JP3884046B2 - Surgical instruments - Google Patents

Description

  The present invention relates to surgical instruments such as forceps and scissors, and more particularly to surgical instruments suitable for use in laparoscopic surgery.

  A forceps having a configuration in which a forceps mechanism provided at a distal end is remotely operated by an operation portion on a proximal end side is known (see Patent Document 1). This forceps has a forceps mechanism composed of a pair of claw members that can be opened and closed at the distal end, and rotates at a proximal end portion of a transmission shaft connected to the forceps mechanism in a direction toward and away from the fixed grip portion. A claw operating means comprising a movable rotating gripping portion is provided, and by rotating the rotating gripping portion of the claw operating means, the transmission rod built in the transmission shaft is pulled and moved in the longitudinal direction. The claw member is configured to open and close.

  By the way, in recent years, laparoscopic surgery, which performs non-laparotomy, is attracting attention in place of appendectomy and gallbladder excision. In this laparoscopic surgery, as shown in FIG. 16, for example, four trocar tubes 107 are inserted into the abdominal cavity 101 through the abdominal wall 100 and inserted through one of the trocar tubes 107. The inside of the abdominal cavity 101 is projected on the monitor image 103 by the camera (endoscope) 102, and the forceps 104, the heel 105 and the electric knife 106 inserted through the other trocar tubes 107 are appropriately operated while viewing the monitor image 103. Thus, a desired surgical procedure is performed within the abdominal cavity 101.

  In such laparoscopic surgery, the trocar tube 107, which is a straight tube, is penetrated and fixed to the abdominal wall 100, and the angle of the trocar tube 107 with respect to the abdominal wall 100 can hardly be changed to protect the tissue of the penetrating portion. Therefore, each of the forceps 104, the scissors 105, and the electric knife 106 has a problem that the region where surgical treatment is possible is limited to a narrow range.

  Therefore, as a method for solving the above problem, for example, after inserting the forceps 104 into the trocar tube 107, the vicinity of the distal end of the long instrument body (transmission shaft) 108 of the forceps 104 is bent or curved (indicated by a one-dot chain line in FIG. 16). It has been proposed to expand the reach of the distal forceps mechanism by combining with the rotation of the forceps 104.

  However, with this method, the bending angle when the long instrument body is bent or bent cannot be made sufficiently large, and the distance from the bending point of the instrument body to the forceps mechanism at the tip tends to increase. Therefore, when the forceps 104 is inserted into a trocar tube perpendicular to the organ surface 109, a gripping operation in a direction parallel to the organ surface 109 cannot be performed immediately below the trocar tube.

Japanese Utility Model Publication No. 5-76413

  An object of the present invention is to provide a surgical instrument capable of performing a surgical procedure in an appropriate posture.

Such an object is achieved by the present inventions (1) to (7) below.
(1) a long instrument body;
A head part provided at the tip of the instrument body so as to be rotatable about a rotation axis substantially orthogonal to the axis of the instrument body;
Surgical operation means that is supported on the head portion by a rotation shaft that is in a torsional position relative to the rotation axis of the head portion, and that opens and closes or rotates around the rotation shaft;
An operation unit that is provided on the proximal end side of the instrument main body and remotely controls the rotation of the head unit and the operation of the surgical operation means;
First transmission means for transmitting an operation at the operation unit and converting the operation into a rotation operation of the head unit;
Regardless of the posture of the head portion, the second transmission means transmits the operation at the operation portion and converts the surgical operation means into an opening / closing or turning operation.
The second transmission means has at least one protruding contact located on or near the axis of the rotation axis of the head portion, and a tapered shape inclined with respect to the axis of the instrument body, And a second push rod having a pressing surface for pressing and moving at the tip, and the surgical operation means is moved around the rotation axis of the surgical operation means by moving the contact point on the pressing surface. A surgical instrument configured to open, close or rotate.

  (2) The surgical instrument according to (1), wherein the contact point is provided on a proximal end side with respect to the rotation shaft of the surgical operation means.

  (3) The surgical instrument according to (1) or (2), wherein the contact has a hemispherical shape.

  (4) The surgical instrument according to any one of (1) to (3), wherein the operation unit has a function of setting and maintaining an opening degree of the surgical operation means.

  (5) The surgical instrument according to any one of (1) to (4), further including an angle setting unit that sets and holds the rotation angle of the head unit.

  (6) The surgical instrument according to any one of (1) to (5), wherein the rotation shaft for rotating the head portion with respect to the instrument body is provided in the vicinity of the surgical operation means. .

  (7) The surgical instrument according to any one of (1) to (6), wherein the head portion is rotatable by approximately 90 ° with respect to the instrument body.

  According to the surgical instrument of the present invention, the operability of the rotation operation of the head portion and the drive operation of the surgical operation means is excellent, and in particular, regardless of the posture (rotation angle) of the head portion, The opening / closing or turning operation can be performed by the same operation.

  For this reason, when the surgical instrument of the present invention is used for, for example, laparoscopic surgery, even when the surgical instrument is inserted perpendicularly or at a steep angle with respect to the organ surface, Surgical operation (for example, grasping of living tissue with forceps) can be performed, and the area where surgical treatment is possible is expanded, so that the operability in surgery is greatly improved and the operation time is shortened. I can plan.

  Further, the first transmission means has a pair of first push rods, and the tips of the first push rods are rotatably supported at positions where the head portions are opposed to each other through the axis of the instrument body. In the case where the mechanism is configured, in particular, the operation unit includes a rotation operation member and a conversion unit that converts the rotation operation of the rotation operation member into the movement of the first push rods in the longitudinal direction and in the opposite directions to each other. Thus, the head portion can be easily and reliably rotated.

  Further, the second transmission means includes a protrusion-shaped, particularly hemispherical contact, and a second push rod having a pressing surface that presses and moves the contact at the tip, and the surgical operation means is provided on the pressing surface. If the head and the surgical operation means are in any posture, the contact and the second push rod are reliably in contact with each other and the point contact is made. can do.

  Further, when the contact point is located on or near the axis of the rotation axis of the head unit with respect to the instrument body, the surgical operation means can be reliably opened / closed or rotated regardless of the posture of the head unit. it can.

  In addition, the operability of the surgical instrument is further improved when the angle setting means for setting and holding the rotation angle of the head portion is provided.

  When the rotation axis of the head part with respect to the instrument body is provided in the vicinity of the surgical operation means, particularly when the head part can be rotated about 90 ° relative to the instrument body, the direction of the surgical operation means is changed. It can be changed at a steep angle, and the surgical procedure can be performed reliably and in a proper posture.

Hereinafter, the surgical instrument of the present invention will be described in detail based on a preferred embodiment shown in the accompanying drawings.
FIG. 1 is an overall side view showing an embodiment in which the surgical instrument of the present invention is applied to forceps, and FIGS. 2 and 3 are plan views each showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. FIG. 4 and FIG. 4 are partial cross-sectional plan views, and FIG. 4 and FIG. 5 are plan views each showing a configuration near the distal end portion of the surgical instrument shown in FIG. 1 and the head portion being perpendicular to the axis of the instrument body. FIG. 6 and FIG. 7 are a side view and a partial cross-sectional side view, respectively, showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, and FIG. 8 is a side view of the surgical instrument shown in FIG. FIG. 9 is a partial cross-sectional side view showing a configuration in the vicinity of the distal end portion and showing a state in which the forceps are opened. FIG. 9 is a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. FIG. 10 is a partial cross-sectional side view showing a state in which the forceps is opened at a right angle. FIG. 11 is a partial cross-sectional side view showing a configuration in the vicinity of the distal end portion of the surgical instrument, in which the head portion is perpendicular to the axis of the instrument main body, and FIG. 12 and FIG. 13 are partial cross-sectional side views showing the configuration of the operating portion installed at the proximal end portion of the surgical instrument shown in FIG. 1, respectively, and FIGS. 14 and 15 are the configurations of the distal end portion of the operating portion, respectively. FIG.

  In the following description, the right side in FIG. 1 to FIG. 10 and FIG. 12 to FIG. 15 is referred to as “base end”, and the left side is referred to as “distal end”. Moving is called “retreat”.

  A surgical instrument 1 of the present invention shown in FIG. 1 is a forceps mainly used in laparoscopic surgery, and includes a long instrument body 2 and a head part 3 provided at the distal end of the instrument body 2. A surgical operation means 4 that is provided in the head unit 3 and performs an opening / closing operation or a rotation operation; an operation unit 5 provided on the proximal end side of the instrument main body 2; Regardless of the position (rotation angle) of the head unit 3 and the first transmission unit that converts the rotation unit 3 to the rotation operation, the operation of the operation unit 5 is transmitted and the surgical operation unit 4 is opened and closed or rotated. And a second transmission means for conversion.

  The instrument body 2 is a hollow long member in which a space capable of accommodating push rods 71, 72, 8 and the like to be described later is formed, and a base end thereof is fixed to an operation unit body 51 to be described later. Yes.

  Although the cross-sectional shape of the instrument main body 2 is not specifically limited, for example, a circle, an ellipse, a polygon, etc., Preferably it is set as a circle. In this case, the outer diameter is such that it can be inserted into the trocar tube. Specifically, the outer diameter of the instrument body 2 is preferably about 5 to 18 mm.

  In the configuration shown in the figure, the instrument body 2 is linear in consideration of insertion into the trocar tube, but is not limited to this, and may be curved or bent in a desired shape in advance. . Further, after insertion into the trocar tube, the distal end of the instrument body 2 may be bent or bent into a desired shape.

  As shown in FIGS. 2 to 5, a head portion 3 is rotatably supported at the distal end portion of the instrument body 2. The head portion 3 includes a holder 31, a rotation shaft 32 that protrudes above and below the central portion of the holder 31, and shafts 33 and 34 that are erected on the base end side of the holder 31.

  A pair of opposing tongue pieces 21 are formed at the distal end portion of the instrument body 2, and holes 22 are formed at the distal end portions of the respective tongue pieces 21. Rotating shafts 32 are respectively inserted into these holes 22, whereby the head portion 3 is rotatably supported between both tongue pieces 21. In addition, the maximum angle range in the rotation of the head unit 3 is about ± 90 ° with respect to the shaft 25 of the instrument body 2.

  Each of the shafts 33 and 34 is formed at a position (symmetric) opposite to both sides of the head portion 3, that is, the shaft 25 of the instrument body 2.

  In the instrument body 2, there are a pair of first push rods 71 and 72 for rotating the head portion 3, and a second push rod 8 for opening / closing or rotating the surgical operation means 4. It is accommodated so as to be movable in the longitudinal direction. In this case, the first push rods 71 and 72 are arranged to face each other via the shaft 25, and the first push rod 71 is located on the front side of the paper surface of FIG. The 1 push rod 72 is displaced and arranged on the back side of the paper surface. The second push rod 8 is disposed on the center of the instrument body 2, that is, on the shaft 25.

  The distal ends of the first push rods 71 and 72 are supported so as to be rotatable with respect to the holder 31 by shafts 33 and 34, respectively. Thereby, a link mechanism is comprised by both the 1st push rods 71 and 72 and the holder 31 which connects those front-end | tips. This link mechanism corresponds to the first transmission means.

  In addition, the shafts 33 and 34 which are connecting portions to the first push rods 71 and 72 are provided on the upper surface (front side of the paper surface of FIG. 3) and the lower surface (back side of the paper surface of FIG. 3) of the holder 31, respectively. As shown in FIG. 5, the first push rods 71 and 72 are configured not to interfere when the head portion 3 rotates (bends).

  Further, as shown in FIGS. 7 to 9, a pair of upper and lower tapered pressing surfaces 81 are formed at the tip of the second push rod 8. A pair of contact points 45 provided at the proximal end portion of the surgical operation means 4 to be described later abut on these pressing surfaces 81. These contact points 45 and the second push rod 8 constitute the second transmission means.

  As shown in FIGS. 6 to 8, the surgical operation means 4 constitutes a forceps mechanism that can hold a living tissue, and a pair of movable holding pieces 41 that are rotatably supported by a shaft 43 with respect to a holder 31. , 42. The leading ends of these movable sandwiching pieces 41 and 42 constitute a gripping portion 44, and minute concavities and convexities for preventing slipping of the gripping object are formed on the inner joint surface thereof.

  On the proximal end side of the shafts 43 of the movable holding pieces 41 and 42, protruding contact points 45 are formed so as to protrude inward. These contact points 45 have a hemispherical shape, and a part of the spherical surface thereof is in contact with the pressing surface 81. Further, the two contact points 45 are located on or near the axis of the rotary shaft 32 when the movable holding pieces 41 and 42 are in the open state (the two contact points 45 are in contact with or approaching each other) (FIGS. 8 and 9). reference).

  Moreover, the movable clamping pieces 41 and 42 are always urged in the direction in which they are opened by an urging means (not shown), whereby each contact point 45 is in contact with the pressing surface 81. Examples of the urging means include a structure utilizing the attraction force or repulsion force of various springs and magnets.

  The length from the rotation axis of the head portion 3 to the instrument body 2 to the tip of the instrument, that is, the length from the center of the rotation axis 32 to the tip of the surgical operation means 4 is not particularly limited, but for example 9 to 20 mm, preferably 15 It is about ~ 17mm. With such a length, the direction of the surgical operation means 4 can be changed at a steep angle even immediately below the trocar tube, and the surgical procedure can be performed in an appropriate posture.

  As shown in FIGS. 12 and 13, on the proximal end side of the instrument main body 2, an operation unit 5 for remotely operating the rotation operation of the head unit 3 and the opening / closing of the surgical operation means 4 is provided. The operation unit 5 includes an operation unit main body (casing) 51, a dial 52 that rotates the head unit 3, a handle unit 53 that operates the surgical operation means 4, a ratchet release handle 54, and a ratchet 55. It is configured. The operation unit 5 is provided with angle setting means 6 for setting and holding the rotation angle of the head unit 3.

  The distal end of the operation unit main body 51 is connected and fixed to the proximal end of the instrument main body 2, and the first push rods 71 and 72 inserted into the instrument main body 2 and the proximal end of the second push rod 8 are The operation portion 51 is extended to the inside.

  On the base end side of the first push rods 71 and 72, a dial (rotation operation member) 52 that rotates about the second push rod 8 as a rotation axis is provided. Further, a cam member 521 having a tapered cam surface 522 that is inclined at a predetermined angle with respect to the rotation axis of the dial 52 is fixed to the surface on the distal end side of the dial 52. For example, the cam surface 522 is configured by a cut surface obtained by cutting the middle of the cylindrical body with a surface that is not parallel to the bottom surface.

  On the other hand, first push rods 71 and 72 have base end portions formed with first push rod positioning convex portions 73, respectively. Both convex portions 73 are installed in the operation portion main body 51. One end of the coil spring 56 in the compressed state is locked. Thus, the first push rods 71 and 72 are urged toward the base end side by the elastic force of the coil spring 56, and the base ends thereof are pressed against the cam surface 522. The cam member 521, the both convex portions 73, and the two coil springs 56 constitute conversion means for converting the rotation operation of the dial 52 into the movement of the first push rods 71, 72 in the longitudinal direction and in the opposite directions.

  Note that minute irregularities (knurls) for preventing slippage are formed on the outer peripheral surface of the dial 52.

  When the dial 52 is rotated, the cam surface 522 is also rotated at the same time, and one of the first push rods 71 and 72 whose base end is in contact with the cam surface 522 is advanced, and the other is retracted. Thereby, the head part 3 rotates by the said link mechanism in the front-end | tip part of the instrument main body 2. FIG.

  An angle setting means 6 is provided on the base end side of the dial 52. The angle setting means 6 constitutes a click mechanism when the dial 52 is rotated. The angle setting means 6 is installed on the slider 61 and a slider 61 that can slide in the longitudinal direction of the second push rod 8 along a guide (not shown). And a plurality of holes 64 formed at equal intervals along the circumferential direction of the dial on the base end surface of the dial 52. . The distal end portion of the plunger 62 is rounded and is selectively inserted into each hole 64 as the dial 52 rotates.

  The slider 61 is urged by the spring 63 and pressed toward the distal end, and the distal end of the plunger 62 comes into contact with the base end surface of the dial 52. When the plunger 62 and the hole 64 coincide with each other when the dial 52 rotates, The plunger 62 is inserted into the hole 64, whereby the rotation of the dial 52 is temporarily stopped and positioning is performed. When the rotation of the dial 52 is stopped, the movement of the first push rods 71 and 72 is also stopped, and the rotation angle of the head unit 3 is fixed. When the dial 52 is rotated again, the slider 61 moves against the biasing force of the spring 63, and the dial 52 rotates until the plunger 62 comes out of the hole 64 and is inserted into the next adjacent hole 64. To do. Thereafter, this operation is repeated.

  The handle portion 53 includes a fixed handle 532 that is fixed to or integrally with the operation portion main body 51, and a movable handle 533 that opens and closes (rotates) with respect to the fixed handle 532. The movable handle 533 is rotatably attached to the operation unit main body 51 by a shaft member 531 and is urged clockwise in FIG. 12 by a torsion spring 536 so that the handle is always kept open. .

  A long hole 534 and a ratchet engaging claw 535 are formed at the upper end of the movable handle 533 in FIGS.

  A pin 82 protruding from the proximal end of the second push rod 8 is inserted into the long hole 534. The claw 535 is inserted into a ratchet hole 551 formed in the ratchet 55 described later.

  The ratchet 55 has a function of restricting the rotation of the movable handle 533 and setting and holding the rotation angle, that is, the opening degree (gripping force) of the movable holding pieces 41 and 42 as desired. The ratchet 55 is composed of a T-shaped plate piece, and is attached to the operation unit main body 51 so as to be displaceable in the vertical direction on the paper surface of FIG.

  Further, the ratchet 55 is formed with a ratchet hole portion 551 made up of a plurality of grooves arranged along the movement locus of the claw 535 when the movable handle 533 is rotated. And the ratchet 55 is always urged | biased to the back | inner side of the paper surface of FIG. 12 by biasing members (not shown), such as a spring, so that the nail | claw 535 may be inserted in the groove | channel of the ratchet hole 551. .

  A ratchet release handle 54 is supported by a shaft 541 so as to be rotatable with respect to the operation portion main body 51 in the vicinity of the tip end side of the ratchet 55. The ratchet release handle 54 is urged clockwise in FIG. 12 by a spring 543.

  A taper surface 542 whose height (thickness in a direction perpendicular to the paper surface of FIG. 12) gradually increases toward the base end is formed in the middle of the ratchet release handle 54. The ratchet release handle 54 is shown in FIG. When it is turned counterclockwise, the tapered surface 542 presses the tip of the ratchet 55 and displaces the ratchet 55 toward the front side of the paper surface. Thereby, the nail | claw 535 will remove | deviate from the ratchet hole part 551, and the movable handle 533 can be freely rotated now. Next, the operation of the surgical instrument 1 will be described.

[1] Rotation operation of the head unit 3 As shown in FIGS. 14 and 15, for example, when the dial 52 is rotated in a predetermined direction with the index finger of the hand holding the handle unit 53, the first push is performed according to the rotation angle. The contact position of the base ends of the rods 71 and 72 with the cam surface 522 changes. Accordingly, the first push rods 71 and 72 move in the longitudinal direction of the instrument body 2 in opposite directions.

  The rotation angle of the dial 52 is set and held by inserting the distal end portion of the plunger 62 into the hole 64. Therefore, the longitudinal position of the first push rods 71 and 72 and the rotation angle of the head portion 3 are also set. , Set and retained.

  When the first push rod 71 moves forward and the first push rod 72 moves backward as shown in FIG. 14 by the rotation operation of the dial 52, the distal end portion of the instrument body 2 is shown in FIGS. 4 and 5. As described above, the head 3 is rotated clockwise by the displacement of the shafts 33 and 34 in the link mechanism. In this case, the maximum rotation angle of the head unit 3 is set so that the angle formed by the center line 46 of the surgical operation means 4 and the shaft 25 is about + 90 °.

  Further, when the first push rod 71 is retracted and the first push rod 72 is advanced by rotating the dial 52, as shown in FIG. The head portion 3 rotates counterclockwise. In this case, the maximum rotation angle of the head unit 3 is set so that the angle formed by the center line 46 of the surgical operation means 4 and the shaft 25 is about −90 °.

  In the intermediate state (basic state) between the state shown in FIG. 14 and the state shown in FIG. 15, that is, in the state where the longitudinal positions of both base ends of the first push rods 71 and 72 coincide, as shown in FIG. The head part 3 faces in the same direction as the instrument body 2 (the center line 46 and the axis 25 coincide).

[2] Opening / closing operation of surgical operation means 4 As shown in FIGS. 8 and 13, the movable handle 533 is opened and the movable clamping pieces 41, 42 are opened. The movable handle 533 is rotated counterclockwise in FIG. 13 against the urging force (a state indicated by a dotted line in FIG. 13). Thereby, the edge part of the long hole 534 formed in the edge part of the movable handle 533 presses the pin 82 to a front end direction, and the 2nd push rod 8 advances. As the second push rod 8 moves forward, as shown in FIGS. 6 and 7, the pressing surface 81 at the tip of the second push rod 8 presses the corresponding contact 45, and the both contacts 45 follow the pressing surface 81. Accordingly, the movable clamping pieces 41 and 42 are closed, and a surgical operation is performed.

  As the movable handle 533 is rotated, the claws 535 formed at the end of the movable handle 533 are sequentially inserted into the grooves of the ratchet hole 551. It fits in the groove and is not allowed to move in the opposite direction. That is, the movable clamping pieces 41 and 42 are prohibited from rotating in the opening direction.

  At this time, for example, when the ratchet release handle 54 is rotated counterclockwise in FIG. 12 with the index finger of the hand holding the handle portion 53, the tapered surface 542 presses the tip of the ratchet 55, and the ratchet 55 is The claw 535 is disengaged from the ratchet hole 551. As a result, the restriction on the rotation of the movable handle 533 is released, and when the gripping force of the handle portion 53 is reduced, the movable handle 533 is rotated clockwise by the urging force of the torsion spring 536 to be opened originally. Return to state. Accordingly, the second push rod 8 is retracted, and the pressing of the contact 45 by the pressing surface 81 is released, so that the movable clamping pieces 41 and 42 are opened again by the action of a biasing means (not shown).

  As described above, the opening and closing of the movable holding pieces 41 and 42 is interlocked with the opening and closing operation of the movable handle 533, and the opening degree (gripping force) of both the movable holding pieces 41 and 42 is determined by the fixed handle 532 and the movable handle 533. It corresponds to the opening of.

[3] Opening / closing operation of the surgical operation means 4 when the head section 3 is bent FIGS. 9 and 10 respectively show the surgical operation means when the head section 3 shown in FIG. FIG. 3 is a partial cross-sectional side view in an open state and a closed state.

  As described above, both the contacts 45 are hemispherical, and they are located on the axis of the rotary shaft 32 when the movable holding pieces 41 and 42 are in the open state. Even if it is bent with respect to 2, as shown in FIG. 9, the positional relationship between the pressing surfaces 81 and the corresponding contacts 45 does not change. Therefore, when the movable handle 533 is rotated and the second push rod 8 is advanced in this state in the same manner as described above, both the contacts 45 move in a direction away from each other on the pressing surface 81 as shown in FIG. Accordingly, the movable clamping pieces 41 and 42 are closed, and a surgical operation is performed. The same applies to the case where the movable handle 533 is rotated in the opposite direction to retract the second push rod 8 and the movable clamping pieces 41 and 42 are opened.

  Such an opening / closing operation of the movable clamping pieces 41, 42 can be performed regardless of the rotation angle of the head portion 3, that is, the direction of the surgical operation means 4, and its operability and responsiveness are also constant.

  As mentioned above, although the surgical instrument of this invention was demonstrated about the Example shown in figure, this invention is not limited to these. For example, the structure of the surgical operation means 4 is composed of a pair of opening / closing members that are driven and opened by one side, that is, a fixed holding piece and a movable holding piece that rotates with respect to the fixed holding piece. Also good. Further, the configuration is not limited to rotation, and for example, a configuration that opens and closes by parallel movement may be used. Furthermore, it may have a configuration in which one member rotates, such as a bowing forceps, an electric knife, and an ultrasonic knife.

  Further, the first transmission means and the second transmission means are not limited to the configuration shown in the figure, and for example, a pair of pulling wires may be used instead of the pair of first push rods.

  The type of surgical instrument of the present invention is not limited to forceps, and may be, for example, scissors such as scissors, ligators, needle holders, electric scalpels, ultrasonic scalpels, and laser scalpels. In addition, the application is not limited to that used for laparoscopic surgery, and can be applied to other operations such as brain surgery, thoracoscopic surgery, urological surgery, and the like.

It is a whole side view which shows the Example at the time of applying the surgical instrument of this invention to forceps. It is a top view which shows the structure of the front-end | tip part vicinity of the surgical instrument shown in FIG. FIG. 2 is a partial cross-sectional plan view showing a configuration in the vicinity of a distal end portion of the surgical instrument shown in FIG. 1. FIG. 2 is a plan view showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, wherein the head portion is bent at a right angle with respect to the axis of the instrument body. FIG. 2 is a partial cross-sectional plan view showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, wherein the head portion is bent at a right angle to the axis of the instrument body. It is a side view which shows the structure of the front-end | tip part vicinity of the surgical instrument shown in FIG. It is a partial cross section side view which shows the structure of the front-end | tip part vicinity of the surgical instrument shown in FIG. FIG. 2 is a partial cross-sectional side view showing a configuration in the vicinity of a distal end portion of the surgical instrument shown in FIG. FIG. 2 is a partial cross-sectional side view showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, wherein the head portion is bent at right angles to the axis of the instrument body and the forceps are opened. FIG. 2 is a partial cross-sectional side view showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, wherein the head portion is bent at a right angle with respect to the axis of the instrument body. It is a perspective view which shows the structural example of the dial in this invention. It is a partial cross section side view which shows the structure of the operation part installed in the base end part of the surgical instrument shown in FIG. It is a fragmentary sectional side view which shows the operation state of the handle part in the operation part installed in the base end part of the surgical instrument shown in FIG. It is a fragmentary sectional side view which shows the structure of the front-end | tip part of the operation part shown in FIG. It is a fragmentary sectional side view which shows the structure of the front-end | tip part of the operation part shown in FIG. It is sectional drawing which shows the state of a laparoscopic surgery typically.

Explanation of symbols

1 Surgical instruments (forceps)
2 Instrument body 21 Tongue piece 22 Hole 25 Axis 3 Head part 31 Holder 32 Rotating axis 33, 34 Axis 4 Surgical operation means 41, 42 Movable clamping piece 43 Axis 44 Grasping part 45 Contact 46 Center line 5 Operation part 51 Operation part body 52 Dial 521 Cam member 522 Cam surface 53 Handle portion 531 Shaft member 532 Fixed handle 533 Movable handle 534 Long hole 535 Claw 536 Torsion spring 54 Ratchet release handle 541 Shaft 542 Taper surface 543 Spring 55 Ratchet 551 Ratchet hole angle 56 Spring 6 Means 61 Slider 62 Plunger 63 Spring 64 Hole 71, 72 First push rod 73 Protrusion 8 Second push rod 81 Pressing surface 82 Pin 100 Abdominal wall 101 Abdominal cavity 102 Small camera 103 Monitor image 104 Forceps 1 5 scissors 106 electric knife 107 trocar tube 108 instrument body 109 organ surface

Claims (7)

A long instrument body,
A head part provided at the tip of the instrument body so as to be rotatable about a rotation axis substantially orthogonal to the axis of the instrument body;
Surgical operation means that is supported on the head portion by a rotation shaft that is in a torsional position relative to the rotation axis of the head portion, and that opens and closes or rotates around the rotation shaft;
An operation unit that is provided on the proximal end side of the instrument main body and remotely controls the rotation of the head unit and the operation of the surgical operation means;
First transmission means for transmitting an operation at the operation unit and converting the operation into a rotation operation of the head unit;
Regardless of the posture of the head portion, the second transmission means for transmitting the operation in the operation section and converting the surgical operation means into an opening / closing or turning operation,
The second transmission means has at least one protruding contact located on or near the axis of the rotation axis of the head portion, and a tapered shape inclined with respect to the axis of the instrument body, And a second push rod having a pressing surface for pressing and moving at the tip, and the surgical operation means is moved around the rotation axis of the surgical operation means by moving the contact point on the pressing surface. A surgical instrument configured to open, close or rotate.   The surgical instrument according to claim 1, wherein the contact point is provided on a proximal end side with respect to the rotation shaft of the surgical operation means.   The surgical instrument according to claim 1 or 2, wherein the contact has a hemispherical shape.   The surgical instrument according to any one of claims 1 to 3, wherein the operation unit has a function of setting and maintaining an opening degree of the surgical operation means.   The surgical instrument according to any one of claims 1 to 4, further comprising angle setting means for setting and maintaining a rotation angle of the head portion.   The surgical instrument according to any one of claims 1 to 5, wherein the rotation shaft for rotating the head portion with respect to the instrument body is provided in the vicinity of the surgical operation means.   The surgical instrument according to any one of claims 1 to 6, wherein the head portion is rotatable by approximately 90 ° with respect to the instrument body.

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