JP2017189231A - Endoscopic surgical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable a shaft part of a surgical instrument to be bent appropriately so as to approach a lesioned part and perform an effective operation for the lesioned part in an endoscope.SOLUTION: An endoscopic surgical instrument includes a slender shaft part 12, a treatment part 14 provided at the tip of the shaft part 12 for executing a treatment for a lesioned part, and a grip part 13 for gripping, which is connected to the tail end part of the shaft part 12. The shaft part 12 is formed with flexible increased parts 16 and 17 to facilitate bending of the shaft part 12.SELECTED DRAWING: Figure 1

Description

  Embodiments described herein relate generally to an endoscopic surgical instrument used to excise and remove a tumor or the like under an endoscope.

In recent years, endoscopic surgery has been widely performed. Endoscopic surgery is a minimally invasive operation that places less burden on the patient than conventional surgical operations that make large incisions in the patient's body.
Endoscopic surgery is being applied in an ever-increasing area, supported by advances in endoscopes, digital cameras, and image processing technologies. In recent years, endoscopic surgery has been successful in the field of brain surgery, including laparoscopic surgery for gastrointestinal cancers such as gastric cancer.

  In endoscopic surgery, a small hole is made in the patient's body surface, and surgical instruments such as an endoscope, long forceps, and exfoliator are inserted through this hole through a tube such as a trocar. There are many types of surgical instruments such as forceps, peelers, scalpels and scissors. All the surgical instruments are common in that they have an elongated rod-like shaft portion, and while observing the endoscopic image, the affected part is grasped by the inserted surgical instrument, and treatments such as peeling and excision are performed.

  As a prior art of a surgical instrument used for treatment in endoscopic surgery, there is a surgical instrument as disclosed in Patent Document 1.

Japanese Patent Laying-Open No. 2015-092948

In recent years, in the field of neurosurgery, it has become possible to accurately observe the affected area using a high-resolution endoscope, and it has become possible to perform nerve and blood vessel peeling operations relatively safely. Various surgical methods such as a keyhole approach have been developed.
Endoscopic neurosurgery requires very fine manipulations such as exfoliation, incision, and coagulation after reaching the distal end of the surgical instrument to the lesion in the brain through a narrow corridor. .

  However, in surgery deep in the brain behind the skull, such as skull base tumor surgery, conventional devices such as bipolar, forceps, and exfoliants may not reach the affected area or are effective even if they reach it. There was a scene that could not be operated.

  In this way, the surgical instrument does not reach the lesion, making it difficult to operate effectively. With conventional instruments, the shaft is circular in cross section, so the shaft rotates even when the angle is freely adjusted. This is because there is a problem that it is easy to adjust and angle adjustment is difficult.

  The present invention has been made in view of the above-described problems of the prior art, such as an exfoliator in which a shaft portion can be bent easily and appropriately so that an approach to a lesioned portion and effective operation can be performed. An object is to provide an endoscopic surgical instrument.

  In order to achieve the above object, an endoscopic surgical instrument according to the present invention is provided with a shaft portion, a treatment portion provided at a distal end portion of the shaft portion, for performing treatment on a lesioned portion, and the shaft portion. And a gripping grip portion connected to the tail end portion, wherein the shaft portion is formed with a bendability increasing portion for facilitating the bending of the shaft portion.

It is a top view which shows the peeling element which is an endoscopic surgical instrument by embodiment of this invention. It is a front view of the peeling element of FIG. It is a perspective view which shows the flexibility increase part formed in the front-end | tip part of a peeling element. It is a figure explaining the bending in the front-end | tip part of a peeling element. It is a front view which shows the modification of the treatment part of the peeler which is an endoscopic surgical instrument by embodiment of this invention. It is a top view which shows the other modification of the treatment part of a peeler. It is a front view which shows the further another modification of the treatment part of a peeler.

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, the best embodiment of an endoscopic surgical instrument according to the present invention will be described with reference to the accompanying drawings.
FIG. 1 is a plan view showing the best embodiment in which the present invention is applied to a peeler used in endoscopic surgery, and FIG. 2 is a front view of the peeler according to the same embodiment.

The peeler 10 is roughly composed of an elongated shaft portion 12 and a grip portion 13 that is held by a surgeon with a hand. A treatment portion 14 is provided at the tip of the shaft portion 12 for performing a treatment such as peeling a ulcer from a lesioned portion.
In this embodiment, the treatment portion 14 is configured as a ring-shaped curette. This curette is made of mariaburu (for example, SUS316). In this embodiment, the grip portion 13 is formed in a round bar shape, and its surface is knurled to prevent slipping.

Next, the shaft portion 12 will be described.
The shaft portion 12 is a long and thin shaft having a circular cross section made of stainless steel having good corrosion resistance. The shaft portion 12 is gradually narrowed toward the tip. Flexibility increasing portions 16 and 17 that are easily bent are provided at predetermined positions of the shaft portion 12 as follows.
In this embodiment, the bendability increasing portion is close to the grip portion 13 at the first bendability increasing portion 16 at a position close to the treatment portion 14 on the distal end side of the shaft portion 12 and the tail end portion of the shaft portion 12. It is provided at two places of the second bendability increasing portion 17 at the position. The reason why the first flexibility increasing portion 16 is provided on the distal end side of the shaft portion 12 is to ensure that the treatment portion 14 reaches the lesioned portion, and the second flexibility increasing portion 17 is connected to the tail of the shaft portion 12. The reason why it is provided on the end side is to prevent interference between the high resolution endoscope and the shaft portion 12.

Here, FIG. 3 is a perspective view showing the tip of the shaft portion 12. In FIG. 3, the direction is defined as follows. The X direction is the axial direction of the shaft portion 12, and the directions perpendicular to the X direction are the Y direction and the Z direction, respectively.
As shown in FIG. 3, in the first bendability increasing portion 16, the concave portions 20 a and 20 b that are crushed from both sides and formed with a thin concave surface are connected in the axial direction. In this case, a similar recess 20a is also formed on the back side of the recess 20a shown in FIG. The same applies to the recess 20b.

  One of the recesses 20a, 20a,... Is arranged at a constant interval, forming a first recess part row. In FIG. 3, the central portion of the recess 20a that looks oval when viewed from the Z direction forms a concave surface that is recessed in the Z direction.

The other concave portions 20b, 20b,... Are also arranged at the same interval to form a second concave row, and the central portion of the concave portion 20b that looks oval when viewed from the Y direction in FIG. 3 has a concave surface recessed in the Y direction. And
In such a first recessed portion row and a second recessed portion row, the recessed portions 20a and the recessed portions 20b are in a relationship shifted by a half pitch. In addition, the direction of the oval concave surface of the concave portion 20 a and the concave portion 20 b is different by 90 degrees with respect to the axis of the shaft portion 12.

  Next, the second bendability increasing portion 17 formed at the tail end portion of the shaft portion 12 is also formed in the same structure as the first bendability increasing portion 16.

  As shown in FIGS. 1 and 2, a series of recesses 26a, recesses 26a,... Forms a first recess array, and a series of recesses 26b, recesses 26b,. In this case, the concave surface 26a and the concave portion 26b are alternately different in the direction of the concave surface by 90 degrees, and the concave portion 26a and the concave portion 26b are shifted by a half pitch.

The endoscopic surgical instrument according to the present embodiment is configured as described above. Next, its operation and effect will be described.
In the peeler according to the present embodiment, since the first bendability increasing portion 16 and the second bendability increasing portion 17 are formed on the shaft portion 12, the shaft portion can be easily bent as follows. ing.

Here, FIG. 4 is a diagram illustrating the bending of the first bendability increasing portion 16 at the tip of the shaft portion 12.
In FIG. 4 (a), the recess 20a that looks like an oval is a recess that is relatively thin in the Z direction, which makes the tip of the shaft portion 12 easily bent in the Z direction. The first bendable portion 16 can be easily bent in the Z direction, as virtually indicated by a chain line.

  In addition to this, the concave portion 20b that looks oval in FIG. 4B forms a concave portion that is relatively thin in the Y direction, which makes the tip portion of the shaft portion 12 easy to bend in the Y direction. As virtually indicated by a chain line in FIG. 4A, the first increase in flexibility 16 can be easily bent in the Y direction.

As described above, in the distal end portion of the shaft portion 12 according to the present embodiment, the first bendability in which the directions of the recesses 20a and the recesses 20b are alternately different by 90 degrees and the recesses 20a and the recesses 20b are shifted by a half pitch. Since the increased portion 16 is formed, the tip portion of the shaft portion 12 can be freely bent not only in one direction but also in various directions.
Since the second bendability increasing portion 17 shown in FIGS. 1 and 2 has the same structure as the first bendability increasing portion 16, the base portion of the shaft portion 12 can be freely adjusted in various directions as required. It becomes possible to bend. Moreover, by combining the first bendability increasing portion 16 and the second bendability increasing portion 17, the degree of freedom of the bending shape applied to the shaft portion 12 is increased. As a result, there is an effect that it is possible to ensure that the treatment portion 14 reaches the lesioned portion and to prevent interference with the high-resolution endoscope or the like. The first bendability increasing portion 16 and the second bendability increasing portion 17 can be easily returned to the original straight state after being bent.

  As described above, according to the peeler according to the present embodiment, the shaft portion 12 is formed at the first bendability increasing portion 16 and the second bendability increasing portion 17 in accordance with the bend of the approach path to the lesioned portion. Can be easily bent, so that the treatment section 14 at the distal end can reach the lesion, and operations such as peeling and excision can be effectively performed. For example, in transnasal endoscopic surgery, when the tumor is in the deep brain, the shape of the shaft portion 12 can be bent so that it can be easily reached along the corridor. The treatment section 14 is reached, and effective peeling, excision, and extraction operations can be performed.

  As described above, the endoscopic surgical instrument according to the present invention has been described with reference to the best embodiment. However, various variations are possible for the bendability increasing portion provided in the shaft portion.

  In the above-described embodiment, in the first bendability-increasing portion 16, the recesses 20a and 20b are crushed from both sides of the shaft 12 to form concave surfaces, but are crushed only from one side to form concave surfaces. You may make it do. The concave surface may be processed not only by plastic processing but also by cutting. The same applies to the second bendability increasing portion 17.

  Further, the first bendability increasing portion 16 and the second bendability increasing portion 17 may have a substantially rectangular cross-sectional shape. Further, the first bendability increasing portion 16 and the second bendability increasing portion 17 may have a bellows-like structure processed by bending or the like.

  Furthermore, in the above-described embodiment, the first bendability increasing portion 16 has the concave portions 20a and 20b whose concave surfaces are 90 degrees different from each other. However, only one of the concave portions may be provided. The same applies to the second bendability increasing portion 17.

  In the above-described embodiment, the first bendability increasing portion 16 has a structure in which the plurality of recesses 20a and 20b are arranged in the axial direction. You only need one. The same applies to the second flexibility increasing portion 17.

(Modification)
Next, a modified example of the peeler according to the present embodiment will be described with reference to FIGS.
5 to 7 show modified examples of the treatment portion 14 of the peeler 10. In this case, the configuration of the shaft portion 12 is the same as that of the embodiment shown in FIGS.

  Among these, FIG. 5 shows the treatment portion 14 including a hook-shaped hook 30 for peeling a nerve or the like. FIG. 6 shows the treatment section 14 composed of a small disc-shaped round dish 31. FIG. 7 shows the treatment section 14 consisting of a curved spatula 32. Thus, various shapes can be adopted for the treatment section 14.

  The above is an embodiment in which the present invention is applied to a peeler among endoscopic surgical instruments, but the present invention can also be applied to a female such as a bipolar and forceps. In that case, since it is common to the peeler in that it has an elongated shaft portion, a bendability increasing portion may be formed on the shaft portion.

  Moreover, although the above embodiment is an example in which the 1st flexibility increase part 16 and the 2nd flexibility increase part 17 are two places, it is not limited to this. Only one of the first bendability increasing portion 16 and the second bendability increasing portion 17 may be provided, or three or more locations may be provided. Moreover, the whole shaft part 12 may be a bendability increasing part.

DESCRIPTION OF SYMBOLS 10 ... Stripper, 12 ... Shaft part, 13 ... Grip part, 14 ... Treatment part, 15 ... Joint, 16 ... 1st flexibility increase part, 17 ... 2nd flexibility increase part, 20a, 20b ... Recessed part, 26a, 26b ... recess, 30 ... hook, 31 ... round plate, 32 ... spatula

Claims (7)

A shaft portion;
A treatment portion provided at a tip portion of the shaft portion, for performing treatment on a lesion;
A grip portion for gripping connected to the tail end portion of the shaft portion, and
An endoscopic surgical instrument, wherein the shaft portion is formed with a bendability increasing portion that facilitates bending of the shaft portion.   The endoscopic surgical instrument according to claim 1, wherein the bendability increasing portion has one or more recesses formed in the shaft portion.   The bendability increasing portion includes a first recess row in which a plurality of the recesses are arranged in the axial direction at a constant pitch on the surface of the shaft portion, and a plurality of recesses having different orientations of 90 degrees around the axis of the shaft portion. The endoscopic surgical instrument according to claim 2, further comprising a second recess array arranged in the axial direction at the same pitch on the surface of the section.   The endoscopic surgical instrument according to claim 3, wherein the first recess row and the second recess row are shifted in the axial direction by a half pitch.   The endoscopic surgical instrument according to claim 1, wherein the bendability increasing portion is formed at a distal end portion of a shaft portion adjacent to the treatment portion.   The endoscopic surgical instrument according to claim 1, wherein the bendability increasing portion is further formed at a tail end portion of the shaft portion adjacent to the grip portion.   The endoscopic surgical instrument according to any one of claims 2 to 6, wherein the concave portion of the bendability increasing portion has an oval concave surface.

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