shaft is divided into a distal operation shaft and a proximal operation shaft, both of which are arranged in series in the advancing and retreating direction of the operation shaft and the second operation force transmission mechanism. are connected by the operation force transmission mechanism, before Symbol first operating force transmitting mechanism is divided The second operating force transmission mechanism is closely connected to the distal end side operation shaft and the proximal end side by a breaking pin that penetrates an engagement portion between the distal end side operation shaft and the proximal end operation shaft. It is characterized in that it is connected with play with a securing pin that penetrates a long hole that is provided in one of the engaging portions with the operating shaft and extends in the forward and backward direction.
[0007]
For example, when grasping tissue in a living body with the forceps having the above-described configuration, when the operation force at the operation unit is excessive and a force exceeding a predetermined value is applied to the operation shaft, the first operation force transmission mechanism is broken or separated. However, since the second operating force transmission mechanism has play in the advancing and retreating direction, the operating portion and the action member are connected via the second operation force transmission mechanism, and the action member can be opened and closed.
[0008]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, each embodiment of the present invention will be described with reference to the drawings.
1 to 4 show a first embodiment, and FIG. 1 is an external view schematically showing an entire grasping forceps 1 used for an endoscopic surgical operation. The grasping forceps 1 has a rigid insertion portion 2 formed from a straight tube sheath, and a grasping portion 3 as an action member is provided at the distal end of the insertion portion 2. An operation unit 6 is attached to the proximal end portion of the insertion unit 2 via an operation unit main body 5.
[0009]
In the lumen of the insertion portion 2, a round bar-like operation shaft 7 as a transmission means for transmitting the movement of the operation portion 6 to the grip portion 3 on the distal end side is disposed so as to be able to advance and retreat in the axial direction. The operation shaft 7 constitutes a transmission means that connects the grip part 3 on the distal end side and the operation part 6 on the proximal side, receives an operation on the operation part 6, and transmits the operation force to the grip part 3 on the distal end.
[0010]
As shown in FIG. 1, the grip portion 3 is of a type in which a pair of grip members 8a and 8b are opened and closed via a link mechanism (not shown). A fixed handle 9 is integrally formed with the operation unit 6 that opens and closes the grip unit 3. A connection screw 10 with a pivot support pin is screwed into the middle portion of the fixed handle 9, and a movable handle 11 is pivotally attached to the pivot pin portion of the connection screw 10.
[0011]
The operation section body 5 is provided with an insertion hole 12 formed coaxially with the lumen of the insertion section 2. The operation shaft 7 is inserted into the insertion hole 12 so as to be able to advance and retract. The distal end side of the operation shaft 7 is connected to the link mechanism, and the proximal end side is connected to the movable handle 11.
[0012]
Further, as shown in FIGS. 2 and 3, the operation shaft 7 is separated into a distal end side operation shaft 13 connected to the grip portion 3 and a proximal end side operation shaft 14 connected to the movable handle 11. A flat insertion protrusion 15 is integrally provided at the rear end portion of the distal end side operation shaft 13 by notching both left and right side portions. A fitting hole 16 made of a round hole is formed on the distal end side of the fitting convex portion 15, and a floating hole 17 made of a long hole extending in the axial direction of the operation shaft 7 is made on the proximal end side.
[0013]
In addition, a fitting recess 18 made of a slot into which the fitting projection 15 is closely fitted is provided at the distal end portion of the proximal-side operation shaft 14. A first holding hole 19 corresponding to the fitting hole 16 of the fitting convex portion 15 and a second holding hole 20 corresponding to the floating hole 17 are formed on both side portions of the proximal operation shaft 14 sandwiching the fitting concave portion 18. It has been drilled.
[0014]
A breaking pin 21 that passes through the fitting hole 16 is inserted into the first holding hole 19, and both ends are fixed by caulking. The breaker pin 21 connects the distal end side operation shaft 13 and the proximal end side operation shaft 14 to constitute a first operation force transmission mechanism that transmits the operation force of the operation portion 6 to the grip portion 3. Further, the second holding hole 20 is provided with a securing pin 22 penetrating the tip end side of the floating hole 17 by caulking and fixing both ends. The securing pin 22 connects the distal end side operation shaft 13 and the proximal end side operation shaft 14 with play to constitute a second operation force transmission mechanism for transmitting the operation force of the operation portion 6 to the grip portion 3. ing.
[0015]
In this embodiment, the securing pin 22 is formed to have a larger diameter than the breaking pin 21 and has a higher breaking strength than the breaking pin 21, but the securing pin 22 is higher than the material of the breaking pin 21. A material having a breaking strength may be formed to have the same diameter, and the breaking strength of the same breaking strength or securing pin 22 may be lower than that of the breaking pin 21.
[0016]
Next, the operation of the first embodiment will be described. When the gripping forceps 1 are used, the operation shaft 7 slides in the insertion hole 12 in accordance with the rotation of the movable handle 11 by rotating the movable handle 11 with respect to the fixed handle 9 in the operation unit 6. Then, it advances and retreats in the axial direction of the insertion portion 2, and opens and closes the gripping members 8 a and 8 b in the gripping portion 3.
[0017]
Here, the operation shaft 7 is divided into a distal end side operation shaft 13 and a proximal end side operation shaft 14, both of which are connected by a breaking pin 21, so that the movable handle 11 is rotated in the direction of arrow a in FIG. 1. When the gripping members 8a and 8b are to be closed, if a force larger than the breaking strength of the breaking pin 21, that is, an unnecessarily strong operating force is applied to the breaking pin 21, as shown in FIG. Is broken at the boundary portion between the fitting convex portion 15 and the fitting concave portion 16, and only the proximal-side operation shaft 14 is retracted, and the securing pin 22 relatively moves to the rear end side of the floating hole 17.
[0018]
Therefore, although the distal end side operation shaft 13 is in the normal position, the proximal end side operation shaft 14 is retracted until the play of the securing pin 22, so that the movable handle 11 is in the normal position (indicated by a one-dot chain line) as shown in FIG. Rotate to the fixed handle 9 side (shown by a solid line). When the movable handle 11 is rotated from the normal position to the maximum gripping position in this way, the operator can recognize by hand sensation that the amount of rotation of the movable handle 11 is abnormal, that is, the breaking pin 21 is broken.
[0019]
At this time, since the securing pin 22 approaches or contacts the rear end inside the floating hole 17, when the movable handle 11 is rotated in the direction of arrow b in FIG. 4, the rear end side operation shaft 14 of the operation shaft 7 is moved. With advancement, the securing pin 22 moves forward of the floating hole 17 and abuts against the tip of the floating hole 17 with this advancement. When the rear end side operation shaft 14 further moves forward, the operation force is transmitted to the front end side operation shaft 13 via the securing pin 22, and the gripping members 8a and 8b can be opened via the link mechanism.
[0020]
Therefore, even when an abnormality occurs in which the breaking pin 21 is broken in the operation process of grasping the living tissue by closing the grasping members 8a and 8b, the grasping forceps 1 is opened in the body cavity by opening the grasping members 8a and 8b and releasing them. Can be removed from.
[0021]
5 and 6 show the second embodiment, and the same components as those of the first embodiment are denoted by the same reference numerals and the description thereof is omitted.
The breaker pin 21 connects the distal end side operation shaft 13 and the proximal end side operation shaft 14 to constitute a first operation force transmission mechanism for transmitting the operation force of the operation portion 6 to the grip portion 3, and the second operation force transmission mechanism. The retaining hole 20 is provided with a securing pin 22 penetrating the rear end side of the floating hole 17 by caulking and fixing both ends. The securing pin 22 connects the distal end side operation shaft 13 and the proximal end side operation shaft 14 with play to constitute a second operation force transmission mechanism for transmitting the operation force of the operation portion 6 to the grip portion 3. ing.
[0022]
Next, the operation of the second embodiment will be described. The operation shaft 7 is divided into a distal end side operation shaft 13 and a proximal end side operation shaft 14, and both are connected by a breaking pin 21. Therefore, the movable handle 11 is rotated in the direction of arrow c in FIG. When a force greater than the breaking strength of the breaking pin 21, that is, an unnecessarily strong operating force is applied to the breaking pin 21 when trying to close 8 a, 8 b, as shown in FIG. Is broken at the boundary portion between the fitting convex portion 15 and the fitting concave portion 16, and only the proximal-side operation shaft 14 is retracted, and the securing pin 22 relatively moves to the rear end side of the floating hole 17.
[0023]
Accordingly, the proximal-side operation shaft 14 is retracted, but the gripping members 8a and 8b are not closed because the distal-side operation shaft 13 is in the normal position. The surgeon knows that the amount of rotation of the movable handle 11 is abnormal, that is, the breaking pin 21 is broken. After the breaking pin 21 is broken, as shown in FIG. 6, the movable handle 11 is rotated in a direction (shown by a solid line) away from the fixed handle 9 from the fully closed normal position (shown by a one-dot chain line) by a stroke increase amount W due to play. To do. When the movable handle 11 is thus rotated from the normal position to the maximum opening position, as shown in FIG. 5C, the proximal-side operation shaft 14 moves forward, and the securing pin 22 moves forward in the floating hole 17. It moves and comes into contact with the front end of the floating hole 17, and the securing pin 22 pushes the distal end side operation shaft 13 forward. W shown in FIG. 6 is a play amount from the tip between the floating hole 17 and the securing pin 22, so that even if the movable handle 11 comes into contact with the operation unit main body 5 and becomes immovable, it is gripped. The members 8a and 8b are not opened at all.
[0024]
Further, when the movable handle 11 is rotated in the direction of the one-dot chain line, the rear end side operation shaft 14 of the operation shaft 7 is retracted, and the securing pin 22 is moved to the rear of the floating hole 17 along with this retraction, and the floating hole 17. It contacts the rear end. When the rear end side operation shaft 14 is further retracted, the operation force is transmitted to the front end side operation shaft 13 through the securing pin 22, and the gripping members 8a and 8b can be closed through the link mechanism.
[0025]
Therefore, even when an abnormality occurs in which the breaking pin 21 breaks while the gripping members 8a and 8b are open, the gripping forceps 1 can be removed from the body cavity by closing the gripping members 8a and 8b.
[0026]
FIG. 7 shows a third embodiment, and the same components as those of the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, the position of the floating hole 17 provided in the insertion convex portion 15 of the distal end side operation shaft 13 is shifted to move the movable handle 11 from the fully open normal position (indicated by a one-dot chain line) to the opening direction limit position ( The base end side operation shaft 14 moves forward when it is rotated to the position (shown by a solid line), the securing pin 22 moves forward inside the floating hole 17 and comes into contact with the front end of the floating hole 17, and the securing pin 22 operates at the distal end side. In order to push the shaft 13 forward, the gripping members 8a and 8b are opened.
[0027]
FIG. 8 shows a fourth embodiment, and the same components as those of the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, the floating shaft 22 is positioned in the middle of the floating hole 17 provided in the fitting convex portion 15 of the distal end side operation shaft 13.
[0028]
With this configuration, when the movable handle 11 is rotated from the fully open normal position (indicated by a one-dot chain line) to the opening direction limit position (indicated by a solid line) of the movable handle 11, the proximal operation shaft 14 moves forward and secured. The pin 22 moves forward in the floating hole 17 and contacts the front end of the floating hole 17, and the securing pin 22 pushes the front end side operation shaft 13 forward, so that the gripping members 8a and 8b are half opened. It is. X is the upper limit of the stroke amount in the movable handle 11.
[0029]
According to the first to fourth embodiments, when the operator grasps the living tissue by grasping the operating part 3 and opening and closing the movable handle 11 to open and close the grasping members 8a and 8b of the grasping part 3. Even when a predetermined force or more is applied to the operating shaft 7 and the breaking pin 21 is broken, the front end side operating shaft 13 and the base end side operating shaft 14 are held in a connected state with play by the securing pin 22. Accordingly, since the movable handle 11 is rotated more than the normal position by the play, the surgeon can know the abnormality by feeling, and the front end side operation shaft 13 and the base end side operation shaft 14 are connected by the securing pin 22. Therefore, since the holding members 8a and 8b can be opened and closed, safety is high.
[0030]
9 to 11 show a first disclosed example, and the basic configuration is the same as that of the grasping forceps shown in FIG. A ratchet mechanism 31 is provided between the fixed handle 9 and the movable handle 11 of the grasping forceps 30 so that the movable handle 11 can be locked at a desired position. Usually, the ratchet mechanism 31 includes an index finger F. A ratchet release lever 32 that is operated at is provided. When the ratchet release lever 32 is pushed downward with the index finger F, the ratchet 33 rotates counterclockwise against the urging force of the leaf spring 34 to release the ratchet, and the rotation handle 11 is unlocked. It has become.
[0031]
Further, a coating layer 34 a is applied to a portion of the leaf spring 34 that contacts the ratchet 33. The coating layer 34a is a hard coating such as TiC (PVD), TiN (PVD), Ni-based metal + Teflon coating, and the like, and the wear of the leaf spring 34 can be prevented by the coating layer 34a, and the durability of the ratchet mechanism 31 is improved. It can be improved.
[0032]
Furthermore, the finger hook portion 32a of the ratchet release lever 32 is formed of an elastic member such as a synthetic resin member or silicon rubber. Therefore, operator fatigue and pain can be reduced.
[0033]
FIG. 12 shows a second disclosed example, which shows a gripping portion 35, which has a W jumper 37 having a cam groove 36 connected to the operation shaft 36, and is formed in the cam groove 36 of the W jumper 37. A cam roller 40 of a forceps portion 39 such as a pair of jaws or scissors forceps that can be opened and closed with a pivot 38 as a fulcrum is engaged.
[0034]
Further, at least one outer surface of the W jumper 37 and the forceps 39 is coated with TiC by PVD, CVD, plasma CVD or the like. Here, when comparing the friction coefficient μ,
μ (Steel / Steel) = 0.56
μ (TiN / TiN) = 0.53
μ (TiC / TiN) = 0.15
μ (TiC / TiC) = 0.17
Thus, there is an effect that the durability of the drive part and the sliding part of the grip part 35 is improved.
FIG. 13 shows a third disclosed example, in which a convex portion 42 is integrally provided on a ratchet arm 41 of the ratchet mechanism 31. The protrusion 42 is provided with a notch 43 and a retaining protrusion 44 that narrows the opening of the notch 43. The shaft portion 45a of the roller 45 is fitted into the notch portion 43 by pushing the opening of the notch portion 43 wide, and the roller 45 is rotatable with respect to the convex portion 42. The roller 45 is rotated with the leaf spring 34. It comes to move. Therefore, the roller 45 rotates due to the friction between the roller 45 and the leaf spring 34, so that the wear of the leaf spring 34 can be prevented and the durability of the ratchet mechanism 31 can be improved.
[0035]
According to the embodiment described above, the following configuration is obtained.
(Supplementary note 1) In a forceps used together with an endoscope, the forceps that breaks or separates when a predetermined force or more is applied in the forward / backward direction to the operation shaft that transmits the forward / backward movement due to the opening / closing operation of the operation portion to the action member at the tip. A forceps provided with a first operation force transmission mechanism and a second operation force transmission mechanism connected with play in the advancing and retreating direction of the operation shaft.
[0036]
(Additional remark 2) The said operating shaft is divided | segmented into the front end side operating shaft and the base end side operating shaft, and both are the 1st operating force transmission mechanism and 2nd operating force which are arrange | positioned in series in the advancing / retreating direction of the operating shaft. The forceps according to appendix 1, wherein the forceps are connected by a transmission mechanism.
[0037]
(Supplementary note 3) The forceps according to Supplementary note 1 or 2, wherein the first operation force transmission mechanism is a breaking pin, and the second operation force transmission mechanism is a securing pin.
(Supplementary note 4) The forceps according to Supplementary note 3, wherein the securing pin has higher breaking strength than the breaking pin.
[0038]
(Supplementary Note 5) In the forceps used together with the endoscope, a force greater than or equal to a predetermined value is applied in the advance / retreat direction to the operation shaft that transmits the advance / retreat movement by the opening / closing operation of the operation portion including the fixed handle and the movable handle to the action member at the tip. A forceps provided with a first operating force transmission mechanism that is broken or separated when the operation shaft is connected, and a second operating force transmission mechanism that is connected with play in the advancing and retreating direction of the operating shaft.
[0039]
(Supplementary note 6) The forceps according to supplementary note 5, wherein the play is a long hole whose position when the movable handle is closed is a position rotated more than a normal position. (Supplementary note 7) The forceps according to Supplementary note 5, wherein the play is a long hole whose opening position is larger than the normal position when the movable handle is opened.
[0040]
(Supplementary Note 8) The first operation force transmission mechanism is tightly coupled with a pin that penetrates the engagement portion between the divided distal end side operation shaft and the proximal end operation shaft, and the second operation force transmission mechanism. Is connected to one of the engagement portions of the distal end side operation shaft and the proximal end side operation shaft with a pin through a long hole extending in the advancing and retreating direction, and the play is provided closer to the distal end side of the long hole. The forceps according to appendix 1 or 5, wherein
[0041]
(Supplementary Note 9) The first operating force transmission mechanism is tightly coupled with a pin that penetrates the engagement portion between the divided distal end side operation shaft and the proximal end side operation shaft, and the second operation force transmission mechanism. Is connected to one of the engaging portions of the distal end side operation shaft and the proximal end side operation shaft with a pin through a long hole extending in the advancing and retreating direction so that the play is closer to the proximal end side of the long hole. The forceps according to appendix 1 or 5, wherein the forceps is provided.
[0042]
【The invention's effect】
As described above, according to the present invention, even if broken force is applied more than the predetermined the operating shaft for transmitting the operating force of the operating unit to the working member of the tip, and enables the opening closing operation of the working member There is an effect that safety can be improved.
[Brief description of the drawings]
FIG. 1 is an overall configuration diagram of a forceps showing a first embodiment of the present invention.
2A and 2B show a normal operation axis of the embodiment, in which FIG. 2A is a longitudinal plan view, and FIG.
FIGS. 3A and 3B show an operation shaft at the time of fracture according to the embodiment, where FIG. 3A is a longitudinal plan view, and FIG.
FIG. 4 is an overall configuration diagram of forceps for explaining the operation of the embodiment.
FIGS. 5A and 5B show a second embodiment of the present invention, wherein FIG. 5A is a vertical plan view of an operation shaft at a normal time, FIG. 5B is a vertical plan view of the operation shaft at break, and FIG. The longitudinal section for demonstrating the effect | action after a fracture | rupture.
FIG. 6 is an overall configuration diagram of forceps for explaining the operation of the embodiment.
FIG. 7 is an overall configuration diagram of a forceps for explaining an operation of a third embodiment of the present invention.
FIG. 8 is an overall configuration diagram of a forceps for explaining the operation of a fourth embodiment of the present invention.
FIG. 9 is a side view of a forceps showing a first disclosed example.
FIG. 10 is a side view showing a ratchet mechanism of the disclosed example.
FIG. 11 is a side view showing a ratchet mechanism of the disclosed example.
FIG. 12 is a side view of a grip portion showing a second disclosed example.
13A is a side view showing a part of a ratchet mechanism, and FIG. 13B is a cross-sectional view along AA.
[Explanation of symbols]
2 ... Insertion part 3 ... Grasping part 6 ... Operation part 13 ... Front end side operation shaft 14 ... Base end side operation shaft 17 ... Floating hole (play)
21 ... Breaking pin (first operating force transmission mechanism)
22... Securing pin (second operating force transmission mechanism)

Claims (1)

A rigid insert having a distal end and a proximal end;
An action member provided at a tip of the insertion portion;
An operation portion provided at a proximal end of the insertion portion;
An operation shaft provided in the insertion portion so as to freely advance and retract, and transmitting the movement of the operation portion to the action member;
A first operating force transmission mechanism that is provided on the operating shaft and breaks or separates when a predetermined force or more is applied in the advancing and retreating direction of the operating shaft;
In the rigid forceps for a rigid endoscope comprising the second operating force transmission mechanism provided on the operating shaft and connected with play in the advancing and retreating direction of the operating shaft ,
The operation shaft is divided into a distal operation shaft and a proximal operation shaft, and both are connected by a first operation force transmission mechanism and a second operation force transmission mechanism arranged in series in the advance and retreat direction of the operation shaft. And
The first operating force transmission mechanism is tightly coupled by a breaking pin that penetrates the divided engagement portion between the distal end side operation shaft and the proximal end side operation shaft, and the second operation force transmission mechanism is A rigid pin that is connected with play by a securing pin that penetrates a long hole extending in the advancing and retreating direction provided at one of the engaging portions of the distal end side operation shaft and the proximal end side operation shaft. Mirror forceps.

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