JP2005066180A - Medical implement - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical implement of an easy structure and a low price, whose distal end part can be easily bent in any direction to allow easy access to a target region of a patient. <P>SOLUTION: The medical implement includes an insertion portion 2 with an abutting surface 13 inclined toward an insertion direction into a body cavity of a subject, an outer sheath 6 as a moving member mounted to engage the abutting surface 13 and move along an axial direction of the insertion portion 2, and coil springs 11 and 16 as an energizing member to relatively energize the outer sheath 6 so that the abutting surface 13 can abut. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a medical instrument that is inserted into a body cavity of a living body, for example, transendoscopically to grasp or treat a tissue in the body cavity.

  2. Description of the Related Art Medical instruments that are inserted endoscopically into a body cavity of a living body to grasp or treat tissue in the body cavity are known, such as surgical forceps. Since this surgical forceps is used in a narrow surgical site, the distal end portion and the insertion portion connecting the distal end portion and the operation portion are formed very thin. In addition, since the insertion portion is rigid, the following portion has a good followability with respect to the operation of the hand operation portion, and the operation is simple and easy to perform.

  When this forceps is actually used, for example, in the case of laparoscopic surgery, the target surgical site is approached via a forceps or endoscope port called a trocar in the body cavity, and it is also used in other departments. Approach the desired surgical site along the endoscope.

  Here, in the most important forceps operation, the conventional endoscopic surgical forceps are rigid as a whole, and thus the operability is good as described above, but there is a problem that the degree of freedom of movement of the tip is small. there were. For example, when the distal end portion is desired to be turned sideways, the forceps itself must be turned sideways, but a situation occurs in which the orientation cannot be changed greatly because the approach is made through a narrow body cavity.

  Therefore, in order to solve the above-described problems, in the endoscopic surgical forceps, a bending region is provided at the distal end portion of the insertion portion to be inserted into the body cavity to improve the approachability to the side of the jaw. Is known (for example, see Patent Document 1).

For the same purpose as described above, there is known a device in which a jaw is provided at the distal end portion of an insertion portion to be inserted into a body cavity via a link mechanism (see, for example, Patent Document 2).
JP-A-6-269460 JP-A-8-206120

  However, the bending region of Patent Document 1 is formed by “crimping”, and the bending is corrected and straightened when passing through the trocar. For this reason, for example, when the biological tissue is gripped by the jaws and is to be pulled strongly toward the hand side, the bending of the bending region is extended, and the responsiveness of the forceps to the operation is deteriorated. In addition, since the “crease” portion is not rigid, there is a drawback that the responsiveness of the forceps tip is not good.

  Further, Patent Document 2 uses a link mechanism to bend the direction of the jaw at the tip, and can reliably bend the jaw to a desired angle. Therefore, unlike the patent document 1, the bending is not unexpectedly corrected as in the case of “crimping”, and the responsiveness of the forceps is very good. However, for the bending operation, the operator has to operate the dial to rotate the dial, so that the operability is poor, and the structure is complicated and expensive.

  The present invention has been made paying attention to the above circumstances, and the purpose of the present invention is to easily change the direction of the treatment portion at the distal end portion of the insertion portion, and to easily approach the target portion. Another object of the present invention is to provide a medical device that is structurally simple and inexpensive.

  In order to achieve the above object, according to a first aspect of the present invention, an insertion portion having an abutting surface inclined with respect to an insertion direction of a subject into a body cavity is engaged with the abutting surface. And a moving member provided so as to be movable in the axial direction of the insertion portion, and a biasing member that relatively biases the moving member so as to abut the abutting surface. In medical instruments.

  A second aspect of the present invention provides an actuator unit provided at a distal end of the insertion portion according to the first aspect, an operation member provided inside the insertion portion and connected to be able to operate the actuator unit, and a hand of the insertion portion And an operation unit that operates the operation member.

  According to a third aspect of the present invention, the operation portion according to the second aspect includes an engagement groove in which a proximal side of the operation member is slidably engaged.

  According to the present invention, since the distal end portion of the medical instrument can be easily bent in an arbitrary direction, the approach to the target site is simple, and a structurally simple and inexpensive medical instrument can be provided.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  As shown in FIGS. 1 to 4, an endoscopic surgical forceps 1 as a medical instrument includes an insertion portion 2, a treatment portion 3 provided at a distal end portion of the insertion portion 2, and a proximal side of the insertion portion 2. It is comprised from the hand operation part 4 provided in this. The insertion portion 2 has a double tube structure of an inner sheath 5 and an outer sheath 6 as a moving member. A hard part 7 is provided on the proximal side of the inner sheath 5, and an actuator unit 9 is provided on the distal end side of the hard part 7 via a soft part 8.

  Further, a flange portion 10 is integrally provided at a proximal end portion of the rigid portion 7 of the inner sheath 5, and a proximal end of a coil spring 11 as a biasing member is in contact with the flange portion 10. The actuator unit 9 is covered with a distal end cover 12, and a contact surface 13 formed of an inclined surface that is inclined with respect to the axis of the inner sheath 5 is formed at the proximal end portion of the distal end cover 12.

  An outer sheath 6 is fitted to the inner sheath 5 so as to be movable back and forth in the axial direction. A contact surface 14 formed of an inclined surface that engages with the contact surface 13 of the distal end cover 12 is formed at the distal end portion of the outer sheath 6. Further, an operation ring 15 whose outer peripheral surface is knurled is provided at one end at the base end portion of the outer sheath 6, and a coil spring 16 as a biasing member is accommodated in the operation ring 15. .

  The tip cover 12 is provided with a pair of jaws 17 constituting the treatment section 3 so as to be openable and closable with a pivot 18 as an axis. The jaw 17 is driven to open and close by an actuator unit 9 covered by the tip cover 12, and the actuator unit 9 is driven by the hand operation unit 4.

  Next, the hand operating part 4 will be described. An operating rod 19 as an operating member is inserted into the inner sheath 5 of the inserting part 2 so as to be able to advance and retract in the axial direction. The distal end portion of the operation rod 19 is connected to the actuator unit 9, and the base end portion projects rearward from the flange portion 10, and the operation ball 20 is integrally provided at the base end portion.

  The hand operation unit 4 includes a fixed handle 21 having a finger hook ring 21a, and a movable handle 23 having a finger hook ring 23a rotatably connected to the fixed handle 21 via a pivot pin 22. . A connection portion 24 is provided integrally with the fixed handle 21, and the flange portion 10 and the coil spring 11 provided at the proximal end portion of the inner sheath 5 are inserted into the connection portion 24.

  The connecting portion 24 of the fixed handle 21 is provided with an abutting portion 25, and the coil spring 11 is interposed between the inner surface 25 a of the abutting portion 25 and the flange portion 10. Further, a coil spring 16 is interposed between the outer surface 25 b of the abutting portion 25 and the inner step of the operation ring 15. Further, an engagement groove 26 is provided in the movable handle 23, and the operation ball 20 of the operation rod 19 is movably engaged with the engagement groove 26. The movable handle 23 and the operation bar 19 are connected so that the operation bar 19 advances and retreats in the axial direction by the rotation of the movable handle 23.

  Therefore, the surgeon grasps the hand operation unit 4 and puts his / her fingers on the finger handles 21 a and 23 a of the fixed handle 21 and the movable handle 23, and opens and closes the movable handle 23 with respect to the fixed handle 21 using the pivot pin 22 as a fulcrum. As a result, the operation ball 20 slides in the engagement groove 26 and the operation rod 19 advances and retreats in the axial direction. Accordingly, the jaw 17 is opened and closed around the pivot 18 by the actuator unit 9 interlocked with the operation rod 19. The actuator unit 9 may have any structure such as a link mechanism and a cam mechanism, and any structure may be used because the structure does not affect the object and effect of the present invention.

  Further, a connection portion 24 is formed on the fixed handle 21 of the hand operation portion 4, and the inner sheath 5 of the insertion portion 2 is inserted into the connection portion 24. A coil spring 11 is provided at the rear end of the inner sheath 5, and the coil spring 11 is interposed between the flange portion 10 and the inner surface 25 a of the abutting portion 25. Therefore, the inner sheath 5 and the actuator unit 9 of the insertion portion 2 are urged toward the hand operating portion 4 by the coil spring 11.

  An outer sheath 6 is movably provided on the outer periphery of the inner sheath 5 of the insertion portion 2, and an operation ring 15 is formed on the hand side. A coil spring 16 is provided inside the operation ring 15, and the coil spring 16 is interposed between the outer surface 25 b of the abutting portion 25 and the inner step of the operation ring 15. Moreover, since the spring constants of the coil spring 11 and the coil spring 16 are set such that the coil spring 11> the coil spring 16, the outer sheath 6 is biased toward the actuator unit 9.

  The contact surface 14 of the outer sheath 6 is engaged with the contact surface 13 of the tip cover 12 of the actuator unit 9, and the contact surface 13 and the contact surface 14 are formed at an angle with respect to the center of the insertion portion 2. The coil spring 11 and the coil spring 16 are in pressure contact with each other.

  Further, a soft portion 8 is formed at a connection portion of the insertion portion 2 with the actuator unit 9, and a hard portion 7 is formed at the rear portion thereof. In addition, the operating rod 19 is formed so as to be soft and transmit a necessary amount of operating force using, for example, a metal wire. Therefore, the insertion portion 2 can change the direction of the actuator unit 9 or the jaw 17 with respect to the central axis of the soft portion 8. Moreover, the outer sheath 6 is made of a material harder than at least the hardness of the soft portion 8 of the insertion portion 2 so that the shape of the soft portion 8 can be regulated during the operation described later.

  Next, the operation of the endoscopic surgical forceps 1 configured as described above will be described.

  As shown in FIG. 6, the jaw 17 opens and closes according to the opening and closing operation of the movable handle 23 with respect to the fixed handle 21, and the movable handle 23 is moved to an arbitrary position as a preparation stage for the bending operation of the actuator unit 9. The position is fixed with respect to the fixed handle 21 by manually restraining.

  The bending operation of the actuator unit 9 will be described. As shown in FIG. 7, the operation ring 15 is pulled toward the hand side, and the contact surface 13 and the contact surface 14 are separated from the coil spring 16 against the urging force. To move. In this state, as shown in FIG. 8, the operation ring 15 is rotated to a desired angle with respect to the substantially central axis direction of the insertion portion 2. The bending direction of the actuator unit 9 can be arbitrarily set by this rotation angle.

  By returning the operation ring 15 toward the distal end of the forceps 1 for endoscopic surgery, as shown in FIG. 9, the flexible portion 8 is bent until the contact surfaces 13 and 14 are engaged, and the actuator unit 9 is inserted into the insertion portion. 2 is bent with respect to the substantially central axis direction, and the operating rod 19 is also elastically deformed to follow the bending. However, the jaw 17 can be opened and closed in conjunction with the opening and closing operation of the movable handle 23.

  Thus, the endoscopic surgical forceps 1 is used by bending the direction of the actuator unit 9 in an arbitrary direction depending on how the contact surface 14 of the outer sheath 6 and the contact surface 13 of the distal end cover 12 come into contact. be able to. Therefore, the freedom degree of forceps operation can be improved without incurring costs while maintaining good operability.

  In the embodiment, the contact surface 13 provided on the distal end cover 12 and the contact surface 14 of the outer sheath 6 are inclined surfaces that are inclined with respect to the axis of the insertion portion 2. It is not limited to, but may be any one of a sawtooth shape, a wave shape, and an uneven shape.

  In the above-described embodiment, the insertion portion 2 has a double tube structure of the inner sheath 5 and the outer sheath 6 as the moving member. However, the inner sheath 5 inserted into the body cavity is the insertion portion, and this insertion is performed. A movable member that is movable in the axial direction of the insertion portion may be engaged with the contact surface 13 provided in the portion. Therefore, the moving member is not limited to being an outer sheath (tubular member) as in the above-described embodiment, and may be movable in the axial direction of the insertion portion, and whether or not it is inserted into a body cavity. It doesn't matter.

  According to the said structure, the following structures are obtained.

  (Supplementary Note 1) An insertion portion having an abutting surface inclined with respect to the insertion direction of the subject into the body cavity, and an engagement portion that engages with the abutting surface and is movable in the axial direction of the insertion portion. A medical instrument comprising: a moving member; and a biasing member that relatively biases the moving member so as to abut the abutting surface.

  (Additional remark 2) The said insertion part is a double-tube structure of an inner sheath and an outer sheath, and a hard part is provided in the hand side of the inner sheath, and the actuator unit is provided in the front end side of this hard part via a soft part. The medical instrument according to appendix 1, characterized in that is provided.

  (Supplementary Note 3) The inner sheath has a tip cover that covers the actuator unit, the tip cover is provided with one contact surface inclined, and the outer sheath contacts the contact surface of the tip cover. The medical instrument according to supplementary note 2, comprising a contact surface.

  (Appendix 4) The medical device according to appendix 1, 2 or 3, wherein the biasing member is interposed between the inner sheath and the outer sheath, and biases in a direction in which the abutting surfaces come into contact with each other. Instruments.

  (Supplementary note 5) The medical instrument according to supplementary note 1, wherein the contact surface is any one of an inclined surface inclined with respect to an axis of the insertion portion, a sawtooth shape, a wave shape, and an uneven shape.

  (Supplementary note 6) The medical instrument according to supplementary note 1, wherein the moving member is a tubular member provided to be movable in an axial direction of the insertion portion.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Moreover, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, you may combine suitably the component covering different embodiment.

The side view of the forceps for endoscopic surgery which shows 1st Embodiment of this invention. The side view which partly cut away the endoscopic surgical forceps which shows the embodiment. The side view of the inner sheath of the forceps for endoscopic surgery which shows the embodiment. The side view which notched the outer sheath of the forceps for endoscopic surgery which shows the same embodiment partially. The side view which notched the operation part of the forceps for endoscopic surgery which shows the same embodiment partially. The side view for demonstrating the effect | action of the forceps for endoscopic surgery which shows the embodiment. The side view for demonstrating the effect | action of the forceps for endoscopic surgery which shows the embodiment. The side view for demonstrating the effect | action of the forceps for endoscopic surgery which shows the embodiment. The side view for demonstrating the effect | action of the forceps for endoscopic surgery which shows the embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscopic forceps, 2 ... Insertion part, 3 ... Treatment part, 4 ... Hand operation part, 5 ... Inner sheath, 6 ... Outer sheath, 7 ... Hard part, 8 ... Soft part, 9 ... Actuator unit, 11, 16 ... Coil spring, 13, 14 ... Contact surface, 19 ... Operation rod

Claims (3)

An insertion portion having a contact surface inclined with respect to the insertion direction into the body cavity of the subject;
A moving member that engages with the contact surface and is movable in the axial direction of the insertion portion;
A medical device, comprising: a biasing member that relatively biases the moving member so as to abut the abutting surface. An actuator unit provided at the tip of the insertion portion;
An operation member provided inside the insertion portion and connected to be able to operate the actuator unit;
The medical instrument according to claim 1, further comprising: an operation unit provided on a hand side of the insertion unit and operating the operation member.   The medical instrument according to claim 2, wherein the operation portion includes an engagement groove in which a proximal side of the operation member is slidably engaged.

Images