JPH0813304B2 - Incision opening device - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an incision opening device used in surgery.

[0002]

2. Description of the Related Art For example, in the operation of removing the gallbladder, after incising the skin and subcutaneous fat, an incision opening device 40 formed by bending a wire is inserted into the incision as shown in FIG. While the incision is opened, the small intestine 41 and the large intestine 42 are pushed away by the opening device 40 to expose the gallbladder 43 and the gallbladder 43 is extracted.

[0003]

However, since the above-mentioned conventional opening device 40 is simply formed by bending the wire rod, the small intestine 41 and the large intestine 42 pushed away by the opening device 40 become the wire rod in the opening device 40. The gallbladder 43 comes to enter the original place through the gap between the gallbladder 4 and
There was a problem that the extraction of No. 3 could not be performed easily. An object of the present invention is to provide an incision opening device that can solve the above problems.

[0004]

In order to achieve the above object, a feature of the present invention is that a pair of upper and lower gripping levers are pivotally connected to each other by a support shaft so that they can be opened and closed vertically. The cross section has an elliptical shape and is inserted into the incision, the cylinder is inserted elastically between the two gripping levers to urge both gripping levers in the opening direction, and the inside of the incision is illuminated. The tubular body is divided into a pair of divided bodies with the minor axis portion as a division surface, and each divided body is arranged on each side of the support shaft, and the tip of each gripping lever is arranged. From the parts, respectively. In addition, the base portion side of the grip lever may be bent with respect to the tip end portion side, and the base portion side may be inclined so as to move upward toward the base end. Further, a holding means for holding both gripping levers in a closed posture may be provided. Further, the grip lever and the divided body may be made of synthetic resin. Further, the divided body may be made of metal, and the inner surface of the divided body may be coated with rubber or synthetic resin. Further, the illumination means may have a grip lever, an optical fiber embedded in the divided body, and a light source for illuminating via the optical fiber. Further, the illuminating means may have a planar light-emitting body which is provided on the inner surface of the divided body and which is energized to emit light.

[0005]

[Operation] During surgery, the tubular body of the incision opening device
The incision is opened, the internal organs are pushed away, and the inside of the incision is illuminated by the illumination means.

[0006]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to the drawings of FIGS. 1 to 9. The incision opening device comprises first and second gripping levers 1 and 2 and a cylindrical body 3. Left and right pair of first and second split bodies 4, 5, spring 6, and optical fiber 7
And a light source 8.

The first gripping lever 1 has a body 10 elongated in the left-right direction, and a ring-shaped flange portion 11 connected to the left end which is the tip of the body 10.
0 and the right side portion of the flange portion 11 are inclined upward to the right (inclined shape that moves upward toward the base end), and the right side portion that is the base side of the main body 10 is the left side that is the tip side. It is bent so as to be inclined at a steeper angle than the portion, and is located above the left portion. Body 1
From the lower surface on the left side of 0, a pair of front and rear support portions 12 are provided so as to project downward, and an opening portion 13 opening in the front-rear direction is formed from below in the support portion 12, and the lower portion of the opening portion 13 is It is narrower than the top. The lower surface of the flange 11 is stepped at the center in the left-right direction, and the left half thereof is thicker than the right half, and notches are formed in the front and rear portions of the stepped portion of the lower surface, respectively. The part 14 is recessed from the right side.

The second gripping lever 2 has a body 16 which is elongated in the left-right direction and a semi-ring flange 17 which is connected to the left end which is the tip of the body 16. The left side portion of the main body 16 and the flange portion 17 are horizontal, but the right side portion, which is the base side of the main body 16, is inclined upward to the right (inclined shape that moves upward toward the base end). , Located higher than the left side portion on the tip side. At the front and rear ends of the left end of the flange portion 17,
Each of them has a protrusion 18 protruding leftward.
Each protrusion 18 is inserted into each notch 14 of the flange portion 11 of the first grip lever 1, and each protrusion 18 and the first
By inserting the support shaft 19 arranged in the front-rear direction into the portion of the flange portion 11 of the gripping lever 1 that sandwiches the projecting portions 18 in the front-rear direction, the gripping levers 1 and 2 can be opened and closed in the vertical direction at the left end. Part (tip) is pivotally connected.

The cross section of the cylindrical body 3 is an elliptical shape with the major axis in the left-right direction, and the cylindrical body 3 has first and second divided bodies 4, 5 with the minor axis portion as a dividing surface. Is divided into The first and second divided bodies 4 and 5 are arranged on each of the left and right sides sandwiching the support shaft 19, and the inner peripheral surface of the left half of the flange portion 11 of the first grip lever 1 or the second grip lever 2 is arranged. Of the flange portion 17 is projected downward from the inner peripheral surface of the flange portion 17. Each of the divided bodies 4 and 5 has a substantially U shape in a side view.

The first gripping lever 1 and the first divided body 4 are integrally formed of hard synthetic resin, and the second gripping lever 2 and the second divided body 5 are integrally formed of hard synthetic resin. The spring 6 is integrally formed of a relatively hard synthetic resin having elasticity, has a bent plate shape projecting downward, and has a shaft body 21 projecting forward and backward at the left end thereof. There is. Each shaft body 21 is pushed into the opening portion 13 of the support portion 12 of the first grip lever 1 from below through elastic deformation and is held at the upper portion of the opening portion 13, whereby
The spring 6 is pivotally supported by the first gripping lever 1 so as to be swingable, and the left and right midway portion projecting downward thereof elastically abuts on the main body 16 of the second gripping lever 2, so that both gripping levers 1, Two
Is urged in the opening direction to urge both split bodies 4, 5 in the closing direction.

The optical fiber 7 and the light source 8 constitute an illuminating means for illuminating the front side, that is, the lower side in the axial direction of the cylindrical body 3. The optical fiber 7 is the main body 1 of both gripping levers 1 and 2.
0, 16 are embedded side by side in the width direction, and the base side is internally contained in the cord 22 so that each main body 10, 11
The light source 8 is connected to the light source 8 by extending from the base end portion thereof to the outside. Further, the tip end side of the optical fiber 7 is embedded in the flange portions 11 and 17 of both gripping levers 1 and 2 in a radially aligned manner, and the optical fibers 7 are arranged in the circumferential direction of the flange portions 11 and 17. The two divided bodies 4, 5 are extended downward in the respective divided bodies 4, 5 from the equally distributed portions.
It is exposed downward on the bottom surface of. A suitable lamp is used as the light source 8, and the light from this light source passes through the optical fiber 7 to illuminate the lower part of the cylindrical body 3.

According to the embodiment configured as described above, in the operation of removing the gallbladder, after the skin and subcutaneous fat are incised, the tubular body 3 of the incision opening device is incised as shown in FIG. The small intestine 23 and the large intestine 24 are pushed away, and the gallbladder 25 is exposed. Further, by the light source 8 and the optical fiber 7, below the cylindrical body 3, that is,
The gallbladder 25 is extracted by illuminating the inside of the incision. In the above case, a. The incision can be opened by the cylindrical body 3, and b. Since the small intestine 23 and the large intestine 24 are pushed away by the tubular body 3, the pushed back small intestine 23 and the large intestine 24 do not return to their original places and cover the gallbladder 25.
Can be easily extracted. Also, the light source 8 and the optical fiber 7
Thus, since the lower part of the tubular body 3, that is, the inside of the incision is illuminated, the gallbladder 25 and its surroundings are bright and easy to see, and the gallbladder 25 can be removed more easily.

Further, since the tubular body 3 has an elliptical shape, the tubular body 3
By rotating (for example, rotating from the position shown by the solid line in FIG. 9 to the position shown by the phantom line),
The inside of the gallbladder 25 can be seen larger and the gallbladder 25 can be removed more easily. Further, since the cylindrical body 3 is divided into a pair of divided bodies 4 and 5, and the divided bodies 4 and 5 are projected downward from the tip end portions of the grasping levers 1 and 2, the grasping levers 1 and 2 are By closing and opening both split bodies 4 and 5, the incision can be opened more largely, and the small intestine 23 and the large intestine 24 can be pushed further apart. This allows the gallbladder 25
The gall bladder 2 can be exposed to a large degree and its surroundings.
Extraction of 5 can be performed more easily. Further, since the tubular body 3 is divided into the pair of divided bodies 4 and 5 with the short diameter portion serving as the dividing surface, the tubular body 3 can be expanded in the major axis direction when both the divided bodies 4 and 5 are opened. In this state, if the incision opening device is rotated, the inside of the small incision can be seen larger and the gallbladder 25 can be removed more easily.
Further, since the spring 6 urges both gripping levers 1 and 2 in the opening direction and urges both split bodies 4 and 5 in the closing direction, during normal operation when both split bodies 4 and 5 are closed, There is no need for the surgeon to keep the posture of the two divided bodies 4, 5.

Further, since both gripping levers 1 and 2 and the cylindrical body 3 are made of synthetic resin, when an electric knife is used when the gallbladder 25 is removed, the electric knife cuts both gripping levers 1 and 2 and the cylindrical body 3.
There is no risk of electrical leakage if accidentally touched. Further, since the base side of each of the gripping levers 1 and 2 has an inclined shape that moves upward as it goes toward the base end, and is positioned above the tip end side, respectively, when the gripping levers 1 and 2 are opened. In either case, the hands holding the gripping levers 1 and 2 do not come into contact with the abdomen 26 of the patient, and it is easy to operate the incision opening device.

FIG. 10 shows a second embodiment of the present invention. A planar light-emitting body 28 such as electroluminescence is provided on the inner surface of each of the divided bodies 4 and 5, and this planar light-emitting body 28 is provided. , The electric wire 29 for energizing both gripping levers 1,
It is embedded in the two main bodies 10 and 16 and the flange portions 11 and 17.

FIG. 11 shows a third embodiment of the present invention. A pair of left and right supporting portions 31 are formed on the right end portion of the main body 10 of the first gripping lever 1 so as to project upward.
Further, an opening 32 that opens in the left-right direction is formed from above. The opening 32 is narrowed upward. Reference numeral 34 is a fixed piece in the shape of an arc, and a pair of shaft bodies 35 protruding left and right are formed at the base end portion thereof. Each shaft 35 is inserted into the lower part of the opening 32 of each support 31 through elastic deformation, and the fixing piece 34 is rotatably supported by the first gripping lever 1. The fixing piece 34 has a U-shaped tip, and is fitted to the main bodies 10 and 16 of the gripping levers 1 and 2 through elastic deformation so that the gripping levers 1 and 2 are closed. Hold in position. According to the third embodiment configured as described above, the fixing piece 34 can hold both gripping levers 1 and 2 in a closed posture, and both split bodies 4 and 5 can be held in an open posture. When holding the bodies 4 and 5 in the open posture, the operator does not need to hold the gripping levers 1 and 2 in the closed posture.

In the embodiment, the grip lever and the cylinder are made of synthetic resin, but they are made of metal so that the surface of the cylinder where the electric knife may come into contact is coated with rubber or synthetic resin. You may

[0018]

As described in detail above, according to the present invention,
During an operation, the incision part can be easily opened by the tubular body of the incision opening opening device, and the internal organs can be easily pushed away, and the internal body, etc. can be pushed away by the tubular body. , It is possible to easily remove the internal organs without returning to the original place and covering the extraction part and the like. Further, since the illuminating means for illuminating the inside of the incision portion is provided, the excised portion and its surroundings are bright and easy to see, and excision of the internal organs can be performed more easily. Furthermore, since the cross-section of the cylinder inserted into the incision has an elliptical cross section, the inside of the incision can be enlarged even if the incision is small by rotating the incision opening device. Can be done more easily. Further, since the tubular body is divided into a pair of divided bodies, and each divided body is projected downward from the tip end portion of each gripping lever, both gripping levers are closed and both split bodies are opened. The incision can be opened more widely, and the built-in parts can be pushed further out. As a result, the excised portion and its surroundings can be largely exposed, and excision of internal organs and the like can be further facilitated.
Furthermore, since the tubular body is divided into a pair of divided bodies with the minor axis portion serving as the dividing surface, the tubular body can be expanded in the major axis direction when both divided bodies are opened. By rotating the incision opening device in this state, the inside of the small incision can be seen larger and the internal organs can be more easily removed. Further, since the springs for urging both gripping levers in the opening direction are provided, it is sufficient to operate both gripping levers only when the two divided bodies are opened, and the opening and closing operations of both divided bodies can be easily performed.

Further, according to claim 2, the base side of the grip lever is bent with respect to the distal end side, and the base side is inclined so as to move upward toward the base end, so that the grip lever is opened. In both cases, the hand holding both gripping levers does not come into contact with the patient's abdomen or the like and the incision opening device is easy to operate. Also, claim 3
According to this, since both holding bodies can be held in the open posture by the holding means, it is not necessary for the operator to hold the two holding bodies in the open posture. Further, according to claim 4 or 5, when an electric knife is used for surgery, even if the electric knife comes into contact with the incision opening device, there is no risk of or leakage of electric current.

[Brief description of drawings]

FIG. 1 is a perspective view showing a first embodiment of the present invention.

FIG. 2 is a front view of the same.

FIG. 3 is a front view showing the same operating state.

FIG. 4 is an exploded perspective view of the same portion.

FIG. 5 is an enlarged view of the same portion.

6 is a cross-sectional view taken along the line AA of FIG.

7 is a cross-sectional view taken along the line BB of FIG.

8 is a sectional view taken along line CC of FIG. 7;

9 is a cross-sectional view taken along the line DD of FIG.

FIG. 10 is a cross-sectional view of a main part showing a second embodiment of the present invention.

FIG. 11 is a cross-sectional view of a main part showing a third embodiment of the present invention.

FIG. 12 is a perspective view showing a conventional example.

[Explanation of symbols]

 1 1st gripping lever 2 2nd gripping lever 3 Cylindrical body 4 1st division body 5 2nd division body 6 Spring 7 Optical fiber 8 Light source 28 Planar light-emitting body 34 Fixed piece

Claims (7)

[Claims] 1. A pair of upper and lower gripping levers pivotally connected by a support shaft at a tip end portion so as to be openable and closable in the vertical direction, a cylindrical body having an elliptical cross section and inserted into an incision, and both gripping grips. It has a spring interposed elastically between the levers, which urges both gripping levers in the opening direction, and an illumination means for illuminating the inside of the incision part. An incision opening device, which is divided into a pair of divided bodies, each divided body being arranged on each side of the support shaft and projecting downward from the tip of each gripping lever. 2. The incision opening instrument according to claim 1, wherein the base side of the grip lever is bent with respect to the tip side, and the base side is inclined so as to move upward toward the base end. 3. The incision opening device according to claim 1, further comprising holding means for holding both gripping levers in a closed posture. 4. The incision opening device according to claim 1, wherein the grip lever and the divided body are made of synthetic resin. 5. The divided body is made of metal, and the divided body has an inner surface,
The incision opening device according to claim 1, which is coated with rubber or synthetic resin. 6. The illuminating means has a grip lever, an optical fiber embedded in the divided body, and a light source for illuminating via the optical fiber.
The incision opening device according to any one of 5 above. 7. The incision opening device according to claim 1, wherein the lighting means has a planar light-emitting body which is provided on the inner surface of the divided body and which emits light when energized.