JP6812006B2 - Medical equipment - Google Patents

Description

The present invention relates to a medical device that is inserted into a human or animal hole.

Conventionally, as a medical device to be inserted into a human hole, a medical device including a pair of rotatably connected blades is known. For example, a speculum, which is an example of the above medical device, is used when performing an examination on the vagina or the uterus, surgery, or other medical measures.

Medical treatment may be performed with the speculum inserted into the vaginal cavity. At this time, the medical treatment may not proceed smoothly because the distance between the opposite side edges of the blades is narrow.

Problems such as those mentioned above can also occur when performing medical procedures on sites other than the vagina, such as the anus. Moreover, not only medical treatment for humans but also medical treatment for animals other than humans can occur in the same way.

Special table 2001-509706

One of the objects of the present invention is to provide a medical device capable of smoothly performing medical treatment for a hole in a human or an animal.

The medical device according to the present invention includes a first blade, a second blade, and a connecting mechanism. The first blade includes a first base end portion, a first tip portion, a first side edge between the first tip end portion and the first base end portion, and a second side opposite to the first side edge. It has an edge, and its cross section along the first width direction intersecting the first extending direction from the first base end portion to the first tip end portion is arcuate. The second blade has a second base end portion, a second tip portion, a third side edge facing the first side edge, and a fourth side edge facing the second side edge, and the second blade. The cross section along the second width direction intersecting the second extending direction from the base end portion to the second tip end portion is arcuate. The connecting mechanism holds the holding portion connected to the first base end portion, the handle extending from the second base end portion, and both ends of the second base end portion in the second width direction, respectively. A pin having a pin rotatably connected to a portion, a male screw having one end rotatably connected to the handle, a knob having a female screw through which the male screw is passed, and a hole through which the male screw is passed are provided. located between the handle and the knob includes a handle portion extending from the holding portion, said first blade as said first blade and said second blade is rotatable about said pin And the second blade is connected. The first side edge has a first recess. The depth of the first recess along the direction orthogonal to the first extension direction and the first width direction is between both ends of the first recess in the first extension direction. Has a large shape in.

According to the invention having the above configuration, it is possible to smoothly perform medical measures for a hole in a human or an animal.

The schematic perspective view of the speculum which concerns on 1st Embodiment. Schematic side view of the speculum. A cross-sectional view taken along the first width direction of the upper blade and the second width direction of the lower blade included in the speculum. Top view of the speculum. The schematic perspective view of the speculum which concerns on 2nd Embodiment. Schematic side view of the speculum according to the third embodiment.

Hereinafter, some embodiments will be described with reference to the drawings. In each embodiment, a speculum inserted into a person's vagina is disclosed as an example of a medical device.

[First Embodiment]
FIG. 1 is a schematic perspective view of the speculum 100 according to the first embodiment. The speculum 100 includes an upper blade 1, a lower blade 2, a handle 3, and a connecting member 4. 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. In the present embodiment, the upper blade 1 is an example of the first blade, and the lower blade 2 is an example of the second blade.

The upper blade 1 is formed on the base end portion 10, the tip end portion 11 on the opposite side of the base end portion 10, the first side edge 12 between the base end portion 10 and the tip end portion 11, and the opposite side of the first side edge. It has a second side edge 13. The upper blade 1 has a long spatula shape in the first extending direction from the base end portion 10 to the tip end portion 11. That is, the cross section of the blade 1 along the first width direction orthogonal to the first extension direction is arcuate.

The lower blade 2 has a base end portion 20, a tip portion 21 on the opposite side of the base end portion 20, a third side edge 22 facing the first side edge 12, and a fourth side facing the second side edge 13. It has an edge 23. Like the upper blade 1, the lower blade 2 has a long spatula shape in the second extending direction from the base end portion 20 to the tip end portion 21. That is, the cross section of the lower blade 2 along the second width direction orthogonal to the second extension direction is arcuate.

The handle 3 extends downward in the drawing from the base end portion 20 of the lower blade 2. The handle 3 has a through hole 30. The handle 3 is integrated with the lower blade 2 in the illustrated example, but may be a different part from the lower blade 2.

The connecting member 4 includes a semicircular holding portion 40 that connects to the base end portion 10 of the upper blade 1, a handle portion 41 that extends downward from the holding portion 40 in the drawing, and a through portion provided in the handle portion 41. It has a hole 42. Both ends of the base end portion 20 of the lower blade 2 in the second width direction are rotatably connected to the holding portion 40 by pins 43, respectively.

The speculum 100 further comprises a bolt 5. The bolt 5 has a knob 50 having a female screw and a male screw 51 threaded through the female screw of the knob 50. One end of the male screw 51 is passed through the through hole 30 and is rotatably connected to the handle 3. The other end of the male screw 51 is passed through the through hole 42. The knob 50 is passed between the other end of the male screw 51 and the handle 41. When the knob 50 is rotated in a predetermined direction, the knob 50 moves in a direction approaching one end connected to the handle 3 of the male screw 51. Along with this, the handle portion 41 moves in the direction approaching the handle 3. That is, the movable range of the handle 41 with respect to the handle 3 can be adjusted by the knob 50. Here, the upper blade 1 is connected to the connecting member 4 including the handle portion 41. Further, the lower blade 2 is connected to the handle 3 and further rotatably connected to the holding portion 40 of the connecting member 4 by a pin 43. Therefore, the rotation range of the upper blade 1 with respect to the lower blade 2 can be adjusted by the knob 50.

In this way, the upper blade 1 is rotatably connected to the lower blade 2 by the connecting mechanism composed of the handle 3, the connecting member 4, the bolt 5, and the like. However, the mechanism for rotatably connecting the upper blade 1 and the lower blade 2 is not limited to the illustrated example.

The first side edge 12 of the upper blade 1 has a recess 6. In the recess 6, the upper blade 1 is cut out along a direction intersecting the first extending direction and the first width direction of the upper blade 1. Further, the third side edge 22 of the lower blade 2 has a recess 7. In the recess 7, the lower blade 2 is cut out along a direction intersecting the second extending direction and the second width direction of the lower blade 2. The recesses 6 and 7 are formed in the first and third side edges 12 and 22 by, for example, grinding the upper blade 1 and the lower blade 2. As described above, when the recesses 6 and 7 are included between the first side edge 12 and the third side edge 22 in the speculum 100, the first side edge 12 and the third side are provided by the amount of the recesses 6 and 7. The space between the edge 22 and the edge 22 becomes wider.

For example, in laparoscopic surgery, a uterine manipulator that can adjust the position of the uterus may be used to secure the surgical field of view. For example, a uterine manipulator includes a shaft, a movable member attached to one end of the shaft, and a handle for moving the movable member, and the movable member can be moved by operating the handle. For example, such a uterine manipulator is inserted into the vaginal cavity from between the lateral edge of the upper blade and the lateral edge of the lower blade with the vaginal cavity opened by a speculum.

In the speculum 100 according to the present embodiment, the space between the first side edge 12 and the third side edge 22 is widened by the recesses 6 and 7. Therefore, it is easy to insert the uterine manipulator from between the first side edge 12 and the third side edge 22 with the vaginal cavity opened by the speculum 100. Further, when the speculum 100 is taken out from the vagina after the insertion of the uterine manipulator, the wide space between the first side edge 12 and the third side edge 22 makes it difficult for the speculum 100 to get caught in the uterine manipulator.

Further, for example, in an operation performed by inserting the speculum 100 into the vagina, when the affected part is excised by an electric knife or a laser knife, smoke is generated and smoke is exhausted by a suction tube. When this suction tube is inserted through the opening OP, the suction tube itself or an assistant holding the suction tube may interfere with the procedure by the doctor. Further, even if an attempt is made to insert the suction tube from between the second side edge 13 and the fourth side edge 23 which do not have a recess, there is a possibility that there is not enough space. On the other hand, since a wide space is created between the first side edge 12 and the third side edge 22 due to the recesses 6 and 7, it is easy to insert the suction tube. Further, when the suction tube is inserted without passing through the opening OP in this way, the suction tube can be stably held without disturbing the treatment by a doctor. This makes it possible to proceed smoothly with the surgery.

FIG. 2 is a schematic side view of the speculum 100. Here, the speculum 100 is shown in a closed state. In the speculum 100, the first side edge 12 of the upper blade 1 has a recess 6, and the third side edge 22 of the lower blade 2 has a recess 7. As described above, when the first and third side edges 12 and 22 facing each other have the recesses 6 and 7, both the recesses 6 and 7 are between the first side edge 12 and the third side edge 22. It is included. As a result, a wider space between the first side edge 12 and the third side edge 22 is secured as compared with the case where only either the first side edge 12 or the third side edge 22 facing each other has the recess. it can.

The recess 6 has a depth D along a direction orthogonal to the first extending direction and the first width direction of the upper blade 1. In FIG. 2, near the ends 60 and 61 of the recess 6, the first side edge 12 is curved in an arc shape, whereby the recess 6 is tapered. On the other hand, except for the vicinity of the end portions 60 and 61, the depth D becomes substantially linear from the base end portion 10 toward the tip end portion 11. That is, the depth D includes a portion that becomes smaller from the base end portion 10 toward the tip end portion 11.

When the speculum 100 does not have recesses 6 and 7, the distance between the first side edge 12 and the third side edge 22 is the tip portion when the speculum 100 is opened as shown in FIG. It becomes smaller from 11 toward the base end portion 10. On the other hand, as in the present embodiment, the first side edge 12 has the recess 6, and the recess 6 includes a portion where the depth D increases from the tip 11 side to the base 10 side. Even on the end portion 10 side, a wide space between the first side edge 12 and the third side edge 22 can be secured.

From the viewpoint of obtaining the above-mentioned effects regarding the insertion of the uterine manipulator and the suction tube, the depth D is preferably, for example, 6 mm or more, more preferably 7 mm or more, and even more preferably 8 mm or more at the maximum position. From the same viewpoint, the depth D is preferably 2 mm or more, more preferably 3 mm or more, and even more preferably 4 mm or more at the position where the tapering starts near the end portion 61. On the other hand, if the depth D is too large, the strength of the upper blade 1 and the lower blade 2 may decrease, and when the speculum 100 is inserted into the vaginal cavity, the first side edge 12 and the third side edge 22 become The vaginal wall may get in between them and interfere with the procedure. Therefore, the depth D is preferably 14 mm or less, more preferably 12 mm or less, and even more preferably 10 mm or less at the maximum position, for example. From the same viewpoint, the depth D is preferably 9 mm or less, more preferably 8 mm or less, and even more preferably 7 mm or less at the position where the tapering starts near the end portion 61. Although the description has been made using the recess 6 here, the same applies to the recess 7.

FIG. 2 shows a state in which the speculum 100 is closed, that is, the portions of the first and third side edges 12 and 22 other than the recesses 6 and 7 are close to each other, and the second and fourth side edges 13 and 23 are close to each other. It is in a state of being. In this state, the end 60 of the recess 6 on the base end 10 side coincides with the end 70 of the recess 7 on the base end 20 side, and the end 61 of the recess 6 on the tip 11 side is on the tip 21 side. It coincides with the end 71 of the recess 7. As a result, the opening formed between the recess 6 and the recess 7 can be made into a smooth shape.

FIG. 3 is a cross-sectional view of the speculum 100 along lines III-III of FIG. The height H1 in the figure is the height at which the height from the upper blade 1 to the lower blade 2 is the maximum in the cross section, and the height H2 is the height from the recess 6 to the recess 7 in the cross section. As an example, the height H2 is preferably 1/3 or more of the height H1, and more preferably 1/2 or more. Such a relationship between the heights H1 and H2 may be established at all positions except for the portion where the recess 6 is tapered near the ends 60 and 61 in FIG. 2, for example.

FIG. 4 is a schematic plan view of the speculum 100. The width Wmin in the figure is the minimum value in the recess 6 having a width along the first width direction of the upper blade 1. The region A refers to the space between the recess 6 and the tip portion 11, and the width WA is the length along the first width direction of the upper blade 1 in the region A. The upper blade 1 has a shape in which the vicinity of the tip portion 11 is tapered in an arc shape. The width WA in the region A excluding the vicinity of the tip portion 11 is larger than the width Wmin. The width WA is maximized, for example, at the end 61. Although the description has been made using the recess 6 here, the same applies to the recess 7.

With such a configuration, the contact area between the vaginal wall and the upper blade 1 and the lower blade 2 in the region A becomes large when the speculum 100 is inserted into the vagina. Therefore, the speculum 100 makes it easy to open the vaginal cavity. As an example, the difference between the maximum value of the width WA and the width Wmin can be expected to have the above-mentioned effect when it is 3 mm or more, preferably 4 mm or more, and even more preferably 5 mm or more.

L in FIG. 4 is the length in the first extending direction from the pin 43 shown in FIG. 1 to the end portion 61 of the recess 6. In the present embodiment, the length L is ½ or more of the length in the first extending direction from the pin 43 to the tip portion 11. Further, in the present embodiment, the length between the ends 60 and 61 in the first extension direction is also ½ or more of the length in the first extension direction from the pin 43 to the tip 11. That is, the recess 6 is also formed on the tip 11 side from the midpoint between the pin 43 and the tip 11. As a result, it is possible to secure a wide space between the first side edge 12 and the third side edge 22 also on the tip portion 11 side.

According to the speculum 100 according to the first embodiment, the first and third side edges 12 and 22 have recesses 6 and 7, so that the medical treatment using the above-mentioned uterine manipulator and suction tube can be smoothly performed. It becomes possible to do.

Further, in the speculum 100 according to the first embodiment, the second and fourth side edges 13 and 23 do not have recesses. As a result, the strength of the upper blade 1 and the lower blade 2 can be increased as compared with the case where the recesses are also provided in the second and fourth side edges 13 and 23.

Further, if the recess is provided, the vaginal wall easily enters between the upper blade 1 and the lower blade 2 when the speculum 100 is inserted into the vaginal cavity, and the practitioner's field of view is narrowed. In the case where the recesses 6 and 7 are provided in the first and third side edges 12 and 22, as in the first embodiment, as compared with the case where the recesses are also provided in the second and fourth side edges 13 and 23, It is possible to reduce the amount of vaginal wall entering between the upper blade 1 and the lower blade 2 and widen the field of view.

In the first embodiment described above, the ends 60 and 61 of the recess 6 and the ends 70 and 71 of the recess 7 are in agreement with each other in the state where the speculum 100 is closed, but they do not have to be in agreement. For example, the end 60 may coincide with the end 70 and the end 61 may not coincide with the end 71. Further, for example, the end portion 60 may not coincide with the end portion 70, and the end portion 61 may not coincide with the end portion 71. Further, the length between the ends 60 and 61 in the first extension direction and the length between the ends 70 and 71 in the second extension direction may be the same or different.

In the above-described first embodiment, the above-mentioned effect can be obtained even if the first side edge 12 is replaced with the second side edge 13 and the third side edge 22 is replaced with the fourth side edge 23. That is, in the above-described first embodiment, the second side edge 13 has a recess 6, the fourth side edge 23 has a recess 7, and the first and third side edges 12 and 22 do not have a recess. The above-mentioned effect can be obtained.

In the above-described first embodiment, an example in which recesses 6 and 7 are provided in both the first side edge 12 and the third side edge 22 has been disclosed. As another example, only one of the recesses 6 and 7 may be provided. Further, the recesses 6 and 7 may not be provided in the first side edge 12 and the third side edge 22, but the recesses may be provided in both or one of the second side edge 13 and the third side edge 23.

[Second Embodiment]
FIG. 5 is a schematic perspective view of the speculum 200 according to the second embodiment. The speculum 200 is described above in that the second and fourth side edges 13 and 23 have recesses 8 and 9 in addition to the recesses 6 and 7 of the first and third side edges 12 and 22. Different from 100. The same elements as the speculum 100 are designated by the same reference numerals, and the description thereof will be omitted.

For example, the recesses 8 and 9 have the same shape as the recesses 6 and 7. However, the shapes of the recesses 8 and 9 and the shapes of the recesses 6 and 7 may be different.

In the present embodiment, recesses 6 and 7 are included between the first side edge 12 and the third side edge 22, and recesses 8 and 9 are provided between the second side edge 13 and the fourth side edge 23. It is included. Thus, for example, with the speculum 200 inserted, the uterus, either from between the first side edge 12 and the third side edge 22 or between the second side edge 13 and the fourth side edge 23. Instruments such as manipulators and suction tubes can be easily inserted.

In a conventional speculum that does not have a recess, the vaginal wall may be pinched between the side edge of the upper blade and the side edge of the lower blade, especially when performing a procedure for a patient with a narrow vaginal cavity. By providing recesses on both the first side edge 12 and the third side edge 22 and the second side edge 13 and the fourth side edge 23 as in the present embodiment, the speculum 200 sandwiches the vaginal wall. Can be suppressed. That is, since the first to fourth side edges 12, 13, 22, 23 of the speculum 200 have recesses 6, 7, 8 and 9, it is possible to smoothly proceed with medical treatment.
Even with the configuration of the present embodiment, the same effect as that of the first embodiment can be obtained.

In the second embodiment described above, an example is shown in which the first to fourth side edges 12, 13, 22, and 23 have recesses 6 to 9, respectively. As another example, recesses may be provided in one of the first and second side edges 12 and 13 and one of the third and fourth side edges 22 and 23, respectively.

[Third Embodiment]
FIG. 6 is a schematic plan view of the speculum 300 according to the third embodiment. The speculum 300 has recesses 6 and 7 on the first and third side edges like the speculum 100 described above, but the length between the ends 60 and 61 of the recess 60 and the end 70 of the recess 7. , 71 is different from the speculum 100 described above. The same elements as the speculum 100 are designated by the same reference numerals, and the description thereof will be omitted.

In the speculum 300, the position of the end 60 is the same as the position of the end 60 in the speculum 100 shown in FIG. 2, but the position of the end 61 is the position of the end 61 in the speculum 100 shown in FIG. It is located closer to the base end 10 than the position. That is, the length between the ends 60 and 61 of the recess 6 in the speculum 300 is smaller than that of the speculum 100 shown in FIG.

Specifically, in the example of FIG. 4, the length L in the first extension direction from the pin 43 (see FIG. 1) to the end portion 61 is the length in the first extension direction from the pin 43 to the tip portion 11. It is less than 1/2 of that. The length between the ends 60 and 61 in the first extension direction is preferably 1/2 or less of the length in the first extension direction from the pin 43 to the tip 11, preferably 1/3 or less. Is even more preferable. That is, in the present embodiment, the recess 6 is not formed on the tip 11 side from the midpoint of the length from the pin 43 to the tip 11. As a result, the length of the region A becomes larger than that of the speculum 100 in the first embodiment. Therefore, the entry of the vaginal wall into the recesses 6 and 7 when the vaginal cavity is opened by the speculum 300 can be further suppressed as compared with the case of the speculum 100, and the practitioner's field of view can be satisfactorily secured. Although the description has been made using the recess 6 here, the same applies to the recess 7.

In the third embodiment described above, even when the second side edge 13 has a recess 6, the fourth side edge 23 has a recess 7, and the first and third side edges 12 and 22 do not have a recess. , The above-mentioned effect can be obtained.

In addition, even with the configuration of the present embodiment, the same effect as that of the first embodiment can be obtained.

The structures disclosed in the above first to third embodiments can be combined as appropriate. For example, in the speculum 300, the second and fourth side edges 13 and 23 may have recesses 8 and 9, as in the example of FIG.

In each embodiment, the recesses 6, 7, 8 and 9 are illustrated with the same shape, but the recesses may have different shapes.

In each embodiment, speculums 100, 200, and 300 having a connecting mechanism capable of rotating the upper blade 1 with respect to the lower blade 2 have been exemplified. However, the configurations relating to the recesses 6, 7, 8 and 9 are also applicable to other types of speculum. For example, in a speculum in which the upper blade can be raised and lowered with respect to the lower blade and can be rotated, a recess may be provided in at least one of the side edges of the upper blade and the lower blade.

In each embodiment, a speculum inserted into a human vagina is disclosed as an example of a medical device. However, configurations relating to recesses 6, 7 and the like can also be applied to other types of medical devices with two blades (first and second blades), such as anoscopy. Further, the target of use of the medical device is not limited to humans, and may be animals other than humans.

For example, in some anosscopes, one of the first blade and the second blade facing each other is rotatably connected to each other, and the other facing side edges are opened and closed by operating a handle or the like. By providing a recess on the side edge on the opening and closing side of the anoscopy, it is possible to widen the field of view when observing the anus with the anoscopy inserted, and it becomes possible to smoothly proceed with medical treatment.

Each of the embodiments described above does not limit the scope of the invention to the configurations disclosed in these embodiments. The present invention can be implemented in various other forms. The configurations disclosed in each embodiment and modifications thereof are included in the scope of the invention described in the claims and the equivalent scope thereof.

100, 200, 300 ... speculum, 1 ... upper blade, 12 ... first side edge, 13 ... second side edge,
2 ... Lower blade, 22 ... 3rd side edge, 23 ... 4th side edge, 3 ... Handle, 4 ... Connecting member,
6,7,8,9 ... Recessed.

Claims (6)

A medical device that is inserted into a human or animal hole
First proximal end, the first end having the said first tip portion first side edge between the first proximal portion, and an opposite second side edge of said first side edge, the A first blade having an arc-shaped cross section along the first width direction intersecting the first extending direction from the first base end portion to the first tip end portion.
It has a second base end, a second tip, a third side edge facing the first side edge, and a fourth side edge facing the second side edge, from the second base end to the second. 2 A second blade with an arc-shaped cross section along the second width direction that intersects the second extension direction toward the tip.
A holding portion connected to the first base end portion, a handle extending from the second base end portion, and both ends of the second base end portion in the second width direction are rotated with respect to the holding portion. A pin having a pin that can be connected to the handle, a male screw having one end rotatably connected to the handle, a knob having a female screw through which the male screw is passed, and a hole through which the male screw is passed located between, anda handle portion extending from the holding portion, said first blade as said first blade and said second blade is rotatable about said pin and said second blade With a connecting mechanism to connect
The first side edge has a first recess.
The depth of the first recess along the direction orthogonal to the first extension direction and the first width direction is between both ends of the first recess in the first extension direction. A medical device that has a large shape in. The third side edge has a second recess.
The depth of the second recess along the direction orthogonal to the second extending direction and the second width direction is between both ends of the second recess rather than both ends of the second recess in the second extending direction. Has a large shape in
The medical device according to claim 1. The second side edge and the fourth side edge do not have a recess.
The medical device according to claim 2. The first recess includes a shape in which the depth along the direction orthogonal to the first extending direction and the first width direction decreases from the first base end side toward the first tip side.
The second recess includes a shape in which the depth along the direction orthogonal to the second extending direction and the second width direction decreases from the second base end side toward the second tip side.
The medical device according to claim 2 or 3. The first blade is located between the first recess and the first tip portion in the first width direction with respect to a portion of the first recess along the first width direction where the width of the first blade is minimized. Has a wide portion of the first blade along
The second blade is located between the second recess and the second tip portion in the second width direction with respect to a portion of the second recess along the second width direction where the width of the second blade is minimized. Has a wide portion of the second blade along
The medical device according to any one of claims 2 to 4. In a state where the first blade and the second blade are closed, both ends of the first recess in the first extending direction coincide with both ends of the second recess in the second extending direction. To do
The medical device according to any one of claims 2 to 5.

Images