JP2005177053A - Forceps for clip - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To facilitate installation of a clip in cerebral aneurysm by forceps for the clip. <P>SOLUTION: This forceps 1 for the clip is provided with a clip holding part clampingly holding the clip 4, a handle part openingly/closingly operating the clip holding part, and a swinging means 12 swinging the clip relative to the clip holding part by the operation of the hand holding the handle part. After the clip holding part is inserted into the body of a patient, the clip 4 is swung to change the direction of the clip 4 to the forceps 1. This constitution allow the clip 4 to smoothly and appropriately approach the affected part and reduce the types of clips to be prepared. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a clip forceps for operating a medical clip to pinch a cerebral aneurysm or the like.

  For example, to treat a cerebral aneurysm, after making a hole in the head and reaching the cerebral aneurysm with various treatment tools, grasp the cerebral aneurysm clip with the clip forceps, approach the affected area, and release the clip. This is done by inserting a cerebral aneurysm.

  However, since conventional clip forceps hold the clip in a stationary state, the tip of the forceps is held in accordance with the position, posture, etc. of the cerebral aneurysm in order to approach the complicated affected area in the brain. The surgeon must turn the clip with his / her finger, or replace the clip with another type, and insert and remove the forceps into the brain each time. Therefore, the work of attaching the clip to the affected part becomes complicated, and there are problems that it is necessary to prepare as many kinds of clips as possible.

  Therefore, an object of this invention is to provide the clip forceps which can eliminate the said malfunction.

  In order to solve the above-mentioned problem, the invention according to claim 1 is a clip forceps having a clip gripping portion holding a clip (4) and a handle portion for opening and closing the clip gripping portion. The clip forceps (1) provided with the swing operation means (10 a, 12, etc.) for swinging the clip (4) with respect to the clip gripping part by the above operation is employed.

  According to a second aspect of the present invention, in the clip forceps according to the first aspect of the present invention, the swing operation means includes a rotating piece (10a) that contacts the clip (4) on the clip gripping portion, and a handle portion. The attached operating portion (12) and a transmission device (14) for transmitting the movement of the operating portion (12) to the rotating piece (10a) and rotating the clip (4) on the clip gripping portion via the rotating piece. Etc.) is used.

  According to a third aspect of the present invention, in the clip forceps (1) according to the second aspect, the operation portion is formed of a pulley (12), and the endless body (14) wound around the pulley (12). Employs a clip forceps (1) that is dynamically connected to the rotating piece (10a).

  According to the first aspect of the present invention, in the clip forceps provided with the clip gripping portion that holds the clip (4) and the handle portion that opens and closes the clip gripping portion, the clip gripping is performed by operating the hand having the handle portion. Since the swinging operation means for swinging the clip with respect to the head is provided, the clip (4) is swung even after the clip gripping part is inserted into the patient's body, and the clip (4) forceps ( The orientation with respect to 1) can be changed, so that the approach of the clip (4) to the affected part (5) can be performed smoothly and appropriately, and the types of clips to be prepared can be reduced accordingly.

  According to the invention according to claim 2, in the clip forceps (1) according to claim 1, the swing operation means has a rotating piece (10a) that abuts on the clip (4) on the clip gripping portion; The operation part (12) attached to the handle part and the movement of the operation part (12) are transmitted to the rotating piece (10a), and the clip (4) is rotated on the clip holding part through the rotating piece (10a). Since the power transmission device (14 etc.) is provided, the clip (4) can be swung by operating the operation portion (12) with a hand that grips the handle portion. Installation work can be simplified.

  According to the invention according to claim 3, in the clip forceps (1) according to claim 2, the operation portion is formed of the pulley (12), and the endless body (14) wound around the pulley (12). Since it is connected to the rotating piece (10a), the operation portion and the transmission device can be integrated to simplify the structure of the forceps (1).

  The best mode for carrying out the invention will be described below with reference to the drawings.

  For example, as shown in FIG. 5, the clip forceps 1 is an instrument for inserting the clip 4 into the skull through the hole 3 formed in the head 2 and transporting the clip 4 to the affected part such as the cerebral aneurysm 5.

  As illustrated in FIGS. 3 to 5, the clip 4 has a handle portion 4 a and a sandwiching portion 4 b, and a spring 4 c is integrally formed on the handle portion 4 a. As shown in FIG. 3A, the clip 4 closes the pinching portion 4b by the urging force of the spring 4c in the released state, but when the handle portion 4a is pressed as shown in FIG. 3B, the pinching portion 4b. Is supposed to open. The clip 4 used in this embodiment is a small and lightweight clip for sandwiching the cerebral aneurysm 5, and is made of a material having high biocompatibility, such as a titanium alloy or a cobalt base alloy. Various types of clips other than those shown in the drawings are prepared, but each clip is provided with a handle portion 4a that can be held by the clip forceps 1.

  As shown in FIG. 1, the clip forceps 1 is configured such that two lever members 1 a and 1 b intersect with each other like a scissors in the middle and are pivotally connected by a longitudinal pivot 6 at the intersection. The two lever members 1a and 1b connected to each other have a clip gripping portion having the clip 4 sandwiched between the pivots 6 and a rear portion serving as a handle portion for opening and closing the clip gripping portion.

  A concave groove 7 for inserting the handle 4a of the clip 4 is formed at a position where the lever members 1a and 1b are opposed to each other in the clip gripping portion.

  The curved leaf springs 8a and 8b are fixed to the lever members 1a and 1b in the handle portion, respectively. Both leaf springs 8a and 8b extend rearward of the lever members 1a and 1b, and their rear ends are connected to each other. Due to the spring action of both leaf springs 8a and 8b, both lever members 1a and 1b are always urged in the expanding direction, so that as shown in FIG. Keep open. When a gripping force is applied to the handle portion, the clip gripping portion is closed as shown in FIG. At this time, as shown in FIG. 3 (A), when the handle 4a of the clip 4 is inserted into the clip holding portion, the clip holding portion removes the handle 4a of the clip 4 as shown in FIG. 3 (B). Since it presses, the clamping part 4b expands.

  As shown in FIG. 1 (A), a locking tool is provided inside the lever members 1a and 1b in the handle portion. The locking tool includes hook-shaped locking pieces 9a and 9b protruding from the lever members 1a and 1b. When a gripping force is applied to the handle portion to close the clip gripping portion as shown in FIG. 2, when the engaging pieces 9a and 9b are engaged with each other, the clip gripping portion is kept closed. Therefore, as shown in FIG. 3 (A), when the handle 4a of the clip 4 is inserted into the clip gripping portion and the gripping portions 9a and 9b of the locking tool are engaged with each other, the gripping force is applied from the gripping portion. Even if the clip is released, the clip 4 is held by the forceps 1 with the clip 4b open as shown in FIG.

  The clip forceps 1 is provided with a swing operation means for swinging the clip 4 with respect to the clip gripping portion by operating a hand having a handle portion.

  As shown in FIGS. 1 to 4, the swinging operation means is configured such that the rotating pieces 10 a and 10 b that come into contact with the clip 4 on the clip gripping portion, the operating portion attached to the handle portion, and the movement of the operating portion. A transmission device that transmits to the rotating piece 10a and rotates the clip 4 on the clip gripping portion via the rotating piece 10a.

  As shown in FIGS. 1 to 3, the rotating pieces 10a and 10b are formed as small-diameter disks, for example, and are arranged so as to confront each other in the concave groove 7 at the tip of each lever member 1a and 1b which is a clip gripping portion. The The rotating pieces 10a and 10b are rotatably supported at the tips of the lever members 1a and 1b by a support shaft 11 extending in the opening / closing direction of the clip gripping portion. Thereby, as shown in FIG. 3B, the clip 4 gripped by the clip gripping portion via the rotating pieces 10a and 10b can be rotated in a direction perpendicular to the axis of the support shaft 11 as shown in FIG. Become.

  As shown in FIGS. 1, 2 and 4, the operation portion is formed as a pulley 12, for example, and the support member 12a is interposed on the side surface of one lever member 1a of the two lever members 1a and 1b which are handle portions. Attached. This pulley 12 is arranged so that it can be rotated with the fingers of the hand that holds the handle of the forceps 1. A protrusion 12b that can be hung by the finger is preferably attached to the pulley 12.

  As shown in FIGS. 1 to 4, in the transmission device, the pulley 12 is used as a driving pulley, and a wire 14 as an endless body is provided between the pulley 12 and a driven pulley 13 fixed to the support shaft 11 of one rotating piece 10a. It is configured as a wound winding transmission. The wire 14 is guided by various guide pins 15a, 15b, 15c and a groove member 16 fixed to the side surfaces of the lever members 1a, 1b. A guide plate 17 is disposed along the side surfaces of the lever members 1a and 1b for the purpose of guiding and protecting the wire 14. The guide plate 17 is supported by the guide pins 15a, 15b, 15c. When the driving pulley 12 is rotated as shown in FIG. 4 with the finger of the hand gripping the handle portion of the forceps 1, the rotation of the driving pulley 12 is transmitted to the driven pulley 13 via the wire 14, and the rotating piece together with the driven pulley 13 is rotated. 10a rotates. As a result, the clip 4 sandwiched between the rotating pieces 10a and 10b of the clip gripper swings in the vertical direction as shown in FIG.

  Next, the operation of the clip forceps having the above configuration will be described.

  An example of the operation of attaching the clip 4 to the cerebral aneurysm 5 will be described. As shown in FIG. 5A, a hole 3 is drilled in the head 2 of the patient by the operator.

  Further, the surgeon attaches the cerebral aneurysm clip 4 to the clip gripping portion of the clip forceps 1.

  The operator inserts the handle 4a of the clip 4 into the clip holding portion of the forceps 1 in the state of FIG. 1 as shown in FIG. 3A, and then grasps and presses the handle portion of the forceps 1. As a result, as shown in FIG. 3B, the rotating pieces 10a and 10b of the clip gripping part press the handle part 4a of the clip 4, and the clip part 4b of the clip 4 is expanded.

  Further, by engaging the engaging pieces 9a and 9b of the locking tool as shown in FIG. 2, even if the operator releases the pressing force from the handle portion, the clip holding portion is the clip 4 shown in FIG. Is held in an expanded state.

  Next, the operator inserts the forceps 1 into the head 2 through the hole 3 as shown in FIG. 5A, and brings the clip 4 closer to the cerebral aneurysm 5. Then, the pulley 12 is rotated as shown in FIG. 4 with the finger of the hand gripping the handle of the forceps 1, and the clip 4 is swung at the tip of the forceps 1. Thereby, the direction of the clip 4 is changed according to the position, posture, and the like of the cerebral aneurysm 5, and the cerebral aneurysm 5 is introduced into the sandwiched portion 4 b of the clip 4.

  Therefore, when the operator strongly grasps the handle portion of the forceps 1 to release the engagement of the locking pieces 9a and 9b and loosens the force applied to the handle portion, the forceps 1 is restored by the leaf springs 8a and 8b as shown in FIG. 3A, the clip 4 closes its pinch portion 4b and clips and closes the cerebral aneurysm 5 as shown in FIG. 5B.

  Thereafter, the forceps 1 is removed from the hole 3 of the head 2 by the operator, and the clipping procedure is completed.

  In addition, this invention is not limited to the said embodiment, For example, although the said embodiment demonstrated the treatment of a patient's head, it is applicable also to the treatment of another site | part.

The clip forceps concerning this invention are shown in an open state, (A) is a partial notch top view, (B) is a partially notched side view. It is a partial notch top view which shows the forceps for clip in a press state. It is an enlarged top view of the clip holding part of the forceps for clip, (A) shows before clip press, (B) shows after clip press. It is a partial notch side view explaining the swing action of the clip forceps. (A) is explanatory drawing which inserts a clip in a head with the forceps for clip, (B) is explanatory drawing which shows the state which mounted | wore the cerebral aneurysm.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Clip forceps 4 ... Clip 10a ... Turning piece 12 ... Pulley 14 ... Wire

Claims (3)

  In a clip forceps having a clip gripping part that holds a clip and a handle part that opens and closes the clip gripping part, a swing operation that swings the clip with respect to the clip gripping part by operating the hand that has the handle part A clip forceps provided with means.   2. The clip forceps according to claim 1, wherein the swinging operation means includes a rotating piece that comes into contact with the clip on the clip gripping portion, an operating portion attached to the handle portion, and a movement of the operating portion. A clip forceps comprising: a transmission device configured to transmit and rotate a clip on a clip gripping portion via a rotating piece.   The clip forceps according to claim 2, wherein the operation portion is formed of a pulley, and an endless body wound around the pulley is dynamically connected to the rotating piece.

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