JP2016171911A - Medical gripper and its manufacturing method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical gripper with a pair of movable gripping pieces that is hard to cause settling and can obtain high gripping force, and provide its manufacturing method.SOLUTION: This gripper 10 includes a body part 15 having a base part 20 and movable gripping pieces 30, 30, and a frame-like slide member 50. Each movable gripping piece 30 is provided with a moving regulating part 36 for regulating a movement position of the frame-like slide member 50. When viewing from a perpendicular direction to the expanding direction C of the movable gripping pieces 30, 30, a thickness of a portion 31 extending from a base part 20 and curved in the expanding direction of each movable gripping piece 30 is assumed as A, and the thickness of a portion 35 opposed to the inner surface of the frame-like slide member 50 in the position where the frame-like slide member 50 of each movable gripping piece 30 is moved to the moving regulating part 36 is assumed as B. Then, the thickness B is formed thicker than the thickness A.SELECTED DRAWING: Figure 4

Description

  The present invention relates to a medical gripping tool housed in a medical tube and used for gripping tissue in the body by remote control and a method for manufacturing the medical gripping tool.

  Relatively small cancers and polyps generated in the body such as the stomach and intestine may be removed by endoscopic surgery. A wound generated at that time is opened and closed by a remote operation of a medical gripping tool through an endoscope, a section around the wound is gripped, and the wound is subjected to stitching, hemostasis, ligation, and the like.

  As a conventional medical gripping tool of this type, the following Patent Document 1 discloses a fixing clip having an elongated plate shape, a base end portion fixed to the fixing clip, and the fixing clip toward the distal end of the fixing clip. A pair of movable clips that have a gripping claw that extends in the opening direction and protrudes toward the fixed clip at the distal end, and the outer sides of the pair of movable clips from the proximal end side to the distal end side of the fixed clip. A ring member that is slidably mounted so as to hold down, and when the ring member is slid toward the distal end side of the fixed clip, the pair of movable clips are shifted to the fixed clip side at different timings from both sides. A medical gripping tool configured as described above is described. The pair of movable clips is formed by bending an elongated plate made of a Ni-Ti alloy and having a constant thickness, and has a base-side inclined portion and a tip-side inclined portion having different inclination angles with respect to the fixed clip. (See paragraphs 0031 and 0032).

  Further, the medical gripping tool is accommodated in a state where the pair of movable clips are closed in the distal end portion of the outer cylinder tube of the transport device including the outer cylinder tube, the inner cylinder tube, the hand operator, and the like. In a state, the pair of movable clips are closed with respect to the fixed clip by appropriately operating the hand operating element connected to the proximal end side of the fixed clip, and then the wound etc. It can be closed.

JP 2013-244054 A

  In the medical method gripping tool of Patent Document 1 described above, when the plate thickness of the pair of movable clips is increased in order to increase the gripping force on the wound or the like in the body, when it is accommodated in the distal end portion of the outer tube and then released, On the other hand, if the thickness of the movable clip is reduced in order to make the movable clip difficult to sag, the gripping force may be reduced.

  Further, since each movable clip is formed by bending a plate material having a certain thickness, the thickness of each movable clip on the base end side and the position closed by the ring member, that is, the base side by pressing the ring member There is no change in the thickness (see FIG. 7) of the portion facing the inner surface of the ring member of the base-side inclined portion when abutting in the middle of the inclined portion, so that it is difficult to produce a high gripping force. It is done.

  Therefore, an object of the present invention is to make it difficult to loosen the pair of movable gripping pieces when housed in a medical tube, and to provide a high gripping force when closing the pair of movable gripping pieces with a frame-shaped slide member. An object of the present invention is to provide a medical gripper that can be obtained and a method for manufacturing the same.

  In order to achieve the above object, a medical gripping tool according to the present invention is accommodated in a medical tube, transported to a predetermined position in the body, and used to grip tissue in the body. A base portion detachably attached to an operation wire provided on the tube, a main body portion having a pair of movable gripping pieces connected to the base portion so as to be openable and closable, and a frame-like slide attached to the outer periphery of the main body portion A pair of movable gripping pieces, the base end side of which is connected to the base portion and extends so that the distal end side is widened away from each other, and the frame-shaped slide member is positioned on the outer periphery of the base portion When the frame-shaped slide member is sometimes opened and moved to the tip side, the outer periphery thereof is pressed and closed, and the frame is placed at a predetermined position in the extending direction of the pair of movable gripping pieces. Of the sliding member, A movement restricting portion for restricting the maximum movement position of the movable gripping piece toward the distal end side is provided, and the pair of movable gripping pieces are viewed from a direction orthogonal to the expanding direction of the pair of movable gripping pieces. The position of each movable gripping piece that extends from the base and curves in the expanding direction is A, and the position of each movable gripping piece that has moved the frame-shaped slide member to the movement restricting portion When the thickness of the portion facing the inner surface of the frame-shaped slide member is B, the thickness B is formed thicker than the thickness A.

  In the medical gripping tool according to the present invention, it is preferable that the pair of movable gripping pieces are formed so as to gradually increase in thickness from the proximal end side toward the distal end side.

  In the medical gripping tool according to the present invention, a plurality of gripping claws are formed integrally with the movable gripping piece over the entire width direction of each movable gripping piece on the opposing surfaces of the pair of movable gripping pieces. It is preferable that

  In the medical gripping tool according to the present invention, the main body portion further includes a fixed grip piece extending from the base portion and disposed between the pair of movable grip pieces. It is preferable that the base end side of the movable grip piece is connected to the base portion while being shifted in the axial direction.

  In the medical gripping tool according to the present invention, a plurality of fixed claws protruding toward each movable gripping piece are provided on a surface of the fixed gripping piece facing the pair of movable gripping pieces. It is preferable that the fixed grip piece is formed integrally with the entire width direction.

  In the medical gripping tool according to the present invention, a plurality of gripping claws are formed integrally with the movable gripping piece over the entire width direction of each movable gripping piece on the opposing surfaces of the pair of movable gripping pieces. Furthermore, the plurality of gripping claws of each movable gripping piece and the plurality of fixed claws of the fixed gripping piece move the frame-shaped slide member to the tip side until it is restricted by the movement restricting portion. In addition, it is preferable that the pair of movable gripping pieces are formed so as to be in positions that are shifted from each other in the axial direction when they are closed.

  In the method for manufacturing a medical gripper according to the present invention, a single metal plate is cut in the thickness direction, and the main body is integrally formed with the same width as the thickness of the metal plate. It is characterized by that.

  According to the present invention, the thickness A of the portion of the pair of movable gripping pieces that extends from the base and curves in the expanding direction can be obtained when the frame-shaped slide member is moved to the movement restricting portion of the movable gripping piece. Since it is thinner than the thickness B of each movable gripping piece located inside the cylindrical slide member, the pair of movable gripping pieces can be made difficult to sag when accommodated in a medical tube. Since B is thicker than the thickness A, the frame-shaped slide member is moved to the movement restricting portion of the movable gripping piece, and the rigidity of the inner portion of the frame-shaped slide member in the state where the movable gripping piece is closed is increased. The gripping force of the medical gripper can be increased.

It is a perspective view which shows one Embodiment of the medical holding tool which concerns on this invention. It is a principal part expanded sectional view of the holding tool. It is a principal part expansion perspective view of the holding tool. FIG. 4 is a plan view of the gripping tool in a state where a pair of movable gripping pieces are opened. FIG. 3 is a plan view of the gripping tool in a state where a pair of movable gripping pieces are closed. It is a perspective view which shows an example of the manufacturing method of the medical holding tool which concerns on this invention. It is explanatory drawing which shows the 1st use condition of the holding tool. It is explanatory drawing which shows the 2nd use condition of the holding tool. It is explanatory drawing which shows the 3rd use state of the holding | gripping tool. It is explanatory drawing which shows the 4th use condition of the holding tool. It is a perspective view which shows other embodiment of the medical holding tool which concerns on this invention. FIG. 4 is a plan view of the gripping tool in a state where a pair of movable gripping pieces are opened. FIG. 3 is a plan view of the gripping tool in a state where a pair of movable gripping pieces are closed. It is explanatory drawing which shows the 1st use condition of the holding tool. It is explanatory drawing which shows the 2nd use condition of the holding tool. It is explanatory drawing which shows the 3rd use state of the holding | gripping tool. It is explanatory drawing which shows the 4th use condition of the holding tool. It is explanatory drawing which shows the 5th use condition of the holding tool. FIG. 2 shows a first other shape of a gripping claw of a movable gripping piece and a fixed claw of a fixed gripping piece in the gripping tool, (a) is an enlarged plan view of a main part with a pair of movable gripping pieces open; b) is an enlarged plan view of a main part in a state where a pair of movable gripping pieces are closed. The second other shape is shown, (a) is an enlarged plan view of the main part with the pair of movable gripping pieces open, and (b) is an enlarged plan view of the main part with the pair of movable gripping pieces closed. is there. The third other shape is shown, and (a) is an enlarged plan view of a main part with a pair of movable gripping pieces open, and (b) is an enlarged plan view of the main part with a pair of movable gripping pieces closed. is there. It is Test Example 1 used for the sag confirmation test of a movable holding piece, (a) is a photograph showing a state before tube storage, and (b) is a photograph showing a state released from the tube after tube storage. It is the example 2 of the test, (a) is a photograph showing a state before tube storage, (b) is a photograph showing a state released from the tube after tube storage.

  Hereinafter, an embodiment of a medical gripper according to the present invention will be described with reference to the drawings.

  As shown in FIG. 1, this medical grasping tool 10 (hereinafter simply referred to as “gripping tool 10”) is accommodated in a medical tube and transported to a predetermined position in the body to grasp tissue in the body. Used for.

  In the case of this embodiment, the medical tube is composed of two tubes 71 and 74 as shown in FIGS. 1 and 2, including these tubes, a medical tube device 70 (hereinafter simply referred to as “tube device 70”). The tube device 70 transports the grasping tool 10 and grasps the body tissue.

  First, the tube device 70 will be described. As shown in FIG. 2, the tube device 70 includes an outer tube 71 having a cylindrical slider 72 fixed to the proximal end side, a tube holding portion 75 attached to the proximal end side, and the outer tube 71 in the outer tube 71. And an inner tube 74 that is slidably inserted.

  A wire operation handle 76 is slidably mounted on the outer periphery of the tube holding portion 75. In the inner tube 74, an operation wire 77 for detachably holding the gripping tool 10 is slidably disposed, and a proximal end thereof is connected to the wire operation handle 76 via a wire fixing member 76a. It is connected.

  Further, as shown in FIGS. 2 and 3, a chuck portion 78 having a bifurcated shape is fixed to the tip of the operation wire 77 through a slit 78a. Convex portions 78b and 78b for holding the base 20 (see FIG. 2) of the gripping tool 10 that has entered the slit 78a project from the inner periphery of the tip of the bifurcated portion of the chuck portion 78, Thereby, the holder 10 is detachably attached to the chuck portion 78.

  For example, when the tube device 70 holds the tube holding portion 75 and slides the slider 72 back and forth in the tube axial direction, the outer tube 71 slides relative to the inner tube 74 and the tube holding portion 75. When the wire operation handle 76 is slid back and forth in the tube axial direction while holding the operation wire 77, the operation wire 77 slides relative to the inner tube 74. Note that the slider 72 may be held and the tube holding portion 75 may be slid, or the wire operation handle 76 may be held and the tube holding portion 75 may be slid, and the operation method is not particularly limited.

  Further, the structure of the medical tube device is not limited to the above-described structure, and is not particularly limited as long as at least the gripping tool can be accommodated and the operation wire can be attached to and detached from the gripping tool. .

  Next, the gripping tool 10 in this embodiment will be described.

  As shown in FIGS. 1, 3, and 4, the gripping tool 10 includes a main body portion 15 and a frame-shaped slide member 50 that is slidably mounted on the outer periphery of the main body portion 15.

  The frame-shaped slide member 50 in this embodiment has a cylindrical shape made of stainless steel, Ti, Ta, or the like, but may have a rectangular tube shape, for example. Further, a part of the outer periphery may be contacted and separated in the axial direction and may be bent so as to form a frame shape.

  Further, as shown in FIG. 6, the main body 15 is manufactured by cutting a single metal plate 5 having a constant thickness made of a shape memory alloy such as stainless steel, Ti, or Ni—Ti. A base 20 detachably attached to an operation wire 77 provided in the tube device 70, and a pair of movable gripping pieces connected to the base 20 so as to be openable and closable. 30 and 30.

  As shown in FIG. 3, the main body 15 is integrally formed with a base 20 and a pair of movable gripping pieces 30, 30 having the same width H as the thickness T of the metal plate 5 shown in FIG. ing. In addition, it is preferable that the width | variety H of the main-body part 15 and the plate | board thickness T of the metal plate 5 are 0.5-10.0 mm, and it is more preferable that it is 1.0-3.0 mm. Further, the width H of the main body 15 is a width when the main body 15 is viewed from the side, that is, from the side of the pair of movable gripping pieces 30 and 30 in the expanding direction C (see FIG. 4). is there.

  As shown in FIG. 4, the base portion 20 has a shape like a “drop” in which the base end side is wide and gradually narrows toward the tip end side. Therefore, as shown in FIGS. 2 and 3, when the base portion 20 is pushed in from the slit opening side of the chuck portion 78, the base portion 20 enters the slit 78a of the chuck portion 78 and is held by the convex portions 78b and 78b. In this state, when the operation wire 77 is pulled toward the hand side and a pulling force is applied to the chuck portion 78 in a direction away from the base portion 20, the base portion 20 comes out of the slit 78 a and the base portion 20 is detached from the chuck portion 78. It is like that. Note that the shape of the base portion 20 may be, for example, spherical, and is not particularly limited as long as the shape is detachable from the operation wire.

  On the other hand, as shown in FIGS. 3 and 4, the pair of movable gripping pieces 30, 30 connected to the base 20 so as to be openable and closable are connected to the base 20 on the base end side, and an external force is applied. In a normal state, the tip side is extended in a substantially square shape so as to expand in a direction away from each other.

  The pair of movable grip pieces 30 and 30 are opened when the frame-shaped slide member 50 is located on the outer periphery of the base portion 20 (see FIG. 4), and when the frame-shaped slide member 50 is moved to the distal end side, The outer periphery is pressed down and is configured to close elastically (see FIG. 5).

  The movable gripping piece 30 will be described in more detail. In this embodiment, as shown in FIGS. 4 and 5, the pair of movable gripping pieces 30, 30 extend from the distal end of the base portion 20 and are movable gripping. A portion 31 (hereinafter simply referred to as a “curved portion 31”) that bends with a predetermined curvature toward the expanding direction C of the piece 30 (the direction in which the pair of movable gripping pieces 30 and 30 are opened away from each other); Temporary holding portions 32, 32 extending substantially parallel to each other from the end portion of the portion 31 and provided with mountain-shaped protrusions 32a, 32a on the outside thereof, and in directions away from the tips of these temporary holding portions 32, 32 It has the extension parts 33 and 33 extended toward the diagonally outward, curving gently.

  As shown in FIG. 4, the protrusions 32 a and 32 a of the temporary holding portions 32 and 32 come into contact with each other when the frame-like slide member 50 arranged on the outer periphery of the base 20 is about to move to the gripping piece tip side This is a portion for temporarily holding the frame-shaped slide member 50. When the frame-shaped slide member 50 is pushed toward the gripping piece tip side, the protrusions 32a, 32a are pressed by the inner periphery of the frame-shaped slide member 50, and the pair of movable gripping pieces 30, 30 are bent, The frame-like slide member 50 can move over the protrusions 32a and 32a to the gripping piece tip side.

  Further, from the distal end side of the extending portions 33, 33, exfoliation portions 34, 34 that gradually become thicker extend toward the gripping piece distal end side. From the tips of these removal parts 34, 34, slide member placement portions 35, 35 having a constant thickness extend, and further, on the tip side of these slide member placement portions 35, 35, outside the gripping piece. The step-like movement restricting portions 36 and 36 bent at right angles to the slide member arrangement portion 35 are provided.

  The movement restricting portions 36 and 36 are portions that restrict the maximum movement position of the frame-shaped slide member 50 toward the distal end side of the movable gripping piece 30 (see FIG. 5). , 35 are portions facing the inner surface of the frame-shaped slide member 50 at a position where the frame-shaped slide member 50 is moved until it contacts the movement restricting portions 36, 36.

  And as shown in FIG. 4, when the main-body part 15 is seen planarly, ie, from the direction orthogonal to the expansion direction C of a pair of movable grip pieces 30, 30, a pair of movable grip pieces 30 is shown. , 30 when the thickness of the curved portion 31 of each movable gripping piece 30 is A, and when the thickness of the slide member arrangement portion 35 of each movable gripping piece 30 is B, the thickness A Also, the thickness B is formed thick.

  In addition, it is preferable that the thickness A of the said curved part 31 is 0.10-0.40 mm, and it is more preferable that it is 0.15-0.25 mm. Moreover, it is preferable that the thickness B of the said slide member arrangement | positioning part 35 is 0.15-0.60 mm, and it is more preferable that it is 0.20-0.40 mm. Further, when the thickness A is 1, A: B is preferably 1: 1.2 to 3.0, and more preferably 1: 1.3 to 1.5.

  Further, from the end of the step-shaped movement restricting portion 36 of the pair of movable gripping pieces 30, 30, the gripping portions 37, 37 having a long plate shape with a constant thickness are respectively extended. As shown in FIG. 5, these gripping portions 37, 37 are moved when the frame-shaped slide member 50 is moved to abut against the movement restricting portions 36, 36 to close the pair of movable gripping pieces 30, 30. Are provided so as to be substantially parallel to each other.

  Further, as shown in FIG. 3, a plurality of gripping claws 38 are integrally formed with the movable gripping piece 30 over the entire width direction of each movable gripping piece 30 on the opposing surfaces of the pair of gripping portions 37, 37. Is formed. In this embodiment, the gripping claws 38 are projected at a total of three locations, that is, the distal end of the gripping portion 37 and two locations that are equidistant from the distal end, and as shown in FIG. Each of the gripping claws 38 protrudes so as to be substantially perpendicular to the gripping portion 37 (see FIG. 4).

  When the frame-shaped slide member 50 is moved to the tip end side of the gripping piece until it contacts the movement restricting portions 36, 36 of each movable gripping piece 30, a pair of movable gripping pieces 30, 30 are resisted against the elastic force. Is closed, and the gripping claws 38, 38 disposed opposite to the movable gripping pieces 30, 30 can grip tissue in the body, for example, the sections 2, 3 of the wound 1 as shown in FIG. 7, as shown in FIG. It is like that. The number and shape of the gripping claws 38 are not particularly limited.

  By the way, in each movable grip piece 30 in this embodiment, the curved portion 31 is formed with a thickness A, and the temporary holding portion 32 excluding the protrusion 32a and the extending portion 33 are substantially the same thickness as the curved portion 31. It is formed with. Further, the removal portion 34 is gradually formed thicker, the slide member placement portion 35 is formed thicker than the removal change portion 34 by a thickness B, and the grip portion 37 is substantially the same as the slide member placement portion 35. They are formed with the same thickness. That is, the pair of movable gripping pieces 30 and 30 are formed so as to gradually increase in thickness from the base end side toward the tip end side as a whole.

  Note that the movable gripping piece 30 of the above embodiment does not need to be provided with the protrusion 32a or the gripping claw 38, and does not have to be provided with the gradually increasing thickness changing portion 34 as described above. The gripping piece 30 is not particularly limited as long as the thickness of the slide member arrangement portion 35 is thicker than the thickness of the curved portion 31.

  The gripping tool 10 described above is manufactured by the following method for manufacturing a medical gripping tool in the present invention (hereinafter simply referred to as “manufacturing method”).

  As shown in FIG. 6, this manufacturing method arranges the cutting blade 7 along the plate thickness direction of the metal plate 5 made of the above-described stainless steel, shape memory alloy such as Ti, Ni—Ti, and the like. By moving the blade 7 along the outer peripheral shape of the main body 15 to be formed and cutting one metal plate 5 with a constant plate thickness T in the plate thickness direction, the plate thickness T of the metal plate 5 and The main body 15 including the base 20 and the pair of movable gripping pieces 30 and 30 having the same width H is integrally formed. That is, this manufacturing method is different from a conventional manufacturing method in which a metal plate is punched and then bent by a press or the like.

  In addition, as the cutting method used in the above manufacturing method, for example, a well-known wire-cutting electric discharge machining, a laser-cutting cutting process, a fusing process using a plasma process, a cutting process using a saw or a grindstone, or the like is adopted. There is no particular limitation. In addition, the said cutting blade 7 is a wire in the case of a wire cut, and is the laser itself irradiated in the case of a laser cut.

  As described above, according to this manufacturing method, the single metal plate 5 is cut in the thickness direction, and the main body portion 15 is integrally formed with the same width H as the thickness T of the metal plate 5. Therefore, the pair of movable gripping pieces 30 can be easily formed with different thicknesses of thickness A and thickness B, and a plurality of gripping claws 38 and other embodiments as shown in FIG. The plurality of fixed claws 41 can be easily formed integrally with the full width H of the movable gripping piece 30 and the fixed gripping piece 40 (see FIG. 11), and the gripping tool can be manufactured easily and efficiently as a whole. Can do.

  Next, an example of how to use the gripping tool 10 according to the present invention having the above-described configuration will be described. First, the gripping tool 10 is accommodated in the outer tube 71 of the tube device 70.

  That is, as shown in FIG. 4, a frame-like slide member 50 is disposed on the outer periphery of the base portion 20 of the main body portion 15 constituting the gripping tool 10 and is brought into contact with the protrusions 32 a and 32 a of the temporary holding portions 32 and 32. Thus, the frame-shaped slide member 50 is temporarily held and the pair of movable gripping pieces 30 and 30 are in an expanded state.

  Further, the tube holding portion 75 of the tube device 70 is held, and the slider 72 is slid in the direction away from the tip of the tube holding portion 75, that is, toward the tube tip side, as shown in FIG. The distal end portion of 71 is protruded from the distal end portion of the inner tube 74. Further, the tube holding portion 75 is held, the wire operation handle 76 is slid to the tube tip side, the operation wire 77 is pushed out, and the chuck portion 78 is inserted from the tip opening of the outer tube 71.

  Then, the base portion 20 of the gripping tool 10 is fitted to the chuck portion 78 of the operation wire 77, and in this state, the tube holding portion 75 is held, and the wire operation handle 76 is connected to the proximal end side of the tube holding portion 75. Pull in the direction approaching, that is, the operator's hand side. Then, the operation wire 77 is pulled, and the base portion 20 of the main body portion 15 is pulled via the chuck portion 78, so that the pair of expanded movable gripping pieces 30, 30 are drawn into the outer tube 71, It is pressed against the inner peripheral surface, closed against the elastic force, and accommodated in the inner periphery of the distal end portion of the outer tube 71 as shown in FIG.

  In this state, the distal end portion of the inner tube 74 abuts on the frame-shaped slide member 50 of the gripping tool 10, and the frame-shaped slide member 50 abuts on the protrusions 32 a and 32 a of the main body portion 15, 20 is positioned and held on the outer periphery of 20 (see FIG. 2).

  In the above state, the entire tube device 70 is moved through the lumen of the endoscope (not shown). As shown in FIG. 8, the distal end of the wound device 1 (in the present invention) is obtained by removing a polyb, cancer or the like. Move it to a position just before the “tissue in the body”).

  Next, when the tube holding portion 75 of the tube device 70 is held and the slider 72 is slid toward the tip of the tube holding portion 75, that is, toward the operator's hand side, the gripping tool is opened from the tip opening of the outer tube 71. As shown in FIG. 8, the pair of movable gripping pieces 30 and 30 are opened.

  Thereafter, the pair of expanded movable gripping pieces 30 and 30 are arranged so as to sandwich the sections 2 and 3 on both sides of the wound, and the gripping claws 38 and 38 on the distal end side of the gripping piece are brought into contact with the sections 2 and 3, In this state, the wire operation handle 76 is held, and the inner tube 74 is pushed out to the distal end side via the tube holding portion 75.

  Then, as shown in FIG. 9, the frame-shaped slide member 50 that is in contact with the distal end of the inner tube 74 in a state where the base portion 20 of the main body portion 15 is held via the operation wire 77, the protruding portion 32 a of the main body portion 15. , 32a are pressed, and the pair of movable gripping pieces 30 is moved inward while being bent inward.

  Then, the frame-shaped slide member 50 gets over the protrusions 32a and 32a of the temporary holding portions 32 and 32, and extends around the outer periphery of the extension portions 33 and 33, the change-over portions 34 and 34, and the slide member arrangement portions 35 and 35. As shown in FIG. 10, when it slides and comes into contact with the movement restricting portions 36, 36, further movement is restricted and the pair of movable gripping pieces 30, 30 are pressed and closed. As a result, the sections 2 and 3 of the wound 1 are gripped by the plurality of gripping claws 38 of the pair of movable gripping pieces 30 and 30, and the wound 1 can be held in a closed state.

  Thereafter, the inner tube 74 is pressed to restrict the movement of the frame-shaped slide member 50, and the wire operation handle 76 is pulled toward the hand side, whereby the base portion 20 comes out from the slit 78a of the chuck portion 78, and the main body portion 15 is removed from the operation wire 77, and as shown in FIG. 10, the tube device 70 can be pulled out from the body leaving only the gripping tool 10 in the body.

  According to the gripping tool 10, as shown in FIG. 4, the thickness A of the curved portion 31 on the proximal end side of the pair of movable gripping pieces 30, 30 is equal to the thickness B of the slide member placement portion 35. As shown in FIG. 2, even if the pair of movable gripping pieces 30 and 30 are accommodated in the inner periphery of the distal end portion of the outer tube 71 constituting the medical tube in a closed state, as shown in FIG. It is possible to make the pair of movable gripping pieces 30 and 30 firmly open while maintaining the elastic restoring force when the movable gripping piece 30 in the closed state expands. it can. Further, since the thickness B of the movable gripping piece 30 is thicker than the thickness A, the frame-shaped slide member 50 is moved to the movement restricting portion 36 as shown in FIG. , 30 in a closed state, the rigidity of the slide member arrangement portion 35 of each movable gripping piece 30 can be increased, and the gripping force of the gripping tool 10 can be improved.

  Further, in this embodiment, as shown in FIG. 4, each movable gripping piece 30 has a curved portion 31, a temporary holding portion 32 excluding the protrusion 32 a, and an extending portion 33 formed with substantially the same thickness. The portion 34 is formed to be gradually thicker, the slide member disposition portion 35 is formed to be the thickest, and is formed so as to gradually increase from the proximal end side toward the distal end side. Therefore, the frame-shaped slide member 50 can be easily moved to the position reaching the movement restricting portion 36 of the movable gripping piece 30, and the stress concentration of the movable gripping piece 30 can be eased to make it difficult to kink.

  Further, in this embodiment, as shown in FIG. 3, a plurality of gripping claws 38 are formed on the opposing surfaces of the pair of gripping portions 37, 37 over the entire width direction of each movable gripping piece 30. Since it is formed integrally with the piece 30, the gripping force when the pair of movable gripping pieces 30, 30 are closed by moving the frame-shaped slide member 50 toward the tip of the gripping piece can be further increased.

  11 to 21 show other embodiments of the medical gripping tool according to the present invention. Note that substantially the same parts as those of the above-described embodiment are denoted by the same reference numerals, and description thereof is omitted.

  In the medical gripping tool 10A of this embodiment (hereinafter simply referred to as “gripping tool 10A”), the main body portion 15 includes a pair of movable gripping pieces 30 and 30A and a fixed gripping piece 40 provided therebetween. It has approximately three-piece structure.

  As shown in FIG. 12, in this embodiment, the base portion 20 </ b> A constituting the main body portion 15 includes a wide rigid portion 21, a knob portion 22 provided on the proximal end side, and a distal end side of the rigid portion 21. , And a protruding portion 23 protruding so as to be thinner than the rigid portion 21. The knob portion 22 has the same shape and the same function as the base portion 20 of the gripping tool 10 of the above embodiment, and is attached to the chuck portion 78 fixed to the tip of the operation wire 77 constituting the tube device 70. The main body 15 is detachably attached.

  A fixed grip piece 40 having a long plate shape is extended from the distal end of the projecting portion 23 projecting from the distal end side of the rigid portion 21 with the same thickness and a constant thickness as the projecting portion 23. A plurality of fixed claws 41 projecting toward each movable gripping piece 30 are provided across the entire width direction of the fixed gripping piece 40 on the surface of the fixed gripping piece 40 facing the pair of movable gripping pieces 30, 30 </ b> A. The fixed grip piece 40 is integrally formed.

  As shown in FIGS. 11 and 12, in this embodiment, the fixing claws 41 and 41 protrude from both side surfaces of the distal end of the fixed gripping piece 40, and are equidistant from the stationary pawl 41 on the distal end side. Three fixed claws 41 protrude from each side of the gripping piece, and four fixed claws 41 are provided, one on each side of the fixed gripping piece 40. As shown in FIG. 12, when the gripping tool 10 </ b> A is viewed in plan, each fixed claw 41 protrudes so as to be substantially perpendicular to the fixed gripping piece 40. Note that the fixed claws 41 and 41 on the distal end side of the fixed grip piece 40 protrude slightly longer than the other fixed claws 41. Further, the shape and number of the fixing claws 41 are not particularly limited.

  On the other hand, as shown in FIG. 12, of the pair of movable gripping pieces, one movable gripping piece 30 has the same shape as that of the above-described embodiment and is a slide member with respect to the thickness A of the curved portion 31. A thickness B of the arrangement portion 35 is formed thick. Further, of the pair of movable gripping pieces, the other movable gripping piece 30 </ b> A has a shape in which the slide member arrangement portion 35 extending from the change-over part 34 extends linearly longer than the one movable gripping piece 30. In addition, the thickness B of the slide member arrangement portion 35 is formed thicker than the thickness A of the curved portion 31 (see FIG. 12).

  Of the pair of movable gripping pieces 30 and 30A, the base end side of one movable gripping piece 30 is connected to one side surface of the protruding portion 23 of the base portion 20A, and the base end of the other movable gripping piece 30A. The side is connected to the other side surface (the surface opposite to the movable gripping piece 30) of the rigid portion 21 of the base portion 20A. That is, in this embodiment, a pair of movable gripping pieces 30 and 30A having an asymmetric shape are coupled with the fixed gripping piece 40 sandwiched and the base end side thereof being shifted in the axial direction with respect to the base portion 20A. Has a structure. As shown in FIG. 13, the movement restricting portions 36, 36 of the movable gripping pieces 30, 30A are provided so as to be aligned in the axial direction when the pair of movable gripping pieces 30, 30A are closed. It has been.

  Therefore, when the frame-shaped slide member 50 is moved to the distal end side of the gripping piece, the pair of movable gripping pieces 30, 30 </ b> A are closed with respect to the fixed gripping piece 40 at different timings.

  In this embodiment, the plurality of gripping claws 38 of each movable gripping piece 30, 30 </ b> A and the plurality of fixed claws 41 of the fixed gripping piece 40 are restricted by the movement restricting portion 36. When the pair of movable gripping pieces 30 and 30A are closed by moving them to the tip end side of the gripping piece, the plurality of gripping claws 38 enter between the plurality of fixed claws 41, respectively, and are shifted from each other in the axial direction and mesh with each other. (See FIG. 13).

  Note that the fixed claws of the fixed grip piece and the grip claws of each movable grip piece are not limited to the above shapes, and may have shapes as shown in FIGS.

  In the shapes shown in FIGS. 19A and 19B, the fixed claws 41 </ b> A and 41 </ b> A that protrude in an arc shape project from both ends of the fixed grip piece 40 and are spaced from the fixed grip piece 40 by a predetermined interval. Thus, the fixing claws 41B and 41B protrude substantially at a right angle. On the other hand, from the distal end side of each movable gripping piece 30, a gripping claw 38 </ b> A that is bent at an acute angle toward the proximal end side of the movable gripping piece 30 protrudes.

  As shown in FIG. 19B, when the pair of movable gripping pieces 30 and 30A are closed with respect to the fixed gripping piece 40, the gripping claws 38A enter the fixed claws 41A and 41B. Yes. In this shape, the gripping claws 38A are bent at an acute angle toward the base end side, so that the gripping claws 38A are difficult to be pulled out because they easily bite into the sections 2 and 3 of the wound 1.

  20A and 20B, the gripping claws of the movable gripping pieces 30 and 30A are different from the shape shown in FIG. That is, the gripping claws 38B of the movable gripping pieces 30 and 30A in this case protrude from the distal ends of the movable gripping pieces 30 and 30A, and further, the leading end side is folded back toward the base end side of the movable gripping pieces 30 and 30A. It is almost U-shaped.

  Then, as shown in FIG. 20B, when the pair of movable gripping pieces 30 and 30A are closed with respect to the fixed gripping piece 40, the gripping claws 38B enter into the fixed claws 41A and 41B. Yes. In this shape, the gripping claw 38B has a substantially U-shape folded back toward the base end side of the movable gripping piece 30, so that the periphery of the sections 2 and 3 of the wound 1 is sandwiched in a relatively wide range. , Can be easy to bite.

  In the shapes shown in FIGS. 21A and 21B, plate-like fixed claws 41C protrude from both ends of the fixed gripping piece 40, and are connected to the fixed claws 41C so as to protrude like a saw blade. The three fixed claws 41D are provided. On the other hand, on the movable gripping pieces 30, 30A, three gripping claws 38C having a saw blade shape project from the tip side.

  Then, as shown in FIG. 21B, when the pair of movable gripping pieces 30 and 30A are closed with respect to the fixed gripping piece 40, a plurality of gripping claws 38C are formed in the gaps between the fixed claws 41C and 41D. It is designed to go into mesh. In this shape, the plurality of gripping claws 38C having a saw blade shape enter the gap between the fixed claws 41C and 41D having the same saw blade shape, so that the gap between the claws can be reduced and the wound 1 The sections 2 and 3 can be firmly held in a wavy shape.

  Next, an example of a method of using the gripping tool 10A having the above configuration will be described. In the gripping tool 10A having a substantially three-piece structure, the wound 1 can be firmly gripped even when the wound is relatively wide as shown in FIG.

  First, the gripping tool 10A is accommodated in the outer tube 71 of the tube device 70 in the same procedure as in the above embodiment, and the entire tube device 70 is moved through the lumen of the endoscope (not shown), as shown in FIG. Next, it is moved to a position that is slightly in front of the wound 1.

  Thereafter, the tube holding part 75 is held, the slider 72 is slid toward the hand side, the gripping tool 10A is released from the distal end opening of the outer tube 71, and the pair of movable gripping pieces 30 and 30A are opened (see FIG. 15). ).

  After that, the movable gripping piece 30 </ b> A and the fixed gripping piece 40 are arranged so as to sandwich one section 2 of the wound 1, and in this state, the wire operation handle 76 is held and the tube holding portion 75 is interposed therebetween. To push the inner tube 74 forward.

  Then, in a state where the base portion 20 of the main body portion 15 is held via the operation wire 77, the frame-shaped slide member 50 is moved to the grip piece distal end side by the inner tube 74, and the movable grip piece 30A is bent inward, Since it closes with respect to the fixed holding piece 40, the slice 2 is held by the holding claw 38 and the fixed claw 41 as shown in FIG.

  Next, while maintaining the above gripping state, one section 2 is pulled toward the other section 3 (see the arrow in FIG. 16), and the gripping claw 38 of the movable gripping piece 30 is hooked on the other section 3 of the wound 1. . In this state, as described above, the wire operation handle 76 is held, and the inner tube 74 is pushed out to the distal end side via the tube holding portion 75, so that the frame-shaped slide member 50 is gripped by the inner tube 74. Moving to the distal end side, the movable gripping piece 30 bends inward and closes to the fixed gripping piece 40, so that one section 2 side is drawn toward the other section 3 side (see FIG. 17).

  When the frame-like slide member 50 is further moved toward the tip of the gripping piece until it abuts against the movement restricting portions 36, 36, the further movement is restricted and the pair of movable gripping pieces 30, 30A are fixed gripping pieces. 40 is completely closed, the plurality of gripping claws 38 and the plurality of fixed claws 41 are shifted from each other in the axial direction and engaged with each other, and both the sections 2 and 3 of the wound 1 are gripped and the wound 1 is closed. Can be held (see FIG. 18). Thereafter, by removing the main body 15 from the chuck portion 78 of the operation wire 77 in the same procedure as in the above embodiment, as shown in FIG. 18, only the gripping tool 10A is left in the body, and the tube device 70 is removed from the body. Can be pulled out.

  As described above, in this embodiment, the fixed grip piece 40 is provided between the pair of movable grip pieces 30 and 30A, and the base end side of the pair of movable grip pieces 30 and 30A is an axis with respect to the base portion 20A. Since the frame-shaped slide member 50 is moved toward the distal end side of the gripping piece, the pair of movable gripping pieces 30, 30 </ b> A can be closed at different timings with respect to the fixed gripping piece 40. it can. Therefore, after releasing the gripping tool 10A from the outer tube 71, one section 2 of the wound 1 is positioned between the movable gripping piece 30A and the fixed gripping piece 40, and the frame-like slide member 50 is moved to the tip side of the gripping piece. By moving, the movable gripping piece 30A can be closed toward the fixed gripping piece 40 to grip one section 2. In this state, while moving one section 2 of the wound 1 toward the other section 3, By positioning the movable gripping piece 30 between the movable gripping piece 30 and the fixed gripping piece 40 and moving the frame-shaped slide member 50 further toward the tip of the gripping piece, the movable gripping piece 30 is closed toward the fixed gripping piece 40 and the wound The other section 3 of 1 can also be grasped, and even a wide wound 1 can be easily closed.

  Furthermore, in this embodiment, a plurality of fixed claws 41 projecting toward the movable gripping pieces 30 and 30A are fixedly gripped on the surface of the fixed gripping piece 40 facing the pair of movable gripping pieces 30 and 30A. Since it is integrally formed with the fixed gripping piece 40 over the entire width direction of the piece 40, the frame-shaped slide member 50 is moved to the tip of the gripping piece, and the pair of movable gripping pieces 30 and 30A are timed. When closed by shifting, the gripping force can be further increased, and even a wide wound can be maintained in a closed state.

  In this embodiment, the plurality of gripping claws 38 of the pair of movable gripping pieces 30, 30 </ b> A and the plurality of fixed claws 41 of the fixed gripping piece 40 move the frame-shaped slide member 50 to move the movable gripping piece 30. When the pair of movable gripping pieces 30 and 30A are moved to the tip end side until they are restricted by the restricting portion 36 and are closed, they are formed so as to be shifted to each other in the axial direction and mesh with each other. The slices 2 and 3 of 1 can be gripped in a wavy shape, and the gripping force on the wound 1 can be further improved.

  It should be noted that the present invention is not limited to the above-described embodiment, and various modified embodiments are possible within the scope of the present invention, and such an embodiment is also included in the scope of the present invention. .

  The movable gripping piece was tested to see how far the movable gripping piece would be when the thickness of the “curved part” curved from the tip of the base toward the expanding direction of the movable gripping piece was changed. Test).

(Test Example 1)
As shown in FIG. 22, a main body part of a medical gripping tool that is substantially the same as the embodiment shown in FIGS. 11 and 12 was manufactured. The main body was manufactured by integrally cutting a fixed grip piece and a pair of movable grip pieces by cutting a stainless metal plate having a thickness of 1.0 mm by wire-cut electric discharge machining. Moreover, the thickness of the curved part of each movable grip piece is 0.20 mm.

(Test Example 2)
The body part of the medical gripping tool shown in FIG. 23 was manufactured under the same conditions as in Test Example 1 except that the thickness of the curved portion of the movable gripping piece was set to 0.15 mm.

(Heat condition check test)
A medical tube having an inner diameter of 2.2 mm was prepared, and the main body portions of Test Example 1 and Test Example 2 were inserted into the medical tube, and the pair of movable gripping pieces were accommodated in a closed state. Then, each main-body part of the test example 1 and the test example 2 was open | released from the medical tube, and a pair of movable holding piece was opened. At this time, the opening angle of each movable grip piece with respect to the fixed grip piece (angle after tube storage) was measured. For each of Test Example 1 and Test Example 2, five of these were performed.

  The results are shown in Table 1 below and FIGS. 22 (b) and 23 (b). Table 1 shows the opening angle of each movable gripping piece with respect to the fixed gripping piece before tube storage (angle before tube storage) and the opening angle of each movable gripping piece with respect to the fixed gripping piece before and after storing the tube. The difference (angle deformation) is also shown.

  As shown in Table 1 above, it was found that the smaller the curved portion of the movable grip piece, the smaller the amount of angular deformation of the movable grip piece. Therefore, when the thickness A of the curved portion 31 of the movable gripping piece 30 is thinner than the thickness B of the slide member arranging portion 35 as in the gripping tools 10 and 10A according to the present invention, the movable gripping piece 30 is sluggish. I found it difficult.

10, 10A Medical gripping tool (gripping tool)
15 Body 20, 20 A Base 30, 30 A Movable gripping piece 31 Curved portion 35 Slide member placement portion 36 Movement restricting portion 38, 38 A, 38 B, 38 C Grip claw 40 Fixed gripping piece 41, 41 A, 41 B Fixed claw 50 Frame-shaped slide member 70 Medical tube device 71 Outer tube 74 Inner tube 77 Operation wire

Claims (7)

A medical gripping tool that is housed in a medical tube and transported to a predetermined position in the body and used to grip tissue in the body,
A base portion detachably attached to an operation wire provided in the medical tube, and a main body portion having a pair of movable gripping pieces connected to the base portion so as to be opened and closed;
A frame-like slide member mounted on the outer periphery of the main body,
The pair of movable gripping pieces extend so that the base end side is connected to the base portion and the tip end side is expanded in a direction away from each other, and opens when the frame-shaped slide member is located on the outer periphery of the base portion. When the frame-shaped slide member is moved to the tip side, its outer periphery is pressed down and closed,
At a predetermined position in the extending direction of the pair of movable gripping pieces, a movement restricting portion for restricting the maximum movement position of the frame-shaped slide member to the distal end side of the movable gripping piece is provided.
The thickness of the portion of each movable gripping piece that extends from the base and curves in the spreading direction when viewed from the direction orthogonal to the spreading direction of the pair of movable gripping pieces. Where A is the thickness, and B is the thickness of the portion of each movable gripping piece facing the inner surface of the frame-shaped slide member at the position where the frame-shaped slide member is moved to the movement restricting portion. The medical grasping tool, wherein the thickness B is formed to be thicker than the thickness A.   The medical gripping tool according to claim 1, wherein the pair of movable gripping pieces are formed so as to gradually increase in thickness from the proximal end side toward the distal end side.   The medical device according to claim 1 or 2, wherein a plurality of gripping claws are formed integrally with the movable gripping piece over the entire width direction of each movable gripping piece on the opposing surfaces of the pair of movable gripping pieces. Gripping tool. The main body portion further includes a fixed grip piece extending from the base portion and disposed between the pair of movable grip pieces,
The medical gripping tool according to any one of claims 1 to 3, wherein the pair of movable gripping pieces are connected with their base ends shifted in the axial direction with respect to the base portion.   A plurality of fixed claws projecting toward each movable gripping piece are provided on a surface of the fixed gripping piece facing the pair of movable gripping pieces over the entire width direction of the fixed gripping piece. The medical gripping tool according to claim 4, wherein the medical gripping tool is formed integrally with the medical gripping tool. On the opposing surfaces of the pair of movable grip pieces, a plurality of grip claws are formed integrally with the movable grip pieces over the entire width direction of each movable grip piece,
Furthermore, the plurality of gripping claws of each movable gripping piece and the plurality of fixed claws of the fixed gripping piece move the frame-shaped slide member to the tip side until it is regulated by the movement restricting portion, and 6. The medical gripping tool according to claim 5, wherein when the movable gripping piece is closed, the movable gripping piece is formed so as to be in a position to be engaged with each other while being shifted in the axial direction. It is a manufacturing method of the medical gripper according to any one of claims 1 to 6,
A method of manufacturing a medical gripping device, comprising: cutting a single metal plate in a plate thickness direction, and integrally forming the main body portion with the same width as the plate thickness of the metal plate.