JP2006263160A - Grasping forceps - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a pair of grasping forceps which enables a surgeon to understand a position of a lesion accurately by looking at the outside of a hollow organ with the lesion. <P>SOLUTION: The pair of grasping forceps 2 comprises a magnet 21 which attracts a magnet 10 across a wall part of the hollow organ and a supporting bar for supporting the magnet 21 removably and grasps the hollow organ from outside in cooperation with the magnet 10 placed inside the hollow organ. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a grasping forceps used in a surgical operation or the like.

In the surgical operation by laparoscope or laparotomy, there is a scoring method as a treatment for grasping a lesion part generated inside a luminal organ such as the stomach or the large intestine. The inking method is a method that involves injecting ink from the inside of the luminal organ into the living tissue where the lesion has occurred, several days to several weeks before the operation. This is a treatment that makes it easy to identify the position of a lesion from the outside directly or indirectly with the naked eye. Specifically, an endoscope is inserted from the mouth, and ink is injected by inserting a needle into the organ wall located near the lesion from the inside of the luminal organ. The injected ink spreads along the wall, and assists in visually confirming the lesioned part at the time of excision.
At this time, it is necessary to keep in mind that the needle tip does not penetrate through the wall portion and is injected to a depth that allows the position of the tattoo to be visually recognized when the lumen organ is viewed from the outside. If the needle penetrates the wall, not only the lesion site is unclear, but many other organs may be covered with ink so that surgery cannot continue. Further, if the ink can not be injected so that it can be seen on the outside of the stomach, the lesion site cannot be identified, which may cause the lesion to be left behind. In short, the problem with this inking method is that it requires a high technique for adjusting the depth of needle insertion so as to ensure the inking.

  In view of this, a method has been proposed that makes it possible to accurately grasp a desired location of a luminal organ without performing high-quality inking in laparoscopic or open surgery. The method is to insert an endoscope into a luminal organ such as the stomach or large intestine before the operation, and to place an indwelling device having a magnetic body inside the luminal organ, This is a treatment for identifying the position of a lesion by detecting the magnetism of the indwelling device from the outside of the organ (see, for example, Patent Documents 1 and 2).

  In addition, an indwelling device including a magnet is arranged in the vicinity of the lesioned part to grip the living tissue, and the indwelling device is pulled from outside by applying a magnetic force to the indwelling device, and the living tissue including the lesioned part is lifted together with the indwelling device A method for separating from surrounding normal tissue has been proposed (see, for example, Patent Document 3).

  In addition, a magnetic material is placed in advance at a predetermined position inside the lumen organ, and a magnetic material with variable magnetic flux density is brought close to the outside of the lumen organ during the operation, and the magnetic body is placed inside the lumen organ. Is attracted to the magnetic forceps together with the living tissue of the luminal organ (see Non-Patent Document 1 below). According to this method, when the magnetic forceps are brought close to the outside of the lumen organ in which the magnetic body is placed, the magnetic body is attracted to the magnetic forceps so that the wall portion of the lumen organ in which the magnetic body is placed rises outward. Transforms into Therefore, by visually recognizing the deformation from the outside of the luminal organ, the position where the magnetic body is placed can be easily grasped accurately in a short time.

In addition to attracting the magnetic material placed inside the lumen organ to the magnetic forceps together with the living tissue of the lumen organ, the magnetic material is adsorbed to the magnetic forceps together with the living tissue of the lumen organ, thereby It is possible to grasp a desired part of an organ accurately and without damaging a living tissue.
International Publication WO99 / 02098 Pamphlet JP 2002-159508 A JP 2004-105247 A Japanese Society of Surgery, Vol. 105, Special Issue, March 15, 2004 “Abstracts of the 104th Annual Meeting of the Japanese Surgical Society”, p. 307, “Magnetic flux density variable type for lesion capture and intestinal resection under endoscopic surgery” Usefulness of magnetic forceps: Takeshi Ohira, Masami Masako, Hideo Nagai

  In the method for exploring a luminal organ using a magnetic material as described above, when the magnetic forceps and the magnetic material are once separated and the treatment is performed, the magnetic material is placed inside the luminal organ. If the indwelling tool is separated, there is a problem that the position of the lesion cannot be grasped even when viewed from the outside of the luminal organ.

  The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a grasping forceps that makes it possible to accurately grasp the position of a lesion as viewed from the outside of a luminal organ.

As means for solving the above problems, a grasping forceps having the following configuration is employed.
That is, the indwelling device of the present invention is a grasping forceps for grasping the luminal organ from the outside in cooperation with the first magnetic body detained on the inner side of the luminal organ. A second magnetic body that adsorbs the first magnetic body with a support interposed therebetween; and a support rod that removably supports the second magnetic body.

  The surgeon inserts a support rod equipped with the second magnetic body into the body cavity, brings the second magnetic body closer to the luminal organ, and the first magnetic body and the second magnetic body placed inside the luminal organ. The magnetic material is adsorbed. Then, the second magnetic body is detached from the support rod. The second magnetic body adsorbs to the magnet 10 of the indwelling device 1 across the wall of the lumen organ, and stays outside the lumen organ. When the luminal organ is viewed from the outside, the second magnetic body indicates the position of the lesioned part, so that the position of the lesioned part can be accurately grasped.

  In the grasping forceps of the present invention, it is preferable that the support rod can be attached with the second magnetic body once detached. Since the second magnetic body once detached can be attached to the support rod, the lumen organ can be grasped or released by the support rod as necessary.

  The grasping forceps of the present invention preferably includes a sheath inserted through the support rod, and the inner diameter of the sheath is preferably smaller than that of the second magnetic body. Furthermore, it is preferable to provide a third magnetic body that adsorbs to the second magnetic body at the tip of the support rod. When the support rod with the second magnetic body attached to the tip is operated so as to be pulled inside the sheath, the second magnetic body comes into contact with one end of the sheath, but does not enter the inside of the sheath. The second magnetic body is detached from Further, when the tip of the support bar is projected from one end of the sheath, the second magnetic body and the third magnetic body are attracted to each other, and the second magnetic body is attached to the tip of the support bar. Therefore, the second magnetic body can be attached to and detached from the support bar with a very simple structure.

  According to the present invention, the position of a lesion can be accurately grasped when viewed from the outside of a luminal organ. Furthermore, the luminal organ in which the indwelling device is placed can be grasped or released as necessary, and as a result, the procedure during the operation can be easily performed.

An embodiment of the present invention will be described with reference to FIGS.
FIG. 1 and FIG. 2 show an indwelling device 1 that is placed inside a luminal organ such as the stomach and the large intestine, and a grasping forceps 2 that grips the luminal organ using the indwelling device 1.
The indwelling device 1 includes a magnet (first magnetic body) 10, a clip 11, and a wire 12 that connects the magnet 10 and the clip 11. Both the clip 11 and the wire 12 are made of metal. The magnet 10 is formed in a ring shape. Each member constituting the indwelling device 1 is coated with silicon, titanium, or the like in order to eliminate the influence on the living body.

  The grasping forceps 2 includes an insertion portion 20 that is inserted into the abdominal cavity, a magnet (second magnetic body) 21 that attracts and attracts the indwelling device 1, and an operation portion 22 for operating the insertion portion 20. Yes. The insertion portion 20 includes a linear support rod 23 and a sheath 24 inserted through the support rod 23 inside. A magnet (third magnetic body) 25 is fixed to the tip of the support bar 23. The magnet 21 is attached to the tip of the support bar 23 by adsorbing with the magnet 25. The magnet 21, the support rod 23, and the magnet 25 are all cylindrical, and the sheath 24 is cylindrical. The outer diameters of the support rod 23 and the magnet 25 are slightly smaller than the inner diameter of the sheath 24, and the inner diameter of the sheath 24 is smaller than the outer diameter of the magnet 21. At one end of the sheath 24, an enlarged diameter portion 24a slightly larger than the outer diameter of the magnet 21 is formed, and the magnet 21 is fitted into the enlarged diameter portion 24a. The operation unit 22 is connected to the support bar 23, and when the operation unit 22 is operated, the support bar 23 moves back and forth inside the sheath 24.

  The grasping forceps 2 is used in combination with a hard sheath 3. The sheath 3 has a cylindrical shape having an inner diameter slightly larger than the outer diameter of the insertion portion 10. The grasping forceps 2 is inserted into the abdominal cavity while being disposed inside the sheath 3, and is used in a state where the distal end of the grasping forceps 1 (the distal end of the insertion portion 10) protrudes from the sheath 3.

Next, surgery using the instrument configured as described above will be described.
First, the indwelling device 1 is placed inside a luminal organ where a lesion has occurred several days to several weeks before the operation. Specifically, the endoscope is inserted from the mouth, the indwelling tool 1 is inserted inside the lumen organ through the insertion portion of the endoscope, and the living tissue in the vicinity of the lesion is grasped and fixed to the clip 11. At this time, care is taken that the clip 11 firmly grasps the mucous membrane of the living tissue in order to prevent the clip 11 from falling off. In addition, the positional relationship between the lesioned part and the place where the indwelling device 1 is fixed is accurately recorded so that the lesioned part can be appropriately excised during the operation.

  During surgery, a laparoscopic trocar (a device for inserting a surgical instrument into the abdominal cavity) is inserted into the abdominal wall of the patient, and carbon dioxide is injected into the abdominal cavity through this laparoscopic trocar to inflate the abdominal cavity. Secure surgical space. Then, the laparoscope is inserted into the abdominal cavity through a laparoscopic trocar. The operator observes the abdominal cavity through a laparoscope.

  The sheath 3 is inserted into the abdominal cavity through the forceps trocar, and then the grasping forceps 2 is inserted into the abdominal cavity through the sheath 3. When the tip of the grasping forceps 2 is brought close to the outside of the lumen organ Or, as shown in FIG. 3, the magnet 10 of the indwelling tool 1 is adsorbed to the tip of the grasping forceps 2 and the wall of the lumen organ Or having the lesioned portion is formed. The part is as if it was adsorbed to the tip of the grasping forceps 2. The operator performs a treatment on the lumen organ while holding the lumen organ Or with the grasping forceps 2.

  When it is necessary to once separate the grasping forceps 2 from the luminal organ Or during the operation (for example, when it is necessary to insert a treatment tool different from the grasping forceps 2 through the forceps trocar), When the operating portion 22 is operated to retract the support rod 23, as shown in FIG. 4, the magnet 21 is locked to the tip of the sheath 24 due to the difference in diameter, and the magnet 21 and the magnet 25 are attracted to each other. Separate on the contrary. The magnet 21 is detached from the sheath 24, is attracted to the magnet 10 of the indwelling device 1 across the wall portion of the luminal organ Or, and stays outside the luminal organ Or.

  When the once separated magnet 21 is attached to the grasping forceps 2 again, the operation portion 22 is operated to advance the support rod 23, and the outside of the lumen organ Or is visually confirmed through the laparoscope. The tip of the grasping forceps 2 is brought close to the magnet 21. When the tip of the grasping forceps 2 approaches, the magnet 21 is attached to the tip of the grasping forceps 2 so as to be attracted to the magnet 25 and enter the enlarged diameter portion 24a.

  According to the present invention, it is possible to accurately grasp the position of a lesion as viewed from the outside of the luminal organ Or. Furthermore, the luminal organ Or in which the indwelling device 1 is placed inside can be grasped or released as necessary, and as a result, the procedure during surgery can be easily performed.

  In the above embodiment, a magnet having its own magnetic force is used as a magnetic body placed in the body. However, if the magnetic forceps generates a strong magnetic force, the magnet is placed on the magnetic body placed in the body. It is not necessary to use a metal material that is simply adsorbed to the magnet when a magnetic force acts on it.

  As mentioned above, although preferable embodiment of this invention was described, this invention is not limited to said embodiment. Additions, omissions, substitutions, and other modifications can be made without departing from the spirit of the present invention. The present invention is not limited by the above description, but only by the scope of the appended claims.

It is a perspective view which shows embodiment of the grasping forceps and indwelling device of this invention. It is sectional drawing which shows the structure of a grasping forceps. It is a partial cross section figure which shows the state which hold | gripped the lumen organ which detained the indwelling tool inside with the grasping forceps. It is a partial sectional view showing the state where grasping forceps separated the luminal organ which indwelled the indwelling device.

Explanation of symbols

1: indwelling device, 2: grasping forceps, sheath 3, 10: magnet (first magnetic body), 11: clip, 12: wire, 20: insertion portion, 21: magnet (second magnetic body), 22: Operation unit, 23: support rod, 24: sheath, 24a: expanded diameter part, 25: magnet (third magnetic body), Or: lumen organ

Claims (4)

A grasping forceps for grasping the lumen organ from the outside in cooperation with the first magnetic body placed inside the lumen organ,
A second magnetic body that adsorbs to the first magnetic body across a wall of the luminal organ;
A grasping forceps comprising: a support rod that removably supports the second magnetic body.   The grasping forceps according to claim 1, wherein the second magnetic body once detached can be attached to the support bar.   3. The grasping forceps according to claim 1, further comprising a sheath inserted through the support rod, wherein an inner diameter of the sheath is smaller than that of the second magnetic body. The grasping forceps according to claim 2 or 3, further comprising a third magnetic body that adsorbs to the second magnetic body at a tip of the support bar.

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