JP2017144096A - Surgical scalpel - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical scalpel capable of reducing resistance during an incision of body tissue while restraining a cutting part from bending.SOLUTION: A surgical scalpel comprises a blade body 10 having a cutting part 12 in which a blade edge 17 is formed. The blade body 10 assumes a spear shape with a pointed tip of the blade part 12. A rib 18 extended toward a base end side from a base end side position with respect to the tip 121 of the blade part 12 is protrusively provided in the width-direction center of a first surface 13 of the blade part 12.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a scalpel for cutting a living tissue, and more particularly to a scalpel scalpel for cutting a cornea or sclera of an eyeball.

  Conventionally, as this type of scalpel for ophthalmic surgery, there is a scalpel described in Patent Document 1, for example. FIG. 7A of the same document describes a knife provided with a blade body having a scissors shape with a sharp tip at the tip of the blade portion. In addition, FIG. 7B of the same document describes a knife provided with a blade body having a circular arc shape at the tip of the blade portion.

  For example, when cataract surgery is performed using the scalpel having the above-mentioned scissors-shaped blade, first, the tip of the blade is in the order of the conjunctiva 40 and the sclera 41 as indicated by the thick solid line in FIG. Insert the part. When the distal end of the blade portion is pierced by about 0.5 mm into the sclera 41, the traveling direction of the blade portion is changed as shown by a thick solid line in FIG. The distal end portion of the blade portion is inserted into the cornea 42 by pressing it in opposition. Then, the blade portion is advanced by about 1 mm, and the cornea 42 is pierced. Thereafter, as indicated by a thick solid line in FIG. 10C, the advancing direction of the blade portion is changed again, and a tunnel-shaped incision wound is formed by drilling in the anterior chamber 43.

Japanese Patent No. 4269299

  By the way, in the conventional scalpel, the resistance when piercing the relatively hard cornea 42 is large, and a large force is required to form the incision wound. Accordingly, the present inventor has considered that it is effective to reduce the thickness of the blade portion in order to reduce the resistance when the cornea 42 is incised. However, if the plate thickness of the blade part is reduced, the rigidity of the blade part will be insufficient, and the blade part will be bent when the cornea 42 is incised, making it difficult to accurately form the incision wound.

  Such a problem is not limited to the above-mentioned scalpel-shaped knife used for cataract surgery, but can also occur in a similar manner in a knife having a circular arc-shaped blade at the tip of the blade. It is.

  An object of the present invention is to provide a scalpel for operation that can reduce resistance when cutting a living tissue while suppressing bending of a blade portion.

  A scalpel for achieving the above object includes a blade body having a blade portion on which a blade edge is formed, and at the center in the width direction of at least one surface of the blade portion, than the tip of the blade portion. A rib extending from the position on the base end side toward the base end side is projected.

  According to this configuration, since the rigidity of the blade portion is enhanced by the rib, the blade portion is prevented from bending when incising the living tissue while reducing the plate thickness of the portion of the blade portion where the rib is not provided. can do.

In addition, since the rib is provided, a space is generated between the surface of the blade portion where the rib is provided and the living tissue, and the contact area between the surface and the living tissue is reduced.
Therefore, it is possible to reduce the resistance when cutting the living tissue while suppressing the bending of the blade portion.

  In the surgical knife, a surface of the blade portion on which the rib is provided has an inclined surface portion that forms the blade edge, and a tip edge of the top surface of the rib is adjacent to the inclined surface portion and the edge of the blade edge. It is preferable to follow the tip portion.

According to this configuration, the inclined surface portion and the tip edge of the top surface of the rib are smoothly connected, and the resistance when incising the living tissue can be suitably reduced.
In the surgical knife, it is preferable that the rib extends to the position of the maximum width portion where the width of the blade portion is maximum.

According to this configuration, when the blade portion is advanced from the position of the proximal end of the top edge of the top surface of the rib to the position of the maximum width portion, it is possible to appropriately suppress the rib from bending.
In the surgical knife, it is preferable that the rib has the same cross-sectional shape from the position of the proximal end of the distal end edge of the top surface of the rib to the position of the maximum width portion.

  According to this configuration, the cross-sectional shape of the rib does not change when the blade is advanced from the position of the proximal end of the top edge of the rib to the position of the maximum width. For this reason, it can prevent that resistance at the time of making a knife advance due to the cross-sectional shape of a rib is fluctuated.

In the surgical knife, it is preferable that the blade body has a scissor shape with a sharp tip at the tip of the blade portion.
According to this configuration, the above-described effects can be suitably achieved in a knife having a so-called saddle-shaped blade.

  ADVANTAGE OF THE INVENTION According to this invention, resistance at the time of incising a biological tissue can be reduced, suppressing that a blade part bends.

The front view which shows the whole scalpel about one Embodiment of the scalpel for surgery. The enlarged plan view which expands and shows the knife body of the knife of the embodiment. The enlarged side view which expands and shows the blade body of the knife of the embodiment. Sectional drawing which shows the cross-section of the blade body along line 4-4 in FIG. (A) is a plan view of a blade body that is not ribbed, (b) is a plan view of a blade body with a rib width of 0.2 mm, and (c) is a plane of a blade body with a rib width of 0.5 mm. FIG. 4D is a plan view of a blade body having a rib width of 1.0 mm, and FIG. 5E is a plan view of a blade body having a rib width of 1.5 mm. The graph which shows the measurement result of the time transition of a stab resistance value. It is a figure explaining the operation of the knife of the embodiment, and is a sectional view showing typically the state where the rib bites into living tissue. Sectional drawing which shows typically the cross-section of the blade body in a modification. Sectional drawing which shows typically the cross-section of the blade body in another modification. It is sectional drawing which shows the procedure which forms an incision wound in the sclera and cornea of an eyeball, Comprising: (a) is a figure which shows the state by which the front-end | tip part of the blade part was pierced by the sclera, (b) is a blade The figure which shows the state by which the front-end | tip part of the part was pierced by the cornea, (c) is a figure which shows the state pierced in the anterior chamber.

Hereinafter, an embodiment in which a surgical scalpel (hereinafter simply referred to as a scalpel) is embodied as a bevel-up scalpel used for cataract surgery will be described with reference to FIGS.
As shown in FIG. 1, the scalpel includes a round bar-shaped handle 30 formed of a metal material such as aluminum or a hard resin material, and a stainless steel blade body 10 attached to the tip of the handle 30. Yes.

  The blade body 10 includes a shaft portion 11 and a flat blade portion 12 that is integrally formed on the distal end side of the shaft portion 11 and has a sharp tip portion, and has a hook shape. The shaft portion 11 has a proximal end portion 111 attached to the handle 30 and a distal end portion 112 connected to the blade portion 12, and the distal end portion 112 is at a predetermined angle (for example, 45 degrees) with respect to the proximal end portion 111. It is bent.

As shown in FIGS. 2 to 4, the blade portion 12 has a first surface 13 located on the upper side and a second surface 14 located on the lower side.
As shown in FIG. 2, the blade portion 12 has a symmetrical shape about the virtual straight line V in plan view. The width of the blade portion 12 (vertical length in the figure) is continuously increased from the distal end 121 toward the proximal end side, and is maximized at the maximum width portion 122.

  As shown in FIGS. 2 to 4, the first surface 13 includes a pair of inclined surface portions 16 that form a pair of blade edges 17, and a pair of flat surface portions that are respectively positioned inside the pair of inclined surface portions 16 in the width direction. 15. The pair of inclined surface portions 16 are adjacent to the pair of flat surface portions 15 in the width direction. The knife of the present embodiment is a bevel in which the base end portion 111 of the shaft portion 11 is bent upward with respect to the distal end portion 112 in a state in which the pair of inclined surface portions 16 functioning as blade attachment surfaces are directed upward. An up-type knife is configured (see FIG. 1).

  As shown in FIG. 2, between the center in the width direction of the first surface 13, that is, between the pair of flat portions 15 in the width direction, from the position on the base end side to the base end side from the tip 121 of the blade part 12. A rib 18 extending in a protruding manner is provided.

  As shown in FIG. 4, the rib 18 has a pair of side surfaces 20 that are orthogonal to the pair of plane portions 15, and a top surface 19 that is parallel to the plane portion 15, and the width direction It has a long, substantially rectangular cross-sectional shape. The corner portion 21 between the top surface 19 and the side surface 20 of the rib 18 has a curved surface shape.

As shown in FIGS. 2 and 4, the tip edge 191 of the top surface 19 of the rib 18 has a V shape along the tip portion of the blade edge 17, and is adjacent to the inclined surface portion 16.
The rib 18 has the same cross-sectional shape from the base end position A1 of the front end edge 191 of the top surface 19 to the base end side position from the position A2 of the maximum width portion 122, and the width and height of the rib 18 Are the same (see FIG. 4). Further, the rib 18 is connected to the tip end portion 112 of the shaft portion 11.

On the other hand, as shown in FIGS. 3 and 4, the entire second surface 14 is planar.
Next, the measurement result of the resistance value (hereinafter referred to as the puncture resistance value) when the blade portion is pierced against the silicon sheet simulating the cornea of the eyeball will be described. In this measurement, the blades 10 and 110 shown in FIGS. 5 (a) to 5 (e) were used and measured at a piercing speed of 20 mm / min.

In each of the blade bodies 10 and 110 shown in FIGS. 5A to 5E, the blade angle α (see FIG. 4) is 20 degrees, and the width of the maximum width portion 122 is 2.75 mm. Yes.
The blade body 110 of the comparative example shown in FIG. 5A does not have the rib 18 and has a maximum plate thickness of 0.15 mm.

  All of the blade bodies 10 shown in FIGS. 5B to 5E have ribs 18, and the plate thickness of the ribs 18 is 0.15 mm. Moreover, the plate | board thickness in the plane part 15 is 0.07 mm, and the protrusion height of the rib 18 from the plane part 15 is 0.08 mm. That is, the maximum plate thickness of the blade body 10 having the ribs 18 is the same as the maximum plate thickness of the blade body of the comparative example.

The blade body 10 shown in FIGS. 5B to 5E has ribs 18 each having a width W of 0.2 mm, 0.5 mm, 1.0 mm, and 1.5 mm.
In FIG. 6, the measurement result of the time transition of a stab resistance value is shown.

  As shown in FIG. 6, the puncture resistance value increased rapidly with the passage of time until about 3 seconds from the start of measurement, that is, until the tip of the blade portion started to pierce the surface of the silicon sheet. At this time, the puncture resistance value changed substantially in the same manner regardless of the presence or absence of the rib 18 and the width W of the rib 18.

  After that, until about 5 seconds, that is, until about 0.5 mm from the tip of the blade portion was pierced by the silicon sheet, the puncture resistance value increased with time, but the inclination was It became more gradual. At this time, in the case of the blade 10 with the width W of the rib 18 of 0.2 mm and 0.5 mm, the puncture resistance value increased most slowly.

  Thereafter, until about 11 seconds when the maximum width portion 122 was pierced by the silicon sheet, the puncture resistance value decreased with time. At this time, in the case of the blade 10 with the width W of the rib 18 of 0.2 mm and 0.5 mm, the piercing resistance value decreased most rapidly. Further, in the case of the blade 10 having the rib 18 having a width W of 1.0 mm, the piercing resistance value was lower than that in the case of the blade 110 having no rib 18.

  Thereafter, the puncture resistance value decreased with the lapse of time until about 13 seconds when the tunnel-shaped incision was formed in the cornea 42 (see FIG. 10). However, the inclination was sharper than before. became.

From the above measurement results, it can be said that setting the width W of the rib 18 to 0.2 mm or more and 0.5 mm or less is preferable in reducing the puncture resistance value when the cornea 42 is pierced.
According to the surgical knife according to the present embodiment described above, the following effects can be obtained.

(1) At the center of the first surface 13 of the blade portion 12 in the width direction, a rib 18 extending from the position on the proximal end side to the proximal end side with respect to the distal end 121 of the blade portion 12 is projected. .
According to such a configuration, the rigidity of the blade portion 12 is enhanced by the ribs 18, so that the thickness of the portion of the blade portion 12 where the ribs 18 are not provided is reduced, and the relatively hard living tissue such as the cornea of the eyeball is reduced. When the blade part 12 is pierced, it can suppress that the blade part 12 bends.

  Further, as schematically shown in FIG. 7, the provision of the ribs 18 creates a space between the first surface 13 of the blade portion 12 where the ribs 18 are provided and the biological tissue B. The contact area between the first surface 13 and the living tissue B is reduced.

Therefore, it is possible to reduce resistance when the blade 12 is pierced into the living tissue B while suppressing the bending of the blade 12.
Further, according to the above configuration, as schematically shown in FIG. 7, when the blade 12 is pierced into the biological tissue B, the rib 12 bites into the biological tissue B, so that the blade 12 extends the rib 18. Guided along the current direction. For this reason, the rectilinearity of the blade part 12 improves, and the displacement of the blade part 12 in the width direction, that is, the lateral shake can be suitably suppressed. Accordingly, the living tissue of the incisional wound is less likely to be damaged, that is, it becomes minimally invasive, and the self-closing of the incisional wound is accelerated.

(2) The tip edge 191 of the top surface 19 of the rib 18 is adjacent to the inclined surface portion 16 and is along the tip portion of the blade edge 17.
According to such a configuration, the pair of inclined surface portions 16 and the tip edge 191 of the top surface 19 of the rib 18 are smoothly connected to each other, and the resistance when the living tissue is incised can be suitably reduced.

  (3) The rib 18 extends to the shaft portion 11. For this reason, the rigidity of the blade part 12 can be improved suitably. Therefore, when the blade portion 12 is advanced from the base position A1 of the distal end edge 191 of the top surface 19 of the rib 18 to the position A2 of the maximum width portion 122, it is possible to appropriately suppress the rib 18 from bending.

(4) The rib 18 has the same cross-sectional shape from the position A1 of the base end of the top edge 191 of the top surface 19 to the position A2 of the maximum width portion 122.
According to such a configuration, the cross-sectional shape of the rib 18 does not change when the blade portion 12 is advanced from the base end position A1 of the distal end edge 191 of the top surface 19 of the rib 18 to the position A2 of the maximum width portion 122. For this reason, it can prevent that resistance at the time of advancing the knife due to the cross-sectional shape of the rib 18 fluctuates.

(5) Since the corner portion 21 between the top surface 19 and the side surface 20 of the rib 18 is curved, it is possible to prevent the living tissue from being damaged by the corner portion 21 of the rib 18.
<Modification>
In addition, the said embodiment can also be changed as follows, for example.

-The width | variety, blade angle, etc. of the rib 18 can be changed suitably in the range of the objective of this invention.
The surface such as the second surface 14 of the blade portion 12, the pair of flat surface portions 15, the top surface 19 of the rib 18, or the side surface 20 may not be a complete flat surface. For example, when the blade body 10 is formed by press working, a step or a press mark resulting from the press working may remain on these surfaces. Even in such a case, the operational effects according to the operational effects (1) to (5) of the above embodiment can be obtained.

  In the above embodiment, the rib 18 having a substantially rectangular cross-sectional shape is illustrated, but the cross-sectional shape of the rib 18 may be substantially trapezoidal. Even in this case, it is preferable that the corners 21 of the ribs 18 have a curved surface. Further, the cross-sectional shape of the rib 18 may be an arc shape such as a semicircular shape.

-The corner | angular part 21 of the rib 18 can also be made into a right-angle shape.
For example, the cross-sectional shape of the rib 18 can be set so that the cross-sectional area of the rib 18 continuously increases toward the base end side of the blade portion 12.

The rib 18 may not be continuous with the shaft portion 11.
In the above-described embodiment, the pair of inclined surface portions 16 and the pair of flat surface portions 15 are adjacent to each other in the width direction, but the first inclined surface portion forming the blade edge 17 and the flat surface portion are first The 2nd inclined surface part inclined with respect to both an inclined surface part and a plane part can also be provided.

-For example, you may make the plate | board thickness of the blade part 12 in the rib 18 thicker toward the base end side. Further, the width of the rib 18 may be increased toward the base end side.
The present invention can be applied to a bevel-down type knife. As shown in FIG. 8, in the bevel-down type knife, an inclined surface portion 26 that forms the blade edge 17 is formed on the second surface 14 of the blade portion 12. Although not shown in the drawings, the base end portion 111 of the shaft portion 11 is bent upward with respect to the tip end portion 112 in a state where the pair of inclined surface portions 26 functioning as the blade attachment surfaces are directed downward. Yes. In this case, the ribs 28 may be provided between the pair of flat portions 25 formed on the second surface 14.

  The present invention can be applied to a bibevel type knife. As shown in FIG. 9, the bibevel type knife has inclined surface portions 16 and 26 that form the blade edge 17 on both the first surface 13 and the second surface 14 of the blade portion 12. Although not shown, the base end portion 111 of the shaft portion 11 is the distal end portion in a state in which the pair of inclined surface portions 16 that respectively function as the blade attachment surfaces are directed upward and the pair of inclined surface portions 26 are directed downward. Bent upward with respect to 112. In this case, ribs 18 and 28 may protrude from both the first surface 13 and the second surface 14. Further, the rib 18 may be provided only on the first surface 13, or the rib 28 may be provided only on the second surface 14.

The tip portion 112 of the shaft portion 11 may not be bent with respect to the base end portion 111, that is, the tip portion 112 and the base end portion 111 may be arranged on the same straight line.
In the above embodiment, the blade portion 12 having a symmetric shape with the virtual straight line V as an axis in the plan view is illustrated, but the present invention may be applied to a knife having an asymmetrical blade portion.

  -In the said embodiment and the said modification, although illustrated about the blade body 10 which makes a bowl shape, this invention is applied with respect to the blade body which makes the circular arc shape of the front-end | tip part of a blade part, and what is called a crescent-shaped blade body. You can also

  DESCRIPTION OF SYMBOLS 10,110 ... Blade body, 11 ... Shaft part, 111 ... Base end part, 112 ... Tip part, 12 ... Blade part, 121 ... Tip, 122 ... Maximum width part, 13 ... First surface, 14 ... Second surface, 15, 25 ... Planar part, 16, 26 ... Inclined surface part, 17 ... Blade edge, 18, 28 ... Rib, 19 ... Top face, 191 ... Tip edge, 20 ... Side face, 21 ... Corner part, 30 ... Handle, 40 ... Conjunctiva, 41 ... sclera, 42 ... cornea, 43 ... anterior chamber.

Claims (5)

Comprising a blade body having a blade portion formed with a blade edge;
At the center in the width direction of at least one surface of the blade portion, a rib extending from the position on the base end side to the base end side with respect to the tip end of the blade portion is protruded.
Surgical scalpel. The surface provided with the rib in the blade portion has an inclined surface portion forming the blade edge,
The leading edge of the top surface of the rib is adjacent to the inclined surface portion and along the leading edge portion of the blade edge,
The surgical knife according to claim 1. The rib extends to the position of the maximum width part where the width of the blade part is maximum,
The surgical scalpel according to claim 1 or claim 2. The rib has the same cross-sectional shape from the position of the base end of the top edge of the top surface of the rib to the position of the maximum width portion.
The surgical knife according to claim 3. The blade body has a sharp ridge shape at the tip of the blade portion,
The scalpel for operation according to any one of claims 1 to 4.

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