WO2016117619A1 - Direct laryngoscope - Google Patents
Direct laryngoscope Download PDFInfo
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- WO2016117619A1 WO2016117619A1 PCT/JP2016/051609 JP2016051609W WO2016117619A1 WO 2016117619 A1 WO2016117619 A1 WO 2016117619A1 JP 2016051609 W JP2016051609 W JP 2016051609W WO 2016117619 A1 WO2016117619 A1 WO 2016117619A1
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- arm
- laryngoscope
- opening device
- patient
- tongue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
Definitions
- the present invention relates to a pharyngeal direct mirror, and more specifically, can open a patient's mouth during surgery, can adjust the insertion depth of the laryngoscope body inserted into the oral cavity, and is further placed behind the tongue and throat.
- the present invention relates to a laryngeal direct mirror that can lift and hold a certain epiglottis stably.
- Patent Document 1 discloses a laryngoscope that includes a tongue depressor with a lever and a palatal spatula that presses the jaw with a lever and is inserted into a patient's oral cavity to expose the throat region. According to this, by operating the lever by hand, the tongue can be lifted and the palate can be expanded without damaging the teeth with little effort.
- the laryngoscope as described above is merely for expanding the palate, and it is impossible to adjust where the laryngoscope is positioned and to stably hold the adjusted laryngoscope. Further, the above laryngoscope cannot hold the size of the open mouth, that is, the length between the upper jaw and the lower jaw.
- the patient is anesthetized during the operation and is in a suspended head position (the face is facing up and the head is lowered).
- the pharynx (into) 26 extends from the back of the oral cavity 25 to the entrance of the esophagus 31 and is divided into an upper pharynx 26a, an oropharynx 26b, and a lower pharynx 26c.
- the part reaching 29 is called the larynx 23, and a vocal cord 32 exists behind the larynx 23.
- the epiglottis 24 at the entrance of the trachea 29 obstructs the hypopharynx 26c. Therefore, it is necessary to lift the epiglottis 24, the tongue 22, and the tongue base 22a. In addition, it is necessary to hold the laryngoscope stably during the operation. Furthermore, it is necessary to hold the mouth in a greatly expanded state during the operation.
- the throat refers to the pharynx 26 and the larynx 23, and the laryngeal direct mirror is a device for operating this portion.
- the laryngoscope body is an auxiliary tool for lifting the epiglottis 24, tongue 22, and tongue base 22a.
- An object of the present invention is to provide a pharyngeal direct-view mirror that can accurately adjust the insertion position of the laryngoscope body, can stably hold the laryngoscope body, and can arbitrarily hold the size of the open mouth. is there.
- the laryngopharyngeal direct mirror according to the present invention is a laryngeal direct mirror that is attached to the hanger and is provided with a hanger rotatably attached to a slide portion of an extension rod extending from a support leg fixed to an operating table.
- the opening device is provided with a frame having an adjustment lever with a hook on the upper portion, and the opening device holding metal fitting is provided with a plurality of locking plates for locking the hook in the vertical direction. To do.
- the biting portion is slidably fitted into the lower portion of the opening device and is pressed by a presser spring.
- the arm 1 and the laryngoscope body 2 can be rotated around the pin 9 by turning the handle 6 of the operation unit 21.
- the rotation by the pin 9 has little friction, and the laryngoscope body 2 can be inserted smoothly and the depth can be adjusted.
- the laryngoscope body 2 can be inserted to the vicinity of the vocal cords, and the larynx, tongue base and tongue can be lifted well.
- the position of the laryngoscope main body 2 can be stably held by the operation shaft 6a of the handle 6, the feed portion 7 and the receiving portion 8 that are screwed together.
- a frame having an adjustment lever with a hook is provided on the upper part of the opening device, and on the other hand, a plurality of locking plates are provided in the vertical direction to lock the hook to the opening device presser fitting.
- the opening device By engaging with the plate, the opening device can be moved in the vertical direction with respect to the opening device retainer. Thereby, the patient's mouth can be opened and held in an arbitrary size.
- the biting part can be slid to the lower part of the opening device and pressed by a presser spring, so that it cannot be easily moved from the position where the biting part is slid.
- FIG. 4 is a detailed structural diagram of the adjustment lever of FIG. 3. It is a figure at the time of mounting
- (A) shows a case where insertion of the laryngoscope body into the oral cavity is shallow.
- (B) shows the case where the laryngoscope body is inserted deeply into the vicinity of the epiglottis by turning the handle. It is a figure which shows the structure of an oral cavity and a pharynx. It is a figure which shows the operation state of a patient.
- FIG. 1 is a perspective view (front side) of a pharyngeal direct mirror 100 according to the present invention.
- the laryngoscope direct mirror 100 includes an arm 1 and a laryngoscope body 2 connected to the lower end of the arm 1.
- the laryngoscope body 2 is inserted into the oral cavity 25 of the patient and lifts the patient's tongue 22, tongue base 22a, and epiglottis 24.
- the laryngoscope main body 2 has a downwardly convex warped shape, a semicircular cross section, and a groove that guides forceps inside. Note that the warped shape may be an arc shape, for example. As shown in FIG.
- an armor presser fitting 3 is attached to the arm 1 so as to be rotatable by a pin 9, and an aperturer 4 is connected to the lower end of the aperturer presser fitting 3.
- the pin 9 is on the arm 1 and is located near the center of the radius of curvature of the laryngoscope body 2 having a downwardly convex shape.
- a pair of biting portions 5 and 5 to be engaged with the patient's upper teeth 30 are provided below the opening device 4.
- the biting portions 5 and 5 are provided with three semicircular grooves and can be bitten in accordance with the position of the upper teeth 30 of the patient.
- the arm 1 is not limited to this shape, and may be L-shaped, saddle-shaped, semicircular, or arc-shaped.
- the operation unit 21 includes an operation shaft 6a having a male screw, a feed unit 7 having a female screw provided on the arm 1 and screwed to the operation shaft 6a, and a lower end of the operation shaft 6a attached to the opening device presser bracket 3 so that the lower end of the operation shaft 6a can be rotated. And a handle 6 that is provided at the upper end of the operation shaft 6a and rotates the operation shaft 6a. By rotating the handle 6, the interval between the feeding portion 7 and the receiving portion 8 can be increased or decreased. Since the lower end of the opening device holder 3 and the opening device 2 are fixed to the upper teeth 30 by the biting portion 5 and the upper end rotates around the pin 9, it is impossible to move in the front-rear direction. When the handle 6 is rotated, the arm 1 and the laryngoscope body 2 connected thereto move back and forth.
- FIG. 2 is a rear view of the laryngeal direct mirror 100 according to the present invention.
- a pair of biting portions 5 and 5 are fitted in the lower portion of the opening device 4 and can be slid in the left-right direction.
- the adjustment lever 19 can slide the opening device 4 in the vertical direction by operating the adjustment lever 19.
- the vertical position of the opening device 4 can be adjusted by the adjustment lever 19 so that the biting portion 5 can be adjusted to the position of the patient's upper teeth.
- FIG. 3 is a perspective view (rear side) of the laryngeal direct mirror 100 according to the present invention.
- the feed portion 7 is a female screw tap that is screwed into the male screw of the operation shaft 6 a and is attached to the side surface of the arm 1.
- the feed portion 7 may be formed in the arm 1 by drilling a female screw.
- the receiving portion 8 is formed with a hole in the tap, and is held so as to be rotatable so that the lower end of the operation shaft 6a does not come off.
- FIG. 4 is a detailed structural diagram of the adjusting lever 19 of FIG.
- the opening device 4 is provided with a frame 16 that can slide up and down.
- the frame body 16 is provided with an adjustment lever 19, and a hook 18 is provided at the tip thereof.
- a plurality of locking plates 17 on which the hooks 18 are locked are provided in the opening device pressing member 3 in the vertical direction.
- reference numeral A when the adjustment lever 19 is pressed against the spring 20, the hook 18 is removed from the hole of the frame body 16 as indicated by reference numeral B. In this state, the adjustment lever 19 and the frame body 16 are slid as indicated by reference numeral C, and the opening device 4 is slid up and down.
- FIG. 5 is a view when the presser spring 10 is attached to the biting portions 5 and 5 of FIG.
- the pair of biting portions 5 and 5 are slidably fitted into the frame of the opening device 4, and one side of the biting portions 5 and 5 is pressed by the presser spring 10. Accordingly, the biting portions 5 and 5 can be held so as not to slide easily.
- FIG. 6 is a perspective view showing another embodiment of the laryngoscope main body 2.
- the laryngoscope main body 2 has a semicircular cross section, but here, it has a plate shape with a wide cross section and a flat top surface. Both ends are bent slightly downward. According to this, since there is no height, a wide space in the front side region of the opening device 4 can be secured, and forceps, fibers, and the like can be easily inserted into the opening device 4. Moreover, since the cross section is wide and the upper surface is flat, the contact area with the tongue 22 increases, and this can be lifted stably.
- FIG. 7 is an operation explanatory diagram of the pharyngeal direct mirror 100 according to the present invention.
- A shows the case where the insertion of the laryngoscope body 2 into the oral cavity is shallow.
- B shows the case where the laryngoscope body is inserted deeply into the vicinity of the epiglottis 24 by turning the handle.
- the handle 6 is turned to one side in the state of (A)
- the distance between the feeding part 7 and the receiving part 8 is narrowed, and the laryngoscope body 2 can be inserted deeply into the vicinity of the epiglottis 24 as shown in (B).
- the laryngoscope body 2 can be inserted up to the vicinity of the vocal cord 32.
- FIG. 8 shows the structure of the oral cavity 25, the pharynx 26, and the vocal cords 32.
- Air entering from the nose 27 passes through the nasal cavity 28, passes through the pharynx 26 and vocal cords 32, and enters the trachea 29.
- the food that has entered the mouth enters the esophagus 31 from the oral cavity 25 through the pharynx 26.
- the epiglottis 24 prevents food from entering the trachea 29 when the food is swallowed.
- the pharynx 26 is divided into an upper pharynx 26a, an oropharynx 26b, and a hypopharynx 26c. In the operation or the like of the hypopharynx 26c, it is necessary to lift the epiglottis 24, the tongue base 22a, and the tongue 22.
- FIG. 9 is a diagram showing a patient's surgical condition.
- the patient is in a suspended position with the head hanging.
- the support leg 14 is fixed to the operating table, and the overhang bar 13 extends obliquely upward from the support leg 14.
- a slide portion 12 is provided at the tip of the overhang bar 13.
- the hanger 11 is attached to a shaft 40 of a worm gear provided at the lower part of the slide portion 12. When the knob 41 is rotated, the shaft 40 of the worm gear can be rotated, and the whole including the hanger 11 is rotated to fix the overhanging bar 13 to the support leg 14.
- the arm 1 is connected by fixing to the legs of the hanger 11 (two in front and rear, and two in left and right in total) with screws.
- the laryngopharyngeal direct mirror of the present invention is a device that opens the patient's mouth at the time of surgery, can adjust the insertion depth of the laryngoscope body inserted into the oral cavity, and can stably hold the patient's larynx in a lifted state. Is preferred.
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Abstract
Provided is a direct laryngoscope with which it is possible to accurately adjust and stably maintain an insertion position of a laryngoscope body, and to maintain the size of the open mouth as desired. A direct laryngoscope attached to a hanger rotatably provided to a slide portion of an overhanging rod extending from support legs, wherein the direct laryngoscope is provided with: an arm threadably secured to the hanger; a laryngoscope body connected to the lower end of the arm, the laryngoscope body lifting the tongue, tongue base, and epiglottis by a downward warped convex shape; a mouth opener bracing that is rotatably attached by a pin to the arm; a mouth opener connected to the lower end of the mouth opener bracing; a pair of bite portions provided to the mouth opener, the pair of bite portions engaging the upper teeth of the patient; and an operation unit comprising an operating stem, a feed portion provided to the arm and in threadable engagement with the operating stem, a receiving portion provided to the mouth opener bracing, the receiving portion rotatably holding the lower end of the operating stem, and a handle for rotating the operating stem.
Description
本発明は、咽喉頭直達鏡に係り、より詳しくは、手術時に患者の口を開口でき、また、口腔に挿入される喉頭鏡本体の挿入深さが調節でき、さらに、舌や喉の奥にある喉頭蓋を持ち上げて安定して保持できる咽喉頭直達鏡に関する。
The present invention relates to a pharyngeal direct mirror, and more specifically, can open a patient's mouth during surgery, can adjust the insertion depth of the laryngoscope body inserted into the oral cavity, and is further placed behind the tongue and throat. The present invention relates to a laryngeal direct mirror that can lift and hold a certain epiglottis stably.
特許文献1には、レバー付きの舌圧子と、レバー付きの顎を押える口蓋へらからなり、患者の口腔に挿入されて、咽喉域を露出させる喉頭鏡が示されている。これによれば、レバーを手で操作することにより、わずかな労力で歯を毀損することなく、舌を持ち上げて口蓋を拡開することができる。
Patent Document 1 discloses a laryngoscope that includes a tongue depressor with a lever and a palatal spatula that presses the jaw with a lever and is inserted into a patient's oral cavity to expose the throat region. According to this, by operating the lever by hand, the tongue can be lifted and the palate can be expanded without damaging the teeth with little effort.
しかしながら、上記のような喉頭鏡は、単に口蓋を拡開するためのものであり、どこに喉頭鏡を位置させるかの調整や、位置調整した喉頭鏡を安定して保持することができない。また、上記の喉頭鏡は開いた口の大きさ、すなわち上顎と下顎の距離を開口させた長さで保持することができない。
However, the laryngoscope as described above is merely for expanding the palate, and it is impossible to adjust where the laryngoscope is positioned and to stably hold the adjusted laryngoscope. Further, the above laryngoscope cannot hold the size of the open mouth, that is, the length between the upper jaw and the lower jaw.
図9に示すように、患者は手術の際、麻酔されて、懸垂頭位(顔が上を向き、頭部が下がった)の状態にある。また、図8に示すように、咽頭(いんとう)26は、口腔25の奥から食道31の入口までをいい、上咽頭26a、中咽頭26b、下咽頭26cに区分され、咽頭26の下部から気管29に至る部位は、喉頭(こうとう)23と呼ばれ、喉頭23の奥に声帯32が存在する。例として咽頭下咽頭26cにできた腫瘍切除を行なう場合、気管29の入口にある喉頭蓋24が邪魔をして下咽頭26cが見えにくい。そのため、喉頭蓋24、舌22、舌根部22aを持ち上げる必要がある。また、手術の間、喉頭鏡を安定して保持する必要がある。さらに、手術の間は口が大きく広がった状態で保持されている必要がある。なお、咽喉(いんこう)は、咽頭26と喉頭23を指し、咽喉頭直達鏡は、この部分を手術するための装置とする。喉頭鏡本体は、喉頭蓋24、舌22、舌根部22aを持ち上げるための補助具とする。
As shown in FIG. 9, the patient is anesthetized during the operation and is in a suspended head position (the face is facing up and the head is lowered). In addition, as shown in FIG. 8, the pharynx (into) 26 extends from the back of the oral cavity 25 to the entrance of the esophagus 31 and is divided into an upper pharynx 26a, an oropharynx 26b, and a lower pharynx 26c. The part reaching 29 is called the larynx 23, and a vocal cord 32 exists behind the larynx 23. For example, when performing tumor resection on the hypopharyngeal pharynx 26c, the epiglottis 24 at the entrance of the trachea 29 obstructs the hypopharynx 26c. Therefore, it is necessary to lift the epiglottis 24, the tongue 22, and the tongue base 22a. In addition, it is necessary to hold the laryngoscope stably during the operation. Furthermore, it is necessary to hold the mouth in a greatly expanded state during the operation. The throat refers to the pharynx 26 and the larynx 23, and the laryngeal direct mirror is a device for operating this portion. The laryngoscope body is an auxiliary tool for lifting the epiglottis 24, tongue 22, and tongue base 22a.
本発明の目的は、喉頭鏡本体の挿入位置が正確に調整でき、また喉頭鏡本体を安定して保持でき、さらに開いた口の大きさを任意に保持できる咽喉頭直達鏡を提供することにある。
An object of the present invention is to provide a pharyngeal direct-view mirror that can accurately adjust the insertion position of the laryngoscope body, can stably hold the laryngoscope body, and can arbitrarily hold the size of the open mouth. is there.
本発明による咽喉頭直達鏡は、手術台に固定される支持脚から伸びる張り出し棒のスライド部に回動可能にハンガーが設けられ、該ハンガーに取り付けられる咽喉頭直達鏡であって、前記ハンガーにネジ固定されるアームと、前記アームの下端に連結され、下方向に凸の反り返った形状で、舌と舌根部と喉頭蓋を持ち上げる喉頭鏡本体と、前記アームにピンで回動可能に取り付けられる開口器押え金具と、前記開口器押え金具の下端に連結される開口器と、前記開口器に設けられ、患者の上歯に係合させる一対の噛み込み部と、オネジを備えた操作軸と、前記アームに設けられ前記操作軸と螺合するメネジを備えた送り部と、前記開口器押え金具に設けられ前記操作軸の下端を回動可能に保持する受け部と、前記操作軸を回転させるハンドルと、からなる操作部と、が備えられ、前記噛み込み部を患者の上歯に係合させた状態で、前記ハンドルを一方向に回転すると、前記アームと前記喉頭鏡本体が、前記ピンを中心に回動することを特徴とする。
The laryngopharyngeal direct mirror according to the present invention is a laryngeal direct mirror that is attached to the hanger and is provided with a hanger rotatably attached to a slide portion of an extension rod extending from a support leg fixed to an operating table. A screw-fixed arm, a laryngoscope body that is connected to the lower end of the arm and has a convexly warped downward shape and lifts the tongue, tongue base, and epiglottis, and an opening that is pivotally attached to the arm with a pin A presser fitting, an opener connected to a lower end of the pusher clamp, a pair of biting portions provided on the opener and engaged with a patient's upper teeth, and an operation shaft provided with a male screw, A feed portion provided on the arm and provided with a female screw threadably engaged with the operation shaft; a receiving portion provided on the opener presser fitting for rotatably holding a lower end of the operation shaft; and rotating the operation shaft. hand When the handle is rotated in one direction with the biting portion engaged with the upper teeth of the patient, the arm and the laryngoscope body It is characterized by rotating around the center.
前記開口器には、上部にフック付き調節レバーを有する枠体が設けられ、前記開口器押え金具には、前記フックが係止される複数の係止板が上下方向に設けられることを特徴とする。
The opening device is provided with a frame having an adjustment lever with a hook on the upper portion, and the opening device holding metal fitting is provided with a plurality of locking plates for locking the hook in the vertical direction. To do.
前記噛み込み部は、前記開口器の下部にスライド可能に嵌め込まれ、押えバネで押圧されていることを特徴とする。
The biting portion is slidably fitted into the lower portion of the opening device and is pressed by a presser spring.
本発明の咽喉頭直達鏡によれば、(a)操作部21のハンドル6を回すことによりアーム1と喉頭鏡本体2を、ピン9を中心に回動させることができる。(b)ピン9による回動は摩擦が小さく、喉頭鏡本体2をなめらかに挿入でき、深さの調節ができる。(c)喉頭鏡本体2を声帯近くまで挿入し、喉頭蓋、舌根部それに舌を良好に持ち上げることができる。(d)ハンドル6の操作軸6aと、これと螺合する送り部7、受け部8によって、喉頭鏡本体2の位置を安定に保持することができる。(e)喉頭鏡本体2で喉頭蓋を持ち上げることができるので、下咽頭の軟性内視鏡による観察や鉗子による手術が容易となる。(f)開口器4に一対の噛み込み部5を設けたので、開口器押え金具3と開口器4を安定して保持できる。
According to the throat larynx direct mirror of the present invention, (a) the arm 1 and the laryngoscope body 2 can be rotated around the pin 9 by turning the handle 6 of the operation unit 21. (B) The rotation by the pin 9 has little friction, and the laryngoscope body 2 can be inserted smoothly and the depth can be adjusted. (C) The laryngoscope body 2 can be inserted to the vicinity of the vocal cords, and the larynx, tongue base and tongue can be lifted well. (D) The position of the laryngoscope main body 2 can be stably held by the operation shaft 6a of the handle 6, the feed portion 7 and the receiving portion 8 that are screwed together. (E) Since the laryngoscope can be lifted by the laryngoscope body 2, observation of the hypopharynx with a flexible endoscope and surgery with forceps are facilitated. (F) Since the opening device 4 is provided with the pair of biting portions 5, the opening device pressing member 3 and the opening device 4 can be stably held.
開口器の上部にフック付きの調節レバーを有する枠体を設け、一方、開口器押え金具にフックが係止される複数の係止板を上下方向に設けたので、フックをいずれかの係止板に係止させることにより、開口器を開口器押え金具に対して上下方向に移動できる。これにより、患者の口を任意の大きさに開き保持することができる。
A frame having an adjustment lever with a hook is provided on the upper part of the opening device, and on the other hand, a plurality of locking plates are provided in the vertical direction to lock the hook to the opening device presser fitting. By engaging with the plate, the opening device can be moved in the vertical direction with respect to the opening device retainer. Thereby, the patient's mouth can be opened and held in an arbitrary size.
噛み込み部は、開口器の下部にスライド可能で、押えバネで押圧するようにしたので、噛み込み部をスライドさせた位置から容易には動けないようにできる。
The biting part can be slid to the lower part of the opening device and pressed by a presser spring, so that it cannot be easily moved from the position where the biting part is slid.
以下、図面を参照して、本発明による咽喉頭直達鏡を詳しく説明する。
Hereinafter, with reference to the drawings, the laryngeal direct mirror according to the present invention will be described in detail.
図1は、本発明による咽喉頭直達鏡100の斜視図(前方側)である。咽喉頭直達鏡100は、アーム1と、アーム1の下端に連結される喉頭鏡本体2を備える。喉頭鏡本体2は患者の口腔25に挿入され、患者の舌22と舌根部22aと喉頭蓋24を持ち上げる。喉頭鏡本体2は、下方向に凸の反り返った形状で、断面が半円形で、内側が鉗子をガイドする溝となっている。なお、反り返った形状を例えば円弧状にしてもよい。図1に示すように、アーム1には、ピン9で回動可能に開口器押え金具3が取り付けられ、開口器押え金具3の下端には、開口器4が連結される。ピン9は、アーム1の上にあって、下方に凸の形状の喉頭鏡本体2の曲率半径の中心付近に位置する。開口器4の下部には、患者の上歯30に係合させる一対の噛み込み部5、5が設けられる。噛み込み部5、5には3つの半円形の溝が設けてあり、患者の上歯30の位置に合わせて噛み込ませることができる。なお、アーム1は、この形状に限られるものではなく、L型、鉤型、半円型、弧型としてもよい。
FIG. 1 is a perspective view (front side) of a pharyngeal direct mirror 100 according to the present invention. The laryngoscope direct mirror 100 includes an arm 1 and a laryngoscope body 2 connected to the lower end of the arm 1. The laryngoscope body 2 is inserted into the oral cavity 25 of the patient and lifts the patient's tongue 22, tongue base 22a, and epiglottis 24. The laryngoscope main body 2 has a downwardly convex warped shape, a semicircular cross section, and a groove that guides forceps inside. Note that the warped shape may be an arc shape, for example. As shown in FIG. 1, an armor presser fitting 3 is attached to the arm 1 so as to be rotatable by a pin 9, and an aperturer 4 is connected to the lower end of the aperturer presser fitting 3. The pin 9 is on the arm 1 and is located near the center of the radius of curvature of the laryngoscope body 2 having a downwardly convex shape. A pair of biting portions 5 and 5 to be engaged with the patient's upper teeth 30 are provided below the opening device 4. The biting portions 5 and 5 are provided with three semicircular grooves and can be bitten in accordance with the position of the upper teeth 30 of the patient. The arm 1 is not limited to this shape, and may be L-shaped, saddle-shaped, semicircular, or arc-shaped.
操作部21は、オネジを有する操作軸6aと、アーム1に設けられ操作軸6aと螺合するメネジを有する送り部7と、開口器押え金具3に取り付けられ操作軸6aの下端が回動可能に保持される受け部8と、操作軸6aの上端に設けられ、操作軸6aを回転させるハンドル6と、から構成される。ハンドル6を回転させることにより、送り部7と受け部8の間隔を広げたり狭めたりできる。開口器押え金具3と開口器2は、下端が噛み込み部5で上歯30に固定され、上端がピン9を中心に回動するものの、前後方向への移動が不可となっているため、ハンドル6を回転させると、アーム1及びこれに連結される喉頭鏡本体2が前後動する。
The operation unit 21 includes an operation shaft 6a having a male screw, a feed unit 7 having a female screw provided on the arm 1 and screwed to the operation shaft 6a, and a lower end of the operation shaft 6a attached to the opening device presser bracket 3 so that the lower end of the operation shaft 6a can be rotated. And a handle 6 that is provided at the upper end of the operation shaft 6a and rotates the operation shaft 6a. By rotating the handle 6, the interval between the feeding portion 7 and the receiving portion 8 can be increased or decreased. Since the lower end of the opening device holder 3 and the opening device 2 are fixed to the upper teeth 30 by the biting portion 5 and the upper end rotates around the pin 9, it is impossible to move in the front-rear direction. When the handle 6 is rotated, the arm 1 and the laryngoscope body 2 connected thereto move back and forth.
図2は、本発明による咽喉頭直達鏡100の背面図である。開口器4の下部には、一対の噛み込み部5、5が嵌め込まれており、左右方向にスライドさせることができる。調節レバー19は、これを操作することにより、開口器4を上下方向にスライドさせることができる。調節レバー19で開口器4の上下位置を調節し、噛み込み部5を患者の上歯の位置に合わせることができる。噛み込み部5、5を患者の上歯の位置に固定し、調節レバー19で開口器4の位置を調節しすることにより、患者の口を任意の大きさに開いた状態で保持することができる。
FIG. 2 is a rear view of the laryngeal direct mirror 100 according to the present invention. A pair of biting portions 5 and 5 are fitted in the lower portion of the opening device 4 and can be slid in the left-right direction. The adjustment lever 19 can slide the opening device 4 in the vertical direction by operating the adjustment lever 19. The vertical position of the opening device 4 can be adjusted by the adjustment lever 19 so that the biting portion 5 can be adjusted to the position of the patient's upper teeth. By fixing the biting portions 5 and 5 at the position of the upper teeth of the patient and adjusting the position of the opening device 4 with the adjustment lever 19, the patient's mouth can be held open to an arbitrary size. it can.
図3は、本発明による咽喉頭直達鏡100の斜視図(後方側)である。送り部7は、操作軸6aのオネジに螺合するメネジのタップであり、アーム1の側面に取り付けた。これに限らず、送り部7をアーム1にメネジの穿設で形成してもよい。受け部8は、タップに孔が形成されており、操作軸6aの下端が抜けないようにかつ回動可能に保持される。
FIG. 3 is a perspective view (rear side) of the laryngeal direct mirror 100 according to the present invention. The feed portion 7 is a female screw tap that is screwed into the male screw of the operation shaft 6 a and is attached to the side surface of the arm 1. However, the feed portion 7 may be formed in the arm 1 by drilling a female screw. The receiving portion 8 is formed with a hole in the tap, and is held so as to be rotatable so that the lower end of the operation shaft 6a does not come off.
図4は、図3の調節レバー19の詳細構造図である。開口器4には、上下にスライド可能な枠体16が設けられる。枠体16には、調節レバー19が設けられ、その先端にはフック18が設けられる。一方、開口器押え金具3には、フック18が係止される複数の係止板17が上下方向に設けられる。符号Aで示すように、跳ね上げバネ20に抗して調節レバー19を押下すると、符号Bで示すように、フック18が枠体16の孔から外れる。この状態で、符号Cで示すように調節レバー19及び枠体16を滑らせて、開口器4を上下にスライドさせる。
FIG. 4 is a detailed structural diagram of the adjusting lever 19 of FIG. The opening device 4 is provided with a frame 16 that can slide up and down. The frame body 16 is provided with an adjustment lever 19, and a hook 18 is provided at the tip thereof. On the other hand, a plurality of locking plates 17 on which the hooks 18 are locked are provided in the opening device pressing member 3 in the vertical direction. As indicated by reference numeral A, when the adjustment lever 19 is pressed against the spring 20, the hook 18 is removed from the hole of the frame body 16 as indicated by reference numeral B. In this state, the adjustment lever 19 and the frame body 16 are slid as indicated by reference numeral C, and the opening device 4 is slid up and down.
図5は、図3の噛み込み部5、5に押えバネ10を装着した場合の図である。一対の噛み込み部5、5が、開口器4の枠にスライド可能に嵌め込まれており、噛み込み部5、5の一側が、押えバネ10で押圧されている。これにより噛み込み部5、5が容易にスライドしないよう保持できる。
FIG. 5 is a view when the presser spring 10 is attached to the biting portions 5 and 5 of FIG. The pair of biting portions 5 and 5 are slidably fitted into the frame of the opening device 4, and one side of the biting portions 5 and 5 is pressed by the presser spring 10. Accordingly, the biting portions 5 and 5 can be held so as not to slide easily.
図6は、喉頭鏡本体2の他の実施例を示す斜視図である。図1では喉頭鏡本体2は、断面が半円形のものとしたが、ここでは、断面が幅広で上面が平坦な板状とした。両側端は下方向に少し折り曲げている。これによれば、高さがないので、開口器4の正面側領域の広い空間を確保でき、鉗子やファイバーなどを開口器4に挿入しやすい。また、断面が幅広で上面が平坦なので、舌22との接触面積が増え、これを安定して持ち上げることができる。
FIG. 6 is a perspective view showing another embodiment of the laryngoscope main body 2. In FIG. 1, the laryngoscope main body 2 has a semicircular cross section, but here, it has a plate shape with a wide cross section and a flat top surface. Both ends are bent slightly downward. According to this, since there is no height, a wide space in the front side region of the opening device 4 can be secured, and forceps, fibers, and the like can be easily inserted into the opening device 4. Moreover, since the cross section is wide and the upper surface is flat, the contact area with the tongue 22 increases, and this can be lifted stably.
図7は、本発明による咽喉頭直達鏡100の動作説明図である。(A)は、喉頭鏡本体2の口腔への挿入が浅い場合を示す。(B)は、ハンドルを回して喉頭鏡本体を喉頭蓋24の付近まで深く挿入した場合を示す。(A)の状態で、ハンドル6を一方に回すと、送り部7と受け部8の間隔が狭まって、(B)に示すように、喉頭鏡本体2を喉頭蓋24の付近まで深く挿入できる。図には示さないが、喉頭鏡本体2を声帯32付近まで挿入できる。逆に(B)の状態で、ハンドル6を他方に回すと、送り部7と受け部8の間隔が広がって、(A)に示すように、喉頭鏡本体2を喉頭蓋24又は声帯32から離すことができる。ここで、アーム1は、ハンガー11にネジで固定されているものとする。また、ハンガー11は、ウォームギアの軸40で回動可能に取り付けられているものとする。ウォームギアの軸40は、ノブ41(図9参照)を回転させると回動し、ハンガー11を含む全体を回動させる時に使用する。ここでは、張り出し棒13が支持脚14に固定されていないとして図示した。これによれば、開口器4は、患者の上歯30に固定されているので、ハンドル6を回すことで、図7(A)や(B)に示す状態にできる。
FIG. 7 is an operation explanatory diagram of the pharyngeal direct mirror 100 according to the present invention. (A) shows the case where the insertion of the laryngoscope body 2 into the oral cavity is shallow. (B) shows the case where the laryngoscope body is inserted deeply into the vicinity of the epiglottis 24 by turning the handle. When the handle 6 is turned to one side in the state of (A), the distance between the feeding part 7 and the receiving part 8 is narrowed, and the laryngoscope body 2 can be inserted deeply into the vicinity of the epiglottis 24 as shown in (B). Although not shown in the drawing, the laryngoscope body 2 can be inserted up to the vicinity of the vocal cord 32. Conversely, when the handle 6 is turned to the other side in the state of (B), the distance between the feeding part 7 and the receiving part 8 is widened, and the laryngoscope body 2 is separated from the epiglottis 24 or the vocal cord 32 as shown in (A). be able to. Here, it is assumed that the arm 1 is fixed to the hanger 11 with a screw. Moreover, the hanger 11 shall be attached so that rotation with the axis | shaft 40 of a worm gear is possible. The shaft 40 of the worm gear rotates when the knob 41 (see FIG. 9) is rotated, and is used when the whole including the hanger 11 is rotated. Here, the overhang bar 13 is illustrated as not being fixed to the support leg 14. According to this, since the opening device 4 is being fixed to the patient's upper tooth 30, it can be made into the state shown to FIG. 7 (A) and (B) by turning the handle | steering-wheel 6. FIG.
図8は、口腔25と咽頭26と声帯32の構造を示す図である。鼻27から入った空気は、鼻腔28を通り、咽頭26と声帯32を通過して気管29に入る。口に入った食べ物は、口腔25から、咽頭26を通過して食道31に入る。ここで、喉頭蓋24は、食べ物を飲み込む際は、食べ物が気管29に入らないようにしている。咽頭26は、上咽頭26aと、中咽頭26bと、下咽頭26cに区分される。下咽頭26cの手術等では、喉頭蓋24と、舌根部22aと、舌22を持ち上げる必要がある。
FIG. 8 shows the structure of the oral cavity 25, the pharynx 26, and the vocal cords 32. Air entering from the nose 27 passes through the nasal cavity 28, passes through the pharynx 26 and vocal cords 32, and enters the trachea 29. The food that has entered the mouth enters the esophagus 31 from the oral cavity 25 through the pharynx 26. Here, the epiglottis 24 prevents food from entering the trachea 29 when the food is swallowed. The pharynx 26 is divided into an upper pharynx 26a, an oropharynx 26b, and a hypopharynx 26c. In the operation or the like of the hypopharynx 26c, it is necessary to lift the epiglottis 24, the tongue base 22a, and the tongue 22.
図9は、患者の手術状態を示す図である。患者は、頭部が垂れて懸垂頭位の状態にある。支持脚14は手術台に固定され、張り出し棒13が支持脚14から斜め上方に伸びる。張り出し棒13の先端には、スライド部12が設けられる。ハンガー11は、スライド部12の下部に設けられたウォームギアの軸40に取り付けられる。ノブ41を回転すると、ウォームギアの軸40が回動でき、ハンガー11を含む全体を回動させて、張り出し棒13を支持脚14に固定する。アーム1は、ハンガー11の脚(前後に2本、左右に2本の計4本)にネジで固定することで連結される。
FIG. 9 is a diagram showing a patient's surgical condition. The patient is in a suspended position with the head hanging. The support leg 14 is fixed to the operating table, and the overhang bar 13 extends obliquely upward from the support leg 14. A slide portion 12 is provided at the tip of the overhang bar 13. The hanger 11 is attached to a shaft 40 of a worm gear provided at the lower part of the slide portion 12. When the knob 41 is rotated, the shaft 40 of the worm gear can be rotated, and the whole including the hanger 11 is rotated to fix the overhanging bar 13 to the support leg 14. The arm 1 is connected by fixing to the legs of the hanger 11 (two in front and rear, and two in left and right in total) with screws.
本発明の咽喉頭直達鏡は、手術時に患者の口を開口させ、口腔に挿入される喉頭鏡本体の挿入深さ調節ができ、かつ患者の喉頭蓋を持ち上げた状態で安定して保持できる装置として好適である。
The laryngopharyngeal direct mirror of the present invention is a device that opens the patient's mouth at the time of surgery, can adjust the insertion depth of the laryngoscope body inserted into the oral cavity, and can stably hold the patient's larynx in a lifted state. Is preferred.
1 アーム
2 喉頭鏡本体
3 開口器押え金具
4 開口器
5 噛み込み部
6 ハンドル
6a 操作軸
7 送り部
8 受け部
9 ピン
10 押えバネ
11 ハンガー
12 スライド部
13 張り出し棒
14 支持脚
15 鉗子
16 枠体
17 係止板
18 フック
19 調節レバー
20 跳ね上げバネ
21 操作部
22 舌
22a 舌根部
23 喉頭
24 喉頭蓋
25 口腔
26 咽頭
26a 上咽頭
26b 中咽頭
26c 下咽頭
27 鼻
28 鼻腔
29 気管
30 患者の上歯
31 食道
32 声帯
40 ウォームギアの軸
41 ノブ
100 咽喉頭直達鏡 DESCRIPTION OFSYMBOLS 1 Arm 2 Laryngoscope body 3 Opening device presser fitting 4 Opening device 5 Biting part 6 Handle 6a Operation shaft 7 Feeding part 8 Receiving part 9 Pin 10 Pressing spring 11 Hanger 12 Slide part 13 Overhang bar 14 Support leg 15 Forceps 16 Frame 17 Locking plate 18 Hook 19 Adjusting lever 20 Bounce spring 21 Operation part 22 Tongue 22a Tongue root 23 Larynx 24 Larynx 25 Oral 26 Pharynx 26a Nasopharynx 26b Oropharynx 26c Hyopharynx 27 Nasal 28 Nasal cavity 29 Trachea 30 Patient upper teeth 31 Esophagus 32 vocal cords 40 worm gear shaft 41 knob 100 throat larynx direct mirror
2 喉頭鏡本体
3 開口器押え金具
4 開口器
5 噛み込み部
6 ハンドル
6a 操作軸
7 送り部
8 受け部
9 ピン
10 押えバネ
11 ハンガー
12 スライド部
13 張り出し棒
14 支持脚
15 鉗子
16 枠体
17 係止板
18 フック
19 調節レバー
20 跳ね上げバネ
21 操作部
22 舌
22a 舌根部
23 喉頭
24 喉頭蓋
25 口腔
26 咽頭
26a 上咽頭
26b 中咽頭
26c 下咽頭
27 鼻
28 鼻腔
29 気管
30 患者の上歯
31 食道
32 声帯
40 ウォームギアの軸
41 ノブ
100 咽喉頭直達鏡 DESCRIPTION OF
Claims (3)
- 手術台に固定される支持脚から伸びる張り出し棒のスライド部に回動可能にハンガーが設けられ、該ハンガーに取り付けられる咽喉頭直達鏡であって、
前記ハンガーにネジ固定されるアームと、
前記アームの下端に連結され、下方向に凸の反り返った形状で、舌と舌根部と喉頭蓋を持ち上げる喉頭鏡本体と、
前記アームにピンで回動可能に取り付けられる開口器押え金具と、
前記開口器押え金具の下端に連結される開口器と、
前記開口器に設けられ、患者の上歯に係合させる一対の噛み込み部と、
オネジを備えた操作軸と、前記アームに設けられ前記操作軸と螺合するメネジを備えた送り部と、前記開口器押え金具に設けられ前記操作軸の下端を回動可能に保持する受け部と、前記操作軸を回転させるハンドルと、からなる操作部と、が備えられ、
前記噛み込み部を患者の上歯に係合させた状態で、前記ハンドルを一方向に回転すると、前記アームと前記喉頭鏡本体が、前記ピンを中心に回動することを特徴とする咽喉頭直達鏡。
A hangar is provided on the slide part of the overhanging rod extending from the support leg fixed to the operating table so that the hanger can be rotated,
An arm screwed to the hanger;
A laryngoscope body that is connected to the lower end of the arm and has a downwardly convex warped shape, lifting the tongue, tongue base, and epiglottis;
An opening retainer fitting that is pivotally attached to the arm with a pin;
An opener connected to the lower end of the opener retainer;
A pair of biting portions provided in the opening device and engaged with the upper teeth of the patient;
An operation shaft provided with a male screw, a feed portion provided with a female screw that is provided on the arm and screwed with the operation shaft, and a receiving portion that is provided on the opening device pressing member and rotatably holds the lower end of the operation shaft. And an operation unit comprising a handle for rotating the operation shaft,
When the handle is rotated in one direction with the biting portion engaged with the patient's upper teeth, the arm and the laryngoscope body rotate about the pin. Direct mirror.
- 前記開口器には、上部にフック付き調節レバーを有する枠体が設けられ、前記開口器押え金具には、前記フックが係止される複数の係止板が上下方向に設けられることを特徴とする請求項1に記載の咽喉頭直達鏡。
The opening device is provided with a frame having an adjustment lever with a hook on the upper portion, and the opening device holding metal fitting is provided with a plurality of locking plates for locking the hook in the vertical direction. The throat larynx direct mirror according to claim 1.
- 前記噛み込み部は、前記開口器の下部にスライド可能に嵌め込まれ、押えバネで押圧されていることを特徴とする請求項1に記載の咽喉頭直達鏡。 The throat laryngeal direct mirror according to claim 1, wherein the biting portion is slidably fitted into a lower portion of the opening device and pressed by a presser spring.
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JP2015010170A JP5855776B1 (en) | 2015-01-22 | 2015-01-22 | Throat larynx mirror |
JP2015-010170 | 2015-01-22 |
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CN113180850A (en) * | 2021-05-15 | 2021-07-30 | 王丹 | Mouth gag for severe patient |
Also Published As
Publication number | Publication date |
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JP5855776B1 (en) | 2016-02-09 |
TW201635971A (en) | 2016-10-16 |
JP2016131822A (en) | 2016-07-25 |
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