JP2020127678A - forceps - Google Patents

Abstract

To provide forceps which minimize restriction of a field of view by the distal end of a movable part.SOLUTION: Forceps 1 comprise: a fixed part 3 having a fixed blade 2; a movable part 5 having a movable blade 4 for gripping or cutting off a target portion in cooperation with the fixed blade 2; an operation part 14 for moving the movable part 5 between a front position where the fixed blade 2 and the movable blade 4 cooperate with each other and a restriction position in the rear in accordance with guide by a guiding part provided at the fixed part 3; and a restriction position setting part 15 for setting the restriction position to be changeable to a first position P1 or a second position P2 in the rear.SELECTED DRAWING: Figure 1

Description

The present invention relates to forceps that grips or cuts a target site with a fixed blade and a movable blade.

Conventionally, as such forceps, a bone forceps that grasps or excises bone has been known (for example, refer to Patent Document 1). The rongeur of Patent Document 1 includes a fixed portion having a fixed blade facing rearward at a front end, and a movable portion having a movable blade facing forward at a front end.

A guide for guiding the movable part to the fixed part so that the movable part can be moved between a front position where the fixed blade and the movable blade cooperate to grasp or excise the target site and a retracted position which is separated rearward from the front position. Sections are provided. The movable part is moved by the operation part according to the guide part, released from the guide part in the retracted position, and can be removed.

Further, the rongeur forceps is provided with a locking means capable of switching between a locked state that prevents the movable portion from moving to the retracted position and an unlocked state that allows the movable portion to move. The locking means has a lever pivotally supported at a position where a finger of a handle forming the operation portion is hooked. The locked state and the unlocked state are switched by rotating this lever rotatably supported by the handle and turning on another pair of handles.

The rongeur forceps are normally used in the locked state. Then, in the unlocked state, the movement of the movable portion is not limited, and the movable portion can be moved backward and removed.

JP, 2010-46114, A

However, according to the rongeur of Patent Document 1, it is used in a locked state, that is, in a state in which the movable portion can move within a certain range suitable for gripping or excising a target site. Therefore, when positioning the rongeur forceps on the target site using an endoscope or when searching for an affected part, the field of view is limited by the tip of the movable part, which may hinder positioning and searching.

An object of the present invention is to provide a forceps capable of avoiding, as much as possible, the limitation of the field of view due to the distal end portion of the movable portion in view of the problems of the conventional art.

The forceps of the present invention is
A fixed part having a fixed blade facing rearward at the front end,
A movable part having a movable blade at the front end that cooperates with the fixed blade to grip or excise a target site,
A guide portion which is provided on the fixed portion and guides the movable portion so as to be movable in the front-rear direction;
An operating portion for moving the movable portion between a front position where the fixed blade and the movable blade cooperate with each other and a limit position rearward of the front position, in accordance with the guidance of the guide portion,
A limit position setting unit configured to changeably set the limit position to a predetermined first position or a second position rearward of the first position.

In this configuration, when the movable portion is restricted to move to the first position when the forceps is positioned at the target site using an endoscope or when the affected area is searched by the forceps, the distal end of the movable portion is set. The field of view may be limited to some extent by part.

In this case, by changing the limit position to the second position by the limit position setting unit and moving the movable unit to the second position, it is possible to avoid limiting the field of view by the tip of the movable unit as much as possible. it can. As a result, it is possible to more efficiently perform the positioning to the symmetrical portion and the search for the target portion.

In the present invention, the second position is a position set when positioning the distal end portion of the forceps on the target site, and the first position grips or cuts the target site after the positioning. The position may be set at that time.

According to this, it is possible to position the movable portion at the second position and position the distal end portion of the forceps at the target site while avoiding that the visual field is limited by the distal end portion of the movable portion. Moreover, after that, the movable part can be positioned at the first position, and the target site can be appropriately grasped or excised.

In the present invention, the limit position setting part contacts the rear end surface of the movable part to contact the movable part and a first rotation position that restricts the movable part from moving rearward from the first position. It is preferable to include a rotating member provided on the operation portion so as to be rotatable between the second rotating position and the second rotating position.

According to this, by rotating the rotating member to the first rotating position, when the movable portion moves rearward, the rotating member comes into contact with the rear end surface of the movable portion and directly moves the movable portion. Since the movement range of is limited to the first position, this limitation can be performed reliably and accurately.

In this case, the operation unit is
A fixed handle fixed to the fixed portion,
A movable handle that is rotatably connected to the movable portion and the fixed handle, and that is movable with respect to the fixed handle to move the movable portion according to the guide portion.
The rotating member is provided on the fixed handle,
The limit position setting unit abuts against each other when the movable unit moves to the second position to limit the rearward movement of the movable unit to the second position. It is preferable to provide an abutment surface provided on the handle.

According to this, by rotating the rotating member to the first rotating position as described above, the limit position can be set to the first position, and by rotating the rotating member to the second rotating position. The limit position can be set to the second position. That is, the operation of setting the limit position to the first position or the second position can be easily performed by operating only the rotating member.

It is a front view of the forceps concerning one embodiment of the present invention. It is a side view of the forceps of FIG. It is the III-III sectional view taken on the line of FIG. It is a front view in another state of the forceps of FIG. FIG. 5 is a side view of the forceps in the state of FIG. 4.

Embodiments of the present invention will be described below with reference to the drawings. As shown in FIG. 1, a forceps 1 according to an embodiment of the present invention includes a fixed portion 3 having a fixed blade 2 facing rearward at a front end, a movable portion 5 having a movable blade 4 at a front end, and a fixed portion 3. And a guide portion that guides the movable portion 5 so as to be movable in the front-rear direction.

The movable blade 4 faces forward and cooperates with the fixed blade 2 to have a function of gripping or excising a target site such as cartilage. That is, the forceps 1 is called a Kerrison punch, a rongeur forceps, or the like, and is used for grasping or removing bone or cartilage tissue. The movable blade 4 and the fixed blade 2 may be upright with an angle of 90° with respect to the front-rear direction, or may be inclined.

The movable portion 5 includes a rod-shaped rod portion 6 and a movable front end portion 7 detachably attached to the front end of the rod portion 6. The movable blade 4 is provided at the front end of the movable front end portion 7.

The fixed portion 3 includes a hollow pipe-shaped pipe portion 8 and a fixed front end portion 9 provided at the front end of the pipe portion 8. The fixed front end portion 9 includes a front end-side semi-cylindrical front half portion 10 and a rear end-side semi-cylindrical rear half portion 11. The fixed blade 2 is provided at the front end of the front half portion 10.

As shown in FIG. 3, a guide rail 12 is provided on the upper surface of the semi-cylindrical front half 10 to guide the movable front end 7 with a T-shaped cross section. The movable front end portion 7 is provided with a T-shaped groove 13 that fits and slides on the guide rail 12. The movable front end portion 7 is guided in the front-rear direction by the guide rail 12 through the groove 13.

The inner surface of the pipe portion 8 and the inner surface of the rear half portion 11 of the fixed front end portion 9 guide the rod portion 6 in the front-rear direction. Therefore, the guide portion that guides the movable portion 5 includes the guide rail 12 of the front half portion 10, the rear half portion 11 and the inner surface of the pipe portion 8.

According to the guidance of the guide portion, the movable portion 5 is moved by the operation portion 14 between a front position where the fixed blade 2 and the movable blade 4 cooperate with each other and a limit position rearward of the front position. This limit position is set by the limit position setting unit 15 so as to be changeable to a predetermined first position P1 or a second position P2 behind the first position P1.

The second position P2 is, for example, a position that is set when the tip portion of the forceps 1 is positioned at a target site that needs to be grasped or excised by the forceps 1, and the first position P1 is the position after the positioning. It is a position set when gripping or excising a target site.

The limit position setting unit 15 includes a rotating member 16 provided on the operation unit 14. As shown in FIGS. 1 and 2, the rotating member 16 contacts the rear end surface of the movable portion 5 and a first rotating position C1 that restricts the movable portion 5 from moving rearward from the first position P1. , Is provided so as to be rotatable between a second rotation position C2 that is not in contact with the movable portion 5.

The operation unit 14 is rotatably connected to the fixed handle 17 fixed to the fixed unit 3, the movable unit 5 and the fixed handle 17, and is rotated with respect to the fixed handle 17 to move the movable unit 5 to the above. And a movable handle 18 for moving the guide according to the guide section.

The rotating member 16 is provided on the fixed handle 17. That is, the rotating shaft 19 of the rotating member 16 is supported by the fixed handle 17. Further, the fixed handle 17 is provided with a ball plunger 20 for releasably fixing the rotating member 16 to the first rotating position C1.

The limit position setting unit 15 further moves the movable handle 18 and the movable handle 18 so as to limit the rearward movement of the movable unit 5 to the second position P2 by abutting each other when the movable unit 5 moves to the second position P2. The fixed handle 17 is provided with contact surfaces 21 respectively.

The movable portion 5 also includes an abutting member 22 fixed to the rear end of the rod portion 6 and rotatably connected to the upper end portion of the movable handle 18. When the movable portion 5 is moved rearward, the abutting member 22 comes into contact with the rotating member 16 located at the first rotating position C1, whereby the rearward movement is limited to the first position P1. R.

Therefore, in the limit position setting unit 15, the limit position when the movable unit 5 moves rearward is set to the first position P1 by positioning the rotating member 16 at the first rotating position C1. By positioning 16 at the second rotation position C2, the limit position can be set at the second position P2.

FIG. 1 and FIG. 2 show a state in which the limit position is set to the first position P1. FIG. 4 and FIG. 5 show a state where the limit position is set to the second position P2 and the movable portion 5 is located at the second position P2.

The fixed handle 17 is fixed to the fixed portion 3 via a cylindrical member 23 provided at the rear end of the pipe portion 8. Therefore, a part of the outer surface of the cylindrical member 23 is fixed to the front end portion of the fixed handle 17. The rod portion 6 passes through the inside of the pipe portion 8, projects from the rear end surface of the cylindrical member 23, and is fixed to the front end portion of the contact member 22.

A compression coil spring 24 that biases the contact member 22 rearward with respect to the cylindrical member 23 is provided in a portion of the rod portion 6 between the cylindrical member 23 and the contact member 22.

The movable front end portion 7 can be released from the fixation by loosening the screw fixing the movable front end portion 7 to the rod portion 6. Then, the movable front end portion 7 is slid backward until it comes into contact with the front end of the pipe portion 8 in a state where the fixed position is set to the second position P2 and the fixing is released as shown in FIG. The fitting with 12 is released, and it can be removed upward.

In this configuration, when the forceps 1 is used while observing with an endoscope or the like, the following method of use can be considered. That is, first, it is assumed that the rotating member 16 of the limit position setting unit 15 is positioned at the second rotating position C2, as shown in FIGS. 4 and 5.

That is, the limit position of the rearward movement of the movable portion 5 is set to the second position P2 at which the contact surfaces 21 of the movable handle 18 and the fixed handle 17 contact each other. The movable member 5 is located at the second position P2 because the contact member 22 is pushed rearward by the biasing force of the compression coil spring 24.

In this manner, with the movable portion 5 positioned at the second position P2, the operator grips the operating portion 14 and positions the tip portion of the forceps 1 at the target site. At this time, since the movable portion 5 is located at the second position P2, the movable blade 4 of the movable portion 5 is apart from the fixed blade 2 of the fixed portion 3 by about 20 mm as shown in FIG. For this reason, when the fixed blade 2 is positioned on the target site, the target site is not hidden behind the movable blade 4, so that the positioning is performed without any trouble.

Next, the operator brings the movable handle 18 of the operation unit 14 closer to the fixed handle 17 to position the contact member 22 on the front side of the rotating member 16, and moves the rotating member 16 to the first rotating position C1. Position. As a result, the rear end of the movable range of the movable part 5 is set to the first position P1 where the contact member 22 of the movable part 5 contacts the rotating member 16.

After that, when the operator loosens the force for gripping the operation portion 14, the movable portion 5 is positioned at the first position P1 by the biasing force of the compression coil spring 24. As a result, the amount of stroke that the movable portion 5 can move forward is about 6 mm.

Next, the operator operates the operation unit 14 to bring the movable handle 18 close to the fixed handle 17, thereby bringing the movable blade 4 close to the fixed blade 2 and moving a part of bone or cartilage as a target site to the movable blade. It can be grasped or cut by being sandwiched between 4 and the fixed blade 2. The target site separated by cutting is stored in the space inside the movable blade 4.

The separated target site is easy because the surgeon loosens the force for gripping the operation unit 14 to move the movable blade 4 backward by the compression coil spring 24 and push the guide rail 12 of the first half 10 forward. It is discharged from the movable blade 4.

As described above, the movable front end portion 7 sets the limit position to the second position P2 and slides the movable portion 5 rearward to release the fixation of the movable front end portion 7 to the rod portion 6, and further to move the movable front end portion. It can be easily removed by sliding the part 7 rearward. Thereby, the fixed front end 9 and the movable front end 7 can be easily maintained.

As described above, according to the present embodiment, the limit position setting unit 15 changes the limit position to the second position P2, and the movable unit 5 is moved to the second position P2. It is possible to avoid limiting the field of view as much as possible.

Further, when positioning the distal end portion of the forceps 1 at the target site, the limiting position is set to the second position P2 to perform the positioning reliably and quickly under a wide field of view, and then the limiting position is set to the first position P1. The target site can be set and reliably gripped or excised.

Further, since the contact member 22 and the rotating member 16 can contact each other by rotating the rotating member 16 to the first rotating position C1, the limit position is set to the first position P1. The movement of the movable part 5 to the first position P1 can be surely and accurately restricted.

Further, since the contact surface 21 of the limit position setting unit 15 is configured to limit the rearward movement of the movable unit 5 to the second position P2, the rotating member 16 is rotated to the second rotating position C2. Thus, the limit position can be set to the second position P2.

That is, according to the limit position setting unit 15, the operation of setting the limit position to the first position P1 or the second position P2 sets the position of the rotating member 16 to the first rotating position C1 or the second rotating position C2. This can be easily done by switching.

Although the embodiment of the present invention has been described above, the present invention is not limited to this. For example, the limit position setting unit is configured by means for selectively arranging two types of members that come into contact with the movable unit 5 at the first position P1 and the second position P2 on the moving path of the movable unit 5. Good.

DESCRIPTION OF SYMBOLS 1... Forceps, 2... Fixed blade, 3... Fixed part, 4... Movable blade, 5... Movable part, 6... Rod part, 7... Movable front end part, 8... Pipe part, 9... Fixed front end part, 10... Front half part , 11... latter half part, 12... guide rail, 13... line groove, 14... operation part, 15... limit position setting part, 16... rotating member, 17... fixed handle, 18... movable handle, 19... rotating shaft, 20... Ball plunger, 21... Contact surface, 22... Contact member, 23... Cylindrical member, 24... Compression coil spring, P1... 1st position, P2... 2nd position, C1... 1st rotation position, C2 …Second rotation position.

Claims (4)

A fixed part having a fixed blade facing rearward at the front end,
A movable part having a movable blade at the front end that cooperates with the fixed blade to grip or excise a target site,
A guide portion which is provided on the fixed portion and guides the movable portion so as to be movable in the front-rear direction;
An operating portion for moving the movable portion between a front position where the fixed blade and the movable blade cooperate with each other and a limit position rearward of the front position, in accordance with the guidance of the guide portion,
A forceps, comprising: a limit position setting unit configured to changeably set the limit position to a predetermined first position or a second position rearward of the first position. The second position is a position set when the distal end portion of the forceps is positioned at the target site,
The forceps according to claim 1, wherein the first position is a position set when gripping or excising the target site after the positioning. The limit position setting section contacts the rear end surface of the movable section and restricts the movable section from moving rearward from the first position, and a second rotation position that does not contact the movable section. The forceps according to claim 1 or 2, further comprising a rotating member provided on the operating portion so as to be rotatable between the forceps and the moving position. The operation unit is
A fixed handle fixed to the fixed portion,
A movable handle that is rotatably connected to the movable portion and the fixed handle, and that is movable with respect to the fixed handle to move the movable portion according to the guide portion.
The rotating member is provided on the fixed handle,
The limit position setting unit abuts against each other when the movable unit moves to the second position to limit the rearward movement of the movable unit to the second position. The forceps according to claim 3, further comprising an abutment surface provided on the handle.

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