JPH06197906A - 連合された駆動機構を有する内視鏡式回転機構 - Google Patents

連合された駆動機構を有する内視鏡式回転機構

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Publication number
JPH06197906A
JPH06197906A JP5275946A JP27594693A JPH06197906A JP H06197906 A JPH06197906 A JP H06197906A JP 5275946 A JP5275946 A JP 5275946A JP 27594693 A JP27594693 A JP 27594693A JP H06197906 A JPH06197906 A JP H06197906A
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tube
knob
handle
articulation
outer tube
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Inventor
William L Hassler
ウイリアム・エル・ハスラー
Thomas Murray
トーマス・マレイ
Charles R Armstrong
チヤールズ・アール・アームストロング
Daniel Price
ダニエル・プライス
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Ethicon Inc
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Ethicon Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Ophthalmology & Optometry (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)
  • Endoscopes (AREA)

Abstract

(57)【要約】 【目的】 内視鏡の操作性を拡大する。 【構成】 切開用器、鋏、把握用器のような内視鏡式装
置であって、装置の長手方向中心軸を定める軸が設けら
れた装置。この軸は装置のハンドル部分の周りで回転で
きる。この機構は、軸の長手方向中心軸に関する端部実
行用具の関節運動も提供する。この関節運動は、軸に関
する端部実行用具の角度付けを生ずることにより達成さ
れる。ケーブルの駆動が任意のかかる角度周りで達成さ
れるので、端部実行用具を連続して操作できる。

Description

【発明の詳細な説明】
【０００１】
【産業上の利用分野】一般に、本発明は内視鏡式機構に
関する。より特別には、本発明は、回転可能な把握用
器、切開用器、及び鋏のような内視鏡式機構に関する。
最も特別には、本発明は、器具がその装置の長手方向中
心軸周りに回転しながら、軸が軸と０゜から９０゜の角
度で動き得るように、軸の端部が関節運動により曲がり
得るような機構に関する。
【０００２】
【従来技術及びその課題】内視鏡外科において、把握用
器、切開用器、鋏、及びその他の基本的な外科用装置の
ような簡単な器具に対する認識された要求がある。これ
らの装置は内視鏡式処置中に簡単な機能を遂行するため
に必要である。特に、把握用器のような器具は、作業す
べき組織を離して外科医が作業できるように、作業部位
をその他の生体器官から離して適正に動かすために必要
である。鋏は、組織、筋肉又はその他の血管の適切な切
断を行うために必要である。切開用器は、組織の一部を
その他の部分から分離するために必要である。これらの
装置は、虫垂切除、胆嚢切除、ヘルニア縫合などのよう
な手術を行うために、ステープラー及び結紮用クリップ
アプリケーターのような別の大きな装置に十分な体積の
空間を持たせることも可能である。
【０００３】伝統的に、把握用器、切開用器、及び鋏の
ような内視鏡式装置は一般に真っすぐな軸に取り付けら
れる。これらの軸は、その軸の長手方向中心軸周りに回
転でき、又はできない。いずれにしろ、軸の端部の実行
用具のために、軸の長手方向中心軸に関して角度を付け
得ることが必要である。これにより、外科医は、傾いた
角度から手術すべき組織を攻撃することができる。実際
上、軸はその軸の長手方向中心軸に関して９０゜まで曲
がることが望ましい。多くの方法で、この機能は腕「中
心軸」周りで回転しかつ手首の周りで「曲げる」人の手
の能力に相似させることができる。勿論、手は純粋回転
でも機能でき、手首の作用で与えられる自由度がより大
きく、これが多くの方法で簡単な日常の機能を行う手の
能力を強化する。従って、前述のような機構の機能がよ
り多能であるように、関節式に曲がる内視鏡式装置に対
する要求が認められる。
【０００４】従来、関節式の装置を作る試みはあった
が、内視鏡機構の長手方向軸に対して９０゜の角度にお
いて機能を遂行する能力を有する装置は無かった。この
ことは、大部分がかかる装置の製造業者の遭遇する許容
差と材料強度の問題による。かかる角度を作り得る装置
を有するだけでなく、かかる角度において端部の実行用
具を操作できることも必要であることを忘れてはいけな
い。この組合せは作ることが困難であり、かつ設計上の
犠牲を強制される。一般に、かかる装置の多能性を犠牲
にし、このため、かかる内視鏡式装置は、装置の軸に対
して９０゜で曲げることはできない。勿論、この拘束的
な限定のため、かかる角度付けの究極の能力は満足され
ない。
【０００５】
【課題を解決するための手段】ここに明らかにされるの
は、装置の長手方向中心軸を定める軸が設けられた切開
用器、鋏又は把握用器にような内視鏡式装置である。こ
の軸は装置のハンドル部分周りに回転できる。かかる回
転は、装置の端部に置かれる鋏及び把握用器のような端
部の実行用具の回転も生ずる。かかる回転は、装置のハ
ンドル部分に向かって置かれた回転用ノブにより起こさ
れる。把握又は切断及び類似作業を行うための装置の操
作は、装置の後部に置かれた１対のハンドルの鋏状の運
動により達成される。一方のハンドルは駆動軸に関して
固定される。他方のハンドルは軸の長手方向中心軸に関
して旋回できる。この回転は、機構の外管内に収容され
た駆動軸の滑り運動を起こす。かかる駆動部分の滑り運
動は可撓性ケーブルを作動させることができる。この可
撓性駆動ケーブルはＵリンクに関して動き、これがかか
る機構に収容された端部の実行用具の作動を生ずる。こ
の方法で、機構の運転が達成され、外科医は静止した手
の位置を維持できる。
【０００６】この機構が軸の長手方向中心軸に関する端
部実行用具の関節運動も与えることが重要である。この
関節運動は、軸に関する端部実行用具の角度を生ずるこ
とにより得られる。関節運動は、機構に収容された関節
運動用の管に取り付けられた翼付きナットとの相対運動
を螺旋ねじに生じさせる関節運動用ノブの使用により発
生される。この駆動ねじの運動により、関節運動用の管
は、機構の外管及び駆動軸の両者に関して動かされる。
この相対運動の発生により、関節運動用の管は、旋回取
付けされた連結部を機構の外管に関して動かす。この連
結部は外管の長手方向中心軸に関して端部実行用具の角
度付けを行わせる。関節運動用ノブにより行われた関節
運動の大きさに応じて外軸は機構の外軸に関して０゜か
ら９０゜の角度で曲がるであろう。
【０００７】機構が関節運動したとき、装置の操作を続
け得ることが重要であることは当然である。これはケー
ブル式の機構で達成でき、この機構は関節式の曲げによ
り作られた角度の周りで軸及びその端部実行用具を作動
させることができる。ケーブルの駆動は任意のかかる角
度周りで達成できるので、端部実行用具は操作可能であ
り続ける。この方法で、器具の使用は、軸の長手方向中
心軸に関して０゜から９０゜の間の任意の角度で行うこ
とができる。
【０００８】最後に、全関節式機構を回転させるように
作動する装置の回転態様を許す固定機構がここに明らか
にされる。この方法で、回転運動中は、関節は適正位置
に固定され、軸の長手方向中心軸に関する端部実行用具
の関節運動はない。対照的に、関節運動中は、回転機構
は適正位置に固定され、従って相対回転運動が維持され
る。この「クラッチ」式機構により、使用者は内視鏡処
置中の多くの異なった機能を達成できる。効用は維持さ
れ、この関節式角度付けにより生じた強化が続けて実現
される。
【０００９】この新規な発明は本発明の詳細な説明に関
連して得られる付属図面に関してよく理解されるであろ
う。
【００１０】
【実施例】内視鏡処置を行う器具１がここに説明され、
かつ一般的に図１に見られる。この器具１は機構の軸又
は外管１０の周りで回転できる。なお、この器具１は、
機構の端部実行用具部分１００が、図４によく見られる
ように、機構の軸により形成された長手方向中心軸に関
して９０゜までの角度に置き得るように角度付けをする
ことができる。これらの機能の各がここに説明されるで
あろう。
【００１１】図２によく見られるように、一般に円柱状
でありかつ装置の全長を走る駆動ロッド３０が説明され
る。この駆動ロッド３０は関節運動用の管２０内に置く
ことができる。関節運動用の管２０も円筒状であり、か
つ駆動ロッド３０に関して長手方向に動かすことができ
る。更に、関節運動用の管２０及び駆動ロッド３０は機
構の外管１０内に適合する。
【００１２】さて、この機構及びその端部の実行用具の
駆動部分が説明されるであろう。先に説明されたよう
に、駆動ロッド２０は外管１０に関して摺動方向で動く
ことができる。この駆動ロッド３０は、駆動ロッド３０
の末端のクリンプ部３２で駆動ケーブル５０に連結され
る。この駆動ケーブル５０はケーブルスリーブ１４０内
に緊密に適合する。駆動ケーブル５０の末端部分に、ク
リンプ部１０２においてロッド端部具１０１に取り付け
られる。このロッド端部具１０１は特定の機構の機構を
発生させることができる。ロッド端部具１０１はＵリン
ク４０の長手方向の中心部４２内に保持される。駆動ケ
ーブル５０はＵリンク４０の中心部４２内にも緊密に適
合され、ロッド端部具１０１と駆動ケーブル５０の両者
はＵリンク４０に関して動くことができる。
【００１３】駆動ケーブル５０がＵリンク４０に関して
動かされると、これがロッド端部具１０１をＵリンク４
０に関して長手方向で案内する。この際、ロッド端部具
１０１は１対のジョーリンク８０を旋回させることがで
きる。これらジョーリンク８０は、張出し端部８２に連
結された旋回点１０３において、ロッド端部具１０１の
周りで回転し、ジョーリンク８０は駆動ロッド３０及び
駆動ケーブル５０により作られる中心軸から外向きに張
り出す。
【００１４】ロッドリンク８０の末端に装置の端部実行
用具が取り付けられる。例えば、この例においては、把
握用機構の上方ジョー６０と下方ジョー７０とを備えた
端部実行用具が示される。しかし、これら端部実行用具
は鋏又は切開用器又はその他の内視鏡装置となし得るこ
とを理解すべきである。必要なことは、ジョーリンク８
０が端部実行用具６０、７０の運動を案内するために、
端部実行用具６０、７０は、それぞれの手元側端部６
２、７２においてジョーリンク８０の末端８４に取り付
けられることである。
【００１５】そこで、駆動ロッド３０が使用者の方に向
かって手元側に動かされると、駆動ケーブル５０が同様
に手元側に引かれる。この駆動ケーブル５０は、ロッド
端部具１０１を引いてこれを手元側に動かすことができ
る。ジョーリンク８０は１対の旋回点１０３においてロ
ッド端部具１０１に連結されているので、ジョーリンク
８０も同様に手元側に引かれる。この方法で、ジョーリ
ンク８０は、駆動ロッド３０の長手方向中心軸に関して
外向きに張り出した位置から内側に広げられた位置に戻
る。これが生ずると、ジョーリンク８０はその末端にお
いて端部実行用具６０、７０を装置の長手方向中心軸の
方に回転させる。端部実行用具６０、７０は、Ｕリンク
４０の端部に設けられた旋回穴４４に取り付けられた肩
ねじ９０の周りを廻るように、点６４、７４において旋
回可能に取り付けられる。そこで、端部実行用具６０、
７０は、全機構が「閉じられる」ようにＵリンク４０の
周りを回転する。
【００１６】これとは逆に、駆動ロッド３０が末端方向
に押されると、ロッド端部具１０１がジョーリンク８０
を駆動ロッド３０の長手方向中心軸から外向きに張り出
させる。この外向きの張出し運動は、端部実行用具６
０、７０の端部６６、７６を同時に外向きに張り出す。
端部実行用具６０、７０は、Ｕリンク４０の旋回穴４４
に連結された肩ねじ９０を廻るように点６４、７４周り
で旋回する。従って、この回転により、端部実行用具６
０、７０は、今度は器具が「開かれる」ように旋回す
る。このため、この方法で、駆動ロッド３０の往復運動
が機構１のジョー６０、７０を作動させる。
【００１７】駆動ロッド３０は、機構１の関節運動用の
管２０と外管１０の両者に関して動き得ることを理解す
べきである。この方法で、関節運動用の管２０又は外管
１０のいずれの相対位置とも無関係に駆動ロッド３０の
運動が可能である。そこで、管ロッド３０の運動によ
り、機構１の適宜の回転方向位置における端部実行用具
６０、７０の操作を行わせることができる。
【００１８】機構１の末端又は端部の実行用具部分１０
０における関節機能について更に説明する。この関節運
動は機構の外管に関する関節運動用の管２０の運動の観
察より理解される。関節運動用の管２０はその末端２２
において摺動エルボー１２０の内室１２２に溶接で連結
される。外管１０は、その末端１２において、固定エル
ボー１３０の手元側端部に設けられた小直径の円周部１
３２の上に適合するように強固に連結される。摺動エル
ボー１２０は、機構１の長手方向中心軸に沿って外管１
０に関して動き得る。（これは、例えば図１及び４によ
く見られる。これらの図では、関節運動用の管３０は末
端方向に動かされている。同様に、摺動エルボー１２０
は関節運動用の管２０により末端方向に動かされてい
る。この摺動運動が機構の端部実行用具部分１００を角
度付けさせるが、これはここに更に詳細に説明されるで
あろう。）摺動エルボー１２０の末端１２４はピン１５
０によりエルボーリンク１１０の手元側端部１１２に連
結される。このエルボーリンク１１０はその反対側又は
末端１１４において同様なピン１５０によりＵリンク４
０のタブ１４６の旋回穴４６に連結される。同様に、Ｕ
リンク４０は反対側のタブ１４８の旋回穴４８において
ピン１５０により固定エルボー１３０に連結される。こ
のように配置されたこれらの連結により、装置の長手方
向中心軸周りの端部実行用具部分１００の角度付けを遂
行できる。即ち、関節運動用の管２０が末端方向に動か
されると、摺動エルボー１２０も末端方向に動かされ
る。摺動エルボー１２０のこの末端方向の運動が摺動エ
ルボー１２０に連結された手元側端部１１２周りのエル
ボーリンク１１０の回転を生ずる。かかる運動は、同様
に、エルボーリンク１１０とＵリンク４０とを連結して
いる末端１１４周りのエルボーリンク１１０の運動を生
ずる。しかし、Ｕリンク４０は、外管１０の長手方向中
心軸に連結された固定エルボー１３０にタブ１４８にお
いて固定されるので、Ｕリンク４０は、典型的な四つ棒
リンク機構の方法で、外管１０の長手方向中心軸周りに
回転させる。
【００１９】これは、運動が達成された図４に最もよく
見られる。この図に、摺動エルボー１２０の末端方向の
運動により外管１０周りのＵリンクの角度付けが生じた
ことが見られる。勿論、関節運動用の管２０の手元側方
向の運動により起こされた摺動エルボー１２０の手元側
方向の運動は、Ｕリンク４０と外管１０の長手方向中心
軸との間に角度のない位置への、Ｕリンク４０の戻り回
転を生ずる。
【００２０】外管１０に関するＵリンク４０の任意の角
度において、この機構の作動を達成できることが互に望
ましい。従って、駆動ロッド３０については、Ｕリンク
４０の任意の角度位置において、Ｕリンク４０に関して
動き得ることが重要である。これは、駆動ケーブル５０
への駆動ロッド３０の取付け具の使用により達成され
る。駆動ケーブル５０は撓み得るので、これは外管１
０、関節運動用の管２０及び駆動ロッド３０の位置に関
連したＵリンク４０の角度方向の位置決めに従って動く
ことができる。駆動ケーブル５０はテフロン（商品名）
のような低摩擦材料製のケーブルスリーブ１４０内に収
容され、従ってＵリンク４０内の駆動ケーブル５０の運
動は容易に行える。
【００２１】このようにして、外管１０に関するＵリン
ク４０の任意の角度位置（９０゜であっても）における
駆動ケーブル５０の運動が達成される。これは、これま
ではいかなる関節式内視鏡装置についても不可能であっ
た。
【００２２】機構の端部実行用具部分１００が説明され
たが、この機構１はそのハンドルが収容された装置の制
御部分に関して理解されなければならない。端部実行用
具６０、７０の角度付け及び操作が達成される間、僅か
３個の部分だけがハンドル内に伸びることを忘れてはな
らない。即ち、外管１０、関節運動用の管２０、及び駆
動ロッド３０だけが装置のハンドル部分内に伸びる。外
管は、そのフランジ１４により、装置の関節運動用ノブ
２６０の前部品の端部キャップ２４０に連結されること
に注意すべきである。これは図３及び５に最もよく見ら
れる。関節運動用の管２０は、図３によく見られるよう
に、翼付きナット２５０の翼２５２の直前に適合するよ
うに位置決めされ、従って翼付きナット２５０の運動は
管２０の運動を起こす。駆動管３０は全機構を通って伸
び、かつその手元側端部において駆動ボール３１０に連
結され、この駆動ボールは機構１の手元側端部に収容さ
れた引き金３５０内に維持される。この駆動ボール３１
０は止めねじ３２０により引き金３５０内に保持され
る。
【００２３】引き金３５０は、旋回穴３５２、３６２に
おいてハンドルと引き金の両者を連結するピン３３０に
より、装置のハンドル３６０の周りを回転できる。この
ピン３３０は図３によく見られるように引き金カバー３
４０により適正位置に保持される。従って、この装置の
端部実行用具６０、７０の駆動は、引き金３５０に関す
るハンドル３６０の鋏作用によるだけで達成されること
が容易に理解されるであろう。引き金３５０がハンドル
３６０に近づくように回されると、駆動ボール３１０が
ハンドル３６０に関して手元側に回される。駆動ボール
３１０のこの手元側への運動が駆動ロッド３０の手元側
への運動を生じ、従って端部実行用具６０、７０を互い
に接近させる。そこで、把握又は切開、或いは任意の所
望の内視鏡機能を行うことができる。引き金３５０のハ
ンドル３６０から離れる運動は、ピン３３０周りの回転
を生じ、従って駆動ロッド３０の末端方向運動が生ず
る。この方法で、これが、駆動ロッド３０の末端３２に
おける末端方向運動を生じ、端部実行用具のジョー６
０、７０を互いに離れるように動かし、これにより鋏又
は把握用器或いはその他の任意の内視鏡端部実行用具の
開口を行う。
【００２４】機構１の駆動能力は、上述の関節運動又は
角度付けに関連して理解されたが、更にこの装置の回転
に関連して理解されねばならない。第１に、この装置の
関節運動の態様が説明されるであろう。関節運動は、端
部キャップ２４０、前部関節運動用ノブ２６０及び後部
関節運動用ノブ２７０を備えた関節運動用ノブ組立体に
より行われる。この関節運動用ノブ組立体内に、二重ス
ロット付きの管１６０のスロット１６４内に適合する関
節運動用翼付きナット２５０が保持される。スロット付
きの管１６０はねじ１６２においてキャップ２４０にね
じ止めされる。この機構は、二重スロット管１６０が関
節運動用翼つきナット２５０の組立体を緊密に保持する
ように配置される。ばね２３０が、端部キャップ２４０
とスロット１６４との間の関節運動用翼付きナット２５
０の運動を調整する。この関節運動用翼付きナット２５
０は、一方では、機構の末端における端部実行用具６
０、７０及びＵリンク４０と相互作用ができる関節運動
用の管２０に連結される。外管１０はフランジ１４にお
いて関節運動用端部キャップ２４０にも連結されるた
め、関節運動がなされたとき、関節運動用の管２０が外
管１０に関して動き得ることは勿論である。
【００２５】使用者は、関節運動を行いたいときは、関
節運動用ノブ組立体を回転させる。この方法で、前部関
節運動用ノブ２６０の内側螺旋ねじ２６２が関節運動用
翼付きナット２５０の翼２５２と装置のその他の部分と
の間の相対運動を生ずる。言い換えると、反時計方向の
運動により、関節運動用翼付きナット２５０はノブ２６
０の中央部２６４内で使用者の方に向かって手元側に引
かれる。この方法で、関節運動用の管２０が同様に手元
側に動き、従って摺動エルボー１２０も手元側に動かさ
れる。これが、Ｕリンク４０を機構の軸の長手方向中心
軸に関して真っすぐにしようとする。反対に、ノブ２６
０、２７０が時計方向に動かされたときは、ノブ２６０
の螺旋部分２６２が関節運動用翼付きナット２５０をス
ロット１６４内で末端方向に動かす。この末端方向の運
動が摺動エルボー１２０の末端方向の運動を引き起こ
し、Ｕリンク４０を軸の長手方向中心軸に関して角度を
付けさせる。
【００２６】螺旋２６２は、ノブ２６０、２７０の回転
運動を関節運動用の管２０の直線運動に変換する。この
回転運動は、これと関節運動との間の一般に１：１の比
率を与える。軸を９０゜関節運動させるには約１２０゜
のノブの回転が必要である。使用者は、（使用者の観点
から）比較的容易な運動の長さを通してＵリンク４０の
角度について一般的な「感覚」を得ることができる。
【００２７】次に、この装置の回転運動についての説明
が必要であろう。しかし、そうするためには、装置の関
節運動部分と装置の回転運動部分との間の相互関係の理
解が必要である。一般に、図面より見られるように、回
転用ばね２２０が回転用ノブ２９０を装置内で手元側に
動かす。この回転用ノブ２９０はその中に収容された一
連の固定用ラチェット２９２を持つ。これらの固定用ラ
チェット２９２は回転止め具３００のラチェット３０２
と組み合う。回転止め具３００はハンドル３６０の開口
３６４内に入れられ、かつ止め具３００を保持する管１
８０の末端１８２上に置かれた保持用リング２００によ
り、開口内の一定位置に維持される。従って回転用ばね
２２０が回転用ノブを押すと、これが回転用ノブ２９０
のフランジと回転止め具ラチェット３０２とを当たら
せ、従って回転用ノブ２９０はハンドル３６０内で静止
状態に置かれる。こうして、典型的には、使用者が関節
運動用ノブ２６０、２７０を回転させると、これら関節
運動用ノブ２６０、２７０は、回転用ノブ２９０の回転
とは無関係に回転させることができる。これが、静止外
管１０及び静止ハンドル３６０、引き金３５０及び回転
用ノブ２９０組立体を含んだ全機構に関する関節運動用
翼２５０及びこれに付属した関節運動用の管２０の運動
を生ずる。
【００２８】回転用ノブ２９０の末端開口２９４内に関
節運動用ラチェット止め具２８０が保持される。この関
節運動用ラチェット止め２８０は一連の刻み目２８２を
有し、これが後部関節運動用ノブ２７０の手元側部分２
７４内に設けられた刻み目２７２と相互作用できる。更
に回転用ノブ２９０の中央部内に管１８０が保持され
る。この管１８０は固定ハンドル３６０内に固定して置
かれる。この管は保持用リング２００によりその中に保
持される。管１８０は、上述のように、回転止め具３０
０を保持するフランジ１８２を有することに注意される
であろう。回転止め具３００はフランジ１８２と保持用
リング２００との間に保持される。管１８０はその末端
にねじ１８４を有し、これが関節運動用ノブ２６０、２
７０内に保持されたスロット付きの管１６０のねじと組
み合う。関節運動用翼２５０がハンドル３６０／引き金
３５０の組合せに関して動けるように、関節運動用ノブ
２６０、２７０はハンドル３６０に関して自由に回転で
きる。駆動管３０は約１０mmの管１８０の中央１８６を
通って延ばされ、前述のようにハンドル３６０内に入
る。
【００２９】スロット付きの管１６０上のスナップリン
グ１９０により定位置に保持されるばね保持具１７０と
関節運動用ラチェット止め具２８０との間に関節運動用
ばね２１０が置かれる。この組立体は、関節運動用ラチ
ェット止め具２８０の手元側で回転用ノブの末端開口２
９４内に置かれる。そこで、回転用ばね２２０は、関節
運動用ラチェット止め具２８０に末端方向の力を加える
ことができる。しかし、この回転用ばね２２０は、より
剛の関節運動用ばね２１０よりも小さなばね力を持つた
めに、自由浮動の関節運動用ラチェット止め具２８０
は、一般に後部関節運動用ノブ２７０から手元側に移動
した位置に置かれる。従って、回転用ばね２２０もまた
回転用ノブ２９０上に手元側方向の力を加えるので、ノ
ブ２９０は回転ラチェット止め具３００と組み合わせら
れる。関節運動用ばね２１０は、保持リング１９０によ
りスロット付きの管１６０上に保持されるばね保持具１
７０により、管１６０の末端１６８上の適正位置に保持
される。
【００３０】管１０、２０、３０をハンドル３６０に関
して回転させたいときは、使用者は、回転用ノブ２９０
に末端方向の力を加える必要がある。このとき、関節運
動用ラチェット止め具２８０が関節運動用ノブ２７０と
接触する。そこで、回転用ノブ２９０がスロット付きの
管１６０と組み合って、スロット付きの管１６０が前部
関節運動用ノブ２６０の螺旋ねじ２６２に回転を伝え
る。ノブ２６０は関節運動用翼つきナット２５０の翼２
５２と回転方向でのみ組み合い、長手方向には組み合わ
ず、従って関節運動用の管は関節運動用ノブ２６０、２
７０の長手方向位置に関して適正位置に効果的に「固
定」される。従って、回転用ノブ２９０の末端方向の運
動は、全回転機構の「ロックアップ」を生ずる。この方
法で、回転用ノブ２９０の回転は関節運動用ノブ２６
０、２７０の回転を生じ、これが外管１０並びに関節運
動用の管２０の回転を生ずる。この回転は、更に固定エ
ルボー１３０、並びにＵリンク４０を回転させる。従っ
て、ジョー６０、７０の回転方向の位置が変えられる。
【００３１】ジョーは駆動ケーブル５０を経て駆動ロッ
ド３０に連結されるので、これが駆動ロッド３０を全機
構内で回転させる。（即ち、駆動ロッド３０は関節運動
用の管２０及び外管１０とは無関係に動くことを忘れて
はならない。）駆動管３０の回転はハンドル３６０内で
のボール３１０の回転を生ずる。従って、駆動ロッド３
０の方向はハンドル３６０内で変えられる。しかし、引
き金３５０は駆動ロッド３０の任意の回転方向位置で駆
動ロッド３０の運動を起こし得るので、ハンドル３６０
／引き金３５０の組合せの有用性は影響を受けない。
【００３２】勿論、前述のように、関節運動用ノブ２６
０、２７０が回転用ノブ２９０との接触状態に保持され
ないときの装置の関節運動の可能性もある。
【００３３】この機構の機能的な能力の総てが適切に説
明されたが、この器具は特に好ましい実施例に関連して
説明された。本発明の範囲内にあると考えられる相当装
置を具体化することは可能であり、かかる発明及びその
相当例が特許請求の範囲から誘導される。
【００３４】本発明の主な特徴および態様は次の通りで
ある。
【００３５】１．内視鏡式機構にして、外管を有する内
視鏡式部分であって前記管がその長手方向中心軸を定め
かつこれを通して駆動ロッドを操作できる内視鏡式部
分；前記外管内に収容された駆動ロッドであってハンド
ルに連結された手元側端部と端部実行用具部分に連結さ
れた末端とを有する駆動ロッド；前記駆動ロッドに連結
された引き金であって前記端部実行用具部分を操作しう
る前記引き金；及び前記外管に対して９０゜まで曲がり
得る前記端部実行用具部分を備えた機構。
【００３６】２．前記外管が前記長手方向中心軸周りに
回転できる上記１の機構。
【００３７】３．前記駆動ロッドが前記端部実行用具部
分において駆動ケーブルに連結され、前記ケーブルが前
記端部実行用具部分の任意の位置において作動し得る上
記１の機構。
【００３８】４．前記端部実行用具部分が関節運動用の
管に連結され、前記関節運動用の管が前記端部実行用具
部分を前記長手方向中心軸に関して動かし得る上記１の
機構。 ５．前記関節運動用の管が前記ハンドル内で関節運動用
ノブに連結される上記４の機構。
【００３９】６．前記端部実行用具部分が前記長手方向
中心軸周りに回転できる上記５の機構。
【００４０】７．前記端部実行用具部分が前記外管に連
結され、前記外管が前記ハンドル内で回転用ノブにより
操作される上記６に機構。
【００４１】８．前記外管が前記関節運動用ノブと接触
しているときだけ、前記回転用ノブが前記外管を回転さ
せ得るように、前記回転用ノブが前記関節運動用ノブと
組み合うことができる上記７の機構。
【００４２】９．強固な中空の筒状の軸及び端部実行用
具部分を有する内視鏡式機構であって、前記端部実行用
具部分が前記強固な軸周りに回転できる機構において、
前記筒状の軸及び前記端部実行用具部分内に収容された
駆動ケーブルを備え、前記駆動ケーブルが前記軸に関す
る前記端部実行用具部分の任意の方向において前記端部
実行用具部分に関して往復できる改良。
【００４３】１０．内視鏡式処置を実行するための機構
にして、中空の内部を有しかつ長手方向中心軸を定める
外管；前記中空の外管に連結された端部実行用具部分で
あって前記管の周りで旋回可能な前記端部実行用具部
分；前記端部実行用具部分に連結された関節運動用機構
であって前記長手方向中心軸に関して往復できる前記関
節運動用機構；及び前記関節運動用機構に取り付けられ
たハンドル部分であって前記関節運動用の管を往復させ
得る関節運動用ノブを有する前記ハンドル部分を備えた
機構。
【００４４】１１．前記関節運動用ノブが前記端部実行
用具部分を前記外管の周りで９０゜まで旋回させ得る上
記１０の機構。
【００４５】１２．前記関節運動用ノブが螺旋状の内部
を有し、かつ前記関節運動用の管が前記螺旋状内部の中
で翼付きナットに連結され、前記関節運動用ノブの回転
により翼付きナットが前記関節運動用の管を前記長手方
向中心軸に関して往復させる上記１１の機構。
【００４６】１３．軸を有する内視鏡式装置のハンドル
であって、前記ハンドルが前記装置に一つの機能を行わ
せ得る一つのノブ及び前記装置に第２の機能を行わせ得
る第２のノブに連結され、前記ハンドルが前記ノブを分
離するばね機構を更に有するハンドル。
【００４７】１４．前記第２のノブが前記ばね機構のば
ね力に打ち勝つためには使用者により加えられる力を必
要とし、前記ばね力の克服が前記第１のノブと第２のノ
ブとの結合を生じ、かつ前記ノブの結合が前記第２のノ
ブの前記第２の機能の発生を許す上記１３のハンドル。
【００４８】１５．前記結合が前記第１のノブの前記第
１の機能の発生を防止する上記１４のハンドル。
【００４９】１６．前記第１のノブが関節運動用ノブで
あり、前記第１の機能が前記装置の軸の関節運動である
上記１４のハンドル。
【００５０】１７．前記第２のノブが回転用ノブであ
り、前記第２の機能が前記軸の回転である上記１４のハ
ンドル。
【００５１】１８．前記ノブの各が、前記結合中、互い
に相互結合する刻み目を有する上記１４のハンドル。
【００５２】１９．前記ノブが組み合わされないとき、
前記第２のノブが前記ばね力により前記ハンドルとの固
定部分に止められる上記１４のハンドル。
【図面の簡単な説明】
【図１】本発明の内視鏡式装置の斜視図である。
【図２】本発明の装置の端部実行用具部分の分解図であ
る。
【図３】本発明のハンドル部分の分解図である。
【図４】本発明の装置の関節運動式端部の斜視図であ
る。
【図５】図１の線５−５を横切って得られた本発明の装
置のハンドル部分の断面図である。
【符号の説明】
１ 器具 １０ 外管 ２０ 管 ３０ 駆動ロッド ４０ Ｕリンク ５０ 駆動ケーブル ６０ 上方ジョー ７０ 下方ジョー ８０ ジョーリンク １００ 実行用具部分
───────────────────────────────────────────────────── フロントページの続き (72)発明者 チヤールズ・アール・アームストロング アメリカ合衆国オハイオ州45247シンシナ テイ・サンブライトドライブ8473 (72)発明者 ダニエル・プライス アメリカ合衆国オハイオ州45140ラブラン ド・ケリードライブ9708

Claims (4)

    【特許請求の範囲】
  1. 【請求項１】 内視鏡式機構にして、 外管を有する内視鏡式部分であって前記管がその長手方
    向中心軸を定めかつこれを通して駆動ロッドを操作でき
    る内視鏡式部分；前記外管内に収容された駆動ロッドで
    あってハンドルに連結された手元側端部と端部実行用具
    部分に連結された末端とを有する駆動ロッド；前記駆動
    ロッドに連結された引き金であって前記端部実行用具部
    分を操作しうる前記引き金；及び前記外管に対して９０
    ゜まで曲がり得る前記端部実行用具部分を備えた機構。
  2. 【請求項２】 強固な中空の筒状の軸及び端部実行用具
    部分を有する内視鏡式機構であって、前記端部実行用具
    部分が前記強固な軸周りに回転できる機構において、前
    記筒状の軸及び前記端部実行用具部分内に収容された駆
    動ケーブルを備え、前記駆動ケーブルが前記軸に関する
    前記端部実行用具部分の任意の方向において前記端部実
    行用具部分に関して往復できる機構。
  3. 【請求項３】 内視鏡式処置を実行するための機構にし
    て、 中空の内部を有しかつ長手方向中心軸を定める外管；前
    記中空の外管に連結された端部実行用具部分であって前
    記管の周りで旋回可能な前記端部実行用具部分；前記端
    部実行用具部分に連結された関節運動用機構であって前
    記長手方向中心軸に関して往復できる前記関節運動用機
    構；及び前記関節運動用機構に取り付けられたハンドル
    部分であって前記関節運動用の管を往復させ得る関節運
    動用ノブを有する前記ハンドル部分を備えた機構。
  4. 【請求項４】 軸を有する内視鏡式装置のハンドルであ
    って、前記ハンドルが前記装置に一つの機能を行わせ得
    る一つのノブ及び前記装置に第２の機能を行わせ得る第
    ２のノブに連結され、前記ハンドルが前記ノブを分離す
    るばね機構を更に有するハンドル。
JP5275946A 1992-10-09 1993-10-08 連合された駆動機構を有する内視鏡式回転機構 Pending JPH06197906A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US959017 1992-10-09
US07/959,017 US5330502A (en) 1992-10-09 1992-10-09 Rotational endoscopic mechanism with jointed drive mechanism

Publications (1)

Publication Number Publication Date
JPH06197906A true JPH06197906A (ja) 1994-07-19

Family

ID=25501565

Family Applications (1)

Application Number Title Priority Date Filing Date
JP5275946A Pending JPH06197906A (ja) 1992-10-09 1993-10-08 連合された駆動機構を有する内視鏡式回転機構

Country Status (10)

Country Link
US (1) US5330502A (ja)
EP (1) EP0592243B1 (ja)
JP (1) JPH06197906A (ja)
AT (1) ATE151973T1 (ja)
AU (1) AU667239B2 (ja)
BR (1) BR9304189A (ja)
CA (1) CA2107931A1 (ja)
DE (1) DE69310072T2 (ja)
ES (1) ES2100470T3 (ja)
IL (1) IL107203A0 (ja)

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AU667239B2 (en) 1996-03-14
ATE151973T1 (de) 1997-05-15
BR9304189A (pt) 1994-04-12
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EP0592243A3 (en) 1994-12-28
DE69310072D1 (de) 1997-05-28
CA2107931A1 (en) 1994-04-10
AU4890093A (en) 1994-04-21
US5330502A (en) 1994-07-19
EP0592243B1 (en) 1997-04-23
EP0592243A2 (en) 1994-04-13
IL107203A0 (en) 1994-01-25

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