JP2008289679A - Surgical holder - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a surgical holder for holding a surgical treatment instrument which has a simple structure and excellent durability and is produced at low cost and is reusable. <P>SOLUTION: The surgical holder comprises a fixing unit having a fixing member to be fixed to a retractor and a support member extending in almost a vertical direction from the top surface of the fixing member and having an inner cavity, and an attaching unit having an attaching/detaching member to be attached detachably to the inner cavity of the support member and having a rod extending further upward than the support member and a surgical treatment instrument attaching member mounted on the upper end of the attaching/detaching member and fixed in almost the vertical direction of the attaching/detaching member. The surgical treatment instrument attaching member can be fixed at least at three positions in the circumferential direction centering the support member. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a surgical holder.

In recent years, catheter intervention for patients with ischemic heart diseases such as myocardial infarction has been rapidly spreading. Typical catheter interventions include coronary vasodilatation and endovascular stenting, but these treatments are characterized by low invasiveness to the patient and a short hospital stay.
On the other hand, the effectiveness of coronary artery bypass surgery (hereinafter abbreviated as CABG) using cardiopulmonary bypass is widely recognized for patients who are not subject to catheter treatment. This method is intended to eliminate ischemia by anastomosing one end of bypass blood vessels such as the internal thoracic artery and gastroepiploic artery that have been exfoliated to the peripheral side of the coronary artery in which stenosis causing ischemia has occurred. .

  In recent years, attempts have been made to anastomote bypass grafts under heartbeat without using heart-lung machines, and good results have been obtained. This method is called coronary artery bypass surgery under heartbeat. The problem with coronary artery bypass surgery under heart beat is that the heart is moving, and skill is required to perform a perfect anastomosis in a short time. If the anastomosis is poor, a blood clot is generated in the coronary artery or bypass blood vessel from the anastomosis, causing the blockage. This problem has been improved by using a surgical treatment tool (stabilizer) that compresses the anastomosis of the heart, relaxes the pulsation of the heart, and stabilizes the anastomosis. Furthermore, by using a surgical treatment tool (positioner) that adjusts the position of the heart, the anastomosis portion of the heart can be viewed from the front, and an anastomosis portion with higher accuracy can be created. Therefore, the results of coronary artery bypass grafting under heartbeat improved dramatically.

In coronary artery bypass surgery under heart beat, a patient is incised longitudinally in the anterior chest under general anesthesia, then the sternum is cut, and the chest is opened using a retractor. The part opened by this retracting device becomes the surgical field, and the surgeon performs an operation on the heart exposed to the surgical field.
Therefore, as a surgical treatment tool as described above, generally, a fixing member for connecting and fixing to a retracting instrument, and a substantially U-shape that is in direct contact with the heart for stabilizing the anastomosis of the heart Shaped attachments or suction cup shaped attachments that are in direct contact with the heart to position the heart are used. Furthermore, as a holding part, in order to hold the attachment after adjusting the attachment to an arbitrary position to some extent, a flexible articulated arm having a plurality of segments, and the interior of each segment of the articulated arm are provided. A cable extending therethrough, and a tension control means for controlling the tension of the cable. The cable is tightened by the tension control means to generate friction due to the engagement, and the attachment and the flexible arm Is configured to be fixed and held with respect to the retractor. (For example, refer to Patent Document 1).

JP 2005-507702 A

Since the surgical holding tool including the articulated arm as described above has a relatively complicated structure, there is a problem in that it is costly and is durable and easily breaks down. It was also difficult to reuse.
The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide a reusable surgical holder having a simple structure, low cost, excellent durability, and reusability.

Such an object is achieved by the present invention described in the following (1) to (5).
(1) a fixing unit composed of a fixing member fixed to the retractor, and a support member having a lumen extending in a substantially vertical direction on the upper surface of the fixing member;
A detachable member having a rod-like portion that is detachable in the lumen of the column member and extends upward from the column member, and is attached to an upper end portion of the detachable member, and fixed in a substantially vertical direction of the detachable member. And a surgical instrument mounting member, wherein the surgical tool mounting member is fixedly variable at least at three positions in the circumferential direction with the support member as an axis.
(2) The surgical holder according to (1), wherein the cross-section of the detachable member has a shape having a triangle or more.
(3) The surgical holder according to (1) or (2), wherein the inner surface of the cross-section of the support member has a shape with a corner equal to or larger than a triangle into which the detachable member can be inserted. (4) The surgical instrument attachment The member according to (1), wherein the member has a plurality of grooves for attaching the surgical treatment tool.
(5) The surgical holder according to any one of (1) to (4), wherein the surgical holder is made of a stainless steel material or a polyphenylsulfone material.

  According to the present invention, it is possible to provide a reusable surgical holder that has a simple structure, low cost, excellent durability, and reusability.

Hereinafter, the surgical holder according to the present invention will be described in detail with reference to the drawings. In the description of the drawings, the same reference numerals are assigned to the same elements, and duplicate descriptions are omitted.
FIG. 1 is a perspective view showing an embodiment of a surgical holder according to the present invention. FIG. 2 is a perspective view showing an embodiment when the surgical holder according to the present invention is used. FIG. 3 is a cross-sectional view taken along the line AA ′ of FIG. 1 and shows an embodiment in which a detachable member is inserted into the support member.

  The surgical holding tool 10 includes a fixing member 3 that is fixed to the retracting device 11 and a support member 2 that has a support member 2 having a lumen extending in a substantially vertical direction on the upper surface of the fixing member 1. A detachable member 4 having a rod-like portion that is detachable from the inner cavity of the column member 2 and extends upward from the column member 2, and an upper end portion of the detachable member 4. It is comprised from the attachment part unit 6 comprised from the surgical treatment tool attachment member 5 fixedly provided by the substantially perpendicular direction.

  The cross-section of the detachable member 4 is preferably a shape having a corner equal to or greater than a triangle, and the inner surface of the cross-section of the column member 2 can be inserted and fitted into the detachable member 4. It is preferable that the shape has a corner. By attaching the cross section of the detachable member 4 and the strut member 2 to a triangle or more, the surgical treatment instrument mounting member 5 attached and fixed to the upper end of the detachable member 4 and fixed in the substantially vertical direction of the detachable member 4 is provided. It is possible to adjust and fix at least three positions in the circumferential direction with the support member 2 as an axis. Since treatment at various angles and positions is possible, it is preferable to use a 5-6 hexagon. FIG. 3 shows a cross-sectional view of the detachable member 4 and the column member 2 that are hexagonal as an embodiment of the present invention. In this way, with a simple structure in which the detachable member 4 is simply attached and detached, the surgical treatment instrument mounting member 5 can be adjusted and fixed at the optimum position in the circumferential direction with the support member 2 as an axis. In addition, by doing this, it is possible to improve the workability at the time of manufacturing and further reduce the cost.

  Moreover, the inner surface of the cross section of the support | pillar member 2 can be made into the shape which has an angle | corner more than a triangle at least one part, and the other inner surface can be made circular. By doing so, the workability at the time of manufacture can be improved and the cost can be further reduced.

  Although the length of the support | pillar member 2 is not specifically limited, For example, it is 20 mm or more and 200 mm or less, Preferably it can be 50 mm or more and 100 mm or less. Moreover, the length of the detachable member 4 can be, for example, 50 mm or more and 300 mm or less, preferably 100 mm or more and 200 mm or less. Therefore, in a state where the detachable member 4 is inserted and fitted into the support member 2, the height from the fixing member 1 to the surgical treatment instrument mounting member 5 can be set to 50 mm or more and 300 mm or less. By doing so, a sufficient surgical work space can be secured, and thus, for example, the operability when raising the heart in the vertical direction in order to adjust the position of the heart can be improved. Furthermore, the height of the surgical instrument mounting member 5 at the time of surgery can be adjusted by preparing two levels of the length of the detachable member 4 of, for example, 100 mm and 200 mm.

  The cross-sectional shape of the column member 2 is not particularly limited, and may be circular or square. The outer diameter in the case of a circle is not particularly limited, but may be, for example, 5 mm or more and 30 mm or less, preferably 10 mm or more and 20 mm or less. Further, the outer diameter of the detachable member 4 is slightly smaller than that of the support member, for example, 2 mm or more and 25 mm or less, preferably 5 mm or more and 15 mm or less. In this way, a sufficient working space can be secured and the strength necessary for holding the surgical treatment instrument can be secured.

  The surgical treatment tool attachment member 5 preferably has a plurality of grooves 7 for attaching the surgical treatment tool in a substantially vertical direction of the detachable member 4. The cross-sectional shape of the groove 7 can be substantially U-shaped. By doing so, as a surgical treatment tool, for example, a substantially U-shaped attachment 12 that directly contacts the heart 14 for stabilizing the anastomosis portion of the heart, or a direct contact with the heart 14 for adjusting the position of the heart For example, the suction cup-shaped attachment 13 is provided with a rod-shaped member or string-like member having an outer diameter larger than that of the substantially U-shaped groove 7, for example. These surgical treatment tools can be held by being fitted into the substantially U-shaped groove 7 and fixed by friction engagement. In addition, the operability when removing the surgical treatment tool from the surgical treatment tool mounting member 5 can be improved.

  Furthermore, since the plurality of grooves 7 are provided, it is possible to adjust the position optimally in the horizontal direction when holding the surgical treatment instrument, and the degree of freedom during position adjustment can be improved. Further, since the plurality of grooves 7 are provided, a plurality of surgical treatment tools, for example, a substantially U-shaped attachment 12 that directly contacts the heart for stabilizing the anastomosis portion of the heart 14 or a position of the heart 14 is adjusted. The surgical treatment instrument having the suction cup-shaped attachment 13 that is in direct contact with the heart can be held simultaneously.

  Further, instead of the groove 7, for example, a clip such as an alligator clip may be provided. By doing so, it is possible to improve the operability when connecting and removing the surgical treatment tool.

  The length of the surgical treatment instrument mounting portion 5 can be set to, for example, 50 mm or more and 300 mm or less, preferably 100 mm or more and 200 mm or less. In addition, the thickness of the surgical treatment instrument mounting portion 5 can be set to, for example, 2 mm to 20 mm, preferably 5 mm to 10 mm. This makes it possible to adjust the position optimally in the horizontal direction when holding the surgical treatment tool, and to improve the degree of freedom during position adjustment. The strength required for holding can be ensured.

The fixing member 1 fixed to the retracting device 11 includes, for example, a fixing portion main body portion to which the support member 2 is connected and fixed, and a fixing portion movable that can move in a horizontal direction in a tightening direction and a direction in which the tightening can be released. And a fixing portion operating portion for moving and moving the movable portion and maintaining and fixing the clamped state with respect to the retractor.
The fixed part movable part and the fixed part operation part are engaged with each other in the form of a gear, and the fixed part movable part can be moved in the horizontal direction by rotating the fixed part operation part. In addition, for example, a spring washer is provided between the fixed unit operating unit and the fixed unit main body, and the fixed unit operating unit and the fixed unit main unit are tightened and fixed to each other by tilting the fixed unit operating unit laterally. That is, the fixed part movable part can also be fixed.

The material of the surgical holder 10 according to the present invention can be, for example, a metal material, preferably a stainless steel material. In this way, the strength for holding the surgical holder is ensured, the durability is excellent, and high-pressure steam sterilization (autoclave) is possible, so that the reusable surgical holder can be obtained. . Further, for example, a heat-resistant engineering plastic, preferably polyphenylsulfone can be used as the material. By doing so, since the workability at the time of manufacture is excellent, the cost can be further reduced and the weight can be reduced, so that the operability can be improved.
The present invention has been described based on the embodiments. It is to be understood by those skilled in the art that these embodiments are merely examples, and that various modifications are possible and that such modifications are within the scope of the present invention.

It is a perspective view which shows one Embodiment of the surgical holder by this invention. It is a perspective view which shows one Embodiment at the time of use of the surgical holder by this invention. It is A-A 'sectional drawing of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Fixing member 2 Support | pillar member 3 Fixing unit 4 Detachable member 5 Surgical treatment tool attachment member 6 Attachment part unit 7 Groove 10 Surgical holder 11 Retracting instrument 12 Approximate direct contact with the heart for stabilizing the anastomosis part of the heart U-shaped attachment 13 Suction cup-shaped attachment 14 in direct contact with the heart to position the heart 14 Heart

Claims (5)

A fixing unit composed of a fixing member fixed to the retracting device, and a support member having a lumen extending in a substantially vertical direction on the upper surface of the fixing member;
A detachable member having a rod-like portion that is detachable in the lumen of the column member and extends upward from the column member, and is attached to an upper end portion of the detachable member, and fixed in a substantially vertical direction of the detachable member. An attachment unit composed of a surgical instrument attachment member;
Consists of
The surgical treatment tool, wherein the surgical treatment tool mounting member and the detachable member are fixed and variable at at least three positions in the circumferential direction with the support member as an axis. The surgical holder according to claim 1, wherein a cross section of the detachable member has a shape having a corner equal to or greater than a triangle. The surgical holding tool according to claim 1 or 2, wherein an inner surface of a cross section of the support member has a shape having a corner of a triangle or more into which the detachable member can be inserted. The surgical holding tool according to claim 1, wherein the surgical treatment tool mounting member has a plurality of grooves for attaching the surgical treatment tool. The surgical holder according to any one of claims 1 to 4, wherein the surgical holder is made of a stainless steel material or a polyphenylsulfone material.

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