JP2008253638A - Gripping forceps - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide gripping forceps, surely gripping in-vivo tissue without causing damage such as contused wound. <P>SOLUTION: The gripping forceps includes a pair of forceps members respectively having pivoted parts pivoted to relatively rotate by a common rotating shaft and arm parts extending from the pivoted parts toward the tip, and performing opening and closing operation to make pawl parts provided on the tip parts of the arm parts approach and separate each other around the pivoted parts, wherein a lightening part is formed in each of opposite surface parts of the arm parts so that when the paired forceps members are closed, the space between the whole opposite surfaces of the arm parts is uniformly spread wider than the space between the base parts of the pawl parts. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a grasping forceps used transendoscopically when grasping a tissue in a body cavity.

A grasping forceps of a general form includes a pair of forceps members pivotally attached to a distal end portion of a sheath inserted into a body cavity, and the pair of forceps members is a distal end of an arm portion extended from the pivotally attached portion. The parts are rotated relative to each other about the opening / closing axis in a direction in which the parts approach each other and a direction in which the parts approach each other. Opposite claws are provided at the distal ends of the arm portions of the forceps members, and opposite claws are provided in the middle of the claw portions and the opening / closing shaft. When the pair of forceps members are closed, The nail | claw part made | formed and the collar part which makes a pair each mesh | engage. However, when the pair of forceps members are closed, the body tissue is strongly pinched locally by the buttocks, and the mucosal tissue at the pinched portion may be destroyed. If mucosal crush occurs, it will hinder the diagnosis of a lesion that is grasped and removed by grasping forceps. In order to prevent such problems, in Patent Document 1, the toothed teeth are provided only at the tip position close to the claw portion.
JP-A-9-173341

  Even when the heel portion is provided only in the vicinity of the distal end portion of the grasping forceps as in Patent Document 1, there is still a possibility that the mucous membrane tissue may be damaged by the pinching of the heel portion. Get higher. In other words, there is a strong demand for reducing the diameter of the grasping forceps as the diameter of the endoscope decreases, and the length of the arm portion of the grasping forceps tends to be limited in accordance with the decrease in diameter. When the arm portion is shortened, it is difficult to set the position by shifting the collar portion toward the distal end side with a sufficient margin as intended by Patent Document 1. Furthermore, if the size of the grasping forceps is further reduced, it may be difficult to secure a space for providing the collar portion itself.

  Further, the crushing of the body tissue due to the pinching may occur not only at the buttocks but also at the proximal end portion in the vicinity of the shaft attachment portion of the pair of forceps members. If the close amount of the pair of forceps members is restricted by firmly sandwiching the body tissue at the proximal end portion, the nail portion at the distal end cannot be sufficiently bited into the grasped portion of the body tissue and the mucosa There was a risk that the slid off and could not be gripped reliably.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide a grasping forceps capable of reliably grasping a body tissue without causing damage such as squashing.

  The present invention has a shaft attachment portion that is pivotally supported by a common rotation shaft so as to be relatively rotatable, and an arm portion that extends from the shaft attachment portion in a distal direction, and the distal end of the arm portion with the shaft attachment portion as a center. In the grasping forceps provided with a pair of forceps members that can open and close the nail portions provided on the portions, when the pair of forceps members are closed, the distance between the base portions of the nail portions is larger than the distance between the opposing surfaces of the arm portions. A feature is that a lightening portion is formed on the opposing surface portion of the arm portion so that the interval is uniformly wide.

  It is preferable that the lightening portions of the pair of forceps members are continuously formed not only on the facing surface portion of the arm portion but also on the region extending over the axial attachment portion.

  It is preferable that a notch portion that makes the arm portion narrower than the claw portion in the axial direction of the rotation shaft that pivotally supports the forceps member is preferably formed in each arm portion of the pair of forceps members. For example, in each of the pair of arm portions, the cutout portions are formed at both side positions sandwiching the thinned portion, and the cutout portions on both sides are gradually moved toward each other as they approach the shaft attachment portion from the claw portion side of the forceps member. It is good to form as a pair of inclined surface shape part which widens the space | interval.

  According to the gripping forceps of the present invention described above, the opposing surface portions of the arm portions of the pair of forceps members have a uniform interval between the opposing surface portions of the arm portions, rather than the interval between the base portions of the claw portions, contrary to the conventional heel portion. Since the widened portion to be widened is formed, there is no possibility that the body tissue is strongly pinched locally at an intermediate position of the arm portion, and the body tissue can be reliably grasped by the nail portion.

  The details of the grasping forceps 10 according to the first embodiment to which the present invention is applied will be described with reference to FIGS. The grasping forceps 10 has a base member 12 fixed to a distal end portion of a flexible coil sheath 11. The base member 12 has a guide hole 13 therein, and a slide member 14 is slidably supported in the guide hole 13. Connected to the slide member 14 is a distal end portion of an operation wire 40 inserted into the coil sheath 11. The proximal end portion of the operation wire 40 is connected to an operation member provided in an operation unit (not shown), and the slide member 14 can be moved forward and backward through the operation member and the operation wire 40.

  The base end portions of the pair of links 16 and 17 are rotatably supported at the distal end portion of the slide member 14 via the link support shaft 15. The link support shaft 15 is not fixed with respect to the base member 12 and can change its position in the forward / backward direction of the slide member 14. The proximal ends of the pair of forceps members 20 and 21 are rotatably supported at the distal ends of the links 16 and 17 via connecting shafts 18 and 19, respectively. The forceps member 20 and the forceps member 21 are further rotatable relative to each other by an opening / closing rotation shaft 22 fixed to the base member 12 at shaft attachment portions 28 and 29 positioned slightly closer to the tip than the connection position by the connection shafts 18 and 19. It is supported by.

  As shown in FIG. 2, the base member 12 has a pair of upper and lower wall portions 23 that are spaced apart and face each other in the axial direction of the opening / closing rotation shaft 22 (hereinafter referred to as the axial length direction). The link support shaft 15, the entire links 16, 17, the connecting shafts 18, 19, the shaft attachment portions 28, 29 of the forceps members 20, 21, and the opening / closing rotation shaft 22 are interposed between the pair of upper and lower wall portions 23. Is retained. In the base member 12, both side portions of the upper and lower wall portions 23 are open, and the links 16 and 17 can be protruded laterally as shown in FIGS. 4 and 5. In FIG. 1, the upper and lower wall portions 23 on the near side toward the paper surface are removed.

  Each of the pair of forceps members 20 and 21 has linear arm portions 24 and 25 extending from the shaft attachment portions 28 and 29 toward the distal end, and the claw portions 26 and 25 are attached to the distal ends of the arm portions 24 and 25, respectively. 27. As shown in FIG. 1, the claw portions 26 and 27 are curved so as to approach each other as they proceed toward the distal ends of the arm portions 24 and 25, respectively. As shown in FIG. 3, the claw 26 on the arm 24 side is made smaller in width toward the distal end side, and the claw 27 on the arm 25 side that receives the claw 26 has the forceps member 20 and the forceps member 21. It has a bifurcated tip shape that meshes with the claw portion 26 in a closed state.

  On the outside of the pair of forceps members 20 and 21, an outer surface having no step is formed from the claw portions 26 and 27 on the distal end side to the arm portions 24 and 25, whereas the arm portion 24 and the arm in the forceps members 20 and 21 are formed. On the inner facing surface portion of the portion 25, there are formed the inner side hollow portions 30, 31 that are concave toward the outer side (opening direction of the grasping forceps 10) than the base portions 26a, 27a of the claws 26, 27. . In the state where the pair of forceps members 20 and 21 are closed as shown in FIG. 1, the inner facing surfaces 26b and 27b of the base portions 26a and 27a of the claws 26 and 27 are opposed to each other, and the opposing gripping surfaces 24a of the arm portions 24 and 25 are opposed. , 25a are opposed to each other, but by forming the inner surface thinned portions 30, 31, the interval W2 between the opposed gripping surfaces 24a, 25a is larger than the interval W1 between the inner opposed surfaces 26b, 27b. . When the forceps members 20 and 21 are closed, the inner facing surfaces 26b and 27b of the pair of claws 26 and 27 and the opposing gripping surfaces 24a and 25a of the paired arm portions 24 and 25 are opened and closed, respectively. It may be a non-parallel facing surface that gradually increases the distance between each other as it moves toward the moving shaft 22 side, or may be a facing surface that is parallel to each other. In any case, the relationship between the maximum distance (W1) between the inner facing surfaces 26b and 27b and the minimum distance (W2) between the inner facing surfaces 26b and 27b only needs to satisfy the relationship W1 <W2.

  Further, the inner wall thinning portions 30 and 31 are formed continuously from the arm portions 24 and 25 to the shaft attachment portions 28 and 29 in the pair of forceps members 20 and 21. More specifically, on the inner surfaces of the shaft attachment portions 28 and 29, the shaft attachment portions 28 and 29 extend from the proximal end side end portions of the opposing gripping surfaces 24a and 25a when the forceps members 20 and 21 are closed as shown in FIG. Concave spaces 32 and 33 are formed, which continue smoothly to the intersection point P (a position in the vicinity of the opening / closing rotation shaft 22). The concave spaces 32 and 33 are respectively connected to the axis 28 and the virtual straight line G (FIG. 1) connecting the intersection point P of the axes 28 and 29 and the proximal end of the opposing gripping surfaces 24a and 25a. 29 is formed as a concave portion of an arc-shaped inner surface that is wound toward the outer side of 29 (opening direction of the grasping forceps 10), and does not have an opposing surface in the vicinity of the intersection position P. Therefore, when the forceps members 20, 21 are closed In addition, the gripping target is not caught by the shaft attaching portions 28 and 29.

  In addition, as shown in FIG. 2, the arm portion 25 of the forceps member 21 is provided with an arm portion 25 at a vertical position sandwiching the inner wall thinning portion 31 (opposing gripping surface 25 a) in the axial length direction of the opening / closing rotation shaft 22. A pair of side surface cutout portions 35 that are narrower in the axial length direction than the claw portion 27 and the shaft attachment portion 29 are formed. Although not shown in FIG. 2, the arm portion 24 of the forceps member 20 has the same configuration, and is a vertical position sandwiching the inner surface thinning portion 30 (opposing gripping surface 24 a) in the axial length direction of the opening / closing rotation shaft 22. In addition, a pair of side notch portions 34 (only one of which is shown in FIG. 1) are formed to make the arm portion 24 narrower in the axial length direction than the claw portion 26 and the shaft attachment portion 28.

  When the gripping forceps 10 moves the slide member 14 in the right hand direction of FIGS. 1 and 2 via the operation wire 40, the axial position interval between the link support shaft 15 and the opening / closing rotation shaft 22 increases, and the link With the support shaft 15 as the center of rotation, the links 16 and 17 are rotated so that the connecting shaft 18 and the connecting shaft 19 approach each other. Then, according to the position change of the connecting shaft 18 and the connecting shaft 19, the pair of forceps members 20 and 21 rotate relative to each other about the opening / closing rotation shaft 22 in the closing direction in which the claw portions 26 and 27 at the distal ends are approached. Move. FIG. 1 shows a state where the slide member 14 is moved to the maximum in the right hand direction in the drawing and the forceps members 20 and 21 are closed. At this time, as shown in FIG. 3, the claw portion 26 and the claw portion 27 mesh with each other. On the other hand, when the slide member 14 is moved in the left-hand direction of FIGS. 1 and 2 via the operation wire 40, the link support shaft 15 approaches the opening / closing rotation shaft 22, and the link support shaft 15 is used as the rotation center. The links 16 and 17 are rotated so that the connecting shaft 18 and the connecting shaft 19 are separated from each other. Then, according to the position change of the connecting shaft 18 and the connecting shaft 19, the pair of forceps members 20, 21 is centered on the opening / closing rotation shaft 22 in the opening direction that separates the claw portion 26 and the claw portion 27 at the tip. Relative rotation.

  FIG. 4 shows a state where the slide member 14 is slid to the moving end in the left hand direction in the drawing, and the forceps members 20 and 21 of the grasping forceps 10 are opened to the maximum. When the body forceps are grasped by the grasping forceps 10, the pair of forceps members 20 and 21 are opened as shown in FIG. 4 after insertion into the body cavity, and the distal end portion of the base member 12 with respect to the raised tissue portion R to be grasped The grasping forceps 10 is pushed in until it is pressed. The raised tissue portion R can be either pre-existing in a size that can be grasped as a lesioned portion in the body, or artificially formed by injecting physiological saline or the like into the lower portion of the lesioned portion. Then, the formation process of the raised tissue part R does not matter. In the state of FIG. 4, the raised tissue portion R is in wide contact with the opposing gripping surfaces 24 a and 25 a of the arm portions 24 and 25 of the gripping forceps 10 and is also in contact with the tips of the claws 26 and 27. . On the other hand, the raised tissue portion R is not in contact with the opposed inner surface portions of the claw portions 26 and 27 including the inner opposed surfaces 26b and 27b and the inner surfaces of the concave spaces 32 and 33 of the pivoting portions 28 and 29. .

  FIG. 5 shows a state where the forceps members 20 and 21 of the grasping forceps 10 are closed and the raised tissue portion R is grasped. As can be seen from the figure, while the tip portions of the claw portions 26 and 27 bite into the raised tissue portion R and securely hold them, the inner facing surfaces 26b and 27b of the base portions 26a and 27a of the claw portions 26 and 27 The raised tissue portion R is not sandwiched in the portions such as the shaft-attached portions 28 and 29 (concave spaces 32 and 33), and a local strong clamping state does not occur in these portions. Although the raised tissue portion R is also in contact with the opposing gripping surfaces 24a and 25a, the opposing gripping surfaces 24a and 25a are formed as uniform concave planes by the inner surface hollowed portions 30 and 31, and thus the opposing gripping surface 24a. 25a, excessive pinching force does not act locally on the raised tissue portion R. Further, since the pair of forceps members 20 and 21 are formed with the side cutout portions 34 and 35, respectively, the surplus portion R1 of the raised tissue portion R with respect to the pressing (clamping) pressure applied by the opposing gripping surfaces 24a and 25a. It can easily bulge and deform so as to escape to the outside of the arm portions 24, 25, and this also contributes to the prevention of local concentration of the clamping force. Then, with the gripping forceps 10 gripped as described above, the root portion of the raised tissue portion R is excised using a snare forceps or the like.

  As described above, the grasping forceps 10 according to the present embodiment has a strong local pinching state that causes mucosal tissue crushing in the portions extending from the pivoting portions 28 and 29 to the arm portions 24 and 25. The raised tissue portion R can be gripped by securely biting the claw portions 26 and 27 at the distal end without being generated. Therefore, it is possible to securely grasp the body tissue without causing damage such as squashing.

  6 to 8 show a grasping forceps 100 according to the second embodiment of the present invention. In the gripping forceps 100, portions common to the first embodiment are denoted by common reference numerals and description thereof is omitted. In the grasping forceps 10 of the first embodiment, the side cutout portion 34 of the arm portion 24 and the side cutout portion 35 of the arm portion 25 are respectively parallel plane cutout portions that are substantially parallel to the advancing / retreating direction of the slide member 14. In contrast, the gripping forceps 100 according to the second embodiment is different in that the side surface notches 134 and 135 are inclined with respect to the advancing / retreating direction of the slide member 14. The side notch 135 of the forceps member 21 shown in FIG. 7 will be described as a representative. The side notch 135 is formed by an upper side notch 135A formed by an inclined concave 135a and an inclined concave 135b. The lower side notch 135B is formed. The inclined concave surface 135a and the inclined concave surface 135b are closest to each other in the axial length direction of the opening / closing rotation shaft 22 on the distal end side of the forceps member 21 adjacent to the base portion 27a of the claw portion 27, and approach the shaft attachment portion 29. As a result, it is formed as an axisymmetric inclined surface that gradually increases the distance between them. Although not shown in detail, a pair of side cutouts 134 of the forceps member 20 is provided at a vertical position sandwiching the opposing gripping surface 24a, like the side cutouts 135 (135A, 135B) of the forceps member 21, The side notches 134 are closest to each other in the axial length direction of the opening / closing rotation shaft 22 on the distal end side (claw portion 26 side) of the forceps member 20, and gradually gradually approach the shaft attachment portion 28. It is formed by a pair of line-symmetric inclined concave surfaces that increase the distance between each other. According to the side cutouts 134 and 135 having the above shape, when the raised tissue portion R is gripped by the gripping forceps 100 as shown in FIG. 8, the surplus portion R ′ is more efficiently expanded outside the forceps members 20 and 21. Can be deformed.

It is the top view which abbreviate | omitted and showed one part of the base member of the holding forceps which concern on the 1st Embodiment of this invention. It is a sectional side view which follows the II-II sectional line of the grasping forceps of FIG. It is a figure which shows the nail | claw part of the grasping forceps tip seen from the arrow III direction of FIG. It is a figure which shows the state which opened the grasping forceps which concern on 1st Embodiment, and pressed on the body tissue. FIG. 5 is a diagram showing a state in which a pair of forceps members are closed and a body tissue is gripped from the state of FIG. 4. It is the top view which abbreviate | omitted and showed a part of base member of the grasping forceps which concern on the 2nd Embodiment of this invention. It is a sectional side view which follows the VII-VII sectional line of the grasping forceps of FIG. It is a figure which shows the state which hold | gripped the body tissue with the grasping forceps which concern on 2nd Embodiment.

Explanation of symbols

10 100 Grip forceps 11 Coil sheath 12 Base member 15 Link support shaft 16 17 Link 18 19 Connection shaft 20 21 Forceps member 22 Opening / closing rotation shaft 24 25 Arm portion 24a 25a Opposing gripping surface 26 27 Claw portion 26a 27a Claw base portion 26b 27b Inner facing surface 28 29 Axis mounting portion 30 31 Inner surface thinning portion 32 33 Recessed space 34 35 134 135 (135A, 135B) Side cut-out portion 40 Operation wire R Raised tissue portion

Claims (4)

It has a shaft mounting portion that is pivotally supported by a common rotation shaft so as to be relatively rotatable, and an arm portion that extends from the shaft mounting portion in the distal direction, and is provided at the distal end portion of the arm portion with the shaft mounting portion as a center. In a grasping forceps provided with a pair of forceps members capable of opening and closing to and away from each other,
It is characterized in that when the pair of forceps members are closed, a cutout portion is formed on the opposing surface portion of the arm portion so that the interval of the entire opposing surface of the arm portion is uniformly wider than the interval of the base portion of the claw portion. Grasping forceps. 2. The grasping forceps according to claim 1, wherein the thinned portions of the pair of forceps members are continuously formed from a facing surface portion of the arm portion to a region extending from the axial attachment portion. The gripping forceps according to claim 1 or 2, wherein each arm portion of the pair of forceps members has a notch portion that makes the arm portion narrower than the claw portion in the axial direction of the rotation shaft. forceps. 4. The grasping forceps according to claim 3, wherein the notch portions are formed on both sides of the cutout portion in the axial direction of the rotation shaft, and the notch portions on both sides are on the claw portion side of the forceps member. A grasping forceps, wherein the grasping forceps are formed as a pair of inclined surface-shaped portions that gradually widen the distance from each other as they approach the shaft attachment portion.

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