JP6045668B1 - Endoscopic forceps - Google Patents

Abstract

Provided is an endoscopic surgical port that makes it easy for a doctor to feel a feeling of gripping an affected part when the affected part in a patient's abdomen is gripped by forceps. An endoscopic surgical port 1 is mounted in a hole formed in the abdomen of a patient undergoing laparoscopic surgery, the port main body 2 being formed in a cylindrical shape and mounted in a hole in the patient's abdomen. A port lid 5 having a disc portion 4 detachably attached to the upper opening 3 of the port body 2, provided on the port lid 5, one end extending upward from the port lid 5, and the other end being a port lid 5 extends below the lower opening 6 of the port body 2 and supports the forceps 11 and 12 for holding the affected part in the abdomen of the patient, and the port lid 5 in the upper opening 3 of the port body 2. A lock mechanism 8 is provided which is moved in the longitudinal direction of the support column 7 and fixed so as not to rotate. [Selection] Figure 1

Description

The present invention relates to an endoscopic surgical forceps used for laparoscopic surgery or the like.

  When performing laparoscopic surgery, first, a hole (single hole) is formed in the patient's abdomen (eg, umbilicus) with a scalpel or the like, and a cylindrical endoscopic surgical port is attached to the hole. Next, a forceps, a camera, an electric knife or the like is inserted into the port from the outside of the patient's abdomen, and the affected part in the abdomen is observed from outside the abdomen through the camera, while the affected part in the abdomen is forceps, An operation is performed from outside the abdomen using an electric knife or the like (see Patent Documents 1 and 2).

  This type of endoscopic surgical port generally has a cylindrical port body that is attached to a hole in a patient's abdomen, and a port lid that is detachably attached to an upper opening of the port body. In addition, an insertion hole for inserting a device such as a forceps, a camera, or an electric knife is formed. The port lid has a male screw part and is screwed into a female screw part formed in the upper opening of the port body.

  When performing laparoscopic surgery, first, a hole is formed in the abdomen (umbilical part, etc.) of the patient undergoing surgery using a scalpel, and the cylindrical port body is attached to the hole with the port lid attached. Installing. Thereafter, devices such as forceps, a camera, and an electric knife are inserted into the insertion hole of the port lid.

JP 2013-85933 A JP 2011-31046 A

  By the way, in laparoscopic surgery, when a doctor performing surgery grasps the affected part in the abdomen of the patient with forceps, it is important for the doctor to feel the feeling of grasping the affected part in order to appropriately perform the operation. That is, it is preferable that the feeling of gripping the affected part in the patient's abdomen with forceps is appropriately fed back from the outside of the abdomen to the fingertip of the doctor who is operating the forceps.

  However, the forceps used in laparoscopic surgery is inserted into the abdomen from the outside of the abdomen through the insertion hole of the port after attaching the port for endoscopic surgery to the abdominal hole of the patient. The part to be bent is very long and is easy to bend. For this reason, when the affected part in the patient's abdomen is grasped with forceps, the elongated part of the forceps is bent, and it cannot be said that the feeling of grasping the affected part is sufficiently fed back to the doctor.

  Although the conventional port for endoscopic surgery has an insertion hole for inserting an elongated forceps as described above, this insertion hole only has a function of guiding the forceps from the outside of the patient's abdomen into the abdomen. There is no room for improvement, leaving room for improvement.

The object of the present invention was developed in consideration of the above circumstances, when gripping the inside of the affected part, such as a patient's abdomen or chest with forceps, endoscopic capable of easily feel the touch gripping the affected part to the physician It is to provide forceps for mirror surgery.

According to the present invention created to achieve the above-described object, it is attached to a hole formed in a patient's abdomen, chest, head, or joint and is used for endoscopic surgery to grip an affected area inside the hole. A forceps, a port body formed in a cylindrical shape and attached to a patient's abdomen, chest, head, or joint, and a port lid having a disk part removably attached to an upper opening of the port body; A column provided integrally with the port lid, with one end extending upward from the port lid and the other end extending downward from the port lid below the lower opening of the port body, and at least one end and the other end of the column At the position, the forceps fixed integrally with the rigid and the port lid provided with the support post to which the forceps are fixed are moved to the upper opening of the port body in the longitudinal direction of the support post and fixed unrotatable. And a locking mechanism Endoscopic surgical forceps is provided.

According to the present invention, the port lid attached to the upper opening of the port body is provided with the support for supporting the forceps, and one end of the support extends upward from the port cover, and the other end extends from the port cover. than the lower opening of the main body and extending downward, so to secure the forceps rigid at least one end and the other end position of such a post, the deflection can be suppressed forceps support portion to the post. Therefore , when the affected part in the patient's abdomen, chest, head, or joint part is gripped by the forceps, it is possible to make the doctor feel the feeling of gripping the affected part.

Further, Oite the present invention, the locking mechanism for attaching the port cover to the port body, not screwing the conventional port body port lid as, the port body port lid is moved in the longitudinal direction of the strut Because it is fixed to the upper opening in a non-rotatable manner, when the port lid is attached to the port body attached to the hole of the patient's abdomen, chest, head or joint, the forceps supported by the column of the port lid It does not rotate in the patient's abdomen, chest, head or joint, and the forceps can prevent the affected part in the patient's abdomen, chest, head or joint from being damaged.

It is an exploded perspective view of the port for endoscopic operation concerning a 1st embodiment of the present invention. It is a disassembled side view of the port for endoscopic surgery of FIG. It is an assembly side view of the port for endoscopic surgery of FIG. It is explanatory drawing which shows the forceps (forceps mechanism) for endoscopic surgery supported by the support | pillar of the port lid of the port for endoscopic surgery of FIG. It is a side view which shows another forceps (forceps apparatus) supported by the support | pillar of the port cover of the endoscope operation port of FIG. It is a disassembled perspective view of the port for endoscopic surgery which concerns on 2nd Embodiment of this invention. FIG. 7 is a partially sectional exploded side view of the endoscopic surgical port of FIG. 6.

  Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. The dimensions, materials, and other specific numerical values shown in the embodiment are merely examples for facilitating understanding of the invention, and do not limit the present invention unless otherwise specified. In the present specification and drawings, elements having substantially the same function and configuration are denoted by the same reference numerals, and redundant description is omitted, and elements not directly related to the present invention are not illustrated. To do.

(First embodiment)
1 to 3 show an endoscopic surgical port 1 according to a first embodiment of the present invention. An endoscopic surgical port 1 according to this embodiment is a single-hole endoscopic surgical port that is attached to a hole formed in the abdomen of a patient undergoing laparoscopic surgery, and is formed in a cylindrical shape. A port body 2 having a port body 2 attached to a hole in the abdomen, a port lid 5 having a disk portion 4 removably attached to an upper opening 3 of the port body 2, and a port lid 5 provided at one end. And the other end of the port body 5 extends downward from the lower opening 6 of the port body 2 and supports the forceps for holding the affected part in the abdomen of the patient. The upper opening 3 of the port body 2 is provided with a lock mechanism 8 that is moved in the longitudinal direction of the support column 7 and fixed so as not to rotate.

  When performing laparoscopic surgery using this endoscopic surgical port (single-hole endoscopic surgical port) 1, first, a hole is formed in the abdomen (umbilical portion) of a patient undergoing surgery using a scalpel or the like. Then, the cylindrical port body 2 is mounted in the hole. The port body 2 is formed in a cylindrical shape whose center is constricted from resin or metal, and has an upper opening 3 located outside the abdomen of the patient and a lower opening 6 located inside the abdomen when worn.

  Next, a port lid 5 made of resin or metal is attached to the upper opening 3 of the port body 2. The port lid 5 has a disc portion 4, and a post 7 that supports forceps for grasping the affected part in the abdomen of the patient is provided perpendicularly to the disc portion 4. ing. Note that the forceps are not shown in FIGS. One end 7a of the column 7 extends upward from the port lid 5, and as shown in FIG. 3, when the port lid 5 is attached to the port body 2, the other end 7b opens from the port lid 5 to the lower opening of the port body 2. It extends below 6.

  As shown in FIG. 1, a long hole 9 elongated in the diameter direction is formed in the center of the disk portion 4 of the port lid 5. As shown in FIG. 4, a device 10 such as a camera for photographing an affected part in a patient's abdomen or an electric knife for excising the affected part is inserted into the abdomen from outside the abdomen. A device 10 such as a camera or an electric knife is formed to be elongated so that it can be inserted into the long hole 9.

  As shown in FIG. 4, two struts 7 shown in FIG. 1 may be provided with the long hole 9 interposed therebetween, but may be one or three or more. The support column 7 is provided vertically avoiding the center of the disc portion 4, and the forceps (forceps mechanism 11) shown in FIG. 4 and the forceps (forceps device 12) shown in FIG. 5 are supported on the support column 7. . In FIG. 1 to FIG. 3, the forceps (forceps mechanism 11 and forceps device 12) supported by the column 7 are not shown.

  The forceps mechanism 11 shown in FIG. 4 includes a plurality of arms 13 to 16 supported by a portion in the abdomen of the column 7, a saddle-shaped gripping unit 17 provided at the end of the arm 14, and the abdomen outside the column 7. The rod 18 is supported by this portion, and the operation portion 19 provided at the end of the rod 18. The rod 18 is supported by one end (upper end) 7 a of the support column 7, and the arm 16 is supported by the other end (lower end) 7 b of the support column 7. The forceps mechanism 11 is a state in which the arms 13 to 16 are narrowed from the expanded state shown in FIG. 4 by operating the operation unit 19 (a state where the inner diameter is smaller than the inner diameter of the port body 2 and can be inserted into the port body 2). In addition, the grip portion 17 can be opened and closed.

  The forceps device 12 shown in FIG. 5 includes a rod portion 20 formed in an elongated rod shape, a grip portion 21 provided at the tip of the rod portion 20, and an operation for opening and closing the grip portion 21 provided at the base of the rod portion 20. Part 22. The rod portion 20 is supported by the support column 7 by at least one end (upper end) 7a and the other end (lower end) 7b of the support column 7. The rod portion 20 is disposed perpendicularly to the disc portion 4 along the support column 7, and is provided so as to penetrate the disc portion 4 shown in FIG. It is done. In addition, 23 of FIG. 5 is a patient's abdomen, 24 is a hole formed in the abdomen.

  In addition, as shown in FIG. 1, this endoscopic surgical port 1 has a lock mechanism 8 that fixes the port lid 5 to the upper opening 3 of the port body 2 in the longitudinal direction of the column 7 so that it cannot rotate. Have The lock mechanism 8 includes a concave portion 25 formed on the outer peripheral surface of the disc portion 4 of the port lid 5, a convex portion 26 disposed on the inner peripheral surface of the upper opening 3 of the port body 2, and the convex portion 26 inside. A release mechanism 27 is provided for retreating to or from the circumferential surface.

  The release mechanism 27 normally protrudes the convex portion 26 inward from the inner peripheral surface of the upper opening 3 by an elastic member (such as rubber or a spring) (not shown), and when the release lever 28 is operated, the elastic member is compressed and convex. The portion 26 is configured to recede flush with the inner peripheral surface or more. As shown in FIG. 1, the port body 2 and the port lid 5 are provided with marks 29 and 30 for matching the position of the convex portion 26 and the position of the concave portion 25. In order to reliably prevent the port lid 5 from rotating with respect to the upper opening 3 of the port body 2, it is preferable that a plurality of protrusions 26 and recesses 25 are provided at equal intervals in the circumferential direction (two in FIG. 1).

  As shown in FIG. 1, a seal member 31 is provided between the upper opening 3 of the port body 2 and the port lid 5 to seal the gap therebetween. The seal member 31 is composed of an annular O-ring (such as rubber) 31 attached to the outer peripheral surface of the disc portion 4 of the port lid 5, and the upper portion when the port lid 5 is fitted into the upper opening 3 of the port body 2. It is pressed against the inner peripheral surface of the opening 3 and elastically deforms to hermetically seal between them. Thereby, it is possible to suppress the air supplied into the abdomen of the patient for the purpose of securing the visual field in the abdominal cavity from leaking between the port lid 5 and the port body 2.

(Action / Effect)
According to the endoscopic surgical port 1 having the above configuration, as shown in FIGS. 1 to 3, the post that supports the forceps (the forceps mechanism 11 in FIG. 4 and the forceps device 12 in FIG. 5) on the port lid 5. 7 has one end 7a extending upward from the port lid 5, and the other end 7b extending downward from the lower opening 6 of the port body 2 from the port lid 5. A part (part) of the forceps (forceps mechanism 11, forceps device 12) supported by the column 7 is fixed to the rigid, and the bending of the forceps in the portion supported by the column 7 can be suppressed. Therefore, according to the port 1 for endoscopic surgery, when the affected part in the abdomen of the patient is grasped by the forceps (forceps mechanism 11, forceps device 12), the doctor feels the feeling of grasping the affected part (feeds back). Can be made easier.

  Further, in the endoscopic surgical port 1 according to the present embodiment, the lock mechanism 8 for attaching the port lid 5 to the port main body 2 does not screw the port lid 5 into the port main body 2 as in the prior art. 1 to 3, since the port lid 5 is moved in the longitudinal direction of the support column 7 and fixed to the upper opening 3 of the port body 2 so as not to rotate, the port body 2 attached to the abdomen of the patient. When attaching the port lid 5 to the head, the forceps (the forceps mechanism 11 in FIG. 4 and the forceps device 12 in FIG. 5) supported by the column 7 of the port lid 5 do not rotate within the abdomen of the patient. 11. The forceps device 12) can be prevented from damaging the affected area in the patient's abdomen.

  In addition, even after the port lid 5 is attached to the port body 2, the lock mechanism 8 prevents the port lid 5 from rotating with respect to the port body 2. Therefore, the port lid 5 does not rotate with respect to the port main body 2 against the intention of the doctor (operator) during the operation, and the forceps (shown in FIG. The forceps mechanism 11 and the forceps device 12 shown in FIG. 5 can be prevented from rotating inside the patient's abdomen and damaging the affected area by the forceps (forceps mechanism 11 and forceps device 12). Further, since the gap between the port lid 5 and the port body 2 is hermetically sealed by the seal member 31, air supplied into the abdomen of the patient for the purpose of securing a visual field in the abdominal cavity leaks from the gap. Can be suppressed.

(Second Embodiment)
6 and 7 show an endoscope operation port (single-hole endoscope operation port) 1a according to a second embodiment of the present invention. The basic configuration of the second embodiment is the same as that of the first embodiment described above, and the structure for attaching the port lid 5 to the port body 2 is different from that of the first embodiment. Therefore, the same structure as that of the first embodiment will be omitted with the same reference numerals omitted, and the differences will be described. For the sake of drawing, the column 7 is omitted in FIG. A broken line 7 in FIG. 6 indicates a portion where a support column is provided.

  As shown in FIGS. 6 and 7, the port lid 5 of the second embodiment includes a disc portion 32 and a cylindrical portion 33, and the inner peripheral surface of the cylindrical portion 33 fits into the upper outer peripheral surface of the port body 2. Thus, it is formed so as to cover the upper opening 3 of the port body 2. A long hole 9 is formed in the disc portion 32. As shown in FIG. 4, a device 10 such as a camera for photographing the affected part in the abdomen of the patient and an electric knife for excising the affected part is inserted into the long hole 9.

  As shown in FIGS. 6 and 7, this endoscopic surgical port 1 a has a lock mechanism for fixing the port lid 5 to the upper opening 3 of the port body 2 in the longitudinal direction of the support column 7 so that it cannot rotate. 34. The lock mechanism 34 includes a concave portion 35 formed on the outer peripheral surface of the upper portion of the port body 2, a convex portion 36 disposed on the inner peripheral surface of the cylindrical portion 33 of the port lid 5, and the convex portion 36 as an inner peripheral surface. And a release mechanism 37 for retreating to the same level or higher.

  The release mechanism 37 normally has a convex portion 36 protruding inward from the inner peripheral surface of the cylindrical portion 33 of the port lid 5 by an elastic member (rubber, spring, etc.) not shown, and when the release lever 38 is operated, the elastic member The protrusion 36 is configured to be compressed so as to recede flush with the inner peripheral surface or more. A plurality of protrusions 36 and recesses 35 (two in FIG. 6) are preferably provided at equal intervals in the circumferential direction in order to reliably prevent the port lid 5 from rotating relative to the upper opening 3 of the port body 2.

  As shown in FIGS. 6 and 7, a seal member 39 for sealing between the upper opening 3 of the port body 2 and the port lid 5 is provided on the upper portion of the port body 2. The seal member 39 includes an annular O-ring (rubber or the like) 39 attached to the outer peripheral surface of the upper portion of the port body 2, and when the cylindrical portion 33 of the port lid 5 is fitted into the upper portion of the port body 2, the port lid 5 is fitted into the annular recess 40 on the inner peripheral surface of the cylindrical portion 33 and elastically deformed, and the space between them is hermetically sealed. Thereby, it is possible to suppress the air supplied into the abdomen of the patient for the purpose of securing the visual field in the abdominal cavity from leaking between the port lid 5 and the port body 2.

  Since the operation effect of the endoscope operation port according to the second embodiment is the same as that of the first embodiment, description thereof is omitted.

  The preferred embodiments of the present invention have been described above with reference to the accompanying drawings. However, the present invention is not limited to the above-described embodiments, and various modifications within the scope described in the claims. Needless to say, the modified examples also belong to the technical scope of the present invention. For example, the present invention relates to an endoscopic surgical port attached to a hole formed in the chest of a patient in thoracoscopic surgery, or a hole formed in a nostril of a patient in head endoscopic surgery (brain surgery). The present invention can also be applied to an endoscopic surgical port that is attached to the endoscope, and an endoscopic surgical port that is attached to a hole formed in a joint portion such as an elbow or knee of a patient in arthroscopic surgery. Further, the present invention is not limited to a single-hole endoscope operation port.

INDUSTRIAL APPLICABILITY The present invention can be used for endoscopic surgical forceps attached to a hole formed in a patient's abdomen or the like in laparoscopic surgery or the like.

DESCRIPTION OF SYMBOLS 1 Endoscopic operation port 2 Port main body 3 Upper opening 4 Disk part 5 Port lid 6 Lower opening 7 Strut 8 Lock mechanism 11 Forceps (forceps mechanism)
12 Forceps (forceps device)
31 Seal member

Claims (1)

An endoscopic surgical forceps that is attached to a hole formed in a patient's abdomen, chest, head, or joint, and grips the affected area inside the hole,
A port body formed in a cylindrical shape and attached to the abdomen, chest, head or joint of a patient;
A port lid having a disc portion detachably attached to the upper opening of the port body;
A column provided integrally with the port lid, with one end extending upward from the port lid and the other end extending downward from the port lid below the lower opening of the port body;
Forceps integrally fixed to the rigid at the position of at least one end and the other end on the support ;
A lock mechanism for fixing a port lid provided with a post to which the forceps are fixed to the upper opening of the port main body in a longitudinal direction of the post so as to be unrotatable;
Endoscopic surgical forceps characterized by the above.

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