JP2017104494A - Medical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical instrument that allows both of grasping operation and peeling operation to be suitably performed.SOLUTION: A medical instrument 1 has a slender first member 10 having a grasping face 12a, and a slender second member 50 having the grasping face 12a, and the first member 10 and the second member 50 are coupled together so that they can be rotated relative to each other with their mutual grasping faces 12a facing each other.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a medical instrument used for a surgical procedure or the like.

  Conventionally, during a surgical operation, various biological tissues are gripped or peeled off. The gripping operation and the peeling operation are performed before reaching the target lesion, and are also performed when treating the target lesion.

  A medical insulator is known as a medical instrument for gripping (for example, refer to Patent Document 1). A medical exfoliator is known as a medical instrument for exfoliation. In general, gripping and peeling are performed using different medical instruments, so that it takes time to replace the medical instrument. In addition, since both gripping and peeling are frequently performed, it is a cause of lengthening the operation time.

Japanese Examined Patent Publication No. 6-6126

The insulator described in Patent Document 1 has a substantially V shape in which one end portions of a pair of sandwiching pieces are connected to each other. The clamping surface provided at the other end of the insulator is separated in the initial state, and when the force is loosened from the state where the clamping surface is approached by applying force to the other end, the clamping surface is caused by the elastic force of the clamping piece. Tries to move in the direction of separation.
Although it is possible to use such an operation of the sandwiching surface for the peeling operation, it may not be the original usage of the insulator, and the operability is poor.

  An object of this invention is to provide the medical instrument which can perform both holding | grip operation and peeling operation suitably.

  The present invention includes an elongated first member having a gripping surface and an elongated second member having a gripping surface, and the first member and the second member face each other with the gripping surfaces facing each other. It is the medical instrument connected so that relative rotation is possible.

  The medical instrument of the present invention further comprises a guide portion provided on one of the first member and the second member, and a guided portion provided on the other of the first member and the second member, When the medical instrument is closed so that the distal end portions of the first member and the second member are close to each other, the guided portion is guided by the guide portion, whereby the distal end of the first member and the first member are The medical instrument may be configured to be closed so that the position of the tip of the two members coincides.

  The medical instrument of the present invention may further include a spring member that biases the positional relationship between the first member and the second member so as to have a predetermined initial shape.

  According to the medical instrument of the present invention, both the gripping operation and the peeling operation can be suitably performed.

It is a front view of the medical instrument which concerns on 1st embodiment of this invention. It is a bottom view of the medical instrument. It is a top view of the medical instrument. It is a left view of the medical instrument. It is a right view of the medical instrument. It is a rear view of the medical instrument. It is a figure which expands and shows the front-end | tip part of the medical instrument. It is a figure which shows an example of holding | grip operation with the medical instrument. It is a figure which shows an example of peeling operation by the medical instrument. It is a front view of the medical instrument which concerns on 2nd embodiment of this invention.

A first embodiment of the present invention will be described with reference to FIGS.
1 to 6 are six views showing the medical device 1 of the present embodiment. FIG. 1 is a front view, FIG. 2 is a bottom view, FIG. 3 is a plan view, FIG. 4 is a left side view, and FIG. FIG. 6 is a right side view and FIG. 6 is a rear view. As shown in FIG. 1, the medical device 1 has a basic configuration in which an elongated rod-shaped first member 10 and a second member 50 are rotatably connected.

The first member 10 includes a rod-shaped main body portion 11, a connecting portion 20 and a guide portion 25 provided on the main body portion 11.
The main body 11 includes a distal end portion 12 that comes into contact with tissue during gripping and peeling, a proximal end portion 14 provided with a guide portion 25, and an intermediate portion disposed between the distal end portion 12 and the proximal end portion 14. 13.

  The distal end portion 12 is formed in a tapered shape that gradually decreases as it approaches the distal end. As shown in FIGS. 1 and 2, the distal end portion 12 is formed with a gripping surface 12a that comes into contact with a tissue during gripping and a peeling surface 12b that comes into contact with a tissue during peeling. In the first member 10, the gripping surface 12 a is formed on the side facing the second member 50, and the peeling surface 12 b is formed on the side opposite to the gripping surface in the first member 10. There is no particular limitation on the shape of the gripping surface 12a and the peeling surface 12b, but it is preferable to form the gripping surface 12a and the peeling surface 12b flat. If necessary, the gripping surface 12a or the peeling surface 12b may be provided with minute irregularities by a known surface roughening process or the like to provide an anti-slip function.

  The intermediate portion 13 has a substantially semicircular cross section perpendicular to the longitudinal direction, and has a curved first outer peripheral surface and a substantially planar second outer peripheral surface. The cross-sectional shape of the intermediate portion 13 is formed such that the radius of curvature of the first outer peripheral surface repeats increasing and decreasing at a predetermined cycle in the longitudinal direction. Thereby, as shown in FIGS. 1 and 4, nodes 13 a are formed on the first outer peripheral surface of the intermediate portion 13 at regular intervals, and have a shape similar to bamboo.

The base end portion 14 of the present embodiment has the same cross-sectional shape as the intermediate portion 13 in a direction orthogonal to the longitudinal direction, and is formed so as to have continuity with the intermediate portion 13. In the base end part 14, the curvature radius of the curved outer peripheral surface is fixed, and is formed in a semi-cylindrical shape.
The cross-sectional shape orthogonal to the longitudinal direction of the base end portion 14 is not necessarily the same as that of the intermediate portion 13. For example, the base end portion may be formed in a plate shape so that it is easy to give a display such as a user name or a department of use.

  As shown in FIGS. 1 and 6, the connecting portion 20 is provided at a boundary portion between the intermediate portion 13 and the base end portion 14 and protrudes toward the second member 50. The connecting portion 20 is formed with a shaft hole 20a through which the shaft member 21 is inserted.

  As shown in FIGS. 1 and 6, the guide portion 25 has a pair of guide members 26 and 27 provided near the base end of the base end portion 14. As shown in FIG. 3, the pair of guide members 26 and 27 protrude toward the second member 50 substantially in parallel with a predetermined interval.

  Similar to the first member 10, the second member 50 has an elongated rod-like basic shape and includes a distal end portion 12, an intermediate portion 13, and a proximal end portion 14. As shown in FIG. 5, the intermediate part 13 of the second member 50 also has a plurality of nodes 13a. As shown in FIGS. 1 and 2, the first member 10 and the second member 50 are disposed such that the gripping surfaces 12 a face each other.

  As shown in FIG. 1, the connecting portion 20 formed on the second member 50 has the same shape as that provided on the first member 10 and protrudes toward the first member 10.

  The second member 50 is provided with a guided portion 28. As shown in FIGS. 1 and 3, the shape of the guided portion 28 is substantially the same as that of the guide member 26 and the guide member 27, and protrudes toward the first member 10 and enters between the pair of guide members 26 and 27. doing.

  The first member 10 and the second member 50 have the shaft member 21 in a state in which the shaft hole 20a of the connecting portion 20 is coaxial and the guided portion 28 enters between the guide members 26 and 27 of the guide portion 25. Are connected by being inserted through the shaft holes 20 a of the first member 10 and the second member 50. Thereby, the first member 10 and the second member 50 are in a state in which the base end portions 14 are not connected to each other, and can relatively rotate about the shaft member 21 as a rotation center.

A spring member 30 is disposed between the two connecting portions 20. As shown in FIGS. 1 and 6, the first end (not shown) of the spring member 30 is fixed between the two connecting portions 20, and the second end 30 a is formed on the second member 50. It has entered into the groove 31. The spring member 30 presses the bottom surface of the groove 31 to bias the distal end portion 12 of the second member 50 away from the distal end portion of the first member 10. This urging force is preferably set to a very small value, for example, about 0.1 Newton (N) to 1.0 N.
Due to the urging force of the spring member 30, the medical device 1 is held in an initial shape in which the pair of distal end portions 12 are separated from each other as shown in FIG. The initial shape can be set to a desired shape by changing the shape of the spring member or the groove.

The distal end portions 12 of the first member 10 and the second member 50 are connected to the intermediate portion 13 so as to be offset, and each distal end portion 12 is located closer to the other member disposed opposite to the intermediate portion 13. is there. Further, as shown in FIG. 1, the gripping surfaces 12 a of the first member 10 and the second member 50 are formed so as to be gradually separated from each other as they approach the tip of the medical instrument 1 in the initial shape.
As a result, as shown in FIG. 7, even when the medical instrument 1 is closed and the pair of gripping surfaces 12 a are brought into close contact with each other, the proximal end side of the distal end portion 12 where the gripping surfaces are not provided is separated. Is maintained, and the distance between the intermediate portions 13 is maintained longer than that between the proximal ends of the distal end portion 12, so that an operation feeling close to that of chopsticks is realized as described later.

The operation at the time of use of the medical instrument 1 of the present embodiment configured as described above will be described.
The user takes the medical instrument 1 having the initial shape with a dominant hand and holds the first member 10 and the second member 50 in a desired manner. Although there is no restriction | limiting in particular in the holding method of the medical instrument 1, In the example mentioned later, as an example of a standard holding method, the 1st member 10 is pinched | interposed between the thumb TH and the index finger F1, and the 2nd member 50 is inserted. A method of lightly holding the three fingers of the thumb TH, the index finger F1, and the middle finger F2 is shown. This is almost the same as the way of holding chopsticks used for eating in Japan.

  When one of the first member 10 and the second member 50 is rotated about the shaft member 21 with respect to the other while the medical instrument 1 is held, the pair of distal end portions 12 are brought close to and separated from each other for medical use. The instrument 1 can be opened and closed. As the medical instrument 1 is opened and closed, the gripping surface 12a and the peeling surface 12b also operate so as to approach and separate from each other.

FIG. 8 shows an example of a grip operation by the medical instrument 1. As described above, even if the grasping surface 12a is approached to grasp tissue or the like, the distance between the intermediate portions 13 is kept relatively large, and the user can easily operate.
When the gripping operation is performed, the reaction force by the spring member 30 acts in the direction of separating the distal end portions 12 of the first member 10 and the second member 50, but occurs when the biasing force by the spring member 30 is set to a very small value. The reaction force is very small. As a result, the effect of the gripping surface 12a on the reaction force received from the grasped tissue or the like is remarkably reduced, and the user accurately grasps the properties such as hardness with respect to the grasped tissue and appropriately proceeds with the procedure. Can do.

In FIG. 9, an example of peeling operation by the medical instrument 1 is shown. While the tissue to be peeled is in contact with one of the pair of peeling surfaces 12b, the first member 10 and the second member 50 are relatively rotated so that the distal end portion 12 is separated, thereby moving the tissue etc. Can be peeled off.
During the peeling operation, if the tip end portion 12 is separated by a predetermined distance or more, the spring member 30 is separated from the bottom surface of the groove 31, and the urging force by the spring member 30 does not act on the second member 50. In this state, the user can feel only the reaction force received from the tissue or the like through the medical instrument 1, so that the tissue to be peeled, such as the properties such as hardness, the degree of adhesion, etc. Accurately grasp and proceed appropriately. When the urging force generated by the spring member 30 is set to be sufficiently small, the urging force hardly affects the reaction force received from the tissue or the like. Therefore, even when the spring member 30 is not separated from the bottom surface of the groove 31, It is possible to accurately grasp properties and conditions.

As described above, according to the medical instrument 1 of the present embodiment, the elongated first member 10 and the second member 50 have a structure that is rotatably connected. Unlike conventional medical instruments configured to cause elastic deformation, an excessive biasing force or reaction force is not generated in any of the opening / closing operations. As a result, the user can sense in detail the minute reaction force received from the tissue to be operated by the hand holding the medical instrument 1, and appropriately perform both the gripping operation and the peeling operation using the medical instrument 1. It can be suitably performed with a large amount of force. Therefore, it is possible to save the labor and time required for exchanging the instrument, and it is possible to contribute to the reduction of the operation time and the burden on the patient.
In particular, in the field of neurosurgery, the nature and state of the tissue, etc. are judged based on slight differences in the reaction force received from the tissue, etc., and the magnitude of the force applied to the tissue is finely adjusted based on this judgment. Since the procedure is performed, the merit brought by the above configuration is remarkably large.

  In addition, the first member 10 and the second member 50 are arranged so that the guided portion 28 is disposed between the pair of guide members 26 and 27, so that the guided portion 28 is guided by the guide portion 25 and the relative rotation is performed. Move. As a result, even if the size of the tip of the tip 12 is as thin as 1 mm or less, for example, the tip is unlikely to shift during the gripping operation. Accordingly, even a small object gripping operation can be reliably performed.

  Furthermore, since the intermediate portion 13 has a shape having a plurality of nodes 13a, the user can hold the medical device 1 by placing his / her finger on an appropriate node according to the size of the hand, the length of the finger, or the like. . Therefore, it can be set as the structure which it is hard to slip and is easy to use in a wide user.

  In addition, since the spring member 30 urges the first member 10 and the second member 50 to have the initial shape, the shape when not in use is stable to the initial shape while being configured to be relatively rotatable. It's easy to do. Therefore, it is possible to suppress the relative rotation during the delivery of the medical instrument 1 during the operation, and to perform the delivery smoothly.

  In the present embodiment, the position of the guide member and the position of the connecting portion may be reversed. That is, the connecting part may be provided at the base end part. Furthermore, both the guide member and the connecting portion may be provided at the intermediate portion or the base end portion.

  Since the opening / closing operation of the medical instrument of the present invention is close to chopsticks used for meals in Japan, a user living in Japan can use it with almost the same operation as familiar chopsticks without any discomfort. . At present, when chopsticks are used worldwide due to the spread of Japanese food, it is estimated that more users can use the medical instrument of the present invention without a sense of incongruity.

  In addition, the holding | maintenance aspect of the medical instrument 1 mentioned above is an example, and the usage aspect of the medical instrument 1 is not restrict | limited by this. Like the chopsticks described above being used in various ways in Japan and around the world, the user holds the medical instrument 1 in an easy-to-use manner, and the first member 10 and the second member The gripping operation and the peeling operation can be performed by relatively rotating 50.

  A second embodiment of the present invention will be described with reference to FIG. The medical instrument of this embodiment is different from the first embodiment in the configuration of the guide part and the guided part. In the following description, components that are the same as those already described are denoted by the same reference numerals and redundant description is omitted.

  FIG. 10 is a front view showing the medical instrument 101 of the present embodiment. The medical instrument 101 includes a guide part 125 and a guided part 128 instead of the guide part 25 and the guided part 28.

The guide portion 125 is a recess provided on the surface facing the second member 50 at the distal end portion 12 of the first member 10. The guided portion 128 is a protrusion provided at the distal end portion 12 of the second member 50 so as to protrude from the surface facing the first member 50. The size of the guided portion 128 is set so that at least a part thereof can enter the guide portion 125.
The positions of the guide part 125 and the guided part 128 are set so that the tip positions of the pair of tip parts 12 are aligned when the guided part 128 enters the guide part 125.

  In the medical instrument 101, when the user approaches the pair of tip portions 12 during a gripping operation, the guided portion 128 is guided by the guide portion 125 and enters the guide portion 125. As a result, the tip positions of the pair of tip parts 12 are aligned without deviation, and a gripping operation can be suitably performed.

In the present embodiment, the guided portion may have a tapered shape that becomes narrower as it approaches the opposing first member. In this case, even if a slight deviation occurs in the tip position when the first member and the second member are rotated relative to each other, the tip member is invited and enters the guide portion within a predetermined range. It can be corrected to align the tip position.
Further, the guide portion may be formed as a through-hole instead of a bottomed recess.

  Furthermore, the guide part may be provided on the second member, and the guided part may be provided on the first member. This is the same in the first embodiment.

  The embodiments of the present invention have been described above. However, the technical scope of the present invention is not limited to the above-described embodiments, and the constituent elements of different embodiments may be combined without departing from the spirit of the present invention. Various changes can be added to or deleted from the components.

  The material of the medical instrument of the present invention is not particularly limited, but titanium, stainless steel, and the like are preferable from the viewpoint of biocompatibility and resistance to sterilization.

  In addition, a sheet-like friction reducing member may be disposed between the two connecting portions of the first member and the second member in order to reduce friction during relative rotation. Thereby, the frictional resistance generated during the opening / closing operation can be reduced, the attenuation of the force applied to the tissue can be suppressed, and the gripping operation and the peeling operation can be performed more smoothly. As a material of the friction reducing member, for example, a fluorine-based resin can be exemplified.

Furthermore, in the medical instrument of the present invention, a spring member for biasing the first member and the second member to the initial shape is not essential. When the spring member is not provided, the stability of the shape when not in use is slightly reduced, but the effect that both the gripping operation and the peeling operation can be suitably performed is exhibited without any problem.
In addition, when the spring member is provided, the biasing mode may be set so that the initial shape is a state in which the pair of gripping surfaces come into contact or approach and the first member and the second member are non-parallel. .
In addition, the spring member may be provided on both of the first member and the second member.

  The application area | region of the medical instrument of this invention is not restricted to the brain surgery area | region mentioned above. Even in other regions, it is possible to contribute to the reduction of the operation time and the burden on the patient by performing the gripping operation and the peeling operation with one medical device.

DESCRIPTION OF SYMBOLS 1,101 Medical instrument 10 1st member 12 Front-end | tip part 12a Holding surface 25, 125 Guide part 28, 128 Guided part 30 Spring member 50 Second member

Claims (3)

An elongated first member having a gripping surface;
An elongated second member having a gripping surface;
With
The first member and the second member are connected so as to be capable of relative rotation in a state where the gripping surfaces are opposed to each other.
Medical instrument. A guide portion provided on one of the first member and the second member;
A guided portion provided on the other of the first member and the second member;
Further comprising
When the medical instrument is closed so that the distal end portions of the first member and the second member are close to each other, the guided portion is guided by the guide portion, whereby the distal end of the first member and the first member are The medical instrument is closed so that the position of the tip of the two members coincides;
The medical instrument according to claim 1.   The medical instrument according to claim 1 or 2, further comprising a spring member that biases the positional relationship between the first member and the second member so as to have a predetermined initial shape.

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