JP3222240U - Blade for opposing edge expansion holding tool - Google Patents

Abstract

The present invention provides a blade for an opposed edge spread holding device, which is easy to attach and detach to an arm and easy to clean. The body part abuts against the opposite edge part B of the body tissue to maintain an expanded state between the edge parts, and extends in a direction perpendicular to the longitudinal direction of the base part 1 and the base part. A blade for opposing edge portion expanding and holding equipment used in an opposing edge portion expanding and holding instrument provided with a pair of arms 4a and 4b provided with adjustable separation distances, and abutting against the edge portion Part 51 and a fixed part 53 fixed to the arm by inserting the arm, and the fixed part has an opening 55 that opens on the side opposite to the contact side with the edge part. . [Selected figure] Figure 5

Description

  The present invention relates to a blade used in a facing edge widening holding device which holds a widening state of the facing edge.

  2. Description of the Related Art There is conventionally known a device (a facing edge spread holding device) that abuts on opposing edge portions and holds a separated state between the edge portions. For example, instruments called retractors and open chests are used to maintain the open state of the incision during surgery. As such a retractor, there exist some which were disclosed by patent documents 1 to 4, for example.

  The retractor disclosed in Patent Document 1 includes a fixed arm and a movable arm on which a protruding piece is formed, and a bent piece is formed at an end of the protruding piece. Also, the separation distance between the projecting pieces can be changed to a desired distance.

  The medical retractor disclosed in Patent Document 2 includes a rail, a stationary arm provided at an end of the rail, and a movable arm sliding on the rail. Also, at the tip of each arm, a blade is provided that abuts soft tissue.

  When using a retractor such as these, the retractor is exposed to the incision so that the bent pieces (blades) contact body tissue, and the distance between the protruding pieces is adjusted to a desired distance. Thereby, the expanded state of the body tissue can be maintained.

Unexamined-Japanese-Patent No. 9-299373 Utility model registration No. 3077381 Japanese Patent Publication No. 2000-507146 Japanese Patent Publication No. 2015-506228

  The retractor after being used for surgery needs to be cleaned for the next use. In particular, since the blade is a portion directly in contact with body tissue, careful cleaning is required. However, the retractor disclosed in Patent Literatures 1 and 2 has a structure in which the blade can not be easily removed from the arm, and it takes much time to clean.

  On the other hand, in the retractor disclosed in Patent Literatures 3 and 4, the blade is configured to be removable from the arm. However, in the retractor disclosed in Patent Literatures 3 and 4, the blade needs to be detached from the longitudinal direction of the arm, and the removal of the blade is not easy. Further, in the retractor disclosed in Patent Document 3, the arm is inserted into the through hole formed in the blade in the longitudinal direction (slide direction), so cleaning of the inside of the through hole is not easy. .

  This invention is made in view of the said subject, The objective is to provide the braid | blade for the opposing edge part expansion holding tool which is easy to desorb | desorb with respect to an arm, and is easy to wash | clean.

  An opposing edge spread holding tool for holding an expanded state between adjacent edges in contact with opposite edges, for solving the above problems, comprising: a base portion 1 and a longitudinal direction of the base portion And a pair of arms 4 provided in a direction orthogonal to the above and having an adjustable distance between each other in the longitudinal direction, and a blade for a facing edge spread holding device used for a facing edge spread holding device In one of the preferred embodiments of the present invention 5, the contact portion 51 in contact with the edge B and the fixed portion 53 fixed to the arm by inserting the arm 4 are provided. An opening 55 is provided on the side opposite to the side abutting against the edge.

  In this configuration, the opening formed in the portion to be fixed opens laterally, that is, to the short side of the arm, so that the arm can be detached from the arm from the side. In addition, since the opening direction of the opening is opposite to the side in contact with the edge, the closing force of the edge acts on the blade so that the blade is not easily detached from the arm.

  In one of the preferred embodiments of the blade for an opposed edge spread holding tool according to the present invention, the fixed portion is formed in a substantially U-shape in a horizontal direction in the longitudinal direction of the arm, and the contact portion and the fixed portion are fixed. The department is connected in a single stroke.

  By configuring the contact portion and the fixing portion in this manner, it is possible to form from the plate-like material, and the manufacturing cost can be reduced.

  The blade for the opposed edge spread holding device according to the present invention can be manufactured from various materials including FRP (Fiber Reinforced Plastics). In the case of using FRP, it is general to use a plurality of thin plate-like molding materials in which a thin layer of a fibrous material called a prepreg is impregnated with a resin. However, it has been found that peeling between the plates and wrinkling of the surface are likely to occur when a prepreg is used to form a blade for an opposed edge spread holding tool whose contact portion has a curved surface shape. There is. The present inventors have found that wrinkles are less likely to occur on the surface if the blade for the opposing edge spread holding tool is formed from alternate piles of non-impregnated fiber layers and resin films.

  Therefore, in one of the preferred embodiments of the blade for an opposed edge spread holding device according to the present invention, the contact portion is formed in a curved surface shape, and alternately accumulated fiber layers not impregnated and resin film. It is molded from multiple layers.

It is a perspective view of a retractor. It is an exploded perspective view of a retractor. It is a side view of a movable arm. (A) Top view of blade, (b) Bottom view of blade, (c) Front view of blade. It is a V-V cross-sectional view of FIG. 1 in a use state.

  Hereinafter, an embodiment of a blade for an opposed edge spread holding tool according to the present invention will be described using the drawings. In the present embodiment, the present invention is applied to a retractor (an example of a facing edge spread holding device) for holding an expanded state of an incision. Therefore, the two side edges of the incision correspond to the opposite edges in the present invention.

  FIG. 1 is a perspective view of a retractor, and FIG. 2 is an exploded perspective view of the retractor. In the following description, a plan view, a front view, a side view and the like are defined by the directions shown in FIG. As shown in the figure, the retractor comprises an angi 1 (corresponding to a base portion in the present invention), a handle 2, a dowel fitting 3, a pair of arms 4 and a pair of blades 5 (opposite edge holding and holding device in the present invention) (Equivalent to a blade).

  The escape 1 is made of a prepreg which is a horizontally long plate-like member. A plurality of valley portions 1 a and peak portions 1 b are alternately formed on one long side of the escape ring 1.

  The handle 2 has a substantially long ladder shape. Both sides of the handle 2 are notched over a predetermined distance from the small diameter end of the handle 2 to form a neck 21. Further, near the end of the neck portion 21, support shafts 22 protruding to both sides are provided.

  The doublet fitting 3 includes a head 31 and a base 33, and a pair of shafts 32 are provided from the bottom of the head 31 to the top of the base 33. The head 31 is substantially cylindrical, and the base 33 is substantially disk-shaped. Further, the diameter of the head 31 is larger than the diameter of the base 33. A pair of shafts 32 are provided at the diametrically opposite ends of the base 33, and the distance between the pair of shafts 32 is configured to match the distance between adjacent valleys 1a of the escapement 1. That is, the pair of shafts 32 is configured to mesh with the valley portion 1 a of the escape wheel 1, and the escape wheel 1 and the doublet fitting 3 constitute a so-called rack and pinion. Although two shafts 32 are provided in the present embodiment, the number of shafts 32 can also be increased. In that case, the valley portion 1a and the peak portion 1b may be adapted to the configuration of the shaft 32. Further, a support groove 31a and an insertion groove 31b are formed on the upper surface of the head 31 so as to cross in a cross shape.

  As shown in FIG. 1, the support groove 31 a is configured such that the support shaft 22 of the handle 2 is inserted and the support shaft 22 is supported. Therefore, in the state where the support shaft 22 of the handle 2 is inserted into the support groove 31a, the handle can be swung about the axial center of the support shaft 22.

  Further, as shown in FIG. 1, the insertion groove 31 b is configured such that the neck portion 21 of the handle 2 is inserted in a state in which the handle 2 is turned down. Therefore, when the handle 2 is rotated about the axial center of the dodget 3 in a state where the handle 2 is turned down, the dodget 3 also rotates together. As described above, since the gangue 1 and the dajet fitting 3 constitute a rack and pinion, the dajet fitting 3 linearly moves along the longitudinal direction of the base portion along with its rotation. Specifically, when the handle 2 is rotated clockwise, the docket fitting 3 moves in the right direction in FIG. 1, and when the handle 2 is rotated counterclockwise, the docket fitting 3 moves in the left direction in FIG.

  The arm 4 is composed of a movable arm 4a and a fixed arm 4b. The fixed arm 4 b is fixed to one end of the mounting 1. On the other hand, the movable arm 4 a is configured to be able to slide along the longitudinal direction of the escape 1. Therefore, it is possible to change the distance between the movable arm 4a and the fixed arm 4b.

  The arm 4 includes a base 41 supported by the escape 1, and a support 42 extending from the base 41 in a direction perpendicular to the longitudinal direction of the escape 1. The support portion 42 is formed narrower than the base portion 41. Specifically, a constriction is formed on the outer side in a plan view of the connection portion between the base portion 41 and the support portion 42. Moreover, as shown in FIG. 3, the support part 42 is connected to the base 41 so that the front-end | tip part falls.

  A circular hole 41a is formed in the base 41 of the movable arm 4a from the top surface to the bottom surface. The diameter of the circular hole 41 a is adapted to the diameter of the base 33 of the dodget 3. Therefore, when the docket fitting 3 is attached to the circular hole 41a, the base 33 of the docket fitting 3 can pass through the circular hole 41a, but the head 31 can not pass through. Therefore, the dowel fitting 3 is supported on the upper surface of the base 41 of the movable arm 4a.

  In addition, rectangular holes 41 b are formed across both side surfaces of the base 41 of the movable arm 4 a. The rectangular hole 41 b is configured to allow insertion of the escape 1. With such a configuration, when the handle 2 is rotated in a tilted state, the dodget 3 rotates and linearly moves along the longitudinal direction of the escape 1. At this time, the movable arm 4 a also moves along the longitudinal direction of the escape 1. Thereby, the distance between the fixed arm 4b and the movable arm 4a (the distance in the longitudinal direction of the escape 1) can be changed.

  On an upper surface near the approximate center of the support portion 42 of the arm 4, a convex portion 42 a having an elliptical shape in a plan view is formed. The shape and the number of the convex portions 42 a can be changed as appropriate.

  FIGS. 4A, 4B, and 4C are a plan view, a bottom view, and a front view, respectively, of the blade 5. FIG. Although the blade 5 attached to the movable arm 4a and the blade 5 attached to the fixed arm 4b have the same shape, their mounting postures are opposite. FIG. 4 shows the blade 5 in a posture to be attached to the movable arm 4a.

  As shown in FIG. 4C, the blade 5 includes an abutting portion 51, a jaw 52, and a fixed portion 53. The contact portion 51 is formed in a substantially vertical direction, and is a portion that contacts body tissue during use. The jaws 52 extend from the lower end of the contact portion 51 in a substantially horizontal direction (a direction substantially perpendicular to the contact portion 51) and contact the lower portion of the edge of the body tissue to make it difficult for the blade 5 to come out of the incisional wound It has a function.

  Specifically, as shown in FIGS. 4A and 4B, the plan view shape of the contact portion 51 is formed in a circular arc shape convex toward the opening 54 (described later). Further, as shown in FIG. 4C, the front view shape of the contact portion 51 is also formed in the shape of a loose circular arc convex to the opening 54. That is, it has a template. Furthermore, similarly to the contact portion 51, the tip end portion of the jaw portion 52 is also formed in a convex arc shape at the opening 54. That is, the contact portion 51 is formed in a curved shape both in the longitudinal direction and in the longitudinal direction. Since the edge when expanding the incision is circular, the load applied to the contact portion becomes relatively uniform by configuring the contact portion 51 and the jaw portion 52 in this way, and the contact portion It can be in a gentle contact state.

  The to-be-fixed part 53 is a part fixed to the support part 42 of the arm 4, and the front view shape is formed in the substantially U shape of horizontal direction. The fixed portion 53 of the present embodiment includes a bottom wall 53a, a side wall 53b, and an upper wall 53c. The bottom wall 53 a is flat and extends from the upper end of the contact portion 51 in substantially the same direction as the jaws 52. The side wall 53b is flat and extends vertically upward from the end of the bottom wall 53a. The upper wall 53c is extended in the opposite direction to the bottom wall 53a so as to be folded back from the upper end of the side wall 53b. The distance from the upper surface of the bottom wall 53a to the bottom surface of the upper wall 53c is slightly larger than the thickness of the flat portion (the portion where the convex portion 42a is not formed) of the support portion 42 of the arm 4 It is configured to be slightly smaller than the thickness of the portion where the portion 42a is formed. In the present invention, the substantially U shape is a shape in which one of four directions is open, and any other specific shape is not particularly limited.

  By configuring the blade 5 in this manner, the front view shape of the blade 5 becomes substantially S-shaped, and two openings 54 and 55 opening toward the side are formed, and the opening directions thereof are opposite to each other. It has become. In this figure, the opening 54 is to the right and the upper opening 55 is to the left. As described above, since the front view shape of the blade 5 is substantially S-shaped, that is, a single-stroke writing shape, the blade 5 is formed from alternate stacked layers of a resin layer and a fiber layer not impregnated with resin. be able to. This can reduce the production cost. Such a configuration is also advantageous in terms of strength as compared to the case where the fixed portion 53 and the contact portion 51 are fixed by adhesion or the like.

  The blade 5 can be made of various materials including metal materials such as titanium alloy and reinforced plastic. In the present embodiment, the blade 5 is made of a composite material containing a fibrous material not impregnated with a resin or the like. Carbon fiber etc. are used as a fibrous material. Specifically, a material in which a layer of carbon fiber and a layer of PEEK (polyether ether ketone) resin are alternately laminated is heated and pressed to form the above-described shape.

  Generally, for molding a reinforced plastic material, a material called a prepreg of a molding material in which a fibrous material is impregnated with a resin or the like and heated to form a semi-cured plate is used. However, the blade 5 in the present embodiment, in particular, the contact portion 51 has a curved surface structure in two directions, and when a molded product having such a curved surface structure is molded using a prepreg, wrinkles are easily generated on the surface. Is known. Therefore, the present inventors apply a composite material in which a fibrous material (fiber layer) not impregnated with resin or the like and a resin film are alternately laminated to all or part of the blade. It has been found that heat and pressure can be used to reduce surface wrinkles, and the blade 5 according to the present invention has been created.

  Next, a method of assembling the retractor according to the present embodiment will be described with reference to FIG. First, the support shaft 22 of the handle 2 is fitted into the support groove 31 a of the dowel fitting 3. Next, the base 33 of the dodget 3 is inserted into the circular hole 41a of the movable arm 4a. At this time, the attitude of the dowel fitting 3 is adjusted so that the pair of shafts 32 of the dowel fitting 3 are aligned in the longitudinal direction of the arm 4, that is, in the direction orthogonal to the longitudinal direction of the escapement 1. In this manner, the escape 1 is inserted into the rectangular hole 41b of the movable arm 4a in which the dodget 3 and the handle 2 are assembled. At this time, one of the shafts 32 abuts on the end of the escapement 1, and insertion of the escapement 1 is inhibited. In this state, when the handle 2 is rotated clockwise, the shaft 32 engages with the valley portion 1 a of the escapement 1, and the rotation is converted to the linear movement of the movable arm 4 a via the dajet fitting 3. As a result, the steering wheel 1 is inserted into the receiving hole 41a of the movable arm 4a, and the movable arm 4a moves in the direction approaching the fixed arm 4b.

  In this manner, when the movable arms 4 a are assembled to the escape wheel 1, the blades 5 are attached to the respective arms 4. As described above, the fixed portion 53 of the blade 5 is formed with the opening 55 opened to the side, so the blade 5 is in the lateral direction (direction orthogonal to the longitudinal direction of the arm 4) with respect to the arm 4 Can be inserted. In FIG. 2, each blade 5 can be inserted from the outside of the arm 4.

  When the blade 5 is inserted into the arm 4, the convex portion 42 a of the arm 4 abuts on the lower surface of the upper wall 53 c of the fixed portion 53 to lift the upper wall 53 c slightly upward. At this time, a force to elastically return downward is generated on the upper wall 53c, so the support portion 42 of the arm 4 is sandwiched by the bottom wall 53a and the upper wall 53c of the fixed portion 53. Thereby, the blade 5 can be fixed to the arm 4.

  FIG. 5 is a view of using the retractor according to the present embodiment to hold the expanded state of the peripheral portion of the body tissue B on both sides of the incision, and the retractor is represented by the VV cross section in FIG. ing. As shown in the figure, the edge portion of the body tissue B abuts on the contact portion 51 of the blade 5, and the expanded state of the edge portion of the body tissue B is maintained. Generally, the edge of the incised and expanded body tissue B is in an arc shape, but as described above, since the contact portion 51 of the blade 5 is configured in an arc shape in plan view, a straight line The force applied to each position of the peripheral edge portion of the body tissue B is likely to be equalized as compared with the contact portion configured above.

  In order to close the peripheral edge of the body tissue B, an inward force acts on the contact portion 51 of the blade 5. At this time, since the jaws 52 of the blade 5 abut on the lower surface of the peripheral portion of the body tissue B, the blade 5 is difficult to come out of the incision. At the same time, the blade 5, particularly the fixed portion 53, is pressed to the arm 4 side, but the opening direction of the opening 55 formed in the fixed portion 53 of the blade 5 is the direction in which the peripheral portion of the body tissue B is closed. Therefore, when the side wall 53 b of the fixed portion 53 abuts on the arm 4, the blade 5 is not detached from the arm 4.

  On the other hand, when the blade 5 is pulled in the direction opposite to the opening direction of the opening 55, the blade 5 can be easily removed from the retractor. Further, since the blade 5 has a simple configuration as described above, it can be easily cleaned and sterilized everywhere.

  Also, in recent years, a facility called a hybrid operating room has been developed in which an operating room and an X-ray imaging apparatus are combined. In this hybrid operating room, radiography and surgery can be performed in parallel. However, since the conventional retractor is made of stainless steel or titanium, X-ray transmission is low, and it interferes with observation of an affected area or the like during X-ray imaging. On the other hand, since the blade 5 in the present embodiment is made of a composite material containing a carbon fibrous material, the X-ray permeability is high, and the observation of the affected area is less likely to occur.

  Furthermore, the blade 5 as in the present embodiment contributes not only to the advantages at the time of X-ray imaging but also to weight reduction. The weight of the conventional titanium alloy retractor was about 1100 g, but if the blade 5 is configured as described above and the gangue 1, the arm 4 etc. are composed of FRP using PEEK resin, the weight is about 380 g. It is confirmed by the research of the inventor of the present invention that it is possible to reduce the weight.

  Thus, according to the blade 5 in the present embodiment, desorption and cleaning of the arm 4 are facilitated. In addition to achieving weight reduction, interference with X-ray imaging is reduced.

[Another embodiment]
(1) The contact portion 51, the jaws 52 or the fixed portion 53 of the blade 5 may be divided in the longitudinal direction of the blade 5.

(2) On the side of the opening 55 of the fixed portion 53 of the blade 5, by coming into contact with the outer side of the support portion 42 of the arm 4, a detachment prevention may be provided to prevent inadvertent detachment. For example, a claw projecting downward can be provided at the opening 55 side end portion of the lower surface of the upper wall 53c.

(3) The distance between the upper surface of the bottom wall 53a of the fixed portion 53 and the lower surface of the upper wall 53c can be larger on the opening 55 side. Thereby, insertion of the arm 4 to the to-be-fixed part 53 becomes easy. However, since the fixation of the blade 5 to the arm 4 becomes weak if the distance difference becomes too large, it is desirable that the distance difference be small.

(4) In the above-mentioned embodiment, although braid 5 was fabricated using a material in which a carbon fiber layer not impregnated and a resin film are alternately laminated, it may be replaced with carbon fiber depending on the application, such as glass fiber Other fibrous materials may be used.

(5) In the above embodiment, the fixed portion 53 of the blade 5 is directly extended from the end of the contact portion 51. However, the fixed portion 53 is indirectly extended from the end of the contact portion 51 It does not matter as a structure provided. In other words, another component may be provided between the upper end of the contact portion 51 and the end of the bottom wall 53 a of the fixed portion 53. At this time, in front view, it is preferable that the fixed portion 53 be continuously provided from the contact portion 51 in the shape of a single stroke, since the blade 5 can be formed from the above-described multiple stacked layers.

(6) In the above embodiment, the blade 5 is formed using a multi-layered material, but the contact portion 51 and the fixed portion 53 are formed by separate members, and the blade 5 is configured by fixing them. You can also By the way, the retractor to which the present invention is applied is assumed to include a thoracotomy and an opener.

B: Edge portion (body structure) 1: Ongi (base portion) 4: Arm 4a: Movable arm 4b: Fixed arm 5: Blade (blade for opposed edge spread holding tool) 51: Contact portion 53: Fixed portion 55: Opening.

Claims (3)

An opposite edge spread holding tool which abuts on an opposite edge to hold a spread state between the edges, the base extends in a direction orthogonal to the longitudinal direction of the base, and the length A blade for an opposed edge spread holding device used for an opposed edge spread holding device comprising: a pair of arms provided so as to adjust the distance between them in the direction.
An abutment portion that abuts the edge portion;
And a fixed portion fixed to the arm by inserting the arm.
The blade for an opposed edge spread holding tool, the fixed portion includes an opening that opens on the opposite side to the side in contact with the edge portion. In the longitudinal view of the arm,
The to-be-fixed portion is formed in a substantially U-shape in the lateral direction,
The blade according to claim 1, wherein the contact portion and the fixed portion are connected in a single stroke. The contact portion is formed in a curved shape,
3. A blade according to claim 1, wherein all or part of the blade is formed of alternating layers of non-impregnated fiber layers and resin films.