JPH0534645Y2 - - Google Patents

Description

[Detailed description of the invention] [Industrial application field] This invention can be used to remove cartilage (articular meniscus, articular cartilage), articular aneurysms, tumors, etc. from outside the body cavity to within the body cavity without making an incision, such as in the joint cavity of the knee etc. The present invention relates to a surgical excision instrument that excises and discharges the body cavity.

[Prior Art] Conventionally, joint surgery has been mainly performed by an incisional method (open surgery). For example, common joint surgeries require relatively large incisions, such as removing tumors on the patella and removing damaged cartilage, bone, etc. from the knee joint. Therefore, the incision causes trauma, which is accompanied by pain and restriction of movement, and has the disadvantage that it takes a long time to completely heal.

Therefore, in recent years, surgical resection instruments have been proposed that perform surgery by forming a small puncture hole in the joint without making an incision under arthroscopic (endoscope) observation, and inserting the insertion part into this puncture hole. has been done.

Conventional surgical cutting instruments are, for example, disclosed in Japanese Patent Application Laid-Open No.
As shown in Japanese Patent No. 116346, an inner tube having a cutting edge near its tip is rotatably inserted into the outer tube, and tissue is cut by rotating the inner tube. . In addition, in this surgical resection instrument, the tissue suction path was composed of an opening at the tip of the insertion section, a suction path within the inner tube, and a suction hole provided perpendicular to the suction path at the rear end. .

[Problems to be solved by the invention] However, with the conventional surgical resection instruments as described above, when cleaning the suction path in the inner canal or removing tissue clogging in the suction path, it is necessary to use a cleaning brush or the like. It was extremely difficult to insert it into the suction channel. This is because, as shown in FIG. 7, the cleaning brush 36 is inserted, for example, through a suction hole 33 formed in a sleeve 38 connected to the output shaft of a motor, but the suction path 31 and suction hole 33 are approximately perpendicular to each other. Therefore, it is extremely difficult to insert the cleaning brush 36. As a result, the inside of the inner tube 21 could not be sufficiently cleaned, and cut pieces and the like tended to remain in the suction path 31, making it apt to become unclean.

[Purpose of the invention] The present invention was made in view of the above circumstances, and is a surgical device that can easily and reliably remove clogs and clean the suction passage in the internal tube, and that can be kept in a clean state. The purpose is to provide cutting instruments.

[Means for Solving the Problems] The surgical resection instrument of the present invention includes an outer tube having an opening near its tip, and an inner tube inserted into the outer tube, and has tissue in the vicinity of the tip of the inner tube. The inner tube has a suction path extending in the longitudinal direction, and the tip of the suction path opens near the tip of the inner tube, and the inner tube has a suction path extending in the longitudinal direction. The end is opened not parallel to the suction path but at a predetermined angle by a suction hole provided near the proximal end of the inner tube, and the end is substantially coaxial with the suction path. At least one hole for cleaning the suction path communicating with the suction path is provided.

[Operation] In the surgical resection instrument of the present invention, a cleaning brush or the like is inserted into the suction path in the inner tube through the hole for cleaning the suction path to clean the suction path.

[Example] Hereinafter, an example of the present invention will be described with reference to the drawings.

1 to 3 relate to the first embodiment of the present invention, in which FIG. 1 is a sectional view of the insertion part, FIG. 2 is an explanatory view showing the state in which the cleaning brush is inserted from the cleaning hole, and FIG.
The figure is a side view showing the entire surgical cutting instrument.

As shown in FIG. 3, the surgical cutting instrument 1 includes a main body 2 and a rigid, elongated insertion section 3 attached to the distal end of the main body 2. As shown in FIG. At the rear end of the main body 2, there is a suction tube 5 connected to the suction device 4 for suctioning and discharging the resected pieces, and a power source connected to the control unit 6 and supplying power to the motor built into the main body 2. Code 7 is attached. The control unit 6 includes:
A foot switch 8 is connected, and the operator can control the surgical cutting instrument 1, such as driving the motor, using the foot switch 8.

As shown in FIG. 1, the insertion section 3 includes a hard and elongated outer tube 11 and an inner tube 21 rotatably housed within the outer tube 11. As shown in FIG. Said outer tube 1
1 has an outer pipe 13, and an outer cutter 15 having a cutting edge 14 on the edge of a semicircular opening is fitted into the tip of the outer pipe 13, and is fixed by soldering or the like. There is. Further, a flange 16 that can be detachably connected to the main body 2 is fitted into the base end of the outer pipe 13 and fixed by soldering or the like.

Further, the inner pipe 21 has an inner pipe 23 that can be inserted into the outer pipe 13.
3 has a cutting edge 2 at the edge of the semicircular opening.
The inner cutter 25 provided with 4 is fitted and fixed by soldering or the like. Further, a sleeve 26 that is engaged with the output shaft of the motor inside the main body 2 is fitted into the base end of the inner pipe 23 and fixed by soldering or the like. Note that the inner cutter 25 is arranged within the outer cutter 15.

A suction path 31 is formed within the inner pipe 23 . In addition, near the tip of the insertion section 3,
An opening 32 for taking in tissue that communicates with the suction path 31 is formed by the semicircular openings of the inner cutter 25 and the outer cutter 15. The sleeve 26 also has a suction hole 33 that communicates with the suction path 31 and is provided perpendicularly to the axis of the inner pipe 23, and a suction hole 33 that communicates with the suction path 31 and is provided approximately coaxially with the suction path 31. A cleaning hole 35 for cleaning the formed suction path 31 is provided.

Next, the operation of this embodiment will be explained.

For example, when resecting a target region within the knee joint cavity, a small hole is formed in the knee using a trocar or the like to insert the insertion part 3 of the surgical resection instrument 1, and a small hole is inserted into the small hole through the trocar or the like. Alternatively, the insertion section 3 is directly inserted. Then, while observing the inside of the joint cavity with an arthroscope inserted into the joint cavity through a trocar or the like, the opening 32 near the tip of the insertion section 3 is brought into contact with the tissue to be resected, and in this state, , drives the motor in the main body 2 to rotate the inner tube 21 via the sleeve 26. By rotating the inner tube 21, the cutting edge 14 of the outer cutter 15 and the inner cutter 25
The tissue is excised by the cutting blade 24 , and the resected pieces are suctioned and discharged by the suction device 4 through the opening 32 , the suction path 31 , the suction hole 33 and the suction tube 5 .

On the other hand, when cleaning the suction path 31 in the inner tube 21 of the surgical resection instrument 1, for example, as shown in FIG. A brush 36 is inserted, and the cleaning brush 36 cleans the suction path 31 up to the opening 32 at the tip. In addition, the inner pipe 21
When cleaning, the inner tube 21 is removed from the outer tube 11.

On the other hand, as in the conventional example shown in FIG. 7, without the cleaning hole 35, it is extremely difficult to insert the cleaning brush 36 into the suction path 31.

As described above, according to this embodiment, since the cleaning hole 35 communicating with the suction path 31 is provided approximately coaxially with the suction path 31, the suction hole 31 in the inner tube 21 can be easily removed from blockages and cleaned. This can be done reliably, and the surgical cutting instrument 1 can always be stored in a clean state.

FIG. 4 is a sectional view of the distal end side of the insertion portion in the second embodiment of the present invention.

In this embodiment, the shape of the tip of the inner cutter 45 is different from the shape of the inner cutter 25 of the first embodiment. That is, a cleaning hole 46 is provided at the tip of the inner cutter 45 substantially coaxially with the suction path 31 .

According to this embodiment, for example, when removing a blockage in the suction path 31, it is easy to remove a blockage by inserting a thin rod through either of the cleaning holes 35 and 46 and pushing out the clogged tissue to the other cleaning hole. The blockage can be removed.

Other configurations, operations, and effects are similar to those of the first embodiment.

FIG. 5 is a sectional view of the insertion portion in the third embodiment of the present invention.

In this embodiment, the inner cutter 45 is similar to the second embodiment.
A cleaning hole 46 is provided at the tip of the sleeve 26 approximately coaxially with the suction path 31, and the sleeve 26 is not provided with a cleaning hole 35.

In this embodiment, the cleaning brush 36 and the like are inserted through the cleaning hole 46 provided in the inner blade 45, and the suction path 3
1 cleaning etc. can be performed.

Other configurations, operations, and effects are similar to those of the first embodiment.

FIG. 6 is a sectional view of the distal end side of the insertion portion in the fourth embodiment of the present invention.

This example is an example of a surgical cutting instrument having a spherical cutting edge for cartilage formation.

In this embodiment, the outer cutter 15 has an open end and a notch at the side. Further, behind this notch 51, a plurality of tissue suction holes 52 are provided along the circumferential direction.

On the other hand, a connecting portion 54 is provided at the tip of the inner pipe 23.
A spherical cutting edge 55 is attached via the .
This spherical cutting edge 55 protrudes from the opening at the tip of the outer cutter 15 and the notch 51 on the side. Further, a tissue suction hole 56 is provided on the distal end side of the inner pipe 23 and at a position behind the tissue suction hole 52 formed in the outer blade 15 .

As in the first embodiment, a sleeve 26 is attached to the base end of the inner pipe 15, and the sleeve 26 is provided with a suction hole 33 and a cleaning hole 35.

In the surgical cutting instrument of this embodiment, the spherical cutting blade 55
The tissue is excised by bringing the spherical cutting blade 55 into contact with the tissue and rotating the spherical cutting blade 55 through the inner pipe 23. Cut piece 5 cut by the spherical cutting blade 55
8 is the tissue suction hole 52 of the outer blade 15 and the inner pipe 2
The tissue is suctioned into the suction path 31 in the inner pipe 23 through the tissue suction hole 56 of No. 3, and is discharged from the body.

Other configurations, operations, and effects are similar to those of the first embodiment.

Note that the present invention is not limited to the above-mentioned embodiments, and for example, the inner cutter and the outer cutter can have various shapes. Alternatively, tissue may be removed by sliding the inner tube within the outer tube, or the inner tube may be fixed and the outer tube may be rotated or slid.

[Effects of the invention] As explained above, according to the invention, at least one suction passage cleaning hole is provided approximately coaxially with the suction passage in the inner tube and communicates with the suction passage. This has the effect that the suction path can be easily and reliably unclogged and cleaned, and the surgical resection instrument can be kept clean.

[Brief explanation of the drawing]

1 to 3 relate to the first embodiment of the present invention, in which FIG. 1 is a sectional view of the insertion part, FIG. 2 is an explanatory view showing the state in which the cleaning brush is inserted from the cleaning hole, and FIG.
The figure is a side view showing the entire surgical cutting instrument, FIG. 4 is a cross-sectional view of the distal end side of the insertion portion in the second embodiment of the present invention, and FIG. 5 is a cross-section of the insertion portion in the third embodiment of the present invention. 6 is a sectional view of the distal end side of the insertion portion in the fourth embodiment of the present invention, and FIG. 7 is an explanatory view showing a state in which a cleaning brush is inserted from the suction hole in a conventional surgical cutting instrument. 1... Surgical resection instrument, 3... Insertion section, 11...
...Outer tube, 14...Cutting blade, 15...Outer blade, 21...
Inner tube, 24... Cutting blade, 25... Inner blade, 26... Sleeve, 31... Suction path, 32... Opening, 33
...Suction hole, 35...Washing hole.

Claims (1)

[Claims for Utility Model Registration] An outer tube having an opening near its tip, and an inner tube inserted into the outer tube, and a blade portion for cutting and resecting tissue is provided near the tip of the inner tube. and the inner tube has a suction path extending in the longitudinal direction,
The distal end of the suction path opens near the distal end of the inner tube, and the proximal end of the suction path is not parallel to the suction path but at a predetermined position due to a suction hole provided near the proximal end of the inner tube. A surgical resection instrument having an opening at an angle of , wherein at least one hole for cleaning the suction path is provided substantially coaxially with the suction path and communicates with the suction path. utensils.