JP2005296179A - Instrument for thread penetrating surgery - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an instrument for thread penetrating surgery which enables a surgeon without skills to penetrate a needle through a specified position of living tissues, or a subject for penetrating a thread, safely, precisely, and in a short period of time in surgery of creating a palpebral fold. <P>SOLUTION: The instrument for thread penetrating surgery comprises a pair of operating arms 2 which are equipped with a finger engaging part 3 on one end side and a clamping part 4 for tightly holding the subject for penetrating a thread on the other end and are connected to relatively rotate around a spindle P, an oscillating lever 5 operated to oscillate around the spindle P, and a needle retaining cassette 6 which retains a pair of needles 7 for penetrating the thread through the subject for penetrating the thread held by the clamping part 4 by moving in conjunction with the rowing operation of the oscillating lever 5. One side 4a of the clamping part 4 is formed into a ring shape so that the needle passes through the inside, and the other side 4b has a slit formed for guiding the needle 7 with the thread penetrated. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a threading surgical instrument, and more particularly to a threading surgical instrument useful in plastic surgery for double folds.

  Conventionally, in plastic surgery for double scissors, tweezers having a circular gripping part that clamps the scissors at the tip part, and a needle holder that can be switched between a pinching state that clamps the needle at the tip part and an open state that opens the needle ( Nippers).

  To describe in detail, mark the position where the needle penetrates on the eyelid, insert one end of the tweezers between the eyelid and the eyeball with the marking as a mark, peel off from the eyeball by grabbing the eyelid with the tweezers, After confirming that the needle held by the tip of the needle holder held by the hand opposite to the hand holding the tweezers is squeezed from the back of the heel grasped by the tweezers and penetrates to the marking position It has been necessary to repeat a predetermined number of operations by inserting a needle from the back side of the heel and penetrating the needle, and then changing the tweezers holding the heel to the pinching tweezers and grasping and pulling out the penetrating needle tip.

A needle is tied to each end of the thread. After the needle at one end is passed through the heel by the above-described operation, the above-described operation is repeated at a position spaced apart from the marking center by a certain distance. It was necessary to apply a series of treatments that penetrate the heel to multiple locations on both the left and right heels. Although not directly related, the following patent documents are disclosed as related to medical devices.
JP 2000-135218 A JP-A-10-295567

  However, in the conventional double scissors plastic surgery described above, the needle piercing position can be used to penetrate the two needles tied to both ends of the thread to the correct position from the back of the scissors, relying on the markings attached to the front side of the scissors. It is necessary to change a plurality of general-purpose instruments such as tweezers and needle holders while searching, and there is a problem that not only high skill is required, but also the accuracy is inferior and the operation time is long.

  In view of the above-described conventional drawbacks, the present invention allows a needle to penetrate a designated position of a living tissue that is a threading target in a safe, accurate, and short time, even if it is not a skilled person in plastic surgery for double scissors. It is in the point which provides the threading surgical instrument which can be performed.

  In order to achieve the above-mentioned object, a first characteristic configuration of a threading surgical instrument according to the present invention includes a finger engaging portion formed on one end side as described in claim 1 of the document of the claims. A pair of operation arms that are connected to the support shaft so as to be relatively rotatable around the support shaft, and are swingably operated around the support shaft. It is configured to include a swing lever and a needle holding cassette that holds a pair of needles that pass through a thread passing object clamped by the clamp portion in conjunction with a swing operation of the swing lever. is there.

  According to the above-described characteristic configuration, the position where the needle is penetrated is marked on the heel, and one side of the clamping portion is inserted between the heel and the eyeball with the marking as a mark to engage the pair of finger engaging portions. By holding the operating arm with the combined fingers, grab the eyelid at the holding part at the other end, peel it off from the eyeball as if scooping it further, and in that state, use the rest of the fingers of the same hand to move the swing lever. By swinging, the pair of needles held by the needle holding cassette moving along the swing trajectory can be passed through the scissors at the same time. The penetrating needle can be easily pulled out by grasping the tip of the needle with the tweezers for pinching the needle held in the other hand. In addition, the penetrating position of the needle can be accurately performed without variation.

  In addition to the first feature configuration described above, the second feature configuration is formed in an annular shape in which one side of the clamping portion allows a needle to pass through the second feature configuration. A slit for guiding the needle threaded through is formed.

  According to the above-described configuration, the pair of needles tied to both ends of one thread passes through the inside of the one-side holding portion formed in an annular shape, and then penetrates from the back side of the bag, and further, the holding portion The tip of the needle protrudes from the slit formed on the other side of the needle, and the holding portion is configured so that the periphery of the needle penetration portion of the heel is held with substantially equal force. When penetrating, the surface around the slit formed on the other side is pressed in the direction opposite to the penetrating direction of the needle, so that it can be penetrated more quickly, and the thread is formed in an annular shape at that time As a result, the thread does not get tangled in the clamping part.

  In the third feature configuration, in addition to the second feature configuration described above, the position of the thread passing marker marked on the thread passing target object on the other side of the clamping portion is the same as the second feature configuration described above. A positioning marker for alignment is provided.

  When the thread passing object is clamped by the clamping part, the thread passing marker is clamped while adjusting the position so that the threading marker marked on the thread passing object and the positioning marker provided on the clamping part match. Thus, the threading position can be accurately positioned without damaging the object.

  In the fourth feature configuration, as described in claim 4, in addition to any of the first to third feature configurations described above, the needle holding cassette includes a pair of support plates and a support plate. A pressure contact mechanism for holding the needle by pressure contact, and a guide groove for positioning and holding the needle in a predetermined posture is formed on one or both of the support plates.

  By attaching a pair of needles tied to both ends of a single thread along a guide groove formed on the support plate, the needles are pressed and supported so that the posture of the needles is held in a predetermined posture. When the needle penetrates the thread passing object, the needle is accurately penetrated without breaking the posture.

  In the fifth feature configuration, as described in claim 5, in addition to the fourth feature configuration described above, the needle penetrates the thread passing object by the swinging operation at the first angle of the swing lever. In addition, a press release mechanism is provided in which the press contact between the support plates by the press contact mechanism is released by a swing operation at a second angle larger than the first angle.

  Although it is necessary to further pull out the needle from the state in which the tip of the needle penetrates the thread passing object, the needle cannot be pulled out in a state where the needle is pressed against the support plate by the pressure contact mechanism. Therefore, when the needle tip is passed through the thread passing object by operating the swing lever, the pressure contact release mechanism is activated by releasing the needle contact to release the pressure contact between the support plates. In this state, the needle can be easily pulled out by operating the needle clamping forceps with the other hand and pulling out the needle tip.

  In the sixth feature configuration, as described in the sixth aspect, in addition to the fourth or fifth feature configuration described above, the needle holding cassette is configured such that the needle held by the swing lever is the clamping portion. Between the threading position located below and the retracted position retracted toward the finger engaging portion with respect to the clamping portion.

  In other words, when holding the pupil, which is a thread passing object, in the initial stage, the needle holding cassette is retracted to the retracted position, thereby eliminating the possibility of damaging the eyeball or the like by the needle holding cassette. In addition, the needle can be pinched neatly, and when the threading operation is performed after the pinching, the needle holding cassette can be quickly moved to the threading position by sliding.

  As described above, according to the present invention, even if not an expert, a threading surgical instrument that allows a needle to penetrate a specified position of a living tissue that is a threading target safely, accurately, and in a short time. Can now be provided.

  Embodiments of a threading surgical instrument according to the present invention will be described below. As shown in FIGS. 1 and 2, the threading surgical instrument 1 is finger-fitted to one end of a pair of metal operation arms 2 (2a, 2b) that are rotatably supported around a support shaft P. A joint portion 3 (3a, 3b) is formed, and a sandwiching portion 4 (4a, 4b) is formed on the other end side to sandwich the thread passing object. Further, the swing lever is swingable around the support shaft P. 5, a swing operation portion 5 a is formed on one end side of the swing lever 5, and a needle holding cassette 6 that is linked to the disturbance operation of the swing operation portion 5 a is attached to the other end side. ing.

  As shown in FIG. 3, one side 4a of the clamping part 4 (4a, 4b) is formed in an annular shape that allows a needle to pass through it, and the other side 4b is held by the needle holding cassette 6 and passes through. A pair of slits 4c for guiding the needle that has passed through the yarn object is formed. The clamping is performed in a clamped state so as to be clamped between the annular portion formed on the one side 4a and a portion of the clamping surface of the other side 4b facing the annular portion with a uniform clamping force. It is comprised so that the part 4 (4a, 4b) may become a substantially parallel attitude | position. Further, a positioning marker 4d is provided on the surface of the other side 4b of the pinching portion 4 to perform alignment with a threading marker marked on the threading object.

  As shown in FIGS. 3 and 4 (a) and 4 (b), the swing lever 5 is formed so as to be bifurcated toward the other end of the swing operation portion 5a. A plate spring 5e is provided which is pivotally supported around the support shaft P and is oscillated and biased in a direction away from the operation arm 2. The plate spring 5e is provided in a non-operating state. It is urged to swing to a position where it is restrained by a restraining pin 5d fitted in the operation arm 2. In addition, a pair of groove portions 5c for slidably holding the needle holding cassette 6 is formed on the opposing surface of the other end portion 5b of the swing lever 5.

  As shown in FIG. 5 (a), the needle holding cassette 6 has a pair of upper and lower metal support plates 6a and 6b that are bolted at the base end side and hold the pair of needles 7 (7a and 7b) at the tip end side. And a pressure contact mechanism 8 that presses the support plates 6a and 6b to hold the pair of supported needles 7 (7a and 7b) in a predetermined posture, and bends from below the support plates 6a and 6b toward the tip side. The flexible protection member 9 is formed. The protective member is made of rubber or synthetic resin.

  As shown in FIGS. 4B, 4C, and 4D, the upper support plate 6a includes a narrow portion W1 on the front end side, a wide portion W3 on the rear end side, and an intermediate portion W2 having an intermediate width therebetween. Configured such that the width of the intermediate portion W2 and the width of the groove portion 5c are substantially equal so that the groove portion 5c of the swing lever 5 is inserted from the narrow-width portion W1 at the tip and is held by the intermediate portion W2. Has been. Elliptical arc-shaped guide grooves 6c and 6d are formed on the lower surface of the narrow portion W1 to position and hold the needle 7 having an elliptical cross section that is bent so that its tip portion is in an upward posture. The lower support plate 6b is configured by a leaf spring bent at the center, and thus the needle 7 is stably held between the upper support plate 6a and the lower support plate 6b. Has been. That is, the press contact mechanism 8 is constituted by the lower support plate 6b.

  Concave and convex portions 6e are formed on both sides of the intermediate portion W2 so that the needle holding cassette 6 does not easily slide relative to the groove portion 5c during the treatment. When the upper support plate 6a is inserted into the groove portion 5c and the rear end is pushed in, the protruding end surface 6f of the wide portion W3 enters to a position where it comes into contact with the swing lever 5, and this position is the needle. The needle 7 held by the holding unit 6 becomes a threading position located below the clamping unit 4. On the contrary, the retracted position is a position where the gripping part 4 is retracted so as to be retracted toward the finger engaging part 3 side.

  When the needle holding cassette 6 is advanced to the threading position and the swing lever 5 is swung at a predetermined first angle against the urging force of the leaf spring 5e, the swing lever 5 In conjunction with this, the needle holding cassette 6 swings upward, and the needle 7 passes through the thread passing object clamped by the clamping unit 4. Further, when the rocking operation is performed at a second angle larger than the first angle, the press release pin 2c inserted into the operation arm 2 passes through a long hole 6g formed on the distal end side of the upper support plate 6a. When the lower support plate 6b is pressed, the press contact between the support plates 6a and 6b by the press contact mechanism 8 is released from the press contact state shown in FIG. 5 (e), as shown in FIG. 5 (f). It is configured to transition to the release state. That is, the pressure release mechanism is constituted by the pressure release pin 2c and the long hole 6g.

  A procedure for performing a double heel plastic surgery using the above-described threading instrument will be described. In an operation for forming a double fold as shown in FIG. 7 (a), as shown in FIG. 7 (b), first, a position for threading through two positions on both sides of the epithelium of the pupil is specified. As shown in FIG. 6 (a), with the needle holding cassette 6 holding the needle 7 retracted to the retracted position, the thumb and little finger of the right hand are placed on the finger engaging portion 3 (3a, 3b). Is engaged to open the clamping part 4, and one side 4a of the clamping part is inserted between the eyelid and the eyeball so that the positioning marker 4d coincides with the marking, as shown in FIG. The eyelid is grasped by sandwiching the operation arm 2 with the fingers engaged with the pair of finger engaging portions, and then peeled off from the eyeball in such a manner that the eyelid is further pinched.

  In this state, as shown in FIG. 6B, after the needle holding cassette 6 is advanced to the threading position, the index finger of the same hand is engaged with the swing operation portion 5a and the central portion of the operation arm 2b. A needle holding cassette that moves along a swinging locus as shown in FIG. 6C by engaging the middle finger with the engaging projection 3c formed on the head and swinging the swinging lever 5. A pair of needles held by 6 are simultaneously passed through the heel.

  In this state, the rocking lever 5 is rocked further deeply to shift to the pressure release state as shown in FIG. 6 (d). Then, by operating the needle clamping tweezers with the other hand and pulling out the needle tip, as shown in FIG. 7 (d), the thread tied to the ends of both needles 7 is inserted from the back side of the heel to the front side. Is done. The threading operation is completed by suturing the inserted thread according to a predetermined procedure and performing an operation called a knot at each marking position.

  Another embodiment of the threading surgical instrument according to the present invention will be described below. In the above-described embodiment, the elliptical arc-shaped guide grooves 6c and 6d are formed on the lower surface of the upper support plate 6a. However, the formation position of the guide grooves is not limited to the lower surface of the upper support plate 6a. It may be formed on the upper surface of the lower support plate 6b, or may be formed on both the upper support plate 6a and the lower support plate 6b. Further, the shape of the guide groove has been described as an elliptical arc shape along the cross-sectional shape of the needle so that the posture is not deformed while the needle 7 is held, but it is not necessarily limited to the elliptical shape, What is necessary is just to be able to hold the held needle 7 firmly so as not to rotate or tilt around the axis.

  Moreover, although the lower support plate 6b is configured by a leaf spring bent at the center and the press contact mechanism 8 is configured by the lower support plate 6b, the configuration of the needle holding cassette 6 is limited to this. For example, as shown in FIGS. 8A and 8B, an upper support plate 6a and a lower support plate 6b are formed in a clip shape that can hold the needle 7 by a plate spring 6h. The pressing mechanism 8 may be constituted by the leaf spring 6h.

  Further, as shown in FIG. 7C, a second leaf spring 6 i is attached to the upper support plate 6 a of the needle holding cassette 6, and the swing operation portion 5 a swings away from the operation arm 2. You may replace with the above-mentioned leaf | plate spring 5e which energizes.

  One side 4a of the clamping part 4 (4a, 4b) is formed in an annular shape through which a needle passes, and a slit 4c is formed in the other side 4b, and the annular part formed on the one side 4a; The clamping part 4 (4a, 4b) is in a substantially parallel posture in a clamping state so as to be clamped with a uniform threading force with the thread passing object between the clamping surface of the other side 4b and the part facing the annular part. However, the outer shape of the clamping part 4 (4a, 4b) is preferably a circle or an ellipse, and the size of the pair is held by the needle holding cassette 6. It is preferable to be determined by the distance between the needles 7.

Front view of a threading instrument according to the invention Top view of a threading instrument according to the invention The perspective view of the principal part of the instrument for threading operation by this invention (A) is a left side view of the swing lever, and (b) is a front view of the swing lever. Illustration of needle holding cassette A procedure for forming a double fold is shown, and (a) to (d) are front views of the threading surgical instrument. Explanatory drawing showing the formation process of double folds 4A is a front view of a needle holding cassette with a needle in a pressure contact state, FIG. 4B is a front view of the needle holding cassette with a needle in a pressure release state, and FIG. Front view of

Explanation of symbols

1: threading surgical instrument 2, 2a, 2b: operating arms 3, 3a, 3b: finger engaging parts 4, 4a, 4b: clamping part 5: swing lever 5a: swing operating part 6: needle holding cassette 7 : Needle 8: Pressure contact mechanism 9: Protection member P: Support shaft

Claims (6)

  A pair of operation arms, each having a finger engaging portion formed on one end side and a sandwiching portion sandwiching a thread passing object formed on the other end side, and connected to each other so as to be relatively rotatable around a support shaft; A swing lever attached so as to be swingable around the shaft, and a pair of needles that hold a pair of needles that pass through a thread passing object that is clamped by the clamping portion in conjunction with the disturbance operation of the swing lever A threading surgical instrument comprising a holding cassette.   The threading surgical instrument according to claim 1, wherein one side of the clamping portion is formed in an annular shape that allows a needle to pass through the slit, and a slit that guides the needle threaded through the other side is formed.   The threading surgical instrument according to claim 2, wherein a positioning marker for aligning with a threading marker marked on a threading object is provided on the other side of the pinching portion.   The needle holding cassette includes a pair of support plates and a pressure contact mechanism that presses the support plates and holds the needles, and positions and holds the needles in a predetermined posture on one or both of the support plates. The threading surgical instrument according to any one of claims 1 to 3, wherein a guide groove is formed.   The needle is passed through the thread passing object by a swinging operation at the first angle of the swinging lever, and the support plates by the press contact mechanism are moved by a swinging operation at a second angle larger than the first angle. The threading surgical instrument according to claim 4, wherein a press-contact releasing mechanism for releasing the press-contact is provided.   In the needle holding cassette, the swing lever has a thread holding position between a threading position where the needle is positioned below the clamping part and a retracting position where the needle is retracted toward the finger engaging part with respect to the clamping part. The threading surgical instrument according to claim 4 or 5, which is mounted so as to be slidable.