JP2006081597A - Aneurysm clip clamping forceps - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide forceps eliminating crushing of a spring part at a base part of a clip when clamping the root part of the aneurysm with an aneurysm clip, preventing the occurrence of imperfect clamp by the clip and capable of surely clamping. <P>SOLUTION: In this aneurysm clip clamping forceps, clamping parts 25 and 25 of a pair of clamping members 21 and 21 having a cross part pivoted by a pivot 22 are opposedly provided with recesses 26 and 26 for receiving the spring part 2 at the base part of the clip 1, the outer ends of the recesses are provided with pressurizing parts 27 and 27 pressing the pressing parts 4 and 4 of the clip, and a clip intrusion preventing part 30 preventing the intrusion of the spring part of the clip into the inner side is provided in the inner end position of the recesses. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a forceps for pinching an aneurysm clip to prevent fatal damage due to rupture of an aneurysm by preventing the blood from flowing into the aneurysm by pinching the root of the aneurysm.

  If an aneurysm is formed in a part of an artery, particularly an artery in the back of the brain, it may be technically impossible to remove it. If such an aneurysm is left unattended, it will become more and more enlarged due to the inflow of blood into the aneurysm and will eventually rupture due to internal pressure, leading to a cerebral hemorrhage with a fatal result.

  For this reason, when an aneurysm b is formed in a part of the artery a as shown in FIG. 8A, the root portion c of the aneurysm b is recently shown in FIG. 8B. The implantable aneurysm clip 1 is sandwiched and squeezed to prevent the blood from flowing into the aneurysm b, thereby preventing the aneurysm b from becoming enlarged and preventing the rupture from occurring. Technology has been developed and widely adopted to make a major contribution to saving lives.

  As shown in FIG. 9, the clip 1 is formed by bending a metal wire rich in elasticity and corrosion resistance, such as titanium, and is wound in a loop shape (ring shape) at the base. And the two sandwiching portions 3 and 3 on the tip side extend so as to cross each other, and the space between the spring portion 2 and the sandwiching portions 3 and 3 expands outward. The pressed portions 4 and 4 are formed in a protruding shape. When the external pressure in the directions of arrows P and P is applied to the pressed portions 4 and 4, the sandwiched portions 3 and 3 are opened, and when the external pressure is released, the sandwiched portion 3. 3, the root portion c of the aneurysm b is sandwiched between them and is strongly sandwiched by the elasticity of the spring portion 2, and the blood flow into the aneurysm b is stopped. Reference numeral 5 denotes an auxiliary spring for reliably closing the sandwiching portions 3 and 3.

  In order to clamp the clip 1 to the root portion c of the aneurysm b in the human body, the clip 1 is held and inserted into the affected area, and the clamping portions 3 and 3 of the clip 1 are opened as described above. A dedicated forceps is used to position the base part c of the aneurysm b and to clamp it to the base part c.

  As shown in FIG. 10 as a use state diagram, the presently provided forceps 6 crosses a pair of scissors members 7 and 7 and is pivotally supported by a shaft 8 in the same manner as a normal surgical forceps. A semicircular recess having a saddle structure and capable of receiving the loop-shaped spring portion 2 of the clip 1 on the opposing inner surfaces of the flange portions 7a and 7a on the tip side of the shaft 8 of the flange members 7 and 7 9 and 9 are formed, and when the spring portion 2 is positioned in the recesses 9 and 9, the pressing portions 10 and 10 at the outer ends of the recesses 9 and 9 are positioned at the tops of the pressing portions 4 and 4 of the clip 1. Then, the grip portions 7a and 7a are closed by grasping the operation portions 11 and 11 of the flange members 7 and 7, so that the pressing portions 4 and 4 are pressurized and the sandwiching portions 3 and 3 of the clip 1 are opened. It is configured.

  As described above, the clip portions 3 and 3 of the clip 1 are opened, the root portion c of the aneurysm b is positioned between the clip portions 3 and 3, and then the operation portions 11 and 11 of the scissors members 7 and 7. By releasing the grip of the clip 1, the clamping parts 3 and 3 of the clip 1 are closed by the elasticity of the spring part 2, and the root part c of the aneurysm b is strongly squeezed to stop the blood flow to the aneurysm b. It has become.

  By the way, when the clip 1 is set on the affected part using the above-described forceps 6, when the aneurysm b is present in the back of the brain, it is performed while looking at the screen of the two-dimensional image by the microscope camera. In order to position the clip 1 relative to the aneurysm b, the clip 1 must be re-gripped several times and after trial and error, the clip 1 is clamped at an appropriate position with respect to the aneurysm b. Become.

  However, during the above operation, the clip portions 3 and 3 of the clip 1 are often covered with the aneurysm b so that the positions thereof are not well understood. As a result, as shown in FIG. The ridges 7a and 7a of the forceps 6 may enter deeper than the recesses 9 and 9. Therefore, when the pressing parts 4 and 4 are shifted to the concave parts 9 and 9 and the operating parts 11 and 11 of the scissors members 7 and 7 are gripped as they are, the spring part 2 is pinched and the function of the spring is lost. There is a problem that it becomes impossible to securely clamp the root portion c of the aneurysm b with a predetermined force, and it becomes impossible to prevent blood from flowing into the aneurysm b due to incomplete clamping. .

JP 2003-102736 A

  The present invention prevents accidental pinching of the spring portion of the base of the clip when the clip is pinched to the root of the aneurysm, prevents incomplete pinching of the clip, and ensures pinching The objective is to achieve this.

  As a means for solving the above-mentioned problems, the present invention comprises a pair of a spring portion formed by bending a metal wire rich in elasticity and wound around the base portion in a loop shape, and extending in a crossed manner on the tip side. It has a sandwiching part and a pressing part that protrudes outwardly between the spring part and the intersecting part. By applying external pressure to the pressing part, the sandwiching part is opened and the external pressure is released. Is a forceps for setting an aneurysm clip that is clamped to the root portion of the aneurysm by the body, and is opposed to the buttocks of a pair of heel members whose intersection is pivotally supported by a shaft The surface has a recess for receiving the spring portion of the clip opposite to each other and a pressing portion for pressing the pressing portion of the clip at the outer end of the recess, and the spring of the clip is located at the back end position of the recess. A clip entry prevention part that prevents entry to the back side of the part is provided. That.

  In addition, the structure of the clip entry blocking portion is formed at the projecting pieces projecting on the left and right inner surfaces of the back end position of the concave portion of one collar portion and at both end portions of the deep end position of the concave portion of the other collar portion. It is composed of a concave groove into which the projecting piece can be inserted when the collar is closed, and when the clip is sandwiched between the collars, the spring part of the clip is in contact with the projecting piece so as not to enter into the back side. It is to have done.

  In addition, when the clip entry blocking portion is configured such that the pin protruding from the inner surface of the back end position of the concave portion of one hook portion and the deep end position of the concave portion of the other hook portion are closed and the hook portion is closed The pin is configured with a hole into which the pin can be inserted, and when the clip is sandwiched between the flanges, the spring portion of the clip is in contact with the pin so that it does not enter further into the pin.

  Furthermore, the structure of the clip entry blocking portion is constituted by an abutment surface formed integrally with the flange portion at the back end position of the recess portion of at least one flange portion, and when the clip is sandwiched between the flange portions, The spring part is in contact with the abutting surface so that it does not enter further into the back side.

  According to the present invention, the pressing portion including the spring portion of the clip is sandwiched between the buttocks of the forceps and inserted into the body, and the clip is re-gripped when set to an appropriate position with respect to the root portion of the aneurysm. However, the spring part hits the clip entry blocking part provided on the back side of the recess and cannot enter the back side, so the pressing part at the tip of the collar part is always the pressing part of the clip. The clip clamp part can be opened reliably by the pressure applied by the hook part, and if the pressure applied by the hook part is released, the clamp part can be reliably secured by the elasticity of the spring part. Thus, the proper position of the root part of the aneurysm can be pinched with a clip accurately to prevent blood flow.

  In particular, since the ring-shaped spring part of the clip is always aligned with the position of the concave part of the collar part, the spring part is prevented from being crushed by the collar part, thereby preventing the clip function from being impaired. In addition, it is possible to prevent inadequate clamping of the aneurysm at the base of the aneurysm.

  FIG. 1 is a perspective view showing an embodiment of an aneurysm clip clamping forceps 20 according to the present invention. An aneurysm clip 1 (hereinafter simply referred to as a clip) to be used is the same as that shown in FIG. In the following description, the same reference numerals as those in FIG. 9 are used.

  The forceps 20 has a pair of scissors members 21 and 21 intersecting like a normal surgical forceps, and the intersection is pivotally supported by a shaft 22, and the rear part (right side in FIG. 1) of these scissors members 21 and 21 is The operation parts 23 and 23 are provided with slip stoppers that are easy to grip, and the rear part 23a has a thin spring property, and the rear end thereof is integrally connected by a connecting part 24. The habit of opening the flanges 25 and 25 at the tips of 21 and 21 is given.

  The semi-circular recesses 26 and 26 that can receive the loop-like spring part 2 of the base part of the clip 1 are formed corresponding to the inner surfaces of the flange parts 25 and 25 that face each other. The tip portions of the recesses 26 and 26 serve as pressurizing units 27 and 27 for pressurizing the pressing units 4 and 4 of the clip 1. The pressurizing units 27 and 27 Grooves 27a and 27a into which the pressing portions 4 and 4 are fitted so as to be surely pressed are provided.

  In the present invention, a clip entry preventing portion 30 that prevents the spring portion 2 of the clip 1 from entering the deeper side than the recesses 26 and 26 is provided at the back end position of the recesses 26 and 26 of the flange portions 25 and 25. ing.

  The clip entry preventing portion 30 in the embodiment shown in FIGS. 1 to 3 includes a pair of projecting pieces 31 and 31 projecting on both right and left inner surfaces of the inner end of the recess 26 of the one flange portion 25, and the other. It is formed with concave grooves 32 and 32 that are formed on both left and right sides of the rear end position of the concave portion 26 of the flange portion 25 and into which the protruding pieces 31 and 31 can be fitted when the flange portions 25 and 25 are closed.

  When the flanges 25, 25 are open, that is, in the previous stage (shown in FIG. 2 (A)) where the clip 1 is sandwiched, the upper ends of the protrusions 31, 31 are the other flanges. The height is set so as to slightly enter or close to the concave grooves 32 and 32 of the portion 25.

  In FIG. 1, reference numerals 33 and 34 are provided on the inner surfaces of the operation units 23 and 23 in order to hold the operation units 23 and 23 and maintain the flanges 25 and 25 in a closed state (a state in which the clip 1 is held). A hook portion for temporary locking, which is composed of a thin spring plate, and the bent portions 33a and 34a at the tips thereof are engaged with each other to maintain the flange portions 25 and 25 in a closed state. The hooks 25 and 25 are released by grasping 23 and releasing the engagement.

  Therefore, when the clip 1 is to be clamped as shown in FIG. 2 (A), the flange portions 25 and 25 are left open, and the clip 1 is inserted from the spring portion 2 side between the flange portions 25 and 25 in this state. To do.

  At this time, as shown in FIG. 2 (B), the end portion of the spring portion 2 of the clip 1 hits the side surfaces of the protruding pieces 31 and 31 of the flange portion 25 and cannot enter further into the back side. Remains in alignment with the recesses 26, 26.

  Thereby, the pressurization parts 27 and 27 of the collar parts 25 and 25 are made to face the top part of the press parts 4 and 4 of the clip 1, and if the operation parts 23 and 23 are grasped and the collar parts 25 and 25 are closed, it will pressurize. The pressing portions 4, 4 are reliably pressed by the portions 27, 27, and the clip portions 3, 3 of the clip 1 can be opened reliably.

  After positioning the clip portions 3 and 3 of the clip 1 so as to sandwich the root portion c of the aneurysm b, if the gripping portions 25 and 25 are released by releasing the operation portions 23 and 23, the clip 1 The sandwiching portions 3 and 3 are closed by the elasticity of the spring portion 2 and can be sandwiched by the root portion c of the aneurysm b.

  If the clip 1 is not in an appropriate position with respect to the root portion c at the time of clamping, it is necessary to hold the clip 1 again. At this time, the operation parts 23 and 23 are gripped again to open the collar parts 25 and 25, and the clip 1 that has been sandwiched is held again.

  At that time, when the clip 1 is inserted between the flange portions 25, 25, the spring portion 2 hits the projecting pieces 31, 31, so that feeling is transmitted to the hand, and the clip 1 may be pinched. I understand. If the collars 25 and 25 are closed in this state, the pressing parts 4 and 4 are surely pressed by the pressing parts 27 and 27 as described above, and the sandwiching parts 3 and 3 are opened, so that the root part c of the aneurysm b is opened. Can be pinched again, and can be clamped at an appropriate position.

  In this way, even if the clip 1 is re-gripped several times, the clip 1 can always be held correctly, and thus can be accurately pinched to the root portion c of the aneurysm b.

  3 illustrates the relationship between the forceps 20 and the clip 1 during each of the above operations. FIG. 3A is a fully closed state of the forceps 20, and FIG. In the state where the clip 1 is held and the hooks 25 and 25 are closed and the clip portions 3 and 3 of the clip 1 are fully opened, (C) shows the clamp portion 3 of the clip 1 released from the grasping of the forceps 20. 3 shows a fully closed state, and FIG. 3D shows a state in which the collars 25 and 25 of the forceps 20 are fully opened.

  FIG. 4 shows another embodiment of the clip entry preventing portion 30 of the aneurysm clip clamping forceps 20 according to the present invention, and the clip entry preventing portion 30 in this embodiment is located at the back of the recess 26 of the one heel portion 25. It comprises a pin 35 projecting from the inner surface of the central portion in the width direction of the end position, and a hole 36 that is drilled in the back end position of the recess 26 of the other flange 25 and into which the pin 35 can be fitted.

  The pin 35 has a height at which the upper end of the pin 35 slightly enters or close to the hole 36 when the flanges 25 and 25 are opened.

  Also in this embodiment, when the clip 1 is held between the flange portions 25, 25, the spring portion 2 hits the pin 35 as shown in FIG. The pressurization parts 27 and 25 of 25 and 25 can face the top part of the press parts 4 and 4 of the clip 1, and can open the clip 1 reliably.

  In addition, when the clip 1 is re-gripped, it can be understood that the spring portion 2 can be held correctly by hitting the pin 35 as in the above-described embodiment. There is no occurrence of crushing, and reliable pinching of the aneurysm b to the root portion c can be performed.

  5 to 7 show still another embodiment of the clip entry preventing portion 30 of the aneurysm clip clamping forceps 20 according to the present invention. In this embodiment, the clip entry preventing portion 30 includes the flange portions 25 and 25. It is comprised by the abutting surfaces 37 and 37 integrally formed with this collar part 25 and 25 in the back end position of the recessed parts 26 and 26. As shown in FIG.

  The abutting surfaces 37, 37 are formed so that both the abutting surfaces 37, 37 are substantially linear in a side view as seen in FIGS. 5A and 5B when the flanges 25, 25 are opened. It is formed so that when the clip 1 is sandwiched, the spring portion 2 abuts against the abutting surfaces 37, 37 of any one of the flange portions 25, 25 and does not enter further into the back side.

  In addition, when the overlap width of the side surfaces of the collar parts 25 and 25 is wide, you may make it provide an abutment surface only in any one (wide one).

  Also in this embodiment, the setting operation of the clip 1 functions in the same manner as in the above-described embodiment, and thus detailed description thereof is omitted.

  In the above description, each of the pair of flanges 21 and 21 is shown as having substantially the same shape, but as long as each of the pair of flanges 21 and 21 is formed with a clip entry blocking portion, They may have different shapes.

The external appearance perspective view which shows one Embodiment of the aneurysm clip clamping forceps by this invention. (A), (B) is operation | movement explanatory drawing of the forceps shown in FIG. (A)-(D) is an effect | action explanatory drawing which shows the clamping operation | movement of the clip by the forceps shown in FIG. The other embodiment of the aneurysm clip clamping forceps by this invention is shown, (A) and (B) are FIG. 2 (A) and (B) equivalent figure. The other embodiment of the forceps for aneurysm clip pinching by this invention is shown, (A), (B) is FIG. 2 (A), (B) equivalent figure. (A) and (B) are exploded views of FIG. The side view of the principal part of the state which assembled the collar member of FIG. (A) shows the aneurysm which arose in the blood vessel, (B) is explanatory drawing which shows the state which clamped the aneurysm clip in the root part of the aneurysm. The side view which shows an example of the aneurysm clip used conventionally. The conventional forceps for pinching an aneurysm clip are shown, (A), (B) is the operation explanatory drawing.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Clip 2 Spring part 3 Clamping part 4 Press part 6, 20 Forceps 7, 21 Claw member 9, 26 Recess 10, 27 Pressurization part 11, 23 Operation part 25 Claw part 30 Clip entry prevention part 31 Projection piece 32 Recessed groove 33, 34 Hook part 35 Pin 36 Hole 37 Impact surface a Blood vessel (artery)
b Aneurysm c Root

Claims (4)

  A spring part formed by bending a metal wire rich in elasticity and looped around its base part, a pair of sandwiching parts extending in a crossed manner on the tip side, and the spring part and the intersection part A pressing portion that protrudes outward, and the external portion of the pressure portion is opened to open the pinching portion, and the external pressure is released to close the pinching portion and the root of the aneurysm A forceps for setting an aneurysm clip to be clamped to a part in the body, and receiving a spring part of the clip on a facing surface of a pair of heel members whose intersection is pivotally supported by a shaft And a pressing portion that presses the pressing portion of the clip at the outer end of the recess, and prevents the clip from entering the spring portion at the back end position of the recess. A forceps for pinching an aneurysm clip provided with an entry blocking portion.   The clip entry blocking portion is formed on the left and right side portions of the inner surface at the inner end of the inner end of the concave portion of one of the flanges, and on the left and right sides of the inner end of the concave portion of the other flange. When the clip is held, the spring part of the clip is in contact with the protruding piece so that it does not enter deeper than the protruding groove. The aneurysm clip clamping forceps according to claim 1.   The clip insertion prevention part is inserted into the pin protruding from the inner surface of the back end position of the concave part of one hook part, and the pin is inserted when the hook part is closed at the deep end position of the concave part of the other hook part The aneurysm clip sandwiching device according to claim 1, wherein the clip spring portion is in contact with the pin so as not to enter into the back side when the clip is held between the buttocks. forceps.   The clip entry blocking portion is configured with an abutting surface formed integrally with the flange portion at the back end position of the recess portion of at least one flange portion, and when the clip is held between the flange portions, the spring portion of the clip is The aneurysm clip clamping forceps according to claim 1, wherein the forceps is attached to an abutting surface so as not to enter into the back side.

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