JP6758644B2 - Switchable laparoscopic surgical forceps - Google Patents

Description

The present invention relates to forceps used in laparoscopic surgery.

In recent years, laparoscopic surgery using an endoscope has been performed as a surgical technique for reducing the burden on patients as much as possible. It is often used especially in surgery on the digestive organs. Laparoscopic surgery involves making several holes in the abdomen and providing a temporary port called Trakar. An endoscope or surgical instrument is inserted into the abdominal cavity from this tracal to perform surgery.

Since the tracal is a hole with a diameter of several tens of mm, the shape of the instrument that can be inserted inside is also restricted. Patent Document 1 describes typical forceps used in such laparoscopic surgery. Basically, this type of forceps has a jaw that opens and closes at the tip of a shaft that incorporates an elongated rod, and the rod is controlled by the grip opening of the handle. The shape resembles a pistol.

Since the tracal is only provided in a few places, the amount of equipment that can be brought into the abdominal cavity through the tracal is also limited. Therefore, forceps for bringing a plurality of forceps into the abdominal cavity from one tracal have also been proposed.

Patent Document 2 shows that two forceps are provided at the tip of one shaft. Further, Patent Document 3 discloses one in which three forceps are provided at the tip of one shaft.

Japanese Unexamined Patent Publication No. 08-164144 Special Table 2014-512870 Special Table No. 08-502438 Gazette

As disclosed in Patent Documents 2 and 3, it is a useful idea to bring a plurality of forceps into the abdominal cavity at one time. As the surgery progresses, the type of forceps required will change. Therefore, it is necessary to replace the forceps sequentially as the surgery progresses. However, exchanging forceps increases the chances of inserting and removing the tip of the forceps from the tracal, which is troublesome and causes a long operation time.

However, as in Patent Documents 2 and 3, when a plurality of forceps are projected from one shaft into the abdominal cavity, it becomes difficult to know which handle operates which forceps in the narrow field of view of the endoscope. In addition, forceps that are out of the field of view of the endoscope may touch unnecessary organs.

The present invention has been conceived in view of the above problems, and one shaft may be provided with a plurality of forceps, necessary forceps may be projected from the shaft, and only the projected forceps can be operated with one handle. A forceps for switchable laparoscopic surgery is provided.

More specifically, the switchable laparoscopic surgical forceps (1) according to the present invention
A plurality of forceps units (30) housed in a tubular body (10) so as to be projectable,
It has a handle portion (20) for controlling the opening and closing of the forceps unit (30) protruding from the tubular main body (10).
The forceps unit (30)
A forceps portion (32) having a jaw portion (32a) that opens and closes and a link mechanism (32b) that opens and closes the jaw portion (32a).
A rod (40) having one end connected to the link mechanism (32b) and driving the link mechanism (32b),
A slit connecting member (38) fixed to the other end (40b) of the rod (40) and
A shaft (36) that houses a part of the forceps portion (32) and the rod (40) and is provided with a load spring fastening (36a) on the inner surface on the slit connecting member (38) side .
Before SL formed through the rod (40) has a loading spring (42) for connecting the said load spring clasp (36a) and said slit connecting member (38),
The handle portion (20) is connected to a wire (52) engaged with a slit (38s) of each slit connecting member (38) of the forceps unit (30) via a wire pin (50). It is characterized by. The rod (40) is not visible in the shaft (36) in FIGS. 1 and 2. See FIG.

In the forceps for switchable laparoscopic surgery according to the present invention, since a plurality of forceps units are arranged in the shaft, a plurality of forceps can be brought into the abdominal cavity at a time from one tracal. Further, since only the forceps unit protruding from the shaft is operated with one handle at hand, there is no operation error.

Further, if only one forceps is projected from the shaft, it is possible to prevent other forceps from touching an organ that does not need to be touched, and the risk of injuring the abdominal cavity is extremely low.

It is a figure which shows the appearance and the cut cross section of the forceps for switchable laparoscopic surgery which concerns on this invention. It is a figure which shows the state which removed the main body of the forceps for switchable laparoscopic surgery. 2 is an enlarged view of FIG. 2, a perspective view from an oblique rear view and a perspective view from an oblique front view. It is a figure which shows the stopper provided on the outside of a main body. It is a block diagram which shows the inside of the forceps unit part of the forceps for switchable laparoscopic surgery. It is a figure which shows the internal structure of the wire switching member. It is a figure explaining the operation (usage) of the forceps for switchable laparoscopic surgery.

The switchable laparoscopic surgical forceps according to the present invention will be described below with reference to drawings and examples. The following description illustrates one embodiment and one embodiment of the present invention, and the present invention is not limited to the following description. The following description can be modified without departing from the spirit of the present invention.

<Overall configuration>
FIG. 1 shows an external view (FIG. 1 (a)) and a cut sectional view (FIG. 1 (b)) of the forceps 1 for switchable laparoscopic surgery according to the present invention. Also in FIG. 1A, the handle portion 20 is excluding the exterior. The switchable laparoscopic surgical forceps 1 is composed of a main body 10 and a handle portion 20. The main body 10 has a tubular shape. A plurality of forceps units 30 are housed in the main body 10. FIG. 1 shows a case where two forceps units 30 are housed. Of course, there may be three or more forceps units 30 to be housed.

In the following description, the handle portion 20 side of the switchable laparoscopic surgical forceps 1 is referred to as "posterior", and the opposite side thereof is referred to as "anterior". Further, in the two forceps units 30, the upper forceps unit 30 is referred to as "(A side) forceps unit 30A" and the lower forceps unit 30 is referred to as "(B side) forceps unit 30B". In addition, when distinguishing each forceps unit 30 and the members constituting them, add "A" or "B" after the code of each member to distinguish them, and if not particularly distinguished, simply refer to the code. Attach.

Each forceps unit 30 is housed in the main body 10 in a state where the direction and the axial direction of the forceps portion 32 are aligned with each other and further aligned with the axial direction of the main body 10. Here, the shaft refers to the center line (rotation center) in the front-rear direction of the main body 10 and the shaft 36 (described later).

The handle portion 20 is provided with a thumb hole 21 and a lower finger hole 22. The lower finger hole 22 is fixed to the main body 10, and the thumb hole 21 is pivotally supported by a pivot 21a provided in the handle portion 20, and can be opened and closed with respect to the main body 10 centering on the pivot 21a. In addition, a ratchet 23 is arranged adjacent to the lower finger hole 22. The ratchet 23 locks the movement of the thumb hole 21.

Each forceps unit 30 is provided with an operating lever 34 protruding from the main body 10. The operation lever 34 is for moving the forceps unit 30 in the main body 10 in the axial direction (front-back direction). Further, a stopper 11 for fixing the position of the operating lever 34 is provided on the outer surface of the main body 10.

When the operating lever 34 is pushed out toward the tip of the main body 10 (forward), the forceps portion 32 of the forceps unit 30 protrudes from the tip of the main body 10.

FIG. 2 shows a state in which the main body 10 is removed. The internal configuration of the forceps unit 30 will be described later with reference to FIG. In the forceps unit 30, an operation lever 34 is attached to a shaft 36 which is an exterior of the forceps unit 30. Therefore, when the operating lever 34 is moved forward, the forceps unit 30 also moves in the axial direction (front and rear). FIG. 2 shows a state in which the lower forceps unit 30B is pushed forward.

A slit connecting member 38 is connected to a rod 40 (not visible in the shaft 36 in FIG. 2) arranged in the shaft 36 of the forceps unit 30. The slit connecting member 38 is a member in which a slit is formed in the vertical direction of the long member. As the long member, for example, a shape such as a cylinder, a strip, or a cube can be preferably used.

A wire pin 50 is locked to the slit 38s of the slit connecting member 38. The wire 52 attached to the wire pin 50 is connected to the thumb hole 21 of the handle portion 20 via the wire switching member 54.

The wire switching member 54 and the handle portion 20 are fixed. Further, the wire switching member 54 and the main body 10 (see FIG. 1) are also fixed. Then, the wire 52 is pulled or pulled out to the handle portion 20 side (rear) by the closing and opening operation of the thumb hole 21 and the lower finger hole 22.

The spring fastening 13 is fixed inside the main body 10. The spring fastening 13 is a wall material in which a hole (not shown) through which the shaft 36 penetrates is formed for each forceps unit 30. The spring retainer 13 is arranged between the operating lever 34 of the forceps unit 30 and the forceps portion 32 at the tip. A shaft spring 36s is arranged between the spring fastening 13 and the operating lever 34 with the shaft 36 of the forceps unit 30 penetrating.

A forceps holding plate 12 is arranged at the head portion of the main body 10. The forceps holding plate 12 forcibly closes the jaw portion 32a of the forceps unit 30 when the forceps unit 30 is housed in the main body 10. Specifically, the forceps portion 32 of the forceps unit 30 is a plate in which a through hole is formed so that the forceps portion 32 can pass through with the jaw portion 32a closed. The forceps holding plate 12 is fixed to the main body 10.

FIG. 3 is an enlarged view of FIG. 2, showing a perspective view from diagonally rearward (FIG. 3 (a)) and a perspective view from diagonally forward (FIG. 3B). The operating lever 34 is fixed to the shaft 36. At the end of the shaft 36 on the handle portion 20 side, the slit connecting member 38 is fixed to the rod 40 (described with reference to FIG. 5). The slit connecting member 38 is an elongated member having substantially the same diameter as the shaft 36, and slits 38s are formed in the length direction thereof.

The wire 52 is connected to the wire pin 50 in a state where the wire pin 50 is inserted into the slit connecting member 38. That is, the wire pin 50 is movably arranged along the slit 38s in the slit 38s of the slit connecting member 38.

In FIG. 3, in the upper forceps unit 30A (see FIG. 2), the wire pin 50A is located in the middle of the slit 38sA of the slit connecting member 38A. On the other hand, in the lower forceps unit 30B (see FIG. 2), the wire pin 50B is in a state of being locked to the rear end of the slit 38sB of the slit connecting member 38B. The rear end of the slit connecting member 38 is referred to as a "locking end 38t". In FIG. 3, the locking end 38tA and the locking end 38tB are shown only in FIG. 3B.

The slit connecting member 38, the wire pin 50, and the wire 52 are provided for each forceps unit 30. Then, the wires 52 from each forceps unit 30 are put together by the wire switching member 54. Within the wire switching member 54, all the wires 52 are grouped together and connected to the thumb holes 21 (see also FIGS. 1 and 2) (details of the wire switching member 54 will also be described later).

FIG. 4 shows a stopper 11 provided outside the main body 10. FIG. 4A shows the forceps unit 30A (see FIG. 2) side, and FIG. 4B shows the forceps unit 30B (see FIG. 2) side. Now, it is assumed that the forceps unit 30B side is pushed forward. The main body 10 is provided with a slit 10s. The operating lever 34 projects from the slit 10s to the outside of the main body 10 and is installed so as to be movable back and forth along the slit 10s.

The stopper 11 is provided around the main body 10 of the slit 10s portion. Further, the stopper 11 also has a slit 11s cut out at a position overlapping the slit 10s. Therefore, the operating lever 34 can be manually moved back and forth at the slit 10s and the overlapping portion of the slit 10s and the slit 11s.

The stopper 11 is provided with a stopper piece 11a that can slide in a direction perpendicular to the slit 11s. Further, the slide range of the stopper piece 11a can be slid to a position where the slit 11s of the stopper 11 is closed. In other words, the stopper piece 11a can be moved in the circumferential direction of the main body 10 in the stopper 11, and is slidably provided from a position where the slit 11s is completely opened to a position where the slit 11s is closed.

When the forceps unit 30 is housed in the main body 10, the operation lever 34A is located behind the stop piece 11a as shown in FIG. 4A. On the other hand, when the forceps unit 30 is projected from the main body 10 as shown in FIG. 4B, the operation lever 34B is located in front of the stop piece 11a. Then, when the stop piece 11a is slid to close the slit 11s at each location, the operation lever 34 does not move in the front-rear direction from that position.

FIG. 5 is a configuration diagram in which the internal configuration of the forceps unit 30 portion of the forceps 1 for switchable laparoscopic surgery in FIGS. 1 and 2 is made easier to see. 5 (a) and 5 (b) show a single forceps unit 30, and FIG. 5 (c) shows a state in which two forceps units 30 are housed in the main body 10.

With reference to FIG. 5A, the forceps unit 30 is composed of a forceps portion 32, a rod 40, a shaft 36, a load spring 42, and a slit connecting member 38.

In the forceps portion 32, a pair of jaw portions 32a are connected to the link mechanism 32b. The configuration of the pair of jaw portions 32a and the link mechanism 32b may be known configurations. It is the rod 40 that drives the link mechanism 32b. The rod 40 is a long rod-shaped member and has rigidity in the length direction. In other words, if one end is pushed and moved, the other end moves by the length of the pushed end without bending in the middle.

A link mechanism 32b is connected to one end 40a of the rod 40. On the other hand, a slit connecting member 38 is coupled to the other end 40b of the rod 40.

The link mechanism 32b is configured to open the jaw portion 32a when the rod 40 is pushed in, and close the jaw portion 32a when the rod 40 is pulled out. FIG. 5A shows a state in which the rod 40 is pulled out with respect to the shaft 36, and FIG. 5B shows a state in which the rod 40 is pushed against the shaft 36.

Since the slit connecting member 38 is connected to the other end 40b of the rod 40, when the slit connecting member 38 is pushed against the shaft 36, the jaw portion 32a opens and the slit connecting member 38 is pulled out from the shaft 36. It can be said that the jaw portion 32a is closed.

The moving distance of the rod 40 required for opening and closing the jaw portion 32a is called an opening / closing length 40L. Since the jaw portion 32a and the rod 40 are connected by the link mechanism 32b, the jaw portion 32a is opened and closed by the operation of pushing and pulling out the rod 40. On the contrary, when the open jaw portion 32a is forcibly closed, the rod 40 is pushed backward by the opening / closing length of 40 L.

The link mechanism 32b and the rod 40 are covered by the shaft 36. However, at least the jaw portion 32a is arranged outside the shaft 36. The link mechanism 32b is fixed to the shaft 36.

Further, on the slit connecting member 38 side, at least the slit 38s of the slit connecting member 38 is arranged so as to be outside the shaft 36. The slit connecting member 38 is not fixed to the shaft 36. In FIGS. 1 to 3, the shaft 36 is visible, and the rod 40 is inside the shaft 36 and cannot be seen. The shaft 36 is a tubular member. It is preferably configured in a cylindrical shape that is easy to manufacture.

A load spring fastening 36a is provided on the inner surface of the shaft 36 on the slit connecting member 38 side. The load spring 42 is penetrated through the rod 40 to connect the load spring fastening 36a and the slit connecting member 38. Then, with the rod 40 pushing the link mechanism 32b, the load spring 42 is still urged in the contracting direction.

Therefore, the slit connecting member 38 is attracted toward the shaft 36 unless a force is applied in the front-rear direction. As a result, the rod 40 pushes the link mechanism 32b against the shaft 36, and the jaw portion 32a is maintained in an open state. That is, the forceps unit 30 is set to the normally open state.

Further, since the rod 40 constantly pushes the link mechanism 32b, when the slit connecting member 38 is pulled backward with respect to the shaft 36, the rod 40 pulls out the link mechanism 32b, and as a result, the jaw portion 32a is closed. When the rearward pull of the slit connecting member 38 is released, the slit connecting member 38 is pulled back toward the shaft 36, and the rod 40 pushes the link mechanism 32b. As a result, the jaw 32a opens.

That is, the rod 40 can be pulled out or pushed in by applying or releasing a rearward force to the slit connecting member 38. As a result, the jaw portion 32a can be opened and closed by applying or releasing a rearward force to the slit connecting member 38.

In the present embodiment, the forceps unit 30 having such a configuration is housed in the two unit main body 10. The main body 10 is provided with a spring fastening 13. The shaft spring 36s is arranged between the spring fastening 13 and the operating lever 34 in a state of being inserted into each forceps unit 30.

FIG. 6 shows the internal structure of the wire switching member 54. The wire switching member 54 is formed on the wire inlet 54a side and the wire outlet 54b side. The wire inlet 54a side is arranged on the slit connecting member 38 side, and the wire outlet 54b side is arranged on the handle portion 20 side (see FIG. 3).

On the wire inlet 54a side, the wire 52A from the upper forceps unit 30A and the wire 52B from the lower forceps unit 30B are inserted. Inside, rotatable wire rolls 55aA, 55bA, 55aB, 55bB arranged in parallel are arranged for each wire.

Then, each wire 52 is hugged by each other's wire roll 55 and pulled out from the wire outlet 54b side. That is, on the wire outlet 54b side, the wires 52 for each forceps unit 30 are put together. The bundled wire 52 is connected to the thumb hole 21 of the handle portion 20.

By passing the wires 52 between the rotatable wire rolls 55 parallel to each other in this way, it is possible to prevent the wires 52 from being entangled with each other even if the wires 52 move back and forth.

The operation of the forceps 1 for switchable laparoscopic surgery having the above configuration will be described. See FIG. 7. The main body 10 of the switchable laparoscopic surgical forceps 1 is inserted into the body through a tracal (not shown). At this time, the operating lever 34 is outside the body of the tracal.

The operator selects the A-side forceps unit 30A or the B-side forceps unit 30B as necessary. The operator pushes the operating lever 34 of the forceps unit 30 on the selected side forward and fixes it with the stopper 11 (see FIG. 1). This state is shown in FIG. 7 (a).

In FIG. 7A, it is assumed that the lower forceps unit 30B of the two forceps units 30 is in the selected state. At this time, in the forceps unit 30A on the A side, the jaw portion 32aA is restricted to the closed state by the forceps holding plate 12. The load spring 42A adjusted to the normally open state is in a state of being extended by the opening / closing length of 40 L (see FIG. 5).

In other words, the load spring 42A exerts a force for returning the slit connecting member 38A to the shaft 36A side. Further, in the slit 38sA of the slit connecting member 38A, the wire pin 50A is located at a point far from the locking end 38tA of the slit 38sA.

See FIG. 7 (b). If the operation is performed so as to open the thumb hole 21 of the handle portion 20 in this state, the wire 52A is pulled toward the handle portion 20 side. However, since the wire pin 50A does not cover the locking end 38tA of the slit 38sA of the slit connecting member 38A, it only slides in the slit 38sA. That is, the rod 40A does not move, and the jaw portion 32aA does not open or close.

On the other hand, the forceps unit 30B on the B side pushes the operation lever 34B forward. By the pushing operation of the forceps unit 30B, the forceps portion 32, which is the tip end portion of the forceps unit 30B, protrudes from the main body 10, and the restriction from the forceps holding plate 12 is released. Therefore, the load spring 42B can return to the normal state and pulls the rod 40B back to a fixed position with respect to the shaft 36B. As a result, the jaw 32aB opens. Further, the wire pin 50B moves to the locking end 38tB of the slit 38sB of the slit connecting member 38B.

See FIG. 7 (b). When the thumb hole 21 of the handle portion 20 is opened in this state, the wire 52B is pulled toward the handle portion 20 side. Then, the wire pin 50B of the B-side forceps unit 30B pulls the slit connecting member 38B toward the handle portion 20 side. The rod 40B connected to the slit connecting member 38B moves to the handle portion 20 side. As a result, the jaw 32aB is closed. At this time, the load spring 42B is stretched, and the slit connecting member 38B is urged to return to the front.

When the thumb hole 21 is returned to its original position, the slit connecting member 38B returns to the tip side according to the bias of the load spring 42B. Rod 40B also returns at the same time. As a result, the jaw 32aB opens. In this way, the jaw portion 32aB is opened and closed by the opening and closing operation of the thumb hole 21.

On the other hand, since the A-side forceps unit 30A is in the storage position of the main body 10, even if the wire pin 50A moves back and forth by opening and closing the thumb hole 21 of the handle portion 20, it moves in the slit 38sA of the slit connecting member 38A. However, the jaw portion 32aA is not opened or closed.

When replacing the forceps unit 30, the operation lever 34B is operated to house the B-side forceps unit 30B in the main body 10. After that, the operation lever 34A is operated to push the A-side forceps unit 30A forward. By this pushing operation, the A-side forceps unit 30A can open and close the jaw portion 32aA by opening and closing the handle portion 20.

As described above, in the forceps 1 for switchable laparoscopic surgery according to the present invention, only the forceps unit 30 pushed forward (protruded) by the operating lever 34 responds to the opening and closing of the thumb hole 21 of the handle portion 20. Then, the jaw portion 32a is opened and closed.

The forceps for switchable laparoscopic surgery according to the present invention can be suitably used for laparoscopic surgery using an endoscope.

1 Switchable laparoscopic surgical forceps 10 Main body 10s Slit 11 Stopper 11s Slit 11a Stop piece 12 Forceps holding plate 13 Spring fastening 20 Handle part 21 Thumb hole 22 Lower finger hole 21a Pivot 30 Forceps unit 32 Forceps part 32a Jaw 32b Link mechanism 34 Operating lever 36 Shaft 38 Slit connecting member 38s Slit 40 Rod 40a One end 40b Another end 40L Opening and closing length 42 Road spring 50 Wire pin 52 Wire 36s Shaft spring 36a Road spring fastening 38t Locking end 54 Wire switching member 54a Wire inlet 54b Wire Exit 55 wire roll

Claims (4)

Multiple forceps units housed in a tubular body so that they can protrude,
It has a handle portion that controls the opening and closing of the forceps unit protruding from the tubular body.
The forceps unit
A jaw that opens and closes, a forceps that has a link mechanism that opens and closes the jaw, and
A rod whose one end is connected to the link mechanism and drives the link mechanism,
A slit connecting member fixed to the other end of the rod,
A shaft that houses the forceps portion and a part of the rod and is provided with a load spring fastening on the inner surface on the slit connecting member side .
Formed through prior Symbol rod has a loading spring for connecting the said slit connecting member and the load spring clasp,
The switchable forceps for laparoscopic surgery, wherein the handle portion is connected to a wire engaged with a slit of each slit connecting member of the forceps unit via a wire pin. An operating lever protruding from the tubular body is fixed to the shaft.
A spring clasp is fixed inside the tubular body,
The forceps for switchable laparoscopic surgery according to claim 1, wherein a shaft spring is arranged between the spring fastening and the operating lever. The forceps for switchable laparoscopic surgery according to claim 1, wherein a forceps holding plate for forcibly closing the jaw is arranged on the front portion of the tubular body. Arranged between the tubular body and the handle portion,
The switching type according to any one of claims 1 to 3, further comprising a wire switching member that bundles the wires of each forceps unit into a bundle after passing the wires between a pair of parallel wire rolls. Forceps for laparoscopic surgery.