JP2013022083A - Forceps unit for laparoscopic surgery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a forceps unit for a laparoscopic surgery, in which an alligator part of a size thicker than a tubular shaft is used as the distal end of narrow diameter forceps positioned inside an abdominal cavity.SOLUTION: The forceps unit for a laparoscopic surgery includes: a trocar 12 in an appropriate size; a trocar 13 serving also as a tubular shaft, which has a diameter smaller than the trocar, has a handle 17 attached to the end, and is to be a different insertion part into the abdominal cavity; an insert 14 which is freely inserted and removed into/from the trocar serving also as the tubular shaft, and has an alligator part 15 of the size thicker than the trocar serving also as the tubular shaft connected to the distal end of the insert 14; a cylindrical distal end shaft 16 attached to the alligator part so as to cover the end part on the alligator part side of the insert; an inner cylinder for puncture, which is freely inserted and removed into/from the trocar serving also as the tubular shaft; and a handle. The insert and the alligator part are integrally connected, and the trocar serving also as the tubular shaft is connected so as to hold both ends thereof by the distal end shaft attached to the alligator part and the handle at the end respectively.

Description

The present invention relates to a forceps unit for laparoscopic surgery that is used when performing surgery under an endoscope in the abdominal cavity, and the distal end of a small-diameter forceps located in the abdominal cavity is a mouth portion that is thicker than a tubular shaft It is related with the forceps unit for laparoscopic surgery which can make the tip mouth part and tip shaft to be thick.

As shown in FIG. 8, the laparoscopic forceps can remotely open and close the openable and closable gripping structure provided at the distal end portion of the thin-diameter tubular shaft 1 at the opposite end as the hand portion. is there. In this specification, the gripping structure of the forceps tip is referred to as a “mouth portion”.
The mouth portion 2 is formed by coupling a pair of gripping members A and B so as to be rotatable around a rotation axis of the fulcrum portion 3. More specifically, each of the gripping members A and B has an action point portion 4 that applies a force for gripping the object and a force point portion 5 that is applied a force for gripping from the operation side.
In addition, a groove for suitably holding the target object is provided in the objective surfaces 4a and 4b that directly contact the target object among the action point portions 4 as necessary. In such a configuration, when a force for opening and closing is transmitted to the power point portion 5 using the wire 7 or the like connected to the handle 6 from the opposite end serving as the hand portion, for example, the action point portion around the rotation axis of the fulcrum portion 3 4 rotates and closes, and the object can be grasped.

Due to the above-described configuration of the mouth portion, the laparoscopic forceps are used for various operations that need to grasp a deep object in a minute gap. Thus, laparoscopic forceps are particularly useful in the field of intra-abdominal surgery.
Such laparoscopic forceps have a general first forceps having a tubular shaft diameter of about 5 mm and a second small diameter forceps having a tubular shaft diameter of about 2 mm when performing surgery on the abdomen. Using this, it is attempted to perform complicated work in the abdominal cavity from both sides of the treatment site.

And when performing an operation on the abdomen as described above, a tubular shaft having a diameter of about 5 mm is pierced through the living tissue to reach the inguinal region, but a passage for that is formed with a diameter of about 5 mm. It is a trocar.
That is, in laparoscopic surgery, a plurality of communication tubes called trocars are inserted into the abdominal cavity through the abdominal wall, and the inside of the abdominal cavity is displayed as a monitor image by a small camera (endoscope) inserted from one trocar. While observing, various surgical procedures are performed in the abdominal cavity while viewing the monitor image with instruments such as forceps, scissors, scalpel, needle holder inserted from other trocars.
Similarly, a tube shaft having a diameter of about 2 mm (more specifically, 2.1 mm) is pierced through a living tissue to form a passage for reaching the inguinal region to the affected area. .2 mm) small diameter port (trade name: MINI-PORT) is used.

US Patent Publication 2010/0298774

In the above-described conventional example, in addition to a general first forceps having a tubular shaft diameter of about 5 mm, the tip of the second thin forceps having a tubular shaft diameter of about 2 mm is passed through the small diameter port. The size of the mouth part of the mouth is also the size combined with the small diameter port of about 2mm diameter, the strength of the mouth part as well as the force to pinch the affected part of the mouth part is weak, and the operability is very bad was there.

A main object of the present invention is a laparoscopic forceps unit used when performing an endoscopic surgical operation in the abdominal cavity, the tip of a small-diameter forceps positioned in the abdominal cavity being easily sized. To provide a novel forceps unit for laparoscopic surgery which can be a mouthpiece.

That is, the forceps unit for laparoscopic surgery according to the present invention includes an appropriately sized trocar (for example, 5 mm) serving as one insertion portion into the abdominal cavity,
Tubular shaft and trocar serving as another insertion part into the abdominal cavity having a smaller diameter than the trocar and having a handle attached to the end,
An insert that can be inserted into and removed from the tubular shaft / trocar, is connected to a distal end of a lip portion that is thicker than the tubular shaft / trocar, and is formed without interruption to the end, and an end portion on the throat portion side of the insert. A cylindrical tip shaft attached to the mouth portion so as to cover;
An inner cylinder for puncture that can be inserted into and removed from the tubular shaft and trocar;
A handle that is detachably attached to the end portion of the insert protruding from the other insertion portion into the abdominal cavity,
The insert and the mouth part are integrally connected, and the tubular shaft and trocar is connected so that both ends of the tubular shaft and trocar are sandwiched between the tip shaft and the end handle attached to the mouth part, respectively, so as to have high rigidity. It is characterized by this.

In the forceps unit for laparoscopic surgery according to the present invention, the cylindrical tip shaft fixed to the end of the mouth portion having a size larger than the insert has a tip portion formed thickly inserted in the insert shaft. Is also a feature.

In the forceps unit for laparoscopic surgery according to the present invention, the puncture inner cylinder detachably inserted into the tubular shaft / trocar is a first puncture inner cylinder whose tip is narrowed via a large diameter portion, or It is also characterized by comprising a second puncture inner cylinder that is thinned without increasing the diameter of the tip.

Therefore, when using the laparoscopic forceps unit of the present invention, a trocar having a diameter of approximately 5 mm to be inserted into the abdominal cavity is inserted into the abdomen.
On the other hand, a tubular shaft and trocar is inserted into another position of the abdomen at a certain distance from the trocar with a puncture inner tube attached, and the tip is protruded from the trocar. The inner cylinder is extracted from the front end or rear end side of the tubular shaft / trocar.
In that state, the insert with the mouth part integrally connected to the end is drawn into the abdominal cavity using the tubular shaft / trocar as a guide, and the insert end is pulled out from the abdominal cavity, and the insert together with the tubular shaft / trocar is inserted. Attach the handle to the end of the.
When the handle is operated after being assembled in this way, the mouth portion provided at the distal end of the tubular shaft / trocar can be freely operated within the abdominal cavity.

According to the forceps unit for laparoscopic surgery according to claims 1 to 3, the insert having the mouth portion integrally connected to the end portion is inserted into the abdominal cavity through the trocar portion, and the tubular shaft / trocar is guided. The insert is pulled into the abdominal cavity and the end of the insert is pulled out from the abdominal cavity, and the handle is attached to the end of the insert together with the tubular shaft and trocar. The provided easy-to-handle appropriately sized mouth portion can be freely operated within the abdominal cavity.
Moreover, since the diameter of the mouth part integrally provided at the end of the insert of the small-diameter forceps is the same as the structure of the tip of a normal forceps of 5 mm, it can almost break down during intraperitoneal treatment. Absent.

The Example of the forceps unit for laparoscopic surgery of this invention is shown, and it is explanatory drawing which shows the state which removed the tubular shaft and trocar from the said insert. It is the side view which shows the state which mounted | wore the tubular shaft and trocar of thin forceps with the handle | steering-wheel, and shows the 1st inner cylinder for puncture. It is a side view which shows the state which penetrated the inner cylinder for 2nd punctures to the tubular shaft and trocar of thin forceps. It is a side view which shows the state which extracted the inner cylinder for 2nd puncture from the tubular shaft and trocar of thin diameter forceps. It is the schematic of the state which connects the cylindrical front shaft attached to the terminal of the shed part, and a tubular shaft and trocar. It is the schematic which shows the state which inserts the tubular shaft and trocar of a thin forceps through the trocar inserted in the abdominal part, and is trying to insert the insert which connected the mouth part integrally with the front-end | tip to a tubular shaft and trocar. It is the schematic which shows the state which tries to attach a handle to the edge part of the insert by which the mouth part and the front end shaft were drawn in the abdominal cavity, and were integrally connected with the mouth part. It is a side view which shows an example of the conventional forceps for laparoscopic surgery.

Embodiments of a laparoscopic forceps unit according to the present invention will be described below in detail with reference to the drawings.
FIGS. 1 to 7 show an embodiment of a forceps unit for laparoscopic surgery according to the present invention. FIG. 1 shows a state in which a throat portion is attached to the tip of an insert inserted into a tubular shaft and trocar of a thin forceps, FIG. 2 shows a state where a handle is attached to a tubular shaft / trocar of a small forceps, and a relationship with the first puncture inner cylinder is also illustrated. FIG. 4 shows a state where the inner cylinder for puncture is inserted, FIG. 4 shows a state where the second inner cylinder for puncture is pulled out from the tubular shaft and trocar of the small forceps, and FIG. 5 shows a cylindrical tip shaft provided with a mouth portion. Fig. 6 shows a state where the tubular shaft / trocar is connected to the tubular shaft / trocar, and FIG. The condition to be passing, further 7 alligator and distal shaft is pulled into the abdominal cavity, and shows the state in which you are installing the handle on the end of the insert which is integrally connected with alligator portion, respectively.

That is, the laparoscopic forceps unit 11 of this embodiment is constituted by at least the following members.
1) Appropriately sized trocar 12 to be inserted into the abdominal cavity
2) Tubular shaft and trocar 13 serving as another insertion portion into the abdominal cavity having a diameter smaller than that of the trocar 12 serving as an insertion portion into the abdominal cavity and having a handle attached to the end thereof; And an insert 14 (also serving as an operation wire) integrally connected to a distal end of the mouth shaft 15 having a size larger than the tubular shaft and trocar 13 and connected to an end of the mouth portion 15, A small forceps 20 comprising a cylindrical tip shaft 16 through which a thick tip portion of the insert is inserted.
3) The first puncture inner cylinder 31a whose tip is narrowed via the large diameter portion, or the second puncture inner cylinder 31b whose tip diameter is narrowed without increasing the diameter.
4) A handle 17 detachably attached to the distal end portion of the tubular shaft / trocar 13 together with the insert.

As shown in FIG. 6, an appropriately sized trocar 12 inserted through the abdomen serving as an insertion part into the abdominal cavity has an inner diameter of about 5 mm, and is larger in size than the tubular shaft and trocar 13 described later. The inner diameter size is such that the throat portion 15 and the cylindrical tip shaft 16 attached to the end thereof can be inserted.
As shown in FIG. 7, a tubular shaft / trocar 13 is inserted into the abdomen at a position different from the trocar 12. The tubular shaft / trocar 13 has an inner diameter of about 2 mm (more specifically, 2.2 mm), and an insert 14 is inserted through the inner diameter.

FIG. 1 shows a state in which the tubular shaft / trocar 13 is removed from the insert 14, and shows that the distal end mouth portion 15, the distal end shaft 16, and the insert 14 are integrally formed. In particular, it is very important from the viewpoint of maintaining the rigidity of the small-diameter forceps 20 that the insert 14 is formed so as not to be interrupted to the end with a single rod.
That is, as shown in FIG. 1, the insert 14 is integrally fitted with an opening 15 having a larger size than the tubular shaft and trocar 13 at the end thereof, and is inserted through the thickened tip portion of the insert 14. A cylindrical tip shaft 16 is integrally attached to the terminal end of the front port portion 15 by caulking, welding, screwing, or other appropriate means.

A pair of gripping members A and B are coupled to the distal end portion of the mouth opening 15 so as to be rotatable around a rotation shaft 21 as a fulcrum. More specifically, the shed portion 15 includes a gripping portion 15a that applies a force for grasping an object and a pulling portion 15b that is provided with a force for grasping from the handle side.
A groove for suitably holding the object is provided as necessary on the object surface directly contacting the object in the pair of grasping members A and B at the tip of the grasping portion 15a.
In such a configuration, when the force for opening and closing is transmitted to the traction portion 15b using the insert 14 connected to the handle from the opposite end serving as the hand portion, for example, the grip portion 15a rotates around the rotation shaft 21 of the fulcrum. You can close and grab the object.

FIG. 2 shows a thin forceps in which a handle 17 is attached to the first puncture inner cylinder 31a and the tubular shaft / trocar 13.
That is, the tubular shaft and trocar 13 can be detachably mounted with the first puncture inner cylinder 31a. That is, the first puncture inner cylinder 31a is inserted into the tubular shaft / trocar 13 from the spherical portion at the rear end, and when the entire insertion is finished, the large diameter portion of the puncture portion at the front end is the tubular shaft / trocar 13 It is adapted to be engaged with the end portion.

When using the laparoscopic forceps unit 11 of this example, as shown in FIG. 6, a trocar 12 having a diameter of approximately 5 mm to be inserted into the abdominal cavity is inserted into the abdomen.
Similarly, the tubular shaft / trocar 13 into which the first puncture inner cylinder 31a is fitted is inserted into another position of the abdomen at a predetermined distance from the trocar 12, and the tip of the tubular shaft / trocar 13 is inserted into the trocar 12. Can be protruded from. Next, the first puncture inner cylinder 31 a is extracted from the position of the tubular shaft / trocar 13 protruding from the trocar 12, and the insert 14 with the mouthpiece 15 integrally attached to the tip is inserted. FIG. 7 shows this state.

The insert 14 is entirely inserted through the tubular shaft / trocar 13 and its end is pushed into the handle 17 and fixed. Reference numeral 22 denotes an attachment / detachment button used when the inner cylinders 31a, 31b for puncture and the insert 14 are attached to or detached from the handle 17.
On the other hand, the tubular shaft and trocar 13 is connected to the end of a cylindrical tip shaft 16 attached to the end of the mouth opening 15. That is, as shown in FIG. 5, the notch 16a of the cylindrical tip shaft 16 is introduced into an engaging portion 19 from a guide groove 18 provided in the tubular shaft / trocar 13 and rotated at a predetermined angle. Fixed.
Thereafter, the insert 14 constituting the small-sized forceps 20 is drawn into the abdominal cavity from the trocar 12 together with the distal shaft 16 and the mouth portion 15 attached to the distal end of the tubular shaft / trocar 13. The state is shown in FIG.
When the handle 17 is operated after being assembled in this way, the mouth portion 15 provided at the distal end of the tubular shaft / trocar 13 can be freely operated within the abdominal cavity.

FIG. 3 shows the relationship between the second puncture inner cylinder 31 b and the tubular shaft / trocar 13.
A second puncture inner cylinder 31b can be detachably attached to the tubular shaft / trocar 13. That is, the second puncture inner cylinder 31b is inserted into the tubular shaft / trocar 13 from the tip. When the entire insertion is completed, as shown in FIG. 4, the puncture portion at the distal end protrudes from the end portion of the tubular shaft / trocar 13.
In US Patent Publication No. 2010/0298774 (Patent Document 1), as described above, a puncture device is inserted into the abdominal cavity from the tip and protruded from a trocar pierced to another position of the abdomen. 23.
However, nothing is shown about the use of the “insert 14 with the mouthpiece 15 integrally attached to the tip” which is the point of the present invention.

When using the laparoscopic forceps unit 11 of this example, a trocar 12 having a diameter of approximately 5 mm to be inserted into the abdominal cavity is inserted through the abdomen.
Similarly, the tubular shaft and trocar 13 into which the second puncture inner cylinder 31b is fitted is inserted into another position of the abdomen at a predetermined distance from the trocar 12, and the tip of the tubular shaft / trocar 13 is inserted into the trocar 12. Can be protruded from. Next, the second puncture inner cylinder 31b is extracted from the rear end of the tubular shaft / trocar 13 and the mouth portion 15 is integrally attached to the front end from the distal end portion of the tubular shaft / trocar 13 14 is inserted. FIG. 6 shows this state.

The insert 14 is entirely inserted through the tubular shaft / trocar 13 and its end is pushed into the handle 17 and fixed. Reference numeral 23 denotes a fixing ring used when the insert 14 is attached to or detached from the handle 17.
On the other hand, the tubular shaft and trocar 13 is connected to the end of the cylindrical tip shaft 16 attached to the end of the mouth opening 15 as in the above example. That is, the notch 16a of the cylindrical tip shaft 16 is connected and fixed by introducing it into the engaging portion 19 from the guide groove 18 provided in the tubular shaft / trocar 13 and turning it at a predetermined angle.
Thereafter, the insert 14 constituting the small-sized forceps 20 is drawn into the abdominal cavity from the trocar 12 together with the distal shaft 16 and the mouth portion 15 attached to the distal end of the tubular shaft / trocar 13. The state is shown in FIG.
When the handle 17 is operated after being assembled in this way, the mouth portion 15 provided at the distal end of the tubular shaft / trocar 13 can be freely operated within the abdominal cavity.

In any case, the insert 14 in which the mouth portion 15 is integrally attached to the tip end has a tip shaft 16 in which the tip of the tubular shaft / trocar 13 is attached to the end of the mouth portion 15 using a mechanism as shown in FIG. Since the insert 14 is fixed to the handle 17 through the tubular shaft / trocar 13, even if the tubular shaft / trocar 13 is made of a thin metal, etc. It is a combined state with a feeling and high strength.
That is, the insert 14 and the mouth opening 15 are integrally connected, and the tubular shaft / trocar 13 is connected so that both ends thereof are sandwiched between the tip shaft 16 and the end handle 17 so as to have high rigidity. Become.

As for the size of the tubular shaft of the small-sized forceps used in the laparoscopic forceps unit of the present invention, various cases have been described in the case of about 2 mm. However, if the tubular shaft has a smaller diameter than the mouth portion. The size is not limited to about 2 mm, and it may be larger or smaller.

In addition, the use of the forceps unit for laparoscopic surgery according to the present invention is applicable to forceps used for appropriate purposes such as hemostasis and tissue gripping of a target site in the abdominal cavity, grasping of a suture thread, or removal of foreign matter. be able to.

11 Forceps unit for laparoscopic surgery 12 trocar 13 tubular shaft and trocar 14 insert 15 mouth part 15a gripping part 15b pulling part 16 tip shaft 16a notch 17 handle 18 guide groove 19 engaging part 20 small diameter forceps 21 rotating shaft 22 detaching button 23 Fixing ring 31a First puncture inner cylinder 31b Second puncture inner cylinder A, B Gripping member

Claims (3)

An appropriately sized trocar that becomes one insertion part into the abdominal cavity,
Tubular shaft and trocar serving as another insertion part into the abdominal cavity having a smaller diameter than the trocar and having a handle attached to the end,
An insert that can be inserted into and removed from the tubular shaft / trocar, is connected to a distal end of a lip portion that is thicker than the tubular shaft / trocar, and is formed without interruption to the end, and an end portion on the throat portion side of the insert. A cylindrical tip shaft attached to the mouth portion so as to cover;
An inner cylinder for puncture that can be inserted into and removed from the tubular shaft and trocar;
A handle that is detachably attached to the end portion of the insert protruding from the other insertion portion into the abdominal cavity,
The insert and the mouth part are integrally connected, and the tubular shaft and trocar is connected so that both ends of the tubular shaft and trocar are sandwiched between the tip shaft and the end handle attached to the mouth part, respectively, so as to have high rigidity. A forceps unit for laparoscopic surgery characterized by the above. 2. The laparoscope according to claim 1, wherein a cylindrical tip shaft fixed at the end of the mouth portion having a size larger than the insert has a tip portion formed thickly inserted in the insert shaft. Surgical forceps unit. The inner cylinder for puncture that can be inserted into and removed from the tubular shaft and trocar is thinned without increasing the diameter of the first inner cylinder for puncturing, or the diameter of the distal end is made large. The forceps unit for laparoscopic surgery according to claim 1, comprising a second puncture inner cylinder.

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