JP2016064130A - Surgical tool and vasodilatation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical tool capable of safely and securely preventing leakage of fluid under pressure without damaging a blood vessel in a vasodilation surgery, and a vasodilatation device composed of the surgical tool and an insertion tube.SOLUTION: A vasodilatation device includes an insertion tube 10 and a surgical tool 20. The insertion tube 10 includes a step formed in a shape that a connection 15 is smaller in diameter than that of an insertion tip 11. The surgical tool 20 includes a first recess 26a recessed in an arc shape formed on a first holding member 26, a second recess 27a recessed in an arc shape formed at a position corresponding to the first recess 26a on a second holding member 27, a retention mechanism 24 to keep a closed state of the first holding member 26 and the second holding member 27. In the state where the first holding member 26 and the second holding member 27 are closed, a diameter of a blood vessel holder 23 formed with the first recess 26a and the second recess 27a is substantially equal to that of the connection 15 at the step.SELECTED DRAWING: Figure 4

Description

  The present invention relates to a surgical instrument used for vasodilation of a blood vessel that has been exfoliated and collected, and a vasodilator comprising the surgical instrument and an insertion tube.

  For example, in blood access preparation for dialysis in patients with end-stage renal failure, it is necessary to expand the detached blood vessels (autologous veins) for blood circulation reconstruction. There is a need to securely and safely expand a wide range of veins from the anastomosis site of the skin vein) to the central arm where the central arm is not separated from the forearm to the upper arm.

  Similarly, in the coronary artery bypass surgery for ischemic heart disease, lower limb revascularization for lower limb obstructive arteriosclerosis, head and neck revascularization, etc. It is necessary to dilate blood vessels during treatment, confirmation of damaged parts, and repair.

  Specifically, vascular dilation as described above is performed by inserting a tapered insertion tube (cannula) or a spherical cannula, injecting heparin-containing physiological saline into the lumen, and adding the blood vessel from the inside. Press to expand. In order to control the leakage of liquid from the cannula insertion part, straight forceps may be used, but the part where the forceps and the cannula are in contact is limited, and leakage from other parts causes blood vessels. Expansion work becomes insufficient. Because of these problems, in clinical practice, it is often forced to ligate from the outside of the blood vessel with a thin silk thread to control leakage. The work of ligating not only requires manpower and time, but also takes time to remove the ligature after vasodilation. Further, there is a risk that the blood vessel ligation part is damaged by ligation from the outside, or the blood vessel is damaged when the ligature is removed. The damaged portion of the blood vessel has to be excised, and as a result, there is a drawback that it is impossible to maintain an appropriate length as a bypass graft (particularly in the case of blood access for dialysis).

  Further, for example, techniques disclosed in Patent Documents 1 and 2 are disclosed as techniques for stably grasping an object to be grasped during surgery. The technique shown in Patent Document 1 includes a clip-operating forceps 10 having a clip holding portion 18 constituted by a movable jaw 12 and a fixed jaw 13 at the distal end of a tubular shaft 11, and a movable jaw 22 and a fixed jaw 23 at the distal end of the tubular shaft 21. An endoscopic surgical instrument set including a clip attaching / detaching forceps 20 having a clip holding portion 28 and a clip 30, and the clip operating forceps is always in the axial direction of the tubular shaft when holding the clip. The holding recesses 16 and 17 are formed so as to be held in a fixed direction, and the clip attaching / detaching forceps are always held at the same angle with respect to the axial direction of the tubular shaft when the clip is held. The holding recesses 26 and 27 are formed, and the clip is held by the movable jaw and the fixed jaw of the clip operation forceps. When, in which clamped portion sandwiched by the movable jaw and the fixed jaw of the clip removable forceps are formed.

  The technique disclosed in Patent Document 2 is a guide assisting instrument 1 for guiding an endoscope introduced into a body cavity to a notch opening in the body cavity. A hook-shaped gripping member 6 is connected to the tip, and the sheath 2 receives the gripped portion of the endoscope taken into the gripping member 6 at the tip position of the sheath 2, and the inner portion is interposed between the hook-shaped portion 6. An elastic member 7 that sandwiches a grasped portion of the endoscope is provided, and an operation portion 3 that moves the grasping member 6 forward and backward via the operation rod 5 is provided on the proximal end side of the sheath 2.

JP 2012-232066 A JP-A-10-272139

  However, the techniques shown in the above-mentioned patent documents only hold the object to be gripped stably, and cannot hold the pressurized liquid firmly and safely without causing leakage. Absent. That is, it is not a technique that can solve the problems in vascular dilation as described above.

  The present invention provides a surgical instrument capable of safely and reliably preventing leakage of liquid due to pressurization without damaging a blood vessel in a vasodilation operation, and a vasodilator comprising the surgical instrument and an insertion tube.

  The present invention provides a cylindrical insertion tube having an insertion tip portion to be inserted into a blood vessel, a connection portion to which a liquid injection device (syringe) is connected, a first clamping member, a second clamping member, and the first A vascular dilator having a connecting part that connects the first holding member and the second holding member so as to be openable and closable, and a surgical instrument that holds the insertion tip inserted into a blood vessel. Is provided on the outer surface of the insertion tip portion, and includes a stepped portion having an outer diameter on the connection portion side smaller than the outer diameter on the insertion tip portion side, and the surgical instrument in the first clamping member A first recess recessed in an arc shape formed on a surface facing the second clamping member, and a position corresponding to the first recess on the surface facing the first clamping member in the second clamping member. A second recess recessed in a circular arc shape, the first clamping member and the second A holding mechanism for holding the holding member in a closed state, and the diameter of the blood vessel holding portion formed by the first recess and the second recess in the closed state of the first holding member and the second holding member is The present invention relates to a vasodilator that is formed substantially equal to the outer diameter of the stepped portion on the connection portion side.

  Further, the present invention has a first clamping member, a second clamping member, and a connecting portion that connects the first clamping member and the second clamping member so as to be openable and closable, and the distal end portion is inserted into the blood vessel. A surgical instrument for clamping an insertion tube, wherein a plurality of first recesses formed on a surface of the first clamping member facing the second clamping member, each having a different diameter and recessed in an arc shape, and the second The present invention relates to a surgical instrument further comprising a plurality of second recesses that are formed in positions corresponding to the plurality of first recesses on the surface of the sandwiching member that faces the first clamping member and are recessed in an arc shape.

  In addition, a boundary portion between a plurality of the first recesses and a surface of the first clamping member where the plurality of first recesses are formed, and a surface of the second clamping member where the plurality of second recesses are formed. It is preferable that the boundary part with several this 2nd recessed part is comprised by a curved surface.

  Moreover, it is preferable that the center angle of the arcs of the plurality of first recesses is configured to be larger than the center angle of the arcs of the plurality of second recesses.

  In addition, the present invention provides a first clamping member and a second clamping member that are made of an elastically deformable resin member, and the first clamping member that can open and close the front end sides of the first clamping member and the second clamping member. And a connecting part for connecting the proximal end side of the second clamping member, and a surgical instrument for clamping an insertion tube inserted into a blood vessel, wherein the second clamping member in the first clamping member A first recess recessed in an arc shape formed on a surface facing the first recess, and an arcuate recess formed in a position corresponding to the first recess on the surface facing the first clamping member in the second clamping member A second recess, an engagement portion for engaging the first clamping member and the second clamping member on the front end side of the first clamping member and the second clamping member, and holding the closed state; The outer surface of the base end side of each of the holding member and the second holding member is recessed. A disengagement section to be made relates to surgical instruments comprising a.

  In addition, the present invention provides a blood vessel comprising an insertion tip portion inserted into a blood vessel, a cylindrical insertion tube having a connection portion to which a liquid injection device is connected, and the surgical instrument described above. In the expansion device, the insertion tube is provided on an outer surface of the insertion tip portion, and includes a stepped portion having an outer diameter on the connection portion side smaller than an outer diameter on the insertion tip portion side. In the closed state of the first clamping member and the second clamping member, the diameter of the blood vessel clamping portion formed by the first recess and the second recess is formed substantially equal to the outer diameter of the stepped portion on the connection portion side. The present invention relates to a vasodilator.

  According to the present invention, in a vasodilation operation, a surgical instrument capable of preventing removal of an insertion tube inserted into a blood vessel without damaging the blood vessel and preventing leakage of liquid due to pressurization safely and reliably. A vasodilator comprising the surgical instrument and an insertion tube can be provided.

It is a figure which shows the structure of the insertion pipe | tube inserted in the blood vessel which comprises the vasodilator of this invention. It is sectional drawing when an insertion front-end | tip part is inserted in the blood vessel. It is an external view of the surgical instrument which concerns on 1st Embodiment. It is a figure which shows the utilization form in the case of utilizing an insertion tube and a surgical instrument (vasodilator) in actual surgery. It is a figure which shows the relationship of the hardness of the blood vessel, the inner wall member of a surgical instrument, and the outer peripheral member of an insertion tube. It is a figure which shows the 1st application example of the surgical instrument which concerns on 1st Embodiment. It is a figure which shows the 2nd application example of the surgical instrument which concerns on 1st Embodiment. It is a 1st figure which shows the structure of the surgical instrument which concerns on 2nd Embodiment. It is a 2nd figure which shows the structure of the surgical instrument which concerns on 2nd Embodiment. It is a 3rd figure which shows the structure of the surgical instrument which concerns on 2nd Embodiment.

  Embodiments of the present invention will be described below. The present invention can be implemented in many different forms. Also, the same reference numerals are given to the same elements throughout the present embodiment.

(First embodiment of the present invention)
A surgical instrument and a vasodilator according to this embodiment will be described with reference to FIGS. The surgical instrument according to the present embodiment is used when expanding a blood vessel (autologous vein or autologous artery) obtained by exfoliation in revascularization, and an insertion tube to be inserted into the blood vessel and a blood vessel in which the insertion tube is inserted Are sandwiched and fixed at the same time. In addition, the vasodilator according to the present embodiment is configured by a set of an insertion tube and a surgical instrument.

FIG. 1 is a diagram showing a structure of an insertion tube to be inserted into a blood vessel. The insertion tube 10 has an insertion tip portion 11 inserted into a blood vessel, and stores a conduit portion 13 in which a flow path 12 for penetrating the center and flowing liquid into the blood vessel is formed, and liquid flowing into the blood vessel. The connecting portion that connects the syringe 17 and the insertion tube 10 by inserting the storage portion 14 and the distal end portion 16 of the syringe 17 as a liquid injection device for injecting liquid into the blood vessel via the insertion tube 10. 15. The liquid discharged from the syringe 17 flows into the blood vessel through the distal end portion 16, the connection portion 15, the storage portion 14, the flow path 12, and the insertion distal end portion 11. The insertion tube 10 is prepared in accordance with different standards depending on the thickness of the blood vessel. For example, there are standards in which the diameter of the convex portion of the insertion tip portion 11 is 2 mm, 3 mm, and 4 mm.
The insertion tube 10 is provided on the outer surface of the insertion tip portion 11 and has a stepped portion having an outer diameter on the connection portion 15 side that is smaller than the outer diameter on the insertion tip portion 11 side.

  FIG. 2 is a cross-sectional view when the insertion tip 11 is inserted into the blood vessel. A portion up to a position slightly deeper than the insertion tip portion 11 (the thicker portion of the conduit portion 13 is defined as a deep position) is inserted into the blood vessel S that has been separated and collected. That is, the region of the insertion tip 11 + α is covered with the blood vessel S. This + α region is used as a region where the blood vessel S is fastened and fixed by the surgical instrument 20 of the present embodiment described later. As shown in FIG. 2 (B), a step formed between the insertion tip 11 and the conduit 13 is used, and the convex portion 18 and the surgical instrument 20 formed by this step form the blood vessel S. The recessed portion 19 may be formed in the tightened portion of the surgical instrument 20 so as to be fitted through. In any case of FIGS. 2A and 2B, the gap between the insertion tube 10 and the surgical instrument 20 can be prevented by utilizing the difference in level between the insertion tip portion 11 and the conduit portion 13. Can do.

  Further, in FIG. 1, the distal end portion 16 of the syringe 17 is tightly fixed to the connection portion 15 using an elastic force such as an elastic body, and injects the liquid in the syringe 17 into the conduit portion 13. The injected liquid passes through the conduit portion 13 and flows into the blood vessel S. As shown in FIG. 2, the insertion tube 10 and the blood vessel S are tightly fixed by a surgical instrument (details will be described later), so that the insertion tube 10 and the blood vessel S are sealed without gaps, and the liquid in the syringe 17 is pressed into the blood vessel in a pressurized state. Can be sent. The blood vessel S is sufficiently expanded by inflowing the liquid under pressure.

  Next, a surgical instrument according to this embodiment for fixing the insertion tube 10 and the blood vessel S will be described. FIG. 3 is an external view of the surgical instrument according to the present embodiment. FIG. 3A shows a state in which the tightening portion is closed (state in which the insertion tube 10 and the blood vessel S are tightened), and FIG. 3B shows a state in which the tightening portion is open (in which the insertion tube 10 and the blood vessel S are tightened). State).

  The surgical instrument 20 has a clip structure in which a first clamping member 26 as a first clamping member and a second clamping member 27 as a second clamping member are coupled at a coupling portion 24, and can be opened and closed at hand. The open / close state of the tightening portion 22 is controlled according to the operation of the operation portion 21 to tighten the blood vessel S. That is, when the width of the opening / closing operation part 21 is reduced, the width of the tightening part 22 is increased, and when the width of the opening / closing operation part 21 is increased, the width of the tightening part 22 is reduced. The opening / closing operation portion 21 has a spring-like elastic portion 29 so that an elastic force acts in the opening / closing direction. When no external force is applied, the opening / closing operation portion 21 is operated by the elastic portion 29. 21 is held in an open state, that is, in a state in which the tightening portion 22 is closed. That is, the elastic portion 29 functions as a holding mechanism that holds the closed state of the tightening portion 22 (the first tightening member 26 and the second clamping member 27). When the blood vessel S is sandwiched and tightened, stress is applied from the outside in the direction of arrow A to close the opening / closing operation unit 21 and simultaneously open the tightening unit 22. When the blood vessel S is inserted into the desired tightening holes 23a to 23c, the tightening portion 22 is closed by releasing the stress applied in the direction of the arrow A, and the blood vessel S is fixed. As described above, for example, when the insertion tube 10 has three standards, the tightening holes 23a (2 mmφ), 23b (3 mmφ), and 23c (4 mmφ) are formed in accordance with the standards.

  Each tightening hole 23a-23c is formed in a circular shape by combining the first tightening member 26 and the second tightening member 27. In other words, the first tightening member 26 is provided with a plurality of semicircular cutouts 26 a to 26 c as first recesses formed on the surface facing the second tightening member 27 and recessed in an arc shape. The second tightening member 27 has a semicircle as a plurality of second recesses formed in positions corresponding to the plurality of notches 26a to 26c on the surface facing the first clamping member 26 and recessed in an arc shape. Shaped notches 27a-27c are arranged. And in the closed state of the 1st clamping member 26 and the 2nd clamping member 27, the notch parts 26a-26c and the notch parts 27a-27c match | combine, and the clamping holes 23a- as a circular blood vessel clamping part are combined. 23c is formed. Then, as shown in FIG. 2, these tightening holes 23 a to 23 c can tighten the blood vessel S having a circular cross section so as to wrap from the circumferential direction. In the present embodiment, the plurality of notches 26a to 26c are formed with different diameters, and the plurality of notches 27a to 27c are also formed with different diameters. Further, the corresponding notch 26a and notch 27a, the notch 26b and notch 27b, and the notch 26c and notch 27c are formed to have the same diameter.

  FIG. 4 is a diagram showing a usage pattern when the insertion tube 10 and the surgical instrument 20 are used in actual surgery. The insertion tube 10 is inserted into the blood vessel S peeled and collected from the tip of the arm, the insertion portion is tightened with the surgical instrument 20, and a liquid such as physiological saline containing heparin is injected from the syringe 17 in a pressurized state. The injected liquid circulates in the blood vessel S at a high pressure and undergoes vasodilation.

  In the present embodiment, the hardness of the inner wall member in contact with the blood vessel S in the surgical instrument 20 and the hardness of the outer peripheral member in contact with the blood vessel S in the insertion tube 10 are appropriately adjusted with respect to the hardness of the blood vessel S. It is desirable. FIG. 5 is a diagram showing the relationship between the hardness of the blood vessel, the inner wall member 51 of the surgical instrument, and the outer peripheral member 52 of the insertion tube 10. 5, the hardness of each part is (1) hardness of the inner wall member 51 in contact with the blood vessel S in the surgical instrument 20> hardness of the blood vessel S> hardness of the outer peripheral member 52 in contact with the blood vessel S in the insertion tube 10, or (2) It is desirable that the outer peripheral member 52 be formed so as to maintain a relationship of hardness> blood vessel S hardness> inner wall member 51 hardness. That is, by sandwiching the blood vessel S between a hard member and a soft member, it is possible to simultaneously realize strong tightening by the hard member and prevention of blood vessel damage by the soft member.

  In addition, as shown in FIG. 2B, by forming the concavo-convex portions on the inner wall member 51 and the outer peripheral member 52, it is possible to prevent the insertion tube 10 and the surgical instrument 20 from being displaced during the operation. For lifting that may be damaged, it is desirable that the surfaces of the inner wall member 51 and the outer peripheral member 52 that are in contact with the blood vessel S are smooth as shown in FIG.

  The diameters of the tightening holes 23 a to 23 c formed by the notches 26 a to 26 c and the notches 27 a to 27 c in the closed state of the first tightening member 26 and the second tightening member 27 are the stepped portions of the insertion tube 10. It is preferable that the outer diameter on the side of the connecting portion 15 is substantially equal. That is, when configuring the vascular dilator with the surgical instrument 20 and the insertion tube 10 as a set, the diameter of the small diameter portion of the step portion of the insertion tube 10 is configured to be approximately equal to the diameter of any of the tightening holes 23a to 23c. By setting the inserted insertion tube 10 and the surgical instrument 20 as a set, the blood vessel can be suitably tightened, and the tightened blood vessel can be hardly detached.

  Furthermore, it is desirable that the inner diameters of the tightening holes 23 a to 23 c of the surgical instrument 20 with respect to the outer circumference of the insertion tube 10 are formed according to the plastic deformation rate of the blood vessel S. That is, it is desirable that the outer peripheral dimensions of the insertion tube 10 and the inner diameters of the tightening holes 23a to 23c are formed so that the tightening force takes into account the allowable amount when the blood vessel S is deformed.

  Furthermore, as shown in FIG. 6, edge portions 63a to 63d, 64a to 64d (first tightening members 26) at locations where the flat portions 61a to 61c and 62a to 62c are connected from the notches 26a, 26b, 27a and 27b. Boundary surfaces between the plurality of notches 26a and 26b and the plurality of notches 26a and 26b, and the surfaces 62a to 62b on the second tightening member 27 where the plurality of notches 27a and 27b are formed. 62c and a plurality of notches 27a and 27b) are preferably formed on a curved surface. By doing so, it can prevent that the edge parts 63a-63d and 64a-64d pinch the blood vessel S and damage it. At this time, it is assumed that the curvature of the curved surface of the edge portion in consideration of the plastic deformation rate of the blood vessel is set so that the surgical instrument 20 is not sufficiently tightened.

  Furthermore, as shown in FIG. 7, the notches 26a, 26b, 27a, and 27b do not have to be cut into a semicircular shape, and may be cut into a fan-shaped arc having a different central angle. By doing so, the blood vessel S can be stably fixed to the large notches 27a and 27b (the side where the arc of the notch is large, that is, the side where the central angle is large), and the edge portions 63a to 63d ( The edge angle in the edge portion on the side facing the sandwiching where the blood vessel S is not installed) can be increased, and damage to the blood vessel can be prevented.

  Thus, in the surgical instrument 20 and the vasodilator according to the present embodiment, the surgical instrument 20 can be fitted to the outer periphery of the insertion tube 10 to prevent liquid leakage due to pressurization, and ligation or the like can be performed. It is possible to perform vascular dilation safely and reliably.

(Second embodiment of the present invention)
A surgical instrument according to this embodiment will be described with reference to FIGS. The surgical instrument according to the present embodiment has only one tightening hole 23, and tightens a circular blood vessel by engaging and fixing a semicircular tightening member at the tip. By making the tightening hole one and engaging and fixing the tightening member, the size and mass can be reduced, and the influence on the surgical operation can be minimized.

  8 to 10 are diagrams showing a configuration of the surgical instrument according to the present embodiment. The surgical instrument 20 shown in FIG. 8 shows a state before the blood vessel S is sandwiched, and the surgical instrument 20 shown in FIG. 9 shows a state where the blood vessel S is sandwiched and fixed, and FIG. A surgical instrument 20 shown in A) shows a state when the surgical instrument is released from a state in which the blood vessel S is sandwiched.

  As shown in FIG. 8, the surgical instrument 20 according to the present embodiment sandwiches the blood vessel S and fixes it together with the insertion tube 10 as in the case of the first embodiment. Although it is configured by a set of the instrument 20 and the insertion tube 10, it does not include the opening / closing operation unit 21 as shown in FIG. 3, and includes only one tightening hole 23. That is, although versatility is reduced as compared with the structure of FIG. 3, it can be reduced in size and weight, and does not interfere with the operation. Further, mass production using a material such as a synthetic resin can be used as a disposable surgical instrument 20, and improvement in hygiene can be achieved.

  In FIG. 8, the surgical instrument 20 is made of, for example, a synthetic resin or the like having a supportive and elastic force (elastically deformable) and having a semicircular opening and a second tightening member. The member 27 is connected by a base portion 81 as a connecting portion. The first tightening member 26 and the second tightening member 27 are fixed to be openable and closable with the base 81 as a base point. When the blood vessel S is sandwiched or removed from the blood vessel S, the first tightening member 26 and the second tightening member 27 are fixed. 2 The tightening member 27 is moved in the direction of arrow A in FIGS. An engaging portion including one engaging convex portion 82 and the other engaging concave portion 83 is provided at the distal end portions (positions facing the base portion 81) of the first tightening member 26 and the second tightening member 27. As shown in FIG. 9, the engagement convex portion 82 and the engagement concave portion 83 are engaged to form a circular tightening hole 23.

  Further, as shown in FIG. 10A, the outer surfaces of the first tightening member 26 and the second tightening member 27 are recessed in the vicinity of the base 81 in the first tightening member 26 and the second tightening member 27, respectively. The disengagement part which consists of the latching recessed parts 84 and 85 formed in this is arrange | positioned, and the thickness of the 1st clamping member 26 and the 2nd clamping member 27 in the arrangement | positioning part of this latching recessed part 84 and 85 is the same. Forming a thin film creates great absorbability. When a pressing force is applied to each of the locking recesses 84 and 85, the circular shape of the tightening hole 23 is broken, and the engagement projection 82 is detached from the engagement recess 83, so that the surgical instrument 20 can be opened.

  In addition, when applying a pressing force to the locking recesses 84 and 85, it may be performed with a finger, but the diameter of the tightening hole 23 is as very small as 2 to 4 mm, and the pressing force may not be applied well with a finger. . Such lifting may be performed, for example, by applying a pressing force to the locking recesses 84 and 85 with a pliers-like dedicated instrument 89 as shown in FIG. That is, the front end portions 86 and 87 of the dedicated instrument 89 are brought into contact with the locking concave portions 84 and 85, and the engaging convex portion 82 is detached from the engaging concave portion 83 by applying force in the direction of arrow B. Good. Further, the engaging protrusion 82 is detached from the engaging recess 83 by deforming the engaging recess 83 so as to be scratched outward by a claw or the like without necessarily applying a pressing force to the locking recesses 84 and 85. You may do it.

  As described above, in the surgical instrument according to the present embodiment, it is possible to securely tighten the blood vessel in a pressurized state and perform the blood vessel expansion safely and reliably, and at the same time, to have a small and mass-produced structure. This makes it possible to improve the hygiene and minimize the hindrance to the operation.

  Also in the present embodiment, as in the first embodiment, the diameter of the tightening hole 23 in the closed state of the first tightening member 26 and the second tightening member 27 is the connection at the step portion of the insertion tube 10. It is preferable that the outer diameter on the part 15 side is substantially equal. That is, when the vascular dilator is configured by setting the surgical instrument 20 and the insertion tube 10 as a set, the diameter of the small diameter portion of the step portion of the insertion tube 10 is configured to be substantially equal to the diameter of the tightening hole 23. And the surgical instrument 20 as a set, the blood vessel can be suitably tightened, and the tightened blood vessel can be hardly detached.

  The preferred embodiments of the present invention have been described above, but it can be said that the present invention has the following characteristics.

  (1) A surgical instrument according to the present invention is a surgical instrument that inserts an insertion tube into a peeled and collected blood vessel, and expands the blood vessel across the blood vessel into which the insertion tube is inserted. From a blood vessel holding portion that has substantially the same opening hole, is formed to be openable and closable in a weekly direction with a part of the outer periphery of the opening hole as a fulcrum, and sandwiches the blood vessel into which the insertion tube is inserted from the inner wall of the opening hole It will be.

  As described above, the surgical instrument according to the present invention has an opening hole that is substantially equal to the outer diameter of the insertion tube inserted into the peeled and collected blood vessel, and is opened and closed in the circumferential direction using a part of the outer periphery of the opening hole as a fulcrum. Since it is formed freely and consists of a blood vessel clamping part that sandwiches the blood vessel in which the insertion tube is inserted from the outside with the inner wall of the opening hole, the blood vessel clamping unit is fitted to the outer periphery of the insertion tube to prevent liquid leakage due to pressurization It is possible to perform vasodilation safely and reliably without ligation or the like.

  (2) In the surgical instrument according to the present invention, the blood vessel clamping portion is composed of a semicircular first member and a second member, and the circular opening hole is formed in a state where the first member and the second member are combined. Is formed.

  As described above, in the surgical instrument according to the present invention, the blood vessel clamping portion includes the semicircular first member and the second member, and the circular opening hole in a state where the first member and the second member are combined. Therefore, the insertion tube inserted into the blood vessel can be sandwiched from the outside, and the blood vessel can be safely and reliably expanded without damaging the blood vessel.

  (3) In the surgical instrument according to the present invention, at least the inner wall of the blood vessel clamping portion is formed smoothly.

  Thus, in the surgical instrument according to the present invention, since at least the inner wall of the blood vessel clamping portion is formed smoothly, there is an effect that the blood vessel can be expanded safely and reliably without damaging the blood vessel. .

  (4) In the surgical instrument according to the present invention, the hardness of the inner wall member in contact with the blood vessel in the blood vessel clamping portion is smaller than the hardness of the blood vessel, and the outer peripheral member in contact with the blood vessel in the insertion tube Hardness is large, or the hardness of the inner wall member in contact with the blood vessel in the blood vessel clamping portion is large, and the hardness of the outer peripheral member in contact with the blood vessel in the insertion tube is small.

  Thus, in the surgical instrument according to the present invention, the hardness of the inner wall member in contact with the blood vessel in the blood vessel clamping portion is small and the hardness of the outer peripheral member in contact with the blood vessel in the insertion tube is large relative to the hardness of the blood vessel. Or, since the hardness of the inner wall member in contact with the blood vessel in the blood vessel clamping portion is large and the hardness of the outer peripheral member in contact with the blood vessel in the insertion tube is small, the blood vessel can be expanded safely and reliably without damaging the blood vessel. There is an effect that can be. That is, when the blood vessel is sandwiched from the inside and the outside, either the inside or outside hardness is small relative to the blood vessel hardness, and either one is high, so the pressure applied to the blood vessel is small. Even if the material of the other side absorbs it, it has an effect that the blood vessel can be surely expanded without damaging the blood vessel even if it is sandwiched strongly.

  (5) In the surgical instrument according to the present invention, the inner wall shape of the blood vessel clamping portion is formed by a convex portion and / or a concave portion that fits into the concave portion and / or the convex portion formed on the outer periphery of the insertion tube. Is.

  Thus, in the surgical instrument according to the present invention, the inner wall shape of the blood vessel sandwiching portion is formed by the convex portion and / or the concave portion that fits into the concave portion and / or the convex portion formed on the outer periphery of the insertion tube. Therefore, there is an effect that the insertion tube and the blood vessel clamping portion can be prevented from being displaced and can be firmly fixed.

  (6) In the surgical instrument according to the present invention, the inner peripheral dimension in the opening hole of the blood vessel clamping portion with respect to the outer peripheral dimension of the insertion tube is formed by a dimensional difference based on the plastic deformation rate of the blood vessel.

  As described above, in the surgical instrument according to the present invention, the inner peripheral dimension in the opening hole of the blood vessel clamping portion with respect to the outer peripheral dimension of the insertion tube is formed with a dimensional difference based on the plastic deformation rate of the blood vessel. Based on the plastic deformation rate, the blood vessel can be expanded without damaging the blood vessel and preventing leakage of liquid due to pressurization.

The preferred embodiments of the surgical instrument and vasodilator of the present invention have been described above. However, the present invention is not limited to the above-described embodiments, and can be modified as appropriate.
For example, in the first embodiment, the surgical instrument 20 includes the three tightening holes 23a to 23c, but is not limited thereto. That is, you may comprise the surgical instrument of 1st Embodiment by one clamping hole.

DESCRIPTION OF SYMBOLS 10 Insertion tube 11 Insertion front-end | tip part 12 Flow path 13 Conduit part 14 Storage part 15 Connection part 16 Tip part 17 Syringe (liquid injection | pouring instrument)
DESCRIPTION OF SYMBOLS 20 Surgical instrument 21 Opening-closing operation part 22 Tightening part 23 (23a-23c) Tightening hole 26 1st fastening member (1st clamping member)
26a-26c Notch (first recess)
27 Second tightening member (second clamping member)
27a-27c Notch (second recess)
DESCRIPTION OF SYMBOLS 29 Elastic part 51 Inner wall member 52 Outer peripheral member 61a-61d Flat part 62a-62d Flat part 63a-63f Edge part 64a-64f Edge part 81 Base 82 Engagement convex part 83 Engagement recessed part 84,85 Engagement recessed part

Claims (6)

A cylindrical insertion tube having an insertion tip portion to be inserted into the blood vessel and a connection portion to which a liquid injection device is connected;
A surgical instrument that has a first clamping member, a second clamping member, and a connecting part that connects the first clamping member and the second clamping member so as to be openable and closable, and clamps the insertion tip inserted into a blood vessel; A vasodilator comprising:
The insertion tube is provided on an outer surface of the insertion tip portion, and includes a step portion formed with an outer diameter on the connection portion side smaller than an outer diameter on the insertion tip portion side,
The surgical instrument is:
A first recess recessed in an arc shape formed on a surface of the first clamping member facing the second clamping member;
A second recess recessed in an arc shape formed at a position corresponding to the first recess on a surface of the second sandwiching member facing the first sandwiching member;
A holding mechanism for holding a closed state of the first clamping member and the second clamping member,
In the closed state of the first clamping member and the second clamping member, the diameter of the blood vessel clamping portion formed by the first recess and the second recess is substantially equal to the outer diameter of the stepped portion on the connection portion side. Vasodilator. Surgery that has a first clamping member, a second clamping member, and a connecting portion that connects the first clamping member and the second clamping member so as to be openable and closable, and clamps an insertion tube having a distal end inserted into a blood vessel. An instrument,
A plurality of first concave portions formed on a surface of the first clamping member facing the second clamping member, each of which has a different diameter and is recessed in an arc shape;
A surgical instrument further comprising: a plurality of second recesses formed in positions corresponding to the plurality of first recesses on a surface of the second holding member facing the first clamping member and recessed in an arc shape.   A boundary portion between a plurality of first recesses in the first clamping member and a plurality of first recesses, and a surface in the second clamping member on which the second recesses are formed and a plurality of The surgical instrument according to claim 2, wherein a boundary portion with the second recess is configured by a curved surface.   The surgical instrument according to claim 2 or 3, wherein a center angle of the arcs of the plurality of first recesses is configured to be larger than a center angle of the arcs of the plurality of second recesses. A first clamping member and a second clamping member configured by an elastically deformable resin member, and the first clamping member and the second clamping member so as to be able to open and close the front ends of the first clamping member and the second clamping member. A surgical instrument that sandwiches an insertion tube inserted into a blood vessel,
A first recess recessed in an arc shape formed on a surface of the first clamping member facing the second clamping member;
A second recess recessed in an arc shape formed at a position corresponding to the first recess on a surface of the second sandwiching member facing the first sandwiching member;
An engagement portion that engages the first clamping member and the second clamping member on the front end side of the first clamping member and the second clamping member, and holds the closed state;
A surgical instrument comprising: a disengagement portion formed by recessing an outer surface on a proximal end side of each of the first clamping member and the second clamping member. A vascular dilation device comprising: an insertion tip portion inserted into a blood vessel; a cylindrical insertion tube having a connection portion to which a liquid injection device is connected; and the surgical instrument according to claim 5,
The insertion tube is provided on an outer surface of the insertion tip portion, and includes a step portion formed with an outer diameter on the connection portion side smaller than an outer diameter on the insertion tip portion side,
In the closed state of the first clamping member and the second clamping member, the diameter of the blood vessel clamping portion formed by the first recess and the second recess is substantially equal to the outer diameter of the stepped portion on the connection portion side. Vasodilator.

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