JP5145113B2 - 内視鏡用処置具の操作部 - Google Patents

内視鏡用処置具の操作部 Download PDF

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JP5145113B2
JP5145113B2 JP2008122831A JP2008122831A JP5145113B2 JP 5145113 B2 JP5145113 B2 JP 5145113B2 JP 2008122831 A JP2008122831 A JP 2008122831A JP 2008122831 A JP2008122831 A JP 2008122831A JP 5145113 B2 JP5145113 B2 JP 5145113B2
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sheath
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憲幸 杉田
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1482Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/32056Surgical snare instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477Coupling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2911Handles rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/2909Handles
    • A61B2017/2912Handles transmission of forces to actuating rod or piston
    • A61B2017/2919Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1407Loop

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Description

この発明は内視鏡用処置具の操作部に関する。
内視鏡用処置具の操作部は一般に、可撓性シース内に軸線方向に進退自在に挿通配置された操作ワイヤを基端側から進退操作するためのワイヤ操作部材が、操作部本体にスライド自在に設けられた構成になっている(例えば、特許文献1)。
また、処置具の種類によっては、可撓性シースを、操作部本体に対して軸線周り方向に回転自在に連結されるように構成して、使い勝手をよくした操作部もある(例えば、特許文献2)。
特開2004−261372 実公昭61−18885
内視鏡用処置具は極めて種類が多いので、種類が相違する各種処置具に共用の操作部を取り付けて製造、販売することにより、操作部のためにかかるコストの大幅な削減が図られている。
そこで、さらに、可撓性シースが操作部本体に対し回転自在に連結される処置具の操作部と、回転できない状態に連結される処置具の操作部も、共通化することでコスト削減を図ることが考えられる。
そのような共通化の手段として、例えば、可撓性シースを操作部本体に対し回転自在に連結することができる操作部を用いて、可撓性シースが回転してはいけない処置具に使用する場合は回転部を接着等で固定してしまう方法等が考えられる。
しかし、接着固定を行うためには、接着剤を塗布する工程だけでなく乾燥工程等も必要なので、全体として大幅なコストアップ(例えば数十円ないし百円以上のアップ)になってしまう。また、接着固定が施された操作部と施されていない操作部との見分けが外観上困難なので、誤使用しないための管理が大変になる。
本発明は、可撓性シースが操作部本体に対し回転自在に連結される処置具の操作部と、回転できない状態に連結される処置具の操作部を、極めて簡単に低コストでしかも誤使用の恐れなく共通化することができる内視鏡用処置具の操作部を提供することを目的とする。
上記の目的を達成するため、本発明の内視鏡用処置具の操作部は、可撓性シース内に軸線方向に進退自在に挿通配置された操作ワイヤを基端側から進退操作するための内視鏡用処置具の操作部において、可撓性シースの基端が連結されたシース連結環と、シース連結環が軸線周り方向に回転自在に嵌合した状態に連結される連結環受け部を最先端部分に有する操作部本体と、シース連結環と連結環受け部との嵌合面にシース連結環と連結環受け部の双方にまたがって形成されたピン受け孔とを備え、ピン受け孔内にピンを嵌め込むことにより、シース連結環が連結環受け部に対して軸線周り方向に回転できない状態になるものである。
なお、シース連結環が、連結環受け部に対して軸線方向への移動が規制された状態に嵌合するとよく、ピン受け孔内に嵌め込まれたピンが外部から視認可能であるとよい。また、ピン受け孔がシース連結環の軸線及び連結環受け部の軸線と平行方向に形成されていてもよく、シース連結環と連結環受け部とに、一つのピン受け孔を形成する連結環側凹溝と受け部側凹溝とが、シース連結環と連結環受け部との嵌合面から各々凹んで形成されていてもよい。また、受け部側凹溝が、シース連結環で覆われる領域のみに形成されていてもよく、ピンがスプリングピンであってもよい。
本発明によれば、シース連結環と操作部本体の連結環受け部との嵌合面に双方にまたがって形成されたピン受け孔内にピンを嵌め込むことにより、シース連結環が連結環受け部に対して軸線周り方向に回転できない状態になるように構成したことにより、組み立て時にピン受け孔内にピンを嵌め込むか否かだけで、可撓性シースが操作部本体に対し回転自在に連結される処置具の操作部と、回転できない状態に連結される処置具の操作部とを、極めて簡単にしかも低コストで共通化することができ、ピンを外部から視認できるようにすることで、ピン有りの操作部かピン無しの操作部かの見分けがついて、誤使用の恐れもない。
可撓性シース内に軸線方向に進退自在に挿通配置された操作ワイヤを基端側から進退操作するための内視鏡用処置具の操作部において、可撓性シースの基端が連結されたシース連結環と、シース連結環が軸線周り方向に回転自在に嵌合した状態に連結されるように操作部本体の最先端部分に形成された連結環受け部と、シース連結環と連結環受け部との嵌合面にシース連結環と連結環受け部の双方にまたがって形成されたピン受け孔とを備え、ピン受け孔内にピンを嵌め込むことにより、シース連結環が連結環受け部に対して軸線周り方向に回転できない状態になる。
以下、図面を参照して本発明の実施例を説明する。
図2は内視鏡用処置具の一つである高周波スネアを示している。
1は、図示されていない内視鏡の処置具挿通チャンネルに挿脱される可撓性シースである。可撓性シース1内には、導電性の操作ワイヤ2が軸線方向に進退自在に且つ軸線周り方向に回転自在に挿通配置されていて、先端処置部材3であるスネアループが、可撓性シース1の先端から突没するように操作ワイヤ2の先端に連結されている。
4は、可撓性シース1の基端に固定的に取り付けられたシース基端口金であり、ルアーロック雄口金状に形成されている。5は、可撓性シース1の基端付近が急激に曲がって折損するのを防止するために可撓性シース1の基端付近に被覆された折れ止めチューブである。
10は内視鏡用処置具の操作部であり、プラスチック材で細長く形成された操作部本体11の手元側端部(後端部)には、操作者の第1指を係合させるための指掛け12が形成されている。
操作部本体11に長手方向に細長く形成されたスリット13には、操作ワイヤ2を基端側から進退操作するためのワイヤ操作部材14がスライド自在に係合している。ワイヤ操作部材14には、操作者の第2指と第3指を係合させるための指掛けが形成されている。
また、ワイヤ操作部材14には、図示されていない高周波電源コードを接続するための接続端子15が配置されていて、操作ワイヤ2の基端部2aが接続端子15の電極の先端でワイヤ操作部材14に押圧固定されている。
その結果、ワイヤ操作部材14を矢印Aで示されるように操作部本体11の長手方向に進退操作すると、操作ワイヤ2が可撓性シース1内で軸線方向に進退して、矢印Bで示されるように先端処置部材3が進退して可撓性シース1の先端内から突没し、操作ワイヤ2を介して先端処置部材3に高周波電流を通電することができる。
17は、シース基端口金4に対し連結固定及び分離自在にプラスチック材で形成されたシース連結環であり、その先側半部にはシース基端口金4が係脱自在なルアーロック雌口金18が形成され、後側半部は、外面にローレット状の凸凹を有する円筒状に形成されている。ただし、シース連結環17が可撓性シース1の基端部に対し完全に固定された状態に取り付けられていてもよい。
操作部本体11の最先端部分には、シース連結環17の円筒状部分が軸線周り方向に回転自在に嵌合した状態に連結される連結環受け部16が略円柱状に形成されている。ただし、連結環受け部16とシース連結環17の各々の軸線位置には、操作ワイヤ2が通過する貫通孔が形成されている。
シース連結環17は、矢印Rで示されるように、連結環受け部16に対して軸線周り方向に回転自在に嵌合している。ただし、その部分を拡大図示する図3に示されるように、連結環受け部16とシース連結環17に互いに係合するように周方向に形成された円周溝21と突起部22により、シース連結環17は連結環受け部16に対し軸線方向への移動が規制された状態に嵌合している。
図4は、内視鏡用処置具の一つである嘴状高周波切開具を示しており、先端処置部材3′である一対の嘴状電極が開閉自在に可撓性シース1の最先端部に配置されていて、操作部10においてワイヤ操作部材14を矢印Cで示されるように進退操作することにより、操作ワイヤ2が可撓性シース1内で進退して、一対の先端処置部材3′が矢印Dで示されるように嘴状に開閉するようになっている。ただし、可撓性シース1の先端と操作ワイヤ2の先端とが軸線周り方向に一緒に回転する構造になっている点が高周波スネアと相違する。
操作部10としては、図2に示されている高周波スネアと同じ構成のものが用いられているが、可撓性シース1が操作部本体11に対して軸線周り方向に自由に回転すると操作ワイヤ2が捩じれてしまうので、シース連結環17が操作部本体11の連結環受け部16に対して軸線周り方向に回転しないように取り付けられている。操作部10は、その点だけが高周波スネアの場合と相違する。その相違内容については、詳細に後述する。
図5は、高周波スネア及び嘴状高周波切開具の双方に用いることができる操作部本体11単体の側面図、図6はそのVI−VI断面図、図7は操作部本体11の先端にシース連結環17が取り付けられた状態の平面図、図8はその部分拡大平面断面図、図9はそのIX−IX断面図である。
図5及び図6に示されるように、操作部本体11の連結環受け部16の中間部分には、円周溝21が全周にわたって凹んで形成されており、図9に示されるように、連結環受け部16の外周面に嵌合するシース連結環17の内周面から内方に突出形成された突起部22が連結環受け部16側の円周溝21と係合している。
その結果、シース連結環17は操作部本体11の連結環受け部16に対し軸線周り方向に回転自在であるが軸線方向には移動できない状態に取り付けられる。なお、図9に示されるように突起部22は全周には形成されてはおらず、180°対称の位置に分断された状態に形成されているので、組み立て工程で連結環受け部16にシース連結環17を取り付ける作業は、プラスチック製のシース連結環17を弾性変形させるだけで行うことができる。
図8及び図9に示されるように、シース連結環17と連結環受け部16とが嵌合するその境界部分である嵌合面には、シース連結環17と連結環受け部16の双方にまたがって、断面形状が円形の一つのピン受け孔23がシース連結環17の軸線及び連結環受け部16の軸線と平行方向に形成されている。
そのような一つのピン受け孔23を形成するように、シース連結環17と連結環受け部16とには、連結環側凹溝23Aと受け部側凹溝23Bが、シース連結環17と連結環受け部16との嵌合面から各々凹んで形成されている。
そして、操作部10が嘴状高周波切開具に用いられる場合には、図8及び図9に示されるように、連結環側凹溝23Aと受け部側凹溝23Bとにまたがって硬質のピン25がピン受け孔23にきつく嵌め込まれ、それによってシース連結環17が連結環受け部16に対して軸線周り方向に回転できない状態になっている。
一方、操作部10が高周波スネアに用いられる場合には、ピン受け孔23にピン25を嵌め込むことなくシース連結環17が連結環受け部16に取り付けられる。その結果、シース連結環17が連結環受け部16に対して軸線周り方向に回転自在となる。
図1は、その部分をわかり易く図示しており、操作部10が嘴状高周波切開具に用いられる場合には、受け部側凹溝23Bに側方からピン25を係合させた状態で、連結環受け部16にシース連結環17を取り付けて、受け部側凹溝23B内から出っ張っているピン25の半部を連結環側凹溝23Aに係合させながら突起部22を円周溝21に係合させることにより、シース連結環17が、連結環受け部16に対し軸線周り方向にも軸線方向にも固定された状態に取り付けられる。
そして、操作部10が高周波スネアに用いられる場合には、ピン25を受け部側凹溝23Bに係合させることなく、連結環受け部16にシース連結環17を取り付けて突起部22を円周溝21に係合させることにより、シース連結環17が、連結環受け部16に対し軸線周り方向には回転自在で軸線方向には固定された状態に取り付けられる。
このようにして、部品コストが例えば1円程度の安価なピン25をピン受け孔23に嵌め込むかどうかの相違だけで、可撓性シース1が操作部本体11に対し回転自在に連結される処置具の操作部と、回転できない処置具の操作部を、極めて簡単に低コストで共通化することができる。
そして、図8に示されるように、シース連結環17で覆われる領域のみに受け部側凹溝23Bが形成されて、そこに係合するピン25が外部のものに触れないように構成することにより、使用中にピン25が外れる恐れがない。ピン25として、図10に示されるようなスプリングピン25′をピン受け孔23にきつく嵌め込めば、より外れ難くなる。
また、図8に示されるように、ピン受け孔23内に嵌め込まれたピン25を、シース連結環17の後端と操作部本体11の外周部との間の隙間を通して外部から視認可能に構成することにより、その操作部10にピン25が組み付けられているかどうかが外観から分かるので、その操作部10が、可撓性シース1を回転自在に連結するタイプのものか回転できないタイプのものかを簡単に見分けることができる。
その場合、ピン25の両端面に視認性を高める塗料等を塗布しておけばピン25の存否の確認が容易になり、蛍光塗料や蓄光塗料等を用いれば視認性がより高まって、操作部の誤選択を確実に防止することができる。
なお、本発明は上記実施例に限定されるものではなく、例えば高周波電流を使用しない各種内視鏡用処置具の操作部にも本発明を適用することができる。
本発明の実施例の内視鏡用処置具の操作部の部分分解斜視図である。 本発明の実施例の操作部が用いられた内視鏡用高周波スネアの全体構成図である。 本発明の実施例の内視鏡用処置具の操作部の可撓性シースと操作部との連結部の側面断面図である。 本発明の実施例の操作部が用いられた内視鏡用嘴状高周波切開具の全体構成図である。 本発明の実施例の操作部本体の側面図である。 本発明の実施例の図5におけるVI−VI断面図である。 本発明の実施例の操作部本体にシース連結環が取り付けられた状態の平面図である。 本発明の実施例の操作部本体にシース連結環が取り付けられた状態の部分拡大平面断面図である。 本発明の実施例の図8におけるIX−IX断面図である。 本発明の実施例の内視鏡用処置具の操作部に用いられるスプリングピンの側面図である。
符号の説明
1 可撓性シース
2 操作ワイヤ
3,3′ 先端処置部材
4 シース基端口金
10 操作部
11 操作部本体
14 ワイヤ操作部材
16 連結環受け部
17 シース連結環
21 円周溝
22 突起部
23 ピン受け孔
23A 連結環側凹溝
23B 受け部側凹溝
25 ピン
25′ スプリングピン

Claims (7)

  1. 可撓性シース内に軸線方向に進退自在に挿通配置された操作ワイヤを基端側から進退操作するための内視鏡用処置具の操作部において、
    上記可撓性シースの基端が連結されたシース連結環と、
    上記シース連結環が軸線周り方向に回転自在に嵌合した状態に連結される連結環受け部を最先端部分に有する操作部本体と、
    上記シース連結環と上記連結環受け部との嵌合面に上記シース連結環と上記連結環受け部の双方にまたがって形成されたピン受け孔とを備え、
    上記ピン受け孔内にピンを嵌め込むことにより、上記シース連結環が上記連結環受け部に対して軸線周り方向に回転できない状態になることを特徴とする内視鏡用処置具の操作部。
  2. 上記シース連結環が、上記連結環受け部に対して軸線方向への移動が規制された状態に嵌合する請求項1記載の内視鏡用処置具の操作部。
  3. 上記ピン受け孔内に嵌め込まれた上記ピンが外部から視認可能である請求項1又は2記載の内視鏡用処置具の操作部。
  4. 上記ピン受け孔が上記シース連結環の軸線及び上記連結環受け部の軸線と平行方向に形成されている請求項1ないし3のいずれかの項に記載の内視鏡用処置具の操作部。
  5. 上記シース連結環と上記連結環受け部とに、上記一つのピン受け孔を形成する連結環側凹溝と受け部側凹溝とが、上記シース連結環と上記連結環受け部との嵌合面から各々凹んで形成されている請求項1ないし4のいずれかの項に記載の内視鏡用処置具の操作部。
  6. 上記受け部側凹溝が、上記シース連結環で覆われる領域のみに形成されている請求項5記載の内視鏡用処置具の操作部。
  7. 上記ピンがスプリングピンである請求項1ないし6のいずれかの項に記載の内視鏡用処置具の操作部。
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