JP2021153727A - Surgical instrument - Google Patents

Abstract

To provide a surgical instrument that allows a spring member to be replaced appropriately.SOLUTION: The surgical instrument includes: a function part 2 for holding an object with a pair of operation members 2A and 2B; an operation part 6 that enables an object holding operation by the function part 2 by applying force so that a pair of grips 1A and 1B get close to each other; and a pair of leaf springs 6A and 6B attached to the grips 1A and 1B respectively for energizing the grips 1A and 1B in a direction to cause them to be separated by causing the end part on the side attached to the grips 1A and 1B to engage with the end part on the opposite side. The leaf springs 6A and 6B are removably fastened to the grips 1A and 1B by screws 9, and flat attaching parts 5 to which the leaf springs 6A and 6b of the grips 1A and 1B are attached respectively are provided with regulation parts for preventing the leaf springs 6A and 6B from turning with the screws 9 as fulcrums.SELECTED DRAWING: Figure 4

Description

The present invention relates to a surgical instrument, and more particularly to a surgical instrument that holds an object against the urging force of a leaf spring.

Medical instruments for surgery equipped with a spring member include forceps, needle holders, knot pushers, and the like, and are used for grasping and pulling an object in surgery. Forceps are used to pinch tissues, foreign objects, etc., needle holders are used to grip sutures, and knot pushers are used to hold sutures.

In these medical instruments, a functional unit that holds an object with a pair of moving members and an operating unit that enables the functional unit to hold the object by applying a force so that the pair of handles come close to each other. , And usually keep a pair of operating members in an open state, but a structure is known in which a leaf spring urges the pair of handles in a direction away from each other (for example, Patent Document). See 1).

Japanese Unexamined Patent Publication No. 2014-117438

In a medical instrument having a spring member in this way, when the practitioner tries to hold the object by the functional part, the pair of handles are gripped so as to approach each other against the spring force of the spring member. Holds the object in the functional part for a long time. For example, a knot pusher hooks a knotted suture on the tip of a functional part and grips the handle while performing a procedure of feeding the suture knot to a target site under a microscope. There are individual differences in the feeling of the hand when performing the procedure while grasping the work.

Therefore, even if it is the same type of medical device, a plurality of types having different repulsive amounts of spring members depending on the individual who uses it are prepared, which is uneconomical.

Therefore, in view of the above-mentioned conventional problems, it is an object of the present invention to provide a surgical instrument capable of appropriately exchanging a spring member with respect to the main body.

The surgical instrument according to the present invention enables the functional portion that holds the object by the pair of moving members and the functional portion that holds the object by applying a force so that the pair of handles are brought close to each other. A pair of leaf springs that urge the handles to separate from each other by engaging the ends attached to the handles and the ends opposite to the ends attached to the handles. A surgical instrument to be provided, wherein the leaf spring is detachably fastened to the handle with a screw, and the screw is used as a fulcrum at each flat attachment portion to which the leaf spring of the handle is attached. It is characterized by providing a regulating part that prevents the leaf spring from rotating.

In the first embodiment of the surgical instrument according to the present invention, a groove having a bottom surface in contact with the surface of the end portion of the leaf spring and a pair of side walls engaging with both side edges in the elongated direction of the end portion is formed. It is the regulation department.

Further, in the second embodiment of the surgical instrument according to the present invention, the restricting portion has a protrusion formed on the surface of the mounting portion and fitted with an insertion hole formed in the leaf spring member. It is supposed to be.

Further, the spring property of the leaf spring can be enhanced by providing the handle with a protrusion at a position where the leaf spring extends away from the mounting portion.

Regarding the attachment of the leaf spring to the handle, one end of the leaf spring is attached to the handle in a state of extending outward from the operation portion.

Further, one end of the leaf spring may be attached to the handle in a state of extending inward from the operating portion in the direction of the functional portion.

It is provided with a first shaft that connects one of the operating members and the handle on the same side as the operating member, and a second shaft that connects the other operating member and the handle on the same side as the operating member. The first shaft and the second shaft are fixed at the center to become a long surgical instrument, which is used in a surgical method in which a small incision is made in the chest or abdomen and the tube is inserted into the body. Best for.

According to the present invention, the leaf spring can be easily replaced by screwing the leaf spring. Therefore, a plurality of types of leaf springs can be prepared according to the spring force, and a leaf spring having a spring force preferred by the user can be selected and attached. Since the attached leaf spring is prevented from rotating around the screw by the regulating part, a surgical instrument that can be used stably without the leaf spring being displaced or the screw loosening is provided. Will be done.

The plan view of the surgical instrument (knot pusher) which concerns on one Embodiment of this invention is shown. The enlarged view of the main part explaining the operation between the operation part and the shaft part of the surgical instrument of FIG. 1 is shown. The enlarged view of the main part explaining the operation between the shaft part and the functional part of the surgical instrument of FIG. 1 is shown. An example of the configuration of the regulation portion by the groove is shown in a plan view, and (b) is shown in a cross-sectional view. A perspective view shows an example of the configuration of the regulation portion by the protrusion. A side view shows another configuration example of the groove regulation portion. The surgical instrument (tweezers) according to another embodiment of the present invention is shown in a plan view. The surgical instrument (needle holder) according to another embodiment of the present invention is shown in a perspective view.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

FIG. 1 shows a knot pusher 10 as a surgical instrument according to an embodiment of the present invention. The knot pusher 10 is a device that carries a knot made outside the patient's body into the body, and includes an operation unit 1 on the proximal end side, a functional unit 2 on the distal end side, and a shaft portion 3 connecting the operation unit 1 and the functional unit 2. It is composed of.

The operation unit 1 includes a pair of handles 1A and handles 1B to be knurled, and the handles 1A and 1B are urged by a spring member 6 in a direction in which they are separated from each other. The spring member 6 in this example is composed of a pair of leaf springs 6A and 6B, and the leaf springs 6A and 6B are attached to the rear ends of the handle 1A and the handle 1B, respectively, and are connected by engaging the rear ends of each other. ing. The handle 1B is rotatable around the rotation shaft 4A as a fulcrum. Therefore, when the handle 1A and the handle 1B are gripped against the spring force of the leaf springs 6A and 6B, the handle 1B rotates and the handle 1B rotates. Move towards 1A.

The functional unit 2 includes an operating member 2A bent in an "L" shape and an operating member 2B whose tip is bent like a fishhook and through which sutures are passed. The operating member 2A rotates freely with respect to the operating member 2A with the rotating shaft 4A as a fulcrum.

The shaft portion 3 includes a pair of shafts 3A and a shaft 3B. The shafts 3A and 3B, which are made of rods having a substantially semicircular cross section, are arranged so as to face each other with their flat surfaces, and their central portions are joined by a fastening portion 7. The base end side of the shaft 3A is integrally formed by communicating with the handle 1A, and a rotating shaft 4A that pivotally supports the operating member 2A is provided at the opposite end end side to operate. The member 2A is connected to the member 2A via the rotating shaft 4A. Further, the shaft 3B is provided with the above-mentioned rotating shaft 4B at the end on the base end side thereof, is connected to the handle 1B via the rotating shaft 4B, and the end on the base end side is connected to the operating member 2B. They are communicated and formed integrally.

The shaft portion 3 includes, for example, a wire (not shown) whose both ends are circulated around the rotating shaft 4A and the rotating shaft 4B, respectively, and the wire causes this rotational force on the rotating shaft 4A in response to the rotation of the rotating shaft 4B. To convey. A surgical instrument including a shaft portion 3 that transmits rotational force by linear movement by a wire can be configured to be long, so that a small incision is made in the chest or abdomen and passed through a tube inserted into the body. It is the most suitable surgical instrument to be used in the surgical technique to be performed. And, although it is a long instrument, it is suitable for performing delicate treatment because the operating range of the moving part is small. The shafts 3A and 3B may slide without using a wire.

2A and 2B show an enlarged view of a connecting portion between the handle 1B and the shaft 3B, where FIG. 2A is a front view of a main part and FIG. 2B is a right side view thereof. As shown in the figure, the end portion of the shaft 3B connected to the handle 1B has a concave shape, and the rotating shaft 4B is rotatably supported by the shaft 3B across the concave portion 11. The end portion of the handle 1B connected to the shaft 3B forms the operating portion 12. The operating portion 12 has a convex shape that fits into the concave portion 11 of the shaft 3B, and is fixedly supported by the rotating shaft 4B. Therefore, the handle 1B is rotatably connected to the shaft 3B via the rotating shaft 4B.

The rotatable handle 1B is normally located at a position away from the handle 1A due to the urging of the spring member 6, and at this time, a part of the operating portion 12 is the shaft 3A as shown in FIG. 2 (b). A slight gap 13 is formed between the shafts 3A and 3B because it protrudes from the recess 11 toward the shaft. Therefore, normally, the shafts 3A and 3B are pressed by the operating portion 12 from the central portion joined by the fastening portion 7 to the connecting portion of the shaft 3B with the handle 1B.

3A and 3B show an enlarged view of a connecting portion between the shaft 3A and the operating member 2A, where FIG. 3A is a front view of a main part and FIG. 3B is a left side view thereof. As shown in the figure, the end portion of the shaft 3A connected to the operating member 2A has a concave shape, and the rotating shaft 4A is provided so as to straddle the concave portion 16 and is rotatably supported by the shaft 3A. The end portion of the operating member 2A connected to the shaft 3A forms the operating portion 15. The operating portion 15 has a convex shape that fits into the concave portion 11 of the shaft 3B, and is fixedly supported by the rotating shaft 4A. Therefore, the operating portion 15 is rotatably connected to the shaft 3A via the rotating shaft 4A.

The rotatable operating member 2A is normally located at a position away from the operating member 2B, and at this time, the operating portion 15 partially protrudes toward the shaft 3B as shown in FIG. 3 (b). A slight gap 14 is formed between the shafts 3A and 3B. Therefore, normally, the shafts 3A and 3B are pressed by the operating portion 15 from the central portion connected by the fastening portion 7 to the connecting portion of the shaft 3A with the operating member 2A.

As described above, the shafts 3A and 3B to which the central portions thereof are joined by the fastening portion 7 are in a state in which a part of the operating portions 12 and 15 protrudes between both ends thereof. In this state, when the operating portion 1 is gripped against the spring force of the leaf springs 6A and 6B and the handle 1B is pushed toward the handle 1A, the operating portion 12 is pushed by the handle 1A and the inside of the recess 11 of the shaft 3B. Move to leave. This movement of the operating portion 12 causes the rotating shaft 4B supporting the operating portion 12 to rotate, and this rotational force is transmitted to the rotating shaft 4A via the wire. Therefore, as the rotating shaft 4A also rotates, the operating portion 15 moves so as to retract into the recess 16 of the shaft 3A. As a result, the operating member 2A moves toward the shaft 3B and closes in a state of approaching the operating member 2B. Therefore, while the operating unit 1 is being gripped, the binding thread hooked on the operating member 2B continues to be held by closing the operating member 2A.

The surgeon uses the knot pusher 10 to carefully move the knot pusher 10 so as not to affect the surrounding biological tissue when guiding the knot thread held by the functional part 2 to the target site in the patient's body. Therefore, the surgeon maintains the grip of the operation unit 1 for a relatively long time. When performing such a fine procedure, the sensation is different for each operator in order to grip the operation unit 1, and a spring force corresponding to the sensation is required. Therefore, a plurality of spring members 6 are prepared according to the spring force, and the leaf springs 6A and 6B are fastened to the handles 1A and 1B with screws 9 so that they can be replaced according to the operator.

As shown in FIG. 4, the flat mounting portions 5 of the handles 1A and 1B to which the leaf springs 6A and 6B are mounted have a bottom surface 8a in contact with the end surface of the leaf springs 6A and 6B and the length of the end portion. A groove 8 having a pair of side walls that engage the bilateral edges 8b in the longitudinal direction is formed. The width (short side) dimensions of the leaf springs 6A and 6B and the handles 1A and 1B are all substantially the same, but the width dimension w of the connecting portion 19 attached to the handles 1A and 1B of the leaf springs 6A and 6B is a groove. It matches the width dimension of 8. Therefore, if the connecting portions 19 of the leaf springs 6A and 6B are fitted into the grooves 8 of the handles 1A and 1B and fastened with the screws 9, the rotational movement of the leaf springs 6A and 6B with the screws 9 as the fulcrum is performed. It is blocked by both side edges 8b of the groove 8. Therefore, the groove 8 acts as a regulating portion for blocking the rotation of the leaf springs 6A and 6B, and the screw 9 does not loosen or the leaf springs 6A and 6B do not displace during the use of the knot pusher 10 and is stable. Can be used.

To form the groove 8 in the mounting portion 5, as shown in FIG. 6, by providing the protrusion 10 at the end of the handles 1A and 1B, the leaf springs 6A and 6B are directed inward (between the handles 1A and 1B). It bends more and extends, which has the effect of increasing the springiness.

As such a regulating portion, as shown in FIG. 5, a protruding portion 17 formed in the mounting portion 5 may be used. The protrusion 17 fits into the insertion hole 18 drilled in the leaf springs 6A and 6B, and holds the leaf springs 6A and 6B at two points with the fastening screw 9. Therefore, the engagement between the protrusion 17 and the insertion hole 18 prevents the rotational movement of the leaf springs 6A and 6B with the screw 9 as a fulcrum.

In the above embodiment, the leaf springs 6A and 6B are attached to the handles 1A and 1B, respectively, in a state where the leaf springs 6A and 6B extend outward from the operation unit 1, but the leaf springs 6A and 6B are attached to the handles 1A and 1B, respectively. One end of the handle 1A, 1B may be attached to the handle 1A, 1B in a state of being fitted between the handles 1A, 1B and extending toward the shaft portion 3.

FIG. 7 shows the tweezers 20 attached with the leaf springs 6A and 6B extending toward the shaft portion 3. The tweezers 20 also have an operation unit 1 on the base end side and a function unit 2 on the tip end side, and a shaft unit 3 is provided between the operation unit 1 and the function unit 2. The operation portion 1 and the shaft portion 3 have the same structure as the knot pusher 10 described with reference to FIG. 2, except that the leaf springs 6A and 6B extend in opposite directions. Regarding the attachment of the handles 1A and 1B of the leaf springs 6A and 6B, the handles 1A and 1B are attached with the screws 9 and the groove 8 described in FIG. 4 or the protrusion 17 described in FIG. 5 is provided as a regulating portion. Is the same as the knot pusher 10.

The functional unit 2 in the case of the tweezers 20 has a holding member 21A that is rotatable around the rotating shaft 4B as a fulcrum and a fixed holding member 21B, and has a handle against the spring force of the leaf springs 6A and 6B. By gripping 1A and 1B, the holding member 21A rotates and moves toward the holding member 21B to sandwich the object between the two.

Further, as shown in FIG. 8, the leg piece 22A and the handle 1B and the operating member 2B, which are not provided with the shaft portion and in which the handle 1A of the operating unit 1 and the operating member 2A of the functional unit 2 are continuous, are continuous. There is a surgical medical device 30, for example, a needle holder, which has a structure in which a leg piece 22B is combined in an X shape and a shaft support 23 is formed at an intersection. The pair of leaf springs 6A and 6B of the spring portion 6 are fitted into the grooves 8 formed in the mounting portions 5 of the handles 1A and 1B, respectively, and are fastened with screws 9. The protrusions 10 formed at the ends of the handles 1A and 1B allow the leaf springs 6A and 6B to bend and extend inward (between the handles 1A and 1B). In this case as well, the regulating portion is not limited to the groove 8, and may be the protruding portion 17 described with reference to FIG.

Although the embodiments of the present invention have been described above, the present invention is not limited to the above embodiments, and various modifications can be made based on the gist of the present invention, and these are excluded from the scope of the present invention. is not it.

The present invention relates to an improvement in the operability of a needle holder used in a surgical operation for gripping a suture needle, and has industrial applicability.

1 Operation unit 1A Handle 1B Handle 2 Functional unit 2A Operating member 2B Operating member 3 Shaft unit 3A Shaft 3B Shaft 5 Mounting unit 6 Spring member 6A Leaf spring 6B Leaf spring 8 Groove (regulatory unit)
9 Screw 10 Protrusion 17 Protrusion (Regulatory part)

The surgical instrument according to the present invention enables the functional portion that holds the object by the pair of moving members and the functional portion that holds the object by applying a force so that the pair of handles are brought close to each other. A pair of leaf springs that are attached to the handles and are attached to the handles, and a pair of leaf springs that urge the handles to separate from each other by engaging the ends on the opposite side of the handles. provided, the plate springs each flat attachment portion attached to the handle, the regulating portion is provided to prevent rotation of the leaf spring to pivot the screw, the plate spring, the pair of handles A plurality of items having different urging forces to be separated are prepared, and any one selected from the plurality of items is detachably fastened to the handle .

It is provided with a first shaft that connects one of the operating members and the handle on the same side as the operating member, and a second shaft that connects the other operating member and the handle on the same side as the operating member. By locking the first shaft and the second shaft at their respective central portions (also referred to as "fixing" in the present specification) , it becomes a long surgical instrument and can hold the chest or abdomen. It is ideal for surgical procedures performed through a small incision and a tube inserted into the body.

The surgical instrument according to the present invention enables the functional part to hold the object by the functional part by applying a force so that the functional part holding the object with a pair of moving members and the pair of handles approach each other. A pair of leaf springs that urge the handles to separate from each other by engaging the operating portion to be operated with the ends attached to the handles and the ends opposite to the ends attached to the handles, and the front. The screw is attached to each of the flat mounting portions to which the leaf spring of the handle is attached by means of a protrusion formed on the surface of the mounting portion and fitted with an insertion hole formed in the leaf spring. comprising a regulating portion for preventing the rotation of the leaf spring to the fulcrum, and the plate spring, the pair of biasing force for separating the handle are prepared different plurality of in advance, any from among the plurality It is characterized in that one of the selected ones is detachably fastened to the handle with a screw to fit the insertion hole into the protrusion .

Claims (7)

A functional unit that holds an object with a pair of moving members,
An operation unit that enables the functional unit to hold the object by applying a force so that the pair of handles come close to each other.
A pair of leaf springs that are attached to the handles and urge the handles to separate from each other by engaging the ends opposite to the ends attached to the handles.
It is a surgical instrument equipped with
The leaf spring is detachably fastened to the handle with screws.
A surgical instrument characterized in that each flat attachment portion to which the leaf spring of the handle is attached is provided with a restricting portion that prevents the leaf spring from rotating with the screw as a fulcrum. The first aspect of the invention, wherein the regulating portion is a groove having a bottom surface in contact with the surface of the end portion of the leaf spring and a pair of side walls engaging with both side edges of the end portion in the elongated direction. Surgical instruments. The surgical instrument according to claim 1, wherein the restricting portion is a protrusion formed on the surface of the mounting portion and fitted with an insertion hole formed in the leaf spring member. .. The surgical instrument according to claim 1, wherein the handle is provided with a protrusion at a position where the leaf spring extends away from the mounting portion. The surgical instrument according to claim 1, wherein one end of the leaf spring is attached to the handle in a state of extending outward from the operating portion. The surgery according to claim 1, wherein one end of the leaf spring is attached to the handle in a state of extending inward in the direction of the functional portion from the operating portion. Surgical instruments. It is provided with a first shaft that connects one of the operating members and the handle on the same side as the operating member, and a second shaft that connects the other operating member and the handle on the same side as the operating member. The surgical instrument according to claim 1, wherein the first shaft and the second shaft are anchored at the center.

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