JP6724262B1 - Medical instruments and medical instrument systems - Google Patents

Abstract

The medical device includes a first blade, a second blade, a connecting member, a first handle, a second handle, a bolt, and an inner nut, and the opening degrees of the first blade and the second blade are It is variable. The first handle extends from a first proximal end of the first blade. The second handle extends from the second base end portion of the second blade, faces the first handle, and has a through hole. The bolt is passed through the through hole, and one end of the bolt is connected to the first handle. The inner nut is arranged between the first handle and the second handle, and the bolt is passed through the inner nut. Furthermore, the upper limit of the opening degree of the first blade and the second blade can be adjusted by the position of the inner nut of the bolt.

Description

The present invention relates to a medical device to be inserted into a human or animal hole and a medical device system including the medical device.

2. Description of the Related Art Conventionally, as a medical instrument to be inserted into a human hole, one having a pair of rotatably connected blades is known. For example, a vaginal mirror (Cusco), which is an example of the above-mentioned medical instrument, is used when performing inspections, surgery, and other medical measures on the vagina and uterus.

The vaginal speculum is used to expand and fix the vagina during diagnosis by a doctor or treatment through the vagina. A general vaginal mirror has a pair of handles extending from a pair of blades, a bolt whose end is connected to one handle and which is passed through an opening of the other handle, and which protrudes from the opening of the bolt. And a nut attached to the part.

In such a vaginal mirror, the opening of the pair of blades can be adjusted only within a range in which the other handle can move between the handle and the nut to which the bolt is connected. That is, when the two handles are brought closer to each other, the opening degree increases, and when the two handles are moved away from each other, the opening degree decreases. The position of the nut on the bolt determines the lower limit of the opening of the pair of blades.

JP-A-49-82193

When the opening of the pair of blades is increased after the vaginal mirror having the above-described structure is inserted into the vagina, a force is applied to the vaginal wall of the patient in the direction of expanding the vaginal wall. In this case, the patient feels pain and may cause laceration of the vaginal wall and vulva.

Therefore, it is an object of the present invention to provide a medical device capable of suppressing pain and laceration during use and a medical device system including the medical device.

The medical device according to one embodiment includes a first blade, a second blade, a connecting member, a first handle, a second handle, a bolt, and a nut. The first blade has a first tip portion and a first base end portion. The second blade has a second tip end and a second base end. The connecting member connects the first base end portion and the second base end portion such that the opening degrees of the first blade and the second blade are variable. The first handle extends from the first proximal end. The second handle extends from the second base end portion, faces the first handle, and has a through hole. The bolt is passed through the through hole, and one end of the bolt is connected to the first handle. The inner nut is arranged between the first handle and the second handle, and the bolt is passed through the inner nut. Furthermore, the upper limit of the opening degree of the first blade and the second blade can be adjusted by the position of the inner nut of the bolt.

The medical device may further include an outer nut through which the bolt is passed. In this case, the second handle is located between the inner nut and the outer nut, and the lower limit of the opening degree of the first blade and the second blade can be adjusted by the position of the outer nut in the bolt. ..

The first distal end portion may have a first recessed portion that is recessed toward the first proximal end portion. Further, the second tip end portion may have a second recessed portion that is recessed toward the second base end portion.

A medical device system according to one embodiment includes the medical device and a tissue recovery bag having an opening having a size that allows the first blade and the second blade to pass therethrough.

The medical device system may further include an auxiliary guard formed of a sheet material that is harder than the tissue recovery bag. The auxiliary guard can be passed through the opening in a tubularly rolled state, and the first blade and the second blade can be passed inward in the tubularly rolled state. is there.

The medical device system may further include a stretchable cover that can be placed over the medical device. The cover may include a first portion into which the first blade can be inserted and a second portion into which the second blade can be inserted.

According to the present invention, it is possible to provide a medical device capable of suppressing pain and laceration during use and a medical device system including the medical device. Other effects of the present invention will be apparent from the entire description of the present specification.

FIG. 1 is a schematic perspective view of a vaginal mirror (medical device) according to an embodiment. FIG. 2 is a perspective view showing another example of the shapes of the first tip portion and the second tip portion, which can be applied to the vaginal mirror shown in FIG. FIG. 3 is a diagram for explaining the outline of the first pessary withdrawal method using the vaginal mirror shown in FIG. 1. FIG. 4 is a diagram for explaining the outline of the second pessary removing method using the vaginal mirror shown in FIG. 1. FIG. 5: is a figure which shows schematically an example of the medical device system which concerns on one Embodiment. FIG. 6 is a schematic cross-sectional view showing a state in which the cover included in the medical device system shown in FIG. 5 is attached to the vaginal scope. FIG. 7: is a figure which shows schematically an example of the medical treatment using the medical device system shown in FIG. FIG. 8: is a figure which shows schematically an example of the medical treatment following FIG. FIG. 9 is a schematic perspective view showing another configuration example of the vaginal mirror.

An embodiment of the present invention will be described below with reference to the drawings. In this embodiment, as an example of a medical device, a vaginal mirror to be inserted into a person's vagina is disclosed.

FIG. 1 is a schematic perspective view of a vaginal mirror 100 (double nut fixed vaginal mirror or Igarashi type vaginal mirror) according to the present embodiment. The vaginal mirror 100 includes a first blade 1, a second blade 2, a first handle 3, a second handle 4, a pair of connecting members 5, a bolt 6, an inner nut 7, and an outer nut 8. I have it. All of these elements are made of metal such as stainless steel. However, at least a part of these elements may be formed of a material other than metal such as a resin material. Also, at least some of these elements may be coated with a non-conductive material.

The first blade 1 has a first base end portion 10 and a first tip end portion 11 opposite to the first base end portion 10. The first blade 1 has a spatula shape elongated in the extending direction from the first base end portion 10 toward the first tip end portion 11. That is, the cross section of the first blade 1 along the width direction orthogonal to the extending direction is arcuate.

The second blade 2 has a second base end portion 20 and a second tip end portion 21 opposite to the second base end portion 20. Similar to the first blade 1, the second blade 2 has a spatula shape elongated in the extending direction from the second base end portion 20 toward the second tip end portion 21. That is, the cross section of the second blade 2 along the width direction orthogonal to the extending direction is arcuate.

The first handle 3 extends upward from the first base end portion 10 of the first blade 1 in the drawing. The first handle 3 has a support hole 30 in the middle of the longitudinal direction. The first handle 3 is integrated with the first blade 1 in the illustrated example, but may be a component different from the first blade 1.

The second blade 2 further has a semi-arcuate holding portion 22 provided on the second base end portion 20. The second handle 4 extends upward from the holding portion 22 in the drawing and faces the first handle 3. The second handle 4 has a through hole 40 in the middle of the extending direction.

The pair of connecting members 5 are, for example, pins, and rotatably connect both ends of the first base end portion 10 in the width direction to the holding portion 22. The first base end portion 10 is located inside the holding portion 22 and the second base end portion 20.

A male screw is formed entirely on the outer peripheral surface of the bolt 6. One end of the bolt 6 is rotatably connected to the first handle 3 in the support hole 30. The bolt 6 is passed through the through hole 40 of the second handle 4.

The bolt 6 is passed through the inner nut 7 and the outer nut 8. That is, the inner nut 7 and the outer nut 8 each have an internal thread, and the bolt 6 is screwed into this internal thread. The inner nut 7 is arranged between the first handle 3 and the second handle 4. The outer nut 8 is located outside the second handle 4, that is, between the second handle 4 and the other end of the bolt 6 that is opposite to the one end connected to the first handle 3. From another point of view, the second handle 4 is located between the inner nut 7 and the outer nut 8.

In such a configuration, by adjusting the distance between the first handle 3 and the second handle 4 (angle between both handles) with a finger, the opening degree of the first blade 1 and the second blade 2 can be adjusted. It is possible to adjust. For example, the opening can be defined as a distance between the first tip 11 and the second tip 21 or an angle formed by the first blade 1 and the second blade 2.

A circular opening OP is formed between the first base end portion 10 and the second base end portion 20. As shown in FIG. 1, when the first blade 1 and the second blade 2 are open, when the opening OP is viewed from the base end portions 10 and 20 side, the front end portions 11 and 21 side are visually recognized. You can

The adjustable range of the opening degrees of the first blade 1 and the second blade 2 is determined by the positions of the inner nut 7 and the outer nut 8 of the bolt 6. That is, the inner nut 7 restricts relative movement of the first handle 3 and the second handle 4 in the direction in which the distance between the first handle 3 and the second handle 4 decreases. Therefore, the upper limit of the opening degree of the first blade 1 and the second blade 2 can be adjusted by the position of the inner nut 7 on the bolt 6.

On the other hand, the outer nut 8 restricts the relative movement of the first handle 3 and the second handle 4 in the direction in which the distance between them increases. Therefore, the lower limit of the opening degree of the first blade 1 and the second blade 2 can be adjusted by the position of the outer nut 8 on the bolt 6.

In the example of FIG. 1, the first tip portion 11 and the second tip portion 21 are rounded in an arc shape. However, the shapes of the first tip portion 11 and the second tip portion 21 are not limited to this example.

FIG. 2 is a perspective view showing another example of the shapes of the first tip portion 11 and the second tip portion 21. In this example, the first tip 11 is provided with the first recess 11a, and the second tip 21 is provided with the second recess 21a. The first recess 11 a is recessed in an arc shape toward the first base end 10. The second recess 21 a is recessed in an arc shape toward the second base end 20.

The shapes of the first tip portion 11 and the second tip portion 21 are not limited to the examples shown in FIGS. 1 and 2. For example, the first tip 11 and the second tip 21 may be flatter than the example shown in FIG. Further, the first tip portion 11 and the second tip portion 21 may have a shape that forms a cylindrical opening when the first blade 1 and the second blade 2 are closed.

The conventional vaginal mirror does not include at least an element corresponding to the inner nut 7. Therefore, the upper limit of the opening between both blades cannot be set arbitrarily. In this case, when both blades are inserted into the patient's vagina and a force is applied to open both blades, a vector in the front or diagonal direction (vector intersecting the vaginal axis) is added to the vaginal wall and May cause lacerations. Also, if the patient is conscious, the patient may complain of pain before the laceration occurs.

On the other hand, in the vaginal mirror 100 according to the present embodiment, the upper limit of the opening degree of the first blade 1 and the second blade 2 can be set by the inner nut 7. As a result, the first blade 1 and the second blade 2 do not open more than necessary, so laceration and pain can be suppressed.

Further, in the vaginal mirror 1, the lower limit of the opening degree of the first blade 1 and the second blade 2 can be determined by the outer nut 8. For example, if the second handle 4 is sandwiched between the inner nut 7 and the outer nut 8, the openings of the first blade 1 and the second blade 2 can be fixed, which can contribute to the smooth progress of medical treatment.

Next, a usage example of the vaginal mirror 100 according to the present embodiment will be described.
As a typical example of the procedure through the vaginal scope 100, particularly the procedure for pulling out something from the patient's body through the vaginal scope 100 inserted into the vagina, there is removal of the pessary inserted into the genital prolapse patient. It is said that about 1 out of every 10 women lose their genitals mainly due to childbirth. For patients with genital prolapse, insert a vinyl chloride ring-shaped soft pessary (Wallace ring pessary, etc.) into the vagina and leave it in place for a long period of time to prevent the bladder and uterus from escaping from the vaginal opening and drooping. Conservative therapy is used worldwide.

Pessaries need replacement every 3 to 6 months. If the pessary is not replaced, the pessary may dig into the vaginal wall. In the past, it has been reported that Pessary escaped into the abdominal cavity. Modern soft pessaries are deformable and easier to insert and remove than the previously used ebonite hard pessaries.

However, the procedure in which the doctor removes the pessary puts a burden on the perineal hole and is violent to the patient even if a pain-relieving jelly or the like is used. During the procedure, the patient may complain of pain, sometimes with vaginal wall or perineal lacerations. At present, patients endure the pain of pessary and regularly visit the hospital to replace it.

The vaginal mirror 100 according to the present embodiment is suitable for removing a pessary. Hereinafter, two types of pessary removal methods using the vaginal mirror 100 will be exemplified.

[First Pessary Removal Method]
FIG. 3 is a view for explaining the outline of the first pessary P removal method using the vaginal mirror 100. Here, it is assumed that the vaginal mirror 100 includes the first recess 11a and the second recess 21a shown in FIG. However, the vaginal mirror 100 used in the first extraction method may not include the first concave portion 11a and the second concave portion 21a.

In the first removal method, first, the inner nut 7 is stopped at a predetermined position where the opening degrees of the first blade 1 and the second blade 2 are appropriate, and the vaginal scope 100 is inserted into the vagina of the patient. This predetermined position is, for example, a position where it is possible to pull the pessary P inside the patient's body into the vaginal scope 100 without placing an excessive burden on the perineal hiatus.

When the vaginal mirror 100 is inserted, the opening and closing directions of the first blade 1 and the second blade 2 intersect the circumferential direction of the pessary P. Therefore, by rotating the vaginal mirror 100 by about 90 degrees, the opening and closing directions of the first blade 1 and the second blade 2 are made to coincide with the circumferential direction of the pessary P as shown in FIG. Further, by operating the first handle 3 and the second handle 4 within the range between the inner nut 7 and the outer nut 8, the first blade 1 and the second blade 2 are opened, and the first recess 11a and the second recess 21a are opened. Fit the outer peripheral surface of the pessary P on.

Then, the pessary P is pulled by the forceps F (for example, Tsukahara forceps) inserted through the opening OP of the vaginal mirror 100. At this time, the pessary P may be removed through the opening OP. Alternatively, after pulling at least a part of the pessary P between the first blade 1 and the second blade 2 and moving the vaginal mirror 100 back and forth in this state to check whether or not the vaginal wall is involved, as shown by an arrow R1. The pessary P together with the vaginal mirror 100 may be removed from the vagina.

According to such a first extraction method, the width of the first blade 1 and the second blade 2 opened below the upper limit determined by the inner nut 7, or the amount by which the pessary P slightly protrudes with respect to this width. The width equivalent to (the vaginal mirror 100 and the pessary P) comes out from the vaginal opening. If the first removal method is performed with a conventional vaginal mirror, the elastic force of the pessary P or the like causes the pair of blades to open greatly. On the other hand, when the vaginal mirror 100 according to the present embodiment is used, the first blade 1 and the second blade 2 do not open more than necessary. Therefore, the burden on the vagina and vulva is small, and there is almost no pain in the patient.

[Second pessary removal method]
FIG. 4 is a diagram for explaining the outline of the second pessary P withdrawal method using the vaginal mirror 100. Here, it is assumed that the first distal end portion 11 and the second distal end portion 21 use an arcuate mirror 100 as shown in FIG. However, in the second extraction method, the vaginal mirror 100 having the shape shown in FIG. 2 may be used.

In the second removal method, the doctor releases the adhesion between the pessary P and the vaginal wall with a finger in advance, inserts the vaginal mirror 100 into the vagina, and confirms the pessary P with the anterior vaginal dome. At this time, the inner nut 7 is stopped at a predetermined position where the openings of the first blade 1 and the second blade 2 are appropriate, as in the first removal method.

After that, the pessary P is held by the forceps F (for example, Martin forceps) inserted through the opening OP, and the pessary P is cut by the cooper also inserted through the opening OP. Further, as shown by an arrow R2, the forceps F is pulled while rotating clockwise, for example, and the pessary P is pulled out through the opening OP.

Even in such a second removal method, the pessary P and the like hit the vaginal wall beyond the width of the first blade 1 and the second blade 2 opened within the range of the upper limit of the opening defined by the inner nut 7 or less. There is no. Therefore, there is little burden on the vagina and perineum, and there is almost no patient pain.

In principle, vinyl chloride pessaries (Warreth ring pessaries) are not reused. Therefore, even if the pessary is cut as in the second extraction method, no particular disadvantage occurs. On the other hand, when exchanging a silicone soft pessary (Mirex Pessary), which is becoming popular in the United States and the like, at the hospital, the first removal method is suitable.

[Transvaginal uterine recovery]
Another typical example of extracting some object from the patient's body through the vagina is transvaginal uterine recovery in total laparoscopic hysterectomy (TLH) for uterine fibroids, adenomyosis, endometrial cancer, and the like.

Generally, 40% of all women have uterine fibroids. If uterine fibroids cause symptoms such as hypermenorrhea, anemia, infertility, and urinary frequency, TLH may be performed. Also in uterine adenomyosis in which the endometrium enters the myometrium, severe dysmenorrhea, hypermenorrhea, anemia, or infertility may occur. Therefore, TLH may be similarly performed.

If the uterus is sub-umbilical in size, there are many facilities worldwide that select TLH for removing the uterus from the vagina by excising the uterus under laparoscope rather than laparotomy. When collecting the uterus through the vagina, the enlarged uterine fibroid, uterine adenomyosis site or uterine body is pulled out from the vagina while being finely cut with a scalpel or surgical scissors. Even in this case, a laceration similar to that at the time of delivery can occur. In particular, when the patient is a nulliparous woman and the weight of the uterus is as large as more than 220 g, lacerations often occur in the vaginal wall and the perineum. Recovery of organs such as the uterus from the vagina is efficient and effective because the diameter of the vaginal canal is generally larger than the diameter of the opening formed in the abdominal wall and is extensible. However, using a scalpel or surgical scissors in the vagina or near the vaginal entrance, or pulling the uterus with strong force can be a violent procedure. Therefore, it is necessary to carefully perform a series of measures.

On the other hand, a medical device system for recovering a uterine fibroid or uterus from an opening formed in the abdominal wall has been developed. This medical device system includes a tissue collection bag for housing the uterus and the like, and a guard for protecting the abdominal wall and the tissue collection bag from a scalpel and the like. For example, in the United States, when recovering a uterus or the like from an opening formed in the abdominal wall, a surgical method that does not use a tissue recovery bag is prohibited. By putting the uterus etc. in the tissue collection bag and collecting it outside the body, it is possible to prevent the parasite myome in which fragments of uterine fibroids spread into the abdominal cavity and develop uterine fibroids from the abdominal wall and intestine, and malignant cells in the uterus It is possible to avoid the scattering of the cells in the case where there is. In addition, by using the guard, the surgical operation time can be shortened because the scalpel can be used firmly and speedily, and the abdominal wall and the tissue collection bag can be protected.

However, such a medical device system is for collecting the uterus and the like through the opening of the abdominal wall, and its use in the TLH is basically not recommended. Certainly, even if an attempt is made to use the medical instrument system for recovering the uterus or the like through the vagina, the guard cannot be sufficiently covered because the guard is short. Further, since the guard is hard, the vaginal wall portion against which the guard hits is frequently torn. Even if there is a guard that sufficiently covers the vaginal canal, unlike the abdominal wall, the vaginal canal is spread and the guard is spread by the pulling of the organ, which may cause a swelling and tear of the vagina.

As described above, there are various problems regarding the recovery of the cut uterus and the like. Therefore, a novel medical device system suitable for a series of treatments for recovering the uterus and the like through the vagina will be disclosed below.

FIG. 5: is a figure which shows schematically an example of the medical device system 200 which concerns on this embodiment. The medical device system 200 includes the above-described vaginal mirror 100, a tissue recovery bag 210, an auxiliary guard 220, a cover 230, and a band 240.

The tissue recovery bag 210 has a bag portion 211, a ring 212, a tether cord 213, and a tag 214. The bag portion 211 is made of polyurethane, for example, and has an opening 211a. The ring 212 is provided on the edge of the opening 211a. The ring 212 is a tube-shaped or rubber ring. In the case of a tube, the tether cord 213 is passed inside, and in the case of a rubber ring, the tether cord 213 is tied, and the tag 214 is attached to the tether cord 213. Attached to the end of. A ring 212, which is a tubular or rubber ring, can be pulled out of the vagina by manually pulling the tag 214 and the tether cord 213.

The auxiliary guard 220 is a rectangular sheet material that can be rolled into a tubular shape as shown by a broken line, and is made of a material that is harder than the bag portion 211. As an example, the material of the auxiliary guard 220 is plastic, but is not limited to this example. The short side of the auxiliary guard 220 (the side along the axis when rolled into a cylinder) is preferably 7 cm or more, and the long side of the auxiliary guard 220 (the side that forms a circular edge when rolled into a cylinder). Is preferably 15 cm or more and 20 cm or less.

The cover 230 is, for example, a stretchable rubber product, and has a first portion 231, a second portion 232, and an opening 233. The first blade 1 can be inserted into the first portion 231, and the second blade 2 can be inserted into the second portion 232. The first portion 231 preferably has an inner diameter smaller than the outer surface shape of the first blade 1 in a natural state in which no external force is applied so that the first portion 231 is in close contact with the surface of the blade when the first blade 1 is inserted. Similarly, the inner diameter of the second portion 232 in the natural state where no external force is applied is smaller than the outer surface shape of the second blade 2 so that the second portion 232 is in close contact with the surface of the blade when the second blade 2 is inserted. preferable. The 1st part 231 and the 2nd part 232 are connected in the valley part between these. In the illustrated example, the cover 230 has no openings other than the opening 233.

The shape of the cover 230 is not limited to that shown in FIG. For example, the opening 233 of the cover 230 may be larger than that shown in FIG. In this case, the cover 230 can be easily attached to the vaginal mirror 100.

The band 240 is, for example, a stretchable clean rubber band. The medical device system 200 may include multiple bands 240.

FIG. 6 is a schematic cross-sectional view showing a state in which the cover 230 is attached to the vaginal mirror 100. The vaginal mirror 100 can be inserted into the cover 230 through the opening 233. In the illustrated state, the first blade 1 is inserted in the first portion 231, and the second blade 2 is inserted in the second portion 232.

The cover 230 also covers the first handle 3 and the second handle 4. With the vaginal mirror 100 placed in the cover 230, the band 240 is wound from above the cover 230 over the portion between the first handle 3 and the second handle 4 and the second proximal end portion 20. As shown, a portion of the band 240 may be wrapped around the base of the first handle 3.

When the cover 230 is attached to the vaginal mirror 100 in this way, the region between the first blade 1 and the second blade 2 is closed by the cover 230. With the cover 230 attached, some object can be sandwiched in the space S between the first blade 1 and the second blade 2.

The cover 230 may be replaced with surgical gloves. That is, the first blade 1 and the second blade 2 may be inserted into any two of the plurality of finger portions of the surgical glove and fixed with the band 240 as in the example of FIG. 6.

Subsequently, an example of use of the medical device system 200 will be described.
Usually, in TLH, a uterine operation forceps with a balloon that expands in the vagina is used. After performing an operation of cutting an organ such as a uterus under a laparoscope, when the uterine operation forceps is pulled out, the abdominal cavity and the outside air communicate with each other through a hole formed in the back of the vaginal canal. If the uterus or the like is collected through the vagina in this state, the carbon dioxide gas injected into the abdominal cavity will leak.

Therefore, as shown in FIG. 6, the cover 230 is attached to the vaginal scope 100 in advance, and after the uterine operation forceps are removed, the vaginal scope 100 is inserted into the vagina. In this way, since the cover 230 closes the opening OP and the like of the vaginal mirror 100, carbon dioxide does not leak from the vagina.

Furthermore, the folded tissue recovery bag 210 may be sandwiched in the space S of FIG. 6 when the vaginal mirror 100 with the cover 230 attached is inserted into the vagina. In this case, the tissue collection bag 210 can be inserted into the abdominal cavity of the patient when the vaginal speculum 100 is inserted.

FIG. 7 is a diagram schematically showing a state in which the tissue recovery bag 210 is placed in the abdominal cavity C of the patient. After the tissue recovery bag 210 is placed in the abdominal cavity C, the cut organ W such as the uterus is inserted into the tissue recovery bag 210 by operating an instrument inserted through an opening (not shown) of the abdominal wall W.

Then, while pulling out the vaginal mirror 100 from the vagina V, the tag 214 of the tissue recovery bag 210 is pulled and the tether cord 213 is taken out of the vagina V. Further, the tether cord 213 is traced to release the ring 212 from the abdominal cavity C through the vagina V. As a result, as shown in the drawing, the opening 211a of the bag portion 211 goes out of the vagina V, and the bottom side of the bag portion 211 containing the organ O remains in the abdominal cavity C.

FIG. 8 is a diagram schematically showing the procedure following FIG. 7. After the state shown in FIG. 7, the auxiliary guard 220 that is rolled into a tubular shape is sandwiched between the pair of paeans, and is inserted into the vagina V from the inside of the bag portion 211 through the opening 211a. As a result, the bag portion 211 inside the vagina V is covered from the inside.

From this state, the vaginal mirror 100 with the cover 230 removed is further inserted into the vagina V from the inside of the auxiliary guard 220. Thereby, as shown in FIG. 8, the inner wall of the vagina V is protected by the auxiliary guard 220 and the first blade 1 and the second blade 2 of the vaginal mirror 100.

At this time, the outer nut 8 of the vaginal mirror 100 may be positioned at an appropriate position on the bolt 6 so that a space suitable for a later treatment is ensured in the vagina V. Further, the inner nut 7 may be positioned at an appropriate position on the bolt 6 so that the vagina V does not spread too much.

For example, in recovering the organ O, which is the uterus, outside the body, first, while pulling the cervix with the forceps inserted into the vagina V through the vaginal mirror 100, the cervix and the lower part of the uterus are vertically lengthened with long scissors. Cut in half. Thereafter, the uterus and uterine fibroids are thinned and collected by a popular cutting method such as a C-shaped incision method.

In such a procedure, even if the uterus or uterine fibroid is strongly pulled, the force vector can be widely dispersed because the vagina V is protected by the vaginal mirror 100 and the auxiliary guard 220. As a result, laceration is less likely to occur in the vagina V and its periphery.

Further, since the bag portion 211 and the vagina V are protected by the vaginal mirror 100 and the auxiliary guard 220, scissors and a scalpel can be operated relatively freely and safely within the vagina V. Further, since the visual field through the vaginal scope 100 can be secured by the auxiliary guard 220, the operability in the vagina V such as scissors is improved, and the operation time can be shortened.

When the recovery of the organ O is completed, the vaginal mirror 100, the tissue recovery bag 210, and the auxiliary guard 220 are pulled out from the vagina V, and the presence or absence of laceration in the vagina V and its periphery and the presence or absence of damage in the tissue recovery bag 210 are checked.

In such a procedure, since the auxiliary guard 220 is in the bag portion 211 at the time of use and is fixed to the vaginal wall by the vaginal mirror 100, there is no risk of escaping into the abdominal cavity C. In addition, the fragments of uterine fibroids that may occur when the organ O is cut are also collected in the bag portion 211 without scattering in the abdominal cavity C.

After collecting the organ O, the cover 230 is attached to the vaginal mirror 100 again and inserted into the vagina V. This again allows good pneumoperitoneum and facilitates laparoscopic suturing of the vaginal canal. In the conventional vaginal scope, since the tips of both blades move, it is difficult to substitute for the operation for securing the pneumoperitoneum and the operation for suturing the vaginal canal under the laparoscope. Therefore, for example, when a suture operation of the vaginal canal is performed, a closed and expensive tubular member made of plastic has been required. The vaginal mirror 100 according to the present embodiment can be used instead of such a tubular member.

As described above, in the vaginal mirror 100 according to the present embodiment, the upper and lower limits of the opening degrees of the first blade 1 and the second blade 2 can be determined by the inner nut 7 and the outer nut 8, so that various medical treatments can be performed. A suitable effect is exhibited in measures.

The configuration of the vaginal mirror 100 is not limited to that illustrated in FIG. FIG. 9 is a perspective view showing another configuration example of the vaginal mirror 100. In the example of this figure, the vaginal mirror 100 does not include the outer nut 8. Even in this case, the upper limit of the opening degree of the first blade 1 and the second blade 2 can be determined by the inner nut 7.

The vaginal speculum 100 can be used in various medical procedures other than the first extraction method, the second extraction method, and the transvaginal uterine recovery as illustrated in the present embodiment. Further, the configuration of the medical device system including the vaginal mirror 100 is not limited to that illustrated in FIG.

The present embodiment does not limit the scope of the present invention to the configurations disclosed in the respective embodiments. The present invention can be implemented by modifying the configuration disclosed in the above embodiment into various aspects. For example, the medical device according to the present invention is not limited to a vaginal mirror, and may be another type of medical device that is inserted into another hole of a person or an animal. Similarly, medical device systems according to the present invention may include other types of medical devices that are inserted into other holes in humans and animals.

100... Vaginal mirror, 1... 1st blade, 2... 2nd blade, 3... 1st handle, 4... 2nd handle, 5... Connection member, 6... Bolt, 7... Inner nut, 8... Outer nut, 200... Medical device system, 210... Tissue recovery bag, 220... Auxiliary guard, 230... Cover, 240... Band.

Claims (7)

A first blade having a first tip and a first base, and
A second blade having a second tip and a second base;
A connecting member that connects the first base end portion and the second base end portion such that the opening degrees of the first blade and the second blade are variable,
A first handle extending from the first proximal end;
A second handle extending from the second base end portion, facing the first handle and having a through hole;
A bolt that is passed through the through hole and has one end connected to the first handle,
An inner nut disposed between the first handle and the second handle and having the bolt passed therethrough,
By the position of the inner nut in the bolt, it is possible to adjust the upper limit of the opening of the first blade and the second blade,
Wherein the first tip, that having a first recess that is recessed toward the first proximal portion, a medical instrument. Said second tip that having a second recess which is recessed toward the second proximal portion,
The medical device according to claim 1. A first blade having a first tip and a first base, and
A second blade having a second tip and a second base;
A connecting member that connects the first base end portion and the second base end portion so that the opening degrees of the first blade and the second blade are variable,
A first handle extending from the first proximal end;
A second handle extending from the second base end portion, facing the first handle and having a through hole;
A bolt that is passed through the through hole and has one end connected to the first handle,
An inner nut disposed between the first handle and the second handle and having the bolt passed therethrough,
By the position of the inner nut in the bolt, it is possible to adjust the upper limit of the opening of the first blade and the second blade,
Said second tip that having a second recess which is recessed toward the second proximal portion, a medical instrument. Further comprising an outer nut through which the bolt is passed,
The second handle is located between the inner nut and the outer nut,
By the position of the outer nut in the bolt, it is possible to adjust the lower limit of the opening of the first blade and the second blade,
The medical device according to any one of claims 1 to 3. The medical device according to any one of claims 1 to 4,
A tissue recovery bag having an opening sized to allow the first blade and the second blade to pass through;
Medical device system comprising. A medical device system including a medical device, a tissue collection bag, and an auxiliary guard,
The medical device is
A first blade having a first tip and a first base, and
A second blade having a second tip and a second base;
A connecting member that connects the first base end portion and the second base end portion so that the opening degrees of the first blade and the second blade are variable,
A first handle extending from the first proximal end;
A second handle extending from the second base end portion, facing the first handle and having a through hole;
A bolt that is passed through the through hole and has one end connected to the first handle,
An inner nut disposed between the first handle and the second handle and having the bolt passed therethrough,
By the position of the inner nut in the bolt, it is possible to adjust the upper limit of the opening of the first blade and the second blade,
The tissue recovery bag has an opening sized to allow the first blade and the second blade to pass therethrough,
The auxiliary guard is formed of a sheet material that is harder than the tissue recovery bag, is capable of passing through the opening in a tubularly rolled state, and is the first blade in the tubularly rolled state. And a medical device system capable of passing the second blade inward. A medical device system comprising a medical device, a tissue recovery bag, and a stretchable cover that can be put on the medical device,
The medical device is
A first blade having a first tip and a first base, and
A second blade having a second tip and a second base;
A connecting member that connects the first base end portion and the second base end portion so that the opening degrees of the first blade and the second blade are variable,
A first handle extending from the first proximal end;
A second handle extending from the second base end portion, facing the first handle and having a through hole;
A bolt that is passed through the through hole and has one end connected to the first handle,
An inner nut disposed between the first handle and the second handle and having the bolt passed therethrough,
By the position of the inner nut in the bolt, it is possible to adjust the upper limit of the opening of the first blade and the second blade,
The tissue recovery bag has an opening sized to allow the first blade and the second blade to pass therethrough,
The medical instrument system wherein the cover includes a first portion into which the first blade can be inserted and a second portion into which the second blade can be inserted.

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