JP5633877B2 - Delivery forceps - Google Patents

Description

  The present invention relates to a delivery forceps used to quickly deliver a fetus from the mother's body.

Conventionally, delivery is under conditions that impending fetal death without becoming a normal course, doctors and midwife order to expulsion quickly in a few minutes fetus in the mother uses labor forceps. As shown in FIG. 5, the delivery forceps 110 includes a left lobe portion 111 and a right lobe portion 112 that are formed of metal into a predetermined shape. These left lobe portion 111 and right lobe portion 112 have proximal end portions as forceps handles 113A and 113B, distal end portions as forceps rods 114A and 114B, and intermediate portions as joint portions 115. The delivery forceps 110 is configured such that the left lobe 111 and the right lobe 112 are connected to each other by a joint 115 so that the left lobe 111 and the right lobe 112 can be opened / closed and detachable in consideration of the convenience of insertion into the mother body as will be described later. Has been.
At the time of delivery, due to the anatomical limitation of the size of the vaginal cavity, the delivery forceps 110 first insert the left lobe portion 111 and then the right lobe portion 112 individually into the mother body, and forceps ridges 114A and 114B. The left lobe 111 and the right lobe 112 are matched at the joint 115 while adjusting the position so that both sides of the fetal head can be combined and held in the mother body, and the fetal head is sandwiched between the forceps folds 114A and 114B. By pulling, the fetus is delivered from the mother's body.

Philip C.I. By Dennen, translated by Maki Nakata, "Forceps Delivery", Medical View Co., Ltd., first printed on June 1, 1991

However, in the conventional delivery forceps 110, the position of the advanced part of the fetus (the most advanced part of the fetus, usually the back of the head, usually the occipital region) in the mother's body that cannot be seen before use is the position of the delivery. It must be determined whether the forceps can be safely used (forceps proper position). Further, the forceps ridges 114A and 114B are made of a hard metal, and the maternal pelvic lumen is about 10 cm, whereas the fetal head diameter is also about 10 cm, which is almost around the fetal head. There is no gap, and the forceps ridges 114A and 114B have a shape with a thickness of about 6 to 9 mm in the thickest part, so a narrow gap around the fetal head is invisible. In order to insert the forceps rods 114A and 114B, the forceps rods 114A and 114B are too hard and too thick.
As described above, the use of the above-mentioned conventional delivery forceps 110 places a heavy burden on the fetal head and the uterus and vagina wall of the mother. In some cases, the brain of the fetus is damaged and the pubic bone is opened to the mother. Serious sequelae such as separation and damage to the mother's lumen may occur. Furthermore, the use of the above-mentioned conventional delivery forceps 110 does not apply excessive force to the head sandwiched between the forceps ridges 114A and 114B, and also applies force from the mother's body so as not to damage the mother's body. rice and did not have to be carried out remains of an invisible state the delicate task of towing (60kg weight at the maximum).
As described above, since the conventional delivery forceps 110 require abundant experience and high skill, the delivery by cesarean section has become mainstream recently, and the forceps delivery has decreased. However, delivery by caesarean section is an easy method, so in Japan it has resulted in about 200,000 unnecessary cesarean sections per year, and cesarean section has a heavy burden on the mother due to laparotomy. Therefore, there was a problem that it took days to recover after the operation, and there was a demerit such as the onset of cesarean syndrome.
The present invention has been made paying attention to such problems existing in the prior art. The object is to provide a delivery forceps that is easy to use and that can suitably pull the fetal head during delivery and that places less burden on both the mother and the fetus.

In order to achieve the above object, the invention of the delivery forceps according to claim 1 has a left lobe and a right lobe, and is a synthetic resin used to deliver a fetus from the mother body during delivery. Or a fiber reinforced plastic delivery forceps, wherein the left lobe and the right lobe have a proximal end as a forceps handle for grasping and a distal end as an insertion rod inserted into the mother's body. The intermediate portion is a joint portion, and the joint portions are configured to be connected to each other so as to be openable and detachable and detachable. A belt-like belt made of a material having a belt is provided, and at the tip of the belt, as a connecting means for detachably connecting the leading ends of the belt respectively provided on the left lobe and the right lobe, All provided with and a hook-and-loop fastener The connecting band may be one obtained by forming a plurality of folds by folding a sheet in a predetermined direction, sterically be deployable configured by the folds spreads, the one side edge with respect to the belt locking The hook-and-loop fastener is sewn on the other side edge of the connecting band, and is sewn in a curved shape corresponding to the fact that the connecting band can be developed three-dimensionally. The thickness of the belt, the connecting band, and the hook-and-loop fastener are each less than 3 mm so that the belt can be inserted into a narrow gap between the mother's pelvic lumen and the fetal head. By inserting the left lobe belt, connecting band and hook-and-loop fastener, and inserting the belt, connecting band and hook-and-loop fastener into the gap between the maternal pelvic lumen and the fetal head, A belt is placed on one side of the fetal head Adjusting the position of the left lobe so that the connecting band and the hook-and-loop fastener are placed on the back of the fetus, and then inserting the right lobe belt, connecting band and hook-and-loop fastener into the mother body, By inserting the belt, the connecting band and the hook-and-loop fastener into the gap between the pelvic lumen and the fetal head, the belt is arranged on the other side of the fetal head, and the connecting band and By adjusting the position of the right lobe so that the hook-and-loop fastener rests on the connecting band and hook-and-loop fastener of the left lobe, the belt is placed on both sides of the fetal head in the mother body . upon, by occipital of said fetal in contact with each other of the surface fastener of the left lobe portion and the right lobe portions connecting the leading ends of the belt at the back of the head of the fetus, the fetus a pair of belt connected Hook on the back of the head and connect to each other with the hook-and-loop fastener And summarized in that you configured so that is enclosed fetal head inside the belt in a substantially annular by.
The invention according to claim 2 is the invention of the delivery forceps according to claim 1, wherein each of the right lobe and the left lobe is operated by operating an operation portion provided at a base end portion. Auxiliary forceps configured to open and close an arm provided in the portion and assisting the joining of the surface fasteners by grasping the surface fastener with the arm are inserted into the right lobe portion and the left lobe portion. The gist is that it is detachably attached via a hook provided on the upper surface of the bag.
According to a third aspect of the present invention, in the invention of the delivery forceps according to the first or second aspect, at the tip of the insertion rod, an operation relating to the connection of the belt tips by the connecting means is visually recognized. The gist of the present invention is that an imaging device is provided by forming the left lobe portion and the right lobe portion in a hollow shape and accommodating them in the interior or by mounting them on the auxiliary forceps .

[Action]
According to labor forceps of the present invention surrounds the head portion of the fetus in the belt, with a configuration that tends to drive, it is not the force sandwiching the conventional forceps spoon is applied to the fetal head. Furthermore, since the traction force when the fetus is delivered from the mother's body is transmitted to the fetus without waste, the operator adjusts the delicate force adjustment such as pulling the fetus while preventing excessive force from being applied to the fetal head. It is easy to use labor forceps.
In addition, since the belts arranged on both sides of the fetal head are made of a flexible material in a thin strip shape, it is easy to insert in the narrow gap around the fetal head in the maternal pelvic lumen, At the time of contact with the maternal pelvis and fetal head when inserted, the burden on these is small.
Further, by providing the auxiliary forceps, it is possible to suitably connect the leading ends of the belts by the connecting means.
In addition, by providing an imaging device such as a video camera or a fiberscope, it is possible to visually confirm the state of the mother body and the connection between the belt ends by the connecting means with a monitor television or the like.

〔effect〕
According to the delivery forceps of the present invention, it is easy to use and can suitably pull the fetal head during delivery.

(A) which shows the delivery forceps of embodiment is a top view, (b) is a side view. The perspective view which expanded a part which shows a connection means. (A) which shows the state which fixed the fetal head with the belt is a side view, (b) is a top view. (A) which shows an auxiliary | assistant arm and its attaching part is a side view, (b) is a front view. The conventional delivery forceps (a) is a plan view, (b) is a side view.

Hereinafter, an embodiment embodying the delivery forceps of the present invention will be described.
As shown in FIGS. 1A and 1B, the delivery forceps 10 has a left lobe portion 11A and a right lobe portion 11B. As for the left lobe 11A and the right lobe 11B, the proximal end is a forceps handle 12 for gripping, the distal end is an insertion rod 13 to be inserted into the mother body, and the middle is the joint 14 It is said that.
The joint 14 has a configuration in which a pin 14A is provided in the left lobe 11A, and a notch 14B that opens at the outer edge is provided in the right lobe 11B. The left lobe portion 11A and the right lobe portion 11B are made to coincide with each other at the joint portion 14 by inserting the pin 14A into the cutout portion 14B, and can be opened and closed with respect to the joint portion 14 as a center. It is configured. Further, the left lobe 11A and the right lobe 11B are configured to be detachable by inserting the pin 14A into the notch 14B at the joint 14 or by extracting the pin 14A from the notch 14B. Yes.
Note that the delivery forceps 1 0 For example, port Riechiren (PE), and an olefin resin such as polypropylene (PP), and an ester resin such as polyethylene terephthalate (PET), polymethyl methacrylate (PMMA) acrylic resins such as and, it is polycarbonate (PC) made of synthetic resin such like, or carbon fiber reinforced plastics (CFRP) or glass fiber reinforced plastic (GFRP) fiber-reinforced plastics such like (FRP) made. In particular, if the delivery forceps 10 is a disposable type, that is, a disposable type, it is desirable to use a synthetic resin.

Two belts 15 are respectively extended from the tip of the insertion rod 13 in the left lobe 11A and the right lobe 11B. That is, the base end portion of each belt 15 is fixed to the distal end of the insertion rod 13. Further, in the left lobe 11A and the right lobe 11B, each pair of belts 15 is obliquely attached to the distal end of the insertion rod 13 so that the distance from each other increases from the base end toward the distal end. ing.
As shown in FIG. 2, the belt 15 is formed in a thin strip shape by a base material 15a and a covering material 15b covering one surface of the base material 15a. The base material 15a is formed in a thin belt shape using a flexible material such as a synthetic resin such as nylon or polypropylene, an elastic material such as natural rubber, synthetic rubber, foamed rubber, or thermoplastic elastomer. By giving flexibility to 15, it becomes easy to insert the belt 15 into the mother's body, and the force to be applied to the fetal head is relieved. The covering material 15b is formed in a belt shape using a material made of fibers such as gauze, woven fabric, knitted fabric, non-woven fabric, and the like, and covers one surface in contact with the fetal head on the surface of the base material 15a. The base material 15a is prevented from coming into direct contact with the fetal head, and the belt 15 is prevented from slipping with respect to the fetal head.
The thickness of the belt 15, from the viewpoint can be inserted into a narrow gap between the lumen and the fetal head maternal pelvis, together with the thickness of the thickness of the base member 15a covering member 15b, and less than 3 mm, More preferably, it is 2 mm or less. When the thickness of the belt 15 is 3 mm or more, there is a high possibility that a burden on the belt 15 becomes large when contacting the fetal head, the maternal pubic bone, the maternal pelvis, or the like.

As shown in FIG. 2, a connecting band 16 and a hook-and-loop fastener 17 as connecting means are attached to the tip of the belt 15.
The connecting band 16 is formed by folding a sheet made of the same material as the covering material 15b, such as a surgical mask, in a predetermined direction to form a plurality of folds 16a. It is configured to be deployable. The connecting band 16 is fixed to the belt 15 by sewing both corners of one side edge to the tip of each belt 15 with respect to the two belts 15, and the tips of the two belts 15. By connecting the portions, these belts 15 are prevented from being twisted and the distance between the two belts 15 being unnecessarily widened.
The hook-and-loop fastener 17 is sewn on the other side edge of the connecting band 16 and is sewn in a curved shape corresponding to the fact that the connecting band 16 can be developed in three dimensions. Then, by joining the hook-and-loop fasteners 17 to each other, the tip of the belt 15 provided on the left leaf portion 11A and the tip of the belt 15 provided on the right leaf portion 11B are connected. .
The thickness of the connecting band 16 and the surface fastener 17, in view of being able to insert into a narrow gap between the lumen and the fetal head maternal pelvis, respectively less than 3 mm, it is more desirable to 2mm or less. When the thickness of either the connecting band 16 or the hook-and-loop fastener 17 is 3 mm or more, there is a possibility that the burden on these will increase when the connecting band 16 or the hook-and-loop fastener 17 contacts the fetal head, the maternal pubic bone, the maternal pelvis, or the like. Becomes higher.

When using the delivery forceps 10 having the above-described configuration, first, the belt 15 of the left lobe 11A, the connecting band 16 and the hook-and-loop fastener 17 are inserted into the mother body, and the belt 15 is attached to one side of the fetal head H. The left lobe portion 11A is adjusted so that the connecting band 16 and the hook-and-loop fastener 17 are placed on the back of the fetus.
As described above, when the belt 15, the connecting band 16 and the hook-and-loop fastener 17 of the left lobe 11A are inserted into the mother body, the delivery forceps 10 having the above-described configuration has the belt 15, the connecting band 16 and the hook-and-loop fastener 17 having a thickness of about 2 mm. Therefore, when inserted into a very narrow gap between the maternal pelvic lumen and the fetal head H, it is easily and smoothly inserted.
Next, the belt 15, the connecting band 16 and the hook-and-loop fastener 17 of the right lobe 11B are inserted into the mother body, the belt 15 is arranged on the other side of the fetal head H, and the connecting band 16 and the hook-and-loop fastener 17 are The position of the right lobe 11B is adjusted so as to be placed on the connecting band 16 and the hook-and-loop fastener 17 of the left lobe 11A, and the hook and loop fasteners 17 of the left lobe 11A and the right lobe 11B are brought into contact with each other at the back of the fetus. Let
As described above, with the belt 15, the connecting band 16 and the hook-and-loop fastener 17 of the left lobe 11A already inserted into the mother body, the belt 15, the connecting band 16 and the hook-and-loop fastener 17 of the right lobe 11B are inserted. However, as described above, each belt 15 and the like is as thin as 2 mm, and the thickness of both the belt 15 and the like of the left leaf portion 11A and the belt 15 and the like of the right leaf portion 11B is about 4 mm. The forceps of the conventional delivery forceps is extremely thin compared with the thickness of both of them being about 6 to 9 mm. These belts 15 and the like are used for the pelvic lumen of the mother and the head of the fetus with almost no gap. It is the optimum thickness for insertion between H.
Further, since the pair of hook-and-loop fasteners 17 that are in contact with each other are sewn in a curved surface shape, at least the peripheral portions are always joined by contacting each other so that one covers the other. When the connection forceps 10 are deployed by pulling the delivery forceps 10 from this state as will be described later, the tension (tension) due to the deployment is applied to the hook-and-loop fastener 17, so that the left and right leaf portions 11 </ b> A and 11 </ b> B are connected to each other. 17 will be in the state joined over the whole. Further, the hook-and-loop fastener 17 sewed in a curved surface has an advantage that it is less likely to be displaced at the time of contact with each other than the flat hook-and-loop fastener. Further, since the connecting band 16 using a nonwoven fabric or the like is provided at the position adjacent to the hook-and-loop fastener 17, even if the hook-and-loop fastener 17 is greatly displaced from each other, the hook-and-loop fastener 17 and the connecting band 16 are joined. To
Thereafter, the right lobe 11B is made to coincide with the left lobe 11A at the joining portion 14, and as shown in FIGS. 3 (a) and 3 (b), they are connected to each other by a hook-and-loop fastener 17 to form a substantially ring shape. The fetal head H is enclosed inside the belt 15.
Then, when the delivery forceps 10 is first pulled obliquely downward in the above-described state, the connecting band 16 is expanded by the belt 15 and spreads so as to wrap around the back of the fetus. The fetus head H is pulled from the mother body by pulling the delivery forceps 10 in an arc shape as it is, that is, pulling it while pulling along the shape of the mother's pelvis. Be delivered.
In addition, after the delivery forceps 10 is used, since the covering material 15b and the connecting band 16 of the belt 15 are made of non-woven fabric or the like as described above, it adheres to the covering material 15b and the connecting band 16 of such a belt 15. DNA can be easily collected from blood, amniotic fluid, and the like.

The delivery forceps 10 of the present invention is not limited to the configuration of the above-described embodiment, and can be embodied by changing the configuration as described below.
As shown in FIGS. 4A and 4B, a hook 13a may be provided on the upper surface of the insertion rod 13, and the auxiliary forceps 21 may be attached to the hook 13a. The auxiliary forceps 21 is configured such that an arm 21B provided at a distal end can be opened and closed by operating an operation portion 21A provided at a proximal end, and the hook-and-loop fastener 17 is operated by the arm 21B. It is possible to assist the joining of the hook-and-loop fasteners 17 by grasping or the like.
Further, the left lobe portion 11A and the right lobe portion 11B may be formed in a hollow shape, and an imaging device such as a video camera or a fiberscope may be accommodated therein. The imaging device is attached to a mother's body by being connected to a monitor or the like, and visually confirms the joining of the surface fasteners 17 and the joining assistance of the surface fasteners 17 by the auxiliary arm 21. it can. The imaging device may be mounted on the auxiliary forceps 21. When the imaging device is mounted on the auxiliary forceps 21 as described above, the auxiliary forceps 21 is removed from the insertion rod 13 and moved to move the lumen of the mother body. You will be able to see parts that are difficult to see.
In addition to the imaging device, a display unit such as a pressure sensor, an indicator for displaying the pressure measured by the pressure sensor, and a level meter are provided inside the left lobe part 11A and the right lobe part 11B. Sometimes, the force applied to the head H of the fetus is measured by the pressure sensor and displayed on the display unit, so that the delivery forceps 10 can be operated more easily. Moreover, you may comprise a display part so that an external thing may be connected, without providing in the said left lobe part 11A and the said right lobe part 11B .
On SL belt 15 and connecting band 16 and the surface fastener 17 to be exchangeable, for example, it may be equal changed every single use. Alternatively, the left lobe portion 11A and the right lobe portion 11B may be made of synthetic resin and the delivery forceps 10 may be a disposable disposable type in order to form a hollow shape as described above.
The delivery forceps 10 is not limited to simply being used as a forceps, and various usage forms can also be mentioned. That is, when the imaging device is mounted on the auxiliary forceps 21 as described above, by leaving the auxiliary forceps 21 in the mother body after delivery of the fetus, the remnants of fetal appendages such as egg membranes are left. It is also possible to confirm or remove, or to confirm the presence or absence and extent of damage to the uterine wall by the imaging device. If the belt 15, the connecting band 16, the hook-and-loop fastener 17, etc. are made of cloth, they adhere to the belt 15 or the like. It is possible to collect fetal DNA, umbilical cord blood, and the like from the attached matter.

According to the delivery forceps of the present invention, unnecessary force is not applied to the head of the fetus, it is easy to use, the fetus can be suitably pulled during delivery, and the burden on the mother due to delivery can be reduced. Therefore, it has industrial applicability.

DESCRIPTION OF SYMBOLS 10 Delivery forceps 11A Left lobe part 11B Right lobe part 12 Forceps handle 13 Insertion hook 14 Joint part 15 Belt 16 Connection belt | band | zone which comprises a connection means 17 Surface fastener which comprises a connection means

Claims (3)

It has a left lobe and a right lobe, and is a delivery forceps made of synthetic resin or fiber reinforced plastic used to deliver a fetus from the mother body during delivery,
The left lobe and the right lobe have a proximal end portion as a forceps handle for gripping, a distal end portion as an insertion rod inserted into the mother body, an intermediate portion as a joint portion, It is configured so that it can be opened and closed and detachably connected to each other by matching the joints.
Further, a belt-like belt made of a flexible material is inserted from the tip of the insertion rod, and the tips of the belts provided on the left lobe and the right lobe are respectively attached to the tip of the belt. A connecting band and a hook-and-loop fastener are provided as connecting means for connecting the two in a separable manner,
The connecting band is formed by folding a sheet in a predetermined direction to form a plurality of folds. The folds are configured to expand three-dimensionally, and one side edge is fixed to the belt. And
The hook-and-loop fastener is sewn on the other side edge of the connecting band, and is sewn in a curved shape corresponding to the fact that the connecting band can be developed three-dimensionally.
Furthermore, the thickness of the belt, the connecting band, and the hook-and-loop fastener is less than 3 mm each so that it can be inserted into a narrow gap between the lumen of the mother's pelvis and the fetal head,
In use,
First, the left lobe belt, connecting band and hook-and-loop fastener are inserted into the mother body, and the belt, connecting band and hook-and-loop fastener are inserted into the gap between the maternal pelvic lumen and the fetal head. Thus, the belt is arranged on one side of the fetal head, and the position of the left lobe is adjusted so that the connecting band and the hook-and-loop fastener rest on the posterior head of the fetus,
Next, the right lobe belt, connecting band and hook-and-loop fastener are inserted into the mother body, and the belt, connecting band and hook-and-loop fastener are inserted into the gap between the maternal pelvic lumen and the fetal head. Thus, the position of the right lobe is adjusted so that the belt is arranged on the other side of the fetal head, and the connecting band and the hook-and-loop fastener rest on the connecting band and hook-and-loop fastener of the left lobe. by doing,
The belt at the base upon which the state arranged on both sides of the fetal head, tips of each other a surface fastener in contact the belt of the left lobe portion and the right lobe portions at the back of the head of said fetal by linking with occipital of the fetus, a pair of belt connected by hooking to the back of the head of the fetus, fetal head enclosure inside the belt in a substantially annular by being interconnected with said surface fastener filled-delivery forceps characterized by being configured to so that. Each of the right lobe part and the left lobe part is configured to be able to open and close an arm provided at a distal end by operating an operation part provided at a base end part, and the hook and loop fasteners are configured to be operated by the arm. The auxiliary forceps for assisting the joining of the hook-and-loop fasteners by grasping the hook is detachably attached via hooks provided on the upper surfaces of the insertion hooks of the right lobe and the left lobe. Delivery forceps as described in. An imaging device for visually confirming the work related to the connection of the belt tips by the connecting means is formed by forming the left lobe portion and the right lobe portion in a hollow shape and accommodating them inside, or the auxiliary Provided by mounting on forceps
Delivery forceps according to 請 Motomeko 2.