JP5457934B2 - Endoscopic grasping forceps - Google Patents

Description

  The present invention relates to a grasping forceps used when excising a disc herniation that has moved greatly to the head side or the tail side in percutaneous endoscopic surgery of the spine.

  Percutaneous endoscopic lumbar disc herniation, which is one of the spinal percutaneous endoscopic operations, inserts a cylindrical rigid outer cylinder with a diameter of 6 to 8 mm into the intervertebral disc by microincision. This is a method in which a scope is installed in an outer cylinder, an image from a camera is projected on a television screen, and the hernia is grasped and extracted with forceps inserted into the outer cylinder while watching it. For insertion into an elongated outer cylinder, the forceps are long and small in diameter and have an outer diameter of 3.5 mm, which is approximately 370 mm long. However, since a strong gripping force and durability are required, the structure of the forceps is limited to a simple one.

  At present, the grasping forceps for hernia extraction that can be inserted into an outer cylinder having a diameter of 6 mm has a single-opening grasping forceps (FIG. 1) that opens only one of the spoon-shaped jaws facing the tip of the forceps, and two jaws. There is a bi-action grasping forceps (FIG. 2) that opens in the opposite direction at the same time. Other than the grasping forceps for hernia extraction, one of the jaws called basket punch forceps (FIG. 3) has a protruding inner blade, and the other jaw has an outer blade with a lumen and accepts the protruding inner blade. There are forceps that can cut tissue and scissors type forceps (FIG. 4).

  The percutaneous endoscope used for the lumbar disc herniation is thin so that it can be inserted into the disc space, but it is an operation near the nerve and a high image quality is required for safety, so it is a rigid endoscope. The movement of the rigid outer cylinder is restricted by the intervertebral foramen, intervertebral discs and vertebral bodies, and it is often impossible to move the tip of the outer cylinder freely in the direction of the head and tail. For this reason, when the hernia piece is away from the tip of the outer cylinder to the side, only the object within the length of the jaw can be reached by opening the one-side gripping forceps (FIG. 1). Moreover, even if the grasping forceps can be opened and the object can be contacted at the tip of the jaw, the object cannot often be slid and grasped when the jaw is closed to be grasped. Although some have a serrated shape with minute jagged lines on the jaw and increase the frictional force, only those that easily peel can still be gripped.

  With gripping forceps, both jaws can be moved and pinched in the same direction, even hernias that are so far away can be gripped, but the structure is complicated, so an outer cylinder with a diameter of 6 mm is used. There is nothing that can be inserted, it becomes a larger diameter and cannot be used.

  Accordingly, an object of the present invention is to make it possible to grasp and extract a wide range of objects with a grasping forceps for removing a herniated disc in percutaneous endoscopic surgery of the spine.

  It consists of a main function part, a cylinder part, and an operation part. The main function part is a curved part where two highly elastic and strongly bent plate-like objects face each other at the end of a long shaft part. There is a pinch part ahead. The cylindrical portion has a rigid and long flexible cylindrical portion at the end of a long and cylindrical cylindrical shaft portion, and a rigid ring portion at the tip thereof. The flexible part has a film bonded to the center side of the fold and is restricted from extending. The cylinder part covers the main function part, and when the cylinder part is pushed out in the distal direction by the operation part, the ring part covers the curved part, and the two pinch parts can approach and be picked. Since the curvatures of the two bent portions are different, the pinch portions are separated from each other when the ring portion does not cover the bent portion. When the cylindrical shaft part covers the entire bent part, it becomes straight and easy to insert into the scope.

  There is a wire & ring type forceps (FIG. 5) as a tissue grasping forceps used in a digestive endoscope, but the structure is greatly different because it is used under a flexible endoscope. The wire is not greatly bent in the same direction as in the present invention, and the portion continuing to the ring is a soft cylinder such as a tension coil spring steel wire. There is no such a long rigid cylindrical structure, and there is no structure that restricts extension to one side like the flexible part.

  Due to the simple structure, even an elongated instrument that can be inserted into a thin spinal percutaneous endoscope can have sufficient gripping force and durability. By bending the bent portion, it is possible to extract an object in a wide range lateral to the axial direction of the outer cylinder.

  The ratio of the length of the flexible part to the entire length of the tube part is small, and because there is a structure that restricts the extension to the center of the flexible part, the ring part can be pulled out and pulled out in a stable position. Since it can be stopped, the gripping force can be increased.

  An embodiment of the present invention will be described with reference to FIGS. As shown in FIG. 6, the main functional part has two high-elasticity bent parts 2 and 3 that are strongly bent in the same direction at the end of the long cylindrical shaft part 1. There are pinch portions 4 and 5 at the ends of the two bent portions 2 and 3, and there is a small sawtooth structure on the sides facing each other. As shown in FIG. 7, the cylindrical portion has a flexible portion 7 that can be bent at the end of a long cylindrical cylindrical shaft portion 6 made of metal, and a rigid annular ring portion 8 at the tip thereof. The flexible portion 7 has a low-strength coil-shaped low-elastic steel wire with no gap, and a low-stretch film is bonded only to the center side of the bend to restrict elongation. The cylinder part covers the main function part. The two bent portions 2 and 3 are bent in the same direction, but have different curvatures. Therefore, when the ring portion 8 is not covered, the pinched portions 4 and 5 at the ends of the two bent portions 2 and 3 are provided. Are separated from each other. As shown in FIG. 8, when the cylindrical portion is pushed out in the distal direction by the operation portion, the ring portion 8 covers the curved portion, and the pinch portions 4 and 5 approach each other and can be picked. As shown in FIG. 9, when the cylindrical portion is further pushed out in the distal direction, the cylindrical shaft portion 6 covers the entire bent portion and becomes a straight line, so that the forceps can be easily inserted into the insertion hole of the percutaneous endoscope.

  The cylindrical portion has an outer diameter of 3.5 mm and a length of about 370 mm. The ring portion 8 also has an outer diameter of 3.5 mm, and the outer diameter when the two bent portions 2 and 3 are closed is slightly smaller than the inner diameter of the ring portion 8. The length of the flexible part 7 is about 10 mm.

It is a perspective view of a single opening grasping forceps. It is a perspective view of a bi-action grasping forceps. It is a perspective view of a basket punch forceps. It is a perspective view of scissors type forceps. It is a side view of a forceps of a wire & ring type. It is a side view of the main function part of this invention. It is a side view in the state before grasping of the main function part and cylinder part of the present invention. It is a side view in the state at the time of the holding | grip of the main function part and cylinder part of this invention. It is a side view in the state before insertion of the main function part and cylinder part of this invention.

1 Shaft 2 High Fold Curve 3 Low Fold Fold 4 Pinch (High Fold Fold)
5 Pinch part (the tip of the low fold part)
6 Cylindrical shaft part 7 Flexible part 8 Ring part

Claims (5)

  A grasping forceps used in percutaneous endoscopic surgery, which is mainly composed of a main function part, a cylinder part, and an operation part. The main function part has two elastic members at the end of a long rod-shaped shaft part. There is a bent part bent in the same direction by the material, and there is a pinch part facing each other at the end of the bent part, and the cylindrical part is flexible by the flexible material at the end of the cylindrical cylindrical shaft part by the hard material There is a part with an annular ring part made of hard material at the tip, but there is a cylinder part so that it covers the main function part, and the cylinder part is slid with respect to the main function part at the operation part A featured instrument.   The grasping forceps according to claim 1, wherein the cylindrical shaft portion occupies most of the entire length of the cylindrical portion, and the flexible portion has a low stretchable material bonded to the center side of the curve.   In the gripping forceps according to any one of claims 1 and 2, when the ring portion does not cover the bent portion, the two bent portions have different curvatures, so that the pinch portions are separated from each other. An instrument characterized in that the combined outer diameter is slightly smaller than the inner diameter of the ring portion, and the two pinch portions approach when the ring portion covers the bent portion.   The grasping forceps according to any one of claims 1 to 3, wherein the pinch portion has a small sawtooth structure on each facing side.   The gripping forceps according to any one of claims 1 to 4, wherein the bent portion is bent in a state where there is no external force, and the cylindrical shaft portion of the cylindrical portion is pushed in the distal direction, and the cylindrical shaft portion covers the entire bent portion. A device characterized by the fact that the curved portion is linear.

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