JP2005319208A - Surgical treatment instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a surgical treatment instrument capable of easily holding a needle in an arbitrary posture and achieving excellent operability. <P>SOLUTION: A needle holding part 5 in a tapered cone-shape, for example, is fused/fixed at the distal end of an insertion part 3. The needle holding part 5 is made of an elastic material such as silicone rubber, to hold a needle 6 as punctured with the needle. With this structure, a treatment part 4 can be stably located at a desired position without requiring the opening/closing operation for holding the needle such as a needle holder with a forceps structure, and the needle holding part 5 can be punctured with the needle in various directions regardless of the posture of the surgical treatment instrument 1, so that the needle can be easily delivered. Furthermore, as the needle is passively rotated according to the force applied from a tissue when the needle piercing the tissue is held by the needle holder part 5 and pulled out, the needle can be easily handled without applying excessive tension to the tissue. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a surgical treatment instrument for holding a needle, for example, during anastomosis of a cardiovascular or ureteral tube.

  For example, as disclosed in Patent Document 1, conventionally, for example, as a surgical treatment instrument for holding a needle such as a suture needle when performing anastomosis or suturing of a cardiovascular or ureter, the needle is held by gripping. A surgical treatment instrument (needle holder) having a so-called pinching forceps structure in a treatment section is widely used.

For example, in an endoscopic operation performed using this type of surgical treatment tool, generally, an insertion portion is inserted into a body cavity through a trocar or the like, and a body cavity is opened and closed by opening and closing the treatment portion connected to the distal end of the insertion portion. Grip (hold) the needle inside.
US Pat. No. 5,810,877

  However, the surgical treatment instrument disclosed in Patent Document 1 described above needs to change the posture of the treatment unit according to the direction of the needle when gripping the needle, and the operation becomes complicated. In addition, in particular, in an operation performed under an endoscope, there is a limit to the operation range of the treatment unit in a body cavity or the like, and thus there may be a case where an optimal posture for grasping the needle cannot be obtained.

  Moreover, since the above-mentioned surgical treatment tool requires opening / closing operation of the treatment portion when grasping the needle, the distal end position is easy to move, and skill is required for operation. In particular, in order to grasp a fine suture needle or the like used for anastomosis of a thin tube such as a cardiovascular vessel or a ureter, high skill is required for the operation.

  Also, when pulling out a needle stuck in a tissue such as a blood vessel at the time of anastomosis, etc., it is necessary to move the needle according to the curvature of the needle so as not to damage the tissue. Therefore, a highly skilled operation such as gripping the needle with a light gripping force that is passively rotated according to the force received from the tissue is required.

  The present invention has been made in view of the above circumstances, and an object thereof is to provide a surgical treatment instrument that can easily hold a needle in an arbitrary posture and can realize excellent operability.

  The present invention is characterized in that the treatment portion connected to the distal end of the insertion portion is provided with needle holding means capable of holding the needle by being inserted.

  According to the surgical treatment instrument of the present invention, the needle can be easily held in any posture, and excellent operability can be realized.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. 1 to 5 relate to a first embodiment of the present invention, FIG. 1 is a perspective view showing a schematic configuration of a surgical treatment instrument, and FIG. 2 is an explanation showing a needle delivery operation from a needle holder to a needle holder. FIGS. 3 and 3 are explanatory views of a needle holding portion holding a needle in a blood vessel, and FIGS. 4 and 5 are explanatory views showing a needle movement operation by a surgical treatment instrument.

  In FIG. 1, reference numeral 1 denotes a surgical treatment instrument that can hold a suturing needle 6 (see FIGS. 2 to 5), for example, at the time of anastomosis or suturing of a cardiovascular or ureter. This surgical treatment instrument 1 has an operation part 2 for an operator to hold and operate with one hand, and an insertion part 3 is continuously provided at the distal end of the operation part 2, and further, at the distal end of the insertion part 3. The treatment section 4 is continuously provided to constitute a main part.

  In this embodiment, the operation unit 2 and the insertion unit 3 are integrally formed of, for example, a stainless steel bar, and the outer diameter of the insertion unit 3 is smaller than that of the operation unit 2 by stepping of the bar. . Specifically, the insertion portion 3 is formed to have a thickness that can be inserted into a trocar used for an operation under an endoscope, whereby the surgical treatment tool 1 can be operated under an endoscope or It can be used for any surgery (open surgery) by laparotomy or the like.

  Here, the material of the operation unit 2 and the insertion unit 3 may be so-called engineering plastics such as polycarbonate and PEEK. Of course, the outer diameters of the operation portion 2 and the insertion portion 3 may be formed to be equal. In addition, it is preferable that the operation part 2 is processed to prevent slipping. Examples of the anti-slip process include knurling and sand blasting.

  A needle holding part 5 as a needle holding means constituting the treatment part 4 is welded and fixed to the distal end of the insertion part 3. The main part of the needle holding part 5 is constituted by an elastic body such as a tapered substantially conical silicone rubber, and the needle 6 can be held by being inserted into the elastic body. Here, various shapes such as a substantially spherical shape, a substantially cylindrical shape, a substantially polygonal pyramid shape, or a substantially polygonal column shape can be set as the shape of the needle holding portion 5. Moreover, as a material of the needle holding part 5, various materials such as fluoro rubber, polyvinyl chloride, or polyurethane can be set, and the hardness of the needle holding part 5 is appropriately set by selecting the material or the like. Thus, the needle holder 5 can hold the inserted needle 6 with an optimum holding force.

  In the surgical treatment tool 1 having such a configuration, the surgeon grasps the operation unit 2 with one hand and operates the position of the treatment unit 4 to lift or push the tissue in the surgical field. Can be done.

  Further, for example, as shown in FIG. 2, when the operator is suturing the blood vessel 7 while operating the needle holder 10 with the opposite hand, the operator holds the needle holder 10 to hold it. The needle 6 can be delivered to the surgical treatment instrument 1 by inserting the tip of the existing needle 6 into the needle holder 5 from an arbitrary direction. In this case, in particular, as shown in FIGS. 2 and 3, when the needle 6 held by the needle holder 10 is moved on the blood vessel 7, the needle holding portion 5 is inserted from the opening of the blood vessel 7. By pressing the needle holder 5 against the inside of the blood vessel 7 in the vicinity of the insertion point, the operation of supporting the blood vessel 7 by the surgical treatment tool 1 and the operation of receiving the needle 6 can be performed simultaneously. The same operation is also possible when the needle 6 is pierced from the inside to the outside of the blood vessel 7.

  As shown in FIGS. 4 and 5, the needle 6 held by the needle holder 5 can be rotated with the insertion point into the needle holder 5 as the rotation axis 8, and therefore the surgical treatment instrument 1 is used. When the needle 6 penetrating the blood vessel 7 is removed, the needle 6 can be passively rotated according to the force that the needle 6 receives from the blood vessel 7. For example, as shown in FIG. 5, when the needle holding unit 5 is moved back and forth in the direction indicated by the arrow A in the figure, the needle 6 is centered on, for example, the rotation shaft 8 according to the force received from the penetrating position of the blood vessel 7. Rotate in the direction of arrow B in the figure.

  According to such a configuration, since the needle is inserted into and held in the needle holder 5, it is not necessary to perform an opening / closing operation for holding the needle like a needle holder having a pinch forceps structure, The treatment section 4 can be stably positioned at a desired position, and the needle delivery operation can be easily performed. In particular, in a fine work such as suturing a thin tube such as a cardiovascular or urinary tract, the operability when the needle is transferred is greatly improved.

  Further, since the needle can be inserted into the needle holder 5 from various directions regardless of the posture of the surgical treatment instrument 1, the operability when the needle is transferred from a needle holder or the like can be further improved. it can. This is particularly effective in an operation under an endoscope in which the posture that the surgical treatment instrument 1 can take is limited.

  Further, when a needle penetrating a tissue such as a blood vessel is held and removed by the needle holder 5, the needle rotates passively according to the force received from the tissue, so that a great deal of tension is not applied to the tissue. Good hand movement can be realized.

  Further, when the needle is inserted into a tissue such as a blood vessel by a needle holder or the like, the holding of the tissue and the needle receiving operation can be performed simultaneously by arranging the needle holding portion 5 on the back side of the needle insertion point, A series of operations from the insertion of the needle into the tissue to the removal can be performed quickly. In addition, since the tissue can be supported and the needle can be received with a single instrument, the number of treatment tools to be used can be reduced. For example, in an operation performed under an endoscope, a patient is inserted to insert a treatment tool. Thus, the number of ports opened to the center can be reduced, and a less invasive surgery can be realized.

  Furthermore, when the needle is held by the needle holder 5, the needle tip is buried in the needle holder 5, so that peripheral devices, tissues, and the like can be accurately protected from the needle tip.

  Next, FIGS. 6 and 7 relate to the second embodiment of the present invention, FIG. 6 is a cross-sectional view of the main part of the treatment part, and FIG. 7 is a cross-sectional view of the main part of the treatment part holding the needle. In the present embodiment, the configuration of the needle holding portion is mainly different from the first embodiment described above. In addition, about the same structure, the same code | symbol is attached | subjected and description is abbreviate | omitted.

  As shown in FIG. 6, a stepped protrusion 24 having a plurality of stepped portions is provided at the distal end of the insertion portion 3, and the stepped protrusion 24 constitutes the treatment portion 4. The needle holding part 20 (needle holding means) is fitted and supported. In this case, for example, two may be insert-molded.

  In this embodiment, the needle holding portion 20 is configured by a two-layered elastic body including an outer layer 21 and an inner layer 22, and the inner layer 22 is an elastic member that is softer than the elastic member that constitutes the outer layer 21. It is configured. Here, as materials of the outer layer 21 and the inner layer 22 of the needle holding unit 20, various materials such as silicon rubber, fluororubber, polyvinyl chloride, and polyurethane can be suitably applied.

  With this configuration, as shown in FIG. 7, the needle 6 held by the needle holding portion 20 is rotated between the outer and inner layers 21 and 22 in addition to the rotation operation in the direction of the arrow B in the figure around the rotation shaft 8. The relative hardness difference makes it possible to swing in the direction of arrow C in the figure with the insertion point 23 into the outer layer 21 as a fulcrum.

  According to such a form, in addition to the effect substantially similar to the effect obtained in the first form described above, the force received from the tissue when the needle is held by the needle holding unit 20 and removed from the tissue such as a blood vessel. Accordingly, the needle can be moved three-dimensionally, and the effect that the tension applied to the tissue can be reduced more effectively.

  Next, FIGS. 8 and 9 relate to a third embodiment of the present invention, FIG. 8 is a perspective view showing a schematic configuration of the surgical treatment instrument, and FIG. 9 is a longitudinal sectional view showing a main part of the surgical treatment instrument. . This embodiment is mainly different from the first embodiment described above in that a function for variably adjusting the holding force of the needle by the needle holding portion is added. In addition, about the same structure, the same code | symbol is attached | subjected and description is abbreviate | omitted.

  As shown in FIGS. 8 and 9, in the present embodiment, the operation unit 2 is configured to include a handle portion 42 that incorporates a link mechanism portion 40. The handle portion 42 includes a pair of handle portion halves 42a and 42b connected by screws 41 to form a main portion, and a sliding bearing portion 43 that penetrates and supports a proximal end side of a rod 46 described later at a distal end portion thereof. Is arranged.

  In addition, a base end portion of a hollow outer cylinder 44 constituting the insertion portion 3 is fitted to the inner periphery of the sliding bearing portion 43. The handle portion 42, the sliding bearing portion 43, and the outer cylinder 44 are fitted. However, they are fastened and fixed to each other by screws 45a, 45b, 45c arranged at intervals of 120 degrees on the same circumference, for example.

  As shown in FIG. 9, a screw portion 47 is engraved at the base portion of the rod 46 that passes through the sliding bearing portion 43 and is exposed in the handle portion 42, and a nut 48 a that is screwed into the screw portion 47. , 48b restricts the movement of the rod 46 toward the tip side.

  Further, the distal end portion of the joint 49 is screwed to the proximal end portion of the screw portion 47, and one end portion of the arm 51 is rotatably connected to the proximal end portion of the joint 49 via the pin 50. ing.

  Here, an opening 52 is formed at the joint between the handle half halves 42 a and 42 b, and the other end of the arm 51 is exposed to the outside through the opening 52. A free end portion of the lever 53 is rotatably connected to the other end portion of the arm 51 via a pin 54.

  Further, the fixed end portion of the lever 53 is swingably supported via a pin 55 embedded on the proximal end side of the handle portion halves 42a and 42b, so that the operation portion 2 has a lever for the handle portion 42. A link mechanism portion 40 is configured to move the rod 46 forward and backward within the outer cylinder 44 by 53 inclining / standing operation.

  On the other hand, a sliding bearing portion 56 that penetrates and supports the rod 46 is fixed to the distal end portion of the outer cylinder 44 by a screw 57, and the distal end of the rod 46 that penetrates the sliding bearing portion 56 and is exposed to the treatment portion 4 side. A screw part 58 is engraved on the part.

  Further, a cap 59 is screwed into the screw portion 58, and a needle holding portion 60 (needle holding means) made of a substantially cylindrical elastic body is sandwiched between the cap 59 and the sliding bearing portion 56. Yes. Here, the needle holding portion 60 is formed of an elastic member made of, for example, silicon rubber, fluororubber, polyvinyl chloride, polyurethane, or the like.

  In such a configuration, when the lever 53 is operated to fall down by an operator holding the operation unit 2, the rod 46 is moved to the proximal end side together with the joint 49 via the arm 51, thereby the sliding bearing unit. The needle holder 60 sandwiched between 56 and the cap 59 is compressed. The holding force of the needle 6 by the needle holding part 60 is strengthened by the elastic deformation of the needle holding part 60 by this compression. That is, in this embodiment, the holding force of the needle 6 is made variable by elastically deforming the needle holding portion 60 by the link mechanism portion 40 disposed in the operation portion 2 and the cap 59 interlocking with the link mechanism portion 40. A needle holding force adjusting mechanism to be adjusted is realized.

  The adjustment of the holding force with respect to the needle holding unit 60 is normally performed after the delivery of the needle 6 or the like, so that the needle 6 is transferred from the needle holder 10 or the like to the surgical treatment instrument 1 or the like. The operability at that time is maintained well.

  According to such a form, in addition to the effect substantially the same as the effect obtained in the first form described above, the holding force of the needle inserted into the needle holding part 60 can be enhanced by the compression of the needle holding part 60. Therefore, there is an effect that a more reliable needle holding operation is possible.

  Next, FIGS. 10 to 12 relate to a fourth embodiment of the present invention, FIG. 10 is a perspective view showing a schematic configuration of a surgical treatment instrument, FIG. 11 is a cross-sectional view of the main part of the treatment section, and FIG. It is explanatory drawing of. In this embodiment, the configuration of the treatment section 4 is mainly different from the first embodiment described above. In addition, about the same structure, the same code | symbol is attached | subjected and description is abbreviate | omitted.

  As shown in FIGS. 10 and 11, in this embodiment, a needle holding unit 100 as a needle holding unit disposed in the treatment unit 4 includes a distal end cap 101 connected to the distal end of the insertion unit 3 via a connector 104. And an elastic body 102 covered on the surface thereof.

  A concave portion 106 is opened at the distal end of the insertion portion 3, and the base portion of the connector 104 is fitted into the concave portion 106. The connector 104 is connected and held to the insertion portion 3 by screwing the screw portion 105 penetrating from the side portion of the insertion portion 3 into the concave portion 106 to the base portion of the connector 104.

  Further, a screw hole penetrating in the axial direction is formed in the center of the connector 104, and a screw portion 103 connected to the base portion of the tip cap 101 is screwed into the screw hole. When the tip cap 101 is connected to the connector 104 by screwing of the screw portion 103, the edge of the elastic body 102 is sandwiched between the tip cap 101 and the connector 104, so that the elastic body 102 becomes the tip cap. 101 is held on the surface.

  Here, the elastic body 102 is composed of an elastic member in which a plurality of holes 107 having a diameter smaller than the diameter of the needle 6 are arranged in a mesh shape. As shown in FIG. 12, when the needle 6 is inserted into the hole 107, the needle 6 is held by the elastic restoring force (contraction force) of the hole 107.

  According to such a form, in addition to the effect substantially the same as the effect obtained in the first form described above, the deteriorated elastic body 102 can be easily removed from the connector 104 by the configuration in which the tip cap 101 and the elastic body 102 can be easily detached. Can be easily exchanged, and the cost can be reduced.

  Next, FIGS. 13 to 17 relate to a fifth embodiment of the present invention, FIG. 13 is a perspective view showing a schematic configuration of a surgical treatment instrument, FIG. 14 is a cross-sectional view of a main part of an operation unit, and FIG. FIG. 16 is an explanatory view showing an elastic body in a normal state, and FIG. 17 is an explanatory view showing the elastic body when elastically deformed. This embodiment is mainly different from the first embodiment described above in that a function for variably adjusting the holding force of the needle by the needle holding portion is added. In addition, about the same structure, the same code | symbol is attached | subjected and description is abbreviate | omitted.

  As shown in FIGS. 13 and 14, in the present embodiment, the operation unit 2 is configured to include a handle unit 122 that incorporates a link mechanism unit 120. The handle portion 122 includes a pair of handle portion halves 122a and 122b connected by screws 121 to form a main portion, and a sliding bearing portion 123 that penetrates and supports a proximal end side of a rod 126 described later at a distal end portion thereof. Is arranged.

  Further, a base portion of a hollow outer cylinder 124 constituting the insertion portion 3 is fitted to the inner periphery of the sliding bearing portion 123, and the handle portion 122, the sliding bearing portion 123, and the outer cylinder 124 are For example, they are fastened and fixed to each other by screws 125a, 125b, and 125c arranged at intervals of 120 degrees on the same circumference.

  As shown in FIG. 14, a screw portion 127 is engraved at the base portion of the rod 126 that passes through the sliding bearing portion 123 and is exposed in the handle portion 122, and a nut 128 a that is screwed into the screw portion 127. , 128b restricts the movement of the rod 126 toward the tip side.

  Further, the distal end portion of the joint 129 is screwed to the proximal end portion of the screw portion 127, and one end portion of the arm 131 constituting the link mechanism portion 120 is connected to the pin 130 at the proximal end portion of the joint 129. It is connected via a pivot.

  Here, an opening 132 is formed at the joint between the handle half halves 122 a and 122 b, and the other end of the arm 131 is exposed to the outside through the opening 132. A midway portion of the lever 133 is rotatably connected to the other end portion of the arm 131 via a pin 134.

  Further, the fixed end portion of the lever 133 is supported so as to be swingable through a pin 135 embedded in the proximal end side of the handle portion halves 122a and 122b, whereby the operation portion 2 has a lever for the handle portion 122. The link mechanism 120 is configured to move the rod 126 forward and backward within the outer cylinder 124 by the standing / falling operation of 133.

  On the other hand, as shown in FIG. 15, a connector 136 is fixed to the distal end portion of the outer cylinder 124 with a screw 137. A screw hole that penetrates the connector 136 in the axial direction is formed in the center of the connector 136, and a sliding bearing portion 138 that penetrates and supports the rod 126 is connected to the connector 136 through the screw hole. Yes. Specifically, a hollow threaded portion 139 is continuously provided on the sliding bearing portion 138, and the sliding bearing portion 138 is connected to the connector 136 by screwing the threaded portion 139 into the screw hole of the connector 136. It is connected to.

  Further, a threaded portion 141 is engraved at the tip of the rod 126 that passes through the sliding bearing portion 138 and is exposed to the treatment portion 4 side. A tip pusher 142 is screwed onto the screw portion 141, and the tip pusher 142 is covered with an elastic body 140 constituting a needle holding portion 143 (needle holding means). Here, when the sliding bearing portion 138 is connected to the connector 136 by screwing of the screw portion 139, the elastic body 140 is held on the surface of the tip pusher 142 by sandwiching an edge portion between them. Yes.

  As shown in FIG. 16, the elastic body 140 is composed of an elastic member in which a plurality of holes 144 into which the needle 6 can be inserted are arranged in a mesh shape. Here, as a material of the elastic body 140, for example, silicon rubber, fluororubber, polyvinyl chloride, polyurethane, or the like is preferably used.

  In such a configuration, when the lever 133 is tilted by the operator holding the operation unit 2, the rod 126 is moved to the distal end side together with the joint 129 via the arm 131, whereby the distal end pusher 142 is moved to the distal end. Moved to the side. When the distal end pusher 142 is moved to the distal end side, the elastic body 140 covering the distal end pusher 142 is pulled toward the distal end side, and the hole 144 is elastically deformed by the tension due to the pulling, whereby the needle 6 by the needle holding portion 143 is obtained. Is strengthened (see FIG. 17). In other words, in the present embodiment, the elastic body 140 is elastically deformed and the holding force of the needle 6 is made variable by the link mechanism unit 120 disposed in the operation unit 2 and the tip pusher 142 interlocked with the link mechanism unit 120. A needle holding force adjusting mechanism to be adjusted is realized.

  The adjustment of the holding force of the needle holding portion 143 is normally performed after the delivery of the needle 6 or the like, so that the needle 6 is transferred from the needle holder 10 or the like to the surgical treatment instrument 1 or the like. The operability at that time is maintained well.

  According to such a form, in addition to the effect substantially the same as the effect obtained in the first form described above, the holding force of the needle inserted into the hole 144 by pulling the needle holding part 143 can be enhanced. There is an effect that a more reliable needle holding operation is possible.

  Next, FIG. 18 is related with the 6th form of this invention, FIG. 18 is a perspective view which shows the principal part of a treatment part. Note that this embodiment is mainly different from the first embodiment described above in that a plurality of cut portions are provided in the needle holding portion. Other similar configurations are denoted by the same reference numerals and description thereof is omitted.

  As shown in FIG. 18, for example, the needle holding portion 5 constituting the treatment portion 4 is provided with a plurality of cut portions 162 along the circumferential direction and the long axis direction.

  In such a configuration, when the needle 6 is delivered from the needle holder 10 to the surgical treatment instrument 1, the needle tip is inserted into the notch 162 and clamped, so that the needle tip is held by the needle holder 5. The needle 6 can be held by the needle holding part 5 without being inserted. Needless to say, the needle holding unit 5 can hold the needle 6 even by being inserted into a part other than the notch 162.

  According to such a form, in addition to the effect substantially similar to the effect obtained in the first form described above, it is not necessary to insert a needle into the needle holding part 5, so the needle holding part 5 holds the needle. The work is facilitated and the operability can be further improved.

  In addition, the cut portion 162 can hold a portion other than the needle tip, and the operability can be further improved.

  Next, FIG. 19 is related with the 7th form of this invention, FIG. 19 is a perspective view which shows the principal part of a treatment part. Note that this embodiment is mainly different from the first embodiment described above in that the needle holding portion is covered with an adhesive layer. Other similar configurations are denoted by the same reference numerals and description thereof is omitted.

  As shown in FIG. 19, an adhesive layer 201 is formed on the surface of the needle holding part 5 constituting the treatment part 4.

  In such a configuration, when the needle 6 is delivered from the needle holder 10 to the surgical treatment instrument 1, the needle tip is inserted into the needle holder 5 by bringing the needle 6 into contact with the adhesive layer 201. The needle 6 can be held on the surface of the needle holding portion 5 without any problem. Needless to say, the needle holding unit 5 can hold the needle 6 even by insertion.

  According to such a form, in addition to the effect substantially similar to the effect obtained in the first form described above, it is not necessary to insert a needle into the needle holding part 5, so the needle holding part 5 holds the needle. The work is facilitated and the operability can be further improved.

  Further, the adhesive layer 201 can also hold a portion other than the needle tip, and the operability can be further improved.

  Next, FIG. 20 is related to the 8th form of this invention, FIG. 20 is principal part sectional drawing of a treatment part. Note that this embodiment is mainly different from the first embodiment described above in that the needle holding portion is configured by incorporating a magnet in the elastic body. Other similar configurations are denoted by the same reference numerals and description thereof is omitted.

  As shown in FIG. 20, the needle holding unit 220 as a needle holding unit includes, for example, a tapered magnet 221 having a substantially conical shape and an elastic body 224 that is welded and fixed to the surface thereof. Here, as the elastic body 224, for example, silicon rubber, fluororubber, polyvinyl chloride, polyurethane, or the like is preferably used.

  A screw hole 223 is provided at the base of the magnet 221, and the needle holding part 220 is connected to the insertion part 3 by screwing the screw hole 223 into a screw part 222 protruding from the tip of the insertion part 3. ing.

  In such a configuration, when the needle 6 is delivered from the needle holder 10 to the surgical treatment instrument 1, the needle 6 is adsorbed by a magnetic force so that the needle tip is not inserted into the elastic body 221. It becomes possible to hold the needle 6 in the portion 220. Needless to say, the needle holding unit 5 can hold the needle 6 even by insertion into the elastic body 221.

  According to such a form, in addition to the effect substantially similar to the effect obtained in the first form described above, the needle located at a position away from the needle holding unit 5 can also be attracted to the treatment unit 4, for example, There are effects such as easy operation when re-holding the needle that has fallen into the body.

  Next, FIGS. 21 to 23 relate to the ninth embodiment of the present invention, FIG. 21 is a longitudinal sectional view showing the main part of the surgical treatment instrument, FIG. 22 is a perspective view of the treatment part, and FIG. It is AA sectional drawing. In this embodiment, the configuration of the treatment section is mainly different from the above-described third embodiment. Other similar configurations are denoted by the same reference numerals and description thereof is omitted. However, in this embodiment, the link mechanism unit 40 is used for the operation of a forceps structure unit to be described later, instead of the use for elastically deforming the needle holding unit 60.

  As shown in FIG. 21, in this embodiment, a spring 252 that urges the joint 49 toward the distal end side is disposed in the handle portion 42.

  Further, as shown in FIGS. 21 to 23, a fixed clamping piece 241 is connected to the distal end of the insertion portion 3. More specifically, the fixed clamping piece 241 has a base portion 241a having a substantially columnar shape, and the base portion 241a is fitted into the outer cylinder 44 of the insertion portion 3 and is fixed by a screw 242 to thereby insert the insertion portion. 3 is connected. Further, at the center of the base portion 241 a connected to the insertion portion 3, the tip end portion of the rod 46 penetrating the outer cylinder 44 is inserted so as to be able to advance and retreat in the long axis direction.

  In addition, a clamping surface portion 243 for clamping a needle or the like is integrally formed on the distal end side of the base portion 241a. The sandwiching surface portion 243 is configured by a substantially ring-shaped member having a through hole 244 opened at the center portion, and is provided along a surface substantially coincident with the surface including the major axis direction of the rod 46 and the axis of the pin 50. ing. The sandwiching surface portion 243 is filled with an elastic body 245 constituting the needle holding portion 5 from the back surface side of the sandwiching surface portion 243 to the through hole 244.

  In addition, the fixed clamping piece 241 is provided with a concave portion 241b on the distal end side in the vicinity of the connecting portion between the base portion 241a and the clamping surface portion 243 (see FIG. 23), and the concave portion 241b has a base portion of the movable clamping piece 247. 247b is provided. Further, a pin 246 parallel to the pin 50 is supported in the recess 241b, and the base 247b of the movable holding piece 247 is pivotally supported on the pin 246. Furthermore, the distal end portion of the rod 46 is rotatably connected to the proximal end portion of the base portion 247 via a pin 248 parallel to the pin 246.

  On the other hand, a sandwiching surface portion 249 facing the sandwiching surface portion 243 is integrally formed on the distal end side of the base 247b of the movable sandwiching piece 247. The sandwiching surface portion 249 is configured by a substantially ring-shaped member having a through hole 250 opened at the center portion, and is filled with an elastic body 251 constituting the needle holding portion 5 from the back surface side of the sandwiching surface portion 249 to the through hole 250. ing. Accordingly, a forceps structure unit that is linked to the link mechanism unit 40 is configured in the treatment unit 4.

  Here, as a material constituting the elastic bodies 245 and 251, silicon rubber, fluororubber, polyvinyl chloride, polyurethane, or the like is preferably used. Moreover, as shown in FIG. 22, it is preferable that anti-slip | skid processing is given to the mutually opposing surface of the clamping surface part 243 and the clamping surface part 249. As shown in FIG. As the anti-slip process, an electric discharge process, a knurling process, a fine diamond spraying process on metal plating, and the like are preferably applied.

  In such a configuration, when the lever 53 is tilted to the handle portion 42 side, and the joint 49 and the rod 46 are pulled toward the rear end side against the biasing force of the spring 252 via the arm 51, the lever 53 is movable. The clamping piece 247 is rotated around the pin 246, and thereby the clamping surface portion 249 is closed toward the clamping surface portion 243.

  According to such a form, in addition to the effect substantially the same as the effect obtained in the first form described above, a forceps function is added to the surgical treatment instrument 1 to hold the needle by the needle holding part 5. In addition, the needle and other tissues can be held by the opening / closing operation of the clamping surface portion 249, and the effect of reducing the number of times of exchanging the treatment instrument during the operation is obtained.

  Next, FIG. 24 is related to the 10th form of this invention, FIG. 24 is a perspective view which shows the principal part of a treatment part. Note that this embodiment is mainly different from the first embodiment described above in that a water absorption pipe is opened in the treatment section. Other similar configurations are denoted by the same reference numerals and description thereof is omitted.

  As shown in FIG. 24, in this embodiment, the needle holding part 5 has an elastic body 262 having a substantially cylindrical shape, for example, and an opening 263 of a water absorption pipe communicating with a pump (not shown) is opened at the tip thereof. ing. Here, as a material constituting the elastic body 262, for example, silicon rubber, fluorine rubber, polyvinyl chloride, polyurethane, or the like is preferably used.

  In such a configuration, the surgical treatment instrument 1 can suck the liquid in the vicinity of the opening 263 by the operation of the pump communicating with the water absorption pipe.

  According to such a form, in addition to the effect substantially the same as the effect obtained in the first form described above, the number of treatment instruments to be used can be reduced by adding a water absorption function to the surgical treatment instrument 1. For example, in an operation performed under an endoscope, the number of ports opened to a patient for inserting a treatment tool can be reduced, and an effect of realizing a less invasive operation can be achieved.

  Next, FIG. 25 relates to an eleventh embodiment of the present invention, and FIG. 25 is a perspective view showing a main part of the treatment portion. Note that this embodiment is mainly different from the first embodiment described above in that a blower passage is opened in the treatment portion. Other similar configurations are denoted by the same reference numerals and description thereof is omitted.

  As shown in FIG. 25, in this embodiment, the needle holder 5 has an elastic body 267 having a substantially cylindrical shape, for example, and an opening 268 of a blower passage communicating with a blower device (not shown) is opened at the tip thereof. Has been. Here, as a material constituting the elastic body 267, for example, silicon rubber, fluororubber, polyvinyl chloride, polyurethane, or the like is preferably used.

  In such a configuration, the surgical treatment instrument 1 can remove liquid or the like in the vicinity of the opening 268 by the operation of the blower device communicating with the blower passage.

  According to such a form, in addition to the effect substantially the same as the effect obtained in the first form described above, the number of treatment instruments to be used can be reduced by adding a blower function to the surgical treatment instrument 1. For example, in an operation performed under an endoscope, the number of ports opened to a patient for inserting a treatment tool can be reduced, and an effect of realizing a less invasive operation can be achieved.

  In addition, this invention is not limited to the structure of each above-mentioned form, For example, of course, you may comprise the surgical treatment tool 1 combining the structure demonstrated by each form suitably.

The perspective view which concerns on the 1st form of this invention and shows schematic structure of the surgical treatment tool. Explanatory drawing which shows the delivery operation of the needle from a needle holder to a needle holding part same as the above Same as above, explanatory view of the needle holding part holding the needle in the blood vessel Explanatory drawing which shows the needle movement operation | movement with a surgical treatment tool same as the above Explanatory drawing which shows the needle movement operation | movement with a surgical treatment tool same as the above Sectional drawing of the principal part of a treatment part according to the second embodiment of the present invention. Same as above, main part sectional view of the treatment part holding the needle The perspective view which concerns on the 3rd form of this invention and shows schematic structure of the surgical treatment tool. Same as above, longitudinal section showing the main part of the surgical instrument The perspective view which concerns on the 4th form of this invention and shows schematic structure of the surgical treatment tool. Same as above, sectional view of main part of treatment section Same as above, illustration of mesh member The perspective view which concerns on the 5th form of this invention and shows schematic structure of the surgical treatment tool. Same as above, sectional view of the main part of the operation unit Same as above, sectional view of main part of treatment section As above, an explanatory diagram showing a mesh member in a normal state Explanatory drawing which shows the mesh-like member at the time of carrying out elastic deformation same as the above The perspective view which concerns on the 6th form of this invention and shows the principal part of a treatment part. The perspective view which concerns on the 7th form of this invention and shows the principal part of a treatment part. Sectional drawing of the principal part of a treatment part in connection with the 8th form of this invention. The longitudinal cross-sectional view which concerns on the 9th form of this invention and shows the principal part of a surgical treatment tool. Same as above, perspective view of treatment section Same as above, AA sectional view of FIG. The perspective view which concerns on the 10th form of this invention and shows the principal part of a treatment part. The perspective view which concerns on the 11th form of this invention and shows the principal part of a treatment part.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Surgical treatment tool 3 ... Insertion part 4 ... Treatment part 5 ... Needle holding part (needle holding means)
6 ... Needle 20 ... Needle holder (needle holding means)
21 ... Outer layer 22 ... Inner layer 40 ... Link mechanism (needle holding force adjusting mechanism)
59… Cap (needle holding force adjustment mechanism)
60 ... Needle holding part (needle holding means)
100 ... Needle holding part (needle holding means)
102 ... Elastic body 101 ... Tip cap (needle holding force adjusting mechanism)
120 ... Link mechanism (needle holding force adjusting mechanism)
140 ... elastic body 142 ... tip pusher (needle holding force adjusting mechanism)
143 ... Needle holding part (needle holding means)
162 ... notch part 201 ... adhesive layer 220 ... needle holding part (needle holding means)
221 ... Magnet 221 ... Elastic body 224 ... Elastic body 245 ... Elastic body 251 ... Elastic body 262 ... Elastic body 267 ... Elastic body
Agent Patent Attorney Susumu Ito

Claims (9)

  A surgical treatment instrument characterized in that a needle holding means having an elastic body capable of holding a needle by insertion is provided in a treatment portion provided continuously with a distal end of the insertion portion. The elastic body has a two-layer structure including an outer layer and an inner layer,
The surgical treatment instrument according to claim 1, wherein the inner layer is made of an elastic member that is softer than the outer layer.   The surgical treatment instrument according to claim 1 or 2, further comprising a needle holding force adjusting mechanism that variably adjusts the holding force of the needle inserted into the elastic body by elastically deforming the elastic body. .   The surgical treatment instrument according to claim 3, wherein the needle holding force adjusting mechanism elastically deforms the elastic body by compression.   The surgical treatment instrument according to claim 3, wherein the needle holding force adjusting mechanism elastically deforms the elastic body by pulling.   The surgical procedure according to any one of claims 1 to 5, wherein the elastic body includes an elastic member in which a plurality of holes into which needles can be inserted are arranged in a mesh shape. Ingredients.   The surgical treatment instrument according to any one of claims 1 to 6, wherein the elastic body is provided with a notch capable of sandwiching a needle.   The surgical treatment instrument according to any one of claims 1 to 7, wherein the needle holding means has an adhesive layer on a surface of the elastic body.   The surgical treatment instrument according to any one of claims 1 to 8, wherein the needle holding means includes a magnet inside the elastic body.

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