JP2002253561A - Forceps - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a forceps used by any operator at favorable operability and having a stable operability. SOLUTION: A handle part 30 comprises a fixed operation handle 40 integrated with a case 36 and a movable operation handle 60 relatively movable to the fixed operation handle 40. The movable operation handle 60 comprises two members, a finger engaging ring 62 having a ring part 62a and a turning part 64 to which the finger engaging ring 62 is detachably connected. An angle formed by the finger engaging ring 62 and the turning part 64 is adjustable so that the moving locus of the ring part 62a of the movable operation handle 60 relatively to a ring part 40a of the fixed operation handle 40 becomes adjustable.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to forceps such as grasping forceps and peeling forceps used for endoscopy, endoscopic surgery and the like, and more particularly to improvement of a handle portion thereof.

[0002]

2. Description of the Related Art Conventionally, for example, in endoscopic surgery, forceps have been used to perform operations such as grasping, peeling, and resection of tissue in place of a surgeon's hand. Generally, a forceps is an elongated shaft portion to be inserted into a body, a distal end operating portion having a link mechanism at a distal end portion of the shaft portion, and a handle portion at a distal end portion of the shaft portion for operating the distal end operating portion. By operating the handle portion, the rod in the shaft portion is reciprocated to operate the distal end operating portion. Depending on the use during the operation, there are many types of forceps with different shapes of the distal working portion, for example, grasping forceps for grasping tissue,
There is a peeling forceps for performing the peeling. Grasping forceps, for example, in the case of cholecystectomy, inserted from a cannula, grasping the bottom of the gallbladder, used for work such as grasping or pulling the liver to the ventral head, peeling forceps are used for the gallbladder duct and It is used for exfoliating or exposing the gallbladder artery.

[0003] As described above, the required performance of the forceps is different because the use of the forceps differs depending on the type. For example, what is required for a grasping forceps, a strong holding force is obtained and a constant holding force is obtained, and it is required to sufficiently consider tissue damageability.What is required for a peeling forceps is that rotation of the forceps shaft is easy. What is required is that it can be performed and that the range of the parallel opening and closing operation is small. In Japanese Patent Application Laid-Open No. 5-285149,
A gripping forceps is disclosed in which an operating portion is provided with a lock member and an engagement member that engages with the lock member in consideration of tissue damageability, and the engagement member is removable to improve durability. Is being planned. Also, Japanese Patent Application Laid-Open No. 6-31
Japanese Patent Application Publication No. 1986 discloses a forceps in which a mechanism portion of a distal jaw portion that opens and closes during surgery is covered with a cover to prevent blood and body fluid from sticking to the mechanism portion.

[0004]

As described above, although the conventional forceps have been developed from the viewpoint of improving the performance thereof, they have been developed from the viewpoint of operability for individuals during surgery. There is a current situation that is not done much. Not surprisingly, the size of the surgeon's hand varies widely. Therefore, even with the same forceps, the degree of ease of use differs depending on the operator. In long-term surgery, if the forceps are not adapted to the hands of the operator, the operator will be extremely burdened and may possibly interfere with safe operations. In addition, in endoscopic surgery in which surgery is performed while looking at the monitor, forceps are inserted through a cannula, so it is possible that an unreasonable posture or angle may be taken when treating the affected part, making it difficult to use forceps In some cases.

[0005] The present invention has been made in view of the above problems,
An object of the present invention is to provide a forceps capable of improving operability for any operator and having stable operability.

[0006]

SUMMARY OF THE INVENTION In order to achieve the above-mentioned object, the present invention provides a shaft, a tip operating section at a tip of the shaft, and a tip operating section at a distal end of the shaft. A handle portion for operating the handle portion, further comprising a handle portion, each of which has an operating portion to enable relative movement, and has two handles for actuating the distal end working portion by the relative movement. The relative movement locus of the operating portion of the other handle with respect to the operating portion of the handle can be adjusted. By adjusting the relative movement trajectory of the operating parts of the two handles according to the size of the operator's hand operating the operating part or the posture of the operator at the time of the operation, always a state of good operability Can be operated with.

According to a second aspect of the present invention, in the first aspect, the handle portion further includes a case, and the one handle is fixed to the case, while the other handle is fixed to the case. The handle is relatively movable in the direction of approaching and separating from one handle, and the relative movement trajectory of the operating portion of the other handle is adjustable in the direction of approaching and separating. By adjusting the operating part of the other handle so that it approaches or separates from the operating part of one handle, the distance between the two operating parts can be adjusted to the size of the surgeon's hand. It can be adjusted together or according to the posture of the operator during operation.

According to a third aspect of the present invention, in the second aspect, the other handle is pivotally mounted on a case and is pivotally mounted on the case to operate the distal end operating section; Comprising an operation member having the operation unit,
The operation member is characterized in that it is detachably connected to the rotating part and is connected to the rotating part so as to be adjustable in angle.
After removing the operating member provided with the operating portion from the rotating portion, adjusting the angle formed with the rotating portion, and then connecting the operating member to the rotating portion again, as a result, the other handle is operated. The relative motion trajectory of the section can be adjusted in the approaching / separating direction.

The invention described in claim 4 is the first to third aspects of the present invention.
Any one of the above, further comprising a movement restricting means for restricting the relative movement of the two handles in only one direction. When adjusting the operating part of the other handle, the relative movement of the two handles is restricted by the movement restricting means, so that the relative movement in an unintended direction occurs carelessly and the tip operating part is operated. Can be prevented. Therefore, it is possible to adjust the operation unit while maintaining the state of the distal end operation unit or allowing only the relative movement in the other direction.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. The following embodiments do not limit the present invention.

FIG. 1 is a diagram showing a schematic overall configuration of a forceps 1 according to the present invention. The forceps 1 includes a shaft portion 10 inserted into a body through a cannula, and a shaft portion 10.
And a handle portion 30 at the distal end of the shaft portion 10 for operating the distal end operating portion 20.

As shown in FIG. 2, the shaft portion 10 includes a sheath 13 mainly formed of a hollow tube made of a metal material such as stainless steel, a rod 12 penetrating the sheath 13 so as to reciprocate, and a sheath 13. And a coating tube 11 made of an insulating material for coating the outside of the tube.

The distal end operating section 20 has a link mechanism 21 and a pair of jaws 22 connected to the link mechanism 21. The pair of jaws 22 are provided at the distal end of the sheath 13 with the support pins 1.
4 rotatably supported. Link mechanism 21
Is connected to one end of the rod 12, and in response to the rod 12 reciprocating in the shaft portion 10, the link mechanism 21 operates to open and close the pair of jaws 22.

The handle portion 30 mainly includes the right case 3
2 and a left case 34, and a right case 3
2 and a movable operation handle 60 which is relatively movable with respect to the fixed operation handle 40. Movable operating handle 60
Is rotatably attached to the case 36, and is relatively movable in the direction of approaching / separating from the fixed operation handle 40 in a range of a cutout portion 32c formed in the lower edge of the right case 32. ing.

As shown in FIG. 4, the left case 34 includes
The cover 80 is rotatably mounted on a shaft.
Is lightly locked at a position covering the notch 34a formed in the left case 34. That is, the cover 80 is formed with a knob portion 80a, and the knob portion 80a is lightly locked to the first locking portion 32a formed on the right case 32. Also, by removing the knob portion 80a from the first locking portion 32a and rotating the cover 80, the cover 80 is lightly locked to the second locking portion 32b similarly formed on the right case 32,
The notch 34a of the left case 34 can be exposed.

The fixed operation handle 40 is formed with a ring portion 40a which is an operation portion for hooking an operator's finger. On the other hand, the movable operation handle 60 is
And a rotating part 64 that is rotatably mounted on the right case 32 and to which the finger ring 62 is detachably connected. As shown in FIG. 5 and FIG. 6, the finger hanging ring 62 has a ring portion 62 a as an operation portion for hanging the operator's finger, and a circle protruding laterally at an end opposite to the ring portion 62 a. A convex portion 62b is formed, and a gear is formed on the outer peripheral surface of the circular convex portion 62b. Also,
The finger hanging ring 62 is provided with a center hole 62c passing through the center of the circular convex portion 62b.

The rotating portion 64 has a circular concave portion 64a formed at the center thereof, and the inner peripheral surface of the circular concave portion 64a can mesh with the gear of the circular convex portion 62b. Gear is formed. Further, a center hole 64c passing through the center of the circular concave portion 64a is formed in the rotating portion 64. A pin 66 passes through the center hole 62c of the finger ring 62 and the center hole 64c of the rotating part 64, and one end of the pin 66 is screwed and fixed to the right case 32. The circular convex portion 62b of the finger hanging ring 62 fits into the circular concave portion 64a of the rotating portion 64, and the gears mesh with each other, whereby the rotation of the finger hanging ring 62 around the center hole 62c is performed. , To the rotating portion 64. Further, one end of a link 68 is connected to the rotating portion 64, and the other end of the link 68 is connected to the rod 12. The rod 12 is reciprocated via the link 68 to move the distal end operating portion 20. Can be activated. The connection between the finger ring 62 and the rotating part 64 is not limited to the engagement by the gear as shown in this embodiment.
For example, the pin and the disk may be engaged with each other using a plurality of holes formed on the disk, or may be formed using an appropriate frictional force.

The length of the pin 66 is set to be greater than the thickness of the finger ring 62 and the rotating portion 64, and the finger ring 62 is slidable along the axis of the pin 66. The flange 66a at the other end of the pin 66 interferes with the circular convex portion 62b of the finger ring 62, and the sliding limit of the finger ring 62 is reached.
Is prevented from coming off. However, in the state of FIG. 5, sliding of the finger hanging ring 62 by the cover 80 is prohibited. On the other hand, the rotating portion 64 always has the pin 66
Sliding along the axis is prohibited.

As shown in FIG. 3, a movement restricting means is provided below the front end of the case 36. The movement restricting means includes a ratchet release switch 50 and a ratchet 52.
And a lock 53 integrated with the rotating portion 64. The ratchet release switch 50 is connected to the case 36
Is provided slidably in the front-rear direction with respect to the inner side of the case 36 of the ratchet release switch 50.
A pressing portion 50a is formed. A ratchet 52 is rotatably mounted on the right case 32 so that one arm 52 a of the ratchet 52 can engage with the pressing portion 50 a of the ratchet release switch 50.
One end of a spring 54 disposed in the case 36 is in contact with the other arm 52 b of the ratchet 52, and the ratchet 5
Reference numeral 2 denotes a direction in which the ratchet teeth 52c formed on the other arm of the ratchet 52 mesh with the ratchet teeth 53a formed on the lock 53 at all times so as to rotate rightward in FIG. Has been urged to. Thus, the rotation of the lock 53, that is, the rotation portion 64 in the clockwise direction in FIG. 3 is always allowed, and the rotation in the counterclockwise direction is restricted. Further, by sliding the ratchet release switch 50, the ratchet 52 is rotated leftward by the pressing portion 50a, and the engagement between the ratchet teeth 52c and the ratchet teeth 53a of the ratchet 52 is released. The rotation restriction can be released.

An operation knob 70 connected to the shaft 10 is rotatably attached to the front end of the handle 30 so as to rotate the shaft 10 and the tip operating unit 20 around the shaft axis. ing. With this operation knob 70, it is possible to grasp and peel tissue in various directions around the shaft axis direction.

A terminal 71 is provided on the upper portion of the handle portion 30 so as to protrude rearward.
When the terminal 71 is electrically connected to the terminal 71 from an external power supply (not shown), a current flows through the body tissue gripped and peeled off by the distal end operating portion 20 to perform hemostasis and the like. It has become.

In the forceps 1 configured as described above, the coupling angle between the finger ring 62 and the rotating portion 64 is variable, so that the surgeon can move his or her finger to an adaptive position where it is easy to operate before surgery. The hanging ring 62 can be adjusted. In order to adjust, the knob 80a of the cover 80 is detached from the first locking portion 32a, and the cover 80 is rotated to lock the knob 80a to the second locking portion 32b.
As shown in FIG. 7, the finger hanging ring 62 is slidable along the axis of the pin 66, so that the finger hanging ring 62 is slid so that the circular convex portion 62b is taken out from the circular concave portion 64a. The connection between the hanging ring 62 and the rotating portion 64 is temporarily released. As a result, the finger ring 62 is
, The finger ring 62 is rotated to move it to an appropriate position with respect to the fixed operation handle 40. Next, the circular convex portion 62b is inserted into the circular concave portion 64a at an appropriate position, and the two are engaged with each other. Then, the cover 80 is rotated in the opposite direction, and the knob portion 80a is moved to the first engaging position. When locked to the stop portion 32 a, the finger hook ring 62 cannot slide along the axis of the pin 66, and does not come off the rotating portion 64. Thus, the fixed operation handle 40
Ring portion 6 of finger ring 62 with respect to ring portion 40a of
By adjusting the position of 2a in the direction in which the movable operation handle 60 approaches and separates from the fixed operation handle 40,
Allows the surgeon to adapt to his own hands.

Thereafter, the shaft section 10 and the tip operating section 2
0 is inserted into the body via a cannula to perform operations such as grasping tissue. That is, the ring portion 40a of the fixed operation handle 40 and the finger ring 62 of the movable operation handle 60
The operator's finger is hung on each of the ring portions 62a, and the finger ring 62 is rotated toward the fixed operation handle 40, whereby the rotation of the finger ring 62 is transmitted to the rotation portion 64, The rotating portion 64 pulls the link 68, the rod 12 moves within the shaft portion 10, the pair of jaws 22 are closed, and operations such as grasping tissue can be performed. The operator can obtain a stable operation feeling during the operation because the movable operation handle 60 of the forceps 1 is adjusted to his / her preference. By returning the cover 80 to the position covering the notch 34a, the rotating portion 64 of the movable operation handle 60 and the finger ring 62 are not inadvertently separated during use, that is, during surgery. With the rotation of the rotation part 64,
The lock 53 moves while the ratchet teeth 53 a formed on the lock 53 mesh with the ratchet teeth 52 c of the ratchet 52. In this way, the rotation of the rotating portion 64 in the return direction is restricted. As described above, since the return of the rotating portion 64 is prevented, the movable operation handle 60 can be adjusted even during the operation while holding the affected part. That is, while grasping the tissue, the posture of the handle 30
You may want to change the way you hold your phone. In such a case, the cover 80 is rotated in the same manner as described above, and the finger ring 62 is slid along the axis of the pin 66 to rotate the cover 6.
4 by removing the circular convex portion 62b from the circular concave portion 64a,
After moving the finger hanging ring 62 to a desired angle, the circular convex portion 62b of the finger hanging ring 62 is
Then, the cover 80 is returned to the original position, so that the position of the ring portion 62a of the finger hook ring 62 with respect to the ring portion 40a of the fixed operation handle 40 can be adjusted.
Is adjusted in the direction of contact and separation with respect to the fixed operation handle 40, so that the operator can adapt to the posture during the operation. Even if the operator is in an unreasonable posture, by immediately changing the position of the link portion 62a of the finger hook ring 62, it is possible to avoid a situation in which the operator assumes an unreasonable posture. At this time, since the rotation of the rotating portion 64 in the direction in which the grip is released is prevented by the ratchet 52, the grip by the jaw 22 can be maintained. When the user wants to release the grip, the ratchet release switch 50 is operated to separate the ratchet teeth 52c of the ratchet 52 from the ratchet teeth 53a of the lock 53, so that the rotation unit 64 rotates in the direction to release the grip. To be able to move.

[0024]

As described above, according to the present invention, the operating portions of the two handles are controlled according to the size of the operator's hand operating the operating portion or the posture of the operator at the time of the operation. By adjusting the relative movement trajectory, it is possible to arbitrarily adjust the operating dimensions of each operator, so there is no need to prepare different products for each operator, A single product can handle it. In this way, it is possible to reduce time and effort for managing products / products, and to provide products / products at low cost.

[Brief description of the drawings]

FIG. 1 is an overall perspective view of a forceps according to an embodiment of the present invention.

FIG. 2 is an enlarged view of a distal end working unit.

FIG. 3 is an enlarged view of a movement restricting unit.

FIG. 4 is an exploded perspective view of a handle portion.

FIG. 5 is a sectional view of a movable operation handle.

FIG. 6 is an exploded perspective view of a movable operation handle.

FIG. 7 is a sectional view of the movable operation handle at the time of adjustment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Shaft part 20 Front-end operation part 30 Handle part 36 Case 40 Fixed operation handle 40a Ring part (operation part) 50 Ratchet release switch 52 Ratchet 53 Lock 60 Movable operation handle 62a Ring part (operation part) 64 Rotating part

Claims (4)

[Claims] 1. A shaft, a distal end operating portion at a distal end of the shaft portion, and a handle portion at a distal end of the shaft portion for operating the distal end operating portion. A forceps having an operation unit and capable of performing relative movement, and having two handles for operating the distal end operation unit by the relative movement; adjusting a relative movement trajectory of the operation unit of the other handle with respect to the operation unit of the other handle; A forceps characterized by being made possible. 2. The handle portion further includes a case, wherein the one handle is fixed to the case, and the other handle is moved relative to the one handle in a direction of moving toward and away from the one handle. 2. The forceps according to claim 1, wherein the relative movement trajectory of the operating portion of the other handle is adjustable in the direction of approach and separation. 3. The operating member according to claim 1, wherein the other handle comprises a rotating portion pivotally mounted on a case, the rotating portion actuating the distal end operating portion, and an operating member having the operating portion. The forceps according to claim 2, characterized in that the forceps are detachably connected to the rotating part and are adjustable so as to adjust an angle between the rotating part and the rotating part. 4. The forceps according to claim 1, further comprising a movement restricting means for restricting a relative movement of the two handles in only one direction.