JPH05220157A - Excision device for medical treatment - Google Patents

Abstract

PURPOSE:To provide the excision device for medical treatment which can be easily washed and disinfected, efficiently cools an excision blade and can efficiently recover a perfusate into a suction path. CONSTITUTION:This excision device has a handpiece contg. a motor and an outside pipe 11 and inside pipe 12 constituting double pipes freely attachable and detachable to the handpiece. The inside pipe 12 is rotated within the outside pipe 11 by the rotation of the motor. Apertures 14, 16 having the blades for taking in and cutting the tissues 17 to be incised are respectively formed in the front end side parts of the outside pipe 11 and the inside pipe 12. Further, the excision device for medical treatment formed with the inside hole of the inside pipe 12 as the suction path 7 is provided with a water feed port for supplying the perfusate to a spacing 18 between the outside pipe 11 and the inside pipe 12 on the operator side of the outside pipe 11. The front end of the inside hole of the outside pipe 11 and the front end of the inside pipe 12 are parted and disposed in the axial direction to form a flow passage 23 so that the perfusate supplied through this flow passage 23 to the spacing 18 is introduced into the suction path 7 of the inside pipe 12.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical excision device for excising tissue such as meniscus and cartilage in joint space and nucleus pulposus tissue in intervertebral disc.

[0002]

2. Description of the Related Art Conventionally, a medical resection device for resecting a tissue such as a meniscus or a cartilage in a joint cavity or a nucleus pulposus tissue in an intervertebral disc has been known. These medical cutting devices include:
As disclosed in Japanese Utility Model Laid-Open No. 3-3314 and Japanese Patent Laid-Open No. 50-15476, a handpiece has a built-in motor and a cutting blade is driven to rotate. Incorporating a motor in the piece, converting the rotation of the motor into forward and backward movement of the cutting blade to move the cutting blade back and forth, as shown in JP-A-61-92662, the cutting blade is moved back and forth by air pressure. It is known to make things happen. Each of these has a suction path inside,
The excised tissue pieces can be removed by suction.

[0003]

By the way, since the cutting device disclosed in Japanese Utility Model Laid-Open No. 3-3314 does not have a water supply channel, a perfusion solution for cooling the blade portion and efficiently sucking and removing the tissue piece. There is a problem that can not flow.

Further, in the cutting device disclosed in Japanese Patent Publication No. 2-21814 and Japanese Patent Laid-Open No. 50-15476, the outer circumference of the cutting blade is covered with an outer tube or sleeve assembly, and an annular ring is provided between them. A space is formed and water is sent. However, since the insertion portion has a triple structure, the outer diameter becomes large. Therefore, when used in a narrow area such as in an intervertebral disc, the living tissue is greatly invaded. Further, since each of the outlets of the water supply is provided separately from the opening serving as the cutting blade, there is a problem that the water supply cannot be efficiently collected from the opening into the suction passage.

On the other hand, the excision device disclosed in Japanese Patent Laid-Open No. 61-92662 has a structure in which a perfusate is caused to flow between a fixed needle and a tubular member which moves back and forth through the needle, and the thickness is also thin. In addition, the perfusate can be efficiently collected in the suction passage. However, since the insertion part consisting of the needle and tubular member cannot be attached to or detached from the handpiece, it cannot be washed or sterilized such as the suction passage, and it must be used as a disposable instrument, but in that case, the cost is high. Become.

Further, since the cutting blade is configured to move back and forth in this device, even if the insertion portion is slightly bent, the tubular member becomes difficult to move back and forth, and the cutting efficiency is reduced. Furthermore, in the reciprocating resection method, when a relatively hard tissue such as meniscus or cartilage is excised, the tubular member generates a force to bend the needle at the opening for taking in the tissue, so that the needle bends. There is a risk of damage or damage.

The object of the present invention is that it is easy to clean and disinfect, is strong against external load, and efficiently cools the cutting blade,
Moreover, it is another object of the present invention to provide a medical excision device capable of efficiently collecting the perfusate into the suction passage.

[0008]

The present invention comprises a handpiece having a built-in motor, and an outer tube and an inner tube which are detachably connected to the handpiece and constitute a double tube. The tube is connected to the motor and is rotated in the outer tube by the rotation of the motor, and each of the outer tube and the inner tube is formed with an opening provided with a blade for taking in and cutting tissue to be cut. In the medical excision device using the inner hole of the inner tube as a suction path, a water supply port for supplying a perfusate is provided in a gap between the outer tube and the inner tube on the proximal side of the outer tube, and the outer tube is provided. And a tip of the inner tube is axially separated from each other to form a flow path, and the perfusion liquid supplied to the gap through the flow path is introduced into the suction path of the inner tube. It is characterized by doing.

Therefore, since the outer tube and the inner tube constituting the cutting blade are detachably attached to the handpiece, the cutting blade can be separated from the handpiece for cleaning and disinfection.
Since the perfusate flows in the gap between the outer tube and the inner tube, the frictional heat due to the rotation of the inner tube is cooled and the tip of the inner hole of the outer tube and the tip of the inner tube are axially separated from each other to form a flow path. Since the perfusion liquid is formed, the perfusate always flows efficiently into the suction passage through the flow passage and is collected by suction.

[0010]

Embodiments of the present invention will be described below with reference to the drawings.

1 to 3 show a medical cutting device according to a first embodiment of the present invention. As shown in FIG. 1, the medical cutting device 1 includes a handpiece 2 and a cutter (cutting blade) 3. Motor 4 in handpiece 2
The motor 4 is connected to the control unit 5 via a cable 6. Also, cutter-3
The suction passage provided therein is connected via a suction tube 9 to a suction device 8 that generates suction pressure. And
A foot switch 10 is connected to the control unit 5.

As shown in FIG. 2 and FIG. 3, the cutter-3 has a double pipe structure of an outer pipe 11 and an inner pipe 12. A connection portion 13 that can be detachably connected to the handpiece 2 is provided at the proximal portion of the inner pipe 12, and the rotation of the motor 4 in the handpiece 2 is transmitted to the connection portion 13 to rotate the inner pipe 12. It is like this. Further, a suction port 15 is formed in the connection portion 13, and the suction port 15 communicates with the opening 14 formed on the side surface of the distal end portion of the inner pipe 12 and the suction passage 7 formed over the entire length of the inner pipe 12. Further, the suction path (not shown) provided in the handpiece 2 is communicated with the external suction device 8.

On the other hand, the tip of the outer tube 11 is formed into a spherical shape for enhancing safety, and the inner tube 12 is formed on the side surface of the outer tube 11.
An opening 16 is formed at the same position as the opening 14 in the longitudinal direction. Blades are formed at the edges of the opening 16 of the outer tube 11 and the opening 14 of the inner tube 12, respectively, and these blades cooperate with each other by the rotational movement of the inner tube 12 to suck them into the openings 14, 16. The tissue 17 thus taken in is cut into small pieces.

Further, an annular gap through which the perfusate flows is formed over substantially the entire length of the outer pipe 11 and the inner pipe 12, and this gap constitutes the water supply passage 18. A connecting member 19 is provided on the proximal side of the outer pipe 11, and the inner pipe 12 is connected to the outer pipe 11 so as to be rotatable in a liquid-tight state. The connecting member 19 is provided with a water supply port 22, and the water supply port 22 is connected to an external water supply bottle 20 via a water supply tube 21 so that the perfusate stored in the water supply bottle 20 is supplied to the water supply tube. Bulb 21, water supply port 22, and water supply channel 18
It is supplied to the tip of the cutter-3 via the.

Further, as shown in FIG. 3, the tip of the inner hole of the outer tube 11 and the tip of the inner tube 12 are separated from each other by x in the axial direction, preventing contact between the outer tube 11 and the inner tube 12, and A flow path 23 is formed for smoothly rotating 12 and allowing the perfusate flowing through the water supply path 18 to always flow into the suction path 7. Next, the operation of the medical cutting device according to the first embodiment will be described.

At the time of use, first, the cutter 3 is attached to the handpiece 2, and the motor 4 and the cutter in the handpiece 2 are attached.
3 and the inner pipe 12 are connected. And the operation switch 10
Is operated to drive the motor 4, the rotation of the motor 4 is transmitted to the inner pipe 12. Then, when the tissue to be excised from the openings 14 and 16 is taken in by suction by the operation of the suction device 8, the tissue is cut by the blades provided in the openings 14 and 16 by the rotation of the inner tube 12. The cut tissue piece is sucked and removed by the external suction device 8 through the suction passage 7, the suction port 15, and the suction tube 9.

Simultaneously with the excision of the tissue, the perfusate in the water supply bottle 20 passes through the water supply tube 21 and the water supply port 22 and the water supply passage 1
8 and is further sucked into the suction passage 7 through the flow passage 23. Therefore, the cut tissue piece is surely sucked and removed by riding on the flow of the perfusate sucked into the suction passage 7. After using the cutting device, the cutter 3 may be removed from the handpiece 2, and then the outer tube 11 and the inner tube 12 may be disassembled, and the suction passage 7 and the like may be washed and disinfected.

In the medical cutting device constructed as described above, since the cutter has a double structure of an outer tube and an inner tube, it is possible to reduce the diameter of the cutter and to reduce it to a narrow portion such as an intervertebral disc. Can be inserted by invasion. Further, since the water supply liquid flows through the annular space between the outer pipe and the inner pipe, it is possible to effectively cool the cutter from becoming hot due to frictional heat caused by rotation.

Further, by providing a flow path between the tip of the outer tube and the tip of the inner tube, the perfusate always flows efficiently from the water supply path to the suction path, and the perfusate can be efficiently sucked and recovered. Further, since the cutter is detachable from the handpiece, cleaning / disinfection after use can be easily performed.

Further, when the tissue piece is clogged in the suction passage, the tissue piece can be easily removed by removing the cutter from the handpiece even during use, and the operation is not interrupted for a long time. Also, since the tissue is cut by the rotation of the inner tube, compared to the method of moving the cutter back and forth,
It is strong against external load, and even when cutting relatively hard tissue such as meniscus and cartilage, the tip opening is not damaged, and the cutting can be performed safely. Next, a second embodiment of the present invention will be described with reference to FIG. In the second embodiment, the suction passage in the handpiece is formed straight.

As shown in FIG. 4, the handpiece 24 includes:
A grip portion 26 extending laterally is provided, and a motor 27 is incorporated in the grip portion 26. A gear 28 is fixed to the rotary shaft 27a of the motor 27.

Further, similarly to the first embodiment, a suction passage 29 communicating with the suction passage provided in the cutter 25 is provided in the handpiece 24, and an inner pipe (not shown) of the cutter 25 is provided. A rotating member 30 that transmits rotation is provided. A gear 31 that meshes with the gear 28 and rotates the rotating member 30 is fixed to the rotating member 30. Further, at the rear end of the handpiece 24, a suction mouthpiece 32 for connecting a suction tube (not shown) communicating with an external suction device (not shown) is provided so as to project. The O-rings 34 and 35 are the rotary shaft 27a of the motor 27.
And a bearing of the rotating member 30 and a watertight member. Other configurations are similar to those of the first embodiment.

In the second embodiment, in addition to the effect of the first embodiment, since the suction passage 29 is formed in a straight shape from the cutter 25 to the suction mouthpiece 32, clogging of the tissue piece in the suction passage is achieved. Can be prevented. Next, a third embodiment of the present invention will be described with reference to FIG.

In this embodiment, an outer tube 37 for inserting the cutter 36 into the living body is provided on the outer circumference of the cutter 36.
An elastic member 39 such as a spring is provided between the outer tube 37 and the tip of the handpiece 38.

The outer tube 37 has a water supply port 40 for supplying the perfusate through a gap between the cutter 36 and the inner cavity of the outer tube 37, and prevents water leakage from the proximal side of the outer tube 37. A watertight member 41 such as a rubber cap is provided.

In the third embodiment, as shown in FIG. 5A, the cutter 36 is inserted into the outer tube 37 until the elastic member 39 contacts the watertight member 41. In this state, the tip of the cutter 36 does not protrude from the tip of the outer tube 37.
Next, as shown in FIG. 5B, when the cutter 36 is pushed against the elastic force of the elastic member 39, the tip of the cutter 36 projects from the tip of the outer tube 37 so that the living tissue can be cut off. become. Then, when the force pushing the cutter 36 is weakened, the elastic force of the elastic member 39 causes the force shown in FIG.
Return to the state of.

That is, by repeating this operation,
The tissue is excised in the state of FIG. 5 (b), and the perfusate supplied from the water supply port 40 of the outer tube 37 in the state of FIG. 5 (a) is cut by a cutter.
36 can be sucked through the opening 42 at the tip. Other configurations are similar to those of the first embodiment.

In the third embodiment, in addition to the effect of the first embodiment, since the tissue piece can be sucked together with the perfusate flowing from the water supply port of the mantle tube, the tissue piece is not clogged in the middle of the suction passage. Can suck efficiently.

[0029]

As described above, in the medical cutting device of the present invention, since the cutting blade has the double structure of the outer tube and the inner tube,
The cutting blade can be made thinner, and it can be inserted into narrow areas such as intervertebral discs with minimal invasiveness. Further, since the water supply liquid flows through the annular space between the outer pipe and the inner pipe, it is possible to effectively cool the cutting blade from becoming hot due to frictional heat caused by rotation.

Further, by providing a flow path between the tip of the outer tube and the tip of the inner tube, the perfusate always flows efficiently from the water supply path to the suction path, and the perfusate can be efficiently sucked and recovered. Since the cutting blade is detachable from the handpiece, it can be easily washed and disinfected after use.

Further, when the tissue piece is clogged in the suction path, the tissue piece can be easily removed by removing the cutting blade from the handpiece even during use, and the operation is not interrupted for a long time. Also, since the tissue is cut by the rotation of the inner tube, it is more resistant to external load than the method of moving the cutting blade back and forth, and the tip opening is damaged even when cutting relatively hard tissue such as meniscus and cartilage. The excision can be performed safely without performing.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a medical cutting device according to a first embodiment of the present invention.

FIG. 2 is an overall view of the cutter shown in FIG.

FIG. 3 is a sectional view of the cutter.

FIG. 4 is a partial sectional view of a medical cutting device according to a second embodiment of the present invention.

5 (a) is an overall configuration diagram of a medical cutting device according to a third embodiment of the present invention, and FIG. 5 (b) is a partial view showing a usage state of a cutter.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Medical excision device, 2 ... Hand piece, 3 ... Cutter, 4 ... Motor, 7 ... Suction path, 11 ... Outer pipe, 12 ... Inner pipe, 14, 16 ... Opening, 18 ... Water supply passage, 22 ... water outlet,
23 ... Flow path.

Claims (1)

[Claims] 1. A handpiece having a built-in motor, and an outer pipe and an inner pipe which are detachably connected to the handpiece and which form a double pipe, the inner pipe being connected to the motor, Rotation in the outer tube by the rotation of the inner tube, each of the outer tube and the inner tube is formed with an opening provided with a blade for taking in and cutting the tissue to be excised in the tip side portion, and the inner hole of the inner tube is suctioned. In the medical excision device described above, a water supply port for supplying a perfusate is provided in the gap between the outer tube and the inner tube on the proximal side of the outer tube, and the inner hole tip of the outer tube and the tip of the inner tube are Is separated from each other in the axial direction to form a flow path, and the perfusate supplied to the gap through the flow path is introduced into the suction path of the inner tube. ..