JP2003010192A - Surgical manipulating handle disassembly structure - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical manipulating handle disassembly structure capable of simply disposing metal-made parts and plastic parts according to the types after use. SOLUTION: A push bar 126 is disposed movably in the longitudinal direction in a grip case 124, a rotary piece 130 is disposed in the tip opening of the grip case 124, and a return spring 132 is interposed between the internal step part of the rotary piece 130 and the push bar 126 to thereby energize the push bar 126 backward. The rotary piece 130 is provided with a base 130a disposed in the interior of the grip case 124, a screw part 130c disposed outside the grip case 124, and a fragile part 130e formed between the base 130a and the screw part 130c. The screw part 130c is twisted to the base part 130a, whereby the rotary piece 130 can be cut at the fragile part 130e, and the return spring 132 can be taken out of the broken rotary piece 130.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a disassembled structure of a surgical operation handle for use by a surgical instrument used in surgical treatment and operated by an operator.

[0002]

2. Description of the Related Art For example, in endoscopic surgery, a small incision is made in the abdomen, and a medical instrument such as an elongated tube or a cannula for guiding the inside and outside the body is inserted into the incision, and a surgical instrument is inserted through them. The surgical instrument is inserted, and for example, a clip is attached to the trachea, blood vessels, ducts, and other body tissues in the body, or cutting and suturing are performed.

There are two types of surgical instruments of this type: disposable and reusable reuse. In the former disposable, after being used for one patient, it is discarded without being reused. There is a need.

[0004]

However, the conventional disposable surgical instrument as described above does not have a structure in which the metal parts and the plastic parts are separated and discarded, and therefore the surgical instrument is used. However, there is a problem that it takes a lot of time and effort to separate the metal parts from the above, and the current situation is that the metal parts are almost integrated and discarded. Therefore, there is a problem in that the disposal cost such as incineration is increased as it is integrated, which increases the processing cost.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and an object thereof is to provide a surgical operation handle disassembling structure which can be easily sorted after use.

[0006]

In order to achieve the above-mentioned object, the invention according to claim 1 is such that a push bar is movably arranged in the grip case in the front-rear direction and movably attached to the grip case. In the surgical operation handle in which the push bar is moved forward by operating the trigger, the tubular body is disposed in the tip opening of the grip case, and the return spring inserted between the tubular body and the push bar is used. The push bar is biased rearward, and the tubular body is formed between the base portion arranged inside the grip case, the external connection portion arranged outside the grip case, and the base portion and the external connection portion. It is equipped with a fragile part, and by twisting the external connection part with respect to the base part,
The tubular body can be broken at the fragile portion, and the return spring can be taken out from the broken tubular body.

After use, the return spring, which is usually made of metal, can be easily taken out from the grip case by twisting the external connection portion of the tubular body with respect to the base portion and breaking the tubular body. And other parts can be separately processed.

According to a second aspect of the present invention, the base portion of the first aspect is rotatably arranged with respect to the grip case, and the grip case of the base portion is formed with an elastically deformable elastic piece. The elastic piece can be engaged with the base portion. The elastic piece formed on the grip case is pushed into the inside of the grip case and engaged with the base portion to prevent the base portion of the tubular body from rotating with respect to the grip case. Thus, by rotating the external connecting portion, the external connecting portion can be twisted with respect to the base portion.

According to a third aspect of the present invention, a plurality of jigs capable of communicating with a plurality of slits formed in the outer peripheral portion of the tip opening of the grip case on the front surface side of the base portion according to the first aspect. An insertion hole is formed, and a projection formed on the jig can be inserted into the slit and the jig insertion hole. By inserting the protrusions of the jig into the slits of the grip case and the jig insertion holes of the base and engaging the jig with the base, rotation of the base of the tubular body with respect to the grip case is prevented. Thus, by rotating the external connecting portion, the external connecting portion can be twisted with respect to the base portion.

The invention according to claim 4 is the invention according to claims 1 to 3.
Ratchet teeth are formed along the moving direction of the push bar according to any one of claims 1 to 3, and a ratchet member is disposed in the grip case, and a head central portion of the ratchet member is provided in the grip case. The ratchet member is pivotally attached to the ratchet member, and the tip of the head of the ratchet member has a chevron shape, and ratchet teeth that mesh with the ratchet teeth of the push bar are formed on both slopes of the ratchet member. A leaf spring portion extending in the direction opposite to the tip end is formed, and the grip case is formed with a regulating portion for regulating the rotation range of the leaf spring portion of the ratchet member around the shaft attachment portion. Characterize.

When the ratchet teeth of the push bar move along with the movement of the push bar, the head of the ratchet member rotates about the pivot point, and the tip of the head tilts in the moving direction of the push bar. The ratchet teeth formed on one of the two slopes at the tip of the head mesh with the ratchet teeth of the push bar. At this time, since the rotation range of the leaf spring portion is regulated by the regulation portion, the leaf spring portion bends,
The ratchet teeth at the tip of the head are urged by the leaf spring portion in the direction in which they mesh with the ratchet teeth of the push bar. In this state, the head of the ratchet member cannot escape so as to allow the push bar to move in the direction opposite to the direction in which the push bar is moving, and thus such push bar movement in the opposite direction is prohibited. It Thus, the push bar moves only in the direction it is moving until its ratchet teeth have completely passed the ratchet teeth of the ratchet member.

Next, when the push bar moves in the direction opposite to the moving direction, the head of the ratchet member rotates in the opposite direction to the tip, and the head end of the head tilts in the moving direction of the push bar, and the head moves. The ratchet teeth formed on the other of the two slopes at the tip end mesh with the ratchet teeth of the push bar. This causes the head of the ratchet member to move in the opposite direction because the head of the ratchet member cannot escape to allow movement in the direction opposite to the direction in which the push bar is moving, by the same action as above. Is prohibited. Thus, the push bar moves only in the direction it is moving until its ratchet teeth have completely passed the ratchet teeth of the ratchet member. Since the ratchet member is provided with the leaf spring portion, the moving direction of the push bar can be regulated only by the ratchet member without requiring a spring. Since the ratchet member does not require a spring, it can be disposed of after being stored in the grip case after use.

[0013]

BEST MODE FOR CARRYING OUT THE INVENTION 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 an overall perspective view of a clip applying device as a surgical instrument using a surgical operation handle structure according to the present invention. This surgical clip applying device 10
As a whole, it has a handle portion 12, a shaft portion 14 extending from the handle portion 12 to the tip side, and a jaw 18 arranged near the tip portion of the shaft portion 14. A plurality of clips are accommodated in the shaft portion 14, and further, a push rod that is movable in the axial direction according to the operation of the handle portion 12 and a push rod that is connected to the push rod to connect the jaw element of the jaw 18 to each other. A jaw closure member for moving to the proximal position and a clip supply mechanism for sequentially supplying clips one by one between the jaw elements of the jaws 18 are housed.

As shown in FIG. 1, the handle portion 12 is
A grip right case 121 and a grip left case 122 are provided, and the grip right case 121 and the grip left case 122 constitute a grip case 124, and a case internal space is defined therein. . The grip case 124 includes a grip portion 1 suitable for being gripped by an operator.
24a is formed. As shown in FIG. 2, the trigger 123 is axially mounted in the space inside the case.
The pin 124b protruding from the inside of the case of the grip case 124 passes through the third pin through hole 123a.
The lower end portion of the trigger 123 projects from the grip case 124 and swings so as to be able to move toward and away from the grip portion 124a. The operator holding the grip portion 124a can set a clip on the jaw 18 by pulling the trigger 123, tighten the clip, and perform a series of operations for applying the clip to a desired portion of the body tissue.

As shown in FIG. 2, the upper end portion of the trigger 123 is engaged with a protrusion 126a formed on a push bar 126 arranged on the same line as the shaft portion 14. In the space inside the case, the push bar 126 is
It is arranged so as to be movable in the axial direction of the shaft portion 14,
The swinging movement of the trigger 123 is converted into movement of the push bar 126 in the axial direction of the shaft portion 14. As shown in FIG. 3, a downward bulging portion is formed at the rear end portion of the push bar 126, and ratchet teeth 126b are formed on the lower surface of the bulging portion. This ratchet tooth 1
Each tooth of 26b has a contour of an isosceles right triangle.
The front side and the rear side of the bulging portion where the ratchet teeth 126b are formed are relief portions 126c and 126d. A shaft portion 126e extends at the tip end portion of the push bar 126, and a receiving portion 126f that is connected to the rear end of the push rod so as to be relatively rotatable is formed at the tip end of the shaft portion 126e.

Further, a ratchet member 128 is axially mounted in the space inside the case. That is, the ratchet member 1
The pin 28 has a pin through hole 128a formed at the center of its head.
A pin 124c protruding from the inner space of the case 24 passes through the case. As shown in FIG. 4, the tip of the head of the ratchet member 128 is formed in a mountain shape, and ratchet teeth 128b, 12 are formed on both slopes of the mountain shape, respectively.
8c is formed. These ratchet teeth 128
b and 128c have an isosceles right triangle contour so that they can mesh with the ratchet teeth 126b of the push bar 126. From the head of the ratchet member 128, a thin plate-shaped leaf spring portion 12 having flexibility in the direction opposite to the front end is provided.
8d is formed. The leaf spring portion 128d of the ratchet member 128 passes through a gate (regulating portion) 124d formed in the case internal space of the grip case 124, and within a range where the leaf spring portion 128d exists in the gate 124d, the ratchet portion 128d is provided. The member 128 is rotatable around the pin 124c. The gate 124d is
The ratchet member 128 is formed symmetrically with respect to the ratchet member 128 so that the leaf spring portion 128d passes through the intermediate position when the ratchet member 128 is in the neutral position in which the ratchet member 128 is perpendicular to the push bar 126 (see FIG. 2). It looks asymmetric because it is a slightly oblique view).

A rotating piece (cylindrical body) 130 is rotatably disposed at the tip opening of the grip case 124. As shown in FIG. 5, the rotating piece 130 includes a base portion 130 a arranged in the space inside the case and a base portion 130 a of the rotating piece 130.
A screw portion (external connection portion) 130c disposed on the tip side of the grip case 124 and outside the grip case 124;
0a and the threaded portion 130c between the fragile portion 130 formed
e and. The fragile portion 130e may have any configuration, but in the present embodiment, a plurality of openings 130g are provided in the circumferential direction to make it weaker than other portions.

A plurality of ribs 130b extending in the outer diameter direction are formed on the base 130a, and the ribs 130b are cut and raised on the case surfaces of the grip right case 121 and the grip left case 122, respectively. It is possible to mesh the elastic piece 121a formed by (4) with 122a (only 122a is shown in FIG. 1).

Further, a plurality of jig insertion holes 130f are formed on the front surface side of the base portion 130a so as to be spaced apart in the circumferential direction. In this embodiment, the jig insertion hole 130f is formed over the entire length of the base 130a.

A return spring 132 is wound around the outer periphery of the shaft portion 126e of the push bar 126, and the tip end of the return spring 132 is a stepped portion 130d formed inside the rotary piece 130 (see FIG. b))
Is in contact with. The rear end of the return spring 132 is in contact with the step portion 126g of the push bar 126, and the push bar 126 is
Is always urged in the direction to move backward. Also,
The receiving portion 126f and the shaft portion 126 of the push bar 126.
When the push bar 126 is moved forward against the urging force of the return spring 132, the tip of e moves to the rotating top 1
The handle portion 12 can be inserted and penetrated from the handle portion 12.

The components that make up the handle portion 12 are:
The return spring 132 is only made of metal, and the remaining parts, the grip right case 121, the grip left case 122, the trigger 123, the push bar 126,
The ratchet member 128 and the rotating piece 130 are all made of plastic. Preferably, if all of these plastic parts are made of the same plastic material, it will be more advantageous when carrying out a recycling process as described later.

The shaft portion 14 comprises a rotary knob 142 and a guide pipe 144. The threaded portion 142b formed on the inner peripheral surface of the rotation knob 142 is screwed into the threaded portion 130c of the rotating piece 130. In addition, the guide pipe 144
A collar portion 144 a formed at the rear end of the step portion 1 formed on the front end surface of the rotating piece 130 and the inner peripheral surface of the rotation knob 142.
It is sandwiched between 42a. Now the rotary knob 142,
The guide pipe 144 and the rotating piece 130 are integrally connected, and when the operator rotates the rotating knob 142, the guide pipe 144 and the rotating piece 130 are integrally rotated, and the components arranged in the guide pipe 144 are arranged. Also rotates together. Therefore, when the operator wants to rotate the direction in which the clip is applied, it can be adjusted as appropriate by rotating the rotation knob 142.

The receiving portion 126f of the push bar 126 is connected to a push rod extending inside the shaft portion 14.
A locking member, which is a part of the clip supply mechanism, is connected to the push rod, and the locking member is locked to a clip carrier that pushes a clip between the jaw elements of the jaws 18. A jaw closing member for closing the jaw elements of the jaws 18 is connected to the front end of the push rod. When the push rod advances, the clip feeding mechanism starts to operate with the advance of the push rod, the clip is pushed between the pair of jaw elements of the jaw 18, and the advance of the push rod locks the clip applying operation. The member is disengaged from the clip carrier and the clip carrier is retracted, while the jaw closure member is advanced to move the pair of jaw elements to the approximated position so that the clip is tightened and the desired clip is reached. Given to the body tissue of
When the push rod retracts, the locking member retracts with the push rod and locks again on the clip carrier.
It is performed in the flow.

The operation of the handle portion 12 constructed as above will be described. The operator holds the grip portion 124a,
When the trigger 123 is pulled to approach the grip 124a,
The upper end of the trigger 123 is the protrusion 126 of the push bar 126.
Since it is engaged with a, the push bar 126 moves forward, that is, moves toward the shaft portion 14. As a result, the tip end head portion of the ratchet member 128 hits the ratchet teeth 126b of the push bar 126, and as shown in FIG. 6, the tip end head portion is centered on the pin 124c so as to be pushed down to the front side, that is, the shaft portion 14 side. To rotate as. Then, the ratchet teeth 128b are attached to the push bar 12.
6 ratchet teeth 126b. At the same time, the leaf spring portion 128d is bent so as to be convex to the right in FIG. 6 while hitting the pillar at the right end of the gate 124d in FIG. Due to the spring force of the leaf spring portion 128d, the ratchet member 1
The tip end portion of 28 is pressed toward the ratchet teeth 126b of the push bar 126, and particularly toward the upper right of FIG. If you continue to push the push bar 126 forward,
The head portion of the ratchet member 128 swings between the upper right portion and the lower left portion in FIG. 6, and the ratchet teeth 128b move relative to the ratchet tooth 126b while appropriately escaping from the ratchet tooth 126b. When the swinging movement of the trigger 123 is stopped and the forward movement of the push bar 126 is stopped, the tip end head portion of the ratchet member 128 is pressed upward rightward toward the ratchet teeth 126b, and the ratchet teeth 128b and the ratchet teeth 128b. Engagement with the teeth 126b is secured, and the stop of the push bar 126 is held.
At this time, the push bar 126 is acted on by the biasing force of the return spring 132 so as to move the push bar 126 backward.
And the ratchet teeth 126b are in mesh with each other, and the ratchet teeth 128b cannot escape in the direction in which the push bar 126 can be retracted.
The retreat of 6 is prohibited.

When the push bar 126 is further advanced by further pulling the trigger 123, as shown in FIG. 7, the ratchet teeth 128b of the ratchet member 128 and the ratchet teeth 126b of the push bar 126 are disengaged, and the ratchet member 128 is disengaged. The tip of the head is the escape portion 126.
Enter d. In this way, the push bar 126 is released from the ratchet member 128. Ratchet member 12
8 returns to a straight line.

When the force on the trigger 123 is released, the push bar 1 is urged by the urging force of the return spring 132.
26 moves back. At this time, the tip head portion of the ratchet member 128 has the ratchet teeth 126 b of the push bar 126.
As shown in FIG. 8, the pin 124 is pushed so that its tip head portion is pushed down to the rear side, that is, the side opposite to the shaft 14.
Rotate around c. And ratchet teeth 128
c meshes with the ratchet teeth 126b of the push bar 126. At the same time, the leaf spring portion 128d is bent so as to be convex to the left in FIG. 8 while hitting the pillar at the left end of the gate 124d in FIG. Due to the spring force of the plate spring portion 128d, the tip end head portion of the ratchet member 128 is pressed toward the ratchet teeth 126b of the push bar 126, and particularly toward the upper left of FIG. Push bar 12
As the ratchet member 128 continues to move backward, the tip end head of the ratchet member 128 swings between the upper left side and the lower right side of FIG. 8, and the ratchet tooth 128c appropriately escapes from the ratchet tooth 126b, and comes to the ratchet tooth 126b. Move relative to.
If the trigger 123 is pulled again to move the push bar 126 forward in the midway state as shown in FIG. 8, the ratchet teeth 128c and the ratchet teeth 126b are meshed with each other, and the ratchet teeth 128c are the same as the push bar 12.
The forward movement of the push bar 126 is prohibited because it cannot escape in the direction in which the forward movement of 6 is permitted.

When the push bar 126 is further retracted, the state shown in FIG. 2 is restored, and the ratchet teeth 128c of the ratchet member 128 and the ratchet teeth 126b of the push bar 126 are disengaged from each other, and the ratchet member 12 is released.
The tip end head of 8 enters the escape portion 126c. In this way, the push bar 126 is released from the ratchet member 128.

By the action of the push bar 126 and the ratchet member 128 described above, the one-cycle operation including the complete pulling operation and the complete releasing operation of the trigger 123 is surely performed, and the halfway operation is prevented. However, the provision of the clip and the preparation of the next clip are ensured.

When the clips are used up, it is necessary to dispose of them. Next, the disposal procedure of the handle portion 12 will be described. First, the rotation knob 142 of the shaft portion 14 and the rotating piece 130 of the handle portion 12 are unscrewed to separate the shaft portion 14 from the handle portion 12.

Next, the elastic pieces 121a and 122a formed by cutting and raising on the case surfaces of the grip right case 121 and the grip left case 122, respectively, are pushed toward the inside of the case to push the elastic pieces 121a and 122a into the ribs 130b.
When engaged with, the base 130a cannot rotate with respect to the grip case 124. In this state, when the screw part 130c is twisted with respect to the base part 130a by using pliers or the like, the rotary piece 130 is broken at the fragile part 130b (see FIG. 3 (c)), and the return spring in the internal space of the case is broken. 132 is removed (FIG. 10). Thus, the only metal part, the return spring 1
Since 32 can be taken out and the rest are plastic parts, the metal parts and the plastic parts can be separated and disposed.

Further, optionally, the jig 134 shown in FIG.
It is also possible to stop the rotation of the rotating piece 130 by using.
The jig 134 includes a ring-shaped main body 134a and a main body 134.
A projection 134b formed corresponding to the jig insertion hole 130f is formed from a. Ring-shaped body 134
The screw portion 130c of the rotating piece 130 can pass through the inside of a. Further, at the tip opening of the grip case 124, a gap is formed between the grip right case 121 and the grip left case 122, and these gaps are slits 124e and 124e, and the slits 124e and 124e are fixed. The intervals and numbers are such that they are communicated with the jig insertion hole 130f when aligned with the tool insertion hole 130f.

When disassembling, after removing the rotary knob 142 and disassembling the shaft portion 14 and the handle portion 12,
As shown in FIG. 12, the threaded portion 130c of the rotating piece 130 is inserted into the main body 134a of the jig 134, and the projection 134b is formed.
Is inserted into the jig insertion hole 130f through the slits 124e, 124e. As a result, the base portion 130a of the rotating piece 130 cannot rotate with respect to the grip case 124. In this state, when the screw portion 130c is twisted with respect to the base portion 130a by using pliers or the like, the rotary piece 130 is broken at the fragile portion 130b, and the return spring 132 in the case internal space is taken out.

After the inspection, the metal return spring 132 can be reused after being subjected to high temperature pressure sterilization by an autoclave. Also, the remaining plastic parts can be reused after sterilization. For example, according to the treatment method described in Japanese Patent Application Laid-Open No. 9-990919, by mixing a plastic part to which a biochemical substance having an amino group adheres and an epoxy compound having an oxirane ring, It is possible to cause a ring-opening reaction of an oxirane ring of an epoxy compound to generate a solidified product of a plastic part and an epoxy curable resin, sterilize it, and then reuse it.

In the above embodiments, the clip applying device has been described as an example, but the present invention is not limited to this, and it can be used for forceps, for example.

[0036]

As described above, according to the present invention, after use, the external connecting portion of the tubular body is twisted with respect to the base portion to rupture the tubular body, so that the return spring is usually made of metal. Can be easily taken out from the grip case, the return spring and other parts can be separated, and the cost for disposal can be reduced. It also makes it possible to reuse parts,
When reused, it can be made into a product considering the environment.

[Brief description of drawings]

FIG. 1 is an overall perspective view of a clip applying device as a surgical instrument using a surgical operation handle structure of the present invention.

FIG. 2 is a diagram showing an internal configuration of the handle portion when the grip left case is removed.

FIG. 3 is a side view of a push bar of a handle portion.

FIG. 4 is a side view of a ratchet member of a handle portion.

FIG. 5A is a perspective view of a rotating top of the handle portion;
(B) is a semi-longitudinal cross-sectional view, and (c) is a side view in a broken state.

FIG. 6A is a diagram showing an internal configuration in the middle of pulling the trigger as seen when the grip left case of the handle portion is removed, and FIG. 6B is a diagram showing the ratchet teeth of the push bar and the ratchet member of the ratchet member. FIG.

FIG. 7 is a diagram showing an internal configuration showing a state in which the grip left case of the handle portion is removed and the trigger is completely pulled.

FIG. 8A is a view showing an internal configuration in the middle of returning the trigger as seen after removing the grip left case of the handle portion, and FIG. 8B is an enlarged view of the ratchet teeth of the push bar and the ratchet teeth of the ratchet member. Is.

FIG. 9 is a vertical cross-sectional view of a rotating top and a shaft portion.

FIG. 10 is a diagram when the handle portion is disassembled.

FIG. 11 is a perspective view of a jig.

FIG. 12 is a perspective view when a jig is used.

[Explanation of symbols]

12 Handle 14 Shaft 121a, 122a elastic piece 123 Trigger 124 grip case 124d Gate (Regulatory Department) 126 push bar 126b ratchet teeth 128 ratchet member 128b, 128c ratchet teeth 128d leaf spring part 130 rotating pieces (cylindrical body) 130a base 130c screw part (external connection part) 130e fragile part 130f jig insertion hole 132 Return spring

Claims (4)

[Claims] 1. A surgical operating handle in which a push bar is disposed in a grip case so as to be movable in the front-rear direction, and the push bar is moved forward by operating a trigger movably attached to the grip case. A cylinder is arranged in the tip opening of the grip case, and the push bar is biased rearward by a return spring inserted between the cylinder and the push bar. A base portion arranged, and an external connection portion arranged outside the grip case,
The fragile portion formed between the base portion and the external connecting portion is provided, and by twisting the external connecting portion with respect to the base portion, the tubular body can be ruptured at the fragile portion. A surgical operation handle disassembling structure, wherein the return spring can be taken out from a cylindrical body. 2. The base is rotatably arranged with respect to a grip case, and an elastically deformable elastic piece is formed on the grip case of the base, and the elastic piece is the base. The surgical operating handle disassembling structure according to claim 1, wherein the operating handle disassembling structure is engageable with the. 3. A plurality of jig insertion holes, which can communicate with a plurality of slits formed in an outer peripheral portion of the tip opening of the grip case, are formed on a front surface side of the base portion, and the slits are formed. The surgical operation handle disassembling structure according to claim 1 or 2, wherein a projection formed on the jig can be inserted into the jig insertion hole. 4. The push bar has ratchet teeth formed along the moving direction of the push bar, a ratchet member is provided in the grip case, and a central portion of the head of the ratchet member is attached to the grip case. The tip of the head of the ratchet member has a chevron shape, and ratchet teeth that mesh with the ratchet teeth of the push bar are formed on both slopes of the ratchet member. A leaf spring portion extending in the front end direction is formed, and the grip case is formed with a regulating portion that regulates a rotation range of the leaf spring portion of the ratchet member around the shaft attachment portion. The surgical operating handle disassembling structure according to any one of claims 1 to 3.